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1.
Nat Commun ; 13(1): 7390, 2022 Nov 30.
Article in English | MEDLINE | ID: mdl-36450728

ABSTRACT

Mercury's southern inner magnetosphere is an unexplored region as it was not observed by earlier space missions. In October 2021, BepiColombo mission has passed through this region during its first Mercury flyby. Here, we describe the observations of SERENA ion sensors nearby and inside Mercury's magnetosphere. An intermittent high-energy signal, possibly due to an interplanetary magnetic flux rope, has been observed downstream Mercury, together with low energy solar wind. Low energy ions, possibly due to satellite outgassing, were detected outside the magnetosphere. The dayside magnetopause and bow-shock crossing were much closer to the planet than expected, signature of a highly eroded magnetosphere. Different ion populations have been observed inside the magnetosphere, like low latitude boundary layer at magnetopause inbound and partial ring current at dawn close to the planet. These observations are important for understanding the weak magnetosphere behavior so close to the Sun, revealing details never reached before.

2.
Nat Commun ; 13(1): 924, 2022 Feb 17.
Article in English | MEDLINE | ID: mdl-35177615

ABSTRACT

The magnetic gradient and curvature drift of energetic ions can form a longitudinal electric current around a planet known as the ring current, that has been observed in the intrinsic magnetospheres of Earth, Jupiter, and Saturn. However, there is still a lack of observational evidence of ring current in Mercury's magnetosphere, which has a significantly weaker dipole magnetic field. Under such conditions, charged particles are thought to be efficiently lost through magnetopause shadowing and/or directly impact the planetary surface. Here, we present the observational evidence of Mercury's ring current by analysing particle measurements from MErcury Surface, Space Environment, GEochemistry, and Ranging (MESSENGER) spacecraft. The ring current is bifurcated because of the dayside off-equatorial magnetic minima. Test-particle simulation with Mercury's dynamic magnetospheric magnetic field model (KT17 model) validates this morphology. The ring current energy exceeds [Formula: see text] J during active times, indicating that magnetic storms may also occur on Mercury.

3.
Space Sci Rev ; 217(1): 11, 2021.
Article in English | MEDLINE | ID: mdl-33487762

ABSTRACT

The ESA-JAXA BepiColombo mission to Mercury will provide simultaneous measurements from two spacecraft, offering an unprecedented opportunity to investigate magnetospheric and exospheric particle dynamics at Mercury as well as their interactions with solar wind, solar radiation, and interplanetary dust. The particle instrument suite SERENA (Search for Exospheric Refilling and Emitted Natural Abundances) is flying in space on-board the BepiColombo Mercury Planetary Orbiter (MPO) and is the only instrument for ion and neutral particle detection aboard the MPO. It comprises four independent sensors: ELENA for neutral particle flow detection, Strofio for neutral gas detection, PICAM for planetary ions observations, and MIPA, mostly for solar wind ion measurements. SERENA is managed by a System Control Unit located inside the ELENA box. In the present paper the scientific goals of this suite are described, and then the four units are detailed, as well as their major features and calibration results. Finally, the SERENA operational activities are shown during the orbital path around Mercury, with also some reference to the activities planned during the long cruise phase.

4.
J Geophys Res Space Phys ; 125(7): e2019JA027410, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32999805

ABSTRACT

The Vlasiator hybrid-Vlasov code was developed to investigate global magnetospheric dynamics at ion-kinetic scales. Here we focus on the role of magnetic reconnection in the formation and evolution of magnetic islands at the low-latitude magnetopause, under southward interplanetary magnetic field conditions. The simulation results indicate that (1) the magnetic reconnection ion kinetics, including the Earthward pointing Larmor electric field on the magnetospheric side of an X-point and anisotropic ion distributions, are well-captured by Vlasiator, thus enabling the study of reconnection-driven magnetic island evolution processes, (2) magnetic islands evolve due to continuous reconnection at adjacent X-points, "coalescence" which refers to the merging of neighboring islands to create a larger island, "erosion" during which an island loses magnetic flux due to reconnection, and "division" which involves the splitting of an island into smaller islands, and (3) continuous reconnection at adjacent X-points is the dominant source of magnetic flux and plasma to the outer layers of magnetic islands resulting in cross-sectional growth rates up to + 0.3 RE 2/min. The simulation results are compared to the Magnetospheric Multiscale (MMS) measurements of a chain of ion-scale flux transfer events (FTEs) sandwiched between two dominant X-lines. The MMS measurements similarly reveal (1) anisotropic ion populations and (2) normalized reconnection rate ~0.18, in agreement with theory and the Vlasiator predictions. Based on the simulation results and the MMS measurements, it is estimated that the observed ion-scale FTEs may grow Earth-sized within ~10 min, which is comparable to the average transport time for FTEs formed in the subsolar region to the high-latitude magnetopause. Future simulations shall revisit reconnection-driven island evolution processes with improved spatial resolutions.

