Adjuvant early breast cancer systemic therapies according to daily used technologies.

Prognosis of early breast cancer patients is significantly improved with the use of adjuvant therapies. Various guidelines have been proposed to select patients who will derive the most benefit from such treatments. However, classifications have limited usefulness in subsets of patients such as those with node negative breast cancer. The 2007 St. Paul de Vence Clinical Practice Recommendations proposed to consider adjuvant therapy in accordance with the 10-year relapse-free survival reduction estimated by Adjuvant! Online. However, many limitations remain regarding the use of Adjuvant! Online. Among them, adverse prognostic and/or predictive factors such as vascular invasion, mitotic activity, progesterone receptor negativity, and HER-2 expression are not incorporated in the routine clinical decision process. Our group has therefore issued guidelines based on the consideration of both Adjuvant! Online calculations and the prognostic and/or predictive effects of these markers. In addition, web-accessible comprehensive tables summarizing these recommendations are provided.

Hazardous substances in frequently used professional cleaning products.

A growing number of studies have identified cleaners as a group at risk for adverse health effects of the skin and the respiratory tract. Chemical substances present in cleaning products could be responsible for these effects. Currently, only limited information is available about irritant and health hazardous chemical substances found in cleaning products. We hypothesized that chemical substances present in cleaning products are known health hazardous substances that might be involved in adverse health effects of the skin and the respiratory tract. We performed a systematic review of cleaning products used in the Swiss cleaning sector. We surveyed Swiss professional cleaning companies (n = 1476) to identify the most used products (n = 105) for inclusion. Safety data sheets (SDSs) were reviewed and hazardous substances present in cleaning products were tabulated with current European and global harmonized system hazard labels. Professional cleaning products are mixtures of substances (arithmetic mean 3.5 +/- 2.8), and more than 132 different chemical substances were identified in 105 products. The main groups of chemicals were fragrances, glycol ethers, surfactants, solvents; and to a lesser extent, phosphates, salts, detergents, pH-stabilizers, acids, and bases. Up to 75% of products contained irritant (Xi), 64% harmful (Xn) and 28% corrosive (C) labeled substances. Hazards for eyes (59%) and skin (50%), and hazards by ingestion (60%) were the most reported. Cleaning products potentially give rise to simultaneous exposures to different chemical substances. As professional cleaners represent a large workforce, and cleaning products are widely used, it is a major public health issue to better understand these exposures. The list of substances provided in this study contains important information for future occupational exposure assessment studies.

Letter health consultation : foundry slag used for road rock, Washington County, Iowa (2008)

A resident within one of the counties in your region has expressed some concern regarding potential adverse health effects from dust and material that may be found within foundry slag that has been used as a replacement for road rock. This consultation includes a comparison of nuisance issues from dust generated from a road constructed of foundry slag and dust generated from a road constructed from typical road rock. This consultation also includes a discussion of the potential health effects of exposure of heavy metals from incidental ingestion of foundry slag.

Correcting Interdevice Bias of Horizontal White-to-White and Sulcus-to-Sulcus Measures Used for Implantable Collamer Lens Sizing.

PURPOSE: To assess the agreement and repeatability of horizontal white-to-white (WTW) and horizontal sulcus-to-sulcus (STS) diameter measurements and use these data in combination with available literature to correct for interdevice bias in preoperative implantable collamer lens (ICL) size selection. DESIGN: Interinstrument reliability and bias assessment study. METHODS: A total of 107 eyes from 56 patients assessed for ICL implantation at our institution were included in the study. This was a consecutive series of all patients with suitable available data. The agreement and bias between WTW (measured with the Pentacam and BioGraph devices) and STS (measured with the HiScan device) were estimated. RESULTS: The mean spherical equivalent was -8.93 ± 5.69 diopters. The BioGraph measures of WTW were wider than those taken with the Pentacam (bias = 0.26 mm, P < .01), and both horizontal WTW measures were wider than the horizontal STS measures (bias >0.91 mm, P < .01). The repeatability (Sr) of STS measured with the HiScan was 0.39 mm, which was significantly reduced (Sr = 0.15 mm) when the average of 2 measures was used. Agreement between the horizontal WTW measures and horizontal STS estimates when bias was accounted for was г = 0.54 with the Pentacam and г = 0.64 with the BioGraph. CONCLUSIONS: Large interdevice bias was observed for WTW and STS measures. STS measures demonstrated poor repeatability, but the average of repeated measures significantly improved repeatability. In order to conform to the US Food and Drug Administration's accepted guidelines for ICL sizing, clinicians should be aware of and account for the inconsistencies between devices.

