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Mini review: Breast cancer care in individuals with differences of sexual development.
Disorders or differences of sexual development encompasses an important group of conditions that affects up to 1 in 5,000 live births. Many individuals living in the female gender includes Turner syndrome, congenital adrenal hyperplasia and conditions with 46XY karyotype such as gonadal dysgenesis (Swyer syndrome). Individuals are commenced on high dose oestrogen to initiate and maintain development of secondary sexual characteristics such as breasts which is paramount in them identifying in the female gender. We highlight the first case of a patient with Swyer syndrome who was treated with long term oestrogen therapy and later developed breast cancer. In individuals with gonadal dysgenesis, testicular malignancy is a recognised risk and is screened for. Prolonged exposure to exogenous and endogenous hormones can increase the risk of breast cancer however how much this risk increases in those taking high dose hormones is not documented in the literature. We aim to highlight the importance of breast cancer treatment and surgical reconstruction in this group and whether they should be considered for early breast cancer screening. CONCLUSION: It is imperative that triple assessment is undertaken in every patient with a breast lump, regardless of gender identification. Clinicians must not delay investigations in this patient group due to a misunderstanding of their condition. Those on long term hormone supplementation should be entered into the breast screening program at an earlier age with Magnetic Resonance Imaging surveillance. Careful consideration of post treatment endocrine therapy is required and under the care of the multi-disciplinary team
Transcatheter and surgical intervention for secondary mitral regurgitation
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effects in secondary mitral regurgitation of:. Surgical mitral valve intervention and coronary artery bypass graft versus coronary artery bypass graft alone; and Transcatheter mitral valve intervention and medical therapy versus medical therapy alone
Phase Mixing of Alfvén Waves Near a 2D Magnetic Null Point
The propagation of linear Alfvén wave pulses in an inhomogeneous plasma near a 2D coronal null point is investigated. When a uniform plasma density is considered, it is seen that an initially planar Alfvén wavefront remains planar, despite the varying equilibrium Alfvén speed, and that all the wave collects at the separatrices. Thus, in the non-ideal case, these Alfvénic disturbances preferentially dissipate their energy at these locations. For a non-uniform equilibrium density, it is found that the Alfvén wavefront is significantly distorted away from the initially planar geometry, inviting the possibility of dissipation due to phase mixing. Despite this however, we conclude that for the Alfvén wave, current density accumulation and preferential heating still primarily occur at the separatrices, even when an extremely non-uniform density profile is considered
Fusion dual-tracer SPECT-based hepatic dosimetry predicts outcome after radioembolization for a wide range of tumour cell types
Purpose Fusion dual-tracer SPECT imaging enables physiological rather than morphological voxel-based partitioning and dosimetry for Y-90 hepatic radioembolization (RE). We evaluated its prognostic value in a large heterogeneous cohort of patients with extensive hepatic malignancy. Methods A total of 122 patients with primary or secondary liver malignancy (18 different cell types) underwent SPECT imaging after intraarterial injection of Tc-99m macroaggregated albumin (TcMAA) as a simulation of subsequent Y-90 microsphere distribution, followed by administration of an excess of intravenous Tc-99m-labelled sulphur colloid (TcSC) as a biomarker for functional liver, and a second SPECT scan. TcMAA distribution was used to estimate Y-90 radiation absorbed dose in tumour (D (T)) and in functional liver. Laboratory and clinical follow-up were recorded for 12 weeks after RE, and radiographic responses according to (m)RECIST were evaluated at 3 and 6 months. Dose-response relationships were determined for efficacy and toxicity. Results Patients were treated with a median of 1.73 GBq activity of resin microspheres (98 patients) or glass microspheres (24 patients), in a whole-liver approach (97 patients) or a lobar approach (25 patients). The objective response rate was 41 % at 3 months and 48 % at 6 months. Response was correlated with D (T) (P <0.01). Median overall survival was 10.1 months (95 % confidence interval 7.4 - 12.8 months). Responders lived for 36.0 months compared to 8.7 months for nonresponders (P <0.01). Stratified for tumour cell type, D (T) was independently associated with survival (P <0.01). Absorbed dose in functional liver was correlated with toxicity grade change (P <0.05) and RE-induced liver disease (P <0.05). Conclusion Fusion dual-tracer SPECT imaging offers a physiology-based functional imaging tool to predict efficacy and toxicity of RE. This technique can be refined to define dosing thresholds for specific tumour types and treatments, but appears generally predictive even in a heterogeneous cohort
Strong interface-induced spin-orbit coupling in graphene on WS2
Interfacial interactions allow the electronic properties of graphene to be
modified, as recently demonstrated by the appearance of satellite Dirac cones
in the band structure of graphene on hexagonal boron nitride (hBN) substrates.
Ongoing research strives to explore interfacial interactions in a broader class
of materials in order to engineer targeted electronic properties. Here we show
that at an interface with a tungsten disulfide (WS2) substrate, the strength of
the spin-orbit interaction (SOI) in graphene is very strongly enhanced. The
induced SOI leads to a pronounced low-temperature weak anti-localization (WAL)
effect, from which we determine the spin-relaxation time. We find that
spin-relaxation time in graphene is two-to-three orders of magnitude smaller on
WS2 than on SiO2 or hBN, and that it is comparable to the intervalley
scattering time. To interpret our findings we have performed first-principle
electronic structure calculations, which both confirm that carriers in
graphene-on-WS2 experience a strong SOI and allow us to extract a
spin-dependent low-energy effective Hamiltonian. Our analysis further shows
that the use of WS2 substrates opens a possible new route to access topological
states of matter in graphene-based systems.Comment: Originally submitted version in compliance with editorial guidelines.
