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US is a widely available, commonly used, and indispensable imaging modality for breast evaluation. It is often the primary imaging modality for the detection and diagnosis of breast cancer in low-resource settings. In addition, it is frequently employed as a supplemental screening tool via either whole breast handheld US or automated breast US among women with dense breasts. In recent years, a variety of artificial intelligence systems have been developed to assist radiologists with the detection and diagnosis of breast lesions on US. This article reviews the background and evidence supporting the use of artificial intelligence tools for breast US, describes implementation strategies and impact on clinical workflow, and discusses potential emerging roles and future directions.

To evaluate the association between interpregnancy interval (IPI) and risk for gestational diabetes mellitus (GDM). We conducted a retrospective cohort study among singleton, non-anomalous, live birth pregnancies of 5,705,812 pregnant individuals in the United States from 2016 to 2018. We examined IPI of 4–

Objective To determine patient sociodemographic characteristics associated with breast imaging utilization on Saturdays to inform potential initiatives designed to improve access and reduce disparities in breast cancer care. Methods This was an IRB-approved retrospective cross-sectional study. All adult women (aged ≥18 years) who received a screening or diagnostic examination at our breast imaging facility from January 1, 2016 to December 31, 2017 were included. Patient characteristics including age, race, primary language, partnership status, insurance status, and primary care physician status were collected using the electronic medical record. Multiple variable logistic regression analyses were performed to evaluate patient characteristics associated with utilization. Results Of 53 695 patients who underwent a screening examination and 10 363 patients who underwent a diagnostic examination over our study period, 9.6% (5135/53 695) and 2.0% (209/10 363) of patients obtained their respective examination on a Saturday. In our multiple variable logistic regression analyses, racial/ethnic minorities (odds ratio [OR], 1.5; 95% confidence interval [CI]: 1.4–1.6; P Conclusion Racial/ethnic minorities and women who speak English as a second language were more likely to obtain their screening mammogram on Saturdays than their respective counterparts. Initiatives to extend availability of breast imaging exams outside of standard business hours increases access for historically underserved groups, which can be used as a tool to reduce breast cancer–related disparities in care.

Supplementary Table 1 from Ionizing Radiation Predisposes Nonmalignant Human Mammary Epithelial Cells to Undergo Transforming Growth Factor β–Induced Epithelial to Mesenchymal Transition

Transforming growth factor β1 (TGFβ) is a tumor suppressor during the initial stage of tumorigenesis, but it can switch to a tumor promoter during neoplastic progression. Ionizing radiation (IR), both a carcinogen and a therapeutic agent, induces TGFβ activation in vivo. We now show that IR sensitizes human mammary epithelial cells (HMEC) to undergo TGFβ-mediated epithelial to mesenchymal transition (EMT). Nonmalignant HMEC (MCF10A, HMT3522 S1, and 184v) were irradiated with 2 Gy shortly after attachment in monolayer culture or treated with a low concentration of TGFβ (0.4 ng/mL) or double treated. All double-treated (IR + TGFβ) HMEC underwent a morphologic shift from cuboidal to spindle shaped. This phenotype was accompanied by a decreased expression of epithelial markers E-cadherin, β-catenin, and ZO-1, remodeling of the actin cytoskeleton, and increased expression of mesenchymal markers N-cadherin, fibronectin, and vimentin. Furthermore, double treatment increased cell motility, promoted invasion, and disrupted acinar morphogenesis of cells subsequently plated in Matrigel. Neither radiation nor TGFβ alone elicited EMT, although IR increased chronic TGFβ signaling and activity. Gene expression profiling revealed that double-treated cells exhibit a specific 10-gene signature associated with Erk/mitogen-activated protein kinase (MAPK) signaling. We hypothesized that IR-induced MAPK activation primes nonmalignant HMEC to undergo TGFβ-mediated EMT. Consistent with this, Erk phosphorylation was transiently induced by irradiation and persisted in irradiated cells treated with TGFβ, and treatment with U0126, a MAP/Erk kinase (MEK) inhibitor, blocked the EMT phenotype. Together, these data show that the interactions between radiation-induced signaling pathways elicit heritable phenotypes that could contribute to neoplastic progression. [Cancer Res 2007;67(18):8662–70]

Due to the increasing rates of substance use disorders (SUDs), accidental overdoses, and associated high mortality rates, there is an urgent need for well-trained physicians who can grasp these complex issues and help struggling patients. Preparing these physicians occurs through targeted education and clinical exposure in conjunction with medical school curricula in the field of addiction medicine. Medical students can often feel overwhelmed by the medical school curriculum and changes to the curriculum take time, money, and administrative commitment to ratify. Implementing a student organization dedicated to SUD education can be a solution to provide clinical exposure, education and student autonomy in their medical school experience. At Wayne State University School of Medicine, Detroit vs. Addiction (DvA) is a student-run organization that is filling the gap in SUD education for medical students whilst providing assistance to the community. DvA not only extends clinical education for physicians in training, but it also provides the medical school with an opportunity to allow students to create a blueprint for education initiatives that can be incorporated as a mainstay in the school's technical trainings. Herein, we describe the evolution of this organization and its activities.

