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Sample records for risk pooled individual

  1. Baseline participant characteristics and risk for dropout from ten obesity randomized controlled trials: a pooled analysis of individual level data

    Directory of Open Access Journals (Sweden)

    Kathryn Ann Kaiser

    2014-12-01

    Full Text Available Introduction: Understanding participant demographic characteristics that inform the optimal design of obesity RCTs have been examined in few studies. The objective of this study was to investigate the association of individual participant characteristics and dropout rates (DORs in obesity randomized controlled trials (RCT by pooling data from several publicly available datasets for analyses. We comprehensively characterize DORs and patterns in obesity RCTs at the individual study level, and describe how such rates and patterns vary as a function of individual-level characteristics. Methods: We obtained and analyzed nine publicly-available, obesity RCT datasets that examined weight loss or weight gain prevention as a primary or secondary endpoint. Four risk factors for dropout were examined by Cox proportional hazards including sex, age, baseline BMI, and race/ethnicity. The individual study data were pooled in the final analyses with a random effect for study, and HR and 95% CIs were computed. Results: Results of the multivariate analysis indicated that the risk of dropout was significantly higher for females compared to males (HR= 1.24, 95% CI = 1.05, 1.46. Hispanics and Non-Hispanic blacks had a significantly higher dropout rate compared to non-Hispanic whites (HR= 1.62, 95% CI = 1.37, 1.91; HR= 1.22, 95% CI = 1.11, 1.35, respectively. There was a significantly increased risk of dropout associated with advancing age (HR= 1.02, 95% CI = 1.01, 1.02 and increasing BMI (HR= 1.03, 95% CI = 1.03, 1.04. Conclusion/Significance: As more studies may focus on special populations, researchers designing obesity RCTs may wish to oversample in certain demographic groups if attempting to match comparison groups based on generalized estimates of expected dropout rates, or otherwise adjust a priori power estimates. Understanding true reasons for dropout may require additional methods of data gathering not generally employed in obesity RCTs, e.g. time on

  2. The new pooled cohort equations risk calculator

    DEFF Research Database (Denmark)

    Preiss, David; Kristensen, Søren L

    2015-01-01

    total cardiovascular risk score. During development of joint guidelines released in 2013 by the American College of Cardiology (ACC) and American Heart Association (AHA), the decision was taken to develop a new risk score. This resulted in the ACC/AHA Pooled Cohort Equations Risk Calculator. This risk...... disease and any measure of social deprivation. An early criticism of the Pooled Cohort Equations Risk Calculator has been its alleged overestimation of ASCVD risk which, if confirmed in the general population, is likely to result in statin therapy being prescribed to many individuals at lower risk than...

  3. Sharing as risk pooling in a social dilemma experiment

    Directory of Open Access Journals (Sweden)

    Todd L. Cherry

    2015-03-01

    Full Text Available In rural economies with missing or incomplete markets, idiosyncratic risk is frequently pooled through informal networks. Idiosyncratic shocks, however, are not limited to private goods but can also restrict an individual from partaking in or benefiting from a collective activity. In these situations, a group must decide whether to provide insurance to the affected member. We describe results of a laboratory experiment designed to test whether a simple sharing institution can sustain risk pooling in a social dilemma with idiosyncratic risk. We tested whether risk could be pooled without a commitment device and, separately, whether effective risk pooling induced greater cooperation in the social dilemma. We found that even in the absence of a commitment device or reputational considerations, subjects voluntarily pooled risk, thereby reducing variance in individual earnings. In spite of effective risk pooling, however, cooperation in the social dilemma was unaffected.

  4. Accuracy of Pooled-Cohort Equation and SCORE cardiovascular risk calculators to identify individuals with high coronary atherosclerotic burden - implications for statin treatment.

    Science.gov (United States)

    Tralhão, António; Ferreira, António M; Gonçalves, Pedro de Araújo; Rodrigues, Rita; Costa, Cátia; Guerreiro, Sara; Cardim, Nuno; Marques, Hugo

    2016-11-01

    Different cardiovascular risk calculators and risk-based thresholds for initiating statin therapy are currently in use. Using coronary computed tomography angiography, we sought to compare the Pooled-Cohort Equation [atherosclerotic cardiovascular disease (ASCVD) score] with the Systematic COronary Risk Evaluation (SCORE) in the identification of patients with high coronary atherosclerotic burden. In a single-center prospective registry of patients undergoing coronary computed tomography angiography, we identified individuals aged 40-75 years without diabetes or known cardiovascular disease. Cardiovascular risk and eligibility for statin therapy were determined individually on the basis of the two calculators and the guidelines that endorse them. Coronary atherosclerotic burden was assessed by coronary calcium score, presence of stenosis greater than or equal to 50%, and several measures of plaque severity and extension. In the 327 patients assessed (181 men, mean age 59±9 years), the median SCORE and ASCVD values were 2.6 and 9.7%, respectively. Compared with SCORE, the ASCVD calculator showed greater discriminative power to identify patients with calcium score greater than or equal to 300 [C-statistic 0.74, 95% confidence interval (CI) 0.67-0.82 vs. 0.69, 95% CI 0.61-0.78, P=0.008] and showed a trend toward better identification of patients with obstructive stenosis (C-statistic 0.72, 95% CI 0.64-0.80 vs. 0.68, 95% CI 0.60-0.76, P=0.053). The proportion of statin-eligible patients would be higher with the SCORE-based criteria, particularly among individuals with little or no detectable coronary atherosclerosis. The SCORE calculator seems to be less discriminative than the ASCVD equation in identifying patients with high atherosclerotic burden. Current SCORE-based criteria would assign statin therapy to a larger proportion of patients with low-risk features, which could result in a lower yield of cholesterol-reducing strategies.

  5. Increased risk of lung cancer in individuals with a family history of the disease: A pooled analysis from the International Lung Cancer Consortium.

    NARCIS (Netherlands)

    Cote, M.L.; Liu, M.; Bonassi, S.; Neri, M.; Schwartz, A.G.; Christiani, D.C.; Spitz, M.R.; Muscat, J.E.; Rennert, G.; Aben, K.K.H.; Andrew, A.S.; Bencko, V.; Bickeboller, H.; Boffetta, P.; Brennan, P.; Brenner, H.; Duell, E.J.; Fabianova, E.; Field, J.K.; Foretova, L.; Friis, S.; Harris, C.C.; Holcatova, I.; Hong, Y.C.; Isla, D.; Janout, V.; Kiemeney, L.A.L.M.; Kiyohara, C.; Lan, Q.; Lazarus, P.; Lissowska, J.; Marchand, L. le; Mates, D.; Matsuo, K.; Mayordomo, J.I.; McLaughlin, J.R.; Morgenstern, H.; Mueller, H.; Orlow, I.; Park, B.J.; Pinchev, M.; Raji, O.Y.; Rennert, H.S.; Rudnai, P.; Seow, A.; Stucker, I.; Szeszenia-Dabrowska, N.; Teare, M.D.; Tjonnelan, A.; Ugolini, D.; Heijden, E. van der; Wichmann, E.; Wiencke, J.K.; Woll, P.J.; Yang, P.; Zaridze, D.; Zhang, Z.F.; Etzel, C.J.; Hung, R.J.

    2012-01-01

    BACKGROUND AND METHODS: Familial aggregation of lung cancer exists after accounting for cigarette smoking. However, the extent to which family history affects risk by smoking status, histology, relative type and ethnicity is not well described. This pooled analysis included 24 case-control studies i

  6. Swimming pool use and birth defect risk.

    Science.gov (United States)

    Agopian, A J; Lupo, Philip J; Canfield, Mark A; Mitchell, Laura E

    2013-09-01

    Swimming during pregnancy is recommended. However, the use of swimming pools is also associated with infection by water-borne pathogens and exposure to water disinfection byproducts, which are 2 mechanisms that are suspected to increase risk for birth defects. Thus, we evaluated the relationship between maternal swimming pool use during early pregnancy and risk for select birth defects in offspring. Data were evaluated for nonsyndromic cases with 1 of 16 types of birth defects (n = 191-1829) and controls (n = 6826) from the National Birth Defects Prevention Study delivered during 2000-2006. Logistic regression analyses were conducted separately for each birth defect type. Separate analyses were conducted to assess any pool use (yes vs no) and frequent use (5 or more occasions in 1 month) during the month before pregnancy through the third month of pregnancy. There was no significant positive association between any or frequent pool use and any of the types of birth defects, even after adjustment for several potential confounders (maternal race/ethnicity, age at delivery, education, body mass index, folic acid use, nulliparity, smoking, annual household income, surveillance center, and season of conception). Frequent pool use was significantly negatively associated with spina bifida (adjusted odds ratio, 0.68; 95% confidence interval, 0.47-0.99). Among offspring of women 20 years old or older, pool use was associated with gastroschisis (adjusted odds ratio, 1.3; 95% confidence interval, 1.0-1.8), although not significantly so. We observed little evidence suggesting teratogenic effects of swimming pool use. Because swimming is a common and suggested form of exercise during pregnancy, these results are reassuring. Copyright © 2013 Mosby, Inc. All rights reserved.

  7. Health risks of early swimming pool attendance.

    Science.gov (United States)

    Schoefer, Yvonne; Zutavern, Anne; Brockow, Inken; Schäfer, Torsten; Krämer, Ursula; Schaaf, Beate; Herbarth, Olf; von Berg, Andrea; Wichmann, H-Erich; Heinrich, Joachim

    2008-07-01

    Swimming pool attendance and exposure to chlorination by-products showed adverse health effects on children. We assessed whether early swimming pool attendance, especially baby swimming, is related to higher rates of early infections and to the development of allergic diseases. In 2003-2005, 2192 children were analysed for the 6-year follow-up of a prospective birth cohort study. Data on early swimming pool attendance, other lifestyle factors and medical history were collected by parental-administered questionnaire. Bivariate and multivariate logistic regression analyses were used to evaluate associations. Babies who did not participate in baby swimming had lower rates of infection in the 1st year of life (i) diarrhoea: OR 0.68 CI 95% 0.54-0.85; (ii) otitis media: OR 0.81 CI 95% 0.62-1.05; (iii) airway infections: OR 0.85 CI 95% 0.67-1.09. No clear association could be found between late or non-swimmers and atopic dermatitis or hay fever until the age of 6 years, while higher rates of asthma were found (OR 2.15 95% CI 1.16-3.99), however, potentially due to reverse causation. The study indicates that, in terms of infections, baby swimming might not be as harmless as commonly thought. Further evidence is needed to make conclusions if the current regulations on chlorine in Germany might not protect swimming pool attendees from an increased risk of gastrointestinal infections. In terms of developing atopic diseases there is no verifiable detrimental effect of early swimming.

  8. Application of solar roof shallow pool at individual residental buildings

    Directory of Open Access Journals (Sweden)

    Gavrilović Dragan J.

    2011-01-01

    Full Text Available The paper discusses the possibility of applying shallow roof pools of water on the basis of passive solar water capture functioning as thermal batteries and thermal "regulators" in a "hot - cold" mode with individual residential buildings. With this application, the utilization of the existing functionality of the building roof area would improve and open up the possibility of achieving better overall bio-climate individual object. By using this system, a flat roof impassable "terrace" takes on a new, additional energy function, which proves the ability to reduce overall energy consumption of total conventional seasonal heating and cooling consumption of a building. Supporting of this intention, the paper gives a variant solution of an easily prefabricated reinforced concrete roof system of shallow water pool that works on the principle of passive solar energy capture.

  9. Apolipoprotein E genotype, cardiovascular biomarkers and risk of stroke: Systematic review and meta-analysis of 14 015 stroke cases and pooled analysis of primary biomarker data from up to 60 883 individuals

    Science.gov (United States)

    Khan, Tauseef A; Shah, Tina; Prieto, David; Zhang, Weili; Price, Jackie; Fowkes, Gerald R; Cooper, Jackie; Talmud, Philippa J; Humphries, Steve E; Sundstrom, Johan; Hubacek, Jaroslav A; Ebrahim, Shah; Lawlor, Debbie A; Ben-Shlomo, Yoav; Abdollahi, Mohammad R; Slooter, Arjen JC; Szolnoki, Zoltan; Sandhu, Manjinder; Wareham, Nicholas; Frikke-Schmidt, Ruth; Tybjærg-Hansen, Anne; Fillenbaum, Gerda; Heijmans, Bastiaan T; Katsuya, Tomohiro; Gromadzka, Grazyna; Singleton, Andrew; Ferrucci, Luigi; Hardy, John; Worrall, Bradford; Rich, Stephen S; Matarin, Mar; Whittaker, John; Gaunt, Tom R; Whincup, Peter; Morris, Richard; Deanfield, John; Donald, Ann; Davey Smith, George; Kivimaki, Mika; Kumari, Meena; Smeeth, Liam; Khaw, Kay-Tee; Nalls, Michael; Meschia, James; Sun, Kai; Hui, Rutai; Day, Ian; Hingorani, Aroon D; Casas, Juan P

    2013-01-01

    Background At the APOE gene, encoding apolipoprotein E, genotypes of the ε2/ε3/ε4 alleles associated with higher LDL-cholesterol (LDL-C) levels are also associated with higher coronary risk. However, the association of APOE genotype with other cardiovascular biomarkers and risk of ischaemic stroke is less clear. We evaluated the association of APOE genotype with risk of ischaemic stroke and assessed whether the observed effect was consistent with the effects of APOE genotype on LDL-C or other lipids and biomarkers of cardiovascular risk. Methods We conducted a systematic review of published and unpublished studies reporting on APOE genotype and ischaemic stroke. We pooled 41 studies (with a total of 9027 cases and 61 730 controls) using a Bayesian meta-analysis to calculate the odds ratios (ORs) for ischaemic stroke with APOE genotype. To better evaluate potential mechanisms for any observed effect, we also conducted a pooled analysis of primary data using 16 studies (up to 60 883 individuals) of European ancestry. We evaluated the association of APOE genotype with lipids, other circulating biomarkers of cardiovascular risk and carotid intima-media thickness (C-IMT). Results The ORs for association of APOE genotypes with ischaemic stroke were: 1.09 (95% credible intervals (CrI): 0.84–1.43) for ε2/ε2; 0.85 (95% CrI: 0.78–0.92) for ε2/ε3; 1.05 (95% CrI: 0.89–1.24) for ε2/ε4; 1.05 (95% CrI: 0.99–1.12) for ε3/ε4; and 1.12 (95% CrI: 0.94–1.33) for ε4/ε4 using the ε3/ε3 genotype as the reference group. A regression analysis that investigated the effect of LDL-C (using APOE as the instrument) on ischaemic stroke showed a positive dose-response association with an OR of 1.33 (95% CrI: 1.17, 1.52) per 1 mmol/l increase in LDL-C. In the separate pooled analysis, APOE genotype was linearly and positively associated with levels of LDL-C (P-trend: 2 × 10−152), apolipoprotein B (P-trend: 8.7 × 10−06) and C-IMT (P-trend: 0.001), and negatively and

  10. Validation and comparison of imaging-based scores for prediction of early stroke risk after transient ischaemic attack: a pooled analysis of individual-patient data from cohort studies.

    Science.gov (United States)

    Kelly, Peter J; Albers, Gregory W; Chatzikonstantinou, Anastasios; De Marchis, Gian Marco; Ferrari, Julia; George, Paul; Katan, Mira; Knoflach, Michael; Kim, Jong S; Li, Linxin; Lee, Eun-Jae; Olivot, Jean-Marc; Purroy, Francisco; Raposo, Nicolas; Rothwell, Peter M; Sharma, Vijay K; Song, Bo; Tsivgoulis, Georgios; Walsh, Cathal; Xu, Yuming; Merwick, Aine

    2016-11-01

    Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up. All patients were assessed by stroke specialists in hospital settings as inpatients, in emergency departments, or in transient ischaemic attack clinics. Inclusion criteria were stroke-specialist confirmed transient ischaemic attack, age of 18 years or older, and MRI done within 7 days of index transient ischaemic attack and before stroke recurrence. Multivariable logistic regression was done to analyse the predictive utility of abnormal diffusion-weighted MRI, carotid stenosis, and transient ischaemic attack within 1 week of index transient ischaemic attack (dual transient ischaemic attack) after adjusting for ABCD2 score. We compared the prognostic utility of the ABCD2, ABCD2-I, and ABCD3-I scores using discrimination, calibration, and risk reclassification. In 2176 patients from 16 cohort studies done between 2005 and 2015, after adjusting for ABCD2 score, positive diffusion-weighted imaging (odds ratio [OR] 3·8, 95% CI 2·1-7·0), dual transient ischaemic attack (OR 3·3, 95% CI 1·8-5·8), and ipsilateral carotid stenosis (OR 4·7, 95% CI 2·6-8·6) were associated with 7 day stroke after index transient ischaemic attack (p<0·001 for all). 7 day stroke risk increased with increasing ABCD2-I and ABCD3-I scores (both p<0·001). Discrimination to identify early stroke risk was improved for ABCD2-I versus ABCD2 (2 day c statistic 0·74 vs 0·64; p=0·006). However, discrimination was further improved by ABCD3-I compared with ABCD2 (2 day c statistic 0·84 vs 0·64; p<0·001) and

  11. Individual Property Risk Management

    Directory of Open Access Journals (Sweden)

    Michael S. Finke

    2010-01-01

    Full Text Available This paper reviews household property risk management and estimates normatively optimal choice under theoretical assumptions. Although risk retention limits are common in the financial planning industry, estimates of optimal risk retention that include both financial and human wealth far exceed limits commonly recommended. Households appear to frame property losses differently from other wealth losses leading to wealth-reducing, excess risk transfer. Possible theoretical explanations for excess sensitivity to loss are reviewed. Differences between observed and optimal risk management imply a large potential gain from improved choice.

  12. 77 FR 68133 - Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples From Donors of...

    Science.gov (United States)

    2012-11-15

    ...The Food and Drug Administration (FDA) is announcing the availability of a document entitled ``Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples from Donors of Whole Blood and Blood Components, including Source Plasma, to Reduce the Risk of Transmission of Hepatitis B Virus,'' dated October 2012. The guidance document provides recommendations on the use of FDA-......

  13. 76 FR 72950 - Draft Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples From...

    Science.gov (United States)

    2011-11-28

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Use of Nucleic Acid Tests (NAT) on Pooled and Individual Samples from Donors of Whole Blood and Blood Components (including Recovered Plasma, Source Plasma and Source Leukocytes) to Adequately and Appropriately Reduce the Risk of Transmission of Hepatitis B Virus (HBV),......

  14. Accounting Considerations in Public Sector Risk Management Pools.

    Science.gov (United States)

    Commons, Harriet V.

    1987-01-01

    The Government Accounting Standards Board's Insurance Issues Project has issued an invitation to comment on two issues: (1) whether governmental risk pools should follow the same accounting principles as commercial insurance companies and (2) financial statement disclosures required of entities with public accountability (MLF)

  15. Accounting Considerations in Public Sector Risk Management Pools.

    Science.gov (United States)

    Commons, Harriet V.

    1987-01-01

    The Government Accounting Standards Board's Insurance Issues Project has issued an invitation to comment on two issues: (1) whether governmental risk pools should follow the same accounting principles as commercial insurance companies and (2) financial statement disclosures required of entities with public accountability (MLF)

  16. A statistical approach to determining responses to individual peptides from pooled-peptide ELISpot data.

    Science.gov (United States)

    Ström, Peter; Støer, Nathalie; Borthwick, Nicola; Dong, Tao; Hanke, Tomáš; Reilly, Marie

    2016-08-01

    To investigate in detail the effect of infection or vaccination on the human immune system, ELISpot assays are used to simultaneously test the immune response to a large number of peptides of interest. Scientists commonly use "peptide pools", where, instead of an individual peptide, a test well contains a group of peptides. Since the response from a well may be due to any or many of the peptides in the pool, pooled assays usually need to be followed by confirmatory assays of a number of individual peptides. We present a statistical method that enables estimation of individual peptide responses from pool responses using the Expectation Maximization (EM) algorithm for "incomplete data". We demonstrate the accuracy and precision of these estimates in simulation studies of ELISpot plates with 90 pools of 6 or 7 peptides arranged in three dimensions and three Mock wells for the estimation of background. In analysis of real pooled data from 6 subjects in a HIV-1 vaccine trial, where 199 peptides were arranged in 80 pools if size 9 or 10, our estimates were in very good agreement with the results from individual-peptide confirmatory assays. Compared to the classical approach, we could identify almost all the same peptides with high or moderate response, with less than half the number of confirmatory tests. Our method facilitates efficient use of the information available in pooled ELISpot data to avoid or reduce the need for confirmatory testing. We provide an easy-to-use free online application for implementing the method, where on uploading two spreadsheets with the pool design and pool responses, the user obtains the estimates of the individual peptide responses.

  17. Neuroanatomy Predicts Individual Risk Attitudes

    Science.gov (United States)

    Gilaie-Dotan, Sharon; Tymula, Agnieszka; Cooper, Nicole; Kable, Joseph W.; Glimcher, Paul W.

    2014-01-01

    Over the course of the last decade a multitude of studies have investigated the relationship between neural activations and individual human decision-making. Here we asked whether the anatomical features of individual human brains could be used to predict the fundamental preferences of human choosers. To that end, we quantified the risk attitudes of human decision-makers using standard economic tools and quantified the gray matter cortical volume in all brain areas using standard neurobiological tools. Our whole-brain analysis revealed that the gray matter volume of a region in the right posterior parietal cortex was significantly predictive of individual risk attitudes. Participants with higher gray matter volume in this region exhibited less risk aversion. To test the robustness of this finding we examined a second group of participants and used econometric tools to test the ex ante hypothesis that gray matter volume in this area predicts individual risk attitudes. Our finding was confirmed in this second group. Our results, while being silent about causal relationships, identify what might be considered the first stable biomarker for financial risk-attitude. If these results, gathered in a population of midlife northeast American adults, hold in the general population, they will provide constraints on the possible neural mechanisms underlying risk attitudes. The results will also provide a simple measurement of risk attitudes that could be easily extracted from abundance of existing medical brain scans, and could potentially provide a characteristic distribution of these attitudes for policy makers. PMID:25209279

  18. Income inequality, individual income, and mortality in Danish adults: analysis of pooled data from two cohort studies

    DEFF Research Database (Denmark)

    Osler, Merete; Prescott, Eva; Grønbaek, Morten;

    2002-01-01

    in the parishes with the least equal income distribution. After adjustment for individual risk factors, parish income inequality was not associated with mortality, whereas individual household income was. Thus, individuals in the highest income quarter had lower mortality than those in the lowest quarter......OBJECTIVE: To analyse the association between area income inequality and mortality after adjustment for individual income and other established risk factors. DESIGN: Analysis of pooled data from two cohort studies. The relation between income inequality in small areas of residence (parishes...... (adjusted hazard ratio for men 0.51 (95% confidence interval 0.45 to 0.59) and for women 0.60 (0.54 to 0.68)). CONCLUSION: Area income inequality is not in itself associated with all cause mortality in this Danish population. Adjustment for individual risk factors makes the apparent effect disappear...

  19. The Value of Risk Pooling for Mitigating Water Utility Financial Risks Arising From Water Scarcity

    Science.gov (United States)

    Baum, R.; Characklis, G. W.; Hughes, J.; Eskaf, S.

    2015-12-01

    Water utilities across the United States face growing supply risks as demand growth and extreme weather events make water scarcity more common. As it has become more difficult and expensive to build new supply capacity to accommodate these events, many utility managers respond by either imposing conservation measures, which reduces revenues, or acquiring additional water from other sources, which increases costs. These actions lead to changing financial trends that are difficult to predict and that utilities are currently ill-equipped to manage. As a result, adaptation strategies and tools are being developed to reduce utility vulnerabilities, ensuring both financial stability and continued access to low cost financing, a critical consideration for a capital intensive industry. Previous work in this area has involved the development of utility specific financial hedging tools. However, the time and informational requirements associated with developing these individualized strategies may be a limiting factor for widespread implementation. The objective of this research is to develop more generalized hedging instruments that can be applied simultaneously to multiple utilities across the United States, thereby increasing the potential for widespread implementation. This work first analyzes the financial risks of water scarcity for a large set of water utilities across the country and then proposes a financial hedging solution to mitigate these risks through hydrologic index-based financial insurance. Results provide insights into the most effective indices, the potential for risk pooling to reduce insurance costs, and the performance of these contracts in managing utility financial risk arising from drought.

  20. Why a national high-risk insurance pool is not a workable alternative to the marketplace.

    Science.gov (United States)

    Hall, Jean P

    2014-12-01

    The Pre-Existing Condition Insurance Plan (PCIP) was a national high-risk pool established under the Affordable Care Act (ACA) to provide coverage for individuals with preexisting conditions who had been uninsured for at least six months. It was intended to be a temporary program: PCIPs opened in 2010 and closed in April 2014. At that point, those with preexisting conditions could shop for health insurance in the marketplaces, where plans are prevented from using applicants' health status to deny coverage or charge more. This issue brief draws on the PCIP experience to outline why national high-risk pools, which continue to be proposed as policy alternatives to ACA coverage expansions, are expensive to enrollees as well as their administrators and ultimately unsustainable. The key lesson--and the principle on which the ACA is built--is that insurance works best when risk is evenly spread across a broad population.

  1. DNA adducts and cancer risk in prospective studies: a pooled analysis and a meta-analysis

    DEFF Research Database (Denmark)

    Veglia, Fabrizio; Loft, Steffen; Matullo, Giuseppe;

    2008-01-01

    Bulky DNA adducts are biomarkers of exposure to aromatic compounds and of the ability of the individual to metabolically activate carcinogens and to repair DNA damage. Their ability to predict cancer onset is uncertain. We have performed a pooled analysis of three prospective studies on cancer risk...... in which bulky DNA adducts have been measured in blood samples collected from healthy subjects (N = 1947; average follow-up 51-137 months). In addition, we have performed a meta-analysis by identifying all articles on the same subject published up to the end of 2006, including case-control studies....... In the pooled analysis, a weakly statistically significant increase in the risk of lung cancer was apparent (14% per unit standard deviation change in adduct levels, 95% confidence interval 1-28%; using the weighted mean difference method, 0.15 SD, units higher adducts in cases than in controls...

  2. On the Effects of Risk Pooling in Supply Chain Management:Review and Extensions

    Institute of Scientific and Technical Information of China (English)

    Xia Cai; Dong-lei Du

    2009-01-01

    The primary challenge in supply chain management (SCM) is matching supply with uncertain demand.Risk pooling is an efficient and promising strategy to meet this challenge by reducing the underlying demand uncertainty through aggregation.The main focus of this paper is to analyze the effects of risk pooling under different supply chain settings.There are two main contributions.First,we propose a mathematical framework which serves the multi-purpose of (1) unifying existing models on risk pooling in the literature,(2) providing new facets and insights of understanding existing results on risk pooling,and (3) setting up new ground for extending existing models and results.Second,we investigate one interesting effect of risk pooling,namely,the decreasing marginal return (or supermodulaxity).We show that there axe decreasing marginal returns in risk pooling practices under certain conditions,specifically when the demand is independent and identically distributed (I.I.D.) and normally distributed.

  3. To pool or not to pool? Impact of the use of individual and pooled fecal samples for in vitro fermentation studies

    NARCIS (Netherlands)

    Aguirre, M.; Ramiro Garcia, J.; Koenen, M.E.; Venema, K.

    2014-01-01

    This study investigated the stability and the activity of the microbiota from a single and a pool of donors in the TNO in vitro model of the colon (TIM-2 system). Our findings demonstrate the suitability of the preparation of a pool of fecal sample to be used for fermentation experiments.

  4. To pool or not to pool? Impact of the use of individual and pooled fecal samples for in vitro fermentation studies

    NARCIS (Netherlands)

    Aguirre, M.; Ramiro-Garcia, J.; Koenen, M.E.; Venema, K.

    2014-01-01

    This study investigated the stability and the activity of the microbiota from a single and a pool of donors in the TNO in vitro model of the colon (TIM-2 system). Our findings demonstrate the suitability of the preparation of a pool of fecal sample to be used for fermentation experiments. Chemicals/

  5. Individual cryopreservation with dimethyl sulfoxide and polyvinylpyrrolidone of ejaculates and pooled semen of three avian species.

    Science.gov (United States)

    Herrera, J A; Quintana, J A; López, M A; Betancourt, M; Fierro, R

    2005-01-01

    Artificial insemination (AI) has been used for avian reproduction due to the discovery of cryoprotectants extending its usefulness both in production of domestic fowl and conservation of wild species. The goal of this study was to assess the effect on domestic and wild fowl pooled semen and individual ejaculate cryopreservation with dimethyl sulfoxide (DMSO) and polyvinylpyrrolidone (PVP). Twenty ejaculates and twenty samples of pooled semen of roosters, pheasants and hawks were frozen in media containing DMSO or PVP. DMSO and PVP cryopreservation are equally effective both for ejaculates and pooled semen. Even PVP is a good alternative since no significant difference was found when compared to DMSO. The fertilizing capacity of fresh and cryopreserved pooled semen was analyzed through AI of hens and female pheasants. Similar fertility rates using DMSO, PVP or frozen-thawed samples demonstrated that reproduction is possible through the use of cryopreserved semen. In the case of female pheasants, the same values were obtained with both cryopreserved and fresh semen.

  6. A risk assessment of Pseudomonas aeruginosa in swimming pools: a review.

    Science.gov (United States)

    Rice, Scott A; van den Akker, Ben; Pomati, Francesco; Roser, David

    2012-06-01

    Despite routine monitoring and disinfection, treated swimming pools are frequently contaminated with the opportunistic pathogen Pseudomonas aeruginosa, which can represent a significant public health threat. This review was undertaken to identify the current understanding of risk factors associated with pool operation with respect to P. aeruginosa. The ecology and factors that promote growth of P. aeruginosa in the pool environment are complex and dynamic and so we applied a systematic risk assessment approach to integrate existing data, with the aim to improve pool management and safety. Sources of P. aeruginosa, types of infections, dose responses, routes of transmission, as well as the efficacy of current disinfectant treatments were reviewed. This review also highlights the critical knowledge gaps that are required for a more robust, quantitative risk assessment of P. aeruginosa. Quantitative risk management strategies have been successfully applied to drinking water systems and should similarly be amenable to developing a better understanding of the risk posed by P. aeruginosa in swimming pools.

  7. Human Papillomavirus 16 E6 Antibodies in Individuals Without Diagnosed Cancer: A Pooled Analysis

    Science.gov (United States)

    Lang Kuhs, Krystle A.; Anantharaman, Devasena; Waterboer, Tim; Johansson, Mattias; Brennan, Paul; Michel, Angelika; Willhauck-Fleckenstein, Martina; Purdue, Mark P.; Holcátová, Ivana; Ahrens, Wolfgang; Lagiou, Pagona; Polesel, Jerry; Simonato, Lorenzo; Merletti, Franco; Healy, Claire M.; Kjaerheim, Kristina; Conway, David I.; Macfarlane, Tatiana V.; Thomson, Peter; Castellsagué, Xavier; Znaor, Ariana; Black, Amanda; Huang, Wen-Yi; Krogh, Vittorio; Trichopoulou, Antonia; Bueno-de-Mesquita, H.B(as).; Clavel-Chapelon, Françoise; Weiderpass, Elisabete; Ekström, Johanna; Riboli, Elio; Tjønneland, Anne; Sánchez, María-José; Travis, Ruth C.; Hildesheim, Allan; Pawlita, Michael; Kreimer, Aimée R.

    2015-01-01

    Background The increasing incidence of oropharyngeal cancer in many developed countries has been attributed to human papillomavirus type 16 (HPV16) infections. Recently, HPV16 E6 serology has been identified as a promising early marker for oropharyngeal cancer. Therefore, characterization of HPV16 E6 seropositivity among individuals without cancer is warranted. Methods 4,666 controls were pooled from several studies of cancer and HPV seropositivity, all tested within the same laboratory. HPV16 E6 seropositive controls were classified as having i) moderate (mean fluorescent intensity [MFI]≥484 & <1000) or ii) high seroreactivity (MFI≥1000). Associations of moderate and high HPV16 E6 seroreactivity with i) demographic risk factors; and seropositivity for ii) other HPV16 proteins (E1, E2, E4, E7 and L1) and iii) E6 proteins from non-HPV16 types (HPV6, 11, 18, 31, 33, 45 and 52) were evaluated. Results Thirty-two (0.7%) HPV16 E6 seropositive controls were identified; 17 (0.4%) with moderate and 15 (0.3%) with high seroreactivity. High HPV16 E6 seroreactivity was associated with former smoking (odds ratio [OR] 5.5 [95% confidence interval [CI]:1.2-51.8]), and seropositivity against HPV16 L1 (OR 4.8, 95%CI:1.3-15.4); E2 (OR 7.7, 95%CI:1.4-29.1); multiple HPV16 proteins (OR 25.3, 95%CI:2.6-119.6 for 3 HPV16 proteins beside E6) and HPV33 E6 (OR 17.7, 95%CI:1.9-81.8). No associations were observed with moderate HPV16 E6 seroreactivity. Conclusions High HPV16 E6 seroreactivity is rare among individuals without diagnosed cancer and was not explained by demographic factors. Impact Some HPV16 E6 seropositive individuals without diagnosed HPV-driven cancer, especially those with seropositivity against other HPV16 proteins, may harbor a biologically relevant HPV16 infection. PMID:25623733

  8. Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium.

    Science.gov (United States)

    Zhang, Li Rita; Morgenstern, Hal; Greenland, Sander; Chang, Shen-Chih; Lazarus, Philip; Teare, M Dawn; Woll, Penella J; Orlow, Irene; Cox, Brian; Brhane, Yonathan; Liu, Geoffrey; Hung, Rayjean J

    2015-02-15

    To investigate the association between cannabis smoking and lung cancer risk, data on 2,159 lung cancer cases and 2,985 controls were pooled from 6 case-control studies in the US, Canada, UK, and New Zealand within the International Lung Cancer Consortium. Study-specific associations between cannabis smoking and lung cancer were estimated using unconditional logistic regression adjusting for sociodemographic factors, tobacco smoking status and pack-years; odds-ratio estimates were pooled using random effects models. Subgroup analyses were done for sex, histology and tobacco smoking status. The shapes of dose-response associations were examined using restricted cubic spline regression. The overall pooled OR for habitual versus nonhabitual or never users was 0.96 (95% CI: 0.66-1.38). Compared to nonhabitual or never users, the summary OR was 0.88 (95%CI: 0.63-1.24) for individuals who smoked 1 or more joint-equivalents of cannabis per day and 0.94 (95%CI: 0.67-1.32) for those consumed at least 10 joint-years. For adenocarcinoma cases the ORs were 1.73 (95%CI: 0.75-4.00) and 1.74 (95%CI: 0.85-3.55), respectively. However, no association was found for the squamous cell carcinoma based on small numbers. Weak associations between cannabis smoking and lung cancer were observed in never tobacco smokers. Spline modeling indicated a weak positive monotonic association between cumulative cannabis use and lung cancer, but precision was low at high exposure levels. Results from our pooled analyses provide little evidence for an increased risk of lung cancer among habitual or long-term cannabis smokers, although the possibility of potential adverse effect for heavy consumption cannot be excluded. © 2014 UICC.

  9. Comparison of individual and pooled sampling methods for detecting bacterial pathogens of fish

    Science.gov (United States)

    Mumford, Sonia; Patterson, Chris; Evered, J.; Brunson, Ray; Levine, J.; Winton, J.

    2005-01-01

    Examination of finfish populations for viral and bacterial pathogens is an important component of fish disease control programs worldwide. Two methods are commonly used for collecting tissue samples for bacteriological culture, the currently accepted standards for detection of bacterial fish pathogens. The method specified in the Office International des Epizooties Manual of Diagnostic Tests for Aquatic Animals permits combining renal and splenic tissues from as many as 5 fish into pooled samples. The American Fisheries Society (AFS) Blue Book/US Fish and Wildlife Service (USFWS) Inspection Manual specifies the use of a bacteriological loop for collecting samples from the kidney of individual fish. An alternative would be to more fully utilize the pooled samples taken for virology. If implemented, this approach would provide substantial savings in labor and materials. To compare the relative performance of the AFS/USFWS method and this alternative approach, cultures of Yersinia ruckeri were used to establish low-level infections in groups of rainbow trout (Oncorhynchus mykiss) that were sampled by both methods. Yersinia ruckeri was cultured from 22 of 37 groups by at least 1 method. The loop method yielded 18 positive groups, with 1 group positive in the loop samples but negative in the pooled samples. The pooled samples produced 21 positive groups, with 4 groups positive in the pooled samples but negative in the loop samples. There was statistically significant agreement (Spearman coefficient 0.80, P < 0.001) in the relative ability of the 2 sampling methods to permit detection of low-level bacterial infections of rainbow trout.

  10. Developmental Dyslexia: Predicting Individual Risk

    Science.gov (United States)

    Thompson, Paul A.; Hulme, Charles; Nash, Hannah M.; Gooch, Debbie; Hayiou-Thomas, Emma; Snowling, Margaret J.

    2015-01-01

    Background: Causal theories of dyslexia suggest that it is a heritable disorder, which is the outcome of multiple risk factors. However, whether early screening for dyslexia is viable is not yet known. Methods: The study followed children at high risk of dyslexia from preschool through the early primary years assessing them from age 3 years and 6…

  11. Developmental Dyslexia: Predicting Individual Risk

    Science.gov (United States)

    Thompson, Paul A.; Hulme, Charles; Nash, Hannah M.; Gooch, Debbie; Hayiou-Thomas, Emma; Snowling, Margaret J.

    2015-01-01

    Background: Causal theories of dyslexia suggest that it is a heritable disorder, which is the outcome of multiple risk factors. However, whether early screening for dyslexia is viable is not yet known. Methods: The study followed children at high risk of dyslexia from preschool through the early primary years assessing them from age 3 years and 6…

  12. Anthropometric and Hormonal Risk Factors for Male Breast Cancer: Male Breast Cancer Pooling Project Results

    Science.gov (United States)

    Brinton, Louise A.

    2014-01-01

    Background The etiology of male breast cancer is poorly understood, partly because of its relative rarity. Although genetic factors are involved, less is known regarding the role of anthropometric and hormonally related risk factors. Methods In the Male Breast Cancer Pooling Project, a consortium of 11 case–control and 10 cohort investigations involving 2405 case patients (n = 1190 from case–control and n = 1215 from cohort studies) and 52013 control subjects, individual participant data were harmonized and pooled. Unconditional logistic regression generated study design–specific (case–control/cohort) odds ratios (ORs) and 95% confidence intervals (CIs), with exposure estimates combined using fixed effects meta-analysis. All statistical tests were two-sided. Results Risk was statistically significantly associated with weight (highest/lowest tertile: OR = 1.36; 95% CI = 1.18 to 1.57), height (OR = 1.18; 95% CI = 1.01 to 1.38), and body mass index (BMI; OR = 1.30; 95% CI = 1.12 to 1.51), with evidence that recent rather than distant BMI was the strongest predictor. Klinefelter syndrome (OR = 24.7; 95% CI = 8.94 to 68.4) and gynecomastia (OR = 9.78; 95% CI = 7.52 to 12.7) were also statistically significantly associated with risk, relations that were independent of BMI. Diabetes also emerged as an independent risk factor (OR = 1.19; 95% CI = 1.04 to 1.37). There were also suggestive relations with cryptorchidism (OR = 2.18; 95% CI = 0.96 to 4.94) and orchitis (OR = 1.43; 95% CI = 1.02 to 1.99). Although age at onset of puberty and histories of infertility were unrelated to risk, never having had children was statistically significantly related (OR = 1.29; 95% CI = 1.01 to 1.66). Among individuals diagnosed at older ages, a history of fractures was statistically significantly related (OR = 1.41; 95% CI = 1.07 to 1.86). Conclusions Consistent findings across case–control and cohort investigations, complemented by pooled analyses, indicated important roles for

  13. Risk Pooling, Commitment and Information: An experimental test of two fundamental assumptions

    OpenAIRE

    Abigail Barr

    2003-01-01

    This paper presents rigorous and direct tests of two assumptions relating to limited commitment and asymmetric information that current underpin current models of risk pooling. A specially designed economic experiment involving 678 subjects across 23 Zimbabwean villages is used to solve the problems of observability and quantification that have frustrated previous attempts to conduct such tests. I find that more extrinsic commitment is associated with more risk pooling, but that more informat...

  14. Infant swimming in chlorinated pools and the risks of bronchiolitis, asthma and allergy.

    Science.gov (United States)

    Voisin, C; Sardella, A; Marcucci, F; Bernard, A

    2010-07-01

    Recent studies suggest that swimming in chlorinated pools during infancy may increase the risks of lower respiratory tract infection. The aim of the present study was to assess the influence of swimming in chlorinated pools on the risks of bronchiolitis and its late consequences. A total of 430 children (47% female; mean age 5.7 yrs) in 30 kindergartens were examined. Parents completed a questionnaire regarding the child's health history, swimming practice and potential confounders. Attendance at indoor or outdoor chlorinated pools ever before the age of 2 yrs was associated with an increased risk of bronchiolitis (OR 1.68; 95% CI 1.08-2.68; p = 0.03), which was exposure-dependent for both types of pool (p-value for trend 20 h spent in chlorinated pools during infancy. Infant swimmers who developed bronchiolitis also showed higher risks of asthma and respiratory allergies later in childhood. Swimming pool attendance during infancy is associated with a higher risk of bronchiolitis, with ensuing increased risks of asthma and allergic sensitisation.

  15. Identifying sexual orientation health disparities in adolescents: analysis of pooled data from the Youth Risk Behavior Survey, 2005 and 2007.

    Science.gov (United States)

    Mustanski, Brian; Van Wagenen, Aimee; Birkett, Michelle; Eyster, Sandra; Corliss, Heather L

    2014-02-01

    We studied sexual orientation disparities in health outcomes among US adolescents by pooling multiple Youth Risk Behavior Survey (YRBS) data sets from 2005 and 2007 for 14 jurisdictions. Here we describe the methodology for pooling and analyzing these data sets. Sexual orientation-related items assessed sexual orientation identity, gender of sexual contacts, sexual attractions, and harassment regarding sexual orientation. Wording of items varied across jurisdictions, so we created parallel variables and composite sexual minority variables. We used a variety of statistical approaches to address issues with the analysis of pooled data and to meet the aims of individual articles, which focused on a range of health outcomes and behaviors related to cancer, substance use, sexual health, mental health, violence, and injury.

  16. Fruits and vegetables and ovarian cancer risk in a pooled analysis of 12 cohort studies

    NARCIS (Netherlands)

    Koushik, A.; Hunter, D.J.; Spiegelman, D.; Anderson, K.E.; Arslan, A.A.; Beeson, W.L.; Brandt, P.A. van den; Buring, J.E.; Cerhan, J.R.; Colditz, G.A.; Fraser, G.E.; Freudenheim, J.L.; Genkinger, J.M.; Goldbohm, R.A.; Hankinson, S.E.; Koenig, K.L.; Larsson, S.C.; Leitzmann, M.; McCullough, M.L.; Miller, A.B.; Patel, A.; Rohan, T.E.; Schatzkin, A.; Smit, E.; Willett, W.C.; Wolk, A.; Zhang, S.M.; Smith-Warner, S.A.

    2005-01-01

    Because fruits and vegetables are rich in bioactive compounds with potential cancer-preventive actions, increased consumption may reduce the risk of ovarian cancer. Evidence on the association between fruit and vegetable intake and ovarian cancer risk has not been consistent. We analyzed and pooled

  17. Alcohol consumption and risk of lung cancer: A pooled analysis of cohort studies

    NARCIS (Netherlands)

    Freudenheim, J.L.; Ritz, J.; Smith-Warner, S.A.; Albanes, D.; Bandera, E.V.; Brandt, P.A. van den; Colditz, G.; Feskanich, D.; Goldbohm, R.A.; Harnack, L.; Miller, A.B.; Rimm, E.; Rohan, T.E.; Sellers, T.A.; Virtamo, J.; Willett, W.C.; Hunter, D.J.

    2005-01-01

    Background: Although smoking is the primary cause of lung cancer, much is unknown about lung cancer etiology, including risk determinants for nonsmokers and modifying factors for smokers. Objective: We hypothesized that alcohol consumption contributes to lung cancer risk. Design: We conducted a pool

  18. NSAID Use and Risk of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: The Liver Cancer Pooling Project.

    Science.gov (United States)

    Petrick, Jessica L; Sahasrabuddhe, Vikrant V; Chan, Andrew T; Alavanja, Michael C; Beane-Freeman, Laura E; Buring, Julie E; Chen, Jie; Chong, Dawn Q; Freedman, Neal D; Fuchs, Charles S; Gaziano, John Michael; Giovannucci, Edward; Graubard, Barry I; Hollenbeck, Albert R; Hou, Lifang; Jacobs, Eric J; King, Lindsay Y; Koshiol, Jill; Lee, I-Min; Linet, Martha S; Palmer, Julie R; Purdue, Mark P; Rosenberg, Lynn; Schairer, Catherine; Sesso, Howard D; Sigurdson, Alice J; Wactawski-Wende, Jean; Zeleniuch-Jacquotte, Anne; Campbell, Peter T; McGlynn, Katherine A

    2015-12-01

    Chronic inflammation plays a pivotal role in the pathogenesis of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), the two most common types of liver cancer. A number of prior experimental studies have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen, may potentially protect against liver cancer. However, no observational study has examined the association between aspirin duration and dose or other over-the-counter non-aspirin NSAIDs, such as ibuprofen, and liver cancer incidence. Furthermore, the association between NSAID use and risk of ICC is unclear. As part of the Liver Cancer Pooling Project, we harmonized data on 1,084,133 individuals (HCC = 679, ICC = 225) from 10 U.S.-based prospective cohort studies. Cox proportional hazards regression models were used to evaluate multivariable-adjusted HRs and 95% confidence intervals (CI). Current aspirin use, versus nonuse, was inversely associated with HCC (HR, 0.68; 95% CI, 0.57-0.81), which persisted when restricted to individuals not using non-aspirin NSAIDs and in a 5- and 10-year lag analysis. The association between aspirin use and HCC risk was stronger for users who reported daily use, longer duration use, and lower dosage. Ibuprofen use was not associated with HCC risk. Aspirin use was associated with a reduced ICC risk in men (HR, 0.64; 95% CI, 0.42-0.98) but not women (HR, 1.34; 95% CI, 0.89-2.01; P(interaction) = 0.01). The observed inverse association between aspirin use and liver cancer in our study, together with previous data, suggests the merit of future intervention studies of aspirin and other agents that affect chronic inflammatory pathways for HCC and possibly ICC.

  19. Semi-Professional Rugby League Players have Higher Concussion Risk than Professional or Amateur Participants: A Pooled Analysis.

    Science.gov (United States)

    King, Doug; Hume, Patria; Gissane, Conor; Clark, Trevor

    2017-02-01

    A combined estimate of injuries within a specific sport through pooled analysis provides more precise evidence and meaningful information about the sport, whilst controlling for between-study variation due to individual sub-cohort characteristics. The objective of this analysis was to review all published rugby league studies reporting injuries from match and training participation and report the pooled data estimates for rugby league concussion injury epidemiology. A systematic literature analysis of concussion in rugby league was performed on published studies from January 1990 to October 2015. Data were extracted and pooled from 25 studies that reported the number and incidence of concussions in rugby league match and training activities. Amateur rugby league players had the highest incidence of concussive injuries in match activities (19.1 per 1000 match hours) while semi-professional players had the highest incidence of concussive injuries in training activities (3.1 per 1000 training hours). This pooled analysis showed that, during match participation activities, amateur rugby league participants had a higher reported concussion injury rate than professional and semi-professional participants. Semi-professional participants had nearly a threefold greater concussion injury risk than amateur rugby league participants during match participation. They also had nearly a 600-fold greater concussion injury risk than professional rugby league participants during training participation.

  20. Attendance at chlorinated indoor pools and risk of asthma in adult recreational swimmers.

    Science.gov (United States)

    Ferrari, Marcello; Schenk, Kai; Mantovani, William; Papadopoulou, Christina; Posenato, Chiara; Ferrari, Pietro; Poli, Albino; Tardivo, Stefano

    2011-05-01

    To study a potential correlation between attendance at chlorinated indoor pools and the onset of asthma in adult leisure swimmers. 1136 adult swimmers attending indoor pools in the city of Verona completed a modified ECRHS questionnaire. The cumulative time spent in the pools was calculated on the basis of the mean frequency and duration of weekly swim activity for every year of attendance. The median value (320 h) was used to divide participants into 2 groups. Other questions concerned the family history of allergies, the medical diagnosis and the onset of asthma. The prevalence of respiratory symptoms in the study group was compared with that of a general population sample. New-onset asthma, first identified at least 12 months after the start of regular pool attendance, was more prevalent among swimmers characterized by a higher cumulative pool attendance (23/514, 4.5%) than in swimmers who were attending indoor pools less frequently (2/508, 0.4%; ratio 11.1, 95% CI 2.6-47.4). The statistical analysis revealed an independent association between the cumulative lifetime hours spent in indoor swimming pools and new onset asthma (relative risk 1.05, 95% CI 1.02-1.07). Respiratory symptoms were less frequent in the study population versus a general population sample (prevalence ratio 0.26-0.68). Attendance at chlorinated indoor pools may constitute a risk factor for developing asthma in leisure adult swimmers. Future research and efforts should aim at improving disinfection techniques, hygiene and ventilation in indoor swimming pools in order to provide an unobjectionable ambient for salubrious swim activities. Copyright © 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  1. Sex and the syndrome: individual and population consistency in behaviour in rock pool prawn Palaemon elegans.

    Directory of Open Access Journals (Sweden)

    Ben B Chapman

    Full Text Available Animal personality has been widely documented across a range of species. The concept of personality is composed of individual behavioural consistency across time and between situations, and also behavioural trait correlations known as behavioural syndromes. Whilst many studies have now investigated the stability of individual personality traits, few have analysed the stability over time of entire behavioural syndromes. Here we present data from a behavioural study of rock pool prawns. We show that prawns are temporally consistent in a range of behaviours, including activity, exploration and boldness, and also that a behavioural syndrome is evident in this population. We find correlations between many behavioural traits (activity, boldness, shoaling and exploration. In addition, behavioural syndrome structure was consistent over time. Finally, few studies have explicitly studied the role of sex differences in personality traits, behavioural consistency and syndrome structure. We report behavioural differences between male and female prawns but no differences in patterns of consistency. Our study adds to the growing literature on animal personality, and provides evidence showing that syndromes themselves can exhibit temporal consistency.

  2. Risk factors for oligodendroglial tumors: a pooled international study

    DEFF Research Database (Denmark)

    McCarthy, Bridget J; Rankin, Kristin M; Aldape, Ken

    2011-01-01

    (CIs), adjusted for age group, gender, and study site. Data on 617 cases and 1260 controls were available for analyses. Using data from all 7 studies, history of allergies and/or asthma was associated with a decreased risk of anaplastic oligodendroglioma (OR = 0.6; 95% CI: 0.4-0.9), and history...

  3. Prior individual training and self-organized queuing during group emergency escape of mice from water pool.

    Directory of Open Access Journals (Sweden)

    Caesar Saloma

    Full Text Available We study the impact of prior individual training during group emergency evacuation using mice that escape from an enclosed water pool to a dry platform via any of two possible exits. Experimenting with mice avoids serious ethical and legal issues that arise when dealing with unwitting human participants while minimizing concerns regarding the reliability of results obtained from simulated experiments using 'actors'. First, mice were trained separately and their individual escape times measured over several trials. Mice learned quickly to swim towards an exit-they achieved their fastest escape times within the first four trials. The trained mice were then placed together in the pool and allowed to escape. No two mice were permitted in the pool beforehand and only one could pass through an exit opening at any given time. At first trial, groups of trained mice escaped seven and five times faster than their corresponding control groups of untrained mice at pool occupancy rate ρ of 11.9% and 4%, respectively. Faster evacuation happened because trained mice: (a had better recognition of the available pool space and took shorter escape routes to an exit, (b were less likely to form arches that blocked an exit opening, and (c utilized the two exits efficiently without preference. Trained groups achieved continuous egress without an apparent leader-coordinator (self-organized queuing-a collective behavior not experienced during individual training. Queuing was unobserved in untrained groups where mice were prone to wall seeking, aimless swimming and/or blind copying that produced circuitous escape routes, biased exit use and clogging. The experiments also reveal that faster and less costly group training at ρ = 4%, yielded an average individual escape time that is comparable with individualized training. However, group training in a more crowded pool (ρ = 11.9% produced a longer average individual escape time.

  4. The risk of contracting infectious diseases in public swimming pools: a review

    Directory of Open Access Journals (Sweden)

    Zsófia Barna

    2012-12-01

    Full Text Available A review of pathogenic microorganisms presenting risk of infection in pool based artificial recreational water venues is extracted from the available scientific literature. The microorganisms are grouped both according to their way of spread and their survival and growth strategies and their characteristics relevant for the pool and spa based recreation are discussed. In order to put the proposed risks on a solid basis, among others a ten year excerpt of the waterborne disease statistics of the Centers for Disease Control and Prevention (CDC is used throughout the article.

  5. Occurrence and health risk assessment of halogenated disinfection byproducts in indoor swimming pool water.

    Science.gov (United States)

    Hang, Chen; Zhang, Beibei; Gong, Tingting; Xian, Qiming

    2016-02-01

    Swimming pool disinfection byproducts (DBPs) have become a concern in many countries all over the world. In this study, the concentrations of several categories of DBPs, including trihalomethanes (THMs), haloacetic acids (HAAs), haloacetonitriles (HANs), haloketones (HKs) and trichloronitromethane (TCNM), in 13 public indoor swimming pools in Nanjing, China were determined, the correlations between DBPs and water quality parameters as well as between different DBP categories were evaluated, and the health risks of the DBPs to human were examined. The results indicate that the DBP levels in the swimming pools in Nanjing were relatively high, with HAAs as the most dominant category, followed by THMs, HANs, HKs and TCNM sequentially. Bromochloroacetic acid (BCAA), trichloromethane (TCM), dichloroacetonitrile (DCAN), and 1,1,1-trichloropropanone (1,1,1-TCP) were the most dominant species among HAAs, THMs, HANs, and HKs, respectively. For all the different categories of DBPs, the concentrations in the pool disinfected with ozonation/chlorination were lower than those in the pool disinfected with chlorination. The DBP levels were generally not affected by the number of swimmers and the DBP levels on different dates were relatively stable. Besides, the chlorine residual seemed to be a critical concern in most of the swimming pools in this study. Moreover, there were some correlations between DBPs and water quality parameters as well as between different DBP categories. It is to be noted that the predicted cancer and health risks of the DBPs in these swimming pools were generally higher than the regulatory limits by USEPA, and thus DBPs in these swimming pools should be concerned.

  6. Long noncoding RNAs as auxiliary biomarkers for gastric cancer screening: A pooled analysis of individual studies

    Science.gov (United States)

    Cui, Zhaolei; Chen, Yan; Xiao, Zhenzhou; Hu, Minhua; Lin, Yingying; Chen, Yansong; Zheng, Yuhong

    2016-01-01

    Background Long non-coding RNAs (lncRNAs) are highlighted as novel cancer biomarkers with great promise. Herein, we focused on summarizing the overall diagnostic performance of lncRNAs for gastric cancer (GC). Methods Publications fulfilling the search criteria were selected from the online databases. Study quality was assessed according to the Quality Assessment for Studies of Diagnostic Accuracy (QUADAS) checklist. The summary receiver operator characteristic (SROC) curve was plotted using a bivariate meta-analysis model. Statistical analysis was performed based on the platforms of STATA 12.0 and Meta-Disc 1.4 software. Results Fifteen studies with 1252 patients and 1283 matched controls were included. The pooled sensitivity and specificity for lncRNA expression profile in differentiating GC patients from cancer-free individuals were 0.68 (95%CI: 0.61-0.74) and 0.79 (95%CI: 0.72-0.84), respectively, corresponding to an area under curve (AUC) of 0.80. Moreover, the stratified analyses demonstrated that plasma-based lncRNA profiling harbored higher accuracy than that tissue-based assay (specificity: 0.80 versus 0.75; AUC: 0.84 versus 0.77). Conclusions LncRNA profiling hallmarks a moderate diagnostic value in the management of GC and that lncRNA expression patterns may potentially be utilized as auxiliary biomarkers in confirming GC. PMID:27015554

  7. Individual Perceptions of Local Crime Risk

    NARCIS (Netherlands)

    Salm, M.; Vollaard, B.A.

    2014-01-01

    We provide evidence that perceptions of crime risk are severely biased for many years after a move to a new neighborhood. Based on four successive waves of a large crime survey, matched with administrative records on household relocations, we find that the longer an individual lives in a

  8. Comparison of individual, pooled, and composite fecal sampling methods for detection of Salmonella on U.S. dairy operations

    Science.gov (United States)

    The objectives of this study were to estimate the prevalence of Salmonella for individual, pooled, and composite fecal samples and to compare culture results from each sample type for determining herd Salmonella infection status and identifying Salmonella serotype(s). The USDA’s National Animal Hea...

  9. Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies

    DEFF Research Database (Denmark)

    Cardwell, Chris R; Stene, Lars C; Joner, Geir

    2011-01-01

    The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous...

  10. Lung cancer risk among bricklayers in a pooled analysis of case-control studies.

    NARCIS (Netherlands)

    Consonni, Dario; De Matteis, Sara; Olsson, Ann; Pesch, Beate; Kromhout, Hans; Straif, Kurt; Brüning, Thomas

    2014-01-01

    OBJECTIVES: Bricklayers may be exposed to several lung carcinogens, including crystalline silica and asbestos. Previous studies reported an excess of lung cancer among these workers. We examined lung cancer risk among bricklayers within SYNERGY, a large international pooled analysis of case-control

  11. Pooled analysis of prospective cohort studies on height, weight and breast cancer risk

    NARCIS (Netherlands)

    Brandt, P.A. van den; Spiegelman, D.; Yaun, S-S.; Adami, H-O.; Beeson, L.; Folsom, A.R.; Fraser, G.; Goldbohm, R.A.; Graham, S.; Kushi, L.; Marshall, J.R.; Miller, A.B.; Rohan, T.; Smith-Warner, S.A.; Speizer, F.E.; Willett, W.C.; Wolk, A.; Hunter, D.J.

    2000-01-01

    The association between anthropometric indices and the risk of breast cancer was analyzed using pooled data from seven prospective cohort studies. Together, these cohorts comprise 337,819 women and 4,385 incident invasive breast cancer cases. In multivariate analyses controlling for reproductive, di

  12. Influence of a Small Fraction of Individuals with Enhanced Mutations on a Population Genetic Pool

    Science.gov (United States)

    Cebrat, S.; Stauffer, D.

    It has been observed that a higher mutation load could be introduced into the genomes of children conceived by assisted reproduction technology (fertilization in-vitro). This generates two effects — slightly higher mutational pressure on the whole genetic pool of population and inhomogeneity of mutation distributions in the genetic pool. Computer simulations of the Penna ageing model suggest that already a small fraction of births with enhanced number of new mutations can negatively influence the whole population.

  13. [Evaluating individual occupational risk in teachers].

    Science.gov (United States)

    Stepanov, E G; Ishmukhametov, I B

    2012-01-01

    The authors analyzed work conditions of comprehensive school teachers according to workplace assessment. Additional studies covered opportunistic pathogens content of air in classrooms. Auxiliary medical examination evaluated health state of the teachers. Individual occupational risk was calculated with consideration of actual work conditions and health state. Comprehensive school teacher's work is characterized by constant or transitory influence by complex of occupational and work hazards that are mostly (according to to workplace assessment) increased work intensity, noise and inadequate illumination parameters. Ambient air of classrooms constantly contains high number of opportunistic pathogens, that could decrease immune system parameters and cause more droplet infections. Individual occupational risk of teachers, calculated with consideration of work conditions and health state parameters, appears to be high and proves high possibility of teachers' health damage at work. Recommendations cover evaluation of biologic factors within the workplace assessment, obligatory preliminary (before employment) and periodic medical examinations for comprehensive school teachers as for workers exposed to occupational hazards.

  14. Cancer risk assessment from exposure to trihalomethanes in tap water and swimming pool water

    Institute of Scientific and Technical Information of China (English)

    PANYAKAPO Mallika; SOONTORNCHAI Sarisak; PAOPUREE Pongsri

    2008-01-01

    We investigated the concentration of trihalomethanes (THMs) in tap water and swimming pool water in the area of the Nakhon Path-om Municipality during the period April 2005-March 2006.The concentrations of total THMs,chloroform,bromodichloromethane,dibromochloromethane and bromoform in tap water were 12.70-41.74,6.72-29.19,1.12-11.75,0.63-3.55 and 0.08-3.40 μg/L,respectively,whereas those in swimming pool water were 26.15-65.09,9.50-36.97,8.90-18.01,5.19-22.78 and ND-6.56 μg/L,respectively.It implied that the concentration of THMs in swimming pool water was higher than those in tap water,particularly,brominated-THMs.Both tap water and swimming pool water contained concentrations of total THMs below the standards of the World Health Organization (WHO),European Union (EU) and the United States Environmental Protection Agency (USEPA) phase Ⅰ,but 1 out of 60 tap water samples and 60 out of 72 swimming pool water samples contained those over the Standard of the USEPA phase Ⅱ.From the two cases of cancer risk assessment including Case Ⅰ Non-Swimmer and Case Ⅱ Swimmer,assessment of cancer risk of non-swimmers from exposure to THMs at the highest and the average concentrations was 4.43×10-5 and 2.19×10-5,respectively,which can be classified as acceptable risk according to the Standard of USEPA.Assessment of cancer risk of swimmers from exposure to THMs at the highest and the average concentrations was 1.47×10-3 and 7.99×10-4,respectively,which can be classified as unacceptable risk and needs to be improved.Risk of THMs exposure from swimming was 93.9%-94.2% of the total risk.Cancer risk of THMs concluded from various routes in descending order was:skin exposure while swimming,gastro-intestinal exposure from tap water intake,and skin exposure to tap water and gastro-intestinal exposure while swimming.Cancer risk from skin exposure while swimming was 94.18% of the total cancer risk.

  15. Comparison of individual and pooled urine samples for estimating the presence and intensity of Schistosoma haematobium infections at the population level.

    Science.gov (United States)

    Degarege, Abraham; Erko, Berhanu; Mekonnen, Zeleke; Legesse, Mengistu; Negash, Yohannes; Vercruysse, Jozef; Levecke, Bruno

    2015-11-16

    There is a lack of cost-effective diagnostic strategies to evaluate whether mass drug administration (MDA) programmes to control Schistosoma haematobium progress as anticipated. The purpose of this study is to provide a proof-of-principle for examination of pooled urine samples as a strategy for rapid assessment of presence and intensity of Schistosoma haematobium infections at the population level. A total of 640 urine samples were collected from 520 school-aged children (520 at baseline and 120 at follow-up) during a clinical trial that was designed to assess the efficacy of praziquantel against Schistosoma haematobium infections in Ethiopia. Individual and pooled urine samples were screened using the filtration technique (volume of 10 ml urine) to determine the number of S. haematobium eggs in 10 ml of urine. Samples were pooled into pools of 5 (n = 128), 10 (n = 64) and 20 (n = 32) individual samples. The sensitivity, the probability of finding at least one egg in a pooled sample when the mean urine egg count (UEC) of the corresponding individual urine samples was not zero, was calculated for each pool size. UECs of a pooled examination strategy were compared with the mean UECs of the corresponding individual samples. The sensitivity of a pooled examination strategy was 50.6% for pools of 5, 68.6% for pools of 10 and 63.3% for pools of 20. The sensitivity of a pooled examination strategy increased as a function of increasing mean UEC of the corresponding individual urine samples. For each of the three pool sizes, there was a significant positive correlation between mean UECs of individual and those obtained in pooled samples (correlation coefficient: 0.81 - 0.93). Examination of pools of 5 provided significantly lower UECs compared to the individual examination strategy (3.9 eggs/10 ml urine versus 5.0 eggs/10 ml urine). For pools of 10 (4.4 eggs/10 ml) and 20 (4.2 eggs/10 ml), no significant difference in UECs was observed. Examination of pooled

  16. Poor-quality water in swimming pools associated with a substantial risk of otitis externa due to Pseudomonas aeruginosa.

    Science.gov (United States)

    Hajjartabar, M

    2004-01-01

    There are many large and small public outdoor and indoor swimming pools in Tehran that hundreds of people use, especially on hot summer days. The bacteriological quality of the water of some of these pools was assayed over a period of about one year (2001-2002). To assess if these swimming pools were a health risk to users, eleven public swimming pools, in the east and northeast of the city, were examined, and the exposed people were monitored. Samples of swimming-pool waters were examined for colony counts, Escherichia coli and coliforms. In addition, Pseudomonas aeruginosa was isolated from nine (81.8%) of those pools. P. aeruginosa grew in seven (63.6%) of the swimming-pool water samples. In two (18.2%) other samples, in addition to P. aeruginosa, high rates of total bacterial count, total coliforms and faecal coliform counts were also found. At the same time, users of the swimming pools were asked to complete a questionnaire. Ear swabs were collected from 179 users with a history of ear problems during the previous two weeks. An adequate control group was chosen randomly from those who never used the investigated pools. P. aeruginosa was isolated from the ear swabs of 142 (79.3%) of the cases, as well as from 4% of the controls. Results were matched for age, sex, duration of time spent in the pools, place of occurrence and other useful information. Investigation of the contaminated swimming pools revealed that chlorination was often inadequate, especially when high numbers of people led to overuse of the pools. Although the results of this research showed that otitis externa was strongly associated with the swimming pools, due to P. aeruginosa, an extensive follow-up study is needed to determine the other possible health risks associated with public pools.

  17. Reviewing risk for individuals with developmental disabilities.

    Science.gov (United States)

    Darrow, Sabrina M; Follette, William C; Maragakis, Alexandros; Dykstra, Thane

    2011-04-01

    There are many categories of risky behaviors that are of interest to individuals, agencies, and institutions interested in care for developmentally disabled persons. These include challenging behaviors such as aggression and self-injury, psychiatric diagnoses, medical problems, criminal behaviors, and victimization. The literature in this area is difficult to digest due to a number of methodological problems. This paper reviews the research on one of these behaviors, self-injury, and provides a framework that can be applied to other research on predicting risk. Additionally, it attempts to organize the findings in such a way as to maximize the utility to providers and suggest useful directions for future research.

  18. Diabetes mellitus and cancer risk: pooled analysis of eight cohort studies in Japan.

    Science.gov (United States)

    Sasazuki, Shizuka; Charvat, Hadrien; Hara, Azusa; Wakai, Kenji; Nagata, Chisato; Nakamura, Kozue; Tsuji, Ichiro; Sugawara, Yumi; Tamakoshi, Akiko; Matsuo, Keitaro; Oze, Isao; Mizoue, Tetsuya; Tanaka, Keitaro; Inoue, Manami; Tsugane, Shoichiro

    2013-11-01

    Although a growing body of evidence suggests a link between diabetes and cancer, it is not clear whether diabetes independently increases the risk of cancer. We conducted a comprehensive assessment of the association between pre-existing diabetes and total and site-specific cancer risk based on a pooled analysis of eight cohort studies in Japan (>330 000 subjects). We estimated a summary hazard ratio by pooling study-specific hazard ratios for total and site-specific cancer by using a random-effects model. A statistically increased risk was observed for cancers at specific sites, such as colon (hazard ratio; HR = 1.40), liver (HR = 1.97), pancreas (HR = 1.85) and bile duct (HR = 1.66; men only). Increased risk was also suggested for other sites, and diabetes mellitus was associated with an overall 20% increased risk in total cancer incidence in the Japanese population. The association between these two diseases has important implications for reiterating the importance of controlling lifestyle factors and may suggest a possible strategy for cancer screening among patients with diabetes. Studies continuously investigating the risk factors for diabetes are also important.

  19. Empirical evaluation of selective DNA pooling to map QTL in dairy cattle using a half-sib design by comparison to individual genotyping and interval mapping

    Directory of Open Access Journals (Sweden)

    Robinson Nicholas

    2007-04-01

    Full Text Available Abstract This study represents the first attempt at an empirical evaluation of the DNA pooling methodology by comparing it to individual genotyping and interval mapping to detect QTL in a dairy half-sib design. The findings indicated that the use of peak heights from the pool electropherograms without correction for stutter (shadow product and preferential amplification performed as well as corrected estimates of frequencies. However, errors were found to decrease the power of the experiment at every stage of the pooling and analysis. The main sources of errors include technical errors from DNA quantification, pool construction, inconsistent differential amplification, and from the prevalence of sire alleles in the dams. Additionally, interval mapping using individual genotyping gains information from phenotypic differences between individuals in the same pool and from neighbouring markers, which is lost in a DNA pooling design. These errors cause some differences between the markers detected as significant by pooling and those found significant by interval mapping based on individual selective genotyping. Therefore, it is recommended that pooled genotyping only be used as part of an initial screen with significant results to be confirmed by individual genotyping. Strategies for improving the efficiency of the DNA pooling design are also presented.

  20. Circulating Leptin and Risk of Pancreatic Cancer: A Pooled Analysis From 3 Cohorts.

    Science.gov (United States)

    Stolzenberg-Solomon, Rachael Z; Newton, Christina C; Silverman, Debra T; Pollak, Michael; Nogueira, Leticia M; Weinstein, Stephanie J; Albanes, Demetrius; Männistö, Satu; Jacobs, Eric J

    2015-08-01

    Adiposity is associated with pancreatic cancer; however, the underlying mechanism(s) is uncertain. Leptin is an adipokine involved in metabolic regulation, and obese individuals have higher concentrations. We conducted a pooled, nested case-control study of cohort participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, and the Cancer Prevention Study II Nutrition Cohort to investigate whether prediagnostic serum leptin was associated with pancreatic cancer. A total of 731 pancreatic adenocarcinoma cases that occurred between 1986 and 2010 were included (maximum follow-up, 23 years). Incidence density-selected controls (n = 909) were matched to cases by cohort, age, sex, race, and blood draw date. Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. Sex-specific quintiles were based on the distribution of the controls. Overall, serum leptin was not associated with pancreatic cancer (quintile 5 vs. quintile 1: odds ratio = 1.13, 95% confidence interval: 0.75, 1.71; Ptrend = 0.38). There was a significant interaction by follow-up time (P = 0.003), such that elevated risk was apparent only during follow-up of more than 10 years after blood draw (quintile 5 vs. quintile 1: odds ratio = 2.55, 95% confidence interval: 1.23, 5.27; Ptrend = 0.004). Our results support an association between increasing leptin concentration and pancreatic cancer; however, long follow-up is necessary to observe the relationship. Subclinical disease may explain the lack of association during early follow-up.

  1. Folate intake and the risk of oral cavity and pharyngeal cancer: a pooled analysis within the INHANCE Consortium

    Science.gov (United States)

    Galeone, Carlotta; Edefonti, Valeria; Parpinel, Maria; Leoncini, Emanuele; Matsuo, Keitaro; Talamini, Renato; Olshan, Andrew F.; Zevallos, Jose P.; Winn, Deborah M.; Jayaprakash, Vijayvel; Moysich, Kirsten; Zhang, Zuo-Feng; Morgenstern, Hal; Levi, Fabio; Bosetti, Cristina; Kelsey, Karl; McClean, Michael; Schantz, Stimson; Yu, Guo-Pei; Boffetta, Paolo; Lee, Yuan-Chin Amy; Hashibe, Mia; La Vecchia, Carlo; Boccia, Stefania

    2014-01-01

    There are suggestions of an inverse association between folate intake and serum folate levels and the risk of oral cavity and pharyngeal cancers (OPC), but most studies are limited in sample size, with only few reporting information on the source of dietary folate. This study aims to investigate the association between folate intake and the risk of OPC within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. We analyzed pooled individual-level data from 10 case-control studies participating in the INHANCE consortium, including 5,127 cases and 13,249 controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were estimated for the associations between total folate intake (natural, fortification and supplementation) and natural folate only, and OPC risk. We found an inverse association between total folate intake and overall OPC risk (the adjusted OR for the highest versus the lowest quintile was 0.65, 95% CI: 0.43–0.99), with a stronger association for oral cavity (OR=0.57, 95% CI: 0.43–0.75). A similar inverse association, though somewhat weaker, was observed for folate intake from natural sources only (OR=0.64, 95% CI: 0.45–0.91). The highest OPC risk was observed in heavy alcohol drinkers with low folate intake as compared to never/light drinkers with high folate (OR=4.05, 95% CI: 3.43–4.79); the attributable proportion due to interaction was 11.1%(95% CI: 1.4–20.8%). The present project of a large pool of case-control studies supports a protective effect total folate intake on OPC risk. PMID:24974959

  2. Income inequality, individual income, and mortality in Danish adults: analysis of pooled data from two cohort studies

    DEFF Research Database (Denmark)

    Osler, Merete; Prescott, Eva; Grønbaek, Morten;

    2002-01-01

    To analyse the association between area income inequality and mortality after adjustment for individual income and other established risk factors.......To analyse the association between area income inequality and mortality after adjustment for individual income and other established risk factors....

