Success rates of re-excision after positive margins for invasive lobular carcinoma of the breast.

Rates of positive margins after surgical resection of invasive lobular carcinoma (ILC) are high (ranging from 18 to 60%), yet the efficacy of re-excision lumpReceptor subtypeectomy for clearing positive margins is unknown. Concerns about the diffuse nature of ILC may drive increased rates of completion mastectomy to treat positive margins, thus lowering breast conservation rates. We therefore determined the success rate of re-excision lumpectomy in women with ILC and positive margins after surgical resection. We identified 314 cases of stage I-III ILC treated with breast conserving surgery (BCS) at the University of California, San Francisco. Surgical procedures, pathology reports, and outcomes were analyzed using univariate and multivariate statistics and Cox-proportional hazards models. We evaluated outcomes before and after the year 2014, when new margin management consensus guidelines were published. Positive initial margins occurred in 118 (37.6%) cases. Of these, 62 (52.5%) underwent re-excision lumpectomy, which cleared the margin in 74.2%. On multivariate analysis, node negativity was significantly associated with successful re-excision (odds ratio [OR] 3.99, 95% CI 1.15-13.81, p = 0.029). After 2014, we saw fewer initial positive margins (42.7% versus 25.5%, p = 0.009), second surgeries (54.6% versus 20.2%, p < 0.001), and completion mastectomies (27.7% versus 4.5%, p < 0.001). In this large cohort of women with ILC, re-excision lumpectomy was highly successful at clearing positive margins. Additionally, positive margins and completion mastectomy rates significantly decreased over time. These findings highlight improvements in management of ILC, and suggest that completion mastectomy may not be required for those with positive margins after initial BCS

Calidad de la administración del aprendizaje en la modalidad presencial del nivel superior en la UAEM, con el apoyo de un LMS

Una de las perspectivas para balancear los indicadores en pro de la medición de la calidad en un Balanced Scorecard según Robert Kaplan y David Norton es la perspectiva clientes que trasladándolo a los términos del ámbito educativo es el usuario estudiante. En este sentido, un indicador relacionado es la satisfacción del estudiante con respecto a su evaluación del aprendizaje. Tiene que ver con la necesidad de disponer en cualquier momento y lugar con información tal como programación, contenido de actividades de aprendizaje y criterios de evaluación a realizar así como su retroalimentación personalizada. Además de disponer de las evidencias entregadas por el estudiante y calificaciones para tener claridad durante todo el proceso de enseñanza-aprendizaje e ir conformando la evaluación sin tener lugar a duda sobre las entregas y evaluación. En este trabajo de corte cualitativo refleja la perspectiva del estudiante que hace uso de un Sistema administrador del aprendizaje (LMS) como una herramienta de apoyo a la modalidad presencial en el nivel superior. Tal análisis se basa en las respuestas de los estudiantes al aplicarles una encuesta que previamente se revisó su confiabilidad, validez y objetividad

Analysis of UV technologies for disinfection of public areas: A systematic literature review

ABSTRACT At present we live a health problem because of the Covid-19, therefore the study carried out is a systematic review of the different technological UV alternatives that have been developed to reduce the spread of Covid-19 and other pathogens harmful to health, since it has been proven that the UV-C range which is considered to have a very powerful radiation. In the present investigation 34 scientific articles were synthesized, taken from databases such as: Scopus/Elsevier, ScienceDirect, IEEE Xplore, Researchgate. Of these, 39% are oriented towards the health area and 21 % are used in the disinfection of public areas. In conclusion, the rates of use of this germicide and how to sterilize by means of ultraviolet radiation were announced

High-Pressure Properties of Several Narrow Bandgap Semiconductors from First-Principles Calculations

The electronic, thermodynamic, and structural properties of three semiconducting materials, ZnO, InN, and PbS, at high pressure are investigated utilizing first-principles calculations based on density function theory. The first two systems, ZnO and InN, crystalize as hexagonal structures at ambient conditions and transition to a cubic structure at higher pressures. The last system, PbS, is cubic at ambient conditions, but transitions to an orthorhombic structure at higher pressure. At ambient conditions, these materials are well known semiconductors with vast amount of research and a variety of wide ranging applications in electrical devices. However, there is a lack of understanding of their physical properties at high pressures. In this thesis, an attempt is made to establish an understanding of the fundamental properties of the high-pressure phase of these materials. DFT and Boltzmann transport theory are used to find how pressure- induced phase transitions affect the electronic and heat transport of these materials. From harmonic approximations, a frozen phonon method is used to calculate the phonon frequencies and thermodynamic properties

