The Influence of Patient Exposure to Breast Reconstruction Approaches and Education on Patient Choices in Breast Cancer Treatment.

BackgroundThe landscape of surgical and medical management and patient choices for breast cancer treatment changes as breast reconstruction and oncoplastic approaches improve and diversify. Increased access to breast reconstruction, in addition to patient education, influences the breast cancer patient. Therefore, the examination of the possible impact of reconstructive surgery on all stages of the breast cancer management per se seemed timely.MethodsPlastic surgery consults were arranged for 520 new patients diagnosed with breast cancer (2012-2016) including patients with noninvasive breast cancer but at high risk of further cancer development. To test the plastic surgery impact on patient choices regarding the management of the cancer, a subset of 90 patients was identified to test the plastic surgery impact on patient choices. These patients were referred to plastic surgery, following the first round of consultations by surgical and medical oncologists with only the preliminary oncological management plan defined. After a plastic surgery consultation, but prior to finalization of the overall oncological management plan, they were surveyed on the subject of modification of their personal choices and requests pertaining to their cancer management.ResultsIn this subset of 90 patients 40 (44%) returned to their surgical or medical oncologist considering changes of the primary management plan after their plastic surgery consultation. Twenty-six (28%) ultimately altered their plan, and the following patient-driven changes were made: mastectomy as opposed to lumpectomy (18 patients [20%]), contralateral prophylactic mastectomy (11 patients [12%]), nipple/areola removal as opposed to nipple/areola sparing suggested by the oncologists (5 patients [6%]), oncoplastic breast reduction as part of lumpectomy (5 patients [6%]), and other modifications (3 patients [3%]).ConclusionsDecisions for altering the preliminary oncologic plan or choosing a specific alternative (eg, lumpectomy plus radiation vs mastectomy) resulted from patient education on (1) reconstructive options, (2) aesthetic pitfalls and results. and (3) their interfacing with the oncological outcomes. Ultimately, plastic surgeons influence the multispecialty breast cancer management and patient decision-making process. Therefore, oncological literacy for plastic surgeons is essential to provide state-of-the-art breast cancer care and avoidance of suboptimal patient decisions

Asset Liability Management of Conventional and Islamic Banks in Malaysia

The objective of the paper is to investigate the effect of asset liability management on the financial performance of 6 conventional and 6 Islamic banks in Malaysia during the period of 2010 to 2013. The variables used in the study are capital adequacy, asset quality, management efficiency, earnings quality, liquidity, size of bank and degree of risk aversion in relation to asset liability management to examine the return on equity (ROE), which is the measure of profitability of the banks. The quantitative analysis using correlation and regression analysis concluded that there is a positive relationship between asset liability management and the financial performance of the banks.DOI: 10.15408/aiq.v9i1.333

Tree species composition, growing space and management in Hong Kong’s commercial sky gardens

Sky gardens, a type of above-ground urban green space, have been increasingly welcomed and installed in cities. However, few studies have assessed tree planting, management and health in high-rise greenery. This study investigated tree species composition, planting space design and management, and their relationships with tree health in sky gardens in 15 commercial sky gardens with 480 trees in Hong Kong. We assessed the differences between old and new sites regarding tree species, height, crown diameter, and health. We also evaluated selected planting and management factors, including planter type, distance to neighbor trees, root-growth obstacles, canopy barriers, canopy overlap and topping history. Tree species selection in commercial sky gardens was substantially different from public and private residential green spaces. Older sky gardens had more palm trees by species and tree counts. Newer gardens had increased adoption of broadleaf and conifer species with high ornamental value and compact form but fewer native tree species and lower species diversity. The widely planted Ficus spp. had created long-term management issues. Trees were often densely planted, particularly in newer sky gardens. The common practice of topping indicates poor species selection and mismanagement. Planter types with insufficient growing space had dampened tree health. Our findings reveal the trend of tree species adoption, narrower planting spaces and wider adoption of the sunken planter. Improvements in species selection, growing space design and management practices could promote healthy, stable and safe trees in sky gardens with contributions to biodiversity and other ecosystem services

Optical studies of carrier and phonon dynamics in Ga_{1-x}Mn_{x}As

We present a time-resolved optical study of the dynamics of carriers and phonons in Ga_{1-x}Mn_{x}As layers for a series of Mn and hole concentrations. While band filling is the dominant effect in transient optical absorption in low-temperature-grown (LT) GaAs, band gap renormalization effects become important with increasing Mn concentration in Ga_{1-x}Mn_{x}As, as inferred from the sign of the absorption change. We also report direct observation on lattice vibrations in Ga1-xMnxAs layers via reflective electro-optic sampling technique. The data show increasingly fast dephasing of LO phonon oscillations for samples with increasing Mn and hole concentration, which can be understood in term of phonon scattering by the holes.Comment: 13 pages, 3 figures replaced Fig.1 after finding a mistake in previous versio

Polarization dependence of coherent phonon generation and detection in highly-aligned single-walled carbon nanotubes

