Digoxin treatment is associated with an increased incidence of breast cancer: a population-based case-control study

INTRODUCTION. Laboratory and epidemiologic studies have suggested a modifying effect of cardiac glycosides (for example, digoxin and digitoxin) on cancer risk. We explored the association between digoxin treatment and invasive breast cancer incidence among postmenopausal Danish women. METHODS. We used Danish registries to identify 5,565 postmenopausal women diagnosed with incident invasive breast carcinoma between 1 January 1991 and 31 December 2007, and 55,650 matched population controls. Cardiac glycoside prescriptions were ascertained from county prescription registries. All subjects had at least 2 years of recorded prescription drug and medical history data. We estimated the odds ratio associating digoxin use with breast cancer in conditional logistic regression models adjusted for age, county of residence, and use of anticoagulants, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, and hormone replacement therapy. We also explored the impact of confounding by indication and detection bias. RESULTS. Digoxin was the sole cardiac glycoside prescribed to subjects during the study period. There were 324 breast cancer cases (5.8%) and 2,546 controls (4.6%) with a history of digoxin use at least 1 year before their index date (adjusted odds ratio (OR): 1.30; 95% confidence interval: 1.14 to 1.48). The breast cancer OR increased modestly with increasing duration of digoxin exposure (adjusted OR for 7 to 18 years of digoxin use: 1.39; 95% confidence interval: 1.10 to 1.74). The association was robust to adjustment for age, receipt of hormone replacement therapy, coprescribed drugs, and confounding by indication. A comparison of screening mammography rates between cases and controls showed no evidence of detection bias. CONCLUSIONS. Our results suggest that digoxin treatment increases the risk of invasive breast cancer among postmenopausal women.Congressionaly Directed Medical Research Programs (BC073012); Karen Elise Jensen Foundation; Western Danish Research Forum for Health Science

Hot dense capsule implosion cores produced by z-pinch dynamic hohlraum radiation

Hot dense capsule implosions driven by z-pinch x-rays have been measured for the first time. A ~220 eV dynamic hohlraum imploded 1.7-2.1 mm diameter gas-filled CH capsules which absorbed up to ~20 kJ of x-rays. Argon tracer atom spectra were used to measure the Te~ 1keV electron temperature and the ne ~ 1-4 x10^23 cm-3 electron density. Spectra from multiple directions provide core symmetry estimates. Computer simulations agree well with the peak compression values of Te, ne, and symmetry, indicating reasonable understanding of the hohlraum and implosion physics.Comment: submitted to Phys. Rev. Let

The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of Patients

<p>Abstract</p> <p>Background</p> <p>The Charlson comorbidity index is often used to control for confounding in research based on medical databases. There are few studies of the accuracy of the codes obtained from these databases.</p> <p>We examined the positive predictive value (PPV) of the ICD-10 diagnostic coding in the Danish National Registry of Patients (NRP) for the 19 Charlson conditions.</p> <p>Methods</p> <p>Among all hospitalizations in Northern Denmark between 1 January 1998 and 31 December 2007 with a first-listed diagnosis of a Charlson condition in the NRP, we selected 50 hospital contacts for each condition. We reviewed discharge summaries and medical records to verify the NRP diagnoses, and computed the PPV as the proportion of confirmed diagnoses.</p> <p>Results</p> <p>A total of 950 records were reviewed. The overall PPV for the 19 Charlson conditions was 98.0% (95% CI; 96.9, 98.8). The PPVs ranged from 82.0% (95% CI; 68.6%, 91.4%) for diabetes with diabetic complications to 100% (one-sided 97.5% CI; 92.9%, 100%) for congestive heart failure, peripheral vascular disease, chronic pulmonary disease, mild and severe liver disease, hemiplegia, renal disease, leukaemia, lymphoma, metastatic tumour, and AIDS.</p> <p>Conclusion</p> <p>The PPV of NRP coding of the Charlson conditions was consistently high.</p

Exploring the role of professional associations in collective learning in London and New York's advertising and law professional service firm clusters.

The value of regional economies for collective learning has been reported by numerous scholars. However often work has been criticised for lacking analytical clarity and failing to explore the architectures of collective learning and the role of the knowledge produced in making firms in a cluster economy successful. This paper engages with these problematics and investigates how collective learning is facilitated in the advertising and law professional service firm clusters in London and New York. It explores the role of professional associations and investigates how they mediate a collective learning process in each city. It argues that professional associations seed urban communities of practice that emerge outside of the formal activities of professional associations. In these communities individual with shared interests in advertising and law learn from one-another and are therefore able to adapt and evolve one-another approaches to common industry challenges. The paper suggests this is another form of the variation Marshall highlighted in relation to cluster-based collective learning. The paper also shows how the collective learning process is affected by the presence, absence and strength of an institutional thickness. It is therefore argued that a richer understanding of institutional affects is needed in relation to CL

