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1.
PLoS One ; 19(5): e0295726, 2024.
Article in English | MEDLINE | ID: mdl-38809844

ABSTRACT

Initial data analysis (IDA) is the part of the data pipeline that takes place between the end of data retrieval and the beginning of data analysis that addresses the research question. Systematic IDA and clear reporting of the IDA findings is an important step towards reproducible research. A general framework of IDA for observational studies includes data cleaning, data screening, and possible updates of pre-planned statistical analyses. Longitudinal studies, where participants are observed repeatedly over time, pose additional challenges, as they have special features that should be taken into account in the IDA steps before addressing the research question. We propose a systematic approach in longitudinal studies to examine data properties prior to conducting planned statistical analyses. In this paper we focus on the data screening element of IDA, assuming that the research aims are accompanied by an analysis plan, meta-data are well documented, and data cleaning has already been performed. IDA data screening comprises five types of explorations, covering the analysis of participation profiles over time, evaluation of missing data, presentation of univariate and multivariate descriptions, and the depiction of longitudinal aspects. Executing the IDA plan will result in an IDA report to inform data analysts about data properties and possible implications for the analysis plan-another element of the IDA framework. Our framework is illustrated focusing on hand grip strength outcome data from a data collection across several waves in a complex survey. We provide reproducible R code on a public repository, presenting a detailed data screening plan for the investigation of the average rate of age-associated decline of grip strength. With our checklist and reproducible R code we provide data analysts a framework to work with longitudinal data in an informed way, enhancing the reproducibility and validity of their work.


Subject(s)
Data Analysis , Longitudinal Studies , Humans , Reproducibility of Results , Male , Female , Research Design
2.
Vet Ophthalmol ; 2024 Apr 02.
Article in English | MEDLINE | ID: mdl-38563215

ABSTRACT

OBJECTIVE: To assess the accuracy of canine intraocular pressure (IOP) estimates from the eyeTelemed IOPvet indentation tonometer. ANIMALS STUDIED: Part 1 included 54 eyes from 28 Beagle dogs-23 ADAMTS10-mutants with open-angle glaucoma and 5 normals. Part 2 involved five normal canine ex vivo globes. PROCEDURE: Part 1 (in vivo) compared IOPvet estimates in normal and glaucomatous dogs to Reichert Tono-Vera® Vet rebound tonometry. The three IOPvet estimates were green (normal; <20 mmHg, according to the manufacturer), yellow (elevated; 20-30 mmHg), and red (high; >30 mmHg). In Part 2 (ex vivo), the pressure inside freshly enucleated normal canine eyes was progressively increased from 5 to 80 mmHg and compared to IOPvet estimates. Descriptive statistics compared IOPvet estimates to rebound tonometry and direct manometry, with the threshold from normal to glaucoma set at 30 mmHg. RESULTS: In Part 1 (in vivo), normal pressures (≤30 mmHg) were mainly identified correctly as green or yellow-110 of 111 estimates, corresponding to a specificity of 99%. Only 16 of 125 affected estimates were correctly displayed in the >30-mmHg range; the remaining 109 showed ≤30 mmHg, corresponding to a sensitivity of 13%. In Part 2 (ex vivo), all normal pressures were correctly estimated with green, but 64 of 88 manometric IOPs >30 mmHg were falsely estimated as 20-30 mmHg. CONCLUSIONS: The IOPvet is inaccurate in estimating canine IOP with a low sensitivity at identifying dogs with IOP > 30 mmHg. Canine-specific instrument revision is required to correctly identify elevated (yellow = 20-30 mmHg) and high (red >30 mmHg) IOPs.

