321 research outputs found

    On compact solution vectors in Kronecker-based Markovian analysis

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    State based analysis of stochastic models for performance and dependability often requires the computation of the stationary distribution of a multidimensional continuous-time Markov chain (CTMC). The infinitesimal generator underlying a multidimensional CTMC with a large reachable state space can be represented compactly in the form of a block matrix in which each nonzero block is expressed as a sum of Kronecker products of smaller matrices. However, solution vectors used in the analysis of such Kronecker-based Markovian representations require memory proportional to the size of the reachable state space. This implies that memory allocated to solution vectors becomes a bottleneck as the size of the reachable state space increases. Here, it is shown that the hierarchical Tucker decomposition (HTD) can be used with adaptive truncation strategies to store the solution vectors during Kronecker-based Markovian analysis compactly and still carry out the basic operations including vector–matrix multiplication in Kronecker form within Power, Jacobi, and Generalized Minimal Residual methods. Numerical experiments on multidimensional problems of varying sizes indicate that larger memory savings are obtained with the HTD approach as the number of dimensions increases. © 2017 Elsevier B.V

    Compact representation of solution vectors in Kronecker-based Markovian analysis

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    It is well known that the infinitesimal generator underlying a multi-dimensional Markov chain with a relatively large reachable state space can be represented compactly on a computer in the form of a block matrix in which each nonzero block is expressed as a sum of Kronecker products of smaller matrices. Nevertheless, solution vectors used in the analysis of such Kronecker-based Markovian representations still require memory proportional to the size of the reachable state space, and this becomes a bigger problem as the number of dimensions increases. The current paper shows that it is possible to use the hierarchical Tucker decomposition (HTD) to store the solution vectors during Kroneckerbased Markovian analysis relatively compactly and still carry out the basic operation of vector-matrix multiplication in Kronecker form relatively efficiently. Numerical experiments on two different problems of varying sizes indicate that larger memory savings are obtained with the HTD approach as the number of dimensions increases. © Springer International Publishing Switzerland 2016

    The locus of legitimate interpretation in Big Data sciences : Lessons for computational social science from -omic biology and high-energy physics

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    This paper argues that analyses of the ways in which Big Data has been enacted in other academic disciplines can provide us with concepts that will help understand the application of Big Data to social questions. We use examples drawn from our Science and Technology Studies (STS) analyses of -omic biology and high energy physics to demonstrate the utility of three theoretical concepts: (i) primary and secondary inscriptions, (ii) crafted and found data, and (iii) the locus of legitimate interpretation. These help us to show how the histories, organisational forms, and power dynamics of a field lead to different enactments of big data. The paper suggests that these concepts can be used to help us to understand the ways in which Big Data is being enacted in the domain of the social sciences, and to outline in general terms the ways in which this enactment might be different to that which we have observed in the ‘hard’ sciences. We contend that the locus of legitimate interpretation of Big Data biology and physics is tightly delineated, found within the disciplinary institutions and cultures of these disciplines. We suggest that when using Big Data to make knowledge claims about ‘the social’ the locus of legitimate interpretation is more diffuse, with knowledge claims that are treated as being credible made from other disciplines, or even by those outside academia entirely

    Breast tumor characteristics of BRCA1 and BRCA2 gene mutation carriers on MRI

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    The appearance of malignant lesions in BRCA1 and BRCA2 mutation carriers (BRCA-MCs) on mammography and magnetic resonance imaging (MRI) was evaluated. Thus, 29 BRCA-MCs with breast cancer were retrospectively evaluated and the results compared with an age, tumor size and tumor type matched control group of 29 sporadic breast cancer cases. Detection rates on both modalities were evaluated. Tumors were analyzed on morphology, density (mammography), enhancement pattern and kinetics (MRI). Overall detection was significantly better with MRI than with mammography (55/58 vs 44/57, P = 0.021). On mammography, lesions in the BRCA-MC group were significantly more described as rounded (12//19 vs 3/13, P = 0.036) and with sharp margins (9/19 vs 1/13, P = 0.024). On MRI lesions in the BRCA-MC group were significantly more described as rounded (16/27 vs 7/28, P = 0.010), with sharp margins (20/27 vs 7/28, P < 0.001) and with rim enhancement (7/27 vs 1/28, P = 0.025). No significant difference was found for enhancement kinetics (P = 0.667). Malignant lesions in BRCA-MC frequently have morphological characteristics commonly seen in benign lesions, like a rounded shape or sharp margins. This applies for both mammography and MRI. However the possibility of MRI to evaluate the enhancement pattern and kinetics enables the detection of characteristics suggestive for a malignancy

