Agc, ultrasound score, menopausal status, B clinical inipression score and serum CA 125 level were assesscd to scc how they could best distinguish between patients with benign ( n = 101) and malignant ( n = 42) pelvic masses. Each criteria uscd alone provided statistically significant discrimination. Thc most useful individual criteria were a serum CA 125 level of 30 U/m1 (sensitivity 81 %) , specificity 75%)) anti an ultrasound score of 2 (sensitivity 71 %. specificity 83%). Three criteria could be combined in a risk ol malignancy index (RMI) which is siniply calculated using thc product of the serum CA 125 level (Uitnl), the ultrasound scan result (expressed as a score of 0, 1 or 3) and the menopausal status (1 if premenopausal and 3 if postmenopausal). This index was statistically virtually as effective a discriminant hetween cancer and benign lesions as more formal methods. Using an KMI cut-off level of 200, the sensitivity was 85%) and thc specificity was 97%. Patients with an RMT score of grcatcr than 200 had, on average, 32 times the background risk of cancer and those with a lower value 0.15 times the background risk.The greatest opportunity to influence the naturai history ol' ovarian cancer occurs at the time of the initial laparotamy. The aims of surgical management at this time arc to determine accurately the cxtent of disease and to I-educe residual tumour volume to a minimum (Griffiths l9S7 Hackcr 1987). In spite of the knowlcdgc of thc bcncfits of accurate surgical staging and cyto-reductive surgery, many patients do not receive appropriate surgery at the time of surgical diagnosis (Young ff d. . Adequate treatment at primary laparotamy is generally considered to require persistent, time consuming and aggi-essive surgery that ia oftcn not fcasihlc during a routine operatiiig list. Ideally. patients with ovarian maligiiancy should therefore he referred
In typical British diets replacing 60% of saturated fats by other fats and avoiding 60% of dietary cholesterol would reduce blood total cholesterol by about 0.8 mmol/l (that is, by 10-15%), with four fifths of this reduction being in low density lipoprotein cholesterol.
Quantum effects dominate the behaviour of many diverse materials. Of particular current interest are those systems in the vicinity of a quantum critical point (QCP). Their physical properties are predicted to reflect those of the nearby QCP with universal features independent of the microscopic details. The prototypical QCP is the Luttinger liquid (LL) which is of relevance to many quasione-dimensional materials. The magnetic material KCuF 3 realizes an array of weakly-coupled spin chains (or LLs) and thus lies close to but not exactly at the Luttinger liquid quantum critical point. By using inelastic neutron scattering we have collected a complete data set of the magnetic correlations of KCuF 3 as a function of momentum, energy, and temperature. The LL description is found to be valid over an extensive range of these parameters, and departures from this behaviour at high and low energies and temperatures have been identified and explained.The concept of a quantum critical point 1,2 -a zero temperature phase transition between quantum ground states -provides an attractive approach for describing regions dominated by quantum mechanics in condensed matter. In its vicinity universal behaviors are predicted that are independent of the microscopic details of the system. An example of this is universal energy/temperature (E/T) scaling of the collective response of the system -a phenomenon that has received heightened attention due to its observation in both cuprate high-temperature superconductors 3,4,5 and unconventional metals 6,7,8 . By exploiting the powerful mathematics of scaling, the aim is to set up systematic expansions of the physical properties about these special points thus explaining the quantum-dominated behaviour found in a diverse range of systems. In quasi-onedimensional quantum magnets experimental and theoretical techniques 9 are now sufficiently advanced to study these ideas and methods in depth. Here we consider the generic problem of an array of one-dimensional systems weakly coupled together into three dimensions.Quantum critical states in one-dimension (1D) are thought to apply to systems as diverse as carbon nanotubes, stripes in cuprate high-temperature superconductors, and spin chains 10,11 . The prototypical example is the spin-1/2 (S=1/2) Heisenberg antiferromagnetic chain (HAFC) which maps onto the Luttinger liquid QCP. Here the magnetic ions possess spin angular momentum of 1/2, and interact with their nearest neighbours via antiferromagnetic Heisenberg exchange couplings in only one crystallographic direction. This system fails to develop long-range Néel ordering (where + Present address -Clarendon
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