Mapping change in medical student attitudes regarding lesbian, gay and bisexual healthcare

Despite significant social advances among lesbian, gay, bisexual, and transgender (LGBT) individuals, healthcare disparities remain prevalent. Medical education represents a prime opportunity for addressing this need. Thus, we undertook this study to explore second year medical students’ attitudes regarding equal access to healthcare services including erectile dysfunction medication, family planning medications and technology, and partner health insurance coverage. Nearly 1500 allopathic medical students were surveyed from 2006 to 2014 during their second pre-clinical training year. While attitudes regarding care between LGB patients and heterosexual patients were often similar, there was a significant change in favor of providing insurance coverage for in-vitro and assisted reproduction services for lesbian women (increasing from 70% of students in favor in 2008 to 87% of students in 2013). Similarly, the proportion of students in favor of providing health insurance coverage for prescription drugs to same sex partners significantly increased from 2009 to 2013. Additionally, students noted healthcare providers should be required to provide equal access to care for all patients regardless of marital status or sexual practices (96% agreement in 2006 and 98.6% agreement in 2014). Even with this significant increase in medical student approval of certain healthcare services for LGB patients, continuing to integrate LGBT healthcare topics into medical education curriculum remains critically important

Mass detection on mammograms: signal variations and performance changes for human and model observers

We studied the influence of signal variability on human and model observer performances for a detection task with mammographic backgrounds and computer generated clustered lumpy backgrounds (CLB). We used synthetic yet realistic masses and backgrounds that have been validated by radiologists during previous studies, ensuring conditions close to the clinical situation. Four trained non-physician observers participated in two-alternative forced-choice (2-AFC) experiments. They were asked to detect synthetic masses superimposed on real mammographic backgrounds or CLB. Separate experiments were conducted with sets of benign and malignant masses. Results under the signal-known-exactly (SKE) paradigm were compared with signal-known-statistically (SKS) experiments. In the latter case, the signal was chosen randomly for each of the 1,400 2-AFC trials (image pairs) among a set of 50 masses with similar dimensions, and the observers did not know which signal was present. Human observers' results were then compared with model observers (channelized Hotelling with Difference-of-Gaussian and Gabor channels) in the same experimental conditions. Results show that the performance of the human observers does not differ significantly when benign masses are superimposed on real images or on CLB with locally matched gray level mean and standard deviation. For both benign and malignant masses, the performance does not differ significantly between SKE and SKS experiments, when the signals' dimensions do not vary throughout the experiment. However, there is a performance drop when the SKS signals' dimensions vary from 5.5 to 9.5 mm in the same experiment. Noise level in the model observers can be adjusted to reproduce human observers' proportion of correct answers in the 2-AFC task within 5% accuracy for most condition

Fast algorithms for histogram matching: Application to texture synthesis

Texture synthesis is the ability to create ensembles of images of similar structures from sample textures that have been photographed. The method we employ for texture synthesis is based on histogram matching of images at multiple scales and orientations. This paper reports two fast and in one case simple algorithms for histogram matching We show that the sort-matching and the optimal cumulative distribution function (CDF)-matching (OCM) algorithms provide high computational speed compared to that provided by the conventional approach. The sort-matching algorithm also provides exact histogram matching. Results of texture synthesis using either method show no subjective perceptual differences. The sort-matching algorithm is attractive because of its simplicity and speed, however as the size of the image increases, the OCM algorithm may be preferred for optimal computational speed

The Swift X-Ray Telescope: Status and Performance

We present science highlights and performance from the Swift X-ray Telescope (XRT), which was launched on November 20, 2004. The XRT covers the 0.2-10 keV band, and spends most of its time observing gamma-ray burst (GRB)afterglows, though it has also performed observations of many other objects. By mid-August 2007, the XRT had observed over 220 GRB afterglows, detecting about 96% of them. The XRT positions enable followup ground-based optical observations, with roughly 60% of the afterglows detected at optical or near IR wavelengths. Redshifts are measured for 33% of X-ray afterglows. Science highlights include the discovery of flaring behavior at quite late times, with implications for GRB central engines; localization of short GRBs, leading to observational support for compact merger progenitors for this class of bursts; a mysterious plateau phase to GRB afterglows; as well as many other interesting observations such as X-ray emission from comets, novae, galactic transients, and other objects.Comment: 9 pages, 14 figure

