Reduced breast cancer mortality in women under age 50: updated results from the Malm? Mammographic Screening Program

This article provides additional follow-up data of two cohorts from the Malm? Mammographic Screening Trial (MMST). The first cohort, MMST I, contained 7,984 women under age 50 at entry into MMST who were born between 1927 and 1932. Half were assigned to a control group and were not invited for examination until four years after the code was broken in the MMST in 1988. The second cohort, MMST II, contained 17,786 women born between 1933 and 1945. Fifty four percent of these women were randomly invited to screening between 1978 and 1990. The remaining 46%--the control group--was invited to screening between 1991 and 1994. Nine screening rounds were completed in MMST I, and a mean of five rounds were completed in MMST II; the screening interval ranged from 18 to 24 months. The effect of screening on breast cancer mortality was assessed by pooling the two cohorts. At the end of follow-up--December 1993 for MMST I and December 1995 for MMST II--there was a statistically significant 36% reduction in breast cancer mortality in the intervention groups (relative risk = 0.64; 95% CI: 0.45-0.89; P = 0.009). A harm-benefit analysis showed, however, that for every two breast cancer deaths prevented, one clinically insignificant cancer was diagnosed; for each breast cancer death prevented, 63 cancer-free women had been called back for further examinations; and for every 20 lives saved, one radiation-induced breast cancer death may have occurred. Recommendations for screening must therefore weigh mortality benefits against these negative effects.     

Cytokine production in mononuclear cells of human milk studied at the single-cell level

Twelve cerebello-pontine angles of the corpses of six adults were dissected with the aid of a surgical microscope. The following parameters were analyzed: the superior-inferior (vertical) and the anterior-posterior (horizontal) dimensions of the internal acoustic meatus (IAM); and the distances from the IAM to the Meckel's cave, the superior jugular foramen (SJF) and the inferior jugular foramen (IJF). We used a mathematical formula to calculate the area of the IAM. Important variations in the IAM's measurements were found, mainly concerning its area. This study contributes to a better understanding of cerebello-pontine angle (CPA) structures and their relationships with osseous parameters in Brazilian individuals.     

Polyhedral perturbations that preserve topological form

The idea, that we are willing to accept variation in an object but that we insist it should retain its original topological form, has powerful intuitive appeal, and the concept appears in many applied fields. Some of the most important of these are tolerancing and metrology, solid modeling, engineering design, finite element analysis, surface reconstruction, computer graphics, path planning in robotics, fairing procedures, image analysis, and medical imaging. In this paper we focus on the field of tolerancing and metrology. The requirement that two objects or sets should have the same topological form requires a precise definition. We specify “same topological form” to mean that there exists a “space homeomorphism” from R³ onto R³ that carries a nominal object S onto another design object. In general, establishing the existence of such space homeomorphisms can be considerably more difficult than demonstrating classical topological equivalence by a homeomorphism. In the special case when the boundary of S is a polyhedral two-sphere in R³, one of the authors has previously given a simple sufficient condition for the existence of a space homeomorphism mapping S onto another design object. This paper presents an analogous sufficient condition for the case when S is a finite polyhedron in R³. The result relies upon a triangulation of the boundary and upon a dependent parameter that specifies the maximum size of permissible perturbations of the vertices of the polyhedron.     

Point reconstruction from noisy images

In this paper we treat the problem of determining optimally (in the least-squares sense) the 3D coordinates of a point, given its noisy images formed by any number of cameras of known geometry. The optimality criterion is determined by the covariance matrices associated with the images of the point. The covariance matrices are not restricted to be positive definite but are allowed to be singular. Thus, image points constrained to lie along straight lines can be handled as well. Estimation of the covariance of the reconstructed point is provided.The often appearing two-camera stereo case is treated in detail. It is shown in this case that, under reasonable conditions, the main step of the reconstruction reduces to finding the unique zero of a sixth degree polynomial in the interval (0, 1).The authors are listed in random order.     

Packaging throughout the value chain in the customer perspective marketing mix

Lauterborn has suggested that McCarthy's 4 P marketing mix classification be viewed by suppliers as the customers' four Cs, i.e. customer value, cost to satisfy, convenience and communication (the 4C perspective). 1 This paper seeks to illustrate the impacts of the four Cs on packaging value in the area of fast‐moving consumer goods throughout the whole value chain from the packaging producer to the end‐user, the consumer. Findings from two separate studies regarding trade‐offs in package values between different actors in the value chain, created through development of value‐adding package solutions, are presented and elaborated on. The positive effects of brand advertising can be acknowledged, but they cannot compensate for less efficient packaging. The market need will easily be affected and turned into a higher demand chain pull when creating packaging solutions that will attract retail business. Dynamics in values and trade‐offs were identified, even though requirements from the whole value chain were considered. The packaging solutions created gave the majority of stakeholders in the value chain great advantages, but the lack of dynamism in available infrastructure demanded adaptation that diminished value addition for all actors in the value chain. The contribution of this article is to theorize the 4C concept in the process of package design, taking value chain actor needs and value optimisation into consideration. Furthermore, a suggestion of an evaluation model from the 4C perspective on all value chain actors is presented and elaborated on. Copyright­© 2002 John Wiley & Sons, Ltd.     

Patients with premenstrual syndrome have a different sensitivity to a neuroactive steroid during the menstrual cycle compared to control subjects

We have evaluated the functional sensitivity to a neuroactive steroid in 12 women with and 12 women without premenstrual syndrome (PMS) at two stages of the menstrual cycle, by comparing the effects of three increasing doses of intravenous pregnanolone (3alpha-hydroxy-5beta-pregnan-20-one) on saccadic eye velocity (SEV) and self-rated sedation. Control subjects in the follicular and luteal phase showed a significant reduction in SEV after pregnanolone injections compared to vehicle. In PMS patients, pregnanolone injections induced a significant dose-related decrease in SEV compared to vehicle only in the follicular phase, not in the luteal phase. After pregnanolone injections, sedation scores increased significantly from vehicle among control subjects in the luteal phase but not among PMS patients in either cycle phase. High-severity PMS patients responded with less decrease in SEV and less increase in sedation scores following pregnanolone injections compared to low-severity patients. Control subjects increased their SEV response to pregnanolone in the luteal phase compared to the follicular phase, whereas PMS patients did not. These findings are compatible with a decreased GABAA-receptor sensitivity in brain areas controlling saccadic eye movements among PMS patients in the late luteal phase.     

Increased cerebrospinal fluid ganglioside GD3 concentrations as a marker of microglial activation in HIV type 1 infection

Human immunodeficiency virus type 1 (HIV-1) invades the central nervous system (CNS) early in the infectious course. The predominant, productively infected cell type within the CNS is the microglial cell. We have analyzed the cerebrospinal fluid (CSF) levels of the ganglioside GD3, a microglia/macrophage and astrocyte marker, in 22 HIV-1-infected individuals at different stages of the disease, and in 44 age-matched HIV-negative, healthy controls. To distinguish between microglial/macrophage and astroglial involvement, the GD3 levels were compared with CSF levels of the glial fibrillary acidic protein (GFAp), which is expressed exclusively in astrocytes. A significantly higher mean CSF concentration of GD3 was found in HIV-1-infected patients compared to controls (56.7 and 40.1 nmol/L, respectively, p < 0.001). Seven of 22 HIV-1-infected patients had increased CSF levels of GD3 (above mean + 2 SD in controls), all but one of these had normal levels of GFAp, indicating a microglial activation or proliferation as the major source of the increased GD3 levels.