Objective To determine the value of patient‐reported symptoms in diagnosing endometriosis.
Design A national case–control study.
Setting Data from the UK General Practice Research Database for ...years 1992–2001.
Sample A total of 5540 women aged 15–55 years, diagnosed with endometriosis, each matched to four controls without endometriosis.
Methods Data were analysed to determine whether specific symptoms were highly indicative of endometriosis. Odds ratios for these symptoms were derived by conditional logistic regression analysis.
Main outcome measures Symptoms associated with endometriosis.
Results The prevalence of diagnosed endometriosis was 1.5%. A greater proportion of women with endometriosis had abdominopelvic pain, dysmenorrhoea or menorrhagia (73%) compared with controls (20%). Compared with controls, women with endometriosis had increased risks of abdominopelvic pain (OR 5.2 95% CI: 4.7–5.7), dysmenorrhoea (OR 8.1 95% CI: 7.2–9.3), menorrhagia (OR 4.0 95% CI: 3.5–4.5), subfertility (OR 8.2 95% CI: 6.9–9.9), dyspareunia and/or postcoital bleeding (OR 6.8 95% CI: 5.7–8.2), and ovarian cysts (OR 7.3 95% CI: 5.7–9.4), and of being diagnosed with irritable bowel syndrome (IBS) (OR 1.6 95% CI: 1.3–1.8) or pelvic inflammatory disease (OR 3.0 95% CI: 2.5–3.6). Women with endometriosis were also found to consult the doctor more frequently than the controls and were twice as likely to have time off work.
Conclusions Specific symptoms and frequent medical consultation are associated with endometriosis and appear useful in the diagnosis. Endometriosis may coexist with or be misdiagnosed as pelvic inflammatory disease or IBS.
The Radar Echo Telescope for Cosmic Rays (RET-CR) is a recently funded experiment designed to detect the englacial cascade of a cosmic ray-initiated air shower via in-ice radar, toward the goal of a ...full-scale, next-generation experiment to detect ultrahigh energy neutrinos in polar ice. For cosmic rays with a primary energy greater than 10 PeV, roughly 10% of an air shower’s energy reaches the surface of a high elevation ice sheet (≳2 ˙km) concentrated into a radius of roughly 10 cm. This penetrating shower core creates an in-ice cascade orders of magnitude more dense than the preceding in-air cascade. Additionally, this dense cascade can be detected via the radar echo technique, where transmitted radio waves are reflected from the ionization deposit left in the wake of the cascade. RET-CR will test the radar echo method in nature, with the in-ice cascade of a cosmic ray-initiated air shower serving as a test beam. In this work, we present the projected event rate and sensitivity based upon a three part simulation using corsika, geant4, and radioscatter. RET-CR expects ~1 radar echo event per day.
We report the observation of radar echoes from the ionization trails of high-energy particle cascades. Data were taken at the SLAC National Accelerator Laboratory, where the full electron beam ...(∼10^{9} e^{-} at ∼10 GeV/e^{-}) was directed into a plastic target to simulate an ultrahigh-energy neutrino interaction. The target was interrogated with radio waves, and coherent radio reflections from the cascades were detected with properties consistent with theoretical expectations. This is the first definitive observation of radar echoes from high-energy particle cascades, which may lead to a viable neutrino detection technology for energies ≳10^{16} eV.
Relative brain size has long been considered a reflection of cognitive capacities and has played a fundamental role in developing core theories in the life sciences. Yet, the notion that relative ...brain size validly represents selection on brain size relies on the untested assumptions that brain-body allometry is restrained to a stable scaling relationship across species and that any deviation from this slope is due to selection on brain size. Using the largest fossil and extant dataset yet assembled, we find that shifts in allometric slope underpin major transitions in mammalian evolution and are often primarily characterized by marked changes in body size. Our results reveal that the largest-brained mammals achieved large relative brain sizes by highly divergent paths. These findings prompt a reevaluation of the traditional paradigm of relative brain size and open new opportunities to improve our understanding of the genetic and developmental mechanisms that influence brain size.
