66 research outputs found

    A multilevel investigation of inequalities in clinical and psychosocial outcomes for women after breast cancer

    Get PDF
    Background In Australia, breast cancer is the most common cancer affecting Australian women. Inequalities in clinical and psychosocial outcomes have existed for some time, affecting particularly women from rural areas and from areas of disadvantage. We have a limited understanding of how individual and area-level factors are related to each other, and their associations with survival and other clinical and psychosocial outcomes. Methods/Design This study will examine associations between breast cancer recurrence, survival and psychosocial outcomes (e.g. distress, unmet supportive care needs, quality of life). The study will use an innovative multilevel approach using area-level factors simultaneously with detailed individual-level factors to assess the relative importance of remoteness, socioeconomic and demographic factors, diagnostic and treatment pathways and processes, and supportive care utilization to clinical and psychosocial outcomes. The study will use telephone and self-administered questionnaires to collect individual-level data from approximately 3, 300 women ascertained from the Queensland Cancer Registry diagnosed with invasive breast cancer residing in 478 Statistical Local Areas Queensland in 2011 and 2012. Area-level data will be sourced from the Australian Bureau of Statistics census data. Geo-coding and spatial technology will be used to calculate road travel distances from patients' residence to diagnostic and treatment centres. Data analysis will include a combination of standard empirical procedures and multilevel modelling. Discussion The study will address the critical question of: what are the individual- or area-level factors associated with inequalities in outcomes from breast cancer? The findings will provide health care providers and policy makers with targeted information to improve the management of women with breast cancer, and inform the development of strategies to improve psychosocial care for women with breast cancer

    A Novel Signaling Network Essential for Regulating Pseudomonas aeruginosa Biofilm Development

    Get PDF
    The important human pathogen Pseudomonas aeruginosa has been linked to numerous biofilm-related chronic infections. Here, we demonstrate that biofilm formation following the transition to the surface attached lifestyle is regulated by three previously undescribed two-component systems: BfiSR (PA4196-4197) harboring an RpoD-like domain, an OmpR-like BfmSR (PA4101-4102), and MifSR (PA5511-5512) belonging to the family of NtrC-like transcriptional regulators. These two-component systems become sequentially phosphorylated during biofilm formation. Inactivation of bfiS, bfmR, and mifR arrested biofilm formation at the transition to the irreversible attachment, maturation-1 and -2 stages, respectively, as indicated by analyses of biofilm architecture, and protein and phosphoprotein patterns. Moreover, discontinuation of bfiS, bfmR, and mifR expression in established biofilms resulted in the collapse of biofilms to an earlier developmental stage, indicating a requirement for these regulatory systems for the development and maintenance of normal biofilm architecture. Interestingly, inactivation did not affect planktonic growth, motility, polysaccharide production, or initial attachment. Further, we demonstrate the interdependency of this two-component systems network with GacS (PA0928), which was found to play a dual role in biofilm formation. This work describes a novel signal transduction network regulating committed biofilm developmental steps following attachment, in which phosphorelays and two sigma factor-dependent response regulators appear to be key components of the regulatory machinery that coordinates gene expression during P. aeruginosa biofilm development in response to environmental cues

    On the Use of Field RR Lyrae as Galactic Probes. V. Optical and Radial Velocity Curve Templates

    Get PDF
    We collected the largest spectroscopic catalog of RR Lyrae (RRLs) including ≈20,000 high-, medium-, and low-resolution spectra for ≈10,000 RRLs. We provide the analytical forms of radial velocity curve (RVC) templates. These were built using 36 RRLs (31 fundamental—split into three period bins—and five first-overtone pulsators) with well-sampled RVCs based on three groups of metallic lines (Fe, Mg, Na) and four Balmer lines (Hα, HÎČ, HÎł, HÎŽ). We tackled the long-standing problem of the reference epoch to anchor light-curve and RVC templates. For the V-band, we found that the residuals of the templates anchored to the phase of the mean magnitude along the rising branch are ∌35% to ∌45% smaller than those anchored to the phase of maximum light. For the RVC, we used two independent reference epochs for metallic and Balmer lines and we verified that the residuals of the RVC templates anchored to the phase of mean RV are from 30% (metallic lines) up to 45% (Balmer lines) smaller than those anchored to the phase of minimum RV. We validated our RVC templates by using both the single-point and the three phase point approaches. We found that barycentric velocities based on our RVC templates are two to three times more accurate than those available in the literature. We applied the current RVC templates to Balmer lines RVs of RRLs in the globular NGC 3201 collected with MUSE at VLT. We found the cluster barycentric RV of VÎł = 496.89 ± 8.37(error) ± 3.43 (standard deviation) km s−1, which agrees well with literature estimates

    On the Use of Field RR Lyrae As Galactic Probes: IV. New Insights Into and Around the Oosterhoff Dichotomy*

