RESUMEN
BACKGROUND: The potential of an increased risk of breast cancer in women with diabetes has been the subject of a great deal of recent research. METHODS: A meta-analysis was undertaken using a random effects model to investigate the association between diabetes and breast cancer risk. RESULTS: Thirty-nine independent risk estimates were available from observational epidemiological studies. The summary relative risk (SRR) for breast cancer in women with diabetes was 1.27 (95% confidence interval (CI), 1.16-1.39) with no evidence of publication bias. Prospective studies showed a lower risk (SRR 1.23 (95% CI, 1.12-1.35)) than retrospective studies (SRR 1.36 (95% CI, 1.13-1.63)). Type 1 diabetes, or diabetes in pre-menopausal women, were not associated with risk of breast cancer (SRR 1.00 (95% CI, 0.74-1.35) and SRR 0.86 (95% CI, 0.66-1.12), respectively). Studies adjusting for body mass index (BMI) showed lower estimates (SRR 1.16 (95% CI, 1.08-1.24)) as compared with those studies that were not adjusted for BMI (SRR 1.33 (95% CI, 1.18-1.51)). CONCLUSION: The risk of breast cancer in women with type 2 diabetes is increased by 27%, a figure that decreased to 16% after adjustment for BMI. No increased risk was seen for women at pre-menopausal ages or with type 1 diabetes.
Asunto(s)
Neoplasias de la Mama/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Índice de Masa Corporal , Neoplasias de la Mama/etiología , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Humanos , Medición de Riesgo , Factores de RiesgoRESUMEN
Contemporary bioscience is seeing the emergence of a new data economy: with data as its fundamental unit of exchange. While sharing data within this new 'economy' provides many potential advantages, the sharing of individual data raises important social and ethical concerns. We examine ongoing development of one technology, DataSHIELD, which appears to elide privacy concerns about sharing data by enabling shared analysis while not actually sharing any individual-level data. We combine presentation of the development of DataSHIELD with presentation of an ethnographic study of a workshop to test the technology. DataSHIELD produced an application of the norm of privacy that was practical, flexible and operationalizable in researchers' everyday activities, and one which fulfilled the requirements of ethics committees. We demonstrated that an analysis run via DataSHIELD could precisely replicate results produced by a standard analysis where all data are physically pooled and analyzed together. In developing DataSHIELD, the ethical concept of privacy was transformed into an issue of security. Development of DataSHIELD was based on social practices as well as scientific and ethical motivations. Therefore, the 'success' of DataSHIELD would, likewise, be dependent on more than just the mathematics and the security of the technology.
Asunto(s)
Investigación Biomédica , Seguridad Computacional/legislación & jurisprudencia , Seguridad Computacional/normas , Confidencialidad/normas , Almacenamiento y Recuperación de la Información/métodos , Proyectos de Investigación , Seguridad Computacional/ética , Confidencialidad/ética , Confidencialidad/legislación & jurisprudencia , Comités de Ética , Humanos , InvestigaciónRESUMEN
Objetivo: Evaluar la correlación existente entre la calidad de vida percibida por los pacientes y dos parámetros objetivos de gravedad: a) la gravedad de la obstrucción por el volumen espiratorio máximo en el primer segundo (FEV1), y b) el índice BODE (Body Mass Index, Airflow Obstruction, Dyspnea and Exercice Capacity). Material y métodos: Estudio observacional descriptivo de corte transversal, realizado en 40 pacientes diagnosticados de la enfermedad pulmonar obstructiva crónica (EPOC) y clasificados según la escala GOLD (Global initiative for chronic obstructive lung disease) en moderados o graves, a los que se entrevistó mediante el cuestionario respiratorio de St. George (SGRQ). Se calculó el índice BODE, previa medición de los parámetros que lo componen. También se recogieron datos antropométricos y demográficos de los pacientes. Resultados: De los 40 pacientes del estudio, 38 eran varones (95%), con una edad media ± desviación estándar (DE) de 76,15 ± 5,82 años. Las medias ± DE obtenidas en referencia a la variable subjetiva del cuestionario SGRQ fueron de 33,58 ± 18,14. En referencia a los datos conseguidos de las variables objetivas, obtuvimos del FEV1 una media ± DE de 49,05 ± 15,731, y del índice BODE de 2,33 ± 1,8 y de sus parámetros integrantes: test de los 6 minutos, 440 ± 87,9; escala Medical Research Council, 1,4 ± 0,6; índice de masa corporal, 28,16 ± 4,4. Según los valores obtenidos observamos la existencia de correlación entre SGRQ y el índice BODE, al igual que entre la actividad, como subescala de la SGRQ y el índice BODE. Conclusiones: El resultado del índice BODE se correlaciona débilmente con los resultados de la SGRQ de forma conjunta, por lo que un elevado índice BODE afecta negativamente a la calidad de vida de los pacientes con EPOC moderados o graves (AU)
Objective: To measure the correlation between perceived quality of life and two objective severity parameters: forced expiratory volume in one second (FEV1) and body mass, airflow obstruction, dyspnea and exercise capacity (BODE) index. Material and methods: Observational descriptive cross-sectional study involving 40 Chronic Obstruction Pulmonary Disease (COPD) patients. They were classified using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system into moderate or severe. The Saint George Respiratory Questionnaire (SGRQ) was carried out by interview and the BODE value was analyzed after measurement of the parameters included in it. Anthropometry and demography data were also collected. Results: A study including 40 patients, 38 of them men 38 (95%), with mean age 76.15 ± 5.82 was performed. The means obtained for the subjective variable of the SGRQ was 33.58 ± 18.14. Regarding the data obtained for the objective variables, the FEV1 had a mean of 49.05 ± 15.731, and the BODE index showed 2.33 ± 1.8. The parameters making it up were: 6-minute exercise test 440 ± 87.9, mean MRC score: 1.4 ± 0.6, and body mass index (BMI) 28.16 ± 4.4. According to the values obtained, we observed the existence of a correlation between SGRO and the BODE index and between the activity, and subscale of the SGRO and BODE index. Conclusions: The BODE index are weakly correlative with the results of the SGRO combined. High index BODE negatively affects the perceived quality of life of moderate/severe COPD patients (AU)
Asunto(s)
Humanos , Ápice del Flujo Espiratorio/fisiología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Calidad de Vida , Autoimagen , Encuestas y CuestionariosRESUMEN
The hippocampus has long been thought essential for implementing a cognitive map of the environment. However, almost 30 years since place cells were found in rodent hippocampal field CA1, it is still unclear how such an allocentric representation arises from an ego-centrically perceived world. By means of a competitive Hebbian learning rule responsible for coding visual and path integration cues, our model is able to explain the diversity of place cell responses observed in a large set of electrophysiological experiments with a single fixed set of parameters. Experiments included changes observed in place fields due to exploration of a new environment, darkness, retrosplenial cortex inactivation, and removal, rotation, and permutation of landmarks. To code for visual cues for each landmark, we defined two perceptual schemas representing landmark bearing and distance information over a linear array of cells. The information conveyed by the perceptual schemas is further processed through a network of adaptive layers which ultimately modulate the resulting activity of our simulated place cells. In path integration terms, our system is able to dynamically remap a bump of activity coding for the displacement of the animal in relation to an environmental anchor. We hypothesize that path integration information is computed in the rodent posterior parietal cortex and conveyed to the hippocampus where, together with visual information, it modulates place cell activity. The resulting network yields a more direct treatment of partial remapping of place fields than other models. In so doing, it makes new predictions regarding the nature of the interaction between visual and path integration cues during new learning and when the system is challenged with environmental changes.