A novelty-based multi-objective evolutionary algorithm for identifying functional dependencies in complex technical infrastructures from alarm data

In this work, a Multi-Objective Evolutionary Algorithm (MOEA) is developed to identify Functional Dependencies (FDEPs) in Complex Technical Infrastructures (CTIs) from alarm data. The objectives of the search are the maximization of a measure of novelty, which drives the exploration of the solution space avoiding to get trapped in local optima, and of a measure of dependency among alarms, which drives the uncovering of functional dependencies. The main contribution of the work is the direct identification of patterns of dependent alarms; this avoids going through the preliminary step of mining association rules, as typically done by state-of-the-art methods which, however, fail to identify rare functional dependencies due to the need of setting a balanced minimum occurrence threshold. The proposed framework for FDEPs identification is applied to a synthetic alarm database generated by a simulated CTI model and to a real large-scale database of alarms collected at the CTI of CERN (European Organization for Nuclear Research). The obtained results show that the framework enables the thorough exploration of the solution space and captures also rare functional dependencies.

Translation and Validation of M.D. Anderson Symptom Inventory-Thyroid Cancer Module in Chinese Thyroid Cancer Patients: A Cross-Sectional and Methodological Study

Aim To translate and validate the Chinese version of the MDASI-THY among thyroid cancer patients. Background The M.D. Anderson Symptom Inventory-Thyroid Cancer module (MDASI-THY) is one of well-validated instruments for thyroid-specific symptom assessment. To date, the instrument has not been used in China. Methods After standard forward- and back-translation procedures, two instruments, the Chinese version of MDASI-THY and the European Organization for Research and Treatment of Cancer QLQ C30, were answered by 309 thyroid patients. The content, convergent discriminant validity and reliability of the MDASI-THY were evaluated. The Standards for Reporting Diagnostic Accuracy Studies (STARD) was used as reporting checklist. Results S-CVI and I-CVI of the instrument were over 0.80. There were significant relationships between MDASI-THY and EORTC QLQ-C30 (p<0.001). Symptoms were severer for patients underwent surgical treatment. The Cronbach’s alpha was 0.966 (between 0.954 and 0.827 for subscales). Most symptom items had moderate to high interitem correlations. Conclusions The Chinese version of MDASI-THY demonstrated favorable validity and reliability. It can be used in development of symptom management program in thyroid cancer patients in China. Relevance to clinical practice: Nurse can apply this instrument to assess Chinese thyroid cancer patients to increase the understanding of their symptom experience, resulting in a better symptom management.

FIVE YEARS SURVIVAL AND QUALITY OF LIFE AFTER RADICAL NEPHRECTOMY: A DESCRIPTIVE SINGLE CENTER STUDY

Objective: This study aims to evaluate five years of survival rate, and quality of life of the patient after radical nephrectomy in our center. Material & Methods: This descriptive longitudinal study included thirty patients who were diagnosed as having renal mass in the Urology division H. Adam Malik General Hospital between January 2014 and December 2015. All patients were completely followed-up for 5 years or the patient died during the observation. We used a translated and validated Indonesian written European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30) questionnaire to assess the patient’s quality of life. Results: Overall 5-years survival of kidney tumor patients was 100%, 66.67%, 50%, 8.33%, respectively for stage 1 to 4. We found a sharp decrease in the cumulative survival rate of stage IV group in the first 24 months compared to the first 12 months, from 66.67% to 25%. This pattern of decrease was not found in the other group of stage. Overall, the quality of life of patients has increased in the first three years postoperatively and decreased in the two years afterward. These fluctuations consistently occur in all groups. All of the groups had reached the maximum quality of life at the third year postoperatively. Conclusion: Stage I renal cell carcinoma patient shown the best five-years survival rate and quality of life among others. The quality of life for all groups inclined for the first three years after surgery and decline consistently afterward. These findings are in accordance with many studies that have been published previously.