Objective To assess awareness and implementation of the American College of Surgeons Oncology Group Z0011 trial findings, approaches to axillary nodal imaging, and to identify differences in practice based on respondent characteristics. Methods An online survey was distributed to members of the Society of Breast Imaging. Questions regarded demographics, evaluation approaches, and impact of the Z0011 trial. Poisson regression with robust standard errors to regression was used to generate multivariable-adjusted relative risks and 95% confidence intervals (CIs) for associations. Results The response rate was 21.7% (430/2007). The majority (295/430, 68.6%) reported always performing axillary US in patients with a BI-RADS 4B, 4C, or 5 breast mass. Most respondents (299/430, 69.5%) were familiar with the findings of the Z0011 trial. Radiologists in academic practice were 0.67 (95% CI: 0.54–0.83) times less likely than private practice radiologists to perform axillary US in all masses and 1.31 (95% CI: 1.13–1.52) times more likely to be very familiar with the trial. Frequency of axillary US showed no association with time spent in breast imaging, years in practice, or presence of dedicated breast surgeons. Increased time in breast imaging and presence of dedicated breast surgeons was strongly associated with familiarity with the trial. No association was observed with years in practice. Most respondents (291/430, 67.7%) made little or no change to their practice based on trial findings. Conclusion There is wide variability in approaches to axillary nodal evaluation, demonstrating a need for improved education and guidelines for axillary imaging in breast cancer patients.

The treatment of emissions from natural gas engines is an important area of research since methane is a potent greenhouse gas. The benchmark catalysts, based on Pd, still face challenges such as water poisoning and long-term stability. Here we report an approach for catalyst synthesis that relies on the trapping of metal single atoms on the support surface, in thermally stable form, to modify the nature of further deposited metal/metal oxide. By anchoring Pt ions on a catalyst support we can tailor the morphology of the deposited phase. In particular, two-dimensional (2D) rafts of PdOx are formed, resulting in higher reaction rates and improved water tolerance during methane oxidation. The results show that modifying the support by trapping single atoms could provide an important addition to the toolkit of catalyst designers for controlling the nucleation and growth of metal and metal oxide clusters in heterogeneous catalysts. Despite its importance in the context of natural gas engines emissions treatment, methane oxidation remains challenging. Now, the authors introduce an approach to stabilize PdOx rafts on ceria by trapping Pt single atoms in the support resulting in a superior catalyst for this transformation.

Diaphragm wall was adopted for the subsurface excavation for LG06 underground station, one of the Wanda line stations in Taipei MRT, and it encountered many geological challenges during construction. The geological conditions in this zone are mostly clay and hard rock layer. The unconfined compression strengths of the extremely hard rock samples were tested during construction. The results were far beyond that obtained during site investigation, and hence is a big challenge for constructing the diaphragm wall. Furthermore, the Tai-power 161 kV high-voltage power cable box is longitudinally crossing the entire station zone. It leads to great difficulty during the construction of diaphragm walls. The neighbored houses are very close to the job site and cause a high risk of diaphragm wall construction. Engineers must find the solution to protect the Tai-power cable box and the adjacent houses to prevent any disasters. This paper presents how the borehole drilling method was adopted to conquer the complicated rock problem for diaphragm wall excavation. Engineers proposed a unique method by moving the rebar cage horizontally to avoid damaging the 161 kV power concrete box. Besides, a series of grouting piles with reinforcing bars were installed before excavating guide ditches for the diaphragm wall. With the innovative mitigations, the challenges, as mentioned earlier, have been mitigated. Sustainable construction technologies were successfully executed for the diaphragm wall of the LG06 station project, Wanda line of Taipei MRT.

We modify the partnership dissolution model pioneered by Cramton et al. (Econometrica 55:615–632, 1987) to consider the possibility that each partner has an optimal scale and hence values only a fraction of an object, called a block. To achieve efficiency, a partnership should be reorganized so that multiple blocks are allocated one-to-one to the partners who have the highest valuations. The set of initial ownership distributions under which efficient reorganization can be achieved is non-convex. A condition reveals the relationship between the possibility of efficient reorganization for any given partnership and three characteristics that it entails: the number of blocks available (K), the total number of partners (N), and the number of partners who own up to a block (S). Given that K and N are fixed, efficiency can be achieved if and only if S is sufficiently low. In addition, given that N and S are fixed, efficiency can be achieved if and only if K is sufficiently high.

