1,320 research outputs found
Exploring the Cosmic Evolution of Habitability with Galaxy Merger Trees
We combine inferred galaxy properties from a semi-analytic galaxy evolution
model incorporating dark matter halo merger trees with new estimates of
supernova and gamma ray burst rates as a function of metallicity from stellar
population synthesis models incorporating binary interactions. We use these to
explore the stellar mass fraction of galaxies irradiated by energetic
astrophysical transients and its evolution over cosmic time, and thus the
fraction which is potentially habitable by life like our own. We find that 18
per cent of the stellar mass in the Universe is likely to have been irradiated
within the last 260 Myr, with GRBs dominating that fraction. We do not see a
strong dependence of irradiated stellar mass fraction on stellar mass or
richness of the galaxy environment. We consider a representative merger tree as
a Local Group analogue, and find that there are galaxies at all masses which
have retained a high habitable fraction (>40 per cent) over the last 6 Gyr, but
also that there are galaxies at all masses where the merger history and
associated star formation have rendered galaxies effectively uninhabitable.
This illustrates the need to consider detailed merger trees when evaluating the
cosmic evolution of habitability.Comment: 11 page, 10 figures. MNRAS accepted 13th Dec 2017. Updated to match
accepted version, with additional discussion of metallicity effect
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British research in accounting and finance (2001–2007): the 2008 research assessment exercise
No abstract available
Maximum tumor diameter is associated with event-free survival in PET-negative patients with stage I/IIA Hodgkin lymphoma.
Introduction: the high cure rates achieved in early-stage (ES) Hodgkin lymphoma (HL) are one of the great successes of hemato-oncology, but late treatment-related toxicity undermines long-term survival. Improving overall survival and quality of life further will require maintaining disease control while potentially de-escalating chemotherapy and/or omitting radiotherapy to reduce late toxicity. Accurate stratification of patients is required to facilitate individualized treatment approaches. Response assessment using 18F-fluorodeoxyglucose positron emission tomography (PET) is a powerful predictor of outcome in HL,1,2 and has been used in multiple studies, including the United Kingdom National Cancer Research Institute Randomised Phase III Trial to Determine the Role of FDG–PET Imaging in Clinical Stages IA/IIA Hodgkin’s Disease (UK NCRI RAPID) trial, to investigate whether patients achieving complete metabolic remission (CMR) can be treated with chemotherapy alone.3-5 These PET-adapted trials have demonstrated that omitting radiotherapy results in higher relapse rates, but without compromising overall survival.3-5
For the 75% of patients who achieved CMR in RAPID, neither baseline clinical risk stratification (favorable/unfavorable) nor PET (Deauville score 1/2) predicted disease relapse; additional biomarkers are needed.1 Tumor bulk has long been recognized as prognostic in HL,1,6 but there remains uncertainty about the significance and definition of bulk in the era of PET-adapted treatment.7 We performed a subsidiary analysis of RAPID to assess the prognostic value of baseline maximum tumor dimension (MTD) in patients achieving CMR.
Methods: ee have previously reported the RAPID trial design, primary results, and outcomes according to pretreatment risk stratification and PET score.1,3 Patients were aged 16 to 75 years with untreated ES-HL and without B-symptoms or mediastinal bulk (mass > 1/3 internal mediastinal diameter at T5/6).6 Metabolic response after 3 cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine) was centrally assessed using PET (N = 562). Patients with CMR (ie, Deauville score 1-2) were randomly assigned to receive involved field radiotherapy (IFRT; n = 208) or no further therapy (NFT; n = 211). PET-positive patients (score, 3-5; n = 143) received a fourth cycle of ABVD and IFRT.
Baseline disease assessment was performed by computed tomography, and bidimensional target lesion measurements were reported by local radiologists in millimeters. The association of baseline MTD with HL-related event-free survival (EFS: progression or HL-related death) and progression-free survival (PFS) (progression or any-cause death) was assessed using Kaplan-Meier and Cox regression analyses. Non-HL deaths were either related to primary treatment toxicity or occurred in HL remission.1
United Kingdom ethical approval for the RAPID trial was via the UK Multicentre Research ethics committee.
