54 research outputs found
Identification of Design Principles
This report identifies those design principles for a (possibly new) query and transformation
language for the Web supporting inference that are considered essential. Based upon these
design principles an initial strawman is selected. Scenarios for querying the Semantic Web
illustrate the design principles and their reflection in the initial strawman, i.e., a first draft of
the query language to be designed and implemented by the REWERSE working group I4
Extramammary Paget disease of the perianal region:the potential role of imiquimod in achieving disease control
Extramammary Paget disease (EMPD) is a rare perineal neoplasia associated with a high rate of local recurrence. Surgical excision is the standard treatment; however, this has high rates of post-operative morbidity in combination with potentially mutilating results. Previous literature has demonstrated good response with imiquimod 5% cream in patients with vulval EMPD, yet its effectiveness in primary perianal disease is unknown. We describe the case of a 40-year-old woman presenting with EMPD of the perianal region, providing detailed histological and pictoral evidence of its response to topical imiquimod 5% cream over a 16-week period, which initially resulted in remission prior to metastatic lymph node recurrence. This case demonstrates the potential for topical imiquimod cream to avoid major surgery and its associated complications in patients presenting with EMPD of the perianal region. We discuss the current evidence for treating this rare condition with medical therapy, how this case adds to current literature and possible future directions
Colonic irrigation for defecation disorders after dynamic graciloplasty
AB - BACKGROUND AND AIMS: Dynamic graciloplasty (DGP) improves anal continence and quality of life for most patients. However, in some patients, DGP fails and fecal incontinence is unsolved or only partially improved. Constipation is also a significant problem after DGP, occurring in 13-90%. Colonic irrigation can be considered as an additional or salvage treatment for defecation disorders after unsuccessful or partially successful DGP. In this study, the effectiveness of colonic irrigation for the treatment of persistent fecal incontinence and/or constipation after DGP is investigated. MATERIALS AND METHODS: Patients with defecation disorders after DGP visiting the outpatient clinic of the University Hospital Maastricht were selected for colonic irrigation as additional therapy or salvage therapy in the period between January 1999 and June 2003. The Biotrol(R) Irrimatic pump or the irrigation bag was used for colonic irrigation. Relevant physical and medical history was collected. The patients were asked to fill out a detailed questionnaire about colonic irrigation. RESULTS: Forty-six patients were included in the study with a mean age of 59.3 +/- 12.4 years (80% female). On average, the patients started the irrigation 21.39 +/- 38.77 months after the DGP. Eight patients started irrigation before the DGP. Fifty-two percent of the patients used the irrigation as additional therapy for fecal incontinence, 24% for constipation, and 24% for both. Irrigation was usually performed in the morning. The mean frequency of irrigation was 0.90 +/- 0.40 times per day. The mean amount of water used for the irrigation was 2.27 +/- 1.75 l with a mean duration of 39 +/- 23 min. Four patients performed antegrade irrigation through a colostomy or appendicostomy, with good results. Overall, 81% of the patients were satisfied with the irrigation. Thirty-seven percent of the patients with fecal incontinence reached (pseudo-)continence, and in 30% of the patients, the constipation completely resolved. Side effects of the irrigation were reported in 61% of the patients: leakage of water after irrigation, abdominal cramps, and distended abdomen. Seven (16%) patients stopped the rectal irrigation. CONCLUSION: Colonic irrigation is an effective alternative for the treatment of persistent fecal incontinence after DGP and/or recurrent or onset constipation additional to unsuccessful or (partially) successful DG
Stochastic ionization through noble tori: Renormalization results
We find that chaos in the stochastic ionization problem develops through the
break-up of a sequence of noble tori. In addition to being very accurate, our
method of choice, the renormalization map, is ideally suited for analyzing
properties at criticality. Our computations of chaos thresholds agree closely
with the widely used empirical Chirikov criterion
Impacts of changes in environmental exposures and health behaviours due to the COVID-19 pandemic on cardiovascular and mental health : A comparison of Barcelona, Vienna, and Stockholm
