Anterior Subcapsular Cataract Secondary to Black Mold Exposure

A case report of a 31-year-old woman who developed anterior subacapsular cataracts, and associated dermatological signs, after exposure to black mold. While atopic illness is commonly seen in childhood, a growing body of literature supports adult onset atopic dermatitis. Anterior subcapsular cataracts are pathognomonic for atopic illness, and can support a definitive and expedited dermatologic diagnosis of adult onset disease

Six of one, half dozen of the other: Expanding and contracting numerical dimensions produces preference reversals

ABSTRACT-The scales used to describe the attributes of different choice options are usually open to alternative expressions, such as inches versus feet or minutes versus hours. More generally, a ratio scale can be multiplied by an arbitrary factor (e.g., 12) while preserving all of the information it conveys about different choice alternatives. We propose that expanded scales (e.g., price per year) lead decision makers to discriminate between choice options more than do contracted scales (e.g., price per month) because they exaggerate the difference between options on the expanded attribute. Two studies show that simply increasing the size of an attribute's scale systematically changes its weight in both multiattribute preferences and willingness to pay: Expanding scales for one attribute shifts preferences to alternatives favored on that attribute. In the cult classic This Is Spinal Tap, Nigel points out to the director that the dials on the band's amplifiers are numbered all the way to 11: ''You see, most blokes will be playing at 10. You're on 10, all the way up, all the way up. . . . Where can you go from there? Nowhere. What we do, is if we need that extra push over the cliff. . . . Eleven. One louder.'' The director asks, ''Why don't you just make 10 louder and make 10 be the top number, and make that a little louder?'' Nigel thinks for a bit and replies, ''These go to 11.'' This arbitrary use of scales is not limited to comedy. Consumer Reports rates cars along six attributes. Most attributes are described on 5-point scales, but the overall test score is expressed on a 100-point scale. Will this difference in scales affect which car consumers prefer? It should not. After all, a 5-point scale can easily be converted to a 100-point scale, and vice versa (a fact that Nigel misses). More generally, a scale with ratio properties can be converted from one scale to another by multiplying the original values by some constant factor without changing the information provided by the scale. Thus, a product that is superior to another by 20 points on a 100-point scale is still superior by the same proportion if the information is expressed as a 1-point difference on a 5-point scale. Nevertheless, this trivial transformation seems psychologically consequential. The expanded scale highlights the difference between the two choice options, making it potentially easier to discriminate between them. In contrast, the contracted scale minimizes the difference. Consider a recent demonstration of currency effects. Our argument parallels past findings on risk and ratio judgments. For example, Yamagishi (1997) has shown that people judge ratios expressed with large numerators and denominators (1,286/10,000) as riskier than larger ratios expressed with small numerators and denominators (24.14/100). Stone, Yates, and Parker (1997) were able to exaggerate such effects by putting the 1074 Volume 20-Number 9 Copyright r 2009 Association for Psychological Science information in graphs that made differences in numerators even more salient. Similarly, We believe that previous research on denominator neglect STUDY 1: PREFERENCES AND CHOICE In Study 1, we used a choice paradigm to test participants' preference for options that entail trade-offs across attributes. We predicted that participants would more strongly prefer the option that dominates on an attribute that is expanded. We created two choice sets. The first scenario presented cell-phone plans that varied in cost and number of dropped calls. This scenario contained a strong manipulation such that, when one attribute was expanded, the other was contracted. The second scenario presented movie-rental plans, in which we manipulated the expansion of one attribute (new movies per period of time) while leaving the other attribute (cost) untouched. We predicted that, in both scenarios, preference would increase for the option that was superior on an expanded attribute, causing preference reversal to arise between conditions. Method One hundred six University of Michigan undergraduates completed this study as part of a course requirement. The first scenario (cell-phone plans) asked participants to