The minimum crystal size needed for a complete diffraction data set

A formula for absolute scattering power is derived to include spot fading arising from radiation damage and the crystal volume needed to collect diffraction data to a given resolution is calculated

What Drives Patient Choice: Preferences for Approaches to Surgical Treatments for Breast Cancer Beyond Traditional Clinical Benchmarks

Importance:. Understanding what drives breast cancer (BC) patient’s surgical decision-making and why, as survival continues to improve, are women continuing to choose mastectomy in increasing numbers. Objective:. We sought to understand better what drives patient choice in surgical decision-making regarding BC treatment options. Design:. We used a dynamic model, adaptive conjoint–based survey experiment, to assess multiple factors concurrently impacting patient choice, conducted from December 2016 to January 2017 using the Army of Women. Setting:. Army of Women, is a U.S.–based nation-wide registry of women, both healthy and previous BC patients. Participants:. An e-mail invitation was sent to the AWOL’s 108,933 members, with 1,233 signing up to participate and 858 responding (548 healthy, 310 previous BC). Two hundred thirty-nine BC patients who underwent treatment > 5 years were excluded due to potential recall bias and changes in BC treatment paradigms. All subjects who did not complete the adaptive conjoint–based survey were also excluded due to inability to calculate preferences. The final sample consisted of 522 healthy women and 71 previous BC patients. Interventions or Exposures:. Study of patient preference and decision drivers, without, interventions or exposures. Main Outcome(s) and Measure(s):. Shares of preferences for various surgical treatment options were calculated using the highest-ranked factors, by the importance that drove patient decision-making. Results:. Survey response rate was 69.5%. Among healthy women, the most important of the 9 factors in making a surgical choice were doctor’s recommendation at 21.4% (SD, 13.6%) and overall survival (OS) at 20.5% (SD, 9.8%) while among previous BC patients, the most important factor was OS at 19% (SD, 9%) and doctor’s recommendation at 17.2% (SD, 10.3%). Conclusion and Relevance:. While OS accounted for the largest single driver of patient choice at ~20 %, it is notable that 80% of patient decision-making was driven by factors unrelated to survival such as cost, intensity and recovery time, and breast image. By understanding what drives choice, we can provide better patient-centric education and treatments

Two Unusual Presentations Of Appendiceal Masses

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The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes

Background:. Studies report that incision management with closed incision negative pressure therapy (ciNPT) may provide clinical benefits, including protecting surgical incisions, for postsurgical closed incisions (eg, orthopedic, sternotomy, and colorectal). This retrospective analysis compared postoperative outcomes in patients who received ciNPT versus standard of care (SOC) for incision management after breast reconstruction postmastectomy. Methods:. Patient demographics, chemotherapy exposure, surgical technique, ciNPT use, number of drains, time to drain removal, and 90-day postoperative complication rates were analyzed from records of 356 patients (ciNPT = 177, SOC = 179) with 665 closed breast incisions (ciNPT = 331, SOC = 334). Results:. Overall complication rate was 8.5% (28/331) in ciNPT group compared with 15.9% (53/334) in SOC group (P = 0.0092). Compared with the SOC group, the ciNPT group had significantly lower infection rates [7/331 (2.1%) versus 15/334 (4.5%), respectively; P = 0.0225], dehiscence rates [8/331 (2.4%) versus 18/334 (5.4%), respectively; P = 0.0178], necrosis rates [17/331 (5.1%) versus 31/334 (9.3%), respectively; P = 0.0070], and seroma rates [6/331 (1.8%) versus 19/334 (5.7%), respectively; P = 0.0106]. The ciNPT group required significantly fewer returns to operating room compared with the SOC group [8/331 (2.4%) versus 18/334 (5.4%), respectively; P = 0.0496]. Time to complete drain removal per breast for ciNPT versus SOC groups was 9.9 versus 13.1 days (P < 0.0001), respectively. Conclusions:. Patients who received ciNPT over closed incisions following postmastectomy breast reconstruction experienced a shorter time to drain removal and significantly lower rates of infection, dehiscence, necrosis, and seromas, compared with the SOC group. Randomized controlled studies are needed to corroborate the findings in our study