Omitting radiotherapy in women >= 65 years with low-risk early breast cancer after breast-conserving surgery and adjuvant endocrine therapy is safe

Purpose: The aim of this study was to verify if radiotherapy (RT) safely can be omitted in older women treated for estrogen-receptor positive early breast cancer with breast-conserving surgery (BCS) and endocrine therapy (ET). Patients and Methods: Eligibility criteria were: consecutive patients with age >= 65 years, BCS + sentinel node biopsy, clear margins, unifocal T1N0M0 breast cancer tumor, Elston-Ellis histological grade 1 or 2 and estrogen receptor-positive tumor. After informed consent, adjuvant ET for 5 years was prescribed. Primary endpoint was ipsilateral breast tumor recurrence (IBTR). Secondary endpoints were contralateral breast cancer and overall survival. Results: Between 2006 and 2012, 603 women were included from 14 Swedish centers. Median age was 71.1 years (range 65-90). After a median follow-up of 68 months 16 IBTR (cumulative incidence at five-year follow-up; 1.2%, 95% CI, 0.6% to 2.5%), 6 regional recurrences (one combined with IBTR), 2 distant recurrences (both without IBTR or regional recurrence) and 13 contralateral breast cancers were observed. There were 48 deaths. One death (2.1%) was due to breast cancer and 13 (27.1%) were due to other cancers (2 endometrial cancers). Five-year overall survival was 93.0% (95% CI, 90.5% to 94.9%). Conclusion: BCS and ET without RT seem to be a safe treatment option in women >= 65 years with early breast cancer and favorable histopathology. The risk of IBTR is comparable to the risk of contralateral breast cancer. Moreover, concurrent morbidity dominates over breast cancer as leading cause of death in this cohort with low-risk breast tumors. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.Peer reviewe

The unwanted citizens : The ‘Legality’ of Jewish destruction in Croatia and Romania during World War II

This article examines the establishment of the legal framework that led to the destruction and elimination of Jewish communities in Croatia and Romania during World War II. It argues that both regimes, supported by domestic fascist ideologies, evolving antisemitism, and inspired by the Nazi regime, promulgated anti-Jewish legal norms to present and establish new political, ideological, and social values and categories to their citizens. This article employs the theoretical framework of norms developed by Paul Morrow, whereby norms are seen as practical prescriptions, permissions or prohibitions. We argue that these destructive norms served as guidelines for individuals within the fascist new worldview and new reality. As such, these norms received state authorisation and implementation, serving as the ‘legal’ basis for the institutional destruction of unwanted citizens. This gave local and state actors a ‘legal’ pretext for the persecution and murder of Jews, who were stripped of their rights, assets, properties and right to life. The article concludes that the two legal frameworks enacted the process by which Jewish communities in Croatia and Romania faced a devastation of unseen proportions, which testifies to the importance and impact of legal norms on individuals, be they victims, bystanders or perpetrators

Inhalable railroad particles at ground level and subterranean stations - Physical and chemical properties and relation to train traffic

The paper compares PM10 concentrations in railroad environments with EU air quality standards and characterizes particle concentrations and particle properties in relation to train traffic. The results show that PM10 concentrations in ground-level railroad environments do not exceed the EU directive 24-h limit value, while on the platforms of the two subterranean stations PM10 concentrations were far above the outdoor limit value. Diurnal and weekly patterns in PM10 concentration could be identified, co-varying with train traffic intensity. The particle mass size distribution peaked at around 2-6 um. The elemental composition of PM10 at the subterranean stations was dominated by Fe. (C) 2011 Elsevier Ltd. All rights reserved

Factors influencing PM10 emissions from road pavement wear

Accelerated pavement wear is one of the major environmental disadvantages of studded tyres in northern regions and results in increased levels of PM10. Measurements of PM10 in a road simulator hall have been used to study the influence of pavement properties, tyre type and vehicle speed on pavement wear. The test set-up included three different pavements (one granite and two quartzite with different aggregate sizes), three different tyre types (studded, non-studded, and summer tyres) and different speeds (30-70 km h(-1)). The results show that the granite pavement was more prone to PM10 production compared to the quartzite pavements. Studded winter tyres yield tens of times higher PM10 concentrations compared to non-studded winter tyres. Wear from summer tyres was negligible in comparison. It was also shown that wear is strongly dependent on speed; every 10 km h(-1) increase yielded an increase of the PM10 concentration of 680 mu g m(-3) in one of the simulator experiments. (C) 2008 Elsevier Ltd. All rights reserved