3.
Curr Oncol ; 30(6): 5795-5806, 2023 06 13.
Article in English | MEDLINE | ID: mdl-37366916

ABSTRACT

Ductal carcinoma in situ (DCIS), especially in the era of mammographic screening, is a commonly diagnosed breast tumor. Despite the low breast cancer mortality risk, management with breast conserving surgery (BCS) and radiotherapy (RT) is the prevailing treatment approach in order to reduce the risk of local recurrence (LR), including invasive LR, which carries a subsequent risk of breast cancer mortality. However, reliable and accurate individual risk prediction remains elusive and RT continues to be standardly recommended for most women with DCIS. Three molecular biomarkers have been studied to better estimate LR risk after BCS-Oncotype DX DCIS score, DCISionRT Decision Score and its associated Residual Risk subtypes, and Oncotype 21-gene Recurrence Score. All these molecular biomarkers represent important efforts towards improving predicted risk of LR after BCS. To prove clinical utility, these biomarkers require careful predictive modeling with calibration and external validation, and evidence of benefit to patients; on this front, further research is needed. Most trials do not incorporate molecular biomarkers in evaluating de-escalation of therapy for DCIS; however, one-the Prospective Evaluation of Breast-Conserving Surgery Alone in Low-Risk DCIS (ELISA) trial-incorporates the Oncotype DX DCIS score in defining a low-risk population and is an important next step in this line of research.


Subject(s)
Breast Neoplasms , Carcinoma, Intraductal, Noninfiltrating , Female , Humans , Carcinoma, Intraductal, Noninfiltrating/diagnosis , Carcinoma, Intraductal, Noninfiltrating/genetics , Carcinoma, Intraductal, Noninfiltrating/therapy , Breast Neoplasms/genetics , Breast Neoplasms/therapy , Breast Neoplasms/diagnosis , Risk , Biomarkers, Tumor/genetics , Overtreatment
4.
Educ Psychol Meas ; 83(1): 93-115, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36601257

ABSTRACT

Multidimensionality and hierarchical data structure are common in assessment data. These design features, if not accounted for, can threaten the validity of the results and inferences generated from factor analysis, a method frequently employed to assess test dimensionality. In this article, we describe and demonstrate the application of the multilevel bifactor model to address these features in examining test dimensionality. The tool for this exposition is the Child Observation Record Advantage 1.5 (COR-Adv1.5), a child assessment instrument widely used in Head Start programs. Previous studies on this assessment tool reported highly correlated factors and did not account for the nesting of children in classrooms. Results from this study show how the flexibility of the multilevel bifactor model, together with useful model-based statistics, can be harnessed to judge the dimensionality of a test instrument and inform the interpretability of the associated factor scores.

5.
Article in English | MEDLINE | ID: mdl-36078725

ABSTRACT

Handgrip strength (GS) is used as an indicator of overall muscle strength and health outcomes for aging adults. GS has also been evaluated as a potential link with sport performances. We quantified the age-associated decline in grip strength for males and females engaged in weekly vigorous physical activity, differentiated by body mass, and investigated whether there was an acceleration of decline at any age. The Survey of Health, Ageing and Retirement in Europe is a multinational complex panel data survey with a target population of individuals aged 50 years or older. Data from 48,070 individuals from 20 European countries, collected from 2004 to 2015, were used in multivariable regression models to study the association of age and body weight with grip strength for individuals engaged in vigorous physical activity at least once a week. The annual rate of change in GS differed for males and females; it was constant from ages 50 to 55 years and then accelerated for females, possibly due to the menopausal transition. In contrast, the decline in GS accelerates with each year of increase in age for males. Higher body mass was associated with an increase in GS, but the increase was less pronounced for older males. The increase in GS diminished with a body mass above the median even with engagement in weekly vigorous physical activities. GS reference values for individuals engaged in vigorous physical activity add to existing reference values for general populations.


Subject(s)
Hand Strength , Sex Characteristics , Adult , Aging/physiology , Exercise , Female , Hand Strength/physiology , Humans , Male , Muscle Strength/physiology
6.
J Am Assoc Lab Anim Sci ; 61(5): 482-494, 2022 09 01.
Article in English | MEDLINE | ID: mdl-36045004

