Many American pet owners struggle financially, and the COVID-19 pandemic has only exacerbated this problem. Yet, the positive effects that companion animals have in people's lives create the need for supportive systems to ensure that financial limitations, and other barriers, do not preclude pet ownership. To help address these barriers, and reach underserved communities, various forms of community-based veterinary medicine programs have been developed across the country. This study assesses two community-based veterinary programs in North Carolina, USA. In addition to perceptions surrounding veterinary services, this study paid specific attention to communication and respect; two additional elements needed for successful community-based veterinary programs. Surveys were given to clients accessing Asheville Humane Society (AHS) mobile veterinary care clinic and Asheville Humane Society (AHS) Affordable Pet Care Clinic. Results of the anonymous survey indicate that the majority of clients had positive veterinary care experiences in terms of both veterinary services and client communication. In conclusion, low-cost or free community veterinary programs—with effective communication, empathy, and cultural competence—can help open the door to future positive veterinary experiences for disadvantaged pet owners.

HighlightsAn examination of mutations in PIK3CA signaling pathways and radioresistance.PIK3CA mutation was found to be associated with local failure after lung SBRT.This is a small study and there is need for further validation.

An association was found between SUVmax, the SD, and MAD of DCE-MRI metrics derived during contrast uptake in NSCLC, reflecting that intratumoral heterogeneity in wash-in contrast kinetics is associated with tumor metabolism. Although MAD(IAUCtthp) was a significant feature in both UVA and MVA, the LASSO-based multivariate regression model yielded better predictability of SUVmax than a univariate regression model using MAD(IAUCtthp). This study will facilitate understanding of the complex relationship between tumor vascularization and metabolism and eventually help in guiding targeted therapy.

Purpose Capsular contracture (CC) is a serious complication in patients receiving implant-based reconstruction for breast cancer. Currently, no objective methods are available for assessing CC. The goal of the present study was to identify image-based surrogates of CC using magnetic resonance imaging (MRI). Methods and Materials We analyzed a retrospective data set of 50 patients who had undergone both a diagnostic MRI scan and a plastic surgeon’s evaluation of the CC score (Baker’s score) within a 6-month period after mastectomy and reconstructive surgery. The MRI scans were assessed for morphologic shape features of the implant and histogram features of the pectoralis muscle. The shape features, such as roundness, eccentricity, solidity, extent, and ratio length for the implant, were compared with the Baker score. For the pectoralis muscle, the muscle width and median, skewness, and kurtosis of the intensity were compared with the Baker score. Univariate analysis (UVA) using a Wilcoxon rank-sum test and multivariate analysis with the least absolute shrinkage and selection operator logistic regression was performed to determine significant differences in these features between the patient groups categorized according to their Baker’s scores. Results UVA showed statistically significant differences between grade 1 and grade ≥2 for morphologic shape features and histogram features, except for volume and skewness. Only eccentricity, ratio length, and volume were borderline significant in differentiating grade ≤2 and grade ≥3. Features with P<.1 on UVA were used in the multivariate least absolute shrinkage and selection operator logistic regression analysis. Multivariate analysis showed a good level of predictive power for grade 1 versus grade ≥2 CC (area under the receiver operating characteristic curve 0.78, sensitivity 0.78, and specificity 0.82) and for grade ≤2 versus grade ≥3 CC (area under the receiver operating characteristic curve 0.75, sensitivity 0.75, and specificity 0.79). Conclusions The morphologic shape features described on MR images were associated with the severity of CC. MRI has the potential to further improve the diagnostic ability of the Baker score in breast cancer patients who undergo implant reconstruction.

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