The use of adjuvant radiation therapy in breast cancer patients treated with mastectomy and adjuvant chemotherapy has been controversial. In order to assess the necessity and effectiveness of ...adjuvant radiation therapy in this setting, we reviewed the results in 510 patients with T1-T3 tumors and pathologically positive nodes or tumors larger than 5 cm and negative nodes who were treated with adjuvant chemotherapy. Patients with four or more positive nodes or at least one positive apical node were randomized to receive either five or ten cycles of cyclophosphamide/Adriamycin (Adria Laboratories, Columbus, OH) (CA) and patients with one to three positive nodes or operable tumors larger than 5 cm and pathologically negative nodes were randomized to receive eight cycles of either cyclophosphamide, methotrexate, and 5-fluorouracil (5-FU) (CMF) or methotrexate and 5-FU (MF) chemotherapy. Two hundred six of these patients were subsequently rerandomized to receive either no further treatment or adjuvant radiotherapy. Thirty-five patients withdrew after randomization, including 34 who declined to receive radiotherapy. Radiation therapy consisted of 4,500 cGy in 5 weeks to the chest wall and appropriate draining lymph nodes. Median follow-up from chemotherapy randomization is 45 months for patients in the CA arm and 53 months for those in the CMF/MF arm. The crude rate of local failure (chest wall or draining lymph node areas) as first site of failure for patients randomized to receive chemotherapy only was 14%; for those randomized to receive both chemotherapy and radiotherapy it was 5% (P = .03). For patients in the CMF/MF arm, the rate of local failure as the first site of failure was nearly the same for patients randomized to chemotherapy only as for those randomized to adjuvant radiotherapy as well (5% v 2%). For patients in the CA arm, the crude rate of local failure was 20% for patients randomized to receive chemotherapy only, and 6% for those randomized to both types of adjuvant treatment (P = .03). Among the 43 patients treated with CA who actually received radiotherapy, there was only one local failure, compared with 12 local failures among the 59 patients (20%) who actually did not receive radiotherapy (P = .007). No significant difference was seen in disease-free survival or overall survival in either the CA or the CMF/MF arm between patients randomized to receive radiation therapy and those randomized to no further treatment.
This paper describes a study of techniques for identifying Higgs bosons at high transverse momenta decaying into bottom-quark pairs, Formula omitted, for proton-proton collision data collected by the ...ATLAS detector at the Large Hadron Collider at a centre-of-mass energy Formula omitted Formula omitted. These decays are reconstructed from calorimeter jets found with the anti- Formula omitted Formula omitted jet algorithm. To tag Higgs bosons, a combination of requirements is used: b-tagging of Formula omitted track-jets matched to the large-R calorimeter jet, and requirements on the jet mass and other jet substructure variables. The Higgs boson tagging efficiency and corresponding multijet and hadronic top-quark background rejections are evaluated using Monte Carlo simulation. Several benchmark tagging selections are defined for different signal efficiency targets. The modelling of the relevant input distributions used to tag Higgs bosons is studied in 36 fb Formula omitted of data collected in 2015 and 2016 using Formula omitted and Formula omitted event selections in data. Both processes are found to be well modelled within the statistical and systematic uncertainties.
Distant metastases are the major cause of morbidity and mortality in women with breast cancer. The ability to predict the metastatic proclivity is essential in choosing the optimal treatment. Tumor ...size and grade, which are frequently used markers in node-negative breast cancer patients, are inadequate markers for prognosis and individualized treatment design. The steps in metastatic progression include angiogenesis, invasion, and changes in adhesion characteristics. We developed a strategy for choosing biomarkers representing these steps in malignant progression to identify patients with occult metastases who will need chemotherapy and spare those women whose tumors have not developed the capacity to spread. To evaluate the added significance of E-cadherin to that of nm23-H1 and angiogenesis in determining metastatic proclivity, we used archival material from 168 node-negative breast cancer patients who were treated with mastectomy without any adjuvant chemotherapy or hormone therapy. Immunohistochemistry was used to detect E-cadherin and nm23-H1 expression, whereas angiogenesis was determined by microvessel count (MVC) after immunohistochemical staining. The median follow-up is 14 years. We found that E-cadherin is better in identifying the poor prognosis patients. The 14-year disease-free survival (DFS) is 84%, 80%, and 56% in patients with high, intermediate, and low E-cadherin. The worst prognosis group using nm23-H1 and MVC as biomarkers has a 14-year DFS of 62%. In this group, if E-cadherin is low, the 14-year DFS is further decreased to 44%. Nm23-H1 and MVC are better in identifying the good prognosis patients. The long-term DFS is >90% if MVC is low or if nm23-H1 is high. Multivariate analysis shows that E-cadherin, nm23-H1, and MVC are more significant prognostic biomarkers than tumor size or grade. Loss of E-cadherin appears to be a latter step in the metastatic progression compared to angiogenesis and the loss of nm23-H1 expression.
