THE EFFECT OF LANGUAGE BARRIERS ON VARIATION AND RECEIPT OF EARLY STAGE BREAST CANCER TREATMENT

Background: Arriving at and implementing an appropriate patient centered treatment plan for early stage breast cancer requires significant dialogue between healthcare providers and patients. How language barriers affect this process has not been thoroughly explored in the literature. The aim of this paper is to examine the effect of language barrier on variation and receipt of early stage breast cancer treatment. Methods: Rates of lumpectomy, mastectomy, and contralateral prophylactic mastectomy (CPM) with or without reconstruction were compared between English speaking and Low English Proficiency (LEP) cohorts. Patients with recurrent or bilateral breast cancer, male patients, and/or known genetic mutations were excluded. Receipt of recommended treatments including chemotherapy, hormonal therapy and radiation were compared between the two groups, as well as patient refusal and loss of follow-up. Regression analysis for all-cause mortality within this time period was tabulated for each group. Results: There were no significant differences between receipt of recommended treatments, patient refusal or loss of follow up between the cohorts. LEP patients had a greater proportion of lumpectomies (79.7 versus 70.7%) while 9.2% of English-speaking patients had CPM or CPM with reconstruction compared to none of the LEP patients. These trends, however, did not rise to statistical significance within our small population sample. Age, insurance type, and LEP were associated with significant difference in all-cause mortality, however only age and insurance remained significant in adjusted analysis. Conclusion: Our results indicate a non-statistically significant trend towards less variation of surgical treatment variation for early stage breast cancer in the LEP population, including a greater frequency of lumpectomy and less utilization of CPM. Larger, multicenter studies would be needed to affirm and further investigate these trends

Static Properties of Trapped Bose-Fermi Mixed Condensate of Alkali Atoms

Static properties of a bose-fermi mixture of trapped potassium atoms are studied in terms of coupled Gross-Pitaevskii and Thomas-Fermi equations for both repulsive and attractive bose-fermi interatomic potentials. Qualitative estimates are given for solutions of the coupled equations, and the parameter regions are obtained analytically for the boson-density profile change and for the boson/fermion phase separation. Especially, the parameter ratio $R_{int}$ is found that discriminates the region of the large boson-profile change. These estimates are applied for numerical results for the potassium atoms and checked their consistency. It is suggested that a small fraction of fermions could be trapped without an external potential for the system with an attractive boson-fermion interaction.Comment: 8 pages,5 figure

Deep-sea benthic habitats and the impacts of trawling on them in the offshore Greenland halibut fishery, Davis Strait, west Greenland

The offshore Greenland halibut (Reinhardtius hippoglossoides) fishery, west Greenland, employs demersal trawl gear at depths of 800–1400 m. In contrast to many deep-sea fisheries, the target stock appears stable and the fishery is of significant economic importance. Recent Marine Stewardship Council certification of this fishery highlighted the paucity of knowledge of benthic habitats and trawling impacts, which this study aimed to address using a towed benthic video sled. The spatially discrete northern and southern areas of the fishery were found to be distinct in terms of the communities present, which non-metric multidimensional scaling suggests is primarily driven by temperature. Extensive physical evidence of trawling was observed. Trawling effort was significantly linked with community composition, with a negative association between trawling effort and abundance of some taxa, including some vulnerable marine ecosystem (VME) indicator species. Three potential VMEs are identified: (i) Flabellum alabastrum cup coral meadows; (ii) a Halipteris finmarchica sea pen field; and (iii) areas exhibiting mixed assemblages of VME indicators. Of immediate conservation concern is a H. finmarchica field, which seems to be at least regionally rare, is situated within the fringes of existing trawling effort and is currently afforded no protection by management measures

Dic(9;20)(p13;q11) in childhood acute lymphoblastic leukaemia is related to low cellular resistance to asparaginase, cytarabine and corticosteroids.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldDic(9;20)(p13;q11) was first described as a nonrandom chromosome abnormality in B-cell precursor acute lymphoblastic leukaemia (BCP ALL) in the mid 1990s,1, 2 and 71 dic(9;20)-positive cases have since then been reported.3, 4, 5 Approximately 90% of these cases were children or adolescents, with dic(9;20) occurring in about 2% of childhood BCP ALL.6 The recent review by Forestier et al.5 describes that dic(9;20)-leukaemias are of B-cell precursor immunophenotype, never have a high hyperdiploid modal number, show a female predominance, and have a significant age incidence peak at 3 years. Most patients are allocated to non-standard risk treatment arms due to high WBC (median 24 109/l) and a relatively high frequency of CNS disease or other extra-medullary leukaemia (EML) at diagnosis. The prognostic implications of dic(9;20) are to a large extent unknown. A relatively large proportion of the relapses reported in the literature have been extra-medullary, and post-relapse treatment including block therapy has been successful in several patients, as illustrated by a p-EFS of 0.62 and a predicted overall survival of 0.82 at 5 years for the 24 Nordic cases.

