Impact Of Different Techniques Research Articles

Is Quality of Life After Breast Reduction Influenced by Different Surgery's Technique? A Prospective Study.

Breast hyperplasia is a condition with a significant impact on the quality of life and psychological well-being of patients. Over time, various surgical techniques have been developed to reduce breast mass, which have proven effective in improving the quality of life of women undergoing the procedure. It is not yet well described how various techniques may influence the improvement in QoL (Quality of Life). The aim of this study is to assess the impact of different techniques on the improvement of quality of life. We analyzed the responses to the Breast-Q questionnaire from 95 patients undergoing breast reduction surgery between 2021 and 2023. The questionnaires were completed both before the procedure and during the 6-month follow-up. We assessed the questionnaire responses and overall satisfaction with the results, categorizing the data based on the specific surgical technique used. A statistically significant improvement in the quality of life was observed in the postoperative period, as well as a remarkable satisfaction with the outcome (mean score of 81 out of 100). We did not detect statistically significant differences in the levels of quality of life and satisfaction with the outcome among the various techniques. The breast reduction surgery procedure continues to prove its ability to significantly improve the quality of life for patients with breast hypertrophy, regardless of the specific surgical technique employed. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Exploring the Role of Dimensionality Reduction in Enhancing Machine Learning Algorithm Performance

In this study, we delve into the pivotal role of dimension reduction techniques in influencing the performance of machine learning algorithms for heart disease prediction. Through a comprehensive exploration of a dataset encompassing crucial features such as age, sex, chest pain type, blood pressure, cholesterol levels, and more, we investigate the impact of different techniques—namely, Principal Component Analysis (PCA), Kernel Principal Component Analysis (KPCA), and Linear Discriminant Analysis (LDA) on classification algorithm effectiveness. The classification algorithms considered were Logistic Regression, Support Vector Machine (SVM), k-Nearest Neighbors (KNN), Naive Bayes, and Deep Neural Network (DNN). We used K-fold cross validation to train and validate the classification algorithms. The performance of these algorithms was assessed using a range of key metrics including accuracy, F1-score, precision, recall, and specificity. The results reveals that Linear Discriminant Analysis consistently emerged as a potent method, remarkably enhancing algorithm performance across all assessed metrics. We also identified Naive Bayes and Logistic Regression as standout algorithms, demonstrating remarkable resilience and reliability across diverse scenarios. These findings collectively shed light on the intricate interplay between dimension reduction techniques and algorithm selection, offering critical insights for crafting more accurate and robust strategies in the prediction of heart disease.

Impact of palatoplasty techniques on tympanic membrane findings and hearing prognosis in children with cleft palate.

Children with cleft palate (CP) are at high risk of developing otitis media with effusion (OME) due to Eustachian tube (ET) dysfunction. Palatoplasty has been reported to decrease the frequency of middle ear disease and improve ET function, and although various techniques have been developed, there is no consensus on the differences in the impact of different techniques on the middle ear. The purpose of this study was to determine the differential effects of palatoplasty on middle ear function and hearing. We performed a retrospective observational survey of pediatric patients who underwent palatoplasty for CP between June 2010 and October 2018at Tohoku University Hospital. Cases were divided into three groups depending on the palatoplasty procedures performed: the push-back palatoplasty group, the two-flap palatoplasty group, and the Furlow double-opposing Z-plasty group. We examined the differences in clinical characteristics between patients who underwent each procedure. The primary outcome variable was tympanic membrane (TM) findings, and the secondary outcome was hearing test results. Children who underwent the two-flap palatoplasty had a higher tympanostomy tube (TT) insertion rate and a higher total number of TT insertions than those who underwent the Furlow double-opposing Z-plasty or the push-back palatoplasty. The TM retraction rate tended to be lower in the Furlow double-opposing Z-plasty group than in the push-back palatoplasty group or the two-flap palatoplasty group. The hearing test results at the last visit were not significantly different among the three groups. Children who underwent the two-flap palatoplasty had a higher rate of TT insertions, potentially increasing the risk of TM perforation. In contrast, the Furlow double-opposing Z-plasty group had a lower tendency for TM regression, possibly due to improved ET function and reduced incidence of OME. It is important to understand the advantages and disadvantages of each technique before selecting one suitable for the child's cleft and arch width. Additionally, it is important to conduct regular follow-up of TM findings and hearing test results even after palatoplasty.

