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INTRODUCTION: Racial/ethnic disparities in breast cancer survival are well documented, but the influence of health care institutions is unclear. We therefore examined the effect of hospital characteristics on survival. METHODS: Harmonized data pooled from 5 case-control and prospective cohort studies within the California Breast Cancer Survivorship Consortium were linked to the California Cancer Registry and the California Neighborhoods Data System. The study included 9,701 patients with breast cancer who were diagnosed between 1993 and 2007. First reporting hospitals were classified by hospital type-National Cancer Institute (NCI) -designated cancer center, American College of Surgeons (ACS) Cancer Program, other-and hospital composition of the neighborhood socioeconomic status and race/ethnicity of patients with cancer. Multivariable Cox proportional hazards models adjusted for clinical and patient-level prognostic factors were used to examine the influence of hospital characteristics on survival. RESULTS: Fewer than one half of women received their initial care at an NCI-designated cancer center (5%) or ACS program (38%) hospital. Receipt of initial care in ACS program hospitals varied by race/ethnicity-highest among non-Latina White patients (45%), and lowest among African Americans (21%). African-American women had superior breast cancer survival when receiving initial care in ACS hospitals versus other hospitals (non-ACS program and non-NCI-designated cancer center; hazard ratio, 0.67; 95% CI, 0.55 to 0.83). Other hospital characteristics were not associated with survival. CONCLUSION: African American women may benefit significantly from breast cancer care in ACS program hospitals; however, most did not receive initial care at such facilities. Future research should identify the aspects of ACS program hospitals that are associated with higher survival and evaluate strategies by which to enhance access to and use of high-quality hospitals, particularly among African American women.

IntroductionRacial/ethnic disparities in breast cancer survival are well documented, but the influence of health care institutions is unclear. We therefore examined the effect of hospital characteristics on survival.MethodsHarmonized data pooled from 5 case-control and prospective cohort studies within the California Breast Cancer Survivorship Consortium were linked to the California Cancer Registry and the California Neighborhoods Data System. The study included 9,701 patients with breast cancer who were diagnosed between 1993 and 2007. First reporting hospitals were classified by hospital type-National Cancer Institute (NCI) -designated cancer center, American College of Surgeons (ACS) Cancer Program, other-and hospital composition of the neighborhood socioeconomic status and race/ethnicity of patients with cancer. Multivariable Cox proportional hazards models adjusted for clinical and patient-level prognostic factors were used to examine the influence of hospital characteristics on survival.ResultsFewer than one half of women received their initial care at an NCI-designated cancer center (5%) or ACS program (38%) hospital. Receipt of initial care in ACS program hospitals varied by race/ethnicity-highest among non-Latina White patients (45%), and lowest among African Americans (21%). African-American women had superior breast cancer survival when receiving initial care in ACS hospitals versus other hospitals (non-ACS program and non-NCI-designated cancer center; hazard ratio, 0.67; 95% CI, 0.55 to 0.83). Other hospital characteristics were not associated with survival.ConclusionAfrican American women may benefit significantly from breast cancer care in ACS program hospitals; however, most did not receive initial care at such facilities. Future research should identify the aspects of ACS program hospitals that are associated with higher survival and evaluate strategies by which to enhance access to and use of high-quality hospitals, particularly among African American women.

Merkel cell carcinoma (MCC) usually arises in sun-exposed areas of older patients and might be more aggressive in the immunocompromised. We performed a retrospective chart review of 40 consecutive MCC patients treated at our institution between the years 2006-2017. Clinical and epidemiologic data were utilized and therapy and survival were analyzed. Compared to Surveillance, Epidemiology, and End Results (SEER) data, our population was entirely Caucasian (100% versus 95%; P=0.11) and male predominant (75% versus 63%; P=0.11). The median age was 76. The patients more often had Tumor-Node-Metastasis (TNM) stage I disease (50% versus 39%; P=0.00003) and a primary tumor size

