Community- and Individual-Level Socioeconomic Status and Breast Cancer Risk: Multilevel Modeling on Cape Cod, Massachusetts

BACKGROUND. Previous research demonstrated increased risk of breast cancer associated with higher socioeconomic status (SES) measured at both the individual and community levels. However, little attention has been paid to simultaneously examining both measures. OBJECTIVES. We evaluated the independent influences of individual and community SES on the risk of breast cancer using case-control data. Because our previous work suggests that associations may be stronger after including a latency period, we also assessed the effect of community-level SES assuming a 10-year latency period. METHODS. We obtained individual education for cases and matched controls diagnosed between 1987 and 1993 on Cape Cod, Massachusetts (USA). We acquired community-level SES from census data for 1980 and 1990. Using SES data at diagnosis and 10 years earlier, we constructed models for breast cancer risk using individual-level SES only, community-level SES only, and a multilevel analysis including both. We adjusted models for other individual-level risk factors. RESULTS. Women with the highest education were at greater risk of developing breast cancer in both 1980 and 1990 [odds ratio (OR) = 1.17 and 1.19, respectively]. Similarly, women living in the highest-SES communities in 1990 had greater risk (OR = 1.30). Results were stronger in the analyses considering a latency period (OR = 1.69). Adjusting for intragroup correlation had little effect on the analyses. CONCLUSIONS. Models including individual- or community-level measures of SES produced associations similar to those observed in previous research. Results for models including both measures are consistent with a contextual effect of SES on risk of breast cancer independent of individual SES.Boston University Center for Interdisciplinary Research in Environmental Exposures and Health; National Institute of Environmental Health (P42ES007381

A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial

BACKGROUND: Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. METHODS: The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. DISCUSSION: This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service and for policy makers

Histopathological characterization of experimentally induced cutaneous loxoscelism in rabbits inoculated with Loxosceles similis venom

Envenomation by Loxosceles bites is characterized by dermonecrotic and/or systemic features that lead to several clinical signs and symptoms called loxoscelism. Dermonecrotic lesions are preceded by thrombosis of the dermal plexus. Recent studies show that atheromatous plaque is prone to thrombosis due to endothelial cell apoptosis. To the best of our knowledge, there are no reports of microscopic dermal lesion and endothelial cell apoptosis induced by Loxosceles similis venom in the literature. Thus, the aim of the present study is to describe histological lesions induced by L. similis venom in rabbit skin and to elucidate whether apoptosis of endothelial cells is involved in the pathogenesis of loxoscelism. Forty male rabbits were split into two groups: the control group (intradermally injected with 50 µL of PBS) and the experimental group (intradermally injected with 0.5 µg of L. similis crude venom diluted in 50 µL of PBS). After 2, 4, 6 and 8 hours of injection, skin fragments were collected and processed for paraffin or methacrylate embedding. Sections of 5 µm thick were stained by HE, PAS or submitted to TUNEL reaction. Microscopically, severe edema, diffuse heterophilic inflammatory infiltrate, perivascular heterophilic infiltrate, thrombosis, fibrinoid necrosis of arteriolar wall and cutaneous muscle necrosis were observed. Two hours after venom injection, endothelial cells with apoptosis morphology were evidenced in the dermal plexus. Apoptosis was confirmed by TUNEL reaction. It seems that endothelial cell apoptosis and its consequent desquamation is an important factor that induces thrombosis and culminates in dermonecrosis, which is characteristic of cutaneous loxoscelism

Quantum Spectral Curve at Work: From Small Spin to Strong Coupling in N=4 SYM

We apply the recently proposed quantum spectral curve technique to the study of twist operators in planar N=4 SYM theory. We focus on the small spin expansion of anomalous dimensions in the sl(2) sector and compute its first two orders exactly for any value of the 't Hooft coupling. At leading order in the spin S we reproduced Basso's slope function. The next term of order S^2 structurally resembles the Beisert-Eden-Staudacher dressing phase and takes into account wrapping contributions. This expansion contains rich information about the spectrum of local operators at strong coupling. In particular, we found a new coefficient in the strong coupling expansion of the Konishi operator dimension and confirmed several previously known terms. We also obtained several new orders of the strong coupling expansion of the BFKL pomeron intercept. As a by-product we formulated a prescription for the correct analytical continuation in S which opens a way for deriving the BFKL regime of twist two anomalous dimensions from AdS/CFT integrability.Comment: 53 pages, references added; v3: due to a typo in the coefficients C_2 and D_2 on page 29 we corrected the rational part of the strong coupling predictions in equations (1.5-6), (6.22-24), (6.27-30) and in Table

A rare genomic duplication in 2p14 underlies autosomal dominant hearing loss DFNA58

Here we define a ~ 200Kb genomic duplication in 2p14 as the genetic signature that segregates with post-lingual progressive sensorineural autosomal dominant hearing loss in 20 affected individuals from the DFNA58 family, first reported in 2009. The duplication includes two entire genes, PLEK and CNRIP1, and the first exon of PPP3R1 (protein-coding), in addition to four uncharacterized long noncoding (lnc) RNA genes and part of a novel protein-coding gene. Quantitative analysis of mRNA expression in blood samples revealed selective overexpression of CNRIP1 and of two lncRNA genes (LOC107985892 and LOC102724389) in all affected members tested, but not in unaffected ones. Qualitative analysis of mRNA expression identified also fusion transcripts involving parts of PPP3R1, CNRIP1 and an intergenic region between PLEK and CNRIP1, in the blood of all carriers of the duplication, but were heterogeneous in nature. By in situ hybridization and immunofluorescence, we showed that Cnrip1, Plek and Ppp3r1 genes are all expressed in the adult mouse cochlea including the spiral ganglion neurons, suggesting changes in expression levels of these genes in the hearing organ could underlie the DFNA58 form of deafness. Our study highlights the value of studying rare genomic events leading to hearing loss such as copy number variations. Further studies will be required to determine which of these genes, either coding proteins or non-coding RNAs, is or are responsible for DFNA58 hearing loss

Cochlear Implant: the complexity involved in the decision making process by the family

El objetivo de esta investigación es comprender los significados atribuidos por la familia a las etapas del proceso de la toma de decisiones para el implante coclear en el hijo

Inter-rater reliability of categorical versus continuous scoring of fish vitality: does it affect the utility of the reflex action mortality predictor (RAMP) approach?

