An Observed Lack of Substructure in Starless Cores

In this paper we present the results of a high resolution (5") CARMA and SZA survey of the 3mm continuum emission from 11 of the brightest (at 1.1mm) starless cores in the Perseus molecular cloud. We detect 2 of the 11 cores, both of which are composed of single structures, and the median 3 sigma upper limit for the non-detections is 0.2 M_sun in a 5" beam. These results are consisent with, and as stringent as, the low detection rate of compact 3mm continuum emission in dense cores in Perseus reported by Olmi et al. (2005). From the non-detection of multiple components in any of the eleven cores we conclude that starless core mass functions derived from bolometer maps at resolutions from 10"-30" (e.g. with MAMBO, SCUBA or Bolocam) are unlikely to be significantly biased by the blending of lower mass cores with small separations. These observations provide additional evidence that the majority of starless cores in Perseus have inner density profiles shallower than r^-2.Comment: 9 pages, including 3 figures and 3 tables. Accepted to Ap

The McDonald Observatory Planet Search: New Long-Period Giant Planets, and Two Interacting Jupiters in the HD 155358 System

We present high-precision radial velocity (RV) observations of four solar-type (F7-G5) stars - HD 79498, HD 155358, HD 197037, and HD 220773 - taken as part of the McDonald Observatory Planet Search Program. For each of these stars, we see evidence of Keplerian motion caused by the presence of one or more gas giant planets in long-period orbits. We derive orbital parameters for each system, and note the properties (composition, activity, etc.) of the host stars. While we have previously announced the two-gas-giant HD 155358 system, we now report a shorter period for planet c. This new period is consistent with the planets being trapped in mutual 2:1 mean-motion resonance. We therefore perform an in-depth stability analysis, placing additional constraints on the orbital parameters of the planets. These results demonstrate the excellent long-term RV stability of the spectrometers on both the Harlan J. Smith 2.7 m telescope and the Hobby-Eberly telescope.Comment: 38 pages, 10 figures, 6 tables. Accepted for publication in Ap

Supernova Remnants and Star Formation in the Large Magellanic Cloud

It has often been suggested that supernova remnants (SNRs) can trigger star formation. To investigate the relationship between SNRs and star formation, we have examined the known sample of 45 SNRs in the Large Magellanic Cloud to search for associated young stellar objects (YSOs) and molecular clouds. We find seven SNRs associated with both YSOs and molecular clouds, three SNRs associated with YSOs but not molecular clouds, and eight SNRs near molecular clouds but not associated with YSOs. Among the 10 SNRs associated with YSOs, the association between the YSOs and SNRs can be either rejected or cannot be convincingly established for eight cases. Only two SNRs have YSOs closely aligned along their rims; however, the time elapsed since the SNR began to interact with the YSOs' natal clouds is much shorter than the contraction timescales of the YSOs, and thus we do not see any evidence of SNR-triggered star formation in the LMC. The 15 SNRs that are near molecular clouds may trigger star formation in the future when the SNR shocks have slowed down to <45 km/s. We discuss how SNRs can alter the physical properties and abundances of YSOs.Comment: 24 pages, 5 figures, 1 table, Accepted for publication in the August 2010 edition of the Astronomical Journa

Implementation of laparoscopic hysterectomy for endometrial cancer over the past decade

Background: Laparoscopic hysterectomy (LH) for the treatment of early-stage endometrial carcinoma/cancer (EC) has demonstrated to be safe in several randomized controlled trials. Yet, data on implementation of LH in clinical practice are limited. In the present study, implementation of LH for EC was evaluated in a large oncology network in the Netherlands. Results: Retrospectively, a total of 556 EC patients with FIGO stage I-II were registered in the selected years. The proportion of LH gradually increased from 11% in 2006 to 85% in 2015. LH was more often performed in patients with low-grade EC and was not related to the studied patient characteristics. The introduction of TLH was frequently preceded by LAVH. Patients treated in teaching hospitals were more likely to undergo a LH compared to patients in non-teaching hospitals. The conversion rate was 7.7%, and the overall complication rates between LH and AH were comparable, but less postoperative complications in LH. Conclusions: Implementation of laparoscopic hysterectomy for early-stage EC increased from 11 to 85% in 10 years. Implementation of TLH was often preceded by LAVH and was faster in teaching hospitals

Masses, radii, and orbits of small Kepler planets : The transition from gaseous to rocky planets

