Distinct Patterns Of Association Research Articles

Factorial Structure and Nomological Network of the Inventory of Callous-Unemotional Traits Accounting for Item Keying Variance

The factorial structure of the Inventory of Callous Unemotional Traits (ICU) is currently under dispute. The present study aims to test the factorial structure of a Greek adaptation of the ICU by considering item keying variance and examining alternative theoretical and empirically derived models. Additionally, it aims to investigate the nomological network of the ICU subscales, after controlling for item keying variance. The sample consisted of 1536 Greek-Cypriot adolescents, who completed a battery of questionnaires, including the ICU. Results showed that the consideration of item keying variance improved the overall fit of all the examined models and led to significant changes in the predictive validity of the subscales, while method factors presented distinct patterns of associations with external variables. Overall, results suggest that ICU is contaminated by item keying variance, which can be filtered out to provide clinically useful insight into the factorial structure of the ICU.

Socioeconomic determinants of excess weight and obesity among Indigenous women: findings from the First National Survey of Indigenous People's Health and Nutrition in Brazil.

This article assesses the nutritional status of Indigenous women from 14 to 49 years of age in Brazil. Sample size was calculated for each region considering a prevalence of 50 % for all disease outcomes, a relative error of 5 % and a CI of 95 %. In the initial data analysis, the prevalence of excess weight and obesity was calculated according to independent variables. Multivariate multilevel hierarchical analyses were conducted based on a theoretical model of two ranked blocks. The 2010 Indigenous population in Brazil was 896 000, with approximately 300 Indigenous ethnic groups, making Brazil one of the most ethnically diverse countries in the Americas and the world. Of the total target sample of 6722 women evaluated by the National Survey, thirty did not participate, 939 were not eligible for analyses due to pregnancy or unknown pregnancy status, and thirty-nine were excluded due to missing anthropometric data. The evaluation of nutritional status was completed for 5714 non-pregnant women (99·3 % of eligible participants for this outcome). High prevalence rates were encountered for both excess weight (46·2 %) and obesity (15·8 %) among the sampled women. In the multivariate analyses, higher socioeconomic indicators, market-integrated living conditions and less reliance on local food production, as well as increased age and parity were associated with excess weight and obesity. Results point to distinct patterns of associations between socioeconomic indicators and the occurrence of excess weight and obesity among Indigenous women, which have potentially significant implications from a public policy perspective for Indigenous peoples in Brazil.

Spectral-power associations reflect amplitude modulation and within-frequency interactions on the sub-second timescale and cross-frequency interactions on the seconds timescale.

We investigated the global structure of intrinsic cross-frequency dynamics by systematically examining power-based temporal associations among a broad range of oscillation frequencies both within and across EEG-based current sources (sites). We focused on power-based associations that could reveal unique timescale dependence independently of interacting frequencies. Large spectral-power fluctuations across all sites occurred at two characteristic timescales, sub-second and seconds, yielding distinct patterns of cross-frequency associations. On the fast sub-second timescale, within-site (local) associations were consistently between pairs of β-γ frequencies differing by a constant Δf (particularly Δf ~ 10 Hz at posterior sites and Δf ~ 16 Hz at lateral sites) suggesting that higher-frequency oscillations are organized into Δf amplitude-modulated packets, whereas cross-site (long-distance) associations were all within-frequency (particularly in the >30 Hz and 6-12 Hz ranges, suggestive of feedforward and feedback interactions). On the slower seconds timescale, within-site (local) associations were characterized by a broad range of frequencies selectively associated with ~10 Hz at posterior sites and associations among higher (>20 Hz) frequencies at lateral sites, whereas cross-site (long-distance) associations were characterized by a broad range of frequencies at posterior sites selectively associated with ~10 Hz at other sites, associations among higher (>20 Hz) frequencies among lateral and anterior sites, and prevalent associations at ~10 Hz. Regardless of timescale, within-site (local) cross-frequency associations were weak at anterior sites indicative of frequency-specific operations. Overall, these results suggest that the fast sub-second-timescale coordination of spectral power is limited to local amplitude modulation and insulated within-frequency long-distance interactions (likely feedforward and feedback interactions), while characteristic patterns of cross-frequency interactions emerge on the slower seconds timescale. The results also suggest that the occipital α oscillations play a role in organizing higher-frequency oscillations into ~10 Hz amplitude-modulated packets to communicate with other regions. Functional implications of these timescale-dependent cross-frequency associations await future investigations.

