A Rare Case of Bilateral Synchronous Phyllodes Tumor and Triple Negative Breast Cancer

Synchronous breast cancer is a rare event. The majority of cases of synchronous breast cancer will have minor differences in receptor status, but rarely different origins of the tumors. Various breast tumors can have either epithelial or mesenchymal origin and have different treatment strategies and outcomes. In the literature there is a paucity of information regarding the synchronous presentation and treatment of a triple negative invasive ductal carcinoma (TN IDC) and a malignant phyllodes tumor (mPT). This case presentation discusses a 64-year-old woman who presented with a left breast TN IDC and a right breast malignant phyllodes tumor

The Finslerian compact star model

We construct a toy model for compact stars based on the Finslerian structure of spacetime. By assuming a particular mass function, we find an exact solution of the Finsler-Einstein field equations with an anisotropic matter distribution. The solutions are revealed to be physically interesting and pertinent for the explanation of compact stars.Comment: Published in Eur.Phys.J.

SmartDR: A Device-to-Device Communication for Post-Disaster Recovery

Natural disasters, such as earthquakes, can cause severe destruction and create havoc in the society.Buildings and other structures may collapse during disaster incidents causing injuries and deaths to victims trapped under debris and rubble. Immediately after a natural disaster incident, it becomes extremely difficult for first responders and rescuers to find and save trapped victims. Often searches are carried out blindly in random locations, which delay the rescue of the victims. This paper introduces a Smartphone Assisted Disaster Recovery (SmartDR) method for post-disaster communication using Smartphones. SmartDR utilizes the device-to-device (D2D) communication technology in Fifth Generation (5G) networks, which enables direct communication between proximate devices without the need of relaying through a network infrastructure, such as mobile access points or mobile base stations. We examine a scenario of multi-hop D2D communication where smartphones carried by trapped victims and other people in disaster affected areas can self-detect the occurrence of a disaster incident by monitoring the radio environment and then can self-switch to a disaster mode to transmit emergency help messages with their location coordinates to other nearby smartphones. To locate other nearby smartphones also operating in the disaster mode and in the same channel, each smartphone runs a rendezvous process. The emergency messages are thus relayed to the functional base station or rescue centre. To facilitate routing of the emergency messages, we propose a path selection algorithm, which considers both delay and the leftover energy of a device (a smartphone in this case). Thus, the SmartDR method includes: (i) a multi-channel channel hopping rendezvous protocol to improve the victim localization or neighbor discovery, and (ii) an energy-aware multi-path routing (Energy-aware ad-hoc on-demand distance vector or E-AODV) protocol to overcome the higher energy depletionrate at devices associated with single shortest path routing. The SmartDR method can guide search and rescue operations and increase the possibility of saving lives immediately aftermath a disasterincident. A simulation-based performance study is conducted to evaluate the protocol performance in post-disaster scenario. Simulation results show that a significant performance gain is achievable when a device utilises the channel information for the rendezvous process and the leftover energy

Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK.

OBJECTIVES: To characterise the costs to the UK National Health Service of cardiovascular (CV) events among individuals receiving lipid-modifying therapy. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records from 2006 to 2012 to identify individuals with their first and second CV-related hospitalisations (first event and second event cohorts). Within-person differences were used to estimate CV-related outcomes. SETTING: Patients in the UK who had their first CV event between January 2006 and March 2012. PARTICIPANTS: Patients ≥18 years who had a CV event and received at least 2 lipid-modifying therapy prescriptions within 180 days beforehand. PRIMARY AND SECONDARY OUTCOME MEASURES: Direct medical costs (2014 £) were estimated in 3 periods: baseline (pre-event), acute (6 months afterwards) and long-term (subsequent 30 months). Primary outcomes included incremental costs, resource usage and total costs per period. RESULTS: There were 24 093 patients in the first event cohort of whom 5274 were included in the second event cohort. The mean incremental acute CV event costs for the first event and second event cohorts were: coronary artery bypass graft/percutaneous transluminal coronary angioplasty (CABG/PTCA) £5635 and £5823, myocardial infarction £4275 and £4301, ischaemic stroke £3512 and £4572, heart failure £2444 and £3461, unstable angina £2179 and £2489 and transient ischaemic attack £1537 and £1814. The mean incremental long-term costs were: heart failure £848 and £2829, myocardial infarction £922 and £1385, ischaemic stroke £973 and £682, transient ischaemic attack £705 and £1692, unstable angina £328 and £677, and CABG/PTCA £-368 and £599. Hospitalisation accounted for 95% of acute and 61% of long-term incremental costs. Higher comorbidity was associated with higher long-term costs. CONCLUSIONS: Revascularisation and myocardial infarction were associated with the highest incremental costs following a CV event. On the basis of real-world data, the economic burden of CV events in the UK is substantial, particularly among those with greater comorbidity burden

Economical Way of GPRS Based Fully Automated Energy Metering System

This paper presents a design of secure and economical (low cost) way of GPRS based fully automated energy metering system that measures and transmits the total electrical energy consumption to main server using general packet radio service (GPRS) technology provided by GSM networks and also present how the meter reading, disconnection and reconnection can be controlled from server end. The proposed EGFAEM system consist of four main parts: Energy Meters, Communication part over GPRS, Server and Management part and consumer end for billing and payment. A single phase energy meter prototype has been implemented to provide measurement up to 40A load current and 230V line to neutral voltage. Communication part is implemented by GPRS module and microcontroller, sever and consumer end are implemented in web server