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ABSTRACT IMPACT: This study assesses patient and volumetric risk factors for distant recurrence within 6 months of completion of curative chemoradiation with brachytherapy in locally advanced cervical cancer. OBJECTIVES/GOALS: Initial tumor volume and tumor shrinkage velocity are prognostic of cure and survival after curative chemoradiation (CRT) for cervical cancer. We explored whether local tumor volumetric changes influence time to distant recurrences outside the radiation field. METHODS/STUDY POPULATION: We performed a retrospective cohort study of patients with FIGO Stage IB-IVA cervical cancer treated with curative CRT and brachytherapy at a tertiary academic center with minimum 3 months follow up and standard post-treatment FDG-PET. Patients received 6 weekly fractions of brachytherapy interdigitated with external beam radiation and cisplatin. Tumor volumes were assessed by MRI at brachytherapy planning. Patients who developed distant metastasis were classified as earliest (3-6 months), early (6-24 months) or late (>24 months) following completion of CRT. Absolute and percent decrease in tumor volume for each fraction were calculated with respect to first brachytherapy volume. Fisher’s exact and Mann Whitney-U tests were used for comparison of categorical and continuous variables. RESULTS/ANTICIPATED RESULTS: 143 of 574 (25%) patients developed distant metastasis. Distribution of age, histology, FIGO 2018 stage, primary tumor SUVmax, treatment length, and pre/post treatment squamous cell carcinoma antigen levels were not associated in each group. Para-aortic lymph metastases were more common in patients with earliest distant recurrence (33% earliest, 26% early, 12% late, p=0.03). Median initial tumor volume in the earliest (n=24), early (n =29) and late (n=9) groups was 57, 28 and 40 mL, respectively (p=0.08); 57 (earliest) vs 30mL (early+late groups), p=0.04. Average mid treatment (fraction 4) and end of treatment (fraction 6) percent shrinkage was 80 (earliest) vs 73 (early+late), p=0.84 and 94 vs 92, p=0.95, respectively. Neither absolute nor percent tumor shrinkage differed between early vs. late groups. DISCUSSION/SIGNIFICANCE OF FINDINGS: Tumor volumetric changes during definitive chemoradiation were not associated with the timing of developing distant metastasis, which is linked to presence of lymph node metastasis and tumor volume at diagnosis.
Although atom probe tomography (APT) reconstructions do not directly influence the local elemental analysis, any structural inferences from APT volumes demand a reliable reconstruction of the point cloud. Accurate estimation of the reconstruction parameters is crucial to obtain reliable spatial scaling. In the current work, a new automated approach of calibrating atom probe reconstructions is developed using only one correlative projection electron microscopy (EM) image. We employed an algorithm that implements a 2D cross-correlation of microstructural features observed in both the APT reconstructions and the corresponding EM image. We apply this protocol to calibrate reconstructions in a Cu(In,Ga)Se2-based semiconductor and in a Co-based superalloy. This work enables us to couple chemical precision to structural information with relative ease.
Recent progress in video compression is seemingly reaching its limits making it very hard to improve coding efficiency significantly further. The adaptive loop filter (ALF) has been a topic of interest for many years. ALF reaches high coding gains and has motivated many researchers over the past years to further improve the state-of-the-art algorithms. The main idea of ALF is to apply a classification to partition the set of all sample locations into multiple classes. After that, Wiener filters are calculated and applied for each class. Therefore, the performance of ALF essentially relies on how its classification behaves. In this paper, we extensively analyze multiple feature-based classifications for ALF (MCALF) and extend the original MCALF by incorporating sample adaptive offset filtering. Furthermore, we derive new block-based classifications which can be applied in MCALF to reduce its complexity. Experimental results show that our extended MCALF can further improve compression efficiency compared to the original MCALF algorithm.
In this paper we combine video compression and modern image processing methods. We construct novel iterative filter methods for prediction signals based on Partial Differential Equation (PDE)-based methods. The central idea of the signal adaptive filters is explained and demonstrated geometrically. The meaning of particular parameters is discussed in detail. Furthermore, thorough parameter tests are introduced which improve the overall bitrate savings. It is shown that these filters enhance the rate-distortion performance of the state-of-the-art hybrid video codecs. In particular, based on mathematical denoising techniques, two types of diffusion filters are constructed: a uniform diffusion filter using a fixed filter mask and a signal adaptive diffusion filter that incorporates the structures of the underlying prediction signal. The latter has the advantage of not attenuating existing edges while the uniform filter is less complex. The filters are embedded into a software based on HEVC with additional QTBT (Quadtree plus Binary Tree) and MTT (Multi-Type-Tree) block structure. Overall, the diffusion filter method achieves average bitrate savings of 2.27% for Random Access having an average encoder runtime increase of 19% and 17% decoder runtime increase. For UHD (Ultra High Definition) test sequences, bitrate savings of up to 7.36% for Random Access are accomplished.
