Trends in the Treatment of Adults with Ureteropelvic Junction Obstruction

Background and Purpose: Minimally invasive pyeloplasty is an effective treatment for patients with ureteropelvic junction obstruction that offers quicker convalescence than open pyeloplasty. Technical challenges, however, may have limited its dissemination. We examined population trends and determinants of surgical options for ureteropelvic junction obstruction. Patients and Methods: Using the State Inpatient and Ambulatory Surgery Databases for Florida, we identified adults who underwent ureteropelvic junction obstruction repair between 2001 and 2009. After determining the surgical approach (minimally invasive pyeloplasty, open pyeloplasty, or endopyelotomy), we estimated annual utilization rates and the effects of patient, surgeon, and hospital predictors on surgery type, using multilevel multinomial logistic regression. Results: Rates of minimally invasive pyeloplasty increased 360% (P for monotonic trendPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140371/1/end.2012.0017.pd

Overscreening and Underscreening in Solid-Electrolyte Grain Boundary Space-Charge Layers

Polycrystalline solids can exhibit material properties that differ significantly from those of equivalent single-crystal samples, in part, because of a spontaneous redistribution of mobile point defects into so-called space-charge regions adjacent to grain boundaries. The general analytical form of these space-charge regions is known only in the dilute limit, where defect-defect correlations can be neglected. Using kinetic Monte Carlo simulations of a three-dimensional Coulomb lattice gas, we show that grain-boundary space-charge regions in non-dilute solid electrolytes exhibit overscreening -- damped oscillatory space-charge profiles -- and underscreening -- decay lengths that are longer than the corresponding Debye length and that increase with increasing defect-defect interaction strength. Overscreening and underscreening are known phenomena in concentrated liquid electrolytes, and the observation of functionally analogous behaviour in solid electrolyte space-charge regions suggests that the same underlying physics drives behaviour in both classes of systems. We therefore expect theoretical approaches developed to study non-dilute liquid electrolytes to be equally applicable to future studies of solid electrolytes

The salience of children increases adult prosocial values

Organizations often put children front and center in campaigns to elicit interest and support for prosocial causes. Such initiatives raise a key theoretical and applied question that has yet to be addressed directly: Does the salience of children increase prosocial motivation and behavior in adults? We present findings aggregated across eight experiments involving 2,054 adult participants: Prosocial values became more important after completing tasks that made children salient compared to tasks that made adults (or a mundane event) salient or compared to a no-task baseline. An additional field study showed that adults were more likely to donate money to a child-unrelated cause when children were more salient on a shopping street. The findings suggest broad, reliable interconnections between human mental representations of children and prosocial motives, as the child salience effect was not moderated by participants’ gender, age, attitudes, or contact with children

The Role of Patient Activation in Preferences for Shared Decision Making: Results From a National Survey of US Adults

Financial support for this study was provided by a contract with UnitedHealthcare, Optum Institute. The funding agreement ensured our independence in designing the study, interpreting the data, and writing and publishing the report. Samuel G. Smith is supported by a Cancer Research UK Postdoctoral Fellowship (C42785=A17965). Carol J. Simon and Steven R. Rush are employed by the sponsor

Solar Contamination in Extreme-precision Radial-velocity Measurements: Deleterious Effects and Prospects for Mitigation

Solar contamination, due to moonlight and atmospheric scattering of sunlight, can cause systematic errors in stellar radial velocity (RV) measurements that significantly detract from the ~10 cm s−1 sensitivity required for the detection and characterization of terrestrial exoplanets in or near habitable zones of Sun-like stars. The addition of low-level spectral contamination at variable effective velocity offsets introduces systematic noise when measuring velocities using classical mask-based or template-based cross-correlation techniques. Here we present simulations estimating the range of RV measurement error induced by uncorrected scattered sunlight contamination. We explore potential correction techniques, using both simultaneous spectrometer sky fibers and broadband imaging via coherent fiber imaging bundles, that could reliably reduce this source of error to below the photon-noise limit of typical stellar observations. We discuss the limitations of these simulations, the underlying assumptions, and mitigation mechanisms. We also present and discuss the components designed and built into the NEID (NN-EXPLORE Exoplanet Investigations with Doppler spectroscopy) precision RV instrument for the WIYN 3.5 m telescope, to serve as an ongoing resource for the community to explore and evaluate correction techniques. We emphasize that while "bright time" has been traditionally adequate for RV science, the goal of 10 cm s−1 precision on the most interesting exoplanetary systems may necessitate access to darker skies for these next-generation instruments

Discovery of the most luminous quasar of the last 9 Gyr

We report the discovery of a bright (g = 14.5 mag (AB), K = 11.9 mag (Vega)) quasar at redshift z = 0.83 -- the optically brightest (unbeamed) quasar at z > 0.4. SMSS J114447.77-430859.3, at a Galactic latitude of b = +18.1deg, was identified by its optical colours from the SkyMapper Southern Survey (SMSS) during a search for symbiotic binary stars. Optical and near-infrared spectroscopy reveals broad MgII, H-beta, H-alpha, and Pa-beta emission lines, from which we measure a black hole mass of log10(M_BH/M_Sun) = 9.4 +/- 0.5. With its high luminosity, L_bol = (4.7 +/- 1.0) * 10^47 erg/s or M_i(z=2) = -29.74 mag (AB), we estimate an Eddington ratio of ~1.4. As the most luminous quasar known over the last ~9 Gyr of cosmic history, having a luminosity 8 times greater than 3C 273, the source offers a range of potential follow-up opportunities.Comment: 13 pages. Accepted for publication in PAS

