Use of tamoxifen and raloxifene for breast cancer chemoprevention in 2010

PURPOSE: Two selective estrogen receptor modulators (SERMs), tamoxifen and raloxifene, have been shown in randomized clinical trials to reduce the risk of developing primary invasive breast cancer (IBC) in high-risk women. In 1998, the U.S. Food and Drug Administration (FDA) used these studies as a basis for approving tamoxifen for primary breast chemoprevention in both premenopausal and postmenopausal women at high risk. In 2007, the FDA approved raloxifene for primary breast cancer chemoprevention for postmenopausal women. METHODS: Data from the year 2010 National Health Interview Survey (NHIS) were analyzed to estimate the prevalence of tamoxifen and raloxifene use for chemoprevention of primary breast cancers among U.S. women. RESULTS: Prevalence of use of chemopreventive agents for primary tumors was 20,598 (95% CI, 518–114,864) for U.S. women aged 35 to 79 for tamoxifen. Prevalence was 96,890 (95% CI, 41,277–192,391) for U.S. women aged 50 to79 for raloxifene. CONCLUSION: Use of tamoxifen and raloxifene for prevention of primary breast cancers continues to be low. In 2010, women reporting medication use for breast cancer chemoprevention were primarily using the more recently FDA-approved drug raloxifene. Multiple possible explanations for the low use exist, including lack of awareness and/or concern about side effects among primary care physicians and patients

Thermo-mechanical analysis of dental silicone polymers

Soft lining materials are used to replace the inner surface of a conventional complete denture, especially for weak elderly patients, with delicate health who cannot tolerate the hard acrylic denture base. Most of these patients have fragile supporting mucosa, excessive residual ridge resorption, particularly on the mandibular arch. The application of a soft liner to the mandibular denture allows absorbing impact forces during mastication and relieving oral mucosa. Actually, the silicone rubbers constitute the main family of commercialised soft lining materials. This study was conducted to understand the relationships between the mechanical properties and the physical structure of polysiloxanes. For this purpose, a series of polysiloxanes of various chemical compositions have been investigated. The evolution of their physical structure as a function of temperature has been followed by differential scanning calorimetry (DSC). In order to facilitate comparisons, the mechanical modulus has been analysed upon the same heating rate using dynamic mechanical analysis (DMA). Polysiloxanes actually commercialised as soft denture liners are three-dimensional networks: the flexibility of chains allows a crystalline organisation in an amorphous phase leading to the low value of the shear modulus. The dynamic mechanical analysis shows that they are used in the rubbery state. So, polysiloxanes have steady mechanical properties during physiological utilisation

The White Dwarf Luminosity Functions from the Pan-STARRS 1 3π Steradian Survey

A large sample of white dwarfs is selected by both proper motion and colours from the Pan-STARRS 1 3{\pi} Steradian Survey Processing Version 2 to construct the White Dwarf Luminosity Functions of the discs and halo in the solar neighbourhood. Four-parameter astrometric solutions were recomputed from the epoch data. The generalised maximum volume method is then used to calculate the density of the populations. After removal of crowded areas near the Galactic plane and centre, the final sky area used by this work is 7.833 sr, which is 83% of the 3{\pi} sky and 62% of the whole sky. By dividing the sky using Voronoi tessellation, photometric and astrometric uncertainties are recomputed at each step of the integration to improve the accuracy of the maximum volume. Interstellar reddening is considered throughout the work. We find a disc-to-halo white dwarf ratio of about 100

D-cycloserine-augmented one-session treatment of specific phobias in children and adolescents.

BACKGROUND: D-Cycloserine has potential to enhance exposure therapy outcomes. The current study presents a preliminary randomized, placebo-controlled double-blind pilot trial of DCS-augmented one-session treatment (OST) for youth (7-14 years) with specific phobia. A secondary aim of this pilot study was to explore the effects of youth age and within-session fear reduction as potential moderators of DCS outcomes in order to generate hypotheses for a larger trial. It was hypothesized that DCS would be associated with greater improvements than placebo, that children (7-10 years) would have greater benefits than adolescents (11-14 years), and that DCS effects would be stronger for participants with the greater within-session fear reduction during the OST. METHODS: Thirty-five children and adolescents were randomized to either OST combined with DCS (n = 17), or OST combined with placebo (PBO; n = 18) and assessed at 1 week, 1 month, and 3 month following treatment. RESULTS: There were no significant pre- to post-treatment or follow-up benefits of DCS relative to placebo. Secondary analyses of age indicated that relative to PBO, DCS was associated with greater improvements for children (but not adolescents) on measures of severity at 1-month follow-up. Children in the DCS condition also showed significantly greater improvement to 1 month on global functioning relative to other groups. Conversely, adolescents had significant post-treatment benefits in the PBO condition on symptom severity measures relative to DCS, and adolescents in the DCS condition had significantly poorer functioning at 3 months relative to all other groups. Finally, there was a trend for within-session fear reduction to be associated with moderating effects of DCS, whereby greater reduction in fear was associated with greater functioning at one-month follow-up for children who received DCS, relative to PBO. LIMITATIONS: The study sample was small and therefore conclusions are tentative and require replication. CONCLUSIONS: Age and within-session fear reduction may be important moderators of DCS-augmented one-session exposure therapy, which requires testing in a fully powered randomized controlled trial