Scoring reflex responsiveness and injury of aquatic organisms has gained popularity as predictors of discard survival. Given this method relies upon the individual interpretation of scoring criteria, an evaluation of its robustness is done here to test whether protocol-instructed, multiple raters with diverse backgrounds (research scientist, technician, and student) are able to produce similar or the same reflex and injury score for one of the same flatfish (European plaice, Pleuronectes platessa) after experiencing commercial fishing stressors. Inter-rater reliability for three raters was assessed by using a 3-point categorical scale (‘absent’, ‘weak’, ‘strong’) and a tagged visual analogue continuous scale (tVAS, a 10 cm bar split in three labelled sections: 0 for ‘absent’, ‘weak’, ‘moderate’, and ‘strong’) for six reflex responses, and a 4-point scale for four injury types. Plaice (n = 304) were sampled from 17 research beam-trawl deployments during four trips. Fleiss kappa (categorical scores) and intra-class correlation coefficients (ICC, continuous scores) indicated variable inter-rater agreement by reflex type (ranging between 0.55 and 0.88, and 67% and 91% for Fleiss kappa and ICC, respectively), with least agreement among raters on extent of injury (Fleiss kappa between 0.08 and 0.27). Despite differences among raters, which did not significantly influence the relationship between impairment and predicted survival, combining categorical reflex and injury scores always produced a close relationship of such vitality indices and observed delayed mortality. The use of the continuous scale did not improve fit of these models compared with using the reflex impairment index based on categorical scores. Given these findings, we recommend using a 3-point categorical over a continuous scale. We also determined that training rather than experience of raters minimised inter-rater differences. Our results suggest that cost-efficient reflex impairment and injury scoring may be considered a robust technique to evaluate lethal stress and damage of this flatfish species on-board commercial beam-trawl vessels

Adaptation and validation of the Inventory of family protective factors for the portuguese culture

Aim: Describe the process of cultural adaptation and validation of Inventory of Family Protective Factors (IFPF) for portuguese culture. This instrument assesses the protective factors that contribute to family resilience. Studies of resilience fall the salutogenic paradigm, which focuses on protective factors of individuals or groups, without minimizing the risk factors and vulnerability. Methods: We applied this instrument to 85 families of children with special needs and, after linguistic and conceptual equivalence, used an exploratory factor analysis with principal components analysis (with varimax rotation) and calculated the Cronbach's alpha coefficient for each dimension. Results: adequate psychometric properties to be used in Portuguese population (Cronbach´s alpha =.90). Conclusion: IFPF is an useful instrument for studies which propose assess the protective factors of family resilience, however we suggest further studies of revalidation.Objetivo: Describir el proceso de adaptación cultural y validación para la cultura portuguesa de Inventory of Family Protective Factors (IFPF). Este instrumento evalúa los factores de protección que contribuyan a la resiliencia familiar. Estudios de resiliência familiar se apoyan en el paradigma salutogénico, que se centra en los factores de protección de individuos o grupos, sin subestimar los factores de riesgo y vulnerabilidad. Metodologia: Aplicamos este instrumento a 85 familias de niños con necesidades especiales y, después de la equivalencia lingüística y conceptual, hemos llevado a cabo un análisis factorial exploratorio de componentes principales con rotación varimax y calculamos el coeficiente alfa de Cronbach. Resultados: la IFPF tiene adecuadas propiedades psicométricas para la población portuguesa (alfa de Cronbach = .90). Conclusion: Esta es una herramienta útil para evaluar los factores protectores de la resiliencia familiar, sin embargo sugerimos estudios futuros de revalidación.Objetivos: adaptar e validar o Inventory of Family Protective Factors (IFPF) para a cultura portuguesa. Este instrumento avalia os fatores protetores que contribuem para a resiliência familiar. Os estudos sobre resiliência inserem-se no paradigma salutogénico, abordando os fatores protetores dos indivíduos ou grupos, sem subestimar os fatores de risco ou vulnerabilidade. Método: para avaliar a equivalência linguística e conceitual do IFPF realizamos a tradução, retroversão e reflexão falada; para aferir as características psicométricas do instrumento verificamos a sensibilidade, confiabilidade e a validade dos resultados. Realizamos uma análise fatorial de componentes principais com rotação varimax dos itens da escala e calculamos o coeficiente Alpha de Cronbach para cada dimensão. Através de uma amostragem aleatória simples, aplicamos este instrumento a 85 famílias de crianças com necessidades especiais que o auto-preencheram. Resultados: o IFPF apresenta características psicométricas adequadas para a população portuguesa (alfa de Cronbach de .90). Conclusão: o IFPF foi adaptado e validado para a cultura portuguesa. Consideramos tratar-se de um instrumento útil para estudos que se proponham avaliar os fatores protetores da resiliência familiar