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UniPron is A Fully Effective non-hormonal Reversible Contraceptive in Baboon Model (Papio Anubis)

Journal of Reproduction and Contraception 2008年第2期19卷 107-118页

作者： Jael A.Obiero Maureen n.Mburu Benson M.ndung'u Kenneth K.Waititu Isaac Mulei Idle O.Farah Peter G.Mwethera Department of Reproductive Health and Reproductive Biology Institute of Primate ResearchKarenNairobiKenya

Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.Methods Vaginal swabs were obtained before and after UniPron administration, cultured onto appropriate culture media and bacteria identification was done based on type of media used, Gram stain reactions, colony morphology and biochemical tests. Vaginal biopsy tissues were processed using paraffin wax method, stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues. The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations. For efficacy studies, male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages. Results All the five females （100%） that were treated with UniPron did not conceive and they regained total fertility when the treatment was stopped while all the controls conceived. At a concentration of 40%, UniPron completely immobilized spermatozoa in an in-vitro system. UniPron mechanism of action was by lowering the vaginal pH and on application in baboon, the pH was lowered for at least 3 h after which it went back to normal.Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV, our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model （Papio anubis）.

关键词： Papio anubis UniPron vagina epithelium pH microflora microbicidal contraceptive

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Drug Seeking Behavior of Amphetamine Addicted Sprague-Dawley Rats Is Eliminated after nutritional Supplementation

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Journal of Behavioral and Brain Science 2017年第12期7卷 585-597页

作者： Annice Webber-Waugh karen Thaxter nesbeth Pauline Anderson-Johnson Ajibike Salako-Akande Helen Asemota Lauriann Young Department of Basic Medical Sciences The University of the West Indies (UWI) Mona Campus Kingston Jamaica UWI School of nursing Mona Campus Kingston Jamaica Getwele natureceuticals LLC Halethorpe MD USA The Biotechnology Centre UWI Kingston Jamaica

Aim: The effectiveness of nutritional supplementation on drug-seeking behavior of amphetamine-addicted rats during withdrawal was investigated using a biased conditioned place preference (CPP) paradigm. Method: Twenty-four male Sprague-Dawley rats exhibiting baseline preference for the black chamber during a 20-minute pre-conditioning exploration of the CPP box completed the study. On alternate days of an 8-day schedule, twelve rats (Group AMP) were randomly selected, given either amphetamine sulfate (5 mg/ml, i.p.) and confined to the white chamber;or vehicle (1 ml saline, i.p.) and confined to the black chamber. A significant increased percentage time spent and number of entries made by Group AMP to the drug-paired, white chamber on the test day confirmed amphetamine addiction. Group AMP subsequently received increasing doses of amphetamine over 6 days. Following acute drug withdrawal, their CPP performance was compared with that of vehicle treated rats (Group SAL). Groups AMP and SAL were equally divided and randomly assigned to animals fed chow reconstituted with the nutritional supplement (AMP-S and SAL-S) over 8 weeks or standard rat chow (AMP-n and SAL-n). CPP performances for all rats were determined blindly from video recordings following this period. Results: nutritionally supplemented, amphetamine withdrawn rats (AMP-S) exhibited significantly decreased percentage entries and time spent in the white chamber (p ?ve, control animals. Conclusion: Drug-seeking behavior by amphetamine-addicted animals was eliminated after treatment with a nutritionally supplemented diet.

关键词： Amphetamine Conditioned Place Preference nutritional Supplement Addiction Animal Model

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High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross- sectional survey

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General Psychiatry 2021年第5期34卷 31-41,I0006-I0025页