  3. Pooled analysis of two German studies on the lung cancer risk by radon in homes

    Energy Technology Data Exchange (ETDEWEB)

    Schaffrath Rosario, A.; Heid, I.M.; Kreuzer, M.; Heinrich, J.; Kreienbrock, L.; Wichmann, H.E. [GSF-National Research Center for Environment and Health, Inst. of Epidemiology, Neuherberg (Germany)

    2005-07-01

    Studies on underground miners have shown an increased risk of lung cancer after exposure to high doses of radon and radon daughters. However, in the range of typical indoor radon exposures, there are still some uncertainties about the strength of the association between radon exposure and the risk of lung cancer. Since 1990, population-based epidemiological studies have been performed in various countries in North America, Europe, and China. The pooled analysis of two large German case-control studies on the lung cancer risk due to radon in homes is described. The analysis is based on an extended dataset compared to previous publications, including 2,963 lung cancer cases and 4,232 population controls. A linear increase in the relative lung cancer risk of 0.10 (95% CI -0.02 to 0.39) is found. The risk estimates tend to be higher when measurement error in the radon concentrations is reduced. Furthermore, an outlook is given on the activities regarding the pooling of radon studies worldwide. (orig.)

  4. Cultural theory and individual perceptions of environmental risks

    NARCIS (Netherlands)

    Steg, L; Sievers, [No Value

    2000-01-01

    Understanding differences in environmental risk perception and risk judgments might facilitate the development of effective environmental risk management strategies, including risk communication. Cultural theory holds that systematic individual differences exist in the perception of environmental ri

  5. Risk of lung cancer and residental radon in China: pooled results of two studies

    Energy Technology Data Exchange (ETDEWEB)

    Lubin, J.H.; Kleinerman, R.A. [Div. of Cancer Epidemiology and Genetics, National Cancer Inst., Rockville, ML (United States); Wang, Z.Y. [Lab. of Industrial Hygiene, Ministry of Health, Beijing (China); Boice, J.D.; Blot, W.J. [International Epidemiology Inst. (United States); Xu, Z.Y. [Liaoning Center for Disease Control and Prevention, Shenyang (China); Wang, L.D. [Ministry of Health, Beijing (China)

    2005-07-01

    Studies of radon-exposed underground miners predict that residential radon is the second leading cause of lung cancer mortality; however, case-control studies of residential radon have not provided unambiguous evidence of an association. Owing to small expected risks from residential radon and uncertainties in dosimetry, large studies or pooling of multiple studies are needed to fully evaluate effects. We pooled data from 2 case-control studies of residential radon representing 2 large radon studies conducted in China. The studies included 1,050 lung cancer cases and 1,996 controls. In the pooled data, odds ratios (OR) increased significantly with greater radon concentration. Based on a linear model, the OR with 95% confidence intervals (CI) at 100 Becquerel/cubic-meter (Bq/m{sup 3}) was 1.13 (1.01, 1.36). For subjects resident in the current home for 30 years or more, the OR at 100 Bq/m{sup 3} was 1.32 (1.07, 1.91). Results across studies were consistent with homogeneity. Estimates of ORs were similar to extrapolations from miner data and consistent with published residential radon studies in North American and Europe, suggesting long-term radon exposure at concentrations found in many homes increases lung cancer risk. (orig.)

  6. Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2)

    Science.gov (United States)

    Yang, H P; Cook, L S; Weiderpass, E; Adami, H-O; Anderson, K E; Cai, H; Cerhan, J R; Clendenen, T V; Felix, A S; Friedenreich, C M; Garcia-Closas, M; Goodman, M T; Liang, X; Lissowska, J; Lu, L; Magliocco, A M; McCann, S E; Moysich, K B; Olson, S H; Petruzella, S; Pike, M C; Polidoro, S; Ricceri, F; Risch, H A; Sacerdote, C; Setiawan, V W; Shu, X O; Spurdle, A B; Trabert, B; Webb, P M; Wentzensen, N; Xiang, Y-B; Xu, Y; Yu, H; Zeleniuch-Jacquotte, A; Brinton, L A

    2015-01-01

    Background: Nulliparity is an endometrial cancer risk factor, but whether or not this association is due to infertility is unclear. Although there are many underlying infertility causes, few studies have assessed risk relations by specific causes. Methods: We conducted a pooled analysis of 8153 cases and 11 713 controls from 2 cohort and 12 case-control studies. All studies provided self-reported infertility and its causes, except for one study that relied on data from national registries. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: Nulliparous women had an elevated endometrial cancer risk compared with parous women, even after adjusting for infertility (OR=1.76; 95% CI: 1.59–1.94). Women who reported infertility had an increased risk compared with those without infertility concerns, even after adjusting for nulliparity (OR=1.22; 95% CI: 1.13–1.33). Among women who reported infertility, none of the individual infertility causes were substantially related to endometrial cancer. Conclusions: Based on mainly self-reported infertility data that used study-specific definitions of infertility, nulliparity and infertility appeared to independently contribute to endometrial cancer risk. Understanding residual endometrial cancer risk related to infertility, its causes and its treatments may benefit from large studies involving detailed data on various infertility parameters. PMID:25688738

  7. Follicle pool, ovarian surgery and the risk for a subsequent trisomic pregnancy

    DEFF Research Database (Denmark)

    Honorato, T C; Henningsen, Anna-Karina Aaris; Haadsma, M L

    2015-01-01

    STUDY QUESTION: Is there an association between trisomic pregnancy, a marker for decreased oocyte quality, and the reduced oocyte quantity that follows ovarian surgery? SUMMARY ANSWER: Previous ovarian surgery is not associated with an increased risk for a subsequent trisomic pregnancy. WHAT......, correction for these factors was not performed. WIDER IMPLICATIONS OF THE FINDINGS: We did not confirm the hypothesis that ovarian surgery, a marker for decreased oocyte quantity, is related to trisomic pregnancy, a marker for decreased oocyte quality. This suggests that ovarian surgery, which has a direct...... reductive effect on the size of the follicle pool, may affect oocyte quality differently when compared with the reduction in follicle pool size due to ageing. STUDY FUNDING/COMPETING INTERESTS: The study was supported by grants from the Gratama Stichting, University of Groningen and the University Medical...

  8. Coffee Consumption and Risk of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma by Sex: The Liver Cancer Pooling Project.

    Science.gov (United States)

    Petrick, Jessica L; Freedman, Neal D; Graubard, Barry I; Sahasrabuddhe, Vikrant V; Lai, Gabriel Y; Alavanja, Michael C; Beane-Freeman, Laura E; Boggs, Deborah A; Buring, Julie E; Chan, Andrew T; Chong, Dawn Q; Fuchs, Charles S; Gapstur, Susan M; Gaziano, John Michael; Giovannucci, Edward L; Hollenbeck, Albert R; King, Lindsay Y; Koshiol, Jill; Lee, I-Min; Linet, Martha S; Palmer, Julie R; Poynter, Jenny N; Purdue, Mark P; Robien, Kim; Schairer, Catherine; Sesso, Howard D; Sigurdson, Alice J; Zeleniuch-Jacquotte, Anne; Wactawski-Wende, Jean; Campbell, Peter T; McGlynn, Katherine A

    2015-09-01

    Coffee consumption has been reported to be inversely associated with hepatocellular carcinoma (HCC), the most common type of liver cancer. Caffeine has chemopreventive properties, but whether caffeine is responsible for the coffee-HCC association is not well studied. In addition, few studies have examined the relationship by sex, and no studies have examined whether there is an association between coffee and intrahepatic cholangiocarcinoma (ICC), the second most common type of liver cancer. In the Liver Cancer Pooling Project, a consortium of U.S.-based cohort studies, data from 1,212,893 individuals (HCC, n = 860; ICC, n = 260) in nine cohorts were pooled. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using proportional hazards regression. Higher coffee consumption was associated with lower risk of HCC (HR>3 cups/day vs. non-drinker, 0.73; 95% CI, 0.53-0.99; Ptrend cups/day = risk was seen among women than men (Pinteraction = 0.07). Women who consumed more than three cups of coffee per day were at a 54% lower risk of HCC (HR, 0.46; 95% CI, 0.26-0.81), whereas men had more modest reduced risk of HCC (HR, 0.93; 95% CI, 0.63-1.37). The associations were stronger for caffeinated coffee (HR>3 cups/day vs. non-drinker, 0.71; 95% CI, 0.50-1.01) than decaffeinated coffee (HR, 0.92; 95% CI, 0.55-1.54). There was no association between coffee consumption and ICC. These findings suggest that, in a U.S. population, coffee consumption is associated with reduced risk of HCC. Further research into specific coffee compounds and mechanisms that may account for these associations is needed. ©2015 American Association for Cancer Research.

  9. Population-based rare variant detection via pooled exome or custom hybridization capture with or without individual indexing

    Directory of Open Access Journals (Sweden)

    Ramos Enrique

    2012-12-01

    Full Text Available Abstract Background Rare genetic variation in the human population is a major source of pathophysiological variability and has been implicated in a host of complex phenotypes and diseases. Finding disease-related genes harboring disparate functional rare variants requires sequencing of many individuals across many genomic regions and comparing against unaffected cohorts. However, despite persistent declines in sequencing costs, population-based rare variant detection across large genomic target regions remains cost prohibitive for most investigators. In addition, DNA samples are often precious and hybridization methods typically require large amounts of input DNA. Pooled sample DNA sequencing is a cost and time-efficient strategy for surveying populations of individuals for rare variants. We set out to 1 create a scalable, multiplexing method for custom capture with or without individual DNA indexing that was amenable to low amounts of input DNA and 2 expand the functionality of the SPLINTER algorithm for calling substitutions, insertions and deletions across either candidate genes or the entire exome by integrating the variant calling algorithm with the dynamic programming aligner, Novoalign. Results We report methodology for pooled hybridization capture with pre-enrichment, indexed multiplexing of up to 48 individuals or non-indexed pooled sequencing of up to 92 individuals with as little as 70 ng of DNA per person. Modified solid phase reversible immobilization bead purification strategies enable no sample transfers from sonication in 96-well plates through adapter ligation, resulting in 50% less library preparation reagent consumption. Custom Y-shaped adapters containing novel 7 base pair index sequences with a Hamming distance of ≥2 were directly ligated onto fragmented source DNA eliminating the need for PCR to incorporate indexes, and was followed by a custom blocking strategy using a single oligonucleotide regardless of index sequence

  10. Comparison of the Becton Dickinson strand displacement amplification and Cobas Amplicor Roche PCR for the detection of Chlamydia trachomatis: pooling versus individual tests

    DEFF Research Database (Denmark)

    Bang, D; Angelsø, Lene; Schirakow, Bente

    2003-01-01

    The objective of the study was to examine the influence of pooling Chlamydia trachomatis specimens. We compared Becton Dickinson ProbeTec strand displacement amplification (SDA) with Cobas Amplicor Roche (PCR). With PCR as the standard, SDA performed equally well in single-sample testing....... For pooled PCR samples (compared to individual PCR), we found a sensitivity of 100% and a specificity of 98.9%. For pooled SDA tests (compared to individual SDA), we found a sensitivity of 86.5% and a specificity of 98.9%. Our conclusion is that 2-sucrose phosphate buffer (2-SP) can be used for individual...

  11. Risk of infection associated with microbiological quality of public swimming pools in Bologna, Italy.

    Science.gov (United States)

    Leoni, E; Legnani, P; Guberti, E; Masotti, A

    1999-09-01

    Twelve public swimming pools in Bologna (Emilia-Romagna region, Italy) were investigated for the microbiological quality of water and surfaces of the pool edges, showers and changing rooms. At the same time a cross-sectional study was carried out on the health of 238 users (bathers) compared with 238 controls who practised sports other than swimming. Data regarding duration and frequency of exposure, behaviour and recent medical history were gathered by means of a questionnaire. All participants also underwent a medical examination. Compliance of the pool water to the microbiological standards set by Italian regulations was generally good; compliance was total when free chlorine residual was within the recommended limits. However, when analysis was extended to the various surfaces, potentially pathogenic bacteria such as P. aeruginosa and C. albicans were isolated. Eye burning and diarrhoea were the only declared symptoms and verrucas the only diagnosed disease showing statistically significant differences between bathers and controls. Verrucas tended to increase in proportion to exposure. Athlete's foot had a very high prevalence among both bathers (34 %) and controls (27.3%) and controls (27%). The environmental and epidemiological investigations both confirmed the risk of infection, mainly associated with the contamination of surfaces.

  12. Pooling of Individual Patient Data from Clinical Trials. Improvement of analyses of subgroups

    NARCIS (Netherlands)

    Koopman, L.

    2008-01-01

    Meta-analyses that use individual patient data (IPD), that is, the raw data of individual trials, rather than simply the overall results of each trial have been proposed as a major improvement in subgroup analyses. Since IPD meta-analyses often include more detailed data, they usually have greater s

  13. Risk factors for MRSA in fattening pig herds - a meta-analysis using pooled data.

    Science.gov (United States)

    Fromm, Sabine; Beißwanger, Elena; Käsbohrer, Annemarie; Tenhagen, Bernd-Alois

    2014-11-01

    The importance of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) as an infectious agent for humans has increased in recent years in Germany. Although it is well known that the prevalence of MRSA in pig farms is high, risk factors for the presence of MRSA in herds of fattening pigs are still poorly understood. The aim of this study was to evaluate available data from previous studies on MRSA in fattening pigs in a meta-analysis to answer the question: What are the factors associated with the occurrence of MRSA in fattening pig herds? The studies on MRSA in pigs that were identified by literature research were heterogeneous with respect to the risk factors investigated and the type of herds focused on. Therefore we decided to carry out a pooling analysis on herd level rather than a typical meta-analysis. Eligible herd data were identified based on the published literature and communication with the authors. The final data set covered 400 fattening pig herds from 10 different studies and 12 risk factors. The prevalence of MRSA in the 400 fattening pig herds was 53.5%. Data were analyzed using generalized estimating equations (GEE). The resulting multivariate model confirmed previously identified risk factors for MRSA in pig herds (herd size and herd type). It also identified further risk factors: group treatment of fattening pigs with antimicrobial drugs (OR=1.79) and housing fattening pig herds on at least partially slatted floors (OR=2.39) compared to plain floor. In contrast, according to the model, fattening pig herds on farms keeping other livestock along with pigs were less likely to harbor MRSA (OR=0.54). The results underline the benefits from a pooling analysis and cooperative re-evaluation of published data.

  14. Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies

    DEFF Research Database (Denmark)

    Cardwell, Chris R; Stene, Lars C; Joner, Geir

    2010-01-01

    BACKGROUND: The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis...... and after adjustment for confounders, and investigate heterogeneity. RESULTS: Data were available for 6 cohort and 25 case-control studies, including 11¿955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age...... at birth and other confounders, a reduction in the risk of diabetes in second- or later born children became apparent [fully adjusted OR¿=¿0.90 95% confidence interval (CI) 0.83-0.98; P¿=¿0.02] but this association varied markedly between studies (I(2)¿=¿67%). An a priori subgroup analysis showed...

  15. Needles in the haystack: identifying individuals present in pooled genomic data.

    Directory of Open Access Journals (Sweden)

    Rosemary Braun

    2009-10-01

    Full Text Available Recent publications have described and applied a novel metric that quantifies the genetic distance of an individual with respect to two population samples, and have suggested that the metric makes it possible to infer the presence of an individual of known genotype in a sample for which only the marginal allele frequencies are known. However, the assumptions, limitations, and utility of this metric remained incompletely characterized. Here we present empirical tests of the method using publicly accessible genotypes, as well as analytical investigations of the method's strengths and limitations. The results reveal that the null distribution is sensitive to the underlying assumptions, making it difficult to accurately calibrate thresholds for classifying an individual as a member of the population samples. As a result, the false-positive rates obtained in practice are considerably higher than previously believed. However, despite the metric's inadequacies for identifying the presence of an individual in a sample, our results suggest potential avenues for future research on tuning this method to problems of ancestry inference or disease prediction. By revealing both the strengths and limitations of the proposed method, we hope to elucidate situations in which this distance metric may be used in an appropriate manner. We also discuss the implications of our findings in forensics applications and in the protection of GWAS participant privacy.

  16. Survey of high-risk pool enrollees suggests that targeted transition education and outreach should begin soon.

    Science.gov (United States)

    Blewett, Lynn A; Lukanen, Elizabeth; Call, Kathleen T; Dahlen, Heather

    2013-09-01

    Several provisions of the Affordable Care Act make state and federal high-risk pools unnecessary beginning in January 2014. As a result, thousands of enrollees in those pools will be transferred to Medicaid and the new state and federal insurance exchanges. Our study analyzed new survey data collected from enrollees in the country's oldest and largest state-based high-risk pool, the Minnesota Comprehensive Health Association. We estimate that approximately half of the enrollees in that pool will qualify for Medicaid or premium subsidies in the exchange. More than 60 percent of the enrollees reported being somewhat or very unfamiliar with health care reform and the resulting changes to their current coverage. Their concerns about the expected impact of health reform varied by income, geography, and level of deductible. Targeting education and outreach information to address these concerns will be critical for this population's smooth transition to new coverage.

  17. Associations of Breast Cancer Risk Factors With Tumor Subtypes : A Pooled Analysis From the Breast Cancer Association Consortium Studies

    NARCIS (Netherlands)

    Yang, Xiaohong R.; Chang-Claude, Jenny; Goode, Ellen L.; Couch, Fergus J.; Nevanlinna, Heli; Milne, Roger L.; Gaudet, Mia; Schmidt, Marjanka K.; Broeks, Annegien; Cox, Angela; Fasching, Peter A.; Hein, Rebecca; Spurdle, Amanda B.; Blows, Fiona; Driver, Kristy; Flesch-Janys, Dieter; Heinz, Judith; Sinn, Peter; Vrieling, Alina; Heikkinen, Tuomas; Aittomaeki, Kristiina; Heikkilae, Paeivi; Blomqvist, Carl; Lissowska, Jolanta; Peplonska, Beata; Chanock, Stephen; Figueroa, Jonine; Brinton, Louise; Hall, Per; Czene, Kamila; Humphreys, Keith; Darabi, Hatef; Liu, Jianjun; Van 't Veer, Laura J.; Van Leeuwen, Flora E.; Andrulis, Irene L.; Glendon, Gord; Knight, Julia A.; Mulligan, Anna Marie; O'Malley, Frances P.; Weerasooriya, Nayana; John, Esther M.; Beckmann, Matthias W.; Hartmann, Arndt; Weihbrecht, Sebastian B.; Wachter, David L.; Jud, Sebastian M. S.; Loehberg, Christian R.; Baglietto, Laura; English, Dallas R.; Giles, Graham G.; McLean, Catriona A.; Severi, Gianluca; Lambrechts, Diether; Vandorpe, Thijs; Weltens, Caroline; Paridaens, Robert; Smeets, Ann; Neven, Patrick; Wildiers, Hans; Wang, Xianshu; Olson, Janet E.; Cafourek, Victoria; Fredericksen, Zachary; Kosel, Matthew; Vachon, Celine; Cramp, Helen E.; Connley, Daniel; Cross, Simon S.; Balasubramanian, Sabapathy P.; Reed, Malcolm W. R.; Doerk, Thilo; Bremer, Michael; Meyer, Andreas; Karstens, Johann H.; Ay, Aysun; Park-Simon, Tjoung-Won; Hillemanns, Peter; Arias Perez, Jose Ignacio; Menendez Rodriguez, Primitiva; Zamora, Pilar; Bentez, Javier; Ko, Yon-Dschun; Fischer, Hans-Peter; Hamann, Ute; Pesch, Beate; Bruening, Thomas; Justenhoven, Christina; Brauch, Hiltrud; Eccles, Diana M.; Tapper, William J.; Gerty, Sue M.; Sawyer, Elinor J.; Tomlinson, Ian P.; Jones, Angela; Kerin, Michael; Miller, Nicola; McInerney, Niall; Anton-Culver, Hoda; Ziogas, Argyrios; Shen, Chen-Yang; Hsiung, Chia-Ni; Wu, Pei-Ei; Yang, Show-Lin; Yu, Jyh-Cherng; Chen, Shou-Tung; Hsu, Giu-Cheng; Haiman, Christopher A.; Henderson, Brian E.; Le Marchand, Loic; Kolonel, Laurence N.; Lindblom, Annika; Margolin, Sara; Jakubowska, Anna; Lubinski, Jan; Huzarski, Tomasz; Byrski, Tomasz; Gorski, Bohdan; Gronwald, Jacek; Hooning, Maartje J.; Hollestelle, Antoinette; van den Ouweland, Ans M. W.; Jager, Agnes; Kriege, Mieke; Tilanus-Linthorst, Madeleine M. A.; Collee, Margriet; Wang-Gohrke, Shan; Pylkaes, Katri; Jukkola-Vuorinen, Arja; Mononen, Kari; Grip, Mervi; Hirvikoski, Pasi; Winqvist, Robert; Mannermaa, Arto; Kosma, Veli-Matti; Kauppinen, Jaana; Kataja, Vesa; Auvinen, Paeivi; Soini, Ylermi; Sironen, Reijo; Bojesen, Stig E.; Orsted, David Dynnes; Kaur-Knudsen, Diljit; Flyger, Henrik; Nordestgaard, Borge G.; Holland, Helene; Chenevix-Trench, Georgia; Manoukian, Siranoush; Barile, Monica; Radice, Paolo; Hankinson, Susan E.; Hunter, David J.; Tamimi, Rulla; Sangrajrang, Suleeporn; Brennan, Paul; Mckay, James; Odefrey, Fabrice; Gaborieau, Valerie; Devilee, Peter; Huijts, P. E. A.; Tollenaar, R. A. E. M.; Seynaeve, C.; Dite, Gillian S.; Apicella, Carmel; Hopper, John L.; Hammet, Fleur; Tsimiklis, Helen; Smith, Letitia D.; Southey, Melissa C.; Humphreys, Manjeet K.; Easton, Douglas; Pharoah, Paul; Sherman, Mark E.; Garcia-Closas, Montserrat

    Background Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. Methods We pooled tumor marker and epidemiological risk factor data from 35 568 invasive breast cancer case patients

  18. Associations of Breast Cancer Risk Factors With Tumor Subtypes : A Pooled Analysis From the Breast Cancer Association Consortium Studies

    NARCIS (Netherlands)

    Yang, Xiaohong R.; Chang-Claude, Jenny; Goode, Ellen L.; Couch, Fergus J.; Nevanlinna, Heli; Milne, Roger L.; Gaudet, Mia; Schmidt, Marjanka K.; Broeks, Annegien; Cox, Angela; Fasching, Peter A.; Hein, Rebecca; Spurdle, Amanda B.; Blows, Fiona; Driver, Kristy; Flesch-Janys, Dieter; Heinz, Judith; Sinn, Peter; Vrieling, Alina; Heikkinen, Tuomas; Aittomaeki, Kristiina; Heikkilae, Paeivi; Blomqvist, Carl; Lissowska, Jolanta; Peplonska, Beata; Chanock, Stephen; Figueroa, Jonine; Brinton, Louise; Hall, Per; Czene, Kamila; Humphreys, Keith; Darabi, Hatef; Liu, Jianjun; Van 't Veer, Laura J.; Van Leeuwen, Flora E.; Andrulis, Irene L.; Glendon, Gord; Knight, Julia A.; Mulligan, Anna Marie; O'Malley, Frances P.; Weerasooriya, Nayana; John, Esther M.; Beckmann, Matthias W.; Hartmann, Arndt; Weihbrecht, Sebastian B.; Wachter, David L.; Jud, Sebastian M. S.; Loehberg, Christian R.; Baglietto, Laura; English, Dallas R.; Giles, Graham G.; McLean, Catriona A.; Severi, Gianluca; Lambrechts, Diether; Vandorpe, Thijs; Weltens, Caroline; Paridaens, Robert; Smeets, Ann; Neven, Patrick; Wildiers, Hans; Wang, Xianshu; Olson, Janet E.; Cafourek, Victoria; Fredericksen, Zachary; Kosel, Matthew; Vachon, Celine; Cramp, Helen E.; Connley, Daniel; Cross, Simon S.; Balasubramanian, Sabapathy P.; Reed, Malcolm W. R.; Doerk, Thilo; Bremer, Michael; Meyer, Andreas; Karstens, Johann H.; Ay, Aysun; Park-Simon, Tjoung-Won; Hillemanns, Peter; Arias Perez, Jose Ignacio; Menendez Rodriguez, Primitiva; Zamora, Pilar; Bentez, Javier; Ko, Yon-Dschun; Fischer, Hans-Peter; Hamann, Ute; Pesch, Beate; Bruening, Thomas; Justenhoven, Christina; Brauch, Hiltrud; Eccles, Diana M.; Tapper, William J.; Gerty, Sue M.; Sawyer, Elinor J.; Tomlinson, Ian P.; Jones, Angela; Kerin, Michael; Miller, Nicola; McInerney, Niall; Anton-Culver, Hoda; Ziogas, Argyrios; Shen, Chen-Yang; Hsiung, Chia-Ni; Wu, Pei-Ei; Yang, Show-Lin; Yu, Jyh-Cherng; Chen, Shou-Tung; Hsu, Giu-Cheng; Haiman, Christopher A.; Henderson, Brian E.; Le Marchand, Loic; Kolonel, Laurence N.; Lindblom, Annika; Margolin, Sara; Jakubowska, Anna; Lubinski, Jan; Huzarski, Tomasz; Byrski, Tomasz; Gorski, Bohdan; Gronwald, Jacek; Hooning, Maartje J.; Hollestelle, Antoinette; van den Ouweland, Ans M. W.; Jager, Agnes; Kriege, Mieke; Tilanus-Linthorst, Madeleine M. A.; Collee, Margriet; Wang-Gohrke, Shan; Pylkaes, Katri; Jukkola-Vuorinen, Arja; Mononen, Kari; Grip, Mervi; Hirvikoski, Pasi; Winqvist, Robert; Mannermaa, Arto; Kosma, Veli-Matti; Kauppinen, Jaana; Kataja, Vesa; Auvinen, Paeivi; Soini, Ylermi; Sironen, Reijo; Bojesen, Stig E.; Orsted, David Dynnes; Kaur-Knudsen, Diljit; Flyger, Henrik; Nordestgaard, Borge G.; Holland, Helene; Chenevix-Trench, Georgia; Manoukian, Siranoush; Barile, Monica; Radice, Paolo; Hankinson, Susan E.; Hunter, David J.; Tamimi, Rulla; Sangrajrang, Suleeporn; Brennan, Paul; Mckay, James; Odefrey, Fabrice; Gaborieau, Valerie; Devilee, Peter; Huijts, P. E. A.; Tollenaar, R. A. E. M.; Seynaeve, C.; Dite, Gillian S.; Apicella, Carmel; Hopper, John L.; Hammet, Fleur; Tsimiklis, Helen; Smith, Letitia D.; Southey, Melissa C.; Humphreys, Manjeet K.; Easton, Douglas; Pharoah, Paul; Sherman, Mark E.; Garcia-Closas, Montserrat

    2011-01-01

    Background Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. Methods We pooled tumor marker and epidemiological risk factor data from 35 568 invasive breast cancer case patients f

  19. Diet and the risk of head and neck cancer: a pooled analysis in the INHANCE consortium.

    LENUS (Irish Health Repository)

    Chuang, Shu-Chun

    2012-01-01

    We investigated the association between diet and head and neck cancer (HNC) risk using data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. The INHANCE pooled data included 22 case-control studies with 14,520 cases and 22,737 controls. Center-specific quartiles among the controls were used for food groups, and frequencies per week were used for single food items. A dietary pattern score combining high fruit and vegetable intake and low red meat intake was created. Odds ratios (OR) and 95% confidence intervals (CI) for the dietary items on the risk of HNC were estimated with a two-stage random-effects logistic regression model. An inverse association was observed for higher-frequency intake of fruit (4th vs. 1st quartile OR = 0.52, 95% CI = 0.43-0.62, p (trend) < 0.01) and vegetables (OR = 0.66, 95% CI = 0.49-0.90, p (trend) = 0.01). Intake of red meat (OR = 1.40, 95% CI = 1.13-1.74, p (trend) = 0.13) and processed meat (OR = 1.37, 95% CI = 1.14-1.65, p (trend) < 0.01) was positively associated with HNC risk. Higher dietary pattern scores, reflecting high fruit\\/vegetable and low red meat intake, were associated with reduced HNC risk (per score increment OR = 0.90, 95% CI = 0.84-0.97).

  20. Coping styles in healthy individuals at risk of affective disorder

    DEFF Research Database (Denmark)

    Vinberg, Maj; Froekjaer, Vibe Gedsoe; Kessing, Lars Vedel

    2010-01-01

    Coping styles may influence the perceived life stress experienced by an individual and, therefore, also be critical in the development of affective disorders. This study examined whether familial risk of affective disorder is associated with the use of maladaptive coping styles, in healthy...... individuals. One hundred twelve high-risk and 78 low-risk individuals were identified through nation-wide registers and invited to participate in an extensive psychiatric evaluation including the Coping Inventory for Stressful Situations. The high-risk individuals used more Emotion-oriented (p = 0.......001) and Avoidance coping (p = 0.04) than individuals not at risk. Adjusted for gender, age, years of education, and recent stressful life events the high-risk individuals used more emotion-oriented coping (p = 0.03). In conclusion, maladaptive coping style may represent a trait marker for mood disorder improving...

  1. Prevalence of adenomas and colorectal cancer in average risk individuals: a systematic review and meta-analysis.

    Science.gov (United States)

    Heitman, Steven J; Ronksley, Paul E; Hilsden, Robert J; Manns, Braden J; Rostom, Alaa; Hemmelgarn, Brenda R

    2009-12-01

    There is an extensive yet inconsistent body of literature reporting on the prevalence of adenomatous polyps (adenomas) and colorectal cancer among average risk individuals. The objectives of our study were to determine the pooled prevalence of adenomas and colorectal cancer, as well as nonadvanced and advanced adenomas, among average risk North Americans. Articles were obtained by searching electronic databases (MEDLINE: 1950 through March 2008 and EMBASE: 1980 through March 2008), bibliographies, major journals, and conference proceedings, with no language restrictions. Two reviewers independently selected cross-sectional studies reporting adenoma and colorectal cancer prevalence rates in average risk individuals and assessed studies for inclusion and quality, and extracted the data for analysis. Pooled adenoma and colorectal cancer prevalence rates were estimated using fixed and random effects models. Stratification and metaregression was used to assess heterogeneity. Based on 18 included studies, the pooled prevalence of adenomas, colorectal cancer, nonadvanced adenomas, and advanced adenomas was 30.2%, 0.3%, 17.7%, and 5.7%, respectively. Heterogeneity was observed in the pooled prevalence rates for overall adenomas, advanced adenomas, and colorectal cancer and was explained by the mean age (> or = 65 years vs prevalence rates. None of the study quality indicators was found to be significant predictors of heterogeneity. The high prevalence of advanced adenomas and colorectal cancer, especially among older screen-eligible individuals, provides impetus for expanding colorectal cancer screening programs. Furthermore, the pooled prevalence estimates can be used as quality indicators for established programs.

  2. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the INHANCE consortium

    Science.gov (United States)

    Hashibe, Mia; Brennan, Paul; Chuang, Shu-chun; Boccia, Stefania; Castellsague, Xavier; Chen, Chu; Curado, Maria Paula; Maso, Luigino Dal; Daudt, Alexander W.; Fabianova, Eleonora; Fernandez, Leticia; Wünsch-Filho, Victor; Franceschi, Silvia; Hayes, Richard B.; Herrero, Rolando; Kelsey, Karl; Koifman, Sergio; La Vecchia, Carlo; Lazarus, Philip; Levi, Fabio; Lence, Juan J.; Mates, Dana; Matos, Elena; Menezes, Ana; McClean, Michael D.; Muscat, Joshua; Eluf-Neto, Jose; Olshan, Andrew F.; Purdue, Mark; Rudnai, Peter; Schwartz, Stephen M.; Smith, Elaine; Sturgis, Erich M.; Szeszenia-Dabrowska, Neonilia; Talamini, Renato; Wei, Qingyi; Winn, Deborah M.; Shangina, Oxana; Pilarska, Agnieszka; Zhang, Zuo-Feng; Ferro, Gilles; Berthiller, Julien; Boffetta, Paolo

    2011-01-01

    Background The magnitude of risk conferred by the interaction between tobacco and alcohol use on the risk of head and neck cancers is not clear, since studies have used various methods to quantify the excess head and neck cancer burden. Methods We analyzed individual-level pooled data from 17 European and American case-control studies (11,221 cases and 16,168 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. We estimated the multiplicative interaction parameter (ψ) and population attributable risks (PAR). Results A greater than multiplicative joint effect between ever tobacco and alcohol use was observed for head and neck cancer risk (ψ=2.15, 95%CI=1.53–3.04). The PAR for tobacco or alcohol was 72% (95%CI=61%–79%) for head and neck cancer, of which 4% was due to alcohol alone, 33% was due tobacco alone and 35% was due to tobacco and alcohol combined. The total PAR differed by subsite (64% for oral cavity cancer, 72% for pharyngeal cancer, 89% for laryngeal cancer), by sex (74% for men, 57% for women) by age (33% for cases 60 years) and by region (84% in Europe, 51% in North America, 83% in Latin America). Conclusions Our results confirm that the joint effect between tobacco and alcohol use is greater than multiplicative on head and neck cancer risk. However, a substantial proportion of head and neck cancers cannot be attributed to tobacco or alcohol use, particularly for oral cavity cancer, for head and neck cancer among women and among young onset cases. PMID:19190158

  3. Risks of new-onset allergic sensitization and airway inflammation after early age swimming in chlorinated pools.

    Science.gov (United States)

    Voisin, Catherine; Sardella, Antonia; Bernard, Alfred

    2014-01-01

    Irritant chlorination products in swimming pools can cause respiratory problems in swimmers but their possible implication in allergies development is still unclear. To assess prospectively whether early-life attendance at chlorinated pools increases the risks of IgE sensitization and of airways inflammation later during childhood. We conducted a two-year prospective study among 196 kindergarten children (mean age of 5.7 years, 54% of boys). We measured exhaled nitric oxide (eNO) and aeroallergen-specific IgE in nasal mucosa. Parents completed a questionnaire about the child's health, chlorinated pool attendance and potential confounders. Ever swimming at indoor or outdoor chlorinated pools before the age of three years was associated with higher odds for new-onset IgE sensitization to house dust mite (adjusted odds ratio [aOR] 2.93, 95% confidence interval [CI] 1.14-7.55) and for new-onset increased eNO (>15 ppb; aOR, 4.54, 95% CI 1.48-13.9). For both outcomes, aORs increased dose-dependently with time spent in chlorinated pools with values reaching, respectively, 3.60 (95% CI 1.21-10.7) and 5.92 (95% CI 1.72-20.5) when the cumulative pool attendance exceeded 60 h These risks appeared independently of each other, of parental history of allergies and of pre-existing diseases, including eczema, which at baseline was more prevalent in early swimmers (aOR, 2.91; 95% CI 1.23-6.89). Such associations were not seen with IgE sensitization to pollen or cat allergens. Attendance at chlorinated swimming pools in early life is associated with higher risks of new-onset airways inflammation and IgE sensitization to house dust mite, independently of other risk factors. Copyright © 2013 Elsevier GmbH. All rights reserved.

  4. Bleeding risk and mortality of edoxaban: a pooled meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Shuang Li

    Full Text Available OBJECTIVE(S: Edoxaban, a factor Xa inhibitor, is a new oral anticoagulant that has been developed as an alternative to vitamin K antagonists. However, its safety remains unexplored. METHODS: Medline, Embase and Web of Science were searched to March 8, 2014 for prospective, randomized controlled trials (RCTs that assessed the safety profile of edoxaban with warfarin. Safety outcomes examined included bleeding risk and mortality. RESULTS: Five trials including 31,262 patients that met the inclusion criteria were pooled. Overall, edoxaban was associated with a significant decrease in major or clinically relevant nonmajor bleeding events [risk ratio (RR 0.78, 95% confidence interval (CI 0.74 to 0.82, p<0.001] and any bleeding events [RR 0.82, 95% CI 0.79 to 0.85, p<0.001]. Edoxaban also showed superiority to warfarin both in all-cause mortality [RR 0.92, 95% CI 0.85 to 0.99, p = 0.02] and cardiovascular mortality [RR 0.87, 95% CI 0.79 to 0.96, p = 0.004]. Subgroup analyses indicated that RRs of edoxaban 30, 60 or 120 mg/d were 0.67 (p<0.001, 0.87 (p<0.001 and 3.3 (p = 0.004 respectively in major or clinically relevant nonmajor bleeding; 0.71 (p<0.001, 0.89 (p<0.001 and 2.29 (p = 0.002 respectively in any bleeding; as well as 0.86 (p = 0.01, 0.87 (p = 0.01 and 0.28 (p = 0.41 respectively in cardiovascular death… Meanwhile, paramount to note that pooled results other than the largest trial showed edoxaban was still associated with a decrease in the rate of major or clinically relevant nonmajor bleeding event (p = 0.02 and any bleeding (p = 0.002, but neither in all-cause death (p = 0.66 nor cardiovascular death (p = 0.70. CONCLUSIONS: Edoxaban, a novel orally available direct factor Xa inhibitor, seems to have a favorable safety profiles with respect to bleeding risk and non-inferior in mortality when compared to warfarin. Further prospective RCTs are urgently needed to confirm the results of this meta-analysis.

  5. Coping styles in healthy individuals at risk of affective disorder

    DEFF Research Database (Denmark)

    Vinberg, Maj; Froekjaer, Vibe Gedsoe; Kessing, Lars Vedel

    2010-01-01

    .001) and Avoidance coping (p = 0.04) than individuals not at risk. Adjusted for gender, age, years of education, and recent stressful life events the high-risk individuals used more emotion-oriented coping (p = 0.03). In conclusion, maladaptive coping style may represent a trait marker for mood disorder improving...

  6. Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium.

    Directory of Open Access Journals (Sweden)

    Paolo Boffetta

    Full Text Available BACKGROUND: The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. METHODS AND FINDINGS: A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5-24.9 kg/m² as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76 for BMI lower than 15.0 kg/m² to 2.23 (95% CI 1.86, 2.67 for BMI higher than 34.9 kg/m². The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001, in cohorts from India and Bangladesh (p<0.001, in individuals with low education (p-value 0.02, and in smokers (p-value 0.03; no differences were observed by gender, urban residence, or alcohol drinking. CONCLUSIONS: This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of

  7. Potential risks of TiO{sub 2} and ZnO nanoparticles released from sunscreens into outdoor swimming pools

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Soo-kyung [Center for Water Resource Cycle, Green City Technology Institute, Korea Institute of Science and Technology (KIST), Seoul 136-791 (Korea, Republic of); Energy Environment Policy and Technology, Green School, Korea University (KU)-Korea Institute of Science and Technology (KIST), Seoul 136-701 (Korea, Republic of); Kim, Eun-ju [Center for Water Resource Cycle, Green City Technology Institute, Korea Institute of Science and Technology (KIST), Seoul 136-791 (Korea, Republic of); Lee, Jaesang [Energy Environment Policy and Technology, Green School, Korea University (KU)-Korea Institute of Science and Technology (KIST), Seoul 136-701 (Korea, Republic of); Civil, Environmental, and Architectural Engineering, Korea University, Seoul 136-701 (Korea, Republic of); Lee, Seunghak, E-mail: seunglee@kist.re.kr [Center for Water Resource Cycle, Green City Technology Institute, Korea Institute of Science and Technology (KIST), Seoul 136-791 (Korea, Republic of); Energy Environment Policy and Technology, Green School, Korea University (KU)-Korea Institute of Science and Technology (KIST), Seoul 136-701 (Korea, Republic of)

    2016-11-05

    Highlights: • Nanoparticles from sunscreen products can be released into public pools. • Nanoparticles and organic ingredients can generate reactive oxygen species (ROS). • A negative impact of ROS should not be significant in swimming pool. - Abstract: The potential risks of nanoparticles (NPs) in sunscreens being released into swimming water were evaluated by a series of laboratory experiments simulating the fate and transport of NPs in outdoor swimming pools. NPs released from sunscreen-applied skin were estimated using pig skins covered with five different commercial sunscreens containing TiO{sub 2}, ZnO, or both at various concentrations. Assuming that the swimming water treatment processes consisted of filtration, UV irradiation, heating, and chlorination, possible removal of the released NPs by each process was estimated. Generation of hydrogen peroxide (H{sub 2}O{sub 2}) by the NPs under sunlight and after UV photochemical treatment were measured, and the H{sub 2}O{sub 2} concentration possibly present in the swimming pool was calculated based on some specific scenarios of operating an outdoor swimming pool. It was found that a significant amount of the NPs in sunscreens could be released into the swimming water, and accumulate during circulation through the treatment system. However, the concentration of H{sub 2}O{sub 2} possibly present in the swimming pool should be below the level at which an adverse effect to bathers is concerned.

  8. Reducing outbreaks: using international governmental risk pools to fund research and development of infectious disease medicines and vaccines.

    Science.gov (United States)

    Erfe, J Mark

    2014-12-01

    The deadliest Ebola outbreak the world has ever seen is currently ravaging West Africa, despite the concerted efforts of the World Health Organization and many national governments. The current picture is troubling, but not altogether unexpected. Ebola was initially identified in 1976, and since that time, few drugs have been developed to combat it. The same is true for myriad other dangerous infectious diseases to which the world is currently susceptible. One proposal that might prevent outbreaks of this scale and magnitude from recurring would be to have the World Health Organization (WHO) and its technical partners assess which of its member states are at high risk for a disease, either directly or indirectly, and facilitate the creation of international governmental risk pools of those member states. Risk pools would offer open-indexed grant contracts to fund vaccine and drug development for a particular disease, and pharmaceutical companies could browse the index to apply for these grants. If the risk-pool states and a particular company sign a contract, a mutually agreed upon amount of the vaccine or drug would be produced at a below-market purchase price for those states. In return, the company would keep any patents or intellectual property rights for the developed vaccines or drugs. Risk-pool countries that did not use their vaccine or drug could resell that supply on secondary markets to other countries outside of the risk pool. This arrangement will increase the supply of tested drug and vaccine candidates available for combatting unexpected outbreaks of any previously discovered major infectious disease in the future.

  9. Dependency of Crop Production between Global Breadbaskets: A Copula Approach for the Assessment of Global and Regional Risk Pools.

    Science.gov (United States)

    Gaupp, Franziska; Pflug, Georg; Hochrainer-Stigler, Stefan; Hall, Jim; Dadson, Simon

    2016-12-29

    As recent events have shown, simultaneous crop losses in different parts of the world can cause serious risks to global food security. However, to date, little is known about the spatial dependency of lower than expected crop yields from global breadbaskets. This especially applies in the case of extreme events, i.e., where one or more breadbaskets are experiencing far below average yields. Without such information, risk management approaches cannot be applied and vulnerability to extremes may remain high or even increase in the future around the world. We tackle both issues from an empirical perspective focusing on wheat yield. Interdependencies between historically observed wheat yield deviations in five breadbaskets (United States, Argentina, India, China, and Australia) are estimated via copula approaches that can incorporate increasing tail dependencies. In doing so, we are able to attach probabilities to interregional as well as global yield losses. To address the robustness of our results, we apply three different methods for constructing multivariate copulas: vine copulas, ordered coupling using a minimax approach, and hierarchical structuring. We found interdependencies between states within breadbaskets that led us to the conclusion that risk pooling for extremes is less favorable on the regional level. However, notwithstanding evidence of global climatic teleconnections that may influence crop production, we also demonstrate empirically that wheat production losses are independent between global breadbaskets, which strengthens the case for interregional risk pooling strategies. We argue that through interregional risk pooling, postdisaster liabilities of governments and international donors could be decreased. © 2016 Society for Risk Analysis.

  10. Follicle pool, ovarian surgery and the risk for a subsequent trisomic pregnancy.

    Science.gov (United States)

    Honorato, T C; Henningsen, A A; Haadsma, M L; Land, J A; Pinborg, A; Lidegaard, Ø; Groen, H; Hoek, A

    2015-03-01

    Is there an association between trisomic pregnancy, a marker for decreased oocyte quality, and the reduced oocyte quantity that follows ovarian surgery? Previous ovarian surgery is not associated with an increased risk for a subsequent trisomic pregnancy. Ovarian surgery diminishes the number of oocytes. The risk for a trisomic pregnancy is suggested to be higher in women with fewer oocytes, independent of their chronological age. This is a matched case-control study. Cases are women with a confirmed trisomic pregnancy occurring between 1 January 2000 and 31 December 2010 regardless of pregnancy outcome and controls are women that had a live born child without a trisomy. In total, there were 8573 participants in the study; 1723 cases and 6850 controls. Data were obtained from Danish medical registries. Matching criteria were maternal age and year of conception. Number of controls matched per case ranged from one to four. Among cases and controls with a trisomic pregnancy, 2.7% (46/1723) versus 2.5% (172/6850) had undergone ovarian surgery before pregnancy. History of ovarian surgery is not associated with a higher risk for a subsequent trisomic pregnancy (odds ratio = 1.00, 95% confidence interval 0.99-1.01). Subgroup analyses by indication of surgery and interval between ovarian surgery and pregnancy do not show an effect on trisomic pregnancy risk. The medical registries used to select cases and controls did not contain information on surgical technique nor volume of ovarian tissue resected, previous trisomic pregnancy prior to the ovarian surgery or long-term use of oral contraceptives. Therefore, correction for these factors was not performed. We did not confirm the hypothesis that ovarian surgery, a marker for decreased oocyte quantity, is related to trisomic pregnancy, a marker for decreased oocyte quality. This suggests that ovarian surgery, which has a direct reductive effect on the size of the follicle pool, may affect oocyte quality differently when

  11. Efficacy and Safety of Canagliflozin in Individuals Aged 75 and Older with Type 2 Diabetes Mellitus: A Pooled Analysis.

    Science.gov (United States)

    Sinclair, Alan J; Bode, Bruce; Harris, Stewart; Vijapurkar, Ujjwala; Shaw, Wayne; Desai, Mehul; Meininger, Gary

    2016-03-01

    To compare the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 inhibitor developed to treat type 2 diabetes mellitus (T2DM), in individuals younger than 75 and those aged 75 and older. Randomized Phase 3 studies. International study centers. Adults with T2DM. Changes from baseline in glycosylated hemoglobin (HbA1c ), fasting plasma glucose (FPG), blood pressure (BP), and body weight were measured. Efficacy was evaluated using pooled data from six randomized, double-blind, placebo-controlled studies (N = 4,158; n = 3,975 aged Canagliflozin 100 and 300 mg were associated with placebo-subtracted mean reductions in HbA1c in participants younger than 75 (-0.69% and -0.85%, respectively) and aged 75 and older (-0.65% and -0.55%, respectively). Dose-related reductions in FPG, body weight, and BP were seen with canagliflozin 100 and 300 mg in participants in both age groups. Overall AE incidence was 67.1% with canagliflozin 100 mg, 68.6% with canagliflozin 300 mg, and 65.9% with non-canagliflozin (pooled group of comparators in all studies) in participants younger than 75, and 72.4%, 79.1%, and 72.3%, respectively, in those aged 75 and older, with a similar safety profile in both groups. The incidence of volume depletion-related AEs was 2.2%, 3.1%, and 1.4% in participants younger than 75 with canagliflozin 100 and 300 mg and non-canagliflozin, respectively, and 4.9%, 8.7%, and 2.6%, respectively, in those aged 75 and older. Canagliflozin improved glycemic control, body weight, and BP in participants aged 75 and older. The overall incidence of AEs was high across treatment groups in participants aged 75 and older and higher than in those younger than 75. The safety profile of canagliflozin was generally similar in both age groups, with a higher incidence of AEs related to volume depletion observed with canagliflozin in participants aged 75 and older than in those younger than 75. These findings support canagliflozin, starting with the 100

  12. Cigarette smoking, N-acetyltransferase 2 genotypes, and breast cancer risk: pooled analysis and meta-analysis.

    Science.gov (United States)

    Ambrosone, Christine B; Kropp, Silke; Yang, Jun; Yao, Song; Shields, Peter G; Chang-Claude, Jenny

    2008-01-01

    Approximately 10 years ago, it was noted that smoking increased risk of breast cancer among women with N-acetyltransferase 2 (NAT2) slow acetylation genotypes. This report was followed by a number of studies to address this question. We pooled data from 10 existing studies and also conducted a meta-analysis of 13 studies published from 1996 to October 2006 that were conducted among women, were published in English, and had adequate information on smoking and NAT2 genotyping. Raw data were requested from authors. Unconditional logistic regression was done for pooled analysis, and random effect models was done for meta-analysis. Study heterogeneity was assessed, and sensitivity tests were done when subgroups were excluded from the analysis. In the pooled analysis, there was a significant interaction between smoking, NAT2 genotype, and risk of breast cancer [pack-years (continuous variable, P(interaction) = 0.03)], with higher pack-years significantly associated with an increased risk of breast cancer among women with NAT2 slow genotypes (pooled analysis relative risk, 1.49; 95% confidence interval, 1.08-2.04). These findings were supported by the meta-analysis including all studies; pack-years were significantly associated with risk among slow acetylators in a dose-dependent fashion (meta-analysis relative risk, 1.44; 95% confidence interval, 1.23-1.68 for > or =20 pack-years versus never smokers), but not among rapid acetylators. Similar relationships were noted for smoking status (ever, never) and duration of smoking. Our results show that cigarette smoking is associated with an increase in breast cancer risk among women with NAT2 slow acetylation genotypes. Because slow NAT2 genotypes are present in 50% to 60% of Caucasian populations, smoking is likely to play an important role in breast cancer etiology.

  13. Pooled Analysis of Phosphatidylinositol 3-kinase Pathway Variants and Risk of Prostate Cancer

    Science.gov (United States)

    Koutros, Stella; Schumacher, Fredrick R.; Hayes, Richard B.; Ma, Jing; Huang, Wen-Yi; Albanes, Demetrius; Canzian, Federico; Chanock, Stephen J.; Crawford, E. David; Diver, W. Ryan; Feigelson, Heather Spencer; Giovanucci, Edward; Haiman, Christopher A.; Henderson, Brian E.; Hunter, David J.; Kaaks, Rudolf; Kolonel, Laurence N.; Kraft, Peter; Le Marchand, Loïc; Riboli, Elio; Siddiq, Afshan; Stampfer, Mier J.; Stram, Daniel O.; Thomas, Gilles; Travis, Ruth C.; Thun, Michael J.; Yeager, Meredith; Berndt, Sonja I.

    2010-01-01

    The phosphatidylinositol 3-kinase (PI3K) pathway regulates various cellular processes, including cellular proliferation and intracellular trafficking and may impact prostate carcinogenesis. Thus, we explored the association between single nucleotide polymorphisms (SNPs) in PI3K genes and prostate cancer. Pooled data from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium were examined for associations between 89 SNPs in PI3K genes (PIK3C2B, PIK3AP1, PIK3C2A, PIK3CD, and PIK3R3) and prostate cancer risk in 8,309 cases and 9,286 controls. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. SNP rs7556371 in PIK3C2B was significantly associated with prostate cancer risk (ORper allele=1.08 (95% CI: 1.03, 1.14), p-trend = 0.0017) after adjustment for multiple testing (Padj=0.024). Simultaneous adjustment of rs7556371 for nearby SNPs strengthened the association (ORper allele=1.21 (95% CI: 1.09, 1.34); p-trend =0.0003). The adjusted association was stronger for men who were diagnosed before 65 years (ORper allele= 1.47 (95% CI: 1.20, 1.79), p-trend = 0.0001) or had a family history (ORper allele= 1.57 (95% CI: 1.11, 2.23), p-trend = 0.0114), and was strongest in those with both characteristics (ORper allele= 2.31 (95% CI: 1.07, 5.07), p-interaction = 0.005). Increased risks were observed among men in the top tertile of circulating insulin like growth factor-1 (IGF-1) levels (ORper allele= 1.46 (95% CI: 1.04, 2.06), p-trend=0.075). No differences were observed with disease aggressiveness (≥8/stage T3/T4/fatal). In conclusion, we observed a significant association between PIK3C2B and prostate cancer risk, especially for familial, early onset disease, which may be attributable to IGF-dependent PI3K signaling. PMID:20197460

  14. Similar exemplar pooling processes underlie the learning of facial identity and handwriting style: Evidence from typical observers and individuals with Autism.

    Science.gov (United States)

    Ipser, Alberta; Ring, Melanie; Murphy, Jennifer; Gaigg, Sebastian B; Cook, Richard

    2016-05-01

    Considerable research has addressed whether the cognitive and neural representations recruited by faces are similar to those engaged by other types of visual stimuli. For example, research has examined the extent to which objects of expertise recruit holistic representation and engage the fusiform face area. Little is known, however, about the domain-specificity of the exemplar pooling processes thought to underlie the acquisition of familiarity with particular facial identities. In the present study we sought to compare observers' ability to learn facial identities and handwriting styles from exposure to multiple exemplars. Crucially, while handwritten words and faces differ considerably in their topographic form, both learning tasks share a common exemplar pooling component. In our first experiment, we find that typical observers' ability to learn facial identities and handwriting styles from exposure to multiple exemplars correlates closely. In our second experiment, we show that observers with Autism Spectrum Disorder (ASD) are impaired at both learning tasks. Our findings suggest that similar exemplar pooling processes are recruited when learning facial identities and handwriting styles. Models of exemplar pooling originally developed to explain face learning, may therefore offer valuable insights into exemplar pooling across a range of domains, extending beyond faces. Aberrant exemplar pooling, possibly resulting from structural differences in the inferior longitudinal fasciculus, may underlie difficulties recognising familiar faces often experienced by individuals with ASD, and leave observers overly reliant on local details present in particular exemplars.

  15. Inverse Association Between Gluteofemoral Obesity and Risk of Barrett's Esophagus in a Pooled Analysis.

    Science.gov (United States)

    Kendall, Bradley J; Rubenstein, Joel H; Cook, Michael B; Vaughan, Thomas L; Anderson, Lesley A; Murray, Liam J; Shaheen, Nicholas J; Corley, Douglas A; Chandar, Apoorva K; Li, Li; Greer, Katarina B; Chak, Amitabh; El-Serag, Hashem B; Whiteman, David C; Thrift, Aaron P

    2016-10-01

    Gluteofemoral obesity (determined by measurement of subcutaneous fat in the hip and thigh regions) could reduce risks of cardiovascular and diabetic disorders associated with abdominal obesity. We evaluated whether gluteofemoral obesity also reduces the risk of Barrett's esophagus (BE), a premalignant lesion associated with abdominal obesity. We collected data from non-Hispanic white participants in 8 studies in the Barrett's and Esophageal Adenocarcinoma Consortium. We compared measures of hip circumference (as a proxy for gluteofemoral obesity) from cases of BE (n = 1559) separately with 2 control groups: 2557 population-based controls and 2064 individuals with gastroesophageal reflux disease (GERD controls). Study-specific odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using individual participant data and multivariable logistic regression and combined using a random-effects meta-analysis. We found an inverse relationship between hip circumference and BE (OR per 5-cm increase, 0.88; 95% CI, 0.81-0.96), compared with population-based controls in a multivariable model that included waist circumference. This association was not observed in models that did not include waist circumference. Similar results were observed in analyses stratified by frequency of GERD symptoms. The inverse association with hip circumference was statistically significant only among men (vs population-based controls: OR, 0.85; 95% CI, 0.76-0.96 for men; OR, 0.93; 95% CI, 0.74-1.16 for women). For men, within each category of waist circumference, a larger hip circumference was associated with a decreased risk of BE. Increasing waist circumference was associated with an increased risk of BE in the mutually adjusted population-based and GERD control models. Although abdominal obesity is associated with an increased risk of BE, there is an inverse association between gluteofemoral obesity and BE, particularly among men. Copyright © 2016 AGA Institute. Published by

  16. Depression and Risk of Mortality in Individuals with Diabetes: A Meta-Analysis and Systematic Review

    Science.gov (United States)

    Park, Mijung; Katon, Wayne J.; Wolf, Fredric M.

    2013-01-01

    OBJECTIVES To estimate risk of comorbid depression on all-cause mortality over time among individuals with diabetes METHODS Medline, CINAHL, Cochrane Library, Embase, and Science Direct database were searched through September. 30, 2012. We limited our search to longitudinal or prospective studies reporting all-cause mortality among those having depression and diabetes, compared with those having diabetes alone that used hazard ratios as the main outcome. Two reviewers independently extracted primary data and evaluated quality of studies using predetermined criteria. The pooled random effects adjusted hazard ratios (HRs) were estimated using meta-analysis. The impact of moderator variables on study effect size was examined with meta-regression. RESULTS A total of 42,363 respondents from 10 studies were included in the analysis. Depression was significantly associated with risk of mortality (Pooled HRs: 1.50, 95% CI: 1.35, 1.66). Little evidence for heterogeneity was found across the studies (Cochran Q: 13.52, p-value: 0.20, I2: 26.03). No significant possibility of publication bias was detected (Egger’s regression intercept: 0.98, p-value: 0.23). CONCLUSION Depression significantly increases the risk of mortality among individuals with diabetes. Early detection and treatment of depression may improve health outcomes in this population. PMID:23415577

  17. Does Pet Ownership in Infancy Lead to Asthma or Allergy at School Age? Pooled Analysis of Individual Participant Data from 11 European Birth Cohorts

    NARCIS (Netherlands)

    Carlsen, Karin C. Lodrup; Roll, Stephanie; Carlsen, Kai-Hakon; Mowinckel, Petter; Wijga, Alet H.; Brunekreef, Bert; Torrent, Maties; Roberts, Graham; Arshad, S. Hasan; Kull, Inger; Kraemer, Ursula; von Berg, Andrea; Eller, Esben; Host, Arne; Kuehni, Claudia; Spycher, Ben; Sunyer, Jordi; Chen, Chih-Mei; Reich, Andreas; Asarnoj, Anna; Puig, Carmen; Herbarth, Olf; John, Jestinah M. Mahachie; Van Steen, Kristel; Willich, Stefan N.; Wahn, Ulrich; Lau, Susanne; Keil, Thomas

    2012-01-01

    Objective: To examine the associations between pet keeping in early childhood and asthma and allergies in children aged 6-10 years. Design: Pooled analysis of individual participant data of 11 prospective European birth cohorts that recruited a total of over 22,000 children in the 1990s. Exposure de

  18. Genetic and environmental influences on height from infancy to early adulthood: An individual-based pooled analysis of 45 twin cohorts

    DEFF Research Database (Denmark)

    Jelenkovic, Aline; Sund, Reijo; Hur, Yoon-Mi;

    2016-01-01

    Height variation is known to be determined by both genetic and environmental factors, but a systematic description of how their influences differ by sex, age and global regions is lacking. We conducted an individual-based pooled analysis of 45 twin cohorts from 20 countries, including 180,520 pai...

  19. Does pet ownership in infancy lead to asthma or allergy at school age? Pooled analysis of individual participant data from 11 European birth cohorts.

    NARCIS (Netherlands)

    Lodrup Carlsen, K.C.; Roll, S.; Carlsen, K.H.; Mowinckel, P.; Wijga, A.H.; Brunekreef, B.; Torrent, M.; Roberts, G.; Arshad, S.H.; Kull, I.; Kramer, U.; von Berg, A.; Eller, E.; Host, A.; Kuehni, C.; Spycher, B.; Sunyer, J.; Chen, C.M.; Reich, A.; Asarnoj, A.; Puig, C.; Herbarth, O.; Mahachie John, J.M.; Van Steen, K.; Willich, S.N.; Wahn, U.; Lau, S.; Smit, H.A.; et al, X; Keil, T.

    2012-01-01

    OBJECTIVE: To examine the associations between pet keeping in early childhood and asthma and allergies in children aged 6-10 years. DESIGN: Pooled analysis of individual participant data of 11 prospective European birth cohorts that recruited a total of over 22,000 children in the 1990s. EXPOSURE DE

  20. Does Pet Ownership in Infancy Lead to Asthma or Allergy at School Age? Pooled Analysis of Individual Participant Data from 11 European Birth Cohorts

    NARCIS (Netherlands)

    Carlsen, Karin C. Lodrup; Roll, Stephanie; Carlsen, Kai-Hakon; Mowinckel, Petter; Wijga, Alet H.; Brunekreef, Bert; Torrent, Maties; Roberts, Graham; Arshad, S. Hasan; Kull, Inger; Kraemer, Ursula; von Berg, Andrea; Eller, Esben; Host, Arne; Kuehni, Claudia; Spycher, Ben; Sunyer, Jordi; Chen, Chih-Mei; Reich, Andreas; Asarnoj, Anna; Puig, Carmen; Herbarth, Olf; John, Jestinah M. Mahachie; Van Steen, Kristel; Willich, Stefan N.; Wahn, Ulrich; Lau, Susanne; Keil, Thomas

    2012-01-01

    Objective: To examine the associations between pet keeping in early childhood and asthma and allergies in children aged 6-10 years. Design: Pooled analysis of individual participant data of 11 prospective European birth cohorts that recruited a total of over 22,000 children in the 1990s. Exposure de

  1. You can pool faecal samples from individual pigs to test for Porcine Circovirus Type 2 and Lawsonia intracellularis using real-time PCRs

    DEFF Research Database (Denmark)

    Holyoake, Patricia K.; Hjulsager, Charlotte Kristiane; Larsen, Lars Erik;

    Introduction Real-time PCR tests have been developed to detect and quantify Porcine Circovirus type 2 (PCV2) and Lawsonia intracellularis in pigs’ faeces. Pooling of individual faecal samples is often used to reduce the costs of diagnostic testing. The objective of this study was to evaluate any ...

  2. Risk of Colon Cancer and Coffee, Tea, and Sugar-Sweetened Soft Drink Intake: Pooled Analysis of Prospective Cohort Studies

    Science.gov (United States)

    Zhang, Xuehong; Albanes, Demetrius; Beeson, W. Lawrence; van den Brandt, Piet A.; Buring, Julie E.; Flood, Andrew; Freudenheim, Jo L.; Giovannucci, Edward L.; Goldbohm, R. Alexandra; Jaceldo-Siegl, Karen; Jacobs, Eric J.; Krogh, Vittorio; Larsson, Susanna C.; Marshall, James R.; McCullough, Marjorie L.; Miller, Anthony B.; Robien, Kim; Rohan, Thomas E.; Schatzkin, Arthur; Sieri, Sabina; Spiegelman, Donna; Virtamo, Jarmo; Wolk, Alicja; Willett, Walter C.; Zhang, Shumin M.

    2010-01-01

    Background The relationships between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk remain unresolved. Methods We investigated prospectively the association between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk in a pooled analysis of primary data from 13 cohort studies. Among 731 441 participants followed for up to 6–20 years, 5604 incident colon cancer case patients were identified. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models and then pooled using a random-effects model. All statistical tests were two-sided. Results Compared with nonconsumers, the pooled multivariable relative risks were 1.07 (95% CI = 0.89 to 1.30, Ptrend = .68) for coffee consumption greater than 1400 g/d (about six 8-oz cups) and 1.28 (95% CI = 1.02 to 1.61, Ptrend = .01) for tea consumption greater than 900 g/d (about four 8-oz cups). For sugar-sweetened carbonated soft drink consumption, the pooled multivariable relative risk comparing consumption greater than 550 g/d (about 18 oz) to nonconsumers was 0.94 (95% CI = 0.66 to 1.32, Ptrend = .91). No statistically significant between-studies heterogeneity was observed for the highest category of each beverage consumed (P > .20). The observed associations did not differ by sex, smoking status, alcohol consumption, body mass index, physical activity, or tumor site (P > .05). Conclusions Drinking coffee or sugar-sweetened carbonated soft drinks was not associated with colon cancer risk. However, a modest positive association with higher tea consumption is possible and requires further study. PMID:20453203

  3. Genetic profiling and individualized assessment of fracture risk.

    Science.gov (United States)

    Nguyen, Tuan V; Eisman, John A

    2013-03-01

    Osteoporosis and its consequence of fragility fracture impose a considerable demand on health-care services because fracture is associated with a series of adverse events, including re-fracture and mortality. One of the major priorities in osteoporosis care is the development of predictive models to identify individuals at high risk of fracture for early intervention and management. Existing predictive models include clinical factors and anthropometric characteristics but have not considered genetic variants in the prediction. Genome-wide association studies conducted in the past decade have identified several genetic variants relevant to fracture risk. These genetic variants are common in frequency but have very modest effect sizes. A remaining challenge is to use these genetic data to individualize fracture risk assessment on the basis of an individual's genetic risk profile. Empirical and simulation studies have shown that the usefulness of a single genetic variant for fracture risk assessment is very limited, but a profile of 50 genetic variants, each with odds ratio ranging from 1.02 to 1.15, could improve the accuracy of fracture prediction beyond that obtained by use of existing clinical risk factors. Thus, genetic profiling when integrated with existing risk assessment models could inform a more accurate prediction of fracture risk in an individual.

  4. Anthropometric Factors and Thyroid Cancer Risk by Histological Subtype: Pooled Analysis of 22 Prospective Studies

    Science.gov (United States)

    McCullough, Marjorie L.; Franceschi, Silvia; Rinaldi, Sabina; Wolk, Alicja; Neta, Gila; Olov Adami, Hans; Anderson, Kristin; Andreotti, Gabriella; Beane Freeman, Laura E.; Bernstein, Leslie; Buring, Julie E.; Clavel-Chapelon, Francoise; De Roo, Lisa A.; Gao, Yu-Tang; Gaziano, J. Michael; Giles, Graham G.; Håkansson, Niclas; Horn-Ross, Pamela L.; Kirsh, Vicki A.; Linet, Martha S.; MacInnis, Robert J.; Orsini, Nicola; Park, Yikyung; Patel, Alpa V.; Purdue, Mark P.; Riboli, Elio; Robien, Kimberly; Rohan, Thomas; Sandler, Dale P.; Schairer, Catherine; Schneider, Arthur B.; Sesso, Howard D.; Shu, Xiao-Ou; Singh, Pramil N.; van den Brandt, Piet A.; Ward, Elizabeth; Weiderpass, Elisabete; White, Emily; Xiang, Yong-Bing; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Hartge, Patricia; Berrington de González, Amy

    2016-01-01

    Background: Greater height and body mass index (BMI) have been associated with an increased risk of thyroid cancer, particularly papillary carcinoma, the most common and least aggressive subtype. Few studies have evaluated these associations in relation to other, more aggressive histologic types or thyroid cancer-specific mortality. Methods: This large pooled analysis of 22 prospective studies (833,176 men and 1,260,871 women) investigated thyroid cancer incidence associated with greater height, BMI at baseline and young adulthood, and adulthood BMI gain (difference between young-adult and baseline BMI), overall and separately by sex and histological subtype using multivariable Cox proportional hazards regression models. Associations with thyroid cancer mortality were investigated in a subset of cohorts (578,922 men and 774,373 women) that contributed cause of death information. Results: During follow-up, 2996 incident thyroid cancers and 104 thyroid cancer deaths were identified. All anthropometric factors were positively associated with thyroid cancer incidence: hazard ratios (HR) [confidence intervals (CIs)] for height (per 5 cm) = 1.07 [1.04–1.10], BMI (per 5 kg/m2) = 1.06 [1.02–1.10], waist circumference (per 5 cm) = 1.03 [1.01–1.05], young-adult BMI (per 5 kg/m2) = 1.13 [1.02–1.25], and adulthood BMI gain (per 5 kg/m2) = 1.07 [1.00–1.15]. Associations for baseline BMI and waist circumference were attenuated after mutual adjustment. Baseline BMI was more strongly associated with risk in men compared with women (p = 0.04). Positive associations were observed for papillary, follicular, and anaplastic, but not medullary, thyroid carcinomas. Similar, but stronger, associations were observed for thyroid cancer mortality. Conclusion: The results suggest that greater height and excess adiposity throughout adulthood are associated with higher incidence of most major types of thyroid cancer, including the least common but

  5. Comparison of individual and pooled samples for quantification of antimicrobial resistance genes in swine feces by high-throughput qPCR

    DEFF Research Database (Denmark)

    Clasen, Julie; Mellerup, Anders; Olsen, John Elmerdahl

    2015-01-01

    There is a considerable societal interest in the careful monitoring of antimicrobial resistance (AMR) levels in human and animal populations. Sampling and data analysis can be both costly and time consuming. Optimization of sample pooling procedures is therefore important to reduce costs and anal......There is a considerable societal interest in the careful monitoring of antimicrobial resistance (AMR) levels in human and animal populations. Sampling and data analysis can be both costly and time consuming. Optimization of sample pooling procedures is therefore important to reduce costs...... samples were taken from each pen with respect to the number of pigs in the pen. A total of 48 pools were made of increasing number of individual samples. The levels of 9 different AMR-genes were quantified using dynamic qPCR arrays on the BioMark HD system(Fluidigm®).DNA was extracted using the Maxwell...

  6. A Comparison of the Proteomic Expression in Pooled Saliva Specimens from Individuals Diagnosed with Ductal Carcinoma of the Breast with and without Lymph Node Involvement

    Directory of Open Access Journals (Sweden)

    Charles F. Streckfus

    2009-01-01

    Full Text Available Purpose. The objective was to compare the salivary protein profiles of saliva specimens from individuals diagnosed with invasive ductal carcinoma of the breast (IDC with and without lymph node involvement. Methods. Three pooled saliva specimens from women were analyzed. One pooled specimen was from healthy women; another was from women diagnosed with Stage IIa IDC and a specimen from women diagnosed with Stage IIb. The pooled samples were trypsinized and the peptide digests labeled with the appropriate iTRAQ reagent. Labeled peptides from each of the digests were combined and analyzed by reverse phase capillary chromatography on an LC-MS/MS mass spectrometer. Results. The results yielded approximately 174 differentially expressed proteins in the saliva specimens. There were 55 proteins that were common to both cancer stages in comparison to each other and healthy controls while there were 20 proteins unique to Stage IIa and 28 proteins that were unique to Stage IIb.

  7. Genetic variation and risks of introgression in the wild Coffea arabica gene pool in south-western Ethiopian montane rainforests

    OpenAIRE

    Aerts, Raf; Berecha, Gezahegn; Gijbels, Pieter; Hundera, Kitessa; Vandepitte,Katrien; Van Glabeke, Sabine; Muys, Bart; Roldan-Ruiz, Isabel; Honnay, Olivier

    2012-01-01

    The montane rainforests of SW Ethiopia are the primary centre of diversity of Coffea arabica and the origin of all Arabica coffee cultivated worldwide. This wild gene pool is potentially threatened by forest fragmentation and degradation, and by introgressive hybridisation with locally improved coffee varieties. We genotyped 703 coffee shrubs from unmanaged and managed coffee populations, using 24 microsatellite loci. Additionally, we genotyped 90 individuals representing 23 Ethiopian cult...