Wear particles generated from studded tires and pavement induces inflammatory reactions in mouse macrophage cells

Health risks associated with exposure to airborne particulate matter (PM) have been shown epidemiologically as well as experimentally, pointing to both respiratory and cardiovascular effects. These health risks are of increasing concern in society, and to protect public health, a clarification of the toxic properties of particles from different sources is of importance. Lately, wear particles generated from traffic have been recognized as a major contributing source to the overall particle load, especially in the Nordic countries where studded tires are used. The aim of this study was to further investigate and compare the ability to induce inflammatory mediators of different traffic-related wear particles collected from an urban street, a subway station, and studded tire-pavement wear. Inflammatory effects were measured as induction of nitric oxide (NO), IL-6, TNF-alpha, arachidonic acid (AA), and lipid peroxidation after exposure of the murine macrophage like cell line RAW 264.7. In addition, the redox potential of the particles was measured in a cell-free system. The results show that all particles tested induce IL-6, TNF-alpha, and NO, and those from the urban street were the most potent ones. In contrast, particles collected from a subway station were most potent to induce lipid peroxidation, AA release, and formation of ROS. Particles from studded tire-pavement wear, generated using a road simulator, were able to induce inflammatory cytokines, NO, lipid peroxidation, and ROS formation. Interestingly, particles generated from pavement containing granite as the main stone material were more potent than those generated from pavement containing quartzite as the main stone material

Local starburst galaxies and their descendants. Statistics from the Sloan Digital Sky Survey

Despite strong interest in the starburst phenomenon in extragalactic astronomy, the concept remains ill-defined. Here we use a strict definition of starburst to examine the statistical properties of starburst galaxies in the local universe. We also seek to establish links between starburst galaxies, post-starburst (hereafter postburst) galaxies, and active galaxies. Data were selected from the Sloan Digital Sky Survey DR7. We applied a novel method of treating dust attenuation and derive star formation rates, ages, and stellar masses assuming a two-component stellar population model. Dynamical masses are calculated from the width of the H-alpha line. These masses agree excellently with the photometric masses. The mass (gas+stars) range is approximately 10( exp 9) - 10(exp 11.5) solar mass. As a selection criterion for starburst galaxies, we use, the birthrate parameter, b = SFR/SFR, requiring that b is greater than 3. For postburst galaxies, we use, the equivalent width of Hdelta in absorption with the criterion EW (sub Hdelta_abs) is greater than 6 A. Results. We find that only 1% of star-forming galaxies are starburst galaxies. They contribute 3-6% to the stellar production and are therefore unimportant for the local star formation activity. The median starburst age is 70 Myr roughly independent of mass, indicating that star formation is mainly regulated by local feedback processes. The b-parameter strongly depends on burst age. Values close to b = 60 are found at ages approximately 10 Myr, while almost no starbursts are found at ages greater than 1 Gyr. The median baryonic burst mass fraction of sub-L galaxies is 5% and decreases slowly towards high masses. The median mass fraction of the recent burst in the postburst sample is 5-10%. A smaller fraction of the postburst galaxies, however, originates in non-bursting galaxies. The age-mass distribution of the postburst progenitors (with mass fractions is greater than 3%) is bimodal with a break at logM(solar mass ) 10.6, above which the ages are doubled. The starburst and postburst luminosity functions (LFs) follow each other closely until M(sub r ) (is) approximately -21, when active galactic nuclei (AGNs) begin to dominate. The postburst LF continues to follow the AGN LF, while starbursts become less significant. This suggests that the number of luminous starbursts is underestimated by about one dex at high luminosities, because of having large amounts of dust and/or being outshone by an AGN. It also indicates that the starburst phase preceded the AGN phase. Finally, we look at the conditions for global gas outflow caused by stellar feedback and find that massive starburst galaxies are susceptible to such outflows