scholarly journals 54 Digestibility of forages in ruminally cannulated Jersey steers supplemented with liquid glycerol on a wheat straw forage diet

2019 ◽  
Vol 97 (Supplement_1) ◽  
pp. 84-84
Author(s):  
Itzel A Soto ◽  
Jamie Boyd
Keyword(s):  
Statistical Significance ◽  
Latin Square ◽  
Test Period ◽  
Control Treatment ◽  
Treatment Control ◽  
Forage Digestibility ◽  
Significant Difference ◽  
Glycerol Treatment ◽  
The Impact

Abstract The purpose of this study was to determine the impact of supplementation of glycerol at a rate of 15% of DMI on forage digestibility on a diet of mature wheat hay. Forages tested included bermuda hay, wheat hay, alfalfa hay, and sorghum sudan hay. Samples were ground through a 2mm screen and placed in Ankom forage in-situ bags. Samples were run in triplicate to reduce error and increase statistical significance. Two ruminally cannulated steers were used in a 2x2 Latin square design for the study with ad libitum access to wheat hay and water. Animals were housed in a dry lot pen for the study. Diets offered were Control = wheat hay and Treatment= control + glycerol at 15% of daily DMI. The study consisted of 2 three-week periods. Each period had a 2-week standardization followed by a 1-week test period. During the test period, forage bags were placed in each steer for 0 h, 48 h, 72 h, 96 h, and 144 h for fermentation. At the end of the incubation period, bags were collected and cold shocked to stop microbial digestion. The samples were then dried at 55°C and stored for later analysis for NDF. A significant impact on NDFdig by treatment (P < 0.0001) was observed. NDFdig was 59.2% w/ glycerol versus control at 49.13% overall. In addition, there was a significant difference between steers (P = 0.0001) on glycerol treatment (51.95% versus 66.45% NDFdig between steer A and B), indicating difference in ruminal population efficiency between individual animals. No significant difference (P = 0.98) between steers on the control treatment was observed. Implications of this study are the inclusion of dietary glycerol in the diet of ruminants on a low-quality forage diet may increase energy level and improve ruminal digestibility and animal response may be dependent on the unique ruminal environment of individual animals.

scholarly journals 145 Digestibility of forages in ruminally cannulated Jersey steers supplemented with liquid glycerol on a wheat straw forage diet

2019 ◽  
Vol 97 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Itzel A Soto ◽  
Jamie Boyd
Keyword(s):  
Statistical Significance ◽  
Latin Square ◽  
Test Period ◽  
Control Treatment ◽  
Treatment Control ◽  
Forage Digestibility ◽  
Significant Difference ◽  
Glycerol Treatment ◽  
The Impact

Abstract The purpose of this study was to determine the impact of supplementation of glycerol at a rate of 15% of DMI on forage digestibility on a diet of mature wheat hay. Forages tested included bermuda hay, wheat hay, alfalfa hay, and sorghum sudan hay. Samples were ground through a 2mm screen and placed in Ankom forage in-situ bags. Samples were run in triplicate to reduce error and increase statistical significance. Two ruminally cannulated steers were used in a 2x2 Latin square design for the study with ad libitum access to wheat hay and water. Animals were housed in a dry lot pen for the study. Diets offered were Control = wheat hay and Treatment= control + glycerol at 15% of daily DMI. The study consisted of 2 three-week periods. Each period had a 2-week standardization followed by a 1-week test period. During the test period, forage bags were placed in each steer for 0 h, 48 h, 72 h, 96 h, and 144 h for fermentation. At the end of the incubation period, bags were collected and cold shocked to stop microbial digestion. The samples were then dried at 55°C and stored for later analysis for NDF. A significant impact on NDFdig by treatment (P < 0.0001) was observed. NDFdig was 59.2% w/ glycerol versus control at 49.13% overall. In addition, there was a significant difference between steers (P = 0.0001) on glycerol treatment (51.95% versus 66.45% NDFdig between steer A and B), indicating difference in ruminal population efficiency between individual animals. No significant difference (P = 0.98) between steers on the control treatment was observed. Implications of this study are the inclusion of dietary glycerol in the diet of ruminants on a low-quality forage diet may increase energy level and improve ruminal digestibility and animal response may be dependent on the unique ruminal environment of individual animals.

