641 research outputs found
Two-photon quantum walks in an elliptical direct-write waveguide array
Integrated optics provides an ideal test bed for the emulation of quantum
systems via continuous-time quantum walks. Here we study the evolution of
two-photon states in an elliptic array of waveguides. We characterise the
photonic chip via coherent-light tomography and use the results to predict
distinct differences between temporally indistinguishable and distinguishable
two-photon inputs which we then compare with experimental observations. Our
work highlights the feasibility for emulation of coherent quantum phenomena in
three-dimensional waveguide structures.Comment: 8 pages, 7 figure
A pilot randomised controlled trial of personalised care after treatment for prostate cancer (TOPCAT-P): nurse-led holistic-needs assessment and individualised psychoeducational intervention: study protocol
INTRODUCTION. Prostate cancer is common and the incidence is increasing, but more men are living longer after diagnosis, and die with their disease rather than of it. Nonetheless, specific and substantial physical, sexual, emotional and mental health problems often lead to a poor quality of life. Urology services increasingly struggle to cope with the demands of follow-up care, and primary care is likely to play the central role in long-term follow-up. The present phase II trial will evaluate the feasibility and acceptability of a nurse-led, person-centred psychoeducational intervention, delivered in community or primary care settings.
METHODS AND ANALYSIS. Prostate cancer survivors diagnosed in the past 9-48 months and currently biochemically stable will be identified from hospital records by their treating clinician. Eligible men would have either completed radical treatment, or would be followed up with prostate specific antigen monitoring and symptom reporting. We will recruit 120 patients who will be randomised to receive either an augmented form of usual care, or an additional nurse-led intervention for a period of 36 weeks. Following the health policy in Wales, the intervention is offered by a key worker, is promoting prudent healthcare and is using a holistic needs assessment. Outcome measures will assess physical symptoms, psychological well-being, confidence in managing own health and quality of life. Healthcare service use will be measured over 36 weeks. Feedback interviews with patients and clinicians will further inform the acceptability of the intervention. Recruitment, attrition, questionnaire completion rates and outcome measures variability will be assessed, and results will inform the design of a future phase III trial and accompanying economic evaluation.
ETHICS AND DISSEMINATION. Ethics approval was granted by Bangor University and North Wales REC (13/WA/0291). Results will be reported in peer-reviewed publications, at scientific conferences, and directly through national cancer and primary care networks.
TRIAL REGISTRATION NUMBER. ISRCTN 34516019
Association of Trauma Molecular Endotypes With Differential Response to Transfusion Resuscitation Strategies
IMPORTANCE: It is not clear which severely injured patients with hemorrhagic shock may benefit most from a 1:1:1 vs 1:1:2 (plasma:platelets:red blood cells) resuscitation strategy. Identification of trauma molecular endotypes may reveal subgroups of patients with differential treatment response to various resuscitation strategies.
OBJECTIVE: To derive trauma endotypes (TEs) from molecular data and determine whether these endotypes are associated with mortality and differential treatment response to 1:1:1 vs 1:1:2 resuscitation strategies.
DESIGN, SETTING, AND PARTICIPANTS: This was a secondary analysis of the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) randomized clinical trial. The study cohort included individuals with severe injury from 12 North American trauma centers. The cohort was taken from the participants in the PROPPR trial who had complete plasma biomarker data available. Study data were analyzed on August 2, 2021, to October 25, 2022.
EXPOSURES: TEs identified by K-means clustering of plasma biomarkers collected at hospital arrival.
MAIN OUTCOMES AND MEASURES: An association between TEs and 30-day mortality was tested using multivariable relative risk (RR) regression adjusting for age, sex, trauma center, mechanism of injury, and injury severity score (ISS). Differential treatment response to transfusion strategy was assessed using an RR regression model for 30-day mortality by incorporating an interaction term for the product of endotype and treatment group adjusting for age, sex, trauma center, mechanism of injury, and ISS.
RESULTS: A total of 478 participants (median [IQR] age, 34.5 [25-51] years; 384 male [80%]) of the 680 participants in the PROPPR trial were included in this study analysis. A 2-class model that had optimal performance in K-means clustering was found. TE-1 (n = 270) was characterized by higher plasma concentrations of inflammatory biomarkers (eg, interleukin 8 and tumor necrosis factor α) and significantly higher 30-day mortality compared with TE-2 (n = 208). There was a significant interaction between treatment arm and TE for 30-day mortality. Mortality in TE-1 was 28.6% with 1:1:2 treatment vs 32.6% with 1:1:1 treatment, whereas mortality in TE-2 was 24.5% with 1:1:2 treatment vs 7.3% with 1:1:1 treatment (P for interaction = .001).
CONCLUSIONS AND RELEVANCE: Results of this secondary analysis suggest that endotypes derived from plasma biomarkers in trauma patients at hospital arrival were associated with a differential response to 1:1:1 vs 1:1:2 resuscitation strategies in trauma patients with severe injury. These findings support the concept of molecular heterogeneity in critically ill trauma populations and have implications for tailoring therapy for patients at high risk for adverse outcomes
Mechanism of injury and special considerations as predictive of serious injury: A systematic review.
