Variation in advanced stage at diagnosis of lung and female breast cancer in an English region 2006-2009

This is the final published version. Available from Springer Nature via the DOI in this record.Background: Understanding variation in stage at diagnosis can inform interventions to improve the timeliness of diagnosis for patients with different cancers and characteristics. Methods: We analysed population-based data on 17 836 and 13 286 East of England residents diagnosed with (female) breast and lung cancer during 2006-2009, with stage information on 16 460 (92%) and 10 435 (79%) patients, respectively. Odds ratios (ORs) of advanced stage at diagnosis adjusted for patient and tumour characteristics were derived using logistic regression. Results :We present adjusted ORs of diagnosis in stages III/IV compared with diagnosis in stages I/II. For breast cancer, the frequency of advanced stage at diagnosis increased stepwise among old women (ORs: 1.21, 1.46, 1.68 and 1.78 for women aged 70-74, 75-79, 80-84 and ≥85, respectively, compared with those aged 65-69, P<0.001). In contrast, for lung cancer advanced stage at diagnosis was less frequent in old patients (ORs: 0.82, 0.74, 0.73 and 0.66, P<0.001). Advanced stage at diagnosis was more frequent in more deprived women with breast cancer (OR: 1.23 for most compared with least deprived, P=0.002), and in men with lung cancer (OR: 1.14, P=0.011). The observed patterns were robust to sensitivity analyses approaches for handling missing stage data under different assumptions. Conclusion: Interventions to help improve the timeliness of diagnosis of different cancers should be targeted at specific age groups. © 2012 Cancer Research UK All rights reserved

Laser-wakefield accelerators as hard x-ray sources for 3D medical imaging of human bone

A bright μm-sized source of hard synchrotron x-rays (critical energy Ecrit > 30 keV) based on the betatron oscillations of laser wakefield accelerated electrons has been developed. The potential of this source for medical imaging was demonstrated by performing micro-computed tomography of a human femoral trabecular bone sample, allowing full 3D reconstruction to a resolution below 50 μm. The use of a 1 cm long wakefield accelerator means that the length of the beamline (excluding the laser) is dominated by the x-ray imaging distances rather than the electron acceleration distances. The source possesses high peak brightness, which allows each image to be recorded with a single exposure and reduces the time required for a full tomographic scan. These properties make this an interesting laboratory source for many tomographic imaging applications

Observation of absorbing aerosols above clouds over the south-east Atlantic Ocean from the geostationary satellite SEVIRI – Part 1: Method description and sensitivity

This is the final version. Available on open access from EGU via the DOI in this recordData availability: The data used for this study are available from the corresponding author, FP, upon reasonable request.High-temporal-resolution observations from satellites have a great potential for studying the impact of biomass burning aerosols and clouds over the south-east Atlantic Ocean (SEAO). This paper presents a method developed to simultaneously retrieve aerosol and cloud properties in aerosol above-cloud conditions from the geostationary instrument Meteosat Second Generation/Spinning Enhanced Visible and Infrared Imager (MSG/SEVIRI). The above-cloud aerosol optical thickness (AOT), the cloud optical thickness (COT) and the cloud droplet effective radius (CER) are derived from the spectral contrast and the magnitude of the signal measured in three channels in the visible to shortwave infrared region. The impact of the absorption from atmospheric gases on the satellite signal is corrected by applying transmittances calculated using the water vapour profiles from a Met Office forecast model. The sensitivity analysis shows that a 10 % error on the humidity profile leads to an 18.5 % bias on the above-cloud AOT, which highlights the importance of an accurate atmospheric correction scheme. In situ measurements from the CLARIFY-2017 airborne field campaign are used to constrain the aerosol size distribution and refractive index that is assumed for the aforementioned retrieval algorithm. The sensitivities in the retrieved AOT, COT and CER to the aerosol model assumptions are assessed. Between 09:00 and 15:00 UTC, an uncertainty of 40 % is estimated on the above-cloud AOT, which is dominated by the sensitivity of the retrieval to the single-scattering albedo. The absorption AOT is less sensitive to the aerosol assumptions with an uncertainty generally lower than 17 % between 09:00 and 15:00 UTC. Outside of that time range, as the scattering angle decreases, the sensitivity of the AOT and the absorption AOT to the aerosol model increases. The retrieved cloud properties are only weakly sensitive to the aerosol model assumptions throughout the day, with biases lower than 6 % on the COT and 3 % on the CER. The stability of the retrieval over time is analysed. For observations outside of the backscattering glory region, the time series of the aerosol and cloud properties are physically consistent, which confirms the ability of the retrieval to monitor the temporal evolution of aerosol above-cloud events over the SEAO.Research Council of NorwayNetB

