Cancer Prevention Institute of California
Cancer Prevention Institute of California
News Article | May 2, 2017
At ProPublica, Michael Grabell investigates how U.S. companies take advantage of immigrant workers, focusing on Case Farms poultry plants, which former OSHA chief David Michaels once described as “an outrageously dangerous place to work.” He reports that Case Farms built its business by recruiting some of the world’s most vulnerable immigrants, who often end up working in the kind of dangerous and abusive conditions that few Americans would put up with. Grabell chronicles the history of Case Farms and how it first began recruiting refugees from Guatemala who were fleeing a brutal civil war in their home country. A former Case Farms human resource manager said of the new Guatemalan workforce in a book cited in the article: “Mexicans will go back home at Christmastime. You’re going to lose them for six weeks. And in the poultry business you can’t afford that. You just can’t do it. But Guatemalans can’t go back home. They’re here as political refugees. If they go back home, they get shot.” The article begins with the story of worker Osiel López. Grabell writes: On April 7, 2015, Osiel put on bulky rubber boots and a white hard hat, and trained a pressurized hose on the plant’s stainless steel machines, blasting off the leftover grease, meat and blood. A Guatemalan immigrant, Osiel was just weeks past his 17th birthday, too young by law to work in a factory. A year earlier, after gang members shot his mother and tried to kidnap his sisters, he left his home, in the mountainous village of Tectitán, and sought asylum in the United States. He got the job at Case Farms with a driver’s license that said his name was Francisco Sepulveda, age 28. The photograph on the ID was of his older brother, who looked nothing like him, but nobody asked any questions. Osiel sanitized the liver giblet chiller, a tublike contraption that cools chicken innards by cycling them through a near-freezing bath, then looked for a ladder, so that he could turn off the water valve above the machine. As usual, he said, there weren’t enough ladders to go around, so he did as a supervisor had shown him: He climbed up the machine, onto the edge of the tank, and reached for the valve. His foot slipped; the machine automatically kicked on. Its paddles grabbed his left leg, pulling and twisting until it snapped at the knee and rotating it 180 degrees, so that his toes rested on his pelvis. The machine “literally ripped off his left leg,” medical reports said, leaving it hanging by a frayed ligament and a five-inch flap of skin. Osiel was rushed to Mercy Medical Center, where surgeons amputated his lower leg. Back at the plant, Osiel’s supervisors hurriedly demanded workers’ identification papers. Technically, Osiel worked for Case Farms’ closely affiliated sanitation contractor, and suddenly the bosses seemed to care about immigration status. Within days, Osiel and several others — all underage and undocumented — were fired. Read the entire investigation, which was co-published with the New Yorker, at ProPublica. Washington Post: Drew Harwell reports that workers in the Chinese factory that produces Ivanka Trump’s fashion line work about 60 hours a week for little more than $62 per week. According to a factory audit, inspectors with the Fair Labor Association found two-dozen violations of international labor standards at the factory, where workers were getting at or below China’s minimum wage. The story comes as Ivanka Trump is positioning herself as an advocate for women in the workplace. Harwell reports: “Fewer than a third of the factory’s workers were offered legally mandated coverage under China’s ‘social insurance’ benefits, including a pension and medical, maternity, unemployment and work-related injury insurance, inspectors found. The factory also did not contribute, as legally required, to a fund designed to help workers afford housing, inspectors said.” California Healthline (via KQED): Pauline Bartolone reports that advocates are calling on California lawmakers to approve a bill that would require cosmetic companies to disclose ingredients in products used in professional salons. The bill, which already passed the state Assembly health committee, would mandate product labeling that flags hazardous chemicals and require that manufacturers provide ingredient lists on their websites. Right now, federal labeling laws pertain to consumer products, but not to professional products used in salons. Bartolone reports: “Dr. Thu Quach, a researcher at the Cancer Prevention Institute