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Involved margins after surgery for early breast cancer increase the risk of local recurrence (LR), but international guidelines suggest that’ no tumour’ on ink is sufficient margin clearance after breast conserving surgery (BCS). Data on the effect of margin clearance on distant recurrence (DR) are lacking. Our aim was to determine the association between margin involvement, recurrence (DR) and breast cancer deaths. Methods Data from breast cancer units in Greater Manchester (GM) and the UK National Cancer Registry (NCRAS) were analysed. Margin status was prospectively recorded after surgery according to National Health Service Breast Screening Pathology (NHSBSP) minimum pathology data standards All patients underwent curative surgery and received adjuvant therapy according to local guidelines. Patients not undergoing curative surgery(T4, inflammatory or metastatic cancer) were excluded .Cox-proportional hazards models investigated factors associated with LR, DR and risk of breast cancer death.NCRAS records breast cancer deaths . Results GM analysis included 3270 patients from 2010 to 2014, 2295 (70.2%) had margins (>2mm) ,302 (9.2%) close (1-2mm) margin clearance and 673 (20.6%) involved (2mm. For Breast Conservation margins1mm (67.5%) and 3,935 (9.6%) were classed as “clear margins” and 9,325 (22.8%) cancer patients had involved margins 1mm were associated with reduced DR and should be essential surgical management. Current guidelines about surgical margins need to be re-evaluated to achieve reduced DR and cancer deaths. Citation Format: Nigel James Bundred, Sarah Michael, John Broggio, Anne Armstrong, Glen Martin, Mohamed Absar, Jane Ooi. Increased distant recurrence following margin involvement in early invasive breast cancer in two large UK cohorts [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-20-01.

Background/Aims Methotrexate (MTX) is the preferred first line therapy for rheumatoid arthritis (RA), according to NICE guidelines. MTX has several advantages over other treatments including effectiveness and low cost; however, around 40% of patients are classed as non-responders after 6 months. Therefore, there is a clinical need to identify patients at high-risk of poor outcomes, such that patients could potentially be fast tracked onto alternative therapies to improve their clinical outcomes and quality of life. Such risk stratification is possible through prognostic prediction models, although models which have previously been developed appear to have had little impact on practice. This may be in part due to methodological features of their development and validation but, to date, no review has collated the evidence in this field. This review therefore aimed to (i) identify and summarise multivariable prediction models of MTX treatment outcomes in biologic-naïve adult RA patients, and (ii) appraise their methodological properties. Methods A systematic search was carried out using Medline Ovid to identify studies developing or validating prediction models of MTX outcomes in the population of interest, including demographic, disease-specific or treatment-related covariates, published between 2005 and 2020. Models were stratified by outcome definition, and information on predictors, predictor associations with the outcome, model performance, handling of missing data and model validation were extracted. Results Twenty-two studies (14 (64%) using data from observational studies and 8 (36%) from randomised controlled trials) were identified. Of these, 15 (68%) based their outcome on a state of disease activity, such as low disease activity or remission, 4 (18%) used the EULAR response criteria, and 3 (14%) predicted discontinuation due to adverse events (AEs). AEs were also incorporated into the composite outcome with disease activity in 3 (14%) studies, 1 (5%) investigated both outcomes in separate models, and only 1 (5%) accounted for potential competing risks to their primary outcome. Internal validation using cross sampling techniques, which is critical for reducing overfitting, was completed in only 5 (23%) studies. Only 4 (18%) studies carried out external validation in new data. Missing data was appropriately handled using multiple imputation in 5 (23%) studies, whilst others used single imputation (n = 1, 4%) or complete case analysis (n = 13, 59%), resulting in potentially biased risk estimates, or did not report how they handled missing data (n = 3, 14%). Conclusion This review summarises current prediction models of MTX treatment outcomes in RA. It highlights several methodological shortcomings that should be addressed in future model development and validation to improve accuracy of predictions. Without tackling these issues, prediction of MTX treatment outcomes will remain at high risk of bias and should not be recommended for informing risk stratification for RA treatment decisions. Disclosure C. Gehringer: None. G. Martin: None. K. Hyrich: None. S. Verstappen: None. J. Sergeant: None.

