The waiting time paradox: population based retrospective study of treatment delay and survival of women with endometrial cancer in Scotland

No abstract available

The physician as patient in palliative care: A retrospective case-note audit

Short Report.Background: Dying physicians may present unique challenges to palliative care teams. Studies of dying physicians are scarce, but those that exist suggest a potential absence of a coordinating clinician, prolongation of curative treatments, resistance to palliative care input and barriers to discussing psychosocial needs. Aim: The aim was to describe and examine the care provided to physician-patients referred to an Australian palliative care service, and to identify issues faced by the physician-patient and by the treating team. Design and participants: A retrospective case-note audit of the case notes of medical practitioners referred for palliative care and dying between January 2007 and April 2013 was conducted. Results: There was evidence of medically qualified friends or family members initiating referrals and directing treatment decisions. There was some evidence of increased consultant-led decision-making and bypassing of usual referral pathways and systems for providing after-hours advice and calling consultants directly. There also appeared to be some reluctance by junior doctors to make decisions, because of the patient’s desire for consultant-level advice only. Conclusion: This study adds to the growing body of literature that identifies the potential difficulties associated with caring for medical practitioners. By understanding some of the complexity of this particular doctor–patient relationship, clinicians can approach the management of physician-patients facing the end of their lives with a more sound understanding of their particular care needs.Lachlan C McMichael, Sofia C Zambrano and Gregory B Crawfor

Upper crustal velocity structure beneath the central Lucky Strike Segment from seismic refraction measurements

Geochemistry Geophysics Geosystems, vol. 11, pp. Q05001, 21 pp, 2010International audienceWe present a three-dimensional velocity model of the upper crust around the central volcano of the Lucky Strike Segment, Mid-Atlantic Ridge. The model, constructed from a 3-D array of air gun shots (37.5 m spacing along line and 100 m between lines) to ocean bottom seismometers fired during a 3-D seismic reflection survey, shows an off-axis velocity increase (∼1 km/s), a low-velocity region within the median valley, and a low-velocity anomaly underneath the Lucky Strike volcano. Our observations indicate a porosity decrease of 1%–9% (corresponding to a velocity increase of ∼0.5–1 km/s) over a distance of 8 km from the ridge axis (∼0.7 Ma) and a porosity decrease of 4%–11% (corresponding to a velocity increase of ∼2 km/s) between a depth of 0.5 and 1.75 km below seafloor. A sinusoidal variation in the traveltime residuals indicates the presence of azimuthal anisotropy with cracks aligned approximately along the ridge axis. We favor an interpretation in which upper crustal porosities are created by a combination of magmatic accretion (lava–sheeted dike boundary) and active extension (faults, fractures, and fissures). The porosity variation with depth probably depends on pore space collapse, hydrothermal alteration, and a change of stress accommodation. The off-axis porosities are possibly influenced by both hydrothermal precipitation and the aging of the crust

Effect of Ordering on Spinodal Decomposition of Liquid-Crystal/Polymer Mixtures

Partially phase-separated liquid-crystal/polymer dispersions display highly fibrillar domain morphologies that are dramatically different from the typical structures found in isotropic mixtures. To explain this, we numerically explore the coupling between phase ordering and phase separation kinetics in model two-dimensional fluid mixtures phase separating into a nematic phase, rich in liquid crystal, coexisting with an isotropic phase, rich in polymer. We find that phase ordering can lead to fibrillar networks of the minority polymer-rich phase

Nuclear Spin-Isospin Correlations, Parity Violation, and the fπf_\pi Problem

The strong interaction effects of isospin- and spin-dependent nucleon-nucleon correlations observed in many-body calculations are interpreted in terms of a one-pion exchange mechanism. Including such effects in computations of nuclear parity violating effects leads to enhancements of about 10%. A larger effect arises from the one-boson exchange nature of the parity non-conserving nucleon- nucleon interaction, which depends on both weak and strong meson-nucleon coupling constants. Using values of the latter that are constrained by nucleon-nucleon phase shifts leads to enhancements of parity violation by factors close to two. Thus much of previously noticed discrepancies between weak coupling constants extracted from different experiments can be removed.Comment: 8 pages 2 figures there should have been two figures in v

