Sociodemographic disparities associated with advanced stages and distant metastatic breast cancers at diagnosis in Indonesia: a cross-sectional study.

Background: The global health burden of breast cancer is increasing with 5-year survival rates being much shorter in low-income and middle-income countries. Sociodemographic and clinical disparities in early cancer detection affect long-term outcome. Methods: The authors compared social, demographic, and pathological characteristics associated with metastatic and late stages of breast cancer diagnosis using data collected from a special registry developed by Perhimpunan Bedah Onkologi Indonesia (PERABOI) in 2015. Results: Of 4959 patients recruited in this study, 995 women (20.1%) were diagnosed with metastatic breast cancer. Lower education status and living in rural areas were significantly associated with Stage IV at diagnosis [odds ratio (OR)=1.256, 95% CI=1.093-1.445, P=0.001; and OR=1.197, 95% CI=1.042-1.377, P=0.012; respectively). Main complaints other than lump (ulceration, breast pain, and discharge) and occupation as a housewife were also associated with the presentation of metastatic diseases (OR=2.598, 95% CI=2.538-3.448, P<0.001 and OR=1.264, 95% CI=1.056-1.567, P=0.030, respectively). Having lower education and living outside Java and Bali islands were associated with the diagnosis of late-stage breast cancers (OR=1.908, 95% CI=1.629-2.232, P<0.001 and OR=3.039, 95% CI=2.238-4.126, P<0.001; respectively). A higher proportion of breast cancer patients were relatively younger with bigger tumour size, positive axillary nodal involvement, and more frequent Human epidermal growth factor receptor 2 overexpression. Conclusion: The authors identified sociodemographic disparities in the metastatic and late-stage diagnosis of breast cancers among Indonesian women. The subsequent action is required to reduce disparities faced by women with lower social and educational levels for early diagnosis and better healthcare access.

Therapeutic Drug Monitoring of Inhaled Tobramycin in a Post-Hematopoietic Cell Transplant Patient With Bronchiolitis Obliterans and End-Stage Renal Disease.

There are no widely accepted dose alterations for inhaled tobramycin in the setting of renal dysfunction, and serum concentrations are not typically monitored. Herein we describe a case report of a 16-year-old female with a history of 2 hematopoietic cell transplants and a kidney transplant who received inhaled tobramycin for chronic Pseudomonas aeruginosa management. The patient developed chronic kidney disease, and tobramycin concentrations were monitored. Initially she received a reduced dose of inhaled tobramycin, with repeated doses based on serum concentrations. The dose was increased, but serum concentrations obtained the following day remained higher than desired, leading to a suspicion of delayed systemic absorption. Tobramycin administration was changed from immediately prior to dialysis to the evening prior to the next day's dialysis session, and serum concentrations were consistently <1 mg/L postdialysis. In conclusion, systemic absorption of inhaled tobramycin in non-cystic fibrosis (CF) patients may differ compared to that observed in CF patients. Renal dysfunction may lead to systemic accumulation of inhaled tobramycin, and the timing of inhaled tobramycin administration with respect to dialysis has a potentially significant influence on drug clearance. Thus, monitoring may be required. Further cases are required to verify these observations.

Nitrification and autotrophic nitrifying bacteria in a hydrocarbon-polluted soil.

In vitro ammonia-oxidizing bacteria are capable of oxidizing hydrocarbons incompletely. This transformation is accompanied by competitive inhibition of ammonia monooxygenase, the first key enzyme in nitrification. The effect of hydrocarbon pollution on soil nitrification was examined in situ. In a microcosm study, adding diesel fuel hydrocarbon to an uncontaminated soil (agricultural unfertilized soil) treated with ammonium sulfate dramatically reduced the amount of KCl-extractable nitrate but stimulated ammonium consumption. In a soil with long history of pollution that was treated with ammonium sulfate, 90% of the ammonium was transformed into nitrate after 3 weeks of incubation. Nitrate production was twofold higher in the contaminated soil than in the agricultural soil to which hydrocarbon was not added. To assess if ammonia-oxidizing bacteria acquired resistance to inhibition by hydrocarbon, the contaminated soil was reexposed to diesel fuel. Ammonium consumption was not affected, but nitrate production was 30% lower than nitrate production in the absence of hydrocarbon. The apparent reduction in nitrification resulted from immobilization of ammonium by hydrocarbon-stimulated microbial activity. These results indicated that the hydrocarbon inhibited nitrification in the noncontaminated soil (agricultural soil) and that ammonia-oxidizing bacteria in the polluted soil acquired resistance to inhibition by the hydrocarbon, possibly by increasing the affinity of nitrifying bacteria for ammonium in the soil.

