The Road to Retirement: Bumpy or Smooth, Depends on Your Route

Defined Contribution (DC) plans are rapidly becoming the primary retirement investment vehicle for a majority of employees across the US and other markets around the globe. Asset allocation for DC plans has to strike a balance between growth and protection assets over the savings lifecycle while protecting the long-term purchasing power of the nest egg. Due to the long duration of retirement investing and various risks associated with it, implementing the right asset allocation has become critical and challenging for DC plans. The unique Risk Focused methodology presented in this paper aims to address the shortcomings of conventional Target Date Funds experienced during the 2008 financial crisis. The proposed approach addresses the cumulative impact of shortfall, sequence of returns, longevity, and market risks in determining asset allocation at different time horizons. This is accomplished by combining the term structure of risk, return, and covariance of asset classes with an explicit risk budget. The Risk Focused glide path potentially delivers comparable retirement wealth outcomes with enhanced downside protection, lower journey volatility, and attempts to facilitate a smoother journey on the road to retirement. Hence, the caption of the paper, Road to Retirement – Bumpy or Smooth, Depends on your Route

Electron microscopic and interferometric studies of diamond crystals

Early chapters review the structure and physical properties of diamond, the theories of crystal growth and dissolution and the methods for synthesizing diamond. Chapter 5 describes surface topographical studies on diamonds by previous workers and chapter 6 presents a survey of previous experiments on diamond e telling. Chapter 7 describes the techniques used and these include interferometry and electron microscopy. A single-stage replica technique developed during the present investigation for studying the surfaces of microcrystals only a few microns in size and a two-stage technique for crystals more than 100 microns in size are described in detail. The former was used for studying the surfaces of Du-Pont synthetic diamonds. De Beers synthetic diamonds are for the first time studied in detail. Electron microscopic studies reveal many new surface details. A notable change of orientation of etch pits on the cubic faces was discovered at about 600 to 650&deg;C. To investigate this phenomenon, an etching apparatus was designed which agitated the specimen during etching. Results indicate that the by-products of the etching reaction at sites of fast etching are responsible for the change in etch-pit orientation. The change in etch-pit orientation was observed also on the cube faces of cubo-octahedral diamonds and on polished (100) faces which indicated that the phenomenon is probably an intrinsic property of all cubic faces. Detailed studies on the etching of naturally smooth cubic faces are here being reported for the first time. Optical and electron optical studies indicate that the cube faces of these cubo-octahedral crystals probably arise from a dissolution mechanism. Electron-microscopic studies on the natural cubic diamonds suggest that 'quadrons' are growth features. In addition, octahedral faces of the Premier Mine micro-diamonds are studied in detail. They show various features in addition to the usual ones. A mechanism for their formation is suggested. <p

Should a Sentinel Node Biopsy Be Performed in Patients with High-Risk Breast Cancer?

A negative sentinel lymph node (SLN) biopsy spares many breast cancer patients the complications associated with lymph node irradiation or additional surgery. However, patients at high risk for nodal involvement based on clinical characteristics may remain at unacceptably high risk of axillary disease even after a negative SLN biopsy result. A Bayesian nomogram was designed to combine the probability of axillary disease prior to nodal biopsy with customized test characteristics for an SLN biopsy and provides the probability of axillary disease despite a negative SLN biopsy. Users may individualize the sensitivity of an SLN biopsy based on factors known to modify the sensitivity of the procedure. This tool may be useful in identifying patients who should have expanded upfront exploration of the axilla or comprehensive axillary irradiation

Extramammary Paget’s diseases in men from the Shanghai area: its association with PSA level increase*

Shi G, Ye D-W, Yao X, Zhang S, Dai B, Zhang H, Shen Y, Zhu Y, Zhu Y, Xiao W, Ma C. Extramammary Paget’s diseases in men from the Shanghai area: its association with PSA level increase. APMIS 2010; 118: 777–81

On the way to specifically targeting minimal residual disease?

The target of all adjuvant systemic therapies after surgery in breast cancer is the eradication of a minimal subclinical residual disease. Although it is well known that tumor cell dissemination takes place already at an early stage of the disease, little is known about the tumorbiological parameters of these residual cells. Selection of patients eligible for adjuvant endocrine therapies is based on the analysis of receptor expression in the primary tumor – although the analysis is directed against disseminated tumor cells, these cells may vary in receptor expression in comparison with the primary tumor

Insulin Like Growth Factor-1 (IGF-1) Causes Overproduction of IL-8, an Angiogenic Cytokine and Stimulates Neovascularization in Isoproterenol-Induced Myocardial Infarction in Rats

