Impact of breast cancer subtypes on 3-year survival among adolescent and young adult women.

IntroductionYoung women have poorer survival after breast cancer than do older women. It is unclear whether this survival difference relates to the unique distribution of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2)-defined molecular breast cancer subtypes among adolescent and young adult (AYA) women aged 15 to 39 years. The purpose of our study was to examine associations between breast cancer subtypes and short-term survival in AYA women, as well as to determine whether the distinct molecular subtype distribution among AYA women explains the unfavorable overall breast cancer survival statistics reported for AYA women compared with older women.MethodsData for 5,331 AYA breast cancers diagnosed between 2005 and 2009 were obtained from the California Cancer Registry. Survival by subtype (triple-negative; HR+/HER2-; HR+/HER2+; HR-/HER2+) and age-group (AYA versus 40- to 64-year-olds) was analyzed with Cox proportional hazards regression with follow-up through 2010.ResultsWith up to 6 years of follow-up and a mean survival time of 3.1 years (SD = 1.5 years), AYA women diagnosed with HR-/HER + and triple-negative breast cancer experienced a 1.6-fold and 2.7-fold increased risk of death, respectively, from all causes (HR-/HER + hazard ratio: 1.55; 95% confidence interval (CI): 1.10 to 2.18; triple-negative HR: 2.75; 95% CI, 2.06 to 3.66) and breast cancer (HR-/HER + hazard ratio: 1.63; 95% CI, 1.12 to 2.36; triple-negative hazard ratio: 2.71; 95% CI, 1.98 to 3.71) than AYA women with HR+/HER2- breast cancer. AYA women who resided in lower socioeconomic status neighborhoods, had public health insurance, and were of Black, compared with White, race/ethnicity experienced worse survival. This race/ethnicity association was attenuated somewhat after adjusting for breast cancer subtypes (hazard ratio, 1.33; 95% CI, 0.98 to 1.82). AYA women had similar all-cause and breast cancer-specific short-term survival as older women for all breast cancer subtypes and across all stages of disease.ConclusionsAmong AYA women with breast cancer, short-term survival varied by breast cancer subtypes, with the distribution of breast cancer subtypes explaining some of the poorer survival observed among Black, compared with White, AYA women. Future studies should consider whether distribution of breast cancer subtypes and other factors, including differential receipt of treatment regimens, influences long-term survival in young compared with older women

Direct photonic coupling of a semiconductor quantum dot and a trapped ion.

Coupling individual quantum systems lies at the heart of building scalable quantum networks. Here, we report the first direct photonic coupling between a semiconductor quantum dot and a trapped ion and we demonstrate that single photons generated by a quantum dot controllably change the internal state of a Yb^{+} ion. We ameliorate the effect of the 60-fold mismatch of the radiative linewidths with coherent photon generation and a high-finesse fiber-based optical cavity enhancing the coupling between the single photon and the ion. The transfer of information presented here via the classical correlations between the σ_{z} projection of the quantum-dot spin and the internal state of the ion provides a promising step towards quantum-state transfer in a hybrid photonic network.We acknowledge support by the University of Cambridge, the Alexander-von-Humboldt Stiftung, EPSRC (EP/H005676/1), the European Research Council (Grant numbers 240335 and 617985), EU-FP7 Marie Curie Initial Training Networks COMIQ and S3NANO.This is the accepted manuscript. The final version is available at http://journals.aps.org/prl/abstract/10.1103/PhysRevLett.114.123001

Linking the subcultures of physics: Virtual empiricism and the bonding role of trust

This article draws on empirical material concerning the communication and use of knowledge in experimental physics and their relations to the culture of theoretical physics. The role that trust plays in these interactions is used to create a model of social distance between interacting theoretical and experimental cultures. This article thus seeks to reintroduce trust as a fundamental element in answering the problem of disunity in the sociology of knowledge

Self-organizing actin waves that simulate phagocytic cup structures

This report deals with actin waves that are spontaneously generated on the planar, substrate-attached surface of Dictyostelium cells. These waves have the following characteristics. (1) They are circular structures of varying shape, capable of changing the direction of propagation. (2) The waves propagate by treadmilling with a recovery of actin incorporation after photobleaching of less than 10 seconds. (3) The waves are associated with actin-binding proteins in an ordered 3-dimensional organization: with myosin-IB at the front and close to the membrane, the Arp2/3 complex throughout the wave, and coronin at the cytoplasmic face and back of the wave. Coronin is a marker of disassembling actin structures. (4) The waves separate two areas of the cell cortex that differ in actin structure and phosphoinositide composition of the membrane. The waves arise at the border of membrane areas rich in phosphatidylinositol (3,4,5) trisphosphate (PIP3). The inhibition of PIP3 synthesis reversibly inhibits wave formation. (5) The actin wave and PIP3 patterns resemble 2-dimensional projections of phagocytic cups, suggesting that they are involved in the scanning of surfaces for particles to be taken up

A comparison of hospital readmission rates between two general physicians with different outpatient review practices

