Structured diabetes education (SDE) is an evidence-based intervention that supports self-management in people with type 2 diabetes. In the United Kingdom, health care providers working in primary care settings are responsible for referring people with type 2 diabetes to SDE programs. However, national audits record a high percentage of nonattenders. We explored the personal experience of living with type 2 diabetes that led to individuals declining invitations to attend SDE programs. The themes suggested that emotional, cognitive, and social issues related to diagnosis and living with diabetes may be responsible for declining to attend SDE and that these factors may be masked by explanations of practical barriers. A person-centered approach to understanding the personal meaning of being diagnosed and living with type 2 diabetes may help to identify individuals’ psychosocial barriers to attending SDE.

People with type 1 diabetes may receive a significant portion of their care from primary care providers (PCPs). To understand the involvement of PCPs in delivering type 1 diabetes care, we performed surveys in California and Florida, two of the most populous and diverse states in the United States. PCPs fill insulin prescriptions but report low confidence in providing type 1 diabetes care and difficulty accessing specialty referrals to endocrinologists.

Background:

Relatives of patients with bladder cancer have been shown to be at increased risk for kidney, lung, thyroid, and cervical cancer after correcting for smoking-related behaviors that may concentrate in some families. We demonstrate a novel approach to simultaneously assess risks for multiple cancers to identify distinct multicancer configurations (multiple different cancer types that cluster in relatives) surrounding patients with familial bladder cancer.

Methods:

This study takes advantage of a unique population-level data resource, the Utah Population Database (UPDB), containing vast genealogy and statewide cancer data. Familial risk is measured using standardized incidence risk (SIR) ratios that account for sex, age, birth cohort, and person-years of the pedigree members.

Results:

We identify 1,023 families with a significantly higher bladder cancer rate than population controls (familial bladder cancer). Familial SIRs are then calculated across 25 cancer types, and a weighted Gower distance with K-medoids clustering is used to identify familial multicancer configurations (FMC). We found five FMCs, each exhibiting a different pattern of cancer aggregation. Of the 25 cancer types studied, kidney and prostate cancers were most commonly enriched in the familial bladder cancer clusters. Laryngeal, lung, stomach, acute lymphocytic leukemia, Hodgkin disease, soft-tissue carcinoma, esophageal, breast, lung, uterine, thyroid, and melanoma cancers were the other cancer types with increased incidence in familial bladder cancer families.

Conclusions:

This study identified five familial bladder cancer FMCs showing unique risk patterns for cancers of other organs, suggesting phenotypic heterogeneity familial bladder cancer.

Impact:

FMC configurations could permit better definitions of cancer phenotypes (subtypes or multicancer) for gene discovery and environmental risk factor studies.

Women of Latin American origin in the United States are more likely to be diagnosed with advanced breast cancer and have a higher risk of mortality than non-Hispanic White women. Studies in U.S. Latinas and Latin American women have reported a high incidence of HER2 positive (+) tumors; however, the factors contributing to this observation are unknown. Genome-wide genotype data for 1,312 patients from the Peruvian Genetics and Genomics of Breast Cancer Study (PEGEN-BC) were used to estimate genetic ancestry. We tested the association between HER2 status and genetic ancestry using logistic and multinomial logistic regression models. Findings were replicated in 616 samples from Mexico and Colombia. Average Indigenous American (IA) ancestry differed by subtype. In multivariate models, the odds of having an HER2+ tumor increased by a factor of 1.20 with every 10% increase in IA ancestry proportion (95% CI, 1.07–1.35; P = 0.001). The association between HER2 status and IA ancestry was independently replicated in samples from Mexico and Colombia. Results suggest that the high prevalence of HER2+ tumors in Latinas could be due in part to the presence of population-specific genetic variant(s) affecting HER2 expression in breast cancer.Significance:The positive association between Indigenous American genetic ancestry and HER2+ breast cancer suggests that the high incidence of HER2+ subtypes in Latinas might be due to population and subtype-specific genetic risk variants.

Consistently, the field of genetic counseling has advocated that parents be advised to defer elective genetic testing of minors until adulthood to prevent a range of potential harms, including stigma, discrimination, and the loss of the child's ability to decide for him- or herself as an adult. However, consensus around the policy of "defer-when-possible" obscures the extent to which this norm is currently under siege. Increasingly, routine use of full or partial genome sequencing challenges our ability to control what is discovered in childhood or, when applied in a prenatal context, even before birth. The expansion of consumer-initiated genetic testing services challenges our ability to restrict what is available to minors. As the barriers to access crumble, medical professionals should proceed with caution, bearing in mind potential risks and continuing to assess the impact of genetic testing on this vulnerable population.

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.

