Protection of the Installment Buyer of Goods Under the Uniform Commercial Code

The present topic for discussion, protection of the installment buyer under the Code, is part of a larger topic-protection of the consumer under the Code. The remarks that follow sometimes apply generally to the status of the consumer under the Code. There are times when no distinction should be made between our model installment buyer and other consumer buyers

Anchoring tools to communities: insights into perceptions of flood informational tools from a flood-prone community in Louisiana, USA

The lack of community-relevant flood informational resources and tools often results in inadequate and divergent understandings of flood risk and can impede communities' ability to function cohesively in the face of increasing flood threats. The current study reports on a set of workshops that the authors conducted with various groups (citizens, city engineers and planners, realtors and builders, and media representatives) within a flood prone community to evaluate how novel hydroinformatic tools that include hydrodynamic modeling, geospatial visualization, and socioeconomic analysis can enhance understanding of flood risk and engagement in flood risk mitigation among diverse community members. The workshops were designed to help identify stakeholder preferences regarding key functionality needed for integrated hydroinformatic technologies and socioeconomic analyses for flood risk reduction. Workshop participants were asked to use and comment on examples of prototype flood risk informational tools, such as: (1) flood damage estimation tool, (2) drivability and emergency accessibility tool, and (3) community-scale social and economic metrics tool. Data gathered from workshops were analyzed using qualitative analysis based on a grounded-theory approach. Data were coded by hand based on themes identified by the research team and incorporated deviant case analysis to ensure minority opinions was represented. The study results are focused on the following main themes and how flood tools can address them: (1) improving the understanding of flood risk and engagement in flood risk mitigation, (2) reducing the gap between individual and community risk, (3) challenges in communicating flood risk information, (4) enhancing relevance to and engagement of the community, and (5) enabling actionable information. Our research demonstrates the need for community-anchored tools and technologies that can illustrate local context, include local historical and simulated events at multiple levels of community impact, enable analyses by flood professionals while also providing simplified tools of use by citizens, and allow individuals to expand their knowledge beyond their homes, businesses, and places of work

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment

Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials

Background Neoadjuvant chemotherapy (NACT) for early breast cancer can make breast-conserving surgery more feasible and might be more likely to eradicate micrometastatic disease than might the same chemotherapy given after surgery. We investigated the long-term benefits and risks of NACT and the influence of tumour characteristics on outcome with a collaborative meta-analysis of individual patient data from relevant randomised trials. Methods We obtained information about prerandomisation tumour characteristics, clinical tumour response, surgery, recurrence, and mortality for 4756 women in ten randomised trials in early breast cancer that began before 2005 and compared NACT with the same chemotherapy given postoperatively. Primary outcomes were tumour response, extent of local therapy, local and distant recurrence, breast cancer death, and overall mortality. Analyses by intention-to-treat used standard regression (for response and frequency of breast-conserving therapy) and log-rank methods (for recurrence and mortality). Findings Patients entered the trials from 1983 to 2002 and median follow-up was 9 years (IQR 5–14), with the last follow-up in 2013. Most chemotherapy was anthracycline based (3838 [81%] of 4756 women). More than two thirds (1349 [69%] of 1947) of women allocated NACT had a complete or partial clinical response. Patients allocated NACT had an increased frequency of breast-conserving therapy (1504 [65%] of 2320 treated with NACT vs 1135 [49%] of 2318 treated with adjuvant chemotherapy). NACT was associated with more frequent local recurrence than was adjuvant chemotherapy: the 15 year local recurrence was 21·4% for NACT versus 15·9% for adjuvant chemotherapy (5·5% increase [95% CI 2·4–8·6]; rate ratio 1·37 [95% CI 1·17–1·61]; p=0·0001). No significant difference between NACT and adjuvant chemotherapy was noted for distant recurrence (15 year risk 38·2% for NACT vs 38·0% for adjuvant chemotherapy; rate ratio 1·02 [95% CI 0·92–1·14]; p=0·66), breast cancer mortality (34·4% vs 33·7%; 1·06 [0·95–1·18]; p=0·31), or death from any cause (40·9% vs 41·2%; 1·04 [0·94–1·15]; p=0·45). Interpretation Tumours downsized by NACT might have higher local recurrence after breast-conserving therapy than might tumours of the same dimensions in women who have not received NACT. Strategies to mitigate the increased local recurrence after breast-conserving therapy in tumours downsized by NACT should be considered—eg, careful tumour localisation, detailed pathological assessment, and appropriate radiotherapy