Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials

Background: As trials of 5 years of tamoxifen in early breast cancer mature, the relevance of hormone receptor measurements (and other patient characteristics) to long-term outcome can be assessed increasingly reliably. We report updated meta-analyses of the trials of 5 years of adjuvant tamoxifen.
Methods: We undertook a collaborative meta-analysis of individual patient data from 20 trials (n=21457) in early breast cancer of about 5 years of tamoxifen versus no adjuvant tamoxifen, with about 80% compliance. Recurrence and death rate ratios (RRs) were from log-rank analyses by allocated treatment.
Findings: In oestrogen receptor (ER)-positive disease (n=10 645), allocation to about 5 years of tamoxifen substantially reduced recurrence rates throughout the first 10 years (RR 0.53 [SE 0.03] during years 0-4 and RR 0.68 [0.06] during years 5-9 [both 2p<0.00001]; but RR 0.97 [0.10] during years 10-14, suggesting no further gain or loss after year 10). Even in marginally ER-positive disease (10-19 fmol/mg cytosol protein) the recurrence reduction was substantial (RR 0.67 [0.08]). In ER-positive disease, the RR was approximately independent of progesterone receptor status (or level), age, nodal status, or use of chemotherapy. Breast cancer mortality was reduced by about a third throughout the first 15 years (RR 0.71 [0.05] during years 0-4, 0.66 [0.05] during years 5-9, and 0.68 [0.08] during years 10-14; p<0.0001 for extra mortality reduction during each separate time period). Overall non-breast-cancer mortality was little affected, despite small absolute increases in thromboembolic and uterine cancer mortality (both only in women older than 55 years), so all-cause mortality was substantially reduced. In ER-negative disease, tamoxifen had little or no effect on breast cancer recurrence or mortality.
Interpretation: 5 years of adjuvant tamoxifen safely reduces 15-year risks of breast cancer recurrence and death. ER status was the only recorded factor importantly predictive of the proportional reductions. Hence, the absolute risk reductions produced by tamoxifen depend on the absolute breast cancer risks (after any chemotherapy) without tamoxifen.
Funding: Cancer Research UK, British Heart Foundation, and Medical Research Council.

Effects of species loss and nutrients on biodiversity:Anthropogenic impacts on marine biodiversity: effects of enhanced nutrients and species loss on the biodiversity and ecosystem functioning of rocky shores

The focus of this study was to disentangle the effects of multiple stressors on biodiversity, ecosystem functioning and stability. This project examined the effects of anthropogenic increased nutrient loads on the diversity of coastal ecosystems and the effects of loss of species on ecosystem functioning. Specifically, the direct effect of sewage outfalls on benthic communities was assessed using a fully replicated survey that incorporated spatial and temporal variation. In addition, two field experiments examined the effects of loss of species at multiple trophic levels, and tested for potential interactive effects with enhanced nutrient concentration conditions on benthic assemblage structure and ecosystem functioning. This research addressed priority issues outlined in the Biodiversity Knowledge Programme for Ireland (2006) and also aimed to deliver information relevant to European Union (EU) directives (the Water Framework Directive [WFD], the Habitats Directive and the Marine Strategy Framework Directive).

Environmental context determines multi-trophic effects of consumer species loss

Loss of biodiversity and nutrient enrichment are two of the main human impacts on ecosystems globally, yet we understand very little about the interactive effects of multiple stressors on natural communities and how this relates to biodiversity and ecosystem functioning. Advancing our understanding requires the following: (1) incorporation of processes occurring within and among trophic levels in natural ecosystems and (2) tests of context-dependency of species loss effects. We examined the effects of loss of a key predator and two groups of its prey on algal assemblages at both ambient and enriched nutrient conditions in a marine benthic system and tested for interactions between the loss of functional diversity and nutrient enrichment on ecosystem functioning. We found that enrichment interacted with food web structure to alter the effects of species loss in natural communities. At ambient conditions, the loss of primary consumers led to an increase in biomass of algae, whereas predator loss caused a reduction in algal biomass (i.e. a trophic cascade). However, contrary to expectations, we found that nutrient enrichment negated the cascading effect of predators on algae. Moreover, algal assemblage structure varied in distinct ways in response to mussel loss, grazer loss, predator loss and with nutrient enrichment, with compensatory shifts in algal abundance driven by variation in responses of different algal species to different environmental conditions and the presence of different consumers. We identified and characterized several context-dependent mechanisms driving direct and indirect effects of consumers. Our findings highlight the need to consider environmental context when examining potential species redundancies in particular with regard to changing environmental conditions. Furthermore, non-trophic interactions based on empirical evidence must be incorporated into food web-based ecological models to improve understanding of community responses to global change.

