Injuries to pedal cyclists on New Zealand roads, 1988-2007

<p>Abstract</p> <p>Background</p> <p>The risk of injury is one of the major barriers to engaging in cycling. We investigated exposure-based rates and profiles of traffic injuries sustained by pedal cyclists that resulted in death or hospital inpatient treatment in New Zealand, one of the most car dependent countries.</p> <p>Methods</p> <p>Pedal cyclist traffic injuries were identified from the Mortality Collection and the National Minimum Dataset. Total time spent cycling was used as the measure of exposure and computed from National Household Travel Surveys. Analyses were undertaken for the periods 1988-91, 1996-99 and 2003-07 in relation to other major road users and by age, gender and body region affected. A modified Barell matrix was used to characterise the profiles of pedal cyclist injuries by body region affected and nature of injury.</p> <p>Results</p> <p>Cyclists had the second highest rate of traffic injuries compared to other major road user categories and the rate increased from 1996-99 to 2003-07. During 2003-07, 31 injuries occurred per million hours spent cycling. Non-collision crashes (40%) and collisions with a car, pick-up truck or van (26%) accounted for two thirds of the cycling injuries. Children and adolescents aged under 15 years were at the highest risk, particularly of non-collision crashes. The rate of traumatic brain injuries fell from 1988-91 to 1996-99; however, injuries to other body parts increased steadily. Traumatic brain injuries were most common in collision cases whereas upper extremity fractures were most common in other crashes.</p> <p>Conclusions</p> <p>The burden of fatal and hospitalised injuries among pedal cyclists is considerable and has been increasing over the last decade. This underscores the development of road safety and injury prevention programmes for cyclists alongside the cycling promotion strategies.</p

Computerized FDTD Method for Longitudinal Optical Phonon Energy on Semiconductor Hybrid Structure for High Power Devices Fabrication

The research problem in this study is the longitudinal optical phonon energy on metal/semiconductor interface for high performance semiconductor device. The research solution is to make the software model with finite difference time domain (FDTD) solution for transmission and reflection pulse between metal and semiconductor interface for carrier dynamics effects. The objective of this study is to find the quantum mechanics understanding on interface engineering for fabricating the high performance device for future semiconductor technology development. The analysis was carried out with the help of MATLAB. The quantum mechanical spatial field on metal-semiconductor stripe structure has been analyzed by FDTD techniques. This emission reveals a characteristic polar radiation distribution of electric dipoles and a wavelength independent of the structure size or the direction of emission; consequently, it is attributed to thermally generate electric dipoles resonating with the longitudinal optical phonon energy. Phonon energy occurs lattice vibration of material by the polarization of light, if the material has rigid structure reflect back the incident light. So, high reflective metal-semiconductor structure always use as photodectors devices in optical fiber communication. No lattice vibration material structure has no phonon effect, so this structure based devices can get high performance any other structure based devices. The transmission and reflection coefficient of metal-semiconductor GaN/Au layer structure compare with GaN/Ti and GaN/Pt structure. Parallel (P) and transverse (S) polarization of light incident on a metal-semiconductor nanolayer structure with IR wavelength. Efficient use of the layer by layer (LbL) method to fabricate nanofilms requires meeting certain conditions and limitations that were revealed in the course of research on model systems

Obesity and breast cancer outcomes in chemotherapy patients in New Zealand - a population-based cohort study

