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Showing papers by "University of Leicester published in 2019"


Journal ArticleDOI
06 Nov 2019-Nature
TL;DR: The current range of approaches to electric-vehicle lithium-ion battery recycling and re-use are outlined, areas for future progress are highlighted, and processes for dismantling and recycling lithium-ions from scrap electric vehicles are outlined.
Abstract: Rapid growth in the market for electric vehicles is imperative, to meet global targets for reducing greenhouse gas emissions, to improve air quality in urban centres and to meet the needs of consumers, with whom electric vehicles are increasingly popular. However, growing numbers of electric vehicles present a serious waste-management challenge for recyclers at end-of-life. Nevertheless, spent batteries may also present an opportunity as manufacturers require access to strategic elements and critical materials for key components in electric-vehicle manufacture: recycled lithium-ion batteries from electric vehicles could provide a valuable secondary source of materials. Here we outline and evaluate the current range of approaches to electric-vehicle lithium-ion battery recycling and re-use, and highlight areas for future progress. Processes for dismantling and recycling lithium-ion battery packs from scrap electric vehicles are outlined.

1,333 citations


Journal ArticleDOI
21 Aug 2019-BMJ
TL;DR: Higher levels of total physical activity, at any intensity, and less time spent sedentary, are associated with substantially reduced risk for premature mortality, with evidence of a non-linear dose-response pattern in middle aged and older adults.
Abstract: Objective To examine the dose-response associations between accelerometer assessed total physical activity, different intensities of physical activity, and sedentary time and all cause mortality. Design Systematic review and harmonised meta-analysis. Data sources PubMed, PsycINFO, Embase, Web of Science, Sport Discus from inception to 31 July 2018. Eligibility criteria Prospective cohort studies assessing physical activity and sedentary time by accelerometry and associations with all cause mortality and reported effect estimates as hazard ratios, odds ratios, or relative risks with 95% confidence intervals. Data extraction and analysis Guidelines for meta-analyses and systematic reviews for observational studies and PRISMA guidelines were followed. Two authors independently screened the titles and abstracts. One author performed a full text review and another extracted the data. Two authors independently assessed the risk of bias. Individual level participant data were harmonised and analysed at study level. Data on physical activity were categorised by quarters at study level, and study specific associations with all cause mortality were analysed using Cox proportional hazards regression analyses. Study specific results were summarised using random effects meta-analysis. Main outcome measure All cause mortality. Results 39 studies were retrieved for full text review; 10 were eligible for inclusion, three were excluded owing to harmonisation challenges (eg, wrist placement of the accelerometer), and one study did not participate. Two additional studies with unpublished mortality data were also included. Thus, individual level data from eight studies (n=36 383; mean age 62.6 years; 72.8% women), with median follow-up of 5.8 years (range 3.0-14.5 years) and 2149 (5.9%) deaths were analysed. Any physical activity, regardless of intensity, was associated with lower risk of mortality, with a non-linear dose-response. Hazards ratios for mortality were 1.00 (referent) in the first quarter (least active), 0.48 (95% confidence interval 0.43 to 0.54) in the second quarter, 0.34 (0.26 to 0.45) in the third quarter, and 0.27 (0.23 to 0.32) in the fourth quarter (most active). Corresponding hazards ratios for light physical activity were 1.00, 0.60 (0.54 to 0.68), 0.44 (0.38 to 0.51), and 0.38 (0.28 to 0.51), and for moderate-to-vigorous physical activity were 1.00, 0.64 (0.55 to 0.74), 0.55 (0.40 to 0.74), and 0.52 (0.43 to 0.61). For sedentary time, hazards ratios were 1.00 (referent; least sedentary), 1.28 (1.09 to 1.51), 1.71 (1.36 to 2.15), and 2.63 (1.94 to 3.56). Conclusion Higher levels of total physical activity, at any intensity, and less time spent sedentary, are associated with substantially reduced risk for premature mortality, with evidence of a non-linear dose-response pattern in middle aged and older adults. Systematic review registration PROSPERO CRD42018091808.

805 citations


Journal ArticleDOI
Andrea Cossarizza1, Hyun-Dong Chang, Andreas Radbruch, Andreas Acs2  +459 moreInstitutions (160)
TL;DR: These guidelines are a consensus work of a considerable number of members of the immunology and flow cytometry community providing the theory and key practical aspects offlow cytometry enabling immunologists to avoid the common errors that often undermine immunological data.
Abstract: These guidelines are a consensus work of a considerable number of members of the immunology and flow cytometry community. They provide the theory and key practical aspects of flow cytometry enabling immunologists to avoid the common errors that often undermine immunological data. Notably, there are comprehensive sections of all major immune cell types with helpful Tables detailing phenotypes in murine and human cells. The latest flow cytometry techniques and applications are also described, featuring examples of the data that can be generated and, importantly, how the data can be analysed. Furthermore, there are sections detailing tips, tricks and pitfalls to avoid, all written and peer-reviewed by leading experts in the field, making this an essential research companion.

