Background
Oncoplastic techniques applied to breast-conserving surgery (BCS) allow large-volume resections without compromising cosmetic results. Level II oncoplastic techniques are based on ...mammoplasties. When required, they allow resection of more than 20 % of the breast volume; however, a subgroup of these patients will still have positive margins. The clinical management of positive margins after level II oncoplastic surgery (OPS) is a challenge.
Methods
All patients who had undergone level II oncoplastic techniques at The Paris Breast Center between 2004 and 2013 were reviewed. The choice of the optimal mammoplasty technique was based on the tumor location and the ‘quadrant per quadrant atlas’.
Results
A total of 277 level II oncoplastic techniques were performed on 272 patients. The mean tumor size was 26 mm (range 2–160 mm), with a mean resected weight of 175 g (range 50–1540 g). The rate of positive margins was 11.9 %. Risk factors for positive margins identified in univariate analysis were histologic subgroup, tumor size, T stage and grade. In multivariate analysis, only patients with invasive lobular carcinoma had a significantly higher risk of positive margins. A second operation was required in 33 cases, and a third operation was required in three cases because of positive margins. Final breast conservation rate was 91 %.
Conclusions
Level II OPS results in a low positive margin rate despite large tumor size. Patients with involved margins can be offered a second BCS if the remaining volume allows this.
THE MATERHORN Fernando, H. J. S.; Pardyjak, E. R.; Di Sabatino, S. ...
Bulletin of the American Meteorological Society,
11/2015, Letnik:
96, Številka:
11
Journal Article
Recenzirano
Odprti dostop
Emerging application areas such as air pollution in megacities, wind energy, urban security, and operation of unmanned aerial vehicles have intensified scientific and societal interest in mountain ...meteorology. To address scientific needs and help improve the prediction of mountain weather, the U.S. Department of Defense has funded a research effort—the Mountain Terrain Atmospheric Modeling and Observations (MATERHORN) Program—that draws the expertise of a multidisciplinary, multiinstitutional, and multinational group of researchers. The program has four principal thrusts, encompassing modeling, experimental, technology, and parameterization components, directed at diagnosing model deficiencies and critical knowledge gaps, conducting experimental studies, and developing tools for model improvements. The access to the Granite Mountain Atmospheric Sciences Testbed of the U.S. Army Dugway Proving Ground, as well as to a suite of conventional and novel high-end airborne and surface measurement platforms, has provided an unprecedented opportunity to investigate phenomena of time scales from a few seconds to a few days, covering spatial extents of tens of kilometers down to millimeters. This article provides an overview of the MATERHORN and a glimpse at its initial findings. Orographic forcing creates a multitude of time-dependent submesoscale phenomena that contribute to the variability of mountain weather at mesoscale. The nexus of predictions by mesoscale model ensembles and observations are described, identifying opportunities for further improvements in mountain weather forecasting.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The impact of emissions of volatile organic compounds (VOCs) to the
atmosphere on the production of secondary pollutants, such as ozone and
secondary organic aerosol (SOA), is mediated by the ...concentration of nitric
oxide (NO). Polluted urban atmospheres are typically considered to be
“high-NO” environments, while remote regions such as rainforests, with
minimal anthropogenic influences, are considered to be “low NO”. However,
our observations from central Beijing show that this simplistic separation
of regimes is flawed. Despite being in one of the largest megacities in the
world, we observe formation of gas- and aerosol-phase oxidation products
usually associated with low-NO “rainforest-like” atmospheric oxidation
pathways during the afternoon, caused by extreme suppression of NO
concentrations at this time. Box model calculations suggest that during
the morning high-NO chemistry predominates (95 %) but in the afternoon
low-NO chemistry plays a greater role (30 %). Current emissions
inventories are applied in the GEOS-Chem model which shows that such models,
when run at the regional scale, fail to accurately predict such an extreme
diurnal cycle in the NO concentration. With increasing global emphasis on
reducing air pollution, it is crucial for the modelling tools used to
develop urban air quality policy to be able to accurately represent such
extreme diurnal variations in NO to accurately predict the formation of
pollutants such as SOA and ozone.
