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AbstractThere is great interest in developing an adequate partial factor format for the assessment of existing structures, and in particular bridges, that should be able to take various aspects into account linked to the fact that the structure already exists. As the structure is existing, additional information related to material parameters, loading conditions, local structural defects, etc. can be accounted for. In addition, the degree of conservatism needs to be well balanced to avoid unnecessary investment of resources in replacement or retrofitting. This contribution considers the experience gained in recent years in parallel with some ongoing standardisation work in relation to Eurocodes and the next edition of the fibModel Code for new and existing concrete structures. The current state of the art of partial factors for the assessment of existing structures is explored and the differences are assessed based on a comparison between (i) the use of recommended fixed partial factors as provided in many national and international codes, (ii) adjusted (flexible) partial factors derived for the individual case under consideration, and (ii) reliability-based verification. In order to assess the adequacy of proposals and identify some differences, the available partial factor formats are applied to two case studies of reinforced concrete bridges and they are critically assessed.

Abstract:University students who are placed on academic warning are often required to enroll in a course or program to support their return to good academic standing. This case study investigated the major issues that contributed to first-year students’ academic struggles and how their participation in the Learning Contract course, guided by Appreciative Advising, addressed their needs and supported their development. Implications for advising practice are discussed.

This study examined the effects of sacubitril/valsartan on N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels and determined patient characteristics associated with favorable NT-proBNP reduction response.

ABSTRACTSouth Africa’s bridge design code, TMH7, was first introduced in 1981. In deriving the code a fully probabilistic approach was not possible due to insufficient data at the time. Various studies have shown that the code underestimates measured values in hogging, sagging and shear. A new load model, based on seven years of Weigh in Motion (WIM) data, is developed in this contribution. The Weibull distribution offers the best solution to the statistical extrapolation of load effects. A return period of 975 years is used to obtain static characteristic values for the required internal forces. As a result, the most appropriate load model for South African traffic consists of either tridem or quad axle group with an extrapolated axle weight of 160 kN and an appropriate constant UDL loading as specified in this paper. It is shown that TMH7 NA loading produces significantly smaller values than the measured WIM data for all load effects. This serves as motivation to urgently revise TMH7 loading.

The article discusses the global internship program in Sandusky City Schools. It explores the apprenticeship program in a school district that provides an alternative path for non-college-going students into the workforce and gain work experience in various technical fields. It refers to the global internship programs that exposes high school seniors to careers of interest.

The article discusses the cost benefits of using 3-D sand printing techniques in the fabrication of molds and cores in metal casting processes. Details related to the costs involved in the tooling and fabrication process, creation of CAD design models, along with the companson of various sand casting processes are presented.

3D sand printing provides a means to fabricate molds and cores without the need to fabricate patterns and core boxes. It is desirable to understand when to use this evolving advanced technology versus conventional pattern making. This analysis evaluates this question by examining the cost of molds and cores as a function of part design complexity quantified by a complexity factor. Two case studies are presented where the complexity of the castings is systematically varied by changing the geometry and number of cores. Tooling costs and fabrication costs are estimated for both 3D sand printing and conventional pattern making. The breakeven points are identified, and it is shown that 3D sand printing is cost-effective for castings with complexity factor values greater than that of the breakeven points. For low volume production of these castings, 3D sand printing is shown to be cost-effective for low quantities (<45 parts) of castings with lower complexity. However, it can also be very cost-effective for casting with higher complexity even at quantities of 1000 units. Since breakeven point is sensitive to the cost of 3D sand printing, lowering the materials and operations costs can significantly improve the cost-effectiveness of 3D sand printing for varied production volume and part design complexity.

We demonstrate a method for self-compensation of scale factor changes of an interferometric fiber-optic current sensor caused by source wavelength shifts, e.g., due to changes in source temperature or drive current. An adequately tailored fiber-optic retarder in the optical circuit introduces wavelength-dependent mixing of the orthogonal polarization modes of the sensor. The resulting change in scale factor balances the variation of the Faraday effect with wavelength. The wavelength dependence of the sensor is suppressed by more than an order of magnitude to <0.2% over wavelength spans of at least 10 nm around 1305 nm. The retarder is designed as an athermal device for operation between −40°C and 80°C.

