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1. Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association ConsortiumBreast Cancer Risk Factors and Survival By Tumor Subtype

Author: Morra, Anna, Jung, Audrey Y, Behrens, Sabine, Keeman, Renske, Ahearn, Thomas U, Anton-Culver, Hoda, Arndt, Volker, Augustinsson, Annelie, Auvinen, Päivi K, Freeman, Laura E Beane, Becher, Heiko, Beckmann, Matthias W, Blomqvist, Carl, Bojesen, Stig E, Bolla, Manjeet K, Brenner, Hermann, Briceno, Ignacio, Brucker, Sara Y, Camp, Nicola J, Campa, Daniele, Canzian, Federico, Castelao, Jose E, Chanock, Stephen J, Choi, Ji-Yeob, Clarke, Christine L, Investigators, for the ABCTB, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Dörk, Thilo, Dunning, Alison M, Dwek, Miriam, Easton, Douglas F, Eccles, Diana M, Egan, Kathleen M, Evans, D Gareth, Fasching, Peter A, Flyger, Henrik, Gago-Dominguez, Manuela, Gapstur, Susan M, García-Sáenz, José A, Gaudet, Mia M, Giles, Graham G, Grip, Mervi, Guénel, Pascal, Haiman, Christopher A, Håkansson, Niclas, Hall, Per, Hamann, Ute, Han, Sileny N, Hart, Steven N, Hartman, Mikael, Heyworth, Jane S, Hoppe, Reiner, Hopper, John L, Hunter, David J, Ito, Hidemi, Jager, Agnes, Jakimovska, Milena, Jakubowska, Anna, Janni, Wolfgang, Kaaks, Rudolf, Kang, Daehee, Kapoor, Pooja Middha, Kitahara, Cari M, Koutros, Stella, Kraft, Peter, Kristensen, Vessela N, Collaborators, for the NBCS, Lacey, James V, Lambrechts, Diether, Le Marchand, Loic, Li, Jingmei, Lindblom, Annika, Lubiński, Jan, Lush, Michael, Mannermaa, Arto, Manoochehri, Mehdi, Margolin, Sara, Mariapun, Shivaani, Matsuo, Keitaro, Mavroudis, Dimitrios, Milne, Roger L, Muranen, Taru A, Newman, William G, Noh, Dong-Young, Nordestgaard, Børge G, Obi, Nadia, Olshan, Andrew F, Olsson, Håkan, Park-Simon, Tjoung-Won, Petridis, Christos, Pharoah, Paul DP, Plaseska-Karanfilska, Dijana, Presneau, Nadege, Rashid, Muhammad U, Rennert, Gad, Rennert, Hedy S, and Rhenius, Valerie
Subjects: Health Services and Systems, Biomedical and Clinical Sciences, Health Sciences, Oncology and Carcinogenesis, Clinical Research, Aging, Estrogen, Cancer, Prevention, Breast Cancer, Good Health and Well Being, Adult, Aged, Breast Neoplasms, Cause of Death, Female, Humans, Life Style, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prospective Studies, Risk Factors, Survival Analysis, ABCTB Investigators, NBCS Collaborators, Medical and Health Sciences, Epidemiology, Biomedical and clinical sciences, Health sciences
Abstract: BackgroundIt is not known whether modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype.MethodsWe analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype.ResultsThere was no evidence of heterogeneous associations between risk factors and mortality by subtype (P adj > 0.30). The strongest associations were between all-cause mortality and BMI ≥30 versus 18.5-25 kg/m2 [HR (95% confidence interval (CI), 1.19 (1.06-1.34)]; current versus never smoking [1.37 (1.27-1.47)], high versus low physical activity [0.43 (0.21-0.86)], age ≥30 years versus 0-
Published: 2021

2. Combined Associations of a Polygenic Risk Score and Classical Risk Factors With Breast Cancer Risk.

Author: Kapoor, Pooja Middha, Mavaddat, Nasim, Choudhury, Parichoy Pal, Wilcox, Amber N, Lindström, Sara, Behrens, Sabine, Michailidou, Kyriaki, Dennis, Joe, Bolla, Manjeet K, Wang, Qin, Jung, Audrey, Abu-Ful, Zomoroda, Ahearn, Thomas, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Aronson, Kristan J, Auer, Paul L, Freeman, Laura E Beane, Becher, Heiko, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bernstein, Leslie, Bojesen, Stig E, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Cai, Qiuyin, Campa, Daniele, Canzian, Federico, Carracedo, Angel, Carter, Brian D, Castelao, Jose E, Chanock, Stephen J, Chatterjee, Nilanjan, Chenevix-Trench, Georgia, Clarke, Christine L, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Dai, James Y, Earp, H Shelton, Ekici, Arif B, Eliassen, A Heather, Eriksson, Mikael, Evans, D Gareth, Fasching, Peter A, Figueroa, Jonine, Fritschi, Lin, Gabrielson, Marike, Gago-Dominguez, Manuela, Gao, Chi, Gapstur, Susan M, Gaudet, Mia M, Giles, Graham G, González-Neira, Anna, Guénel, Pascal, Haeberle, Lothar, Haiman, Christopher A, Håkansson, Niclas, Hall, Per, Hamann, Ute, Hatse, Sigrid, Heyworth, Jane, Holleczek, Bernd, Hoover, Robert N, Hopper, John L, Howell, Anthony, Hunter, David J, ABCTB Investigators, kConFab/AOCS Investigators, John, Esther M, Jones, Michael E, Kaaks, Rudolf, Keeman, Renske, Kitahara, Cari M, Ko, Yon-Dschun, Koutros, Stella, Kurian, Allison W, Lambrechts, Diether, Le Marchand, Loic, Lee, Eunjung, Lejbkowicz, Flavio, Linet, Martha, Lissowska, Jolanta, Llaneza, Ana, MacInnis, Robert J, Martinez, Maria Elena, Maurer, Tabea, McLean, Catriona, Neuhausen, Susan L, Newman, William G, Norman, Aaron, O'Brien, Katie M, Olshan, Andrew F, Olson, Janet E, Olsson, Håkan, and Orr, Nick
Subjects: ABCTB Investigators, kConFab/AOCS Investigators, Humans, Breast Neoplasms, Genetic Predisposition to Disease, Receptors, Estrogen, Medical History Taking, Body Mass Index, Logistic Models, Risk Factors, Case-Control Studies, Polymorphism, Single Nucleotide, Aged, Aged, 80 and over, Middle Aged, Female, White People, Aging, Breast Cancer, Prevention, Cancer, Clinical Research, 2.1 Biological and endogenous factors, Aetiology, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract: We evaluated the joint associations between a new 313-variant PRS (PRS313) and questionnaire-based breast cancer risk factors for women of European ancestry, using 72 284 cases and 80 354 controls from the Breast Cancer Association Consortium. Interactions were evaluated using standard logistic regression and a newly developed case-only method for breast cancer risk overall and by estrogen receptor status. After accounting for multiple testing, we did not find evidence that per-standard deviation PRS313 odds ratio differed across strata defined by individual risk factors. Goodness-of-fit tests did not reject the assumption of a multiplicative model between PRS313 and each risk factor. Variation in projected absolute lifetime risk of breast cancer associated with classical risk factors was greater for women with higher genetic risk (PRS313 and family history) and, on average, 17.5% higher in the highest vs lowest deciles of genetic risk. These findings have implications for risk prevention for women at increased risk of breast cancer.
Published: 2021

3. Association of Known Melanoma Risk Factors with Primary Melanoma of the Scalp and Neck

Author: Wood, Renee P, Heyworth, Jane S, McCarthy, Nina S, Mauguen, Audrey, Berwick, Marianne, Thomas, Nancy E, Millward, Michael J, Anton-Culver, Hoda, Cust, Anne E, Dwyer, Terence, Gallagher, Richard P, Gruber, Stephen B, Kanetsky, Peter A, Orlow, Irene, Rosso, Stefano, Moses, Eric K, Begg, Colin B, and Ward, Sarah V
Subjects: Biomedical and Clinical Sciences, Health Sciences, Oncology and Carcinogenesis, Dental/Oral and Craniofacial Disease, Clinical Trials and Supportive Activities, Cancer, Clinical Research, Aged, Female, Humans, Male, Melanoma, Middle Aged, Neck, Risk Factors, Scalp, Skin Neoplasms, Medical and Health Sciences, Epidemiology, Biomedical and clinical sciences, Health sciences
Abstract: BackgroundScalp and neck (SN) melanoma confers a worse prognosis than melanoma of other sites but little is known about its determinants. We aimed to identify associations between SN melanoma and known risk genes, phenotypic traits, and sun exposure patterns.MethodsParticipants were cases from the Western Australian Melanoma Health Study (n = 1,200) and the Genes, Environment, and Melanoma Study (n = 3,280). Associations between risk factors and SN melanoma, compared with truncal and arm/leg melanoma, were investigated using binomial logistic regression. Facial melanoma was also compared with the trunk and extremities, to evaluate whether associations were subregion specific, or reflective of the whole head/neck region.ResultsCompared with other sites, increased odds of SN and facial melanoma were observed in older individuals [SN: OR = 1.28, 95% confidence interval (CI) = 0.92-1.80, P trend = 0.016; Face: OR = 4.57, 95% CI = 3.34-6.35, P trend < 0.001] and those carrying IRF4-rs12203592*T (SN: OR = 1.35, 95% CI = 1.12-1.63, P trend = 0.002; Face: OR = 1.29, 95% CI = 1.10-1.50, P trend = 0.001). Decreased odds were observed for females (SN: OR = 0.49, 95% CI = 0.37-0.64, P < 0.001; Face: OR = 0.66, 95% CI = 0.53-0.82, P < 0.001) and the presence of nevi (SN: OR = 0.66, 95% CI = 0.49-0.89, P = 0.006; Face: OR = 0.65, 95% CI = 0.52-0.83, P < 0.001).ConclusionsDifferences observed between SN melanoma and other sites were also observed for facial melanoma. Factors previously associated with the broader head and neck region, notably older age, may be driven by the facial subregion. A novel finding was the association of IRF4-rs12203592 with both SN and facial melanoma.ImpactUnderstanding the epidemiology of site-specific melanoma will enable tailored strategies for risk factor reduction and site-specific screening campaigns.
Published: 2020

4. Assessment of interactions between 205 breast cancer susceptibility loci and 13 established risk factors in relation to breast cancer risk, in the Breast Cancer Association Consortium

Author: Kapoor, Pooja Middha, Lindström, Sara, Behrens, Sabine, Wang, Xiaoliang, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Dennis, Joe, Dunning, Alison M, Pharoah, Paul DP, Schmidt, Marjanka K, Kraft, Peter, García-Closas, Montserrat, Easton, Douglas F, Milne, Roger L, Chang-Claude, Jenny, Ahearn, Thomas, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Aronson, Kristan J, Auer, Paul L, Augustinsson, Annelie, Freeman, Laura E Beane, Beckmann, Matthias W, Benitez, Javier, Bernstein, Leslie, Berrandou, Takiy, Bojesen, Stig E, Brauch, Hiltrud, Brenner, Hermann, Brock, Ian W, Broeks, Annegien, Brooks-Wilson, Angela, Butterbach, Katja, Cai, Qiuyin, Campa, Daniele, Canzian, Federico, Carter, Brian D, Castelao, Jose E, Chanock, Stephen J, Chenevix-Trench, Georgia, Cheng, Ting-Yuan David, Clarke, Christine L, Cordina-Duverger, Emilie, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Dai, James Y, Dite, Gillian S, Earp, H Shelton, Eliassen, A Heather, Eriksson, Mikael, Evans, D Gareth, Fasching, Peter A, Figueroa, Jonine, Flyger, Henrik, Fritschi, Lin, Gabrielson, Marike, Gago-Dominguez, Manuela, Gapstur, Susan M, Gaudet, Mia M, Giles, Graham G, González-Neira, Anna, Grundy, Anne, Guénel, Pascal, Haeberle, Lothar, Haiman, Christopher A, Håkansson, Niclas, Hall, Per, Hamann, Ute, Hankinson, Susan E, Harkness, Elaine F, Harstad, Tricia, He, Wei, Heyworth, Jane, Hoover, Robert N, Hopper, John L, Humphreys, Keith, Hunter, David J, Marrón, Pablo Isidro, John, Esther M, Jones, Michael E, Jung, Audrey, Kaaks, Rudolf, Keeman, Renske, Kitahara, Cari M, Ko, Yon-Dschun, Koutros, Stella, Krüger, Ute, Lambrechts, Diether, Le Marchand, Loic, Lee, Eunjung, Lejbkowicz, Flavio, Linet, Martha, Lissowska, Jolanta, Llaneza, Ana, Lo, Wing-Yee, and Makalic, Enes
Subjects: Genetics, Estrogen, Clinical Research, Cancer, Breast Cancer, Prevention, 2.1 Biological and endogenous factors, Aetiology, Alleles, Breast Neoplasms, Case-Control Studies, Europe, Factor XIII, Female, Gene-Environment Interaction, Genetic Predisposition to Disease, Genome-Wide Association Study, Genotype, Humans, Polymorphism, Single Nucleotide, Receptors, Estrogen, Risk Factors, White People, Breast Cancer Association Consortium, Europeans, Gene-environment interaction, breast cancer, epidemiology, risk factors, single nucleotide polymorphism, Statistics, Public Health and Health Services, Epidemiology
Abstract: BackgroundPrevious gene-environment interaction studies of breast cancer risk have provided sparse evidence of interactions. Using the largest available dataset to date, we performed a comprehensive assessment of potential effect modification of 205 common susceptibility variants by 13 established breast cancer risk factors, including replication of previously reported interactions.MethodsAnalyses were performed using 28 176 cases and 32 209 controls genotyped with iCOGS array and 44 109 cases and 48 145 controls genotyped using OncoArray from the Breast Cancer Association Consortium (BCAC). Gene-environment interactions were assessed using unconditional logistic regression and likelihood ratio tests for breast cancer risk overall and by estrogen-receptor (ER) status. Bayesian false discovery probability was used to assess the noteworthiness of the meta-analysed array-specific interactions.ResultsNoteworthy evidence of interaction at ≤1% prior probability was observed for three single nucleotide polymorphism (SNP)-risk factor pairs. SNP rs4442975 was associated with a greater reduction of risk of ER-positive breast cancer [odds ratio (OR)int = 0.85 (0.78-0.93), Pint = 2.8 x 10-4] and overall breast cancer [ORint = 0.85 (0.78-0.92), Pint = 7.4 x 10-5) in current users of estrogen-progesterone therapy compared with non-users. This finding was supported by replication using OncoArray data of the previously reported interaction between rs13387042 (r2 = 0.93 with rs4442975) and current estrogen-progesterone therapy for overall disease (Pint = 0.004). The two other interactions suggested stronger associations between SNP rs6596100 and ER-negative breast cancer with increasing parity and younger age at first birth.ConclusionsOverall, our study does not suggest strong effect modification of common breast cancer susceptibility variants by established risk factors.
Published: 2020

5. Defining the volume of consultations for musculoskeletal infection encountered by pediatric orthopaedic services in the United States

Author: Koehler, Ryan J, Shore, Benjamin J, Hedequest, Daniel, Heyworth, Benton E, May, Colin, Miller, Patricia E, Rademacher, Emily S, Sanborn, Ryan M, Murphy, Joshua S, Roseman, Alyssa, Stoneback, Jason W, Trizno, Anastasiya A, Goldstein, Rachel Y, Harris, Liam, Nielsen, Ena, Talwar, Divya, Denning, Jaime R, Saaed, Noor, Kutz, Brooke, Laine, Jennifer C, Naas, Mary, Truong, Walter H, Rotando, Matthew, Spence, David D, Brighton, Brian K, Churchill, Christine, Janicki, Joseph A, King, Kiana, Wild, Jacob, Beebe, Allan C, Crouse, Schon, Rough, Teaya, Rowan, Mallory, Singh, Satbir, Davis-Juarez, Amanda, Gould, Adam, Hughes, Olivia, Rickert, Kathleen D, Upasani, Vidyadhar V, Blumberg, Todd J, Bompadre, Viviana, Lindberg, Antoinette W, Miller, Mark L, Hill, Jaclyn F, Peoples, Hayley, Rosenfeld, Scott B, Turner, Rod, Copley, Lawson A, Lindsay, Eduardo A, Ramo, Brandon A, Tareen, Naureen, Winberly, R Lane, Li, G Ying, Sessel, Jordyn, Johnson, Megan E, Johnson, Samuel, Moore-Lotridge, Stephanie N, Shelton, Julie, Baldwin, Keith D, and Schoenecker, Jonathan G
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Pediatric, Child, Female, Humans, Infections, Male, Musculoskeletal Diseases, Orthopedics, Referral and Consultation, Retrospective Studies, United States, Children’s Orthopaedic Trauma and Infection Consortium for Evidence Based Study (CORTICES) Group, General Science & Technology
Abstract: OBJECTIVE:Adequate resources are required to rapidly diagnose and treat pediatric musculoskeletal infection (MSKI). The workload MSKI consults contribute to pediatric orthopaedic services is unknown as prior epidemiologic studies are variable and negative work-ups are not included in national discharge databases. The hypothesis was tested that MSKI consults constitute a substantial volume of total consultations for pediatric orthopaedic services across the United States. STUDY DESIGN:Eighteen institutions from the Children's ORthopaedic Trauma and Infection Consortium for Evidence-based Study (CORTICES) group retrospectively reviewed a minimum of 1 year of hospital data, reporting the total number of surgeons, total consultations, and MSKI-related consultations. Consultations were classified by the location of consultation (emergency department or inpatient). Culture positivity rate and pathogens were also reported. RESULTS:87,449 total orthopaedic consultations and 7,814 MSKI-related consultations performed by 229 pediatric orthopaedic surgeons were reviewed. There was an average of 13 orthopaedic surgeons per site each performing an average of 154 consultations per year. On average, 9% of consultations were MSKI related and 37% of these consults yielded positive cultures. Finally, a weak inverse monotonic relationship was noted between percent culture positivity and percent of total orthopedic consults for MSKI. CONCLUSION:At large, academic pediatric tertiary care centers, pediatric orthopaedic services consult on an average of ~3,000 'rule-out' MSKI cases annually. These patients account for nearly 1 in 10 orthopaedic consultations, of which 1 in 3 are culture positive. Considering that 2 in 3 consultations were culture negative, estimating resources required for pediatric orthopaedic consult services to work up and treat children based on culture positive administrative discharge data underestimates clinical need. Finally, ascertainment bias must be considered when comparing differences in culture rates from different institution's pediatric orthopaedics services, given the variability in when orthopaedic physicians become involved in a MSKI workup.
Published: 2020

6. Genome-wide association and transcriptome studies identify target genes and risk loci for breast cancer.

Author: Ferreira, Manuel A, Gamazon, Eric R, Al-Ejeh, Fares, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arason, Adalgeir, Arndt, Volker, Aronson, Kristan J, Arun, Banu K, Asseryanis, Ella, Azzollini, Jacopo, Balmaña, Judith, Barnes, Daniel R, Barrowdale, Daniel, Beckmann, Matthias W, Behrens, Sabine, Benitez, Javier, Bermisheva, Marina, Białkowska, Katarzyna, Blomqvist, Carl, Bogdanova, Natalia V, Bojesen, Stig E, Bolla, Manjeet K, Borg, Ake, Brauch, Hiltrud, Brenner, Hermann, Broeks, Annegien, Burwinkel, Barbara, Caldés, Trinidad, Caligo, Maria A, Campa, Daniele, Campbell, Ian, Canzian, Federico, Carter, Jonathan, Carter, Brian D, Castelao, Jose E, Chang-Claude, Jenny, Chanock, Stephen J, Christiansen, Hans, Chung, Wendy K, Claes, Kathleen BM, Clarke, Christine L, EMBRACE Collaborators, GC-HBOC Study Collaborators, GEMO Study Collaborators, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Daly, Mary B, de la Hoya, Miguel, Dennis, Joe, Devilee, Peter, Diez, Orland, Dörk, Thilo, Dunning, Alison M, Dwek, Miriam, Eccles, Diana M, Ejlertsen, Bent, Ellberg, Carolina, Engel, Christoph, Eriksson, Mikael, Fasching, Peter A, Fletcher, Olivia, Flyger, Henrik, Friedman, Eitan, Frost, Debra, Gabrielson, Marike, Gago-Dominguez, Manuela, Ganz, Patricia A, Gapstur, Susan M, Garber, Judy, García-Closas, Montserrat, García-Sáenz, José A, Gaudet, Mia M, Giles, Graham G, Glendon, Gord, Godwin, Andrew K, Goldberg, Mark S, Goldgar, David E, González-Neira, Anna, Greene, Mark H, Gronwald, Jacek, Guénel, Pascal, Haiman, Christopher A, Hall, Per, Hamann, Ute, He, Wei, Heyworth, Jane, Hogervorst, Frans BL, Hollestelle, Antoinette, Hoover, Robert N, Hopper, John L, Hulick, Peter J, Humphreys, Keith, Imyanitov, Evgeny N, ABCTB Investigators, HEBON Investigators, and BCFR Investigators
Subjects: EMBRACE Collaborators, GC-HBOC Study Collaborators, GEMO Study Collaborators, ABCTB Investigators, HEBON Investigators, BCFR Investigators, Humans, Breast Neoplasms, Genetic Predisposition to Disease, Gene Expression Profiling, Quantitative Trait Loci, Female, Genome-Wide Association Study, Prevention, Cancer, Human Genome, Aging, Breast Cancer, Genetics, Biotechnology, 2.1 Biological and endogenous factors
Abstract: Genome-wide association studies (GWAS) have identified more than 170 breast cancer susceptibility loci. Here we hypothesize that some risk-associated variants might act in non-breast tissues, specifically adipose tissue and immune cells from blood and spleen. Using expression quantitative trait loci (eQTL) reported in these tissues, we identify 26 previously unreported, likely target genes of overall breast cancer risk variants, and 17 for estrogen receptor (ER)-negative breast cancer, several with a known immune function. We determine the directional effect of gene expression on disease risk measured based on single and multiple eQTL. In addition, using a gene-based test of association that considers eQTL from multiple tissues, we identify seven (and four) regions with variants associated with overall (and ER-negative) breast cancer risk, which were not reported in previous GWAS. Further investigation of the function of the implicated genes in breast and immune cells may provide insights into the etiology of breast cancer.
Published: 2019

7. The prevalence of tinnitus in the Australian working population

Author: Lin Fritschi, Helen Goulios, Warwick Williams, Elinor Ytterstad, Kate Lewkowski, and Jane Heyworth
Subjects: Male, medicine.medical_specialty, Population, Population health, Occupational safety and health, Tinnitus, Age groups, Occupational Exposure, Prevalence, otorhinolaryngologic diseases, Humans, Medicine, Working population, education, Aged, education.field_of_study, business.industry, Public health, Australia, General Medicine, Cross-Sectional Studies, Workforce, Female, medicine.symptom, business, Demography
Abstract: Objectives To estimate the prevalence of tinnitus in Australian working people; to identify occupational and demographic factors associated with tinnitus. Design Cross-sectional national telephone survey of self-reported frequency and duration of tinnitus. Setting, participants Australian Workplace Exposure Survey (AWES) - Hearing; 4970 currently employed people aged 18-64 years, recruited by random digit dialling, representative by sex of the workforce population, 7 June 2016 - 20 March 2017. Main outcome measures Prevalence of occasional, intermittent, and constant tinnitus, and of any tinnitus, by occupational group, sex, and other demographic characteristics; estimated numbers of working people with constant or any tinnitus, by occupational group and sex. Results Of 4970 respondents, 1317 reported experiencing tinnitus (26.5%): 713 people had occasional tinnitus (14.3%), 259 intermittent tinnitus (5.2%), and 345 constant tinnitus (6.9%). The sample prevalence of constant tinnitus was greater among men (7.5%; 95% CI, 6.2-8.7%) than women (3.3%; 95% CI, 2.3-4.3%), and was higher in older age groups. After rake weighting our survey responses, we estimated that 2.4 million workers (24.8%; 95% CI, 23.2-26.4%) experience tinnitus, including 529 343 with constant tinnitus (5.5%; 95% CI, 4.6-6.3%). The estimated prevalence of constant tinnitus was highest for automotive workers (16.7%; 95% CI, 9.5-23.8%), drivers (13.0%; 95% CI, 7.3-18.6%), farmers (12.1%; 95% CI, 5.9-18.4%), and workers in other trades (10.4%; 95% CI, 4.6-16.2%). Conclusions The prevalence of tinnitus in the Australian workforce is high, particularly in certain occupations. Workplace practices and conditions that increase the risk of tinnitus should be examined, and targeted workplace prevention strategies developed.
Published: 2021

8. Two-Year Functional Outcomes of Operative vs Nonoperative Treatment of Completely Displaced Midshaft Clavicle Fractures in Adolescents: Results From the Prospective Multicenter FACTS Study Group

Author: Benton E. Heyworth, Andrew T. Pennock, Ying Li, Elizabeth S. Liotta, Brittany Dragonetti, David Williams, Henry B. Ellis, Jeffrey J. Nepple, David Spence, S. Clifton Willimon, Crystal A. Perkins, Nirav K. Pandya, Mininder S. Kocher, Eric W. Edmonds, Philip L. Wilson, Michael T. Busch, Coleen S. Sabatini, Frances Farley, and Donald S. Bae
Subjects: Fracture Healing, Male, Adolescent, Physical Therapy, Sports Therapy and Rehabilitation, Clavicle, Cohort Studies, Fracture Fixation, Internal, Fractures, Bone, Treatment Outcome, Quality of Life, Humans, Orthopedics and Sports Medicine, Female, Prospective Studies, Child
Abstract: Background: The optimal treatment of midshaft clavicle fractures is controversial. Few previous comparative functional outcome studies have investigated these fractures in adolescents, the most commonly affected epidemiologic subpopulation. Purpose/Hypothesis: The purpose was to prospectively compare the outcomes of operative versus nonoperative treatment in adolescents with completely displaced midshaft clavicle fractures. The study hypothesis was that surgery would yield superior outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: Patients aged 10 to 18 years treated for a midshaft clavicle fracture over a 5-year period at 1 of 8 pediatric centers were prospectively screened, with independent treatment decisions determined by individual musculoskeletal professionals. Demographics, radiographic clinical features, complications, and patient-reported outcomes (PROs) were prospectively recorded for 2 years. Regression and matching techniques were utilized to adjust for potential age- and fracture severity–based confounders for creation of comparable subgroups for analysis. Results: Of 416 adolescents with completely displaced midshaft clavicle fractures, 282 (68) provided 2-year PRO data. Operative patients (n = 88; 31%) demonstrated no difference in sex (78% male) or athletic participation but were older (mean age, 15.2 vs 13.5 years; P < .001), had more comminuted fractures (49.4% vs 26.3%; P < .001), and had greater fracture shortening (25.5 vs 20.7 mm; P < .001) than nonoperative patients (n = 194; 69%). There was no difference in mean PRO scores or rates of “suboptimal” scores (based on threshold values established a priori) between the operative and nonoperative treatment groups (American Shoulder and Elbow Surgeons, 96.8 vs 98.4; shortened version of the Disabilities of the Arm, Shoulder and Hand, 3.0 vs 1.6; EuroQol [EQ] visual analog scale, 93.0 vs 93.9; EQ–5 Dimensions index, 0.96 vs 0.98), even after regression and matching techniques adjusted for confounders. Operative patients had more unexpected subsequent surgery (10.4% vs 1.4%; P = .004) and clinically significant complications (20.8% vs 5.2%; P = .001). Overall, nonunion (0.4%), delayed union (1.9%), symptomatic malunion (0.4%), and refracture (2.6%) were exceedingly rare, with no difference between treatment groups. Conclusion: Surgery demonstrated no benefit in patient-reported quality of life, satisfaction, shoulder-specific function, or prevention of complications after completely displaced clavicle shaft fractures in adolescents at 2 years after injury. Registration: NCT04250415 ( ClinicalTrials.gov identifier).
Published: 2022

9. Exposure to Hand-Arm Vibration in the Australian Workforce

Author: Lin Fritschi, Warwick Williams, Matthew J Pugliese, Elinor Ytterstad, Jane Heyworth, Hans Pettersson, Kate Lewkowski, Kahlia McCausland, and Ian Li
Subjects: Male, business.industry, Australia, Public Health, Environmental and Occupational Health, Psychological intervention, Vibration, 030210 environmental & occupational health, Telephone survey, 03 medical and health sciences, Engineering controls, Cross-Sectional Studies, 0302 clinical medicine, Occupational Exposure, Environmental health, Exposure reduction, Workforce, Humans, Medicine, Working population, Female, 030212 general & internal medicine, business, Hand arm, Exposure assessment
Abstract: ObjectiveTo estimate the prevalence of hand-arm vibration (HAV) in Australian workplaces.MethodsThe Australian Workplace Exposure Survey (AWES)—Hearing was a cross-sectional telephone survey of Australian workers conducted in 2016–2017. Respondents were asked about the time spent using tools or performing tasks known to be associated with HAV during their most recent working day. We created a library of HAV magnitude levels for each tool/task and estimated each worker’s daily HAV exposure level using standard formulae. We categorized each worker as to whether they exceeded the daily occupational limits of 2.5 and 5.0 m/s2. Results were extrapolated to the Australian working population using a raked weighting method.ResultsIn our sample of 4991 workers, 5.4% of men and 0.7% of women exceeded the HAV action limit of 2.5 m/s2 on their most recent working day. We estimate that 3.8% of the Australian workforce exceeds the HAV limit of 2.5 m/s2 and 0.8% exceeds the 5 m/s2 limit. Men were more likely to exceed the HAV limits than women, as were those with trade qualifications, and those who worked in remote locations. Workers in the construction, farming, and automobile industries had the highest prevalence of HAV exposure. Tool groups that contributed to higher exposure levels included: compactors, rollers, and tampers; power hammers and jackhammers; and underground mining equipment.ConclusionsHAV is common in the Australian working population. Given the health risks associated with this exposure, reduction strategies and interventions should be developed, with engineering controls as the starting point for exposure reduction strategies.
Published: 2021

10. Breast cancer risk factors and survival by tumor subtype

Author: Päivi Auvinen, Hoda Anton-Culver, Stig E. Bojesen, Gad Rennert, Christos Petridis, Taru A. Muranen, Lukas Schwentner, Jenny Chang-Claude, Chen-Yang Shen, Melissa A. Troester, Sara Y. Brucker, Miriam Dwek, Jingmei Li, Nadia Obi, Montserrat Garcia-Closas, Soo Hwang Teo, Pascal Guénel, Hidemi Ito, Sabine Behrens, Rulla M. Tamimi, Melissa C. Southey, Michelle D. Holmes, Christopher A. Haiman, Henrik Flyger, Roger L. Milne, Per Hall, Jyh-Cherng Yu, Thomas U. Ahearn, William G. Newman, D. Gareth Evans, Dong-Young Noh, Qin Wang, Robert Winqvist, Tjoung-Won Park-Simon, Angela Cox, Dimitrios Mavroudis, Federico Canzian, Celine M. Vachon, Annelie Augustinsson, Shivaani Mariapun, Keitaro Matsuo, Mia M. Gaudet, Anna Jakubowska, Loic Le Marchand, Rob A. E. M. Tollenaar, Paul D.P. Pharoah, Mikael Hartman, Jane Heyworth, Alison M. Dunning, Daniele Campa, Keun-Young Yoo, Anna Morra, Sileny Han, Anna H. Wu, David J. Hunter, Laura E. Beane Freeman, Mehdi Manoochehri, Volker Arndt, Elinor J. Sawyer, Peter A. Fasching, Alicja Wolk, Xiao-Ou Shu, José A. García-Sáenz, Hermann Brenner, Børge G. Nordestgaard, Pooja Middha Kapoor, Diether Lambrechts, Kamila Czene, Marjanka K. Schmidt, Nadege Presneau, Stephen J. Chanock, Mervi Grip, Ignacio Briceño, Stella Koutros, Nicola J. Camp, Kathleen M. Egan, Wei Zheng, Reiner Hoppe, Simon S. Cross, James V. Lacey, Manjeet K. Bolla, Cari M. Kitahara, Annika Lindblom, Carl Blomqvist, William J. Tapper, Diana Torres, Jan Lubinski, Milena Jakimovska, Vessela N. Kristensen, Jose E. Castelao, Graham G. Giles, Andrew F. Olshan, John L. Hopper, A. Heather Eliassen, Valerie Rhenius, Christopher G. Scott, Agnes Jager, Thilo Dörk, Justin A. Williams, Ian Tomlinson, Emmanouil Saloustros, Ji Yeob Choi, Dijana Plaseska-Karanfilska, Thérèse Truong, Audrey Y. Jung, Daehee Kang, Argyrios Ziogas, Peter Kraft, Arto Mannermaa, Rudolf Kaaks, Heiko Becher, Wolfgang Janni, Niclas Håkansson, Steven N. Hart, Xiaohong R. Yang, Håkan Olsson, Fergus J. Couch, Renske Keeman, Ute Hamann, Atocha Romero, Daniel O. Stram, Andreas Schneeweiss, Susan M. Gapstur, Michael Lush, Diana Eccles, Sara Margolin, Hedy S. Rennert, Muhammad Usman Rashid, Mitul Shah, Matthias W. Beckmann, Sophia S. Wang, Douglas F. Easton, Manuela Gago-Dominguez, Christine L. Clarke, and Medical Oncology
Subjects: 0301 basic medicine, Oncology, Adult, medicine.medical_specialty, Epidemiology, Estrogen receptor, Breast Neoplasms, Article, 03 medical and health sciences, Aged, Cause of Death, Female, Humans, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prospective Studies, Risk Factors, Survival Analysis, Life Style, 0302 clinical medicine, Breast cancer, SDG 3 - Good Health and Well-being, Internal medicine, medicine, business.industry, Proportional hazards model, Cancer, medicine.disease, Confidence interval, 3. Good health, Tumor Subtype, 030104 developmental biology, Clinical research, 030220 oncology & carcinogenesis, business, Body mass index
Abstract: Background: It is not known whether modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype. Methods: We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer–specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype. Results: There was no evidence of heterogeneous associations between risk factors and mortality by subtype (Padj > 0.30). The strongest associations were between all-cause mortality and BMI ≥30 versus 18.5–25 kg/m2 [HR (95% confidence interval (CI), 1.19 (1.06–1.34)]; current versus never smoking [1.37 (1.27–1.47)], high versus low physical activity [0.43 (0.21–0.86)], age ≥30 years versus 0– Conclusions: We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype. Impact: Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.
Published: 2021