  8. Individual Aging and Cancer Risk: How are They Related?

    Directory of Open Access Journals (Sweden)

    2003-10-01

    Full Text Available When individuals get older, the risk of many chronic diseases increases. This increase is in agreement with common theories of aging, such as mutation accumulation, wear and tear, antagonistic pleiotropy, etc. Surprisingly, however, the risk of some chronic conditions (e.g. asthma, arterial hypertension declines in the old. The cancer incidence rate also declines at old ages after a steep increase during adult life. It contrasts with the continuing increase in total mortality that is often referred to as the aging process. Which forces contribute to a decline in cancer risk in the old? In this paper we review evidence from experimental biology, illustrating the ambivalent role of individual aging in cancer risk, in particular in forming non-monotonic age-patterns of cancer incidence rate. We show that age-associated changes in the organism may contribute not only to the rise, but also to the deceleration and the decline in cancer risk at old ages.

  9. Targeted screening for colorectal cancer in high-risk individuals.

    Science.gov (United States)

    Wong, Martin C S; Wong, Sunny H; Ng, Siew C; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y

    2015-12-01

    The idea of targeted screening for colorectal cancer based on risk profiles originates from its benefits to improve detection yield and optimize screening efficiency. Clinically, it allows individuals to be more aware of their own risk and make informed decisions on screening choice. From a public health perspective, the implementation of risk stratification strategies may better justify utilization of colonoscopic resources, and facilitate resource-planning in the formulation of population-based screening programmes. There are several at-risk groups who should receive earlier screening, and colonoscopy is more preferred. This review summarizes the currently recommended CRC screening strategies among subjects with different risk factors, and introduces existing risk scoring systems. Additional genetic, epidemiological, and clinical parameters may be needed to enhance their performance to risk-stratify screening participants. Future research studies should refine these scoring systems, and explore the adaptability, feasibility, acceptability, and user-friendliness of their use in clinical practice among different population groups.

  10. The science of pooling

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, E.

    1995-10-01

    The pooling of data from radon studies is described. Pooling refers to the analysis of original data from several studies, not meta-analysis in which summary measures from published data are analyzed. A main objective for pooling is to reduce uncertainty and to obtain more precise estimates of risk than would be available from any single study.

  11. Age-specific risk factor profiles of adenocarcinomas of the esophagus: A pooled analysis from the international BEACON consortium.

    Science.gov (United States)

    Drahos, Jennifer; Xiao, Qian; Risch, Harvey A; Freedman, Neal D; Abnet, Christian C; Anderson, Lesley A; Bernstein, Leslie; Brown, Linda; Chow, Wong-Ho; Gammon, Marilie D; Kamangar, Farin; Liao, Linda M; Murray, Liam J; Ward, Mary H; Ye, Weimin; Wu, Anna H; Vaughan, Thomas L; Whiteman, David C; Cook, Michael B

    2016-01-01

    Esophageal (EA) and esophagogastric junction (EGJA) adenocarcinoma have been steadily increasing in frequency in younger people; however, the etiology of these cancers is poorly understood. We therefore investigated associations of body mass index (BMI), cigarette smoking, alcohol consumption, gastroesophageal reflux and use of nonsteroidal anti-inflammatory drugs (NSAIDs) in relation to age-specific risks of EA and EGJA. We pooled individual participant data from eight population-based, case-control studies within the international Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). The analysis included 1,363 EA patients, 1,472 EGJA patients and 5,728 control participants. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for age-specific (<50, 50-59, 60-69, ≥70 years) cancer outcomes, as well as interactions by age. BMI, smoking status and pack-years, recurrent gastroesophageal reflux and frequency of gastroesophageal reflux were positively associated with EA and EGJA in each age group. Early-onset EA (<50 years) had stronger associations with recurrent gastroesophageal reflux (OR = 8.06, 95% CI: 4.52, 14.37; peffect modification  = 0.01) and BMI (ORBMI ≥ 30 vs . <25  = 4.19, 95% CI: 2.23, 7.87; peffect modification  = 0.04), relative to older age groups. In contrast, inverse associations of NSAID use were strongest in the oldest age group (≥70 years), although this apparent difference was not statistically significant. Age-specific associations with EGJA showed similar, but slightly weaker patterns and no statistically significant differences by age were observed. Our study provides evidence that associations between obesity and gastroesophageal reflux are stronger among earlier onset EA cancers.

  12. Targeted Cancer Screening in Average-Risk Individuals.

    Science.gov (United States)

    Marcus, Pamela M; Freedman, Andrew N; Khoury, Muin J

    2015-11-01

    Targeted cancer screening refers to use of disease risk information to identify those most likely to benefit from screening. Researchers have begun to explore the possibility of refining screening regimens for average-risk individuals using genetic and non-genetic risk factors and previous screening experience. Average-risk individuals are those not known to be at substantially elevated risk, including those without known inherited predisposition, without comorbidities known to increase cancer risk, and without previous diagnosis of cancer or pre-cancer. In this paper, we describe the goals of targeted cancer screening in average-risk individuals, present factors on which cancer screening has been targeted, discuss inclusion of targeting in screening guidelines issued by major U.S. professional organizations, and present evidence to support or question such inclusion. Screening guidelines for average-risk individuals currently target age; smoking (lung cancer only); and, in some instances, race; family history of cancer; and previous negative screening history (cervical cancer only). No guidelines include common genomic polymorphisms. RCTs suggest that targeting certain ages and smoking histories reduces disease-specific cancer mortality, although some guidelines extend ages and smoking histories based on statistical modeling. Guidelines that are based on modestly elevated disease risk typically have either no or little evidence of an ability to affect a mortality benefit. In time, targeted cancer screening is likely to include genetic factors and past screening experience as well as non-genetic factors other than age, smoking, and race, but it is of utmost importance that clinical implementation be evidence-based.

  13. Does pet ownership in infancy lead to asthma or allergy at school age? Pooled analysis of individual participant data from 11 European birth cohorts.

    Directory of Open Access Journals (Sweden)

    Karin C Lødrup Carlsen

    Full Text Available OBJECTIVE: To examine the associations between pet keeping in early childhood and asthma and allergies in children aged 6-10 years. DESIGN: Pooled analysis of individual participant data of 11 prospective European birth cohorts that recruited a total of over 22,000 children in the 1990s. EXPOSURE DEFINITION: Ownership of only cats, dogs, birds, rodents, or cats/dogs combined during the first 2 years of life. OUTCOME DEFINITION: Current asthma (primary outcome, allergic asthma, allergic rhinitis and allergic sensitization during 6-10 years of age. DATA SYNTHESIS: Three-step approach: (i Common definition of outcome and exposure variables across cohorts; (ii calculation of adjusted effect estimates for each cohort; (iii pooling of effect estimates by using random effects meta-analysis models. RESULTS: We found no association between furry and feathered pet keeping early in life and asthma in school age. For example, the odds ratio for asthma comparing cat ownership with "no pets" (10 studies, 11489 participants was 1.00 (95% confidence interval 0.78 to 1.28 (I(2 = 9%; p = 0.36. The odds ratio for asthma comparing dog ownership with "no pets" (9 studies, 11433 participants was 0.77 (0.58 to 1.03 (I(2 = 0%, p = 0.89. Owning both cat(s and dog(s compared to "no pets" resulted in an odds ratio of 1.04 (0.59 to 1.84 (I(2 = 33%, p = 0.18. Similarly, for allergic asthma and for allergic rhinitis we did not find associations regarding any type of pet ownership early in life. However, we found some evidence for an association between ownership of furry pets during the first 2 years of life and reduced likelihood of becoming sensitized to aero-allergens. CONCLUSIONS: Pet ownership in early life did not appear to either increase or reduce the risk of asthma or allergic rhinitis symptoms in children aged 6-10. Advice from health care practitioners to avoid or to specifically acquire pets for primary prevention of asthma or allergic

  14. Disentangling genetic and environmental risk factors for individual diseases from multiplex comorbidity networks

    CERN Document Server

    Klimek, Peter; Thurner, Stefan

    2016-01-01

    Most disorders are caused by a combination of multiple genetic and/or environmental factors. If two diseases are caused by the same molecular mechanism, they tend to co-occur in patients. Here we provide a quantitative method to disentangle how much genetic or environmental risk factors contribute to the pathogenesis of 358 individual diseases, respectively. We pool data on genetic, pathway-based, and toxicogenomic disease-causing mechanisms with disease co-occurrence data obtained from almost two million patients. From this data we construct a multilayer network where nodes represent disorders that are connected by links that either represent phenotypic comorbidity of the patients or the involvement of a certain molecular mechanism. From the similarity of phenotypic and mechanism-based networks for each disorder we derive measure that allows us to quantify the relative importance of various molecular mechanisms for a given disease. We find that most diseases are dominated by genetic risk factors, while envir...

  15. Societal and individual landslide risk to the population of Italy

    Science.gov (United States)

    Salvati, Paola; Bianchi, Cinzia; Mondini, Alessandro; Rossi, Mauro; Guzzetti, Fausto

    2010-05-01

    Landslides cause damage to people every year in Italy. The number of fatalities (deaths and missing persons) and the number of casualties (deaths, missing persons, and injured people) are a direct, quantitative measure of the intensity of a disaster, and can be used to evaluate individual and societal risk quantitatively. Individual-risk criteria are expressed using mortality (or death) rates, which are given by the number of deaths per 100,000 people, in a given period. Societal-risk criteria are commonly established constructing frequency-consequences plots. In these plots, the number of losses (deaths, fatalities, or casualties) in each event is plotted versus the frequency of the event. Societal risk is then determined investigating the relationships linking the frequency of the events to their intensity, measured by the number of the losses. We have updated existing estimates of societal and individual landslide risk in Italy. For our assessment, we have used an improved version of the catalogue of historical landslide events that have resulted in loss of life, missing persons, injured people, and homelessness in Italy, from 1850 to 2008. This is the recent portion of a larger catalogue spanning the 1941-year period from 68 AD to 2008. This information was used to update the existing national estimates and to obtain first regional estimates of societal and individual landslide risk in Italy. To model the distribution of the frequency of landslide events with casualties in Italy, and in each of the 20 Regions in Italy, we adopted a Zipf distribution. We used the scaling exponent of the probability mass function (PMF) of the intensity of the events, which controls the proportion of small, medium and large events, to compare societal landslide risk levels in different geographical areas and for different periods. To consider the frequency of the events with casualties, we have scaled the PMF obtained for the individual Regions to the total number of events in

  16. Assessing the general safety and tolerability of vildagliptin: value of pooled analyses from a large safety database versus evaluation of individual studies

    Directory of Open Access Journals (Sweden)

    Schweizer A

    2011-02-01

    Full Text Available Anja Schweizer1, Sylvie Dejager2, James E Foley3, Wolfgang Kothny31Novartis Pharma AG, Basel, Switzerland; 2Novartis Pharma SAS, Rueil-Malmaison, France; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USAAim: Analyzing safety aspects of a drug from individual studies can lead to difficult-to-interpret results. The aim of this paper is therefore to assess the general safety and tolerability, including incidences of the most common adverse events (AEs, of vildagliptin based on a large pooled database of Phase II and III clinical trials.Methods: Safety data were pooled from 38 studies of ≥12 to ≥104 weeks' duration. AE profiles of vildagliptin (50 mg bid; N = 6116 were evaluated relative to a pool of comparators (placebo and active comparators; N = 6210. Absolute incidence rates were calculated for all AEs, serious AEs (SAEs, discontinuations due to AEs, and deaths.Results: Overall AEs, SAEs, discontinuations due to AEs, and deaths were all reported with a similar frequency in patients receiving vildagliptin (69.1%, 8.9%, 5.7%, and 0.4%, respectively and patients receiving comparators (69.0%, 9.0%, 6.4%, and 0.4%, respectively, whereas drug-related AEs were seen with a lower frequency in vildagliptin-treated patients (15.7% vs 21.7% with comparators. The incidences of the most commonly reported specific AEs were also similar between vildagliptin and comparators, except for increased incidences of hypoglycemia, tremor, and hyperhidrosis in the comparator group related to the use of sulfonylureas.Conclusions: The present pooled analysis shows that vildagliptin was overall well tolerated in clinical trials of up to >2 years in duration. The data further emphasize the value of a pooled analysis from a large safety database versus assessing safety and tolerability from individual studies.Keywords: type 2 diabetes, dipeptidyl peptidase-4, edema, safety, vildagliptin

  17. Review of screening for pancreatic cancer in high risk individuals

    Institute of Scientific and Technical Information of China (English)

    Alina Stoita; Ian D Penman; David B Williams

    2011-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  18. Review of screening for pancreatic cancer in high risk individuals.

    Science.gov (United States)

    Stoita, Alina; Penman, Ian D; Williams, David B

    2011-05-21

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  19. Benefits and risks of diversification for individual fishers.

    Science.gov (United States)

    Anderson, Sean C; Ward, Eric J; Shelton, Andrew O; Adkison, Milo D; Beaudreau, Anne H; Brenner, Richard E; Haynie, Alan C; Shriver, Jennifer C; Watson, Jordan T; Williams, Benjamin C

    2017-09-18

    Individuals relying on natural resource extraction for their livelihood face high income variability driven by a mix of environmental, biological, management, and economic factors. Key to managing these industries is identifying how regulatory actions and individual behavior affect income variability, financial risk, and, by extension, the economic stability and the sustainable use of natural resources. In commercial fisheries, communities and vessels fishing a greater diversity of species have less revenue variability than those fishing fewer species. However, it is unclear whether these benefits extend to the actions of individual fishers and how year-to-year changes in diversification affect revenue and revenue variability. Here, we evaluate two axes by which fishers in Alaska can diversify fishing activities. We show that, despite increasing specialization over the last 30 years, fishing a set of permits with higher species diversity reduces individual revenue variability, and fishing an additional permit is associated with higher revenue and lower variability. However, increasing species diversity within the constraints of existing permits has a fishery-dependent effect on revenue and is usually (87% probability) associated with increased revenue uncertainty the following year. Our results demonstrate that the most effective option for individuals to decrease revenue variability is to participate in additional or more diverse fisheries. However, this option is expensive, often limited by regulations such as catch share programs, and consequently unavailable to many individuals. With increasing climatic variability, it will be particularly important that individuals relying on natural resources for their livelihood have effective strategies to reduce financial risk.

  20. Organizational and individual attributes influencing patient risk detection.

    Science.gov (United States)

    Despins, Laurel A

    2014-10-01

    This study examined organizational and individual variables impacting patient risk detection by Intensive Care Unit nurses and their decision to reduce the risk of failure to rescue. Thirty-four nurses were randomly assigned to two groups. A video of a manager and staff nurse patient safety discussion was used to prime one group to prioritize patient safety. Participants provided demographic information, received end-of-shift report on two fictional patients, experienced 52 alarm trials during a medication preparation scenario, and completed the Safety Attitude Questionnaire. No difference existed in risk detection; however, nurses who perceived their work environment quality to be good correctly ignored a clinically irrelevant alarm more often and were more apt to classify an alarm as irrelevant. They chose to reduce the risk of medication error rather than that of failure to rescue. This information can assist nurses to balance disregarding distractions with responding to potential patient risk signals.

  1. Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke.

    Science.gov (United States)

    Hayward, Kathryn S; Schmidt, Julia; Lohse, Keith R; Peters, Sue; Bernhardt, Julie; Lannin, Natasha A; Boyd, Lara A

    2017-01-01

    To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1) characterize brain biomarkers; 2) determine relationship(s) between biomarkers and motor outcome; and 3) establish relationship(s) between biomarkers and motor recovery. Three electronic databases were searched up to October 2, 2015. Eligible studies included adults with severe arm impairment after stroke. Descriptive statistics were calculated to characterize brain biomarkers, and pooling of individual patient data was performed using mixed-effects linear regression to examine relationships between brain biomarkers and motor outcome and recovery. Thirty-eight articles including individual data from 372 people with severe arm impairment were analysed. The majority of individuals were in the chronic (> 6 months) phase post stroke (51%) and had a subcortical stroke (49%). The presence of a motor evoked potential (indexed by transcranial magnetic stimulation) was the only biomarker related to better motor outcome (p = 0.02). There was no relationship between motor outcome and stroke volume (cm(3)), location (cortical, subcortical, mixed) or side (left vs. right), and corticospinal tract asymmetry index (extracted from diffusion weighted imaging). Only one study had longitudinal data, thus no data pooling was possible to address change over time (preventing our third objective). Based on the available evidence, motor evoked potentials at rest were the only biomarker that predicted motor outcome in individuals with severe arm impairment following stroke. Given that few biomarkers emerged, this review highlights the need to move beyond currently known biomarkers and identify new indices with sufficient variability and sensitivity to guide recovery models in individuals with severe motor impairments following stroke.

  2. Individual contributions to portfolio risk: risk decomposition for the BET-FI index

    Directory of Open Access Journals (Sweden)

    Marius ACATRINEI

    2015-06-01

    Full Text Available The paper applies Euler formula for decomposing the standard deviation and the Expected Shortfall for the BET-FI equity index. Risk attribution allows the decomposition of the total risk of the portfolio in individual risk units. In this way we can compute the contribution of each company to the overall standard deviation/Expected Shortfall of the portfolio.

  3. Individual contributions to portfolio risk: risk decomposition for the BET-FI index

    OpenAIRE

    Marius ACATRINEI

    2015-01-01

    The paper applies Euler formula for decomposing the standard deviation and the Expected Shortfall for the BET-FI equity index. Risk attribution allows the decomposition of the total risk of the portfolio in individual risk units. In this way we can compute the contribution of each company to the overall standard deviation/Expected Shortfall of the portfolio.

  4. Early somatosensory processing in individuals at risk for developing psychoses

    Directory of Open Access Journals (Sweden)

    Florence eHagenmuller

    2014-09-01

    Full Text Available Human cortical somatosensory evoked potentials (SEPs allow an accurate investigation of thalamocortical and early cortical processing. SEPs reveal a burst of superimposed early (N20 high-frequency oscillations around 600 Hz. Previous studies reported alterations of SEPs in patients with schizophrenia. This study addresses the question whether those alterations are also observable in populations at risk for developing schizophrenia or bipolar disorders. To our knowledge to date, this is the first study investigating SEPs in a population at risk for developing psychoses.Median nerve SEPs were investigated using multichannel EEG in individuals at risk for developing bipolar disorders (n=25, individuals with high-risk status (n= 59 and ultra-high-risk status for schizophrenia (n= 73 and a gender and age-matched control group (n=45. Strengths and latencies of low- and high-frequency components as estimated by dipole source analysis were compared between groups.Low- and high-frequency source activity was reduced in both groups at risk for schizophrenia, in comparison to the group at risk for bipolar disorders. HFO amplitudes were also significant reduced in subjects with high-risk status for schizophrenia compared to healthy controls. These differences were accentuated among cannabis non-users. Reduced N20 source strengths were related to higher positive symptom load.These results suggest that the risk for schizophrenia, in contrast to bipolar disorders, may involve an impairment of early cerebral somatosensory processing. Neurophysiologic alterations in schizophrenia precede the onset of initial psychotic episode and may serve as indicator of vulnerability for developing schizophrenia.

  5. Genital powder use and risk of ovarian cancer: a pooled analysis of 8,525 cases and 9,859 controls

    Science.gov (United States)

    Terry, Kathryn L.; Karageorgi, Stalo; Shvetsov, Yurii B.; Merritt, Melissa A.; Lurie, Galina; Thompson, Pamela J.; Carney, Michael E.; Weber, Rachel Palmieri; Akushevich, Lucy; Lo-Ciganic, Wei-Hsuan; Cushing-Haugen, Kara; Sieh, Weiva; Moysich, Kirsten; Doherty, Jennifer A.; Nagle, Christina M.; Berchuck, Andrew; Pearce, Celeste L.; Pike, Malcolm; Ness, Roberta B.; Webb, Penelope M.; Rossing, Mary Anne; Schildkraut, Joellen; Risch, Harvey; Goodman, Marc T.

    2013-01-01

    Genital powder use has been associated with risk of epithelial ovarian cancer in some, but not all, epidemiologic investigations, possibly reflecting the carcinogenic effects of talc particles found in most of these products. Whether risk increases with number of genital-powder applications and for all histologic types of ovarian cancer also remains uncertain. Therefore, we estimated the association between self-reported genital powder use and epithelial ovarian cancer risk in eight population-based case-control studies. Individual data from each study was collected and harmonized. Lifetime number of genital-powder applications was estimated from duration and frequency of use. Pooled odds ratios were calculated using conditional logistic regression matched on study and age and adjusted for potential confounders. Subtype-specific risks were estimated according to tumor behavior and histology. 8,525 cases and 9,859 controls were included in the analyses. Genital powder use was associated with a modest increased risk of epithelial ovarian cancer (odds ratio 1.24, 95% confidence interval 1.15–1.33) relative to women who never used powder. Risk was elevated for invasive serous (1.20, 1.09–1.32), endometrioid (1.22, 1.04–1.43), and clear cell (1.24, 1.01–1.52) tumors, and for borderline serous tumors (1.46, 1.24–1.72). Among genital powder users, we observed no significant trend (p=0.17) in risk with increasing number of lifetime applications (assessed in quartiles). We noted no increase in risk among women who only reported non-genital powder use. In summary, genital powder use is a modifiable exposure associated with small-to-moderate increases in risk of most histologic subtypes of epithelial ovarian cancer. PMID:23761272

  6. Genital powder use and risk of ovarian cancer: a pooled analysis of 8,525 cases and 9,859 controls.

    Science.gov (United States)

    Terry, Kathryn L; Karageorgi, Stalo; Shvetsov, Yurii B; Merritt, Melissa A; Lurie, Galina; Thompson, Pamela J; Carney, Michael E; Weber, Rachel Palmieri; Akushevich, Lucy; Lo-Ciganic, Wei-Hsuan; Cushing-Haugen, Kara; Sieh, Weiva; Moysich, Kirsten; Doherty, Jennifer A; Nagle, Christina M; Berchuck, Andrew; Pearce, Celeste L; Pike, Malcolm; Ness, Roberta B; Webb, Penelope M; Rossing, Mary Anne; Schildkraut, Joellen; Risch, Harvey; Goodman, Marc T

    2013-08-01

    Genital powder use has been associated with risk of epithelial ovarian cancer in some, but not all, epidemiologic investigations, possibly reflecting the carcinogenic effects of talc particles found in most of these products. Whether risk increases with number of genital powder applications and for all histologic types of ovarian cancer also remains uncertain. Therefore, we estimated the association between self-reported genital powder use and epithelial ovarian cancer risk in eight population-based case-control studies. Individual data from each study were collected and harmonized. Lifetime number of genital powder applications was estimated from duration and frequency of use. Pooled ORs were calculated using conditional logistic regression matched on study and age and adjusted for potential confounders. Subtype-specific risks were estimated according to tumor behavior and histology. 8,525 cases and 9,859 controls were included in the analyses. Genital powder use was associated with a modest increased risk of epithelial ovarian cancer [OR, 1.24; 95% confidence interval (CI), 1.15-1.33] relative to women who never used powder. Risk was elevated for invasive serous (OR, 1.20; 95% CI, 1.09-1.32), endometrioid (OR, 1.22; 95% CI, 1.04-1.43), and clear cell (OR, 1.24; 95% CI, 1.01-1.52) tumors, and for borderline serous tumors (OR, 1.46; 95% CI, 1.24-1.72). Among genital powder users, we observed no significant trend (P = 0.17) in risk with increasing number of lifetime applications (assessed in quartiles). We noted no increase in risk among women who only reported nongenital powder use. In summary, genital powder use is a modifiable exposure associated with small-to-moderate increases in risk of most histologic subtypes of epithelial ovarian cancer.

  7. Risk of lung cancer and consumption of vegetables and fruit in Japanese: A pooled analysis of cohort studies in Japan.

    Science.gov (United States)

    Wakai, Kenji; Sugawara, Yumi; Tsuji, Ichiro; Tamakoshi, Akiko; Shimazu, Taichi; Matsuo, Keitaro; Nagata, Chisato; Mizoue, Tetsuya; Tanaka, Keitaro; Inoue, Manami; Tsugane, Shoichiro; Sasazuki, Shizuka

    2015-08-01

    International reviews have concluded that consumption of fruit and vegetables might decrease the risk of lung cancer. However, the relevant epidemiological evidence still remains insufficient in Japan. Therefore, we performed a pooled analysis of data from four population-based cohort studies in Japan with >200 000 participants and >1700 lung cancer cases. We computed study-specific hazard ratios by quintiles of vegetable and fruit consumption as assessed by food frequency questionnaires. Summary hazard ratios were estimated by pooling the study-specific hazard ratios with a fixed-effect model. In men, we found inverse associations between fruit consumption and the age-adjusted and area-adjusted risk of mortality or incidence of lung cancer. However, the associations were largely attenuated after adjustment for smoking and energy intake. The significant decrease in risk among men remained only for a moderate level of fruit consumption; the lowest summary hazard ratios were found in the third quintile of intake (mortality: 0.71, 95% confidence interval 0.60-0.84; incidence: 0.83, 95% confidence interval 0.70-0.98). This decrease in risk was mainly detected in ever smokers. Conversely, vegetable intake was positively correlated with the risk of incidence of lung cancer after adjustment for smoking and energy intake in men (trend P, 0.024); the summary hazard ratio for the highest quintile was 1.26 (95% confidence interval 1.05-1.50). However, a similar association was not detected for mortality from lung cancer. In conclusion, a moderate level of fruit consumption is associated with a decreased risk of lung cancer in men among the Japanese population.

  8. Individual versus systemic risk and the Regulator's Dilemma.

    Science.gov (United States)

    Beale, Nicholas; Rand, David G; Battey, Heather; Croxson, Karen; May, Robert M; Nowak, Martin A

    2011-08-02

    The global financial crisis of 2007-2009 exposed critical weaknesses in the financial system. Many proposals for financial reform address the need for systemic regulation--that is, regulation focused on the soundness of the whole financial system and not just that of individual institutions. In this paper, we study one particular problem faced by a systemic regulator: the tension between the distribution of assets that individual banks would like to hold and the distribution across banks that best supports system stability if greater weight is given to avoiding multiple bank failures. By diversifying its risks, a bank lowers its own probability of failure. However, if many banks diversify their risks in similar ways, then the probability of multiple failures can increase. As more banks fail simultaneously, the economic disruption tends to increase disproportionately. We show that, in model systems, the expected systemic cost of multiple failures can be largely explained by two global parameters of risk exposure and diversity, which can be assessed in terms of the risk exposures of individual actors. This observation hints at the possibility of regulatory intervention to promote systemic stability by incentivizing a more diverse diversification among banks. Such intervention offers the prospect of an additional lever in the armory of regulators, potentially allowing some combination of improved system stability and reduced need for additional capital.

  9. Risk Perception for Developing Diabetes among Non-diabetic Individuals

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2016-06-01

    Full Text Available Background: the incidence and prevalence of type 2 diabetes mellitus have increased in recent decades and this trend is expected to continue. Objective: to determine the risk perception for developing type 2 diabetes among non-diabetic individuals. Methods: a cross-sectional study involving non-diabetic individuals in the catchment area of the doctor-and-nurse office No.15 of the Manuel Fajardo Polyclinic in Cienfuegos was conducted between May 2013 and June 2014. The universe consisted of 1145 people, and the sample included 323 individuals of different age groups selected by sex. The variables studied were: age, sex, body mass index, nutritional assessment, and having a perceived risk when they answered 70 % of questions correctly. The arithmetic mean, standard deviation, Chi-square test, and risk estimation were calculated with a 95 % confidence interval. Results: individuals aged 25 to 34 years and females predominated. Fifty nine point two percent of the study participants knew of their risk. Eighty one point one percent understood that diabetes is preventable and 93.5 % stated that it is their responsibility to prevent its development. Thirty five point two percent of women considered normal-weight/thin fully agreed on the importance of physical activity and diabetes prevention. Eighty point five percent of women and 78.5 % of men answered positively to the question about obesity and diabetes. Conclusions: study participants knew of their risk of developing type 2 diabetes, although a large number of them attributed all responsibility for prevention to the health personnel.

  10. Successes and failures of compulsory risk mitigation: re-evaluating the Turkish Catastrophe Insurance Pool.

    Science.gov (United States)

    Başbuğ-Erkan, B Burcak; Yilmaz, Ozlem

    2015-10-01

    The Turkish Catastrophe Insurance Pool (TCIP) is one of the best practices of public-private partnerships in an emerging market designed to reduce economic losses from disasters. This paper reviews the application of this compulsory mechanism along with data relating to the performance of the scheme following recent earthquakes in Turkey. We also consider the current perceptions of Turkish society towards the TCIP and how they can be enhanced. Our conclusions aim to assist stakeholders in government, homeowners, insurance companies, media, banks and civil society to appreciate the value of the system and key actions necessary to improve it.

  11. Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled Youth Risk Behavior Surveys.

    Science.gov (United States)

    Rosario, Margaret; Corliss, Heather L; Everett, Bethany G; Reisner, Sari L; Austin, S Bryn; Buchting, Francisco O; Birkett, Michelle

    2014-02-01

    We examined sexual orientation disparities in cancer-related risk behaviors among adolescents. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex orientation as sexual minority and the remainder as heterosexual. We compared the groups on risk behaviors and stratified by gender, age ( 14 years), and race/ethnicity. Sexual minorities (7.6% of the sample) reported more risk behaviors than heterosexuals for all 12 behaviors (mean = 5.3 vs 3.8; P sexual orientation disparities in analyses by gender, followed by age, and then race/ethnicity; they persisted in analyses by gender, age, and race/ethnicity, although findings were nuanced. Data on cancer risk, morbidity, and mortality by sexual orientation are needed to track the potential but unknown burden of cancer among sexual minorities.

  12. Dietary fiber intake and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology consortium.

    Science.gov (United States)

    Kawakita, Daisuke; Lee, Yuan-Chin Amy; Turati, Federica; Parpinel, Maria; Decarli, Adriano; Serraino, Diego; Matsuo, Keitaro; Olshan, Andrew F; Zevallos, Jose P; Winn, Deborah M; Moysich, Kirsten; Zhang, Zuo-Feng; Morgenstern, Hal; Levi, Fabio; Kelsey, Karl; McClean, Michael; Bosetti, Cristina; Garavello, Werner; Schantz, Stimson; Yu, Guo-Pei; Boffetta, Paolo; Chuang, Shu-Chun; Hashibe, Mia; Ferraroni, Monica; La Vecchia, Carlo; Edefonti, Valeria

    2017-11-01

    The possible role of dietary fiber in the etiology of head neck cancers (HNCs) is unclear. We used individual-level pooled data from ten case-control studies (5959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium, to examine the association between fiber intake and cancer of the oral cavity/pharynx and larynx. Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were estimated using unconditional multiple logistic regression applied to quintile categories of non-alcohol energy-adjusted fiber intake and adjusted for tobacco and alcohol use and other known or putative confounders. Fiber intake was inversely associated with oral and pharyngeal cancer combined (OR for 5th vs. 1st quintile category = 0.49, 95% CI: 0.40-0.59; p for trend <0.001) and with laryngeal cancer (OR = 0.66, 95% CI: 0.54-0.82, p for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral and pharyngeal cancer combined. Nonetheless, inverse associations were consistently observed for the subsites of oral and pharyngeal cancers and within most strata of the considered covariates, for both cancer sites. Our findings from a multicenter large-scale pooled analysis suggest that, although in the presence of between-study heterogeneity, a greater intake of fiber may lower HNC risk. © 2017 UICC.

  13. Empathy in individuals clinically at risk for psychosis

    DEFF Research Database (Denmark)

    Derntl, B.; Michel, T. M.; Prempeh, P.

    2015-01-01

    Background Empathy is a basic human ability, and patients with schizophrenia show dysfunctional empathic abilities on the behavioural and neural level. Aims These dysfunctions may precede the onset of illness; thus, it seems mandatory to examine the empathic abilities in individuals at clinical...... high risk for psychosis. Method Using functional magnetic resonance imaging, we measured 15 individuals at clinical high risk of psychosis (CHR group) and compared their empathy performance with 15 healthy volunteers and 15 patients with schizophrenia. Results Behavioural data analysis indicated...... no significant deficit in the CHR group. Functional data analysis revealed hyperactivation in a frontotemporoparietal network including the amygdala in the CHR group compared with the other two groups. Conclusions Despite normal behavioural performance, the CHR group activated the neural empathy network...

  14. Review of screening for pancreatic cancer in high risk individuals

    OpenAIRE

    Stoita, Alina; Penman, Ian D; Williams, David B.

    2011-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in...

  15. Body weight trajectories and risk of oesophageal and gastric cardia adenocarcinomas: a pooled analysis of NIH-AARP and PLCO Studies.

    Science.gov (United States)

    Petrick, Jessica L; Kelly, Scott P; Liao, Linda M; Freedman, Neal D; Graubard, Barry I; Cook, Michael B

    2017-03-28

    Elevated body mass index (BMI, kg m(-2)) has been consistently associated with oesophageal adenocarcinoma (EA) and gastric cardia adenocarcinoma (GCA) incidence. However, effects of adiposity over the life course in relation to EA/GCA have not been thoroughly explored. We pooled two prospective cohort studies: NIH-AARP Diet and Health Study and Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, with data on 409 796 individuals (633 EA, 415 GCA). At baseline, participants reported their height and weight at ages 20 and 50 years, and current. Body mass index trajectories were determined using latent class analysis. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using proportional hazards regression. Compared with individuals with a BMIobesity (⩾30 kg m(-2)) by age 50 was associated with increased risks of EA (HR=2.90, 95% CI: 1.67-5.04) and GCA (HR=4.07, 95% CI: 2.32-7.15), compared with individuals with a normal weight (⩾18.5-<25 kg m(-2)) trajectory. Weight gain of ⩾20 kg between age 20 and baseline was also associated with a two times increased risk of EA (HR=1.97, 95% CI: 1.43-2.73) and more modestly with GCA (HR=1.40, 95% CI: 0.96-2.05). Being overweight in early adulthood and weight gain later in life were each associated with increased risks of EA and GCA. This underscores the potential of weight control programs for reducing EA and GCA risk.

  16. Risk factors for vaginal fistula symptoms in Sub-Saharan Africa: a pooled analysis of national household survey data.

    Science.gov (United States)

    Maheu-Giroux, Mathieu; Filippi, Véronique; Maulet, Nathalie; Samadoulougou, Sékou; Castro, Marcia C; Meda, Nicolas; Pouliot, Mariève; Kirakoya-Samadoulougou, Fati

    2016-04-21

    Vaginal fistula (VF) is one of the most severe maternal morbidities with the immediate consequence of chronic urinary and/or fecal incontinence. The epidemiological evidence regarding risk factors for VF is dominated by facility-based studies. Our aim is to estimate the effect size of selected risk factors for VF using population-based survey data. We pooled all available Demographic and Health Surveys and Multiple Indicators Cluster Surveys carried out in sub-Saharan Africa that collected information on VF symptoms. Bayesian matched logistic regression models that accounted for the imperfect sensitivity and specificity of self-reports of VF symptoms were used for effect size estimation. Up to 27 surveys were pooled, including responses from 332,889 women. Being able to read decreased the odds of VF by 13% (95% Credible Intervals (CrI): 1% to 23%), while higher odds of VF symptoms were observed for women of short stature (fistula. Concomitant improvements in access to quality sexual and reproductive healthcare are, however, required to end fistula in sub-Saharan Africa.

  17. Lifestyle factors and mortality risk in individuals with diabetes mellitus

    DEFF Research Database (Denmark)

    Sluik, Diewertje; Boeing, Heiner; Li, Kuanrong

    2014-01-01

    AIMS/HYPOTHESIS: Thus far, it is unclear whether lifestyle recommendations for people with diabetes should be different from those for the general public. We investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without diabetes....... METHODS: Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was formed of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes. Joint Cox proportional hazard regression models of people with and without diabetes were built for the following...... lifestyle factors in relation to overall mortality risk: BMI, waist/height ratio, 26 food groups, alcohol consumption, leisure-time physical activity, smoking. Likelihood ratio tests for heterogeneity assessed statistical differences in regression coefficients. RESULTS: Multivariable adjusted mortality risk...

  18. Reward, attention, and HIV-related risk in HIV+ individuals.

    Science.gov (United States)

    Anderson, Brian A; Kronemer, Sharif I; Rilee, Jessica J; Sacktor, Ned; Marvel, Cherie L

    2016-08-01

    Human immunodeficiency virus (HIV) is often contracted through engaging in risky reward-motivated behaviors such as needle sharing and unprotected sex. Understanding the factors that make an individual more vulnerable to succumbing to the temptation to engage in these risky behaviors is important to limiting the spread of HIV. One potential source of this vulnerability concerns the degree to which an individual is able to resist paying attention to irrelevant reward information. In the present study, we examine this possible link by characterizing individual differences in value-based attentional bias in a sample of HIV+ individuals with varying histories of risk-taking behavior. Participants learned associations between experimental stimuli and monetary reward outcome. The degree of attentional bias for these reward-associated stimuli, reflected in their ability to capture attention when presented as task-irrelevant distractors, was then assessed both immediately and six months following reward learning. Value-driven attentional capture was related to substance abuse history and non-planning impulsiveness during the time leading up to contraction of HIV as measured via self-report. These findings suggest a link between the ability to ignore reward-associated information and prior HIV-related risk-taking behavior. Additionally, particular aspects of HIV-associated neurocognitive disorders were related to attentional bias, including motor deficits commonly associated with HIV-induced damage to the basal ganglia. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Estrogen receptor beta rs1271572 polymorphism and invasive ovarian carcinoma risk: pooled analysis within the Ovarian Cancer Association Consortium.

    Directory of Open Access Journals (Sweden)

    Galina Lurie

    Full Text Available The association of ovarian carcinoma risk with the polymorphism rs1271572 in the estrogen receptor beta (ESR2 gene was examined in 4946 women with primary invasive ovarian carcinoma and 6582 controls in a pooled analysis of ten case-control studies within the Ovarian Cancer Association Consortium (OCAC. All participants were non-Hispanic white women. Odds ratios (ORs and 95% confidence intervals (CIs were estimated using unconditional logistic regression adjusted for site and age. Women with the TT genotype were at increased risk of ovarian carcinoma compared to carriers of the G allele (OR = 1.10; 95%; CI: 1.01-1.21; p = 0.04; the OR was 1.09 (CI: 0.99-1.20; p = 0.07 after excluding data from the center (Hawaii that nominated this SNP for OCAC genotyping A stronger association of rs1271572 TT versus GT/GG with risk was observed among women aged ≤50 years versus older women (OR = 1.35; CI: 1.12-1.62; p = 0.002; p for interaction = 0.02 that remained statistically significant after excluding Hawaii data (OR = 1.34; CI: 1.11-1.61; p = 0.009. No heterogeneity of the association was observed by study, menopausal status, gravidity, parity, use of contraceptive or menopausal hormones, tumor histological type, or stage at diagnosis. This pooled analysis suggests that rs1271572 might influence the risk of ovarian cancer, in particular among younger women.

  20. Statistical means to enhance the comparability of data within a pooled analysis of individual data in neurobehavioral toxicology

    DEFF Research Database (Denmark)

    Meyer-Baron, Monika; Schäper, Michael; Knapp, Guido

    2011-01-01

    approaches the comparability of data might be increased. An analysis of individual data on the neurobehavioral impact of manganese (Mn) exemplifies challenges and effects of a multilevel statistical procedure. Confounding from individual-level and study-level covariates was shown by analyses of variance...

  1. Arsenic Exposure and Predicted 10-Year Atherosclerotic Cardiovascular Risk Using the Pooled Cohort Equations in U.S. Hypertensive Adults.

    Science.gov (United States)

    Nong, Qingjiao; Zhang, Yiyi; Guallar, Eliseo; Zhong, Qiuan

    2016-11-07

    This study was to evaluate the association of urine arsenic with predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk in U.S. adults with hypertension. Cross-sectional analysis was conducted in 1570 hypertensive adults aged 40-79 years in the 2003-2012 National Health and Nutrition Examination Survey (NHANES) with determinations of urine arsenic. Predicted 10-year ASCVD risk was estimated by the Pooled Cohort Equations, developed by the American College of Cardiology/American Heart Association in 2013. For men, after adjustment for sociodemographic factors, urine dilution, ASCVD risk factors and organic arsenic intake from seafood, participants in the highest quartiles of urine arsenic had higher 10-year predicted ASCVD risk than in the lowest quartiles; the increases were 24% (95% confidence interval (CI): 2%, 53%) for total arsenic, 13% (95% CI: 2%, 25%) for dimethylarsinate and 22% (95% CI: 5%, 40%) for total arsenic minus arsenobetaine separately. For women, the corresponding increases were 5% (95% CI: -15%, 29%), 10% (95% CI: -8%, 30%) and 0% (95% CI: -15%, 19%), respectively. Arsenic exposure, even at low levels, may contribute to increased ASCVD risk in men with hypertension. Furthermore, our findings suggest that particular circumstances need urgently to be considered while elucidating cardiovascular effects of low inorganic arsenic levels.

  2. Pooling Bio-Specimens in the Presence of Measurement Error and Non-Linearity in Dose-Response: Simulation Study in the Context of a Birth Cohort Investigating Risk Factors for Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Karyn Heavner

    2015-11-01

    Full Text Available We sought to determine the potential effects of pooling on power, false positive rate (FPR, and bias of the estimated associations between hypothetical environmental exposures and dichotomous autism spectrum disorders (ASD status. Simulated birth cohorts in which ASD outcome was assumed to have been ascertained with uncertainty were created. We investigated the impact on the power of the analysis (using logistic regression to detect true associations with exposure (X1 and the FPR for a non-causal correlate of exposure (X2, r = 0.7 for a dichotomized ASD measure when the pool size, sample size, degree of measurement error variance in exposure, strength of the true association, and shape of the exposure-response curve varied. We found that there was minimal change (bias in the measures of association for the main effect (X1. There is some loss of power but there is less chance of detecting a false positive result for pooled compared to individual level models. The number of pools had more effect on the power and FPR than the overall sample size. This study supports the use of pooling to reduce laboratory costs while maintaining statistical efficiency in scenarios similar to the simulated prospective risk-enriched ASD cohort.

  3. Neural Network to Identify Individuals at Health Risk

    Directory of Open Access Journals (Sweden)

    Tanja Magoc

    2011-05-01

    Full Text Available The risk of diseases such as heart attack and high blood pressure could be reduced by adequate physicalactivity. However, even though majority of general population claims to perform some physical exercise,only a minority exercises enough to keep a healthy living style. Thus, physical inactivity has become oneof the major concerns of public health in the past decade. Research shows that the highest decrease inphysical activity is noticed from high school to college. Thus, it is of great importance to quickly identifycollege students at health risk due to physical inactivity. Research also shows that the level of physicalactivity of an individual is highly correlated to demographic features such as race and gender, as well asself motivation and support from family and friends. This information could be collected from eachstudent via a 20 minute questionnaire, but the time needed to distribute and analyze each questionnaire isinfeasible on a collegiate campus. Thus, we propose an automatic identifier of students at risk, so thatthese students could easier be targeted by collegiate campuses and physical activity promotiondepartments. We present in this paper preliminary results of a supervised backpropagation multilayerneural network for classifying students into at-risk or not at-risk group.

  4. Neural Network to Identify Individuals at Health Risk

    Directory of Open Access Journals (Sweden)

    Tanja Magoc

    2011-04-01

    Full Text Available The risk of diseases such as heart attack and high blood pressure could be reduced by adequate physical activity. However, even though majority of general population claims to perform some physical exercise, only a minority exercises enough to keep a healthy living style. Thus, physical inactivity has become one of the major concerns of public health in the past decade. Research shows that the highest decrease in physical activity is noticed from high school to college. Thus, it is of great importance to quickly identify college students at health risk due to physical inactivity. Research also shows that the level of physical activity of an individual is highly correlated to demographic features such as race and gender, as well as self motivation and support from family and friends. This information could be collected from each student via a 20 minute questionnaire, but the time needed to distribute and analyze each questionnaire is infeasible on a collegiate campus. Thus, we propose an automatic identifier of students at risk, so that these students could easier be targeted by collegiate campuses and physical activity promotion departments. We present in this paper preliminary results of a supervised backpropagation multilayer neural network for classifying students into at-risk or not at-risk group.

  5. Gene expression profiling to predict the risk of locoregional recurrence in breast cancer: a pooled analysis.

    Science.gov (United States)

    Drukker, C A; Elias, S G; Nijenhuis, M V; Wesseling, J; Bartelink, H; Elkhuizen, P; Fowble, B; Whitworth, P W; Patel, R R; de Snoo, F A; van 't Veer, L J; Beitsch, P D; Rutgers, E J Th

    2014-12-01

    The 70-gene signature (MammaPrint) has been developed to predict the risk of distant metastases in breast cancer and select those patients who may benefit from adjuvant treatment. Given the strong association between locoregional and distant recurrence, we hypothesize that the 70-gene signature will also be able to predict the risk of locoregional recurrence (LRR). 1,053 breast cancer patients primarily treated with breast-conserving treatment or mastectomy at the Netherlands Cancer Institute between 1984 and 2006 were included. Adjuvant treatment consisted of radiotherapy, chemotherapy, and/or endocrine therapy as indicated by guidelines used at the time. All patients were included in various 70-gene signature validation studies. After a median follow-up of 8.96 years with 87 LRRs, patients with a high-risk 70-gene signature (n = 492) had an LRR risk of 12.6% (95% CI 9.7-15.8) at 10 years, compared to 6.1% (95% CI 4.1-8.5) for low-risk patients (n = 561; P risk model for the clinicopathological factors such as age, tumour size, grade, hormone receptor status, LVI, axillary lymph node involvement, surgical treatment, endocrine treatment, and chemotherapy resulted in a multivariable HR of 1.73 (95% CI 1.02-2.93; P = 0.042). Adding the signature to the model based on clinicopathological factors improved the discrimination, albeit non-significantly [C-index through 10 years changed from 0.731 (95% CI 0.682-0.782) to 0.741 (95% CI 0.693-0.790)]. Calibration of the prognostic models was excellent. The 70-gene signature is an independent prognostic factor for LRR. A significantly lower local recurrence risk was seen in patients with a low-risk 70-gene signature compared to those with high-risk 70-gene signature.

  6. Folate intake and the risk of oral cavity and pharyngeal cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology Consortium.

    Science.gov (United States)

    Galeone, Carlotta; Edefonti, Valeria; Parpinel, Maria; Leoncini, Emanuele; Matsuo, Keitaro; Talamini, Renato; Olshan, Andrew F; Zevallos, Jose P; Winn, Deborah M; Jayaprakash, Vijayvel; Moysich, Kirsten; Zhang, Zuo-Feng; Morgenstern, Hal; Levi, Fabio; Bosetti, Cristina; Kelsey, Karl; McClean, Michael; Schantz, Stimson; Yu, Guo-Pei; Boffetta, Paolo; Lee, Yuan-Chin Amy; Hashibe, Mia; La Vecchia, Carlo; Boccia, Stefania

    2015-02-15

    There are suggestions of an inverse association between folate intake and serum folate levels and the risk of oral cavity and pharyngeal cancers (OPCs), but most studies are limited in sample size, with only few reporting information on the source of dietary folate. Our study aims to investigate the association between folate intake and the risk of OPC within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. We analyzed pooled individual-level data from ten case-control studies participating in the INHANCE consortium, including 5,127 cases and 13,249 controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were estimated for the associations between total folate intake (natural, fortification and supplementation) and natural folate only, and OPC risk. We found an inverse association between total folate intake and overall OPC risk (the adjusted OR for the highest vs. the lowest quintile was 0.65, 95% CI: 0.43-0.99), with a stronger association for oral cavity (OR = 0.57, 95% CI: 0.43-0.75). A similar inverse association, though somewhat weaker, was observed for folate intake from natural sources only in oral cavity cancer (OR = 0.64, 95% CI: 0.45-0.91). The highest OPC risk was observed in heavy alcohol drinkers with low folate intake as compared to never/light drinkers with high folate (OR = 4.05, 95% CI: 3.43-4.79); the attributable proportion (AP) owing to interaction was 11.1% (95% CI: 1.4-20.8%). Lastly, we reported an OR of 2.73 (95% CI:2.34-3.19) for those ever tobacco users with low folate intake, compared with nevere tobacco users and high folate intake (AP of interaction =10.6%, 95% CI: 0.41-20.8%). Our project of a large pool of case-control studies supports a protective effect of total folate intake on OPC risk. © 2014 UICC.

  7. Impact of obesity as a mortality predictor in high-risk patients with myocardial infarction or chronic heart failure: a pooled analysis of five registries

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Køber, Lars; Abildstrøm, Steen Z

    2008-01-01

    AIMS: To explore the influence of obesity on prognosis in high-risk patients with myocardial infarction (MI) or heart failure (HF). METHODS AND RESULTS: Individual data of 21 570 consecutively hospitalized patients from five Danish registries were pooled together. After a follow-up of 10.4 years......, all-cause mortality using multivariate model and adjusted hazard ratios (HR) with 95% confidence intervals were calculated. Compared with normal weight [body mass index (BMI) 18.5-24.9 kg/m2], obesity class II (BMI >or= 35 kg/m2) was associated with increased risk of death in patients with MI...... but not HF [HR = 1.23 (1.06-1.44), P = 0.006 and HR = 1.13 (0.95-1.36), P = 0.95] (P-value for interaction = 0.004). Obesity class I (BMI 30-34.9 kg/m2) was not associated with increased risk of death in MI or HF [HR = 0.99 (0.92-1.08) and 1.00 (0.90-1.11), P > 0.1]. Pre-obesity (BMI 25-29.9 kg/m2...

  8. Suicide risk factors among trans feminine individuals in Lebanon.

    Science.gov (United States)

    Kaplan, Rachel L; Nehme, Simon; Aunon, Frances; de Vries, David; Wagner, Glenn

    Transgender women are disproportionately affected by high rates of depression and suicide attempts. It is therefore important to identify factors that influence suicidal risk, particularly in the Middle East where little research has examined the mental health of transgender women. We examined risk factors associated with suicide attempts among 54 trans feminine individuals in Beirut, Lebanon. Data were collected using interviewer-administered questionnaires and analyzed using bivariate statistics. Twenty-five (46%) participants reported having ever attempted suicide. Among them, only one participant received some kind of counseling in response to the attempted suicide. Low general social support, low social integration, and low support from peers were significantly associated with a history of attempted suicide, as were being more open about transgender identity in public and any hormone use (past or current). These findings suggest that progression in gender transition can have unintended consequences related to mental health and suicide risk, while social support systems can mitigate the impact of mental health problems. Some of these findings mirror other contexts around the globe and can inform mental health services for trans feminine individuals in Lebanon, the greater Middle East region, and other international settings.

  9. Dietary fiber intake and risk of colorectal cancer: A pooled analysis of prospective cohort studies

    NARCIS (Netherlands)

    Park, Y.; Hunter, D.J.; Spiegelman, D.; Bergkvist, L.; Berrino, F.; Brandt, P.A. van den; Buring, J.E.; Colditz, G.A.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.; Goldbohm, R.A.; Graham, S.; Harnack, L.; Hartman, A.M.; Jacobs, D.R.; Kato, I.; Krogh, V.; Leitzmann, M.F.; McCullough, M.L.; Miller, A.B.; Pietinen, P.; Rohan, T.E.; Schatzkin, A.; Willett, W.C.; Wolk, A.; Zeleniuch-Jacquotte, A.; Zhang, S.M.; Smith-Warner, S.A.

    2005-01-01

    Context: Inconsistent findings from observational studies have continued the controversy over the effects of dietary fiber on colorectal cancer. Objective: To evaluate the association between dietary fiber intake and risk of colorectal cancer. Design, Setting, and Participants: From 13 prospective

  10. Intakes of vitamins A, C, and e and use of multiple vitamin supplements and risk of colon cancer: A pooled analysis of prospective cohort studies

    NARCIS (Netherlands)

    Park, Y.; Spiegelman, D.; Hunter, D.J.; Albanes, D.; Bergkvist, L.; Buring, J.E.; Freudenheim, J.L.; Giovannucci, E.; Goldbohm, R.A.; Harnack, L.; Kato, I.; Krogh, V.; Leitzmann, M.F.; Limburg, P.J.; Marshall, J.R.; McCullough, M.L.; Miller, A.B.; Rohan, T.E.; Schatzkin, A.; Shore, R.; Sieri, S.; Stampfer, M.J.; Virtamo, J.; Weijenberg, M.; Willett, W.C.; Wolk, A.; Zhang, S.M.; Smith-Warner, S.A.

    2010-01-01

    Objective: To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer. Methods: Using the primary data from 13 cohort studies, we estimated study-and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random

  11. Individualized Risk of Surgical Complications: An Application of the Breast Reconstruction Risk Assessment Score

    Science.gov (United States)

    Mlodinow, Alexei S.; Khavanin, Nima; Hume, Keith M.; Simmons, Christopher J.; Weiss, Michael J.; Murphy, Robert X.; Gutowski, Karol A.

    2015-01-01

    Background: Risk discussion is a central tenet of the dialogue between surgeon and patient. Risk calculators have recently offered a new way to integrate evidence-based practice into the discussion of individualized patient risk and expectation management. Focusing on the comprehensive Tracking Operations and Outcomes for Plastic Surgeons (TOPS) database, we endeavored to add plastic surgical outcomes to the previously developed Breast Reconstruction Risk Assessment (BRA) score. Methods: The TOPS database from 2008 to 2011 was queried for patients undergoing breast reconstruction. Regression models were constructed for the following complications: seroma, dehiscence, surgical site infection (SSI), explantation, flap failure, reoperation, and overall complications. Results: Of 11,992 cases, 4439 met inclusion criteria. Overall complication rate was 15.9%, with rates of 3.4% for seroma, 4.0% for SSI, 6.1% for dehiscence, 3.7% for explantation, 7.0% for flap loss, and 6.4% for reoperation. Individualized risk models were developed with acceptable goodness of fit, accuracy, and internal validity. Distribution of overall complication risk was broad and asymmetric, meaning that the average risk was often a poor estimate of the risk for any given patient. These models were added to the previously developed open-access version of the risk calculator, available at http://www.BRAscore.org. Conclusions: Population-based measures of risk may not accurately reflect risk for many individual patients. In this era of increasing emphasis on evidence-based medicine, we have developed a breast reconstruction risk assessment calculator from the robust TOPS database. The BRA Score tool can aid in individualizing—and quantifying—risk to better inform surgical decision making and better manage patient expectations. PMID:26090295

  12. Emotional intelligence, risk perception in abstinent cocaine dependent individuals.

    Science.gov (United States)

    Romero-Ayuso, Dulce; Mayoral-Gontán, Yolanda; Triviño-Juárez, José-Matías

    2016-01-01

    Cocaine is now responsible for the second-highest number of cessation intervention requests. In this study we analyze the different skills of emotional intelligence in cocaine- dependent patients maintaining abstinence. The Mayer- Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Balloon Analogue Risk Task (BART) were administered to 50 subjects (25 individuals with no history of drug use and 25 individuals in treatment at the Addictive Behaviors Unit in a state of withdrawal at the time of evaluation). The results showed differences between these groups in overall emotional intelligence quotient, strategic emotional intelligence, understanding emotions and emotional management. Cocaine-addicted participants showed difficulties in analyzing complex emotions and regulating their emotional response, aspects that can interfere with interactions in daily life.

  13. Forecasting individual breast cancer risk using plasma metabolomics and biocontours

    DEFF Research Database (Denmark)

    Bro, Rasmus; Kamstrup-Nielsen, Maja Hermann; Engelsen, Søren Balling

    2015-01-01

    by chemometric data fusion. It was possible to create a biocontour, which we define as a complex pattern of relevant biological and phenotypic information. While single markers or known risk factors have close to no predictive value, the developed biocontour provides a forecast which, several years before...... in a subject 2–5 years after the sample is taken with sensitivity and specificity well above 80 %. The model was built on data obtained in 1993–1996 and tested on persons sampled a year later in 1997. Metabolic forecasting of cancer by biocontours opens new possibilities for early prediction of individual...

  14. Individuals at high risk for suicide are categorically distinct from those at low risk.

    Science.gov (United States)

    Witte, Tracy K; Holm-Denoma, Jill M; Zuromski, Kelly L; Gauthier, Jami M; Ruscio, John

    2017-04-01

    Although suicide risk is often thought of as existing on a graded continuum, its latent structure (i.e., whether it is categorical or dimensional) has not been empirically determined. Knowledge about the latent structure of suicide risk holds implications for suicide risk assessments, targeted suicide interventions, and suicide research. Our objectives were to determine whether suicide risk can best be understood as a categorical (i.e., taxonic) or dimensional entity, and to validate the nature of any obtained taxon. We conducted taxometric analyses of cross-sectional, baseline data from 16 independent studies funded by the Military Suicide Research Consortium. Participants (N = 1,773) primarily consisted of military personnel, and most had a history of suicidal behavior. The Comparison Curve Fit Index values for MAMBAC (.85), MAXEIG (.77), and L-Mode (.62) all strongly supported categorical (i.e., taxonic) structure for suicide risk. Follow-up analyses comparing the taxon and complement groups revealed substantially larger effect sizes for the variables most conceptually similar to suicide risk compared with variables indicating general distress. Pending replication and establishment of the predictive validity of the taxon, our results suggest the need for a fundamental shift in suicide risk assessment, treatment, and research. Specifically, suicide risk assessments could be shortened without sacrificing validity, the most potent suicide interventions could be allocated to individuals in the high-risk group, and research should generally be conducted on individuals in the high-risk group. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Safety and efficacy of different lanreotide doses in the treatment of polycystic liver disease: pooled analysis of individual patient data.

    Science.gov (United States)

    Temmerman, F; Gevers, T; Ho, T A; Vanslembrouck, R; Coudyzer, W; van Pelt, J; Bammens, B; Pirson, Y; Drenth, J P; Nevens, F

    2013-08-01

    Long-acting lanreotide (LAN) 120 mg every 4 weeks reduces liver volume (LV) in patients with polycystic liver diseases (PCLD). Animal studies demonstrated that the inhibition of hepatic and renal cystogenesis is dose dependent. To investigate the safety and efficacy of two different LAN doses in PCLD patients. The 6-month results of the LOCKCYST I trial, its extension study and the LOCKCYST II trial were pooled. LV at baseline and month 6 was measured by CT-scan and blindly re-analysed by two independent radiologists. The study population [132 treatment periods, age 49 years (IQR: 45-55), 114 women] consisted of three groups. Each received treatment every 4 weeks during 6 months: placebo (n = 26); LAN 90 mg (n = 55) or LAN 120 mg (n = 51). The inter-observer variability and agreement in the calculation of LV were excellent. Severe side effects occurred with placebo, LAN 90 mg and LAN 120 mg in respectively 0%, 7% and 16%. Change in LV's after 6 months in these three groups were respectively: increase of +36 mL [(-45)-(+138)]; decrease of -82 mL [(-285)-(+92)] and decrease of -123 mL [(-312)-(+4)] (Kruskal-Wallis One Way anova on Ranks; P = 0.002). Based on ROC analysis, a reduction of ≥120 mL in LV has a positive predictive value of 64% for improving symptoms (ROC analysis AUC: 0.729; sensitivity 73%, specificity 69%, P < 0.0001). Both LAN 90 mg and LAN 120 mg reduce liver volume. LAN 90 mg has less side effects. This suggests that in case of intolerance to LAN 120 mg, a dose reduction to LAN 90 mg is meaningful. © 2013 John Wiley & Sons Ltd.

  16. Mediation by peer violence victimization of sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors: pooled youth risk behavior surveys.

    Science.gov (United States)

    Rosario, Margaret; Corliss, Heather L; Everett, Bethany G; Russell, Stephen T; Buchting, Francisco O; Birkett, Michelle A

    2014-06-01

    We examined the role of adolescent peer violence victimization (PVV) in sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex sexual attraction, partners, or identity as sexual minority and the remainder as heterosexual. We had 4 indicators of tobacco and alcohol use and 4 of sexual risk and 2 PVV factors: victimization at school and carrying weapons. We stratified associations by gender and race/ethnicity. PVV was related to disparities in cancer-related risk behaviors of substance use and sexual risk, with odds ratios (ORs) of 1.3 (95% confidence interval [CI] = 1.03, 1.6) to 11.3 (95% CI = 6.2, 20.8), and to being a sexual minority, with ORs of 1.4 (95% CI = 1.1, 1.9) to 5.6 (95% CI = 3.5, 8.9). PVV mediated sexual orientation disparities in substance use and sexual risk behaviors. Findings were pronounced for adolescent girls and Asian/Pacific Islanders. Interventions are needed to reduce PVV in schools as a way to reduce sexual orientation disparities in cancer risk across the life span.

  17. Dietary fiber intake and risk of colorectal cancer: A pooled analysis of prospective cohort studies

    NARCIS (Netherlands)

    Park, Y.; Hunter, D.J.; Spiegelman, D.; Bergkvist, L.; Berrino, F.; Brandt, P.A. van den; Buring, J.E.; Colditz, G.A.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.; Goldbohm, R.A.; Graham, S.; Harnack, L.; Hartman, A.M.; Jacobs, D.R.; Kato, I.; Krogh, V.; Leitzmann, M.F.; McCullough, M.L.; Miller, A.B.; Pietinen, P.; Rohan, T.E.; Schatzkin, A.; Willett, W.C.; Wolk, A.; Zeleniuch-Jacquotte, A.; Zhang, S.M.; Smith-Warner, S.A.

    2005-01-01

    Context: Inconsistent findings from observational studies have continued the controversy over the effects of dietary fiber on colorectal cancer. Objective: To evaluate the association between dietary fiber intake and risk of colorectal cancer. Design, Setting, and Participants: From 13 prospective c

  18. Dietary Carotenoids and Risk of Lung Cancer in a Pooled Analysis of Seven Cohort Studies

    NARCIS (Netherlands)

    Männistö, S.; Smith-Warner, S.A.; Spiegelman, D.; Albanes, D.; Anderson, K.; Brandt, P.A. van den; Cerhan, J.R.; Colditz, G.; Feskanich, D.; Freudenheim, J.L.; Giovannucci, E.; Goldbohm, R.A.; Graham, S.; Miller, A.B.; Rohan, T.E.; Virtamo, J.; Willett, W.C.; Hunter, D.J.

    2004-01-01

    Intervention trials with supplemental β-carotene have observed either no effect or a harmful effect on lung cancer risk. Because food composition databases for specific carotenoids have only become available recently, epidemiological evidence relating usual dietary levels of these carotenoids with l

  19. Dietary carotenoids and risk of colorectal cancer in a pooled analysis of 11 cohort studies

    NARCIS (Netherlands)

    Männistö, S.; Yaun, S.S.; Hunter, D.J.; Spiegelman, D.; Adami, H.O.; Albanes, D.; Brandt, P.A. van den; Buring, J.E.; Cerhan, J.R.; Colditz, G.A.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.; Goldbohm, R.A.; Harnack, L.; Leitzmann, M.; McCullough, M.L.; Miller, A.B.; Rohan, T.E.; Schatzkin, A.; Virtamo, J.; Willett, W.C.; Wolk, A.; Zhang, S.M.; Smith-Warner, S.A.

    2007-01-01

    Dietary carotenoids have been hypothesized to protect against epithelial cancers. The authors analyzed the associations between intakes of specific carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein + zeaxanthin, and lycopene) and risk of colorectal cancer using the primary data

  20. Fruits, vegetables, and colon cancer risk in a pooled analysis of 14 cohort studies

    NARCIS (Netherlands)

    Koushik, A.; Hunter, D.J.; Spiegelman, D.; Beeson, W.L.; Brandt, P.A. van den; Buring, J.E.; Calle, E.E.; Cho, E.; Fraser, G.E.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.L.; Goldbohm, R.A.; Harnack, L.; Jacobs Jr., D.R.; Kato, I.; Krogh, V.; Larsson, S.C.; Leitzmann, M.F.; Marshall, J.R.; McCullough, M.L.; Miller, A.B.; Pietinen, P.; Rohan, T.E.; Schatzkin, A.; Sieri, S.; Virtanen, M.J.; Wolk, A.; Zeleniuch-Jacquotte, A.; Zhang, S.M.; Smith-Warner, S.A.

    2007-01-01

    Background Fruit and vegetable intakes have been associated with a reduced risk of colon cancer; however, in more recent studies associations have been less consistent. Statistical power to examine associations by colon site has been limited in previous studies. Methods Fruit and vegetable intakes

  1. Dietary carotenoids and risk of colorectal cancer in a pooled analysis of 11 cohort studies

    NARCIS (Netherlands)

    Männistö, S.; Yaun, S.S.; Hunter, D.J.; Spiegelman, D.; Adami, H.O.; Albanes, D.; Brandt, P.A. van den; Buring, J.E.; Cerhan, J.R.; Colditz, G.A.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.; Goldbohm, R.A.; Harnack, L.; Leitzmann, M.; McCullough, M.L.; Miller, A.B.; Rohan, T.E.; Schatzkin, A.; Virtamo, J.; Willett, W.C.; Wolk, A.; Zhang, S.M.; Smith-Warner, S.A.

    2007-01-01

    Dietary carotenoids have been hypothesized to protect against epithelial cancers. The authors analyzed the associations between intakes of specific carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein + zeaxanthin, and lycopene) and risk of colorectal cancer using the primary data

  2. Fruits, vegetables, and colon cancer risk in a pooled analysis of 14 cohort studies

    NARCIS (Netherlands)

    Koushik, A.; Hunter, D.J.; Spiegelman, D.; Beeson, W.L.; Brandt, P.A. van den; Buring, J.E.; Calle, E.E.; Cho, E.; Fraser, G.E.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.L.; Goldbohm, R.A.; Harnack, L.; Jacobs Jr., D.R.; Kato, I.; Krogh, V.; Larsson, S.C.; Leitzmann, M.F.; Marshall, J.R.; McCullough, M.L.; Miller, A.B.; Pietinen, P.; Rohan, T.E.; Schatzkin, A.; Sieri, S.; Virtanen, M.J.; Wolk, A.; Zeleniuch-Jacquotte, A.; Zhang, S.M.; Smith-Warner, S.A.

    2007-01-01

    Background Fruit and vegetable intakes have been associated with a reduced risk of colon cancer; however, in more recent studies associations have been less consistent. Statistical power to examine associations by colon site has been limited in previous studies. Methods Fruit and vegetable intakes i

  3. Dairy products and pancreatic cancer risk: A pooled analysis of 14 cohort studies

    NARCIS (Netherlands)

    Genkinger, J.M.; Wang, M.; Li, R.; Albanes, D.; Anderson, K.E.; Bernstein, L.; Brandt, P.A. van den; English, D.R.; Freudenheim, J.L.; Fuchs, C.S.; Gapstur, S.M.; Giles, G.G.; Goldbohm, R.A.; Håkansson, N.; Horn-Ross, P.L.; Koushik, A.; Marshal, J.R.; McCullough, M.L.; Miller, A.B.; Robien, K.; Rohan, T.E.; Schairer, C.; Silverman, D.T.; Stolzenberg-Solomon, R.Z.; Virtamo, J.; Willett, W.C.; Wolk, A.; Ziegler, R.G.; Smith-Warner, S.A.

    2014-01-01

    Pancreatic cancer has few early symptoms, is usually diagnosed at late stages, and has a high case-fatality rate. Identifying modifiable risk factors is crucial to reducing pancreatic cancer morbidity and mortality. Prior studies have suggested that specific foods and nutrients, such as dairy produc

  4. Vitamin E intake and risk of amyotrophic lateral sclerosis: a pooled analysis of data from 5 prospective cohort studies.

    Science.gov (United States)

    Wang, Hao; O'Reilly, Éilis J; Weisskopf, Marc G; Logroscino, Giancarlo; McCullough, Marjorie L; Schatzkin, Arthur; Kolonel, Laurence N; Ascherio, Alberto

    2011-03-15

    The authors investigated whether vitamin E intake was associated with amyotrophic lateral sclerosis (ALS) in the Nurses' Health Study (1976-2004), the Health Professionals Follow-up Study (1986-2004), the Cancer Prevention Study II Nutrition Cohort (1992-2004), the Multiethnic Cohort Study (1993-2005), and the National Institutes of Health-AARP Diet and Health Study (1995-2005). ALS deaths were identified through the National Death Index. In the Nurses' Health Study and the Health Professionals Follow-up Study, confirmed nonfatal ALS cases were also included. Cohort-specific results were estimated using Cox proportional hazards models and pooled using random-effects models. Among 1,055,546 participants, 805 developed ALS. Overall, using vitamin E supplements was not associated with ALS. However, within cohorts with information on duration of vitamin E supplement use (231 cases), ALS rates declined with increasing years of use (P-trend=0.01). Compared with nonusers, the multivariable-adjusted relative risk was 1.05 (95% confidence interval (CI): 0.60, 1.84) among users for ≤1 year (12 cases), 0.77 (95% CI: 0.33, 1.77) among users for 2-4 years (7 cases), and 0.64 (95% CI: 0.39, 1.04) among users for ≥5 years (18 cases). For dietary vitamin E intake, the multivariable-adjusted relative risk comparing the highest quartile with the lowest was 0.79 (95% CI: 0.61, 1.03); an inverse dose-response was evident in women (P-trend=0.002) but not in men (P-trend=0.71). In this large, pooled prospective study, long-term vitamin E supplement use was associated with lower ALS rates. A possible protective effect of vitamin E deserves further consideration.

  5. A New ELISA Using the ANANAS Technology Showing High Sensitivity to diagnose the Bovine Rhinotracheitis from Individual Sera to Pooled Milk.

    Science.gov (United States)

    Casarin, Elisabetta; Lucchese, Laura; Grazioli, Santina; Facchin, Sonia; Realdon, Nicola; Brocchi, Emiliana; Morpurgo, Margherita; Nardelli, Stefano

    2016-01-01

    Diagnostic tests for veterinary surveillance programs should be efficient, easy to use and, possibly, economical. In this context, classic Enzyme linked ImmunoSorbent Assay (ELISA) remains the most common analytical platform employed for serological analyses. The analysis of pooled samples instead of individual ones is a common procedure that permits to certify, with one single test, entire herds as "disease-free". However, diagnostic tests for pooled samples need to be particularly sensitive, especially when the levels of disease markers are low, as in the case of anti-BoHV1 antibodies in milk as markers of Infectious Bovine Rhinotracheitis (IBR) disease. The avidin-nucleic-acid-nanoassembly (ANANAS) is a novel kind of signal amplification platform for immunodiagnostics based on colloidal poly-avidin nanoparticles that, using model analytes, was shown to strongly increase ELISA test performance as compared to monomeric avidin. Here, for the first time, we applied the ANANAS reagent integration in a real diagnostic context. The monoclonal 1G10 anti-bovine IgG1 antibody was biotinylated and integrated with the ANANAS reagents for indirect IBR diagnosis from pooled milk mimicking tank samples from herds with IBR prevalence between 1 to 8%. The sensitivity and specificity of the ANANAS integrated method was compared to that of a classic test based on the same 1G10 antibody directly linked to horseradish peroxidase, and a commercial IDEXX kit recently introduced in the market. ANANAS integration increased by 5-fold the sensitivity of the 1G10 mAb-based conventional ELISA without loosing specificity. When compared to the commercial kit, the 1G10-ANANAS integrated method was capable to detect the presence of anti-BHV1 antibodies from bulk milk of gE antibody positive animals with 2-fold higher sensitivity and similar specificity. The results demonstrate the potentials of this new amplification technology, which permits improving current classic ELISA sensitivity limits

  6. A New ELISA Using the ANANAS Technology Showing High Sensitivity to diagnose the Bovine Rhinotracheitis from Individual Sera to Pooled Milk.

