The morbidity of urethral stricture disease among male Medicare beneficiaries

<p>Abstract</p> <p>Background</p> <p>To date, the morbidity of urethral stricture disease among American men has not been analyzed using national datasets. We sought to analyze the morbidity of urethral stricture disease by measuring the rates of urinary tract infections and urinary incontinence among men with a diagnosis of urethral stricture.</p> <p>Methods</p> <p>We analyzed Medicare claims data for 1992, 1995, 1998, and 2001 to estimate the rate of dual diagnoses of urethral stricture with urinary tract infection and with urinary incontinence occurring in the same year among a 5% sample of beneficiaries. Male Medicare beneficiaries receiving co-incident ICD-9 codes indicating diagnoses of urethral stricture and either urinary tract infection or urinary incontinence within the same year were counted.</p> <p>Results</p> <p>The percentage of male patients with a diagnosis of urethral stricture who also were diagnosed with a urinary tract infection was 42% in 2001, an increase from 35% in 1992. Eleven percent of male Medicare beneficiaries with urethral stricture disease in 2001 were diagnosed with urinary incontinence in the same year. This represents an increase from 8% in 1992.</p> <p>Conclusions</p> <p>Among male Medicare beneficiaries diagnosed with urethral stricture disease in 2001, 42% were also diagnosed with a urinary tract infection, and 11% with incontinence. Although the overall incidence of stricture disease decreased over this time period, these rates of dual diagnoses increased from 1992 to 2001. Our findings shed light into the health burden of stricture disease on American men. In order to decrease the morbidity of stricture disease, early definitive management of strictures is warranted.</p

Multidisciplinary consensus statement on the clinical management of patients with pancreatic cancer

Pancreatic cancer (PC) remains one of the most aggressive tumors with an increasing incidence rate and reduced survival. Although surgical resection is the only potentially curative treatment for PC, only 15-20% of patients are resectable at diagnosis. To select the most appropriate treatment and thus improve outcomes, the diagnostic and therapeutic strategy for each patient with PC should be discussed within a multidisciplinary expert team. Clinical decision-making should be evidence-based, considering the staging of the tumor, the performance status and preferences of the patient. The aim of this guideline is to provide practical and evidence-based recommendations for the management of PC

Microlensing by natural wormholes: theory and simulations

We provide an in depth study of the theoretical peculiarities that arise in effective negative mass lensing, both for the case of a point mass lens and source, and for extended source situations. We describe novel observational signatures arising in the case of a source lensed by a negative mass. We show that a negative mass lens produces total or partial eclipse of the source in the umbra region and also show that the usual Shapiro time delay is replaced with an equivalent time gain. We describe these features both theoretically, as well as through numerical simulations. We provide negative mass microlensing simulations for various intensity profiles and discuss the differences between them. The light curves for microlensing events are presented and contrasted with those due to lensing produced by normal matter. Presence or absence of these features in the observed microlensing events can shed light on the existence of natural wormholes in the Universe.Comment: 16 pages, 24 postscript figures (3 coloured), revtex style, submitted to Phys. Rev.

The Chandra Multi-Wavelength Project: Optical Spectroscopy and the Broadband Spectral Energy Distributions of X-ray Selected AGN

From optical spectroscopy of X-ray sources observed as part of ChaMP, we present redshifts and classifications for a total of 1569 Chandra sources from our targeted spectroscopic follow up using the FLWO, SAAO, WIYN, CTIO, KPNO, Magellan, MMT and Gemini telescopes, and from archival SDSS spectroscopy. We classify the optical counterparts as 50% BLAGN, 16% NELG, 14% ALG, and 20% stars. We detect QSOs out to z~5.5 and galaxies out to z~3. We have compiled extensive photometry from X-ray to radio bands. Together with our spectroscopic information, this enables us to derive detailed SEDs for our extragalactic sources. We fit a variety of templates to determine bolometric luminosities, and to constrain AGN and starburst components where both are present. While ~58% of X-ray Seyferts require a starburst event to fit observed photometry only 26% of the X-ray QSO population appear to have some kind of star formation contribution. This is significantly lower than for the Seyferts, especially if we take into account torus contamination at z>1 where the majority of our X-ray QSOs lie. In addition, we observe a rapid drop of the percentage of starburst contribution as X-ray luminosity increases. This is consistent with the quenching of star formation by powerful QSOs, as predicted by the merger model, or with a time lag between the peak of star formation and QSO activity. We have tested the hypothesis that there should be a strong connection between X-ray obscuration and star-formation but we do not find any association between X-ray column density and star formation rate both in the general population or the star-forming X-ray Seyferts. Our large compilation also allows us to report here the identification of 81 XBONG, 78 z>3 X-ray sources and 8 Type-2 QSO candidates. Also we have identified the highest redshift (z=5.4135) X-ray selected QSO with optical spectroscopy.Comment: 17 pages, 16 figures, accepted for publication in ApJS. Full data table and README file can be found online at http://hea-www.harvard.edu/~pgreen/Papers.htm

Physiological effects of tourism and associated food provisioning in an endangered iguana

