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Abstract Objective To investigate whether Molybdenum blood level is a marker of cancer risk on BRCA1 carriers. Methods A prospective cohort study was conducted among 989 initially unaffected women with a BRCA1 mutation. Blood samples were collected to measure molybdenum levels, and participants were followed for an average of 7.5 years. Cox proportional hazards models were used to assess the association between blood molybdenum levels and cancer incidence, adjusting for potential confounders. Results High blood molybdenum levels (> 0.70 µg/L) were significantly associated with an increased risk of developing ovarian cancer (HR = 5.55; 95%CI: 1.59–19.4; p = 0.007) and any cancer (HR = 1.74; 95%CI: 1.17–2.61; p = 0.007) but not breast cancer (HR = 1.46, CI = 0.91–2.33; p = 0.12). The cumulative incidence of ovarian cancer at ten years was 1.2% for the lowest molybdenum tertile, 4.2% for the middle tertile, and 8.7% for the highest tertile. Conclusion Elevated blood molybdenum levels are associated with an increased risk of ovarian cancer on BRCA1 mutation carriers. Lowering molybdenum levels may potentially reduce cancer risk in this population, and high molybdenum levels could serve as a marker for considering preventive oophorectomy in BRCA1 carriers. Further research is warranted to confirm these findings and explore interventions targeting molybdenum levels as a preventive measure for ovarian cancer in BRCA1 mutation carriers.

Background: Preventive vaccinations play a significant role in reducing the spread of infectious diseases. They mitigate the course of infectious diseases and limit the occurrence thereof. Thus, they allow maintaining the health security of citizens and are one of the activities that allow for effective population health management. However, even though vaccinations bring significant benefits to the population as a whole, the attitudes of individuals to them raise a number of controversies. Objective: The aim of the study was to analyze the characteristics and factors of patient attitudes towards COVID-19 preventive vaccinations based on the opinions of healthcare experts. The study was carried out in the framework of a project "The interdependence of lifestyle and attitudes towards COVID-19 preventive vaccinations", which finished in June 2023. Method: The research method was an in-depth telephone interview with experts who had previously studied the research problem and the results of quantitative research, and expressed individual opinions on the factors of patient attitudes towards COVID-19 vaccinations. The experts indicated various factors which, in their opinion, can influence patient willingness to be vaccinated against COVID-19. In the research process, four main factors were found: patient social environment and patient experience; patient knowledge and awareness, social impact (message of medical authorities and political decision makers), balance of benefits and risks. Results: The results obtained in the study and the conclusions drawn show the need for further, in-depth research in patient attitudes towards preventive vaccinations, not only COVID-19 vaccinations.

OBJECTIVES: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research. DESIGN: Systematic scoping review. SETTINGS AND PARTICIPANTS: PLWD and their care partners in the ED setting. METHODS: Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized. RESULTS: From 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication. CONCLUSIONS AND IMPLICATIONS: Research exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange.

Pathogenic mutations in BRCA1 (BReast CAncer gene 1) confer high risks of both breast (up to 70%) and ovarian (up to 40%) cancers. Zinc (Zn) and copper (Cu) are essential for various physiological functions, including antioxidant reactions. Their balance, reflected in the Zn/Cu ratio, plays a crucial role in maintaining redox homeostasis, which is vital for cancer prevention. This study examines the antioxidant properties of Zn and Cu, specifically focusing on the blood Zn/Cu ratio as a potential marker for cancer risk among BRCA1 mutation carriers. The study cohort consisted of 989 initially unaffected women, followed up for 7.5 years. Blood samples were analyzed using inductively coupled plasma mass spectrometry. Although individual Zn and Cu levels did not significantly correlate with overall cancer risk, those women with a Zn/Cu ratio above 6.38 experienced a significantly lower cancer risk than women with a ratio below this cut-off point. This suggests that the Zn/Cu ratio may be a valuable biomarker for cancer prevention in this high-risk group. Given the increased cancer risk in BRCA1 mutation carriers, optimizing Zn and Cu levels through dietary and active interventions could provide a preventive strategy.