Sunshine Wonder Villas là dự án nằm trong chuỗi biệt thự mang thương hiệu Sunshine Villas của Tập đoàn Sunshine, được ra đời nhằm kiến tạo nên một không gian sống đậm chất sinh thái, nghỉ dưỡng đẳng cấp bậc nhất Thủ đô.

Cập nhật mới nhất nhà Lavender City Thạnh Phú, Vĩnh Cửu, Đồng Nai, hỗ trợ vay ngân hàng từ 800 - 1 tỷ. Lãi suất ưu đãi 0,9%/tháng. * E4 - 17 72m2 4*18m (trệt lửng) hướng Bắc: 1,25 tỷ. * B5 - 15 75m2 5*15m (trệt lửng) Tây Nam; 1,35 tỷ. * B5 - 21 75m2 5*15m (1 lầu 1 trệt) Tây Nam: ...

Bán nhà sổ riêng, thổ cư 100% khu dân cư Lavender City xã Thạnh Phú, Vĩnh Cửu, ĐN, LH 0933601178. Cách khu du lịch Bửu Long 7km. Cách ngã tư Tân Phong 5km. Cách Làng Bưởi Tân Triều 3km. Diện tích 4x18m, 5x15m, 5x16m, 5x18m. Giá từ 1,27 tỷ, hỗ trợ vay 70% giá trị....

The room is beautiful, clean and convenience. On top of that, it nears to the airport. We have free wifi, amenities, modern furniture, elevator, TV. We also have a kitchen shared with everyone. In the kitchen, we have modern equipment for cooking. We have laundry, clothes drier,....

Studio apartment at Gateway Thao Dien for sale has an area of 50m2, the architecture includes 1 bedroom, 1 bathroom, living room, kitchen, dining room, ... with full of luxury furniture. The apartment on the middle floor of Aspen tower is very beautiful, interior with a series of...

Authorities of the Northern province Lang Son has requested VND3.16 trillion ($136 million) from the government to build the Chi Lang-Huu Nghi Expressway.

Condo is currently the top trend among single-family home buyers as it is a good way to own a home without breaking budget, in addition to various utilities a condo could bring to its owner. For a first-time home buyer, here are 8 things to consider before purchasing a condo if you don't want to regret it later.

For those who have a limited budget, a bank loan is the perfect financial solution to buy a home. To choose the right bank, here are 5 things you should consider.

Buying a new home is not always easy, especially when you have kids to consider. Here are 5 tips to choose the most suitable home for your kids.

Finding your first apartment is an exciting milestone. But as with many firsts, your first apartment hunt can be overwhelming and stressful. This guide can help you navigate the search and find the perfect first place.

Buy-to-let is enjoying a bit of renaissance: more mortgages available, higher rental yields and high demand. But have you considered the investment risks?

“Dear Designer” is a blog series on orienting novice practitioners to the discipline of instructional design and learning experience design.

The post Dear Designer: 3 Considerations for Length When Shifting to VILT appeared first on e-Learning Feeds.

It’s time to start planning our return to the workplace. Adjustments made during the pandemic will extend into and impact our return to the office. […]

The post 5 L&D considerations for returning to the workplace appeared first on e-Learning Feeds.

मांडा के आधी गांव में एक साथ तीन हत्याओं से सनसनी फैल गई। मौके पर पहुंचे ग्रामीणों ने तीनों शवों की हालत देखी तो उनका कलेजा मुंह को आ गया। कमरे में किशोरी की लाश पड़ी थी और चारपाई खून से सनी हुई थी। उधर, बाहर मिले पति-पत्नी के शव के आसपास भी काफी...

Fancy a 1v1 match on Shipment? Of course not. Duels to the death are played out and boring. Subscribing to the view that bigger is indeed always better, Call Of Duty: Modern Warfare has brought back its 10v10 Shipment playlist. After briefly appearing as an April Fool’s jab, Infinity Ward have decided to make 20-player […]

Windsor’s tech community came together Friday to share all the ways they are making the most of the COVID-19 pandemic. During an online event, leaders of seven local tech companies explained how they are dealing with, and capitalizing on the current pandemic. From the ability to scan facial temperatures, checking your blood for COVID-19 immunity, […]

Crawling on his belly through a sewer pipe beneath the streets of Warsaw, Poland, with a battle raging overhead, 16-year-old Lucjan Krause could scarcely have imagined he would survive the fighting, let alone go on to build a globally admired atomic physics program at the University of Windsor. Now 92 and still in full command […]

A sci-fi collection explores extreme corporate futures, such as a Tinder-run city where you can swipe left or right for everything from sex to teachers

Honeywell, the same company that might make your humidifier or home security system, is unveiling a powerful quantum computer that will be available to the public

Glass has an unusual atomic structure that resembles a liquid frozen in place, making it hard to predict how it will behave. DeepMind has developed an AI capable of doing so, which may also be able to predict traffic jams

Businesses, individuals with land, and local governments are competing to host an underground nuclear waste facility in the UK, and receive a yearly £2.5 million incentive

Martha Wells's action-packed novel Network Effect puts you inside the head of a Murderbot. It raises fascinating questions you will think about for a long time, says Sally Adee

While this experiment may sound odd, it could represent the start of a whole new field of research.

