Definitive Interpretation Research Articles

DENTAL IMAGING DILEMMAS IN KLIPPEL-FEIL ANOMALY

<h3>Background</h3> Because of the broad range of findings, Klippel-Feil syndrome has also been referred to as <i>Klippel-Feil sequence</i> and <i>Klippel-Feil anomaly</i>. It is classified into 3 types that differ in degree and location of vertebral fusion. Another contemporary classification also includes patterns of inheritance. <h3>Case Report</h3> A 19-year-old male needed panoramic imaging to evaluate his third molars. However, because of Klippel-Feil disfigurement, his head and neck posture did not fit into various panoramic imaging units. With an altered oblique head positioning in a cone beam computed tomography (CBCT) scanner (NewTom VGi), his jaws were scanned. The CBCT volumetric data were then realigned and reconstructed in CBCT viewing software (InVivoDental 6.0). These reconstructions were appropriate to assess the indicated dental status and to update the assessment of the cervical vertebral development—a limiting condition of Klippel-Feil syndrome. <h3>Definitive Interpretation</h3> The scan data were able to provide the indicated periapical assessment, particularly of the third molars. Postural compromises were also noted in the anterior alignment of the odontoid process–C1 articulation and their alignment to the clivus of the occipital bone. There was also cervical vertebral aplasia with complete fusion of C2-C7. These findings were contributory to his altered posture. <h3>Discussion of Imaging</h3> The availability of large volume CBCT scanners, with their larger footprint, scanning circumference, and larger scanning size area, provide an imaging option for patients with mental and physical disabilities. In the past, a single large field of view (FOV) CBCT scan has been purported by CBCT manufacturers to be a one-stop imaging solution for all extraoral imaging. Dosimetry data and FDA selection criteria have since contraindicated the use of large volume FOV scanning to replace standard periapical, panoramic, and cephalometric imaging. This case report supports the alternative use of CBCT to acquire standard extraoral images when standard imaging is not possible.

TEMPOROMANDIBULAR CONDYLAR OSTEOCHONDROMAS: CHARACTERISTICS AND COMPLICATIONS

<h3>Background</h3> Benign, solitary osteochondromas arise in response to an event (e.g., trauma, x-radiation), rather than as true neoplasms. Typically, osteochondromas represent 10% to 15% of all bone tumors and approximately 35% of benign bone tumors. They usually develop during a known age range and at largely predictable anatomic sites, whether the osteochondroma is benign or malignant. The most important piece of clinical information is the patient's age, although exceptions exist. Most osteochondromas occur on the metaphysis of appendicular long bones. <h3>Clinical and Radiographic findings</h3> Three cases are of temporomandibular condylar osteochondromas are presented. All patients were adult males with ages 29, 55, and 56 years. Each tumor arose from the condylar articular surface and developed into abnormal morphologies that followed the outline of adjacent structures. <h3>Definitive Interpretation</h3> The radiographic findings of an exostotic bony tumor with smooth but irregular outlines, sclerosed cortices, and moderately dense trabeculation confined within the joint capsule were consistent with the radiographic appearance of osteochondroma. <h3>Discussion</h3> Radiographically, 2-D imaging is adequate to establish an initial radiographic diagnosis. However, more advanced modalities (computed tomography/magnetic resonance imaging [CT/MRI) are indicated to better evaluate the orientation of the tumor and assist in the surgical management. The 3-D imaging of the 3 cases presented here emphasize this point. Positron emission tomography/fluorodeoxyglucose (PET/FDG) imaging has also been recommended for specific cases. MRI may overestimate tumor aggressiveness secondary to the influence of bone marrow and soft tissue edema. The recognition of an osteochondroma is significant because it is benign, but it can lead to disfigurement and loss or altered mandibular function, if not treated.