698 citations


Journal ArticleDOI
TL;DR: This tutorial provides a structured approach for planning and reporting simulation studies, which involves defining aims, data‐generating mechanisms, estimands, methods, and performance measures (“ADEMP”).
Abstract: Simulation studies are computer experiments that involve creating data by pseudo‐random sampling. A key strength of simulation studies is the ability to understand the behavior of statistical methods because some “truth” (usually some parameter/s of interest) is known from the process of generating the data. This allows us to consider properties of methods, such as bias. While widely used, simulation studies are often poorly designed, analyzed, and reported. This tutorial outlines the rationale for using simulation studies and offers guidance for design, execution, analysis, reporting, and presentation. In particular, this tutorial provides a structured approach for planning and reporting simulation studies, which involves defining aims, data‐generating mechanisms, estimands, methods, and performance measures (“ADEMP”); coherent terminology for simulation studies; guidance on coding simulation studies; a critical discussion of key performance measures and their estimation; guidance on structuring tabular and graphical presentation of results; and new graphical presentations. With a view to describing recent practice, we review 100 articles taken from Volume 34 of Statistics in Medicine, which included at least one simulation study and identify areas for improvement.

578 citations


Journal ArticleDOI
TL;DR: This review considers the commonly used term of ‘aerosol transmission’ in the context of some infectious agents that are well-recognized to be transmissible via the airborne route, and discusses other agents, like influenza virus, where the potential for airborne transmission is much more dependent on various host, viral and environmental factors, and where its potential for aerosol transmission may be underestimated.
Abstract: Although short-range large-droplet transmission is possible for most respiratory infectious agents, deciding on whether the same agent is also airborne has a potentially huge impact on the types (and costs) of infection control interventions that are required. The concept and definition of aerosols is also discussed, as is the concept of large droplet transmission, and airborne transmission which is meant by most authors to be synonymous with aerosol transmission, although some use the term to mean either large droplet or aerosol transmission. However, these terms are often used confusingly when discussing specific infection control interventions for individual pathogens that are accepted to be mostly transmitted by the airborne (aerosol) route (e.g. tuberculosis, measles and chickenpox). It is therefore important to clarify such terminology, where a particular intervention, like the type of personal protective equipment (PPE) to be used, is deemed adequate to intervene for this potential mode of transmission, i.e. at an N95 rather than surgical mask level requirement. With this in mind, this review considers the commonly used term of ‘aerosol transmission’ in the context of some infectious agents that are well-recognized to be transmissible via the airborne route. It also discusses other agents, like influenza virus, where the potential for airborne transmission is much more dependent on various host, viral and environmental factors, and where its potential for aerosol transmission may be underestimated.

578 citations


Journal ArticleDOI
TL;DR: Progress in cancer control over the study period was evident for stomach, colon, lung (in males), and ovarian cancer, and the impact of comorbidity are likely the main determinants of patient outcomes.
Abstract: Summary Background Population-based cancer survival estimates provide valuable insights into the effectiveness of cancer services and can reflect the prospects of cure. As part of the second phase of the International Cancer Benchmarking Partnership (ICBP), the Cancer Survival in High-Income Countries (SURVMARK-2) project aims to provide a comprehensive overview of cancer survival across seven high-income countries and a comparative assessment of corresponding incidence and mortality trends. Methods In this longitudinal, population-based study, we collected patient-level data on 3·9 million patients with cancer from population-based cancer registries in 21 jurisdictions in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the UK) for seven sites of cancer (oesophagus, stomach, colon, rectum, pancreas, lung, and ovary) diagnosed between 1995 and 2014, and followed up until Dec 31, 2015. We calculated age-standardised net survival at 1 year and 5 years after diagnosis by site, age group, and period of diagnosis. We mapped changes in incidence and mortality to changes in survival to assess progress in cancer control. Findings In 19 eligible jurisdictions, 3 764 543 cases of cancer were eligible for inclusion in the study. In the 19 included jurisdictions, over 1995–2014, 1-year and 5-year net survival increased in each country across almost all cancer types, with, for example, 5-year rectal cancer survival increasing more than 13 percentage points in Denmark, Ireland, and the UK. For 2010–14, survival was generally higher in Australia, Canada, and Norway than in New Zealand, Denmark, Ireland, and the UK. Over the study period, larger survival improvements were observed for patients younger than 75 years at diagnosis than those aged 75 years and older, and notably for cancers with a poor prognosis (ie, oesophagus, stomach, pancreas, and lung). Progress in cancer control (ie, increased survival, decreased mortality and incidence) over the study period was evident for stomach, colon, lung (in males), and ovarian cancer. Interpretation The joint evaluation of trends in incidence, mortality, and survival indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, international disparities persist. While truly valid comparisons require differences in registration practice, classification, and coding to be minimal, stage of disease at diagnosis, timely access to effective treatment, and the extent of comorbidity are likely the main determinants of patient outcomes. Future studies are needed to assess the impact of these factors to further our understanding of international disparities in cancer survival. Funding Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; National Health Service England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; The Scottish Government; Western Australia Department of Health; and Wales Cancer Network.

555 citations


Journal ArticleDOI
26 Nov 2019
TL;DR: The guidelines are divided into nine sections: motivation and scope, data sources, choice of genetic variants, variant harmonization, primary analysis, supplementary and sensitivity analyses, data presentation, and interpretation.
Abstract: This paper provides guidelines for performing Mendelian randomization investigations. It is aimed at practitioners seeking to undertake analyses and write up their findings, and at journal editors and reviewers seeking to assess Mendelian randomization manuscripts. The guidelines are divided into nine sections: motivation and scope, data sources, choice of genetic variants, variant harmonization, primary analysis, supplementary and sensitivity analyses (one section on robust statistical methods and one on other approaches), data presentation, and interpretation. These guidelines will be updated based on feedback from the community and advances in the field. Updates will be made periodically as needed, and at least every 18 months.