In urban metro construction, shield tunneling often needs to pass through building and bridge pile foundations, potentially affecting the stability of existing structures. Therefore, accurately assessing the impact of shield tunneling on bridges and buildings is crucial. This study presents a comprehensive prediction method combining numerical simulation and empirical formulas, taking the underpass project of the Shijiazhuang–Wuhan High-Speed Railway Bridge by Zhengzhou Metro Line 5 as a case study. Three-dimensional numerical model calculations were performed using finite element software to analyze the displacement and stress changes of buildings and tunnel structures at different construction stages, revealing the deformation patterns of buildings adjacent to the tunnel during shield tunneling. In particular, the ground settlement caused by twin-tunnel excavation was compared with Peck's empirical formula to verify the reliability of the numerical simulation. The results show that twin-tunnel excavation exacerbates the horizontal displacement, uplift, and settlement of the ground, with maximum deformation rates increasing by 7.10%, 20%, and 11.4%, respectively. Comparing the ground deformation results of Peck's empirical formulas with numerical calculations revealed similar trends in the settlement curves, with a maximum deviation of 6.67%. It can be concluded that using Peck's empirical formula to calculate ground deformation characteristics complements the limitations of numerical simulations, making the assessment results more reliable. The findings of this study demonstrate that integrating numerical simulation with empirical formulas significantly enhances the reliability of deformation predictions in complex tunneling scenarios. This research not only offers a comprehensive safety assessment method for shield tunneling construction but also provides valuable guidance for the design and construction of similar projects, serving as a theoretical reference for future engineering endeavors. [ABSTRACT FROM AUTHOR]

We reported the new synthesis of Sm2Co17 particles by a microwave-assisted combustion (MACS) method. This process enables the controlled decomposition of Sm(NO3)3 and Co(NO3)2 into SmCo-O particles, followed by calcium reduction-diffusion. This SmCo-O particle provides an approach for achieving high magnetic properties in Sm2Co17 magnetic materials. The rhombohedral Sm2Co17 particles can be incorporated into epoxy resin and oriented, displaying a square-like hysteresis loop. The particles display magnetic properties at room temperature, with a saturation magnetization of 112.3 emu/g, coercivity of 5.6 kOe, and a maximum energy product of 9.4 MGOe. This method improves the synthesis efficiency of rare earth cobalt-based nano-materials, expands the synthesis scope, and provides ideas for the synthesis and applications of other rare earth nano-materials. [ABSTRACT FROM AUTHOR]

In this study, common multiwalled and carboxylated carbon nanotubes (CNTs) were added to the cemented lithium tailings backfill (CLTB). The effects of CNTs on the mechanical properties, hydration products, damage process, and microstructure of CLTB specimens were studied by uniaxial compression (UCS), infrared spectroscopy (FT-IR), and scanning electron microscopy (SEM). The experimental results show that the addition of CNTs effectively increased the compressive strength compared with the blank control group. When the concentration was 0.05–0.20%, the compressive strength was proportional to the content, the optimal addition amount was 0.2%, and the enhancement effect was 75% and 95.31%, respectively. The FT-IR results indicate that the addition of CNTs increased the total amount of the hydration product but did not affect its type. The hydration of the three-dimensional reciprocal penetration network formed by moderate amounts of CNTs has a positive effect on the mechanical strength of CLTB specimens. [ABSTRACT FROM AUTHOR]

As a typical liquid-like thermoelectric material, Cu2 Se not only has good electrical transport performance, but also has low lattice thermal conductivity. Nanoengineering is an effective method to achieve high thermoelectric properties for thermoelectrics. However, nanoscale Cu2 Se particles are extremely easy to be oxidized in the process of synthesizing, thus affecting its thermoelectric performance. In order to study the effect of powder reduction on the thermoelectric performance of Cu2 Se, nano-sized Cu2 Se powders were synthesized by hydrothermal method. Hydrogen argon mixed gas ( hydrogen volume fraction of 5%) and pure argon were used to purge the powders, respectively. Cu2 Se bulk materials with density above 95% were prepared by spark plasma sintering. The results show that the oxygen content of Cu2 Se bulk is significantly reduced after powder reduction, and there is a 41% decrease in thermal conductivity at 800 K, with a 16% increase in ZT value. [ABSTRACT FROM AUTHOR]