NASOPALATINE DUCT CYSTS: A SPECTRUM OF IMAGING PRESENTATIONS

<h3>Background</h3> Nasopalatine duct cysts are the most common nonodontogenic cysts of the oral cavity. These cysts are classified as being developmental in nature because they most likely develop after spontaneous cystic degeneration of the epithelial remnants of the nasopalatine duct. Imaging plays a vital role in the diagnosis and management of these cysts. <h3>Discussion/Conclusions</h3> We present 5 cases consisting of 3 males and 2 females seen in the Oral and Maxillofacial Radiology clinic at University of Toronto Faculty of Dentistry (Toronto, Canada). The ages of the patients ranged from 40 to 65 years. These cases all exhibited unusual imaging features that posed difficulties in interpretation. One potential difficulty in the radiologic interpretation of these entities was that these cysts exhibited a range of growth patterns that were unconventional; for example, some were asymmetric, and their epicenters were not located in the midlines of the anterior maxillae. Furthermore, some entities demonstrated benign-appearing expansile characteristics, whereas others had more aggressive features. Because of their positions and their proximities to the maxillary anterior teeth, the lesions appeared to resorb or displace teeth. Therefore, the possibility that these entities could be interpreted as rarefying osteitis (e.g., radicular cysts) or odontogenic keratocysts could not be ruled out on the basis of plain film imaging alone. Although there is value in planar film imaging as the preliminary imaging modality, atypical features, such as asymmetric location and loss of normal anatomic structures, made routine interpretation difficult. As a result, we undertook advanced imaging of these patients which enabled us to identify additional key features that enabled us to make a more definitive interpretation. This presentation aims to demonstrate the range of atypical presentations of the nasopalatine duct cysts. A clear understanding of this range of imaging features will improve the interpretive skill of oral and maxillofacial radiologists.

Поняття території дипломатичного представництва та консульської установи України за кордоном

Метою дослідження є наукове визначення та юридичне тлумачення терміну «територія дипломатичного представництва та консульської установи України за кордоном», яке наведено у главі 41 Кримінального процесуального кодексу України. Завданнями статті є юридичний аналіз статей глави 41 та теоретичне обґрунтування означеного терміну через категорії наступних галузей права: міжнародного права (категорії «приміщення представництва», «консульське приміщення»); теорії держави і права (категорія «територія держави»); кримінально-процесуального права (категорія «дія процесуального закону у просторі»).Наукова новизна полягає у системному дослідженні поняття «територія дипломатичного представництва». Окремі вітчизняні та зарубіжні науковці торкалися цієї проблематики частково, досліджуючи, в основному, питання вчинення процесуальних дій на території дипломатичних представництв. Більшість науковців поставило під сумнів можливість використання терміну «територія дипломатичного представництва та консульської установи» у кримінальному процесуальному законодавстві.Автором доводиться, що український законодавець у кримінально-процесуальному законі вдало та правильно застосував саме термін «територія дипломатичного представництва та консульської установи». Свою думку автор обґрунтовує трьома аргументами: 1) український законодавець відокремлює «територію України» від «території дипломатичного представництва та консульської установи України за кордоном», підкреслюючи, що це не одне і теж саме, і перше не охоплює друге; 2) у Кримінальному процесуальному кодексі України використаний спеціальний юридичний термін, який притаманний спеціальній юридичній термінології кримінально-процесуального права; 3) аналіз повноважень керівників дипломатичних представництв та консульських установ України за кордоном щодо здійснення ними кримінального провадження показав, що саме вони, використовуючи положення теорії екстериторіальності, приймають рішення про допуск чи недопуск на територію дипломатичних представництв представників правоохоронних органів країни перебування. Але, у будь-якому випадку скоєння на території дипломатичного представництва кримінального правопорушення, вони зобов’язані провести відповідні процесуальні дії.Висновки. Територія дипломатичного представництва або консульської установи України за кордоном у сенсі можливості вчинення процесуальних дій – це: 1) не територія України, тобто держави, що акредитує, а територія країни перебування; 2) територія зі спеціальним правовим статусом, який передбачає недоторканність та інші дипломатичні імунітети та привілеї; 3) сукупність будівель, частин будівель та приміщень, а також дипломатичні транспортні засоби; 4) земельна ділянка, яка позначена на місцевості і оточена парканом.

