The disruption of nearby galaxies by the Milky Way

Interactions between galaxies are common and are an important factor in determining their physical properties such as position along the Hubble sequence and star-formation rate. There are many possible galaxy interaction mechanisms, including merging, ram-pressure stripping, gas compression, gravitational interaction and cluster tides. The relative importance of these mechanisms is often not clear, as their strength depends on poorly known parameters such as the density, extent and nature of the massive dark halos that surround galaxies. A nearby example of a galaxy interaction where the mechanism is controversial is that between our own Galaxy and two of its neighbours -- the Large and Small Magellanic Clouds. Here we present the first results of a new HI survey which provides a spectacular view of this interaction. In addition to the previously known Magellanic Stream, which trails 100 degrees behind the Clouds, the new data reveal a counter-stream which lies in the opposite direction and leads the motion of the Clouds. This result supports the gravitational model in which leading and trailing streams are tidally torn from the body of the Magellanic Clouds.Comment: 17 pages with 5 figures in gif format, scheduled for publication in the August 20th, 1998 issue of Natur

Options for early breast cancer follow-up in primary and secondary care : a systematic review

Background Both incidence of breast cancer and survival have increased in recent years and there is a need to review follow up strategies. This study aims to assess the evidence for benefits of follow-up in different settings for women who have had treatment for early breast cancer. Method A systematic review to identify key criteria for follow up and then address research questions. Key criteria were: 1) Risk of second breast cancer over time - incidence compared to general population. 2) Incidence and method of detection of local recurrence and second ipsi and contra-lateral breast cancer. 3) Level 1–4 evidence of the benefits of hospital or alternative setting follow-up for survival and well-being. Data sources to identify criteria were MEDLINE, EMBASE, AMED, CINAHL, PSYCHINFO, ZETOC, Health Management Information Consortium, Science Direct. For the systematic review to address research questions searches were performed using MEDLINE (2011). Studies included were population studies using cancer registry data for incidence of new cancers, cohort studies with long term follow up for recurrence and detection of new primaries and RCTs not restricted to special populations for trials of alternative follow up and lifestyle interventions. Results Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival. Conclusions Long term support, surveillance mammography and fast access to medical treatment at point of need may be better than hospital based surveillance limited to five years but further large, randomised controlled trials are needed

New Galaxies Discovered in the First Blind HI Survey of the Centaurus A Group

We have commenced a 21-cm survey of the entire southern sky (\delta < 0 degrees, -1200 km/s < v < 12700 km/s) which is ''blind'', i.e. unbiased by previous optical information. In the present paper we report on the results of a pilot project which is based on data from this all-sky survey. The project was carried out on an area of 600 square degrees centred on the nearby Centaurus A (Cen A) group of galaxies at a mean velocity of v ~ 500 km/s. This was recently the subject of a separate and thorough optical survey. We found 10 new group members to add to the 21 galaxies already known in the Cen A group: five of these are previously uncatalogued galaxies, while five were previously catalogued but not known to be associated with the group. We found optical counterparts for all the HI detections, most of them intrinsically very faint low surface brightness dwarfs. The new group members add approximately 6% to the HI mass of the group and 4% to its light. The HI mass function, derived from all the known group galaxies in the interval 10^7 \Msun of HI to 10^9 \Msun of HI, has a faint-end slope of 1.30 +/- 0.15, allowing us to rule out a slope of 1.7 at 95% confidence. Even if the number in the lowest mass bin is increased by 50%, the slope only increases to 1.45 +/- 0.15.Comment: 19 pages Latex, 6 figures (Fig. 2 in four parts, Fig.5 in two parts). To appear in The Astrophysical Journal (Vol. 524, October 1999

Parasympathetic Activity and Blood Catecholamine Responses Following a Single Partial-Body Cryostimulation and a Whole-Body Cryostimulation

The aim of this study was to compare the effects of a single whole-body cryostimulation (WBC) and a partial-body cryostimulation (PBC) (i.e., not exposing the head to cold) on indices of parasympathetic activity and blood catecholamines. Two groups of 15 participants were assigned either to a 3-min WBC or PBC session, while 10 participants constituted a control group (CON) not receiving any cryostimulation. Changes in thermal, physiological and subjective variables were recorded before and during the 20-min after each cryostimulation. According to a qualitative statistical analysis, an almost certain decrease in skin temperature was reported for all body regions immediately after the WBC (mean decrease±90% CL, -13.7±0.7°C) and PBC (-8.3±0.3°C), which persisted up to 20-min after the session. The tympanic temperature almost certainly decreased only after the WBC session (-0.32±0.04°C). Systolic and diastolic blood pressures were very likely increased after the WBC session, whereas these changes were trivial in the other groups. In addition, heart rate almost certainly decreased after PBC (-10.9%) and WBC (-15.2%) sessions, in a likely greater proportion for WBC compared to PBC. Resting vagal-related heart rate variability indices (the root-mean square difference of successive normal R-R intervals, RMSSD, and high frequency band, HF) were very likely increased after PBC (RMSSD: +54.4%, HF: +138%) and WBC (RMSSD: +85.2%, HF: +632%) sessions without any marked difference between groups. Plasma norepinephrine concentrations were likely to very likely increased after PBC (+57.4%) and WBC (+76.2%), respectively. Finally, cold and comfort sensations were almost certainly altered after WBC and PBC, sensation of discomfort being likely more pronounced after WBC than PBC. Both acute cryostimulation techniques effectively stimulated the autonomic nervous system (ANS), with a predominance of parasympathetic tone activation. The results of this study also suggest that a whole-body cold exposure induced a larger stimulation of the ANS compared to partial-body cold exposure