Correlation of lung collapse and gas exchange

Background: Atelectasis can provoke pulmonary and non-pulmonary complications after general anaesthesia. Unfortunately, there is no instrument to estimate atelectasis and prompt changes of mechanical ventilation during general anaesthesia. Although arterial partial pressure of oxygen (PaO2) and intrapulmonary shunt have both been suggested to correlate with atelectasis, studies yielded inconsistent results. Therefore, we investigated these correlations. Methods: Shunt, PaO2 and atelectasis were measured in 11 sheep and 23 pigs with otherwise normal lungs. In pigs, contrasting measurements were available 12 hours after induction of acute respiratory distress syndrome (ARDS). Atelectasis was calculated by computed tomography relative to total lung mass (Mtotal). We logarithmically transformed PaO2 (lnPaO2) to linearize its relationships with shunt and atelectasis. Data are given as median (interquartile range). Results: Mtotal was 768 (715–884) g in sheep and 543 (503–583) g in pigs. Atelectasis was 26 (16–47)% in sheep and 18 (13–23) % in pigs. PaO2 (FiO2 = 1.0) was 242 (106–414) mmHg in sheep and 480 (437–514) mmHg in pigs. Shunt was 39 (29–51)% in sheep and 15 (11–20) % in pigs. Atelectasis correlated closely with lnPaO2 (R2 = 0.78) and shunt (R2 = 0.79) in sheep (P-values<0.0001). The correlation of atelectasis with lnPaO2 (R2 = 0.63) and shunt (R2 = 0.34) was weaker in pigs, but R2 increased to 0.71 for lnPaO2 and 0.72 for shunt 12 hours after induction of ARDS. In both, sheep and pigs, changes in atelectasis correlated strongly with corresponding changes in lnPaO2 and shunt. Discussion and Conclusion: In lung-healthy sheep, atelectasis correlates closely with lnPaO2 and shunt, when blood gases are measured during ventilation with pure oxygen. In lung-healthy pigs, these correlations were significantly weaker, likely because pigs have stronger hypoxic pulmonary vasoconstriction (HPV) than sheep and humans. Nevertheless, correlations improved also in pigs after blunting of HPV during ARDS. In humans, the observed relationships may aid in assessing anaesthesia-related atelectasis

SPICES: Spectro-Polarimetric Imaging and Characterization of Exoplanetary Systems

SPICES (Spectro-Polarimetric Imaging and Characterization of Exoplanetary Systems) is a five-year M-class mission proposed to ESA Cosmic Vision. Its purpose is to image and characterize long-period extrasolar planets and circumstellar disks in the visible (450 - 900 nm) at a spectral resolution of about 40 using both spectroscopy and polarimetry. By 2020/22, present and near-term instruments will have found several tens of planets that SPICES will be able to observe and study in detail. Equipped with a 1.5 m telescope, SPICES can preferentially access exoplanets located at several AUs (0.5-10 AU) from nearby stars ($<$25 pc) with masses ranging from a few Jupiter masses to Super Earths ($\sim$2 Earth radii, $\sim$10 M$_{\oplus}$) as well as circumstellar disks as faint as a few times the zodiacal light in the Solar System

The NEID Precision Radial Velocity Spectrometer: Port Adapter Overview, Requirements, and Test Plan

The NEID spectrometer is an optical (380-930 nm), fiber-fed, precision Doppler spectrometer currently in development for the WIYN 3.5 m telescope at Kitt Peak National Observatory as part of the NN-EXPLORE partnership. Designed to achieve a radial velocity precision of < 30 cm/s, NEID will be sensitive enough to detect terrestrial-mass exoplanets around low-mass stars. Light from the target stars is focused by the telescope to a bent Cassegrain port at the edge of the primary mirror mechanical support. The specialized NEID "Port Adapter" system is mounted at this bent Cassegrain port and is responsible for delivering the incident light from the telescope to the NEID fibers. In order to provide stable, high-quality images to the science instrument, the Port Adapter houses several sub-components designed to acquire the target stars, correct for atmospheric dispersion, stabilize the light onto the science fibers, and calibrate the spectrometer by injecting known wavelength sources such as a laser frequency comb. Here we provide an overview of the overall opto-mechanical design and system requirements of the Port Adapter. We also describe the development of system error budgets and testplans to meet those requirements

Genetic architecture of Environmental Sensitivity reflects multiple heritable components: a twin study with adolescents

Humans differ substantially in how strongly they respond to similar experiences. Theory suggests that such individual differences in susceptibility to environmental influences have a genetic basis. The present study investigated the genetic architecture of Environmental Sensitivity (ES) by estimating its heritability, exploring the presence of multiple heritable components and its genetic overlap with common personality traits. ES was measured with the Highly Sensitive Child (HSC) questionnaire and heritability estimates were obtained using classic twin design methodology in a sample of 2868 adolescent twins. Results indicate that the heritability of sensitivity was 0.47, and that the genetic influences underlying sensitivity to negative experiences are relatively distinct from sensitivity to more positive aspects of the environment, supporting a multi-dimensional genetic model of ES. The correlation between sensitivity, neuroticism and extraversion was largely explained by shared genetic influences, with differences between these traits mainly attributed to unique environmental influences operating on each trait