Clinically guided core biopsy and cutaneous punch biopsy in the evaluation of breast lesions:a necessary test or an obsolete skill?

OBJECTIVE: The vast majority of breast cancers are diagnosed via image-guided procedures yet despite significant advances, imaging does not identify all breast malignancies. Clinically suspicious breast lesions with normal breast imaging remain a cause for concern. The aim of this study is to determine the diagnostic value of clinical core and cutaneous punch biopsies in the diagnosis of breast malignancy in clinically suspicious lesions with normal breast imaging. METHODS: All patients with suspicious clinical breast findings and normal imaging who underwent a clinical core and/or cutaneous punch biopsy from 2012 to 2019 were reviewed retrospectively. Patients with subsequent breast malignant diagnosis were analysed. RESULTS: A total of 283 biopsies (166 clinical core, 117 cutaneous punch) performed over the 7-year period were included in the analysis. A total of 263/283 (93%) yielded a benign outcome. A total of 2/283 (0.7%) yielded B3 lesions (probably benign). These lesions were benign on final surgical excision. A total of 18/283 (6.3%) yielded a malignant histopathology. Sixteen out of 18 were cutaneous punch biopsies, and 2/18 were clinical core biopsies. A total of 14/18 patients presented with nipple changes, while 4/18 had a palpable area of concern. Histopathological analysis demonstrated Paget’s disease of the nipple in 8/18, invasive carcinoma in 9/18 out of which two represented a recurrence of breast malignancy. Cutaneous squamous cell carcinoma was diagnosed in 1/18. CONCLUSION: Clinical core and cutaneous punch biopsies remain a valuable tool in the diagnosis of breast cancer particularly in the management of clinically suspicious radiographically occult malignancies

Dissipation and the Relaxation to Equilibrium

Using the recently derived Dissipation Theorem and a corollary of the Transient Fluctuation Theorem (TFT), namely the Second Law Inequality, we derive the unique time independent, equilibrium phase space distribution function for an ergodic Hamiltonian system in contact with a remote heat bath. We prove under very general conditions that any deviation from this equilibrium distribution breaks the time independence of the distribution. Provided temporal correlations decay, and the system is ergodic, we show that any nonequilibrium distribution that is an even function of the momenta, eventually relaxes (not necessarily monotonically) to the equilibrium distribution. Finally we prove that the negative logarithm of the microscopic partition function is equal to the thermodynamic Helmholtz free energy divided by the thermodynamic temperature and Boltzmann's constant. Our results complement and extend the findings of modern ergodic theory and show the importance of dissipation in the process of relaxation towards equilibrium.Comment: 18 pages, no figure

Internal delensing of cosmic microwave background polarization B-Modes with the POLARBEAR experiment

International audienceUsing only cosmic microwave background polarization data from the polarbear experiment, we measure B-mode polarization delensing on subdegree scales at more than 5σ significance. We achieve a 14% B-mode power variance reduction, the highest to date for internal delensing, and improve this result to 22% by applying for the first time an iterative maximum a posteriori delensing method. Our analysis demonstrates the capability of internal delensing as a means of improving constraints on inflationary models, paving the way for the optimal analysis of next-generation primordial B-mode experiments

Measurement of the cosmic microwave background polarization lensing power spectrum from two years of POLARBEAR data

We present a measurement of the gravitational lensing deflection power spectrum reconstructed with two seasons of cosmic microwave background polarization data from the POLARBEAR experiment. Observations were taken at 150 GHz from 2012 to 2014 and surveyed three patches of sky totaling 30 square degrees. We test the consistency of the lensing spectrum with a cold dark matter cosmology and reject the no-lensing hypothesis at a confidence of 10.9σ, including statistical and systematic uncertainties. We observe a value of AL = 1.33 ± 0.32 (statistical) ±0.02 (systematic) ±0.07 (foreground) using all polarization lensing estimators, which corresponds to a 24% accurate measurement of the lensing amplitude. Compared to the analysis of the first- year data, we have improved the breadth of both the suite of null tests and the error terms included in the estimation of systematic contamination

