inc Risk of Ipsilateral Reamputation Following an Incident Toe Amputation Among U.S. Military Veterans With Diabetes, 2005-2016 By care.diabetesjournals.org Published On :: 2020-04-20T12:00:32-07:00 OBJECTIVE To assess whether the risk of subsequent lower-limb amputations and death following an initial toe amputation among individuals with diabetes has changed over time and varies by demographic characteristics and geographic region. RESEARCH DESIGN AND METHODS Using Veterans Health Administration (VHA) electronic medical records from 1 October 2004 to 30 September 2016, we determined risk of subsequent ipsilateral minor and major amputation within 1 year after an initial toe/ray amputation among veterans with diabetes. To assess changes in the annual rate of subsequent amputation over time, we estimated age-adjusted incidence of minor and major subsequent ipsilateral amputation for each year, separately for African Americans (AAs) and whites. Geographic variation was assessed across VHA markets (n = 89) using log-linear Poisson regression models adjusting for age and ethnoracial category. RESULTS Among 17,786 individuals who had an initial toe amputation, 34% had another amputation on the same limb within 1 year, including 10% who had a major ipsilateral amputation. Median time to subsequent ipsilateral amputation (minor or major) was 36 days. One-year risk of subsequent major amputation decreased over time, but risk of subsequent minor amputation did not. Risk of subsequent major ipsilateral amputation was higher in AAs than whites. After adjusting for age and ethnoracial category, 1-year risk of major subsequent amputation varied fivefold across VHA markets. CONCLUSIONS Nearly one-third of individuals require reamputation following an initial toe amputation, although risks of subsequent major ipsilateral amputation have decreased over time. Nevertheless, risks remain particularly high for AAs and vary substantially geographically. Full Article
inc Incidence and Associations of Chronic Kidney Disease in Community Participants With Diabetes: A 5-Year Prospective Analysis of the EXTEND45 Study By care.diabetesjournals.org Published On :: 2020-04-20T12:00:32-07:00 OBJECTIVE To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 in people with diabetes. RESEARCH DESIGN AND METHODS We identified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006–2014) that linked the Sax Institute’s 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m2 recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m2 at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m2 and multivariable Cox regression to examine factors associated with the study outcome. RESULTS Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m2 over a median follow-up time of 5.7 years (interquartile range, 3.0–5.9 years). The eGFR <60 mL/min/1.73 m2 incidence rate per 100 person-years was 6.0 (95% CI 5.7–6.3) overall, 1.5 (1.3–1.9) in participants aged 45–54 years, 3.7 (3.4–4.0) for 55–64 year olds, 7.6 (7.1–8.1) for 65–74 year olds, 15.0 (13.0–16.0) for 75–84 year olds, and 26.0 (22.0–32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19–1.26), geography (outer regional and remote versus major city: 1.36; 1.17–1.58), obesity (obese class III versus normal: 1.44; 1.16–1.80), and the presence of hypertension (1.52; 1.33–1.73), coronary heart disease (1.13; 1.02–1.24), cancer (1.30; 1.14–1.50), and depression/anxiety (1.14; 1.01–1.27). CONCLUSIONS In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m2 was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence. Full Article
inc An increase in MYC copy number has a progressive negative prognostic impact in patients with diffuse large B-cell and high-grade lymphoma, who may benefit from intensified treatment regimens By www.haematologica.org Published On :: 2020-05-01T00:05:42-07:00 MYC translocations, a hallmark of Burkitt lymphoma, occur in 5-15% of diffuse large B-cell lymphoma, and have a negative prognostic impact. Numerical aberrations of MYC have also been detected in these patients, but their incidence and prognostic role are still controversial. We analyzed the clinical impact of MYC increased copy number on 385 patients with diffuse large B-cell lymphoma screened at diagnosis for MYC, BCL2, and BCL6 rearrangements. We enumerated the number of MYC copies, defining as amplified those cases with an uncountable number of extra-copies. The prevalence of MYC translocation, increased copy number and amplification was 8.8%, 15%, and 1%, respectively. Patients with 3 or 4 gene copies, accounting for more than 60% of patients with MYC copy number changes, had a more favorable outcome compared to patients with >4 copies or translocation of MYC, and were not influenced by the type of treatment received as first-line. Stratification according to the number of MYC extra-copies showed a negative correlation between an increasing number of copies and survival. Patients with >7 copies or the amplification of MYC had the poorest prognosis. Patients with >4 copies of MYC showed a similar, trending towards worse prognosis compared to patients with MYC translocation. The survival of patients with >4 copies, translocation or amplification of MYC seemed to be superior if intensive treatments were used. Our study underlines the importance of fluorescence in situ hybridization testing at diagnosis of diffuse large B-cell lymphoma to detect the rather frequent and clinically significant numerical aberrations of MYC. Full Article