evaluate cellular phone plan options described in terms of number of dropped calls and cost. Number of dropped calls was either on an expanded scale (dropped calls per 1,000 calls) or a contracted scale (dropped calls per 100 calls). Price was also described either on an expanded scale (price per year) or a contracted scale (price per month). When one attribute was presented as expanded, the other was presented as contracted, thus creating two conditions (see The second scenario (movie rentals) tested discriminability by varying the expansion of only one attribute. Participants evaluated two movie-rental plans that were described in terms of new movie availability and price (see For both scenarios, participants indicated their preference for Plan A versus Plan B on a 7-point scale (1 5 strongly prefer plan A, 4 5 indifferent, 7 5 strongly prefer plan B). Note. Participants evaluated cell-phone plans described in terms of number of dropped calls and cost. Number of dropped calls was either on an expanded scale (dropped calls per 1,000 calls) or on a contracted scale (dropped calls per 100 calls). Price was also described either on an expanded scale (price per year) or on a contracted scale (price per month). In Condition 1, the number of dropped calls was presented on a contracted scale, and price was given on an expanded scale. In Condition 2, the number of dropped calls was presented on an expanded scale, and price was given on a contracted scale. Volume 20-Number 9 1075 Katherine A. Burson, Richard P. Larrick, and John G. Lynch, Jr. Results and Discussion An independent-samples t test showed a significant shift in plan preference based on attribute expansion for both scenarios. For the first scenario, preferences favored Plan B (the plan that was superior on price) when price was expanded and the number of dropped calls was contracted (M 5 4.45). However, preferences favored Plan A (the plan that was superior on the number of dropped calls) when the number of dropped calls was expanded and price was contracted (M 5 3.08), t(104) 5 À3.60, p < .001, d 5 0.706. We converted these data to choice proportions to test for preference reversals. Plan B was preferred when it was described as having a lower price per year but more dropped calls per 100 than Plan A (53% vs. 31%, respectively). 1 However, Plan A was preferred when it was described as having fewer dropped calls per 1,000 but a higher price per month than Plan B (69% vs. 23%, respectively); w 2 (1, N 5 106) 5 13.93, p < .001, j c 5 .363 for the linear contrast of the ordinal choice categories between conditions. For the second scenario, participants favored the superior plan for new movies (Plan B) more when new movies were expanded (M 5 4.33) than when they were contracted (M 5 3.38), t(104) 5 2.16, p 5 .033, d 5 0.424. A test of choice proportions showed that 56% of participants preferred Plan B when number of new movies was expanded to a yearly scale, compared to 38% who preferred Plan A. Contracting number of new movies to a weekly scale resulted in 33% preferring Plan B and 57% preferring Plan A, a significant reversal for the linear contrast of the ordinal choice categories, w The results of Study 1 show that attribute expansion increases preference for the alternative favored on an expanded attribute, despite the fact that the relative differences between alternatives remained the same. STUDY 2: PRICING In this experiment, we modified the second scenario of Study 1 to create a matching paradigm in order to determine participants' valuation of options that entail a trade-off across attributes (e.g., We manipulated both attribute expansion and product valence. Valence was manipulated by presenting the product as either better or worse than the average plan. We predicted that valence would interact with attribute expansion: The difference in willingness to pay for the above-average plan versus the below-average plan would be greater when framed as movies per year (expanded) rather than movies per week (contracted). Method Sixty-three University of Michigan students completed this 2 (attribute expansion: expanded vs. contracted) Â 2 (product valence: above vs. below average) design study in combination with other materials and were paid $8 for their participation. Participants were asked to evaluate two movie-rental plans, as in the second scenario in Study 1. One plan was labeled the average plan and the other was the target plan. Price was provided only for the average plan. Half of the participants evaluated the two movie-rental plans described in terms of new movies per week (i.e., the contracted attribute). The other participants evaluated the two plans described in terms of new movies per year (i.e., the expanded attribute). These plans are presented i