作者： natasha Smallwood Leila Karimi Marie Bismark Mark Putland Douglas Johnson Shyamali Chandrika Dharmage Elizabeth Barson nicola Atkin Claire Long Irene ng Anne Holland Jane E Munro Irani Thevarajan Cara Moore Anthony McGillion Debra Sandford karen Willis Department of Respiratory Medicine Alfred HospitalPrahranVictoriaAustralia Department of Allergy Immunology and Respiratory MedicineCentral Clinical SchoolAlfred HospitalMonash UniversityMelbourneVictoriaAustralia School of Psychology and Public Health La Trobe UniversityMelbourneVictoriaAustralia School of Medicine and Healthcare Management Caucasus UniversityTbilisiGeorgia Department of Psychiatry The Royal Melbourne HospitalParkvilleVictoriaAustralia Department of Public Health Law Melbourne School of Population and Global HealthThe University of MelbourneParkvilleVictoriaAustralia Department of Emergency Services The Royal Melbourne HospitalParkvilleVictoriaAustralia Department of Critical Care Faculty of MedicineDentistry and Health SciencesThe University of MelbourneMelbourneVictoriaAustralia Departments of General Medicine and Infectious Diseases The Royal Melbourne HospitalParkvilleVictoriaAustralia Department of Medicine The Royal Melbourne HospitalThe University of MelbourneParkvilleVictoriaAustralia Allergy and Lung Health Unit School of Population and Global HealthThe University of MelbourneParkvilleVictoriaAustralia Department of Allied Health The Royal Melbourne HospitalParkvilleVictoriaAustralia Parkville Integrated Palliative Care Service The Royal Melbourne HospitalParkvilleVictoriaAustralia Sir Peter MacCallum Department of Oncology The University of MelbourneParkvilleVictoriaAustralia Department of Geriatric Medicine Western HealthFootscrayVictoriaAustralia Department of Anaesthesia and Pain Management The Royal Melbourne HospitalParkvilleVictoriaAustralia Centre for Integrated Critical Care Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia Department of Physiotherapy Alfred HealthMelbourneVictoriaAustralia Rheumatology Unit Royal Children's HospitalParkvilleVictoriaAustralia Arthritis and Rheumatology Murdoch Children's Research InstituteParkvilleVictoriaAustralia Department of Infectious Diseases T

Background The coronavirus disease 2019(COVID-19)pandemic has had a profound and prolonged impact on healthcare services and healthcare *** The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues,as well as the social,workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 *** A nationwide,voluntary,anonymous,single timepoint,online survey was conducted between 27 August and 23 October *** self-identifying as frontline healthcare workers in secondary or primary care were invited to *** were recruited through health organisations,professional associations or colleges,universities,government contacts and national ***,home and work situation,health and psychological well-being data were *** A total of 9518 survey responses were received;of the 9518 participants,7846(82.4%)participants reported complete *** regard to age,4110(52.4%)participants were younger than 40 years;6344(80.9%)participants were *** were nurses(n=3088,39.4%),doctors(n=2436,31.1%),allied health staff(n=1314,16.7%)or in other roles(n=523,6.7%).In addition,1250(15.9%)participants worked in primary *** measured mental health symptoms were common:mild to severe anxiety(n=4694,59.8%),moderate to severe burnout(n=5458,70.9%)and mild to severe depression(n=4495,57.3%).Participants were highly resilient(mean(SD)=3.2(0.66)).Predictors for worse outcomes on all scales included female gender;younger age;pre-existing psychiatric condition;experiencing relationship problems;nursing,allied health or other roles;frontline area;being worried about being blamed by colleagues and working with patients with *** The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare *** preparedness together with policies and pra

关键词： distress nurse workers

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Maize Carbohydrate Partitioning Defective33 Encodes an MCTP Protein and Functions in Sucrose Export from Leaves

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Molecular Plant 2019年第9期12卷 1278-1293页

作者： Thu M.Tran Tyler J.McCubbin Saadia Bihmidine Benjamin T.Julius R.Frank Baker Martin Schauflinger Clifford Weil nathan Springer Paul Chomet Ruth Wagner Jeff Woessner karen Grote Jeanette Peevers Thomas L.Slewinski David M.Braun Division of Biological Sciences’Interdisciplinary Plant Group Missouri Maize CenterUniversity of MissouriColumbiaMO 65211USA Division of Plant Sciences University of MissouriColumbiaMO 65211USA Electron Microscopy Core Facility University of MissouriColumbiaMO 65211USA Department of Agronomy Purdue UniversityWest LafayetteIN 47907USA Department of Plant and Microbial Biology University of MinnesotaSaint PaulMN 55108USA nRGene Inc. 8910 University Center Lane\r\n S u ite 400San DiegoCA 92122USA Bayer Crop Science ChesterfieldMO 63017USA national Key Laboratory for Plant Cell Technology Agricultural Genetics InstituteHanoiVietnam

