The full cohort of 512 patients and the nested controlled trial in 93 patients in the Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) study raise doubts about the effective size at present claimed

A comparison of the relative merits of video-assisted pulmonary metastasectomy versus thoracotomy is predicated on the assumption that removal of asymptomatic lung metastases favourably influences survival and that it does so by a large degree. Recently published but long-awaited evidence from a prospective cohort study and a randomised trial of Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) challenges that assumption.

Russian Foreign Policy

Russian foreign policy has undergone substantial shifts in the post–Cold War period. Scholarly attention toward the topic has also experienced ebbs and flows as the breakup of the Soviet Union drastically decreased general interest toward a newly emerged Russia. The initial period of Russian foreign policy in the early 1990s was to a large degree a continuation of Soviet foreign policy, with its focus on cooperative relations with the West. This, in turn, combined with the general weakness of the Russian state, resulted in the relative disregard of other foreign policy directions. The deepening domestic power struggle led to a growing opposition toward the pro-Western course and paved the way for a number of domestic players to influence Russia’s foreign policy course. Vladimir Putin’s arrival to power in 2000 and the domestic changes he introduced freed foreign policy from most of its domestic constraints, at least temporarily. During his first presidential term (2000–2004), Russian foreign policy oscillated between competition with the West (the United States in particular) and attempts to integrate Russia as the West’s equal partner. The consolidation of the regime, which accelerated in Putin’s second presidential term (2004–2008), left its mark on foreign policy. Russia’s engagement with the external world underwent substantial changes, which turned out to be durable for the next decade and a half. Material resurgence, the strengthening of the state, and the domestic political consolidation fueled Russia’s assertiveness in international politics. These processes culminated in Putin’s 2007 Munich speech and the 2008 war with Georgia. The following period of the so-called tandemocracy (2008–2012), with Putin becoming prime minister and Dmitri Medvedev serving as president, led to a partial warming in relations with the West, though Russia continued its assertive policy. Russia also deepened its cooperation with a rising China. Putin’s return to power in 2012 initiated the conservative-nationalist turn in domestic politics, which was reflected in foreign policy. Russia increasingly positioned itself not only as a geopolitical challenger to the West, but also a normative one. The annexation of Crimea (2014), followed by the military intervention in Syria (2015), opened a new phase in Russian foreign policy. Moscow became bolder in using military force abroad and enlarged its presence in such regions as sub-Saharan Africa. The explanations of change and continuity in Russian foreign policy can be grouped in several camps, with scholars emphasizing power politics and external constraints, domestic politics, and the role of ideas and identity. The emerging trend is the growing popularity of pluralist explanations of Russian foreign policy.

Promises and Challenges of Medical Patient Healthcare Portals in Underserved Communities

As a safety-net medical center that serves many underserved communities, Einstein Medical Center Philadelphia (EMCP) faces many challenges in providing healthcare to its communities. To improve those services, EMCP has released a new IT healthcare portal (app). This chapter describes some of the promises and challenges EMCP is currently facing in their attempts to convince communities in its catchment area to adopt that healthcare portal. The challenges are discussed in the contexts of poor social determinants of health (SDOH), unique social factors, as well as the importance of managing community trust in EMCP within the broader contexts of underserved communities of which the new portal is only part of the story. This is not a typical case of IT adoption. The challenges at hand are not only technical but to a large degree social, dealing in part with issues of cultural diversity, perceived lack of respect, and poor health literacy.

THE PROTECTION OF WORKERS WITH FAMILY RESPONSIBILITES – SELECTED ISSUES

Balancing personal and professional spheres remains a major challenge for growing number of employees. This concerns, to a large degree, a family life of employee. Family responsibilities, more often than any other non-work commitments of employees, restrict their possibilities of preparing for, entering, participating in or advancing in economic activity. In the light of demographic and social changes, the protection of workers with family responsibilities evolved towards more „equal” approach to family responsibilities and broader than previously scope of family responsibilites as duties not only to young children of employees but also to other members of his family. This contribution aims to describe the selected isuues of protection of workers with family responsibilities

Brain–Computer Interface Training Based on Brain Activity Can Induce Motor Recovery in Patients With Stroke: A Meta-Analysis

Background Brain–computer interface (BCI) is a procedure involving brain activity in which neural status is provided to the participants for self-regulation. The current review aims to evaluate the effect sizes of clinical studies investigating the use of BCI-based rehabilitation interventions in restoring upper extremity function and effective methods to detect brain activity for motor recovery. Methods A computerized search of MEDLINE, CENTRAL, Web of Science, and PEDro was performed to identify relevant articles. We selected clinical trials that used BCI-based training for post-stroke patients and provided motor assessment scores before and after the intervention. The pooled standardized mean differences of BCI-based training were calculated using the random-effects model. Results We initially identified 655 potentially relevant articles; finally, 16 articles fulfilled the inclusion criteria, involving 382 participants. A significant effect of neurofeedback intervention for the paretic upper limb was observed (standardized mean difference = .48, [.16-.80], P = .006). However, the effect estimates were moderately heterogeneous among the studies ( I2 = 45%, P = .03). Subgroup analysis of the method of measurement of brain activity indicated the effectiveness of the algorithm focusing on sensorimotor rhythm. Conclusion This meta-analysis suggested that BCI-based training was superior to conventional interventions for motor recovery of the upper limbs in patients with stroke. However, the results are not conclusive because of a high risk of bias and a large degree of heterogeneity due to the differences in the BCI interventions and the participants; therefore, further studies involving larger cohorts are required to confirm these results.