scholarly journals Does Social Support Affect the Health of the Elderly in Rural China? A Meta-Analysis Approach

2019 ◽  
Vol 16 (18) ◽  
pp. 3471 ◽  
Author(s):  
Natuya Zhuori ◽  
Yu Cai ◽  
Yan Yan ◽  
Yu Cui ◽  
Minjuan Zhao
Keyword(s):  
Social Support ◽  
Rural Areas ◽  
Rural China ◽  
Statistical Significance ◽  
Empirical Studies ◽  
Relevant Literature ◽  
The Elderly ◽  
Significant Difference ◽  
Meta Regression ◽  
The Impact

As the trend of aging in rural China has intensified, research on the factors affecting the health of the elderly in rural areas has become a hot issue. However, the conclusions of existing studies are inconsistent and even contradictory, making it difficult to form constructive policies with practical value. To explore the reasons for the inconsistent conclusions drawn by relevant research, in this paper we constructed a meta-regression database based on 65 pieces of relevant literature published in the past 25 years. For more valid samples to reduce publication bias, we also set the statistical significance of social support to the health of the elderly in rural areas as a dependent variable. Finally, combined with multi-dimensional social support and its implications for the health of the elderly, meta-regression analysis was carried out on the results of 171 empirical studies. The results show that (1) subjective support rather than objective support can have a significant impact on the health of the elderly in rural areas, and there is no significant difference between other dimensions of social support and objective support; (2) the health status of the elderly in rural areas in samples involving western regions is more sensitive to social support than that in samples not involving the western regions; (3) among the elderly in rural areas, social support for the older male elderly is more likely to improve their health than that for the younger female elderly; and (4) besides this, both data sources and econometric models greatly affect the heterogeneity of the effect of social support on the health of the elderly in rural areas, but neither the published year nor the journal is significant. Finally, relevant policies and follow-up studies on the impact of social support on the health of the elderly in rural areas are discussed.

Impact of Hybrid Operating Rooms on Long-Term Clinical Outcomes Following Fenestrated and Branched Endovascular Aortic Repair

2021 ◽  
pp. 152660282199672
Author(s):  
Giovanni Tinelli ◽  
Marie Bonnet ◽  
Adrien Hertault ◽  
Simona Sica ◽  
Gian Luca Di Tanna ◽  
...  
Keyword(s):  
Operating Room ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Statistical Significance ◽  
Aortic Aneurysms ◽  
Study Patient ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
The Impact

Purpose: Evaluate the impact of hybrid operating room (HOR) guidance on the long-term clinical outcomes following fenestrated and branched endovascular repair (F-BEVAR) for complex aortic aneurysms. Materials and Methods: Prospectively collected registry data were retrospectively analyzed to compare the procedural, short- and long-term outcomes of consecutive F-BEVAR performed from January 2010 to December 2014 under standard mobile C-arm versus hybrid room guidance in a high-volume aortic center. Results: A total of 262 consecutive patients, including 133 patients treated with a mobile C-arm equipped operating room and 129 with a HOR guidance, were enrolled in this study. Patient radiation exposure and contrast media volume were significantly reduced in the HOR group. Short-term clinical outcomes were improved despite higher case complexity in the HOR group, with no statistical significance. At a median follow-up of 63.3 months (Q1 33.4, Q3 75.9) in the C-arm group, and 44.9 months (Q1 25.1, Q3 53.5, p=0.53) in the HOR group, there was no statistically significant difference in terms of target vessel occlusion and limb occlusion. When the endograft involved 3 or more fenestrations and/or branches (complex F-BEVAR), graft instability (36% vs 25%, p=0.035), reintervention on target vessels (20% vs 11%, p=0.019) and total reintervention rates (24% vs 15%, p=0.032) were significantly reduced in the HOR group. The multivariable Cox regression analysis did not show statistically significant differences for long-term death and aortic-related death between the 2 groups. Conclusion: Our study suggests that better long-term clinical outcomes could be observed when performing complex F-BEVAR in the latest generation HOR.