inc Disease progression in myeloproliferative neoplasms: comparing patients in accelerated phase with those in chronic phase with increased blasts (<10%) or with other types of disease progression By www.haematologica.org Published On :: 2020-05-01T00:05:42-07:00 Full Article
inc INTRODUCING THE BEST PRACTICE GUIDE FOR STRATEGIC PLANNING TO INCREASE STUDENT CHOICE OF FAMILY MEDICINE [Family Medicine Updates] By www.annfammed.org Published On :: 2020-03-09T14:00:11-07:00 Full Article
inc Previous Infection Positively Correlates to the Tumor Incidence Rate of Patients with Cancer By cancerimmunolres.aacrjournals.org Published On :: 2020-05-01T00:05:25-07:00 We conducted a 7-year case–control study of people ≥30 years of age on the prevalence of influenza, gastroenteritis, hepatitis, and pneumonia infections to indirectly examine whether these infections correlated to malignant cancer formation. Data were extracted from a large medical claims database of a Japanese social health insurance system; the case group included 2,354 people with their first cancer diagnosis in the 7th year of this study, and the control group included 48,395 people with no cancer diagnosis by the 7th year. The yearly prevalence rates of influenza, gastroenteritis, hepatitis, and pneumonia infections increased throughout the study period. Age-adjusted ORs and 95% confidence intervals (CI) in cases 1 year before cancer detection were significantly higher—for influenza 1.29 (95% CI, 1.14–1.46), for gastroenteritis 1.60 (95% CI, 1.41–1.82), for hepatitis 3.38 (95% CI, 2.12–5.37), for pneumonia 2.36 (95% CI, 1.79–3.13), and for any of these four diseases 1.55 (95% CI, 1.40–1.70). In influenza infections, significant ORs were found only in the 2nd and 6th years before cancer diagnosis. For each cancer site, an increased rate of infection prior to cancer diagnosis was observed. Here, we showed that increased infections during the precancerous stage, a possible surrogate for tumor-induced immune suppression, correlated to eventual cancer development. Full Article
inc Patient and primary care physician characteristics associated with billing incentives for chronic diseases in British Columbia: a retrospective cohort study By www.cmajopen.ca Published On :: 2020-05-05T05:00:14-07:00 Background: Incentive payments for chronic diseases in British Columbia were intended to support primary care physicians in providing more comprehensive care, but research shows that not all physicians bill incentives and not all eligible patients have them billed on their behalf. We investigated patient and physician characteristics associated with billing incentives for chronic diseases in BC. Methods: We conducted a retrospective cohort analysis using linked administrative health data to examine community-based primary care physicians and patients with eligible chronic conditions in BC during 2010–2013. Descriptive analyses of patients and physicians compared 3 groups: no incentives in any of the 4 years, incentives in all 4 years, and incentives in any of the study years. We used hierarchical logistic regression models to identify the patient- and physician-level characteristics associated with billing incentives. Results: Of 428 770 eligible patients, 142 475 (33.2%) had an incentive billed on their behalf in all 4 years, and 152 686 (35.6%) never did. Of 3936 physicians, 2625 (66.7%) billed at least 1 incentive in each of the 4 years, and 740 (18.8%) billed no incentives during the study period. The strongest predictors of having an incentive billed were the number of physician contacts a patient had (odds ratio [OR] for > 48 contacts 134.77, 95% confidence interval [CI] 112.27–161.78) and whether a physician had a large number of patients in his or her practice for whom incentives were billed (OR 42.38 [95% CI 34.55–52.00] for quartile 4 v. quartile 1). Interpretation: The findings suggest that primary care physicians bill incentives for patients based on whom they see most often rather than using a population health management approach to their practice. Full Article
inc Characteristics of high-drug-cost beneficiaries of public drug plans in 9 Canadian provinces: a cross-sectional analysis By www.cmajopen.ca Published On :: 2020-04-28T01:30:11-07:00 Background: Drugs are the fastest growing cost in the Canadian health care system, owing to the increasing number of high-cost drugs. The objective of this study was to examine the characteristics of high–drug-cost beneficiaries of public drug plans across Canada relative to other beneficiaries. Methods: We conducted a cross-sectional study among public drug plan beneficiaries residing in all provinces except Quebec. We used the Canadian Institute for Health Information’s National Prescription Drug Utilization Information System to identify all drugs dispensed to beneficiaries of public drug programs in 2016/17. We stratified the cohort into 2 groups: high–drug-cost beneficiaries (top 5% of beneficiaries based on annual costs) and other beneficiaries (remaining 95%). For each group, we reported total drug costs, prevalence of high-cost claims (> $1000), median number of drugs, proportion of beneficiaries aged 65 or more, the 10 most costly reimbursed medications and the 10 medications most commonly reimbursed. We reported estimates overall and by province. Results: High–drug-cost beneficiaries accounted for nearly half (46.5%) of annual spending, with an average annual spend of $14 610 per beneficiary, compared to $1570 among other beneficiaries. The median number of drugs dispensed was higher among high–drug-cost beneficiaries than among other beneficiaries (13 [interquartile range (IQR) 7–19] v. 8 [IQR 4–13]), and a much larger proportion of high–drug-cost beneficiaries than other beneficiaries received at least 1 high-cost claim (40.9% v. 0.6%). Long-term medications were the most commonly used medications for both groups, whereas biologics and antivirals were the most costly medications for high–drug-cost beneficiaries. Interpretation: High–drug-cost beneficiaries were characterized by the use of expensive medications and polypharmacy relative to other beneficiaries. Interventions and policies to help reduce spending need to consider both of these factors. Full Article
