Quality of life in patients post sacral resection using patient reported outcomes measurements.

BACKGROUND CONTEXT: There is little consensus about what tools to use to assess quality of life in these patients who undergo enbloc removal of the sacrum for malignant disease. Symptoms can vary from wound complications to loss of bowel, bladder and sexual function. It is clear that no one questionnaire can cover the full spectrum of symptoms. PURPOSE: To assess physical and mental function, pain intensity and pain interference in patients after resection of a primary sacral tumor. STUDY DESIGN: This was a multi-institutional pilot cross-sectional study. PATIENT SAMPLE: Consecutive patients who visited the out-patient clinic for follow-up post sacrectomy at MSKCC, MGH and MC between January 2012 and October 2013 were included. The study population comprised of 79 patients. OUTCOME MEASURES: Patients were classified as having had a total, hemi, high or low sacrectomy based on the level of sacral resection. METHODS: Patient data was collected using a tablet PC in the out-patient clinic and stored in an online database. Further data was collected from clinic notes and hospital records that included operative notes and radiology reports. RESULTS:Total and hemi sacrectomies were associated with worse pain intensity compared to high and low sacrectomies (p CONCLUSIONS: The pool of literature regarding sacrectomy QoL outcomes is virtually nonexistent. This study demonstrates the need for a universal QoL tool which measures overall QoL, physical function, mental function, pain, bowel, bladder and sexual function. To our knowledge this is the first study to attempt to measure the QoL in patients post sacrectomy

Two proposals for testing quantum contextuality of continuous-variable states

We investigate the violation of non-contextuality by a class of continuous variable states, including variations of entangled coherent states (ECS's) and a two-mode continuous superposition of coherent states. We generalise the Kochen-Specker (KS) inequality discussed in A. Cabello, Phys. Rev. Lett. {\bf 101}, 210401 (2008) by using effective bidimensional observables implemented through physical operations acting on continuous variable states, in a way similar to an approach to the falsification of Bell-CHSH inequalities put forward recently. We test for state-independent violation of KS inequalities under variable degrees of state entanglement and mixedness. We then demonstrate theoretically the violation of a KS inequality for any two-mode state by using pseudo-spin observables and a generalized quasi-probability function.Comment: 7 pages, 2 figures, RevTeX

Non-Markovian effects on non-locality of a qubit-oscillator system

Non-Markovian evolutions are responsible for a wide variety of physically interesting effects. Here, we study non-locality of the non-classical state of a system consisting of a qubit and an oscillator exposed to the effects of non-Markovian evolutions. We find that the different facets of non-Markovianity affect non-locality in different and non-obvious ways: ranging from pronounced insensitivity of the Bell function to quite a spectacular evidence of information kick-back.Comment: 7 pages, 3 figures, RevTeX

Public views on principles for health care priority setting: findings of a European cross-country study using Q methodology

International audienc

The discovery of I-BRD9, a selective cell active chemical probe for bromodomain containing protein 9 inhibition

Acetylation of histone lysine residues is one of the most well-studied post-translational modifications of chromatin, selectively recognized by bromodomain “reader” modules. Inhibitors of the bromodomain and extra terminal domain (BET) family of bromodomains have shown profound anticancer and anti-inflammatory properties, generating much interest in targeting other bromodomain-containing proteins for disease treatment. Herein, we report the discovery of I-BRD9, the first selective cellular chemical probe for bromodomain-containing protein 9 (BRD9). I-BRD9 was identified through structure-based design, leading to greater than 700-fold selectivity over the BET family and 200-fold over the highly homologous bromodomain-containing protein 7 (BRD7). I-BRD9 was used to identify genes regulated by BRD9 in Kasumi-1 cells involved in oncology and immune response pathways and to the best of our knowledge, represents the first selective tool compound available to elucidate the cellular phenotype of BRD9 bromodomain inhibition

Abdominal aortic aneurysm is associated with a variant in low-density lipoprotein receptor-related protein 1