To sustain plant growth,development,and crop yield,sucrose must be transported from leaves to distant parts of the plant,such as seeds and *** identify genes that regulate sucrose accumulation and transport in maize(Zea mays),we isolated carbo/iydrafe part/f/ofi/ngf defecf/Ve33(cpd33),a recessive mutant that accumulated excess starch and soluble sugars in mature *** cpd33 mutants also exhibited chlorosis in the leaf blades,greatly diminished plant growth,and reduced ***33 encodes a protein containing multiple C2 domains and transmembrane *** localization experiments showed the CPD33 protein localized to plasmodesmata(PD),the plasma membrane,and the endoplasmic *** also found that a loss-of-function mutant of the CPD33 homolog in Arabidopsis,QUIRKY,had a similar carbohydrate hyperaccumulation *** labeled sucrose transport assays showed that sucrose export was significantly lower in cpd33 mutant leaves relative to wild-type ***,PD transport in the adaxial-abaxial direction was unaffected in cpd33 mutant ***,transmission electron microscopy revealed fewer PD at the companion cell-sieve element interface in mutant phloem tissue,providing a possible explanation for the reduced sucrose export in mutant ***,our results suggest that CPD33 functions to promote symplastic transport into sieve elements.

关键词： carbohydrate accumulation companion cells phloem, plasmodesmata sieve elements symplastictransport

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Evolving concepts in bone infection: redefining “biofilm”,“acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy”

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Bone Research 2019年第3期7卷 225-242页

作者： Elysia A. Masters Ryan P. Trombetta karen L. de Mesy Bentley Brendan F Boyce Ann Lindley Gill Steven R. Gill Kohei nishitani Masahiro Ishikawa Yugo Morita Hiromu Ito Sheila n. Bello-Irizarry Mark ninomiya James D. Brodell Jr. Charles C. Lee Stephanie P. Hao Irvin Oh Chao Xie Hani A. Awad John L. Daiss John R. Owen Stephen L. Kates Edward M. Schwarz Gowrishankar Muthukrishnan Center for Musculoskeletal Research University of Rochester Medical Center Rochester NY USA Department of Biomedical Engineering University of Rochester Medical Center Rochester NY USA Department of Pathology and Laboratory Medicine University of Rochester Medical Center Rochester NY USA Department of Orthopaedics University of Rochester Medical Center Rochester NY USA Department of Microbiology & Immunology University of Rochester Medical Center Rochester NY USA Department of Orthopaedic Surgery Kyoto University Kyoto Japan Department of Orthopaedic Surgery Virginia Commonwealth University Medical Center Richmond VA USA

Osteomyelitis is a devastating disease caused by microbial infection of bone. While the frequency of infection following elective orthopedic surgery is low, rates of reinfection are disturbingly high. Staphylococcus aureus is responsible for the majority of chronic osteomyelitis cases and is often considered to be incurable due to bacterial persistence deep within bone. Unfortunately, there is no consensus on clinical classifications of osteomyelitis and the ensuing treatment algorithm. Given the high patient morbidity,mortality, and economic burden caused by osteomyelitis, it is important to elucidate mechanisms of bone infection to inform novel strategies for prevention and curative treatment. Recent discoveries in this field have identified three distinct reservoirs of bacterial biofilm including: Staphylococcal abscess communities in the local soft tissue and bone marrow, glycocalyx formation on implant hardware and necrotic tissue, and colonization of the osteocyte-lacuno canalicular network(OLCn) of cortical bone. In contrast, *** intracellular persistence in bone cells has not been substantiated in vivo, which challenges this mode of chronic osteomyelitis. There have also been major advances in our understanding of the immune proteome against S. aureus, from clinical studies of serum antibodies and media enriched for newly synthesized antibodies(MEnSA), which may provide new opportunities for osteomyelitis diagnosis, prognosis, and vaccine development. Finally, novel therapies such as antimicrobial implant coatings and antibiotic impregnated 3D-printed scaffolds represent promising strategies for preventing and managing this devastating disease. Here, we review these recent advances and highlight translational opportunities towards a cure.