    Directory of Open Access Journals (Sweden)

    Elisabetta Casarin

    Full Text Available Diagnostic tests for veterinary surveillance programs should be efficient, easy to use and, possibly, economical. In this context, classic Enzyme linked ImmunoSorbent Assay (ELISA remains the most common analytical platform employed for serological analyses. The analysis of pooled samples instead of individual ones is a common procedure that permits to certify, with one single test, entire herds as "disease-free". However, diagnostic tests for pooled samples need to be particularly sensitive, especially when the levels of disease markers are low, as in the case of anti-BoHV1 antibodies in milk as markers of Infectious Bovine Rhinotracheitis (IBR disease. The avidin-nucleic-acid-nanoassembly (ANANAS is a novel kind of signal amplification platform for immunodiagnostics based on colloidal poly-avidin nanoparticles that, using model analytes, was shown to strongly increase ELISA test performance as compared to monomeric avidin. Here, for the first time, we applied the ANANAS reagent integration in a real diagnostic context. The monoclonal 1G10 anti-bovine IgG1 antibody was biotinylated and integrated with the ANANAS reagents for indirect IBR diagnosis from pooled milk mimicking tank samples from herds with IBR prevalence between 1 to 8%. The sensitivity and specificity of the ANANAS integrated method was compared to that of a classic test based on the same 1G10 antibody directly linked to horseradish peroxidase, and a commercial IDEXX kit recently introduced in the market. ANANAS integration increased by 5-fold the sensitivity of the 1G10 mAb-based conventional ELISA without loosing specificity. When compared to the commercial kit, the 1G10-ANANAS integrated method was capable to detect the presence of anti-BHV1 antibodies from bulk milk of gE antibody positive animals with 2-fold higher sensitivity and similar specificity. The results demonstrate the potentials of this new amplification technology, which permits improving current classic ELISA

  7. Risk assessment tools for identifying individuals at risk of developing type 2 diabetes.

    Science.gov (United States)

    Buijsse, Brian; Simmons, Rebecca K; Griffin, Simon J; Schulze, Matthias B

    2011-01-01

    Trials have demonstrated the preventability of type 2 diabetes through lifestyle modifications or drugs in people with impaired glucose tolerance. However, alternative ways of identifying people at risk of developing diabetes are required. Multivariate risk scores have been developed for this purpose. This article examines the evidence for performance of diabetes risk scores in adults by 1) systematically reviewing the literature on available scores and 2) their validation in external populations; and 3) exploring methodological issues surrounding the development, validation, and comparison of risk scores. Risk scores show overall good discriminatory ability in populations for whom they were developed. However, discriminatory performance is more heterogeneous and generally weaker in external populations, which suggests that risk scores may need to be validated within the population in which they are intended to be used. Whether risk scores enable accurate estimation of absolute risk remains unknown; thus, care is needed when using scores to communicate absolute diabetes risk to individuals. Several risk scores predict diabetes risk based on routine noninvasive measures or on data from questionnaires. Biochemical measures, in particular fasting plasma glucose, can improve prediction of such models. On the other hand, usefulness of genetic profiling currently appears limited.

  8. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts

    DEFF Research Database (Denmark)

    Madsen, Ida E H; Hannerz, Harald; Nyberg, Solja T

    2013-01-01

    scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field. METHODS: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job......-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled...... using random effects meta-analysis. DISCUSSION: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled...

  9. Chlorinated pool attendance, airway epithelium defects and the risks of allergic diseases in adolescents: Interrelationships revealed by circulating biomarkers

    Energy Technology Data Exchange (ETDEWEB)

    Bernard, Alfred, E-mail: Alfred.bernard@uclouvain.be; Nickmilder, Marc; Dumont, Xavier

    2015-07-15

    It has been suggested that allergic diseases might be epithelial disorders driven by various environmental stressors but the epidemiological evidence supporting this concept is limited. In a cross-sectional study of 835 school adolescents (365 boys; mean age, 15.5 yr), we measured the serum concentrations of Club cell protein (CC16), surfactant-associated protein D (SP-D) and of total and aeroallergen-specific IgE. We used the serum CC16/SP-D concentration ratio as an index integrating changes in the permeability (SP-D) and secretory function (CC16) of the airway epithelium. In both sexes, early swimming in chlorinated pools emerged as the most consistent and strongest predictor of low CC16 and CC16/SP-D ratio in serum. Among girls, a low CC16/SP-D ratio was associated with increased odds (lowest vs. highest tertile) for pet sensitization (OR 2.97, 95% CI 1.19–8.22) and for hay fever in subjects sensitized to pollen (OR 4.12, 95% CI 1.28–14.4). Among boys, a low CC16/SP-D ratio was associated with increased odds for house-dust mite (HDM) sensitization (OR 2.01, 95% CI 1.11–3.73), for allergic rhinitis in subjects sensitized to HDM (OR 3.52, 95% CI 1.22–11.1) and for asthma in subjects sensitized to any aeroallergen (OR 3.38, 95% CI 1.17–11.0), HDM (OR 5.20, 95% CI 1.40–24.2) or pollen (OR 5.82, 95% CI 1.51–27.4). Odds for allergic sensitization or rhinitis also increased with increasing SP-D or decreasing CC16 in serum. Our findings support the hypothesis linking the development of allergic diseases to epithelial barrier defects due to host factors or environmental stressors such as early swimming in chlorinated pools. - Highlights: • We conducted a cross-sectional study of 835 school adolescents. • The airway epithelium integrity was evaluated by measuring serum pneumoproteins. • The risk of allergic diseases was associated with a defective airway epithelium. • Childhood swimming in chlorinated pools can cause persistent epithelial

  10. Fruit and vegetable intake and the risk of overall cancer in Japanese: A pooled analysis of population-based cohort studies.

    Science.gov (United States)

    Takachi, Ribeka; Inoue, Manami; Sugawara, Yumi; Tsuji, Ichiro; Tsugane, Shoichiro; Ito, Hidemi; Matsuo, Keitaro; Tanaka, Keitaro; Tamakoshi, Akiko; Mizoue, Tetsuya; Wakai, Kenji; Nagata, Chisato; Sasazuki, Shizuka

    2017-04-01

    A series of recent reports from large-scale cohort studies involving more than 100,000 subjects reported no or only very small inverse associations between fruit and vegetable intake and overall cancer incidence, despite having sufficient power to do so. To date, however, no such data have been reported for Asian populations. To provide some indication of the net impact of fruit and vegetable consumption on overall cancer prevention, we examined these associations in a pooled analysis of large-scale cohort studies in Japanese populations. We analyzed original data from four cohort studies that measured fruit and vegetable consumption using validated questionnaires at baseline. Hazard ratios (HRs) in the individual studies were calculated, with adjustment for a common set of variables, and combined using a random-effects model. During 2,318,927 person-years of follow-up for a total of 191,519 subjects, 17,681 cases of overall cancers were identified. Consumption of fruit or vegetables was not associated with decreased risk of overall cancers: corresponding HRs for the highest versus lowest quartiles of intake for men and women were 1.03 (95% CI, 0.97-1.10; trend p = 1.00) and 1.03 (95% CI, 0.95-1.11; trend p = 0.97), respectively, for fruit and 1.07 (95% CI, 1.01-1.14; trend p = 0.18) and 0.98 (95% CI, 0.91-1.06; trend p = 0.99), respectively, for vegetables, even in analyses stratified by smoking status and alcohol drinking. The results of this pooled analysis do not support inverse associations of fruit and vegetable consumption with overall cancers in the Japanese population. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  11. Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies.

    Science.gov (United States)

    Pearce, Celeste Leigh; Templeman, Claire; Rossing, Mary Anne; Lee, Alice; Near, Aimee M; Webb, Penelope M; Nagle, Christina M; Doherty, Jennifer A; Cushing-Haugen, Kara L; Wicklund, Kristine G; Chang-Claude, Jenny; Hein, Rebecca; Lurie, Galina; Wilkens, Lynne R; Carney, Michael E; Goodman, Marc T; Moysich, Kirsten; Kjaer, Susanne K; Hogdall, Estrid; Jensen, Allan; Goode, Ellen L; Fridley, Brooke L; Larson, Melissa C; Schildkraut, Joellen M; Palmieri, Rachel T; Cramer, Daniel W; Terry, Kathryn L; Vitonis, Allison F; Titus, Linda J; Ziogas, Argyrios; Brewster, Wendy; Anton-Culver, Hoda; Gentry-Maharaj, Alexandra; Ramus, Susan J; Anderson, A Rebecca; Brueggmann, Doerthe; Fasching, Peter A; Gayther, Simon A; Huntsman, David G; Menon, Usha; Ness, Roberta B; Pike, Malcolm C; Risch, Harvey; Wu, Anna H; Berchuck, Andrew

    2012-04-01

    Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. 13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2%] of 674 cases vs 818 [6·2%] of 13 226 controls, odds ratio 3·05, 95% CI 2·43-3·84, pSmith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC)

    Science.gov (United States)

    Marcotte, Erin L; Thomopoulos, Thomas P; Infante-Rivard, Claire; Clavel, Jacqueline; Petridou, Eleni Th; Schüz, Joachim; Ezzat, Sameera; Dockerty, John D; Metayer, Catherine; Magnani, Corrado; Scheurer, Michael E; Mueller, Beth A; Mora, Ana M; Wesseling, Catharina; Skalkidou, Alkistis; Rashed, Wafaa M; Francis, Stephen S; Ajrouche, Roula; Erdmann, Friederike; Orsi, Laurent; Spector, Logan G

    2017-01-01

    Summary Background Results from case-control studies have shown an increased risk of acute lymphoblastic leukaemia (ALL) in young children born by caesarean delivery, and prelabour caesarean delivery in particular; however, an association of method of delivery with childhood leukaemia subtypes has yet to be established. We therefore did a pooled analysis of data to investigate the association between childhood leukaemia and caesarean delivery. Methods We pooled data from 13 case-control studies from the Childhood Leukemia International Consortium done in nine countries (Canada, Costa Rica, Egypt, France, Germany, Greece, Italy, New Zealand, and the USA) for births from 1970-2013. We analysed caesarean delivery overall and by indications that probably resulted in prelabour caesarean delivery or emergency caesarean delivery. We used multivariable logistic regression models, adjusted for child's birthweight, sex, age, ethnic origin, parental education, maternal age, and study, to estimate odds ratios (ORs) and 95% CIs for the risk of ALL and acute myeloid leukaemia (AML) in children aged 0-14 years at diagnosis. Findings The studies provided data for 8780 ALL cases, 1332 AML cases, and 23 459 controls, of which the birth delivery method was known for 8655 (99%) ALL cases, 1292 (97%) AML cases, and 23 351 (>99%) controls. Indications for caesarean delivery were available in four studies (there were caesarean deliveries for 1061 of 4313 ALL cases, 138 of 664 AML cases, and 1401 of 5884 controls). The OR for all indications of caesarean delivery and ALL was 1.06 (95% CI 0.99–1.13), and was significant for prelabour caesarean delivery and ALL (1.23 [1.04-1.47]; p=0.018). Emergency caesarean delivery was not associated with ALL (OR 1.02 [95% CI 0.81-1.30]). AML was not associated with caesarean delivery (all indications OR 0.99 [95% CI 0.84-1.17]; prelabour caesarean delivery 0.83 [0.54-1.26]; and emergency caesarean delivery 1.05 [0.63-1.77]). Interpretation Our

  13. The long shadow of the past: risk pooling and the political development of health care reform in the States.

    Science.gov (United States)

    Chen, Anthony S; Weir, Margaret

    2009-10-01

    Why do the states seem to be pursuing different types of policy innovation in their health reform? Why so some seem to follow a "solidarity principle," while others seem guided by a commitment to "actuarial fairness"? Our analysis highlights the reciprocal influence of stakeholder mobilization and public policy over time. We find that early policy choices about how to achieve cost containment led the states down different paths of reform. In the 1970s and 1980s, states that featured oligopolistic or near-monopolistic markets for private insurance (usually dominated by Blue Cross) and strong urban-academic hospitals tended to adopt regulatory strategies for cost containment that led to broader forms of pooling and financing the costs of health risks--which subsequently positioned them to pursue major, solidaristic reform on favorable terms. On the other hand, states with competitive markets for private insurance and weak, decentralized hospitals tended to adopt market-based strategies for cost containment that led to the hypersegmentation of risk and the uneven financing of costs--thereby encouraging the proliferation of incremental policies that reinforce the principle of actuarial fairness. We illustrate our analysis with a brief comparison of Massachusetts and California, and we conclude with some thoughts on what our findings imply for the federal role in catalyzing health reform.

  14. Modelling body mass index and endometrial cancer risk in a pooled-analysis of three case-control studies.

    Science.gov (United States)

    Rota, M; Rumi, F; Bagnardi, V; Dal Maso, L; Zucchetto, A; Levi, F; La Vecchia, C; Tavani, A

    2016-01-01

    To quantify the relation between body mass index (BMI) and endometrial cancer risk, and to describe the shape of such a relation. Pooled analysis of three hospital-based case-control studies. Italy and Switzerland. A total of 1449 women with endometrial cancer and 3811 controls. Multivariate odds ratios (OR) and 95% confidence intervals (95% CI) were obtained from logistic regression models. The shape of the relation was determined using a class of flexible regression models. The relation of BMI with endometrial cancer. Compared with women with BMI 18.5 to BMI ≥35 kg/m(2) . The odds ratios were 1.10 (95% CI 1.09-1.12) and 1.63 (95% CI 1.52-1.75) respectively for an increment of BMI of 1 and 5 units. The relation was stronger in never-users of oral contraceptives (OR 3.35, 95% CI 2.78-4.03, for BMI ≥30 versus BMI ≥30 versus best fitted by a cubic model, although after the exclusion of the 5% upper and lower tails, it was best fitted by a linear model. The results of this study confirm a role of elevated BMI in the aetiology of endometrial cancer and suggest that the risk in obese women increases in a cubic nonlinear fashion. The relation was stronger in never-users of oral contraceptives and in women with diabetes. © 2015 Royal College of Obstetricians and Gynaecologists.

  15. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies.

    Science.gov (United States)

    Yang, Xiaohong R; Chang-Claude, Jenny; Goode, Ellen L; Couch, Fergus J; Nevanlinna, Heli; Milne, Roger L; Gaudet, Mia; Schmidt, Marjanka K; Broeks, Annegien; Cox, Angela; Fasching, Peter A; Hein, Rebecca; Spurdle, Amanda B; Blows, Fiona; Driver, Kristy; Flesch-Janys, Dieter; Heinz, Judith; Sinn, Peter; Vrieling, Alina; Heikkinen, Tuomas; Aittomäki, Kristiina; Heikkilä, Päivi; Blomqvist, Carl; Lissowska, Jolanta; Peplonska, Beata; Chanock, Stephen; Figueroa, Jonine; Brinton, Louise; Hall, Per; Czene, Kamila; Humphreys, Keith; Darabi, Hatef; Liu, Jianjun; Van 't Veer, Laura J; van Leeuwen, Flora E; Andrulis, Irene L; Glendon, Gord; Knight, Julia A; Mulligan, Anna Marie; O'Malley, Frances P; Weerasooriya, Nayana; John, Esther M; Beckmann, Matthias W; Hartmann, Arndt; Weihbrecht, Sebastian B; Wachter, David L; Jud, Sebastian M; Loehberg, Christian R; Baglietto, Laura; English, Dallas R; Giles, Graham G; McLean, Catriona A; Severi, Gianluca; Lambrechts, Diether; Vandorpe, Thijs; Weltens, Caroline; Paridaens, Robert; Smeets, Ann; Neven, Patrick; Wildiers, Hans; Wang, Xianshu; Olson, Janet E; Cafourek, Victoria; Fredericksen, Zachary; Kosel, Matthew; Vachon, Celine; Cramp, Helen E; Connley, Daniel; Cross, Simon S; Balasubramanian, Sabapathy P; Reed, Malcolm W R; Dörk, Thilo; Bremer, Michael; Meyer, Andreas; Karstens, Johann H; Ay, Aysun; Park-Simon, Tjoung-Won; Hillemanns, Peter; Arias Pérez, Jose Ignacio; Menéndez Rodríguez, Primitiva; Zamora, Pilar; Benítez, Javier; Ko, Yon-Dschun; Fischer, Hans-Peter; Hamann, Ute; Pesch, Beate; Brüning, Thomas; Justenhoven, Christina; Brauch, Hiltrud; Eccles, Diana M; Tapper, William J; Gerty, Sue M; Sawyer, Elinor J; Tomlinson, Ian P; Jones, Angela; Kerin, Michael; Miller, Nicola; McInerney, Niall; Anton-Culver, Hoda; Ziogas, Argyrios; Shen, Chen-Yang; Hsiung, Chia-Ni; Wu, Pei-Ei; Yang, Show-Lin; Yu, Jyh-Cherng; Chen, Shou-Tung; Hsu, Giu-Cheng; Haiman, Christopher A; Henderson, Brian E; Le Marchand, Loic; Kolonel, Laurence N; Lindblom, Annika; Margolin, Sara; Jakubowska, Anna; Lubiński, Jan; Huzarski, Tomasz; Byrski, Tomasz; Górski, Bohdan; Gronwald, Jacek; Hooning, Maartje J; Hollestelle, Antoinette; van den Ouweland, Ans M W; Jager, Agnes; Kriege, Mieke; Tilanus-Linthorst, Madeleine M A; Collée, Margriet; Wang-Gohrke, Shan; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Mononen, Kari; Grip, Mervi; Hirvikoski, Pasi; Winqvist, Robert; Mannermaa, Arto; Kosma, Veli-Matti; Kauppinen, Jaana; Kataja, Vesa; Auvinen, Päivi; Soini, Ylermi; Sironen, Reijo; Bojesen, Stig E; Ørsted, David Dynnes; Kaur-Knudsen, Diljit; Flyger, Henrik; Nordestgaard, Børge G; Holland, Helene; Chenevix-Trench, Georgia; Manoukian, Siranoush; Barile, Monica; Radice, Paolo; Hankinson, Susan E; Hunter, David J; Tamimi, Rulla; Sangrajrang, Suleeporn; Brennan, Paul; McKay, James; Odefrey, Fabrice; Gaborieau, Valerie; Devilee, Peter; Huijts, P E A; Tollenaar, R A E M; Seynaeve, C; Dite, Gillian S; Apicella, Carmel; Hopper, John L; Hammet, Fleur; Tsimiklis, Helen; Smith, Letitia D; Southey, Melissa C; Humphreys, Manjeet K; Easton, Douglas; Pharoah, Paul; Sherman, Mark E; Garcia-Closas, Montserrat

    2011-02-02

    Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. We pooled tumor marker and epidemiological risk factor data from 35,568 invasive breast cancer case patients from 34 studies participating in the Breast Cancer Association Consortium. Logistic regression models were used in case-case analyses to estimate associations between epidemiological risk factors and tumor subtypes, and case-control analyses to estimate associations between epidemiological risk factors and the risk of developing specific tumor subtypes in 12 population-based studies. All statistical tests were two-sided. In case-case analyses, of the epidemiological risk factors examined, early age at menarche (≤12 years) was less frequent in case patients with PR(-) than PR(+) tumors (P = .001). Nulliparity (P = 3 × 10(-6)) and increasing age at first birth (P = 2 × 10(-9)) were less frequent in ER(-) than in ER(+) tumors. Obesity (body mass index [BMI] ≥ 30 kg/m(2)) in younger women (≤50 years) was more frequent in ER(-)/PR(-) than in ER(+)/PR(+) tumors (P = 1 × 10(-7)), whereas obesity in older women (>50 years) was less frequent in PR(-) than in PR(+) tumors (P = 6 × 10(-4)). The triple-negative (ER(-)/PR(-)/HER2(-)) or core basal phenotype (CBP; triple-negative and cytokeratins [CK]5/6(+) and/or epidermal growth factor receptor [EGFR](+)) accounted for much of the heterogeneity in parity-related variables and BMI in younger women. Case-control analyses showed that nulliparity, increasing age at first birth, and obesity in younger women showed the expected associations with the risk of ER(+) or PR(+) tumors but not triple-negative (nulliparity vs parity, odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.75 to 1.19, P = .61; 5-year increase in age at first full-term birth, OR = 0.95, 95% CI = 0.86 to 1.05, P = .34; obesity in younger women, OR = 1.36, 95% CI = 0.95 to 1

  16. Neural network to identify individuals at health risk

    CERN Document Server

    Magoc, Tanja

    2011-01-01

    The risk of diseases such as heart attack and high blood pressure could be reduced by adequate physical activity. However, even though majority of general population claims to perform some physical exercise, only a minority exercises enough to keep a healthy living style. Thus, physical inactivity has become one of the major concerns of public health in the past decade. Research shows that the highest decrease in physical activity is noticed from high school to college. Thus, it is of great importance to quickly identify college students at health risk due to physical inactivity. Research also shows that the level of physical activity of an individual is highly correlated to demographic features such as race and gender, as well as self motivation and support from family and friends. This information could be collected from each student via a 20 minute questionnaire, but the time needed to distribute and analyze each questionnaire is infeasible on a collegiate campus. Thus, we propose an automatic identifier o...

  17. Illustrative probabilistic biosphere model for Yucca Mountain individual risk calculations

    Energy Technology Data Exchange (ETDEWEB)

    Wilems, R.E. [Del Mar Consulting, Corpus Christi, TX (United States)

    1994-12-31

    The proposed EPA Standards for the disposal of spent fuel, high-level and transuranic radioactive waste prescribe future biosphere--one in which no sustained human activity occurs inside the controlled zone, yet sustained use of groundwater occurs just outside the controlled zone boundary. Performance assessments have generally assumed a person at this location extracts all his water needs directly from the projected contaminated plume for all of his life. Dose to this maximally-exposed individual is too conservative a measure of performance for a nuclear waste repository and does not reflect the isolation characteristics of a site. A better measure is individual risk in which uncertainties in biosphere characteristics for the longer periods of performance, for a site like Yucca Mountain only those characteristics associated with well water scenarios need be prescribed. Such a prescription of the biosphere is appropriate because the goal of the regulations is to provide indicators of future performance so the regulators can make a responsible decision regarding reasonable assurance of public health and safety.

  18. Asenapine effects on individual Young Mania Rating Scale items in bipolar disorder patients with acute manic or mixed episodes: a pooled analysis

    Directory of Open Access Journals (Sweden)

    Cazorla P

    2013-03-01

    Full Text Available Pilar Cazorla, Jun Zhao, Mary Mackle, Armin Szegedi Merck, Rahway, NJ, USA Background: An exploratory post hoc analysis was conducted to evaluate the potential differential effects over time of asenapine and olanzapine compared with placebo on the eleven individual items comprising the Young Mania Rating Scale (YMRS in patients with manic or mixed episodes in bipolar I disorder. Methods: Data were pooled from two 3-week randomized, controlled trials in which the eleven individual items comprising the YMRS were measured over 21 days. An analysis of covariance model adjusted by baseline value was used to test for differences in changes from baseline in YMRS scores between groups. Results: Each of the eleven individual YMRS item scores was significantly reduced compared with placebo at day 21. After 2 days of treatment, asenapine and olanzapine were superior to placebo for six of the YMRS items: disruptive/aggressive behavior, content, irritability, elevated mood, sleep, and speech. Conclusion: Reduction in manic symptoms over 21 days was associated with a broad-based improvement across all symptom domains with no subset of symptoms predominating. Keywords: asenapine, Young Mania Rating Scale, bipolar disorder, YMRS, antipsychotic, olanzapine

  19. Hydrogen isotopes in individual amino acids reflect differentiated pools of hydrogen from food and water in Escherichia coli.

    Science.gov (United States)

    Fogel, Marilyn L; Griffin, Patrick L; Newsome, Seth D

    2016-08-01

    Hydrogen isotope (δ(2)H) analysis is widely used in animal ecology to study continental-scale movement because δ(2)H can trace precipitation and climate. To understand the biochemical underpinnings of how hydrogen is incorporated into biomolecules, we measured the δ(2)H of individual amino acids (AAs) in Escherichia coli cultured in glucose-based or complex tryptone-based media in waters with δ(2)H values ranging from -55‰ to +1,070‰. The δ(2)H values of AAs in tryptone spanned a range of ∼250‰. In E. coli grown on glucose, the range of δ(2)H among AAs was nearly 200‰. The relative distributions of δ(2)H of AAs were upheld in cultures grown in enriched waters. In E. coli grown on tryptone, the δ(2)H of nonessential AAs varied linearly with the δ(2)H of media water, whereas δ(2)H of essential AAs was nearly identical to δ(2)H in diet. Model calculations determined that as much as 46% of hydrogen in some nonessential AAs originated from water, whereas no more than 12% of hydrogen in essential AAs originated from water. These findings demonstrate that δ(2)H can route directly at the molecular level. We conclude that the patterns and distributions in δ(2)H of AAs are determined through biosynthetic reactions, suggesting that δ(2)H could become a new biosignature for studying novel microbial pathways. Our results also show that δ(2)H of AAs in an organism's tissues provides a dual tracer for food and environmental (e.g., drinking) water.

  20. Adverse effects of mefloquine for the treatment of uncomplicated malaria in Thailand: A pooled analysis of 19, 850 individual patients

    Science.gov (United States)

    Lee, Sue J.; ter Kuile, Feiko O.; Luxemburger, Christine

    2017-01-01

    Mefloquine (MQ) has been used for the treatment of malaria since the mid-1980s, first as monotherapy or as fixed combination with sulfadoxine-pyrimethamine (MSP) and since the mid-1990s in combination with artesunate. There is a renewed interested in MQ as part of a triple therapy for the treatment of multi-drug resistance P. falciparum malaria. The widespread use of MQ beyond south-East Asia has been constrained by reports of poor tolerability. Here we present the side effect profile of MQ for the treatment of uncomplicated malaria on the Thai-Myanmar/Cambodia borders. In total 19,850 patients received seven different regimens containing either 15 or 24–25 mg/kg of MQ, the latter given either as a single dose, or split over two or three days. The analysis focused on (predominantly) gastrointestinal and neuropsychiatric events as compared to the new fixed dose combination of MQ plus artesunate given as equal doses of 8 mg/kg MQ per day over three days. Gastrointestinal side effects were dose-dependent and associated with the severity of malaria symptoms. Serious neuropsychiatric side effects associated with MQ use were rare: for a single 25 mg/kg dose it was 11.9 per 10,000 treatments (95% confidence interval, CI, 4–285) vs. 7.8 (3–15) for the 15 mg/kg dose. The risk with 25 mg/kg was much higher when it was given as repeat dosing in patients who had failed treatment with 15 mg/kg MQ in the preceding month; (RR 6.57 (95% CI 1.33 to 32.4), p = 0.0077). MQ was best tolerated as 15 mg/kg or as 24 mg/kg when given over three days in combination with artesunate. We conclude that the tolerance of a single dose of MQ in the treatment of uncomplicated malaria is moderate, but can be improved by administering it as a split dose over three days. PMID:28192434

  1. A new surveillance and response tool: risk map of infected Oncomelania hupensis detected by Loop-mediated isothermal amplification (LAMP) from pooled samples.

    Science.gov (United States)

    Tong, Qun-Bo; Chen, Rui; Zhang, Yi; Yang, Guo-Jing; Kumagai, Takashi; Furushima-Shimogawara, Rieko; Lou, Di; Yang, Kun; Wen, Li-Yong; Lu, Shao-Hong; Ohta, Nobuo; Zhou, Xiao-Nong

    2015-01-01

    Although schistosomiasis remains a serious health problem worldwide, significant achievements in schistosomiasis control has been made in the People's Republic of China. The disease has been eliminated in five out of 12 endemic provinces, and the prevalence in remaining endemic areas is very low and is heading toward elimination. A rapid and sensitive method for monitoring the distribution of infected Oncomelania hupensis is urgently required. We applied a loop-mediated isothermal amplification (LAMP) assay targeting 28S rDNA for the rapid and effective detection of Schistosoma japonicum DNA in infected and prepatent infected O. hupensis snails. The detection limit of the LAMP method was 100 fg of S. japonicum genomic DNA. To promote the application of the approach in the field, the LAMP assay was used to detect infection in pooled samples of field-collected snails. In the pooled sample detection, snails were collected from 28 endemic areas, and 50 snails from each area were pooled based on the maximum pool size estimation, crushed together and DNA was extracted from each pooled sample as template for the LAMP assay. Based on the formula for detection from pooled samples, the proportion of positive pooled samples and the positive proportion of O. hupensis detected by LAMP of Xima village reached 66.67% and 1.33%, while those of Heini, Hongjia, Yangjiang and Huangshan villages were 33.33% and 0.67%, and those of Tuanzhou and Suliao villages were 16.67% and 0.33%, respectively. The remaining 21 monitoring field sites gave negative results. A risk map for the transmission of schistosomiasis was constructed using ArcMap, based on the positive proportion of O. hupensis infected with S. japonicum, as detected by the LAMP assay, which will form a guide for surveillance and response strategies in high risk areas.

  2. Meta- and pooled analyses of the methylenetetrahydrofolate reductase C677T and A1298C polymorphisms and gastric cancer risk: A Huge-GSEC review

    NARCIS (Netherlands)

    S. Boccia (Stefania); R.J. Hung (Rayjean); G. Ricciardi (Gualtiero); F. Gianfagna (Francesco); M.P.A. Ebert (Matthias); J.Y. Fang; C.M. Gao; T. Götze (Tobias); F. Graziano (Francesco); M. Lacasaña-Navarro (Marina); D. Lin (Dongxin); L. López-Carrillo (Lizbeth); Y.L. Qiao; H. Shen (Hongbing); R. Stolzenberg-Solomon (Rachael); T. Takezaki (Toshiro); Y.R. Weng; F.F. Zhang; P. Tikka-Kleemola (Päivi); P. Boffetta (Paolo); E. Taioli (Emanuela)

    2008-01-01

    textabstractMethylenetetrahydrofolate reductase (MTHFR) is a key enzyme in the metabolism of folate, whose role in gastric carcinogenesis is controversial. The authors performed a meta-analysis and individual data pooled analysis of case-control studies that examined the association between C677T

  3. Depression as a risk factor for mortality in individuals with diabetes: a meta-analysis of prospective studies.

    Directory of Open Access Journals (Sweden)

    Mareike Hofmann

    Full Text Available OBJECTIVE: To quantify the impact of depression measured by self-reports and depression measured by clinical interview on all-cause mortality in individuals with diabetes and to analyze the strength of both associations, the influence of covariates, and possible differences between studies assessing self-rated depressive symptoms and those using a clinical interview to measure depression as predictors of mortality. RESEARCH DESIGN AND METHODS: PUBMED and PsycINFO were searched up to July 2013 for prospective studies assessing depression, diabetes and mortality. The pooled hazard ratios were calculated using random-effects models. RESULTS: Sixteen studies met the inclusion criteria. After adjustment for demographic variables depression measured by self-reports was associated with an increased all-cause mortality risk (pooled HR = 2.56, 95% CI 1.89-3.47, and the mortality risk remained high after additional adjustment for diabetes complications (HR = 1.76, 95% CI 1.45-2.14,. Six studies reporting adjusted HRs for depression measured by clinical interviews supported the results of the other models (HR = 1.49, 95% CI 1.15-1.93. CONCLUSIONS: Both depression measured by self-report and depression measured by clinical interview have an unfavorable impact on mortality in individuals with diabetes. The results, however, are limited by the heterogeneity of the primary studies. It remains unclear whether self-reports or clinical interviews for depression are the more precise predictor.

  4. Smell identification in individuals at clinical high risk for schizophrenia.

    Science.gov (United States)

    Gill, Kelly Elizabeth; Evans, Elizabeth; Kayser, Jürgen; Ben-David, Shelly; Messinger, Julie; Bruder, Gerard; Malaspina, Dolores; Corcoran, Cheryl Mary

    2014-12-15

    Smell identification deficits exist in schizophrenia, and may be associated with its negative symptoms. Less is known about smell identification and its clinical correlates in individuals at clinical high risk (CHR) for schizophrenia and related psychotic disorders. We examined smell identification, symptoms and IQ in 71 clinical high-risk (CHR) subjects and 36 healthy controls. Smell identification was assessed using both the 40-item University of Pennsylvania Smell Identification Test (UPSIT; Doty, R.L., Shaman, P., Kimmelman, C.P., Dann, M.S., 1984. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 94, 176-178) and its extracted 12-item Brief Smell Identification Test (Goudsmit, N., Coleman, E., Seckinger, R.A., Wolitzky, R., Stanford, A.D., Corcoran, C., Goetz, R.R., Malaspina, D., 2003. A brief smell identification test discriminates between deficit and non-deficit schizophrenia. Psychiatry Research 120, 155-164). Smell identification did not significantly differ between CHR subjects and controls. Among CHR subjects, smell identification did not predict schizophrenia (N=19; 27%) within 2 years, nor was it associated with negative or positive symptoms. This is the third prospective cohort study to examine smell identification in CHR subjects, and overall, findings are inconclusive, similar to what is found for other disorders in adolescents, such as autism spectrum, attention deficit and anxiety disorders. Smell identification deficit may not have clear utility as a marker of emergent schizophrenia and related psychotic disorders. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Individual spatial responses towards roads: implications for mortality risk.

    Directory of Open Access Journals (Sweden)

    Clara Grilo

    Full Text Available BACKGROUND: Understanding the ecological consequences of roads and developing ways to mitigate their negative effects has become an important goal for many conservation biologists. Most mitigation measures are based on road mortality and barrier effects data. However, studying fine-scale individual spatial responses in roaded landscapes may help develop more cohesive road planning strategies for wildlife conservation. METHODOLOGY/PRINCIPAL FINDINGS: We investigated how individuals respond in their spatial behavior toward a highway and its traffic intensity by radio-tracking two common species particularly vulnerable to road mortality (barn owl Tyto alba and stone marten Martes foina. We addressed the following questions: 1 how highways affected home-range location and size in the immediate vicinity of these structures, 2 which road-related features influenced habitat selection, 3 what was the role of different road-related features on movement properties, and 4 which characteristics were associated with crossing events and road-kills. The main findings were: 1 if there was available habitat, barn owls and stone martens may not avoid highways and may even include highways within their home-ranges; 2 both species avoided using areas near the highway when traffic was high, but tended to move toward the highway when streams were in close proximity and where verges offered suitable habitat; and 3 barn owls tended to cross above-grade highway sections while stone martens tended to avoid crossing at leveled highway sections. CONCLUSIONS: Mortality may be the main road-mediated mechanism that affects barn owl and stone marten populations. Fine-scale movements strongly indicated that a decrease in road mortality risk can be realized by reducing sources of attraction, and by increasing road permeability through measures that promote safe crossings.

  6. Education in Twins and Their Parents Across Birth Cohorts Over 100 years: An Individual-Level Pooled Analysis of 42-Twin Cohorts.

    Science.gov (United States)

    Silventoinen, Karri; Jelenkovic, Aline; Latvala, Antti; Sund, Reijo; Yokoyama, Yoshie; Ullemar, Vilhelmina; Almqvist, Catarina; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth J F; Kandler, Christian; Honda, Chika; Inui, Fujio; Iwatani, Yoshinori; Watanabe, Mikio; Rebato, Esther; Stazi, Maria A; Fagnani, Corrado; Brescianini, Sonia; Hur, Yoon-Mi; Jeong, Hoe-Uk; Cutler, Tessa L; Hopper, John L; Busjahn, Andreas; Saudino, Kimberly J; Ji, Fuling; Ning, Feng; Pang, Zengchang; Rose, Richard J; Koskenvuo, Markku; Heikkilä, Kauko; Cozen, Wendy; Hwang, Amie E; Mack, Thomas M; Siribaddana, Sisira H; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Sung, Joohon; Kim, Jina; Lee, Jooyeon; Lee, Sooji; Nelson, Tracy L; Whitfield, Keith E; Tan, Qihua; Zhang, Dongfeng; Llewellyn, Clare H; Fisher, Abigail; Burt, S Alexandra; Klump, Kelly L; Knafo-Noam, Ariel; Mankuta, David; Abramson, Lior; Medland, Sarah E; Martin, Nicholas G; Montgomery, Grant W; Magnusson, Patrik K E; Pedersen, Nancy L; Dahl Aslan, Anna K; Corley, Robin P; Huibregtse, Brooke M; Öncel, Sevgi Y; Aliev, Fazil; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Willemsen, Gonneke; Bartels, Meike; van Beijsterveldt, Catharina E M; Silberg, Judy L; Eaves, Lindon J; Maes, Hermine H; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas S; Rasmussen, Finn; Tynelius, Per; Baker, Laura A; Tuvblad, Catherine; Ordoñana, Juan R; Sánchez-Romera, Juan F; Colodro-Conde, Lucia; Gatz, Margaret; Butler, David A; Lichtenstein, Paul; Goldberg, Jack H; Harden, K Paige; Tucker-Drob, Elliot M; Duncan, Glen E; Buchwald, Dedra; Tarnoki, Adam D; Tarnoki, David L; Franz, Carol E; Kremen, William S; Lyons, Michael J; Maia, José A; Freitas, Duarte L; Turkheimer, Eric; Sørensen, Thorkild I A; Boomsma, Dorret I; Kaprio, Jaakko

    2017-10-01

    Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990-1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.

  7. Incorporating location, routing, and inventory decisions in a bi-objective supply chain design problem with risk-pooling

    Science.gov (United States)

    Tavakkoli-Moghaddam, Reza; Forouzanfar, Fateme; Ebrahimnejad, Sadoullah

    2013-07-01

    This paper considers a single-sourcing network design problem for a three-level supply chain. For the first time, a novel mathematical model is presented considering risk-pooling, the inventory existence at distribution centers (DCs) under demand uncertainty, the existence of several alternatives to transport the product between facilities, and routing of vehicles from distribution centers to customer in a stochastic supply chain system, simultaneously. This problem is formulated as a bi-objective stochastic mixed-integer nonlinear programming model. The aim of this model is to determine the number of located distribution centers, their locations, and capacity levels, and allocating customers to distribution centers and distribution centers to suppliers. It also determines the inventory control decisions on the amount of ordered products and the amount of safety stocks at each opened DC, selecting a type of vehicle for transportation. Moreover, it determines routing decisions, such as determination of vehicles' routes starting from an opened distribution center to serve its allocated customers and returning to that distribution center. All are done in a way that the total system cost and the total transportation time are minimized. The Lingo software is used to solve the presented model. The computational results are illustrated in this paper.

  8. [Risk Assessment of Single-Donor (Apheresis) Platelet Concentrates and Pooled Whole-Blood-Derived Platelet Concentrates].

    Science.gov (United States)

    Hitzler, Walter; Hutschenreuter, Gabriele; Wartensleben, Herbert

    2015-01-01

    According to the risk estimates of the Robert-Koch-Institute (RKI) and the Paul Ehrlich-Institute (PEI) an equivalence cannot be assumed to exist between the two different platelet preparations. Differences between single-donor (apheresis) platelet concentrates (ATK) and pooled whole-blood-derived platelet concentrates (PTK) result from donor populations, donation intervals, and preparation techniques. There are no prospective randomized studies with regard to the clinical efficacy, which would unambiguously demonstrate equivalence of the therapeutic efficacy of PTK (buffy coat method) in comparison to ATK. The German Association of Blood Transfusion Services (StKB) points out that, due to the non-equivalence of PTK and ATK, it is incumbent on the transfusion physician to select the platelet concentrate, make the appropriate disclosures, and assume treatment responsibility. Proper compensation for ATK and PTK must be ensured by the health insurance companies, whereby a special indication for the selection of either PTK or ATK is not given. Exceptions are patients with known HLA antibodies in which only selected platelet concentrates may be administered. Otherwise, no indication exists in the selection of the different platelet concentrates (Article is in German).

  9. Total Exposure and Exposure Rate Effects for Alcohol and Smoking and Risk of Head and Neck Cancer: A Pooled Analysis of Case-Control Studies

    OpenAIRE

    Lubin, Jay H.; Purdue, Mark; Kelsey, Karl; Zhang, Zuo-Feng; Winn, Debbie; Wei, Qingyi; Talamini, Renato; Szeszenia-Dabrowska, Neonilia; Sturgis, Erich M.; Smith, Elaine; Shangina, Oxana; Schwartz, Stephen M.; Rudnai, Peter; Neto, Jose Eluf; Muscat, Joshua

    2009-01-01

    Although cigarette smoking and alcohol consumption increase risk for head and neck cancers, there have been few attempts to model risks quantitatively and to formally evaluate cancer site-specific risks. The authors pooled data from 15 case-control studies and modeled the excess odds ratio (EOR) to assess risk by total exposure (pack-years and drink-years) and its modification by exposure rate (cigarettes/day and drinks/day). The smoking analysis included 1,761 laryngeal, 2,453 pharyngeal, an...

  10. Discrepancies between estimated and perceived risk of cancer among individuals with hereditary nonpolyposis colorectal cancer

    DEFF Research Database (Denmark)

    Domanska, K; Nilbert, Mef; Soller, M;

    2007-01-01

    to individual characteristics. A perceived risk of colorectal cancer above 60% was reported by 22/45 individuals, and only one out of five mutation carriers reported a perceived risk > 80%. Female mutation carriers, individuals below age 50, and individuals who received their oncogenetic counseling within 1...

  11. Vitamin E intake from natural sources and head and neck cancer risk: a pooled analysis in the International Head and Neck Cancer Epidemiology consortium.

    Science.gov (United States)

    Edefonti, V; Hashibe, M; Parpinel, M; Ferraroni, M; Turati, F; Serraino, D; Matsuo, K; Olshan, A F; Zevallos, J P; Winn, D M; Moysich, K; Zhang, Z-F; Morgenstern, H; Levi, F; Kelsey, K; McClean, M; Bosetti, C; Schantz, S; Yu, G-P; Boffetta, P; Chuang, S-C; A Lee, Y-C; La Vecchia, C; Decarli, A

    2015-06-30

    Evidence for the possible effect of vitamin E on head and neck cancers (HNCs) is limited. We used individual-level pooled data from 10 case-control studies (5959 cases and 12 248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium to assess the association between vitamin E intake from natural sources and cancer of the oral cavity/pharynx and larynx. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models applied to quintile categories of non-alcohol energy-adjusted vitamin E intake. Intake of vitamin E was inversely related to oral/pharyngeal cancer (OR for the fifth vs the first quintile category=0.59, 95% CI: 0.49-0.71; P for trend <0.001) and to laryngeal cancer (OR=0.67, 95% CI: 0.54-0.83, P for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral/pharyngeal cancer. Inverse associations were generally observed for the anatomical subsites of oral and pharyngeal cancer and within covariate strata for both sites. Our findings suggest that greater vitamin E intake from foods may lower HNC risk, although we were not able to explain the heterogeneity observed across studies or rule out certain sources of bias.

  12. Risk evaluation methods at individual ship and company level

    NARCIS (Netherlands)

    C. Heij (Christiaan); S. Knapp (Sabine)

    2011-01-01

    textabstractSafety management and risk profiling to identify substandard ships are of importance to the shipping industry. Whereas current methods rely heavily on detention risk and flag state performance, we extend the risk assessment by considering various risk dimensions and by evaluating a wide

  13. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh.

    Science.gov (United States)

    Rahman, A K M Anisur; Dirk, Berkvens; Fretin, David; Saegerman, Claude; Ahmed, Muzahed Uddin; Muhammad, Noor; Hossain, Akram; Abatih, Emmanuel

    2012-03-01

    Brucellosis is an occupational hazard of livestock farmers, dairy workers, veterinarians, slaughterhouse workers, and laboratory personnel, all of whom are considered to belong to the high-risk occupational group (HROG). A study was undertaken to determine the seroprevalence of brucellosis, identify risk factors associated with brucellosis seropositivity, and detect Brucella at genus level using real-time polymerase chain reaction (PCR) among people in the HROG in the Dhaka division of Bangladesh. A sample of 500 individuals from the HROG was collected from three districts of Dhaka division of Bangladesh. A multiple random effects logistic regression model was used to identify potential risk factors. Two types of real-time PCR methods were applied to detect Brucella genus-specific DNA using serum from seropositive patients. The prevalence of brucellosis based on the three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. Noticeable variation in brucellosis seropositivity among humans within the three districts was noted. All of the 13 individuals who tested positive for the serological tests were also positive in two types of real-time PCR using the same serum samples. Livestock farmers of brucellosis positive herds had a significantly higher probability to be seropositive for brucellosis. The study emphasized that contact with livestock, especially goats, is a significant risk factor for the transmission of brucellosis among individuals in the HROG.

  14. The Future of Pooling.

    Science.gov (United States)

    Young, Peter C.; Fone, Martin

    1997-01-01

    Discusses seven propositions underlying the strategies that insurance pools can, will, and must pursue: (1) risk management versus risk financing; (2) elimination of windfall advantages; (3) the maintenance of market-dominant status; (4) cost leadership; (5) client focus; (6) innovation and diversification; and (7) leadership challenges. A sidebar…

  15. Social Cognition in Individuals at Ultra-High Risk for Psychosis: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    R J M van Donkersgoed

    Full Text Available Treatment in the ultra-high risk stage for a psychotic episode is critical to the course of symptoms. Markers for the development of psychosis have been studied, to optimize the detection of people at risk of psychosis. One possible marker for the transition to psychosis is social cognition. To estimate effect sizes for social cognition based on a quantitative integration of the published evidence, we conducted a meta-analysis of social cognitive performance in people at ultra high risk (UHR.A literature search (1970-July 2015 was performed in PubMed, PsychINFO, Medline, Embase, and ISI Web of Science, using the search terms 'social cognition', 'theory of mind', 'emotion recognition', 'attributional style', 'social knowledge', 'social perception', 'empathy', 'at risk mental state', 'clinical high risk', 'psychosis prodrome', and 'ultra high risk'. The pooled effect size (Cohen's D and the effect sizes for each domain of social cognition were calculated. A random effects model with 95% confidence intervals was used.Seventeen studies were included in the analysis. The overall significant effect was of medium magnitude (d = 0.52, 95% Cl = 0.38-0.65. No moderator effects were found for age, gender and sample size. Sub-analyses demonstrated that individuals in the UHR phase show significant moderate deficits in affect recognition and affect discrimination in faces as well as in voices and in verbal Theory of Mind (TOM. Due to an insufficient amount of studies, we did not calculate an effect size for attributional bias and social perception/ knowledge. A majority of studies did not find a correlation between social cognition deficits and transition to psychosis, which may suggest that social cognition in general is not a useful marker for the development of psychosis. However some studies suggest the possible predictive value of verbal TOM and the recognition of specific emotions in faces for the transition into psychosis. More research is needed on

  16. Impact of cigarette smoking on the relationship between body mass index and coronary heart disease: a pooled analysis of 3264 stroke and 2706 CHD events in 378579 individuals in the Asia Pacific region

    Directory of Open Access Journals (Sweden)

    2009-08-01

    Full Text Available Abstract Background Elevated levels of body mass index (BMI and smoking are well established lifestyle risk factors for coronary heart disease (CHD and stroke. If these two risk factors have a synergistic relationship, rigorous lifestyle modification may contribute to greater reduction in cardiovascular burden than previously expected. Methods A pooled analysis of individual participant data from 38 cohorts, involving 378,579 participants. Hazards ratios (HRs and 95% confidence intervals (CIs for BMI by cigarette smoking status were estimated using Cox proportional hazard models. Results During a mean follow-up of 3.8 years, 2706 CHD and 3264 strokes were recorded. There was a log-linear, positive relationship of BMI with CHD and stroke in both smokers and non-smokers with evidence of a synergistic effect of smoking on the association between BMI and CHD only: HRs (95% CIs associated with a 2 kg/m2 higher BMI were 1.13 (1.10 – 1.17 in current smokers and 1.09 (1.06 – 1.11 in non-smokers (p-value for interaction = 0.04. Conclusion Smoking amplifies the positive association between BMI and CHD but not stroke. If confirmed, these results suggest that effective strategies that target smoking cessation and weight loss are likely to have a greater impact than anticipated on reducing the burden of CHD.

  17. Risk of Fall for Individuals with Intellectual Disability

    Science.gov (United States)

    Chiba, Yoichi; Shimada, Atsuyoshi; Yoshida, Futoshi; Keino, Hiromi; Hasegawa, Mariko; Ikari, Hiroyuki; Miyake, Shikako; Hosokawa, Masanori

    2009-01-01

    Our aim was to identify risk factors for falling and establish a method to assess risk for falls in adults with intellectual disabilities. In a cross-sectional survey of 144 Japanese adults, we found that age, presence of epilepsy, and presence of paretic conditions were independent risk factors. The Tinetti balance and gait instrument was…

  18. Risk of Fall for Individuals with Intellectual Disability

    Science.gov (United States)

    Chiba, Yoichi; Shimada, Atsuyoshi; Yoshida, Futoshi; Keino, Hiromi; Hasegawa, Mariko; Ikari, Hiroyuki; Miyake, Shikako; Hosokawa, Masanori

    2009-01-01

    Our aim was to identify risk factors for falling and establish a method to assess risk for falls in adults with intellectual disabilities. In a cross-sectional survey of 144 Japanese adults, we found that age, presence of epilepsy, and presence of paretic conditions were independent risk factors. The Tinetti balance and gait instrument was…

  19. Vernal Pools

    Data.gov (United States)

    California Department of Resources — This is a polygon layer representing existing vernal pool complexes in California's Central Valley, as identified and mapped by Dr. Robert F. Holland. The purpose of...

  20. Cognition in individuals at risk for Parkinson's: Parkinson associated risk syndrome (PARS) study findings.

    Science.gov (United States)

    Chahine, Lama M; Weintraub, Daniel; Hawkins, Keith A; Siderowf, Andrew; Eberly, Shirley; Oakes, David; Seibyl, John; Stern, Matthew B; Marek, Kenneth; Jennings, Danna

    2016-01-01

    The Parkinson Associated Risk Syndrome Study identified a cohort of healthy adults with hyposmia and dopamine transporter binding reduction to characterize individuals at risk for Parkinson's disease (PD). We describe the cognitive profile of this cohort. Individuals older than 50 y without PD were recruited. Two hundred twenty-five completed cognitive testing and were included in the final analysis. A neuropsychological test battery was administered and normative scores created for global cognition, memory, executive function/working memory, processing speed/attention, visuospatial abilities, and language domains. Other non-motor symptoms (constipation, depression, anxiety, and rapid eye movement sleep behavior disorder) were assessed through questionnaires. Individuals with both hyposmia and reduced dopamine transporter binding (n = 38) had lower mean scores for global cognition, executive function/working memory, and memory compared with all other participants (n = 187). In separate multivariate logistic regression models, lower global cognition (odds ratio, 1.97, P = 0.004), and specifically executive function/working memory (odds ratio, 1.84, P = 0.004) scores were associated with membership in the hyposmia with dopamine transporter reduction group. Combining hyposmia with relative impairment on specific cognitive domains increased the odds of dopamine transporter binding reduction compared with hyposmia alone, with the greatest increase in odds for hyposmia plus executive function/working memory relative impairment (68% increase in odds from 4.14 to 6.96). Changes in global cognitive abilities, and specifically executive function/working memory, are present in individuals at risk for PD. Combining non-motor features, including cognition, improves prediction of dopamine transporter binding reduction. © 2015 International Parkinson and Movement Disorder Society.

  1. General practitioners’ use of absolute risk versus individual risk factors in cardiovascular disease prevention: an experimental study

    OpenAIRE

    Jansen, Jesse; Bonner, Carissa; McKinn, Shannon; Irwig, Les; Glasziou, Paul ,; Doust, Jenny; Teixeira-Pinto, Armando; Hayen, Andrew; Turner, Robin; McCaffery, Kirsten

    2014-01-01

    Objective To understand general practitioners’ (GPs) use of individual risk factors (blood pressure and cholesterol levels) versus absolute risk in cardiovascular disease (CVD) risk management decision-making. Design Randomised experiment. Absolute risk, systolic blood pressure (SBP), cholesterol ratio (total cholesterol/high-density lipoprotein (TC/HDL)) and age were systematically varied in hypothetical cases. High absolute risk was defined as 5-year risk of a cardiovascular event >15%, hig...

  2. Running in the family or swimming in the gene pool: discriminating between family history and genetic risk in illness perceptions.

    Science.gov (United States)

    Riggs, Abigail L; Giuliano, Traci A

    2007-11-01

    The present study sought to understand how the genetic component of a disease affects individual's risk perceptions. Specifically, participants read three scenarios that asked them to imagine that they had either genetic, ambiguous, of no family history for a hypothetical disease and to imagine that their parents' lifestyles were either healthy or unhealthy. As expected, when participants received an ambiguous family history (rather than a genetic history or no family history), they rated a healthy diet and exercise as more effective at preventing the disease when their parents lifestyles were discribed as unhealthy rather than healthy (N = 97).

  3. Infarct size, left ventricular function, and prognosis in women compared to men after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: results from an individual patient-level pooled analysis of 10 randomized trials.

    Science.gov (United States)

    Kosmidou, Ioanna; Redfors, Björn; Selker, Harry P; Thiele, Holger; Patel, Manesh R; Udelson, James E; Magnus Ohman, E; Eitel, Ingo; Granger, Christopher B; Maehara, Akiko; Kirtane, Ajay; Généreux, Philippe; Jenkins, Paul L; Ben-Yehuda, Ori; Mintz, Gary S; Stone, Gregg W

    2017-06-01

    Studies have reported less favourable outcomes in women compared with men after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). Whether sex-specific differences in the magnitude or prognostic impact of infarct size or post-infarction cardiac function explain this finding is unknown. We pooled patient-level data from 10 randomized primary PCI trials in which infarct size was measured within 1 month (median 4 days) by either cardiac magnetic resonance imaging or technetium-99m sestamibi single-photon emission computed tomography. We assessed the association between sex, infarct size, and left ventricular ejection fraction (LVEF) and the composite rate of death or heart failure (HF) hospitalization within 1 year. Of 2632 patients with STEMI undergoing primary PCI, 587 (22.3%) were women. Women were older than men and had a longer delay between symptom onset and reperfusion. Infarct size did not significantly differ between women and men, and women had higher LVEF. Nonetheless, women had a higher 1-year rate of death or HF hospitalization compared to men, and while infarct size was a strong independent predictor of 1-year death or HF hospitalization (P size or LVEF on the risk of death or HF hospitalization. In this large-scale, individual patient-level pooled analysis of patients with STEMI undergoing primary PCI, women had a higher 1-year rate of death or HF hospitalization compared to men, a finding not explained by sex-specific differences in the magnitude or prognostic impact of infarct size or by differences in post-infarction cardiac function.

  4. Genetic and environmental influences on height from infancy to early adulthood: An individual-based pooled analysis of 45 twin cohorts

    Science.gov (United States)

    Jelenkovic, Aline; Sund, Reijo; Hur, Yoon-Mi; Yokoyama, Yoshie; Hjelmborg, Jacob v. B.; Möller, Sören; Honda, Chika; Magnusson, Patrik K. E.; Pedersen, Nancy L.; Ooki, Syuichi; Aaltonen, Sari; Stazi, Maria A.; Fagnani, Corrado; D’Ippolito, Cristina; Freitas, Duarte L.; Maia, José Antonio; Ji, Fuling; Ning, Feng; Pang, Zengchang; Rebato, Esther; Busjahn, Andreas; Kandler, Christian; Saudino, Kimberly J.; Jang, Kerry L.; Cozen, Wendy; Hwang, Amie E.; Mack, Thomas M.; Gao, Wenjing; Yu, Canqing; Li, Liming; Corley, Robin P.; Huibregtse, Brooke M.; Derom, Catherine A.; Vlietinck, Robert F.; Loos, Ruth J. F.; Heikkilä, Kauko; Wardle, Jane; Llewellyn, Clare H.; Fisher, Abigail; McAdams, Tom A.; Eley, Thalia C.; Gregory, Alice M.; He, Mingguang; Ding, Xiaohu; Bjerregaard-Andersen, Morten; Beck-Nielsen, Henning; Sodemann, Morten; Tarnoki, Adam D.; Tarnoki, David L.; Knafo-Noam, Ariel; Mankuta, David; Abramson, Lior; Burt, S. Alexandra; Klump, Kelly L.; Silberg, Judy L.; Eaves, Lindon J.; Maes, Hermine H.; Krueger, Robert F.; McGue, Matt; Pahlen, Shandell; Gatz, Margaret; Butler, David A.; Bartels, Meike; van Beijsterveldt, Toos C. E. M.; Craig, Jeffrey M.; Saffery, Richard; Dubois, Lise; Boivin, Michel; Brendgen, Mara; Dionne, Ginette; Vitaro, Frank; Martin, Nicholas G.; Medland, Sarah E.; Montgomery, Grant W.; Swan, Gary E.; Krasnow, Ruth; Tynelius, Per; Lichtenstein, Paul; Haworth, Claire M. A.; Plomin, Robert; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Harden, K. Paige; Tucker-Drob, Elliot M.; Spector, Timothy; Mangino, Massimo; Lachance, Genevieve; Baker, Laura A.; Tuvblad, Catherine; Duncan, Glen E.; Buchwald, Dedra; Willemsen, Gonneke; Skytthe, Axel; Kyvik, Kirsten O.; Christensen, Kaare; Öncel, Sevgi Y.; Aliev, Fazil; Rasmussen, Finn; Goldberg, Jack H.; Sørensen, Thorkild I. A.; Boomsma, Dorret I.; Kaprio, Jaakko; Silventoinen, Karri

    2016-01-01

    Height variation is known to be determined by both genetic and environmental factors, but a systematic description of how their influences differ by sex, age and global regions is lacking. We conducted an individual-based pooled analysis of 45 twin cohorts from 20 countries, including 180,520 paired measurements at ages 1–19 years. The proportion of height variation explained by shared environmental factors was greatest in early childhood, but these effects remained present until early adulthood. Accordingly, the relative genetic contribution increased with age and was greatest in adolescence (up to 0.83 in boys and 0.76 in girls). Comparing geographic-cultural regions (Europe, North-America and Australia, and East-Asia), genetic variance was greatest in North-America and Australia and lowest in East-Asia, but the relative proportion of genetic variation was roughly similar across these regions. Our findings provide further insights into height variation during childhood and adolescence in populations representing different ethnicities and exposed to different environments. PMID:27333805

  5. Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case-Control Studies.

    Science.gov (United States)

    Rasmussen, Christina B; Kjaer, Susanne K; Albieri, Vanna; Bandera, Elisa V; Doherty, Jennifer A; Høgdall, Estrid; Webb, Penelope M; Jordan, Susan J; Rossing, Mary Anne; Wicklund, Kristine G; Goodman, Marc T; Modugno, Francesmary; Moysich, Kirsten B; Ness, Roberta B; Edwards, Robert P; Schildkraut, Joellen M; Berchuck, Andrew; Olson, Sara H; Kiemeney, Lambertus A; Massuger, Leon F A G; Narod, Steven A; Phelan, Catherine M; Anton-Culver, Hoda; Ziogas, Argyrios; Wu, Anna H; Pearce, Celeste L; Risch, Harvey A; Jensen, Allan

    2017-01-01

    Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according to tumor behavior and histotype. We pooled data from 13 case-control studies, conducted between 1989 and 2009, from the Ovarian Cancer Association Consortium (OCAC), including 9,162 women with ovarian cancers, 2,354 women with borderline tumors, and 14,736 control participants. Study-specific odds ratios were estimated and subsequently combined into a pooled odds ratio using a random-effects model. A history of PID was associated with an increased risk of borderline tumors (pooled odds ratio (pOR) = 1.32, 95% confidence interval (CI): 1.10, 1.58). Women with at least 2 episodes of PID had a 2-fold increased risk of borderline tumors (pOR = 2.14, 95% CI: 1.08, 4.24). No association was observed between PID and ovarian cancer risk overall (pOR = 0.99, 95% CI: 0.83, 1.19); however, a statistically nonsignificantly increased risk of low-grade serous tumors (pOR = 1.48, 95% CI: 0.92, 2.38) was noted. In conclusion, PID was associated with an increased risk of borderline ovarian tumors, particularly among women who had had multiple episodes of PID. Although our results indicated a histotype-specific association with PID, the association of PID with ovarian cancer risk is still somewhat uncertain and requires further investigation. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. THE FEATURES OF RISK ASSESSMENT AT THE CONCLUSION OF THE INDIVIDUAL PROPERTY INSURANCE POLICIES

    Directory of Open Access Journals (Sweden)

    T. Kryvoshlyk

    2014-03-01

    Full Text Available The article reveals the essence of risk assessment in contracting individual insurance as well as its place in underwriting business of the insurance company. It is stated that the mechanism of assessment in contracting certain individual property insurance is to include the following stages; identification of risks, selection of risks and quantitative risk assessment. At the stage of identifying risk in contracting individual property insurance it is suggested the following steps; identification of insurance objects and disclosure of all circumstances involving risk that are relevant to these objects and which will be considered in determining payment for insurance.

  7. Individual risk assessment for intracranial haemorrhage during thrombolytic therapy

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); A.P. Maggioni; G. Knatterud; J.D. Leimberger; P.P.T. de Jaegere (Peter); R.T. van Domburg (Ron); H. Boersma (Eric); M. Grazia Franzosi (M.); R.M. Califf (Robert); R. Schroder; E. Braunwald (Eugene)

    1993-01-01

    textabstractThrombolytic therapy improves outcome in patients with myocardial infarction but is associated with an increased risk of intracranial haemorrhage. For some patients, this risk may outweigh the potential benefits of thrombolytic treatment. Using data from other studies, we developed a mod

  8. PDA: Pooled DNA analyzer

    Directory of Open Access Journals (Sweden)

    Lin Chin-Yu

    2006-04-01

    Full Text Available Abstract Background Association mapping using abundant single nucleotide polymorphisms is a powerful tool for identifying disease susceptibility genes for complex traits and exploring possible genetic diversity. Genotyping large numbers of SNPs individually is performed routinely but is cost prohibitive for large-scale genetic studies. DNA pooling is a reliable and cost-saving alternative genotyping method. However, no software has been developed for complete pooled-DNA analyses, including data standardization, allele frequency estimation, and single/multipoint DNA pooling association tests. This motivated the development of the software, 'PDA' (Pooled DNA Analyzer, to analyze pooled DNA data. Results We develop the software, PDA, for the analysis of pooled-DNA data. PDA is originally implemented with the MATLAB® language, but it can also be executed on a Windows system without installing the MATLAB®. PDA provides estimates of the coefficient of preferential amplification and allele frequency. PDA considers an extended single-point association test, which can compare allele frequencies between two DNA pools constructed under different experimental conditions. Moreover, PDA also provides novel chromosome-wide multipoint association tests based on p-value combinations and a sliding-window concept. This new multipoint testing procedure overcomes a computational bottleneck of conventional haplotype-oriented multipoint methods in DNA pooling analyses and can handle data sets having a large pool size and/or large numbers of polymorphic markers. All of the PDA functions are illustrated in the four bona fide examples. Conclusion PDA is simple to operate and does not require that users have a strong statistical background. The software is available at http://www.ibms.sinica.edu.tw/%7Ecsjfann/first%20flow/pda.htm.

  9. The risk of venous thrombosis in individuals with a history of superficial vein thrombosis and acquired venous thrombotic risk factors.

    Science.gov (United States)

    Roach, Rachel E J; Lijfering, Willem M; van Hylckama Vlieg, Astrid; Helmerhorst, Frans M; Rosendaal, Frits R; Cannegieter, Suzanne C

    2013-12-19

    Superficial vein thrombosis (SVT) increases the risk of venous thrombosis fourfold to sixfold. As most individuals with SVT do not develop venous thrombosis, additional risk factors may explain the risk of developing a venous thrombosis. In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study, we assessed the risk of venous thrombosis in individuals with previous SVT and a mild thrombotic risk factor (smoking or overweight/obesity), a strong risk factor (surgery, hospitalization, plaster cast immobilization, or malignancy), or a reproductive factor in women (oral contraception, postmenopausal hormone therapy, or pregnancy/puerperium). Individuals with previous SVT alone had a 5.5-fold (95% confidence interval [CI], 4.4-6.8) increased risk of venous thrombosis. This was 9.3 (95% CI, 7.2-12.1) combined with a mild thrombotic risk factor, 31.4 (95% CI, 14.6-67.5) with a strong risk factor, and 34.9 (95% CI, 19.1-63.8) in women with a reproductive risk factor. The highest separate risk estimates were found for SVT with surgery (42.5; 95% CI, 10.2-177.6), hospitalization (49.8; 95% CI, 11.9-209.2), or oral contraception (43.0; 95% CI, 15.5-119.3 in women). In conclusion, the risk of venous thrombosis is markedly increased in individuals with previous SVT who have an acquired thrombotic risk factor.

  10. Identifying individuals at risk for fracture in Guatemala.

    Directory of Open Access Journals (Sweden)

    Keaton M Nasser

    Full Text Available INTRODUCTION: The FRAX calculator combines a set of clinical risk factors with country-specific incidence rates to determine the ten-year absolute risk of major osteoporotic fracture. However, regional or country-specific databases from Central American countries are not available. We compared the use of various FRAX databases and the Pluijm algorithm in determining risk of fracture. METHODS: We collected clinical risk factor data needed for the FRAX calculator and Pluijm algorithm of Hispanic women in Guatemala and calculated the FRAX absolute risk measures of major osteoporotic fracture and hip fracture. Subjects were postmenopausal women greater than age 40 with no history of using medication that affect bone. A random sample of 204 women in 34 different regions women in Guatemala City was visited in their homes to complete the surveys. The Pluijm risk score and FRAX risk score using the US Hispanic, Spain, and Mexican databases were calculated. RESULTS: We used the US NOF guidelines for treatment which suggest a treatment threshold for patients with a 10-year hip fracture probability ≥ 3% or a 10-year major osteoporotic fracture risk ≥ 20%. The number of patients meeting the suggested threshold limits for treatment using the Spain and Mexico calculators were identical. There was 100% conformity in threshold limits for both hip and major osteoporotic fracture risk. The mean conformity for any fracture risk between US Hispanic and the other two databases was 97.5%. Conformity was 99.0% based on major osteoporotic fracture and 97.5% based on risk of hip fracture. The Pluijm evaluation shows conformity of 87.2% and 83.3%, respectively, when compared to the US Hispanic and Spain/Mexico FRAX thresholds for risk of fracture. DISCUSSION: Although the different FRAX databases provide variations in the absolute risk of fracture, the overall conformity to treatment thresholds amongst the US Hispanic, Spain, and Mexico databases show the database

  11. Predictors and moderators of outcomes of HIV/STD sex risk reduction interventions in substance abuse treatment programs: a pooled analysis of two randomized controlled trials

    Science.gov (United States)

    2014-01-01

    Background The objective of the current study was to examine predictors and moderators of response to two HIV sexual risk interventions of different content and duration for individuals in substance abuse treatment programs. Methods Participants were recruited from community drug treatment programs participating in the National Institute on Drug Abuse Clinical Trials Network (CTN). Data were pooled from two parallel randomized controlled CTN studies (one with men and one with women) each examining the impact of a multi-session motivational and skills training program, in comparison to a single-session HIV education intervention, on the degree of reduction in unprotected sex from baseline to 3- and 6- month follow-ups. The findings were analyzed using a zero-inflated negative binomial (ZINB) model. Results Severity of drug use (p < .01), gender (p < .001), and age (p < .001) were significant main effect predictors of number of unprotected sexual occasions (USOs) at follow-up in the non-zero portion of the ZINB model (men, younger participants, and those with greater severity of drug/alcohol abuse have more USOs). Monogamous relationship status (p < .001) and race/ethnicity (p < .001) were significant predictors of having at least one USO vs. none (monogamous individuals and African Americans were more likely to have at least one USO). Significant moderators of intervention effectiveness included recent sex under the influence of drugs/alcohol (p < .01 in non-zero portion of model), duration of abuse of primary drug (p < .05 in non-zero portion of model), and Hispanic ethnicity (p < .01 in the zero portion, p < .05 in the non-zero portion of model). Conclusion These predictor and moderator findings point to ways in which patients may be selected for the different HIV sexual risk reduction interventions and suggest potential avenues for further development of the interventions for increasing their effectiveness within certain

  12. Espacio Pool

    OpenAIRE

    2013-01-01

    Espacio Pool es un grupo abierto de usuarios vinculados a la Facultad de Bellas Artes UCM que actúa sobre los márgenes que la circundan. Toma su nombre de los estanques vacíos ubicados en los jardines de la cafetería, y elige el término anglosajón por sus connotaciones relativas a lo participativo y autogestionado. Su objetivo es habitar los espacios de “vacuidad” para que sean efectivos y permutadores. Espacio Pool organiza la celebración de encuentros a partir de la construcción de disposit...

  13. Risk Transfer Formula for Individual and Small Group Markets

    Data.gov (United States)

    U.S. Department of Health & Human Services — Volume 4, Issue 3 of the Medicare and Medicaid Research Review includes three articles describing the Department of Health and Human Services (HHS) developed risk...

  14. Individual versus systemic risk and the Regulator's Dilemma

    National Research Council Canada - National Science Library

    Nicholas Beale; David G. Rand; Heather Battey; Karen Croxson; Robert M. May; Martin A. Nowak

    2011-01-01

    .... Many proposals for financial reform address the need for systemic regulation—that is, regulation focused on the soundness of the whole financial system and not just that of individual institutions...

  15. Vitamin D receptor rs2228570 polymorphism and invasive ovarian carcinoma risk: pooled analysis in five studies within the Ovarian Cancer Association Consortium

    DEFF Research Database (Denmark)

    Lurie, Galina; Wilkens, Lynne R; Thompson, Pamela J

    2011-01-01

    The association of invasive ovarian carcinoma risk with the functional polymorphism rs2228570 (aka rs10735810; FokI polymorphism) in the vitamin D receptor (VDR) gene was examined in 1820 white non-Hispanic cases and 3479 controls in a pooled analysis of five population-based case-control studies...... within the Ovarian Cancer Association Consortium. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Carriers of the rare T allele were at increased risk of ovarian carcinoma compared to women with the CC genotype in all studies combined; each...... analysis provides further evidence that the VDR rs2228570 polymorphism might influence ovarian cancer susceptibility....

  16. Coping strategies in individuals at risk and not at risk of mobile phone addiction

    Directory of Open Access Journals (Sweden)

    Dziurzyńska Ewa

    2016-12-01

    Full Text Available The aim of the present study was to provide an answer to the question of whether, and what, differences in stress coping strategies could be found between university students at risk and those not at risk of mobile phone addiction. The study included 408 students aged 19 to 28 years. The following instruments were used: a sociodemographic questionnaire, the Mobile Phone Addiction Assessment Questionnaire (in Polish, Kwestionariusz do Badania Uzależnienia od Telefonu Komórkowego, KBUTK by Pawłowska and Potembska, and the Coping with Stress Questionnaire (SVF by Janke, Erdmann, and Boucsein, translated into Polish by Januszewska. The results of the study showed that individuals at risk of mobile phone addiction were more likely to cope with stress by seeking substitute gratification, reacting with resignation, passivity, dejection and hopelessness, blaming themselves, pitying themselves and looking for support. They also tended to ruminate over their suffering, withdraw from social interactions, react with aggression and/or take to drinking.

  17. The effects of earthquake measurement concepts and magnitude anchoring on individuals' perceptions of earthquake risk

    Science.gov (United States)

    Celsi, R.; Wolfinbarger, M.; Wald, D.

    2005-01-01

    The purpose of this research is to explore earthquake risk perceptions in California. Specifically, we examine the risk beliefs, feelings, and experiences of lay, professional, and expert individuals to explore how risk is perceived and how risk perceptions are formed relative to earthquakes. Our results indicate that individuals tend to perceptually underestimate the degree that earthquake (EQ) events may affect them. This occurs in large part because individuals' personal felt experience of EQ events are generally overestimated relative to experienced magnitudes. An important finding is that individuals engage in a process of "cognitive anchoring" of their felt EQ experience towards the reported earthquake magnitude size. The anchoring effect is moderated by the degree that individuals comprehend EQ magnitude measurement and EQ attenuation. Overall, the results of this research provide us with a deeper understanding of EQ risk perceptions, especially as they relate to individuals' understanding of EQ measurement and attenuation concepts. ?? 2005, Earthquake Engineering Research Institute.

  18. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Uhre; O'Reilly, Eilis J; Heitmann, Berit Lilienthal

    2009-01-01

    fatty acids or carbohydrates should replace energy from SFAs to prevent CHD. DESIGN: This was a follow-up study in which data from 11 American and European cohort studies were pooled. The outcome measure was incident CHD. RESULTS: During 4-10 y of follow-up, 5249 coronary events and 2155 coronary deaths...