A new method for the determination of plutonium and americium using high pressure microwave digestion and alpha-spectrometry or ICP-SMS

Plutonium and americium are radionuclides particularly difficult to measure in environmental samples because they are α-emitters and therefore necessitate a careful separation before any measurement, either using radiometric methods or ICP-SMS. Recent developments in extraction chromatography resins such as Eichrom® TRU and TEVA have resolved many of the analytical problems but drawbacks such as low recovery and spectral interferences still occasionally occur. Here, we report on the use of the new Eichrom® DGA resin in association with TEVA resin and high pressure microwave acid leaching for the sequential determination of plutonium and americium in environmental samples. The method results in average recoveries of 83±15% for plutonium and 73±22% for americium (n=60), and a less than 10% deviation from reference values of four IAEA reference materials and three samples from intercomparisons exercises. The method is also suitable for measuring 239Pu in water samples at the μBq/l level, if ICP-SMS is used for the measuremen

“A Voice In Your Ear” Podcast – The Second Year

In July of 2016, the University of Texas Rio Grande Valley (UTRGV) School of Medicine matriculated their first cohort (Class of 2020). In an attempt to organize the advice that the Class of 2020 planned to provide future classes, a podcast was developed by several medical students from the Class of 2020 in cooperation with faculty and administration

Sistema web para el proceso de denuncias policiales en la comisaria de Monserrat

El presente trabajo de investigación tiene como titulo: “Sistema web para el proceso de denuncias policiales en la comisaria de monserrat” tiene como objetivo importante garantizar la influencia de un sistema web en el proceso de denuncias, en el desarrollo de la presente investigación se fue demostrando la mejora de los ´procesos en busca a la impelmenstacion de un Sistema Web. El modelado de dicha investigación se ejecutó utilizando la metodología RUP por ser una de las metodologías completa y detallada, además porque la comisaria lo requería, lo cual es esencial para poder concebir con exactitud los métodos internos. El software se desarrolló en PHP, con los lenguajes de diseño y maquetación HTML, CSS y las validaciones con Java Script. Como base de datos se utilizó phpMyAdmin. . Los indicadores a medir en la presente investigación fueron, tasa de denuncias cerradas y porcentaje de denuncias improcedentes.El tipo de investigación fue aplicada-experimental, con un diseño Pre-experimental.Para la compilación de los requerimientos se utilizó las cédulas de registro, instrumentos policiales y el apoyo del personal de la Policía Nacional del Per

Calidad de servicio bancario al cliente en la agencia Vista Alegre del Banco de Crédito del Perú, Lima-2018.

La investigación titulada. “Calidad de servicio bancario al cliente en la Agencia Vista Alegre del Banco del Crédito del Perú. Lima-2018”, tuvo como objetivo general: Describir la calidad de servicio bancario al cliente en la Agencia Vista Alegre del Banco del Crédito del Perú. La hipótesis general fue: La calidad de servicio bancario al cliente es eficaz en la Agencia Vista Alegre del banco del crédito del Perú. La investigación fue de tipo básica, nivel de investigación descriptivo, diseño de investigación descriptivo simple. Los métodos empleados fueron: el método descriptivo y estadístico. La variable principal tuvo 9 dimensiones: Información y transparencia, Trato y amabilidad, Flexibilidad y comprensión, Profesionalidad, Rapidez y diligencia, Eficacia y Mecanización, Oficinas instalaciones, Productos y servicios, Imagen La muestra de estudio estuvo conformada por 173 clientes, la técnica usada fue el cuestionario y el instrumento encuesta, con 40 ítems, el tipo para determinar el tamaño de muestra fue el muestreo probabilístico y la técnica estratificada. Luego del trabajo de campo y procesamiento de los mismos, se llegó a la siguiente conclusión, las dos categorías observadas fueron mala y buena, al sumar los porcentajes de mala (muy mala, mala) fue de 47,4% y la buena conformada por (moderada, buena y muy buena) fue de 52,6%. Las diferencias porcentuales permiten deducir que el cliente al opinar mayoritariamente como buena, da el valor de satisfacción respecto a la calidad de servicio que brinda el colaborador.Tesi