Ecological and social strategies for managing fisheries using the Resist-Accept- Direct (RAD) framework

Fisheries management is a complex task made even more challenging by rapid and unprecedented socioecological transformations associated with climate change. The Resist-Accept- Direct (RAD) framework can be a useful tool to support fisheries management in facing the high uncertainty and variability associated with aquatic ecosystem transformations. Here, RAD strategies are presented to address ecological goals for aquatic ecosystems and social goals for fisheries. These strategies are mapped on a controllability matrix which explores the ability to guide a system\u27s behaviour towards a desired state based on ecological responsiveness and societal receptivity to change. Understanding and improving the controllability of aquatic systems and fisheries can help managers to maintain the broadest suite of available RAD management strategies

Trends in utilization and costs of BRCA testing among women aged 18–64 years in the United States, 2003–2014

Purpose We examined 12-year trends in BRCA testing rates and costs in the context of clinical guidelines, national policies, and other factors. Methods We estimated trends in BRCA testing rates and costs from 2003 to 2014 for women aged 18–64 years using private claims data and publicly reported revenues from the primary BRCA testing provider. Results The percentage of women with zero out-of-pocket payments for BRCA testing increased during 2013–2014, after 7 years of general decline, coinciding with a clarification of Affordable Care Act coverage of BRCA genetic testing. Beginning in 2007, family history accounted for an increasing proportion of women with BRCA tests compared with personal history, coinciding with BRCA testing guidelines for primary care settings and direct-to-consumer advertising campaigns. During 2013–2014, BRCA testing rates based on claims grew at a faster rate than revenues, following 3 years of similar growth, consistent with increased marketplace competition. In 2013, BRCA testing rates based on claims increased 57%, compared with 11% average annual increases over the preceding 3 years, coinciding with celebrity publicity. Conclusion The observed trends in BRCA testing rates and costs are consistent with possible effects of several factors, including the Affordable Care Act, clinical guidelines and celebrity publicity

Canvass: a crowd-sourced, natural-product screening library for exploring biological space

