Diagnostic Performance and Additional Value of Elastosonography in Focal Breast Lesions: Statistical Correlation between Size-Dependant Strain Index Measurements, Multimodality-BI-RADS Score, and Histopathology in a Clinical Routine Setting

Objective. To evaluate the diagnostic benefit of real-time elastography (RTE) in clinical routine. Strain indices (SI) for benign and malignant tumors were assessed. Methods. 100 patients with 110 focal breast lesions were retrieved. Patients had mammography (MG), ultrasound (US), and, if necessary, MRI. RTE was conducted after ultrasound. Lesions were assessed with BI-RADS for mammography and ultrasound. Diagnosis was established with histology or follow-up. Results. SI for BI-RADS 2 was 1.71 ± 0.86. Higher SI (2.21 ± 1.96) was observed for BI-RADS 3 lesions. SI of BI-RADS 4 and 5 lesions were significantly higher (16.92 ± 20.89) and (19.54 ± 10.41). 31 malignant tumors exhibited an average SI of 16.13 ± 14.67; SI of benign lesions was 5.29 ± 11.87 (P value <0.0001). ROC analysis threshold was >3.8 for malignant disease. Sensitivity of sonography was 90.3% (specificity 78.5%). RTE showed a sensitivity of 87.1% (specificity 79.7%). Accuracy of all modalities combined was 96.8%. In BI-RADS 3 lesions RTE was able to detect all malignant lesions (sensitivity 100%, specificity 92.9%, and accuracy 93.9%). Conclusions. RTE increased sensitivity and specificity for breast cancer detection when used in combination with ultrasound.

Extreme River Floods in Western Switzerland and the Lake of Constance Region in the Period Prior to Instrumental Measurements

The floods that occurred on the Aare and Rhine rivers in May 2015 and the mostly successful handling of this event in terms of flood protection measures are a good reminder of how important it is to comprehend the causes and processes involved in such natural hazards. While the needed data series of gauge measurements and peak discharge calculations reach back to the 19th century, historical records dating further back in time can provide additional and useful information to help understanding extreme flood events and to evaluate prevention measures such as river dams and corrections undertaken prior to instrumental measurements. In my PhD project I will use a wide range of historical sources to assess and quantify past extreme flood events. It is part of the SNF-funded project “Reconstruction of the Genesis, Process and Impact of Major Pre-instrumental Flood Events of Major Swiss Rivers Including a Peak Discharge Quantification” and will cover the research locations Fribourg (Saane R.), Burgdorf (Emme R.), Thun, Bern (both Aare R.), and the Lake of Constance at the locations Lindau, Constance and Rorschach. My main goals are to provide a long time series of quantitative data for extreme flood events, to discuss the occurring changes in these data, and to evaluate the impact of the aforementioned human influences on the drainage system. Extracting information given in account books from the towns of Basel and Solothurn may also enable me to assess the frequency and seasonality of less severe river floods. Finally, historical information will be used for remodeling the historical hydrological regime to homogenize the historical data series to modern day conditions and thus make it comparable to the data provided by instrumental measurements. The method I will apply for processing all information provided by historical sources such as chronicles, newspapers, institutional records, as well as flood marks, paintings and archeological evidence has been developed and successfully applied to the site of Basel by Wetter et al. (2011). They have also shown that data homogenization is possible by reconstructing previous stream flow conditions using historical river profiles and by carefully observing and re-constructing human changes of the river bed and its surroundings. Taken all information into account, peak discharges for past extreme flood events will be calculated with a one-dimensional hydrological model.

