Neoplasia at 10-year follow-up screening colonoscopy in a private U.S. practice: comparison of yield to first-time examinations

Background and Aims Prior studies assessing the yield of a second screening colonoscopy performed 10 years after an initial negative screening colonoscopy did not include a control group of persons undergoing their first screening colonoscopy during the same time interval. Our aim was to describe the incidence of neoplasia at a second screening colonoscopy (performed at least 8 years after the first colonoscopy) in average risk individuals and compare it with the yield of first screening examinations performed during the same time interval. Methods Review of a database of outpatient screening colonoscopies performed between January 2010 and December 2015 in an Atlanta private practice. Results A total of 2105 average risk individuals underwent screening colonoscopy, including 470 individuals (53.6% female; mean age 64.0 ± 3.9 years) who underwent a second screening examination. In those undergoing second screening, the mean interval between examinations was 10.4 years (±1.1; range 8-15 years). At second screening, the polyp detection rate (PDR), adenoma detection rate (ADR) and advanced neoplasm rate (ANR) were 44.7%, 26.6%, and 7.4%, respectively. Of 40 advanced neoplasms in 35 individuals, 33 (82.5%) were proximal to the sigmoid colon, and there were no cancers. During the same interval, 1635 individuals (49.4% female; mean age 52.6 ± 3.4 years) underwent their first screening colonoscopy. The PDR, ADR and ANR were 53.5%, 32.2%, and 11.7%, respectively. Of 243 advanced neoplasms in 192 individuals, 152 (62.6%) were proximal to the sigmoid colon, and there were no cancers. After adjustment for age, gender, body mass index, and endoscopist, PDR, ADR, and ANR were all lower at the second screening colonoscopies than at first-time colonoscopies (all p<0.001). Conclusions Despite being 10 years older, persons with a negative screening colonoscopy 10 years earlier had numerically lower rates of adenomas and advanced neoplasms at their second screening examination compared with patients in the same practice undergoing their first screening colonoscopy, and they had no cancers. The fraction of advanced neoplasms that were proximal to the sigmoid was high in both first and second screenings. These results support the safety of the recommended 10-year interval between colonoscopies in average risk persons with an initial negative examination

Toward a sustainable and resilient future

This chapter focuses on the implications of changing climate extremes for development, and considers how disaster risk management and climate change adaptation together can contribute to a sustainable and resilient future. Changes in the frequency, timing, magnitude, and characteristics of extreme events pose challenges to the goals of reducing disaster risk and vulnerability, both in the present and in the future. Enhancing the capacity of social-ecological systems to cope with, adapt to, and shape change is central to building sustainable and resilient development pathways in the face of climate change. The concept for social-ecological systems recognizes the interdependence of social and ecological factors in the generation and management of risk, as well as in the pursuit of sustainable development. Despite 20 years on the policy agenda, sustainable development remains contested and elusive. However, within the context of climate change, it is becoming increasingly clear that the sustainability of humans on the Earth is closely linked to resilient social-ecological systems, which is influenced by social institutions, human agency, and human capabilities

Prediction of protein submitochondria locations by hybridizing pseudo-amino acid composition with various physicochemical features of segmented sequence

BACKGROUND: Knowing the submitochondria localization of a mitochondria protein is an important step to understand its function. We develop a method which is based on an extended version of pseudo-amino acid composition to predict the protein localization within mitochondria. This work goes one step further than predicting protein subcellular location. We also try to predict the membrane protein type for mitochondrial inner membrane proteins. RESULTS: By using leave-one-out cross validation, the prediction accuracy is 85.5% for inner membrane, 94.5% for matrix and 51.2% for outer membrane. The overall prediction accuracy for submitochondria location prediction is 85.2%. For proteins predicted to localize at inner membrane, the accuracy is 94.6% for membrane protein type prediction. CONCLUSION: Our method is an effective method for predicting protein submitochondria location. But even with our method or the methods at subcellular level, the prediction of protein submitochondria location is still a challenging problem. The online service SubMito is now available at

Women and postfertilization effects of birth control: consistency of beliefs, intentions and reported use