Risk of malignancy assessment of the different cytologic categories in respiratory cytology samples according to the new guidelines of the Papanicolaou Society of Cytopathology.

Cytology is extremely important for diagnosis of lung carcinoma and the Papanicolaou Society of Cytopathology (PSC) had proposed a new classification system for respiratory cytology for better communication between physicians and better patient management. The objective of this study is to analyze our samples in accordance with this classification and to evaluate the diagnostic accuracy of various cytologic techniques and to assess the risk of malignancy. Eight hundred and twenty respiratory cytology specimens (FNA, BAL, washing, brushing, sputum) collected between 2019 and 2022 were classified according to the PSC system and the risk of malignancy was assessed for each category using follow-up surgical samples. Sensitivity, specificity, and accuracy rates were determined based on a categorial approach, according to a similar study. The data of 820 respiratory cytology specimens from 576 patients were analyzed. 2.6% of these were non-diagnostic, 64.1% were NM, 5% were AC, 0.4% were N-B-LG, 4% were SM and 23.9% were ML. The risk of malignancy for each diagnostic category were: 42.8% for non-diagnostic, 31.2% for NM, 43.9% for AC, 87.9% for SM, 94.3% for ML. Sensitivity and specificity was calculated using only the malignant cases considered as positive tests and was 45.57% and 97.34% respectively. Our results correlated with the PSC system, and it was considered useful in clinical practice. However, more studies should be performed to evaluate the usefulness of this system. The ROMs of each category and the impact of different techniques should be further studied.

The Impact of Venous Anastomosis Technique on Outcomes of Free Tissue Transfer to the Head and Neck.

Objectives: To evaluate the impact of different techniques of microvascular venous anastomosis on the outcome of free tissue transfer to the head and neck. Methods: Retrospective case series of patients undergoing microvascular free tissue transfer (MFTT) from January 2006 to September 2021. Chi-square tests and t-tests were utilized to identify differences in flap outcomes by technique, and log-binomial regression analyses were utilized to identify differences in flap outcomes by technique. Results: A total of 1055 consecutive MFTTs were analyzed. One hundred four cases required a return to the operating room for any reason, and 19 were attributed to venous compromise (18.0%). Ultimately, there were 22 FTT failures requiring complete revision (2.1%). In total, 1055 MFTTs involved 1352 venous anastomoses, ranging from 1 to 3 anastomoses in each case. End-to-end (ETE) was used 1040 times (76.9%) and end-to-side (ETS) 204 times (15.0%). The calculated risk ratio for venous complication for ETS compared with ETE was 1.17 (0.34-3.98). A microvascular coupler was used in 355 cases (33.6%). The calculated risk ratio for coupler compared with suture anastomoses was 0.92 (0.35-2.39). Conclusions: There were no significant difference in regard to outcomes of MFTT when comparing ETE with ETS, nor when comparing coupler with suture anastomoses.

Exploring Preprocessing Techniques for Natural LanguageText: A Comprehensive Study Using Python Code

The paper highlights the significance of efficient text preprocessing strategies in Natural Language Processing (NLP), a field focused on enabling machines to understand and interpret human language. Text preprocessing is a crucial step in converting unstructured text into a machine-understandable format. It plays a vital role in various text classification tasks, including web search, document classification, chatbots, and virtual assistants. Techniques such as tokenization, stop word removal, and lemmatization are carefully studied and applied in a specific order to ensure accurate and efficient information retrieval. The paper emphasizes the importance of selecting and ordering preprocessing techniques wisely to achieve high-quality results. Effective text preprocessing involves cleaning and filtering textual data to eliminate noise and enhance efficiency. Furthermore, it provides insights into the impact of different techniques, such as raw text, tokenization, stop word removal, and stemming, using a Python implementation.