Coracoid Abnormalities and Their Relationship with Glenohumeral Deformities in Children with Obstetric Brachial Plexus Injury

<p>Abstract</p> <p>Background</p> <p>Patients with incomplete recovery from obstetric brachial plexus injury (OBPI) usually develop secondary muscle imbalances and bone deformities at the shoulder joint. Considerable efforts have been made to characterize and correct the glenohumeral deformities, and relatively less emphasis has been placed on the more subtle ones, such as those of the coracoid process. The purpose of this retrospective study is to determine the relationship between coracoid abnormalities and glenohumeral deformities in OBPI patients. We hypothesize that coracoscapular angles and distances, as well as coracohumeral distances, diminish with increasing glenohumeral deformity, whereas coracoid overlap will increase.</p> <p>Methods</p> <p>39 patients (age range: 2-13 years, average: 4.7 years), with deformities secondary to OBPI were included in this study. Parameters for quantifying coracoid abnormalities (coracoscapular angle, coracoid overlap, coracohumeral distance, and coracoscapular distance) and shoulder deformities (posterior subluxation and glenoid retroversion) were measured on CT images from these patients before any surgical intervention. Paired Student t-tests and Pearson correlations were used to analyze different parameters.</p> <p>Results</p> <p>Significant differences between affected and contralateral shoulders were found for all coracoid and shoulder deformity parameters. Percent of humeral head anterior to scapular line (PHHA), glenoid version, coracoscapular angles, and coracoscapular and coracohumeral distances were significantly lower for affected shoulders compared to contralateral ones. Coracoid overlap was significantly higher for affected sides compared to contralateral sides. Significant and positive correlations were found between coracoscapular distances and glenohumeral parameters (PHHA and version), as well as between coracoscapular angles and glenohumeral parameters, for affected shoulders. Moderate and positive correlations existed between coracoid overlap and glenohumeral parameters for affected shoulders. On the contrary, all correlations between the coracoid and glenohumeral parameters for contralateral shoulders were only moderate or relatively low.</p> <p>Conclusions</p> <p>These results indicate that the spatial orientation of the coracoid process differs significantly between affected and contralateral shoulders, and it is highly correlated with the glenohumeral deformity. With the progression of glenohumeral deformity, the coracoid process protrudes more caudally and follows the subluxation of the humeral head which may interfere with the success of repositioning the posteriorly subluxed humeral head anteriorly to articulate with the glenoid properly.</p

Arm rotated medially with supination – the ARMS variant: description of its surgical correction

<p>Abstract</p> <p>Background</p> <p>Patients who have suffered obstetric brachial plexus injury (OBPI) have a high incidence of musculoskeletal complications stemming from the initial nerve injury. The presence of muscle imbalances and contractures leads to typical bony changes affecting the shoulder, including the SHEAR (Scapular Hypoplasia, Elevation and Rotation) deformity. The SHEAR deformity commonly occurs in conjunction with Medial Rotation Contracture (MRC) of the arm. OBPI also causes muscle imbalances at the level of the forearm, that lead to a fixed supination deformity (SD) in a small number of patients. Both MRC and SD will cause severe functional limitations without surgical intervention.</p> <p>Methods</p> <p>Fourteen OBPI patients were diagnosed with MRC of the shoulder and SD of the forearm along with SHEAR deformity during a 16 month study period, with eight patients available to long-term follow-up (age range 2.2 – 18 years). Surgical correction of the MRC was performed as a triangle tilt or humeral osteotomy depending on the age of the child, after which, the patients were treated with a radial osteotomy to correct the fixed supination deformity. Function was assessed using the modified Mallet scale, examination of apparent supination and appearance of the extremity at rest.</p> <p>Results</p> <p>Significant functional improvements were observed in patients with surgical reconstruction. Mallet score increased by an average of 5.2 (p < 0.05). Overall forearm position was not significantly changed from an average of 5° to an average of 34° maximum apparent supination after both shoulder rotation and forearm rotation corrective surgeries.</p> <p>Conclusion</p> <p>The simultaneous presence of two opposing deformities in the same limb will visually offset each other at the level of the wrist and hand, giving the false impression of neutral positioning of the limb. In reality, the neutral-appearing position of the hand indicates a fixed supination posture of the forearm in the face of a medial rotation contracture of the shoulder. Both of these deformities require surgical attention, and the presence of concurrent MRC and SD should be monitored for in OBPI patients.</p

