792 research outputs found
The Health and Well-Being of Young Children of Immigrants
Provides an overview of immigration trends and their effects on the composition of the young child population. Looks at poverty, family structure, parental work patterns, immigrant parents' education, health status, and health insurance coverage
Cavity-enhanced optical detection of carbon nanotube Brownian motion
Optical cavities with small mode volume are well-suited to detect the
vibration of sub-wavelength sized objects. Here we employ a fiber-based,
high-finesse optical microcavity to detect the Brownian motion of a freely
suspended carbon nanotube at room temperature under vacuum. The optical
detection resolves deflections of the oscillating tube down to 50pm/Hz^1/2. A
full vibrational spectrum of the carbon nanotube is obtained and confirmed by
characterization of the same device in a scanning electron microscope. Our work
successfully extends the principles of high-sensitivity optomechanical
detection to molecular scale nanomechanical systems.Comment: 14 pages, 11 figure
A note on the invariant distribution of a quasi-birth-and-death process
The aim of this paper is to give an explicit formula of the invariant
distribution of a quasi-birth-and-death process in terms of the block entries
of the transition probability matrix using a matrix-valued orthogonal
polynomials approach. We will show that the invariant distribution can be
computed using the squared norms of the corresponding matrix-valued orthogonal
polynomials, no matter if they are or not diagonal matrices. We will give an
example where the squared norms are not diagonal matrices, but nevertheless we
can compute its invariant distribution
Characterisation and classification of oligometastatic disease : a European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation
Oligometastatic disease has been proposed as an intermediate state between localised and systemically metastasised disease. In the absence of randomised phase 3 trials, early clinical studies show improved survival when radical local therapy is added to standard systemic therapy for oligometastatic disease. However, since no biomarker for the identification of patients with true oligometastatic disease is clinically available, the diagnosis of oligometastatic disease is based solely on imaging findings. A small number of metastases on imaging could represent different clinical scenarios, which are associated with different prognoses and might require different treatment strategies. 20 international experts including 19 members of the European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer OligoCare project developed a comprehensive system for characterisation and classification of oligometastatic disease. We first did a systematic review of the literature to identify inclusion and exclusion criteria of prospective interventional oligometastatic disease clinical trials. Next, we used a Delphi consensus process to select a total of 17 oligometastatic disease characterisation factors that should be assessed in all patients treated with radical local therapy for oligometastatic disease, both within and outside of clinical trials. Using a second round of the Delphi method, we established a decision tree for oligometastatic disease classification together with a nomenclature. We agreed oligometastatic disease as the overall umbrella term. A history of polymetastatic disease before diagnosis of oligometastatic disease was used as the criterion to differentiate between induced oligometastatic disease (previous history of polymetastatic disease) and genuine oligometastatic disease (no history of polymetastatic disease). We further subclassified genuine oligometastatic disease into repeat oligometastatic disease (previous history of oligometastatic disease) and de-novo oligometastatic disease (first time diagnosis of oligometastatic disease). In de-novo oligometastatic disease, we differentiated between synchronous and metachronous oligometastatic disease. We did a final subclassification into oligorecurrence, oligoprogression, and oligopersistence, considering whether oligometastatic disease is diagnosed during a treatment-free interval or during active systemic therapy and whether or not an oligometastatic lesion is progressing on current imaging. This oligometastatic disease classification and nomenclature needs to be prospectively evaluated by the OligoCare study
Existential witness extraction in classical realizability and via a negative translation
We show how to extract existential witnesses from classical proofs using
Krivine's classical realizability---where classical proofs are interpreted as
lambda-terms with the call/cc control operator. We first recall the basic
framework of classical realizability (in classical second-order arithmetic) and
show how to extend it with primitive numerals for faster computations. Then we
show how to perform witness extraction in this framework, by discussing several
techniques depending on the shape of the existential formula. In particular, we
show that in the Sigma01-case, Krivine's witness extraction method reduces to
Friedman's through a well-suited negative translation to intuitionistic
second-order arithmetic. Finally we discuss the advantages of using call/cc
rather than a negative translation, especially from the point of view of an
implementation.Comment: 52 pages. Accepted in Logical Methods for Computer Science (LMCS),
201
Costs of Biopsy and Complications in Patients with Lung Cancer
PURPOSE: To describe the distribution of diagnostic procedures, rates of complications, and total cost of biopsies for patients with lung cancer.
