The Economic Cost of Community-Based Interventions to Improve Breast Cancer Control among African-American Women

A number of intervention strategies to improve the rate of early stage breast cancer detection have been proposed and evaluated. Though good effectiveness data exist, policymakers and medical administrators may be reluctant to implement such interventions because of cost considerations. Few cost-effectiveness analyses have been conducted on culturally-sensitive interventions that increase mammography screening rates or reduce barriers to receiving timely diagnostic testing and treatment for African-American women. This paper discusses an innovative cost effectiveness model, funded by the National Cancer Institute, and presents microeconomic estimates the cost of twelve community-based intervention strategies designed to improve early stage breast cancer detection rates and appropriate follow-up after an abnormal mammogram among African-American women. An innovation in the estimates is to include the value of women’s time. Community-based program costs range from $47 to$161 per patient on an ongoing basis. Same day scheduling of a mammogram with or without patient transportation, public service announcements, physician education, physician audit with feedback, and same day scheduling of a biopsy cost $47-$53 per patient per year on an ongoing basis. Interventions that require fulltime personnel to maintain the program, such as patient reminder letters, theory-based education, physician reminders, and telephone counseling, are more expensive and cost approximately $54-$57 per patient on an ongoing basis. The three most expensive interventions are the mobile mammography van, lay health workers, and church based navigators, costing approximately $67-$161 per patient In conclusion, the added costs of community-based cancer control programs for vulnerable African-American women are small and have the potential to be offset by the gains in quality-adjusted life years saved as a result of detection at an earlier stage of diagnosis and improved follow-up and treatment, particularly among high-risk communities

Local density of states in superconductor-strong ferromagnet structures

We study the dependence of the local density of states (LDOS) on coordinates for a superconductor-ferromagnet (S/F) bilayer and a S/F/S structure assuming that the exchange energy h in the ferromagnet is sufficiently large: $>>1,$ where $\tau$ is the elastic relaxation time. This limit cannot be described by the Usadel equation and we solve the more general Eilenberger equation. We demonstrate that, in the main approximation in the parameter $(h\tau)^{-1}$, the proximity effect does not lead to a modification of the LDOS in the S/F system and a non-trivial dependence on coordinates shows up in next orders in $(h\tau) ^{-1}.$ In the S/F/S sandwich the correction to the LDOS is nonzero in the main approximation and depends on the phase difference between the superconductors. We also calculate the superconducting critical temperature $T_{c}$ for the bilayered system and show that it does not depend on the exchange energy of the ferromagnet in the limit of large h and a thick F layer.Comment: 9 pages, 5 figure

Spontaneous Spin Polarized Currents in Superconductor-Ferromagnetic Metal Heterostructures

We study a simple microscopic model for thin, ferromagnetic, metallic layers on semi-infinite bulk superconductor. We find that for certain values of the exchange spliting, on the ferromagnetic side, the ground states of such structures feature spontaneously induced spin polarized currents. Using a mean-field theory, which is selfconsistent with respect to the pairing amplitude $\chi$, spin polarization $\vec{m}$ and the spontaneous current $\vec{j}_s$, we show that not only there are Andreev bound states in the ferromagnet but when their energies $E_n$ are near zero they support spontaneous currents parallel to the ferromagnetic-superconducting interface. Moreover, we demonstrate that the spin-polarization of these currents depends sensitively on the band filling.Comment: 4 pages, 5 Postscript figures (included

