630 resultados para Skinner, Quentin


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There is evidence from retrospective studies that radical cystectomy with extended pelvic lymph node dissection provides better staging and outcomes than limited lymph node dissection. However, the optimal limits of extended lymph node dissection remain unclear. We compared oncological outcomes at 2 cystectomy centers where 2 different extended lymph node dissection templates are practiced to determine whether removing lymphatic tissue up to the inferior mesenteric artery confers an additional survival advantage.

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With the increasing use of laparoscopic and robotic radical cystectomy (RC), there are perceived concerns about the adequacy of lymph node dissection (LND).

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For many childhood cancer survivors follow-up care is important long after treatment completion. We aimed to describe the availability and characteristics of long-term follow-up programs (LTFU) across Europe, their content and aims, their problems, and to assess opinions on different models of LTFU.

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A summary of the 2nd International Consultation on Bladder Cancer recommendations on the reconstructive options after radical cystectomy (RC), their outcomes, and their complications.

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BACKGROUND: Duplications and deletions in the human genome can cause disease or predispose persons to disease. Advances in technologies to detect these changes allow for the routine identification of submicroscopic imbalances in large numbers of patients. METHODS: We tested for the presence of microdeletions and microduplications at a specific region of chromosome 1q21.1 in two groups of patients with unexplained mental retardation, autism, or congenital anomalies and in unaffected persons. RESULTS: We identified 25 persons with a recurrent 1.35-Mb deletion within 1q21.1 from screening 5218 patients. The microdeletions had arisen de novo in eight patients, were inherited from a mildly affected parent in three patients, were inherited from an apparently unaffected parent in six patients, and were of unknown inheritance in eight patients. The deletion was absent in a series of 4737 control persons (P=1.1x10(-7)). We found considerable variability in the level of phenotypic expression of the microdeletion; phenotypes included mild-to-moderate mental retardation, microcephaly, cardiac abnormalities, and cataracts. The reciprocal duplication was enriched in nine children with mental retardation or autism spectrum disorder and other variable features (P=0.02). We identified three deletions and three duplications of the 1q21.1 region in an independent sample of 788 patients with mental retardation and congenital anomalies. CONCLUSIONS: We have identified recurrent molecular lesions that elude syndromic classification and whose disease manifestations must be considered in a broader context of development as opposed to being assigned to a specific disease. Clinical diagnosis in patients with these lesions may be most readily achieved on the basis of genotype rather than phenotype.

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There is a paucity of therapies for most neurological disorders--from rare lysosomal storage diseases to major public health concerns such as stroke and Alzheimer's disease. Advances in the targeting of drugs to the CNS are essential for the future success of neurotherapeutics; however, the delivery of many potentially therapeutic and diagnostic compounds to specific areas of the brain is restricted by the blood-brain barrier, the blood-CSF barrier, or other specialised CNS barriers. These brain barriers are now recognised as a major obstacle to the treatment of most brain disorders. The challenge to deliver therapies to the CNS is formidable, and the solution will require concerted international efforts among academia, government, and industry. At a recent meeting of expert panels, essential and high-priority recommendations to propel brain barrier research forward in six topical areas were developed and these recommendations are presented here.

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We present the design, fabrication, and testing of a microelectromechanical systems (MEMS) light modulator based on pixels patterned with periodic nanohole arrays. Flexure-suspended silicon pixels are patterned with a two dimensional array of 150 nm diameter nanoholes using nanoimprint lithography. A top glass plate assembled above the pixel array is used to provide a counter electrode for electrostatic actuation. The nanohole pattern is designed so that normally-incident light is coupled into an in-plane grating resonance, resulting in an optical stop-band at a desired wavelength. When the pixel is switched into contact with the top plate, the pixel becomes highly reflective. A 3:1 contrast ratio at the resonant wavelength is demonstrated for gratings patterned on bulk Si substrates. The switching time is 0.08 ms and the switching voltage is less than 15V.