Continuous tempering molecular dynamics (CTMD) generalizes simulated tempering (ST) to a continuous temperature space. Opposed to ST the CTMD equations of motion are fully deterministic and feature a conserved quantity that can be used to validate the simulation. Three variants of CTMD are discussed and compared by means of a simple test system. The implementation features of the most stable and simplest variant CTMD-Uin the program package Iphigenieare described. Two applications – alanine dipeptide (Ac-Ala-NHMe) in explicit water and octa-alanine (Ac-(Ala)8-NHMe) simulated in a dielectric continuum – demonstrate the functionality of CTMD-U. Furthermore, they serve to evaluate its sampling efficiency. Here, CTMD-Uoutperforms ST by 35% and replica exchange even by 75%.

Abstract: Studies on survival between familial and sporadic cancers have been inconclusive and only recent data on a limited number of cancers are available on the concordance of survival between family members. In this review, we address these questions by evaluating the published and unpublished data from the nation-wide Swedish Family-Cancer Database and a total of 13 cancer sites were assessed. Using sporadic cancer as reference, HRs were close to 1.0 for most of the familial cancers in both the offspring and parental generations, which suggested that survival in patients with familial and sporadic cancers was equal, with an exception for ovarian cancer with a worse prognosis. Compared to offspring whose parents had a poor survival, those with a good parental survival had a decreased risk of death for most cancers and HR was significantly decreased for cancers in the breast, prostate, bladder, and kidney. For colorectal and nervous system cancers, favorable survival between the generations showed a borderline significance. These data are consistent in showing that both good and poor survival in certain cancers aggregate in families. Genetic factors are likely to contribute to the results. These observations call for intensified efforts to consider heritability in survival as one mechanism regulating prognosis in cancer patients.

Background:Family history has been reported to be associated with an increased risk of pancreatic cancer. However, its possible influence on pancreatic cancer survival has rarely been studied, probably because of the rareness of cases in the same family. Methods:We used the nationwide Swedish Family-Cancer Database to examine the survival differences between familial and sporadic pancreatic cancers. Hazard ratios (HRs) for cause-specific and overall survival in pancreatic cancer were examined. HRs show the probability of death in the study group compared to the reference group. Results:A total of 75 familial pancreatic cancers were noted. HRs were significantly higher among offspring with an affected parent compared to those without an affected parent; for cause-specific and overall survival, the HRs were 1.44 and 1.37, respectively. Reversing the analysis and deriving HRs for parents (offspring asprobands) showed that familial pancreatic cancer had a worse prognosis than sporadic cases (HR 1.37 for cause-specific and 1.28 for overall survival). The HRs were close to unity among spouses with concordant pancreatic cancer. Conclusion:The data show that survival in familial pancreatic cancer is worse than that in sporadic disease, which could be explained by genetic factors, if other confounding factors can be excluded.

AbstractBackground:Family history has been reported to be associated with an increased risk of pancreatic cancer. However, its possible influence on pancreatic cancer survival has rarely been studied, probably because of the rareness of cases in the same family. Methods:We used the nationwide Swedish Family-Cancer Database to examine the survival differences between familial and sporadic pancreatic cancers. Hazard ratios (HRs) for cause-specific and overall survival in pancreatic cancer were examined. HRs show the probability of death in the study group compared to the reference group. Results:A total of 75 familial pancreatic cancers were noted. HRs were significantly higher among offspring with an affected parent compared to those without an affected parent; for cause-specific and overall survival, the HRs were 1.44 and 1.37, respectively. Reversing the analysis and deriving HRs for parents (offspring as probands) showed that familial pancreatic cancer had a worse prognosis than sporadic cases (HR 1.37 for cause-specific and 1.28 for overall survival). The HRs were close to unity among spouses with concordant pancreatic cancer. Conclusion:The data show that survival in familial pancreatic cancer is worse than that in sporadic disease, which could be explained by genetic factors, if other confounding factors can be excluded.Copyright © 2008 S. Karger AG, Basel and IAP

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The article outlines the tensions between globalized markets and state regulative authority in the context of weakened regulative authority at the national level, liberalization of financial markets, and the convergence of forms of government as well as the divergence of capital development models. Specifically it addresses changes and variations in statehood models among southern nations and their dependency relations. The economic underpinnings of so-called failed states are examined, as well as forms of state economic and coercion monopolies.

