Background Over the past several decades, the incidence of esophageal adenocarcinoma (EAC) has rapidly increased. The purpose of this analysis was to examine temporal trends in EAC incidence and mortality within the US population and, in addition, to explore these trends within subgroups of the population. Methods The National Cancer Institute (NCI) Surveillance, Epidemiology and End Results (SEER 9) data were used to examine incidence and incidence-based (IB) mortality in EAC from 1975 to 2009. Secular trends in incidence and IB mortality by cancer stage, sex, and race were further characterized using the NCI's Joinpoint Regression program. Results Based on SEER 9 data, EAC incidence and IB mortality continues to increase in the United States. However, since the mid-1990s, the overall rate of increase in both EAC incidence and IB mortality appears to be slowing. In addition, in early-stage cancers, there is a noticeable leveling off of IB mortality rates and divergence from incidence starting in the late 1990s. Over the study period, the average annual percentage increase in incidence was 6.1% in men and 5.9% in women. Conclusions EAC incidence and IB mortality rates continue to rise in the United States, although at a slower rate in more recent years. In early-stage cancers, IB mortality and incidence rates have diverged primarily because IB mortality rates have plateaued beginning in the late 1990s. Although EAC continues to be less common in women, the rate of increase in EAC incidence is similar in both sexes.

Background The incidence of esophageal adenocarcinoma (EAC) has increased five-fold in the United States since 1975. The aim of our study was to estimate future U.S. EAC incidence and mortality and to shed light on the potential drivers in the disease process that are conduits for the dramatic increase in EAC incidence. Methods A consortium of three research groups calibrated independent mathematical models to clinical and epidemiologic data including EAC incidence from the Surveillance, Epidemiology, and End Results (SEER 9) registry from 1975–2010. We then used a comparative modeling approach to project EAC incidence and mortality to year 2030. Results Importantly, all three models identified birth cohort trends affecting cancer progression as a major driver of the observed increases in EAC incidence and mortality. All models predict that incidence and mortality rates will continue to increase until 2030 but with a plateauing trend for recent male cohorts. The predicted ranges of incidence and mortality rates (cases per 100,000 person years) in 2030 are 8.4–10.1 and 5.4–7.4 respectively for males, and 1.3–1.8 and 0.9–1.2 for females. Estimates of cumulative cause-specific EAC deaths among both sexes for years 2011–2030 range between 142,300 and 186,298, almost double the number of deaths in the past 20 years. Conclusions Through comparative modeling, the projected increases in EAC cases and deaths represent a critical public health concern that warrants attention from cancer control planners to prepare potential interventions. Impact Quantifying this burden of disease will aid health policy makers to plan appropriate cancer control measures.

In this paper measurements of momentum and current transport caused by current driven tearing instability are reported. The measurements are done in the Madison Symmetric Torus reversed-field pinch ͓R.

