Early discontinuation of endocrine therapy for breast cancer: Who is at risk in clinical practice?

Purpose: Despite evidence supporting at least five years of endocrine therapy for early breast cancer, many women discontinue therapy early. We investigated the impact of initial therapy type and specific comorbidities on discontinuation of endocrine therapy in clinical practice. Methods We identified women in a population-based cohort with a diagnosis of early breast cancer and an incident dispensing of anastrozole, letrozole or tamoxifen from 2003-2008 (N = 1531). Pharmacy and health service data were used to determine therapy duration, treatment for pre-existing and post-initiation comorbidities (anxiety, depression, hot flashes, musculoskeletal pain, osteoporosis, vaginal atrophy), demographic and other clinical characteristics. Time to discontinuation of initial, and any, endocrine therapy was calculated. Cox regression determined the association of different characteristics on early discontinuation. Results Initial endocrine therapy continued for a median of 2.2 years and any endocrine therapy for 4.8 years. Cumulative probability of discontinuing any therapy was 17% after one year and 58% by five years. Initial tamoxifen, pre-existing musculoskeletal pain and newly-treated anxiety predicted shorter initial therapy but not discontinuation of any therapy. Early discontinuation of any therapy was associated with newly-treated hot flashes (HR = 2.1, 95%CI = 1.3-3.3), not undergoing chemotherapy (HR = 1.4, 95%CI = 1.1-1.8) and not undergoing mastectomy (HR = 1.5, 95%CI = 1.2-1.8). Conclusions Less than half of women completed five years of endocrine therapy. Women at greatest risk of stopping any therapy early were those with newly-treated hot flashes, no initial chemotherapy, or no initial mastectomy. This suboptimal use means that the reductions in recurrence demonstrated in clinical trials may not be realised in practice

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Opportunities for Additional Recovery in University Lands Reservoirs -- Characterization of University Lands Reservoirs, Final Report

In 1984, The University of Texas System funded a Bureau of Economic Geology project, "Characterization of University Lands Reservoirs," to assess in detail the potential for incremental recovery of oil from University Lands reservoirs by extended conventional methods. The objectives of the 5-year project were to quantify the volumes of unrecovered mobile oil remaining in reservoirs on University Lands, to determine whether the specific location of the unrecovered mobile oil could be delineated through integrated geoscience characterization of individual reservoirs, and to develop strategies to optimize recovery of this resource. Unrecovered mobile oil is mobile at reservoir conditions but is prevented from migrating to the wellbore by geologic complexities or heterogeneities. This final report describes results of the 5 years of research conducted on University Lands reservoirs. One hundred and one reservoirs, each of which has produced more than 1 million stock tank barrels (MMSTB) of oil, were included in a resource assessment and play analysis undertaken (1) to determine the volumes and distribution of all components of the University Lands resource base and (2) to select reservoirs for detailed analysis. These reservoirs collectively contained 7.25 billion barrels (BSTB) of oil at discovery, have produced 1.5 BSTB, and contain 200 MMSTB of reserves. Ultimate recovery at implemented technology is projected to be 24 percent of the original oil in place; thus, 5.5 BSTB of oil will remain after recovery of existing reserves. Unrecovered mobile oil (exclusive of reserves) amounts to 2.2 BSTB, and immobile, or residual, oil totals 3.3 BSTB.Bureau of Economic Geolog

MARTA: a high-energy cosmic-ray detector concept for high-accuracy muon measurement

A new concept for the direct measurement of muons in air showers is presented. The concept is based on resistive plate chambers (RPCs), which can directly measure muons with very good space and time resolution. The muon detector is shielded by placing it under another detector able to absorb and measure the electromagnetic component of the showers such as a water-Cherenkov detector, commonly used in air shower arrays. The combination of the two detectors in a single, compact detector unit provides a unique measurement that opens rich possibilities in the study of air showers.Peer Reviewe

Japan Perspectives Recent Articles from the Tokyo Foundation Website [No.3]

oai:repo-tkfd.jp:00000010articl

Plasma Aβ42/Aβ40 and phospho‐tau217 concentration ratios increase the accuracy of amyloid PET classification in preclinical Alzheimer's disease

INTRODUCTION: Incorporating blood-based Alzheimer's disease biomarkers such as tau and amyloid beta (Aβ) into screening algorithms may improve screening efficiency. METHODS: Plasma Aβ, phosphorylated tau (p-tau)181, and p-tau217 concentration levels from AHEAD 3-45 study participants were measured using mass spectrometry. Tau concentration ratios for each proteoform were calculated to normalize for inter-individual differences. Receiver operating characteristic (ROC) curve analysis was performed for each biomarker against amyloid positivity, defined by > 20 Centiloids. Mixture of experts analysis assessed the value of including tau concentration ratios into the existing predictive algorithm for amyloid positron emission tomography status. RESULTS: The area under the receiver operating curve (AUC) was 0.87 for Aβ42/Aβ40, 0.74 for phosphorylated variant p-tau181 ratio (p-tau181/np-tau181), and 0.92 for phosphorylated variant p-tau217 ratio (p-tau217/np-tau217). The Plasma Predicted Centiloid (PPC), a predictive model including p-tau217/np-tau217, Aβ42/Aβ40, age, and apolipoprotein E improved AUC to 0.95. DISCUSSION: Including plasma p-tau217/np-tau217 along with Aβ42/Aβ40 in predictive algorithms may streamline screening preclinical individuals into anti-amyloid clinical trials. CLINICALTRIALS: gov Identifier: NCT04468659 HIGHLIGHTS: The addition of plasma phosphorylated variant p-tau217 ratio (p-tau217/np-tau217) significantly improved plasma biomarker algorithms for identifying preclinical amyloid positron emission tomography positivity. Prediction performance at higher NAV Centiloid levels was improved with p-tau217/np-tau217. All models generated for this study are incorporated into the Plasma Predicted Centiloid (PPC) app for public use

Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort

Correction to Banks E, Jorm L, Lujic S, Rogers K. Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort. ANZ Health Policy 2009; 6: 16