First-in-Human Evaluation of Site-Specifically Labeled Zr-Pertuzumab in Patients with HER2-Positive Breast Cancer.

Radioimmunoconjugates targeting human epidermal growth factor receptor 2 (HER2) have shown potential to noninvasively visualize HER2-positive tumors. However, the stochastic approach that has been traditionally used to radiolabel these antibodies yields poorly defined and heterogeneous products with suboptimal in vivo performance. Here, we describe a first-in-human PET study on patients with HER2-positive breast cancer evaluating the safety, biodistribution, and dosimetry of Zr-site-specific (ss)-pertuzumab PET, a site-specifically labeled radioimmunoconjugate designed to circumvent the limitations of random stochastic lysine labeling.

Quality Care in Survivorship: Lessons Learned From the ASCO Quality Oncology Practice Initiative.

Purpose: The ASCO Quality Oncology Practice Initiative (QOPI) project was established to evaluate the influence of guideline recommendations on routine clinical practice.

Methods: QOPI provided summary data from 839 unique practices in which data were collected every six months from the Fall of 2015 to the Spring of 2019. From these data, six items were chosen based on their relationship to domains of survivorship.

Improving Adherence to Endocrine Therapy in Women With HR-Positive Breast Cancer.

Aromatase inhibitors (AIs) are the standard treatment for postmenopausal women with hormone receptor-positive breast cancers. One of the most common side effects of AIs is joint pain; it is also the most frequently cited reason for nonadherence and discontinuation before completion of the prescribed treatment course. Nonadherence and, in particular, discontinuation, can lead to increased rates of breast cancer mortality.

Anger Self-Management Training for Chronic Moderate to Severe Traumatic Brain Injury: Results of a Randomized Controlled Trial.

Objective: To test efficacy of 8-session, 1:1 treatment, anger self-management training (ASMT), for chronic moderate to severe traumatic brain injury (TBI).

Setting: Three US outpatient treatment facilities.

Participants: Ninety people with TBI and elevated self-reported anger; 76 significant others (SOs) provided collateral data.

Economic evaluation of telephone-based concussion management for combat-related mild traumatic brain injury.

Introduction Mild traumatic brain injury (mTBI) is an unfortunately common repercussion of military service in a combat zone. The CONTACT study tested an individualized telephone support intervention employing problem solving therapy (PST) for mTBI in soldiers recently returned from deployment. We sought to determine the cost effectiveness of this intervention from a military healthcare system perspective.

Telephone Problem Solving for Service Members with Mild Traumatic Brain Injury: A Randomized, Clinical Trial.

Mild traumatic brain injury (mTBI) is a common injury for service members in recent military conflicts. There is insufficient evidence of how best to treat the consequences of mTBI. In a randomized, clinical trial, we evaluated the efficacy of telephone-delivered problem-solving treatment (PST) on psychological and physical symptoms in 356 post-deployment active duty service members from Joint Base Lewis McChord, Washington, and Fort Bragg, North Carolina.

Characteristics and Concerns of Caregivers of Adults With Traumatic Brain Injury.

Objective: To describe the characteristics of caregivers of adults with traumatic brain injury (TBI) and their concerns in the first months after community discharge of the TBI survivor.

Design: Secondary analysis of data collected during a parallel-group randomized controlled trial.

Setting: Community.

Telephone Problem-Solving Treatment Improves Sleep Quality in Service Members With Combat-Related Mild Traumatic Brain Injury: Results From a Randomized Clinical Trial.

Objective: Evaluate sleep quality, its correlates, and the effect of telephone-based problem-solving treatment (PST) in active duty postdeployment service members with mild traumatic brain injury (mTBI) SETTING:: Randomized clinical trial.

Participants: Active duty service members with combat-related mTBI.

Study Design: Education-only (EO) and PST groups (N = 178 each) received printed study materials and 12 educational brochures.

Telephone-delivered problem-solving training after mild traumatic brain injury: Qualitative analysis of service members' perceptions.