inc Deprivation and mortality related to pediatric respiratory tract infection: a cohort study in 3 high-income jurisdictions By www.cmajopen.ca Published On :: 2020-04-28T01:30:11-07:00 Background: Deaths from respiratory tract infections (RTIs) in children are preventable through timely access to public health and medical interventions. We aimed to assess whether socioeconomic disparities in mortality related to pediatric RTI persisted after accounting for health status at birth. Methods: We compared the prevalence of and risk factors for RTI-related death in singletons aged 28 days to 4 years across Ontario (Canada), Scotland and England (jurisdictions with universal health care) using linked administrative data for 2003–2013. We estimated rates of RTI-related mortality for children living in deprived areas and those born to teenage girls; we estimated both crude rates and those adjusted for health status at birth. Results: A total of 1 299 240 (Ontario), 547 556 (Scotland) and 3 910 401 (England) children were included in the study. Across all jurisdictions, children born in the most deprived areas experienced the highest rates of RTI-related mortality. After adjustment for high-risk chronic conditions and prematurity, we observed differences in mortality according to area-level deprivation in Ontario and England but not in Scotland. In Ontario, teenage motherhood was also an independent risk factor for RTI-related mortality. Interpretation: Socioeconomic disparities played a substantial role in child mortality related to RTI in all 3 jurisdictions. Context-specific investigations around the mechanisms of this increased risk and development of programs to address socioeconomic disparities are needed. Full Article
inc Lung cancer incidence and mortality with extended follow-up in the National Lung Screening Trial By breathe.ersjournals.com Published On :: 2020-03-18T06:44:39-07:00 Since lung cancer (LC) is still the leading cause of cancer deaths worldwide [1], early detection through screening represents an important opportunity to improve LC survival and is a priority area for cancer care. The National Lung Screening Trial (NLST) aimed to compare low-dose helical computed tomography (LDCT) with chest radiography in LC screening of current or former heavy smokers. The trial found a relative reduction in mortality from LC of 20% in those who had undergone LDCT screening. LC screening has regained prominence in the thoracic oncology literature with the completion of NELSON and other European trials, which support the role of LC screening in achieving early diagnosis and reducing mortality. A growing number of implementation pilots are providing an impetus towards organised, national programmes for LC screening, which are in need of long-term follow-up data such as those presented in this study. Full Article
inc Lung cancer incidence and mortality with extended follow-up in the National LungScreening Trial By breathe.ersjournals.com Published On :: 2020-03-18T06:44:39-07:00 A 78-year-old male presented at the emergency room complaining of dry cough, fever up to 38.5 °C and malaise for 1 month. He had visited a general practitioner and received amoxicillin 500 mg three times a day for 7 days for a presumed chest infection, without improvement. He had a history of diabetes and arterial blood hypertension, for which he was receiving metformin 1000 mg twice a day and amlodipine 10 mg a day for 7 years. He reported no alcohol abuse and was an ex-smoker of 20 pack-years (quit 30 years ago). He had no recent hospitalisations or any medical interventions. Full Article
inc Worldwide Increase in Diagnosis of Hypertension in Children By aapgrandrounds.aappublications.org Published On :: 2020-05-01T00:59:36-07:00 Full Article
inc In Vitro Activity of Ceftazidime-Avibactam against Isolates from Respiratory and Blood Specimens from Patients with Nosocomial Pneumonia, Including Ventilator-Associated Pneumonia, in a Phase 3 Clinical Trial [Susceptibility] By aac.asm.org Published On :: 2020-04-21T08:01:10-07:00 Nosocomial pneumonia (NP), including ventilator-associated pneumonia (VAP), is increasingly associated with multidrug-resistant Gram-negative pathogens. This study describes the in vitro activity of ceftazidime-avibactam, ceftazidime, and relevant comparator agents against bacterial pathogens isolated from patients with NP, including VAP, enrolled in a ceftazidime-avibactam phase 3 trial. Gram-positive pathogens were included if coisolated with a Gram-negative pathogen. In vitro susceptibility was determined at a central laboratory using Clinical and Laboratory Standards Institute broth microdilution methods. Of 817 randomized patients, 457 (55.9%) had ≥1 Gram-negative bacterial pathogen(s) isolated at baseline, and 149 (18.2%) had ≥1 Gram-positive pathogen(s) coisolated. The most common isolated pathogens were Klebsiella pneumoniae (18.8%), Pseudomonas