38 research outputs found
Uncertainties and challenges in surgical and transcatheter tricuspid valve therapy: a state-of-the-art expert review
Tricuspid regurgitation (TR) is a frequent and complex problem, commonly combined with left-sided heart disease, such as mitral regurgitation. Significant TR is associated with increased mortality if left untreated or recurrent after therapy. Tricuspid regurgitation was historically often disregarded and remained undertreated. Surgery is currently the only Class I Guideline recommended therapy for TR, in the
form of annuloplasty, leaflet repair, or valve replacement. As growing experience of transcatheter therapy in structural heart disease,
many dedicated transcatheter tricuspid repair or replacement devices, which mimic well-established surgical techniques, are currently
under development. Nevertheless, many aspects of TR are little understood, including the disease process, surgical or interventional risk
stratification, and predictors of successful therapy. The optimal treatment timing and the choice of proper surgical or interventional technique for significant TR remain to be elucidated. In this context, we aim to highlight the current evidence, underline major controversial
issues in this field and present a future roadmap for TR therapy
The Cancer Genome Atlas Comprehensive Molecular Characterization of Renal Cell Carcinoma
Renal cell carcinoma(RCC) is not a single disease, but several histologically defined cancers with different genetic drivers, clinical courses, and therapeutic responses. The current study evaluated 843 RCC from the three major histologic subtypes, including 488 clear cell RCC, 274 papillary RCC, and 81 chromophobe RCC. Comprehensive genomic and phenotypic analysis of the RCC subtypes reveals distinctive features of each subtype that provide the foundation for the development of subtype-specific therapeutic and management strategies for patients affected with these cancers. Somatic alteration of BAP1, PBRM1, and PTEN and altered metabolic pathways correlated with subtype-specific decreased survival, while CDKN2A alteration, increased DNA hypermethylation, and increases in the immune-related Th2 gene expression signature correlated with decreased survival within all major histologic subtypes. CIMP-RCC demonstrated an increased immune signature, and a uniform and distinct metabolic expression pattern identified a subset of metabolically divergent (MD) ChRCC that associated with extremely poor survival
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Erratum: Galaxy source counts at 7.7 μm, 10 μm and 15 μm with the james webb space telescope (Monthly Notices of the Royal Astronomical Society (2022) 517:1 (853–857) DOI: 10.1093/mnras/stac2716)
This is a correction to the paper’Galaxy source counts at 7.7 μm, 10 μm and 15 μm with the James Webb Space Telescope’, Monthly Notices of the Royal Astronomical Society, Volume 517, Issue 1, November 2022, Pages 853–857, https://doi.org/10.1093/mnras/stac 2716. In the published version of the manuscript, a conversion error was introduced in the formula for the conversion between the observed number counts (dN/dS) and the differential source counts normalised to the Euclidean space (dN/dS × S2.5). The error originated in the calculation of the S2.5 term. By considering the width of each flux bin (S), we derived the term by the following formula (Equation presented) i.e. the final flux S was defined by the average of the flux values on both sides of the bin. The error was induced by two missing parentheses (Equation presented) where the exponent was incorrectly calculated first. This results in an overestimation of the conversion from dN/dS to dN/dS × S2.5 by a factor of 0.5/0.52.5 ∼ 3. Also, the conversion from dN/dS × S2.5 to dN/dS is underestimated by a factor of about 3. The error affects part of the data points in Fig. 6, 7 and 8 of the paper and could therefore lead to misleading results when using the data. The correct version of Fig. 6, 7 and 8 of the paper are presented in Fig. 1, 2 and 3, respectively. The observed number counts (the top panel of Fig. 2 and 3) of Elbaz et al. (1999); Gruppioni et al. (2002); Pearson et al. (2010); Takagi et al. (2012) shift upwards, while the differential source counts (the bottom panel of Fig. 1, 2 and 3) of JWST-002, JWST-006 (data points from the paper), Cowley et al. (2018) and Fazio et al. (2004) shift downwards. The effects of the error on our conclusions are summarised below: (i) The agreement between JWST data points (our work) and previous observation data (i.e. Elbaz et al. 1999; Gruppioni et al. 2002; Fazio et al. 2004; Pearson et al. 2010; Takagi et al. 2012) becomes slightly better after the correction. In addition, the correction contributes a small improvement in the agreement, especially for Takagi et al. (2012), as the deviation between the faint end of Takagi et al. (2012) and JWST data points is now reduced. (Equation presented) (ii) The agreement between JWST data points and model prediction from Cowley et al. (2018) remains the same. Nevertheless, the correction creates a discrepancy between our result and the source count model of Gruppioni et al. (2011) in 10 and 15 μm, which might suggest the model is overestimated at the faint end. Note that most parts of the 15 μm source model of Gruppioni et al. (2011) in JWST flux coverage (≲ 10−1 mJy) are obtained by the linear extrapolation, a solid conclusion may be hard to draw due to the uncertainty in the extrapolation
Source counts at 7.7–21 μm in CEERS field with JWST
