514 research outputs found

    Toxicity of radiotherapy in patients with collagen vascular disease

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    BACKGROUND. A diagnosis of collagen vascular disease (CVD) may predispose to radiotherapy (RT) toxicity. The objective of the current study was to identify factors that influence RT toxicity in the setting of CVD. METHODS. A total of 86 RT courses for 73 patients with CVD were delivered between 1985 and 2005. CVD subtypes include rheumatoid arthritis (RA; 33 patients), systemic lupus erythematosus (SLE; 13 patients), scleroderma (9 patients), dermatomyositis/polymyositis (5 patients), ankylosing spondylitis (4 patients), polymyalgia rheumatica/temporal arteritis (4 patients), Wegener granulomatosis (3 patients), and mixed connective tissue disorders (MCTD)/other (2 patients). Each patient with CVD was matched to 1 to 3 controls with respect to sex, race, site irradiated, RT dose (±2 Gray), and age (±5 years). RESULTS. There was no significant difference between CVD patients (65.1%) and controls (72.5%) experiencing any acute toxicity. CVD patients had a higher incidence of any late toxicity (29.1% vs 14%; P = .001), and a trend toward an increased rate of severe late toxicity (9.3% vs 3.7%; P = .079). RT delivered to the breast had increased risk of severe acute toxicity, whereas RT to the pelvis had increased risk of severe acute and late toxicity. RT administered in the setting of scleroderma carried a higher risk of severe late toxicity, whereas RT to SLE patients carried a higher risk of severe acute and late toxicity. CONCLUSIONS. Although generally well tolerated, RT in the setting of CVD appears to carry a higher risk of late toxicity. RT to the pelvis or in the setting of SLE or scleroderma may predispose to an even greater risk of severe toxicity. These issues should be considered when deciding whether to offer RT for these patients. Cancer 2008. © 2008 American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60460/1/23591_ftp.pd

    Cation Disorder and Lithium Insertion Mechanism of Wadsley-Roth Crystallographic Shear Phases from First Principles.

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    Wadsley-Roth crystallographic shear phases form a family of compounds that have attracted attention due to their excellent performance as lithium-ion battery electrodes. The complex crystallographic structure of these materials poses a challenge for first-principles computational modeling and hinders the understanding of their structural, electronic and dynamic properties. In this article, we study three different niobium-tungsten oxide crystallographic shear phases (Nb12WO33, Nb14W3O44, Nb16W5O55) using an enumeration-based approach and first-principles density-functional theory calculations. We report common principles governing the cation disorder, lithium insertion mechanism, and electronic structure of these materials. Tungsten preferentially occupies tetrahedral and block-central sites within the block-type crystal structures, and the local structure of the materials depends on the cation configuration. The lithium insertion proceeds via a three-step mechanism, associated with an anisotropic evolution of the host lattice. Our calculations reveal an important connection between long-range and local structural changes: in the second step of the mechanism, the removal of local structural distortions leads to the contraction of the lattice along specific crystallographic directions, buffering the volume expansion of the material. Niobium-tungsten oxide shear structures host small amounts of localized electrons during initial lithium insertion due to the confining effect of the blocks, but quickly become metallic upon further lithiation. We argue that the combination of local, long-range, and electronic structural evolution over the course of lithiation is beneficial to the performance of these materials as battery electrodes. The mechanistic principles we establish arise from the compound-independent crystallographic shear structure and are therefore likely to apply to niobium-titanium oxide or pure niobium oxide crystallographic shear phases.We acknowledge the use of Athena at HPC Midlands+, which was funded by the EPSRC on grant EP/P020232/1, in this research via the EPSRC RAP call of spring 2018. C.P.K. thanks the Winton Programme for the Physics of Sustainability and EPSRC for financial support. K.J.G. thanks the Winston Churchill Foundation of the United States and the Herchel Smith Foundation. K.J.G. and C.P.G. also thank the EPSRC for funding under a program grant (EP/M009521/1)

    First-Principles Study of Localised and Delocalised Electronic States in Crystallographic Shear Phases of Niobium Oxide