491 citations


Journal ArticleDOI
Heather Orpana1, Heather Orpana2, Laurie B. Marczak3, Megha Arora3  +338 moreInstitutions (173)
06 Feb 2019-BMJ
TL;DR: Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide and can be targeted towards vulnerable populations if they are informed by variations in mortality rates.
Abstract: Objectives To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016. Design Systematic analysis. Main outcome measures Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education). Results The total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%). Conclusions Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.

472 citations


Journal ArticleDOI
TL;DR: The United Kingdom Earth System Model UKESM1 as discussed by the authors was developed and tuned to achieve acceptable performance in key physical and Earth system quantities, and discuss the challenges involved in mitigating biases in a model with complex connections between its components.
Abstract: We document the development of the first version of the United Kingdom Earth System Model UKESM1. The model represents a major advance on its predecessor HadGEM2‐ES, with enhancements to all component models and new feedback mechanisms. These include: a new core physical model with a well‐resolved stratosphere; terrestrial biogeochemistry with coupled carbon and nitrogen cycles and enhanced land management; tropospheric‐stratospheric chemistry allowing the holistic simulation of radiative forcing from ozone, methane and nitrous oxide; two‐moment, five‐species, modal aerosol; and ocean biogeochemistry with two‐way coupling to the carbon cycle and atmospheric aerosols. The complexity of coupling between the ocean, land and atmosphere physical climate and biogeochemical cycles in UKESM1 is unprecedented for an Earth system model. We describe in detail the process by which the coupled model was developed and tuned to achieve acceptable performance in key physical and Earth system quantities, and discuss the challenges involved in mitigating biases in a model with complex connections between its components. Overall the model performs well, with a stable pre‐industrial state, and good agreement with observations in the latter period of its historical simulations. However, global mean surface temperature exhibits stronger‐than‐observed cooling from 1950 to 1970, followed by rapid warming from 1980 to 2014. Metrics from idealised simulations show a high climate sensitivity relative to previous generations of models: equilibrium climate sensitivity (ECS) is 5.4 K, transient climate response (TCR) ranges from 2.68 K to 2.85 K, and transient climate response to cumulative emissions (TCRE) is 2.49 K/TtC to 2.66 K/TtC.

416 citations


Journal ArticleDOI
TL;DR: The results highlight the importance of community-based studies and the identification and inclusion of well-characterized samples to reduce heterogeneity and bias in estimates of prevalence for comorbidity in adults with ASD and other populations with complex psychiatric presentations.
Abstract: Adults with autism spectrum disorder (ASD) are thought to be at disproportionate risk of developing mental health comorbidities, with anxiety and depression being considered most prominent amongst these Yet, no systematic review has been carried out to date to examine rates of both anxiety and depression focusing specifically on adults with ASD This systematic review and meta-analysis examined the rates of anxiety and depression in adults with ASD and the impact of factors such as assessment methods and presence of comorbid intellectual disability (ID) diagnosis on estimated prevalence rates Electronic database searches for studies published between January 2000 and September 2017 identified a total of 35 studies, including 30 studies measuring anxiety (n = 26 070; mean age = 309, sd = 62 years) and 29 studies measuring depression (n = 26 117; mean age = 311, sd = 68 years) The pooled estimation of current and lifetime prevalence for adults with ASD were 27% and 42% for any anxiety disorder, and 23% and 37% for depressive disorder Further analyses revealed that the use of questionnaire measures and the presence of ID may significantly influence estimates of prevalence The current literature suffers from a high degree of heterogeneity in study method and an overreliance on clinical samples These results highlight the importance of community-based studies and the identification and inclusion of well-characterized samples to reduce heterogeneity and bias in estimates of prevalence for comorbidity in adults with ASD and other populations with complex psychiatric presentations

380 citations


Journal ArticleDOI
TL;DR: This review aims to provide a focused overview of the latest achievements made in MIP-based sensor technology, with emphasis on research toward real-life applications.

Journal ArticleDOI
TL;DR: In this paper, a catalogue of white dwarf candidates selected from the second data release of Gaia (DR2) is presented, consisting of 486641 stars with calculated probability of being a white dwarf (PWD) for all Gaia sources that passed the initial selection.
Abstract: We present a catalogue of white dwarf candidates selected from the second data release of Gaia (DR2). We used a sample of spectroscopically confirmed white dwarfs from the Sloan Digital Sky Survey (SDSS) to map the entire space spanned by these objects in the Gaia Hertzsprung–Russell diagram. We then defined a set of cuts in absolute magnitude, colour, and a number of Gaia quality flags to remove the majority of contaminating objects. Finally, we adopt a method analogous to the one presented in our earlier SDSS photometric catalogues to calculate a probability of being a white dwarf (PWD) for all Gaia sources that passed the initial selection. The final catalogue is composed of 486641 stars with calculated PWD from which it is possible to select a sample of ≃260000 high-confidence white dwarf candidates in the magnitude range 8 7000 K, at high Galactic latitudes (|b| > 20°). However, the completeness drops at low Galactic latitudes, and the magnitude limit of the catalogue varies significantly across the sky as a function of Gaia’s scanning law. We also provide the list of objects within our sample with available SDSS spectroscopy. We use this spectroscopic sample to characterize the observed structure of the white dwarf distribution in the H–R diagram.

