Inhibited Inelastic Scattering of Incoherent Excitons for Near-Band Edge Excitations.

A multiple pump-terahertz probe experiment enables the clear distinction between elastic and inelastic scattering of excitons with a free electron-hole plasma in (Ga,In)As multiquantum wells. Low plasma energies dictate the prevalence of elastic scattering by inhibiting inelastic processes due to the absence of final states for quasiparticles. Yet, an increased plasma energy results in a progressive destruction of excitons. Notably, despite plasma energy variations, the interaction strength between excitons and the electron-hole plasma remains unaltered.

Thrombus or tumor? A case report of a rare sarcoma entity: intimal sarcoma of the pulmonary arteries.

BACKGROUND: Tumor embolism is a very rare primary manifestation of cancers and the diagnosis is challenging, especially if located in the pulmonary arteries, where it can mimic nonmalignant pulmonary embolism. Intimal sarcoma is one of the least commonly reported primary tumors of vessels with only a few cases reported worldwide. A typical location of this malignancy is the pulmonary artery. Herein, we present a case report of an intimal sarcoma with primary manifestation in the pulmonary arteries. A 53-year-old male initially presented with dyspnea. On imaging, a pulmonary artery embolism was detected and was followed by thrombectomy of the right ventricular outflow tract, main pulmonary artery trunk, and right pulmonary artery after ineffective lysis therapy. Complementary imaging of the chest and abdomen including a PET-CT scan demonstrated no evidence of a primary tumor. Subsequent pathology assessment suggested an intimal sarcoma further confirmed by DNA methylation based molecular analysis. We initiated adjuvant chemotherapy with doxorubicin. Four months after the completion of adjuvant therapy a follow-up scan revealed a local recurrence without distant metastases. DISCUSSION: Primary pulmonary artery intimal sarcoma (PAS) is an exceedingly rare entity and pathological diagnosis remains challenging. Therefore, the detection of entity-specific molecular alterations is a supporting argument in the diagnostic spectrum. Complete surgical resection is the prognostically most important treatment for intimal cardiac sarcomas. Despite adjuvant chemotherapy, the prognosis of cardiac sarcomas remains very poor. This case of a PAS highlights the difficulty in establishing a diagnosis and the aggressive natural course of the disease. CONCLUSION: In case of atypical presentation of a pulmonary embolism, a tumor originating from the great vessels should be considered. Molecular pathology techniques support in establishing a reliable diagnosis.

Ultrasound Elastography in Breast Cancer Diagnosis.

Ultrasound elastography is an established method for characterization of focal lesions in the breast. Different techniques and analyses of the images may be used for the characterization. This article addresses the use of ultrasound elastography in breast cancer diagnosis. In the first part of the article the techniques behind both strain- and shear-wave-elastography are explained and followed by a section on how to obtain adequate elastography images and measurements. In the second part of the article the application of elastography as an adjunct to B-mode ultrasound in clinical practice is described, and the potential diagnostic gains and limitations of elastography are discussed.

Distribution of scattering matrix elements in quantum chaotic scattering.

Scattering is an important phenomenon which is observed in systems ranging from the micro- to macroscale. In the context of nuclear reaction theory, the Heidelberg approach was proposed and later demonstrated to be applicable to many chaotic scattering systems. To model the universal properties, stochasticity is introduced to the scattering matrix on the level of the Hamiltonian by using random matrices. A long-standing problem was the computation of the distribution of the off-diagonal scattering-matrix elements. We report here an exact solution to this problem and present analytical results for systems with preserved and with violated time-reversal invariance. Our derivation is based on a new variant of the supersymmetry method. We also validate our results with scattering data obtained from experiments with microwave billiards.

Automated coaching to help parents increase their children's brushing frequency: an exploratory trial.

UNLABELLED: Advances in digital communication, such as the internet, now provide a cost effective channel to reach and help families struggling to establish good oral hygiene in their homes. This paper describes a novel internet based oral hygiene intervention whose design draws from advances in social cognitive models of behaviour change. Intervention components included role-modelling cartoons for children, a guide for parents on using rewards, a personalised plan with clear steps, tips to follow and a weekly 10-minute review of progress. OBJECTIVE: To evaluate the efficacy of the online coaching programme; specifically we expected that those in the intervention group would brush their teeth more frequently during the intervention period than those in the control group. BASIC RESEARCH DESIGN: An exploratory trial using a randomised controlled parallel approach. PARTICIPANTS: Children aged 5 to 9 years from 44 families (23 control and 21 intervention). MAIN OUTCOME MEASURE: An objective monitoring of tooth brushing. RESULTS: In the 3-week intervention period, children from families assigned to the coaching programme brushed their teeth 38% more often than those in the control group. CONCLUSIONS: The programme was effective in a number of respects. Opportunities for further research are discussed, including the need to create a more engaging system and so increase compliance.

