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Ziele: Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Deutschen Krebsgesellschaft (DKG) publiziert und koordiniert wurde, ist es, die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms zu optimieren.
Methoden: Der Aktualisierungsprozess der S3-Leitlinie aus 2012 basierte zum einen auf der Adaptation identifizierter Quellleitlinien und zum anderen auf Evidenzübersichten, die nach Entwicklung von PICO-(Patients/Interventions/Control/Outcome-)Fragen, systematischer Recherche in Literaturdatenbanken sowie Selektion und Bewertung der gefundenen Literatur angefertigt wurden. In den interdisziplinären Arbeitsgruppen wurden auf dieser Grundlage Vorschläge für Empfehlungen und Statements erarbeitet, die im Rahmen von strukturierten Konsensusverfahren modifiziert und graduiert wurden.
Empfehlungen: Der Teil 1 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms: Der Stellenwert des Mammografie-Screenings wird in der aktualisierten Leitlinienversion bestätigt und bildet damit die Grundlage der Früherkennung. Neben den konventionellen Methoden der Karzinomdiagnostik wird die Computertomografie (CT) zum Staging bei höherem Rückfallrisiko empfohlen. Die Nachsorgekonzepte beinhalten Untersuchungsintervalle für die körperliche Untersuchung, Ultraschall und Mammografie, während weiterführende Gerätediagnostik und Tumormarkerbestimmungen bei der metastasierten Erkrankung Anwendung finden.
Purpose: The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer.
Methods: The process of updating the S3 guideline dating from 2012 was based on the adaptation of identified source guidelines which were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and the results of a systematic search of literature databases and the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point to develop recommendations and statements which were modified and graded in a structured consensus procedure.
Recommendations: Part 1 of this short version of the guideline presents recommendations for the screening, diagnosis and follow-up care of breast cancer. The importance of mammography for screening is confirmed in this updated version of the guideline and forms the basis for all screening. In addition to the conventional methods used to diagnose breast cancer, computed tomography (CT) is recommended for staging in women with a higher risk of recurrence. The follow-up concept includes suggested intervals between physical, ultrasound and mammography examinations, additional high-tech diagnostic procedures, and the determination of tumor markers for the evaluation of metastatic disease.
In Eurotransplant kidney allocation system (ETKAS), candidates can be considered unlimitedly for repeated re‐transplantation. Data on outcome and benefit are indeterminate. We performed a retrospective 15‐year patient and graft outcome data analysis from 1464 recipients of a third or fourth or higher sequential deceased donor renal transplantation (DDRT) from 42 transplant centers. Repeated re‐DDRT recipients were younger (mean 43.0 vs. 50.2 years) compared to first DDRT recipients. They received grafts with more favorable HLA matches (89.0% vs. 84.5%) but thereby no statistically significant improvement of patient and graft outcome was found as comparatively demonstrated in 1st DDRT. In the multivariate modeling accounting for confounding factors, mortality and graft loss after 3rd and ≥4th DDRT (P < 0.001 each) and death with functioning graft (DwFG) after 3rd DDRT (P = 0.001) were higher as compared to 1st DDRT. The incidence of primary nonfunction (PNF) was also significantly higher in re‐DDRT (12.7%) than in 1st DDRT (7.1%; P < 0.001). Facing organ shortage, increasing waiting time, and considerable mortality on dialysis, we question the current policy of repeated re‐DDRT. The data from this survey propose better HLA matching in first DDRT and second DDRT and careful selection of candidates, especially for ≥4th DDRT.
The production of J/ψ is measured as a function of charged-particle multiplicity at forward rapidity in proton-proton (pp) collisions at center-of-mass energies s√ = 5.02 and 13 TeV. The J/ψ mesons are reconstructed via their decay into dimuons in the rapidity interval (2.5 < y < 4.0), whereas the charged-particle multiplicity density (dNch/dη) is measured at midrapidity (|η| < 1). The production rate as a function of multiplicity is reported as the ratio of the yield in a given multiplicity interval to the multiplicity-integrated one. This observable shows a linear increase with charged-particle multiplicity normalized to the corresponding average value for inelastic events (dNch/dη/〈dNch/dη〉), at both the colliding energies. Measurements are compared with available ALICE results at midrapidity and theoretical model calculations. First measurement of the mean transverse momentum (〈pT〉) of J/ψ in pp collisions exhibits an increasing trend as a function of dNch/dη/〈dNch/dη〉 showing a saturation towards high charged-particle multiplicities.
The multiplicity dependence of jet production in pp collisions at the centre-of-mass energy of s√=13 TeV is studied for the first time. Jets are reconstructed from charged particles using the anti-kT algorithm with resolution parameters R varying from 0.2 to 0.7. The jets are measured in the pseudorapidity range |ηjet|<0.9−R and in the transverse momentum range 5<pchT,jet<140 GeV/c. The multiplicity intervals are categorised by the ALICE forward detector V0. The pT differential cross section of charged-particle jets are compared to leading order (LO) and next-to-leading order (NLO) perturbative quantum chromodynamics (pQCD) calculations. It is found that the data are better described by the NLO calculation, although the NLO prediction overestimates the jet cross section below 20 GeV/c. The cross section ratios for different R are also measured and compared to model calculations. These measurements provide insights into the angular dependence of jet fragmentation. The jet yield increases with increasing self-normalised charged-particle multiplicity. This increase shows only a weak dependence on jet transverse momentum and resolution parameter at the highest multiplicity. While such behaviour is qualitatively described by the present version of PYTHIA, quantitative description may require implementing new mechanisms for multi-particle production in hadronic collisions.