Journal ArticleDOI
01 Sep 2019
TL;DR: The GGIR package includes a range of literature-supported methods to clean the data and provide day-by-day, as well as full recording, weekly, weekend, and weekday estimates of physical activity and sleep parameters.
Abstract: Recent technological advances have transformed the research on physical activity initially based on questionnaire data to the most recent objective data from accelerometers. The shift to availability of raw accelerations has increased measurement accuracy, transparency, and the potential for data harmonization. However, it has also shifted the need for considerable processing expertise to the researcher. Many users do not have this expertise. The R package GGIR has been made available to all as a tool to convermulti-day high resolution raw accelerometer data from wearable movement sensors into meaningful evidence-based outcomes and insightful reports for the study of human daily physical activity and sleep. This paper aims to provide a one-stop overview of GGIR package, the papers underpinning the theory of GGIR, and how research contributes to the continued growth of the GGIR package. The package includes a range of literature-supported methods to clean the data and provide day-by-day, as well as full recording, weekly, weekend, and weekday estimates of physical activity and sleep parameters. In addition, the package also comes with a shell function that enables the user to process a set of input files and produce csv summary reports with a single function call, ideal for users less proficient in R. GGIR has been used in over 90 peer-reviewed scientific publications to date. The evolution of GGIR over time and widespread use across a range of research areas highlights the importance of open source software development for the research community and advancing methods in physical behavior research.

Journal ArticleDOI
TL;DR: This study attempted to predict solidification defects by DNN regression with a small dataset that contains 487 data points and found that a pre-trained and fine-tuned DNN shows better generalization performance over shallow neural network, support vector machine, and DNN trained by conventional methods.

Journal ArticleDOI
Ayush Giri1, Jacklyn N. Hellwege2, Jacob M. Keaton2, Jacob M. Keaton1, Jihwan Park3, Chengxiang Qiu3, Helen R. Warren4, Helen R. Warren5, Eric S. Torstenson2, Eric S. Torstenson1, Csaba P. Kovesdy6, Yan V. Sun7, Otis D. Wilson2, Otis D. Wilson1, Cassianne Robinson-Cohen1, Christianne L. Roumie1, Cecilia P. Chung1, K A Birdwell6, K A Birdwell1, Scott M. Damrauer6, Scott L. DuVall, Derek Klarin, Kelly Cho8, Yu Wang1, Evangelos Evangelou9, Evangelos Evangelou10, Claudia P. Cabrera4, Claudia P. Cabrera5, Louise V. Wain5, Louise V. Wain11, Rojesh Shrestha3, Brian S. Mautz1, Elvis A. Akwo1, Muralidharan Sargurupremraj12, Stéphanie Debette12, Michael Boehnke13, Laura J. Scott13, Jian'an Luan14, Zhao J-H.14, Sara M. Willems14, Sébastien Thériault15, Nabi Shah16, Nabi Shah17, Christopher Oldmeadow18, Peter Almgren19, Ruifang Li-Gao20, Niek Verweij21, Thibaud Boutin22, Massimo Mangino23, Massimo Mangino24, Ioanna Ntalla4, Elena V. Feofanova25, Praveen Surendran14, James P. Cook26, Savita Karthikeyan14, Najim Lahrouchi27, Ching-Ti Liu28, Nuno Sepúlveda29, Tom G. Richardson30, Aldi T. Kraja31, Philippe Amouyel32, Martin Farrall33, Neil Poulter9, Markku Laakso34, Eleftheria Zeggini35, Peter S. Sever36, Robert A. Scott14, Claudia Langenberg14, Nicholas J. Wareham14, David Conen37, Palmer Cna.17, John Attia18, Daniel I. Chasman38, Paul M. Ridker38, Olle Melander19, Dennis O. Mook-Kanamori20, Harst Pvd.21, Francesco Cucca39, David Schlessinger36, Caroline Hayward22, Tim D. Spector24, Jarvelin M-R.1, Branwen J. Hennig29, Branwen J. Hennig40, Nicholas J. Timpson30, Wei W-Q.1, J C Smith1, Yaomin Xu1, Michael E. Matheny, E E Siew1, C M Lindgren27, C M Lindgren41, C M Lindgren33, Herzig K-H., George Dedoussis42, Josh C. Denny1, Bruce M. Psaty43, Howson Jmm.14, Patricia B. Munroe4, Patricia B. Munroe5, Christopher Newton-Cheh44, Mark J. Caulfield5, Mark J. Caulfield4, Paul Elliott5, Paul Elliott9, J M Gaziano45, J M Gaziano46, John Concato, Wilson Pwf.6, Philip S. Tsao45, D.R. Velez Edwards2, D.R. Velez Edwards1, Katalin Susztak3, Christopher J. O'Donnell38, Adriana M. Hung2, Adriana M. Hung1, Todd L. Edwards1, Todd L. Edwards2 
TL;DR: Analysis of blood pressure data from the Million Veteran Program trans-ethnic cohort identifies common and rare variants, and genetically predicted gene expression across multiple tissues associated with systolic, diastolic and pulse pressure in over 775,000 individuals.
Abstract: In this trans-ethnic multi-omic study, we reinterpret the genetic architecture of blood pressure to identify genes, tissues, phenomes and medication contexts of blood pressure homeostasis. We discovered 208 novel common blood pressure SNPs and 53 rare variants in genome-wide association studies of systolic, diastolic and pulse pressure in up to 776,078 participants from the Million Veteran Program (MVP) and collaborating studies, with analysis of the blood pressure clinical phenome in MVP. Our transcriptome-wide association study detected 4,043 blood pressure associations with genetically predicted gene expression of 840 genes in 45 tissues, and mouse renal single-cell RNA sequencing identified upregulated blood pressure genes in kidney tubule cells.

