Risk-based recommendations for mammographic screening for women in their forties

PURPOSE: To develop risk-based recommendations for mammographic screening for women in their 40s that take into account the woman's age, race, and specific risk factors. METHODS: We assumed that regular mammographic screening is justified for a 50-year-old woman, even one with no risk factors, and that a younger woman with an expected 1-year breast cancer incidence rate as great or greater than that of a 50-year-old woman with no risk factors would benefit sufficiently to justify regular screening. Recommendations under this criterion were based on age- and race-specific breast cancer incidence rates from the National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End Results (SEER) Program; assessments of risk factors from the Breast Cancer Detection and Demonstration Project (BCDDP); and reports in the literature. RESULTS: Two methods, the exact-age procedure (EAP) and the grouped-age procedure (GAP), were developed. The less precise GAP only requires following a flow diagram. The proportion of white women recommended for screening by the EAP ranges from 10% for 40-year-old women to 95% for 49-year-old women, and the corresponding percentages for black women are 16% and 95%. The assumptions that underlie the guidelines are discussed critically. CONCLUSION: For women or physicians who prefer an individualized approach in deciding whether to initiate regular mammographic screening in the age range of 40 to 49 years, the present report offers recommendations based on individualized risk-factor data and clearly stated assumptions that have an empiric basis. These recommendations can be used to facilitate the counseling process.     

Evidence for interaction between transmembrane segments in assembly of Kv1.3

Previously, we showed that the N-terminal recognition domain (T1) of Kv1.3 was not required for assembly of functional channels [Tu et al. (1996) J. Biol. Chem. 271, 18904-18911]. Moreover, specific Kv1.3 peptide fragments including regions of the central core are able to inhibit expression of current produced from a channel lacking the T1 domain, Kv1.3(T1-). To elucidate the mechanism whereby Kv1.3 peptide fragments suppress Kv1.3(T1-) current, we have studied the ability of peptide fragments containing the transmembrane segments S1, S1-S2, or S1-S2-S3 to physically associate with the Kv1.3(T1-) polypeptide subunit in vitro in microsomal membranes. Using c-myc (9E10) epitope-labeled peptide fragments and anti-myc antibody as well as antisera to the Kv1.3 C-terminus, we now demonstrate specific association of these peptide fragments with Kv1.3(T1-). Association of peptide fragments with Kv1.3(T1-) was correlated with integration of both proteins into the membrane. Furthermore, the relative strength and kinetics of this association directly correlated with the ability of fragments to suppress Kv1.3(T1-) current. The rate-limiting step in the sequential synthesis, integration, and formation of a complex was the association of integrated polypeptides within the plane of the lipid bilayer. These results strongly suggest that the physical association of transmembrane segments provides the basis for suppression of K+ channel function by K+ channel peptide fragments in vivo. Moreover, the S1-S2-S3 peptide fragment potently suppressed full-length Kv1.3, thus implicating a role for the S1-S2-S3 region of Kv1.3 in the assembly of the Kv1.3 channel. We refer to these putative association sites as IMA (intramembrane association) sites.     

Detection of melanoma by monitoring the intracellular fluorescein fluorescence polarization changes in lymphocytes

The effectiveness of detecting melanoma by measuring the intracellular fluorescein fluorescent polarization (IFFP) of patients' SCM (structuredness of the cytoplasmic matrix)-responding lymphocytes was examined. SCM-responding lymphocytes from 46 melanoma patients and 32 healthy volunteers were labeled with fluorescein diacetate and challenged with different stimuli, and the resulting polarization was determined. The polarizations (P) obtained upon stimulation with nothing (P-0), encephalitogenic factor (P-EF), phytohaemagglutinin (P-PHA), or melanoma antigen (P-MEL), and the ratios RR(ef) (P-EF/P-PHA) and RR(mel) (P-MEL/P-PHA) were lower for SCM-responding lymphocytes from the patients as a group than for those of the controls. The specificity and sensitivity of the IFFP tests (using cutoff values) to detect melanoma were 90.6 and 73.9%, respectively. The IFFP tests may facilitate the discrimination between melanoma patients and healthy subjects, and may be used in follow-up of patients with melanoma.     

THE FEDERAL ROLE IN ENERGY R&D

This paper documents and analyzes recent trends in Federal energy research and development programs. In light of the marketplace philosophy of the present Administration, the possible benefits of a strong Federal research program versus the potential advantages of relying on private sector research programs to develop new technology alternatives are analyzed in some detail. The impacts of the Reagan budget cuts and other initiatives on several major energy programs, including nuclear power, photovoltaics, and conservation, are also analyzed. This analysis reveals some of the difficulties inherent in attempting to project the consequences of particular policy decisions in a complex and changing environment, and identifies some of the problems of trying to evaluate the success of particular programs or actions on a limited time scale.     

Psychogenic-organic symptom overlap: Considerations for nonmedical psychotherapists.

Discusses common presenting complaints and those of emergent significance that have an organic etiology. The following categories are discussed: head, eyes, ears, throat, neck, cardiac, respiratory, gastrointestinal, genito-urinary, musculoskeletal, and neurologic complaints. It is suggested that many therapists lack adequate medical information to suspect the presence of organic problems when symptoms are indistinguishable from psychogenic/psychosomatic problems. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of stochastic approaches to the transportation problem:a case study

The objective of this case study is to provide insight to practitioners about the methodology of using the space-time autoregressive integrated moving average (STARIMA) class of models to formulate stochastic demand of the transportation problem. While providing insight, two other methods-expected value (EV) and stochastic approximation (SA)-are also employed to formulate demand. A comparative evaluation of the methods using brewery data for the distribution of four products from five production plants to 64 distribution centers is presented. It is shown that the demand characterized by the STARIMA approach results in a lower total cost of transportation. This occurs because the STARIMA approach results in better forecasts. Based upon the case study, the cost analysis indicated that the STARIMA method when used without (with) updating resulted in a 9.49% (10.5%) increase in the Company's net profit as compared with the SA method. Similarly, the STARIMA approach when used without (with) updating resulted in an 11.36% (12.37%) increase in the net profit as compared with the EV method. For the STARIMA approach, computations for a large size problem are shown to be identical to those of the deterministic transportation problem given the demand forecasts. Extra computation effort for producing STARIMA forecasts are easily justified in terms of the increased profit margin