Incident malignancies among older long-term breast cancer survivors and an age-matched and site-matched nonbreast cancer comparison group over 10 years of follow-up

BACKGROUND Of the approximately 2.4 million American women with a history of breast cancer, 43% are aged ≥ 65 years and are at risk for developing subsequent malignancies. METHODS Women from 6 geographically diverse sites included 5-year breast cancer survivors (N = 1361) who were diagnosed between 1990 and 1994 at age ≥ 65 years with stage I or II disease and a comparison group of women without breast cancer (N = 1361). Women in the comparison group were age-matched and site-matched to breast cancer survivors on the date of breast cancer diagnosis. Follow-up began 5 years after the index date (survivor diagnosis date or comparison enrollment date) until death, disenrollment, or through 15 years after the index date. Data were collected from medical records and electronic sources (cancer registry, administrative, clinical, National Death Index). Analyses included descriptive statistics, crude incidence rates, and Cox proportional hazards regression models for estimating the risk of incident malignancy and were adjusted for death as a competing risk. RESULTS Survivors and women in the comparison group were similar: >82% were white, 55% had a Charlson Comorbidity Index of 0, and ≥ 73% had a body mass index ≤ 30 kg/m(2) . Of all 306 women (N = 160 in the survivor group, N = 146 in the comparison group) who developed a first incident malignancy during follow-up, the mean time to malignancy was similar (4.37 ± 2.81 years vs 4.03 ± 2.76 years, respectively; P = .28), whereas unadjusted incidence rates were slightly higher in survivors (1882 vs 1620 per 100,000 person years). The adjusted hazard of developing a first incident malignancy was slightly elevated in survivors in relation to women in the comparison group, but it was not statistically significant (hazard ratio, 1.17; 95% confidence interval, 0.94-1.47). CONCLUSIONS Older women who survived 5 years after an early stage breast cancer diagnosis were not at an elevated risk for developing subsequent incident malignancies up to 15 years after their breast cancer diagnosis.

High-resolution mineral dust and sea ice proxy records from the Talos Dome ice core

In this study we report on new non-sea salt calcium (nssCa2+, mineral dust proxy) and sea salt sodium (ssNa+, sea ice proxy) records along the East Antarctic Talos Dome deep ice core in centennial resolution reaching back 150 thousand years (ka) before present. During glacial conditions nssCa2+ fluxes in Talos Dome are strongly related to temperature as has been observed before in other deep Antarctic ice core records, and has been associated with synchronous changes in the main source region (southern South America) during climate variations in the last glacial. However, during warmer climate conditions Talos Dome mineral dust input is clearly elevated compared to other records mainly due to the contribution of additional local dust sources in the Ross Sea area. Based on a simple transport model, we compare nssCa2+ fluxes of different East Antarctic ice cores. From this multi-site comparison we conclude that changes in transport efficiency or atmospheric lifetime of dust particles do have a minor effect compared to source strength changes on the large-scale concentration changes observed in Antarctic ice cores during climate variations of the past 150 ka. Our transport model applied on ice core data is further validated by climate model data. The availability of multiple East Antarctic nssCa2+ records also allows for a revision of a former estimate on the atmospheric CO2 sensitivity to reduced dust induced iron fertilisation in the Southern Ocean during the transition from the Last Glacial Maximum to the Holocene (T1). While a former estimate based on the EPICA Dome C (EDC) record only suggested 20 ppm, we find that reduced dust induced iron fertilisation in the Southern Ocean may be responsible for up to 40 ppm of the total atmospheric CO2 increase during T1. During the last interglacial, ssNa+ levels of EDC and EPICA Dronning Maud Land (EDML) are only half of the Holocene levels, in line with higher temperatures during that period, indicating much reduced sea ice extent in the Atlantic as well as the Indian Ocean sector of the Southern Ocean. In contrast, Holocene ssNa+ flux in Talos Dome is about the same as during the last interglacial, indicating that there was similar ice cover present in the Ross Sea area during MIS 5.5 as during the Holocene.

Regulation and the Management of Expectations - Rating Agencies Revisited

In the aftermath of the 2008 crisis, scholars have begun to revise their conceptions of how market participants interact. While the traditional “rationalist optic” posits market participants who are able to process decisionrelevant information and thereby transform uncertainty into quantifiable risks, the increasingly popular “sociological optic” stresses the role of uncertainty in expectation formation and social conventions for creating confidence in markets. Applications of the sociological optic to concrete regulatory problems are still limited. By subjecting both optics to the same regulatory problem—the role of credit rating agencies (CRAs) and their ratings in capital markets—this paper provides insights into whether the sociological optic offers advice to tackle concrete regulatory problems and discusses the potential of the sociological optic in complementing the rationalist optic. The empirical application suggests that the sociological optic is not only able to improve our understanding of the role of CRAs and their ratings, but also to provide solutions complementary to those posited by the rationalist optic.

