Photon-assisted shot noise in graphene in the Terahertz range

When subjected to electromagnetic radiation, the fluctuation of the electronic current across a quantum conductor increases. This additional noise, called photon-assisted shot noise, arises from the generation and subsequent partition of electron-hole pairs in the conductor. The physics of photon-assisted shot noise has been thoroughly investigated at microwave frequencies up to 20 GHz, and its robustness suggests that it could be extended to the Terahertz (THz) range. Here, we present measurements of the quantum shot noise generated in a graphene nanoribbon subjected to a THz radiation. Our results show signatures of photon-assisted shot noise, further demonstrating that hallmark time-dependant quantum transport phenomena can be transposed to the THz range.Comment: includes supplemental materia

Growth hormone-releasing hormone resistance in pseudohypoparathyroidism type Ia: New evidence for imprinting of the Gsα gene

Heterozygous inactivating mutations in the Gs\u3b1 gene cause Albright's hereditary osteodystrophy. Consistent with the observation that only maternally inherited mutations lead to resistance to hormone action [pseudohypoparathyroidism type Ia (PHP Ia)], recent studies provided evidence for a predominant maternal origin of Gs\u3b1 transcripts in endocrine organs, such as thyroid, gonad, and pituitary. The aim of this study was to investigate the presence of pituitary resistance to hypothalamic hormones acting via Gs\u3b1-coupled receptors in patients with PHP Ia. Six of nine patients showed an impaired GH responsiveness to GHRH plus arginine, consistent with a complete GH deficiency (GH peak from 2.6-8.6 \u3bcg/liter, normal > 16.5), and partial (GH peak 13.9 and 13.6 \u3bcg/liter) and normal responses were found in two and one patient, respectively. Accordingly, IGF-I levels were below and in the low-normal range in seven and two patients. All patients had a normal cortisol response to 1 \u3bcg ACTH test, suggesting a normal corticotroph function that was confirmed by a normal ACTH and cortisol response to CRH test in three patients. In conclusion, we report that in addition to PTH and TSH resistance, patients with PHP Ia display variable degrees of GHRH resistance, consistent with Gs\u3b1 imprinting in human pituitary

AME position statement on adrenal incidentaloma.

Objective: To assess currently available evidence on adrenal incidentaloma and provide recommendations for clinical practice. Design: A panel of experts (appointed by the Italian Association of Clinical Endocrinologists (AME)) appraised the methodological quality of the relevant studies, summarized their results, and discussed the evidence reports to find consensus. Radiological assessment: Unenhanced computed tomography (CT) is recommended as the initial test with the use of an attenuation value of <= 10 Hounsfield units (HU) to differentiate between adenomas and non-adenomas. For tumors with a higher baseline attenuation value, we suggest considering delayed contrast-enhanced CT studies. Positron emission tomography (PET) or PET/CT should be considered when CT is inconclusive, whereas fine needle aspiration biopsy may be used only in selected cases suspicious of metastases (after biochemical exclusion of pheochromocytoma). Hormonal assessment: Pheochromocytoma and excessive overt cortisol should be ruled out in all patients, whereas primary aldosteronism has to be considered in hypertensive and/or hypokalemic patients. The 1 mg overnight dexamethasone suppression test is the test recommended for screening of subclinical Cushing's syndrome (SCS) with a threshold at 138 nmol/l for considering this condition. A value of 50 nmol/l virtually excludes SCS with an area of uncertainty between 50 and 138 nmol/l. Management: Surgery is recommended for masses with suspicious radiological aspects and masses causing overt catecholamine or steroid excess. Data are insufficient to make firm recommendations for or against surgery in patients with SCS. However, adrenalectomy may be considered when an adequate medical therapy does not reach the treatment goals of associated diseases potentially linked to hypercortisolism