Taxonomic reassessment of the genus Dichotomius (Coleoptera: Scarabaeinae) through integrative taxonomy.

Dung beetles of the subfamily Scarabaeinae are widely recognised as important providers of multiple ecosystem services and are currently experiencing revisions that have improved our understanding of higher-level relationships in the subfamily. However, the study of phylogenetic relationships at the level of genus or species is still lagging behind. In this study we investigated the New World beetle genus Dichotomius, one of the richest within the New World Scarabaeinae, using the most comprehensive molecular and morphological dataset for the genus to date (in terms of number of species and individuals). Besides evaluating phylogenetic relationships, we also assessed species delimitation through a novel Bayesian approach (iBPP) that enables morphological and molecular data to be combined. Our findings support the monophyly of the genus Dichotomius but not that of the subgenera Selenocopris and Dichotomius sensu stricto (s.s). Also, our results do not support the recent synonymy of Selenocopris with Luederwaldtinia. Some species-groups within the genus were recovered, and seem associated with elevational distribution. Our species delimitation analyses were largely congruent irrespective of the set of parameters applied, but the most robust results were obtained when molecular and morphological data were combined. Although our current sampling and analyses were not powerful enough to make definite interpretations on the validity of all species evaluated, we can confidently recognise D. nisus, D. belus and D. mamillatus as valid and well differentiated species. Overall, our study provides new insights into the phylogenetic relationships and classification of dung beetles and has broad implications for their systematics and evolutionary analyses.

Poziom cytokin IL-35, TNF-α, BAFF i VEGF w surowicy w różnych chorobach reumatycznych.

ObjectivesInflammatory processes in rheumatic diseases spread via various types of immune system cells and tissues with the aid of inflammatory cytokines and growth factors and the participation of vascular endothelium. Research is still conducted to determine the role of individual factors in the pathophysiology of rheumatic diseases. The task is complicated because the multiplane network of cytokines is characterized by complex correlations manifesting as positive and negative feedback, which impedes the definitive interpretation of the role of specific cytokines. Therefore, it seems justified to perform a comparative analysis of the expression of at least several molecules in one study, which may help reveal their role in the pathogenesis of rheumatic diseases and have prognostic value.Material and methodsThe aim of the study involves the assessment and comparative analysis of the concentrations of interleukin 35 (IL-35), tumour necrosis factor α (TNF-α), B-cell-activating factor (BAFF), and vascular endothelial growth factor (VEGF) in peripheral blood serum in patients with rheumatoid arthritis (RA) (n = 43), systemic lupus erythematosus (SLE) (n = 28), antiphospholipid syndrome (APS) (n = 24), and mixed connective tissue disease (MCTD) (n = 9). The main intention is to search for biomarkers for specific rheumatic diseases. Cytokine and growth factor levels were determined using specific ELISA kits.ResultsStatistically significant differences in VEGF and IL-35 concentrations occurred between patients with APS vs. RA and SLE vs. RA. There was a significant high positive correlation between the concentration of BAFF and TNF-α (r = 0.77, p < 0.0000) in patients with APS, as well as in patients with SLE (r = 0.55, p = 0.00).ConclusionsBAFF and TNF-α may be promising biomarkers in patients with APS and VEGF in patients with RA. Additionally, IL-35 may be a useful marker for the diagnosis of APS. Positive correlation of BAFF and TNF-α concentrations in APS and SLE potentially indicates much more similar etiopathogenesis of these diseases than it could be previously predicted.