Responses to COVID-19 altered environmental exposures and health behaviours associated with non-communicable diseases. We aimed to (1) quantify changes in nitrogen dioxide (NO2), noise, physical activity, and greenspace visits associated with COVID-19 policies in the spring of 2020 in Barcelona (Spain), Vienna (Austria), and Stockholm (Sweden), and (2) estimated the number of additional and prevented diagnoses of myocardial infarction (MI), stroke, depression, and anxiety based on these changes. We calculated differences in NO2, noise, physical activity, and greenspace visits between pre-pandemic (baseline) and pandemic (counterfactual) levels. With two counterfactual scenarios, we distinguished between Acute Period (March 15th – April 26th, 2020) and Deconfinement Period (May 2nd – June 30th, 2020) assuming counterfactual scenarios were extended for 12 months. Relative risks for each exposure difference were estimated with exposure-risk functions. In the Acute Period, reductions in NO2 (range of change from −16.9 μg/m3 to −1.1 μg/m3), noise (from −5 dB(A) to −2 dB(A)), physical activity (from −659 MET*min/wk to −183 MET*min/wk) and greenspace visits (from −20.2 h/m to 1.1 h/m) were largest in Barcelona and smallest in Stockholm. In the Deconfinement Period, NO2 (from −13.9 μg/m3 to −3.1 μg/m3), noise (from −3 dB(A) to −1 dB(A)), and physical activity levels (from −524 MET*min/wk to −83 MET*min/wk) remained below pre-pandemic levels in all cities. Greatest impacts were caused by physical activity reductions. If physical activity levels in Barcelona remained at Acute Period levels, increases in annual diagnoses for MI (mean: 572 (95% CI: 224, 943)), stroke (585 (6, 1156)), depression (7903 (5202, 10,936)), and anxiety (16,677 (926, 27,002)) would be anticipated. To decrease cardiovascular and mental health impacts, reductions in NO2 and noise from the first COVID-19 surge should be sustained, but without reducing physical activity. Focusing on cities’ connectivity that promotes active transportation and reduces motor vehicle use assists in achieving this goal
Early Planet Formation in Embedded Disks (eDisk). II. Limited Dust Settling and Prominent Snow Surfaces in the Edge-on Class I Disk IRAS 04302+2247
While dust disks around optically visible, Class II protostars are found to
be vertically thin, when and how dust settles to the midplane are unclear. As
part of the Atacama Large Millimeter/submillimeter Array (ALMA) large program,
Early Planet Formation in Embedded Disks, we analyze the edge-on, embedded,
Class I protostar IRAS 04302+2247, also nicknamed the ``Butterfly Star." With a
resolution of 0.05" (8~au), the 1.3 mm continuum shows an asymmetry along the
minor axis which is evidence of an optically thick and geometrically thick disk
viewed nearly edge-on. There is no evidence of rings and gaps, which could be
due to the lack of radial substructure or the highly inclined and optically
thick view. With 0.1" (16~au) resolution, we resolve the 2D snow surfaces,
i.e., the boundary region between freeze-out and sublimation, for CO
=2--1, CO =2--1, CO =2--1, CO
=--, and SO =--, and constrain the CO
midplane snow line to au. We find Keplerian rotation around a
protostar of using CO. Through forward
ray-tracing using RADMC-3D, we find that the dust scale height is au
at a radius of 100~au from the central star and is comparable to the gas
pressure scale height. The results suggest that the dust of this Class~I source
has yet to vertically settle significantly.Comment: 33 pages, 21 figures. Accepted for publication in ApJ as one of the
first-look papers of the eDisk ALMA Large Progra
Early Planet Formation in Embedded Disks (eDisk) III: A first high-resolution view of sub-mm continuum and molecular line emission toward the Class 0 protostar L1527 IRS
Studying the physical and chemical conditions of young embedded disks is
crucial to constrain the initial conditions for planet formation. Here, we
present Atacama Large Millimeter/submillimeter Array (ALMA) observations of
dust continuum at 0.06" (8 au) resolution and molecular line emission at
0.17" (24 au) resolution toward the Class 0 protostar L1527 IRS from the
Large Program eDisk (Early Planet Formation in Embedded Disks). The continuum
emission is smooth without substructures, but asymmetric along both the major
and minor axes of the disk as previously observed. The detected lines of
CO, CO, CO, HCO, c-CH, SO, SiO, and DCN trace
different components of the protostellar system, with a disk wind potentially
visible in CO. The CO brightness temperature and the HCO line
ratio confirm that the disk is too warm for CO freeze out, with the snowline
located at 350 au in the envelope. Both molecules show potential evidence
of a temperature increase around the disk-envelope interface. SO seems to
originate predominantly in UV-irradiated regions such as the disk surface and
the outflow cavity walls rather than at the disk-envelope interface as
previously suggested. Finally, the continuum asymmetry along the minor axis is
consistent with the inclination derived from the large-scale (100" or 14,000
au) outflow, but opposite to that based on the molecular jet and envelope
emission, suggesting a misalignment in the system. Overall, these results
highlight the importance of observing multiple molecular species in multiple
transitions to characterize the physical and chemical environment of young
disks.Comment: 27 pages, 16 figures, 2 tables, 10 pages appendix with 12 figures.
