969 research outputs found
Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil
OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.OBJETIVO: Identificar fatores de risco para o baixo peso ao nascer (BPN) entre nascidos vivos de parto vaginal e verificar se o desaparecimento da associação entre BPN e fatores socioeconômicos foi devido ao confundimento pela cesariana. MÉTODOS: Foram estudadas duas coortes de base populacional de recém-nascidos únicos de parto vaginal em Ribeirão Preto, Sudeste do Brasil. A primeira incluiu 4.698 crianças nascidas entre junho de 1978 e maio de 1979 e a segunda 1.399 crianças nascidas entre maio e agosto de 1994. Os riscos de BPN foram testados num modelo de regressão logÃstica, incluindo interações entre ano da pesquisa e todas as variáveis independentes em análise. RESULTADOS: A incidência de BPN entre partos vaginais aumentou de 7,8% em 1978/79 para 10% em 1994 para crianças do sexo feminino, para os primogênitos, para nascidos de mães sem companheiro, para nascidos de mães que fizeram menor número de consultas pré-natais ou com menos anos de estudo e para nascidos de mães fumantes. A interação entre ano do parto e idade gestacional indicou que o risco de BPN entre os nascidos prematuros caiu de 17,8 para 8,7 em 15 anos. A média do peso ao nascer reduziu-se mais entre os filhos de famÃlias mais qualificadas, que tiveram o maior aumento nos nascimentos pré-termo e nas mães sem companheiro. CONCLUSÕES: O BPN entre partos vaginais aumentou principalmente devido ao incremento nos nascimentos pré-termo e nas mães sem companheiro. A associação entre cesariana e BPN tendeu a encobrir as diferenças socioeconômicas na probabilidade do BPN. Na análise dos partos vaginais isoladamente, as diferenças socioeconômicas reapareceram
The Emergence of Precision Urologic Oncology: A Collaborative Review on Biomarker-driven Therapeutics
CONTEXT:
Biomarker-driven cancer therapy, also referred to as precision oncology, has received increasing attention for its promise of improving patient outcomes by defining subsets of patients more likely to respond to various therapies.
OBJECTIVES:
In this collaborative review article, we examine recent literature regarding biomarker-driven therapeutics in urologic oncology, to better define the state of the field, explore the current evidence supporting utility of this approach, and gauge potential for the future.
EVIDENCE ACQUISITION:
We reviewed relevant literature, with a particular focus on recent studies about targeted therapy, predictors of response, and biomarker development.
EVIDENCE SYNTHESIS:
The recent advances in molecular profiling have led to a rapid expansion of potential biomarkers and predictive information for patients with urologic malignancies. Across disease states, distinct molecular subtypes of cancers have been identified, with the potential to inform choices of management strategy. Biomarkers predicting response to standard therapies (such as platinum-based chemotherapy) are emerging. In several malignancies (particularly renal cell carcinoma and castration-resistant prostate cancer), targeted therapy against commonly altered signaling pathways has emerged as standard of care. Finally, targeted therapy against alterations present in rare patients (less than 2%) across diseases has the potential to drastically alter patterns of care and choices of therapeutic options.
CONCLUSIONS:
Precision medicine has the highest potential to impact the care of patients. Prospective studies in the setting of clinical trials and standard of care therapy will help define reliable predictive biomarkers and new therapeutic targets leading to real improvement in patient outcomes.
