The Implications of Insurance Status on Presentation, Surgical Management and Mortality among Non-Metastatic Breast Cancer Patients in Indiana

Background The National Breast and Cervical Cancer Early Detection Program seeks to reduce health care disparities by providing uninsured and underinsured women access to screening mammograms. The objective of this study is to identify the differences in presentation, surgical management, and mortality among nonmetastatic uninsured patients diagnosed through Indiana's Breast and Cervical Cancer Program compared with patients with private and government (Medicare or Medicaid) insurance. Methods Study data were obtained using the Indiana state cancer registry and Indiana's Breast and Cervical Cancer Program. Women aged 50 to 64 with an index diagnosis of stage 0 to III breast cancer from January 1, 2006 to December 31, 2013, were included in the study. Bivariate intergroup analysis was conducted. Kaplan-Meier estimates between insurance types were compared using the log rank test. All-cause mortality was evaluated using a mixed effects model. Results The groups differed significantly for sociodemographic and clinical variables. Uninsured Indiana Breast and Cervical Cancer Program patients presented with later disease stage (P < .001) and had the highest overall mortality (hazard ratio 2.2, P = .003). Surgical management only differed among stage III patients (P = .012). Conclusion To improve insurance-based disparities in Indiana, implementation of the Breast and Cervical Cancer Program in conjunction with expansion of insurance coverage to vulnerable low-income populations need to be optimized

Relativistic models for quasi-elastic neutrino scattering

We present quasi-elastic neutrino-nucleus cross sections in the energy range from 150 MeV up to 5 GeV for the target nuclei 12C and 56Fe. A relativistic description of the nuclear dynamics and the neutrino-nucleus coupling is adopted. For the treatment of final-state interactions (FSI) we rely on two frameworks succesfully applied to exclusive electron-nucleus scattering: a relativistic optical potential and a relativistic multiple-scattering Glauber approximation. At lower energies, the optical-potential approach is considered to be the optimum choice, whereas at high energies a Glauber approach is more natural. Comparing the results of both calculations, it is found that the Glauber approach yields valid results down to the remarkably small nucleon kinetic energies of 200 MeV. We argue that the nuclear transparencies extracted from A(e,e'p) measurements can be used to obtain realistic estimates of the effect of FSI mechanisms on quasi-elastic neutrino-nucleus cross sections. We present two independent relativistic plane-wave impulse approximation (RPWIA) calculations of quasi-elastic neutrino-nucleus cross sections. They agree at the percent level, showing the reliability of the numerical techniques adopted and providing benchmark RPWIA results.Comment: revised version,28 pages, 7 figures, accepted in Phys.Rev.

Nondegenerate two-photon lasing in a single quantum dot

We propose two-mode two-photon microlaser using a single semiconductor quantum dot grown inside a two-mode microcavity. We explore both incoherent and coherent pumping at low temperatures to achieve suitable conditions for two-mode two-photon lasing. The two-mode two-photon stimulated emission is strongly suppressed but the single-photon stimulated emission is enhanced by exciton-phonon interactions. In coherently pumped quantum dot one can achieve large two-mode two-photon lasing where single-photon lasing is almost absent. We also discuss generation of steady state two-mode entangled state using two-photon resonant pumping.Comment: 12 pages, 13 figure

Distribution, incidence and severity of viral diseases of yam (Dioscorea spp.) in Côte d’Ivoire

A survey was conducted in major yam cultivation zones in Côte d’Ivoire in 2009 to determine the incidence, severity of viral diseases, and viruses associated with the infected plants. Incidence and severity of the viral diseases were estimated based on symptoms. Enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR)-based techniques were used for the detection of Yam mosaic virus (YMV), Cucumber mosaic virus (CMV), Dioscorea mottle virus (DMoV) and yam badnaviruses in the sampled yam leaves. Disease incidence varied from 0 to 90% and symptom severity from 1 to 5. There were significant difference in incidence and severity between different agro-ecological zones (P &lt; 0.001). About 36% of the samples tested positive to YMV, ca. 1.5% tested positive to CMV, ca. 39.1% samples tested positive to yam infecting badnaviruses, and none of the samples tested positive to DMoV. This study demonstrated high incidence of virus diseases in all the yam production regions and warrants implementation of virus disease control measures.Keywords: Yam, enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), viruses, Côte d’IvoireAfrican Journal of Biotechnology, Vol. 13(3), pp. 465-470, 15 January, 201

To Sleep, Perchance to Dream: Acute and Chronic Sleep Deprivation in Acute Care Surgeons

