675 research outputs found
Is the incidence of depressive disorders increased following cerebral concussion?
Q: Is the incidence of depressive disorders increased following cerebral concussion? Evidence-based answer: yes, in some populations. Youth and adolescents with self-reported history of concussion had increased risk of depressive disorders (strength of recommendation [SOR]: B, based on a prospective cohort study and a retrospective cohort study). Evidence was inconsistent for college athletes. Athletes with ≥ 3 concussions exhibited more depressive disorders, but no association was observed for those with 1 or 2 concussions compared to nonconcussion injuries (SOR: B, based on a cross-sectional study, a small prospective cohort study, and a case-control study). In semiprofessional and professional athletes, evidence was variable and may be sport related. Retired rugby players with a history of concussion showed no increase in depression compared to controls with no concussion history (SOR: B, based on a case-control study). Retired football players with previous concussions displayed increased incidence of depression, especially after ≥ 3 concussions (SOR: B, based on a prospective cohort study and a small case-control study). There is a significant risk of bias in these studies because of their reliance on self-reported concussions, differing definitions of depression, and possible unmeasured confounders in the study designs, making a causative relationship between concussion and depression unclear.Jason W. Deck, MD; Thomas Kern, MD; LaMont Cavanagh, MD; Matthew Bartow, DO; Franklin T. Perkins III, MD (Department of Family and Community Medicine, OU-TU School of Community Medicine, University of Oklahoma Health Sciences Center, Tulsa); Toni Hoberecht, MA, MLIS, AHIP; Alyssa Migdalski, MLIS (Schusterman Library, University of Oklahoma-Tulsa
Comparative evaluation of [(99m)tc]tilmanocept for sentinel lymph node mapping in breast cancer patients: results of two phase 3 trials.
BackgroundSentinel lymph node (SLN) surgery is used worldwide for staging breast cancer patients and helps limit axillary lymph node dissection. [(99m)Tc]Tilmanocept is a novel receptor-targeted radiopharmaceutical evaluated in 2 open-label, nonrandomized, within-patient, phase 3 trials designed to assess the lymphatic mapping performance.MethodsA total of 13 centers contributed 148 patients with breast cancer. Each patient received [(99m)Tc]tilmanocept and vital blue dye (VBD). Lymph nodes identified intraoperatively as radioactive and/or blue stained were excised and histologically examined. The primary endpoint, concordance (lower boundary set point at 90 %), was the proportion of nodes detected by VBD and [(99m)Tc]tilmanocept.ResultsA total of 13 centers contributed 148 patients who were injected with both agents. Intraoperatively, 207 of 209 nodes detected by VBD were also detected by [(99m)Tc]tilmanocept for a concordance rate of 99.04 % (p < 0.0001). [(99m)Tc]tilmanocept detected a total of 320 nodes, of which 207 (64.7 %) were detected by VBD. [(99m)Tc]Tilmanocept detected at least 1 SLN in more patients (146) than did VBD (131, p < 0.0001). In 129 of 131 patients with ≥1 blue node, all blue nodes were radioactive. Of 33 pathology-positive nodes (18.2 % patient pathology rate), [(99m)Tc]tilmanocept detected 31 of 33, whereas VBD detected only 25 of 33 (p = 0.0312). No pathology-positive SLNs were detected exclusively by VBD. No serious adverse events were attributed to [(99m)Tc]tilmanocept.Conclusion[(99m)Tc]Tilmanocept demonstrated success in detecting a SLN while meeting the primary endpoint. Interestingly, [(99m)Tc]tilmanocept was additionally noted to identify more SLNs in more patients. This localization represented a higher number of metastatic breast cancer lymph nodes than that of VBD
Two Transiting Earth-size Planets Near Resonance Orbiting a Nearby Cool Star
Discoveries from the prime Kepler mission demonstrated that small planets (<
3 Earth-radii) are common outcomes of planet formation. While Kepler detected
many such planets, all but a handful orbit faint, distant stars and are not
amenable to precise follow up measurements. Here, we report the discovery of
two small planets transiting K2-21, a bright (K = 9.4) M0 dwarf located
656 pc from Earth. We detected the transiting planets in photometry
collected during Campaign 3 of NASA's K2 mission. Analysis of transit light
curves reveals that the planets have small radii compared to their host star,
2.60 0.14% and 3.15 0.20%, respectively. We obtained follow up NIR
spectroscopy of K2-21 to constrain host star properties, which imply planet
sizes of 1.59 0.43 Earth-radii and 1.92 0.53 Earth-radii,
