Number Of Relatives Research Articles

Village networks and entrepreneurial farming in Uganda

The transition from semi-subsistence farming to more entrepreneurial farming by the adoption of new crops or improved seeds is important for poverty reduction in developing countries. In rural societies, farmers’ propensity to experiment with new technologies is influenced by their access to information and support, provided by networks of friends and relatives. Considering that the same connection can share both information and support, we study the separate effects as well as the interaction of both network functions. Using two waves of data from a sample of Ugandan farmers, we find that the propensity to adopt new crops or improved seeds increases with the number of friends or relatives who adopted new crops or improved seeds before. The effect on the adoption of new crops is stronger if the same friends or relatives also provide support in the form of gifts or loans. At the same time, we find a positive effect of support that is conditional on friends or relatives having adopted new crops before.

Cascade Genetic Risk Education and Testing in Families With Hereditary Cancer Syndromes: A Pilot Study.

Cascade genetic risk evaluation in families with hereditary cancer can reduce the burden of disease but the rate of germline genetic testing in relatives of patients at risk is low. We identified all 277 women diagnosed with breast cancer in Georgia in 2017 who linked to a clinically actionable germline pathogenic variant through a Surveillance, Epidemiology, and End Results registry-variant linkage initiative. We surveyed them, and then invited eligible respondents to an online platform hosted by a navigator that offered cancer genetic risk education and germline genetic testing to untested relatives. We randomly assigned patient-family clusters at the time of the patient enrollment offer to free versus $50 (USD) test cost. Patients invited relatives to join the study through personalized e-mail. Enrolled relatives received online cancer genetic education and the opportunity to order clinical germline genetic testing through the platform. The primary outcome was the number of relatives who ordered genetic testing. One hundred twenty-five of 277 patients completed surveys (45.2%). Most respondents were eligible for the trial offer (113 of 125; 90.4%). In the free testing arm, 20 of 56 eligible patients participated (35.7% of eligible respondents) and they invited 28 relatives: 12 relatives enrolled and 10 ordered testing. In the $50 (USD) arm, 16 of 57 eligible patients participated (28.1%) and they invited 38 relatives: 18 relatives enrolled and 17 ordered testing. Cascade genetic testing in families with hereditary cancer syndromes accrued through a population-based cancer registry can be achieved through an online platform that offers genetic risk education and low-cost testing to relatives. A modest charge did not appear to influence the percentage of participating patients, numbers of participating relatives, and numbers of relatives who received genetic testing.

On the Prospects of In Situ Conservation of Medicinal- and Aromatic-Plant Genetic Resources at Ancient-Hillfort Sites: A Case Study from Lithuania.

Twenty-three ancient-hillfort sites were investigated to evaluate the potential for the in situ conservation of medicinal- and aromatic-plant populations. An evaluation of the site's suitability was carried out by employing three major groups of criteria: species-specific, site-specific, and threat assessment. The species-specific criteria included the total species number, target species number, the cover-abundance of the target species estimated by mean Braun-Blanquet score, and, as an additional criterion, the number and cover-abundance of crop wild relatives. The site-specific criteria included site evaluation with respect to climatic region, the area size of a site, the habitat type, and the site's protection status. The threat assessment was focused on anthropogenic activities, such as recreational, agricultural, and others. The total number of vascular plant species inventoried was 264, including 82 species of medicinal and aromatic plants (MAP). There was a strong and highly significant correlation between the total and the MAP species numbers (rs = 0.77, p < 0.001), and the two most species-rich sites, Žuklijai and Pamiškė, contained the highest total and MAP species numbers. The investigated hillfort sites covered the populations of 49 species, or about 33% of the priority species list, with 5 or more populations. The most frequent species, Hypericum perforatum, occurred at 21 sites. The twenty-three hillfort sites represent three of the four climatic regions and six of the ten climatic subregions of Lithuania. Although these hillfort sites are quite small (1.24 ± 0.75 ha on average, without buffer zone), they are scattered across the country and are state-protected as archaeological objects, which makes them suitable for the in situ conservation of MAP genetic resources. In addition, seven hillfort sites (30.4% of the investigated ones) belong to the European network of special areas of conservation of habitats (Natura 2000), thus increasing their international importance. The threat assessment showed that anthropogenic activities (recreational, agricultural, etc.) are among the major factors affecting target-species populations.