International survey of acute stroke imaging used to make revascularization treatment decisions.

BACKGROUND: To assess the differences across continental regions in terms of stroke imaging obtained for making acute revascularization therapy decisions, and to identify obstacles to participating in randomized trials involving multimodal imaging. METHODS: STroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA)-Imaging circulated an online survey through its website, through the websites of national professional societies from multiple countries as well as through email distribution lists from STIR and the above mentioned societies. RESULTS: We received responses from 223 centers (2 from Africa, 38 from Asia, 10 from Australia, 101 from Europe, 4 from Middle East, 55 from North America, 13 from South America). In combination, the sites surveyed administered acute revascularization therapy to a total of 25,326 acute stroke patients in 2012. Seventy-three percent of these patients received intravenous (i.v.) tissue plasminogen activator (tPA), and 27%, endovascular therapy. Vascular imaging was routinely obtained in 79% (152/193) of sites for endovascular therapy decisions, and also as part of standard IV tPA treatment decisions at 46% (92/198) of sites. Modality, availability and use of acute vascular and perfusion imaging before revascularization varied substantially between geographical areas. The main obstacles to participate in randomized trials involving multimodal imaging included: mainly insufficient research support and staff (50%, 79/158) and infrequent use of multimodal imaging (27%, 43/158) . CONCLUSION: There were significant variations among sites and geographical areas in terms of stroke imaging work-up used tomake decisions both for intravenous and endovascular revascularization. Clinical trials using advanced imaging as a selection tool for acute revascularization therapy should address the need for additional resources and technical support, and take into consideration the lack of routine use of such techniques in trial planning.

Charting the territory : how female artist/teachers balance their artistic practice with their institutional responsibilities as teachers /

This r\.~et.lrch examined ho\\' ~ight \\'omen artists \\'ho t~ach at the uni versity and college level, balance thcir artistic practic~ and their institu tional responsibilities as tcachers. This thesis reprt.~ents the culmination of \\'ork for my second graduate degree. For my first degrCt! on th~ grad uat~ level, I concentratoo on d~veloping my artistic practice. This ~Iaster's Degree in Education is no k~ important to m~. In pursuing studies in the field of education I \\'anted to understand my rol~ as both an educator and an artist and in the process I uncovered the interplay of race, class, and gender at \\'ork in th~ classroom. Coming from a \\'orking-class, immigrant background \\'here higher education \vas vie\\'cd as a stepping stone that \"ould enable my siblings and me a greater spectrum of opportunities, I \\'as at last able to understand my o\\'n educational experiences, more clearly. I discovered ho\\' d\.~ply I internalized the racism, sexism and class discrimination, I submitted to in my history as a student. Becoming a\\'are about the social forc\.~ at "'ork \\'ithin my day to day life has provided me \\'ith instruments \\'hich I can usc to examine and respond to these inequities as I confront them in th~ future. This \,'ork exists as a serk'S of responses and further av~nues for investigation on some themes I first began to explor~, albeit very tentati\'~ly, during my first incarnation as a graduate student and so though the h\'o bound volum~s rna-\' one da.v sit si.d~ b\' s id~ on the bookshelf, th~\-' exist in the context of my life as a set of brackets surrounding a series of qUl'Stions about being a \\'Onlan, a teachcr and an artist.

