Prospective evaluation of prognostic factors in operable breast cancer.

In 215 patients with operable breast cancer (T1-T3, N0-1, M0) and no other or previous cancer, presenting to a single breast unit, sufficient tumour was available for the prospective determination of four putative biochemical markers of prognosis: oestrogen receptor (ER) activity, cathepsin D (cath D), epidermal growth factor receptor (EGFR) activity and cyclic AMP-binding proteins (c-AMP-b). There were significant inter-relationships between ER and EGFR (r = -0.26), c-AMP-b and cath D (r = +0.32) and ER and c-AMP-b (r = +0.14). After follow-up (median 36.2 months), a total of 55 recurrences (18 locoregional only) and 35 deaths were recorded. By univariate analysis, up to 10 of 18 biochemical, clinical and histopathological variables of potential prognostic value were significantly related to disease-free interval or death, but by multivariate analysis only oestrogen receptor concentration and node status contributed significantly to risk of both distant recurrence/death; in addition, tumour size made a small contribution to the risk for a distant recurrence only. Only two parameters, tumour grade and ER concentration, were significantly related to risk of locoregional recurrence by univariate analysis, but by multivariate analysis, only tumour grade was important. It is concluded that tumour ER concentration, axillary nodal status and tumour grade remain as the most important prognostic factors in the early years after presentation of operable breast cancer, with a minor influence of tumour size. At this time, the prognostic significance of quantitative measurements of ER concentration, carefully controlled for the quality of both assay and tumour specimen, is probably greater than is generally appreciated. We have yet to identify other factors, which add significantly to the short-term prognostic value of these key features

Scenario Analyses Concerning Energy Efficiency and Climate Protection in Regional and National Residential Building Stocks. Examples from Nine European Countries. - EPISCOPE Synthesis Report No. 3

This report documents methodological aspects and selected results of the scenario analyses to assess refurbishment as well as energy saving processes and project future energy consumption.. It covers scenario calculations conducted for regional residential building stocks in Salzburg/Austria, the Comunidat Valenciana/Spain, the Piedmont Region/Italy, the national non-profit housing stock in the Netherlands as well as the national residential building stocks in Germany, England, Greece, Norway, and Slovenia. Thereby, the objective of the scenario analysis is not a prediction of future energy demand in the respective building stock. Rather, the objective is to show the potential future impact of predefined assumptions. This may help respective key actors and policy makers to decide on strategies and policies for transforming building stocks towards carbon dioxide neutrality

Outcome after extended follow-up in a prospective study of operable breast cancer: key factors and a prognostic index

In 1990, 215 patients with operable breast cancer were entered into a prospective study of the prognostic significance of five biochemical markers and 15 other factors (pathological/chronological/patient). After a median follow-up of 6.6 years, there were 77 recurrences and 77 deaths (59 breast cancer-related). By univariate analysis, patient outcome related significantly to 13 factors. By multivariate analysis, the most important of nine independent factors were: number of nodes involved, steroid receptors (for oestrogen or progestogen), age, clinical or pathological tumour size and grade. Receptors and grade exerted their influence only in the first 3 years. Progestogen receptors (immunohistochemical) and oestrogen receptors (biochemical) were of similar prognostic significance. The two receptors were correlated (r=+0.50, P=0.001) and displaced each other from the analytical model but some evidence for the additivity of their prognostic values was seen when their levels were discordant

Tracking of Energy Performance Indicators in Residential Building Stocks – Different Approaches and Common Results - EPISCOPE Synthesis Report No. 4

A central task of IEE EPISCOPE project was to carry out energy balance calculations and scenario analysis for national, regional or local residential building stocks against the background of energy saving and climate protection targets. The EPISCOPE Synthesis Report No. 4 documents the individual approaches of collecting information for the investigated residential building stocks as a foundation for building stock models and scenario calculations. Issues related to the availability of data and data quality are discussed, and concepts for a continuous monitoring (a regular data collection) are presented as a basis for a future tracking of energy performance in the observed building stocks

Rapid Identification of Novel Psychoactive and Other Controlled Substances Using Low-Field 1H NMR Spectroscopy

An automated approach to the collection of 1H NMR (nuclear magnetic resonance) spectra using a benchtop NMR spectrometer and the subsequent analysis, processing, and elucidation of components present in seized drug samples are reported. An algorithm is developed to compare spectral data to a reference library of over 300 1H NMR spectra, ranking matches by a correlation-based score. A threshold for identification was set at 0.838, below which identification of the component present was deemed unreliable. Using this system, 432 samples were surveyed and validated against contemporaneously acquired GC–MS (gas chromatography–mass spectrometry) data. Following removal of samples which possessed no peaks in the GC–MS trace or in both the 1H NMR spectrum and GC–MS trace, the remaining 416 samples matched in 93% of cases. Thirteen of these samples were binary mixtures. A partial match (one component not identified) was obtained for 6% of samples surveyed whilst only 1% of samples did not match at all

A View from the Top: International Politics, Norms and the Worldwide Growth of NGOs

This article provides a top-down explanation for the rapid growth of nongovernmental organizations (NGOs) in the postwar period, focusing on two aspects of political globalization. First, I argue that international political opportunities in the form of funding and political access have expanded enormously in the postwar period and provided a structural environment highly conducive to NGO growth. Secondly, I present a norm-based argument and trace the rise of a pro-NGO norm in the 1980s and 1990s among donor states and intergovernmental organizations (IGOs), which has actively promoted the spread of NGOs to non-Western countries. The article ends with a brief discussion of the symbiotic relationship among NGOs, IGOs, and states promoting international cooperation

Localization of type 1 diabetes susceptibility to the MHC class I genes HLA-B and HLA-A

The major histocompatibility complex (MHC) on chromosome 6 is associated with susceptibility to more common diseases than any other region of the human genome, including almost all disorders classified as autoimmune. In type 1 diabetes the major genetic susceptibility determinants have been mapped to the MHC class II genes HLA-DQB1 and HLA-DRB1 (refs 1-3), but these genes cannot completely explain the association between type 1 diabetes and the MHC region. Owing to the region's extreme gene density, the multiplicity of disease-associated alleles, strong associations between alleles, limited genotyping capability, and inadequate statistical approaches and sample sizes, which, and how many, loci within the MHC determine susceptibility remains unclear. Here, in several large type 1 diabetes data sets, we analyse a combined total of 1,729 polymorphisms, and apply statistical methods - recursive partitioning and regression - to pinpoint disease susceptibility to the MHC class I genes HLA-B and HLA-A (risk ratios >1.5; Pcombined = 2.01 × 10-19 and 2.35 × 10-13, respectively) in addition to the established associations of the MHC class II genes. Other loci with smaller and/or rarer effects might also be involved, but to find these, future searches must take into account both the HLA class II and class I genes and use even larger samples. Taken together with previous studies, we conclude that MHC-class-I-mediated events, principally involving HLA-B*39, contribute to the aetiology of type 1 diabetes. ©2007 Nature Publishing Group