Investigation of the effect of simulated lens yellowing, transparency loss and refractive error on in vivo resonance Raman spectroscopy

To separately investigate the impact of simulated age-related lens yellowing, transparency loss and refractive error on measurements of macular pigment (MP) using resonance Raman spectroscopy.

Rod photoreceptor loss in Rho(-/-) mice reduces retinal hypoxia and hypoxia-regulated gene expression

PURPOSE. This study was conducted to evaluate whether regions of the retinal neuropile become hypoxic during periods of high oxygen consumption and whether depletion of the outer retina reduces hypoxia and related changes in gene expression.

METHODS. Retinas from rhodopsin knockout (Rho(-/-)) mice were evaluated along with those of wild-type (WT) control animals. Retinas were also examined at the end of 12-hour dark or light periods, and a separate group was treated with L-cis-diltiazem at the beginning of a 12-hour dark period. Hypoxia was assessed by deposition of hypoxyprobe (HP) and HP-protein adducts were localized by immunohistochemistry and quantified using ELISA. Also, hypoxia-regulated gene expression and transcriptional activity were assessed alongside vascular density.

RESULTS. Hypoxia was observed in the inner nuclear and ganglion cell layers in WT retina and was significantly reduced in Rho (-/-) mice (P < 0.05). Retinal hypoxia was significantly increased during dark adaptation in WT mice (P < 0.05), whereas no change was observed in Rho(-/-) or with L-cis-diltiazem-treated WT mice. Hypoxia-inducible factor (HIF)-1 alpha DNA-binding and VEGF mRNA expression in Rho(-/-) retina was significantly reduced in unison with outer retinal depletion (P < 0.05). Retina from the Rho(-/-) mice displayed an extensive intraretinal vascular network after 6 months, although there was evidence that capillary density was depleted in comparison with that in WT retinas.

CONCLUSIONS. Relative hypoxia occurs in the inner retina especially during dark adaptation. Photoreceptor loss reduces retinal oxygen usage and hypoxia which corresponds with attenuation of the retinal microvasculature. These studies suggest that in normal physiological conditions and diurnal cycles the adult retina exists in a state of borderline hypoxia, making this tissue particularly susceptible to even subtle reductions in perfusion.

Recurrence of Urothelial Carcinoma of the Bladder: A Role for Insulin-Like Growth Factor-II Loss of Imprinting and Cytoplasmic E-Cadherin Immunolocalization

Purpose:This study documents the frequency of insulin-like growth factor-II (IGF-II) loss of imprinting (LOI) in a series of 87 bladder tissues. E-cadherin (CDH1) immunolocalization was also investigated due to the known redistribution of this adherence protein to the cytoplasm following exogenous exposure to IGF-II.
Experimental Design: Informative IGF-II cases were identified following DNA-PCR amplification and subsequent sequencing of the transcribable ApaI RFLP in exon 9 of IGF-II. Similar approaches using primer-specific cDNA templates identified the imprinting status of IGF-II in these informative cases. CDH1cellular localization was assessed on a tissue microarray platform of 114 urothelial carcinoma of the bladder (UCB) cases (70 pTanoninvasive and 44 pT1laminapropria invasive) using the commercially available Novocastra antibody.
Results: IGF-IILOI was evident in 7 of17 (41%) UCB tumors and 4 of11 (36%) tumor-associated normal urothelial samples.Two of four pT1grade 3 tumors, the subject of much debate concerning their suitability for radical cystectomy, showed LOI at the IGF-II locus. In those tumors showing IGF-II LOI, 4 of 7 (57%) displayed concomitant CDH1cytoplasmic staining. In contrast, only 3 of 10 (30%) IGF-IImaintenance ofimprinting tumorshad concomitant CDH1cytoplasmiclocalization. UCB cell lines displaying cytoplasmic CDH1immunolocalization expressed significantly higher levels of IGF-II (CAL29, HT1376, and RT112) compared with RT4, a cell line displaying crisp membranous CDH1staining. Finally, cytoplasmic CDH1staining was an independent predictor of a shorter time to recurrence independent of tumor grade and stage.
Conclusions: We suggest that CDH1 cytoplasmic immunolocalization as a result of increased IGF-II levels identifies those nonmuscle invasive presentations most likely to recur and therefore might benefit from more radical nonconserving bladder surgery

Understanding Racial Tensions in Northern Ireland: Threat, Paranoia and the Fear of Loss

This paper will explore the development of increased group tensions in Northern Ireland
over the past decade with a special emphasis being placed upon rising racial tensions in cities such
as Belfast and Lisburn. The paper will analyse why Northern Ireland has been described as the new
race-hate capital of Europe and, through a case-study of Loyalism, will argue that if this growth in
racist sentiment is to be prevented, more needs to be done to understand the causes of such feeling,
particularly within loyalist working-class areas. I will argue that society as a whole needs to address
the fears and anxieties of those that perceive themselves to be under threat from the recent increase
in immigration or else we risk creating a new cause célèbre for those that would seek to extend the
lifetime of our paramilitary organisations. Moreover, at a time when loyalist communities feel politically
alienated and lacking representation, there is a real danger of British far-right groups exploiting the
situation and making long-term political capital.

