To evaluate the attitudes, knowledge, and practices of US medical oncologists that are related to management of cancer pain.
An anonymous survey was mailed to a geographically representative sample ...of medical oncologists randomly selected from the American Medical Association's Physician Master File.
From a total of 2,000 oncologists, 354 responded to the original questionnaire and 256 responded to one of two subsequent shortened versions (overall response rate, 32%). Responders were demographically similar to all US medical oncologists. Using numeric rating scales of 0 to 10, oncologists rated their specialty highly for the ability to manage cancer pain (median, 7; interquartile range IQR, 6 to 8) but rated their peers as more conservative prescribers than themselves (median, 3; IQR, 2 to 5). The quality of pain management training during medical school and residency was rated as 3 (IQR, 1 to 5) and 5 (IQR, 3 to 7), respectively. The most important barriers to pain management were poor assessment (median, 6; IQR, 4 to 7) and patient reluctance to take opioids (median, 6; IQR, 5 to 7) or report pain (median, 6; IQR, 4 to 7). Other barriers included physician reluctance to prescribe opioids (median, 5; IQR, 3 to 7) and perceived excessive regulation (median, 4; IQR, 2 to 7). In response to two vignettes describing challenging clinical scenarios, 60% and 87%, respectively, endorsed treatment decisions that would be considered unacceptable by pain specialists. Frequent referrals to pain or palliative care specialists were reported by only 14% and 16%, respectively.
These data suggest that, for more than 20 years, a focus on cancer pain has not adequately addressed the perception of treatment barriers or limitations in pain-related knowledge and practice within the oncology community. Additional efforts are needed to achieve meaningful progress.
As quantum coherence times of superconducting circuits have increased from nanoseconds to hundreds of microseconds, they are currently one of the leading platforms for quantum information processing. ...However, coherence needs to further improve by orders of magnitude to reduce the prohibitive hardware overhead of current error correction schemes. Reaching this goal hinges on reducing the density of broken Cooper pairs, so-called quasiparticles. Here, we show that environmental radioactivity is a significant source of nonequilibrium quasiparticles. Moreover, ionizing radiation introduces time-correlated quasiparticle bursts in resonators on the same chip, further complicating quantum error correction. Operating in a deep-underground lead-shielded cryostat decreases the quasiparticle burst rate by a factor thirty and reduces dissipation up to a factor four, showcasing the importance of radiation abatement in future solid-state quantum hardware.
The next generation of bolometric experiments searching for rave events, in particular for the neutrino-less double beta decay, needs fast, high-sensitivity and easy-to-scale cryogenic light ...detectors. The CALDER project (2014–2020) developed a new technology for light detection at cryogenic temperature. In this paper we describe the achievements and the final prototype of this project, consisting of a
5
×
5
cm
2
,
650
μ
m
thick silicon substrate coupled to a single kinetic inductance detector made of a three-layer aluminum-titanium-aluminum. The baseline energy resolution is
34
±
1
(stat)
±
2
(syst) eV RMS and the response time is
120
μ
s. These features, along with the natural multiplexing capability of kinetic inductance detectors, meet the requirements of future large-scale experiments.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
L-carnitine, a popular complementary and alternative medicine product, is used by patients with cancer for the treatment of fatigue, the most commonly reported symptom in this patient population. The ...purpose of this study was to determine the efficacy of L-carnitine supplementation as a treatment for fatigue in patients with cancer.
In this double-blind, placebo-controlled trial, patients with invasive malignancies and fatigue were randomly assigned to either 2 g/d of L-carnitine oral supplementation or matching placebo. The primary end point was the change in average daily fatigue from baseline to week 4 using the Brief Fatigue Inventory (BFI).
Three hundred seventy-six patients were randomly assigned to treatment with L-carnitine supplementation or placebo. L-carnitine supplementation resulted in significant carnitine plasma level increase by week 4. The primary outcome, fatigue, measured using the BFI, improved in both arms compared with baseline (L-carnitine: -0.96, 95% CI, -1.32 to -0.60; placebo: -1.11, 95% CI -1.44 to -0.78). There were no statistically significant differences between arms (P = .57). Secondary outcomes, including fatigue measured by the Functional Assessment of Chronic Illness Therapy-Fatigue instrument, depression, and pain, did not show significant difference between arms. A separate analysis of patients who were carnitine-deficient at baseline did not show statistically significant improvement in fatigue or other outcomes after L-carnitine supplementation.
Four weeks of 2 g of L-carnitine supplementation did not improve fatigue in patients with invasive malignancies and good performance status.
We present the first continuous operation in a surface lab of BULLKID, a detector for searches of light Dark Matter and precision measurements of the coherent and elastic neutrino-nucleus scattering. ...The detector consists of an array of 60 cubic silicon particle absorbers of 0.34 g each, sensed by cryogenic kinetic inductance detectors. The data presented focusses on one of the central elements of the array and on its surrounding elements used as veto. The energy spectrum resulting from an exposure of 39 h to ambient backgrounds, obtained without radiation shields, is flat at the level of
(
2.0
±
0.1
stat
.