The impact of Covid-19 pandemic on Italian surgeons: a national survey

Background: During the Covid-19 pandemic many surgeons found themselves in unfamiliar settings, trying to combine the increased workload with family duties. We hypothesized that female surgeons might have been subjected to higher stress levels and work-life tensions compared to their male counterpart. The aim of this study was to assess the psychological impact of the pandemic on Italian surgeons and investigate possible gender differences. Materials and Methods: A 47-items-questionnaire was distributed from February 7th to March 31st 2022 among Italian surgeons. Stress levels, mental health status, work-life tensions, gender equity, personal and professional satisfaction were explored. Results: A total of 869 responders were included in the analysis. Most responders were female (64%) with a median age significantly lower than the male counterparts (36 versus 45, p<0.001). The academic position was most often held by male surgeons (17%), while most of women were non-academic faculty (66%) or surgeon in-training (28%) (p<0.001). Even if male surgeons reported a higher number of dependent children and elder relatives (p<0.05), female surgeons perceived an increased burden related to their care-giving role (p=0.042). Being younger, in training and without an academic position was associated with higher stress levels, mostly occurring among women surgeons (p<0.05). Conclusions: Female surgeons, during the second peak of Covid-19 pandemic, experienced higher stress levels compared to men. Designed interventions are needed to support the female surgical workforce also in a post-pandemic setting.

Social support across eating disorder diagnostic groups: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III)

IntroductionPrevious studies have suggested the positive influence of social support on the treatment and recovery of eating disorders (EDs). Yet, more research is needed on how objective and subjective social support differ between ED diagnostic groups using nationally representative data. Therefore, the current secondary data analysis examined associations between EDs and objective and subjective social support using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) study. MethodsParticipants completed measures of lifetime and past year diagnostic criteria for anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) and items assessing objective social support (i.e., number of close friends and close relatives) and subjective social support (i.e., perceptions of availability of support). ResultsCompared to those without EDs, those with AN, BN, and BED had poorer subjective social support—or lower perceptions of social support. However, there were fewer differences regarding objective social support. Individuals with BN reported a lower number of close relatives compared to those without EDs and those with AN, but there were no differences in the number of close friends between ED groups. Those who experienced remission from EDs had higher perceptions of social support compared to those with past year EDs. DiscussionThe findings show deficits in subjective social support across EDs but only lower objective social support in BN. This highlights the clinical utility of increasing perceptions of social support across EDs. The findings also show the importance of perceived social support in recovery from EDs.

Family History of Prostate Cancer and Survival Outcomes in the UK Genetic Prostate Cancer Study

BackgroundA family history (FH) of prostate cancer (PrCa) is associated with an increased likelihood of PrCa diagnosis. Conflicting evidence exists regarding familial PrCa and clinical outcomes among PrCa patients, including all-cause mortality/overall survival (OS), PrCa-specific survival (PCSS), aggressive histology, and stage at diagnosis. ObjectiveTo determine how the number, degree, and age of a PrCa patient’s affected relatives are associated with OS and PCSS of those already diagnosed with PrCa. Design, setting, and participantsThe UK Genetic Prostate Cancer Study is a longitudinal, multi-institutional, observational study collecting baseline and follow-up clinical data since 1992. We examined OS and PCSS in 16340 men by degree and number of relatives with prostate and genetically related cancers (breast, ovarian, and colorectal). Outcome measurements and statistical analysisThe primary outcome was all-cause mortality among PrCa patients. The risk of death with respect to FH was assessed by calculating hazard ratios from Cox proportional hazard regression models, adjusting for relevant factors. Results and limitationsA stronger FH was inversely associated with the risk of all-cause and PrCa-specific mortality. This association was greater in those with an increasing number (p-trend < 0.001) and increasing closeness (p-trend < 0.001) of the diagnosed relatives. Patients with at least one first-degree relative were at a lower risk of all-cause mortality than those with no FH (hazard ratio = 0.82 [95% confidence interval 0.75–0.89]). The population is largely of European ancestry, and this may cause an issue with representation and generalisation. Data are missing on epidemiological risk factors for death such as smoking and on comorbidities. Recall of family members' diagnoses may affect the classification of FH in unconfirmed cases. ConclusionsBased on the investigation of the type and timing of relatives’ cancers, it is likely that reductions in mortality are due almost completely to a greater awareness of the disease. This study provides information for clinicians guiding patients and their relatives based on their familial risk. It shows the importance of screening and awareness programmes, which are likely to improve survival among men with an FH. Patient summaryWe were interested in how a family history of prostate cancer affects survival in prostate cancer patients. We studied 16340 patients, categorised them according to the strength of their family history, and found that the stronger their family history, the better they did in terms of overall survival. We looked at the type and timing of patients’ diagnoses compared with those of their relatives and found that this effect is likely to be explained by awareness, which indicates the importance of screening and awareness programmes.