Analysis of the state of formation of managerial competence of the future managers of general secondary education institutions

The article presents the results of the conducted ascertaining experiment that covered undergraduates in the specialty 073 «Management» of the sphere of knowledge 07 «Management and Administration». The experimental research questionnaires are structured into blocks that make it possible to predict the need to create and implement the pedagogical system of forming the managerial competence of the future heads of institutions of general secondary education.&#x0D; At the stage of conducting the ascertainment experiment, the level of understanding and perception of the concepts of management activity was investigated, which showed the lack of clear interpretation and differentiation of managerial definitions; the self-needs of the undergraduates in the formation of managerial competence and readiness for the implementation of managerial functions were carried out, which showed the lack of personal readiness for managerial activity; we cleared out own attitude of students of the second (master’s) level of higher education to the expediency of forming of the aggregate competences, which create the managerial function. We made self-assessment of factors influencing the effectiveness of managerial activity, confirming the need for the formation of managerial competence through the acquisition of ethical, communicative, conflictological, psychological, general sectoral, economic, legal, subject-methodological, diagnostic, educational, information technical competence as well as competences, of self-development and productive activity.

Discovery of topological constraints on spatial object classes using a refined topological model

In a typical data collection process, a surveyed spatial object is annotated upon creation, and is classified based on its attributes. This annotation can also be guided by textual definitions of objects. However, interpretations of such definitions may differ among people, and thus result in subjective and inconsistent classification of objects. This problem becomes even more pronounced if the cultural and linguistic differences are considered. As a solution, this paper investigates the role of topology as the defining characteristic of a class of spatial objects. We propose a data mining approach based on frequent itemset mining to learn patterns in topological relations between objects of a given class and other spatial objects. In order to capture topological relations between more than two (linear) objects, this paper further proposes an extension of the 9-intersection model for topological relations of line geometries. The discovered topological relations form topological constraints of an object class that can be used for spatial object classification. A case study has been carried out on bridges in the OSM dataset for the state of Victoria, Australia. The results show that the proposed approach can successfully learn topological constraints for the class bridge, and that the proposed extended topological model for line geometries outperforms the 9-intersection model in this task.

ДО ВИЗНАЧЕННЯ МІЦНОСТІ І КЛАСУ БЕТОНУ

В статті узагальнено досвід роботи відділу досліджень конструкцій будівель і споруд щодо спірних питань визначення класу і міцності бетону на стиск. Головним показником якості бетону в бетонних і залізобетонних збірних та монолітних конструкціях є клас бетону на стиск, що відповідає величині його характеристичної міцності. Відомі аналітичне і графічне представлення цього показника. Його не однозначне трактування в існуючій нормативній базі на стадіях підбору складу бетону, виготовлення продукції, експлуатації будівель і споруд призводить до конфлікту економічнихінтересів між сторонами: виробник бетону, будівельник, інвестор. Вирішення проблем однозначного трактування результатів руйнівних та неруйнівних методів випробувань міцності бетону можливе лише за умови перегляду і узгодження чинних нормативів. Представлено аналіз та приклади використання нормативної бази визначення міцності і класу бетону, що діє для виробників і споживачів бетону, та визначення міцності і класу бетону безпосередньо в конструкціях. Наведено приклади необґрунтованого оцінювання міцності при використанні неруйнівних механічних і ультразвукових методів та за контрольними зразками через ігнорування нормативних умов. Для експлуатації конструкцій суттєво забезпеченняфактичного класу міцності бетону, що встановлено проектом. Для його достовірного визначення застосовують випробування зразків з вибурених із конструкції бетонних кернів та тарованих ними неруйнівних методів. Проаналізовано на прикладі різні методи оцінки результатів випробування міцності кернів. Однозначності потребує метод визначення результатів випробування – за окремими результатами чи за їх партіями.

