ABSTRACT
OBJECTIVE: Adrenocortical carcinoma (ACC) is a rare malignancy without established association with environmental risk factors. ACC incidence is stable based on large surgical databases while referral centers data reported increasing number of cases seen. We studied ACC incidence and distribution at a county level to find potential ACC "hot spots" that could be linked to environmental exposures. METHODS: A retrospective analysis of Texas Cancer Registry that included ACC patients diagnosed between 2000 and 2018. County-level heatmaps were created and compared with breast, prostate, and lung cancer. RESULTS: We identified 448 ACC cases during the study period. Cases were registered in 110 of the 254 counties (43.3%) in Texas, representing 92.74% of the total population. The median incidence was 23 new cases/y (range 14-33). The mean population-adjusted ACC incidence rate was 0.104 per 100 000 per year (standard deviation 0.005; 95% CI, 0.092-0.116). Seven counties (6.3%) accounted for 215 (48.0%) cases, with more than 10 cases each and median standardized incidence ratio (SIR) of 0.1 (range, 0.0-0.9). One hundred three counties (93.7%) accounted for the remaining 233 cases (52%), with fewer than 10 cases per county. The highest standardized incidence ratios were found in counties with a median population of fewer than 14 000 residents and with only one reported case. CONCLUSION: Our analysis is the first report to create ACC heatmap and could not detect any geographic clustering of ACC in Texas. The incidence of ACC remained stable and consistent with data from other large databases.
Subject(s)
Adrenal Cortex Neoplasms , Adrenocortical Carcinoma , Male , Humans , Adrenocortical Carcinoma/epidemiology , Adrenocortical Carcinoma/pathology , Retrospective Studies , Incidence , Registries , Adrenal Cortex Neoplasms/epidemiology , Adrenal Cortex Neoplasms/pathologyABSTRACT
Joint attention, or the shared focus of attention between objects or events and a social partner, is a crucial milestone in the development of social communication and a notable area of deficit in children with autism spectrum disorder. While valid parent-report screening measures of social communication are available, the majority of these measures are designed to assess a wide range of behaviors. Targeted assessment of joint attention and related skills is primarily limited to semi-structured, examiner-led interactions, which are time-consuming and laborious to score. The Pictorial Infant Communication Scale is an efficient parent-report measure of joint attention that can be used as a complement to structured assessments in fully characterizing early social communication development. This study examined the psychometric properties of the Pictorial Infant Communication Scale. Results revealed a high degree of internal consistency and strong intercorrelations between subscales. Additionally, confirmatory factor analysis supported a three-factor model of joint attention. Furthermore, significant correlations between the Pictorial Infant Communication Scale and direct clinical measures of child joint attention, language skills, and autism spectrum disorder symptom severity were suggestive of concurrent validity. Findings suggest that the Pictorial Infant Communication Scale is a promising tool for measuring joint attention skills in preschool-aged children with autism spectrum disorder.
Subject(s)
Autism Spectrum Disorder/psychology , Communication , Social Skills , Attention , Autism Spectrum Disorder/diagnosis , Child, Preschool , Female , Humans , Male , Psychological Tests , Psychometrics , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
A new methodology for measuring human security is presented. The three stages of the methodology are: i) threat assessment, ii) data collection and organization, and iii) data visualization and analysis, using Geographic Information Systems. Results from a Cambodia case study are highlighted. The United Nations Development Program's notion of human security, which gives equal weight to economic, health, food, political, personal, and environmental factors, is used. Country-specific threats in each category are determined, and local, spatially referenced data are collected. In this paper, poverty, dengue fever, and tuberculosis are used as examples of the analytic process. Regions of Cambodia exposed to all three of these threats ("hot spots") are located, and spatial correlation between poverty, dengue fever, and tuberculosis is calculated. The methodology i) advances a broad concept of human security, ii) will potentially assist policy and decision makers, and iii) identifies research questions that cannot be resolved using single-sector analysis.