Genome of Paspalum vaginatum and the role of trehalose mediated autophagy in increasing maize biomass

A number of crop wild relatives can tolerate extreme stress to a degree outside the range observed in their domesticated relatives. However, it is unclear whether or how the molecular mechanisms employed by these species can be translated to domesticated crops. Paspalum (Paspalum vaginatum) is a self-incompatible and multiply stress-tolerant wild relative of maize and sorghum. Here, we describe the sequencing and pseudomolecule level assembly of a vegetatively propagated accession of P. vaginatum. Phylogenetic analysis based on 6,151 single-copy syntenic orthologues conserved in 6 related grass species places paspalum as an outgroup of the maize-sorghum clade. In parallel metabolic experiments, paspalum, but neither maize nor sorghum, exhibits a significant increase in trehalose when grown under nutrient-deficit conditions. Inducing trehalose accumulation in maize, imitating the metabolic phenotype of paspalum, results in autophagy dependent increases in biomass accumulation.

Sex ratio and relatedness in the Griffon vulture (Gyps fulvus) population of Serbia.

Once a widespread species across the region of Southeast Europe, the Griffon vulture is now confined to small and isolated populations across the Balkan Peninsula. The population from Serbia represents its biggest and most viable population that can serve as an important reservoir of genetic diversity from which the birds can be used for the region's reintroduction programmes. The available genetic data for this valuable population are scarce and as a protected species that belongs to the highly endangered vulture group, it needs to be well described so that it can be properly managed and used as a restocking population. Considering the serious recent bottleneck event that the Griffon vulture population from Serbia experienced we estimated the overall relatedness among the birds from this population. Sex ratio, another important parameter that shows the vitality and strength of the population was evaluated as well. During the annual monitoring that was performed in the period from 2013-2021, we collected blood samples from individual birds that were marked in the nests. In total, 169 samples were collected and each was used for molecular sexing while 58 presumably unrelated birds from different nests were used for inbreeding and relatedness analyses. The relatedness was estimated using both biparentally (10 microsatellite loci) and uniparentally (Cytb and D-loop I of mitochondrial DNA) inherited markers. The level of inbreeding was relatively high and on average it was 8.3% while the mean number of relatives for each bird was close to three. The sex ratio was close to 1:1 and for the analysed period of 9 years, it didn't demonstrate a statistically significant deviation from the expected ratio of 1:1, suggesting that this is a stable and healthy population. Our data suggest that, even though a relatively high level of inbreeding can be detected among the individual birds, the Griffon vulture population from Serbia can be used as a source population for restocking and reintroduction programmes in the region. These data combined with previously observed genetic differentiation between the populations from the Iberian and Balkan Peninsulas suggest that the introduction of foreign birds should be avoided and that local birds should be used instead.

Prediction of breast cancer risk among women of the Mariana Islands: the BRISK retrospective case–control study

ObjectivesTo develop a breast cancer risk prediction model for Chamorro and Filipino women of the Mariana Islands and compare its performance to that of the Breast Cancer Risk Assessment Tool...