PATIENT SUMMARY:
Precision oncology uses molecular information (DNA and RNA) from the individual and the tumor to match the right patient with the right treatment. Tremendous strides have been made in defining the molecular underpinnings of urologic malignancies and understanding how these predict response to treatment—this represents the future of urologic oncology
Comparação entre duas coortes de mães adolescentes em municÃpio do Sudeste do Brasil
OBJECTIVE: To compare the prevalence of pregnancy among adolescents and analyze trends in some social and biological variables among two cohorts of adolescent mothers in Ribeirão Preto, Brazil, during 1978/79 and 1994. METHODS: Two cohorts of adolescent mothers were interviewed shortly after delivery, comprising 943 women in the first survey (1978/79) and 499 in the second (1994). Both surveys covered more than 98% of births in all childbirth clinics. Only singleton livebirths from adolescent mothers living in the municipality were included in the analysis. The Chi-square test was used for statistical analysis, with a 0.05 significance level. RESULTS: The percentage of adolescent mothers increased from 14.1% in 1978/79 to 17.5% in 1994 (pOBJETIVO: Comparar a prevalência de gravidez na adolescência e analisar variáveis sociobiológicas relacionadas ao binômio mãe-filho entre duas coortes de mães adolescentes de nascidos vivos em Ribeirão Preto (1978-1979 e 1994). MÉTODOS: Foram entrevistadas mães adolescentes logo após o parto, sendo 943 em 1978/79 e 499 em 1994, abrangendo nascidos vivos de parto único, de famÃlias residentes em Ribeirão Preto, SP. Foi utilizado o teste do qui-quadrado, com nÃvel de significância de 0,05. RESULTADOS: O percentual de mães adolescentes aumentou de 14,1% em 1978/79 para 17,5% em 1994 (
Comparação entre duas coortes de mães adolescentes em municÃpio do Sudeste do Brasil
OBJECTIVE: To compare the prevalence of pregnancy among adolescents and analyze trends in some social and biological variables among two cohorts of adolescent mothers in Ribeirão Preto, Brazil, during 1978/79 and 1994. METHODS: Two cohorts of adolescent mothers were interviewed shortly after delivery, comprising 943 women in the first survey (1978/79) and 499 in the second (1994). Both surveys covered more than 98% of births in all childbirth clinics. Only singleton livebirths from adolescent mothers living in the municipality were included in the analysis. The Chi-square test was used for statistical analysis, with a 0.05 significance level. RESULTS: The percentage of adolescent mothers increased from 14.1% in 1978/79 to 17.5% in 1994 (pOBJETIVO: Comparar a prevalência de gravidez na adolescência e analisar variáveis sociobiológicas relacionadas ao binômio mãe-filho entre duas coortes de mães adolescentes de nascidos vivos em Ribeirão Preto (1978-1979 e 1994). MÉTODOS: Foram entrevistadas mães adolescentes logo após o parto, sendo 943 em 1978/79 e 499 em 1994, abrangendo nascidos vivos de parto único, de famÃlias residentes em Ribeirão Preto, SP. Foi utilizado o teste do qui-quadrado, com nÃvel de significância de 0,05. RESULTADOS: O percentual de mães adolescentes aumentou de 14,1% em 1978/79 para 17,5% em 1994 (
Composite GUTs: models and expectations at the LHC
We investigate grand unified theories (GUTs) in scenarios where electroweak
(EW) symmetry breaking is triggered by a light composite Higgs, arising as a
Nambu-Goldstone boson from a strongly interacting sector. The evolution of the
standard model (SM) gauge couplings can be predicted at leading order, if the
global symmetry of the composite sector is a simple group G that contains the
SM gauge group. It was noticed that, if the right-handed top quark is also
composite, precision gauge unification can be achieved. We build minimal
consistent models for a composite sector with these properties, thus
demonstrating how composite GUTs may represent an alternative to supersymmetric
GUTs. Taking into account the new contributions to the EW precision parameters,
we compute the Higgs effective potential and prove that it realizes
consistently EW symmetry breaking with little fine-tuning. The G group
structure and the requirement of proton stability determine the nature of the
light composite states accompanying the Higgs and the top quark: a coloured
triplet scalar and several vector-like fermions with exotic quantum numbers. We
analyse the signatures of these composite partners at hadron colliders:
distinctive final states contain multiple top and bottom quarks, either alone
or accompanied by a heavy stable charged particle, or by missing transverse
energy.Comment: 55 pages, 13 figures, final version to be published in JHE
A slice of AdS_5 as the large N limit of Seiberg duality
A slice of AdS_5 is used to provide a 5D gravitational description of 4D
strongly-coupled Seiberg dual gauge theories. An (electric) SU(N) gauge theory
in the conformal window at large N is described by the 5D bulk, while its
weakly coupled (magnetic) dual is confined to the IR brane. This framework can
be used to construct an N = 1 MSSM on the IR brane, reminiscent of the original
Randall-Sundrum model. In addition, we use our framework to study
strongly-coupled scenarios of supersymmetry breaking mediated by gauge forces.
