Comprehensive surface magnetotransport study of SmB6

After the theoretical prediction that SmB6 is a topological Kondo insulator, there has been an explosion of studies on the SmB6 surface. However, there is not yet an agreement on even the most basic quantities such as the surface carrier density and mobility. In this paper, we carefully revisit Corbino disk magnetotransport studies to find those surface transport parameters. We first show that subsurface cracks exist in the SmB6 crystals, arising both from surface preparation and during the crystal growth. We provide evidence that these hidden subsurface cracks are additional conduction channels, and the large disagreement between earlier surface SmB6 studies may originate from previous interpretations not taking this extra conduction path into account. We provide an update of more reliable magnetotransport data than the previous one (S. Wolgast et al., Phys. Rev. B 92, 115110) and find that the orders-of-magnitude large disagreements in carrier density and mobility come from the surface preparation and the transport geometry rather than the intrinsic sample quality. From this magnetotransport study, we find an updated estimate of the carrier density and mobility of 2.71×1013 (1/cm2) and 104.5 (cm2/Vsec), respectively. We compare our results with other studies of the SmB6 surface. By this comparison, we provide insight into the disagreements and agreements of the previously reported angle-resolved photoemission spectroscopy, scanning tunneling microscopy, and magnetotorque quantum oscillations measurements

Student Knowledge of Signs, Risk Factors, and Resources for Depression, Anxiety, Sleep Disorders, and Other Mental Health Problems on Campus

A mixed methods study sought to assess knowledge of the signs, risk factors, and campus services available for mental health disorders. A survey was completed by 831 participants at a college of approximately 9,000 students in the northeastern region of the United States. Students evidenced a need for more education about mental health problems on the college campus. Respondents felt more knowledgeable about depression than about anxiety and sleep disorders. Over half of the respondents were unable to identify specific mental health problems that they were aware of. Upperclassmen had a keener awareness of risk factors for anxiety and sophomores were in the greatest danger of failing to recognize risk factors for anxiety. Females consistently recognized signs and risk factors for anxiety, sleep disorders, and depression more frequently than males. Support groups, courses, and workshops on managing relationships, transition to college, and other mental health issues are recommended to increase awareness of mental health needs and services. Convenient access to counseling and fitness activities are encouraged

The clinical presentation and prognostic factors for intrahepatic and extrahepatic cholangiocarcinoma in a tertiary care centre

Aliment Pharmacol Ther   31 , 625–633The incidence of cholangiocarcinoma is rising. Accurate predictors of survival at diagnosis are not well defined.To clarify the clinical presentation and prognostic factors of intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma in a contemporary cohort of patients.Records for consecutive patients at the University of Michigan hospital diagnosed with cholangiocarcinoma between January 2003 and April 2008 were reviewed.In all, 136 patients had cholangiocarcinoma (79 intra- and 57 extrahepatic cholangiocarcinoma). Median survival was 27.3 months–25.8 months for intrahepatic cholangiocarcinoma and 30.3 months for extrahepatic cholangiocarcinoma. Independent predictors of mortality at presentation on multivariate analysis were elevated bilirubin level (HR 1.04, 95%CI 1.01–1.07), CA 19-9 levels >100 U/mL (HR 1.90, 95%CI 1.17–3.08) and stage of disease (HR 1.51, 95%CI 1.16–1.96). After adjusting for baseline prognostic factors, surgical therapy was associated with improved survival (HR 0.48; 95% CI 0.26–0.88). There were no significant differences regarding clinical presentation, disease stage ( P  = 0.98), and survival ( P  = 0.51) between intra- and extrahepatic cholangiocarcinoma.Survival for cholangiocarcinoma remains poor with no significant difference in outcomes between intra- and extrahepatic cholangiocarcinoma. Stage of disease, bilirubin level and CA 19-9 level are important prognostic factors at presentation. Surgical therapy provides similar efficacy for both tumours when adjusted for other prognostic variables.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79101/1/j.1365-2036.2009.04218.x.pd

Consensus recommendations for the treatment and management of patients with Fabry disease on migalastat: a modified Delphi study

