Analysis of margin classification systems for assessing the risk of local recurrence after soft tissue sarcoma resection

Purpose: To compare the ability of margin classification systems to determine local recurrence (LR) risk after soft tissue sarcoma (STS) resection. Methods: Two thousand two hundred seventeen patients with nonmetastatic extremity and truncal STS treated with surgical resection and multidisciplinary consideration of perioperative radiotherapy were retrospectively reviewed. Margins were coded by residual tumor (R) classification (in which microscopic tumor at inked margin defines R1), the R+1mm classification (in which microscopic tumor within 1 mm of ink defines R1), and the Toronto Margin Context Classification (TMCC; in which positive margins are separated into planned close but positive at critical structures, positive after whoops re-excision, and inadvertent positive margins). Multivariate competing risk regression models were created. Results: By R classification, LR rates at 10-year follow-up were 8%, 21%, and 44% in R0, R1, and R2, respectively. R+1mm classification resulted in increased R1 margins (726 v 278, P < .001), but led to decreased LR for R1 margins without changing R0 LR; for R0, the 10-year LR rate was 8% (range, 7% to 10%); for R1, the 10-year LR rate was 12% (10% to 15%) . The TMCC also showed various LR rates among its tiers (P < .001). LR rates for positive margins on critical structures were not different from R0 at 10 years (11% v 8%, P = .18), whereas inadvertent positive margins had high LR (5-year, 28% [95% CI, 19% to 37%]; 10-year, 35% [95% CI, 25% to 46%]; P < .001). Conclusion: The R classification identified three distinct risk levels for LR in STS. An R+1mm classification reduced LR differences between R1 and R0, suggesting that a negative but < 1-mm margin may be adequate with multidisciplinary treatment. The TMCC provides additional stratification of positive margins that may aid in surgical planning and patient education

Transfer of Training on the Vertical Motion Simulator

This paper describes a transfer-of-training study in the NASA Ames Vertical Motion Simulator (VMS). Sixty-one general aviation pilots, divided in four groups, trained on four challenging commercial transport tasks with four motion conditions: no motion, small hexapod, large hexapod, and VMS motion. Then, every pilot repeated the tasks with VMS motion to determine if training with different motion conditions had an effect. New objective motion criteria guided the selection of the motion parameters for the small and large hexapod conditions. Considering results that were statistically significant, or marginally, the motion condition used in training affected 1) longitudinal and lateral touchdown location; 2) the number of secondary stall warnings in a stall recovery; 3) pilot ratings of motion utility and maximum load factor obtained in an overbanked upset recovery; and 4) pilot ratings of motion utility and pedal input reaction time in the engine-out-on-takeoff task. Since the motion condition revealed statistical differences on objective measures in all the tasks, even with some in the direction not predicted, trainers should be cautious not to oversimplify the effects of platform motion. Evidence suggests that the new objective motion criteria may offer valid standardization benefits, as instances arose when the higher-fidelity hexapod motion, as predicted by the criteria, provided better cues in training than the lower-fidelity hexapod motion

Relativistic diffusion processes and random walk models

The nonrelativistic standard model for a continuous, one-parameter diffusion process in position space is the Wiener process. As well-known, the Gaussian transition probability density function (PDF) of this process is in conflict with special relativity, as it permits particles to propagate faster than the speed of light. A frequently considered alternative is provided by the telegraph equation, whose solutions avoid superluminal propagation speeds but suffer from singular (non-continuous) diffusion fronts on the light cone, which are unlikely to exist for massive particles. It is therefore advisable to explore other alternatives as well. In this paper, a generalized Wiener process is proposed that is continuous, avoids superluminal propagation, and reduces to the standard Wiener process in the non-relativistic limit. The corresponding relativistic diffusion propagator is obtained directly from the nonrelativistic Wiener propagator, by rewriting the latter in terms of an integral over actions. The resulting relativistic process is non-Markovian, in accordance with the known fact that nontrivial continuous, relativistic Markov processes in position space cannot exist. Hence, the proposed process defines a consistent relativistic diffusion model for massive particles and provides a viable alternative to the solutions of the telegraph equation.Comment: v3: final, shortened version to appear in Phys. Rev.