Notarization and Anti-Plagiarism: A New Blockchain Approach

In traditional notarization processes, the correctness of the activities between the parties is guaranteed by a central authority or guaranteeing institution. In this case, the authority is not able to quickly establish the originality of the content to be notarized, or at least to have a large degree of certainty without the use of automated systems. This paper presents a new notarization platform that uses blockchain technology and integrates advanced anti-plagiarism approaches able to effectively detect copyright violations of documents that users want to notarize. In addition, our proposal includes the use of models, methods, and techniques, through which a very high level of privacy and information security can be guaranteed.

Atomistic Simulation of Microstructural Evolution of Ni50.8Ti Wires during Torsion Deformation

To explore the microstructural evolution of Ni50.8Ti wires during torsion deformation, single and polycrystalline models with various grain sizes (d = 9 nm, 5.6 nm, and 3.4 nm) were established on an atomic scale to explore their grain morphology evolution, stress-induced martensitic transformation, and dislocation movement. The results indicated that the grains were rotated and elongated to form long strips of grains during the torsion simulation. With the increase in torsion deformation, the elongated grains were further split, forming smaller grains. Stress-induced martensitic transformation took place and the martensite preferentially nucleated near the grain boundary, resulting in the formation of 30% austenites and 50% martensites. Additionally, a certain number of dislocations were generated during the torsion simulation. Under a low degree of torsion deformation, the main mechanism of plastic deformation was dislocation movement, while with a large degree of torsion deformation, the main mechanism of plastic deformation was grain rotation.

Confirmation and variability of the Allee effect in Dictyostelium discoideum cell populations,possible role of chemical signaling within cell clusters

In studies of the unicellular eukaryote Dictyostelium discoideum, many have anecdotally observed that cell dilution below a certain "threshold density” causes cells to undergo a period of slow growth (lag). However, little is documented about the slow growth phase and the reason for different growth dynamics below and above this threshold density. In this paper, we extend and correct our earlier work to report an extensive set of experiments, including the use of new cell counting technology, that set this slow-to-fast growth transition on a much firmer biological basis. We show that dilution below a certain density (around 10E4 cells/ml) causes cells to grow slower on average and exhibit a large degree of variability: sometimes a sample does not lag at all, while sometimes it takes many moderate density cell cycle times to recover back to fast growth. We perform conditioned media experiments to demonstrate that a chemical signal mediates this endogenous phenomenon. Finally, we argue that while simple models involving fluid transport of signal molecules or cluster-based signaling explain typical behavior, they do not capture the high degree of variability between samples but nevertheless favor an intra-cluster mechanism.

The Antibiotic Fosfomycin Mimics the Effects of the Intermediate Metabolites Phosphoenolpyruvate and Glyceraldehyde-3-Phosphate on the Stenotrophomonas maltophilia Transcriptome

Stenotrophomonas maltophilia is an opportunistic pathogen with an environmental origin, which presents a characteristically low susceptibility to antibiotics and is capable of acquiring increased levels of resistance to antimicrobials. Among these, fosfomycin resistance seems particularly intriguing; resistance to this antibiotic is generally due to the activity of fosfomycin-inactivating enzymes, or to defects in the expression or the activity of fosfomycin transporters. In contrast, we previously described that the cause of fosfomycin resistance in S. maltophilia was the inactivation of enzymes belonging to its central carbon metabolism. To go one step further, here we studied the effects of fosfomycin on the transcriptome of S. maltophilia compared to those of phosphoenolpyruvate—its structural homolog—and glyceraldehyde-3-phosphate—an intermediate metabolite of the mutated route in fosfomycin-resistant mutants—. Our results show that transcriptomic changes present a large degree of overlap, including the activation of the cell-wall-stress stimulon. These results indicate that fosfomycin activity and resistance are interlinked with bacterial metabolism. Furthermore, we found that the studied compounds inhibit the expression of the smeYZ efflux pump, which confers intrinsic resistance to aminoglycosides. This is the first description of efflux pump inhibitors that can be used as antibiotic adjuvants to counteract antibiotic resistance in S. maltophilia.

Dialetics and Structural Organization in the Ẹ̀bìbì Festival Performances of the Ẹ̀pẹ́ People in Lagos State, Nigeria

There is growing interest in the study of festivals by literary scholars in African orature. In Nigeria, the festival resources of the Ìjèbú in southwest ̣ - ern Nigeria, specifically the Èbìbì ̣ festival, has been given cursory multi-disciplinary attention in areas such as anthropology, sociology, religions and history. However, scant attention has been paid to the literariness of this corpus of festivals. Moreover, the variety of the festival celebrated by the Èpẹ́ ̣ people in the coastal area of the Ìjẹ̀bú people appears to have been neglected in previous studies of Ìjẹ̀bu festivals. Using salient aspects of literary semiot ́ - ics, this paper explores the Èbìbì ̣ festival of the Èpẹ́ ̣ people by undertaking a literary evaluation of the structural organization, dialetics and interconnectedness of the performances. Observations revealed that levels of structural organization are interconnected to various degrees. Narrative and textual structures are maintained in spite of translations into other languages. Èbìbì ̣ is structured beginning with formulaic exchanges, invocation by the Oluwo and the beating of the sacred Gbẹ̀du drums. Performers sometimes use the formula within a performance to develop oral text. Actions include flogging, as well as acrobatic and gymnastic displays by the performers. The costumes and masks have motifs of riverine animals and fishing accessories. Color codes are symbolically white for cleansing, green for fertility, brown for earth and red for positive energy. The Èbìbì ̣ festival celebrated in Èpẹ́ ̣ is indeed rich in oral 200 Babatunde Olanrewaju Adebua and Mobolanle Ebunoluwa Sotunsa aesthetic forms such as narration, wording, texture and dramatization which enhance its performance aesthetics to a large degree.