What is the Point: Will Screening Mammography Save my Life?

Background: We analyzed the claim mammography saves lives by calculating the life-saving absolute benefit of screening mammography in reducing breast cancer mortality in women ages 40 to 65. Methods: To calculate the absolute benefit, we first estimated the screen-free absolute death risk from breast cancer by adjusting the Surveillance, Epidemiology and End Results Program 15-year cumulative breast cancer mortality to account for the separate effects of screening mammography and improved therapy. We calculated the absolute risk reduction (reduction in absolute death risk), the number needed to screen assuming repeated screening, and the survival percentages without and with screening. We varied the relative risk reduction from 10%–30% based on the randomized trials of screening mammography. We developed additional variations of the absolute risk reduction for a screening intervention, including the average benefit of a single screen, as well as the life-saving proportion among patients with earlier cancer detection. Results: Because the screen-free absolute death risk is approximately 1% overall but rises with age, the relative risk reduction from repeated screening mammography is about 100 times the absolute risk reduction between the starting ages of 50 and 60. Assuming a base case 20% relative risk reduction, repeated screening starting at age 50 saves about 1.8 (overall range, 0.9–2.7) lives over 15 years for every 1000 women screened. The number needed to screen repeatedly is 1000/ 1.8, or 570. The survival percentage is 99.12% without and 99.29% with screening. The average benefit of a single screening mammogram is 0.034%, or 2970 women must be screened once to save one life. Mammography saves 4.3% of screen-detectable cancer patients\u27 lives starting at age 50. This means 23 cancers must be found starting at age 50, or 27 cancers at age 40 and 21 cancers at age 65, to save one life. Conclusion: The life-saving absolute benefit of screening mammography increases with age as the absolute death risk increases. The number of events needed to save one life varies depending on the prospective screening subset or reference class. Less than 5% of women with screen-detectable cancers have their lives saved

M2 growth in 1995: a return to normalcy?

A discussion of M2's demise as a reliable indicator of financial conditions in the economy, and a look at recent evidence suggesting that even though the aggregate has been behaving more normally over the past year or so, it is unlikely to regain its status as a key policy guide any time soon.Economic indicators ; Money supply

How does age affect baseline screening mammography performance measures? A decision model

Background: In order to promote consumer-oriented informed medical decision-making regarding screening mammography, we created a decision model to predict the age dependence of the cancer detection rate, the recall rate and the secondary performance measures (positive predictive values, total intervention rate, and positive biopsy fraction) for a baseline mammogram. Methods: We constructed a decision tree to model the possible outcomes of a baseline screening mammogram in women ages 35 to 65. We compared the single baseline screening mammogram decision with the no screening alternative. We used the Surveillance Epidemiology and End Results national cancer database as the primary input to estimate cancer prevalence. For other probabilities, the model used population-based estimates for screening mammography accuracy and diagnostic mammography outcomes specific to baseline exams. We varied radiologist performance for screening accuracy. Results: The cancer detection rate increases from 1.9/1000 at age 40 to 7.2/1000 at age 50 to 15.1/ 1000 at age 60. The recall rate remains relatively stable at 142–157/1000, which varies from 73– 236/1000 at age 50 depending on radiologist performance. The positive predictive value of a screening mammogram increases from 1.3% at age 40 to 9.8% at age 60, while the positive predictive value of a diagnostic mammogram varies from 2.9% at age 40 to 19.2% at age 60. The model predicts the total intervention rate = 0.013*AGE2 - 0.67*AGE + 40, or 34/1000 at age 40 to 47/1000 at age 60. Therefore, the positive biopsy (intervention) fraction varies from 6% at age 40 to 32% at age 60. Conclusion: Breast cancer prevalence, the cancer detection rate, and all secondary screening mammography performance measures increase substantially with age

Genetic Diversity of Acacia Crassicarpa A. Cunn. Ex Benth.Plus Trees of a Provenance Trial in Serdang, Malaysia

