The effectiveness of varicocele embolisation for the treatment of varicocele related orchalgia

PURPOSE: Orchalgia is a common problem with varicoceles however the association between varicocele embolisation for the treatment of varicocele related pain has not been widely investigated. We aim to investigate the effectiveness of varicocele embolisation for the treatment of orchalgia secondary to varicoceles; and to see if pre-embolisation pain scores can be used to predict treatment outcomes. METHODS: A prospectively collected database of patients undergoing varicocele embolisation for pain was analysed over a 10-year period. Pain scores were assessed with a 10-point visual analogue score. Analgesia requirements and satisfaction scores were assessed with questionnaires. RESULTS: Total of 96 cases. Median age was 34 years old. Median pain scores reduced significantly following embolisation (p < 0.001). 74% had reduced pain (30% of these had resolution of pain), 24% had no change in symptoms and 1% had worsening pain. Those with moderate or severe pain had a reduction of pain in 81 and 79% of cases respectively, however 64% of cases with mild pain did not experience any benefit. We also noted a reduction in analgesia requirements and a median satisfaction score of 8/10. CONCLUSION: Primary varicocele embolisation can successfully reduce varicocele related orchalgia. It works best in those with moderate or severe pain. The majority of patients with mild pain may not experience any benefit so should be counseled appropriately. The classification of patients into those with mild, moderate or severe symptoms prior to embolisation should be done, so robust consenting can be performed

Harmonic analysis of cosmic microwave background data I: ring reductions and point-source catalogue

We present a harmonic model for the data analysis of an all-sky cosmic microwave background survey, such as Planck, where the survey is obtained through ring-scans of the sky. In this model, resampling and pixelisation of the data are avoided. The spherical transforms of the sky at each frequency, in total intensity and polarization, as well as the bright-point-source catalogue, are derived directly from the data reduced onto the rings. Formal errors and the most significant correlation coefficients for the spherical transforms of the frequency maps are preserved. A clean and transparent path from the original samplings in the time domain to the final scientific products is thus obtained. The data analysis is largely based on Fourier analysis of rings; the positional stability of the instrument's spin axis during these scans is a requirement for the data model and is investigated here for the Planck satellite. Brighter point sources are recognised and extracted as part of the ring reductions and, on the basis of accumulated data, used to build a catalogue. The analysis of the rings is performed iteratively, involving a range of geometric and detector response calibrations. The reconstructed spherical transforms of the sky form the input to the subsequent analysis stages. Although the methods in this paper were developed with the data processing for Planck in mind, many aspects should have wider application, such as in the construction of real-space pixelised maps. (Abridged)Comment: 20 pages, 9 figures. To appear in MNRA

All-sky convolution for polarimetry experiments

We discuss all-sky convolution of the instrument beam with the sky signal in polarimetry experiments, such as the Planck mission which will map the temperature anisotropy and polarization of the cosmic microwave background (CMB). To account properly for stray light (from e.g. the galaxy, sun, and planets) in the far side-lobes of such an experiment, it is necessary to perform the beam convolution over the full sky. We discuss this process in multipole space for an arbitrary beam response, fully including the effects of beam asymmetry and cross-polarization. The form of the convolution in multipole space is such that the Wandelt-Gorski fast technique for all-sky convolution of scalar signals (e.g. temperature) can be applied with little modification. We further show that for the special case of a pure co-polarized, axisymmetric beam the effect of the convolution can be described by spin-weighted window functions. In the limits of a small angle beam and large Legendre multipoles, the spin-weight 2 window function for the linear polarization reduces to the usual scalar window function used in previous analyses of beam effects in CMB polarimetry experiments. While we focus on the example of polarimetry experiments in the context of CMB studies, we emphasise that the formalism we develop is applicable to anisotropic filtering of arbitrary tensor fields on the sphere.Comment: 8 pages, 1 figure; Minor changes to match version accepted by Phys. Rev.