BackgroundEvidence has accumulated showing that recreational physical activity reduces breast cancer risk. However, it is unclear whether risk reduction pertains to specific receptor-defined subtypes. Moreover, few studies have examined whether changes in the amount of recreational physical activity during adulthood influence breast cancer risk.MethodsA total of 108,907 women, ages 22 to 79 years with no history of breast cancer when joining the California Teachers Study in 1995-1996, completed a baseline questionnaire and were eligible for the study. Through 2012, 5882 women were diagnosed with invasive breast cancer. Breast cancer subtypes were defined by the expression status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Multivariable Cox proportional hazards models provided adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) for breast cancer overall and ER/PR/HER2-defined subtypes associated with long-term (from high school through age 54 or age at cohort entry, whichever was younger) and baseline (during 3 years prior to baseline) recreational physical activity. Among women who also completed a follow-up questionnaire at 10 years after baseline in 2005-2008 (54,686 women, 1406 with invasive breast cancer), risk associated with changes in the amount of recreational physical activity from baseline to the 10-year follow-up (during 3 years prior to the 10-year follow-up) was determined.ResultsBoth long-term and baseline strenuous recreational physical activity were inversely associated with risk of invasive breast cancer (P trend ≤0.03). The observed associations were mainly confined to women with triple negative breast cancer (TNBC, ER-/PR-/HER2-, P trend ≤0.02) or luminal A-like subtype (ER+ or PR+ plus HER2-) who were former users of menopausal hormone therapy at baseline (P trend = 0.02, P homogeneity of trends ≤0.03). Moreover, women who consistently engaged in the highest level (≥3.51 h/wk/y) of strenuous recreational physical activity between baseline and 10-year follow-up had the lowest risk of breast cancer (HR = 0.71, 95 % CI = 0.52-0.98) when compared to those who were consistently low (≤0.50 h/wk/y).ConclusionsStrenuous recreational physical activity is associated with lower breast cancer risk, especially TNBC. The benefit may be maximized by consistently engaging in high-intensity recreational physical activity during adulthood.

Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality. We used data from the California Breast Cancer Survivorship Consortium and the California Neighborhoods Data System (CNDS) to examine the neighborhood environment, body mass index, and mortality after breast cancer. We studied 8,995 African American, Asian American, Latina, and non-Latina white women with breast cancer. Residential addresses were linked to the CNDS to characterize neighborhoods. We used multinomial logistic regression to evaluate the associations between neighborhood factors and obesity and Cox proportional hazards regression to examine associations between neighborhood factors and mortality. For Latinas, obesity was associated with more neighborhood crowding [quartile 4 (Q4) vs. Q1: OR, 3.24; 95% confidence interval (CI), 1.50-7.00]; breast cancer-specific mortality was inversely associated with neighborhood businesses (Q4 vs. Q1: HR, 0.46; 95% CI, 0.25-0.85) and positively associated with multifamily housing (Q3 vs. Q1: HR, 1.98; 95% CI, 1.20-3.26). For non-Latina whites, lower neighborhood socioeconomic status (SES) was associated with obesity [quintile 1 (Q1) vs. Q5: OR, 2.52; 95% CI, 1.31-4.84], breast cancer-specific (Q1 vs. Q5: HR, 2.75; 95% CI, 1.47-5.12), and all-cause (Q1 vs. Q5: HR, 1.75; 95% CI, 1.17-2.62) mortality. For Asian Americans, no associations were seen. For African Americans, lower neighborhood SES was associated with lower mortality in a nonlinear fashion. Attributes of the neighborhood environment were associated with obesity and mortality following breast cancer diagnosis, but these associations differed across racial/ethnic groups.