CORR® Tumor Board: Can Navigation Improve the Ability to Achieve Tumor-free Margins in Pelvic and Sacral Primary Bone Sarcoma Resections? A Historically Controlled Study

CORR® Tumor Board: Can Navigation Improve the Ability to Achieve Tumor-free Margins in Pelvic and Sacral Primary Bone Sarcoma Resections? A Historically Controlled Study

Defining undertreatment and overtreatment in older patients with cancer: A scoping review of the literature.

e23020 Background: The terms “undertreatment” and “overtreatment” are often used to describe the management of older adults with cancer. The aim of this scoping review was to explore the explicit and implicit definitions associated with the use of these terms. Methods: We searched PubMed (NCBI), Embase (Elsevier), and CINAHL (EBSCO) for titles and abstracts that included the terms "undertreatment" or "overtreatment" (overtreat OR undertreat OR over treat OR under treat) of older adults with cancer. We included all types of articles, cancers, and treatments. We excluded studies that only included patients younger than 60 years old or studies without a defined focus on older adults. CD and KL independently reviewed a subset of included articles to assess for inter-reviewer reliability. Results: We identified 224 primary and secondary research articles that used the terms “undertreatment” (192), “overtreatment” (72), or both (45) regarding the management of older adults with cancer. Only 14 (6.3%) articles provided an explicit definition; for the remaining articles, we derived the implicit definitions from the terms’ surrounding context. There was substantial agreement between CD and KL in their interpretation of definitions of these terms (kappa 0.81). “Undertreatment” was commonly used to imply less than “standard” therapy (130 articles, 67.7%), or less than “standard” therapy that contributed to worse outcomes (62, 32.3%). Many articles did not account for the underrepresentation of older adults in trials leading to “standard” therapy, and 24 primary studies performed no or limited adjustment for geriatric domains (e.g., function) in their analyses that suggested worse survival in older adults treated with substandard therapy. “Overtreatment” was commonly used to imply cancer treatment in an older adult whose cancer would not have caused symptoms in his/her remaining lifetime (31, 43.1%), or aggressive treatment in whom the harms of treatment outweigh its benefits (41, 56.9%). Conclusions: Nearly all articles used the terms “undertreatment” and/or “overtreatment” without an explicit definition, and we identified variability and limitations in the meanings implied by these terms.

The right against self-incrimination in India: the compelling case of Kathi Kalu Oghad

ABSTRACTIn 1961, the Indian Supreme Court delivered what continues to be the definitive interpretation of the constitutional right against self-incrimination. Despite great scholarly emphasis on fundamental rights cases, and the recent emphasis on the Court’s assumption of executive functions, the decision in State of Bombay v Kathi Kalu Oghad remains criminally under-examined. This paper attempts to fill this gap. It adopts a historical approach to appreciate the import and significance of the issues in Oghad, and better appreciate the interpretive choices adopted by the Supreme Court in the case. Besides developing existing legal critiques against the outcome in Oghad, the paper goes on to suggest that the decision was an example of the Court deferring to the political process. It concludes that, perhaps, it is time to re-evaluate those choices, and reclaim the potential of the right against self-incrimination to serve as a bulwark against police coercion in India.

Feminization of Transgender Women With Thyroid Chondroplasty and Laryngoplasty.

In recent years, gender affirmation surgery has broadened significantly from its previous focus on genital conformation only to include other areas of the body as well. As society reconsiders its interpretations of masculinity, femininity, and gender definitions, transgender individuals have realized that they will only be able to truly transition if they are recognized by the public in their chosen societal role. The authors review the literature and describe their own techniques for feminizing thyroid chondroplasty and laryngoplasty.

Reclaiming the Right against Self-Incrimination in India

In 1961, eleven Justices of the Indian Supreme Court delivered what continues to be the definitive interpretation of the constitutional right against self-incrimination. Despite great scholarly emphasis on fundamental rights cases of the Supreme Court, and the recent emphasis on the Court’s enhanced position in the balance of powers, the decision in State of Bombay v Kathi Kalu Oghad remains criminally under-examined. This paper attempts to fill this gap. It adopts a historical approach to appreciate the import and significance of the issues in Oghad, and to better appreciate the nature of interpretive choices adopted by the Supreme Court in the case. Besides agreeing with and developing the existing legal critique against the outcome in Oghad, the paper goes on to suggest that the decision itself was an example of the Court deferring to the political process. It concludes that it is time for a re-evaluation of those choices, and thus reclaiming the potential of the fundamental right against self-incrimination to serve as a bulwark against police coercion in India.

