Social delphinids employ a vocal repertoire of clicks for echolocation and whistles for communication. Conversely, the less social and acoustically cryptic harbour porpoises (Phocoena phocoena) only ...produce narrow-band high-frequency (NBHF) clicks with properties that appear poorly suited for communication. Nevertheless, these small odontocetes likely mediate social interactions, such as mate choice and mother-calf contact, with sound. Here, we deployed six tags (DTAG3) on wild porpoises in Danish waters for a total of 96 hours to investigate if the patterns and use of stereotyped NBHF click trains are consistent with a communication function. We show that wild porpoises produce frequent (up to 27 • min
), high-repetition rate click series with repetition rates and output levels different from those of foraging buzzes. These sounds are produced in bouts and frequently co-occur with emission of similar sounds by nearby conspecifics, audible on the tags for >10% of the time. These results suggest that social interactions are more important to this species than their limited social encounters at the surface may indicate and that these interactions are mediated by at least two broad categories of calls composed of short, high-repetition rate click trains that may encode information via the repetition rate of their stereotyped NBHF clicks.
The extragalactic background light (EBL), a diffuse photon field in the optical and infrared range, is a record of radiative processes over the universe's history. Spectral measurements of blazars at ...very high energies (>100 GeV) enable the reconstruction of the spectral energy distribution (SED) of the EBL, as the blazar spectra are modified by redshift- and energy-dependent interactions of the gamma-ray photons with the EBL. The spectra of 14 VERITAS-detected blazars are included in a new measurement of the EBL SED that is independent of EBL SED models. The resulting SED covers an EBL wavelength range of 0.56-56 m, and is in good agreement with lower limits obtained by assuming that the EBL is entirely due to radiation from cataloged galaxies.
Background
To evaluate the effects of administering chemotherapy following surgery, or following surgery plus radiotherapy (known as adjuvant chemotherapy) in patients with early stage non‐small cell ...lung cancer (NSCLC),we performed two systematic reviews and meta‐analyses of all randomised controlled trials using individual participant data. Results were first published in The Lancet in 2010.
Objectives
To compare, in terms of overall survival, time to locoregional recurrence, time to distant recurrence and recurrence‐free survival:
A. Surgery versus surgery plus adjuvant chemotherapy
B. Surgery plus radiotherapy versus surgery plus radiotherapy plus adjuvant chemotherapy
in patients with histologically diagnosed early stage NSCLC.
(2)To investigate whether or not predefined patient subgroups benefit more or less from cisplatin‐based chemotherapy in terms of survival.
Search methods
We supplemented MEDLINE and CANCERLIT searches (1995 to December 2013) with information from trial registers, handsearching relevant meeting proceedings and by discussion with trialists and organisations.
Selection criteria
We included trials of a) surgery versus surgery plus adjuvant chemotherapy; and b) surgery plus radiotherapy versus surgery plus radiotherapy plus adjuvant chemotherapy, provided that they randomised NSCLC patients using a method which precluded prior knowledge of treatment assignment.
Data collection and analysis
We carried out a quantitative meta‐analysis using updated information from individual participants from all randomised trials. Data from all patients were sought from those responsible for the trial. We obtained updated individual participant data (IPD) on survival, and date of last follow‐up, as well as details of treatment allocated, date of randomisation, age, sex, histological cell type, stage, and performance status. To avoid potential bias, we requested information for all randomised patients, including those excluded from the investigators' original analyses. We conducted all analyses on intention‐to‐treat on the endpoint of survival. For trials using cisplatin‐based regimens, we carried out subgroup analyses by age, sex, histological cell type, tumour stage, and performance status.
Main results
We identified 35 trials evaluating surgery plus adjuvant chemotherapy versus surgery alone. IPD were available for 26 of these trials and our analyses are based on 8447 participants (3323 deaths) in 34 trial comparisons. There was clear evidence of a benefit of adding chemotherapy after surgery (hazard ratio (HR)= 0.86, 95% confidence interval (CI)= 0.81 to 0.92, p< 0.0001), with an absolute increase in survival of 4% at five years.
We identified 15 trials evaluating surgery plus radiotherapy plus chemotherapy versus surgery plus radiotherapy alone. IPD were available for 12 of these trials and our analyses are based on 2660 participants (1909 deaths) in 13 trial comparisons. There was also evidence of a benefit of adding chemotherapy to surgery plus radiotherapy (HR= 0.88, 95% CI= 0.81 to 0.97, p= 0.009). This represents an absolute improvement in survival of 4% at five years.