We report on the masses, sizes, and orbits of the planets orbiting 22 Kepler stars. There are 49 planet candidates around these stars, including 42 detected through transits and 7 revealed by precise Doppler measurements of the host stars. Based on an analysis of the Kepler brightness measurements, along with high-resolution imaging and spectroscopy, Doppler spectroscopy, and (for 11 stars) asteroseismology, we establish low false-positive probabilities (FPPs) for all of the transiting planets (41 of 42 have an FPP under 1%), and we constrain their sizes and masses. Most of the transiting planets are smaller than three times the size of Earth. For 16 planets, the Doppler signal was securely detected, providing a direct measurement of the planet's mass. For the other 26 planets we provide either marginal mass measurements or upper limits to their masses and densities; in many cases we can rule out a rocky composition. We identify six planets with densities above 5 g cm-3, suggesting a mostly rocky interior for them. Indeed, the only planets that are compatible with a purely rocky composition are smaller than 2 R ⊕. Larger planets evidently contain a larger fraction of low-density material (H, He, and H2O).Peer reviewedFinal Accepted Versio

Planetary population synthesis

In stellar astrophysics, the technique of population synthesis has been successfully used for several decades. For planets, it is in contrast still a young method which only became important in recent years because of the rapid increase of the number of known extrasolar planets, and the associated growth of statistical observational constraints. With planetary population synthesis, the theory of planet formation and evolution can be put to the test against these constraints. In this review of planetary population synthesis, we first briefly list key observational constraints. Then, the work flow in the method and its two main components are presented, namely global end-to-end models that predict planetary system properties directly from protoplanetary disk properties and probability distributions for these initial conditions. An overview of various population synthesis models in the literature is given. The sub-models for the physical processes considered in global models are described: the evolution of the protoplanetary disk, the planets' accretion of solids and gas, orbital migration, and N-body interactions among concurrently growing protoplanets. Next, typical population synthesis results are illustrated in the form of new syntheses obtained with the latest generation of the Bern model. Planetary formation tracks, the distribution of planets in the mass-distance and radius-distance plane, the planetary mass function, and the distributions of planetary radii, semimajor axes, and luminosities are shown, linked to underlying physical processes, and compared with their observational counterparts. We finish by highlighting the most important predictions made by population synthesis models and discuss the lessons learned from these predictions - both those later observationally confirmed and those rejected.Comment: 47 pages, 12 figures. Invited review accepted for publication in the 'Handbook of Exoplanets', planet formation section, section editor: Ralph Pudritz, Springer reference works, Juan Antonio Belmonte and Hans Deeg, Ed

Regional to Global Assessments of Phytoplankton Dynamics From The SeaWiFS Mission

Photosynthetic production of organic matter by microscopic oceanic phytoplankton fuels ocean ecosystems and contributes roughly half of the Earth's net primary production. For 13 years, the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) mission provided the first consistent, synoptic observations of global ocean ecosystems. Changes in the surface chlorophyll concentration, the primary biological property retrieved from SeaWiFS, have traditionally been used as a metric for phytoplankton abundance and its distribution largely reflects patterns in vertical nutrient transport. On regional to global scales, chlorophyll concentrations covary with sea surface temperature (SST) because SST changes reflect light and nutrient conditions. However, the oceanmay be too complex to be well characterized using a single index such as the chlorophyll concentration. A semi-analytical bio-optical algorithm is used to help interpret regional to global SeaWiFS chlorophyll observations from using three independent, well-validated ocean color data products; the chlorophyll a concentration, absorption by CDM and particulate backscattering. First, we show that observed long-term, global-scale trends in standard chlorophyll retrievals are likely compromised by coincident changes in CDM. Second, we partition the chlorophyll signal into a component due to phytoplankton biomass changes and a component caused by physiological adjustments in intracellular chlorophyll concentrations to changes in mixed layer light levels. We show that biomass changes dominate chlorophyll signals for the high latitude seas and where persistent vertical upwelling is known to occur, while physiological processes dominate chlorophyll variability over much of the tropical and subtropical oceans. The SeaWiFS data set demonstrates complexity in the interpretation of changes in regional to global phytoplankton distributions and illustrates limitations for the assessment of phytoplankton dynamics using chlorophyll retrievals alone

The METEX study: Methotrexate versus expectant management in women with ectopic pregnancy: A randomised controlled trial