Artificial Intelligence in Surgical Coding: Evaluating Large Language Models for Current Procedural Terminology Accuracy in Hand Surgery

PURPOSE: The advent of large language models (LLMs) like ChatGPT has introduced notable advancements in various surgical disciplines. These developments have led to an increased interest in the use of LLMs for Current Procedural Terminology (CPT) coding in surgery. With CPT coding being a complex and time-consuming process, often exacerbated by the scarcity of professional coders, there is a pressing need for innovative solutions to enhance coding efficiency and accuracy. METHODS: This observational study evaluated the effectiveness of five publicly available large language models-Perplexity.AI, Bard, BingAI, ChatGPT 3.5, and ChatGPT 4.0-in accurately identifying CPT codes for hand surgery procedures. A consistent query format was employed to test each model, ensuring the inclusion of detailed procedure components where necessary. The responses were classified as correct, partially correct, or incorrect based on their alignment with established CPT coding for the specified procedures. RESULTS: In the evaluation of artificial intelligence (AI) model performance on simple procedures, Perplexity.AI achieved the highest number of correct outcomes (15), followed by Bard and Bing AI (14 each). ChatGPT 4 and ChatGPT 3.5 yielded 8 and 7 correct outcomes, respectively. For complex procedures, Perplexity.AI and Bard each had three correct outcomes, whereas ChatGPT models had none. Bing AI had the highest number of partially correct outcomes (5). There were significant associations between AI models and performance outcomes for both simple and complex procedures. CONCLUSIONS: This study highlights the feasibility and potential benefits of integrating LLMs into the CPT coding process for hand surgery. The findings advocate for further refinement and training of AI models to improve their accuracy and practicality, suggesting a future where AI-assisted coding could become a standard component of surgical workflows, aligning with the ongoing digital transformation in health care. TYPE OF STUDY/LEVEL OF EVIDENCE: Observational, IIIb

'Linkage' pharmaceutical evergreening in Canada and Australia

'Evergreening' is not a formal concept of patent law. It is best understood as a social idea used to refer to the myriad ways in which pharmaceutical patent owners utilise the law and related regulatory processes to extend their high rent-earning intellectual monopoly privileges, particularly over highly profitable (either in total sales volume or price per unit) 'blockbuster' drugs. Thus, while the courts are an instrument frequently used by pharmaceutical brand name manufacturers to prolong their patent royalties, 'evergreening' is rarely mentioned explicitly by judges in patent protection cases. The term usually refers to threats made to competitors about a brand-name manufacturer's tactical use of pharmaceutical patents (including over uses, delivery systems and even packaging), not to extension of any particular patent over an active product ingredient. This article focuses in particular on the 'evergreening' potential of so-called 'linkage' provisions, imposed on the regulatory (safety, quality and efficacy) approval systems for generic pharmaceuticals of Canada and Australia, by specific articles in trade agreements with the US. These 'linkage' provisions have also recently appeared in the Korea-US Free Trade Agreement (KORUSFTA). They require such drug regulators to facilitate notification of, or even prevent, any potential patent infringement by a generic pharmaceutical manufacturer. This article explores the regulatory lessons to be learnt from Canada's and Australia's shared experience in terms of minimizing potential adverse impacts of such 'linkage evergreening' provisions on drug costs and thereby potentially on citizen's access to affordable, essential medicines

Factors associated with use of breast cancer screening services by women aged ≥ 40 years in Korea: The Third Korea National Health and Nutrition Examination Survey 2005 (KNHANES III)

<p>Abstract</p> <p>Background</p> <p>Despite evidence that breast cancer screening reduces morbidity and mortality, until recently most women have not undergone regular mammogram examinations in Korea. We aimed to identify factors associated with use of breast cancer screening services.</p> <p>Methods</p> <p>The Health Promotion Knowledge, Attitude and Practice survey (HP-KAP survey) is part of the Third Korea National Health and Nutrition Examination Survey 2005 (KNHANES III), a nationwide health survey in Korea. Of 7,802 individuals who participated in the HP-KAP survey, 4,292 were female. Of these, 2,583 were women aged at least 40 years and without a history of breast cancer; these women were included in this study. Information about breast cancer screening participation was obtained from the responses to questionnaires. The overall rate of regular breast cancer screening was measured. Factors that affect participation in a breast cancer screening program were identified using multiple logistic regression analysis.</p> <p>Results</p> <p>Among women aged at least 40 years, 30.4% complied with breast screening recommendations. Age of at least 65 years (adjusted odds ratio, aOR 0.61, 95% CI: 0.42-0.88), education level (no [ref], elementary school [aOR 1.51, 95% CI: 1.06-1.47], middle/high school [aOR 1.99, 95% CI: 1.36-2.92], university/higher [aOR 2.73, 95% CI: 1.71-4.35]), private health insurance (aOR 1.42, 95% CI: 1.71-4.35), attitude towards screening tests (aOR 0.18, 95% CI: 0.14-0.23), self-reported health status of 'fair' (aOR 1.26 95% CI: 1.00-1.58), and smoking (aOR 0.52, 95% CI: 0.35-0.79) were associated with the rate of regular breast cancer screening</p> <p>Conclusions</p> <p>To increase the nationwide breast cancer screening rate, more attention should be given to underrepresented groups, particularly the elderly, those with a low education level, smokers, and those with a negative attitude towards screening tests. These issues highlight the need for a new emphasis in health education, promotional campaigns and public health policy aimed at these underrepresented groups.</p