Mccullochmygind4186
We retrospectively examined 57 patients with multiple myeloma who underwent autologous stem cell transplantation (ASCT) at our institution. A receiver-operating characteristic curve (ROC) analysis showed that the reduction rate of quantitative serum monoclonal protein (M-protein) before ASCT and the difference in involved and uninvolved free light chains (dFLC) 30 days after ASCT, respectively, had the greatest predictive value for all patients (area under the curve [AUC] 0.791 and 0.660, respectively). Based on the ROC curve-based cutoff values of tumor burden parameters, progression-free survival (PFS) in the high serum M-protein reduction (≥90 %) group was significantly better than that in the low serum M-protein reduction group ( less then 90 %) (2-year PFS 79.5 % vs. 17.0 %, p less then 0.001), but there were no significant differences in PFS between the low ( less then 5.2 mg/L) and high (≥5.2 mg/L) dFLC groups (2-year PFS, 72.0 % vs. 46.0 %; p = 0.149). A multivariate analysis identified the reduction in serum M-protein as an independent predictive factor before ASCT for PFS (hazard ratio [HR] 0.287, p = 0.022) and high dFLC on day 30 after ASCT for PFS (HR 3.902, p = 0.040). These results demonstrate that a good prognosis can be expected with a reduction of serum M-protein before and after ASCT.Thrombus composition and mechanical properties significantly impact the ease and outcomes of thrombectomy procedures in patients with acute ischemic stroke. A wide variation exists in the composition of thrombi between patients. If a relationship can be determined between the composition of a thrombus and its mechanical behaviour, as well as between the composition of a thrombus and its radiological imaging characteristics, then there is the potential to personalise thrombectomy treatment based on each individual thrombus. This review aims to give an overview of the current literature addressing this issue. Here, we present a scoping review detailing associations between thrombus composition, mechanical behaviour and radiological imaging characteristics. We conducted two searches 1) on the association between thrombus composition and the mechanical behaviour of the tissue and 2) on the association between radiological imaging characteristics and thrombus composition in the acute stroke setting. The review sugker of clot contraction.Bicycles gained significant popularity among Americans in 2020. Greater investment in adequate bicycle safety facilities will be needed. Crash data from police will undoubtedly play a role in decision-making. This research evaluated the data quality of text narratives in police reports on bicycle crashes. The aims were to identify situations in which police officers wrote more detail in the narrative text, investigate if longer reports translate to more in-depth crash descriptions, examine the extent to which narrative texts cover details useful for those charged with bicycle safety. This is a 4-year retrospective cohort study of vehicle-vs-bicycle crashes that occurred between January 1, 2009, and December 31, 2012, in Boston, Massachusetts (USA). Police reports were matched with the Pedestrian and Bicycle Crash Analysis Tool (PBCAT) to measure how much information was captured and when reports were more likely to capture more information. Police reports only captured most information in one area of the standardized form (Crash Typing), with average total missingness of over 75%. Longer reports did reduce the amount of missingness, and officers were more likely to write longer reports when they were on the crash site, when there was an injury, when the crash involved an extended car door, and during the day. A 100% increase in the report's words was associated with a four-percentage point reduction in PBCAT missingness. While longer reports result in less missingness when measured against the standardized crash form, the average report still misses most of the information that the form would capture. We recommend that police departments adopt a standardized form to facilitate information capture at the scene of bicycle-vehicle crashes.Defect detection during pulse-echo ultrasonic testing (UT) is challenging when defects are located in a dead zone where the echoes from the defects are overshadowed by disturbances from the initial ringing signal of the UT transducer. The time-gate method is one of the most widely used approaches in UT to filter out such unwanted components, but defects in the dead zone are virtually impossible to detect using conventional methods. This paper proposes an autoencoder-based end-to-end ultrasonic testing method to detect defects within the dead zone of a transducer. The autoencoder is designed to predict the normal behavior of ultrasonic signals including disturbances, thus enabling the identification of even subtle deviations made by defects. To advance the performance of the autoencoder further with a limited amount of training data, a two-step training procedure is presented, involving training using pure normal signals measured from a defect-free specimen and re-training using pseudo-normal samples identified by the autoencoder with a smart thresholding strategy. This two-step procedure enables us to develop an adaptive autoencoder model that can be effectively employed to process the newly measured ultrasonic signals. For a demonstration of the proposed method, UT-based B-scan inspections of aluminum blocks with near-surface defects are conducted. The results suggest that the proposed method outperforms the conventional gate-based inspection approach with regard to its ability to identify the sizes and locations of near-surface defects.Angiosarcomas are aggressive, malignant endothelial cell tumors derived from the vascular or lymphatic epithelium. Angiosarcomas makes up less than 1% of all soft tissue sarcomas. Primary pulmonary angiosarcoma is a rare tumor that most commonly presents as metastatic disease and carries a grim prognosis. The disease rarity and low index of suspicion make the diagnosis problematic. In this report, we present a case of primary pulmonary angiosarcoma with aberrant neuroendocrine differentiation. The diagnostic images, pathology and management strategy are discussed in this case with overall longer survival. The unique neuroendocrine pathologic subtype may contribute to the overall longer survival, however, there are only a few limited cases published. Further recognition and investigation of primary pulmonary angiosarcoma with aberrant neuroendocrine differentiation is warranted to further characterize diagnostic markers, determine more effective treatment strategies, and establish a possible link to improved survival.Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a rare condition related to textured breast implants. Veliparib inhibitor Recognition of characteristic imaging and pathological features are important, given the absence of symptoms can delay diagnosis, as illustrated by this case. Late-onset peri-implant effusion is commonly encountered whilst an associated mass or lymphadenopathy are rare. Clinical and radiological suspicion enables dedicated pathology work-up for diagnosis. Ultrasound is vital for initial work-up whilst MRI and PET-CT assist in staging. Surgical explantation is followed by adjuvant chemo-radiotherapy according to disease extent.
