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Non-invasive transabdominal fetal pulse oximetry (TFO) can provide physicians with a better metric of fetal well-being than currently-used fetal monitoring methods. There are two major challenges in this light-based measurement modality. One is in detecting the weak fetal signal at the surface of the maternal abdomen, and the other is in recovering the fetal signal from the diffuse reflectance measured, which contains a mixture of information about both maternal and fetal tissue. In this paper, we describe the TFO system we developed and evaluate its ability to recover the fetal signal in a preclinical setting. In particular, we assess its capability to measure the fetal signal over several thicknesses of maternal tissue and gauge the effectiveness of different approaches in removing the maternal influence from the mixed signal. Our results show that our TFO system, built using commodity low-cost components, can measure the highly-attenuated fetal signal through maternal tissue as thick as 5 cm. Furthermore, we determine that adaptive noise cancellation techniques are the most effective for separating the fetal signal from the maternally-influenced noise. These findings strongly support our TFO system's ability to perform well on a variety of different pregnant body types.

Commercial-off-the-shelf (COTS) materials were evaluated as surface samplers for the Department of Homeland Security Chemical Forensics Program. The program helps evidence collectors identify trace chemical residues at incident scenes. COTS items are widely available, produced in large lots, and with strict controls. Chemical attribution signatures were collected from common surfaces. Eight tape lift candidates were considered, five were chosen based on performance and tested for analytical interferences and extraction efficiencies with 14 chemicals. Three products (duct tape, print lifters, command strips) were evaluated for uptake from common interior surfaces (glass, tile, ABS plastic). Duct tape provided highest recoveries across all surfaces. Even the most volatile analytes were detected in the ABS plastic samples (nondetections in others), regardless of tape lift material used. The porous plastic substrate provides better target retention than glass and tile surfaces. Forensic field operators should sample surfaces made of ABS plastic (keyboards, remotes, phones, etc.) whenever possible.

The UK healthcare system holds a favorable position in the development of stratified medicines through strong scientific innovation, robust biotechnology and pharmaceutical industries and comparatively simple regulatory and reimbursement processes. Organizations such as its robust health technology assessment agency, the NICE and its mature socialized healthcare system, the National Health Service, enable innovative medicines, including stratified treatments for cancer and infectious disease, to be rapidly assessed for their effectiveness and value to patients in the UK. However, our recent observations with a variety of UK healthcare stakeholders suggest that certain features need to be improved if the favorable position in stratified medicine development, and consequential beneficial outcome to patients, is to be sustained and indeed further enhanced to a position of pre-eminence. Key changes suggested are removing healthcare silos and enabling multidisciplinary teams to translate scientific and medical innovation into the best practice; expanding the UK skill base in certain disciplines including medical pathology, health economics and clinical informatics; and using successful pilot cases of stratified medicines to better educate stakeholders in a drive to change healthcare culture. Through this cultural change, the UK would offer healthcare based on prediction and prevention rather than symptom-based diagnosis and reactive treatment.

Background Unplanned hospital readmissions after surgical treatment for breast cancer are an indicator of morbidity. We explore the relationship between the rate of unplanned hospital readmissions within 42 days of initial treatment and various factors, including tumor size and histology, lymph node involvement, type of surgical treatment, mastectomy, or breast-conserving surgery, and patient demographics. Methods Linked Western Australian cancer mortality and hospital morbidity data were used in the assessment of readmissions within a period of 42 days after initial surgical treatment for breast cancer. Planned admissions for adjuvant treatment such as chemotherapy or radiotherapy were deleted. Survival models for multiple events per subject were applied to analyze the data. Results The analysis reveals that patients more likely to experience lower recurrence of short-term unplanned hospital readmissions include those with smaller tumors, private insurance, and who reside in metropolitan areas. The model also includes important two-way interaction terms involving tumor histology, area of residence, and surgical treatment, and between lymph node involvement and patient age. Conclusions This study suggests that the choice of breast-conserving surgery as a treatment for breast cancer does not invariably result in better postoperative morbidity, but rather, that other factors, including tumor size and patient demographics, play a critical role in the short term. These results differ from a previous study of longterm hospital readmissions—country of birth and method of payment were found to be associated with short-term hospital admission but not with longterm readmissions.

The focus of this study was the relative survival rates of breast cancer patients whose treatment was breast-conserving surgery compared with that of mastectomy, adjusting for tumor size and nodal status because these factors may be intrinsically associated with mastectomy being the treatment of choice. Patient age was also accounted for in the model. By adjusting for these factors, we mitigate them as confounders of treatment choice in assessing effects on survival rates. Data were sourced from linked administrative data from the Western Australian Department of Health Record Linkage Unit. The data consisted of linked records containing the diagnosis, subsequent hospital admission, and death records of about 3000 women diagnosed with cancer in Western Australia between 1 January 1995 and 31 December 1999. Cox proportional hazards regression was used to investigate survival outcomes of breast-conserving surgery compared with that of mastectomy, adjusting for tumor size, nodal status, and subject age. The hazard of death is reduced by a factor of about one half for subjects whose treatment was breast-conserving surgery over treatment by mastectomy. Furthermore, the hazard of death increases substantially for subjects with nodal involvement over subjects for whom there has been no identified spread to regional lymph nodes. Hazard of death increases as both age and tumor size increase. Western Australian breast cancer patients treated with breast-conserving surgery have improved survival outcomes over those treated with mastectomy, after allowing for tumor size, patient age, and lymph node involvement.

Background A critical choice facing breast cancer patients is which surgical treatment – mastectomy or breast conserving surgery (BCS) – is most appropriate. Several studies have investigated factors that impact the type of surgery chosen, identifying features such as place of residence, age at diagnosis, tumor size, socio-economic and racial/ethnic elements as relevant. Such assessment of "propensity" is important in understanding issues such as a reported under-utilisation of BCS among women for whom such treatment was not contraindicated. Using Western Australian (WA) data, we further examine the factors associated with the type of surgical treatment for breast cancer using a classification tree approach. This approach deals naturally with complicated interactions between factors, and so allows flexible and interpretable models for treatment choice to be built that add to the current understanding of this complex decision process. Methods Data was extracted from the WA Cancer Registry on women diagnosed with breast cancer in WA from 1990 to 2000. Subjects' treatment preferences were predicted from covariates using both classification trees and logistic regression. Results Tumor size was the primary determinant of patient choice, subjects with tumors smaller than 20 mm in diameter preferring BCS. For subjects with tumors greater than 20 mm in diameter factors such as patient age, nodal status, and tumor histology become relevant as predictors of patient choice. Conclusion Classification trees perform as well as logistic regression for predicting patient choice, but are much easier to interpret for clinical use. The selected tree can inform clinicians' advice to patients.