Hormone replacement therapy and breast cancer risk in California

Numerous studies have documented increased breast cancer risks with hormone replacement therapy (HRT), but these do not give a woman her specific absolute risk for the remainder of her life. This article estimates the magnitude of the effect of HRT on breast cancer incidence in California and calculates a woman's cumulative risk of breast cancer with different formulations and durations of HRT use. The effects of HRT on the underlying breast cancer incidence were estimated using the attributable fraction method, applying HRT prevalence data from the 2001 California Health Interview Survey and published rates of higher relative risk (RR) from HRT use from the Women's Health Initiative (WHI) study and Million Women's Survey (MWS). The annual number of breast cancers potentially attributable to HRT in California was estimated, along with individual cumulative risk of breast cancer for various ages to 79 years according to HRT use, duration, and formulation. Using the WHI data, 829 of 19,000 breast cancers (4.3%) in California may be attributable to HRT This figure increases to 3401 (17.4%) when the MWS RRs are applied. Use of estrogen-only HRT or short-term (approximately 5 years) use of combined HRT has a minimal effect on the cumulative risk calculated to the age of 79 years; application of the MWS data to a Californian woman commencing HRT at the age of 50 years (no HRT, 8.5%; estrogen only, 8.6%; combined, 9.1%). Prolonged (approximately 10 years) use of combined HRT increases the cumulative risk to 10.3%. This article demonstrates that HRT will generate a small additional risk of breast cancer in an individual. The reduction in perimenopausal symptoms may be considered sufficient to warrant this extra risk. However, this view needs to be balanced because the small increases in individual risk will be magnified, producing a noticeable change in population cancer caseload where HRT use is high.

What role does knowledge of wildlife play in providing support for species' conservation?

Conservation of biodiversity is a complex issue. Apart from the creation of nature reserves, there is a plethora of other factors that are part of this complex web. One such factor is the public knowledge of species. Since public funding is imperative for the conservation of species and creation of reserves for them it is important to determine the public’s awareness of species and their knowledge about them. In the absence of such awareness and knowledge, it is possible that the public may misallocate their support. In other words, resources may be provided for species that do not need support urgently. We show how availability of balanced information about species helps the public to make rational decisions and to allocate support (e.g. monetary) to species that need it most. Other implications of a ‘wildlife knowledgeable’ public are also discussed.

Stiffly accurate Runge-Kutta methods for stiff stochastic differential equations

In this paper we discuss implicit methods based on stiffly accurate Runge-Kutta methods and splitting techniques for solving Stratonovich stochastic differential equations (SDEs). Two splitting techniques: the balanced splitting technique and the deterministic splitting technique, are used in this paper. We construct a two-stage implicit Runge-Kutta method with strong order 1.0 which is corrected twice and no update is needed. The stability properties and numerical results show that this approach is suitable for solving stiff SDEs. (C) 2001 Elsevier Science B.V. All rights reserved.

Patterns of community integration 2-5 years post-discharge from brain injury rehabilitation

Outcome after traumatic brain injury (TBI) is characterized by a high degree of variability which has often been difficult to capture in traditional outcome studies. The purpose of this study was to describe patterns of community integration 2-5 years after TBI. Participants were 208 patients admitted to a Brain Injury Rehabilitation Unit between 1991-1995 in Brisbane, Australia. The design comprised retrospective data collection and questionnaire follow-up by mail. Mean follow-up was 3.5 years. Demographic, injury severity and functional status variables were retrieved from hospital records. Community integration was assessed using the Community Integration Questionnaire (CIQ), and vocational status measured by a self administered questionnaire. Data was analysed using cluster analysis which divided the data into meaningful subsets. Based on the CIQ subscale scores of home, social and productive integration, a three cluster solution was selected, with groups labelled as working (n = 78), balanced (n = 46) and poorly integrated (n = 84). Although 38% of the sample returned to a high level of productive activity and 22% achieved a balanced lifestyle, overall community integration was poor for the remainder. This poorly integrated group had more severe injury characterized by longer periods of acute care and post-traumatic amnesia (PTA) and greater functional disability on discharge. These findings have implications for service delivery prior to and during the process of reintegration after brain injury.

Model-based procedure for scale-up of wet, overflow ball mills - Part III: Validation and discussion

A new ball mill scale-up procedure is developed. This procedure has been validated using seven sets of Ml-scale ball mil data. The largest ball mills in these data have diameters (inside liners) of 6.58m. The procedure can predict the 80% passing size of the circuit product to within +/-6% of the measured value, with a precision of +/-11% (one standard deviation); the re-circulating load to within +/-33% of the mass-balanced value (this error margin is within the uncertainty associated with the determination of the re-circulating load); and the mill power to within +/-5% of the measured value. This procedure is applicable for the design of ball mills which are preceded by autogenous (AG) mills, semi-autogenous (SAG) mills, crushers and flotation circuits. The new procedure is more precise and more accurate than Bond's method for ball mill scale-up. This procedure contains no efficiency correction which relates to the mill diameter. This suggests that, within the range of mill diameter studied, milling efficiency does not vary with mill diameter. This is in contrast with Bond's equation-Bond claimed that milling efficiency increases with mill diameter. (C) 2001 Elsevier Science Ltd. All rights reserved.

