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Breast cancer screening has been shown to reduce breast cancer-associated mortality. However, screening is limited to the targeted age group of 45 to 69 years in New Zealand despite the recognized increased risk with age. This study aims to compare the outcomes of women aged over 70 years with screen-detected and clinically detected cancers.A retrospective review was performed of prospectively collected data from June 2000 to May 2013 by the Auckland Breast Cancer Register. Demographic and tumor characteristics of women with invasive cancer and ductal carcinoma in situ diagnosis aged 70 years and over were compared between those screened and clinically detected. Five-year disease-free and overall survival outcomes were reviewed.A total of 2128 women aged 70 years and over were diagnosed with breast cancer (median, 77 years; interquartile range [IQR], 74-84 years). Of these, 416 (19.5%) were diagnosed through mammography screening, with a median age of 74 years (IQR, 71-77 years) compared with 79 years (IQR, 74-85 years) for those with clinical detected cancer diagnosis. Screen-detected cancers accounted for a significantly higher proportion of diagnoses in those aged 70 to 74 years compared with older patients (P .001). Screen-detected cancers were of lower T and N stages. Disease-specific survival was significantly longer in screen-detected cancers versus other cancers (5-year survival, 93.7% vs. 81.9%; P .001), as was overall survival (5-year survival, 84.7% vs. 57.4%; P .001).Screening in those aged 70 years and over continues to identify breast cancer at early stages and with improved survival. Although aware of the potential for lead-time bias and the healthy volunteer effect, there should still be consideration to extend breast cancer screening to patients aged to up 74 years after appropriate assessment of comorbidities and functional status.

The Netherlands is characterized by highly variable land use within a small area, and a strong influence of the North Sea on national climate. Devoid of significant topography, it is an excellent location for assessing the relative influence of various factors on fog occurrence in the absence of terrain effects. Using observations from a dense network of weather stations throughout the country, the climatology of fog in the Netherlands is assessed over a period of 45 years. On a national scale, interannual variability is linked to changes in synoptic pressure-gradient forcing. Within the country, a comprehensive in-depth analysis of regional differences between fog occurrence is made, together with an assessment of local physical factors which could bias fog formation in one location over another. Regional variability is shown to be strongly related to the mesoscale influences of urbanization and the North Sea. In fact, some locations experience over twice as much fog as others. From this finding, a simple index is presented, which combines the water and urban fraction surrounding a station. This “Regionally Weighted Index” (RWI) is able to accurately sort the stations according to their relative fogginess. Its practical use is encouraged for assessing a given site's climatological favourability, even when in situ meteorological observations are unavailable.

Herein, the conversion times of biomass pyrolysis are measured at temperatures between 450 and 550 °C and particle size fractions between 0 and 400 μm using a cyclonic thermogravimetric analyzer (TGA) device. Beech, spruce, and ash wood are investigated, as well as torrefied samples. The conversion time decreases with the increasing temperature from 7 to less than 1 s. The influence of the type of biomass on the conversion time is limited and only significant for low temperatures, when kinetics dominates the conversion process. A clear influence of the torrefaction process on the pyrolysis conversion time is noted and can be explained by the modified porosity of the biomass particles during the torrefaction process. Kinetic data are extracted from the conversion times, and a model is developed for a better interpretation of the measured results. The model shows good comparison with the experimental data and may also be used for design purposes of fast pyrolysis reactors.

Pain is a symptom of many disorders associated with actual or potential tissue damage in human body. Managing pain is not only a duty but also highly cost prone. The most primitive state of pain management is the assessment of pain. Traditionally it was accomplished by self-report or visual inspection by experts. However, automatic pain assessment systems from facial videos are also rapidly evolving due to the need of managing pain in a robust and cost effective way. Among different challenges of automatic pain assessment from facial video data two issues are increasingly prevalent: first, exploiting both spatial and temporal information of the face to assess pain level, and second, incorporating multiple visual modalities to capture complementary face information related to pain. Most works in the literature focus on merely exploiting spatial information on chromatic (RGB) video data on shallow learning scenarios. However, employing deep learning techniques for spatio-temporal analysis considering Depth (D) and Thermal (T) along with RGB has high potential in this area. In this paper, we present the first state-of-the-art publicly available database, 'Multimodal Intensity Pain (MIntPAIN)' database, for RGBDT pain level recognition in sequences. We provide a first baseline results including 5 pain levels recognition by analyzing independent visual modalities and their fusion with CNN and LSTM models. From the experimental evaluation we observe that fusion of modalities helps to enhance recognition performance of pain levels in comparison to isolated ones. In particular, the combination of RGB, D, and T in an early fusion fashion achieved the best recognition rate.

