Meta-analysis of melanoma incidence in the United States: demographic variation and relationship with UV index and latitude

A link between exposure to ultraviolet (UV) radiation and melanoma skin cancer formation has generally been accepted in the scientific community, but precise quantification of such a link into a predictive equation is difficult to find in scientific literature. It was the aim of this study to determine if a quantifiable relationship exists between UV exposure and melanoma rates in the United States. Prior to the initiation of this study, it was hypothesized that existing predictive equations using accumulated UV index and latitude for general skin cancer incidence (i.e., including both melanoma and non-melanoma skin cancers) in Chile would be effective in predicting melanoma incidence rates in the United States. It was also hypothesized that melanoma rates for specific locations in the United States are related to the latitudes and accumulated UV index values for those locations, respectively. After accumulated UV index values, latitudes, and melanoma incidence rates for locations across the United States were obtained, regression analyses were performed in Microsoft Excel 2010® between accumulated UV index, latitude, and melanoma incidence rates for all demographic groups combined as well as differing demographic groups. The Chilean skin cancer equations (Rivas equations) were found to have no predictive power for melanoma rates in the United States. The only demographic group which had a significant relationship with accumulated UV index and latitude was American Indian or Alaska Native. For the remaining ethnicities, the regression analyses failed to reject the null hypotheses. Due to a variety of confounding variables and the limitations of the available data, a quantifiable relationship between UV exposure and melanoma might be determined only by more complex methodology. Factors such as skin color variation within each listed ethnicity, differences in UV exposure patterns between individuals, and inconsistent reporting to cancer registries by dermatologists may preclude the formation of simple predictive equations for melanoma incidence. Future research which incorporates individuals\u27 behaviors (e.g., time spent in the sun) may have more success

Disraeli and Bentinck and Personal and Political Relationship in History and Memory

Benjamin Disraeli has long been the source of wonder and examination for the academic world. Indeed, is now perhaps the most discussed nineteenth-century politician. His political practices, ideas and writings have been extensively mined to come up with a coherent understanding of his life and career. He has for so long been understood in relation to the contemporary allegation that he was an adventurer, opportunist, and man of few political principles. A man apart from his parliamentary colleagues who distrusted and disliked him. A view largely cemented by the formidable professional histories of the 1960s. More recent works on Disraeli have explored his ideas on race, empire and his own Jewish identity. This work attempts to move away from those valuable contributions to once again explore Disraeli’s politics and political thought. It is all too easy to lose the bigger picture. It would have been quite impossible for a metropolitan, middle-class, Jewish novelist dandy and parvenu to climb to the top of British politics, where he stayed for over thirty years without both political principle and a extraordinary ability to collaborate. Therefore, this work attempts to re-establish Disraeli in his own contemporary context. An Englishman and a thorough-going Tory, who rather than being different or apart from his colleagues, was a first-rate political collaborator

Meta-analysis of melanoma incidence in the United States: demographic variation and relationship with UV index and latitude

A link between exposure to ultraviolet (UV) radiation and melanoma skin cancer formation has generally been accepted in the scientific community, but precise quantification of such a link into a predictive equation is difficult to find in scientific literature. It was the aim of this study to determine if a quantifiable relationship exists between UV exposure and melanoma rates in the United States. Prior to the initiation of this study, it was hypothesized that existing predictive equations using accumulated UV index and latitude for general skin cancer incidence (i.e., including both melanoma and non-melanoma skin cancers) in Chile would be effective in predicting melanoma incidence rates in the United States. It was also hypothesized that melanoma rates for specific locations in the United States are related to the latitudes and accumulated UV index values for those locations, respectively. After accumulated UV index values, latitudes, and melanoma incidence rates for locations across the United States were obtained, regression analyses were performed in Microsoft Excel 2010® between accumulated UV index, latitude, and melanoma incidence rates for all demographic groups combined as well as differing demographic groups. The Chilean skin cancer equations (Rivas equations) were found to have no predictive power for melanoma rates in the United States. The only demographic group which had a significant relationship with accumulated UV index and latitude was American Indian or Alaska Native. For the remaining ethnicities, the regression analyses failed to reject the null hypotheses. Due to a variety of confounding variables and the limitations of the available data, a quantifiable relationship between UV exposure and melanoma might be determined only by more complex methodology. Factors such as skin color variation within each listed ethnicity, differences in UV exposure patterns between individuals, and inconsistent reporting to cancer registries by dermatologists may preclude the formation of simple predictive equations for melanoma incidence. Future research which incorporates individuals’ behaviors (e.g., time spent in the sun) may have more success

Mucin structural interactions with an alginate oligomer mucolytic in cystic fibrosis sputum

Cystic fibrosis (CF) is an autosomal recessive, life-limiting condition characterized by progressive lung disease, which is a major cause of morbidity and mortality for these patients. The inhalation therapy, OligoG CF-5/20, is a low molecular weight (mean Mn 3200 g/mol) alginate oligomer, with a high guluronic acid content (>85%). The ability of OligoG CF-5/20 to enhance the activity of antimicrobial/antibiotic therapies, modify the rheological properties of CF sputum and interact with mucin, has previously been shown. To further characterize the physicochemical interactions of OligoG CF-5/20 with CF sputum, Fourier-transform infrared (FTIR) spectroscopy was used to analyze ex vivo sputum samples from adolescent CF patients (n = 13) following treatment with 0.2% OligoG CF-5/20. FTIR analysis confirmed the interaction of OligoG CF-5/20 with mucin glycans in CF sputum, which showed a shift in wavenumber from 1078 cm−1 to 1070 cm-1 and subsequent loss of the 1053 cm−1 peak in the OligoG CF-5/20 treated samples. OligoG CF-5/20 interaction with key terminal moieties in mucin were also evident, with a significant change in sulphation at wavenumber 1116 cm−1, suggesting a link with sulphated Lewis x antigen. There were also significant shifts at wavenumber 1637 cm-1 indicative of β-sheet conformational changes in the mucin peptide caused by action of OligoG. The alterations in charge of glycan and mucin structures support previous observations wherein OligoG CF-5/20 modifies the viscoelastic properties of CF sputum. These findings suggest a possible mechanism of action for the rheological changes observed with this novel therapy