The energy deposited at very forward rapidities (very forward energy) is a powerful tool for characterising proton fragmentation in pp and p-Pb collisions. The correlation of very forward energy with particle production at midrapidity provides direct insights into the initial stages and the subsequent evolution of the collision. Furthermore, the correlation with the production of particles with large transverse momenta at midrapidity provides information complementary to the measurements of the underlying event, which are usually interpreted in the framework of models implementing centrality-dependent multiple parton interactions.
Results about very forward energy, measured by the ALICE zero degree calorimeters (ZDCs), and its dependence on the activity measured at midrapidity in pp collisions at s√ = 13 TeV and in p-Pb collisions at sNN−−−√ = 8.16 TeV are discussed. The measurements performed in pp collisions are compared with the expectations of three hadronic interaction event generators: PYTHIA 6 (Perugia 2011 tune), PYTHIA 8 (Monash tune), and EPOS LHC. These results provide new constraints on the validity of models in describing the beam remnants at very forward rapidities, where perturbative QCD cannot be used.
Understanding the production mechanism of light (anti)nuclei is one of the key challenges of nuclear physics and has important consequences for astrophysics, since it provides an input for indirect dark-matter searches in space. In this paper, the latest results about the production of light (anti)nuclei in pp collisions at s√ = 13 TeV are presented, focusing on the comparison with the predictions of coalescence and thermal models. For the first time, the coalescence parameters B2 for deuterons and B3 for helions are compared with parameter-free theoretical predictions that are directly constrained by the femtoscopic measurement of the source radius in the same event class. A fair description of the data with a Gaussian wave function is observed for both deuteron and helion, supporting the coalescence mechanism for the production of light (anti)nuclei in pp collisions. This method paves the way for future investigations of the internal structure of more complex nuclear clusters, including the hypertriton.
Two-particle Azimuthal correlations are measured with the ALICE apparatus in pp collisions at s√=13 TeV to explore strangeness- and multiplicity-related effects in the fragmentation of jets and the transition regime between bulk and hard production, probed with the condition that a strange meson (KS0) or baryon (Λ) with transverse momentum pT>3 GeV/c is produced. Azimuthal correlations between kaons or Λ hyperons with other hadrons are presented at midrapidity for a broad range of the trigger (3<ptriggT<20 GeV/c) and associated particle pT (1 GeV/c <passocT<ptriggT), for minimum-bias events and as a function of the event multiplicity. The near- and away-side peak yields are compared for the case of either KS0 or Λ(Λ¯¯¯¯) being the trigger particle with that of inclusive hadrons (a sample dominated by pions). In addition, the measurements are compared with predictions from PYTHIA 8 and EPOS LHC event generators.
Angular correlations of heavy-flavour and charged particles in high-energy proton–proton collisions are sensitive to the production mechanisms of heavy quarks and to their fragmentation as well as hadronisation processes. The measurement of the azimuthal-correlation function of prompt D mesons with charged particles in proton–proton collisions at a centre-of-mass energy of s√=13 TeV with the ALICE detector is reported, considering D0, D+, and D∗+ mesons in the transverse-momentum interval 3<pT<36 GeV/c at midrapidity (|y|<0.5), and charged particles with pT>0.3 GeV/c and pseudorapidity |η|<0.8. This measurement has an improved precision and provides an extended transverse-momentum coverage compared to previous ALICE measurements at lower energies. The study is also performed as a function of the charged-particle multiplicity, showing no modifications of the correlation function with multiplicity within uncertainties. The properties and the transverse-momentum evolution of the near- and away-side correlation peaks are studied and compared with predictions from various Monte Carlo event generators. Among those considered, PYTHIA8 and POWHEG+PYTHIA8 provide the best description of the measured observables. The obtained results can provide guidance on tuning the generators.
A measurement of the inclusive b-jet production cross section is presented in pp and p-Pb collisions at sNN−−−√ = 5.02 TeV, using data collected with the ALICE detector at the LHC. The jets were reconstructed in the central rapidity region |η| < 0.5 from charged particles using the anti-kT algorithm with resolution parameter R = 0.4. Identification of b jets exploits the long lifetime of b hadrons, using the properties of secondary vertices and impact parameter distributions. The pT-differential inclusive production cross section of b jets, as well as the corresponding inclusive b-jet fraction, are reported for pp and p-Pb collisions in the jet transverse momentum range 10 ≤ pT,ch jet ≤ 100 GeV/c, together with the nuclear modification factor, Rb−jetpPb. The analysis thus extends the lower pT limit of b-jet measurements at the LHC. The nuclear modification factor is found to be consistent with unity, indicating that the production of b jets in p-Pb at sNN−−−√ = 5.02 TeV is not affected by cold nuclear matter effects within the current precision. The measurements are well reproduced by POWHEG NLO pQCD calculations with PYTHIA fragmentation.