Sensitivity of Nuclear Transition Frequencies to Temporal Variation of the Fine Structure Constant or the Strong Interaction

There exist in nature a few nuclear isomers with very low (eV) excitation energies, and the combination of low energy and narrow width makes them possible candidates for laser-based investigations. The best candidate is the lowest-energy excited state known in nuclear physics, the 7.6(5) eV isomer of $^{229}$Th. A recent study suggests that a measurement of the temporal variation of the excitation energy of this isomer would have 5-6 orders of magnitude enhanced sensitivity to a variation of the fine structure constant ($\alpha \cong 1/137.036$) or of a strong interaction parameter ($m_q/\Lambda_{QCD}$). We reexamine the physics involved in these arguments. By invoking the Feynman-Hellmann Theorem we argue that there is no expectation of significantly enhanced sensitivity to a variation in the fine structure constant (beyond that obtained from experimental considerations such as the low energy and narrow width of the isomer). A similar argument applies to the strong interaction, but evaluating the shift due to temporal variations of the underlying parameters of the strong interaction may be beyond current nuclear structure techniques.Comment: 4 Pages, no figure

Adherence to endocrine therapy including ovarian suppression: A large observational cohort study of US women with early breast cancer

Background: Recent clinical trials support adding ovarian suppression (OS) to oral endocrine therapy (ET) for premenopausal women with early breast cancer. The adoption of OS among real-world populations and the impact of OS on ET adherence have not been evaluated. Methods: This study examined a retrospective, observational cohort of women under the age of 50 years with incident early breast cancer from 2001 to 2016. The IBM MarketScan Commercial insurance claims database was used to identify new users of ET with or without OS and to track discontinuation of or adherence to ET. In all, 21,948 women filled at least 1 prescription for ET within 12 months of their diagnosis after a washout period of 12 months with no prior claims. Patients who received an aromatase inhibitor without a synchronous OS drug were excluded. Results: Use of OS increased over time and reached 11.3% in 2016. In an unadjusted analysis, 40.2% of ET+OS users discontinued ET early, whereas 48.8% of tamoxifen-alone users did. In adjusted analyses, ET+OS users had a similar likelihood of discontinuing ET in comparison with tamoxifen-alone users (hazard ratio, 0.92; 95% confidence interval, 0.83-1.03). Approximately 30% of women had low adherence over the first year of use. The likelihood of high adherence was similar, regardless of OS exposure. Conclusions: The use of OS among young, commercially insured patients with breast cancer increased over time in agreement with recent clinical trial results but remained relatively low. Nonadherence to ET was common, but the use of OS was not associated with lower adherence to ET in this observational, nonrandomized cohort. These findings may reassure oncologists that use of OS does not endanger ET adherence, although prospective studies are needed for confirmation

Transcranial Doppler Directed Dextran Therapy in the Prevention of Carotid Thrombosis: Three Hour Monitoring is as Effective as Six Hours

AbstractBackgroundsix hours» monitoring by transcranial Doppler (TCD) has been successful in directing Dextran therapy in patients at high risk of thrombotic stroke after carotid endarterectomy (CEA).Objectivesis 3 h of routine monitoring as effective as 6 h in the prevention of early postoperative thrombotic stroke?Designprospective, consecutive study in all patients with an accessible cranial window.Methodsone hundred and sixty-six patients undergoing CEA underwent 3 h of postoperative monitoring by TCD. Any patient with >25 emboli detected in any 10 min period or those with emboli that distorted the arterial waveform were commenced on an incremental infusion of dextran 40.Resultsthe majority of patients destined to embolise will do so within the first 2 postoperative hours. Dextran therapy was instituted in nine patients (5%) and rapidly controlled this phase of embolisation although the dose had to be increased in three (33%). No patient suffered a postoperative carotid thrombosis but one suffered a minor stroke on day 5 and was found to have profuse embolisation on TCD; high dose dextran therapy was again instituted, the embolus count rate fell rapidly and he made a good recovery thereafter. Overall, the death and disabling stroke rate was 1.2% and the death/any stroke rate was 2.4%.Conclusionthree hours of postoperative TCD monitoring is as effective as 6 h in the prevention of postoperative carotid thrombosis

Coherence as ultrashort pulse train generator

Intense, well-controlled regular light pulse trains start to play a crucial role in many fields of physics. We theoretically demonstrate a very simple and robust technique for generating such periodic ultrashort pulses from a continuous probe wave which propagates in a dispersive thermal gas media

Nuclear Octupole Correlations and the Enhancement of Atomic Time-Reversal Violation

We examine the time-reversal-violating nuclear ``Schiff moment'' that induces electric dipole moments in atoms. After presenting a self-contained derivation of the form of the Schiff operator, we show that the distribution of Schiff strength, an important ingredient in the ground-state Schiff moment, is very different from the electric-dipole-strength distribution, with the Schiff moment receiving no strength from the giant dipole resonance in the Goldhaber-Teller model. We then present shell-model calculations in light nuclei that confirm the negligible role of the dipole resonance and show the Schiff strength to be strongly correlated with low-lying octupole strength. Next, we turn to heavy nuclei, examining recent arguments for the strong enhancement of Schiff moments in octupole-deformed nuclei over that of 199Hg, for example. We concur that there is a significant enhancement while pointing to effects neglected in previous work (both in the octupole-deformed nuclides and 199Hg) that may reduce it somewhat, and emphasizing the need for microscopic calculations to resolve the issue. Finally, we show that static octupole deformation is not essential for the development of collective Schiff moments; nuclei with strong octupole vibrations have them as well, and some could be exploited by experiment.Comment: 25 pages, 4 figures embedded in tex

