Patient-Reported Outcomes Measurement Information System physical function correlates with Toronto Extremity Salvage Score in an orthopaedic oncology population

Background: The National Institute of Health\u27s Patient-Reported Outcomes Measurement Information System (PROMIS) uses computerised-adaptive testing to reduce survey burden and improve sensitivity. PROMIS is being used across medical and surgical disciplines but has not been studied in orthopaedic oncology. Questions/purposes: The aim of the study was to compare PROMIS measures with upper extremity (UE) and lower extremity (LE) Toronto Extremity Salvage Score (TESS) by assessing the following: (1) responder burden, (2) correlation between scores and (3) floor/ceiling effects. Patients and methods: This cross-sectional trial analysed all 97 adult patients treated surgically for a bone or soft tissue tumour at a tertiary institution between November 2015 and March 2016. TESS (UE or LE) and PROMIS (Physical Function, Pain Interference and Depression) surveys were administered preoperatively. Pearson correlations between each PROMIS domain and TESS were calculated, as were floor/ceiling effects of each outcome measure. Results: (1) Completion of three PROMIS questionnaires required a mean total of 16.8 (+/- 5.8 standard deviation) questions, compared with 31 and 32 questions for the LE and UE TESS questionnaires, respectively. (2) The PROMIS Physical Function scores demonstrated a strong positive correlation with the LE TESS (r = 0.84; 95% confidence interval [CI], 0.72-0.91; p \u3c 0.001) and moderate positive correlation with the UE TESS (r = 0.64; 95% CI, 0.34-0.83; p = 0.055). The PROMIS Depression scores demonstrated a weak negative correlation with both the LE TESS (r = -0.38; 95% CI, -0.61 to -0.10; p = 0.010) and with UE TESS (r = -0.38; 95% CI, -0.67 to -0.01; p = 0.055). The PROMIS Pain Interference scores demonstrated a strong negative correlation with the LE TESS (r = -0.71; 95% CI, -0.83 to -0.52; p \u3c 0.001) and a moderate negative correlation with the UE TESS (r = -0.62; 95% CI, -0.81 to -0.30; p = 0.001). (3) The UE TESS had a range of scores from 16 to 100 with a 27% ceiling effect and no floor effect, and the LE TESS had a range from 10 to 98 with no floor or ceiling effect. There was no floor or ceiling effect for any PROMIS measures. Conclusions: In an orthopaedic oncology population, the PROMIS Physical Function and Pain Interference scores correlate with the TESS and have the benefit of reduced survey burden and ceiling effect. The PROMIS Depression scores may provide additional information regarding patient outcomes not captured by the TESS. Level of Evidence: Level III. The translational potential of this article: Patient reported outcome measures asses patients\u27 symptoms, function and health-related quality of life and are designed to capture more clinical information than can be gathered by objective medial testing alone. As reimbursements and the understanding of patient outcomes are becoming tied to performance on PROMIS measures, it is an important step to establish how PROMIS measures correlate and compare to traditional legacy measures

Innermost stable circular orbits around relativistic rotating stars

We investigate the innermost stable circular orbit (ISCO) of a test particle moving on the equatorial plane around rotating relativistic stars such as neutron stars. First, we derive approximate analytic formulas for the angular velocity and circumferential radius at the ISCO making use of an approximate relativistic solution which is characterized by arbitrary mass, spin, mass quadrupole, current octapole and mass $2^4$-pole moments. Then, we show that the analytic formulas are accurate enough by comparing them with numerical results, which are obtained by analyzing the vacuum exterior around numerically computed geometries for rotating stars of polytropic equation of state. We demonstrate that contribution of mass quadrupole moment for determining the angular velocity and, in particular, the circumferential radius at the ISCO around a rapidly rotating star is as important as that of spin.Comment: 12 pages, 2 figures, accepted for publication in Phys. Rev.

4-Bit Microprocessor: Design, Simulation, Fabrication, and Testing

The work presented demonstrates the unique ability of Rochester Institute of Technology’s Microelectronic Engineering department to design, simulate, fabricate, and test complex digital integrated circuits. Utilizing the resources available, the author would be the first undergraduate at RIT to successfully drive the creation of a microprocessor from design through fabrication to test. The microprocessor created is the most complex digital circuit ever fabricated at RIT. Fabrication was completed on three lots using the well-established RIT sub μm CMOS Process. Functional CMOS transistors were demonstrated at the Metal 1 level, but complex digital integrated circuits were not realized beyond that

Dust Formation and He II 4686 emission in the Dense Shell of the Peculiar Type Ib Supernova 2006jc