We present a combined electrochemical, kinetic, and synthetic study with a novel and easily accessible class of titanocene catalysts for catalysis in single-electron steps. The tailoring of the electronic properties of our Cp

In this paper, force and particle-image-velocimetry vorticity measurements of biologically inspired hover kinematics are compared to corresponding results of an unsteady aerodynamic vortex model and a Navier–Stokes (NS) solver. The Reynolds number and the reduced frequency are 4.8×103 and 0.38, respectively. Three kinematics derived from the measured hovering kinematics of an Agrius convolvuli are considered: 1) without elevation angle, 2) elevation angle accounted in the pitch angle, and 3) pure sinusoidal pitch–plunge neglecting higher harmonics. The Navier–Stokes computations show good qualitative agreement with experiments with consistent underprediction. The time-averaged thrust coefficients obtained using Navier–Stokes computations are 82 to 87% of the corresponding force measurements. The standard deviation of time history of thrust coefficients, also normalized by the measured time-averaged values, is 13 to 20%. The underprediction is possibly due to blockage effects in the experiments, also refle...

Although calcium (Ca) precipitation may play a pathogenic role in atherosclerosis, information on temporal patterns of microcalcifications in human coronary arteries, their relation to expression of calcification-regulating proteins, and colocalization with iron (Fe) and zinc (Zn) is scarce. Human coronary arteries were analyzed post mortem with a proton microprobe for element concentrations and stained (immuno)histochemically for morphological and calcification-regulating proteins. Microcalcifications were occasionally observed in preatheroma type I atherosclerotic intimal lesions. Their abundance increased in type II, III, and IV lesions. Moreover, their appearance preceded increased expression of calcification-regulating proteins, such as osteocalcin and bone morphogenetic protein-2. In contrast, their presence coincided with increased expression of uncarboxylated matrix Gla protein (MGP), whereas the content of carboxylated MGP was increased in type DI and IV lesions, indicating delayed posttranslational conversion of biologically inactive into active MGP. Ca/phosphorus ratios of the microcalcifications varied from 1.6 to 3.0, including amorphous Ca phosphates. Approximately 75% of microcalcifications colocalized with the accumulation of Fe and Zn. We conclude that Ca microprecipitation occurs in the early stages of atherosclerosis, inferring a pathogenic role in the sequel of events, resulting in overt atherosclerotic lesions. Microcalcifications may be caused by local events triggering the precipitation of Ca rather than by increased expression of calcification-regulating proteins. The high degree of colocalization with Fe and Zn suggests a mutual relationship between these trace elements and early deposition of Ca salts. (Ant J Pathol 2011, 178:2879-2887; DOI: 10.1016/j.ajpath.2011.02.004)

Summary Evidence is accumulating that calcium-rich microdeposits in the vascular wall might play a crucial role in the onset and progression of atherosclerosis. Here we investigated an atherosclerotic lesion of the carotid artery in an established murine model, i.e. the apolipoprotein E-deficient (APOE ) ⁄ ) ) mouse to identify (i) the presence of microcalcifications, if any, (ii) the elemental composition of microcalcifications with special reference to calcium ⁄ phosphorus mass ratio and (iii) co-localization of increased concentrations of iron and zinc with microcalcifications. Atherosclerosis was induced by a flow-divider placed around the carotid artery resulting in low and high shear-stress regions. Element composition was assessed with a proton microprobe. Microcalcifications, predominantly present in the thickened intima of the low shear-stress region, were surrounded by areas with normal calcium levels, indicating that calcium-precipitation is a local event. The diameter of intimal microcalcifications varied from 6 to 70 lm. Calcium ⁄ phosphorus ratios of microcalcifications varied from 0.3 to 4.8, mainly corresponding to the ratio of amorphous calciumphosphate. Increased iron and zinc concentrations commonly co-localized with microcalcifications. Our findings indicate that the atherosclerotic process in the murine carotid artery is associated with locally accumulated calcium, iron and zinc. The calcium-rich deposits resemble amorphous calcium phosphate rather than pure hydroxyapatite. We propose that the APOE ) ⁄ ) mouse, in which atherosclerosis was evoked by a flow-divider, offers a useful model to investigate the pathophysiological significance of accumulation of elements such as calcium, iron and zinc.

