Randomized trial of breast self-examination in Shanghai: methodology and preliminary results

BACKGROUND: The efficacy of breast self-examination in helping to reduce mortality from breast cancer has not been rigorously demonstrated. PURPOSE: To assess efficacy, a large, randomized trial was initiated in Shanghai, China. METHODS: From October 1989 to October 1991, 267040 current and retired female employees associated with 520 factories in the Shanghai Textile Industry Bureau were randomly assigned on the basis of factory to either a self-examination instruction group (133375 women) or a control group (133665 women). The women were born within the period from 1925 through 1958. Women in the instruction group were given intensive training in breast self-examination, including the use of silicone breast models and personalized instruction, plus two subsequent reinforcement sessions and multiple reminders to practice the technique. Women in the control group were asked to attend training sessions on the prevention of low back pain. All women have been followed for the development of breast diseases and for death from breast cancer. RESULTS: A high level of participation during the first 4-5 years of the trial was documented among women in the instruction group. Randomly sampled women in this group demonstrated greater proficiency in detecting lumps in breast models than did randomly sampled women in the control group. Approximately equal numbers of breast cancers were detected in the two groups (331 in the instruction group and 322 in the control group) through 1994, which is the last year for which case-finding efforts have been completed. The breast cancers detected in the instruction group were not diagnosed at an appreciably earlier stage or smaller size than those in the control group. More benign breast lesions were detected in the instruction group than in the control group (1457 versus 623, respectively), suggesting a higher index of suspicion for women who received training. Cumulative breast cancer mortality rates through 5 years from entry into the study were nearly equivalent for the two groups. CONCLUSIONS: Breast self-examination has not led to a reduction in mortality from breast cancer in this study cohort in the first several years since the trial began. A shift toward the diagnosis of disease at a less advanced stage in women given instruction has also not been demonstrated. Longer follow-up of participants in this trial is required before final assessment can be made of the efficacy of breast self-examination. IMPLICATIONS: At this time, there is insufficient evidence to recommend for or against the teaching of breast self-examination.     

Electrical properties of N2O/NH3 plasma grownoxynitride on strained-Si

Growth of ultrathin (<100 Å) oxynitride on strained-Si using microwave N₂O and NH₃ plasma is reported. X-ray photoelectron spectroscopy (XPS) results indicate a nitrogen-rich layer at the strained-Si/SiO₂ interface. The electrical properties of oxynitrides have been characterized using a metal-insulator-semiconductor (MIS) structure. A moderately low value of insulator charge density (6.1×10¹⁰ cm^-2) has been obtained for NH₃ plasma treated N₂O oxide sample. Nitrided oxide shows a larger breakdown voltage and an improved charge trapping properties under Fowler-Nordheim (F-N) constant current stress     

The infrared infiltration and joining of advanced material

JOM - Infrared processing is a newly developed technique for materials processing. Key features include rapid processing, simplicity, and low cost. Because of the rapid processing, very little...     

Optimal virtual topologies for one-to-many communication in WDM paths and rings

In this paper we examine the problem of constructing optimal virtual topologies for one-to-many communication in optical networks employing wavelength-division multiplexing. A virtual topology is a collection of optical lightpaths embedded in a physical topology. A packet sent from the source node travels over one or more lightpaths en route to its destination. Within a lightpath, transmission is entirely optical. At the terminus of a lightpath the data is converted into the electronic domain where it may be retransmitted on another lightpath toward its destination. Since the conversion of the packet from the optical to the electronic domain introduces delays and uses limited physical resources, one important objective is to find virtual topologies which minimize either the maximum or average number of lightpaths used from the source to all destination nodes. Although this problem is NP-complete in general, we show that minimizing the maximum or average number of lightpaths in path and ring topologies can be solved optimally by efficient algorithms.     

Vision-based obstacle detection for rotorcraft flight

The ability of rotorcraft to fly at low altitude is hindered by the high pilot workload required to avoid obstacles. The development of automation tools that can detect obstacles in the rotorcraft flight path, warn the crew, and interact with the guidance system to avoid detected obstacles would significantly reduce pilot workload and increase safety. This article describes an obstacle detection approach based on feature tracking and recursive range estimation that takes into account the characteristics of rotorcraft flight. The merits and weaknesses of the approach are discussed using image sequences from the laboratory and from flight. © 1992 John Wiley & Sons, Inc.