NCATS thanks Dingyin Tao for assistance with compound characterization. This research was supported by the Intramural Research Program of the National Center for Advancing Translational Sciences, National Institutes of Health (NIH). R.B.A. acknowledges support from NSF (CHE-1665145) and NIH (GM126221). M.K.B. acknowledges support from NIH (5R01GM110131). N.Z.B. thanks support from NIGMS, NIH (R01GM114061). J.K.C. acknowledges support from NSF (CHE-1665331). J.C. acknowledges support from the Fogarty International Center, NIH (TW009872). P.A.C. acknowledges support from the National Cancer Institute (NCI), NIH (R01 CA158275), and the NIH/National Institute of Aging (P01 AG012411). N.K.G. acknowledges support from NSF (CHE-1464898). B.C.G. thanks the support of NSF (RUI: 213569), the Camille and Henry Dreyfus Foundation, and the Arnold and Mabel Beckman Foundation. C.C.H. thanks the start-up funds from the Scripps Institution of Oceanography for support. J.N.J. acknowledges support from NIH (GM 063557, GM 084333). A.D.K. thanks the support from NCI, NIH (P01CA125066). D.G.I.K. acknowledges support from the National Center for Complementary and Integrative Health (1 R01 AT008088) and the Fogarty International Center, NIH (U01 TW00313), and gratefully acknowledges courtesies extended by the Government of Madagascar (Ministere des Eaux et Forets). O.K. thanks NIH (R01GM071779) for financial support. T.J.M. acknowledges support from NIH (GM116952). S.M. acknowledges support from NIH (DA045884-01, DA046487-01, AA026949-01), the Office of the Assistant Secretary of Defense for Health Affairs through the Peer Reviewed Medical Research Program (W81XWH-17-1-0256), and NCI, NIH, through a Cancer Center Support Grant (P30 CA008748). K.N.M. thanks the California Department of Food and Agriculture Pierce's Disease and Glassy Winged Sharpshooter Board for support. B.T.M. thanks Michael Mullowney for his contribution in the isolation, elucidation, and submission of the compounds in this work. P.N. acknowledges support from NIH (R01 GM111476). L.E.O. acknowledges support from NIH (R01-HL25854, R01-GM30859, R0-1-NS-12389). L.E.B., J.K.S., and J.A.P. thank the NIH (R35 GM-118173, R24 GM-111625) for research support. F.R. thanks the American Lebanese Syrian Associated Charities (ALSAC) for financial support. I.S. thanks the University of Oklahoma Startup funds for support. J.T.S. acknowledges support from ACS PRF (53767-ND1) and NSF (CHE-1414298), and thanks Drs. Kellan N. Lamb and Michael J. Di Maso for their synthetic contribution. B.S. acknowledges support from NIH (CA78747, CA106150, GM114353, GM115575). W.S. acknowledges support from NIGMS, NIH (R15GM116032, P30 GM103450), and thanks the University of Arkansas for startup funds and the Arkansas Biosciences Institute (ABI) for seed money. C.R.J.S. acknowledges support from NIH (R01GM121656). D.S.T. thanks the support of NIH (T32 CA062948-Gudas) and PhRMA Foundation to A.L.V., NIH (P41 GM076267) to D.S.T., and CCSG NIH (P30 CA008748) to C.B. Thompson. R.E.T. acknowledges support from NIGMS, NIH (GM129465). R.J.T. thanks the American Cancer Society (RSG-12-253-01-CDD) and NSF (CHE1361173) for support. D.A.V. thanks the Camille and Henry Dreyfus Foundation, the National Science Foundation (CHE-0353662, CHE-1005253, and CHE-1725142), the Beckman Foundation, the Sherman Fairchild Foundation, the John Stauffer Charitable Trust, and the Christian Scholars Foundation for support. J.W. acknowledges support from the American Cancer Society through the Research Scholar Grant (RSG-13-011-01-CDD). W.M.W.acknowledges support from NIGMS, NIH (GM119426), and NSF (CHE1755698). A.Z. acknowledges support from NSF (CHE-1463819). (Intramural Research Program of the National Center for Advancing Translational Sciences, National Institutes of Health (NIH); CHE-1665145 - NSF; CHE-1665331 - NSF; CHE-1464898 - NSF; RUI: 213569 - NSF; CHE-1414298 - NSF; CHE1361173 - NSF; CHE1755698 - NSF; CHE-1463819 - NSF; GM126221 - NIH; 5R01GM110131 - NIH; GM 063557 - NIH; GM 084333 - NIH; R01GM071779 - NIH; GM116952 - NIH; DA045884-01 - NIH; DA046487-01 - NIH; AA026949-01 - NIH; R01 GM111476 - NIH; R01-HL25854 - NIH; R01-GM30859 - NIH; R0-1-NS-12389 - NIH; R35 GM-118173 - NIH; R24 GM-111625 - NIH; CA78747 - NIH; CA106150 - NIH; GM114353 - NIH; GM115575 - NIH; R01GM121656 - NIH; T32 CA062948-Gudas - NIH; P41 GM076267 - NIH; R01GM114061 - NIGMS, NIH; R15GM116032 - NIGMS, NIH; P30 GM103450 - NIGMS, NIH; GM129465 - NIGMS, NIH; GM119426 - NIGMS, NIH; TW009872 - Fogarty International Center, NIH; U01 TW00313 - Fogarty International Center, NIH; R01 CA158275 - National Cancer Institute (NCI), NIH; P01 AG012411 - NIH/National Institute of Aging; Camille and Henry Dreyfus Foundation; Arnold and Mabel Beckman Foundation; Scripps Institution of Oceanography; P01CA125066 - NCI, NIH; 1 R01 AT008088 - National Center for Complementary and Integrative Health; W81XWH-17-1-0256 - Office of the Assistant Secretary of Defense for Health Affairs through the Peer Reviewed Medical Research Program; P30 CA008748 - NCI, NIH, through a Cancer Center Support Grant; California Department of Food and Agriculture Pierce's Disease and Glassy Winged Sharpshooter Board; American Lebanese Syrian Associated Charities (ALSAC); University of Oklahoma Startup funds; 53767-ND1 - ACS PRF; PhRMA Foundation; P30 CA008748 - CCSG NIH; RSG-12-253-01-CDD - American Cancer Society; RSG-13-011-01-CDD - American Cancer Society; CHE-0353662 - National Science Foundation; CHE-1005253 - National Science Foundation; CHE-1725142 - National Science Foundation; Beckman Foundation; Sherman Fairchild Foundation; John Stauffer Charitable Trust; Christian Scholars Foundation)Published versionSupporting documentatio

The Decline of Remarriage: Evidence From German Village Populations in the Eighteenth and Nineteenth Centuries