BRCA1 mutations predispose women to breast and ovarian cancer. The anticancer effect of zinc is typically linked to its antioxidant abilities and protecting cells against oxidative stress. Zinc regulates key processes in cancer development, including DNA repair, gene expression, and apoptosis. We took a blood sample from 989 female BRCA1 mutation carriers who were initially unaffected by cancer and followed them for a mean of 7.5 years thereafter. There were 172 incident cases of cancer, including 121 cases of breast cancer, 29 cases of ovarian cancers, and 22 cancers at other sites. A zinc level in the lowest tertile was associated with a modestly higher risk of ovarian cancer compared to women with zinc levels in the upper two tertiles (HR = 1.65; 95% CI 0.80 to 3.44; p = 0.18), but this was not significant. Among those women with zinc levels in the lowest tertile, the 10-year cumulative risk of ovarian cancer was 6.1%. Among those in the top two tertiles of zinc level, the ten-year cumulative risk of ovarian cancer was 4.7%. There was no significant association between zinc level and breast cancer risk. Our preliminary study does not support an association between serum zinc level and cancer risk in BRCA1 mutation carriers.

Screening significantly decreases the severity and incidence of conditions, as well as mortality, and therefore can improve the health of the population. Screening in Poland falls below the acceptable level of 45% of organised screening uptake and the recommended level of 65%. Multidimensional factors have been implicated as barriers and facilitators of screening uptake in the primary care setting. This paper summarises the existing evidence on factors influencing screening uptake in a Pap smear for cervical cancer (CC), mammography screening for breast cancer and faecal occult blood test (FOBT) for colorectal cancer (CRC). We performed a literature search in the MEDLINE (PubMed) and EMBASE databases and included articles of any study design published between 2010 and 2020. We also demonstrate the original concept of ‘Ugly Value’, which describes factors that may reduce screening uptake. Primary care practitioners play a vital role in increasing screening rates in the populations and can improve these rates through a variety of systematically implemented strategies and interventions. We determine four areas to improve cancer screening uptake in primary healthcare institutions: data gathering and data use (IT systems, meaningful use of Electronic Health Records to generate reminders, prompting healthcare professionals to refer patients for screening), cost effectiveness (avoiding overuse of screening in low-risk populations), innovative efficient management (use of effective interventions and thoughtful allocation of resources, e.g. engaging nurses into patient navigation instead of assigning them to answer patient concerns about screening by telephone), organisational system (team based, integrated care and patient navigation are ways to improve screening rates).

This work presents the results of new archaeological research carried out in Tetzcotzinco, Mexico, with a special focus on its water management. Survey documentation at the site, with the use of 3D photogrammetry, offered new images and maps of water control features, namely, canals, reservoirs, and aqueducts. The integration of these data into a GIS database, as well as the complementation of information from previous archaeological research and colonial historical accounts, allowed further analysis of the flow, velocity, and quantity of water distributed at the site, and its possible connections with watercourses in its surroundings. This research studies the broader regional water sources and three possible courses of water in the area which could have provided the flow of liquid into Tetzcotzinco. This article is a contribution to a better understanding of the importance of water and its distribution not only in Tetzcotzinco but also in the Center of Mexico during pre-Hispanic times.