of California, says informing workers of potential risks is especially important given their level of exposure to salon products. Beauty salon workers may absorb chemicals both through their skin and the air they breathe, Quach said. A cosmetologist could apply a chemical-laden treatment to customers 10 times a day, or work in a space where chemicals are recirculating in the air all day, she added.” Seattle Times: Janet Tu reports that a superior court judge has denied a motion from business trade groups to void the state’s new minimum wage and paid sick leave law, which Washington voters approved last year. In his ruling, the judge said plaintiffs had failed to prove the new laws violated the state constitution. The voter-approved initiative raises the state minimum wage to $13.50 by 2020 and requires paid sick leave for workers. Tu reports: “Judge Sparks wrote in a letter accompanying his ruling that he tries to adhere to the ‘bedrock principle’ that judges should not interfere with laws enacted by the people, whether through referenda or elected officials, unless there is a clear legal necessity.” Reveal (Center for Investigative Reporting): Jennifer Gollan reports on Trump’s proposal to cut $60 million in grants from the Department of Labor’s Bureau of International Affairs, which addresses child and forced labor abroad. In the budget proposal, Trump suggests that the agency should instead focus on ensuring trade agreements are fair for American workers. Gollan cites a 2014 report on conditions inside Malaysia’s electronics industry as an example of the work the grants support. That report, which revealed highly abusive labor conditions, led to increased scrutiny of the industry and stronger safeguards against trafficking. Gollan writes of the proposed Trump budget cut: “The cuts would hobble one of the country’s key methods for combatting child and forced labor around the globe, and potentially limit the federal government’s ability to help countries comply with labor provisions in 13 free trade agreements. In addition, the cuts could effectively do the opposite of what Trump intends by forcing U.S. companies to increasingly compete with overseas companies that flout worker safeguards and pay meager wages.” Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — @kkrisberg.
News Article | May 8, 2017
Improving the worst environments in the US could prevent 39 in every 100,000 cancer deaths. That’s according to the first study to address the impact of cumulative exposure to environmental hazards on cancer incidence in the US, which found strong links between poor environmental quality and increased rates of cancer. The environment we live in can influence biological processes such as hormone function and gene expression, or cause DNA damage – all of which can alter the risk of developing certain cancers. For instance, lung cancer incidence can increase due to chronic exposure to certain pesticides, diesel exhaust and the radioactive gas radon. Social factors also take their toll – poverty is linked to liver cancer, for example, due to increased alcohol consumption. Jyotsna Jagai at the University of Illinois and her colleagues investigated these links by comparing data from the Environmental Quality Index – a measure of cumulative environmental exposures between the years of 2000 and 2005 – with cancer incidence across the US from 2006 to 2010. The results showed increases in cancer incidence with decreasing environmental quality. The link was clearest with prostate and breast cancer. “There is a tension in the field as to whether to focus on individual or cumulative environmental exposures,” says Scarlett Gomez of the Cancer Prevention Institute of California in an accompanying editorial. She says that although identifying individual exposures can allow them to be addressed in a targeted way, pinpointing them can be difficult because many potential cancer factors are linked together. For example, people of low socioeconomic status tend to live in areas that score poorly for multiple environmental factors. Even so, the data compiled by Jagai’s team can at least help identify which communities are most vulnerable to high cancer rates. However, this may be hampered by new legislative proposals, introduced in January, that seek to rein in federal collection of local area data. Jagai and her team also warn that a bill introduced in February to terminate the Environmental Protection Agency, which provided the environmental data used in the study, will severely harm researchers’ abilities to further investigate the factors that contribute to disease.