11. Examining telehealth use among primary care patients, providers, and clinics during the COVID-19 pandemic

Author: Claudia Der-Martirosian, Karen Chu, W. Neil Steers, Tamar Wyte-Lake, Michelle D. Balut, Aram Dobalian, Leonie Heyworth, Neil M. Paige, and Lucinda Leung
Subjects: Male, Primary Health Care, COVID-19, Humans, Female, Family Practice, Delivery of Health Care, Pandemics, Telemedicine
Abstract: Background At the onset of COVID-19, there was a rapid expansion of telehealth (video/telephone) visits to maintain delivery of primary care (PC) services at the Veterans Health Administration (VA). This study examines patient, provider, and site-level characteristics of any virtual and video-based care in PC. Methods Interrupted time series (ITS) design was conducted using VA administrative/clinical, electronic healthcare data, 12-months before and 12-months after COVID-19 onset (set at March 2020) at the VA Greater Los Angeles Healthcare System (GLA), between 2019 and 2021. Patients with at least one visit to a VA PC clinic at GLA (n = 547,730 visits) were included in the analysis. The two main outcomes for this study were 1) any telehealth (versus in-person), as well as 2) video-based care (versus telephone). For the ITS analysis, segmented logistic regression on repeated monthly observations of any telehealth and video-based care was used. Results Percent telehealth and video use increased from 13.9 to 63.1%, and 0.3 to 11.3%, respectively, before to after COVID-19 onset. According to adjusted percentages, GLA community-based clinics (37.7%, versus 29.8% in hospital-based clinics, p p p p’s Conclusions Since telehealth care provision is likely to continue after COVID-19, additional research is needed to identify which PC outpatient services are better suited for telephone (e.g., case management) versus video-based care (e.g., integrated mental health visits). Additionally, it is important to understand how all clinics can systematically increase access to both telephone- and video-based PC services, while ensuring equitable care for all patient populations.
Published: 2022

12. Association of known melanoma risk factors with primary melanoma of the scalp and neck

Author: Anne E. Cust, Hoda Anton-Culver, Michael Millward, Eric K. Moses, Sarah V. Ward, Colin B. Begg, Nancy E. Thomas, Richard P. Gallagher, Jane Heyworth, Stephen B. Gruber, Audrey Mauguen, Marianne Berwick, Irene Orlow, Stefano Rosso, Terence Dwyer, Renee P. Wood, Peter A. Kanetsky, and Nina S. McCarthy
Subjects: 0301 basic medicine, Oncology, Male, medicine.medical_specialty, Skin Neoplasms, Epidemiology, Clinical Trials and Supportive Activities, Medical and Health Sciences, Article, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Clinical Research, Internal medicine, medicine, Humans, Risk factor, Dental/Oral and Craniofacial Disease, Head and neck, neoplasms, Melanoma, Aged, Cancer, Scalp, business.industry, Middle Aged, medicine.disease, Trunk, Confidence interval, 030104 developmental biology, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, Sun exposure, business, Neck
Abstract: Background: Scalp and neck (SN) melanoma confers a worse prognosis than melanoma of other sites but little is known about its determinants. We aimed to identify associations between SN melanoma and known risk genes, phenotypic traits, and sun exposure patterns. Methods: Participants were cases from the Western Australian Melanoma Health Study (n = 1,200) and the Genes, Environment, and Melanoma Study (n = 3,280). Associations between risk factors and SN melanoma, compared with truncal and arm/leg melanoma, were investigated using binomial logistic regression. Facial melanoma was also compared with the trunk and extremities, to evaluate whether associations were subregion specific, or reflective of the whole head/neck region. Results: Compared with other sites, increased odds of SN and facial melanoma were observed in older individuals [SN: OR = 1.28, 95% confidence interval (CI) = 0.92–1.80, Ptrend = 0.016; Face: OR = 4.57, 95% CI = 3.34–6.35, Ptrend < 0.001] and those carrying IRF4-rs12203592*T (SN: OR = 1.35, 95% CI = 1.12–1.63, Ptrend = 0.002; Face: OR = 1.29, 95% CI = 1.10–1.50, Ptrend = 0.001). Decreased odds were observed for females (SN: OR = 0.49, 95% CI = 0.37–0.64, P < 0.001; Face: OR = 0.66, 95% CI = 0.53–0.82, P < 0.001) and the presence of nevi (SN: OR = 0.66, 95% CI = 0.49–0.89, P = 0.006; Face: OR = 0.65, 95% CI = 0.52–0.83, P < 0.001). Conclusions: Differences observed between SN melanoma and other sites were also observed for facial melanoma. Factors previously associated with the broader head and neck region, notably older age, may be driven by the facial subregion. A novel finding was the association of IRF4-rs12203592 with both SN and facial melanoma. Impact: Understanding the epidemiology of site-specific melanoma will enable tailored strategies for risk factor reduction and site-specific screening campaigns.
Published: 2022

13. Safety of hospital discharge before return of bowel function after elective colorectal surgery

Author: J Chapman, S, Blanco-Colino, R, Pérez-Ajates, S, O Anabitarte Bautista, Hodson, J, C Glasbey, J, Pata, F, Pellino, G, Sgrò, A, Soares, A, T van Elst, S Van Straten, Nepogodiev, D, Borakati, A, F Bath, M, H Yasin, I, Mclean, K, Arthur, T, Kovacevic, M, Delibegovic, S, Karamanliev, M, Swamad, M, Žebrák, R, Paramasivam, R, Martensen, A, M Larsen, H, Rädeker, L, E Frey, P, Kechagias, A, Venara, A, Duchalais, E, Ioannidis, A, Pasquali, S, Simioni, A, Farina, V, Podda, M, Lorenzon, L, Schaeff, V, Otto, A, Jakubauskas, M, R van Elst, T, Chu, M, Pvb, Fagan, I Wells, C, A Alagoa João, Juloski, J, Y El Kasmy El Kasmi, Espin-Basany, E, Clerc, D, Ciubotaru, C, Popescu, S, Yanishev, A, Lee, S, B Ozkan, B, A Yagız Sen, K Aktas, M, E Baki, B, Yüksek, B, Kamarajah, S, A Khaw, R, Mills, E, Goodson, R, Thakral, N, D Ablett, A, Adra, M, Kwek, I, M Khan, S, Quinn, P, R Manley, L, Badran, A, Ramjeeawon, A, Campbell, A, L Tan, H, S Rye, D, Rajaraman, N, G Norman, J, Vutipongsatorn, K, Solomou, G, Akhbari, M, Ali, A, Murray, V, M Baker, D, D Brandao, B, Stainer, B, Thavayogan, R, Jones, D, O Onafowokan, O, Gharooni, A, Dabab, N, Carlton-Carew, S, Kungwengwe, G, Gabriel, M, Sewart, E, C Shortland, T, Lawday, S, Pockney, P, Dawson, A, D Brumfitt, C, Stewart, P, B, Ng, K Luong, J, Ivanov, V, Borisova, A, Neykov, V, Kunčarová, K, Kološová, B, Antonova, T, Farkašová, M, L Harbjerg, J, Brandsborg, S, Brinck, S, D Kjaer, M, Mark-Christensen, A, P Unbehaun, K, Dalsgaard, P, D Lycke, K, Lenaoures, P, Brigand, C, Dumange, E, Gout, M, Moehwald, C, Prem, M, Alhalabi, O, Sliwinski, S, Krupp, J, Gablenz, E, Schmitzer, L, Kopp, A, Steinle, J, Gsenger, J, J Pohl, L, Riccardi, M, M Christodoulou, I, Konstantinidis, M, Machairas, N, Zoikas, A, Balalis, D, K Manatakis, D, L Aguilera, M, Marano, L, Fleres, F, Lovisetto, F, Sasia, D, Segalini, E, Pata, G, Lucchi, A, Sagnotta, A, Campagnaro, T, Petrelli, F, Gallo, G, Papandrea, M, Testa, V, Sinibaldi, G, F Di Candido, Colombo, F, Perrone, G, Aresu, S, Biancafarina, A, Canonico, G, Pagnanelli, M, Curletti, G, Bini, R, A de Manzoni Garberini, Impellizzeri, H, Cillara, N, Tutino, R, Picciariello, A, Coletta, D, Savino, G, Ferrara, F, Tamini, N, Talamo, G, Parini, D, Giamundo, P, A Lo Conte, Pagano, G, Ripetti, V, Pesce, A, Menduni, N, Giudicissi, R, Goldin, E, Rega, D, Belli, A, Andriola, V, Gordini, L, Foppa, C, Piccolo, G, Birindelli, A, Ferrari, C, Ballarini, Z, Tirelli, F, Milone, M, M De Rosa, S Pipitone Federico, N, Molteni, B, L Tilocca, P, Sancini, G, N Piozzi, G, Lauretta, A, Poillucci, G, Mulas, S, Simcikas, D, Portelli, L, Jwm van Wijnbergen, L Dinger, T, Sfh Ten Doesschate, Ashm van Dalen, D van den Bos, D, Hansmann, M, J Medina Feliz, Z Kuiper, S, Abdulrahman, Z, R Pruijssers, S, Farik, S, M Elliott, B, P Geneta, V, Wilton, S, Kandelaki, H, L Peng, S, Campbell, S, K Lim, Y, S Yassaie, S, Murray, M, Haran, C, Tan, J, Castro, J, Laranjeira, A, Catarino, S, Neves-Marques, C, G Correia, J, N Vieira, B, C Quintela, A, L Serra, M, Maciel, J, Cunha, M, J Aparício, D, Neves, J, Azevedo, J, Romano, M, Eiró, F, Romano, J, Monteiro, C, Claro, M, R Almeida, M, Peyroteo, M, D Machado, N, Capote, H, Ferreira, M, Sousa, X, Devesa, H, Cavadas, D, Guerreiro, I, Costa, M, Rosete, M, Salman, M, English, C, Mohammed, N, Litvin, A, V Ćuk, V, Mészárosová, K, Jaich, R, H De Lima, Brooks, S, Marx, M, M Nshalati Salvation, J García Cardo, Mora-Guzmán, I, J Sancho Muriel, U de Andres Olabarria, Muriel, P, C Jimenez Viñas, Alconchel, F, O Esteban Sinovas, C Fairén Oro, M López Otero, S Figueroa Jiménez, O Claramonte Bellmunt, J Martínez Caballero, Rubio-Pérez, I, M Aguilar-Martínez, M, J Segura-Sampedro, J, C Olmedo Moreno, D Negre Parra, M Estévez Diz, A, Martín-Balbuena, R, C Bustamante Recuenco, E Licardie Bolaños, R, Fernández, P, A Díaz Padillo, Forero-Torres, A, I Alberdi San Román, H Salvador Rosés, M Merayo Álvarez, P Villarejo Campos, C Lopes Moreira, C, P Uriol Peralta, M Serrano Navidad, Ripollés-Melchor, J, Garcea, A, H Gómez Facundo, P Troncoso Pereira, V Pérez Guarinos, C, Blaser, B, Piazza, G, Gagliardi, B, Serin, H, S Yurdaor, S, Arslan, E, Kopac, O, Uyanik, A, B Ozmen, B, Tiftik, E, Aksoy, B, Yalcinkaya, A, Ozoglu, F, D Kocer, M, Bilicen, G, N Cinar, E, Uslu, Ö, Kaya, Y, Demirci, K, Wong, J, Mmh, Farhan-Alanie, Suresh, G, Asif, A, J Finch, B, Bhahirathan, Y, Herron, J, Z Yi Tew, Obukofe, R, Russell, C, Suchett-Kay, I, Netke, T, Williams, L, Kisiel, A, Y Liu, F, Claireaux, H, James, P, Mondal, A, Kalderon, R, H Nadama, H, Al-Saraff, Z, Jph, Tam, Powell-Chandler, A, Wood, F, Rebecca, Gorgievska, Ragavoodoo, A, Thakrar, C, Rojoa, D, Palmer, C, Davidson, K, Giacci, L, Hale, J, W Gan, F, Makin-Taylor, R, Y Hey, C, Toh, C, M Findlay, J, Griffiths, N, Ganesananthan, S, Jasionowska, S, Poustie, M, Wong, C, Turner, T, Pyc, W, Sloper, W, Warner, C, Coey, J, Mason, D, Sait, S, Kowal, M, Owen, M, Saiyed, A, Ashworth, I, Akbari, K, Curran, M, Martin, P, Parker, D, Kwok, K, Lye, C, Ghaly, M, Sammour, T, Lewis, D, Mundasad, R, Wilkes, A, Ctercteko, G, Maslyankov, S, Dimov, R, Iliev, S, Dimitrov, D, Marek, F, Örhalmi, J, Skalický, P, Skalický, T, Chrz, K, Christensen, P, Worsøe, J, S Kristensen, E, J Emmertsen, K, S Loeve, U, L Mihaljevic, A, Herrle, F, M Konstantinidis, K, Korkolis, D, Karanikas, I, Vincenti, L, Anania, G, Borghi, F, Agresta, F, Maretto, I, Parisi, A, Bucci, L, G De Palma, Guglielmi, A, Cucinotta, E, F La Torre, Cianchi, F, Guerrieri, M, Trompetto, M, Persiani, R, Micheletto, G, Delrio, P, Cantafio, S, Ronconi, M, Pag, Bisagni, M De Prizio, Franceschi, A, Galleano, R, Cavallini, M, Brescia, A, D'Ambra, L, Benevento, A, Niolu, P, Calgaro, M, Colangelo, E, Grottola, T, F Altomare, D, Puleo, S, Salamone, G, Pietrabissa, A, Poggioli, G, Erdas, E, Ottonello, R, Tonini, V, Selvaggi, F, Sammarco, G, Ceccarelli, G, C De Nisco, Surgo, D, Taglietti, L, Ozolins, A, Sivinš, A, Poskus, T, Psaila, J, A Bemelman, W, J Graat, L, Langenhoff, B, Bpl, Wijnhoven, Ahw van de Ven, Poelman, M, Lps, Stassen, Slooter, G, Yiz, Acherman, Hoff, C, F Gerhards, M, Mwj, Stommel, J Hazebroek, E, Aaw van Geloven, A Schasfoort, R, L van Leeuwen, B, B Tuynman, J, Mwa van Tilburg, G Boerma, E, Sharma, P, Jenkins, B, P Bissett, I, Herd, A, Gordon, A, Vernon, D, Omundsen, M, J, Ly, Reddy, A, Bonnet, G, Harmston, C, Morales, M, Francisco, V, Costa, S, Manso, A, Amorim, E, Pereira, J, Cardoso, J, Ourô, S, Caratão, M, Nascimento, C, B Ribeiro da Silva, Taranu, V, Dias, R, Mendes, J, Allen, M, Silva, A, Carlos, S, Barbosa, E, Carneiro, C, Ramos, L, Lencastre, L, Martins, R, Silva-Vaz, P, F Ridgway, P, A McNamara, D, Cahill, R, Hogan, A, Larkin, J, R O'Connell, P, Negoi, I, Abelevich, A, M Ćuk, V, Vician, M, Ede, C, Sardiwalla, I, Mulira, S, Montwedi, D, Oyomno, M, Sabia, D, V Portugal Porras, Vigorita, V, G Sanz Ortega, García, J, A Espí Macías, F Blanco Antona, A Luján Mompeán, J, S Salvans Ruiz, Villarejo-Campos, P, M Romero Simó, Sánchez-Guillén, L, M Jiménez-Gómez, L, A Sánchez López, Golda, T, D Julià Bergkvist, Nevado, C, F Noguera Aguilar, J, B Ricardo Felipe, Septiem, J, A Rodríguez Sánchez, Cañete-Gómez, J, I Ruiz Montesinos, Millán-Scheiding, M, Prieto-Nieto, I, Frasson, M, D García Olmo, Hübner, M, Petermann, D, O Sauvain, M, Ozben, V, E Geçim, I, Disçi, E, Rencuzogullari, A, Kurt, A, Bisgin, T, Pehlivan, M, Isik, A, Onur, E, Leventoglu, S, C Haksal, M, S Erturk, M, Keskin, M, Guner, A, S Tutcu Sahin, S Ozbalci, G, Pergel, A, Albayrak, D, Bruce, D, Fearnhead, N, Arthur, J, Harron, M, Beattie, G, Titu, L, Saunders, M, Phillips, J, Dindyal, S, Cresswell, B, Gercek, Y, Lee, J, Linn, T, Faulkner, G, Lockwood, S, Rees, J, Charalabopoulos, A, Campbell, B, Kontovounisios, C, Amarnath, T, Johnson, M, Epanomeritakis, E, Vigs, S, Nastro, P, Gilliam, A, Smolarek, S, Wilson, T, Orbell, J, Mcintyre, R, Agarwal, T, Hainsworth, P, Patel, P, Vijay, J, Liu, B, P Dhruva Rao, Roxburgh, C, Vipond, M, Youssef, H, Thorn, C, Schizas, A, Denley, S, Bowley, D, Das, K, Cuming, T, Saha, A, Chung, L, Pitt, J, Davis, P, Jones, O, Taylor, M, Bhargava, A, Haji, A, Watson, N, Bloom, I, Singh, B, Norwood, M, Gurjar, S, Stylianides, N, Mirza, S, Evans, M, Williams, G, Patil, P, Hernon, J, Finch, G, Green, S, Chapple, K, Fafemi, O, Warusavitarne, J, Samee, A, Carden, C, Ong, L, Verma, K, Joseph, A, Rawat, N, Pinkney, T, Oke, O, Glen, P, Maxwell-Armstrong, C, Oliphant, R, Garner, J, J Moug, S, Middleton, S, N Lund, J, J Smart, N, Osborn, G, Moore, T, Raymond, T, H Knowles, C, S Hany, T, Clarke, R, Khera, G, Brady, R, Sellahewa, C, Mason, C, Torrance, A, Lasithiotakis, K, Knight, J, Pullybank, A, Ainsworth, P, Reid, F, Ramwell, A, Maslekar, S, George, R, Skull, A, Holtham, S, Muhammad, K, Lal, R, Varcada, M, M Smith, F, Howlader, M, Defriend, D, Kirk, S, Richards, T, Evans, C, M Borg, C, Telford, K, Sarfraz, N, Busby, K, Hollingshead, J, Speake, D, Pawa, N, West, D, Chadwick, M, Komolafe, O, Richardson, S, Thornton, M, Goede, A, Osborne, C, Bandyopadhyay, D, Foong, J, J Lee, Y, Liebenberg, P, Mijalkov, D, Wells, A, Bull, N, Ajmera, A, Warburton, T, Morgan, S, Mahmoud, A, Schachtel, M, Mikhail, B, Fomin, I, Mekaeil, B, Taylor, N, Stevenson, C, Drane, A, Pahalawatta, U, T Lai, L, Debiasio, A, Hjs, Jun, Hengpoonthana, R, M Mendis, D, M Robb, P, J Lee, H, Aab, Wyche, T Davis, L, Chrimes, A, Agarwal, A, Zhao, J, Williams, S, Jmsn, Jayalath, Khor, S, Muddasani, T, Childs, S, Ridgway, S, Nda, Blefari, Tam, H, Puchalski, N, Ngai, C, Mackenzie, J, Johnson, N, Holmes, M, Zuzek, R, Saluja, T, Gould, T, K Goh, Y, Selvaraj, T, Z Beh, Y, N Dudi-Venkata, N, Horne, D, L Borrow, J, Campbell, C, Cousins, G, Jackson, L, Maheepala, K, Zhao, S, Holden, E, Tutt, L, Thompson, B, Collins, H, Louie, F, Buckland, B, Smith, D, Chong, C, H Chua, T, Nayak, C, Redmond, J, R Tan, R, Gramlick, M, S Teh, J, Y Ng, S, Britten-Jones, P, R Mohd Rosli, Hdv, Pham, Jegathees, T, Smcj, Coulter-Nile, P Gosselink, M, L Wang, Y, Maciaszek, M, S Chrapko, P, Nair, A, 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Kenny R., Kan P., Lee D.E., Khosla S., Samake M., Shaban F., Aftab R., Gough M., Woodburn B., Vayalapra S., McMurrugh K., Jimulia D., Deol S., Pike S., Embury-Young Y., Patel M., Kilgallon E., Keating R., Walsh A., Khan H., Logue G., Orekoya M., Alasmar M., Charalambides M., Llavall A.C., Williamson E., Bharwada Y., Zearmal S., Evans H., Panikkar M., de la Cruz G., Caplan J., Ruparelia A., Tanvir T., Soare C., Pang Y.L., Trotter J., Zaidi A., Thakrar V., Pulickal P., Ahmed H., Parnell J., Lennock S., Ford V., Brignall R., O'Neill D., Hanna R., Kane R., Nicola M., Rajput K., Xiao Y., Michael S., Wright E., Juniper S., Thompson E., Hoskyns L., Kanitkar A., Ross C., Unsworth A., Rshaidat H., Demarre K., Chiang A., Bareh A., van Dellen J., Faqihinejad C., Gadhvi A., Grant R., Lewsey J., Morris A., Martin H., McClarty C., Sanyal S., Alsaif A., Palkhi A., Bhopal S., Burford C., Huq T., Irwin E., Matthews L., Ngu W.S., Hosfield T., Muneeb F., Page O., Zeb E., Al-Azzawi A., McIntosh J., Vucicevic A., Hughes M., Brooks L., Fanibi B., Dixon M., Njoku P., Morris D., Jobson J., Chowdhury H., Joseph N., Zulkefley N., Hunt G., Christodoulou T., Wright O., Soman S., Jamal M., Beqiri S., Borgas P., Christie S., Pereira F., Browne S., Yiu J., Dworkin A., Brayley J., Palmer A., Charalambos M., Jones C.S., Toner S., Cowden R., Lee L., Nicol P., Holman O., Imtiaz M., Albert V., Leung S.P., Erotocritou M., Stroud R., Wilkin R., Thomson W., Mackee L., Kler A., Reynolds L., Mohamed S.H., Majeed Y., Fakim B., Jones A., Liversedge G., Carrington Z., Windebank J., Izzarina A., Akbani U., Craven J., Aldarragi A., Harding S., Millward A., Bedford M., Gopalan V., Midgen A., Khadka P., Cheng O., Taneja S., Manobharath N., Kok J.Y., Lim D.W.E., Buick T., Boland M., Piya S., Devlin R., Fairfield C.J., George R.J., Rahi M., Zaman S., Hajiev S., Ross T., Crisp E., Thompson C., Charalambous A., Hollywood J.L., Hammond R.F.L., Matthews J., Mendonca V., Spinty J., Khan K., Cheng J., Glynn N., Muhammad U., Khan M., Anderson L., Mccormack K., Mak J., Patrawala S., Milinkovic N., Schofield R., Chauhan M., Hartley L., Hind J., Nelson L., Ratnasingham D., Whitehead T., Dimitriadis S., Marshall K., Flint E.J., Horner C., Heybourne A., Morgan H., Wickstone C., Panagiotou D., O'Connell E., Dean K., Iqbal R., Walsh L., Yu N., Rana N., Massie E., Ng J., Jung M., Lee Y.D., Harris M., White S., Boev B., Tonchev P., Prochazka V., Risko J., Skalicky A., Ravn S., Ojakaar A., Dorr-Harim C., Koutserimpas C., Giraudo G., Armellini A., Ruzzenente A., Mazzeo C., De Padua C., Luc A.R., Maroli A., Vitali M., Gusai G.P., Quattromani R., Virgilio E., Berti S., Di Mola F.F., Papagni V., Tuminello F., Vittori L., Longheu A., Loche G.A., Braccio B., De Luca E., Resta G., Ancans G., Tamosiunas A., Petrulionis M., Abdulrahman N., van de Pas K.G.H., Thomas G., Brandsma A.M., Davids J., Rottier S.J., de Roy van Zuidewijn D., Hawkins R., Ong H.I., Li Y., Desmond B., Winstanley J., Martins M., Americano M., Frade S., Senhorinho R., Peixoto R., Alves-Vale C., Lamas M., O'Connor D.B., Hoo M., Gopaul A., Scanlon K., O'Dwyer N., Jovanovic M., Panyko A., Van Vuuren S., Centeno A., Bernado I.R., Senorans M.P.G., Amor L.G., Ramirez A.C., Abrisqueta J., Gomez M.E., Arroyo A., Cerdan C., Romeu N.G., Enriquez-Navascues J.M., Collado-Roura F., Curchod P., Gaspar S., Imadalou L., Mutlu D., Akyol C., Uygur F.A., Eray I.C., Biyiklioglu O., Cetin M.F., Isik A.E., Karip B., Dogan H., Sarigul L., Tunc E., Aydin T., Bodur S., Karabulut K., Francis A.A., Al-hadithi A., Lau I.S.F., Smith E., Mahapatra S., McAuliffe O., Imam L., Akram B., Hossaini S., Davies R., Ko M., Collins J., Pandya A., Reilly S., Archer J., Livie J., Chaudhry F.A., Ntakomyti E., Diallo R., Bylinski T., Wright J., Masiha E., Tung J., Shirazi B., Neilson A., Epton S., Patel N., Trussell S., Couldrey A., Donnelly C., Eftychiou S., Salman M., Skejo, Licari L., Men, Chapman, S. J., Blanco-Colino, R., Perez-Ajates, S., Bautista, O. A., Hodson, J., Glasbey, J. C., Pata, F., Pellino, G., Soares, A. S. A., van Elst, T., Van Straten, S., Nepogodiev, D., Borakati, A., Bath, M. F., Yasin, I. H., Mclean, K., Arthur, T., Kovacevic, M., Delibegovic, S., Karamanliev, M., Swamad, M., Zebrak, R., Paramasivam, R., Martensen, A., Larsen, H. M., Radeker, L., Frey, P. E., Kechagias, A., Venara, A., Duchalais, E., Ioannidis, A., Pasquali, S., Simioni, A. S. A., Farina, V., Podda, M., Lorenzon, L., Jakubauskas, M., Schaeff, V., Otto, A., Fagan, P. V. B., Wells, C. I., Joao, A. A., Soares, A., Juloski, J., El Kasmi, Y. E. K., Espin-Basany, E., Clerc, D., Ciubotaru, C., Popescu, S., Yanishev, A., Lee, S., Ozkan, B. B., Sen, A. Y., Aktas, M. K., Baki, B. E., Yuksek, B., Kamarajah, S., Khaw, R. A., Mills, E., Goodson, R., Thakral, N., Ablett, A. D., Adra, M., Kwek, I., Khan, S. M., Quinn, P., Manley, L. R., Badran, A., Ramjeeawon, A., Campbell, A., Tan, H. L., Rye, D. 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V., Lin, Q., Muniesa, C., Avelino, L., Cholewa, H., Sancho-Muriel, J., Navasquillo, M., Navio, A., Abello, D., De Jesus, M., Alvarez, E., Garcia, J. M., Gil, A., Giordano, H. E., Mignon, G., Vanoni, A., Henkens, A., Jarrar, G., Odovic, M., Willemin, M., Milliet, O., Hahnloser, D., Demartines, N., Teixeira, H., Pittet, O., Haller, M. L., Huot, A., Kefleyesus, A., Bugmann, A., Piotet, L. M., Meijers, L., Kurtoglu, G. K., Sel, E. K., Isler, V. C., Guner, B., Islek, E. C., Tombul, H. B., Boztug, C. Y., Tinaz, A., Yilmaz, M., Karaman, Y., Akin, F. A., Dansuk, S., Bascavus, M., Kaya, M., Kutlu, B., Seker, M. C., Erten, V., Memis, U., Kocak, Z. B., Karapinar, Y. E., Fakirullahoglu, M., Koseoglu, E., Yeni, M., Aykun, N., Agca, M. H., Bilen, C., Kilinc, I., Atar, C., Kilic, V., Aktuna, C., Aba, M., Alim, Y. E., Binbuga, M., Kurklu, O., Ceylan, C., Yilmaz, S., Calar, S. N., Yildirim, N., Yavuz, G., Can, B., Cesmeli, E., Kus, D., Kavar, R. C., Cevlik, A. D., Cengiz, U., Turk, E. G., Yilmaz, I., Erdonmez, H., Gursoy, F., Kara, H., Onsal, U., Ozbek, M., Kasar, P. A., Ipor, A., Ozen, D., Olmez, M., Altintas, E., Toklu, R., Saricicek, T., Tipi, O. U., Benli, G. E., Tasdelen, I., Tura, A., Ucar, A., Ekci, B., Bilgili, A. C., Kiraz, I. N., Aksoy, H., Basak, A., Erdem, M., Kayacan, S., Sahin, C., Uysal, M., Karakus, K., Altiner, S., Demirci, Z. S., Eren, E., Yavas, M., Aksoy, A. B., Karagoz, E., Sabanci, R., Tumer, S. S., Kargici, K., Banaz, T., Abdulrahman, S. M. F., Yesilsancak, M., Yanikoglu, E., Karabulut, A., Yilmaz, D., Yarenci, E., Demiroglu, Y., Sunal, A., Baykan, B., Abbasguliyev, H., Mutlu, V., Mahmoudi, Y., Dossa, S. A. A., Mizan, S. R., Demirtas, B., Cavus, T., Yuksek, A., Mazlum, S. S., Yelkenci, C., Baran, T., Satilmisoglu, M., Sahin, A. Z., Kilinc, A., Isik, K., Yumurtaci, O., Emin, A., Girit, C., Yildirak, M. K., Senyigit, E., Guldag, A., Soyleyici, B., Aytin, Y. E., Akay, F. E., Iskan, N. G., Mutlu, B., Sunay, A. O., Tie-Gill, T., Ramsay, G., De Paola, L., Mcguckin, S., Alshakhs, A., Ahmeidat, A., Goergen, N., Ali, Z., Mullarkey, L., Walshe, R., Lewis, E., Berry, B., Moneim, J., Mookerjee, S., Christy, S., Ojofeitimi, O., Carroll, L., Hylands, A., Delaugere, L. P., Reveendran, D., Coulter, C., Ralston, C., Laverty, L., Gallagher, P., Ahmed, A., Yeo, Y. Q., Elliott, D., Bennett, J., Mcnamara, M., Sivarajah, S., Dunmore, C., Aitken, G., Nair, M., Aly, M. H., Buari, M., Ahmed, K., Sheikh, Z., Monks, M., Lehmann, J., Rotimi, O., Bell, T., Limnatitou, D., Gormley, S., Taleongpong, P., Patel, V., Macgregor, L., Amini, S., Turner, C., Dwyer-Hemmings, L., Busuttil, A., Powell, J., Hensher, C., Vivian, F., Wcislo, K., Millar, Z., Hirosue, S., Ogunmwonyi, I., Nakakande, D., Gaze, H., Pillai, S., Khoury, G., Powell, T., Maleyko, I., Sangheli, A., Ransome, M., Isse, M., Aromolaran, O., Bholah, H., Anbarasan, J., Rehman, S., Hu, E., Timms, S., Reynolds, W., Hotchkies, A., Misra, V., Murray, V., Theocharidou, L., Malik, T., Janmohamed, I., Carhart, B., Khan, A., Hullait, R., Rylance, A., Butt, S., Leathes, J., Rajathasan, T. P., Jeddy, H., Kyaw, H. A., Wong, N., Karelia, S., Clements, J. M., Rainey, M., Joshi, N., Rahman, A., Gallagher, M., Rebuffa, N., Abdelgalil, R., Lai, R. S. Y., Laurence, N., Thomas, S., Green, C., Frostick, R., Khera, R., Povey, M., Wong, H. L., Mccusker, C., Hlukha, L., Pike, G., Kamel, F., Thakkar, R., Donaldson, C., Campos, M. S., Bradbury, M., Osunronbi, T., Tam, L. Y. C., Kaabneh, A. K., Lawther, J., Fisher, P., Tribedi, T., Moosa, A., Ramdin, A., Goble, M., Downs, E., Wheldon, L., Baggus, E., Mandal, A., Nayeem, A., Ahmed, S., Fradley, W., Wilson, C., Gallagher, S., Criswell, T., Ward, J., Mukkavilli, A., Stubbs, B., Fordyce, W., Suchdev, N., Lim, S. W., Sookramanien, S. R., Chan, A., Bointas, G., Paul, M., Ward, K. L., Bagnall, M., Pherwani, S. A., Wang, K., Mitchell, L., Heyworth, J., Ayyar, S., Polson, R., Mackenzie, E., Doyle, N., Habib, Z., Zardab, M., Sartaj, F., Farooq, H., Tabibi, M., Drury, D. J., James, S. J., Barnett, R., Cahya, E., Lou, G., Coyle, M., Homyer, K., Zhu, L. Y., Woods, M., Chang, J., O'Callaghan, H., Suchett-Kaye, I., Mihailidis, T. H., Alawattegama, H., Seite, E., Barrett, A., Riordan, E., Lam, W., Dowdeswell, M., Mulvenna, C., Awokoya, O., Gurowich, L., Dhera, K., Hayat, S., Tincknell, L., Spazzapan, M., Teeling, F., Sysum, K., Latter, J., Latter, M., Khan, S., Woodmass, M., Hayden, H., Ali, Y., Husain, S., Arnold, A., Pedersen, A. C., Cunha, P., Ahmed, M., Al Zawawi, S., Kudva, V., Theodoropoulou, K., Miscampbell, M., Robinson, A. V., Johnston, J., Dharni, A., Lamb, S., Westerman, T., Evans, E., Campbell, L., Gillespie, M., Cheong, C. M., Kulathevanayagam, K., Varghese, A., Ike, S. I., Chu, T. S. M., Baljer, B., Mogg, J. A. W., Rai, P., Claireaux, H. A., Williams, M., Smillie, R., Goetz, J., Appleby, E., Fadipe, T., Vaughan-Burleigh, S., Jovaisaite, A., Shah, S. M., Khalid, N., Gutmann, D., Davison, S., Alame, Y. J., Syed, L., Owen, W. J., Ahsan, S. D., Anthony-Uzoeto, U., Hall, C. M., Zheng, S., Wynter, K., James, C., Sapre, D., Ghosh, R., Baird, J., Cockburn, L., Blackwood, O., Simpson, W., Jeong, S., Bishop, S., Bate, R., Hobson, C., Adam, A. H., Redclift, C., Do, J., Adeleye, O., Poli, F., Batterham, A., Brown, S., Parekh, J. N., Clay, W., Pieri, K., Jackson, A., Saxena, A., Gurung, B., Oyebola, T., O'Brien, F., Djeugam, B., Gardezi, S., Ul-Hasan, S., Martin-Hernandez, M. P., Sisley, M., Modi, S., Antakia, R., Elbayouk, A., Soh, Y. J., Mather, J., Yusuf, Z., Al-Sarraf, Z., Naja, M., Rassool, S. B., Convill, J., Nikookam, Y., Warsame, A., Pace, C., Kiandee, M., Ridwan, R., Carey, C., Hirri, F., Mcmillan, M. J. A., Ling, J. J., Pendelbury, L., Kerimzade, K., Tang, A., Howard, E. O., Humayun, S., Wadsworth, O. J., Tan, K., Abdelhameed, F., Haglund, C., Radnaeva, I., Hu, N., Rambhatla, S., Waldron, D., Madahar, P., Malik, S., Meney, L. C., Ibrahim, I., Kang, C. K., Chiu, J. Z. J., Livie, V., Ibrahim, B., Khalil, M., Pooley, G., Shishkin, B., Docherty, J., Southgate, A., Coomes, A., Mcgee, F., Flanagan, S., Tan, Q. J., Anwar, H., Clough, R., Chrisp, B., Cassels, J., Cross, G. W. V., Mercer, L., Mercer, C., Refalo, A., Hadley, R., Mctighe, A., Farrow, F., Brodie, A., Davis, G., Shah, D. R., Bowers, C., Patel, S., Morice, O., Burzic, A., Cheung, J., Shashidhara, A., Theodoraki, G., Birk, J., Ong, A., Ng, M. P. E., Wong, R. T. W., Maese, S., Yeap, B., Iqbal, Z., Melaugh, T., Perchard, W., Scurr, T., Campbell, E., Kelk, L., Ghosh, A., Gibbins, A., Mala, D., Loizidou, A., Hall, O., Mecia, L., Hew, C., Varathan, K., Tong, L., Chandrasekar, B., Buchanan, E., O'Connell, M., Kwak, S. Y., Ong, E. H., Gardner, S., Lim, J., Maden, C., Illahi, M., Tan, Z. X., Edwards, S., Stahl, R., Stahl, J., Hickman, A., Collett, D., Goolam-Mahomed, Z., Allen, B., Atiyah, A., Ahmad, H., Jones, J., Mcgregor, O., Ogundiya, E., Boulbadaoui, A., Kirnon-Jackman, O., Lim, Q. X., Peckham, H., Yeoh, T., Yong, S. Q., Chen, J. Y., Siva, S., Sam, Z. H., Gilani, M., Goh, Y. N., Muthukumar, M. G., Phillips, S., Tjoakarfa, J., Giri, A., Suresan, S., Thomas, P., Johnson, T. A., Williams, R. I., Rashid, A., Kushairi, A., Rais, A., James, A., Bugelli, M., Chechelnitskaya, Y., Sandhu, N., Tandon, R., Gray, M., Kumar, A., Ciurleo, C., Nyamali, I., Hiremath, S., Sinha, S., Chowdhary, M., Bradley, E., Mctiernan, M., Macdonald, S., Sharkey, S., Mclaughlin, N., Amey, C., Kraria, L., Skan, O., Kind, C., Tupper, P., Van Rhee, C., Honeyman, S. I., Menon, G., Jegatheeswaran, L., Madhavan, A., Warne, M., Malcolm, F. L., Lessware, T., Wilkerson, H. T., Chatterjee-Woolman, S., Yoong, A., Ahmed, W. U. R., Longshaw, A., Flannery, O., Green, R., Leaning, M., Cragg, J., Sharriff, H., Doherty, C., Kwan, K. W. L., Sanders-Crook, L., Bhatia, S., Eames, S., Lewis, F., Kirupananthan, P., Boh, Z. Y., Dass, S., Soma, A., Newton, A., Hill, M., Shafiq, Y., Brkljac, M., Boyce, L., English, W. J., Lam, S., Chipeta, C., Jain, C., Garofalidou, T., Novotny, S. A., Locke, S., Bowman, C., Begaj, A., Murphy, C., Radcliffe, K., Chong, J. T., Jeffrey, E., Chaudhury, N., Rajendran, K., Akbar, Z., Walters, B., Kulendrarajah, B., Tran, N., Shrestha, S., Parmar, S., Gallagher, C., Hennessy, L., Pentti, E., Badhrinarayanan, S., Fung, A., Mansoor, M., Kenny, R., Kan, P., Lee, D. E., Khosla, S., Samake, M., Shaban, F., Aftab, R., Gough, M., Woodburn, B., Vayalapra, S., Mcmurrugh, K., Jimulia, D., Deol, S., Pike, S., Embury-Young, Y., Patel, M., Kilgallon, E., Keating, R., Walsh, A., Khan, H., Logue, G., Orekoya, M., Alasmar, M., Charalambides, M., Llavall, A. C., Williamson, E., Bharwada, Y., Zearmal, S., Evans, H., Panikkar, M., de la Cruz, G., Caplan, J., Ruparelia, A., Tanvir, T., Soare, C., Pang, Y. L., Trotter, J., Zaidi, A., Thakrar, V., Pulickal, P., Ahmed, H., Parnell, J., Lennock, S., Ford, V., Brignall, R., O'Neill, D., Hanna, R., Kane, R., Nicola, M., Rajput, K., Xiao, Y., Michael, S., Wright, E., Juniper, S., Thompson, E., Hoskyns, L., Kanitkar, A., Ross, C., Unsworth, A., Rshaidat, H., Demarre, K., Chiang, A., Bareh, A., van Dellen, J., Faqihinejad, C., Gadhvi, A., Grant, R., Lewsey, J., Morris, A., Martin, H., Mcclarty, C., Sanyal, S., Alsaif, A., Palkhi, A., Bhopal, S., Burford, C., Huq, T., Irwin, E., Matthews, L., Ngu, W. S., Hosfield, T., Muneeb, F., Page, O., Zeb, E., Al-Azzawi, A., Mcintosh, J., Vucicevic, A., Hughes, M., Brooks, L., Fanibi, B., Dixon, M., Njoku, P., Morris, D., Jobson, J., Chowdhury, H., Joseph, N., Zulkefley, N., Hunt, G., Christodoulou, T., Wright, O., Soman, S., Jamal, M., Beqiri, S., Borgas, P., Christie, S., Pereira, F., Browne, S., Yiu, J., Dworkin, A., Brayley, J., Palmer, A., Charalambos, M., Jones, C. S., Toner, S., Cowden, R., Lee, L., Nicol, P., Holman, O., Imtiaz, M., Albert, V., Leung, S. P., Erotocritou, M., Stroud, R., Wilkin, R., Thomson, W., Mackee, L., Kler, A., Reynolds, L., Mohamed, S. H., Majeed, Y., Fakim, B., Jones, A., Liversedge, G., Carrington, Z., Windebank, J., Izzarina, A., Akbani, U., Craven, J., Aldarragi, A., Harding, S., Millward, A., Bedford, M., Gopalan, V., Midgen, A., Khadka, P., Cheng, O., Taneja, S., Manobharath, N., Kok, J. Y., Lim, D. W. E., Buick, T., Boland, M., Piya, S., Devlin, R., Fairfield, C. J., George, R. J., Rahi, M., Zaman, S., Hajiev, S., Ross, T., Crisp, E., Thompson, C., Charalambous, A., Hollywood, J. L., Hammond, R. F. L., Matthews, J., Mendonca, V., Spinty, J., Khan, K., Cheng, J., Glynn, N., Muhammad, U., Khan, M., Anderson, L., Mccormack, K., Mak, J., Patrawala, S., Milinkovic, N., Schofield, R., Chauhan, M., Hartley, L., Hind, J., Nelson, L., Ratnasingham, D., Whitehead, T., Dimitriadis, S., Marshall, K., Flint, E. J., Horner, C., Heybourne, A., Morgan, H., Wickstone, C., Panagiotou, D., O'Connell, E., Dean, K., Iqbal, R., Walsh, L., Yu, N., Rana, N., Massie, E., Ng, J., Jung, M., Lee, Y. D., Harris, M., White, S., Boev, B., Tonchev, P., Prochazka, V., Risko, J., Skalicky, A., Ravn, S., Ojakaar, A., Dorr-Harim, C., Koutserimpas, C., Giraudo, G., Armellini, A., Ruzzenente, A., Mazzeo, C., De Padua, C., Luc, A. R., Maroli, A., Vitali, M., Gusai, G. P., Quattromani, R., Virgilio, E., Berti, S., Di Mola, F. F., Papagni, V., Tuminello, F., Vittori, L., Longheu, A., Loche, G. A., Braccio, B., De Luca, E., Resta, G., Ancans, G., Tamosiunas, A., Petrulionis, M., Abdulrahman, N., van de Pas, K. G. H., Thomas, G., Brandsma, A. M., Davids, J., Rottier, S. J., de Roy van Zuidewijn, D., Hawkins, R., Ong, H. I., Li, Y., Desmond, B., Winstanley, J., Martins, M., Americano, M., Frade, S., Senhorinho, R., Peixoto, R., Alves-Vale, C., Lamas, M., O'Connor, D. B., Hoo, M., Gopaul, A., Scanlon, K., O'Dwyer, N., Jovanovic, M., Panyko, A., Van Vuuren, S., Centeno, A., Bernado, I. R., Senorans, M. P. G., Amor, L. G., Ramirez, A. C., Abrisqueta, J., Gomez, M. E., Arroyo, A., Cerdan, C., Romeu, N. G., Enriquez-Navascues, J. M., Collado-Roura, F., Curchod, P., Gaspar, S., Imadalou, L., Mutlu, D., Akyol, C., Uygur, F. A., Eray, I. C., Biyiklioglu, O., Cetin, M. F., Isik, A. E., Karip, B., Dogan, H., Sarigul, L., Tunc, E., Aydin, T., Bodur, S., Karabulut, K., Francis, A. A., Al-hadithi, A., Lau, I. S. F., Smith, E., Mahapatra, S., Mcauliffe, O., Imam, L., Akram, B., Hossaini, S., Davies, R., Ko, M., Collins, J., Pandya, A., Reilly, S., Archer, J., Livie, J., Chaudhry, F. A., Ntakomyti, E., Diallo, R., Bylinski, T., Wright, J., Masiha, E., Tung, J., Shirazi, B., Neilson, A., Epton, S., Patel, N., Trussell, S., Couldrey, A., and Donnelly, C.
Subjects: operative, Male, postoperative discharge, Postoperative Complications, 0302 clinical medicine, Colostomy, CRITERIA, Prospective Studies, Bowel function, Colectomy, IMAGINE, stoma, intestines, Proctectomy, Ileostomy, digestive, oral, and skin physiology, patient discharge, colorectal surgery, hospital discharge, bowel function, RECOVERY, Middle Aged, adult, colostomy, elective surgical procedures, female, follow-up studies, humans, ileostomy, ileus, male, middle aged, multivariate analysis, patient readmission, patient safety, postoperative complications, prospective studies, recovery of function, colectomy, proctectomy, Patient Discharge, Colorectal surgery, ileus - - discharge - bowel function - elective - colorectal surgery, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Patient Safety, Cohort study, safety, Adult, medicine.medical_specialty, Ileus, Patient Readmission, defecation, 03 medical and health sciences, medicine, Hospital discharge, Humans, colorectal surgery, colorectal resection, Colorectal resection, defecation, postoperative complications, colorectal surgery, intestines, patient discharge, patient readmission, safety, surgical procedures, operative, colorectal resection, ileus, business.industry, Recovery of Function, Odds ratio, medicine.disease, digestive system diseases, surgical procedures, Surgery, Multivariate Analysis, Defecation, business, Follow-Up Studies
Abstract: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110).Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.El íleo es frecuente tras la cirugía colorrectal y se asocia con un aumento del riesgo de las complicaciones postoperatorias. Identificar las características de una recuperación normal del tránsito y la idoneidad para el alta hospitalaria es una tarea difícil. Este estudio examinó la seguridad del alta hospitalaria antes del restablecimiento de la función intestinal. MÉTODOS: Se llevó a cabo un estudio de cohortes prospectivo y multicéntrico a través de una red de colaboración internacional. Se incluyeron pacientes adultos sometidos a resección electiva colorrectal entre enero y abril 2018. El objetivo principal fue el reingreso hospitalario durante los 30 primeros días tras la intervención. Se utilizó un análisis de regresión multivariable para evaluar el impacto del momento del alta en función del restablecimiento de la función intestinal. El objetivo secundario fue las complicaciones postoperatorias en los primeros 30 días después de la cirugía, valoradas mediante el sistema de clasificación de Clavien-Dindo.Se incluyeron en el análisis 3.288 pacientes, de los cuales 301 (9,2%) fueron dados de alta antes del restablecimiento de la función intestinal. La mediana de la estancia hospitalaria de los pacientes dados de alta antes y después del restablecimiento de la función intestinal fue 5 (rango intercuartílico: 4-7) y 7 (6-8) días, respectivamente (P 0,001). No hubo diferencias significativas en las tasas de reingreso entre estos grupos (6,6% versus 8,0%; P = 0,499), y este resultado se mantuvo en el análisis multivariable tras el ajuste por diferencias basales (razón de opotunidades, odds ratio, OR 0,90; i.c. del 95% 0,55-1,46, P = 0,659). Las tasas de complicaciones postoperarorias fueron similares en aquellos dados de alta antes o después del restablecimiento de la función intestinal (complicaciones menores: 34,7% versus 39,5%; complicaciones mayores 3,3% versus 3,4%; P = 0,110). CONCLUSIÓN: Dar de alta antes del restablecimiento de la función intestinal tras cirugía colorrectal electiva parece ser seguro en pacientes debidamente seleccionados.
Published: 2020