aeruginosa (15.8%), and Staphylococcus aureus (11.5%). Ceftazidime-avibactam was highly active in vitro against 370 isolates of Enterobacteriaceae, with 98.6% susceptible (MIC90, 0.5 μg/ml) compared with 73.2% susceptible for ceftazidime (MIC90, >64 μg/ml). The percent susceptibility values for ceftazidime-avibactam and ceftazidime against 129 P. aeruginosa isolates were 88.4% and 72.9% (MIC90 values of 16 μg/ml and 64 μg/ml), respectively. Among ceftazidime-nonsusceptible Gram-negative isolates, ceftazidime-avibactam percent susceptibility values were 94.9% for 99 Enterobacteriaceae and 60.0% for 35 P. aeruginosa. MIC90 values for linezolid and vancomycin (permitted per protocol for Gram-positive coverage) were within their respective MIC susceptibility breakpoints against the Gram-positive pathogens isolated. This analysis demonstrates that ceftazidime-avibactam was active in vitro against the majority of Enterobacteriaceae and P. aeruginosa isolates from patients with NP, including VAP, in a phase 3 trial. (This study has been registered at ClinicalTrials.gov under identifier NCT01808092.) Full Article
inc Synthesis and Biological Activity of Novel Zinc-Itraconazole Complexes in Protozoan Parasites and Sporothrix spp. [Susceptibility] By aac.asm.org Published On :: 2020-04-21T08:01:09-07:00 The new complexes Zn(ITZ)2Cl2 (1) and Zn(ITZ)2(OH)2 (2) were synthetized by a reaction of itraconazole with their respective zinc salts under reflux. These Zn-ITZ complexes were characterized by elemental analyses, molar conductivity, mass spectrometry, 1H and 13C{1H} nuclear magnetic resonance, and UV-vis and infrared spectroscopies. The antiparasitic and antifungal activity of Zn-ITZ complexes was evaluated against three protozoans of medical importance, namely, Leishmania amazonensis, Trypanosoma cruzi, and Toxoplasma gondii, and two fungi, namely, Sporothrix brasiliensis and Sporothrix schenckii. The Zn-ITZ complexes exhibited a broad spectrum of action, with antiparasitic and antifungal activity in low concentrations. The strategy of combining zinc with ITZ was efficient to enhance ITZ activity since Zn-ITZ-complexes were more active than the azole alone. This study opens perspectives for future applications of these Zn-ITZ complexes in the treatment of parasitic diseases and sporotrichosis. Full Article
inc Drug Effect of Clofazimine on Persisters Explains an Unexpected Increase in Bacterial Load in Patients [Pharmacology] By aac.asm.org Published On :: 2020-04-21T08:01:09-07:00 Antituberculosis (anti-TB) drug development is dependent on informative trials to secure the development of new antibiotics and combination regimens. Clofazimine (CLO) and pyrazinamide (PZA) are important components of recommended standard multidrug treatments of TB. Paradoxically, in a phase IIa trial aiming to define the early bactericidal activity (EBA) of CLO and PZA monotherapy over the first 14 days of treatment, no significant drug effect was demonstrated for the two drugs using traditional statistical analysis. Using a model-based analysis, we characterized the statistically significant exposure-response relationships for both drugs that could explain the original findings of an increase in the numbers of CFU with CLO treatment and no effect with PZA. Sensitive analyses are crucial for exploring drug effects in early clinical trials to make the right decisions for advancement to further development. We propose that this quantitative semimechanistic approach provides a rational framework for analyzing phase IIa EBA studies and can accelerate anti-TB drug development. Full Article
inc Distinct Mechanisms of Dissemination of NDM-1 Metallo-{beta}-Lactamase in Acinetobacter Species in Argentina [Epidemiology and Surveillance] By aac.asm.org Published On :: 2020-04-21T08:01:09-07:00 A 4-year surveillance of carbapenem-resistant Acinetobacter spp. isolates in Argentina identified 40 strains carrying blaNDM-1. Genome sequencing revealed that most were Acinetobacter baumannii, whereas seven represented other Acinetobacter spp. The A. baumannii genomes were closely related, suggesting recent spread. blaNDM-1 was located in the chromosome of A. baumannii strains and on a plasmid in non-A. baumannii strains. A resistance gene island carrying blaPER-7 and other resistance determinants was found on a plasmid in some A. baumannii strains. Full Article
inc Whole-Genome Characterization of a Shewanella algae Strain Coharboring blaCTX-M-15 and armA Genes on a Novel IncC Plasmid [Letters] By aac.asm.org Published On :: 2020-04-21T08:01:09-07:00 Full Article
inc Encephalitozoon cuniculi Genotype III Evinces a Resistance to Albendazole Treatment in both Immunodeficient and Immunocompetent Mice [Experimental Therapeutics] By aac.asm.org Published On :: 2020-04-21T08:01:09-07:00 Of four genotypes of Encephalitozoon cuniculi, E. cuniculi genotype II is considered to represent a parasite that occurs in many host species in a latent asymptomatic form, whereas E. cuniculi genotype III seems to be more aggressive, and infections caused by this strain can lead to the death of even immunocompetent hosts. Although albendazole has been considered suitable for treatment of Encephalitozoon species, its failure in control of E. cuniculi genotype III infection has been reported. This study determined the effect of a 100x recommended daily dose of albendazole on an Encephalitozoon cuniculi genotype III course of infection in immunocompetent and immunodeficient mice and compared the results with those from experiments performed