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At least 235 records · Page 13

Impact of Insurance Status on Radiation Treatment Modality Selection Among Potential Candidates for Prostate, Breast, or Gynecologic Brachytherapy

Purpose: The Patient Protection and Affordable Care Act looks to expand both private and Medicaid insurance. To evaluate how these changes may affect the field of radiation oncology, we evaluated the association of insurance status with the use of brachytherapy in cancers for which this treatment technique is used. Methods and Materials: A total of 190,467 patients met the inclusion criteria, of whom 95,292 (50.0%) had breast cancer, 61,096 (32.1%) had prostate cancer, 28,194 (14.8%) had endometrial cancer, and 5885 (3.1%) had cervical cancer. A multivariate logistic regression model was used to determine the association between insurance status and receipt of brachytherapy among patients treated definitively for prostate and cervical cancer or postoperatively for breast and endometrial cancer. Results: The rates of non-Medicaid insurance were 49.9% (cervical), 85.3% (endometrial), 87.4% (breast), and 90.9% (prostate) (P<.001). In a logistic regression, patients who received radiation therapy were less likely to receive brachytherapy if they had Medicaid coverage (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.53-0.61, P<.001) or did not have insurance coverage (OR 0.50, 95% CI 0.45-0.56, P<.001) compared with those with non-Medicaid insurance. On subset analysis, patients with Medicaid coverage or without insurance coverage were significantly less likely to receive brachytherapy than were those with non-Medicaid insurance for all 4 sites, except for patients with endometrial cancer. Conclusions: Despite being a cost-effective treatment modality, brachytherapy is less often used in the definitive or postoperative management of cancer in patients with Medicaid coverage or without insurance. Upcoming health policy changes resulting in the expansion of private insurance and Medicaid will likely increase access to and demand for brachytherapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Radical Cystectomy Compared to Combined Modality Treatment for Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis

Purpose: To perform a comprehensive comparison of overall survival (OS), disease-specific survival (DSS), progression-free survival (PFS), and treatment-related complications between radical cystectomy (RC) and combined modality treatment (CMT—radiation therapy, concurrent chemotherapy, and maximal transurethral resection of bladder tumor) in the setting of muscle-invasive bladder cancer. Methods and Materials: We searched 7 databases (PubMed, Scopus, EMBASE, Proquest, CINAHL, and (ClinicalTrials.gov)) for randomized, controlled trials and prospective and retrospective studies directly comparing RC with CMT from database inception to March 2016. We conducted meta-analyses evaluating OS, DSS, and PFS with hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Nineteen studies evaluating 12,380 subjects were selected. For the 8 studies encompassing 9554 subjects eligible for meta-analyses, we found no difference in OS at 5 years (HR 0.96, favoring CMT, 95% CI 0.72-1.29; P=.778) or 10 years (HR 1.02, favoring cystectomy, 95% CI 0.73-1.42; P=.905). No difference was observed in DSS at 5 years (HR 0.83, favoring radiation, 95% CI 0.54-1.28; P=.390) or 10 years (HR 1.17, favoring cystectomy, 95% CI 0.89-1.55; P=.264), or PFS at 10 years (HR 0.85, favoring CMT, 95% CI 0.43-1.67; P=.639). The cystectomy arms had higher rates of early major complications, whereas rates of minor complications were similar between the 2 treatments. Conclusion: Current meta-analysis reveals no differences in OS, DSS, or PFS between RC and CMT. Further randomized, controlled trials are necessary to identify the optimal treatment for specific patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Long-Term Outcomes of Patients With Early Stage Nonbulky Hodgkin Lymphoma Treated With Combined Modality Therapy in the Stanford V Trials (the G4 and G5 Studies)

Combined modality therapy (CMT) is standard therapy for early-stage Hodgkin lymphoma (ESHL). We previously reported excellent outcomes with the abbreviated Stanford V regimen. Herein we report updated results with median follow-up >10 years on survival, therapy-related late effects, and impact of disease risk factors on patient outcomes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Entropy stable modal discontinuous Galerkin schemes and wall boundary conditions for the compressible Navier-Stokes equations

Entropy stable schemes ensure that physically meaningful numerical solutions also satisfy a semi-discrete entropy inequality under appropriate boundary conditions. Here in this work, we describe a discretization of viscous terms in the compressible Navier-Stokes equations which enables a simple and explicit imposition of entropy stable no-slip and reflective (symmetry) wall boundary conditions for discontinuous Galerkin (DG) discretizations. Specifically, we derive methods for imposing adiabatic no-slip and reflective (symmetry) boundary conditions for modal entropy stable DG formulations which preserve a semi-discrete entropy inequality. Numerical results confirm the robustness and accuracy of the proposed approaches.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Multi-modal characterization methods of solid-electrolyte interphase in silicon-graphite composite electrodes