© The Author 2013. Deliberately feeding wildlife is an increasingly popular tourism-related activity despite a limited understanding of long-term impacts on the species being fed. As a result, tourist behaviours that may have adverse impacts on imperiled species have often been encouraged without the necessary evaluation or oversight. Here, we report the responses of Northern Bahamian Rock Iguanas (Cyclura cychlura) to human-visitation pressure and associated food provisioning. We compared a variety of blood chemistry parameters of iguanas subjected to supplemental feeding at popular tourist destinations with iguanas occurring on islands where supplemental feeding does not take place. We demonstrate that male and female iguanas inhabiting tourist-visited islands where supplemental feeding occurs do not differ in body condition or baseline stress and stress response (determined by corticosterone levels) compared with iguanas from non-visited islands. Both males and females from tourist-visited sites experienced a greater incidence of endoparasitic infection and atypical loose faeces. Indicators of dietary nutrition, including glucose, potassium, and uric acid values, also differed for both sexes from tourist-visited and unvisited islands. Male iguanas from visited islands differed significantly from those on non-visited islands in calcium, cholesterol, cobalt, copper, magnesium, packed cell volume, selenium, and triglyceride concentrations, whereas female iguanas from visited islands differed significantly in ionized calcium. Although the interpretation of these differences is challenging, chronic biochemical stressors could compromise individual health over time or decrease survivorship during periods of environmental stress. We suggest protocols that can be adopted throughout the region to ensure that supplemental feeding has fewer impacts on these long-lived iguanas

Core-collapse and Type Ia supernovae with the SKA

Core-collapse SNe (CCSNe): Systematic searches of radio emission from CCSNe are still lacking, and only targeted searches of radio emission from just some of the optically discovered CCSNe in the local universe have been carried out. Optical searches miss a significant fraction of CCSNe due to dust obscuration; CCSN radio searches are thus more promising for yielding the complete, unobscured star-formation rates in the local universe. The SKA yields the possibility to piggyback for free in this area of research by carrying out commensal, wide-field, blind transient survey observations. SKA1-SUR should be able to discover several hundreds of CCSNe in just one year, compared to about a dozen CCSNe that the VLASS would be able to detect in one year, at most. SKA, with an expected sensitivity ten times that of SKA1, is expected to detect CCSNe in the local Universe by the thousands. Therefore, commensal SKA observations could easily result in an essentially complete census of all CCSNe in the local universe, thus yielding an accurate determination of the volumetric CCSN rate. Type Ia SNe: We advocate for the use of the SKA to search for the putative prompt (~first few days after the explosion) radio emission of any nearby type Ia SN, via target-of-opportunity observations. The huge improvement in sensitivity of the SKA with respect to its predecessors will allow to unambiguously discern which progenitor scenario (single-degenerate vs. double-degenerate) applies to them.Comment: Proceedings of Science: Advancing Astrophysics with the Square Kilometre Array. Accepted version, including comments by the refere

The order parameter-entropy relation in some universal classes: experimental evidence

The asymptotic behaviour near phase transitions can be suitably characterized by the scaling of $\Delta s/Q^2$ with $\epsilon=1-T/T_c$, where $\Delta s$ is the excess entropy and $Q$ is the order parameter. As $\Delta s$ is obtained by integration of the experimental excess specific heat of the transition $\Delta c$, it displays little experimental noise so that the curve $\log(\Delta s/Q^2)$ versus $\log\epsilon$ is better constrained than, say, $\log\Delta c$ versus $\log\epsilon$. The behaviour of $\Delta s/Q^2$ for different universality classes is presented and compared. In all cases, it clearly deviates from being a constant. The determination of this function can then be an effective method to distinguish asymptotic critical behaviour. For comparison, experimental data for three very different systems, Rb2CoF4, Rb2ZnCl4 and SrTiO3, are analysed under this approach. In SrTiO3, the function $\Delta s/Q^2$ does not deviate within experimental resolution from a straight line so that, although Q can be fitted with a non mean-field exponent, the data can be explained by a classical Landau mean-field behaviour. In contrast, the behaviour of $\Delta s/Q^2$ for the antiferromagnetic transition in Rb2CoF4 and the normal-incommensurate phase transition in Rb2ZCl4 is fully consistent with the asymptotic critical behaviour of the universality class corresponding to each case. This analysis supports, therefore, the claim that incommensurate phase transitions in general, and the A$_2$BX$_4$ compounds in particular, in contrast with most structural phase transitions, have critical regions large enough to be observable.Comment: 13 pp. 9 ff. 2 tab. RevTeX. Submitted to J. Phys.: Cond. Matte

Unveiling the AGN in IC 883: discovery of a parsec-scale radio jet

IC 883 is a luminous infrared galaxy (LIRG) classified as a starburst-active galactic nucleus (AGN) composite. In a previous study we detected a low-luminosity AGN (LLAGN) radio candidate. Here we report on our radio follow-up at three frequencies which provides direct and unequivocal evidence of the AGN activity in IC 883. Our analysis of archival X-ray data, together with the detection of a transient radio source with luminosity typical of bright supernovae, give further evidence of the ongoing star formation activity, which dominates the energetics of the system. At sub-parsec scales, the radio nucleus has a core-jet morphology with the jet being a newly ejected component showing a subluminal proper motion of 0.6–1 c. The AGN contributes less than two per cent of the total IR luminosity of the system. The corresponding Eddington factor is ∼ 10−3, suggesting this is a low-accretion rate engine, as often found in LLAGNs. However, its high bolometric luminosity (∼ 1044 erg s−1) agrees better with a normal AGN. This apparent discrepancy may just be an indication of the transition nature of the nucleus from a system dominated by star-formation, to an AGN-dominated system. The nucleus has a strongly inverted spectrum and a turnover at ∼ 4.4 GHz, thus qualifying as a candidate for the least luminous (L5.0 GHz ∼ 6.3 × 1028 erg s−1 Hz−1) and one of the youngest (∼ 3 × 103 yr) gigahertz-peaked spectrum (GPS) sources. If the GPS origin for the IC 883 nucleus is confirmed, then advanced mergers in the LIRG category are potentially key environments to unveil the evolution of GPS sources into more powerful radio galaxies