126 research outputs found
Exploring global barriers to optimal ovarian cancer care:thematic analysis
Objective: To explore the barriers to ovarian cancer care, as reported in the open ended responses of a global expert opinion survey, highlighting areas for improvement in global ovarian cancer care. Potential solutions to overcome these barriers are proposed. Methods: Data from the expert opinion survey, designed to assess the organization of ovarian cancer care worldwide, were analyzed. The survey was distributed across a global network of physicians. We examined free text, open ended responses concerning the barriers to ovarian cancer care. A qualitative thematic analysis was conducted to identify, analyze, and report meaningful patterns within the data. Results: A total of 1059 physicians from 115 countries completed the survey, with 438 physicians from 93 countries commenting on the barriers to ovarian cancer care. Thematic analysis gave five major themes, regardless of income category or location: societal factors, inadequate resources in hospital, economic barriers, organization of the specialty, and need for early detection. Suggested solutions include accessible resource stratified guidelines, multidisciplinary teamwork, public education, and development of gynecological oncology training pathways internationally. Conclusions: This analysis provides an international perspective on the main barriers to optimal ovarian cancer care. The themes derived from our analysis highlight key target areas to focus efforts to reduce inequalities in global care. Future regional analysis involving local representatives will enable country specific recommendations to improve the quality of care and ultimately to work towards closing the care gap
Exploring global barriers to optimal ovarian cancer care:thematic analysis
Objective: To explore the barriers to ovarian cancer care, as reported in the open ended responses of a global expert opinion survey, highlighting areas for improvement in global ovarian cancer care. Potential solutions to overcome these barriers are proposed. Methods: Data from the expert opinion survey, designed to assess the organization of ovarian cancer care worldwide, were analyzed. The survey was distributed across a global network of physicians. We examined free text, open ended responses concerning the barriers to ovarian cancer care. A qualitative thematic analysis was conducted to identify, analyze, and report meaningful patterns within the data. Results: A total of 1059 physicians from 115 countries completed the survey, with 438 physicians from 93 countries commenting on the barriers to ovarian cancer care. Thematic analysis gave five major themes, regardless of income category or location: societal factors, inadequate resources in hospital, economic barriers, organization of the specialty, and need for early detection. Suggested solutions include accessible resource stratified guidelines, multidisciplinary teamwork, public education, and development of gynecological oncology training pathways internationally. Conclusions: This analysis provides an international perspective on the main barriers to optimal ovarian cancer care. The themes derived from our analysis highlight key target areas to focus efforts to reduce inequalities in global care. Future regional analysis involving local representatives will enable country specific recommendations to improve the quality of care and ultimately to work towards closing the care gap
Exploring international differences in ovarian cancer care: a survey report on global patterns of care, current practices, and barriers
OBJECTIVE: Although global disparities in survival rates for patients with ovarian cancer have been described, variation in care has not been assessed globally. This study aimed to evaluate global ovarian cancer care and barriers to care. METHODS: A survey was developed by international ovarian cancer specialists and was distributed through networks and organizational partners of the International Gynecologic Cancer Society, the Society of Gynecologic Oncology, and the European Society of Gynecological Oncology. Respondents received questions about care organization. Outcomes were stratified by World Bank Income category and analyzed using descriptive statistics and logistic regressions. RESULTS: A total of 1059 responses were received from 115 countries. Respondents were gynecological cancer surgeons (83%, n=887), obstetricians/gynecologists (8%, n=80), and other specialists (9%, n=92). Income category breakdown was as follows: high-income countries (46%), upper-middle-income countries (29%), and lower-middle/low-income countries (25%). Variation in care organization was observed across income categories. Respondents from lower-middle/low-income countries reported significantly less frequently that extensive resections were routinely performed during cytoreductive surgery. Furthermore, these countries had significantly fewer regional networks, cancer registries, quality registries, and patient advocacy groups. However, there is also scope for improvement in these components in upper-middle/high-income countries. The main barriers to optimal care for the entire group were patient co-morbidities, advanced presentation, and social factors (travel distance, support systems). High-income respondents stated that the main barriers were lack of surgical time/staff and patient preferences. Middle/low-income respondents additionally experienced treatment costs and lack of access to radiology/pathology/genetic services as main barriers. Lack of access to systemic agents was reported by one-third of lower-middle/low-income respondents. CONCLUSIONS: The current survey report highlights global disparities in the organization of ovarian cancer care. The main barriers to optimal care are experienced across all income categories, while additional barriers are specific to income levels. Taking action is crucial to improve global care and strive towards diminishing survival disparities and closing the care gap
The ALMA REBELS Survey: The First Infrared Luminosity Function Measurement at $\mathbf{z \sim 7}
We present the first observational infrared luminosity function (IRLF)
measurement in the Epoch of Reionization (EoR) based on a UV-selected galaxy
sample with ALMA spectroscopic observations. Our analysis is based on the ALMA
large program Reionization Era Bright Emission Line Survey (REBELS), which
targets 42 galaxies at with [CII] 158\micron line scans.