14. Long-Term Follow-up of Skeletally Immature Patients With Physeal-Sparing Combined Extra-/Intra-articular Iliotibial Band Anterior Cruciate Ligament Reconstruction: A 3-Dimensional Motion Analysis

Author: Mininder S. Kocher, Kathryn A. Williams, Jeff J. Brodeur, Elizabeth S. Liotta, Lyle J. Micheli, Amy Whited, Benton E. Heyworth, and Dai Sugimoto
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Knee Joint, Anterior cruciate ligament reconstruction, Long term follow up, Anterior cruciate ligament, medicine.medical_treatment, Physical Therapy, Sports Therapy and Rehabilitation, Knee Injuries, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Intra articular, Humans, Medicine, Orthopedics and Sports Medicine, Anterior Cruciate Ligament, Child, 030222 orthopedics, Anterior Cruciate Ligament Reconstruction, business.industry, Anterior Cruciate Ligament Injuries, 030229 sport sciences, Biomechanical Phenomena, Surgery, medicine.anatomical_structure, Physeal sparing, Female, business, Follow-Up Studies
Abstract: Background: The physeal-sparing iliotibial band (ITB) anterior cruciate ligament (ACL) reconstruction (ACLR) is a well-established technique for treating skeletally immature patients with ACL rupture. However, the long-term implications of the procedure on the intricacies of kinetic and kinematic function of the knee have not been comprehensively investigated. Purpose: To assess the short-, mid-, and long-term effects of ITB ACLR on kinetic and kinematic parameters of knee functions. Study Design: Case series; Level of evidence, 4. Methods: A total of 38 patients who had undergone an ITB ACLR as a skeletally immature child were recruited to participate in a 3-dimensional (3D) motion analysis testing protocol at an institutional injury prevention center between 1 and 20 years after reconstruction. Exclusion criteria were congenital ACL deficiency and any other major knee injury (defined as an injury requiring surgery or rehabilitation >3 months) on either knee. 3D and force plate parameters included in the analysis were knee moment, ground-reaction force, and vertical jump height measured during drop vertical jump and vertical single-limb hop. Paired t tests and equivalency analyses were used to compare the parameters between cases (ITB ACLR limb) and controls (contralateral/nonsurgical limbs). Results: Paired t tests showed no statistically significant differences between limbs, and equivalency analyses confirmed equivalency between limbs for all tested outcome variables. Conclusion: The ITB ACLR appears to restore normal, symmetric, physiologic kinetic and kinematic function in the growing knee by 1 year after reconstruction, with maintenance of normal parameters for up to 20 years.
Published: 2020

15. Outcomes of Surgically Treated Chronic Exertional Compartment Syndrome in Runners

Author: Mininder S. Kocher, Lyle J. Micheli, Benton E. Heyworth, Adam Y. Nasreddine, Kathleen Maguire, and Matthew J. Salzler
Subjects: Adult, Male, Reoperation, Adolescent, medicine.medical_treatment, Physical Therapy, Sports Therapy and Rehabilitation, Compartment Syndromes, Running, Fasciotomy, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Orthopedics and Sports Medicine, Child, Surgical treatment, Chronic exertional compartment syndrome, Pain, Postoperative, 030222 orthopedics, biology, business.industry, Athletes, Moderate pain, 030229 sport sciences, Current Research, biology.organism_classification, medicine.disease, Return to play, Return to Sport, Treatment Outcome, Patient Satisfaction, Anesthesia, Female, business, human activities
Abstract: Background: Chronic exertional compartment syndrome (CECS) is primarily seen in running athletes. Previous outcomes of surgical treatment with fasciotomy have suggested moderate pain relief, but evidence is lacking regarding postoperative return to running. Hypothesis: Running athletes with limiting symptoms of CECS will show high rates of return to running after fasciotomy. Study Design: Case series. Level of Evidence: Level 4. Methods: Running athletes treated with fasciotomy for CECS at a single institution were identified using a surgical database and asked to complete a questionnaire designed to assess postoperative pain, activity level, return to running, running distances, overall satisfaction, and rate of revision fasciotomy. Results: A total of 43 runners met the inclusion criteria, and 32 runners completed outcomes questionnaires at a mean postoperative follow-up of 66 months. In total, 27 of these 32 patients (84%) returned to sport(s) after fasciotomy. However, 9 (28%) of these patients pursued nonrunning sports, 5 (16%) due to recurrent pain with running. Of the 18 patients who returned to running sports (56%), the mean weekly running distance decreased postoperatively. Recurrence of symptoms was reported in 6 patients (19%), 4 of whom had returned to running and 2 of whom had been unable to return to sports. All of these 6 patients elected to undergo revision fasciotomy surgery. Twenty-five (78.1%) patients reported being satisfied with their procedure. In the overall cohort, the mean visual analog scale scores for pain during activities/sports decreased from 7.9 preoperatively to 1.7 postoperatively. Conclusion: Fasciotomy for CECS in runners may provide significant improvement in pain and satisfaction in over three-quarters of patients and return to sports in 84% of patients. However, only 56% returned to competitive running activity, with a subset (19%) developing recurrent symptoms resulting in revision surgery. Clinical Relevance: Fasciotomy has been shown to decrease pain in most patients with CECS. This study provides outcomes in running athletes after fasciotomy for CECS with regard to return to sports, maintenance of sports performance, and rates of revision surgery.
Published: 2020

16. Driver Self-Regulation Practices in Older Drivers with and Without Mild Cognitive Impairment

Author: Feng, Ying Ru, Meuleners, Lynn, Stevenson, Mark, Heyworth, Jane, Murray, Kevin, and Maher, Sean
Subjects: self-regulation, Male, Automobile Driving, aging, Australia, Self-Control, mild cognitive impairment, Cross-Sectional Studies, Sex Factors, older drivers, Clinical Interventions in Aging, driving, Humans, Cognitive Dysfunction, Female, Self Report, human activities, Original Research, Aged
Abstract: Ying Ru Feng,1 Lynn Meuleners,1 Mark Stevenson,2,3 Jane Heyworth,1 Kevin Murray,1 Sean Maher4 1School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; 2Transport, Health and Urban Design, Melbourne School of Design, University of Melbourne, Melbourne, VIC, Australia; 3Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; 4Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, WA, AustraliaCorrespondence: Lynn MeulenersSchool of Population and Global Health, The University of Western Australia (M431), 35 Stirling Hwy, Crawley, Perth, WA 6009, AustraliaTel +61 8 6488 7375Email lynn.meuleners@uwa.edu.auObjective: To assess the impact of cognitive, socio-demographic and driving-related characteristics on self-regulation practices in older drivers with mild cognitive impairment (MCI) (determined by the Telephone Cognitive Screen (T-CogS) score), compared with drivers with no cognitive impairment.Design, Setting, Participants: A cross-sectional study collected information from 362 drivers with MCI and 611 drivers with no cognitive impairment, who were aged 65+ years, and were living in Western Australia between November 2018 and February 2019.Measurements: Self-reported self-regulation driving practices.Results: The majority of drivers with MCI (62.4%) and those with no cognitive impairment (57.1%) reported self-regulating their driving in at least one situation, in the past three months. The most common situations that both groups of drivers self-regulated in were “driving at night in the rain”, “parallel parking”, and “driving when raining”. Drivers with MCI were only significantly more likely to self-regulate when “making turns across oncoming traffic” and “driving at night”. They also had 39% greater odds of self-regulating in at least one driving situation, compared with drivers with no cognitive impairment (OR: 1.39, 95% CI=1.04– 1.85, p=0.02). Females also had 2.3 times greater odds of self-regulating (OR=2.34, 95% CI=1.76– 3.12, p< 0.001). Drivers aged 75+ years had 1.6 times greater odds of self-regulating, compared with drivers aged 65– 69 years (OR=1.58, 95% CI=1.12– 2.23, p=0.01).Conclusion: Older drivers with MCI were more likely to self-regulate their driving, compared to drivers with no cognitive impairment, particularly in complex driving situations. This suggests that some drivers with MCI may be able to recognize their cognitive limitations and adjust their driving accordingly. However, several drivers with MCI, particularly males, did not self-regulate their driving. This highlights the importance of advising patients about the impact of MCI on driving ability, suitable self-regulation strategies, as well as monitoring their driving ability.Keywords: driving, aging, self-regulation, older drivers, mild cognitive impairment
Published: 2020

17. Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort

Author: Mininder S. Kocher, Nathan L. Grimm, Henry G. Chambers, Sasha Carsen, Philip L. Wilson, Mark V. Paterno, Rick W. Wright, Michael T. Busch, Eric W. Edmonds, Norbert M. Meenen, J. Lee Pace, Stephanie W. Mayer, Jennifer M. Weiss, Peter D. Fabricant, Jie C. Nguyen, Regina O. Kostyun, Kevin Latz, Bradley J. Nelson, Theodore J. Ganley, Jay C. Albright, Aaron J. Krych, Cathy S. Carlson, Andrew T. Pennock, Eric J. Wall, James L. Carey, Emily Shearier, Henry B. Ellis, Christian N. Anderson, Kevin G. Shea, Roger Lyon, John B. Erickson, Paul Saluan, Benton E. Heyworth, Gregory D. Myer, Andrew M. Zbojniewicz, Matthew D. Milewski, Crystal A Perkins, Jutta M. Ellermann, Daniel W. Green, Dustin Loveland, Carl W. Nissen, James Hui Hoi Po, S. Clifton Willimon, John D. Polousky, Jeffrey J. Nepple, and Marc Tompkins
Subjects: Male, Pediatrics, medicine.medical_specialty, Demographics, Adolescent, Knee Joint, business.industry, Physical Therapy, Sports Therapy and Rehabilitation, Descriptive epidemiology, medicine.disease, Osteochondritis dissecans, Osteochondritis Dissecans, Cross-Sectional Studies, Medicine, Humans, Orthopedics and Sports Medicine, Female, Prospective Studies, business, Prospective cohort study, Child, Retrospective Studies
Abstract: Background: Osteochondritis dissecans (OCD) occurs most commonly in the knees of young individuals. This condition is known to cause pain and discomfort in the knee and can lead to disability and early knee osteoarthritis. The cause is not well understood, and treatment plans are not well delineated. The Research in Osteochondritis Dissecans of the Knee (ROCK) group established a multicenter, prospective cohort to better understand this disease. Purpose: To provide a baseline report of the ROCK multicenter prospective cohort and present a descriptive analysis of baseline data for patient characteristics, lesion characteristics, and clinical findings of the first 1000 cases enrolled into the prospective cohort. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients were recruited from centers throughout the United States. Baseline data were obtained for patient characteristics, sports participation, patient-reported measures of functional capabilities and limitations, physical examination, diagnostic imaging results, and initial treatment plan. Descriptive statistics were completed for all outcomes of interest. Results: As of November 2020, a total of 27 orthopaedic surgeons from 17 institutions had enrolled 1004 knees with OCD, representing 903 patients (68.9% males; median age, 13.1 years; range, 6.3-25.4 years), into the prospective cohort. Lesions were located on the medial femoral condyle (66.2%), lateral femoral condyle (18.1%), trochlea (9.5%), patella (6.0%), and tibial plateau (0.2%). Most cases involved multisport athletes (68.1%), with the most common primary sport being basketball for males (27.3% of cases) and soccer for females (27.6% of cases). The median Pediatric International Knee Documentation Committee (Pedi-IKCD) score was 59.9 (IQR, 45.6-73.9), and the median Pediatric Functional Activity Brief Scale (Pedi-FABS) score was 21.0 (IQR, 5.0-28.0). Initial treatments were surgical intervention (55.4%) and activity restriction (44.0%). When surgery was performed, surgeons deemed the lesion to be stable at intraoperative assessment in 48.1% of cases. Conclusion: The multicenter ROCK group has been able to enroll the largest knee OCD cohort to date. This information is being used to further understand the pathology of OCD, including its cause, associated comorbidities, and initial presentation and symptoms. The cohort having been established is now being followed longitudinally to better define and elucidate the best treatment algorithms based on these presenting signs and symptoms.
Published: 2021

18. Many Radiographic and Magnetic Resonance Imaging Assessments for Surgical Decision Making in Pediatric Patellofemoral Instability Patients Demonstrate Poor Interrater Reliability

Author: Peter D. Fabricant, Madison R. Heath, Douglas N. Mintz, Kathleen Emery, Matthew Veerkamp, Simone Gruber, Daniel W. Green, Sabrina M. Strickland, Eric J. Wall, Beth E. Shubin Stein, Shital N. Parikh, Jacqueline M. Brady, Caitlin C. Chambers, Henry B. Ellis, Jack Farr, Benton E. Heyworth, Jason L. Koh, Dennis E. Kramer, Robert A. Magnussen, Lauren H. Redler, Seth L. Sherman, Marc A. Tompkins, and Philip L. Wilson
Subjects: Adult, Joint Instability, Male, Adolescent, Tibia, Decision Making, Reproducibility of Results, Magnetic Resonance Imaging, Patellofemoral Joint, Young Adult, Humans, Orthopedics and Sports Medicine, Female, Prospective Studies, Child
Abstract: To evaluate the interrater reliability of several common radiologic parameters used for patellofemoral instability and to attempt to improve reliability for measurements demonstrating unacceptable interrater reliability through consensus training.Fifty patients with patellar instability between the ages of 10 and 19 years were selected from a prospectively enrolled cohort. For measurements demonstrating unacceptable interrater reliability (intraclass correlation coefficient [ICC]:0.6), raters discussed consensus methods to improve reliability and re-examined a subset of 20 images from the previous set of images. If reliability was still low after the second round of assessment, the measure was considered unreliable.Of the 50 included subjects, 22 (44%) were male and the mean age at the time of imaging was 14 ± 2 years. With 1 or fewer consensus training sessions, the interrater reliability of the following radiograph indices were found to be reliable: trochlea crossing sign (ICC: 0.625), congruence angle (ICC: 0.768), Caton-Deshamps index (ICC: 0.644), lateral patellofemoral angle (ICC: 0.768), and mechanical axis deviation on hip-to-ankle alignment radiographs (ICC: 0.665-0.777). Reliable magnetic resonance imaging (MRI) indices were trochlear depth (ICC: 0.743), trochlear bump (ICC: 0.861), sulcus angle (ICC: 0.684), patellar tilt (ICC: 0.841), tibial tubercle to trochlear groove distance (ICC: 0.706), effusion (ICC: 0.866), and bone marrow edema (ICC: 0.961).With 1 or fewer consensus training sessions, the interrater reliability of the following patellofemoral indices were found to be reliable for trochlear morphology: trochlea crossing sign and congruence angle on radiograph and trochlear depth, trochlear bump, and sulcus angle on MRI. Reliable patellar position measurements included: Caton-Deshamps index and lateral patellofemoral angle on radiograph and patellar tilt and tibial tubercle to trochlear groove distance on MRI. Additional global measurements (e.g., mechanical axis deviation on standing radiographs) and MRI assessments demonstrated acceptable reliability.II, prospective diagnostic study.
Published: 2021

19. Prenatal exposure to mixtures of persistent environmental chemicals and fetal growth outcomes in Western Australia

Author: Anna C. Callan, Luke D. Knibbs, Nina Lazarevic, Peter D. Sly, A.L. Hinwood, Adrian G. Barnett, Jane Heyworth, and Ania Stasinska
Subjects: Physiology, 010501 environmental sciences, 01 natural sciences, Fetal Development, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Fetal growth, Medicine, Humans, 030212 general & internal medicine, Prenatal exposure, 0105 earth and related environmental sciences, General Environmental Science, business.industry, Public Health, Environmental and Occupational Health, Australia, Infant, Newborn, Bayes Theorem, Environmental Exposure, Western Australia, Maternal Exposure, Prenatal Exposure Delayed Effects, General Earth and Planetary Sciences, Environmental Pollutants, Female, business
Abstract: Environmental chemicals have been implicated in the etiology of impaired fetal growth. However, few studies have assessed the effects of chemical mixtures or considered the possibility of non-monotonic exposure-response relationships for chemicals that act through the endocrine system.We assessed exposure to polybrominated diphenyl ethers, organochlorine pesticides, metals, and perfluorinated alkyl substances in blood and urine samples collected approximately two weeks prior to delivery in 166 non-smoking pregnant women, and subsequent birth weight, length, and head circumference of neonates who were part of the Australian Maternal Exposures to Toxic Substances (AMETS) study. We used Bayesian structured additive regression models with spike-slab priors to estimate mixture effects, identify important exposures, and model non-linearity in exposure-response relationships.Mixtures of polybrominated diphenyl ethers, organochlorine pesticides, metals, and perfluorinated alkyl substances were not associated with fetal growth outcomes. Estimated change in fetal growth outcomes for an increase in exposure from the 25th to 75th percentile suggested no meaningful associations; the strongest evidence was for a small inverse association between birth weight and cesium exposure measured in whole blood (-124 g, 90% credible interval: -240 to -3 g). We identified several chemicals that may be associated with fetal growth non-linearly; however, 90% credible intervals contained small values consistent with no meaningful association.Using a Bayesian penalized regression method, we assessed the shapes of exposure-response relationships, controlled for confounding by co-exposure, and estimated the single and combined effects of a large mixture of correlated environmental chemicals on fetal growth. Our findings, based on a small sample of mother-neonate pairs, suggest that mixtures of persistent chemicals are not associated with birth weight, length, and head circumference. The potential for non-monotonic relationships between environmental chemicals and fetal growth outcomes warrants further study.
Published: 2021

