648 research outputs found
Optimised procedures for the cryopreservation of different species of Heterorhabditis
It is demonstrated that the protocols developed for the cryopreservation of Heterorhabditis bacteriophora could be successfully applied to strains of the H. bacteriophora species complex and to members of the North West European species of Heterorhabditis. However the currently available protocols were not suitable for cryopreserving the Irish or the tropical Heterorhabditis species. Therefore, the postcryopreservation viabilities of Heterorhabditis species in response to preincubation in a range of cryoprotectants at varying concentrations and incubation times were determined. Species and strain specific differences in cryopreservation response were observed among Heterorhabditis isolates and optimal conditions were developed for the cryopreservation of Irish, NW European and tropical isolates of Heterorhabditis. These optimum conditions are described in this paper
Design, recruitment outcomes, and sample characteristics of the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial
This manuscript describes the study protocol, recruitment outcomes, and baseline participant characteristics for the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial. SPACE is a pragmatic randomized comparative effectiveness trial conducted in multiple VA primary care clinics within one VA health care system. The objective was to compare benefits and harms of opioid therapy versus non-opioid medication therapy over 12 months among patients with moderate-to-severe chronic back pain or hip/knee osteoarthritis pain despite analgesic therapy; patients already receiving regular opioid therapy were excluded. Key design features include comparing two clinically-relevant medication interventions, pragmatic eligibility criteria, and flexible treat-to-target interventions. Screening, recruitment and study enrollment were conducted over 31 months. A total of 4491 patients were contacted for eligibility screening; 53.1% were ineligible, 41.0% refused, and 5.9% enrolled. The most common reasons for ineligibility were not meeting pain location and severity criteria. The most common study-specific reasons for refusal were preference for no opioid use and preference for no pain medications. Of 265 enrolled patients, 25 withdrew before randomization. Of 240 randomized patients, 87.9% were male, 84.1% were white, and age range was 21–80 years. Past-year mental health diagnoses were 28.3% depression, 17% anxiety, 9.4% PTSD, 7.9% alcohol use disorder, and 2.6% drug use disorder. In conclusion, although recruitment for this trial was challenging, characteristics of enrolled participants suggest we were successful in recruiting patients similar to those prescribed opioid therapy in usual care
Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain
Importance:
Limited evidence is available regarding long-term outcomes of opioids compared with nonopioid medications for chronic pain.
Objective:
To compare opioid vs nonopioid medications over 12 months on pain-related function, pain intensity, and adverse effects.
Design, Setting, and Participants:
Pragmatic, 12-month, randomized trial with masked outcome assessment. Patients were recruited from Veterans Affairs primary care clinics from June 2013 through December 2015; follow-up was completed December 2016. Eligible patients had moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use. Of 265 patients enrolled, 25 withdrew prior to randomization and 240 were randomized.
Interventions:
Both interventions (opioid and nonopioid medication therapy) followed a treat-to-target strategy aiming for improved pain and function. Each intervention had its own prescribing strategy that included multiple medication options in 3 steps. In the opioid group, the first step was immediate-release morphine, oxycodone, or hydrocodone/acetaminophen. For the nonopioid group, the first step was acetaminophen (paracetamol) or a nonsteroidal anti-inflammatory drug. Medications were changed, added, or adjusted within the assigned treatment group according to individual patient response.
Main Outcomes and Measures:
The primary outcome was pain-related function (Brief Pain Inventory [BPI] interference scale) over 12 months and the main secondary outcome was pain intensity (BPI severity scale). For both BPI scales (range, 0-10; higher scores = worse function or pain intensity), a 1-point improvement was clinically important. The primary adverse outcome was medication-related symptoms (patient-reported checklist; range, 0-19).
Results:
Among 240 randomized patients (mean age, 58.3 years; women, 32 [13.0%]), 234 (97.5%) completed the trial. Groups did not significantly differ on pain-related function over 12 months (overall P = .58); mean 12-month BPI interference was 3.4 for the opioid group and 3.3 for the nonopioid group (difference, 0.1 [95% CI, -0.5 to 0.7]). Pain intensity was significantly better in the nonopioid group over 12 months (overall P = .03); mean 12-month BPI severity was 4.0 for the opioid group and 3.5 for the nonopioid group (difference, 0.5 [95% CI, 0.0 to 1.0]). Adverse medication-related symptoms were significantly more common in the opioid group over 12 months (overall P = .03); mean medication-related symptoms at 12 months were 1.8 in the opioid group and 0.9 in the nonopioid group (difference, 0.9 [95% CI, 0.3 to 1.5]).
Conclusions and Relevance:
Treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain
Contribution of patient, physician, and environmental factors to demographic and health variation in colonoscopy follow-up for abnormal colorectal cancer screening test results
BACKGROUND:
Patient, physician, and environmental factors were identified, and the authors examined the contribution of these factors to demographic and health variation in colonoscopy follow-up after a positive fecal occult blood test/fecal immunochemical test (FOBT/FIT) screening.
