821 research outputs found
Fluid Particle Accelerations in Fully Developed Turbulence
The motion of fluid particles as they are pushed along erratic trajectories
by fluctuating pressure gradients is fundamental to transport and mixing in
turbulence. It is essential in cloud formation and atmospheric transport,
processes in stirred chemical reactors and combustion systems, and in the
industrial production of nanoparticles. The perspective of particle
trajectories has been used successfully to describe mixing and transport in
turbulence, but issues of fundamental importance remain unresolved. One such
issue is the Heisenberg-Yaglom prediction of fluid particle accelerations,
based on the 1941 scaling theory of Kolmogorov (K41). Here we report
acceleration measurements using a detector adapted from high-energy physics to
track particles in a laboratory water flow at Reynolds numbers up to 63,000. We
find that universal K41 scaling of the acceleration variance is attained at
high Reynolds numbers. Our data show strong intermittency---particles are
observed with accelerations of up to 1,500 times the acceleration of gravity
(40 times the root mean square value). Finally, we find that accelerations
manifest the anisotropy of the large scale flow at all Reynolds numbers
studied.Comment: 7 pages, 4 figure
Impact of adverse events, treatment modifications, and dose intensity on survival among patients with advanced renal cell carcinoma treated with first‐line sunitinib: a medical chart review across ten centers in five European countries
Angiogenesis inhibitors have become standard of care for advanced and/or metastatic renal cell carcinoma (RCC), but data on the impact of adverse events (AEs) and treatment modifications associated with these agents are limited. Medical records were abstracted at 10 tertiary oncology centers in Europe for 291 patients ≥18 years old treated with sunitinib as first-line treatment for advanced RCC (no prior systemic treatment for advanced disease). Logistic regression models were estimated to compare dose intensity among patients who did and did not experience AEs during the landmark periods (18, 24, and 30 weeks). Cox proportional hazard models were used to explore the possible relationship of low-dose intensity (defined using thresholds of 0.7, 0.8, and 0.9) and treatment modifications during the landmark periods to survival. 64.4% to 67.9% of patients treated with sunitinib reported at least one AE of any grade, and approximately 10% of patients experienced at least one severe (grade 3 or 4) AE. Patients reporting severe AEs were statistically significantly more likely to have dose intensities below either 0.8 or 0.9. Dose intensity below 0.7 and dose discontinuation during all landmark periods were statistically significantly associated with shorter survival time. This study of advanced RCC patients treated with sunitinib in Europe found a significant relationship between AEs and dose intensity. It also found correlations between dose intensity and shorter survival, and between dose discontinuation and shorter survival. These results confirm the importance of tolerable treatment and maintaining dose intensity
Basal Ganglia Pathways Associated With Therapeutic Pallidal Deep Brain Stimulation for Tourette Syndrome
BACKGROUND: Deep brain stimulation (DBS) targeting the globus pallidus internus (GPi) can improve tics and
comorbid obsessive-compulsive behavior (OCB) in patients with treatment-refractory Tourette syndrome (TS).
However, some patients’ symptoms remain unresponsive, the stimulation applied across patients is variable, and
the mechanisms underlying improvement are unclear. Identifying the fiber pathways surrounding the GPi that are
associated with improvement could provide mechanistic insight and refine targeting strategies to improve outcomes.
METHODS: Retrospective data were collected for 35 patients who underwent bilateral GPi DBS for TS. Computational models of fiber tract activation were constructed using patient-specific lead locations and stimulation settings
to evaluate the effects of DBS on basal ganglia pathways and the internal capsule. We first evaluated the relationship
between activation of individual pathways and symptom improvement. Next, linear mixed-effects models with
combinations of pathways and clinical variables were compared in order to identify the best-fit predictive models
of tic and OCB improvement.
RESULTS: The best-fit model of tic improvement included baseline severity and the associative pallido-subthalamic
pathway. The best-fit model of OCB improvement included baseline severity and the sensorimotor pallidosubthalamic pathway, with substantial evidence also supporting the involvement of the prefrontal, motor, and
premotor internal capsule pathways. The best-fit models of tic and OCB improvement predicted outcomes across
the cohort and in cross-validation.
CONCLUSIONS: Differences in fiber pathway activation likely contribute to variable outcomes of DBS for TS.
