Pretreatment prognostic value of dynamic contrast-enhanced magnetic resonance imaging vascular, texture, shape, and size parameters compared with traditional survival indicators obtained from locally advanced breast cancer patients

Objectives: The aim of this study was to determine if associations exist between pretreatment dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI)-based metrics (vascular kinetics, texture, shape, size) and survival intervals. Furthermore, the aim of this study was to compare the prognostic value of DCE-MRI parameters against traditional pretreatment survival indicators. Materials and Methods: A retrospective study was undertaken. Approval had previously been granted for the retrospective use of such data, and the need for informed consent was waived. Prognostic value of pretreatment DCE-MRI parameters and clinical data was assessed via Cox proportional hazards models. The variables retained by the final overall survival Cox proportional hazards model were utilized to stratify risk of death within 5 years. Results: One hundred twelve subjects were entered into the analysis. Regarding disease-free survival-negative estrogen receptor status, T3 or higher clinical tumor stage, large ( > 9.8 cm 3 ) MR tumor volume, higher 95th percentile ( > 79%) percentage enhancement, and reduced ( > 0.22) circularity represented the retained model variables. Similar results were noted for the overall survival with negative estrogen receptor status, T3 or higher clinical tumor stage, and large ( > 9.8 cm 3 ) MR tumor volume, again all been retained by the model in addition to higher ( > 0.71) 25th percentile area under the enhancement curve. Accuracy of risk stratification based on either traditional (59%) or DCEMRI (65%) survival indicators performed to a similar level. However, combined traditional and MR risk stratification resulted in the highest accuracy (86%). Conclusions: Multivariate survival analysis has revealed thatmodel-retained DCEMRI variables provide independent prognostic information complementing traditional survival indicators and as such could help to appropriately stratify treatment

Pion double charge exchange on 4He

The doubly differential cross sections for the $^4$He$(\pi^+,\pi^-) 4p$ reaction were calculated using both a two-nucleon sequential single charge exchange model and an intranuclear cascade code. Final state interactions between the two final protons which were the initial neutrons were included in both methods. At incident pion energies of 240 and 270 MeV the low-energy peak observed experimentally in the energy spectrum of the final pions can be understood only if the contribution of pion production is included. The calculated cross sections are compared with data.Comment: 25 pages, 9 figure

A study of liquid propellant autoignition

Data and theory pertinent to the autoignition of liquid oxygen/liquid hydrogen and liquid oxygen propellants were reviewed. Physical models of the processes supporting or contributing to autoignition were developed. Emphasis was placed on the description of the physical environment and its relationship to the autoignition phenomenon

Pigment analysis by Raman microscopy and portable X-ray fluorescence (pXRF) of thirteenth to fourteenth century illuminations and cuttings from Bologna

Non-destructive pigment analysis by Raman microscopy (RM) and portable X-ray fluorescence (pXRF) has been carried out on some Bolognese illuminations and cuttings chosen to represent the beginnings, evolution and height of Bolognese illuminated manuscript production. Dating to the thirteenth and fourteenth centuries and held in a private collection, the study provides evidence for the pigments generally used in this period. The results, which are compared with those obtained for other north Italian artwork, show the developments in usage of artistic materials and technique. Also addressed in this study is an examination of the respective roles of RM and pXRF analysis in this area of technical art history

WHICH RETAIL FOOD SERVICES ARE CONSUMERS WILLING TO DO WITHOUT

Consumer/Household Economics,

Estimation of Kalman filter model parameters from an ensemble of tests

A methodology for estimating initial mean and covariance parameters in a Kalman filter model from an ensemble of nonidentical tests is presented. In addition, the problem of estimating time constants and process noise levels is addressed. Practical problems such as developing and validating inertial instrument error models from laboratory test data or developing error models of individual phases of a test are generally considered

Cost-Benefit Analysis of a Pediatric Patient Blood Management Program

Introduction Red blood cell (RBC) transfusions can be a life-saving and important intervention used to replace blood loss or manage anemia, but they also come with risks from transfusion-associated adverse events (TAAEs). Patient blood management (PBM) involves a multidisciplinary approach to optimize care of patients who may need a transfusion, including blood conservation modalities, patient-centered decision making, among others. The impact of PBM in the pediatric setting is not well understood, particularly the impact on TAAEs and the economic impact of these programs. The following specific aims were pursued: (1) To investigate the effect of a PBM program on transfusion utilization and the incidence of TAAEs, and (2) to compare the costs related to supporting a health-system level PBM program to the costs of transfusion utilization. Methods This study used a retrospective cohort design to evaluate the impact of a PBM program on patient outcomes in a pediatric hospital system. Clinical and demographic information from pediatric patients between the ages of four months and eighteen years who had an inpatient hospitalization were compared for the year prior to the program (2015) and the year post-implementation (2019). Transfusion utilization was compared before and after the program using generalized estimating equation. A cost-benefit analysis examined program costs and compared them to program outputs. Results This study examined a total of 35,245 hospitalizations and over 3,800 transfusions in the pre- and post-intervention years. The post-intervention year had lower pre-transfusion hemoglobin values and smaller volumes of RBC transfusions ordered, and this was statistically significant (p\u3c0.01). While this study did not see a statistically significant difference in the incidence of TAAEs, fewer hospitalizations had RBC transfusions ordered in 2019 when compared to 2015. When examining transfusion utilization while adjusting for potential confounders, group year was not statistically significant (p = 0.11). Overall, activity-based transfusion costs based on projections were higher in the post-intervention year. Conclusion This study explored the impact of a PBM program on pediatric hospitalized patients at a large tertiary academic medical center. The results suggest that this work was effective in reducing the mean hemoglobin pre-transfusion for RBC transfusion and reduced the mean volume of transfusion when adjusted for severity of illness and length of stay. The results of the cost-benefit analysis suggest that this investment in safety did not correspond with decreased utilization costs, but there were limitations in the analysis. More research is needed to understand the impact of reductions in transfusion-associated adverse events and their true cost

An Overview of Natural Gas Supply and Availability

Natural gas presently supplies almost one-third of the total U.S. energy supply--and like oil, has had its proven reserves reduced by ever-increasing production. The potential gas reserves of the United States are sufficient to maintain our present demand for a considerable period of time, if these reserves can be found. The exploration necessary has to be financed by increased gas cost. Additional technology will be necessary to increase the amounts of gas that can be produced from our present and future supplies. Several methods of obtaining the capital necessary to perform the additional drilling and areas of technical improvement are discussed

The photon blockade effect in optomechanical systems

We analyze the photon statistics of a weakly driven optomechanical system and discuss the effect of photon blockade under single photon strong coupling conditions. We present an intuitive interpretation of this effect in terms of displaced oscillator states and derive analytic expressions for the cavity excitation spectrum and the two photon correlation function $g^{(2)}(0)$. Our results predict the appearance of non-classical photon correlations in the combined strong coupling and sideband resolved regime, and provide a first detailed understanding of photon-photon interactions in strong coupling optomechanics