Handoff and Deposit: Designing Temporal Coordination in Cross-Device Transfer Techniques for Mixed-Focus Collaboration

When working together, people frequently share information with each other to enable division of labour, assistance, and delegation of responsibility. The literature has explored both synchronous and asynchronous transfer techniques, known as Handoff and Deposit, respectively. However, current cross-device environments tend to only provide a single mechanism. Moreover, we have little understanding of the impact of different techniques on collaborative process. To understand how Handoff and Deposit may be designed to support complex sensemaking tasks, we followed a Research through Design process to iteratively design Handoff and Deposit techniques using paper and digital sketches and high-fidelity prototypes. We consulted the HCI literature to corroborate our findings with studies and descriptions of existing cross-device transfer designs and to understand the potential impact of those designs on mixed-focus collaboration. We learned that as we move away from a restricted physical workspace and leverage the flexibility of digital personal devices, there is a large design space for realizing cross-device transfer. To inform these designs, we provide five design considerations for cross-device transfer techniques: Transfer Acceptance, Action Dependencies, Immediate Usability, Interruption Potential, and Connection Actions.

A data driven Dantzig–Wolfe decomposition framework

We face the issue of finding alternative paradigms for the resolution of generic Mixed Integer Programs (MIP), by considering the perspective option of general purpose solvers which switch to decomposition methods when pertinent. Currently, the main blocking factor in their design is the problem of automatic decomposition of MIPs, that is to produce good MIP decompositions algorithmically, looking only at the algebraic structure of the MIP instance. We propose to employ Dantzig–Wolfe reformulation and machine learning methods to obtain a fully data driven automatic decomposition framework. We also design strategies and introduce algorithmic techniques in order to make such a framework computationally effective. An extensive experimental analysis shows our framework to grant substantial improvements, in terms of both solutions quality and computing time, with respect to state-of-the-art automatic decomposition techniques. It also allows us to gain insights into the relative impact of different techniques. As a side product of our research, we provide a dataset of more than 31 thousand random decompositions of MIPLIB instances, with 121 features, including computations of their root node relaxation.

Making the most of comparable corpora in Neural Machine Translation: a case study

Comparable corpora can benefit the development of Neural Machine Translation models, in particular for under-resourced languages. We present a case study centred on the exploitation of a large comparable corpus for Basque-Spanish, created from independently-produced news by the Basque public broadcaster eitb, where we evaluate the impact of different techniques to exploit the original data, in order to complement parallel datasets for this language pair in both translation directions. Two efficient methods for parallel sentence mining are explored, which identified a common core of approximately half of the total number of aligned sentences, each one uniquely identifying valid parallel sentences not captured by the other method. Filtering the data via identification of length-difference outliers proved highly effective to improve the models, as was the use of tags to discriminate between comparable and parallel data in the training corpora. The use of backtranslated data is also evaluated in this work, with results indicating that alignment-based datasets remain the most beneficial, although complementary backtranslations should also be included to fully exploit the available comparable data. Overall, the results in this work demonstrate that this type of data needs to be carefully analysed prior to its use as training data for Neural Machine Translation, since issues such as information imbalance between source and target data can lead to unoptimal results for a given translation pair.

