74,938 research outputs found
One-step nucleic acid amplification: the possible value in assessing sentinel lymph node metastasis during mastectomy
No full textAlison E Hunter-Smith, Zenon Rayter Breast Surgery Unit, Bristol Breast Care Centre, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, UK Abstract: Breast cancer is the most common cancer in women, worldwide, and 1,400 deaths per day are attributed to it. The success of national screening programs has seen breast cancers being diagnosed at an earlier stage. With conservative surgery to the breast demonstrating equivalent long-term outcomes, the last 10 years have seen a growing interest in the safety of less invasive management for the axilla in breast cancer patients. One-step nucleic acid amplification (OSNA) is a validated, reliable, and efficient tool in identifying micro- and macro-metastases intraoperatively. It is the most widely used intraoperative analysis tool within the United Kingdom, and is employed by over 320 units across Europe and Asia. Recent evidence from the AMAROS, IBCSG 23-01, and ACOSOG Z0011 trials has changed surgical practice in managing the axilla of patients with breast cancer. We propose a clinical algorithm demonstrating the role of OSNA as an intraoperative analysis tool in today’s management of breast cancer as well as prospects for the future use of OSNA. Keywords: breast cancer, sentinel lymph node, intraoperative assessment, one-stop nucleic acid amplification, mastectom
The Benefits of Being Economics Professor A (and not Z)
No full textAlphabetic name ordering on multi-authored academic papers, which is the convention in the economics discipline and various other disciplines, is to the advantage of people whose last name initials are placed early in the alphabet. As it turns out, Professor A, who has been a first author more often than Professor Z, will have published more articles and experienced afaster growth rate over the course of her career as a result of reputation and visibility. Moreover, authors know that name ordering matters and indeed take ordering seriously: Several characteristics of an author group composition determine the decision to deviate from the default alphabetic name order to a significant extent.performance measurement, incentives, economists, name ordering
A multicentre prospective longitudinal study establishing level II evidence of health related quality of life after types of immediate latissimus dorsi (LD) breast reconstruction
No full textFinal word on Jersey Dutch
No full textIn this article, William Z. Shetter compares and contrasts the dialects that developed between different Dutch colonies in the New World. He explores in-depth the nuances of Jersey Dutch, and provides theories to explain how Dutch and colonial languages blended. The article is reprinted from American Speech, December 1958, Volum XXXIII, No. 4
Logarithmic variance profiles and the corresponding f-1 spectra of temperature fluctuations in turbulent Rayleigh-Bénard convection
No full textWe report experimental results for the temperature variance 2(z) and the corresponding frequency spectra P(f) in turbulent Rayleigh-Bénard convection (RBC) in a cylindrical sample of aspect ratioT= D/L = 1:00 (D = 1:12 m is the diameter and L = 1:12 m the height). The measurements were conducted in the Rayleigh-number range 1011 < Ra < 1:35 1014 and Pr ' 0:8. For Ra = 1:35x1014, 2(z) could be described well by a logarithmic dependence on the vertical position z in a range of z 1 < z < z 2 with z 1 ' 70 and z 2 = 0:1L. Here L=(2Nu) is the thickness of a thin thermal sublayer adjacent to the horizontal plate where the heat flux (denoted by the Nusselt number Nu) is carried mostly by thermal diffusion. In the log layer, we found that the temperature spectra had a significant frequency range over which P(f) f with close to 1. As Ra decreased, increased so that the log layer became thinner. At Ra = 2:05 1011, z 2 < z 1 and therefore there was no range for a log layer. Correspondingly, the temperature spectrum near the horizontal plate did not have the f1 scaling form either
A multi centre prospective longitudinal study evaluating health related quality of life after immediate Latissimus dorsi (LD) breast reconstruction
No full textIntroduction: NICE recommends that the majority of women should be offered immediate breast reconstruction with its potential to improve health related quality of life (HRQL). There is conflicting evidence with a lack of ‘hard’data to best inform clinicians and their patients. Our aim was to evaluate the effects of implant-assisted LD (LDI) versus autologous LD (ALD) breast reconstruction on HRQL over 12 months. Methods: A prospective longitudinal multicentre study commenced in early 2007. Patient reported outcome measures using the EORTC C30 (general HRQL), BR-23 (breast + arm symptoms), Body Image Scale (BIS) and HADS, were completed pre-operatively and at 3, and 12 months after surgery. Longitudinal analyses tested the effects of treatment variables, baseline HRQL, age and time on QL domains (3–12 months). Significance was set at p = 0.01. Results: One hundred and seventy one patients (93 ALD, 78 LDI) were recruited. There were no significant differences in HRQL domains between LDI and ALD (±RT). Chemotherapy patients reported poorer overall HRQL (p < 0.001), poorer role (p = 0.003) and social (p = 0.01) functioning, and greater fatigue (p = 0.002) and depression (p = 0.01). Older patients had fewer HRQL issues (p = 0.01). Significant improvements over time were seen for overall HRQL and other domains (p < 0.001). There were no significant differences between LDI and ALD for patient satisfaction with surgical outcome. Good satisfaction with overall breast appearance and surgical outcome was significantly associated with fewer body image concerns. Conclusion: There is an important need for cumulative clinical evidence in this field on which to base patient informed consent and clinical recommendations
Statistics of the subgrid scales after the shock-turbulence interaction
No full textThe interaction of a normal shock with isotropic turbulence (IT) represents a basic problem for studying some of the phenomena associated with high speed flows, such as hypersonic flight, supersonic combustion and Inertial Confinement Fusion (ICF). In general, in practical applications, the shock width is much smaller than the turbulence scales and the upstream turbulent Mach number is modest. In this case, recent high resolution shock-resolved Direct Numerical Simulations (DNS) (Ryu and Livescu, J. Fluid Mech., 756, R1, 2014) show that the interaction can be described by the Linear Interaction Approximation (LIA). By using LIA to alleviate the need to solve the shock, DNS post-shock data can be generated at much higher Reynolds numbers than previously possible. Here, such results with Taylor Reynolds number around are used to investigate the properties of the subgrid scales (SGS). In particular, it is shown that the shock interaction decreases the asymmetry of the SGS dissipation PDF as the shock Mach number increases, with a significant enhancement in size of the regions and magnitude of backscatter
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