Validation of the IBIS breast cancer risk evaluator for women with lobular carcinoma in-situ.

BACKGROUND: Management advice for women with lobular carcinoma in situ (LCIS) is hampered by the lack of accurate personalised risk estimates for subsequent invasive breast cancer (BC). Prospective validation of the only tool that estimates individual BC risk for a woman with LCIS, the International Breast Cancer Intervention Study Risk Evaluation Tool (IBIS-RET), is lacking. METHODS: Using population-based cancer registry data for 732 women with LCIS, the calibration and discrimination accuracy of IBIS-RET Version 7.2 were assessed. RESULTS: The mean observed 10-year risk of invasive BC was 14.1% (95% CI:11.3%-17.5%). IBIS-RET overestimated invasive BC risk (p = 0.0003) and demonstrated poor discriminatory accuracy (AUC 0.54, 95% CI: 0.48 - 0.62). CONCLUSIONS: Clinicians should understand that IBIS-RET Version 7.2 may overestimate 10-year invasive BC risk for Australian women with LCIS. The newer IBIS-RET Version 8.0, released September 2017, includes mammographic density and may perform better, but validation is needed

Presbyopia:Effectiveness of correction strategies

Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states “presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements”. Presbyopia is inevitable if one lives long enough, but intrinsic and extrinsic risk factors including cigarette smoking, pregnancy history, hyperopic or astigmatic refractive error, ultraviolet radiation, female sex (although accommodation is similar to males), hotter climates and some medical conditions such as diabetes can accelerate the onset of presbyopic symptoms. Whilst clinicians can ameliorate the symptoms of presbyopia with near vision spectacle correction, bifocal and progressive spectacle lenses, monovision, translating or multifocal contact lenses, monovision, extended depth of focus, multifocal (refractive, diffractive and asymmetric designs) or ‘accommodating’ intraocular lenses, corneal inlays, scleral expansion, laser refractive surgery (corneal monovision, corneal shrinkage, corneal multifocal profiles and lenticular softening), pharmacologic agents, and electro-stimulation of the ciliary muscle, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is gives on presbyopic correction evaluation techniques

Water quality and benthic macroinvertebrate bioassessment of Gallinas Creek, San Miguel County, New Mexico, 1987-90 /

Shipping list no.: 96-0223-P.Mode of access: Internet

BRIC : an IBM-704 two-dimensional nuclear-thermal depletion program with distributed void effects /

"Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania, operated for the U.S. Atomic Energy Commission by Westinghouse Electric Corporation.""Contract AT-11-1-GEN-14.""WAPD-TM-208 ; UC-34: Physics and Mathematics ; TID-4500 (16th Ed.).""January 1961."Includes bibliographical references (page 28).Mode of access: Internet

ABRAC : an IBM-704 three dimensional nuclear-thermal depletion program with distributed void effects /

"Bettis Atomic Power Laboratory, Pittsburgh, Pennsylvania, operated for the U.S. Atomic Energy Commission by Westinghouse Electric Corporation.""Contract AT-11-1-GEN-14.""WAPD-TM-203 ; UC-34: Physics and Mathematics ; TID-4500 (15th Ed.).""March 1960."Includes bibliographical references (page 130).Mode of access: Internet