Health professionals in primary care teams need to know how to effectively encourage patients to change health behaviors to achieve treatment goals. Understanding the behavioral patterns and psychological underpinnings of making changes can help healthcare professionals deliver interventions with a higher success rate. The aim of the study was to assess the importance of behavior patterns in shaping patients' health attitudes and behaviors. There are three types of theoretical models that explain how health behaviors are initiated and changed: motivational, post-intentional, and multistage models. Motivation models describe the role of individual cognitive variables in the process of creating the intention to change behavior. Changing habits in the context of health promotion takes place by influencing the perception of patients. This can be achieved using the TRA (Theory of Reasoned Action), TBP (Theory of Planned Behavior) and HBM (Health Belief Model) models by convincing the public about susceptibility to a given disease, disseminating knowledge about effective methods of prevention and generating persuasion, support, admiration or recognition in society after positive behaviors such as smoking cessation or regular physical activity. Post-intentional models indicate factors that increase the chance of translating motivation into action. They commit the individual to a certain action when certain environmental circumstances are met, thus helping to translate the intention of the goal into action. Multi-stage models describe health behaviors as involving several separate stages. These theories are based on the assumption that people at different stages will behave differently, so the types of interventions and information needed to change behavior will vary depending on the stage they are at. Helping patients set realistic goals, such as moving to the next stage, can facilitate the change process. Effective behavioral interventions must be based on changing the approach of medical staff to the interpersonal process with the patient. This approach should be patient-centred and collaborative. Medical staff should assess the importance that the patient attaches to his health and the treatment process, and thus also the willingness and motivation to comply with the recommendations. Merely providing information will not guarantee a change in their behavior. Healthcare professionals should use active listening techniques (using open-ended questions, explanations, reflective and summarizing statements), should encourage patients to express concerns, and should be able to weigh the pros and cons of different treatment approaches.

ObjectiveThe overall goal of this work is to produce a set of recommendations (SoNHR-Social Networks in Health Research) that will improve the reporting and dissemination of social network concepts, methods, data, and analytic results within health sciences research.MethodsThis study used a modified-Delphi approach for recommendation development consistent with best practices suggested by the EQUATOR health sciences reporting guidelines network. An initial set of 28 reporting recommendations was developed by the author team. A group of 67 (of 147 surveyed) experienced network and health scientists participated in an online feedback survey. They rated the clarity and importance of the individual recommendations, and provided qualitative feedback on the coverage, usability, and dissemination opportunities of the full set of recommendations. After examining the feedback, a final set of 18 recommendations was produced.ResultsThe final SoNHR reporting guidelines are comprised of 18 recommendations organized within five domains: conceptualization (how study research questions are linked to network conceptions or theories), operationalization (how network science portions of the study are defined and operationalized), data collection & management (how network data are collected and managed), analyses & results (how network results are analyzed, visualized, and reported), and ethics & equity (how network-specific human subjects, equity, and social justice concerns are reported). We also present a set of exemplar published network studies which can be helpful for seeing how to apply the SoNHR recommendations in research papers. Finally, we discuss how different audiences can use these reporting guidelines.ConclusionsThese are the first set of formal reporting recommendations of network methods in the health sciences. Consistent with EQUATOR goals, these network reporting recommendations may in time improve the quality, consistency, and replicability of network science across a wide variety of important health research areas.

Access to health care should be universal and equal regardless of health needs, socio-economic status and place of residence. Empirical research confirms, however, that there are differences in access to health care between people in urban and rural areas. The main challenges for the health care system in rural areas are staff shortages, greater distance from large hospitals, difficult access to specialist and preventive services, and lower effectiveness of emergency care. The aim of the study was to analyze practical solutions to improve the organization of care in POZ, taking into account the principles of coordinated care in rural areas. As part of this study, an attempt was made to present practical solutions that may help to improve the organization of care in primary health care in rural areas. It is worth emphasizing once again that effective and efficient care for the population must be consistent with the concept of care coordination. In addition, the work shows how important from the perspective of the development of medicine in rural areas can be the inclusion of teamwork, financial motivators, including the so-called 'Rural addition' and the impact of modern technologies based on self-care and remote monitoring of patients' health.

