336 research outputs found
Interplay between static and dynamic polar correlations in relaxor Pb(Mg_{1/3}Nb_{2/3})O_{3}
We have characterized the dynamics of the polar nanoregions in
Pb(MgNb)O (PMN) through high-resolution neutron
backscattering and spin-echo measurements of the diffuse scattering cross
section. We find that the diffuse scattering intensity consists of \emph{both}
static and dynamic components. The static component first appears at the Curie
temperature K, while the dynamic component freezes completely
at the temperature T K; together, these components account for
all of the observed spectral weight contributing to the diffuse scattering
cross section. The integrated intensity of the dynamic component peaks near the
temperature at which the frequency-dependent dielectric constant reaches a
maximum (T) when measured at 1 GHz, i. e. on a timescale of
ns. Our neutron scattering results can thus be directly related to dielectric
and infra-red measurements of the polar nanoregions. Finally, the global
temperature dependence of the diffuse scattering can be understood in terms of
just two temperature scales, which is consistent with random field models.Comment: (8 pages, 5 figures, submitted to Phys. Rev. B
Neoadjuvant Treatment in Patients With Resectable and Borderline Resectable Pancreatic Cancer
Approximately 20% of pancreatic ductal adenocarcinoma (PDAC) patients have (borderline) resectable pancreatic cancer [(B)RPC] at diagnosis. Upfront resection with adjuvant chemotherapy has long been the standard of care for these patients. However, although surgical quality has improved, still about 50% of patients never receive adjuvant treatment. Therefore, recent developments have focused on a neoadjuvant approach. Directly comparing results from neoadjuvant and adjuvant regimens is challenging due to differences in patient populations that influence outcomes. Neoadjuvant trials include all patients who have (B)RPC on imaging, while adjuvant-only trials include patients who underwent a complete resection and recovered to a good performance status without any evidence of residual disease. Guidelines recommend neoadjuvant treatment for BRPC patients mainly to improve negative resection margin (R0) rates. For resectable PDAC, upfront resection is still considered the standard of care. However, theoretical advantages of neoadjuvant treatment, including the increased R0 resection rate, early delivery of systemic therapy to all patients, directly addressing occult metastatic disease, and improved patient selection for resection, may also apply to these patients. A systematic review by intention-to-treat showed a superior median overall survival (OS) for any neoadjuvant approach (19 months) compared to upfront surgery (15 months) in (B)RPC patients. A neoadjuvant approach was recently supported by three randomized controlled trials (RCTs). For resectable PDAC, neoadjuvant treatment was superior in a Japanese RCT of neoadjuvant gemcitabine with S-1 vs. upfront surgery, with adjuvant S-1 in both arms (median OS: 37 vs. 27 months, p = 0.015). A Korean trial of neoadjuvant gemcitabine-based chemoradiotherapy vs. upfront resection in BRPC patients was terminated early due to superiority of the neoadjuvant group (median OS: 21 vs. 12 months, p = 0.028; R0 resection: 52 vs. 26%, p = 0.004). The PREOPANC-1 trial for (B)RPC patients also showed favorable outcome for neoadjuvant gemcitabine-based chemoradiotherapy vs. upfront surgery (median OS: 17 vs. 14 months, p = 0.07; R0 resection: 63 vs. 31%, p < 0.001). FOLFIRINOX is likely a better neoadjuvant regimen, because of superiority compared to gemcitabine in both the metastatic and adjuvant setting. Currently, five RCTs evaluating neoadjuvant modified or fulldose FOLFIRINOX are accruing patients
Current evidence of nutritional therapy in pancreatoduodenectomy: Systematic review of randomized controlled trials
Aim: Evidence of nutritional therapies in pancreatoduodenectomy (PD) has been shown. However, few studies focus on the association between different nutritional therapies and outcomes. The aim of this review was to summarize the current evidence of nutritional therapies such as enteral nutrition (EN), immunonutrition, and synbiotics on postoperative outcomes after PD.
Methods: A systematic literature search of Embase, Medline Ovid, and Cochrane CENTRAL was done to summarize the available evidence, including randomized controlled trials, metaâanalyses and reviews, regarding nutritional therapy in PD.
Results: A total of 20 randomized controlled trials were included in this review. Safety and tolerability of EN in PD was shown. Giving postoperative EN can shorten length of stay compared to parenteral nutrition; however, the effect of EN on postoperative complications remains controversial. Postoperative EN should be given only on selective indications rather than routinely used, and preoperative EN is indicated only in patients with severe malnutrition. Giving preoperative immunonutrition is considered to reduce the incidence of infectious complications; however, evidence level is moderate and recommendation grade is weak. The beneficial effect of perioperative synbiotics on postoperative infectious complications is limited. Furthermore, the effectiveness of other nutritional supplements remains unclear.