    Get PDF
    We discuss the largest and most homogeneous spectroscopic data set of field RR Lyrae variables (RRLs) available to date. We estimated abundances using both high-resolution and low-resolution (ΔS method) spectra for fundamental (RRab) and first overtone (RRc) RRLs. The iron abundances for 7941 RRLs were supplemented with similar estimates that are available in the literature, ending up with 9015 RRLs (6150 RRab, 2865 RRc). The metallicity distribution shows a mean value of 〈[Fe/H]〉 = −1.51 ± 0.01, and σ(standard deviation) = 0.41 dex with a long metal-poor tail approaching [Fe/H] ≃ − 3 and a sharp metal-rich tail approaching solar iron abundance. The RRab variables are more metal-rich (〈[Fe/H]〉ab = −1.48 ± 0.01, σ = 0.41 dex) than RRc variables (〈[Fe/H]〉c = −1.58 ± 0.01, σ = 0.40 dex). The relative fraction of RRab variables in the Bailey diagram (visual amplitude versus period) located along the short-period (more metal-rich) and the long-period (more metal-poor) sequences are 80% and 20%, while RRc variables display an opposite trend, namely 30% and 70%, respectively. We found that the pulsation period of both RRab and RRc variables steadily decreases when moving from the metal-poor to the metal-rich regime. The visual amplitude shows the same trend, but RRc amplitudes are almost two times more sensitive than RRab amplitudes to metallicity. We also investigated the dependence of the population ratio (Nc/Ntot) of field RRLs on the metallicity and we found that the distribution is more complex than in globular clusters. The population ratio steadily increases from ∌0.25 to ∌0.36 in the metal-poor regime, it decreases from ∌0.36 to ∌0.18 for −1.8 ≀ [Fe/H] ≀ −0.9 and it increases to a value of ∌0.3 approaching solar iron abundance

    Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

    Get PDF
    DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties

    Interventions for acute stroke management in Africa: a systematic review of the evidence

    Get PDF
    Abstract Background The past decades have witnessed a rapid evolution of research on evidence-based acute stroke care interventions worldwide. Nonetheless, the evidence-to-practice gap in acute stroke care remains variable with slow and inconsistent uptake in low-middle income countries (LMICs). This review aims to identify and compare evidence-based acute stroke management interventions with alternative care on overall patient mortality and morbidity outcomes, functional independence, and length of hospital stay across Africa. Methods This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. An electronic search was conducted in six databases comprising MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Academic Search Complete and Cochrane Library for experimental and non-experimental studies. Eligible studies were abstracted into evidence tables and their methodological quality appraised using the Joanna Briggs Institute checklist. Data were analysed and presented narratively with reference to observed differences in patient outcomes, reporting p values and confidence intervals for any possible relationship. Results Initially, 1896 articles were identified and 37 fully screened. Four non-experimental studies (three cohort and one case series studies) were included in the final review. One study focused on the clinical efficacy of a stroke unit whilst the remaining three reported on thrombolytic therapy. The results demonstrated a reduction in patient deaths attributed to stroke unit care and thrombolytic therapy. Thrombolytic therapy was also associated with reductions in symptomatic intracerebral haemorrhage (SICH). However, the limited eligible studies and methodological limitations compromised definitive conclusions on the extent of and level of efficacy of evidence-based acute stroke care interventions across Africa. Conclusion Evidence from this review confirms the widespread assertion of low applicability and uptake of evidence-based acute stroke care in LMICs. Despite the limited eligible studies, the overall positive patient outcomes following such interventions demonstrate the applicability and value of evidence-based acute stroke care interventions in Africa. Health policy attention is thus required to ensure widespread applicability of such interventions for improved patients’ outcomes. The review findings also emphasises the need for further research to unravel the reasons for low uptake. Systematic review registration PROSPERO CRD4201605156

    Design, construction and operation of the ProtoDUNE-SP Liquid Argon TPC

    Get PDF
    The ProtoDUNE-SP detector is a single-phase liquid argon time projection chamber (LArTPC) that was constructed and operated in the CERN North Area at the end of the H4 beamline. This detector is a prototype for the first far detector module of the Deep Underground Neutrino Experiment (DUNE), which will be constructed at the Sandford Underground Research Facility (SURF) in Lead, South Dakota, U.S.A. The ProtoDUNE-SP detector incorporates full-size components as designed for DUNE and has an active volume of 7 × 6 × 7.2 m3. The H4 beam delivers incident particles with well-measured momenta and high-purity particle identification. ProtoDUNE-SP's successful operation between 2018 and 2020 demonstrates the effectiveness of the single-phase far detector design. This paper describes the design, construction, assembly and operation of the detector components

    Searching for solar KDAR with DUNE

    Get PDF

    Low exposure long-baseline neutrino oscillation sensitivity of the DUNE experiment

    Get PDF
    The Deep Underground Neutrino Experiment (DUNE) will produce world-leading neutrino oscillation measurements over the lifetime of the experiment. In this work, we explore DUNE's sensitivity to observe charge-parity violation (CPV) in the neutrino sector, and to resolve the mass ordering, for exposures of up to 100 kiloton-megawatt-years (kt-MW-yr). The analysis includes detailed uncertainties on the flux prediction, the neutrino interaction model, and detector effects. We demonstrate that DUNE will be able to unambiguously resolve the neutrino mass ordering at a 3σ (5σ) level, with a 66 (100) kt-MW-yr far detector exposure, and has the ability to make strong statements at significantly shorter exposures depending on the true value of other oscillation parameters. We also show that DUNE has the potential to make a robust measurement of CPV at a 3σ level with a 100 kt-MW-yr exposure for the maximally CP-violating values \delta_{\rm CP}} = \pm\pi/2. Additionally, the dependence of DUNE's sensitivity on the exposure taken in neutrino-enhanced and antineutrino-enhanced running is discussed. An equal fraction of exposure taken in each beam mode is found to be close to optimal when considered over the entire space of interest
    • 

    corecore