20. A Longitudinal Study Examining Self-Regulation Practices in Older Drivers with and without Suspected Mild Cognitive Impairment

Author: Ying Ru Feng, Lynn Meuleners, Mark Stevenson, Jane Heyworth, Kevin Murray, Michelle Fraser, and Sean Maher
Subjects: longitudinal, driving patterns, General Medicine, cognitive decline, Self-Control, Cohort Studies, Cognition, driving restriction, Clinical Interventions in Aging, Humans, Cognitive Dysfunction, Female, Longitudinal Studies, Geriatrics and Gerontology, human activities, Aged, Original Research, driving behaviour
Abstract: Ying Ru Feng,1 Lynn Meuleners,1 Mark Stevenson,2,3 Jane Heyworth,4 Kevin Murray,4 Michelle Fraser,1 Sean Maher5 1Western Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; 2Transport, Health and Urban Design Research Lab, Melbourne School of Design, University of Melbourne, Melbourne, VIC, Australia; 3Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; 4School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia; 5Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, WA, AustraliaCorrespondence: Lynn MeulenersWestern Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia (M431), 35 Stirling Hwy, Perth, WA, 6009, AustraliaTel +61 8 6488 7375Email lynn.meuleners@uwa.edu.auPurpose: Mild cognitive impairment can impact driving performance and self-regulation practices. However, there is little evidence on how cognitive impairment may impact these self-regulation practices over a period of time. Therefore, the aim of this study was to examine changes in the number and type of situations in which older drivers with and without suspected mild cognitive impairment (MCI) self-regulate their driving over a one-year period, after accounting for relevant confounders.Participants and Methods: A longitudinal cohort study involving older drivers (65+ years) from metropolitan Western Australia was interviewed by a telephone interview at baseline and one-year follow-up. The Telephone Cognitive Screen (T-CogS) was also administered to determine changes in their cognitive status. The outcome of interest was the number and type of situations older drivers self-regulated their driving.Results: A total of 670 drivers were interviewed at baseline (suspected MCI: n = 227; no cognitive impairment: n = 443) and one-year follow-up (suspected MCI: n = 251; no cognitive impairment: n = 419), which provided 1340 observations. Drivers with suspected MCI increased the number of driving situations in which they self-regulated by 13% over a period of one-year compared with drivers without cognitive impairment (IRR = 1.13, 95% CI = 1.02â 1.27, p = 0.025). Specifically, drivers with suspected MCI had 60% increased odds of self-regulating when âmaking turns across oncoming trafficâ compared with drivers without cognitive impairment (unadjusted OR = 1.60, 95% CI = 1.02â 2.53, p = 0.041). Other significant factors included being female (IRR = 1.87, 95% = 1.52â 2.32, p = 0.001), aged 75+ years (IRR = 1.33, 95% CI = 1.10â 1.60, p = 0.003), higher number of comorbidities (1â 3 comorbidities: IRR = 1.26, 95% CI = 1.01â 1.58, p = 0.040; 4+ comorbidities: IRR = 1.39, 95% CI = 1.08â 1.78, p = 0.011), âdecreased driving confidenceâ (IRR = 1.32, 95% CI = 1.10â 1.58, p-value = 0.003) and âpreference of having someone else driveâ (IRR = 1.38, 95% CI = 1.12â 1.70, p = 0.003). Having one or more traffic infringements was also associated with a decrease in the number of self-regulated driving situations (IRR = 0.80, 95% CI = 0.67â 0.95, p = 0.011).Conclusion: Over a one-year period, drivers with suspected MCI increased the number of situations in which they self-regulated their driving compared with drivers without cognitive impairment, particularly when âmaking turns across oncoming trafficâ. Future studies should examine whether this increase in the types and number of self-regulated driving situations is enough to compensate for declines in cognition.Keywords: longitudinal, cognitive decline, driving behaviour, driving restriction, driving patterns
Published: 2021

21. The Impact of Cognition and Gender on Speeding Behaviour in Older Drivers with and without Suspected Mild Cognitive Impairment

Author: Michelle L. Fraser, Sean Maher, Jane Heyworth, Ying Ru Feng, Lynn B. Meuleners, Mark Stevenson, and Kevin Murray
Subjects: Male, Psychological intervention, Affect (psychology), naturalistic, Cognition, Injury prevention, Activities of Daily Living, driver monitoring, Medicine, Humans, Cognitive Dysfunction, Cognitive decline, Cognitive impairment, Aged, Original Research, business.industry, Speed limit, General Medicine, cognitive decline, gender differences, Clinical Interventions in Aging, Female, Geriatrics and Gerontology, Naturalistic driving, business, human activities, Goals, Clinical psychology, driving behaviour
Abstract: Ying Ru Feng,1 Lynn Meuleners,1 Mark Stevenson,2,3 Jane Heyworth,4 Kevin Murray,4 Michelle Fraser,1 Sean Maher5 1Western Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; 2Transport, Health and Urban Design Research Lab, Melbourne School of Design, University of Melbourne, Melbourne, VIC, Australia; 3Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; 4School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia; 5Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, WA, AustraliaCorrespondence: Lynn MeulenersWestern Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia (M431), 35 Stirling Highway, Crawley, WA, 6009, AustraliaTel +61 8 6488 7375Email lynn.meuleners@uwa.edu.auPurpose: Mild cognitive impairment and gender can impact different aspects of driving performance and behaviour in older drivers. However, there is little evidence on how these may affect naturalistic speeding behaviour. Therefore, the aim of this study was to examine the relationship between speeding events and cognitive status for older male and female drivers.Participants and Methods: A naturalistic driving study collected objective driving information over a two-week period using an in-vehicle monitoring device from 36 older drivers with suspected mild cognitive impairment and 35 older drivers without cognitive impairment. The outcome of interest examined was the number of speeding events, defined as travelling 5+ km/h over the posted speed limit for at least a minute.Results: The majority of participants (n=58, 81.69%) did not have a speeding event during the two-week monitoring period. Twenty-three speeding events were recorded among seven drivers with suspected mild cognitive impairment and six drivers without cognitive impairment. The majority of speeding events (82.61%) were by older male drivers and occurred in 60km/h and 70km/h speed zones. The results of the two negative binomial regression models found that in older male drivers, suspected mild cognitive impairment (IRR=7.45, 95% CI=1.53â 36.15, p=0.01) was associated with a significantly higher rate of speeding events, while increasing age was associated with a lower rate of speeding events (IRR=0.80, 95% CI=0.64â 1.00, p=0.04). For older female drivers, there were no factors significantly associated with the rate of speeding events.Conclusion: While the overall number of speeding events were infrequent, suspected mild cognitive impairment was associated with a significant increase in the rate of speeding events for older male drivers, but not for older female drivers. Speeding interventions and injury prevention policy strategies may need to be targeted differently for male and female drivers with mild cognitive impairment.Keywords: naturalistic, driver monitoring, cognitive decline, gender differences, driving behaviour
Published: 2021

22. Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Author: Chapman, Sj, Clerc, D, Blanco‐colino, R, Otto, A, Nepogodiev, D, Pagano, G, Schaeff, V, Soares, A, Zaffaroni, G, Žebrák, R, Hodson, J, Glasbey, Jc, Pata, P, Pellino, G, Sgrò, A, Elst, T, Van Straten, S, Knowles, Ch, Borakati, A, Bath, Mf, Yasin, Ih, Mclean, K, Arthur, T, Kovacevic, M, Delibegovic, S, Karamanliev, M, Swamad, M, Paramasivam, R, Martensen, A, Larsen, Hm, Rädeker, L, Frey, Pe, Kechagias, A, Venara, A, Duchalais, E, Ioannidis, A, Pata, F, Pasquali, S, Simioni, A, Farina, V, Podda, M, Lorenzon, L, Jakubauskas, M, Elst, Tr, Chu, M, Fagan, Pvb, Wells, Ci, Alagoa João, A, Juloski, J, Ciubotaru, C, Popescu, S, Yanishev, A, Lee, S, Ozkan, Bb, Yagız Sen, A, Aktas, Mk, Baki, Be, Yüksek, B, Kamarajah, S, Khaw, Ra, Mills, E, Goodson, R, Thakral, N, Ablett, Ad, Adra, M, Kwek, I, Khan, Sm, Quinn, P, Manley, Lr, Badran, A, Ramjeeawon, A, Campbell, A, Tan, Hl, Rye, Ds, Rajaraman, N, Norman, Jg, Vutipongsatorn, K, Solomou, G, Akhbari, M, Ali, A, Murray, V, Baker, Dm, Brandao, Bd, Stainer, B, Thavayogan, R, Jones, D, Onafowokan, Oo, Gharooni, A, Dabab, N, Carlton‐carew, S, Kungwengwe, G, Gabriel, M, Sewart, E, Shortland, Tc, Lawday, S, Pockney, P, Dawson, A, Brumfitt, Cd, Stewart, P, Ng, B, Luong, Jk, Ivanov, V, Borisova, A, Neykov, V, Kunčarová, K, Kološová, B, Antonova, T, Farkašová, M, Harbjerg, Jl, Brandsborg, S, Brinck, S, Kjaer, Md, Mark‐christensen, A, Unbehaun, Kp, Dalsgaard, P, Lycke, Kd, Lenaoures, P, Brigand, C, Dumange, E, Gout, M, Moehwald, C, Prem, M, Alhalabi, O, Sliwinski, S, Krupp, J, Gablenz, E, Schmitzer, L, Kopp, A, Steinle, J, Gsenger, J, Pohl, Lj, Riccardi, M, Christodoulou, Im, Konstantinidis, M, Machairas, N, Zoikas, A, Balalis, D, Manatakis, Dk, Aguilera, Ml, Marano, L, Fleres, F, Lovisetto, F, Sasia, D, Segalini, E, Pata, G, Lucchi, A, Sagnotta, A, Campagnaro, T, Petrelli, F, Gallo, G, Papandrea, M, Testa, V, Sinibaldi, G, Di Candido, F, Colombo, F, Perrone, G, Aresu, S, Biancafarina, A, Canonico, G, Pagnanelli, M, Curletti, G, Bini, R, Manzoni Garberini, A, Impellizzeri, H, Cillara, N, Tutino, R, Picciariello, A, Coletta, D, Savino, G, Ferrara, F, Tamini, N, Talamo, G, Parini, D, Giamundo, P, lo Conte, A, Ripetti, V, Pesce, A, Menduni, N, Giudicissi, R, Goldin, E, Rega, D, Belli, A, Andriola, V, Gordini, L, Foppa, C, Piccolo, G, Birindelli, A, Ferrari, C, Ballarini, Z, Tirelli, F, Milone, M, De Rosa, M, Pipitone Federico, Ns, Molteni, B, Tilocca, Pl, Sancini, G, Piozzi, Gn, Lauretta, A, Poillucci, G, Mulas, S, Simcikas, D, Portelli, L, Wijnbergen, Jwm, Dinger, Tl, Doesschate, Sfh, Dalen, Ashm, Bos, Dd, Hansmann, M, Medina Feliz, J, Kuiper, Sz, Abdulrahman, Z, Pruijssers, Sr, Farik, S, Elliott, Bm, Geneta, Vp, Wilton, S, Kandelaki, H, Peng, Sl, Campbell, S, Lim, Yk, Yassaie, Ss, Murray, M, Haran, C, Tan, J, Castro, J, Laranjeira, A, Catarino, S, Neves‐marques, C, Correia, Jg, Vieira, Bn, Quintela, Ac, Serra, Ml, Maciel, J, Cunha, M, Aparício, Dj, Neves, J, Azevedo, J, Romano, M, Eiró, F, Romano, J, Monteiro, C, Claro, M, Almeida, Mr, Peyroteo, M, Machado, Nd, Capote, H, Ferreira, M, Sousa, X, Devesa, H, Cavadas, D, Guerreiro, I, Costa, M, Salman, M, English, C, Mohammed, N, Litvin, A, Ćuk, Vv, Mészárosová, K, Jaich, R, De Lima, H, Brooks, S, Marx, M, Nshalati Salvation, M, Blaser, B, Piazza, G, Gagliardi, B, Serin, H, Yurdaor, Ss, Arslan, E, Kopac, O, Uyanik, A, Ozmen, Bb, Tiftik, E, Aksoy, B, Yalcinkaya, A, Ozoglu, F, Kocer, Md, Bilicen, G, Cinar, En, Uslu, Ö, Kaya, Y, Wong, J, Farhan‐alanie, Mmh, Suresh, G, Asif, A, Finch, Bj, Bhahirathan, Y, Herron, J, Yi Tew, Z, Obukofe, R, Russell, C, Suchett‐kay, I, Netke, T, Williams, L, Kisiel, A, Liu, Fy, Claireaux, H, James, P, Mondal, A, Kalderon, R, Nadama, Hh, Al‐saraff, Z, Tam, Jph, Powell‐chandler, A, Wood, F, Gorgievska, Rebecca, Ragavoodoo, A, Thakrar, C, Rojoa, D, Palmer, C, Davidson, K, Giacci, L, Hale, J, Gan, Fw, Makin‐taylor, R, Hey, Cy, Toh, C, Findlay, Jm, Griffiths, N, Ganesananthan, S, Jasionowska, S, Poustie, M, Wong, C, Turner, T, Pyc, W, 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A., Murphy C., Radcliffe K., Chong J.T., Jeffrey E., Chaudhury N., Rajendran K., Akbar Z., Walters B., Kulendrarajah B., Tran N., Shrestha S., Parmar S., Gallagher C., Hennessy L., Pentti E., Badhrinarayanan S., Fung A., Mansoor M., Kenny R., Kan P., Lee D.E., Khosla S., Samake M., Shaban F., Aftab R., Gough M., Woodburn B., Vayalapra S., McMurrugh K., Jimulia D., Deol S., Pike S., Embury-Young Y., Patel M., Kilgallon E., Keating R., Walsh A., Khan H., Logue G., Orekoya M., Alasmar M., Charalambides M., Clave Llavall A., Williamson E., Bharwada Y., Zearmal S., Evans H., Panikkar M., de la Cruz G., Caplan J., Ruparelia A., Tanvir T., Soare C., Pang Y.L., Trotter J., Zaidi A., Thakrar V., Pulickal P., Ahmed H., Parnell J., Lennock S., Ford V., Brignall R., O'Neill D., Hanna R., Kane R., Nicola M., Rajput K., Xiao Y., Michael S., Wright E., Juniper S., Thompson E., Hoskyns L., Kanitkar A., Ross C., Unsworth A., Rshaidat H., Demarre K., Chiang A., Bareh A., van Dellen J., Faqihinejad C., Gadhvi A., Grant R., Lewsey J., Morris A., Martin H., McClarty C., Sanyal S., Alsaif A., Palkhi A., Bhopal S., Vishnu K S., Papanikolaou A., Mitra A., Nur A., Ali F., Burford C., Huq T., Irwin E., Matthews L., Ngu W.S., Hosfield T., Muneeb F., Page O., Zeb E., Al-Azzawi A., McIntosh J., Vucicevic A., Hughes M., Brooks L., Fanibi B., Dixon M., Njoku P., Morris D., Jobson J., Chowdhury H., Alawode D.O.T., Wynell-Mayow W., Udayachandran V., Alsoof D., Ekert J., Joseph N., Zulkefley N., Hunt G., Christodoulou T., Wright O., Soman S., Jamal M., Beqiri S., Borgas P., Christie S., Pereira F., Browne S., Yiu J., Dworkin A., Brayley J., Palmer A., Charalambos M., Jones C.J., Toner S., Cowden R., Lee L., Nicol P., Holman O., Imtiaz M., Albert V., Leung S.P., Erotocritou M., Stroud R., Wilkin R., Thomson W., Mackee L., G N., Bei Y., Mckenna Favier S., Ibrahim A., Kler A., Reynolds L., Mohamed S.H., Majeed Y., Fakim B., Jones A., Liversedge G., Carrington Z., Windebank J., Izzarina A., Akbani U., Craven J., Aldarragi A., Harding S., Millward A., Bedford M., Gopalan V., Midgen A., Khadka P., Cheng O., Taneja S., Manobharath N., Kok J.Y., Lim D.W.E., Buick T., Boland M., Piya S., Devlin R., Fairfield C.J., George R.J., Rahi M., Zaman S., Hajiev S., Ross T., Crisp E., Thompson C., Charalambous A., Hollywood J.L., Hammond R.F.L., Matthews J., Mendonca V., Spinty J., Khan K., Cheng J., Glynn N., Muhammad U., Khan M., Anderson L., Mccormack K., Mak J., Patrawala S., Milinkovic N., Schofield R., Chauhan M., Hartley L., Hind J., Nelson L., Ratnasingham D., Whitehead T., Dimitriadis S., Marshall K., Flint E.J., Horner C., Heybourne A., Morgan H., Wickstone C., Panagiotou D., O'Connell E., Dean K., Iqbal R., Walsh L., Yu N., Rana N., Massie E., Ng J., Jung M., Lee Y.D., Harris M., White S., Boev B., Tonchev P., Prochazka V., Skalicky A., Ravn S., Ojakaar A., Dorr-Harim C., Koutserimpas C., Giraudo G., Armellini A., Ruzzenente A., Mazzeo C., De Padua C., Realis Luc A., Maroli A., Giani I., Cufari M.E., Vitali M., Gusai G.P., Quattromani R., Virgilio E., Berti S., Di Mola F.F., Papagni V., Tuminello F., Vittori L., Longheu A., Loche G.A., Braccio B., De Luca E., Resta G., Ancans G., Tamosiunas A., Petrulionis M., Andrejevic P., Stellingwerf M.E., Abdulrahman N., van de Pas K.G.H., Thomas G., Brandsma A.M., Davids J., Rottier S.J., de Roy van Zuidewijn D., Hawkins R., Ong H.I., Li Y., Desmond B., Winstanley J., Martins M., Americano M., Frade S., Senhorinho R., Peixoto R., Alves-Vale C., Lamas M., O'Connor D.B., Hoo M., Gopaul A., Scanlon K., O'Dwyer N., Jovanovic M., Panyko A., Van Vuuren S., Curchod P., Gaspar S., Imadalou L., Mutlu D., Akyol C., Uygur F.A., Eray I.C., Biyiklioglu O., Cetin M.F., Isik A.E., Karip B., Dogan H., Sarigul L., Tunc E., Aydin T., Bodur S., Karabulut K., Francis A.A., Al-hadithi A., To N., Lau I.S.F., Smith E., Mahapatra S., McAuliffe O., Imam L., Akram B., Hossaini S., Davies R., Ko M., Collins J., Pandya A., Reilly S., Archer J., Auty C., 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L., Marano, L., Fleres, F., Lovisetto, F., Sasia, D., Segalini, E., Pata, G., Lucchi, A., Sagnotta, A., Campagnaro, T., Petrelli, F., Gallo, G., Papandrea, M., Testa, V., Sinibaldi, G., Di Candido, F., Colombo, F., Perrone, G., Aresu, S., Biancafarina, A., Canonico, G., Pagnanelli, M., Curletti, G., Bini, R., de Manzoni Garberini, A., Impellizzeri, H., Cillara, N., Tutino, R., Picciariello, A., Coletta, D., Savino, G., Ferrara, F., Tamini, N., Talamo, G., Parini, D., Giamundo, P., lo Conte, A., Ripetti, V., Pesce, A., Menduni, N., Giudicissi, R., Goldin, E., Rega, D., Belli, A., Andriola, V., Gordini, L., Foppa, C., Piccolo, G., Birindelli, A., Ferrari, C., Ballarini, Z., Tirelli, F., Milone, M., De Rosa, M., Pipitone Federico, N. S., Molteni, B., Tilocca, P. L., Sancini, G., Piozzi, G. N., Lauretta, A., Poillucci, G., Mulas, S., Simcikas, D., Portelli, L., van Wijnbergen, J. W. M., Dinger, T. L., ten Doesschate, S. F. H., van Dalen, A. S. H. M., van den Bos, D. 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N., Uslu, O., Kaya, Y., Wong, J., Farhan-Alanie, M. M. H., Suresh, G., Asif, A., Finch, B. J., Bhahirathan, Y., Herron, J., Yi Tew, Z., Obukofe, R., Russell, C., Suchett-Kay, I., Netke, T., Williams, L., Kisiel, A., Liu, F. Y., Claireaux, H., James, P., Mondal, A., Kalderon, R., Nadama, H. H., Al-Saraff, Z., Tam, J. P. H., Powell-Chandler, A., Wood, F., Gorgievska, R., Ragavoodoo, A., Thakrar, C., Rojoa, D., Palmer, C., Davidson, K., Giacci, L., Hale, J., Gan, F. W., Makin-Taylor, R., Hey, C. Y., Toh, C., Findlay, J. M., Griffiths, N., Ganesananthan, S., Jasionowska, S., Poustie, M., Wong, C., Turner, T., Pyc, W., Sloper, W., Warner, C., Coey, J., Mason, D., Sait, S., Kowal, M., Owen, M., Saiyed, A., Ashworth, I., Akbari, K., Curran, M., Martin, P., Parker, D., Kwok, K., Lye, C., Ghaly, M., Sammour, T., Lewis, D., Mundasad, R., Wilkes, A., Ctercteko, G., Maslyankov, S., Dimov, R., Iliev, S., Dimitrov, D., Marek, F., Orhalmi, J., Skalicky, P., Skalicky, T., Chrz, K., Christensen, P., Worsoe, J., Kristensen, E. S., Emmertsen, K. J., Loeve, U. S., Mihaljevic, A. L., Herrle, F., Konstantinidis, K. M., Korkolis, D., Karanikas, I., Vincenti, L., Anania, G., Borghi, F., Agresta, F., Maretto, I., Parisi, A., Bucci, L., De Palma, G., Guglielmi, A., Cucinotta, E., La Torre, F., Cianchi, F., Guerrieri, M., Trompetto, M., Persiani, R., Micheletto, G., Cantafio, S., Ronconi, M., Bisagni, P. A. 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Zh, Goh, Yn, Muthukumar, Mg, Johnson, Ta, Williams, Ri, Honeyman, Si, Malcolm, Fl, Wilkerson, Ht, Chatterjee‐woolman, S, Ahmed, Wur, Kwan, Kwl, Sanders‐crook, L, Boh, Zy, English, Wj, Novotny, Sa, Chong, Jt, Lee, De, Embury‐young, Y, Clavé Llavall, A, Pang, Yl, Dellen, J, Al‐azzawi, A, Alawode, Dot, Wynell‐mayow, W, Christodoulou, T, Jones, Cj, Leung, Sp, Mohamed, Sh, Kok, Jy, Lim, Dwe, Fairfield, Cj, George, Rj, Hollywood, Jl, Hammond, Rfl, Flint, Ej, Lee, Yd, Skalický, A, Ojakäär, A, Dörr‐harim, C, Cufari, Me, Gusai, Gp, Di Mola, Ff, Loche, Ga, Stellingwerf, Me, Pas, Kgh, Brandsma, Am, Rottier, Sj, Roy van Zuidewijn, D, Ong, Hi, Alves‐vale, C, O'Connor, Db, Jovanović, M, Uygur, Fa, Eray, Ic, Çetin, Mf, Isik, Ae, Sarıgül, L, Francis, Aa, Al‐hadithi, A, Lau, Isf, Roche, Cd, and Chaudhry, Fa
Subjects: Male, renal failure, Time Factors, medicine.medical_treatment, Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal, Elective Surgical Procedures, Female, Humans, Ileus, Kaplan-Meier Estimate, Middle Aged, Patient Safety, Postoperative Care, Postoperative Complications, Proportional Hazards Models, Prospective Studies, Recovery of Function, Treatment Outcome, Colectomy, Proctectomy, Anti-Inflammatory Agents, colorectal surgery, ileus, non-steroidal anti-inflammatory drugs, NSAIDS, 030230 surgery, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Prospective cohort study, Colorectal, RISK, Hazard ratio, Acute kidney injury, Colorectal surgery, NSAID, 030220 oncology & carcinogenesis, Non-Steroidal, Cohort study, colorectal Surgery, ileus, non-steroidal anti-inflammatory drugs, medicine.medical_specialty, Non‐steroidal anti‐inflammatory drugs. NSAIDs. Postoperative ileus. Colorectal surgery, ACUTE KIDNEY INJURY, anti-inflammatory agents, 03 medical and health sciences, Internal medicine, medicine, Adverse effect, non-steroidal anti-inflammatory drugs - ileus - colorectal surgery, business.industry, medicine.disease, Settore MED/18 - Chirurgia Generale, colorectal cancer, Surgery, business
Abstract: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery.A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury.A total of 4164 patients were included, with a median age of 68 (i.q.r. 57-75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1-3, of whom 1061 (92·0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P 0·001).NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.El ileo es frecuente tras cirugía colorrectal electiva y se asocia con un incremento de los eventos adversos y de la duración de la estancia hospitalaria. El objetivo fue evaluar el papel de los fármacos antiinflamatorios no esteroideos (non-steroidal anti-inflammatory drugs, NSAIDs) para reducir el ileo tras la cirugía. MÉTODOS: Estudio de cohortes prospectivo y multicéntrico efecuado por un grupo colaborativo dirigido por estudiantes y cirujanos en formación. Se incluyeron pacientes adultos sometidos a cirugía colorectal electiva entre enero y abril 2018. El resultado primario fue el tiempo hasta la recuperaciòn gastrointestinal, medido por una variable compuesta de función intestinal y tolerancia a la alimentación oral. El impacto de los NSAIDs se exploró utilizando un análisis de regresión de Cox, que incluía los resultados de una encuesta específica dirigida a los centros sobre la adherencia a los principios de la recuperación intensificada. Los resultados secundarios de seguridad incluyeron la dehiscencia anastomótica y la insuficiencia renal aguda.Se incluyeron 4.164 pacientes con una mediana de edad de 68 años (rango intercuartílico: 57-75; 54,9% varones). Un total de 1.153 (27,7%) pacientes fueron tratados con NSAIDs en los días postoperarorios 1-3, de los cuales 1.061 (92,0%) recibieron inhibidores no selectivos de la ciclooxigenasa. Tras los ajustes por las diferencias basales, el tiempo medio hasta la recuperación gastrointestinal no difería significativamente entre pacientes que recibieron o no recibieron NSAIDs (4,6 versus 4,8 días; cociente de riesgos instantáneos, hazard ratio, HR 1,04, i.c. del 95%: 0,96-1,12, P = 0,360). No hubo diferencias significativas en la tasa de dehiscencias anastomóticas (5,4% versus 4,6%; P = 0,349) o insuficiencia renal aguda (14,3% versus 13,8%; P = 0,666) entre los grupos. Sin embargo, significativamente menos pacientes de los que recibieron NSAIDs precisaron una analgesia intensa con opioides (35,3% versus 56,7%; P 0,001). CONCLUSIÓN: La administración de NSAIDs no redujo el tiempo hasta la recuperación gastrointestinal tras cirugía colorrectal, pero fueron seguros y se asociaron con una reducción en la necesidad de opioides postoperarorios.
Published: 2019

23. No association between night shiftwork and mammographic density

Author: Elizabeth Wylie, Jennifer Stone, Lin Fritschi, Christobel Saunders, Terry Boyle, Sonia El-Zaemey, Jane Heyworth, El-Zaemey, Sonia, Fritschi, Lin, Heyworth, Jane, Boyle, Terry, Saunders, Christobel, Wylie, Elizabeth, and Stone, Jennifer
Subjects: 0301 basic medicine, Breast Neoplasms, Shift work, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Risk Factors, medicine, Humans, cancer, Breast, Breast Density, Related factors, Sleep disorder, business.industry, Confounding, Public Health, Environmental and Occupational Health, MAMMOGRAPHIC DENSITY, Cancer, Shift Work Schedule, Western Australia, medicine.disease, 030104 developmental biology, shift work, Risk factors for breast cancer, 030220 oncology & carcinogenesis, Case-Control Studies, Female, business, Demography, Mammography
Abstract: BackgroundIncreased mammographic density is one of the strongest risk factors for breast cancer. Night shiftwork and its related factors, which include light at night, phase shift and sleep disruption, are believed to increase breast cancer risk however, their effects on mammographic density have barely been studied.MethodsThis study included 1821 women enrolled in the Breast Cancer Environment and Employment Study between 2009 and 2011. Mammographic density was measured using the Cumulus software program. The association of night shiftwork factors with square root transformed absolute dense area (DA) and percentage dense area (PDA) were modelled using linear regression adjusted for confounders.ResultsEver doing graveyard shiftwork (between 24:00 and 05:00 hours) was not associated with PDA (β=−0.10; 95% CI −0.27 to 0.08)) and DA (β=−0.12; 95% CI −0.33 to 0.09)). No association was found between night shiftwork related factors (light at night, phase shift and sleep disturbance) with PDA or DA.ConclusionsShiftwork and its related factors are not associated with mammographic density. Using high-quality, comprehensive shiftwork data from a large population-based breast cancer case–control study, this study suggests that mammographic density does not play a role in the relationship between shiftwork and breast cancer risk.
Published: 2020

24. Pediatric Venous Thromboembolism: Different Rates of Incidence, Anatomic Locations, and Risk Factors Between Orthopaedic and Nonorthopaedic Related Patients

Author: Ryan Sanborn, Benjamin J. Shore, Danielle Cook, Benton E. Heyworth, Aneesh V Samineni, Jodie Shea, and Collin May
Subjects: Male, medicine.medical_specialty, Adolescent, Deep vein, Walking, Cohort Studies, Upper Extremity, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Central Venous Catheters, Humans, Orthopedics and Sports Medicine, Orthopedic Procedures, Child, Venous Thrombosis, 030222 orthopedics, Central line, business.industry, Incidence (epidemiology), Incidence, General Medicine, Venous Thromboembolism, medicine.disease, Thrombosis, Confidence interval, medicine.anatomical_structure, Orthopedics, Lower Extremity, Child, Preschool, Pediatrics, Perinatology and Child Health, Cohort, Wounds and Injuries, Female, business, Venous thromboembolism, Cohort study
Abstract: BACKGROUND The prevalence of venous thromboembolism (VTE) may be increasing in children; however, scarce literature exists comparing incidence rates between pediatric orthopaedic patients and other pediatric patients. The purpose of this study was to compare the incidence, anatomic locations, and risk factors of VTEs between orthopaedic and nonorthopaedic pediatric related patients to determine if important differences exist. METHODS Computed tomography and ultrasound data were reviewed for children (below 19 y old) with a diagnosed VTE between January 1, 2009 and December 31, 2016. Demographic and clinical data, including VTE anatomic location and risk factors, were recorded. Two major cohorts were identified: orthopaedic-related (ORTH) and nonorthopaedic-related (NORTH) VTEs. Incidence rates were estimated and risk factors were compared using χ2 testing. RESULTS There were 373 children diagnosed with a VTE (average age 10.3 y) of a total of 810,097 treated as in-patients for an incidence rate of 4.60 per 10,000 cases (95% confidence interval=4.15 to 5.10 per 10,000 cases). The rate of ORTH VTEs (28 of 188,669 orthopaedic patients, 1.48 per 10,000 cases) was significantly lower than that of NORTH VTEs (345 of 621,428 nonorthopaedic patients, 5.55 per 10,000 cases; P
Published: 2021

25. Surgical Treatment of Solitary Periarticular Osteochondromas About the Knee in Pediatric and Adolescent Patients: Complications and Functional Outcomes