Introduction and objective Coordinated care has been defined as a function that helps ensure satisfaction of patient’s needs. Coordinated care maximizes the value of services provided to patients by facilitating effective, safe and high-quality services and improving healthcare outcomes.The article analyzes the phenomenon of interpretation of a coordinator’s responsibilities by service providers, especially due to the Rapid Oncology Therapy programme in Poland. The scope of medical care coordination in Poland is compared with the United Kingdom and The Netherlands, among others Brief description of the state of knowledge The role of the medical coordinator was introduced into the Polish legislation for the first time in 2014 as the coordinator of oncological treatment. There are various interpretations among Polish healthcare providers with regard to duties of a coordinator, but there is no model on which certain patterns could be built. Most coordinators work together with the hospital medical staff and organizational units, take care of the completeness of the documentation in order to correctly settle oncological services, coordinate the treatment plan established by the medical council, provide the patient with information related to further treatment, participate in medical council meetings,and issue the Diagnostic and Oncological Treatment Card (Karta Diagnostyki i Leczenia Onkologicznego – DiLO). Countries including the UK and The Netherlands are examples of effective implementation of coordinated primary care due to their high level of medical resource management. Conclusions In order to make full use of the potential of cancer treatment coordinators, it is necessary to provide them with greater opportunities to cooperate with the patient, rather than independently.

Pathogenic mutations in BRCA1 (BReast CAncer gene 1) confer high risks of both breast (up to 70%) and ovarian (up to 40%) cancers. Zinc (Zn) and copper (Cu) are essential for various physiological functions, including antioxidant reactions. Their balance, reflected in the Zn/Cu ratio, plays a crucial role in maintaining redox homeostasis, which is vital for cancer prevention. This study examines the antioxidant properties of Zn and Cu, specifically focusing on the blood Zn/Cu ratio as a potential marker for cancer risk among BRCA1 mutation carriers. The study cohort consisted of 989 initially unaffected women, followed up for 7.5 years. Blood samples were analyzed using inductively coupled plasma mass spectrometry. Although individual Zn and Cu levels did not significantly correlate with overall cancer risk, those women with a Zn/Cu ratio above 6.38 experienced a significantly lower cancer risk than women with a ratio below this cut-off point. This suggests that the Zn/Cu ratio may be a valuable biomarker for cancer prevention in this high-risk group. Given the increased cancer risk in BRCA1 mutation carriers, optimizing Zn and Cu levels through dietary and active interventions could provide a preventive strategy. [ABSTRACT FROM AUTHOR]

Ustawa o zawodzie farmaceuty oraz świadczenia planowane w ramach opieki farmaceutycznej w Polsce wprowadzą szereg zmian w funkcjonowaniu aptek ogólnodostępnych, które wymagają skutecznego i efektywnego wdrożenia. Celem niniejszej pracy była analiza doświadczeń międzynarodowych w zakresie opieki farmaceutycznej oraz poszukiwanie rozwiązań, które byłyby możliwe do zaimplementowania w Polsce. Analizie poddano zakresy świadczeń udzielanych w ramach opieki farmaceutycznej w Stanach Zjednoczonych, Wielkiej Brytanii, Królestwie Niderlandów, Szwecji, Austrii i Australii. Kraje te przeanalizowano pod kątem zakresu świadczonych usług w ramach opieki farmaceutycznej, przebiegu wdrożenia opieki farmaceutycznej, premiowania farmaceutów za świadczenie dodatkowych usług oraz pod kątem oceny systemu IT.

Effectiveness of medical care is one of the most reliable parameters to assess individual aspects of the health care system. However, it should be emphasized that there is no unified definition of effectiveness in health care, on the basis of which these aspects can be assessed and compared. The aim of the study was to draw attention to the inability to make a reliable and authoritative assessment of effectiveness in health care due to the lack of a uniform definition and to emphasize their importance in the light of international comparative analysis. A review of the literature relating to the assessment of the quality and effectiveness of services provided by healthcare entities was performed. It has been defined that efficiency grows as the quality of healthcare increases and/or the cost of healthcare decreases, and effectiveness measurement should refer to a specific member of a medical stuff.