An examination of the mediation process as it is used to resolve sexual harassment complaints in Canadian universities /

The ways in which the process of mediation affected those involved in the resolution of sexual harassment complaints in Canadian universities were explored. Questionnaires were sent to forty- six Canadian universities and interviews were conducted with fifteen advisors. An analysis of the twenty- two questionnaires returned indicated that mediation was utilized in 11% of the sexual harassment complaints and effected a successful resolution in 67% of these. Both complainants and those con^lained against were reported to have spoken more favourably than unfavourably about the process and outcome of mediation. Questionnaire respondents in general found mediation a slightly less than satisfactory method of complaint resolution. Those respondents who had successfully used mediation; however, describe its usefulness within a university context.

Metabolite changes during Riesling icewine fermentation when yeast micronutrients are used /

Icewine is an intensely s\veet dessert \vine fermented from the juice of naturally frozen grapes. Icewine fermentation poses many challenges such as failure to reach desired ethanol levels and production of high levels of volatile acidity in the fonn of acetic acid. This study investigated the impact of micronutrient addition (GO-FERM® and NATSTEP®) during the rehydration stage of the commercial \vine yeast Saccharomyces cerevisiae KI-VIII6 during Ice\vine fermentation. Sterile-filtered and unfiltered Riesling Ice\vine juice was inoculated \vith yeast rehydrated under four different conditions: in water only; with GO-FERM®; with NATSTEP®; or the combination of both micronutrient products in the rehydration water. Using sterile-filtered Icewine juice, yeast rehydration had a positive impact of reducing the rate of acetic acid produced as a function of sugar consumed, reducing the ratio of acetic acid/ethanol and reducing the ratio of acetic acid/glycerol. In the sterile-filtered fermentation, yeast rehydrated with micronutrients generated 9-times less acetic acid per gram of sugar in the first 48 hours compared to yeast rehydrated only \vith water and resulted in a 17% reduction in acetic acid in the final \vine \vhen normalized to sugar consumed. However, the sterile-filtered fermentations likely became stuck due to the overc1arification of the juice as evidenced from the low sugar consumption (117 gIL) that could not be completely overcome by the micronutrient treatments (144 gIL sugar consumed) to reach a target ethanol of IO%v/v. Contrary to \vhat \vas observed in the sterile-filtered treatements, using unfiltered Ice\vine juice, yeast micronutrient addition had no significant impact of reducing the rate of acetic acid produced as a function of sugar consumed, reducing the ratio of acetic acid/ethanol and reducing the ratio of acetic acid/glycerol. However, in the unfiltered fermentation, micronutrient addition during yeast rehydration caused a reduction in the acetic acid produced as a function of sugar consumed up to 150 giL sugar consumed.. In contrast to the sterile-filtered fermentations, the unfiltered fermentations did not become stuck as evidenced from the higher sugar consumption (l47-174g1L). The largest effects of micronutrient addition are evident in the first two days of both sterile and unfiltered fermentations.

Developing and nurturing professional learning communities: principles used by elementary administrators /

This study examined the strategies used by elementary school principals to facilitate and nurture the development of professional learning communities (PLC) within their school settings. Using a reputational sample of administrators whose schools were demonstrating observable characteristics of PLCs, this study documented and described the strategies and actions taken by the principals to move their schools forward. Data collection included the use of open-ended interviews as well as observations capturing the means by which the principals addressed the areas of culture, processes, and structures within their school setting. A grounded theory approach to data analysis uncovered 4 guiding principles used by the principals to facilitate the development of the PLCs within their school: (a) protecting the purpose; (b) attending to relationships; (c) sharing the responsibility; and (d) valuing the journey. The guiding principles were used by each administrator to anchor the decisions they made and develop responsive, contextspecific strategies to support the PLC at their school. The results highlighted the complex role of the principal and the supports required to tackle the difficult work of facilitating PLCs.