ABSTRACT

Surgical procedures are commonly performed using mice but can have major effects on their core body temperature, including development of hypothermia. In this study, we evaluated active perioperative warming with and without surgical draping with adherent plastic wrap to refine practices, improve animal welfare, and optimize research experiments. Mice were randomized into treatment groups (n = 6; 8 CD1 mice per group). Treatments included placement within a small-animal forced-air incubator at 38 ° C for 30 min before surgery (Pre), after surgery (Post), or before and after surgery (Both). To explore the effect of surgical draping, one group received incubator warming before and after surgery in addition to surgical draping (Both/ Drape), whereas another group received surgical draping only without incubator warming (Control/Drape). The final group of mice received neither warming nor draping (Control). Subcutaneous temperature transponders were placed in all mice. Approximately 5 d after transponder placement, mice were anesthetized with ketamine-xylazine and underwent laparotomy. Subcutaneous body temperatures were collected perioperatively from transponders, and rectal temperatures were taken every minute during surgery. For recovery from anesthesia, mice were placed either in a standard cage on a warm water blanket set to 38 °C (100.4 °F) or in the incubator. Subcutaneous body temperatures were significantly higher in mice prewarmed for 30 min (Pre, Both, Both/Drape) as compared with mice that were not prewarmed. Anesthetic recovery times were significantly longer for mice placed in the incubator (Pre, Post, Both, Both/Drape) than for those that did not receive incubator warming (Control, Control/Drape). Mean intraoperative rectal temperatures of Both/Drape mice tended to be greater than those of mice in the Both group, suggesting a warming benefit of surgical draping. Using a forced air incubator and adherent plastic draping mitigated body temperature loss in mice during both surgery and postoperative recovery.


Subject(s)
Hypothermia , Ketamine , Animals , Body Temperature , Hypothermia/prevention & control , Hypothermia/veterinary , Mice , Plastics , Water , Xylazine
7.
J Am Assoc Lab Anim Sci ; 60(3): 365-373, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33952387

ABSTRACT

Rodents are frequently used for models that require surgical procedures. At our institution, laboratory rats are increasingly preferred for investigations of neurologic disorders, cardiovascular interventions, and assessment and treatment of addictive and depressive behaviors. For these types of studies, surgical preparations of the head and neck areas are necessary for catheterization and instrumentation. Based upon our former work in laboratory mice, we sought to improve rat surgery outcomes and confirm the efficacy of a waterless alcohol-based (WAB) antiseptic for skin disinfection prior to incision. In addition, we wanted to investigate whether active warming efforts improved perioperative body temperatures for rats to aid in return to consciousness. Prior to cranial surgical incision and placement in stereotactic equipment, rats were assessed after skin preparation with WAB and after thermal interventions, including prewarming cages for 30 min before anesthesia and delivery of warmed fluid (NaCl) supplementation. Core temperatures were recorded and aerobic culture swabs collected from surgical sites at multiple time points. As previously shown in mice, bacterial counts in rats were effectively diminished by WAB agents. Assessment of intraoperative body temperature trajectories did not identify appreciable differences between control rats and rats that were exposed to prewarming or warmed fluid supplementation or both. However, heavier male rats recovered more rapidly from isoflurane anesthesia than did lighter male and female rats. Although these thermal support measures did not significantly improve anesthetic recovery times in rats, animals warmed for 30 min trended toward a faster return to righting reflex after exposure to isoflurane. These findings confirm that WAB antiseptic is an acceptable option for skin preparation in rats and suggest that continued evaluation of thermal interventions remains of interest for improved outcomes in rat surgery.


Subject(s)
Anti-Infective Agents, Local , Hypothermia , Isoflurane , Animals , Body Temperature , Ethanol , Female , Humans , Male , Mice , Preoperative Care , Rats
8.
Am J Med ; 132(4): e552-e553, 2019 04.
Article in English | MEDLINE | ID: mdl-30660329
9.
Am J Med ; 132(1): 88-92, 2019 01.
Article in English | MEDLINE | ID: mdl-30290192

ABSTRACT

BACKGROUND: There are sparse data to support the recommendation for inferior vena cava (IVC) filters in patients with recurrent pulmonary embolism while on anticoagulant therapy. METHODS: This was a retrospective cohort study of administrative data from the Premier Healthcare Database, 2009-2014. All-cause mortality according to the use of IVC filters was evaluated in patients who suffered a recurrent pulmonary embolism within 3 months of an index pulmonary embolism. Patients were identified by International Classification of Disease, 9th Clinical Modification codes. A time-dependent analysis controlled for immortal time bias. RESULTS: An IVC filter was inserted in 603 of 814 (74.1%) of patients hospitalized for recurrent pulmonary embolism within 3 months of an index pulmonary embolism. Mortality with an IVC filter was 18 of 603 (3.0%) vs 83 of 211 (39.3%) (P < .0001) without a filter. Among patients with recurrent pulmonary embolism who were stable and did not receive thrombolytic therapy or undergo pulmonary embolectomy, mortality with an IVC filter was 15 of 572 (2.6%) vs 72 of 169 (42.6%) (P < .0001) without a filter. CONCLUSION: In the United States, usual practice was to insert an IVC filter in patients with early recurrent pulmonary embolism. Mortality was lower in those who received an IVC filter. Even stable patients with early recurrent pulmonary embolism showed a decreased mortality with IVC filters, even though in other circumstances, IVC filters do not reduce mortality in stable patients. Additional cohort studies would be useful in the absence of a randomized controlled trial.


