A multi-layer edge-on single photon counting silicon microstrip detector for innovative techniques in diagnostic radiology

A three-layer detector prototype, obtained by stacking three edge-on single photon counting silicon microstrip detectors, has been developed and widely tested. This was done in the framework of the Synchrotron Radiation for Medical Physics/Frontier Radiology (SYRMEP/FRONTRAD) collaboration activities, whose aim is to improve the quality of mammographic examinations operating both on the source and on the detector side. The active surface of the device has been fully characterized making use of an edge-scanning technique and of a well-collimated laminar synchrotron radiation beam. The obtained data (interlayer distances, channel correspondence, etc.) have then been used to combine information coming from each detector layer, without causing any loss in spatial and contrast resolution of the device. Contrast and spatial resolution have also been separately evaluated for each detector layer. Moreover, imaging techniques (phase contrast, refraction, and scatter imaging), resulting in an increased visibility of low absorbing details, have been implemented, and their effectiveness has been tested on a biological sample. Finally, the possibility of simultaneously acquiring different kind of images with the different detector layers is discussed. This would result in maximizing the information extracted from the sample, while at the same time the high absorption efficiency of the detector device would allow a low dose delivery

The Effect of Race/Ethnicity on the Age of Colon Cancer Diagnosis

ABSTRACT BACKGROUND: Colorectal cancer is the third most commonly diagnosed cancer in the United States. Notably, racial/ethnic disparities exist in both incidence and mortality. PURPOSE: The aim of this case study was to investigate the impact of race/ethnicity on age at diagnosis of colorectal cancer in a defined population in Suffolk County, NY. METHODS: Data were retrospectively collected on race/ethnicity, health insurance status, age at diagnosis, stage at diagnosis, gender, smoking status, alcohol intake, tumor location, and body mass index for colorectal cancer patients with medical records in the Stony Brook University Medical Center database (2005-2011). Population-based data on Hispanic and non-Hispanic Whites were obtained from the Surveillance, Epidemiology, and End Results registry of New York State for an overlapping time period. Permutation-based ANCOVA and logistic regression with stepwise variable selection were conducted to identify covariates and first-order interactions associated with younger age at diagnosis and cancer stage as a dependent categorical variable. RESULTS: Of 328 colorectal cancer patients, Hispanics were diagnosed at a median younger age of 57y vs. 67y than non-Hispanic Whites (FDR = 0.001). Twenty-six percent of Hispanics were diagnosed with colorectal cancer prior to the recommended age (50y) for colorectal cancer surveillance compared to 11% of non-Hispanic Whites (FDR =0.007). Analysis of New York State registry data corroborated our findings that Hispanic colorectal cancer patients were diagnosed at a median younger age than non-Hispanic Whites. Permutation-based ANCOVA identified race/ethnicity and health insurance as significantly associated with age of diagnosis (P=0.001). Logistic regression selected (younger) age at diagnosis as being significantly associated with stage IV disease. The limitations of the case study reside in the use of self-reporting of race and ethnicity and in the small sample sizes. CONCLUSIONS: Hispanics may be at higher risk for colorectal cancer (y) and younger age at diagnosis is associated with advanced disease

Prognostic factors in node-negative colorectal cancer: a retrospective study from a prospective database

PURPOSE: There is a need to identify a subgroup of high-risk patients with node-negative colorectal cancer who have a poor long-term prognosis and may benefit from adjuvant therapies. The aim of this study was to evaluate the prognostic impact of clinical and pathological parameters in a retrospective study from a prospective, continuous database of homogenously treated patients. METHODS: This study included 362 patients operated in a single institution for Dukes A and B (node-negative) colorectal cancer. The median follow-up was 140 months. The prognostic value of 13 clinical and pathological parameters was investigated. RESULTS: Multivariate analysis identified six independent prognostic factors: age at time of diagnosis (hazard ratio (HR) = 1.076), number of lymph nodes removed (HR = 0.948), perineural invasion (HR = 2.173), venous invasion (HR = 1.959), lymphatic vessel invasion (HR = 2.126), and T4 stage (HR = 5.876). CONCLUSION: These parameters could be useful in identifying patients with high-risk node-negative colorectal cancer who should be presented to adjuvant therapy

Morphological and geochemical features of crater lakes in Costa Rica: an overview.

