Is adjuvant chemotherapy of benefit for postmenopausal women who receive endocrine treatment for highly endocrine-responsive, node-positive breast cancer? International Breast Cancer Study Group Trials VII and 12-93

To compare the efficacy of chemoendocrine treatment with that of endocrine treatment (ET) alone for postmenopausal women with highly endocrine responsive breast cancer. In the International Breast Cancer Study Group (IBCSG) Trials VII and 12-93, postmenopausal women with node-positive, estrogen receptor (ER)-positive or ER-negative, operable breast cancer were randomized to receive either chemotherapy or endocrine therapy or combined chemoendocrine treatment. Results were analyzed overall in the cohort of 893 patients with endocrine-responsive disease, and according to prospectively defined categories of ER, age and nodal status. STEPP analyses assessed chemotherapy effect. The median follow-up was 13 years. Adding chemotherapy reduced the relative risk of a disease-free survival event by 19% (P = 0.02) compared with ET alone. STEPP analyses showed little effect of chemotherapy for tumors with high levels of ER expression (P = 0.07), or for the cohort with one positive node (P = 0.03). Chemotherapy significantly improves disease-free survival for postmenopausal women with endocrine-responsive breast cancer, but the magnitude of the effect is substantially attenuated if ER levels are high.

COMPUTATIONAL STUDY OF MICROSTRUCTURE-PROPERTYMECHANISM RELATIONS IN FERROIC COMPOSITES

Ferroic materials, as notable members of smart materials, have been widely used in applications that perform sensing, actuation and control. The macroscopic property change of ferroic materials may become remarkably large during ferroic phase transition, leading to the fact that the macroscopic properties can be tuned by carefully applying a suitable external field (electric, magnetic, stress). To obtain an enhancement in physical and/or mechanical properties, different kinds of ferroic composites have been fabricated. The properties of a ferroic composite are determined not only by the properties and relative amounts of the constituent phases, but also by the microstructure of individual phase such as the phase connectivity, phase size, shape and spatial arrangement. This dissertation mainly focuses on the computational study of microstructure – property – mechanism relations in two representative ferroic composites, i.e., two-phase particulate magnetoelectric (ME) composite and polymer matrix ferroelectric composite. The former is a great example of ferroic composite exhibiting a new property and functionality that neither of the constituent phases possesses individually. The latter well represents the kind of ferroic composites having property combinations that are better than the existing materials. Phase field modeling was employed as the computing tool, and the required models for ferroic composites were developed based on existing models for monolithic materials. Extensive computational simulations were performed to investigate the microstructure-property relations and the underlying mechanism in ferroic composites. In particulate, it is found that for ME composite 0-3 connectivity (isolated magnetostrictive phase) is necessary to exhibit ME effect, and small but finite electrical conductivity of isolated magnetic phase can beneficially enhance ME effect. It is revealed that longitudinal and transverse ME coefficients of isotropic 0-3 particulate composites can be effectively tailored by controlling magnetic domain structures without resort to anisotropic two-phase microstructures. Simulations also show that the macroscopic properties of the ferroelectricpolymer composites critically depend on the ferroelectric phase connectivity while are not sensitive to the sizes and internal grain structures of the ceramic particles. Texturing is found critical to exploit the paraelectric«ferroelectric phase transition and nonlinear polarization behavior in paraelectric polycrystal and its polymer matrix composite. Additionally, a Diffuse Interface Field model was developed to simulate packing and motion in liquid phase which is promising for studying the fabrication of particulatepolymer composites.

Ten year clinical follow-up after Sirolimus-eluting stent implantation

BACKGROUND: Little is known on the "very" long-term incidence of major adverse cardiac events (MACE), target-lesion revascularization (TLR), target-vessel revascularization and stent thrombosis after sirolimus-eluting stent (SES) implantation. We present the first study to provide a 10-year clinical follow-up in an unselected patient population who underwent SES implantation. METHODS AND RESULTS: We ran a systematic 10-year clinical follow-up in a series of 200 consecutive patients treated with unrestricted SES implantation between April 2002 and April 2003 in two Swiss hospitals. Outcomes and follow-up were obtained in all 200 patients. The cumulative 10-year MACE rate was 47% with all-cause death of 20%, cardiac death of 9%, myocardial infarction of 7%, TLR and target-vessel revascularization of 8% and 11% respectively. Academic Research Consortium-defined "definite and probable" stent thrombosis-rate was 2.5%. TLR risk was maximal between 3 to 6 years. New lesion revascularization increased throughout the study period. CONCLUSION: Incidence of TLR was maximal 3 to 6 years after SES implantation and decreased thereafter. MACE and non-TLR revascularization rates steadily increased during the complete follow-up underlining the progression of coronary artery disease.