In the selection of the best species for forest plantation, few criterias have to be considered including morphological and genetic diversity. Thus, the objective of this study was to investigate the diversity of Acacia crassicarpa plus trees using morphological and genetic markers. The genetic structure and mating system of the species were also studied. Plus trees were selected from a provenance trial in Universiti Putra Malaysia (UPM), Serdang based on 8 qualitative and 2 quantitative parameters from 2 regions i.e. Queensland (8 plus trees) and Papua New Guinea (23 plus trees). Leaf samples were collected from these trees and were analysed using 20 isozyme and 15 RAPD markers. The morphological study observed higher variation and better growth perfonnance of trees from Papua New Guinea. However, trees from Queensland have higher retention towards strong wind contradictory to trees from Papua New Guinea. The isozyme analysis observed 36 loci with 24 loci being polymorphic. The mean expected heterozygosities were 0.2316 and 0.2675 for Queensland and Papua New Guinea respectively. The proportions of polymorphic loci for both regions were found to be similar. In the RAPD analysis, a total of 8710ci were scored ranging from 0.10 kb to more than 2.10 kb. Generally, provenances from Papua New Guinea were found to produce higher polymorphism levels as compared to the Queensland provenances. Life history and the ecological characteristics of the species were believed to be the possible reasons for such conditions. Cluster analyses produced three different dendrogram patterns with a tendency of similarity to a certain. The effect of different approaches was suggested to have caused these differences. Relationships of clusters according to number of parent trees, altitudes and longitudes were also observed. The species was found to be highly outcrossing with rates ranging from 0.69 and 0.94. Genetic differentiation in the species observed 60 to 70% of the total diversity to be within provenances. Factors such as reproductive biology, seed dispersal, history and gene flow were suggested to be some of the possible causes for such phenomena

Influence of soil chemical properties on relative abundance of arbuscular mycorrhiza in forested soils in Malaysia

Th eeff ect of soil chemical properties on the diversity and colonization of arbuscular mycorrhiza (AM) varies among ecosystems. This study was conducted to assess and compare the abundance of AM in a rehabilitated forest and a logged-over forest soil using the most probable number and spore number methods. Glomus (71.7%-82.1%) and Acaulospora (17.4%-19.5%) were found to be abundant in both sites, while Gigaspora was found only in the loggedover forest. Th e abundance of AM in the rehabilitated forest based on the spore count was signifi cantly higher than in the logged-over forest by a 6-fold diff erence. Furthermore, root colonization in the rehabilitated forest was found to be almost 9-fold higher than in the logged-over forest. Such diff erences are linked to the soil chemical properties. The addition of organic matter during forest rehabilitation activity had created favorable conditions for AM sporulation. Soil P in both forests was positively related to the spore count (r > 0.68, P < 0.001) while the most probable number (MPN)was negatively infl uenced by soil K (r = –0.632, P <0.01). In conclusion, this study showed that soil chemical properties have a direct eff ect on the abundance of AM

Results of a study of the stability of cointegrating relations comprised of broad monetary aggregates

There is strong evidence of a stable “money demand” relationship for MZM and M2 through the 1990s. Though the M2 relationship breaks down somewhere around 1990, evidence has been accumulating that the disturbance is well characterized as a permanent upward shift in M2 velocity that began around 1990 and was largely over by 1994. This paper’s results support the hypothesis that households permanently reallocated a portion of their wealth from time deposits to mutual funds. This reallocation may have been induced by depository restructuring, but it could also be explained by appropriately measured opportunity cost.Demand for money

Resveratrol given intraperitoneally does not inhibit the growth of high-risk t(4;11) acute lymphoblastic leukemia cells in a NOD/SCID mouse model.

The efficacy of resveratrol as a preventive agent against the growth of t(4;11) acute lymphoblastic leukemia (ALL) was evaluated in NOD.CB17-Prkdcscid/J mice engrafted with the human t(4;11) ALL SEM cell line. SEM cells were injected into the tail vein and engraftment was monitored by flow cytometry. Once engraftment was observed, mice were injected intraperitoneally with resveratrol (10 mg/kg body weight) dissolved in dimethylsulfoxide (DMSO) or DMSO alone (control) every other day, or vincristine (0.5 mg/kg body weight) 3 times per week for 4 weeks (n=16 per group). Comparisons of the percent of human leukemia cells in blood and survival curves showed resveratrol did not inhibit progression of the disease. Liquid chromatography-tandem mass spectrometry analyses of mouse sera showed resveratrol was rapidly metabolized to glucuronidated and sulfated forms 1 h post-injection, with low to no resveratrol or metabolites observed in sera by 24-48 h. These data indicate that in contrast to findings in in vitro models, parenterally administered resveratrol does not have potential as a preventive agent against high risk t(4;11) ALL