Mapping coastal resilience: Precision insights for green infrastructure suitability.

Addressing the need for effective flood risk mitigation strategies and enhanced urban resilience to climate change, we introduce a cloud-computed Green Infrastructure Suitability Index (GISI) methodology. This approach combines remote sensing and geospatial modeling to create a cloud-computed blend that synthesizes land cover classifications, biophysical variables, and flood exposure data to map suitability for green infrastructure (GI) implementation at both street and landscape levels. The GISI methodology provides a flexible and robust tool for urban planning, capable of accommodating diverse data inputs and adjustments, making it suitable for various geographic contexts.

Adaptive Trials in Stroke: Current Use and Future Directions.

Inclusion of adaptive design features in a clinical trial provides preplanned flexibility to dynamically modify a trial during its conduct while preserving validity and integrity. Adaptive trials are needed to accelerate the conduct of more efficient, informative, and ethical clinical research in the field of neurology. Stroke is a natural candidate for adoption of these innovative approaches to trial design.

Should Palpable Nodes Be Exclusionary in Patients Who Are Otherwise Candidates for ACOSOG Z0011-Type Trials?

Background: Palpable nodes were exclusionary in American College of Surgeons Oncology Group (ACOSOG) Z0011, while SINODAR-ONE excluded those with positive axillary nodes by palpation and ultrasound. To determine whether clinical nodal status should be exclusionary in those fulfilling pathologic criteria for ACOSOG Z0011 and similar trials, this study analyzed the accuracy and implications of clinical nodal positivity.

Methods: Patients ≥ 18 years old with cT1-T2, cN0-cN1, M0 breast cancer were identified in the National Cancer Database between 2004 and 2019.

Nodal Surgery for Patients ≥ 70 Undergoing Mastectomy for DCIS? Choose Wisely.

Background: Routine sentinel lymphadenectomy (SLNB) for early-stage HR+/HER2- breast cancer in women ≥70 is discouraged by Choosing Wisely, but whether SLNB can be routinely omitted in women ≥70 with DCIS undergoing mastectomy is unclear. This study aims to evaluate rates of axillary surgery and nodal positivity (pN+) in this population to determine the impact of axillary surgery on treatment decisions.

Methods: Females ≥70 with DCIS undergoing mastectomy were identified from the National Cancer Database (2012-2020).