Gaming National Emergency Access Target performance using Emergency Treatment Performance definitions and emergency department short stay units.

To evaluate potential gaming of the 4 h ED length of stay metric known as the National Emergency Access Target (NEAT) in Australia and Emergency Treatment Performance (ETP) in New South Wales (NSW). Descriptive statistical analysis was used to recalculate and compare the scores for NEAT and the NSW ETP using variations in the definitions of their measurement on 32 184 presentations during 2016. A computer simulation using a discrete event model illustrated the effect of the use of ED short stay beds on the ETP scores. Using the timestamp of the intent to discharge a patient, called, 'ready for departure' instead of the time of a patient physically leaving the department, resulted in an apparent 6% performance improvement. A local interpretation of the NSW state definition of the 'transferred' patient resulted in the ETP for 'admitted' patients improving by 16%. The discrete event model demonstrated that without changing patient length of stay, ETP scores can be improved by optimising the time of the admit decision or increasing the number of ED short stay beds. The opportunity of NEAT may be squandered unless gaming of the definitions and use of ED short stay beds is addressed. We argue that the longstanding issue of 'departure time' should be defined as 'physically leaving' the department, in accordance with the Australasian College for Emergency Medicine (ACEM) definition. Patient occupancy is a real measure of ED resource use and NSW and national recommendations should be adjusted. ACEM accreditation of EDs should include review of their application of NEAT definitions to ensure they truly reflect patient flow processes.

Metabolism of cyclic phenones in rainbow trout in vitro assays

1. Cyclic phenones are chemicals of interest to the USEPA due to their potential for endocrine disruption to aquatic and terrestrial species.2. Prior to this report, there was very limited information addressing metabolism of cyclic phenones by fish species and the potential for estrogen receptor (ER) binding and vitellogenin (Vtg) gene activation by their metabolites.3. The main objectives of the current research were to characterize rainbow trout (rt) liver slice-mediated in vitro metabolism of model parent cyclic phenones exhibiting disparity between ER binding and ER-mediated Vtg gene induction, and to assess the metabolic competency of fish liver in vitro tests to help determine the chemical form (parent and/or metabolite) associated with the observed biological response.4. GC-MS, HPLC and LC-MS/MS technologies were applied to investigate the in vitro biotransformation of cyclobutyl phenyl ketone (CBP), benzophenone (DPK), cyclohexyl phenyl ketone (CPK) mostly in the absence of standards for metabolite characterization.5. It was concluded that estrogenic effects of the studied cyclic phenones are mediated by the parent chemical structure for DPK, but by active metabolites for CPK. A definitive interpretation was not possible for CBP and CBPOH (alcohol), although a contribution of both structures to gene induction is suspected.

Bohemond VI and the Enigmatic Inscription from Tripoli

The inscription in Old French on a marble plaque from Tripoli of which Bohemond VI was the commissioner, remains enigmatic until the present day. The damaged state of the inscription, especially where the date of the text is given and the use of the term 'communauté de Tripoli', are the main obstacles for a definite interpretation of this inscription. The marble slab, discovered in 1928 in Tripoli, in or near the port, is now in the National Museum of Beirut. A mould of the inscription arrived in Paris as a gift from the National Museum in Beirut in 1936 and is part of the collection of the Cité de l'Architecture et du Patrimoine (Palais de Chaillot, Paris). The marble plate measures 60cm x 60cm x 9 cm

Effectiveness of Interpreter Training in the Japanese Interpretive Context and Opportunities for Improving Interpretation: An Impact Assessment of a Training Program in Japan

