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Abstract Background Breast reconstruction (BR) is the reconstructive surgical technique that focuses on restoring normal form and function to the breast following oncologic resection. The goal of this study was to determine if BR disparities exist among rural female patients in Kentucky.
Methods A retrospective (2006‐2015), population‐based cohort study was conducted on breast cancer patients (stages I‐III) treated with mastectomy with or without BR. We used 2013 Beale codes to stratify patients according to geographic status. Chi‐square tests were used to examine the association of BR along the rural‐urban continuum. A multivariate logistic regression model controlling for patient, disease, and treatment factors was used to predict BR. The likelihood of BR was reported in odds ratios (OR) using a 95% confidence interval (CI).
Results Overall, 10,032 patients met study criteria. Of those, 2,159 (21.5%) underwent BR. The rate of BR among urban, near‐metro, and rural patients was 31.1%, 20.4%, and 13.4%, respectively (
P < .001). Multivariate analysis revealed that women from near metro (OR 0.54, CI: 0.47‐0.61;P < .001) and rural areas (OR 0.36, CI: 0.31‐0.41;P < .001) were less likely to undergo BR than women from urban areas.Conclusion Although BR benefits are well documented, women from rural Kentucky undergo BR at lower rates and are less likely to receive BR than their urban counterparts. Efforts should seek to promote equitable access to BR for all patients, including those from rural areas.
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Abstract Plasma and wave measurements from the NASA Magnetospheric Multiscale mission are presented for magnetotail reconnection events on 3 July and 11 July 2017. Linear dispersion analyses were performed using distribution functions comprising up to six drifting bi‐Maxwellian distributions. In both events electron crescent‐shaped distributions are shown to be responsible for upper hybrid waves near the X‐line. In an adjacent location within the 3 July event a monodirectional field‐aligned electron beam drove parallel‐propagating beam‐mode waves. In the 11 July event an electron distribution consisting of a drifting core and two crescents was shown to generate upper‐hybrid and beam‐mode waves at three different frequencies, explaining the observed broadband waves. Multiple harmonics of the upper hybrid waves were observed but cannot be explained by the linear dispersion analysis since they result from nonlinear beam interactions.
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Abstract Electron inflow and outflow velocities during magnetic reconnection at and near the dayside magnetopause are measured using satellites from NASA's Magnetospheric Multiscale (MMS) mission. A case study is examined in detail, and three other events with similar behavior are shown, with one of them being a recently published electron‐only reconnection event in the magnetosheath. The measured inflow speeds of 200–400 km/s imply dimensionless reconnection rates of 0.05–0.25 when normalized to the relevant electron Alfvén speed, which are within the range of expectations. The outflow speeds are about 1.5–3 times the inflow speeds, which is consistent with theoretical predictions of the aspect ratio of the inner electron diffusion region. A reconnection rate of 0.04 ± 25% was obtained for the case study event using the reconnection electric field as compared to the 0.12 ± 20% rate determined from the inflow velocity.
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