This paper presents a study on the influence of psychophysical stimuli on facial thermal emissions. Two independent groups of stimuli are proposed to investigate facial changes resulting from human stress and physical exhaustion. One pertains to physical effort while the other is linked to stress invoked by solving a simple written test. Subjects’ face reactions were measured through collecting and analysing long-wavelength infrared images. A methodology for numerical processing of images is proposed. Results of numerical analysis with respect to different facial regions of interest are provided. An automatic deep learning based algorithm to classify specific thermal face patterns is proposed. The algorithm consists of detection of regions of interests as well as numerical analysis of thermal energy emissions of facial parts. The results of presented experiments allowed the authors to associate emission changes in specific facial regions with psychophysical stimulations of the person being examined. This work proves high usability of thermal imaging to capture changes of heat distribution of face as reactions for external stimuli.

Abstract Background Increasingly, scholars argue that de-implementation is a distinct concept from implementation; factors contributing to stopping a current practice might be distinct from those that encourage adoption of a new one. One such distinction is related to de-implementation outcomes. We offer preliminary analysis and guidance on de-implementation outcomes, including how they may differ from or overlap with implementation outcomes, how they may be conceptualized and measured, and how they could be measured in different settings such as clinical care vs. community programs. Conceptualization of outcomes We conceptualize each of the outcomes from Proctor and colleagues’ taxonomy of implementation outcomes for de-implementation research. First, we suggest key considerations for researchers assessing de-implementation outcomes, such as considering how the cultural or historical significance to the practice may impact de-implementation success and, as others have stated, the importance of the patient in driving healthcare overuse. Second, we conceptualize de-implementation outcomes, paying attention to a number of factors such as the importance of measuring outcomes not only of the targeted practice but of the de-implementation process as well. Also, the degree to which a practice should be de-implemented must be distinguished, as well as if there are thresholds that certain outcomes must reach before action is taken. We include a number of examples across all outcomes, both from clinical and community settings, to demonstrate the importance of these considerations. We also discuss how the concepts of health disparities, cultural or community relevance, and altruism impact the assessment of de-implementation outcomes. Conclusion We conceptualized existing implementation outcomes within the context of de-implementation, noted where there are similarities and differences to implementation research, and recommended a clear distinction between the target for de-implementation and the strategies used to promote de-implementation. This critical analysis can serve as a building block for others working to understand de-implementation processes and de-implement practices in real-world settings.

Idea opieki farmaceutycznej zakłada ścisłą współpracę farmaceuty z przedstawicielami innych profesji medycznych w celu objęcia pacjenta holistyczną opieka zdrowotną. Zadaniem farmaceuty jest rozpoznawanie oraz proponowanie rozwiązań w zakresie problemów i interakcji lekowych. Realizacji tego procesu nie byłaby możliwa bez odpowiednich narzędzi. W ramach niniejszej pracy zaprezentowano istotę i zakres kwestionariusza przeglądu lekowego farmaceuty. Kwestionariusz ten jest autorskim narzędziem stworzonym w oparciu o doświadczenie i praktykę medyczno-biznesową podmiotu leczniczego Centrum Medyczno-Diagnostyczne w Siedlcach. Kwestionariusz przeglądu lekowego farmaceuty umożliwia zbieranie następujących informacji: dane osobowe pacjenta, subiektywne odczucia pacjenta dotyczące jego stanu zdrowia, informacje o chorobach, alergiach, szczepieniach, badaniach okresowych i prewencyjnych oraz inne dodatkowe dane medyczne. Istotną częścią kwestionariusza jest blok informacji dot. farmakoterapii, w tym rodzaju i typie leków przyjmowanych przez pacjenta, dawkowaniu, efektywności terapii, działaniach niepożądanych związanych z przyjmowaniem produktów leczniczych oraz zasobach lekowych pacjenta. Prezentowane narzędzie zawiera także dodatkowe informacje bazujące na wywiadzie z pacjentem oraz odpowiednie zalecenia farmaceuty. Prawidłowa identyfikacja oraz poszerzenie zakresu informacji zawartych w ramach kwestionariusza przeglądu lekowego farmaceuty ma kluczowe znaczenie dla implementacji oraz realizacji koordynowanej opieki zdrowotnej, uwzgledniającej aspekt opieki farmaceutycznej.