Abdominal aortic aneurysm (AAA) is a common cause of morbidity and mortality and has a significant heritability. We carried out a genome-wide association discovery study of 1866 patients with AAA and 5435 controls and replication of promising signals (lead SNP with a p value < 1 × 10-5) in 2871 additional cases and 32,687 controls and performed further follow-up in 1491 AAA and 11,060 controls. In the discovery study, nine loci demonstrated association with AAA (p < 1 × 10-5). In the replication sample, the lead SNP at one of these loci, rs1466535, located within intron 1 of low-density-lipoprotein receptor-related protein 1 (LRP1) demonstrated significant association (p = 0.0042). We confirmed the association of rs1466535 and AAA in our follow-up study (p = 0.035). In a combined analysis (6228 AAA and 49182 controls), rs1466535 had a consistent effect size and direction in all sample sets (combined p = 4.52 × 10-10, odds ratio 1.15 [1.10-1.21]). No associations were seen for either rs1466535 or the 12q13.3 locus in independent association studies of coronary artery disease, blood pressure, diabetes, or hyperlipidaemia, suggesting that this locus is specific to AAA. Gene-expression studies demonstrated a trend toward increased LRP1 expression for the rs1466535 CC genotype in arterial tissues; there was a significant (p = 0.029) 1.19-fold (1.04-1.36) increase in LRP1 expression in CC homozygotes compared to TT homozygotes in aortic adventitia. Functional studies demonstrated that rs1466535 might alter a SREBP-1 binding site and influence enhancer activity at the locus. In conclusion, this study has identified a biologically plausible genetic variant associated specifically with AAA, and we suggest that this variant has a possible functional role in LRP1 expression

Tests of fundamental quantum mechanics in continuous variable systems

Finding the boundary between quantum and classical domains is very much an open question that is fundamental to a great deal of research spanning across many physics communities. The division is not clear cut and a deeper understanding is necessary for the future generation and engineering of quantum devices. In this thesis we introduce and apply a variety of tests that will reveal non classicality in real physical systems. The systems that we consider in many instances can be deemed classical and so our study is well motivated by the endeavor to explain the quantum to classical transition. We investigate three main classes of nonclassicality tests: Bell non locality, Kochen-Specker quantum contextuality and violation of Leggett-Garg macrorealism. These tests are applied to specific continuous variable systems that live in infinite dimensional Hilbert spaces and represent various states of the electromagnetic field. Firstly we test non locality in multimode versions of the thermal state. We show numerous violations of relevant Bell inequalities under quite unfavorable conditions and include state generation schemes. We then demonstrate through the violation of a Kochen-Specker inequality the state-independent quantum contextuality of a range of continuous variable states. These states include variations of entangled coherent states, a two-mode squeezed state and states represented by a generalized quasi-probability function. In what follows in the thesis we study non-locality of the nonclassical state of a system consisting of a qubit and an oscillator exposed to the effects of non-Markovian evolutions. Here we show interesting features related to the various facets with which non-Markovianity manifests itself. Finally this work tests macroscopic realism of a coherent and thermal state. We successively show violation of a Leggett-Garg inequality for a range of coherent state amplitude and degree of thermal mixedness.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Evaluating patient presentations for care delivered by emergency nurse practitioners : a retrospective analysis of 12 months

Background\ud \ud The delivery of quality patient care in the emergency department (ED) is emerging as one of the most important service indicators to be measured in health services today. The emergency nurse practitioner role was implemented as a service innovation in a Emergency & Trauma Centre (ETC), Melbourne, Australia, in July 2004 .The primary aim of the role was intended to enhance healthcare services, improve the efficiency and timely delivery of high quality care to patients. \ud \ud Aim \ud \ud To conduct a retrospective study of patient presentations at the ETC to obtain a profile of the characteristics of patients managed by emergency nurse practitioners. Specifically the objectives of the study were to:\ud \ud 1) examine the demographics of the patient population\ud 2) evaluate data on emergency department service indicators for this patient cohort\ud \ud Method \ud \ud All patients presenting to the ETC from January 01 2011 to December 31 2011 and managed by emergency nurse practitioners were included in the review. Data collection included baseline demographics, waiting times to be seen, length of stay, emergency department discharge diagnoses and referral patterns. Data were extracted and imported directly from the emergency department Patient Information System (Cerner log), for the specified time frame.\ud \ud Results\ud \ud A total of 5212 patients were reviewed in the study period. The median age of patients was 35 years and 61% of patients were male. The most common discharge diagnosis was open wounds to hand/wrist. Waiting times to be seen by the emergency nurse practitioner were 14 minutes and length of stay for patients with a discharge disposition of home were 122 minutes.\ud \ud Conclusions\ud \ud This study has provided information on patient baseline characteristics and performance on important service indicators for this patient sample that will inform further research to evaluate specific outcomes of the emergency nurse practitioner service