Journal ArticleDOI
TL;DR: The results suggest that substantially shortening treatment courses with stereotactic body radiotherapy does not increase either gastrointestinal or genitourinary acute toxicity.
Abstract: Summary Background Localised prostate cancer is commonly treated with external-beam radiotherapy. Moderate hypofractionation has been shown to be non-inferior to conventional fractionation. Ultra-hypofractionated stereotactic body radiotherapy would allow shorter treatment courses but could increase acute toxicity compared with conventionally fractionated or moderately hypofractionated radiotherapy. We report the acute toxicity findings from a randomised trial of standard-of-care conventionally fractionated or moderately hypofractionated radiotherapy versus five-fraction stereotactic body radiotherapy for low-risk to intermediate-risk localised prostate cancer. Methods PACE is an international, phase 3, open-label, randomised, non-inferiority trial. In PACE-B, eligible men aged 18 years and older, with WHO performance status 0–2, low-risk or intermediate-risk prostate adenocarcinoma (Gleason 4 + 3 excluded), and scheduled to receive radiotherapy were recruited from 37 centres in three countries (UK, Ireland, and Canada). Participants were randomly allocated (1:1) by computerised central randomisation with permuted blocks (size four and six), stratified by centre and risk group, to conventionally fractionated or moderately hypofractionated radiotherapy (78 Gy in 39 fractions over 7·8 weeks or 62 Gy in 20 fractions over 4 weeks, respectively) or stereotactic body radiotherapy (36·25 Gy in five fractions over 1–2 weeks). Neither participants nor investigators were masked to allocation. Androgen deprivation was not permitted. The primary endpoint of PACE-B is freedom from biochemical or clinical failure. The coprimary outcomes for this acute toxicity substudy were worst grade 2 or more severe Radiation Therapy Oncology Group (RTOG) gastrointestinal or genitourinary toxic effects score up to 12 weeks after radiotherapy. Analysis was per protocol. This study is registered with ClinicalTrials.gov , NCT01584258 . PACE-B recruitment is complete and follow-up is ongoing. Findings Between Aug 7, 2012, and Jan 4, 2018, we randomly assigned 874 men to conventionally fractionated or moderately hypofractionated radiotherapy (n=441) or stereotactic body radiotherapy (n=433). 432 (98%) of 441 patients allocated to conventionally fractionated or moderately hypofractionated radiotherapy and 415 (96%) of 433 patients allocated to stereotactic body radiotherapy received at least one fraction of allocated treatment. Worst acute RTOG gastrointestinal toxic effect proportions were as follows: grade 2 or more severe toxic events in 53 (12%) of 432 patients in the conventionally fractionated or moderately hypofractionated radiotherapy group versus 43 (10%) of 415 patients in the stereotactic body radiotherapy group (difference −1·9 percentage points, 95% CI −6·2 to 2·4; p=0·38). Worst acute RTOG genitourinary toxicity proportions were as follows: grade 2 or worse toxicity in 118 (27%) of 432 patients in the conventionally fractionated or moderately hypofractionated radiotherapy group versus 96 (23%) of 415 patients in the stereotactic body radiotherapy group (difference −4·2 percentage points, 95% CI −10·0 to 1·7; p=0·16). No treatment-related deaths occurred. Interpretation Previous evidence (from the HYPO-RT-PC trial) suggested higher patient-reported toxicity with ultrahypofractionation. By contrast, our results suggest that substantially shortening treatment courses with stereotactic body radiotherapy does not increase either gastrointestinal or genitourinary acute toxicity. Funding Accuray and National Institute of Health Research.

Journal ArticleDOI
TL;DR: This perspective article re-evaluate studies of influenza virus survival in aerosols, transmission in animal models and influenza incidence to show that the combination of temperature and RH is equally valid as AH as a predictor, and presents a mechanistic explanation based on droplets evaporation and its impact on droplet physics and chemistry for why RH is more likely than AH to modulate virus survival and transmission.
Abstract: Influenza incidence and seasonality, along with virus survival and transmission, appear to depend at least partly on humidity, and recent studies have suggested that absolute humidity (AH) is more important than relative humidity (RH) in modulating observed patterns. In this perspective article, we re-evaluate studies of influenza virus survival in aerosols, transmission in animal models and influenza incidence to show that the combination of temperature and RH is equally valid as AH as a predictor. Collinearity must be considered, as higher levels of AH are only possible at higher temperatures, where it is well established that virus decay is more rapid. In studies of incidence that employ meteorological data, outdoor AH may be serving as a proxy for indoor RH in temperate regions during the wintertime heating season. Finally, we present a mechanistic explanation based on droplet evaporation and its impact on droplet physics and chemistry for why RH is more likely than AH to modulate virus survival and transmission.

