16,877 research outputs found
The long-term outcome of treated high-risk nonmuscle-invasive bladder cancer
This article is available open access through the publisher’s website from the link below. Copyright © 2012 American Cancer Society.BACKGROUND: The treatment of high-risk nonmuscle-invasive bladder cancer (NMIBC) is difficult given its unpredictable natural history and patient comorbidities. Because current case series are mostly limited in size, the authors report the outcomes from a large, single-center series.
METHODS: The authors reviewed all patients with primary, high-risk NMIBC at their institution from 1994 to 2010. Outcomes were matched with clinicopathologic data. Patients who had muscle invasion within 6 months or had insufficient follow-up (<6 months) were excluded. Correlations were analyzed using multivariable Cox regression and log-rank analysis (2-sided; P < .05).
RESULTS: In total, 712 patients (median age, 73.7 years) were included. Progression to muscle invasion occurred in 110 patients (15.8%; 95% confidence interval [CI], 13%-18.3%) at a median of 17.2 months (interquartile range, 8.9-35.8 months), including 26.5% (95% CI, 22.2%-31.3%) of the 366 patients who had >5 years follow-up. Progression was associated with age (hazard ratio [HR], 1.04; P = .007), dysplastic urothelium (HR, 1.6; P = .003), urothelial cell carcinoma variants (HR, 3.2; P = .001), and recurrence (HR, 18.3; P .6).
CONCLUSIONS: Within a program of conservative treatment, progression of high-risk NMIBC was associated with a poor prognosis. Surveillance and bacillus Calmette-Guerin were ineffective in altering the natural history of this disease. The authors concluded that the time has come to rethink the paradigm of management of this disease.GlaxoSmithKline, Yorkshire Cancer Research, Sheffield Hospitals Charitable Trust, Astellas Educational Foundation, and the European Union
Generating the cosmic microwave background power asymmetry with g(NL)
We consider a higher order term in the expansion for the CMB power
asymmetry generated by a superhorizon isocurvature field fluctuation. The term
can generate the asymmetry without requiring a large value of . Instead
it produces a non-zero value of . A combination of constraints lead to
an allowed region in space. To produce the asymmetry with this
term without a large value of we find that the isocurvature field
needs to contribute less than the inflaton towards the power spectrum of the
curvature perturbation.Comment: 6 pages, 1 figure. Updated to match published version. Minor
typographical correction
Global oceanic emission of ammonia: constraints from seawater and atmospheric observations
Current global inventories of ammonia emissions identify the ocean as the largest natural
source. This source depends on seawater pH, temperature, and the concentration of total seawater
ammonia (NHx(sw)), which reflects a balance between remineralization of organic matter, uptake by
plankton, and nitrification. Here we compare [NHx(sw)] from two global ocean biogeochemical models
(BEC and COBALT) against extensive ocean observations. Simulated [NHx(sw)] are generally biased high.
Improved simulation can be achieved in COBALT by increasing the plankton affinity for NHx within observed
ranges. The resulting global ocean emissions is 2.5 TgN a−1, much lower than current literature values
(7–23 TgN a−1), including the widely used Global Emissions InitiAtive (GEIA) inventory (8 TgN a−1). Such
a weak ocean source implies that continental sources contribute more than half of atmospheric NHx over
most of the ocean in the Northern Hemisphere. Ammonia emitted from oceanic sources is insufficient to
neutralize sulfate aerosol acidity, consistent with observations. There is evidence over the Equatorial Pacific
for a missing source of atmospheric ammonia that could be due to photolysis of marine organic nitrogen at
the ocean surface or in the atmosphere. Accommodating this possible missing source yields a global ocean
emission of ammonia in the range 2–5 TgN a−1, comparable in magnitude to other natural sources from
open fires and soils
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Resonances in coupled πk,ηK scattering from lattice QCD
Coupled-channel and scattering amplitudes are determined by
studying the finite-volume energy spectra obtained from dynamical lattice QCD
calculations. Using a large basis of interpolating operators, including both
those resembling a construction and those resembling a pair of
mesons with relative momentum, a reliable excited-state spectrum can be
obtained. Working at , we find a gradual increase in
the phase-shift which may be identified with a broad scalar
resonance that couples strongly to and weakly to . The
low-energy behavior of this amplitude suggests a virtual bound-state that may
be related to the resonance. A bound state with is found
very close to the threshold energy, whose coupling to the
channel is compatible with that of the experimental . Evidence is
found for a narrow resonance in . Isospin--3/2 scattering is
also studied and non-resonant phase-shifts spanning the whole elastic
scattering region are obtained.We thank our colleagues within the Hadron Spectrum
Collaboration. We also thank R. Briceno, M.R. Pennington,
C.J.Shultz and A.P. Szczepaniak for fruitful discussions.
