Early surgery versus initial conservative treatment in patients with traumatic intracerebral haemorrhage [STITCH(Trauma)] : the first randomized trial

Acknowledgements This project was funded by the NIHR Health Technology Assessment programme (project number 07/37/16). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.Peer reviewedPublisher PD

How should we discuss genetic testing with women newly diagnosed with breast cancer? Design and implementation of a randomized controlled trial of two models of delivering education about treatment-focused genetic testing to younger women newly diagnosed with breast cancer

BACKGROUND: Germline BRCA1 and BRCA2 mutation testing offered shortly after a breast cancer diagnosis to inform women's treatment choices - treatment-focused genetic testing 'TFGT' - has entered clinical practice in specialist centers and is likely to be soon commonplace in acute breast cancer management, especially for younger women. Yet the optimal way to deliver information about TFGT to younger women newly diagnosed with breast cancer is not known, particularly for those who were not suspected of having a hereditary breast cancer syndrome prior to their cancer diagnosis. Also, little is known about the behavioral and psychosocial impact or cost effectiveness of educating patients about TFGT. This trial aims to examine the impact and efficiency of two models of educating younger women newly diagnosed with breast cancer about genetic testing in order to provide evidence for a safe and effective future clinical pathway for this service. DESIGN/METHODS: In this non-inferiority randomized controlled trial, 140 women newly diagnosed with breast cancer (aged less than 50 years) are being recruited from nine cancer centers in Australia. Eligible women with either a significant family history of breast and/or ovarian cancer or with other high risk features suggestive of a mutation detection rate of > 10% are invited by their surgeon prior to mastectomy or radiotherapy. After completing the first questionnaire, participants are randomized to receive either: (a) an educational pamphlet about genetic testing (intervention) or (b) a genetic counseling appointment at a family cancer center (standard care). Each participant is offered genetic testing for germline BRCA mutations. Decision-related and psychosocial outcomes are assessed over 12 months and include decisional conflict (primary outcome);uptake of bilateral mastectomy and/or risk-reducing salpingo-oophorectomy; cancer-specific- and general distress; family involvement in decision making; and decision regret. A process-oriented retrospective online survey will examine health professionals' attitudes toward TFGT; a health economic analysis will determine the cost effectiveness of the intervention. DISCUSSION: This trial will provide crucial information about the impact, efficiency and cost effectiveness of an educational pamphlet designed to inform younger women newly diagnosed with breast cancer about genetic testing. Issues regarding implementation of the trial are discussed

The health system impact of false positive newborn screening results for medium-chain acyl-CoA dehydrogenase deficiency: A cohort study

Background - There is no consensus in the literature regarding the impact of false positive newborn screening results on early health care utilization patterns. We evaluated the impact of false positive newborn screening results for medium-chain acyl-CoA dehydrogenase deficiency (MCADD) in a cohort of Ontario infants. Methods - The cohort included all children who received newborn screening in Ontario between April 1, 2006 and March 31, 2010. Newborn screening and diagnostic confirmation results were linked to province-wide health care administrative datasets covering physician visits, emergency department visits, and inpatient hospitalizations, to determine health service utilization from April 1, 2006 through March 31, 2012. Incidence rate ratios (IRRs) were used to compare those with false positive results for MCADD to those with negative newborn screening results, stratified by age at service use. Results - We identified 43 infants with a false positive newborn screening result for MCADD during the study period. These infants experienced significantly higher rates of physician visits (IRR: 1.42) and hospitalizations (IRR: 2.32) in the first year of life relative to a screen negative cohort in adjusted analyses. Differences in health services use were not observed after the first year of life. Conclusions - The higher use of some health services among false positive infants during the first year of life may be explained by a psychosocial impact of false positive results on parental perceptions of infant health, and/or by differences in underlying health status. Understanding the impact of false positive newborn screening results can help to inform newborn screening programs in designing support and education for families. This is particularly important as additional disorders are added to expanded screening panels, yielding important clinical benefits for affected children but also a higher frequency of false positive findings.This study was Funded through a Canadian Institutes of Health Research (CIHR) Emerging Team Grant (TR3-119195). Maria Karaceper received a graduate scholarship through a charitable donation to the Children’s Hospital of Eastern Ontario. This study was performed at the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC)

