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We present a gauge-invariant framework for bubble nucleation in theories with radiative symmetry breaking at high temperature. As a procedure, this perturbative framework establishes a practical, gaugeinvariant computation of the leading order nucleation rate, based on a consistent power counting in the high-temperature expansion. In model building and particle phenomenology, this framework has applications such as the computation of the bubble nucleation temperature and the rate for electroweak baryogenesis and gravitational wave signals from cosmic phase transitions.

Amplification of the mesenchymal epithelial transition (MET) gene is a mechanism of acquired resistance to epidermal growth factor receptor (EGFR)-tyrosine-kinase-inhibitors (TKIs) in over 20% of patients with advanced EGFR-mutated (EGFRm+) non-small lung cancer (NSCLC). However, it may also occur de novo in 2–8% of EGFRm+ NSCLC cases as a potential mechanism of intrinsic resistance. These patients represent a group with unmet needs, since there is no standard therapy currently approved. Several new MET inhibitors are being investigated in clinical trials, but the results are awaited. Meanwhile, as an alternative strategy, combinations of EGFR-TKIs with the MET/ALK/ROS1-TKI Crizotinib may be used in this setting, despite this use is principally off-label. Thus, we studied five of these MET amplified cases receiving EGFR-TKI and Crizotinib doublet after progression on EGFR-TKI treatment to assess the benefits and challenges related to this combination and the possible occurrence of genomic and phenotypic co-alterations. Furthermore, we compared our cases with other real-world reports on Crizotinib/EGFR-TKI combinations, which appeared effective, especially in patients with high-level MET amplification. Yet, we observed that the co-occurrence of other genomic and phenotypical alterations may affect the response to combined EGFR-TKI and Crizotinib. Finally, given the heterogeneity of MET amplification, the diagnostic methods for assessing it may be discrepant. In this respect, we observed that for optimal detection, immunohistochemistry, fluorescence in situ hybridization, and next-generation sequencing should be used together, as these methods possess different sensitivities and complement each other in characterizing MET amplification. Additionally, we addressed the issue of managing EGFR-mutated NSCLC patients with de novo MET amplification causing primary EGFR-TKI resistance. We conclude that, while data from clinical trials with new MET inhibitors are still pen

Bakgrund: Återhämtning och nutrition är viktiga aspekter för att minimera risken för skador hos idrottare. Ett för lågt energiintag kan leda till flera negativa fysiologiska effekter då kroppens energibehov inte tillgodoses. Hos kvinnor är menstruationsdysfunktion (MD) ett vanligt symptom på långvarig låg energitillgänglighet och hög förekomst har främst rapporterats hos kvinnliga idrottare inom viktkänsliga idrotter såsom uthållighetsidrott. Syfte: Syftet med denna studie var därför att beskriva skadebilden hos svenska och danska kvinnliga landslagsidrottare på seniornivå samt undersöka eventuella samband mellan förekomst av skador och menstruation. Metod: Alla danska och svenska kvinnliga landslagsidrottare blev kontaktade per mejl och tillfrågade om deltagande via online-enkät där frågor om skador det senaste året och menstruation ingick. Deltagare blev klassificerade att ha MD om de uppgav att de aldrig haft menstruation, ingen menstruation de senaste tre månaderna, menstruationscykler med längre intervall än 35 dagar eller <9 menstruationscykler de senaste 12 månaderna. Alla deltagare blev klassificerade som antingen icke-viktkänsliga (t.ex. bollsport) eller viktkänslig idrottare (t.ex. uthålligsidrott). Resultat: Totalt svarade 634 (25%) idrottare på enkäten. Den rapporterade skadeprevalensen under de senaste 12 månaderna för samtliga inkluderade deltagare var 57%. 30% av deltagarna blev klassificerade att ha MD med en högre förekomst i viktkänsliga idrotter (39% vs 24%; P = <0,001). Deltagare med MD rapporterade fler skador under de senaste 12 månaderna (P = 0,004) och hade en högre risk för skada (OR = 1,52; 95% CI = 1,06–2,19; P = 0,024) samt högre risk för att ha varit långvarigt skadad (>22 dagar) (OR = 1,87; 95% CI = 1,23–2,55; P = 0,003) jämfört med deltagare med regelbunden menstruation. Deltagare från viktkänsliga idrotter hade en högre risk för skada (OR = 1,50; 95% CI = 1,02–2,21; P = 0,039) och högre risk för att ha varit långvarigt skadad, Background: Recovery and nutrition are important aspects in order to minimize injury risk in athletes. Multiple negative physiological impairments have been recognized in athletes due to low energy intake. One common symptom of prolonged low energy availability in females is menstrual dysfunction (MD) and high prevalence has been reported mostly in female athletes in weight-sensitive sports like endurance sports. Aim: The aim of the present study was to describe injuries among Swedish and Danish female national team athletes and to investigate potential connections between injury prevalence and menstruation. Method: All Swedish and Danish national team athletes were invited via e-mail to complete an anonymous online survey, which held questions about injuries the past year and menstruation. Participants were classified with MD if they stated that they never had menstruation, no menstruation the last three months, menstruation cycles with longer intervals than 35 days or <9 menstruation cycles the last 12 months. The participants were also divided in groups of non-weight sensitive athletes (e.g. ball game) or weight sensitive athletes (e.g. endurance sport). Results: A total of 634 (25%) athletes completed the survey. Among all participants an injury prevalence of 57% was observed and 30% were classified with MD. Higher prevalence of MD was reported in weight-sensitive sports (39% vs. 24%; P = <0,001). Athletes with MD sustained more injuries (P = 0,004), reported higher risk of injury (OR = 1,52; 95% CI = 1,06–2,19; P = 0,024) and to be long-term injured (>22 days) (OR = 1,87; 95% CI = 1,23–2,55; P = 0,003) compared to athletes with regular menstruation. In athletes from weight-sensitive sports a higher risk of injury was observed (OR = 1,50; 95% CI = 1,02–2,21; P = 0,039) and also to be long-term injured (OR = 2,11; 95% CI = 1,38–3,24; P = <0,001) compared to athletes from non weight-sensitive sports. Conclusion: The result indicates that female nationa