ARLTS1 – a member of ADP-ribosylation factor family, is a newly described candidate tumour suppressor gene. Recent studies show that a nonsense polymorphism, G446A (Trp149Stop), in ARLTS1 gene is significantly more frequent in familial cancer cases than in sporadic cancer cases. This study presents analysis of the germ-line G446A polymorphism in the ARLTS1 gene among 1686 consecutively collected patients with breast cancer, prostate cancer, malignant melanoma, thyroid papillary cancer or laryngeal cancer in Poland. The G446A allele was present in 1.81% (9/497) breast cancer patients, 1.46% (5/343) prostate cancer patients, 1.76% (7/397) melanoma patients, 1.65% (3/182) thyroid papillary carcinoma patients and 2.68% (8/299) of laryngeal cancer patients. The frequency of this polymorphism in the control group was 1.45% (8/552). Differences in the frequency of the G446A polymorphism between case and control groups were not statistically significant. In addition, there was no significant difference in the number of Cancer Familial Aggregations (CFA) among breast, prostate, thyroid or laryngeal cancer cases harbouring the G446A polymorphism, when compared to the G446A negative cases. Interestingly out of the CFA melanoma cases, 4/6 (66.6%) were found to harbour the change compared to only 20.2% (69/341) sporadic melanoma cases. This difference was statistically significant (p= 0.02, OR = 7.8). The results of this study suggest that the G446A in ARLTS1 gene is probably not associated with an increased risk of sporadic breast cancer, prostate cancer, melanoma, thyroid papillary cancer or laryngeal cancer. Moreover, the G446A polymorphism is not significantly more frequent in CFA cases except for families in which the proband had melanoma. To confirm this result more cases of melanoma should be analysed.ARLTS1 – a member of ADP-ribosylation factor family, is a newly described candidate tumour suppressor gene. Recent studies show that a nonsense polymorphism, G446A (Trp149Stop), in ARLTS1 gene is significantly more frequent in familial cancer cases than in sporadic cancer cases. This study presents analysis of the germ-line G446A polymorphism in the ARLTS1 gene among 1686 consecutively collected patients with breast cancer, prostate cancer, malignant melanoma, thyroid papillary cancer or laryngeal cancer in Poland. The G446A allele was present in 1.81% (9/497) breast cancer patients, 1.46% (5/343) prostate cancer patients, 1.76% (7/397) melanoma patients, 1.65% (3/182) thyroid papillary carcinoma patients and 2.68% (8/299) of laryngeal cancer patients. The frequency of this polymorphism in the control group was 1.45% (8/552). Differences in the frequency of the G446A polymorphism between case and control groups were not statistically significant. In addition, there was no significant difference in the number of Cancer Familial Aggregations (CFA) among breast, prostate, thyroid or laryngeal cancer cases harbouring the G446A polymorphism, when compared to the G446A negative cases. Interestingly out of the CFA melanoma cases, 4/6 (66.6%) were found to harbour the change compared to only 20.2% (69/341) sporadic melanoma cases. This difference was statistically significant (p= 0.02, OR = 7.8). The results of this study suggest that the G446A in ARLTS1 gene is probably not associated with an increased risk of sporadic breast cancer, prostate cancer, melanoma, thyroid papillary cancer or laryngeal cancer. Moreover, the G446A polymorphism is not significantly more frequent in CFA cases except for families in which the proband had melanoma. To confirm this result more cases of melanoma should be analysed.