Composite silicon-graphite (Si-Gr) anodes can improve battery energy density, due to Si's high gravimetric capacity, while mitigating mechanical degradation of the anode and solid-electrolyte interphase (SEI) caused by Si volumetric expansion. Optimizing these anodes is challenging, in part due to difficulty characterizing the SEI structure and composition. In this work, we present multi-modal characterization of the SEI on composite Si-Gr anodes to relate SEI chemical composition and structure to functional properties. Discrepancies in elemental concentrations from X-ray photoelectron spectroscopy, Auger electron spectroscopy, and energy-dispersive X-ray spectroscopy (EDS) are attributed to varying information depth and lateral resolution of the individual probes. However, by combining quantitative composition information with spatially resolved element mapping from scanning transmission electron microscopy, EDS, and electron energy loss spectroscopy, a holistic picture of the SEI emerges. We observe the bilayer SEI structure and a direct correlation between elemental Li and F, suggesting that most Li in the SEI exists as lithium fluoride (LiF). Further, LiF concentration is directly proportional to the maximum SEI resistivity, as determined by scanning spreading resistance microscopy. Lastly, there is an inverse relationship between lithium carbonate and LiF concentration in the SEI, providing insight into the detailed chemistry of SEI formation and evolution.

25 ENERGY STORAGE↗

Synthesis and characterization of high-surface-area millimeter-sized silica beads with hierarchical multi-modal pore structure by the addition of agar

Millimeter-sized spherical silica foams (SSFs) with hierarchical multi-modal pore structure featuring high specific surface area and ordered mesoporous frameworks were successfully prepared using aqueous agar addition, foaming and drop-in-oil processes. The pore-related properties of the prepared spherical silica (SSs) and SSFs were systematically characterized by field emission-scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), small-angle X-ray diffraction (SAXRD), Hg intrusion porosimetry, and N{sub 2} adsorption–desorption isotherm measurements. Improvements in the BET surface area and total pore volume were observed at 504 m{sup 2} g{sup −1} and 5.45 cm{sup 3} g{sup −1}, respectively, after an agar addition and foaming process. Despite the increase in the BET surface area, the mesopore wall thickness and the pore size of the mesopores generated from the block copolymer with agar addition were unchanged based on the SAXRD, TEM, and BJH methods. The SSFs prepared in the present study were confirmed to have improved BET surface area and micropore volume through the agar loading, and to exhibit interconnected 3-dimensional network macropore structure leading to the enhancement of total porosity and BET surface area via the foaming process. - Highlights: • Millimeter-sized spherical silica foams (SSFs) are successfully prepared. • SSFs exhibit high BET surface area and ordered hierarchical pore structure. • Agar addition improves BET surface area and micropore volume of SSFs. • Foaming process generates interconnected 3-D network macropore structure of SSFs.

36 MATERIALS SCIENCE↗

Dosimetric evaluation of 4 different treatment modalities for curative-intent stereotactic body radiation therapy for isolated thoracic spinal metastases

To investigate the dosimetric characteristics of 4 SBRT-capable dose delivery systems, CyberKnife (CK), Helical TomoTherapy (HT), Volumetric Modulated Arc Therapy (VMAT) by Varian RapidArc (RA), and segmental step-and-shoot intensity-modulated radiation therapy (IMRT) by Elekta, on isolated thoracic spinal lesions. CK, HT, RA, and IMRT planning were performed simultaneously for 10 randomly selected patients with 6 body types and 6 body + pedicle types with isolated thoracic lesions. The prescription was set with curative intent and dose of either 33 Gy in 3 fractions (3F) or 40 Gy in 5F to cover at least 90% of the planning target volume (PTV), correspondingly. Different dosimetric indices, beam-on time, and monitor units (MUs) were evaluated to compare the advantages/disadvantages of each delivery modality. In ensuring the dose-volume constraints for cord and esophagus of the premise, CK, HT, and RA all achieved a sharp conformity index (CI) and a small penumbra volume compared to IMRT. RA achieved a CI comparable to those from CK, HT, and IMRT. CK had a heterogeneous dose distribution in the target as its radiosurgical nature with less dose uniformity inside the target. CK had the longest beam-on time and the largest MUs, followed by HT and RA. IMRT presented the shortest beam-on time and the least MUs delivery. For the body-type lesions, CK, HT, and RA satisfied the target coverage criterion in 6 cases, but the criterion was satisfied in only 3 (50%) cases with the IMRT technique. For the body + pedicle-type lesions, HT satisfied the criterion of the target coverage of ≥90% in 4 of the 6 cases, and reached a target coverage of 89.0% in another case. However, the criterion of the target coverage of ≥90% was reached in 2 cases by CK and RA, and only in 1 case by IMRT. For curative-intent SBRT of isolated thoracic spinal lesions, RA is the first choice for the body-type lesions owing to its delivery efficiency (time); the second choice is CK or HT; HT is the preferential choice for the body + pedicle-type lesions. This study suggests further clinical investigations with longer follow-up for these studied cases.

