Work-up of the solitary pulmonary nodule

Abstract Although the solitary pulmonary nodule (SPN) is a common presentation of lung cancer, most SPNs are benign. The challenge in evaluating SPNs is to avoid invasive procedures in patients who have benign nodules, without allowing potentially curable bronchogenic carcinomas the time to progress to more advanced or even unresectable disease. Various approaches include assessment of nodule morphology, interval growth and contrast enhancement, as well as techniques such as percutaneous biopsy, positron emission tomography scanning and depreotide imaging. The role of each of these approaches is discussed.http://deepblue.lib.umich.edu/bitstream/2027.42/111300/1/40644_2015_Article_13.pd

Artificial neural networks for 3D cell shape recognition from confocal images

We present a dual-stage neural network architecture for analyzing fine shape details from microscopy recordings in 3D. The system, tested on red blood cells, uses training data from both healthy donors and patients with a congenital blood disease. Characteristic shape features are revealed from the spherical harmonics spectrum of each cell and are automatically processed to create a reproducible and unbiased shape recognition and classification for diagnostic and theragnostic use.Comment: 17 pages, 8 figure

Prognostic variables and scores identifying the end of life in COPD: a systematic review.

INTRODUCTION: COPD is a major cause of mortality, and the unpredictable trajectory of the disease can bring challenges to end-of-life care. We aimed to investigate known prognostic variables and scores that predict prognosis in COPD in a systematic literature review, specifically including variables that contribute to risk assessment of patients for death within 12 months. METHODS: We conducted a systematic review on prognostic variables, multivariate score or models for COPD. Ovid MEDLINE, EMBASE, the Cochrane database, Cochrane CENTRAL, DARE and CINAHL were searched up to May 1, 2016. RESULTS: A total of 5,276 abstracts were screened, leading to 516 full-text reviews, and 10 met the inclusion criteria. No multivariable indices were developed with the specific aim of predicting all-cause mortality in stable COPD within 12 months. Only nine indices were identified from four studies, which had been validated for this time period. Tools developed using expert knowledge were also identified, including the Gold Standards Framework Prognostic Indicator Guidance, the RADboud Indicators of Palliative Care Needs, the Supportive and Palliative Care Indicators Tool and the Necesidades Paliativas program tool. CONCLUSION: A number of variables contributing to the prediction of all-cause mortality in COPD were identified. However, there are very few studies that are designed to assess, or report, the prediction of mortality at or less than 12 months. The quality of evidence remains low, such that no single variable or multivariable score can currently be recommended

Spectroscopic Factors in 40^{40}Ca and 208^{208}Pb from (e,e′p)(e,e'p): Fully Relativistic Analysis

We present results for spectroscopic factors of the outermost shells in $^{40}$Ca and $^{208}$Pb, which have been derived from the comparison between the available quasielastic ($e,e'p$) data from NIKHEF-K and the corresponding calculated cross-sections obtained within a fully relativistic formalism. We include exactly the effect of Coulomb distortion on the electron wave functions and discuss its role in the extraction of the spectroscopic factors from experiment. Without any adjustable parameter, we find spectroscopic factors of about 70\%, consistent with theoretical predictions. We compare our results with previous relativistic and nonrelativistic analyses of ($e,e'p$) data. In addition to Coulomb distortion effects we discuss different choices of the nucleon current operator and also analyze the effects due to the relativistic treatment of the outgoing-distorted and bound nucleon wave functions.Comment: 9 pages RevTeX, 5 figures can be obtained from the author

External validation of ADO, DOSE, COTE and CODEX at predicting death in primary care patients with COPD using standard and machine learning approaches

Background Several models for predicting the risk of death in people with chronic obstructive pulmonary disease (COPD) exist but have not undergone large scale validation in primary care. The objective of this study was to externally validate these models using statistical and machine learning approaches. Methods We used a primary care COPD cohort identified using data from the UK Clinical Practice Research Datalink. Age-standardised mortality rates were calculated for the population by gender and discrimination of ADO (age, dyspnoea, airflow obstruction), COTE (COPD-specific comorbidity test), DOSE (dyspnoea, airflow obstruction, smoking, exacerbations) and CODEX (comorbidity, dyspnoea, airflow obstruction, exacerbations) at predicting death over 1–3 years measured using logistic regression and a support vector machine learning (SVM) method of analysis. Results The age-standardised mortality rate was 32.8 (95%CI 32.5–33.1) and 25.2 (95%CI 25.4–25.7) per 1000 person years for men and women respectively. Complete data were available for 54879 patients to predict 1-year mortality. ADO performed the best (c-statistic of 0.730) compared with DOSE (c-statistic 0.645), COTE (c-statistic 0.655) and CODEX (c-statistic 0.649) at predicting 1-year mortality. Discrimination of ADO and DOSE improved at predicting 1-year mortality when combined with COTE comorbidities (c-statistic 0.780 ADO + COTE; c-statistic 0.727 DOSE + COTE). Discrimination did not change significantly over 1–3 years. Comparable results were observed using SVM. Conclusion In primary care, ADO appears superior at predicting death in COPD. Performance of ADO and DOSE improved when combined with COTE comorbidities suggesting better models may be generated with additional data facilitated using novel approaches