For both meta‐analyses, we found similar benefits for recurrence outcomes and there was little variation in effect according to the type of chemotherapy, other trial characteristics or patient subgroup.
We did not undertake analysis of the effects of adjuvant chemotherapy on quality of life and adverse events. Quality of life information was not routinely collected during the trials, but where toxicity was assessed and mentioned in the publications, it was thought to be manageable. We considered the risk of bias in the included trials to be low.
Authors' conclusions
Results from 47 trial comparisons and 11,107 patients demonstrate the clear benefit of adjuvant chemotherapy for these patients, irrespective of whether chemotherapy was given in addition to surgery or surgery plus radiotherapy. This is the most up‐to‐date and complete systematic review and individual participant data (IPD) meta‐analysis that has been carried out.
Making sense of rapidly evolving evidence on genetic associations is crucial to making genuine advances in human genomics and the eventual integration of this information in the practice of medicine ...and public health. Assessment of the strengths and weaknesses of this evidence, and hence the ability to synthesize it, has been limited by inadequate reporting of results. The STrengthening the REporting of Genetic Association studies (STREGA) initiative builds on the STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE) Statement and provides additions to 12 of the 22 items on the STROBE checklist. The additions concern population stratification, genotyping errors, modelling haplotype variation, Hardy–Weinberg equilibrium, replication, selection of participants, rationale for choice of genes and variants, treatment effects in studying quantitative traits, statistical methods, relatedness, reporting of descriptive and outcome data and the volume of data issues that are important to consider in genetic association studies. The STREGA recommendations do not prescribe or dictate how a genetic association study should be designed, but seek to enhance the transparency of its reporting, regardless of choices made during design, conduct or analysis.
Wireless networks with a large number of peer nodes are known as mobile ad hoc networks (MANETs). In MANETs, the mobility of nodes causes a number of challenges, including path preservation, battery ...life, safety, dependability, and unexpected connection characteristics. As a result, the network’s quality of service (QoS) would be compromised (QoS). For the discovery and maintenance of pathways in MANETs, the routing protocol is critical. By implementing the multicast routing protocol, the MANET network’s reliability may be improved significantly. Evaluation of multicast routing for quality of service (QoS) is the primary goal of this study. In multicasting, data packets from one node are transmitted to a set of receiver nodes at a time, simultaneously. Multicasting reduces transmission costs. Cluster head selection is one of the challenges in MANET. This proposed research paper optimal route selection (ORS) provides the cluster head selection and alternate cluster head selection for avoiding the failure of the cluster head, generation of the optimal path between the cluster head and member node based on reliability pair factor and node’s energy, and establishment of the path based on maximum energy and number of hops between the nodes (minimum number of hops). In comparison to existing methods, ORS is more effective in the energy-efficient path between base station and cluster head, and member node is provided by an ORS route. Results show that the proposed ORSMAN has higher throughput, minimum latency, minimum jitter, and maximum packet delivery ratio, when compared to the existing methodologies.
Goal-directed blood pressure management in the intensive care unit can improve trauma outcomes but is labor-intensive. Automated critical care systems can deliver scaled interventions to avoid ...excessive fluid or vasopressor administration. We compared a first generation automated drug and fluid delivery platform, Precision Automated Critical Care Management (PACC-MAN), to a more refined algorithm, incorporating additional physiologic inputs and therapeutics. We hypothesized that the enhanced algorithm would achieve equivalent resuscitation endpoints with less crystalloid utilization in the setting of distributive shock.
Twelve swine underwent 30% hemorrhage and 30 min of aortic occlusion to induce an ischemia-reperfusion injury and distributive shock state. Next, animals were transfused to euvolemia and randomized into a standardized critical care (SCC) of PACC-MAN or an enhanced version (SCC+) for 4.25 hrs. SCC+ incorporated lactate and urine output to assess global response to resuscitation and added vasopressin as an adjunct to norepinephrine at certain thresholds. Primary and secondary outcomes were decreased crystalloid administration and time at goal blood pressure, respectively.
Weight-based fluid bolus volume was lower in SCC+ compared to SCC (26.9 ml/kg vs. 67.5 ml/kg, p = 0.02). Cumulative norepinephrine dose required was not significantly different (SCC+: 26.9 mcg/kg vs. SCC: 13.76 mcg/kg, p = 0.24). Three of 6 animals (50%) in SCC+ triggered vasopressin as an adjunct. Percent time spent between 60-70 mmHg, terminal creatinine and lactate, and weight-adjusted cumulative urine output were equivalent.