5.
Benef Microbes ; 11(2): 101-129, 2020 Mar 27.
Article in English | MEDLINE | ID: mdl-32073295

ABSTRACT

The inherent and diverse capacity of dietary fibres, nondigestible oligosaccharides (NDOs) and prebiotics to modify the gut microbiota and markedly influence health status of the host has attracted rising interest. Research and collective initiatives to determine the composition and diversity of the human gut microbiota have increased over the past decade due to great advances in high-throughput technologies, particularly the 16S ribosomal RNA (rRNA) sequencing. Here we reviewed the application of 16S rRNA-based molecular technologies, both community wide (sequencing and phylogenetic microarrays) and targeted methodologies (quantitative PCR, fluorescent in situ hybridisation) to study the effect of chicory inulin-type fructans, NDOs and specific added fibres, such as resistant starches, on the human intestinal microbiota. Overall, such technologies facilitated the monitoring of microbiota shifts due to prebiotic/fibre consumption, though there are limited community-wide sequencing studies so far. Molecular studies confirmed the selective bifidogenic effect of fructans and galactooligosaccharides (GOS) in human intervention studies. Fructans only occasionally decreased relative abundance of Bacteroidetes or stimulated other groups. The sequencing studies for various resistant starches, polydextrose and beta-glucan showed broader effects with more and different types of gut microbial species being enhanced, often including phylotypes of Ruminococcaceae. There was substantial variation in terms of magnitude of response and in individual responses to a specific fibre or NDO which may be due to numerous factors, such as initial presence and relative abundance of a microbial type, diet, genetics of the host, and intervention parameters, such as intervention duration and fibre dose. The field will clearly benefit from a more systematic approach that will support defining the impact of prebiotics and fibres on the gut microbiome, identify biomarkers that link gut microbes to health, and address the personalised response of an individual's microbiota to prebiotics and dietary fibres.


Subject(s)
Diet , Dietary Fiber , Fructans , Gastrointestinal Microbiome/genetics , Prebiotics , Feces/microbiology , Humans , Phylogeny , RNA, Ribosomal, 16S/genetics
6.
J Geophys Res Space Phys ; 123(12): 10109-10123, 2018 Dec.
Article in English | MEDLINE | ID: mdl-31008003

ABSTRACT

A simple Monte Carlo model is presented that considers the effects of spacecraft orbital sampling on the inferred distribution of magnetic flux ropes, generated through magnetic reconnection in the magnetotail current sheet. When generalized, the model allows the determination of the number of orbits required to constrain the underlying population of structures: It is able to quantify this as a function of the physical parameters of the structures (e.g., azimuthal extent and probability of generation). The model is shown adapted to the Hermean magnetotail, where the outputs are compared to the results of a recent survey. This comparison suggests that the center of Mercury's neutral line is located dawnward of midnight by 0 . 3 7 - 1 . 02 + 1 . 21 R M and that the flux ropes are most likely to be wide azimuthally (∼50% of the width of the Hermean tail). The downtail location of the neutral line is not self-consistent or in agreement with previous (independent) studies unless dissipation terms are included planetward of the reconnection site; potential physical explanations are discussed. In the future the model could be adapted to other environments, for example, the dayside magnetopause or other planetary magnetotails.