A method to represent subgrid-scale updraft velocity in kilometer-scale models: Implication for aerosol activation

©2014. American Geophysical Union. All Rights Reserved. Updraft velocities strongly control the activation of aerosol particles or that component that act as cloud condensation nuclei (CCN). For kilometer-scale models, vertical motions are partially resolved but the subgrid-scale (SGS) contribution needs to be parametrized or constrained to properly represent the activation of CCNs. This study presents a method to estimate the missing SGS (or unresolved) contribution to vertical velocity variability in models with horizontal grid sizes up to ∼2 km. A framework based on Large Eddy Simulations (LES) and high-resolution aircraft observations of stratocumulus and shallow cumulus clouds has been developed and applied to output from the United Kingdom Met Office Unified Model (UM) operating at kilometer-scale resolutions in numerical weather prediction configuration. For a stratocumulus deck simulation, we show that the UM 1 km model underestimates significantly the variability of updraft velocity with an averaged cloud base standard deviation between 0.04 and 0.05 m s-1 compared to LES and aircraft estimates of 0.38 and 0.54 m s-1, respectively. Once the SGS variability is considered, the UM corrected averages are between 0.34 and 0.44 m s-1. Off-line calculations of CCN-activated fraction using an activation scheme have been performed to illustrate the implication of including the SGS vertical velocity. It suggests increased CCN-activated fraction from 0.52 to 0.89 (respectively, 0.10 to 0.54) for a clean (respectively, polluted) aerosol environment for simulations with a 1 km horizontal grid size. Our results highlight the importance of representing the SGS vertical velocity in kilometer-scale simulations of aerosol-cloud interactions. Key PointsWe seek to improve the aerosol activation behavior in kilometer-scale modelsA method to constrain the subgrid-scale updraft velocity is presentedWe highlight the potential implication for aerosol-cloud interactions modeling.This work was funded by the Natural Environment Research Council (NERC) Aerosol-Cloud Interactions—a Directed Programme to Reduce Uncertainty in Forcing (ACID-PRUF) programme, grant code NE/I020121/1. The authors thank the scientists, ground crew and aircrew of the FAAM BAe-146 and C-130 aircraft, who were instrumental in the collection of the data analyzed from the VOCALS-REx campaign. The C-130 data were provided by NCAR/EOL, under sponsorship of the National Science Foundation. http://data.eol. ucar.edu/. The FAAM BAe-146 is jointly funded by the UK Met Office and the Natural Environment Research Council. VOCALS was supported by the UK Met Office and NERC, the latter through grant NE/F019874/1

A survey of physicians knowledge regarding awareness of maternal alcohol use and the diagnosis of FAS.