Journal ArticleDOI
Nick Shrine1, Anna L. Guyatt1, A. Mesut Erzurumluoglu1, Victoria E. Jackson1, Victoria E. Jackson2, Victoria E. Jackson3, Brian D. Hobbs4, Carl A. Melbourne1, Chiara Batini1, Katherine A. Fawcett1, Kijoung Song5, Phuwanat Sakornsakolpat6, Phuwanat Sakornsakolpat4, Xingnan Li7, Ruth Boxall8, Nicola F. Reeve1, Ma'en Obeidat9, Jing Hua Zhao10, Matthias Wielscher11, Stefan Weiss12, Katherine A. Kentistou13, James P. Cook14, Benjamin B. Sun10, Jian Zhou, Jennie Hui15, Stefan Karrasch, Medea Imboden16, Sarah E. Harris13, Jonathan Marten13, Stefan Enroth17, Shona M. Kerr13, Ida Surakka18, Vitart13, Terho Lehtimäki19, Richard J. Allen1, Per Bakke20, Terri H. Beaty21, Eugene R. Bleecker7, Yohan Bossé22, Corry-Anke Brandsma23, Zhengming Chen8, James D. Crapo, John Danesh, Dawn L. DeMeo4, Frank Dudbridge1, Ralf Ewert12, Christian Gieger, Amund Gulsvik20, Anna Hansell1, Ke Hao24, Joshua D. Hoffman5, John E. Hokanson25, Georg Homuth12, Peter K. Joshi13, Philippe Joubert22, Claudia Langenberg10, Liming Li26, Kuang Lin8, Lars Lind27, Nicholas Locantore, Jian'an Luan10, Anubha Mahajan28, Joseph C. Maranville29, Alison Catherine Murray30, David C. Nickle29, Richard Packer1, Margaret M. Parker4, Megan L. Paynton1, David J. Porteous13, Dmitry Prokopenko4, Dandi Qiao4, Rajesh Rawal31, Heiko Runz29, Ian Sayers32, Don D. Sin9, Blair H. Smith33, María Soler Artigas34, David Sparrow35, Ruth Tal-Singer, Timmers Prhj, van den Berge M23, John C. Whittaker, Prescott G. Woodruff36, Laura M Yerges Armstrong5, Olga G. Troyanskaya37, Olli T. Raitakari38, Mika Kähönen19, Ozren Polasek39, Ozren Polasek13, Ulf Gyllensten17, Igor Rudan13, Ian J. Deary13, Nicole Probst-Hensch16, Nicole Probst-Hensch40, Holger Schulz, Alan James41, Alan James15, James F. Wilson13, Beate Stubbe12, Eleftheria Zeggini42, Marjo-Riitta Järvelin, Nicholas J. Wareham10, Edwin K. Silverman4, Caroline Hayward13, Andrew P. Morris28, Andrew P. Morris14, Adam S. Butterworth10, Robert A. Scott, Robin G Walters8, Deborah A. Meyers7, Michael H. Cho4, David P. Strachan43, Ian P. Hall32, Tobin32, Louise V. Wain44, Louise V. Wain1 
TL;DR: In this paper, a genome-wide association study in 400,102 individuals of European ancestry was conducted to define 279 lung function signals, 139 of which are new and the combined effect of these variants showed generalizability across smokers and never smokers, and across ancestral groups.
Abstract: Reduced lung function predicts mortality and is key to the diagnosis of chronic obstructive pulmonary disease (COPD). In a genome-wide association study in 400,102 individuals of European ancestry, we define 279 lung function signals, 139 of which are new. In combination, these variants strongly predict COPD in independent populations. Furthermore, the combined effect of these variants showed generalizability across smokers and never smokers, and across ancestral groups. We highlight biological pathways, known and potential drug targets for COPD and, in phenome-wide association studies, autoimmune-related and other pleiotropic effects of lung function-associated variants. This new genetic evidence has potential to improve future preventive and therapeutic strategies for COPD.

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TL;DR: This update aims to build on the earlier 2014 review by bringing up to date the understanding of the molecular biology of HNSCCs and provide insights into areas of ongoing research and perspectives for the future.
Abstract: Head and neck squamous cell carcinomas (HNSCCs) are an aggressive, genetically complex and difficult to treat group of cancers. In lieu of truly effective targeted therapies, surgery and radiotherapy represent the primary treatment options for most patients. But these treatments are associated with significant morbidity and a reduction in quality of life. Resistance to both radiotherapy and the only available targeted therapy, and subsequent relapse are common. Research has therefore focussed on identifying biomarkers to stratify patients into clinically meaningful groups and to develop more effective targeted therapies. However, as we are now discovering, the poor response to therapy and aggressive nature of HNSCCs is not only affected by the complex alterations in intracellular signalling pathways but is also heavily influenced by the behaviour of the extracellular microenvironment. The HNSCC tumour landscape is an environment permissive of these tumours' aggressive nature, fostered by the actions of the immune system, the response to tumour hypoxia and the influence of the microbiome. Solving these challenges now rests on expanding our knowledge of these areas, in parallel with a greater understanding of the molecular biology of HNSCC subtypes. This update aims to build on our earlier 2014 review by bringing up to date our understanding of the molecular biology of HNSCCs and provide insights into areas of ongoing research and perspectives for the future.

