Abstract We present new catalogs of likely globular clusters (GCs) in 17 nearby spiral galaxies studied as part of the PHANGS Hubble Space Telescope (HST) Treasury Survey. The galaxies were imaged in ...five broadband filters from the near-ultraviolet through the I band. PHANGS-HST has produced catalogs of stellar clusters of all ages by selecting extended sources (from multiple concentration index measurements) followed by morphological classification (centrally concentrated and symmetric or asymmetric, multiple peaks, and contaminants) by visually examining the V -band images and separately by a machine-learning algorithm which classified larger samples to reach fainter limits. From both cluster catalogs, we select an initial list of candidate GCs which have B − V ≥ 0.5 and V − I ≥ 0.73 mag, then remove likely contaminants (including reddened young clusters, background galaxies misclassified by the neural network, and chance superpositions/blends of stars) after a careful visual inspection. We find that ≈86% of the color-selected candidates classified as spherically symmetric and 68% of those classified as centrally concentrated but asymmetric are likely to be GCs. The luminosity functions of the GC candidates in two of our 17 galaxies, NGC 628 and NGC 3627, are atypical, and continue to rise at least 1 mag fainter than the expected turnover near M V ∼ −7.4. These faint candidate GCs have more extended spatial distributions than their bright counterparts, and may reside in the disk rather than the bulge/halo, similar to faint GCs previously discovered in M101. These faint clusters may be somewhat younger since the age–metallicity degeneracy makes it difficult to determine precise cluster ages from integrated colors once they reach ≈1 Gyr.
Ipsilateral breast tumor recurrence (IBTR) can occur in 5-20% of women with early-stage breast cancer treated with breast-conserving therapy. Two entities of IBTR have been described: true recurrence ...(TR), suggested to be regrowth of disease at the tumor bed, and new primary (NP), distinct from the index lesion in histology and location. This study compared survival outcomes between two patient cohorts classified clinically as having either TR or NP.
Between 1989 and 1999, 6,020 women were referred to the BC Cancer Agency with newly diagnosed pT1-2, N0-1, M0 invasive breast cancer, treated with breast-conserving surgery. Of these, 289 patients had pathologically confirmed IBTR. Retrospective analysis was performed, and a set of decision rules was applied to classify cases as TR or NP based on change in histology, grade, hormone receptor status, and tumor location. Of 289 patients, 129 (45%) were classified as having TR and 139 (48%) as having NP; 21 (7%) were unclassified.
The distributions of age at diagnosis, age at recurrence, and histopathologic factors were similar in the TR and NP cohorts (all p > 0.05). The mean time to recurrence was shorter in TR patients than in NP patients (4.8 years vs. 6.3 years, p = 0.001). Treatment of the IBTR did not differ between the two groups. In the TR and NP cohorts, breast cancer-specific survival was 55.7% vs. 61.3% (p = 0.93), and overall survival was 43.7% vs. 54.8% (p = 0.53).
Time to recurrence is significantly shorter in patients with IBTR classified as true recurrence compared to new primary. Non-statistically significant trends for less favorable survival were observed for patients with TR. Further investigation of the hypothesis that TR and NP tumors are distinct entities with different survival prognoses will require standardized pathology review and molecular analyses.
Objective To evaluate the correlation between the International Prostate Symptom Score (IPSS) and the Visual Prostate Symptom Score (VPSS), a visual assessment of urinary stream, frequency, nocturia, ...and quality of life using pictograms, in a health safety net population. Methods Men presenting to San Francisco General Hospital with lower urinary tract symptoms completed the IPSS and the VPSS without and then with assistance. Statistical analysis was performed using the chi-square test, the Wilcoxon signed rank test, and the Spearman rank correlation. Results One hundred twenty-one patients were enrolled between December 2013 and May 2014 with a mean age of 54 years. There were statistically significant correlations between total VPSS and total IPSS (ρ = 0.71; P <.001) and for frequency (ρ = 0.47; P <.001), nocturia (ρ = 0.69; P <.001), force of stream (ρ = 0.65; P <.001), and quality of life (ρ = 0.69; P <.001). In addition, there were statistically significant correlations between total VPSS and both VPSS quality of life (ρ = 0.69; P <.001) and Qmax (ρ = −0.473; P = .006). The mean absolute disagreement for participants who took the IPSS independently vs with assistance was greater than for those who took the VPSS independently vs assistance for all symptoms: frequency (0.64 vs 0.3, respectively; P <.001), weak stream (0.82 vs 0.14, respectively; P <.001), nocturia (0.38 vs 0.23, respectively; P = .023), and quality of life (0.63 vs 0.32, respectively; P = .005). Conclusion Many men altered their IPSS responses when they received assistance. There was significantly less alteration in responses using the VPSS, suggesting that the VPSS is useful in determining lower urinary tract symptoms, particularly in patients with limited education and literacy.
