Incidence and risk factors for bone metastases at presentation in solid tumors.

Introduction: Bone metastases are associated with increased morbidity and decreased quality of life in patients with solid tumors. Identifying patients at increased risk of bone metastases at diagnosis could lead to earlier interventions. We sought to retrospectively identify the incidence and predictive factors for bone metastases at initial diagnosis in a large population-based dataset. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients 18 years-old or older diagnosed with solid cancers from 2010 to 2019. Patients with hematologic malignancies and primary tumors of the bone were excluded. We calculated the incidence and predictive factors for bone metastases according to demographic and tumor characteristics. Results: Among 1,132,154 patients identified, 1,075,070 (95.0%) had known bone metastasis status and were eligible for the study. Bone metastases were detected in 55,903 patients (5.2% of those with known bone metastases status). Among patients with bone metastases, the most common primary tumors arose from lung (44.4%), prostate (19.3%), breast (12.3%), kidney (4.0%), and colon (2.2%). Bone metastases at presentation were most common in small cell lung cancer (25.2%), non-small cell lung cancer (18.0%), and esophageal adenocarcinoma (9.4%). In addition to stage classification, predictors for bone metastases included Gleason score (OR 95.7 (95% CI 73.1 - 125.4) for Grade Group 5 vs 1 and OR 42.6 (95% CI 32.3 - 55.9) for Group 4 vs 1) and PSA (OR 14.2 (95% CI 12.6 - 16.0) for PSA > 97 vs 0 - 9.9) for prostate cancer, HER2 and hormonal receptor (HR) status (OR 2.2 (95% CI 1.9 - 2.6) for HR+/HER2+ vs HR-/HER2-) for breast cancer, histology (OR 2.5 (95% CI 2.3 - 2.6) for adenocarcinoma vs squamous) for lung cancer, and rectal primary (OR 1.2 (95% 1.1 - 1.4) vs colon primary) and liver metastases (OR 8.6 (95% CI 7.3 - 10.0) vs no liver metastases) for colorectal tumors. Conclusions: Bone metastases at presentation are commonly seen in solid tumors, particularly lung, prostate, breast, and kidney cancers. Clinical and pathologic factors are associated with a significantly increased risk for bone metastases.

Micronutrient status in children aged 6-59 months with severe wasting and/or nutritional edema: implications for nutritional rehabilitation formulations.

Undernutrition remains a global struggle and is associated with almost 45% of deaths in children younger than 5 years. Despite advances in management of severe wasting (though less so for nutritional edema), full and sustained recovery remains elusive. Children with severe wasting and/or nutritional edema (also commonly referred to as severe acute malnutrition and part of the umbrella term "severe malnutrition") continue to have a high mortality rate. This suggests a likely multifactorial etiology that may include micronutrient deficiency. Micronutrients are currently provided in therapeutic foods at levels based on expert opinion, with few supportive studies of high quality having been conducted. This narrative review looks at the knowledge base on micronutrient deficiencies in children aged 6-59 months who have severe wasting and/or nutritional edema, in addition to highlighting areas where further research is warranted (See "Future Directions" section).

Trends in Stage I Lung Cancer.

INTRODUCTION: The American Cancer Society has recently reported an increase in the percentage of patients with localized lung cancer from 2004 to 2018, coinciding with the initial lung cancer screening guidelines issued in 2013. We conducted a National Cancer Database (NCDB) study to further evaluate the trends in stage I according to patient and tumor characteristics. METHODS: We selected patients with lung cancer from the NCDB Public Benchmark Report diagnosed between 2010 and 2017. Patients with stages I to IV according to the AJCC seventh edition were evaluated according to the year of diagnosis, histology, age, sex, race, and insurance. RESULTS: Among the 1,447,470 patients identified in the database, 56,382 (3.9%) were excluded due to stage 0 or unknown, or incorrect histology, leaving 1,391,088 patients eligible. The percentage of patients with stage I increased from 23.5% in 2010 to 29.1% in 2017 for all lung cancers, from 25.9% to 31.8% in non-small-cell lung cancer (NSCLC), and from 5.0% to 5.4% in small-cell lung cancer (SCLC). Patients younger than 70 years, males and blacks had lower percentages of stage I compared to older patients, females, and nonblacks respectively. Patients with no insurance had the lowest percentage of stage I. CONCLUSIONS: There has been a significant increase in the percentage of stage I lung cancer at diagnosis from 2010 to 2017, which occurred mostly in NSCLC. Although the staging shift was observed in all subsets of patients, there were noticeable imbalances according to demographic factors.