Results and discussion: baseline patient characteristics have been previously described.1 Median age was 34 years (range, 16-75 years); 184 (37.4%) of 492 patients had unfavorable risk by European Organisation for Research and Treatment of Cancer criteria, and 155 (32.3%) of 480 by German Hodgkin Study Groupcriteria. Median MTD for patients achieving CMR was 3.0 cm (interquartile range, 2.0-4.0 cm) and 3.0 cm (interquartile range, 1.8-4.5 cm) in the NFT and IFRT groups, respectively, whereas PET-positive patients had a median MTD of 3.9 cm (interquartile range, 2.8-5.1 cm). After a median follow-up of 61.6 m, 44 HL progression events occurred: 21 NFT, 9 IFRT and 14 PET-positive. No patient received salvage treatment without documented progression. Only 5 HL-related deaths occurred (1 IFRT, 4 PET-positive), and 12 non-HL deaths (4 NFT, 6 IFRT, 2 PET-positive).1
For patients with CMR (N = 419), there was a strong association between MTD and EFS (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.02-1.39; P = .02), adjusting for treatment group, with an approximate 19% increase in HL risk per centimeter increase in MTD. The association was similar in both treatment groups (NFT HR, 1.20 [95% CI, 0.99-1.44; P = .06]; IFRT HR, 1.19 [95% CI, 0.92-1.55; P = .19]). The observed effect sizes did not markedly change after adjusting for baseline clinical risk factors, and similar results were observed for PFS (supplemental Table 1). In contrast, for PET-positive patients, there was no association between MTD and EFS (HR, 0.88; 95% CI, 0.70-1.11; P = .29) or PFS (HR, 0.87; 95% CI, 0.70-1.08; P = .21).
In an exploratory analysis within the NFT group, MTD was dichotomized using increasing 1-cm intervals to investigate the relationship between MTD thresholds and EFS. The largest effect size was observed with an MTD threshold of ≥5 cm (Table 1). Similar results were observed for PFS; this threshold also performed best in time-dependent receiver operating characteristic curve analyses. It was not possible to assess MTD thresholds in the IFRT group with only 9 events. Among all randomized patients, 79 (18.9%) had MTD of ≥5 cm, the majority with mediastinal (n = 43), supraclavicular (n = 17), or cervical (n = 16) locations. Five-year EFS for patients with MTD of ≥5 cm randomly assigned to NFT and IFRT was 79.3% (n = 39; 95% CI, 66.6%-92.0%) and 94.9% (n = 40; 95% CI, 88.0%-100%), respectively (P = .03; Figure 1)
Positron Emission Tomography Score Has Greater Prognostic Significance Than Pretreatment Risk Stratification in Early-Stage Hodgkin Lymphoma in the UK RAPID Study.
PURPOSE: Accurate stratification of patients is an important goal in Hodgkin lymphoma (HL), but the role of pretreatment clinical risk stratification in the context of positron emission tomography (PET) -adapted treatment is unclear. We performed a subsidiary analysis of the RAPID trial to assess the prognostic value of pretreatment risk factors and PET score in determining outcomes. PATIENTS AND METHODS: Patients with stage IA to IIA HL and no mediastinal bulk underwent PET assessment after three cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine; 143 PET-positive patients (PET score, 3 to 5) received a fourth doxorubicin, bleomycin, vinblastine, and dacarbazine cycle and involved-field radiotherapy, and 419 patients in complete metabolic remission were randomly assigned to receive involved-field radiotherapy (n = 208) or no additional treatment (n = 211). Cox regression was used to investigate the association between PET score and pretreatment risk factors with HL-specific event-free survival (EFS). RESULTS: High PET score was associated with inferior EFS, before (P .4). CONCLUSION: In RAPID, a positive PET scan did not carry uniform prognostic weight; only a PET score of 5 was associated with inferior outcomes. This suggests that in future trials involving patients without B symptoms or mediastinal bulk, a score of 5 rather than a positive PET result should be used to guide treatment escalation in early-stage HL
The Fundamental Diagram of Pedestrian Movement Revisited
The empirical relation between density and velocity of pedestrian movement is
not completely analyzed, particularly with regard to the `microscopic' causes
which determine the relation at medium and high densities. The simplest system
for the investigation of this dependency is the normal movement of pedestrians
along a line (single-file movement). This article presents experimental results
for this system under laboratory conditions and discusses the following
observations: The data show a linear relation between the velocity and the
inverse of the density, which can be regarded as the required length of one
pedestrian to move. Furthermore we compare the results for the single-file
movement with literature data for the movement in a plane. This comparison
shows an unexpected conformance between the fundamental diagrams, indicating
that lateral interference has negligible influence on the velocity-density
relation at the density domain . In addition we test a
procedure for automatic recording of pedestrian flow characteristics. We
present preliminary results on measurement range and accuracy of this method.Comment: 13 pages, 9 figure
Prehistory of Transit Searches
Nowadays the more powerful method to detect extrasolar planets is the transit
method. We review the planet transits which were anticipated, searched, and the
first ones which were observed all through history. Indeed transits of planets
in front of their star were first investigated and studied in the solar system.
