Ductal carcinoma in situ of the breast (DCIS) with heterogeneity of nuclear grade: prognostic effects of quantitative nuclear assessment

<p>Abstract</p> <p>Background</p> <p>Previously, 50% of patients with breast ductal carcinoma <it>in situ (</it>DCIS) had more than one nuclear grade, and neither worst nor predominant nuclear grade was significantly associated with development of invasive carcinoma. Here, we used image analysis in addition to histologic evaluation to determine if quantification of nuclear features could provide additional prognostic information and hence impact prognostic assessments.</p> <p>Methods</p> <p>Nuclear image features were extracted from about 200 nuclei of each of 80 patients with DCIS who underwent lumpectomy alone, and received no adjuvant systemic therapy. Nuclear images were obtained from 20 representative nuclei per duct, from each of a group of 5 ducts, in two separate fields, for 10 ducts. Reproducibility of image analysis features was determined, as was the ability of features to discriminate between nuclear grades. Patient information was available about clinical factors (age and method of DCIS detection), pathologic factors (DCIS size, nuclear grade, margin size, and amount of parenchymal involvement), and 39 image features (morphology, densitometry, and texture). The prognostic effects of these factors and features on the development of invasive breast cancer were examined with Cox step-wise multivariate regression.</p> <p>Results</p> <p>Duplicate measurements were similar for 89.7% to 97.4% of assessed image features. For the pooled assessment with ~200 nuclei per patient, a discriminant function with one densitometric and two texture features was significantly (p < 0.001) associated with nuclear grading, and provided 78.8% correct jackknifed classification of a patient's nuclear grade. In multivariate assessments, image analysis nuclear features had significant prognostic associations (p ≤ 0.05) with the development of invasive breast cancer. Texture (difference entropy, p < 0.001; contrast, p < 0.001; peak transition probability, p = 0.01), densitometry (range density, p = 0.004), and measured margin (p = 0.05) were associated with development of invasive disease for the pooled data across all ducts.</p> <p>Conclusion</p> <p>Image analysis provided reproducible assessments of nuclear features which quantitated differences in nuclear grading for patients. Quantitative nuclear image features indicated prognostically significant differences in DCIS, and may contribute additional information to prognostic assessments of which patients are likely to develop invasive disease.</p

Effect of Quantitative Nuclear Image Features on Recurrence of Ductal Carcinoma In Situ (DCIS) of the Breast

BACKGROUND: Nuclear grade has been associated with breast DCIS recurrence and progression to invasive carcinoma; however, our previous study of a cohort of patients with breast DCIS did not find such an association with outcome. Fifty percent of patients had heterogeneous DCIS with more than one nuclear grade. The aim of the current study was to investigate the effect of quantitative nuclear features assessed with digital image analysis on ipsilateral DCIS recurrence.CONCLUSION: Analysis of nuclear features measured by image cytometry may contribute to the classification and prognosis of breast DCIS patients with more than one nuclear grade.Author manuscript. Published in final edited form as: Cancer Informatics 2008:4 99–109.The final published version of this article is located at: http://la-press.com/article.php?article_id=583NIH U56 CA113004; to David E. AxelrodThis work was funded by the New Jersey Commission for Cancer Research 1076-CCRS0, the National Institutes of Health U56 CA113004, the Hyde and Watson Foundation, the Busch Memorial Fund, and the E.B. Fish Research Fund.NJ Commission on Cancer Research 1076-CCR-SO; to David E. Axelro

Stories of self, us, and now: narrative and power for health equity in grassroots community organizing

IntroductionCommunity organizing initiatives, which build power through cycles of listening, participatory research, collective action, and reflection, have demonstrated the capacity to intervene on, complicate, and resist dominant societal narratives while promoting alternative public narratives focused on shared values and hope for a better future.MethodsTo explore processes of public narrative change and their relationship to community and organizational empowerment, we interviewed 35 key leaders in community organizing initiatives in Detroit, MI and Cincinnati, OH about how narrative change takes place within community organizing practices.ResultsLeaders’ perspectives revealed crucial roles for narrative and storytelling in guiding individual and collective behavior, supporting the development of relationships of trust and accountability, and linking personal and collective experiences to pressing social issues.DiscussionFindings from this study indicate that systemic change is a labor-intensive process and one that requires the development of leaders (stories of self) and the cultivation of collective structures (stories of us) capable of enacting power to effect change with urgency (stories of now). We conclude by discussing implications of these findings for public narrative interventions and related health equity promotion efforts

