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Coronary Artery Dose-Volume Parameters Predict Risk of Calcification After Radiation Therapy
Sarah A. Milgrom,Bibin Varghese,Gregory W. Gladish,Andrew D. Choi,Wenli Dong,Zarana S. Patel,Caroline C. Chung,Arvind Rao,Chelsea C. Pinnix,Jillian R. Gunther,Bouthaina S. Dabaja,Steven H. Lin,Karen E 한국심초음파학회 2019 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.27 No.4
BACKGROUND: Radiation exposure increases the risk of coronary artery disease (CAD). We explored the association of CAD with coronary artery dose-volume parameters in patients treated with 3D-planned radiation therapy (RT). METHODS: Patients who received thoracic RT and were evaluated by cardiac computed tomography ≥ 1 year later were included. Demographic data and cardiac risk factors were retrospectively collected. Dosimetric data (mean heart dose, dmax, dmean, V50 - V5) were collected for the whole heart and for each coronary artery. A coronary artery calcium (CAC) Agatston score was calculated on a per-coronary basis and as a total score. Multivariable generalized linear mixed models were generated. The predicted probabilities were used for receiver operating characteristic analyses. RESULTS: Twenty patients with a median age of 53 years at the time of RT were included. Nine patients (45%) had ≥ 3/6 conventional cardiac risk factors. Patients received RT for breast cancer (10, 50%), lung cancer (6, 30%), or lymphoma/myeloma (4, 20%) with a median dose of 60 Gy. CAC scans were performed a median of 32 months after RT. CAC score was significantly associated with radiation dose and presence of diabetes. In a multivariable model adjusted for diabetes, segmental coronary artery dosimetric parameters (dmax, dmean, V50, V40 V30, V20, V10, and V5) were significantly associated with CAC score > 0. V50 had the highest area under the ROC curve (0.89, 95% confidence interval, 0.80-0.97). CONCLUSIONS: Coronary artery radiation exposure is strongly correlated with subsequent segmental CAC score. Coronary calcification may occur soon after RT and in individuals with conventional cardiac risk factors.
The significance of firm and occupation specific human capital for hiring and promotions
Kwon, I.,Meyersson Milgrom, E.M. North Holland 2014 LABOUR ECONOMICS Vol.31 No.-
This paper analyzes firms' hiring and promotion patterns, and infers the relative significance of the firm- and occupation-specific human capital required for each job rank. The results suggest that firm-specific skills are just as valuable as occupation-specific skills, and that the value of these specific skills increases in job rank. However, there is great heterogeneity across occupations. This paper also shows that the lengths of firm- and occupation-tenure are noisy measures of firm- and occupation-specific human capital, and contrasts our results with those of other recent studies on the returns to firm- and occupation-tenure for wages.
Atypical viscous fracture of human femurs
Yosibash, Zohar,Mayo, Romina Plitman,Milgrom, Charles Techno-Press 2014 Advances in biomechanics & applications Vol.1 No.2
Creep phenomenon at the scale of bone tissue (small specimens) is known to be present and demonstrated for low strains. Here creep is demonstrated on a pair of fresh-frozen human femurs at the organ level at high strains. Under a constant displacement applied on femur's head, surface strains at the upper neck location increase with time until fracture, that occurs within 7-13 seconds. The monotonic increase in strains provides evidence on damage accumulation in the interior (probably damage to the trabeculae) prior to final fracture, a fact that hints on probable damage of the trabecular bone that occurs prior to the catastrophic fracture of the cortical surface layer.