Humphreys College

The National Comprehensive Cancer Network guidelines recommend tumor phenotyping for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 at initial breast cancer diagnosis, with repeat biopsy considered at disease progression. This study assessed the frequency, timing, regional variation, and predictors of repeat biopsies among patients with metastatic breast cancer (mBC) treated at community oncology practices in the United States. A weighted random sample of 911 mBC patients was selected from 15 practices within the ONCare Alliance network. The data included demographics, clinical characteristics, number and types of biopsies, and associated findings. Multivariate negative binomial regression, adjusted for disease duration, was used to identify predictors of biopsy frequency. Among the cohort, 42.2% had a history of early-stage disease, while 57.8% were diagnosed with de novo stage IV mBC. After adjusting for disease duration, patients with prior early-stage disease underwent significantly more biopsies (mean: 3.9; 95% CI: 3.7-4.0) than those with de novo mBC (mean: 2.2; 95% CI: 2.1-2.3; P<0.001). Factors associated with fewer biopsies included non-Black, non-Asian minority status (RR=0.80, P<0.001), longer time to metastatic progression (RR=0.93, P<0.001), poor performance status, and geographic region. A substantial proportion of patients with mBC, particularly those with de novo disease, did not undergo repeat biopsy at progression. These findings reveal disparities in biopsy practices and underscore the need for improved adherence to guideline-based care in community oncology settings.

Geographic Information Systems (GIS), computerbased systems that allow decision makers to incorporate geographically based data into their analyses, are widespread and powerful tools in many business and scientific settings today. In this paper, we discuss ways in which GIS functionality can be implemented within the spreadsheet environment. We show the straightforward and natural analogy between several GIS functions with spreadsheet functions, particularly for raster based data. We present two realistic examples meshing analytical models with GIS methods --- an integration which is greatly enhanced by the “remarkable development platform” provided by spreadsheets. We discuss the many benefits of the spreadsheet enabled seamless integration of geographical data, mathematical analysis, and mapping displays.

No abstract available.

As an industry approaches stabilization, greater and greater stress must belaid on its technologic progress, which becomes a prime aid in improving itscondition. The oil industry is tending toward this stage and hence itsengineers must be pressed into greater service to prevent stabilization andstagnation from becoming synonymous, and to supply, either by improvements inprocesses or by new machinery, a means of obtaining savings in raw and finishedproducts. Thus profits can be assured warranting continued investment. It may be repeated, technology must apply a slight improvement here, achange there, or a complete renovation, to eliminate inefficiencies and makeeach dollar invested yield greater results. The profits of yesterday were madeof rich strikes, of monopolized patents or processes, of control of prices andof markets. Sixty-five years of growth, of large investment, of healthfulcompetition, and of expanding markets, have put the oil industry in theforemost rank of world industries. Just as the railroads passed a similarperiod of expansion and growth, and are being stabilized with reasonableprofits, so the oil industry must take advantage of the efforts of itsengineers and experts to promote its healthful growth and a better service tothe people. Herein is attempted a review of recent progress in which is presented theadvances in exploration, production engineering, transportation, refining and greater efficiency in uses of petroleum, with a view not only tostressing important new processes and methods, but also the problems that pressfor solution. This review can only touch outstanding developments of recentyears, but the several Petroleum Division symposiums of program will presentdetails worthy of attention. Exploration Geology offers directly little new in the technique of oil-finding majorstress being laid on improvement in subsurface correlation by means offoraminiferal studies, additions to the knowledge of which are being made, slowly but surely, and by means of mineral, and especially heavy mineral, determinations in well samples.