Abstract: Background. Evidence has accumulated showing that physical activity reduces breast cancer risk. Whether risk reduction pertains to all breast cancer or specific receptor-defined subtypes is unclear. Moreover, few studies have examined whether changes in the amount of physical activity during adulthood influence breast cancer risk. Methods. Among 108,907 women, ages 22 to 79 years with no history of breast cancer when they joined the California Teachers Study in 1995-1996 (baseline), 5,578 women were diagnosed with invasive breast cancer during follow-up through December, 2011. Subtypes were defined by the expression status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were fit to data to estimate adjusted hazard rate ratios (HRs) and 95% confidence intervals (CIs) associated with long-term and recent (within 3 years of baseline) recreational physical activity. Among 54,690 women who provided updated information on physical activity in 2005-2008, we also assessed whether changes in the level of physical activity since baseline influenced breast cancer risk (654 cases diagnosed during follow-up). Results. Long-term and recent recreational physical activity were inversely associated with risk of triple negative breast cancer (TNBC, both Ptrend ≤ 0.05), but not other subtypes (all Ptrend ≥ 0.07). The reduced risk of TNBC was limited to strenuous physical activity. A 50% (HR = 0.50, 95% CI = 0.29-0.86) lower risk of TNBC was observed among women in the highest (≥5.01 h/wk) versus lowest category (≤0.50 h/wk) of long-term strenuous recreational physical activity; this was not modified by baseline body mass index (

BACKGROUND: The role of comorbidities in survival of patients with breast cancer has not been well studied, particularly in non-white populations. METHODS: We investigated the association of specific comorbidities with mortality in a multiethnic cohort of 8,952 breast cancer cases within the California Breast Cancer Survivorship Consortium (CBCSC), which pooled questionnaire and cancer registry data from five California-based studies. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Using multivariable Cox proportional hazards regression, we estimated HRs and 95% confidence intervals (CI) for overall and breast cancer-specific mortality associated with previous cancer, diabetes, high blood pressure (HBP), and myocardial infarction. RESULTS: Risk of breast cancer-specific mortality increased among breast cancer cases with a history of diabetes (HR, 1.48; 95% CI, 1.18-1.87) or myocardial infarction (HR, 1.94; 95% CI, 1.27-2.97). Risk patterns were similar across race/ethnicity (non-Latina white, Latina, African American, and Asian American), body size, menopausal status, and stage at diagnosis. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiotherapy nor chemotherapy (HR, 2.11; 95% CI, 1.32-3.36); no increased risk was observed among those who received both treatments (HR, 1.13; 95% CI, 0.70-1.84; P(interaction) = 0.03). A similar pattern was found for myocardial infarction by radiotherapy and chemotherapy (P(interaction) = 0.09). CONCLUSION: These results may inform future treatment guidelines for patients with breast cancer with a history of diabetes or myocardial infarction. IMPACT: Given the growing number of breast cancer survivors worldwide, we need to better understand how comorbidities may adversely affect treatment decisions and ultimately outcome.

With diminishing natural aggregate resources and increasing environmental protection efforts, the use of recycled fine aggregate is a more sustainable approach, although challenges persist in achieving comparable mechanical properties. Exploration into the incorporation of steel fibers with recycled aggregate has led to the development of steel-fiber-reinforced recycled aggregate concrete. This study investigates the shrinkage performance and compressive constitutive relationship of steel fiber recycled concrete with different steel fibers and recycled aggregate dosages. Initially, based on different replacement rates of recycled coarse aggregate and different volume contents of steel fiber, experimental results demonstrate that as the replacement rate of recycled coarse aggregate increases, shrinkage also increases, while the addition of steel fiber can mitigate this effect. An empirical shrinkage model for steel fiber recycled concrete under natural curing conditions is also proposed. Subsequently, based on the uniaxial compression test, findings indicate that with an increasing replacement rate of recycled fine aggregate, the peak stress and elastic modulus of concrete decrease, accompanied by an increase in peak strain, and the addition of steel fiber limits concrete crack development and enhances its brittleness while the peak stress and strain of recycled fine aggregate concrete are enhanced. However, the steel fiber volume percentage has a negligible effect on the elastic modulus. A constitutive relationship for concrete considering the effects of recycled fine aggregate and steel fiber is also proposed. This finding provides foundational support for the influence patterns of steel fiber dosage and recycled aggregate ratio on the mechanical properties of steel fiber recycled concrete. [ABSTRACT FROM AUTHOR]

