Association between Melanocytic Nevi and Risk of Breast Diseases: The French E3N Prospective Cohort

Background: While melanocytic nevi have been associated with genetic factors and childhood sun exposure, several observations also suggest a potential hormonal influence on nevi. To test the hypothesis that nevi are associated with breast tumor risk, we explored the relationships between number of nevi and benign and malignant breast disease risk. Methods and Findings: We prospectively analyzed data from E3N, a cohort of French women aged 40–65 y at inclusion in 1990. Number of nevi was collected at inclusion. Hazard ratios (HRs) for breast cancer and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. Associations of number of nevi with personal history of benign breast disease (BBD) and family history of breast cancer were estimated using logistic regression. Over the period 15 June 1990–15 June 2008, 5,956 incident breast cancer cases (including 5,245 invasive tumors) were ascertained among 89,902 women. In models adjusted for age, education, and known breast cancer risk factors, women with “very many” nevi had a significantly higher breast cancer risk (HR = 1.13, 95% CI = 1.01–1.27 versus “none”; ptrend = 0.04), although significance was lost after adjustment for personal history of BBD or family history of breast cancer. The 10-y absolute risk of invasive breast cancer increased from 3,749 per 100,000 women without nevi to 4,124 (95% CI = 3,674–4,649) per 100,000 women with “very many” nevi. The association was restricted to premenopausal women (HR = 1.40, ptrend = 0.01), even after full adjustment (HR = 1.34, ptrend = 0.03; phomogeneity = 0.04), but did not differ according to breast cancer type or hormone receptor status. In addition, we observed significantly positive dose–response relationships between number of nevi and history of biopsy-confirmed BBD (n = 5,169; ptrend<0.0001) and family history of breast cancer in first-degree relatives (n = 7,472; ptrend = 0.0003). The main limitations of our study include self-report of number of nevi using a qualitative scale, and self-reported history of biopsied BBD. Conclusions: Our findings suggest associations between number of nevi and the risk of premenopausal breast cancer, BBD, and family history of breast cancer. More research is warranted to elucidate these relationships and to understand their underlying mechanisms. Please see later in the article for the Editors' Summar

The monetary benefit of early flood warnings in Europe

Effective disaster risk management relies on science-based solutions to close the gap between prevention and preparedness measures. The consultation on the United Nations post-2015 framework for disaster risk reduction highlights the need for cross-border early warning systems to strengthen the preparedness phases of disaster risk management, in order to save lives and property and reduce the overall impact of severe events. Continental and global scale flood forecasting systems provide vital early flood warning information to national and international civil protection authorities, who can use this information to make decisions on how to prepare for upcoming floods. Here the potential monetary benefits of early flood warnings are estimated based on the forecasts of the continental-scale European Flood Awareness System (EFAS) using existing flood damage cost information and calculations of potential avoided flood damages. The benefits are of the order of 400 Euro for every 1 Euro invested. A sensitivity analysis is performed in order to test the uncertainty in the method and develop an envelope of potential monetary benefits of EFAS warnings. The results provide clear evidence that there is likely a substantial monetary benefit in this cross-border continental-scale flood early warning system. This supports the wider drive to implement early warning systems at the continental or global scale to improve our resilience to natural hazards

Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE)

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Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts: Results from the ESCAPE and TRANSPHORM projects

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Assessment of the Costs of Business Interruption caused by Large-scale Floods

In the Netherlands one of the most important methods to determine the level of flood protection is a cost-benefit analysis. In this analysis the costs (investment and maintenance costs of dikes) are balanced with the benefits (a reduction of flood risk). Risk is defined as the product of probability and consequence. This approach requires a good estimate of the consequences of floods. A large contributor to the total costs of a flood are the losses due to business interruption. This is defined as forgone value added that is not created due to the fact that firms have to stop production. The causes of the production stop considered in this thesis are material damage to the production facilities of the considered firms and both forward and backward effects in the supply chain. The latter effects include the interruption of firms which are not flooded themselves, unlike their suppliers or buyers. In the Netherlands the software package HIS-SSM (Hoogwater Informatie Systeem – Schade en Slachtoffer Module) is used to determine the consequences of possible floods. This model uses a damage function approach to determine the losses due to business interruption, in which the duration of the business interruption depends on the water depth only. As a result of this assumption, the losses due to business interruption expressed as a share of the material damage range between 1.5 and 5%, independent of the scale of the flood according to HIS-SSM. An analysis of actual floods shows that these figures are between 30% and 125% for large-scale floods. The considered floods for these figures are hurricane Katrina in 2005, hurricane Sandy in 2012, the tsunami in Japan in 2011 and the river floods in Thailand in 2011. Therefore, the losses due to business interruption as calculated by HIS-SSM are expected to be an underestimation of the actual losses due to business interruption. For this reason the ARIO (Adaptive Regional Input-Output) model has been used to determine the losses due to business interruption as well. The ARIO model has only been used for academic purposes so far. Both models have been applied to three cases in the Netherlands, which comprise the flooding of the province of South-Holland, Groningen and the small town of Arcen. The results of the case studies show that the estimates of the losses due to business interruption as calculated by the ARIO model are more in line with figures from actual floods. Both HIS-SSM and the ARIO model have some drawbacks however. The ARIO model appears to be able to determine the losses due to business interruption more accurately than HIS-SSM. Many important processes in the aftermath of a flood are not considered in both models however, such as flood duration and substitution effects. In both models the consequences of flooding of unique firms or infrastructure are underestimated. This is a result of the sector approach in both models, in which all firms are assigned to a certain sector. The transformation of material damage to production capacity has a large influence on the results of the ARIO model. The costs of permanent relocation of firms to foreign countries is also not taken into account in these models, while a simple calculation shows that these might contribute significantly to the total costs of a flood. Some assumptions in this calculation are based on interviews conducted with a member of the Dutch parliament and a professor at Delft University of Technology. Measures to reduce the losses due to business interruption should also be considered in the Dutch flood protection policy, after a cost-benefit analysis has been performed for these measures.Hydraulic EngineeringCivil Engineering and Geoscience

