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Low-dose CT (LDCT) is widely accepted as the preferred method for detecting pulmonary nodules. However, the determination of whether a nodule is benign or malignant involves either repeated scans or invasive procedures that sample the lung tissue. Noninvasive methods to assess these nodules are needed to reduce unnecessary invasive tests. In this study, we have developed a pulmonary nodule classifier (PNC) using RNA from whole blood collected in RNA-stabilizing PAXgene tubes that addresses this need. Samples were prospectively collected from high-risk and incidental subjects with a positive lung CT scan. A total of 821 samples from 5 clinical sites were analyzed. Malignant samples were predominantly stage 1 by pathologic diagnosis and 97% of the benign samples were confirmed by 4 years of follow-up. A panel of diagnostic biomarkers was selected from a subset of the samples assayed on Illumina microarrays that achieved a ROC-AUC of 0.847 on independent validation. The microarray data were then used to design a biomarker panel of 559 gene probes to be validated on the clinically tested NanoString nCounter platform. RNA from 583 patients was used to assess and refine the NanoString PNC (nPNC), which was then validated on 158 independent samples (ROC-AUC = 0.825). The nPNC outperformed three clinical algorithms in discriminating malignant from benign pulmonary nodules ranging from 6–20 mm using just 41 diagnostic biomarkers. Overall, this platform provides an accurate, noninvasive method for the diagnosis of pulmonary nodules in patients with non–small cell lung cancer.Significance:These findings describe a minimally invasive and clinically practical pulmonary nodule classifier that has good diagnostic ability at distinguishing benign from malignant pulmonary nodules.

Regenüberlaufbecken, Stauraumkanäle und Regenrückhaltebecken entlasten das Kanalnetz und Kläranlagen. Mit einer steigenden Zahl an Bauwerken wachsen auch die Aufgaben zu deren Überwachung, Unterhaltung und Störungsbeseitigung. Der Aggerverband hat alles im Blick.

Introduction: The profunda artery perforator (PAP) flap represents a valuable alternative to the deep inferior epigastric artery perforator flap which, nowadays, is considered the golden standard for autologous breast reconstruction. The goal of this study was to evaluate the long-term satisfaction, functional outcomes of the donor site following PAP flap-based breast reconstruction and to present our personal learning experience along with suggestions for technique refinements. Methods: In this prospective single-center appraisal, 18 patients who underwent PAP flap-based breast reconstruction between January 2016 and November 2019 were enrolled. The Patient and Observer Scar Assessment Scale (POSAS) and the Breast-Q questionnaire were employed to evaluate the results 12 months postoperative. Data were analyzed with the Q-Score program. Complications were recorded in the medical database and classified with the Clavien-Dindo classification. Results: In the questionable time frame, 164 female patients underwent free flap breast reconstruction. Of those, 18 patients that received PAP flaps (9 bilateral) were included in this study. We recorded one flap loss because of venous failure. Most complications concerned the donor site, including hematoma, seroma, and wound healing problems. Patients’ satisfaction was high at 12 months post-surgery, despite critical evaluation of the donor site scar. Conclusion: The PAP flap serves as an excellent option for breast reconstruction in patients who do not have abundant abdominal tissue. The overall clinical outcome was good and patients’ evaluation showed high satisfaction after 12 months despite high complication rates. Modifications in planning and flap harvesting might improve the donor site outcome and the overall complication rate.

Au cœur d’une industrie moderne où la culture populaire s’entremêle avec la culture matérielle, cette étude vise à décrypter, d’un point de vue sémiologique, la présence du langage marketing de Nike à l’intérieur du film Forrest Gump (1994) de Robert Zemeckis. Ce film a été réalisé dans un contexte où les propriétaires de la marque, qui sont remerciés pour leur assistance par les producteurs du film, tentaient de parfaire son image en déposant le nouveau slogan « Just Do It ». Il est donc intéressant d’appréhender la façon dont le réalisateur du film, dans la mise en scène de son personnage principal, Forrest Gump, suggère un lien de causalité entre la pratique du « running » et la chaussure de sport. Du fait de sa forte proéminence audiovisuelle dans l’ensemble du récit, l’histoire de la marque à la virgule se fond dans l’histoire racontée, laquelle contribue à perpétuer in fine sa propre mythologie.

(1) Background: This work aimed to conduct a comparative study, providing long-term data about patient-reported outcome measures and donor site scar assessments, as well as an aesthetic evaluation of the reconstructed breasts in patients with DIEP versus PAP flap breast reconstruction. (2) Methods: This prospective, single-center, matched cohort study included a total of 36 patients after DIEP and PAP flap breast reconstruction. The evaluation was carried out using the Breast-Q and POSAS questionnaire, as well as the Breast Aesthetic Scale for cosmetic analysis, by four plastic surgeons. (3) Results: The postoperative Breast-Q evaluation revealed no significant differences between both patient groups for the categories of the physical well-being of the donor site, the physical well-being of the breast, and satisfaction with the breast. A scar evaluation of the donor site region showed equivalent results for the thigh and abdomen regions, concerning the overall opinion of the patients and the observers. There was no significant difference between both methods of reconstruction for all aspects of breast aesthetics. (4) Conclusions: Similar results for donor site morbidity, scar quality, and the aesthetic outcome of the breasts in both the DIEP and PAP patient groups have been demonstrated. Hence, in those cases suitable for both types of reconstruction, the decision can be based on factors such as patients’ lifestyles, leisure activities, and preferences.

