The photons payload, G-494: A learning experience

PHOTONS (Photometric Thermospheric Oxygen Nightglow Study) is an optical remote sensing payload developed for Get Away Special (GAS) flight by the National Research Council of Canada. The device is extremely sensitive and is suitable for making measurements of low intensity, aeronomically generated atmospheric emissions in the nadir and the limb and of Shuttle ram glow. The unit uses a sealed canister and UV transmitting viewing ports. During the flight of STS 61-C, PHOTONS received one hour of operation and aeronomic observations were made. Good diagnostic data were obtained and the science part of the experiment malfunctioned. Post flight inspection revealed that the payload was in perfect working order except for total failure of the photomultiplier detectors. The experiment and the payload are described and the flight results are discussed along with the cause of the malfunctions. It is shown that enough was learned from the flight diagnostic data and about the cause of the malfunction to conclude that the engineering flight was successful and that subsequent flight of the PHOTONS payload will be productive

Proton aurora and substorm intensifications

Ground based measurements from the CANOPUS array of meridian scanning photometers and precipitating ion and electron data from the DMSP F9 satellite show that the electron arc which brightens to initiate substorm intensifications is formed within a region of intense proton precipitation that is well equatorward (approximately four to six degrees) of the nightside open-closed field line boundary. The precipitating protons are from a population that is energized via earthward convection from the magnetotail into the dipolar region of the magnetosphere and may play an important role in the formation of the electron arcs leading to substorm intensifications on dipole-like field lines

Adjuvant chemotherapy vs radiotherapy in high-risk endometrial carcinoma: results of a randomised trial

Patients with high-risk endometrial carcinoma (stage IcG3, IIG3 with myometrial invasion >50%, and III) receive adjuvant therapy after surgery but it is not clear whether radiotherapy (RT) or chemotherapy (CT) is better. We randomly assigned 345 patients with high-risk endometrial carcinoma to adjuvant CT (cisplatin (50 mg m−2), doxorubicin (45 mg m−2), cyclophosphamide (600 mg m−2) every 28 days for five cycles, or external RT (45–50 Gy on a 5 days week−1 schedule). The primary end points were overall and progression-free survival. After a median follow-up of 95.5 months women in the CT group as compared with the RT group, had a no significant hazard ratio (HR) for death of 0.95 (95% confidence interval (CI), 0.66–1.36; P=0.77) and a nonsignificant HR for event of 0.88 (95% CI, 0.63–1.23; P=0.45). The 3, 5 and 7-year overall survivals were 78, 69 and 62% in the RT group and 76, 66 and 62% in the CT group. The 3, 5 and 7-year progression-free survivals were, respectively, 69, 63 and 56 and 68, 63 and 60%. Radiotherapy delayed local relapses and CT delayed metastases but these trends did not achieve statistical significance. Overall, both treatments were well tolerated. This trial failed to show any improvement in survival of patients treated with CT or the standard adjuvant radiation therapy. Randomised trials of pelvic RT combined with adjuvant cytotoxic therapy compared with RT alone are eagerly awaited

Staging quality is related to the survival of women with endometrial cancer: a Scottish population based study.Deficient surgical staging and omission of adjuvant radiotherapy is associated with poorer survival of women diagnosed with endometrial cancer in Scotland during 1996 and 1997

The association between treatment variation and survival of women with endometrial cancer was investigated. A retrospective cohort based upon the complete Scottish population registered on in-patient and day-case hospital discharge data (Scottish Morbidity Record-1) and cancer registration (Scottish Morbidity Record-6) coded C54 and C55 in ICD10, between 1st January 1996 to 31st December 1997 were analysed. Seven hundred and three patients who underwent surgical treatment out of 781 patients that were diagnosed with endometrial cancer in Scotland during 1996 and 1997. The overall quality of surgical staging was poor. The quality of staging was related to both the year that the surgeon passed the Member of the Royal College of Obstetricians and Gynaecologists examination and also to ‘specialist’ status but was not related to surgeon caseload. Two clinically important prognostic factors were found to be associated with survival; whether the International Federation of Obstetrics and Gynaecology stage was documented, RHR=2.0 (95% CI=1.3 to 3.1) and also to the use of adjuvant radiotherapy, RHR=2.2 (95% CI=1.5 to 3.5). The associations with survival were strongest in patients with advanced disease, International Federation of Obstetrics and Gynaecology stages 1C through to stage 3. Deficiencies in staging and variations in the use of adjuvant radiotherapy represent a possible source of avoidable mortality in patients with endometrial cancer. Consequently, there should be a greater emphasis on improving the overall quality of surgical staging in endometrial cancer