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The integration of block-copolymers and nanoimprint lithography presents a novel and cost-effective approach to achieving nanoscale patterning capabilities. The authors demonstrate the fabrication of a surface-enhanced Raman scattering device using templates created by the block-copolymers nanoimprint lithography integrated method.

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Metallic nanocups provide a unique method for redirecting scattered light by creating magnetic plasmon responses at optical frequencies. Despite considerable development of nanocup fabrication processes, simultaneously achieving accurate control over the placement, orientation, and geometry of nanocups has remained a significant challenge. Here we present a technique for fabricating large, periodically ordered arrays of uniformly oriented three-dimensional gold nanocups for manipulating light at subwavelength scales. Nanoimprint lithography, soft lithography, and shadow evaporation were used to fabricate nanocups onto the tips of polydimethylsiloxane nanopillars with precise control over the shapes and optical properties of asymmetric nanocups.

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The authors describe the design, fabrication, and testing of a passive wireless sensor platform utilizing low-cost commercial surface acoustic wave filters and sensors. Polyimide and polyethylene terephthalate sheets are used as substrates to create a flexible sensor tag that can be applied to curved surfaces. A microfabricated antenna is integrated on the substrate in order to create a compact form factor. The sensor tags are fabricated using 315 MHz surface acoustic wave filters and photodiodes and tested with the aid of a fiber-coupled tungsten lamp. Microwave energy transmitted from a network analyzer is used to interrogate the sensor tag. Due to an electrical impedance mismatch at the SAW filter and sensor, energy is reflected at the sensor load and reradiated from the integrated antenna. By selecting sensors that change electrical impedance based on environmental conditions, the sensor state can be inferred through measurement of the reflected energy profile. Testing has shown that a calibrated system utilizing this type of sensor tag can detect distinct light levels wireless and passively. The authors also demonstrate simultaneous operation of two tags with different center passbands that detects light. Ranging tests show that the sensor tags can operate at a distance of at least 3.6 m.

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Electrospinning (ES) can readily produce polymer fibers with cross-sectional dimensions ranging from tens of nanometers to tens of microns. Qualitative estimates of surface area coverage are rather intuitive. However, quantitative analytical and numerical methods for predicting surface coverage during ES have not been covered in sufficient depth to be applied in the design of novel materials, surfaces, and devices from ES fibers. This article presents a modeling approach to ES surface coverage where an analytical model is derived for use in quantitative prediction of surface coverage of ES fibers. The analytical model is used to predict the diameter of circular deposition areas of constant field strength and constant electrostatic force. Experimental results of polyvinyl alcohol fibers are reported and compared to numerical models to supplement the analytical model derived. The analytical model provides scientists and engineers a method for estimating surface area coverage. Both applied voltage and capillary-to-collection-plate separation are treated as independent variables for the analysis. The electric field produced by the ES process was modeled using COMSOL Multiphysics software to determine a correlation between the applied field strength and the size of the deposition area of the ES fibers. MATLAB scripts were utilized to combine the numerical COMSOL results with derived analytical equations. Experimental results reinforce the parametric trends produced via modeling and lend credibility to the use of modeling techniques for the qualitative prediction of surface area coverage from ES. (Copyright: 2014 American Vacuum Society.)

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We present in this paper several contributions on the collision detection optimization centered on hardware performance. We focus on the broad phase which is the first step of the collision detection process and propose three new ways of parallelization of the well-known Sweep and Prune algorithm. We first developed a multi-core model takes into account the number of available cores. Multi-core architecture enables us to distribute geometric computations with use of multi-threading. Critical writing section and threads idling have been minimized by introducing new data structures for each thread. Programming with directives, like OpenMP, appears to be a good compromise for code portability. We then proposed a new GPU-based algorithm also based on the "Sweep and Prune" that has been adapted to multi-GPU architectures. Our technique is based on a spatial subdivision method used to distribute computations among GPUs. Results show that significant speed-up can be obtained by passing from 1 to 4 GPUs in a large-scale environment.