  19. Trichloroethylene risk assessment: Relevance of inter-individual differences

    NARCIS (Netherlands)

    Vermeulen, N.P.E.; Bladeren, van P.J.

    2001-01-01

    Interindividual variability in the disposition and effects of xenobiotics in humans and related inter-species differences should play a major role in human risk assessment. In particular for low-dose exposures to potentially carcinogenic compounds, novel tools and concepts are necessary to assess

  20. The contribution of neighbours to an individual's risk of typhoid outcome.

    Science.gov (United States)

    Chao, D L; Park, J K; Marks, F; Ochiai, R L; Longini, I M; Halloran, M E

    2015-12-01

    An individual's risk of infection from an infectious agent can depend on both the individual's own risk and protective factors and those of individuals in the same community. We hypothesize that an individual's exposure to an infectious agent is associated with the risks of infection of those living nearby, whether their risks are modified by pharmaceutical interventions or by other factors, because of the potential for transmission from them. For example, unvaccinated individuals living in a highly vaccinated community can benefit from indirect protection, or living near more children in a typhoid-endemic region (where children are at highest risk) might result in more exposure to typhoid. We tested this hypothesis using data from a cluster-randomized typhoid vaccine trial. We first estimated each individual's relative risk of confirmed typhoid outcome using their vaccination status and age. We defined a new covariate, potential exposure, to be the sum of the relative risks of all who live within 100 m of each person. We found that potential exposure was significantly associated with an individual's typhoid outcome, and adjusting for potential exposure affected estimates of vaccine efficacy. We suggest that it is useful and feasible to adjust for spatially heterogeneous distributions of individual-level risk factors, but further work is required to develop and test such approaches.

  1. Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes

    NARCIS (Netherlands)

    Kraeima, J.; Siesling, Sabine; Vliegen, Ingrid; Klaase, J.M.; IJzerman, Maarten Joost

    2013-01-01

    Background: Breast cancer follow-up is not tailored to the risk of locoregional recurrences in individual patients or as a function of time. The objective of this study was to identify prognostic factors, and to estimate individual and time dependent locoregional recurrence risk rates, in order to

  2. Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes

    NARCIS (Netherlands)

    Kraeima, J.; Siesling, Sabine; Vliegen, Ingrid; Klaase, J.M.; IJzerman, Maarten Joost

    2013-01-01

    Background: Breast cancer follow-up is not tailored to the risk of locoregional recurrences (LRRs) in individual patients or as a function of time. The objective of this study was to identify prognostic factors and to estimate individual and time-dependent LRR risk rates. Methods: Prognostic factors

  3. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts

    DEFF Research Database (Denmark)

    Madsen, Ida E H; Hannerz, Harald; Nyberg, Solja T

    2013-01-01

    BACKGROUND: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom...... scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field. METHODS: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job...... using random effects meta-analysis. DISCUSSION: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled...

  4. The application of computational fluid dynamics and small-scale physical models to assess the effects of operational practices on the risk to public health within large indoor swimming pools.

    Science.gov (United States)

    Lewis, Lowell; Chew, John; Woodley, Iain; Colbourne, Jeni; Pond, Katherine

    2015-12-01

    Swimming pools provide an excellent facility for exercise and leisure but are also prone to contamination from microbial pathogens. The study modelled a 50-m × 20-m swimming pool using both a small-scale physical model and computational fluid dynamics to investigate how water and pathogens move around a pool in order to identify potential risk spots. Our study revealed a number of lessons for pool operators, designers and policy-makers: disinfection reaches the majority of a full-scale pool in approximately 16 minutes operating at the maximum permissible inlet velocity of 0.5 m/s. This suggests that where a pool is designed to have 15 paired inlets it is capable of distributing disinfectant throughout the water body within an acceptable time frame. However, the study also showed that the exchange rate of water is not uniform across the pool tank and that there is potential for areas of the pool tank to retain contaminated water for significant periods of time. 'Dead spots' exist at either end of the pool where pathogens could remain. This is particularly significant if there is a faecal release into the pool by bathers infected with Cryptosporidium parvum, increasing the potential for waterborne disease transmission.

  5. The Risk of Dupuytren Surgery in Obese Individuals.

    Science.gov (United States)

    Hacquebord, Jacques H; Chiu, Vicki Y; Harness, Neil G

    2017-03-01

    Dupuytren disease is a common benign fibroproliferative disorder causing thickening and shortening of the palmar fascia of the hand. The exact etiology of the disease is unclear but known risk factors such as increased age, male sex, and northern European ethnicity have been established. A link between body mass index (BMI) and Dupuytren disease has not been established previously. The purpose of this study was to test the hypothesis that lower BMI is associated with increased risk for Dupuytren disease diagnosis. After we obtained institutional review board approval, we performed a retrospective review using an electronic medical record and an administrative database from Kaiser Permanente Southern California to identify all enrolled patients there between 2007 and 2014 who were diagnosed with Dupuytren disease. Basic demographic data including age, sex, ethnicity, and BMI were collected. Bivariate and multivariable logistical regression analyses were performed to evaluate for associations between Dupuytren disease and BMI. A total of 2,049,803 patients aged 18 years and older were enrolled in Kaiser Permanente Southern California from 2007 to 2014. During that period, 14,844 patients were identified as having Dupuytren disease. The data were consistent with well-defined demographic trends in Dupuytren disease, with increased rates seen in males, Caucasians, and patients aged 50 years and older. In the multivariable analysis, when controlling for age, race, and sex, the risk of Dupuytren disease was inversely proportional to BMI. The current study showed that higher BMI is associated with decreased odds of having Dupuytren disease. Further work will be required to determine the cause for the apparent relationship between Dupuytren disease and BMI and whether physiologic factors related to obesity may be protective against the development of Dupuytren disease. Prognostic II. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All

  6. Intake of vitamins A, C, and E and folate and the risk of ovarian cancer in a pooled analysis of 10 cohort studies

    Science.gov (United States)

    Koushik, Anita; Wang, Molin; Anderson, Kristin E.; van den Brandt, Piet; Clendenen, Tess V.; Eliassen, A. Heather; Freudenheim, Jo L.; Genkinger, Jeanine M.; Håkansson, Niclas; Marshall, James R.; McCullough, Marjorie L.; Miller, Anthony B.; Robien, Kim; Rohan, Thomas E.; Schairer, Catherine; Schouten, Leo J.; Tworoger, Shelley S.; Wang, Ying; Wolk, Alicja; Zeleniuch-Jacquotte, Anne; Smith-Warner, Stephanie A.

    2016-01-01

    Purpose Vitamins A, C and E and folate have anticarcinogenic properties and thus might protect against cancer. Few known modifiable risk factors for ovarian cancer exist. We examined the associations between dietary and total (food and supplemental) vitamin intake and the risk of invasive epithelial ovarian cancer. Methods The primary data from 10 prospective cohort studies in North America and Europe were analyzed. Vitamin intakes were estimated from validated food frequency questionnaires in each study. Study-specific relative risks (RR) were estimated using the Cox proportional hazards model and then combined using a random-effects model. Results Among 501,857 women, 1,973 cases of ovarian cancer occurred during a maximum follow-up of 7-22 years across studies. Dietary and total intake of each vitamin was not significantly associated with ovarian cancer risk. The pooled multivariate RRs (95% confidence intervals (CIs)) for incremental increases in total intake of each vitamin were 1.02 (0.97-1.07) for vitamin A (increment: 1300 mcg/day), 1.01 (0.99-1.04) for vitamin C (400 mg/day), 1.02 (0.97-1.06) for vitamin E (130 mg/day) and 1.01 (0.96-1.07) for folate (250 mcg/day). Multivitamin use (vs. non-use) was not associated with ovarian cancer risk (pooled multivariate RR=1.00, 95% CI: 0.89-1.12). Associations did not vary substantially by study, or by subgroups of the population. Greater vitamin intakes were associated with modestly higher risks of endometrioid tumors (n=156 cases), but not other histological types. Conclusion These results suggest that consumption of vitamins A, C, and E and folate during adulthood does not play a major role in ovarian cancer risk. PMID:26169298

  7. Balancing individual benefits and risks of warfarin in patients with atrial fibrillation

    NARCIS (Netherlands)

    Van Den Ham, Rianne; Klungel, Olaf H.; Leufkens, Hubert G.M.; Van Staa, Tjeerd P.

    2013-01-01

    Background: Anticoagulation with warfarin reduces the risk of ischaemic stroke in patients with atrial fibrillation (AF) but may increase the risk of bleeding. A positive benefit-risk balance in the overall AF population has been well established, but hardly studied on an individual level.

  8. Discrepancies between estimated and perceived risk of cancer among individuals with hereditary nonpolyposis colorectal cancer

    DEFF Research Database (Denmark)

    Domanska, K; Nilbert, Mef; Soller, M;

    2007-01-01

    Communicating cancer risk and recommending adequate control programs is central for genetic counseling. Individuals affected by hereditary nonpolyposis colorectal cancer (HNPCC) are at about 80% life-time risk of colorectal cancer and for female carriers 40-60% risk of endometrial cancer and 10-1...

  9. Risk for trisomy 21 in offspring of individuals who have relatives with trisomy 21.

    Science.gov (United States)

    Abuelo, D; Barsel-Bowers, G; Busch, W; Pueschel, S; Pezzullo, J

    1986-10-01

    This study was performed to determine if sibs and other relatives of individuals with trisomy 21 are themselves at increased risk for having offspring with trisomy 21. The results suggest that the reproductive risk to these relatives is not increased beyond the risk to the general population.

  10. Assessing risk prediction models using individual participant data from multiple studies

    DEFF Research Database (Denmark)

    Bladbjerg, Else-Marie; Jespersen, Jørgen

    2014-01-01

    -reactive protein and conventional risk factors for coronary heart disease in the Emerging Risk Factors Collaboration, a collation of individual data from multiple prospective studies with an average follow-up duration of 9.8 years (dates varied). We derive risk prediction models using Cox proportional hazards...

  11. Educational Outcomes for Children At-Risk: The Influence of Individual Differences in Children's Temperaments

    Science.gov (United States)

    Al-Hendawi, Maha; Reed, Evelyn

    2012-01-01

    Individual differences in temperament can be protective or risk factors that may enhance or interfere with children's healthy development and educational success. This study examined the concurrent and predictive relationships between temperament, school adjustment, and academic achievement in children at-risk. Seventy-seven children at-risk, ages…

  12. Somatotype of the individuals with lower extremity amputation and its association with cardiovascular risk.

    Science.gov (United States)

    Mozumdar, Arupendra; Roy, Subrata K

    2008-03-01

    Anthropometric somatotyping is one of the methods to describe the shape of the human body, which shows some associations with an individual's health and disease condition, especially with cardiovascular diseases (CVD). Individuals with lower extremity amputation (LEA) are known to be more vulnerable to the cardiovascular risk. The objectives of the present study are to report the somatotype of the individuals having lower extremity amputation, to study the possible variation in somatotype between two groups of amputated individuals, and to study the association between cardiovascular disease risk factor and somatotype components among individuals with locomotor disability. 102 adult male individuals with unilateral lower-extremity amputation residing in Calcutta and adjoining areas were investigated. The anthropometric data for somatotyping and data on cardiovascular risk traits (such as body mass index, blood pressure measurements, blood lipids) have been collected. The somatotyping technique of Carter & Heath (1990) has been followed. The result shows high mean values of endomorphy and mesomorphy components and a low mean value of the ectomorphy component among the amputated individuals having cardiovascular risks. The results of both discriminant analysis and logistic regression analysis show a significant relationship between somatotype components and CVD risk among the individuals with LEA. The findings of the present study support the findings of similar studies conducted on the normal population. Diagnosis of CVD risk condition through somatotyping can be utilized in prevention/treatment management for the individuals with LEA.

  13. Prevalence of RAS mutations and individual variation patterns among patients with metastatic colorectal cancer: A pooled analysis of randomised controlled trials

    NARCIS (Netherlands)

    Peeters, M.; Kafatos, G.; Taylor, A.; Gastanaga, V.M.; Oliner, K.S.; Hechmati, G.; Terwey, J.H.; Krieken, J.H.J.M. van

    2015-01-01

    BACKGROUND: The use of epidermal growth factor receptor inhibitors to treat metastatic colorectal cancer (mCRC) patients requires prior confirmation of tumour wild type (WT) RAS mutation status (exons 2/3/4 for KRAS or NRAS). This retrospective pooled analysis aims to robustly estimate RAS mutation

  14. INDIVIDUAL ABOUT COLLECTIVE RISKS IN SPORT AND POSSIBILITIES THEIR COVER

    Directory of Open Access Journals (Sweden)

    Željko Vojinović

    2011-03-01

    Full Text Available Ones of unavoidable factors by the occupation sports activities and the sport are the sport insurance. Apart from disturb the health, permanently or temporarily, accidents cause occasionally and financial expenses, in smaller or the larger scope of work, depending on from the period of time of rehabilitation emerge violations. The insuring house in that case pays is contracted the amount (the contracted indemnity the insured person. Every participant in the sport contest would need that possesses the personally insurance. Reasons for the processing of subject are in that that most briefly explained themselves and get to know make the insurance of participant in sport, how individuals so and groups for which act or for which work.

  15. Management of dyslipidemia as a cardiovascular risk factor in individuals with nonalcoholic fatty liver disease.

    Science.gov (United States)

    Corey, Kathleen E; Chalasani, Naga

    2014-07-01

    Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of liver disease in the United States and is associated with an increased risk of cardiovascular disease (CVD) and cardiovascular (CV) mortality, independent of traditional cardiovascular risk factors. CVD is one of the most common causes of death among individuals with NAFLD and management of NAFLD must extend beyond liver disease to include CVD risk modification. Clinicians should assess CVD risk with the Framingham Risk Score and screen for CVD risk factors including dyslipidemia, diabetes mellitus, hypertension, tobacco use, and the metabolic syndrome. CVD risk factors, particularly dyslipidemia, require aggressive medical management to reduce the high risk of CVD events and death in individuals with NAFLD.

  16. Examining suicide-risk individuals who go online for suicide-related purposes.

    Science.gov (United States)

    Harris, Keith M; McLean, John P; Sheffield, Jeanie

    2009-01-01

    The objective of this study was to better help those in suicidal crisis by examining the types of suicide-risk individuals who make use of the Internet in relation to their suicidal problems. An anonymous online survey examined suicide-risk individuals who went online for suicide-related purposes (n = 165) and a reference group of suicide-risk individuals with no such experience (n = 125). Suicide-risk individuals who went online for suicide-related purposes, compared with online users who did not, reported greater suicide-risk symptoms, were less likely to seek help, and perceived less social support. Online, many reported more support, felt less alienated, believed they reduced their suicidality, but also sought suicide methods and were likely to visit "pro suicide" sites. Implications include designing help sites that allow peer-to-peer communications and anonymous professional support.

  17. Risks and Opportunities of Individual Growth in Postmodern Society

    Directory of Open Access Journals (Sweden)

    Sorin Tudor MAXIM

    2014-06-01

    Full Text Available The present volume brings together a number of original researches, of good academic value, aimed at analyzing the impact of postmodern society on current human inner growth. These approaches so very different in their areas of coverage - from Figure of Kidult (Bernardini, 2014 and the influence of technology on individual welfare (Choudhury & Barman, 2014 to the impact of consumption theory on the postmodern consumer (Bouagina, 2014 and the relationship between visual feminisms - postmodernism (Manolache, 2014 – could be well suited to the meditations of Senecca (Epistolae 33.11, according to which "the truth is accessible to everyone; it is not fully taken. A lot has remained from it, even for those who come from now on." The volume includes also some new perspectives on building a new ethical expertise model, trying to define the supervision of ethics (Caras, 2014 and a review of the various approaches to the concept of ethnic community, starting from the classical ones and ending with the postmodern ones (Fedor, 2014. Classification-JEL: A23

  18. Study of Commercial Bank Risk Monitoring Model in Individual Consumption Credit

    Institute of Scientific and Technical Information of China (English)

    刘春红

    2003-01-01

    With the development of individual consumption credit (ICC) in China, commercial banks have been exposed to more and more risks. The loan failure has been an important problem that the banking must face and revolve. This paper develops a factor system to explain how the borrower's risk is affected, and then establishes a risk monitoring model with AHP to pre-warn the banks how much the risk is.

  19. Identification of resilient individuals and those at risk for performance deficits under stress

    National Research Council Canada - National Science Library

    Winslow, Brent D; Carroll, Meredith B; Martin, Jonathan W; Surpris, Glenn; Chadderdon, George L

    2015-01-01

    .... The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements...

  20. Premorbid adjustment in individuals at ultra-high risk for developing psychosis

    DEFF Research Database (Denmark)

    Dannevang, Anders; Randers, Lasse; Gondan, Matthias

    2016-01-01

    Objective: Deterioration in premorbid adjustment is related to ultra-high risk (UHR) individuals developing psychosis, but it has not been examined how UHR individuals’ development differs compared to healthy controls. This study investigates differences in premorbid adjustment between UHR...

  1. Elderly individuals with increased risk of falls show postural balance impairment

    OpenAIRE

    Oliveira,Márcio Rogério de; Inokuti,Thiago Tadashi; Bispo,Nuno Noronha da Costa; Oliveira,Deise Aparecida de Almeida Pires; Oliveira, Rodrigo Franco de; Silva Jr.,Rubens Alexandre da

    2015-01-01

    Introduction Falls are a serious public health problem. Objective The aim of this study was to evaluate whether elderly individuals with increased risk of falls have a postural balance deficit, evaluated using a force platform during a one-leg stance. Materials and methods The sample consisted of 94 physically independent elderly individuals from the EELO project. The instruments used were the Downton scale, in order to assess the risk as well as the history of falls, and the force platform t...

  2. Comparing risk profiles of individuals diagnosed with diabetes by OGTT and HbA1c

    DEFF Research Database (Denmark)

    Borg, R; Vistisen, D; Witte, Daniel Rinse;

    2010-01-01

    Glycated haemoglobin (HbA(1c)) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods.......Glycated haemoglobin (HbA(1c)) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods....

  3. Comparing risk profiles of individuals diagnosed with diabetes by OGTT and HbA1c

    DEFF Research Database (Denmark)

    Borg, R; Vistisen, D; Witte, Daniel Rinse

    2010-01-01

    Glycated haemoglobin (HbA(1c)) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods.......Glycated haemoglobin (HbA(1c)) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods....

  4. Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies

    Science.gov (United States)

    Park, Yikyung; Spiegelman, Donna; Hunter, David J.; Albanes, Demetrius; Bergkvist, Leif; Buring, Julie E.; Freudenheim, Jo L.; Giovannucci, Edward; Goldbohm, R. Alexandra; Harnack, Lisa; Kato, Ikuko; Krogh, Vittorio; Leitzmann, Michael F.; Limburg, Paul J.; Marshall, James R.; McCullough, Marjorie L.; Miller, Anthony B.; Rohan, Thomas E.; Schatzkin, Arthur; Shore, Roy; Sieri, Sabina; Stampfer, Meir J.; Virtamo, Jarmo; Weijenberg, Matty; Willett, Walter C.; Wolk, Alicja; Zhang, Shumin M.

    2011-01-01

    Objective To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer. Methods Using the primary data from 13 cohort studies, we estimated study- and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model. Results Among 676,141 men and women, 5,454 colon cancer cases were identified (7–20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76–1.02, >4,000 vs. ≤1,000 μg/day) for vitamin A, 0.81 (0.71–0.92, >600 vs. ≤100 mg/day) for vitamin C, and 0.78 (0.66–0.92, >200 vs. ≤6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81–0.96). Conclusions Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study. PMID:20820901

  5. Associations between unprocessed red and processed meat, poultry, seafood and egg intake and the risk of prostate cancer: A pooled analysis of 15 prospective cohort studies.

    Science.gov (United States)

    Wu, Kana; Spiegelman, Donna; Hou, Tao; Albanes, Demetrius; Allen, Naomi E; Berndt, Sonja I; van den Brandt, Piet A; Giles, Graham G; Giovannucci, Edward; Alexandra Goldbohm, R; Goodman, Gary G; Goodman, Phyllis J; Håkansson, Niclas; Inoue, Manami; Key, Timothy J; Kolonel, Laurence N; Männistö, Satu; McCullough, Marjorie L; Neuhouser, Marian L; Park, Yikyung; Platz, Elizabeth A; Schenk, Jeannette M; Sinha, Rashmi; Stampfer, Meir J; Stevens, Victoria L; Tsugane, Shoichiro; Visvanathan, Kala; Wilkens, Lynne R; Wolk, Alicja; Ziegler, Regina G; Smith-Warner, Stephanie A

    2016-05-15

    Reports relating meat intake to prostate cancer risk are inconsistent. Associations between these dietary factors and prostate cancer were examined in a consortium of 15 cohort studies. During follow-up, 52,683 incident prostate cancer cases, including 4,924 advanced cases, were identified among 842,149 men. Cox proportional hazard models were used to calculate study-specific relative risks (RR) and then pooled using random effects models. Results do not support a substantial effect of total red, unprocessed red and processed meat for all prostate cancer outcomes, except for a modest positive association for tumors identified as advanced stage at diagnosis (advanced(r)). For seafood, no substantial effect was observed for prostate cancer regardless of stage or grade. Poultry intake was inversely associated with risk of advanced and fatal cancers (pooled multivariable RR [MVRR], 95% confidence interval, comparing ≥ 45 vs. <5 g/day: advanced 0.83, 0.70-0.99; trend test p value 0.29), fatal, 0.69, 0.59-0.82, trend test p value 0.16). Participants who ate ≥ 25 versus <5 g/day of eggs (1 egg ∼ 50 g) had a significant 14% increased risk of advanced and fatal cancers (advanced 1.14, 1.01-1.28, trend test p value 0.01; fatal 1.14, 1.00-1.30, trend test p value 0.01). When associations were analyzed separately by geographical region (North America vs. other continents), positive associations between unprocessed red meat and egg intake, and inverse associations between poultry intake and advanced, advanced(r) and fatal cancers were limited to North American studies. However, differences were only statistically significant for eggs. Observed differences in associations by geographical region warrant further investigation.

  6. Immunodeficiency, AIDS-related pneumonia, and risk of lung cancer among HIV-infected individuals.

    Science.gov (United States)

    Marcus, Julia L; Leyden, Wendy A; Chao, Chun R; Horberg, Michael A; Klein, Daniel B; Quesenberry, Charles P; Towner, William J; Silverberg, Michael J

    2017-04-24

    The objective is to clarify the role of immunodeficiency and pneumonia in elevated lung cancer risk among HIV-infected individuals. Cohort study of HIV-infected and HIV-uninfected adults in a large integrated healthcare system in California during 1996-2011. We used Poisson models to obtain rate ratios for lung cancer associated with HIV infection, overall and stratified by recent CD4 cells/μl (HIV-uninfected as reference group), with χ tests for trends across CD4 strata. Fully adjusted models included demographics, cancer risk factors (smoking, drug/alcohol abuse, overweight/obesity), and prior pneumonia. Among 24 768 HIV-infected and 257 600 HIV-uninfected individuals, the lung cancer rate per 100 000 person-years was 66 (n = 80 events) for HIV-infected and 33 (n = 506 events) for HIV-uninfected individuals [rate ratio 2.0, 95% confidence interval (CI): 1.7-2.2]. Overall, HIV-infected individuals were at increased risk of lung cancer after adjustment for demographics and cancer risk factors (rate ratio 1.4, 95% CI: 1.1-1.7), but not after additional adjustment for pneumonia (rate ratio 1.2, 95% CI: 0.9-1.6). Lower CD4 cell counts were associated with higher risk of lung cancer in unadjusted and demographics-adjusted models (P cancer risk factors and pneumonia. Compared with HIV-uninfected individuals, HIV-infected individuals with CD4 less than 200 cells/μl were not at increased risk of lung cancer in fully adjusted models. The increased lung cancer risk among HIV patients is attributable to differences in demographics, risk factors such as smoking, and history of pneumonia. Immunodeficiency does not appear to have an independent effect on lung cancer risk.

  7. Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes.

    Science.gov (United States)

    Kraeima, J; Siesling, S; Vliegen, I M H; Klaase, J M; IJzerman, M J

    2013-08-20

    Breast cancer follow-up is not tailored to the risk of locoregional recurrences (LRRs) in individual patients or as a function of time. The objective of this study was to identify prognostic factors and to estimate individual and time-dependent LRR risk rates. Prognostic factors for LRR were identified by a scoping literature review, expert consultation, and stepwise multivariate regression analysis based on 5 years of data from women diagnosed with breast cancer in the Netherlands in 2005 or 2006 (n=17,762). Inter-patient variability was elucidated by examples of 5-year risk profiles of average-, medium-, and high-risk patients, whereby 6-month interval risks were derived from regression estimates. Eight prognostic factors were identified: age, tumour size, multifocality, gradation, adjuvant chemo-, adjuvant radiation-, hormonal therapy, and triple-negative receptor status. Risk profiles of the low-, average-, and high-risk example patients showed non-uniform distribution of recurrence risks (2.9, 7.6, and 9.2%, respectively, over a 5-year period). Individual risk profiles differ substantially in subgroups of patients defined by prognostic factors for recurrence and over time as defined in 6-month time intervals. To tailor follow-up schedules and to optimise allocation of scarce resources, risk factors, frequency, and duration of follow-up should be taken into account.

  8. Risk of colon cancer and coffee, tea, and sugar-sweetened soft drink intake: Pooled analysis of prospective cohort studies

    NARCIS (Netherlands)

    Zhang, X.; Albanes, D.; Beeson, W.L.; Brandt, P.A. van den; Buring, J.E.; Flood, A.; Freudenheim, J.L.; Giovannucci, E.L.; Goldbohm, R.A.; Jaceldo-Siegl, K.; Jacobs, E.J.; Krogh, V.; Larsson, S.C.; Marshall, J.R.; McCullough, M.L.; Miller, A.B.; Robien, K.; Rohan, T.E.; Schatzkin, A.; Sieri, S.; Spiegelman, D.; Virtamo, J.; Wolk, A.; Willett, W.C.; Zhang, S.M.; Smith-Warner, S.A.

    2010-01-01

    BackgroundThe relationships between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk remain unresolved. MethodsWe investigated prospectively the association between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk in a

  9. Genome-wide association study of subtype-specific epithelial ovarian cancer risk alleles using pooled DNA

    DEFF Research Database (Denmark)

    Earp, Madalene A; Kelemen, Linda E; Magliocco, Anthony M

    2014-01-01

    Epithelial ovarian cancer (EOC) is a heterogeneous cancer with both genetic and environmental risk factors. Variants influencing the risk of developing the less-common EOC subtypes have not been fully investigated. We performed a genome-wide association study (GWAS) of EOC according to subtype by...

  10. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies

    DEFF Research Database (Denmark)

    Yang, Xiaohong R; Chang-Claude, Jenny; Goode, Ellen L;

    2011-01-01

    Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors.......Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors....

  11. Occupation and Risk of Non-Hodgkin Lymphoma and Its Subtypes: A Pooled Analysis from the InterLymph Consortium

    NARCIS (Netherlands)

    't Mannetje, Andrea; De Roos, Anneclaire J; Boffetta, Paolo; Vermeulen, Roel; Benke, Geza; Fritschi, Lin; Brennan, Paul; Foretova, Lenka; Maynadié, Marc; Becker, Nikolaus; Nieters, Alexandra; Staines, Anthony; Campagna, Marcello; Chiu, Brian; Clavel, Jacqueline; de Sanjose, Silvia; Hartge, Patricia; Holly, Elizabeth A; Bracci, Paige; Linet, Martha S; Monnereau, Alain; Orsi, Laurent; Purdue, Mark P; Rothman, Nathaniel; Lan, Qing; Kane, Eleanor; Seniori Costantini, Adele; Miligi, Lucia; Spinelli, John J; Zheng, Tongzhang; Cocco, Pierluigi; Kricker, Anne

    2016-01-01

    BACKGROUND: Various occupations have been associated with an elevated NHL risk but results have been inconsistent across studies. OBJECTIVES: To investigate occupational risk of non-Hodgkin lymphoma (NHL) and four common NHL subtypes with particular focus on occupations of a priori interest. METHODS

  12. Risk of colon cancer and coffee, tea, and sugar-sweetened soft drink intake: Pooled analysis of prospective cohort studies

    NARCIS (Netherlands)

    Zhang, X.; Albanes, D.; Beeson, W.L.; Brandt, P.A. van den; Buring, J.E.; Flood, A.; Freudenheim, J.L.; Giovannucci, E.L.; Goldbohm, R.A.; Jaceldo-Siegl, K.; Jacobs, E.J.; Krogh, V.; Larsson, S.C.; Marshall, J.R.; McCullough, M.L.; Miller, A.B.; Robien, K.; Rohan, T.E.; Schatzkin, A.; Sieri, S.; Spiegelman, D.; Virtamo, J.; Wolk, A.; Willett, W.C.; Zhang, S.M.; Smith-Warner, S.A.

    2010-01-01

    BackgroundThe relationships between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk remain unresolved. MethodsWe investigated prospectively the association between coffee, tea, and sugar-sweetened carbonated soft drink consumption and colon cancer risk in a p

  13. Risk of bilateral visual impairment in individuals with amblyopia: The Rotterdam study

    NARCIS (Netherlands)

    R. van Leeuwen (Redmer); M.J.C. Eijkemans (René); J.R. Vingerling (Hans); A. Hofman (Albert); P.T.V.M. de Jong (Paulus); H.J. Simonsz (Huib)

    2007-01-01

    textabstractBackground: The excess risk of bilateral visual impairment (BVI; bilateral visual acuity <0.5) among individuals with amblyopia is an argument for screening for amblyopia, but data are scarce. Methods: The risk was estimated by determining the incidence of BVI in the Rotterdam Study, a

  14. Job Strain and the risk of stroke: An individual-participant data meta-analysis

    NARCIS (Netherlands)

    Fransson, E.I.; Nyberg, S.T.; Heikkilä, K.; Alfredsson, L.; Bjorner, J.B.; Borritz, M.; Burr, H.; Dragano, N.; Geuskens, G.A.; Goldberg, M.; Hamer, M.; Hooftman, W.E.; Houtman, I.L.; Joensuu, M.; Jokela, M.; Knutsson, A.; Koskenvuo, M.; Koskinen, A.; Kumari, M.; Leineweber, C.; Lunau, T.; Madsen, I.E.H.; Hanson, L.L.M.; Nielsen, M.L.; Nordin, M.; Oksanen, T.; Pentti, J.; Pejtersen, J.H.; Rugulies, R.; Salo, P.; Shipley, M.J.; Steptoe, A.; Suominen, S.B.; Theorell, T.; Toppinen-Tanner, S.; Vahtera, J.; Virtanen, M.; Väänänen, A.; Westerholm, P.J.M.; Westerlund, H.; Zins, M.; Britton, A.; Brunner, E.J.; Singh-Manoux, A.; Batty, G.D.; Kivimäki, M.

    2015-01-01

    BACKGROUND AND PURPOSE: Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain. METHODS: We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort st

  15. Individual-Level Risk Factors for Gun Victimization in a Sample of Probationers

    Science.gov (United States)

    Wells, William; Chermak, Steven

    2011-01-01

    Interventions aimed at preventing the important problem of gun injuries could be improved with an understanding of whether there are unique factors that place individuals at an increased risk of gun victimization. Much remains to be known about the victims of gun violence. The purpose of this article is to assess whether there are individual-level…

  16. Perceptions of cervical cancer risk and screening among transmasculine individuals: patient and provider perspectives.

    Science.gov (United States)

    Agénor, Madina; Peitzmeier, Sarah M; Bernstein, Ida M; McDowell, Michal; Alizaga, Natalie M; Reisner, Sari L; Pardee, Dana J; Potter, Jennifer

    2016-10-01

    Transmasculine people (individuals assigned a female sex at birth who identify as male or masculine) are at risk of cervical cancer. Despite low rates of Pap test use in this population, research examining the determinants of cervical cancer screening among transmasculine individuals is scarce. We conducted in-depth interviews and focus groups with 49 participants (32 transmasculine patients and 17 healthcare providers) in order to examine transmasculine individuals' and healthcare providers' perceptions of cervical cancer risk and screening among individuals on the transmasculine continuum. Overall, patients believed that transmasculine individuals should receive regular Pap tests, especially in the event of gynaecological concerns. While healthcare providers' views varied, many perceived transmasculine individuals to be at low risk of cervical cancer. Contrary to existing screening guidelines, several providers believed that transmasculine individuals who did not engage in penile-vaginal intercourse with cisgender men, expressed discomfort about Pap testing or intended to obtain a hysterectomy might not need to be screened regularly or at all. Our findings underscore the importance of educating patients and providers about cervical cancer risk among transmasculine individuals and establishing evidence-based guidelines for cervical cancer screening in this underserved population.

  17. Individual-Level Risk Factors for Gun Victimization in a Sample of Probationers

    Science.gov (United States)

    Wells, William; Chermak, Steven

    2011-01-01

    Interventions aimed at preventing the important problem of gun injuries could be improved with an understanding of whether there are unique factors that place individuals at an increased risk of gun victimization. Much remains to be known about the victims of gun violence. The purpose of this article is to assess whether there are individual-level…

  18. 28 CFR 105.11 - Individuals not requiring a security risk assessment.

    Science.gov (United States)

    2010-07-01

    ... citizen or national of the United States prior to providing training in the operation of an aircraft with... BACKGROUND CHECKS Aviation Training for Aliens and Other Designated Individuals § 105.11 Individuals not requiring a security risk assessment. (a) Citizens and nationals of the United States. A citizen or...

  19. Determining the optimal number of individual samples to pool for quantification of average herd levels of antimicrobial resistance genes in Danish pig herds using high-throughput qPCR

    DEFF Research Database (Denmark)

    Clasen, Julie; Mellerup, Anders; Olsen, John Elmerdahl

    2016-01-01

    The primary objective of this study was to determine the minimum number of individual fecal samples to pool together in order to obtain a representative sample for herd level quantification of antimicrobial resistance (AMR) genes in a Danish pig herd, using a novel high-throughput qPCR assay....... The secondary objective was to assess the agreement between different methods of sample pooling. Quantification of AMR was achieved using a high-throughput qPCR method to quantify the levels of seven AMR genes (ermB, ermF, sulI, sulII, tet(M), tet(O) and tet(W)). A large variation in the levels of AMR genes...

  20. Computing limits on medicine risks based on collections of individual case reports

    OpenAIRE

    Caster, Ola; Norén, G. Niklas; Edwards, I. Ralph

    2014-01-01

    Background Quantifying a medicine’s risks for adverse effects is crucial in assessing its value as a therapeutic agent. Rare adverse effects are often not detected until after the medicine is marketed and used in large and heterogeneous patient populations, and risk quantification is even more difficult. While individual case reports of suspected harm from medicines are instrumental in the detection of previously unknown adverse effects, they are currently not used for risk quantification. Th...

  1. Effects of residential mobility on individual versus population risk of radon-related lung cancer.

    Science.gov (United States)

    Warner, K E; Courant, P N; Mendez, D

    1995-12-01

    The U.S. Environment Protection Agency (EPA) does not consider the effects of normal patterns of residential mobility in estimating individual radon-related lung cancer risks. As a consequence, the EPA's population risk estimates may have little bearing on individual risks, and remediation of high-radon homes may have only small health benefits for the individual who remediate their homes. Through a stimulation analysis, we examine the effects of residential mobility on random exposure and lung cancer risk. Given normal mobility, only 7% of eventual radon-related mortality among current 30 year old will occur in the 5% currently living in homes above pCi/l (the EPA's action level for remediation) in contrast with you estimate of 31% of deaths when mobility's ignored. About 10 pCi/l the no-mobility assumption implies 10.3% of deaths, compared to only 0.4% when mobility taken into account. We conclude that knowledge of one's current random exposure not necessarily a useful guide to one's risk, especially for residents of the high-radon homes targeted for remediation by the EPA. The risk of such individuals is like to be substantially lower than that implied in the EPA's risk charts. If people currently living in high radon homes remediate their houses, the majority of the resulting health benefits will accrue to future occupants of their homes.

  2. Polymorphisms in Genes of Relevance for Oestrogen and Oxytocin Pathways and Risk of Barrett's Oesophagus and Oesophageal Adenocarcinoma: A Pooled Analysis from the BEACON Consortium.

    Directory of Open Access Journals (Sweden)

    Katarina Lagergren

    Full Text Available The strong male predominance in oesophageal adenocarcinoma (OAC and Barrett's oesophagus (BO continues to puzzle. Hormonal influence, e.g. oestrogen or oxytocin, might contribute.This genetic-epidemiological study pooled 14 studies from three continents, Australia, Europe, and North America. Polymorphisms in 3 key genes coding for the oestrogen pathway (receptor alpha (ESR1, receptor beta (ESR2, and aromatase (CYP19A1, and 3 key genes of the oxytocin pathway (the oxytocin receptor (OXTR, oxytocin protein (OXT, and cyclic ADP ribose hydrolase glycoprotein (CD38, were analysed using a gene-based approach, versatile gene-based test association study (VEGAS.Among 1508 OAC patients, 2383 BO patients, and 2170 controls, genetic variants within ESR1 were associated with BO in males (p = 0.0058 and an increased risk of OAC and BO combined in males (p = 0.0023. Genetic variants within OXTR were associated with an increased risk of BO in both sexes combined (p = 0.0035 and in males (p = 0.0012. We followed up these suggestive findings in a further smaller data set, but found no replication. There were no significant associations between the other 4 genes studied and risk of OAC, BO, separately on in combination, in males and females combined or in males only.Genetic variants in the oestrogen receptor alpha and the oxytocin receptor may be associated with an increased risk of BO or OAC, but replication in other large samples are needed.

  3. Coastal risk management: how to motivate individual economic decisions to lower flood risk?

    NARCIS (Netherlands)

    Filatova, Tatiana; Mulder, J.P.M. P.M.; van der Veen, A.

    2011-01-01

    Coastal flood risk is defined as a product of probability of event and its effect, measured in terms of damage. The paper is focused on coastal management strategies aimed to decrease risk by decreasing potential damage. We review socio-economic literature to show that total flood damage depends on

  4. Risk factors for severe outcomes following 2009 influenza A (H1N1 infection: a global pooled analysis.

    Directory of Open Access Journals (Sweden)

    Maria D Van Kerkhove

    2011-07-01

    Full Text Available BACKGROUND: Since the start of the 2009 influenza A pandemic (H1N1pdm, the World Health Organization and its member states have gathered information to characterize the clinical severity of H1N1pdm infection and to assist policy makers to determine risk groups for targeted control measures. METHODS AND FINDINGS: Data were collected on approximately 70,000 laboratory-confirmed hospitalized H1N1pdm patients, 9,700 patients admitted to intensive care units (ICUs, and 2,500 deaths reported between 1 April 2009 and 1 January 2010 from 19 countries or administrative regions--Argentina, Australia, Canada, Chile, China, France, Germany, Hong Kong SAR, Japan, Madagascar, Mexico, The Netherlands, New Zealand, Singapore, South Africa, Spain, Thailand, the United States, and the United Kingdom--to characterize and compare the distribution of risk factors among H1N1pdm patients at three levels of severity: hospitalizations, ICU admissions, and deaths. The median age of patients increased with severity of disease. The highest per capita risk of hospitalization was among patients <5 y and 5-14 y (relative risk [RR] = 3.3 and 3.2, respectively, compared to the general population, whereas the highest risk of death per capita was in the age groups 50-64 y and ≥65 y (RR = 1.5 and 1.6, respectively, compared to the general population. Similarly, the ratio of H1N1pdm deaths to hospitalizations increased with age and was the highest in the ≥65-y-old age group, indicating that while infection rates have been observed to be very low in the oldest age group, risk of death in those over the age of 64 y who became infected was higher than in younger groups. The proportion of H1N1pdm patients with one or more reported chronic conditions increased with severity (median = 31.1%, 52.3%, and 61.8% of hospitalized, ICU-admitted, and fatal H1N1pdm cases, respectively. With the exception of the risk factors asthma, pregnancy, and obesity, the proportion of

  5. Between-airport heterogeneity in air toxics emissions associated with individual cancer risk thresholds and population risks

    Directory of Open Access Journals (Sweden)

    Levy Jonathan I

    2009-05-01

    Full Text Available Abstract Background Airports represent a complex source type of increasing importance contributing to air toxics risks. Comprehensive atmospheric dispersion models are beyond the scope of many applications, so it would be valuable to rapidly but accurately characterize the risk-relevant exposure implications of emissions at an airport. Methods In this study, we apply a high resolution atmospheric dispersion model (AERMOD to 32 airports across the United States, focusing on benzene, 1,3-butadiene, and benzo [a]pyrene. We estimate the emission rates required at these airports to exceed a 10-6 lifetime cancer risk for the maximally exposed individual (emission thresholds and estimate the total population risk at these emission rates. Results The emission thresholds vary by two orders of magnitude across airports, with variability predicted by proximity of populations to the airport and mixing height (R2 = 0.74–0.75 across pollutants. At these emission thresholds, the population risk within 50 km of the airport varies by two orders of magnitude across airports, driven by substantial heterogeneity in total population exposure per unit emissions that is related to population density and uncorrelated with emission thresholds. Conclusion Our findings indicate that site characteristics can be used to accurately predict maximum individual risk and total population risk at a given level of emissions, but that optimizing on one endpoint will be non-optimal for the other.

  6. The ABC's of Suicide Risk Assessment: Applying a Tripartite Approach to Individual Evaluations.

    Directory of Open Access Journals (Sweden)

    Keith M Harris

    Full Text Available There is considerable need for accurate suicide risk assessment for clinical, screening, and research purposes. This study applied the tripartite affect-behavior-cognition theory, the suicidal barometer model, classical test theory, and item response theory (IRT, to develop a brief self-report measure of suicide risk that is theoretically-grounded, reliable and valid. An initial survey (n = 359 employed an iterative process to an item pool, resulting in the six-item Suicidal Affect-Behavior-Cognition Scale (SABCS. Three additional studies tested the SABCS and a highly endorsed comparison measure. Studies included two online surveys (Ns = 1007, and 713, and one prospective clinical survey (n = 72; Time 2, n = 54. Factor analyses demonstrated SABCS construct validity through unidimensionality. Internal reliability was high (α = .86-.93, split-half = .90-.94. The scale was predictive of future suicidal behaviors and suicidality (r = .68, .73, respectively, showed convergent validity, and the SABCS-4 demonstrated clinically relevant sensitivity to change. IRT analyses revealed the SABCS captured more information than the comparison measure, and better defined participants at low, moderate, and high risk. The SABCS is the first suicide risk measure to demonstrate no differential item functioning by sex, age, or ethnicity. In all comparisons, the SABCS showed incremental improvements over a highly endorsed scale through stronger predictive ability, reliability, and other properties. The SABCS is in the public domain, with this publication, and is suitable for clinical evaluations, public screening, and research.

  7. Exercise-induced improvement in endothelial dysfunction is not mediated by changes in CV risk factors: pooled analysis of diverse patient populations.

    Science.gov (United States)

    Green, Daniel J; Walsh, Jennifer H; Maiorana, Andrew; Best, Matthew J; Taylor, Roger R; O'Driscoll, J Gerard

    2003-12-01

    We have pooled data from a series of our exercise training studies undertaken in groups with a broad range of vascular (dys) function to the examine the hypothesis that exercise-induced improvements in the conduit and/or resistance vessel function are related to improvements in risk factors for cardiovascular (CV) disease. Endothelium-dependent and -independent conduit vessel function were assessed by using wall tracking of high-resolution ultrasound images of the brachial artery response to flow-mediated dilation (FMD) and glyceryl trinitrate. Resistance vessel function was assessed using intrabrachial administration of acetylcholine (ACh), sodium nitroprusside, and NG-monomethyl-l-arginine. Randomized cross-over studies of 8-wk exercise training were undertaken in untreated hypercholesterolemic (n = 11), treated hypercholesterolemic (n = 11), coronary artery disease (n = 10), chronic heart failure (n = 12), Type 2 diabetic (n = 15), and healthy control subjects (n = 16). Exercise training did not significantly alter plasma lipids, blood pressure, blood glucose, waist-to-hip ratio, or body mass index values, despite significant improvement in both FMD and ACh responses. There were no correlations between changes in any risk factor variables and indexes of either resistance or conduit vessel function. We conclude that, in these subjects with antecedent vascular dysfunction, the beneficial effects of relatively short-term exercise training on vascular function are not solely mediated by the effects of exercise on CV risk factors.

  8. Uncertain Futures: Individual Risk and Social Context in Decision-Making in Cancer Screening.

    Science.gov (United States)

    Lee, Simon J Craddock

    2010-04-01

    A core logic of cancer control and prevention, like much in public health, turns on the notion of decision-making under conditions of uncertainty. Population-level data are increasingly used to develop risk profiles, or estimates, that clinicians and the consumer public may use to guide individual decisions about cancer screening. Individual risk perception forms a piece of a larger social economy of decision-making and choice that makes population screening possible. Individual decision-making depends on accessing and interpreting available clinical information, filtered through the lens of personal values and both cognitive and affective behavioral processes. That process is also mediated by changing social roles and interpersonal relationships. This paper begins to elucidate the influence of this "social context" within the complexity of cancer screening. Reflecting on current work in risk and health, I consider how ethnographic narrative methods can enrich this model.

  9. Towards individualized dose constraints: Adjusting the QUANTEC radiation pneumonitis model for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane L; Vogelius, Ivan R.; Farr, Katherina P.

    2014-01-01

    Background. Understanding the dose-response of the lung in order to minimize the risk of radiation pneumonitis (RP) is critical for optimization of lung cancer radiotherapy. We propose a method to combine the dose-response relationship for RP in the landmark QUANTEC paper with known clinical risk......-only QUANTEC model and the model including risk factors. Subdistribution cumulative incidence functions were compared for patients with high/low-risk predictions from the two models, and concordance indices (c-indices) for the prediction of RP were calculated. Results. The reference dose- response relationship...... factors, in order to enable individual risk prediction. The approach is validated in an independent dataset. Material and methods. The prevalence of risk factors in the patient populations underlying the QUANTEC analysis was estimated, and a previously published method to adjust dose...

  10. Hawaii ESI: POOLS (Anchialine Pool Points)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for anchialine pools in Hawaii. Anchialine pools are small, relatively shallow coastal ponds that occur...

  11. Risk score for prediction of 10 year dementia risk in individuals with type 2 diabetes: a cohort study.

    Science.gov (United States)

    Exalto, Lieza G; Biessels, Geert Jan; Karter, Andrew J; Huang, Elbert S; Katon, Wayne J; Minkoff, Jerome R; Whitmer, Rachel A

    2013-11-01

    Although patients with type 2 diabetes are twice as likely to develop dementia as those without this disease, prediction of who has the highest future risk is difficult. We therefore created and validated a practical summary risk score that can be used to provide an estimate of the 10 year dementia risk for individuals with type 2 diabetes. Using data from two longitudinal cohorts of patients with type 2 diabetes (aged ≥60 years) with 10 years of follow-up, we created (n=29,961) and validated (n=2413) the risk score. We built our prediction model by evaluating 45 candidate predictors using Cox proportional hazard models and developed a point system for the risk score based on the size of the predictor's β coefficient. Model prediction was tested by discrimination and calibration methods. Dementia risk per sum score was calculated with Kaplan-Meier estimates. Microvascular disease, diabetic foot, cerebrovascular disease, cardiovascular disease, acute metabolic events, depression, age, and education were most strongly predictive of dementia and constituted the risk score (C statistic 0·736 for creation cohort and 0·746 for validation cohort). The dementia risk was 5·3% (95% CI 4·2-6·3) for the lowest score (-1) and 73·3% (64·8-81·8) for the highest (12-19) sum scores. To the best of our knowledge, this is the first risk score for the prediction of 10 year dementia risk in patients with type 2 diabetes mellitus. The risk score can be used to increase vigilance for cognitive deterioration and for selection of high-risk patients for participation in clinical trials. Kaiser Permanente Community Benefit, National Institute of Health, Utrecht University, ZonMw, and Fulbright. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Job strain and cardiovascular disease risk factors: meta-analysis of individual-participant data from 47,000 men and women.

    Directory of Open Access Journals (Sweden)

    Solja T Nyberg

    Full Text Available BACKGROUND: Job strain is associated with an increased coronary heart disease risk, but few large-scale studies have examined the relationship of this psychosocial characteristic with the biological risk factors that potentially mediate the job strain - heart disease association. METHODOLOGY AND PRINCIPAL FINDINGS: We pooled cross-sectional, individual-level data from eight studies comprising 47,045 participants to investigate the association between job strain and the following cardiovascular disease risk factors: diabetes, blood pressure, pulse pressure, lipid fractions, smoking, alcohol consumption, physical inactivity, obesity, and overall cardiovascular disease risk as indexed by the Framingham Risk Score. In age-, sex-, and socioeconomic status-adjusted analyses, compared to those without job strain, people with job strain were more likely to have diabetes (odds ratio 1.29; 95% CI: 1.11-1.51, to smoke (1.14; 1.08-1.20, to be physically inactive (1.34; 1.26-1.41, and to be obese (1.12; 1.04-1.20. The association between job strain and elevated Framingham risk score (1.13; 1.03-1.25 was attributable to the higher prevalence of diabetes, smoking and physical inactivity among those reporting job strain. CONCLUSIONS: In this meta-analysis of work-related stress and cardiovascular disease risk factors, job strain was linked to adverse lifestyle and diabetes. No association was observed between job strain, clinic blood pressure or blood lipids.

  13. Hepatitis E viral loads in plasma pools for fractionation.

    Science.gov (United States)

    Baylis, Sally A; Corman, Victor M; Ong, Edgar; Linnen, Jeffrey M; Nübling, C Micha; Blümel, Johannes

    2016-10-01

    It is now recognized that blood donors may be silently infected with hepatitis E virus (HEV) and that plasma pools used in the manufacture of plasma-derived medicinal products may also contain detectable virus RNA. The occurrence of HEV-infected blood and plasma donors can vary considerably depending on local epidemiology. Manufacturing plasma pools from North America, Europe, the Middle East, and Asia were examined for the presence of HEV using transcription-mediated amplification of HEV RNA; confirmatory testing was performed using real-time reverse transcription polymerase chain reaction and sequencing. A total of 484 pools were tested. Asian pools were most frequently positive for HEV RNA and had higher viral loads, although none exceeding 300 IU/mL, and the sequenced strains (n = 5) clustered with Genotype 4, including one significantly divergent sequence. Only HEV Genotype 3 was identified in North American (n = 5) and European (n = 5) pools. There was no evidence of HEV in any pools tested from the Middle East. HEV was detected in manufacturing plasma pools from three different continents; viral loads were low-consistent with large pool sizes and moderate levels of HEV viremia at the individual donation level-but are nevertheless informative for risk assessment of plasma-derived medicinal products. Where sequencing was possible, analysis confirmed the presence of viruses consistent with locally circulating genotypes in the respective regions. The absence of HEV in Middle Eastern pools is consistent with the low prevalence of HEV in this region, likely due to low pork consumption. © 2016 AABB.

  14. Serum 25-Hydroxyvitamin D Concentrations ≥40 ng/ml Are Associated with >65% Lower Cancer Risk: Pooled Analysis of Randomized Trial and Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Sharon L McDonnell

    Full Text Available Higher serum 25-hydroxyvitamin D [25(OHD] concentrations have been associated with a lower risk of multiple cancer types across a range of 25(OHD concentrations.To investigate whether the previously reported inverse association between 25(OHD and cancer risk could be replicated, and if a 25(OHD response region could be identified among women aged 55 years and older across a broad range of 25(OHD concentrations.Data from two cohorts representing different median 25(OHD concentrations were pooled to afford a broader range of 25(OHD concentrations than either cohort alone: the Lappe cohort (N = 1,169, a randomized clinical trial cohort (median 25(OHD = 30 ng/ml and the GrassrootsHealth cohort (N = 1,135, a prospective cohort (median 25(OHD = 48 ng/ml. Cancer incidence over a multi-year period (median: 3.9 years was compared according to 25(OHD concentration. Kaplan-Meier plots were developed and the association between 25(OHD and cancer risk was examined with multivariate Cox regression using multiple 25(OHD measurements and spline functions. The study included all invasive cancers excluding skin cancer.Age-adjusted cancer incidence across the combined cohort (N = 2,304 was 840 cases per 100,000 person-years (1,020 per 100,000 person-years in the Lappe cohort and 722 per 100,000 person-years in the GrassrootsHealth cohort. Incidence was lower at higher concentrations of 25(OHD. Women with 25(OHD concentrations ≥40 ng/ml had a 67% lower risk of cancer than women with concentrations <20 ng/ml (HR = 0.33, 95% CI = 0.12-0.90.25(OHD concentrations ≥40 ng/ml were associated with substantial reduction in risk of all invasive cancers combined.

  15. Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Koert N J Burger

    Full Text Available BACKGROUND: Dietary fiber, carbohydrate quality and quantity are associated with mortality risk in the general population. Whether this is also the case among diabetes patients is unknown. OBJECTIVE: To assess the associations of dietary fiber, glycemic load, glycemic index, carbohydrate, sugar, and starch intake with mortality risk in individuals with diabetes. METHODS: This study was a prospective cohort study among 6,192 individuals with confirmed diabetes mellitus (mean age of 57.4 years, and median diabetes duration of 4.4 years at baseline from the European Prospective Investigation into Cancer and Nutrition (EPIC. Dietary intake was assessed at baseline (1992-2000 with validated dietary questionnaires. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs for all-cause and cardiovascular mortality, while adjusting for CVD-related, diabetes-related, and nutritional factors. RESULTS: During a median follow-up of 9.2 y, 791 deaths were recorded, 306 due to CVD. Dietary fiber was inversely associated with all-cause mortality risk (adjusted HR per SD increase, 0.83 [95% CI, 0.75-0.91] and CVD mortality risk (0.76[0.64-0.89]. No significant associations were observed for glycemic load, glycemic index, carbohydrate, sugar, or starch. Glycemic load (1.42[1.07-1.88], carbohydrate (1.67[1.18-2.37] and sugar intake (1.53[1.12-2.09] were associated with an increased total mortality risk among normal weight individuals (BMI≤25 kg/m(2; 22% of study population but not among overweight individuals (P interaction≤0.04. These associations became stronger after exclusion of energy misreporters. CONCLUSIONS: High fiber intake was associated with a decreased mortality risk. High glycemic load, carbohydrate and sugar intake were associated with an increased mortality risk in normal weight individuals with diabetes.

  16. An absolute risk model to identify individuals at elevated risk for pancreatic cancer in the general population.

    Directory of Open Access Journals (Sweden)

    Alison P Klein

    Full Text Available PURPOSE: We developed an absolute risk model to identify individuals in the general population at elevated risk of pancreatic cancer. PATIENTS AND METHODS: Using data on 3,349 cases and 3,654 controls from the PanScan Consortium, we developed a relative risk model for men and women of European ancestry based on non-genetic and genetic risk factors for pancreatic cancer. We estimated absolute risks based on these relative risks and population incidence rates. RESULTS: Our risk model included current smoking (multivariable adjusted odds ratio (OR and 95% confidence interval: 2.20 [1.84-2.62], heavy alcohol use (>3 drinks/day (OR: 1.45 [1.19-1.76], obesity (body mass index >30 kg/m(2 (OR: 1.26 [1.09-1.45], diabetes >3 years (nested case-control OR: 1.57 [1.13-2.18], case-control OR: 1.80 [1.40-2.32], family history of pancreatic cancer (OR: 1.60 [1.20-2.12], non-O ABO genotype (AO vs. OO genotype (OR: 1.23 [1.10-1.37] to (BB vs. OO genotype (OR 1.58 [0.97-2.59], rs3790844(chr1q32.1 (OR: 1.29 [1.19-1.40], rs401681(5p15.33 (OR: 1.18 [1.10-1.26] and rs9543325(13q22.1 (OR: 1.27 [1.18-1.36]. The areas under the ROC curve for risk models including only non-genetic factors, only genetic factors, and both non-genetic and genetic factors were 58%, 57% and 61%, respectively. We estimate that fewer than 3/1,000 U.S. non-Hispanic whites have more than a 5% predicted lifetime absolute risk. CONCLUSION: Although absolute risk modeling using established risk factors may help to identify a group of individuals at higher than average risk of pancreatic cancer, the immediate clinical utility of our model is limited. However, a risk model can increase awareness of the various risk factors for pancreatic cancer, including modifiable behaviors.

  17. Modulation of the Genome and Epigenome of Individuals Susceptible to Autism by Environmental Risk Factors

    Directory of Open Access Journals (Sweden)

    Costas Koufaris

    2015-04-01

    Full Text Available Diverse environmental factors have been implicated with the development of autism spectrum disorders (ASD. Genetic factors also underlie the differential vulnerability to environmental risk factors of susceptible individuals. Currently the way in which environmental risk factors interact with genetic factors to increase the incidence of ASD is not well understood. A greater understanding of the metabolic, cellular, and biochemical events involved in gene x environment interactions in ASD would have important implications for the prevention and possible treatment of the disorder. In this review we discuss various established and more alternative processes through which environmental factors implicated in ASD can modulate the genome and epigenome of genetically-susceptible individuals.

  18. Sex and HIV serostatus differences in decision making under risk among substance-dependent individuals.

    Science.gov (United States)

    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M; Bechara, Antoine; Brand, Matthias

    2016-01-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV- substance-dependent men and women. HIV+ participants made significantly poorer decisions than HIV- participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ substance-dependent individuals (SDIs). Potential factors for the HIV+ women's relatively greater impairment are discussed.

  19. Contribution of Common Infections to Cardiovascular risk in HIV Positive Individuals.

    Science.gov (United States)

    Berquist, Victoria; Hoy, Jennifer F; Trevillyan, Janine M

    HIV-positive individuals are at increased risk for cardiovascular disease due to complex interactions between the increased incidence of traditional cardiovascular risk factors and HIV and antiretroviral-associated inflammation and dyslipidemia. Increasing evidence suggests that a number of important co-pathogens, including cytomegalovirus, hepatitis C virus, and periodontal disease, are likely to also be contributing. Mechanisms such as molecular mimicry and modification of lipids play a role; however, induction of systemic inflammation is the likely key pathogenic link by which this occurs. Treatments to reduce the presence of infection, such as antibiotics, antivirals, or dental hygiene, show potential as modifiers of cardiovascular risk in HIV-positive individuals. This review will discuss the evidence regarding the contribution of these key co-pathogens, Chlamydia pneumoniae, cytomegalovirus, and hepatitis C virus, to cardiovascular risk in HIV-positive individuals. It will also review the roles that inflammation, microbial translocation, and periodontal infection play in promoting cardiovascular disease. The potential cardiovascular benefits of treating these infections with antimicrobials (such as valganciclovir) or improvements in dental hygiene (in the setting of periodontal disease) will be explored. As the life expectancy of HIV-positive individuals increases and the HIV-positive population thus ages, reducing the impact of age-related comorbidities, and particularly cardiovascular disease, will be of increasing importance at both an individual and population level.

  20. Individual and environmental risk factors for dengue and chikungunya seropositivity in North-Eastern Tanzania

    DEFF Research Database (Denmark)

    Kajeguka, Debora C.; Msonga, Maulid; Schiøler, Karin L.

    2017-01-01

    Background: Dengue and chikungunya are mosquito-borne viral diseases of major global health concern. In Tanzania, information on risk factors for dengue and chikungunya is limited. We investigated individual, household, socio-economic, demographic and environmental risk factors for dengue...... of uncovered containers that may serve as breeding sites for mosquitoes, avoiding animal husbandry in the peri-domestic environment and clearing of vegetation surrounding houses. More studies are needed to investigate the association of dengue and G6PD deficiency....

  1. Identification of resilient individuals and those at risk for performance deficits under stress

    OpenAIRE

    Brent eWinslow; Meredith B Carroll; Martin, Jonathan W.; Glenn eSurpris; George L. Chadderdon

    2015-01-01

    Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. H...

  2. Computed tomography imaging of early coronary artery lesions in stable individuals with multiple cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Xi Yang

    2015-04-01

    Full Text Available OBJECTIVES: To investigate the prevalence, extent, severity, and features of coronary artery lesions in stable patients with multiple cardiovascular risk factors. METHODS: Seventy-seven patients with more than 3 cardiovascular risk factors were suspected of having coronary artery disease. Patients with high-risk factors and 39 controls with no risk factors were enrolled in the study. The related risk factors included hypertension, impaired glucose tolerance, dyslipidemia, smoking history, and overweight. The characteristics of coronary lesions were identified and evaluated by 64-slice coronary computed tomography angiography. RESULTS: The incidence of coronary atherosclerosis was higher in the high-risk group than in the no-risk group. The involved branches of the coronary artery, the diffusivity of the lesion, the degree of stenosis, and the nature of the plaques were significantly more severe in the high-risk group compared with the no-risk group (all p < 0.05. CONCLUSION: Among stable individuals with high-risk factors, early coronary artery lesions are common and severe. Computed tomography has promising value for the early screening of coronary lesions.

  3. Prevalence of HIV infection in seronegative high-risk individuals examined by virus isolation and PCR

    DEFF Research Database (Denmark)

    Nielsen, C; Teglbjærg, Lars Stubbe; Pedersen, C

    1991-01-01

    HIV seronegative individuals with high-risk behavior were tested for HIV infection by sensitive virus isolation techniques using T4 lymphocytes and monocyte/macrophages, and by detection of proviral DNA using PCR with three different sets of nested primers. No evidence of HIV infection was found...... among the 31 seronegative high-risk subjects, either by virus isolation of by PCR (97.5% confidence limits, 0-11). Our results indicate that ongoing HIV infection in seronegative persons at high risk of infection is a rare event....

  4. Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts.

    Directory of Open Access Journals (Sweden)

    Emmanuel Stamatakis

    Full Text Available BACKGROUND: There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. METHODS: The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education. RESULTS: In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52-0.89 and cancer (HR = 0.60, 95% CI 0.43-0.85 mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity. CONCLUSIONS: Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

  5. Is the risk of HIV acquisition increased during and immediately after pregnancy? A secondary analysis of pooled HIV community-based studies from the ALPHA network.

    Directory of Open Access Journals (Sweden)

    Milly Marston

    Full Text Available Previous studies of HIV acquisition in pregnancy have been in specific population groups, such as sero-discordant couples which have shown an increased risk of HIV acquisition during pregnancy and studies of sexually active women where the results have been ambiguous. However these studies are unable to tell us what the overall impact of pregnancy is on HIV acquisition in the general population.Data from six community-based HIV cohorts were pooled to give 2,628 sero-conversions and a total of 178,000 person years of observation. Multiple imputation was used to allow for the uncertainty of exact sero-conversion date in surveillance intervals greater than the length of a pregnancy. Results were combined using Rubin's rules to give appropriate error bounds. The analysis was stratified into two periods: pre- and post- widespread availability of prevention of mother-to-child HIV transmission services. This allows us to assess whether there is reporting bias relating to a person's knowledge of their own HIV status which would become more widespread in the latter time period.Results suggest that women while pregnant have a lower risk of acquiring HIV infection over all periods (HRR 0.79, 95%CI 0.70-0.89 than women who were not pregnant. There is no evidence for a difference in the rate of HIV acquisition between postpartum and non-pregnant women (HRR 0.92 95%CI 0.84-1.03.Although there may be immunological reasons for increased risk of HIV acquisition during pregnancy, at a population level this study indicates a lower risk of HIV acquisition for pregnant women. Pregnant women may be more likely to be concordant with their current sexual partner than non-pregnant women, i.e. either already HIV positive prior to the pregnancy or if negative at the time of becoming pregnant more likely to have a negative partner.

  6. Risk of neuroblastoma, birth-related characteristics, congenital malformations and perinatal exposures: A pooled analysis of the ESCALE and ESTELLE French studies (SFCE).

    Science.gov (United States)

    Rios, Paula; Bailey, Helen D; Orsi, Laurent; Lacour, Brigitte; Valteau-Couanet, Dominique; Levy, Dominique; Corradini, Nadège; Leverger, Guy; Defachelles, Anne-Sophie; Gambart, Marion; Sirvent, Nicolas; Thebaud, Estelle; Ducassou, Stéphane; Clavel, Jacqueline

    2016-11-01

    Neuroblastoma (NB), an embryonic tumour arising from neural crest cells, is the most common malignancy among infants. The aetiology of NB is largely unknown. We conducted a pooled analysis to explore whether there is an association between NB and preconception and perinatal factors using data from two French national population-based case-control studies. The mothers of 357 NB cases and 1783 controls younger than 6 years, frequency-matched by age and gender, responded to a telephone interview that focused on demographic, socioeconomic and perinatal characteristics, childhood environment, life-style and maternal reproductive history. Unconditional logistic regression was used to estimate pooled odds ratios and 95% confidence intervals. After controlling for matching variables, study of origin and potential confounders, being born either small (OR 1.4 95% CI 1.0-2.0) or large (OR 1.5 95% CI 1.1-2.2) for gestational age and, among children younger than 18 months, having congenital malformations (OR 3.6 95% CI 1.3-8.9), were significantly associated with NB. Inverse associations were observed with breastfeeding (OR 0.7 95% CI 0.5-1.0) and maternal use of any supplements containing folic acid, vitamins or minerals (OR 0.5 95% CI 0.3-0.9) during the preconception period. Our findings reinforce the hypothesis that fetal growth anomalies and congenital malformations may be associated with an increased risk of NB. Further investigations are needed in order to clarify the role of folic acid supplementation and breastfeeding, given their potential importance in NB prevention.

  7. Participant selection for preventive Regenerative Medicine trials: ethical challenges of selecting individuals at risk.

    Science.gov (United States)

    Niemansburg, Sophie L; Habets, Michelle G J L; Dhert, Wouter J A; van Delden, Johannes J M; Bredenoord, Annelien L

    2015-11-01

    The innovative field of Regenerative Medicine (RM) is expected to extend the possibilities of prevention or early treatment in healthcare. Increasingly, clinical trials will be developed for people at risk of disease to investigate these RM interventions. These individuals at risk are characterised by their susceptibility for developing clinically manifest disease in future due to the existence of degenerative abnormalities. So far, there has been little debate about the ethical appropriateness of including such individuals at risk in clinical trials. We discuss three main challenges of selecting this participant model for testing RM interventions: the challenge of achieving a proportional risk-benefit balance; complexities in the trial design in terms of follow-up and sample size; and the difficulty of obtaining informed consent due to the many uncertainties. We conclude that selecting the model is not ethically justifiable for first-in-man trials with RM interventions due to the high risks and uncertainties. However, the model can be ethically appropriate for testing the efficacy of RM interventions under the following conditions: interventions should be low risk; the degenerative abnormalities (and other risk factors) should be strongly related with disease within a short time frame; robust preclinical evidence of efficacy needs to be present; and the informed consent procedure should contain extra safeguards with regard to communication on uncertainties.

  8. Risk factors of proteinuria in renal cell carcinoma patients treated with VEGF inhibitors: a secondary analysis of pooled clinical trial data.

    Science.gov (United States)

    Sorich, Michael J; Rowland, Andrew; Kichenadasse, Ganessan; Woodman, Richard J; Mangoni, Arduino A

    2016-06-14

    Proteinuria is a common adverse effect of vascular endothelial growth factor targeted agents, particularly in metastatic renal cell carcinoma (mRCC). However, risk factors for proteinuria are poorly defined. Data on 1392 mRCC patients using pazopanib or sunitinib were pooled from two Phase-III clinical trials. Risk factors and prognostic effect of on-therapy proteinuria were evaluated by Cox proportional hazards regression. Any-grade (1-4) and grade 3/4 proteinuria incidence were 15.0% and 3.7%, respectively. Asian ethnicity, diabetes, baseline systolic blood pressure (SBP), pre-existing grade 1 proteinuria and prior nephrectomy were significant independent predictors of either any-grade or grade 3/4 proteinuria. Proteinuria, particularly grade 3/4 (adjusted hazard ratio 0.53 (95% confidence interval 0.30-0.92)), was associated with improved overall survival. In mRCC patients using pazopanib or sunitinib, Asian ethnicity, diabetes, SBP, pre-existing proteinuria and prior nephrectomy were independent predictors of on-therapy proteinuria, which was associated with improved survival.

  9. Prediction of cardiovascular disease mortality by proteinuria and reduced kidney function: pooled analysis of 39,000 individuals from 7 cohort studies in Japan.

    Science.gov (United States)

    Nagata, Masaharu; Ninomiya, Toshiharu; Kiyohara, Yutaka; Murakami, Yoshitaka; Irie, Fujiko; Sairenchi, Toshimi; Miura, Katsuyuki; Okamura, Tomonori; Ueshima, Hirotsugu

    2013-07-01

    There are limited studies addressing whether proteinuria and estimated glomerular filtration rate (eGFR) are independently associated with cardiovascular disease in Asia. Using data from 7 prospective cohorts recruited between 1980 and 1994 in Japan, we assessed the influence of proteinuria (≥1+ on dipstick) and reduced eGFR on the risk of cardiovascular disease mortality in 39,405 participants (40-89 years) without kidney failure. During a 10.1-year follow-up, 1,927 subjects died from cardiovascular disease. Proteinuria was associated with a 1.75-fold (95% confidence interval (CI): 1.44, 2.11) increased risk of cardiovascular disease mortality after adjustment for potential confounding factors. Additionally, the multivariate-adjusted hazard ratio of cardiovascular disease mortality increased linearly with lower eGFR levels (P(trend) cardiovascular disease mortality than those with eGFR of ≥90 mL/minute/1.73 m². Subjects with both proteinuria and eGFR of cardiovascular disease mortality compared with those with neither of these risk factors. There was no evidence of interaction in the relationship between proteinuria and lower eGFR (P(interaction) = 0.77). The present results suggest that proteinuria and lower eGFR are independent risk factors for cardiovascular disease mortality in the Japanese population.

  10. Down Syndrome: what do pregnant women know about their individual risk? A prospective trial.

    Science.gov (United States)

    Strauss, Alexander; Heer, Ivo Markus; Spelsberg, Fritz; Strauss, Carolin

    2013-06-01

    Down Syndrome is the most common chromosomal abnormality causing intellectual disability in western countries. The incidence relates directly to maternal age. Mothers have to face two risks when prenatal diagnosis is concerned: the probability of a congenital aneuploidy in their fetus, on the one hand, and the procedure-related risk of an invasive prenatal intervention, on the other hand. Women need precise information to deal with these risks. The aim of the study was to evaluate women's knowledge about the individual risk of their fetus being affected by Down Syndrome. A structured questionnaire was distributed among all pregnant women who visited the prenatal care unit at Munich University Hospital, Campus Großhadern. Data evaluation was performed using Microsoft Excel 2003 and SPSS 12.0 for Windows. Statistical analysis was achieved by applying the Student t test, with statistical significance defined as p women (96 %) were analyzed. The median gestational age of the study group was 20 (5/7) weeks of gestation [range 5 (1/7)-38 (4/7)]. The median maternal age was 32 years (range 20-41). The collective consisted of 52 % nulliparous, 34 % primiparous and 14 % multiparous women. Their educational history varied with 57 % women who attended high school and 43 % secondary school. Seventy-eight percent (185/237) of these mothers were aware of the fact that a risk of fetal aneuploidy exists, but 22 % (51/237) had never even considered this as an individual risk in their fetus. Most study participants (84 %, 155/185) realized the risk of fetal aneuploidy before conception or at least in early pregnancy. Only 5 % (10/185) of women within late pregnancy considered a chromosomal abnormality as a forthcoming risk for the first time as late as in the second or third trimester. Overall, the women estimated the risk of Down Syndrome being present in their fetus in a ratio of 1:33 (range 1-9,000:10,000); 67 % overestimated the risk and 23 % underrated their individual risk by

  11. Injection Drug Use and Hepatitis C as Risk Factors for Mortality in HIV-Infected Individuals

    DEFF Research Database (Denmark)

    May, Margaret T; Justice, Amy C; Birnie, Kate

    2015-01-01

    BACKGROUND: HIV-infected individuals with a history of transmission through injection drug use (IDU) have poorer survival than other risk groups. The extent to which higher rates of hepatitis C (HCV) infection in IDU explain survival differences is unclear. METHODS: Adults who started antiretrovi...