Subject(s)
Pulmonary Embolism/prevention & control , Vena Cava Filters/statistics & numerical data , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Mortality , Recurrence , Retrospective Studies , Secondary Prevention
10.
J Am Assoc Lab Anim Sci ; 57(4): 401-414, 2018 07 01.
Article in English | MEDLINE | ID: mdl-29970215

ABSTRACT

Preparing the skin of rodents for surgery often involves multiple applications of antiseptic agents. However, fewer applications may achieve the same antiseptic outcome. We evaluated the antimicrobial efficacy and effects on intraoperative body temperature of various surgical scrub agents, including novel waterless alcohol-based (WAB) options. Prior to ventral laparotomy, female C57BL/6 mice were treated with 0.9% saline (control); 70% ethanol; 10% povidone-iodine alternated with saline or 70% ethanol; 2% chlorhexidine digluconate alternated with saline or 70% ethanol; or 1 of 3 WAB products-commercial surgical scrub A, commercial surgical scrub B, or a common commercial hand sanitizer. Core temperatures were recorded, and aerobic culture swabs were collected from the surgical site at multiple time points. Intraoperative temperature trajectories for animals treated with scrub B, 10% povidone-iodine with saline, or hand sanitizer did not differ from saline (control). Temperature trajectories of mice treated with other scrub agents did differ significantly from saline. Bacteria were not detected at the operative site after 3 scrubs of 70% ethanol or 10% povidone-iodine alternated with ethanol, 2 scrubs of scrub A or B, 1 scrub of hand sanitizer, and both 1 and 3 scrubs of 2% chlorhexidine alternated with ethanol. Scrub B and 2% chlorhexidine-ethanol demonstrated prolonged antibacterial efficacy. Histology of corresponding haired skin sections revealed no differences in postoperative healing between groups, and no postoperative infections occurred. These results indicate that various novel WAB disinfectants, particularly scrub B (61% ethanol and 1% chlorhexidine gluconate), mitigate intraoperative temperature effects associated with several traditional agents and combinations. Furthermore, reduction of skin bacterial load without adverse effects on healing was seen with fewer than triplicate applications of most tested agents. Ultimately effective skin preparation can be achieved by using only 1 or 2 applications of scrub, thus rendering the triplicate skin-prep method unnecessary in laboratory mice.


Subject(s)
Anti-Infective Agents, Local/pharmacology , Chlorhexidine/analogs & derivatives , Ethanol/pharmacology , Povidone-Iodine/pharmacology , Surgical Wound Infection/veterinary , Animals , Anti-Bacterial Agents , Anti-Infective Agents , Benzalkonium Compounds , Chlorhexidine/pharmacology , Disinfectants , Female , Humans , Mice , Mice, Inbred C57BL , Preoperative Care , Skin , Surgical Wound Infection/prevention & control
11.
Am J Med ; 131(9): 1104-1109, 2018 09.
Article in English | MEDLINE | ID: mdl-29906426