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TL;DR: This study introduced transfer learning to train the deep neural network based on deep learning structure and transfer learning and achieved accuracy of 100.00%, which outperformed state-of-the-art approaches.

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TL;DR: In this article, the authors explore the physical basis to detect burned areas from satellite observations, describes the historical trends of using satellite sensors to monitor burned areas, summarizes the most recent approaches to map burned areas and evaluates the existing burned area products (both at global and regional scales).

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TL;DR: This study demonstrates that patient-specific ctDNA analysis can be a sensitive and specific approach for disease surveillance for patients with breast cancer, and earlier detection of up to 2 years provides a possible window for therapeutic intervention.
Abstract: Purpose: Up to 30% of patients with breast cancer relapse after primary treatment. There are no sensitive and reliable tests to monitor these patients and detect distant metastases before overt recurrence. Here, we demonstrate the use of personalized circulating tumor DNA (ctDNA) profiling for detection of recurrence in breast cancer. Experimental Design: Forty-nine primary patients with breast cancer were recruited following surgery and adjuvant therapy. Plasma samples (n = 208) were collected every 6 months for up to 4 years. Personalized assays targeting 16 variants selected from primary tumor whole-exome data were tested in serial plasma for the presence of ctDNA by ultradeep sequencing (average >100,000X). Results: Plasma ctDNA was detected ahead of clinical or radiologic relapse in 16 of the 18 relapsed patients (sensitivity of 89%); metastatic relapse was predicted with a lead time of up to 2 years (median, 8.9 months; range, 0.5–24.0 months). None of the 31 nonrelapsing patients were ctDNA-positive at any time point across 156 plasma samples (specificity of 100%). Of the two relapsed patients who were not detected in the study, the first had only a local recurrence, whereas the second patient had bone recurrence and had completed chemotherapy just 13 days prior to blood sampling. Conclusions: This study demonstrates that patient-specific ctDNA analysis can be a sensitive and specific approach for disease surveillance for patients with breast cancer. More importantly, earlier detection of up to 2 years provides a possible window for therapeutic intervention.

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TL;DR: New evidence suggests that the association between hypoglycaemia and cardiovascular events and mortality is likely to be multifactorial, and this risk should be recognised by clinicians when agreeing glycaemic goals with patients and choosing appropriate glucose-lowering therapies.

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TL;DR: In this paper, a locally adapted multitemporal two-phase burned area (BA) algorithm has been developed using as inputs Sentinel-2 MSI reflectance measurements in the short and near infrared wavebands plus the active fires detected by Terra and Aqua MODIS sensors.

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TL;DR: Ambient air pollution exposure was associated with lower lung function and increased COPD prevalence, with stronger associations seen in those with lower incomes, and higher COPD associations were seen for obese, lower income, and non-asthmatic participants.
Abstract: Ambient air pollution increases the risk of respiratory mortality, but evidence for impacts on lung function and chronic obstructive pulmonary disease (COPD) is less well established. The aim was to evaluate whether ambient air pollution is associated with lung function and COPD, and explore potential vulnerability factors. We used UK Biobank data on 303 887 individuals aged 40–69 years, with complete covariate data and valid lung function measures. Cross-sectional analyses examined associations of land use regression-based estimates of particulate matter (particles with a 50% cut-off aerodynamic diameter of 2.5 and 10 µm: PM2.5 and PM10, respectively; and coarse particles with diameter between 2.5 μm and 10 μm: PMcoarse) and nitrogen dioxide (NO2) concentrations with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio and COPD (FEV1/FVC Higher exposures to each pollutant were significantly associated with lower lung function. A 5 µg·m−3 increase in PM2.5 concentration was associated with lower FEV1 (−83.13 mL, 95% CI −92.50– −73.75 mL) and FVC (−62.62 mL, 95% CI −73.91– −51.32 mL). COPD prevalence was associated with higher concentrations of PM2.5 (OR 1.52, 95% CI 1.42–1.62, per 5 µg·m−3), PM10 (OR 1.08, 95% CI 1.00–1.16, per 5 µg·m−3) and NO2 (OR 1.12, 95% CI 1.10–1.14, per 10 µg·m−3), but not with PMcoarse. Stronger lung function associations were seen for males, individuals from lower income households, and “at-risk” occupations, and higher COPD associations were seen for obese, lower income, and non-asthmatic participants. Ambient air pollution was associated with lower lung function and increased COPD prevalence in this large study.

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TL;DR: The prevalence of non-suicidal self-harm (NSSH) has increased in England, but resultant service contact remains low and there are potential lifelong implications of NSSH, such as an increased frequency of suicide, especially if the behaviours are adopted as a long-term coping strategy.