The first observations of sunspots were sometimes mistaken for transits of
unknown planets. The first scientific observation and study of a transit in the
solar system was the observation of Mercury transit by Pierre Gassendi in 1631.
Because observations of Venus transits could give a way to determine the
distance Sun-Earth, transits of Venus were overwhelmingly observed. Some
objects which actually do not exist were searched by their hypothetical
transits on the Sun, as some examples a Venus satellite and an infra-mercurial
planet. We evoke the possibly first use of the hypothesis of an exoplanet
transit to explain some periodic variations of the luminosity of a star, namely
the star Algol, during the eighteen century. Then we review the predictions of
detection of exoplanets by their transits, those predictions being sometimes
ancient, and made by astronomers as well as popular science writers. However,
these very interesting predictions were never published in peer-reviewed
journals specialized in astronomical discoveries and results. A possible
transit of the planet beta Pic b was observed in 1981. Shall we see another
transit expected for the same planet during 2018? Today, some studies of
transits which are connected to hypothetical extraterrestrial civilisations are
published in astronomical refereed journals. Some studies which would be
classified not long ago as science fiction are now considered as scientific
ones.Comment: Submiited to Handbook of Exoplanets (Springer
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Stakeholder views on cognitive communication assessment and intervention for a person living independently in the community with severe traumatic brain injury
Background
Cognitive communication disorder (CCD) following traumatic brain injury (TBI) is well documented and these communication problems impede successful re-integration into community living. While there is growing evidence for intervention to both detect and treat the impact of these deficits across the rehabilitation continuum, there are barriers to accessing services. Cognitive communication impairments may be missed because the person can talk, and this may mask the subtle but debilitating impact of a CCD. Referral to a speech and language therapist (SLT) may be overlooked or not timely, which prevents the individual accessing evidence-based interventions. Inadequate treatment provision and an under- or overestimation of communication capability can potentially undermine the effectiveness of wider team assessment and intervention.
Aims
To report stakeholder views on specialist SLT input for CCD within a multidisciplinary team intervention for a community-dwelling individual with severe TBI. The investigation explored perspectives on understanding of CCD, on practice and on outcomes, in order to inform professional groups on perceived impacts of the evidence-to-practice gap.
Methods and Procedures
A semi-structured interview methodology was employed with 11 stakeholder participants involved in a single case. Data were evaluated using a thematic framework method. Themes were inductively derived from the stakeholder narratives.
Outcomes
Stakeholders reported the following outcomes from specialist SLT input for CCD within a collaborative team approach: improved engagement with rehabilitation and support teams, improved health-related quality of life and well-being, and increased client participation in community activities of personal relevance. Stakeholders also reported inequities in wider service provision where limitations in professional understanding of CCD and knowledge of best practice recommendations preclude access to specialist SLT services.
Conclusions
CCDs are under-recognised and this can have a devastating effect on people with CCD and on those around them. Stakeholder reports provide evidence for the effectiveness of SLT practice recommendations for the treatment of CCD following TBI. They also provide additional evidence of persisting barriers to accessing treatment. Future research to explore ways to close this evidence-to-practice gap is required.
What This Paper Adds
What is already known on this subject
Cognitive communication difficulties are a well-documented consequence of TBI. There is evidence for the effectiveness of person-centred interventions for CCD across the recovery continuum. International evidence-based practice recommendations are in place for CCD assessment and management. Barriers to accessing SLT expertise for CCD have previously been reported.
