Treatment of Girls and Boys with McCune-Albright Syndrome with Precocious Puberty - Update 2017

The most common endocrinopathy associated with McCune-Albright Syndrome (MAS) is peripheral precocious puberty (PP) which occurs far more often in girls than in boys. We will discuss the latest advancements in the treatment of precocious puberty in MAS that have been achieved during the past 10 years. However, due to the rarity of the condition and the heterogeneity of the disease, research in this field is limited particularly in regards to treatment in boys. In girls, a period of watchful waiting is recommended prior to initiating therapy due to extreme variability in the clinical course. This article will review in detail current pharmacologic treatment in girls, which typically consists of either inhibiting estrogen production or blocking estrogen action at the level of the end-organ. The two treatments with the most evidence at this time are Tamoxifen (which is an estrogen receptor modulator) and Letrozole (which is a 3rd generation aromatase inhibitor). This article will also review the current treatment strategies in boys which typically include using an androgen receptor blocker and an aromatase inhibitor. Due to the rarity of the condition, large multicenter collaborative studies are needed to further investigate efficacy and safety with the goal of establishing the gold standard for treatment of PP in children with MAS

Higgs look-alikes at the LHC

The discovery of a Higgs particle is possible in a variety of search channels at the LHC. However the true identity of any putative Higgs boson will at first remain ambiguous, until one has experimentally excluded other possible assignments of quantum numbers and couplings. We quantify to what degree one can discriminate a Standard Model Higgs boson from "look-alikes" at, or close to, the moment of discovery at the LHC. We focus on the fully-reconstructible "golden" decay mode to a pair of Z bosons and a four-lepton final state, simulating sPlot-weighted samples of signal and background events. Considering both on-shell and off-shell Z's, we show how to utilize the full decay information from the events, including the distributions and correlations of the five relevant angular variables. We demonstrate how the finite phase space acceptance of any LHC detector sculpts the decay distributions, a feature neglected in previous studies. We use likelihood ratios to discriminate a Standard Model Higgs from look-alikes with other spins or nonstandard parity, CP, or form factors. For a benchmark resonance mass of 200 GeV/c^2, we achieve a median expected discrimination significance of 3 sigma with as few as 19 events, and even better discrimination for the off-shell decays of a 145 GeV/c^2 resonance.Comment: 39 pages, 55 figures, typos fixed, figures added, and minor clarification

When Can Limited Randomness Be Used in Repeated Games?

The central result of classical game theory states that every finite normal form game has a Nash equilibrium, provided that players are allowed to use randomized (mixed) strategies. However, in practice, humans are known to be bad at generating random-like sequences, and true random bits may be unavailable. Even if the players have access to enough random bits for a single instance of the game their randomness might be insufficient if the game is played many times. In this work, we ask whether randomness is necessary for equilibria to exist in finitely repeated games. We show that for a large class of games containing arbitrary two-player zero-sum games, approximate Nash equilibria of the $n$-stage repeated version of the game exist if and only if both players have $\Omega(n)$ random bits. In contrast, we show that there exists a class of games for which no equilibrium exists in pure strategies, yet the $n$-stage repeated version of the game has an exact Nash equilibrium in which each player uses only a constant number of random bits. When the players are assumed to be computationally bounded, if cryptographic pseudorandom generators (or, equivalently, one-way functions) exist, then the players can base their strategies on "random-like" sequences derived from only a small number of truly random bits. We show that, in contrast, in repeated two-player zero-sum games, if pseudorandom generators \emph{do not} exist, then $\Omega(n)$ random bits remain necessary for equilibria to exist

Bicalutamide as an Androgen Blocker With Secondary Effect of Promoting Feminization in Male-to-Female Transgender Adolescents

PURPOSE: The purpose of the study was to describe the novel use of bicalutamide in transgender youth. METHODS: This is a retrospective review of patients with gender dysphoria followed in the pediatric endocrine clinic at Riley Hospital for Children. RESULTS: Of 104 patients with gender dysphoria, 23 male-to-female adolescents received bicalutamide 50 mg daily as a second-line puberty blocker after insurance company denial of a gonadotropin-releasing hormone analog. Six patients received estrogen concurrently. Of 13 patients treated exclusively with bicalutamide seen in follow-up, 84.6% had breast development within 6 months, the majority being ≥ Tanner stage III. CONCLUSIONS: Bicalutamide may be an alternative to gonadotropin-releasing hormone analogs in transgender male-to-female youth who are also ready to undergo physical transition

Energetic stability of absorbed H in Pd and Pt nanoparticles in a more realistic environment

Absorbed hydrogen can dramatically increase hydrogenation activity of Pd nanoparticles and was predicted to do so also for Pt. This calls for investigations of the energetic stability of absorbed H in Pd and Pt using nanoparticle models as realistic as possible, i.e., (i) sufficiently large, (ii) supported, and (iii) precovered by hydrogen. Herein, hydrogen absorption is studied in MgO(100)-supported 1.6 nm large Pd and Pt nanoparticles with surfaces saturated by hydrogen. The effect of surface H on the stability of absorbed H is found to be significant and to exceed the effect of the support. H absorption is calculated to be endothermic in Pt, energy neutral in Pd(111) and bare Pd nanoparticles, and exothermic in H-covered Pd nanoparticles. Hence, we identify the abundance of surface H and the nanostructuring of Pd as prerequisites for facile absorption of hydrogen in Pd and for the concomitantly altered catalytic activity

Detecting a stochastic background of gravitational waves in the presence of non-Gaussian noise: A performance of generalized cross-correlation statistic

We discuss a robust data analysis method to detect a stochastic background of gravitational waves in the presence of non-Gaussian noise. In contrast to the standard cross-correlation (SCC) statistic frequently used in the stochastic background searches, we consider a {\it generalized cross-correlation} (GCC) statistic, which is nearly optimal even in the presence of non-Gaussian noise. The detection efficiency of the GCC statistic is investigated analytically, particularly focusing on the statistical relation between the false-alarm and the false-dismissal probabilities, and the minimum detectable amplitude of gravitational-wave signals. We derive simple analytic formulae for these statistical quantities. The robustness of the GCC statistic is clarified based on these formulae, and one finds that the detection efficiency of the GCC statistic roughly corresponds to the one of the SCC statistic neglecting the contribution of non-Gaussian tails. This remarkable property is checked by performing the Monte Carlo simulations and successful agreement between analytic and simulation results was found.Comment: 15 pages, 8 figures, presentation and some figures modified, final version to be published in PR

Limits and Confidence Intervals in the Presence of Nuisance Parameters

We study the frequentist properties of confidence intervals computed by the method known to statisticians as the Profile Likelihood. It is seen that the coverage of these intervals is surprisingly good over a wide range of possible parameter values for important classes of problems, in particular whenever there are additional nuisance parameters with statistical or systematic errors. Programs are available for calculating these intervals.Comment: 6 figure

Data-driven efficient score tests for deconvolution problems

We consider testing statistical hypotheses about densities of signals in deconvolution models. A new approach to this problem is proposed. We constructed score tests for the deconvolution with the known noise density and efficient score tests for the case of unknown density. The tests are incorporated with model selection rules to choose reasonable model dimensions automatically by the data. Consistency of the tests is proved