The aries auroral modelling campaign: characterization and modelling of an evening auroral arc observed from a rocket and a ground-based line of meridian scanners

An auroral arc system excited by soft electrons was studied with a combination of in situ rocket measurements and optical tomographic techniques, using data from a photometer on a horizontal, spinning rocket and a line of three meridian scanning photometers. The ground-based scanner data at 4709, 5577, 8446 and 6300 A were successfully inverted to provide a set of volume emission rate distributions in the plane of the rocket trajectory, with a basic time resolution of 24 s. Volume emission rate profiles, derived from these distributions peaked at about 150 km for 5577 and 4709 A, while the 8446 A emission peaked at about 170 km with a more extended height distribution. The rocket photometer gave comparable volume emission rate distributions for the 3914 A emission as reported in a separate paper by McDade et al. (1991, Planet. Space Sci. 39, 895). Instruments on the rocket measured the primary electron flux during the flight and, in particular, the flux precipitating into the auroral arc overflown at apogee (McEwen et al., 1991; in preparation). The local electron density and temperature were measured by probes on the rocket (Margot and McNamara (1991; Can. J. Phys. 69, 950). The electron density measurements on the downleg were modelled using ion production rate data derived from the optical results. Model calculations of the emission height profile based on the measured electron flux agree with the observed profiles. The height distribution of the N2+ emission in the equatorward band, through which the rocket passed during the descent, was measured by both the rocket and the ground-based tomographic techniques and the results are in good agreement. Comparison of these profiles with model profiles indicates that the exciting primary spectrum may be represented by an accelerated Maxwellian or a Gaussian distribution centered at about 3 keV. This distribution is close to what would be obtained if the electron flux exciting the poleward form were accelerated by a 1-2 kV upward potential drop. The relative height profiles for the volume emission rate of the 5577 A OI emission and the 4709 A N2+ emission were almost indistinguishable from each other for both the forms measured, with ratios in the range 38-50; this is equivalent to I(5577)/I(4278) ratios of 8-10. The auroral intensities and intensity ratios measured in the magnetic zenith from the ground during the period before and during the rocket flight are consistent with the primary electron fluxes and height distributions measured from the rocket. Values of I(5577)/I(4278) in the range 8-10 were also measured directly by the zenith ground photometers over which the arc system passed. These values are slightly higher than those reported by Gattinger and Vallance-Jones (1972) and this may possibly indicate an enhancement of the atomic oxygen concentration at the time of the flight. Such an enhancement would be consistent with our result, that the observed values of I(5577) and I(8446) are also significantly higher than those modelled on the basis of the electron flux spectrum measured at apogee.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29020/1/0000050.pd