News Article | December 20, 2016
A new breast cancer model, published today in the Journal of the National Cancer Institute, will help health care providers more accurately predict breast cancer risk in their Hispanic patients. The model, developed by a Kaiser Permanente researcher and his colleagues, is the first to be based exclusively on data from Hispanic women, and will become part of the National Cancer Institute's online tool that helps providers calculate breast cancer risk in individual patients. "Hispanics are the largest racial/ethnic minority group in the U.S., so it's important that the NCI tool include information from these women in determining their risk score. Our model does that because it is based on data from Hispanic women and specifically tailored for them," said Matthew P. Banegas, PhD, MPH, lead author and researcher from the Kaiser Permanente Center for Health Research. NCI's Breast Cancer Risk Assessment Tool asks providers to enter information about the patient's age, race, family history of breast cancer and other risk factors, including: The Breast Cancer Risk Assessment Tool currently includes risk models for non-Hispanic white, African-American and Asian and Pacific Islander women, but no model specific to Hispanic women, and studies show that the tool underestimates breast cancer risk in these women. "Prior studies have shown that Hispanic women born in the U.S. have a higher breast cancer risk than Hispanic women who emigrate here from other countries," said Banegas. "Our model includes data from U.S. and foreign-born women, so providers will be able to more accurately predict risk based on where the woman was born." To build the model, researchers started with data from the San Francisco Bay Area Breast Cancer Study, which included 1,086 Hispanic women who developed breast cancer between 1995 and 2002 and 1,411 women who did not have breast cancer. Nearly 1,000 of the women were born in the United States and 1,500 were born in other countries. The researchers then included breast cancer incidence and mortality data from the California Cancer Registry and NCI's Surveillance, Epidemiology and End Results program. To validate their model, researchers used data from the Women's Health Initiative and the Four-Corners Breast Cancer Study. The new model accurately predicted the number of breast cancers among U.S.-born Hispanic women who participated in the Women's Health Initiative, but slightly overestimated the number of breast cancers among foreign-born Hispanic women in the WHI. "We built the model using data from Hispanic women in California who are mostly of Mexican and Central American descent, so these are the women for whom the model will be most accurate," said Banegas. "As we collect more data on Hispanic women from other regions and countries, we will be able to further refine the model." The new model, like the National Cancer Institute's Breast Cancer Risk Assessment Tool, should not be used for women who already have invasive breast cancer, for women who have an inherited genetic mutation known to cause breast cancer, or for women who received therapeutic radiation of the chest for other types of cancers. This study was supported by the Intramural Research Program of the National Cancer Institute, National Institutes of Health. Other authors include: Esther M. John PhD, MSPH, and Scarlett Lin Gomez, PhD, MPH, Cancer Prevention Institute of California and the Department of Health Research and Policy at the Stanford Cancer Institute; Martha L. Slattery, PhD, MPH, University of Utah Department of Medicine; Mandi Yu, PhD, Division of Cancer Control and Population Sciences, National Cancer Institute; Andrea LaCroix, PhD, Family and Preventive Medicine, University of California, San Diego; David Pee, MPhil, Information Management Services; Rowan T. Chlebowski, MD, PhD, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center; Lisa Hines, ScD, Department of Biology, University of Colorado Colorado Springs; Cynthia Thompson, PhD, RD, Mel and Enid Zuckerman College of Public Health, University of Arizona; and Mitchell Gail, MD, PhD, Division of Cancer Epidemiology and Genetics, National Cancer Institute. About the Kaiser Permanente Center for Health Research The Kaiser Permanente Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Oregon and Honolulu. Visit kpchr.org for more information. Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 10.6 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.
News Article | December 9, 2016
Patient health records revealed two drug combinations that may reduce mortality rates in breast cancer patients, according to a study led by researchers at the Stanford University School of Medicine. The drugs involved were commonly used drugs that turned out to be associated with a longer average survival rate in breast cancer patients. The study will be published online Dec. 9 in the Journal of the American Medical Informatics Association. The lead author is Stanford postdoctoral scholar Yen Low, PhD. The senior author is Nigam Shah, MBBS, PhD, associate professor of medicine and of biomedical data science. Often, when different drugs are taken together, they can have unexpected side effects. For example, some antibiotics and antifungal drugs can interfere with the effectiveness of birth control pills. It occurred to Shah and his team that the opposite could also be true -- that some drug interactions might help patients. "What if we looked for combinations of drugs that have an accidental beneficial effect?" Shah said. The researchers decided to comb through a breast cancer