The conceptualization of mindfulness in health promotion: A scoping review of the literature on physical activity and healthy eating

This review aims to examine conceptualizations of mindfulness within the published literature on positive health behaviors (i.e., healthy eating and physical activity) in non-clinical adult populations, and to develop an integrative concept map of how to conceptualize, measure, and apply mindfulness in health promotion approaches

The conceptualization of mindfulness in health promotion: A scoping review of the literature on physical activity and healthy eating.

This review aims to examine conceptualizations of mindfulness within the published literature on positive health behaviors (i.e., healthy eating and physical activity) in non-clinical adult populations, and to develop an integrative concept map of how to conceptualize, measure, and apply mindfulness in health promotion approaches

Assessment of the losses due to business interruption caused by large-scale floods

The economic consequences of floods, both in the form of material damage and losses due to business interruption, can be large. This paper presents a comparison between two approaches to determine the losses due to business interruption caused by large-scale floods. A model (HIS-SSM) containing a damage function approach and an Adaptive Input-Output model (ARIO) are applied to a hypothetical flood in The Netherlands. The results of the case study are compared to the costs of recent large-scale floods in the US and in Asia. The comparison shows that the losses due to business interruption are underestimated by HIS-SSM. The results of the ARIO model are in line with the figures from recent large-scale floods, but they depend strongly on how material damage is transformed to a production capacity. Furthermore, both models underestimate the losses due to business interruption if a unique object is flooded. We recommend to perform more validation studies with HIS-SSM and possibly replace the damage function approach with an input-output model approach for computing losses due to business interruption. Moreover, we recommend to perform more research on the relation between material damage and production capacity and to determine the consequences of flooding of unique objects on the level of the individual firm.Hydraulic EngineeringCivil Engineering and Geoscience

Normative values for electrochemical skin conductance measurements for quantitative assessment of sudomotor function in healthy Indian adults

Context: Electrochemical skin conductance (ESC) test is a widely accepted objective technique for quantitatively assessing sudomotor dysfunction, which is one of the earliest-detected neurophysiologic abnormalities in diabetic patients with distal symmetric polyneuropathy. Aims: This study aimed to provide normative data for ESC values among healthy Indian participants and assess the potential influence of age, sex, and body mass index (BMI) on ESC measurements. Settings and Design: A sample of 217 healthy participants aged 18–75 years were recruited and assessed for parameters including age, gender, BMI, and ESC measurements of the hands and feet. Statistical Analysis Used: The Shapiro–Wilk test was used to assess the normality of the data. Pearson's correlation was used to evaluate the association between age, gender, and BMI, and ESC measurements. Results: The mean age of the participants was 43.3 ± 13.2 years, and mean BMI was 26.0 ± 4.3 kg/m2. Mean ESC for the hands and feet was 68.9 ± 13.1 and 71 ± 12.9 micro-Siemens, respectively, and there was a significant correlation between values from the right and left hands and feet (r = 0.9, P < 0.0001). A significant correlation was also observed between ESC measurements of the hands and feet (r = 0.94, P < 0.0001). ESC values of both hands and feet declined with age. A weak but significant inverse correlation between ESC and age was observed for the hands (r = 0.02, P = 0.01) and for the feet (r = 0.12, P < 0.0001). There was no significant difference in hand or feet ESC measurement between male and female participants. No significant correlation was observed between BMI and ESC of hands or feet. Only age was identified as a significant determinant of ESC on multivariate logistic regression analysis. Conclusions: Normative values for Indians are lower than that reported for Caucasians

The association of body shape trajectories over the life course with type 2 diabetes risk in adulthood: a group-based modeling approach

International audiencePurpose - Low birth weight is a well-recognized risk factor for type 2 diabetes (T2D), but less is known about risks associated with the evolution of body shape throughout life with incident T2D in adulthood. Methods - In 80,110 women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) cohort study, trajectories of self-reported body shapes from age 8 years to 35-40 years were derived using a group-based modeling approach and studied in relation with incident T2D. Results - Compared with women who maintained a stable midrange body shape trajectory from 8 to 40 years, women in all other observed trajectories were at a higher risk of developing T2D in adulthood: The highest risk was observed for women who were lean at age 8 years and had a sharp increase in body shape (hazards ratio = 2.91 [2.35-3.62]); their T2D risk was higher (P for homogeneity = .059) than for women who maintained the largest body shape (hazards ratio = 2.18 [1.76-2.69]). Conclusions - A group-based modeling approach has identified trajectories of body shape evolution with different risks of developing T2D in adulthood. A sharp increase in body shape after puberty in previously lean girls is a risk factor for the subsequent development of diabetes