Author: Megan E. Anderson, Patricia E. Miller, Mark Wu, Evan T Zheng, Benton E. Heyworth, and Samantha A. Spencer
Subjects: Male, Reoperation, medicine.medical_specialty, Osteochondroma, Sports medicine, Adolescent, Knee Joint, Bone Neoplasms, Lesion, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, medicine, Humans, Orthopedics and Sports Medicine, Femur, Tibia, Patient Reported Outcome Measures, Prospective Studies, Fibula, Surgical treatment, Child, Retrospective Studies, 030222 orthopedics, business.industry, Level iv, 030229 sport sciences, General Medicine, Surgery, Return to Sport, Treatment Outcome, Athletes, Female, medicine.symptom, Neoplasm Recurrence, Local, business
Abstract: Solitary osteochondromas, or osteocartilaginous exostoses (OCEs), represent the most common benign bone tumor. Despite frequently causing symptoms about the knee in younger populations, there is minimal previous literature investigating surgical treatment.We retrospectively reviewed the records of patients20 years old who had undergone surgical treatment of symptomatic, pathologically confirmed, solitary periarticular knee OCE at a single pediatric center between 2003 and 2016. The clinical course, radiographic and pathological features, and complications were assessed. Prospective outreach was performed to investigate patient-reported functional outcomes.Two hundred and sixty-four patients (58% male, 81% athletes) underwent excision of a solitary OCE about the knee at a mean age (and standard deviation) of 14.3 ± 2.24 years. Fifty-five percent of the procedures were performed by orthopaedic oncologists, 25% were performed by pediatric orthopaedic surgeons, and 20% were performed by pediatric orthopaedic sports medicine surgeons, with no difference in outcomes or complications based on training. Of the 264 lesions, 171 (65%) were pedunculated (versus sessile), 157 (59%) were in the distal part of the femur (versus the proximal part of the tibia or proximal part of the fibula), and 182 (69%) were medial (versus lateral). Postoperatively, 96% of the patients returned to sports at a median of 2.5 months (interquartile range, 1.9 to 4.0 months). Forty-two patients (16%) experienced minor complications not requiring operative intervention. Six patients (2%) experienced major complications (symptoms or disability at6 months or requiring reoperation), which were more common in patients with sessile osteochondromas (p = 0.01), younger age (p = 0.01), and distal femoral lesions as compared with proximal tibial lesions (p = 0.003). Lesion recurrence was identified in 3 patients (1.1%). Overall, the median Pediatric International Knee Documentation Committee (Pedi-IKDC) and mean Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) scores were 97 (interquartile range, 93 to 99) and 16.7 ± 8.15, respectively, at a median duration of follow-up of 5.8 years.In our large cohort of pediatric patients who underwent excision of solitary knee osteochondromas, most patients were male adolescent athletes. Most commonly, the lesions were pedunculated, were located in the distal part of the femur, and arose from the medial aspect of the knee. Regardless of surgeon training or lesion location, patients demonstrated excellent functional outcomes, with minimal clinically important postoperative complications and recurrences, although patients with sessile lesions and younger age may be at higher risk for complications.Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Published: 2021

26. Recovery After ACL Reconstruction in Male Versus Female Adolescents: A Matched, Sex-Based Cohort Analysis of 543 Patients

Author: Benton E. Heyworth, Mininder S. Kocher, Lyle J. Micheli, Kathleen Maguire, and Dai Sugimoto
Subjects: functional testing, medicine.medical_specialty, Anterior cruciate ligament reconstruction, business.industry, medicine.medical_treatment, Anterior cruciate ligament, anterior cruciate ligament, Functional testing, Adult population, Postoperative recovery, Article, Surgery, ACL reconstruction, female, medicine.anatomical_structure, Medicine, Orthopedics and Sports Medicine, business, Cohort study
Abstract: Background:Differences in postoperative recovery after anterior cruciate ligament reconstruction (ACLR) between men and women have been demonstrated in the adult population. Sex-based differences have been incompletely investigated in adolescents, which represent the subpopulation most affected by ACL injury.Purpose/Hypothesis:The purpose of this study was to compare the 6-month postoperative functional recovery after ACLR between adolescent boys and girls. It was hypothesized that significant differences in postoperative strength, dynamic balance, and functional hop test performance would be seen between the sexes.Study Design:Cohort study; Level of evidence, 3.Methods:Included in this study were athletes aged 12 to 19 years with closed or closing growth plates who underwent ACLR with hamstring autograft between May 2014 and May 2018 at a single institution. All athletes had undergone strength and functional testing between 5 and 8 months postoperatively. Exclusion criteria were previous knee surgery (contralateral or ipsilateral knee), concomitant injury/surgery other than meniscal tear/repair, allograft supplementation, and incomplete medical records. The limb symmetry index (LSI) for strength (measured with handheld dynamometer), as well as dynamic Y-balance and functional hop test performance, was compared between groups. To account for differences in physical characteristics between the sexes, 1-way between-group multivariate analysis of covariance was used to analyze the data.Results:Overall, 543 patients (211 boys, 332 girls) were included. There was no significant difference in age, body mass index, incidence of concomitant meniscal pathology, use of regional anesthesia, or time to functional testing between cohorts. Female athletes demonstrated a statistically significantly greater deficit in quadriceps strength LSI compared with male athletes (boys, +3.4%; girls, –2.3%; P = .011). Both male and female athletes demonstrated 33% hamstring strength deficits, with no statistically significant sex-based differences in dynamic balance or functional hop testing.Conclusion:Female athletes demonstrated greater quadriceps strength deficits than male athletes at 6 months after ACLR with hamstring autograft. Severe hamstring strength deficits persisted in both male and female patients at this time point. The correlation of such deficits to risk of ACL retear warrants continued study in the adolescent population and may support a delay in return to sports, which has been suggested in the more recent literature.
Published: 2021

27. One-trial perceptual learning in the absence of conscious remembering and independent of the medial temporal lobe

Author: Nadine C. Heyworth, Jennifer C. Frascino, Larry R. Squire, Charlotte S Rivera, and Biyu J. He
Subjects: Adult, Male, medicine.medical_specialty, Unconscious mind, Consciousness, media_common.quotation_subject, Hippocampus, Audiology, Temporal lobe, Memory, Perceptual learning, Perception, medicine, Humans, Learning, Memory impairment, Aged, media_common, Aged, 80 and over, Memory Disorders, Multidisciplinary, Single exposure, Biological Sciences, Middle Aged, Temporal Lobe, Mental Recall, Recognition memory test, Female, Amnesia, Psychology, Photic Stimulation, Psychomotor Performance
Abstract: A degraded, black-and-white image of an object, which appears meaningless on first presentation, is easily identified after a single exposure to the original, intact image. This striking example of perceptual learning reflects a rapid (one-trial) change in performance, but the kind of learning that is involved is not known. We asked whether this learning depends on conscious (hippocampus-dependent) memory for the images that have been presented or on an unconscious (hippocampus-independent) change in the perception of images, independently of the ability to remember them. We tested five memory-impaired patients with hippocampal lesions or larger medial temporal lobe (MTL) lesions. In comparison to volunteers, the patients were fully intact at perceptual learning, and their improvement persisted without decrement from 1 d to more than 5 mo. Yet, the patients were impaired at remembering the test format and, even after 1 d, were impaired at remembering the images themselves. To compare perceptual learning and remembering directly, at 7 d after seeing degraded images and their solutions, patients and volunteers took either a naming test or a recognition memory test with these images. The patients improved as much as the volunteers at identifying the degraded images but were severely impaired at remembering them. Notably, the patient with the most severe memory impairment and the largest MTL lesions performed worse than the other patients on the memory tests but was the best at perceptual learning. The findings show that one-trial, long-lasting perceptual learning relies on hippocampus-independent (nondeclarative) memory, independent of any requirement to consciously remember.
Published: 2021

28. Case–control study to assess the association between colorectal cancer and selected occupational agents using INTEROCC job exposure matrix

Author: Jane Heyworth, Martie van Tongeren, Lin Fritschi, Terry Boyle, Sonia El-Zaemey, T N Anand, El-Zaemey, Sonia, Anand, TN, Heyworth, Jane S, Boyle, Terry, Van Tongeren, Martie, and Fritschi, Lin
Subjects: Adult, Male, Colorectal cancer, Job-exposure matrix, Cumulative Exposure, colorectal cancer, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Occupational Exposure, Environmental health, medicine, Humans, Registries, 030212 general & internal medicine, occupational exposure assessment, Aged, business.industry, Public Health, Environmental and Occupational Health, Case-control study, Cancer, Western Australia, Middle Aged, medicine.disease, Cancer registry, Occupational Diseases, Case-Control Studies, 030220 oncology & carcinogenesis, INTEROCC job exposure matrix, Female, Colorectal Neoplasms, business, Developed country
Abstract: BackgroundColorectal cancer is the third most prevalent cancer in the world and is twice as common in developed countries when compared with low-income and middle-income countries. Few occupational risk factors for colorectal cancer have been identified. This case–control study aimed to assess the association between colorectal cancer and occupational exposure to selected solvents, combustion products, metals, dusts and other agents.MethodsCases (n=918) were enrolled from the Western Australian Cancer Registry from June 2005 to August 2007. Controls (n=1021) were randomly selected from the Western Australian electoral roll. We collected lifetime occupational history from cases and controls, in addition to their demographic and lifestyle characteristics. We applied the INTEROCC job exposure matrix to convert the occupational history to occupational exposure for 18 selected agents. Three exposure indices were developed: (1) exposed versus non-exposed; (2) lifetime cumulative exposure; and (3) total duration of exposure. The associations between colorectal cancer and the selected agents were estimated using logistic regression models adjusting for sex and age.ResultsNone of the 18 selected agents showed an association with colorectal cancer. No dose–response relationships with lifetime cumulative exposure or duration of exposure were observed.ConclusionThere was no evidence to suggest that occupational exposure to 18 selected agents increased the risk of colorectal cancer.
Published: 2017

29. Osteoid Osteoma About the Hip in Children and Adolescents

Author: Collin May, Michael B. Millis, Yi-Meng Yen, Young-Jo Kim, Benton E. Heyworth, Sarah D. Bixby, and Megan E. Anderson
Subjects: Male, musculoskeletal diseases, Osteoid osteoma, Pediatrics, medicine.medical_specialty, Adolescent, Osteoma, Osteoid, Bone Neoplasms, Young Adult, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Hip pain, Young adult, Child, Pelvic Bones, Osteoma, Retrospective Studies, 030203 arthritis & rheumatology, Radiofrequency Ablation, 030222 orthopedics, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Retrospective cohort study, General Medicine, medicine.disease, Arthralgia, Magnetic Resonance Imaging, Child, Preschool, Etiology, Female, Surgery, Presentation (obstetrics), Tomography, X-Ray Computed, business
Abstract: The etiology of hip pain in pediatric and adolescent patients can be unclear. Osteoid osteoma (OO) about the hip in children has only been described in case reports or small studies. The present study assessed the clinical presentation and diagnostic course, imaging, and treatment approaches in a large cohort of pediatric cases of OO about the hip.Medical record and imaging results were reviewed for all cases of OO identified within or around the hip joint in patients20 years old between January 1, 2003, and December 31, 2015, at a tertiary-care pediatric center. Demographic, clinical, and radiographic data were analyzed.Fifty children and adolescents (52% female; mean age, 12.4 years; age range, 3 to 19 years) were identified. Night pain (90%) and symptom relief with nonsteroidal anti-inflammatory drugs (NSAIDs) (88%) were common clinical findings. Sclerosis/cortical thickening was visible in 58% of radiographs, although a radiolucent nidus was visible in only 42%. Diagnostic imaging findings included perilesional edema and a radiolucent nidus on 100% of available magnetic resonance imaging (MRI) and computed tomography (CT) scans, respectively. Initial alternative diagnoses were given in 23 cases (46%), the most common of which was femoroacetabular impingement (FAI). Delay in diagnosis of6 months occurred in 43% of patients. Three patients underwent operative procedures for other hip diagnoses, but all had persistent postoperative pain until the OO was treated. Of the 41 patients (82%) who ultimately underwent radiofrequency ablation (RFA), 38 (93%) achieved complete post-RFA symptom resolution.Initial misdiagnosis, the most common of which was FAI, and delayed correct diagnosis are common in pediatric OO about the hip. Presenting complaints were variable and nonspecific MRI findings were frequent. Night pain and relief with NSAIDs were present in the vast majority of cases. CT scans provided definitive diagnosis in all patients who received them. As increasing numbers of young, active patients are being evaluated for various causes of hip pain, such as FAI, OO should not be overlooked in the differential diagnosis.Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Published: 2019

30. Symptomatic Venous Thromboembolism After Adolescent Knee Arthroscopy

Author: Dennis E. Kramer, Patricia E. Miller, Benton E. Heyworth, Robert F. Murphy, Mininder S. Kocher, Manahil Naqvi, Yi-Meng Yen, and Benjamin J. Shore
Subjects: Male, Pediatrics, medicine.medical_specialty, Adolescent, Knee Joint, MEDLINE, Body Mass Index, Cohort Studies, Arthroscopy, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Health care, Humans, Medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, Retrospective Studies, 030222 orthopedics, Knee arthroscopy, business.industry, Incidence, Incidence (epidemiology), Retrospective cohort study, Venous Thromboembolism, General Medicine, Heparin, Low-Molecular-Weight, Tourniquets, Outcome and Process Assessment, Health Care, Pediatrics, Perinatology and Child Health, Female, business, Venous thromboembolism, Body mass index, Cohort study
Abstract: The frequency of knee arthroscopy procedures is increasing in pediatric and adolescent patients. In general, complications after these procedures in adolescents are uncommon. The purposes of this study are to report the incidence of venous thromboembolism (VTE) in adolescent patients after knee arthroscopy procedures, as well identify risk factors in this patient population.Medical records were reviewed in all pediatric and adolescent patients (≤19 y) who underwent an arthroscopic knee procedure from 2010 to 2014 and were diagnosed with a symptomatic VTE in the postoperative period. Demographic features were recorded, and included age, sex, body mass index, clinical characteristics (diagnosis, type of surgical intervention, tourniquet time), VTE risk factors [family history of VTE, obesity (body mass index30), oral contraceptive use, and smoking use/exposure] and treatment (anticoagulation type/duration).Out of 2783 patients who underwent knee arthroscopy during the 5-year study period, 7 patients (3 males, 4 females, mean age, 16.9 y, range, 15 to 18) developed a symptomatic postoperative VTE (incidence, 0.25%, 95% confidence interval, 0.11%-0.54%). There were 6 unilateral deep venous thrombosis, and 1 bilateral deep venous thrombosis. Arthroscopic procedures performed in this cohort included anterior cruciate ligament reconstruction (3), isolated lateral release (1), meniscectomy (2), and patellar realignment with arthroscopic lateral release, open tibial tubercle osteotomy, and open proximal medial retinacular reefing (1). VTE was diagnosed an average of 9 days following surgery (range, 3 to 16). All patients were initially treated with low-molecular-weight heparin, and 2 were converted to warfarin. Mean duration of anticoagulation treatment was 64 days (range, 28 to 183). All patients had at least 1 identifiable medical or surgical risk factor, including oral contraceptive use (2), smoking (2), obesity (2), an arthroscopically assisted open procedure (4), or tourniquet time60 minutes (3).VTE after adolescent knee arthroscopy has not been well described. The incidence is ∼0.25%. Previously established risk factors for VTE were present in 100% of the affected population. Low-molecular-weight heparin was used to successfully treat this complication.Level IV.
Published: 2019

31. The nature of recollection across months and years and after medial temporal lobe damage

Author: Larry R. Squire and Nadine C. Heyworth
Subjects: Male, medicine.medical_specialty, Hippocampus, Audiology, 050105 experimental psychology, Temporal lobe, 03 medical and health sciences, 0302 clinical medicine, Noun, medicine, Humans, 0501 psychology and cognitive sciences, Narrative, Memory Disorders, Multidisciplinary, Forgetting, Recall, Autobiographical memory, Patient narratives, 05 social sciences, Biological Sciences, Middle Aged, Temporal Lobe, Mental Recall, Female, Psychology, 030217 neurology & neurosurgery
Abstract: We studied the narrative recollections of memory-impaired patients with medial temporal lobe (MTL) damage who took a 25-min guided walk during which 11 planned events occurred. The recollections of the patients, recorded directly after the walk, were compared with the recollections of controls tested directly after the walk (C1), after one month (C2), or after 2.6 years (C3). With respect to memory for the walk, the narrative recollections of the patients were impoverished compared with C1 but resembled the recollections of volunteers tested after long delays (C2 and C3). In addition, how language was used by the patients in their recollections resembled how language was used by groups C2 and C3 (higher-frequency words, less concrete words, fewer nouns, more adverbs, more pronouns, and more indefinite articles). These findings appear to reflect how individuals, either memory-impaired patients or controls, typically speak about the past when memory is weak and lacks detail and need not have special implications about language use and MTL function beyond the domain of memory. A notable exception to the similarity between patient narratives and the narratives of C2 and C3 was that the control groups reported the events of the walk in correct chronological order, whereas the order in which patients reported events bore no relationship to the order in which events occurred. We suggest that the MTL is especially important for accessing global information about events and the relationships among their elements.
Published: 2019

32. Exposure to noise and ototoxic chemicals in the Australian workforce

Author: Corie Gray, Ian Li, Elinor Ytterstad, Kahlia McCausland, Lin Fritschi, Deborah Catherine Glass, Adrian Fuente, Warwick Williams, Jane Heyworth, Ines Florath, Si Si, and Kate Lewkowski
Subjects: Adult, Male, Hearing loss, 03 medical and health sciences, 0302 clinical medicine, Noise exposure, Occupational Exposure, Environmental health, Prevalence, Humans, Medicine, Working population, 030212 general & internal medicine, Hearing Loss, Workplace, business.industry, Australia, Public Health, Environmental and Occupational Health, Ototoxicity, 030210 environmental & occupational health, Telephone survey, Noise, Cross-Sectional Studies, Workforce, Female, Occupational exposure, medicine.symptom, business
Abstract: ObjectiveTo determine the current prevalence of exposure to workplace noise and ototoxic chemicals, including co-exposures.MethodA cross-sectional telephone survey of nearly 5000 Australian workers was conducted using the web-based application, OccIDEAS. Participants were asked about workplace tasks they performed and predefined algorithms automatically assessed worker’s likelihood of exposure to 10 known ototoxic chemicals as well as estimated their full shift noise exposure level (LAeq,8h) of their most recent working day. Results were extrapolated to represent the Australian working population using a raked weighting technique.ResultsIn the Australian workforce, 19.5% of men and 2.8% of women exceeded the recommended full shift noise limit of 85 dBA during their last working day. Men were more likely to be exposed to noise if they were younger, had trade qualifications and did not live in a major city. Men were more likely exposed to workplace ototoxic chemicals (57.3%) than women (25.3%). Over 80% of workers who exceeded the full shift noise limit were also exposed to at least one ototoxic chemical in their workplace.ConclusionThe results demonstrate that exposures to hazardous noise and ototoxic chemicals are widespread in Australian workplaces and co-exposure is common. Occupational exposure occurs predominantly for men and could explain some of the discrepancies in hearing loss prevalence between genders.
Published: 2019

33. Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium

Author: Morra, Anna, Jung, Audrey Y, Behrens, Sabine, Keeman, Renske, Ahearn, Thomas U, Anton-Culver, Hoda, Arndt, Volker, Augustinsson, Annelie, Auvinen, Päivi K, Beane Freeman, Laura E, Becher, Heiko, Beckmann, Matthias W, Blomqvist, Carl, Bojesen, Stig E, Bolla, Manjeet K, Brenner, Hermann, Briceno, Ignacio, Brucker, Sara Y, Camp, Nicola J, Campa, Daniele, Canzian, Federico, Castelao, Jose E, Chanock, Stephen J, Choi, Ji-Yeob, Clarke, Christine L, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Dörk, Thilo, Dunning, Alison M, Dwek, Miriam, Easton, Douglas F, Eccles, Diana M, Egan, Kathleen M, Evans, D Gareth, Fasching, Peter A, Flyger, Henrik, Gago-Dominguez, Manuela, Gapstur, Susan M, García-Sáenz, José A, Gaudet, Mia M, Giles, Graham G, Grip, Mervi, Guénel, Pascal, Haiman, Christopher A, Håkansson, Niclas, Hall, Per, Hamann, Ute, Han, Sileny N, Hart, Steven N, Hartman, Mikael, Heyworth, Jane S, Hoppe, Reiner, Hopper, John L, Hunter, David J, Ito, Hidemi, Jager, Agnes, Jakimovska, Milena, Jakubowska, Anna, Janni, Wolfgang, Kaaks, Rudolf, Kang, Daehee, Kapoor, Pooja Middha, Kitahara, Cari M, Koutros, Stella, Kraft, Peter, Kristensen, Vessela N, Lacey, James V, Lambrechts, Diether, Le Marchand, Loic, Li, Jingmei, Lindblom, Annika, Lubiński, Jan, Lush, Michael, Mannermaa, Arto, Manoochehri, Mehdi, Margolin, Sara, Mariapun, Shivaani, Matsuo, Keitaro, Mavroudis, Dimitrios, Milne, Roger L, Muranen, Taru A, Newman, William G, Noh, Dong-Young, Nordestgaard, Børge G, Obi, Nadia, Olshan, Andrew F, Olsson, Håkan, Park-Simon, Tjoung-Won, Petridis, Christos, Pharoah, Paul DP, Plaseska-Karanfilska, Dijana, Presneau, Nadege, Rashid, Muhammad U, Rennert, Gad, Rennert, Hedy S, Rhenius, Valerie, Romero, Atocha, Saloustros, Emmanouil, Sawyer, Elinor J, Schneeweiss, Andreas, Schwentner, Lukas, Scott, Christopher, Shah, Mitul, Shen, Chen-Yang, Shu, Xiao-Ou, Southey, Melissa C, Stram, Daniel O, Tamimi, Rulla M, Tapper, William, Tollenaar, Rob AEM, Tomlinson, Ian, Torres, Diana, Troester, Melissa A, Truong, Thérèse, Vachon, Celine M, Wang, Qin, Wang, Sophia S, Williams, Justin A, Winqvist, Robert, Wolk, Alicja, Wu, Anna H, Yoo, Keun-Young, Yu, Jyh-Cherng, Zheng, Wei, Ziogas, Argyrios, Yang, Xiaohong R, Eliassen, A Heather, Holmes, Michelle D, García-Closas, Montserrat, Teo, Soo Hwang, Schmidt, Marjanka K, Chang-Claude, Jenny, ABCTB Investigators, NBCS Collaborators, Behrens, Sabine [0000-0002-9714-104X], Keeman, Renske [0000-0002-5452-9933], Ahearn, Thomas U [0000-0003-0771-7752], Arndt, Volker [0000-0001-9320-8684], Augustinsson, Annelie [0000-0003-3415-0536], Brenner, Hermann [0000-0002-6129-1572], Camp, Nicola J [0000-0002-4788-1998], Canzian, Federico [0000-0002-4261-4583], Cox, Angela [0000-0002-5138-1099], Dunning, Alison M [0000-0001-6651-7166], Evans, D Gareth [0000-0002-8482-5784], Fasching, Peter A [0000-0003-4885-8471], Gago-Dominguez, Manuela [0000-0001-6713-4351], García-Sáenz, José A [0000-0001-6880-0301], Gaudet, Mia M [0000-0002-6429-4007], Giles, Graham G [0000-0003-4946-9099], Guénel, Pascal [0000-0002-8359-518X], Hall, Per [0000-0002-5640-9126], Hart, Steven N [0000-0001-7714-2734], Hartman, Mikael [0000-0001-5726-9965], Ito, Hidemi [0000-0002-8023-4581], Jager, Agnes [0000-0002-7713-1450], Jakubowska, Anna [0000-0002-5650-0501], Janni, Wolfgang [0000-0001-5911-2400], Kaaks, Rudolf [0000-0003-3751-3929], Kapoor, Pooja Middha [0000-0001-5503-8215], Koutros, Stella [0000-0001-5294-5485], Lambrechts, Diether [0000-0002-3429-302X], Li, Jingmei [0000-0001-8587-7511], Matsuo, Keitaro [0000-0003-1761-6314], Milne, Roger L [0000-0001-5764-7268], Muranen, Taru A [0000-0002-5895-1808], Newman, William G [0000-0002-6382-4678], Park-Simon, Tjoung-Won [0000-0002-2863-3040], Pharoah, Paul DP [0000-0001-8494-732X], Rennert, Gad [0000-0002-8512-068X], Rennert, Hedy S [0000-0001-5772-2977], Rhenius, Valerie [0000-0003-4215-3235], Romero, Atocha [0000-0002-1634-7397], Saloustros, Emmanouil [0000-0002-0485-0120], Schneeweiss, Andreas [0000-0002-2429-4512], Scott, Christopher [0000-0003-1340-0647], Southey, Melissa C [0000-0002-6313-9005], Stram, Daniel O [0000-0001-7099-9022], Tamimi, Rulla M [0000-0003-2306-8668], Tomlinson, Ian [0000-0003-3037-1470], Torres, Diana [0000-0002-9879-9775], Vachon, Celine M [0000-0002-1962-9322], Wolk, Alicja [0000-0001-7387-6845], Ziogas, Argyrios [0000-0003-4529-3727], Holmes, Michelle D [0000-0002-8664-2172], García-Closas, Montserrat [0000-0003-1033-2650], Teo, Soo Hwang [0000-0002-0444-590X], Schmidt, Marjanka K [0000-0002-2228-429X], Chang-Claude, Jenny [0000-0001-8919-1971], and Apollo - University of Cambridge Repository
Subjects: Adult, Risk Factors, Cause of Death, Humans, Breast Neoplasms, Female, Neoplasm Invasiveness, Prospective Studies, Middle Aged, Life Style, Survival Analysis, Aged, Neoplasm Staging
Abstract: BACKGROUND: It is not known whether modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype. METHODS: We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype. RESULTS: There was no evidence of heterogeneous associations between risk factors and mortality by subtype (P adj > 0.30). The strongest associations were between all-cause mortality and BMI ≥30 versus 18.5-25 kg/m2 [HR (95% confidence interval (CI), 1.19 (1.06-1.34)]; current versus never smoking [1.37 (1.27-1.47)], high versus low physical activity [0.43 (0.21-0.86)], age ≥30 years versus 0
Published: 2021
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34. Household Air Pollution from Biomass Fuel for Cooking and Adverse Fetal Growth Outcomes in Rural Sri Lanka

Author: Pasan Jayasinghe, Jane Heyworth, Duminda Yasaratne, Gayan Bowatte, Rohan Weerasooriya, Alicia Vakalopoulos, Shyamali C. Dharmage, Isabella Ambrose, Olivia Lall, Dinh S Bui, and Samath D Dharmaratne
Subjects: Rural Population, Cross-sectional study, Health, Toxicology and Mutagenesis, household air pollution, Biomass, lcsh:Medicine, 010501 environmental sciences, Logistic regression, 01 natural sciences, Article, Fetal Development, 03 medical and health sciences, 0302 clinical medicine, Air Pollution, Environmental health, medicine, Humans, Cooking, 030212 general & internal medicine, LBW, 0105 earth and related environmental sciences, Sri Lanka, SGA, Pregnancy, indoor air pollution, biomass, lcsh:R, Infant, Newborn, Public Health, Environmental and Occupational Health, Odds ratio, medicine.disease, Low birth weight, Cross-Sectional Studies, Air Pollution, Indoor, Stove, Small for gestational age, Female, pregnancy, medicine.symptom
Abstract: The aim of this study was to investigate the impact of biomass fuel for cooking on adverse fetal growth outcomes in Sri Lanka. A cross-sectional study of mothers recruited at maternity clinics in rural communities in Sri Lanka’s Central Province was undertaken. Data pertaining to household air pollution and fetal growth parameters were collected using an interviewer-administered questionnaire. Logistic regression models, adjusted for potential confounders, were used to evaluate the impact of biomass fuel for cooking on low birth weight (LBW) and small for gestational age (SGA) parameters. Findings showed that exposure to biomass cooking fuels during pregnancy was associated with an increased risk of LBW adjusted odds ratio (aOR) 2.74 (95% CI 1.08–6.96) and SGA (aOR: 1.87, 95% CI 1.03–3.41) compared with the use of clean energy. The risk of LBW was highest for traditional biomass stoves compared to improved biomass stoves (aOR: 3.23, 95% 1.17–8.89) and biomass use in kitchens without a chimney compared to kitchens with a chimney (aOR: 4.63, 95% 1.54–13.93). Similar trends were observed for SGA.
Published: 2021

35. Mental health of new undergraduate students before and after COVID-19 in China

Author: Ning Jiang, Gongbo Chen, Yuming Guo, Chongjian Wang, Hongwei Sun, Lei Yang, Jane Heyworth, Shanshan Li, Hao Xiang, Tingting Ye, Zhenguo Su, Yucheng Pang, Lailai Yan, Peng Lu, Guoxin Xia, Rachel R. Huxley, and Jane Fisher
Subjects: Male, Longitudinal study, China, Adolescent, Science, Anxiety, Gee, Young Adult, Medicine, Humans, Longitudinal Studies, Prospective Studies, Prospective cohort study, Students, Generalized estimating equation, Life Style, Depression (differential diagnoses), Multidisciplinary, business.industry, Depression, COVID-19, Mental health, Mental Health, Cohort, Quarantine, Female, medicine.symptom, business, Sleep, Stress, Psychological, Clinical psychology
Abstract: The purpose of this study was to examine the changes in severity of anxiety and depression symptoms, stress and sleeping quality after three months of mass quarantine for COVID-19 among undergraduate fresh students compared to their pre-COVID-19 measures. We used participants from the Chinese Undergraduate Cohort (CUC), a national prospective longitudinal study to examine the changes in anxiety and depression symptoms severity, stress and sleep quality after being under mass quarantine for three months. Wilcoxon matched pair signed-rank test was used to compare the lifestyle indicators. Severity of anxiety, depression symptoms, stress and sleep quality were compared with Wilcoxon signed-rank test. We used generalized estimating equation (GEE) to further quantify the change in mental health indicators and sleep quality after the COVID-19 mass quarantine compared to baseline. This study found that there was no deterioration in mental health status among Chinese new undergraduate students in 2020 after COVID-19 mass quarantine compared with the baseline measures in 2019. There was an improvement in sleep quality and anxiety symptoms. After adjusting for age, sex, exercise habit, time spent on mobile gadgets, and time spent outdoors, year 2020 was significantly associated with severity of depression symptoms in males (OR:1.52. 95%CI:1.05–2.20, p-value = 0.027). Year 2020 was significantly associated with the improvement of sleeping quality in total (OR:0.45, 95%CI:0.38–0.52, p
Published: 2020

36. An evaluation of self-perceived knowledge, attitudes and behaviours of UK oncologists about LGBTQ+ patients with cancer

Author: Susana Banerjee, Benjamin Heyworth, Daniel Johnathan Hughes, Hannah Tharmalingam, Tom Baker, Daniel Saunders, and Alison May Berner
Subjects: Adult, Male, Cancer Research, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Population, cancer risk, lcsh:RC254-282, cancer care, Likert scale, Sexual and Gender Minorities, Informed consent, sexual orientation, inequalities, Neoplasms, Transgender, Health care, medicine, Humans, education, Original Research, Aged, Oncologists, education.field_of_study, business.industry, Gender Identity, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, United Kingdom, Oncology, Family medicine, Respondent, Sexual orientation, Female, Lesbian, business
Abstract: Introduction Over one million people in the UK identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning). Research has shown that this population experience differing cancer risk factors compared with non-LGBTQ+ patients and persistent inequalities in cancer care. Literature concerning the knowledge of oncologists of this group’s healthcare needs is limited; our study aimed to evaluate knowledge, attitudes and behaviours of UK oncologists about LGBTQ+ patients. Methods A 53-question survey was delivered via a secure online platform. Questions covered respondent demographics, knowledge, attitudes and behaviours with the majority of responses on a Likert scale. Oncologists were recruited via email from professional bodies and social media promotion. Informed consent was sought and responses fully anonymised. Multifactorial ordinal logistic regression and Fisher’s exact test were used to assess for interactions between demographics and responses with Holm-Bonferroni multiple testing correction. Results 258 fully completed responses were received. Respondents had a median age of 43 years (range 28–69); 65% consultants and 35% registrars; 42% medical, and 54% clinical, oncologists. 84% felt comfortable treating LGBTQ+ patients but only 8% agreed that they were confident in their knowledge of specific LGBTQ+ patient healthcare needs. There were low rates of routine enquiry about sexual orientation (5%), gender identity (3%) and preferred pronouns (2%). 68% of oncologists felt LGBTQ+ healthcare needs should be a mandatory component of postgraduate training. Conclusions This survey showed that UK oncologists feel comfortable treating LGBTQ+ patients but may fail to identify these patients in their clinic, making it more difficult to meet LGBTQ+ healthcare needs. There is self-awareness of deficits in knowledge of LGBTQ+ healthcare and a willingness to address this through postgraduate training. Educational resources collated and developed in accordance with this study would potentially improve the confidence of oncologists in treating LGBTQ+ patients and the cancer care these patients receive.
Published: 2020

37. Virtual care expansion in the Veterans Health Administration during the COVID-19 pandemic: clinical services and patient characteristics associated with utilization

