Neoadjuvant chemotherapy followed by surgical cytoreduction in advanced epithelial ovarian cancer

Aim: To study the role of neoadjuvant chemotherapy (NACT) followed by surgical cytoreduction in the management of advanced epithelial ovarian cancers. Materials and Methods: A retrospective analysis of 82 patients with advanced epithelial ovarian cancers (stage IIIC and IV) who were treated with NACT followed by surgical cytoreduction between 1995 and 2004 was performed. Response to NACT, optimal cytoreduction rate, disease-free survival and overall survival were analyzed. Results: There were 59 patients (72%) with stage IIIC disease and 23 (28%) with stage IV disease. Diagnosis was established by imaging, ascitic fluid cytology and CA-125 estimations in 75% and by laparotomy in 25% of the patients. After NACT, complete response occurred in 17 patients (20.7%), 50 (61.0%) had partial response and no response was documented in 15 (18.3%) patients. Optimal surgical cytoreduction could be achieved in 72% of the patients. At the median follow-up of 34 months (range 6-102 months), 5-year disease-free and overall survivals were 31 and 32% respectively. The median disease free interval was 25.4 months. On multivariate analysis, degree of optimal cytoreduction was the only factor ( P <0.05) affecting survival. Conclusions: NACT followed by surgical cytoreduction is a promising treatment strategy for the management of advanced epithelial ovarian cancers. A significant number of patients exhibit response to NACT. Downstaging following NACT leads to higher optimal cytoreduction rates and improved survival in comparison to historical controls

Neoadjuvant chemotherapy followed by surgical cytoreduction in advanced epithelial ovarian cancer

AIMS: To study the role of neoadjuvant chemotherapy (NACT) followed by surgical cytoreduction in the management of advanced epithelial ovarian cancers. MATERIALS AND METHODS: A retrospective analysis of 82 patients with advanced epithelial ovarian cancers (stage IIIC and IV) who were treated with NACT followed by surgical cytoreduction between 1995 and 2004 was performed. Response to NACT, optimal cytoreduction rate, disease-free survival and overall survival were analyzed. RESULTS: There were 59 patients (72%) with stage IIIC disease and 23 (28%) with stage IV disease. Diagnosis was established by imaging, ascitic fluid cytology and CA-125 estimations in 75% and by laparotomy in 25% of the patients. After NACT, complete response occurred in 17 patients (20.7%), 50 (61.0%) had partial response and no response was documented in 15 (18.3%) patients. Optimal surgical cytoreduction could be achieved in 72% of the patients. At the median follow-up of 34 months (range 6-102 months), 5-year disease-free and overall survivals were 31 and 32% respectively. The median disease free interval was 25.4 months. On multivariate analysis, degree of optimal cytoreduction was the only factor ( P < 0.05) affecting survival. CONCLUSIONS: NACT followed by surgical cytoreduction is a promising treatment strategy for the management of advanced epithelial ovarian cancers. A significant number of patients exhibit response to NACT. Downstaging following NACT leads to higher optimal cytoreduction rates and improved survival in comparison to historical controls

Erratum: A library of ATMO forward model transmission spectra for hot Jupiter exoplanets

This is the final version. Available from OUP via the DOI in this recordThe article to which this is the erratum is in ORE at http://hdl.handle.net/10871/30324The paper ‘A library of ATMO forward model transmission spectra for hot Jupiter exoplanets’ was published in MNRAS 474, 4, 5158–5185. In the original manuscript (Goyal et al. 2018), we presented a grid of forward model transmission spectra for hot Jupiter exoplanets. However, we recently identified an error in the treatment of rainout in our 1D atmosphere model ATMO. The correction of this error led to changes in the equilibrium chemical abundances using rainout condensation and thereby the transmission spectra. We note that this error only affects the online library2,3 that includes rainout condensation, the library with local condensation (without rainout) is unaffected. We further note that the gas phase equilibrium scheme used in ATMO has been compared by Drummond et al. (2016) with the analytical schemes of Burrows & Sharp (1999) and Heng & Tsai (2016). The gas phase chemistry with and without local condensation has also been verified in Baudino et al. (2017) against the petitCODE (Mollière et al. 2015, 2017) and Exo-REM (Baudino et al. 2015) models. Therefore, issues with the previous version of the grid were confined to the implementation of rainout

