We explore the relation between diffuse intracluster light (central galaxy included) and the galaxy cluster (baryonic and dark) matter distribution using a sample of 528 clusters at \(0.2\leq z \leq ...0.35\) found in the Dark Energy Survey (DES) Year 1 data. The surface brightness of the diffuse light shows an increasing dependence on cluster total mass at larger radius, and appears to be self-similar with a universal radial dependence after scaling by cluster radius. We also compare the diffuse light radial profiles to the cluster (baryonic and dark) matter distribution measured through weak lensing and find them to be comparable. The IllustrisTNG galaxy formation simulation, TNG300, offers further insight into the connection between diffuse stellar mass and cluster matter distributions -- the simulation radial profile of the diffuse stellar component does not have a similar slope with the total cluster matter content, although that of the cluster satellite galaxies does. Regardless of the radial trends, the amount of diffuse stellar mass has a low-scatter scaling relation with cluster's total mass in the simulation, out-performing the total stellar mass of cluster satellite galaxies. We conclude that there is no consistent evidence yet on whether or not diffuse light is a faithful radial tracer of the cluster matter distribution. Nevertheless, both observational and simulation results reveal that diffuse light is an excellent indicator of the cluster's total mass.
Background The selective estrogen receptor modulator tamoxifen is now widely used for the treatment and prevention of breast cancer. Tamoxifen use has been associated with a variety of gynecologic ...problems. Despite the frequency with which hormonal therapy is used for the treatment of breast cancer, limited population-level data are available to describe the occurrence of gynecologic conditions and the use of surveillance testing in women receiving tamoxifen and aromatase inhibitors. Objective We performed a population-based analysis among women with breast cancer receiving hormonal therapy with tamoxifen, a drug commonly used in premenopausal and sometimes postmenopausal women, to determine the frequency of gynecologic abnormalities and use of diagnostic and surveillance testing. We compared these findings to women treated with aromatase inhibitors, agents commonly used in postmenopausal women. Study Design The MarketScan database was used to identify women diagnosed with breast cancer from 2009 through 2013 who underwent mastectomy or lumpectomy. Women receiving tamoxifen (age <50 vs ≥50 years) were compared to women ≥50 years of age treated with aromatase inhibitors. We examined the occurrence of gynecologic symptoms and diseases (vaginal bleeding, endometrial polyps, endometrial hyperplasia, and endometrial cancer) and gynecologic procedures and interventions (transvaginal ultrasound, endometrial biopsy, hysteroscopy/dilation and curettage, and hysterectomy). Time-dependent analyses were performed to examine symptoms and testing. Results A total of 75,170 women, including 15,735 (20.9%) age <50 years treated with tamoxifen, 13,827 (18.4%) age ≥50 years treated with tamoxifen, and 45,608 (60.7%) age ≥50 years treated with aromatase inhibitors were identified. The cumulative incidence of any gynecologic symptom or pathologic diagnosis during the study period was 20.2%, 12.3%, and 3.5%, respectively ( P < .001), while the cumulative incidence of any gynecologic procedure or intervention during the study period was 34.2%, 20.9%, and 9.0%, respectively ( P < .0001). Among women without symptoms or pathology, interventions were performed in 20.0%, 11.0%, and 6.8%, respectively ( P < .0001). Conclusion Compared to women taking aromatase inhibitors, gynecologic symptoms, procedures, and pathology are higher for both premenopausal and postmenopausal women with breast cancer on tamoxifen. Increased efforts to curb use of gynecologic interventions in asymptomatic women are needed.
Human papillomavirus (HPV) infections appear to be central to the development of cervical cancer. Researchers address the issue of whether testing women who have low-grade squamous intraepithelial ...lesions of the uterine cervix for HPV DNA is useful as a triage strategy.
Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information ...transfer and communication between a tertiary-care academic hospital and its related PAC facilities.
This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013.
We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer.
Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries before discharge to PAC facilities, and provision of hard-copy opioid prescriptions at discharge.
Exposure to nonhuman primates has led to the emergence of important diseases, including Ebola hemorrhagic fever, AIDS, and adult T-cell leukemia. To determine the extent of exposure to nonhuman ...primates, persons were examined in 17 remote villages in Cameroon that represented three habitats (savanna, gallery forest, and lowland forest). Questionnaire data were collected to assess whether persons kept wild animal pets; hunted and butchered wild game; had experienced bites, scratches, or injuries from live animals; or had been injured during hunting or butchering. While all villages had substantial exposure to nonhuman primates, higher rates of exposure were seen in lowland forest sites. The study demonstrates that exposure is not limited to small groups of hunters. A high percentage of rural villagers report exposure to nonhuman primate blood and body fluids and risk acquiring infectious diseases.