respectively, straddling the boundary between high-density, rocky planets and
low-density planets with thick gaseous envelopes. The planets have orbital
periods of 9.32414 days and 15.50120 days, respectively, and have a period
ratio of 1.6624, very near to the 5:3 mean motion resonance, which may be a
record of the system's formation history. Transit timing variations (TTVs) due
to gravitational interactions between the planets may be detectable using
ground-based telescopes. Finally, this system offers a convenient laboratory
for studying the bulk composition and atmospheric properties of small planets
with low equilibrium temperatures.Comment: Updated to ApJ accepted version; photometry available alongside LaTeX
source; 10 pages, 7 figure
All Six Planets Known to Orbit Kepler-11 Have Low Densities
The Kepler-11 planetary system contains six transiting planets ranging in
size from 1.8 to 4.2 times the radius of Earth. Five of these planets orbit in
a tightly-packed configuration with periods between 10 and 47 days. We perform
a dynamical analysis of the system based upon transit timing variations
observed in more than three years of \ik photometric data. Stellar parameters
are derived using a combination of spectral classification and constraints on
the star's density derived from transit profiles together with planetary
eccentricity vectors provided by our dynamical study. Combining masses of the
planets relative to the star from our dynamical study and radii of the planets
relative to the star from transit depths together with deduced stellar
properties yields measurements of the radii of all six planets, masses of the
five inner planets, and an upper bound to the mass of the outermost planet,
whose orbital period is 118 days. We find mass-radius combinations for all six
planets that imply that substantial fractions of their volumes are occupied by
constituents that are less dense than rock. The Kepler-11 system contains the
lowest mass exoplanets for which both mass and radius have been measured.Comment: 39 pages, 10 figure
Sentinel node staging for breast cancer: Intraoperative molecular pathology overcomes conventional histologic sampling errors
BACKGROUND: When sentinel node dissection reveals breast cancer metastasis, completion axillary lymph node dissection is ideally performed during the same operation. Intraoperative histologic techniques have low and variable sensitivity. A new intraoperative molecular assay (GeneSearch BLN Assay; Veridex, LLC, Warren, NJ) was evaluated to determine its efficiency in identifying significant sentinel lymph node metastases (\u3e.2 mm).
METHODS: Positive or negative BLN Assay results generated from fresh 2-mm node slabs were compared with results from conventional histologic evaluation of adjacent fixed tissue slabs.
RESULTS: In a prospective study of 416 patients at 11 clinical sites, the assay detected 98% of metastases \u3e2 mm and 88% of metastasis greater \u3e.2 mm, results superior to frozen section. Micrometastases were less frequently detected (57%) and assay positive results in nodes found negative by histology were rare (4%).
CONCLUSIONS: The BLN Assay is properly calibrated for use as a stand alone intraoperative molecular test
Stellar Spin-Orbit Misalignment in a Multiplanet System
Stars hosting hot Jupiters are often observed to have high obliquities,
whereas stars with multiple co-planar planets have been seen to have low
obliquities. This has been interpreted as evidence that hot-Jupiter formation
is linked to dynamical disruption, as opposed to planet migration through a
protoplanetary disk. We used asteroseismology to measure a large obliquity for
Kepler-56, a red giant star hosting two transiting co-planar planets. These
observations show that spin-orbit misalignments are not confined to hot-Jupiter
systems. Misalignments in a broader class of systems had been predicted as a
consequence of torques from wide-orbiting companions, and indeed
radial-velocity measurements revealed a third companion in a wide orbit in the
Kepler-56 system.Comment: Accepted for publication in Science, published online on October 17
2013; PDF includes main article and supplementary materials (65 pages, 27
figures, 7 tables); v2: small correction to author lis
Observation of activity prior to dielectric breakdown in liquid xenon with the XeBrA experiment
Maintaining the electric fields necessary for the current generation of noble
liquid time projection chambers (TPCs), with drift lengths exceeding one meter,
requires a large negative voltage applied to their cathode. Delivering such
high voltage is associated with an elevated risk of electrostatic discharge and
electroluminescence, which would be detrimental to the performance of the TPC.