Chroma [63] and QUDA [64, 65] were used to perform
this work on clusters at Jefferson Laboratory under the
USQCD Initiative and the LQCD ARRA project. Gauge
configurations were generated using resources awarded
from the U.S. Department of Energy INCITE program
at Oak Ridge National Lab, the NSF Teragrid at the
Texas Advanced Computer Center and the Pittsburgh
Supercomputer Center, as well as at Jefferson Lab. RGE
and JJD acknowledge support from U.S. Department of
Energy contract DE-AC05-06OR23177, under which Jefferson
Science Associates, LLC, manages and operates
Jefferson Laboratory. JJD acknowledges support from
the U.S. Department of Energy Early Career award contract
DE-SC0006765. CET acknowledges partial support
from the Science and Technology Facilities Council
(U.K.) [grant number ST/L000385/1].This is the accepted manuscript. The final version is available at http://journals.aps.org/prd/abstract/10.1103/PhysRevD.91.054008
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Exploring the performance of thin-film superconducting multilayers as kinetic inductance detectors for low-frequency detection
We have solved numerically the diffusive Usadel equations that describe the spatially varying superconducting proximity effect in Ti-Al thin-film bi- and trilayers with thickness values that are suitable for kinetic inductance detectors (KIDs) to operate as photon detectors with detection thresholds in the frequency range of 50-90 GHz. Using Nam's extension of the Mattis-Bardeen calculation of the superconductor complex conductivity, we show how to calculate the surface impedance for the spatially varying case, and hence the surface impedance quality factor. In addition, we calculate energy-and spatially-averaged quasiparticle lifetimes at temperatures well-below the transition temperature and compare to calculation in Al. Our results for the pair-breaking threshold demonstrate differences between bilayers and trilayers with the same total film thicknesses. We also predict high quality factors and long multilayer-averaged quasiparticle recombination times compared to thin-film Al. Our calculations give a route for designing KIDs to operate in this scientifically-important frequency regime
Nonlinear effects in superconducting thin film microwave resonators
We discuss how reactive and dissipative non-linearities affect the intrinsic
response of superconducting thin-film resonators. We explain how most, if not
all, of the complex phenomena commonly seen can be described by a model in
which the underlying resonance is a single-pole Lorentzian, but whose centre
frequency and quality factor change as external parameters, such as readout
power and frequency, are varied. What is seen during a vector-network-analyser
measurement is series of samples taken from an ideal Lorentzian that is
shifting and spreading as the readout frequency is changed. According to this
model, it is perfectly proper to refer to, and measure, the resonant frequency
and quality factor of the underlying resonance, even though the swept-frequency
curves appear highly distorted and hysteretic. In those cases where the
resonance curve is highly distorted, the specific shape of the trajectory in
the Argand plane gives valuable insights into the second-order physical
processes present. We discuss the formulation and consequences of this approach
in the case of non-linear kinetic inductance, two-level-system loss,
quasiparticle generation, and a generic model based on a power-law form. The
generic model captures the key features of specific dissipative
non-linearities, but additionally leads to insights into how general
dissipative processes create characteristic forms in the Argand plane. We
provide detailed formulations in each case, and indicate how they lead to the
wide variety of phenomena commonly seen in experimental data. We also explain
how the properties of the underlying resonance can be extracted from this data.