Clinical Multigene Panel Sequencing Identifies Distinct Mutational Association Patterns in Metastatic Colorectal Cancer.

Extensive molecular characterization of human colorectal cancer (CRC) via Next Generation Sequencing (NGS) indicated that genetic or epigenetic dysregulation of a relevant, but limited, number of molecular pathways typically occurs in this tumor. The molecular picture of the disease is significantly complicated by the frequent occurrence of individually rare genetic aberrations, which expand tumor heterogeneity. Inter- and intratumor molecular heterogeneity is very likely responsible for the remarkable individual variability in the response to conventional and target-driven first-line therapies, in metastatic CRC (mCRC) patients, whose median overall survival remains unsatisfactory. Implementation of an extensive molecular characterization of mCRC in the clinical routine does not yet appear feasible on a large scale, while multigene panel sequencing of most commonly mutated oncogene/oncosuppressor hotspots is more easily achievable. Here, we report that clinical multigene panel sequencing performed for anti-EGFR therapy predictive purposes in 639 formalin-fixed paraffin-embedded (FFPE) mCRC specimens revealed previously unknown pairwise mutation associations and a high proportion of cases carrying actionable gene mutations. Most importantly, a simple principal component analysis directed the delineation of a new molecular stratification of mCRC patients in eight groups characterized by non-random, specific mutational association patterns (MAPs), aggregating samples with similar biology. These data were validated on a The Cancer Genome Atlas (TCGA) CRC dataset. The proposed stratification may provide great opportunities to direct more informed therapeutic decisions in the majority of mCRC cases.

Occupational inequalities in volunteering participation: Using detailed data on jobs to explore the influence of habits and circumstances.

In this paper we present empirical results that show that detailed occupations have distinctive patterns of association with voluntary participation. We draw upon data from four secondary survey datasets from the UK (coverage 1972-2012). Occupations are shown to link to volunteering in a wide range of scenarios and in individual, household, and longitudinal contexts. We argue that these linkages provide insight into social inequalities in volunteering, and that they can help us to understand the relative influence of "circumstance" and "habits" in enabling or inhibiting voluntary participation.

Applying the self‐determination theory continuum to unhealthy eating: Consequences on well‐being and behavioral frequency

AbstractThe present research applies self‐determination theory (SDT) to the context of unhealthy eating. The extent to which each of the six types of motivations stemming from the SDT continuum applies to unhealthy eating is examined, as well as the contribution of each motivation for eating unhealthily in predicting psychological well‐being and frequency of unhealthy eating. A three‐wave longitudinal study (N = 379) was conducted before, during, and after the Christmas holidays. Results demonstrated that three types of motivations (i.e., identified, introjected, and external regulation) for unhealthy eating fluctuated over time and peaked during the holidays, a time when unhealthy eating becomes especially salient in Western societies. However, amotivation for unhealthy eating reached its lowest level during the holidays. While identified regulation was associated with greater well‐being, introjected regulation, and amotivation for unhealthy eating were linked with lower well‐being. Integrated regulation was associated with lower well‐being only before and after the holiday period. Finally, the integrated, introjected, external regulations, and amotivation were linked to higher frequency of unhealthy eating. These results confirm that each type of motivation presents distinct patterns of associations with well‐being and actual behavior. Results also demonstrate that the social context in which eating takes place can have an impact on the relationship between motivations and well‐being as well as behavior.

Comprehensive meta-analysis reveals an association of the HLA-DRB1*1602 allele with autoimmune diseases mediated predominantly by autoantibodies.