Abstract: By use of a load cell, a computer and a fast scanning device we have examined the cutting-forces on the tool in a milling machine. Several experiments have been elaborated with different rotation and feeding speeds. The aim is to study, in detail, how wood chips are produced. By a better understanding of this process it must be possible to manufacture wooden details for furniture and other products with minimal errors and, hence, there will be reduced need for sanding and other expensive extra treatment in order to achieve an acceptable result of the finished surface. The load cell was used to register the forces in three directions. These registrations, however, were not easy to interpret because of the vibrations which were introduced in the experimental setup when milling started. A computerized filter therefore had to be used in order to extract only those registrations which were of interest. We found that the cutting forces in beech varied from approximately 40 up to 86 N/cm in the work-piece feed direction, i.e. in the Y-direction, and from about 14 to 51 N/cm in the X-direction, i.e. in the normal to the cut surface. A larger average chip thickness resulted in larger forces but we could not find a clear relationship which, in full, explained our result.

The high intensities provided by short-pulse Ti:sapphire laser systems call for the utilization of appropriate eye-protecting materials. We summarize the representative results of our characterization measurements on optical filters employed for laser radiation protection. Physical effects are discussed that influence the transmission (and thus the protective properties) of the investigated materials. Potential hazard factors have been recognized and characterized. We make recommendations to the extension of the current characterization methods and illustrate the acquired information in the form of operation charts.

Abstract: The aim of the present study was to investigate whether current smoking, ex-smoking, or amount of current smoking among postmenopausal women was associated with plasma levels of testosterone, and rostenedione, and DHEAs. About 65,000 women in Sweden have participated in two population-based prospective cohort studies where blood samples were collected at baseline, and information on life-style, reproductive history and anthropometrical measurements were available. The present study was based on 407 control subjects from a previous nested case–control study on the relation between steroid hormone levels and risk of breast cancer. A multivariate logistic regression analysis, adjusted for potential confounders, was used in order to obtain odds ratios (OR) with 95 confidence intervals. There was a high risk of high testosterone levels (above the median) in current vs. never smokers, OR1.85 (1.06–3.23). Risk of high testosterone levels increased by amount of daily smoking (increments of 10 cigarettes/day), OR 1.55 (1.02–2.37). Ex-smoking was associated with high testosterone levels, OR: 1.56 (0.98–2.47). Current smoking and increasing amount of current smoking were weakly associated with high androstenedione levels. However, these associations did not reach statistical significance. No association was seen between smoking habits and DHEAs levels. We conclude that current smoking, and increasing amount of daily smoking, is associated with high testosterone levels.

Previous spirometric findings among subjects with chronic tetraplegia that reduction in FEV1and maximal forced expiratory flow, mid-expiratory phase (FEF25–75%) correlated with airway hyperresponsiveness to histamine, and that many of these subjects exhibited significant bronchodilator responsiveness, suggested that baseline airway caliber was low in this population. To better evaluate airway dynamics in patients with spinal cord injury, we used body plethysmography to determine specific airway conductance (sGaw), a less effort-dependent and more reflective surrogate marker of airway caliber.

Introduction.Obesity is associated with risk of breast cancer after menopause. Circulating levels of leptin are high in obesity and leptin stimulates growth of breast cancer cells. Material and methods.In a case-control study nested within the Northern Sweden Health and Disease Cohort, we measured leptin levels in prediagnostic plasma from 149 postmenopausal women who were diagnosed with breast cancer at a mean time 1.7 years (SD 2.0) after recruitment and among 258 control subjects. Results.No significant association between plasma levels of leptin and breast cancer risk was observed. Odds ratios (ORs) of breast cancer with increasing levels of leptin were 1.00 [referent], 1.01 [95% CI = 0.58–1.84], 0.65 [0.36–1.18], and 0.94 [0.53–1.67], and (pfor trend= 0.54). Adjustment for smoking, body mass index, and plasma insulin did not affect risk estimates. Discussion.These data do not support the hypothesis that plasma leptin is a risk factor for breast cancer.