„Mit Flugpost/Par avion“. Die Anfangsjahre des Luftpostverkehrs in der Schweiz (1919–1930)

Die Luftfahrt machte während des Ersten Weltkriegs einen grossen Entwicklungsschritt. Nach Kriegsende standen Flugzeuge, Infrastruktur und ausgebildetes Personal zur Verfügung, was erstmals einen planmässigen und gewerblichen Luftverkehr ermöglichte. Dieser drehte sich in seinen Anfängen in erster Linie um die Beförderung von Luftpost. Die Autorin untersucht die Organisation, das Angebot, die Nachfrage und die Finanzierung des Schweizer Luftpostverkehrs – und erläutert, weshalb der Staat das unrentable Geschäft in hohem Masse unterstützte und somit überhaupt aufrechterhielt.

Etiology and management of recurrent parotid pleomorphic adenoma

The objective of this review study was to encompass the relevant literature and current best practice options for this challenging, sometimes incurable problem. The source of the data was Ovid MEDLINE from 1946 to 2014. Review methods consisted of articles with clinical correlates. The most important cause of recurrence is enucleation with rupture and incomplete tumor excision at operation. Incomplete pseudocapsule, extracapsular extension, pseudopods of pleomorphic adenoma tissue, and satellite pleomorphic beyond the pseudocapsule are also likely linked to recurrent pleomorphic adenoma. Most recurrent pleomorphic adenoma are multinodular. Magnetic resonance imaging is the imaging study of choice for recurrent pleomorphic adenoma. Nerve integrity monitoring may reduce morbidity for recurrent pleomorphic adenoma. Treatment of recurrent pleomorphic adenoma must be individualized. Total parotidectomy, given the multicentricity of recurrent pleomorphic adenoma, is appropriate in many patients, but may be inadequate to control recurrent pleomorphic. There is accumulating evidence from retrospective series that postoperative radiation therapy results in significantly better local control. LEVEL OF EVIDENCE NA Laryngoscope, 2014.

Luminescence and Energy Transfer of [Ru(bpy) 3 ] 2+ , [Cr(ox) 3 ] 3- , and [Os(bpy) 3 ] 2+ in Three-Dimensional Oxalato-Networks

Luminescence and energy transfer in [Zn1-xRux(bpy)3][NaAl1-yCry(ox)3] (x ≈ 0.01, y = 0.006 − 0.22; bpy = 2,2‘-bipyridine, ox = C2O42-) and [Zn1-x-yRuxOsy(bpy)3][NaAl(ox)3] (x ≈ 0.01, y = 0.012) are presented and discussed. Surprisingly, the luminescence of the isolated luminophores [Ru(bpy)3]2+ and [Os(bpy)3]2+ in [Zn(bpy)3][NaAl(ox)3] is hardly quenched at room temperature. Steady-state luminescence spectra and decay curves show that energy transfer occurs between [Ru(bpy)3]2+ and [Cr(ox)3]3- and between [Ru(bpy)3]2+ and [Os(bpy)3]2+ in [Zn1-xRux(bpy)3][NaAl1-yCry(ox)3] and [Zn1-x-yRuxOsy(bpy)3] [NaAl(ox)3], respectively. For a quantitative investigation of the energy transfer, a shell type model is developed, using a Monte Carlo procedure and the structural parameters of the systems. A good description of the experimental data is obtained assuming electric dipole−electric dipole interaction between donors and acceptors, with a critical distance Rc for [Ru(bpy)3]2+ to [Cr(ox)3]3- energy transfer of 15 Å and for [Ru(bpy)3]2+ to [Os(bpy)3]2+ energy transfer of 33 Å. These values are in good agreement with those derived using the Förster−Dexter theory.