Family reconstitution data for fourteen German village populations permit the examination of remarriage during the eighteenth and nineteenth cen turies. The results provide compelling evidence for a secular decline in the tenden cy to remarry. Pronounced age and sex differentials in the likelihood of remar riage were evident: widows were far less likely to remarry than widowers, and the probability of remarriage declined rapidly with age, particularly for women. The probability of remarriage was also inversely associated with the number and age of children. There were, however, no clear differences in either the probability of remarriage or its tendency to decline over time among major occupational groups. The decline in remarriage probabilities was caused in part by declines in adult mortality, which gradually raised the ages of surviving spouses to levels at which remarriage has historically been rather unlikely. However, age-specific marriage probabilities also declined, affecting both men and women and all oc cupational groups, suggesting the presence of a social change of wide scope. Some comments on possible factors contributing to the decline of remarriage are presented. The need for a comprehensive explanation of remarriage trends and differentials remains an important challenge for family historians.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68212/2/10.1177_036319908501000103.pd

Enhanced Efficacy of Aurora Kinase Inhibitors in G2/M Checkpoint Deficient TP53 Mutant Uterine Carcinomas Is Linked to the Summation of LKB1-AKT-p53 Interactions.

Uterine carcinoma (UC) is the most common gynecologic malignancy in the United States. TP53 mutant UCs cause a disproportionate number of deaths due to limited therapies for these tumors and the lack of mechanistic understanding of their fundamental vulnerabilities. Here we sought to understand the functional and therapeutic relevance of TP53 mutations in UC. We functionally profiled targetable TP53 dependent DNA damage repair and cell cycle control pathways in a panel of TP53 mutant UC cell lines and patient-derived organoids. There were no consistent defects in DNA damage repair pathways. Rather, most models demonstrated dependence on defective G2/M cell cycle checkpoints and subsequent upregulation of Aurora kinase-LKB1-p53-AKT signaling in the setting of baseline mitotic defects. This combination makes them sensitive to Aurora kinase inhibition. Resistant lines demonstrated an intact G2/M checkpoint, and combining Aurora kinase and WEE1 inhibitors, which then push these cells through mitosis with Aurora kinase inhibitor-induced spindle defects, led to apoptosis in these cases. Overall, this work presents Aurora kinase inhibitors alone or in combination with WEE1 inhibitors as relevant mechanism driven therapies for TP53 mutant UCs. Context specific functional assessment of the G2/M checkpoint may serve as a biomarker in identifying Aurora kinase inhibitor sensitive tumors

Prognostic value of the 6-gene OncoMasTR test in hormone receptor–positive HER2-negative early-stage breast cancer: Comparative analysis with standard clinicopathological factors

Aim: The aim of the study was to assess the prognostic performance of a 6-gene molecular score (OncoMasTR Molecular Score [OMm]) and a composite risk score (OncoMasTR Risk Score [OM]) and to conduct a within-patient comparison against four routinely used molecular and clinicopathological risk assessment tools: Oncotype DX Recurrence Score, Ki67, Nottingham Prognostic Index and Clinical Risk Category, based on the modified Adjuvant! Online definition and three risk factors: patient age, tumour size and grade. Methods: Biospecimens and clinicopathological information for 404 Irish women also previously enrolled in the Trial Assigning Individualized Options for Treatment [Rx] were provided by 11 participating hospitals, as the primary objective of an independent translational study. Gene expression measured via RT-qPCR was used to calculate OMm and OM. The prognostic value for distant recurrence-free survival (DRFS) and invasive disease-free survival (IDFS) was assessed using Cox proportional hazards models and Kaplan-Meier analysis. All statistical tests were two-sided ones. Results: OMm and OM (both with likelihood ratio statistic [LRS] P Discussion: Both OncoMasTR scores were significantly prognostic for DRFS and IDFS and provided additional prognostic information to the molecular and clinicopathological risk factors/tools assessed. OM was also the most accurate risk classification tool for identifying DR. A concise 6-gene signature with superior risk stratification was shown to increase prognosis reliability, which may help clinicians optimise treatment decisions. Trial registration: ClinicalTrials.gov NCT02050750 NCT00310180.</p