Bullous hemorrhagic lichen sclerosus of the breast: a report of two cases and review of the literature

Lichen sclerosus (LS) is a chronic dermatologic condition characterized by atrophic porcelain-appearing plaques that can cause intense discomfort and eventually lead to destruction of local architecture. Lichen sclerosus most commonly arises in the anogenital area, but up to 20% of cases can present on extragenital skin. Rarely, LS can also present with hemorrhage and bullae; the mechanism by which this occurs is unknown. We report two cases of bullous hemorrhagic LS of the breast arising in 66-year-old and 77-year-old women. Bullous hemorrhagic LS of the breast is exceedingly rare, with few reported cases, and presents a diagnostic challenge to clinicians

Controlled Contact to a C60 Molecule

The conductance of C60 on Cu(100) is investigated with a low-temperature scanning tunneling microscope. At the transition from tunneling to the contact regime the conductance of C60 adsorbed with a pentagon-hexagon bond rises rapidly to 0.25 conductance quanta G0. An abrupt conductance jump to G0 is observed upon further decreasing the distance between the instrument's tip and the surface. Ab-initio calculations within density functional theory and non-equilibrium Green's function techniques explain the experimental data in terms of the conductance of an essentially undeformed C60. From a detailed analysis of the crossover from tunneling to contact we conclude that the conductance in this region is strongly affected by structural fluctuations which modulate the tip-molecule distance.Comment: 4 pages, 3 figure

The application of passive sampler (DGT) technology for improved understanding of metal behaviour at a marine disposal site

Metal behaviour and availability at a contaminated dredge material disposal site within UK waters has been investigated using Diffusive Gradient in Thin films (DGT) passive sampling technology. Three stations representing contrasting history and presence of maintenance dredge disposal, including a control station outside the disposal site, have been studied and depth profiles of fluxes of different metals (Fe, Mn, Pb, Cu, Cd, Cr, Ni, Zn) to the binding gel (Chelex 100) have been derived. Higher flux rates and shallower mobilisation of metals (Mn and Fe) to the binding gel were observed at the disposal stations compared to the control station. Here we describe metal mobilization at different depths, linking the remobilization of Fe2+ and Mn2+ to the sediment (re)supply of other heavy metals of interest with a focus on Cd, Ni and Pb and as they are on the Water Framework Directive (WFD) list of priority substances and OSPAR list of priority pollutants. Results showed that Cd, Pb and Ni exhibited signs of resupply at the sediment-water interface (SWI). There was a potential increased mobilisation and source to the water column of Pb and Ni at the disposal site stations, but there was no Cd source, despite higher total loadings. This information has the potential to improve our current understanding of metal cycles at disposal sites. This work can be used as an indication of likely metal bioavailability and also assist in determining whether the sites act as sources or sinks of heavy metals. This information could assist disposal site monitoring and dredge material licensing

Software Processes SAR Motion-Measurement Data

Motion Measurement Processor (MMP) is one of three computer programs that are used together in the operation of a terrain-mapping dual-frequency interferometric synthetic-aperture-radar (SAR) system. The other two programs - Jurassicprok and Calibration Processor - are described in the two immediately preceding articles. MMP acquires all the motion and attitude data collected by onboard instrumentation systems, including radar, laser and camera metrology, inertial navigation systems, and Global Positioning System (GPS) receivers. MMP combines all this information and processes it into all the trajectory information needed to run Jurassicprok, which performs the interferometric processing and mapping functions. MMP includes several Kalman filters for combining and smoothing aircraft motion and attitude data, and least-squares inversion and filtering software tools for solving for interferometric baseline lengths. MMP synchronizes the motion and radar data. It combines the various measurement data into a unified, seven-dimensional reference system and puts out the resulting filtered trajectory and attitude data along with instructions for use of the data by Jurassicprok, as well as the command files used to operate Jurassicprok

Risk factors for early readmission due to surgical complications after treatment of proximal femoral fractures - A Finnish National Database study of 68,800 patients

Introduction: Hip fracture surgery is associated with a considerable amount medical and surgical complications, which adversely impacts the patient's outcome and/or increases costs. We evaluated what risk factors were associated with the occurrence of early readmission due to surgical complications after hip fracture surgery. Material and methods: A nationwide database with 68,800 hip fracture patients treated between 1999 and 2011 was studied to uncover the association of readmissions with co-morbidities, fracture types, different hospital types and treatment methods using the Cox proportional hazards model. Results: Early readmission within three months due to hip fracture surgery complications occurred at a rate of 4.6%. Increased occurrence of readmission was found among patients with: heavy alcoholism (HR 1.38; 95% CI: 1.23-1.53); Parkinson's disease (PD; HR 1.22; 95% CI: 1.05-1.42); pre-existing osteoarthritis (HR 2.02; 95% CI: 1.83-2.23); rheumatic disease (HR 1.44; 95% CI: 1.27-1.65); as well as those with a fracture of the femur neck, depression, presence of a psychotic disorder, an operative delay of at least three days, or previous treatment with total hip arthroplasty. Conclusion: Our results indicate that there are several factors associated with an increased risk of early readmission. We suggest that in the presence of these factors, the surgical treatment method and postoperative protocol should be carefully planned and performed. (C) 2018 The Authors. Published by Elsevier Ltd.Peer reviewe