ShearWave™ Elastography BE1 multinational breast study: additional SWE™ features support potential to downgrade BI-RADS®-3 lesions.

PURPOSE: To determine the benefit of ShearWave™ Elastography (SWE™) in the ultrasound characterization of BI-RADS® 3 breast lesions in a diagnostic population. MATERIALS AND METHODS: 303 BI-RADS® 3 lesions (mean size: 13.2 mm, SD: 7.5 mm) from the multicenter BE1 prospective study population were analyzed: 201 (66%) had cytology or core biopsy, and the remaining 102 had a minimum follow-up of one year; 8 (2.6%) were malignant. 7 SWE features were evaluated with regard to their ability to downgrade benign BI-RADS® 3 masses. The performance of each SWE feature was assessed by evaluating the number of lesions correctly reclassified and the impact on cancer rates within the new BI-RADS® 3' lesion group. RESULTS: No malignancies were found with an E-color "black to dark blue", which allowed the downgrading of 110/303 benign masses (p < 0.0001), with a non-significant increase in BI-RADS® 3' malignancy rate from 2.6% to 4.1%. E-max ≤ 20 kPa (2.6 m/s) was able to downgrade 48/303 (p < 0.0001) lesions with a lower increase in BI-RADS® 3' malignancy rate (3.1%). No other SWE features were useful for reclassifying benign BI-RADS® 3 lesions. CONCLUSION: Applying simple reclassification rules, SWE assessment of the maximum stiffness of lesions allowed the downgrading of a sub-group of benign BI-RADS® 3 lesions. This was accompanied by a non-significant increase in the malignancy rate in the new BI-RADS® 3 class.

PT symmetry and spontaneous symmetry breaking in a microwave billiard.

We demonstrate the presence of parity-time (PT) symmetry for the non-Hermitian two-state Hamiltonian of a dissipative microwave billiard in the vicinity of an exceptional point (EP). The shape of the billiard depends on two parameters. The Hamiltonian is determined from the measured resonance spectrum on a fine grid in the parameter plane. After applying a purely imaginary diagonal shift to the Hamiltonian, its eigenvalues are either real or complex conjugate on a curve, which passes through the EP. An appropriate basis choice reveals its PT symmetry. Spontaneous symmetry breaking occurs at the EP.

The age-specific differences in histopathological tumor characteristics and TNM classification of breast carcinomas in Quality assured mamma diagnostic (QuaMaDi) program in the state of Schleswig-Holstein in Germany.

BACKGROUND: We explored the hypothesis that high-quality standards in diagnostic mammography can lead to an early diagnosis of breast cancers and identifies at risk populations outside screening programs. The histopathological features and distribution of the TNM classification were examined in relation to patient age in a large group of women with breast cancers participating in the Quality Assured Mamma Diagnostic (QuaMaDi) program of the state of Schleswig-Holstein. PATIENTS AND METHODS: Surgical pathological reports were studied for clinicopathological characteristics, receptor status, molecular subtype and tumor stage. The analysis was conducted by dividing the study population into three age groups: women under 50 years (pre-screening), 50-69 years (peri-screening) and over 70 years (post-screening). RESULTS: 7.111 biopsies and 2.887 resection specimens were included. Breast cancer was diagnosed in 4.241 (59.7%) cases, one fourth of them in women < 50 years. Elderly women (> 70 years) had more well-differentiated, estrogen receptor (ER)-positive and HER2-negative carcinomas, whereas younger women (< 50 years) tended to have more poorly differentiated, ER negative, and HER2-positive carcinomas. 47% of breast carcinoma were luminal B tumors and were most common regardless of age. 70.4% of resected specimen had pT1 stage. Nodal negative were 71.2%. CONCLUSION: In QuaMaDi breast cancer was diagnosed at an early and potentially curable stage of the disease due to high-quality standards in diagnostic mammography. In addition, regardless of age, an increased number of prognostically unfavorable molecular subtypes were detected. Thus, QuaMaDi helps to identify at risk populations. QuaMaDi significantly improves diagnostic mammography and complements mammography screening programs.

Exceptional points in a microwave billiard with time-reversal invariance violation.

We report on the experimental study of an exceptional point (EP) in a dissipative microwave billiard with induced time-reversal invariance (T) violation. The associated two-state Hamiltonian is non-Hermitian and nonsymmetric. It is determined experimentally on a narrow grid in a parameter plane around the EP. At the EP the size of T violation is given by the relative phase of the eigenvector components. The eigenvectors are adiabatically transported around the EP, whereupon they gather geometric phases and in addition geometric amplitudes different from unity.