Background: Obesity has been reported as an adverse prognostic factor in breast cancer, but inconsistently, and under-treatment with chemotherapy may occur. We provide the first assessment of obesity and breast cancer outcomes in a population-based, multi-ethnic cohort of New Zealand patients treated with chemotherapy. Methods: All 3536 women diagnosed with invasive breast cancer in the Waikato region of New Zealand from 2000-2014 were registered and followed until last follow-up in specialist or primary care, death or Dec 2014; median follow-up 4.1 years. For the 1049 patients receiving chemotherapy, mortality from breast cancer, other causes, and all causes, and rates of loco-regional and of distant recurrence, were assessed by body mass index (BMI), recorded after diagnosis, adjusting for other clinico-pathological and demographic factors by Cox regression. Results: BMI was known for 98% (n=1049); 33% were overweight (BMI 25-29.9), 21% were obese (BMI 30-34.9), and 14% were very obese (BMI 35+). There were no significant associations between obesity and survival, after adjustment for demographic and clinical factors (hazard ratios, HR, for very obese compared to BMI 21-24, for breast cancer deaths 0.96 (0.56-1.67), and for all deaths 1.03 (0.63-1.67), respectively, and only small non-significant associations for loco-regional or metastatic recurrence rates (HR 1.17 and 1.33 respectively). Subgroup analyses by age, menopausal status, ethnicity, stage, post-surgical radiotherapy, mode of diagnosis, type of surgery, and receptor status, showed no associations. No associations were seen with BMI as a continuous variable. The results in all patients irrespective of treatment but with recorded BMI data (n=2296) showed similar results. Conclusions: In this population, obesity assessed post-diagnosis had no effect on survival or recurrence, based on 1049 patients with chemotherapy treatment with follow-up up to 14 years

Ethnic disparities in breast cancer survival in New Zealand: which factors contribute?

Background: New Zealand has major ethnic disparities in breast cancer survival with Maori (indigenous people) and Pacific women (immigrants or descended from immigrants from Pacific Islands) faring much worse than other ethnic groups. This paper identified underlying factors and assessed their relative contribution to this risk differential. Methods: This study involved all women who were diagnosed with primary invasive breast cancer in two health regions, covering about 40% of the national population, between January 2000 and June 2014. Maori and Pacific patients were compared with other ethnic groups in terms of demographics, mode of diagnosis, disease factors and treatment factors. Cox regression modelling was performed with stepwise adjustments, and hazards of excess mortality from breast cancer for Maori and Pacific patients were assessed. Results: Of the 13,657 patients who were included in this analysis, 1281 (9.4%) were Maori, and 897 (6.6%) were Pacific women. Compared to other ethnic groups, they were younger, more likely to reside in deprived neighbourhoods and to have co-morbidities, and less likely to be diagnosed through screening and with early stage cancer, to be treated in a private care facility, to receive timely cancer treatment, and to receive breast conserving surgery. They had a higher risk of excess mortality from breast cancer (age and year of diagnosis adjusted hazard ratio: 1.76; 95% CI: 1.51-2.04 for Maori and 1.97; 95% CI: 1.67-2.32 for Pacific women), of which 75% and 99% respectively were explained by baseline differences. The most important contributor was late stage at diagnosis. Other contributors included neighbourhood deprivation, mode of diagnosis, type of health care facility where primary cancer treatment was undertaken and type of loco-regional therapy. Conclusions: Late diagnosis, deprivation and differential access to and quality of cancer care services were the key contributors to ethnic disparities in breast cancer survival in New Zealand. Our findings underscore the need for a greater equity focus along the breast cancer care pathway, with an emphasis on improving access to early diagnosis for Maori and Pacific women

Temporal, seasonal and weather effects on cycle volume: an ecological study

<p>Abstract</p> <p>Background</p> <p>Cycling has the potential to provide health, environmental and economic benefits but the level of cycling is very low in New Zealand and many other countries. Adverse weather is often cited as a reason why people do not cycle. This study investigated temporal and seasonal variability in cycle volume and its association with weather in Auckland, New Zealand's largest city.</p> <p>Methods</p> <p>Two datasets were used: automated cycle count data collected on Tamaki Drive in Auckland by using ZELT Inductive Loop Eco-counters and weather data (gust speed, rain, temperature, sunshine duration) available online from the National Climate Database. Analyses were undertaken using data collected over one year (1 January to 31 December 2009). Normalised cycle volumes were used in correlation and regression analyses to accommodate differences by hour of the day and day of the week and holiday.</p> <p>Results</p> <p>In 2009, 220,043 bicycles were recorded at the site. There were significant differences in mean hourly cycle volumes by hour of the day, day type and month of the year (<it>p </it>< 0.0001). All weather variables significantly influenced hourly and daily cycle volumes (<it>p </it>< 0.0001). The cycle volume increased by 3.2% (hourly) and 2.6% (daily) for 1°C increase in temperature but decreased by 10.6% (hourly) and 1.5% (daily) for 1 mm increase in rainfall and by 1.4% (hourly) and 0.9% (daily) for 1 km/h increase in gust speed. The volume was 26.2% higher in an hour with sunshine compared with no sunshine, and increased by 2.5% for one hour increase in sunshine each day.</p> <p>Conclusions</p> <p>There are temporal and seasonal variations in cycle volume in Auckland and weather significantly influences hour-to-hour and day-to-day variations in cycle volume. Our findings will help inform future cycling promotion activities in Auckland.</p