Modelling the gas–particle partitioning and water uptake of isoprene-derived secondary organic aerosol at high and low relative humidity

This study presents a characterization of the hygroscopic growth behaviour and effects of different inorganic seed particles on the formation of secondary organic aerosols (SOAs) from the dark ozone-initiated oxidation of isoprene at low NOx conditions. We performed simulations of isoprene oxidation using a gas-phase chemical reaction mechanism based on the Master Chemical Mechanism (MCM) in combination with an equilibrium gas–particle partitioning model to predict the SOA concentration. The equilibrium model accounts for non-ideal mixing in liquid phases, including liquid–liquid phase separation (LLPS), and is based on the AIOMFAC (Aerosol Inorganic–Organic Mixtures Functional groups Activity Coefficients) model for mixture non-ideality and the EVAPORATION (Estimation of VApour Pressure of ORganics, Accounting for Temperature, Intramolecular, and Non-additivity effects) model for pure compound vapour pressures. Measurements from the Cosmics Leaving Outdoor Droplets (CLOUD) chamber experiments, conducted at the European Organization for Nuclear Research (CERN) for isoprene ozonolysis cases, were used to aid in parameterizing the SOA yields at different atmospherically relevant temperatures, relative humidity (RH), and reacted isoprene concentrations. To represent the isoprene-ozonolysis-derived SOA, a selection of organic surrogate species is introduced in the coupled modelling system. The model predicts a single, homogeneously mixed particle phase at all relative humidity levels for SOA formation in the absence of any inorganic seed particles. In the presence of aqueous sulfuric acid or ammonium bisulfate seed particles, the model predicts LLPS to occur below ∼ 80 % RH, where the particles consist of an inorganic-rich liquid phase and an organic-rich liquid phase; however, this includes significant amounts of bisulfate and water partitioned to the organic-rich phase. The measurements show an enhancement in the SOA amounts at 85 % RH, compared to 35 % RH, for both the seed-free and seeded cases. The model predictions of RH-dependent SOA yield enhancements at 85 % RH vs. 35 % RH are 1.80 for a seed-free case, 1.52 for the case with ammonium bisulfate seed, and 1.06 for the case with sulfuric acid seed. Predicted SOA yields are enhanced in the presence of an aqueous inorganic seed, regardless of the seed type (ammonium sulfate, ammonium bisulfate, or sulfuric acid) in comparison with seed-free conditions at the same RH level. We discuss the comparison of model-predicted SOA yields with a selection of other laboratory studies on isoprene SOA formation conducted at different temperatures and for a variety of reacted isoprene concentrations. Those studies were conducted at RH levels at or below 40 % with reported SOA mass yields ranging from 0.3 % up to 9.0 %, indicating considerable variations. A robust feature of our associated gas–particle partitioning calculations covering the whole RH range is the predicted enhancement of SOA yield at high RH (> 80 %) compared to low RH (dry) conditions, which is explained by the effect of particle water uptake and its impact on the equilibrium partitioning of all components.

Quality of Life of Emirati Women With Breast Cancer

Background: This study examined the quality of life of Emirati women with breast cancer (BC).Methods: This study was a population-based study of a random sample of 250 Emirati women with BC. Quality of life (QoL) was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Cancer-Specific version (EORTC QLQ-C30, v.3.0) and the EORTC QoL Breast Cancer-Specific version (EORTC QLQ-BR23) translated into Arabic.Results: The mean age and median age of the 250 participants were 53.4 (SD ±11.3) and 52 years, respectively.Participants had a mean global health score of 74.73 (SD ±18.25), with a minimum of 16.67, indicating a good level of wellbeing.On the QLQ-C30, the Emirati women seemed to perform well on the functional scales but poorly on the symptom scales. While social functioning scored the highest (82.33 ±28.38) among the functional scales, emotional functioning scored the lowest (68.43 ±30.02). The most worrying symptom was sleep disturbance (47.87±38.46), followed by fatigue (38.18±30.31) and pain (29.13±28.01). Financial impact scored the lowest, indicating that most women did not have financial issues related to their cancer.On the QLQ-BR23, we found that participants performed above average to very good on the functional scales but poorly on the symptom scales. While sexual functioning scored the highest (86.07±22.61) among the functional scales, future perspective scored the lowest (50.80±37.92). The most worrying symptom was upset by hair loss (61.01±37.35), followed by arm symptoms (33.73±28.08).Conclusions: Emirati BC survivors reported good QoL overall. The most bothersome symptoms were sleep disturbance, fatigue, pain, hair loss and arm symptoms. Emirati women scored average on all functional scales, which indicates mediocre functioning, but high on the symptom scales, which indicates worse symptoms. Factors associated with a decline in the domains of QoL included age, income, education, metastases, mastectomy, and lymph node dissection. Recommendations to address these issues are discussed.Trial Registration: NA

Influência dos Cânceres Gástrico e Hematológico na Qualidade de Vida e na Funcionalidade de Pacientes Oncológicos