Foundation and empire : a critique of Hardt and Negri

In this article, Thompson complements recent critiques of Hardt and Negri's Empire (see Finn Bowring in Capital and Class, no. 83) using the tools of labour process theory to critique the political economy of Empire, and to note its unfortunate similarities to conventional theories of the knowledge economy

Manageable creativity

This article notes a perception in mainstream management theory and practice that creativity has shifted from being disruptive or destructive to 'manageable'. This concept of manageable creativity in business is reflected in a similar rhetoric in cultural policy, especially towards the creative industries. The article argues that the idea of 'manageable creativity' can be traced back to a 'heroic' and a 'structural' model of creativity. It is argued that the 'heroic' model of creativity is being subsumed within a 'structural' model which emphasises the systems and infrastructure around individual creativity rather than focusing on raw talent and pure content. Yet this structured approach carries problems of its own, in particular a tendency to overlook the unpredictability of creative processes, people and products. Ironically, it may be that some confusion in our policies towards creativity is inevitable, reflecting the paradoxes and transitions which characterise the creative process

Transgender and Gender Diverse Clients’ Experiences in Therapy: Responses to Sociopolitical Events and Helpful and Unhelpful Experiences

We examined transgender and gender-diverse (TGD) people’s reports of their therapy experiences over the course of a year. We explored how participants’ therapists integrated discussions about current events, as well as their more general perspectives on helpful and unhelpful experiences. A total of 107 participants provided data on these questions at least once over 12 months of surveys (M age = 33.79; 70.1% White), reflecting on their current therapy experiences. Through thematic analysis of qualitative data, the following themes were constructed regarding discussing sociopolitical events: (a) facilitating coping via bearing witness to clients’ internal experiences and implementing other therapeutic interventions; (b) moving beyond the individual by integrating identity, systems, or contexts; (c) feeling disconnected and misunderstood. We grouped participants’ helpful experiences into the following themes: (1) availability, connection, and therapeutic approaches facilitate positive experiences; (2) the necessity of knowledge, education, and affirmation of TGD identities; (3) helpful therapy means seeing the world in which clients live. We grouped participants’ unhelpful experiences into the following themes: (1) logistical issues can interfere with therapy; (2) lack of depth and disconnection results in subpar therapy; (3) insufficient understandings of TGD identities results in potentially harmful practices. These findings deepen understandings of how to integrate discussions about current events into therapy and provide competent and affirming care to TGD clients

Earth incorporated: centralization and variegation in the global company network

Over the past 20 years, a widening gulf has appeared between the increasingly internationalized financing arrangements of the world’s leading corporations, and the persistence of nationally compartmentalized approaches to the study of corporate control. In lieu of direct empirical evidence on corporate control at the global level, the most widespread assumption is that the globalization of ownership has taken the form of an expansion of arms-length, market-based arrangements traditionally prevailing in the Anglo-American economies. Here, however, we challenge this assumption, both empirically and conceptually. Empirically, we show that three quarters of the world’s 205 largest firms by sales are linked to a single global company network of concentrated (5%) ownership ties. This network has a hierarchically centralized organization, with a dominant “global network core” of US fund managers ringed by a more geographically diverse “state capitalist periphery.” Conceptually, we argue that the this architecture can be broadly explained through a Polanyian “variegated capitalist” model of contradictory market institutionalization, with the formation of the global company network actually a counterintuitive product of global financial marketization. In order to understand this process of network formation, however, it is necessary to extend Polanyi’s model of a double movement mediated through political interventions in the market, to incorporate Veblenian processes of evolutionary institutional change mediated through the market

Events in the affective city: Affect, attention and alignment in two ordinary urban events

In a representational regime, planned urban events are used by urban planners to render urban projects visible and acceptable. As a corollary of the focus of urban studies on their representational dimension and in spite of a burgeoning literature on the notion of affective urbanism, the experiential character of events remains surprisingly unexplored. This paper argues that an ordinary regime of events is mobilised by city-makers to act on the embodied, affective experience of the city and on the ways urban dwellers know and act upon the city. By analysing planned urban events in their embodied, experiential dimension, we focus on the ways in which, through the design of ephemeral material dispositives, urbanists attempt to encourage citizens to incorporate ways of knowing and acting on space and on the modalities of knowing and acting that are at play. We stage an encounter between critical event studies and Ingoldian approaches to affect and attention, examining two urban events in a Swiss canton. We show how intense encounters with urban matter are staged in an attempt to modulate affects, guide attention, and produce alignment with a specific political project, asking urban dwellers either to embody a project still in the making or to cultivate expectations regarding an already-written future