Meeting patient expectations in migraine treatment: what are the key endpoints?

Clinical outcomes of migraine treatment are generally based on two major endpoints: acute pain resolution and effects on quality of life (QOL). Resolution of acute pain can be evaluated in a number of ways, each increasingly challenging to achieve; pain relief, pain freedom at 2 h, sustained pain-freedom, and SPF plus no adverse events (SNAE, the most challenging). QOL questionnaires help assess the burden of migraine and identify optimal treatments. Pain resolution and improved QOL form the basis of the ultimate target-meeting patient expectations, to achieve patient satisfaction. To achieve this, it is crucial to choose appropriate endpoints that reflect realistic treatment goals for individual patients. Moreover, SNAE can help discriminate between triptans, with almotriptan having the highest SNAE score. Kaplan-Meier plots are also relevant when evaluating migraine treatments. The use of symptomatic medication may lead to the paradoxical development of medication-overuse headache. In general practice, patients should use simple tools for pain measurement (e.g. headache diary) and a QOL questionnaire. A composite endpoint of pain resolution and QOL restoration would constitute a step forward in migraine management

The current progress of the ALICE Ring Imaging Cherenkov Detector

Recently, the last two modules (out of seven) of the ALICE High Momentum Particle Identification detector (HMPID) were assembled and tested. The full detector, after a pre-commissioning phase, has been installed in the experimental area, inside the ALICE solenoid, at the end of September 2006. In this paper we review the status of the ALICE/HMPID project and we present a summary of the series production of the CsI photo-cathodes. We describe the key features of the production procedure which ensures high quality photo-cathodes as well as the results of the quality assessment performed by means of a specially developed 2D scanner system able to produce a detailed map of the CsI photo-current over the entire photo-cathode surface. Finally we present our recent R&D efforts toward the development of a novel generation of imaging Cherenkov detectors with the aim to identify, in heavy ions collisions, hadrons up to 30 GeV/c.Comment: Presented at the Imaging-2006 Conference, Stockholm, Sweden, June 200

Advances in the Development of Micropattern Gaseous Detectors with Resistive Electrodes

We describe the most recent efforts made by various groups in implementing resistive electrodes in micropattern gaseous detectors with the aim to combine in the same design the best features of RPCs (for the example, their robustness and spark protection property) with the high granularity and thus the good position resolution offered by microelectronic technology. In the stream of this activity, we have recently developed two novel detectors with resistive electrodes: one was based on resistive micromeshes and the second one is a MSGC with resistive electrodes. We have demonstrated that the resistive meshes are a convenient construction element for various designs of spark protective detectors: RPCs type, GEM type and MICROMEGAS type. These new detectors enable to considerably enhance the RPC and micropattern detectors applications since they feature not only a high position resolution but also a relatively good energy resolution (25-30 persent FWHM at 6 keV) and, if necessary, they can operate in cascaded mode allowing the achievement of a high overall gas gain. The main conclusion from these studies is that the implementation of resistive electrodes in micropattern detectors makes them fully spark protected; on this basis we consider this direction very promising

Chern-Simons Field Theories with Non-semisimple Gauge Group of Symmetry

Subject of this work is a class of Chern-Simons field theories with non-semisimple gauge group, which may well be considered as the most straightforward generalization of an Abelian Chern-Simons field theory. As a matter of fact these theories, which are characterized by a non-semisimple group of gauge symmetry, have cubic interactions like those of non-abelian Chern-Simons field theories, but are free from radiative corrections. Moreover, at the tree level in the perturbative expansion,there are only two connected tree diagrams, corresponding to the propagator and to the three vertex originating from the cubic interaction terms. For such theories it is derived here a set of BRST invariant observables, which lead to metric independent amplitudes. The vacuum expectation values of these observables can be computed exactly. From their expressions it is possible to isolate the Gauss linking number and an invariant of the Milnor type, which describes the topological relations among three or more closed curves.Comment: 16 pages, 1 figure, plain LaTeX + psfig.st