Dusty plasma in active galactic nuclei

Since many years we know that dust in the form of the dusty-molecular torus is responsible for the obscuration in active galactic nuclei (AGN) at large viewing angles and thus for the classification of AGN. Recently, we gained some observational and theoretical insight into geometry of the region and the role of the dust in the dynamics of the outflow and failed winds. We will briefly touch on all these aspects, including our dust-based model (FRADO - Failed Radiatively Accelerated Dusty Outflow) of the formation of the Balmer lines in AGN.Comment: Partially based on talk at 31st Symposium on the Physics of Ionized Gases in Belgrade, submitted to the European Physical Journal D Topical Issue: "Physics of Ionized Gases and Spectroscopy of Isolated Complex Systems: Fundamentals and Applications

Gamma-Knife Radiosurgery in Acromegaly: A 4-Year Follow-Up Study

Stereotactic radiosurgery by gamma-knife (GK) is an attractive therapeutic option after failure of microsurgical removal in patients with pituitary adenoma. In these tumors or remnants of them, it aims to obtain the arrest of cell proliferation and hormone hypersecretion using a single precise high dose of ionizing radiation, sparing surrounding structures. The long-term efficacy and toxicity of GK in acromegaly are only partially known. Thirty acromegalic patients (14 women and 16 men) entered a prospective study of GK treatment. Most were surgical failures, whereas in 3 GK was the primary treatment. Imaging of the adenoma and target coordinates identification were obtained by high resolution magnetic resonance imaging. All patients were treated with multiple isocenters (mean, 8; range, 3\u201311). The 50% isodose was used in 27 patients (90%). The mean margin dose was 20 Gy (range, 15\u201335), and the dose to the visual pathways was always less than 8 Gy. After a median follow-up of 46 months (range, 9\u201396), IGF-I fell from 805 \u3bcg/liter (median; interquartile range, 640\u2013994) to 460 \u3bcg/liter (interquartile range, 217\u2013654; P = 0.0002), and normal age-matched IGF-I levels were reached in 7 patients (23%). Mean GH levels decreased from 10 \u3bcg/liter (interquartile range, 6.4\u201315) to 2.9 \u3bcg/liter (interquartile range, 2\u20135.3; P < 0.0001), reaching levels below 2.5 \u3bcg/liter in 11 (37%). The rate of persistently pathological hormonal levels was still 70% at 5 yr by Kaplan-Meier analysis. The median volume was 1.43 ml (range, 0.20\u20133.7). Tumor shrinkage (at least 25% of basal volume) occurred after 24 months (range, 12\u201336) in 11 of 19 patients (58% of assessable patients). The rate of shrinkage was 79% at 4 yr. In no case was further growth observed. Only 1 patient complained of side-effects (severe headache and nausea immediately after the procedure, with full recovery in a few days with steroid therapy). Anterior pituitary failures were observed in 2 patients, who already had partial hypopituitarism, after 2 and 6 yr, respectively. No patient developed visual deficits. GK is a valid adjunctive tool in the management of acromegaly that controls GH/IGF-I hypersecretion and tumor growth, with shrinkage of adenoma and no recurrence of the disease in the considered observation period and with low acute and chronic toxicit

The quasar main sequence and its potential for cosmology

Nuclear Activity in Galaxies Across Cosmic Time, Proceedings of the conference held 7-11 October 2019 in Addis Ababa, Ethiopia. Edited by Mirjana Pović et al. Proceedings of the International Astronomical Union, Volume 356, pp. 66-71The main sequence offers a method for the systematization of quasar spectral properties. Extreme FeII emitters (or extreme Population A, xA) are believed to be sources accreting matter at very high rates. They are easily identifiable along the quasar main sequence, in large spectroscopic surveys over a broad redshift range. The very high accretion rate makes it possible that massive black holes hosted in xA quasars radiate at a stable, extreme luminosity-to-mass ratio. After reviewing the basic interpretation of the main sequence, we report on the possibility of identifying virial broadening estimators from low-ionization line widths, and provide evidence of the conceptual validity of redshift-independent luminosities based on virial broadening for a known luminosity-to-mass ratio.AdO acknowledges financial support from Spanish grants AYA2016-76682-C3-1-P and SEV-2017-0709