61 RADIATION PROTECTION AND DOSIMETRY↗

Multi-modal tomographic imaging system for poolside characterization of nuclear test fuels: Design considerations and studies

Testing and qualification of advanced nuclear fuels involves an iterative process of prototyping, in-pile irradiation testing, and in-situ or ex-situ examination. Fuel restructuring and fission product migration during burnup are among the most important aspects of fuel evolution that affect several important performance characteristics such as heat removal, accident tolerance, and fission product retention. Pool-side non-destructive characterization techniques provide fuel developers with tools to understand fuel evolution at different points of burnup. A design for a compact, submersible, and multi-modal gamma-ray tomography system for imaging irradiated nuclear fuel is presented here. Detector selection, collimator geometry and fabrication, mechanical design, imaging protocol and acquisition speed are discussed. Modeling calculations show that sub-millimeter resolution can be achieved in both transmission computed tomography images as well as in emission computed tomography images in a matter of hours. Several design compromises and fabrication challenges are discussed which should be taken into consideration for future submersible gamma-ray tomography instruments.

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

Modal dynamics of high-frequency transverse combustion instabilities

This paper investigates the modal dynamics of self-excited high frequency transverse instabilities in a multi-nozzle, swirl-stabilized can combustor. It utilizes results from multiple pressure sensors to decompose the disturbance into clockwise (CW) and counter-clockwise (CCW) waves, enabling a reconstruction of the pressure amplitude, phase, anti-nodal line location, and spin ratio. While these types of decompositions have been demonstrated on small scale combustors, particularly annular combustors, this is the first study to analyze these results for a high power, multi-nozzle can combustor. Its particular focus is in characterizing the system evolution in phase space and the nature of the system attractors under linearly unstable conditions; results are presented in spin ratio-phase difference space, so that limit cycle oscillations appear as fixed points. Results are shown for conditions where three different attractors dominate (standing, CW, and CCW) but are taken for very long time periods (~50,000 cycles) so that the system's interaction with these attractors can be observed. For the standing mode-dominated case, the phase portrait shows spiral trajectories converging to a single fixed point. For the spinning mode dominated cases, however, multiple fixed points and saddle points were observed, and the trajectories showed a more complicated structure. It was also shown that even though the CW mode is dominant, this mode intermittently switches to standing or CCW modes for short period. These results suggest that the strength of each attractor depends on test conditions and that random noise stochastically perturbs the system so that large regions of the phase space are explored. Lastly, one interesting observation is that the angular velocity of the anti-nodal line linearly varies with the spin ratio under standing-mode dominant conditions.

42 ENGINEERING↗

MULTI-MODAL global surveillance methodology for predictive and on-demand characterization of localized processes using cube satellite platforms and deep learning techniques

This paper presents the work completed towards the development of a multi-modal global surveillance methodology using cube satellite (CubeSat) platforms and novel data analysis techniques. A CubeSat system equipped with adequate sensors and data analytics capabilities can autonomously characterize various phenomena of interest on the Earth’s surface. CubeSats are advantageous over conventional satellites in certain remote monitoring applications because of their reduced construction costs (due to the availability of commercially-off-the-shelf components) and are easier to launch. The CubeSat surveillance system developed in this paper focused on phenomena of interest surrounding the nuclear fuel cycle in support of nuclear non-proliferation and emergency response. To observe the phenomena, a constellation of 3U and 6U CubeSats deployed from the ISS with adequate components was chosen. Four different sensor configurations were identified for remote sensing: panchromatic/multispectral in the visible and near-infrared spectrum, multispectral in infrared spectrum, hyperspectral in infrared spectrum, and multispectral in ultraviolet spectrum. While a panchromatic/multispectral sensor configuration has CubeSat flight heritage at the required spatial resolutions, the other three sensor types need future 3 development to meet signature and system requirements. Once each sensor onboard the CubeSat system collects data on a target of interest, the onboard computers would then apply the deep learning-based characterization methodology developed in this paper to identify phenomena. Four surrogate datasets containing representative simplified “images” were created for each sensor type to train the characterization methodology. A convolutional neural network was applied to each dataset and produced recall rates for the phenomena between 89.7% - 99.3% and precision rates between 92.3% - 99.9%. Each phenomenon’s presence probability from each network is then combined into a final characterization solution for a target area. This paper covers multiple interdisciplinary areas to develop the foundation for a CubeSat surveillance system focused on phenomena surrounding the nuclear fuel cycle.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗

