2,502 research outputs found
A New Type of Intensity Correlation in Random Media
A monochromatic point source, embedded in a three-dimensional disordered
medium, is considered. The resulting intensity pattern exhibits a new type of
long-range correlations. The range of these correlations is infinite and their
magnitude, normalized to the average intensity, is of order , where
and are the wave number and the mean free path respectively.Comment: RevTeX, 8 pages, 3 figures, Accepted to Phys. Rev. Let
Three Years in the Life of a Peer Support Initiative for Graduate Students Studying Adult Learning and Leadership – an Action Research Project Implementing the “ALL Peer Connect Project”
The purpose of this action research study is to explore and understand the perceived impacts of a three year peer support initiative on graduate students‘ academic and professional experience and how this initiative can potentially contribute to the development of a community of practice among graduate students. The peer connect program, also referred to as ―Connect ALL‖ was started in the fall semester of 2009 in Adult Learning and Leadership (ALL), a non-cohort program at Teachers College, Columbia University. Under this initiative, each newly admitted student joining the master‘s or doctoral program is matched with a current student or an alumnus, referred to as the ―connector,‖ who assists the newer student, or ―connectee,‖ with negotiating the program and other academic needs. Participation in the program is voluntary. The intent of the program is to expand the peer network and aid students‘ successful integration into the field of Adult Learning and Leadership
Waiting Time from Diagnosis to Treatment has no Impact on Survival in Patients with Esophageal Cancer
Background
Waiting time from diagnosis to treatment has emerged as an important quality indicator in cancer care. This study was designed to determine the impact of waiting time on long-term outcome of patients with esophageal cancer who are treated with neoadjuvant therapy followed by surgery or primary surgery.
Methods
Patients who underwent esophagectomy for esophageal cancer at the University Medical Center Utrecht between 2003 and 2014 were included. Patients treated with neoadjuvant therapy followed by surgery and treated with primary surgery were separately analyzed. The influence of waiting time on survival was analyzed using Cox proportional hazard analyses. Kaplan–Meier curves for short (<8 weeks) and long (≥8 weeks) waiting times were constructed.
Results
A total of 351 patients were included; 214 received neoadjuvant treatment, and 137 underwent primary surgery. In the neoadjuvant group, the waiting time had no impact on disease-free survival (DFS) [hazard ratio (HR) 0.96, 95 % confidence interval (CI) 0.88–1.04; p = 0.312] or overall survival (OS) (HR 0.96, 95 % CI 0.88–1.05; p = 0.372). Accordingly, no differences were found between neoadjuvantly treated patients with waiting times of <8 and ≥8 weeks in terms of DFS (p = 0.506) and OS (p = 0.693). In the primary surgery group, the waiting time had no impact on DFS (HR 1.03, 95 % CI 0.95–1.12; p = 0.443) or OS (HR 1.06, 95 % CI 0.99–1.13; p = 0.108). Waiting times of <8 weeks versus ≥8 weeks did not result in differences regarding DFS (p = 0.884) or OS (p = 0.374).
Conclusions
In esophageal cancer patients treated with curative intent by either neoadjuvant therapy followed by surgery or primary surgery, waiting time from diagnosis to treatment has no impact on long-term outcom
Toward a Partnership in the Transition from Home to a Nursing Home: The TRANSCIT Model
The transition from home to a nursing home can be stressful and traumatic for both older persons and informal caregivers and is often associated with negative outcomes. Additionally, transitional care interventions often lack a comprehensive approach, possibly leading to fragmented care. To avoid this fragmentation and to optimize transitional care, a comprehensive and theory-based model is fundamental. It should include the needs of both older persons and informal caregivers. Therefore, this study, conducted within the European TRANS-SENIOR research consortium, proposes a model to optimize the transition from home to a nursing home, based on the experiences of older persons and informal caregivers. These experiences were captured by conducting a literature review with relevant literature retrieved from the databases CINAHL and PubMed. Studies were included if older persons and/or informal caregivers identified the experiences, needs, barriers, or facilitators during the transition from home to a nursing home. Subsequently, the data extracted from the included studies were mapped to the different stages of transition (pre-transition, mid-transition, and post-transition), creating the TRANSCITmodel. Finally, results were discussed with an expert panel, leading to a final proposed TRANSCIT model.