Background: Patients with ectopic pregnancy (EP) and low serum hCG concentrations and women with a pregnancy of unknown location (PUL) and plateauing serum hCG levels are commonly treated with systemic methotrexate (MTX). However, there is no evidence that treatment in these particular subgroups of women is necessary as many of these early EPs may resolve spontaneously. The aim of this study is whether expectant management in women with EP or PUL and with low but plateauing serum hCG concentrations is an alternative to MTX treatment in terms of treatment success, future pregnancy, health related quality of life and costs. Methods/Design: A multicentre randomised controlled trial in TheNetherlands. Hemodynamically stable patients with an EP visible on transvaginal ultrasound and a plateauing serum hCG concentration < 1,500 IU/L or with a persisting PUL with plateauing serum hCG concentrations < 2,000 IU/L are eligible for the trial. Patients with a viable EP, signs of tubal rupture/abdominal bleeding, or a contra-indication for MTX will not be included. Expectant management is compared with systemic MTX in a single dose intramuscular regimen (1 mg/ kg) in an outpatient setting. Serum hCG levels are monitored weekly; in case of inadequately declining, systemic MTX is installed or continued. In case of hemodynamic instability and/or signs of tubal rupture, surgery is performed. The primary outcome measure is an uneventful decline of serum hCG to an undetectable level by the initial intervention. Secondary outcomes are (re)interventions (additional systemic MTX injections and/or surgery), treatment complications, health related quality of life, financial costs, and future fertility. Analysis is performed according to the intention to treat principle. Quality of life is assessed by questionnaires before and at three time points after randomisation. Costs are expressed as direct costs with data on costs and used resources in the participating centres. Fertility is assessed by questionnaires after 6, 12, 18 and 24 months. Patients' preferences will be assessed using a discrete choice experiment. Discussion: This trial will provide guidance on the present management dilemmas in women with EPs and PULs with low and plateauing serum hCG concentrations

The impact of a cancer Survivorship Care Plan on gynecological cancer patient and health care provider reported outcomes (ROGY Care): study protocol for a pragmatic cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>There is a need for improvement of information provision and post-treatment care for cancer survivors. A Survivorship Care Plan (SCP) is recommended by the American Institute of Medicine and the Dutch Health Council, which is a summary of patients' course of treatment as a formal document, and includes recommendations for subsequent cancer surveillance, management of late effects, and strategies for health promotion. Until now, evidence on the effects of implementing the SCP in clinical practice is lacking. The rationale and study design of a pragmatic cluster randomized trial, aiming to assess the impact of SCP care in routine clinical practice, is presented.</p> <p>Methods/Design</p> <p>A web-based patient registration system 'Registrationsystem Oncological GYnecology' (ROGY) is used by gynecologists in the South of the Netherlands since 2006. A personalized SCP can automatically be generated out of ROGY. In this pragmatic cluster randomized controlled trial, 12 hospitals are randomized to either 'usual care' or 'SCP care'. In patients with 'usual care', the gynecologist provides care as usual. In patients with 'SCP care', information about the tumor stage and treatment is personally discussed with the patient and a document is handed to the patient. Prospectively, all patients diagnosed with endometrial or ovarian cancer in the participating hospitals will be approached for study participation. Patients will complete questionnaires after surgery, and before additional treatment, and after 6, 12, 18 and 24 months. In addition, health care providers will be asked their opinion about implementation of SCP care. Primary outcome is defined as patient satisfaction with information provision and care. Secondary outcomes are illness perception, health-related quality of life, health care use, prevalence, course and referral rate of survivors with psychosocial distress, and health care providers' evaluation of SCP care.</p> <p>Discussion</p> <p>The ROGY Care trial will help to gain insight into the impact of SCP care on patient reported outcomes, and on the evaluation of cancer survivors and health care providers of the different elements of the SCP. Therefore, results will contribute to efforts to improve quality of care for cancer survivors.</p> <p>Trial registration</p> <p>Trial Registration: <url>http://www.ClinicalTrials.gov</url>. Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01185626">NCT01185626</a></p> <p>Medical Research Ethics Committee Reference Number: NL33429.008.10 Grant Reference Number: UVT2010-4743</p

A Formação na Maturidade como Apropriação da Própria História de Vida

No presente artigo, a disposi&#231;&#227;o e a compet&#234;ncia para a apropria&#231;&#227;o da pr&#243;pria hist&#243;ria de vida s&#227;o consideradas como modos de forma&#231;&#227;o1 na maturidade. Estas se relacionam com fatores hist&#243;ricos e s&#243;cio-pol&#237;ticos e est&#227;o inscritas em contextos multigeracionais de forma&#231;&#227;o e processos de desenvolvimento ao longo da vida. Nesta perspectiva, conceitos como gera&#231;&#227;o, geracionalidade, geratividade e transmiss&#227;o transgeracional ganham destaque e ser&#227;o aprofundados no texto. A linha argumentativa que sustenta este ponto de vista baseia-se em estudos de pa&#237;ses de l&#237;ngua alem&#227; sobre crian&#231;as da Segunda Guerra Mundial que envelheceram. Apesar de se tratar de uma situa&#231;&#227;o espec&#237;fica, nos parece poss&#237;vel a extens&#227;o das reflex&#245;es tamb&#233;m para o contexto brasileiro