Introdução: O câncer é uma doença complexa, sendo a segunda maior causa de morte no Brasil e no mundo, com uma média de 9,8 milhões de óbitos ao ano. Objetivo: Verificar a influência do tipo de câncer, gástrico ou hematológico, na qualidade de vida e na funcionalidade dos indivíduos. Método: Trata-se de um estudo clínico, transversal, analítico e de abordagem quantitativa. Utilizaram-se na coleta de dados uma ficha com dados demográficos, antropométricos, habituais e da doença, o Quality of Life Questionnaire-Core30 da European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) e a Escala de Performance de Karnofsky (KPS). Resultados: Foram avaliados 29 pacientes no total; destes, 19 pacientes com câncer hematológico (Grupo A) e dez com câncer gástrico (Grupo B). A correlação entre idade, EORTC QLQ-C30 e KPS foi positiva entre a idade e os sintomas (r=,571, p=0,011) e a idade e a somatória total do EORTC QLQ-C30 (r=,548, p=0,015); e negativa entre a KPS e os sintomas (r=-,495, p=0,031) e a KPS e a somatória total do EORTC QLQ-C30 (r=,-580, p=0,009) no grupo A. No grupo B, não foi observada nenhuma correlação entre essas variáveis. Conclusão: Pacientes com câncer hematológico e câncer gástrico apresentam redução da qualidade de vida, sendo observada uma diminuição da funcionalidade nos pacientes com câncer hematológico quando comparado ao câncer gástrico. A redução da função nesses indivíduos pode estar diretamente relacionada com a idade e os sintomas físicos apresentados.

Effect of chocolate on older patients with cancer in palliative care: a randomised controlled study

Background Older advanced stage cancer patients, with changes in nutritional status, represent an important demand for palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutritional status of older cancer patients in palliative care. Methods Older cancer patients in palliative care with ambulatory (n = 46) monitoring were randomized to control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks for nutritional status (primary outcome), evaluated by the Mini Nutritional Assessment tool (MNA). Food consumption, anthropometry, body composition, laboratory parameters and quality of life (QL) with the European Organization for the Research and Treatment of Cancer instrument were also evaluated. Results IG1 progressed with increased screening (estimated difference [95% CI]: − 1.3 [− 2.2;-0.4], p < 0.01), and nutritional (estimated difference [95% CI]: − 1.3 [− 2.5;-0.1], p = 0.04) scores on the MNA, with no change in anthropometry and body composition. Regarding antioxidant capacity, reduced glutathione levels increased (estimated difference [95% CI]: − 0.8 [− 1.6;-0.02], p = 0.04) and malondealdehyde levels decreased in IG2 (estimated difference [95% CI]:+ 4.9 [+ 0.7;+ 9.1], p = 0.02). Regarding QL, functionality improved in IG1, with higher score in the functional domain (estimated difference [95% CI]:-7.0 [− 13.3;-0.7], p = 0.03). Conclusions The consumption of chocolate with a greater cocoa content may contribute to the improvement of the nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. Trial registration A randomized clinical trial (ClinicalTrials.gov NCT04367493).

Fatigue in breast cancer patients on chemotherapy: a cross-sectional study exploring clinical, biological, and genetic factors

Background Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient’s life (physical, psychosocial, professional, and socioeconomic). The aim of this study was to assess the severity of cancer-related fatigue in a group of breast cancer patients undergoing chemotherapy and explore the association between fatigue scores and sociodemographic, clinical, biological, psychiatric, and genetic factors. Methods A cross-sectional pilot study carried out at the oncology outpatient unit of Hôtel-Dieu de France University Hospital recruited 67 breast cancer patients undergoing chemotherapy between November 2017 and June 2019 to evaluate fatigue using the EORTC QLQ-C30 scale (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire). Genotyping for seven gene polymorphisms (COMT, DRD2, OPRM1, CLOCK, PER2, CRY2, ABCB1) was performed using the Lightcycler® (Roche). Results The prevalence of fatigue was 46.3%. Multivariable analysis taking the fatigue score as the dependent variable showed that a higher number of cycles and a lower hemoglobin level were significantly associated with higher odds of exhibiting fatigue. Moreover, having at least one C allele for DRD2 SNP (vs. TT) was significantly associated with a 4.09 higher odds of expressing fatigue compared to TT patients. Finally, patients with at least one C allele for CLOCK SNP tended to display higher fatigue levels than TT patients. Conclusions Our study showed that anemic breast cancer patients with a high number of chemotherapy cycles and those carrying at least one C allele for DRD2 and CLOCK SNPs are at greater risk of exhibiting fatigue. Since no previous research has reported such genetic results, future studies are necessary to confirm our findings.