Inspection and engineering work inside ducts are a serious challenge in terms of logistics and processing. Processing-wise, a major obstacle is the remote control over a modular mobile unit with a variable cinematic configuration and intended to manage complex operating processes. This paper presents the results of the development of a mobile robot for inspection and engineering work. The items of a specific focus of the development work were the remote-control system structure and the control algorithms for the propulsion module control and the operating module control.

BackgroundThe COVID-19 (the disease caused by the SARS-CoV-2 virus) pandemic has underscored the need for additional data, tools, and methods that can be used to combat emerging and existing public health concerns. Since March 2020, there has been substantial interest in using social media data to both understand and intervene in the pandemic. Researchers from many disciplines have recently found a relationship between COVID-19 and a new data set from Facebook called the Social Connectedness Index (SCI). ObjectiveBuilding off this work, we seek to use the SCI to examine how social similarity of Missouri counties could explain similarities of COVID-19 cases over time. Additionally, we aim to add to the body of literature on the utility of the SCI by using a novel modeling technique. MethodsIn September 2020, we conducted this cross-sectional study using publicly available data to test the association between the SCI and COVID-19 spread in Missouri using exponential random graph models, which model relational data, and the outcome variable must be binary, representing the presence or absence of a relationship. In our model, this was the presence or absence of a highly correlated COVID-19 case count trajectory between two given counties in Missouri. Covariates included each county’s total population, percent rurality, and distance between each county pair. ResultsWe found that all covariates were significantly associated with two counties having highly correlated COVID-19 case count trajectories. As the log of a county’s total population increased, the odds of two counties having highly correlated COVID-19 case count trajectories increased by 66% (odds ratio [OR] 1.66, 95% CI 1.43-1.92). As the percent of a county classified as rural increased, the odds of two counties having highly correlated COVID-19 case count trajectories increased by 1% (OR 1.01, 95% CI 1.00-1.01). As the distance (in miles) between two counties increased, the odds of two counties having highly correlated COVID-19 case count trajectories decreased by 43% (OR 0.57, 95% CI 0.43-0.77). Lastly, as the log of the SCI between two Missouri counties increased, the odds of those two counties having highly correlated COVID-19 case count trajectories significantly increased by 17% (OR 1.17, 95% CI 1.09-1.26). ConclusionsThese results could suggest that two counties with a greater likelihood of sharing Facebook friendships means residents of those counties have a higher likelihood of sharing similar belief systems, in particular as they relate to COVID-19 and public health practices. Another possibility is that the SCI is picking up travel or movement data among county residents. This suggests the SCI is capturing a unique phenomenon relevant to COVID-19 and that it may be worth adding to other COVID-19 models. Additional research is needed to better understand what the SCI is capturing practically and what it means for public health policies and prevention practices.

The article presents issues related to an experimental study of the vibrations of a roller shutter gripper on a robotic palletizing station. The authors presented the developed and built construction of the gripper for handling whole layers of products, separators, and pallets. The concept of the device was developed in cooperation with an integrator company. The authors verified the functionality of the gripper in a virtual environment for modeling and programming industrial robots. After the gripper was manufactured and the control software was developed for it, functional tests and inertia tests were carried out. The main purpose of the tests was to determine the vibration of the robot’s flange and the vibration of the attached gripper. Tests of the gripper’s properties on the robotic test bench were performed using MTi XSENS sensors and a PHANTOM V210 high-speed camera. The testing methodology proposed by the authors made it possible to confirm the occurrence of vibrations in the structure and to determine the relationship between the parameters of the robot’s motion (velocity and acceleration) and the magnitude of the vibrations occurring. During the tests, a disturbance in the decrease in the maximum value of acceleration was noted. This may be due to the appearance of natural vibrations in the structure. They have a damped character; however, they are not steady. In future work, the authors will focus on the possibility of using the proposed methodology to reduce robot vibrations in selected robotic production processes (such as spot welding).

