Quantum phase transitions (QPTs) are usually associated with many-body systems in the thermodynamic limit when their ground states show abrupt changes at zero temperature with variation of a ...parameter in the Hamiltonian. Recently it has been realized that a QPT can also occur in a system composed of only a two-level atom and a single-mode bosonic field, described by the quantum Rabi model (QRM). Here we report an experimental demonstration of a QPT in the QRM using a
Yb
ion in a Paul trap. We measure the spin-up state population and the average phonon number of the ion as two order parameters and observe clear evidence of the phase transition via adiabatic tuning of the coupling between the ion and its spatial motion. An experimental probe of the phase transition in a fundamental quantum optics model without imposing the thermodynamic limit opens up a window for controlled study of QPTs and quantum critical phenomena.
Studies showed that axillary lymph node dissection can be safely omitted in presence of positive sentinel lymph node(s) in breast cancer patients treated with breast conserving therapy. Since the ...outcome of the sentinel lymph node biopsy has no clinical consequence, the value of the procedure itself is being questioned. The aim of the BOOG 2013-08 trial is to investigate whether the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients treated with breast conserving therapy.
The BOOG 2013-08 is a Dutch prospective non-inferiority randomized multicentre trial. Women with pathologically confirmed clinically node negative T1-2 invasive breast cancer undergoing breast conserving therapy will be randomized for sentinel lymph node biopsy versus no sentinel lymph node biopsy. Endpoints include regional recurrence after 5 (primary endpoint) and 10 years of follow-up, distant-disease free and overall survival, quality of life, morbidity and cost-effectiveness. Previous data indicate a 5-year regional recurrence free survival rate of 99% for the control arm and 96% for the study arm. In combination with a non-inferiority limit of 5% and probability of 0.8, this result in a sample size of 1.644 patients including a lost to follow-up rate of 10%. Primary and secondary endpoints will be reported after 5 and 10 years of follow-up.
If the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients undergoing breast conserving therapy, this study will cost-effectively lead to a decreased axillary morbidity rate and thereby improved quality of life with non-inferior regional control, distant-disease free survival and overall survival.
The BOOG 2013-08 study is registered in ClinicalTrials.gov since October 20, 2014, Identifier: NCT02271828. https://clinicaltrials.gov/ct2/show/NCT02271828.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Fracture pattern development has been a challenging area of research in the Earth sciences for more than 100 years. Much has been learned about the spatial and temporal complexity inherent to these ...systems, but severe challenges remain. Future advances will require new approaches. Chemical processes play a larger role in opening‐mode fracture pattern development than has hitherto been appreciated. This review examines relationships between mechanical and geochemical processes that influence the fracture patterns recorded in natural settings. For fractures formed in diagenetic settings (~50 to 200 °C), we review evidence of chemical reactions in fractures and show how a chemical perspective helps solve problems in fracture analysis. We also outline impediments to subsurface pattern measurement and interpretation, assess implications of discoveries in fracture history reconstruction for process‐based models, review models of fracture cementation and chemically assisted fracture growth, and discuss promising paths for future work. To accurately predict the mechanical and fluid flow properties of fracture systems, a processes‐based approach is needed. Progress is possible using observational, experimental, and modeling approaches that view fracture patterns and properties as the result of coupled mechanical and chemical processes. A critical area is reconstructing patterns through time. Such data sets are essential for developing and testing predictive models. Other topics that need work include models of crystal growth and dissolution rates under geological conditions, cement mechanical effects, and subcritical crack propagation. Advances in machine learning and 3‐D imaging present opportunities for a mechanistic understanding of fracture formation and development, enabling prediction of spatial and temporal complexity over geologic timescales. Geophysical research with a chemical perspective is needed to correctly identify and interpret fractures from geophysical measurements during site characterization and monitoring of subsurface engineering activities.
Plain Language Summary
Fracture patterns in rock strongly affect directions, magnitudes, and heterogeneities of both fluid flow and rock strength. Accurate and testable predictions of patterns are essential for understanding many societally important processes in the Earth and for effectively managing subsurface engineering operations. Chemical processes play a larger role in opening‐mode fracture pattern development than has hitherto been appreciated. For fractures formed at depths of ~1–10 km and temperatures of 50–200 °C, new evidence shows chemical reactions are common and more diverse than previously recognized. We describe how viewing fracture formation and evolution from a chemical perspective helps to solve problems in fracture pattern analysis. We outline the main impediments to subsurface fracture pattern measurement and interpretation, assess implications of recent discoveries in fracture history reconstruction for process‐based models of fracture and cement accumulation, review models of fracture cementation and chemically assisted fracture growth, and discuss promising paths for future work. Potential exists for basic scientific investigations to lead to progress on what has been one of the most refractory practical problems in subsurface science. Results suggest that progress in fracture interpretation and prediction can be made using observational, experimental, modeling, and theoretical approaches that view fracture patterns as the result of coupled mechanical and chemical processes.