The long-term development of avalanche risk in settlements considering the temporal variability of damage potential

Recent studies on the avalanche risk in alpine settlements suggested a strong dependency of the development of risk on variations in damage potential. Based on these findings, analyses on probable maximum losses in avalanche-prone areas of the municipality of Davos (CH) were used as an indicator for the long-term development of values at risk. Even if the results were subject to significant uncertainties, they underlined the dependency of today's risk on the historical development of land-use: Small changes in the lateral extent of endangered areas had a considerable impact on the exposure of values. In a second step, temporal variations in damage potential between 1950 and 2000 were compared in two different study areas representing typical alpine socio-economic development patterns: Davos (CH) and Galtür (A). The resulting trends were found to be similar; the damage potential increased significantly in number and value. Thus, the development of natural risk in settlements can for a major part be attributed to long-term shifts in damage potential.

Trends of periodontal conditions in two different randomly selected Swiss (Bernese) cohorts 25 years apart

AIM To assess the periodontal conditions of two randomly selected Swiss cohorts 25 years apart. MATERIAL AND METHODS Standardized examinations were performed to assess the periodontal conditions of two randomly selected populations of the Canton of Bern; oral cleanliness was evaluated using the plaque index (PlI) and the retention index (RI). Gingival health was scored according to the gingival index (GI). Periodontal conditions were evaluated by pocket probing depth (PPD) and loss of attachment (LA). RESULTS At the first examination in 1985, 206 out of 350 subjects were evaluated, while in the second examination in 2010, 134 out of 490 subjects attended the examinations. In 1985, subjects showed a mean PlI of 1.16, and 0.77 in 2010. RI was 0.81 and 0.36 in 1985 and 2010 respectively. Mean GI was 1.34 and 0.6. The mean proportion of PPD ≤3 mm was 72% in 1985 and 97.3% in 2010. PPD ≥ 6 mm affected 2.0% in 1985 and 0.3% in 2010. In 1985, subjects had an average of 20.7 teeth, while in 2010, the average was 24.6. In 1985, 7.3% of the subjects were edentulous, while in 2010, 4.5% had no teeth. CONCLUSIONS Trends to improvements resulting in more teeth in function and better periodontal conditions were recognized.

Patient-Rated Outcomes of Lumbar Fusion in Patients with Degenerative Disease of the Lumbar Spine: Does Age Matter?

STUDY DESIGN Single centre retrospective study of prospectively collected data, nested within the Eurospine Spine Tango data acquisition system. OBJECTIVE The aim of this study was to assess the patient-rated outcome and complication rates associated with lumbar fusion procedures in three different age groups. SUMMARY OF BACKGROUND DATA There is a general reluctance to consider spinal fusion procedures in elderly patients due to the increased likelihood of complications. METHODS Before and at 3, 12, and 24 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI). At the 3-, 12-, and 24-month follow-ups they also rated the Global Treatment Outcome (GTO) and their satisfaction with care. Patients were divided into three age groups: younger (≥50y < 65y; n = 317), older (≥65y < 80y; n = 350), and geriatric (≥ 80y; n = 40). RESULTS 707 consecutive patients were included. The preoperative comorbidity status differed significantly (p < 0.0001) between the age groups, with the highest scores in the geriatric group. Medical complications during surgery were lower in the younger age group (7%) than in the older (13.4%; p = 0.006) and geriatric groups (17.5%; p = 0.007); surgical complications tended to be higher in the elderly group (younger, 6.3%; older, 6.0%; geriatric, 15.0%; p = 0.09). There were no significant group differences (p > 0.05) for the scores on any of the COMI domains, GTO, or patient-rated satisfaction at either 3-, 12-, and 24-months follow-up. CONCLUSIONS Despite greater comorbidity and complication rates in geriatric patients, the patient-rated outcome was as good in the elderly as it was in younger age groups up to two years after surgery. These data indicate that geriatric age needs careful consideration of associated risks but is not per se a contraindication for fusion for lumbar degenerative disease. LEVEL OF EVIDENCE 4.