METHODS:
In total, 76,243 FOBT/FIT-positive patients were identified from 120 Veterans Health Administration (VHA) facilities between August 16, 2009 and March 20, 2011 and were followed for 6 months. Patient demographic (race/ethnicity, sex, age, marital status) and health characteristics (comorbidities), physician characteristics (training level, whether primary care provider) and behaviors (inappropriate FOBT/FIT screening), and environmental factors (geographic access, facility type) were identified from VHA administrative records. Patient behaviors (refusal, private sector colonoscopy use) were estimated with statistical text mining conducted on clinic notes, and follow-up predictors and adjusted rates were estimated using hierarchical logistic regression.
RESULTS:
Roughly 50% of individuals completed a colonoscopy at a VHA facility within 6 months. Age and comorbidity score were negatively associated with follow-up. Blacks were more likely to receive follow-up than whites. Environmental factors attenuated but did not fully account for these differences. Patient behaviors (refusal, private sector colonoscopy use) and physician behaviors (inappropriate screening) fully accounted for the small reverse race disparity and attenuated variation by age and comorbidity score. Patient behaviors (refusal and private sector colonoscopy use) contributed more to variation in follow-up rates than physician behaviors (inappropriate screening).
CONCLUSIONS:
In the VHA, blacks are more likely to receive colonoscopy follow-up for positive FOBT/FIT results than whites, and follow-up rates markedly decline with advancing age and comorbidity burden. Patient and physician behaviors explain race variation in follow-up rates and contribute to variation by age and comorbidity burden. Cancer 2017;123:3502-12. Published 2017. This article is a US Government work and is in the public domain in the USA
A Single Centre Randomised Control Study to Assess the Impact of Pre-Operative Carbohydrate Loading on Women Undergoing Major Surgery for Epithelial Ovarian Cancer
Objective Historically, patients have fasted before elective surgery to ensure an empty stomach to avoid aspiration. A fasting-induced catabolic state however may adversely influence recovery after surgery. Our study was designed to test the effect of oral carbohydrate loading on clinical parameters in patients undergoing major surgery for advanced-stage ovarian cancer. Methods A double-blinded single-centre randomised trial was designed to recruit 110 patients with advanced-stage epithelial ovarian cancer undergoing either primary surgery, or neoadjuvant chemotherapy prior to debulking surgery. Following written informed consent, the patients were randomised into two groups. Group 1 received the carbohydrate drink (intervention) and group 2 received flavoured water (placebo). The quantity of fluid in both groups was 800ml the night before the surgery and 400ml two hours before the induction of anaesthesia. The primary endpoint of the study was the Length of Hospital Stay (LoHS); the secondary parameters assessed were pain scores, nausea and vomiting scores, bowel function, and postoperative complication rate. Results Between March 2009 and December 2011, 80 patients were randomised and 75 completed the study. A decision was made to close the trial early as a change in routine clinical practice meant that patients were admitted on the day of surgery rather than a day before. Analysis of the data revealed that there were no significant differences between the study groups in terms of LoHS and other clinical parameters. Conclusion In this single-center study, which failed to recruit the planned number of patients, we were unable to demonstrate that oral carbohydrate intake pre-operatively has significant impact on the recovery process or the length of hospitalisation postoperatively. Future studies should examine all aspects of an Enhanced Recovery Program after Surgery as a package as compared to a single element to enhance patient outcome. [Abstract copyright: Copyright © 2020, Al-Hirmizy et al.