Author: Jacqueline M Ferguson, Josephine Jacobs, Liberty Greene, Maria Yefimova, Donna M. Zulman, and Leonie Heyworth
Subjects: Adult, Male, Mental Health Services, medicine.medical_specialty, AcademicSubjects/SCI01060, Adolescent, 020205 medical informatics, Coronavirus disease 2019 (COVID-19), Patient characteristics, Health Informatics, 02 engineering and technology, Research and Applications, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Ambulatory Care, 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, 030212 general & internal medicine, Veterans Affairs, AcademicSubjects/MED00580, Veterans, disparities, Aged, access to care, business.industry, COVID-19, Middle Aged, Veterans health, Mental health, Telemedicine, United States, Confidence interval, United States Department of Veterans Affairs, Family medicine, Female, AcademicSubjects/SCI01530, Early phase, business
Abstract: Objectives To describe the shift from in-person to virtual care within Veterans Affairs (VA) during the early phase of the COVID-19 pandemic and to identify at-risk patient populations who require greater resources to overcome access barriers to virtual care. Materials and Methods Outpatient encounters (N = 42 916 349) were categorized by care type (eg, primary, mental health, etc) and delivery method (eg, in-person, video). For 5 400 878 Veterans, we used generalized linear models to identify patient sociodemographic and clinical characteristics associated with: 1) use of virtual (phone or video) care versus no virtual care and 2) use of video care versus no video care between March 11, 2020 and June 6, 2020. Results By June, 58% of VA care was provided virtually compared to only 14% prior. Patients with lower income, higher disability, and more chronic conditions were more likely to receive virtual care during the pandemic. Yet, Veterans aged 45–64 and 65+ were less likely to use video care compared to those aged 18–44 (aRR 0.80 [95% confidence interval (CI) 0.79, 0.82] and 0.50 [95% CI 0.48, 0.52], respectively). Rural and homeless Veterans were 12% and 11% less likely to use video care compared to urban (0.88 [95% CI 0.86, 0.90]) and nonhomeless Veterans (0.89 [95% CI 0.86, 0.92]). Discussion Veterans with high clinical or social need had higher likelihood of virtual service use early in the COVID-19 pandemic; however, older, homeless, and rural Veterans were less likely to have video visits, raising concerns for access barriers. Conclusions and Relevance While virtual care may expand access, access barriers must be addressed to avoid exacerbating disparities.
Published: 2020
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38. Productivity Burden of Occupational Noise-Induced Hearing Loss in Australia: A Life Table Modelling Study

Author: Lin Fritschi, Jane Heyworth, Ian Li, Si Si, Danny Liew, and Kate Lewkowski
Subjects: Male, Longitudinal study, economic evaluation, Hearing loss, Health, Toxicology and Mutagenesis, lcsh:Medicine, Article, 03 medical and health sciences, 0302 clinical medicine, Willingness to pay, Occupational Exposure, Environmental health, medicine, occupational noise exposure, Humans, Life Tables, Longitudinal Studies, 030212 general & internal medicine, Productivity, hearing loss, business.industry, 030503 health policy & services, lcsh:R, Public Health, Environmental and Occupational Health, Australia, medicine.disease, Quality-adjusted life year, Occupational Diseases, Hearing Loss, Noise-Induced, Cohort, Economic evaluation, Noise, Occupational, Female, medicine.symptom, 0305 other medical science, business, Noise-induced hearing loss
Abstract: Background: Occupational noise-induced hearing loss (ONIHL) is one of the most common yet preventable occupational diseases. The aim of this study was to estimate the economic burden of ONIHL in the Australian working population by quantifying and monetising ONIHL&mdash, related loss of Quality Adjusted Life Years (QALY) and Productivity Adjusted Life Years (PALYs). Methods: We simulated the number of moderate-to-severe ONIHL by multiplying the age-specific prevalence of occupational noise exposure by the excess risks of ONIHL. Life table modelling was applied to workers with ONIHL. The QALY and PALY weights attributable to hearing loss were sourced from published data. The 2016 Gross Domestic Product per full-time equivalent worker in Australia was used to estimate the cost of productivity loss due to ONIHL. The cost due to the loss of well-being was quantified using willingness to pay thresholds derived from an Australian longitudinal study. Results: Under current occupational noise exposure levels in Australia, we estimated that over 80,000 male workers and over 31,000 female workers would develop ONIHL over 10 years of exposure. Following this cohort until the age of 65 years, the estimated loss of QALYs and PALYs were 62,218 and 135,561 respectively, with a projected loss of AUD 5.5 billion and AUD 21.3 billion due to well-being and productivity loss, respectively. Reducing noise exposure at work would substantially reduce the economic burden of ONIHL. Conclusion: ONIHL imposes substantial burden on Australian economy. Interventions to reduce occupational noise exposure are warranted.
Published: 2020
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39. Defining the volume of consultations for musculoskeletal infection encountered by pediatric orthopaedic services in the United States

Author: Ena Nielsen, Ryan Sanborn, Mary Naas, Rachel Y. Goldstein, Divya Talwar, Jacob Wild, Olivia Hughes, Brandon A. Ramo, Jonathan G. Schoenecker, Daniel Hedequest, Scott Rosenfeld, Emily S Rademacher, Amanda Davis-Juarez, Noor Saaed, David D. Spence, Hayley Peoples, Mark L Miller, Kiana King, Jaclyn F. Hill, Vidyadhar V. Upasani, Julie Shelton, Anastasiya A Trizno, Samuel R Johnson, Jaime Rice Denning, Rod Turner, Alyssa Roseman, Stephanie N. Moore-Lotridge, Matthew Rotando, Todd J Blumberg, Jordyn Sessel, Allan Beebe, Kathleen D Rickert, Liam Harris, G. Ying Li, Patricia E. Miller, Children’s Orthopaedic Trauma, Ryan J Koehler, Joshua S. Murphy, Satbir Singh, Eduardo A Lindsay, R. Lane Winberly, Megan Johnson, Walter H. Truong, Jason W Stoneback, Lawson A B Copley, Adam Gould, Schon Crouse, Mallory Rowan, Brian K Brighton, Naureen Tareen, Colin May, Keith D. Baldwin, Brooke Kutz, Benjamin J. Shore, Antoinette W. Lindberg, Teaya Rough, Viviana Bompadre, Joseph A. Janicki, Benton E. Heyworth, Christine Churchill, Jennifer C. Laine, and Tse, Herman
Subjects: Male, Critical Care and Emergency Medicine, Medical Doctors, Health Care Providers, Staphylococcus, Orthopedic Surgery, Children’s Orthopaedic Trauma and Infection Consortium for Evidence Based Study (CORTICES) Group, Pathology and Laboratory Medicine, Tertiary care, Pediatrics, 0302 clinical medicine, Medicine and Health Sciences, Medicine, Musculoskeletal Diseases, Medical Personnel, Child, Referral and Consultation, Pediatric, 030222 orthopedics, Multidisciplinary, Workload, Medical microbiology, Work-up, Bacterial Pathogens, Professions, Female, Methicillin-resistant Staphylococcus aureus, Pathogens, Pediatric Infections, Research Article, Pediatric Orthopedics, medicine.medical_specialty, Staphylococcus aureus, General Science & Technology, Science, MEDLINE, Surgical and Invasive Medical Procedures, Musculoskeletal infection, Infections, Microbiology, 03 medical and health sciences, Musculoskeletal System Procedures, Clinical Research, 030225 pediatrics, Physicians, Humans, Microbial Pathogens, Retrospective Studies, Surgeons, Biology and life sciences, Bacteria, business.industry, Organisms, Correction, Retrospective cohort study, Emergency department, United States, Health Care, Orthopedics, Family medicine, Orthopedic surgery, People and Places, Population Groupings, business
Abstract: Objective Adequate resources are required to rapidly diagnose and treat pediatric musculoskeletal infection (MSKI). The workload MSKI consults contribute to pediatric orthopaedic services is unknown as prior epidemiologic studies are variable and negative work-ups are not included in national discharge databases. The hypothesis was tested that MSKI consults constitute a substantial volume of total consultations for pediatric orthopaedic services across the United States. Study design Eighteen institutions from the Children's ORthopaedic Trauma and Infection Consortium for Evidence-based Study (CORTICES) group retrospectively reviewed a minimum of 1 year of hospital data, reporting the total number of surgeons, total consultations, and MSKI-related consultations. Consultations were classified by the location of consultation (emergency department or inpatient). Culture positivity rate and pathogens were also reported. Results 87,449 total orthopaedic consultations and 7,814 MSKI-related consultations performed by 229 pediatric orthopaedic surgeons were reviewed. There was an average of 13 orthopaedic surgeons per site each performing an average of 154 consultations per year. On average, 9% of consultations were MSKI related and 37% of these consults yielded positive cultures. Finally, a weak inverse monotonic relationship was noted between percent culture positivity and percent of total orthopedic consults for MSKI. Conclusion At large, academic pediatric tertiary care centers, pediatric orthopaedic services consult on an average of ~3,000 'rule-out' MSKI cases annually. These patients account for nearly 1 in 10 orthopaedic consultations, of which 1 in 3 are culture positive. Considering that 2 in 3 consultations were culture negative, estimating resources required for pediatric orthopaedic consult services to work up and treat children based on culture positive administrative discharge data underestimates clinical need. Finally, ascertainment bias must be considered when comparing differences in culture rates from different institution's pediatric orthopaedics services, given the variability in when orthopaedic physicians become involved in a MSKI workup.
Published: 2020

40. Transcriptome‐wide association study of breast cancer risk by estrogen‐receptor status

Author: Feng, Helian, Gusev, Alexander, Pasaniuc, Bogdan, Wu, Lang, Long, Jirong, Abu-Full, Zomoroda, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Antoniou, Antonis C, Arason, Adalgeir, Arndt, Volker, Aronson, Kristan J, Arun, Banu K, Asseryanis, Ella, Auer, Paul L, Azzollini, Jacopo, Balmaña, Judith, Barkardottir, Rosa B, Barnes, Daniel R, Barrowdale, Daniel, Beckmann, Matthias W, Behrens, Sabine, Benitez, Javier, Bermisheva, Marina, Białkowska, Katarzyna, Blanco, Ana, Blomqvist, Carl, Boeckx, Bram, Bogdanova, Natalia V, Bojesen, Stig E, Bolla, Manjeet K, Bonanni, Bernardo, Borg, Ake, Brauch, Hiltrud, Brenner, Hermann, Briceno, Ignacio, Broeks, Annegien, Brüning, Thomas, Burwinkel, Barbara, Cai, Qiuyin, Caldés, Trinidad, Caligo, Maria A, Campbell, Ian, Canisius, Sander, Campa, Daniele, Carter, Brian D, Carter, Jonathan, Castelao, Jose E, Chang-Claude, Jenny, Chanock, Stephen J, Christiansen, Hans, Chung, Wendy K, Claes, Kathleen BM, Clarke, Christine L, GEMO Study Collaborators, EMBRACE Collaborators, GC-HBOC study Collaborators, Couch, Fergus J, Cox, Angela, Cross, Simon S, Cybulski, Cezary, Czene, Kamila, Daly, Mary B, de la Hoya, Miguel, De Leeneer, Kim, Dennis, Joe, Devilee, Peter, Diez, Orland, Domchek, Susan M, Dörk, Thilo, Dos-Santos-Silva, Isabel, Dunning, Alison M, Dwek, Miriam, Eccles, Diana M, Ejlertsen, Bent, Ellberg, Carolina, Engel, Christoph, Eriksson, Mikael, Fasching, Peter A, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Friedman, Eitan, Fritschi, Lin, Frost, Debra, Gabrielson, Marike, Ganz, Patricia A, Gapstur, Susan M, Garber, Judy, García-Closas, Montserrat, García-Sáenz, José A, Gaudet, Mia M, Giles, Graham G, Glendon, Gord, Godwin, Andrew K, Goldberg, Mark S, Goldgar, David E, González-Neira, Anna, Greene, Mark H, Gronwald, Jacek, Guénel, Pascal, Haiman, Christopher A, Hall, Per, Hamann, Ute, Hake, Christopher, He, Wei, Heyworth, Jane, Hogervorst, Frans BL, Hollestelle, Antoinette, Hooning, Maartje J, Hoover, Robert N, Hopper, John L, Huang, Guanmengqian, Hulick, Peter J, Humphreys, Keith, Imyanitov, Evgeny N, ABCTB Investigators, HEBON Investigators, BCFR Investigators, OCGN Investigators, Isaacs, Claudine, Jakimovska, Milena, Jakubowska, Anna, James, Paul, Janavicius, Ramunas, Jankowitz, Rachel C, John, Esther M, Johnson, Nichola, Joseph, Vijai, Jung, Audrey, Karlan, Beth Y, Khusnutdinova, Elza, Kiiski, Johanna I, Konstantopoulou, Irene, Kristensen, Vessela N, Laitman, Yael, Lambrechts, Diether, Lazaro, Conxi, Leroux, Dominique, Leslie, Goska, Lester, Jenny, Lesueur, Fabienne, Lindor, Noralane, Lindström, Sara, Lo, Wing-Yee, Loud, Jennifer T, Lubiński, Jan, Makalic, Enes, Mannermaa, Arto, Manoochehri, Mehdi, Manoukian, Siranoush, Margolin, Sara, Martens, John WM, Martinez, Maria E, Matricardi, Laura, Maurer, Tabea, Mavroudis, Dimitrios, McGuffog, Lesley, Meindl, Alfons, Menon, Usha, Michailidou, Kyriaki, Kapoor, Pooja M, Miller, Austin, Montagna, Marco, Moreno, Fernando, Moserle, Lidia, Mulligan, Anna M, Muranen, Taru A, Nathanson, Katherine L, Neuhausen, Susan L, Nevanlinna, Heli, Nevelsteen, Ines, Nielsen, Finn C, Nikitina-Zake, Liene, Offit, Kenneth, Olah, Edith, Olopade, Olufunmilayo I, Olsson, Håkan, Osorio, Ana, Papp, Janos, Park-Simon, Tjoung-Won, Parsons, Michael T, Pedersen, Inge S, Peixoto, Ana, Peterlongo, Paolo, Peto, Julian, Pharoah, Paul DP, Phillips, Kelly-Anne, Plaseska-Karanfilska, Dijana, Poppe, Bruce, Pradhan, Nisha, Prajzendanc, Karolina, Presneau, Nadege, Punie, Kevin, Pylkäs, Katri, Radice, Paolo, Rantala, Johanna, Rashid, Muhammad Usman, Rennert, Gad, Risch, Harvey A, Robson, Mark, Romero, Atocha, Saloustros, Emmanouil, Sandler, Dale P, Santos, Catarina, Sawyer, Elinor J, Schmidt, Marjanka K, Schmidt, Daniel F, Schmutzler, Rita K, Schoemaker, Minouk J, Scott, Rodney J, Sharma, Priyanka, Shu, Xiao-Ou, Simard, Jacques, Singer, Christian F, Skytte, Anne-Bine, Soucy, Penny, Southey, Melissa C, Spinelli, John J, Spurdle, Amanda B, Stone, Jennifer, Swerdlow, Anthony J, Tapper, William J, Taylor, Jack A, Teixeira, Manuel R, Terry, Mary Beth, Teulé, Alex, Thomassen, Mads, Thöne, Kathrin, Thull, Darcy L, Tischkowitz, Marc, Toland, Amanda E, Tollenaar, Rob AEM, Torres, Diana, Truong, Thérèse, Tung, Nadine, Vachon, Celine M, van Asperen, Christi J, van den Ouweland, Ans MW, van Rensburg, Elizabeth J, Vega, Ana, Viel, Alessandra, Vieiro-Balo, Paula, Wang, Qin, Wappenschmidt, Barbara, Weinberg, Clarice R, Weitzel, Jeffrey N, Wendt, Camilla, Winqvist, Robert, Yang, Xiaohong R, Yannoukakos, Drakoulis, Ziogas, Argyrios, Milne, Roger L, Easton, Douglas F, Chenevix-Trench, Georgia, Zheng, Wei, Kraft, Peter, Jiang, Xia, Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland, Antoniou, Antonis [0000-0001-9223-3116], Barnes, Daniel [0000-0002-3781-7570], Dennis, Joe [0000-0003-4591-1214], Dunning, Alison [0000-0001-6651-7166], Leslie, Goska [0000-0001-5756-6222], Pharoah, Paul [0000-0001-8494-732X], Tischkowitz, Marc [0000-0002-7880-0628], Easton, Douglas [0000-0003-2444-3247], Apollo - University of Cambridge Repository, Medical Oncology, Clinical Genetics, Medicum, Research Programs Unit, Genome-Scale Biology (GSB) Research Program, HUSLAB, Department of Medical and Clinical Genetics, Helsinki University Hospital Area, University of Helsinki, HUS Comprehensive Cancer Center, Department of Oncology, Clinicum, INDIVIDRUG - Individualized Drug Therapy, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Biosciences, Institut Català de la Salut, [Feng H] Program in Genetic Epidemiology and Statistical Genetics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. [Gusev A] Dana‐Farber Cancer Institute, Boston, Massachusetts. [Pasaniuc B] UCLA Path & Lab Med, Los Angeles, California. [Wu L] Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii. [Long J] Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt‐Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee. [Abu-full Z] Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel. [Balmaña J] High Risk and Cancer Prevention Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Diez O] Hereditary Cancer Genetics Group, Area of Clinical and Molecular Genetics, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Vall d'Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
Subjects: Oncology, Epidemiology, Neoplasms::Neoplasms by Site::Breast Neoplasms [DISEASES], Genetic Phenomena::Genotype::Genetic Predisposition to Disease [PHENOMENA AND PROCESSES], Vesicular Transport Proteins, Estrogen receptor, Genome-wide association study, VARIANTS, Transcriptome, Breast cancer, Brjóstakrabbamein, Receptors, Medicine and Health Sciences, GWAS, skin and connective tissue diseases, Estrogen Receptor Status, Genetics (clinical), Genetics & Heredity, neoplasias::neoplasias por localización::neoplasias de la mama [ENFERMEDADES], 0303 health sciences, Gen, 030305 genetics & heredity, 1184 Genetics, developmental biology, physiology, Causal gene, Genomics, CARRIERS, STATISTICS, 3. Good health, Receptors, Estrogen, breast cancer subtype, causal gene, TWAS, Breast Neoplasms, Estrogens, Female, Genetic Predisposition to Disease, Humans, Risk Assessment, Genome-Wide Association Study, Medical genetics, Breast Cancer Genetics, Erfðarannsóknir, Life Sciences & Biomedicine, EXPRESSION, medicine.medical_specialty, SUSCEPTIBILITY LOCI, 3122 Cancers, Estrògens, Biology, Article, Càncer de mama, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Internal medicine, Krabbameinsrannsóknir, medicine, fenómenos genéticos::genotipo::predisposición genética a la enfermedad [FENÓMENOS Y PROCESOS], 030304 developmental biology, Genetic association, Science & Technology, IDENTIFICATION, medicine.disease, Estrogen, TISSUE, Breast cancer subtype, Mama - Càncer - Aspectes genètics, Mathematical & Computational Biology
Abstract: Publisher's version (útgefin grein), Previous transcriptome-wide association studies (TWAS) have identified breast cancer risk genes by integrating data from expression quantitative loci and genome-wide association studies (GWAS), but analyses of breast cancer subtype-specific associations have been limited. In this study, we conducted a TWAS using gene expression data from GTEx and summary statistics from the hitherto largest GWAS meta-analysis conducted for breast cancer overall, and by estrogen receptor subtypes (ER+ and ER−). We further compared associations with ER+ and ER− subtypes, using a case-only TWAS approach. We also conducted multigene conditional analyses in regions with multiple TWAS associations. Two genes, STXBP4 and HIST2H2BA, were specifically associated with ER+ but not with ER– breast cancer. We further identified 30 TWAS-significant genes associated with overall breast cancer risk, including four that were not identified in previous studies. Conditional analyses identified single independent breast-cancer gene in three of six regions harboring multiple TWAS-significant genes. Our study provides new information on breast cancer genetics and biology, particularly about genomic differences between ER+ and ER− breast cancer., The authors thank the Cellex Foundation for providing research facilities and equipment. The breast cancer genome‐wide association (BCAC) is funded by Cancer Research UK (C1287/A16563, C1287/A10118), the European Union's Horizon 2020 Research and Innovation Programme (grant nos. 634935 and 633784 for BRIDGES and B‐CAST, respectively), and by the European Community's Seventh Framework Programme under grant agreement number 223175 (grant no. HEALTH‐F2‐2009‐223175) (COGS). The EU Horizon 2020 Research and Innovation Programme funding source had no role in study design, data collection, data analysis, data interpretation or writing of the report. Genotyping of the OncoArray was funded by the NIH grant U19 CA148065, and Cancer UK grant C1287/A16563 and the PERSPECTIVE project supported by the Government of Canada through Genome Canada and the Canadian Institutes of Health Research (grant GPH‐129344), and the Ministère de l’Économie, Science et Innovation du Québec through Genome Québec and the PSRSIIRI‐701 grant, and the Quebec Breast Cancer Foundation. Funding for the iCOGS infrastructure came from: the European Community's Seventh Framework Programme under grant agreement no. 223175 (HEALTH‐F2‐2009‐223175; COGS), Cancer Research UK (C1287/A10118, C1287/A10710, C12292/A11174, C1281/A12014, C5047/A8384, C5047/A15007, C5047/A10692, and C8197/A16565), the National Institutes of Health (CA128978) and Post‐Cancer GWAS initiative (1U19 CA148537, 1U19 CA148065, and 1U19 CA148112—the GAME‐ON initiative), the Department of Defence (W81XWH‐10‐1‐0341), the Canadian Institutes of Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer, and Komen Foundation for the Cure, the Breast Cancer Research Foundation, and the Ovarian Cancer Research Fund. The DRIVE Consortium was funded by U19 CA148065. The Australian Breast Cancer Family Study (ABCFS) was supported by grant UM1 CA164920 from the National Cancer Institute (USA). The content of this manuscript does not necessarily reflect the views or policies of the National Cancer Institute or any of the collaborating centers in the Breast Cancer Family Registry (BCFR), nor does mention of trade names, commercial products, or organizations imply endorsement by the USA Government or the BCFR. The ABCFS was also supported by the National Health and Medical Research Council of Australia, the New South Wales Cancer Council, the Victorian Health Promotion Foundation (Australia) and the Victorian Breast Cancer Research Consortium. J. L. H. is a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellow. M. C. S. is an NHMRC Senior Research Fellow. The ABCS study was supported by the Dutch Cancer Society (grants NKI 2007‐3839; 2009 4363). The Australian Breast Cancer Tissue Bank (ABCTB) is generously supported by the National Health and Medical Research Council of Australia, The Cancer Institute NSW and the National Breast Cancer Foundation. The ACP study is funded by the Breast Cancer Research Trust, UK. The AHS study is supported by the intramural research program of the National Institutes of Health, the National Cancer Institute (grant no. Z01‐CP010119), and the National Institute of Environmental Health Sciences (grant no. Z01‐ES049030). The work of the BBCC was partly funded by ELAN‐Fond of the University Hospital of Erlangen. The BBCS is funded by Cancer Research UK and Breast Cancer Now and acknowledges NHS funding to the NIHR Biomedical Research Centre, and the National Cancer Research Network (NCRN). The BCEES was funded by the National Health and Medical Research Council, Australia and the Cancer Council Western Australia and acknowledges funding from the National Breast Cancer Foundation (JS). For the BCFR‐NY, BCFR‐PA, BCFR‐UT this work was supported by grant UM1 CA164920 from the National Cancer Institute. The content of this manuscript does not necessarily reflect the views or policies of the National Cancer Institute or any of the collaborating centers in the Breast Cancer Family Registry (BCFR), nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government or the BCFR. For BIGGS, E. S. is supported by NIHR Comprehensive Biomedical Research Centre, Guy's and St. Thomas' NHS Foundation Trust in partnership with King's College London, United Kingdom. I. T. is supported by the Oxford Biomedical Research Centre. B. O. C. S. is supported by funds from Cancer Research UK (C8620/A8372/A15106) and the Institute of Cancer Research (UK). B. O. C. S. acknowledges NHS funding to the Royal Marsden/Institute of Cancer Research NIHR Specialist Cancer Biomedical Research Centre. The BREast Oncology GAlician Network (BREOGAN) is funded by Acción Estratégica de Salud del Instituto de Salud Carlos III FIS PI12/02125/Cofinanciado FEDER; Acción Estratégica de Salud del Instituto de Salud Carlos III FIS Intrasalud (PI13/01136); Programa Grupos Emergentes, Cancer Genetics Unit, Instituto de Investigacion Biomedica Galicia Sur. Xerencia de Xestion Integrada de Vigo‐SERGAS, Instituto de Salud Carlos III, Spain; Grant 10CSA012E, Consellería de Industria Programa Sectorial de Investigación Aplicada, PEME I + D e I + D Suma del Plan Gallego de Investigación, Desarrollo e Innovación Tecnológica de la Consellería de Industria de la Xunta de Galicia, Spain (grant EC11‐192). Fomento de la Investigación Clínica Independiente, Ministerio de Sanidad, Servicios Sociales e Igualdad, Spain; and Grant FEDER‐Innterconecta. Ministerio de Economia y Competitividad, Xunta de Galicia, Spain. The BSUCH study was supported by the Dietmar‐Hopp Foundation, the Helmholtz Society and the German Cancer Research Center (DKFZ). The CAMA study was funded by Consejo Nacional de Ciencia y Tecnología (CONACyT; SALUD‐2002‐C01‐7462). Sample collection and processing were funded in part by grants from the National Cancer Institute (NCI R01CA120120 and K24CA169004). C. B. C. S. is funded by the Canadian Cancer Society (grant no. 313404) and the Canadian Institutes of Health Research. C. C. G. P. is supported by funding from the University of Crete. The CECILE study was supported by Fondation de France, Institut National du Cancer (INCa), Ligue Nationale Contre le Cancer, Agence Nationale de Sécurité Sanitaire, de l'Alimentation, de l'Environnement et du Travail (ANSES), Agence Nationale de la Recherche (ANR). The CGPS was supported by the Chief Physician Johan Boserup and Lise Boserup Fund, the Danish Medical Research Council, and Herlev and Gentofte Hospital. The CNIO‐BCS was supported by the Instituto de Salud Carlos III, the Red Temática de Investigación Cooperativa en Cáncer and grants from the Asociación Española Contra el Cáncer and the Fondo de Investigación Sanitario (PI11/00923 and PI12/00070). COLBCCC is supported by the German Cancer Research Center (DKFZ), Heidelberg, Germany. Diana Torres was in part supported by a postdoctoral fellowship from the Alexander von Humboldt Foundation. The American Cancer Society funds the creation, maintenance, and updating of the CPS‐II cohort. The CTS was initially supported by the California Breast Cancer Act of 1993 and the California Breast Cancer Research Fund (contract 97‐10500) and is currently funded through the National Institutes of Health (R01 CA77398, UM1 CA164917, and U01 CA199277). The collection of cancer incidence data was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885. HAC receives support from the Lon V Smith Foundation (LVS39420). The University of Westminster curates the DietCompLyf database funded by Against Breast Cancer Registered Charity No. 1121258 and the NCRN. The coordination of EPIC is financially supported by the European Commission (DG‐SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF) (Germany); the Hellenic Health Foundation, the Stavros Niarchos Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro‐AIRC‐Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC‐Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain); Cancer Research UK (14136 to EPIC‐Norfolk; C570/A16491 and C8221/A19170 to EPIC‐Oxford), Medical Research Council (1000143 to EPIC‐Norfolk, MR/M012190/1 to EPIC‐Oxford) (United Kingdom). The ESTHER study was supported by a grant from the Baden Württemberg Ministry of Science, Research and Arts. Additional cases were recruited in the context of the VERDI study, which was supported by a grant from the German Cancer Aid (Deutsche Krebshilfe). FHRISK is funded from NIHR grant PGfAR 0707‐10031. The GC‐HBOC (German Consortium of Hereditary Breast and Ovarian Cancer) is supported by the German Cancer Aid (grant no 110837, coordinator: Rita K. Schmutzler, Cologne). This work was also funded by the European Regional Development Fund and Free State of Saxony, Germany (LIFE—Leipzig Research Centre for Civilization Diseases, project numbers 713‐241202, 713‐241202, 14505/2470, 14575/2470). The GENICA was funded by the Federal Ministry of Education and Research (BMBF) Germany grants 01KW9975/5, 01KW9976/8, 01KW9977/0 and 01KW0114, the Robert Bosch Foundation, Stuttgart, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, the Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, as well as the Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany. The GEPARSIXTO study was conducted by the German Breast Group GmbH. The GESBC was supported by the Deutsche Krebshilfe e. V. (70492) and the German Cancer Research Center (DKFZ). GLACIER was supported by Breast Cancer Now, CRUK and Biomedical Research Centre at Guy's and St Thomas’ NHS Foundation Trust and King's College London. The HABCS study was supported by the Claudia von Schilling Foundation for Breast Cancer Research, by the Lower Saxonian Cancer Society, and by the Rudolf Bartling Foundation. The HEBCS was financially supported by the Helsinki University Hospital Research Fund, the Finnish Cancer Society, and the Sigrid Juselius Foundation. The HERPACC was supported by MEXT Kakenhi (No. 170150181 and 26253041) from the Ministry of Education, Science, Sports, Culture and Technology of Japan, by a Grant‐in‐Aid for the Third Term Comprehensive 10‐Year Strategy for Cancer Control from Ministry Health, Labour and Welfare of Japan, by Health and Labour Sciences Research Grants for Research on Applying Health Technology from Ministry Health, Labour and Welfare of Japan, by National Cancer Center Research and Development Fund, and “Practical Research for Innovative Cancer Control (15ck0106177h0001)” from Japan Agency for Medical Research and development, AMED, and Cancer Bio Bank Aichi. The HMBCS was supported by a grant from the Friends of Hannover Medical School and by the Rudolf Bartling Foundation. The HUBCS was supported by a grant from the German Federal Ministry of Research and Education (RUS08/017) and by the Russian Foundation for Basic Research and the Federal Agency for Scientific Organizations for supporting the Bioresource collections and RFBR grants 14‐04‐97088, 17‐29‐06014, and 17‐44‐020498. ICICLE was supported by Breast Cancer Now, CRUK and Biomedical Research Centre at Guy's and St Thomas’ NHS Foundation Trust and King's College London. Financial support for KARBAC was provided through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet, the Swedish Cancer Society, The Gustav V Jubilee foundation and Bert von Kantzows foundation. The KARMA study was supported by Märit and Hans Rausings Initiative Against Breast Cancer. The KBCP was financially supported by the special Government Funding (EVO) of Kuopio University Hospital grants, Cancer Fund of North Savo, the Finnish Cancer Organizations, and the strategic funding of the University of Eastern Finland. The kConFab Follow‐Up Study is supported by grants from Cancer Australia, the Australian National Breast Cancer Foundation, the National Health and Medical Research Council, the National Institute of Health USA, the Queensland Cancer Fund, the Cancer Councils of New South Wales, Victoria, Tasmania and South Australia, and the Cancer Foundation of Western Australia. KAP is an Australian National Breast Cancer Foundation Practitioner Fellow. Financial support for the AOCS was provided by the United States Army Medical Research and Materiel Command (DAMD17‐01‐1‐0729), Cancer Council Victoria, Queensland Cancer Fund, Cancer Council New South Wales, Cancer Council South Australia, The Cancer Foundation of Western Australia, Cancer Council Tasmania and the National Health and Medical Research Council of Australia (NHMRC; 400413, 400281, and 199600). G. C. T. and P. W. are supported by the NHMRC. R. B. was a Cancer Institute NSW Clinical Research Fellow. The KOHBRA study was partially supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), and the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (HI16C1127; 1020350; 1420190). L. A. A. B. C. is supported by grants (1RB‐0287, 3PB‐0102, 5PB‐0018, and 10PB‐0098) from the California Breast Cancer Research Program. Incident breast cancer cases were collected by the USC Cancer Surveillance Program (CSP) which is supported under subcontract by the California Department of Health. The CSP is also part of the National Cancer Institute's Division of Cancer Prevention and Control Surveillance, Epidemiology, and End Results Program, under contract number N01CN25403. L. M. B. C. is supported by the “Stichting tegen Kanker.” D. L. is supported by the FWO. The MABCS study is funded by the Research Centre for Genetic Engineering and Biotechnology “Georgi D. Efremov” and supported by the German Academic Exchange Program, DAAD. The MARIE study was supported by the Deutsche Krebshilfe e.V. (70‐2892‐BR I, 106332, 108253, 108419, 110826, 110828), the Hamburg Cancer Society, the German Cancer Research Center (DKFZ) and the Federal Ministry of Education and Research (BMBF) Germany (01KH0402). MBCSG is supported by grants from the Italian Association for Cancer Research (AIRC) and by funds from the Italian citizens who allocated the 5/1,000 share of their tax payment in support of the Fondazione IRCCS Istituto Nazionale Tumori, according to Italian laws (INT‐Institutional strategic projects “5 × 1,000”). The MCBCS was supported by the NIH grants CA192393, CA116167, CA176785, and NIH Specialized Program of Research Excellence (SPORE) in Breast Cancer (CA116201), and the Breast Cancer Research Foundation and a generous gift from the David F. and Margaret T. Grohne Family Foundation. The Melbourne Collaborative Cohort Study (MCCS) cohort recruitment was funded by VicHealth and Cancer Council Victoria. The MCCS was further augmented by Australian National Health and Medical Research Council grants 209057, 396414, and 1074383 and by infrastructure provided by Cancer Council Victoria. Cases and their vital status were ascertained through the Victorian Cancer Registry and the Australian Institute of Health and Welfare, including the National Death Index and the Australian Cancer Database.” The MEC was supported by NIH grants CA63464, CA54281, CA098758, CA132839, and CA164973. The MISS study is supported by funding from ERC‐2011‐294576 Advanced grant, Swedish Cancer Society, Swedish Research Council, Local hospital funds, Berta Kamprad Foundation, Gunnar Nilsson. The MMHS study was supported by NIH grants CA97396, CA128931, CA116201, CA140286, and CA177150. M. S. K. C. C. is supported by grants from the Breast Cancer Research Foundation and Robert and Kate Niehaus Clinical Cancer Genetics Initiative. The work of MTLGEBCS was supported by the Quebec Breast Cancer Foundation, the Canadian Institutes of Health Research for the “CIHR Team in Familial Risks of Breast Cancer” program—grant no. CRN‐87521 and the Ministry of Economic Development, Innovation and Export Trade—grant no. PSR‐SIIRI‐701. MYBRCA is funded by research grants from the Malaysian Ministry of Higher Education (UM.C/HlR/MOHE/06) and Cancer Research Malaysia. MYMAMMO is supported by research grants from Yayasan Sime Darby LPGA Tournament and Malaysian Ministry of Higher Education (RP046B‐15HTM). The NBCS has been supported by the Research Council of Norway grant 193387/V50 (to A.‐L. B.‐D. and V. N. K.) and grant 193387/H10 (to A.‐L. B.‐D. and V. N. K.), South‐Eastern Norway Health Authority (grant 39346 to A.‐L.B‐D. and 27208 to V. N. K.) and the Norwegian Cancer Society (to A.‐L. B.‐D. and 419616‐71248‐PR‐2006‐0282 to V. N. K.). It has received funding from the K.G. Jebsen Centre for Breast Cancer Research (2012‐2015). The NBHS was supported by NIH grant R01CA100374. Biological sample preparation was conducted the Survey and Biospecimen Shared Resource, which is supported by P30 CA68485. The Northern California Breast Cancer Family Registry (NC‐BCFR) and Ontario Familial Breast Cancer Registry (OFBCR) were supported by grant UM1 CA164920 from the National Cancer Institute (USA). The content of this manuscript does not necessarily reflect the views or policies of the National Cancer Institute or any of the collaborating centers in the Breast Cancer Family Registry (BCFR), nor does mention of trade names, commercial products, or organizations imply endorsement by the USA Government or the BCFR. The Carolina Breast Cancer Study was funded by Komen Foundation, the National Cancer Institute (P50 CA058223, U54 CA156733, and U01 CA179715), and the North Carolina University Cancer Research Fund. The NGOBCS was supported by Grants‐in‐Aid for the Third Term Comprehensive Ten‐Year Strategy for Cancer Control from the Ministry of Health, Labor and Welfare of Japan, and for Scientific Research on Priority Areas, 17015049 and for Scientific Research on Innovative Areas, 221S0001, from the Ministry of Education, Culture, Sports, Science, and Technology of Japan. The NHS was supported by NIH grants P01 CA87969, UM1 CA186107, and U19 CA148065. The NHS2 was supported by NIH grants UM1 CA176726 and U19 CA148065. The OBCS was supported by research grants from the Finnish Cancer Foundation, the Academy of Finland (grant no. 250083, 122715 and Center of Excellence grant no. 251314), the Finnish Cancer Foundation, the Sigrid Juselius Foundation, the University of Oulu, the University of Oulu Support Foundation and the special Governmental EVO funds for Oulu University Hospital‐based research activities. The ORIGO study was supported by the Dutch Cancer Society (RUL 1997‐1505) and the Biobanking and Biomolecular Resources Research Infrastructure (BBMRI‐NL CP16). The PBCS was funded by Intramural Research Funds of the National Cancer Institute, Department of Health and Human Services, USA. Genotyping for PLCO was supported by the Intramural Research Program of the National Institutes of Health, NCI, Division of Cancer Epidemiology and Genetics. The PLCO is supported by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics and supported by contracts from the Division of Cancer Prevention, National Cancer Institute, National Institutes of Health. The POSH study is funded by Cancer Research UK (grants C1275/A11699, C1275/C22524, C1275/A19187, C1275/A15956, and Breast Cancer Campaign 2010PR62, 2013PR044. PROCAS is funded from NIHR grant PGfAR 0707‐10031. The RBCS was funded by the Dutch Cancer Society (DDHK 2004‐3124, DDHK 2009‐4318). The SASBAC study was supported by funding from the Agency for Science, Technology, and Research of Singapore (A*STAR), the US National Institute of Health (NIH) and the Susan G. Komen Breast Cancer Foundation. The SBCGS was supported primarily by NIH grants R01CA64277, R01CA148667, UMCA182910, and R37CA70867. Biological sample preparation was conducted the Survey and Biospecimen Shared Resource, which is supported by P30 CA68485. The scientific development and funding of this project were, in part, supported by the Genetic Associations and Mechanisms in Oncology (GAME‐ON) Network U19 CA148065. The SBCS was supported by Sheffield Experimental Cancer Medicine Centre and Breast Cancer Now Tissue Bank. The SCCS is supported by a grant from the National Institutes of Health (R01 CA092447). Data on SCCS cancer cases used in this publication were provided by the Alabama Statewide Cancer Registry; Kentucky Cancer Registry, Lexington, KY; Tennessee Department of Health, Office of Cancer Surveillance; Florida Cancer Data System; North Carolina Central Cancer Registry, North Carolina Division of Public Health; Georgia Comprehensive Cancer Registry; Louisiana Tumor Registry; Mississippi Cancer Registry; South Carolina Central Cancer Registry; Virginia Department of Health, Virginia Cancer Registry; Arkansas Department of Health, Cancer Registry, 4815 W. Markham, Little Rock, AR 72205. The Arkansas Central Cancer Registry is fully funded by a grant from the National Program of Cancer Registries, Centers for Disease Control and Prevention (CDC). Data on SCCS cancer cases from Mississippi were collected by the Mississippi Cancer Registry which participates in the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or the Mississippi Cancer Registry. SEARCH is funded by Cancer Research UK (C490/A10124 and C490/A16561) and supported by the UK National Institute for Health Research Biomedical Research Centre at the University of Cambridge. The University of Cambridge has received salary support for PDPP from the NHS in the East of England through the Clinical Academic Reserve. SEBCS was supported by the BRL (Basic Research Laboratory) program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (2012‐0000347). SGBCC is funded by the NUS start‐up Grant, National University Cancer Institute Singapore (NCIS) Centre Grant and the NMRC Clinician Scientist Award. Additional controls were recruited by the Singapore Consortium of Cohort Studies‐Multi‐ethnic cohort (SCCS‐MEC), which was funded by the Biomedical Research Council, grant no. 05/1/21/19/425. The Sister Study (SISTER) is supported by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences (Z01‐ES044005 and Z01‐ES049033). The Two Sister Study (2SISTER) was supported by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences (Z01‐ES044005 and Z01‐ES102245), and, also by a grant from Susan G. Komen for the Cure, grant FAS0703856. SKKDKFZS is supported by the DKFZ. The SMC is funded by the Swedish Cancer Foundation. The SZBCS and IHCC were supported by Grant PBZ_KBN_122/P05/2004 and the program of the Minister of Science and Higher Education under the name “Regional Initiative of Excellence” in 2019–2022 project number 002/RID/2018/19 amount of financing 12,000,000 PLN. The TBCS was funded by The National Cancer Institute of Thailand. The TNBCC was supported by a Specialized Program of Research Excellence (SPORE) in Breast Cancer (CA116201), a grant from the Breast Cancer Research Foundation, a generous gift from the David F. and Margaret T. Grohne Family Foundation. The TWBCS is supported by the Taiwan Biobank project of the Institute of Biomedical Sciences, Academia Sinica, Taiwan. The UCIBCS component of this research was supported by the NIH (CA58860 and CA92044) and the Lon V Smith Foundation (LVS39420). The UKBGS is funded by Breast Cancer Now and the Institute of Cancer Research (ICR), London and also thank the study participants, study staff, and the doctors, nurses and other health care providers and health information sources who have contributed to the study. ICR acknowledges NHS funding to the NIHR Biomedical Research Centre. The UKOPS study was funded by The Eve Appeal (The Oak Foundation) and supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. The US3SS study was supported by Massachusetts (K. M. E., R01CA47305), Wisconsin (P. A. N., R01 CA47147), and New Hampshire (L. T.‐E., R01CA69664) centers, and Intramural Research Funds of the National Cancer Institute, Department of Health and Human Services, USA. The USRT Study was funded by Intramural Research Funds of the National Cancer Institute, Department of Health and Human Services, USA. The WAABCS study was supported by grants from the National Cancer Institute of the National Institutes of Health (R01 CA89085 and P50 CA125183 and the D43 TW009112 grant), Susan G. Komen (SAC110026), Dr. Ralph and Marian Falk Medical Research Trust, and the Avon Foundation for Women. The WHI program is funded by the National Heart, Lung, and Blood Institute, the US National Institutes of Health and the US Department of Health and Human Services (HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C). This work was also funded by NCI U19 CA148065‐01. D. G. E. is supported by the all Manchester NIHR Biomedical research center Manchester (IS‐BRC‐1215‐20007). HUNBOCS, Hungarian Breast, and Ovarian Cancer Study were supported by Hungarian Research Grant KTIA‐OTKA CK‐80745, NKFI_OTKA K‐112228. C. I. received support from the Survey, Recruitment, and Biospecimen Shared Resource at Georgetown University (NIH/NCI P30‐CA‐51008) and the Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research. K. M. is supported by CRUK C18281/A19169. City of Hope Clinical Cancer Community Research Network and the Hereditary Cancer Research Registry, supported in part by Award Number RC4CA153828 (PI: J Weitzel) from the National Cancer Institute and the office of the Director, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The ICO study is supported by the Asociación Española Contra el Cáncer (AECC), The Instituto de Salud Carlos III (organismo adscrito al Ministerio de Economía y Competitividad) and “Fondo Europeo de Desarrollo Regional (FEDER), una manera de hacer Europa” (PI10/01422, PI13/00285, PIE13/00022, PI15/00854, PI16/00563, and CIBERONC) and The Institut Català de la Salut and Autonomous Government of Catalonia (2009SGR290, 2014SGR338 and PERIS Project MedPerCan). Dr. Beth Karlan is funded by the American Cancer Society Early Detection Professorship (SIOP‐06‐258‐01‐COUN) and the National Center for Advancing Translational Sciences (NCATS), grant UL1TR000124. A.V. is supported by the Spanish Health Research Foundation, Instituto de Salud Carlos III (ISCIII), partially supported by FEDER funds through Research Activity Intensification Program (contract grant nos. INT15/00070, INT16/00154, INT17/00133), and through Centro de Investigación Biomédica en Red de Enferemdades Raras CIBERER (ACCI 2016: ER17P1AC7112/2018); Autonomous Government of Galicia (Consolidation and structuring program: IN607B), and by the Fundación Mutua Madrileña (call 2018). The GEMO resource was initially funded by the French National Institute of Cancer (INCa, PHRC Ile de France, grant AOR 01 082, 2001–2003, grant 2013‐1‐BCB‐01‐ICH‐1), the Association “Le cancer du sein, parlons‐en!” Award (2004) the Association for International Cancer Research (2008–2010), and the Fondation ARC pour la recherche sur le cancer (grant PJA 20151203365). It also received support from the Canadian Institute of Health Research for the “CIHR Team in Familial Risks of Breast Cancer” program (2008–2013), and the European commission FP7, Project «Collaborative Ovarian, breast and prostate Gene‐environment Study (COGS), Large‐scale integrating project» (2009–2013). G. E. M. O. is currently supported by the INCa grant SHS‐E‐SP 18‐015. OSUCCC was funded by the Ohio State University Comprehensive Cancer Center. Leigha Senter, Kevin Sweet, Caroline Craven, Julia Cooper, Amber Aielts, and Michelle O'Conor aided in the recruitment of BRCA1/2 study participants and data collection. Robert Pilarski aided in recruitment and data collection of TNBC cases from the Stefanie Spielman Breast Bank. Clinical Genetics Branch, NCI: the Intramural Research Program of the US National Cancer Institute, NIH, Division of Cancer Epidemiology and Genetics, and by support services contracts NO2‐CP‐11019‐50, N02‐CP‐21013‐63 and N02‐CP‐65504 with Westat, Inc, Rockville, MD. ILUH was funded by the Icelandic Association “Walking for Breast Cancer Research” and by the Landspitali University Hospital Research Fund. The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON) consists of the following Collaborating Centers: Netherlands Cancer Institute (coordinating center), Amsterdam, NL: M.A. Rookus, F.B.L. Hogervorst, F.E. van Leeuwen, M.A. Adank, M.K. Schmidt, D.J. Jenner; Erasmus Medical Center, Rotterdam, NL: J.M. Collée, A.M.W. van den Ouweland, M.J. Hooning, I.A. Boere; Leiden University Medical Center, NL: C.J. van Asperen, P. Devilee, R.B. van der Luijt, T.C.T.E.F. van Cronenburg; Radboud University Nijmegen Medical Center, NL: M.R. Wevers, A.R. Mensenkamp; University Medical Center Utrecht, NL: M.G.E.M. Ausems, M.J. Koudijs; Amsterdam Medical Center, NL: E.J. Meijers‐Heijboer, T.A.M. van Os; VU University Medical Center, Amsterdam, NL: K. van Engelen, J.J.P. Gille; Maastricht University Medical Center, NL: E.B. Gómez‐Garcia, M.J. Blok, M. de Boer; University of Groningen, NL: J.C. Oosterwijk, A.H. van der Hout, M.J.E. Mourits, G.H. de Bock; The Netherlands Comprehensive Cancer Organisation (IKNL): S. Siesling, J. Verloop; The nationwide network and registry of histo‐ and cyto‐pathology in the Netherlands (PALGA): E.C. van den Broek. HEBON thanks the study participants and the registration teams of IKNL and PALGA for part of the data collection. The HEBON study is supported by the Dutch Cancer Society grants NKI1998‐1854, NKI2004‐3088, NKI2007‐3756, the Netherlands Organisation of Scientific Research grant NWO 91109024, the Pink Ribbon grants 110005 and 2014‐187.WO76, the BBMRI grant NWO 184.021.007/CP46, and the Transcan grant JTC 2012 Cancer 12‐054. N.N. Petrov Institute of Oncology is supported by the Russian Foundation for Basic Research (grants 17‐00‐00171, 18‐515‐45012 and 19‐515‐25001).
Published: 2020