What this paper adds to existing knowledge
This investigation explores the views of a diverse group of stakeholders involved in a single case of a community-dwelling individual with severe TBI. Stakeholders report positive real-world outcomes from SLT interventions for CCD within a coordinated multidisciplinary rehabilitation team. Stakeholder reports also indicate inequities in wider service provision and CCD knowledge gaps amongst professional groups providing rehabilitation services for people with TBI.
What are the potential or actual clinical implications of this work?
CCDs are under-recognised, with devastating effect for people with CCD and those around them. These findings underscore the importance of raising professional awareness of CCD and best practice recommendations, in order to improve access to SLT expertise for people with CCD following TBI
Factors affecting outcomes of open surgical repair of pararenal aortic aneurysms: A 10-year experience
PurposeFew large series document surgical outcomes for patients with pararenal abdominal aortic aneurysms (PAAAs), defined as aneurysms including the juxtarenal aorta or renal artery origins that require suprarenal aortic clamping. No standard endovascular alternatives presently exist; however, future endovascular branch graft repairs ultimately must be compared with the gold standard of open repair. To this end, we present a 10-year experience.MethodsBetween 1993 and 2003, 3058 AAAs were repaired. Perioperative variables, morbidity, and mortality were retrospectively assessed. Renal insufficiency was defined as a rise in the concentration of serum creatinine by ≥0.5 mg/dL. Factors predicting complications were identified by multivariate analyses. Morbidity and 30-day mortality were evaluated with multiple logistic regression analysis.ResultsOf a total of 3058 AAA repairs performed, 247 were PAAAs (8%). Mean renal ischemia time was 23 minutes (range, 5 to 60 minutes). Cardiac complications occurred in 32 patients (13%), pulmonary complications in 38 (16%), and renal insufficiency in 54 (22%). Multivariate analysis associated myocardial infarction with advanced age (P = .01) and abnormal preoperative serum creatinine (>1.5 mg/dL) (P = .08). Pulmonary complications were associated with advanced age (P = .03), renal artery bypass (P = .02), increased mesenteric ischemic time (P = .01), suprarenal aneurysm repair (P < .0008), and left renal vein division (P = .01). Renal insufficiency was associated with increased mesenteric ischemic time (P = .001), supravisceral clamping (P = .04), left renal vein division (P = .04), and renal artery bypass (P = .0002), but not renal artery reimplantation or endarterectomy. New dialysis was required in 3.7% (9/242). Abnormal preoperative serum creatinine (>1.5 mg/dL) was predictive of the need for postoperative dialysis (10% vs 2%; P = .04). Patients with normal preoperative renal function had improved recovery (93% vs 36%; P = .0002). The 30-day surgical mortality was 2.5% (6/247) but was not predicted by any factors, and in-hospital mortality was 2.8% (7/247). Median intensive care and hospital stays were 3 and 9 days, respectively, and longer stays were associated with age at surgery (P = .007 and P = .0002, respectively) and any postoperative complication.ConclusionsPAAA repair can be performed with low mortality. Renal insufficiency is the most frequent complication, but avoiding renal artery bypass, prolonged mesenteric ischemia time, or left renal vein transection may improve results
Observations of Low Frequency Solar Radio Bursts from the Rosse Solar-Terrestrial Observatory
The Rosse Solar-Terrestrial Observatory (RSTO; www.rosseobservatory.ie) was
established at Birr Castle, Co. Offaly, Ireland (53 05'38.9", 7 55'12.7") in
2010 to study solar radio bursts and the response of the Earth's ionosphere and
geomagnetic field. To date, three Compound Astronomical Low-cost Low-frequency
Instrument for Spectroscopy and Transportable Observatory (CALLISTO)
spectrometers have been installed, with the capability of observing in the
frequency range 10-870 MHz. The receivers are fed simultaneously by biconical
and log-periodic antennas. Nominally, frequency spectra in the range 10-400 MHz
are obtained with 4 sweeps per second over 600 channels. Here, we describe the
RSTO solar radio spectrometer set-up, and present dynamic spectra of a sample
of Type II, III and IV radio bursts. In particular, we describe fine-scale
structure observed in Type II bursts, including band splitting and rapidly
varying herringbone features
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