关键词： disease caused by soft tissue necrotic tissuel

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Conotruncal heart malformations in Egypt: An epidemiological study

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Open Journal of Epidemiology 2013年第4期3卷 169-176页

作者： Doa’a A. Saleh Sameera Ezzat Hala Hamza Mohamed Abdel-Hamid karen S. Kuehl Christopher A. Loffredo Cairo University Cairo Egypt Children’s national Medical Center Washington DC USA Georgetown University Washington DC USA Menoufiya University Shibin El Kom Egypt Minia University Minia Egypt

Conotruncal malformations of the heart are a major category of birth defects. no previous epidemiological studies on these malformations have been carried out in Egypt;therefore our study aimed to describe associations with maternal and infant factors in order to identify possible risk factors. Cases (n = 255) were children up to two years of age whose heart malformations were confirmed by echocardiography;they were enrolled at the Cardiology Department of the Pediatric Hospital of Cairo University. Controls (n = 155) were free of congenital heart malformations, matched to the cases by age, and recruited from outpatients of the same hospital. Mothers of cases (97%) and controls (89%) provided consent to participate in an interview about their medical, familial, and occupational histories. Odds ratios (OR) and exact 95% confidence intervals (CI) assessed the magnitude and statistical significance of case-control differences. Cases were divided into two groups based on the presence of d-transposition of the great arteries (TGA): there were 139 with TGA and 116 with normally-related great arteries (nGA). Maternal diabetes prevalence was elevated in both the TGA (OR = 3.4) and nGA (OR = 5.5) subgroups. Several agricultural factors were associated with increased risk: raising animals (for TGA: OR = 2.4, 95% CI 1.2-4.6), raising poultry (for nGA: OR = 1.8, 95% CI 1.1-3.2), and using chemical rodenticides (for all conotruncal cases: OR = 3.2, 95% CI 1.1-13.2). These results are consistent with previous studies of associations of maternal diabetes and pesticide exposure with conotruncal malformations. Further research is warranted to explore such associations and determine avenues for prevention.

关键词： Congenital Heart Disease Cardiovascular Malformations Conotruncal Malformations Epidemiology Environmental Factors Diabetes

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Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans

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Military Medical Research 2018年第1期5卷 19-32页

作者： Rebecca A.Johnson David L.Albright James R.Marzolf Jessica L.Bibbo Hayley D.Yaglom Sandra M.Crowder Gretchen K.Carlisle Amy Willard Cynthia L.Russell karen Grindler Steven Osterlind Marita Wassman nathan Harms Research Center for Human Animal interaction College of Veterinary Medicine University of Missouri Columbia MO 65211 USA. ResearchService Harry S. Truman Memorial Veterans' Hospital ColumbiaMO 65211 USA. School of Social Work University of AlabamaTuscaloosa AL 35487 USA. Occupational Health Services Harry S. Truman Memorial Veterans' Hospital Columbia MO 65211 USA. Center for the Human-Animal Bond College of Veterinary MedicinePurdue University West Lafayette IN 47907 USA. School of Health Professions University of Missouri Columbia MO 65211 USA. TREE House of Greater St. Louis Wentzville MO 63385 USA. School of nursing and Health Studies University of Missouri-Kansas CityKansas City MO 64108 USA. Cedar Creek Therapeutic Riding Center Columbia MO 65201 USA. College of Education School and Counseling Psychology University of Missouri Columbia MO 65211USA. Ride-On St. Louis Kimmswick MO 63053 USA.

Background:Large numbers of post-deployment *** are diagnosed with post-traumatic stress disorder(PTSD)and/or traumatic brain injury(TBI),leading to an urgent need for effective interventions to reduce symptoms and increase veterans’*** includes anxiety,flashbacks,and emotional *** symptoms increase health care costs for stress-related illnesses and can make veterans’civilian life ***:We used a randomized wait-list controlled design with repeated measures of *** veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding(THR)program for decreasing PTSD symptoms and increasing coping self-efficacy,emotion regulation,social and emotional *** participants were recruited and 29 enrolled in the randomized *** were randomly assigned to either the horse riding group(n=15)or a wait-list control group(n=14).The wait-list control group experienced a 6-week waiting period,while the horse riding group began *** wait-list control group began riding after 6 weeks of participating in the control *** and health history information was obtained from all the *** symptoms were measured using the standardized PTSD Checklist-Military Version(PCL-M).The PCL-M as well as other instruments including,The Coping Self Efficacy Scale(CSES),The Difficulties in Emotion Regulation Scale(DERS)and The Social and Emotional Loneliness Scale for Adults-short version(SELSA)were used to access different aspects of individual well-being and the PTSD ***:Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR(P≤0.01)as well as a statistically and clinically significant decrease after 6 weeks of THR(P≤0.01).Logistic regression showed that participants had a 66.7%likelihood of having lower PTSD scores at 3 weeks and 87.5%likelihood at 6 *** the generalized linear model(GLM),our AnOVA findings for the coping self

