Background
Women and their health care providers need a reliable answer to this important question: If a woman chooses to participate in regular mammography screening, then how much will this choice ...improve her chances of avoiding a death from breast cancer compared with women who choose not to participate?
Methods
To answer this question, we used comprehensive registries for population, screening history, breast cancer incidence, and disease‐specific death data in a defined population in Dalarna County, Sweden. The annual incidence of breast cancer was calculated along with the annual incidence of breast cancers that were fatal within 10 and within 11 to 20 years of diagnosis among women aged 40 to 69 years who either did or did not participate in mammography screening during a 39‐year period (1977‐2015). For an additional comparison, corresponding data are presented from 19 years of the prescreening period (1958‐1976). All patients received stage‐specific therapy according to the latest national guidelines, irrespective of the mode of detection.
Results
The benefit for women who chose to participate in an organized breast cancer screening program was a 60% lower risk of dying from breast cancer within 10 years after diagnosis (relative risk, 0.40; 95% confidence interval, 0.34‐0.48) and a 47% lower risk of dying from breast cancer within 20 years after diagnosis (relative risk, 0.53; 95% confidence interval, 0.44‐0.63) compared with the corresponding risks for nonparticipants.
Conclusions
Although all patients with breast cancer stand to benefit from advances in breast cancer therapy, the current results demonstrate that women who have participated in mammography screening obtain a significantly greater benefit from the therapy available at the time of diagnosis than do those who have not participated.
After 20 years of follow‐up, women who participate in mammography screening have a 47% lower risk of dying from breast cancer. Although all patients with breast cancer potentially can benefit from advances in breast cancer therapy, women who participate in mammography screening obtain a significantly greater benefit from the therapy available at the time of diagnosis than those who do not participate.
Human infection with the novel avian-origin influenza A (H7N9) virus has aroused global concern. In this report, the clinical characteristics of 111 laboratory-confirmed cases in China are presented.
...On March 30, 2013, three patients with fatal cases of rapid, progressive pneumonia were confirmed to be infected with a novel avian-origin influenza A (H7N9) virus that had not been detected in humans and animals previously.
1
,
2
The new human H7N9 viruses are the product of reassortment of viruses that are of avian origin.
Global attention was soon focused on the situation because of the increasing number of new cases and the high rate of death associated with these infections.
3
As of May 9, the World Health Organization (WHO) had reported 131 laboratory-confirmed cases, including 32 deaths.
4
However, data on . . .
The emergence of blockchain technology has created a number of potential innovations in handling business activities across various industries. However, few studies discuss the potential influence of ...blockchain technology from a business process re-engineering perspective. This study focuses on the feasibility and inceptive application of supply chain processes. We proposed a blockchain-based framework along with the use of an affiliated technology, i.e., smart contracts, to derive the feasible benefits of the supply chain process design. Through the illustrative design of an integrated process, we provide an achievable use case of the disintermediation of business processes via a conceptual, shared information ledger. This ledger not only facilitates the sharing of tracking information but also promotes a network for multilateral collaboration among supply chain members. The pursuit of transparency and accountability across supply chain processes can potentially influence decentralization and automation. A comparative analysis of the current and proposed frameworks is conducted to support the core reasoning of this study. Additionally, future implications on managerial practice and academic research are explored to provide pervasive suggestions for similar attempts in different sectors. We conclude with an evaluation of the potential influence of blockchain technology on supply chain management.
•Blockchain and smart contract technology can help conduct business process re-engineering (BPR) across enterprise borders.•A blockchain-based BPR framework is proposed and explored to automate business flows in tracking supply chain processes.•Blockchain-based business apps can be designed and implemented using the proposed framework to harvest blockchain benefits.•Blockchain and smart contract based business applications may significantly affect our digital life in the near future.
Abstract
Herein, we report an efficient protocol in which formate is used as a precursor of the CO
2
radical anion for the photoinduced defluorocarboxylation of α‐trifluoromethylstyrene. A wide range ...of
gem
‐difluorovinylacetic acids bearing a variety of functional groups were successfully obtained in the absence of metal catalysts. The synthetic value of this protocol was highlighted by successful gram‐scale synthesis and late‐stage modification for complex biologically active molecules. This protocol provides a complementary method that extends the range of currently available methodologies for accessing the structurally versatile
gem
‐difluoroalkenes.
Hybrid manganese halide has attracted much attention in the field of environment friendly ferroelectric and photo‐responsive multifunctional materials. Here, the highly efficient photoluminescent ...inorganic framework MnBr42− is utilized to conceive and synthesize a series of hybrid manganese bromide compounds RQ2MnBr4 by introducing precisely designed quasi‐spherical cations RQ+ (R = H, Me, Et, FEt, Q = quinuclidine). The accurate and effective modification of cations not only achieves the satisfactory ferroelectricity, but also enhances the photoluminescence quantum yield from 38.7% to 83.65%. Moreover, FEtQ2MnBr4 shows a highly efficient X‐ray scintillator performance, including a large range of linear response to X‐ray dose rate from 0.3 to 414.2 μGyair s−1, a high light yield of 34 438 photons per MeV, and a low detection limit of 258 nGyair s−1. This work provides an efficient strategy for the preparation of hybrid manganese halide ferroelectrics with highly efficient light‐emission and X‐ray detection.
By coupling the design for high Curie temperature ferroelectrics and the modulation of photo‐responsive properties through precise modification of spherical cations, an A2MnBr4‐type hybrid ferroelectric with a high photoluminescence quantum yield of 83.65% is obtained. Moreover, the eco‐friendly crystal is promising for high performance X‐ray detectors compared with commercially available scintillators such as bismuth germanium oxide and lutetium yttrium oxyorthosilicate.
