Neutropenic event risk and impaired chemotherapy delivery in six European audits of breast cancer treatment

Goals of work: The aims of this study were to assess chemotherapy treatment characteristics, neutropenic event (NE) occurrence and related risk factors in breast cancer patients in Western Europe. Materials and methods: Six retrospective audits of breast cancer chemotherapy were combined into a dataset of 2,860 individuals. NEs were defined as neutropenia-related hospitalisation, dose reduction ≥15% or dose delay ≥7days. Summation dose intensity (SDI) was calculated to compare different types of chemotherapy regimens on a single scale. Risk factors of NE occurrence and of low relative dose intensity (RDI) ≤85% were identified by multiple logistic regression. Main results: Patient populations were comparable between audits. Until 1998, cyclophosphamide, methotrexate and fluorouracil regimens were most frequently used, but thereafter, anthracycline-based regimens were most common. NEs occurred in 20% of the patients and low RDI in 16%. NE occurrence predicted low RDI and was associated with higher age, bigger body surface area, lower body mass index, regimen type, more chemotherapy cycles planned, normal to high SDI, concomitant radiotherapy and year of treatment. First cycle NE occurrence predicted NEs from cycle 2 onwards. A risk score using age, SDI, number of planned chemotherapy cycles and concomitant radiotherapy differentiated patients with increasing NE risk (9-37%). An alternative score version not using concomitant radiotherapy performed moderately less well. Conclusions: NEs occurred frequently in this combined dataset and they affected treatment delivery. Identifying patients at high NE risk enables targeted prophylaxis and may avoid dose limitation

Quantum Criticality and Global Phase Diagram of Magnetic Heavy Fermions

Quantum criticality describes the collective fluctuations of matter undergoing a second-order phase transition at zero temperature. It is being discussed in a number of strongly correlated electron systems. A prototype case occurs in the heavy fermion metals, in which antiferromagnetic quantum critical points have been explicitly observed. Here, I address two types of antiferromagnetic quantum critical points. In addition to the standard description based on the fluctuations of the antiferromagnetic order, a local quantum critical point is also considered. It contains inherently quantum modes that are associated with a critical breakdown of the Kondo effect. Across such a quantum critical point, there is a sudden collapse of a large Fermi surface to a small one. I also consider the proximate antiferromagnetic and paramagnetic phases, and these considerations lead to a global phase diagram. Finally, I discuss the pertinent experiments on the antiferromagnetic heavy fermions, briefly address the case of ferromagnetic heavy fermions, and outline some directions for future studies.Comment: (v2) reference added, and typos corrected; (v1) 10 pages, 2 figures, based on a plenary talk given at the International Conference on Quantum Criticality and Novel Phases (QCNP09, Dresden

Extended M1 sum rule for excited symmetric and mixed-symmetry states in nuclei

A generalized M1 sum rule for orbital magnetic dipole strength from excited symmetric states to mixed-symmetry states is considered within the proton-neutron interacting boson model of even-even nuclei. Analytic expressions for the dominant terms in the B(M1) transition rates from the first and second $2^+$ states are derived in the U(5) and SO(6) dynamic symmetry limits of the model, and the applicability of a sum rule approach is examined at and in-between these limits. Lastly, the sum rule is applied to the new data on mixed-symmetry states of 94Mo and a quadrupole d-boson ratio $nd(0^+_1)/nd(2^+_2) \approx 0.6$ is obtained in a largely parameter-independent wayComment: 19 pages, 3 figures, Revte

Display of probability densities for data from a continuous distribution

Based on cumulative distribution functions, Fourier series expansion and Kolmogorov tests, we present a simple method to display probability densities for data drawn from a continuous distribution. It is often more efficient than using histograms.Comment: 5 pages, 4 figures, presented at Computer Simulation Studies XXIV, Athens, GA, 201

Virtual Compton Scattering and Neutral Pion Electroproduction in the Resonance Region up to the Deep Inelastic Region at Backward Angles

We have made the first measurements of the virtual Compton scattering (VCS) process via the H$(e,e'p)\gamma$ exclusive reaction in the nucleon resonance region, at backward angles. Results are presented for the $W$-dependence at fixed $Q^2=1$ GeV$^2$, and for the $Q^2$-dependence at fixed $W$ near 1.5 GeV. The VCS data show resonant structures in the first and second resonance regions. The observed $Q^2$-dependence is smooth. The measured ratio of H$(e,e'p)\gamma$ to H$(e,e'p)\pi^0$ cross sections emphasizes the different sensitivity of these two reactions to the various nucleon resonances. Finally, when compared to Real Compton Scattering (RCS) at high energy and large angles, our VCS data at the highest $W$ (1.8-1.9 GeV) show a striking $Q^2$- independence, which may suggest a transition to a perturbative scattering mechanism at the quark level.Comment: 20 pages, 8 figures. To appear in Phys.Rev.