scholarly journals Heart-related mortality after postoperative breast irradiation in patients with ductal carcinoma in situ in the contemporary radiotherapy era

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Jin Lim ◽  
Jaemoon Koh
Keyword(s):  
Competing Risks ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Statistical Significance ◽  
Young Patients ◽  
Subdistribution Hazard ◽  
The Impact ◽  
Related Mortality

AbstractAlthough radiation-induced cardiotoxicity has been addressed, its prognostic relevance to modern radiotherapy (RT) techniques is unclear. This study assessed the impact of adjuvant RT on heart-related deaths in patients with ductal carcinoma in situ. Patients who underwent adjuvant RT after breast-conserving surgery between 1988 and 2008 were identified from the Surveillance, Epidemiology, and End Results database. Kaplan‒Meier and competing risks analyses were conducted after propensity score-matching according to tumor laterality. A total of 41,526 propensity-matched patients were identified (n = 20,763 for either left- or right-sided tumor). In the analysis of the cumulative incidence of heart-related mortality events, there was a greater risk increment in the left-sided group over the first to second decades after RT in patients aged ≤ 50 years (P = 0.048). Competing risks analysis of the young patients showed that left-sided RT was associated with higher heart-related mortality rates (Grey’s test, P = 0.049). The statistical significance remained after adjusting for other covariates (subdistribution hazard ratio 2.35; 95% confidence interval 1.09‒5.10). Regarding the intrinsic effect of modern RT techniques, further strategies to reduce heart-related risks are needed for young patients. Close surveillance within an earlier follow-up period should be considered for these patients in clinics.

617 Who Benefits the Most from Burn Camps?

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S162-S163
Author(s):  
Jennifer B Radics-Johnson ◽  
Daniel W Chacon ◽  
Li Zhang
Keyword(s):  
Retrospective Review ◽  
Burn Injury ◽  
Statistical Significance ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Self Evaluation ◽  
Significant Difference ◽  
Return Home ◽  
The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value&lt; 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

scholarly journals Impact of health disparities on treatment for single-suture craniosynostosis in an era of multimodal care

2021 ◽  
Vol 50 (4) ◽  
pp. E13
Author(s):  
Caitlin Hoffman ◽  
Alyssa B. Valenti ◽  
Eseosa Odigie ◽  
Kwanza Warren ◽  
Ishani D. Premaratne ◽  
...  
Keyword(s):  
Open Surgery ◽  
Statistical Significance ◽  
Demographic Data ◽  
Tertiary Care ◽  
Insurance Status ◽  
Significant Difference ◽  
Race Ethnicity ◽  
The Impact ◽  
Type Of Surgery ◽  
Surgical Group