Growing evidence that SNe Iax are not a one-parameter family The case of PS1-12bwh

In this study, we present observations of a type Iax supernova, PS1-12bwh, discovered during the Pan-STARRS1 3 pi-survey. Our analysis was driven by previously unseen pre-maximum, spectroscopic heterogeneity. While the light curve and post-maximum spectra of PS1-12bwh are virtually identical to those of the well-studied type Iax supernova, SN 2005hk, the -2 day spectrum of PS1-12bwh does not resemble SN 2005hk at a comparable epoch; instead, we found it to match a spectrum of SN 2005hk taken over a week earlier (12 day). We are able to rule out the cause as being incorrect phasing, and argue that it is not consistent with orientation effects predicted by existing explosion simulations. To investigate the potential source of this difference, we performed radiative transfer modelling of both supernovae. We found that the pre-maximum spectrum of PS1-12bwh is well matched by a synthetic spectrum generated from a model with a lower density in the high velocity (greater than or similar to 6000 km s(-1)) ejecta than SN 2005hk. The observed differences between SN 2005hk and PS1-12bwh may therefore be attributed primarily to differences in the high velocity ejecta alone, while comparable densities for the lower velocity ejecta would explain the nearly identical post-maximum spectra. These two supernovae further highlight the diversity within the SNe Iax class, as well as the challenges in spectroscopically identifying and phasing these objects, especially at early epochs

Observations of the GRB Afterglow ATLAS17aeu and Its Possible Association with GW170104

We report the discovery and multiwavelength data analysis of the peculiar optical transient, ATLAS17aeu. This transient was identified in the sky map of the LIGO gravitational wave event GW 170104 by our ATLAS and Pan-STARRS coverage. ATLAS17aeu was discovered 23.1 hr after GW 170104 and rapidly faded over the next three nights, with a spectrum revealing a blue featureless continuum. The transient was also detected as a fading X-ray source by Swift and in the radio at 6 and 15 GHz. The gamma-ray burst GRB 170105A was detected by three satellites 19.04 hr after GW 170104 and 4.10 hr before our first optical detection. We analyze the multiwavelength fluxes in the context of the known GRB population and discuss the observed sky rates of GRBs and their afterglows. We find it statistically likely that ATLAS17aeu is an afterglow associated with GRB 170105A, with a chance coincidence ruled out at the 99% confidence or 2.6 sigma. A long, soft GRB within a redshift range of 1 less than or similar to z less than or similar to 2.9 would be consistent with all the observed multiwavelength data. The Poisson probability of a chance occurrence of GW 170104 and ATLAS17aeu is p = 0.04. This is the probability of a chance coincidence in 2D sky location and in time. These observations indicate that ATLAS17aeu is plausibly a normal GRB afterglow at significantly higher redshift than the distance constraint for GW 170104 and therefore a chance coincidence. However, if a redshift of the faint host were to place it within the GW 170104 distance range, then physical association with GW 170104 should be considered

A Comparative Study on Three Analytical Methods for the Determination of the Neurotoxin BMAA in Cyanobacteria

The cyanobacterial neurotoxin β-N-methylamino-L-alanine (BMAA) has been considered a serious health threat because of its putative role in multiple neurodegenerative diseases. First reports on BMAA concentrations in cyanobacteria were alarming: nearly all cyanobacteria were assumed to contain high BMAA concentrations, implying ubiquitous exposure. Recent studies however question this presence of high BMAA concentrations in cyanobacteria. To assess the real risk of BMAA to human health, this discrepancy must be resolved. We therefore tested whether the differences found could be caused by the analytical methods used in different studies. Eight cyanobacterial samples and two control samples were analyzed by three commonly used methods: HPLC-FLD analysis and LC-MS/MS analysis of both derivatized and underivatized samples. In line with published results, HPLC-FLD detected relatively high BMAA concentrations in some cyanobacterial samples, while both LC-MS/MS methods only detected BMAA in the positive control (cycad seed sarcotesta). Because we could eliminate the use of different samples and treatments as causal factors, we demonstrate that the observed differences were caused by the analytical methods. We conclude that HPLC-FLD overestimated BMAA concentrations in some cyanobacterial samples due to its low selectivity and propose that BMAA might be present in (some) cyanobacteria, but in the low µg/g or ng/g range instead of the high µg/g range as sometimes reported before. We therefore recommend to use only selective and sensitive analytical methods like LC-MS/MS for BMAA analysis. Although possibly present in low concentrations in cyanobacteria, BMAA can still form a health risk. Recent evidence on BMAA accumulation in aquatic food chains suggests human exposure through consumption of fish and shellfish which expectedly exceeds exposure through cyanobacteria