16 sources exhibit a dust detection, 15 of which are also spectroscopically
confirmed through the [CII] line. The IR luminosities of the sample range from
to 12.2. Using the UVLF as a proxy to derive the
effective volume for each of our target sources, we derive IRLF estimates, both
for detections and for the full sample including IR luminosity upper limits.
The resulting IRLFs are well reproduced by a Schechter function with the
characteristic luminosity of . Our
observational results are in broad agreement with the average of predicted
IRLFs from simulations at . Conversely, our IRLFs lie significantly
below lower redshift estimates, suggesting a rapid evolution from to
, into the reionization epoch. The inferred obscured contribution to
the cosmic star-formation rate density at amounts to
which is at
least 10\% of UV-based estimates. We conclude that the presence of dust
is already abundant in the EoR and discuss the possibility of unveiling larger
samples of dusty galaxies with future ALMA and JWST observations.Comment: 9 pages, 5 figure
Reionization Era Bright Emission Line Survey: selection and characterization of luminous interstellar medium reservoirs in the z > 6.5 universe
The Reionization Era Bright Emission Line Survey (REBELS) is a cycle-7 ALMA Large Program (LP) that is identifying and performing a first characterization of many of the most luminous star-forming galaxies known in the z > 6.5 universe. REBELS is providing this probe by systematically scanning 40 of the brightest UV-selected galaxies identified over a 7 deg2 area for bright [C ii]158 μm and [O iii]88 μm lines and dust-continuum emission. Selection of the 40 REBELS targets was done by combining our own and other photometric selections, each of which is subject to extensive vetting using three completely independent sets of photometry and template-fitting codes. Building on the observational strategy deployed in two pilot programs, we are increasing the number of massive interstellar medium (ISM) reservoirs known at z > 6.5 by ∼4-5× to >30. In this manuscript, we motivate the observational strategy deployed in the REBELS program and present initial results. Based on the first-year observations, 18 highly significant ≥ 7σ [C ii]158 μm lines have already been discovered, the bulk of which (13/18) also show ≥3.3σ dust-continuum emission. These newly discovered lines more than triple the number of bright ISM-cooling lines known in the z > 6.5 universe, such that the number of ALMA-derived redshifts at z > 6.5 rival Lyα discoveries. An analysis of the completeness of our search results versus star formation rate (SFR) suggests an ∼79% efficiency in scanning for [C ii]158 μm when the SFRUV+IR is >28 M yr-1. These new LP results further demonstrate ALMA's efficiency as a "redshift machine,"particularly in the Epoch of Reionization
The ALMA REBELS survey: the dust content of z ∼7 Lyman break galaxies
We include a fully coupled treatment of metal and dust enrichment into the Delphi semi-analytic model of galaxy formation to explain the dust content of 13 Lyman break galaxies (LBGs) detected by the Atacama Large millimetre Array (ALMA) REBELS Large Program at z ≃ 7. We find that the galaxy dust mass, Md, is regulated by the combination of Type II supernova dust production, astration, shock destruction, and ejection in outflows; grain growth (with a standard time-scale τ0 = 30 Myr) plays a negligible role. The model predicts a dust-to-stellar mass ratio of ~ 0.07-0.1per cent and a UV-to-total star formation rate relation such that log(ψUV) = -0.05 [log(ψ)]2 + 0.86 log(ψ) - 0.05 (implying that 55-80 per cent of the star formation is obscured) for REBELS galaxies with stellar mass M∗ = 109-1010 M⊙. This relation reconciles the intrinsic UV luminosity of LBGs with their observed luminosity function at z = 7. However, 2 out of the 13 systems show dust-to-stellar mass ratios (~0.94-1.1per cent) that are up to 18 times larger than expected from the fiducial relation. Due to the physical coupling between dust and metal enrichment, even decreasing τ0 to very low values (0.3 Myr) only increases the dust-to-stellar mass ratio by a factor of ∼2. Given that grain growth is not a viable explanation for such high observed ratios of the dust-to-stellar mass, we propose alternative solutions
The ALMA REBELS survey: obscured star formation in massive Lyman-break galaxies at z = 4-8 revealed by the IRX- and relations
We investigate the degree of dust obscured star formation in 49 massive
() Lyman-break galaxies (LBGs) at
- observed as part of the ALMA Reionization Era Bright Emission
Line Survey (REBELS) large program. By creating deep stacks of the photometric
data and the REBELS ALMA measurements we determine the average rest-frame UV,
optical and far-infrared (FIR) properties which reveal a significant fraction
(-) of obscured star formation, consistent with
previous studies. From measurements of the rest-frame UV slope, we find that
the brightest LBGs at these redshifts show bluer () colours
than expected from an extrapolation of the colour-magnitude relation found at
fainter magnitudes. Assuming a modified blackbody spectral-energy distribution
(SED) in the FIR (with dust temperature of and
), we find that the REBELS sources are in agreement with
the local ''Calzetti-like'' starburst Infrared-excess (IRX)- relation.
