The Influence of Patient Exposure to Breast Reconstruction Approaches and Education on Patient Choices in Breast Cancer Treatment.

BackgroundThe landscape of surgical and medical management and patient choices for breast cancer treatment changes as breast reconstruction and oncoplastic approaches improve and diversify. Increased access to breast reconstruction, in addition to patient education, influences the breast cancer patient. Therefore, the examination of the possible impact of reconstructive surgery on all stages of the breast cancer management per se seemed timely.MethodsPlastic surgery consults were arranged for 520 new patients diagnosed with breast cancer (2012-2016) including patients with noninvasive breast cancer but at high risk of further cancer development. To test the plastic surgery impact on patient choices regarding the management of the cancer, a subset of 90 patients was identified to test the plastic surgery impact on patient choices. These patients were referred to plastic surgery, following the first round of consultations by surgical and medical oncologists with only the preliminary oncological management plan defined. After a plastic surgery consultation, but prior to finalization of the overall oncological management plan, they were surveyed on the subject of modification of their personal choices and requests pertaining to their cancer management.ResultsIn this subset of 90 patients 40 (44%) returned to their surgical or medical oncologist considering changes of the primary management plan after their plastic surgery consultation. Twenty-six (28%) ultimately altered their plan, and the following patient-driven changes were made: mastectomy as opposed to lumpectomy (18 patients [20%]), contralateral prophylactic mastectomy (11 patients [12%]), nipple/areola removal as opposed to nipple/areola sparing suggested by the oncologists (5 patients [6%]), oncoplastic breast reduction as part of lumpectomy (5 patients [6%]), and other modifications (3 patients [3%]).ConclusionsDecisions for altering the preliminary oncologic plan or choosing a specific alternative (eg, lumpectomy plus radiation vs mastectomy) resulted from patient education on (1) reconstructive options, (2) aesthetic pitfalls and results. and (3) their interfacing with the oncological outcomes. Ultimately, plastic surgeons influence the multispecialty breast cancer management and patient decision-making process. Therefore, oncological literacy for plastic surgeons is essential to provide state-of-the-art breast cancer care and avoidance of suboptimal patient decisions

Investigation on the Use of a FLIR (Forward Looking Infrared) Camera to Detect Relationships Between Internal and Surface Temperatures of Beef Carcasses During Chilling

The objective of this study was to collect preliminary data on the efficacy of using thermal imaging technology as a means to assess beef carcass chilling

Influence of Post-harvest Circulatory Rinse on Tenderness and Objective Color of Cow Striploin Steaks

The objective of this study was to compare the effect of a post-harvest rinse of an isotonic solution through the circulatory system on tenderness of steaks from cows

The pre-shock gas of SN1006 from HST/ACS observations

We derive the pre-shock density and scale length along the line of sight for the collisionless shock from a deep HST image that resolves the H alpha filament in SN1006 and updated model calculations. The very deep ACS high-resolution image of the Balmer line filament in the northwest (NW) quadrant shows that 0.25 < n_0 < le$ 0.4 cm-3 and that the scale along the line of sight is about 2 x 10^{18} cm, while bright features within the filament correspond to ripples with radii of curvature less than 1/10 that size. The derived densities are within the broad range of earlier density estimates, and they agree well with the ionization time scale derived from the Chandra X-ray spectrum of a region just behind the optical filament. This provides a test for widely used models of the X-ray emission from SNR shocks. The scale and amplitude of the ripples are consistent with expectations for a shock propagating though interstellar gas with ~ 20% density fluctuations on parsec scales as expected from studies of interstellar turbulence. One bulge in the filament corresponds to a knot of ejecta overtaking the blast wave, however. The interaction results from the rapid deceleration of the blast wave as it encounters an interstellar cloud.Comment: 16 pages, 6 figures, to appear in Ap

On transversally elliptic operators and the quantization of manifolds with ff-structure

An $f$-structure on a manifold $M$ is an endomorphism field \phi\in\Gamma(M,\End(TM)) such that $\phi^3+\phi=0$. Any $f$-structure $\phi$ determines an almost CR structure E_{1,0}\subset T_\C M given by the $+i$-eigenbundle of $\phi$. Using a compatible metric $g$ and connection $\nabla$ on $M$, we construct an odd first-order differential operator $D$, acting on sections of $\S=\Lambda E_{0,1}^*$, whose principal symbol is of the type considered in arXiv:0810.0338. In the special case of a CR-integrable almost $\S$-structure, we show that when $\nabla$ is the generalized Tanaka-Webster connection of Lotta and Pastore, the operator $D$ is given by D = \sqrt{2}(\dbbar+\dbbar^*), where \dbbar is the tangential Cauchy-Riemann operator. We then describe two "quantizations" of manifolds with $f$-structure that reduce to familiar methods in symplectic geometry in the case that $\phi$ is a compatible almost complex structure, and to the contact quantization defined in \cite{F4} when $\phi$ comes from a contact metric structure. The first is an index-theoretic approach involving the operator $D$; for certain group actions $D$ will be transversally elliptic, and using the results in arXiv:0810.0338, we can give a Riemann-Roch type formula for its index. The second approach uses an analogue of the polarized sections of a prequantum line bundle, with a CR structure playing the role of a complex polarization.Comment: 31 page

Some constructions of almost para-hyperhermitian structures on manifolds and tangent bundles

In this paper we give some examples of almost para-hyperhermitian structures on the tangent bundle of an almost product manifold, on the product manifold $M\times\mathbb{R}$, where $M$ is a manifold endowed with a mixed 3-structure and on the circle bundle over a manifold with a mixed 3-structure.Comment: 10 pages; This paper has been presented in the "4th German-Romanian Seminar on Geometry" Dortmund, Germany, 15-18 July 200

Influence of Beef Production System on Calpain-1 Autolysis and Troponin-T Degradation

The objective of this study was to determine the impact beef production systems utilizing different levels of growth promotant technology on calpain-1 autolysis and troponin-T degradation, which are measures of tenderness

Altered rainfall patterns increase forb abundance and richness in native tallgrass prairie

Citation: Jones, S. K., Collins, S. L., Blair, J. M., Smith, M. D., & Knapp, A. K. (2016). Altered rainfall patterns increase forb abundance and richness in native tallgrass prairie. Scientific Reports, 6, 10. doi:10.1038/srep20120Models predict that precipitation variability will increase with climate change. We used a 15-year precipitation manipulation experiment to determine if altering the timing and amount of growing season rainfall will impact plant community structure in annually burned, native tallgrass prairie. The altered precipitation treatment maintained the same total growing season precipitation as the ambient precipitation treatment, but received a rainfall regime of fewer, larger rain events, and longer intervals between events each growing season. Although this change in precipitation regime significantly lowered mean soil water content, overall this plant community was remarkably resistant to altered precipitation with species composition relatively stable over time. However, we found significantly higher forb cover and richness and slightly lower grass cover on average with altered precipitation, but the forb responses were manifest only after a ten-year lag period. Thus, although community structure in this grassland is relatively resistant to this type of altered precipitation regime, forb abundance in native tallgrass prairie may increase in a future characterized by increased growing season precipitation variability