Development of core outcome sets for studies relating to awareness and clinical management of reduced fetal movement

Objective: This study aimed to create core outcome sets (COSs) for use in research studies relating to the awareness and clinical management of reduced fetal movement (RFM). Design: Delphi survey and consensus process. Setting: International. Population: A total of 128 participants (40 parents, 19 researchers and 65 clinicians) from 16 countries. Methods: A systematic literature review was conducted to identify outcomes in studies of interventions relating to the awareness and the clinical management of RFM. Using these outcomes as a preliminary list, stakeholders rated the importance of these outcomes for inclusion in COSs for studies of: (i) awareness of RFM; and (ii) clinical management of RFM. Main outcome measures: Preliminary lists of outcomes were discussed at consensus meetings where two COSs (one for studies of RFM awareness and one for studies of clinical management of RFM). Results: The first round of the Delphi survey was completed by 128 participants, 66% of whom (n = 84) completed all three rounds. Fifty outcomes identified by the systematic review, after multiple definitions were combined, were voted on in round one. Two outcomes were added in round one, and as such 52 outcomes were voted on in two lists in rounds two and three. The COSs for studies of RFM awareness and clinical management are comprised of eight outcomes (four maternal and four neonatal) and 10 outcomes (two maternal and eight neonatal), respectively. Conclusions: These COSs provide researchers with the minimum set of outcomes to be measured and reported in studies relating to the awareness and the clinical management of RFM.</p

An Immunocompetent Mouse Model of HPV16(+) Head and Neck Squamous Cell Carcinoma

The incidence of human papilloma virus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) is increasing and implicated in more than 60% of all oropharyngeal carcinomas (OPSCCs). Although whole-genome, transcriptome, and proteome analyses have identified altered signaling pathways in HPV-induced HNSCCs, additional tools are needed to investigate the unique pathobiology of OPSCC. Herein, bioinformatics analyses of human HPV(+) HNSCCs revealed that all tumors express full-length E6 and identified molecular subtypes based on relative E6 and E7 expression levels. To recapitulate the levels, stoichiometric ratios, and anatomic location of E6/E7 expression, we generated a genetically engineered mouse model whereby balanced expression of E6/E7 is directed to the oropharyngeal epithelium. The addition of a mutant PIK3CAE545K allele leads to the rapid development of pre-malignant lesions marked by immune cell accumulation, and a subset of these lesions progress to OPSCC. This mouse provides a faithful immunocompetent model for testing treatments and investigating mechanisms of immunosuppression

Phase evolution of slag-rich cementitious grouts for immobilisation of nuclear wastes

An updated calcium silicate hydrate (C–S–H) model incorporating aluminium-containing end-members was used for thermodynamic modelling of blended cements using blast-furnace slag and Portland cement (BFS:PC) with ratios of 1:1, 3:1 and 9:1, using GEMSelektor. Selective dissolution and magic angle spinning nuclear magnetic resonance (MAS NMR) studies were performed to determine the degree of hydration (DoH) of the anhydrous material as an input parameter for the modelling work. Both techniques showed similar results for determining the DoH of the BFS within each sample. Characterisation of the hardened cement pastes over 360 days, using X-ray diffraction analysis and MAS NMR, demonstrated that the use of the updated C–S–H model can highlight the effect of different blend ratios and curing ages on the phase assemblages in these cements. Validation using this modelling approach was performed on 20 year old specimens from the literature to highlight its applicability for modelling later-age blended cements

Association between concomitant use of hydrochlorothiazide and adverse chemotherapy-related events among older women with breast cancer treated with cyclophosphamide

Background: The pharmacy reference database, Micromedex, lists concomitant hydrochlorothiazide and cyclophosphamide use as a potential, major drug-drug interaction (DDI), although only one small, single-center study supports this claim. Our objective was to estimate associations between this potential DDI and two adverse chemotherapy-related events, neutropenia-related hospitalizations and treatment regimen discontinuation, among a cohort of women with breast cancer initiating adjuvant chemotherapy containing cyclophosphamide. Methods: Using linked Surveillance, Epidemiology, and End Results Program (SEER)-Medicare data, we included women 66 years and older with breast cancer diagnosis between 2007 and 2011, who initiated a regimen containing cyclophosphamide. Risk ratios (RR) and 95% confidence intervals for adverse outcomes comparing women exposed versus unexposed to the potential DDI were assessed using modified multivariable Poisson regression adjusting for potential confounders. Results: In total, 27% of women receiving cyclophosphamide treatment were exposed to concomitant hydrochlorothiazide, of which 11% experienced a neutropenia-related hospitalization and 21% discontinued their chemotherapy regimen prior to completion. Adjusted risks of both adverse events were similar between those exposed and unexposed to the potential DDI [neutropenia-related hospitalization: adjusted RR (aRR) = 0.92 (0.70-1.21); treatment discontinuation: aRR = 1.00 (0.96-1.05)]. Conclusions: Our results do not support an association between concomitant hydrochlorothiazide use and two clinically relevant adverse chemotherapy-related events. Impact: Our results support reassessing and potentially lowering severity of this potential interaction in drug reference databases