Ebbinghaus illusion: effect of figural similarity upon magnitude of illusion when context elements are equal in perceived size.

The magnitude of the Ebbinghaus illusion has been reported to be greater when test element and context elements are figurally similar as opposed to figurally dissimilar. In the current investigation with 16 observers, illusion magnitude was greater for a figurally similar configuration even though the context elements of the figurally similar configuration were perceived as smaller than the context elements of a figurally dissimilar configuration. Hence, figural similarity appears to have a prepotent effect in the Ebbinghaus illusion.

Benussi effect as an integration of disparity by motion.

It was hypothesized that the apparent depth of the Benussi effect could be elicited using stimuli corresponding to retinally disparate images. When such stimuli were presented rapidly and successively in a manner approximating apparent motion, 21 of 22 observers reported apparent depth.

The Benussi effect with rectangles?

The perceived depth of the Benussi effect is usually demonstrated by presenting a configuration of nonconcentric circles on a rotating disc. However, in the current investigation with 21 undergraduates the Benussi effect was elicited by presenting an eccentric configuration of rectangles. Depth was reported when the configuration of eccentric rectangles was alternated rapidly and successively with its mirror image. As is characteristic of the Benussi effect, there was an increase in apparent depth with an increase in the eccentricity of the rectangles.

A size illusion from simultaneous changes in length and direction of a line pattern.

A circle was attached to one of three lines which were changing in length and direction simultaneously. This configuration of moving lines had been found previously to induce the perception of depth. Of 26 observers 20 reported that the moving circle appeared smaller in size than a physically equal stationary circle which was located outside the changing, depth-inducing configuration.

Apparent depth threshold for the Benussi effect.

Using the single staircase psychophysical method, the apparent depth threshold for the Benussi effect was determined for 5 observers. The threshold occurred at an eccentricity of 2r/3, where r equals the radius of the larger circle expressed in millimeters.

Motion parallax, relative size, and Benussi effect.

Many observers perceive depth when a configuration of nonconcentric circles is rotated on a disc. While it has been suggested by a number of investigators that motion parallax has a role in generating this phenomenon, the supporting data are equivocal. The current study proposed that the ambiguity regarding the role of motion parallax may have arisen because there are contradictions between relative size cues and motion parallax cues in the configuration of rotating circles. However, with 17 undergraduate observers, apparent depth was no more reliably reported with consistent cues of motion parallax and relative size than when these cues were contradictory.

Is the Benussi effect a kinetic depth effect?

Rapid, successive presentations of an eccentric circle pattern and its mirror-image elicited apparent depth and, as has been previously demonstrated for the Benussi effect, there was an increase in apparent depth with an increase in circle eccentricity. Taken together, these data were interpreted as contravening Wallach, Adams, and Weisz's account of the Benussi effect as an instance of the kinetic depth effect.

Attenuating Necker cube depth reversals.

Rapid, apparent, to-and-fro (right-left) rotation of the Necker cube sharply reduced reversals in depth for 10 undergraduates. This finding was considered consistent with the satiation theory of Necker cube reversals.

Blackness enhancement.

Since apparent brightness increases as an intermittent luminous source decreases from flicker fusion to approximately 10 cps, the phenomenal blackness induced by an intermittent annulus should also increase as a result of brightness contrast. However, data from 5 observers showed the phenomenal blackness occurring with a 10-cps inducer was greater than that expected on the basis of brightness contrast.