Alcohol intake and endogenous sex hormones in women: Meta‐analysis of cohort studies and Mendelian randomization

Background: The mechanisms underlying alcohol‐induced breast carcinogenesis are not fully understood but may involve hormonal changes. Methods: Cross‐sectional associations were investigated between self‐reported alcohol intake and serum or plasma concentrations of estradiol, estrone, progesterone (in premenopausal women only), testosterone, androstenedione, dehydroepiandrosterone sulfate, and sex hormone binding globulin (SHBG) in 45 431 premenopausal and 173 476 postmenopausal women. Multivariable linear regression was performed separately for UK Biobank, European Prospective Investigation into Cancer and Nutrition, and Endogenous Hormones and Breast Cancer Collaborative Group, and meta‐analyzed the results. For testosterone and SHBG, we also conducted Mendelian randomization and colocalization using the ADH1B (alcohol dehydrogenase 1B) variant (rs1229984). Results: Alcohol intake was positively, though weakly, associated with all hormones (except progesterone in premenopausal women), with increments in concentrations per 10 g/day increment in alcohol intake ranging from 1.7% for luteal estradiol to 6.6% for postmenopausal dehydroepiandrosterone sulfate. There was an inverse association of alcohol with SHBG in postmenopausal women but a small positive association in premenopausal women. Two‐sample randomization identified positive associations of alcohol intake with total testosterone (difference per 10 g/day increment: 4.1%; 95% CI, 0.6–7.6) and free testosterone (7.8%; 4.1–11.5), and an inverse association with SHBG (–8.1%; –11.3% to –4.9%). Colocalization suggested a shared causal locus at ADH1B between alcohol intake and higher free testosterone and lower SHBG (posterior probability for H4, 0.81 and 0.97, respectively). Conclusions: Alcohol intake was associated with small increases in sex hormone concentrations, including bioavailable fractions, which may contribute to its effect on breast cancer risk

The association between body fatness and mortality among breast cancer survivors: results from a prospective cohort study

Evidence linking body fatness to breast cancer (BC) prognosis is limited. While it seems that excess adiposity is associated with poorer BC survival, there is uncertainty over whether weight changes reduce mortality. This study aimed to assess the association between body fatness and weight changes pre- and postdiagnosis and overall mortality and BC-specific mortality among BC survivors. Our study included 13,624 BC survivors from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with a mean follow-up of 8.6 years after diagnosis. Anthropometric data were obtained at recruitment for all cases and at a second assessment during follow-up for a subsample. We measured general obesity using the body mass index (BMI), whereas waist circumference and A Body Shape Index were used as measures of abdominal obesity. The annual weight change was calculated for cases with two weight assessments. The association with overall mortality and BC-specific mortality were based on a multivariable Cox and Fine and Gray models, respectively. We performed Mendelian randomization (MR) analysis to investigate the potential causal association. Five-unit higher BMI prediagnosis was associated with a 10% (95% confidence interval: 5–15%) increase in overall mortality and 7% (0–15%) increase in dying from BC. Women with abdominal obesity demonstrated a 23% (11–37%) increase in overall mortality, independent of the association of BMI. Results related to weight change postdiagnosis suggested a U-shaped relationship with BC-specific mortality, with higher risk associated with losing weight or gaining > 2% of the weight annually. MR analyses were consistent with the identified associations. Our results support the detrimental association of excess body fatness on the survival of women with BC. Substantial weight changes postdiagnosis may be associated with poorer survival