Photosensitive Strip RETHGEM

An innovative photosensitive gaseous detector, consisting of a GEM like amplification structure with double layered electrodes (instead of commonly used metallic ones) coated with a CsI reflective photocathode, is described. In one of our latest designs, the inner electrode consists of a metallic grid and the outer one is made of resistive strips; the latter are manufactured by a screen printing technology on the top of the metallic strips grid The inner metallic grid is used for 2D position measurements whereas the resistive layer provides an efficient spark protected operation at high gains - close to the breakdown limit. Detectors with active areas of 10cm x10cm and 10cm x20cm were tested under various conditions including the operation in photosensitive gas mixtures containing ethylferrocene or TMAE vapors. The new technique could have many applications requiring robust and reliable large area detectors for UV visualization, as for example, in Cherenkov imaging devices.Comment: Presentes at the International Conference NDIP 2008, July 2008, Franc

Graded contractions of bilinear invariant forms of Lie algebras

We introduce a new construction of bilinear invariant forms on Lie algebras, based on the method of graded contractions. The general method is described and the $\Bbb Z_2$-, $\Bbb Z_3$-, and $\Bbb Z_2\otimes\Bbb Z_2$-contractions are found. The results can be applied to all Lie algebras and superalgebras (finite or infinite dimensional) which admit the chosen gradings. We consider some examples: contractions of the Killing form, toroidal contractions of $su(3)$, and we briefly discuss the limit to new WZW actions.Comment: 15 page

GEMs with Double Layred Micropattern Electrodes and their Applications

We have developed and tested several new designs of GEM detectors with micropattern electrodes manufactured by microelectronic technology. In one design, the inner layer of the detector electrode consists of thin metallic strips and the outer layer is made of a resistive grid manufactured by a screen printing technology. In other designs, the electrodes were made of metallic strips fed by HV via micro-resistors manufactured by a screen printing technology. Due to these features, the new detectors have several important advantages over conventional GEMs or ordinary thick GEMs. For example, the resistive grid (in the first design) and the screen printed resistors (in other designs) limited the current in case of discharges, making these detectors intrinsically spark-protected. We will here describe our tests with the photosensitive versions of these detectors (coated with CsI layers) and the efforts of implementing them in several applications. In particular, we will focus on our activity towards the ALICE RICH detector upgrade and on tests of simplified prototypes of cryogenic dark matter detectors.Comment: Presented at the IEEE Nucler Science Symposium, Dresden, 200

Eradication of isolated para-aortic nodal recurrence in a patient with an advanced high grade sorous ovarian carcinoma: our experience and review of literature

Abstract: We report a case report regarding the eradication of isolated lymph-nodal para-aortic recurrence in the aortic region down the left renal vein (LRV) in a patient treated two years earlier in another hospital for a FIGO stage IC2 high-grade serous ovarian carcinoma with a video showing the para-aortic space after eradication of the metastatic tissue. A 66 year-old woman was admitted 24 months after the initial surgical procedure for an increased Ca 125 level and CT scan that revealed a 3 cm para-aortic infrarenal lymph-nodal recurrence that was confirmed by PET/CT scan. A secondary cytoreductive surgery (SCS) with a para-aortic lymph-nodal dissection of the tissue down the LRV and radical omentectomy were performed: during the cytoreduction, the right hemicolon was mobilized. The anterior surface of the inferior vena cava (IVC), aorta and LRV were exposed. The metastatic lymph nodes were detected in the para-ortic space down the proximal part of the LRV and eradicated; an en bloc infrarenal lymph-node dissection from the aortocaval region was performed. The operative time during the surgical procedure was 212 min with a blood loss of 120 mL. No intra- and postoperative complications, including ureteral or vascular injury or renal dysfunction, occurred. At histological examination, three dissected lymph nodes were positive for metastasis, and the patient was discharged five days after laparotomy without side effects and underwent chemotherapy 3 weeks later; after a follow-up of 42 months, no recurrence was detected. In conclusion, secondary debulking surgery can be considered a safe and effective therapeutic option for the management of recurrences, although long-term follow-ups are necessary to evaluate the overall oncologic outcomes of this procedure