EnglishThe concept of emerging countries or economies appeared in the 1980s and gained currency when the BRICS countries (Brazil, Russia, India, China and South Africa) seemed to be moving into a global leadership role. Though the concept remains ill-defined, “emergence” is frequently applied now to countries that show significant economic and social progress. With the rejection of the many economic programmes that are often dictated by development agencies (e.g. structural adjustment programmes), and echoing a resolve on the part of Africans to take their fate into their own hands, there is much talk today of the emergence of Africa and of emergence plans being drawn up in many countries. But the question remains open as to what emergence means, what the main drivers of emergence are and how performance can be evaluated, particularly when it comes to comparing the different trajectories of African countries. The Performances Group consultancy has developed an analysis grid for the process of emergence and produced a model based largely on a typology of the driving factors of emergence (collective ambition, leader- ship and vision, development of the private sector etc.) and economic and social performance indicators (economic growth, shared prosperity etc.). Its chief executive, Victor Ndiaye, and Ruben B. Djogbenou explain that analysis grid here and the way composite indicators have been established that make it possible to evaluate and compare the relative emergence of African countries. They propose an analytical framework for this process and, on the basis of the indicators selected, offer a league-table of countries detailing their performance levels between 2005 and 2015, which will no doubt spark considerable debate. francaisLe concept de pays ou economie emergent(e) est apparu dans les annees 1980 et a acquis sa renommee alors que les BRICS (Bresil, Russie, Inde, Chine et Afrique du Sud) semblaient en voie d’acceder a un leadership mondial. Bien que le concept demeure mal defini, il est desormais frequent de parler d’emergence pour qualifier les pays dont les performances temoignent de progres importants sur le plan economique et social. Tournant le dos aux nombreux programmes souvent dictes par les agences de developpement, tels les programmes d’ajustement structurel, et voulant ainsi temoigner de la volonte des Africains de prendre en main leur destin, on parle aujourd’hui de l’emergence de l’Afrique et des plans d’emergence mis en place dans nombre de pays. Mais la question reste entiere de savoir ce que recouvre cette notion, quels sont les principaux ressorts de l’emergence et comment les performances peuvent etre appreciees, notamment pour pouvoir comparer les trajectoires differentes des pays africains. Le cabinet Performances Group a mis au point une grille d’analyse du processus d’emergence et elabore un modele reposant principalement sur une typologie des facteurs moteurs de l’emergence (ambition collective, leadership et vision, developpement du secteur prive…) et des indicateurs en termes de performances economiques et sociales (croissance economique, prosperite partagee…). Son directeur general, Victor Ndiaye, et Ruben Djogbenou exposent ici cette grille d’analyse et la facon dont ont ete etablis des indicateurs synthetiques qui permettent d’evaluer et comparer l’emergence relative des pays africains. Ils proposent un cadre d’analyse pour ce processus et, sur la base des indicateurs retenus, presentent un classement des pays, ainsi que l’evolution de leurs performances entre 2005 et 2015, qui sans nul doute donnera lieu a bien des debats.

Printed broadsheet maps informing the public about current events were common during the early modern period. Information on the genesis of these maps is scarce, however. This article hopes to thro...

BackgroundVascular calcification is associated with poor cardiovascular outcome. Histochemical analysis of calcification and the expression of proteins involved in mineralization are usually based on whole section analysis, thereby often ignoring regional differences in atherosclerotic lesions. At present, limited information is available about factors involved in the initiation and progression of atherosclerosis.Aim of This StudyThis study investigates the intra-section association of micro-calcifications with markers for atherosclerosis in randomly chosen section areas of human coronary arteries. Moreover, the possible causal relationship between calcifying vascular smooth muscle cells and inflammation was explored in vitro.Technical ApproachTo gain insights into the pathogenesis of atherosclerosis, we performed analysis of the distribution of micro-calcifications using a 3-MeV proton microbeam. Additionally, we performed systematic analyses of 30 to 40 regions of 12 coronary sections obtained from 6 patients including histology and immuno-histochemistry. Section areas were classified according to CD68 positivity. In vitro experiments using human vascular smooth muscle cells (hVSMCs) were performed to evaluate causal relationships between calcification and inflammation.ResultsFrom each section multiple areas were randomly chosen and subsequently analyzed. Depositions of calcium crystals at the micrometer scale were already observed in areas with early pre-atheroma type I lesions. Micro-calcifications were initiated at the elastica interna concomitantly with upregulation of the uncarboxylated form of matrix Gla-protein (ucMGP). Both the amount of calcium crystals and ucMGP staining increased from type I to IV atherosclerotic lesions. Osteochondrogenic markers BMP-2 and osteocalcin were only significantly increased in type IV atheroma lesions, and at this stage correlated with the degree of calcification. From atheroma area type III onwards a considerable number of CD68 positive cells were observed in combination with calcification, suggesting a pro-inflammatory effect of micro-calcifications. In vitro, invasion assays revealed chemoattractant properties of cell-culture medium of calcifying vascular smooth muscle cells towards THP-1 cells, which implies pro-inflammatory effect of calcium deposits. Additionally, calcifying hVSMCs revealed a pro-inflammatory profile as compared to non-calcifying hVSMCs.ConclusionOur data indicate that calcification of VSMCs is one of the earliest events in the genesis of atherosclerosis, which strongly correlates with ucMGP staining. Our findings suggest that loss of calcification inhibitors and/or failure of inhibitory capacity is causative for the early precipitation of calcium, with concomitant increased inflammation followed by osteochondrogenic transdifferentiation of VSMCs.