We use Hubble Space Telescope/Advanced Camera for Surveys images and a photometric catalog of the Cosmic Evolution Survey (COSMOS) field to analyze morphologies of the host galaxies of ~400 active ...galactic nucleus (AGN) candidates at redshifts 0.3 < z < 1.0. We compare the AGN hosts with a sample of nonactive galaxies drawn from the COSMOS field to match the magnitude and redshift distribution of the AGN hosts. We perform two-dimensional surface brightness modeling with GALFIT to yield host galaxy and nuclear point source magnitudes. X-ray-selected AGN host galaxy morphologies span a substantial range that peaks between those of early-type, bulge-dominated and late-type, disk-dominated systems. We also measure the asymmetry and concentration of the host galaxies. Unaccounted for, the nuclear point source can significantly bias results of these measured structural parameters, so we subtract the best-fit point source component to obtain images of the underlying host galaxies. Our concentration measurements reinforce the findings of our two-dimensional morphology fits, placing X-ray AGN hosts between early- and late-type inactive galaxies. AGN host asymmetry distributions are consistent with those of control galaxies. Combined with a lack of excess companion galaxies around AGN, the asymmetry distributions indicate that strong interactions are no more prevalent among AGN than normal galaxies. In light of recent work, these results suggest that the host galaxies of AGN at these X-ray luminosities may be in a transition from disk-dominated to bulge-dominated, but that this transition is not typically triggered by major mergers.
The BUFFALO HST Survey Steinhardt, Charles L.; Jauzac, Mathilde; Acebron, Ana ...
The Astrophysical journal. Supplement series,
04/2020, Letnik:
247, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The Beyond Ultra-deep Frontier Fields and Legacy Observations (BUFFALO) is a 101 orbit + 101 parallel Cycle 25 Hubble Space Telescope (HST) Treasury program taking data from 2018 to 2020. BUFFALO ...will expand existing coverage of the Hubble Frontier Fields (HFF) in Wide Field Camera 3/IR F105W, F125W, and F160W and Advanced Camera for Surveys/WFC F606W and F814W around each of the six HFF clusters and flanking fields. This additional area has not been observed by HST but is already covered by deep multiwavelength data sets, including Spitzer and Chandra. As with the original HFF program, BUFFALO is designed to take advantage of gravitational lensing from massive clusters to simultaneously find high-redshift galaxies that would otherwise lie below HST detection limits and model foreground clusters to study the properties of dark matter and galaxy assembly. The expanded area will provide the first opportunity to study both cosmic variance at high redshift and galaxy assembly in the outskirts of the large HFF clusters. Five additional orbits are reserved for transient follow-up. BUFFALO data including mosaics, value-added catalogs, and cluster mass distribution models will be released via MAST on a regular basis as the observations and analysis are completed for the six individual clusters.
Disease-modifying treatments are currently being trialled in multiple system atrophy. Approaches based solely on clinical measures are challenged by heterogeneity of phenotype and pathogenic ...complexity. Neurofilament light chain protein has been explored as a reliable biomarker in several neurodegenerative disorders but data on multiple system atrophy have been limited. Therefore, neurofilament light chain is not yet routinely used as an outcome measure in multiple system atrophy. We aimed to comprehensively investigate the role and dynamics of neurofilament light chain in multiple system atrophy combined with cross-sectional and longitudinal clinical and imaging scales and for subject trial selection. In this cohort study, we recruited cross-sectional and longitudinal cases in a multicentre European set-up. Plasma and CSF neurofilament light chain concentrations were measured at baseline from 212 multiple system atrophy cases, annually for a mean period of 2 years in 44 multiple system atrophy patients in conjunction with clinical, neuropsychological and MRI brain assessments. Baseline neurofilament light chain characteristics were compared between groups. Cox regression was used to assess survival; receiver operating characteristic analysis to assess the ability of neurofilament light chain to distinguish between multiple system atrophy patients and healthy controls. Multivariate linear mixed-effects models were used to analyse longitudinal neurofilament light chain changes and correlated with clinical and imaging parameters. Polynomial models were used to determine the differential trajectories of neurofilament light chain in multiple system atrophy. We estimated sample sizes for trials aiming to decrease neurofilament light chain levels. We show that in multiple system atrophy, baseline plasma neurofilament light chain levels were better predictors of clinical progression, survival and degree of brain atrophy than the neurofilament light chain rate of change. Comparative analysis of multiple system atrophy progression over the course of disease, using plasma neurofilament light chain and clinical rating scales, indicated that neurofilament light chain levels rise as the motor symptoms progress, followed by deceleration in advanced stages. Sample size prediction suggested that significantly lower trial participant numbers would be needed to demonstrate treatment effects when incorporating plasma neurofilament light chain values into multiple system atrophy clinical trials in comparison to clinical measures alone. In conclusion, neurofilament light chain correlates with clinical disease severity, progression and prognosis in multiple system atrophy. Combined with clinical and imaging analysis, neurofilament light chain can inform patient stratification and serve as a reliable biomarker of treatment response in future multiple system atrophy trials of putative disease-modifying agents.