Lipophilic methotrexate conjugates with glucose-lipoamino acid moieties: Synthesis and in vitro antitumor activity

To obtain methotrexate (MTX) derivatives with a balanced hydrolipophilic character, we synthesized a series of conjugates in which the drug was linked to lipoamino acid (LAA)-glucose residues (LAAG-MTX). These conjugates displayed increased solubility in polar media compared with the corresponding LAA-MTX conjugates previously described. In vitro biological testing of LAAG-MTX indicated that the introduction of the sugar moiety decreased the biological activity of these MTX conjugates. The tetradecyl derivative 6b, however, was effective in inhibiting the dihydrofolate reductase activity in vitro and showed an inhibitory effect on human lymphoblastoid cell growth. (C) 2001 Wiley-Liss, Inc.

Pax Americana: Accent attitudinal evaluations in New Zealand, Australia, and America

This study describes a series of evaluations of gender pairs of New Zealand English, Australian English, American English and RP-type English English voices by over 400 students in New Zealand, Australia and the U.S.A. Voices were chosen to represent the middle range of each accent, and balanced for paralinguistic features. Twenty-two personality and demographic traits were evaluated by Likert-scale questionnaires. Results indicated that the American female voice was rated most favourably on at least some traits by students of all three nationalities, followed by the American male. For most traits, Australian students generally ranked their own accents in third or fourth place, but New Zealanders put the female NZE voice in the mid-low range of all but solidarity-associated traits. All three groups disliked the NZE male. The RP voices did not receive the higher rankings in power/status variables we expected. The New Zealand evaluations downgrade their own accent vis-a`-vis the American and to some extent the RP voices. Overall, the American accent seems well on the way to equalling or even replacing RP as the prestige—or at least preferred—variety, not only in New Zealand but in Australia and some non-English-speaking nations as well. Preliminary analysis of data from Europe suggests this manifestation of linguistic hegemony as ‘Pax Americana’ seems to be prevalent over more than just the Anglophone nations.

Inferring population history from microsatellite and enzyme data in serially introduced cane toads, Bufo marinus

Much progress has been made on inferring population history from molecular data. However, complex demographic scenarios have been considered rarely or have proved intractable. The serial introduction of the South-Central American cane Load Bufo marinas in various Caribbean and Pacific islands involves four major phases: a possible genetic admixture during the first introduction, a bottleneck associated with founding, a transitory, population boom, and finally, a demographic stabilization. A large amount of historical and demographic information is available for those introductions and can be combined profitably with molecular data. We used a Bayesian approach to combine this information With microsatellite (10 loci) and enzyme (22 loci) data and used a rejection algorithm to simultaneously estimate the demographic parameters describing the four major phases of the introduction history,. The general historical trends supported by microsatellites and enzymes were similar. However, there was a stronger support for a larger bottleneck at introductions for microsatellites than enzymes and for a more balanced genetic admixture for enzymes than for microsatellites. Verb, little information was obtained from either marker about the transitory population boom observed after each introduction. Possible explanations for differences in resolution of demographic events and discrepancies between results obtained with microsatellites and enzymes were explored. Limits Of Our model and method for the analysis of nonequilibrium populations were discussed.

Economic Instruments and Regulatory Approaches in Implementing Riparian Revegetation Options: Observations of the Queensland System

Riparian vegetation can be an effective measure for preventing degradation of streambanks and riparian areas. However, riparian revegetation imposes large costs on landholders associated with tree establishment and removal of land from cropping, while providing benefits to downstream landholders, fishers, the local community and environmentalists. Appropriate policy instruments are required to promote sustainable and balanced use of riparian zones. This article analyses the capacity of existing legislation and other instruments to promote restoration of degraded riparian zones on private land. The role of legislation. economic instruments, community engagement and extension programs, in persuading landholders to revegetate riparian areas and improve riparian vegetation cover; is examined in the context ofa small degraded catchment in an intensive farming area in tropical north Queensland. It is found that while legislation and regulations can control undesirable modification of riparian areas, in general they are unable to make a useful contribution to restoration of these areas; incentives and assistance measures appear to offer greater potential.

Investigation of the effects of chrome ball charge on slurry rheology and milling performance

Ten surveys of the ball milling circuit at the Mt Isa Mines (MIM) Copper Concentrator were conducted aiming to identify any changes in slurry theology caused by the use of chrome balls charge, and the associated effect on grinding performance. Slurry theology was measured using an on-line viscometer. The data were mass balanced and analysed with statistical tools. Comparison of the rheogram demonstrated that slurry density and fines content affected slurry rheology significantly, while the effect of the chrome ball charge being negligible. Statistical analysis showed the effects of mill throughput and cyclone efficiency on the Grinding Index (a term describing the overall breakage). There was no difference in the Grinding Index between using the chrome ball charge and the ordinary steel ball charge. (C) 2002 Elsevier Science Ltd. All rights reserved.