with a lower dose of albendazole and E. cuniculi genotype II. The administration of the regular dose of abendazole during the acute phase of infection reduced the number of affected organs in all strains of mice and absolute counts of spores in screened organs. However, the effect on genotype III was minor. Surprisingly, no substantial effect was recorded after the use of a 100x dose of albendazole, with larger reductions seen only in the number of affected organs and absolute counts of spores in all strains of mice, implying variations in albendazole resistance between these Encephalitozoon cuniculi genotypes. These results imply that differences in the course of infection and the response to treatment depend not only on the immunological status of the host but also on the genotype causing the infection. Understanding how microsporidia survive in hosts despite targeted antimicrosporidial treatment could significantly contribute to research related to human health. Full Article
inc Increased B-cell ICOSL Expression Improves Chemotherapy Response [Immunology] By cancerdiscovery.aacrjournals.org Published On :: 2020-05-01T00:05:26-07:00 A chemotherapy-induced shift to ICOSL+ B cells in breast tumors correlated with better survival. Full Article
inc Total Antioxidant Capacity and Pancreatic Cancer Incidence and Mortality in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Background: Total antioxidant capacity (TAC) reflects an individual's overall antioxidant intake. We sought to clarify whether higher TAC is associated with lower risks of pancreatic cancer incidence and mortality in the U.S. general population. Methods: A total of 96,018 American adults were identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. A ferric-reducing ability of plasma score was used to reflect an individual's TAC intake from diet and/or supplements. Cox regression was used to calculate hazard ratios (HR) for pancreatic cancer incidence, and competing risk regression was used to calculate subdistribution HRs for pancreatic cancer mortality. Restricted cubic spline regression was used to test nonlinearity. Results: A total of 393 pancreatic cancer cases and 353 pancreatic cancer–related deaths were documented. Total (diet + supplements) TAC was found to be inversely associated with pancreatic cancer incidence (HR quartile 4 vs. quartile 1 = 0.53; 95% confidence interval, 0.39–0.72; Ptrend = 0.0002) and mortality (subdistribution HR quartile 4 vs. quartile 1 = 0.52; 95% confidence interval 0.38–0.72; Ptrend = 0.0003) in a nonlinear dose–response manner (all Pnonlinearity < 0.01). Similar results were observed for dietary TAC. No association of supplemental TAC with pancreatic cancer incidence and mortality was found. Conclusions: In the U.S. general population, dietary but not supplemental TAC level is inversely associated with risks of pancreatic cancer incidence and mortality in a nonlinear dose–response pattern. Impact: This is the first prospective study indicating that a diet rich in antioxidants may be beneficial in decreasing pancreatic cancer incidence and mortality. Full Article
inc Circulating Biomarker Score for Visceral Fat and Risks of Incident Colorectal and Postmenopausal Breast Cancer: The Multiethnic Cohort Adiposity Phenotype Study By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Background: Visceral adipose tissue (VAT) may play a greater role than subcutaneous fat in increasing cancer risk but is poorly estimated in epidemiologic studies. Methods: We developed a VAT prediction score by regression equations averaged across 100 least absolute shrinkage and selection operator models in a cross-sectional study of 1,801 older adults in the Multiethnic Cohort (MEC). The score was then used as proxy for VAT in case–control studies of postmenopausal breast (950 case–control pairs) and colorectal (831 case–control pairs) cancer in an independent sample in MEC. Abdominal MRI–derived VAT; circulating biomarkers of metabolic, hormonal, and inflammation dysfunctions; and ORs for incident cancer adjusted for BMI and other risk factors were assessed. Results: The final score, composed of nine biomarkers, BMI, and height, explained 11% and 15% more of the variance in VAT than BMI alone in men and women, respectively. The area under the receiver operator curve for VAT >150 cm2 was 0.90 in men and 0.86 in women. The VAT score was associated with risk of breast cancer [OR (95% confidence interval [CI]) by increasing tertiles: 1.00, 1.09 (0.86–1.39), 1.48 (1.16–1.89); Ptrend = 0.002] but not with colorectal cancer (P = 0.84), although an association [1.00, 0.98 (0.68–1.39), 1.24 (0.88–1.76); Ptrend = 0.08] was suggested for this cancer after excluding cases that occurred within 7 years of blood draw (Pheterogeneity = 0.06). Conclusions: The VAT score predicted risks of postmenopausal breast cancer and can be used for risk assessment in diverse populations. Impact: These findings provide specific evidence for a role of VAT in breast cancer. Full Article
