Dense breast on screening mammography: utility and futility of additional ultrasound.

High breast density decreases the sensitivity of mammography. Regardless of masking effect, it is also a stronger predictor for breast cancer than most other risk factors, including family history. Up to 50% of women have dense breast (categories C+D). The relative risk is 2.1 to 2.3 in women with extremely dense breast (category d). There is little consensus on the potential need of additional measures. Breast Ultrasound (US) may be proposed as an adjunctive test, as it is non-invasive and non-irradiating. Since 2012, our program for breast cancer screening propose to realise an additional US to the women with category d breasts. An evaluation of the data of the first year showed that less 50% of the women act upon the recommendation. In spite of the low compliance supplementary cancers were found. Since, no more evaluation was performed. The aim of this study was: To evaluate the effect of the recommendation in term of additional cancer's identification, additional biopsies and additional investigations. To identify the reasons of non compliance

Degree formula for connective K-theory

We apply the degree formula for connective $K$-theory to study rational contractions of algebraic varieties. Examples include rationally connected varieties and complete intersections.Comment: 14 page

Effectiveness of organised versus opportunistic mammography screening

Background: Detailed comparison of effectiveness between organised and opportunistic mammography screening operating in the same country has seldom been carried out. Patients and methods: Prognostic indicators, as defined in the European Guidelines, were used to evaluate screening effectiveness in Switzerland. Matching of screening programmes' records with population-based cancer registries enabled to compare indicators of effectiveness by screening and detection modality (organised versus opportunistic screening, unscreened, interval cancers). Comparisons of prognostic profile were also drawn with two Swiss regions uncovered by service screening of low and high prevalence of opportunistic screening, respectively. Results: Opportunistic and organised screening yielded overall little difference in prognostic profile. Both screening types led to substantial stage shifting. Breast cancer prognostic indicators were systematically more favourable in Swiss regions covered by a programme. In regions without a screening programme, the higher the prevalence of opportunistic screening, the better was the prognostic profile. Conclusions: Organised screening appeared as effective as opportunistic screening. Mammography screening has strongly influenced the stage distribution of breast cancer in Switzerland, and a favourable impact on mortality is anticipated. Extension of organised mammography screening to the whole of Switzerland can be expected to further improve breast cancer prognosis in a cost-effective wa

Ten-year changes in colorectal cancer screening in Switzerland: The Swiss Health Interview Survey 2007, 2012 and 2017

Recent recommendations for colorectal cancer (CRC) screening suggest fecal occult blood test (FOBT) or colonoscopy. Since 2013, mandatory health insurance in Switzerland reimburse CRC screening. We set out to determine if CRC testing rate and type of CRC screening changed in Switzerland from 2007 to 2017 and between the three main language regions. We extracted data on 50–75-year-olds from the Swiss Health Interview Survey (SHIS) 2007, 2012 and 2017 to determine rates of self-reported testing with FOBT within last 2 years and colonoscopy within last 10 years. We estimated prevalence ratio (PR) in multivariate-adjusted logistic regression models and compared rates in German-, French- and Italian-speaking regions, adjusting for sociodemographic, self-rated health and insurance variables. Overall testing rates (FOBT or colonoscopy) increased in all regions from 2007 to 2017 (German-speaking 33.6% to 48.3%; French-speaking 30.8% to 48.8%; Italian-speaking 37.9% to 46.8%), mainly because of an increase in colonoscopy rate for screening reasons (p < 0.001 in all regions). Rates of FOBT testing fell significantly in the German-speaking region (11.9% to 4.4%, p < 0.001), but not in the Italian- (13.9% to 8.5%, p = 0.052) and French-speaking regions (7.6% to 7.4%, p = 0.138). Overall CRC testing rate rose from 33.2% in 2007 to 48.4% in 2017, mainly because of an increase of colonoscopy rate for screening reasons. Coverage remains below the 65% target of European guidelines. Organized screening programs encouraging FOBT screening could contribute to further increasing the CRC testing rate

Boundary value problems for second order linear difference equations: application to the computation of the inverse of generalized Jacobi matrices