ABSTRACT

BACKGROUND: Immortal time bias is a possible confounding factor in cohort studies. In this investigation, we assessed mortality with inferior vena cava (IVC) filters in unstable patients with pulmonary embolism using a design to control for immortal time bias. METHODS: Data were from the Premier Healthcare Database, 2010-2014. International Classification of Diseases-Ninth Revision-Clinical Modification codes were used. Unstable patients with pulmonary embolism and an admitting diagnosis of pulmonary embolism, as well as a primary diagnosis of pulmonary embolism, were included. A time-dependent analysis was used according to the day of insertion of the IVC filter to control for immortal time bias. RESULTS: Among all unstable patients, irrespective of the use of thrombolytic therapy, in-hospital all-cause mortality was 35 of 180 (19.4%) in those who received an IVC filter vs 122 of 299 (40.8%) with no filter (P < .0001). Mortality was lower in patients in whom the IVC filter was inserted on days 1 or 2 (on day 1, 21.4% compared with 40.8%, P = .017, and on day 2, 14.8% compared with 29.2%, P = .023), but it was not lower in those in whom the filter was inserted on subsequent days. CONCLUSIONS: Mortality in unstable patients with pulmonary embolism appeared to be reduced with IVC filters only when the filter was inserted on the first or second day of admission. The design used for these analyses controlled for immortal time bias as a cause of the lower mortality with IVC filters.


Subject(s)
Hospital Mortality , Pulmonary Embolism/therapy , Vena Cava Filters , Aged , Cohort Studies , Databases, Factual , Female , Humans , Male , Middle Aged , Pulmonary Embolism/mortality , Retrospective Studies , Thrombolytic Therapy/statistics & numerical data , Time-to-Treatment , United States/epidemiology
12.
Am J Cardiol ; 121(4): 495-500, 2018 02 15.
Article in English | MEDLINE | ID: mdl-29254678

ABSTRACT

Administrative data were analyzed from the Premier Healthcare Database, 2010 to 2014, to assess whether inferior vena cava (IVC) filters reduce mortality in unstable patients (in shock or on ventilator support) with acute pulmonary embolism and in stable patients who undergo surgical pulmonary embolectomy. Mortality was assumed to be due to pulmonary embolism in patients who had none of the co-morbid conditions listed in the Charlson Comorbidity Index. Data were determined on the basis of International Classification of Disease-9th Clinical Modification (ICD-9-CM) codes. All-cause mortality in unstable patients was lower with IVC filters in-hospital, 288 of 1,972 (23%) versus 1339 of 3002 (45%) (p <0.0001), and at 3 months, all-cause mortality was 316 of 1,272 (25%) versus 1,428 of 3,002 (48%) (p <0.0001). Pulmonary embolism mortality was lower with IVC filters in unstable patients in-hospital, 191 of 926 (21%) versus 913 of 2,138 (43%) (p <0.0001) and at 3 months, 215 of 926 (23%) versus 971 of 2,138 (45%) (p <0.0001). A lower in-hospital and 3-month all-cause mortality and pulmonary embolism mortality was also shown with IVC filters in stable patients who underwent pulmonary embolectomy. These data, in concert with previous retrospective data, suggest that unstable patients with pulmonary embolism and stable patients who undergo pulmonary embolectomy may benefit from an IVC filter. Further investigations would be useful.


Subject(s)
Embolectomy , Pulmonary Embolism/prevention & control , Pulmonary Embolism/surgery , Vena Cava Filters , Acute Disease , Aged , Female , Hospital Mortality , Humans , Male , Middle Aged , Pulmonary Embolism/mortality , Retrospective Studies , United States , Vena Cava, Inferior
13.
Am J Med ; 131(4): 442.e9-442.e12, 2018 04.
Article in English | MEDLINE | ID: mdl-29132839

ABSTRACT

BACKGROUND: Administrative data have shown a lower mortality in hospitalized patients with pulmonary embolism and cancer who receive a vena cava filter. In the absence of a randomized controlled trial of vena cava filters in such patients, further investigation is necessary. Therefore, we performed this investigation using administrative data from a different database than used previously, and we investigate patients hospitalized in more recent years. METHODS: We analyzed administrative data from the Premier Healthcare Database, 2010-2014, in patients hospitalized with pulmonary embolism and solid malignant tumors. Patients were identified on the basis of International Classification of Disease, Ninth Revision, Clinical Modification codes. RESULTS: Patients aged >60 years had a lower in-hospital all-cause mortality with vena cava filters than those who did not have filters, 346 of 4648 (7.4%) compared with 2216 of 19,847 (11.2%) (P < .0001) (relative risk 0.67). Among patients aged >60 years who received an inferior vena cava, all-cause mortality within 3 months was 704 of 4648 (15.1%), compared with 3444 of 19,847 (17.4%) among those who did not receive a filter (P < .0001) (relative risk 0.86). CONCLUSION: Elderly patients with pulmonary embolism and cancer may be a special population in whom inferior vena cava filters reduce in-hospital and 3-month all-cause mortality. Further investigation is needed, particularly in younger patients.