BACKGROUND: This study assesses the consistency of responses among women regarding their beliefs about the mechanisms of actions of birth control methods, beliefs about when human life begins, the intention to use or not use birth control methods that they believe may act after fertilization or implantation, and their reported use of specific methods. METHODS: A questionnaire was administered in family practice and obstetrics and gynecology clinics in Salt Lake City, Utah, and Tulsa, Oklahoma. Participants included women ages 18–50 presenting for any reason and women under age 18 presenting for family planning or pregnancy care. Analyses were based on key questions addressing beliefs about whether specific birth control methods may act after fertilization, beliefs about when human life begins, intention to use a method that may act after fertilization, and reported use of specific methods. The questionnaire contained no information about the mechanism of action of any method of birth control. Responses were considered inconsistent if actual use contradicted intentions, if one intention contradicted another, or if intentions contradicted beliefs. RESULTS: Of all respondents, 38% gave consistent responses about intention to not use or to stop use of any birth control method that acted after fertilization, while 4% gave inconsistent responses. The corresponding percentages for birth control methods that work after implantation were 64% consistent and 2% inconsistent. Of all respondents, 34% reported they believed that life begins at fertilization and would not use any birth control method that acts after fertilization (a consistent response), while 3% reported they believed that life begins at fertilization but would use a birth control method that acts after fertilization (inconsistent). For specific methods of birth control, less than 1% of women gave inconsistent responses. A majority of women (68% or greater) responded accurately about the mechanism of action of condoms, abstinence, sterilization, and abortion, but a substantial percentage of women (between 19% and 57%) were uncertain about the mechanisms of action of oral contraceptives, intrauterine devices (IUDs), Depo-Provera, or natural family planning. CONCLUSION: Women who believe that life begins at fertilization may not intend to use a birth control method that could have postfertilization effects. More research is needed to understand the relative importance of postfertilization effects for women in other populations, and in relation to other properties of and priorities for birth control methods. However, many women were uncertain about the mechanisms of action of specific methods. To respect the principles of informed consent, some women may need more education about what is known and not known about the mechanisms of action of birth control methods

Epistatic Module Detection for Case-Control Studies: A Bayesian Model with a Gibbs Sampling Strategy

The detection of epistatic interactive effects of multiple genetic variants on the susceptibility of human complex diseases is a great challenge in genome-wide association studies (GWAS). Although methods have been proposed to identify such interactions, the lack of an explicit definition of epistatic effects, together with computational difficulties, makes the development of new methods indispensable. In this paper, we introduce epistatic modules to describe epistatic interactive effects of multiple loci on diseases. On the basis of this notion, we put forward a Bayesian marker partition model to explain observed case-control data, and we develop a Gibbs sampling strategy to facilitate the detection of epistatic modules. Comparisons of the proposed approach with three existing methods on seven simulated disease models demonstrate the superior performance of our approach. When applied to a genome-wide case-control data set for Age-related Macular Degeneration (AMD), the proposed approach successfully identifies two known susceptible loci and suggests that a combination of two other loci—one in the gene SGCD and the other in SCAPER—is associated with the disease. Further functional analysis supports the speculation that the interaction of these two genetic variants may be responsible for the susceptibility of AMD. When applied to a genome-wide case-control data set for Parkinson's disease, the proposed method identifies seven suspicious loci that may contribute independently to the disease

Climate change responses among the Maasai Community in Kenya

© 2017, Springer Science+Business Media B.V. The impacts of climate change to the dryland areas of East Africa are especially strong, especially if it is considered that these areas have weak institutions and governance systems. Climate change has also affected many rural communities in a severe way, reducing crop yields and sometimes causing crop failure. In Kenya and Tanzania, where drylands cover over around 80 and 50% of their respective land areas, rural populations have been especially affected. Among them is the tribal group of the Maasai, legendary nomad warriors, who have been suffering from persistent droughts and the negative impacts on their cattle herds. This paper describes how climate change affects the Maasai communities in Kenya and the changes seen in their habits and diet, in order to adapt to a changing climate

East African food security as influenced by future climate change and land use change at local to regional scales

Climate change impacts food production systems, particularly in locations with large, vulnerable populations. Elevated greenhouse gases (GHG), as well as land cover/land use change (LCLUC), can influence regional climate dynamics. Biophysical factors such as topography, soil type, and seasonal rainfall can strongly affect crop yields. We used a regional climate model derived from the Regional Atmospheric Modeling System (RAMS) to compare the effects of projected future GHG and future LCLUC on spatial variability of crop yields in East Africa. Crop yields were estimated with a process-based simulation model. The results suggest that: (1) GHG-influenced and LCLUC-influenced yield changes are highly heterogeneous across this region; (2) LCLUC effects are significant drivers of yield change; and (3) high spatial variability in yield is indicated for several key agricultural sub-regions of East Africa. Food production risk when considered at the household scale is largely dependent on the occurrence of extremes, so mean yield in some cases may be an incomplete predictor of risk. The broad range of projected crop yields reflects enormous variability in key parameters that underlie regional food security; hence, donor institutions strategies and investments might benefit from considering the spatial distribution around mean impacts for a given region. Ultimately, global assessments of food security risk would benefit from including regional and local assessments of climate impacts on food production. This may be less of a consideration in other regions. This study supports the concept that LCLUC is a first-order factor in assessing food production risk