The Complete transmission spectrum of WASP-39b with a precise water constraint

This is the author accepted manuscript. The final version is available from American Astronomical Society via the DOI in this record.WASP-39b is a hot Saturn-mass exoplanet with a predicted clear atmosphere based on observations in the optical and infrared. Here we complete the transmission spectrum of the atmosphere with observations in the near-infrared (NIR) over three water absorption features with the Hubble Space Telescope (HST) Wide Field Camera 3 (WFC3) G102 (0.8-1.1 microns) and G141 (1.1-1.7 microns) spectroscopic grisms. We measure the predicted high amplitude H2O feature centered at 1.4 microns, and the smaller amplitude features at 0.95 and 1.2 microns, with a maximum water absorption amplitude of 2.4 planetary scale heights. We incorporate these new NIR measurements into previously published observational measurements to complete the transmission spectrum from 0.3-5 microns. From these observed water features, combined with features in the optical and IR, we retrieve a well constrained temperature Teq = 1030(+30,-20) K, and atmospheric metallicity 151 (+48,-46)x solar which is relatively high with respect to the currently established mass-metallicity trends. This new measurement in the Saturn-mass range hints at further diversity in the planet formation process relative to our solar system giants.This work is based on observations made with the NASA/ESA Hubble Space Telescope that were obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc. These observations are associated with programs GO-14169 (PI. HR Wakeford) and GO-14260 (PI. D Deming). D.K.S., H.R.W., T.E., B.D., and N.N., acknowledge funding from the European Research Council (ERC) under the European Unions Seventh Framework Programme (FP7/2007-2013)/ERC grant agreement no. 336792. J.G. acknowledges support from Leverhulme Trust. A.L.C. acknowledges support from the STFC. H.R.W. also acknowledges support from the Giacconi Fellowship at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc

Evidence of a Clear Atmosphere for WASP-62b: The Only Known Transiting Gas Giant in the JWST Continuous Viewing Zone

Exoplanets with cloud-free, haze-free atmospheres at the pressures probed by transmission spectroscopy represent a valuable opportunity for detailed atmospheric characterization and precise chemical abundance constraints. We present the first optical to infrared (0.3−5 μm) transmission spectrum of the hot Jupiter WASP-62b, measured with Hubble/STIS and Spitzer/IRAC. The spectrum is characterized by a 5.1σ detection of Na I absorption at 0.59 μm, in which the pressurebroadened wings of the Na D-lines are observed from space for the first time. A spectral feature at 0.4 μm is tentatively attributed to SiH at 2.1σ confidence. Our retrieval analyses are consistent with a cloud-free atmosphere without significant contamination from stellar heterogeneities. We simulate James Webb Space Telescope (JWST) observations, for a combination of instrument modes, to assess the atmospheric characterization potential of WASP-62b. We demonstrate that JWST can conclusively detect Na, H2O, FeH, NH3, CO, CO2, CH4, and SiH within the scope of its Early Release Science (ERS) program. As the only transiting giant planet currently known in the JWST Continuous Viewing Zone, WASP-62b could prove a benchmark giant exoplanet for detailed atmospheric characterization in the James Webb era

Effectiveness of early intervention programs for parents of preterm infants: a meta-review of systematic reviews