PATIENTS AND METHODS: Observational study using data from IBM Marketscan(®) Databases for continuously insured adult patients with a primary lung cancer diagnosis and treatment between July 2013 and June 2017. Costs of lung cancer diagnosis covered 6 months prior to index biopsy through treatment. Costs of chest CT scans, biopsy, and post-procedural complications were estimated from total payments. Costs of biopsies incidental to inpatient admissions were estimated by comparable outpatient biopsies.
RESULTS: The database included 22,870 patients who had a total of 37,160 biopsies, of which 16,009 (43.1%) were percutaneous, 14,997 (40.4%) bronchoscopic, 4072 (11.0%) surgical and 2082 (5.6%) mediastinoscopic. Multiple biopsies were performed on 41.9% of patients. The most common complications among patients receiving only one type of biopsy were pneumothorax (1304 patients, 8.4%), bleeding (744 patients, 4.8%) and intubation (400 patients, 2.6%). However, most complications did not require interventions that would add to costs. Median total costs were highest for inpatient surgical biopsies (1028). Repeat biopsies of the same type increased costs by 40-80%. Complications account for 13% of total costs.
CONCLUSION: Costs of biopsies to confirm lung cancer diagnosis vary substantially by type of biopsy and setting. Multiple biopsies, inpatient procedures and complications result in higher costs
Shape-sensing robotic-assisted bronchoscopy for pulmonary nodules: initial multicenter experience using the Ion™ Endoluminal System
BACKGROUND: Traditional bronchoscopy provides limited approach to peripheral nodules. Shape-sensing robotic-assisted bronchoscopy (SSRAB, Ion™ Endoluminal System) is a new tool for minimally invasive peripheral nodule biopsy. We sought to answer the research question: Does SSRAB facilitate sampling of pulmonary nodules during bronchoscopists\u27 initial experience?
METHODS: The lead-in stage of a multicenter, single-arm, prospective evaluation of the Ion Endoluminal System (PRECIsE) is described. Enrolled subjects ≥ 18 years old had recent computed tomography evidence of one or more solid or semi-solid pulmonary nodules ≥ 1.0 to ≤ 3.5 cm in greatest dimension and in any part of the lung. Subjects were followed at 10- and 30-days post-procedure. This stage provided investigators and staff their first human experience with the SSRAB system; safety and procedure outcomes were analyzed descriptively. Neither diagnostic yield nor sensitivity for malignancy were assessed in this stage. Categorical variables are summarized by percentage; continuous variables are summarized by median/interquartile range (IQR).
RESULTS: Sixty subjects were enrolled across 6 hospitals; 67 nodules were targeted for biopsy. Median axial, coronal and sagittal diameters were \u3c 18 mm with a largest cardinal diameter of 20.0 mm. Most nodules were extraluminal and distance from the outer edge of the nodule to the pleura or nearest fissure was 4.0 mm (IQR: 0.0, 15.0). Median bronchial generation count to the target location was 7.0 (IQR: 6.0, 8.0). Procedure duration (catheter-in to catheter-out) was 66.5 min (IQR: 50.0, 85.5). Distance from the catheter tip to the closest edge of the virtual nodule was 7.0 mm (IQR: 2.0, 12.0). Biopsy completion was 97.0%. No pneumothorax or airway bleeding of any grade was reported.
CONCLUSIONS: Bronchoscopists leveraged the Ion SSRAB\u27s functionality to drive the catheter safely in close proximity of the virtual target and to obtain biopsies. This initial, multicenter experience is encouraging, suggesting that SSRAB may play a role in the management of pulmonary nodules. Clinical Trial Registration identifier and date NCT03893539; 28/03/2019
Comparison of the influence of cyclosporine and tacrolimus on the pharmacokinetics of prednisolone in adult male kidney transplant recipients
Cyclosporine has been observed to precipitate cushingoid features in kidney transplant recipients already on prednisolone. Some pharmacokinetic studies have demonstrated increased prednisolone exposure in patients on cyclosporine therapy compared with azathioprine, whereas other studies have found no difference. The objective of this study was to determine whether cyclosporine impacts on prednisolone exposure as compared with tacrolimus
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