Craniosynostosis is the premature fusion of the skull. There are two forms of treatment: open surgery and minimally invasive endoscope-assisted suturectomy. Candidates for endoscopic treatment are less than 6 months of age. The techniques are equally effective; however, endoscopic surgery is associated with less blood loss, minimal tissue disruption, shorter operative time, and shorter hospitalization. In this study, the authors aimed to evaluate the impact of race/ethnicity and insurance status on age of presentation/surgery in children with craniosynostosis to highlight potential disparities in healthcare access. Charts were reviewed for children with craniosynostosis at two tertiary care hospitals in New York City from January 1, 2014, to August 31, 2020. Clinical and demographic data were collected, including variables pertaining to family socioeconomic status, home address/zip code, insurance status (no insurance, Medicaid, or private), race/ethnicity, age and date of presentation for initial consultation, type of surgery performed, and details of hospitalization. Children with unknown race/ethnicity and those with syndromic craniosynostosis were excluded. The data were analyzed via t-tests and chi-square tests for statistical significance (p < 0.05). A total of 121 children were identified; 62 surgeries were performed open and 59 endoscopically. The mean age at initial presentation of the cohort was 6.68 months, and on the day of surgery it was 8.45 months. Age at presentation for the open surgery cohort compared with the endoscopic cohort achieved statistical significance at 11.33 months (SD 12.41) for the open cohort and 1.86 months (SD 1.1473) for the endoscopic cohort (p < 0.0001). Age on the day of surgery for the open cohort versus the endoscopic cohort demonstrated statistical significance at 14.19 months (SD 15.05) and 2.58 months (SD 1.030), respectively. A statistically significant difference between the two groups was noted with regard to insurance status (p = 0.0044); the open surgical group comprised more patients without insurance and with Medicaid compared with the endoscopic group. The racial composition of the two groups reached statistical significance when comparing proportions of White, Black, Hispanic, Asian, and other (p = 0.000815), with significantly more Black and Hispanic patients treated in the open surgical group. The results demonstrate a relationship between race and lack of insurance or Medicaid status, and type of surgery received; Black and Hispanic children and children with Medicaid were more likely to present later and undergo open surgery.

scholarly journals Composition of raw milk from conventional and organic dairy farming

2016 ◽  
Vol 32 (2) ◽  
pp. 133-143 ◽  
Author(s):  
Denis Kucevic ◽  
Snezana Trivunovic ◽  
Vladan Bogdanovic ◽  
Ksenija Cobanovic ◽  
Dobrila Jankovic ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Raw Milk ◽  
Farming System ◽  
Dairy Farming ◽  
Milk Samples ◽  
High Statistical Significance ◽  
Significant Difference ◽  
Organic Dairy ◽  
One Year ◽  
The Impact

Possible differences between composition of raw milk due to dairy farming system (organic vs conventional) as well as seasonal variations were investigated. The samples were analysed during one year. A total of 6.782 samples of raw milk were collected (4.496 from organic farming). Dairy farms were located in the northern part of Republic of Serbia (Province of Vojvodina). The principle of analysis of raw milk samples was in accordance with the methodology by midinfrared spectrometry and flow cytometry. The fixed effect of system of farming and season (winter, spring, summer and fall) have shown a high statistical significance (P < 0.01) on all examined milk parameters except fat, total solids and somatic cell count, where the impact was slightly lower (P < 0.05). Significant difference wasn't found in number of bacterial colonies (P > 0.05). Composition of milk is also affected by a number of other factors, therefore it is recommended to involve factors such as nutrition of dairy cows, breed and farm management.

scholarly journals Commercial Vinegar Tablets Do Not Display the Same Physiological Benefits for Managing Postprandial Glucose Concentrations as Liquid Vinegar

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Natasha K. Feise ◽  
Carol S. Johnston
Keyword(s):  
Acetic Acid ◽  
Repeated Measures ◽  
Crossover Trial ◽  
Latin Square ◽  
Postprandial Glucose ◽  
Healthy Adults ◽  
Control Treatment ◽  
Water Control ◽  
Glucose Excursion ◽  
The Impact

