Radiological staging in breast cancer: which asymptomatic patients to image and how.

BACKGROUND: Approximately 4% of patients diagnosed with early breast cancer have occult metastases at presentation. Current national and international guidelines lack consensus on whom to image and how. METHODS: We assessed practice in baseline radiological staging against local guidelines for asymptomatic newly diagnosed breast cancer patients presenting to the Cambridge Breast Unit over a 9-year period. RESULTS: A total of 2612 patients were eligible for analysis; 91.7% were appropriately investigated. However in the subset of lymph node negative stage II patients, only 269 out of 354 (76.0%) investigations were appropriate. No patients with stage 0 or I disease had metastases; only two patients (0.3%) with stage II and or =4 positive lymph nodes), III and IV disease, respectively. CONCLUSION: These results prompted us to propose new local guidelines for staging asymptomatic breast cancer patients: only clinical stage III or IV patients require baseline investigation. The high specificity and convenience of computed tomography (chest, abdomen and pelvis) led us to recommend this as the investigation of choice in breast cancer patients requiring radiological staging

Analyzing Multi-key Security Degradation

Contains fulltext : 179039.pdf (preprint version ) (Closed access) Contains fulltext : 179039.pdf (Publisher’s version ) (Open Access)nul

Precision charging of microparticles in plasma via the Rayleigh instability for evaporating charged liquid droplets

In this paper we describe a novel method for delivering a precise, known amount of electric charge to a micron-sized solid target. Aerosolised microparticles passed through a plasma discharge will acquire significant electric charge. The fluid stability under evaporative stress is a key aspect that is core to the research. Initially stable charged aerosols subject to evaporation (i.e. a continually changing radius) may encounter the Rayleigh stability limit. This limit arises from the electrostatic and surface tension forces and determines the maximum charge a stable droplet can retain, as a function of radius. We demonstrate that even if the droplet charge is initially much less than the Rayleigh limit, the stability limit will be encountered as the droplet evaporates. The instability emission mechanism is strongly linked to the final charge deposited on the target, providing a mechanism that can be used to ensure a predictable charge deposit on a known encapsulated microparticle

Male gonadal dose of ionizing radiation delivered during X-ray examinations and monthly probability of pregnancy: a population-based retrospective study

BACKGROUND: Male gonadal exposure to ionizing radiation may disrupt spermatogenesis, but its influence on the fecundity of couples has been rarely studied. We aimed to characterize the influence of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy. METHODS: We recruited a random sample of women who retrospectively described 1110 periods of unprotected intercourse beginning between 1985 and 1999 and leading either to a live birth or to no pregnancy; their duration was censored after 13 months. The male partner answered a telephone questionnaire on radiodiagnostic examinations. We assigned a mean gonadal dose to each type of radiodiagnostic examination. We defined male dose for each period of unprotected intercourse as the sum of the gonadal doses of the X-ray examinations experienced between 18 years of age and the date of discontinuation of contraception. Time to pregnancy was analysed using a discrete Cox model with random effect allowing to estimate hazard ratios of pregnancy. RESULTS: After adjustment for female factors likely to influence fecundity, there was no evidence of an association between male dose and the probability of pregnancy (test of homogeneity, p = 0.55). When compared to couples with a male gonadal dose between 0.01 and 0.20 milligrays (n = 321 periods of unprotected intercourse), couples with a gonadal dose above 10 milligrays had a hazard ratio of pregnancy of 1.44 (95% confidence interval, 0.73–2.86, n = 31). CONCLUSION: Our study provides no evidence of a long-term detrimental effect of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy during the year following discontinuation of contraceptive use. Classification errors due to the retrospective assessment of male gonadal exposure may have limited the statistical power of our study

Trace elements in hemodialysis patients: a systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Hemodialysis patients are at risk for deficiency of essential trace elements and excess of toxic trace elements, both of which can affect health. We conducted a systematic review to summarize existing literature on trace element status in hemodialysis patients.</p> <p>Methods</p> <p>All studies which reported relevant data for chronic hemodialysis patients and a healthy control population were eligible, regardless of language or publication status. We included studies which measured at least one of the following elements in whole blood, serum, or plasma: antimony, arsenic, boron, cadmium, chromium, cobalt, copper, fluorine, iodine, lead, manganese, mercury, molybdenum, nickel, selenium, tellurium, thallium, vanadium, and zinc. We calculated differences between hemodialysis patients and controls using the differences in mean trace element level, divided by the pooled standard deviation.</p> <p>Results</p> <p>We identified 128 eligible studies. Available data suggested that levels of cadmium, chromium, copper, lead, and vanadium were higher and that levels of selenium, zinc and manganese were lower in hemodialysis patients, compared with controls. Pooled standard mean differences exceeded 0.8 standard deviation units (a large difference) higher than controls for cadmium, chromium, vanadium, and lower than controls for selenium, zinc, and manganese. No studies reported data on antimony, iodine, tellurium, and thallium concentrations.</p> <p>Conclusion</p> <p>Average blood levels of biologically important trace elements were substantially different in hemodialysis patients, compared with healthy controls. Since both deficiency and excess of trace elements are potentially harmful yet amenable to therapy, the hypothesis that trace element status influences the risk of adverse clinical outcomes is worthy of investigation.</p