Meiotic pairing and double-strand break formation along the heteromorphic threespine stickleback sex chromosomes.

Double-strand break repair during meiosis is normally achieved using the homologous chromosome as a repair template. Heteromorphic sex chromosomes share little sequence homology, presenting unique challenges to the repair of double-strand breaks. Our understanding of how heteromorphic sex chromosomes behave during meiosis has been focused on ancient sex chromosomes, where the X and Y differ markedly in overall structure and gene content. It remains unclear how more recently evolved sex chromosomes that share considerably more sequence homology with one another pair and form double-strand breaks. One possibility is barriers to pairing evolve rapidly. Alternatively, recently evolved sex chromosomes may exhibit pairing and double-strand break repair that more closely resembles that of their autosomal ancestors. Here, we use the recently evolved X and Y chromosomes of the threespine stickleback fish (Gasterosteus aculeatus) to study patterns of pairing and double-stranded break formation using molecular cytogenetics. We found that the sex chromosomes of threespine stickleback fish did not pair exclusively in the pseudoautosomal region. Instead, the chromosomes fully paired in a non-homologous fashion. To achieve this, the X chromosome underwent synaptic adjustment during pachytene to match the axis length of the Y chromosome. Double-strand break formation and repair rate also matched that of the autosomes. Our results highlight that recently evolved sex chromosomes exhibit meiotic behavior that is reminiscent of autosomes and argues for further work to identify the homologous templates that are used to repair double-strand breaks on the X and Y chromosomes.

Developing and Piloting Videogames to Increase College and University Students' Awareness and Efficacy of the Bystander Role in Incidents of Sexual Violence.

OBJECTIVE: Researchers at the Prevention Innovations Research Center at the University of New Hampshire and the Tiltfactor Laboratory at Dartmouth College collaborated with students to create two videogames to teach college students bystander intervention skills in situations of sexual and relationship violence and stalking. MATERIALS AND METHODS: A key strength of the present study is the collaboration with students to educate game development. The research team pooled its ideas to create a trivia game and an interactive scenario game that were pilot tested on first-year students in a midsized campus of a northeastern university. "Each game included subject matter related to sexual assault and bystander intervention, as well as general campus information so the main themes of the game would not be overt and potentially cause participants to resist shifting their attitudes about sexual assault and bystander intervention." Participants completed a pretest and posttest at each testing session and were invited to complete an online follow-up survey 4 weeks following the session. RESULTS: Researchers found that both games had a significant impact on participant bystander efficacy and attitude scores. The interactive scenario game was especially effective in increasing male attitudes toward bystander intervention. The results were most salient for the posttest; however, there was also an increase in male attitudes at the 4-week follow-up. CONCLUSION: The student input was invaluable to the success of the game prototypes. With their help, we concluded that gameplay shows promise as an effective way to introduce the concept of bystander intervention and increase bystander attitudes and efficacy in situations of sexual and relationship violence and stalking to first-year college students.

The channel catfish genome sequence provides insights into the evolution of scale formation in teleosts.