Carbon capture and storage (CCS) is an industrial scale mitigation strategy for reducing anthropogenic CO
2
from entering the atmosphere. However, for CCS to be routinely deployed, it is critical ...that the security of the stored CO
2
can be verified and that unplanned migration from a storage site can be identified. A number of geochemical monitoring tools have been developed for this purpose, however, their effectiveness critically depends on robust geochemical baselines being established prior to CO
2
injection. Here we present the first multi-well gas and groundwater characterisation of the geochemical baseline at the Carbon Management Canada Research Institutes Field Research Station. We find that all gases exhibit CO
2
concentrations that are below 1%, implying that bulk gas monitoring may be an effective first step to identify CO
2
migration. However, we also find that predominantly biogenic CH
4
(∼90%–99%) is pervasive in both groundwater and gases within the shallow succession, which contain numerous coal seams. Hence, it is probable that any upwardly migrating CO
2
could be absorbed onto the coal seams, displacing CH
4
. Importantly,
4
He concentrations in all gas samples lie on a mixing line between the atmosphere and the elevated
4
He concentration present in a hydrocarbon well sampled from a reservoir located below the Field Research Station (FRS) implying a diffusive or advective crustal flux of
4
He at the site. In contrast, the measured
4
He concentrations in shallow groundwaters at the site are much lower and may be explained by gas loss from the system or
in situ
production generated by radioactive decay of U and Th within the host rocks. Additionally, the injected CO
2
is low in He, Ne and Ar concentrations, yet enriched in
84
Kr and
132
Xe relative to
36
Ar, highlighting that inherent noble gas isotopic fingerprints could be effective as a distinct geochemical tracer of injected CO
2
at the FRS.
To evaluate tolerability and compliance to a walking exercise program and its effect on fatigue during and after radical external beam radiation therapy (EBRT) for prostate cancer.
A total of 50 ...subjects with prostate cancer undergoing EBRT over 6 to 8 weeks were prospectively accrued to an exercise intervention group, matched for age and clinical characteristics to 30 subjects in a historical control group who underwent EBRT with no specific exercise intervention. Starting 1 week before EBRT, exercise participants performed moderate-intensity walking targeting 60% to 70% age-predicted maximum heart rate, at least 20 min/d, 3 d/wk over 12 weeks. The Brief Fatigue Inventory was administered at baseline, mid-EBRT (week 3-4), end-EBRT (week 6-8), and 6 months post-EBRT.
Of 50, 42 (84%) of exercise participants completed the walking program. There were no cardiovascular complications, musculoskeletal injuries, or other adverse events. A total of 89% subjects reported "Good-Excellent" satisfaction during and up to 6 months post-EBRT. Fatigue in control subjects escalated from baseline to end-EBRT, remaining high at 6 months post-EBRT (Pr = 0.03). In contrast, mean total fatigue scores in exercise subjects were stable from baseline up to 6 months post-EBRT (P = 0.52). Trends for higher fatigue interference with quality of life were observed in the control group as compared with the exercise group.
Moderate-intensity walking exercise during radical EBRT is safe and feasible. The high convenience and satisfaction ratings, in conjunction with the observed fatigue trends, indicate that this activity has the potential to attenuate fatigue and improve quality of life for patients with localized prostate cancer undergoing curative therapy.
We present new catalogs of likely globular clusters (GCs) in 17 nearby spiral galaxies studied as part of the PHANGS-HST Treasury Survey. The galaxies were imaged in five broad-band filters from the ...near-ultraviolet through the \(I\) band. PHANGS-HST has produced catalogs of stellar clusters of all ages by selecting extended sources (from multiple concentration index measurements) followed by morphological classification (centrally concentrated and symmetric or asymmetric, multiple peaks, contaminant) by visually examining the V-band image and separately by a machine-learning algorithm which classified larger samples to reach fainter limits. From both cluster catalogs, we select an initial list of candidate GCs to have \(B-V \geq 0.5\) and \(V-I \geq 0.73\)~mag, then remove likely contaminants (including reddened young clusters, background galaxies misclassified by the neural network, and chance superpositions/blends of stars) after a careful visual inspection. We find that \(\approx86\) % of the color-selected candidates classified as spherically symmetric, and \(\approx68\) of those classified as centrally concentrated but asymmetric are likely to be GCs. The luminosity functions of the GC candidates in 2 of our 17 galaxies, NGC 628 and NGC 3627, are atypical, and continue to rise at least 1~mag fainter than the expected turnover near \(M_V \sim -7.4\). These faint candidate GCs have more extended spatial distributions than their bright counterparts, and may reside in the disk rather than the bulge/halo, similar to faint GCs previously discovered in M101. These faint clusters may be somewhat younger since the age-metallicity degeneracy makes it difficult to determine precise cluster ages from integrated colors once they reach \(\approx1\)~Gyr.