The TRANSCIT model identified that older people and informal caregivers expressed an overall need for partnership during the transition from home to a nursing home. Moreover, it identified 4 key components throughout the transition trajectory (ie, pre-, mid-, and post-transition): (1) support, (2) communication, (3) information, and (4) time.
The TRANSCIT model could advise policy makers, practitioners, and researchers on the development and evaluation of (future) transitional care interventions. It can be a guideline reckoning the needs of older people and their informal caregivers, emphasizing the need for a partnership, consequently reducing fragmentation in transitional care and optimizing the transition from home to a nursing home
Study protocol for the OligoMetastatic Esophagogastric Cancer (OMEC) project: A multidisciplinary European consensus project on the definition and treatment for oligometastatic esophagogastric cancer
BACKGROUND
A uniform definition and treatment for oligometastatic esophagogastric cancer is currently lacking. However, a comprehensive definition of oligometastatic esophagogastric cancer is necessary to initiate studies on local treatment strategies (e.g. metastasectomy or stereotactic radiotherapy) and new systemic therapy agents in this group of patients. For this purpose, the OligoMetastatic Esophagogastric Cancer (OMEC) project was established. The OMEC-project aims to develop a multidisciplinary European consensus statement on the definition, diagnosis, and treatment for oligometastatic esophagogastric cancer and provide a framework for prospective studies to improve outcomes of these patients.
METHODS
The OMEC-project consists of five studies, including 1) a systematic review on definitions and outcomes of oligometastatic esophagogastric cancer; 2) real-life clinical scenario discussions in multidisciplinary expert teams to determine the variation in the definition and treatment strategies; 3) Delphi consensus process through a starting meeting, two Delphi questionnaire rounds, and a consensus meeting; 4) publication of a multidisciplinary European consensus statement; and 5) a prospective clinical trial in patients with oligometastatic esophagogastric cancer.
DISCUSSION
The OMEC project aims to establish a multidisciplinary European consensus statement for oligometastatic esophagogastric cancer and aims to initiate a prospective clinical trial to improve outcomes for these patients. Recommendations from OMEC can be used to update the relevant guidelines on treatment for patients with (oligometastatic) esophagogastric cancer
European clinical practice guidelines for the definition, diagnosis, and treatment of oligometastatic esophagogastric cancer (OMEC-4)
Esophageal cancer; Gastric cancer; OligometastasisCàncer d'esòfag; Càncer gàstric; OligometàstasiCáncer de esófago; Cáncer gástrico; OligometástasisIntroduction
The OligoMetastatic Esophagogastric Cancer (OMEC) project aims to provide clinical practice guidelines for the definition, diagnosis, and treatment of esophagogastric oligometastatic disease (OMD).
Methods
Guidelines were developed according to AGREE II and GRADE principles. Guidelines were based on a systematic review (OMEC-1), clinical case discussions (OMEC-2), and a Delphi consensus study (OMEC-3) by 49 European expert centers for esophagogastric cancer. OMEC identified patients for whom the term OMD is considered or could be considered. Disease-free interval (DFI) was defined as the time between primary tumor treatment and detection of OMD.
Results
Moderate to high quality of evidence was found (i.e. 1 randomized and 4 non-randomized phase II trials) resulting in moderate recommendations. OMD is considered in esophagogastric cancer patients with 1 organ with ≤ 3 metastases or 1 involved extra-regional lymph node station. In addition, OMD continues to be considered in patients with OMD without progression in number of metastases after systemic therapy. 18F-FDG PET/CT imaging is recommended for baseline staging and for restaging after systemic therapy when local treatment is considered. For patients with synchronous OMD or metachronous OMD and a DFI ≤ 2 years, recommended treatment consists of systemic therapy followed by restaging to assess suitability for local treatment. For patients with metachronous OMD and DFI > 2 years, upfront local treatment is additionally recommended.