LBODP042 Lean Type Two Diabetes: Risk Factors And Outcomes Compared To Typical Presenting Type Two Diabetes

Abstract Background Lean type 2 diabetes (LT2D) is a prevalent manifestation of type 2 diabetes (T2D). However, it has been an understudied subgroup of T2D. Aim To compare characteristics and outcomes of patients with LT2D with that of typical presenting T2D. Methods A retrospective review of electronic health records was performed between 2013 and 2020. The study included 254 patients with LT2D and 429 patients with typical T2D located in the South Bay of Southern California. LT2D and typical T2D were defined as having a body mass index (BMI) of 18.5 to 24.9 kg/m2 and 25 to 29.9 kg/m2, respectively. Patient-level variables included age, sex, race, ethnicity, educational level, area of deprivation index (ADI), microvascular and macrovascular comorbidities, alcohol use, tobacco use, and diabetes family history. Labs and vital signs obtained included hemoglobin A1c (HbA1c), glomerular filtration rate (GFR), creatinine, albumin, and blood pressure. Student's t-test and Chi-square tests/Fisher's exact tests were performed with SAS version 9.4 to compare differences between the LT2D and typical T2D groups. Results Between the diabetes subgroups, there were several statistically significant differences identified. The LT2D population was older, with a mean age of 78.2 years compared with 74.6 years in the typical T2D (p &amp;lt; 0. 001). The LT2D group had a higher percentage of Asians at 40.6% and fewer Caucasians at 35. 0%, while the typical T2D consisted of 22.4% Asians and 46.4% Caucasians (p=0. 0007). Diastolic blood pressure was lower in the LT2D group at 71.6 compared to 73.9 in the typical T2D group (p=0. 0053). There were no differences in sex, HbA1c, systolic blood pressure, hypertension, dyslipidemia, chronic kidney disease, cardiovascular events, peripheral vascular disease, combined microvascular complications, combined macrovascular complications, substance use, education level, ADI, GFR, creatinine, albumin, or number of relatives with diabetes. Conclusion We identified several key differences between the LT2D and typical T2D cohort, including age, race, and diastolic blood pressure. Further investigation and large studies are warranted to explore the risk factors and long term outcomes of patients presenting with LT2D. Knowing what the key differences are may help identify appropriate diabetes medical treatments and lifestyle interventions for this particular target population rather than using T2D treatments that are used for a more general population of patients. Presentation: No date and time listed

Reduced injury risk links sociality to survival in a group-living primate

Sociality has been linked to a longer lifespan in many mammals, including humans. Yet, how sociality results in survival benefits remains unclear. Using 10 years of data and over 1,000 recorded injuries in rhesus macaques (Macaca mulatta), we tested two injury-related mechanisms by which social status and affiliative partners might influence survival. Injuries increased individual risk of death by 3-fold in this dataset. We found that sociality can affect individuals' survival by reducing their risk of injury but had no effect on the probability of injured individuals dying. Both males and females of high social status (measured as female matrilineal rank and male group tenure) and females with more affiliative partners (estimated using the number of female relatives) experienced fewer injuries and thus were less likely to die. Collectively, our results offer rare insights into one mechanism that can mediate the well-known benefits of sociality on an individual's fitness.

A pilot study to increase cascade genetic risk education and testing in families with hereditary cancer syndromes.