41. Low proportion of skeletally immature patients met return-to-sports criteria at 7 Months following ACL reconstruction

Author: Dai Sugimoto, Mininder S. Kocher, Lyle J. Micheli, Benton E. Heyworth, Sara C. Carpenito, and Farren Davis
Subjects: Male, medicine.medical_specialty, Time Factors, Adolescent, Anterior cruciate ligament, Physical Therapy, Sports Therapy and Rehabilitation, Hamstring Muscles, Physical strength, Return to sport, Quadriceps Muscle, 03 medical and health sciences, 0302 clinical medicine, Primary outcome, medicine, Humans, Orthopedics and Sports Medicine, Muscle Strength, Postoperative Period, Balance (ability), 030222 orthopedics, Anterior Cruciate Ligament Reconstruction, business.industry, Single hop, Anterior Cruciate Ligament Injuries, Outcome measures, 030229 sport sciences, General Medicine, Surgery, Return to Sport, medicine.anatomical_structure, Cross-Sectional Studies, Female, business, Symmetry index, Follow-Up Studies, Sports
Abstract: Objective To examine the proportion of skeletally immature anterior cruciate ligament reconstructed (ACLR) patients who achieve ≥90% of lower extremity recovery at 6–9 months post-operatively. Design Cross-sectional study. Setting Biomechanical laboratory. Participants Skeletally immature ACLR patients. Main outcome measure(s) Muscular strength (quadriceps, hamstrings, hip abductors, and hip extensors), dynamic balance (anterior reach, posteromedial reach, and posterolateral reach), and functional hops tests (single hop, triple hops, cross-over hops, and 6 m timed hops) were examined. The primary outcome variable was the proportion of the study patients whose limb symmetry index (LSI) were ≥90% during return to sport (RTS) tests. Results A total of 105 skeletally immature ACLR patients who are planning to return to sporting activities (age: 13.4 ± 1.4 years) were enrolled. The proportion of skeletally immature ACLR patients who achieved ≥90% of LSI in all four strength, three balance, and four hop tests were 20.0%, 65.4%, and 27.8%. In those who completed all test battery (72/105), only 4.2% of skeletally immature ACLR patients demonstrated ≥90% of LSI in all RTS tests. Conclusion A small proportion of skeletally immature ACLR patients demonstrated ≥90% of lower extremity recovery approximately at 7 months following ACLR.
Published: 2020

42. Assessment of interactions between 205 breast cancer susceptibility loci and 13 established risk factors in relation to breast cancer risk, in the Breast Cancer Association Consortium

Author: Kapoor, PM, Lindström, S, Behrens, S, Wang, X, Michailidou, K, Bolla, MK, Wang, Q, Dennis, J, Dunning, AM, Pharoah, PDP, Schmidt, MK, Kraft, P, García-Closas, M, Easton, DF, Milne, RL, Chang-Claude, J, Ahearn, T, Andrulis, IL, Anton-Culver, H, Arndt, V, Aronson, KJ, Auer, PL, Augustinsson, A, Freeman, LEB, Beckmann, MW, Benitez, J, Bernstein, L, Berrandou, T, Bojesen, SE, Brauch, H, Brenner, H, Brock, IW, Broeks, A, Brooks-Wilson, A, Butterbach, K, Cai, Q, Campa, D, Canzian, F, Carter, BD, Castelao, JE, Chanock, SJ, Chenevix-Trench, G, Cheng, T-YD, Clarke, CL, Cordina-Duverger, E, Couch, FJ, Cox, A, Cross, SS, Czene, K, Dai, JY, Dite, GS, Earp, HS, Eliassen, AH, Eriksson, M, Evans, DG, Fasching, PA, Figueroa, J, Flyger, H, Fritschi, L, Gabrielson, M, Gago-Dominguez, M, Gapstur, SM, Gaudet, MM, Giles, GG, González-Neira, A, Grundy, A, Guénel, P, Haeberle, L, Haiman, CA, Håkansson, N, Hall, P, Hamann, U, Hankinson, SE, Harkness, EF, Harstad, T, He, W, Heyworth, J, Hoover, RN, Hopper, JL, Humphreys, K, Hunter, DJ, Marrón, PI, John, EM, Jones, ME, Jung, A, Kaaks, R, Keeman, R, Kitahara, CM, Ko, Y-D, Koutros, S, Krüger, U, Lambrechts, D, Marchand, LL, Lee, E, Lejbkowicz, F, Linet, M, Lissowska, J, Llaneza, A, Lo, W-Y, Makalic, E, Martinez, ME, Maurer, T, Muñoz-Garzon, VM, Neuhausen, SL, Neven, P, Newman, WG, Nielsen, SF, Nordestgaard, BG, Norman, A, O'Brien, KM, Olshan, AF, Olson, JE, Olsson, H, Orr, N, Perou, CM, Pinchev, M, Prentice, R, Rennert, G, Rennert, HS, Ruddy, KJ, Sandler, DP, Schneider, MO, Schoemaker, MJ, Schöttker, B, Scott, RJ, Scott, C, Sherman, ME, Shrubsole, MJ, Shu, X-O, Southey, MC, Spinelli, JJ, Stone, J, Swerdlow, AJ, Tamimi, RM, Taylor, JA, Thöne, K, Troester, MA, Truong, T, Vachon, CM, van Ongeval, C, van Veen, EM, Wagner, P, Weinberg, CR, Wildiers, H, Willett, W, Winham, SJ, Wolk, A, Yang, XR, Zheng, W, and Ziogas, A
Subjects: 0301 basic medicine, Oncology, medicine.medical_specialty, Genotype, Genome-wide association study, Single-nucleotide polymorphism, Breast Neoplasms, Polymorphism, Single Nucleotide, White People, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, breast cancer, Risk Factors, single nucleotide polymorphism, Internal medicine, medicine, SNP, Humans, risk factors, Genetic Predisposition to Disease, Breast, Alleles, Cancer och onkologi, Factor XIII, Europeans, business.industry, Gene-environment interaction, epidemiology, Case-control study, Cancer, General Medicine, Odds ratio, medicine.disease, Europe, Genetics and Environment, 030104 developmental biology, Receptors, Estrogen, 030220 oncology & carcinogenesis, Case-Control Studies, Cancer and Oncology, Female, Gene-Environment Interaction, business, Genome-Wide Association Study
Abstract: Background Previous gene-environment interaction studies of breast cancer risk have provided sparse evidence of interactions. Using the largest available dataset to date, we performed a comprehensive assessment of potential effect modification of 205 common susceptibility variants by 13 established breast cancer risk factors, including replication of previously reported interactions. Methods Analyses were performed using 28 176 cases and 32 209 controls genotyped with iCOGS array and 44 109 cases and 48 145 controls genotyped using OncoArray from the Breast Cancer Association Consortium (BCAC). Gene-environment interactions were assessed using unconditional logistic regression and likelihood ratio tests for breast cancer risk overall and by estrogen-receptor (ER) status. Bayesian false discovery probability was used to assess the noteworthiness of the meta-analysed array-specific interactions. Results Noteworthy evidence of interaction at ≤1% prior probability was observed for three single nucleotide polymorphism (SNP)-risk factor pairs. SNP rs4442975 was associated with a greater reduction of risk of ER-positive breast cancer [odds ratio (OR)int = 0.85 (0.78-0.93), Pint = 2.8 x 10–4] and overall breast cancer [ORint = 0.85 (0.78-0.92), Pint = 7.4 x 10–5) in current users of estrogen-progesterone therapy compared with non-users. This finding was supported by replication using OncoArray data of the previously reported interaction between rs13387042 (r2 = 0.93 with rs4442975) and current estrogen-progesterone therapy for overall disease (Pint = 0.004). The two other interactions suggested stronger associations between SNP rs6596100 and ER-negative breast cancer with increasing parity and younger age at first birth. Conclusions Overall, our study does not suggest strong effect modification of common breast cancer susceptibility variants by established risk factors.
Published: 2020

43. Collateral Ligament Knee Injuries in Pediatric and Adolescent Athletes

Author: Iman K. Berrahou, Benton E. Heyworth, Dennis E. Kramer, Patricia E. Miller, and Yi-Meng Yen
Subjects: Posterolateral corner injuries, Joint Instability, Male, medicine.medical_specialty, Soft Tissue Injuries, Time Factors, Adolescent, Medial Collateral Ligament, Knee, Poison control, Knee Injuries, Avulsion, 03 medical and health sciences, Patellofemoral Joint, 0302 clinical medicine, Recurrence, Injury prevention, Medicine, Humans, Orthopedics and Sports Medicine, Child, Retrospective Studies, 030222 orthopedics, Medial collateral ligament, business.industry, Medical record, Retrospective cohort study, 030229 sport sciences, General Medicine, Magnetic Resonance Imaging, Surgery, Return to Sport, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Athletic Injuries, Ligament, Female, business, human activities
Abstract: Background The majority of research on medial (MCL) and lateral (LCL) collateral ligament injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament injuries in adolescents, and assess timing for return to sports. Methods Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging-confirmed isolated MCL or LCL injury over an 8-year period. Retrospective review then documented patient and injury characteristics and clinical course. General linear modeling was used to analyze risk factors for prolonged return to sports, continued pain or reinjury. Results Fifty-one knees (33 in males, 65%), mean age 13.8 years (range, 5 to 17), were identified, of which 40 (78%) had MCL injuries. Over half (29, 57%) of knees had an open distal femoral physis including all 5 bony avulsion injuries. Eleven (22%) had LCL injuries of which 3 (6%) had concurrent posterolateral corner injuries. Forty-two (82%) knees had injuries that occurred during sports. Eleven knees (28%) with MCL tears had a simultaneous patellar instability episode. Knee injuries that occurred during sports had 37% shorter recovery time (P=0.02). Eight knees (16%) experienced a reinjury and 12 (24%) were followed over an extended period of time for various knee issues. Football injuries were more likely to be grade 3 (P=0.03), and football and soccer accounted for all grade III injuries. The mean return to sports was 2.2 months, with grade III cases returning at 2.4 months, and 95% of cases within 4 months. Conclusions Isolated collateral ligament injuries are rare in adolescent athletes. MCL injuries, one-quarter of which occurred in conjunction with patellar instability events, were 4 times more common than LCL injuries, one quarter of which have other posterolateral corner structures involved. Grade III injuries represent 20% to 25% of collateral ligament injuries and occurred most commonly in football and soccer. Level of evidence Level IV-retrospective case series.
Published: 2020

