6,214 research outputs found
A method of amputation at the ankle-joint which leaves the heel intact: Tibio-calcaneal resection, with amputation of the remainder of the foot. Notes and illustrations of seven cases
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Submission by Lancaster University for Defra consultation on the Draft Flood and Water Management Bill.
Perspectives on resilience from households in Hull – response to Defra consultation on policy options for promoting property-level flood protection and resilience
Locally appropriate response and recovery – submission by Lancaster University for Defra consultation on the National Flood Emergency Framework.
The ongoing experience of recovery for households in Hull – response to the Pitt Review Interim Report Learning the lessons from the 2007 floods, Chapter 9 of the Pitt Review Interim Report
Brainstem metastases treated with Gamma Knife stereotactic radiosurgery: the Indiana University Health experience
Brainstem metastases offer a unique challenge in cancer treatment, yet stereotactic radiosurgery (SRS) has proven to be an effective modality in treating these tumors. This report discusses the clinical outcomes of patients with brainstem metastases treated at Indiana University with Gamma Knife (GK) radiosurgery from 2008 to 2016. 19 brainstem metastases from 14 patients who had follow-up brain imaging were identified. Median tumor volume was 0.04 cc (range: 0.01-2.0 cc). Median prescribed dose was 17.5 Gy to the 50% isodose line (range: 14-22 Gy). Median survival after GK SRS treatment to brainstem lesion was 17.2 months (range: 2.8-45.6 months). The experience at Indiana University confirms the safety and efficacy of range of GK SRS prescription doses (14-22 Gy) to brainstem metastases
Inflation without Inflaton(s)
We propose a model for early universe cosmology without the need for
fundamental scalar fields. Cosmic acceleration and phenomenologically viable
reheating of the universe results from a series of energy transitions, where
during each transition vacuum energy is converted to thermal radiation. We show
that this `cascading universe' can lead to successful generation of adiabatic
density fluctuations and an observable gravity wave spectrum in some cases,
where in the simplest case it reproduces a spectrum similar to slow-roll models
of inflation. We also find the model provides a reasonable reheating
temperature after inflation ends. This type of model may also be relevant for
addressing the smallness of the vacuum energy today.Comment: 13 pages, 4 figures, published versio
Effects of Proton Center Closure on Pediatric Case Volume and Resident Education at an Academic Cancer Center
Purpose
To analyze effects of closure of an academic proton treatment center (PTC) on pediatric case volume, distribution, and resident education.
Methods and Materials
This was a review of 412 consecutive pediatric (age ≤18 years) cases treated at a single institution from 2012 to 2016. Residents' Accreditation Council for Graduate Medical Education case logs for the same years were also analyzed. Characteristics of the patient population and resident case volumes before and after closure of the PTC are reported.
Results
Overall pediatric new starts declined by approximately 50%, from 35 to 70 per 6 months in 2012 to 2014 to 22 to 30 per 6 months in 2015 to 2016. Central nervous system (CNS) case volume declined sharply, from 121 patients treated in 2012 to 2015 to 18 patients in 2015 to 2016. In 2012 to 2014 our institution treated 36, 24, and 17 patients for medulloblastoma/intracranial primitive neuroectodermal tumor, ependymoma, and low-grade glioma, respectively, compared with 0, 1, and 1 patient(s) in 2015 to 2016. Forty-nine patients were treated with craniospinal radiation (CSI) from 2012 to 2014, whereas only 2 patients underwent CSI between 2015 and 2016. Hematologic malignancy patient volume and use of total body irradiation remained relatively stable. Patients treated when the PTC was open were significantly younger (9.1 vs 10.7 years, P=.010) and their radiation courses were longer (35.4 vs 20.9 days, P<.0001) than those treated after its closure. Resident case logs showed only a small decline in total pediatric cases, because the percentage of pediatric cases covered by residents increased after PTC closure; however, residents logged fewer CNS cases after PTC closure versus before.
Conclusions
Overall pediatric case volume decreased after PTC closure, as did the number of patients treated for potentially curable CNS tumors. Our findings raise important questions regarding resident training in pediatric radiation oncology as these cases become increasingly concentrated at specialized centers
Nearly Half of Metastatic Brain Disease Patients Prescribed 10 Fractions of Whole-Brain Radiation Therapy Die Without Completing Treatment
Metallicities, dust and molecular content of a QSO-Damped Lyman-{\alpha} system reaching log N (H i) = 22: An analog to GRB-DLAs
We present the elemental abundance and H2 content measurements of a Damped
Lyman-{\alpha} (DLA) system with an extremely large H i column density, log N(H
i) (cm-2) = 22.0+/-0.10, at zabs = 3.287 towards the QSO SDSS J 081634+144612.
We measure column densities of H2, C i, C i^*, Zn ii, Fe ii, Cr ii, Ni ii and
Si ii from a high signal-to-noise and high spectral resolution VLT-UVES
spectrum. The overall metallicity of the system is [Zn/H] = -1.10 +/- 0.10
relative to solar. Two molecular hydrogen absorption components are seen at z =
3.28667 and 3.28742 (a velocity separation of \approx 52 km s-1) in rotational
levels up to J = 3. We derive a total H2 column density of log N(H2) (cm-2) =
18.66 and a mean molecular fraction of f = 2N(H2)/[2N(H2) + N(H i)] =
10-3.04+/-0.37, typical of known H2-bearing DLA systems. From the observed
abundance ratios we conclude that dust is present in the Interstellar Medium
(ISM) of this galaxy, with a enhanced abundance in the H2-bearing clouds.
However, the total amount of dust along the line of sight is not large and does
not produce any significant reddening of the background QSO. The physical
conditions in the H2-bearing clouds are constrained directly from the column
densities of H2 in different rotational levels, C i and C i^* . The kinetic
temperature is found to be T = 75 K and the particle density lies in the range
nH = 50-80 cm-3 . The neutral hydrogen column density of this DLA is similar to
the mean H i column density of DLAs observed at the redshift of {\gamma}-ray
bursts (GRBs). We explore the relationship between GRB-DLAs and high column
density end of QSO-DLAs finding that the properties (metallicity and depletion)
of DLAs with log N(H i) > 21.5 in the two populations do not appear to be
significantly different
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