Extremely preterm infants receiving standard care receive very low levels of arachidonic and docosahexaenoic acids

Background & aims Adequate supply of arachidonic (ARA) and docosahexaenoic (DHA) acids is essential for brain development, and extremely preterm infants may be at risk of deficiency. Current levels of ARA and DHA given to extremely preterm infants and the amounts available for accretion have not been established, although recent evidence suggests DHA intake is at a level likely to lead to severe deficits. This study quantified the omega-6 and omega-3 polyunsaturated fatty acid (PUFA) intakes from all sources in the first six weeks of life of preterm infants in standard care. In addition, the relationship between blood levels of circulating cytokines and PUFAs was explored. Methods Single centre longitudinal study with omega-6 and omega-3 PUFA intake data analysed from all sources for 17 infants born <28 weeks gestation. At six weeks of age the infants' whole-blood fatty acid levels were measured along with a range of cytokines and chemokines analysed by Luminex® multiplex array. Results ARA intake was significantly below international recommendations in weeks 1–5 (all p < 0.05), and DHA intake was significantly below recommendations in week 1 (p < 0.0001). The amounts of ARA and DHA available for accretion were significantly below estimated accretion rates in all weeks (all p < 0.001). Mean ARA and DHA intakes were correlated with their respective blood levels (r = 0.568, p = 0.017 and r = 0.704, p = 0.002). There were significant relationships between MIP-1β and blood DHA levels (rs = 0.559, p = 0.02) and between RANTES and omega-6:omega-3 PUFA ratio (rs = −0.498, p = 0.042). Conclusions This study establishes that extremely preterm infants receive insufficient intakes of ARA and DHA. Moreover, blood fatty acid levels may provide a useful measure of intake, where establishing sufficient consumption could have clinical importance. There may also be important interactions between long-chain PUFA status and markers of inflammation, which requires further study

Optical Spectra of SNR Candidates in NGC 300

We present moderate-resolution (<5A) long-slit optical spectra of 51 nebular objects in the nearby Sculptor Group galaxy NGC 300 obtained with the 2.3 meter Advanced Technology Telescope at Siding Spring Observatory, Australia. Adopting the criterion of [SII]/Ha>=0.4 to confirm supernova remnants (SNRs) from optical spectra, we find that of 28 objects previously proposed as SNRs from optical observations, 22 meet this criterion with six showing [SII]/Ha of less than 0.4. Of 27 objects suggested as SNRs from radio data, four are associated with the 28 previously proposed SNRs. Of these four, three (included in the 22 above) meet the criterion. In all, 22 of the 51 nebular objects meet the [SII]/Ha criterion as SNRs while the nature of the remaining 29 objects remains undetermined by these observations.Comment: Accepted for publication in Astrophysics & Space Scienc

Cold Gas in Cluster Cores

I review the literature's census of the cold gas in clusters of galaxies. Cold gas here is defined as the gas that is cooler than X-ray emitting temperatures (~10^7 K) and is not in stars. I present new Spitzer IRAC and MIPS observations of Abell 2597 (PI: Sparks) that reveal significant amounts of warm dust and star formation at the level of 5 solar masses per year. This rate is inconsistent with the mass cooling rate of 20 +/- 5 solar masses per year inferred from a FUSE [OVI] detection.Comment: 10 pages, conference proceeding

Boundaries and Prototypes in Categorizing Direction

Projective terms such as left, right, front, back are conceptually interesting due to their flexibility of contextual usage and their central relevance to human spatial cognition. Their default acceptability areas are well known, with prototypical axes representing their most central usage and decreasing acceptability away from the axes. Previous research has shown these axes to be boundaries in certain non-linguistic tasks, indicating an inverse relationship between linguistic and non-linguistic direction concepts under specific circumstances. Given this striking mismatch, our study asks how such inverse non-linguistic concepts are represented in language, as well as how people describe their categorization. Our findings highlight two distinct grouping strategies reminiscent of theories of human categorization: prototype based or boundary based. These lead to different linguistic as well as non-linguistic patterns