The Xenon Breakdown Apparatus (XeBrA) is a five-liter high-voltage test chamber
built to investigate the factors contributing to high voltage breakdown in
noble liquids. Area scaling and surface finish were observed to be the dominant
factors affecting breakdown. In addition, small electrical activity was
frequently observed during high voltage ramps prior to electrostatic discharge.
The position of breakdowns was reconstructed with a system of high-speed
cameras and good agreement with electric field simulations was found. Based on
the results presented in this work, we recommend that the next generation of
TPCs should not withstand fields larger than 20 kV/cm on the electrode
surfaces.Comment: 29 pages, 13 figures; typo in the author list correcte
New exact solution of Dirac-Coulomb equation with exact boundary condition
It usually writes the boundary condition of the wave equation in the Coulomb
field as a rough form without considering the size of the atomic nucleus. The
rough expression brings on that the solutions of the Klein-Gordon equation and
the Dirac equation with the Coulomb potential are divergent at the origin of
the coordinates, also the virtual energies, when the nuclear charges number Z >
137, meaning the original solutions do not satisfy the conditions for
determining solution. Any divergences of the wave functions also imply that the
probability density of the meson or the electron would rapidly increase when
they are closing to the atomic nucleus. What it predicts is not a truth that
the atom in ground state would rapidly collapse to the neutron-like. We
consider that the atomic nucleus has definite radius and write the exact
boundary condition for the hydrogen and hydrogen-like atom, then newly solve
the radial Dirac-Coulomb equation and obtain a new exact solution without any
mathematical and physical difficulties. Unexpectedly, the K value constructed
by Dirac is naturally written in the barrier width or the equivalent radius of
the atomic nucleus in solving the Dirac equation with the exact boundary
condition, and it is independent of the quantum energy. Without any divergent
wave function and the virtual energies, we obtain a new formula of the energy
levels that is different from the Dirac formula of the energy levels in the
Coulomb field.Comment: 12 pages,no figure
Formation of Super-Earths
Super-Earths are the most abundant planets known to date and are
characterized by having sizes between that of Earth and Neptune, typical
orbital periods of less than 100 days and gaseous envelopes that are often
massive enough to significantly contribute to the planet's overall radius.
Furthermore, super-Earths regularly appear in tightly-packed multiple-planet
systems, but resonant configurations in such systems are rare. This chapters
summarizes current super-Earth formation theories. It starts from the formation
of rocky cores and subsequent accretion of gaseous envelopes. We follow the
thermal evolution of newly formed super-Earths and discuss their atmospheric
mass loss due to disk dispersal, photoevaporation, core-cooling and collisions.
We conclude with a comparison of observations and theoretical predictions,
highlighting that even super-Earths that appear as barren rocky cores today
likely formed with primordial hydrogen and helium envelopes and discuss some
paths forward for the future.Comment: Invited review accepted for publication in the 'Handbook of
Exoplanets,' Planet Formation section, Springer Reference Works, Juan Antonio
Belmonte and Hans Deeg, Ed
Neural-network approach to modeling liquid crystals in complex confinement
Finding the structure of a confined liquid crystal is a difficult task since both the density and order parameter profiles are non-uniform. Starting from a microscopic model and density-functional theory, one has to either (i) solve a non-linear, integral Euler-Lagrange equation, or (ii) perform a direct multi-dimensional free energy minimisation. The traditional implementations of both
approaches are computationally expensive and plagued with convergence problems. Here, as an alternative, we introduce an unsupervised variant of the Multi-Layer Perceptron (MLP) artificial neural network for minimising the free energy of a fluid of hard non-spherical particles confined between planar substrates of variable penetrability. We then test our algorithm by comparing its results for the structure (density-orientation profiles) and equilibrium free energy with those obtained by standard iterative solution of the Euler-Lagrange equations and with Monte Carlo simulation results. Very good agreement is found and the MLP method proves competitively fast, flexible and refinable. Furthermore, it can be readily generalised to the richer experimental patterned-substrate geometries that are now experimentally realisable but very problematic to conventional theoretical treatments
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