Comparison of three measurement modalities for 3D characterization of manufactured features and process-induced porosity in titanium alloy additively manufactured parts

Nondestructive characterization of internal features and defects within complex components is vital for many industrial applications, particularly with the advent of additive manufacturing (AM) technologies. However, community understanding of the limitations of nondestructive methods such as X-ray Computed Tomography (CT) can be limited in certain industrial sectors as these may be emergent applications. In this paper, we investigate the limits of X-ray CT measurements and compare extracted data with mechanical polishing serial sectioning (MPSS) and confocal laser scanning microscopy (CLSM). The test object is an additively manufactured titanium alloy disk that contains both process-induced porosity and machined features, including focused ion beam milled features designed to probe the resolution limits of X-ray CT. Results show that each of these characterization techniques has advantages and disadvantages. We compare data acquisition times, spatial resolution, geometric measurement accuracy and defect visualization fidelity across these modalities to establish a practical framework.

Additive manufacturing↗

Multiple modalities converge on a common gate to control K 2P channel function

Members of the K 2P potassium channel family regulate neuronal excitability and are implicated in pain, anaesthetic responses, thermosensation, neuroprotection, and mood. Unlike other potassium channels, K 2P s are gated by remarkably diverse stimuli that include chemical, thermal, and mechanical modalities. It has remained unclear whether the various gating inputs act through separate or common channel elements. Here, we show that protons, heat, and pressure affect activity of the prototypical, polymodal K 2P , K 2P 2.1 (KCNK2/TREK-1), at a common molecular gate that comprises elements of the pore-forming segments and the N-terminal end of the M4 transmembrane segment. We further demonstrate that the M4 gating element is conserved among K 2P s and is employed regardless of whether the gating stimuli are inhibitory or activating. Our results define a unique gating mechanism shared by K 2P family members and suggest that their diverse sensory properties are achieved by coupling different molecular sensors to a conserved core gating apparatus.

59 BASIC BIOLOGICAL SCIENCES↗

Band-edge engineering for controlled multi-modal nanolasing in plasmonic superlattices

Single band-edge states can trap light and function as high-quality optical feedback for microscale lasers and nanolasers. However, access to more than a single band-edge mode for nanolasing has not been possible because of limited cavity designs. Here, we describe how plasmonic superlattices-finite-arrays of nanoparticles (patches) grouped into microscale arrays-can support multiple band-edge modes capable of multi-modal nanolasing at programmed emission wavelengths and with large mode spacings. Different lasing modes show distinct input-output light behaviour and decay dynamics that can be tailored by nanoparticle size. By modelling the superlattice nanolasers with a four-level gain system and a time-domain approach, we reveal that the accumulation of population inversion at plasmonic hot spots can be spatially modulated by the diffractive coupling order of the patches. Furthermore, we show that symmetry-broken superlattices can sustain switchable nanolasing between a single mode and multiple modes.

42 ENGINEERING↗

Geospatial mapping of distribution grid with machine learning and publicly-accessible multi-modal data

Abstract Detailed and location-aware distribution grid information is a prerequisite for various power system applications such as renewable energy integration, wildfire risk assessment, and infrastructure planning. However, a generalizable and scalable approach to obtain such information is still lacking. In this work, we develop a machine-learning-based framework to map both overhead and underground distribution grids using widely-available multi-modal data including street view images, road networks, and building maps. Benchmarked against the utility-owned distribution grid map in California, our framework achieves > 80% precision and recall on average in the geospatial mapping of grids. The framework developed with the California data can be transferred to Sub-Saharan Africa and maintain the same level of precision without fine-tuning, demonstrating its generalizability. Furthermore, our framework achieves a R 2 of 0.63 in measuring the fraction of underground power lines at the aggregate level for estimating grid exposure to wildfires. We offer the framework as an open tool for mapping and analyzing distribution grids solely based on publicly-accessible data to support the construction and maintenance of reliable and clean energy systems around the world.

