113 research outputs found
Breast Cancer Diagnosed During Pregnancy
Background:
Pregnancy-associated breast cancers are cancers diagnosed during pregnancy or within 1 year of delivery. It is rare, occurring in 2.5-7.5/100,000, but these numbers continue to rise as maternal age increases. As a result, prospective studies evaluating diagnosis and treatment are limited.
Case Description:
Patient is a P1G0 35 yo woman who presented with a new breast mass at 26 wga. Diagnostic workup including core biopsy revealed invasive ductal carcinoma, ER 70%, PR 40%, her-2 negative. After multidisciplinary discussion with the breast team and the patient’s obstetrician, the patient underwent mastectomy with sentinel node biopsy at 28 wga. Pathology showed a 1.9 cm tumor with 5 negative sentinel nodes. Genomic evaluation of her tumor using 21-gene recurrence score revealed significant risk of distant recurrence without chemotherapy. Patient will initiate chemotherapy after delivery.
Conclusion:
The treatment regimen should be as close to standard of care as possible for a non-pregnant woman with the same cancer. Diagnostic workup should include ultrasound and possible mammogram with shielding of the fetus. Core biopsy can provide definitive diagnosis. Surgery is the mainstay of treatment during pregnancy, and decisions regarding breast conservation are dependent on gestational age at presentation. Adjuvant treatments can be performed with modifications and avoidance of radiotherapy during pregnancy. Decisions regarding treatment require multidisciplinary input between the oncology and obstetric teams to provide effective care with minimal toxicity to the fetus.
Clinical Significance:
Physiological changes of the breast during pregnancy make diagnosis of new breast cancer difficult. Furthermore, lack of diagnostic suspicion delays diagnosis. Further research is needed to determine the best diagnostic and therapeutic methods to ensure the best prognosis for mother and baby as the prevalence of breast cancer during pregnancy continues to rise
Color Lie rings and PBW deformations of skew group algebras
We investigate color Lie rings over finite group algebras and their universal enveloping algebras. We exhibit these universal enveloping algebras as PBW deformations of skew group algebras: Every color Lie ring over a finite group algebra with a particular Yetter-Drinfeld structure has universal enveloping algebra that is a quantum Drinfeld orbifold algebra. Conversely, every quantum Drinfeld orbifold algebra of a particular type arising from the action of an abelian group is the universal enveloping algebra of some color Lie ring over the group algebra. One consequence is that these quantum Drinfeld orbifold algebras are braided Hopf algebras
Risky Sexual Behavior and Knowledge of HIV/AIDS Transmission in a Community Sample: Sexual Orientation, Race, and Gender
New cases of HIV/AIDS are disproportionately diagnosed among men who identify as lesbian, gay, and bisexual and Black. Reasons for this disparity may be related to differences in knowledge of how HIV/AIDS is transmitted and differences in willingness to engage in risky sexual behaviors. In this study, we examined whether differences in knowledge of HIV/AIDS transmission and engagement in risky sexual behaviors differed among men and women; lesbian, gay, and bisexual and heterosexual people; and White and Black people. Findings indicate knowledge of HIV/AIDS transmission was not related to sexual orientation or gender; however, White participants had higher scores on a measure of knowledge of HIV/AIDS transmission than Black participants. While neither gender nor race seemed to be related to differences in engaging in risky sexual behavior, differences in what types of risky sexual behavior people participated in existed based on sexual orientation. Implications for prevention efforts are addressed
Low energy H+CO scattering revisited - CO rotational excitation with new potential surfaces
Context. A recent modeling study of brightness ratios for CO rotational transitions in gas typical of the diffuse ISM by Liszt found the role of H collisions to be more important than previously assumed. This conclusion was based on recent quantum scattering calculations using the so-called WKS potential energy surface (PES) which reported a large cross section for the important 0 → 1 rotational transition. This result is in contradiction to one obtained using the earlier BBH PES for which the cross section is quite small and which is consistent with an expected homonuclear-like propensity for even ∆J transitions.
Aims. We revisit this contradiction with new scattering calculations using two new ab initio PESs that focus on the important long- range behavior and explore the validity of the apparent departure from the expected even ∆J propensity in H-CO rotational excitation obtained with the WKS PES.
Methods. Close-coupling (CC) rigid-rotor calculations for CO(v = 0, J = 0) excitation by H are performed on four different PESs. Two of the PESs are obtained in this work using state-of-the-art quantum chemistry techniques at the CCSD(T) and MRCI levels of theory.