  12. Beyond the patient: the broader impact of genetic discrimination among individuals at risk of Huntington disease.

    Science.gov (United States)

    Bombard, Yvonne; Palin, JoAnne; Friedman, Jan M; Veenstra, Gerry; Creighton, Susan; Bottorff, Joan L; Hayden, Michael R

    2012-03-01

    We aimed to address gaps in current understanding of the scope and impact of discrimination, by examining a cohort of individuals at-risk for Huntington disease (HD), to describe the prevalence of concern for oneself and one's family in multiple domains; strategies used to mitigate discrimination; and the extent to which concerns relate to experiences. We conducted a cross-sectional survey of 293 individuals at-risk for HD (80% response rate); 167 respondents were genetically tested and 66 were not. Fear of discrimination was widespread (86%), particularly in the insurance, family and social settings. Approximately half of concerned individuals experienced discrimination (40-62%, depending on genetic status). Concern was associated with "keeping quiet" about one's risk of HD or "taking action to avoid" discrimination. Importantly, concern was highly distressing for some respondents (21% for oneself; 32% for relatives). Overall, concerned respondents with high education levels, who discovered their family history at a younger age, and those who were mutation-positive were more likely to report experiences of discrimination than others who were concerned. Concerns were rarely attributed to genetic test results alone. Concern about genetic discrimination is frequent among individuals at-risk of HD and spans many settings. It influences behavioral patterns and can result in high levels of self-rated distress, highlighting the need for practice and policy interventions. © 2012 Wiley Periodicals, Inc.

  13. Total dietary antioxidant capacity, individual antioxidant intake and breast cancer risk: The Rotterdam study

    NARCIS (Netherlands)

    Pantavos, A.; Ruiter, R.; Feskens, E.J.M.; Keyser, de C.E.; Hofman, A.; Stricker, B.H.C.; Franco, O.H.; Kiefte-de Jong, J.C.

    2015-01-01

    Some studies suggest a favorable role of antioxidants on breast cancer risk but this is still inconclusive. The aim of this study was to assess whether overall dietary antioxidant capacity, as assessed by dietary ferric reducing antioxidant potential (FRAP), and individual dietary antioxidant intake

  14. Diet, risk of obesity and socioeconomic circumstances of individuals in the UK: A seemingly unrelated approach

    Directory of Open Access Journals (Sweden)

    Damilola Olajide

    2012-01-01

    Full Text Available Normal 0 false false false EN-GB X-NONE X-NONE Understanding the link between diet, risk of obesity and the underlying socioeconomic circumstances of the individual is useful for health promotion and improvement interventions. In this study, we examined the socioeconomic factors that jointly affect food consumption choices and risk of obesity. We analyse the National Dietary and Nutrition Survey (2000/01 of adults aged 19-64 years living in private households in the UK, using a health production framework. We used information on the complete food history on individuals in the previous week to create eight common food groups. We estimated a system of linear risk of obesity (as measured by Body Mass Index and eight diet equations with error terms that are correlated across equations for a given individual, but are uncorrelated across individuals, using the seemingly unrelated regression method. Our findings indicate that the socioeconomic factors (e.g. income and education associated with sources of healthy eating differ. While increasing household purchasing power may be more effective for increasing consumption of healthier foods such as fruit and vegetables, more knowledge and information about healthy eating may be more effective for cutting down on consumption of less healthy foods (e.g. preserves and savoury foods. An understanding of these different healthy eating contexts is essential for the development of effective targeted food based policies aimed at reducing the risk of obesity. Link to Appendix

  15. Individual Risk Profiling For Breast Cancer Recurrence: Towards Tailored Follow-Up Schemes

    NARCIS (Netherlands)

    Kraeima, J.; Vliegen, I.; Siesling, S.; Klaase, J.; IJzerman, M.J.

    2013-01-01

    Objectives Current international guidelines for breast cancer follow-up are not specific to individual risk of local regional recurrences. Instead, for personalised follow-up it is required to have more precise estimates of local regional recurrence probability as a function of time. The objective o

  16. Individual Tariffs for Mobile Services: Analysis of Operator Business and Risk Consequences

    NARCIS (Netherlands)

    H. Chen (Hong); L-F. Pau (Louis-François)

    2007-01-01

    textabstractA design approach is offered for individual tariffs for mass customized mobile service products, whereby operators can determine their contract acceptance rules to guarantee with a set probability their minimum profit and risk levels. It uses realistic improvements to earlier reported ne

  17. Individual Risk Profiling For Breast Cancer Recurrence: Towards Tailored Follow-Up Schemes

    NARCIS (Netherlands)

    Kraeima, J.; Vliegen, I.; Siesling, Sabine; Klaase, J.; IJzerman, Maarten Joost

    2013-01-01

    Objectives Current international guidelines for breast cancer follow-up are not specific to individual risk of local regional recurrences. Instead, for personalised follow-up it is required to have more precise estimates of local regional recurrence probability as a function of time. The objective

  18. Individual and social determinants of multiple chronic disease behavioral risk factors among youth

    Directory of Open Access Journals (Sweden)

    Alamian Arsham

    2012-03-01

    Full Text Available Abstract Background Behavioral risk factors are known to co-occur among youth, and to increase risks of chronic diseases morbidity and mortality later in life. However, little is known about determinants of multiple chronic disease behavioral risk factors, particularly among youth. Previous studies have been cross-sectional and carried out without a sound theoretical framework. Methods Using longitudinal data (n = 1135 from Cycle 4 (2000-2001, Cycle 5 (2002-2003 and Cycle 6 (2004-2005 of the National Longitudinal Survey of Children and Youth, a nationally representative sample of Canadian children who are followed biennially, the present study examines the influence of a set of conceptually-related individual/social distal variables (variables situated at an intermediate distance from behaviors, and individual/social ultimate variables (variables situated at an utmost distance from behaviors on the rate of occurrence of multiple behavioral risk factors (physical inactivity, sedentary behavior, tobacco smoking, alcohol drinking, and high body mass index in a sample of children aged 10-11 years at baseline. Multiple behavioral risk factors were assessed using a multiple risk factor score. All statistical analyses were performed using SAS, version 9.1, and SUDAAN, version 9.01. Results Multivariate longitudinal Poisson models showed that social distal variables including parental/peer smoking and peer drinking (Log-likelihood ratio (LLR = 187.86, degrees of freedom (DF = 8, p p p p = .05 contributed minimally to the rate of co-occurrence of behavioral risk factors. Conclusions The results suggest targeting individual/social distal variables in prevention programs of multiple chronic disease behavioral risk factors among youth.

  19. Intimate relationships, individual adjustment, and coronary heart disease: Implications of overlapping associations in psychosocial risk.

    Science.gov (United States)

    Smith, Timothy W; Baucom, Brian R W

    2017-09-01

    Being married or involved in a similar intimate relationship is associated with reduced risk of coronary heart disease (CHD). However, the quality of these relationships matters, as strain and disruption are associated with increased risk. These effects are typically studied separately from well-established psychosocial factors for CHD that are aspects of personality and emotional adjustment, even though discord and disruption in intimate relationships are related to these same individual characteristics. Thus, research to date tends to parse correlated risks, often taking a piecemeal approach by focusing on intimate relationships without considering aspects of personality and emotional adjustment that contribute to risk and protection, or focusing on individual-level risks while largely ignoring closely related health-relevant relationships. As an alternative, this article describes an integrative approach, first reviewing associations of the quality of intimate relationships with personality characteristics and aspects of emotional adjustment that confer CHD risk, and then discussing conceptual models of these associations and the biobehavioral mechanisms linking them with CHD. Current approaches to couple interventions are then discussed, including those that have a combined focus on intimate relationship difficulties and emotional adjustment. An integrative agenda for future research emphasizes aggregated risks, combining concepts and methods in current relationship science with those in biobehavioral research on CHD, and including parallel disparities in relationship functioning, emotional adjustment, and CHD risk. Such efforts could ultimately inform empirically based assessments and interventions for interrelated aspects of individuals and their intimate relationships that influence the development and course of CHD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Introduction to "coping with environmental risk and uncertainty: individual and cultural responses".

    Science.gov (United States)

    Ember, Carol R

    2013-03-01

    The papers in this special issue of Human Nature collectively consider societal and individual responses to a wide variety of environmental and social risks. The first paper considers societal level effects of pathogen risk on collectivism and conformity, avoidance of outsiders, and in-group loyalty in a worldwide cross-cultural sample. The second deals with societal-level effects of resource unpredictability on the nature and conduct of warfare in eastern Africa. The third deals with effects of volcanic eruptions and earthquakes and mediating factors on individual perceptions of risk in Mexico and Ecuador. The final paper deals with effects of various types of father absence on women's reproductive life histories in Bangladesh.

  1. All-Cause Mortality Risk of Metabolically Healthy Obese Individuals in NHANES III

    Directory of Open Access Journals (Sweden)

    C. M. Durward

    2012-01-01

    Full Text Available Mortality risk across metabolic health-by-BMI categories in NHANES-III was examined. Metabolic health was defined as: (1 homeostasis model assessment-insulin resistance (HOMA-IR <2.5; (2 ≤2 Adult Treatment Panel (ATP III metabolic syndrome criteria; (3 combined definition using ≤1 of the following: HOMA-IR ≥1.95 (or diabetes medications, triglycerides ≥1.7 mmol/L, HDL-C <1.04 mmol/L (males or <1.30 mmol/L (females, LDL-C ≥2.6 mmol/L, and total cholesterol ≥5.2 mmol/L (or cholesterol-lowering medications. Hazard ratios (HR for all-cause mortality were estimated with Cox regression models. Nonpregnant women and men were included (n=4373, mean ± SD, age 37.1±10.9 years, BMI 27.3±5.8 kg/m2, 49.4% female. Only 40 of 1160 obese individuals were identified as MHO by all definitions. MHO groups had superior levels of clinical risk factors compared to unhealthy individuals but inferior levels compared to healthy lean groups. There was increased risk of all-cause mortality in metabolically unhealthy obese participants regardless of definition (HOMA-IR HR 2.07 (CI 1.3–3.4, P<0.01; ATP-III HR 1.98 (CI 1.4–2.9, P<0.001; combined definition HR 2.19 (CI 1.3–3.8, P<0.01. MHO participants were not significantly different from healthy lean individuals by any definition. While MHO individuals are not at significantly increased risk of all-cause mortality, their clinical risk profile is worse than that of metabolically healthy lean individuals.

  2. Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium

    Science.gov (United States)

    Wyss, Annah; Hashibe, Mia; Chuang, Shu-Chun; Lee, Yuan-Chin Amy; Zhang, Zuo-Feng; Yu, Guo-Pei; Winn, Deborah M.; Wei, Qingyi; Talamini, Renato; Szeszenia-Dabrowska, Neonila; Sturgis, Erich M.; Smith, Elaine; Shangina, Oxana; Schwartz, Stephen M.; Schantz, Stimson; Rudnai, Peter; Purdue, Mark P.; Eluf-Neto, Jose; Muscat, Joshua; Morgenstern, Hal; Michaluart, Pedro; Menezes, Ana; Matos, Elena; Mates, Ioan Nicolae; Lissowska, Jolanta; Levi, Fabio; Lazarus, Philip; La Vecchia, Carlo; Koifman, Sergio; Herrero, Rolando; Hayes, Richard B.; Franceschi, Silvia; Wünsch-Filho, Victor; Fernandez, Leticia; Fabianova, Eleonora; Daudt, Alexander W.; Dal Maso, Luigino; Curado, Maria Paula; Chen, Chu; Castellsague, Xavier; de Carvalho, Marcos Brasilino; Cadoni, Gabriella; Boccia, Stefania; Brennan, Paul; Boffetta, Paolo; Olshan, Andrew F.

    2013-01-01

    Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (Ptrend ≤ 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers. PMID:23817919

  3. Cigarette smoking and lung cancer--relative risk estimates for the major histological types from a pooled analysis of case-control studies.

    Science.gov (United States)

    Pesch, Beate; Kendzia, Benjamin; Gustavsson, Per; Jöckel, Karl-Heinz; Johnen, Georg; Pohlabeln, Hermann; Olsson, Ann; Ahrens, Wolfgang; Gross, Isabelle Mercedes; Brüske, Irene; Wichmann, Heinz-Erich; Merletti, Franco; Richiardi, Lorenzo; Simonato, Lorenzo; Fortes, Cristina; Siemiatycki, Jack; Parent, Marie-Elise; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Zaridze, David; Cassidy, Adrian; Szeszenia-Dabrowska, Neonila; Rudnai, Peter; Lissowska, Jolanta; Stücker, Isabelle; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Rudin, Charles M; Brennan, Paul; Boffetta, Paolo; Straif, Kurt; Brüning, Thomas

    2012-09-01

    Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age-adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8-143.2) for SqCC, 111.3 (95% CI: 69.8-177.5) for SCLC and 21.9 (95% CI: 16.6-29.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5-124.6), 108.6 (95% CI: 50.7-232.8) and 16.8 (95% CI: 9.2-30.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development.

  4. Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.

    Science.gov (United States)

    Wyss, Annah; Hashibe, Mia; Chuang, Shu-Chun; Lee, Yuan-Chin Amy; Zhang, Zuo-Feng; Yu, Guo-Pei; Winn, Deborah M; Wei, Qingyi; Talamini, Renato; Szeszenia-Dabrowska, Neonila; Sturgis, Erich M; Smith, Elaine; Shangina, Oxana; Schwartz, Stephen M; Schantz, Stimson; Rudnai, Peter; Purdue, Mark P; Eluf-Neto, Jose; Muscat, Joshua; Morgenstern, Hal; Michaluart, Pedro; Menezes, Ana; Matos, Elena; Mates, Ioan Nicolae; Lissowska, Jolanta; Levi, Fabio; Lazarus, Philip; La Vecchia, Carlo; Koifman, Sergio; Herrero, Rolando; Hayes, Richard B; Franceschi, Silvia; Wünsch-Filho, Victor; Fernandez, Leticia; Fabianova, Eleonora; Daudt, Alexander W; Dal Maso, Luigino; Curado, Maria Paula; Chen, Chu; Castellsague, Xavier; de Carvalho, Marcos Brasilino; Cadoni, Gabriella; Boccia, Stefania; Brennan, Paul; Boffetta, Paolo; Olshan, Andrew F

    2013-09-01

    Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (Ptrend ≤ 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers.

  5. Towards individualized dose constraints: Adjusting the QUANTEC radiation pneumonitis model for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane L; Vogelius, Ivan R.; Farr, Katherina P.;

    2014-01-01

    Background. Understanding the dose-response of the lung in order to minimize the risk of radiation pneumonitis (RP) is critical for optimization of lung cancer radiotherapy. We propose a method to combine the dose-response relationship for RP in the landmark QUANTEC paper with known clinical risk...... factors, in order to enable individual risk prediction. The approach is validated in an independent dataset. Material and methods. The prevalence of risk factors in the patient populations underlying the QUANTEC analysis was estimated, and a previously published method to adjust dose......-response relationships for clinical risk factors was employed. Effect size estimates (odds ratios) for risk factors were drawn from a recently published meta-analysis. Baseline values for D50 and γ50 were found. The method was tested in an independent dataset (103 patients), comparing the predictive power of the dose......-only QUANTEC model and the model including risk factors. Subdistribution cumulative incidence functions were compared for patients with high/low-risk predictions from the two models, and concordance indices (c-indices) for the prediction of RP were calculated. Results. The reference dose- response relationship...

  6. Clinical characterization and risk profile of individuals seeking genetic counseling for hereditary breast cancer in Brazil.

    Science.gov (United States)

    Palmero, Edenir Inez; Ashton-Prolla, Patricia; da Rocha, José Cláudio C; Vargas, Fernando Regla; Kalakun, Luciane; Blom, Melissa Brauner; Azevedo, Sérgio J; Caleffi, Maira; Giugliani, Roberto; Schüler-Faccini, Lavinia

    2007-06-01

    Hereditary breast cancer (HBC) accounts for 5-10% of breast cancer cases and it significantly increases the lifetime risk of cancer. Our objective was to evaluate the sociodemographic variables, family history of cancer, breast cancer (BC) screening practices and the risk profile of cancer affected or asymptomatic at-risk women that undergo genetic counseling for hereditary breast cancer in public Brazilian cancer genetics services. Estimated lifetime risk of BC was calculated for asymptomatic women using the Gail and Claus models. The majority of women showed a moderate lifetime risk of developing BC, with an average risk of 19.7% and 19.9% by the Gail and Claus models, respectively. The average prior probability of carrying a BRCA1/2 gene mutation was 16.7% and overall only 32% fulfilled criteria for a hereditary breast cancer syndrome as assessed by family history. We conclude that a significant number of individuals at high-risk for HBC syndromes may not have access to the benefits of cancer genetic counseling in these centers. Contributing factors may include insufficient training of healthcare professionals, disinformation of cancer patients; difficult access to genetic testing and/or resistance in seeking such services. The identification and understanding of these barriers is essential to develop specific strategies to effectively achieve cancer risk reduction in this and other countries were clinical cancer genetics is not yet fully established.

  7. Ethical implications for clinical practice and future research in "at risk" individuals.

    Science.gov (United States)

    Singh, Fiza; Mirzakhanian, Heline; Fusar-Poli, Paolo; de la Fuente-Sandoval, Camilo; Cadenhead, Kristin S

    2012-01-01

    The last 15 years have witnessed a shift in schizophrenia research with increasing interest in earlier stages of illness with the hope of early intervention and ultimately prevention of psychotic illness. Large-scale longitudinal studies have identified clinical and biological risk factors associated with increased risk of psychotic conversion, which together with symptomatic and demographic risk factors may improve the power of prediction algorithms for psychotic transition. Despite these advances, 45-70% of at risk subjects in most samples do not convert to frank psychosis, but continue to function well below their age matched counterparts. The issue is of utmost importance in light of the upcoming DSM-V and the possible inclusion of the attenuated psychotic symptoms syndrome (APSS) diagnosis, with clinical and ethical implications. Clinical considerations include feasibility of reliably diagnosing the at risk state in non-academic medical centers, variable psychotic conversion rates, a non-uniform definition of conversion and extensive debate about treatment for individuals with an ill-defined outcome. On the ethical side, diagnosing APSS could lead to unnecessary prescribing of antipsychotics with long-term deleterious consequences, slow research by providing a false sense of comfort in the diagnosis, and have psychosocial implications for those who receive a diagnosis. Thus it may be prudent to engage at risk populations early and to use broad-spectrum treatments with low risk benefit ratios to relieve functional impairments, while simultaneously studying all subsets of the at risk population.

  8. Total dietary antioxidant capacity, individual antioxidant intake and breast cancer risk: the Rotterdam Study.

    Science.gov (United States)

    Pantavos, Athanasios; Ruiter, Rikje; Feskens, Edith F; de Keyser, Catherine E; Hofman, Albert; Stricker, Bruno H; Franco, Oscar H; Kiefte-de Jong, Jessica C

    2015-05-01

    Some studies suggest a favorable role of antioxidants on breast cancer risk but this is still inconclusive. The aim of this study was to assess whether overall dietary antioxidant capacity, as assessed by dietary ferric reducing antioxidant potential (FRAP), and individual dietary antioxidant intake were associated with breast cancer risk. Data was used from women participating in the Rotterdam Study, a prospective cohort study among subjects aged 55 years and older (N = 3,209). FRAP scores and antioxidant intake (i.e., vitamin A, C, E, selenium, flavonoids and carotenoids) was assessed at baseline by a food frequency questionnaire. Incident cases of breast cancer were confirmed through medical reports. During a median follow-up of 17 years, 199 cases with breast cancer were identified. High dietary FRAP score was associated with a lower risk of breast cancer [hazard ratio (HR): 0.68; 95% confidence intervals (CI): 0.49, 0.96]. No overall association between individual antioxidant intake and breast cancer risk was found. However, low intake of alpha carotene and beta carotene was associated with a higher risk of breast cancer among smokers (HR: 2.48; 95% CI: 1.21, 5.12 and HR: 2.31; 95% CI: 1.12, 4.76 for alpha and beta carotene, respectively) and low intake of flavonoids was associated with breast cancer risk in women over the age of 70 (HR: 1.80; 95% CI: 1.09, 2.99). These results suggest that high overall dietary antioxidant capacity is associated with a lower risk of breast cancer. Individual effects of dietary carotenoids and dietary flavonoids may be restricted to subgroups such as smokers and elderly.

  9. An Experimental Investigation of the Incentives to Form Agricultural Marketing Pools.

    Science.gov (United States)

    Hoffman; Libecap; Shachat

    1998-06-01

    This paper presents theoretical extensions and laboratory tests of Hoffman and Libecap's (1994) model of individual firms' incentives to form agricultural marketing pools. The key incentives are lower variance in output prices and economies in scale in marketing. This paper extends the model by formulating the pooling problem as a game of incomplete information in which firms have heterogeneous and private risk attitudes. An experiment is conducted to test the theoretical implications of this model. Statistical analysis of the experimental data supports the model predictions of pooling rates, but also reveals that subjects form systematic probability biases and do not behave as strategically as the model suggests. Copyright 1998 Academic Press.

  10. Individual psychological and social risk factors for violent criminal behavior in adolescents with organic mental disorder

    Directory of Open Access Journals (Sweden)

    Zubkova A.A.

    2016-10-01

    Full Text Available The article describes the risk factors for criminal aggression in adolescents with an organic mental disorder depending on the level of social deviations or severity of pathopsychological factor. The study involved 113 male adolescents aged 15 to 17 years. The main group consisted of juvenile offenders with organic mental disorder. We used the methods of investigation to determine the individual psychological characteristics, we also used structured risk assessment methods. It is shown that risk factors for criminal aggressive behavior in adolescents with organic mental disorder are a high level of proactive and reactive aggression, combined with underdeveloped mechanisms deter aggressive intentions. With the increase of organic disease, these features become more stable. An important role in shaping the aggressive criminal behavior plays an unsuccessful social environment. Interfamily problems, social deprivation, learning difficulties, communication in antisocial groups and substance abuse - all this increases the risk of aggressive illegal actions.

  11. Perceived Risk of Burglary and Fear of Crime: Individual- and Country-Level Mixed Modeling.

    Science.gov (United States)

    Chon, Don Soo; Wilson, Mary

    2016-02-01

    Given the scarcity of prior studies, the current research introduced country-level variables, along with individual-level ones, to test how they are related to an individual's perceived risk of burglary (PRB) and fear of crime (FC), separately, by using mixed-level logistic regression analyses. The analyses of 104,218 individuals, residing in 50 countries, showed that country-level poverty was positively associated with FC only. However, individual-level variables, such as prior property crime victimization and female gender, had consistently positive relationships with both PRB and FC. However, age group and socioeconomic status were inconsistent between those two models, suggesting that PRB and FC are two different concepts. Finally, no significant difference in the pattern of PRB and FC was found between a highly developed group of countries and a less developed one.

  12. Delay discounting, risk-taking, and rejection sensitivity among individuals with Internet and Video Gaming Disorders

    Science.gov (United States)

    Weinstein, Aviv; Abu, Hodaya Ben; Timor, Ayelet; Mama, Yaniv

    2016-01-01

    Background and aims There is a previous evidence for impulsivity in individuals with Internet and Video Gaming Disorders. The aim of this study was to examine whether Internet and video game addictions are associated with experiential delay discounting, risk-taking, and sensitivity to social rejection using computerized tasks and questionnaires. Methods Twenty participants (mean age 24, SD = 1.55) with high score on the Problematic Online Gaming Questionnaire (POGQ) were compared with 20 participants (mean age 24.8, SD = 1.34) with low score on the POGQ. They performed on computerized Balloon Analog Risk Task and Experiential Delay discounting Task (EDT), and filled in the sensitivity to social rejection questionnaire. Results Participants with high POGQ scores had lower measures of delay discounting, higher measures of risk-taking, and higher measures of sensitivity to social rejection compared with participants with low POGQ scores. Discussion The results of this study support the previous evidence of risk-taking and provide new evidence for difficulties in delay discounting and sensitivity to social rejection among those who score high on Internet and video games. Conclusions The results suggest that Internet- and video game-addicted individuals seek immediate gratification and cannot wait for later reward. Furthermore, these individuals spend time in the virtual world, where they feel safe, and avoid social interactions presumably due to fears of social rejection. PMID:27958761

  13. A prospective study of carpal tunnel syndrome: workplace and individual risk factors

    Science.gov (United States)

    Burt, Susan; Deddens, James A; Crombie, Ken; Jin, Yan; Wurzelbacher, Steve; Ramsey, Jessica

    2015-01-01

    Objectives To quantify the risk for carpal tunnel syndrome (CTS) from workplace physical factors, particularly hand activity level and forceful exertion, while taking into account individual factors including age, gender, body mass index (BMI), and pre-existing medical conditions. Methods Three healthcare and manufacturing workplaces were selected for inclusion on the basis of range of exposure to hand activity level and forceful exertion represented by their jobs. Each study participants job tasks were observed and evaluated ’ onsite and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Individual health assessment entailed electrodiagnostic testing of median and ulnar nerves, physical examination and questionnaires at baseline with annual follow-up for 2 years. Results The incidence of dominant hand CTS during the study was 5.11 per 100 person-years (29 cases). Adjusted HRs for dominant hand CTS were as follows: working with forceful exertion ≥20% but job strain. Conclusions Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions. PMID:23788614

  14. Plasma lipidomic profiling of treated HIV-positive individuals and the implications for cardiovascular risk prediction.

    Science.gov (United States)

    Wong, Gerard; Trevillyan, Janine M; Fatou, Benoit; Cinel, Michelle; Weir, Jacquelyn M; Hoy, Jennifer F; Meikle, Peter J

    2014-01-01

    The increased risk of coronary artery disease in human immunodeficiency virus (HIV) positive patients is collectively contributed to by the human immunodeficiency virus and antiretroviral-associated dyslipidaemia. In this study, we investigate the characterisation of the plasma lipid profiles of treated HIV patients and the relationship of 316 plasma lipid species across multiple lipid classes with the risk of future cardiovascular events in HIV-positive patients. In a retrospective case-control study, we analysed plasma lipid profiles of 113 subjects. Cases (n = 23) were HIV-positive individuals with a stored blood sample available 12 months prior to their diagnosis of coronary artery disease (CAD). They were age and sex matched to HIV-positive individuals without a diagnosis of CAD (n = 45) and with healthy HIV-negative volunteers (n = 45). Association of plasma lipid species and classes with HIV infection and cardiovascular risk in HIV were determined. In multiple logistic regression, we identified 83 lipids species and 7 lipid classes significantly associated with HIV infection and a further identified 74 lipid species and 8 lipid classes significantly associated with future cardiovascular events in HIV-positive subjects. Risk prediction models incorporating lipid species attained an area under the receiver operator characteristic curve (AUC) of 0.78 (0.775, 0.785)) and outperformed all other tested markers and risk scores in the identification of HIV-positive subjects with increased risk of cardiovascular events. Our results demonstrate that HIV-positive patients have significant differences in their plasma lipid profiles compared with healthy HIV-negative controls and that numerous lipid species were significantly associated with elevated cardiovascular risk. This suggests a potential novel application for plasma lipids in cardiovascular risk screening of HIV-positive patients.

  15. Impaired trunk stability in individuals at high risk for Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Walter Maetzler

    Full Text Available BACKGROUND: The search for disease-modifying treatments for Parkinson's disease advances, however necessary markers for early detection of the disease are still lacking. There is compelling evidence that changes of postural stability occur at very early clinical stages of Parkinson's disease, making it tempting to speculate that changes in sway performance may even occur at a prodromal stage, and may have the potential to serve as a prodromal marker for the disease. METHODOLOGY/PRINCIPAL FINDINGS: Balance performance was tested in 20 individuals with an increased risk of Parkinson's disease, 12 Parkinson's disease patients and 14 controls using a cross-sectional approach. All individuals were 50 years or older. Investigated groups were similar with respect to age, gender, and height. An accelerometer at the centre of mass at the lower spine quantified sway during quiet semitandem stance with eyes open and closed, as well as with and without foam. With increasing task difficulty, individuals with an increased risk of Parkinson's disease showed an increased variability of trunk acceleration and a decrease of smoothness of sway, compared to both other groups. These differences reached significance in the most challenging condition, i.e. the eyes closed with foam condition. CONCLUSIONS/SIGNIFICANCE: Individuals with an increased risk of Parkinson's disease have subtle signs of a balance deficit under most challenging conditions. This preliminary finding should motivate further studies on sway performance in individuals with an increased risk of Parkinson's disease, to evaluate the potential of this symptom to serve as a biological marker for prodromal Parkinson's disease.

  16. 密闭汽油罐泄漏池火灾风险评估中的参数不确定性分析%Parameter Uncertainty Analysis of Sealed Gasoline Tank Leaking Pool Fire Risk Assessment

    Institute of Scientific and Technical Information of China (English)

    孙东亮; 杜峰; 蒋军成

    2009-01-01

    Major hazards and gasoline characters of pool fire were analyzed. As some uncertain factors of sealed gasoline tank leaking pool fire quantitative risk assessment can not be confirmed, the hazard result from pool fire accident might be uncertain. A risk assessment model of sealed gasoline tank leaking pool fire was developed and based on random sampling guesswork method, uncertainty analysis method was proposed. The method has been expatiated with the accident case. Hurting scope of gasoline pool fire heat radiation and distribution function of death radius was confirmed by computation and statistical analysis. As a result, the death radius, which plays an important part in quantitative risk assessment of pool fire, was obtained.%分析了汽油的危险特性及池火灾的主要特点,针对密闭汽油罐泄漏池火灾定量风险评估中不确定因素导致事故造成的危害结果不确定性问题,建立了密闭汽油罐泄漏池火灾风险评估模型,提出了一种基于随机抽样推测法的不确定性处理方法,计算了池火灾热辐射伤害范围,并通过统计分析确定人员死亡区域遵循的分布函数,进而确定该区域的大小,对于定量评估池火灾事故风险具有重要意义.

  17. Acculturation and other risk factors of depressive disorders in individuals with Turkish migration backgrounds.

    Science.gov (United States)

    Janssen-Kallenberg, Hanna; Schulz, Holger; Kluge, Ulrike; Strehle, Jens; Wittchen, Hans-Ulrich; Wolfradt, Uwe; Koch-Gromus, Uwe; Heinz, Andreas; Mösko, Mike; Dingoyan, Demet

    2017-07-19

    Acculturation is a long-term, multi-dimensional process occurring when subjects of different cultures stay in continuous contact. Previous studies have suggested that elevated rates of depression among different migrant groups might be due to patterns of acculturation and migration related risk factors. This paper focused on prevalence rates of depressive disorders and related risk factors among individuals with Turkish migration backgrounds. A population-based sample of 662 individuals with Turkish migration backgrounds were interviewed by bilingual interviewers using a standardised diagnostic interview for DSM-IV-TR and ICD-10 diagnoses (CIDI DIA-X Version 2.8). Associations between 12-month prevalence rates of depressive disorders with potential risk factors were assessed, including gender, age, socioeconomic status, acculturation status and migration status. 12-month prevalence rates of any depressive disorder were 29.0%, 14.4% of major depressive disorder (MDD) and 14.7% of dysthymia. Older age and low socioeconomic status were most consistently related to higher risks of depressive disorders. Acculturation status showed associations with subtypes of depressive disorder. Associations differed between men and women. Symptom severity of MDD was linked to gender, with females being more affected by severe symptoms. The prevalence of depressive disorders is high in individuals with Turkish migration backgrounds, which can be partly explained by older age, low socioeconomic status and acculturation pressures. Only a limited number of risk factors were assessed. Acculturation in particular is a complex process which might not be sufficiently represented by the applied measures. Further risk factors have to be identified in representative samples of this migrant group.

  18. Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims.

    Science.gov (United States)

    Jacobs, Paul D; Cohen, Michael L; Keenan, Patricia

    2017-04-01

    The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants' health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments. Before these payments were included, for the 30 percent of insurers with the highest claims costs, claims (not including administrative expenses) exceeded premium revenues by $90-$397 per enrollee per month. The effect was reversed after these payments were included, with revenues exceeding claims costs by $0-$49 per month. The risk adjustment and reinsurance programs were relatively well targeted in the first two years. While there is ongoing discussion regarding the future of the ACA, our findings can shed light on how risk-sharing programs can address risk selection among insurers-a pervasive issue in all health insurance markets.

  19. Biomarkers of cardiovascular disease: contributions to risk prediction in individuals with diabetes.

    Science.gov (United States)

    Bachmann, Katherine N; Wang, Thomas J

    2017-09-28

    Cardiovascular disease is a leading cause of death, especially in individuals with diabetes mellitus, whose risk of morbidity and mortality due to cardiovascular disease is markedly increased compared with the general population. There has been growing interest in the identification of biomarkers of cardiovascular disease in people with diabetes. The present review focuses on the current and potential contributions of these biomarkers to predicting cardiovascular risk in individuals with diabetes. At present, certain biomarkers and biomarker combinations can lead to modest improvements in the prediction of cardiovascular disease in diabetes beyond traditional cardiovascular risk factors. Emerging technologies may enable the discovery of novel biomarkers and generate new information about known biomarkers (such as new combinations of biomarkers), which could lead to significant improvements in cardiovascular disease risk prediction. A critical question, however, is whether improvements in risk prediction will affect processes of care and decision making in clinical practice, as this will be required to achieve the ultimate goal of improving clinical outcomes in diabetes.

  20. Significance of genetic information in risk assessment and individual classification using silicosis as a case model

    Energy Technology Data Exchange (ETDEWEB)

    McCanlies, E.; Landsittel, D.P.; Yucesoy, B.; Vallyathan, V.; Luster, M.L.; Sharp, D.S. [NIOSH, Morgantown, WV (United States)

    2002-06-01

    Over the last decade the role of genetic data in epidemiological research has expanded considerably. The authors recently published a case-control study that evaluated the interaction between silica exposure and minor variants in the genes coding for interleukin-1alpha. (IL-1alpha), interleukin-1 receptor antagonist (IL-1RA) and tumor necrosis factor alpha (TNFalpha) as risk factors associated with silicosis, a fibrotic lung disease. In contrast, this report uses data generated from these studies to illustrate the utility of genetic information for the purposes of risk assessment and clinical prediction. Specifically, this study addresses how, given a known exposure, genetic information affects the characterization of risk groups. Relative operating characteristic (ROC) curves were then used to determine the impact of genetic information on individual classification. Logistic regression modeling procedures were used to estimate the predicted probability of developing silicosis. This probability was then used to construct predicted risk deciles, first for a model with occupational exposure only and then for a model containing occupational exposure and genetic main effects and interactions. The results indicate that genetic information plays a valuable role in effectively characterizing risk groups and mechanisms of disease operating in a substantial proportion of the population. However, in the case of fibrotic lung disease caused by silica exposure, information about the presence or absence of the minor variants of IL-1alpha, IL-1RA and TNFalpha is unlikely to be a useful tool for individual classification.

  1. Allele summation of diabetes risk genes predicts impaired glucose tolerance in female and obese individuals.

    Directory of Open Access Journals (Sweden)

    Katarzyna Linder

    Full Text Available INTRODUCTION: Single nucleotide polymorphisms (SNPs in approximately 40 genes have been associated with an increased risk for type 2 diabetes (T2D in genome-wide association studies. It is not known whether a similar genetic impact on the risk of prediabetes (impaired glucose tolerance [IGT] or impaired fasting glycemia [IFG] exists. METHODS: In our cohort of 1442 non-diabetic subjects of European origin (normal glucose tolerance [NGT] n = 1046, isolated IFG n = 142, isolated IGT n = 140, IFG+IGT n = 114, an impact on glucose homeostasis has been shown for 9 SNPs in previous studies in this specific cohort. We analyzed these SNPs (within or in the vicinity of the genes TCF7L2, KCNJ11, HHEX, SLC30A8, WFS1, KCNQ1, MTNR1B, FTO, PPARG for association with prediabetes. RESULTS: The genetic risk load was significantly associated with the risk for IGT (p = 0.0006 in a model including gender, age, BMI and insulin sensitivity. To further evaluate potential confounding effects, we stratified the population on gender, BMI and insulin sensitivity. The association of the risk score with IGT was present in female participants (p = 0.008, but not in male participants. The risk score was significantly associated with IGT (p = 0.008 in subjects with a body mass index higher than 30 kg/m(2 but not in non-obese individuals. Furthermore, only in insulin resistant subjects a significant association between the genetic load and the risk for IGT (p = 0.01 was found. DISCUSSION: We found that T2D genetic risk alleles cause an increased risk for IGT. This effect was not present in male, lean and insulin sensitive subjects, suggesting a protective role of beneficial environmental factors on the genetic risk.

  2. Practical prediction model for the risk of 2-year mortality of individuals in the general population.

    Science.gov (United States)

    Goldfarb-Rumyantzev, Alexander; Gautam, Shiva; Brown, Robert S

    2016-04-01

    This study proposed to validate a prediction model and risk-stratification tool of 2-year mortality rates of individuals in the general population suitable for office practice use. A risk indicator (R) derived from data in the literature was based on only 6 variables: to calculate R for an individual, starting with 0, for each year of age above 60, add 0.14; for a male, add 0.9; for diabetes mellitus, add 0.7; for albuminuria > 30 mg/g of creatinine, add 0.7; for stage ≥ 3 chronic kidney disease (CKD), add 0.9; for cardiovascular disease (CVD), add 1.4; or for both CKD and CVD, add 1.7. We developed a univariate logistic regression model predicting 2-year individual mortality rates. The National Health and Nutrition Examination Survey (NHANES) data set (1999-2004 with deaths through 2006) was used as the target for validation. These 12,515 subjects had a mean age of 48.9 ± 18.1 years, 48% males, 9.5% diabetes, 11.7% albuminuria, 6.8% CVD, 5.4% CKD, and 2.8% both CKD and CVD. Using the risk indicator R alone to predict mortality demonstrated good performance with area under the receiver operating characteristic (ROC) curve of 0.84. Dividing subjects into low-risk (R=0-1.0), low intermediate risk (R > 1.0-3.0), high intermediate risk (R > 3.0-5.0) or high-risk (R > 5.0) categories predicted 2-year mortality rates of 0.52%, 1.44%, 5.19% and 15.24%, respectively, by the prediction model compared with actual mortality rates of 0.29%, 2.48%, 5.13% and 13.40%, respectively. We have validated a model of risk stratification using easily identified clinical characteristics to predict 2-year mortality rates of individuals in the general population. The model demonstrated performance adequate for its potential use for clinical practice and research decisions.

  3. PREVALENCE AND RISK FACTORS FOR RECOVERY OF FILAMENTOUS FUNGI IN INDIVIDUALS WITH CYSTIC FIBROSIS

    Science.gov (United States)

    Sudfeld, Christopher R.; Dasenbrook, Elliott C.; Merz, William G.; Carroll, Karen C.; Boyle, Michael P.

    2014-01-01

    Background Filamentous fungi are frequently recovered from respiratory cultures of individuals with CF. Methods A CF cohort database was utilized to determine filamentous fungal prevalence and risk factors. Results The prevalence of filamentous fungal isolation increased from 2.0% in 1997 to 28.7% in 2007. The odds of isolating filamentous fungi during a quarter was greater in CF adults [pfilamentous fungi in CF at JHH has increased and risk factors include older age, decreased lung function, and chronic oral antibiotics. PMID:20045384

  4. Sex and HIV serostatus differences in decision making under risk among substance dependent individuals

    Science.gov (United States)

    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M.; Bechara, Antoine; Brand, Matthias

    2016-01-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV− substance dependent men and women. HIV+ participants made significantly poorer decisions compared with HIV− participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ SDIs. Potential factors for the HIV+ women’s relatively greater impairment are discussed. PMID:26882176

  5. Comparable long-term mortality risk associated with individual sulfonylureas in diabetes patients with heart failure

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Gislason, Gunnar H; Jørgensen, Casper H

    2011-01-01

    The aim was to investigate the outcomes of individual sulfonylureas in patients with heart failure (HF). Methods All patients hospitalized with HF for the first time in 1997–2006, alive 30 days after discharge, and who received anti-diabetic monotherapy with glimepiride (n = 1097), glibenclamide...... was not dependent on prior acute myocardial infarction or ischemic heart disease (p for interactions >0.3). Conclusions In current clinical practice, it is unlikely that there are considerable differences in risk of mortality associated with individual sulfonylureas in patients with heart failure....

  6. HIV and Sexually Transmitted Disease Testing Behavior Among Adolescent Sexual Minority Males: Analysis of Pooled Youth Risk Behavior Survey Data, 2005-2013.

    Science.gov (United States)

    Sharma, Akshay; Wang, Li Yan; Dunville, Richard; Valencia, Rachel K; Rosenberg, Eli S; Sullivan, Patrick S

    2017-04-01

    Adolescent sexual minority males (ASMM) comprise a high-risk group that may benefit from expanded human immunodeficiency virus (HIV) and sexually transmitted disease (STD) prevention services. The purpose of this study was to estimate the prevalence of HIV and STD testing among ASMM from pooled high school Youth Risk Behavior Surveys (YRBSs). Data came from 26 YRBSs from 2005 to 2013, which included questions on sexual identity and/or sex of sexual contacts and questions on ever being tested for HIV and/or STDs. Multivariable logistic regression was used to identify factors independently associated with lifetime HIV testing among sexually experienced ASMM. Overall, 3027 of 43,037 (6.3%, 95% confidence interval [CI]: 5.8%-6.8%) males were categorized as ASMM. Among 1229 sexually experienced ASMM, 413 (26.6%, 95% CI: 21.8%-31.4%) reported ever being tested for HIV, and among 571 ASMM who reported not using a condom during last intercourse, 192 (29.4%, 95% CI: 21.3%-37.6%) reported testing. A longer duration since first intercourse (≥3 vs. ≤1 year: adjusted prevalence ratio [aPR]: 1.6, 95% CI: 1.0-2.6) and recent intercourse (within the past 3 months vs. earlier: aPR: 2.2, 95% CI: 1.4-3.4) was associated with a higher adjusted prevalence of HIV testing. Sixty-four of 252 (30.2%, 95% CI: 20.0%-40.4%) sexually experienced ASMM reported ever being tested for STDs. Low levels of testing among sexually experienced ASMM, particularly those who reported sex without a condom at last intercourse, highlight the exigency of improving age-appropriate HIV and STD prevention services. Educating healthcare providers to better assess adolescent sexual histories is essential to increasing testing.

  7. A Simple Risk Score for Identifying Individuals with Impaired Fasting Glucose in the Southern Chinese Population

    Directory of Open Access Journals (Sweden)

    Hui Wang

    2015-01-01

    Full Text Available This study aimed to develop and validate a simple risk score for detecting individuals with impaired fasting glucose (IFG among the Southern Chinese population. A sample of participants aged ≥20 years and without known diabetes from the 2006–2007 Guangzhou diabetes cross-sectional survey was used to develop separate risk scores for men and women. The participants completed a self-administered structured questionnaire and underwent simple clinical measurements. The risk scores were developed by multiple logistic regression analysis. External validation was performed based on three other studies: the 2007 Zhuhai rural population-based study, the 2008–2010 Guangzhou diabetes cross-sectional study and the 2007 Tibet population-based study. Performance of the scores was measured with the Hosmer-Lemeshow goodness-of-fit test and ROC c-statistic. Age, waist circumference, body mass index and family history of diabetes were included in the risk score for both men and women, with the additional factor of hypertension for men. The ROC c-statistic was 0.70 for both men and women in the derivation samples. Risk scores of ≥28 for men and ≥18 for women showed respective sensitivity, specificity, positive predictive value and negative predictive value of 56.6%, 71.7%, 13.0% and 96.0% for men and 68.7%, 60.2%, 11% and 96.0% for women in the derivation population. The scores performed comparably with the Zhuhai rural sample and the 2008–2010 Guangzhou urban samples but poorly in the Tibet sample. The performance of pre-existing USA, Shanghai, and Chengdu risk scores was poorer in our population than in their original study populations. The results suggest that the developed simple IFG risk scores can be generalized in Guangzhou city and nearby rural regions and may help primary health care workers to identify individuals with IFG in their practice.

  8. Display of individuality in avoidance behavior and risk assessment of inbred mice

    Directory of Open Access Journals (Sweden)

    Torben eHager

    2014-09-01

    Full Text Available Factors determining individuality are still poorly understood. Rodents are excellent model organisms to study individuality, due to a rich behavioral repertoire and the availability of well-characterized isogenic populations. However, most current behavioral assays for rodents have short test duration in novel test environments and require human interference, which introduce coercion, thereby limiting the assessment of naturally occurring individuality. Thus, we developed an automated behavior system to longitudinally monitor conditioned fear for assessing PTSD-like behavior in individual mice. The system consists of a safe home compartment connected to a risk-prone test compartment (TC. Entry and exploration of the TC is solely based on deliberate choice determined by individual fear responsiveness and fear extinction. In this novel ethological assay, C57BL/6J mice show homogeneous responses after shock exposure (innate fear, but striking variation in long-lasting fear responses based on avoidance and risk assessment (learned fear, including automated stretch-attend posture quantification. TC entry (retention latencies after foot shock differed >24 h and the re-explored TC area differed >50% among inbred mice. Next, we compared two closely related C57BL/6 substrains. Despite substantial individual differences, previously observed higher fear of C57BL/6N versus C57BL/6J mice was reconfirmed, whereas fear extinction was fast and did not differ. The observed variation in fear expression in isogenic mice suggests individual differences in coping style with PTSD-like avoidance. Investigating the assumed epigenetic mechanisms, with reduced interpretational ambiguity and enhanced translational value in this assay, may help improve understanding of personality type-dependent susceptibility and resilience to neuropsychiatric disorders such as PTSD.

  9. Anticipating early fatality: friends', schoolmates' and individual perceptions of fatality on adolescent risk behaviors.

    Science.gov (United States)

    Haynie, Dana L; Soller, Brian; Williams, Kristi

    2014-02-01

    Past research indicates that anticipating adverse outcomes, such as early death (fatalism), is associated positively with adolescents' likelihood of engaging in risky behaviors. Health researchers and criminologists have argued that fatalism influences present risk taking in part by informing individuals' motivation for delaying gratification for the promise of future benefits. While past findings highlight the association between the anticipation of early death and a number of developmental outcomes, no known research has assessed the impact of location in a context characterized by high perceptions of fatality. Using data from Add Health and a sample of 9,584 adolescents (51% female and 71% white) nested in 113 schools, our study builds upon prior research by examining the association between friends', school mates', and individual perceptions of early fatality and adolescent risk behaviors. We test whether friends' anticipation of being killed prior to age 21 or location in a school where a high proportion of the student body subscribes to attitudes of high fatality, is associated with risky behaviors. Results indicate that friends' fatalism is positively associated with engaging in violent delinquency, non-violent delinquency, and drug use after controlling for individual covariates and prior individual risk-taking. Although friends' delinquency accounts for much of the effect of friends' fatalism on violence, none of the potential intervening variables fully explain the effect of friends' fatalism on youth involvement in non-violent delinquency and drug use. Our results underscore the importance of friendship contextual effects in shaping adolescent risk-taking behavior and the very serious consequences perceptions of fatality have for adolescents' involvement in delinquency and drug use.

  10. Assessing individual employee risk factors for occupational asthma in primary aluminium smelting

    Science.gov (United States)

    Barnard, C; McBride, D; Firth, H; Herbison, G

    2004-01-01

    Aims: To assess the significance of individual risk factors in the development of occupational asthma of aluminium smelting (OAAS). Methods: A matched case-control study nested in a cohort of 545 workers employed in areas with moderate to high levels of smelting dust and fume. The cohort comprised those who had their first pre-employment medical examination between 1 July 1982 and 1 July 1995; follow up was until 31 December 2000. Forty five cases diagnosed with OAAS and four controls per case were matched for the same year of pre-employment and age within ±5 years. The pre-employment medical questionnaires were examined, blinded as to case-control status, and information obtained on demographics and details of allergic symptoms, respiratory risk factors, respiratory symptoms, and spirometry. Data from the subsequent medical notes yielded subsequent history of hay fever, family history of asthma, full work history, date of termination or diagnosis, and tobacco smoking history at the end-point. Results: There was a significant positive association between hay fever diagnosed either at or during employment and OAAS (adjusted OR 3.58, 95% CI 1.57 to 8.21). A higher forced expiratory ratio (FEV1/FVC%) at employment reduced the risk of developing OAAS (adjusted OR 0.93, 95% CI 0.88 to 0.99). The risk of OAAS was more than three times higher in individuals with an FER of 70.0–74.9% than in individuals with an FER ⩾80.0% (adjusted OR 3.46, 95% CI 1.01 to 11.89). Conclusions: Individuals with hay fever may be more susceptible to occupational asthma when exposed to airborne irritants in aluminium smelting. The pathological basis may be reduced nasal filtration and increased bronchial hyperresponsiveness. PMID:15208376

  11. Individuals at Risk of Coronary Heart Disease (CHD), its Prevention and Management by an Indigenous Compound

    OpenAIRE

    Dubey, G.P.; Agrawal, Aruna; S. P. Dixit; Pathak, S.R.

    2000-01-01

    A variety of rist factors have been suspected for causing the coronary heart disease. 406 cases of both sex groups with age range of 35 to 55 years were selected from three distinct localities of varanasi city. Individuals who reported single or more risk factors of CHD were isolated from the population of the particular areas. After a detailed preliminary screening of the subjects various physical, physiological, psychological and biochemical measurements were carried out. Other basis of ini...

  12. Individual- and Structural-Level Risk Factors for Suicide Attempts among Transgender Adults

    OpenAIRE

    Perez-Brumer, Amaya; Hatzenbuehler, Mark L.; Oldenburg, Catherine E.; Bockting, Walter

    2015-01-01

    This study assessed individual (i.e., internalized transphobia) and structural forms of stigma as risk factors for suicide attempts among transgender adults. Internalized transphobia was assessed through a 26-item scale including four dimensions: pride, passing, alienation and shame. State-level structural stigma was operationalized as a composite index, including: density of same-sex couples; proportion of Gay-Straight Alliances per public high school; 5 policies related to sexual orientatio...

  13. Individual and combined effects of maternal anemia and prenatal infection on risk for schizophrenia in offspring.

    Science.gov (United States)

    Nielsen, Philip R; Meyer, Urs; Mortensen, Preben B

    2016-04-01

    Maternal iron deficiency and infection during pregnancy have individually been associated with increased risk of schizophrenia in the offspring, but possible interactions between the two remain unidentified thus far. Therefore, we determined the individual and combined effects of maternal infection during pregnancy and prepartum anemia on schizophrenia risk in the offspring. We conducted a population-based study with individual record linkage of the Danish Civil Registration System, the Danish Hospital Register, and the Central Danish Psychiatric Register. In a cohort of Danish singleton births 1,403,183 born between 1977 and 2002, 6729 developed schizophrenia between 1987 and 2012. Cohort members were considered as having a maternal history of anemia if the mother had received a diagnosis of anemia at any time during the pregnancy. Maternal infection was defined based on infections requiring hospital admission during pregnancy. Maternal anemia and infection were both associated with increased risk of schizophrenia in unadjusted analyses (1.45-fold increase for anemia, 95% CI: 1.14-1.82; 1.32-fold increase for infection, 95% CI: 1.17-1.48). The effect of maternal infection remained significant (1.16-fold increase, 95% CI: 1.03-1.31) after adjustment for possible confounding factors. Combined exposure to anemia and an infection increased the effect size to a 2.49-fold increased schizophrenia risk (95% CI: 1.29-4.27). The interaction analysis, however, failed to provide evidence for multiplicative interactions between the two factors. Our findings indicate that maternal anemia and infection have additive but not interactive effects, and therefore, they may represent two independent risk factors of schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Identification of Resilient Individuals and Those at Risk for Performance Deficits under Stress

    Directory of Open Access Journals (Sweden)

    Brent eWinslow

    2015-09-01

    Full Text Available Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.

  15. Identification of resilient individuals and those at risk for performance deficits under stress.

    Science.gov (United States)

    Winslow, Brent D; Carroll, Meredith B; Martin, Jonathan W; Surpris, Glenn; Chadderdon, George L

    2015-01-01

    Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA) reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.

  16. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals.

    Science.gov (United States)

    Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K; Hercberg, Serge; Péneau, Sandrine

    2015-08-24

    In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19-31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products.

  17. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals

    Directory of Open Access Journals (Sweden)

    Pauline Ducrot

    2015-08-01

    Full Text Available In the ongoing debate about front-of-package (FOP nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230. Four labels were evaluated: Guideline Daily Amounts (GDA, Multiple Traffic Lights (MTL, 5-Color Nutrition Label (5-CNL, Green Tick (Tick, along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001. The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR: 20.24; 95% confidence interval (CI: 13.19–31.06. Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products.

  18. Risk of fracture with thiazolidinediones: an individual patient data meta-analysis

    Directory of Open Access Journals (Sweden)

    Marloes T Bazelier

    2013-02-01

    Full Text Available Background: The use of thiazolidinediones (TZDs has been associated with increased fracture risks. Our aim was to estimate the risk of fracture with TZDs in three different healthcare registries, using exactly the same study design, and to perform an individual patient data meta-analysis of these three studies. Methods: Population-based cohort studies were performed utilizing the British General Practice Research Database (GPRD, the Dutch PHARMO Record Linkage System, and the Danish National Health Registers. In all three databases, the exposed cohort consisted of all patients (aged 18+ with at least one prescription of antidiabetic (AD medication. Cox proportional hazards models were used to estimate hazard ratios (HRs of fracture. The total period of follow-up for each patient was divided into periods of current exposure and past exposure, with patients moving between current and past use.Results: In all three registries, the risk of fracture was increased for women who were exposed to TZDs: HR 1.48 [1.37-1.60] in GPRD, HR 1.35 [1.15-1.58] in PHARMO and HR 1.22 [1.03-1.44] in Denmark. Combining the data in an individual patient data meta-analysis resulted, for women, in a 1.4-fold increased risk of any fracture for current TZD users versus other AD drug users (adj. HR 1.44 [1.35-1.53]. For men, there was no increased fracture risk (adj. HR 1.05 [0.96-1.14]. Risks were increased for fractures of the radius/ulna, humerus, tibia/fibula, ankle and foot, but not for hip/femur or vertebral fractures. Current TZD users with more than 25 TZD presciptions ever before had a 1.6-fold increased risk of fracture compared with other AD drug users (HR 1.59 [1.46-1.74].Conclusion: In this study, we consistently found a 1.2- to 1.5-fold increased risk of fractures for women using TZDs, but not for men, across three different healthcare registries. TZD users had an increased risk for fractures of the extremities, and risks further increased for prolonged users

  19. Descriptive and numeric estimation of risk for psychotic disorders among affected individuals and relatives: implications for clinical practice.

    Science.gov (United States)

    Austin, Jehannine C; Hippman, Catriona; Honer, William G

    2012-03-30

    Studies show that individuals with psychotic illnesses and their families want information about psychosis risks for other relatives. However, deriving accurate numeric probabilities for psychosis risk is challenging, and people have difficulty interpreting probabilistic information; thus, some have suggested that clinicians should use risk descriptors, such as "moderate" or "quite high", rather than numbers. Little is known about how individuals with psychosis and their family members use quantitative and qualitative descriptors of risk in the specific context of chance for an individual to develop psychosis. We explored numeric and descriptive estimations of psychosis risk among individuals with psychotic disorders and unaffected first-degree relatives. In an online survey, respondents numerically and descriptively estimated risk for an individual to develop psychosis in scenarios where they had: A) no affected family members; and B) an affected sibling. Participants comprised 219 affected individuals and 211 first-degree relatives participated. Affected individuals estimated significantly higher risks than relatives. Participants attributed all descriptors between "very low" and "very high" to probabilities of 1%, 10%, 25% and 50%+. For a given numeric probability, different risk descriptors were attributed in different scenarios. Clinically, brief interventions around risk (using either probabilities or descriptors alone) are vulnerable to miscommunication and potentially negative consequences-interventions around risk are best suited to in-depth discussion.

  20. Twelve-single nucleotide polymorphism genetic risk score identifies individuals at increased risk for future atrial fibrillation and stroke.

    Science.gov (United States)

    Tada, Hayato; Shiffman, Dov; Smith, J Gustav; Sjögren, Marketa; Lubitz, Steven A; Ellinor, Patrick T; Louie, Judy Z; Catanese, Joseph J; Engström, Gunnar; Devlin, James J; Kathiresan, Sekar; Melander, Olle

    2014-10-01

    Atrial fibrillation (AF) is prevalent and there is a clinical need for biomarkers to identify individuals at higher risk for AF. Fixed throughout a life course and assayable early in life, genetic biomarkers may meet this need. Here, we investigate whether multiple single nucleotide polymorphisms together as an AF genetic risk score (AF-GRS) can improve prediction of one's risk for AF. In 27 471 participants of the Malmö Diet and Cancer Study, a prospective, community-based cohort, we used Cox models that adjusted for established AF risk factors to assess the association of AF-GRS with incident AF and ischemic stroke. Median follow-up was 14.4 years for incident AF and 14.5 years for ischemic stroke. The AF-GRS comprised 12 single nucleotide polymorphisms that had been previously shown to be associated with AF at genome-wide significance. During follow-up, 2160 participants experienced a first AF event and 1495 had a first ischemic stroke event. Participants in the top AF-GRS quintile were at increased risk for incident AF (hazard ratio, 2.00; 95% confidence interval, 1.73-2.31; P=2.7×10(-21)) and ischemic stroke (hazard ratio, 1.23; 95% confidence interval, 1.04-1.46; P=0.02) when compared with the bottom quintile. Addition of the AF-GRS to established AF risk factors modestly improved both discrimination and reclassification (Pstroke. Targeting diagnostic or therapeutic interventions to this subset may prove clinically useful. © 2014 American Heart Association, Inc.

  1. STUDY OF ANAEMIA AS AN INDIVIDUAL RISK FACTOR IN CVA : ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    Prabhu

    2015-07-01

    Full Text Available To identify anaemia as an individual risk factor in CVA patients , in rural population , Chidambaram. In our study a total of 50 patients were identified in a 3 month non - invasive prospective observational study. The risk factors such as anaemia , diabetes , hypertension , smoking and alcohol consumption , were compared. In our study out of 41 males and 9 females the incidence rate of anaemia was found to be more in males than females. Microcytic Hypochromic anaemia and Dimorphic anaemia are the common types of anaemia identified. The stroke incidence rate was found to be more in hypertensive patients , secondary to anaemia and equal in both alcoholic and non - alcoholic patients. Anaemia was found to be the most common risk factor for stroke followed by hypertension in rural population.

  2. Health behaviour among adolescents in Denmark: influence of school class and individual risk factors

    DEFF Research Database (Denmark)

    Johansen, Anette; Rasmussen, Søren; Madsen, Mette

    2006-01-01

    AIMS: The aim of this study was to assess the relative influence of school class on health behaviour among adolescents versus that of the family's socioeconomic status and individual factors among adolescents. METHODS: The material comprised 3,458 students in grades 8 and 9 in 244 school classes...... the mother's socioeconomic status and the included health behaviour measurements; however, adolescents from the lower socioeconomic groups had a higher risk of unhealthy dietary habits and adolescents whose mothers were unemployed had a significantly lower risk of drinking alcohol weekly versus all other...... adolescents. Not living with both biological parents, focusing on friends, and not being very academically proficient were associated with an increased risk of harmful health behaviour. Health behaviour varied substantially between school classes, especially for daily smoking, weekly alcohol consumption...

  3. [Occupational toxic exposure in the pregnant woman. 1: principles fo individual risk assessment ].

    Science.gov (United States)

    Testud, F; Lambert-Chhum, R; Bellemin, B; Descotes, J

    2001-12-01

    Many women of childbearing age are occupationally exposed to chemicals and concerned with the ensuing risk when pregnant. To describe the principles of individual risk assessment to be applied in pregnant women or women wishing to become pregnant that are exposed to chemicals at the workplace. Each request for risk assessment is based on a comprehensive review of the hazards of the handled products together with a thorough evaluation of the actual exposure at the workplace. A toxicological advice is then written to the gynecologist or the general practitioner in charge of the patient. When the exposure is estimated to be hazardous for the pregnancy, either total withdrawal, avoidance of certain activities or improvements of individual protective devices are recommended. The outcome of the pregnancy is systematically followed-up. An objective assessment of toxic risks in pregnant women exposed to chemicals at the workplace can be done. Thus, patients who must be withdrawn or benefit from improvements of their workstation can be selected.

  4. Fall risk assessment using the Tinetti mobility test in individuals with Huntington's disease.

    Science.gov (United States)

    Kloos, Anne D; Kegelmeyer, Deb A; Young, Gregory S; Kostyk, Sandra K

    2010-12-15

    The Tinetti Mobility Test (TMT) is a clinical balance and gait test that predicts fall risk in the elderly. This study examined the concurrent validity, usefulness of the TMT as a fall risk screening tool, and the potential ability of the TMT to predict falls in individuals with Huntington's disease (HD). Data from a retrospective review of 94 patient records were used. TMT scores were correlated with Unified Huntington Disease Rating Scale (UHDRS) motor scores. The ability of the TMT to accurately assess fall risk was determined using validity index measures. Logistic regression was used to assess the ability of the TMT to predict falls. TMT scores correlated with UHDRS motor scores (r(s) = -0.751, P < 0.0001). Using a cutoff value of 21, the TMT had a sensitivity of 74% and a specificity of 60% to identify fallers. Lower TMT scores and younger age were significant predictors of falls. The TMT is a valid tool for assessing balance and gait status and fall risk of individuals with HD.

  5. Multilevel analysis of workplace and individual risk factors for long-term sickness absence

    DEFF Research Database (Denmark)

    Labriola, Merete; Christensen, Karl B; Lund, Thomas

    2006-01-01

    OBJECTIVE: The objective of this study was to examine if psychosocial and physical work-environment factors predict long-term sickness absence (>8 weeks) at both the individual and the workplace level. MATERIAL AND METHODS: Data were collected in a prospective study in 52 Danish workplaces....... Psychosocial factors were aggregated as workplace means. We used multilevel logistic regression models with psychosocial factors as predictors of long-term sickness absence over 5 years based on data from a national absence register. RESULTS: Long-term sickness absence was predicted by physical work......-environment factors at the individual level and psychosocial work environment factors at the workplace level. Interaction between the individual physical and workplace-level psychosocial risk factors was found. CONCLUSION: Workplace-based absence reduction interventions can be enhanced by concurrently addressing...

  6. Negative symptoms mediate the relationship between neurocognition and function in individuals at ultrahigh risk for psychosis

    DEFF Research Database (Denmark)

    Glenthøj, L B; Jepsen, J R M; Hjorthøj, C

    2017-01-01

    and social skills act as mediators between neurocognition and functional outcome in UHR individuals. METHODS: Ultrahigh risk participants (N = 84) underwent neurocognitive testing using the Brief Assessment of Cognition in Schizophrenia. Social skills and negative symptoms were assessed using the High...... to the measures of functioning. Negative symptoms mediated the relationship between neurocognition and four of the five measures of functioning. We did not find social skills to mediate between neurocognition and functioning. CONCLUSION: Negative symptoms appear to mediate the relationship between neurocognition...... and functional outcome in UHR individuals, but the finding needs to be confirmed and extended to longitudinal studies. This underscores the importance of focusing on both neurocognition and negative symptoms when aiming at improving the functional outcome of UHR individuals....

  7. Amygdala Connectivity Differs Among Chronic, Early Course, and Individuals at Risk for Developing Schizophrenia

    Science.gov (United States)

    Anticevic, Alan; Tang, Yanqing; Cho, Youngsun T.; Repovs, Grega; Cole, Michael W.; Savic, Aleksandar; Wang, Fei; Krystal, John H.; Xu, Ke

    2014-01-01

    Alterations in circuits involving the amygdala have been repeatedly implicated in schizophrenia neuropathology, given their role in stress, affective salience processing, and psychosis onset. Disturbances in amygdala whole-brain functional connectivity associated with schizophrenia have yet to be fully characterized despite their importance in psychosis. Moreover, it remains unknown if there are functional alterations in amygdala circuits across illness phases. To evaluate this possibility, we compared whole-brain amygdala connectivity in healthy comparison subjects (HCS), individuals at high risk (HR) for schizophrenia, individuals in the early course of schizophrenia (EC-SCZ), and patients with chronic schizophrenia (C-SCZ). We computed whole-brain resting-state connectivity using functional magnetic resonance imaging at 3T via anatomically defined individual-specific amygdala seeds. We identified significant alterations in amygdala connectivity with orbitofrontal cortex (OFC), driven by reductions in EC-SCZ and C-SCZ (effect sizes of 1.0 and 0.97, respectively), but not in HR for schizophrenia, relative to HCS. Reduced amygdala-OFC coupling was associated with schizophrenia symptom severity (r = .32, P < .015). Conversely, we identified a robust increase in amygdala connectivity with a brainstem region around noradrenergic arousal nuclei, particularly for HR individuals relative to HCS (effect size = 1.54), but not as prominently for other clinical groups. These results suggest that deficits in amygdala-OFC coupling could emerge during the initial episode of schizophrenia (EC-SCZ) and may present as an enduring feature of the illness (C-SCZ) in association with symptom severity but are not present in individuals with elevated risk for developing schizophrenia. Instead, in HR individuals, there appears to be increased connectivity in a circuit implicated in stress response. PMID:24366718

  8. Total and individual antioxidant intake and risk of epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Gifkins Dina

    2012-06-01

    Full Text Available Abstract Background Limiting oxidative stress to the ovarian epithelium has been proposed as a first-line defense against ovarian cancer. Although evidence for an association between individual dietary antioxidant intake and ovarian cancer risk is conflicting, the combined evidence suggests a modest inverse association. Our study aimed to evaluate the association between total antioxidant capacity (TAC and individual antioxidant intakes (vitamin C, vitamin E, beta-carotene, selenium, lutein, and lycopene and ovarian cancer risk. Methods We conducted a population-based case–control study in New Jersey. Cases were women ages 21 years and older with newly diagnosed epithelial ovarian cancer who resided in six counties of New Jersey. Controls were women in the same age range who resided in the same geographic area. A total of 205 ovarian cancer cases and 390 controls were included. Dietary intake was ascertained using the Block food frequency questionnaire (FFQ, and TAC indices were constructed by linking FFQ-derived estimates to two standardized antioxidant capacity databases, the USDA Oxygen Radical Absorbance Capacity (ORAC Database, and the University of Olso’s Antioxidant Food Database. Multivariate logistic regression models were used to calculate odds ratios and 95 % confidence intervals while controlling for major ovarian cancer risk factors. Results We found a strong inverse association with selenium from food sources (OR: 0.41; 95 % CI: 0.20-0.85, for the highest vs. lowest tertile of dietary selenium intake. However, there was little evidence of an association with dietary TAC or the others individual antioxidants. In contrast, compared to non-users, supplement users had significant increased risk for all micronutrients, but no statistically significant increased risk was observed for combined intake from foods and supplements of any of these antioxidants. Conclusions This study found an inverse association between selenium

  9. Individual common variants exert weak effects on the risk for autism spectrum disorders

    Science.gov (United States)

    Anney, Richard; Klei, Lambertus; Pinto, Dalila; Almeida, Joana; Bacchelli, Elena; Baird, Gillian; Bolshakova, Nadia; Bölte, Sven; Bolton, Patrick F.; Bourgeron, Thomas; Brennan, Sean; Brian, Jessica; Casey, Jillian; Conroy, Judith; Correia, Catarina; Corsello, Christina; Crawford, Emily L.; de Jonge, Maretha; Delorme, Richard; Duketis, Eftichia; Duque, Frederico; Estes, Annette; Farrar, Penny; Fernandez, Bridget A.; Folstein, Susan E.; Fombonne, Eric; Gilbert, John; Gillberg, Christopher; Glessner, Joseph T.; Green, Andrew; Green, Jonathan; Guter, Stephen J.; Heron, Elizabeth A.; Holt, Richard; Howe, Jennifer L.; Hughes, Gillian; Hus, Vanessa; Igliozzi, Roberta; Jacob, Suma; Kenny, Graham P.; Kim, Cecilia; Kolevzon, Alexander; Kustanovich, Vlad; Lajonchere, Clara M.; Lamb, Janine A.; Law-Smith, Miriam; Leboyer, Marion; Le Couteur, Ann; Leventhal, Bennett L.; Liu, Xiao-Qing; Lombard, Frances; Lord, Catherine; Lotspeich, Linda; Lund, Sabata C.; Magalhaes, Tiago R.; Mantoulan, Carine; McDougle, Christopher J.; Melhem, Nadine M.; Merikangas, Alison; Minshew, Nancy J.; Mirza, Ghazala K.; Munson, Jeff; Noakes, Carolyn; Nygren, Gudrun; Papanikolaou, Katerina; Pagnamenta, Alistair T.; Parrini, Barbara; Paton, Tara; Pickles, Andrew; Posey, David J.; Poustka, Fritz; Ragoussis, Jiannis; Regan, Regina; Roberts, Wendy; Roeder, Kathryn; Roge, Bernadette; Rutter, Michael L.; Schlitt, Sabine; Shah, Naisha; Sheffield, Val C.; Soorya, Latha; Sousa, Inês; Stoppioni, Vera; Sykes, Nuala; Tancredi, Raffaella; Thompson, Ann P.; Thomson, Susanne; Tryfon, Ana; Tsiantis, John; Van Engeland, Herman; Vincent, John B.; Volkmar, Fred; Vorstman, JAS; Wallace, Simon; Wing, Kirsty; Wittemeyer, Kerstin; Wood, Shawn; Zurawiecki, Danielle; Zwaigenbaum, Lonnie; Bailey, Anthony J.; Battaglia, Agatino; Cantor, Rita M.; Coon, Hilary; Cuccaro, Michael L.; Dawson, Geraldine; Ennis, Sean; Freitag, Christine M.; Geschwind, Daniel H.; Haines, Jonathan L.; Klauck, Sabine M.; McMahon, William M.; Maestrini, Elena; Miller, Judith; Monaco, Anthony P.; Nelson, Stanley F.; Nurnberger, John I.; Oliveira, Guiomar; Parr, Jeremy R.; Pericak-Vance, Margaret A.; Piven, Joseph; Schellenberg, Gerard D.; Scherer, Stephen W.; Vicente, Astrid M.; Wassink, Thomas H.; Wijsman, Ellen M.; Betancur, Catalina; Buxbaum, Joseph D.; Cook, Edwin H.; Gallagher, Louise; Gill, Michael; Hallmayer, Joachim; Paterson, Andrew D.; Sutcliffe, James S.; Szatmari, Peter; Vieland, Veronica J.; Hakonarson, Hakon; Devlin, Bernie

    2012-01-01

    While it is apparent that rare variation can play an important role in the genetic architecture of autism spectrum disorders (ASDs), the contribution of common variation to the risk of developing ASD is less clear. To produce a more comprehensive picture, we report Stage 2 of the Autism Genome Project genome-wide association study, adding 1301 ASD families and bringing the total to 2705 families analysed (Stages 1 and 2). In addition to evaluating the association of individual single nucleotide polymorphisms (SNPs), we also sought evidence that common variants, en masse, might affect the risk. Despite genotyping over a million SNPs covering the genome, no single SNP shows significant association with ASD or selected phenotypes at a genome-wide level. The SNP that achieves the smallest P-value from secondary analyses is rs1718101. It falls in CNTNAP2, a gene previously implicated in susceptibility for ASD. This SNP also shows modest association with age of word/phrase acquisition in ASD subjects, of interest because features of language development are also associated with other variation in CNTNAP2. In contrast, allele scores derived from the transmission of common alleles to Stage 1 cases significantly predict case status in the independent Stage 2 sample. Despite being significant, the variance explained by these allele scores was small (Vm< 1%). Based on results from individual SNPs and their en masse effect on risk, as inferred from the allele score results, it is reasonable to conclude that common variants affect the risk for ASD but their individual effects are modest. PMID:22843504

  10. What can individuals do to reduce personal health risks from air pollution?

    Science.gov (United States)

    Laumbach, Robert; Meng, Qingyu; Kipen, Howard

    2015-01-01

    In many areas of the world, concentrations of ambient air pollutants exceed levels associated with increased risk of acute and chronic health problems. While effective policies to reduce emissions at their sources are clearly preferable, some evidence supports the effectiveness of individual actions to reduce exposure and health risks. Personal exposure to ambient air pollution can be reduced on high air pollution days by staying indoors, reducing outdoor air infiltration to indoors, cleaning indoor air with air filters, and limiting physical exertion, especially outdoors and near air pollution sources. Limited evidence suggests that the use of respirators may be effective in some circumstances. Awareness of air pollution levels is facilitated by a growing number of public air quality alert systems. Avoiding exposure to air pollutants is especially important for susceptible individuals with chronic cardiovascular or pulmonary disease, children, and the elderly. Research on mechanisms underlying the adverse health effects of air pollution have suggested potential pharmaceutical or chemopreventive interventions, such as antioxidant or antithrombotic agents, but in the absence of data on health outcomes, no sound recommendations can be made for primary prevention. Health care providers and their patients should carefully consider individual circumstances related to outdoor and indoor air pollutant exposure levels and susceptibility to those air pollutants when deciding on a course of action to reduce personal exposure and health risks from ambient air pollutants. Careful consideration is especially warranted when interventions may have unintended negative consequences, such as when efforts to avoid exposure to air pollutants lead to reduced physical activity or when there is evidence that dietary supplements, such as antioxidants, have potential adverse health effects. These potential complications of partially effective personal interventions to reduce exposure or

  11. Associations between polygenic risk for schizophrenia and brain function during probabilistic learning in healthy individuals.