±
0.2
syst
.
)
×
10
6
counts/keV kg days down to the energy threshold of
160
±
13
eV. The data analysis demonstrates the unique capability of rejecting backgrounds generated from interactions in other sites of the array, stemming from the segmented and monolithic structure of the detector.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Radioactivity was recently discovered as a source of decoherence and correlated errors for the real-world implementation of superconducting quantum processors. In this work, we measure levels of ...radioactivity present in a typical laboratory environment (from muons, neutrons, and
γ
-rays emitted by naturally occurring radioactive isotopes) and in the most commonly used materials for the assembly and operation of state-of-the-art superconducting qubits. We present a GEANT-4 based simulation to predict the rate of impacts and the amount of energy released in a qubit chip from each of the mentioned sources. We finally propose mitigation strategies for the operation of next-generation qubits in a radio-pure environment.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We have observed the Andromeda galaxy, Messier 31 (M31), at 6.7 GHz with the Sardinia Radio Telescope. We mapped the radio emission in the C-band, re-analyzed WMAP and Planck maps, as well as other ...ancillary data, and we have derived an overall integrated flux density spectrum from the radio to the infrared. This allowed us to estimate the emission budget from M31. Integrating over the whole galaxy, we found strong and highly significant evidence for anomalous microwave emission (AME), at the level of Jy at the peaking frequency of 25 GHz. Decomposing the spectrum into known emission mechanisms such as free-free, synchrotron, thermal dust, and AME arising from electric dipole emission from rapidly rotating dust grains, we found that the overall emission from M31 is dominated, at frequencies below 10 GHz, by synchrotron emission with a spectral index of , with subdominant free-free emission. At frequencies 10 GHz, AME has a similar intensity to that of synchrotron and free-free emission, overtaking them between 20 and 50 GHz, whereas thermal dust emission dominates the emission budget at frequencies above 60 GHz, as expected.
The Neel IRAM KIDs Array (NIKA) is a fully integrated measurement system based on kinetic inductance detectors (KIDs) currently being developed for millimeter wave astronomy. The instrument includes ...dual-band optics allowing simultaneous imaging at 150 GHz and 220 GHz. The imaging sensors consist of two spatially separated arrays of KIDs. The first array, mounted on the 150 GHz branch, is composed of 144 lumped-element KIDs. The second array (220 GHz) consists of 256 antenna-coupled KIDs. Each of the arrays is sensitive to a single polarization; the band splitting is achieved by using a grid polarizer. The optics and sensors are mounted in a custom dilution cryostat, with an operating temperature of ~70 mK. Electronic readout is realized using frequency multiplexing and a transmission line geometry consisting of a coaxial cable connected in series with the sensor array and a low-noise 4 K amplifier. The dual-band NIKA was successfully tested in 2010 October at the Institute for Millimetric Radio Astronomy (IRAM) 30 m telescope at Pico Veleta, Spain, performing in-line with laboratory predictions. An optical NEP was then calculated to be around 2 X 10--16 W Hz--1/2 (at 1 Hz) while under a background loading of approximately 4 pW pixel--1. This improvement in comparison with a preliminary run (2009) verifies that NIKA is approaching the target sensitivity for photon-noise limited ground-based detectors. Taking advantage of the larger arrays and increased sensitivity, a number of scientifically relevant faint and extended objects were then imaged including the Galactic Center SgrB2 (FIR1), the radio galaxy Cygnus A, and the NGC1068 Seyfert galaxy. These targets were all observed simultaneously in the 150 GHz and 220 GHz atmospheric windows.
The transcranial evoked potential (TEP) is a powerful technique to investigate brain dynamics, but some methodological issues limit its interpretation. A possible contamination of the TEP by ...electroencephalographic (EEG) responses evoked by the somatosensory input generated by transcranial magnetic stimulation (TMS) has been postulated; nonetheless, a characterization of these responses is lacking. The aim of this work was to review current evidence about possible somatosensory evoked potentials (SEP) induced by sources of somatosensory input in the craniofacial region. Among these, only contraction of craniofacial muscle and stimulation of free cutaneous nerve endings may be able to induce EEG responses, but direct evidence is lacking due to experimental difficulties in isolating these inputs. Notably, EEG evoked activity in this context is represented by a N100/P200 complex, reflecting a saliency-related multimodal response, rather than specific activation of the primary somatosensory cortex. Strategies to minimize or remove these responses by EEG processing still yield uncertain results; therefore, data inspection is of paramount importance to judge a possible contamination of the TEP by multimodal potentials caused by somatosensory input.
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•Possible contamination of TEPs by SEPs have been suggested.•SEPs by craniofacial stimulation have not been thoroughly investigated.•We reviewed the evidence and physiology of possible SEPs following this stimulation.•Only activation of craniofacial muscle and free skin nerve endings may induce SEP.•If present, these potentials are represented by vertex multimodal responses.
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