The primary purpose of this study was to determine the relationship between the attitudes held by administrators and counselors toward vocational education (as measured by the ATVE Scale) and the attitudes and abilities of students from their schools attending the area vocational-technical school. Data were analyzed from 10 administrators and 10 counselors from schools participating in an area vocational-technical school as well as from students enrolled in the school for the first time. Student attitudes and characteristics at schools where the administrator or counselor scored above the mean on the ATVE scale were compared to the same criteria of the students from schools where the administrator or counselor scored below the mean on the ATVE Scale. An analysis of the data revealed: (1) There is a correlation between administrator and counselor attitudes toward vocational education (as measured by the ATVE Scale) and student variables, as shown by General Learning Ability scores and occupational pattern test scores, and (2) The more positive counselor and administrator attitudes were related directly to better student scores on these tests. (Author/AG)

In Australia, numerous egg-related human Salmonella typhimurium outbreaks have prompted significant interest among public health authorities and the egg industry to jointly address this human health concern. Nationwide workshops on Salmonella and eggs were conducted in Australia for egg producers and regulatory authorities. State and national regulators represented Primary Production, Communicable Disease Control, Public Health and Food Safety, and Food Standards Australia and New Zealand. All attendees participated in discussions aimed at evaluating current evidence-based information, issues related to quality of egg production, and how to ensure safe eggs in the supply chain, identifying research gaps and practical recommendations. The perceptions from egg producers and regulatory authorities from various states were recorded during the workshops. We presented the issues discussed during the workshops, including Salmonella in the farm environment, Salmonella penetration across eggshell, virulence in humans, food/egg handling in the supply chain, and intervention strategies. We also discussed the perceptions from egg producers and regulators. Recommendations placed emphasis on the future research needs, communication between industry and regulatory authorities, and education of food handlers. Communication between regulators and industry is pivotal to control egg-borne S. typhimurium outbreaks, and collaborative efforts are required to design effective and appropriate control strategies.

The design of a novel apparatus, the Glen Withy torque tester (GWTT), for measuring horizontal shear properties in equine sport surfaces is described. Previous research has considered the effect of vertical loading on equine performance and injury but only limited discussion has concerned the grip or horizontal motion of the hoof. The horizontal support of the hoof by the surface must be sufficient to avoid excess slip without overloading the limb. The GWTT measures the torque necessary to twist an artificial hoof that is being pushed into the surface under a consistently applied vertical load. Its output was validated using a steel surface, then was used to test two sand and fibre surfaces (waxed and non-waxed) through rotations of 40–140°, and vertical loads of 157–1138 N. An Orono biomechanical surface tester (OBST) measured longitudinal shear and vertical force, whilst a traction tester measured rotational shear after being dropped onto the surfaces. A weak, but significant, linear relationship was found between rotational shear measured using the GWTT and longitudinal shear quantified using the OBST. However, only the GWTT was able to detect significant differences in shear resistance between the surfaces. Future work should continue to investigate the strain rate and non-linear load response of surfaces used in equestrian sports. Measurements should be closely tied to horse biomechanics and should include information on the maintenance condition and surface composition. Both the GWTT and the OBST are necessary to adequately characterise all the important functional properties of equine sport surfaces.

Delaire (1978) stellt in seiner kraniofazialen Analysemethode die Balance des neuro- und viszerokranialen Schädels in den Mittelpunkt. Er mißt der Ausgewogenheit der Proportionen eine zentrale Bedeutung bei der Beurteilung viszero- und neurokranialer Strukturen zu. In dieser Arbeit konnte ein Kollektiv von 81 Patienten mit prämaturen Kraniosynostosen nach der Delaire-Analyse untersucht werden. Von diesen 81 erfaßten Patienten (30 Saethre-Chotzen-, 24 Crouzon-, 13 Apert-, 6 Pfeiffer-, 3 Cohen- und 5 Muenke-Syndrom-Patienten) lagen insgesamt 183 auswertbare hochqualitative Fernröntgenbilder vor. Bedingung für die Aufnahme in diese Arbeit war das Mindestalter der Patienten von 3 Jahren, da während der ersten 3 Lebensjahre die Proportionen zwischen Kranium und Gesichtsschädel nicht mit denjenigen eines Erwachsenen vergleichbar sind. Erst ab dem Alter von 3 Jahren wächst der Gesichtsschädel in