7.
J Geophys Res Space Phys ; 123(12): 10124-10138, 2018 Dec.
Article in English | MEDLINE | ID: mdl-31008004

ABSTRACT

A Monte Carlo method of investigating the effects of placing selection criteria on the magnetic signature of in situ encounters with flux ropes is presented. The technique is applied to two recent flux rope surveys of MESSENGER data within the Hermean magnetotail. It is found that the different criteria placed upon the signatures will preferentially identify slightly different subsets of the underlying population. Quantifying the selection biases first allows the distributions of flux rope parameters to be corrected, allowing a more accurate estimation of the intrinsic distributions. This is shown with regard to the distribution of flux rope radii observed. When accounting for the selection criteria, the mean radius of Hermean magnetotail quasi-force-free flux ropes is found to be 58 9 - 269 + 273  km. Second, it is possible to weight the known identifications in order to determine a rate of recurrence that accounts for the presence of the structures that will not be identified. In the case of the Hermean magnetotail, the average rate of quasi-force-free flux ropes is found to 0.12 min-1 when selection effects are accounted for (up from 0.05 min-1 previously inferred from observations).

8.
Geophys Res Lett ; 44(8): 3456-3464, 2017 04 28.
Article in English | MEDLINE | ID: mdl-28713180

ABSTRACT

We report global observations of high-m poloidal waves during the recovery phase of the 22 June 2015 magnetic storm from a constellation of widely spaced satellites of five missions including Magnetospheric Multiscale (MMS), Van Allen Probes, Time History of Events and Macroscale Interactions during Substorm (THEMIS), Cluster, and Geostationary Operational Environmental Satellites (GOES). The combined observations demonstrate the global spatial extent of storm time poloidal waves. MMS observations confirm high azimuthal wave numbers (m ~ 100). Mode identification indicates the waves are associated with the second harmonic of field line resonances. The wave frequencies exhibit a decreasing trend as L increases, distinguishing them from the single-frequency global poloidal modes normally observed during quiet times. Detailed examination of the instantaneous frequency reveals discrete spatial structures with step-like frequency changes along L. Each discrete L shell has a steady wave frequency and spans about 1 RE , suggesting that there exist a discrete number of drift-bounce resonance regions across L shells during storm times.

9.
Science ; 356(6341): 960-963, 2017 06 02.
Article in English | MEDLINE | ID: mdl-28572393

ABSTRACT

The magnetopause deflects the solar wind plasma and confines Earth's magnetic field. We combine measurements made by the four spacecraft of the Magnetospheric Multiscale mission to demonstrate how the plasma and magnetic forces at the boundary affect the interaction between the shocked solar wind and Earth's magnetosphere. We compare these forces with the plasma pressure and examine the electron distribution function. We find that the magnetopause has sublayers with thickness comparable to the ion scale. Small pockets of low magnetic field strength, small radius of curvature, and high electric current mark the electron diffusion region. The flow of electrons, parallel and antiparallel to the magnetic field, reveals a complex topology with the creation of magnetic ropes at the boundary.

10.
Colorectal Dis ; 19(4): 385-394, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27654996

ABSTRACT

AIM: The study investigated the rate of significant venous thromboembolism (VTE) following colorectal resection during the index admission and over 1 year following discharge. It identifies risk factors associated with VTE and considers the length of VTE prophylaxis required. METHOD: All adult patients who underwent colorectal resections in England between April 2007 and March 2008 were identified using Hospital Episode Statistics data. They were studied during the index admission and followed for a year to identify any patients who were readmitted as an emergency with a diagnosis of deep venous thrombosis or pulmonary embolism. RESULTS: In all, 35 997 patients underwent colorectal resection during the period of study. The VTE rate was 2.3%. Two hundred and one (0.56%) patients developed VTE during the index admission and 571 (1.72%) were readmitted with VTE. Following discharge from the index admission, the risk of VTE in patients with cancer remained elevated for 6 months compared with 2 months in patients with benign disease. Age, postoperative stay, cancer, emergency admission and emergency surgery for patients with inflammatory bowel disease (IBD) were all independent risk factors associated with an increased risk of VTE. Patients with ischaemic heart disease and those having elective minimal access surgery appear to have lower levels of VTE. CONCLUSION: This study adds to the benefits of minimal access surgery and demonstrates an additional risk to patients undergoing emergency surgery for IBD. The majority of VTE cases occur following discharge from the index admission. Therefore, surgery for cancer, emergency surgery for IBD and those with an extended hospital stay may benefit from extended VTE prophylaxis. This study demonstrates that a stratified approach may be required to reduce the incidence of VTE.