Results. Cross sections for the J = 0 → 1, as well as other odd ∆J, transitions are significantly suppressed compared to even ∆J transitions in thermal energy CC calculations using the CCSD(T) and MRCI surfaces. This is consistent with the expected even ∆J propensity and in contrast to CC calculations using the WKS PES which predict a dominating 0 → 1 transition.
Conclusions. Inelastic collision cross section calculations are sensitive to fine details in the anisotropic components of the PES and its long-range behavior. The current results obtained with new surfaces for H-CO scattering suggest that the original astrophysical assumption that excitation of CO by H2 dominates the kinetics of CO in diffuse ISM gas is likely to remain valid
Revisiting the neuropathology of sudden infant death syndrome (SIDS)
Background: Sudden infant death syndrome (SIDS) is one of the leading causes of infant mortality in the United States (US). The extent to which SIDS manifests with an underlying neuropathological mechanism is highly controversial. SIDS correlates with markers of poor prenatal and postnatal care, generally rooted in the lack of access and quality of healthcare endemic to select racial and ethnic groups, and thus can be viewed in the context of health disparities. However, some evidence suggests that at least a subset of SIDS cases may result from a neuropathological mechanism. To explain these issues, a triple-risk hypothesis has been proposed, whereby an underlying biological abnormality in an infant facing an extrinsic risk during a critical developmental period SIDS is hypothesized to occur. Each SIDS decedent is thus thought to have a unique combination of these risk factors leading to their death. This article reviews the neuropathological literature of SIDS and uses machine learning tools to identify distinct subtypes of SIDS decedents based on epidemiological data. Methods: We analyzed US Period Linked Birth/Infant Mortality Files from 1990 to 2017 (excluding 1992–1994). Using t-SNE, an unsupervised machine learning dimensionality reduction algorithm, we identified clusters of SIDS decedents. Following identification of these groups, we identified changes in the rates of SIDS at the state level and across three countries. Results: Through t-SNE and distance based statistical analysis, we identified three groups of SIDS decedents, each with a unique peak age of death. Within the US, SIDS is geographically heterogeneous. Following this, we found low birth weight and normal birth weight SIDS rates have not been equally impacted by implementation of clinical guidelines. We show that across countries with different levels of cultural heterogeneity, reduction in SIDS rates has also been distinct between decedents with low vs. normal birth weight. Conclusions: Different epidemiological and extrinsic risk factors exist based on the three unique SIDS groups we identified with t-SNE and distance based statistical measurements. Clinical guidelines have not equally impacted the groups, and normal birth weight infants comprise more of the cases of SIDS even though low birth weight infants have a higher SIDS rate.Fil: Blackburn, Jessica. The Ohio State University College Of Medicine; Estados UnidosFil: Chapur, Valeria Fernanda. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones CientÃficas y Técnicas. Centro CientÃfico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; Argentina. Universidad Nacional de Jujuy. Instituto de BiologÃa de la Altura; ArgentinaFil: Stephens, Julie A.. The Ohio State University College Of Medicine; Estados UnidosFil: Zhao, Jing. The Ohio State University College Of Medicine; Estados UnidosFil: Shepler, Anne. The Ohio State University College Of Medicine; Estados UnidosFil: Pierson, Christopher R.. The Ohio State University College Of Medicine; Estados UnidosFil: Otero, José Javier. The Ohio State University College Of Medicine; Estados Unido
Authenticated storage using small trusted hardware
A major security concern with outsourcing data storage to third-party providers is authenticating the integrity and freshness of data. State-of-the-art software-based approaches require clients to maintain state and cannot immediately detect forking attacks, while approaches that introduce limited trusted hardware (e.g., a monotonic counter) at the storage server achieve low throughput. This paper proposes a new design for authenticating data storage using a small piece of high-performance trusted hardware attached to an untrusted server. The proposed design achieves significantly higher throughput than previous designs. The server-side trusted hardware allows clients to authenticate data integrity and freshness without keeping any mutable client-side state. Our design achieves high performance by parallelizing server-side authentication operations and permitting the untrusted server to maintain caches and schedule disk writes, while enforcing precise crash recovery and write access control
The role of normally hyperbolic invariant manifolds (NHIMS) in the context of the phase space setting for chemical reaction dynamics
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