Perturbation of Retinoid Homeostasis Increases Malformation Risk in Embryos Exposed to Pregestational Diabetes

Funding. This work was supported by funding from Hong Kong Research Grants Council General Research Fund project reference 441606 and 474109 to A.S.W.S., Y.C.L., C.C.W., P.J.M. and A.J.C..Peer reviewedPostprin

Current-voltage correlations in interferometers

We investigate correlations of current at contacts and voltage fluctuations at voltage probes coupled to interferometers. The results are compared with correlations of current and occupation number fluctuations at dephasing probes. We use a quantum Langevin approach for the average quantities and their fluctuations. For higher order correlations we develop a stochastic path integral approach and find the generating functions of voltage or occupation number fluctuations. We also derive a generating function for the joint distribution of voltage or occupation number at the probe and current fluctuations at a terminal of a conductor. For energy independent scattering we found earlier that the generating function of current cumulants in interferometers with a one-channel dephasing or voltage probe are identical. Nevertheless, the distribution function for voltage and the distribution function for occupation number fluctuations differ, the latter being broader than that of former in all examples considered here.Comment: 23 pages, 10 figures, minor changes, additional appendix, added reference

Sexual Relationship Power and Depression among HIV-Infected Women in Rural Uganda

Background: Depression is associated with increased HIV transmission risk, increased morbidity, and higher risk of HIV-related death among HIV-infected women. Low sexual relationship power also contributes to HIV risk, but there is limited understanding of how it relates to mental health among HIV-infected women. Methods: Participants were 270 HIV-infected women from the Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of individuals initiating antiretroviral therapy (ART) in Mbarara, Uganda. Our primary predictor was baseline sexual relationship power as measured by the Sexual Relationship Power Scale (SRPS). The primary outcome was depression severity, measured with the Hopkins Symptom Checklist (HSCL), and a secondary outcome was a functional scale for mental health status (MHS). Adjusted models controlled for socio-demographic factors, CD4 count, alcohol and tobacco use, baseline WHO stage 4 disease, social support, and duration of ART. Results: The mean HSCL score was 1.34 and 23.7% of participants had HSCL scores consistent with probable depression (HSCL>1.75). Compared to participants with low SRPS scores, individuals with both moderate (coefficient b = −0.21; 95%CI, −0.36 to −0.07) and high power (b = −0.21; 95%CI, −0.36 to −0.06) reported decreased depressive symptomology. High SRPS scores halved the likelihood of women meeting criteria for probable depression (adjusted odds ratio = 0.44; 95%CI, 0.20 to 0.93). In lagged models, low SRPS predicted subsequent depression severity, but depression did not predict subsequent changes in SPRS. Results: were similar for MHS, with lagged models showing SRPS predicts subsequent mental health, but not visa versa. Both Decision-Making Dominance and Relationship Control subscales of SRPS were associated with depression symptom severity. Conclusions: HIV-infected women with high sexual relationship power had lower depression and higher mental health status than women with low power. Interventions to improve equity in decision-making and control within dyadic partnerships are critical to prevent HIV transmission and to optimize mental health of HIV-infected women

Gene Ontology Analysis of Pairwise Genetic Associations in Two Genome-Wide Studies of Sporadic ALS

It is increasingly clear that common human diseases have a complex genetic architecture characterized by both additive and nonadditive genetic effects. The goal of the present study was to determine whether patterns of both additive and nonadditive genetic associations aggregate in specific functional groups as defined by the Gene Ontology (GO)

Quantum Graphs II: Some spectral properties of quantum and combinatorial graphs

The paper deals with some spectral properties of (mostly infinite) quantum and combinatorial graphs. Quantum graphs have been intensively studied lately due to their numerous applications to mesoscopic physics, nanotechnology, optics, and other areas. A Schnol type theorem is proven that allows one to detect that a point belongs to the spectrum when a generalized eigenfunction with an subexponential growth integral estimate is available. A theorem on spectral gap opening for ``decorated'' quantum graphs is established (its analog is known for the combinatorial case). It is also shown that if a periodic combinatorial or quantum graph has a point spectrum, it is generated by compactly supported eigenfunctions (``scars'').Comment: 4 eps figures, LATEX file, 21 pages Revised form: a cut-and-paste blooper fixe