371 research outputs found

    A Computer-Assisted Uniqueness Proof for a Semilinear Elliptic Boundary Value Problem

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    A wide variety of articles, starting with the famous paper (Gidas, Ni and Nirenberg in Commun. Math. Phys. 68, 209-243 (1979)) is devoted to the uniqueness question for the semilinear elliptic boundary value problem -{\Delta}u={\lambda}u+u^p in {\Omega}, u>0 in {\Omega}, u=0 on the boundary of {\Omega}, where {\lambda} ranges between 0 and the first Dirichlet Laplacian eigenvalue. So far, this question was settled in the case of {\Omega} being a ball and, for more general domains, in the case {\lambda}=0. In (McKenna et al. in J. Differ. Equ. 247, 2140-2162 (2009)), we proposed a computer-assisted approach to this uniqueness question, which indeed provided a proof in the case {\Omega}=(0,1)x(0,1), and p=2. Due to the high numerical complexity, we were not able in (McKenna et al. in J. Differ. Equ. 247, 2140-2162 (2009)) to treat higher values of p. Here, by a significant reduction of the complexity, we will prove uniqueness for the case p=3

    A Decision Analysis Evaluating Screening for Kidney Cancer Using Focused Renal Ultrasound

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    Background Screening for renal cell carcinoma (RCC) has been identified as a key research priority; however, no randomised control trials have been performed. Value of information analysis can determine whether further research on this topic is of value. Objective To determine (1) whether current evidence suggests that screening is potentially cost effective and, if so, (2) in which age/sex groups, (3) identify evidence gaps, and (4) estimate the value of further research to close those gaps. Design, setting, and participants A decision model was developed evaluating screening in asymptomatic individuals in the UK. A National Health Service perspective was adopted. Intervention A single focused renal ultrasound scan compared with standard of care (no screening). Outcome measurements and statistical analysis Expected lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER), discounted at 3.5% per annum. Results and limitations Given a prevalence of RCC of 0.34% (0.18–0.54%), screening 60-yr-old men resulted in an ICER of Β£18 092/QALY (€22 843/QALY). Given a prevalence of RCC of 0.16% (0.08–0.25%), screening 60-yr-old women resulted in an ICER of Β£37 327/QALY (€47 129/QALY). In the one-way sensitivity analysis, the ICER was <Β£30 000/QALY as long as the prevalence of RCC was β‰₯0.25% for men and β‰₯0.2% for women at age 60 yr. Given the willingness to pay a threshold of Β£30 000/QALY (€37 878/QALY), the population-expected values of perfect information were Β£194 million (€244 million) and Β£97 million (€123 million) for 60-yr-old men and women, respectively. The expected value of perfect parameter information suggests that the prevalence of RCC and stage shift associated with screening are key research priorities. Conclusions Current evidence suggests that one-off screening of 60-yr-old men is potentially cost effective and that further research into this topic would be of value to society. Patient summary Economic modelling suggests that screening 60-yr-old men for kidney cancer using ultrasound may be a good use of resources and that further research on this topic should be performed

    The Wrong Kind of Noise: Understanding and Valuing the Communication of Autistic Children in Schools

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    As a result of the association of autism with speech and language difficulties, autistic school children can be subject to interventions ostensibly intended to remedy these problems. However, my study, based in five mainstream primary schools in England, which incorporated the views and experiences of school staff (n = 36), autistic children (n = 10), their parents (n = 10) and a sample of autistic adults (n = 10), suggests that these inputs do not always provide the children with the help they require. Indeed, notwithstanding some examples of effective assistance, the more evident communication of the autistic children, in its various manifestations, might be ignored and their wishes denied, if deemed not to correspond with the expectations or intentions of the supporting adult. Furthermore, their communication was also found to intersect with the issue of noise in schools, a complex phenomenon which can be an exclusionary factor for autistic children. Indeed, if some forms of noise were tolerated in school, the sounds emanating from autistic children might be disdained, while the communicative value of their silence was not evidently recognised either. Therefore, whether speaking, making noises or remaining silent, autistic children can be deemed to be making the wrong kind of noise. Elucidated via empirical examples from my study, the implications for research and practice are discussed, providing alternative perspectives on how to support the communication of autistic children, leading to greater agency, well-being and educational inclusion on their part