    Sensitivity to systemic therapy for metastatic breast cancer in CHEK2 1100delC mutation carriers

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    Purpose: The role of CHEK2 in DNA repair by homologous recombination suggests that CHEK2-associated breast cancer (BC) patients might be more sensitive to chemotherapy inducing double-strand DNA breaks, but results hereon are lacking. We compared the sensitivity to first-line chemotherapy and endocrine therapy between CHEK2 1100delC and non-CHEK2 metastatic breast cancer (MBC) patients. Methods: Sixty-two CHEK2 1100delC MBC patients were selected from three cohorts genotyped for CHEK2 1100delC (one non-BRCA1/2 cohort and two sporadic cohorts). Controls were 62 non-CHEK2 MBC patients, matched for age at and year of primary BC diagnosis, and year of metastatic disease. Objective response rate (complete and partial response) to, and progression-free survival (PFS) and overall survival (OS) after start of first-line chemotherapy and endocrine therapy were compared between CHEK2 and non-CHEK2 patients. Results: Median age at BC diagnosis was 46 and 51 years at MBC diagnosis. First-line chemotherapy consisted of anthracycline-based chemotherapy (n = 73), taxanes (n = 16), CMF(-like) chemotherapy (n = 33) and taxane/anthracycline regimens (n = 2). CHEK2 and non-CHEK2 patients had a comparable objective response rate (44 vs. 52 %). Also, PFS and OS after start of chemotherapy were comparable between both patient groups (hazard ratio 0.91; 95 % confidence interval 0.63–1.30 and 1.03; 95 % CI 0.71–1.49, respectively). Thirty-six CHEK2 and 32 non-CHEK2 patients received first-line endocrine therapy (mainly tamoxifen) for MBC. No significant differences were observed in objective response rate to, and PFS and OS after start of endocrine therapy. Conclusion: No differ

    FGF receptor genes and breast cancer susceptibility: results from the Breast Cancer Association Consortium

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    Background:Breast cancer is one of the most common malignancies in women. Genome-wide association studies have identified FGFR2 as a breast cancer susceptibility gene. Common variation in other fibroblast growth factor (FGF) receptors might also modify risk. We tested this hypothesis by studying genotyped single-nucleotide polymorphisms (SNPs) and imputed SNPs in FGFR1, FGFR3, FGFR4 and FGFRL1 in the Breast Cancer Association Consortium. Methods:Data were combined from 49 studies, including 53 835 cases and 50 156 controls, of which 89 050 (46 450 cases and 42 600 controls) were of European ancestry, 12 893 (6269 cases and 6624 controls) of Asian and 2048 (1116 cases and 932 controls) of African ancestry. Associations with risk of breast cancer, overall and by disease sub-type, were assessed using unconditional logistic regression. Results:Little evidence of association with breast cancer risk was observed for SNPs in the FGF receptor genes. The strongest evidence in European women was for rs743682 in FGFR3; the estimated per-allele odds ratio was 1.05 (95 confidence interval=1.02-1.09, P=0.0020), which is substantially lower than that observed for SNPs in FGFR2. Conclusion:Our results suggest that common variants in the other FGF receptors are not associated with risk of breast cancer to the degree observed for FGFR2. © 2014 Cancer Research UK

    Options for early breast cancer follow-up in primary and secondary care : a systematic review

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    Background Both incidence of breast cancer and survival have increased in recent years and there is a need to review follow up strategies. This study aims to assess the evidence for benefits of follow-up in different settings for women who have had treatment for early breast cancer. Method A systematic review to identify key criteria for follow up and then address research questions. Key criteria were: 1) Risk of second breast cancer over time - incidence compared to general population. 2) Incidence and method of detection of local recurrence and second ipsi and contra-lateral breast cancer. 3) Level 1–4 evidence of the benefits of hospital or alternative setting follow-up for survival and well-being. Data sources to identify criteria were MEDLINE, EMBASE, AMED, CINAHL, PSYCHINFO, ZETOC, Health Management Information Consortium, Science Direct. For the systematic review to address research questions searches were performed using MEDLINE (2011). Studies included were population studies using cancer registry data for incidence of new cancers, cohort studies with long term follow up for recurrence and detection of new primaries and RCTs not restricted to special populations for trials of alternative follow up and lifestyle interventions. Results Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival. Conclusions Long term support, surveillance mammography and fast access to medical treatment at point of need may be better than hospital based surveillance limited to five years but further large, randomised controlled trials are needed