We present evidence for the formation of dust grains in an unusual Type Ib SN based on late-time spectra of SN 2006jc. The progenitor suffered an LBV-like outburst just 2 yr earlier, and we propose that the dust formation is a consequence of the SN blast wave overtaking that LBV-like shell. The key evidence for dust formation is (a) the appearance of a red/near-IR continuum source fit by 1600 K graphite grains, and (b) fading of the redshifted sides of He I emission lines, yielding progressively more asymmetric blueshifted lines as dust obscures receding material. This provides the strongest case yet for dust formation in any SN Ib/c. Both developments occurred between 51 and 75 d after peak, while other SNe observed to form dust did so after a few hundred days. Geometric considerations indicate that dust formed in the dense swept-up shell between the forward and reverse shocks, and not in the freely expanding SN ejecta. Rapid cooling leading to dust formation may have been aided by extremely high shell densities, as indicated by He I line ratios. The brief epoch of dust formation is accompanied by He II 4686 emission and enhanced X-ray emission. These clues suggest that the unusual dust formation in this object was not due to properties of the SN itself, but instead -- like most peculiarities of SN 2006jc -- was a consequence of the dense environment created by an LBV-like eruption 2 yr before the SN.Comment: ApJ, accepted. added some discussion and 2 figures, better title, conclusions same as previous version. 12 pages, 4 color fig

Progress in the study of CdZnTe strip detectors

We report new performance measurements and computer simulations of a sub-millimeter pitch CdZnTe strip detector under study as a prototype imaging spectrometer for astronomical x-ray and gamma-ray observations. The prototype is 1.5 mm thick with 375 micron strip pitch in both the x and y dimensions. Previously reported work included demonstrations of half-pitch spatial resolution (approximately 190 microns) and good energy resolution and spectral uniformity. Strip detector efficiency measurements have also been presented. A model that includes the photon interaction, carrier transport and the electronics was developed that qualitatively reproduced the measurements. The new studies include measurements of the CdZnTe transport properties for this prototype in an effort to resolve quantitative discrepancies between the measurements and the simulations. Measurements of charge signals produced by laser pulses and (alpha) -rays are used to determine these transport properties. These are then used in the model to predict gamma-ray efficiencies that are compared with the data. The imaging performance of the detector is studied by scanned laser and gamma beam spot measurements. The results support the model\u27s prediction of nearly linear sharing of the charge for interactions occurring in the region between electrodes. The potential for strip detectors with spatial resolution much finer than the strip pitch is demonstrated. A new design scheme for strip detectors is shortly discussed

On the Significance of the Weyl Curvature in a Relativistic Cosmological Model

The Weyl curvature includes the Newtonian field and an additional field, the so-called anti-Newtonian. In this paper, we use the Bianchi and Ricci identities to provide a set of constraints and propagations for the Weyl fields. The temporal evolutions of propagations manifest explicit solutions of gravitational waves. We see that models with purely Newtonian field are inconsistent with relativistic models and obstruct sounding solutions. Therefore, both fields are necessary for the nonlocal nature and radiative solutions of gravitation.Comment: 15 pages, incorporating proof correction

Phase transition and landscape statistics of the number partitioning problem

The phase transition in the number partitioning problem (NPP), i.e., the transition from a region in the space of control parameters in which almost all instances have many solutions to a region in which almost all instances have no solution, is investigated by examining the energy landscape of this classic optimization problem. This is achieved by coding the information about the minimum energy paths connecting pairs of minima into a tree structure, termed a barrier tree, the leaves and internal nodes of which represent, respectively, the minima and the lowest energy saddles connecting those minima. Here we apply several measures of shape (balance and symmetry) as well as of branch lengths (barrier heights) to the barrier trees that result from the landscape of the NPP, aiming at identifying traces of the easy/hard transition. We find that it is not possible to tell the easy regime from the hard one by visual inspection of the trees or by measuring the barrier heights. Only the {\it difficulty} measure, given by the maximum value of the ratio between the barrier height and the energy surplus of local minima, succeeded in detecting traces of the phase transition in the tree. In adddition, we show that the barrier trees associated with the NPP are very similar to random trees, contrasting dramatically with trees associated with the $p$ spin-glass and random energy models. We also examine critically a recent conjecture on the equivalence between the NPP and a truncated random energy model

Minisuperspace Examples of Quantization Using Canonical Variables of the Ashtekar Type: Structure and Solutions

The Ashtekar variables have been use to find a number of exact solutions in quantum gravity and quantum cosmology. We investigate the origin of these solutions in the context of a number of canonical transformations (both complex and real) of the basic Hamiltonian variables of general relativity. We are able to present several new solutions in the minisuperspace (quantum cosmology) sector. The meaning of these solutions is then discussed.Comment: 23 pages, latex, 3 figures (uuencoded, separate file

Generalized Involution Models for Wreath Products

We prove that if a finite group $H$ has a generalized involution model, as defined by Bump and Ginzburg, then the wreath product $H \wr S_n$ also has a generalized involution model. This extends the work of Baddeley concerning involution models for wreath products. As an application, we construct a Gelfand model for wreath products of the form $A \wr S_n$ with $A$ abelian, and give an alternate proof of a recent result due to Adin, Postnikov, and Roichman describing a particularly elegant Gelfand model for the wreath product \ZZ_r \wr S_n. We conclude by discussing some notable properties of this representation and its decomposition into irreducible constituents, proving a conjecture of Adin, Roichman, and Postnikov's.Comment: 29 page