Collision Resistant Hashing from Sub-exponential Learning Parity with Noise

The Learning Parity with Noise (LPN) problem has recently found many cryptographic applications such as authentication protocols, pseudorandom generators/functions and even asymmetric tasks including public-key encryption (PKE) schemes and oblivious transfer (OT) protocols. It however remains a long-standing open problem whether LPN implies collision resistant hash (CRH) functions. Based on the recent work of Applebaum et al. (ITCS 2017), we introduce a general framework for constructing CRH from LPN for various parameter choices. We show that, just to mention a few notable ones, under any of the following hardness assumptions (for the two most common variants of LPN) 1) constant-noise LPN is $2^{n^{0.5+\epsilon}}$-hard for any constant $\epsilon>0$; 2) constant-noise LPN is $2^{\Omega(n/\log n)}$-hard given $q=poly(n)$ samples; 3) low-noise LPN (of noise rate $1/\sqrt{n}$) is $2^{\Omega(\sqrt{n}/\log n)}$-hard given $q=poly(n)$ samples. there exists CRH functions with constant (or even poly-logarithmic) shrinkage, which can be implemented using polynomial-size depth-3 circuits with NOT, (unbounded fan-in) AND and XOR gates. Our technical route LPN$\rightarrow$bSVP$\rightarrow$CRH is reminiscent of the known reductions for the large-modulus analogue, i.e., LWE$\rightarrow$SIS$\rightarrow$CRH, where the binary Shortest Vector Problem (bSVP) was recently introduced by Applebaum et al. (ITCS 2017) that enables CRH in a similar manner to Ajtai\u27s CRH functions based on the Short Integer Solution (SIS) problem. Furthermore, under additional (arguably minimal) idealized assumptions such as small-domain random functions or random permutations (that trivially imply collision resistance), we still salvage a simple and elegant collision-resistance-preserving domain extender that is (asymptotically) more parallel and efficient than previously known. In particular, assume $2^{n^{0.5+\epsilon}}$-hard constant-noise LPN or $2^{n^{0.25+\epsilon}}$-hard low-noise LPN, we obtain a polynomially shrinking collision resistant hash function that evaluates in parallel only a single layer of small-domain random functions (or random permutations) and produces their XOR sum as output

Impaired growth in rural Gambian infants exposed to aflatoxin: a prospective cohort study

Background: Exposure to aflatoxin, a mycotoxin produced by fungi that commonly contaminates cereal crops across sub-Saharan Africa, has been associated with impaired child growth. We investigated the impact of aflatoxin exposure on the growth of Gambian infants from birth to two years of age, and the impact on insulin-like growth factor (IGF)-axis proteins. Methods: A subsample (N = 374) of infants from the Early Nutrition and Immune Development (ENID) trial (ISRCTN49285450) were included in this study. Aflatoxin-albumin adducts (AF-alb) were measured in blood collected from infants at 6, 12 and 18 months of age. IGF-1 and IGFBP-3 were measured in blood collected at 12 and 18 months. Anthropometric measurements taken at 6, 12, 18 and 24 months of age were converted to z-scores against the WHO reference. The relationship between aflatoxin exposure and growth was analysed using multi-level modelling. Results: Inverse relationships were observed between lnAF-alb and length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) z-scores from 6 to 18 months of age (β = − 0·04, P = 0·015; β = − 0·05, P = 0.003; β = − 0·06, P = 0·007; respectively). There was an inverse relationship between lnAF-alb at 6 months and change in WLZ between 6 and 12 months (β = − 0·01; P = 0·013). LnAF-alb at 12 months was associated with changes in LAZ and infant length between 12 and 18 months of age (β = − 0·01, P = 0·003; β = − 0·003, P = 0·02; respectively). LnAF-alb at 6 months was associated with IGFBP-3 at 12 months (r = − 0·12; P = 0·043). Conclusions: This study found a small but significant effect of aflatoxin exposure on the growth of Gambian infants. This relationship is not apparently explained by aflatoxin induced changes in the IGF-axis