关键词： Animal-assisted intervention Coping self-efficacy Emotion regulation Military veterans Post-traumatic stress disorder Social engagement Therapeutic horseback riding Traumatic brain injury

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nationwide retrospective study of hepatitis B virological response and liver stiffness improvement in 465 patients on nucleos(t)ide analogue

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World Journal of Gastroenterology 2022年第31期28卷 4390-4398页

作者： Alnoor Ramji karen Doucette Curtis Cooper Gerald Yosel Minuk Mang Ma Alexander Wong David Wong Edward Tam Brian Conway David Truong Philip Wong Lisa Barrett Hin Hin Ko Sarah Haylock-Jacobs nishi Patel Gilaad G Kaplan Scott Fung Carla S Coffin Department of Medicine University of British ColumbiaVancouver v6t 1z3Canada Department of Medicine University of AlbertaEdmonton t6g 2r7Canada Department of Medicine The Ottawa Hospital Research InstituteUniversity of OttawaOttawa ON K1H 8L6Canada Department of Medicine University of ManitobaWinnipeg r3e 3j7Canada Department of Medicine University of SaskatchewanSaskatoon s7n 5e5Canada Department of Medicine University Health NetworkToronto m5g 2c4Canada Pacific Gastroenterology Associates Vancouver v6z 2k5Canada Vancouver Infectious Disease Centre Vancouver v6z 2c7Canada Department of Medicine McGill UniversityMontreal h3a 0g4Canada Department of Microbiology and Immunology Dalhousie UniversityHalifax b3h 4r2Canada Cumming School of Medicine University of CalgaryCalgary t2n 1n4Canada

BACKGROUnD Hepatitis B virus(HBV)nucleos(t)ide analog(nA)therapy reduces liver disease but requires prolonged therapy to achieve hepatitis B surface antigen(HBsAg)*** is limited north American real-world data using non-invasive tools for fibrosis assessment and few have compared 1st generation nA or lamivudine(LAM)to tenofovir disoproxil fumarate(TDF).AIM To assess impact of nA on virological response and fibrosis regression using liver stiffness measurement(LSM)(i.e.,FibroScan®).METHODS Retrospective,observational cohort study from the Canadian HBV *** collected included demographics,nA,HBV DnA,alanine aminotransferase(ALT),and *** were HBV monoinfected patients,treatment naïve,and received 1 nA with minimum 1 year *** In 465(median 49 years,37%female,35%hepatitis B e antigen+at baseline,84%Asian,6%White,and 9%Black).Percentage of 64(n=299)received TDF and 166 were LAM-treated with similar median duration of 3.9 and 3.7 years,*** mean baseline LSM was 11.2 kPa(TDF)vs 8.3 kPa(LAM)(P=0.003).At 5-year follow-up,the mean LSM was 7.0 kPa in TDF vs 6.7 kPa in LAM(P=0.83).There was a significant difference in fibrosis regression between groups(i.e.,mean-4.2 kPa change in TDF and-1.6 kPa in LAM,Pn treatment showed that all had normal ALT,but more TDF patients were virologically suppressed(n=170/190,89%)vs LAM-treated(n=35/58,60%)(Pnone cleared *** In this real-world north American study,approximately 5 years of nA achieves liver fibrosis regression rarely leads to HBsAg loss.

关键词： nucleos(t)ide analog therapy Functional cure Hepatitis B virus surface antigen loss Fibrosis regression Liver stiffness measurement Transient elastography

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Reducing parental anxiety using a family based intervention for youth mental health: A randomized controlled trial

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Open Journal of Psychiatry 2013年第1期3卷 173-185页

作者： Melanie D. Bertino karen Richens Tess Knight John W. Toumbourou Lina Ricciardelli Andrew J. Lewis Centre for Mental Health and Wellbeing Research School of Psychology Deakin University Burwood Australia