The human leukocytes antigen (HLA)-DRB1*16:02 allele has been suggested to be associated with many autoimmune diseases. However, a validation of the results of the different studies by a comprehensive analysis of the corresponding meta data is lacking. In this study, we performed a meta-analysis of the association between HLA-DRB1*16:02 allele with various autoimmune disorders. Our analysis shows that HLA-DRB1*16:02 allele was associated with systemic lupus erythematosus, anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis, Graves' disease, myasthenia gravis, neuromyelitis optica and antibody-associated systemic vasculitis with microscopic polyangiitis (AASV-MPA). However, no such association was found for multiple sclerosis, autoimmune hepatitis type 1, rheumatoid arthritis, type 1 diabetes and Vogt-Koyanagi-Harada syndrome. Re-analysis of the studies after their categorization into autoantibody-dependent and T cell-dependent autoimmune diseases revealed that the HLA-DRB1*16:02 allele was strongly associated with disorder predominantly mediated by autoantibodies (OR=1.93; 95% CI=1.63-2.28, P=1.95×10-14) but not with those predominantly mediated by T cells (OR=1.08; 95% CI=0.87-1.34, P=.474). In addition, amino acid sequence alignment of common HLA-DRB1 subtypes demonstrated that HLA-DRB1*16:02 carries a unique motif of amino acid residues at position 67-74 which encodes the third hypervariable region. Taken together, the distinct pattern of disease association and the unique amino acid sequence of the third hypervariable region of the HLA-DRB1 provide some hints on how HLA-DRB1*16:02 is involved in the pathogenesis of autoimmune diseases.

Brain aging comprises many modes of structural and functional change with distinct genetic and biophysical associations.

Brain imaging can be used to study how individuals' brains are aging, compared against population norms. This can inform on aspects of brain health; for example, smoking and blood pressure can be seen to accelerate brain aging. Typically, a single 'brain age' is estimated per subject, whereas here we identified 62 modes of subject variability, from 21,407 subjects' multimodal brain imaging data in UK Biobank. The modes represent different aspects of brain aging, showing distinct patterns of functional and structural brain change, and distinct patterns of association with genetics, lifestyle, cognition, physical measures and disease. While conventional brain-age modelling found no genetic associations, 34 modes had genetic associations. We suggest that it is important not to treat brain aging as a single homogeneous process, and that modelling of distinct patterns of structural and functional change will reveal more biologically meaningful markers of brain aging in health and disease.

Are mixed meat and vegetable protein products good alternatives for reducing meat consumption? A case study with burgers

The principal motivations for the worldwide trend towards reducing meat consumption are health, the environment and animal welfare. The present study investigated the willingness of omnivores to introduce mixed (beef-vegetable protein) and 100% vegetable protein products into their diet. The participants (n = 251) were young adult omnivores who consumed meat at least once a week. The stimuli were images of six different products representing two beef burgers, two mixed-protein burgers (50% beef and 50% seitan or soy) and two 100% vegetable protein burgers (seitan and soy). The participants were asked to write down spontaneous associations with each product (Word Association technique) and score their expected liking and purchase intention for them. In addition, they completed a questionnaire (36 statements) to evaluate their attitude towards meat reduction, considering six aspects: diet, habits, ethics, hedonism, health, and the environment. According to their response to these statements, they were classified into three attitude groups: anti- (ANTI, n = 106), intermediate- (INTERM, n = 89), and pro- (PRO, n = 56) meat reduction. All the participants expected to like the 100% beef burger most, the PRO group expected to like all six products to a similar degree and the ANTI group expected to like the mixed product significantly more than the 100% vegetable product, indicating that the introduction of mixed proteins could be a small first step towards meat reduction for those most attached to meat. The associations elicited by the different burgers were mostly the same but were mentioned with different frequencies, which also depended on the attitude group. These distinctive association patterns showed clear connections to the motives underlying each group's attitude towards meat reduction. It may be concluded that mixed products would be a reliable although timid option for consumers who are attached to meat to reduce their meat intake, while any of the products containing vegetable proteins would be an option for consumers who are more favourable towards meat reduction.

Treatment Adherence Perception Questionnaire: Assessing patient perceptions regarding their adherence to medical treatment plans.

The Treatment Adherence Perception Questionnaire (TAPQ) is a new, brief self-report instrument for assessing patient perceptions and attitudes regarding their own adherence to medical treatment plans. It includes 3 distinct scales: Perceived Behavior, Perceived Benefit, and Perceived Burden. In contrast with existing measures, the TAPQ was expected to have a clear factor structure; have good discrimination; and assess distinct types of perception, each of which has different patterns of association with interpersonal, personality, motivational, and emotional variables. Foundational work on the TAPQ (with 891 patients) included 5 quantitative scale development studies and 1 qualitative study. The present report focuses on results from a final validation study using 450 patients recruited via market research panels to complete online questionnaires. This study included a general medical sample and a sample of people with either diabetes or hypertension. A confirmatory factor analysis specifying strict measurement invariance across these groups produced a good fit. Analysis with item-response theory suggested that the scales on the TAPQ provide good discrimination across a wide range of experience levels. The 3 scales on the TAPQ each had distinct patterns of association with criterion variables regarding conscientiousness, health behavior, motivation, affect, type of diagnosis, and interpersonal communication with health-care professionals. These effects could not be explained by another existing measure of adherence or by a measure of response bias. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Fine-Mapping of SNCA in Rapid Eye Movement Sleep Behavior Disorder and Overt Synucleinopathies.