A search for excited electrons produced in pp collisions at Formula omitted = 13 Formula omitted via a contact interaction Formula omitted is presented. The search uses 36.1 fb Formula omitted of ...data collected in 2015 and 2016 by the ATLAS experiment at the Large Hadron Collider. Decays of the excited electron into an electron and a pair of quarks ( Formula omitted) are targeted in final states with two electrons and two hadronic jets, and decays via a gauge interaction into a neutrino and a Formula omitted boson ( Formula omitted) are probed in final states with an electron, missing transverse momentum, and a large-radius jet consistent with a hadronically decaying Formula omitted boson. No significant excess is observed over the expected backgrounds. Upper limits are calculated for the Formula omitted and Formula omitted production cross sections as a function of the excited electron mass Formula omitted at 95% confidence level. The limits are translated into lower bounds on the compositeness scale parameter Formula omitted of the model as a function of Formula omitted. For Formula omitted Formula omitted, the lower bound for Formula omitted is 11 Formula omitted. In the special case of Formula omitted, the values of Formula omitted Formula omitted are excluded. The presented limits on Formula omitted are more stringent than those obtained in previous searches.
The speech of a postlingually deafened preadolescent was recorded and analyzed while a single-electrode cochlear implant (3M/House) was in operation, on two occasions after it failed (1 day and 18 ...days) and on three occasions after stimulation of a multichannel cochlear implant (Nucleus 22) (1 day, 6 months, and 1 year). Listeners judged 3M/House tokens to be the most normal until the subject had one year's experience with the Nucleus device. Spectrograms showed less aspiration, better formant definition and longer final frication and closure duration post-Nucleus stimulation (6 MO. NUCLEUS and 1 YEAR NUCLEUS) relative to the 3M/House and no auditory feedback conditions. Acoustic measurements after loss of auditory feedback (1 DAY FAIL and 18 DAYS FAIL) indicated a constriction of vowel space. Appropriately higher fundamental frequency for stressed than unstressed syllables, an expansion of vowel space and improvement in some aspects of production of voicing, manner and place of articulation were noted one year post-Nucleus stimulation. Loss of auditory feedback results are related to the literature on the effects of postlingual deafness on speech. Nucleus and 3M/House effects on speech are discussed in terms of speech production studies of single-electrode and multichannel patients.
Methylmethacrylate bone cement is associated with severe hypotensive reactions during surgery and anesthesia. The purpose of this in vitro study was to determine if methylmethacrylate monomer could ...produce hypotension by acting directly on vascular smooth muscle. Segments of human saphenous vein or rabbit thoracic aorta were cut into rings. The rings were mounted in isolated tissue chambers in order to measure isometric tension development. Methylmethacrylate monomer (methylmethacrylic acid ester) produced direct relaxation of venous or aortic rings preconstricted with either potassium ion or noradrenaline. The relaxation was concentration-dependent, occurring at concentrations from 10(-3) to 10(-1) M. The relaxation of rabbit aortic rings (preconstricted with noradrenaline) was unaffected by pre-treatment with atropine, propranolol, cimetidine, indomethacin, or methylene blue. Endothelial stripping with Triton X-100, sufficient to completely abolish acetylcholine-induced relaxation, also had little effect on methylmethacrylate-induced relaxation. Methylmethacrylate produced direct relaxation of rabbit aortic rings constricted with either potassium or noradrenaline in calcium-deficient media, and inhibited subsequent calcium-induced constriction. These results suggest that methylmethacrylate monomer may interfere with intracellular and extracellular calcium mobilization and excitation/contraction coupling in vascular smooth muscle. The direct relaxation of venous and arterial smooth muscle produced by methylmethacrylate monomer may contribute in part to the hypotension that can occur when acrylic bone cement is employed during orthopedic procedures.