Ordinary injury, big surprise - Traumatic false aneurysm and arteriovenous fistula of the posterior tibial artery after civilian trauma: A case report.

INTRODUCTION: False traumatic aneurysm (FTA) or pseudoaneurysm and traumatic arteriovenous fistulas (TAVF) are rare pathologies in civilian trauma and mainly result from stabs or gunshot wounds. The posterior tibial artery as site of trauma is very rare. PRESENTATION OF CASE: We report on a 39-year old female patient who was suffering from combined FTA and TAVF of the posterior tibial artery after falling into a wine glass. CT-imaging as well as duplex ultrasound and selective arteriography were performed, and two stent-grafts were inserted. DISCUSSION: Based on the presented case, incidence of the described pathology, treatment options and outcomes are discussed. CONCLUSION: Adequate imaging in penetrating wounds to the extremities is crucial in order to provide diagnosis and treatment of concomitant lesions.

Coherent addition of laser beams in resonant passive optical cavities.

An optical resonator, designed for frequency doubling of cw single-frequency radiation, is simultaneously injected by two phase-coherent laser beams with the same frequency. By using standard methods in laser-cavity stabilization, we are able to stabilize the cavity length on resonance with the laser, as well as the relative phase of the fundamental beams, to fulfill the optimum coupling conditions simultaneously on the two input couplers. By using this method, we generate reliably more than 220 mW of single-frequency radiation at 399 nm using two 0.5 W semiconductor tapered amplifiers at 798 nm. This method can be generalized to a larger number of input couplers and holds promise for improving the performances of extreme-UV frequency combs.

Investigation of calcium crystals in OA knees.

For studies on matrix mineralization in osteoarthritis (OA), a clear analytical approach is necessary to identify and to quantify mineralization in the articular cartilage. The aim of this study is to develop an effective algorithm to quantify and to identify cartilage mineralization in the experimental setting. Four patients with OA of the knee undergoing total knee replacement and four control patients were included. Cartilage calcification was studied by digital contact radiography (DCR), field emission scanning electron microscopy (FE-SEM) X-ray element analysis and Raman spectroscopy (RS). DCR revealed mineralization in all OA cartilage specimens. No mineralization was observed in the control cartilage. Patient I showed rhomboid shaped crystals with a mean Ca:P molar ratio of 1.04 indicated the presence of calcium pyrophosphate dihydrate (CPPD) crystals, while Patients II, III and IV presented carbonate-substituted hydroxyapatite (HA). RS also showed the presence of CPPD crystals in Patient I while Patients II, III and IV revealed spectra confirming the presence of HA crystals. In the corresponding chondrocyte cell culture analyzed with SEM, the presence of CPPD crystals in the culture of Patient I and HA crystals in the culture of Patient II, III and IV was confirmed. No mineralization was found in the cell culture of the controls. The differentiation between BCP and CPPD crystals plays an important role, and the techniques presented here provide an accurate differentiation of these two types of crystals. For quantification of articular cartilage mineralization, DCR is a simple and accurate method.

Properties of nodal domains in a pseudointegrable barrier billiard.

We investigate experimentally the scaling properties of the number of nodal domains of the wave functions and the distribution of the nodal domain areas in a pseudointegrable barrier billiard. The number of nodal domains is smaller than expected for billiards whose dynamics is chaotic or regular. This reduction is explained by the appearance of superscars in the barrier billiard, i.e., regular structures, which are embedded into the underlying chaotic wave functions. Furthermore, the area distribution of nodal domains follows the predictions of a percolation model for chaotic systems.

Chaotic scattering in the regime of weakly overlapping resonances.

We measure the transmission and reflection amplitudes of microwaves in a resonator coupled to two antennas at room temperature in the regime of weakly overlapping resonances and in a frequency range of 3-16GHz . Below 10.1GHz the resonator simulates a chaotic quantum system. The distribution of the elements of the scattering matrix S is not Gaussian. The Fourier coefficients of S are used for a best fit of the autocorrelation function of S to a theoretical expression based on random-matrix theory. We find very good agreement below but not above 10.1GHz .

Interobserver-variability of lung nodule volumetry considering different segmentation algorithms and observer training levels.