Objectives: The Centers for Disease Control and Prevention\u27s field triage guidelines (FTG) are routinely used by emergency medical services personnel for triaging injured patients. The most recent (2011) FTG contains physiologic, anatomic, mechanism, and special consideration steps. Our objective was to systematically review the criteria in the mechanism and special consideration steps that might be predictive of serious injury or need for a trauma center. Methods: We conducted a systematic review of the predictive utility of mechanism and special consideration criteria for predicting serious injury. A research librarian searched in Ovid Medline, EMBASE, and the Cochrane databases for studies published between January 2011 and February 2021. Eligible studies were identified using a priori inclusion and exclusion criteria. Studies were excluded if they lacked an outcome for serious injury, such as measures of resource use, injury severity scores, mortality, or composite measures using a combination of outcomes. Given the heterogeneity in populations, measures, and outcomes, results were synthesized qualitatively focusing on positive likelihood ratios (LR+) whenever these could be calculated from presented data or adjusted odds ratios (aOR
Dynamical Mass Measurement of the Young Spectroscopic Binary V343 Normae AaAb Resolved With the Gemini Planet Imager
We present new spatially resolved astrometry and photometry from the Gemini
Planet Imager of the inner binary of the young multiple star system V343
Normae, which is a member of the beta Pictoris moving group. V343 Normae
comprises a K0 and mid-M star in a ~4.5 year orbit (AaAb) and a wide 10" M5
companion (B). By combining these data with archival astrometry and radial
velocities we fit the orbit and measure individual masses for both components
of M_Aa = 1.10 +/- 0.10 M_sun and M_Ab = 0.290 +/- 0.018 M_sun. Comparing to
theoretical isochrones, we find good agreement for the measured masses and JHK
band magnitudes of the two components consistent with the age of the beta Pic
moving group. We derive a model-dependent age for the beta Pic moving group of
26 +/- 3 Myr by combining our results for V343 Normae with literature
measurements for GJ 3305, which is another group member with resolved binary
components and dynamical masses.Comment: 12 pages, 7 figures. Accepted to A
Improving and Assessing Planet Sensitivity of the GPI Exoplanet Survey with a Forward Model Matched Filter
We present a new matched filter algorithm for direct detection of point
sources in the immediate vicinity of bright stars. The stellar Point Spread
Function (PSF) is first subtracted using a Karhunen-Lo\'eve Image Processing
(KLIP) algorithm with Angular and Spectral Differential Imaging (ADI and SDI).
The KLIP-induced distortion of the astrophysical signal is included in the
matched filter template by computing a forward model of the PSF at every
position in the image. To optimize the performance of the algorithm, we conduct
extensive planet injection and recovery tests and tune the exoplanet spectra
template and KLIP reduction aggressiveness to maximize the Signal-to-Noise
Ratio (SNR) of the recovered planets. We show that only two spectral templates
are necessary to recover any young Jovian exoplanets with minimal SNR loss. We
also developed a complete pipeline for the automated detection of point source
candidates, the calculation of Receiver Operating Characteristics (ROC), false
positives based contrast curves, and completeness contours. We process in a
uniform manner more than 330 datasets from the Gemini Planet Imager Exoplanet
Survey (GPIES) and assess GPI typical sensitivity as a function of the star and
the hypothetical companion spectral type. This work allows for the first time a
comparison of different detection algorithms at a survey scale accounting for
both planet completeness and false positive rate. We show that the new forward
model matched filter allows the detection of fainter objects than a
conventional cross-correlation technique with a Gaussian PSF template for the
same false positive rate.Comment: ApJ accepte
GPI spectra of HR 8799 c, d, and e from 1.5 to 2.4m with KLIP Forward Modeling
We explore KLIP forward modeling spectral extraction on Gemini Planet Imager
coronagraphic data of HR 8799, using PyKLIP and show algorithm stability with
varying KLIP parameters. We report new and re-reduced spectrophotometry of HR
8799 c, d, and e in H & K bands. We discuss a strategy for choosing optimal
KLIP PSF subtraction parameters by injecting simulated sources and recovering
them over a range of parameters. The K1/K2 spectra for HR 8799 c and d are
similar to previously published results from the same dataset. We also present
a K band spectrum of HR 8799 e for the first time and show that our H-band
spectra agree well with previously published spectra from the VLT/SPHERE
instrument. We show that HR 8799 c and d show significant differences in their
H & K spectra, but do not find any conclusive differences between d and e or c
and e, likely due to large error bars in the recovered spectrum of e. Compared
to M, L, and T-type field brown dwarfs, all three planets are most consistent
with mid and late L spectral types. All objects are consistent with low gravity
but a lack of standard spectra for low gravity limit the ability to fit the
best spectral type. We discuss how dedicated modeling efforts can better fit HR
8799 planets' near-IR flux and discuss how differences between the properties
of these planets can be further explored.Comment: Accepted to AJ, 25 pages, 16 Figure
Performance of the Gemini Planet Imager Non-Redundant Mask and spectroscopy of two close-separation binaries HR 2690 and HD 142527
The Gemini Planet Imager (GPI) contains a 10-hole non-redundant mask (NRM),
enabling interferometric resolution in complement to its coronagraphic
capabilities. The NRM operates both in spectroscopic (integral field
spectrograph, henceforth IFS) and polarimetric configurations. NRM observations
were taken between 2013 and 2016 to characterize its performance. Most
observations were taken in spectroscopic mode with the goal of obtaining
precise astrometry and spectroscopy of faint companions to bright stars. We
find a clear correlation between residual wavefront error measured by the AO
system and the contrast sensitivity by comparing phase errors in observations
of the same source, taken on different dates. We find a typical 5-
contrast sensitivity of at . We explore the
accuracy of spectral extraction of secondary components of binary systems by
recovering the signal from a simulated source injected into several datasets.
We outline data reduction procedures unique to GPI's IFS and describe a newly
public data pipeline used for the presented analyses. We demonstrate recovery
of astrometry and spectroscopy of two known companions to HR 2690 and HD
142527. NRM+polarimetry observations achieve differential visibility precision
of in the best case. We discuss its limitations on
Gemini-S/GPI for resolving inner regions of protoplanetary disks and prospects
for future upgrades. We summarize lessons learned in observing with NRM in
spectroscopic and polarimetric modes.Comment: Accepted to AJ, 22 pages, 14 figure
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