BRCA1 mutations substantially elevate the risks of breast and ovarian cancer. Various modifiers, including environmental factors, can influence cancer risk. Lead, a known carcinogen, has been associated with various cancers, but its impact on BRCA1 carriers remains unexplored. A cohort of 989 BRCA1 mutation carriers underwent genetic testing at the Pomeranian Medical University, Poland. Blood lead levels were measured using inductively coupled plasma mass spectrometry. Each subject was assigned to a category based on their tertile of blood lead. Cox regression analysis was used to assess cancer risk associations. Elevated blood lead levels (>13.6 μg/L) were associated with an increased risk of ovarian cancer (univariable: HR = 3.33; 95% CI: 1.23–9.00; p = 0.02; multivariable: HR = 2.10; 95% CI: 0.73–6.01; p = 0.17). No significant correlation was found with breast cancer risk. High blood lead levels are associated with increased risk of ovarian cancer in BRCA1 carriers, suggesting priority for preventive salpingo-oophorectomy. Potential risk reduction strategies include detoxification. Validation in diverse populations and exploration of detoxification methods for lowering lead levels are required. [ABSTRACT FROM AUTHOR]

BRCA1 mutations predispose women to breast and ovarian cancer. The anticancer effect of zinc is typically linked to its antioxidant abilities and protecting cells against oxidative stress. Zinc regulates key processes in cancer development, including DNA repair, gene expression, and apoptosis. We took a blood sample from 989 female BRCA1 mutation carriers who were initially unaffected by cancer and followed them for a mean of 7.5 years thereafter. There were 172 incident cases of cancer, including 121 cases of breast cancer, 29 cases of ovarian cancers, and 22 cancers at other sites. A zinc level in the lowest tertile was associated with a modestly higher risk of ovarian cancer compared to women with zinc levels in the upper two tertiles (HR = 1.65; 95% CI 0.80 to 3.44; p = 0.18), but this was not significant. Among those women with zinc levels in the lowest tertile, the 10-year cumulative risk of ovarian cancer was 6.1%. Among those in the top two tertiles of zinc level, the ten-year cumulative risk of ovarian cancer was 4.7%. There was no significant association between zinc level and breast cancer risk. Our preliminary study does not support an association between serum zinc level and cancer risk in BRCA1 mutation carriers. [ABSTRACT FROM AUTHOR]

Despite the stigmatization of sex work in society, little empirical research has examined attitudes toward sex work, especially its modern incarnations (e.g., sugar relationships, webcamming). Here, a sample of 298 US residents (Mage = 40.06 years; 59.1% male, 40.9% female) was recruited through Amazon Mechanical Turk. Various theoretical predictors (e.g., right-wing authoritarianism [RWA]), sociosexuality) were set to predict the degree to which four sex work domains (prostitution, pornography, sugar relationships, webcamming) provide cisgender women agency (beneficial) or harm them (detrimental). We found that the domains of sex work were organized hierarchically, as theorized by the so-called "whorearchy," whereby the more "unfavorable" domains (e.g., prostitution) fall at the bottom, and the more "favorable" ones (e.g., webcamming) sit at the top. Additionally, multiple regression analyses revealed that RWA (negatively) and sociosexuality (positively) were the strongest predictors of sex work agency across various domains. In predicting harm, RWA, feminism, religiosity, and age were unique positive predictors, whereas sociosexuality and male (vs. female) self-identified sex were unique negative predictors, across the four domains of sex work. Moreover, individual differences (e.g., RWA) were often significantly stronger predictors of agency or harm among female than male participants. The results suggest that although sex work domains vary in agency and harm ratings, individual differences (most notably, RWA and sociosexuality) are important predictors across domains, especially for cisgender women. Given the growing prevalence of such online forms of sex work, along with growing evidence of sugar relationships, it will become increasingly important to track reactions as these forms of sex work evolve. [ABSTRACT FROM AUTHOR]