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Purpose: Women with a remaining lifetime risk of breast cancer of ≥25%, estimated using the International Breast Cancer Intervention Study (IBIS) model, were eligible for the High Risk Ontario Breast Screening Program. This study examined the performance of IBIS 10-year risk estimates in the program., Methods: This retrospective study included 7487 women aged 30 to 69 years referred to the High Risk Ontario Breast Screening Program between July 1, 2011, and December 31, 2016, with follow-up until December 31, 2018. Model calibration and discrimination were assessed. Analyses were conducted overall and stratified by age (< or ≥50 years). Different 10-year risk thresholds were compared with the current eligibility criteria., Results: Overall, IBIS overestimated the risk of breast cancer with an expected vs observed case ratio of 1.17 (95% CI = 1.04-1.35). Overestimation was highest in women aged 50 to 69 years (expected vs observed case ratio = 1.29, 95% CI = 1.03-1.69) and for those in the top quartile of risk. Overall discrimination was fair with a concordance statistic of 0.66 (95% CI = 0.63-0.70). Furthermore, when using different 10-year risk eligibility thresholds, most cases would have been missed in the 30 to 49 age group using the 8% 10-year risk threshold, whereas relatively few women aged 50 to 69 would have been ineligible at any of the thresholds examined., Conclusion: We found that IBIS overestimated the risk of breast cancer in this screening cohort but had adequate discrimination. Age-specific risk thresholds should be considered to optimize the program eligibility criteria., Competing Interests: Conflict of Interest The authors declare no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Previous research has reported negative health consequences and poor academic achievement among college students who are food insecure. It is unknown if students with food insecurity's experiences qualitatively differ from students who are food secure., Objective: To qualitatively evaluate experiences of students who are food secure and food insecure with internal and external factors related to food insecurity., Design: Trained interviewers conducted in-person qualitative interviews from February to August 2018 to gain insights about eating patterns, food environment, financial situation, and ideas for addressing food insecurity on college campuses with students who are food secure and food insecure., Participants and Setting: Students from three universities in the western United States (N = 58) who were classified as food secure (n = 28) and food insecure (n = 30) using the US Department of Agriculture's 6-item Food Security Module participated in this study., Statistical Analyses Performed: Interviews were recorded and transcribed verbatim. Data were analyzed using a conventional content analysis. A random sample of transcripts were independently coded to determine interrater reliability. Researchers divided transcripts for final coding and overarching themes were discussed. Descriptive statistics were used., Results: Students who were both food secure and food insecure obtained food from similar sources (eg, grocery stores); had unexpected expenses that led to financial constraints; indicated transportation barriers altered the amount or package size of food purchased; and reported similar knowledge, attitudes, use, and familial history of food assistance. Students with food insecurity uniquely reported prioritizing rent or other living expenses over food, and when funds were low, reducing food intake, experiencing a variable food supply throughout the month, or using strategies like donating plasma or selling possessions to enhance financial stability., Conclusions: This study helps nutrition and dietetics practitioners better understand how college students' experiences with factors related to food insecurity differ by food security status. Future quantitative research is needed to confirm the coping strategies identified among students with food insecurity in this study., (Copyright © 2023 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Evidence is lacking regarding the efficacy of Optiflow transnasal humidified rapid-insufflation ventilator exchange (THRIVE™) in obese patients. We compared the impact of this technique at 70 L min -1 with 4 L min -1 oxygen via nasal prongs on safe apnoea times of paralysed obese patients., Methods: We randomised adults with a BMI >35 kg m -2 undergoing elective bariatric surgery. While apnoeic and paralysed, Group T received 70 L min -1 oxygen via Optiflow THRIVE™. Group N received nasal prong oxygen at 4 L min -1 . The primary outcome was time to SpO 2 ≤95% while apnoeic, with a 360 s cut-off. This was analysed by applying a time-to-event analysis., Results: Forty-two patients were included. The median (inter-quartile range) BMI was 44.8 kg m -2 (40.0-50.0) in Group T and 42.0 kg m -2 (39.3-45.1) in Group N. Median (inter-quartile range) time to SpO 2 ≤95% in Group T was 356 (165 to ≥360) s and in Group N, 