Influence of Breast Cancer and Metastases on Incidence of Diabete

Purpose: Diabetes increases the risk of subsequent breast cancer. However, the inverse relationship of breast cancer to incident diabetes development is unclear. In preclinical models increased bone turnover due to bone metastases or endocrine therapies impacts insulin secretion. This analysis was conducted to estimate the incidence of diabetes after breast cancer and the influence of metastases and therapeutic agents. Methods: This retrospective case-control study combined data from a large electronic health data exchange and the Indiana State Cancer Registry on breast cancer patients and controls between 2007 and 2017. Primary exposure was presence of breast cancer and bone or non-bone metastases. The primary outcome was frequency of incident diabetes detected by ICD codes, medication use, or laboratory results, compared between breast cancer cases and controls using conditional or ordinary logistic regressions. Results: 36,083 cases and 36,083 matched controls were detected. Incident diabetes was higher in early stage breast cancer (OR 1.17, 95%CI 1.11-1.23, p<0.0001) and metastatic breast cancer (OR 1.62, 95% CI 1.25-2.09, p=0.0002), compared to controls. Bone metastases conferred higher odds of both pre-existing (OR 1.20, 95% CI 1.03-1.63, p=0.0272) and incident diabetes (OR 1.64, 95% CI 1.19-2.25, p=0.0021). Endocrine therapy was associated with reduced diabetes (OR 0.86, 95% CI 0.79-0.83, p=0.002). Anti-resorptives reduced incident diabetes in those with bone metastases (OR 0.44, 95% CI 0.25-0.78, p=0.005). Conclusion: Breast cancer, especially with metastases, increases subsequent risk of diabetes. As patients with breast cancer live longer, identifying and managing diabetes may impact treatment delivery, cost, survival, and quality of life

Less-than-lethal "flashbang" diversionary device.

Diversionary devices such as flashbang grenades are used in a wide variety of military and law-enforcement operations. They function to distract and/or incapacitate adversaries in scenarios ranging from hostage rescue to covert strategic paralysis operations. There are a number of disadvantages associated with currently available diversionary devices. Serious injuries and fatalities have resulted from their use both operationally and in training. Because safety is of paramount importance, desired improvements to these devices include protection against inadvertent initiation, the elimination of the production of high-velocity fragments, less damaging decibel output and increased light output. Sandia National Laboratories has developed a next-generation diversionary flash-bang device that will provide the end user with these enhanced safety features

Shock analysis using the multi point velocimeter (VISAR).

The velocity of short duration high-amplitude shock waves and high-speed motion created by sources such as explosives, high energy plasmas and other rapid-acceleration devices are difficult to measure due to their fast reaction times. One measurement tool frequently used is VISAR (Velocity Interferometer System for Any Reflector). VISAR is an optical-based system that utilizes Doppler interferometry techniques to measure the complete time-history of the motion of a surface. This technique is gaining worldwide acceptance as the tool of choice for measurement of shock phenomena. However, one limitation of the single point VISAR is that it measures only one point on a surface. The new Multi Point VISAR remedies the single point VISAR's limitation by using multiple fiber optics and sensors to send and receive information. Upcoming programs that need analysis of large diameter flyers prompted the concept and design of a single cavity-multiple fiber optic Multi Point VISAR (MPV). Preliminary designs and the testing of a single cavity prototype in 1996 supported the theory of compact fiber optic bundle systems for development into the Multi Point VISAR. The new MPV was used to evaluate the performance of two components; a piezo-driven plane wave generating isolator, and a slim-loop ferroelectric (SFE)-type fireset

Less-than-lethal &quot;Flashbang&quot; Diversionary Device Less-than-lethal &quot;Flashbang&quot; Diversionary Device

Abstract Diversionary devices such as flashbang grenades are used in a wide variety of military and law-enforcement operations. They function to distract and/or incapacitate adversaries in scenarios ranging from hostage rescue to covert strategic paralysis operations. There are a number of disadvantages associated with currently available diversionary devices. Serious injuries and fatalities have resulted from their use both operationally and in training. Because safety is of paramount importance, desired improvements to these devices include protection against inadvertent initiation, the elimination of the production of high-velocity fragments, less damaging decibel output and increased light output. Sandia National Laboratories has developed a next-generation diversionary flash-bang device that will provide the end user with these enhanced safety features.

Challenges in assessing the efficacy of systemic corticosteroids for severe wheezing episodes in preschool children

This letter addresses the controversial issue of the use of oral corticosteroids during wheezing exacerbations in preschool-aged children by demonstrating findings of a prematurely terminated multi-center clinical trial, discussing lessons learned, and suggesting future directions