Overall, our paper provides a self-contained compendium of behaviour that will
help practitioners interpret and determine important parameters from distorted
swept-frequency measurements
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B1 resonance in coupled πω, πφ scattering from lattice QCD
We present the first lattice QCD calculation of coupled and
scattering, incorporating coupled and -wave in
. Finite-volume spectra in three volumes are determined via a
variational analysis of matrices of two-point correlation functions, computed
using large bases of operators resembling single-meson, two-meson and
three-meson structures, with the light-quark mass corresponding to a pion mass
of MeV. Utilizing the relationship between the discrete
spectrum of finite-volume energies and infinite-volume scattering amplitudes,
we find a narrow axial-vector resonance (), the analogue of the
meson, with mass MeV and width
MeV. The resonance is found to couple dominantly to -wave , with
a much-suppressed coupling to -wave , and a negligible coupling
to consistent with the `OZI rule'. No resonant behavior is observed
in , indicating the absence of a putative low-mass analogue of
the claimed in . In order to minimally present the contents
of a unitary three-channel scattering matrix, we introduce an -channel
generalization of the traditional two-channel Stapp parameterization
Decays of an exotic 1-+ hybrid meson resonance in QCD
We present the first determination of the hadronic decays of the lightest
exotic resonance in lattice QCD. Working with SU(3) flavor
symmetry, where the up, down and strange quark masses approximately match the
physical strange-quark mass giving MeV, we compute
finite-volume spectra on six lattice volumes which constrain a scattering
system featuring eight coupled channels. Analytically continuing the scattering
amplitudes into the complex energy plane, we find a pole singularity
corresponding to a narrow resonance which shows relatively weak coupling to the
open pseudoscalar--pseudoscalar, vector--pseudoscalar and vector--vector decay
channels, but large couplings to at least one kinematically-closed
axial-vector--pseudoscalar channel. Attempting a simple extrapolation of the
couplings to physical light-quark mass suggests a broad resonance
decaying dominantly through the mode with much smaller decays into
, , and . A large total width is
potentially in agreement with the experimental candidate state,
observed in , , which we suggest may be heavily suppressed
decay channels
Let me Google that for you:a time series analysis of seasonality in internet search trends for terms related to foot and ankle pain
BACKGROUND: The analysis of internet search traffic may present the opportunity to gain insights into general trends and patterns in information seeking behaviour related to medical conditions at a population level. For prevalent and widespread problems such as foot and ankle pain, this information has the potential to improve our understanding of seasonality and trends within these conditions and their treatments, and may act as a useful proxy for their true incidence/prevalence characteristics. This study aimed to explore seasonal effects, general trends and relative popularity of internet search terms related to foot and ankle pain over the past decade. METHODS: We used the Google Trends tool to obtain relative search engine traffic for terms relating to foot and ankle pain and common treatments from Google search and affiliated pages for major northern and southern hemisphere English speaking nations. Analysis of overall trends and seasonality including summer/winter differences was carried out on these terms. RESULTS: Searches relating to general foot pain were on average 3.4 times more common than those relating to ankle pain, and twice as common as searches relating to heel pain. Distinct seasonal effects were seen in the northern hemisphere, with large increases in search volumes in the summer months compared to winter for foot (p = 0.004, 95 % CI [22.2–32.1]), ankle (p = 0.0078, 95 % CI [20.9–35.5]), and heel pain (p = 0.004, 95 % CI [29.1–45.6]). These seasonal effects were reflected by data from Australia, with the exception of ankle pain. Annual seasonal effects for treatment options were limited to terms related to foot surgery and ankle orthoses (p = 0.031, 95 % CI [3.5–20.9]; p = 0.004, 95 % CI [7.6–25.2] respectively), again increasing in the summer months. CONCLUSIONS: A number of general trends and annual seasonal effects were found in time series internet search data for terms relating to foot and ankle pain. This data may provide insights into these conditions at population levels. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13047-015-0074-9) contains supplementary material, which is available to authorized users
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