Catfish represent 12% of teleost or 6.3% of all vertebrate species, and are of enormous economic value. Here we report a high-quality reference genome sequence of channel catfish (Ictalurus punctatus), the major aquaculture species in the US. The reference genome sequence was validated by genetic mapping of 54,000 SNPs, and annotated with 26,661 predicted protein-coding genes. Through comparative analysis of genomes and transcriptomes of scaled and scaleless fish and scale regeneration experiments, we address the genomic basis for the most striking physical characteristic of catfish, the evolutionary loss of scales and provide evidence that lack of secretory calcium-binding phosphoproteins accounts for the evolutionary loss of scales in catfish. The channel catfish reference genome sequence, along with two additional genome sequences and transcriptomes of scaled catfishes, provide crucial resources for evolutionary and biological studies. This work also demonstrates the power of comparative subtraction of candidate genes for traits of structural significance.

"RePlay Health": An Experiential Role-Playing Sport for Modeling Healthcare Decisions, Policies, and Outcomes.

OBJECTIVE: This article presents the design and empirical investigation of the "RePlay Health" game ( www.replayhealth.com/ ), a novel "role-playing sport" derived from a complex, data-driven, computational simulation of healthcare dynamics. By immersing players in a fictional world in which they take on the role of characters facing specific behavioral and environmental risk factors, the "RePlay Health" game models the impact of health and healthcare policy on individual-level livelihood and community-level productivity. SUBJECTS AND METHODS: A randomized experiment tested the efficacy of the game for inspiring shifts in thinking about public health and healthcare policy. This study compared the impact of actively playing the game versus passively spectating: 31 young adults were assigned to one of these two roles. Participants completed pretest and posttest measures of their subjective ranking of healthcare policies and attributions for health outcomes. RESULTS: Active players (compared with spectators) reported significantly higher prioritizations (from pretest to posttest) in their subjective ranking of several health policies modeled by the game, such as "improving postdischarge care" and "increasing access to healthy foods." Furthermore, players, but not spectators, were significantly more likely following gameplay to identify environmental or systemic factors as potential causes of health problems. CONCLUSIONS: The fact that significant results emerged with a 1-week gap between gameplay and measurement demonstrates that the game could exert a lasting impact on attitudes and perceptions. More broadly, this work illustrates the value of incorporating experiential components, such as narrative, embodiment, and role-playing, in designing efficacious games for health.

Silica exposure on construction sites: results of an exposure monitoring data compilation project.

To expand on the limited size and scope of construction silica exposure studies, a silica monitoring data compilation project was initiated through the American Conference of Governmental Industrial Hygienists Construction Committee. Personal silica exposure monitoring data was collected and analyzed from 13 private, research, and regulatory groups. An effort was made to collect as much detail as possible about task, tool, and environmental and control conditions so as much information as possible could be garnered. There were considerable data gaps, particularly with regulatory agency data, that represented over half of the data set. There were 1374 personal quartz samples reported with a geometric mean of 0.13 mg/m(3) and a GSD of 5.9. Descriptive statistics are reported by trade, task, tool, and data source type. Highest exposures were for abrasive blasters, surface and tuckpoint grinders, jackhammers, and rock drills. The sample period was important, with short-term samples (up to 2 hours) having considerably higher levels than midterm (2-6 hours) or longer (over 6 hours) samples. For nearly all exposure variables, a large portion of variable categories were at or over the quartz occupational exposure limit of 0.05 mg/m(3), including 8 of 8 trade, 13 of 16 task, and 12 of 16 tool categories. The respiratory protection commonly used on construction sites is often inadequate for the exposures encountered. The data variability within task and tool was very large, with some very high exposures reported for a broad spectrum of tools. Further understanding of the conditions leading to high exposures will require more detailed documentation of the sample characteristics following database design recommendations or systematic surveys of exposure in this complex industry.

The efficacy of local exhaust ventilation for controlling dust exposures during concrete surface grinding.