BACKGROUND: There has been a relentless increase in emergency medical admissions in the UK over recent years. Many of these patients suffer with chronic conditions requiring continuing medical attention. We wished to determine whether conventional outpatient clinic follow up after discharge has any impact on the rate of readmission to hospital. METHODS: Two consultant general physicians with the same patient case-mix but markedly different outpatient follow-up practice were chosen. Of 1203 patients discharged, one consultant saw twice as many patients in the follow-up clinic than the other (Dr A 9.8% v Dr B 19.6%). The readmission rate in the twelve months following discharge was compared in a retrospective analysis of hospital activity data. Due to the specialisation of the admitting system, patients mainly had cardiovascular or cerebrovascular disease or had taken an overdose. Few had respiratory or infectious diseases. Outpatient follow-up was focussed on patients with cardiac disease. RESULTS: Risk of readmission increased significantly with age and length of stay of the original episode and was less for digestive system and musculo-skeletal disorders. 28.7% of patients discharged by Dr A and 31.5 % of those discharged by Dr B were readmitted at least once. Relative readmission risk was not significantly different between the consultants and there was no difference in the length of stay of readmissions. CONCLUSIONS: Increasing the proportion of patients with this age- and case-mix who are followed up in a hospital general medical outpatient clinic is unlikely to reduce the demand for acute hospital beds

A Storm in a Tea-Cup? 'Making a Difference' in Two Sure Start Children's Centres

Sure Start Children's Centres were central to the last UK Labour government in improving outcomes for children and families. Yet, participation by those who 'ought' to attend was and remains a focus of concern. Using the work of Foucault, this paper explores parental participation in two Centres to examine how 'government operates at a distance', through the everyday interactions of those who inhabit these spaces. In exploring micro-practices, the humble cup of tea can be seen, not only as a small act of caring but a site of power and struggle over what these spaces meant to parents and practitioners

Understanding barriers to novel data linkages : topic modeling of the results of the LifeInfo survey

Novel consumer and lifestyle data, such as those collected by supermarket loyalty cards or mobile phone exercise tracking apps, offer numerous benefits for researchers seeking to understand diet- and exercise-related risk factors for diseases. However, limited research has addressed public attitudes toward linking these data with individual health records for research purposes. Data linkage, combining data from multiple sources, provides the opportunity to enhance preexisting data sets to gain new insights. The aim of this study is to identify key barriers to data linkage and recommend safeguards and procedures that would encourage individuals to share such data for potential future research. The LifeInfo Survey consulted the public on their attitudes toward sharing consumer and lifestyle data for research purposes. Where barriers to data sharing existed, participants provided unstructured survey responses detailing what would make them more likely to share data for linkage with their health records in the future. The topic modeling technique latent Dirichlet allocation was used to analyze these textual responses to uncover common thematic topics within the texts. Participants provided responses related to sharing their store loyalty card data (n=2338) and health and fitness app data (n=1531). Key barriers to data sharing identified through topic modeling included data safety and security, personal privacy, requirements of further information, fear of data being accessed by others, problems with data accuracy, not understanding the reason for data linkage, and not using services that produce these data. We provide recommendations for addressing these issues to establish the best practice for future researchers interested in using these data. This study formulates a large-scale consultation of public attitudes toward this kind of data linkage, which is an important first step in understanding and addressing barriers to participation in research using novel consumer and lifestyle data. [Abstract copyright: ©Holly Clarke, Stephen Clark, Mark Birkin, Heather Iles-Smith, Adam Glaser, Michelle A Morris. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 17.05.2021.

Economic performance or electoral necessity? Evaluating the system of voluntary income to political parties

Whilst the public funding of political parties is the norm in western democracies, its comprehensive introduction has been resisted in Britain. Political and electoral arrangements in Britain require parties to function and campaign on a regular basis, whilst their income follows cycles largely related to general elections. This article shows that the best predictor of party income is the necessity of a well-funded general election campaign rather than party performance. As a result, income can only be controlled by parties to a limited degree, which jeopardises their ability to determine their own financial position and fulfil their functions as political parties

Is metal theft committed by organized crime groups, and why does it matter?

Using the example of metal theft in the United Kingdom, this study used mixed methods to evaluate the accuracy of police estimates of the involvement of organised crime groups (OCGs) in crime. Police estimate that 20-30% of metal theft is committed by OCGs, but this study found that only 0.5% of metal thieves had previous convictions for offences related to OCGs, that only 1.3% were linked to OCGs by intelligence information, that metal thieves typically offended close to their homes and that almost no metal thefts involved sophisticated offence methods. It appears that police may over-estimate the involvement of OCGs in some types of crime. The reasons for and consequences of this over-estimation are discussed

Increasing inter-generational social mobility: is educational expansion the answer?

Reforms which increase the stock of education in a society have long been held by policy-makers as key to improving rates of intergenerational social mobility. Yet, despite the intuitive plausibility of this idea, the empirical evidence in support of an effect of educational expansion on social fluidity is both indirect and weak. In this paper we use the raising of the minimum school leaving age from 15 to 16 years in England and Wales in 1972 to estimate the effect of educational participation and qualification attainment on rates of intergenerational social class mobility. Because, in expectation, children born immediately before and after the policy was implemented are statistically exchangeable, the difference in the amount of education they received may be treated as exogenously determined. The exogenous nature of the additional education gain means that differences in rates of social mobility between cohorts affected by the reform can be treated as having been caused by the additional education. The data for the analysis come from the ONS Longitudinal Study, which links individual records from successive decennial censuses between 1971 and 2001. Our findings show that, although the reform resulted in an increase in educational attainment in the population as a whole and a weakening of the association between attainment and class origin, there was no reliably discernible increase in the rate of intergenerational social mobility