Context.
Future weak lensing surveys, such as the
Euclid
mission, will attempt to measure the shapes of billions of galaxies in order to derive cosmological information. These surveys will attain ...very low levels of statistical error, and systematic errors must be extremely well controlled. In particular, the point spread function (PSF) must be estimated using stars in the field, and recovered with high accuracy.
Aims.
The aims of this paper are twofold. Firstly, we took steps toward a nonparametric method to address the issue of recovering the PSF field, namely that of finding the correct PSF at the position of any galaxy in the field, applicable to
Euclid
. Our approach relies solely on the data, as opposed to parametric methods that make use of our knowledge of the instrument. Secondly, we studied the impact of imperfect PSF models on the shape measurement of galaxies themselves, and whether common assumptions about this impact hold true in an
Euclid
scenario.
Methods.
We extended the recently proposed resolved components analysis approach, which performs super-resolution on a field of under-sampled observations of a spatially varying, image-valued function. We added a spatial interpolation component to the method, making it a true 2-dimensional PSF model. We compared our approach to
PSFEx
, then quantified the impact of PSF recovery errors on galaxy shape measurements through image simulations.
Results.
Our approach yields an improvement over
PSFEx
in terms of the PSF model and on observed galaxy shape errors, though it is at present far from reaching the required
Euclid
accuracy. We also find that the usual formalism used for the propagation of PSF model errors to weak lensing quantities no longer holds in the case of an
Euclid
-like PSF. In particular, different shape measurement approaches can react differently to the same PSF modeling errors.
Breast Nodule after Radiotherapy: Answer Mondaca, Camila; Naik, Rajshri; Christie-Brown, Jonathan ...
The American journal of dermatopathology,
11/2022, Letnik:
44, Številka:
11
Journal Article
Breast Nodule after Radiotherapy: Challenge Mondaca, Camila; Naik, Rajshri; Christie-Brown, Jonathan ...
The American journal of dermatopathology,
11/2022, Letnik:
44, Številka:
11
Journal Article
Objective To determine the contemporary etiology, burden, and short-term outcomes of seizures in neonates monitored with continuous video-electroencephalogram (cEEG). Study design We prospectively ...collected data from 426 consecutive neonates (56% male, 88% term) ≤44 weeks' postmenstrual age with clinically suspected seizures and/or electrographic seizures. Subjects were assessed between January 2013 and April 2015 at 7 US tertiary care pediatric centers following the guidelines of the American Clinical Neurophysiology Society for cEEG for at-risk neonates. Seizure etiology, burden, management, and outcome were determined by chart review by the use of a case report form designed at study onset. Results The most common seizure etiologies were hypoxic-ischemic encephalopathy (38%), ischemic stroke (18%), and intracranial hemorrhage (11%). Seizure burden was high, with 59% having ≥7 electrographic seizures and 16% having status epilepticus; 52% received ≥2 antiseizure medications. During the neonatal admission, 17% died; 49% of survivors had abnormal neurologic examination at hospital discharge. In an adjusted analysis, high seizure burden was a significant risk factor for mortality, length of hospital stay, and abnormal neurological examination at discharge. Conclusions In this large contemporary profile of consecutively enrolled newborns with seizures treated at centers that use cEEG per the guidelines of the American Clinical Neurophysiology Society, about one-half had high seizure burden, received ≥2 antiseizure medications, and/or died or had abnormal examination at discharge. Greater seizure burden was associated with increased morbidity and mortality. These findings underscore the importance of accurate determination of neonatal seizure frequency and etiology and a potential for improved outcome if seizure burden is reduced.
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