Communication between patients with breast cancer and health care providers. Determinants and implications

BACKGROUND: This study evaluated the perceptions of patients with breast cancer of their medical interactions with providers. The determinants and psychological consequences of communication problems also were examined. METHODS: Ninety-seven patients with Stage I or II breast cancer completed a set of validated questionnaires before initiating postoperative therapy. Data on psychological distress were collected at baseline and 3-month follow-up, and multivariate models were fit to explain the relationship between pretreatment communication problems and subsequent psychological distress. Data on clinical variables were abstracted from medical records. RESULTS: A substantial proportion of patients (84%) reported difficulties communicating with the medical team. Communication problems were more common among patients who were less optimistic about their disease and had less assertive coping styles. Patient-reported communication problems were associated with increased anxiety, depression anger, and confusion at the 3-month follow-up. The association between communication problems and mood disturbance remained significant, although small, after adjusting for baseline mood disturbance, demographic, clinical, and coping style variables. CONCLUSION: Interventions that enhance communication between patients with breast cancer and their providers may improve patients' psychological adjustment to treatment. Conversely, interventions that lower distress and modify coping style may enhance communication.     

Transient characteristics of small salient-pole alternators

The use of small alternators, other than for standby purposes, is increasing and this has focused attention on the reliability and utility of the parameters normally quoted for such machines. Test procedures are described and methods used for parameter estimation discussed, with particular emphasis on the difficulties presented by small brushless machines     

Effect of stepper lens operating conditions on proximity effects in DUV optical lithography down to 250nm

Reduction of optical proximity effects (OPE), at deep uv wavelength of 248nm, caused by the variation of stepper lens operating conditions is investigated. It is shown that many of these effects, which increase as the Rayleigh limit is approached, can be minimised, and in many cases eliminated, by suitable choice of lens numerical aperture (NA) and partial coherence (sigma, σ).

Application of these results should enable the user of advanced wafer steppers to carry out high resolution lithography with a minimum of time consuming optical proximity correction (OPC).     

Cataract and high-pass resolution perimetry

The present study describes the influence of cataract on high-pass resolution perimetry results. Twenty-five otherwise healthy patients were examined before and after cataract surgery. Their preoperative visual acuities ranged from 0.1 to 0.8 and their mean resolution thresholds from 3.9 to 12.3 dB. Both elevated mean thresholds and local visual fields defects were observed. In patients with low-grade cataract, i.e. preoperative visual acuity 0.3 to 0.65, the mean improvement in perimetric results after operation was approximately 1 dB. In patients with higher degrees of lens opacity, visual acuity 0.1 to 0.25, the difference between pre- and postoperative perimetry results showed a wide range, 1.4-6.2 dB. In conclusion, cataract induced different types of visual field defects. The general threshold increase due to low-grade cataract (VA > or = 0.3) could be compensated for by subtracting 1 dB from the measured value.     

APPLICATION OF SITE-SPECIFIC NATURAL ISOTOPE FRACTIONATION (SNIF-NMR) OF HYDROGEN TO THE CHARACTERIZATION OF EUROPEAN BEERS

More than one hundred samples of European beers have been investigated by the new SNIF-NMR method which is based on 2H NMR at the natural abundance level and enables site-specific natural isotope fractionation factors in ethanol to be determined. The relative (R) and absolute (D/H)_i, parameters are shown to be characteristic of the country where the beers are brewed and the observed variations are explained in terms of cereal composition, water resource, and manufacturing processing (fermentation, yeast, temperature cycle). These new parameters find analytical and mechanistic applications in the identification of a beer and in the investigation of a fermentation process.     

Parallel associative combinator evaluation II

A new evaluation model for SK combinator expressions is presented and used as a basis for the design of a novel processor. The resulting machine architecture resembles a dataflow ring, but executions are constrained to be fully lazy. An automatic dynamic load sharing mechanism for a distributed multiprocessor architecture is suggested, and initial simulation results are presented.     

Rate-distortion optimized tree-structured compression algorithms for piecewise polynomial images.

This paper presents novel coding algorithms based on tree-structured segmentation, which achieve the correct asymptotic rate-distortion (R-D) behavior for a simple class of signals, known as piecewise polynomials, by using an R-D based prune and join scheme. For the one-dimensional case, our scheme is based on binary-tree segmentation of the signal. This scheme approximates the signal segments using polynomial models and utilizes an R-D optimal bit allocation strategy among the different signal segments. The scheme further encodes similar neighbors jointly to achieve the correct exponentially decaying R-D behavior (D(R) - c(o)2(-c1R)), thus improving over classic wavelet schemes. We also prove that the computational complexity of the scheme is of O(N log N). We then show the extension of this scheme to the two-dimensional case using a quadtree. This quadtree-coding scheme also achieves an exponentially decaying R-D behavior, for the polygonal image model composed of a white polygon-shaped object against a uniform black background, with low computational cost of O(N log N). Again, the key is an R-D optimized prune and join strategy. Finally, we conclude with numerical results, which show that the proposed quadtree-coding scheme outperforms JPEG2000 by about 1 dB for real images, like cameraman, at low rates of around 0.15 bpp.     

Thermal fatigue effects on the temperature distribution inside IGBT modules for zone engine aeronautical applications

This work examines the thermal fatigue effects on the temperature distribution inside IGBT modules for aeronautical applications. Exactly, they are used in a very different application where temperature cycling due to the working environment is the most limiting fact. In this case, it is concluded that solder delamination does not present any restriction to module lifetime at short term (up to 60% of total delaminated area). In addition, it is proposed only determining the delaminated area behind devices, which is the main responsible of the thermal temperature increase.     

The Future of Mixing Research

This paper is the result of a plenary discussion session held at the 11^th European Conference on Mixing. Three perspectives on mixing research are explored: that of the industrialist, the equipment manufacturer, and the academic researcher. There was strong agreement that, while the one dimensional problems are reasonably well understood and many engineers thus perceive that mixing is simple, current practice actually requires us to address complex, multi‐dimensional problems with interactions between mixing, reaction, multi‐phase physics, surface phenomena, and transport phenomena. Understanding these multi‐scale, multi‐mechanism problems requires models which include interactions between the phenomena, and allow the effects of these interactions to emerge. Developing these models will require us to shift our perspective on mixing from one of equipment design to one of the mixing field as a fundamental physical mechanism.     

Laplace spectra as fingerprints for image recognition

In the area of image retrieval from data bases and for copyright protection of large image collections there is a growing demand for unique but easily computable fingerprints for images. These fingerprints can be used to quickly identify every image within a larger set of possibly similar images. This paper introduces a novel method to automatically obtain such fingerprints from an image. It is based on a reinterpretation of an image as a Riemannian manifold. This representation is feasible for gray value images and color images. We discuss the use of the spectrum of eigenvalues of different variants of the Laplace operator as a fingerprint and show the usability of this approach in several use cases. Contrary to existing works in this area we do not only use the discrete Laplacian, but also with a particular emphasis the underlying continuous operator. This allows better results in comparing the resulting spectra and deeper insights in the problems arising. We show how the well known discrete Laplacian is related to the continuous Laplace-Beltrami operator. Furthermore, we introduce the new concept of solid height functions to overcome some potential limitations of the method.