BACKGROUND: Alcohol is the most widely used drug in the world that is a human teratogen whose use among women of childbearing age has been steadily increasing. It is also probable that Fetal Alcohol Syndrome is under diagnosed by physicians. The objectives of this study were twofold: 1) to evaluate the experience, knowledge and confidence of family physicians with respect to the diagnosis of FAS and 2) to evaluate physicians awareness of maternal drinking patterns. METHODS AND PARTICIPANTS: A multiple choice anonymous questionnaire was sent to a randomly selected group of family physicians in the Metropolitan Toronto area. RESULTS: There was a 73% (75/103) total response rate; Overall, 6/75 (8%) of family physicians reported that they had actually diagnosed a child with FAS. 17.9% had suspicions but did not make a diagnosis and 12.7% reported making a referral to confirm the diagnosis. Physician rated confidence in the ability to diagnosis FAS was low, with 49% feeling they had very little confidence. 75% reported counselling pregnant women and 60.8% reported counselling childbearing women in general on the use of alcohol. When asked what screening test they used to detect the use of alcohol, 75% described frequency/quantity. Not a single respondent identified using the current accepted screening method for alcohol use (TWEAK) which is recommended by The Centre for Addiction and Mental Health. CONCLUSIONS: Family physicians do not feel confident about diagnosing FAS. None of the physicians were aware of the current screening methods to accurately gage alcohol use in pregnant and childbearing wome

Diagnosing human African trypanosomiasis in Angola using a card agglutination test: observational study of active and passive case finding strategies.

OBJECTIVE: To assess the operational feasibility of detecting human African trypanosomiasis by active and passive case finding using the card agglutination test with serial dilution of serum to guide treatment. SETTING: Trypanosomiasis control programme in the Negage focus, northern Angola, during a period of civil war. DESIGN: Observational study. PARTICIPANTS: 359 patients presenting themselves to health centres with symptoms (passive case finding) and 14,446 people actively screened in villages. MAIN OUTCOME MEASURES: Whole blood and serological tests at different dilutions using the card agglutination test, and detection of parasites by microscopy. RESULTS: Active case finding identified 251 people with a positive card agglutination test result, 10 of whom had confirmed parasites. In those presenting for investigation 34 of 51 with a positive card agglutination test result at the dilution of 1:8 or more used to guide treatment had parasites in blood, lymph node fluid, or cerebrospinal fluid, compared with 10 of 76 in those detected by active case finding: positive predictive values of 67% for passive case detection and 13% for active case detection. Only at a cut-off dilution more than 1:32 was the positive predictive value in active case detection reasonable (46%) and at this dilution 40% of microscopically proved cases were missed. CONCLUSIONS: The card agglutination test is useful for initial screening in active detection of cases with human African trypanosomiasis but, given the toxicity of the drugs, serology using the card agglutination test should be not used alone to guide treatment after active case finding. A second confirmatory test is needed

Holographic metastability

We show how supersymmetric QCD in a slice of AdS can naturally acquire metastable vacua. The formulation closely follows that of Intriligator, Seiberg and Shih (ISS), with an "electric" sector on the UV brane and a "magnetic" sector on the IR brane. However the 't Hooft anomaly matching that constrains the Seiberg duality central to ISS is replaced by anomaly inflow and cancellation, and the source of strong coupling is the CFT to which the theory couples rather than the gauge groups. The theory contains an anomaly free R-symmetry that, when broken by UV effects, leads to an O'Raifeartaigh model on the IR brane. In contrast to ISS, the R-symmetry breaking in the UV can be maximal, and yet the R-symmetry breaking in the IR theory remains under strict control: there is no need for retrofitting of small parameters.Comment: 20 pages, 2 figure

A slice of AdS_5 as the large N limit of Seiberg duality

A slice of AdS_5 is used to provide a 5D gravitational description of 4D strongly-coupled Seiberg dual gauge theories. An (electric) SU(N) gauge theory in the conformal window at large N is described by the 5D bulk, while its weakly coupled (magnetic) dual is confined to the IR brane. This framework can be used to construct an N = 1 MSSM on the IR brane, reminiscent of the original Randall-Sundrum model. In addition, we use our framework to study strongly-coupled scenarios of supersymmetry breaking mediated by gauge forces. This leads to a unified scenario that connects the extra-ordinary gauge mediation limit to the gaugino mediation limit in warped space.Comment: 47 Pages, axodraw4j.st