Large multicenter studies comparing outcomes between TURP and photoselective vaporization of the prostate (PVP) are sparse, with no studies having compared the influence of trainee involvement on ...these outcomes. Our objectives were to assess 30-day outcomes after TURP and PVP with respect to trainee involvement using an independent national surgical database.
Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data (2005-2011), 7893 men were identified who underwent TURP or PVP. Regression models were constructed to assess associations between surgical approach, risk-adjusted morbidity and individual complications. Relationships between operative approach, operative duration and duration of stay were also examined and subdivided based upon trainee level.
Of 7893 patients, 4950 (62.7%) underwent TURP and 2943 (37.3%) underwent PVP. TURP patients were older, more likely to have diabetes, cancer, history of steroid use and preoperative transfusion compared with PVP patients, who were more likely to have coronary artery disease or bleeding disorders. Risk-adjusted overall morbidity was similar; however, PVP was associated with less pneumonia (0.2% vs 0.5%, P<0.015), bleeding requiring transfusion (0.5% vs 1.8%, P<0.001) and return to the operating room (1.5% vs 2.2%, P<0.022). PVP patients also had shorter length of stay (0.8 vs 2.1 days, P<0.001). There were no significant differences in outcomes when a trainee was involved. Operative duration was similar for TURP and PVP when performed by an attending alone (52 vs 52 min, P<0.001), but was longer with trainee involvement, regardless of post-graduate year (PGY) level (P<0.001). Comparison of operative duration among trainee subgroups demonstrated longer operative times for the PGY 6-9 subgroup performing PVP when compared with other subgroups (P<0.003).
Within ACS NSQIP hospitals, TURP and PVP demonstrated similar risk-adjusted overall morbidity. Despite longer operative times for TURP and PVP with trainee involvement, there were no significant differences in outcomes.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
We report the observation of a gravitational-wave signal produced by the coalescence of two stellar-mass black holes. The signal, GW151226, was observed by the twin detectors of the Laser ...Interferometer Gravitational-Wave Observatory (LIGO) on December 26, 2015 at 03:38:53 UTC. The signal was initially identified within 70 s by an online matched-filter search targeting binary coalescences. Subsequent off-line analyses recovered GW151226 with a network signal-to-noise ratio of 13 and a significance greater than 5(sigma). The signal persisted in the LIGO frequency band for approximately 1 s, increasing in frequency and amplitude over about 55 cycles from 35 to 450 Hz, and reached a peak gravitational strain of 3.4(+0.7/-0.9) x 10(exp -22). The inferred source-frame initial black hole masses are 14.2(+8.3/-3.7 Stellar Mass and 7.5(+2.3/-2.3) Stellar Mass, and the final black hole mass is 20.8(+6.1/-1.7) Stellar Mass. We find that at least one of the component black holes has spin greater than 0.2. This source is located at a luminosity distance of 440(+180/-190) Mpc corresponding to a redshift of 0.090(+.030/-0.04). All uncertainties define a 90% credible interval. This second gravitational-wave observation provides improved constraints on stellar populations and on deviations from general relativity.
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Tests of General Relativity with GW150914 Aguiar, O D; Arceneaux, C C; Arnaud, N ...
Physical review letters,
2016-Jun-03, Volume:
116, Issue:
22
Journal Article, Web Resource
Peer reviewed
Open access
The LIGO detection of GW150914 provides an unprecedented opportunity to study the two-body motion of a compact-object binary in the large-velocity, highly nonlinear regime, and to witness the final ...merger of the binary and the excitation of uniquely relativistic modes of the gravitational field. We carry out several investigations to determine whether GW150914 is consistent with a binary black-hole merger in general relativity. We find that the final remnant's mass and spin, as determined from the low-frequency (inspiral) and high-frequency (postinspiral) phases of the signal, are mutually consistent with the binary black-hole solution in general relativity. Furthermore, the data following the peak of GW150914 are consistent with the least-damped quasinormal mode inferred from the mass and spin of the remnant black hole. By using waveform models that allow for parametrized general-relativity violations during the inspiral and merger phases, we perform quantitative tests on the gravitational-wave phase in the dynamical regime and we determine the first empirical bounds on several high-order post-Newtonian coefficients. We constrain the graviton Compton wavelength, assuming that gravitons are dispersed in vacuum in the same way as particles with mass, obtaining a 90%-confidence lower bound of 10^{13} km. In conclusion, within our statistical uncertainties, we find no evidence for violations of general relativity in the genuinely strong-field regime of gravity.
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Advanced LIGO Abbott, R; Addesso, P; Aggarwal, N ...
Classical and quantum gravity,
04/2015, Volume:
32, Issue:
7
Journal Article, Web Resource
Peer reviewed
Open access
The Advanced LIGO gravitational wave detectors are second-generation instruments designed and built for the two LIGO observatories in Hanford, WA and Livingston, LA, USA. The two instruments are ...identical in design, and are specialized versions of a Michelson interferometer with 4 km long arms. As in Initial LIGO, Fabry-Perot cavities are used in the arms to increase the interaction time with a gravitational wave, and power recycling is used to increase the effective laser power. Signal recycling has been added in Advanced LIGO to improve the frequency response. In the most sensitive frequency region around 100 Hz, the design strain sensitivity is a factor of 10 better than Initial LIGO. In addition, the low frequency end of the sensitivity band is moved from 40 Hz down to 10 Hz. All interferometer components have been replaced with improved technologies to achieve this sensitivity gain. Much better seismic isolation and test mass suspensions are responsible for the gains at lower frequencies. Higher laser power, larger test masses and improved mirror coatings lead to the improved sensitivity at mid and high frequencies. Data collecting runs with these new instruments are planned to begin in mid-2015.