Modelling predictors of molecular response to frontline imatinib for patients with chronic myeloid leukaemia

BACKGROUND: Treatment of patients with chronic myeloid leukaemia (CML) has become increasingly difficult in recent years due to the variety of treatment options available and challenge deciding on the most appropriate treatment strategy for an individual patient. To facilitate the treatment strategy decision, disease assessment should involve molecular response to initial treatment for an individual patient. Patients predicted not to achieve major molecular response (MMR) at 24 months to frontline imatinib may be better treated with alternative frontline therapies, such as nilotinib or dasatinib. The aims of this study were to i) understand the clinical prediction 'rules' for predicting MMR at 24 months for CML patients treated with imatinib using clinical, molecular, and cell count observations (predictive factors collected at diagnosis and categorised based on available knowledge) and ii) develop a predictive model for CML treatment management. This predictive model was developed, based on CML patients undergoing imatinib therapy enrolled in the TIDEL II clinical trial with an experimentally identified achieving MMR group and non-achieving MMR group, by addressing the challenge as a machine learning problem. The recommended model was validated externally using an independent data set from King Faisal Specialist Hospital and Research Centre, Saudi Arabia. PRINCIPLE FINDINGS: The common prognostic scores yielded similar sensitivity performance in testing and validation datasets and are therefore good predictors of the positive group. The G-mean and F-score values in our models outperformed the common prognostic scores in testing and validation datasets and are therefore good predictors for both the positive and negative groups. Furthermore, a high PPV above 65% indicated that our models are appropriate for making decisions at diagnosis and pre-therapy. Study limitations include that prior knowledge may change based on varying expert opinions; hence, representing the category boundaries of each predictive factor could dramatically change performance of the models.Haneen Banjar, Damith Ranasinghe, Fred Brown, David Adelson, Trent Kroger, Tamara Leclercq, Deborah White, Timothy Hughes, Naeem Chaudhr

Design and characterisation of the CLICTD pixelated monolithic sensor chip

A novel monolithic pixelated sensor and readout chip, the CLIC Tracker Detector (CLICTD) chip, is presented. The CLICTD chip was designed targeting the requirements of the silicon tracker development for the experiment at the Compact Linear Collider (CLIC), and has been fabricated in a modified 180 nm CMOS imaging process with charge collection on a high-resistivity p-type epitaxial layer. The chip features a matrix of 16×128 elongated channels, each measuring 300×30 μm2. Each channel contains 8 equidistant collection electrodes and analog readout circuits to ensure prompt signal formation. A simultaneous 8-bit Time-of-Arrival (with 10 ns time bins) and 5-bit Time-over-Threshold measurement is performed on the combined digital output of the 8 sub-pixels in every channel. The chip has been fabricated in two process variants and characterised in laboratory measurements using electrical test pulses and radiation sources. Results show a minimum threshold between 135 and 180 e‾ and a noise of about 14 e‾ RMS. The design aspects and characterisation results of the CLICTD chip are presented

Spontaneous Symmetry Breaking of phi4(1+1) in Light Front Field Theory

We study spontaneous symmetry breaking in phi^4_(1+1) using the light-front formulation of the field theory. Since the physical vacuum is always the same as the perturbative vacuum in light-front field theory the fields must develop a vacuum expectation value through the zero-mode components of the field. We solve the nonlinear operator equation for the zero-mode in the one-mode approximation. We find that spontaneous symmetry breaking occurs at lambda_critical = 4 pi(3+sqrt 3), which is consistent with the value lambda_critical = 54.27 obtained in the equal time theory. We calculate the value of the vacuum expectation value as a function of the coupling constant in the broken phase both numerically and analytically using the delta expansion. We find two equivalent broken phases. Finally we show that the energy levels of the system have the expected behavior within the broken phase.Comment: 17 pages, OHSTPY-HEP-TH-92-02

Variational Calculation of the Effective Action

An indication of spontaneous symmetry breaking is found in the two-dimensional $\lambda\phi^4$ model, where attention is paid to the functional form of an effective action. An effective energy, which is an effective action for a static field, is obtained as a functional of the classical field from the ground state of the hamiltonian $H[J]$ interacting with a constant external field. The energy and wavefunction of the ground state are calculated in terms of DLCQ (Discretized Light-Cone Quantization) under antiperiodic boundary conditions. A field configuration that is physically meaningful is found as a solution of the quantum mechanical Euler-Lagrange equation in the $J\to 0$ limit. It is shown that there exists a nonzero field configuration in the broken phase of $Z_2$ symmetry because of a boundary effect.Comment: 26 pages, REVTeX, 7 postscript figures, typos corrected and two references adde