Rank-(n – 1) convexity and quasiconvexity for divergence free fields

The CAST experiment at CERN (European Organization of Nuclear Research) searches for axions from the sun. The axion is a pseudoscalar particle that was motivated by theory thirty years ago, with the intention to solve the strong CP problem. Together with the neutralino, the axion is one of the most promising dark matter candidates. The CAST experiment has been taking data during the last two years, setting an upper limit on the coupling of axions to photons more restrictive than from any other solar axion search in the mass range below 0.1 eV. In 2005 CAST will enter a new experimental phase extending the sensitivity of the experiment to higher axion masses. The CAST experiment strongly profits from technology developed for high energy physics and for X-ray astronomy: A superconducting prototype LHC magnet is used to convert potential axions to detectable X-rays in the 1-10 keV range via the inverse Primakoff effect. The most sensitive detector system of CAST is a spin-off from space technology, a Wolter I type X-ray optics in combination with a prototype pn-CCD developed for ESA's XMM-Newton mission. As in other rare event searches, background suppression and a thorough shielding concept is essential to improve the sensitivity of the experiment to the best possible. In this context CAST offers the opportunity to study the background of pn-CCDs and its long term behavior in a terrestrial environment with possible implications for future space applications. We will present a systematic study of the detector background of the pn-CCD of CAST based on the data acquired since 2002 including preliminary results of our background simulations.Comment: 11 pages, 8 figures, to appear in Proc. SPIE 5898, UV, X-Ray, and Gamma-Ray Space Instrumentation for Astronomy XI

Cellular adaptations to hypoxia and acidosis during somatic evolution of breast cancer

Conceptual models of carcinogenesis typically consist of an evolutionary sequence of heritable changes in genes controlling proliferation, apoptosis, and senescence. We propose that these steps are necessary but not sufficient to produce invasive breast cancer because intraductal tumour growth is also constrained by hypoxia and acidosis that develop as cells proliferate into the lumen and away from the underlying vessels. This requires evolution of glycolytic and acid-resistant phenotypes that, we hypothesise, is critical for emergence of invasive cancer. Mathematical models demonstrate severe hypoxia and acidosis in regions of intraductal tumours more than 100 m from the basement membrane. Subsequent evolution of glycolytic and acid-resistant phenotypes leads to invasive proliferation. Multicellular spheroids recapitulating ductal carcinoma in situ (DCIS) microenvironmental conditions demonstrate upregulated glucose transporter 1 (GLUT1) as adaptation to hypoxia followed by growth into normoxic regions in qualitative agreement with model predictions. Clinical specimens of DCIS exhibit periluminal distribution of GLUT-1 and Na+/H+ exchanger (NHE) indicating transcriptional activation by hypoxia and clusters of the same phenotype in the peripheral, presumably normoxic regions similar to the pattern predicted by the models and observed in spheroids. Upregulated GLUT-1 and NHE-1 were observed in microinvasive foci and adjacent intraductal cells. Adaptation to hypoxia and acidosis may represent key events in transition from in situ to invasive cancer

A refined position catalog of the Swift XRT afterglows

We present a catalogue of refined positions of 68 gamma ray burst (GRB) afterglows observed by the Swift X-ray Telescope (XRT) from the launch up to 2005 Oct 16. This is a result of the refinement of the XRT boresight calibration. We tested this correction by means of a systematic study of a large sample of X-ray sources observed by XRT with well established optical counterparts. We found that we can reduce the systematic error radius of the measurements by a factor of two, from 6.5" to 3.2" (90% of confidence). We corrected all the positions of the afterglows observed by XRT in the first 11 months of the Swift mission. This is particularly important for the 37 X-ray afterglows without optical counterpart. Optical follow-up of dark GRBs, in fact, will be more efficient with the use of the more accurate XRT positions.Comment: 4 pages, 4 figures, 1 table ; accepted for publication in A&A Letters. The revised version contains updated position

The in-flight spectroscopic performance of the Swift XRT CCD camera during 2006-2007

The Swift X-ray Telescope focal plane camera is a front-illuminated MOS CCD, providing a spectral response kernel of 135 eV FWHM at 5.9 keV as measured before launch. We describe the CCD calibration program based on celestial and on-board calibration sources, relevant in-flight experiences, and developments in the CCD response model. We illustrate how the revised response model describes the calibration sources well. Comparison of observed spectra with models folded through the instrument response produces negative residuals around and below the Oxygen edge. We discuss several possible causes for such residuals. Traps created by proton damage on the CCD increase the charge transfer inefficiency (CTI) over time. We describe the evolution of the CTI since the launch and its effect on the CCD spectral resolution and the gain.Comment: 8 pages, 5 colour figures, submitted to SPI