OBJECTIVE: Excess weight has been associated with increased risk of cancer at several organ sites. In part, this effect may be modulated through alterations in the metabolism of sex steroids and IGF-I related peptides. The objectives of the study were to examine the association of body mass index (BMI) with circulating androgens (testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEAS)), estrogens (estrone and estradiol), sex hormone-binding globulin (SHBG), IGF-I and IGF-binding protein (IGFBP)-3, and the relationship between sex steroids, IGF-I and IGFBP-3. DESIGN AND METHODS: A cross-sectional analysis was performed using hormonal and questionnaire data of 620 healthy women (177 pre- and 443 post-menopausal). The laboratory measurements of the hormones of interest were available from two previous case-control studies on endogenous hormones and cancer risk. RESULTS: In the pre-menopausal group, BMI was not related to androgens and IGF-I. In the post-menopausal group, estrogens, testosterone and androstenedione increased with increasing BMI. The association with IGF-I was non-linear, with the highest mean concentrations observed in women with BMI between 24 and 25. In both pre- and post-menopausal subjects, IGFBP-3 did not vary across BMI categories and SHBG decreased with increasing BMI. As for the correlations between peptide and steroid hormones, in the post-menopausal group, IGF-I was positively related to androgens, inversely correlated with SHBG, and not correlated with estrogens. In the pre-menopausal group, similar but weaker correlations between IGF-I and androgens were observed. CONCLUSIONS: These observations offer evidence that obesity may influence the levels of endogenous sex-steroid and IGF-related hormones in the circulation, especially after menopause. Circulating IGF-I, androgens and SHBG appear to be related to each other in post-menopausal women.

Among the machinery found in wood manufacturing industries, routers and planers are the most commonly used. These tools, which many times are mounted on metal cylinders, actually operate only briefly, i. e., when a chip is cut from a piece of wood under process. The rest of the time the knife follows the cylinder surface and a cycloid is formed relative to the work piece, which in turn is fed into the machine. A number of knives are mounted on the cutter, which ascertain that the planed surface will become sufficiently planed and does not show too a wavy pattern. This works fine for high revolutions and low feeding speeds even if problems sometimes occur. Factories, however, naturally want to increase the overall manufacturing speed, which means that at the same time more defects are introduced at the planed surface. These defects are the result of the cutting process. In this paper, we examine, by use of a load cell, how the cutting forces vary during the formation of a wood chip. Wood is not an isotropic material and knots and other anomalies make the evaluation harder. In order to simplify the conditions, experiments are also shown from the cutting of a plastic polymer material as well as Medium Density Fibreboard (MDF). It is shown that the work piece vibrated intensely which littered all output data from the cell. Experience from the experiments however made it possible to design a computerised filter which saved only those registrations which were of interest while the others were set to zero. For beech, the forces were found to be of the magnitude 50 N/cm opposite to the feeding direction while the tranverse forces changed signs and had a magnitude of about 5 N/cm.

Some countries now allow celiac patients to include oats in their gluten-free diet. Studies have shown that commercially available oats can be contaminated with gluten. The aim of the study was to analyse oat products and products naturally free from gluten to determine the degree of contamination. A total of 88 oat products and 22 products based on maize, rice, millet or buckwheat were analysed, using a commercially available enzyme-linked immunosorbent assay (ELISA) with a monoclonal antibody to gliadin. The ELISA is quantitative with a detection limit of 20 mg/kg gluten. Some of the positive samples were also analysed for the presence of DNA from wheat, barley or rye. Thirteen percent of the oat products had gluten content over 200 mg/kg. Of the products naturally free from gluten 14% had a gluten content over 200 mg/kg. There was a tendency for higher levels of contamination with increased processing. The risk of gluten contamination in oat products as well as in non-gluten cereals must be considered. The level of contamination was in most cases low. The results regarding oats can be compared to those of such cereals as maize, rice, buckwheat and millet.