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    Crystallographic shear phases of niobium oxide form an interesting family of compounds that have received attention both for their unusual electronic and magnetic properties, as well as their performance as intercalation electrode materials for lithium-ion batteries. Here, we present a first-principles density-functional theory study of the electronic structure and magnetism of H-Nb2_2O5_5, Nb25_{25}O62_{62}, Nb47_{47}O116_{116}, Nb22_{22}O54_{54}, and Nb12_{12}O29_{29}. These compounds feature blocks of niobium-oxygen octahedra as structural units, and we show that this block structure leads to a coexistence of flat and dispersive energy bands, corresponding to localised and delocalised electronic states. Electrons localise in orbitals spanning multiple niobium sites in the plane of the blocks. Localised and delocalised electronic states are both effectively one-dimensional and are partitioned between different types of niobium sites. Flat bands associated with localised electrons are present even at the GGA level, but a correct description of the localisation requires the use of GGA+U or hybrid functionals. We discuss the experimentally observed electrical and magnetic properties of niobium suboxides in light of our results, and argue that their behaviour is similar to that of nn-doped semiconductors, but with a limited capacity for localised electrons. When a threshold of one electron per block is exceeded, metallic electrons are added to existing localised electrons. We propose that this behaviour of shear phases is general for any type of nn-doping, and should transfer to doping by alkali metal (lithium) ions during operation of niobium oxide-based battery electrodes. Future directions for theory and experiment on mixed-metal shear phases are suggested

    Lithium Diffusion in Niobium Tungsten Oxide Shear Structures.

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    Niobium tungsten oxides with crystallographic shear structures form a promising class of high-rate Li-ion anode materials. Lithium diffusion within these materials is studied in this work using density functional theory calculations, specifically nudged elastic band calculations and ab initio molecular dynamics simulations. Lithium diffusion is found to occur through jumps between 4-fold coordinated window sites with low activation barriers (80-300 meV) and is constrained to be effectively one-dimensional by the crystallographic shear planes of the structures. We identify a number of other processes, including rattling motions with barriers on the order of the thermal energy at room temperature, and intermediate barrier hops between 4-fold and 5-fold coordinated lithium sites. We demonstrate differences regarding diffusion pathways between different cavity types; within the ReO3-like block units of the structures, cavities at the corners and edges host more isolated diffusion tunnels than those in the interior. Diffusion coefficients are found to be in the range of 10-12 to 10-11 m2 s-1 for lithium concentrations of 0.5 Li/TM. Overall, the results provide a complete picture of the diffusion mechanism in niobium tungsten oxide shear structures, and the structure-property relationships identified in this work can be generalized to the entire family of crystallographic shear phases.Winton Programme for the Physics of Sustainability Winston Churchill Foundation Herchel Smith Foundatio

    Nodule heterogeneity as shown by size differences between the targeted nodule and the tumor in thyroidectomy specimen

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    BACKGROUND. Missed papillary thyroid carcinoma (PTC) diagnoses on fine-needle aspiration (FNA) can result from many causes. To the authors' knowledge, the issue of whether the detection of PTC is correlated with nodule heterogeneity has not been studied to date. METHODS. The authors identified all thyroidectomy specimens with a diagnosis of PTC that had undergone at least 1 prior FNA in the study institution between 1998 and 2003. The tumor size at the time of the resection, the ultrasound (US)-determined nodule size, and other parameters were compared between the 2 groups in which PTC was or was not diagnosed on FNA. RESULTS. Of a total of 89 specimens, 47 were diagnosed on FNA with an average tumor size of 1.7 cm and an US-determined nodule size of 2.1 cm (a difference of 0.4 cm). Forty-two specimens with a smaller average tumor size of 0.9 cm ( P <.0001) and a US-determined nodule size of 2.4 cm (a difference of 1.5 cm) were missed. The differences with regard to the US-determined nodule size and tumor size between the 2 groups were significant (0.4 cm vs 1.5 cm; P < .0001). In the missed group, 29 specimens were found to have PTC foci that measured ≤1.0 cm and 26 had a reasonable size difference (RSD; defined as a PTC size outside the range of ±50% of the US-determined nodule size) as the indicator of the mixed nature of nodules targeted for FNA, whereas in the diagnostic group, 9 foci measured ≤1.0 cm and 6 had RSD. There was no cytologic evidence with which to render a diagnosis of PTC on further review in the missed group. CONCLUSIONS. The major reason for a missed diagnosis of PTC on FNA is because of inadequate tumor sampling due to the heterogeneity of the nodule targeted for FNA. This is illustrated by the RSD noted between the targeted nodule and the actual PTC tumor focus in the resection specimen. Cancer (Cancer Cytopathol) 2008. © 2007 American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/58022/1/23253_ftp.pd

    Natural abundance solid-state 33S NMR study of NbS3: applications for battery conversion electrodes.

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    We report ultra-wideline, high-field natural abundance solid-state 33S NMR spectra of the Li-ion battery conversion electrode NbS3, the first 33S NMR study of a compound containing disulfide (S22-) units. The large quadrupolar coupling parameters (CQ ≈ 31 MHz) are consistent with values obtained from DFT calculations, and the spectra provide evidence for the linear Peierls distortion that doubles the number of 33S sites
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