Source counts – the number density of sources as a function of flux density – represent one of the fundamental metrics in observational cosmology due to their straightforward and simple nature. It is an important tool that provides information on galaxy formation and evolution. Source counting is a direct measurement. Compared to advanced analyses that require more observational input such as luminosity/mass functions, it is less affected by any cosmological parameter assumptions or any errors propagated from luminosities. In this study, we present source counts at the six mid-infrared (MIR) bands, i.e. 7.7, 10, 12.8, 15, 18, and 21 μm from the MIR instrument of the JWST. Contrasted with the infrared source counts achieved by prior generations of infrared space telescopes, our source counts delve up to ∼100 times deeper, showcasing the exceptional sensitivity of the JWST, and aligning with the model predictions based on preceding observations. In a follow-up study, we utilize our source counts to establish a new IR galaxy population evolutionary model that provides a physical interpretation
Subaru high-z exploration of low-luminosity quasars (SHELLQs) - XV. constraining the cosmic reionization at 5.5 < z < 7
Revealing the cosmic hydrogen reionization history is one of the main goals of the modern cosmology. z > 5 quasars (QSOs) have been used as back-lights to investigate the evolution of the intervening intergalactic medium (IGM) during the cosmic reionization since their first discovery. However, due to the small population of luminous QSOs (∼130 QSOs known to date), a tight constraint on the reionization history has not yet been placed. In this work, we aim to tighten the constraint using the 93 QSOs (5.5 < z < 7.1) recently discovered in the Subaru High-z Exploration of Low-Luminosity Quasars (SHELLQS) project. This is the largest QSO sample used to constrain the epoch of reionization. We measure the mean IGM Ly α transmission and the QSO near-zone size using the UV spectra of these QSOs. The mean IGM Ly α transmission rises above zero at z ≲ 6, indicating the end of the reionization. The near-zone sizes of the SHELLQs QSOs are consistent with sizes spanned by QSOs of lifetime tq ∼ 1–100 Myr in simulations. Due to the scatter created by the low signal-to-noise spectra and large Ly α redshift uncertainty, we cannot conclude whether the redshift evolution of the near-zone size is affected by the reionization effect
Polycyclic aromatic hydrocarbon luminous galaxies in JWST CEERS data
It has been an unanswered question how many dusty galaxies have been undetected from the state-of-The-Art observational surveys. JWST enables us to detect faint infrared (IR) galaxies that have prominent polycyclic aromatic hydrocarbon (PAH) features in the mid-IR wavelengths. PAH is a valuable tracer of star formation and dust properties in the mid-IR wavelength. The JWST Cosmic Evolution Early Release Science (CEERS) fields provide us with wavelength coverage from 7.7 to 21 μm using six photometric bands of the mid-IR instrument (MIRI). We have identified galaxies dominated by mid-IR emission from PAHs, termed PAH galaxies. From our multiband photometry catalogue, we selected 10 PAH galaxies displaying high flux ratios of log (S15/S10) > 0.8. The SED fitting analysis indicates that these galaxies are star-forming galaxies with total IR luminosities of 1010 ∼1011.5 Lat z ∼1. The morphology of PAH galaxies does not show any clear signatures of major merging or interaction within the MIRI resolution. The majority of them are on the star-formation main sequence at z ∼1. Our result demonstrates that JWST can detect PAH emissions from normal star-forming galaxies at z ∼1, in addition to ultra-luminous infrared galaxies or luminous IR galaxies (LIRGs)
The Effect of Moderate Alcohol Intake on Gallblader Motility A Milk Ultrasonographic Study
Constraining the Hubble constant and its lower limit from the proper motion of extragalactic radio jets
The Hubble constant (H0) is a measurement to describe the expansion rate of the Universe in the current era. However, there is a 4.4σ discrepancy between the measurements from the early Universe and the late Universe. In this research, we propose a model-free and distance-free method to constrain H0. Combining Friedman-Lemaître-Robertson-Walker cosmology with geometrical relation of the proper motion of extragalactic jets, the lower limit (H0,min) of H0 can be determined using only three cosmology-free observables: The redshifts of the host galaxies, and the approaching and receding angular velocities of radio jets. Using these, we propose to use the Kolmogorov-Smirnov test (K-S test) between cumulative distribution functions of H0,min to differentiate cosmology. We simulate 100, 200, and 500 extragalactic jets with three levels of accuracy of the proper motion (μa and μr), at 10, 5, and 1 per cent, corresponding to the accuracies of the current and future radio interferometers. We perform K-S tests between the simulated samples as theoretical distributions with different H0 and power-law index of velocity distribution of jets and mock observational data. Our result suggests increasing sample sizes leads to tighter constraints on both power-law index and the Hubble constant at moderate accuracy (i.e. and ), while at 1{ percent}} accuracy, increasing sample sizes leads to tighter constraints on power-law index more. Improving accuracy results in better constraints in the Hubble constant compared with the power-law index in all cases, but it alleviates the degeneracy