Search

Melanoma incidence has been increasing in light-skinned populations worldwide, but the reasons for the increase have been controversial. Our prior assessment in California non-Hispanic whites showed substantial increases in invasive melanoma incidence for tumors of all thicknesses in all neighborhoods categorized by socioeconomic status (SES) between 1988-1992 and 1998-2002. To understand whether these trends continued, we updated our assessment to include the diagnosis period 2008-2012 and more accurate pathologic stage at diagnosis. We used the California Cancer Registry to calculate age-adjusted incidence rates for over 58,000 newly diagnosed melanomas. Incidence rates not only continued to rise over the 10-year period from 1998-2002 and 2008-2012 but also showed significant increases in almost all groups defined jointly by tumor thickness or stage at diagnosis and a small area (census tract) SES measure. The largest relative rate increases were seen for regional, distant, and ulcerated disease, especially among males living in the lowest SES neighborhoods. Considering tumor thickness and stage as proxies for time to screening detection and neighborhood SES as a proxy for health care access, we interpret this pattern to indicate continued, true increases in melanoma occurrence as opposed to a thin tumor phenomenon simply driven by improved access to care.

BACKGROUND: Cadmium (Cd) is a developmental toxicant that is released into the environment during industrial processes. Previous animal studies suggest that Cd may impact the onset of puberty. OBJECTIVES: To determine whether Cd exposure, measured as urinary Cd concentration, was associated with ages at menarche and pubertal development. METHODS: A cohort of 211 girls, ages 10 to 13 years at baseline, was followed for up to two years. Girls completed an interview and self-assessment of Tanner stages of breast development and pubic hair growth. They were followed monthly until menarche. Urinary Cd concentrations were measured in overnight urine specimens. Multivariable Cox regression was used to evaluate the association between urinary Cd and age at menarche and cumulative logit regression was used to evaluate the associations between Cd and breast development and pubic hair growth. RESULTS: The baseline geometric mean creatinine-adjusted Cd concentration was 0.22 μg/g creatinine (geometric standard deviation = 1.6) and decreased with increasing age (p-trend =0.04). Cd levels were higher among Asian than White girls or girls of other/mixed race/ethnicity (p = 0.04). In multivariable analyses, girls with urinary Cd ≥ 0.4 μg/L were less likely to have attained menarche than girls with urinary Cd < 0.2 μg/L (hazard ratio = 0.42; 95% confidence interval, 0.23–0.78). Urinary Cd was negatively associated with pubic hair growth (p-trend = 0.01) but not with breast development (p-trend = 0.72) at baseline. CONCLUSIONS: These findings suggest that a higher Cd body burden may delay some aspects of pubertal development among girls.

Glass red top tubes (RTs), traditionally used to draw blood for biomonitoring studies, have some limitations during field sampling (e.g., tube breakage, timely processing may be difficult). This pilot study examined whether serum separation tubes (SSTs) with delayed processing time (48 h) can be used instead of red top tubes (RTs) to accommodate field conditions. Using state-of-the-art methodologies, PBDEs, PCBs, OCPs, PFCs, cholesterol and triglycerides were measured to evaluate any differences among 2 test conditions (RTs with 2 h processing time; SSTs with 48 h processing time). Between the 2 test conditions, we observed high rank correlations among the measured compounds and no statistically significant differences in the levels of measured compounds. We conclude that SSTs with delayed processing time (48 h) produce similar results as RTs with short processing time (2 h), suggesting that SSTs could be good substitutes for RTs for new epidemiological and biomonitoring field studies. The use of SSTs offers a tremendous opportunity for the use of samples archived in various SSTs.

Many epidemiological studies provide evidence of an association between airborne particles, measured as PM10 (particulate matter less than 10 microm in diameter), and daily morbidity and mortality. Most of these studies have been conducted in urban areas where PM10 consists primarily of fine particles (2.5 microm in diameter). Few studies have investigated impacts associated with coarse mode particles (2.5 microm in diameter). We investigated associations between PM10 and daily mortality in the Coachella Valley, a desert resort and retirement area east of Los Angeles, where coarse particles of geologic origin typically comprise approximately 50-60% of PM10 and can exceed 90% during wind events. Our analysis utilized daily data on mortality from 1989 through 1992 as well as several pollutant and meteorological variables, including PM10, nitrates, sulfates, ozone, nitrogen dioxide, carbon monoxide, temperature, and relative humidity. Outcome variables included several measures of daily mortality, including all-cause, cardiovascular and respiratory mortality, and counts of deaths for those above age 50. Multivariate Poisson regression models were used to explain these health endpoints, controlling for temperature, humidity, day of the week, season, and time, using locally weighted smoothing techniques. The analysis indicated statistically significant associations between PM10 (2- or 3-day lags) and each measure of mortality. The results were robust to various model specifications, correction for autocorrelation and overdispersion, and analysis of influential observations. A 10 microg/m3 change in daily PM10 was associated with an approximately 1% increase in mortality, which is of similar magnitude to particle-associated impacts identified in urban areas. Thus, our findings provide evidence for a mortality effect of PM10 in an area where the particulate mass is dominated by coarse particles.