database built at Stanford called Oncoshare, which takes de-identified patient information -- including tumor and treatment information for each patient -- from Stanford Health Care and from the Palo Alto Medical Foundation and links it to patient outcomes in the California Cancer Registry. The team searched for drugs that patients just happened to be taking and that were statistically associated with better outcomes. "By integrating different kinds of data, we can ask questions we couldn't ask before. Usually, you don't find both survivorship data and all the different kinds of drugs and other treatments patients get all in the same place," said Allison Kurian, MD, associate professor of medicine and of health research and policy. "We looked at all the noncancer drugs that breast cancer patients were on," said Shah. "People have other things going on in life. They might have hypertension, they might have high cholesterol or diabetes. They would be taking drugs for those as well. So the question we were asking was, do any of the drugs they are taking associate with better outcomes for breast cancer?" The team looked at data from nearly 10,000 adult women diagnosed with breast cancer between 2000 and 2013, of whom about 12 percent died within five years of the diagnosis. The team examined 294 drugs in more than 43,000 pairwise combinations. Specifically, they looked for combinations of drugs in which the beneficial effect on survival was greater than the effect of either drug by itself. "So we ran the analysis, and we found a few drug combinations that seemed to associate with better survival," said Shah. Specifically, there were three pairs of drug types: anti-inflammatory drugs, such as aspirin or naproxen, and blood-lipid modifiers, such as statins; lipid modifiers and drugs such as fluticasone used to treat asthmalike conditions; and anti-inflammatories and hormone antagonists -- typically, drugs that suppress the synthesis of estrogen. "But how do we know it's true, and not just an association?" said Shah. The researchers needed to look for confirmation in a data set they had not yet examined. To do so, they turned to Shah's former student Andrew Radin, a co-author of the paper and co-founder of a company called twoXAR that searches for drug interactions using gene-expression data. Radin's company looks for common molecular pathways that might account for drug pairs with apparent synergistic effects, searching for drug-protein interactions in the company's database. Said Shah, "So I asked Andrew, 'If I give you two drugs and a disease, can you tell me if there is any molecular-level evidence that would lead you to believe that, yes, these drugs might have a beneficial effect in treating this disease?' So we gave them our list of three drug pairs, and they looked at the protein targets for all the drugs." Two of the three drug pairs showed a likely molecular mechanism that a reasonable person might think had to do with survival in breast cancer, the study said. These were anti-inflammatories and lipid modifiers, and anti-inflammatories and anti-cancer hormone antagonists. "This study is a nice example of an analysis spanning multiple data modalities. It's the kind of thing that can only happen at Stanford," said Shah, pointing out how his lab worked with Oncoshare, twoXAR, oncologists and statisticians to bring the study off. The work is an example of Stanford Medicine's focus on precision health, the goal of which is to anticipate and prevent disease in the healthy and precisely diagnose and treat disease in the ill. "It's a proof of principle that this kind of data mining has strong practical clinical applications," said Kurian. With electronic health records, she said, the challenge has been getting the data organized in a way that allows fruitful explorations like this one. The key, said Shah, is to ask why these drugs and their protein targets have something to do with breast cancer and to leverage that information for better treatment. "This is a holistic look at the data -- EHR, gene expression, protein targets of drugs -- all in one analysis," he said. Other Stanford co-authors are former research assistant William Chen; senior clinical data engineer Tina Seto; Susan Weber, PhD, director of informatics systems and software development for the Stanford Center for Clinical Informatics; former graduate student Michael Lim, PhD; Trevor Hastie, PhD, professor of statistics and of biomedical data science; biostatistician Maya Mathur; Manisha Desai, PhD, associate professor of medicine and of biomedical data science; research scientist Scarlett Gomez, PhD, MPH; and George Sledge, MD, professor of medicine. Researchers at twoXAR Inc., the Palo Alto Medical Foundation Research Institute and the Cancer Prevention Institute of California were also co-authors of the study. This research was supported by the National Institutes of Health (grants R01LM011369, GM101430RO1, EB00198815 and UL1RR025744), the National Science Foundation, the Susan and Richard Levy Give Fund, the Breast Cancer Research Foundation, the Regents of the University of California's Breast Cancer Research Program and the Stanford University Developmental Research Fund. Stanford's Department of Medicine also supported the work. The Stanford University School of Medicine consistently ranks among the nation's top medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://med. . The medical school is part of Stanford Medicine, which includes Stanford Health Care and Lucile Packard Children's Hospital Stanford. For information about all three, please visit http://med. .