Послеоперационный делирий и когнитивные нарушения при применении регионарных техник послеоперационного обезболивания

Актуальность. Послеоперационный делирий (ПОД) — одно из самых распространенных осложнений после оперативных вмешательств у пациентов пожилого возраста. Цель работы: оценить влияние различных техник регионарной аналгезии на инцидентность послеоперационного делирия и уровень когнитивных нарушений у пациентов пожилого возраста. Материалы и методы. В одноцентровое проспективное исследование были последовательно включены 70 пациентов пожилого возраста, которым выполнялись оперативные вмешательства на органах брюшной полости в ургентном порядке. В зависимости от метода периоперационной аналгезии все больные были разделены на 2 основные группы: контрольную (n = 30) и исследовательскую (n = 40), в которой периоперационно применяли одну из техник регионарной аналгезии — блокаду передней брюшной стенки (подгруппа РА, n = 20) или эпидуральную аналгезию (подгруппа ЭА, n = 20). Результаты. Исходный когнитивный статус пациентов подгруппы ЭА достоверно не отличался от аналогичного показателя в группе контроля и составил 3,0 [3,0; 4,0] балла. В дальнейшем он постепенно улучшался, достигнув 4,0 [3,0; 5,0] балла (р = 0,04) на пятый послеоперационный день. Когнитивный статус пациентов подгруппы РА перед операцией был получше (4,0 [3,0; 4,5] балла), однако тоже достоверно не отличался от аналогичного показателя ни в группе контроля, ни в подгруппе ЭА. Как оказалось, у пациентов обеих подгрупп когнитивные способности на 5-е сутки были даже лучше, чем перед операцией (p ˂ 0,05). Такое улучшение прежде всего связано с прекращением действия важного фактора влияния на когнитивный статус — боли. Выводы. У пациентов пожилого возраста после ургентных оперативных вмешательств при применении эпидуральной аналгезии инцидентность ПОД составляет 5 % и при применении блокад передней брюшной стенки — 10 %. Когнитивная функция пациентов при применении регионарных техник послеоперационного обезболивания восстанавливается на третьи сутки после операции и улучшается на пятые послеоперационные сутки (p < 0,05).

The Impact of Different Techniques of Soil Management on Soil Fertility and the Associated Bacterial Communities in Semi-arid Olive Tree Fields

A remarkable decrease in olive production has been observed in Tunisia since 2000, particularly in the semi-arid region. This downfall was mainly due to a notable change in climatic conditions as a result of wind erosion and over cultivation. The aim of this work was to study the biological, physical, and chemical properties of several semi-arid soils from olive tree fields subjected to different farming practices, such as crop time and type of crop, olive mill wastewater (OMW) application rates, and tillage timing and depth (deep or conventional plowing). We noted that hydraulic conductivity (HC) was proportional to the age of the soil tillage, and the highest values were recorded in the soil cultivated for 100 years, with an average value of 33.05 ± 0.02 mm h−1. An important increment of the iron soil content was observed, especially after the fig tree introduction among the olive trees (12,094 ng μL−1) in 2007. Also, a significant increase of the organic matter (OM) content (up to2.6 mg-OM/g-soil) was identified in soil treated with OMW compared to the lowest OM content (0.83 mg-OM/g-soil) recorded in the soil cultivated since 1901. The bacterial communities of the different soils were characterized by 454 pyrosequencing technology, and showed an important diversity, mainly corresponding to Proteobacteria, Actinobacteria, and Acidobacteria. Many operational taxonomic units (OTUs) are raretons, indicating a high resilience of the soil bacterial communities. Statistical analyses showed significant correlations with the different soil parameters. However, an unexpected correlation was determined between soil respiration and OM (r = − 0.583*), suggesting that OM increases the retention of CO2, a greenhouse gas. The farming techniques analyzed in this study resulted in a reduction of the bacterial diversity, even though the total bacterial biomass augmented.

Impact of Lesion Preparation Technique on Side Branch Compromise in Calcified Coronary Bifurcations: A Subgroup Analysis of the PREPARE-CALC Trial.