Proposal for the determination of nuclear masses by high-precision spectroscopy of Rydberg states

The theoretical treatment of Rydberg states in one-electron ions is facilitated by the virtual absence of the nuclear-size correction, and fundamental constants like the Rydberg constant may be in the reach of planned high-precision spectroscopic experiments. The dominant nuclear effect that shifts transition energies among Rydberg states therefore is due to the nuclear mass. As a consequence, spectroscopic measurements of Rydberg transitions can be used in order to precisely deduce nuclear masses. A possible application of this approach to the hydrogen and deuterium, and hydrogen-like lithium and carbon is explored in detail. In order to complete the analysis, numerical and analytic calculations of the quantum electrodynamic (QED) self-energy remainder function for states with principal quantum number n=5,...,8 and with angular momentum L=n-1 and L=n-2 are described (j = L +/- 1/2).Comment: 21 pages; LaTe

Predicting mortality after acute coronary syndromes in people with chronic obstructive pulmonary disease

Objective To assess the accuracy of Global Registry of Acute Coronary Events (GRACE) scores in predicting mortality at 6 months for people with chronic obstructive pulmonary disease (COPD) and to investigate how it might be improved. Methods Data were obtained on 481 849 patients with acute coronary syndrome admitted to UK hospitals between January 2003 and June 2013 from the Myocardial Ischaemia National Audit Project (MINAP) database. We compared risk of death between patients with COPD and those without COPD at 6 months, adjusting for predicted risk of death. We then assessed whether several modifications improved the accuracy of the GRACE score for people with COPD. Results The risk of death after adjusting for GRACE score predicted that risk of death was higher for patients with COPD than that for other patients (RR 1.29, 95% CI 1.28 to 1.33). Adding smoking into the GRACE score model did not improve accuracy for patients with COPD. Either adding COPD into the model (relative risk (RR) 1.00, 0.94 to 1.02) or multiplying the GRACE score by 1.3 resulted in better performance (RR 0.99, 0.96 to 1.01). Conclusions GRACE scores underestimate risk of death for people with COPD. A more accurate prediction of risk of death can be obtained by adding COPD into the GRACE score equation, or by multiplying the GRACE score predicted risk of death by 1.3 for people with COPD. This means that one third of patients with COPD currently classified as low risk should be classified as moderate risk, and could be considered for more aggressive early treatment after non-ST-segment elevation myocardial infarction or unstable angina

A Laser System for the Spectroscopy of Highly-Charged Bismuth Ions

We present and characterize a laser system for the spectroscopy on highly-charged ^209Bi^82+ ions at a wavelength of 243.87 nm. For absolute frequency stabilization, the laser system is locked to a near-infra-red laser stabilized to a rubidium transition line using a transfer cavity based locking scheme. Tuning of the output frequency with high precision is achieved via a tunable rf offset lock. A sample-and-hold technique gives an extended tuning range of several THz in the UV. This scheme is universally applicable to the stabilization of laser systems at wavelengths not directly accessible to atomic or molecular resonances. We determine the frequency accuracy of the laser system using Doppler-free absorption spectroscopy of Te_2 vapour at 488 nm. Scaled to the target wavelength of 244 nm, we achieve a frequency uncertainty of \sigma_{244nm} = 6.14 MHz (one standard deviation) over six days of operation.Comment: Contribution to the special issue on "Trapped Ions" in "Applied Physics B

g factor of Li-like ions with nonzero nuclear spin

The fully relativistic theory of the g factor of Li-like ions with nonzero nuclear spin is considered for the (1s)^2 2s state. The magnetic-dipole hyperfine-interaction correction to the atomic g factor is calculated including the one-electron contributions as well as the interelectronic-interaction effects of order 1/Z. This correction is combined with the interelectronic-interaction, QED, nuclear recoil, and nuclear size corrections to obtain high-precision theoretical values for the g factor of Li-like ions with nonzero nuclear spin. The results can be used for a precise determination of nuclear magnetic moments from g factor experiments.Comment: 20 pages, 5 figure