Rapid eye movement sleep behavior disorder (RBD) is a prodromal synucleinopathy, as >80% will eventually convert to overt synucleinopathy. We performed an in-depth analysis of the SNCA locus to identify RBD-specific risk variants. Full sequencing and genotyping of SNCA was performed in isolated/idiopathic RBD (iRBD, n = 1,076), Parkinson disease (PD, n = 1,013), dementia with Lewy bodies (DLB, n = 415), and control subjects (n = 6,155). The iRBD cases were diagnosed with RBD prior to neurodegeneration, although some have since converted. A replication cohort from 23andMe of PD patients with probable RBD (pRBD) was also analyzed (n = 1,782 cases; n = 131,250 controls). Adjusted logistic regression models and meta-analyses were performed. Effects on conversion rate were analyzed in 432 RBD patients with available data using Kaplan-Meier survival analysis. A 5'-region SNCA variant (rs10005233) was associated with iRBD (odds ratio [OR] = 1.43, p = 1.1E-08), which was replicated in pRBD. This variant is in linkage disequilibrium (LD) with other 5' risk variants across the different synucleinopathies. An independent iRBD-specific suggestive association (rs11732740) was detected at the 3' of SNCA (OR = 1.32, p = 4.7E-04, not statistically significant after Bonferroni correction). Homozygous carriers of both iRBD-specific SNPs were at highly increased risk for iRBD (OR = 5.74, p = 2E-06). The known top PD-associated variant (3' variant rs356182) had an opposite direction of effect in iRBD compared to PD. There is a distinct pattern of association at the SNCA locus in RBD as compared to PD, with an opposite direction of effect at the 3' of SNCA. Several 5' SNCA variants are associated with iRBD and with pRBD in overt synucleinopathies. ANN NEUROL 2020;87:584-598.

Association Between Gait, Cognition, and Gray Matter Volumes in Mild Cognitive Impairment and Healthy Controls.

To assess the correlation between cognitive functioning and 3 gait parameters (gait speed, cadence, and stride length) in persons with mild cognitive impairment (MCI) and cognitively healthy controls and investigate linear correlations between gait and gray matter volumes. Participants were recruited at IRCCS San Camillo Hospital, Venice, Italy (MCI=43; age-matched controls=43). Participants underwent comprehensive neuropsychological assessment. Gait speed, cadence, and stride length, were assessed with the BTS FREEMG 300 device. Three-dimensional (3D) T1-weighted MR images were acquired using a 1.5 T Philips Achieva MRI system with a Turbo Field Echo sequence. In MCI there was a positive correlation between gait speed and memory tests (P<0.05). In controls all 3 gait parameters correlated with executive functioning (P<0.01). Temporal and limbic areas (ie, superior temporal gyrus, thalamus and parahippocampal gyrus) were associated with gait parameters in MCI whereas in controls the associations were with frontal areas (ie, middle, inferior, and superior frontal gyrus) and in the cerebellum (anterior and posterior lobe). Our results highlight a distinct pattern of association between gray matter volume and gait parameters in MCI patients and controls (temporal areas in MCI and frontal areas in healthy elderly), suggesting a relationship between dementia-related pathology and gait dysfunction.

Trust, happiness and mortality: Findings from a prospective US population-based survey.

There has been an abundance of research discussing the health implications of generalised trust and happiness over the past two decades. Both attitudes have been touted as independent predictors of morbidity and mortality, with strikingly similar trajectories and biological pathways being hypothesised. To date, however, neither trust nor happiness have been considered simultaneously as predictors of mortality. This study, therefore, aims to investigate the effects of generalised trust and happiness on all-cause and cause-specific mortality. The distinction between different causes of death (i.e. cardiovascular vs. cancer-related mortality) allowed us to assess if psychosocial mechanisms could account for associations between generalised trust, happiness and mortality. The study sample was derived from US General Social Survey data from 1978 to 2010 (response rates ranged from 70 to 82 per cent), and combined with death records from the National Death Index. The analytical sample comprised 23,933 individuals with 5382 validated deaths from all-cause mortality by 2014. Analyses were performed with Cox regression models and competing-risk models. In final models, generalised trust, but not happiness, showed robust and independent associations with all-cause mortality. Regarding cause-specific mortality, trust only showed a significant relationship with cardiovascular mortality. The distinct patterns of association between generalised trust and all-cause/cause-specific mortality suggest that their relationship could be being driven by cardiovascular mortality. In turn, this supports the feasibility of psychosocial pathways as possible biological mechanisms from distrust to mortality.