OBJECTIVE: The aim of this study was to investigate the interobserver variability of CT based diameter and volumetric measurements of artificial pulmonary nodules. A special interest was the consideration of different measurement methods, observer experience and training levels. MATERIALS AND METHODS: For this purpose 46 artificial small solid nodules were examined in a dedicated ex-vivo chest phantom with multislice-spiral CT (20 mAs, 120 kV, collimation 16 mm x 0.75 mm, table feed 15 mm, reconstructed slice thickness 1mm, reconstruction increment 0.7 mm, intermediate reconstruction kernel). Two observer groups of different radiologic experience (0 and more than 5 years of training, 3 observers each) analysed all lesions with digital callipers and 2 volumetry software packages (click-point depending and robust volumetry) in a semi-automatic and manually corrected mode. For data analysis the variation coefficient (VC) was calculated in per cent for each group and a Wilcoxon test was used for analytic statistics. RESULTS: Click-point robust volumetry showed with a VC of <0.01% in both groups the smallest interobserver variability. Between experienced and un-experienced observers interobserver variability was significantly different for diameter measurements (p=0.023) but not for semi-automatic and manual corrected volumetry. A significant training effect was revealed for diameter measurements (p=0.003) and semi-automatic measurements of click-point depending volumetry (p=0.007) in the un-experienced observer group. CONCLUSIONS: Compared to diameter measurements volumetry achieves a significantly smaller interobserver variance and advanced volumetry algorithms are independent of observer experience.

Spectral properties of Bunimovich mushroom billiards.

Properties of a quantum mushroom billiard in the form of a superconducting microwave resonator have been investigated. They reveal unexpected nonuniversal features such as, e.g., a supershell effect in the level density and a dip in the nearest-neighbor spacing distribution. Theoretical predictions for the quantum properties of mixed systems rely on the sharp separability of phase space--an unusual property met by mushroom billiards. We however find deviations which are ascribed to the presence of dynamic tunneling.

Rabi oscillations at exceptional points in microwave billiards.

We experimentally investigated the decay behavior with time t of resonances near and at exceptional points, where two complex eigenvalues and also the associated eigenfunctions coalesce. The measurements were performed with a dissipative microwave billiard, whose shape depends on two parameters. The t2 dependence predicted at the exceptional point on the basis of a two-state matrix model could be verified. Outside the exceptional point the predicted Rabi oscillations, also called quantum echoes in this context, were detected.

The effect of a calcium carbonate/perlite toothpaste on the removal of extrinsic tooth stain in two weeks.

OBJECTIVE: To assess the effect of a calcium carbonate/perlite toothpaste on the levels of extrinsic stain removed at two weeks compared to a silica control toothpaste. DESIGN: In this parallel group, double-blind study, subjects were stratified by natural baseline stain and tobacco use and allocated at random to one of the two study toothpastes. Subjects brushed with their allocated toothpaste twice daily for two weeks before extrinsic tooth stain was again assessed. SETTING: The study was performed at 4-Front Research UK Limited, Maldon, UK. PARTICIPANTS: 152 adult subjects with at least eight assessable incisors/ canines with natural extrinsic tooth stain completed the study. METHODS: The extrinsic tooth stain on the facial surfaces of incisors and canines was measured using the Macpherson modification of the Lobene Stain Index. RESULTS: Both of the toothpaste groups had significantly less stain after two weeks of use compared to the baseline value (p<0.001). Analysis of covariance on the sum of the whole mouth stain scores showed that the calcium carbonate/perlite toothpaste removed significantly more stain over the two week study than the silica control toothpaste (p<0.05). CONCLUSIONS: Twice daily brushing for two weeks with a calcium carbonate/perlite toothpaste removes more extrinsic stain than a silica control toothpaste.

Acidic pH amplifies iron-mediated lipid peroxidation in cells.

The goal of our study was to investigate the mechanism by which changes in extracellular pH influence lipid peroxidation processes. Ferrous iron can react with hydroperoxides, via a Fenton-type reaction, to initiate free radical chain processes. Iron is more soluble at lower pH values, therefore we hypothesized that decreasing the environmental pH would lead to increased iron-mediated lipid peroxidation. We used Photofrin, a photosensitizer that produces singlet oxygen, to introduce lipid hydroperoxides into leukemia cells (HL-60, K-562, and L1210). Singlet oxygen reacts with the PUFA of cells producing lipid hydroperoxides. Using EPR spin trapping with POBN, free radical formation from HL-60 cells was only detected when Photofrin, light, and ferrous iron were present. Free radical formation increased with increasing iron concentration; in the absence of extracellular iron, radical formation was below the limit of detection and lipid hydroperoxides accumulated in the membrane. In the presence of iron, lipid-derived radical formation in cells is pH dependent; the lower the extracellular pH (7.5-5.5), the higher the free radical flux; the lower the pH, the greater the membrane permeability induced in K-562 cells, as determined by trypan blue dye exclusion. These data demonstrate that lipid peroxidation processes, mediated by iron, are enhanced with decreasing extracellular pH. Thus, acidic pH not only releases iron from "safe" sites, but this iron will also be more damaging.