This study assessed the effectiveness of a commercially available local exhaust ventilation (LEV) system for controlling respirable dust and crystalline silica exposures during concrete grinding activities. Surface grinding was conducted at six commercial building construction sites in Seattle, WA, by cement masons. Time-integrated filter samples and direct reading respirable dust concentrations were collected using a cyclone in line with a direct reading respirable dust monitor. Personal exposure levels were determined with and without LEV, one sample directly after the other. A total of 28 paired samples were collected in which three different dust collection shroud configurations were tested. Data obtained with a direct reading respirable dust monitor were adjusted to remove non-work task-associated dust exposures and was subsequently used to calculate the exposure reduction achieved. The application of LEV resulted in a reduction in the overall geometric mean respirable dust exposure from 4.5 to 0.14 mg/m(3), a mean exposure reduction of 92%. Despite the effective control of dust generated during surface grinding, 22 and 26% of the samples collected while LEV was being used were greater than the 8 h time-weighted average permissible exposure limit (Occupational Safety and Health Administration) and threshold limit value (American Congress of Governmental Industrial Hygienists) for respirable crystalline silica, respectively.

Silica dust exposures during selected construction activities.

This study characterized exposure for dust-producing construction tasks. Eight common construction tasks were evaluated for quartz and respirable dust exposure by collecting 113 personal task period samples for cleanup; demolition with handheld tools; concrete cutting; concrete mixing; tuck-point grinding; surface grinding; sacking and patching concrete; and concrete floor sanding using both time-integrating filter samples and direct-reading respirable dust monitors. The geometric mean quartz concentration was 0.10 mg/m(3) (geometric standard deviation [GSD]=4.88) for all run time samples, with 71% exceeding the threshold limit value. Activities with the highest exposures were surface grinding, tuck-point grinding, and concrete demolition (GM[GSD] of 0.63[4.12], 0.22[1.94], and 0.10[2.60], respectively). Factors recorded each minute were task, tool, work area, respiratory protection and controls used, estimated cross draft, and whether anyone nearby was making dust. Factors important to exposure included tool used, work area configuration, controls employed, cross draft, and in some cases nearby dust. More protective respirators were employed as quartz concentration increased, although respiratory protection was found to be inadequate for 42% of exposures. Controls were employed for only 12% of samples. Exposures were reduced with three controls: box fan for surface grinding and floor sanding, and vacuum/shroud for surface grinding, with reductions of 57, 50, and 71%, respectively. Exposures were higher for sweeping compound, box fan for cleanup, ducted fan dilution, and wetted substrate. Construction masons and laborers are frequently overexposed to silica. The usual protection method, respirators, was not always adequate, and engineering control use was infrequent and often ineffective.

The effect of local exhaust ventilation controls on dust exposures during concrete cutting and grinding activities.

This study assessed the effectiveness of commercially available local exhaust ventilation (LEV) systems for controlling respirable dust and crystalline silica exposures during concrete cutting and grinding activities. Work activities were performed by union-sponsored apprentices and included tuck-point grinding, surface grinding, paver block and brick cutting (masonry saw), and concrete block cutting (hand-held saw). In a randomized block design, implemented under controlled field conditions, three ventilation rates (0, 30, and 75 cfm) were tested for each tool. Each ventilation treatment was replicated three times in random order for a total of nine 15-min work sessions per study subject. With the exception of the hand-held saw, the use of LEV resulted in a significant (p < 0.05) reduction in respirable dust exposure. Mean exposure levels for the 75 cfm treatments were less than that of the 30 cfm treatments; however, differences between these two treatments were only significant for paver block cutting (p < 0.01). Although exposure reduction was significant (70-90% at the low ventilation rate and 80-95% reduction at the high ventilation rate), personal respirable dust [corrected] exposures remained very high: 1.4-2.8 x PEL (permissible exposure limit) at the low ventilation rate and 0.9-1.7 x PEL at the high ventilation rate. Exposure levels found under actual field conditions would likely be lower due to the intermittent nature of most job tasks. Despite incomplete control LEV has merit, as it would reduce the risk of workers developing disease, allow workers to use a lower level of respiratory protection, protect workers during short duration work episodes reduce exposure to nearby workers, and reduce clean-up associated dust exposures.