We have named generalized Jacobi matrices to those that are practically tridiagonal, except for the two final entries and the two first entries of its first andits last row respectively. This class of matrices encompasses both standard Jacobiand periodic Jacobi matrices that appear in many contexts in pure and appliedmathematics. Therefore, the study of the inverse of these matrices becomes ofspecific interest. However, explicit formulas for inverses are known only in a fewcases, in particular when the coefficients of the diagonal entries are subjected tosome restrictions.We will show that the inverse of generalized Jacobi matrices can be raisedin terms of the resolution of a boundary value problem associated with a secondorder linear difference equation. In fact, recent advances in the study of lineardifference equations, allow us to compute the solution of this kind of boundaryvalue problems. So, the conditions that ensure the uniqueness of the solution ofthe boundary value problem leads to the invertibility conditions for the matrix,whereas that solutions for suitable problems provide explicitly the entries of theinverse matrix.Peer ReviewedPostprint (author's final draft

Change in colorectal cancer (CRC) testing rates associated with the introduction of the first organized screening program in canton Uri, Switzerland: Evidence from insurance claims data analyses from 2010 to 2018

The first canton in Switzerland to implement an organized colorectal cancer screening program (OSP) was Uri. Starting in 2013, it offered 50–69-year-olds free testing with colonoscopy every 10 years or fecal occult blood test (FOBT) every 2 years. We tested the association between the OSP and testing rates over time. We analyzed claims data of 50–69-year-olds from Uri and neighboring cantons (NB) provided by a large health insurance and complemented it with data from the OSP. We fitted multivariate adjusted logistic regression models to compare overall testing rates and by method (colonoscopy or FOBT/both) We computed the 2018 rate of the population up-to-date with testing (colonoscopy within 9 years/FOBT within 2 years). Yearly overall testing rates in Uri increased from 8.7% in 2010 to 10.8% in 2018 and from 6.5% to 7.9% in NB. In Uri, the proportion tested with FOBT/both increased from 4.7% to 6.0% but decreased from 2.8% to 1.1% in NB. Testing by FOBT/both increased more between 2015 and 2018 than 2010–2012 in Uri than in NB (OR:2.1[95%CI:1.8–2.4]), it increased less for colonoscopy (OR:0.60[95%CI:0.51–0.70]), with no change in overall CRC testing (OR:0.91[95%CI:0.81–1.02]). In 2018 in Uri, 42.5% were up-to-date with testing (FOBT/both:9.2%, colonoscopy:35.7%); in NBs, 40.7% (FOBT/both:2.7%, colonoscopy:39%). Yearly FOBT rates in Uri were always higher than in NB. Though the OSP in Uri was not associated with a greater increase in overall testing rates, the OSP was associated with increased FOBT

Espaces de Berkovich sur Z : \'etude locale

We investigate the local properties of Berkovich spaces over Z. Using Weierstrass theorems, we prove that the local rings of those spaces are noetherian, regular in the case of affine spaces and excellent. We also show that the structure sheaf is coherent. Our methods work over other base rings (valued fields, discrete valuation rings, rings of integers of number fields, etc.) and provide a unified treatment of complex and p-adic spaces.Comment: v3: Corrected a few mistakes. Corrected the proof of the Weierstrass division theorem 7.3 in the case where the base field is imperfect and trivially value

Measurement of the WW Boson Mass

A measurement of the mass of the $W$ boson is presented based on a sample of 5982 $W \rightarrow e \nu$ decays observed in $p\overline{p}$ collisions at $\sqrt{s}$ = 1.8~TeV with the D\O\ detector during the 1992--1993 run. From a fit to the transverse mass spectrum, combined with measurements of the $Z$ boson mass, the $W$ boson mass is measured to be $M_W = 80.350 \pm 0.140 (stat.) \pm 0.165 (syst.) \pm 0.160 (scale) GeV/c^2$.Comment: 12 pages, LaTex, style Revtex, including 3 postscript figures (submitted to PRL

Limits on WWgamma and WWZ Couplings from W Boson Pair Production

The results of a search for W boson pair production in pbar-p collisions at sqrt{s}=1.8 TeV with subsequent decay to emu, ee, and mumu channels are presented. Five candidate events are observed with an expected background of 3.1+-0.4 events for an integrated luminosity of approximately 97 pb^{-1}. Limits on the anomalous couplings are obtained from a maximum likelihood fit of the E_T spectra of the leptons in the candidate events. Assuming identical WWgamma and WWZ couplings, the 95 % C.L. limits are -0.62<Delta_kappa<0.77 (lambda = 0) and -0.53<lambda<0.56 (Delta_kappa = 0) for a form factor scale Lambda = 1.5 TeV.Comment: 10 pages, 1 figure, submitted to Physical Review