Objective: The purpose of this study was to identify the specific reasons for service members' satisfaction or dissatisfaction with problem-solving training (PST), telephone delivery, and other aspects of a telephone-delivered PST intervention in order to determine what might enhance this approach for future clinical use.

Method: Standard qualitative methods were employed, using a "process" coding strategy to explore the conceptual perceptions of the intervention experience as suggested by the data recorded from final telephone interviews of 80 service members who participated in a randomized controlled trial evaluating the efficacy of telephone-delivered PST after having sustained concussions or mild traumatic brain injuries during recent (PsycINFO Database Record

A Telehealth Approach to Caregiver Self-Management Following Traumatic Brain Injury: A Randomized Controlled Trial.

Objective: To determine whether a telephone-based, individualized education and mentored problem-solving intervention would improve outcomes for caregivers of persons with traumatic brain injury (TBI).

Design: Parallel group, randomized controlled trial with blinded outcome assessment.

Setting: General community.

Anger self-management in chronic traumatic brain injury: protocol for a psycho-educational treatment with a structurally equivalent control and an evaluation of treatment enactment.

Anger and irritability are important and persistent clinical problems following traumatic brain injury (TBI). Treatment options include medications, behavioral modification, and psychotherapies, but some are impractical and none have proven efficacy with this population. We describe a randomized multi-center clinical trial testing a novel, one-on-one, 8-session psychoeducational treatment program, Anger Self-Management Training (ASMT), designed specifically for people with TBI who have significant cognitive impairment.

Concussion treatment after combat trauma: development of a telephone based, problem solving intervention for service members.

Military service members (SMs) and veterans who sustain mild traumatic brain injuries (mTBI) during combat deployments often have co-morbid conditions but are reluctant to seek out therapy in medical or mental health settings. Efficacious methods of intervention that are patient-centered and adaptable to a mobile and often difficult-to-reach population would be useful in improving quality of life. This article describes a new protocol developed as part of a randomized clinical trial of a telephone-mediated program for SMs with mTBI.

Analyzing the ingredients of a telephone counseling intervention for traumatic brain injury.

Purpose: To develop reliable coding for five treatment ingredients hypothesized to be "active" in a scheduled telephone intervention (STI) for traumatic brain injury (TBI); to examine factors associated with delivery of ingredients over the first year post-injury.

Method: Operational definitions of directive and non-directive action planning; TBI education; reinforcement; and reframing, were refined until kappa >0.80 across multiple coders.

Inpatient rehabilitation approach for a young woman with conversion hemiparesis and sensory deficits.

In the treatment of conversion disorder, the inpatient rehabilitation setting supports interdisciplinary functional goals and a structured approach consistent with encouraging psychological well-being. This case presentation illustrates 1 approach to the rehabilitation of hemiparesis secondary to conversion disorder that includes a behavioral management plan, as well as protocols for "learning to walk" and "learning to use your arm." We provide a practical starting point for advancing function in patients with conversion disorder when functional loss is present in both upper and lower extremities.

University of Washington self-efficacy scale: a new self-efficacy scale for people with disabilities.

Objective: To develop a self-efficacy scale for people living with multiple sclerosis (MS) and spinal cord injury (SCI) that can be used across diagnostic conditions.

Design: The scale was developed using modern psychometric methods including item response theory. Items were administered at 3 time-points of a longitudinal survey of individuals with MS and SCI.

Scheduled telephone intervention for traumatic brain injury: a multicenter randomized controlled trial.

Objective: To evaluate the effect of a Scheduled Telephone Intervention (STI) compared with usual care (UC) on function, health/emotional status, community/work activities, and well-being at 1 and 2 years after traumatic brain injury (TBI).

Design: Two group, randomized controlled trial.

Setting: Telephone contacts with subjects recruited in inpatient rehabilitation.

The influence of margin width and volume of disease near margin on benefit of radiation therapy for women with DCIS treated with breast-conserving therapy.

Objective And Summary Background Data: There remains variation in the use of radiation therapy (RT) in women with ductal carcinoma in situ (DCIS), despite prospective randomized trials documenting its benefit in reducing the risk of ipsilateral breast tumor recurrence (IBTR).