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Lehrvideos erfreuen sich dank aktueller Entwicklungen im Bereich der Online-Lehre (Videoplattformen, MOOCs) auf der einen Seite und einer riesigen Auswahl sowie einer einfachen Produktion und Distribution auf der anderen Seite großer Beliebtheit bei der Wissensvermittlung. Trotzdem bringen Videos einen entscheidenden Nachteil mit sich, welcher in der Natur des Datenformats liegt. So sind die Suche nach konkreten Sachverhalten in einem Video sowie die semantische Aufbereitung zur automatisierten Verknüpfung mit weiteren spezifischen Inhalten mit hohem Aufwand verbunden. Daher werden die lernerfolg-orientierte Selektion von Lehrsegmenten und ihr Arrangement zur auf Lernprozesse abgestimmten Steuerung gehemmt. Beim Betrachten des Videos werden unter Umständen bereits bekannte Sachverhalte wiederholt bzw. können nur durch aufwendiges manuelles Spulen übersprungen werden. Selbiges Problem besteht auch bei der gezielten Wiederholung von Videoabschnitten. Als Lösung dieses Problems wird eine Webapplikation vorgestellt, welche die semantische Aufbereitung von Videos hin zu adaptiven Lehrinhalten ermöglicht: mittels Integration von Selbsttestaufgaben mit definierten Folgeaktionen können auf Basis des aktuellen Nutzerwissens Videoabschnitte automatisiert übersprungen oder wiederholt und externe Inhalte verlinkt werden. Der präsentierte Ansatz basiert somit auf einer Erweiterung der behavioristischen Lerntheorie der Verzweigten Lehrprogramme nach Crowder, die auf den Lernverlauf angepasste Sequenzen von Lerneinheiten beinhaltet. Gleichzeitig werden mittels regelmäßig eingeschobener Selbsttestaufgaben Motivation sowie Aufmerksamkeit des Lernenden nach Regeln der Programmierten Unterweisung nach Skinner und Verstärkungstheorie gefördert. Durch explizite Auszeichnung zusammengehöriger Abschnitte in Videos können zusätzlich die enthaltenden Informationen maschinenlesbar gestaltet werden, sodass weitere Möglichkeiten zum Auffinden und Verknüpfen von Lerninhalten geschaffen werden.

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OBJECTIVE To evaluate oncological outcome trends over the last three decades in patients after radical cystectomy (RC) and extended pelvic lymph node (LN) dissection. PATIENTS AND METHODS Retrospective analysis of the University of Southern California (USC) RC cohort of patients (1488 patients) operated with intent to cure from 1980 to 2005 for biopsy confirmed muscle-invasive urothelial bladder cancer. To focus on outcomes of unexpected (cN0M0) LN-positive patients, the USC subset was extended with unexpected LN-positive patients from the University of Berne (UB) (combined subgroup 521 patients). Patients were grouped and compared according to decade of surgery (1980-1989/1990-1999/≥2000). Survival probabilities were calculated with Kaplan-Meier plots, log-rank tests compared outcomes according to decade of surgery, followed by multivariable verification. RESULTS The 10-year recurrence-free survival was 78-80% in patients with organ-confined, LN-negative disease, 53-60% in patients with extravesical, yet LN-negative disease and ≈30% in LN-positive patients. Although the number of patients receiving systemic chemotherapy increased, no survival improvement was noted in either the entire USC cohort, or in the combined LN-positive USC-UB cohort. In contrast, patient age at surgery increased progressively, suggesting a relative survival benefit. CONCLUSIONS Radical surgery remains the mainstay of therapy for muscle-invasive bladder cancer. Yet, our study reveals predictable outcomes but no survival improvement in patients undergoing RC over the last three decades. Any future survival improvements are likely to result from more effective systemic treatments and/or earlier detection of the disease.