Objectives To analyze the impact of different techniques of lesion preparation of severely calcified coronary bifurcation lesions. Background The impact of different techniques of lesion preparation of severely calcified coronary bifurcation lesions is poorly investigated. Methods We performed an as-treated analysis on 47 calcified bifurcation lesions treated with scoring/cutting balloons (SCB) and 68 lesions treated with rotational atherectomy (RA) in the PREPARE-CALC trial. Compromised side branch (SB) as assessed in the final angiogram was the primary outcome measure and was defined as any significant stenosis, dissection, or thrombolysis in myocardial infarction flow <3. Results True bifurcation lesions were present in 49% vs. 43% of cases in the SCB and RA groups, respectively. After stent implantation, SB balloon dilatation was necessary in around one-third of cases (36% vs. 38%; p = 0.82), and a two-stent technique was performed in 21.3% vs. 25% (p = 0.75). At the end of the procedure, the SB remained compromised in 15 lesions (32%) in the SCB group and 5 lesions (7%) in the RA group (p = 0.001). Large coronary dissections were more frequently observed in the SCB group (13% vs. 2%; p = 0.02). Postprocedural levels of cardiac biomarkers were significantly higher in patients with a compromised SB at the end of the procedure. Conclusions In the PREPARE-CALC trial, side branch compromise was more frequently observed after lesion preparation with SCB as compared with RA. Consequently, in calcified bifurcation lesions, an upfront debulking with an RA-based strategy might optimize the result in the side branch.

P1523 Impact of different techniques for mitral valve repair on left ventricular function: a 2D/3D echocardiographic analysis

Abstract Funding Acknowledgements None Aim Different surgical techniques are available for mitral valve (MV) repair in patients with degenerative severe mitral regurgitation (MR). Leaflet resection (LR) and neochordoplasty (NP), both including ring annuloplasty (RA), are the most frequently performed techniques for posterior mitral leaflet prolapse/flail repair. Despite NP technique is supposed to preserve LV physiology more than LR, it is unclear which technique provides the best haemodynamic pattern. In the present study, the results of the two different surgical techniques in terms of left ventricular (LV) dimension and function are investigated. Methods 23 consecutive patients who underwent MV surgical repair were enrolled. All patients underwent, before surgery and after 8 ± 2 months, 2D and 3D echocardiography with automatic (Heart Model, Philips) assessment of LV volumes and ejection fraction (EF), left atrial (LA) volume, right ventricular (RV) dimension and function, pulmonary artery systolic pressure (PASP), MR, tricuspid regurgitation (TR) and MVPG quantification. MR was corrected using 1) NP with polytetrafluoroethylene sutures and 2) triangular LR, both with RA. Patients were divided in 2 groups according to the surgical technique. Results: techniques were able to successfully correct MR. There were no significant differences in baseline echocardiogram and demographic characteristics between the two groups. There were no significant differences in terms of post-surgical MVPG between the two groups. In all patients a trend in reduction in LV dimension at follow-up was observed, but it was statistically significant only in NP patients (pre-surgical EDV 150 ± 41 VS post-surgical EDV 100 ± 27 ml, p = 0.03). Conclusions Both MV repair techniques showed a successful MV repair and an improvement in LV volumes at follow-up, especially in NP group. Further perspective studies are necessary to demonstrate the hypothesis of more physiological haemodynamic pattern associated with NP techniques. Echo parameters pre VS post MV Repair Parameter pre post p value LVEDV RN (ml) 150 ± 41 100 ± 27 0.03 LVESV RN (ml) 58 ± 20 46 ± 14 NS LVEF RN (%) 58 ± 8 55 ± 7 NS LVEDV RR (ml) 160 ± 58 118 ± 31 NS LVESV RR (ml) 62 ±11 51 ±13 NS LVEF RR (%) 59 ± 8 57 ± 4 NS EDV: end-diastolic volume, ESV: end-systolic volume, EF: ejection fraction, RN = Ring + Neochordae; RR= Ring + Resect.

