Chemoembolization versus radioembolization for the treatment of unresectable intrahepatic cholangiocarcinoma in a single institution image-based efficacy and comparative toxicity

Aim: Compare radioembolization (Y90) and chemoembolization (CE) for the treatment of unresectable intrahepatic cholangiocarcinoma (UICC). Materials & methods: Institutional Review Board-approved, retrospective search was performed. Forty patients with UICC were treated with either Y90 (n = 25, 39 treatments) or CE (n = 15, 35 treatments). Comparative analysis was performed using Student\u27s Results: Median ages were 60 and 64 years for CE and Y90 groups, respectively (p = 0.798). Patient variables including age, Eastern Cooperative Oncology Group score, tumor burden, extra-hepatic disease, prior chemotherapy and prior surgery were similar between groups. Adverse events were similar in both groups (CE 20%, Y90 26%; p \u3e 0.9). Overall response rate (CE 6%, Y90 4%; p \u3e 0.9) and disease control rate (CE 46%, Y90 48%; p \u3e 0.9) were statistically similar. Multilogistic regression did not identify any variables that correlated with disease control rate, including Eastern Cooperative Oncology Group score and tumor burden. Conclusion: Our observation shows that CE and Y90 display similar toxicity and disease control in the treatment of UICC

Ultrafast electro-nuclear dynamics of H2 double ionization

The ultrafast electronic and nuclear dynamics of H2 laser-induced double ionization is studied using a time-dependent wave packet approach that goes beyond the fixed nuclei approximation. The double ionization pathways are analyzed by following the evolution of the total wave function during and after the pulse. The rescattering of the first ionized electron produces a coherent superposition of excited molecular states which presents a pronounced transient H+H- character. This attosecond excitation is followed by field-induced double ionization and by the formation of short-lived autoionizing states which decay via double ionization. These two double ionization mechanisms may be identified by their signature imprinted in the kinetic-energy distribution of the ejected protons

Theoretical study of a cold atom beam splitter

A theoretical model is presented for the study of the dynamics of a cold atomic cloud falling in the gravity field in the presence of two crossing dipole guides. The cloud is split between the two branches of this laser guide, and we compare experimental measurements of the splitting efficiency with semiclassical simulations. We then explore the possibilities of optimization of this beam splitter. Our numerical study also gives access to detailed information, such as the atom temperature after the splitting

Contrasting Views of Physicians and Nurses about an Inpatient Computer-based Provider Order-entry System

Objective: Many hospitals are investing in computer-based provider order-entry (POE) systems, and providers’ evaluations have proved important for the success of the systems. The authors assessed how physicians and nurses viewed the effects of one modified commercial POE system on time spent patients, resource utilization, errors with orders, and overall quality of care. Design: Survey. Measurements: Opinions of 271 POE users on medicine wards of an urban teaching hospital: 96 medical house officers, 49 attending physicians, 19 clinical fellows with heavy inpatient loads, and 107 nurses. Results: Responses were received from 85 percent of the sample. Most physicians and nurses agreed that orders were executed faster under POE. About 30 percent of house officers and attendings or fellows, compared with 56 percent of nurses, reported improvement in overall quality of care with POE. Forty-four percent of house officers and 34 percent of attendings/fellows reported that their time with patients decreased, whereas 56 percent of nurses indicated that their time with patients increased (P \u3c 0.001). Sixty percent of house officers and 41 percent of attendings/fellows indicated that order errors increased, whereas 69 percent of nurses indicated a decrease or no change in errors. Although most nurses reported no change in the frequency of ordering tests and medications with POE, 61 percent of house officers reported an increased frequency. Conclusion: Physicians and nurses had markedly different views about effects of a POE system on patient care, highlighting the need to consider both perspectives when assessing the impact of POE. With this POE system, most nurses saw beneficial effects, whereas many physicians saw negative effects

Csm4, in Collaboration with Ndj1, Mediates Telomere-Led Chromosome Dynamics and Recombination during Yeast Meiosis

Chromosome movements are a general feature of mid-prophase of meiosis. In budding yeast, meiotic chromosomes exhibit dynamic movements, led by nuclear envelope (NE)-associated telomeres, throughout the zygotene and pachytene stages. Zygotene motion underlies the global tendency for colocalization of NE-associated chromosome ends in a “bouquet.” In this study, we identify Csm4 as a new molecular participant in these processes and show that, unlike the two previously identified components, Ndj1 and Mps3, Csm4 is not required for meiosis-specific telomere/NE association. Instead, it acts to couple telomere/NE ensembles to a force generation mechanism. Mutants lacking Csm4 and/or Ndj1 display the following closely related phenotypes: (i) elevated crossover (CO) frequencies and decreased CO interference without abrogation of normal pathways; (ii) delayed progression of recombination, and recombination-coupled chromosome morphogenesis, with resulting delays in the MI division; and (iii) nondisjunction of homologs at the MI division for some reason other than absence of (the obligatory) CO(s). The recombination effects are discussed in the context of a model where the underlying defect is chromosome movement, the absence of which results in persistence of inappropriate chromosome relationships that, in turn, results in the observed mutant phenotypes

Spatially Correlated Cluster Populations in the Outer Disk of NGC 3184

We use deep (~27.5 mag V-band point-source limiting magnitude) V- and U-band LBT imaging to study the outer disk (beyond the optical radius R_25) of the non-interacting, face-on spiral galaxy NGC 3184 (D = 11.1 Mpc; R_25 = 11.1 kpc) and find that this outer disk contains >1000 objects (or marginally-resolved 'knots') resembling star clusters with masses ~10^2 - 10^4 M_sun and ages up to ~1 Gyr. We find statistically significant numbers of these cluster-like knots extending to ~1.4 R_25, with the redder knots outnumbering bluer at the largest radii. We measure clustering among knots and find significant correlation to galactocentric radii of 1.5 R_25 for knot separations <1 kpc. The effective integrated surface brightness of this outer disk cluster population ranges from 30 - 32 mag arcsec^-2 in V. We compare the HI extent to that of the correlated knots and find that the clusters extend at least to the damped Lyman-alpha threshold of HI column density (2e20 cm^-2; 1.62 R_25). The blue knots are correlated with HI spiral structure to 1.5 R_25, while the red knots may be correlated with the outer fringes of the HI disk to 1.7 R_25. These results suggest that outer disks are well-populated, common, and long-lasting features of many nearby disk galaxies.Comment: Accepted for publication in The Astrophysical Journal. 12 pages, 10 figure