News Article | November 10, 2016
SANTA MONICA, Calif., Nov. 10, 2016 (GLOBE NEWSWIRE) -- Opiant Pharmaceuticals, Inc. (“Opiant”) (OTCQB:OPNT), a specialty pharmaceutical company developing pharmacological treatments for substance use, addictive and eating disorders, announced the appointment of Thomas T. Thomas, CFA, to the company’s Board of Directors. Mr. Thomas worked at Genentech, Inc. for more than twelve years, culminating as the company’s Corporate Treasurer. His responsibilities included treasury operations, cash and investment management, corporate finance, global procurement, enterprise risk management, business continuity, and real estate. “With his valuable background, we welcome Thomas T. Thomas to our Board of Directors,” said Roger Crystal, M.D., Chief Executive Officer of Opiant. “We consider his experience at Genentech to be a great asset to Opiant.” “There’s an unmet need for new addiction treatments and Opiant’s compelling approach could have a transformative impact on patients and their families,” Mr. Thomas said. “Opiant could make significant contributions to the field of addiction medicine.” “With NARCAN® Nasal Spray now approved by the FDA and widely available to treat opioid overdoses, via our partner Adapt Pharma, we are focused on advancing our pipeline and Mr. Thomas has the financial experience to help Opiant achieve this,” said Dr. Crystal. Mr. Thomas currently serves as a board member at the Cancer Prevention Institute of California. After his career at Genentech, Mr. Thomas served as Chief Financial Officer and Interim Chief Executive Officer at Stupski Foundation, an organization working to transform the public school system. He has also served in financial roles at Del Monte Foods, Inc. and GE Capital. Mr. Thomas is a Chartered Financial Analyst and has a master’s degree in business administration from the University of Cincinnati. “Opiant is aggressively addressing a serious public health issue with its nasal opioid antagonist technology in NARCAN®,” Mr. Thomas said. “As I join Opiant’s board, I look forward to using my corporate financial experience to help the company advance its pipeline and business operations, and bring forward new and innovative therapies that improve patient’s lives, while continuing to build Opiant’s shareholder value.” Opiant Pharmaceuticals, Inc., is a specialty pharmaceutical company developing pharmacological treatments for substance use, addictive and eating disorders. Over 45 million people in the U.S. have one of these disorders. The National Institute on Drug Abuse (NIDA), a division of the National Institutes of Health (NIH), describes these disorders as chronic relapsing brain diseases which burden society at both the individual and community levels. With its innovative opioid antagonist nasal delivery technology, Opiant is positioned to become a leader in these treatment markets. Its first product, NARCAN® Nasal Spray, is approved for marketing in the U.S. by the company’s partner, Adapt Pharma Limited. Currently, Opiant is developing opioid antagonists for the treatment of substance use, addictive and eating disorders, with a near term focus on cocaine use disorder, bulimia nervosa and binge eating disorder (BED). For more information please visit: www.opiant.com. This press release contains forward-looking statements. These statements relate to future events or our future financial performance and involve known and unknown risks, uncertainties and other factors that may cause our or our industry’s actual results, levels of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed, implied or inferred by these forward-looking statements. In some cases, you can identify forward-looking statements by terminology such as “may,” “will,” “should,” “could,” “would,” “expects,” “plans,” “intends,” “anticipates,” “believes,” “estimates,” “predicts,” “projects,” “potential,” or “continue” or the negative of such terms and other comparable terminology. These statements are only predictions based on our current expectations and projections about future events. You should not place undue reliance on these statements. Actual events or results may differ materially. In evaluating these statements, you should specifically consider various factors. These and other factors may cause our actual results to differ materially from any forward-looking statement. We undertake no obligation to update any of the forward-looking statements after the date of this press release to conform those statements to reflect the occurrence of unanticipated events, except as required by applicable law.