Gender Role Strain and the Precarious Manhood of Sexual Minority Kenyan Men.

Examining the impact of precarious manhood on the mental health of sexual minority men living in Kenya, we hypothesized that (a) men who have sex with men exclusively (MSME) and men who have sex with men and women (MSMW) would display differential patterns of conformity to norms of masculinity; (b) these differences would result in distinct patterns of association between masculine conformity and symptoms of psychological distress for MSME and MSMW; and (c) conformity to norms of masculinity would be bidirectionally associated with symptoms of depression and anxiety. Using data collected from 391 young men who participated in a community-based, cross-sectional study of HIV-related risk and resilience among young sexual minority men in western Kenya, we ran a multivariate analysis of variance (MANOVA) to assess differences in conformity to masculine norms and four hierarchical linear regression models to examine the associations between conformity to masculine norms and symptoms of anxiety and depression for MSME and MSMW. MANOVA results revealed no significant differences between MSME and MSMW in overall conformity to masculinity, although MSMW were significantly more likely to conform to the masculine norm of power over women. Regression results revealed that conformity to norms of masculinity was bidirectionally associated with psychological distress and that these patterns of association were distinct for MSME and MSMW. The discussion explores possible explanations for revealed differences between MSME and MSMW using existing research. Clinical implications, limitations, and opportunities for future research are also discussed.

Executive functions and drawing in young children with cerebral palsy: Comparisons with typical development

ABSTRACT There is evidence that school-aged children with cerebral palsy (CP) may present deficits in executive functions (EF) greater than would be expected considering their intellectual ability. However, no studies have focused on characterizing EF in this group at an earlier critical period – the preschool years. Furthermore, and given evidence from typically-developing (TD) children, deficits in EF are associated with potential detrimental effects on social and educational development – which can include drawing. Our aim was to compare preschool children with CP, matched in chronological age and intellectual ability with a group of TD children, regarding their executive functioning and drawing abilities. In addition, we examined the relationships between these variables in each of the groups. Twenty-eight children were evaluated in executive functions and drawing tasks. Differences were found in some aspects of cognitive flexibility and inhibitory control, but not in working memory. Additionally, the quality of the drawings was significantly poorer in the CP group. In the TD group, there was an association between greater inhibitory control (but not cognitive flexibility or working memory) and drawing quality. In the CP group, although non-significant, medium-sized correlations were observed between drawing and several aspects of executive functioning. Overall, our results suggest more similarities than differences in the executive functioning of children with CP (and preserved cognitive ability) and TD children. However, there were still important between-group differences in their drawing abilities. There was also a distinct pattern of associations between drawing and executive functions in the clinical group.

Ecological Validity of Expressed Emotion in Early Psychosis.

Expressed emotion (EE) is an aspect of the family environment that influences the course of multiple forms of psychopathology. However, there is limited research about how EE dimensions [i.e., criticism and emotional over-involvement (EOI)] are expressed in real-world settings. The present study used experience sampling methodology to investigate: 1) the criterion and construct validity of daily-life, momentary measures of criticism and EOI, and 2) the construct and ecological validity of psychometric EE-dimensions as assessed with the self-report Family Questionnaire (FQ). A total sample of 55 relatives (34 relatives of at-risk mental state patients and 21 of first-episode psychosis patients) were prompted randomly six times daily for 1-week to assess their current emotional experiences and cognitive appraisals. Relatives also completed the FQ. Momentary criticism and EOI were significantly associated with the two FQ-EE dimensions respectively, supporting the criterion validity of real-world assessed EE dimensions. As hypothesized, momentary and FQ-EE dimensions were associated with decreased positive affect, as well as with appraisals of less effective coping in daily life. Only momentary EE dimensions were associated with increased momentary negative affect. Partly in contrast with our hypotheses, momentary criticism and FQ-criticism were more consistently related to situational stress and burden than momentary EOI and FQ-EOI. Finally, neither momentary nor FQ-EE dimensions showed distinct patterns of associations with illness attributions. Findings partly support the construct validity of momentary criticism and EOI as well as the construct and ecological validity of the FQ as a sensitive measure of EE dimensions.