210 (160-270) s. Using a survival analysis framework, median time-to-event in Group T was 356 s (95% confidence interval 165 s-upper limit not defined) and 210 s (95% confidence interval 160-242 s) (P=0.049) in Group N., Conclusions: Compared with oxygen delivered via nasal prongs at 4 L min -1 , oxygen delivery via Optiflow THRIVE™ at a flow rate of 70 L min -1 can prolong safe apnoea time, however, the results are statistically inconclusive. Optiflow THRIVE™ did decrease the rate of reduction in Pa o2 during apnoea., Clinical Trial Registration: ANZCTR 12618000445279., (Copyright © 2021 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Objectives: To obtain arm and finger measurements of women ≥32 weeks gestation to determine: the requirement for different arm cuff sizes; the suitability of available finger cuffs in this population; the best predictor of arm conicity; the frequency of cuff placement on the forearm or leg., Study Design: Prospective observational pilot study., Main Outcome Measures: Right and left mid-arm circumference (MAC) and to compare these to the recommended cuff sizes; right and left finger circumference; right and left arm conicity; the responses of women to a three-point Likert scale regarding cuff placement., Results: Measurements were obtained for 450 women at an Australian tertiary hospital with a median (IQR) gestation of 35.7 (34.0-37.0); 299 (66.4%) were Caucasian and 35 (7.8%) had gestational hypertension. The median (IQR) body mass index (BMI) was 29.6 kg/m 2 (26.2-33.4), range 18.0-62.2. Median (IQR) right MAC was 29.9 cm (27.4-33), range 19.6-53.2. Based on right MAC, 58 (12.9%) required a large cuff and 6 (1.3%) a thigh cuff. Maximum right finger circumference was 7.0 cm. BMI, weight and right MAC were positively correlated with right arm conicity: r = 0.51, 0.42 and 0.45, p < 0.001 for all. R 2 for each were 0.26, 0.17 and 0.20. Fourteen (3.1%) reported cuff placement on the forearm or leg., Conclusions: A small percentage of women are likely to be unsuited to traditional arm cuffs. Available finger-cuffs would suit this population. BMI could potentially be used to select women with cone-shaped arms for future studies of alternative devices., (Copyright © 2018 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Ductal carcinoma in situ (DCIS) is a precursor lesion of invasive ductal carcinoma (IDC) of the breast. To understand the dynamics of genomic alterations in this progression, we used four multicolor fluorescence in situ hybridization probe panels consisting of the oncogenes COX2, MYC, HER2, CCND1, and ZNF217 and the tumor suppressor genes DBC2, CDH1, and TP53 to visualize copy number changes in 13 cases of synchronous DCIS and IDC based on single-cell analyses. The DCIS had a lower degree of chromosomal instability than the IDC. Despite enormous intercellular heterogeneity in DCIS and IDC, we observed signal patterns consistent with a nonrandom distribution of genomic imbalances. CDH1 was most commonly lost, and gain of MYC emerged during progression from DCIS to IDC. Four of 13 DCISs showed identical clonal imbalances in the IDCs. Six cases revealed a switch, and in four of those, the IDC had acquired a gain of MYC. In one case, the major clone in the IDC was one of several clones in the DCIS, and in another case, the major clone in the DCIS became one of the two major clones in the IDC. Despite considerable chromosomal instability, in most cases the evolution from DCIS to IDC is determined by recurrent patterns of genomic imbalances, consistent with a biological continuum., (Copyright © 2012 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)

A 58-year-old white man with prostate-specific antigen (PSA) level of 6 ng/mL, a Gleason score of 6 (3+3), and T2a adenocarcinoma of the prostate underwent prostatectomy. On review of the pathology, the specimen contained a Gleason score of 8 (3+5) with other high-risk features. The patient had a persistently elevated postoperative PSA level and was placed on total androgen blockade. The PSA continued to increase, and the patient developed bone-only metastatic disease. The patient was treated with palliative external-beam radiation and samarium. Six months later, he presented with bilateral hearing loss and was found to have pathologic and radiographic evidence of metastatic prostate cancer to the external auditory canals. This was an unusual late finding. The patient died shortly afterward before completing palliative treatment to the area.

An immunocompetent 29-year-old male presented with an embolic stroke from an unusual primary cardiac lymphoma. The cardiac lesion consisted of a polypoid, left atrial, mural fibrin thrombus with anaplastic tumor cells lining the surface of the clot. Histologic, immunophenotypic, and molecular characterizations were consistent with a diagnosis of CD30+ large B-cell lymphoma with anaplastic cytology. While tumor emboli from invasive primary cardiac lymphomas have been reported, this noninvasive fibrin thrombus-associated lymphoma appears to be unique and previously unreported.