Subject(s)
Colectomy/adverse effects , Postoperative Complications/epidemiology , Pulmonary Embolism/epidemiology , Venous Thromboembolism/epidemiology , Venous Thrombosis/epidemiology , Aged , Aged, 80 and over , Colectomy/methods , Emergency Treatment/adverse effects , Emergency Treatment/methods , England/epidemiology , Female , Follow-Up Studies , Humans , Incidence , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/surgery , Male , Middle Aged , Myocardial Ischemia/complications , Myocardial Ischemia/surgery , Neoplasms/complications , Neoplasms/surgery , Patient Discharge/statistics & numerical data , Patient Readmission/statistics & numerical data , Postoperative Complications/etiology , Pulmonary Embolism/etiology , Retrospective Studies , Risk Factors , Treatment Outcome , Venous Thromboembolism/etiology , Venous Thrombosis/etiology
11.
Geophys Res Lett ; 43(10): 4841-4849, 2016 05 28.
Article in English | MEDLINE | ID: mdl-27867235

ABSTRACT

We report on field-aligned current observations by the four Magnetospheric Multiscale (MMS) spacecraft near the plasma sheet boundary layer (PSBL) during two major substorms on 23 June 2015. Small-scale field-aligned currents were found embedded in fluctuating PSBL flux tubes near the separatrix region. We resolve, for the first time, short-lived earthward (downward) intense field-aligned current sheets with thicknesses of a few tens of kilometers, which are well below the ion scale, on flux tubes moving equatorward/earthward during outward plasma sheet expansion. They coincide with upward field-aligned electron beams with energies of a few hundred eV. These electrons are most likely due to acceleration associated with a reconnection jet or high-energy ion beam-produced disturbances. The observations highlight coupling of multiscale processes in PSBL as a consequence of magnetotail reconnection.

12.
Geophys Res Lett ; 43(10): 4716-4724, 2016 05 28.
Article in English | MEDLINE | ID: mdl-27635105

ABSTRACT

New Magnetospheric Multiscale (MMS) observations of small-scale (~7 ion inertial length radius) flux transfer events (FTEs) at the dayside magnetopause are reported. The 10 km MMS tetrahedron size enables their structure and properties to be calculated using a variety of multispacecraft techniques, allowing them to be identified as flux ropes, whose flux content is small (~22 kWb). The current density, calculated using plasma and magnetic field measurements independently, is found to be filamentary. Intercomparison of the plasma moments with electric and magnetic field measurements reveals structured non-frozen-in ion behavior. The data are further compared with a particle-in-cell simulation. It is concluded that these small-scale flux ropes, which are not seen to be growing, represent a distinct class of FTE which is generated on the magnetopause by secondary reconnection.

13.
Geophys Res Lett ; 43(12): 6012-6019, 2016 06 28.
Article in English | MEDLINE | ID: mdl-27478286

ABSTRACT

We present a statistical study of dipolarization fronts (DFs), using magnetic field data from MMS and Cluster, at radial distances below 12 RE and 20 RE , respectively. Assuming that the DFs have a semicircular cross section and are propelled by the magnetic tension force, we used multispacecraft observations to determine the DF velocities. About three quarters of the DFs propagate earthward and about one quarter tailward. Generally, MMS is in a more dipolar magnetic field region and observes larger-amplitude DFs than Cluster. The major findings obtained in this study are as follows: (1) At MMS ∼57 % of the DFs move faster than 150 km/s, while at Cluster only ∼35 %, indicating a variable flux transport rate inside the flow-braking region. (2) Larger DF velocities correspond to higher Bz  values directly ahead of the DFs. We interpret this as a snow plow-like phenomenon, resulting from a higher magnetic flux pileup ahead of DFs with higher velocities.