Azimuthal anisotropy of pi^0 and eta mesons in Au+Au collisions at sqrt(s_NN)=200 GeV

The azimuthal anisotropy coefficients v_2 and v_4 of pi^0 and eta mesons are measured in Au+Au collisions at sqrt(s_NN)=200 GeV, as a function of transverse momentum p_T (1-14 GeV/c) and centrality. The extracted v_2 coefficients are found to be consistent between the two meson species over the measured p_T range. The ratio of v_4/v_2^2 for pi^0 mesons is found to be independent of p_T for 1-9 GeV/c, implying a lack of sensitivity of the ratio to the change of underlying physics with p_T. Furthermore, the ratio of v_4/v_2^2 is systematically larger in central collisions, which may reflect the combined effects of fluctuations in the initial collision geometry and finite viscosity in the evolving medium.Comment: 384 authors, 71 institutions, 11 pages, 9 figures, and 2 tables. Submitted to Physical Review C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Obesity and the Microvasculature: A Systematic Review and Meta-Analysis

10.1371/journal.pone.0052708PLoS ONE82

Centrality categorization for R_{p(d)+A} in high-energy collisions

High-energy proton- and deuteron-nucleus collisions provide an excellent tool for studying a wide array of physics effects, including modifications of parton distribution functions in nuclei, gluon saturation, and color neutralization and hadronization in a nuclear environment, among others. All of these effects are expected to have a significant dependence on the size of the nuclear target and the impact parameter of the collision, also known as the collision centrality. In this article, we detail a method for determining centrality classes in p(d)+A collisions via cuts on the multiplicity at backward rapidity (i.e., the nucleus-going direction) and for determining systematic uncertainties in this procedure. For d+Au collisions at sqrt(s_NN) = 200 GeV we find that the connection to geometry is confirmed by measuring the fraction of events in which a neutron from the deuteron does not interact with the nucleus. As an application, we consider the nuclear modification factors R_{p(d)+A}, for which there is a potential bias in the measured centrality dependent yields due to auto-correlations between the process of interest and the backward rapidity multiplicity. We determine the bias correction factor within this framework. This method is further tested using the HIJING Monte Carlo generator. We find that for d+Au collisions at sqrt(s_NN)=200 GeV, these bias corrections are small and vary by less than 5% (10%) up to p_T = 10 (20) GeV. In contrast, for p+Pb collisions at sqrt(s_NN) = 5.02 TeV we find these bias factors are an order of magnitude larger and strongly p_T dependent, likely due to the larger effect of multi-parton interactions.Comment: 375 authors, 18 pages, 16 figures, 4 tables. Submitted to Phys. Rev. C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Evidence for e+e−→γχc1,2e^+e^-\to\gamma\chi_{c1, 2} at center-of-mass energies from 4.009 to 4.360 GeV

Using data samples collected at center-of-mass energies of $\sqrt{s}$ = 4.009, 4.230, 4.260, and 4.360 GeV with the BESIII detector operating at the BEPCII collider, we perform a search for the process $e^+e^-\to\gamma\chi_{cJ}$ $(J = 0, 1, 2)$ and find evidence for $e^+e^-\to\gamma\chi_{c1}$ and $e^+e^-\to\gamma\chi_{c2}$ with statistical significances of 3.0$\sigma$ and 3.4$\sigma$, respectively. The Born cross sections $\sigma^{B}(e^+e^-\to\gamma\chi_{cJ})$, as well as their upper limits at the 90% confidence level are determined at each center-of-mass energy.Comment: 8 pages, 7 figures, 3 table

Transverse-energy distributions at midrapidity in pp++pp, dd++Au, and Au++Au collisions at sNN=62.4\sqrt{s_{_{NN}}}=62.4--200~GeV and implications for particle-production models