inc One Size Does Not Fit All: Marked Heterogeneity in Incidence of and Survival from Gastric Cancer among Asian American Subgroups By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Background: Asian Americans are at higher risk for noncardia gastric cancers (NCGC) relative to non-Hispanic Whites (NHW). Asian Americans are genetically, linguistically, and culturally heterogeneous, yet have mostly been treated as a single population in prior studies. This aggregation may obscure important subgroup-specific cancer patterns. Methods: We utilized data from 13 regional United States cancer registries from 1990 to 2014 to determine secular trends in incidence and survivorship from NCGC. Data were analyzed for NHWs and the six largest Asian American subgroups: Chinese, Japanese, Filipino, Korean, Vietnamese, and South Asian (Indian/Pakistani). Results: There exists substantial heterogeneity in NCGC incidence between Asian subgroups, with Koreans (48.6 per 100,000 person-years) having seven-fold higher age-adjusted incidence than South Asians (7.4 per 100,000 person-years). Asians had generally earlier stages of diagnosis and higher rates of surgical resection compared with NHWs. All Asian subgroups also demonstrated higher 5-year observed survival compared with NHWs, with Koreans (41.3%) and South Asians (42.8%) having survival double that of NHWs (20.1%, P < 0.001). In multivariable regression, differences in stage of diagnosis and rates of resection partially explained the difference in survivorship between Asian subgroups. Conclusions: We find substantial differences in incidence, staging, histology, treatment, and survivorship from NCGC between Asian subgroups, data which challenge our traditional perceptions about gastric cancer in Asians. Both biological heterogeneity and cultural/environmental differences may underlie these findings. Impact: These data are relevant to the national discourse regarding the appropriate role of gastric cancer screening, and identifies high-risk racial/ethnic subgroups who many benefit from customized risk attenuation programs. Full Article
inc Increased Notching of the Corpus Callosum in Fetal Alcohol Spectrum Disorder: A Callosal Misunderstanding? [PEDIATRICS] By www.ajnr.org Published On :: 2020-04-09T06:30:48-07:00 BACKGROUND AND PURPOSE: In the medicolegal literature, notching of the corpus callosum has been reported to be associated with fetal alcohol spectrum disorders. Our purpose was to analyze the prevalence of notching of the corpus callosum in a fetal alcohol spectrum disorders group and a healthy population to determine whether notching occurs with increased frequency in the fetal alcohol spectrum disorders population. MATERIALS AND METHODS: We performed a multicenter search for cases of fetal alcohol spectrum disorders and included all patients who had a sagittal T1-weighted brain MR imaging. Patients with concomitant intracranial pathology were excluded. The corpus callosum was examined for notches using previously published methods. A 2 test was used to compare the fetal alcohol spectrum disorders and healthy groups. RESULTS: Thirty-three of 59 patients with fetal alcohol spectrum disorders (0–44 years of age) identified across all centers had corpus callosum notching. Of these, 8 had an anterior corpus callosum notch (prevalence, 13.6%), 23 had a posterior corpus callosum notch (prevalence, 39%), and 2 patients demonstrated undulated morphology (prevalence, 3.4%). In the healthy population, the anterior notch prevalence was 139/875 (15.8%), posterior notch prevalence was 378/875 (43.2%), and undulating prevalence was 37/875 (4.2%). There was no significant difference among the anterior (P = .635), posterior (P = .526), and undulating (P = .755) notch prevalence in the fetal alcohol spectrum disorders and healthy groups. CONCLUSIONS: There was no significant difference in notching of the corpus callosum between patients with fetal alcohol spectrum disorders and the healthy population. Although reported to be a marker of fetal alcohol spectrum disorders, notching of the corpus callosum should not be viewed as a specific finding associated with fetal alcohol spectrum disorders. Full Article
inc Charm city căn hộ Chuẩn resort sở hữu Vincom đầu tiên tại Bình Dương, Pháp Lý Hoàn Chỉnh.1.5 tỷ/căn By batdongsan.com.vn Published On :: Fri, 08 May 2020 10:38:00 GMT - Chiết khấu 1% khi khách hàng booking trước ngày mở bán. - Tặng 2 chỉ vàng khi khách sở hữu căn hộ. - Chiết khấu ưu đãi thanh toán từ 3 - 5%. Và nhiều giá trị ưu đãi vào ngày sự kiện hàng tuần và mở bán. Charm city dự án khu phức hợp căn hộ, thương mại, giải trí trung tâm TP... Full Article
inc Công ty TNHH Bất động sản Vincom Real By batdongsan.com.vn Published On :: Tue, 28 Aug 2018 15:59:00 GMT Full Article
inc Villa Riviera An Phu for sale includes 1 ground floor, 2 floors, 5 bedrooms with garden By batdongsan.com.vn Published On :: Mon, 24 Feb 2020 09:27:00 GMT Villa Rivierais a high-class compound, a luxury villa near the Saigon river with modern and high-class architectural villas. Villa Riviera An Phu villa for salehas an architecture of 1 ground floor, 2 floors with a total area of 350m2, land area of 300m2, including 5 bedrooms, 5 ... Full Article
inc Vincom Center Long Bien By batdongsan.com.vn Published On :: Sat, 14 Jul 2018 12:52:39 GMT Vincom Center Long Bien nằm ở vị trí trung tâm trong dự án Vincom Village, dự án được tạo nên bởi hệ thống phân khu chức năng riêng biệt: khu mua sắm, khu vui chơi, khu ẩm thực, siêu thị tiêu dùng… Full Article
inc Vincom Center Phạm Ngọc Thạch By batdongsan.com.vn Published On :: Mon, 26 Feb 2018 11:51:56 GMT Vincom Center Phạm Ngọc Thạch là một trong những dự án của Tập đoàn Vingroup, dứ án hứa hẹn sẽ đem đến một quần thể đẳng cấp với những tiện ích vượt trội. Full Article
inc Machinco Hà Đông By batdongsan.com.vn Published On :: Sat, 17 Aug 2019 12:05:15 GMT Tổ hợp thương mại Machinco Hà Đông là một sản phẩm của Công ty cổ phần thiết bị (Machinco1), được xây dựng theo lối kiến trúc hiện đại với quy mô 7 tầng nổi làm TTTM cho thuê mặt bằng bán lẻ và 1 tầng gửi xe rộng 6.000m2 với sức chứa lớn. Full Article
