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Papillon treatment is a form of contact X-ray brachytherapy (CXB) which is used as an alternative to surgery for rectal cancer. This study aimed to audit patients who were referred for and treated with CXB over a 6-year period against guidelines derived from a critical review of the evidence base.
Materials and methods:
Patient demographics, tumour characteristics and outcome data were gathered for 31 patients referred for CXB. A critical review of the evidence identified consensus referral criteria and outcome data against which to audit patients.
Referral criteria were derived from six published studies. These applied to patients unfit for surgery or stoma-averse. All referred patients had a visible tumour or scar with a tumour size under 3 cm and sited less than 12 cm from the anal verge. Nodal status varied from N0 to N2, but there was no metastatic disease present. The audited cohort demonstrated demographic equivalence, while the initial clinical complete response and recurrence rates were also comparable.
This audit confirmed the validity of referral and treatment protocols and should guide future referrals until evidence from ongoing studies becomes available. These findings should contribute to the development of robust national guidelines.
Insufficient vitamin D during pregnancy increases risk of adverse outcomes, with known differences by race/ethnicity. We sought to determine whether predictors of vitamin D insufficiency vary by race/ethnicity in an ethnically diverse pregnancy cohort. Plasma 25-hydroxyvitamin D concentrations and patient characteristics were measured at first prenatal visit to prenatal clinics in south-eastern USA between 2009 and 2011 (n 504). Prevalence ratios (PR) and 95 % CI were estimated using multivariable regression to quantify predictors of vitamin D insufficiency, overall and by race/ethnicity. In race/ethnicity-stratified models, season was most associated with vitamin D insufficiency among non-Hispanic white women; PR for winter v. summer were 3·58 (95 % CI 1·64, 7·81) for non-Hispanic white, 1·52 (95 % CI 1·18, 1·95) for Hispanic and 1·14 (95 % CI 0·99, 1·30) for non-Hispanic black women. Although women with darker skin tones are most vulnerable to prenatal vitamin D insufficiency, season may be more strongly associated with insufficiency among women with lighter skin tones.
The stability of VFB catholytes was investigated using both light-scattering measurements and visual observation. V2O5 precipitates after an induction time τ which shows an Arrhenius variation with temperature. The value of τ increases with increasing [S] and with decreasing [VV] but the activation energy remains constant with a value of (1.791±0.020) eV. Plots of ln τ against [S] and [VV] show good linearity and the slopes give values of βS = 2.073 M-1 and βV5 = –3.434 M-1 for the fractional rates of variation of τ with [S] and [VV], respectively. Combining the Arrhenius Equation with the observed log-linear variation of τ with [S] and [VV] provides a model for simulating the stability of catholytes. The addition of H3PO4 has a strong stabilizing effect on catholytes at higher temperatures. For example, at 50°C the induction time for precipitation for a typical catholyte is enhanced ∼ 12.5-fold by 0.1 M added H3PO4. At concentrations of H3PO4 less than ∼0.04 M, the precipitation time increases with increasing concentration at all temperatures investigated (30–70°C). At higher concentrations, induction time begins to decrease with increasing concentration of H3PO4: the changeover concentration depends on the temperature. Experiments at 70°C using other phosphate additives (sodium triphosphate, Na5P3O10, and sodium hexametaphosphate, (NaPO3)6) showed similar results to H3PO4.
The objective of this study was to investigate the effect of both cow genetic index (CGI) and feeding system on the performance of second lactation Holstein-Friesian dairy cows on grass-based feeding systems. There was no interaction between CGI and feeding system for any of the parameters measured. Cows of high genetic index (HGI) produced significantly higher yields of milk (P < 0.001), fat (P < 0.001) protein (P < 0.0001) and lactose (P < 0.001) than medium genetic index cows (MGI). CGI had no effect on the concentration of milk constituents. Averaged across four intake measurements the HGI cows had significantly (P < 0.001) higher grass dry-matter intake (GDMI) and total dry-matter intake (TDMI). Live weight was similar for both genotypes during lactation. The HGI cows had significantly (P < 0.05) higher live-weight loss in the first 10 weeks of lactation, significantly lower live-weight gain from week 10 to the end of lactation and higher (P < 0.05) live-weight gain during the dry period. Condition score was significantly lower with the HGI (P < 0.001) at all stages of lactation. There was a higher proportion (P < 0.05) of the HGI cows non-pregnant at the end of the 13-week breeding season. Feeding system had a significant effect on the yield of milk (P < 0.001), fat (P < 0.001), protein (P < 0.001) and lactose (P < 0.001). Feeding system B produced significantly higher (P < 0.05) milk yield and yield of constituents (when compared with feeding systems A and C). Over the period when feeding systems were being applied, feeding system C had significantly higher (P < 0.05) milk protein concentration. Feeding system had a significant effect (P < 0.001) on both GDMI and TDMI. Feeding system had no effect on live weight, condition score or fertility performance.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
Interest is accruing in indicator traits as predictors of fertility which: 1) can be more easily recorded; 2) can be measured early in life; and, 3) possess a co-heritability that is larger than the heritability of the fertility traits. Potentially interesting indicator traits include body condition score (BCS) and body weight (BW). The objective of this study was to estimate genetic (co) variances between BCS, BCS change, BW, BW change, and fertility traits in dairy cattle.