This article explores human-robot interaction during a 16-hr, high-fidelity urban search and rescue disaster response drill with teleoperated robots. This article examines operator situation ...awareness and technical search team interaction using communication analysis. It analyzes situation awareness, team communication, and the interaction of these constructs using a systematic coding scheme designed for this research. The findings indicate that operators spent significantly more time gathering information about the state of the robot and the state of the environment than they did navigating the robot. Operators had difficulty integrating the robot's view into their understanding of the search and rescue site. They compensated for this lack of situation awareness by communicating with team members at the site, attempting to gather information that would provide a more complete mental model of the site. They also worked with team members to develop search strategies. The article concludes with suggestions for design and future research.
The goals of this study were (i) to compare the degree and (ii) temporal changes in airway obstruction in sheep with pulmonary injury induced by smoke inhalation and/or burn; (iii) to qualitatively ...assess the cellular and mucous content of obstructive material; and (iv) to statistically assess a possible relationship between the degree of airway obstruction and pulmonary dysfunction. Using masked histologic slides, we estimated the degree of luminal obstruction in all cross-sectioned airways. The mean degree of bronchial, bronchiolar, and terminal bronchiolar obstruction was significantly greater in animals with smoke injury alone or combined smoke inhalation and burn (S+B) injury, compared with animals with burn injury alone or uninjured animals (P < 0.05). In S+B animals, the degree of bronchial obstruction was maximal at 24 h, with a progressive decrease over 72 h. In contrast, the degree of bronchiolar obstruction increased over time. Qualitatively, bronchial casts were largely composed of mucus at early times after injury, whereas neutrophils were the principal component of bronchiolar obstructive material. Localization of specific mucin subtypes in S+B tissues suggests that increasing bronchiolar obstruction is derived, in part, from upper airway material. Multiple linear regression analysis of airway obstruction scores compared with PaO2/FIO2 values showed a correlation coefficient of r = 0.76, with bronchial and bronchiolar scores predictive of PaO2/FIO2, (P < 0.05). These results suggest that strategies to remove or decrease formation of upper airway obstructive material may reduce its deposition into small airways and parenchyma and may improve respiratory function in victims of smoke inhalation injury.
On 14 August 2019, the LIGO and Virgo Collaborations detected gravitational waves from a black hole and a 2.6 solar mass compact object, possibly the first neutron star -- black hole (NSBH) merger. ...In search of an optical counterpart, the Dark Energy Survey (DES) obtained deep imaging of the entire 90 percent confidence level localization area with Blanco/DECam 0, 1, 2, 3, 6, and 16 nights after the merger. Objects with varying brightness were detected by the DES Pipeline and we systematically reduced the candidate counterparts through catalog matching, light curve properties, host-galaxy photometric redshifts, SOAR spectroscopic follow-up observations, and machine-learning-based photometric classification. All candidates were rejected as counterparts to the merger. To quantify the sensitivity of our search, we applied our selection criteria to full light curve simulations of supernovae and kilonovae as they would appear in the DECam observations. Since the source class of the merger was uncertain, we utilized an agnostic, three-component kilonova model based on tidally-disrupted NS ejecta properties to quantify our detection efficiency of a counterpart if the merger included a NS. We find that if a kilonova occurred during this merger, configurations where the ejected matter is greater than 0.07 solar masses, has lanthanide abundance less than \(10^{-8.56}\), and has a velocity between \(0.18c\) and \(0.21c\) are disfavored at the \(2\sigma\) level. Furthermore, we estimate that our background reduction methods are capable of associating gravitational wave signals with a detected electromagnetic counterpart at the \(4\sigma\) level in \(95\%\) of future follow-up observations.
Abstract Background Although a number of prohemostatic agents that are applied intraoperatively have been introduced to minimize bleeding, little is known about the patterns of use and the factors ...that influence use. We examined the use of hemostatic agents in patients undergoing major surgery. Methods All patients who underwent major general, gynecologic, urologic, cardiothoracic, or orthopedic surgery from 2000–2010 who were recorded in the Perspective database were analyzed. Results Among 3,633,799 patients, hemostatic agents were used in 30.3% ( n = 1,102,267). The use of hemostatic agents increased from 28.5% in 2000 to 35.2% in 2010. Over the same period, the rates of transfusion declined for pancreatectomy (−14.4%), liver resection (−15.0%), gastrectomy (−11.7%), prostatectomy (−6.6%), nephrectomy (−4.6%), hip arthroplasty (−10.4%), and knee arthroplasty (−6.6%). Over the same time period, the transfusion rate increased for colectomy (6.0%), hysterectomy (3.7%), coronary artery bypass graft (8.4%), valvuloplasty (4.2%), lung resection (1.9%), and spine surgery (1.6%). Transfusion remained relatively stable for thyroidectomy (0.2%). Conclusions The use of hemostatic agents has increased rapidly even for surgeries associated with a small risk of transfusion and bleeding complications. In addition to patient characteristics, surgeon and hospital factors exerted substantial influence on the allocation of hemostatic agents.
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