Measurements of the midrapidity transverse energy distribution, d\Et/d\eta, are presented for $p$$+$$p$, $d$$+$Au, and Au$+$Au collisions at $\sqrt{s_{_{NN}}}=200$ GeV and additionally for Au$+$Au collisions at $\sqrt{s_{_{NN}}}=62.4$ and 130 GeV. The d\Et/d\eta distributions are first compared with the number of nucleon participants $N_{\rm part}$, number of binary collisions $N_{\rm coll}$, and number of constituent-quark participants $N_{qp}$ calculated from a Glauber model based on the nuclear geometry. For Au$+$Au, \mean{d\Et/d\eta}/N_{\rm part} increases with $N_{\rm part}$, while \mean{d\Et/d\eta}/N_{qp} is approximately constant for all three energies. This indicates that the two component ansatz, $dE_{T}/d\eta \propto (1-x) N_{\rm part}/2 + x N_{\rm coll}$, which has been used to represent $E_T$ distributions, is simply a proxy for $N_{qp}$, and that the $N_{\rm coll}$ term does not represent a hard-scattering component in $E_T$ distributions. The $dE_{T}/d\eta$ distributions of Au$+$Au and $d$$+$Au are then calculated from the measured $p$$+$$p$ $E_T$ distribution using two models that both reproduce the Au$+$Au data. However, while the number-of-constituent-quark-participant model agrees well with the $d$$+$Au data, the additive-quark model does not.Comment: 391 authors, 24 pages, 19 figures, and 15 Tables. Submitted to Phys. Rev. C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are publicly available at http://www.phenix.bnl.gov/papers.htm

Azimuthally anisotropic emission of low-momentum direct photons in Au++Au collisions at sNN=200\sqrt{s_{_{NN}}}=200 GeV

The PHENIX experiment at the Relativistic Heavy Ion Collider has measured 2nd and 3rd order Fourier coefficients of the azimuthal distributions of direct photons emitted at midrapidity in Au$+$Au collisions at $\sqrt{s_{_{NN}}}=200$ GeV for various collision centralities. Combining two different analysis techniques, results were obtained in the transverse momentum range of $0.4<p_{T}<4.0$ GeV/$c$. At low $p_T$ the second-order coefficients, $v_2$, are similar to the ones observed in hadrons. Third order coefficients, $v_3$, are nonzero and almost independent of centrality. These new results on $v_2$ and $v_3$, combined with previously published results on yields, are compared to model calculations that provide yields and asymmetries in the same framework. Those models are challenged to explain simultaneously the observed large yield and large azimuthal anisotropies.Comment: 552 authors, 15 pages, 9 figures, 3 tables, 2007 and 2010 data. v2 is version accepted for publication by Phys. Rev. C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Transverse energy production and charged-particle multiplicity at midrapidity in various systems from sNN=7.7\sqrt{s_{NN}}=7.7 to 200 GeV

Measurements of midrapidity charged particle multiplicity distributions, $dN_{\rm ch}/d\eta$, and midrapidity transverse-energy distributions, $dE_T/d\eta$, are presented for a variety of collision systems and energies. Included are distributions for Au$+$Au collisions at $\sqrt{s_{_{NN}}}=200$, 130, 62.4, 39, 27, 19.6, 14.5, and 7.7 GeV, Cu$+$Cu collisions at $\sqrt{s_{_{NN}}}=200$ and 62.4 GeV, Cu$+$Au collisions at $\sqrt{s_{_{NN}}}=200$ GeV, U$+$U collisions at $\sqrt{s_{_{NN}}}=193$ GeV, $d$$+$Au collisions at $\sqrt{s_{_{NN}}}=200$ GeV, $^{3}$He$+$Au collisions at $\sqrt{s_{_{NN}}}=200$ GeV, and $p$$+$$p$ collisions at $\sqrt{s_{_{NN}}}=200$ GeV. Centrality-dependent distributions at midrapidity are presented in terms of the number of nucleon participants, $N_{\rm part}$, and the number of constituent quark participants, $N_{q{\rm p}}$. For all $A$$+$$A$ collisions down to $\sqrt{s_{_{NN}}}=7.7$ GeV, it is observed that the midrapidity data are better described by scaling with $N_{q{\rm p}}$ than scaling with $N_{\rm part}$. Also presented are estimates of the Bjorken energy density, $\varepsilon_{\rm BJ}$, and the ratio of $dE_T/d\eta$ to $dN_{\rm ch}/d\eta$, the latter of which is seen to be constant as a function of centrality for all systems.Comment: 706 authors, 32 pages, 20 figures, 34 tables, 2004, 2005, 2008, 2010, 2011, and 2012 data. v2 is version accepted for publication in Phys. Rev.