Clinical evaluation of the WOMAC 3.0 OA Index in numeric rating scale format using a computerized touch screen version

Background: The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index is a previously described self-administered questionnaire covering three domains: pain, stiffness and function. It has been validated in patients with osteoarthritis (OA) of the hip or knee in a paper-based format. Aim: To validate the WOMAC 3.0 using a numerical rating scale in a computerized touch screen format allowing immediate evaluation of the questionnaire. In the computed version cartoons, written and audio instruments were included in order facilitate application. Methods: Fifty patients, demographically balanced, with radiographically proven primary hip or knee OA completed the classical paper and the new computerized WOMAC version. Subjects were randomized either to paper format or computerized format first to balance possible order effects, Results: The intra-class correlation coefficients for pain, stiffness and function values were 0.915, 0.745 and 0.940, respectively. The Spearman correlation coefficients for pain, stiffness and function were 0.88, 0.77 and 0.87, respectively. Conclusion: These data indicate that the computerized WOMAC OA index 3.0 is comparable to the paper WOMAC in all three dimensions. The computerized version would allow physicians to get an immediate result and if present a direct comparison with a previous exam. (C) 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.

Whither our Art? Clinical Wisdom & Evidence-based Medicine

The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute. For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other, human elements, and to threaten the art of medicine. Clinical wisdom always remains open to question. We want to know why particular beliefs are held, and the epistemological status of claims based in wisdom or experience. The paper critically appraises a number of claims and distinctions, and attempts to clarify the connections between EBM, clinical experience and judgement, and the objective and evaluative categories of medicine. I conclude that to demystify clinical wisdom is not to devalue it. EBM ought not be conceived as needing to be limited or balanced by clinical wisdom, since if its language is translatable into terms comprehensible and applicable to individuals, it helps constitute clinical wisdom. Failure to appreciate this constitutive relation will help perpetuate medical paternalism and delay the adoption of properly evidence-based practice, which would be both unethical and unwise.

Partitioning sets of triples into small planes

We study partitions of the set of all ((v)(3)) triples chosen from a v-set into pairwise disjoint planes with three points per line. Our partitions may contain copies of PG(2, 2) only (Fano partitions) or copies of AG(2, 3) only (affine partitions) or copies of some planes of each type (mixed partitions). We find necessary conditions for Fano or affine partitions to exist. Such partitions are already known in several cases: Fano partitions for v = 8 and affine partitions for v = 9 or 10. We construct such partitions for several sporadic orders, namely, Fano partitions for v = 14, 16, 22, 23, 28, and an affine partition for v = 18. Using these as starter partitions, we prove that Fano partitions exist for v = 7(n) + 1, 13(n) + 1, 27(n) + 1, and affine partitions for v = 8(n) + 1, 9(n) + 1, 17(n) + 1. In particular, both Fano and affine partitions exist for v = 3(6n) + 1. Using properties of 3-wise balanced designs, we extend these results to show that affine partitions also exist for v = 3(2n). Similarly, mixed partitions are shown to exist for v = 8(n), 9(n), 11(n) + 1.

Robust model-order reduction of complex biological processes

This paper addresses robust model-order reduction of a high dimensional nonlinear partial differential equation (PDE) model of a complex biological process. Based on a nonlinear, distributed parameter model of the same process which was validated against experimental data of an existing, pilot-scale BNR activated sludge plant, we developed a state-space model with 154 state variables in this work. A general algorithm for robustly reducing the nonlinear PDE model is presented and based on an investigation of five state-of-the-art model-order reduction techniques, we are able to reduce the original model to a model with only 30 states without incurring pronounced modelling errors. The Singular perturbation approximation balanced truncating technique is found to give the lowest modelling errors in low frequency ranges and hence is deemed most suitable for controller design and other real-time applications. (C) 2002 Elsevier Science Ltd. All rights reserved.

Levene tests of homogeneity of variance for general block and treatment designs

This article develops a weighted least squares version of Levene's test of homogeneity of variance for a general design, available both for univariate and multivariate situations. When the design is balanced, the univariate and two common multivariate test statistics turn out to be proportional to the corresponding ordinary least squares test statistics obtained from an analysis of variance of the absolute values of the standardized mean-based residuals from the original analysis of the data. The constant of proportionality is simply a design-dependent multiplier (which does not necessarily tend to unity). Explicit results are presented for randomized block and Latin square designs and are illustrated for factorial treatment designs and split-plot experiments. The distribution of the univariate test statistic is close to a standard F-distribution, although it can be slightly underdispersed. For a complex design, the test assesses homogeneity of variance across blocks, treatments, or treatment factors and offers an objective interpretation of residual plot.