Discussion
These multidisciplinary European clinical practice guidelines for the uniform definition, diagnosis and treatment of esophagogastric OMD can be used to standardize inclusion criteria in future clinical trials and to reduce variation in treatment
Cortactin overexpression results in sustained epidermal growth factor receptor signaling by preventing ligand-induced receptor degradation in human carcinoma cells
The chromosome 11q13 region is frequently amplified in human carcinomas and results in an increased expression of various genes including cortactin, and is also associated with an increased invasive potential. Cortactin acts as an important regulator of the actin cytoskeleton. It is therefore very tempting to speculate that cortactin is the crucial gene within the 11q13 amplicon that mediates the invasive potential of these carcinomas. Cortactin also participates in receptor-mediated endocytosis, and recent findings have shown that, during receptor internalization, cortactin overexpression inhibits the ubiquitylation-mediated degradation of the epidermal growth factor receptor, resulting in a sustained ligand-induced epidermal growth factor receptor activity
Collimation and asymmetry of the hot blast wave from the recurrent nova V745 Scorpii
The recurrent symbiotic nova V745 Sco exploded on 2014 February 6 and was
observed on February 22 and 23 by the Chandra X-ray Observatory Transmission
Grating Spectrometers. By that time the supersoft source phase had already
ended and Chandra spectra are consistent with emission from a hot, shock-heated
circumstellar medium with temperatures exceeding 10^7K. X-ray line profiles are
more sharply peaked than expected for a spherically-symmetric blast wave, with
a full width at zero intensity of approximately 2400 km/s, a full width at half
maximum of 1200 +/- 30 km/s and an average net blueshift of 165 +/- 10 km/s.
The red wings of lines are increasingly absorbed toward longer wavelengths by
material within the remnant. We conclude that the blast wave was sculpted by an
aspherical circumstellar medium in which an equatorial density enhancement
plays a role, as in earlier symbiotic nova explosions. Expansion of the
dominant X-ray emitting material is aligned close to the plane of the sky and
most consistent with an orbit seen close to face-on. Comparison of an
analytical blast wave model with the X-ray spectra, Swift observations and
near-infrared line widths indicates the explosion energy was approximately
10^43 erg, and confirms an ejected mass of approximately 10^-7 Msun. The total
mass lost is an order of magnitude lower than the accreted mass required to
have initiated the explosion, indicating the white dwarf is gaining mass and is
a supernova Type 1a progenitor candidate.Comment: To appear in the Astrophysical Journa
Glucocorticoid receptor gene polymorphisms do not affect growth in fetal and early postnatal life. The Generation R Study
Background: Glucocorticoids have an important role in early growth and development. Glucocorticoid receptor gene polymorphisms have been identified that contribute to the variability in glucocorticoid sensitivity. We examined whether these glucocorticoid receptor gene polymorphisms are associated with growth in fetal and early postnatal life.Methods: This study was embedded in a population-based prospective cohort study from fetal life onwards. The studied glucocorticoid receptor gene polymorphisms included BclI (rs41423247), TthIIII (rs10052957), GR-9β (rs6198), N363S (rs6195) and R23K (rs6789 and6190). Fetal growth was assessed by ultrasounds in second and third trimester of pregnancy. Anthropometric measurements in early childhood were performed at birth and at the ages of 6, 14 and 24 months postnatally. Analyses focused on weight, length and head circumference. Analyses were based on 2,414 healthy, Caucasian children.Results: Glucocorticoid receptor gene polymorphisms were not associated with fetal weight, birth weight and early postnatal weight. Also, no associations were found with length and head circumference. Neither were these polymorphisms associated with the risks of low birth weight or growth acceleration from birth to 24 months of age.Conclusions: We found in a large population-based cohort no evidence for an effect of known glucocorticoid receptor gene polymorphisms on fetal and early post
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