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TL;DR: In this article, a review of state-of-the-art retrieval methods that have been applied in experimental imaging spectroscopy studies inferring all kinds of vegetation biophysical variables is presented.
Abstract: An unprecedented spectroscopic data stream will soon become available with forthcoming Earth-observing satellite missions equipped with imaging spectroradiometers. This data stream will open up a vast array of opportunities to quantify a diversity of biochemical and structural vegetation properties. The processing requirements for such large data streams require reliable retrieval techniques enabling the spatiotemporally explicit quantification of biophysical variables. With the aim of preparing for this new era of Earth observation, this review summarizes the state-of-the-art retrieval methods that have been applied in experimental imaging spectroscopy studies inferring all kinds of vegetation biophysical variables. Identified retrieval methods are categorized into: (1) parametric regression, including vegetation indices, shape indices and spectral transformations; (2) nonparametric regression, including linear and nonlinear machine learning regression algorithms; (3) physically based, including inversion of radiative transfer models (RTMs) using numerical optimization and look-up table approaches; and (4) hybrid regression methods, which combine RTM simulations with machine learning regression methods. For each of these categories, an overview of widely applied methods with application to mapping vegetation properties is given. In view of processing imaging spectroscopy data, a critical aspect involves the challenge of dealing with spectral multicollinearity. The ability to provide robust estimates, retrieval uncertainties and acceptable retrieval processing speed are other important aspects in view of operational processing. Recommendations towards new-generation spectroscopy-based processing chains for operational production of biophysical variables are given.

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TL;DR: This paper performed a genome-wide association study in 35,735 cases and 222,076 controls from the UK Biobank and additional studies from the International COPD Genetics Consortium and identified 82 loci associated with P < 5'×'10'8; 47 of these were previously described in association with either COPD or population-based measures of lung function.
Abstract: Chronic obstructive pulmonary disease (COPD) is the leading cause of respiratory mortality worldwide. Genetic risk loci provide new insights into disease pathogenesis. We performed a genome-wide association study in 35,735 cases and 222,076 controls from the UK Biobank and additional studies from the International COPD Genetics Consortium. We identified 82 loci associated with P < 5 × 10-8; 47 of these were previously described in association with either COPD or population-based measures of lung function. Of the remaining 35 new loci, 13 were associated with lung function in 79,055 individuals from the SpiroMeta consortium. Using gene expression and regulation data, we identified functional enrichment of COPD risk loci in lung tissue, smooth muscle, and several lung cell types. We found 14 COPD loci shared with either asthma or pulmonary fibrosis. COPD genetic risk loci clustered into groups based on associations with quantitative imaging features and comorbidities. Our analyses provide further support for the genetic susceptibility and heterogeneity of COPD.

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TL;DR: The use of modified weights within two-sample summary-data MR studies is proposed for accurately quantifying heterogeneity and detecting outliers in the presence of weak instruments.
Abstract: BACKGROUND Two-sample summary-data Mendelian randomization (MR) incorporating multiple genetic variants within a meta-analysis framework is a popular technique for assessing causality in epidemiology. If all genetic variants satisfy the instrumental variable (IV) and necessary modelling assumptions, then their individual ratio estimates of causal effect should be homogeneous. Observed heterogeneity signals that one or more of these assumptions could have been violated. METHODS Causal estimation and heterogeneity assessment in MR require an approximation for the variance, or equivalently the inverse-variance weight, of each ratio estimate. We show that the most popular 'first-order' weights can lead to an inflation in the chances of detecting heterogeneity when in fact it is not present. Conversely, ostensibly more accurate 'second-order' weights can dramatically increase the chances of failing to detect heterogeneity when it is truly present. We derive modified weights to mitigate both of these adverse effects. RESULTS Using Monte Carlo simulations, we show that the modified weights outperform first- and second-order weights in terms of heterogeneity quantification. Modified weights are also shown to remove the phenomenon of regression dilution bias in MR estimates obtained from weak instruments, unlike those obtained using first- and second-order weights. However, with small numbers of weak instruments, this comes at the cost of a reduction in estimate precision and power to detect a causal effect compared with first-order weighting. Moreover, first-order weights always furnish unbiased estimates and preserve the type I error rate under the causal null. We illustrate the utility of the new method using data from a recent two-sample summary-data MR analysis to assess the causal role of systolic blood pressure on coronary heart disease risk. CONCLUSIONS We propose the use of modified weights within two-sample summary-data MR studies for accurately quantifying heterogeneity and detecting outliers in the presence of weak instruments. Modified weights also have an important role to play in terms of causal estimation (in tandem with first-order weights) but further research is required to understand their strengths and weaknesses in specific settings.

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TL;DR: The FAIR Data Principles as discussed by the authors are a set of data reuse principles that focus on enhancing the ability of machines to automatically find and use the data, in addition to supporting its reuse by individuals.
Abstract: There is an urgent need to improve the infrastructure supporting the reuse of scholarly data. A diverse set of stakeholders-representing academia, industry, funding agencies, and scholarly publishers-have come together to design and jointly endorse a concise and measureable set of principles that we refer to as the FAIR Data Principles. The intent is that these may act as a guideline for those wishing to enhance the reusability of their data holdings. Distinct from peer initiatives that focus on the human scholar, the FAIR Principles put specific emphasis on enhancing the ability of machines to automatically find and use the data, in addition to supporting its reuse by individuals. This Comment is the first formal publication of the FAIR Principles, and includes the rationale behind them, and some exemplar implementations in the community.