Biopsy techniques in the upper urinary tract for the diagnosis of urothelial carcinoma: systematic review

The diagnostic accuracy of ureteroscopic biopsies in the upper urinary tract is limited by technical difficulties during extraction and small sample size. To evaluate the impact of different techniques and instruments on the histopathologic quality and diagnostic yield of extracted samples as well as the predictive value of clinical grading and staging on final pathologic stage at radical nephroureterectomy. For this systematic review, we searched PubMed and Embase databases for original publications and meeting abstracts according to the PRISMA guidelines. Overall, we included 23studies which comprised atotal of 1547 biopsies for the investigation of diagnostic yield and 778 patients for the assessment of grade and stage concordance. We found that the median diagnostic yields of big retrograde 2F [french] forceps, antegrade 3F forceps and baskets in combination with forceps were 92% (range 83-100), 72% (50-90) and 91% (78-94), respectively. Median rates of grade concordance and upgrading across all techniques ranged between 78-89% and 5-16%, respectively, without relevant differences. The choice of biopsy technique affects the ability to diagnose upper tract urothelial carcinoma. The correct determination of pathologic grading is comparable between different techniques. The combination of biopsy forceps and baskets during ureterorenoscopy seems to achieve optimal diagnostic accuracy.

Noise Power Estimators in ISM Radio Environments: Performance Comparison and Enhancement Using a Novel Samples Separation Technique

Noise power estimation is central to efficient radio resource allocation in modern wireless communication systems. In the literature, there exist many noise power estimation methods that can be classified based on underlying theoretical principle; the most common are spectral averaging, eigenvalues of sample covariance matrix, information theory, and statistical signal analysis. However, how these estimation methods compare against each other in terms of accuracy, stability, and complexity is not well studied, and the focus instead remains on the enhancement of individual methods. In this paper, we adopt a common simulation methodology to perform a detailed performance evaluation of the prominent estimation techniques. The basis of our comparison is the signal-to-noise ratio estimation in the simulated industrial, scientific and medical band transmission, while the reference noise signal is acquired from an industrial production plant using a software-defined radio platform, USRP-2932. In addition, we analyze the impact of different techniques for noise-samples’ separation on the estimation process. As a response to defects in the existing techniques, we propose a novel noise-samples’ separation algorithm based on the adaptation of rank-order filtering. Our analysis shows that the proposed solution, apart from its low complexity, has a very good root-mean-squared error of 0.5 dB and smaller than 0.1-dB resolution, thus achieving a performance comparable with the methods exploiting information theory concepts.

Quality of Care for Cervical and Endometrial Cancer Patients: The Impact of Different Techniques of Sentinel Lymph Node Mapping on Patient Satisfaction.

The purpose of this study was to assess the quality of care in patients who underwent sentinel lymph node (SLN) mapping for endometrial and cervical cancer staging, and evaluate the impact of different techniques on patient satisfaction, i.e. radiotracer Tc99m versus indocyanine green (ICG) or methylene blue injection. Women with preoperative stage I endometrial cancer or stage I (1A2-1B1) cervical cancer who underwent surgical staging, including SLN mapping, were considered for this study. Patient satisfaction was assessed using the European Organisation for Research and Treatment of Cancer IN-PATSAT32 questionnaire. Women were classified into two groups according to the different nodal mapping techniques: intracervical preoperative injection of Tc99m nanocolloid+intraoperative blue dye (Group 1) versus intraoperative cervical injection of ICG or bluedye (Group 2). Differences in patient satisfaction scores between the groups were analyzed. Of the 178 eligible women, 143 were included in the study (endometrial cancer n=106, cervical cancer n=37): 57 underwent SLN mapping with Tc99m and blue dye (Group 1), and 86 women were mapped intraoperatively with blue dye alone or ICG (Group 2). Analysis of IN-PATSAT32 questionnaire scores showed a higher patient satisfaction score for patients in Group 2 (p=0.001), which was independent of the physician and surgical outcomes evaluated. The scores were statistically better for Group 2, and also in rating doctors (p=0.0001), nurses (p=0.006), and care and services organizations (p=0.001). Cervical and endometrial cancer patients who underwent SLN mapping by ICG or blue dye perceived a better quality of care when compared with those patients who underwent the combined radiocolloid and blue dye technique.