By reanalysing the data available for 108 galaxies at - from the
ALPINE ALMA large program using a consistent methodology and assumed FIR SED,
we show that from -, massive galaxies selected in the rest-frame
UV have no appreciable evolution in their derived IRX- relation. When
comparing the IRX- relation derived from the combined ALPINE and
REBELS sample to relations established at , we find a deficit in the
IRX, indicating that at the proportion of obscured star formation is
lower by a factor of at a given a . Our IRX-
results are in good agreement with the high-redshift predictions of simulations
and semi-analytic models for galaxies with similar stellar masses
and SFRs.Comment: 18 pages, 10 figures, 2 tables (plus 1 figure and 2 tables in the
appendix). Updated to match MNRAS accepted version after minor correction
Extremely deep 150 MHz source counts from the LoTSS Deep Fields
International audienceWith the advent of new generation low-frequency telescopes, such as the LOw Frequency ARray (LOFAR), and improved calibration techniques, we have now started to unveil the subgigahertz radio sky with unprecedented depth and sensitivity. The LOFAR Two Meter Sky Survey (LoTSS) is an ongoing project in which the whole northern radio sky will be observed at 150 MHz with a sensitivity better than 100 μJy beam−1 at a resolution of 6′′. Additionally, deeper observations are planned to cover smaller areas with higher sensitivity. The Lockman Hole, the Boötes, and the Elais-N1 regions are among the most well known northern extra-galactic fields and the deepest of the LoTSS Deep Fields so far. We exploited these deep observations to derive the deepest radio source counts at 150 MHz to date. Our counts are in broad agreement with those from the literature and show the well known upturn at ≤1 mJy, mainly associated with the emergence of the star-forming galaxy population. More interestingly, our counts show, for the first time a very pronounced drop around S ~ 2 mJy, which results in a prominent “bump” at sub-mJy flux densities. Such a feature was not observed in previous counts’ determinations (neither at 150 MHz nor at a higher frequency). While sample variance can play a role in explaining the observed discrepancies, we believe this is mostly the result of a careful analysis aimed at deblending confused sources and removing spurious sources and artifacts from the radio catalogs. This “drop and bump” feature cannot be reproduced by any of the existing state-of-the-art evolutionary models, and it appears to be associated with a deficiency of active galactic nuclei (AGN) at an intermediate redshift (1 < z < 2) and an excess of low-redshift (z < 1) galaxies and/or AGN.Key words: galaxies: evolution / surveys / radio continuum: genera
The ALMA REBELS Survey : Average [CII] 158μm Sizes of Star-forming Galaxies from z~7 to z~4
We present the average [C II] 158 μm emission line sizes of UV-bright star-forming galaxies at z ~ 7. Our results are derived from a stacking analysis of [C II] 158 μm emission lines and dust continua observed by the Atacama Large Millimeter/submillimeter Array (ALMA), taking advantage of the large program Reionization Era Bright Emission Line Survey. We find that the average [C II] emission at z ~ 7 has an effective radius re of 2.2 ± 0.2 kpc. It is ≥2× larger than the dust continuum and the rest-frame UV emission, in agreement with recently reported measurements for z ≤ 6 galaxies. Additionally, we compared the average [C II] size with 4 < z < 6 galaxies observed by the ALMA Large Program to INvestigate [C II] at Early times (ALPINE). By analyzing [C II] sizes of 4 < z < 6 galaxies in two redshift bins, we find an average [C II] size of re = 2.2 ± 0.2 kpc and re = 2.5 ± 0.2 kpc for z ~ 5.5 and z ~ 4.5 galaxies, respectively. These measurements show that star-forming galaxies, on average, show no evolution in the size of the [C II] 158 μm emitting regions at redshift between z ~ 7 and z ~ 4. This finding suggests that the star-forming galaxies could be morphologically dominated by gas over a wide redshift range
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