Rachakonda T.D.,University of Colorado at Denver |
Schupp C.W.,Cancer Prevention Institute of California |
Armstrong A.W.,University of Colorado at Denver
Journal of the American Academy of Dermatology | Year: 2014
Background Psoriasis is a chronic inflammatory disorder associated with significant morbidity and mortality. Up-to-date prevalence data on psoriasis provide the foundation for informing population research, education, and health policy. Objective We sought to determine the prevalence of psoriasis among US adults. Methods We performed a cross-sectional study using National Health and Nutrition Examination Survey 2009 through 2010 data to determine psoriasis prevalence rates. Results From 6218 participants older than 20 years of age, 6216 respondents provided complete information regarding a psoriasis diagnosis. The prevalence of psoriasis among US adults ages 20 years and older is 3.2% (95% confidence interval [CI] 2.6%-3.7%). A total of 7.2 million US adults had psoriasis in 2010; an estimated 7.4 million US adults were affected in 2013. When stratifying the sample by race among those between ages 20 and 59 years, the psoriasis prevalence was highest in Caucasians at 3.6% (95% CI 2.7%-4.4%), followed by African Americans (1.9%; 95% CI 1.0%-2.8%), Hispanics (1.6%; 95% CI 0.5%-2.8%), and others (1.4%; 95% CI 0.3%-2.6%). The prevalence of psoriasis among US adults has not changed significantly since 2003 to 2004 (P >.05). Limitations Dermatologist evaluation and skin photographs were unavailable for the 2009 through 2010 surveys. Conclusions In the United States, psoriasis remains a common, immune-mediated disease, affecting 7.4 million adults. Its prevalence has remained stable since the mid-2000s. © 2013 by the American Academy of Dermatology, Inc.
Corbett B.A.,Vanderbilt University |
Schupp C.W.,Cancer Prevention Institute of California |
Lanni K.E.,Veterans Affairs Northern California Healthcare System
Molecular Autism | Year: 2012
Background: Autism spectrum disorders (ASD) are defined by impairment in reciprocal social interaction and flexible adaptation to the environment. This study compared physiological stress in children with and without ASD exposed to two social stress protocols. We hypothesized that the ASD group would show heightened initial and enduring cortisol levels to the social stressors, which would be moderated by age and intelligence. Methods. Twenty-seven children with ASD and 32 with typical development (TYP) completed a standardized social-evaluative performance task and a validated paradigm of social play with peers. Physiological stress was measured by salivary cortisol at nine time points. Statistical approaches included repeated-measures linear mixed models and correlation analyses. Results: The average cortisol level of both groups during initial exposure to social situations was significantly greater than baseline levels (ASD, P = 0.018; TYP, P = 0.006). Stress responsivity was significantly different between the groups; the TYP group showed a significant reduction in cortisol over time (P = 0.023), whereas the ASD group maintained an elevated cortisol level (P >0.05). The ASD group evidenced greater variability in between-group, within-group and intra-individual analyses. Age was a positive moderator of stress for the ASD group (P = 0.047), whereas IQ was a negative moderator for the TYP group (P = 0.061). Conclusions: Initial stress to novel social scenarios is idiosyncratic and predictive of subsequent exposure. Amidst significant variability in cortisol, children with ASD show enhanced and sustained social stress that increases with age. Developmental and cognitive factors differentially moderate stress in children with ASD and TYP, respectively. A model of neuroendocrine reactivity is proposed. © 2012 Corbett et al.; licensee BioMed Central Ltd.