This film gives us insight into a community that’s already endured plenty even before the zombies arrived.

SAVANNAH, Georgia—Allegations Friday that a Georgia district attorney blocked police officers from arresting the killers of 25-year-old Ahmaud Arbery were just the latest blow to a local law enforcement apparatus that has been rocked by a series of troubling and deadly scandals.

Brunswick DA Jackie Johnson’s office allegedly prevented the Glynn County Police Department from arresting Travis and Gregory McMichael in connection with the shooting death of Arbery, an unarmed black man, in late February, the Atlanta Journal-Constitution reported. Johnson has recused herself from that case. But one Glynn County commissioner suggested she personally intervened in early plans to make arrests “to protect her friend” Gregory McMichael. McMichael was a former cop and investigator in the Brunswick DA’s office for 25 years who had reportedly investigated Arbery in the past. 

It is far from the first time the office—and local law enforcement more generally—had come under scathing scrutiny. 

Read more at The Daily Beast.

How can we get a picture of the whole Milky Way if we are inside it? Good sleuthing is needed to combine all the clues, writes Chanda Prescod-Weinstein

Our measurements of the Hubble constant can't seem to come up with a consistent answer. What we learn next may alter our view of the cosmos, writes Chanda Prescod-Weinstein

When Earth and Venus formed, they both had global magma oceans deep underground. Earth’s has turned solid by now, but Venus’s may still remain hidden

Thousands of dead satellites and chunks of debris in orbit are a threat to active satellites, but rockets that launch clouds of talcum powder may prevent a disastrous collision

NASA has awarded $967 million to three space flight companies – Blue Origin, Dynetics and SpaceX – to build lunar landers that will be part of the Artemis programme to send humans to the moon by 2024

Consultancy firm Certified Artificial, which is offering to certify AI companies, has demonstrated its prowess by rating the expertise of Elon Musk and Henry Kissinger

Your weekly selection of awesome robot videos

This robot dog can scale ladders that a real dog would struggle with

In there's no way Vader signed off on this news, this is the 'Nino Star Products Pool Float Black Outdoor' available from Amazon. It costs around $25, kinda looks like a Darth Vader a kid drew, and I can't imagine Darth doesn't wish they all melted in the destruction of the first Death Star. "What am I, a joke to you?!" I imagine him demanding as he Force-chokes the commander who signed off on using his likeness for a cartoony pool float as the other who signed off on the line of upcoming Vader sex toys casually backs out of the room intending to catch the first dropship to Tatooine. Keep going for one more shot of Vader at his most humiliated.

Because we don't have enough on our plates as it is, now we've got 'murder hornets' flying around the United States. Murder hornets (actually Asian Giant Hornets, but that name didn't strike enough fear into the masses) have a sting powerful enough that China recommends medical treatment if stunk more than ten times, and emergency treatment if stung more than 30. *pours out a little liquor for Macaulay Culkin in My Girl*. And where is his glasses?! He can't see without his glasses! Put his glasses on! Here's a video of Coyote Peterson getting stung by one (the Japanese Giant Hornet was previously believed to be a subspecies of the Asian Giant Hornet, but has since been recategorized as a color morph). This is a video of a praying mantis eating a Giant Asian hornet until it's just a pile of limbs. So yeah, praying mantises -- start breeding them. And make sure to selectively breed them too so we can produce them bigger and bigger until they're preying on us because the way things are going how is that not how this ends? Keep going for the video while I surround my Animal Crossings town with preying mantises to protect my villagers and keep my five-star rating (okay, three).

Call of Duty Modern Warfare and Warzone update patch notes have been shared by Infinity Ward to clarify whats changed to the game on May 7.

A public disagreement between a trusted games journalist and the GTA community is showing Rockstar just how eager people are for a GTA 6 announcement

Call of Duty Modern Warfare players can today download a brand new update for Warzone and Modern Warfare multiplayer. Here are the patch notes for PS4, Xbox One and PCs.

Bethesda challenges our hipster fashion instincts. Nintendo is doing something with that NFC sensor. Square Enix is faring pretty well, actually. And then there’s EA…who...

We remember Andrew Long. We’ll miss you, buddy. But the show must go on and we talk about Happy Meals, luminescent children, Kemco games, and...

Nintendo does its best to get Chris to stop building beds in Fallout 4 by offering more Amiibos. Anna has to put down her Animal...