Objective: Fabry disease is a progressive disorder caused by deficiency of the α-galactosidase A enzyme (α-Gal A), leading to multisystemic organ damage with heterogenous clinical presentation. The addition of the oral chaperone therapy migalastat to the available treatment options for Fabry disease is not yet universally reflected in all treatment guidelines. These consensus recommendations are intended to provide guidance for the treatment and monitoring of patients with Fabry disease receiving migalastat. Methods: A modified Delphi process was conducted to determine consensus on treatment decisions and monitoring of patients with Fabry disease receiving migalastat. The multidisciplinary panel comprised 14 expert physicians across nine specialties and two patients with Fabry disease. Two rounds of Delphi surveys were completed and recommendations on the use of biomarkers, multidisciplinary monitoring, and treatment decisions were generated based on statements that reached consensus. Results: The expert panel reached consensus agreement on 49 of 54 statements, including 16 that reached consensus in round 1. Statements that reached consensus agreement are summarized in recommendations for migalastat treatment and monitoring, including baseline and follow-up assessments and frequency. All patients with Fabry disease and an amenable mutation may initiate migalastat treatment if they have evidence of Fabry-related symptoms and/or organ involvement. Treatment decisions should include holistic assessment of the patient, considering clinical symptoms and organ involvement as well as patient-reported outcomes and patient preference. The reliability of α-Gal A and globotriaosylsphingosine as pharmacodynamic response biomarkers remains unclear. Conclusion: These recommendations build on previously published guidelines to highlight the importance of holistic, multidisciplinary monitoring for patients with Fabry disease receiving migalastat, in addition to shared decision-making regarding treatments and monitoring throughout the patient journey. (Figure presented.)

Identification of a humanized mouse model for functional testing of immune-mediated biomaterial foreign body response.

Biomedical devices comprise a major component of modern medicine, however immune-mediated fibrosis and rejection can limit their function over time. Here, we describe a humanized mouse model that recapitulates fibrosis following biomaterial implantation. Cellular and cytokine responses to multiple biomaterials were evaluated across different implant sites. Human innate immune macrophages were verified as essential to biomaterial rejection in this model and were capable of cross-talk with mouse fibroblasts for collagen matrix deposition. Cytokine and cytokine receptor array analysis confirmed core signaling in the fibrotic cascade. Foreign body giant cell formation, often unobserved in mice, was also prominent. Last, high-resolution microscopy coupled with multiplexed antibody capture digital profiling analysis supplied spatial resolution of rejection responses. This model enables the study of human immune cell-mediated fibrosis and interactions with implanted biomaterials and devices

Provider Attitudes and Practice Patterns for Direct-Acting Antiviral Therapy for Patients With Hepatocellular Carcinoma

Background & Aims: Direct-acting antivirals (DAAs) are effective against hepatitis C virus and sustained virologic response is associated with reduced incidence of hepatocellular carcinoma (HCC). However, there is controversy over the use of DAAs in patients with active or treated HCC and uncertainty about optimal management of these patients. We aimed to characterize attitudes and practice patterns of hepatology practitioners in the United States regarding the use of DAAs in patients with HCC. Methods: We conducted a survey of hepatology providers at 47 tertiary care centers in 25 states. Surveys were sent to 476 providers and we received 279 responses (58.6%). Results: Provider beliefs about risk of HCC recurrence after DAA therapy varied: 48% responded that DAAs reduce risk, 36% responded that DAAs do not change risk, and 16% responded that DAAs increase risk of HCC recurrence. However, most providers believed DAAs to be beneficial to and reduce mortality of patients with complete response to HCC treatment. Accordingly, nearly all providers (94.9%) reported recommending DAA therapy to patients with early-stage HCC who received curative treatment. However, fewer providers recommended DAA therapy for patients with intermediate (72.9%) or advanced (57.5%) HCC undergoing palliative therapies. Timing of DAA initiation varied among providers based on HCC treatment modality: 49.1% of providers reported they would initiate DAA therapy within 3 months of surgical resection whereas 45.9% and 5.0% would delay DAA initiation for 3–12 months and >1 year post-surgery, respectively. For patients undergoing transarterial chemoembolization (TACE), 42.0% of providers would provide DAAs within 3 months of the procedure, 46.7% would delay DAAs until 3–12 months afterward, and 11.3% would delay DAAs more than 1 year after TACE. Conclusions: Based on a survey sent to hepatology providers, there is variation in provider attitudes and practice patterns regarding use and timing of DAAs for patients with HCC. Further studies are needed to characterize the risks and benefits of DAA therapy in this patient population

Cutaneous large-cell anaplastic Ki-1 (CD-30) positive T-cell lymphoma

A 72-year-old female patient presented with a large ulceration on the lower half of her right abdomen. Cutaneous anaplastic large-cell lymphoma was diagnosed based upon histopathological and immunohistochemical features. There were no signs of extracutaneous involvement by the lymphoma. Complete remission was achieved by local electron beam radiation, followed by chemotherapy