Water stable oxygen isotope records from six Antarctic ice core sites for the present and last interglacial periods

We compare the present and last interglacial periods as recorded in Antarctic water stable isotope records now available at various temporal resolutions from six East Antarctic ice cores: Vostok, Taylor Dome, EPICA Dome C (EDC), EPICA Dronning Maud Land (EDML), Dome Fuji and the recent TALDICE ice core from Talos Dome. We first review the different modern site characteristics in terms of ice flow, meteorological conditions, precipitation intermittency and moisture origin, as depicted by meteorological data, atmospheric reanalyses and Lagrangian moisture source diagnostics. These different factors can indeed alter the relationships between temperature and water stable isotopes. Using five records with sufficient resolution on the EDC3 age scale, common features are quantified through principal component analyses. Consistent with instrumental records and atmospheric model results, the ice core data depict rather coherent and homogenous patterns in East Antarctica during the last two interglacials. Across the East Antarctic plateau, regional differences, with respect to the common East Antarctic signal, appear to have similar patterns during the current and last interglacials. We identify two abrupt shifts in isotopic records during the glacial inception at TALDICE and EDML, likely caused by regional sea ice expansion. These regional differences are discussed in terms of moisture origin and in terms of past changes in local elevation histories, which are compared to ice sheet model results. Our results suggest that elevation changes may contribute significantly to inter-site differences. These elevation changes may be underestimated by current ice sheet models

International governmental agencies and career guidance

The international Organization for Economic Cooperation and Develop-ment (OECD), like many national and international organizations concerned with economic development believes that career guidance has an important role in promoting the development of a country's human resources. (Mapping the future: Young People and career guidance OECD, 1996). Generally the economic development agencies always recommend that career guidance services should be strengthened. Too frequently, however, they do not recognize the difficulties facing counselor in the schools and do not give clear and specific recommendations, yet they appear to believe that the education or other au thorities who are responsible to guidance will quickly agree and provide more resources for guidance. In addition to economic development agencies, social and educational development agencies also make important recommendations concerning the provision of guidance services. UNESCO, for example, has published two re- cent reports (Policies and Guidelines for Educational and Vocational Guidelines for Equal Access and Opportunity for Girls and Women in Technical and Vocational Education.) It is interesting to compare the OECD and UNESCO rec- ommendations and note that the relative strengths of each set of recommenda- tions, and to imagine how they might be combined in advocating changes in policies and programs.

International governmental agencies and career guidance

The international Organization for Economic Cooperation and Develop-ment (OECD), like many national and international organizations concerned with economic development believes that career guidance has an important role in promoting the development of a country's human resources. (Mapping the future: Young People and career guidance OECD, 1996). Generally the economic development agencies always recommend that career guidance services should be strengthened. Too frequently, however, they do not recognize the difficulties facing counselor in the schools and do not give clear and specific recommendations, yet they appear to believe that the education or other au thorities who are responsible to guidance will quickly agree and provide more resources for guidance. In addition to economic development agencies, social and educational development agencies also make important recommendations concerning the provision of guidance services. UNESCO, for example, has published two re- cent reports (Policies and Guidelines for Educational and Vocational Guidelines for Equal Access and Opportunity for Girls and Women in Technical and Vocational Education.) It is interesting to compare the OECD and UNESCO rec- ommendations and note that the relative strengths of each set of recommenda- tions, and to imagine how they might be combined in advocating changes in policies and programs.

International governmental agencies and career guidance

The international Organization for Economic Cooperation and Develop-ment (OECD), like many national and international organizations concerned with economic development believes that career guidance has an important role in promoting the development of a country's human resources. (Mapping the future: Young People and career guidance OECD, 1996). Generally the economic development agencies always recommend that career guidance services should be strengthened. Too frequently, however, they do not recognize the difficulties facing counselor in the schools and do not give clear and specific recommendations, yet they appear to believe that the education or other au thorities who are responsible to guidance will quickly agree and provide more resources for guidance. In addition to economic development agencies, social and educational development agencies also make important recommendations concerning the provision of guidance services. UNESCO, for example, has published two re- cent reports (Policies and Guidelines for Educational and Vocational Guidelines for Equal Access and Opportunity for Girls and Women in Technical and Vocational Education.) It is interesting to compare the OECD and UNESCO rec- ommendations and note that the relative strengths of each set of recommenda- tions, and to imagine how they might be combined in advocating changes in policies and programs.