Impact of different techniques involving contact with lees on the volatile composition of cider

The effect of different treatments involving contact with natural lees on the aromatic profile of cider has been evaluated. Comparing with the untreated ciders, the contact with lees brought about a significant increase of the concentrations of most of the volatile compounds analysed, in particular fatty acids, alcohols, ethyl esters and 3-ethoxy-1-propanol. The opposite was observed among fusel acetate esters and 4-vinylguaiacol. The addition of β-glucanase enhanced the increase of ethyl octanoate, but produced a decrease in the contents of decanoic acid and all of the major volatiles excepting acetaldehyde, ethyl acetate and acetoine, whereas the application of oxygen influenced the rise of the level of 3-ethoxy-1-propanol only. The olfactometric profiles also revealed significant effects of the treatment with lees for ethyl propionate, diacetyl, cis-3-hexenol, acetic acid, benzyl alcohol, and m-cresol, while the addition of oxygen significantly influenced the perception of ethyl hexanoate, 1-octen-3-one, 3-methyl-2-butenol, t-3-hexenol and c-3-hexenol.

Toward the complete proteome of Synechocystis sp. PCC 6803.

The proteome of the photosynthetic model organism Synechocystis sp. PCC6803 has been extensively analyzed in the last 15years for the purpose of identifying proteins specifically expressed in subcellular compartments or differentially expressed in different environmental or internal conditions. This review summarizes the progress achieved so far with the emphasis on the impact of different techniques, both in sample preparation and protein identification, on the increasing coverage of proteome identification. In addition, this review evaluates the current completeness of proteome identification, and provides insights on the potential factors that could affect the complete identification of the Synechocystis proteome.

The impact of method of biopsy on the incidence of breast cancer sentinel lymph node metastases

The dislocation of the malignant cells along the needle tract during breast cancer (BC) diagnosis has been demonstrated by several studies. However, the published experiences that relate the diagnostic technique with sentinel node (SN) involvement are few and controversial. The aim of our analysis was to evaluate the impact of different techniques for preoperative BC biopsy among prognostic factors of metastases occurrence in SN. We reviewed the institutional clinical database of our Center. A total of 674 patients were diagnosed between February 1999 and December 2006 with invasive BC. SN metastases classification followed the 2002 American Joint Committee on Cancer (AJCC) TNM pathological staging: macrometastases, micrometastases, isolated tumor cells or negative. Only macrometastases and micrometastases were considered positive. Concerning fine-needle aspiration cytology, we used disposable needles of the size of 21-27G. For percutaneous biopsy we used cutting needle type "tru-cut"; the Gauge needle ranged between 14 and 20. At univariate analysis of specific parameters using positive SN as outcome, percutaneous diagnostic technique did not affect significantly the SN positivity (p=0.60). At multivariate models only central quadrant lesion (p=0.005) and lymph vascular invasion (LVI) presence (p<0.0001) maintained the statistical significance as risk factor for positive SN status. Polytomic logistics models showed that only LVI maintained the statistical significance both for prediction of micrometastases and macrometastases. Our analysis showed that different techniques used for BC diagnosis did not influence SN status.

Solar irradiance reduction via climate engineering: Impact of different techniques on the energy balance and the hydrological cycle

Different techniques of solar radiation management (SRM) have been suggested to counteract global warming, among them the injection of sulfur into the stratosphere, mirrors in space, and marine cloud brightening through artificial emissions of sea salt. This study focuses on to what extent climate impacts of these three methods would be different. We present results from simulations with an Earth system model where the forcing from the increase of greenhouse gases in a transient scenario (RCP4.5) was balanced over 50 years by SRM. While global mean temperature increases slightly due to the inertia of the climate system and evolves similar with time for the different SRM methods, responses of global mean precipitation differ considerably among the methods. The hydrological sensitivity is decreased by SRM, most prominently for aerosol‐based techniques, sea salt emissions, and injection of sulfate into the stratosphere. Reasons for these differences are discussed through an analysis of the surface energy budget. Furthermore, effects on large‐scale tropical dynamics and on regional climate are discussed.