Post-Mastectomy Patients in an Urban Safety-Net Hospital: How Do Safety-Net Hospital Breast Reconstruction Rates Compare to National Breast Reconstruction Rates?

Background Breast reconstruction (BR) has documented psychological benefits following mastectomy. Yet, racial/ethnic minority groups have lower reported rates of BR. We sought to evaluate the rate, type, and outcome of BR in a racially and ethnically diverse population within a safety-net hospital system. Methods All patients who underwent mastectomy between October 2015 and July 2019 at Harbor-UCLA Medical Center were retrospectively examined. Rates and type of BR were analyzed according to patient characteristics (race/ethnicity, age, and body mass index), smoking status, cancer stage, and presence of diabetes mellitus. Breast reconstruction outcomes were also assessed. Results Of the 259 patients that underwent mastectomy, 87 (33.6%) received BR. Immediate BR was performed in 79 (30.5%) patients and delayed BR in 8 (3.1%). Of the 79 patients with immediate BR, 58 (73.4%) received implant-based BR and 21 (26.5%) autologous tissue. The BR failure rate was 10%, all implant-based. Increasing age and smoking negatively impacted BR rates. Black ( P =.331) and Hispanic ( P =.132) ethnicity were not independent predictors of decreased breast reconstruction. Conclusion This study demonstrated that the rate, type, and quality of BR in this integrated safety-net hospital within a diverse population are comparable to national rates. When made available, historically underrepresented minority patients of Black and Hispanic ethnicity utilize BR.

The Modified LS-STAG Method Application for Planar Viscoelastic Flow Computation in a 4:1 Contraction Channel

In this study we present the modification of the LS-STAG immersed boundary cut-cell method. This modification is designed for viscoelastic fluids. Linear and quasilinear viscoelastic fluid models of a rate type are considered. The obtained numerical method is implemented in the LS-STAG software package developed by the author. This software is created for viscous incompressible flows simulation both by the LS-STAG method and by it developed modifications. Besides of this, the software package is designed to compute extra-stresses for viscoelastic Maxwell, Jeffreys, upper-convected Maxwell, Maxwell-A, Oldroyd-B, Oldroyd-A, Johnson --- Segalman fluids on the LS-STAG mesh. The construction of convective derivatives discrete analogues is described for Oldroyd, Cotter --- Rivlin, Jaumann --- Zaremba --- Noll derivatives. The centers of base LS-STAG mesh cells are the locations for shear non-Newtonian stresses computation. The corners of these cells are the positions for normal non-Newtonian stresses computation. The first order predictor--corrector scheme is the basis for time-stepping numerical algorithm. Benchmark solutions for the planar flow of Oldroyd-B fluid in a 4:1 contraction channel are presented. A critical value of Weissenberg number is defined. Computational results are in good agreement with the data known in the literature