Methods: Patients with DCIS treated with excision alone or excision plus RT from 1991 to 1995 were identified. Margin width, number of involved ducts at closest margin, age, presence of palpable mass, presence of lobular neoplasia, nuclear grade, and necrosis were tested in uni- and multivariate analysis for association with risk of IBTR and added value of RT.

Concurrent lobular neoplasia increases the risk of ipsilateral breast cancer recurrence in patients with ductal carcinoma in situ treated with breast-conserving therapy.

Background: Multiple clinicopathologic factors have been analyzed for their association with an increased risk of ipsilateral breast tumor recurrence (IBTR) after women receive breast-conserving treatment (BCT) for ductal carcinoma in situ (DCIS). The reported incidence of proliferative lesions, such as atypical ductal hyperplasia (ADH), columnar cell changes (CCC), and lobular neoplasia associated with breast cancer, has been as high as 23%; however, the relevance of these lesions on the natural history of DCIS and the risk of IBTR remains unknown.

Methods: Two hundred ninety-four patients with DCIS who received BCT between 1991 and 1995 were identified from the authors' institutional database.

Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements.

Purpose: Sentinel lymph node biopsy was adopted for the staging of the axilla with the assumption that it would reduce the risk of lymphedema in women with breast cancer. The aim of this study was to determine the long-term prevalence of lymphedema after SLN biopsy (SLNB) alone and after SLNB followed by axillary lymph node dissection (SLNB/ALND).

Patients And Methods: At median follow-up of 5 years, lymphedema was assessed in 936 women with clinically node-negative breast cancer who underwent SLNB alone or SLNB/ALND.

Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: patient perceptions and precautionary behaviors.

Purpose: Sentinel lymph node (SLN) biopsy was adopted for the staging of the axilla with the assumption that it would reduce the risk of lymphedema in women with breast cancer. This study was undertaken to examine patient perceptions of lymphedema and use of precautionary behaviors several years after axillary surgery.

Patients And Methods: Nine hundred thirty-six women who underwent SLN biopsy (SLNB) alone or SLNB followed by axillary lymph node dissection (SLNB/ALND) between June 1, 1999, and May 30, 2003, were evaluated at a median of 5 years after surgery.

Efficient segmentation framework of cell images in noise environments.

In this paper, we propose an efficient segmentation method that exploits local information for automated cell segmentation. This method introduces a new criterion function based on statistical structure of the objects in cell image. Each pixel is initially assigned to the most probable region and then the pixel assignment process is iteratively updated by a new criterion function until steady state is reached.

Interactive detection and visualization of breast lesions from dynamic contrast enhanced MRI volumes.

Mammography is currently regarded as the most effective and widely used method for early detection of breast cancer, but recently its sensitivity in certain high risk cases has been less than desired. The use of Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) has gained considerable attention in the past 10 years, especially for high risk cases, for smaller multi-focal lesions, or very sparsely distributed lesions. In this work, we present an interactive visualization system to identify, process, visualize and quantify lesions from DCE-MRI volumes.

Breast cancer detection in gadolinium-enhanced MR images by static region descriptors and neural networks.

Purpose: To automate the diagnosis of malignancy by classifying breast tissues as negative or positive for malignancy in gadolinium-enhanced dynamic magnetic resonance (MR) images, using static region descriptors and a neural network classifier.

Materials And Methods: We propose a novel approach whereby the classifier evaluates a number of parameters that identify important tumor characteristics, as obtained by digital image processing techniques. These parameters include static signal intensity (SI) after contrast enhancement, mass margin descriptors, evaluation of mass shape by calculation of eccentricity, mass size, and mass granularity by texture analysis.

Two functional magnetic resonance imaging f(MRI) tasks that may replace the gold standard, Wada testing, for language lateralization while giving additional localization information.

Two tasks were used to lateralize and localize language functions noninvasively, using functional magnetic resonance (fMRI BOLD sequences). fMRI images produced during comprehension of the gist of a tale derived from an ordered series of inferential questions were used to lateralize and locate the center of and margins within language dominant hemisphere near posterior temporal-parietal-occipital (TPO) cortical area(s), e.g.