Refinement of the PACC-MAN algorithm decreased crystalloid administration without sacrificing time in normotension, reducing urine output, increasing vasopressor support, or elevating biomarkers of organ damage. Iterative improvements in automated critical care systems to achieve target hemodynamics in a distributive-shock model are feasible.
Level IIIJTACS Study Type: Therapeutic/care management.
Biology of Hepatocellular Carcinoma Pang, Roberta W. C.; Joh, Jae Won; Johnson, Philip J. ...
Annals of surgical oncology,
04/2008, Letnik:
15, Številka:
4
Journal Article
Recenzirano
Hepatocellular carcinoma (HCC) is a common cancer in the world due to high prevalence of hepatitis B or C virus infection. Research in recent years has uncovered important molecular pathways involved ...in development and progression of HCC. Several genetic aberrations and molecular mechanisms responsible for initiation of hepatocarcinogenesis have been identified. Novel biomarkers for HCC are being developed for better detection and prognostication. Alpha-fetoprotein, the conventional marker of HCC, has limited sensitivity and specificity. Serum levels of isoforms of AFP based on differential lectin binding of the glycan moiety appear to be more sensitive and specific than total AFP level in early detection of HCC. The clinical usefulness of other HCC biomarkers such as des-γ-carboxy prothrombin and glypican-3 are under investigation. HCC is an aggressive tumor with early vascular invasion and metastasis. Studies over the past two decades have elucidated the clinical predictors of outcome, leading to several staging systems for HCC based on clinical parameters. However, the predictive accuracy of clinical staging systems is limited. Recent studies suggested that biological factors may provide additional prognostic information. In particular, gene expression profiling appears to be a promising approach. Study of tumor angiogenesis in HCC reveals that the expression of angiogenic factors such as vascular endothelial growth factor and angiopoietins may also predict prognosis. The elucidation of tumor biology of HCC is of particular importance in the current era of rapid development of anti-cancer molecular targeting agents, which provide hope for an effective systemic therapy for HCC.
We present a new measurement of the energy spectrum of iron nuclei in cosmic rays from 20 TeV to 500 TeV. The measurement makes use of a template-based analysis method, which, for the first time, is ...applied to the energy reconstruction of iron-induced air showers recorded by the VERITAS array of imaging atmospheric Cherenkov telescopes. The event selection makes use of the direct Cherenkov light which is emitted by charged particles before the first interaction, as well as other parameters related to the shape of the recorded air shower images. The measured spectrum is well described by a power law dFdE=f0·(EE0)−γ over the full energy range, with γ=2.82±0.30(stat)−0.27+0.24(syst) and f0=(4.82±0.98(stat)−2.70+2.12(syst))×10−7 m−2 s−1 TeV−1 sr−1 at E0=50 TeV, with no indication of a cutoff or spectral break. The measured differential flux is compatible with previous results, with improved statistical uncertainty at the highest energies.
Combined with measurements made by very-long-baseline interferometry, the observations of fast TeV gamma-ray flares probe the structure and emission mechanism of blazar jets. However, only a handful ...of such flares have been detected to date, and only within the last few years have these flares been observed from lower-frequency-peaked BL Lac objects and flat-spectrum radio quasars. We report on a fast TeV gamma-ray flare from the blazar BL Lacertae observed by the Very Energetic Radiation Imaging Telescope Array System (VERITAS). with a rise time of ∼2.3 hr and a decay time of ∼36 min. The peak flux above 200 GeV is (4.2 0.6) × 10−6 photon m−2 s−1 measured with a 4-minute-binned light curve, corresponding to ∼180% of the flux that is observed from the Crab Nebula above the same energy threshold. Variability contemporaneous with the TeV gamma-ray flare was observed in GeV gamma-ray, X-ray, and optical flux, as well as in optical and radio polarization. Additionally, a possible moving emission feature with superluminal apparent velocity was identified in Very Long Baseline Array observations at 43 GHz, potentially passing the radio core of the jet around the time of the gamma-ray flare. We discuss the constraints on the size, Lorentz factor, and location of the emitting region of the flare, and the interpretations with several theoretical models that invoke relativistic plasma passing stationary shocks.
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