QUALIDADE DE VIDA RELACIONADA À SAÚDE DE MULHERES IDOSAS EM TRATAMENTO DE CÂNCER DE MAMA

OBJETIVO: AVALIAR A QUALIDADE DE VIDA RELACIONADA À SAÚDE DE MULHERES IDOSAS EM TRATAMENTO DE CÂNCER DE MAMA. MÉTODO: ESTUDO TRANSVERSAL, DESCRITIVO, COM ABORDAGEM QUANTITATIVA, REALIZADO COM 57 MULHERES IDOSAS EM TRATAMENTO DE CÂNCER DE MAMA. A COLETA DE DADOS OCORREU DURANTE OS MESES DE JUNHO A NOVEMBRO DE 2019, POR MEIO DE UM INSTRUMENTO SEMIESTRUTURADO PARA OBTENÇÃO DE DADOS SOCIODEMOGRÁFICOS E CLÍNICOS E OS QUESTIONÁRIOS EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER QUALITY OF LIFE QUESTIONNAIRE “CORE” 30 E QUALITY OF LIFE QUESTIONNAIRE – BREAST CANCER 23. OS DADOS FORAM ANALISADOS DE FORMA DESCRITIVA COM O AUXÍLIO DO STATISTICAL PACKAGE FOR THE SOCIAL SCIENCE FOR WINDOWS, VERSÃO 22.0. O PROJETO FOI APROVADO PELO COMITÊ DE ÉTICA EM PESQUISA SOB PARECER Nº 3.293.768. RESULTADOS: NA QUALIDADE DE VIDA GERAL, OBSERVOU-SE QUE AS IDOSAS APRESENTARAM BOA MÉDIA NA ESCALA DE SAÚDE GLOBAL E RAZOÁVEL NA ESCALA FUNCIONAL, DESTACANDO-SE A FUNÇÃO SOCIAL. JÁ A ESCALA DE SINTOMAS APRESENTOU MÉDIA BAIXA, DESTACANDO-SE A DIFICULDADE FINANCEIRA, INSÔNIA, FADIGA E DOR. NO QUESTIONÁRIO ESPECÍFICO, A ESCALA FUNCIONAL APRESENTOU MAIOR MÉDIA, COM DESTAQUE POSITIVO PARA A IMAGEM CORPORAL. NA ESCALA DE SINTOMAS, OS EFEITOS COLATERAIS E OS SINTOMAS DA MAMA FORAM OS QUE MAIS CONTRIBUÍRAM PARA A DETERIORAÇÃO DA QUALIDADE DE VIDA. CONCLUSÃO: A QUALIDADE DE VIDA GLOBAL APRESENTOU-SE BOA, NO ENTANTO, A MESMA SOFRE IMPACTOS DEVIDO AOS EFEITOS COLATERAIS AO TRATAMENTO.

The burden of illness in patients with paroxysmal nocturnal hemoglobinuria receiving treatment with the C5-inhibitors eculizumab or ravulizumab: results from a US patient survey

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare and life-threatening disease with symptoms of hemolysis and thrombosis. Current therapies for this complement-mediated disease rely predominantly on inhibition of the C5 complement protein. However, data on treatment responses and quality of life in C5-inhibitor (C5i)-treated PNH patients are scarce. The objective of this study was to determine C5i treatment effects on clinical parameters, PNH symptoms, quality of life, and resource use for PNH patients. This cross-sectional study surveyed 122 individuals in the USA receiving treatment for PNH with C5-targeted monoclonal antibodies, eculizumab (ECU) or ravulizumab (RAV). Despite most patients receiving C5i therapy for ≥ 3 months (ECU 100%, n = 35; RAV 95.4%, n = 83), many patients remained anemic with hemoglobin levels ≤ 12 g/dL in 87.5% (n = 28/32) and 82.9% (n = 68/82) of ECU and RAV recipients, respectively. A majority of patients on ECU (88.6%; n = 31/35) and RAV (74.7%; n = 65/87) reported fatigue symptoms. Among PNH patients receiving C5i therapy for ≥ 12 months, some still reported thrombotic events (ECU, 10.0%, n = 1/10; RAV, 23.5%, n = 4/17) and required transfusions within the past year (ECU, 52.2%, n = 12/23; RAV, 22.6%, n = 7/31). Other patient-reported PNH symptoms included breakthrough hemolysis, shortness of breath, and headaches. Patients reported scores below the average population norms on the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scales. Overall, this study found that PNH patients receiving ECU or RAV therapy demonstrated a significant burden of illness, highlighting the need for improved PNH therapies.