    Discrepancy between radiological and pathological size of renal masses

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    <p>Abstract</p> <p>Background</p> <p>Tumor size is a critical variable in staging for renal cell carcinoma. Clinicians rely on radiological estimates of pathological tumor size to guide patient counseling regarding prognosis, choice of treatment strategy and entry into clinical trials. If there is a discrepancy between radiological and pathological measurements of renal tumor size, this could have implications for clinical practice. Our study aimed to compare the radiological size of solid renal tumors on computed tomography (CT) to the pathological size in an Australian population.</p> <p>Methods</p> <p>We identified 157 patients in the Westmead Renal Tumor Database, for whom data was available for both radiological tumor size on CT and pathological tumor size. The paired Student's <it>t</it>-test was used to compare the mean radiological tumor size and the mean pathological tumor size. Statistical significance was defined as <it>P </it>< 0.05. We also identified all cases in which post-operative down-staging or up-staging occurred due to discrepancy between radiological and pathological tumor sizes. Additionally, we examined the relationship between Fuhrman grade and radiological tumor size and pathological T stage.</p> <p>Results</p> <p>Overall, the mean radiological tumor size on CT was 58.3 mm and the mean pathological size was 55.2 mm. On average, CT overestimated pathological size by 3.1 mm (<it>P </it>= 0.012). CT overestimated pathological tumor size in 92 (58.6%) patients, underestimated in 44 (28.0%) patients and equaled pathological size in 21 (31.4%) patients. Among the 122 patients with pT1 or pT2 tumors, there was a discrepancy between clinical and pathological staging in 35 (29%) patients. Of these, 21 (17%) patients were down-staged post-operatively and 14 (11.5%) were up-staged. Fuhrman grade correlated positively with radiological tumor size (<it>P </it>= 0.039) and pathological tumor stage (<it>P </it>= 0.003).</p> <p>Conclusions</p> <p>There was a statistically significant but small difference (3.1 mm) between mean radiological and mean pathological tumor size, but this is of uncertain clinical significance. For some patients, the difference leads to a discrepancy between clinical and pathological staging, which may have implications for pre-operative patient counseling regarding prognosis and management.</p

    Constitutive Overexpression of the OsNAS Gene Family Reveals Single-Gene Strategies for Effective Iron- and Zinc-Biofortification of Rice Endosperm

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    BACKGROUND: Rice is the primary source of food for billions of people in developing countries, yet the commonly consumed polished grain contains insufficient levels of the key micronutrients iron (Fe), zinc (Zn) and Vitamin A to meet daily dietary requirements. Experts estimate that a rice-based diet should contain 14.5 Β΅g gβˆ’1 Fe in endosperm, the main constituent of polished grain, but breeding programs have failed to achieve even half of that value. Transgenic efforts to increase the Fe concentration of rice endosperm include expression of ferritin genes, nicotianamine synthase genes (NAS) or ferritin in conjunction with NAS genes, with results ranging from two-fold increases via single-gene approaches to six-fold increases via multi-gene approaches, yet no approach has reported 14.5 Β΅g gβˆ’1 Fe in endosperm. METHODOLOGY/PRINCIPAL FINDINGS: Three populations of rice were generated to constitutively overexpress OsNAS1, OsNAS2 or OsNAS3, respectively. Nicotianamine, Fe and Zn concentrations were significantly increased in unpolished grain of all three of the overexpression populations, relative to controls, with the highest concentrations in the OsNAS2 and OsNAS3 overexpression populations. Selected lines from each population had at least 10 Β΅g gβˆ’1 Fe in polished grain and two OsNAS2 overexpression lines had 14 and 19 Β΅g gβˆ’1 Fe in polished grain, representing up to four-fold increases in Fe concentration. Two-fold increases of Zn concentration were also observed in the OsNAS2 population. Synchrotron X-ray fluorescence spectroscopy demonstrated that OsNAS2 overexpression leads to significant enrichment of Fe and Zn in phosphorus-free regions of rice endosperm. CONCLUSIONS: The OsNAS genes, particularly OsNAS2, show enormous potential for Fe and Zn biofortification of rice endosperm. The results demonstrate that rice cultivars overexpressing single rice OsNAS genes could provide a sustainable and genetically simple solution to Fe and Zn deficiency disorders affecting billions of people throughout the world.Alexander A. T. Johnson, Bianca Kyriacou, Damien L. Callahan, Lorraine Carruthers, James Stangoulis, Enzo Lombi and Mark Teste

    Tyrosine Kinase ETK/BMX Is Up-Regulated in Bladder Cancer and Predicts Poor Prognosis in Patients with Cystectomy

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    Deregulation of the non-receptor tyrosine kinase ETK/BMX has been reported in several solid tumors. In this report, we demonstrated that ETK expression is progressively increased during bladder cancer progression. We found that down-regulation of ETK in bladder cancer cells attenuated STAT3 and AKT activity whereas exogenous overexpression of ETK had opposite effects, suggesting that deregulation of ETK may attribute to the elevated activity of STAT3 and AKT frequently detected in bladder cancer. The survival, migration and invasion of bladder cancer cells were significantly compromised when ETK expression was knocked down by a specific shRNA. In addition, we showed that ETK localizes to mitochondria in bladder cancer cells through interacting with Bcl-XL and regulating ROS production and drug sensitivity. Therefore, ETK may play an important role in regulating survival, migration and invasion by modulating multiple signaling pathways in bladder cancer cells. Immunohistochemistry analysis on tissue microarrays containing 619 human bladder tissue samples shows that ETK is significantly upregulated during bladder cancer development and progression and ETK expression level predicts the survival rate of patients with cystectomy. Taken together, our results suggest that ETK may potentially serve as a new drug target for bladder cancer treatment as well as a biomarker which could be used to identify patients with higher mortality risk, who may be benefited from therapeutics targeting ETK activity
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