    Science.gov (United States)

    Lancaster, Thomas M; Ihssen, Niklas; Brindley, Lisa M; Tansey, Katherine E; Mantripragada, Kiran; O'Donovan, Michael C; Owen, Michael J; Linden, David E J

    2016-02-01

    A substantial proportion of schizophrenia liability can be explained by additive genetic factors. Risk profile scores (RPS) directly index risk using a summated total of common risk variants weighted by their effect. Previous studies suggest that schizophrenia RPS predict alterations to neural networks that support working memory and verbal fluency. In this study, we apply schizophrenia RPS to fMRI data to elucidate the effects of polygenic risk on functional brain networks during a probabilistic-learning neuroimaging paradigm. The neural networks recruited during this paradigm have previously been shown to be altered to unmedicated schizophrenia patients and relatives of schizophrenia patients, which may reflect genetic susceptibility. We created schizophrenia RPS using summary data from the Psychiatric Genetic Consortium (Schizophrenia Working Group) for 83 healthy individuals and explore associations between schizophrenia RPS and blood oxygen level dependency (BOLD) during periods of choice behavior (switch-stay) and reflection upon choice outcome (reward-punishment). We show that schizophrenia RPS is associated with alterations in the frontal pole (PWHOLE-BRAIN-CORRECTED  = 0.048) and the ventral striatum (PROI-CORRECTED  = 0.036), during choice behavior, but not choice outcome. We suggest that the common risk variants that increase susceptibility to schizophrenia can be associated with alterations in the neural circuitry that support the processing of changing reward contingencies. Hum Brain Mapp 37:491-500, 2016. © 2015 Wiley Periodicals, Inc.

  12. Oral hygiene status of individuals with cardiovascular diseases and associated risk factors

    Directory of Open Access Journals (Sweden)

    Divya Shetty

    2012-11-01

    Full Text Available Dentist and oral health screening may be the latest weapon in identifying persons at risk of cardiovascular disease. Oral infections, specifically periodontitis, may confer independent risks for different systemic conditions. The risk factors associated with cardiovascular diseases also suggest that the relationship between periodontal disease and diabetes works in both ways. The aim of this study was to support and strengthen the association and relationship between oral hygiene status of individuals with cardiovascular diseases and its associated risk factors. A simple random sampling was carried out in 200 inhabitants of Western Utter Pradesh, India. An oral health visit and examination was made for an equal number of males and females of different age groups with cardiovascular diseases. Evaluation of the oral status was made by means of an oral hygiene index, community periodontal index of treatment needs and loss of attachment. Evaluation of oral status in patients with cardiovascular diseases and in the control group has shown a statistically significant low level of oral health in patients with cardiovascular diseases as compared to control. Prevalence of systemic diseases in different age groups significantly correlated with the prevalence of severe periodontal diseases. Treating gum disease may reduce the risk of heart disease and improve health outcomes for patients with periodontal disease and vascular heart problems.

  13. The Risk of Individual Stocks’ Tail Dependence with the Market and Its Effect on Stock Returns

    Directory of Open Access Journals (Sweden)

    Guobin Fan

    2015-01-01

    Full Text Available Traditional beta is only a linear measure of overall market risk and places equal emphasis on upside and downside risks, but actually the latter is always much stronger probably due to the trading mechanism like short-sale constraints. Therefore, this paper employs the nonlinear measure, tail dependence, to measure the extreme downside risks that individual stocks crash together with the whole market and investigates whether such tail dependence risks will affect stock returns. Our empirical evidence based on Shanghai A shares confirms that most stocks display nonnegligible tail dependence with the whole market, and, more importantly, such tail dependence risks can indeed provide additional information beyond beta and other factors for asset pricing. In cross-sectional regression, it is proved that this tail dependence does help to explain monthly returns on Shanghai A shares, whereas the time-series regression further indicates that mimicking portfolio returns for tail dependence can capture strong common variation of Shanghai A stock returns.

  14. Relationship between amputation and risk factors in individuals with diabetes mellitus: A study with Brazilian patients.

    Science.gov (United States)

    Mantovani, Alessandra M; Fregonesi, Cristina E P T; Palma, Mariana R; Ribeiro, Fernanda E; Fernandes, Rômulo A; Christofaro, Diego G D

    Individuals with diabetes develop lower extremity amputation for several reasons. Investigations into pathways to the development of complications are important both for treatment and prevention. To evaluate the relationship between amputation and risk factors in people with diabetes mellitus. All participants included in this study (n=165) were recruited from the Diabetic Foot Program, developed in a Brazilian University, over seven years (2007-2014) and all information for this study was extracted from their clinical records. The prevalence of amputation in patients with diabetes with four risk factors was up to 20% higher when compared to those with only one risk factor. The main predictive risk factors for amputation in this population were the presence of an ulcer and smoking. The risk factors for amputation can be predicted for people with diabetes mellitus and, in the present study, the main factors were the presence of an ulcer and the smoking habit. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  15. Risk of contrast-medium-induced nephropathy in high-risk patients undergoing MDCT - A pooled analysis of two randomized trials

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Henrik S. [University of Copenhagen, Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, and Department of Diagnostic Sciences, Faculty of Health Sciences, Herlev (Denmark); Morcos, Sameh K. [University of Sheffield, Department of Diagnostic Imaging, Northern General Hospital, Sheffield (United Kingdom)

    2009-04-15

    The incidence of contrast-medium-induced nephropathy (CIN) following intravenous (IV) CM administration of contrast media to renally impaired patients undergoing multidetector computed tomography (MDCT) is not well characterized. Our objective was to investigate the incidence of CIN in patients with glomerular filtration rate (GFR) <60 ml/min undergoing contrast-enhanced MDCT examinations and to compare the rates of CIN following the IV administration of low-osmolar contrast media (LOCM, iopamidol and iomeprol) and an iso-osmolar contrast medium (IOCM, iodixanol). A total of 301 adult patients with moderate-to-severe renal failure received a similar IV contrast dose (40 gI). Serum creatinine (SCr) was measured at screening, baseline and 48-72 {+-} 6 h after the MDCT examination. Primary CIN outcome was an increase in SCr {>=}0.5 mg/dl ({>=}44.2 {mu}mol/l) from baseline. The CIN rates were 2.3% in the total population, 0.6% when GFR >40 ml/min, 4.6% when GFR <40 ml/min and 7.8% in patients with GFR <30 ml/min. The incidence of CIN was significantly higher after iodixanol than after LOCM (seven patients, 4.7% following IOCM, no CIN cases following the LOCM; p = 0.007). Significant differences in favor of the LOCM were also observed in patients with GFR <40 ml/min and GFR <30 ml/min. Following the IV administration of nonionic contrast agents in patients with moderate-to-severe renal insufficiency, the risk of significant CIN seems to be low. The IOCM iodixanol caused a higher rate of CIN than the LOCM iopamidol and iomeprol, especially in high-risk patients. Differences in osmolality between these LOCM and iodixanol do not play a role in the genesis of CIN. (orig.)

  16. Associations between unprocessed red and processed meat, poultry, seafood and egg intake and the risk of prostate cancer: A pooled analysis of 15 prospective cohort studies

    National Research Council Canada - National Science Library

    Wu, Kana; Spiegelman, Donna; Hou, Tao; Albanes, Demetrius; Allen, Naomi E; Berndt, Sonja I; van den Brandt, Piet A; Giles, Graham G; Giovannucci, Edward; Alexandra Goldbohm, R; Goodman, Gary G; Goodman, Phyllis J; Håkansson, Niclas; Inoue, Manami; Key, Timothy J; Kolonel, Laurence N; Männistö, Satu; McCullough, Marjorie L; Neuhouser, Marian L; Park, Yikyung; Platz, Elizabeth A; Schenk, Jeannette M; Sinha, Rashmi; Stampfer, Meir J; Stevens, Victoria L; Tsugane, Shoichiro; Visvanathan, Kala; Wilkens, Lynne R; Wolk, Alicja; Ziegler, Regina G; Smith‐Warner, Stephanie A

    2016-01-01

    ...) and then pooled using random effects models. Results do not support a substantial effect of total red, unprocessed red and processed meat for all prostate cancer outcomes, except for a modest positive association for tumors identified...

  17. Poole High Street study

    OpenAIRE

    Kilburn, David

    2007-01-01

    A presentation given to key decision makers within Poole to improve the retail offer in Poole High Street and leverage the benefit of improved town planning and the introduction of quality retail companies.

  18. Swimming pool cleaner poisoning

    Science.gov (United States)

    Swimming pool cleaner poisoning occurs when someone swallows this type of cleaner, touches it, or breathes in ... The harmful substances in swimming pool cleaner are: Bromine ... copper Chlorine Soda ash Sodium bicarbonate Various mild acids

  19. Swimming Pool Safety

    Science.gov (United States)

    ... Prevention Listen Español Text Size Email Print Share Swimming Pool Safety Page Content ​What is the best way to keep my child safe around swimming pools? An adult should actively watch children at ...

  20. Swimming pool granuloma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001357.htm Swimming pool granuloma To use the sharing features on this page, please enable JavaScript. A swimming pool granuloma is a long-term (chronic) skin ...

  1. Household and Individual Risk Factors for Cholera among Cholera Vaccine Recipients in Rural Haiti.

    Science.gov (United States)

    Matias, Wilfredo R; Teng, Jessica E; Hilaire, Isabelle J; Harris, Jason B; Franke, Molly F; Ivers, Louise C

    2017-08-01

    Oral cholera vaccination was used as part of cholera control in Haiti, but the vaccine does not provide complete protection. We conducted secondary data analyses of a vaccine effectiveness study in Haiti to evaluate risk factors for cholera among cholera vaccine recipients. Individuals vaccinated against cholera that presented with acute watery diarrhea and had a stool sample positive for Vibrio cholerae O1 were included as cases. Up to four vaccinated individuals who did not present for treatment of diarrhea were included as controls for each case, and matched by location of residence, enrollment time, and age. We evaluated sociodemographic characteristics and risk factors for cholera. Univariable and multivariable logistic regression were performed to identify risk factors for cholera among vaccinees. Thirty-three vaccine recipients with culture-confirmed cholera were included as cases. One-hundred-and-seventeen of their matched controls reported receiving vaccine and were included as controls. In a multivariable analysis, self-reporting use of branded household water disinfection products as a means of treating water (adjusted relative risk [aRR] = 44.3, 95% confidence interval [CI] = 4.19-468.05, P = 0.002), and reporting having a latrine as the main household toilet (aRR = 4.22, 95% CI = 1.23-14.43, P = 0.02), were independent risk factors for cholera. Self-reporting always treating water (aRR = 0.09, 95% CI = 0.01-0.57, P = 0.01) was associated with protection against cholera. The field effectiveness of water, sanitation, and hygiene interventions used in combination with cholera vaccination in cholera control should be measured and monitored over time to identify and remediate shortcomings, and ensure successful impact on disease control.

  2. Factors Motivating Individuals to Consider Genetic Testing for Type 2 Diabetes Risk Prediction.

    Directory of Open Access Journals (Sweden)

    Jennifer Wessel

    Full Text Available The purpose of this study was to identify attitudes and perceptions of willingness to participate in genetic testing for type 2 diabetes (T2D risk prediction in the general population. Adults (n = 598 were surveyed on attitudes about utilizing genetic testing to predict future risk of T2D. Participants were recruited from public libraries (53%, online registry (37% and a safety net hospital emergency department (10%. Respondents were 37 ± 11 years old, primarily White (54%, female (69%, college educated (46%, with an annual income ≥$25,000 (56%. Half of participants were interested in genetic testing for T2D (52% and 81% agreed/strongly agreed genetic testing should be available to the public. Only 57% of individuals knew T2D is preventable. A multivariate model to predict interest in genetic testing was adjusted for age, gender, recruitment location and BMI; significant predictors were motivation (high perceived personal risk of T2D [OR = 4.38 (1.76, 10.9]; family history [OR = 2.56 (1.46, 4.48]; desire to know risk prior to disease onset [OR = 3.25 (1.94, 5.42]; and knowing T2D is preventable [OR = 2.11 (1.24, 3.60], intention (if the cost is free [OR = 10.2 (4.27, 24.6]; and learning T2D is preventable [OR = 5.18 (1.95, 13.7] and trust of genetic testing results [OR = 0.03 (0.003, 0.30]. Individuals are interested in genetic testing for T2D risk which offers unique information that is personalized. Financial accessibility, validity of the test and availability of diabetes prevention programs were identified as predictors of interest in T2D testing.

  3. Natural vitamin C intake and the risk of head and neck cancer: A pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.

    Science.gov (United States)

    Edefonti, Valeria; Hashibe, Mia; Parpinel, Maria; Turati, Federica; Serraino, Diego; Matsuo, Keitaro; Olshan, Andrew F; Zevallos, Jose P; Winn, Deborah M; Moysich, Kirsten; Zhang, Zuo-Feng; Morgenstern, Hal; Levi, Fabio; Kelsey, Karl; McClean, Michael; Bosetti, Cristina; Galeone, Carlotta; Schantz, Stimson; Yu, Guo-Pei; Boffetta, Paolo; Amy Lee, Yuan-Chin; Chuang, Shu-Chun; La Vecchia, Carlo; Decarli, Adriano

    2015-07-15

    Evidence of associations between single nutrients and head and neck cancer (HNC) is still more limited and less consistent than that for fruit and vegetables. However, clarification of the protective mechanisms of fruit and vegetables is important to our understanding of HNC etiology. We investigated the association between vitamin C intake from natural sources and cancer of the oral cavity/pharynx and larynx using individual-level pooled data from ten case-control studies (5,959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. After harmonization of study-specific exposure information via the residual method, adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using unconditional multiple logistic regression models on quintile categories of 'non-alcohol energy-adjusted' vitamin C intake. In the presence of heterogeneity of the estimated ORs among studies, we derived those estimates from generalized linear mixed models. Higher intakes of vitamin C were inversely related to oral and pharyngeal (OR = 0.54, 95% CI: 0.45-0.65, for the fifth quintile category versus the first one, p for trendcancers (OR = 0.52, 95% CI: 0.40-0.68, p for trend = 0.006), although in the presence of heterogeneity among studies for both sites. Inverse associations were consistently observed for the anatomical subsites of oral and pharyngeal cancer, and across strata of age, sex, education, body mass index, tobacco, and alcohol, for both cancer sites. The inverse association of vitamin C intake from foods with HNC may reflect a protective effect on these cancers; however, we cannot rule out other explanations.

  4. Nutrient-based dietary patterns and the risk of head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology consortium

    Science.gov (United States)

    Edefonti, V.; Hashibe, M.; Ambrogi, F.; Parpinel, M.; Bravi, F.; Talamini, R.; Levi, F.; Yu, G.; Morgenstern, H.; Kelsey, K.; McClean, M.; Schantz, S.; Zhang, Z.; Chuang, S.; Boffetta, P.; La Vecchia, C.; Decarli, A.

    2012-01-01

    Background The association between dietary patterns and head and neck cancer has rarely been addressed. Patients and methods We used individual-level pooled data from five case–control studies (2452 cases and 5013 controls) participating in the International Head and Neck Cancer Epidemiology consortium. A posteriori dietary patterns were identified through a principal component factor analysis carried out on 24 nutrients derived from study-specific food-frequency questionnaires. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using unconditional logistic regression models on quintiles of factor scores. Results We identified three major dietary patterns named ‘animal products and cereals’, ‘antioxidant vitamins and fiber’, and ‘fats’. The ‘antioxidant vitamins and fiber’ pattern was inversely related to oral and pharyngeal cancer (OR = 0.57, 95% CI 0.43–0.76 for the highest versus the lowest score quintile). The ‘animal products and cereals’ pattern was positively associated with laryngeal cancer (OR = 1.54, 95% CI 1.12–2.11), whereas the ‘fats’ pattern was inversely associated with oral and pharyngeal cancer (OR = 0.78, 95% CI 0.63–0.97) and positively associated with laryngeal cancer (OR = 1.69, 95% CI 1.22–2.34). Conclusions These findings suggest that diets rich in animal products, cereals, and fats are positively related to laryngeal cancer, and those rich in fruit and vegetables inversely related to oral and pharyngeal cancer. PMID:22123733

  5. Natural vitamin C intake and the risk of head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology consortiuma,b

    Science.gov (United States)

    Edefonti, Valeria; Hashibe, Mia; Parpinel, Maria; Turati, Federica; Serraino, Diego; Matsuo, Keitaro; Olshan, Andrew F.; Zevallos, Jose P.; Winn, Deborah M.; Moysich, Kirsten; Zhang, Zuo-Feng; Morgenstern, Hal; Levi, Fabio; Kelsey, Karl; McClean, Michael; Bosetti, Cristina; Galeone, Carlotta; Schantz, Stimson; Yu, Guo-Pei; Boffetta, Paolo; Lee, Yuan-Chin Amy; Chuang, Shu-Chun; La Vecchia, Carlo; Decarli, Adriano

    2014-01-01

    Evidence of associations between single nutrients and head and neck cancer (HNC) is still more limited and less consistent than that for fruit and vegetables. However, clarification of the protective mechanisms of fruit and vegetables is important to our understanding of HNC etiology. We investigated the association between vitamin C intake from natural sources and cancer of the oral cavity/pharynx and larynx using individual-level pooled data from ten case-control studies (5959 cases and 12248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. After harmonization of study-specific exposure information via the residual method, adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using unconditional multiple logistic regression models on quintile categories of ’non-alcohol energy-adjusted’ vitamin C intake. In the presence of heterogeneity of the estimated ORs among studies, we derived those estimates from generalized linear mixed models. Higher intakes of vitamin C were inversely related to oral and pharyngeal (OR=0.54, 95% CI: 0.45–0.65, for the fifth quintile category versus the first one, p for trend<0.001) and laryngeal cancers (OR=0.52, 95% CI: 0.40–0.68, p for trend=0.006), although in the presence of heterogeneity among studies for both sites. Inverse associations were consistently observed for the anatomical subsites of oral and pharyngeal cancer, and across strata of age, sex, education, body mass index, tobacco, and alcohol, for both cancer sites. The inverse association of vitamin C intake from foods with HNC may reflect a protective effect on these cancers; however, we cannot rule out other explanations. PMID:25627906

  6. The accuracy of the functional movement screen to identify individuals with an elevated risk of musculoskeletal injury.

    Science.gov (United States)

    Krumrei, Kirk; Flanagan, Molly; Bruner, Josh; Durall, Chris

    2014-11-01

    Injuries are somewhat commonplace in highly active populations. One strategy for reducing injuries is to identify individuals with an elevated injury risk before participation so that remediative interventions can be provided. Preparticipation screenings have traditionally entailed strength and flexibility measures thought to be indicative of inflated injury risk. Some researchers, however, have suggested that functional movements/tasks should be assessed to help identify individuals with a high risk of future injury. One assessment tool used for this purpose is the Functional Movement Screen (FMS). The FMS generates a numeric score based on performance attributes during 7 dynamic tasks; this score is purported to reflect future injury risk. Expanding interest in the FMS has led researchers to investigate how accurately it can identify individuals with an increased risk of injury. Can the Functional Movement Screen accurately identify highly active individuals with an elevated risk of injury?

  7. Individual and occupational risk factors for knee osteoarthritis – Study protocol of a case control study

    Directory of Open Access Journals (Sweden)

    Bouillon Bertil

    2008-02-01

    Full Text Available Abstract Background Knee osteoarthritis (OA is one of the frequent and functionally impairing disorders of the musculoskeletal system. In the literature, a number of occupational risk factors are discussed as being related to the development and progress of knee joint diseases, e.g. working in kneeling or squatting posture, lifting and carrying of heavy weights. The importance of the single risk factors and the possibility of prevention are currently under discussion. Besides the occupational factors, a number of individual risk factors are important, too. The distinction between work-related factors and individual factors is crucial in assessing the risk and in deriving preventive measures in occupational health. In existing studies, the occupational stress is determined mainly by surveys in employees and/or by making assumptions about individual occupations. Direct evaluation of occupational exposure has been performed only exceptionally. The aim of the research project ArGon is the assessment of different occupational factors in relation to individual factors (e.g. constitutional factors, leisure time activities, sports, which might influence the development and/or progression of knee (OA. The project is designed as a case control study. Methods/Design To raise valid data about the physical stress associated with occupational and leisure time activities, patients with and without knee OA are questioned by means of a standardised questionnaire and an interview. The required sample size was estimated to 800 cases and an equal number of controls. The degree and localisation of the knee cartilage or joint damages in the cases are documented on the basis of radiological, arthroscopic and/or operative findings in a patient record. Furthermore, occupational exposure is analysed at selected workplaces. To evaluate the answers provided in the questionnaire, work analysis is performed. Discussion In this research project, specific information on the

  8. IgE and risk of cancer in 37 747 individuals from the general population

    DEFF Research Database (Denmark)

    Helby, J; Bojesen, S E; Nielsen, S F;

    2015-01-01

    BACKGROUND: Immunoglobulin E (IgE) is produced by plasma cells, often as part of an allergic immune response. It is currently unknown whether plasma IgE levels are associated with risk of cancer in individuals from the general population. We tested the hypothesis that high levels of plasma total IgE...... are associated with overall risk of cancer and with risk of specific cancers. MATERIALS AND METHODS: Plasma total IgE was measured in 37 747 individuals from the general population, and the participants were followed prospectively for up to 30 years. All statistical tests were two-sided. RESULTS: During a mean...... follow-up of 7 years, a first cancer was diagnosed in 3454 participants. The multivariable adjusted hazard ratio for a 10-fold higher level of IgE was 1.05 [95% confidence interval (CI) 1.00-1.11; P = 0.04] for any cancer, 0.44 (0.30-0.64; P = 0.00002) for chronic lymphocytic leukemia (CLL), 0.53 (0...

  9. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts [v2; ref status: indexed, http://f1000r.es/30q

    Directory of Open Access Journals (Sweden)

    Ida E. H. Madsen

    2014-02-01

    Full Text Available Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain” are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  10. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts [v1; ref status: indexed, http://f1000r.es/1yz

    Directory of Open Access Journals (Sweden)

    IPD-Work Consortium

    2013-11-01

    Full Text Available Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain” are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  11. Inflammatory biomarkers and risk of cancer in 84,000 individuals from the general population

    DEFF Research Database (Denmark)

    Allin, Kristine H; Bojesen, Stig E; Nordestgaard, Børge G

    2016-01-01

    Inflammation and cancer are tightly linked. This study tests the hypothesis that an inflammatory score based on plasma levels of C-reactive protein (CRP) and fibrinogen and whole blood leukocyte count is associated with risk of colorectal, lung, breast and prostate cancer. A score ranging from none...... through three elevated biomarkers was constructed in 84,000 individuals from the Danish general population. During a median follow-up time of 4.8 years, 4,081 incident cancers occurred. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of incident cancer. Multifactor......-adjusted HRs for colorectal cancer were 1.28 (95% CI, 1.01 to 1.62), 1.79 (95% CI, 1.41 to 2.27) and 2.18 (95% CI, 1.67 to 2.86) for individuals with elevated levels of one, two and three inflammatory biomarkers compared to individuals with none elevated biomarkers. A similar stepwise increasing risk...

  12. Body mass index and risk of second obesity-associated cancers after colorectal cancer: a pooled analysis of prospective cohort studies.

    Science.gov (United States)

    Gibson, Todd M; Park, Yikyung; Robien, Kim; Shiels, Meredith S; Black, Amanda; Sampson, Joshua N; Purdue, Mark P; Freeman, Laura E Beane; Andreotti, Gabriella; Weinstein, Stephanie J; Albanes, Demetrius; Fraumeni, Joseph F; Curtis, Rochelle E; Berrington de Gonzalez, Amy; Morton, Lindsay M

    2014-12-10

    To determine whether prediagnostic body mass index (BMI) is associated with risk of second obesity-associated cancers in colorectal cancer (CRC) survivors, and whether CRC survivors have increased susceptibility to obesity-associated cancer compared with cancer-free individuals. Incident first primary CRC cases (N = 11,598) were identified from five prospective cohort studies. We used Cox proportional hazards regression models to examine associations between baseline (prediagnostic) BMI and risk of second obesity-associated cancers (postmenopausal breast, kidney, pancreas, esophageal adenocarcinoma, endometrium) in CRC survivors, and compared associations to those for first obesity-associated cancers in the full cohort. Compared with survivors with normal prediagnostic BMI (18.5-24.9 kg/m(2)), those who were overweight (25-29.9 kg/m(2)) or obese (30+ kg/m(2)) had greater risk of a second obesity-associated cancer (n = 224; overweight hazard ratio [HR], 1.39; 95% CI, 1.01 to 1.92; obese HR, 1.47; 95% CI, 1.02 to 2.12; per 5-unit change in BMI HR, 1.12; 95% CI, 0.98 to 1.29). The magnitude of risk for developing a first primary obesity-associated cancer was similar (overweight HR, 1.18; 95% CI, 1.14 to 1.21; obese HR, 1.61; 95% CI, 1.56 to 1.66; per 5-unit change in BMI HR, 1.23; 95% CI, 1.21 to 1.24). Before diagnosis CRC patients were somewhat more likely than the overall cohort to be overweight (44% v 41%) or obese (25% v 21%). CRC survivors who were overweight or obese before diagnosis had increased risk of second obesity-associated cancers compared with survivors with normal weight. The risks were similar in magnitude to those observed for first cancers in this population, suggesting increased prevalence of overweight or obesity, rather than increased susceptibility, may contribute to elevated second cancer risks in colorectal cancer survivors compared with the general population. These results support emphasis of existing weight guidelines for this high-risk

  13. Competing risks of cancer mortality and cardiovascular events in individuals with multimorbidity

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Bayliss

    2014-08-01

    Full Text Available Background: Cancer patients with cardiovascular and other comorbidities are at concurrent risk of multiple adverse outcomes. However, most treatment decisions are guided by evidence from single-outcome models, which may be misleading for multimorbid patients. Objective: We assessed the interacting effects of cancer, cardiovascular, and other morbidity burdens on the competing outcomes of cancer mortality, serious cardiovascular events, and other-cause mortality. Design: We analyzed a cohort of 6,500 adults with initial cancer diagnosis between 2001 and 2008, SEER 5-year survival ≥26%, and a range of cardiovascular risk factors. We estimated the cumulative incidence of cancer mortality, a serious cardiovascular event (myocardial infarction, coronary revascularization, or cardiovascular mortality, and other-cause mortality over 5 years, and identified factors associated with the competing risks of each outcome using cause-specific Cox proportional hazard models. Results: Following cancer diagnosis, there were 996 (15.3% cancer deaths, 328 (5.1% serious cardiovascular events, and 542 (8.3% deaths from other causes. In all, 4,634 (71.3% cohort members had none of these outcomes. Although cancer prognosis had the greatest effect, cardiovascular and other morbidity also independently increased the hazard of each outcome. The effect of cancer prognosis on outcome was greatest in year 1, and the effect of other morbidity was greater in individuals with better cancer prognoses. Conclusion: In multimorbid oncology populations, comorbidities interact to affect the competing risk of different outcomes. Quantifying these risks may provide persons with cancer plus cardiovascular and other comorbidities more accurate information for shared decision-making than risks calculated from single-outcome models.

  14. Linking Genetic Counseling Content to Short-Term Outcomes in Individuals at Elevated Breast Cancer Risk

    Science.gov (United States)

    Ellington, Lee; Schoenberg, Nancy; Agarwal, Parul; Jackson, Thomas; Dickinson, Stephanie; Abraham, Jame; Paskett, Electra D.; Leventhal, Howard; Andrykowski, Michael

    2014-01-01

    Few studies have linked actual genetic counseling content to short-term outcomes. Using the Self-regulation Model, the impact of cognitive and affective content in genetic counseling on short-term outcomes was studied in individuals at elevated risk of familial breast-ovarian cancer. Surveys assessed dependent variables: distress, perceived risk, and 6 knowledge measures (Meaning of Positive Test; Meaning of Negative Test; Personal Behavior; Practitioner Knowledge; Mechanisms of Cancer Inheritance; Frequency of Inherited Cancer) measured at pre- and post-counseling. Proportion of participant cognitive and affective and counselor cognitive and affective content during sessions (using LIWC software) were predictors in regressions. Knowledge increased for 5 measures and decreased for Personal Behavior, Distress and Perceived Risk. Controlling for age and education, results were significant/marginally significant for three measures. More counselor content was associated with decreases in knowledge of Personal Behavior. More participant and less counselor affective content was associated with gains in Practitioner Knowledge. More counselor cognitive, and interaction of counselor cognitive and affective content, were associated with higher perceived risk. Genetic counselors dominate the content of counseling sessions. Therefore, their content is tied more closely to short term outcomes than participant content. A lack of patient communication in sessions may pose problems for understanding of complex concepts. PMID:24671341

  15. Blood pressure values and depression in hypertensive individuals at high cardiovascular risk.

    Science.gov (United States)

    Mejia-Lancheros, Cilia; Estruch, Ramón; Martínez-González, Miguel Angel; Salas-Salvadó, Jordi; Corella, Dolores; Gómez-Gracia, Enrique; Fiol, Miquel; Santos, José Manuel; Fitó, Montse; Arós, Fernando; Serra-Majem, Lluis; Pintó, Xavier; Basora, Josep; Sorlí, José Vicente; Muñoz, Miguel-Angel

    2014-08-26

    Hypertension and depression are both important risk factors for cardiovascular diseases. Nevertheless, the association of blood pressure on and depression has not been completely established. This study aims to analyze whether depression may influence the control of blood pressure in hypertensive individuals at high cardiovascular risk. Cross-sectional study, embedded within the PREDIMED clinical trial, of 5954 hypertensive patients with high cardiovascular risk factor profiles. The relationship between blood pressure control and depression was analyzed. A multivariate analysis (logistic and log-linear regression), adjusting for potential confounders (socio-demographic factors, body mass index, lifestyle, diabetes, dyslipidemia, and antihypertensive treatment), was performed. Depressive patients, with and without antidepressant treatment, had better blood pressure control (OR: 1.28, CI 95%: 1.06-1.55, and OR: 1.30, CI 95%: 1.03-1.65, respectively) than non-depressive ones. Regarding blood pressure levels, systolic blood pressure values (mmHg) were found to be lower in both treated and untreated depressive patients (Log coefficient Beta: -1.59, 95% CI: -0.50 to -2.69 and Log coefficient Beta: -3.49, 95% CI: -2.10 to -4.87, respectively). Among hypertensive patients at high cardiovascular risk, the control of blood pressure was better in those diagnosed with depression. Unique identifier: ISRCTN35739639.

  16. Are Risk Attitudes and Individualism Predictors of Entrepreneurship? A Multivariate Analysis of Romanian Data

    Directory of Open Access Journals (Sweden)

    Adrian Hatos

    2015-02-01

    Full Text Available This paper emerges in the context of authors` previous investigations concerning the individual determinants of entrepreneurship. More specific, it focuses on elaborating and empirically testing hypotheses related to structural push and pull factors, e.g. age, gender, education, type of residence, and also to two kinds of psycho-attitudinal factors, i.e. risk aversion and individualist vs. etatist economic ideology. While the literature review gives credit to both hypotheses, especially for the influence of risk attitudes on starting a business, this paper focuses on the analysis of self-employment by using the block-model logistic regression on 2008 Romanian EVS (European Values Survey data. The results of multivariate analysis confirm the importance of risk aversion for entrepreneurship, as expected, but reject the hypothesis of a significant effect of individual’s option for individualist vs. collectivist (or statist continuum. It is important to notice that, contrary to expectations, two important push factors, i.e. age and education, do not correlate with self-employment and, on the other hand, risk attitude adds itself to the other effects without interacting with it. The theoretical consequences of the findings, the limits of the research and further developments are also discussed in the paper.

  17. How health managers can use data mining for predicting individuals' risks of contracting nosocomial pneumonia.

    Science.gov (United States)

    Duclos-Gosselin, Louis; Rigaux-Bricmont, Benny; Darmon, René Yves

    2015-01-01

    This article explains how managers can use a new data-mining technique for solving problems related to individual risks of contracting nosocomial pneumonia. Using the genetic algorithm, a search technique provides practitioners with an optimal choice of parameters for Gini boosting type decision tree models. Thus, managers and technicians can choose better models. These new parameters are genetically controlled: number of trees, depth of trees, trimming factor, cross-validation (to avoid overfitting), proportion of the population used, and the minimum size to split a node. This technique has been satisfactorily tested on health data.

  18. Individualized Risk Estimation for Postoperative Complications After Surgery for Oral Cavity Cancer

    Science.gov (United States)

    Awad, Mahmoud I.; Palmer, Frank L.; Kou, Lei; Yu, Changhong; Montero, Pablo H.; Shuman, Andrew G.; Ganly, Ian; Shah, Jatin P.; Kattan, Michael W.; Patel, Snehal G.

    2016-01-01

    IMPORTANCE Postoperative complications after head and neck surgery carry the potential for significant morbidity. Estimating the risk of complications in an individual patient is challenging. OBJECTIVE To develop a statistical tool capable of predicting an individual patient’s risk of developing a major complication after surgery for oral cavity squamous cell carcinoma. DESIGN, SETTING, AND PARTICIPANTS Retrospective case series derived from an institutional clinical oncologic database, augmented by medical record abstraction, at an academic tertiary care cancer center. Participants were 506 previously untreated adult patients with biopsy-proven oral cavity squamous cell carcinoma who underwent surgery between January 1, 2007, and December 31, 2012. MAIN OUTCOMES AND MEASURES The primary end point was a major postoperative complication requiring invasive intervention (Clavien-Dindo classification grades III–V). Patients treated between January 1, 2007, and December 31, 2008 (354 of 506 [70.0%]) comprised the modeling cohort and were used to develop a nomogram to predict the risk of developing the primary end point. Univariable analysis and correlation analysis were used to prescreen 36 potential predictors for incorporation in the subsequent multivariable logistic regression analysis. The variables with the highest predictive value were identified with the step-down model reduction method and included in the nomogram. Patients treated between January 1, 2007, and December 31, 2008 (152 of 506 [30.0%]) were used to validate the nomogram. RESULTS Clinical characteristics were similar between the 2 cohorts for most comparisons. Thirty-six patients in the modeling cohort (10.2%) and 16 patients in the validation cohort (10.5%) developed a major postoperative complication. The 6 preoperative variables with the highest individual predictive value were incorporated within the nomogram, including body mass index, comorbidity status, preoperative white blood cell count

  19. Hypertension, cardiovascular risk factors and antihypertensive medication utilisation among HIV-infected individuals in Rakai, Uganda.

    Science.gov (United States)

    Sander, Laura D; Newell, Kevin; Ssebbowa, Paschal; Serwadda, David; Quinn, Thomas C; Gray, Ronald H; Wawer, Maria J; Mondo, George; Reynolds, Steven

    2015-03-01

    To assess the prevalence of hypertension, elevated blood pressure and cardiovascular risk factors among HIV-positive individuals in rural Rakai District, Uganda. We assessed 426 HIV-positive individuals in Rakai, Uganda from 2007 to 2010. Prevalence of hypertension and elevated blood pressure assessed by clinical measurement was compared to clinician-recorded hypertension in case report forms. Multiple logistic regression and z-tests were used to examine the association of hypertension and elevated blood pressure with age, sex, body mass index (BMI), CD4 cell count and antiretroviral treatment (ART) use. For individuals on antihypertensives, medication utilisation was reviewed. The prevalence of hypertension (two elevated blood pressure readings at different time points) was 8.0% (95% CI: 5.4-10.6%), and that of elevated blood pressure (one elevated blood pressure reading) was 26.3% (95% CI: 22.1-30.5%). Age ≥50 years and higher BMI were positively associated with elevated blood pressure. ART use, time on ART and CD4 cell count were not associated with hypertension. Eighty-three percent of subjects diagnosed with hypertension were on antihypertensive medications, most commonly beta-blockers and calcium channel blockers. Hypertension is common among HIV-positive individuals in rural Uganda. © 2014 John Wiley & Sons Ltd.

  20. Polymorphisms in base excision repair genes: Breast cancer risk and individual radiosensitivity

    Science.gov (United States)

    Patrono, Clarice; Sterpone, Silvia; Testa, Antonella; Cozzi, Renata

    2014-01-01

    Breast cancer (BC) is the most common cancer among women worldwide. The aetiology and carcinogenesis of BC are not clearly defined, although genetic, hormonal, lifestyle and environmental risk factors have been established. The most common treatment for BC includes breast-conserving surgery followed by a standard radiotherapy (RT) regimen. However, radiation hypersensitivity and the occurrence of RT-induced toxicity in normal tissue may affect patients’ treatment. The role of DNA repair in cancer has been extensively investigated, and an impaired DNA damage response may increase the risk of BC and individual radiosensitivity. Single nucleotide polymorphisms (SNPs) in DNA repair genes may alter protein function and modulate DNA repair efficiency, influencing the development of various cancers, including BC. SNPs in DNA repair genes have also been studied as potential predictive factors for the risk of RT-induced side effects. Here, we review the literature on the association between SNPs in base excision repair (BER) genes and BC risk. We focused on X-ray repair cross complementing group 1 (XRCC1), which plays a key role in BER, and on 8-oxoguanine DNA glycosylase 1, apurinic/apyrimidinic endonuclease 1 and poly (ADP-ribose) polymerase-1, which encode three important BER enzymes that interact with XRCC1. Although no association between SNPs and radiation toxicity has been validated thus far, we also report published studies on XRCC1 SNPs and variants in other BER genes and RT-induced side effects in BC patients, emphasising that large well-designed studies are needed to determine the genetic components of individual radiosensitivity. PMID:25493225

  1. Cortico-amygdala coupling as a marker of early relapse risk in cocaine-addicted individuals

    Directory of Open Access Journals (Sweden)

    Meredith J Mchugh

    2014-02-01

    Full Text Available Addiction to cocaine is a chronic condition characterized by high rates of early relapse. This study builds on efforts to identify neural markers of relapse risk by studying resting state functional connectivity (rsFC in neural circuits arising from the amygdala; a brain region implicated in relapse-related processes including craving and reactivity to stress following acute and protracted withdrawal from cocaine. Whole-brain resting-state fMRI connectivity (6 min was assessed in 45 cocaine-addicted individuals and 22 healthy controls. Cocaine-addicted individuals completed scans in the final week of a residential treatment episode. To approximate preclinical models of relapse-related circuitry separate seeds were derived for the left and right basolateral (BLA and corticomedial (CMA amygdala. Participants also completed the Iowa Gambling Task, Wisconsin Card Sorting Test, Cocaine Craving Questionnaire, Obsessive Compulsive Cocaine Use scale, Temperament and Character Inventory and the NEO-PI-R. Relapse within the first 30 days post-treatment (n = 24 was associated with reduced rsFC between the left CMA and ventromedial prefrontal cortex/rostral anterior cingulate cortex (vmPFC/rACC relative to cocaine-addicted individuals who remained abstinent (non-relapse, n = 21. Non-relapse participants evidenced reduced rsFC between the bilateral BLA and visual processing regions (lingual gyrus/cuneus compared to controls and relapsed participants. Early relapse was associated with fewer years of education but unrelated to trait reactivity to stress, neurocognitive and clinical characteristics or cocaine use history. Findings suggest that rsFC within neural circuits implicated in preclinical models of relapse may provide a promising marker of relapse risk in cocaine-addicted individuals. Future efforts to replicate the current findings and alter connectivity within these circuits may yield novel interventions and improve treatment outcomes.

  2. Risk of Cataract Surgery in HIV-Infected Individuals: A Danish Nationwide Population-Based Cohort Study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D

    2011-01-01

    Background. Premature aging has been suggested a risk factor for early death in patients infected with human immunodeficiency virus (HIV). Therefore, the risk of age-related diseases, such as cataracts, should be increased in this population. In a nationwide, population-based cohort study we...... assessed the risk of cataract surgery in HIV-infected individuals compared with the general population.Methods. We identified 5315 HIV-infected individuals from a Danish national cohort of HIV-infected individuals and a population-based age- and sex-matched comparison cohort of 53 150 individuals. Data...... analogue reverse-transcriptase inhibitors (NNRTIs) were estimated by Poisson regression analyses and adjusted for age, sex, and calendar year.Results. HIV-infected individuals had a higher risk of cataract surgery than the comparison cohort (adjusted IRR, 1.87; 95% confidence interval (CI): 1...

  3. Risk of Cataract Surgery in HIV-Infected Individuals: A Danish Nationwide Population-Based Cohort Study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D

    2011-01-01

    Background. Premature aging has been suggested a risk factor for early death in patients infected with human immunodeficiency virus (HIV). Therefore, the risk of age-related diseases, such as cataracts, should be increased in this population. In a nationwide, population-based cohort study we...... assessed the risk of cataract surgery in HIV-infected individuals compared with the general population. Methods. We identified 5315 HIV-infected individuals from a Danish national cohort of HIV-infected individuals and a population-based age- and sex-matched comparison cohort of 53¿150 individuals. Data...... analogue reverse-transcriptase inhibitors (NNRTIs) were estimated by Poisson regression analyses and adjusted for age, sex, and calendar year. Results. HIV-infected individuals had a higher risk of cataract surgery than the comparison cohort (adjusted IRR, 1.87; 95% confidence interval (CI): 1...

  4. Sustainability of common pool resources

    Science.gov (United States)

    Timilsina, Raja Rajendra; Kamijo, Yoshio

    2017-01-01

    Sustainability has become a key issue in managing natural resources together with growing concerns for capitalism, environmental and resource problems. We hypothesize that the ongoing modernization of competitive societies, which we refer to as “capitalism,” affects human nature for utilizing common pool resources, thus compromising sustainability. To test this hypothesis, we design and implement a set of dynamic common pool resource games and experiments in the following two types of Nepalese areas: (i) rural (non-capitalistic) and (ii) urban (capitalistic) areas. We find that a proportion of prosocial individuals in urban areas is lower than that in rural areas, and urban residents deplete resources more quickly than rural residents. The composition of proself and prosocial individuals in a group and the degree of capitalism are crucial in that an increase in prosocial members in a group and the rural dummy positively affect resource sustainability by 65% and 63%, respectively. Overall, this paper shows that when societies move toward more capitalistic environments, the sustainability of common pool resources tends to decrease with the changes in individual preferences, social norms, customs and views to others through human interactions. This result implies that individuals may be losing their coordination abilities for social dilemmas of resource sustainability in capitalistic societies. PMID:28212426

  5. Sustainability of common pool resources.

    Science.gov (United States)

    Timilsina, Raja Rajendra; Kotani, Koji; Kamijo, Yoshio

    2017-01-01

    Sustainability has become a key issue in managing natural resources together with growing concerns for capitalism, environmental and resource problems. We hypothesize that the ongoing modernization of competitive societies, which we refer to as "capitalism," affects human nature for utilizing common pool resources, thus compromising sustainability. To test this hypothesis, we design and implement a set of dynamic common pool resource games and experiments in the following two types of Nepalese areas: (i) rural (non-capitalistic) and (ii) urban (capitalistic) areas. We find that a proportion of prosocial individuals in urban areas is lower than that in rural areas, and urban residents deplete resources more quickly than rural residents. The composition of proself and prosocial individuals in a group and the degree of capitalism are crucial in that an increase in prosocial members in a group and the rural dummy positively affect resource sustainability by 65% and 63%, respectively. Overall, this paper shows that when societies move toward more capitalistic environments, the sustainability of common pool resources tends to decrease with the changes in individual preferences, social norms, customs and views to others through human interactions. This result implies that individuals may be losing their coordination abilities for social dilemmas of resource sustainability in capitalistic societies.

  6. Lifetime Risk of Cardiovascular Disease Among Individuals With and Without Diabetes Stratified by Obesity Status in the Framingham Heart Study

    OpenAIRE

    Pencina, Michael J.; Wilson, Peter W. F.; Vasan, Ramachandran S; D’Agostino, Ralph B.; Fox, Caroline; Paynter, Nina Palanza

    2008-01-01

    Objective: We assessed the lifetime risk of cardiovascular disease (CVD) among individuals with and without obesity and diabetes. Research Design and Methods: Participants were drawn from the original and offspring cohorts of the Framingham Heart Study. Lifetime (30-year) risk of CVD was assessed using a modified Kaplan-Meier approach adjusting for the competing risk of death, beginning from age 50 years. Results: Over 30 years, the lifetime risk of CVD among women with diabetes was 54.8% amo...

  7. A genetic risk score of 45 coronary artery disease risk variants associates with increased risk of myocardial infarction in 6041 Danish individuals

    DEFF Research Database (Denmark)

    Krarup, N T; Borglykke, A; Allin, K H;

    2015-01-01

    discrimination improvement (IDI) added to the European SCORE for 10-year MI risk prediction. RESULTS: The GRS associated significantly with risk of incident MI (allele-dependent hazard ratio (95%CI): 1.06 (1.02-1.11), p = 0.01) but not with CAD (p = 0.39). Stratification revealed association of GRS with MI...... in men (1.06 (1.01-1.12), p = 0.02) and in individuals above the median of 45.11 years of age (1.06 (1.00-1.12), p = 0.03). There was no interaction between GRS and gender (p = 0.90) or age (p = 0.83). The GRS improved neither NRI nor IDI. CONCLUSION: The GRS of 45 GWAS identified risk variants increase...

  8. Individualizing risk of multidrug-resistant pathogens in community-onset pneumonia.

    Directory of Open Access Journals (Sweden)

    Marco Falcone

    Full Text Available The diffusion of multidrug-resistant (MDR bacteria has created the need to identify risk factors for acquiring resistant pathogens in patients living in the community.To analyze clinical features of patients with community-onset pneumonia due to MDR pathogens, to evaluate performance of existing scoring tools and to develop a bedside risk score for an early identification of these patients in the Emergency Department.This was an open, observational, prospective study of consecutive patients with pneumonia, coming from the community, from January 2011 to January 2013. The new score was validated on an external cohort of 929 patients with pneumonia admitted in internal medicine departments participating at a multicenter prospective study in Spain.A total of 900 patients were included in the study. The final logistic regression model consisted of four variables: 1 one risk factor for HCAP, 2 bilateral pulmonary infiltration, 3 the presence of pleural effusion, and 4 the severity of respiratory impairment calculated by use of PaO2/FiO2 ratio. A new risk score, the ARUC score, was developed; compared to Aliberti, Shorr, and Shindo scores, this point score system has a good discrimination performance (AUC 0.76, 95% CI 0.71-0.82 and calibration (Hosmer-Lemeshow, χ2 = 7.64; p = 0.469. The new score outperformed HCAP definition in predicting etiology due to MDR organism. The performance of this bedside score was confirmed in the validation cohort (AUC 0.68, 95% CI 0.60-0.77.Physicians working in ED should adopt simple risk scores, like ARUC score, to select the most appropriate antibiotic regimens. This individualized approach may help clinicians to identify those patients who need an empirical broad-spectrum antibiotic therapy.

  9. Community care of individuals at risk of suicide: the Life Promotion Clinic model

    Directory of Open Access Journals (Sweden)

    Kairi Kolves

    2013-09-01

    Full Text Available Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC, Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.

  10. Methods and outcomes of screening for pancreaticadenocarcinoma in high-risk individuals

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Pancreatic ductal adenocarcinoma (PDAC) is a lethalneoplasia, for which secondary prevention (i.e .,screening) is advisable for high-risk individuals with"familiar pancreatic cancer" and with other specificgenetic syndromes (Peutz-Jeghers, p16, BRCA2, PALBand mismatch repair gene mutation carriers). There islimited evidence regarding the accuracy of screeningtests, their acceptability, costs and availability, andagreement on whom to treat. Successful target ofscreening are small resectable PDAC, intraductalpapillary mucinous neoplasms with high-grade dysplasiaand advanced pancreatic intraepithelial neoplasia. Bothmagnetic resonance imaging (MRI) and endoscopicultrasound (EUS) are employed for screening, and theoverall yield for pre-malignant or malignant pancreaticlesions is of about 20% with EUS and 14% with MRI/magnetic resonance colangiopancreatography. EUSperforms better for solid and MRI for cystic lesions.However, only 2% of these detected lesions can beconsidered a successful target, and there are insufficientdata demonstrating that resection of benign or lowgrade lesions improves survival. Many patients in thepublished studies therefore seemed to have receivedan overtreatment by undergoing surgery. It is crucial tobetter stratify the risk of malignancy individually, and tobetter define optimal screening intervals and methodseither with computerized tools or molecular biomarkers,possibly in large multicentre studies. At the moment,screening should be carefully performed within researchprotocols at experienced centres, offering involvedindividuals medical and psychological advice.

  11. Healthy eating opinion survey for individuals at risk for cardiovascular disease.

    Science.gov (United States)

    Mark, Amy E; Riley, Dana L; McDonnell, Lisa A; Pipe, Andrew L; Reid, Robert D

    2014-08-01

    To develop and evaluate the validity and reliability of a questionnaire to measure intentions and beliefs about healthy eating in individuals at risk for coronary heart disease. The Healthy Eating Opinion Survey was developed using the theory of planned behavior. An open-ended elicitation questionnaire was administered to 21 participants, and a 46-item questionnaire was developed for further testing. Test-retest reliability of each question on the survey was assessed by calculating the correlation coefficients between the responses over a 2- week period in 17 participants. Internal consistency was assessed using Cronbach's alpha, and factor analysis was used to assess the construct validity of the questionnaire in a sample of 388 participants. The responses to the elicitation questions were used to develop behavioral beliefs, normative beliefs, and control beliefs questions for the final questionnaire. Test-retest reliability ranged from 0.22-0.90, with the majority (89%) of correlations being moderate to strong. Internal consistency was good, with Cronbach's alpha ranging from 0.74-0.92. All intentions questions loaded onto a single factor; attitude questions loaded onto two factors; subjective norm questions loaded onto two factors; perceived behavioral control questions loaded onto one factor; behavioral beliefs questions loaded onto one factor; normative beliefs questions loaded onto one factor; and control beliefs questions loaded onto one factor. The questionnaire was found to be a reliable, valid questionnaire to assess beliefs and intentions toward eating a healthy diet in individuals at risk for coronary heart disease.

  12. Neuropsychological Profiles in Individuals at Clinical High Risk for Psychosis: Relationship to Psychosis and Intelligence

    Science.gov (United States)

    Woodberry, Kristen A.; Seidman, Larry J.; Giuliano, Anthony J.; Verdi, Mary B.; Cook, William L.; McFarlane, William R.

    2010-01-01

    Background Characterizing neuropsychological (NP) functioning of individuals at clinical high risk (CHR) for psychosis may be useful for prediction of psychosis and understanding functional outcome. The degree to which NP impairments are associated with general cognitive ability and/or later emergence of full psychosis in CHR samples requires study with well-matched controls. Methods We assessed NP functioning across eight cognitive domains in a sample of 73 CHR youth, 13 of whom developed psychotic-level symptoms after baseline assessment, and 34 healthy comparison (HC) subjects. Groups were matched on age, sex, ethnicity, handedness, subject and parent grade attainment, and median family income, and were comparable on WRAT-3 Reading, an estimate of premorbid IQ. Profile analysis was used to examine group differences and the role of IQ in profile shape. Results The CHR sample demonstrated a significant difference in overall magnitude of NP impairment but only a small and nearly significant difference in profile shape, primarily due to a large impairment in olfactory identification. Individuals who subsequently developed psychotic-level symptoms demonstrated large impairments in verbal IQ, verbal memory and olfactory identification comparable in magnitude to first episode samples. Conclusions CHR status may be associated with moderate generalized cognitive impairments marked by some degree of selective impairment in olfaction and verbal memory. Impairments were greatest in those who later developed psychotic symptoms. Future study of olfaction in CHR samples may enhance early detection and specification of neurodevelopmental mechanisms of risk. PMID:20692125

  13. Wild buckwheat is unlikely to pose a risk to buckwheat-allergic individuals.

    Science.gov (United States)

    Nordlee, Julie A; Panda, Rakhi; Baumert, Joseph L; Goodman, Richard E; Taylor, Steve L

    2011-10-01

    Buckwheat (Fagopyrum esculentum) is a commonly allergenic food especially in Asia where buckwheat is more commonly consumed. Wild buckwheat (Polygonum convolvulus, recently changed to Fallopia convolvulus) is an annual weed prevalent in grain-growing areas of the United States. Wild buckwheat is not closely related to edible buckwheat although the seeds do have some physical resemblance. A large shipment of wheat into Japan was halted by the discovery of the adventitious presence of wild buckwheat seeds over possible concerns for buckwheat-allergic consumers. However, IgE-binding was not observed to an extract of wild buckwheat using sera from 3 buckwheat-allergic individuals either by radio-allergosorbent test inhibition or by immunoblotting after protein separation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Furthermore, the extract of wild buckwheat was not detected in a buckwheat enzyme-linked immunosorbent assay developed with antisera against common buckwheat. Thus, wild buckwheat is highly unlikely to pose any risk to buckwheat-allergic individuals. The common names of plants should not be a factor in the risk assessment for possible cross-allergenicity.

  14. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium

    Science.gov (United States)

    Heck, Julia E; Berthiller, Julien; Vaccarella, Salvatore; Winn, Deborah M; Smith, Elaine M; Shan'gina, Oxana; Schwartz, Stephen M; Purdue, Mark P; Pilarska, Agnieszka; Eluf-Neto, Jose; Menezes, Ana; McClean, Michael D; Matos, Elena; Koifman, Sergio; Kelsey, Karl T; Herrero, Rolando; Hayes, Richard B; Franceschi, Silvia; Wünsch-Filho, Victor; Fernández, Leticia; Daudt, Alexander W; Curado, Maria Paula; Chen, Chu; Castellsagué, Xavier; Ferro, Gilles; Brennan, Paul; Boffetta, Paolo; Hashibe, Mia

    2010-01-01

    Background Sexual contact may be the means by which head and neck cancer patients are exposed to human papillomavirus (HPV). Methods We undertook a pooled analysis of four population-based and four hospital-based case–control studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium, with participants from Argentina, Australia, Brazil, Canada, Cuba, India, Italy, Spain, Poland, Puerto Rico, Russia and the USA. The study included 5642 head and neck cancer cases and 6069 controls. We calculated odds ratios (ORs) of associations between cancer and specific sexual behaviours, including practice of oral sex, number of lifetime sexual partners and oral sex partners, age at sexual debut, a history of same-sex contact and a history of oral–anal contact. Findings were stratified by sex and disease subsite. Results Cancer of the oropharynx was associated with having a history of six or more lifetime sexual partners [OR = 1.25, 95% confidence interval (CI) 1.01, 1.54] and four or more lifetime oral sex partners (OR = 2.25, 95% CI 1.42, 3.58). Cancer of the tonsil was associated with four or more lifetime oral sex partners (OR = 3.36, 95 % CI 1.32, 8.53), and, among men, with ever having oral sex (OR = 1.59, 95% CI 1.09, 2.33) and with an earlier age at sexual debut (OR = 2.36, 95% CI 1.37, 5.05). Cancer of the base of the tongue was associated with ever having oral sex among women (OR = 4.32, 95% CI 1.06, 17.6), having two sexual partners in comparison with only one (OR = 2.02, 95% CI 1.19, 3.46) and, among men, with a history of same-sex sexual contact (OR = 8.89, 95% CI 2.14, 36.8). Conclusions Sexual behaviours are associated with cancer risk at the head and neck cancer subsites that have previously been associated with HPV infection. PMID:20022926

  15. Prediction and validation of pool fire development in enclosures by means of CFD Models for risk assessment of nuclear power plants (Poolfire) - Report year 2

    Energy Technology Data Exchange (ETDEWEB)

    van Hees, P.; Wahlqvist, J.; Kong, D. [Lund Univ., Lund (Sweden); Hostikka, S.; Sikanen, T. [VTT Technical Research Centre of Finland (Finland); Husted, B. [Haugesund Univ. College, Stord (Norway); Magnusson, T. [Ringhals AB, Vaeroebacka (Sweden); Joerud, F. [European Spallation Source (ESS), Lund (Sweden)

    2013-05-15

    Fires in nuclear power plants can be an important hazard for the overall safety of the facility. One of the typical fire sources is a pool fire. It is therefore important to have good knowledge on the fire behaviour of pool fire and be able to predict the heat release rate by prediction of the mass loss rate. This project envisages developing a pyrolysis model to be used in CFD models. In this report the activities for second year are reported, which is an overview of the experiments conducted, further development and validation of models and cases study to be selected in year 3. (Author)

  16. [Predicting individual risk of high healthcare cost to identify complex chronic patients].

    Science.gov (United States)

    Coderch, Jordi; Sánchez-Pérez, Inma; Ibern, Pere; Carreras, Marc; Pérez-Berruezo, Xavier; Inoriza, José M

    2014-01-01

    To develop a predictive model for the risk of high consumption of healthcare resources, and assess the ability of the model to identify complex chronic patients. A cross-sectional study was performed within a healthcare management organization by using individual data from 2 consecutive years (88,795 people). The dependent variable consisted of healthcare costs above the 95th percentile (P95), including all services provided by the organization and pharmaceutical consumption outside of the institution. The predictive variables were age, sex, morbidity-based on clinical risk groups (CRG)-and selected data from previous utilization (use of hospitalization, use of high-cost drugs in ambulatory care, pharmaceutical expenditure). A univariate descriptive analysis was performed. We constructed a logistic regression model with a 95% confidence level and analyzed sensitivity, specificity, positive predictive values (PPV), and the area under the ROC curve (AUC). Individuals incurring costs >P95 accumulated 44% of total healthcare costs and were concentrated in ACRG3 (aggregated CRG level 3) categories related to multiple chronic diseases. All variables were statistically significant except for sex. The model had a sensitivity of 48.4% (CI: 46.9%-49.8%), specificity of 97.2% (CI: 97.0%-97.3%), PPV of 46.5% (CI: 45.0%-47.9%), and an AUC of 0.897 (CI: 0.892 to 0.902). High consumption of healthcare resources is associated with complex chronic morbidity. A model based on age, morbidity, and prior utilization is able to predict high-cost risk and identify a target population requiring proactive care. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Differences in Perceived Mental Effort Required and Discomfort during a Working Memory Task between Individuals At-risk And Not At-risk for ADHD

    Science.gov (United States)

    Hsu, Chia-Fen; Eastwood, John D.; Toplak, Maggie E.

    2017-01-01

    Objective: The avoidance of mental effort is a symptom criterion for Attention-Deficit/Hyperactivity Disorder (ADHD), but the experience of mental effort has received relatively little attention in the empirical study of individuals at-risk for ADHD. We explored a novel method to assess the experience of effort and discomfort during a working memory task in a sample of young adults at-risk and not at-risk for ADHD. Method: A sample of 235 undergraduate students (Mean age = 21.02, 86 males) were included in this study. Based on an ADHD-screener (ASRS), 136 participants met criteria for the ADHD-risk group and 99 were in the non-ADHD risk group. Results: Individuals at-risk for ADHD reported higher mental effort and discomfort than individuals not at-risk for ADHD, even when performance on the working memory task was comparable or statistically controlled. Mental effort required and discomfort were more strongly correlated for at-risk compared to not at-risk participants. Individuals at-risk for ADHD displayed a stronger correlation between mental effort required and actual accuracy, but individuals not at-risk for ADHD displayed a stronger association between perceived accuracy and actual accuracy for the hardest experimental conditions. The most intense moment of effort required predicted retrospective discomfort ratings of the task in the ADHD-risk group, but not in the non-risk group. Conclusion: The subjective experience of in the moment mental effort is an important and viable construct that should be more carefully defined and measured. In particular, the experience of effort required (or how taxing a task is) differentiated between individuals at-risk and individuals not at-risk for ADHD in the present study. Whereas previous ADHD research has explored effort exerted, the present work demonstrated that investigating the experience of being mentally taxed might provide a productive line of investigation that could be used to advance our understanding of the

  18. Relationship between framingham risk score and coronary artery calcium score in asymptomatic Korean individuals

    Energy Technology Data Exchange (ETDEWEB)

    Heo, So Young; Park, Noh Hyuck; Park, Chan Sub; Seong, Su Ok [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of)

    2016-02-15

    We explored the association between Framingham risk score (FRS) and coronary artery calcium score (CACS) in asymptomatic Korean individuals. We retrospectively analyzed 2216 participants who underwent routine health screening and CACS using the 64-slice multidetector computed tomography between January 2010 and June 2014. Relationship between CACS and FRS, and factors associated with discrepancy between CACS and FRS were analyzed. CACS and FRS were positively correlated (p < 0.0001). However, in 3.7% of participants with low coronary event risk and high CACS, age, male gender, smoker, hypertension, total cholesterol, diabetes mellitus, and body mass index (BMI; ≥ 35) were associated with the discrepancy. In the diagnostic prediction model for discrepancy, the receiver operating characteristic curve including factors associated with FRS, diastolic blood pressure (≥ 75 mm Hg), diabetes mellitus, and BMI (≥ 35) showed that the area under the curve was 0.854 (95% confidence interval, 0.819–0.890), indicating good sensitivity. Diabetes mellitus or obesity (BMI ≥ 35) compensate for the weakness of FRS and may be potential indicators for application of CACS in asymptomatic Koreans with low coronary event risk.

  19. Who are those “risk-taking adolescents”? Individual differences in developmental neuroimaging research

    Directory of Open Access Journals (Sweden)

    James M. Bjork

    2015-02-01

    Full Text Available Functional magnetic resonance imaging (fMRI has illuminated the development of human brain function. Some of this work in typically-developing youth has ostensibly captured neural underpinnings of adolescent behavior which is characterized by risk-seeking propensity, according to psychometric questionnaires and a wealth of anecdote. Notably, cross-sectional comparisons have revealed age-dependent differences between adolescents and other age groups in regional brain responsiveness to prospective or experienced rewards (usually greater in adolescents or penalties (usually diminished in adolescents. These differences have been interpreted as reflecting an imbalance between motivational drive and behavioral control mechanisms, especially in mid-adolescence, thus promoting greater risk-taking. While intriguing, we caution here that researchers should be more circumspect in attributing clinically significant adolescent risky behavior to age-group differences in task-elicited fMRI responses from neurotypical subjects. This is because actual mortality and morbidity from behavioral causes (e.g. substance abuse, violence by mid-adolescence is heavily concentrated in individuals who are not neurotypical, who rather have shown a lifelong history of behavioral disinhibition that frequently meets criteria for a disruptive behavior disorder, such as conduct disorder, oppositional-defiant disorder, or attention-deficit hyperactivity disorder. These young people are at extreme risk of poor psychosocial outcomes, and should be a focus of future neurodevelopmental research.

  20. Measurement of functional independence level and falls-risk in individuals with undiagnosed phenylketonuria.

    LENUS (Irish Health Repository)

    Mazur, Artur

    2009-01-01

    The aim of the study was to determine the level of functional independence in adult patients with previously undiagnosed or untreated phenylketonuria (PKU). The study was conducted among 400 intellectually impaired adult residents of Social Welfare Homes in South-Eastern Poland born prior to the introduction of neonatal PKU screening programs. PKU was screened by filter paper test using tandem mass spectrometry methods, and confirmed by gas chromatography-mass spectrometric analysis of PKU organic acids in urine. Degree of functional independence included the assessment of activities of daily living (Barthel Index) and measures of balance and gait (Tinetti scale). Eleven individuals with previously untreated PKU were identified whereby eight presented with moderate disability and three with mild disability. Six had a high risk of falls and five had a moderate risk of falls. This study indicates that there is considerable number of undiagnosed PKU patients within the Polish population who require assessment and management in order to reduce the impact of the neurological and neuropsychiatric problems associated with the condition. Appropriate therapy for those with undiagnosed PKU should, in particular, address the risk of falls.

  1. Can ultrasonography make identification of asymptomatic hyperuricemic individuals at risk for developing gouty arthritis more crystal clear?

    Science.gov (United States)

    Schlesinger, Naomi

    2011-04-19

    Hyperuricemia is the most important risk factor for gouty arthritis. The quandary is how to predict which patient with asymptomatic hyperuricemia will develop gouty arthritis. Can ultrasonography help identify hyperuricemic individuals at risk for developing gouty arthritis? In the previous issue of Arthritis Research & Therapy, Pineda and colleagues found ultrasonography changes suggestive of gouty arthritis in 25% of hyperuricemic individuals. These were found exclusively in hyperuricemic individuals but not in normouricemic patients. Ultrasonography may serve as a noninvasive means to diagnose gouty arthritis in hyperuricemic individuals who have yet to develop symptomatic gouty arthritis.

  2. Salmonella typhi O:9,12 polysaccharide-protein conjugates: characterization and immunoreactivity with pooled and individual normal human sera, sera from patients with paratyphoid A and B and typhoid fever, and animal sera.

    Science.gov (United States)

    Aron, L; Di Fabio, J; Cabello, F C

    1993-04-01

    Polysaccharide of O:9,12 specificity purified from Salmonella typhi was conjugated to tetanus toxoid or bovine serum albumin in order to obtain defined antigenic material that would contain O chain free of other S. typhi antigens and that would be suitable for characterizing host humoral response to only S. typhi O-chain antigens. These artificial conjugates were strongly reactive in immunodots with 18 pooled and 3 individual serum samples from patients with typhoid fever and with rabbit anti-Salmonella O antiserum (group D, factors 1, 9, and 12). They reacted weakly with one serum sample from one human with paratyphoid A. These results suggest that the periodate oxidation and the reductive amination used in the conjugation conserved the immunogenicity of the O chain and allowed its absorption to nitrocellulose. They also suggest that the bovine serum albumin conjugate could be used in the diagnosis of S. typhi infections as normal sera may react with the protein molecule of the tetanus toxoid conjugate.

  3. The Expected Cardiovascular Benefit of Plasma Cholesterol Lowering with or Without LDL-C Targets in Healthy Individuals at Higher Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Fernando Henpin Yue Cesena

    Full Text Available Abstract Background: There is controversy whether management of blood cholesterol should be based or not on LDL-cholesterol (LDL-c target concentrations. Objectives: To compare the estimated impact of different lipid-lowering strategies, based or not on LDL-c targets, on the risk of major cardiovascular events in a population with higher cardiovascular risk. Methods: We included consecutive individuals undergoing a routine health screening in a single center who had a 10-year risk for atherosclerotic cardiovascular disease (ASCVD ≥ 7.5% (pooled cohort equations, ACC/AHA, 2013. For each individual, we simulated two strategies based on LDL-c target (≤ 100 mg/dL [Starget-100] or ≤ 70 mg/dL [Starget-70] and two strategies based on percent LDL-c reduction (30% [S30%] or 50% [S50%]. Results: In 1,897 subjects (57 ± 7 years, 96% men, 10-year ASCVD risk 13.7 ± 7.1%, LDL-c would be lowered from 141 ± 33 mg/dL to 99 ± 23 mg/dL in S30%, 71 ± 16 mg/dL in S50%, 98 ± 9 mg/dL in Starget-100, and 70 ± 2 mg/dL in Starget-70. Ten-year ASCVD risk would be reduced to 8.8 ± 4.8% in S50% and 8.9 ± 5.2 in Starget-70. The number of major cardiovascular events prevented in 10 years per 1,000 individuals would be 32 in S30%, 31 in Starget-100, 49 in S50%, and 48 in Starget-70. Compared with Starget-70, S50% would prevent more events in the lower LDL-c tertile and fewer events in the higher LDL-c tertile. Conclusions: The more aggressive lipid-lowering approaches simulated in this study, based on LDL-c target or percent reduction, may potentially prevent approximately 50% more hard cardiovascular events in the population compared with the less intensive treatments. Baseline LDL-c determines which strategy (based or not on LDL-c target is more appropriate at the individual level.

  4. Context of risk for HIV and sexually transmitted infections among incarcerated women in the south: individual, interpersonal, and societal factors.

    Science.gov (United States)

    Fogel, Catherine I; Gelaude, Deborah J; Carry, Monique; Herbst, Jeffrey H; Parker, Sharon; Scheyette, Anna; Neevel, A

    2014-01-01

    Incarcerated women are disproportionately affected by HIV and sexually transmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women.

  5. Thrombophilic risk of individuals with rare compound factor V Leiden and prothrombin G20210A polymorphisms: an international case series of 100 individuals.