inc Vincom Plaza Đồng Hới By batdongsan.com.vn Published On :: Thu, 19 Jul 2018 11:07:48 GMT Vincom Plaza Đồng Hới do Tập đoàn Vingroup làm chủ đầu tư. Dự án nằm trong Khu phức hợp gồm trung tâm thương mại Vincom Plaza Đồng Hới, khách sạn 5 sao Vinpearl và nhà phố thương mại Vincom Shophouse Quảng Bình tọa lạc ngay trung tâm TP. Đồng Hới, tỉnh Quảng Bình với hướng nhìn ra sông Nhật Lệ. Full Article
inc Cho thuê nhà DT 60m2 x 4T tại Khuất Duy Tiến, gần Big C Trần Duy Hưng, Vincom TDH, TT Hội Nghị QG By batdongsan.com.vn Published On :: Fri, 08 May 2020 08:59:00 GMT Cho thuê nhà chính chủ làm văn phòng DT 60m2 x 4 tầng. Tầng 2,3,4 chia 2 phòng, tầng 1 thông suốt. Mặt tiền 5m, cách ngã tư Khuất Duy Tiến - Trần Duy Hưng 10m (nhà trong ngõ cách đường chính mười mét), Ô tô có thể đi vào trong nhà, ngõ rộng thoáng nhiều lối ra vào. Nhà gần Big C ... Full Article
inc Housing prices increase slightly in Q3: MoC By batdongsan.com.vn Published On :: 17:36 01/10/2019 An annual report released by the Ministry of Construction (MoC) at a press conference on Monday showed housing prices in the two mảo cities Hanoi and Ho Chi Minh (HCMC) rose slightly in the third quarter (Q3) of this year. Full Article
inc New investment waves push housing prices in Mekong Delta provinces By batdongsan.com.vn Published On :: 15:58 15/10/2019 The constantly increasing number of new real estate projects which have been implemented in the Mekong Delta region has led to the rising land price and strong fluctuation in the local property market. Full Article
inc HCMC apartment prices increase faster than rents By batdongsan.com.vn Published On :: 15:10 22/10/2019 Asking price of apartments in Ho Chi Minh City (HCMC) rose by 11.8 percent on average in the third quarter (Q3) of 2019, while rents increased by only 5.4 percent. Full Article
inc How to avoid drowning in real estate debt with average income? By batdongsan.com.vn Published On :: 10:48 22/10/2019 [Having appointment with real estate experts #5] While buying a home is quite easy for high-income households, it is another story for the middle-class. With a wise and specific financial plan, the chances of owning a home can still lie within reach even if an average income. Full Article
inc Công ty CP Tư vấn Đầu tư Xây dựng Việt Nam Vinco By batdongsan.com.vn Published On :: Thu, 20 Mar 2014 09:41:00 GMT Full Article
inc How much of income should you spend on housing? By batdongsan.com.vn Published On :: 11:51 24/07/2018 To ensure that you can afford for your living expenditures, you should not spend more than 30-40% of income on housing. Full Article
inc FPS Second Extinction Announced for Xbox Series X, Xbox One and PC By feedproxy.google.com Published On :: Thu, 07 May 2020 17:09:59 GMT Developer Systemic Reaction has announced three-player, online cooperative shooter, Second Extinction, for the Xbox Series X, Xbox One and Windows PC via Steam. "I’m very proud of what our team has created," said Systemic Reaction managing director Tobias Andersson. "As a live game, we plan to support Second Extinction long-term, as we do with all our titles. We can’t wait for players to team up, start playing, and become part of our community." Lead producer Brynley Gibson added, "Second Extinction is a real passion project for our tight-knit team, and we’re just getting started. It’s incredible how far we’ve come in this short time, and I’m super excited to reveal more details, including our live roadmap, in the coming months." View the announcement trailer below: Here is an overview of the game: Second Extinction is an intense three-player cooperative shooter, where your goal is to wipe out the mutated dinosaurs that have taken over the planet. Teamwork is vital as you adopt the role of one of the survivors, using a unique combination of weapons, abilities and skills to take on the vast number of enemies. Fight through a maelstrom of bullets, bombs, teeth, claws and gore, it’s up to you to reclaim Earth! Key Features: Intense Three-Player Co-Op – Earth is overrun by mutated dinosaurs! Team up with up to two other resistance fighters to take it back in short but intense combat operations. Battle Mutated Monstrosities – These dinos are nothing like the ones in your history books! From electric raptors to behemoth T-Rexes that tower over the horizon, these deadly creatures have evolved into the ultimate killing machines. Experience Spectacular Action – Combine your fireteam’s unique weapons and abilities for explosive results against overwhelming opposition in challenging combat set pieces. Take Part in a Joint Effort – Your actions, together with the rest of the community, will shape the course of the war against the dinosaurs. A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel dedicated to gaming Let's Plays and tutorials. You can contact the author at wdangelo@vgchartz.com or on Twitter @TrunksWD.Full Article - https://www.vgchartz.com/article/443423/fps-second-extinction-announced-for-xbox-series-x-xbox-one-and-pc/ Full Article Analysis Charts Industry
