Responding to a Community's Concern: A Comparison of Breast Cancer Characteristics and Initial Treatment in Three Selected North Carolina Counties

BACKGROUND A 2007 national report identified North Carolina's Edgecombe County as having among the highest breast cancer incidence and mortality rates nationally, motivating the initiation of a task force and other local efforts to address the problem. The goal of this study is to examine county breast cancer characteristics before and after the report, including whether geographic variation may mask racial disparities in this majority African American community. METHOD With guidance from community partners, breast cancer cases from 2000 to 2012 in Edgecombe, Nash, and Orange Counties (N = 2,641) were obtained from the North Carolina Central Cancer Registry. Bivariate and trend analyses of tumor and treatment characteristics were examined by county and race. RESULTS Women in Edgecombe and Nash Counties were diagnosed with more advanced stage, higher grade tumors. African Americans in Edgecombe and Nash Counties were diagnosed with advanced disease more often than African Americans in Orange County. Average time-to-treatment was well within guideline recommendations. Incidence and mortality rates appear to have declined, with variation in measures of racial differences over time. LIMITATIONS Changes in coding standards across the observation period required reliance on coarse measures that may partially mute useful findings. CONCLUSIONS Racial disparities remain a concern in North Carolina; however, they appear to be less profound than in the 2007 national report. The portentous statistics in the report represent an all-time high, after which some, but not all, measures reflect positive change amidst ongoing local efforts to improve breast cancer knowledge and care

Implementation of a pharmacogenomics consult service to support the INGENIOUS trial

Hospital systems increasingly utilize pharmacogenomic testing to inform clinical prescribing. Successful implementation efforts have been modeled at many academic centers. In contrast, this report provides insights into the formation of a pharmacogenomics consultation service at a safety-net hospital, which predominantly serves low-income, uninsured, and vulnerable populations. The report describes the INdiana GENomics Implementation: an Opportunity for the UnderServed (INGENIOUS) trial and addresses concerns of adjudication, credentialing, and funding

Search for dark matter produced in association with a hadronically decaying vector boson in pp collisions at sqrt (s) = 13 TeV with the ATLAS detector

A search is presented for dark matter produced in association with a hadronically decaying W or Z boson using 3.2 fb−1 of pp collisions at View the MathML sources=13 TeV recorded by the ATLAS detector at the Large Hadron Collider. Events with a hadronic jet compatible with a W or Z boson and with large missing transverse momentum are analysed. The data are consistent with the Standard Model predictions and are interpreted in terms of both an effective field theory and a simplified model containing dark matter

Performance of Jointed Concrete Pavements. Volume I: Evaluation of Concrete Pavement Performance and Design Features

DTFH61-86-C-00079A major national field and analytical study has been conducted into the effect of various design features on the performance of jointed concrete pavements. Extensive design, construction, traffic, and performance data were obtained from numerous experimental and other concrete pavement sections throughout the country. Field data collected and analyzed included distress, drainage, roughness, present serviceability rating (PSR), deflection, destructive testing (coring and boring), and weigh-in-motion (WIM) on selected sites. This information was compiled into a comprehensive microcomputer database. Projects were evaluated on an individual basis and then compared at a national level to identify performance trends. The performance data were used to evaluate and modify several concrete pavement design procedures and analysis models. This volume provides a brief introduction to the data collection activities and presents a description and performance evaluation of the 95 pavement sections included in the study. Documentation is presented on the effects of the following design features on concrete pavement performance: slab thickness, base type, joint spacing, reinforcement, joint orientation, load transfer, dowel bar coatings, longitudinal joint design, joint sealant, tied shoulders, and subdrainage