Calibration of River Gauge at Afdeyu Research Station, Eritrea: A study conducted by MOA NARI and SLM

Afdeyu Station is one of the few river gauging stations in the highlands of Eritrea where daily measurements are taken. As a result of damages, the station was refurbished, and the cross section of the gauge was changed to have better control of minimal runoff. The gauge therefore had to be re-calibrated. This publication documents this process and also provides the new calibration curve, based on extensive field work carried out in the rainy season 2009

Sonographic Assessment of Fetal Cardiac Function: Indirect Measurements of Fetal Cardiac Function, Newer Techniques and Clinical Applications

Noninvasive blood flow measurements based on Doppler ultrasound studies are the main clinical tool for studying the cardiovascular status of fetuses at risk for circulatory compromise. Usually, qualitative analysis of peripheral arteries and in particular clinical situations such as severe growth restriction or volume overload also of venous vessels close to the heart or of flow patterns in the heart is being used to gauge the level of compensation in a fetus. However, quantitative assessment of the driving force of the fetal circulation, the cardiac output remains an elusive goal in fetal medicine. This article reviews the methods for direct and indirect assessment of cardiac function and explains new clinical applications. Part 1 of this review describes the concept of cardiac function and cardiac output and the techniques that have been used to quantify output. Part 2 summarizes the use of arterial and venous Doppler studies in the fetus and gives a detailed description of indirect measurements of cardiac function (like indices derived from the duration of segments of the cardiac cycle) with current examples of their application.

Measurements of Wgamma and Zgamma production in pp collisions at sqrts= 7 TeV with the ATLAS detector the LHC

The integrated and differential fiducial cross sections for the production of a W or Z boson in association with a high-energy photon are measured using pp collisions at root s = 7 TeV. The analyses use a data sample with an integrated luminosity of 4.6 fb(-1) collected by the ATLAS detector during the 2011 LHC data-taking period. Events are selected using leptonic decays of the W and Z bosons [W(e nu, mu nu) and Z(e(+)e(-), mu(+)mu(-), nu(nu) over bar)] with the requirement of an associated isolated photon. The data are used to test the electroweak sector of the Standard Model and search for evidence for new phenomena. The measurements are used to probe the anomalous WW gamma, ZZ gamma, and Z gamma gamma triple-gauge-boson couplings and to search for the production of vector resonances decaying to Z gamma and W gamma. No deviations from Standard Model predictions are observed and limits are placed on anomalous triple-gauge-boson couplings and on the production of new vector meson resonances.

Bacillus Calmette-Guérin strain differences have an impact on clinical outcome in bladder cancer immunotherapy

BACKGROUND Whether the commonly used bacillus Calmette-Guérin (BCG) strains Connaught and Tice confer different treatment responses in non-muscle-invasive bladder cancer (NMIBC) is unknown. OBJECTIVES To compare clinical efficacy, immunogenicity, and genetics of BCG Connaught and Tice. DESIGN, SETTING, AND PARTICIPANTS A prospective randomized single-institution trial with treatment of 142 high-risk NMIBC patients with BCG Connaught or Tice. INTERVENTION Patients were randomized to receive six instillations of BCG Connaught or Tice. For experimental studies, BCG strains were compared in C57Bl/6 mice. Bladders and lymphoid tissues were analyzed by cytometry and the latter cultivated to detect live BCG. BCG genomic DNA was sequenced and compared with reference genomes. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Recurrence-free survival was the primary end point of the clinical study. The Kaplan-Meier estimator was used for estimating survival and time-to-event end points. Nonparametric tests served for the analysis of the in vivo results. RESULTS AND LIMITATIONS Treatment with BCG Connaught conferred significantly greater 5-yr recurrence-free survival compared with treatment with BCG Tice (p=0.0108). Comparable numbers of patients experienced BCG therapy-related side effects in each treatment group (p=0.09). In mice, BCG Connaught induced stronger T-helper cell 1-biased responses, greater priming of BCG-specific CD8(+) T cells, and more robust T-cell recruitment to the bladder than BCG Tice. Genome sequencing of the BCG strains revealed candidate genes potentially involved in the differential clinical responses. CONCLUSIONS BCG strain may have an impact on treatment outcome in NMIBC immunotherapy. PATIENT SUMMARY We compared the efficacy of two commonly used bacillus Calmette-Guérin (BCG) strains for the treatment of NMIBC and found that treatment with BCG Connaught prevented recurrences more efficiently than BCG Tice. Comparison of the immunogenicity of the two strains in mice indicated superior immunogenicity of BCG Connaught. We also identified genetic differences that may explain the differential efficacy of the Connaught and Tice BCG strains. TRIAL REGISTRATION NCT00003779.