24 POWER TRANSMISSION AND DISTRIBUTION↗

Highly stretchable polymer semiconductor thin films with multi-modal energy dissipation and high relative stretchability

Abstract Stretchable polymer semiconductors (PSCs) have seen great advancements alongside the development of soft electronics. But it remains a challenge to simultaneously achieve high charge carrier mobility and stretchability. Herein, we report the finding that stretchable PSC thin films (<100-nm-thick) with high stretchability tend to exhibit multi-modal energy dissipation mechanisms and have a large relative stretchability ( rS ) defined by the ratio of the entropic energy dissipation to the enthalpic energy dissipation under strain. They effectively recovered the original molecular ordering, as well as electrical performance, after strain was released. The highest rS value with a model polymer (P4) exhibited an average charge carrier mobility of 0.2 cm 2 V −1 s −1 under 100% biaxial strain, while PSCs with low rS values showed irreversible morphology changes and rapid degradation of electrical performance under strain. These results suggest rS can be used as a parameter to compare the reliability and reversibility of stretchable PSC thin films.

36 MATERIALS SCIENCE↗

Correlating activities and defects in (photo)electrocatalysts using in-situ multi-modal microscopic imaging

Photo(electro)catalysts use sunlight to drive chemical reactions such as water splitting. A major factor limiting photocatalyst development is physicochemical heterogeneity which leads to spatially dependent reactivity. To link structure and function in such systems, simultaneous probing of the electrochemical environment at microscopic length scales and a broad range of timescales (ns to s) is required. Here, we address this challenge by developing and applying in- situ (optical) microscopies to map and correlate local electrochemical activity, with hole lifetimes, oxygen vacancy concentrations and photoelectrode crystal structure. Using this multi-modal approach, we study prototypical hematite (α-Fe 2 O 3 ) photoelectrodes. We demonstrate that regions of α-Fe 2 O 3 , adjacent to microstructural cracks have a better photoelectrochemical response and reduced back electron recombination due to an optimal oxygen vacancy concentration, with the film thickness and extended light exposure also influencing local activity. Our work highlights the importance of microscopic mapping to understand activity, in even seemingly homogeneous photoelectrodes.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Advanced multi-modal mass spectrometry imaging reveals functional differences of placental villous compartments at microscale resolution

The placenta is a complex and heterogeneous organ that links the mother and fetus, playing a crucial role in nourishing and protecting the fetus throughout pregnancy. Integrative spatial multi-omics approaches can provide a systems-level understanding of molecular changes underlying the mechanisms leading to the histological variations of the placenta during healthy pregnancy and pregnancy complications. Herein, we advance our metabolome-informed proteome imaging (MIPI) workflow to include lipidomic imaging, while also expanding the molecular coverage of metabolomic imaging by incorporating on-tissue chemical derivatization (OTCD). The improved MIPI workflow advances biomedical investigations by leveraging state-of-the-art molecular imaging technologies. Lipidome imaging identifies molecular differences between two morphologically distinct compartments of a placental villous functional unit, syncytiotrophoblast (STB) and villous core. Next, our advanced metabolome imaging maps villous functional units with enriched metabolomic activities related to steroid and lipid metabolism, outlining distinct molecular distributions across morphologically different villous compartments. Complementary proteome imaging on these villous functional units reveals a plethora of fatty acid- and steroid-related enzymes uniquely distributed in STB and villous core compartments. Integration across our advanced MIPI imaging modalities enables the reconstruction of active biological pathways of molecular synthesis and maternal-fetal signaling across morphologically distinct placental villous compartments with micrometer-scale resolution.

60 APPLIED LIFE SCIENCES↗

Multi-modal characterization of nitrate reduction nano-catalysts with periodic strain distribution

Strain engineering serves as a pivotal strategy to optimize catalytic activity in electrocatalysis. However, the catalyst sizes under industrial conditions are usually large and even beyond nanometer regime. The critical methodological limitations on strain imaging of such catalysts with both large field of view and high spatial resolution obscure the mechanistic understanding of strain-performance correlations. Here, we present an optimized four-dimensional scanning transmission electron microscopy (4D-STEM) method to acquire strain mapping of both bulk and surface across particles up to 500 nm with 0.6 nm spatial resolution and 0.55% precision. We observe the ripple-like periodic strain coupled with elemental fluctuations inside a perovskite-type hydroxide CuCoSn(OH) 6 and find it correlated to electrocatalytic nitrate reduction (NO 3 – RR) absorption energy to achieve the 92.6% Faradaic efficiency and long-term test over 1000 h at membrane electrode assembly (MEA) for ammonia electrosynthesis. This universal framework design offers a practical method that not only develops an advanced measurement combining multi-modal characterization techniques but also reveals the intrinsic structure-property constitutive law of industry-level catalysts.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