Subject(s)
Neoplasms/complications , Neoplasms/mortality , Pulmonary Embolism/mortality , Pulmonary Embolism/prevention & control , Vena Cava Filters , Aged , Aged, 80 and over , Female , Hospital Mortality , Humans , Male , Middle Aged , United States , Vena Cava, Inferior
14.
J Am Assoc Lab Anim Sci ; 56(5): 562-569, 2017 Sep 01.
Article in English | MEDLINE | ID: mdl-28903829

ABSTRACT

Laboratory mice (Mus musculus) are prone to develop hypothermia during anesthesia for surgery, thus potentially impeding anesthetic recovery, wound healing, and future health. The core body temperatures of isoflurane-anesthetized mice are influenced by the choice of supplemental heat sources; however, the contribution of various surgical scrubs on the body temperatures of mice under gas anesthesia has not been assessed. We sought to quantify the effect of using alcohol (70% isopropyl alcohol [IPA]) compared with saline to rinse away surgical scrub on the progression of hypothermia in anesthetized mice (n = 47). IPA, room-temperature saline, or warmed saline (37 °C) was combined with povidone-iodine and then assessed for effects on core (rectal) and surface (infrared) temperatures. Agents were applied to a 2×2-cm shaved abdominal area of mice maintained on a water-recirculating blanket (at 38 °C) under isoflurane anesthesia (1.5% to 2.0% at 0.6 L/min) for 30 min. Although all scrub regimens significantly decreased body temperature at the time of application, treatments that included povidone-iodine led to the coldest core temperatures, which persisted while mice were anesthetized. Compared with room-temperature saline and when combined with povidone-iodine, warming of saline did not ameliorate heat loss. IPA alone demonstrated the most dramatic cooling of both surface and core readings at application but generated an unanticipated warming (rebound) phase during which body temperatures equilibrated with those of controls within minutes of application. Although alcohol is inappropriate as a stand-alone agent for surgical skin preparation, IPA is a viable alternative to saline-based rinses in this context, and its use should be encouraged within institutional guidance for rodent surgical procedures without concern for prolonged hypothermia in mice.


Subject(s)
2-Propanol/adverse effects , Body Temperature , Hypothermia, Induced/veterinary , Povidone-Iodine , Preoperative Care/veterinary , Sodium Chloride/adverse effects , Anesthetics, Inhalation/pharmacology , Animals , Dermatologic Agents/pharmacology , Female , Hot Temperature , Humans , Isoflurane/pharmacology , Male , Mice
15.
Article in English | MEDLINE | ID: mdl-28664829

ABSTRACT

Laboratory mice (Mus musculus) are prone to develop hypothermia during anesthesia for surgery, thus potentially impedinganesthetic recovery, wound healing, and future health. The core body temperatures of isoflurane-anesthetized mice areinfluenced by the choice of supplemental heat sources; however, the contribution of various surgical scrubs on the bodytemperatures of mice under gas anesthesia has not been assessed. We sought to quantify the effect of using alcohol (70%isopropyl alcohol [IPA]) compared with saline to rinse away surgical scrub on the progression of hypothermia in anesthetizedmice (n = 47). IPA, room-temperature saline, or warmed saline (37 °C) was combined with povidone-iodine and thenassessed for effects on core (rectal) and surface (infrared) temperatures. Agents were applied to a 2×2-cm shaved abdominalarea of mice maintained on a water-recirculating blanket (at 38 °C) under isoflurane anesthesia (1.5% to 2.0% at 0.6 L/min)for 30 min. Although all scrub regimens significantly decreased body temperature at the time of application, treatments thatincluded povidone-iodine led to the coldest core temperatures, which persisted while mice were anesthetized. Comparedwith room-temperature saline and when combined with povidone-iodine, warming of saline did not ameliorate heat loss.IPA alone demonstrated the most dramatic cooling of both surface and core readings at application but generated an unanticipatedwarming (rebound) phase during which body temperatures equilibrated with those of controls within minutes ofapplication. Although alcohol is inappropriate as a stand-alone agent for surgical skin preparation, IPA is a viable alternativeto saline-based rinses in this context, and its use should be encouraged within institutional guidance for rodent surgicalprocedures without concern for prolonged hypothermia in mice.