Grit

Abstract. The Grit scale is a popular measure of achievement-striving behavior. Consisting of two subscales, Consistency of Interests (CI) and Perseverance of Effort (PE), this scale has been repeatedly demonstrated to have high reliability and validity. At the same time, an increasing number of studies explicitly report a low correlation between the subscales and distinct patterns of associations with external measures that each subscale forms. We explored whether there is psychometric evidence that a substantive single grit construct underlies the scale. To answer this question, we investigated the scale structure in a more robust framework than the classical test theory and factor analyses could previously provide. The Russian version of the Grit scale was developed and implemented on a representative sample of high school students ( n = 2,269), and different models of item response theory (IRT), both unidimensional and multidimensional, were compared to find the best fitting model. The results confirmed that the subscales reflect related but independent constructs rather than the whole grit construct. The psychometric properties of the subscales were analyzed with the two-dimensional Partial Credit Model. Both subscales of the Russian version of the Grit scale are unidimensional, have good psychometric properties, and can be used to estimate respondents’ ability.

Abstract 620: Evaluating multiple tumor markers in a novel analysis of reproductive factors and breast cancer risk

Abstract Background: Reproductive factors are reported to be differentially associated with risk of breast cancer (BC) subtypes; however, subtype defining markers are highly correlated and clarifying which markers are sources of heterogeneity is challenging. We aimed to define the association of parity, age at first full-term pregnancy (AFFTP), and breastfeeding duration (BFD) with BC subtypes defined by estrogen receptor (ER), progesterone receptor (PR), the human epidermal growth factor receptor 2 (HER2), and grade, and to identify which tumor markers are heterogeneity sources. Methods: We included 56,545 cases and 65,332 controls from 33 population-based studies in the Breast Cancer Association Consortium. A standard polytomous logistic regression with parity (nulliparous (ref), 1, 2, 3, ≥4), AFFTP (&amp;lt;20 years (ref), 20-&amp;lt;25, 25-&amp;lt;30, ≥30), BFD (0 months (ref), &amp;gt;0-6, &amp;gt;6-12, &amp;gt;12-24, &amp;gt;24), age and study was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) with BC subtypes. Subtypes were defined by in situ and invasive intrinsic-like subtypes: luminal A (HR+, HER2-, grade 1&amp;2), luminal B-HER2- (HR+, HER2-, grade 3), luminal B-HER2+ (HR+, HER2+), HER2-enriched (HR-, HER2+) and triple-negative (TN; HR-, HER2-). We used a two-stage polytomous logistic regression to evaluate heterogeneity sources among ER, PR, HER2, grade, and TN specific associations, adjusting for each other and accounting for missing tumor marker data. Results: Luminal A and TN risk patterns were most distinct. Luminal A risk was inversely associated with parity (OR (95%CI): 0.81 (0.73-0.91), 0.71 (0.64-0.79), 0.64 (0.58-0.72), and 0.53 (0.47-0.59), for 1, 2, 3, ≥4 livebirths, respectively), positively associated with later AFTTP (1.00 (0.93-1.08), 1.14 (1.05-1.23), and 1.36 (1.25-1.49) for 20-&amp;lt;25, 25-&amp;lt;30, ≥30 years, respectively) in parous women, but not associated with BFD. In contrast, parous women had a higher TN risk attenuating with more livebirths: 1.38 (1.15-1.65), 1.26 (1.06-1.49), 1.16 (0.97-1.38), and 1.02 (0.84-1.22) for 1, 2, 3, ≥4 livebirths, respectively. TN risk was also inversely associated with late AFFTP (0.92 (0.82-1.03), 0.86 (0.76-0.98), 0.81 (0.69-0.94) for 20-&amp;lt;25, 25-&amp;lt;30, ≥30 years, respectively) as well as with longer BFD (0.93 (0.83-1.04), 0.76 (0.66-0.88), 0.8 (0.68-0.93), and 0.79 (0.64-0.96) for &amp;gt;0-6, &amp;gt;6-12, &amp;gt;12-24, &amp;gt;24 months, respectively). Risk patterns for the other intrinsic-like subtypes and in situ were most like luminal A. Notable sources of heterogeneity for parity and BFD was TN vs non-TN (Phet=0.003 and Phet=0.005, respectively) and for AFFTP were ER (Phet&amp;lt;0.001) and HER2 (Phet=0.003), while grade was not an important source of heterogeneity after accounting for ER, PR, and HER2. Conclusion: We found strong evidence of strong heterogeneity among parity, AFFTP, and BFD with BC subtypes with distinct patterns of associations for TN vs luminal A and other tumor subtypes. Citation Format: Audrey Y. Jung, Thomas U. Ahearn, Sabine Behrens, Haoyu Zhang, Pooja Middha, Marjanka Schmidt, Nilanjan Chatterjee, Montserrat Garcia-Closas, Jenny Chang-Claude, on behalf of the Breast Cancer Association Consortium. Evaluating multiple tumor markers in a novel analysis of reproductive factors and breast cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 620.