Objective: High levels of sex steroid hormones and prolactin have been suggested to enhance breast cancer development. Low levels of SHBG may indicate high levels of (bio-available) steroid hormones. The present study investigates whether high levels of sex steroid hormones and prolactin, and/or low levels of SHBG, are associated with high breast cancer risk. Methods: Blood samples were collected in about 65,000 women participating in two population-based prospective cohort studies in Sweden. Follow-up yielded 173 postmenopausal breast cancer cases who had not been exposed to HRT. Levels of estrone, estradiol, SHBG, FSH, prolactin, testosterone, androstenedione and DHEAs were analysed in cases and 438 controls. Logistic regression analysis yielded odds ratios (ORs), with 95% confidence intervals, adjusted for potential confounders. Results: The risk of breast cancer was associated with the highest versuslowest quartiles of estrone, OR: 2.58 (1.50–4.44), estradiol (dichotomised: high versuslow) (1.73: 1.04–2.88), and testosterone (1.87: 1.08–3.25). High risks, although not statistically significant, were seen for androstenedione (1.58: 0.92–2.72) and DHEAs (1.62: 0.89–2.72). No strong associations were seen between SHBG or prolactin and risk of breast cancer. Conclusions: High levels of estrone, estradiol, testosterone, and possibly androstenedione and DHEAs, in postmenopausal women are associated with a high risk of subsequent breast cancer.

Objective: To investigate the association of prediagnostic circulating levels of C-peptide, as a marker of pancreatic insulin secretion, and IGF binding proteins -1 and -2, as indicators of the biologically active IGF-I concentration, with risk of developing ovarian cancer. Methods: The study was nested within three prospective cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). Case subjects were 132 women with primary invasive epithelial ovarian cancer diagnosed at least one year after blood donation. For each case, two control subjects were selected, matching the case subject on cohort, menopausal status, age and date of recruitment (n = 263). Only women who did not use exogenous hormones at blood donation were included in the study. Results: Odds ratios and their 95% confidence intervals for risk of developing ovarian cancer over quartiles of peptides concentrations after adjustment for BMI and fasting were: 1.00, 0.66 (0.35–1.23), 0.96 (0.51–1.82) and 0.89 (0.44–1.81) for C-peptide; 1.00, 1.10 (0.58–2.09), 1.07 (0.55–2.04) and 0.79 (0.38–1.62) for IGFBP-1; and 1.00, 1.01 (0.54–1.89), 0.98 (0.51–1.88) and 0.87 (0.45–1.68) for IGFBP-2. In women who had ovarian cancer diagnosis before age 55 the ORs for the top tertiles of IGFBP-1 and IGFBP-2 were 0.51 (0.18–1.49) and 0.53 (0.18–1.54), respectively. Conclusions: This study does not support an independent direct etiological role of C-peptide in ovarian cancer pathogenesis, but suggests a possible protective effect of circulating IGFBP-1 and -2 in women who develop ovarian cancer before age 55.

Insulin-like growth factor (IGF)-I, a mitogenic and anti-apoptotic peptide, has been implicated in the development of several cancers. We hypothesized that high circulating IGF-I concentrations may be associated with an increased risk of ovarian cancer. A case–control study was nested within 3 prospective cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). One hundred thirty-two women with primary invasive epithelial ovarian cancer diagnosed at least 1 year after blood donation were case subjects. For each case, 2 control subjects were selected, matching the case subject on cohort, menopausal status, age and date of recruitment (n = 263). Only women who did not use exogenous hormones at blood donation were included in the study. There was no association between IGF-I concentrations and ovarian cancer risk in the study group as a whole. In analyses restricted to subjects who had developed ovarian cancer at a young age (&lt;55), circulating IGF-I was directly and strongly associated with ovarian cancer risk (OR = 4.97; 95% CI = 1.22–20.2 for the top vs. the bottom IGF-I tertile after adjustment for parity, BMI categories and smoking). There was no significant association of IGF binding protein-3 with ovarian cancer risk. We found a strong direct relationship between circulating IGF-I levels and risk of developing ovarian cancer before age 55. Additional, larger studies of this association are needed to provide more precise estimates of effect. © 2002 Wiley-Liss, Inc.