We have investigated the polarization dependence of the generation and detection of radial breathing mode (RBM) coherent phonons (CP) in highly-aligned single-walled carbon nanotubes. Using polarization-dependent pump-probe differential-transmission spectroscopy, we measured RBM CPs as a function of angle for two different geometries. In Type I geometry, the pump and probe polarizations were fixed, and the sample orientation was rotated, whereas, in Type II geometry, the probe polarization and sample orientation were fixed, and the pump polarization was rotated. In both geometries, we observed a very nearly complete quenching of the RBM CPs when the pump polarization was perpendicular to the nanotubes. For both Type I and II geometries, we have developed a microscopic theoretical model to simulate CP generation and detection as a function of polarization angle and found that the CP signal decreases as the angle goes from 0 degrees (parallel to the tube) to 90 degrees (perpendicular to the tube). We compare theory with experiment in detail for RBM CPs created by pumping at the E44 optical transition in an ensemble of single-walled carbon nanotubes with a diameter distribution centered around 3 nm, taking into account realistic band structure and imperfect nanotube alignment in the sample

Chirality-Selective Excitation of Coherent Phonons in Carbon Nanotubes

Using pre-designed trains of femtosecond optical pulses, we have selectively excited coherent phonons of the radial breathing mode of specific-chirality single-walled carbon nanotubes within an ensemble sample. By analyzing the initial phase of the phonon oscillations, we prove that the tube diameter initially increases in response to ultrafast photoexcitation. Furthermore, from excitation profiles, we demonstrate that an excitonic absorption peak of carbon nanotubes periodically oscillates as a function of time when the tube diameter undergoes radial breathing mode oscillations.Comment: 4 pages, 4 figure

Resonant Coherent Phonon Spectroscopy of Single-Walled Carbon Nanotubes

Using femtosecond pump-probe spectroscopy with pulse shaping techniques, one can generate and detect coherent phonons in chirality-specific semiconducting single-walled carbon nanotubes. The signals are resonantly enhanced when the pump photon energy coincides with an interband exciton resonance, and analysis of such data provides a wealth of information on the chirality-dependence of light absorption, phonon generation, and phonon-induced band structure modulations. To explain our experimental results, we have developed a microscopic theory for the generation and detection of coherent phonons in single-walled carbon nanotubes using a tight-binding model for the electronic states and a valence force field model for the phonons. We find that the coherent phonon amplitudes satisfy a driven oscillator equation with the driving term depending on photoexcited carrier density. We compared our theoretical results with experimental results on mod 2 nanotubes and found that our model provides satisfactory overall trends in the relative strengths of the coherent phonon signal both within and between different mod 2 families. We also find that the coherent phonon intensities are considerably weaker in mod 1 nanotubes in comparison with mod~2 nanotubes, which is also in excellent agreement with experiment.Comment: 21 pages, 22 figure

The Red-Sequence Luminosity Function in Galaxy Clusters since z~1

We use a statistical sample of ~500 rich clusters taken from 72 square degrees of the Red-Sequence Cluster Survey (RCS-1) to study the evolution of ~30,000 red-sequence galaxies in clusters over the redshift range 0.35<z<0.95. We construct red-sequence luminosity functions (RSLFs) for a well-defined, homogeneously selected, richness limited sample. The RSLF at higher redshifts shows a deficit of faint red galaxies (to M_V=> -19.7) with their numbers increasing towards the present epoch. This is consistent with the `down-sizing` picture in which star-formation ended at earlier times for the most massive (luminous) galaxies and more recently for less massive (fainter) galaxies. We observe a richness dependence to the down-sizing effect in the sense that, at a given redshift, the drop-off of faint red galaxies is greater for poorer (less massive) clusters, suggesting that star-formation ended earlier for galaxies in more massive clusters. The decrease in faint red-sequence galaxies is accompanied by an increase in faint blue galaxies, implying that the process responsible for this evolution of faint galaxies is the termination of star-formation, possibly with little or no need for merging. At the bright end, we also see an increase in the number of blue galaxies with increasing redshift, suggesting that termination of star-formation in higher mass galaxies may also be an important formation mechanism for higher mass ellipticals. By comparing with a low-redshift Abell Cluster sample, we find that the down-sizing trend seen within RCS-1 has continued to the local universe.Comment: ApJ accepted. 11 pages, 5 figure

Holographic two dimensional QCD and Chern-Simons term

We present a holographic realization of large Nc massless QCD in two dimensions using a D2/D8 brane construction. The flavor axial anomaly is dual to a three dimensional Chern-Simons term which turns out to be of leading order, and it affects the meson spectrum and holographic renormalization in crucial ways. The massless flavor bosons that exist in the spectrum are found to decouple from the heavier mesons, in agreement with the general lore of non-Abelian bosonization. We also show that an external dynamical photon acquires a mass through the three dimensional Chern-Simons term as expected from the Schwinger mechanism. Massless two dimensional QCD at large Nc exhibits anti-vector-meson dominance due to the axial anomaly.Comment: 22 page