Breast cancer risk factors and survival by tumor subtype: pooled analyses from the breast cancer association consortium

Background: It is not known whether modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype.Methods: We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype.Results: There was no evidence of heterogeneous associations between risk factors and mortality by subtype (P-adj > 0.30). The strongest associations were between all-cause mortality and BMI >= 30 versus 18.5-25 kg/m(2) [HR (95% confidence interval (CI), 1.19 (1.06-1.34)]; current versus never smoking [1.37 (1.27-1.47)], high versus low physical activity [0.43 (0.21-0.86)], age >= 30 years versus 0-= 10 years since last full-term birth [1.31 (1.11-1.55)]; ever versus never use of oral contraceptives [0.91 (0.87-0.96)]; ever versus never use of menopausal hormone therapy, including current estrogen-progestin therapy [0.61 (0.54-0.69)]. Similar associations with breast cancer mortality were weaker; for example, 1.11 (1.02-1.21) for current versus never smoking.Conclusions: We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype.Impact: Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.Surgical oncolog

Development of nuclear analysis capabilities for DOE waste management activities. 1998 annual progress report

'The objective of this project is to develop and demonstrate prototypic analysis capabilities that can be used by the nuclear safety analysis practitioners to: (1) demonstrate a more thorough understanding of the underlying physics phenomena that can lead to improved reliability and defensibility of safety evaluations; and (2) optimize operations related to the handling, storage, transportation, and disposal of fissile material and DOE spent fuel. To address these problems, the project will investigate the implementation of sensitivity and uncertainty methods within existing Monte Carlo codes used for criticality safety analyses, as well as within a new deterministic code that allows specification of arbitrary grids to accurately model the geometry details required in a criticality safety analysis. This capability can facilitate improved estimations of the required subcritical margin and potentially enable the use of a broader range of experiments in the validation process. The new arbitrary-grid radiation transport code will also enable detailed geometric modeling valuable for improved accuracy in application to a myriad of other problems related to waste characterization. Application to these problems will also be explored. This report summarizes the progress achieved after only seven months of work on a three-year project.

Medial Patellofemoral Ligament Repair With Suture Tape Augmentation

The medial patellofemoral ligament (MPFL) is the main restraining force in the first 20° of flexion against lateral patellar displacement and is disrupted after patellar subluxation or dislocation. MPFL reconstruction is frequently performed when conservative management fails and the patient has recurrent patellar dislocations. However, a variety of complications have been reported in the literature with this procedure. Internal bracing with suture tape augmentation encourages healing and allows early mobilization. This article describes, with video illustration, MPFL repair with suture tape augmentation

Posterior Cruciate Ligament Repair With Suture Tape Augmentation

The posterior cruciate ligament (PCL) acts as the primary restraint to posterior tibial translation of the knee. Injuries to the PCL are rare in isolation and more often are associated with multiligament injuries to the knee. Several PCL reconstruction and PCL repair techniques have been described in the literature, but no single technique has been shown to be the most superior. Internal bracing with suture tape augmentation encourages natural healing and allows early mobilization. This article describes, with video illustration, PCL repair with suture tape augmentation

Reduction of a Depressed Femoral Lateral Notch at the Time of Lateral Extra-articular Tenodesis

We present a surgical technique to address severe lateral femoral notch depressions using a small extension in the lateral approach for Lemaire extra-articular tenodesis in anterior cruciate ligament reconstruction. Through this approach, the surgeon is able to obtain good exposure of the lateral femoral condyle, with straightforward access for subchondral reduction, without adding any significant morbidity

EMSP project summary (Project ID: 60077): Development of nuclear analysis capabilities for DOE waste management activities

The objective of this project is to develop and demonstrate prototypical analysis capabilities that can be used by nuclear safety analysis practitioners to: (1) demonstrate a more thorough understanding of the underlying physics phenomena that can lead to improved reliability and defensibility of safety evaluations; and (2) optimize operations related to the handling, storage, transportation, and disposal of fissile material and DOE spent fuel. To address these problems, this project has been investigating the implementation of sensitivity and uncertainty methods within existing Monte Carlo codes used for criticality safety analyses. It is also investigating the use of a new deterministic code that allows for specification of arbitrary grids to accurately model geometric details required in a criticality safety analysis. This capability can facilitate improved estimations of the required subcritical margin and potentially enable the use of a broader range of experiments in the validation process. The new arbitrary-grid radiation transport code will also enable detailed geometric modeling valuable for improved accuracy in application to a myriad of other problems related to waste characterization. Application to these problems will also be explored

Percutaneous Medial Collateral Ligament Repair and Posteromedial Corner Repair With Suture Tape Augmentation

The medial collateral ligament (MCL) is among the most commonly injured structures of the knee. Most cases are managed nonoperatively; however, grade III injuries and injuries associated with multiligament injuries to the knee are often managed surgically. MCL reconstruction procedures are the most widely used surgical option, but modern advancements have seen a renewed interest in ligamentous repair that avoids graft-site morbidity. In addition, augmentation of the repair protects the ligament during the healing phase and allows early mobilization. This article describes, with video illustration, percutaneous MCL repair and posteromedial corner repair with suture tape augmentation