16.
J Surg Oncol ; 115(2): 122-130, 2017 Feb.
Article in English | MEDLINE | ID: mdl-28054348

ABSTRACT

BACKGROUND: The impact of surgical treatment on outcomes in breast cacner in very young women remains unclear. We sought to determine the effect of surgery type on risk of recurrence and survival in a population-based cohort. METHODS: All women diagnosed with breast cancer aged ≤35 (1994-2003) were identified from the Ontario Cancer Registry. Patient, tumor, and treatment variables, including primary surgery, recurrences, and death were abstracted from chart review. Cox regression models were fit to determine the effect of surgery type on recurrence and overall survival. RESULTS: We identified 1,381 patients with 11-year median follow-up of which 793 (57%) had BCS. Of the remaining mastectomy patients, 52% had postmastectomy radiation. Overall, 41% of patients sustained a recurrence of any type and 31% died. Controlling for known confounders, there was no association between type of surgery and death from any cause (HR = 0.98, 95% CI = 0.78, 1.25) or first recurrence (HR = 0.93, 95% CI = 0.75, 1.14). Distant recurrence was most common (13% in BCS; 25.3% in mastectomy) with local recurrence 12.4% after BCS and 7.5% after mastectomy. CONCLUSIONS: In this cohort of very young women who were selected for treatment with BCS and mastectomy, we found similar oncologic outcomes. J. Surg. Oncol. 2017;115:122-130. © 2017 Wiley Periodicals, Inc.


Subject(s)
Breast Neoplasms/mortality , Carcinoma, Ductal, Breast/mortality , Carcinoma, Lobular/mortality , Mastectomy, Segmental/mortality , Mastectomy/mortality , Neoplasm Recurrence, Local/mortality , Adolescent , Adult , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/surgery , Carcinoma, Lobular/pathology , Carcinoma, Lobular/surgery , Female , Follow-Up Studies , Humans , Neoplasm Grading , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm Staging , Prognosis , Retrospective Studies , Survival Rate , Young Adult
17.
J Invertebr Pathol ; 125: 9-15, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25527406

ABSTRACT

Honey bees (Apis mellifera) are infected by two species of microsporidia: Nosema apis and Nosemaceranae. Epidemiological evidence indicates that N. ceranae may be replacing N. apis globally in A. mellifera populations, suggesting a potential competitive advantage of N. ceranae. Mixed infections of the two species occur, and little is known about the interactions among the host and the two pathogens that have allowed N. ceranae to become dominant in most geographical areas. We demonstrated that mixed Nosema species infections negatively affected honey bee survival (median survival=15-17days) more than single species infections (median survival=21days and 20days for N. apis and N. ceranae, respectively), with median survival of control bees of 27days. We found similar rates of infection (percentage of bees with active infections after inoculation) for both species in mixed infections, with N. apis having a slightly higher rate (91% compared to 86% for N. ceranae). We observed slightly higher spore counts in bees infected with N. ceranae than in bees infected with N. apis in single microsporidia infections, especially at the midpoint of infection (day 10). Bees with mixed infections of both species had higher spore counts than bees with single infections, but spore counts in mixed infections were highly variable. We did not see a competitive advantage for N. ceranae in mixed infections; N. apis spore counts were either higher or counts were similar for both species and more N. apis spores were produced in 62% of bees inoculated with equal dosages of the two microsporidian species. N. ceranae does not, therefore, appear to have a strong within-host advantage for either infectivity or spore growth, suggesting that direct competition in these worker bee mid-guts is not responsible for its apparent replacement of N. apis.