This paper presents measurements of the Formula omitted and Formula omitted cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data ...were collected in proton-proton collisions at a centre-of-mass energy of 8 Formula omitted with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of Formula omitted. The precision of the cross-section measurements varies between 0.8 and 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.
The ATLAS liquid argon calorimeter has been operating continuously since August 2006. At this time, only part of the calorimeter was readout, but since the beginning of 2008, all calorimeter cells ...have been connected to the ATLAS readout system in preparation for LHC collisions. This paper gives an overview of the liquid argon calorimeter performance measured in situ with random triggers, calibration data, cosmic muons, and LHC beam splash events. Results on the detector operation, timing performance, electronics noise, and gain stability are presented. High energy deposits from radiative cosmic muons and beam splash events allow to check the intrinsic constant term of the energy resolution. The uniformity of the electromagnetic barrel calorimeter response along
η
(averaged over
φ
) is measured at the percent level using minimum ionizing cosmic muons. Finally, studies of electromagnetic showers from radiative muons have been used to cross-check the Monte Carlo simulation. The performance results obtained using the ATLAS readout, data acquisition, and reconstruction software indicate that the liquid argon calorimeter is well-prepared for collisions at the dawn of the LHC era.
The project on ex-vessel core melt stabilization research (ECOSTAR) started in January 2000 to be concluded by end of 2003. The project is performed by 14 partner institutions from five European ...countries and involves a large number of experiments with low- and high-temperature simulant melts and real corium at different scales. Model development and scaling analysis allows application of the research results to existing and to future LWRs in the area of reactor design and accident mitigation. The project is oriented toward the analysis and mitigation of severe accident sequences that could occur in the ex-vessel phase of a postulated core melt accident. The issues are: (1) the release of melt form the pressure vessel, (2) the transfer and spreading of the melt on the basement, (3) the analysis of the physical–chemical processes that are important for corium behavior especially during concrete erosion with onset of solidification, and (4) stabilization of the melt by cooling through direct water contact. The results achieved so far resolve a number of important issues: the amount of melt that could be transferred at RPV failure from the RPV into the containment can be substantially reduced by lowering the residual pressure in the primary circuit. It is found that melt dispersion also strongly depends on the location of the RPV failure, and that lateral failure results in substantially less melt dispersion. During melt release, the impinging melt jet could erode parts of the upper basement surface. Jet experiments and a derived heat transfer relation allow estimation of its contribution to concrete erosion. Spreading of the corium melt on the available basement surface is an important process, which defines the initial conditions for concrete attack or for the efficiency of cooling in case of water contact, respectively. Validation of the spreading codes based on a large-scale benchmark experiment is underway and will allow determination of the initial conditions, for which a corium melt can be assumed to spread homogeneously over the available surface. Experiments with UO
2-based corium melts highlight the role of phase segregation during onset of melt solidification and during concrete erosion. To cool the spread corium melt, the efficacy of top flooding and bottom flooding is investigated in small-scale and in large-scale experiments, supported by model developments. Project assessment is continuing to apply the results to present and future reactors.
Searches for scalar leptoquarks pair-produced in proton-proton collisions at Formula omitted TeV at the Large Hadron Collider are performed by the ATLAS experiment. A data set corresponding to an ...integrated luminosity of 36.1 fb Formula omitted is used. Final states containing two electrons or two muons and two or more jets are studied, as are states with one electron or muon, missing transverse momentum and two or more jets. No statistically significant excess above the Standard Model expectation is observed. The observed and expected lower limits on the leptoquark mass at 95% confidence level extend up to 1.29 TeV and 1.23 TeV for first- and second-generation leptoquarks, respectively, as postulated in the minimal Buchmüller-Rückl-Wyler model, assuming a branching ratio into a charged lepton and a quark of 50%. In addition, measurements of particle-level fiducial and differential cross sections are presented for the Formula omitted, Formula omitted and Formula omitted processes in several regions related to the search control regions. Predictions from a range of generators are compared with the measurements, and good agreement is seen for many of the observables. However, the predictions for the Formula omitted measurements in observables sensitive to jet energies disagree with the data.
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