The genes encoding human leukocyte antigens (HLA) have shown to be associated with cervical neoplasia. To obtain reliable data on HLA associations with cervical tumors, the study should be performed within a strictly defined cohort. To investigate the population attributable risk of cervical cancer associated with the HLA class II haplotypes DR15 and DQ6 (DQA1*0102 and DQB1*0602), we performed a nested case-control study of 85 women who developed invasive cervical cancer and 120 healthy women from a population-based cohort of Swedish women. The relative risks of cervical cancer among DR15 and DQ6-positive women were 3.73 [confidence interval (CI): 1.8–7.4] and 4.33 (CI: 2.1–8.5), corresponding to population attributable proportions of 27.9% and 30.8%, respectively. A susceptibility locus in the HLA class II region is involved in a substantial fraction of the etiology of cervical cancer. © 2002 Wiley-Liss, Inc.

The incidence of ovarian cancer is up to 10 times higher in Western countries than in rural Asia and Africa. One common consequence of a Western lifestyle is the development of excessive body weight and obesity. A multi-centre prospective study was conducted to investigate the association between body mass index (BMI) and ovarian cancer risk. A case-control study was nested within 3 prospective cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). Information on anthropometry, demographic characteristics, medical history and lifestyle was obtained at the time of subjects' recruitment in each cohort. Women diagnosed with primary, invasive epithelial ovarian cancer from the 3 cohorts (n = 122) diagnosed 12 months or later after recruitment into the respective cohort served as case subjects. For each case subject, 2 control subjects that matched the case subject on cohort, menopausal status, age and date of recruitment were randomly identified. Data were analyzed by conditional logistic regression. There was an inverse association between BMI and ovarian cancer risk. For increasing quartiles of BMI above the lowest, the ORs were 0.62 (0.32–1.21), 0.59 (0.30–1.17) and 0.46 (0.23–0.92), p = 0.03. Analyses limited to women diagnosed 3 or more years after recruitment into the cohorts did not alter these findings. When obese women (BMI > 30) were compared to lean women (BMI ≤ 23), the inverse association became stronger, with an OR of 0.38 (0.17–0.85), p &lt; 0.02. There was some evidence of direct association of ovarian cancer with height, which was limited to cancers diagnosed before age 55. Our data suggest that increasing body weight may confer a protection against ovarian cancer. © 2002 Wiley-Liss, Inc.

Objective: To examine the possible relationships of breast cancer risk to prediagnostic plasma levels of insulin; insulin-like growth factor-I (IGF-I); and IGF-binding proteins -1, -2, and -3. Methods: Within two prospective cohorts in Umeå and Malmö we measured plasma concentrations of insulin, IGF-I, and IGFBPs for a total of 513 incident breast cancer cases and 987 matched controls. Results: Globally, risk was unassociated with levels of IGF-I, IGFBP-3, or IGF-I adjusted for IGFBP-3. When breaking down the analysis by subgroups of age at blood donation, an increase in risk was observed for increasing levels of IGF-I in women aged 55 or older, in the Umeå cohort only (odds ratios of 1.00, 1.73, 1.76, 1.90; ptrend= 0.05). This effect weakened, however, when the analysis was restricted to subjects who did not use exogenous hormones for the treatment of menopausal symptoms. Levels of IGF-I and IGFBP-3 were not related to risk in younger women, recruited before age 50, contrary to observations from previous studies. In a subcohort where blood samples had been collected after at least four hours of fasting, breast cancer risk showed no clear associations with levels of insulin, IGFBP-1, or IGFBP-2. Conclusions: Our results do not confirm earlier findings of an association of plasma IGF-I levels with breast cancer risk especially in young women, but suggest a possible association with postmenopausal breast cancer risk, possibly among ERT/HRT users only. Our results do not support the hypothesis that elevated plasma insulin levels, and reduced levels of IGFBP-1 and IGFBP-2, are associated with increased breast cancer risk.

Abstract: Hemoptysis is a frightening and potentially life-threatening symptom. However, most cases can be approached effectively with conservative management. Bronchial artery embolization should be attempted when bleeding is refractory to medical therapy, and surgery may be needed in severe hemorrhage.