This paper describes the compositional and morphological features of the crater lakes found in the volcanoes of Rincón de La Vieja, Poás, Irazú, Congo and Tenorio volcanoes (Costa Rica). As evidenced by the distribution of the water and dissolved gas chemistry along vertical profiles, the different fluid sources feeding the lakes reflect the present status of each of the volcanic systems. The chemical features of the Caliente (Poás volcano) and Rincón crater (Rincón de la Vieja volcano) lakes are mainly dependent on i) inputs of magmatic fluids from sub-lacustrine fumaroles and ii) water-rock interaction processes. Conversely, the Irazú lake is mainly affected by the presence of CO2(H2S)-rich fluids discharged from a hydrothermal system, which masked possible magmatic fluid contributions. Rainfall and organic activity are the main factors responsible for the chemical composition of Hule, Botos, Congo and Tenorio lakes. The chemical and isotopic water composition of Botos, Irazú and Hule lakes have displayed no significant variations along the vertical profiles. In contrast, Caliente lake shows a distinctive chemical stratification, mainly involving F-, Cl- and SO4 2-. The behaviour of these compounds seems to be governed by both dissolution of highly acidic species, i.e. HF, HCl and SO2 released from the magmatic environment, and microbial activity. Despite the significant increases with depth of dissolved CO2 at Caliente and Irazú lakes, the hazard for Nyos-type gas eruptions can be considered negligible, since i) the water volumes are too small and ii) the convective heat transfer limits the CO2 recharge rate. The relatively high concentrations of dissolved CO2 measured at the maximum depth of the Hule lake are likely produced by both degradation of organic material and degassing from a deep source. The sporadic episodes of fish deaths recently observed in this lake can be associated with lake overturn processes that have favoured the rise up to the lake surface of deep, oxygen-depleted waters.Journal of limnolog

Standardized Laparoscopic Intracorporeal Right Colectomy for Cancer: Short-Term Outcome in 111 Unselected Patients

Purpose This study was designed to evaluate the impact of a standardized laparoscopic intracorporeal right colectomy on the short-term outcome of patients with neoplasia. Methods Consecutive patients with histologically proven right colon neoplasia underwent a standardized laparoscopic intracorporeal right colectomy with medial to lateral approach encompassing ten sequential steps: 1) ligation of ileocolic vessels, 2) identification of right ureter, 3) dissection along superior mesenteric vein, 4) division of omentum, 5) division of right branch of middle colic vessels, 6) transection of transverse colon, 7) mobilization of right colon, 8) transection of terminal ileum, 9) ileocolic anastomosis, 10) delivery of specimen. Values were medians (ranges). Results From July 2002 to June 2005, 111 laparoscopic intracorporeal right colectomies were attempted with a 5.4 percent conversion rate. There were 57 women and 54 men, aged 64.9 (range, 40–85) years, with body mass index of 33 (range, 20–43), American Society of Anesthesiology score of 2 (range, 2–4), 36.9 percent comorbidities, and 37.8 percent previous abdominal surgery. The indication for surgery was cancer in 109 patients. Operative time was 120 (range, 80–185) minutes. Estimated blood loss was 69 (range, 50–600) ml. Overall length of skin incisions was 66 (range, 60–66) mm; 29 (range, 2–41) lymph nodes were harvested. Length of stay was four (range, 2–30) days. Complication rate was 4.5 percent. Conclusions A standardized laparoscopic intracorporeal right colectomy resulted in a favorable short-term outcome in unselected patients with neoplasia of the right colon

Exceptional response to immunotherapy in association with radiotherapy in patient with breast metastasis from urothelial carcinoma: A case report

Most common sites of metastasis of urothelial carcinoma (UC) are lungs, liver, lymph nodes and bone. Pembrolizumab, a humanized monoclonal antibody directed against programmed cell death protein-1 (PD-1), represents an effective second-line therapy for advanced UC. Radiotherapy has been shown to induce a mechanism of immunogenic cell death (ICD) resulting in immune memory and advantageous systemic effects. We present the first case of breast metastasis (BM) from a UC described in literature who had an exceptional response to second-line therapy with pembrolizumab in association with radiotherapy, showing the efficacy of combining immunotherapy and radiotherapy even in patients with atypical metastatic sites

Robust Dropping Criteria for F-norm Minimization Based Sparse Approximate Inverse Preconditioning

Dropping tolerance criteria play a central role in Sparse Approximate Inverse preconditioning. Such criteria have received, however, little attention and have been treated heuristically in the following manner: If the size of an entry is below some empirically small positive quantity, then it is set to zero. The meaning of "small" is vague and has not been considered rigorously. It has not been clear how dropping tolerances affect the quality and effectiveness of a preconditioner $M$. In this paper, we focus on the adaptive Power Sparse Approximate Inverse algorithm and establish a mathematical theory on robust selection criteria for dropping tolerances. Using the theory, we derive an adaptive dropping criterion that is used to drop entries of small magnitude dynamically during the setup process of $M$. The proposed criterion enables us to make $M$ both as sparse as possible as well as to be of comparable quality to the potentially denser matrix which is obtained without dropping. As a byproduct, the theory applies to static F-norm minimization based preconditioning procedures, and a similar dropping criterion is given that can be used to sparsify a matrix after it has been computed by a static sparse approximate inverse procedure. In contrast to the adaptive procedure, dropping in the static procedure does not reduce the setup time of the matrix but makes the application of the sparser $M$ for Krylov iterations cheaper. Numerical experiments reported confirm the theory and illustrate the robustness and effectiveness of the dropping criteria.Comment: 27 pages, 2 figure