Development and characterization of concentric capillary nebulizer used in inductively coupled plasma analysis /

A simple, low-cost concentric capillary nebulizer (CCN) was developed and evaluated for ICP spectrometry. The CCN could be operated at sample uptake rates of 0.050-1.00 ml min'^ and under oscillating and non-oscillating conditions. Aerosol characteristics for the CCN were studied using a laser Fraunhofter diffraction analyzer. Solvent transport efficiencies and transport rates, detection limits, and short- and long-term stabilities were evaluated for the CCN with a modified cyclonic spray chamber at different sample uptake rates. The Mg II (280.2nm)/l\/lg 1(285.2nm) ratio was used for matrix effect studies. Results were compared to those with conventional nebulizers, a cross-flow nebulizer with a Scott-type spray chamber, a GemCone nebulizer with a cyclonic spray chamber, and a Meinhard TR-30-K3 concentric nebulizer with a cyclonic spray chamber. Transport efficiencies of up to 57% were obtained for the CCN. For the elements tested, short- and long-term precisions and detection limits obtained with the CCN at 0.050-0.500 ml min'^ are similar to, or better than, those obtained on the same instrument using the conventional nebulizers (at 1.0 ml min'^). The depressive and enhancement effects of easily ionizable element Na, sulfuric acid, and dodecylamine surfactant on analyte signals with the CCN are similar to, or better than, those obtained with the conventional nebulizers. However, capillary clog was observed when the sample solution with high dissolved solids was nebulized for more than 40 min. The effects of data acquisition and data processing on detection limits were studied using inductively coupled plasma-atomic emission spectrometry. The study examined the effects of different detection limit approaches, the effects of data integration modes, the effects of regression modes, the effects of the standard concentration range and the number of standards, the effects of sample uptake rate, and the effect of Integration time. All the experiments followed the same protocols. Three detection limit approaches were examined, lUPAC method, the residual standard deviation (RSD), and the signal-to-background ratio and relative standard deviation of the background (SBR-RSDB). The study demonstrated that the different approaches, the integration modes, the regression methods, and the sample uptake rates can have an effect on detection limits. The study also showed that the different approaches give different detection limits and some methods (for example, RSD) are susceptible to the quality of calibration curves. Multicomponents spectral fitting (MSF) gave the best results among these three integration modes, peak height, peak area, and MSF. Weighted least squares method showed the ability to obtain better quality calibration curves. Although an effect of the number of standards on detection limits was not observed, multiple standards are recommended because they provide more reliable calibration curves. An increase of sample uptake rate and integration time could improve detection limits. However, an improvement with increased integration time on detection limits was not observed because the auto integration mode was used.

A tour from the City of New-York, to Detroit, in the Michigan Territory, made between the 2d of May and the 22d of September, 1818 : the tour extends from New-York, by Albany, Schenectady, and Utica to Sacket's Harbor, and thence throught Lake Ontario, to St. Lawrence river, and down that stream to Hamilton village. Thence along both banks of the St. Lawrence, from Hamilton to the Thousand Islands; thence to Sacket's Harbor by water; from that place by the route of great Sodus, Geneva, Cananaigua and Batavia, to Buffalo; and from thence to Black Rock, Fort Erie, the Falls of Niagara, Queenston, Lewiston, and the memorable fields of Bridgewater and Chippewa after viewing the interesting place of Niagara, the author traversed the south shore of Lake Erie to the City of Detroit, and visited in the latter range, Dunkirk, Erie, Cleveland, Sandusky, and other places of less note. The tour is accompanied with a map upon which the route will be designated; a particular map of the Falls andRiver of Niagara, and the environs of the City of Detroit /

Errata slip inserted.