Ground-state properties of trapped Bose-Fermi mixtures: role of exchange-correlation

We introduce Density Functional Theory for inhomogeneous Bose-Fermi mixtures, derive the associated Kohn-Sham equations, and determine the exchange-correlation energy in local density approximation. We solve numerically the Kohn-Sham system and determine the boson and fermion density distributions and the ground-state energy of a trapped, dilute mixture beyond mean-field approximation. The importance of the corrections due to exchange--correlation is discussed by comparison with current experiments; in particular, we investigate the effect of of the repulsive potential energy contribution due to exchange--correlation on the stability of the mixture against collapse.Comment: 6 pages, 4 figures (final version as published in Physical Review

Microscopic Structure of a Vortex Line in a Superfluid Fermi Gas

The microscopic properties of a single vortex in a dilute superfluid Fermi gas at zero temperature are examined within the framework of self-consistent Bogoliubov-de Gennes theory. Using only physical parameters as input, we study the pair potential, the density, the energy, and the current distribution. Comparison of the numerical results with analytical expressions clearly indicates that the energy of the vortex is governed by the zero-temperature BCS coherence length.Comment: 4 pages, 4 embedded figures. Added references. To be published in Physical Review Letter

Zero-temperature phase diagram of binary boson-fermion mixtures

We calculate the phase diagram for dilute mixtures of bosons and fermions at zero temperature. The linear stability conditions are derived and related to the effective boson-induced interaction between the fermions. We show that in equilibrium there are three possibilities: a) a single uniform phase, b) a purely fermionic phase coexisting with a purely bosonic one and c) a purely fermionic phase coexisting with a mixed phase.Comment: 8 pages, revtex, 3 postscript figures; NORDITA-1999/71 C

Collective ferromagnetism in two-component Fermi-degenerate gas trapped in finite potential

Spin asymmetry of the ground states is studied for the trapped spin-degenerate (two-component) gases of the fermionic atoms with the repulsive interaction between different components, and, for large particle number, the asymmetric (collective ferromagnetic) states are shown to be stable because it can be energetically favorable to increase the fermi energy of one component rather than the increase of the interaction energy between up-down components. We formulate the Thomas-Fermi equations and show the algebraic methods to solve them. From the Thomas-Fermi solutions, we find three kinds of ground states in finite system: 1) paramagnetic (spin-symmetric), 2) ferromagnetic (equilibrium) and 3) ferromagnetic (nonequilibrium) states. We show the density profiles and the critical atom numbers for these states obtained analytically, and, in ferromagnetic states, the spin-asymmetries are shown to occur in the central regions of the trapped gas, and grows up with increasing particle number. Based on the obtained results, we discuss the experimental conditions and current difficulties to realize the ferromagnetic states of the trapped atom gas, which should be overcome.Comment: submit to PR

Which activities threaten independent living of elderly when becoming problematic : inspiration for meaningful service robot functionality

Purpose: In light of the increasing elderly population and the growing demand for home care, the potential of robot support is given increasing attention. In this paper, an inventory of activities was made that threaten independent living of elderly when becoming problematic. Results will guide the further development of an existing service robot, the Care-O-bot®. Method: A systematic literature search of PubMed was performed, focused on the risk factors for institutionalization. Additionally, focus group sessions were conducted in the Netherlands, United Kingdom and France. In these focus group sessions, problematic activities threatening the independence of elderly people were discussed. Three separate target groups were included in the focus group sessions: (1) elderly persons (n = 41), (2) formal caregivers (n = 40) and (3) informal caregivers (n = 32). Results: Activities within the International Classification of Functioning domains mobility, self-care, and interpersonal interaction and relationships were found to be the most problematic. Conclusions: A distinct set of daily activities was identified that may threaten independent living, but no single activity could be selected as the main activity causing a loss of independence as it is often a combination of problematic activities that is person-specific. Supporting the problematic activities need not involve a robotic solution Read More: http://informahealthcare.com/doi/abs/10.3109/17483107.2013.840861Peer reviewe