This leads to a unified scenario that connects the extra-ordinary gauge
mediation limit to the gaugino mediation limit in warped space.Comment: 47 Pages, axodraw4j.st
Loop Quantum Gravity a la Aharonov-Bohm
The state space of Loop Quantum Gravity admits a decomposition into
orthogonal subspaces associated to diffeomorphism equivalence classes of
spin-network graphs. In this paper I investigate the possibility of obtaining
this state space from the quantization of a topological field theory with many
degrees of freedom. The starting point is a 3-manifold with a network of
defect-lines. A locally-flat connection on this manifold can have non-trivial
holonomy around non-contractible loops. This is in fact the mathematical origin
of the Aharonov-Bohm effect. I quantize this theory using standard field
theoretical methods. The functional integral defining the scalar product is
shown to reduce to a finite dimensional integral over moduli space. A
non-trivial measure given by the Faddeev-Popov determinant is derived. I argue
that the scalar product obtained coincides with the one used in Loop Quantum
Gravity. I provide an explicit derivation in the case of a single defect-line,
corresponding to a single loop in Loop Quantum Gravity. Moreover, I discuss the
relation with spin-networks as used in the context of spin foam models.Comment: 19 pages, 1 figure; v2: corrected typos, section 4 expanded
Childhood socioeconomic position, adult socioeconomic position and social mobility in relation to markers of adiposity in early adulthood: evidence of differential effects by gender in the 1978/79 Ribeirao Preto cohort study
Background: Longitudinal studies drawn from high-income countries demonstrate long-term associations of early childhood socioeconomic deprivation with increased adiposity in adulthood. However, there are very few data from resource-poor countries where there are reasons to anticipate different gradients. Accordingly, we sought to characterise the nature of the socioeconomic status (SES)-adiposity association in Brazil. / Methods: We use data from the Ribeirao Preto Cohort Study in Brazil in which 9067 newborns were recruited via their mothers in 1978/79 and one-in-three followed up in 2002/04 (23–25years). SES, based on family income (salaries, interest on savings, pensions and so on), was assessed at birth and early adulthood, and three different adiposity measures (body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)) ascertained at follow-up. The association between childhood SES, adult SES and social mobility (defined as four permutations of SES in childhood and adulthood: low–low, low–high, high–low, high–high), and the adiposity measures was examined using linear regression. / Results: There was evidence that the association between SES and the three markers of adiposity was modified by gender in both adulthood (P<0.02 for all outcomes) and childhood SES (P<0.02 for WC and WHR). Thus, in an unadjusted model, linear regression analyses showed that higher childhood SES was associated with lower adiposity in women (coefficient (95% confidence intervals) BMI: −1.49 (−2.29,−0.69); WC: −3.85 (−5.73,−1.97); WHR: −0.03 (−0.04,−0.02)). However, in men, higher childhood SES was related to higher adiposity (BMI: 1.03 (0.28,−1.78); WC: 3.15 (1.20, 5.09); WHR: 0.009 (−0.001, 0.019)) although statistical significance was not seen in all analyses. There was a suggestion that adult SES (but not adult health behaviours or birthweight) accounted for these relationships in women only. Upward mobility was associated with protection against greater adiposity in women but not men. / Conclusion: In the present study, in men there was some evidence that both higher childhood and adulthood SES was related to a higher adiposity risk, while the reverse gradient was apparent in women
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