To demonstrate the application of economics to health care preparedness by estimating the financial return on investment in a substate regional emergency response team and to develop a financial model aimed at sustaining community-level disaster readiness.
Methods
Economic evaluation methods were applied to the experience of a regional Pennsylvania response capability. A cost-benefit analysis was performed by using information on funding of the response team and 17 real-world events the team responded to between 2008 and 2013. By use of the results of the cost-benefit analysis as well as information on the response team’s catchment area, a risk-based insurance-like membership model was built.
Results
The cost-benefit analysis showed a positive return after 6 years of investment in the regional emergency response team. Financial modeling allowed for the calculation of premiums for 2 types of providers within the emergency response team’s catchment area: hospitals and long-term care facilities.
Conclusion
The analysis indicated that preparedness activities have a positive return on their investment in this substate region. By applying economic principles, communities can estimate their return on investment to make better business decisions in an effort to increase the sustainability of emergency preparedness programs at the regional level. (Disaster Med Public Health Preparedness. 2015;9:344–348)
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
Design
Longitudinal study.
Setting
Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
Subjects
Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
Results
Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
Conclusions
Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
The objective was to examine the effect of BMI on the incidence of various infectious diseases in institutionalised, geriatric subjects. In a retrospective cohort study we analysed medical records of 619 patients aged 75 years and older (mean age 87·6 (sd 6·4) years) who were treated in a geriatric hospital in Vienna, Austria. The total incidence rate of infection in this population was 0·80 per person-year. The most frequent infections were urinary tract infections (0·30 per person-year), followed by infections of the lower respiratory tract (0·19 per person-year), diarrhoea (0·12 per person-year) and other infections (0·20 per person-year). Incidence risk ratios were obtained by a multiplicative Poisson regression model. There was a J-shaped curve in the incidence of infections recorded by BMI with a nadir at 27–28 kg/m2. Compared with the reference group with a BMI of 24–27·9 kg/m2, subjects with a lower BMI had a higher incidence rate of infections. The incidence risk ratios, adjusted for sex, age and chronic diseases, were 1·62 (95 % CI 1·21, 2·17) for those with a BMI of < 20 kg/m2 and 1·84 (95 % CI 1·40, 2·42) for those with a BMI of 20–23·9 kg/m2. However, also patients with a BMI of 28 kg/m2 and above had a higher incidence rate of infections, with an incidence risk ratio of 1·54 (95 % CI 1·07, 2·22). These results show that both underweight and obesity are associated with a higher risk of infections in institutionalised geriatric patients.
Ectoine is a compatible solute accumulated in halophilic bacteria in response to high salt concentrations and offers protection from osmotic stress. The occurrence of compatible solutes is widespread among bacteria, yet ectoine has never been detected in foods. The use of an ectoine producing microorganism (Brevibacterium linens) in the surface ripening of red smear cheeses led to the question whether ectoine can be found in cheese. Therefore we examined samples from a variety of cheese manufacturers and different types of red smear cheeses for the presence of ectoine using HPLC and HPLC/MS analysis. Ectoine solely appears in the rind and was detected up to 178 mg/200 g red smear cheese, depending on several factors like ripening status and conditions throughout the cheese production process (e.g. salt concentrations of used brine baths).
Deposition steps in CVD and ALD applications usually not only cover the surface of the substrate surface but also the walls of the chamber inside. Regular removal of those residuals has to be done to obtain stable and repeatable deposition results with uniform surfaces at acceptable particle levels. The high requirements to sustain stable processes has lead to more frequent chamber cleans. NF3 has emerged as the main clean gas for remote clean applications. While it meets the above mentioned requirements and is considered to fit easily into the fab gas supply it is relatively expensive. The work presented here investigates argon/nitrogen diluted fluorine (F2) as an alternative clean gas with a significantly reduced environmentally destructive global warming emission (GWP). The cleaning behaviour with respect to different materials (SiON, TaN, TiN, W, SiO2) was studied. It is found that in general argon/nitrogen diluted fluorine achieves etch rates comparable to those obtained by NF3 when the comparison is based on the amount of fluorine transported into the reactor.
