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Alex L Dubrava,1,2 Pan Su Pyae Kyaw,1,2 Joseph Newman,1,2 Jarrad Pringle,1,2 Justin Westhuyzen,3 Gina La Hera Fuentes,2 Thomas P Shakespeare,1,2 Renukadas Sakalkale,2,4 Noel J Aherne1– 3 1Department of Radiation Oncology, Mid North Coast Cancer Centre, Coffs Harbour, New South Wales, Australia; 2Coffs Harbour Rural Clinical School, University of New South Wales, Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia; 3School of Health and Human Sciences, Southern Cross University, Coffs Harbour, New South Wales, Australia; 4Coffs Harbour Base Hospital Pathology, Coffs Harbour, New South Wales, AustraliaCorrespondence: Noel J Aherne, Department of Radiation Oncology, Mid North Coast Cancer Centre, Coffs Harbour Hospital, Coffs Harbour, New South Wales, 2450, Australia, Tel + 61 2 6656 5125, Fax +61 2 6656 5855, Email noel.aherne@health.nsw.gov.auPurpose: Triple negative breast cancer (TNBC) is a breast carcinoma subtype that neither expresses estrogen (ER) and progesterone receptors (PR) nor the human epidermal growth factor receptor 2 (HER2). Patients with TNBC have been shown to have poorer outcomes mainly owing to the limited treatment options available. However, some studies have shown TNBC tumors expressing androgen receptors (AR), raising hopes of its prognostic role.Patients and Methods: This retrospective study investigated the expression of AR in TNBC and its relationship with known patient demographics, tumor and survival characteristics. From the records of 205 TNBC patients, 36 had available archived tissue samples eligible for AR staining. For statistical purposes, tumors were classified as either “positive” or “negative” for AR expression. The nuclear expression of AR was scored by measuring the percentage of stained tumor cells and its staining intensity.Results: AR was expressed by 50% of the tissue samples in our TNBC cohort. The relationship between AR status with age at the time of TNBC diagnosis was statistically signific

INTRODUCTION:Given constrained funding for Human Immunodeficiency Virus (HIV) programs across Sub-Saharan Africa, delivering services efficiently is paramount. Voluntary medical male circumcision (VMMC) is a key intervention that can substantially reduce heterosexual transmission-the primary mode of transmission across the continent. There is limited research, however, on what factors may contribute to the efficient and high-quality execution of such programs. METHODS:We analyzed a multi-country, multi-stage random sample of 108 health facilities providing VMMC services in sub-Saharan Africa in 2012 and 2013. The survey collected information on inputs, outputs, process quality and management practices from facilities providing VMMC services. We analyzed the relationship between management practices, quality (measured through provider vignettes) and efficiency (estimated through data envelopment analysis) using Generalized Linear Models and Mixed-effects Models. Applying multivariate regression models, we assessed the relationship between management indices and efficiency and quality of VMMC services. RESULTS:Across countries, both efficiency and quality varied widely. After adjusting for type of facility, country and scale, performance-base funding was negatively correlated with efficiency -0.156 (p < 0.05). In our analysis, we did not find any significant relationships between quality and management practices. CONCLUSIONS:No significant relationship was found between process quality and management practices across 108 VMMC facilities. This study is the first to analyze the potential relationships between management and service quality and efficiency among a sample of VMMC health facilities in sub-Saharan Africa and can potentially inform policy-relevant hypotheses to later test through prospective experimental studies.