Angiogenesis factors are produced in response to hypoxic or ischemic insult at the site of pathology, which will cause neovascularization. Insulin like growth factor-1 (IGF-1) exerts potent proliferative, angiogenic and anti-apoptotic effects in target tissues. The present study was aimed to evaluate the effects of IGF-1 on circulating level of angiogenic cytokine interleukin-8 (IL-8), in experimentally-induced myocardial ischemia in rats. Male Sprague-Dawley rats were divided into control, IGF-1 treated (2 μg/kg/day subcutaneously, for 5 and 10 days), isoproterenol (ISO) treated (85 mg/kg, subcutaneously for two days) and ISO with IGF-1 treated (for 5 and 10 days). Heart weight, serum IGF-1, IL-8 and cardiac marker enzymes (CK-MB and LDH) were recorded after 5 and 10 days of treatment. Histopathological analyses of the myocardium were also done. There was a significant increase in serum cardiac markers with ISO treatment indicating myocardial infarction in rats. IGF-1 level increased significantly in ISO treated groups and the level of IGF-1 was significantly higher after 10 days of treatment. IL-8 level increased significantly after ISO treatment after 5 and 10 days and IGF-1 concurrent treatment to ISO rats had significantly increased IL-8 levels. Histopathologically, myocyte necrosis and nuclear pyknosis were reduced significantly in IGF-1 treated group and there were numerous areas of capillary sprouting suggestive of neovascularization in the myocardium. Thus, IGF-1 protects the ischemic myocardium with increased production of circulating angiogenic cytokine, IL-8 and increased angiogenesis

The impact of loco-regional recurrences on metastatic progression in early-stage breast cancer: a multistate model

To study whether the effects of prognostic factors associated with the occurrence of distant metastases (DM) at primary diagnosis change after the incidence of loco-regional recurrences (LRR) among women treated for invasive stage I or II breast cancer. The study population consisted of 3,601 women, enrolled in EORTC trials 10801, 10854, or 10902 treated for early-stage breast cancer. Data were analysed in a multivariate, multistate model by using multivariate Cox regression models, including a state-dependent covariate. The presence of a LRR in itself is a significant prognostic risk factor (HR: 3.64; 95%-CI: 2.02-6.5) for the occurrence of DM. Main prognostic risk factors for a DM are young age at diagnosis (</=40: HR: 1.79; 95%-CI: 1.28-2.51), larger tumour size (HR: 1.58; 95%-CI: 1.35-1.84) and node positivity (HR: 2.00; 95%-CI: 1.74-2.30). Adjuvant chemotherapy is protective for a DM (HR: 0.66; 95%-CI: 0.55-0.80). After the occurrence of a LRR the latter protective effect has disappeared (P = 0.009). The presence of LRR in itself is a significant risk factor for DM. For patients who are at risk of developing LRR, effective local control should be the main target of therapy

Oligometastases and Oligo-recurrence: The New Era of Cancer Therapy

Recurrence or metastasis of cancer has been considered to occur in the last stage of the patient's life. However, the new notions of oligometastases and oligo-recurrence have been proposed and the paradigm shift in the conceptualization of cancer metastasis or cancer recurrence. Oligometastases is the state in which the patient shows distant relapse in only a limited number of regions. Local therapy such as surgery, radiotherapy and radiofrequency ablation for the relapsed sites could thus improve patient's survival. On the other hand, oligo-recurrence is a notion similar to oligometastases. However, the conditions of oligo-recurrence has a primary site of the cancer controlled, meaning that all gross recurrent or metastatic sites could be treated using local therapy

The Impact of Local and Regional Recurrence on Distant Metastasis and Survival in Patients Treated with Breast Conservation Therapy

PURPOSE: We evaluated the effect of local recurrence (LR) and regional recurrence (RR) on distant metastasis and survival in patients treated with breast conservation therapy (BCT). METHODS: We analyzed 907 patients who were treated for invasive breast cancer between 1993 and 2006. With 53 months of follow-up, 28 patients (3.1%) developed LR in the breast and 12 patients (1.3%) developed RR before distant metastasis. LR and RR were separated into four patterns to determine the prognostic relevance of recurrence site and time to recurrence: LR within 3 years (early LR), LR after 3 years (late LR), RR within 3 years (early RR), and RR after 3 years (late RR). RESULTS: Early LR (hazard ratio [HR], 4.76; p=0.003) and early RR (HR, 18.16; p<0.001) were independent predictors of distant metastasis. In terms of overall survival, early LR (HR, 5.24; p=0.002), and early RR (HR, 18.80; p<0.001) were significantly related with poor survival. Patients with late LR/RR had a similar favorable prognosis compared with patients who never experienced LR/RR. CONCLUSION: The result suggests that time to LR/RR following BCT is a significant predictor developing a distant metastasis and surviving.ope