This paper is dedicated to the memory of the Late Dr. Jonathan T.H. Wu in recognition of his outstanding contribution to the field of reinforced soil structures, especially for the geosynthetic-reinforced soil (GRS) structures with close reinforcement spacing. The objective of this paper is to introduce the sustainable characteristics of reinforced soil walls, including carbon emission, durability, ecology, vegetation, and landscape, which are less emphasized in the literature. In this paper, the sustainable/green characteristics of reinforced soil walls, using case examples from the ancient Great Wall to the modern GRS walls, are first discussed. The reasons for the extraordinary durability and stability of the ancient Great Wall, even though it was only reinforced by discontinuous (intermittent) natural materials, are investigated, and the reinforcing mechanism is discussed. A series of limit equilibrium analyses were performed to demonstrate the effect of closely spaced reinforcement on enhancing the system stability (i.e., the factor of safety). The results of this study reveal the reinforcements with close spacing could effectively confine the soil through the friction between the reinforcement and surrounding soil, and generate a moderate apparent cohesion to internally stabilize the soil mass, forming a stable soil-reinforcement composite. The findings above are supported by the pioneering works by Late Dr. Jonanthan Wu, who strongly advocated the superior merits of closely spaced GRS walls. In addition to the mechanical performance, several significant advantages of reinforced soil walls compared with traditional reinforced concrete retaining walls are discussed, with particular highlights in the aspects of the sustainable/green characteristics. The reinforced soil structure, especially with wrap-around facing on which vegetation can grow, is one of the vital green/sustainable geotechnology and is worth promoting and developing for the engineering practice worldwide.

The Lungmen Nuclear Power Plant (LNPP) Project is the fourth nuclear power plant project in Taiwan, with two sets of 1,350 MW Advanced Boiling Water Reactors designed by General Electric Company (G...

Rationale and Objectives We implemented a rapid abridged multiphase (RAMP) breast magnetic resonance imaging (MRI) protocol to reduce scan time and increase workflow efficiency. In this study, we compared delayed-phase kinetic analyses of benign and malignant lesions on the RAMP protocol versus a full dynamic contrast-enhanced (DCE) MRI protocol. Materials and Methods Consecutive breast MRI examinations obtained from October 2015 to August 2016 with tissue diagnoses of suspicious MRI lesions were identified. RAMP MRI included one precontrast and two postcontrast phases. Full DCE MRI included one precontrast and at least three postcontrast phases. Lesion kinetic analyses including mean delayed-phase volume percentage of washout, predominant curve type, and worst curve type were assessed. Kinetic analyses assessed on RAMP and DCE MRI protocols were compared using Wilcoxon rank-sum test and Chi-Square test. Receiver operating characteristic analysis was performed to discriminate benign and malignant lesions based on delayed-phase parameters. Results The study included 177 consecutive breast lesions (50 benign, 127 malignant) in 162 women. RAMP MRI (23 benign, 61 malignant) and DCE MRI examinations (27 benign, 66 malignant) demonstrated 8.4% vs 9.3% washout (p = 0.36) for benign lesions and 18.5% vs 17% washout (p = 0.66) for malignancies, respectively. There was no difference in the predominant and worst curve types for malignant and benign lesions or in area under the receiver operating characteristic curves for delayed-phased parameters between the two protocols (p > 0.05). Conclusion Lesion kinetic analyses from the RAMP MRI protocol can achieve the same discriminatory ability as the full DCE protocol. By reducing scan time, the RAMP MRI protocol improves patient comfort and enhances workflow efficiency and can be easily implemented in any clinical setting.

We introduce adaptive coding and modulation (ACM) to direct-detection passive optical networks (PONs) operating beyond 10 Gb/s per wavelength to allow each user to transmit at the highest possible bit rate and improve network reliability. Current fixed-rate PONs must allocate significant power margin to ensure reliable long-term operation over channels that vary over time and between users. Introducing adaptive-rate transceivers with ACM is a promising low-cost solution to increasing the overall capacity of optical access networks. The proposed ACM scheme uses two-, three-, or four-level pulse-amplitude modulation (2-, 3-, or 4-PAM) at a fixed symbol rate with direct detection and low-density parity check (LDPC) codes derived from a mother code by shortening and puncturing, decoded using fixed-initialization normalized min-sum decoding. The scheme supports received optical powers spanning a 10-dB range at bit rates of 20–54 Gb/s. In a PON with 64 users transmitting at a symbol rate of 30 Gbaud and a maximum transmission distance of 25 km, the ACM scheme demonstrates more than 3 dB improvement in overall optical power budget. For a fixed margin, ACM can increase throughput up to 60% compared to fixed-rate transmission, from 25 Gb/s to 39.7 Gb/s, or from 37.5 Gb/s to over 50 Gb/s, depending on the received optical power.

Axion Dark Matter eXperiment (ADMX) ultra low noise haloscope technology has enabled the successful completion of two science runs (1A and 1B) that looked for dark matter axions in the $2.66$ to $3.1$ $\mu$eV mass range with Dine-Fischler-Srednicki-Zhitnisky (DFSZ) sensitivity Ref. [1,2]. Therefore, it is the most sensitive axion search experiment to date in this mass range. We discuss the technological advances made in the last several years to achieve this sensitivity, which includes the implementation of components, such as state-of-the-art quantum limited amplifiers and a dilution refrigerator. Furthermore, we demonstrate the use of a frequency tunable Microstrip Superconducting Quantum Interference Device (SQUID) Amplifier (MSA), in Run 1A, and a Josephson Parametric Amplifier (JPA), in Run 1B, along with novel analysis tools that characterize the system noise temperature., Comment: 23 pages, 28 figures