Accepted for publication in ApJ as one of the first-look papers of the eDisk
ALMA Large Progra
Early Planet Formation in Embedded Disks (eDisk). VII. Keplerian Disk, Disk Substructure, and Accretion Streamers in the Class 0 Protostar IRAS 16544-1604 in CB 68
We present observations of the Class 0 protostar IRAS 16544-1604 in CB 68
from the ''Early Planet Formation in Embedded Disks (eDisk)'' ALMA Large
program. The ALMA observations target continuum and lines at 1.3-mm with an
angular resolution of 5 au. The continuum image reveals a dusty
protostellar disk with a radius of 30 au seen close to edge-on, and
asymmetric structures both along the major and minor axes. While the asymmetry
along the minor axis can be interpreted as the effect of the dust flaring, the
asymmetry along the major axis comes from a real non-axisymmetric structure.
The CO image cubes clearly show the gas in the disk that follows a
Keplerian rotation pattern around a 0.14 central protostar.
Furthermore, there are 1500 au-scale streamer-like features of gas
connecting from North-East, North-North-West, and North-West to the disk, as
well as the bending outflow as seen in the CO (2-1) emission. At the
apparent landing point of NE streamer, there are SO (6-5) and SiO (5-4)
emission detected. The spatial and velocity structure of NE streamer can be
interpreted as a free-falling gas with a conserved specific angular momentum,
and the detection of the SO and SiO emission at the tip of the streamer implies
presence of accretion shocks. Our eDisk observations have unveiled that the
Class 0 protostar in CB 68 has a Keplerian rotating disk with flaring and
non-axisymmetric structure associated with accretion streamers and outflows.Comment: 30 pages, 24 figures, accepted for publication in The Astrophysical
Journal as one of the first-look papers of the eDisk ALMA Large Progra
Early Planet Formation in Embedded Disks (eDisk). I. Overview of the Program and First Results
We present an overview of the Large Program, ``Early Planet Formation in
Embedded Disks (eDisk)'', conducted with the Atacama Large
Millimeter/submillimeter Array (ALMA). The ubiquitous detections of
substructures, particularly rings and gaps, in protoplanetary disks around T
Tauri stars raise the possibility that at least some planet formation may have
already started during the embedded stages of star formation. In order to
address exactly how and when planet formation is initiated, the program focuses
on searching for substructures in disks around 12 Class 0 and 7 Class I
protostars in nearby (200 pc) star-forming regions through 1.3 mm continuum
observations at a resolution of au (0.04"). The initial results show
that the continuum emission, mostly arising from dust disks around the sample
protostars, has relatively few distinctive substructures, such as rings and
spirals, in marked contrast to Class II disks. The dramatic difference may
suggest that substructures quickly develop in disks when the systems evolve
from protostars to Class II sources or alternatively that high optical depth of
the continuum emission could obscure internal structures. Kinematic information
obtained through CO isotopologue lines and other lines reveals the presence of
Keplerian disks around protostars, providing us with crucial physical
parameters, in particular, the dynamical mass of the central protostars. We
describe the background of the eDisk program, the sample selection and their
ALMA observations, the data reduction, and also highlight representative
first-look results.Comment: This is a publication of a series of eDisk ALMA large program
first-look paper
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