Background Acute and chronic sleep deprivation are significantly associated with depressive symptoms and felt to be contributors to the development of burnout. In-house call (IHC) inherently includes frequent periods of disrupted sleep and is common amongst acute care surgeons (ACS). The relationship between IHC and sleep deprivation (SD) amongst ACS has not been previously studied. The goal of this study was to determine prevalence and patterns of SD in ACS. Study Design: A prospective study of ACS with IHC responsibilities from two Level I trauma centers was performed. Participants wore a sleep tracking device continuously over a 3-month period. Data collected included age, gender, schedule of IHC, hours and pattern of each sleep stage (light, slow wave (SWS), and REM), and total hours of sleep. Sleep patterns were analyzed for each night excluding IHC and categorized as normal (N), acute sleep deprivation (ASD), or chronic sleep deprivation (CSD). Results 1421 nights were recorded amongst 17 ACS. (35.3% female; ages 37-65, mean 45.5 years). Excluding IHC, average amount of sleep was 6.54 hours with 64.8% of sleep patterns categorized as ASD or CSD. Average amount of sleep was significantly higher on post-call day 1 (6.96 hours, p=0.0016), but decreased significantly on post-call day 2 (6.33 hours, p=0.0006). Sleep patterns with ASD and CSD peaked on post-call day 2, and returned to baseline on post-call day 3 (p=0.046). Conclusion Sleep patterns consistent with ASD and CSD are common amongst ACS and worsen on post-call day 2. Baseline sleep patterns were not recovered until post-call day 3. Future study is needed to identify factors which impact physiologic recovery after IHC and further elucidate the relationship between SD and burnout

Biological and biochemical characterization of isolates of Helicoverpa armigera Nucleopolyhedrovirus [HaNPV] from different geographic locations of India

Six strains of HaNPV collected from different places of India were compared for their biological and biochemical characteristics. Based on the bioassay tests against second and third instar larvae of Helicoverpa armigera the order of activity in increasing order is UASD-HaNPV< AK-HaNPV<TN-HaNPV<PAU-HaNPV<GAUHaNPV< ICRISAT-HaNPV and no correlation was drawn between biological and biochemical characteristics. Electron microscopic observations of polyhedra, alkali disrupted polyhedra during purification and nucleocapsids are also presented

Homing in on endogenous badnaviral elements: development of multiplex PCR-DGGE for detection and rapid identification of badnavirus sequences in yam germplasm

Viruses of the genus Badnavirus (family Caulimoviridae) are double-stranded DNA-reverse transcribing (dsDNA-RT) plant viruses and have emerged as serious pathogens of tropical and temperate crops globally. Endogenous badnaviral sequences are found integrated in the genomes of several economically important plant species. Infection due to activation of replication-competent integrated copies of the genera Badnavirus, Petuvirus and Cavemovirus has been described. Such endogenous badnaviral elements pose challenges to the development of nucleic acid-based diagnostic methods for episomal virus infections and decisions on health certification for international movement of germplasm and seed. One major food security crop affected is yam (Dioscorea spp.). A diverse range of Dioscorea bacilliform viruses (DBVs), and endogenous DBV (eDBV) sequences have been found to be widespread in yams cultivated in West Africa and other parts of the world. This study outlines the development of multiplex PCR-dependent denaturing gradient gel electrophoresis (PCR-DGGE) to assist in the detection and analysis of eDBVs, through the example of analysing yam germplasm from Nigeria and Ghana. Primers targeting the three most prevalent DBV monophyletic species groups in West Africa were designed to improve DGGE resolution of complex eDBV sequence fingerprints. Multiplex PCR-DGGE with the addition of a tailor-made DGGE sequence marker enables rapid comparison of endogenous badnaviral sequence diversity across germplasm, as illustrated in this study for eDBV diversity in yam

Heterogeneity of discontinuous carbon fibre composites: damage initiation captured by Digital Image Correlation

This paper aims to identify architectural features which lead to damage initiation and failure in discontinuous carbon fibre composites formed from randomly orientated bundles. A novel multi-camera digital image correlation system was used to simultaneously view strain fields from opposing surfaces of coupons, in order to map progression of failure. The highest strain concentrations were found to occur when the ends of fibre bundles aligned in the direction of loading coincided with underlying transverse bundles. The failure plane was observed to grow between a number of strain concentrations at critical features, coalescing sites of damage to create the final fracture surface. Although potential failure sites can be detected at low global strains in the form of strain concentrations, the strain field observed at low applied loads cannot be extrapolated to reliably predict final failure

Chromogenic detection of yam mosaic virus by closed-tube reverse transcription loop-mediated isothermal amplification (CT-RT-LAMP)

A closed-tube reverse transcription loop-mediated isothermal amplification (CT-RT-LAMP) assay was developed for the detection of yam mosaic virus (YMV, genus Potyvirus) infecting yam (Dioscorea spp.). The assay uses a set of six oligonucleotide primers targeting the YMV coat protein region, and the amplification products in YMV-positive samples are visualized by chromogenic detection with SYBR Green I dye. The CT-RT-LAMP assay detected YMV in leaf and tuber tissues of infected plants. The assay is 100 times more sensitive in detecting YMV than standard RT-PCR, while maintaining the same specificity