Objective. Research evidence suggests that vinegar may effectively reduce postprandial glucose in both healthy adults and those with type 2 diabetes. There is heightened consumer interest in commercially available vinegar tablets; however, it is not known whether these products lower postprandial glycemia to the same extent as liquid vinegar. This crossover trial examined the impact of liquid vinegar versus commercial vinegar tablet ingestion at the start of a meal on the 60-minute glucose excursion postmeal in healthy adults. Methods. Twelve young men and women (22.6 ± 0.6 y; 21.2 ± 1.2 kg/m2) completed this 4-arm Latin square crossover trial. Testing was separated by one week and consisted of a test meal (64 g carbohydrate) consumed immediately following one of the four oral treatments: CON, 60 g water (control treatment); VIN, 25 g liquid vinegar (5% acidity; 1.25 g acetic acid) diluted with 35 g water; PILL, four vinegar tablets (1.50 g acetic acid) swallowed whole with 60 g water; and PILL-c, four crushed vinegar tablets dissolved in 60 g water. Capillary blood glucose was tested in the fasted state and at 30 and 60 minutes postmeal. Results. The 60-minute glucose excursion varied significantly by treatment (iAUC: 4.9 ± 0.6, 3.4 ± 0.4, 4.9 ± 0.6, and 4.1 ± 0.5 mmol˖h/l for CON, VIN, PILL, and PILL-c, respectively; F (3, 33) = 3.037, p  = 0.043; repeated measures ANOVA). Post hoc analysis revealed a 31% reduction in the glucose postmeal excursion for VIN in comparison to CON and PILL ( p  = 0.040 and p  = 0.049, respectively). Conclusions. These data suggest that commercial vinegar tablets taken whole at mealtime are not as effective as liquid vinegar for reducing the postmeal glucose excursion in young, healthy adults.

The IC50 Assay Is Predictive of Molecular Response, and Indicative of Optimal Dose in De-Novo CML Patients.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1109-1109
Author(s):  
Deborah L White ◽  
Verity A Saunders ◽  
Thea Kalebic ◽  
Timothy P Hughes
Keyword(s):  
De Novo ◽  
Statistical Significance ◽  
Continuous Variable ◽  
Rank Test ◽  
P Value ◽  
Molecular Response ◽  
Optimization Strategy ◽  
Log Reduction ◽  
Significant Difference ◽  
The Impact

Abstract We have previously demonstrated significant interpatient variability in the IC50imatinib, a measure of the intrinsic sensitivity of a patient to imatinib induced kinase inhibition. Furthermore, this measure is predictive of the achievement of major molecular response (MMR &gt; 3 log reduction in BCR-ABL) in de-novo CML patients treated with imatinib (n=60)1. In an expanded patient pool (n=116) we now perform an evaluation of the IC50 as a predictor of response, and address the IC50imatinib as a guide to dose selection. Samples were obtained with informed consent from de novo CML patients enrolled to either the TIDEL (600mg imatinib) or TOPS (randomised 400mg vs 800mg imatinib) trials. Blood was collected pre therapy, and the IC50 was performed as previously1. Outcome data was assessed using Kaplan Meier Analysis and the log rank test was used to assess statistical significance. In our previous analysis the IC50imatinib was divided about the median value for the cohort (0.6μM) into low and high IC50, with a significantly greater proportion of patients with low IC50imatinib achieving MMR by 12 months. In this expanded patient pool, we confirm this finding (&lt;median of 0.7μM for this patient group) (low IC50 65% of patients achieve MMR by 12 mo vs high IC50 39% of patients p=0.014) Dividing the IC50’s into quartiles we now demonstrate that the IC50imatinib is a continuous variable with a greater proportion of patients in the lower quartile achieving MMR than those in the higher (Table 1 Total). Addressing the issue of dose we demonstrate that no patients with IC50&gt;0.95uM achieve MMR on 400mg, and that this is statistically significantly when compared to all other groups. At 600mg while there is no overall significant difference there is a statistically relevant difference between groups 1, 2 and 4 as indicated. In contrast, at 800 mg the effect of IC50imatinib is overcome. MMR by 12 months Total 400mg 600mg 800mg p value Group1 &lt;0.5μM 67% (27) 83% (12)* 50% (8)* 86% (7) 0.470 Group 2 &gt;0.5&lt;0.7μM 63% (30) 67% (6)* 53% (17)* 71% (7) 0.337 Group 3 &gt;0.7&lt;0.95μM 45% (31) 40%(5)* 30% (10) 56% (16) 0.139 Group 4&gt;0.95μM 32% (28) 0% (7)* 22% (9)* 58% (12) 0.016 P value 0.042 0.018 0.108 0.778 Table 1: Dividing the patients into quartile based on the IC50 imatinib and assessing the Impact of dose on the achievement of MMR by 12 month. *p value &lt;0.05 between groups (n). The failure to achieve a Complete Cytogenetic Response by 12 months is considered a suboptimal response. Assessing the molecular equivalent (≥2 log reduction in BCR-ABL) we demonstrate that a significantly greater proportion of patients with IC50imatinib&gt;0.7μM fail to achieve a 2 log reduction when treated with 400mg (IC50 &lt;0.7μM 11%: &gt;0.7μM 33% p=0.034), and 600mg (IC50 &lt;0.7μM 12%: &gt;0.7μM 22% p=0.036). However, there is no significant difference in the 800mg patient cohort (IC50 &lt;0.7μM 7%: &gt;0.7μM 14% p=0.79). This analysis confirms that the IC50imatinib, is predictive of imatinib response. Patients with an IC50imatinib &lt;0.7μM are likely to respond well to doses of 400mg imatinib, as suggested by evaluation of statistically relevant outcome benefit. In contrast patients with higher IC50imatinib (&gt;0.7μM) may benefit from higher dosing regimens (p=0.012). Thus, the accurate assessment of IC50imatinib could support dose optimization strategy for patients with a suboptimal response.