Corbett B.A.,Vanderbilt University |
Corbett B.A.,Vanderbilt Kennedy Center |
Schupp C.W.,Cancer Prevention Institute of California
Hormones and Behavior | Year: 2014
Our ability to adapt to change is fundamental. The cortisol awakening response (CAR) is a sharp rise in cortisol 30min after waking to help prepare an individual for ensuing stress. Children with autism spectrum disorder (ASD) often have difficulty adapting to change. Exploration of the CAR is warranted; yet, the few studies investigating it are inconclusive. The CAR was investigated in 94 pre-pubertal male children 8-to-12years of age with ASD (46) and typical development (TD, 48). Salivary samples were collected over three diurnal cycles involving two morning samples: M1: Immediately upon Waking and M2: 30-min Post Waking (M2-M1=CAR). The magnitude of the CAR was measured by independent two sample t-tests, variability was measured using Levene's Test, the sequence of the CAR was analyzed by a linear mixed-effects model and proportion of children exhibiting a CAR by chi-square test of independence. There were no significant differences on the CAR between the groups based on magnitude (t(92)=-0.14, p=0.89, d=0.04), variability (F(45,47)=1.11, p=0.72, η2=0.11) or the sequence over three days (F(2,88)=0.26, p=0.77, η2=0.01). No significant differences were shown in the proportion of children exhibiting a CAR across the groups based on child (χ2(1)=0.02, p=0.89) or adult criterion (χ2(1)=1.82, p=0.18). Despite group differences in the regulation and responsivity of cortisol, the CAR is indistinguishable between children with and without ASD. Inconsistencies across studies may be due to age, criterion used, and diagnostic distinctions. © 2014 Elsevier Inc.
Reynolds P.,Cancer Prevention Institute of California |
Reynolds P.,Stanford University
Journal of Mammary Gland Biology and Neoplasia | Year: 2013
The potential role of smoking in breast cancer risk has been the subject of over 100 publications, numerous scientific reviews, and animated debate. Tobacco exposure is a well-established cause of lung cancer, and is thought to account for nearly one third of all cancer deaths. Tobacco smoke contains thousands of chemicals, many of which are known to be mammary carcinogens. Although not initially thought to be a tobacco-related cancer, over the last several decades evidence has been accumulating on the role of both active smoking and secondhand smoking in the etiology of breast cancer. The human health evidence has been systematically evaluated not only by several independent researchers but also by several expert agency panels including those of the U.S. Surgeon General, the International Agency for Research on Cancer, the California Environmental Protection Agency, and a coalition of Canadian health agencies. Although the assessments have varied with time and across reviewers, the most recent weight of the evidence has suggested a potentially casual role for active smoking and breast cancer, particularly for long-term heavy smoking and smoking initiation at an early age. The role of secondhand smoking and breast cancer is less clear, although there has been some suggestion for an increased risk for premenopausal breast cancer. Recent studies evaluating the possible modifying role of polymorphisms in genes involved in the metabolism of tobacco products, particularly NAT2, have contributed another dimension to these assessments, although to date that evidence remains equivocal. © 2012 Springer Science+Business Media New York.
Percival M.-E.M.,Stanford University |
Tao L.,Cancer Prevention Institute of California |
Medeiros B.C.,Stanford University |
Clarke C.A.,Cancer Prevention Institute of California
Cancer | Year: 2015
BACKGROUND Acute myeloid leukemia (AML) is treated with conventional induction chemotherapy shortly after diagnosis for the majority of patients aged ≤65 years. A recent report suggested a substantial decline in the early, or 1-month, mortality rate in patients treated on clinical trials over the past 2 decades. It is unknown whether a similar improvement has been observed in the general population. METHODS The authors examined the 1-month mortality rate in a large population-based series of 9380 patients with AML who were aged ≤65 years and were diagnosed and treated with chemotherapy between 1973 and 2010. RESULTS A significant decline was observed in the 1-month mortality rate from 18.7% among patients diagnosed from 1973 through 1977 (95% confidence interval [95% CI], 16.4%-21.2%) to 5.8% for those diagnosed between 2008 and 2010 (95% CI, 4.5%-7.6%) (P <.001). The median overall survival improved significantly from 6 months (95% CI, 5 months-7 months) in 1973 to 1977 to 23 months (95% CI, 16 months-20 months) in 2008 to 2010 (P <.001). Although age and geographic variation were found to significantly influence the 1-month mortality for the period between 1973 and 1977, these differences in 1-month mortality were no longer significant among patients with AML who were treated more recently (2008-2010). CONCLUSIONS Over the past 4 decades, early mortality has become uncommon in younger patients (aged ≤65 years) with newly diagnosed AML undergoing induction chemotherapy. It is encouraging that the improvements noted in 1-month mortality rate among a selective cohort of patients in clinical trials have also been observed in a population-based analysis. Cancer 2015;121:2004-2012. © 2015 American Cancer Society.