This exploratory research examined a four-day interpreter training program in Japan for impacts on participants’ self-reported increases in knowledge and skills. Pre-, during-, and post-training open-ended questionnaires were administered to all 17 participants. Results showed the training program was effective at increasing knowledge of interpretation's definitions, principles, and goals. Participants indicated extended opportunities for understanding the profession as a whole, as well as how to operationalize interpretation and develop strategic outcomes would increase the overall effectiveness of trainings. Future training programs could use a strategic reflection process to emphasize skill development in the design and delivery of interpretation. Results derived from this empirical research provide a guideline for developing a training framework contextualized to the practice of interpretation in Japan.

Singular ‘they’ and novel pronouns: gender-neutral, nonbinary, or both?

Pronouns have recently become a highly visible aspect of the LGBTQ+ movement among the general public and in linguistics. We investigated whether singular, specific ‘they’ and the novel singular gender-neutral pronoun ‘ze’ are interpreted as gender-neutral (slient on gender and the gender binary) or or referring specifically to referents of non-binary gender. Participants read descriptions of scholarship applicants, and guessed which photo matched the applicant they read about from an array of male, female, and non-binary subjects. Results suggest that ‘they’ is interpreted as gender-neutral, including non-binary/gender-nonconforming referents. ‘Ze’ does not appear to be recognized by enough English speakers to determine a definitive interpretation.

Updated mortality analysis of the Mallinckrodt uranium processing workers, 1942–2012

Purpose Mallinckrodt Chemical Works (MCW) was the earliest uranium processing facility in the United States, and in 1942 produced the uranium oxide used for the first sustained and controlled nuclear fission chain-reaction at the University of Chicago. A second follow-up through 2012 was conducted of 2514 White male workers employed 1942–1966 at the MCW for dose-response analyses for selected causes of death. Materials and methods Organ/tissue-specific dose reconstruction included both external (12,686 MCW film badge records, 210 other facility film badge records, and 31,297 occupational chest x-rays) and internal sources of uranium and radium (39,451 urine bioassays, 2341 breath radon measurements, and 6846 ambient radon measurements). Dust measurements from pitchblende facilitated quantitative risk estimates for non-radiogenic effects on the lung and kidney. Vital status was determined from multiple sources including the National Death Index and the Social Security Administration. Cox regression models were used for dose response analyses. Results Vital status was determined for 99% of the workers, of whom 75% had died. The mean lung dose from all sources of external and internal radiation combined was 69.9 mGy (maximum 885 mGy; percent workers >100 mGy, 10%) and there was no evidence for a dose response for lung cancer (Hazard Ratio (HR) of 0.95 (95% CI = 0.81–1.12) at 100 mGy). A significant association with radiation was found for kidney cancer (HR of 1.73 (95% CI = 1.04–2.79) at 100 mGy) and suggested for nonmalignant kidney diseases (HR of 1.30 (95% CI = 0.96–1.76) at 100 mGy). A non-radiation etiology could not be discounted, however, because of the possible renal toxicities of uranium, a heavy metal, and silica, a component of pitchblende dust. Non-significant HRs at 100 mGy for other sites of a priori interest were 0.36 (0.06–2.03) for leukemia other than CLL, 0.68 (0.17–2.77) for liver cancer, and 1.23 (0.79–1.90) for non-Hodgkin lymphoma. The HR at 100 mGy was 1.09 (0.99–1.20) for ischemic heart disease. An association was seen between dust and combined malignant and non-malignant lung disease, HR at 10 mgm−3year−1 of 1.01 (1.00–1.02). Conclusions A positive radiation dose response was observed for malignant and non-malignant kidney disease, and a negative dose response for malignant and non-malignant lung disease. Cumulative measures of dust were significantly associated with malignant and non-malignant lung disease and suggested for malignant and non-malignant kidney disease. Small numbers preclude definitive interpretations which will await the combination with similar studies of early uranium processing workers.