We have developed a reliable and valid questionnaire to measure the psychological consequences of screening mammography. The questionnaire measures the effect of screening on an individual's functioning on emotional, social, and physical life domains. Content validity was ensured by extensive review of the relevant literature, discussion with professionals and interviews with attenders at a pilot Breast X-ray Screening Program in Melbourne, Australia. Discriminant validity was assessed by having expert judges sort items into dimensions which they appeared to be measuring. Acceptable levels of concordance (above 80%) with a priori classifications were found. Concurrent validity was demonstrated by comparison of subscale scores of 53 attenders at the Breast X-ray Program with an independent interview assessment of dysfunction on each of the emotional, social and physical dimensions. There was over 79% agreement between interview scores and questionnaire scores for each dimension. Construct validity was confirmed by showing that subscale scores varied in predicted ways. For women who were recalled for further investigation, scores on each subscale measuring negative consequences, were higher at the recall clinic than at screening clinic (emotional: t = -7.28; df = 70; P less than 0.001; physical: t = -2.53; df = 70; P = 0.014; social: t = -2.49; df = 70; P = 0.015). The internal consistency of all subscales was found to be acceptable. This questionnaire is potentially useful for assessing the psychological consequences of the screening process and should have wide application.

We propose that perceptual quality can be explained by the way neural states figure in dynamic sensorimotor patterns [1xNeural plasticity and consciousness. Hurley, S.L. and Noe, A. Biol. Philos. 2003; 18: 131–168Crossref | Scopus (113)See all References, 2xThe deferential brain in action: Response to Jeffrey Gray. Noe, A. and Hurley, S.L. Trends Cogn. Sci. 2003; 7: 195–196Abstract | Full Text | Full Text PDF | PubMed | Scopus (9)See all References, 3xA sensorimotor approach to vision and visual consciousness. O'Regan, J.K. and Noe, A. Behav. Brain Sci. 2001; 24: 883–975CrossrefSee all References, 4xHurley, S.L. See all References]. Is this a version of functionalism, as Block [5xHow are qualia coupled to function?. Gray, J. Trends Cogn. Sci. 2003; 7: 192–194Abstract | Full Text | Full Text PDF | PubMed | Scopus (19)See all References[5] and Gray [6xTactile sensations/spatial perception. Block, N. Trends Cogn. Sci. 2003; 7: 285–286Abstract | Full Text | Full Text PDF | PubMed | Scopus (18)See all References[6] suggest? No. First, our proposal is compatible with physicalism, that is, with the idea that phenomenology goes with brain state. We reject only a physicalism that holds that properties of cortical states activated by sensory input alone are sufficient for experience. In our view, the relevant neural substrates are dynamic and sensorimotor. Second, we do not hypothesize that function is (or determines) phenomenology. Rather, we propose that sensorimotor context explains the phenomenology. Even on the assumption that phenomenology correlates with neural states, it remains open whether one can bridge the explanatory gaps. One can bridge these gaps, we argue, by looking to dynamic sensorimotor context.Our central claim is empirical: it is possible to explain and predict variations in phenomenology by reference to sensorimotor patterns. For example, applying TMS to V1 during Braille reading by early blind but not normal subjects produces tactile distortions; V1 gives rise to tactile experience because its activation mediates relevant patterns of sensorimotor contingency (e.g. patterns of change in stimulation of the fingers as they move). This point is untouched by Block's observations: (1) that somatosensory cortex is also active during Braille reading; and (2) that V1 may be active in other tactile tasks. Block concludes (3) that it is misleading to speak of visual or tactile cortex, because cortical areas are multi-sensory, and he challenges us (4) to explain the basis of our claim that the phenomenology of Braille is exclusively tactile and not spatial or visual.As for (3), we agree that perceptual areas of the brain are multi-sensory. Activity in V1 is not intrinsically unimodal. Indeed, this is precisely our point: the phenomenology is determined by dynamic patterns of sensorimotor activity. As for (4), we need to be careful: First, there is reason to believe that Braille reading – using fingers to perceive letters and words – is tactile; the burden of proof is on one who claims that Braille readers do not have tactile phenomenology. (Block cannot appeal to the fact that V1 is active during Braille reading, precisely because of the multi-sensory character of neural activity in V1.) Second, a sensory modality isn't spatial as opposed to tactile or visual. Touch and vision are both modalities of spatial perception. But there are differences between the spatial content of touch and that of vision; vision but not touch presents spatial arrays at a distance. Crucially, the spatial content of Braille is that of touch, not vision.This last point is relevant to Block's comments about our treatment of tactile–visual substitution systems (TVSS). We do not claim that the phenomenology of TVSS is exclusively visual, as Block suggests. We insist only that it is not exclusively tactile, and that its spatial content is visual, not tactile. The significance of Block's observation that subjects can concentrate on tactile sensations during TVSS is unclear. Perhaps attention can change the qualities experienced. In any event, the presence of tactile sensations does not make TVSS tactile, for the relevant experiences are not of those sensations.What about the possibility of activity in V1 during TVSS? This would not be evidence against our claim that somatosensory cortex subserves non-tactile phenomenology, just as the existence of activity in somatosensory cortex during Braille reading does not invalidate the claim that V1 subserves touch. This suggests a new, parallel experiment: would TMS to somatosensory cortex in TVSS produce changes in the ‘quasi-visual’ phenomenology of TVSS users? We predict that it would.