(Table 1) Gas tie points used to correlate NorthGRIP and Vostol records

North Atlantic sediment records (MD95-2042), Greenland (Greenland Ice Core Project (GRIP)) and Antarctica (Byrd and Vostok) ice core climate records have been synchronized over marine isotopic stage 3 (MIS 3) (64 to 24 kyr B.P.) (Shackleton et al., 2000). The resulting common timescale suggested that MD95-2042 d18Obenthic fluctuations were synchronous with temperature changes in Antarctica (dDice or d18Oice records). In order to assess the persistency of this result we have used here the recent Greenland NorthGRIP ice core covering the last glacial inception. We transfer the Antarctic Vostok GT4 timescale to NorthGRIP d18Oice and MD95-2042 d18Oplanktonic records and precisely quantify all the relative timing uncertainties. During the rapid warming of Dansgaard-Oeschger 24, MD95-2042 d18Obenthic decrease is in phase with d18Oplanktonic decrease and therefore with NorthGRIP temperature increase, but it takes place 1700 ± 1100 years after the Antarctic warming. Thus the present study reveals that the results obtained previously for MIS 3 cannot be generalized and demonstrates the need to improve common chronologies for marine and polar archives.

Multicentennial resolution proxy records from splicings of MD96-2080 and MD02-2594, Agulhas Bank Splice (ABS)

[1] Planktonic d18O and Mg/Ca-derived sea surface temperature (SST) records from the Agulhas Corridor off South Africa display a progressive increase of SST during glacial periods of the last three climatic cycles. The SST increases of up to 4°C coincide with increased abundance of subtropical planktonic foraminiferal marker species which indicates a progressive warming due to an increased influence of subtropical waters at the core sites. Mg/Ca-derived SST maximizes during glacial maxima and glacial Terminations to values about 2.5°C above full-interglacial SST. The paired planktonic d18O and Mg/Ca-derived SST records yield glacial seawater d18O anomalies of up to 0.8 per mill, indicating measurably higher surface salinities during these periods. The SST pattern along our record is markedly different from a UK'37-derived SST record at a nearby core location in the Agulhas Corridor that displays SST maxima only during glacial Terminations. Possible explanations are lateral alkenone advection by the vigorous regional ocean currents or the development of SST contrasts during glacials in association with seasonal changes of Agulhas water transports and lateral shifts of the Agulhas retroflection. The different SST reconstructions derived from UK'37 and Mg/Ca pose a significant challenge to the interpretation of the proxy records and demonstrate that the reconstruction of the Agulhas Current and interocean salt leakage is not as straightforward as previously suggested.

Aligning and synchronization of MIS5 proxy records from Lake Ohrid (FYROM) with independently dated Mediterranean archives: implications for DEEP core chronology

The DEEP site sediment sequence obtained during the ICDP SCOPSCO project at Lake Ohrid was dated using tephrostratigraphic information, cyclostratigraphy, and orbital tuning through the marine isotope stages (MIS) 15-1. Although this approach is suitable for the generation of a general chronological framework of the long succession, it is insufficient to resolve more detailed palaeoclimatological questions, such as leads and lags of climate events between marine and terrestrial records or between different regions. Here, we demonstrate how the use of different tie points can affect cyclostratigraphy and orbital tuning for the period between ca. 140 and 70 ka and how the results can be correlated with directly/indirectly radiometrically dated Mediterranean marine and continental proxy records. The alternative age model presented here shows consistent differences with that initially proposed by Francke et al. (2015) for the same interval, in particular at the level of the MIS6-5e transition. According to this new age model, different proxies from the DEEP site sediment record support an increase of temperatures between glacial to interglacial conditions, which is almost synchronous with a rapid increase in sea surface temperature observed in the western Mediterranean. The results show how a detailed study of independent chronological tie points is important to align different records and to highlight asynchronisms of climate events. Moreover, Francke et al. (2016) have incorporated the new chronology proposed for tephra OH-DP-0499 in the final DEEP age model. This has reduced substantially the chronological discrepancies between the DEEP site age model and the model proposed here for the last glacial-interglacial transition.

Performance management in the District of Columbia : a progress report : hearing before the Subcommittee on Oversight of Government Management, Restructuring, and the District of Columbia of the Committee on Governmental Affairs, United States Senate, One Hundred Sixth Congress, second session, May 9, 2000.

Shipping list no.: 2001-0042-P.

Duplication, overlap, and fragmentation in government programs : hearing before the Committee on Governmental Affairs, United States Senate, One Hundred Fourth Congress, first session, June 7, 1995.

Shipping list no.: 96-0230-P.

Legislative proposals and issues relevant to the operations of the inspectors general : hearing before the Committee on Governmental Affairs, United States Senate, One Hundred Sixth Congress, second session, July 19, 2000.

Shipping list no.: 2001-0052-P.

Has government been "reinvented"? : hearing before the Oversight of Government Management, Restructuring, and the District of Columbia Subcommittee of the Committee on Governmental Affairs, United States Senate, One Hundred Sixth Congress, second session, May 4, 2000.

Shipping list no.: 2001-0068-P.