378 Background: There is great need to build and evaluate tools and strategies to improve cascade genetic risk evaluation in families at high risk for hereditary cancer. The Genetic Information and Family Testing (GIFT) Trial is a population-based intervention that will examine features of a virtual platform that provides genetic risk education (GRE) and low-cost genetic testing (GT) to relatives of 5000 adult patients diagnosed with cancer in 2018-19 in Georgia and California and who tested positive for a clinically actionable germline pathogenic variant (PV). We present findings of a pilot study that informed the GIFT Trial protocol and platform features. Methods: We surveyed 277 women diagnosed with breast cancer in 2017, reported to the Georgia SEER registry, and who tested positive for a clinically actionable PV in a cancer-associated gene. We then invited respondent patients to enroll in the intervention phase which provided online GRE, human pretest genetic navigator support, and an offer of low-cost GT through Color Health, Inc. to all untested 1st or 2nd degree relatives. Respondent patients were eligible for the intervention if they reported a PV on genetic testing and had at least one relative who had not received GT. Enrolled patients invited relatives through the platform by providing email addresses. Family clusters were block randomized to free vs $50 test costs at the time of the initial patient invitation. Results: 125 of 277 patients (45.2%) returned surveys: median age was 51 and 22% were African American. The most common PV reported by patients were BRCA2 (25.7%), BRCA1 (19.5%), CHEK2 (20.4%), ATM (8.8%) and PALB2 (7.1%). Disclosure of genetic test results to relatives was quite high: 83.6% of patients reported that they discussed results with all their daughters vs 69.4% with sons; 78.1% discussed their results with all sisters vs 61.8% with all brothers. The median number of patient-reported untested relatives in a family was 9 (25th-75th percentile: 4-14). Most respondents were eligible for the trial offer (113 of 125, 90.4%). Overall, results were similar between the free test arm and $50 test arm: In the free testing arm, 20 patient participants invited 28 relatives; 12 relatives enrolled, and all 12 relatives ordered testing. In the $50 arm, 16 patient participants invited 38 relatives of whom 18 enrolled and all 18 ordered testing. For the 66 relatives invited by the patient participants: 47 (71.2%) were first degree (8 parents, 22 siblings, and 17 children) and about half of the relatives were men (47.0%). Conclusions: Breast cancer patients with PVs make substantial efforts to communicate with family members about genetic risk but most relatives do not receive GT. Our study findings suggest that a low-cost online navigator-supported intervention can directly engage relatives to increase cascade genetic risk education and testing with little difference in uptake by test cost arms.

Ultrasonography screening in children and adolescents who have one parent with familial non-medullary thyroid carcinoma.

To evaluate ultrasonography (US) screening for thyroid cancer in children and adolescents who have one parent with familial non-medullary thyroid carcinoma (FNMTC) unrelated to known genetic syndromes. In this prospective study, we selected 72 children and adolescents (age ≤18 years) without a palpable thyroid nodule or history of radiation exposure, but who have one parent diagnosed with FNMTC (i.e. at least one other affected first-degree relative). The children and adolescents were evaluated by US during initial assessment and after 5 years. Initial US revealed pure cysts in five participants and nodules in seven, which were ≥5 mm in five. These patients were submitted to fine needle aspiration, which revealed benign cytology in four and a follicular lesion of undetermined significance in one. Fine needle aspiration was repeated in the last case and in one case with benign cytology but suspicious US. The second cytology was benign in both cases. After 5 years, another two participants with initially normal US had nodules <5 mm in the absence of suspicious findings. The frequency of lesions detected by US was not associated with participant sex or age, number of relatives with thyroid cancer (2 or 3), maternal or paternal origin of tumour, or age of the relatives at diagnosis. The present results suggest that US screening is not necessary in children or adolescents when one parent has a diagnosis of FNMTC (≥2 affected relatives).

Identification and characterization of candidate detoxification genes in Pharsalia antennata Gahan (Coleoptera: Cerambycidae).

