Adequacy of Communicating Results From Screening Mammograms to African American and White Women

Objective. We examined whether African American women were as likely as White women to receive the results of a recent mammogram and to self-report results that matched the mammography radiology report (i.e., were adequately communicated). We also sought to determine whether the adequacy of communication was the same for normal and abnormal results. Methods. From a prospective cohort study of mammography screening, we compared self-reported mammogram results, which were collected by telephone interview, to results listed in the radiology record of 411 African American and 734 White women who underwent screening in 5 hospital-based facilities in Connecticut between October 1996 and January 1998. Using multivariate logistic regression, we identified independent predictors of inadequate communication of mammography results. Results. It was significantly more common for African American women to experience inadequate communication of screening mammography results compared with White women, after adjustment for sociodemographic, access-to-care, biomedical, and psychosocial factors. Abnormal mammogram results resulted in inadequate communication for African American women but not White women (P\u3c.001). Conclusions. African American women may not be receiving the full benefit of screening mammograms because of inadequate communication of results, particularly when mammography results are abnormal

Lesion detection and Grading of Diabetic Retinopathy via Two-stages Deep Convolutional Neural Networks

We propose an automatic diabetic retinopathy (DR) analysis algorithm based on two-stages deep convolutional neural networks (DCNN). Compared to existing DCNN-based DR detection methods, the proposed algorithm have the following advantages: (1) Our method can point out the location and type of lesions in the fundus images, as well as giving the severity grades of DR. Moreover, since retina lesions and DR severity appear with different scales in fundus images, the integration of both local and global networks learn more complete and specific features for DR analysis. (2) By introducing imbalanced weighting map, more attentions will be given to lesion patches for DR grading, which significantly improve the performance of the proposed algorithm. In this study, we label 12,206 lesion patches and re-annotate the DR grades of 23,595 fundus images from Kaggle competition dataset. Under the guidance of clinical ophthalmologists, the experimental results show that our local lesion detection net achieve comparable performance with trained human observers, and the proposed imbalanced weighted scheme also be proved to significantly improve the capability of our DCNN-based DR grading algorithm

Structural Considerations for Larger Upper Stage Development

The selection of design configurations and materials for large vehicles such as those proposed for manned missions to Mars in the early 1980\u27s will require the resolving of major technological questions during the next few years. The structure required to contain the large volume of liquid propellants, particularly hydrogen, must be of efficient design so that payload capability can be maximized. In a typical study recently conducted, design criteria were established for a multimodule upper stage. Each stage module consists of a basic shell structure, an insulated, internally mounted LH2 propellant tank, and the thrust engine with its associated support system and hardware. Meteoroid protection is incorporated in the shell structure. The largest potential for structural weight-saving appears to be in the propellant tank design. Aluminum alloys are currently favored as tank material because of successful experience and the high level of technological development. Titanium alloys, however, offer sizeable potential weight savings because of their superior biaxial strength properties at cryogenic temperatures. The biaxial strengths of titanium alloys range from 30% to 70% greater than their uniaxial strength, compared to less than 15% for the aluminum alloys. However, there are certain requisite programs that must be conducted before titanium can be introduced as a qualified structural material for large cryogenic tankage. This study investigated the following areas: texture strengthening of titanium alloys, nondestructive inspection techniques, critical crack size, proof load levels, compatibility with LH;? under long-term storage conditions, stress corrosion, creep, and low-cycle fatigue. Only with positive results in these areas could the materials be used. Efficient means of attachment of structural components to thin-gage tanks were studied, as were manufacturing considerations for the vehicles. These included material size, development of welding methods and equipment, and techniques for handling the large, thin-gage upper stage structural components before, during, and after fabrication

Evolving frontiers in severe polytrauma management: refining the essential principles

This editorial aims to refine the severe polytrauma management principles. While keeping ABCDE priorities, the termination of futile resuscitation and the early use of tourniquet to stop exsanguinating limb bleeding are crucial. Difficult-airway-management (DAM) is by a structured 5-level approach. The computerised tomography (CT) scanner is the tunnel to death for hemodynamically unstable patients. Focused Abdominal Sonography for Trauma-Ultrasonography (FAST USG) has replaced diagnostic peritoneal lavage (DPL) and is expanding to USG life support. Direct whole-body multidetector-row computed tomography (MDCT) expedites diagnosis & treatment. Non-operative management is a viable option in rapid responders in shock. Damage control resuscitation comprising of permissive hypotension, hemostatic resuscitation & damage control surgery (DCS) help prevent the lethal triad of trauma. Massive transfusion protocol reduces mortality and decreases the blood requirement. DCS attains rapid correction of the deranged physiology. Mortality reduction in major pelvic disruption requires a multi-disciplinary protocol, the novel pre-peritoneal pelvic packing and the angio-embolization. When operation is the definitive treatment for injury, prevention is best therapy. © Penerbit Universiti Sains Malaysia, 2013.published_or_final_versio

Viscous Shock-Layer Analysis of Two-Dimensional and Axisymmetric Flows

Results are obtained for cylindrical leading edges of proposed transatmospheric vehicles by employing a two-dimensional viscous shock-layer code for nonequilibrium gas flows. The accuracy and efficiency of the planar code is verified through detailed comparisons with other predictions. This study includes results for 6-deg half-angle bodies with nose radii ranging from 0.01 to 2.0 ft for both cylindrically blunted wedges and spherically blunted cones (included for comparison). Some results are presented as a ratio of the noncatalytic to the corresponding fully catalytic heating value to illustrate the maximum potential for a heating reduction in dissociated nonequilibrium flows. Generally, this ratio and the individual heating rates are smaller for cylindrically blunted wedges with small nose radii as compared to the spherically blunted cones (for the same nose radius). Therefore, a larger potential exists for heating reduction in cylindrically blunted as compared with the spherically blunted surfaces. However, the results presented at higher altitudes (where the slip effects become important) show that the spherically, blunted nose gives lower stagnation-point heating due to stronger merged shock-layer effects as compared with a cylindrically blunted nose