Final version with expanded discussion of the relation between theory and
experiments to be published in Nature Communication
Evidence for an excess of B -> D(*) Tau Nu decays
Based on the full BaBar data sample, we report improved measurements of the
ratios R(D(*)) = B(B -> D(*) Tau Nu)/B(B -> D(*) l Nu), where l is either e or
mu. These ratios are sensitive to new physics contributions in the form of a
charged Higgs boson. We measure R(D) = 0.440 +- 0.058 +- 0.042 and R(D*) =
0.332 +- 0.024 +- 0.018, which exceed the Standard Model expectations by 2.0
sigma and 2.7 sigma, respectively. Taken together, our results disagree with
these expectations at the 3.4 sigma level. This excess cannot be explained by a
charged Higgs boson in the type II two-Higgs-doublet model. We also report the
observation of the decay B -> D Tau Nu, with a significance of 6.8 sigma.Comment: Expanded section on systematics, text corrections, improved the
format of Figure 2 and included the effect of the change of the Tau
polarization due to the charged Higg
Search for the decay modes D^0 → e^+e^-, D^0 → μ^+μ^-, and D^0 → e^±μ∓
We present searches for the rare decay modes D^0→e^+e^-, D^0→μ^+μ^-, and D^0→e^±μ^∓ in continuum e^+e^-→cc events recorded by the BABAR detector in a data sample that corresponds to an integrated luminosity of 468 fb^(-1). These decays are highly Glashow–Iliopoulos–Maiani suppressed but may be enhanced in several extensions of the standard model. Our observed event yields are consistent with the expected backgrounds. An excess is seen in the D^0→μ^+μ^- channel, although the observed yield is consistent with an upward background fluctuation at the 5% level. Using the Feldman–Cousins method, we set the following 90% confidence level intervals on the branching fractions: B(D^0→e^+e^-)<1.7×10^(-7), B(D^0→μ^+μ^-) within [0.6,8.1]×10^(-7), and B(D^0→e^±μ^∓)<3.3×10^(-7)
Observation and study of baryonic B decays: B -> D(*) p pbar, D(*) p pbar pi, and D(*) p pbar pi pi
We present a study of ten B-meson decays to a D(*), a proton-antiproton pair,
and a system of up to two pions using BaBar's data set of 455x10^6 BBbar pairs.
Four of the modes (B0bar -> D0 p anti-p, B0bar -> D*0 p anti-p, B0bar -> D+ p
anti-p pi-, B0bar -> D*+ p anti-p pi-) are studied with improved statistics
compared to previous measurements; six of the modes (B- -> D0 p anti-p pi-, B-
-> D*0 p anti-p pi-, B0bar -> D0 p anti-p pi- pi+, B0bar -> D*0 p anti-p pi-
pi+, B- -> D+ p anti-p pi- pi-, B- -> D*+ p anti-p pi- pi-) are first
observations. The branching fractions for 3- and 5-body decays are suppressed
compared to 4-body decays. Kinematic distributions for 3-body decays show
non-overlapping threshold enhancements in m(p anti-p) and m(D(*)0 p) in the
Dalitz plots. For 4-body decays, m(p pi-) mass projections show a narrow peak
with mass and full width of (1497.4 +- 3.0 +- 0.9) MeV/c2, and (47 +- 12 +- 4)
MeV/c2, respectively, where the first (second) errors are statistical
(systematic). For 5-body decays, mass projections are similar to phase space
expectations. All results are preliminary.Comment: 28 pages, 90 postscript figures, submitted to LP0
A search for the decay modes B+/- to h+/- tau l
We present a search for the lepton flavor violating decay modes B+/- to h+/-
tau l (h= K,pi; l= e,mu) using the BaBar data sample, which corresponds to 472
million BBbar pairs. The search uses events where one B meson is fully
reconstructed in one of several hadronic final states. Using the momenta of the
reconstructed B, h, and l candidates, we are able to fully determine the tau
four-momentum. The resulting tau candidate mass is our main discriminant
against combinatorial background. We see no evidence for B+/- to h+/- tau l
decays and set a 90% confidence level upper limit on each branching fraction at
the level of a few times 10^-5.Comment: 15 pages, 7 figures, submitted to Phys. Rev.
Search for Charged Higgs Bosons in e+e- Collisions at \sqrt{s} = 189 GeV
A search for pair-produced charged Higgs bosons is performed with the L3
detector at LEP using data collected at a centre-of-mass energy of 188.6 GeV,
corresponding to an integrated luminosity of 176.4 pb^-1. Higgs decays into a
charm and a strange quark or into a tau lepton and its associated neutrino are
considered. The observed events are consistent with the expectations from
Standard Model background processes. A lower limit of 65.5 GeV on the charged
Higgs mass is derived at 95 % confidence level, independent of the decay
branching ratio Br(H^{+/-} -> tau nu)
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