AbstractObjective:The relationship of respiratory symptoms to pulmonary function parameters and smoking status was assessed in subjects with chronic (>1 year) spinal cord injury (SCI).Methods and Participants:As part of their annual physical examination, subjects were queried regarding respiratory symptoms and underwent pulmonary function studies. The 180 patients who successfully completed pulmonary function testing were evaluated, including 79 subjects with tetraplegia (56 nonsmokers and 23 smokers) and 101subjects with paraplegia (78 nonsmokers and 23 smokers).Findings:Logistic-regression analysis revealed the following independent predictors of breathlessness: level of injury (tetraplegia, paraplegia, odds ratio = 3.5, P < 0.0015), cough combined with phlegm and/or wheeze (CPWZ, odds ratio = 3.1, P < 0.015), total lung capacity percentage predicted (TLC < 60%, odds ratio = 3.9, P < 0.02), and expiratory reserve volume (ERV < 0.6 L, odds ratio = 2.5, P < 0.05). Independent predictors of CPWZ were current smoking (odds ratio = 3.3, P < 0.004), breathlessness (odds ratio = 2.9, P < 0.03), and forced expiratory volume in 1second (FEV1< 60%, odds ratio = 3.2, P < 0.01).Conclusion:Altered respiratory mechanics associated with tetraplegia contribute to breathlessness, restrictive ventilatory impairment (low TLC%), and reduced expiratory muscle strength (low ERV). These factors apparently overshadow adverse effects caused by smoking. Conversely, smoking and reduction of airflow (low FEV1%) were predictive of CPWZ, symptoms commonly associated with cigarette use.

The incidence of pulmonary complications in heart transplant recipients has not been extensively studied. We report pulmonary complications in 159 consecutive adult orthotopic heart transplantations (OHTs) performed in 157 patients.

Objective: Using a nested case–referent design we evaluated the relationship between plasma levels of six carotenoids, alpha-tocopherol, and retinol, sampled before diagnosis, and later breast cancer risk. Methods: In total, 201 cases and 290 referents were selected from three population-based cohorts in northern Sweden, where all subjects donated blood samples at enrolment. All blood samples were stored at −80 °C. Cases and referents were matched for age, age of blood sample, and sampling centre. Breast cancer cases were identified through the regional and national cancer registries. Results: Plasma concentrations of carotenoids were positively intercorrelated. In analysis of three cohorts as a group none of the carotenoids was found to be significantly related to the risk of developing breast cancer. Similarly, no significant associations between breast cancer risk and plasma levels of α-tocopherol or retinol were found. However, in postmenopausal women from a mammography cohort with a high number of prevalent cases, lycopene was significantly associated with a decreased risk of breast cancer. A significant trend of an inverse association between lutein and breast cancer risk was seen in premenopausal women from two combined population-based cohorts with only incident cases. A non-significant reduced risk with higher plasma α-carotene was apparent throughout all the sub-analyses. Conclusion: In conclusion, no significant associations were found between plasma levels of carotenoids, α-tocopherol or retinol and breast cancer risk in analysis of three combined cohorts. However, results from stratified analysis by cohort membership and menopausal status suggest that lycopene and other plasma-carotenoids may reduce the risk of developing breast cancer and that menopausal status has an impact on the mechanisms involved.

HIV infection and sarcoidosis occur in the same age group, but there areonly a few reports of the coexistence of the two disorders in the sameindividual. This infrequent occurrence has been attributed to thepaucity of functioning CD4+lymphocytes required forgranuloma formation in patients with HIV infection. We report twopatients with a history of remote sarcoidosis who later in lifecontracted HIV infection and developed recurrent, progressive pulmonarysarcoidosis while receiving highly active antiretroviral therapy(HAART). Progressive pulmonary sarcoidosis should be added to thedifferential diagnosis in patients receiving HAART for HIV infectionwho develop diffuse lung disease with recovery of CD4+lymphocyte population.