The wood-boring beetles, including the majority of Cerambycidae, have developed the ability to metabolize a variety of toxic compounds derived from host plants and the surrounding environment. However, detoxification mechanisms underlying the evolutionary adaptation of a cerambycid beetle Pharsalia antennata to hosts and habitats are largely unexplored. Here, we characterized three key gene families in relation to detoxification (cytochrome P450 monooxygenases: P450s, carboxylesterases: COEs and glutathione-S-transferases: GSTs), by combinations of transcriptomics, gene identification, phylogenetics and expression profiles. Illumina sequencing generated 668,701,566 filtered reads in 12 tissues of P. antennata, summing to 100.28 gigabases data. From the transcriptome, 215 genes encoding 106 P450s, 77 COEs and 32 GSTs were identified, of which 107 relatives were differentially expressed genes. Of the identified 215 genes, a number of relatives showed the orthology to those in Anoplophora glabripennis, revealing 1:1 relationships in 94 phylogenetic clades. In the trees, P. antennata detoxification genes mainly clustered into one or two subfamilies, including 64 P450s in the CYP3 clan, 33 COEs in clade A, and 20 GSTs in Delta and Epsilon subclasses. Combining transcriptomic data and PCR approaches, the numbers of detoxification genes expressed in abdomens, antennae and legs were 188, 148 and 141, respectively. Notably, some genes exhibited significantly sex-biased levels in antennae or legs of both sexes. The findings provide valuable reference resources for further exploring xenobiotics metabolism and odorant detection in P. antennata.

Individual Variation in the Use of Acoustic Signals to Coordinate Group Movements among Tibetan Macaques (Macaca thibetana).

Simple SummaryVocal communication is widely used in most primate groups as one of the most effective ways to transmit information. However, the role of sound signals in group movements and their influencing factors are not well understood. In this study, we not only confirmed the recruitment function of vocalizations in group movements, but also found the effect of sex and social centrality on vocalizations. Social centrality indicates the degree of proximity relations between two individuals in a social network. Female Tibetan macaques and individuals with high social centrality were more likely to use vocalizations during collective movements. This study helps us understand the cooperative mechanisms of animal populations.To maintain group cohesion, social animals need to coordinate their actions during group movements. Several species use vocalizations to communicate with each other during coordination. However, the process of vocal communication and its influence in collective decision making is not clear. We studied a group of free-range Tibetan macaques (Macaca thibetana) at Huangshan, China, and recorded acoustic signals during their group movements. It was found that three kinds of sounds were used in their movements. Group movements with vocalizations recruited more participants than the movements without sound. Moreover, during group departures, individuals in the front emitted a higher frequency of vocalization than individuals in the rear. Sex and social centrality both had a significant influence on vocalizations. Social centrality indicates the degree of proximity relations between two individuals in a social network. Females and individuals with high social centrality emitted more sound in group movements. However, social rank and the number of relatives did not affect the emission of sound. These results suggest that the function of calls in collective movements relates to coordinating group movements. This study provides an insight into the association of acoustic communication with collective decision making.

Prevalence of BRCA1 and BRCA2 pathogenic variants in 8627 unselected patients with breast cancer: stratification of age at diagnosis, family history and molecular subtype.

Comprehensively analyzing the prevalence of BRCA1/2 germline pathogenic variants (PVs) in a large cohort of unselected Chinese patients with breast cancer has great clinical importance. Germline pathogenic variants in full-length BRCA1/2 genes were determined through next-generation sequencing and/or Sanger sequencing assays in 8627 unselected Chinese patients with breast cancer who were treated at the Breast Center of Peking University Cancer Hospital. The prevalence of BRCA1/2 PVs was further stratified by age at diagnosis, family history of cancer and molecular subtype. We found that the overall prevalence of BRCA1/2 PVs was 6.0% in the entire cohort, 2.4% in BRCA1 and 3.7% in BRCA2. The prevalence of BRCA1/2 PVs in patients with early-onset breast cancer (age at diagnosis ≤ 40years) was significantly higher than that in patients over the age of 40 (9.7% vs. 5.1%). The prevalence rates of BRCA1/2 PVs in patients with a family history of breast, ovarian, pancreatic, and prostate cancer were 19.5%, 39.0%, 11.1%, and 12.8%, respectively. Moreover, the number of relatives affected by breast cancer was associated with a higher prevalence of BRCA1/2 PVs. Molecular subtypes were associated with the prevalence of BRCA1/2 PVs. Patients with the triple-negative phenotype had the highest prevalence of BRCA1/2 PVs (13.3%) among the three molecular groups, followed by the HR + and HER2- group (5.9%), and the lowest was in the HER2 + group (2.5%). Our study provides the most comprehensive information to date on the prevalence of BRCA1/2 PVs in unselected Chinese patients with breast cancer.

