Background: The density of breast tissue on a mammogram is a strong predictor of breast cancer risk and may reflect cumulative
estrogen effect on breast tissue. Endogenous and exogenous estrogen ...exposure increases the risk of estrogen receptor (ER)–positive
breast cancer. We determined if mammographic density is associated more strongly with ER-positive breast cancer than with
ER-negative breast cancer.
Methods: We analyzed data from 44,811 participants in the San Francisco Mammography Registry of whom 701 developed invasive
breast cancer. Mammographic density was measured using the Breast Imaging Reporting and Data System (BI-RADS) classification
system (1 = almost entirely fat, 2 = scattered fibroglandular, 3 = heterogeneously dense, 4 = extremely dense). We tested
for associations between mammographic density and ER-positive and ER-negative breast cancer separately. Analyses were adjusted
for age, body mass index, postmenopausal hormone use, family history of breast cancer, menopausal status, parity, and race/ethnicity.
Results: Mammographic density was strongly associated with both ER-positive and ER-negative breast cancers. Compared with
women with BI-RADS 2, women with BI-RADS 1 (lowest density) had a lower risk of ER-positive cancer adjusted hazard ratio
(HR), 0.28; 95% confidence interval (95% CI), 0.16-0.50 and ER-negative cancer (adjusted HR, 0.17; 95% CI, 0.04-0.70). Women
with BI-RADS 4 (highest density) had an increased risk of ER-positive breast cancer (adjusted HR, 2.21; 95% CI, 1.64-3.04)
and an increased risk of ER-negative breast cancer (adjusted HR, 2.21; 95% CI, 1.16-4.18).
Conclusion: Surprisingly, women with high mammographic density have an increased risk of both ER-positive and ER-negative
breast cancers. The association between mammographic density and breast cancer may be due to factors besides estrogen exposure.
Study objective The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ...ureteral stone. We evaluate the STONE score in a multi-institutional cohort compared with physician gestalt and hypothesize that it has a sufficiently high specificity to allow clinicians to defer computed tomography (CT) scan in patients with suspected nephrolithiasis. Methods We assessed the STONE score with data from a randomized trial for participants with suspected nephrolithiasis who enrolled at 9 emergency departments between October 2011 and February 2013. In accordance with STONE predictors, we categorized participants into low-, moderate-, or high-score groups. We determined the performance of the STONE score and physician gestalt for ureteral stone. Results Eight hundred forty-five participants were included for analysis; 331 (39%) had a ureteral stone. The global performance of the STONE score was superior to physician gestalt (area under the receiver operating characteristic curve=0.78 95% confidence interval {CI} 0.74 to 0.81 versus 0.68 95% CI 0.64 to 0.71). The prevalence of ureteral stone on CT scan ranged from 14% (95% CI 9% to 19%) to 73% (95% CI 67% to 78%) in the low-, moderate-, and high-score groups. The sensitivity and specificity of a high score were 53% (95% CI 48% to 59%) and 87% (95% CI 84% to 90%), respectively. Conclusion The STONE score can successfully aggregate patients into low-, medium-, and high-risk groups and predicts ureteral stone with a higher specificity than physician gestalt. However, in its present form, the STONE score lacks sufficient accuracy to allow clinicians to defer CT scan for suspected ureteral stone.
Rocky Mountain spotted fever (RMSF) is a tick-borne infection caused by Rickettsia rickettsii. We report a cluster of fatal cases of RMSF in 2007 in Panama, involving a pregnant woman and two ...children from the same family. The woman presented with a fever followed by respiratory distress, maculopapular rash, and an eschar at the site from which a tick had been removed. She died four days after disease onset. This is the second published report of an eschar in a patient confirmed by PCR to be infected with R. rickettsii. One month later, the children presented within days of one another with fever and rash and died three and four days after disease onset. The diagnosis was confirmed by immunohistochemistry, PCR and sequencing of the genes of R. rickettsii in tissues obtained at autopsy.
Dual diagnosis in rural Australia: A Victorian initiative Hill, Harry; Powell, Mark; Smith, Rebecca
Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists,
12/2022, Letnik:
30, Številka:
6
Journal Article
Over the last ten years, Major League Soccer (MLS) has attracted many overseas players. This study examines the role country of birth plays in salary determination, team performance on the pitch, and ...fan attendance in Major League Soccer for the 2007 through 2014 seasons. Players born in the U.S. earn less than equally productive foreign-born players. However, there is much heterogeneity amongst these foreign-born players. Players born in France, Gambia, Argentina, Brazil, Columbia, and Costa Rica earn salary premiums relative to their productivity. Players born in Trinidad and Tobago earn less than their productivity would suggest. There is little evidence that foreign born players impact team performance on the pitch but may have a positive effect on attendance.
AbstractThis paper introduces a generic multireservoir planning testbed called the Eldorado Utility Planning Model (EUPM). The purpose of the EUPM is to facilitate experimentation with advanced water ...supply planning tools and techniques using a complex system that is not subject to the sensitivities or paradigms of real-world case study models. The model centers on a hypothetical Colorado utility and incorporates the regional context of the western United States, e.g., competition between water users and the spatial and temporal complexities that impact water availability. The benefits of the EUPM are demonstrated through an experimental multiobjective evolutionary algorithm (MOEA) optimization problem formulation designed to generate informative tradeoffs without the use of uncertain estimates of monetary costs. Incorporating two performance measures—minimization of new storage and of new supply—into the set of long-term planning objectives produces a suite of planning alternatives that can facilitate the application of human judgment to broader planning policy discussions, including the implications that a portfolio has on total plan cost.
•N-3 polyunsaturated fatty acid ethyl esters are FDA approved supplements.•N-3 polyunsaturated fatty acid ethyl esters decrease the proliferation of cultured human colorectal cancer cells in a ...dose-responsive manner.•Low concentrations of n-3 polyunsaturated fatty acid ethyl esters decrease the invasion of and PI3K activity in human colorectal cancer cells.•The effects of n-3 polyunsaturated fatty acid ethyl esters on cell invasion, but not cell proliferation, are conferred by their ability to decrease PI3K activity.
N-3 polyunsaturated fatty acid (PUFA) ethyl esters have been approved by the FDA for the treatment of dyslipidemia and are promising cancer therapeutics. The study objectives were to determine if and how n-3 PUFA ethyl esters affected the proliferation and invasion of colorectal cancer cells. SW620 and HCT-116 parental and HCT-116 mutant cells isogenic for constitutively active PI3K were treated with free or ethyl esterified n-3 PUFAs and counted 72 h later. Cells were also administered n-3 PUFA ethyl esters to determine if these compounds decreased invasion through Boyden chambers and PI3K activity via western blot analysis of phosphorylated Akt. Free and n-3 PUFA ethyl esters decreased the proliferation of all cell lines. The invasion and Akt phosphorylation of both parental cell lines was decreased following treatment but this did not occur in mutant cells. The ability of n-3 PUFA ethyl esters to decrease proliferation and invasion in vitro indicates these compounds may be effective in vivo.
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