Seshadri constants on abelian surfaces are fully understood in the case of Picard number one. Little is known so far for simple abelian surfaces of higher Picard number. In this paper we investigate principally polarized abelian surfaces with real multiplication. They are of Picard number two and might be considered the next natural case to be studied. The challenge is to not only determine the Seshadri constants of individual line bundles, but to understand the whole Seshadri function on these surfaces. Our results show on the one hand that this function is surprisingly complex: on surfaces with real multiplication in $$\mathbb {Z}[\sqrt{e}]$$ Z [ e ] it consists of linear segments that are never adjacent to each other—it behaves like the Cantor function. On the other hand, we prove that the Seshadri function is invariant under an infinite group of automorphisms, which shows that it does have interesting regular behavior globally.

ZusammenfassungDas Lesen und Verstehen von Beweisen ist eine wichtige Aktivität in der wissenschaftlichen Disziplin Mathematik. In der Studieneingangsphase eines Mathematikstudiums stellt der lernförderliche Umgang mit Beweisen für die meisten Studierenden eine große Herausforderung dar. Beweise zu verstehen heißt nicht nur, einzelne Begründungsschritte im Beweis nachvollziehen, sondern beispielsweise auch, Hauptideen des Beweises identifizieren zu können. Welche individuellen Merkmale mit dem Beweisverständnis zusammenhängen und wie Studierende im Prozess des Beweisverstehens durch die spezifische Strategie der Beispielnutzung unterstützt werden können, steht im Zentrum der präsentierten Studie. 166 Studierenden mehrerer Analysis-Veranstaltungen wurde der Beweis eines Satzes über monotone Teilfolgen von reellwertigen Folgen vorgelegt. Die Studierenden wurden aufgefordert, diesen durchzulesen und Beispiele zu nutzen, um jeden einzelnen Beweisschritt zu illustrieren. Die Art des Illustrierens am Beispiel wurde in verschiedenen Varianten anhand zweier Bedingungen konkretisiert (2 × 2-Design): In der ersten Bedingung („Lernaktivität“) wird unterschieden, ob die Studierenden ein zum gegebenen Beweis passendes Beispiel selbst konstruieren oder ob sie ein vorgegebenes Beispiel passiv nachvollziehen sollen. In der zweiten Bedingung („Darstellungsform des Beispiels“) wird das Beispiel entweder in symbolischer oder in graphischer Form genutzt. Die Ergebnisse zeigen, dass die schulischen Vorleistungen und insbesondere das inhaltliche Vorwissen das Beweisverständnis erwartungskonform stark prädizieren. Für einzelne Unterstützungsvarianten, konkretisiert in den Bedingungen, konnten wir hingegen keine Vorteile für das individuelle Beweisverstehen ausmachen, dagegen geben die konkreten Bearbeitungsprozesse erhellende Einblicke in die Nutzung von Beispielen durch die Lernenden. Die Ergebnisse diskutieren wir in Bezug auf theoretische und praktische Implikationen für Lernprozesse im Mathematikstudium.

In primary metatarsalgia, Distal Minimally invasive Metatarsal Osteotomy (DMMO) achieves a correct load distribution which is a factor in pain relief, but contrary to the elevation of the metatarsal head, shortening the metatarsal length has no influence on plantar-loading parameters, while the increased metatarsal length is a factor in the development of metatarsalgia. Thus, we hypothesized that metatarsalgia could be partly related to a functional imbalance between bone structure and soft tissues and pain relief after DMMO results from soft tissue relaxation. Many authors have highlighted the correlation between joint pressure and periarticular soft tissue tension. To test our hypothesis, we measured intra-operatively the MTPJ pressure of 19 patients suffering from primary metatarsalgia, before and after DMMO. This pressure is being analyzed as a reflection of joint decompression and forefoot soft tissue release. Many authors have highlighted the correlation between joint pressure and periarticular soft tissue tension. Lower metatarsals presenting metatarsalgia show a significantly lower MTPJ pressure compared to asymptomatic rays, and DMMO induces a significant increase of MTPJ pressure. Those variations reflect the functional imbalance between bone structure and soft tissue in primary metatarsalgia. The biomechanical rationale of the shortening effect of DMMO could therefore be explained by the release of forefoot soft tissue, which could take part in the pain relief by restoring this balance.