A mixed methods systematic review on the effects of arts interventions for children and young people at‐risk of offending, or who have offended on behavioural, psychosocial, cognitive and offending outcomes: A systematic review

Background: Young people who enter the justice system experience complex health and social needs, and offending behaviour is increasingly recognised as a public health problem. Arts interventions can be used with the aim of preventing or reducing offending or reoffending. Objectives: 1. To evaluate evidence on the effectiveness and impact of arts interventions on keeping children and young people safe from involvement in violence and crime. 2. To explore factors impacting the implementation of arts interventions, and barriers and facilitators to participation and achievement of intended outcomes. 3. To develop a logic model of the processes by which arts interventions might work in preventing offending behaviours. Search Methods: We searched AMED, Academic Search Complete; APA PsycInfo; CINAHL Plus; ERIC; SocIndex; SportDiscus, Medline, CENTRAL, Web of Science, Scopus, PTSDPubs and Performing Arts Periodicals Database, Sage, the US National Criminal Justice Reference Service, the Global Policing and British Library EThOS databases, and the National Police Library from inception to January 2023 without language restrictions. Selection Criteria: We included randomised and non‐randomised controlled trials and quasi‐experimental study designs. We included qualitative studies conducted alongside intervention trials investigating experiences and perceptions of participants, and offering insight into the barriers and facilitators to delivering and receiving arts interventions. We included qualitative and mixed methods studies focused on delivery of arts interventions. We included studies from any global setting. We included studies with CYP (8–25 years) who were identified as at‐risk of offending behaviour (secondary populations) or already in the criminal justice system (tertiary populations). We included studies of interventions involving arts participation as an intervention on its own or alongside other interventions. Primary outcomes were: (i) offending behaviour and (ii) anti‐pro‐social behaviours. Secondary outcomes were: participation/attendance at arts interventions, educational attainment, school attendance and engagement and exclusions, workplace engagement, wellbeing, costs and associated economic outcomes and adverse events. Data Collection and Analysis: We included 43 studies (3 quantitative, 38 qualitative and 2 mixed methods). We used standard methodological procedures expected by The Campbell Collaboration. We used GRADE and GRADE CERQual to assess the certainty of and confidence in the evidence for quantitative and qualitative data respectively. Main Results: We found insufficient evidence from quantitative studies to support or refute the effectiveness of arts interventions for CYP at‐risk of or who have offended for any outcome. Qualitative evidence suggested that arts interventions may lead to positive emotions, the development of a sense of self, successful engagement in creative practices, and development of positive personal relationships. Arts interventions may need accessible and flexible delivery and are likely to be engaging if they have support from staff, family and community members, are delivered by professional artists, involve culturally relevant activity, a youth focus, regularity and a sustainable strategy. We found limited evidence that a lack of advocacy, low funding, insufficient wider support from key personnel in adjacent services could act as barriers to success. Methodological limitations resulted in a judgement of very low confidence in these findings. Authors' Conclusions: We found insufficient evidence from quantitative studies to support or refute the effectiveness of arts interventions for CYP at‐risk of offending or who have offended for any outcome. We report very low confidence about the evidence for understanding the processes influencing the successful design and delivery of arts interventions in this population of CYP and their impact on behavioural, psychosocial, cognitive and offending outcomes

Transcriptional Regulation of T-Cell Lipid Metabolism: Implications for Plasma Membrane Lipid Rafts and T-Cell Function

It is well established that cholesterol and glycosphingolipids are enriched in the plasma membrane (PM) and form signalling platforms called lipid rafts, essential for T-cell activation and function. Moreover, changes in PM lipid composition affect the biophysical properties of lipid rafts and have a role in defining functional T-cell phenotypes. Here we review the role of transcriptional regulators of lipid metabolism including liver X receptors α/β (LXR/LXRβ), peroxisome proliferator-activated receptor γ (PPAR-γ), estrogen receptors α/β (ERα/β) and sterol regulatory element-binding proteins (SREBPs) in T-cells. These receptors lie at the interface between lipid metabolism and immune cell function and are endogenously activated by lipids and/or hormones. Importantly, they regulate cellular cholesterol, fatty acid, glycosphingolipid and phospholipid levels but are also known to modulate a broad spectrum of immune responses. The current evidence supporting a role for lipid metabolism pathways in controlling immune cell activation by influencing PM lipid raft composition in health and disease, and the potential for targeting lipid biosynthesis pathways to control unwanted T-cell activation in autoimmunity is reviewed