Geographic Proximity of Family Members and Healthcare Utilization After Complex Surgical Procedures.

We sought to determine the relationship between a patient's proximal familial social support, defined as the geographic proximity of family members, and healthcare utilization after complex cardiovascular and oncologic procedures. Social support mechanisms are increasingly identified as modifiable risk factors for healthcare utilization. We performed a retrospective cohort study of 60,895 patients undergoing complex cardiovascular procedures or oncologic procedures. We defined healthcare utilization outcomes as 30-day all-cause readmission unplanned readmission, nonindex hospital readmission, index hospital length of stay, and home discharge disposition. For each patient, we aggregated the number of first-degree relatives (FDR) living within 30 miles of the patient's home address at the time of the surgical procedure into the following categories: 0 to 1, 2 to 3, 4 to 5, 6+ FDRs. We developed hierarchical multivariable regression models to determine the relationship between the number of FDR living within 30 miles of the patient and the healthcare utilization outcomes. Compared with patients with 0 to 1 FDRs, patients with 6+ FDRs living in close proximity had significantly lower rates of all-cause readmission (12.1% vs 13.5%, P <0.001), unplanned readmission (10.9% vs 12.0%, P =0.001), nonindex readmission (2.6% vs 3.2%, P =0.003); higher rates of home discharge (88.0% vs 85.3%, P <0.001); and shorter length of stay (7.3 vs 7.5 days, P =0.02). After multivariable adjustment, a larger number of FDRs living within 30 miles of the patient was significantly associated with a lower likelihood of all-cause readmission ( P <0.001 for trend), 30-day unplanned readmission ( P <0.001), nonindex readmission ( P <0.001); higher likelihood of home discharge ( P <0.001); and shorter index length of stay ( P <0.001). The geographic proximity of family members is significantly associated with decreased healthcare utilization after complex cardiovascular and oncologic surgical procedures.

An Update on the General Features of Breast Cancer in Male Patients-A Literature Review.

Male breast cancers are uncommon, as men account for less than 1 percent of all breast carcinomas. Among the predisposing risk factors for male breast cancer, the following appear to be significant: (a) breast/chest radiation exposure, (b) estrogen use, diseases associated with hyper-estrogenism, such as cirrhosis or Klinefelter syndrome, and (c) family health history. Furthermore, there are clear familial tendencies, with a higher incidence among men who have a large number of female relatives with breast cancer and (d) major inheritance susceptibility. Moreover, in families with BRCA mutations, there is an increased risk of male breast cancer, although the risk appears to be greater with inherited BRCA2 mutations than with inherited BRCA1 mutations. Due to diagnostic delays, male breast cancer is more likely to present at an advanced stage. A core biopsy or a fine needle aspiration must be performed to confirm suspicious findings. Infiltrating ductal cancer is the most prevalent form of male breast cancer, while invasive lobular carcinoma is extremely uncommon. Male breast cancer is almost always positive for hormone receptors. A worse prognosis is associated with a more advanced stage at diagnosis for men with breast cancer. Randomized controlled trials which recruit both female and male patients should be developed in order to gain more consistent data on the optimal clinical approach.

Exploring Clinical Risk Factors for Breast Cancer Among American Indian Women.

ObjectiveVery little is known about the breast cancer risk profile among American Indian women. Previous research shows that the proportion of American Indian/Alaska Native women with baseline characteristics (commonly known breast cancer risk factors) differs from other ethnicities. This retrospective case control study was designed to the explore the association of these factors among American Indian women with and without breast cancer.MethodsCases and controls were retrospectively selected from the medical records of American Indian women who obtained their health care from Quentin N. Burdick Memorial Health Care Facility (Indian Health Service) in Belcourt, ND. For each woman with breast cancer (n = 141), two controls were selected when possible (n = 278). Risk factors examined included woman's age, age at first live birth, age of menarche, the number of previous benign breast biopsies, the total number of first-degree relatives with breast cancer, body mass index and parity. Odds ratios and 95% confidence intervals were calculated using logistic regression.ResultsMany of the associations found among American Indian women who obtained their health care from Quentin N. Burdick Memorial Health Care Facility (Indian Health Service) in Belcourt, ND, between risk factors commonly identified in other populations and breast cancer were weakly positive. Nulliparity was the only risk factor to consistently show a positive significant association (OR = 2.87, 95% CI 1.16–0.7.12).ConclusionDisparities in breast cancer incidence, mortality and screening among Northern Plains American Indian emphasize the need to better understand the risk factors associated with breast cancer in this population. Based on the results of this study, the value of current risk prediction models in American Indian communities is uncertain and clinicians should be cautious in using these models to inform American Indian patients of their risk for breast cancer.