Key Points
A chemical perspective helps solve challenges to understanding subsurface fractures: inadequate samples, ambiguous analogs, and difficulties determining which models are correct from observations
Many tools of chemical analysis, experiment, modeling, and theory have yet to be brought to bear on understanding how fracture patterns develop at geological timescales
Chemical and mechanical investigations together have great potential to solve challenging practical problems in subsurface science
Background
Marking the axilla with radioactive iodine seed and sentinel lymph node (SLN) biopsy have been proposed for axillary staging after neoadjuvant systemic therapy in clinically node‐positive ...breast cancer. This study evaluated the identification rate and detection of residual disease with combined excision of pretreatment‐positive marked lymph nodes (MLNs) together with SLNs.
Methods
This was a multicentre retrospective analysis of patients with clinically node‐positive breast cancer undergoing neoadjuvant systemic therapy and the combination procedure (with or without axillary lymph node dissection). The identification rate and detection of axillary residual disease were calculated for the combination procedure, and for MLNs and SLNs separately.
Results
At least one MLN and/or SLN(s) were identified by the combination procedure in 138 of 139 patients (identification rate 99·3 per cent). The identification rate was 92·8 per cent for MLNs alone and 87·8 per cent for SLNs alone. In 88 of 139 patients (63·3 per cent) residual axillary disease was detected by the combination procedure. Residual disease was shown only in the MLN in 20 of 88 patients (23 per cent) and only in the SLN in ten of 88 (11 per cent), whereas both the MLN and SLN contained residual disease in the remainder (58 of 88, 66 per cent).
Conclusion
Excision of the pretreatment‐positive MLN together with SLNs after neoadjuvant systemic therapy in patients with clinically node‐positive disease resulted in a higher identification rate and improved detection of residual axillary disease.
Antecedentes
En el cáncer de mama con ganglios positivos clínicamente tras el tratamiento neoadyuvante sistémico, se ha propuesto la utilización de iodo radioactivo (Marking Axilla with Radioactive Iodine, MARI) y de la biopsia de ganglio linfático centinela para la estadificación axilar. En este estudio se evaluó la tasa de identificación y detección de enfermedad residual cuando se combinó la exéresis de los ganglios linfáticos marcados antes del tratamiento (marked lymph nodes, MLN) junto con los ganglios centinela (sentinel lymph nodes, SLN).
Métodos
Se realizó un análisis retrospectivo multicéntrico de pacientes con cáncer de mama con ganglios positivos clínicamente que se sometieron a tratamiento neoadyuvante sistémico y en las que se combinaron ambas técnicas (con o sin disección axilar). Se calcularon las tasas de identificación y detección de enfermedad residual axilar para MLN y SLN por separado y en conjunto.
Resultados
En 138/139 pacientes se identificaron ≥ 1 MLN y/o SLN combinando ambas técnicas (tasa de identificación del 99,3%). La tasa de identificación fue de 92,8% para MLN y del 87,8% para SLN. Combinando ambas técnicas se detectó enfermedad axilar residual en 88/139 (63,3%) pacientes. Se detectó enfermedad residual en 20/88 (22,7%) pacientes utilizando únicamente MLN, en 10/88 (11,4%) pacientes utilizando únicamente SLN y en 58/88 (65,9%) combinando ambas técnicas.
Conclusión
La exéresis conjunta de los ganglios marcados con iodo radioactivo antes del tratamiento neoadyuvante sistémico y de los ganglios centinela después del tratamiento en pacientes con cN+ logró una tasa de identificación más alta y una mejor detección de la enfermedad axilar residual.
Replacing axillary lymph node dissection with less invasive axillary staging procedures in patients with clinically node‐positive breast cancer treated with neoadjuvant systemic therapy is debated. Implementation of several different less invasive procedures is ongoing at some centres. In this cohort, the identification rate and detection of residual disease of combined excision of the pretreatment‐positive marked lymph node with the sentinel lymph nodes were evaluated, and compared with excising only the marked lymph node or the sentinel lymph nodes alone.
Combination superior
We investigate the magnetic field and temperature dependence of the single-electron spin lifetime in silicon quantum dots and find a lifetime of 2.8 ms at a temperature of 1.1 K. We develop a model ...based on spin-valley mixing and find that Johnson noise and two-phonon processes limit relaxation at low and high temperature, respectively. We also investigate the effect of temperature on charge noise and find a linear dependence up to 4 K. These results contribute to the understanding of relaxation in silicon quantum dots and are promising for qubit operation at elevated temperatures.