Computational models of pathway activation could be used to develop novel approaches for preoperative targeting
and selecting stimulation parameters to improve patient outcomes
Methodological Deficits in Diagnostic Research Using ‘-Omics’ Technologies: Evaluation of the QUADOMICS Tool and Quality of Recently Published Studies
Background: QUADOMICS is an adaptation of QUADAS (a quality assessment tool for use in systematic reviews of diagnostic accuracy studies), which takes into account the particular challenges presented by '-omics' based technologies. Our primary objective was to evaluate the applicability and consistency of QUADOMICS. Subsequently we evaluated and describe the methodological quality of a sample of recently published studies using the tool. Methodology/Principal Findings: 45'-omics'- based diagnostic studies were identified by systematic search of Pubmed using suitable MeSH terms (>Genomics>, >Sensitivity and specificity>, >Diagnosis>). Three investigators independently assessed the quality of the articles using QUADOMICS and met to compare observations and generate a consensus. Consistency and applicability was assessed by comparing each reviewer's original rating with the consensus. Methodological quality was described using the consensus rating. Agreement was above 80% for all three reviewers. Four items presented difficulties with application, mostly due to the lack of a clearly defined gold standard. Methodological quality of our sample was poor; studies met roughly half of the applied criteria (mean ± sd, 54.7±18.4°%). Few studies were carried out in a population that mirrored the clinical situation in which the test would be used in practice, (6, 13.3%);none described patient recruitment sufficiently; and less than half described clinical and physiological factors that might influence the biomarker profile (20, 44.4%). Conclusions: The QUADOMICS tool can consistently be applied to diagnostic '-omics' studies presently published in biomedical journals. A substantial proportion of reports in this research field fail to address design issues that are fundamental to make inferences relevant for patient care. © 2010 Parker et al.This work was supported by the Spanish Agency for Health Technology Assessment, Exp PI06/90311, Instituto de Salud Carlos III and CIBER en Epidemiología y Salud Pública (CIBERESP) in SpainPeer Reviewe
Plant virus particles carrying tumour antigen activate TLR7 and induce high levels of protective antibody
Induction of potent antibody is the goal of many vaccines targeted against infections or cancer. Modern vaccine designs that use virus-like particles (VLP) have shown efficacy for prophylactic vaccination against virus-associated cancer in the clinic. Here we used plant viral particles (PVP), which are structurally analogous to VLP, coupled to a weak idiotypic (Id) tumour antigen, as a conjugate vaccine to induce antibody against a murine B-cell malignancy. The Id-PVP vaccine incorporates a natural adjuvant, the viral ssRNA, which acts via TLR7. It induced potent protective anti-Id antibody responses in an in vivo mouse model, superior to the "gold standard" Id vaccine, with prevalence of the IgG2a isotype. Combination with alum further increased antibody levels and maintained the IgG2a bias. Engagement of TLR7 in vivo was followed by secretion of IFN-? by plasmacytoid dendritic cells and by activation of splenic CD11chi conventional dendritic cells. The latter was apparent from up-regulation of co-stimulatory molecules and from secretion of a wide range of inflammatory cytokines and chemokines including the Th1-governing cytokine IL-12, in keeping with the IgG2a antibody isotype distribution. PVP conjugates are a novel cancer vaccine design, offering an attractive molecular form, similar to VLP, and providing T-cell help. In contrast to VLP, they also incorporate a safe "in-built" ssRNA adjuvant
Impacts of climate change on plant diseases – opinions and trends
There has been a remarkable scientific output on the topic of how climate change is likely to affect plant diseases in the coming decades. This review addresses the need for review of this burgeoning literature by summarizing opinions of previous reviews and trends in recent studies on the impacts of climate change on plant health. Sudden Oak Death is used as an introductory case study: Californian forests could become even more susceptible to this emerging plant disease, if spring precipitations will be accompanied by warmer temperatures, although climate shifts may also affect the current synchronicity between host cambium activity and pathogen colonization rate. A summary of observed and predicted climate changes, as well as of direct effects of climate change on pathosystems, is provided. Prediction and management of climate change effects on plant health are complicated by indirect effects and the interactions with global change drivers. Uncertainty in models of plant disease development under climate change calls for a diversity of management strategies, from more participatory approaches to interdisciplinary science. Involvement of stakeholders and scientists from outside plant pathology shows the importance of trade-offs, for example in the land-sharing vs. sparing debate. Further research is needed on climate change and plant health in mountain, boreal, Mediterranean and tropical regions, with multiple climate change factors and scenarios (including our responses to it, e.g. the assisted migration of plants), in relation to endophytes, viruses and mycorrhiza, using long-term and large-scale datasets and considering various plant disease control methods
A descriptive analysis of medical health services utilization of Veterans living in Ontario: a retrospective cohort study using administrative healthcare data
The radicalization of democracy: conflict, social movements and terrorism
The idea of democracy is being championed across the world, with some fifty new countries embracing this type of political system between 1974 and 2011 (Freedom House, 2016). Simultaneously, however, dissatisfaction has grown due to the perceived incapacity of democracy to deal with collective problems, hence the necessity to reconfigure it and redraw some of its principles. This paper links the analysis of the recent evolution of democratic systems with the trajectory of socio-political conflicts and the changing features of contemporary terrorism. It examines, therefore, two intertwined phenomena, namely the radicalization of democracy and the radicalization of the other. It concludes by stressing that encouraging dissent and heeding contentious claims made by social movements may be one way of mitigating both types of radicalization. Embedded in the tradition of critical criminology, this paper attempts to demonstrate that only by outflanking conventional categories of analysis can the criminological community aspire to grasp such thorny contemporary phenomena
Systematic review of factors influencing patient and practitioner delay in diagnosis of upper gastrointestinal cancer
As knowledge on the causation of cancers advances and new treatments are developed, early recognition and accurate diagnosis becomes increasingly important. This review focused on identifying factors influencing patient and primary care practitioner delay for upper gastrointestinal cancer. A systematic methodology was applied, including extensive searches of the literature published from 1970 to 2003, systematic data extraction, quality assessment and narrative data synthesis. Included studies were those evaluating factors associated with the time interval between a patient first noticing a cancer symptom and presenting to primary care, between a patient first presenting to primary care and being referred to secondary care, or describing an intervention designed to reduce those intervals. Twenty-five studies were included in the review. Studies reporting delay intervals demonstrated that the patient phase of delay was greater than the practitioner phase, whilst patient-related research suggests that recognition of symptom seriousness is more important than recognition of the presence of the symptom. The main factors related to practitioner delay were misdiagnosis, application and interpretation of tests, and the confounding effect of existing disease. Greater understanding of patient factors is required, along with evaluation of interventions to ensure appropriate diagnosis, examination and investigation
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