ON THE CONTRIBUTION OF SELF-MEDIATED ORGANIZATION OF KERATIN INTERMEDIATE FILAMENTS TO THEIR BIOLOGICAL FUNCTION IN VIVO

The crucial role of structural support fulfilled by keratin intermediate filaments (IFs) in surface epithelia likely requires that they be organized into crosslinked networks. For IFs comprised of keratins 5 and 14, found in basal epidermal keratinocytes, formation of crosslinked bundles is, in part, self-driven through cis-acting determinants. Here, we targeted the expression of a bundling-competent KRT5/KRT8 chimeric cDNA (KRT8bc), or bundling-deficient wildtype KRT8 as a control, to the epidermal basal layer of Krt5 null mice to assess the functional importance of keratin IF self-organization in vivo. We report that targeted expression of K8bc rescued Krt5 null mice with ~47% frequency, while K8 failed to rescue. This outcome correlated with lower than expected levels of K8bc and especially K8 mRNA and protein in the epidermis of E18.5 replacement embryos. Electron microscopy of E18.5 embryonic skin revealed that the defects observed in filament bundling, cytoarchitecture, and mitochondria are partially restored by KRT8bc expression. As young adults, viable KRT8bc replacement mice develop alopecia and chronic skin lesions, indicating that the skin epithelia are not completely normal. These findings are consistent with a contribution of self-mediated organization of keratin IFs to structural support and cytoarchitecture in basal layer keratinocytes of the epidermis, and underscore the importance of context-dependent regulation for keratins in vivo. Structural support is not the only function fulfilled by K5 in skin. A recent genome-wide association study has identified novel single nucleotide polymorphisms (SNPs) altering the K5 coding sequence and conferring an increased susceptibility to basal cell carcinoma (BCC). We conducted an initial assessment of the properties of the K5 variants G138E and D197E in cultured HeLa cells. We found that these two keratin variants readily integrate into endogenous filament networks of HeLa cells, and do not exhibit any egregious assembly properties. We also show that these mutants do not alter the expression of early effectors in Sonic hedgehog (Shh) or Wnt signaling pathways. Relative to wildtype, expression of these KRT5 variants alter the RNA expression of two inflammatory cytokines, CCL2 and CXCL5. These findings point to a possible mechanism by which KRT5 SNPs may increase BCC susceptibility

Multiplexed direct genomic selection (MDiGS): a pooled BAC capture approach for highly accurate CNV and SNP/INDEL detection

Despite declining sequencing costs, few methods are available for cost-effective single-nucleotide polymorphism (SNP), insertion/deletion (INDEL) and copy number variation (CNV) discovery in a single assay. Commercially available methods require a high investment to a specific region and are only cost-effective for large samples. Here, we introduce a novel, flexible approach for multiplexed targeted sequencing and CNV analysis of large genomic regions called multiplexed direct genomic selection (MDiGS). MDiGS combines biotinylated bacterial artificial chromosome (BAC) capture and multiplexed pooled capture for SNP/INDEL and CNV detection of 96 multiplexed samples on a single MiSeq run. MDiGS is advantageous over other methods for CNV detection because pooled sample capture and hybridization to large contiguous BAC baits reduces sample and probe hybridization variability inherent in other methods. We performed MDiGS capture for three chromosomal regions consisting of ∼550 kb of coding and non-coding sequence with DNA from 253 patients with congenital lower limb disorders. PITX1 nonsense and HOXC11 S191F missense mutations were identified that segregate in clubfoot families. Using a novel pooled-capture reference strategy, we identified recurrent chromosome chr17q23.1q23.2 duplications and small HOXC 5′ cluster deletions (51 kb and 12 kb). Given the current interest in coding and non-coding variants in human disease, MDiGS fulfills a niche for comprehensive and low-cost evaluation of CNVs, coding, and non-coding variants across candidate regions of interest