Exploring Cosmic Origins with CORE: Cosmological Parameters

We forecast the main cosmological parameter constraints achievable with theCORE space mission which is dedicated to mapping the polarisation of the CosmicMicrowave Background (CMB). CORE was recently submitted in response to ESA'sfifth call for medium-sized mission proposals (M5). Here we report the resultsfrom our pre-submission study of the impact of various instrumental options, inparticular the telescope size and sensitivity level, and review the great,transformative potential of the mission as proposed. Specifically, we assessthe impact on a broad range of fundamental parameters of our Universe as afunction of the expected CMB characteristics, with other papers in the seriesfocusing on controlling astrophysical and instrumental residual systematics. Inthis paper, we assume that only a few central CORE frequency channels areusable for our purpose, all others being devoted to the cleaning ofastrophysical contaminants. On the theoretical side, we assume LCDM as ourgeneral framework and quantify the improvement provided by CORE over thecurrent constraints from the Planck 2015 release. We also study the jointsensitivity of CORE and of future Baryon Acoustic Oscillation and Large ScaleStructure experiments like DESI and Euclid. Specific constraints on the physicsof inflation are presented in another paper of the series. In addition to thesix parameters of the base LCDM, which describe the matter content of aspatially flat universe with adiabatic and scalar primordial fluctuations frominflation, we derive the precision achievable on parameters like thosedescribing curvature, neutrino physics, extra light relics, primordial heliumabundance, dark matter annihilation, recombination physics, variation offundamental constants, dark energy, modified gravity, reionization and cosmicbirefringence. (ABRIDGED

Planck 2015 results. XIV. Dark energy and modified gravity

We study the implications of Planck data for models of dark energy (DE) and modified gravity (MG), beyond the cosmological constant scenario. We start with cases where the DE only directly affects the background evolution, considering Taylor expansions of the equation of state, principal component analysis and parameterizations related to the potential of a minimally coupled DE scalar field. When estimating the density of DE at early times, we significantly improve present constraints. We then move to general parameterizations of the DE or MG perturbations that encompass both effective field theories and the phenomenology of gravitational potentials in MG models. Lastly, we test a range of specific models, such as k-essence, f(R) theories and coupled DE. In addition to the latest Planck data, for our main analyses we use baryonic acoustic oscillations, type-Ia supernovae and local measurements of the Hubble constant. We further show the impact of measurements of the cosmological perturbations, such as redshift-space distortions and weak gravitational lensing. These additional probes are important tools for testing MG models and for breaking degeneracies that are still present in the combination of Planck and background data sets. All results that include only background parameterizations are in agreement with LCDM. When testing models that also change perturbations (even when the background is fixed to LCDM), some tensions appear in a few scenarios: the maximum one found is \sim 2 sigma for Planck TT+lowP when parameterizing observables related to the gravitational potentials with a chosen time dependence; the tension increases to at most 3 sigma when external data sets are included. It however disappears when including CMB lensing

Is high cord radical orchidectomy always necessary for testicular cancer?

BACKGROUND: Radical high cord inguinal orchidectomy remains the standard for diagnosis, staging and treatment of testicular neoplasms. Low cord orchidectomy is an alternative to the high cord orchidectomy. OBJECTIVE: To test the hypothesis that there is no difference in relapse rate or mortality between high and low cord orchidectomy for the treatment of testicular cancer. METHODS: A retrospective study was undertaken of all orchidectomies performed for testicular cancer at our hospital between 1981 and 2002. RESULTS: Overall, 120 high cord orchidectomies and 102 low cord orchidectomies were performed for testicular cancer between 1981 and 2002 at our hospital. Analysis showed that there was no significant difference in the mean age of the patients, the rate of relapse, mean time to relapse or survival between surgical approach for stage 1 tumours. For stage 2-4 tumours, there were not sufficient numbers to comment on the statistical significance of relapse or survival differences. CONCLUSIONS: The trend suggests that there is no statistically significant difference in the rate of relapse and mortality between high and low cord orchidectomy for clinically stage 1 tumours. We would, therefore, advocate either a high or low cord orchidectomy for clinically stage 1 tumours