Defining malnutrition: a plea to rethink

In a recent consensus report in Clinical Nutrition the undernourished category of malnutrition was proposed to be defined and diagnosed on the basis of a low BMI or unintentional weight loss combined with low BMI or FFMI with certain cut off points. The definition was endorsed by ESPEN despite recent endorsement of a very different definition. The approach aims to assess whether nutritional intake is sufficient but is imprecise because a low BMI does not always indicate malnutrition and individuals with increasing BMI's may have decreasing FFM's. The pathophysiology of individuals, considered to be malnourished in rich countries and in areas with endemic malnutrition, results predominantly from deficient nutrition combined with infection/inflammation. Both elements jointly determine body composition and function and consequently outcome of disease, trauma or treatment. When following the consensus statement only an imprecise estimate is acquired of nutritional intake without knowing the impact of inflammation. Most importantly, functional abilities are not assessed. Consequently it will remain uncertain how well the individual can overcome stressful events, what the causes are of dysfunction, how to set priorities for treatment and how to predict the effect of nutritional support. We therefore advise to consider the pathophysiology of malnourished individuals leading to inclusion of the following elements in the definition of malnutrition: a disordered nutritional state resulting from a combination of inflammation and a negative nutrient balance, leading to changes in body composition, function and outcome. A precise diagnosis of malnutrition should be based on assessment of these element

Total laparoscopic hysterectomy versus total abdominal hysterectomy with bilateral salpingo-oophorectomy for endometrial carcinoma: a randomised controlled trial with 5-year follow-up

This report is on recovery and long-term outcomes in a small-scale randomised controlled trial (RCT) after total laparoscopic hysterectomy versus total abdominal hysterectomy in (potential) endometrial carcinoma patients. An RCT was performed among women with atypical endometrial hyperplasia and endometrial carcinoma scheduled for hysterectomy in a teaching hospital in The Netherlands. Women were randomised to total laparoscopic hysterectomy versus total abdominal hysterectomy both with bilateral salpingo-oophorectomy and were followed until 5 years after the intervention. Patients completed the RAND 36-Item Short Form Health Survey (RAND-36), Quality of Recovery-40 (QoR-40) and Recovery Index-10 (RI-10) until 12 weeks after surgery. Main outcome measure was quality of life and recovery in the first 12 weeks after surgery. A linear mixed model was used for statistical analysis while accounting for baseline values where applicable. Seventeen women were included, of whom 11 allocated to the laparoscopic arm and 6 to the abdominal arm. Laparoscopic hysterectomy performed better on all scales and subscales used in the study. A statistically significant treatment effect, favouring laparoscopic hysterectomy, was found in the total RAND-36 (difference between groups 142 units, 95% confidence interval 46; 236). Clinical follow-up was completed after median 60 months, but this study was too small for conclusions regarding the safety and survival. Laparoscopic hysterectomy results in better postoperative quality of life in the first 12 weeks after surgery when compared with abdominal hysterectomy

ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

A European consensus conference on endometrial carcinoma was held in 2014 to produce multidisciplinary evidence-based guidelines on selected questions. Given the large body of literature on the management of endometrial carcinoma published since 2014, the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) jointly decided to update these evidence-based guidelines and to cover new topics in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide. ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of endometrial carcinoma (27 experts across Europe). To ensure that the guidelines are evidence-based, the literature published since 2014, identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 191 independent international practitioners in cancer care delivery and patient representatives. The guidelines comprehensively cover endometrial carcinoma staging, definition of prognostic risk groups integrating molecular markers, pre- and intra-operative work-up, fertility preservation, management for early, advanced, metastatic, and recurrent disease and palliative treatment. Principles of radiotherapy and pathological evaluation are also defined

ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

A European consensus conference on endometrial carcinoma was held in 2014 to produce multi-disciplinary evidence-based guidelines on selected questions. Given the large body of literature on the management of endometrial carcinoma published since 2014, the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly decided to update these evidence-based guidelines and to cover new topics in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide

A stage-structured model to predict the effect of temperature and salinity on glass eel Anguilla anguilla pigmentation development

The pigmentation development process of glass eels Anguilla anguilla from stage V-B to VIA3 was modelled by gamma cumulative functions. These functions varied with respect to the factors temperature and salinity whose effects were adjusted by beta functions. Temperature was shown to accelerate pigmentation, while salinity acted as a secondary factor slowing down the pigmentation. The model fits the development of 15 samples kept at various temperatures and salinities in the Vilaine River, as well as samples monitored at other dates and places in Europe. It allows the prediction of the duration of estuarine residency for glass eels, in winter and spring, in the Atlantic estuaries