gleichem Maße wie das Neurokranium und erst dadurch wird die kraniofaziale Analyse nach Delaire aussagekräftig (Delaire et al. 1981). Um eine Vergleichsmöglichkeit der Meßwerte der Patienten mit syndromalen Kraniosynostosen zu erhalten, wurden die modifizierten Bolton-Standard-Werte herangezogen, die für die Delaire-Analyse mit einem Kalottendach versehen werden mußten. In dieser Arbeit wurden die Bolton-Standards von Broadbent et al. (1975) mit Werten von Dekaban (1977) ergänzt und ein Schädeldach hinzugefügt. Das Ergebnis wurde nach der Delaire-Analyse für den Zeitraum 1-18 Jahre ausgemessen und in einer Tabelle aufgeführt. Bei den Kindern mit Saethre-Chotzen-Syndrom zeigte sich, daß die anterior-posteriore Schädelausdehnung (C1, C3 und CF4) signifikant kürzer und „brachyzephaler“ war als bei den Crouzon- und Apert-Syndrom-Patienten. Besonders stellte sich heraus, daß dieser Längenunterschied primär Aufgrund der mangelhaften Ausformung des Os occipitale (CP-OI) und nicht etwa durch die Mittelgesichtshypoplasie bedingt ist. Weiterhin konnte festgestellt werden, daß die anteriore Schädelhöhe (CF1) der Saethre- Chotzen-Patienten durch das „frontal bossing“ signifikant größer ausgeprägt war als bei den Kindern mit Crouzon-Syndrom. Die Crouzon-Syndrom-Patienten waren vor allem durch die fliehende Stirn (CF1) und die verkürzte anteriore Schädelbasis (C1, M-Pts bzw. Pts-CP) charakterisiert. Hier konnte im Vergleich zu den Bolton-Standard-Werten hinsichtlich der Längeneinbuße der S-N-Strecke eine wesentlich genauere Aussage getroffen werden. Die Längeneinbuße liegt im zentralen Anteil der Schädelbasis in der Region um die Sella turcica. Alle untersuchten Apert-Syndrom-Patienten wiesen eine deutliche Turrizephalie auf. Die kraniale Höhe (C2) sowie die kraniofazialen Linien CF1, CF2 und CF3 zeigten eine in Relation zu den übrigen Syndromen signifikant größere Länge. Die Teilstrecke ANS-Na´ der „theoretischen Gesichtshöhe“ CF5 war bei den Kindern mit Apert-Syndrom signifikant verkürzt, übereinstimmend mit der vorliegenden Mittelgesichtshypoplasie. Die Untersuchung der Teilstrecke ANS-Me´ von CF5 ergab eine im Vergleich zu den Saethre-Chotzen- und Crouzon-Syndrom-Patienten längere Strecke. Dies bestätigt das längere Untergesicht und den häufig anterior offenen Biß bei Apert-Patienten. Die kephalometrische Analyse nach Delaire ermöglicht es, mit relativ einfachen Mitteln eine signifikante Aussage hinsichtlich der Unterschiede zwischen den einzelnen syndromalen Kraniosynostosen zu treffen. Dies beinhaltet die Möglichkeit, die folgende Diagnostik zu erleichtern. Das erforderliche laterale Fernröntgenbild wird generell zur eingehenderen Untersuchung erstellt und die spezifischen Strecken der Analyse nach Delaire sind schnell und bei entsprechender Bildqualität, eindeutig zu ermitteln. Die präoperativ spezifisch zuzuordnenden Strecken sind: C1 und insbesondere die Teilstrecke CP-OI, die beim Saethre-Chotzen-Syndrom signifikant kürzer als beim Crouzon- und beim Apert-Syndrom gemessen wurde; C3, die ebenfalls beim Saethre-Chotzen-Syndrom signifikant kürzer ist; CF1, CF2 und CF3, die v.a. beim Apert-Syndrom verlängert auftreten; CF4, die beim Saethre-Chotzen-Syndrom kürzer ist als bei Crouzon; Die präoperative Vermessung der Strecke C1 ergab bei den Saethre-Chotzen-Patienten einen Mittelwert MW von 12,60 cm, bei den Crouzon-Patienten einen Mittelwert MW von 14,90 cm (p=0,0032**), wobei sich für die Teilstrecke CP-OI beim Saethre- Chotzen-Syndrom ein MW von 5,60 cm und beim Crouzon-Syndrom ein MW von 7,30 cm (p=0,0038**) herausstellte. Bei der präoperativen Strecke C3 lag MW für die Saethre-Chotzen-Patienten bei 13,90 cm und für die Crouzon-Patienten bei 16,00 cm (p=0,0016**). Die Strecke CF1 zeigte präoperativ zwischen dem Saethre-Chotzen-Syndrom (mit dem MW von 18,90 cm), und dem Crouzon-Syndrom (mit dem MW von 16,10 cm) einen signifikanten Unterschied (p=0,020*). Auch bei CF4 waren präoperativ signifikante Unterschiede feststellbar. Die Saethre- Chotzen-Patienten wiesen einen MW von 12,40 cm auf, wohingegen die Crouzon- Patienten einen MW von 14,10 cm erreichten (p=0,030*). Die „Architekturelle und Strukturelle Kraniofaziale Analyse“ nach Delaire sollte als eine echte Alternative im Vergleich zur herkömmlichen Kephalometrie gesehen werden. Die in dieser Arbeit dargestellten Untersuchungen und Messungen bestätigen das, was Delaire 1981 postulierte: „Die architekturelle und strukturelle kraniofaziale Analyse stellt die Balance zwischen Neuro- und Viszerokranium dar und birgt so die Möglichkeit die Schädelbasis und das Schädeldach, und dann auch das Gesicht mit dem gesamten Schädel und der kraniospinalen Artikulation in Relation zu setzen. Unabhängig von statistischen Durchschnitten werden die individuellen Merkmale und Proportionen des Skelettes untersucht. Diese Analyse-Methode ist besonders für den Chirurgen interessant, da sie alle maxillofazialen Deformitäten und pathologischen Balancen die korrigiert werden müssen, klar darstellt. Gerade bei gravierenden kraniofazialen Malformationen bietet sie eine bessere Möglichkeit die verschiedenen kranialen und fazialen Anomalien aufzuzeigen, die gerade diese Situation charakterisieren“ (Delaire et al. 1981).