Background: Various intervention programs exist for parents of preterm babies and some systematic reviews (SRs) have synthesised the evidence of their effectiveness. These reviews are, however, limited to specific interventions, components, or outcomes, and a comprehensive evidence base is lacking. The aim of this meta-review was to appraise and meta-synthesise the evidence from existing SRs to provide a comprehensive evidence base on the effectiveness of interventions for parents of preterm infants on parental and infant outcomes. Methods: We conducted a comprehensive search of the following databases to identify relevant SRs: Cochrane library, Web of science, EMBASE, CINAHL, British Nursing Index, PsycINFO, Medline, ScienceDirect, Scopus, IBSS, DOAJ, ERIC, EPPI-Centre, PROSPERO, WHO Library. Additional searches were conducted using authors’ institutional libraries, Google Scholar, and the reference lists of identified reviews. Identified articles were screened in two stages against an inclusion criteria with titles and abstracts screened first followed by full-text screening. Selected SRs were appraised using the AMSTAR tool. Extracted data using a predesigned tool were synthesised narratively examining the direction of impact on outcomes. Results: We found 11 SRs eligible for inclusion that synthesised a total of 343 quantitative primary studies. The average quality of the SRs was ‘medium’. Thirty four interventions were reported across the SRs with considerable heterogeneity in the structural framework and the targeted outcomes that included maternal-infant dyadic, maternal/parental, and infant outcomes. Among all interventions, Kangaroo Care (KC) showed the most frequent positive impact across outcomes (n = 19) followed by Mother Infant Transaction Program (MITP) (n = 14). Other interventions with most consistent positive impact on infant outcomes were Modified-Mother Infant Transaction Program (M-MITP) (n = 6), Infant Health and Development Program (IHDP) (n = 5) and Creating Opportunities for Parent Empowerment (COPE) (n = 5). Overall, interventions with both home and facility based components showed the most frequent positive impact across outcomes. Conclusions: Neonatal care policy and planning for preterm babies should consider the implementation of interventions with most positive impact on outcomes. The heterogeneity in interventions and outcomes calls for the development and implementation of an integrated program for parents of preterm infants with a clearly defined global set of parental and infant outcomes

Into the UV: The Atmosphere of the Hot Jupiter HAT-P-41b Revealed

For solar system objects, ultraviolet spectroscopy has been critical in identifying sources of stratospheric heating and measuring the abundances of a variety of hydrocarbon and sulfur-bearing species, produced via photochemical mechanisms, as well as oxygen and ozone. To date, fewer than 20 exoplanets have been probed in this critical wavelength range (0.2–0.4 μm). Here we use data from Hubble's newly implemented WFC3 UVIS G280 grism to probe the atmosphere of the hot Jupiter HAT-P-41b in the ultraviolet through optical in combination with observations at infrared wavelengths. We analyze and interpret HAT-P-41b's 0.2–5.0 μm transmission spectrum using a broad range of methodologies including multiple treatments of data systematics as well as comparisons with atmospheric forward, cloud microphysical, and multiple atmospheric retrieval models. Although some analysis and interpretation methods favor the presence of clouds or potentially a combination of Na, VO, AlO, and CrH to explain the ultraviolet through optical portions of HAT-P-41b's transmission spectrum, we find that the presence of a significant H− opacity provides the most robust explanation. We obtain a constraint for the abundance of H−, $\mathrm{log}({{\rm{H}}}^{-})=-8.65\pm 0.62$, in HAT-P-41b's atmosphere, which is several orders of magnitude larger than predictions from equilibrium chemistry for a ~1700–1950 K hot Jupiter. We show that a combination of photochemical and collisional processes on hot hydrogen-dominated exoplanets can readily supply the necessary amount of H− and suggest that such processes are at work in HAT-P-41b and the atmospheres of many other hot Jupiters

Hubble PanCET: An isothermal day-side atmosphere for the bloated gas-giant HAT-P-32Ab