14.
Surg Endosc ; 30(8): 3516-25, 2016 08.
Article in English | MEDLINE | ID: mdl-26830413

ABSTRACT

OBJECTIVES: To determine the incidence of bile duct reconstruction (BDR) following laparoscopic cholecystectomy (LC) and to identify associated risk factors. BACKGROUND: Major bile duct injury (BDI) requiring reconstruction is a serious complication of cholecystectomy. METHODS: All LC and attempted LC operations in England between April 2001 and March 2013 were identified. Patients with malignancy, a stone in bile duct or those who underwent bile duct exploration were excluded. This cohort of patients was followed for 1 year to identify those who underwent BDR as a surrogate marker for major BDI. Logistic regression was used to identify factors associated with the need for reconstruction. RESULTS: In total, 572,223 LC and attempted LC were performed in England between April 2001 and March 2013. Five hundred (0.09 %) of these patients underwent BDR. The risk of BDR is lower in patient that do not have acute cholecystitis [odds ratio (OR) 0.48 (95 % CI 0.30-0.76)]. The regular use of on-table cholangiography (OTC) [OR 0.69 (0.54-0.88)] and high consultant caseload >80 LC/year [OR 0.56 (0.39-0.54)] reduced the risk of BDR. Patients who underwent BDR were 10 times more likely to die within a year than those who did not require further surgery (6 vs. 0.6 %). CONCLUSIONS: The rate of BDR following laparoscopic cholecystectomy in England is low (0.09 %). The study suggests that OTC should be used more widely and provides further evidence in support of the provision of LC services by specialised teams with an adequate caseload (>80).


Subject(s)
Bile Ducts/injuries , Bile Ducts/surgery , Cholecystectomy, Laparoscopic/adverse effects , Aged , Cholangiography , Cholecystitis/complications , England , Female , Humans , Intraoperative Complications/etiology , Intraoperative Complications/prevention & control , Male , Middle Aged , Risk Factors
15.
BJR Case Rep ; 1(1): 20150104, 2015.
Article in English | MEDLINE | ID: mdl-30363208

ABSTRACT

We report an occurrence of periosteal chondroma seeding into the medulla of humerus via percutaneous needle biopsy tract. To our knowledge, this is the first described case of benign cartilage tumour biopsy tract seeding in the literature. We discuss the clinical, radiological and histological features of periosteal chondroma, as well as the diagnostic challenges associated with distinguishing this entity from periosteal chondrosarcoma. Finally, we briefly discuss the safety of imaging-guided percutaneous needle biopsy and methods to minimize the risk of iatrogenic tumour seeding.

16.
Earth Space Sci ; 2(4): 115-124, 2015 04.
Article in English | MEDLINE | ID: mdl-27981071

ABSTRACT

In this data report we discuss reprocessing of the Space Technology 5 (ST5) magnetometer database for inclusion in NASA's Coordinated Data Analysis Web (CDAWeb) virtual observatory. The mission consisted of three spacecraft flying in elliptical orbits, from 27 March to 27 June 2006. Reprocessing includes (1) transforming the data into the Modified Apex Coordinate System for projection to a common reference altitude of 110 km, (2) correcting gain jumps, and (3) validating the results. We display the averaged magnetic perturbations as a keogram, which allows direct comparison of the full-mission data with the solar wind values and geomagnetic indices. With the data referenced to a common altitude, we find the following: (1) Magnetic perturbations that track the passage of corotating interaction regions and high-speed solar wind; (2) unexpectedly strong dayside perturbations during a solstice magnetospheric sawtooth oscillation interval characterized by a radial interplanetary magnetic field (IMF) component that may have enhanced the accompanying modest southward IMF; and (3) intervals of reduced magnetic perturbations or "calms," associated with periods of slow solar wind, interspersed among variable-length episodic enhancements. These calms are most evident when the IMF is northward or projects with a northward component onto the geomagnetic dipole. The reprocessed ST5 data are in very good agreement with magnetic perturbations from the Defense Meteorological Satellite Program (DMSP) spacecraft, which we also map to 110 km. We briefly discuss the methods used to remap the ST5 data and the means of validating the results against DMSP. Our methods form the basis for future intermission comparisons of space-based magnetometer data.