Stacked crop rotations and cultural practices for canola and flax yield and quality

Canola (Brassica napus L.) and flax (Linum usitatissimum L.) are important oilseed crops, but improved management practices to enhance their yields and quality are needed. We studied the effect of stacked versus alternate‐year crop rotations and traditional versus improved cultural practices on canola and flax growth, seed yield, oil concentration, and N‐use efficiency from 2006 to 2011 in the northern Great Plains, USA. Stacked rotations were durum (Triticum turgidum L.)‐durum‐canola‐pea (Pisum sativum L.) (DDCP) and durum‐durum‐flax‐pea (DDFP). Alternate‐year rotations were durum‐canola‐durum‐pea (DCDP) and durum‐flax‐durum‐pea (DFDP). The traditional cultural practice included a combination of conventional tillage, recommended seed rate, broadcast N fertilization, and reduced stubble height. The improved cultural practice included a combination of no‐tillage, increased seed rate, banded N fertilization, and increased stubble height. Canola stand count was 36–123% greater with the improved than the traditional cultural practice in 2006, 2009, 2010, and 2011. Canola pod number and oil concentration were 3–36% greater in the improved than the traditional practice in 2007 and 2010, but trends reversed by 5–19% in 2008. Flax stand count was 28% greater with DFDP than DDFP in 2007 and 56% greater in the improved than the traditional practice in 2010. Flax pod number, seed weight, seed yield, N content, N‐use efficiency, and N‐removal index varied with crop rotations, cultural practices, and years. Canola growth and oil concentration increased with the improved cultural practice as well as flax growth, yield, and quality enhanced with alternate‐year crop rotation and the improved cultural practice in wet years

An assessment of multimodal imaging of subsurface text in mummy cartonnage using surrogate papyrus phantoms

Ancient Egyptian mummies were often covered with an outer casing, panels and masks made from cartonnage: a lightweight material made from linen, plaster, and recycled papyrus held together with adhesive. Egyptologists, papyrologists, and historians aim to recover and read extant text on the papyrus contained within cartonnage layers, but some methods, such as dissolving mummy casings, are destructive. The use of an advanced range of different imaging modalities was investigated to test the feasibility of non-destructive approaches applied to multi-layered papyrus found in ancient Egyptian mummy cartonnage. Eight different techniques were compared by imaging four synthetic phantoms designed to provide robust, well-understood, yet relevant sample standards using modern papyrus and replica inks. The techniques include optical (multispectral imaging with reflection and transillumination, and optical coherence tomography), X-ray (X-ray fluorescence imaging, X-ray fluorescence spectroscopy, X-ray micro computed tomography and phase contrast X-ray) and terahertz-based approaches. Optical imaging techniques were able to detect inks on all four phantoms, but were unable to significantly penetrate papyrus. X-ray-based techniques were sensitive to iron-based inks with excellent penetration but were not able to detect carbon-based inks. However, using terahertz imaging, it was possible to detect carbon-based inks with good penetration but with less sensitivity to iron-based inks. The phantoms allowed reliable and repeatable tests to be made at multiple sites on three continents. The tests demonstrated that each imaging modality needs to be optimised for this particular application: it is, in general, not sufficient to repurpose an existing device without modification. Furthermore, it is likely that no single imaging technique will to be able to robustly detect and enable the reading of text within ancient Egyptian mummy cartonnage. However, by carefully selecting, optimising and combining techniques, text contained within these fragile and rare artefacts may eventually be open to non-destructive imaging, identification, and interpretation

Durability improvement of ancient bricks by cementation of porous media

The physicomechanical properties of historic bricks in Toledo (Spain) that have undergone a time-dependent self-healing by natural weathering processes have been improved by porous infill with gypsum, ettringite, and, mainly, calcite. Both these bricks and their experimental replica bricks, made from the original calcareous clays fired at the appropriate historical temperatures (700°–900°C), have been analyzed by X-ray diffraction, optical and scanning electron microscopy, mercury intrusion porosimetry, and ultrasound velocities to compare pore structure and strength evolution by mineral cementation. The resultant microstructure and mineral fillings depend on the brick calcareous composition and firing temperature, the brick location environment, burial, indoor or outdoor walls, the lime-based joint mortars and coat plasters, and infiltration waters.Supported by the Plan Nacional de I+D CICYT 1FD, Grant no. 1997-0561 (Spain) and the CICYT-JCCM (agreement 2002–2004) (Spain)