44. Fine-mapping of 150 breast cancer risk regions identifies 191 likely target genes

Author: Fachal, L., Aschard, H., Beesley, J., Barnes, D.R., Allen, J., Kar, S., Pooley, K.A., Dennis, J., Michailidou, K., Turman, C., Soucy, P., Lemaçon, A., Lush, M., Tyrer, J.P., Ghoussaini, M., Marjaneh, M.M., Jiang, X., Agata, S., Aittomäki, K., Alonso, M.R., Andrulis, I.L., Anton-Culver, H., Antonenkova, N.N., Arason, A., Arndt, V., Aronson, K.J., Arun, B.K., Auber, B., Auer, P.L., Azzollini, J., Balmaña, J., Barkardottir, R.B., Barrowdale, D., Beeghly-Fadiel, A., Benitez, J., Bermisheva, M., Białkowska, K., Blanco, A.M., Blomqvist, C., Blot, W., Bogdanova, N.V., Bojesen, S.E., Bolla, M.K., Bonanni, B., Borg, A., Bosse, K., Brauch, H., Brenner, H., Briceno, I., Brock, I.W., Brooks-Wilson, A., Brüning, T., Burwinkel, B., Buys, S.S., Cai, Q., Caldés, T., Caligo, M.A., Camp, N.J., Campbell, I., Canzian, F., Carroll, J.S., Carter, B.D., Castelao, J.E., Chiquette, J., Christiansen, H., Chung, W.K., Claes, K.B.M., Clarke, C.L., Mari, V., Berthet, P., Castera, L., Vaur, D., Lallaoui, H., Bignon, Y.-J., Uhrhammer, N., Bonadona, V., Lasset, C., Révillion, F., Vennin, P., Muller, D., Gomes, D.M., Ingster, O., Coupier, I., Pujol, P., Collonge-Rame, M.-A., Mortemousque, I., Bera, O., Rose, M., Baurand, A., Bertolone, G., Faivre, L., Dreyfus, H., Leroux, D., Venat-Bouvet, L., Bézieau, S., Delnatte, C., Chiesa, J., Gilbert-Dussardier, B., Gesta, P., Prieur, F.P., Bronner, M., Sokolowska, J., Coulet, F., Boutry-Kryza, N., Calender, A., Giraud, S., Leone, M., Fert-Ferrer, S., Stoppa-Lyonnet, D., Jiao, Y., Lesueur, F.L., Mebirouk, N., Barouk-Simonet, E., Bubien, V., Longy, M., Sevenet, N., Gladieff, L., Toulas, C., Reimineras, A., Sobol, H., Paillerets, B.B.-D., Cabaret, O., Caron, O., Guillaud-Bataille, M., Rouleau, E., Belotti, M., Buecher, B., Caputo, S., Colas, C., Pauw, A.D., Fourme, E., Gauthier-Villars, M., Golmard, L., Moncoutier, V., Saule, C., Donaldson, A., Murray, A., Brady, A., Brewer, C., Pottinger, C., Miller, C., Gallagher, D., Gregory, H., Cook, J., Eason, J., Adlard, J., Barwell, J., Ong, K.-R., Snape, K., Walker, L., Izatt, L., Side, L., Tischkowitz, M., Rogers, M.T., Porteous, M.E., Ahmed, M., Morrison, P.J., Brennan, P., Eeles, R., Davidson, R., Collée, M., Cornelissen, S., Couch, F.J., Cox, A., Cross, S.S., Cybulski, C., Czene, K., Daly, M.B., de la Hoya, M., Devilee, P., Diez, O., Ding, Y.C., Dite, G.S., Domchek, S.M., Dörk, T., dos-Santos-Silva, I., Droit, A., Dubois, S., Dumont, M., Duran, M., Durcan, L., Dwek, M., Eccles, D.M., Engel, C., Eriksson, M., Evans, D.G., Fasching, P.A., Fletcher, O., Floris, G., Flyger, H., Foretova, L., Foulkes, W.D., Friedman, E., Fritschi, L., Frost, D., Gabrielson, M., Gago-Dominguez, M., Gambino, G., Ganz, P.A., Gapstur, S.M., Garber, J., García-Sáenz, J.A., Gaudet, M.M., Georgoulias, V., Giles, G., Glendon, G., Godwin, A.K., Goldberg, M.S., Goldgar, D.E., González-Neira, A., Tibiletti, M.G., Greene, M.H., Grip, M., Gronwald, J., Grundy, A., Guénel, P., Hahnen, E., Haiman, C.A., Håkansson, N., Hall, P., Hamann, U., Harrington, P.A., Hartikainen, J.M., Hartman, M., He, W., Healey, C.S., Heemskerk-Gerritsen, B.A.M., Heyworth, J., Hillemanns, P., Hogervorst, F.B.L., Hollestelle, A., Hooning, M., Hopper, J., Howell, A., Huang, G., Hulick, P.J., Imyanitov, E.N., Sexton, A., Christian, A., Trainer, A., Spigelman, A., Fellows, A., Shelling, A., Fazio, A.D., Blackburn, A., Crook, A., Meiser, B., Patterson, B., Clarke, C., Saunders, C., Hunt, C., Scott, C., Amor, D., Marsh, D., Edkins, E., Salisbury, E., Haan, E., Neidermayr, E., Macrea, F., Farshid, G., Lindeman, G., Chenevix-Trench, G., Mann, G., Gill, G., Thorne, H., Hickie, I., Winship, I., Flanagan, J., Kollias, J., Visvader, J., Stone, J., Taylor, J., Burke, J., Saunus, J., Forbes, J., Kirk, J., French, J., Tucker, K., Wu, K., Phillips, K., Lipton, L., Andrews, L., Lobb, L., Kentwell, M., Spurdle, M., Cummings, M., Gleeson, M., Harris, M., Jenkins, M., Young, M.A., Delatycki, M., Wallis, M., Burgess, M., Price, M., Brown, M., Southey, M., Bogwitz, M., Field, M., Friedlander, M., Gattas, M., Saleh, M., Hayward, N., Pachter, N., Cohen, P., Duijf, P., James, P., Simpson, P., Fong, P., Butow, P., Williams, R., Kefford, R., Scott, R., Milne, R.L., Balleine, R., Dawson, S.–J., Lok, S., O’Connell, S., Greening, S., Nightingale, S., Edwards, S., Fox, S., McLachlan, S.-A., Lakhani, S., Antill, Y., Aalfs, C., Meijers-Heijboer, H., van Engelen, K., Gille, H., Boere, I., van Deurzen, C., Obdeijn, I.-M., van den Ouweland, A., Seynaeve, C., Siesling, S., Verloop, J., van Asperen, C.J., van Cronenburg, T., Blok, R., de Boer, M., Garcia, E.G., Adank, M., Hogervorst, F., Jenner, D., van Leeuwen, F., Rookus, M., Russell, N., Schmidt, M., van den Belt-Dusebout, S., Kets, C., Mensenkamp, A., de Bock, T., van der Hout, A., Mourits, M., Oosterwijk, J., Ausems, M., Koudijs, M., Baxter, R., Yip, D., Carpenter, J., Davis, A., Pathmanathan, N., Graham, D., Sachchithananthan, M., Isaacs, C., Iwasaki, M., Jager, A., Jakimovska, M., Jakubowska, A., James, P.A., Janavicius, R., Jankowitz, R.C., John, E.M., Johnson, N., Jones, M.E., Jukkola-Vuorinen, A., Jung, A., Kaaks, R., Kang, D., Kapoor, P.M., Karlan, B.Y., Keeman, R., Kerin, M.J., Khusnutdinova, E., Kiiski, J.I., Kitahara, C.M., Ko, Y.-D., Konstantopoulou, I., Kosma, V.-M., Koutros, S., Kubelka-Sabit, K., Kwong, A., Kyriacou, K., Laitman, Y., Lambrechts, D., Lee, E., Leslie, G., Lester, J., Lesueur, F., Lindblom, A., Lo, W.-Y., Long, J., Lophatananon, A., Loud, J.T., Lubiński, J., MacInnis, R.J., Maishman, T., Makalic, E., Mannermaa, A., Manoochehri, M., Manoukian, S., Margolin, S., Martinez, M.E., Matsuo, K., Maurer, T., Mavroudis, D., Mayes, R., McGuffog, L., McLean, C., Meindl, A., Miller, A., Miller, N., Montagna, M., Moreno, F., Muir, K., Mulligan, A.M., Muñoz-Garzon, V.M., Muranen, T.A., Narod, S.A., Nassir, R., Nathanson, K.L., Neuhausen, S.L., Nevanlinna, H., Neven, P., Nielsen, F.C., Nikitina-Zake, L., Norman, A., Offit, K., Olah, E., Olopade, O.I., Olsson, H., Orr, N., Osorio, A., Pankratz, V.S., Papp, J., Park, S.K., Park-Simon, T.-W., Parsons, M.T., Paul, J., Pedersen, I.S., Peissel, B., Peshkin, B., Peterlongo, P., Peto, J., Plaseska-Karanfilska, D., Prajzendanc, K., Prentice, R., Presneau, N., Prokofyeva, D., Pujana, M.A., Pylkäs, K., Radice, P., Ramus, S.J., Rantala, J., Rau-Murthy, R., Rennert, G., Risch, H.A., Robson, M., Romero, A., Rossing, M., Saloustros, E., Sánchez-Herrero, E., Sandler, D.P., Santamariña, M., Sawyer, E.J., Scheuner, M.T., Schmidt, D.F., Schmutzler, R.K., Schneeweiss, A., Schoemaker, M.J., Schöttker, B., Schürmann, P., Scott, R.J., Senter, L., Seynaeve, C.M., Shah, M., Sharma, P., Shen, C.-Y., Shu, X.-O., Singer, C.F., Slavin, T.P., Smichkoska, S., Southey, M.C., Spinelli, J.J., Spurdle, A.B., Sutter, C., Swerdlow, A.J., Tamimi, R.M., Tan, Y.Y., Tapper, W.J., Taylor, J.A., Teixeira, M.R., Tengström, M., Teo, S.H., Terry, M.B., Teulé, A., Thomassen, M., Thull, D.L., Toland, A.E., Tollenaar, R.A.E.M., Tomlinson, I., Torres, D., Torres-Mejía, G., Troester, M.A., Truong, T., Tung, N., Tzardi, M., Ulmer, H.-U., Vachon, C.M., van der Kolk, L.E., van Rensburg, E.J., Vega, A., Viel, A., Vijai, J., Vogel, M.J., Wang, Q., Wappenschmidt, B., Weinberg, C.R., Weitzel, J.N., Wendt, C., Wildiers, H., Winqvist, R., Wolk, A., Wu, A.H., Yannoukakos, D., Zhang, Y., Zheng, W., Hunter, D., Pharoah, P.D.P., Chang-Claude, J., García-Closas, M., Schmidt, M.K., Kristensen, V.N., French, J.D., Edwards, S.L., Antoniou, A.C., Simard, J., Easton, D.F., Kraft, P., Dunning, A.M., Collaborators, GEMO Study, Collaborators, EMBRACE, Investigators, KConFab, Investigators, HEBON, Investigators, ABCTB, Fachal, Laura, Aschard, Hugues, Beesley, Jonathan, Barnes, Daniel R, Duijf, Pascal, Dunning, Alison M, GEMO Study Collaborators, EMBRACE Collaborators, KConFab Investigators, HEBON Investigators, ABCTB Investigators, MUMC+: MA Medische Oncologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Klinische Genetica, MUMC+: DA KG Polikliniek (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: DA KG Lab Centraal Lab (9), European Commission, Government of Canada, Canadian Institutes of Health Research, National Institutes of Health (US), Cancer Research UK, Département de Biologie Computationnelle - Department of Computational Biology, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), QIMR Berghofer Medical Research Institute, University of Cambridge [UK] (CAM), NSCAD, University of Cyprus [Nicosia], Harvard T.H. Chan School of Public Health, This work was supported by the European Union’s Horizon 2020 Research and Innovation Programme under Marie Sklodowska-Curie grant agreement number 656144. Genotyping of the OncoArray was principally funded from three sources: the PERSPECTIVE project (funded by the Government of Canada through Genome Canada and the Canadian Institutes of Health Research, the ‘Ministère de l’Économie de la Science et de l’Innovation du Québec’ (through Genome Québec) and the Quebec Breast Cancer Foundation), the NCI Genetic Associations and Mechanisms in Oncology (GAME-ON) initiative and the Discovery, Biology and Risk of Inherited Variants in Breast Cancer (DRIVE) project (NIH grants U19 CA148065 and X01HG007492), and Cancer Research UK (C1287/A10118, C8197/A16565 and C1287/A16563). BCAC is funded by Cancer Research UK (C1287/A16563), by the European Community’s Seventh Framework Programme under grant agreement 223175 (HEALTH-F2-2009-223175) (COGS) and by the European Union’s Horizon 2020 Research and Innovation Programme under grant agreements 633784 (B-CAST) and 634935 (BRIDGES). Genotyping of the iCOGS array was funded by the European Union (HEALTH-F2-2009-223175), Cancer Research UK (C1287/A10710), the Canadian Institutes of Health Research for the ‘CIHR Team in Familial Risks of Breast Cancer’ program, and the Ministry of Economic Development, Innovation and Export Trade of Quebec (grant PSR-SIIRI-701). Combining of the GWAS data was supported in part by NIH Cancer Post-Cancer GWAS initiative grant U19 CA 148065 (DRIVE, part of the GAME-ON initiative). For a full description of funding and acknowledgments, see the Supplementary Note., We thank all of the individuals who took part in these studies, as well as all of the researchers, clinicians, technicians and administrative staff who enabled this work to be carried out, European Project: 656144,H2020,H2020-MSCA-IF-2014,RADIOGENFF(2016), European Project: 223175,EC:FP7:HEALTH,FP7-HEALTH-2007-B,COGS(2009), European Project: 633784,H2020,H2020-PHC-2014-two-stage,B-CAST(2015), European Project: 634935,H2020,H2020-PHC-2014-two-stage,BRIDGES(2015), Clinical Genetics, Medical Oncology, Pathology, Radiology & Nuclear Medicine, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), University of Cyprus [Nicosia] (UCY), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), Targeted Gynaecologic Oncology (TARGON), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Aschard, Hugues [0000-0002-7554-6783], Barnes, Daniel R [0000-0002-3781-7570], Dennis, Joe [0000-0003-4591-1214], Michailidou, Kyriaki [0000-0001-7065-1237], Lemaçon, Audrey [0000-0002-1817-7029], Andrulis, Irene L [0000-0002-4226-6435], Arason, Adalgeir [0000-0003-0480-886X], Arndt, Volker [0000-0001-9320-8684], Auber, Bernd [0000-0003-1880-291X], Azzollini, Jacopo [0000-0002-9364-9778], Bojesen, Stig E [0000-0002-4061-4133], Bonanni, Bernardo [0000-0003-3589-2128], Brauch, Hiltrud [0000-0001-7531-2736], Campbell, Ian [0000-0002-7773-4155], Carroll, Jason S [0000-0003-3643-0080], Claes, Kathleen BM [0000-0003-0841-7372], Collée, J Margriet [0000-0002-9272-9346], Devilee, Peter [0000-0002-8023-2009], Dörk, Thilo [0000-0002-9458-0282], Dwek, Miriam [0000-0001-7184-2932], Fletcher, Olivia [0000-0001-9387-7116], Floris, Giuseppe [0000-0003-2391-5425], Foulkes, William D [0000-0001-7427-4651], García-Sáenz, José A [0000-0001-6880-0301], Greene, Mark H [0000-0003-1852-9239], Guénel, Pascal [0000-0002-8359-518X], Heemskerk-Gerritsen, Bernadette AM [0000-0002-9724-6693], Hollestelle, Antoinette [0000-0003-1166-1966], Hulick, Peter J [0000-0001-8397-4078], Jakimovska, Milena [0000-0002-1506-0669], Jakubowska, Anna [0000-0002-5650-0501], James, Paul A [0000-0002-4361-4657], Jones, Michael E [0000-0001-7479-3451], Kapoor, Pooja Middha [0000-0001-5503-8215], Keeman, Renske [0000-0002-5452-9933], Konstantopoulou, Irene [0000-0002-0470-0309], Leslie, Goska [0000-0001-5756-6222], Lesueur, Fabienne [0000-0001-7404-4549], Matsuo, Keitaro [0000-0003-1761-6314], McLean, Catriona [0000-0002-0302-5727], Miller, Austin [0000-0001-9739-8462], Muir, Kenneth [0000-0001-6429-988X], Muranen, Taru A [0000-0002-5895-1808], Nathanson, Katherine L [0000-0002-6740-0901], Nevanlinna, Heli [0000-0002-0916-2976], Olopade, Olufunmilayo I [0000-0002-9936-1599], Orr, Nick [0000-0003-2866-942X], Pankratz, V Shane [0000-0002-3742-040X], Parsons, Michael T [0000-0003-3242-8477], Paul, James [0000-0001-7367-5816], Peshkin, Beth [0000-0002-2997-4701], Peterlongo, Paolo [0000-0001-6951-6855], Peto, Julian [0000-0002-1685-8912], Plaseska-Karanfilska, Dijana [0000-0001-8877-2416], Pylkäs, Katri [0000-0002-2449-0521], Radice, Paolo [0000-0001-6298-4111], Rennert, Gad [0000-0002-8512-068X], Robson, Mark [0000-0002-3109-1692], Romero, Atocha [0000-0002-1634-7397], Saloustros, Emmanouil [0000-0002-0485-0120], Scott, Christopher [0000-0003-1340-0647], Scott, Rodney J [0000-0001-7724-3404], Spurdle, Amanda B [0000-0003-1337-7897], Stone, Jennifer [0000-0001-5077-0124], Sutter, Christian [0000-0003-4051-5888], Tan, Yen Yen [0000-0003-1063-5352], Teixeira, Manuel R [0000-0002-4896-5982], Toland, Amanda E [0000-0002-0271-1792], Tomlinson, Ian [0000-0003-3037-1470], Viel, Alessandra [0000-0003-2804-0840], Vijai, Joseph [0000-0002-7933-151X], Wolk, Alicja [0000-0001-7387-6845], Yannoukakos, Drakoulis [0000-0001-7509-3510], Pharoah, Paul DP [0000-0001-8494-732X], Schmidt, Marjanka K [0000-0002-2228-429X], Milne, Roger L [0000-0001-5764-7268], Edwards, Stacey L [0000-0001-7428-4139], Simard, Jacques [0000-0001-6906-3390], Easton, Douglas F [0000-0003-2444-3247], Kraft, Peter [0000-0002-4472-8103], Dunning, Alison M [0000-0001-6651-7166], Apollo - University of Cambridge Repository, Academic Medical Center, ARD - Amsterdam Reproduction and Development, Human genetics, CCA - Cancer biology and immunology, Molecular cell biology and Immunology, Medicum, Kristiina Aittomäki / Principal Investigator, HUSLAB, Department of Medical and Clinical Genetics, University of Helsinki, HUS Comprehensive Cancer Center, Department of Oncology, Clinicum, Doctoral Programme in Clinical Research, Staff Services, INDIVIDRUG - Individualized Drug Therapy, HUS Gynecology and Obstetrics, and Department of Obstetrics and Gynecology
Subjects: CHROMATIN, Linkage disequilibrium, Genome-wide association study, Regulatory Sequences, Nucleic Acid, Genome-wide association studies, Linkage Disequilibrium, Basic medicine, 0302 clinical medicine, Breast cancer, MESH: Risk Factors, Risk Factors, COMPREHENSIVE MOLECULAR PORTRAITS, 11 Medical and Health Sciences, HEBON Investigators, Genetics & Heredity, 0303 health sciences, [STAT.AP]Statistics [stat]/Applications [stat.AP], PROTEIN FUNCTION, Tumor, breast tumor, MESH: Polymorphism, Single Nucleotide, 1184 Genetics, developmental biology, physiology, MESH: Genetic Predisposition to Disease, apoptosis, Chromosome Mapping, Single Nucleotide, 3. Good health, MESH: Linkage Disequilibrium, Female, MESH: Biomarkers, Tumor, Biomarkers, Tumor/genetics, [STAT.ME]Statistics [stat]/Methodology [stat.ME], Life Sciences & Biomedicine, SUSCEPTIBILITY LOCI, MESH: Bayes Theorem, Quantitative Trait Loci, ABCTB Investigators, INTEGRATIVE ANALYSIS, Breast Neoplasms, Computational biology, Biology, Quantitative trait locus, Breast Neoplasms/genetics, Polymorphism, Single Nucleotide, Article, ENHANCER, GEMO Study Collaborators, 03 medical and health sciences, breast cancer, SDG 3 - Good Health and Well-being, REVEALS, Genetics, Biomarkers, Tumor, MESH: Regulatory Sequences, Nucleic Acid, Humans, Genetic Predisposition to Disease, Polymorphism, GENOME-WIDE ASSOCIATION, FUNCTIONAL VARIANTS, EMBRACE Collaborators, Gene, 030304 developmental biology, Genetic association, Bayes Theorem, Genome-Wide Association Study, MESH: Humans, Science & Technology, Nucleic Acid, gene mapping, 06 Biological Sciences, MESH: Quantitative Trait Loci, DNA binding site, ESTROGEN-RECEPTOR, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Clinical medicine, Expression quantitative trait loci, MESH: Genome-Wide Association Study, Human genome, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, KConFab Investigators, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], MESH: Chromosome Mapping, Chromosome Mapping/methods, Regulatory Sequences, MESH: Female, Biomarkers, 030217 neurology & neurosurgery, MESH: Breast Neoplasms, Developmental Biology
Abstract: Genome-wide association studies have identified breast cancer risk variants in over 150 genomic regions, but the mechanisms underlying risk remain largely unknown. These regions were explored by combining association analysis with in silico genomic feature annotations. We defined 205 independent risk-associated signals with the set of credible causal variants in each one. In parallel, we used a Bayesian approach (PAINTOR) that combines genetic association, linkage disequilibrium and enriched genomic features to determine variants with high posterior probabilities of being causal. Potentially causal variants were significantly over-represented in active gene regulatory regions and transcription factor binding sites. We applied our INQUSIT pipeline for prioritizing genes as targets of those potentially causal variants, using gene expression (expression quantitative trait loci), chromatin interaction and functional annotations. Known cancer drivers, transcription factors and genes in the developmental, apoptosis, immune system and DNA integrity checkpoint gene ontology pathways were over-represented among the highest-confidence target genes., This work was supported by the European Union’s Horizon 2020 Research and Innovation Programme under Marie Sklodowska-Curie grant agreement number 656144. Genotyping of the OncoArray was principally funded from three sources: the PERSPECTIVE project (funded by the Government of Canada through Genome Canada and the Canadian Institutes of Health Research, the ‘Ministère de l’Économie de la Science et de l’Innovation du Québec’ (through Genome Québec) and the Quebec Breast Cancer Foundation); the NCI Genetic Associations and Mechanisms in Oncology (GAME-ON) initiative and the Discovery, Biology and Risk of Inherited Variants in Breast Cancer (DRIVE) project (NIH grants U19 CA148065 and X01HG007492); and Cancer Research UK (C1287/A10118, C8197/A16565 and C1287/A16563). BCAC is funded by Cancer Research UK (C1287/A16563), by the European Community’s Seventh Framework Programme under grant agreement 223175 (HEALTH-F2-2009-223175) (COGS) and by the European Union’s Horizon 2020 Research and Innovation Programme under grant agreements 633784 (B-CAST) and 634935 (BRIDGES). Genotyping of the iCOGS array was funded by the European Union (HEALTH-F2-2009-223175), Cancer Research UK (C1287/A10710), the Canadian Institutes of Health Research for the ‘CIHR Team in Familial Risks of Breast Cancer’ program, and the Ministry of Economic Development, Innovation and Export Trade of Quebec (grant PSR-SIIRI-701). Combining of the GWAS data was supported in part by NIH Cancer Post-Cancer GWAS initiative grant U19 CA 148065 (DRIVE; part of the GAME-ON initiative).
Published: 2020

45. Combined associations of a polygenic risk score and classical risk factors with breast cancer risk

Author: Diether Lambrechts, James Y. Dai, Pascal Guénel, Graham G. Giles, Montserrat Garcia-Closas, Javier Benitez, Thomas Brüning, Georgia Chenevix-Trench, Stig E. Bojesen, Rodney J Scott, Angela Cox, Anthony Howell, Nilanjan Chatterjee, Volker Arndt, Christopher J. Scott, Rudolf Kaaks, A. Heather Eliassen, Clarice R. Weinberg, Kyriaki Michailidou, Melissa C. Southey, Joe Dennis, Xiaoliang Wang, Niclas Håkansson, Anthony J Swerdlow, Laura E. Beane Freeman, Peter A. Fasching, David J. Hunter, Kristan J. Aronson, Jack A. Taylor, Thomas U. Ahearn, Håkan Olsson, Hoda Anton-Culver, Matthias W. Beckmann, Jenny Chang-Claude, Qiuyin Cai, Renske Keeman, Roger L. Milne, Bernd Holleczek, Jolanta Lissowska, Mia M. Gaudet, Paul D.P. Pharoah, Federico Canzian, Andrew F Olshan, Janet E. Olson, Susan M. Gapstur, Amber N Wilcox, John J. Spinelli, Christine L. Clarke, Stella Koutros, Ann Smeets, Brian D. Carter, Tabea Maurer, W Willett, Catriona McLean, Caroline Weltens, Hiltrud Brauch, Arif B. Ekici, Lin Fritschi, Maria Elena Martinez, Nick Orr, Dale P. Sandler, Yon-Dschun Ko, Simon S. Cross, Xiaohong R. Yang, Aaron D. Norman, Zomoroda Abu-Ful, Flavio Lejbkowicz, Per Hall, Allison W. Kurian, Ben Schöttker, Douglas F. Easton, Lothar Haeberle, Hermann Brenner, Manuela Gago-Dominguez, Robert J. MacInnis, Xiao-Ou Shu, Eunjung Lee, Martha S. Linet, kConFab, Aocs Investigators, Sigrid Hatse, Paul L. Auer, Christobel Saunders, Sara Lindström, Jonine D. Figueroa, Melissa A Troester, Parichoy Pal Choudhury, Ana Llaneza, Peter Kraft, Angel Carracedo, Christopher A. Haiman, Jose E. Castelao, Manjeet K. Bolla, Heiko Becher, Fredrick R. Schumacher, Alicia Beeghly-Fadiel, Hedy S. Rennert, Argyrios Ziogas, Charles M. Perou, Leslie Bernstein, Anna González-Neira, Irene L. Andrulis, H. Shelton Earp, Cari M. Kitahara, G Pita, Stacey J Winham, Wei Zheng, Pooja Middha Kapoor, Abctb Investigators, Kathryn J Ruddy, Minouk J. Schoemaker, Robert N. Hoover, Fergus J. Couch, Ute Hamann, Chi Gao, Rulla M. Tamimi, Kamila Czene, D. Gareth Evans, John L. Hopper, Audrey Y. Jung, Loic Le Marchand, Michael Jones, Marike Gabrielson, Celine M. Vachon, Ross L. Prentice, Katie M. O'Brien, Esther M. John, Jennifer Stone, Daniele Campa, Elke M. van Veen, Qin Wang, Jane Heyworth, Alison M. Dunning, William G. Newman, Nasim Mavaddat, Marjanka K. Schmidt, Gad Rennert, Mikael Eriksson, Sabine Behrens, Susan L. Neuhausen, Stephen J. Chanock, Alicja Wolk, and Eric C Polley
Subjects: Cancer Research, Epidemiology, Gene-environment interactions, Logistic regression, Body Mass Index, 0302 clinical medicine, Breast cancer, Medicine, 10. No inequality, Medical History Taking, Estrogen Receptor Status, Aged, 80 and over, 0303 health sciences, Middle Aged, Risk prediction, 3. Good health, Oncology, Receptors, Estrogen, 030220 oncology & carcinogenesis, Female, AcademicSubjects/MED00010, Medical Genetics, medicine.medical_specialty, Breast Neoplasms, Brief Communication, Polymorphism, Single Nucleotide, White People, Genetic susceptibility, Polygenic risk score, Risk factors, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Genetic Predisposition to Disease, Risk factor, Medicinsk genetik, 030304 developmental biology, Aged, Cancer och onkologi, business.industry, Case-control study, Cancer, Odds ratio, medicine.disease, Logistic Models, Cancer and Oncology, Case-Control Studies, business, Demography
Abstract: We evaluated the joint associations between a new 313-variant PRS (PRS313) and questionnaire-based breast cancer risk factors for women of European ancestry, using 72 284 cases and 80 354 controls from the Breast Cancer Association Consortium. Interactions were evaluated using standard logistic regression and a newly developed case-only method for breast cancer risk overall and by estrogen receptor status. After accounting for multiple testing, we did not find evidence that per-standard deviation PRS313 odds ratio differed across strata defined by individual risk factors. Goodness-of-fit tests did not reject the assumption of a multiplicative model between PRS313 and each risk factor. Variation in projected absolute lifetime risk of breast cancer associated with classical risk factors was greater for women with higher genetic risk (PRS313 and family history) and, on average, 17.5% higher in the highest vs lowest deciles of genetic risk. These findings have implications for risk prevention for women at increased risk of breast cancer. ispartof: JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE vol:113 issue:3 pages:329-337 ispartof: location:United States status: published
Published: 2020

46. Using a Qualitative Phenomenological Approach to Inform the Etiology and Prevention of Occupational Heat-Related Injuries in Australia

Author: Monika Nitschke, Jane Heyworth, Shelley Rowett, Susan Williams, Scott Hanson-Easey, Dino Pisaniello, Alana Hansen, Blesson M. Varghese, Malcolm R Sim, and Peng Bi
Subjects: Adult, Male, medicine.medical_specialty, Hot Temperature, injury, Health, Toxicology and Mutagenesis, Poison control, lcsh:Medicine, australia, Interpersonal communication, Heat Stress Disorders, Suicide prevention, Occupational safety and health, Article, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Environmental health, Occupational Exposure, Epidemiology, Injury prevention, medicine, Humans, 030212 general & internal medicine, occupational, Occupational Health, Aged, lcsh:R, Public Health, Environmental and Occupational Health, Human factors and ergonomics, Middle Aged, 030210 environmental & occupational health, Occupational Injuries, heat exposure, qualitative, Female, Personal experience, Psychology
Abstract: Epidemiological evidence has shown an association between exposure to high temperatures and occupational injuries, an issue gaining importance with environmental change. The aim of this study was to better understand contributing risk factors and preventive actions based on personal experiences. Interviews were conducted with 21 workers from five Australian states using a critical phenomenological approach to capture the lived experiences of participants, whilst exploring contextual factors that surround these experiences. Two case studies are presented: a cerebrovascular injury and injuries among seasonal horticulture workers. Other accounts of heat-related injuries and heat stress are also presented. Risk factors were classified as individual, interpersonal and organizational. In terms of prevention, participants recommended greater awareness of heat risks and peer-support for co-workers. Adding value to current evidence, we have provided new insights into the etiology of the health consequences of workplace heat exposure with workers identifying a range of influencing factors, prevention measures and adaptation strategies. Underpinning the importance of these are future climate change scenarios, suggesting that extended hot seasons will lead to increasing numbers of workers at risk of heat-stress and associated occupational injuries.
Published: 2020

47. False memories in patients with mild cognitive impairment and mild Alzheimer’s disease dementia: Can cognitive strategies help?

Author: Rebecca G. Deason, Rocco Palumbo, Nadine C. Heyworth, Andrew E. Budson, Christopher Malone, and Michelle J. Tat
Subjects: Male, Memory distortion, Emotions, Repression, Psychology, False memory, Disease, Neuropsychological Tests, Article, 050105 experimental psychology, 03 medical and health sciences, Cognition, 0302 clinical medicine, Alzheimer Disease, medicine, Humans, Dementia, Cognitive Dysfunction, 0501 psychology and cognitive sciences, In patient, Cognitive impairment, Aged, Aged, 80 and over, 05 social sciences, nutritional and metabolic diseases, Progressive neurodegenerative disorder, medicine.disease, Cognitive Remediation, Frontal Lobe, Clinical Psychology, Treatment Outcome, Neurology, Mental Recall, Female, Neurology (clinical), Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that presents predominantly with impairments in learning and memory. Patients with AD are also susceptible to false memories, a clinically relevant memory distortion where a patient remembers an incorrect memory that they believe to be true. The use of cognitive strategies to improve memory performance among patients with AD by reducing false memories has taken on added importance given the lack of disease-modifying agents for AD. However, existing evidence suggests that cognitive strategies to reduce false memories in patients with AD are of limited effectiveness, although these strategies may be useful at earlier stages of the disease. The purpose of this review is to examine experimental findings of false memories and associated memory processes in patients with mild cognitive impairment due to AD and mild AD dementia. Cognitive strategies to reduce false memories in these patient populations are also reviewed. Approaches to clinically relevant future research are suggested and discussed.
Published: 2018

48. Nonoperative treatment of stable juvenile osteochondritis dissecans of the knee: effectiveness of unloader bracing

Author: Frances A. Tepolt, Leslie A. Kalish, Benton E. Heyworth, and Mininder S. Kocher
Subjects: Male, medicine.medical_specialty, Adolescent, Knee Joint, Treatment outcome, medicine.disease_cause, Juvenile osteochondritis, Weight-bearing, Weight-Bearing, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, medicine, Humans, Orthopedics and Sports Medicine, Child, Retrospective Studies, 030222 orthopedics, Braces, business.industry, Clinical course, Retrospective cohort study, musculoskeletal system, Osteochondritis Dissecans, Bracing, Surgery, Nonoperative treatment, Pediatrics, Perinatology and Child Health, Multivariate Analysis, Female, business, 030217 neurology & neurosurgery
Abstract: The purpose of this study was to compare the treatment outcomes of stable juvenile osteochondritis dissecans (JOCD) of the knee in a large cohort treated nonoperatively with unloader bracing versus other nonoperative treatment modalities without unloader bracing. This retrospective study assessed the clinical course of skeletally immature patients who underwent a minimum of 3 months nonoperative treatment for stable JOCD of the femoral condyle at a single institution (2001-2014). Treatment was based on physician preference. Unloader bracing was compared with other 'non-unloader' modalities, with successful nonoperative treatment defined as the avoidance of subsequent surgical intervention. Two hundred ninety-eight patients were included, 219 (73%) of whom were male. The mean ± SD age at diagnosis was 11.5 ± 1.6 years. Thirty-five patients were diagnosed with bilateral OCD, resulting in 333 knees in total. One hundred eighty-seven (56%) knees were treated with unloader bracing for a minimum of 3 months, whereas 146 (44%) were treated with other nonoperative modalities. All patients were treated with activity restrictions. Weight-bearing restrictions were applied for a total of 83 (25%) cases, for durations ranging from 19 to 196 days (median: 46 days) and at similar rates across groups. Nonoperative treatment was successful in 189 (57%) knees with a median follow-up of 9.5 months (interquartile range: 5.9-15.7 months). Surgical intervention was required in 144 (43%) knees at a median time of 6.0 months (interquartile range: 4.1-10.5 months). The unloader bracing group more often required surgical intervention when compared with the nonunloader group [93/187 (50%) vs. 51/146 (35%) knees, respectively; P = 0.02]. Male sex (P = 0.05) and Hefti stage I (P = 0.05) showed possible associations with nonoperative treatment success. Nonoperative treatment for stable JOCD of the knee leads to the avoidance of subsequent surgical intervention in 57% of cases. Unloader bracing is not associated with significantly improved outcomes when compared with other nonoperative modalities. Level of Evidence: III Retrospective Comparative Case Series.
Published: 2019

49. Night shift work and breast cancer: a pooled analysis of population-based case–control studies with complete work history

Author: Anne Grundy, Deborah Catherine Glass, John J. Spinelli, Kyriaki Papantoniou, Volker Harth, Pascal Guénel, Manolis Kogevinas, Lin Fritschi, Jane Heyworth, Gemma Castaño-Vinyals, Beate Pesch, Ana Espinosa, Sylvia Rabstein, Kristan J. Aronson, Thomas Brüning, Florence Menegaux, Thomas C. Erren, Emilie Cordina-Duverger, and Alexandru Popa
Subjects: medicine.medical_specialty, Epidemiology, Population, Breast Neoplasms, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Work Schedule Tolerance, medicine, Humans, 030212 general & internal medicine, education, education.field_of_study, business.industry, Public health, Absolute risk reduction, Case-control study, Shift Work Schedule, Odds ratio, medicine.disease, Circadian Rhythm, 030220 oncology & carcinogenesis, Cohort, Female, business, Demography
Abstract: Night shift work has been suspected to increase breast cancer risk but epidemiological studies have been inconsistent due to heterogeneous assessment of exposure to night work. To overcome this limitation, we pooled data of five population-based case-control studies from Australia, Canada, France, Germany, and Spain into a single harmonized dataset using a common definition of night work including 6093 breast cancer cases and 6933 population controls. The odds ratio for breast cancer in women who ever worked at night for at least 3 h between midnight and 5 a.m. as compared to never night workers was 1.12 (95% CI 1.00-1.25). Among pre-menopausal women, this odds ratio was 1.26 [1.06-1.51], increasing to 1.36 [1.07-1.74] for night shifts ≥ 10 h, 1.80 [1.20-2.71] for work ≥ 3 nights/week, and 2.55 [1.03-6.30] for both duration of night work ≥ 10 years and exposure intensity ≥ 3 nights/week. Breast cancer risk in pre-menopausal women was higher in current or recent night workers (OR = 1.41 [1.06-1.88]) than in those who had stopped night work more than 2 years ago. Breast cancer in post-menopausal women was not associated with night work whatever the exposure metric. The increase in risk was restricted to ER+ tumors, particularly those who were both ER+ and HER2+ . These results support the hypothesis that night shift work increases the risk of breast cancer in pre-menopausal women, particularly those with high intensity and long duration of exposure. Risk difference between pre- and post-menopausal women deserves further scrutiny.
Published: 2018

50. Adolescent clavicle nonunions: potential risk factors and surgical management

Author: David D. Spence, Jeffrey J. Nepple, Mininder S. Kocher, Donald S. Bae, Andrew T. Pennock, Philip L. Wilson, Coleen S. Sabatini, Nirav K. Pandya, Kevin G. Shea, Henry B. Ellis, Samuel C. Willimon, Derek M. Kelly, Ying Li, Benton E. Heyworth, Michael T. Busch, Eric W. Edmonds, J. Eric Gordon, and Frances A. Farley
Subjects: Male, Reoperation, medicine.medical_specialty, Time Factors, Adolescent, medicine.medical_treatment, Radiography, Nonunion, Bone grafting, Fracture Fixation, Internal, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Risk Factors, medicine, Humans, Orthopedics and Sports Medicine, Risk factor, Child, Retrospective Studies, Fixation (histology), Fracture Healing, 030222 orthopedics, Bone Transplantation, business.industry, Potential risk, 030229 sport sciences, General Medicine, medicine.disease, Clavicle, Return to Sport, Surgery, Treatment Outcome, surgical procedures, operative, medicine.anatomical_structure, Fractures, Ununited, Cohort, Female, Diaphyses, business, Bone Plates
Abstract: Background Clavicle nonunions in adolescent patients are exceedingly rare. The purpose of this study was to evaluate a series of clavicle nonunions from a pediatric multicenter study group to assess potential risk factors and treatment outcomes. Methods A retrospective review of all clavicle nonunions in patients younger than 19 years was performed at 9 pediatric hospitals between 2006 and 2016. Demographic and surgical data were documented. Radiographs were evaluated for initial fracture classification, displacement, shortening, angulation, and nonunion type. Clinical outcomes were evaluated, including rate of healing, time to union, return to sports, and complications. Risk factors for nonunion were assessed by comparing the study cohort with a separate cohort of age-matched patients with a diaphyseal clavicle fracture. Results There were 25 nonunions (mean age, 14.5 years; range, 10.0-18.9 years) identified, all of which underwent surgical fixation. Most fractures were completely displaced (68%) initially, but 21% were partially displaced and 11% were nondisplaced. Bone grafting was performed in 24 of 25 cases, typically using the hypertrophic callus. Radiographic healing was achieved in 96% of cases. One patient (4%) required 2 additional procedures to achieve union. The primary risk factor for development of a nonunion was a previous history of an ipsilateral clavicle fracture. Conclusions Clavicle nonunions can occur in the adolescent population but are an uncommon clinical entity. The majority occur in male patients with displaced fractures, many of whom have sustained previous fractures of the same clavicle. High rates of union were achieved with plate fixation and the use of bone graft.
Published: 2018

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