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Multiple myeloma (MM) is more common among Black/African American (AA) patients than White patients, but survival rate improvements are less pronounced for AA patients. This study evaluated treatment patterns and survival among 1810 AA and 5904 White adults in the United States with ≥1 MM treatment and ≥3 months of follow-up. Median time from diagnosis to systemic treatment was longer (37 [0-3053] vs. 35 [0-3664] days) and median time to stem cell transplant (SCT) was longer for AA than White patients (255 [1-2352] vs. 225 [1-3094] days), and AA patients were less likely to receive SCT (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.58-0.76). Despite disparities in treatment between AA and White patients, AA patients demonstrated lower risk of death (OR: 0.89; 95% CI: 0.81-0.96). These data highlight the value of equal access to care for the improvement of health outcomes in underserved populations.
Assuntos
Mieloma Múltiplo , Adulto , Humanos , Negro ou Afro-Americano , Disparidades em Assistência à Saúde , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/epidemiologia , Mieloma Múltiplo/terapia , Estados Unidos/epidemiologia , BrancosRESUMO
PURPOSE: This study examined the 1-yr reliability and construct validity of survey items relating to time spent on muscle-strengthening exercise (MSE) in a subset of a large prospective cohort. METHODS: Participants (n = 293 men, 433 women; age, 32-73 yr) were selected from the Cancer Prevention Study-3. Information was collected using a 1-yr presurvey and postsurvey and four 7-d diaries throughout the year. The presurvey and postsurveys collected time spent on MSE in two ways: one question captured MSE activities performed during a typical 24-h period (24-h survey), and another question captured leisure-time physical activities performed in hours per week and months per year (LTPA survey). Time spent on MSE using the LTPA survey was calculated for individual MSE items and summed for total MSE time. One-year reliability was assessed by comparing the responses between the presurvey and postsurvey using Spearman's correlation coefficients. Construct validity was assessed by computing Spearman's correlation coefficients between responses from the postsurvey items and the diary. Additional analyses were conducted to examine whether reliability or validity varied by sociodemographic factors. RESULTS: Reliability estimates for all MSE items were moderate (≥0.40) or strong (≥0.60) overall and across demographic strata. Reliability estimates were strongest for total MSE on the LTPA survey (Spearman ρ = 0.75; 95% confidence interval (CI), 0.71-0.78) compared with the 24-h survey (0.59; 95% CI, 0.54-0.64). In contrast, the validity estimates were similarly strong for the total MSE on the LTPA survey (Spearman ρ = 0.71; 95% CI, 0.67-0.75) and the 24-h survey (Spearman ρ = 0.68; 95% CI, 0.64-0.72). CONCLUSIONS: The CPS-3 surveys have acceptable 1-yr reliability and validity for self-reported time spent on MSE. Reliability and validity estimates are acceptable across all sociodemographic subgroups.
Assuntos
Atividades de Lazer , Força Muscular , Neoplasias , Treinamento Resistido/estatística & dados numéricos , Autorrelato/normas , Adulto , Idoso , Intervalos de Confiança , Diários como Assunto , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Psicometria , Reprodutibilidade dos Testes , Treinamento Resistido/métodos , Fatores Socioeconômicos , Estatísticas não Paramétricas , Fatores de TempoRESUMO
The national EHDI 1-3-6 goals state that all infants should be screened for hearing loss before 1 month of age; with diagnostic testing before 3 months of age for those who do not pass screening; and early intervention (EI) services before 6 months of age for those with permanent hearing loss. This report updates previous summaries of progress on these goals by U.S. states and territories. Data are based on the Hearing Screening and Follow-up Survey (HSFS) conducted annually by the Centers for Disease Control and Prevention for the years 2006-2016. Trends were assessed using 3-year moving averages, with rates of newborns lost to follow-up or lost to documentation (LTF/D) also examined. During this period, the percentage of infants screened before one month increased from 85.1% to 95.3%, while the percentage receiving diagnostic testing before three months increased from 19.8% to 36.6%, and the percentage of infants identified with permanent hearing loss enrolled in early intervention (EI) before six months increased from 25.1% to 47.2%. Percentages of infants who ultimately received screening, diagnostic testing, and early intervention services - regardless of timing - were higher. During this period, LTF/D declined from 42.1% to 31.3% for diagnostic testing, and 39.4% to 20.3% for EI services. Diagnoses of hearing loss recorded increased from 0.9 to 1.7 per 1,000 infants screened, likely reflecting improved data.
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BACKGROUND: Neuronal polarization is an essential step of morphogenesis and connectivity in the developing brain. The serine/threonine kinase LKB1 is a key regulator of cell polarity, metabolism, tumorigenesis, and is required for axon formation. It is allosterically regulated by two related and evolutionarily conserved pseudokinases, STe20-Related ADapters (STRADs) α and ß. The roles of STRADα and STRADß in the developing nervous system are not fully defined, nor is it known whether they serve distinct functions. RESULTS: We find that STRADα is highly spliced and appears to be the primal STRAD paralog. We report that each STRAD is sufficient for axogenesis and promoting cell survival in the developing cortex. We also reveal a reciprocal protein-stabilizing relationship in vivo between LKB1 and STRADα, whereby STRADα specifically maintains LKB1 protein levels via cytoplasmic compartmentalization. CONCLUSIONS: We demonstrate a novel role for STRADß in axogenesis and also show for the first time in vivo that STRADα, but not STRADß, is responsible for LKB1 protein stability.