Excavation in foundation pits can result in serious issues for nearby tunnel structures like deformation, differential settlement, and seepage damage, which profoundly impact project timelines and potentially endanger life and property safety. Therefore, it is imperative to investigate these impacts before and after construction and to facilitate timely adjustments of construction measures and reinforcement where possible. In this study, a foundation pit construction project near a rail transit line is employed as a case to comprehensive study the impact of on-site deep foundation pit excavation on adjacent rail transit structures by numerical simulation. A three-dimensional finite-element model of the foundation pit based on site geological characteristics and construction procedures is established to study the excavation and maintenance processes. Through analysis of key parameters including soil deformation, displacement, shear force, and bending moment of the tunnel structures, the designed protective structure is found to have effectively mitigated soil deformation, ensuring the stability of the foundation pit. As excavation progresses, lateral soil deformation and vertical uplift gradually increase but remain within specified control values. During various excavation stages, the maximum displacement of the tunnel structure gradually increases, with the increase rates of maximum settlement being 29.09%, 20.51%, and 6.45%, respectively. This indicates a gradual enhancement of the stability of the tunnel structure. Additionally, excavation of the foundation pit has a significant impact on the bending moment distribution of the tunnel structure but does not affect the axial force and shear force of the tunnel structure. The findings of this study offer crucial scientific insights for evaluating the safety and stability of construction near tunnel structures. [ABSTRACT FROM AUTHOR]

Nanorods assembled 3D microspheres of TiO2/MnO2 were prepared via a simple one-pot hydrothermal approach. The resultant composite material exhibited remarkable electrocatalytic activity for hydrogen peroxide (H2O2) in comparison to each single component. The electrochemical sensor constructed with TiO2/MnO2 exhibited a linear relationship within the range 0.0001–5.6 mmol·L−1 for H2O2. The limit of detection (LOD) and sensitivity for H2O2 were 0.03 µmol·L−1 (S/N = 3) and 316.6 µA (mmol·L−1)−1 cm−2. Moreover, this sensor can be employed to detect trace amount of H2O2 in serum and urine samples successfully, supporting an insight and strategy for a more sensitive electrochemical sensor. [ABSTRACT FROM AUTHOR]

We investigated body size and survival by race/ethnicity in 11,351 breast cancer patients diagnosed from 1993 to 2007 with follow-up through 2009 by using data from questionnaires and the California Cancer Registry. We calculated hazard ratios and 95% confidence intervals from multivariable Cox proportional hazard model-estimated associations of body size (body mass index (BMI) (weight (kg)/height (m)(2)) and waist-hip ratio (WHR)) with breast cancer-specific and all-cause mortality. Among 2,744 ascertained deaths, 1,445 were related to breast cancer. Being underweight (BMI

We investigated body size and survival by race/ethnicity in 11,351 breast cancer patients diagnosed from 1993 to 2007 with follow-up through 2009 by using data from questionnaires and the California Cancer Registry. We calculated hazard ratios and 95% confidence intervals from multivariable Cox proportional hazard model–estimated associations of body size (body mass index (BMI) (weight (kg)/height (m)2) and waist-hip ratio (WHR)) with breast cancer–specific and all-cause mortality. Among 2,744 ascertained deaths, 1,445 were related to breast cancer. Being underweight (BMI