Identification and Replication of Six Loci Associated With Gallstone Disease.

Gallstone disease is a common complex disease that confers a substantial economic burden on society. The genetic underpinnings of gallstone disease remain incompletely understood. We aimed to identify genetic associations with gallstone disease using publicly available data from the UK Biobank and two large Danish cohorts. We extracted genetic associations with gallstone disease from the Global Biobank Engine (GBE), an online browser of genome-wide associations in UK Biobank participants (14,940 cases and 322,268 controls). Significant associations (P < 5 × 10-8 ) were retested in two Copenhagen cohorts (comprising 1,522 cases and 18,266 controls). In the Copenhagen cohorts, we also tested whether a genetic risk score was associated with gallstone disease and whether individual gallstone loci were associated with plasma levels of lipids, lipoproteins, and liver enzymes. We identified 19 loci to be associated with gallstone disease in the GBE. Of these, 12 were replicated in the Copenhagen cohorts, including six previously unknown loci (in hepatocyte nuclear factor 4 alpha [HNF4A], fucosyltransferase 2, serpin family A member 1 [SERPINA1], jumonji domain containing 1C, AC074212.3, and solute carrier family 10A member 2 [SLC10A2]) and six known loci (in adenosine triphosphate binding cassette subfamily G member 8 [ABCG8], sulfotransferase family 2A member 1, cytochrome P450 7A1, transmembrane 4 L six family member 4, ABCB4, and tetratricopeptide repeat domain 39B). Five of the gallstone associations are protein-altering variants, and three (HNF4A p.Thr139Ile, SERPINA1 p.Glu366Lys, and SLC10A2 p.Pro290Ser) conferred per-allele odds ratios for gallstone disease of 1.30-1.36. Individuals with a genetic risk score >2.5 (prevalence 1%) had a 5-fold increased risk of gallstones compared to those with a score <1.0 (11%). Of the 19 lithogenic loci, 11 and ten exhibited distinct patterns of association with plasma levels of lipids and liver enzymes, respectively. Conclusion: We identified six susceptibility loci for gallstone disease.

Medical Consultation Experience Questionnaire: Assessing perceived alliance and experienced confusion during medical consultations.

The Medical Consultation Experience Questionnaire (MCEQ) is a new, brief self-report instrument that can be used with both adult patients and parents of child patients to assess two dimensions of people's experiences interacting with medical practitioners: Alliance and Confusion. In contrast with existing measures, the MCEQ was expected to provide good discrimination across a full range of experience levels and to assess two distinct dimensions of experience with good factor validity. It was developed in a series of 7 preliminary studies (with 758 participants) and tested in 3 subsequent validation studies, which are the focus of the present report. Study 1 was an Internet sample of 199 parents of child patients, Study 2 was a hospital sample of 173 parents of child surgery patients, and Study 3 was an Internet sample of 204 adult patients. A confirmatory factor analysis specifying strict measurement invariance across the 3 groups produced a good fit. An item response theory analysis suggested that scales on the MCEQ provide good discrimination across a wide range of experience levels. The new scales measuring Alliance and Confusion each had a distinct pattern of convergent validity associations with criterion variables regarding alternate measures of consultation experience, treatment context, and patient-reported perception, behavior, and affect. Results support the validity of the MCEQ and suggest that Alliance and Confusion are two distinct and informative dimensions of medical consultation experience. (PsycINFO Database Record (c) 2018 APA, all rights reserved).