Surface electromyography (sEMG) can be used to measure the electrical activity of the respiratory muscles. The possible applications of sEMG span from patients suffering from acute respiratory ...failure to patients receiving chronic home mechanical ventilation, to evaluate muscle function, titrate ventilatory support and guide treatment. However, sEMG is mainly used as a monitoring tool for research and its use in clinical practice is still limited-in part due to a lack of standardization and transparent reporting. During this round table meeting, recommendations on data acquisition, processing, interpretation, and potential clinical applications of respiratory sEMG were discussed. This paper informs the clinical researcher interested in respiratory muscle monitoring about the current state of the art on sEMG, knowledge gaps and potential future applications for patients with respiratory failure.
Summary
Background
Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) worldwide. It remains incompletely understood in the real world how anti‐viral therapy affects ...survival after HCC diagnosis.
Methods
This was an international multicentre cohort study of 2518 HBV‐related HCC cases diagnosed between 2000 and 2015. Cox proportional hazards models were utilised to estimate hazard ratios (HR) with 95% (CI) for anti‐viral therapy and cirrhosis on patients' risk of death.
Results
Approximately, 48% of patients received anti‐viral therapy at any time, but only 17% were on therapy at HCC diagnosis (38% at US centres, 11% at Asian centres). Anti‐viral therapy would have been indicated for >60% of the patients not on anti‐viral therapy based on American criteria. Patients with cirrhosis had lower 5‐year survival (34% vs 46%; P < 0.001) while patients receiving anti‐viral therapy had increased 5‐year survival compared to untreated patients (42% vs 25% with cirrhosis and 58% vs 36% without cirrhosis; P < 0.001 for both). Similar findings were seen for other patient subgroups by cancer stages and cancer treatment types. Anti‐viral therapy was associated with a decrease in risk of death, whether started before or after HCC diagnosis (adjusted HR 0.62 and 0.79, respectively; P < 0.001).
Conclusions
Anti‐viral therapy improved overall survival in patients with HBV‐related HCC across cancer stages and treatment types but was underutilised at both US and Asia centres. Expanded use of anti‐viral therapy in HBV‐related HCC and better linkage‐to‐care for HBV patients are needed.
Basin-scale planning is needed to minimize impacts in mega-diverse rivers
The world's most biodiverse river basins—the Amazon, Congo, and Mekong—are experiencing an unprecedented boom in construction ...of hydropower dams. These projects address important energy needs, but advocates often overestimate economic benefits and underestimate far-reaching effects on biodiversity and critically important fisheries. Powerful new analytical tools and high-resolution environmental data can clarify trade-offs between engineering and environmental goals and can enable governments and funding institutions to compare alternative sites for dam building. Current site-specific assessment protocols largely ignore cumulative impacts on hydrology and ecosystem services as ever more dams are constructed within a watershed (
1
). To achieve true sustainability, assessments of new projects must go beyond local impacts by accounting for synergies with existing dams, as well as land cover changes and likely climatic shifts (
2
,
3
). We call for more sophisticated and holistic hydropower planning, including validation of technologies intended to mitigate environmental impacts. Should anything less be required when tampering with the world's great river ecosystems?
All-optical switching (AOS) of magnetic materials describes the reversal of the magnetization using short (femtosecond) laser pulses, and received extensive attention in the past decade due to its ...high potential for fast and energy-efficient data writing in future spintronic memory applications. Unfortunately, the AOS mechanism in the ferromagnetic multilayers commonly used in spintronics needs multiple pulses for the magnetization reversal, losing its speed and energy efficiency. Here, we experimentally demonstrate on-the-fly single-pulse AOS in combination with spin Hall effect (SHE) driven motion of magnetic domains in Pt/Co/Gd synthetic-ferrimagnetic racetracks. Moreover, using field-driven-SHE-assisted domain wall (DW) motion measurements, both the SHE efficiency in the racetrack is determined and the chirality of the optically written DW's is verified. Our experiments demonstrate that Pt/Co/Gd racetracks facilitate both single-pulse AOS as well as efficient SHE-induced domain wall motion, which might ultimately pave the way towards integrated photonic memory devices.
Three-dimensional topological Weyl semimetals can generally support a zero-dimensional Weyl point characterized by a quantized Chern number or a one-dimensional Weyl nodal ring characterized by a ...quantized Berry phase in the momentum space. Here, in a dissipative system with particle gain and loss, we discover a new type of topological ring, dubbed a Weyl exceptional ring consisting of exceptional points at which two eigenstates coalesce. Such a Weyl exceptional ring is characterized by both a quantized Chern number and a quantized Berry phase, which are defined via the Riemann surface. We propose an experimental scheme to realize and measure the Weyl exceptional ring in a dissipative cold atomic gas trapped in an optical lattice.
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