Pre-1990 published responses to supplementation at pasture ranged from 0.4 to 0.6kg milk/kg concentrate fed. However since 1990 higher responses to concentrate supplementation at pasture have been published (Delaby 2001). The objective of this study was to determine if milk production responses of Holstein-Friesian dairy cows to concentrate supplementation at pasture are influenced by genetic merit (milk yield potential) in a spring calving grass based system of milk production.
In recent years the relevance of continued selection for higher milk yield alone has been questioned for three reasons (Simm, 1998): 1) the introduction of milk quotas in some countries, 2) the now well documented deleterious effect of selection for yield on health and fertility (Pryce and Veerkamp, 2001), and, 3) the increased emphasis in payment schemes in many countries on milk composition. The purpose of this study was to measure the biological efficiency of two dual-purpose breeds (Montbeliarde (MB) and Normande (NR)) relative to two Holstein-Friesian strains (upgraded Irish Holstein-Friesian (CL) and Dutch Holstein-Friesian (HF)) on a spring-calving milk production system based mainly on grazed grass as a feed.
This contribution gave three examples of X-ray transients in the Magellanic Clouds and the Milky Way that have been observed as part of the SALT Transients Large Programme. The transients (SMC X-3, MAXI J1957+032 and ASASSN-16oh) have been triggered from both space-based wide-field monitoring facilities (Swift/XRT, MAXI) and ground-based ones (ASASSN, the All Sky Automated Survey for SN), providing insights into the physics of super-Eddington accretion onto neutron stars and white dwarfs, and also into the long-term properties of accreting millisecond X-ray pulsars.
Using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), it was shown for four different types of carbon that electrode treatments at negative potentials enhance the kinetics of VIV-VV and inhibit the kinetics of VII-VIII while electrode treatments at positive potentials inhibit the kinetics of VIV-VV and enhance the kinetics of VII-VIII. These observations may explain conflicting reports in the literature. The potentials required for activation and deactivation of electrodes were examined in detail. The results suggest that interchanging the positive and negative electrodes in a vanadium flow battery (VFB) would reduce the overpotential at the negative electrode and so improve the performance. This is supported by flow-cell experiments. Thus, periodic catholyte-anolyte interchange, or equivalent alternatives such as battery overdischarge, show promise of improving the voltage efficiency of VFBs.
The stability of vanadium flow battery (VFB) catholytes was investigated using both lightscattering measurements and visual observation. V2O5 precipitates after an induction time τ which shows an Arrhenius variation with temperature. The value of τ increases with increasing concentration of sulfate and with decreasing concentration of VV but the activation energy remains constant with a value of (1.791±0.020) eV. Plots of ln τ against [S] and [VV] show good linearity and the slopes give values of βS = 2.073 M-1 and βV5 = –3.434 M-1 for the fractional rates of variation of τ with [S] and [VV], respectively. Combining the Arrhenius Equation with the observed log-linear variation of τ with [S] and [VV] provides a model for simulating the stability of catholytes.
The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.