inc Footage of Cancelled Prince of Persia: Redemption from 2012 Discovered By feedproxy.google.com Published On :: Thu, 07 May 2020 17:49:41 GMT A gameplay trailer for a Prince of Persia reboot, called Prince of Persia: Redemption, was posted on YouTube in March 2012 and was discovered this week. The LinkedIn profile for the former Ubisoft employee Christophe Prelot revealed he worked on a cancelled Prince of Persia title from April 2010 to 2011 as a 3D level artist. The game was in development for the PlayStation 3, Xbox 360 and Windows PC. Ubisoft assistant technical director Marc-Andre Belleau in 2018 left a comment on the video asking, "Where did you get that?!" View the video below: Thanks ResetEra. A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel dedicated to gaming Let's Plays and tutorials. You can contact the author at wdangelo@vgchartz.com or on Twitter @TrunksWD.Full Article - https://www.vgchartz.com/article/443408/footage-of-cancelled-prince-of-persia-redemption-from-2012-discovered/ Full Article Analysis Charts Industry
inc Local COVID-19 death rate higher than provincial; another senior dies By windsorstar.com Published On :: Fri, 08 May 2020 23:06:32 +0000 A centenarian who tested positive for COVID-19 has become the oldest local resident to die from the virus. The woman in her 100s was a resident of a long-term care or retirement home. She died on Thursday, the Windsor-Essex County Health Unit reported during its end-of-week epidemic data summary on Friday. “I would like to […] Full Article Local News coronavirus Covid-19 Dr. Wajid Ahmed WECHU Windsor-Essex County Health Unit
inc Election cyberattacks? It’s incompetence we need to worry about By www.newscientist.com Published On :: Wed, 12 Feb 2020 18:00:00 +0000 Concerns about adversaries hacking democracy abound, but it’s sheer incompetence we should really be worried about, writes Annalee Newitz Full Article
inc Robot with pincers can detect and remove weeds without harming crops By www.newscientist.com Published On :: Wed, 29 Apr 2020 17:07:03 +0000 A robot that uses artificial intelligence to find and remove weeds could eventually be used as an alternative to chemical insecticides Full Article
inc Zoom Backgrounds Now Include a Selection From TfL - That's Not a Reference to Star Wars By feedproxy.google.com Published On :: Thu, 07 May 2020 15:00:18 +0000 TfL as in Transport for London. Greeeeeaaat. Full Article
inc Calculator Hacked for Cheating Includes a Secret OLED Screen, Wifi, and Even a Chat Function By feedproxy.google.com Published On :: Fri, 08 May 2020 19:00:57 +0000 But can you still write "BOOBS" on it? Full Article
inc Since You Have More Time on Your Hands, Why Not Give Composting a Shot By feedproxy.google.com Published On :: Sat, 09 May 2020 14:00:00 GMT Being at home this long, or really, just in one place for this long, has led me to see how much waste I produce. Spoiler alert: it’s a lot more than I thought. But I’m not here to shame anyone, in fact, quite the opposite. I think there are plenty of small ways we can cut down our carbon footprint, from driving less (check), to not using a washing machine or dryer (also, sadly, check), but gardening is what I’ve been doing, and is something that I’d recommend everyone give a shot now that we all have a little more times on our hands.GETTING STARTEDComposting is a natural way to recycle all of the organic materials in your house through decomposition. Compost can improve your soil’s water retention, which saves you money on your water bills, and helps keep excess garbage out of landfills, too. To get started you need two things. The first is a compost bin for your kitchen. This is great whether you want to start a compost at home or if you have a compost center you can bring them to. You want something sleek, designy, yet simple because after all, it’s really just a trash can. This is an excellent one.Read more at The Daily Beast. Full Article
inc Little Richard’s Raw Sexiness Inspired the Beatles, David Bowie and Prince By feedproxy.google.com Published On :: Sat, 09 May 2020 14:18:14 GMT Andy Lyons/Getty ImagesIt’s not going out on much of a limb to say that the single greatest line in any rock and roll song—shall we double down and say all music ever?—is “A-wop-bom-a-loo-mop-a-lomp-bom-bom!!” Surely that says it all. As with any truly oracular pronouncement, it inspires consternation in the first-time listener, and the second-time listener, and the third, the fourth, and on and on. The mystery never diminishes.Read more at The Daily Beast. Full Article Entertainment
inc How Much Apple's New 13-Inch MacBook Pro Costs In Australia By feeds.gizmodo.com.au Published On :: Tue, 05 May 2020 08:38:47 +1000 Apple dropped its brand new 13-inch MacBook Pro overnight, which is exciting because the dreaded butterfly keyboard is now finally dead. For real. In its place you'll find the newer Magic Keyboard which has previously been added to the 16-inch MacBook Pro and the MacBook Air. Today is a good day. If you're keen to get your paws on the new laptop, here's how much it will set you back in Australia. More » Full Article
inc Long space flights can increase the volume of astronauts’ brains By www.newscientist.com Published On :: Tue, 14 Apr 2020 15:00:47 +0000 Spending at least six months in microgravity can cause astronauts’ brain volumes to increase, causing pressure to build up in their heads and creating vision problems Full Article
inc Second Extinction reveal: Xbox Series X game gives us serious Turok vibes By www.dailystar.co.uk Published On :: Thu, 7 May 2020 16:33:58 +0000 During Inside Xbox's special stream today, Systemic Reaction gave us our first taste of next-gen dino hunting glory Full Article Gaming
inc RPGCast – Episode 465: “Pinch Britting” By feedproxy.google.com Published On :: Sat, 16 Jun 2018 22:18:36 +0000 E3 had a bit of something for everyone. From Pokémon walking simulators to dragons who fetch bacon. But the true star of the show was... Full Article E3 News Podcasts RPG Cast E3 2018