Conclusion: Recently, evidence of enhanced recovery after surgery (ERAS) in PD has been increasing. Early oral intake with systematic nutritional support is an important aspect of the ERAS concept. Future wellâdesigned studies should investigate the impact of systematic nutritional therapies on outcomes following PD
Comments on two papers by Kapusta and Wong
We critically examine recently published results on the thermal production of
massive vector bosons in a quark-gluon plasma. We claim the production rate is
a collinear safe observable.Comment: 6 pages LATEX documen
Renormalization Group Approach to Field Theory at Finite Temperature
Scalar field theory at finite temperature is investigated via an improved
renormalization group prescription which provides an effective resummation over
all possible non-overlapping higher loop graphs. Explicit analyses for the
lambda phi^4 theory are performed in d=4 Euclidean space for both low and high
temperature limits. We generate a set of coupled equations for the mass
parameter and the coupling constant from the renormalization group flow
equation. Dimensional reduction and symmetry restoration are also explored with
our improved approach.Comment: 29 pages, can include figures in the body of the text using epsf.st
Two problems in thermal field theory
In this talk, I review recent progress made in two areas of thermal field
theory. In particular, I discuss various approaches for the calculation of the
quark gluon plasma thermodynamical properties, and the problem of its photon
production rate.Comment: 10 pages Latex document, 15 postscript figures. Invited talk given at
the 6th Workshop on High Energy Particle Physics, Chennai, India, 3-15 Jan
200
Efficacy and feasibility of stereotactic radiotherapy after folfirinox in patients with locally advanced pancreatic cancer (LAPC-1 trial)
Background: We conducted a multicentre phase II trial to investigate feasibility and antitumor activity of sequential FOLFIRINOX and Stereotactic Body Radiotherapy (SBRT) in patients with locally advanced pancreatic cancer (LAPC), (LAPC-1 trial). Methods: Patients with biopsy-proven LAPC treated in four hospitals in the Netherlands between December 2014 and June 2017. Patients received 8 cycles of FOLFIRINOX followed by SBRT (5 fractions/8 Gy) if no tumour progression after the FOLFIRINOX treatment was observed. Primary outcome was 1-year overall survival (OS). Secondary outcomes were median OS, 1-year progression-free survival (PFS), treatment-related toxicity, and resection rate. The study is registered with ClinicalTrials.gov, NCT02292745, and is completed. Findings: Fifty patients were included. Nineteen (38%) patients did not receive all 8 cycles of FOLFIRINOX, due to toxicity (n = 12), disease progression (n = 6), or patientsâ preference (n = 1). Thirty-nine (78%) patients received the SBRT treatment. The 1-year OS and PFS were 64% (95% CI: 50%-76%) and 3
Treatment of patients with gastro-entero-pancreatic (GEP) tumours with the novel radiolabelled somatostatin analogue [177Lu-DOTA0,Tyr3]octreotate
Medical treatment and chemotherapy are seldom successful in achieving objective tumour reduction in patients with metastatic neuroendocrine tumours. Treatment with the radiolabelled somatostatin analogue [90Y-DOTA0,Tyr3]octreotide may result in partial remissions in 10â25% of patients. The newer analogue [DOTA0,Tyr3]octreotate (octreotate) has a ninefold higher affinity for the somatostatin receptor subtype 2 as compared with [DOTA0,Tyr3]octreotide. Also, labelled with the beta- and gamma-emitting radionuclide 177Lu, it has proved very successful in achieving tumour regression in animal models. The effects of 177Lu-octreotate therapy were studied in 35 patients with neuroendocrine gastro-entero-pancreatic (GEP) tumours who underwent follow-up for 3â6 months after receiving their final dose. Patients were treated with doses of 100, 150 or 200Â mCi 177Lu-octreotate, to a final cumulative dose of 600â800Â mCi, with treatment intervals of 6â9 weeks. Nausea and vomiting within the first 24Â h after administration were present in 30% and 14% of the administrations, respectively. WHO toxicity grade 3 anaemia, leucocytopenia and thrombocytopenia occurred after 0%, 1% and 1% of the administrations, respectively. Serum creatinine and creatinine clearance did not change significantly. The effects of the therapy on tumour size were evaluable in 34 patients. Three months after the final administration, complete remission was found in one patient (3%), partial remission in 12 (35%), stable disease in 14 (41%) and progressive disease in seven (21%), including three patients who died during the treatment period. Tumour response was positively correlated with a high uptake on the octreoscan, limited hepatic tumour mass and a high Karnofsky Performance Score. Because of the limited efficacy of alternative therapies, many physicians currently adopt an expectant attitude when dealing with patients with metastatic GEP tumours. However, in view of the high success rate of therapy with 177Lu-octreotate and the absence of serious side-effects, we advocate its use in patients with GEP tumours without waiting for tumour progression
A Generalized Fluctuation-Dissipation Theorem for Nonlinear Response Functions
A nonlinear generalization of the Fluctuation-Dissipation Theorem (FDT) for
the n-point Green functions and the amputated 1PI vertex functions at finite
temperature is derived in the framework of the Closed Time Path formalism. We
verify that this generalized FDT coincides with known results for n=2 and 3.
New explicit relations among the 4-point nonlinear response and correlation
(fluctuation) functions are presented.Comment: 34 pages, Revte
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