Measurement of the 58Ni(α, γ) 62Zn reaction and its astrophysical impact

Funding Details: PHY 08-22648, NSF, National Science Foundation; PHY 0969058, NSF, National Science Foundation; PHY 1102511, NSF, National Science FoundationCross section measurements of the 58Ni(α,γ)62Zn reaction were performed in the energy range Eα=5.5to9.5 MeV at the Nuclear Science Laboratory of the University of Notre Dame, using the NSCL Summing NaI(Tl) detector and the γ-summing technique. The measurements are compared to predictions in the statistical Hauser-Feshbach model of nuclear reactions using the SMARAGD code. It is found that the energy dependence of the cross section is reproduced well but the absolute value is overestimated by the prediction. This can be remedied by rescaling the α width by a factor of 0.45. Stellar reactivities were calculated with the rescaled α width and their impact on nucleosynthesis in type Ia supernovae has been studied. It is found that the resulting abundances change by up to 5% when using the new reactivities. © 2014 American Physical Society.Peer reviewe

The SOS Pilot Study: a RCT of routine oxygen supplementation early after acute stroke—effect on recovery of neurological function at one week

Mild hypoxia is common after stroke and associated with poor long-term outcome. Oxygen supplementation could prevent hypoxia and improve recovery. A previous study of routine oxygen supplementation showed no significant benefit at 7 and 12 months. This pilot study reports the effects of routine oxygen supplementation for 72 hours on oxygen saturation and neurological outcomes at 1 week after a stroke

Noisy Kondo impurities

The anti-ferromagnetic coupling of a magnetic impurity carrying a spin with the conduction electrons spins of a host metal is the basic mechanism responsible for the increase of the resistance of an alloy such as Cu${}_{0.998}$Fe${}_{0.002}$ at low temperature, as originally suggested by Kondo . This coupling has emerged as a very generic property of localized electronic states coupled to a continuum . The possibility to design artificial controllable magnetic impurities in nanoscopic conductors has opened a path to study this many body phenomenon in unusual situations as compared to the initial one and, in particular, in out of equilibrium situations. So far, measurements have focused on the average current. Here, we report on \textit{current fluctuations} (noise) measurements in artificial Kondo impurities made in carbon nanotube devices. We find a striking enhancement of the current noise within the Kondo resonance, in contradiction with simple non-interacting theories. Our findings provide a test bench for one of the most important many-body theories of condensed matter in out of equilibrium situations and shed light on the noise properties of highly conductive molecular devices.Comment: minor differences with published versio

Manifestation of triplet superconductivity in superconductor-ferromagnet structures

We study proximity effects in a multilayered superconductor/ferromagnet (S/F) structure with arbitrary relative directions of the magnetization ${\bf M}$. If the magnetizations of different layers are collinear the superconducting condensate function induced in the F layers has only a singlet component and a triplet one with a zero projection of the total magnetic moment of the Cooper pairs on the ${\bf M}$ direction. In this case the condensate penetrates the F layers over a short length $\xi_J$ determined by the exchange energy $J$. If the magnetizations ${\bf M}$ are not collinear the triplet component has, in addition to the zero projection, the projections $\pm1$. The latter component is even in the momentum, odd in the Matsubara frequency and penetrates the F layers over a long distance that increases with decreasing temperature and does not depend on $J$ (spin-orbit interaction limits this length). If the thickness of the F layers is much larger than $\xi_J$, the Josephson coupling between neighboring S layers is provided only by the triplet component, so that a new type of superconductivity arises in the transverse direction of the structure. The Josephson critical current is positive (negative) for the case of a positive (negative) chirality of the vector ${\bf M}$. We demonstrate that this type of the triplet condensate can be detected also by measuring the density of states in F/S/F structures.Comment: 14 pages; 9 figures. Final version, to be published in Phys. Rev.

Resonant flux motion and I-V -characteristics in frustrated Josephson junctions

We describe the dynamics of fluxons moving in a frustrated Josephson junction with p, d, and f-wave symmetry and calculate the I-V characteristics. The behavior of fluxons is quite distinct in the long and short length junction limit. For long junctions the intrinsic flux is bound at the center and the moving integer fluxon or antifluxon interacts with it only when it approaches the junction's center. For small junctions the intrinsic flux can move as a bunched type fluxon introducing additional steps in the I-V characteristics. Possible realization in quantum computation is presented.Comment: 21 pages, 8 figure