    Cost-effectiveness of MRI compared to mammography for breast cancer screening in a high risk population

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    <p>Abstract</p> <p>Background</p> <p>Breast magnetic resonance imaging (MRI) is a sensitive method of breast imaging virtually uninfluenced by breast density. Because of the improved sensitivity, breast MRI is increasingly being used for detection of breast cancer among high risk young women. However, the specificity of breast MRI is variable and costs are high. The purpose of this study was to determine if breast MRI is a cost-effective approach for the detection of breast cancer among young women at high risk.</p> <p>Methods</p> <p>A Markov model was created to compare annual breast cancer screening over 25 years with either breast MRI or mammography among young women at high risk. Data from published studies provided probabilities for the model including sensitivity and specificity of each screening strategy. Costs were based on Medicare reimbursement rates for hospital and physician services while medication costs were obtained from the Federal Supply Scale. Utilities from the literature were applied to each health outcome in the model including a disutility for the temporary health state following breast biopsy for a false positive test result. All costs and benefits were discounted at 5% per year. The analysis was performed from the payer perspective with results reported in 2006 U.S. dollars. Univariate and probabilistic sensitivity analyses addressed uncertainty in all model parameters.</p> <p>Results</p> <p>Breast MRI provided 14.1 discounted quality-adjusted life-years (QALYs) at a discounted cost of 18,167whilemammographyprovided14.0QALYsatacostof18,167 while mammography provided 14.0 QALYs at a cost of 4,760 over 25 years of screening. The incremental cost-effectiveness ratio of breast MRI compared to mammography was 179,599/QALY.Inunivariateanalysis,breastMRIscreeningbecame<179,599/QALY. In univariate analysis, breast MRI screening became < 50,000/QALY when the cost of the MRI was < 315.Intheprobabilisticsensitivityanalysis,MRIscreeningproducedanethealthbenefitof0.202QALYs(95315. In the probabilistic sensitivity analysis, MRI screening produced a net health benefit of -0.202 QALYs (95% central range: -0.767 QALYs to +0.439 QALYs) compared to mammography at a willingness-to-pay threshold of 50,000/QALY. Breast MRI screening was superior in 0%, < 50,000/QALYin2250,000/QALY in 22%, > 50,000/QALY in 34%, and inferior in 44% of trials.</p> <p>Conclusion</p> <p>Although breast MRI may provide health benefits when compared to mammographic screening for some high risk women, it does not appear to be cost-effective even at willingness to pay thresholds above $120,000/QALY.</p

    Impact of screening for breast cancer in high-risk women on health-related quality of life

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    The effectiveness of intensive surveillance in women at high risk for breast cancer due to a familial or genetic predisposition is uncertain and is currently being evaluated in a Dutch magnetic resonance imaging (MRI) screening (MRISC) study, in which annual imaging consists of mammography and MRI. Unfavourable side effects on health-related quality of life may arise from this screening process. We examined the short-term effects of screening for breast cancer in high-risk women on generic health-related quality of life and distress. A total of 519 participants in the MRISC study were asked to complete generic health-status questionnaires (SF-36, EQ-5D) as well as additional questionnaires for distress and items relating to breast cancer screening, at three different time points around screening. The study population showed significantly better generic health-related quality of life scores compared to age-/sex-adjusted reference scores from the general population. Neither generic health-related quality of life scores nor distress scores among the study sample (n = 334) showed significant changes over time. The impact of the screening process on generic health status did not differ between risk categories. Relatively more women reported mammography as quite to very painful (30.1%) compared to MRI. Anxiety was experienced by 37% of the women undergoing MRI. We conclude that screening for breast cancer in high-risk women does not have an unfavourable impact on short-term generic health-related quality of life and general distress. In this study, high-risk women who opted for regular breast cancer screening had a better health status than women from the general population
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