Measuring Under-Five Mortality: Validation of New Low-Cost Methods

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A novel use of honey's aggregation approach to the analysis of repertory grids

This paper examines and appraises a novel approach to generating shared group constructs through aggregative analysis: the application of Honey’s aggregation procedure to repertory grid technique (RGT) data. Revisiting Personal Construct Theory’s underlying premises and adopting a social constructivist epistemology, we argue that, whilst “implicit theories” of the world, elicited via RGT, are unique to individuals, the constructs on which they are founded may be shared collectively. Drawing on a study of workplace performance, we outline a protocol for this novel use of Honey’s (1979a; 1979b) approach demonstrating how it can be utilized to generate shared constructs inductively to facilitate theory building. We argue that, unlike other grid aggregation processes, the approach does not compromise data granularity, offering a useful augmentation to traditional idiographic approaches examining individual-level constructs only. This approach appears especially suited to addressing complex and implicit topics, where individuals struggle to convey thoughts and ideas

CP Violation and Baryogenesis due to Heavy Majorana Neutrinos

We analyze the scenario of baryogenesis through leptogenesis induced by the out-of-equilibrium decays of heavy Majorana neutrinos and pay special attention to CP violation. Extending a recently proposed resummation formalism for two-fermion mixing to decay amplitudes, we calculate the resonant phenomenon of CP violation due to the mixing of two nearly degenerate heavy Majorana neutrinos. Solving numerically the relevant Boltzmann equations, we find that the isosinglet Majorana mass may range from 1 TeV up to the grand unification scale, depending on the mechanism of CP violation and/or the flavour structure of the neutrino mass matrix assumed. Finite temperature effects and possible constraints from the electric dipole moment of electron and other low-energy experiments are briefly discussed.Comment: 46 pages, LaTeX, 4 encapsulated figures include

Magnetoelectric ordering of BiFeO3 from the perspective of crystal chemistry

In this paper we examine the role of crystal chemistry factors in creating conditions for formation of magnetoelectric ordering in BiFeO3. It is generally accepted that the main reason of the ferroelectric distortion in BiFeO3 is concerned with a stereochemical activity of the Bi lone pair. However, the lone pair is stereochemically active in the paraelectric orthorhombic beta-phase as well. We demonstrate that a crucial role in emerging of phase transitions of the metal-insulator, paraelectric-ferroelectric and magnetic disorder-order types belongs to the change of the degree of the lone pair stereochemical activity - its consecutive increase with the temperature decrease. Using the structural data, we calculated the sign and strength of magnetic couplings in BiFeO3 in the range from 945 C down to 25 C and found the couplings, which undergo the antiferromagnetic-ferromagnetic transition with the temperature decrease and give rise to the antiferromagnetic ordering and its delay in regard to temperature, as compared to the ferroelectric ordering. We discuss the reasons of emerging of the spatially modulated spin structure and its suppression by doping with La3+.Comment: 18 pages, 5 figures, 3 table

Numerical convergence of the block-maxima approach to the Generalized Extreme Value distribution

In this paper we perform an analytical and numerical study of Extreme Value distributions in discrete dynamical systems. In this setting, recent works have shown how to get a statistics of extremes in agreement with the classical Extreme Value Theory. We pursue these investigations by giving analytical expressions of Extreme Value distribution parameters for maps that have an absolutely continuous invariant measure. We compare these analytical results with numerical experiments in which we study the convergence to limiting distributions using the so called block-maxima approach, pointing out in which cases we obtain robust estimation of parameters. In regular maps for which mixing properties do not hold, we show that the fitting procedure to the classical Extreme Value Distribution fails, as expected. However, we obtain an empirical distribution that can be explained starting from a different observable function for which Nicolis et al. [2006] have found analytical results.Comment: 34 pages, 7 figures; Journal of Statistical Physics 201