OBJECTIVE -High-viscosity hydroxypropylmethylcellulose (HV-HPMC) is a modified cellulose fiber that produces a viscous gel in the gastrointestinal tract. Clinical trials demonstrate that consumption of HV-HPMC significantly lowers cholesterol, but limited information has been available on the influence of HV-HPMC on postprandial insulin and glucose responses. The objective of this investigation was to assess the influence of HV-HPMC on postprandial glucose and insulin responses in overweight and obese men and women.RESEARCH DESIGN AND METHODS -Participants were 31 overweight or obese men and women without diabetes who underwent three breakfast meal tests in random order, separated by Ն72 h. Test meals containing 75 g carbohydrate plus 4 or 8 g HV-HPMC or control meals containing 8 g cellulose were delivered in a double-blind fashion.RESULTS -Peak glucose was significantly lower (P Ͻ 0.001) after both HV-HPMCcontaining meals (7.4 mmol/l [4 g] and 7.4 mmol/l [8 g]) compared with the control meal (8.6 mmol/l). Peak insulin concentrations and the incremental areas for glucose and insulin from 0 to 120 min were also significantly reduced after both HV-HPMC doses versus control (all P Ͻ 0.01).CONCLUSIONS -These findings indicate that HV-HPMC consumption reduces postprandial glucose and insulin excursions, which may favorably alter risks for diabetes and cardiovascular disease. Diabetes Care 30:1039 -1043, 2007I nsulin resistance and compensatory hyperinsulinemia are believed to play important pathophysiological roles in the development of a number of conditions, including diabetes, coronary heart disease, and hypertension (1,2). Insulin resistance is a state in which a given circulating concentration of insulin produces subnormal clearance of glucose from the blood (2).In the presence of insulin resistance, the pancreas will increase insulin secretion to maintain normal glucose tolerance (2). However, the resulting excessive demand on the pancreatic ␤-cells may, over an extended period, lead to pancreatic exhaustion and the eventual development of glucose intolerance (1,2). Furthermore, insulin resistance may not be present to the same degree for all tissues and actions of insulin. Therefore, the hyperinsulinemia required to maintain normal glucose tolerance may produce undesirable physiological effects, including increased synthesis of VLDL, enhanced renal sodium reabsorption, and remodeling of vascular and cardiac tissues (1-3).Slowing the absorption of digestible dietary carbohydrates shows promise as a way to reduce hyperinsulinemia and its unwanted consequences on pancreatic function and the development of hemodynamic disturbances (1,4 -6). One class of medication, the ␣-glucosidase inhibitors, slows glucose absorption by reducing the rate of enzymatic digestion of starch, thereby delaying the release of glucose molecules for absorption. These agents reduce postprandial glucose and insulin levels (7). A Cochrane Review of five trials (2,360 participants) concluded that there is evidence that acarbose reduced the ...

We have increased substantially the electron and ion temperatures, the electron density, and the total beta in plasmas with improved energy confinement in the Madison Symmetric Torus (MST). The improved confinement is achieved with a well-established current profile control technique for reduction of magnetic tearing and reconnection. A sustained ion temperature >1 keV is achieved with intensified reconnection-based ion heating followed immediately by current profile control. In the same plasmas, the electron temperature reaches 2 keV, and the electron thermal diffusivity drops to about 2 m 2 s −1. The global energy confinement time is 12 ms. This and the reported temperatures are the largest values yet achieved in the reversed-field pinch (RFP). These results were attained at a density ∼10 19 m −3. By combining pellet injection with current profile control, the density has been quadrupled, and total beta has nearly doubled to a record value of about 26%. The Mercier criterion is exceeded in the plasma core, and both pressure-driven interchange and pressure-driven tearing modes are calculated to be linearly unstable, yet energy confinement is still improved. Transient momentum injection with biased probes reveals that global momentum transport is reduced with current profile control. Magnetic reconnection events drive rapid momentum transport related to large Maxwell and Reynolds stresses. Ion heating during reconnection events occurs globally, locally, or not at all, depending on which tearing modes are involved in the reconnection. To potentially augment inductive current profile control, we are conducting initial tests of current drive with lower-hybrid and electron-Bernstein waves.

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Alkaline earth fluoride crystals doped with trivalent rare earth contain both isolated and clustered rare earths. Electronic nonradiative relaxation for isolated rare earths proceeds solely by multiphonon relaxation while for clustered rare earths, it proceeds by both efficient nonresonant energy transfer and multiphonon relaxation. We have measured the rates of all the relaxation processes for representative sites in CaF2, SrF2, and BaF2 in order to obtain a comprehensive understanding of relaxation in the materials. Exponential dependences of the multiphonon and energy transfer rates on energy gap have been found. The rates do not appear to scale simply with the lattice phonon energies but depend upon the details of the phonon distribution and coupling. Temperature dependence of the rates indicate a complex mixture of phonons may contribute to the observed relaxation.