Virtual Compton Scattering and the Generalized Polarizabilities of the Proton at Q^2=0.92 and 1.76 GeV^2

Virtual Compton Scattering (VCS) on the proton has been studied at Jefferson Lab using the exclusive photon electroproduction reaction (e p --> e p gamma). This paper gives a detailed account of the analysis which has led to the determination of the structure functions P_LL-P_TT/epsilon and P_LT, and the electric and magnetic generalized polarizabilities (GPs) alpha_E(Q^2) and beta_M(Q^2) at values of the four-momentum transfer squared Q^2= 0.92 and 1.76 GeV^2. These data, together with the results of VCS experiments at lower momenta, help building a coherent picture of the electric and magnetic GPs of the proton over the full measured Q^2-range, and point to their non-trivial behavior.Comment: version 2: modified according to PRC Editor's and Referee's recommendations. Archival paper for the E93-050 experiment at JLab Hall A. 28 pages, 23 figures, 5 cross-section tables. To be submitted to Phys.Rev.

Backward electroproduction of pi0 mesons on protons in the region of nucleon resonances at four momentum transfer squared Q**2 = 1.0 GeV**2

Exclusive electroproduction of pi0 mesons on protons in the backward hemisphere has been studied at Q**2 = 1.0 GeV**2 by detecting protons in the forward direction in coincidence with scattered electrons from the 4 GeV electron beam in Jefferson Lab's Hall A. The data span the range of the total (gamma* p) center-of-mass energy W from the pion production threshold to W = 2.0 GeV. The differential cross sections sigma_T+epsilon*sigma_L, sigma_TL, and sigma_TT were separated from the azimuthal distribution and are presented together with the MAID and SAID parametrizations.Comment: 17 pages, 11 figures, information can be found at http://hallaweb.jlab.org/experiment/E93-050/vcs.html updated content about SAID analysis updated MAID results following new reference nucl-th/0310041 updated figure

The reaction dynamics of the 16O(e,e'p) cross section at high missing energies

We measured the cross section and response functions (R_L, R_T, and R_LT) for the 16O(e,e'p) reaction in quasielastic kinematics for missing energies 25 <= E_miss <= 120 MeV at various missing momenta P_miss <= 340 MeV/c. For 25 < E_miss < 50 MeV and P_miss \approx 60 MeV/c, the reaction is dominated by single-nucleon knockout from the 1s1/2-state. At larger P_miss, the single-particle aspects are increasingly masked by more complicated processes. For E_miss > 60 MeV and P_miss > 200 MeV/c, the cross section is relatively constant. Calculations which include contributions from pion exchange currents, isobar currents and short-range correlations account for the shape and the transversity but only for half of the magnitude of the measured cross section.Comment: 6 pages, 4 figures, submitted to Phys Rev Lett, formatting error fixe

Large Momentum Transfer Measurements of the Deuteron Elastic Structure Function A(Q^2) at Jefferson Laboratory

The deuteron elastic structure function A(Q^2) has been extracted in the Q^2 range 0.7 to 6.0 (GeV/c)^2 from cross section measurements of elastic electron-deuteron scattering in coincidence using the Hall A Facility of Jefferson Laboratory. The data are compared to theoretical models based on the impulse approximation with inclusion of meson-exchange currents, and to predictions of quark dimensional scaling and perturbative quantum chromodynamicsComment: Submitted to Physical Review Letter

Yersinia pestis Evolution on a Small Timescale: Comparison of Whole Genome Sequences from North America

Yersinia pestis, the etiologic agent of plague, was responsible for several devastating epidemics throughout history and is currently of global importance to current public heath and biodefense efforts. Y. pestis is widespread in the Western United States. Because Y. pestis was first introduced to this region just over 100 years ago, there has been little time for genetic diversity to accumulate. Recent studies based upon single nucleotide polymorphisms have begun to quantify the genetic diversity of Y. pestis in North America.To examine the evolution of Y. pestis in North America, a gapped genome sequence of CA88-4125 was generated. Sequence comparison with another North American Y. pestis strain, CO92, identified seven regions of difference (six inversions, one rearrangement), differing IS element copy numbers, and several SNPs.The relatively large number of inverted/rearranged segments suggests that North American Y. pestis strains may be undergoing inversion fixation at high rates over a short time span, contributing to higher-than-expected diversity in this region. These findings will hopefully encourage the scientific community to sequence additional Y. pestis strains from North America and abroad, leading to a greater understanding of the evolutionary history of this pathogen