Individualized Dynamic Prediction Model for Patient-Reported Voice Quality in Early-Stage Glottic Cancer

Objective: Early-stage glottic cancer (ESGC) is a malignancy of the head and neck. Besides disease control, preservation and improvement of voice quality are essential. To enable expectation management and well-informed decision-making, patients should be sufficiently counseled with individualized information on expected voice quality. This study aims to develop an individualized dynamic prediction model for patient-reported voice quality. This model should be able to provide individualized predictions at every time point from intake to the end of follow-up. Study Design: Longitudinal cohort study. Setting: Tertiary cancer center. Methods: Patients treated for ESGC were included in this study (N = 294). The Voice Handicap Index was obtained prospectively. The framework of mixed and joint models was used. The prognostic factors used are treatment, age, gender, comorbidity, performance score, smoking, T-stage, and involvement of the anterior commissure. The overall performance of these models was assessed during an internal cross-validation procedure and presentation of absolute errors using box plots. Results: The mean age in this cohort was 67 years and 81.3% are male. Patients were treated with transoral CO2 laser microsurgery (57.8%), single vocal cord irradiation up to (24.5), or local radiotherapy (17.5%). The mean follow-up was 43.4 months (SD 21.5). Including more measurements during prediction improves predictive performance. Including more clinical and demographic variables did not provide better predictions. Little differences in predictive performance between models were found. Conclusion: We developed a dynamic individualized prediction model for patient-reported voice quality. This model has the potential to empower patients and professionals in making well-informed decisions and enables tailor-made counseling.</p

Associations of autozygosity with a broad range of human phenotypes

In many species, the offspring of related parents suffer reduced reproductive success, a phenomenon known as inbreeding depression. In humans, the importance of this effect has remained unclear, partly because reproduction between close relatives is both rare and frequently associated with confounding social factors. Here, using genomic inbreeding coefficients (F-ROH) for >1.4 million individuals, we show that F-ROH is significantly associated (p <0.0005) with apparently deleterious changes in 32 out of 100 traits analysed. These changes are associated with runs of homozygosity (ROH), but not with common variant homozygosity, suggesting that genetic variants associated with inbreeding depression are predominantly rare. The effect on fertility is striking: F-ROH equivalent to the offspring of first cousins is associated with a 55% decrease [95% CI 44-66%] in the odds of having children. Finally, the effects of F-ROH are confirmed within full-sibling pairs, where the variation in F-ROH is independent of all environmental confounding.Peer reviewe

The influence of media violence on youth

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/83429/1/2003.Anderson_etal.InfluenceofMediaViolenceonYouth.PsychologicalScienceinthePublicInterest.pd

The role of certification in the Brazilian fruit sector [O Papel da certificação na fruticultura Brasileira]

Certification systems play an important role in any market that is bur- dened with a high degree of information asymmetry and quality uncertainty. Thus, producers and exporters of fresh fruit in developing countries like Brazil are in- creasingly required to demonstrate the safety and traceability of their produce up to the consumption stage. This paper aims at presenting a comparative analysis of the different certification schemes applied to fruit production in Brazil. A survey of 303 grape and mango farmers was conducted in 2006 in the Juazeiro and Petrolina re- gions of the São Francisco Valley. The results of the certification schemes adopted by grape farmers show that GlobalGAP certified ones have higher productivity. The income of farmers with one certificate is higher than that of those with two certifi- cates. The comparative analysis of small and medium farms concludes that there is no evidence of the marginalization of small farmers

Biomarkers di stress ossidativo, livelli residuali e ormone triiodotironina in trota iridea alimentata con diete medicate con florfenicolo (FF)

Il Florfenicolo (FF), analogo fluorinato sintetico di Tiamfenicolo e Cloramfenicolo (CA), \ue8 un antibiotico ad ampio spettro molto utilizzato in acquacoltura. Nonostante la sua efficacia sia pari a quella del CA, rispetto a quest\u2019ultimo, esercita una pi\uf9 bassa tossicit\ue0 nei confronti dell\u2019organismo sottoposto a terapia antibiotica, per l\u2019assenza del nitrogruppo. Notoriamente gli antibiotici possono provocare fotosensibilizzazione: un eventuale effetto fototossico di questi composti \ue8 mediato, a livello cellulare, anche da una maggiore produzione di radicali liberi e radicali dell\u2019ossigeno. L\u2019aumento della concentrazione di radicali liberi pu\uf2 causare una condizione di stress ossidativo nell\u2019organismo. Obiettivo \ue8 la valutazione di biomarkers di stress ossidativo, glutatione S-transferasi, glutatione reduttasi e concentrazione di glutatione totale, livelli residuali nel fegato e livelli dell\u2019ormone tiroideo triiodotironina nel sangue di trota iridea alimentati per dieci giorni con due diete medicate con FF (7,5 e 15 mg/kg). La dose raccomandata per il florfenicolo in acquacoltura \ue8 10 mg/kg per pesce per 10 giorni. Le due diete sperimentali sono state preparate a partire da un mangime commerciale per pesci di allevamento (controllo), a cui \ue8 stata aggiunta una premiscela commerciale di florfenicolo (Nuflor, 40 mg/g). Dopo l\u2019acclimatazione, gli esemplari di trota iridea sono stati divisi in due gruppi sperimentali, di cui il primo esposto all\u2019irradiazione di lampade solari per 12 ore al giorno, mentre l\u2019altro \ue8 stato mantenuto in una condizione di costante ombreggiatura. Tra gli esemplari sottoposti a condizioni di irradiazione solare e quelli all\u2019ombra, sono state evidenziate differenze di risposta sia per quanto riguarda i livelli residuali che per gli indici biochimici indagati. I livelli residuali erano pi\uf9 alti nelle trote mantenute in condizioni di irradiazione solare rispetto a quelle in condizioni di ombreggiatura. Livelli pi\uf9 bassi dell\u2019ormone tiroideo T3 sono stati evidenziati nel gruppo trattato con un alto dosaggio di farmaco in condizioni di ombreggiamento ed in tutti e due i gruppi trattati con FF e mantenuti in condizioni di luce artificiale. La valutazione dei biomarkers di stress ossidativo ha indicato una pi\uf9 marcata condizione di stress ossidativo negli esemplari di trota iridea trattati con l\u2019antibiotico e sottoposti ad irradiazione solare, come conseguenza di un potenziamento dell\u2019effetto tossico dovuto all\u2019azione combinata di ambedue i fattori. Infatti, sebbene l\u2019effetto proossidante del FF, alle due dosi testate, sia stato evidente in ambedue i gruppi sperimentali, esso era pi\uf9 rilevante in condizioni di irradiazione solare, rispetto a quelle di costante ombreggiatur