This is the author accepted manuscript. The final version is available from OUP via the DOI in this recordWe present a thermal emission spectrum of the bloated hot Jupiter HAT-P-32Ab from a single eclipse observation made in spatial scan mode with the Wide Field Camera 3 (WFC3) aboard the Hubble Space Telescope (HST). The spectrum covers the wavelength regime from 1.123 to 1.644 microns which is binned into 14 eclipse depths measured to an averaged precision of 104 parts-per million. The spectrum is unaffected by a dilution from the close M-dwarf companion HAT-P-32B, which was fully resolved. We complemented our spectrum with literature results and performed a comparative forward and retrieval analysis with the 1D radiative-convective ATMO model. Assuming solar abundance of the planet atmosphere, we find that the measured spectrum can best be explained by the spectrum of a blackbody isothermal atmosphere with Tp = 1995 +/- 17K, but can equally-well be described by a spectrum with modest thermal inversion. The retrieved spectrum suggests emission from VO at the WFC3 wavelengths and no evidence of the 1.4 micron water feature. The emission models with temperature profiles decreasing with height are rejected at a high confidence. An isothermal or inverted spectrum can imply a clear atmosphere with an absorber, a dusty cloud deck or a combination of both. We find that the planet can have continuum of values for the albedo and recirculation, ranging from high albedo and poor recirculation to low albedo and efficient recirculation. Optical spectroscopy of the planet's day-side or thermal emission phase curves can potentially resolve the current albedo with recirculation degeneracy.NN, DKS and TME acknowledge funding from the European Research Council under the European Unions Seventh Framework Programme (FP7/2007-2013)/ERC grant agreement no. 336792. JG acknowledges support from a Leverhulme Trust Research Project Grant. G.W.H. and M.H.W. acknowledge long-term support from Tennessee State University and the State of Tennessee through its Centers of Excellence program and from the Space Telescope Science Institue under HST-GO-14767. This work has been carried out in the frame of the National Centre for Competence in Research PlanetS supported by the Swiss National Science Foundation (SNSF). DE and VB acknowledge the financial support of the SNSF. This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (project FOUR ACES; grant agreement No 724427)

Solar-to-supersolar sodium and oxygen absolute abundances for a ‘hot Saturn’ orbiting a metal-rich star

This is the author accepted manuscript. The final version is available from Oxford University Press via the DOI in this recordDATA AVAILABILITY: Raw and calibrated Hubble Space Telescope spectral transit time series and Spitzer Space Telescope transit and eclipse time series photometry are publicly available at the Mikulski Archive for Space Telescopes (MAST; https://archive.stsci.edu) and the NASA/IPAC Infrared Science Archive (IRSA; https: //sha.ipac.caltech.edu/applications/Spitzer/SHA/), respectively. TESS light curves are publicly available at the MAST archive. Calibrated and extracted high-resolution FEROS spectra are publicly available via the European Southern Observatory’s Spectral Data Products Query Form (http://archive.eso.org/wdb/ wdb/adp/phase3_spectral/form). Broad-band light curves are publicly available at the webpage of the All-Sky Automated Survey for Supernovae (ASAS-SN; https://asas-sn.osu.edu).We present new analysis of infrared transmission spectroscopy of the cloud-free hot-Saturn WASP-96b performed with the Hubble and Spitzer Space Telescopes (HST and Spitzer). The WASP-96b spectrum exhibits the absorption feature from water in excellent agreement with synthetic spectra computed assuming a cloud-free atmosphere. The HST-Spitzer spectrum is coupled with Very Large Telescope (VLT) optical transmission spectroscopy which reveals the full pressure-broadened profile of the sodium absorption feature and enables the derivation of absolute abundances. We confirm and correct for a spectral offset of $\Delta R_{{\rm p}}/R_{\ast }=(-4.29^{+0.31}_{-0.37})\, \times 10^{-3}$ of the VLT data relative to the HST-Spitzer spectrum. This offset can be explained by the assumed radius for the common-mode correction of the VLT spectra, which is a well-known feature of ground-based transmission spectroscopy. We find evidence for a lack of chromospheric and photometric activity of the host star which, therefore, make a negligible contribution to the offset. We measure abundances for Na and O that are consistent with solar to supersolar, with abundances relative to solar values of $21^{+27}_{-14}$ and $7^{+11}_{-4}$, respectively. We complement the transmission spectrum with new thermal emission constraints from Spitzer observations at 3.6 and 4.5μm, which are best explained by the spectrum of an atmosphere with a temperature decreasing with altitude. A fit to the spectrum assuming an isothermal blackbody atmosphere constrains the dayside temperature to be Tp = 1545 ± 90K.Science and Technology Facilities CouncilUK Research and InnovationNASAEuropean Research CouncilLeverhulme TrustSTSc