Atomic Resonance and Scattering

Contains reports on eight research projects.National Science Foundation (Grant PHY79-09743)National Bureau of Standards (Grant NB-8-NAHA-3017)Joint Services Electronics Program (Contract DAAG29-80-C-0104)National Science Foundation (Grant PHY82-10486)U.S. Navy - Office of Naval Research (Contract N00014-79-C-0183)National Science Foundation (Grant CHE79-02967-A04)U.S. Air Force - Office of Scientific Research (Contract AFOSR-81-0067)Joint Services Electronics Program (Contract DAAG29-83-K-0003

Clinical and Genomic Risk to Guide the Use of Adjuvant Therapy for Breast Cancer

BACKGROUND The use of adjuvant chemotherapy in patients with breast cancer may be guided by clinicopathological factors and a score based on a 21-gene assay to determine the risk of recurrence. Whether the level of clinical risk of breast cancer recurrence adds prognostic information to the recurrence score is not known. METHODS We performed a prospective trial involving 9427 women with hormone-receptor–positive, human epidermal growth factor receptor 2–negative, axillary node–negative breast cancer, in whom an assay of 21 genes had been performed, and we classified the clinical risk of recurrence of breast cancer as low or high on the basis of the tumor size and histologic grade. The effect of clinical risk was evaluated by calculating hazard ratios for distant recurrence with the use of Cox proportional-hazards models. The initial endocrine therapy was tamoxifen alone in the majority of the premenopausal women who were 50 years of age or younger. RESULTS The level of clinical risk was prognostic of distant recurrence in women with an intermediate 21-gene recurrence score of 11 to 25 (on a scale of 0 to 100, with higher scores indicating a worse prognosis or a greater potential benefit from chemotherapy) who were randomly assigned to endocrine therapy (hazard ratio for the comparison of high vs. low clinical risk, 2.73; 95% confidence interval [CI], 1.93 to 3.87) or to chemotherapy plus endocrine (chemoendocrine) therapy (hazard ratio, 2.41; 95% CI, 1.66 to 3.48) and in women with a high recurrence score (a score of 26 to 100), all of whom were assigned to chemoendocrine therapy (hazard ratio, 3.17; 95% CI, 1.94 to 5.19). Among women who were 50 years of age or younger who had received endocrine therapy alone, the estimated (±SE) rate of distant recurrence at 9 years was less than 5% (≤1.8±0.9%) with a low recurrence score (a score of 0 to 10), irrespective of clinical risk, and 4.7±1.0% with an intermediate recurrence score and low clinical risk. In this age group, the estimated distant recurrence at 9 years exceeded 10% among women with a high clinical risk and an intermediate recurrence score who received endocrine therapy alone (12.3±2.4%) and among those with a high recurrence score who received chemoendocrine therapy (15.2±3.3%). CONCLUSIONS Clinical-risk stratification provided prognostic information that, when added to the 21-gene recurrence score, could be used to identify premenopausal women who could benefit from more effective therapy

Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer

BACKGROUND The recurrence score based on the 21-gene breast cancer assay predicts chemotherapy benefit if it is high and a low risk of recurrence in the absence of chemotherapy if it is low; however, there is uncertainty about the benefit of chemotherapy for most patients, who have a midrange score. METHODS We performed a prospective trial involving 10,273 women with hormone-receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative, axillary node–negative breast cancer. Of the 9719 eligible patients with follow-up information, 6711 (69%) had a midrange recurrence score of 11 to 25 and were randomly assigned to receive either chemoendocrine therapy or endocrine therapy alone. The trial was designed to show noninferiority of endocrine therapy alone for invasive disease–free survival (defined as freedom from invasive disease recurrence, second primary cancer, or death). RESULTS Endocrine therapy was noninferior to chemoendocrine therapy in the analysis of invasive disease–free survival (hazard ratio for invasive disease recurrence, second primary cancer, or death [endocrine vs. chemoendocrine therapy], 1.08; 95% confidence interval, 0.94 to 1.24; P=0.26). At 9 years, the two treatment groups had similar rates of invasive disease–free survival (83.3% in the endocrine-therapy group and 84.3% in the chemoendocrine-therapy group), freedom from disease recurrence at a distant site (94.5% and 95.0%) or at a distant or local–regional site (92.2% and 92.9%), and overall survival (93.9% and 93.8%). The chemotherapy benefit for invasive disease–free survival varied with the combination of recurrence score and age (P=0.004), with some benefit of chemotherapy found in women 50 years of age or younger with a recurrence score of 16 to 25. CONCLUSIONS Adjuvant endocrine therapy and chemoendocrine therapy had similar efficacy in women with hormone-receptor–positive, HER2-negative, axillary node–negative breast cancer who had a midrange 21-gene recurrence score, although some benefit of chemotherapy was found in some women 50 years of age or younger