16,877 research outputs found

    The long-term outcome of treated high-risk nonmuscle-invasive bladder cancer

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    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)

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    We consider a higher order term in the δN\delta N 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 fNLf_{NL}. Instead it produces a non-zero value of gNLg_{NL}. A combination of constraints lead to an allowed region in fNLgNLf_{NL}-g_{NL} space. To produce the asymmetry with this term without a large value of fNLf_{NL} 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

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    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

    Nonlinear effects in superconducting thin film microwave resonators

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    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

    Decays of an exotic 1-+ hybrid meson resonance in QCD

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    We present the first determination of the hadronic decays of the lightest exotic JPC=1+J^{PC}=1^{-+} 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 mπ700m_\pi \sim 700 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 π1\pi_1 resonance decaying dominantly through the b1πb_1 \pi mode with much smaller decays into f1πf_1 \pi, ρπ\rho \pi, ηπ\eta' \pi and ηπ\eta \pi. A large total width is potentially in agreement with the experimental π1(1564)\pi_1(1564) candidate state, observed in ηπ\eta \pi, ηπ\eta' \pi, 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

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    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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