17.
Oncogene ; 34(22): 2922-33, 2015 May 28.
Article in English | MEDLINE | ID: mdl-25043296

ABSTRACT

Osteosarcoma (OS) is the most common cancer of bone. Parathyroid hormone (PTH) regulates calcium homeostasis and bone development, while the paracrine/autocrine PTH-related protein (PTHrP) has central roles in endochondral bone formation and bone remodeling. Using a murine OS model, we found that OS cells express PTHrP and the common PTH/PTHrP receptor (PTHR1). To investigate the role of PTHR1 signaling in OS cell behavior, we used shRNA to reduce PTHR1 expression. This only mildly inhibited proliferation in vitro, but markedly reduced invasion through collagen and reduced expression of RANK ligand (RANKL). Administration of PTH(1-34) did not stimulate OS proliferation in vivo but, strikingly, PTHR1 knockdown resulted in a profound growth inhibition and increased differentiation/mineralization of the tumors. Treatment with neutralizing antibody to PTHrP did not recapitulate the knockdown of PTHR1. Consistent with this lack of activity, PTHrP was predominantly intracellular in OS cells. Knockdown of PTHR1 resulted in increased expression of late osteoblast differentiation genes and upregulation of Wnt antagonists. RANKL production was reduced in knockdown tumors, providing for reduced homotypic signaling through the receptor, RANK. Loss of PTHR1 resulted in the coordinated loss of gene signatures associated with the polycomb repressive complex 2 (PRC2). Using Ezh2 inhibitors, we demonstrate that the increased expression of osteoblast maturation markers is in part mediated by the loss of PRC2 activity. Collectively these results demonstrate that PTHR1 signaling is important in maintaining OS proliferation and undifferentiated state. This is in part mediated by intracellular PTHrP and through regulation of the OS epigenome.


Subject(s)
Bone Neoplasms/genetics , Bone Neoplasms/pathology , Cell Differentiation/genetics , Cell Proliferation/genetics , Osteosarcoma/genetics , Osteosarcoma/pathology , Receptor, Parathyroid Hormone, Type 1/genetics , Animals , Cell Differentiation/drug effects , Cell Proliferation/drug effects , Down-Regulation/drug effects , Down-Regulation/genetics , Gene Expression Regulation, Neoplastic/drug effects , Gene Knockdown Techniques , Humans , Mice , Mice, Inbred BALB C , Mice, Nude , Neoplasm Invasiveness , RNA, Small Interfering/pharmacology , Receptor, Parathyroid Hormone, Type 1/antagonists & inhibitors , Tumor Cells, Cultured
18.
Br J Cancer ; 111(12): 2254-61, 2014 Dec 09.
Article in English | MEDLINE | ID: mdl-25321190

ABSTRACT

BACKGROUND: Preoperative radiotherapy (RT) is commonly used to treat localised soft-tissue sarcomas (STS). Hypoxia is an important determinant of radioresistance. Whether antiangiogenic therapy can 'normalise' tumour vasculature, thereby improving oxygenation, remains unknown. METHODS: Two cohorts were prospectively enrolled. Cohort A evaluated the implications of hypoxia in STS, using the hypoxic tracer (18)F-azomycin arabinoside (FAZA-PET). In cohort B, sunitinib was added to preoperative RT in a dose-finding phase 1b/2 design. RESULTS: In cohort A, 13 out of 23 tumours were hypoxic (FAZA-PET), correlating with metabolic activity (r(2)=0.85; P<0.001). Two-year progression-free (PFS) and overall (OS) survival were 61% (95% CI: 0.44-0.84) and 87% (95% CI: 0.74-1.00), respectively. Hypoxia was associated with radioresistance (P=0.012), higher local recurrence (Hazard ratio (HR): 10.2; P=0.02), PFS (HR: 8.4; P=0.02), and OS (HR: 41.4; P<0.04). In Cohort B, seven patients received sunitinib at dose level (DL): 0 (50 mg per day for 2 weeks before RT; 25 mg per day during RT) and two patients received DL: -1 (37.5 mg per day for entire period). Dose-limiting toxicities were observed in 4 out of 7 patients at DL 0 and 2 out of 2 patients at DL -1, resulting in premature study closure. Although there was no difference in PFS or OS, patients receiving sunitinib had higher local failure (HR: 8.1; P=0.004). CONCLUSION: In STS, hypoxia is associated with adverse outcomes. The combination of sunitinib with preoperative RT resulted in unacceptable toxicities, and higher local relapse rates.


Subject(s)
Antineoplastic Agents/administration & dosage , Indoles/administration & dosage , Pyrroles/administration & dosage , Sarcoma/drug therapy , Sarcoma/radiotherapy , Adult , Aged , Aged, 80 and over , Cohort Studies , Dose-Response Relationship, Drug , Dose-Response Relationship, Radiation , Female , Humans , Male , Middle Aged , Neoadjuvant Therapy , Neoplasm Recurrence, Local , Positron-Emission Tomography , Prospective Studies , Radiotherapy, Adjuvant , Sunitinib
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