Using a high-throughput experimentation approach we found a selective and mild Pd-catalyzed oxidative coupling reaction between anilide derivatives and acrylates that occurs through ortho C−H bond ...activation. The reaction is carried out in an acidic environment and occurs even at room temperature with use of a cheap oxidant (benzoquinone) in yields up to 91%. The benzoquinone possibly also functions as a ligand, stabilizing the catalyst. From the electronic dependence of the reaction and the observed kinetic isotope effect (k H/k D = 3) the key step of the catalytic cycle is believed to be electrophilic attack by a PdOAc+ complex on the π-system of the arene.
NuRadioMC is a Monte Carlo framework designed to simulate ultra-high energy neutrino detectors that rely on the radio detection method. This method exploits the radio emission generated in the ...electromagnetic component of a particle shower following a neutrino interaction. NuRadioMC simulates everything from the neutrino interaction in a medium, the subsequent Askaryan radio emission, the propagation of the radio signal to the detector and finally the detector response. NuRadioMC is designed as a modern, modular Python-based framework, combining flexibility in detector design with user-friendliness. It includes a state-of-the-art event generator, an improved modelling of the radio emission, a revisited approach to signal propagation and increased flexibility and precision in the detector simulation. This paper focuses on the implemented physics processes and their implications for detector design. A variety of models and parameterizations for the radio emission of neutrino-induced showers are compared and reviewed. Comprehensive examples are used to discuss the capabilities of the code and different aspects of instrumental design decisions.
Summary
Objective
The objective of this study is to systematically assess the quality of existing patient‐reported outcome measures developed and/or validated for Quality of Life measurement in ...bariatric surgery (BS) and body contouring surgery (BCS).
Methods
We conducted a systematic literature search in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Database Systematic Reviews and CENTRAL identifying studies on measurement properties of BS and BCS Quality of Life instruments. For all eligible studies, we evaluated the methodological quality of the studies by using the COnsensus‐based Standards for the selection of health Measurement INstruments checklist and the quality of the measurement instruments by applying quality criteria. Four degrees of recommendation were assigned to validated instruments (A–D).
Results
Out of 4,354 articles, a total of 26 articles describing 24 instruments were included. No instrument met all requirements (category A). Seven instruments have the potential to be recommended depending on further validation studies (category B). Of these seven, the BODY‐Q has the strongest evidence for content validity in BS and BCS. Two instruments had poor quality in at least one required quality criterion (category C). Fifteen instruments were minimally validated (category D).
Conclusion
The BODY‐Q, developed for BS and BCS, possessed the strongest evidence for quality of measurement properties and has the potential to be recommended in future clinical trials.
Summary Tumours respond differently to immunotherapies compared with chemotherapeutic drugs, raising questions about the assessment of changes in tumour burden—a mainstay of evaluation of cancer ...therapeutics that provides key information about objective response and disease progression. A consensus guideline—iRECIST—was developed by the RECIST working group for the use of modified Response Evaluation Criteria in Solid Tumours (RECIST version 1.1) in cancer immunotherapy trials, to ensure consistent design and data collection, facilitate the ongoing collection of trial data, and ultimate validation of the guideline. This guideline describes a standard approach to solid tumour measurements and definitions for objective change in tumour size for use in trials in which an immunotherapy is used. Additionally, it defines the minimum datapoints required from future trials and those currently in development to facilitate the compilation of a data warehouse to use to later validate iRECIST. An unprecedented number of trials have been done, initiated, or are planned to test new immune modulators for cancer therapy using a variety of modified response criteria. This guideline will allow consistent conduct, interpretation, and analysis of trials of immunotherapies.
We report here on a novel analysis of the complete set of four Stokes parameters that uniquely determine the linear and/or circular polarization of the radio signal for an extensive air shower. The ...observed dependency of the circular polarization on azimuth angle and distance to the shower axis is a clear signature of the interfering contributions from two different radiation mechanisms, a main contribution due to a geomagnetically-induced transverse current and a secondary component due to the build-up of excess charge at the shower front. The data, as measured at LOFAR, agree very well with a calculation from first principles. This opens the possibility to use circular polarization as an investigative tool in the analysis of air shower structure, such as for the determination of atmospheric electric fields.
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