The effects of postural threat on cognitive strategies used to maintain upright stance

It is well established that postural threat modifies postural control, although little is known regarding the underlying mechanism(s) responsible. It is possible that changes in postural control under conditions of elevated postural threat result from alterations in cognitive strategies. The purpose of this study was to determine the influence of elevated postural threat on cognitive strategies and to determine the relationship between postural control, psychological, and cognitive measures. It was hypothesized that elevated postural threat would cause a shift to more conscious control of posture. It was also expected that a relationship between fear of falling and postural control would exist that could be explained by changes in conscious control of posture. Forty-eight healthy young adults stood on a force plate at two different surface heights: ground level (LOW) and 3.2m above ground level (HIGH). Center of pressure (COP) summary measures calculated to quantify postural control were the mean position (AP-COP MP), root mean square (AP-COP RMS) and mean power frequency (AP-COP MPF) in the anteriorposterior direction. Trunk sway measures calculated in the pitch direction were trunk angle and trunk velocity. Psychological measures including perceived balance confidence, perceived fear of falling, perceived anxiety, and perceived stability were self reported. As a physiological indicator of anxiety, electrodermal activity was collected. The cognitive strategies assessed were movement reinvestment and attention focus. A modified state-sp-ecific version of the Movement Specific Reinvestment Scale was used to measure conscious motor processing (CMP) and movement self-consciousness (MSC). An attention focus questionnaire was developed to assess the amount of attention directed to internal and external sources. An effect of postural threat on cognitive strategies was observed as participants reported more conscious control and a greater concern or worry about their posture at the HIGH postural threat condition as well as an increased internal and external focus of attention. In addition changes in postural control, psychological, and physiological measures were found. The participants leaned away from the edge of the platform, the frequency of their postural adjustments increased, and the velocity of their trunk movements increased. Participants felt less confident, more fearful, more anxious, and less stable with an accompanying increase in physiological anxiety. Significant correlations between perceived anxiety, AP-COP MP, and cognitive measures revealed a possible relationship that could be mediated by cognitive measures. It was found that with greater conscious motor processing, more movement self-consciousness, and a greater amount of attention focused externally there was a larger shift of the mean position away from the edge of the platform. This thesis provides evidence that postural threat can influence cognitive strategies causing a shift to more conscious control of movement which is associated with leaning away from the edge of the platform. Shifting the position of the body away from the direction of the postural threat may reflect a cognitive strategy to ensure safety in this situation due to the inability to employ a stepping strategy when standing on an elevated platform.

The Relationship between athlete motivation, strategies used to cope with stress and affective outcomes in Canadian University athletes

Motivation to perform and coping with stress during performance are key factors in determining numerous outcomes of sporting performance. However, less evidence is in place assessing their relationship. The aim of this investigation was to assess the relationship between athlete motivation and the coping strategies used to deal with stress during their sporting performance, as well as the relationship between motivation and affect and coping and affect. One hundred and forty five university athletes completed questionnaires. Regressions revealed that two of the three self determined levels of motivation, identified and integrated regulation, predicted increased task-oriented coping strategies. Two of the three non-self determined levels of motivation, amotivation and external regulation, significantly predicted disengagement-oriented coping. Additionally, intrinsic motivation and task-oriented coping predicted increase positive affect. Increased disengagement-oriented coping predicted decreased positive affect. Disengagement-oriented coping significantly predicted increased negative affect. These findings increase understanding of motivations role in predicting athletes coping.

Investigation of motivation strategies used by school teachers for workplace engagement

The purpose of this study was to explore the strategies that elementary school teachers use to be engaged in their work. Participation was solicited from a random sample of schools stratified by location (i.e., urban, inner city, and rural) of a large school board. The study used an anonymous quantitative/qualitative questionnaire. The survey tool was based upon Kahn's (1990) psychological engagement framework, which presents the foundation of availability of self, meaningfulness of work, and safety while at work. Forty-one surveys were analyzed descriptively including a subgroup of self-rated highly engaged teachers. Teachers tended to favour physical and emotional strategies compared to cognitive type strategies, with the exception of the highly engaged subgroup. The theme of preferred strategies reflected a setting outside the school/workplace, that is, a preference for horne based strategies. The study's main contribution highlights the teachers' sense of importance for physical and emotional health in a profession that is heavily focused in the cognitive domain. This may influence administrative and teacher discourse regarding workplace engagement with strategies to help reduce stress and to maintain and increase teacher engagement.