Information on the genetic diversity and population structure of cattle breeds is useful when deciding the most optimal, for example, crossbreeding strategies to improve phenotypic performance by exploiting heterosis. The present study investigated the genetic diversity and population structure of the most prominent dairy and beef breeds used in Ireland. Illumina high-density genotypes (777 962 single nucleotide polymorphisms; SNPs) were available on 4623 purebred bulls from nine breeds; Angus (n=430), Belgian Blue (n=298), Charolais (n=893), Hereford (n=327), Holstein-Friesian (n=1261), Jersey (n=75), Limousin (n=943), Montbéliarde (n=33) and Simmental (n=363). Principal component analysis revealed that Angus, Hereford, and Jersey formed non-overlapping clusters, representing distinct populations. In contrast, overlapping clusters suggested geographical proximity of origin and genetic similarity between Limousin, Simmental and Montbéliarde and to a lesser extent between Holstein, Friesian and Belgian Blue. The observed SNP heterozygosity averaged across all loci was 0.379. The Belgian Blue had the greatest mean observed heterozygosity (HO=0.389) among individuals within breed while the Holstein-Friesian and Jersey populations had the lowest mean heterozygosity (HO=0.370 and 0.376, respectively). The correlation between the genomic-based and pedigree-based inbreeding coefficients was weak (r=0.171; P<0.001). Mean genomic inbreeding estimates were greatest for Jersey (0.173) and least for Hereford (0.051). The pair-wise breed fixation index (Fst) ranged from 0.049 (Limousin and Charolais) to 0.165 (Hereford and Jersey). In conclusion, substantial genetic variation exists among breeds commercially used in Ireland. Thus custom-mating strategies would be successful in maximising the exploitation of heterosis in crossbreeding strategies.
The provision of financial services through mobile phones is a powerful tool to foster financial inclusion, and thus economic growth, in developing countries. However, it raises important regulatory issues. Given the vulnerability of most potential customers of these services, the protection of customer funds is important. In common law countries, trust accounts are an effective response to these concerns. In civil law jurisdictions however, in the absence of trusts, protection of customer funds is more difficult. This paper identifies the theoretical and practical problems that regulators in civil law jurisdictions might face when trying to protect customer funds and explores how fiduciary contracts, mandate contracts and direct regulation might be used to achieve this goal. It offers a series of practical recommendations for policymakers in developing countries that provide a range of regulatory options that combine private law and regulation.
Background: About 35% of patients with epilepsy may develop drug-resistant epilepsy (DRE). Identifying risk factors associated with DRE will allow us to identify earlier patients in the course of the disease. Methods: This is a case-control study nested within a cohort. Chart reviews of subjects who full fill inclusion criteria were completed. Inclusion criteria included age>18 years, focal epilepsy determined by clinical correlation and EEG. DRE was determined by ILAE criteria. Results: 149 subjects were included. Seventy had DRE (cases), and seventy-nine did not have DRE (controls). DRE group had a mean age of 41 years (SD+14.8) compared to the control group (49+17.5) (p=0.003). DRE group had a mean age at diagnosis of epilepsy of 19+15.3 compared to the control group with a mean of 33.6+21. (p=<0.001). The main risk factors identified in this study were; cortical dysplasia OR 8.67 (CI 1.04-72.3, p=0.026); mesial temporal sclerosis (MTS) (OR 2.69; CI 1.12-6.47; p=0.024); and presence of complex partial seizures (OR 2.04. Conclusions: Young age at diagnosis of focal epilepsy, diagnosis of cortical dysplasia, MTS, and presence of complex partial seizures are risk factors for DRE
We report the analysis of 154 hours of nearly continuous high-speed photometric data on the pulsating DB white dwarf (DBV) GD 358 obtained during the Whole Earth Telescope (WET) run of May 1990. The Fourier transform (FT) of the light curve is dominated by power in the range from 1200 – 1700μHz with more than 180 significant peaks in the total transform. We also see significant power at the sums and differences of the dominant frequencies, indicating the importance of nonlinear behavior. We can use this data to obtain an accurate total stellar mass, and surface He layer mass. The implied surface He layer mass, if correct, provides a significant and surprising challenge to stellar evolution theory, as well as the theory of chemical mixing.
Our multi-epoch observations show that UW Pic undergoes very pronounced changes in accretion geometry. We explain our observations in terms of changing accretion rates of UW Pic coupled with a particular orientation of the system to the observer.
The variability of CD-24 7599 (V=11.48 mag) was discovered by JCC during observing run XCOV7 of the Whole Earth Telescope (WET, Nather et al. 1990) network in February, 1992. The star was observed as an additional target and 117 hours of high-quality temporal spectroscopic observations were obtained.
Our analysis of these data revealed the presence of 7 independent pulsation modes between 27.0 and 38.1 cycles per day (313 – 441 μHz) with semiamplitudes of 2.1 – 10.2 milli-modulation amplitudes (mma). We showed that peaks at linear combination frequencies detected in the power spectra were not due to eigenmodes excited to visible amplitude by resonant mode coupling.