The 1993 annual National Council on Family Relations (NCFR) Videotape Competition was hosted by the Home Economics Department, College of Applied Science and Technology, Illinois State University, Normal, Illinois from March 15 to April 2, 1993. The purpose of the annual competition is to evaluate quality and endorse excellence in the production of videotapes with themes relevant to family issues, to promote the effective use of these resources, and to encourage high standards in the development of creative learning opportunities. Entries solicited were placed in one of the following 16 categories: Addiction/Substance Abuse; Aging; Contemporary Social Issues; Divorce/Remarriage; Families with Special Needs; Family Violence/Abuse; Human Development Across the Life Span; Human Reproduction and Family Planning; Marital and Family Issues and Communications; Mental Health, Stress, Transitions and Crisis Management; Non-Traditional Family Systems; Parenting Issues; Sexuality and Sex Role Development; Teenage Pregnancy and Sexuality; STD/AIDS; and Other, which emphasized public policy this year. The following entry guidelines were imposed by NCFR: Submissions were to be first-time entries to the competition, carry a release date no earlier than January 1, 1991, and be available for purchase, rental, or loan on a nation-wide basis. Each producer/distributor could submit only one entry per category. All entries, which were to be 1/2" videocassette recordings, were to be received by March 1, 1993. One hundred and fourteen (114) entries were received. Although producer/distributors identified the category for their entry, the competition director reserved the right to modify categories or to change the category of an entry. No entries were received for the Divorce/Remarriage category. For each category, a panel of appropriate judges was selected from a pool of nearly 40 interested volunteers. Included in this pool were university faculty, staff, and students (graduate and undergraduate); public school teachers and counselors; social service agency staff; family and individual counselors/therapists; Cooperative Extension Service specialists and 4-H youth staff; clerics; practitioners working in domestic and drug abuse programs; hospital gerontologists; local AIDS task force members; and law enforcement professionals. After viewing an entry in a particular category, each judge on the panel was asked to independently make both quantitative and qualitative assessments of the videotape. The evaluation form allowed for numerical ratings on the basis of content (40 possible points), artistic quality (20 points), and the degree to which stated goals and intended audience were matched (20 points). Additionally, the form asked for the judge to provide a qualitative analysis of the major strengths and weaknesses/limitations of each entry. When more than one judge viewed an entry at the same time, they often concluded the rating process with a brief discussion of their assessment. Generally, the videotapes were required to receive an average minimum score of 67 out of 80 to be declared a Category Winner or Runner-Up; therefore, not every category had a winner. An average minimum score of 60 was necessary to be awarded Honorable Mention status. The following listing identifies the Winner, Runner-Up, and Honorable Mention recipients by category. The goals, objectives, and synopsis of each entry were provided by the producer/director and do not necessarily reflect the opinion of NCFR, the competition director, or the judges. Intended audiences are noted in this manner: PG for primary grades, JH for junior high, HS for high school, C for college, G for general, P for parents, and PRO for professionals. WINNERS BY CATEGORY 1. ADDICTION/SUBSTANCE ABUSE * Winner: Boy Wonder (28 minutes). Producer: Forefront Productions, 609-402 West Pender Street, Vancouver, B.C., Canada V6B 1T6. Distributor: Bureau for At-Risk Youth, 79 Carley Avenue, Huntington, NY 11743. …