20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment

Seasonal variations of the digestive tract of the Eurasian beaver castor fiber.

Forage availability for wild rodents varies with season. In turn, the composition of food can affect morphometric parameters of the digestive tract. This study was performed in Eurasian beavers (Castor fiber) whose population was close to extinction in most Eurasian countries, but has now increased. Due to the previous low number of studies, information about the effect of forage availability on the digestive tract morphology has previously been lacking. This study was performed using beavers captured from the natural environment during three seasons of different forage availability: winter, summer and autumn. It was found that the diet of the beaver varied during the year; in winter it was dominated by woody material consisting of willow shoots, whereas in summer the diet was primarily herbs, grass and leaves. Season also affected the mass of digested contents of the digestive tract. The digestive content increased in the caecum and colon in winter and autumn, when poor-quality food dominated the beaver's diet. The results indicated that the digestive tract parameters of beavers varied based on the composition of available forage

Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials

Background Neoadjuvant chemotherapy (NACT) for early breast cancer can make breast-conserving surgery more feasible and might be more likely to eradicate micrometastatic disease than might the same chemotherapy given after surgery. We investigated the long-term benefits and risks of NACT and the influence of tumour characteristics on outcome with a collaborative meta-analysis of individual patient data from relevant randomised trials. Methods We obtained information about prerandomisation tumour characteristics, clinical tumour response, surgery, recurrence, and mortality for 4756 women in ten randomised trials in early breast cancer that began before 2005 and compared NACT with the same chemotherapy given postoperatively. Primary outcomes were tumour response, extent of local therapy, local and distant recurrence, breast cancer death, and overall mortality. Analyses by intention-to-treat used standard regression (for response and frequency of breast-conserving therapy) and log-rank methods (for recurrence and mortality). Findings Patients entered the trials from 1983 to 2002 and median follow-up was 9 years (IQR 5–14), with the last follow-up in 2013. Most chemotherapy was anthracycline based (3838 [81%] of 4756 women). More than two thirds (1349 [69%] of 1947) of women allocated NACT had a complete or partial clinical response. Patients allocated NACT had an increased frequency of breast-conserving therapy (1504 [65%] of 2320 treated with NACT vs 1135 [49%] of 2318 treated with adjuvant chemotherapy). NACT was associated with more frequent local recurrence than was adjuvant chemotherapy: the 15 year local recurrence was 21·4% for NACT versus 15·9% for adjuvant chemotherapy (5·5% increase [95% CI 2·4–8·6]; rate ratio 1·37 [95% CI 1·17–1·61]; p=0·0001). No significant difference between NACT and adjuvant chemotherapy was noted for distant recurrence (15 year risk 38·2% for NACT vs 38·0% for adjuvant chemotherapy; rate ratio 1·02 [95% CI 0·92–1·14]; p=0·66), breast cancer mortality (34·4% vs 33·7%; 1·06 [0·95–1·18]; p=0·31), or death from any cause (40·9% vs 41·2%; 1·04 [0·94–1·15]; p=0·45). Interpretation Tumours downsized by NACT might have higher local recurrence after breast-conserving therapy than might tumours of the same dimensions in women who have not received NACT. Strategies to mitigate the increased local recurrence after breast-conserving therapy in tumours downsized by NACT should be considered—eg, careful tumour localisation, detailed pathological assessment, and appropriate radiotherapy

Supervision of technical status of air defence systems to secure dependability and safety of use

W artykule przedstawiono warunki efektywnego funkcjonowania procesu nadzorowania eksploatacji systemów przeciwlotniczych pod kątem niezawodności i bezpieczeństwa. Zaprezentowano warunki dla funkcjonowania Systemu z Dozorowania Eksploatacji, Systemu Planowania Eksploatacji oraz Systemu Nadzorowania Niezawodności i Bezpieczeństwa rakiet obrony przeciwlotniczej. Ponadto przedstawiono dotychczasowe doświadczenia i osiągnięcia w dziedzinie badań, diagnostyki, dozorowania i bezpiecznej eksploatacji, które należy brać pod uwagę przy modelowaniu systemu obrony powietrznej.This article focuses on conditions of effective supervision of air-defence system. Several aspects of operational supervision and secure inspection are presented. Moreover, the article provides an overview of achievements in the areas of research diagnostics inspection and secure operating of missiles over a span of forty years

Determination of Unit Pressure Force in Material Volume in the Course of Refractory Stamping Press Moulding

The paper presents results of assessment of the unit pressure force within the refractory material volume in the course press-moulding of stampings for refractory precast shapes. The force was evaluated with the use of physical simulation of deformation undergone by lead balls placed in the raw refractory mass subjected to pressing in a metal die. To determine the value of unit pressure force applied to the aggregate grains in the course of stamping press-moulding, physical model of deformation of a sphere induced by the uniaxial stress state was used

Determination of Unit Pressure Force in Material Volume in the Course of Refractory Stamping Press Moulding

The paper presents results of assessment of the unit pressure force within the refractory material volume in the course press-moulding of stampings for refractory precast shapes. The force was evaluated with the use of physical simulation of deformation undergone by lead balls placed in the raw refractory mass subjected to pressing in a metal die. To determine the value of unit pressure force applied to the aggregate grains in the course of stamping press-moulding, physical model of deformation of a sphere induced by the uniaxial stress state was used