Quantitative and qualitative trapping of arsines deployed to assess loss of volatile arsenic from paddy soil

Arsenic volatilization in the environment is thought to be an important pathway for transfer from terrestrial pools to the atmosphere. However, this phenomenon is not well characterized due to inherent sampling issues in trapping, quantifying and qualifying these arsine gases; including arsine (AsH(3)), monomethyl arsine (MeAsH(2)), dimethyl arsine (Me(2)AsH) and trimethyl arsine (TMAs). To quantify and qualify arsines in air we developed a novel technique based on silver nitrate impregnated silica gel filled tubes. The method was characterized by measuring the recovery of trapped arsines after elution of this chemo-trap with hot boiling diluted nitric acid. Results from three separate experiments, measured by ICP-MS, showed that the method is reproducible and quantitative. Arsine species recovery ranged from 80.1 to 95.6%, with limit of detection as low as 3.8 ng per chemo-trap tube. Moreover, HPLC-ICP-MS analysis of hot boiling water eluted traps showed that the corresponding oxy ions of the arsines were formed with the As-C bonds of the molecule intact, hence, allowing qualification of trapped arsine species. A microcosm study examining volatile arsenic evolution from field contaminated Bangladeshi paddy soils (24.2 mg/kg arsenic) was used to show the application of silver nitrate chemo-trapping approach. Traps were placed on the inlet and the outlet of microcosms containing the soils that were either (cattle derived) manured or not, or flooded or not, in a factorial design. The headspace was purged with air at a flow rate of 12 mL/min. Results showed that as much as 320 ng of arsenic (0.014% of total soil content) could be emitted in a 3 week period for manured and flooded soils and that TMAs was the dominant species evolved, with lesser quantities of Me(2)AsH. No volatile arsenic evolution was observed for nonmanured treatments, and arsine release from the nonflooded, manured treatment was much less than the flooded treatment.

A 76-84 GHz SiGe power amplifier array employing low-loss four-way differential combining transformer

This paper presents holistic design of a novel four-way differential power-combining transformer for use in millimeter-wave power-amplifier (PA). The combiner with an inner radius of 25 µm exhibits a record low insertion loss of 1.25 dB at 83.5 GHz. It is designed to simultaneously act as a balanced-to-unbalanced converter, removing the need for additional BALUNs typically required in differential circuits. A complete circuit comprised of a power splitter, two-stage differential cascode PA array, a power combiner as well as input and output matching elements was designed and realized in SiGe technology with f/f 170/250 GHz. Measured small-signal gain of at least 16.8 dB was obtained from 76.4 to 85.3 GHz with a peak 19.5 dB at 83 GHz. The prototype delivered 12.5 dBm output referred 1 dB compression point and 14 dBm saturated output power when operated from a 3.2 V dc supply voltage at 78 GHz.

Ultrafast low-loss 42-70 GHz differential SPDT switch in 0.35 μm SiGe technology

This paper presents an ultrafast wideband low-loss single-pole double-throw (SPDT) differential switch in 0.35 µ m SiGe bipolar technology. The proposed topology adopting current-steering technique results in a total measured switching time of 75 ps , which suggests a maximum switching rate of 13 Gb/s, the fastest ever reported at V-band. In addition, the switch exhibits an insertion loss lower than 1.25 dB and an isolation higher than 18 dB from 42 GHz to 70 GHz. © 2006 IEEE.

40-70 GHz 13 Gbps 1-dB loss SPST and SPDT differential switches in 0.35 μm SiGe technology

This paper presents the design and characterization of ultrafast wideband low-loss single-pole single-throw (SPST) and single-pole double-throw (SPDT) differential switches. The SPDT switch exhibits insertion loss of lower than 1.25 dB from 42 to 70 GHz and isolation of better than 20 dB from 40 to 65 GHz. Similar low-loss and broadband characteristics are also observed from the measured SPST switch. The proposed switch topologies adopting current-steering technique and implemented in 0.35 µm SiGe bipolar technology result in a switching time of only 75 ps. This suggests a maximum switching speed of 13 Gbps, the fastest ever reported at V-band.