The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and ...adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs).
Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols.
The Executive Summary of this 2020 updated guideline contains 52 recommendations: 21 Grade A (40%), 24 Grade B (46%), 7 Grade C (14%), and no Grade D (0%). These detailed, evidence-based recommendations allow for nuance-based clinical decision-making that addresses multiple aspects of real-world care of patients. The evidence base presented in the subsequent Appendix provides relevant supporting information for the Executive Summary recommendations. This update contains 368 citations: 123 (33.5%) evidence level (EL) 1 (highest), 132 (36%) EL 2 (intermediate), 20 (5.5%) EL 3 (weak), and 93 (25%) EL 4 (lowest). New or updated topics in this CPG include: clarification of the diagnosis of osteoporosis, stratification of the patient according to high-risk and very-high-risk features, a new dual-action therapy option, and transitions from therapeutic options.
This guideline is a practical tool for endocrinologists, physicians in general, regulatory bodies, health-related organizations, and interested laypersons regarding the diagnosis, evaluation, and treatment of post-menopausal osteoporosis.
= 25-hydroxyvitamin D;
= American Association of Clinical Endocrinologists;
= American College of Endocrinology;
= atypical femoral fracture;
= American Society for Bone and Mineral Research;
= best evidence level;
= bone mineral density;
= bone turnover marker;
= confidence interval;
= clinical practice guideline;
= C-terminal telopeptide type-I collagen;
= dual-energy X-ray absorptiometry;
= evidence level;
= U.S. Food and Drug Administration;
= Fracture Risk Assessment Tool;
= gastrointestinal;
= Health Outcomes and Reduced Incidence with Zoledronic acid ONce yearly Pivotal Fracture Trial (zoledronic acid and zoledronate are equivalent terms);
= International Society for Clinical Densitometry;
= international units;
= intravenous;
= least significant change;
= National Osteoporosis Foundation;
= osteonecrosis of the jaw;
= serum amino-terminal propeptide of type-I collagen;
= parathyroid hormone;
= recommendation;
= region of interest;
= relative risk;
= standard deviation;
= trabecular bone score;
= vertebral fracture assessment;
= World Health Organization.
The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and ...adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs).
Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols.
The Executive Summary of this 2020 updated guideline contains 52 recommendations: 21 Grade A (40%), 24 Grade B (46%), 7 Grade C (14%), and no Grade D (0%). These detailed, evidence-based recommendations allow for nuance-based clinical decision-making that addresses multiple aspects of real-world care of patients. The evidence base presented in the subsequent Appendix provides relevant supporting information for the Executive Summary recommendations. This update contains 368 citations: 123 (33.5%) evidence level (EL) 1 (highest), 132 (36%) EL 2 (intermediate), 20 (5.5%) EL 3 (weak), and 93 (25%) EL 4 (lowest). New or updated topics in this CPG include: clarification of the diagnosis of osteoporosis, stratification of the patient according to high-risk and very-high-risk features, a new dual-action therapy option, and transitions from therapeutic options.
This guideline is a practical tool for endocrinologists, physicians in general, regulatory bodies, health-related organizations, and interested laypersons regarding the diagnosis, evaluation, and treatment of post-menopausal osteoporosis.
AACE = American Association of Clinical Endocrinologists AFF = atypical femur fracture ASBMR = American Society for Bone and Mineral Research BEL = best evidence level BMD = bone mineral density BTM ...= bone turnover marker CBC = complete blood count CI = confidence interval DXA = dual-energy X-ray absorptiometry EL = evidence level FDA = U.S. Food and Drug Administration FLEX = Fracture Intervention Trial (FIT) Long-term Extension FRAX
= Fracture Risk Assessment Tool GFR = glomerular filtration rate GI = gastrointestinal HORIZON = Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly IOF = International Osteoporosis Foundation ISCD = International Society for Clinical Densitometry IU = international units IV = intravenous LSC = least significant change NBHA = National Bone Health Alliance NOF = National Osteoporosis Foundation 25(OH)D = 25-hydroxy vitamin D ONJ = osteonecrosis of the jaw PINP = serum carboxy-terminal propeptide of type I collagen PTH = parathyroid hormone R = recommendation RANK = receptor activator of nuclear factor kappa-B RANKL = receptor activator of nuclear factor kappa-B ligand RCT = randomized controlled trial RR = relative risk S-CTX = serum C-terminal telopeptide SQ = subcutaneous VFA = vertebral fracture assessment WHO = World Health Organization.
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