A Phase-Field Model of Spiral Dendritic Growth

Domains of condensed-phase monolayers of chiral molecules exhibit a variety of interesting nonequilibrium structures when formed via pressurization. To model these domain patterns, we add a complex field describing the tilt degree of freedom to an (anisotropic) complex-phase-field solidification model. The resulting formalism allows for the inclusion of (in general, non-reflection symmetric) interactions between the tilt, the solid-liquid interface, and the bond orientation. Simulations demonstrate the ability of the model to exhibit spiral dendritic growth.Comment: text plus Four postscript figure file

Reversible Metal-Semiconductor Transition of ssDNA-Decorated Single-Walled Carbon Nanotubes

A field effect transistor (FET) measurement of a SWNT shows a transition from a metallic one to a p-type semiconductor after helical wrapping of DNA. Water is found to be critical to activate this metal-semiconductor transition in the SWNT-ssDNA hybrid. Raman spectroscopy confirms the same change in electrical behavior. According to our ab initio calculations, a band gap can open up in a metallic SWNT with wrapped ssDNA in the presence of water molecules due to charge transfer.Comment: 13 pages, 6 figure

Nucleoside transport inhibition by dipyridamole prevents angiogenesis impairment by homocysteine and adenosine

© 2015, Canadian Society for Pharmaceutical Sciences. All rights reserved.Purpose. Adenosine plays an important role in the pathogenesis of homocysteine-associated vascular complications. Methods: This study examined the effects of dipyridamole, an inhibitor for nucleoside transport, on impaired angiogenic processes caused by homocysteine and adenosine in human cardiovascular endothelial cell line (EAhy926). Results: The results showed that dipyridamole restored the extracellular adenosine and intracellular S-adenosylhomocysteine concentrations disrupted by the combination of homocysteine and adenosine. Dipyridamole also ameliorated the impaired proliferation, migration and formation of capillary-like tubes of EAhy926 cells caused by the combination of homocysteine and adenosine. Mechanism analysis revealed that dipyridamole induced the phosphorylation of mitogen-activated protein kinase kinase (MEK) and extracellular signal-regulated kinases (ERK) and its effect on cell growth was attenuated by the MEK inhibitor, U0126. Conclusion: Dipyridamole protected against impaired angiogenesis caused by homocysteine and adenosine, at least in part, by activating the MEK/ERK signalling pathway, and this could be associated with its effects in suppressing intracellular S-adenosylhomocysteine accumulation. Novelty of the Work: This is the first paper showing that nucleoside transport inhibition by dipyridamole reduced impaired angiogenic process caused by homocysteine and adenosine. © 2015, Canadian Society for Pharmaceutical Sciences. All rights reserve

A two dimensional nanopatterned thin metallic transparent conductor with high transparency from the ultraviolet to the infrared

Cataloged from PDF version of article.The optical properties of a two-dimensional nanohole patterned aluminum thin film in hexagonal lattice are studied. The transmission dip can be moved out from the visible range by manipulating the lattice constant. The resulting nanopatterned thin film is demonstrated to exhibit a high transparency in a wide wavelength range. The origins of the transmission dip and the transmission drop are explained. For constant resistance, thicker films with a larger filling ratio lead to better transmittance in the visible range. Angular response of the nanopatterned metallic film is also analyzed, and transmittances using several other metals are compared. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4765341

Idarucizumab for Dabigatran Reversal - Full Cohort Analysis.

BACKGROUND: Idarucizumab, a monoclonal antibody fragment, was developed to reverse the anticoagulant effect of dabigatran. METHODS: We performed a multicenter, prospective, open-label study to determine whether 5 g of intravenous idarucizumab would be able to reverse the anticoagulant effect of dabigatran in patients who had uncontrolled bleeding (group A) or were about to undergo an urgent procedure (group B). The primary end point was the maximum percentage reversal of the anticoagulant effect of dabigatran within 4 hours after the administration of idarucizumab, on the basis of the diluted thrombin time or ecarin clotting time. Secondary end points included the restoration of hemostasis and safety measures. RESULTS: A total of 503 patients were enrolled: 301 in group A, and 202 in group B. The median maximum percentage reversal of dabigatran was 100% (95% confidence interval, 100 to 100), on the basis of either the diluted thrombin time or the ecarin clotting time. In group A, 137 patients (45.5%) presented with gastrointestinal bleeding and 98 (32.6%) presented with intracranial hemorrhage; among the patients who could be assessed, the median time to the cessation of bleeding was 2.5 hours. In group B, the median time to the initiation of the intended procedure was 1.6 hours; periprocedural hemostasis was assessed as normal in 93.4% of the patients, mildly abnormal in 5.1%, and moderately abnormal in 1.5%. At 90 days, thrombotic events had occurred in 6.3% of the patients in group A and in 7.4% in group B, and the mortality rate was 18.8% and 18.9%, respectively. There were no serious adverse safety signals. CONCLUSIONS: In emergency situations, idarucizumab rapidly, durably, and safely reversed the anticoagulant effect of dabigatran. (Funded by Boehringer Ingelheim; RE-VERSE AD ClinicalTrials.gov number, NCT02104947 .)