The proportion of people over 65+ is expected to increase in the future. The elderly is one of the most frequent users of open public space. One type of open public space is urban green space, which is a recurring appreciated element for the elderly population. Despite this, cities are often considered to neglect the needs and wants of the elderly population regarding design and shape. What we need and want in urban green areas differs among different age- and culture groups. Therefor it is important to shed light upon elderly’s experience linked to the use and needs of urban green space to get a better understanding of how these areas are perceived. Which this study aims to do based upon elderly living the city of Umeå. The paper takes a qualitative approach to answer the research questions. Semi-structured interviews were conducted with 7 informants living in the Umeå urban area. Results show that many of the elderly informant’s values urban green space with a high perceived naturalness which is also considered to be lacking in many Umeås central parks. However, what types of greenery which contributes to the perceived naturalness can vary. Woodlands as well as smaller leafy and heavily green influenced areas can equally result in a high perceived naturalness. Areas with a high perceived naturalness also enables elderly’s motives for being in areas of greenery to a greater extent. Like the daily walk, relaxing and socializing with friends. All open green space in the city is not sought-after by the elderly informants. Further factors that make some of the elderly informants seek out different open green areas are lack of amenities and the feeling of inaccessibility.

Background: Radiotherapy (RT) planning for cervical cancer patients entails the acquisition of both Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Further, molecular imaging by Positron Emission Tomography (PET) could contribute to target volume delineation as well as treatment response monitoring. The objective of this study was to investigate the feasibility of a PET/MRI-only RT planning workflow of patients with cervical cancer. This includes attenuation correction (AC) of MRI hardware and dedicated positioning equipment as well as evaluating MRI-derived synthetic CT (sCT) of the pelvic region for positioning verification and dose calculation to enable a PET/MRI-only setup. Material and methods: 16 patients underwent PET/MRI using a dedicated RT setup after the routine CT (or PET/CT), including eight pilot patients and eight cervical cancer patients who were subsequently referred for RT. Data from 18 patients with gynecological cancer were added for training a deep convolutional neural network to generate sCT from Dixon MRI. The mean absolute difference between the dose distributions calculated on sCT and a reference CT was measured in the RT target volume and organs at risk. PET AC by sCT and a reference CT were compared in the tumor volume. Results: All patients completed the examination. sCT was inferred for each patient in less than 5 s. The dosimetric analysis of the sCT-based dose planning showed a mean absolute error (MAE) of 0.17 ± 0.12 Gy inside the planning target volumes (PTV). PET images reconstructed with sCT and CT had no significant difference in quantification for all patients. Conclusions: These results suggest that multiparametric PET/MRI can be successfully integrated as a one-stop-shop in the RT workflow of patients with cervical cancer.

Background: Small cell lung cancer (SCLC) is an aggressive cancer often presenting in an advanced stage and prognosis is poor. Early response evaluation may have impact on the treatment strategy. Aim: We evaluated 18F-fluorothymidine-(FLT)-PET/diffusion-weighted-(DW)-MRI early after treatment start to describe biological changes during therapy, the potential of early response evaluation, and the added value of FLT-PET/DW-MRI. Methods: Patients with SCLC referred for standard chemotherapy were eligible. FLT-PET/DW-MRI of the chest and brain was acquired within 14 days after treatment start. FLT-PET/DW-MRI was compared with pretreatment FDG-PET/CT. Standardized uptake value (SUV), apparent diffusion coefficient (ADC), and functional tumor volumes were measured. FDG-SUVpeak, FLT-SUVpeak, and ADCmedian; spatial distribution of aggressive areas; and voxel-by-voxel analyses were evaluated to compare the biological information derived from the three functional imaging modalities. FDG-SUVpeak, FLT-SUVpeak, and ADCmedian were also analyzed for ability to predict final treatment response. Results: Twelve patients with SCLC completed FLT-PET/MRI 1–9 days after treatment start. In nine patients, pretreatment FDG-PET/CT was available for comparison. A total of 16 T-sites and 12 N-sites were identified. No brain metastases were detected. FDG-SUVpeak was 2.0–22.7 in T-sites and 5.5–17.3 in N-sites. FLT-SUVpeak was 0.6–11.5 in T-sites and 1.2–2.4 in N-sites. ADCmedian was 0.76–1.74 × 10− 3 mm2/s in T-sites and 0.88–2.09 × 10−3 mm2/s in N-sites. FLT-SUVpeak correlated with FDG-SUVpeak, and voxel-by-voxel correlation was positive, though the hottest regions were dissimilarly distributed in FLT-PET compared to FDG-PET. FLT-SUVpeak was not correlated with ADCmedian, and voxel-by-voxel ana