This paper presents findings on parent anxiety and attachment relationship style from the Deakin Family Options (DFO) pilot study, a randomized controlled pilot study comparing a family-based treatment (BEST Plus), versus a youth only treatment (CBT) versus a group who received both of these treatments (COMBInED). Eligible participants were families with a young person (aged 12 - 25 years) with a high prevalence mental health problem. Youth from participating families scored in the clinical or subclinical range for depression, anxiety and/or substance misuse symptoms on standardized measures during the initial assessment. The collected sample was drawn from regional and urban centers in Victoria, Australia and allocated to treatment condition using a simple randomization procedure (parallel design). It was hypothesized that families receiving the BEST Plus would experience greater reductions in youth and parent mental health symptoms, and improved parent-child relationships, compared with those in the CBT condition. This paper describes and discusses changes in parent anxiety and parent attachment, according to whether the parent participated in a treatment (BEST Plus) or did not (nOnBEST Plus). Participants were blind to the study hypotheses. In total 71 parent participants returned pre data and were allocated to a treatment group. In this paper, data from parent participants who completed pre and post measures (n = 48) and pre, post, and 6-month follow-up measures (n = 28) on anxiety and attachment were analyzed by group (BEST Plus versus nOnBEST Plus). The results of this study suggest that parent anxiety decreased significantly more following parent involvement in a group treatment, than for parents that did not receive treatment. Unexpectedly, avoidant attachment increased in the no treatment group, but remained relatively stable following the BEST Plus group. There were no significant findings in relation to compulsive traits and anxious attachment. These find

关键词： Adolescent Parenting Anxiety Depression Attachment Randomized Controlled Trial

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Competing risks of death in younger and older postmenopausal breast cancer patients

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World Journal of Clinical Oncology 2014年第5期5卷 1088-1096页

作者： Judy-Anne W Chapman Kathleen I Pritchard Paul E Goss James n Ingle Hyman B Muss Susan F Dent Ted A Vandenberg Brian Findlay karen A Gelmon Carolyn F Wilson Lois E Shepherd Michael n Pollak nCIC Clinical Trials Group Queen's University Kingston ON K7L 3N6 Canada Sunnybrook Odette Cancer Centre University of Toronto Toronto ON M4N 3M5 Canada Massachusetts General Hospital Harvard University Boston MA 02114 United States Mayo Clinic Rochester MN 55902 United States Lineberger Comprehensive Cancer Center at the University of north Carolina at Chapel Hill Chapel Hill NC27514 United States Ottawa Hospital Cancer Center University of Ottawa Ottawa ON K1H8L6 Canada London Health Sciences Centre University of Western Ontario London ON N6G 2V4 Canada niagara Health System McM aster University St. Catharines ON L2R 2Z4 Canada BC Cancer Agency University of British Columbia Vancouver BC V5Z 1L3 Canada nCIC Clinical Trials Group Queen's University Kingston Ontario K7L 3N6 Canada Lady Davis Institute Jewish General Hospital McG ill University Montreal QC H3T 1E2 Canada

AIM: To show a new paradigm of simultaneously testing whether breast cancer therapies impact other causes of death. METHODS: MA.14 allocated 667 postmenopausal women to 5 years of tamoxifen 20 mg/daily ± 2 years of octreotide 90 mg, given by depot intramuscular injections monthly. Event-free survival was the primary endpoint of MA.14; at median 7.9 years, the tamoxifen+octreotide and tamoxifen arms had similar event-free survival(P = 0.62). Overall survival was a secondary endpoint, and the two trial arms also had similar overall survival(P = 0.86). We used the median 9.8 years follow-up to examine by intention-to-treat, the multivariate time-to-breast cancer-specific(Br Ca) and other cause(OC) mortality with log-normal survival analysis adjusted by treatment and stratification factors. We tested whether baseline factors including Insulin-like growth factor 1(IGF1), IGF binding protein-3, C-peptide, body mass index, and 25-OH vitamin D were associated with(1) all cause mortality, and if so; and(2) cause-specific mortality. We also fit step-wise forward cause-specific adjusted ***: The analyses were performed on 329 patients allocated tamoxifen and 329 allocated tamoxifen+octreotide. The median age of MA.14 patients was 60.1 years: 447(82%) nd 120(18%) ≥ 70 years. There were 170 deaths: 106(62.3%) BrC a; 55(32.4%) OC, of which 24 were other malignancies, 31 other causes of death; 9(5.3%) patients with unknown cause of death were excluded from competing risk assessments. BrC a and OC deaths were not significantly different by treatment arm(P = 0.40): tamoxifen patients experienced 50 BrC a and 32 OC deaths, while tamoxifen + octreotide patients experienced 56 Br Ca and 23 OC deaths. Proportionately more deaths(P = 0.004) were from BrC a for patientsn of deaths from OC increased with increasing body mass index(BMI)(P = 0.02). Higher pathol

关键词： Breast cancer Postmenopausal Hormone receptor positive Competing risks Tamoxifen Octreotide LAR

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