We study the degradation behaviour of GaN gain guided laser diodes (LDs) on SiC substrates with cleaved facets and reflective coatings on none, one, or both facets. This allows us to demonstrate that in addition to volume effects there is a contribution of the laser facets to laser degradation. We observe that for the uncoated LDs the threshold current density is increasing considerably faster compared to LDs with mirror coatings. Degradation is observed during operation but not during storage at ambient conditions and thus expected to be photon or current induced. Operation of the uncoated laser in a nitrogen atmosphere reduces the degradation rate with respect to operation in air.
The prion was defined by Stanley B. Prusiner as the infectious agent that causes transmissible spongiform encephalopathies. A pathological protein accumulating in the brain of scrapie-infected hamsters was isolated in 1982 and termed prion protein (PrPSc). Its cognate gene Prnp was identified more than a decade ago by Charles Weissmann, and shown to encode the host protein PrPC. Since the latter discovery, transgenic mice have contributed many important insights into the field of prion biology, including the understanding of the molecular basis of the species barrier for prions. By disrupting the Prnp gene, it was shown that an organism that lacks PrPC is resistant to infection by prions. Introduction of mutant PrP genes into PrP-deficient mice was used to investigate the structure-activity relationship of the PrP gene with regard to scrapie susceptibility. Ectopic expression of PrP in PrP knockout mice proved a useful tool for the identification of host cells competent for prion replication. Finally, the availability of PrP knockout mice and transgenic mice overexpressing PrP allows selective reconstitution experiments aimed at expressing PrP in neurografts or in specific populations of haemato- and lymphopoietic cells. The latter studies have allowed us to clarify some of the mechanisms of prion spread and disease pathogenesis.
We test whether the conversion price (ratio) is viewed by the stock market as a credible signal of the firm's future earnings prospects (Kim (1990)) and, subsequently, whether convertible debt serves as backdoor equity financing (Stein (1992)). Examining the conversion price in relation to current stock prices and a priori growth expectations produces an average expected time of less than 1.5 years for convertible bonds to be at-the-money. Thus, as Stein suggests, convertibles appear to be a method of drawing equity into a firm's capital structure. We also find that the size of the firm's announcement period abnormal returns is positively related to the expected time for the convertible to become at-the-money. Given these relationships, we conclude that convertible debt issue announcements, on average, send an equity-like signal to the market.
Two versions of a deposition method referred to as CYCLIC-CVD are presented. Both are based on the repetition of cycles involving two steps: a) a thin a-Si:H layer deposition and b) a hydrogen plasma treatment. In the first version the cycles consist of a thermal CVD deposition step at 500–550 °C followed by a hydrogen plasma step. Device quality a-Si:H films of less than 3 at.% hydrogen content have been prepared. In the second version, which we call Closed Chamber CVD (CC-CVD) the deposition step is done by conventional PE CVD. However, the hydrogenation step is performed with closed reactor chamber. The latter step provides conservation of silicon mass at an equilibrium between H-etching and redeposition. As a result, μc-Si films of high crystallinity are produced with a high overall deposition rate.
A case of an aggressive supraglottic squamous cell carcinoma, which was managed with neo-adjuvant chemotherapy and radical surgery, is described. The post-operative course was of rapid deterioration and death due to progressive metastatic disease involving bone marrow and liver. This is the first reported case of bone marrow infiltration by squamous cell carcinoma of the head and neck diagnosed ante-mortem. The incidence and pattern of metastatic disease from head and neck tumours is reviewed, and the importance of initial staging in determining the risk of distant metastatic disease is emphasised.
A recently proposed model of shock consolidation of powders quantitatively predicts regimes of input energy and shock duration required to produce well-bonded compacts. A growing data base from shock experiments in which the shock wave and powder parameters of importance are controlled allows evaluation of the model.
Rapidly solidified crystalline AISI 9310, and microcrystalline Markomet 3.11, as well as amorphous Markomet 1064 and crystalline Mo powders, have been consolidated by shocks up to 2 μsec duration. The formation of amorphous layers on Marko 3.11 particle surfaces indicates that surface melting and rapid solidification occurred. Decreasing amounts of amorphous structure are retained in Marko 3.11 and 1064 powder compacts with increasing shock energies. Significant improvement in Mo particle bonding is achieved by reducing surface oxides prior to shock consolidation.
Critics of the American House of Representatives frequently cite, in one form or another, a national model of representation as a basis for criticizing both the House and the behaviour of some of its individual members. One of the more familiar criticisms, for example, is that members of the House are so motivated by local or regional concerns and interests that representation in some meaningful national form is rendered almost impossible. So widely is this characterization shared that it is hardly ever asked whether or not members of the House behave in ways that would be consistent and meaningful in terms of a national model of representation.
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