Associations between Dietary Acid Load and Biomarkers of Inflammation and Hyperglycemia in Breast Cancer Survivors.

Metabolic acidosis can lead to inflammation, tissue damage, and cancer metastasis. Dietary acid load contributes to metabolic acidosis if endogenous acid-base balance is not properly regulated. Breast cancer survivors have reduced capacities to adjust their acid-base balance; yet, the associations between dietary acid load and inflammation and hyperglycemia have not been examined among them. We analyzed data collected from 3042 breast cancer survivors enrolled in the Women's Healthy Eating and Living (WHEL) Study who had provided detailed dietary intakes and measurements of plasma C-reactive protein (CRP) and hemoglobin A1c (HbA1c). Using a cross-sectional design, we found positive associations between dietary acid load and plasma CRP and HbA1c. In the multivariable-adjusted models, compared to women with the lowest quartile, the intakes of dietary acid load among women with the highest quartile showed 30-33% increases of CRP and 6-9% increases of HbA1c. Our study is the first to demonstrate positive associations between dietary acid load and CRP and HbA1c in breast cancer survivors. Our study identifies a novel dietary factor that may lead to inflammation and hyperglycemia, both of which are strong risk factors for breast cancer recurrence and comorbidities

Accurate estimation of SNP-heritability from biobank-scale data irrespective of genetic architecture.

SNP-heritability is a fundamental quantity in the study of complex traits. Recent studies have shown that existing methods to estimate genome-wide SNP-heritability can yield biases when their assumptions are violated. While various approaches have been proposed to account for frequency- and linkage disequilibrium (LD)-dependent genetic architectures, it remains unclear which estimates reported in the literature are reliable. Here we show that genome-wide SNP-heritability can be accurately estimated from biobank-scale data irrespective of genetic architecture, without specifying a heritability model or partitioning SNPs by allele frequency and/or LD. We show analytically and through extensive simulations starting from real genotypes (UK Biobank, N = 337 K) that, unlike existing methods, our closed-form estimator is robust across a wide range of architectures. We provide estimates of SNP-heritability for 22 complex traits in the UK Biobank and show that, consistent with our results in simulations, existing biobank-scale methods yield estimates up to 30% different from our theoretically-justified approach

In whom do we trust? Critical success factors impacting intercultural communication in multicultural project teams

Trust is a significant enabler for intercultural communication in project teams. Researchers and practitioners, therefore, need to know which factors might enhance trust in intercultural communication. Contributing to the yet limited number of studies in the field of intercultural communication for multicultural project teams, this research theoretically analyzes and empirically investigates the enablers of trust for intercultural communication focusing on emotional intelligence, empathy, interaction, and transparency. Using a field sample of 117 experienced project managers working in multicultural project teams, we find that interaction and transparency significantly and positively influence trust in intercultural communication; empathy marginally and positively influences trust. Emotional intelligence does not exert an effect on it. These results provide novel theoretical and empirical insights which have practical implications for project managers. The findings direct suggestions for additional theoretical work

Withering the citizen, managing the consumer: complaints in healthcare settings

This paper considers concepts of citizenship and consumerism in light of complaints about healthcare, which have risen since the early1990s, due to a greater willingness by the healthcare user to complain, and also the reforms in complaint systems. The narrow legal model for dealing with complaints has been replaced by a managerial model based on corporate sector practice that views complaint handling as a way of retaining customers and organisational learning. The managerial model has proved difficult to embed into the English NHS and has been superposed with a centralised regulatory system that aims to manage performance while also being responsible for reviewing, complaints and being responsive to complainants. It is argued that this may have positive consequences in terms of improving healthcare quality but more negatively, the promotion of consumerism within complaints processes has led to a loss of the right to due process and public accountability

Functional dimension of feedforward ReLU neural networks

It is well-known that the parameterized family of functions representable by fully-connected feedforward neural networks with ReLU activation function is precisely the class of piecewise linear functions with finitely many pieces. It is less well-known that for every fixed architecture of ReLU neural network, the parameter space admits positive-dimensional spaces of symmetries, and hence the local functional dimension near any given parameter is lower than the parametric dimension. In this work we carefully define the notion of functional dimension, show that it is inhomogeneous across the parameter space of ReLU neural network functions, and continue an investigation - initiated in [14] and [5] - into when the functional dimension achieves its theoretical maximum. We also study the quotient space and fibers of the realization map from parameter space to function space, supplying examples of fibers that are disconnected, fibers upon which functional dimension is non-constant, and fibers upon which the symmetry group acts non-transitively.Comment: 51 pages, 1 figur

Examining the impact of early longitudinal patient exposure on medical students’ career choices

Background: Medical schools include career direction experiences to help students make informed career decisions. Most experiences are short, precluding students from attaining adequate exposure to long-term encounters within medicine. We investigated the impact of the First Patient Program (FPP), which fosters longitudinal patient exposure by pairing junior medical students with chronically ill patients through their healthcare journey, in instilling career direction. Methods: Medical students who completed at least 6-months in the FPP participated in a cross-sectional survey. Students’ answers were analyzed with respect to the number of FPP appointments attended. Thematic analysis was conducted to explore qualitative responses.Results: One hundred and forty-eight students participated in the survey. Only 28 (19%) students stated that the FPP informed their career decisions. Thirty-nine percent of students who attended four or more appointments indicated that the FPP informed their career decisions, compared to 16% of students who attended less (p=0.021). Thematic analysis revealed two themes: 1) Students focused mainly on patient encounters within FPP; and 2) Students sought career directions from other experiences.Conclusion: The majority of students did not attain career guidance from the FPP, but rather used the program to understand the impact of chronic illness from the patient’s perspective