Discovery and Follow-up Observations of the Young Type Ia Supernova 2016coj
The Type~Ia supernova (SN~Ia) 2016coj in NGC 4125 (redshift ) was
discovered by the Lick Observatory Supernova Search 4.9 days after the fitted
first-light time (FFLT; 11.1 days before -band maximum). Our first detection
(pre-discovery) is merely day after the FFLT, making SN 2016coj one
of the earliest known detections of a SN Ia. A spectrum was taken only 3.7 hr
after discovery (5.0 days after the FFLT) and classified as a normal SN Ia. We
performed high-quality photometry, low- and high-resolution spectroscopy, and
spectropolarimetry, finding that SN 2016coj is a spectroscopically normal SN
Ia, but with a high velocity of \ion{Si}{2} 6355 (\,\kms\
around peak brightness). The \ion{Si}{2} 6355 velocity evolution can
be well fit by a broken-power-law function for up to a month after the FFLT. SN
2016coj has a normal peak luminosity ( mag), and it
reaches a -band maximum \about16.0~d after the FFLT. We estimate there to be
low host-galaxy extinction based on the absence of Na~I~D absorption lines in
our low- and high-resolution spectra. The spectropolarimetric data exhibit weak
polarization in the continuum, but the \ion{Si}{2} line polarization is quite
strong () at peak brightness.Comment: Submitte
The Palomar Transient Factory Orion Project: Eclipsing Binaries and Young Stellar Objects
The Palomar Transient Factory (PTF) Orion project is an experiment within the
broader PTF survey, a systematic automated exploration of the sky for optical
transients. Taking advantage of the wide field of view available using the PTF
camera at the Palomar 48" telescope, 40 nights were dedicated in December
2009-January 2010 to perform continuous high-cadence differential photometry on
a single field containing the young (7-10Myr) 25 Ori association. The primary
motivation for the project is to search for planets around young stars in this
region. The unique data set also provides for much ancillary science. In this
first paper we describe the survey and data reduction pipeline, and present
initial results from an inspection of the most clearly varying stars relating
to two of the ancillary science objectives: detection of eclipsing binaries and
young stellar objects. We find 82 new eclipsing binary systems, 9 of which we
are candidate 25 Ori- or Orion OB1a-association members. Of these, 2 are
potential young W UMa type systems. We report on the possible low-mass (M-dwarf
primary) eclipsing systems in the sample, which include 6 of the candidate
young systems. 45 of the binary systems are close (mainly contact) systems; one
shows an orbital period among the shortest known for W UMa binaries, at
0.2156509 \pm 0.0000071d, with flat-bottomed primary eclipses, and a derived
distance consistent with membership in the general Orion association. One of
the candidate young systems presents an unusual light curve, perhaps
representing a semi-detached binary system with an inflated low-mass primary or
a star with a warped disk, and may represent an additional young Orion member.
Finally, we identify 14 probable new classical T-Tauri stars in our data, along
with one previously known (CVSO 35) and one previously reported as a candidate
weak-line T-Tauri star (SDSS J052700.12+010136.8).Comment: 66 pages, 27 figures, accepted to Astronomical Journal. Minor
typographical corrections and update to author affiliation
Statistical Models of the Variability of Plasma in the Topside Ionosphere:2. Performance assessment
Statistical models of the variability of plasma in the topside ionosphere based on the Swarm data have been developed in the “Swarm Variability of Ionospheric Plasma” (Swarm-VIP) project within the European Space Agency’s Swarm+4D-Ionosphere framework. The models can predict the electron density, its gradients for three horizontal spatial scales – 20, 50 and 100 km – along the North-South direction and the level of the density fluctuations. Despite being developed by leveraging on Swarm data, the models provide predictions that are independent of these data, having a global coverage, fed by various parameters and proxies of the helio-geophysical conditions. Those features make the Swarm-VIP models useful for various purposes, which include the possible support for already available ionospheric models and proxy of the effect of ionospheric irregularities of the medium scales that affect the signals emitted by Global Navigation Satellite Systems (GNSS). The formulation, optimisation and validation of the Swarm-VIP models are reported in Paper 1 (Wood et al. 2024. J Space Weather Space Clim. in press). This paper describes the performance assessment of the models, by addressing their capability to reproduce the known climatological variability of the modelled quantities, and the ionospheric weather as depicted by ground-based GNSS, as a proxy for the ionospheric effect on GNSS signals. Additionally, we demonstrate that, under certain conditions, the model can better reproduce the ionospheric variability than a physics-based model, namely the Thermosphere-Ionosphere-Electrodynamics General Circulation Model (TIE-GCM)
Catching Element Formation In The Act
Gamma-ray astronomy explores the most energetic photons in nature to address
some of the most pressing puzzles in contemporary astrophysics. It encompasses
a wide range of objects and phenomena: stars, supernovae, novae, neutron stars,
stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays
and relativistic-particle acceleration, and the evolution of galaxies. MeV
gamma-rays provide a unique probe of nuclear processes in astronomy, directly
measuring radioactive decay, nuclear de-excitation, and positron annihilation.
The substantial information carried by gamma-ray photons allows us to see
deeper into these objects, the bulk of the power is often emitted at gamma-ray
energies, and radioactivity provides a natural physical clock that adds unique
information. New science will be driven by time-domain population studies at
gamma-ray energies. This science is enabled by next-generation gamma-ray
instruments with one to two orders of magnitude better sensitivity, larger sky
coverage, and faster cadence than all previous gamma-ray instruments. This
transformative capability permits: (a) the accurate identification of the
gamma-ray emitting objects and correlations with observations taken at other
wavelengths and with other messengers; (b) construction of new gamma-ray maps
of the Milky Way and other nearby galaxies where extended regions are
distinguished from point sources; and (c) considerable serendipitous science of
scarce events -- nearby neutron star mergers, for example. Advances in
technology push the performance of new gamma-ray instruments to address a wide
set of astrophysical questions.Comment: 14 pages including 3 figure
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