To estimate the long-term (29-year) effect of mammographic screening on breast cancer mortality in terms of both relative and absolute effects.
This study was carried out under the auspices of the ...Swedish National Board of Health and Welfare. The board determined that, because randomization was at a community level and was to invitation to screening, informed verbal consent could be given by the participants when they attended the screening examination. A total of 133 065 women aged 40-74 years residing in two Swedish counties were randomized into a group invited to mammographic screening and a control group receiving usual care. Case status and cause of death were determined by the local trial end point committees and, independently, by an external committee. Mortality analysis was performed by using negative binomial regression.
There was a highly significant reduction in breast cancer mortality in women invited to screening according to both local end point committee data (relative risk RR = 0.69; 95% confidence interval: 0.56, 0.84; P < .0001) and consensus data (RR = 0.73; 95% confidence interval: 0.59, 0.89; P = .002). At 29 years of follow-up, the number of women needed to undergo screening for 7 years to prevent one breast cancer death was 414 according to local data and 519 according to consensus data. Most prevented breast cancer deaths would have occurred (in the absence of screening) after the first 10 years of follow-up.
Invitation to mammographic screening results in a highly significant decrease in breast cancer-specific mortality. Evaluation of the full impact of screening, in particular estimates of absolute benefit and number needed to screen, requires follow-up times exceeding 20 years because the observed number of breast cancer deaths prevented increases with increasing time of follow-up.
Lilium is a large genus that includes approximately 110 species distributed throughout cold and temperate regions of the Northern Hemisphere. The species-level phylogeny of Lilium remains unclear; ...previous studies have found universal markers but insufficient phylogenetic signals. In this study, we present the use of complete chloroplast genomes to explore the phylogeny of this genus. We sequenced nine Lilium chloroplast genomes and retrieved seven published chloroplast genomes for comparative and phylogenetic analyses. The genomes ranged from 151,655 bp to 153,235 bp in length and had a typical quadripartite structure with a conserved genome arrangement and moderate divergence. A comparison of sixteen Lilium chloroplast genomes revealed ten mutation hotspots. Single nucleotide polymorphisms (SNPs) for any two Lilium chloroplast genomes ranged from 8 to 1,178 and provided robust data for phylogeny. Except for some of the shortest internodes, phylogenetic relationships of the Lilium species inferred from the chloroplast genome obtained high support, indicating that chloroplast genome data will be useful to help resolve the deeper branches of phylogeny.
Background
Vessels encapsulating tumor clusters (VETC) pattern is a novel microvascular pattern associated with poor outcomes of hepatocellular carcinoma (HCC). Preoperative estimation of VETC has ...potential to improve treatment decisions.
Purpose
To develop and validate a nomogram based on gadoxetate disodium‐enhanced MRI for estimating VETC in HCC and to evaluate whether the estimations are associated with recurrence after hepatic resection.
Study Type
Retrospective.
Population
A total of 320 patients with HCC and histopathologic VETC pattern assessment from three centers (development cohort:validation cohort = 173:147).
Field Strength/Sequence
A3.0 T/turbo spin‐echo T2‐weighted, spin‐echo echo‐planar diffusion‐weighted, and 3D T1‐weighted gradient‐echo sequences.
Assessment
A set of previously reported VETC‐ and/or prognosis‐correlated qualitative and quantitative imaging features were assessed. Clinical and imaging variables were compared based on histopathologic VETC status to investigate factors indicating VETC pattern. A regression‐based nomogram was then constructed using the significant factors for VETC pattern. The nomogram‐estimated VETC stratification was assessed for its association with recurrence.
Statistical Tests
Fisher exact test, t‐test or Mann–Whitney test, logistic regression analyses, Harrell's concordance index (C‐index), nomogram, Kaplan–Meier curves and log‐rank tests. P value < 0.05 was considered statistically significant.
Results
Pathological VETC pattern presence was identified in 156 patients (development cohort:validation cohort = 83:73). Tumor size, presence of heterogeneous enhancement with septations or with irregular ring‐like structures, and necrosis were significant factors for estimating VETC pattern. The nomogram incorporating these indicators showed good discrimination with a C‐index of 0.870 (development cohort) and 0.862 (validation cohort). Significant differences in recurrence rates between the nomogram‐estimated high‐risk VETC group and low‐risk VETC group were found (2‐year recurrence rates, 50.7% vs. 30.3% and 49.6% vs. 31.8% in the development and validation cohorts, respectively).
Data Conclusion
The nomogram integrating gadoxetate disodium‐enhanced MRI features was associated with VETC pattern preoperatively and with postoperative recurrence in patients with HCC.
Evidence Level
4
Technical Efficacy
Stage 2
Personalized medical care focuses on prediction of disease risk and response to medications. To build the risk models, access to both large-scale genomic resources and human genetic studies is ...required. The Taiwan Biobank (TWB) has generated high-coverage, whole-genome sequencing data from 1492 individuals and genome-wide SNP data from 103,106 individuals of Han Chinese ancestry using custom SNP arrays. Principal components analysis of the genotyping data showed that the full range of Han Chinese genetic variation was found in the cohort. The arrays also include thousands of known functional variants, allowing for simultaneous ascertainment of Mendelian disease-causing mutations and variants that affect drug metabolism. We found that 21.2% of the population are mutation carriers of autosomal recessive diseases, 3.1% have mutations in cancer-predisposing genes, and 87.3% carry variants that affect drug response. We highlight how TWB data provide insight into both population history and disease burden, while showing how widespread genetic testing can be used to improve clinical care.
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