    Science.gov (United States)

    Lim, Ming Y; Deal, Allison M; Kim, Steven; Musty, Michael D; Conard, Jacqueline; Simioni, Paolo; Dutrillaux, Fabienne; Eid, Suhair S; Middeldorp, Saskia; Halbmayer, Walter M; Boneu, Bernard; Moia, Marco; Moll, Stephan

    2016-10-01

    The risk of thrombosis in individuals with rare compound thrombophilias, homozygous factor V Leiden (FVL) plus heterozygous prothrombin G20210A (PTM), homozygous PTM plus heterozygous FVL, and homozygous FVL plus homozygous PTM, is unknown. We identified, worldwide, individuals with these compound thrombophilias, predominantly through mailing members of the International Society on Thrombosis and Haemostasis. Physicians were sent a clinical questionnaire. Confirmatory copies of the genetic results were obtained. One hundred individuals were enrolled; 58% were female. Seventy-one individuals had a venous thrombosis (includes superficial and deep vein thrombosis, and pulmonary embolism), 4 had an arterial thrombosis and 6 had both. Nineteen individuals had never had a thrombotic event. Thrombosis-free survival curves demonstrated that 50% of individuals had experienced a thrombotic event by 35 yrs of age, while 50% had a first venous thromboembolic event (VTE; includes all venous thrombosis except superficial thrombosis) by 41 yrs of age; 38.2% of first VTEs were unprovoked. 37% of patients had at least one VTE recurrence. Seventy percent of first pregnancies carried to term and not treated with anticoagulation were thrombosis-free. In conclusion, patients with these rare compound thrombophilias are not exceedingly thrombogenic, even though they have a substantial risk for VTE. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Hepatitis C Viremia and the Risk of Chronic Kidney Disease in HIV-Infected Individuals

    Science.gov (United States)

    Lucas, Gregory M.; Jing, Yuezhou; Sulkowski, Mark; Abraham, Alison G.; Estrella, Michelle M.; Atta, Mohamed G.; Fine, Derek M.; Klein, Marina B.; Silverberg, Michael J.; Gill, M. John; Moore, Richard D.; Gebo, Kelly A.; Sterling, Timothy R.; Butt, Adeel A.; Kirk, Gregory D.; Benson, Constance A.; Bosch, Ronald J.; Collier, Ann C.; Boswell, Stephen; Grasso, Chris; Mayer, Ken; Hogg, Robert S.; Harrigan, Richard; Montaner, Julio; Cescon, Angela; Brooks, John T.; Buchacz, Kate; Gebo, Kelly A.; Moore, Richard D.; Carey, John T.; Rodriguez, Benigno; Horberg, Michael A.; Silverberg, Michael J.; Horberg, Michael A.; Thorne, Jennifer E.; Goedert, James J.; Jacobson, Lisa P.; Klein, Marina B.; Rourke, Sean B.; Burchell, Ann; Rachlis, Anita R.; Rico, Puerto; Hunter-Mellado, Robert F.; Mayor, Angel M.; Gill, M. John; Deeks, Steven G.; Martin, Jeffrey N.; Patel, Pragna; Brooks, John T.; Saag, Michael S.; Mugavero, Michael J.; Willig, James; Eron, Joseph J.; Napravnik, Sonia; Kitahata, Mari M.; Crane, Heidi M.; Justice, Amy C.; Dubrow, Robert; Fiellin, David; Sterling, Timothy R.; Haas, David; Bebawy, Sally; Turner, Megan; Gange, Stephen J.; Anastos, Kathryn; Moore, Richard D.; Saag, Michael S.; Gange, Stephen J.; Kitahata, Mari M.; McKaig, Rosemary G.; Justice, Amy C.; Freeman, Aimee M.; Moore, Richard D.; Freeman, Aimee M.; Lent, Carol; Kitahata, Mari M.; Van Rompaey, Stephen E.; Crane, Heidi M.; Webster, Eric; Morton, Liz; Simon, Brenda; Gange, Stephen J.; Althoff, Keri N.; Abraham, Alison G.; Lau, Bryan; Zhang, Jinbing; Jing, Jerry; Golub, Elizabeth; Modur, Shari; Hanna, David B.; Rebeiro, Peter; Wong, Cherise; Mendes, Adell

    2013-01-01

    Background. The role of active hepatitis C virus (HCV) replication in chronic kidney disease (CKD) risk has not been clarified. Methods. We compared CKD incidence in a large cohort of HIV-infected subjects who were HCV seronegative, HCV viremic (detectable HCV RNA), or HCV aviremic (HCV seropositive, undetectable HCV RNA). Stages 3 and 5 CKD were defined according to standard criteria. Progressive CKD was defined as a sustained 25% glomerular filtration rate (GFR) decrease from baseline to a GFR < 60 mL/min/1.73 m2. We used Cox models to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results. A total of 52 602 HCV seronegative, 9508 HCV viremic, and 913 HCV aviremic subjects were included. Compared with HCV seronegative subjects, HCV viremic subjects were at increased risk for stage 3 CKD (adjusted HR 1.36 [95% CI, 1.26, 1.46]), stage 5 CKD (1.95 [1.64, 2.31]), and progressive CKD (1.31 [1.19, 1.44]), while HCV aviremic subjects were also at increased risk for stage 3 CKD (1.19 [0.98, 1.45]), stage 5 CKD (1.69 [1.07, 2.65]), and progressive CKD (1.31 [1.02, 1.68]). Conclusions. Compared with HIV-infected subjects who were HCV seronegative, both HCV viremic and HCV aviremic individuals were at increased risk for moderate and advanced CKD. PMID:23904290

  7. Hormonal contraception and the risk of HIV acquisition: an individual participant data meta-analysis.

    Directory of Open Access Journals (Sweden)

    Charles S Morrison

    2015-01-01

    Full Text Available Observational studies of a putative association between hormonal contraception (HC and HIV acquisition have produced conflicting results. We conducted an individual participant data (IPD meta-analysis of studies from sub-Saharan Africa to compare the incidence of HIV infection in women using combined oral contraceptives (COCs or the injectable progestins depot-medroxyprogesterone acetate (DMPA or norethisterone enanthate (NET-EN with women not using HC.Eligible studies measured HC exposure and incident HIV infection prospectively using standardized measures, enrolled women aged 15-49 y, recorded ≥15 incident HIV infections, and measured prespecified covariates. Our primary analysis estimated the adjusted hazard ratio (aHR using two-stage random effects meta-analysis, controlling for region, marital status, age, number of sex partners, and condom use. We included 18 studies, including 37,124 women (43,613 woman-years and 1,830 incident HIV infections. Relative to no HC use, the aHR for HIV acquisition was 1.50 (95% CI 1.24-1.83 for DMPA use, 1.24 (95% CI 0.84-1.82 for NET-EN use, and 1.03 (95% CI 0.88-1.20 for COC use. Between-study heterogeneity was mild (I(2 < 50%. DMPA use was associated with increased HIV acquisition compared with COC use (aHR 1.43, 95% CI 1.23-1.67 and NET-EN use (aHR 1.32, 95% CI 1.08-1.61. Effect estimates were attenuated for studies at lower risk of methodological bias (compared with no HC use, aHR for DMPA use 1.22, 95% CI 0.99-1.50; for NET-EN use 0.67, 95% CI 0.47-0.96; and for COC use 0.91, 95% CI 0.73-1.41 compared to those at higher risk of bias (p(interaction = 0.003. Neither age nor herpes simplex virus type 2 infection status modified the HC-HIV relationship.This IPD meta-analysis found no evidence that COC or NET-EN use increases women's risk of HIV but adds to the evidence that DMPA may increase HIV risk, underscoring the need for additional safe and effective contraceptive options for women at high HIV risk

  8. Time trends for risk of severe age-related diseases in individuals with and without HIV infection in Denmark

    DEFF Research Database (Denmark)

    Rasmussen, Line D; May, Margaret T; Kronborg, Gitte

    2015-01-01

    BACKGROUND: Whether the reported high risk of age-related diseases in HIV-infected people is caused by biological ageing or HIV-associated risk factors such as chronic immune activation and low-grade inflammation is unknown. We assessed time trends in age-standardised and relative risks of nine...... serious age-related diseases in a nationwide cohort study of HIV-infected individuals and population controls. METHODS: We identified all HIV-infected individuals in the Danish HIV Cohort Study who had received HIV care in Denmark between Jan 1, 1995, and June 1, 2014. Population controls were identified...... from the Danish Civil Registration System and individually matched in a ratio of nine to one to the HIV-infected individuals for year of birth, sex, and date of study inclusion. Individuals were included in the study if they had a Danish personal identification number, were aged 16 years or older...

  9. Can ultrasonography make identification of asymptomatic hyperuricemic individuals at risk for developing gouty arthritis more crystal clear?

    OpenAIRE

    Schlesinger, Naomi

    2011-01-01

    Hyperuricemia is the most important risk factor for gouty arthritis. The quandary is how to predict which patient with asymptomatic hyperuricemia will develop gouty arthritis. Can ultrasonography help identify hyperuricemic individuals at risk for developing gouty arthritis? In the previous issue of Arthritis Research & Therapy, Pineda and colleagues found ultrasonography changes suggestive of gouty arthritis in 25% of hyperuricemic individuals. These were found exclusively in hyperuricemic i...

  10. Individualized patient-centered lifestyle recommendations: an expert system for communicating patient specific cardiovascular risk information and prioritizing lifestyle options.

    Science.gov (United States)

    Chi, Chih-Lin; Nick Street, W; Robinson, Jennifer G; Crawford, Matthew A

    2012-12-01

    We propose a proof-of-concept machine-learning expert system that learned knowledge of lifestyle and the associated 10-year cardiovascular disease (CVD) risks from individual-level data (i.e., Atherosclerosis Risk in Communities Study, ARIC). The expert system prioritizes lifestyle options and identifies the one that maximally reduce an individual's 10-year CVD risk by (1) using the knowledge learned from the ARIC data and (2) communicating for patient-specific cardiovascular risk information and personal limitations and preferences (as defined by variables used in this study). As a result, the optimal lifestyle is not only prioritized based on an individual's characteristics but is also relevant to personal circumstances. We also explored probable uses and tested the system in several examples using real-world scenarios and patient preferences. For example, the system identifies the most effective lifestyle activities as the starting point for an individual's behavior change, shows different levels of BMI changes and the associated CVD risk reductions to encourage weight loss, identifies whether weight loss or smoking cessation is the most urgent change for a diabetes patient, etc. Answers to the questions noted above vary based on an individual's characteristics. Our validation results from clinical trial simulations, which compared original with the optimal lifestyle using an independent dataset, show that the optimal individualized patient-centered lifestyle consistently reduced 10-year CVD risks. Copyright © 2012. Published by Elsevier Inc.

  11. Intimate partner violence and HIV/STD risk among lesbian, gay, bisexual, and transgender individuals.

    Science.gov (United States)

    Heintz, Adam Jackson; Melendez, Rita M

    2006-02-01

    To date, there has been little research examining HIV/STD risk among lesbian, gay, bisexual, and transgender (LGBT) individuals who are in abusive relationships. This article uses data collected from a community-based organization that provides counseling for LGBT victims of intimate partner violence (IPV). A total of 58 clients completed the survey, which inquired as to sexual violence and difficulties negotiating safer sex with their abusive partners. A large percentage of participants reported being forced by their partners to have sex (41%). Many stated that they felt unsafe to ask their abusive partners to use safer sex protection or that they feared their partners' response to safer sex (28%). In addition, many participants experienced sexual (19%), physical (21%), and/or verbal abuse (32%) as a direct consequence of asking their partner to use safer sex protection. Training counselors on issues of sexuality and safer sex will benefit victims of IPV.

  12. Risk factors for West Nile virus infection and disease in populations and individuals.

    Science.gov (United States)

    Montgomery, Ruth R; Murray, Kristy O

    2015-03-01

    West Nile virus (WNV) is a mosquito-borne enveloped positive-strand RNA virus that emerged in North America in 1999 in New York City. Over the past 15 years, WNV has become established throughout the USA and has spread into Canada, Mexico and the Caribbean. CDC reports indicate >41,000 clinical cases, including more than 1700 fatalities. An estimated 3 million people in the USA may have been infected to date. Infection with WNV is dependent on many factors including climate, mosquito habitats and immunologically naïve bird populations. In addition, variations within individuals contribute to the risk of severe disease, in particular, advanced age, hypertension, immunosuppression and critical elements of the immune response. Recent advances in technology now allow detailed analysis of complex immune interactions relevant to disease susceptibility.

  13. Neighborhood disorder, individual protective factors, and the risk of adolescent delinquency.

    Science.gov (United States)

    Calvert, Wilma J

    2002-01-01

    Traditionally, violent and delinquent behaviors have been addressed by the criminal justice system, with the focus being secondary and tertiary interventions. During the last decade, the focus on violence as a public health issue has increased. The purpose of this research was to examine how individual protective factors for adolescent delinquency varied according to neighborhood quality. The researcher conducted a secondary data analysis, using data from the National Youth Survey A total of 1,621 adolescents comprised the sample. The majority of the respondents participated in some type of delinquent behavior, with more Blacks reporting participation in violent behaviors. There was a positive relationship between academic history and no participation in delinquent behavior. The regression model for violent delinquency accounted for 10% of the variance in the disordered neighborhoods. Primary prevention efforts, commonly used by public health nurses, should be aimed at eliminating risk factors such as those found in disordered neighborhoods.

  14. Cluster Individuals Based on Phenotype and Determine the Risk for Atrial Fibrillation in the PREVEND and Framingham Heart Study Populations

    NARCIS (Netherlands)

    Rienstra, Michiel; Geelhoed, Bastiaan; Yin, Xiaoyan; Siland, Joylene; Vermond, Robert; Mulder, Bart A; Van Der Harst, Pim; Hillege, Hans L; Benjamin, Emelia J; Van Gelder, Isabelle C

    2016-01-01

    BACKGROUND: Risk prediction of atrial fibrillation (AF) is of importance to improve the early diagnosis and treatment of AF. Latent class analysis takes into account the possible existence of classes of individuals each with shared risk factors, and maybe a better method of incorporating the

  15. Cluster Individuals Based on Phenotype and Determine the Risk for Atrial Fibrillation in the PREVEND and Framingham Heart Study Populations

    NARCIS (Netherlands)

    Rienstra, Michiel; Geelhoed, Bastiaan; Yin, Xiaoyan; Siland, Joylene; Vermond, Robert; Mulder, Bart A; Van Der Harst, Pim; Hillege, Hans L; Benjamin, Emelia J; Van Gelder, Isabelle C

    2016-01-01

    BACKGROUND: Risk prediction of atrial fibrillation (AF) is of importance to improve the early diagnosis and treatment of AF. Latent class analysis takes into account the possible existence of classes of individuals each with shared risk factors, and maybe a better method of incorporating the phenoty

  16. Risk of All-Cause Mortality in Alcohol-Dependent Individuals: A Systematic Literature Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Philippe Laramée

    2015-10-01

    Interpretation: AD was found to significantly increase an individual's risk of all-cause mortality. While abstinence in alcohol-dependent subjects led to greater mortality reduction than non-abstinence, this study suggests that alcohol-dependent subjects can significantly reduce their mortality risk by reducing alcohol consumption.

  17. Changes in biomarkers of cardiovascular risk after a switch to abacavir in HIV-1-infected individuals receiving combination antiretroviral therapy

    DEFF Research Database (Denmark)

    Kristoffersen, U S; Kofoed, K; Kronborg, G;

    2009-01-01

    OBJECTIVES: To investigate, using a longitudinal design, whether biomarkers of cardiovascular risk change after a switch to an abacavir (ABC)-containing regimen in HIV-1-infected individuals already receiving combination antiretroviral therapy (ART). METHODS: Thirty-five HIV-1-infected individuals...

  18. 34 CFR 97.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

    Science.gov (United States)

    2010-07-01

    ... prospect of direct benefit to individual subjects, but likely to yield generalizable knowledge about the... § 97.406 Research involving greater than minimal risk and no prospect of direct benefit to individual... an intervention or procedure that does not hold out the prospect of direct benefit for the...

  19. Survey of Individual and Institutional Risk Associated with the Use of Social Media

    Directory of Open Access Journals (Sweden)

    Manish Garg

    2016-05-01

    identifiable patient information (p=0.0004 than were residents. Conclusion: EM residents and faculty members cause and encounter HRTPE frequently while using SM; these events present significant risks to the individuals responsible and their associated institution. Awareness of these risks should prompt responsible SM use and consideration of CORD’s Social Media Task Force recommendations.

  20. Individual and work related risk factors for neck pain among office workers: a cross sectional study.

    Science.gov (United States)

    Cagnie, B; Danneels, L; Van Tiggelen, D; De Loose, V; Cambier, D

    2007-05-01

    Work related neck disorders are common problems in office workers, especially among those who are intensive computer users. It is generally agreed that the etiology of work related neck disorders is multidimensional which is associated with, and influenced by, a complex array of individual, physical and psychosocial factors. The aim of the current study was to estimate the one-year prevalence of neck pain among office workers and to determine which physical, psychological and individual factors are associated with these prevalences. Five hundred and twelve office workers were studied. Information was collected by an online questionnaire. Self-reported neck pain during the preceding 12 months was regarded as a dependent variable, whereas different individual, work-related physical and psychosocial factors were studied as independent variables. The 12 month prevalences of neck pain in office workers was 45.5%. Multivariate analysis revealed that women had an almost two-fold risk compared with men (OR = 1.95, 95% CI 1.22-3.13). The odds ratio for age indicates that persons older than 30 years have 2.61 times more chance of having neck pain than younger individuals (OR = 2.61, 95% CI 1.32-3.47). Being physically active decreases the likelihood of having neck pain (OR = 1.85, 95% CI 1.14-2.99). Significant associations were found between neck pain and often holding the neck in a forward bent posture for a prolonged time (OR = 2.01, 95% CI 1.20-3.38), often sitting for a prolonged time (OR = 2.06, 95% CI 1.17-3.62) and often making the same movements per minute (OR = 1.63, 95% CI 1.02-2.60). Mental tiredness at the end of the workday (OR = 2.05, 95% CI 1.29-3.26) and shortage of personnel (OR = 1.71, 95% CI 1.06-2.76) are significantly associated with neck pain. The results of this study indicate that physical and psychosocial work factors, as well as individual variables, are associated with the frequency of neck pain. These association patterns suggest also

  1. Prevalence of colorectal neoplasms in young, average risk individuals: A turning tide between East and West.

    Science.gov (United States)

    Leshno, Ari; Moshkowitz, Menachem; David, Maayan; Galazan, Lior; Neugut, Alfred I; Arber, Nadir; Santo, Erwin

    2016-08-28

    To determine the prevalence of colorectal neoplasia in average risk persons 40-59 years of age in Israel and to compare the results with other populations. We reviewed the results of asymptomatic average-risk subjects, aged 40 to 59 years, undergoing their first screening colonoscopy between April 1994 and January 2014. The detection rates of adenoma, advanced adenoma (AA) and colorectal cancer (CRC) were determined in the 40's and 50's age groups by gender. The prevalence of lesions was compared between age groups. After meticulous review of the literature, these results were compared to published studies addressing the prevalence of colorectal neoplasia in similar patient groups, in a variety of geographical locations. We included first screening colonoscopy results of 1750 individuals. The prevalence of adenomas, AA and CRC was 8.3%, 1.0% and 0.2% in the 40-49 age group and 13.7%, 2.4% and 0.2% in the 50-59 age group, respectively. Age-dependent differences in adenoma and AA rates were significant only among men (P colorectal neoplasia in Asian populations requires further investigation and reconsideration as to the starting age of screening in that population.

  2. Advancing training to identify, intervene, and follow up with individuals at risk for suicide through research.

    Science.gov (United States)

    Osteen, Philip J; Frey, Jodi J; Ko, Jungyai

    2014-09-01

    Research and training on suicide is critical given the fact that the majority of suicide deaths are preventable with accurate identification of risk and intervention by trained individuals. However, implementing and evaluating training is difficult because of the multiple factors involved, including, but not limited to, the heterogeneity of trainees, their diverse roles in suicide prevention, absence of clear guidelines for training content across settings, and limited methods for assessing outcomes. Here, three groups of trainees are discussed: community and professional gatekeepers and behavioral health providers. The roles each group plays in managing suicide risk and the training content it needs to be effective are addressed. A staged training approach is proposed, building on the core components of currently used suicide training: knowledge, attitudes, and skills/behaviors. Limitations of current assessment methods are identified and recommendations for alternative methods are provided. The article concludes with a discussion of next steps in moving the field forward, including overcoming challenges and identifying and engaging opportunities. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Individualized Early Prediction of Familial Risk of Dyslexia: A Study of Infant Vocabulary Development.

    Science.gov (United States)

    Chen, Ao; Wijnen, Frank; Koster, Charlotte; Schnack, Hugo

    2017-01-01

    We examined early vocabulary development in children at familial risk (FR) of dyslexia and typically developing (TD) children between 17 and 35 months of age. We trained a support vector machine to classify TD and FR using these vocabulary data at the individual level. The Dutch version of the McArthur-Bates Communicative Development Inventory (Words and Sentences) (N-CDI) was used to measure vocabulary development. We analyzed group-level differences for both total vocabulary as well as lexical classes: common nouns, predicates, and closed class words. The generalizability of the classification model was tested using cross-validation. At the group level, for both total vocabulary and the composites, the difference between TD and FR was most pronounced at 19-20 months, with FRs having lower scores. For the individual prediction, highest cross-validation accuracy (68%) was obtained at 19-20 months, with sensitivity (correctly classified FR) being 70% and specificity (correctly classified TD) being 67%. There is a sensitive window in which the difference between FR and TD is most evident. Machine learning methods are promising techniques for separating FR and TD children at an early age, before they start reading.

  4. Individualized Early Prediction of Familial Risk of Dyslexia: A Study of Infant Vocabulary Development

    Science.gov (United States)

    Chen, Ao; Wijnen, Frank; Koster, Charlotte; Schnack, Hugo

    2017-01-01

    We examined early vocabulary development in children at familial risk (FR) of dyslexia and typically developing (TD) children between 17 and 35 months of age. We trained a support vector machine to classify TD and FR using these vocabulary data at the individual level. The Dutch version of the McArthur-Bates Communicative Development Inventory (Words and Sentences) (N-CDI) was used to measure vocabulary development. We analyzed group-level differences for both total vocabulary as well as lexical classes: common nouns, predicates, and closed class words. The generalizability of the classification model was tested using cross-validation. At the group level, for both total vocabulary and the composites, the difference between TD and FR was most pronounced at 19–20 months, with FRs having lower scores. For the individual prediction, highest cross-validation accuracy (68%) was obtained at 19–20 months, with sensitivity (correctly classified FR) being 70% and specificity (correctly classified TD) being 67%. There is a sensitive window in which the difference between FR and TD is most evident. Machine learning methods are promising techniques for separating FR and TD children at an early age, before they start reading. PMID:28270778

  5. Perceived ethnic discrimination and persecutory paranoia in individuals at ultra-high risk for psychosis.

    Science.gov (United States)

    Shaikh, Madiha; Ellett, Lyn; Dutt, Anirban; Day, Fern; Laing, Jennifer; Kroll, Jasmine; Petrella, Sabrina; McGuire, Philip; Valmaggia, Lucia R

    2016-07-30

    Despite a consensus that psychosocial adversity plays a role in the onset of psychosis, the nature of this role in relation to persecutory paranoia remains unclear. This study examined the complex relationship between perceived ethnic discrimination and paranoid ideation in individuals at Ultra High Risk (UHR) for psychosis using a virtual reality paradigm to objectively measure paranoia. Data from 64 UHR participants and 43 healthy volunteers were analysed to investigate the relationship between perceived ethnic discrimination and persecutory ideation in a virtual reality environment. Perceived ethnic discrimination was higher in young adults at UHR in comparison to healthy controls. A positive correlation was observed between perceived ethnic discrimination and paranoid persecutory ideation in the whole sample. Perceived ethnic discrimination was not a significant predictor of paranoid persecutory ideation in the VR environment. Elevated levels of perceived ethnic discrimination are present in individuals at UHR and are consistent with current biopsychosocial models in which psychosocial adversity plays a key role in the development of psychosis and attenuated symptomatology.

  6. Risk Factors for E. coli O157 and Cryptosporidiosis Infection in Individuals in the Karst Valleys of East Tennessee, USA

    Directory of Open Access Journals (Sweden)

    Ingrid Luffman

    2014-08-01

    Full Text Available This research examines risk factors for sporadic cryptosporidiosis and Escherichia coli (E. coli O157 infection in East Tennessee, using a case-control approach and spatial logistic regression models. The risk factors examined are animal density, land use, geology, surface water impairment, poverty rate and availability of private water supply. Proximity to karst geology, beef cow population density and a high percentage of both developed land and pasture land are positively associated with both diseases. The availability of private water supply is negatively associated with both diseases. Risk maps generated using the model coefficients show areas of elevated risk to identify the communities where background risk is highest, so that limited public health resources can be targeted to the risk factors and communities most at risk. These results can be used as the framework upon which to develop a comprehensive epidemiological study that focuses on risk factors important at the individual level.

  7. Prediction of depression in individuals at high familial risk of mood disorders using functional magnetic resonance imaging.

    Directory of Open Access Journals (Sweden)

    Heather C Whalley

    Full Text Available OBJECTIVE: Bipolar disorder is a highly heritable condition. First-degree relatives of affected individuals have a more than a ten-fold increased risk of developing bipolar disorder (BD, and a three-fold risk of developing major depressive disorder (MDD than the general population. It is unclear however whether differences in brain activation reported in BD and MDD are present before the onset of illness. METHODS: We studied 98 young unaffected individuals at high familial risk of BD and 58 healthy controls using functional Magnetic Resonance Imaging (fMRI scans and a task involving executive and language processing. Twenty of the high-risk subjects subsequently developed MDD after the baseline fMRI scan. RESULTS: At baseline the high-risk subjects who later developed MDD demonstrated relatively increased activation in the insula cortex, compared to controls and high risk subjects who remained well. In the healthy controls and high-risk group who remained well, this region demonstrated reduced engagement with increasing task difficulty. The high risk subjects who subsequently developed MDD did not demonstrate this normal disengagement. Activation in this region correlated positively with measures of cyclothymia and neuroticism at baseline, but not with measures of depression. CONCLUSIONS: These results suggest that increased activation of the insula can differentiate individuals at high-risk of bipolar disorder who later develop MDD from healthy controls and those at familial risk who remain well. These findings offer the potential of future risk stratification in individuals at risk of mood disorder for familial reasons.

  8. Do we need antiplatelet therapy in thrombocytosis? Contra. Proposal for an individualized risk-adapted treatment.

    Science.gov (United States)

    Scharf, Rüdiger E

    2016-11-07

    Thrombocytosis is a frequent laboratory finding but not a diagnosis. Therefore, elevated platelet counts (>450 x 10(9)/l) require careful diagnostic work-up to differentiate between reactive thrombocytosis (RT), caused by various conditions, and essential thrombocythemia (ET), a myeloproliferative neoplasm (MPN). In either setting, aspirin is widely used in clinical practice. However, RT (even at platelet counts >1000 x 10(9)/l) has never been shown to cause thrombosis or bleeding due to acquired von Willebrand factor defects in association with high platelet counts. Identification of reactive conditions and appropriate therapy of the underlying disorder are most relevant. By contrast to RT, ET and related MPN can be associated with thrombosis and/or hemorrhage. Current recommendations suggest the use of low-dose aspirin in all patients with ET unless contraindicated. However, the strength of this recommendation is weak, i. e. evidence level IIb grade B. A potential benefit of aspirin used for primary thromboprophylaxis in ET is mostly derived from the ECLAP study in polycythemia vera (PV). However, translating study results from PV to ET appears to be highly questionable and may be biased. In the absence of robust data regarding the benefit-risk balance of aspirin in ET, it appears reasonable (1) to stratify patients according to their individual thrombotic and bleeding risk, (2) to restrict the use of aspirin to high-risk categories and patients with microcirculatory disturbances, (3) to test for pharmacological efficacy (COX-1 inhibition; measurement of TXB2), and (4) to modify the aspirin dosing regimen (twice instead of once daily) if required.

  9. Understanding the Impacts of Dark Pools on Price Discovery

    OpenAIRE

    Ye, Linlin

    2016-01-01

    This paper investigates the impact of dark pools on price discovery (the efficiency of prices on stock exchanges to aggregate information). Assets are traded in either an exchange or a dark pool, with the dark pool offering better prices but lower execution rates. Informed traders receive noisy and heterogeneous signals about an asset's fundamental. We find that informed traders use dark pools to mitigate their information risk and there is a sorting effect: in equilibrium, traders with stron...

  10. Knowledge of risk factors for diabetes or cardiovascular disease (CVD) is poor among individuals with risk factors for CVD.

    Science.gov (United States)

    Kilkenny, Monique F; Dunstan, Libby; Busingye, Doreen; Purvis, Tara; Reyneke, Megan; Orgill, Mary; Cadilhac, Dominique A

    2017-01-01

    There is limited evidence on whether having pre-existing cardiovascular disease (CVD) or risk factors for CVD such as diabetes, ensures greater knowledge of risk factors important for motivating preventative behaviours. Our objective was to compare knowledge among the Australian public participating in a health check program and their risk status. Data from the Stroke Foundation 'Know your numbers' program were used. Staff in community pharmacies provided opportunistic health checks (measurement of blood pressure and diabetes risk assessment) among their customers. Participants were categorised: 1) CVD ± risk of CVD: history of stroke, heart disease or kidney disease, and may have risk factors; 2) risk of CVD only: reported having high blood pressure, high cholesterol, diabetes or atrial fibrillation; and 3) CVD risk free (no CVD or risk of CVD). Multivariable logistic regression analyses were performed including adjustment for age and sex. Among 4,647 participants, 12% had CVD (55% male, 85% aged 55+ years), 47% were at risk of CVD (40% male, 72% 55+ years) and 41% were CVD risk free (33% male, 27% 55+ years). Participants with CVD (OR: 0.66; 95% CI: 0.55, 0.80) or risk factors for CVD (OR: 0.65; 95% CI: 0.57, 0.73) had poorer knowledge of the risk factors for diabetes/CVD compared to those who were CVD risk free. After adjustment, only participants with risk factors for CVD (OR: 0.80; 95% CI: 0.69, 0.93) had poorer knowledge. Older participants (55+ years) and men had poorer knowledge of diabetes/CVD risk factors and complications of diabetes. Participants with poorer knowledge of risk factors were older, more often male or were at risk of developing CVD compared with those who were CVD risk free. Health education in these high risk groups should be a priority, as diabetes and CVD are increasing in prevalence throughout the world.

  11. The association between polyunsaturated fatty acid consumption and the transition to psychosis in ultra-high risk individuals.

    Science.gov (United States)

    Pawełczyk, T; Trafalska, E; Kotlicka-Antczak, M; Pawełczyk, A

    2016-05-01

    PUFA deficiencies in cellular membranes have been observed in ultra-high risk (HR) individuals and in early schizophrenia. It is uncertain whether dietary PUFA consumption can be associated with the risk of transition to psychosis in HR individuals. The aim of the study was to assess PUFA consumption and confirm whether dietary habits are related to the risk of transition to full-threshold psychosis in HR individuals during a 12-month follow-up. PUFA consumption during the previous year was analyzed in 62 h individuals and 33 healthy controls (HC) at the beginning of the follow-up period using a validated Food-Frequency Questionnaire and the Polish Food Composition Tables. Fifteen HR individuals converted into psychosis (C-HR) during the 12-month follow-up. C-HR individuals reported significantly higher consumption of n-6 fatty acids (linoleic acid, LA and arachidonic acid, AA) in comparison with individuals who did not develop psychosis (NC-HR). The C-HR group reported a significantly higher AA/(EPA+DHA) consumption ratio than the NC-HR group. HC reported significantly higher consumption of most n-3 PUFA and lower consumption of all n-6 PUFA than both groups of HR individuals. The results suggest that dietary patterns of PUFA consumption may play a role in the conversion to psychosis of HR individuals.

  12. Simple and practical screening approach to identify HIV-infected individuals with depression or at risk of developing depression

    DEFF Research Database (Denmark)

    Rodkjaer, L; Gabel, C; Laursen, T

    2016-01-01

    OBJECTIVES: Studies have shown that depression and other mental illnesses are under-diagnosed among HIV-infected individuals. The aim of this study was to evaluate the use of mental health history and questionnaire-based screening instruments to identify HIV-infected individuals at risk...... of depression. CONCLUSIONS: We suggest that the mental health of HIV-infected individuals should be reviewed and a "risk-flag" three-step approach should be used (1) to screen routinely with the two verbal questions suggested by the EACS, (2) to identify whether there is a risk of depression and then screen...... with the BDI-II, and (3) to identify whether there is still a risk and then perform a full evaluation and obtain an accurate psychiatric diagnosis by a psychiatrist....

  13. Association between activity space exposure to food establishments and individual risk of overweight.

    Directory of Open Access Journals (Sweden)

    Yan Kestens

    Full Text Available OBJECTIVE: Environmental exposure to food sources may underpin area level differences in individual risk for overweight. Place of residence is generally used to assess neighbourhood exposure. Yet, because people are mobile, multiple exposures should be accounted for to assess the relation between food environments and overweight. Unfortunately, mobility data is often missing from health surveys. We hereby test the feasibility of linking travel survey data with food listings to derive food store exposure predictors of overweight among health survey participants. METHODS: Food environment exposure measures accounting for non-residential activity places (activity spaces were computed and modelled in Montreal and Quebec City, Canada, using travel surveys and food store listings. Models were then used to predict activity space food exposures for 5,578 participants of the Canadian Community Health Survey. These food exposure estimates, accounting for daily mobility, were used to model self-reported overweight in a multilevel framework. Median Odd Ratios were used to assess the proportion of between-neighborhood variance explained by such food exposure predictors. RESULTS: Estimates of food environment exposure accounting for both residential and non-residential destinations were significantly and more strongly associated with overweight than residential-only measures of exposure for men. For women, residential exposures were more strongly associated with overweight than non-residential exposures. In Montreal, adjusted models showed men in the highest quartile of exposure to food stores were at lesser risk of being overweight considering exposure to restaurants (OR = 0.36 [0.21-0.62], fast food outlets (0.48 [0.30-0.79], or corner stores (0.52 [0.35-0.78]. Conversely, men experiencing the highest proportion of restaurants being fast-food outlets were at higher risk of being overweight (2.07 [1.25-3.42]. Women experiencing higher residential exposures

  14. Next Generation Sequencing of Pooled Samples: Guideline for Variants’ Filtering

    Science.gov (United States)

    Anand, Santosh; Mangano, Eleonora; Barizzone, Nadia; Bordoni, Roberta; Sorosina, Melissa; Clarelli, Ferdinando; Corrado, Lucia; Martinelli Boneschi, Filippo; D’Alfonso, Sandra; De Bellis, Gianluca

    2016-01-01

    Sequencing large number of individuals, which is often needed for population genetics studies, is still economically challenging despite falling costs of Next Generation Sequencing (NGS). Pool-seq is an alternative cost- and time-effective option in which DNA from several individuals is pooled for sequencing. However, pooling of DNA creates new problems and challenges for accurate variant call and allele frequency (AF) estimation. In particular, sequencing errors confound with the alleles present at low frequency in the pools possibly giving rise to false positive variants. We sequenced 996 individuals in 83 pools (12 individuals/pool) in a targeted re-sequencing experiment. We show that Pool-seq AFs are robust and reliable by comparing them with public variant databases and in-house SNP-genotyping data of individual subjects of pools. Furthermore, we propose a simple filtering guideline for the removal of spurious variants based on the Kolmogorov-Smirnov statistical test. We experimentally validated our filters by comparing Pool-seq to individual sequencing data showing that the filters remove most of the false variants while retaining majority of true variants. The proposed guideline is fairly generic in nature and could be easily applied in other Pool-seq experiments. PMID:27670852

  15. Waist circumference is the best index for obesity-related cardiovascular disease risk in individuals with spinal cord injury.

    Science.gov (United States)

    Ravensbergen, Henrike Rianne Joanna Cornelie; Lear, Scott Alexander; Claydon, Victoria Elizabeth

    2014-02-01

    Obesity is an important identifier of cardiovascular disease (CVD) risk, but is challenging to determine accurately in individuals with spinal cord injury (SCI). Body mass index (BMI) is used worldwide as a simple indicator of obesity, but is difficult to measure in individuals with SCI. Furthermore, standard BMI cutoffs underestimate obesity in this population. Therefore, we aimed to identify the best marker of obesity in individuals with SCI, considering both practicality, and ability to detect adiposity and CVD risk. Five anthropometric measures were evaluated: BMI; waist circumference (WC); waist-to-height ratio (WHtR); waist-to-hip ratio; and neck circumference. We evaluated relationships between these measures and abdominal and total body-fat percentage, seven cardiovascular metabolic risk factors (fasting insulin, glucose, glucose tolerance, triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol), and the Framingham risk score. BMI, WC, and WHtR were correlated with abdominal fat percentage. WC and WHtR were correlated with five metabolic risk factors as well as the Framingham risk score. WC is a more practical measure for an SCI population. The optimal cutoff for identifying adverse CVD risk in individuals with SCI was identified as WC ≥94 cm, with 100% sensitivity and 79% specificity. We propose that WC is a simple, more sensitive alternative to BMI in this population that is easy to use in multiple settings. The cutoff provides a simple tool to predict adverse CVD risk profiles that can be used to guide risk management, as well as as a practical aid for individuals with SCI to maintain a healthy body composition.

  16. Factors contributing to risk for cancer among HIV-infected individuals, and evidence that earlier combination antiretroviral therapy will alter this risk

    DEFF Research Database (Denmark)

    Borges, Alvaro Humberto Diniz; Dubrow, Robert; Silverberg, Michael J

    2014-01-01

    PURPOSE OF REVIEW: To critically appraise recent published literature about factors associated with cancer risk likely to be influenced by combination antiretroviral therapy (cART) in HIV-infected individuals, and the potential of earlier cART initiation to reduce this risk. RECENT FINDINGS...... and epidemiological data have been reported as to whether (and how) cART affects NADM risk. Furthermore, secondary analyses of randomized controlled trials comparing early versus delayed cART initiation were inconclusive. SUMMARY: Continuous epidemiological surveillance is warranted to monitor trends in cancer...... incidence among HIV-infected individuals and to better understand the impact of earlier cART on NADM risk. The role of adjuvant anti-inflammatory or antithrombotic therapies to reduce cancer risk deserves further investigation....

  17. Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease: An Individual Participant Data Meta-Analysis.

    Science.gov (United States)

    Ohkuma, Toshiaki; Ninomiya, Toshiharu; Tomiyama, Hirofumi; Kario, Kazuomi; Hoshide, Satoshi; Kita, Yoshikuni; Inoguchi, Toyoshi; Maeda, Yasutaka; Kohara, Katsuhiko; Tabara, Yasuharu; Nakamura, Motoyuki; Ohkubo, Takayoshi; Watada, Hirotaka; Munakata, Masanori; Ohishi, Mitsuru; Ito, Norihisa; Nakamura, Michinari; Shoji, Tetsuo; Vlachopoulos, Charalambos; Yamashina, Akira

    2017-06-01

    An individual participant data meta-analysis was conducted in the data of 14 673 Japanese participants without a history of cardiovascular disease (CVD) to examine the association of the brachial-ankle pulse wave velocity (baPWV) with the risk of development of CVD. During the average 6.4-year follow-up period, 687 participants died and 735 developed cardiovascular events. A higher baPWV was significantly associated with a higher risk of CVD, even after adjustments for conventional risk factors (P for trend analysis clearly established baPWV as an independent predictor of the risk of development of CVD in Japanese subjects without preexisting CVD. Thus, measurement of the baPWV could enhance the efficacy of prediction of the risk of development of CVD over that of the Framingham risk score, which is based on the traditional cardiovascular risk factors. © 2017 American Heart Association, Inc.

  18. Pooling strategies for St Petersburg gamblers

    OpenAIRE

    Csörgö, Sandor; Simons, Gordon

    2006-01-01

    Peter offers to play exactly one St Petersburg game with each of [math] players, Paul [math] , [math] , Paul [math] , whose conceivable pooling strategies are described by all possible probability distributions [math] . Comparing infinite expectations, we characterize among all [math] those admissible strategies for which the pooled winnings, each distributed as [math] , yield a finite added value for each and every one of Paul [math] , [math] , Paul [math] in comparison with their individual...

  19. Pooling strategies for St Petersburg gamblers

    OpenAIRE

    Csörgö, Sandor; Simons, Gordon

    2006-01-01

    Peter offers to play exactly one St Petersburg game with each of [math] players, Paul [math] , [math] , Paul [math] , whose conceivable pooling strategies are described by all possible probability distributions [math] . Comparing infinite expectations, we characterize among all [math] those admissible strategies for which the pooled winnings, each distributed as [math] , yield a finite added value for each and every one of Paul [math] , [math] , Paul [math] in comparison with their individual...

  20. Body mass index and risk of head and neck cancer in a pooled analysis of case–control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium

    Science.gov (United States)

    Gaudet, Mia M; Olshan, Andrew F; Chuang, Shu-Chun; Berthiller, Julien; Zhang, Zuo-Feng; Lissowska, Jolanta; Zaridze, David; Winn, Deborah M; Wei, Qingyi; Talamini, Renato; Szeszenia-Dabrowska, Neolilia; Sturgis, Erich M; Schwartz, Stephen M; Rudnai, Peter; Eluf-Neto, Jose; Muscat, Joshua; Morgenstern, Hal; Menezes, Ana; Matos, Elena; Bucur, Alexandru; Levi, Fabio; Lazarus, Philip; La Vecchia, Carlo; Koifman, Sergio; Kelsey, Karl; Herrero, Rolando; Hayes, Richard B; Franceschi, Silva; Wunsch-Filho, Victor; Fernandez, Leticia; Fabianova, Eleonora; Daudt, Alexander W; Dal Maso, Luigino; Paula Curado, Maria; Chen, Chu; Castellsague, Xavier; Benhamou, Simone; Boffetta, Paolo; Brennan, Paul; Hashibe, Mia

    2010-01-01

    Background Head and neck cancer (HNC) risk is elevated among lean people and reduced among overweight or obese people in some studies; however, it is unknown whether these associations differ for certain subgroups or are influenced by residual confounding from the effects of alcohol and tobacco use or by other sources of biases. Methods We pooled data from 17 case–control studies including 12 716 cases and the 17 438 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between body mass index (BMI) at different ages and HNC risk, adjusted for age, sex, centre, race, education, tobacco smoking and alcohol consumption. Results Adjusted ORs (95% CIs) were elevated for people with BMI at reference (date of diagnosis for cases and date of selection for controls) ≤18.5 kg/m2 (2.13, 1.75–2.58) and reduced for BMI >25.0–30.0 kg/m2 (0.52, 0.44–0.60) and BMI ≥30 kg/m2 (0.43, 0.33–0.57), compared with BMI >18.5–25.0 kg/m2. These associations did not differ by age, sex, tumour site or control source. Although the increased risk among people with BMI ≤18.5 kg/m2 was not modified by tobacco smoking or alcohol drinking, the inverse association for people with BMI > 25 kg/m2 was present only in smokers and drinkers. Conclusions In our large pooled analysis, leanness was associated with increased HNC risk regardless of smoking and drinking status, although reverse causality cannot be excluded. The reduced risk among overweight or obese people may indicate body size is a modifier of the risk associated with smoking and drinking. Further clarification may be provided by analyses of prospective cohort and mechanistic studies. PMID:20123951

  1. Relationship between Individual Characteristics and High Risk Behavior in Intravenous Drug Addicts in Ardabil, 2012

    Directory of Open Access Journals (Sweden)

    Nasrin Fouladi

    2014-12-01

    Full Text Available Background & objectives: Addiction is one of the problems in world threating the social, economic and culture factors. It is essential to have an accurate knowledge about the characteristics of drug users in order to diminish the high-risk behaviors of intravenous drug addicts. This research has been done to assess relationship between individual characteristics and high risk behavior in intravenous drug addicts.   Method: In this descriptive-analytic research, 360 drug users were selected from different places in Ardabil city and interviewed by a prepared questionnaire. The data were analyzed using descriptive and analytical tests including t-test, Pearson correlation and ANOVA with SPSS statistical software.   Results: The results showed that the age, gender, material status, job position, age of addiction start, age of injection start, injection frequency, injection frequency per day, syringe supply place and the partner’s gender during recent few months had no significant difference compared to drug users with needle sharing and without needle sharing. The educational level of drug users with needle sharing was lower (P=0.037 and the number of new syringe usage per month was also lesser (P=0.001. They predicted to be more likely infected with AIDS (P=0.001 and had a less argument with their partner about using condom, also mostly have not used condom at their last sexual relationship (P=0.001. The average number of their partners during last three months was high (P=0.003 and there was a meaningful relationship between true sense of peril and using condom in drug users with needle sharing group (p=0.001.   Conclusion: There is a significant relationship between the true sense of danger and the using condom. It is necessary to have an appropriate advertising to increase using condoms among injecting drug users.

  2. Personal support networks, social capital, and risk of relapse among individuals treated for substance use issues.

    Science.gov (United States)

    Panebianco, Daria; Gallupe, Owen; Carrington, Peter J; Colozzi, Ivo

    2016-01-01

    The success of treatment for substance use issues varies with personal and social factors, including the composition and structure of the individual's personal support network. This paper describes the personal support networks and social capital of a sample of Italian adults after long-term residential therapeutic treatment for substance use issues, and analyses network correlates of post-treatment substance use (relapse). Using a social network analysis approach, data were obtained from structured interviews (90-120 min long) with 80 former clients of a large non-governmental therapeutic treatment agency in Italy providing voluntary residential treatments and rehabilitation services for substance use issues. Participants had concluded the program at least six months prior. Data were collected on socio-demographic variables, addiction history, current drug use status (drug-free or relapsed), and the composition and structure of personal support networks. Factors related to risk of relapse were assessed using bivariate and multivariate logistic regression models. A main goal of this study was to identify differences between the support network profiles of drug free and relapsed participants. Drug free participants had larger, less dense, more heterogeneous and reciprocal support networks, and more brokerage social capital than relapsed participants. Additionally, a lower risk of relapse was associated with higher socio-economic status, being married/cohabiting, and having network members with higher socio-economic status, who have greater occupational heterogeneity, and reciprocate support. Post-treatment relapse was found to be negatively associated with the socioeconomic status and occupational heterogeneity of ego's support network, reciprocity in the ties between ego and network members, and a support network in which the members are relatively loosely connected with one another (i.e., ego possesses "brokerage social capital"). These findings suggest the

  3. Pool spacing in forest channels

    Science.gov (United States)

    David R. Montgomery; John M. Buffington; Richard D. Smith; Kevin M. Schmidt; George Pess

    1995-01-01

    Field surveys of stream channels in forested mountain drainage basins in southeast Alaska and Washington reveal that pool spacing depends on large woody debris (LWD) loading and channel type, slope, and width. Mean pool spacing in pool-riffle, plane-bed, and forced pool-riffle channels systematically decreases from greater than 13 channel widths per pool to less than 1...

  4. Revisiting causal neighborhood effects on individual ischemic heart disease risk: a quasi-experimental multilevel analysis among Swedish siblings.

    Science.gov (United States)

    Merlo, Juan; Ohlsson, Henrik; Chaix, Basile; Lichtenstein, Paul; Kawachi, Ichiro; Subramanian, S V

    2013-01-01

    Neighborhood socioeconomic disadvantage is associated to increased individual risk of ischemic heart disease (IHD). However, the value of this association for causal inference is uncertain. Moreover, neighborhoods are often defined by available administrative boundaries without evaluating in which degree these boundaries embrace a relevant socio-geographical context that condition individual differences in IHD risk. Therefore, we performed an analysis of variance, and also compared the associations obtained by conventional multilevel analyses and by quasi-experimental family-based design that provides stronger evidence for causal inference. Linking the Swedish Multi-Generation Register to several other national registers, we analyzed 184,931 families embracing 415,540 full brothers 45-64 years old in 2004, and residing in 8408 small-area market statistics (SAMS) considered as "neighborhoods" in our study. We investigated the association between low neighborhood income (categorized in groups by deciles) and IHD risk in the next four years. We distinguished between family mean and intrafamilial-centered low neighborhood income, which allowed us to investigate both unrelated individuals from different families and full brothers within families. We applied multilevel logistic regression techniques to obtain odds ratios (OR), variance partition coefficients (VPC) and 95% credible intervals (CI). In unrelated individuals a decile unit increase of low neighborhood income increased individual IHD risk (OR = 1.04, 95% CI: 1.03-1.07). In the intrafamilial analysis this association was reduced (OR = 1.02, 95% CI: 1.02-1.04). Low neighborhood income seems associated with IHD risk in middle-aged men. However, despite the family-based design, we cannot exclude residual confounding by genetic and non-shared environmental factors. Besides, the low neighborhood level VPC = 1.5% suggest that the SAMS are a rather inappropriate construct of the socio-geographic context that

  5. Identifying individuals at high risk of psychosis: predictive utility of Support Vector Machine using structural and functional MRI data

    Directory of Open Access Journals (Sweden)

    Isabel eValli

    2016-04-01

    Full Text Available The identification of individuals at high risk of developing psychosis is entirely based on clinical assessment, associated with limited predictive potential. There is therefore increasing interest in the development of biological markers that could be used in clinical practice for this purpose. We studied 25 individuals with an At Risk Mental State for psychosis and 25 healthy controls using structural MRI, and functional MRI in conjunction with a verbal memory task. Data were analysed using a standard univariate analysis, and with Support Vector Machine (SVM, a multivariate pattern recognition technique that enables statistical inferences to be made at the level of the individual, yielding results with high translational potential. The application of SVM to structural MRI data permitted the identification of individuals at high risk of psychosis with a sensitivity of 68% and a specificity of 76%, resulting in an accuracy of 72% (p<0.001. Univariate volumetric between-group differences did not reach statistical significance. In contrast, the univariate fMRI analysis identified between-group differences (p<0.05 corrected while the application of SVM to the same data did not. Since SVM is well suited at identifying the pattern of abnormality that distinguishes two groups, whereas univariate methods are more likely to identify regions that individually are most different between two groups, our results suggest the presence of focal functional abnormalities in the context of a diffuse pattern of structural abnormalities in individuals at high clinical risk of psychosis.

  6. Identifying Individuals at High Risk of Psychosis: Predictive Utility of Support Vector Machine using Structural and Functional MRI Data

    Science.gov (United States)

    Valli, Isabel; Marquand, Andre F.; Mechelli, Andrea; Raffin, Marie; Allen, Paul; Seal, Marc L.; McGuire, Philip

    2016-01-01

    The identification of individuals at high risk of developing psychosis is entirely based on clinical assessment, associated with limited predictive potential. There is, therefore, increasing interest in the development of biological markers that could be used in clinical practice for this purpose. We studied 25 individuals with an at-risk mental state for psychosis and 25 healthy controls using structural MRI, and functional MRI in conjunction with a verbal memory task. Data were analyzed using a standard univariate analysis, and with support vector machine (SVM), a multivariate pattern recognition technique that enables statistical inferences to be made at the level of the individual, yielding results with high translational potential. The application of SVM to structural MRI data permitted the identification of individuals at high risk of psychosis with a sensitivity of 68% and a specificity of 76%, resulting in an accuracy of 72% (p < 0.001). Univariate volumetric between-group differences did not reach statistical significance. By contrast, the univariate fMRI analysis identified between-group differences (p < 0.05 corrected), while the application of SVM to the same data did not. Since SVM is well suited at identifying the pattern of abnormality that distinguishes two groups, whereas univariate methods are more likely to identify regions that individually are most different between two groups, our results suggest the presence of focal functional abnormalities in the context of a diffuse pattern of structural abnormalities in individuals at high clinical risk of psychosis. PMID:27092086

  7. Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data.

    Science.gov (United States)

    Madsen, I E H; Nyberg, S T; Magnusson Hanson, L L; Ferrie, J E; Ahola, K; Alfredsson, L; Batty, G D; Bjorner, J B; Borritz, M; Burr, H; Chastang, J-F; de Graaf, R; Dragano, N; Hamer, M; Jokela, M; Knutsson, A; Koskenvuo, M; Koskinen, A; Leineweber, C; Niedhammer, I; Nielsen, M L; Nordin, M; Oksanen, T; Pejtersen, J H; Pentti, J; Plaisier, I; Salo, P; Singh-Manoux, A; Suominen, S; Ten Have, M; Theorell, T; Toppinen-Tanner, S; Vahtera, J; Väänänen, A; Westerholm, P J M; Westerlund, H; Fransson, E I; Heikkilä, K; Virtanen, M; Rugulies, R; Kivimäki, M

    2017-06-01

    Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

  8. Greater Risk of Stroke of Undetermined Etiology in a Contemporary HIV-Infected Cohort Compared with Uninfected Individuals.

    Science.gov (United States)

    Chow, Felicia C; Price, Richard W; Hsue, Priscilla Y; Kim, Anthony S

    2017-05-01

    Although ischemic stroke risk is increased among people living with HIV infection, little is known about the epidemiology of ischemic stroke subtypes in contemporary HIV-infected cohorts. We examined the distribution of ischemic stroke subtypes among predominantly treated HIV-infected individuals to determine if and how the distribution differs from that of the general population. We studied 60 HIV-infected and 60 HIV-uninfected adults with a history of first-ever ischemic stroke between 2000 and 2012. Ischemic strokes were classified as 1 of 5 subtypes based on established criteria. We used multinomial logistic regression models to compare the relative frequency of ischemic stroke subtypes by HIV status. Large artery atherosclerosis (23%) and stroke of undetermined etiology (23%) were the most common stroke subtypes among HIV-infected individuals. The most recent plasma HIV viral load before the stroke event differed by subtype, with a median undetectable viral load for individuals with large artery stroke and stroke of undetermined etiology. Using cardioembolic stroke as the reference subtype, HIV-infected individuals were at higher proportional risk of stroke of undetermined etiology compared with uninfected individuals (relative risk ratio [RRR]: 8.6, 95% confidence interval [CI]: 1.2-63.7, P = .04). Among HIV-infected individuals with virologically suppressed infection, we observed a trend toward a greater proportion of strokes attributable to large artery atherosclerosis (RRR: 6.7, 95% CI: .8-57.9, P = .08). HIV-infected individuals may be at greater proportional risk of stroke of undetermined etiology compared with uninfected individuals. Further investigation is warranted to confirm this finding and determine underlying reasons for this greater risk. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. Individual Differences in Children's Risk Perception and Appraisals in Outdoor Play Environments

    Science.gov (United States)

    Little, Helen; Wyver, Shirley

    2010-01-01

    Child characteristics including age, gender, risk-taking behaviour and sensation seeking are thought to influence children's ability to appraise risks. The present study investigated children's risk perceptions and appraisals in the context of common outdoor physical play activities. Risk perceptions and appraisal of four- and five-year olds were…

  10. Thyroid hormones and mortality risk in euthyroid individuals: the Kangbuk Samsung health study.

    Science.gov (United States)

    Zhang, Yiyi; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Lee, Won-Young; Rhee, Eun-Jung; Kwon, Min-Jung; Pastor-Barriuso, Roberto; Rampal, Sanjay; Han, Won Kon; Shin, Hocheol; Guallar, Eliseo

    2014-07-01

    Hyperthyroidism and hypothyroidism, both overt and subclinical, are associated with all-cause and cardiovascular mortality. The association between thyroid hormones and mortality in euthyroid individuals, however, is unclear. To examine the prospective association between thyroid hormones levels within normal ranges and mortality endpoints. A prospective cohort study of 212 456 middle-aged South Korean men and women who had normal thyroid hormone levels and no history of thyroid disease at baseline from January 1, 2002 to December 31, 2009. Free T4 (FT4), free T3 (FT3), and TSH levels were measured by RIA. Vital status and cause of death ascertainment were based on linkage to the National Death Index death certificate records. After a median follow-up of 4.3 years, 730 participants died (335 deaths from cancer and 112 cardiovascular-related deaths). FT4 was inversely associated with all-cause mortality (HR = 0.77, 95% confidence interval 0.63-0.95, comparing the highest vs lowest quartile of FT4; P for linear trend = .01), and FT3 was inversely associated cancer mortality (HR = 0.62, 95% confidence interval 0.45-0.85; P for linear trend = .001). TSH was not associated with mortality endpoints. In a large cohort of euthyroid men and women, FT4 and FT3 levels within the normal range were inversely associated with the risk of all-cause mortality and cancer mortality, particularly liver cancer mortality.

  11. Individual, Psycho-Social and Disease-Related Risk Factors in Diabetic Neuropathy

    Directory of Open Access Journals (Sweden)

    Isaac Rahimian-Boogar

    2012-09-01

    Full Text Available Background: Neuropathy is the mostly prevalent of complications and the major cause of amputation, pain and disability in patients with diabetes. The purpose of this study was to investigate the role of individual, psycho-social, and disease-related risk factors in neuropathy of type 2 diabetes patients.Materials and Methods: In this retrospective cross-sectional study, 271 patients with type 2 diabetes were selected by convenience sampling in diabetic outpatient clinics of Tehran University of Medical Sciences and the Iranian Diabetic Association. The data were collected by demographical and disease characteristics questionnaires and DASS-42, QOLS, DSMS, and DKS scales. Then, the data were analyzed by r binary logistic regression along with PASW software.Results: Socio-economic status, glycosylated hemoglobin, body mass index, diabetes self-management, depression, quality of life, diabetes knowledge, and diabetes duration were significantly able to differentiate diabetic patients with neuropathy from diabetic patients without neuropathy (p0.05. The total regression model explained that 95.2% of cases were classified correctly.Conclusion: Inappropriate socio-economic status, glycosylated hemoglobin over 9%, being overweight and obesity, poor diabetes self-management, clinical depression, low quality of life, poor diabetes knowledge, and longer diabetes duration contribute to the incidence of neuropathy in patients with type 2 diabetes and attention must be paid to them for neuropathy prevention.

  12. Recommendations for presymptomatic genetic testing and management of individuals at risk for hereditary transthyretin amyloidosis

    Science.gov (United States)

    Obici, Laura; Kuks, Jan B.; Buades, Juan; Adams, David; Suhr, Ole B.; Coelho, Teresa; Kyriakides, Theodore

    2016-01-01

    Purpose of review These recommendations highlight recent experience in genetic counselling for the severe autosomal-dominant, late-onset transthyretin familial amyloid polyneuropathy (TTR-FAP) disease, and present a structured approach towards identification and monitoring of asymptomatic carriers of the mutated gene. Recent findings The effectiveness of current treatment options is still limited in patients with TTR-FAP beyond stage I. Diagnosis in the early stages of TTR-FAP is essential to prevent or delay the progression of disease. Existing legal and cultural issues differ among countries within Europe. Experts of the European Network for TTR-FAP (ATTReuNET) concluded that genetic counselling for diagnosed individuals and at-risk family members is mostly beneficial and should be carried out with care by trained professionals. Systematic and regular monitoring of an asymptomatic carrier is necessary to detect early signs of TTR-FAP and maximize the effectiveness of treatment. This includes five areas of assessment: history/clinical examination, sensorimotor function, autonomic dysfunction, cardiac function, and renal function. At least two related symptoms and positive biopsy findings are required to confirm diagnosis of TTR-FAP. Summary Early detection of TTR-FAP is essential to improve the prognosis of TTR-FAP. ATTReuNET recommends genetic counselling and routine monitoring for asymptomatic carriers of TTR-FAP. PMID:26734953

  13. Hepatitis E virus seroprevalence and risk factors for individuals in working contact with animals.

    Science.gov (United States)

    Chaussade, Hélène; Rigaud, Emma; Allix, Aurore; Carpentier, Audrey; Touzé, Antoine; Delzescaux, Didier; Choutet, Patrick; Garcia-Bonnet, Nathalie; Coursaget, Pierre

    2013-11-01

    In industrial countries genotypes 3 and 4 of HEV are detected in swine, wild boar, deer and rabbits, and they are associated with autochthonous infections suggesting the existence of zoonotic HEV infections, compatible with the putative involvement of undercooked pork and big game products as a source of infection. To evaluate the prevalence of anti-HEV antibodies in different population groups in contact with animals and to investigate risk factors for HEV infection. Serum samples were collected from 859 healthy French subjects, including pig farm workers, forestry workers and individuals without working contact with animals (control group). In addition, 58 swine veterinarians were included in the study. Subjects were interviewed using a structured questionnaire, and anti-HEV antibodies were investigated using a sensitive and specific sandwich ELISA. Anti-Hepatitis E virus (HEV) antibodies were detected in 26% of control population, and in 36% and 44% of forestry and pig farm workers, respectively. In addition, an increase in seroprevalence from the north to the south of France was observed (30.2% versus 40.7%). Consumption of pork liver sausage (AOR 4.4, p sausage or pork liver play a significant role in HEV transmission in industrial countries. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  14. Individual- and Structural-Level Risk Factors for Suicide Attempts Among Transgender Adults.

    Science.gov (United States)

    Perez-Brumer, Amaya; Hatzenbuehler, Mark L; Oldenburg, Catherine E; Bockting, Walter

    2015-01-01

    This study assessed individual (ie, internalized transphobia) and structural forms of stigma as risk factors for suicide attempts among transgender adults. Internalized transphobia was assessed through a 26-item scale including four dimensions: pride, passing, alienation, and shame. State-level structural stigma was operationalized as a composite index, including density of same-sex couples; proportion of Gay-Straight Alliances per public high school; 5 policies related to sexual orientation discrimination; and aggregated public opinion toward homosexuality. Multivariable logistic generalized estimating equation models assessed associations of interest among an online sample of transgender adults (N = 1,229) representing 48 states and the District of Columbia. Lower levels of structural stigma were associated with fewer lifetime suicide attempts (AOR 0.96, 95% CI 0.92-0.997), and a higher score on the internalized transphobia scale was associated with greater lifetime suicide attempts (AOR 1.18, 95% CI 1.04-1.33). Addressing stigma at multiple levels is necessary to reduce the vulnerability of suicide attempts among transgender adults.

  15. Bridging the etiologic and prognostic outlooks in individualized assessment of absolute risk of an illness: application in lung cancer.

    Science.gov (United States)

    Karp, Igor; Sylvestre, Marie-Pierre; Abrahamowicz, Michal; Leffondré, Karen; Siemiatycki, Jack

    2016-11-01

    Assessment of individual risk of illness is an important activity in preventive medicine. Development of risk-assessment models has heretofore relied predominantly on studies involving follow-up of cohort-type populations, while case-control studies have generally been considered unfit for this purpose. To present a method for individualized assessment of absolute risk of an illness (as illustrated by lung cancer) based on data from a 'non-nested' case-control study. We used data from a case-control study conducted in Montreal, Canada in 1996-2001. Individuals diagnosed with lung cancer (n = 920) and age- and sex-matched lung-cancer-free subjects (n = 1288) completed questionnaires documenting life-time cigarette-smoking history and occupational, medical, and family history. Unweighted and weighted logistic models were fitted. Model overfitting was assessed using bootstrap-based cross-validation and 'shrinkage.' The discriminating ability was assessed by the c-statistic, and the risk-stratifying performance was assessed by examination of the variability in risk estimates over hypothetical risk-profiles. In the logistic models, the logarithm of incidence-density of lung cancer was expressed as a function of age, sex, cigarette-smoking history, history of respiratory conditions and exposure to occupational carcinogens, and family history of lung cancer. The models entailed a minimal degree of overfitting ('shrinkage' factor: 0.97 for both unweighted and weighted models) and moderately high discriminating ability (c-statistic: 0.82 for the unweighted model and 0.66 for the weighted model). The method's risk-stratifying performance was quite high. The presented method allows for individualized assessment of risk of lung cancer and can be used for development of risk-assessment models for other illnesses.

  16. Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case-Control Studies

    NARCIS (Netherlands)

    Rasmussen, C.B.; Kjaer, S.K.; Albieri, V.; Bandera, E.V.; Doherty, J.A.; Hogdall, E.; Webb, P.M.; Jordan, S.J.; Rossing, M.A.; Wicklund, K.G.; Goodman, M.T.; Modugno, F.; Moysich, K.B.; Ness, R.B.; Edwards, R.P.; Schildkraut, J.M.; Berchuck, A.; Olson, S.H.; Kiemeney, L.A.L.M.; Massuger, L.F.A.G.; Narod, S.A.; Phelan, C.M.; Anton-Culver, H.; Ziogas, A.; Wu, A.H.; Pearce, C.L.; Risch, H.A.; Jensen, A.

    2017-01-01

    Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according to

  17. Vitamin D Pooling Project

    Science.gov (United States)

    The Vitamin D Pooling Project of Rarer Cancers brought together investigators from 10 cohorts to conduct a large prospective epidemiologic study of the association between vitamin D status and seven rarer cancers.

  18. A meta-analysis of the risk of major affective disorder in relatives of individuals affected by major depressive disorder or bipolar disorder.

    Science.gov (United States)

    Wilde, A; Chan, H-N; Rahman, B; Meiser, B; Mitchell, P B; Schofield, P R; Green, M J

    2014-04-01

    To conduct a meta-analysis to estimate the incidence of major depressive disorder (MDD) and bipolar disorder (BD) in first-degree relatives (FDRs) of probands affected by MDD or BD. The risk for MDD in FDR of BD probands and vice versa is also investigated. A systematic review of case-control and cohort studies, which were published between 1977 and 2012; reported relative risks (RR) or odd ratios (OR) or equivalent raw data; made an explicit distinction between MDD and BD; used operational diagnostic criteria; and reported systematic proband recruitment and ascertainment of relatives. Studies were obtained by electronic MEDLINE and EMBASE searches and hand-searching. Estimates were derived from pooled data using random effects methods. Of an initial sample of 241 articles, 22 were eligible for inclusion. For FDRs of one proband with MDD compared to healthy control probands, estimates for MDD were OR=2.14 (95% CI 1.72-2.67), increasing to OR=3.23 (95% CI 2.11-4.94) for two MDD probands. For FDRs of one BD proband compared to healthy control probands, estimates for BD were OR=7.92 (95% CI 2.45-25.61), and OR=6.58 (95% CI 2.64-16.43) for FDRs of two BD probands. These findings support previously published data indicating strong familiality for both MDD and BD. Data will be useful in providing individuals with a family history of MDD or BPD with tailored risk estimates. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Physical activity and risk of all-cause and cardiovascular disease mortality in diabetic adults from Great Britain: pooled analysis of 10 population-based cohorts.

    Science.gov (United States)

    Sadarangani, Kabir P; Hamer, Mark; Mindell, Jenny S; Coombs, Ngaire A; Stamatakis, Emmanuel

    2014-04-01

    OBJECTIVE To examine associations between specific types of physical activity and all-cause and cardiovascular disease (CVD) mortality in a large nationally representative sample of adults with diabetes from Great Britain. RESEARCH DESIGN AND METHODS There were a total of 3,038 participants (675 deaths) with diabetes in the Health Survey for England and the Scottish Health Surveys conducted between 1997 and 2008. Participants aged ≥50 years at baseline were followed up for an average of 75.2 months for all-cause and CVD mortality. Data were collected on self-reported frequency, duration, and intensity of participation in sports and exercise, walking, and domestic physical activity, from which the number of MET-hours/week were derived. Sex-specific medians of time spent in each type of physical activity (for those physically active) were calculated, and Cox proportional hazards regression conducted to examine type-specific associations between the level of physical activity and all-cause and CVD mortality risk. RESULTS Inverse associations with all-cause and CVD mortality were observed for overall physical activity in a dose-response manner after adjusting for covariates. Compared with those who individuals were inactive, participants who reported some activity, but below the recommended amount, or who met the physical activity recommendations had a 26% (95% CI 39-11) and 35% (95% CI 47-21) lower all-cause mortality, respectively. Similar results were found for below/above median physical activity levels. Sports and exercise participation was inversely associated with all-cause (but not CVD) mortality, as were above average levels of walking. Domestic physical activity was not associated with mortality. CONCLUSIONS Moderate physical activity levels were associated with better prognosis in diabetic adults.

  20. Individual actual or perceived property flood risk: did it predict evacuation from Hurricane Isabel in North Carolina, 2003?

    Science.gov (United States)

    Horney, Jennifer A; Macdonald, Pia D M; Van Willigen, Marieke; Berke, Philip R; Kaufman, Jay S

    2010-03-01

    Individual perception of risk has consistently been considered an important determinant of hurricane evacuation in published studies and reviews. Adequate risk assessment is informed by environmental and social cues, as well as evacuation intentions and past disaster experience. This cross-sectional study measured perceived flood risk of 570 residents of three coastal North Carolina counties, compared their perception with actual risk determined by updated flood plain maps, and determined if either was associated with evacuation from Hurricane Isabel in 2003. Census blocks were stratified by flood zone and 30 census blocks were randomly selected from each flood zone. Seven interviews were conducted at random locations within selected blocks. Bivariate and multivariable analyses were conducted to produce crude and adjusted risk differences. Neither the designated flood zone of the parcel where the home was located nor the residents' perceived flood risk was associated with evacuation from Hurricane Isabel in the bivariate analysis. In the multivariable analysis, intention to evacuate and home type were important confounders of the association between actual risk and evacuation. The belief that one is at high risk of property damage or injury is important in evacuation decision making. However, in this study, while coastal residents' perceived risk of flooding was correlated with their actual flood risk, neither was associated with evacuation. These findings provide important opportunities for education and intervention by policymakers and authorities to improve hurricane evacuation rates and raise flood risk awareness.

  1. Short telomere length, cancer survival, and cancer risk in 47102 individuals

    DEFF Research Database (Denmark)

    Weischer, Maren; Nordestgaard, Børge G; Cawthon, Richard M;

    2013-01-01

    Recent meta-analyses have suggested that short telomere length was associated with increased risk of cancer. We therefore tested the hypotheses that short telomere length was associated with increased risk of cancer and with increased risk of early death after cancer.......Recent meta-analyses have suggested that short telomere length was associated with increased risk of cancer. We therefore tested the hypotheses that short telomere length was associated with increased risk of cancer and with increased risk of early death after cancer....

  2. Childhood trauma and suicide risk in a sample of young individuals aged 14-35 years in southern Brazil.

    Science.gov (United States)

    Barbosa, Luana Porto; Quevedo, Luciana; da Silva, Giovanna Del Grande; Jansen, Karen; Pinheiro, Ricardo Tavares; Branco, Jerônimo; Lara, Diogo; Oses, Jean; da Silva, Ricardo Azevedo

    2014-07-01

    Suicide is among the main causes of death of people aged between 15 and 44 years old. Childhood trauma is an important risk factor for suicide. Hence, the objective of this study was to verify the relationship between childhood trauma and current suicide risk (suicidal behavior and ideation) in individuals aged 14-35 years, in the city of Pelotas, Brazil. This is a cross-sectional, population-based study. Sample selection was performed by clusters. Suicide risk was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Moreover, the participants responded to a questionnaire concerning socioeconomic status, work, and substance use. The sample was composed of 1,380 individuals. The prevalence of suicide risk was 11.5%. The prevalence figures of childhood trauma were 15.2% (emotional neglect), 13.5% (physical neglect), 7.6% (sexual abuse), 10.1% (physical abuse), and 13.8% (emotional abuse). Suicide risk was associated (psuicide risk were higher in women (OR=1.8), people who were not currently working (OR=2.3), individuals who presented alcohol abuse (OR=2.6), and among tobacco smokers (OR=3.4). Moreover, suicide risk was increased in all types of trauma: emotional neglect (OR=3.7), physical neglect (OR=2.8), sexual abuse (OR=3.4), physical abuse (OR=3.1), and emotional abuse (OR=6.6). Thus, preventing early trauma may reduce suicide risk in young individuals.

  3. Is psychodynamic psychotherapy an effective intervention for individuals at ultra-high risk (UHR) of psychosis?: a case report

    OpenAIRE

    2012-01-01

    OBJECTIVE: To report a case and to discuss the use of psychodynamic psychotherapy (PD-P) to treat individuals at ultra-high risk (UHR) of psychosis. METHODS: An individual at UHR was followed up for 24 months. The baseline evaluation included a psychiatric interview, the Structured Interview for Prodromal Symptoms (SIPS), the Scale of Prodromal Symptoms (SOPS), and neuropsychological assessment. He underwent weekly sessions of PD-P for 12 months and was followed up for 12 months after the end...

  4. Cumulative impact of common genetic variants and other risk factors on colorectal cancer risk in 42 103 individuals

    NARCIS (Netherlands)

    Dunlop, Malcolm G.; Tenesa, Albert; Farrington, Susan M.; Ballereau, Stephane; Brewster, David H.; Koessler, Thibaud; Pharoah, Paul; Schafmayer, Clemens; Hampe, Jochen; Voelzke, Henry; Chang-Claude, Jenny; Hoffmeister, Michael; Brenner, Hermann; von Holst, Susanna; Picelli, Simone; Lindblom, Annika; Jenkins, Mark A.; Hopper, John L.; Casey, Graham; Duggan, David; Newcomb, Polly A.; Abuli, Anna; Bessa, Xavier; Ruiz-Ponte, Clara; Castellvi-Bel, Sergi; Niittymaeki, Iina; Tuupanen, Sari; Karhu, Auli; Aaltonen, Lauri; Zanke, Brent; Hudson, Tom; Gallinger, Steven; Barclay, Ella; Martin, Lynn; Gorman, Maggie; Carvajal-Carmona, Luis; Walther, Axel; Kerr, David; Lubbe, Steven; Broderick, Peter; Chandler, Ian; Pittman, Alan; Penegar, Steven; Campbell, Harry; Tomlinson, Ian; Houlston, Richard S.

    2013-01-01

    Objective Colorectal cancer (CRC) has a substantial heritable component. Common genetic variation has been shown to contribute to CRC risk. A study was conducted in a large multi-population study to assess the feasibility of CRC risk prediction using common genetic variant data combined with other r

  5. Intra-individual Neurocognitive Variability Confers Risk of Dependence in Activities of Daily Living among HIV-Seropositive Individuals without HIV-Associated Neurocognitive Disorders

    Science.gov (United States)

    Morgan, Erin E.; Woods, Steven Paul; Grant, Igor

    2012-01-01

    Although HIV-associated neurocognitive disorders (HAND) are the strong predictors of everyday functioning difficulties, approximately half of all functionally impaired individuals are labeled “neurocognitively normal” according to the standard neuropsychological measures, suggesting that novel predictors of functional problems in this prevalent subgroup are needed. The present study hypothesized that increased