Chest radiographs (CXR) are frequently used as a screening tool for patients with suspected COVID-19 infection pending reverse transcriptase polymerase chain reaction (RT-PCR) results, despite recommendations against this. We evaluated radiologist performance for COVID-19 diagnosis on CXR at the time of patient presentation in the Emergency Department (ED).
We extracted RT-PCR results, clinical history, and CXRs of all patients from a single institution between March and June 2020. 984 RT-PCR positive and 1043 RT-PCR negative radiographs were reviewed by 10 emergency radiologists from 4 academic centers. 100 cases were read by all radiologists and 1927 cases by 2 radiologists. Each radiologist chose the single best label per case Normal, COVID-19, Other - Infectious, Other - Noninfectious, Non-diagnostic, and Endotracheal Tube. Cases labeled with endotracheal tube (246) or non-diagnostic (54) were excluded. Remaining cases were analyzed for label distribution, clinical history, and inter-reader agreement.
1727 radiographs (732 RT-PCR positive, 995 RT-PCR negative) were included from 1594 patients (51.2% male, 48.8% female, age 59±19years). For 89 cases read by all readers, there was poor agreement for RT-PCR positive (Fleiss Score 0.36) and negative (Fleiss Score 0.46) exams. Agreement between two readers on 1638 cases was 54.2% (373/688) for RT-PCR positive cases and 71.4% (679/950) for negative cases. Agreement was highest for RT-PCR negative cases labeled as Normal (50.4%, n=479). Reader performance did not improve with clinical history or time between CXR and RT-PCR result.
At the time of presentation to the emergency department, emergency radiologist performance is non-specific for diagnosing COVID-19.
At the time of presentation to the emergency department, emergency radiologist performance is non-specific for diagnosing COVID-19.
To investigate the utility of digital breast tomosynthesis (DBT) in the evaluation of focal breast pain, considering breast density and breast cancer risk.
Ninety-one cases of focal breast pain evaluated with DBT and ultrasound (US) from 12/30/2014 to 11/9/2017 with 2-year follow-up were identified. Exclusion criteria were non-focal, axillary, or radiating pain; palpable or skin changes; pregnancy or lactation; and history of ipsilateral cancer, trauma, or infection. Demographic data, Tyrer-Cuzick Score (TCS), medical history, breast density, imaging results, and pathology were recorded. Descriptive statistics were reported.
Eighteen percent (16/91) of cases demonstrated findings, all benign. Of these, 6% (1/16) were detected by DBT only, 88% (14/16) by US only, and 6% (1/16) by DBT and US. US resulted in 3 benign biopsies. Ninety-nine percent (75/76) of cases with no findings at the site of pain on US also had no findings on DBT. Ninety-eight percent (89/91) of cases with no cancer detected at the site of pain on US also did not have cancer on DBT. DBT detected 2 incidental cancers not associated with pain. DBT and US agreed that there was no finding at the site of pain in 82% (75/91) of cases. A high degree of agreement between DBT and US was seen when stratified by breast density and TCS.
DBT may be appropriate for the evaluation of focal pain. Low breast cancer incidence was observed at the site of focal pain across all mammographic breast densities and breast cancer risks.
DBT may be appropriate for the evaluation of focal pain. Low breast cancer incidence was observed at the site of focal pain across all mammographic breast densities and breast cancer risks.
Tissue magnetic susceptibility sign can potentially be detected on susceptibility weighted imaging (SWI) phase (SW-P). This study aims to investigate its performance for depicting brain susceptibility structures.
A simulation was performed to depict magnetic susceptibility structures of various geometries on SW-P and quantitative susceptibility mapping (QSM). Brain MRI was performed on 25 subjects using SWI on a 3T MRI system. QSM was generated from the same data. SW-P and QSM were analyzed according to radiological assessment for depicting globus pallidus nuclei, optic radiation white matter tracts, and lateral ventricular choroid plexus calcifications. In 11 of these subjects, CT was available and correlated with SW-P and QSM to assess their performance in quantifying calcifications in the choroid plexus.
In simulation, the appearance of a sphere on SW-P ranged from centric nodule to mixed positive and negative values as the diameter increased. Large cylinders also appeared as mixed positive and negative values.
