Risk factors for pre-term birth in Iraq: a case-control study

BACKGROUND: Preterm birth (PTB)is a major clinical problem associated with perinatal mortality and morbidity. The aim of the present study is to identify risk factors associated with PTB in Mosul, Iraq. METHODS: A case-control study was conducted in Mosul, Iraq, from 1(st )September, 2003 to 28(th )February, 2004. RESULTS: A total of 200 cases of PTB and 200 controls of full-term births were screened and enrolled in the study. Forward logistic regression analysis was used in the analysis. Several significant risk associations between PTB and the following risk factors were identified: poor diet (OR = 4.33), heavy manual work (OR = 1.70), caring for domestic animals (OR = 5.06), urinary tract infection (OR = 2.85), anxiety (OR = 2.16), cervical incompetence (OR = 4.74), multiple pregnancies (OR = 7.51), direct trauma to abdomen (OR = 3.76) and abortion (OR = 6.36). CONCLUSION: The main determinants of PTB in Iraq were low socio-economic status and factors associated with it, such as heavy manual work and caring for domestic animals, in addition to urinary tract infections and poor obstetric history

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment

Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials

Background Neoadjuvant chemotherapy (NACT) for early breast cancer can make breast-conserving surgery more feasible and might be more likely to eradicate micrometastatic disease than might the same chemotherapy given after surgery. We investigated the long-term benefits and risks of NACT and the influence of tumour characteristics on outcome with a collaborative meta-analysis of individual patient data from relevant randomised trials. Methods We obtained information about prerandomisation tumour characteristics, clinical tumour response, surgery, recurrence, and mortality for 4756 women in ten randomised trials in early breast cancer that began before 2005 and compared NACT with the same chemotherapy given postoperatively. Primary outcomes were tumour response, extent of local therapy, local and distant recurrence, breast cancer death, and overall mortality. Analyses by intention-to-treat used standard regression (for response and frequency of breast-conserving therapy) and log-rank methods (for recurrence and mortality). Findings Patients entered the trials from 1983 to 2002 and median follow-up was 9 years (IQR 5–14), with the last follow-up in 2013. Most chemotherapy was anthracycline based (3838 [81%] of 4756 women). More than two thirds (1349 [69%] of 1947) of women allocated NACT had a complete or partial clinical response. Patients allocated NACT had an increased frequency of breast-conserving therapy (1504 [65%] of 2320 treated with NACT vs 1135 [49%] of 2318 treated with adjuvant chemotherapy). NACT was associated with more frequent local recurrence than was adjuvant chemotherapy: the 15 year local recurrence was 21·4% for NACT versus 15·9% for adjuvant chemotherapy (5·5% increase [95% CI 2·4–8·6]; rate ratio 1·37 [95% CI 1·17–1·61]; p=0·0001). No significant difference between NACT and adjuvant chemotherapy was noted for distant recurrence (15 year risk 38·2% for NACT vs 38·0% for adjuvant chemotherapy; rate ratio 1·02 [95% CI 0·92–1·14]; p=0·66), breast cancer mortality (34·4% vs 33·7%; 1·06 [0·95–1·18]; p=0·31), or death from any cause (40·9% vs 41·2%; 1·04 [0·94–1·15]; p=0·45). Interpretation Tumours downsized by NACT might have higher local recurrence after breast-conserving therapy than might tumours of the same dimensions in women who have not received NACT. Strategies to mitigate the increased local recurrence after breast-conserving therapy in tumours downsized by NACT should be considered—eg, careful tumour localisation, detailed pathological assessment, and appropriate radiotherapy

Seasonal changes in metabolism of the lizard, Lacerta vivippara,

Acute oxygen consumption determinations for both adults and sub-adults of L. vivipara were made over the temperature range 5-30°C during summer and winter. During winter dormancy, both adults and sub-adults were found to have a metabolic rate lower than the metabolic rate of summer animals at each experimental temperature. This reduction of oxygen consumption in winter lizards can be interpreted as an "inverse compensation" (Precept's Type 5 pattern of response). It is concluded that this adjustment can reduce energy costs during the winter period and is a pre-requisite for survival during winter dormancy

An improved BAT algorithm for solving job scheduling problems in hotels and restaurants

One popular example of metaheuristic algorithms from the swarm intelligence family is the Bat algorithm (BA). The algorithm was first presented in 2010 by Yang and quickly demonstrated its efficiency in comparison with other common algorithms. The BA is based on echolocation in bats. The BA uses automatic zooming to strike a balance between exploration and exploitation by imitating the deviations of the bat’s pulse emission rate and loudness as it searches for prey. The BA maintains solution diversity using the frequency-tuning technique. In this way, the BA can quickly and efficiently switch from exploration to exploitation. Therefore, it becomes an efficient optimizer for any application when a quick solution is needed. In this paper, an improvement on the original BA has been made to speed up convergence and make the method more practical for large applications. To conduct a comprehensive comparative analysis between the original BA, the modified BA proposed in this paper, and other state-of-the-art bio-inspired metaheuristics, the performance of both approaches is evaluated on a standard set of 23 (unimodal, multimodal, and fixed-dimension multimodal) benchmark functions. Afterwards, the modified BA was applied to solve a real-world job scheduling problem in hotels and restaurants. Based on the achieved performance metrics, the proposed MBA establishes better global search ability and convergence than the original BA and other approaches