The Association Between Family History of Upper Gastrointestinal Cancer and the Risk of Death from Upper Gastrointestinal Cancer-based on Linxian Dysplasia Nutrition Intervention Trial (NIT) Cohort.

ObjectiveExplore the influence of family history of upper gastrointestinal (UGI) cancer on UGI cancer death, based on the Linxian Dysplasia Nutrition Intervention Trial (NIT) cohort.MethodsFamily history of UGI cancer was defined as at least one first-degree relative (parent, child, or sibling) had a history of esophageal or gastric cancer. Cancer death was carried out by ICD-10 code. Family history information was collected at baseline and cancer deaths were assessed at each annual follow-up. The COX proportional risk model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI). We compared the positive family history group with the negative to determine the risk of family history on UGI cancer death. The effect of category of relatives, number of relatives with UGI cancer, and diagnosis age of relatives on the UGI death risk were further analyzed. Interaction and stratification analyses were done to see the subgroup effects. Sensitivity analyses were also conducted by exclusion of individuals who were followed up less than three years. We considered controlling of covariates including: gender, age (continuity), community, education level, number of siblings (continuity), BMI (continuity), smoking, alcohol use, fresh fruit intake, fresh vegetable intake, hot beverage intake, edible oil intake, meat intake, and moldy staple food intake. All food intake variables were converted into categorical variables.ResultsFrom1985 to2015, we followed up total 3,318 individuals with 898 UGI cancer deaths (537 from ESCC, 77 from GNCC, and 284 from GCC). In a single factor analysis, family history of UGI cancer increased the risk of death of esophageal squamous cell carcinoma (ESCC) by 27% (HR=1.270, 95%CI1.072-1.504). No associations were observed in gastric cardia carcinoma (GCC) and gastric non-cardia carcinoma (GNCC). After adjusting for multi-factor, a family history of UGI cancer risk of death increased by 31.9% from ESCC (HR=1.319,95%CI:1.110-1.567). Subgroup analysis of different types of relatives with UGI cancers, UGI cancers in the mother (HR=1.457,95%CI:1.200-1.768), brother (HR=1.522,95%CI:1.117-2.073), and sister (HR=1.999,95%CI:1.419-2.817) were independent risk factors for ESCC death, while the father was not. In addition, 2 relatives with UGI cancer (HR=1.495, 95%, CI:1.110-2.013) and ≥3 relatives with UGI cancer (HR=2.836, 95%CI:1.842-4.367) significantly increased the risk of ESCC death, and the trend test was statistically significant (P<0.001). Relatives’ diagnostic age of 51-60 years (HR=1.322, 95%CI:1.046-1.672) and 41-50 years (HR=1.442, 95%CI:1.078-1.930) were the risk factors for ESCC death, with statistical significance in the trend test (P=0.010). No statistically significant result of the family history effect on the risk of death from GCC or GNCC was found. Sensitivity analysis of 80% of subjects, randomly selected, did not change the results.ConclusionA family history of UGI cancer may predict the risk of death from ESCC but not from GCC or GNCC. UGI cancer in the mother may predict the risk of death from ESCC, but not father, which indicates gender differences. Gender and smoking are the interaction items with family history in a similar extent. In the subgroup, the risk of ESCC death is more distinct by family history in younger, female, and better-lifestyle individuals, which indicates the unique role of genetic factors.