Mitotane concentrations influence outcome in patients with advanced adrenocortical carcinoma

Mitotane is the main option of treatment for advanced adrenocortical carcinoma (ACC). However, limited evidence is available regarding the impact of plasma mitotane levels on patient outcome. To address this question, we retrospectively analyzed patients with advanced ACC treated with mitotane for 653 months, with 653 measurements of plasma mitotane reported in the Lysosafe Online\uae database (HRA Pharma, France), followed at 12 tertiary centers in Italy from 2005 to 2017. We identified 80 patients, initially treated with mitotane alone (56.2%) or plus chemotherapy (43.8%). The preference toward combination therapy was given to de novo stage IV ACC and younger patients. After the first line of treatment, 25% of valid cases experienced clinical benefit (14.5% objective response, 10.5% stabilization of disease) and 75% progression, without differences between the groups of treatment. Patients with progression had a lower time in the target range (TTR) of plasma mitotane and an unfavorable outcome. Death occurred in 76.2% of cases and multivariate analysis showed that clinical benefit after first treatment and longer TTR were favorable predictors of overall survival (OS). In conclusion, the present findings support the importance of mitotane monitoring and strengthen the concept of a therapeutic window for mitotane

Correction to: Multiple endocrine neoplasia type 1: analysis of germline MEN1 mutations in the Italian multicenter MEN1 patient database.

The original version of this article unfortunately contained a mistake in Table 2. The table 2 was truncated in the original publication. The full table 2 is given below

Management of occult adrenocorticotropin-secreting bronchial carcinoids : limits of endocrine testing and imaging techniques

The differential diagnosis and the identification of the source of ACTH in occult ectopic Cushing's syndrome due to a bronchial carcinoid still represents a challenge for the endocrinologist. We report our experience in six patients with occult bronchial carcinoid in whom extensive hormonal, imaging, and scintigraphic evaluation was performed. All patients presented with hypercortisolism associated with high plasma ACTH values. The CRH test and high dose dexamethasone suppression test suggested an ectopic source of ACTH in three of six patients. During bilateral inferior petrosal sinus sampling, none of the patients showed a central to peripheral ACTH gradient. At the time of diagnosis, none of the patients had radiological evidence of the ectopic source of ACTH, whereas pentetreotide scintigraphy identified the lesion in two of four patients. Finally, a chest computed tomography scan revealed the presence of a bronchial lesion in all patients, and pentetreotide scintigraphy identified four of six lesions. In all patients a bronchial carcinoid was found and removed. In one patient with scintigraphic evidence of residual disease after two operations, radioguided surgery, using a hand-held \u3b3 probe after iv administration of radiolabeled pentetreotide, was performed; this allowed detection and removal of residual multiple mediastinal lymph node metastases. In conclusion, our data show that there is not a single endocrine test or imaging procedure accurate enough to diagnose and localize occult ectopic ACTH-secreting bronchial carcinoids. Radioguided surgery appears to be promising in the presence of multiple tumor foci and previous incomplete removal of the tumor

The porin and the permeating antibiotic: A selective diffusion barrier in gram-negative bacteria

Gram-negative bacteria are responsible for a large proportion of antibiotic resistant bacterial diseases. These bacteria have a complex cell envelope that comprises an outer membrane and an inner membrane that delimit the periplasm. The outer membrane contains various protein channels, called porins, which are involved in the influx of various compounds, including several classes of antibiotics. Bacterial adaptation to reduce influx through porins is an increasing problem worldwide that contributes, together with efflux systems, to the emergence and dissemination of antibiotic resistance. An exciting challenge is to decipher the genetic and molecular basis of membrane impermeability as a bacterial resistance mechanism. This Review outlines the bacterial response towards antibiotic stress on altered membrane permeability and discusses recent advances in molecular approaches that are improving our knowledge of the physico-chemical parameters that govern the translocation of antibiotics through porin channel