Evaluation of Breast Cancer Patients with Genetic Risk in a University Hospital: Before and After the Implementation of a Heredofamilial Cancer Unit

The identification of patients at risk for breast cancer by genetic testing has proven to reduce breast cancer mortality. In 2010, due to a lack of systematization in hereditary cancer assistance in our center, we implemented a multidisciplinary Heredofamilial Cancer Unit (HFCU). We analyze if the HFCU improved the rates of referrals and preventive management of breast cancer patients with genetic risk. We retrospectively compared family history records, referrals of high-risk patients to genetic counseling, and detection and management of patients with BRCA1/2 mutations in two cohorts of breast cancer patients diagnosed before (first period: 2007–2010) and after the creation of the HFCU (second period: 2010–2013). In the first period, 893 patients were included, and 902 were included in the second. Due to the inability to establish their genetic risk, 142 patients (15.9%) vs. 70 (7.8%) were excluded from analysis (p?<?0.001). Among the evaluable patients, 194 (25.8%) vs. 223 (26.8%) fulfilled one or more risk criteria (p?=?0.65). Family history documentation in patient’s medical records (92.4 vs. 97.8%, p?<?0.001) and referral rate (26.3 vs. 52%, p?<?0.0001) significantly increased in the second period. Eight BRCA1/2 mutations were detected among patients referred in the first period and 17 among those referred to the HFCU. The rate of preventive surgeries in patients with BRCA mutations significantly increased in the second period (25 vs. 76.5%, p?=?0.03). In conclusion, there was a clear improvement in family history records, referrals, and preventive surgeries in breast cancer patients with genetic risk after the implementation of the HFCU.     

The Work of Words: Poetry,Language and the Dawn of Community

Topoi - This essay explores the ontological movement of poetry, its language and words, by establishing a dialogue with the thought of three Japanese thinkers, Ki no Tsurayuki, Motoori Norinaga and...     

Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes

The validity of rating of perceived exertion (RPE) in predicting lactate threshold during an incremental test was analyzed in 15 men with type 2 diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventilation (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds. Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9-10, 12-13, and 16-17 also identified workloads above which there was an overproportional increase in VE and [lac]. These workload breakpoints did not differ, although at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13 and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately predicted lactate threshold.     

Comparison of classical and modern methods for measuring and correcting for acquiescence

Likert-type self-report scales are frequently used in large-scale educational assessment of social-emotional skills. Self-report scales rely on the assumption that their items elicit information only about the trait they are supposed to measure. However, different response biases may threaten this assumption. Specifically, in children, the response style of acquiescence is an important source of systematic error. Balanced scales, including an equal number of positively and negatively keyed items, have been proposed as a solution to control for acquiescence, but the reasons why this design feature worked from the perspective of modern psychometric models have been underexplored. Three methods for controlling for acquiescence are compared: classical method by partialling out the mean; an item response theory method to measure differential person functioning (DPF); and multidimensional item response theory (MIRT) with random intercept. Comparative analyses are conducted on simulated ratings and on self-ratings provided by 40,649 students (aged 11–18) on a fully balanced 30-item scale assessing conscientious self-management. Acquiescence bias was explained as DPF and it was demonstrated that: the acquiescence index is highly related to DPF; balanced scales produce scores controlled for DPF; and MIRT factor scores are highly related to scores controlled for DPF and the random intercept is highly related to DPF.     

Conceptual Analysis and Empirical Observations of Animal Minds

Philosophia - The relation between conceptual analysis and empirical observations when ascribing or denying concepts and beliefs to non-human animals is not straightforward. In order to reflect on...     

True or False? Keying Direction and Acquiescence Influence the Validity of Socio-Emotional Skills Items in Predicting High School Achievement

What type of items, keyed positively or negatively, makes social-emotional skill or personality scales more valid? The present study examines the different criterion validities of true- and false-keyed items, before and after correction for acquiescence. The sample included 12,987 children and adolescents from 425 schools of the State of São Paulo Brazil (ages 11–18 attending grades 6–12). They answered a computerized 162-item questionnaire measuring 18 facets grouped into five broad domains of social-emotional skills, i.e.: Open-mindedness (O), Conscientious Self-Management (C), Engaging with others (E), Amity (A), and Negative-Emotion Regulation (N). All facet scales were fully balanced (3 true-keyed and 3 false-keyed items per facet). Criterion validity coefficients of scales composed of only true-keyed items versus only false-keyed items were compared. The criterion measure was a standardized achievement test of language and math ability. We found that coefficients were almost as twice as big for false-keyed items’ scales than for true-keyed items’ scales. After correcting for acquiescence coefficients became more similar. Acquiescence suppresses the criterion validity of unbalanced scales composed of true-keyed items. We conclude that balanced scales with pairs of true and false keyed items make a better scale in terms of internal structural and predictive validity.     

Automated theorem proving for non-classical logics

Automated theorem proving for non-classical logics     

Visuospatial working memory for locations,colours, and binding in typically developing children and in children with dyslexia and non‐verbal learning disability

This study examined forward and backward recall of locations and colours and the binding of locations and colours, comparing typically developing children – aged between 8 and 10 years – with two different groups of children of the same age with learning disabilities (dyslexia in one group, non‐verbal learning disability [NLD] in the other). Results showed that groups with learning disabilities had different visuospatial working memory problems and that children with NLD had particular difficulties in the backward recall of locations. The differences between the groups disappeared, however, when locations and colours were bound together. It was concluded that specific processes may be involved in children in the binding and backward recall of different types of information, as they are not simply the resultant of combining the single processes needed to recall single features.