Subject(s)
Bees/microbiology , Nosema/physiology , Animals , Colony Count, Microbial , Host-Pathogen Interactions , Species Specificity
18.
Br J Nutr ; 108 Suppl 1: S27-36, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22916812

ABSTRACT

Pulses (dry beans, peas, lentils) are nutrient-dense foods that are recommended as good choices in either the vegetable or meat and alternative food groups in Canada's Food Guide. To examine the prevalence and the effect of pulse consumption on nutrient intake in Canadian adults ( ≥ 19 years), we analysed cross-sectional data (n 20,156) from the 2004 Canadian Community Health Survey, Cycle 2·2. Participants were divided into non-consumers and quartiles of pulse intake. Sample weights were applied and logistic regression analysis was used to explore the association of nutrient intakes and pulse consumption, with cultural background, sex, age and economic status included as covariates. On any given day, 13 % of Canadians consume pulses, with the highest consumption in the Asian population. The pulse intake of consumers in the highest quartile was 294 (se 40) g/d and, compared with non-consumers, these individuals had higher intakes of carbohydrate, fibre and protein. As well, the micronutrient intake of pulse consumers was enhanced, resulting in fewer individuals who were below the estimated average requirement for thiamin, vitamin B6, folate, Fe, Mg, P and Zn, compared with non-consumers. Although pulses are generally low in Na, its intake also was higher in pulse consumers. Among the higher quartiles of pulse consumers, fruit and vegetable intake was one serving higher. These data indicate that pulse consumption supports dietary advice that pulses be included in healthful diets. Further studies elucidating the sources of increased Na in pulse consumers will be necessary so that dietary advice to increase consumption of pulses will maximise their nutritional benefits.


Subject(s)
Diet , Fabaceae , Seeds , Adult , Aged , Asia/ethnology , Canada , Cross-Sectional Studies , Diet Surveys , Dietary Carbohydrates/administration & dosage , Dietary Fiber/administration & dosage , Dietary Proteins/administration & dosage , Ethnicity , Female , Health Promotion , Health Surveys , Humans , Male , Micronutrients/administration & dosage , Middle Aged , Nutritional Requirements
19.
J Commun Disord ; 44(4): 444-58, 2011.
Article in English | MEDLINE | ID: mdl-21477813

ABSTRACT

It is well established that monolingual preschoolers' oral language development (vocabulary and oral comprehension) contributes to their later reading abilities; however, less is known about this relationship in bilingual populations where children are developing knowledge of two languages. It may be that children's abilities in one language do not contribute to their reading abilities in their other language or that children's experiences with either language assist them in developing a common underlying proficiency that they draw upon when learning to read. The purpose of this study was to investigate the relationship among bilingual children's receptive language development and reading outcomes in first grade. Eighty-one bilingual children who were attending Head Start participated in the study. Growth curve models were used to examine the relationship between children's language abilities during two years in Head Start and reading outcomes at the end of first grade. Children's growth in both English and Spanish receptive vocabulary and oral comprehension predicted their English and Spanish reading abilities at the end of first grade within languages. Associations were also observed between languages with growth in English receptive language predicting Spanish reading comprehension and growth in Spanish receptive language predicting English reading comprehension.


Subject(s)
Educational Status , Multilingualism , Reading , Child , Child, Preschool , Educational Measurement , Humans , Language Development , Language Tests , Speech
20.
Prev Sci ; 12(1): 12-22, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21271357

ABSTRACT

Two media-based interventions designed to reduce adolescent marijuana use ran concurrently from 2005 to 2009. Both interventions used similar message strategies, emphasizing marijuana's inconsistency with personal aspirations and autonomy. "Be Under Your Own Influence" was a randomized community and school trial replicating and extending a successful earlier intervention of the same name (Slater et al. Health Education Research 21:157-167, 2006). "Above the Influence" is a continuing national television, radio, and print campaign sponsored by the Office of National Drug Control Policy (ONDCP). This study assessed the simultaneous impact of the interventions in the 20 U.S. communities. Results indicate that earlier effects of the "Be Under Your Own Influence" intervention replicated only in part and that the most plausible explanation of the weaker effects is high exposure to the similar but more extensive ONDCP "Above the Influence" national campaign. Self-reported exposure to the ONDCP campaign predicted reduced marijuana use, and analyses partially support indirect effects of the two campaigns via aspirations and autonomy.


Subject(s)
Freedom , Marijuana Smoking , Mass Media , Adolescent , Adolescent Behavior , Child , Humans
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