Impact of margin status and re-excision on local control in patients undergoing breast-conservation therapy for ductal carcinoma in situ.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 57-57
Author(s):  
Talha Shaikh ◽  
Tianyu Li ◽  
Fatima Sheikh ◽  
Colin T. Murphy ◽  
Nicholas Zaorsky ◽  
...  
Keyword(s):  
Local Control ◽  
Ductal Carcinoma In Situ ◽  
Hormonal Therapy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conservation ◽  
Breast Conservation Therapy ◽  
Significant Difference ◽  
The Impact

57 Background: The purpose of this study was to identify the impact of final surgical margin (SM) status, SM width, and re-excision on outcomes in patients with ductal carcinoma in situ (DCIS) undergoing breast conservation therapy (BCT). Methods: The study population consisted of women diagnosed with DCIS undergoing BCT between 1989-2014. All women received adjuvant whole breast radiation plus a boost. The primary endpoint was local control (LC) defined as an ipsilateral breast failure. A negative SM was defined as > 2 mm, close SM was defined as > 0 to < 2 mm, and a positive SM was defined as tumor at the inked SM. Cox proportional hazards model was used to determine predictors of outcomes on multivariate analysis (MVA). Actuarial incidence of LC was estimated using the Kaplan-Meier method. Results: A total of 498 patients were included. The median age was 58 (range 30-91) and the median follow-up was 8.3 years (3 months-27 years). A total of 400 patients had a final negative SM, 87 had a close SM, and 11 had a positive SM. A total of 172 patients received adjuvant hormonal therapy, 265 patients required at least one re-excision. Patients with positive or close SMs were more likely to receive a radiation dose > 60 Gy (p < 0.001) and undergo re-excision (p < 0.01). The 10-year LC rates were not significantly different between patients with a negative (93.5%), close (91.8%), or positive (100%) SM (p = 0.57). There was no difference in 10-year LC rates according to a SM width of 0-1 mm (100%), > 1 to 2 mm (88.5%), or > 2 mm (93.5%) (p = 0.85). On univariate analysis, there was no significant difference in LC when comparing negative versus close or positive (p = 1.0) SMs. There was no difference in LC in patients undergoing re-excision for initial close or positive SMs (p = 0.55). On MVA, after controlling for age, dose, hormonal therapy, comedo subtype, and grade, there were no factors associated with LC. Conclusions: This large single-institution experience demonstrates that risks of local failure remain poorly characterized. Re-excision and whole breast radiation plus boost resulted in excellent LC for women with DCIS. Our data suggests that trials aimed at personalized de-intensified local therapy are warranted.

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