Ethnic Differences in Survival after Breast Cancer in South East Asia

Background: The burden of breast cancer in Asia is escalating. We evaluated the impact of ethnicity on survival after breast cancer in the multi-ethnic region of South East Asia. Methodology/Principal Findings Using the Singapore-Malaysia hospital-based breast cancer registry, we analyzed the association between ethnicity and mortality following breast cancer in 5,264 patients diagnosed between 1990 and 2007 (Chinese: 71.6%, Malay: 18.4%, Indian: 10.0%). We compared survival rates between ethnic groups and calculated adjusted hazard ratios (HR) to estimate the independent effect of ethnicity on survival. Malays (n = 968) presented at a significantly younger age, with larger tumors, and at later stages than the Chinese and Indians. Malays were also more likely to have axillary lymph node metastasis at similar tumor sizes and to have hormone receptor negative and poorly differentiated tumors. Five year overall survival was highest in the Chinese women (75.8%; 95%CI: 74.4%–77.3%) followed by Indians (68.0%; 95%CI: 63.8%–72.2%), and Malays (58.5%; 95%CI: 55.2%–61.7%). Compared to the Chinese, Malay ethnicity was associated with significantly higher risk of all-cause mortality (HR: 1.34; 95%CI: 1.19–1.51), independent of age, stage, tumor characteristics and treatment. Indian ethnicity was not significantly associated with risk of mortality after breast cancer compared to the Chinese (HR: 1.14; 95%CI: 0.98–1.34). Conclusion: In South East Asia, Malay ethnicity is independently associated with poorer survival after breast cancer. Research into underlying reasons, potentially including variations in tumor biology, psychosocial factors, treatment responsiveness and lifestyle after diagnosis, is warranted

Swyer syndrome in a woman with pure 46, XY gonadal dysgenesis and a hypoplastic uterus

Swyer syndrome or pure 46, XY gonadal dysgenesis is a condition in which the individuals have female appearance. They classically present as sexually infantile phenotypic females with primary amenorrhoea. People with this disorder have female external genitalia but the uterus and fallopian tubes are underdeveloped. However, they do not have functional gonads (ovaries or testes). Instead, they have streak gonads. We are reporting a case of Swyer syndrome with partially developed breasts, hypoplastic uterus, and absent streak gonads. The patient was treated with hormonal therapy and few years after her presentation, breast and uterine development were noted. In view that the patient is already married, the option of fertility was discussed with her. This case illustrates a rare case of gonadal dysgenesis and demonstrates the importance of counseling on the options of treatment, especially regarding fertility

Defining knowledge constituents and contents

While it appears that a consensus is crystalising with regard to the hierarchy of concepts such as “knowledge”, “definition” and “information”, there is an increasing urgency for improving definitions of these terms. Strategies such as “knowledge extraction” or “data mining” rely on the increasing availability of digital (electronic) records addressing almost any aspect of socio-economic realm. Information processors are invaluable in the capacity of turning large amount of data into information. However, a new problem emerged on the surface in this new information environment: numerous concepts and terms are blurred by ambiguous definitions (including the concept of ‘definition’ itself). This triggered a need for mitigating hindrances such as homonymy and synonymy, leading further to demands on the decoding software complexity of which equals the artificial intelligence applications. Information technology presumably copes with this diversity by providing the information decoding ‘tools’. This opens a never-ending opportunity for further permutations of tasks and service abilities. The solution, however, is to address the causes rather than indulge in multiplying the superficial remedies. Clearly, the multiplicity of definitions for the same concepts, false synonyms and so forth show that there is a need for introducing definitions of sufficient dimensionality. In this article, a number of examples of important concepts are presented first to point at the ambiguities associated with them, and then to propose their disambiguation. The minimum intent is to demonstrate how these key terms can be defined to avoid ambiguities such as pleonasm, homonymy, synonymy and circularity

Defining knowledge constituents and contents

While it appears that a consensus is crystalising with regard to the hierarchy of concepts such as “knowledge”, “definition” and “information”, there is an increasing urgency for improving definitions of these terms. Strategies such as “knowledge extraction” or “data mining” rely on the increasing availability of digital (electronic) records addressing almost any aspect of socio-economic realm. Information processors are invaluable in the capacity of turning large amount of data into information. However, a new problem emerged on the surface in this new information environment: numerous concepts and terms are blurred by ambiguous definitions (including the concept of ‘definition’ itself). This triggered a need for mitigating hindrances such as homonymy and synonymy, leading further to demands on the decoding software complexity of which equals the artificial intelligence applications. Information technology presumably copes with this diversity by providing the information decoding ‘tools’. This opens a never-ending opportunity for further permutations of tasks and service abilities. The solution, however, is to address the causes rather than indulge in multiplying the superficial remedies. Clearly, the multiplicity of definitions for the same concepts, false synonyms and so forth show that there is a need for introducing definitions of sufficient dimensionality. In this article, a number of examples of important concepts are presented first to point at the ambiguities associated with them, and then to propose their disambiguation. The minimum intent is to demonstrate how these key terms can be defined to avoid ambiguities such as pleonasm, homonymy, synonymy and circularity