On September 14, 2015 at 09:50:45 UTC the two detectors of the Laser Interferometer Gravitational-wave Observatory (LIGO) simultaneously observed the binary black hole merger GW150914. We report the ...results of a matched-filter search using relativistic models of compact-object binaries that recovered GW150914 as the most significant event during the coincident observations between the two LIGO detectors from September 12 to October 20, 2015. GW150914 was observed with a matched filter signal-to-noise ratio of 24 and a false alarm rate estimated to be less than 1 event per 203000 years, equivalent to a significance greater than 5.1
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The first observational run of the Advanced LIGO detectors, from September 12, 2015 to January 19, 2016, saw the first detections of gravitational waves from binary black hole mergers. In this paper ...we present full results from a search for binary black hole merger signals with total masses up to 100M solar mass and detailed implications from our observations of these systems. Our search, based on general-relativistic models of gravitational wave signals from binary black hole systems, unambiguously identified two signals, GW150914 and GW151226, with a significance of greater than 5 alpha over the observing period. It also identified a third possible signal, LVT151012, with substantially lower significance, which has a 87 probability of being of astrophysical origin. We provide detailed estimates of the parameters of the observed systems. Both GW150914 and GW151226 provide an unprecedented opportunity to study the two-body motion of a compact-object binary in the large velocity, highly nonlinear regime. We do not observe any deviations from general relativity, and place improved empirical bounds on several high-order post-Newtonian coefficients. From our observations we infer stellar-mass binary black hole merger rates lying in the range 9-240 Gpc-3 yr-1. These observations are beginning to inform astrophysical predictions of binary black hole formation rates, and indicate that future observing runs of the Advanced detector network will yield many more gravitational wave detections.
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A wide variety of astrophysical and cosmological sources are expected to contribute to a stochastic gravitational-wave background. Following the observations of GW150914 and GW151226, the rate and ...mass of coalescing binary black holes appear to be greater than many previous expectations. As a result, the stochastic background from unresolved compact binary coalescences is expected to be particularly loud. We perform a search for the isotropic stochastic gravitational-wave background using data from Advanced Laser Interferometer Gravitational Wave Observatory's (aLIGO) first observing run. The data display no evidence of a stochastic gravitational-wave signal. We constrain the dimensionless energy density of gravitational waves to be Ω_{0}<1.7×10^{-7} with 95% confidence, assuming a flat energy density spectrum in the most sensitive part of the LIGO band (20-86 Hz). This is a factor of ∼33 times more sensitive than previous measurements. We also constrain arbitrary power-law spectra. Finally, we investigate the implications of this search for the background of binary black holes using an astrophysical model for the background.
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The detection of gravitational waves from compact binary mergers by LIGO has opened the era of gravitational wave astronomy, revealing a previously hidden side of the cosmos. To maximize the reach of ...the existing LIGO observatory facilities, we have designed a new instrument able to detect gravitational waves at distances 5 times further away than possible with Advanced LIGO, or at greater than 100 times the event rate. Observations with this new instrument will make possible dramatic steps toward understanding the physics of the nearby Universe, as well as observing the Universe out to cosmological distances by the detection of binary black hole coalescences. This article presents the instrument design and a quantitative analysis of the anticipated noise floor.
On 14 September 2015, a gravitational wave signal from a coalescing black hole binary system was observed by the Advanced LIGO detectors. This paper describes the transient noise backgrounds used to ...determine the significance of the event (designated GW150914) and presents the results of investigations into potential correlated or uncorrelated sources of transient noise in the detectors around the time of the event. The detectors were operating nominally at the time of GW150914. We have ruled out environmental influences and non-Gaussian instrument noise at either LIGO detector as the cause of the observed gravitational wave signal.
ABSTRACT A transient gravitational-wave signal, GW150914, was identified in the twin Advanced LIGO detectors on 2015 September 2015 at 09:50:45 UTC. To assess the implications of this discovery, the ...detectors remained in operation with unchanged configurations over a period of 39 days around the time of the signal. At the detection statistic threshold corresponding to that observed for GW150914, our search of the 16 days of simultaneous two-detector observational data is estimated to have a false-alarm rate (FAR) of , yielding a p-value for GW150914 of . Parameter estimation follow-up on this trigger identifies its source as a binary black hole (BBH) merger with component masses at redshift (median and 90% credible range). Here, we report on the constraints these observations place on the rate of BBH coalescences. Considering only GW150914, assuming that all BBHs in the universe have the same masses and spins as this event, imposing a search FAR threshold of 1 per 100 years, and assuming that the BBH merger rate is constant in the comoving frame, we infer a 90% credible range of merger rates between (comoving frame). Incorporating all search triggers that pass a much lower threshold while accounting for the uncertainty in the astrophysical origin of each trigger, we estimate a higher rate, ranging from depending on assumptions about the BBH mass distribution. All together, our various rate estimates fall in the conservative range .
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