Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium.

BACKGROUND: Head and neck cancer (HNC) risk is elevated among lean people and reduced among overweight or obese people in some studies; however, it is unknown whether these associations differ for certain subgroups or are influenced by residual confounding from the effects of alcohol and tobacco use or by other sources of biases. METHODS: We pooled data from 17 case-control studies including 12 716 cases and the 17 438 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between body mass index (BMI) at different ages and HNC risk, adjusted for age, sex, centre, race, education, tobacco smoking and alcohol consumption. RESULTS: Adjusted ORs (95% CIs) were elevated for people with BMI at reference (date of diagnosis for cases and date of selection for controls) 25.0-30.0 kg/m(2) (0.52, 0.44-0.60) and BMI >/=30 kg/m(2) (0.43, 0.33-0.57), compared with BMI >18.5-25.0 kg/m(2). These associations did not differ by age, sex, tumour site or control source. Although the increased risk among people with BMI 25 kg/m(2) was present only in smokers and drinkers. CONCLUSIONS: In our large pooled analysis, leanness was associated with increased HNC risk regardless of smoking and drinking status, although reverse causality cannot be excluded. The reduced risk among overweight or obese people may indicate body size is a modifier of the risk associated with smoking and drinking. Further clarification may be provided by analyses of prospective cohort and mechanistic studies.

Improvement of productivity and polysaccharide-protein complex in Agaricus blazei

The objective of this work was to assess the productivity and polysaccharide-protein complex content of Agaricus blazei on rice straw medium, in comparison to conventional sawdust, using four casing soils. The A. blazei strain used was BCRC36814T, purchased from the Food Industry Research and Development Institute, Hsin-Chu, Taiwan. The two media were evaluated as to A. blazei productivity, harvesting time, and production costs. The experimental design used was a randomized complete block, with four replicates. Three local casing soils - Typic Paleudult (CCe), Typic Udorthent (Tq) and Oxyaquic Paleudult (TSp) - were compared to imported peat soil (PS, Saprists, Histosols), used as the control. The productivity of A. blazei using Tq and TSp soil was significantly higher. The TSp casing treatment resulted in earlier harvest by at least 14 to 27 days, when compared to the other treatments. The polysaccharide content in CCe (13.2%) and Tq soils (13.2%) did not differ significantly from the PS (13.4%) and TSp (10.6%) treatments. Local casing soils decreased the production costs of A. blazei cultivation. Composted rice straw can substitute sawdust as the culture medium for A. blazei production with increased yield.

Beneficial bacterial strains on Agaricus blazei cultivation

The objective of this work was to evaluate the effects of six bacterial strains isolated from Agaricus blazei (ABM) on its cultivation. The six strains were characterized as to their effects on the productivity, polysaccharide-protein complex (PSPC), and polysaccharide contents of ABM cultured on sterilized casing soils. Three isolates enhanced ABM mycelium growth. Inoculation of Arthrobacter sp. or Exiguobacterium sp. on sterile peat casing soil resulted in 64% increase in ABM mushroom total fresh matter yield compared to the uninoculated control. Inoculation of Exiguobacterium sp., Microbacterium esteraromaticum or Pseudomonas resinovorans on sterilized loamy casing soil resulted in 62, 95, and 59% increase in ABM mushroom total fresh matter yield, respectively. The PSPC content in ABM increased 7 to 10% in casing soil inoculated with five of the six isolates compared to the uninoculated control. Exiguobacterium sp. inoculated on casing soil resulted in a mushroom-polysaccharide content 15% higher than the control. Moreover, inoculation of five of the six isolates on the casing soil reduced the harvesting time from 10 to 27 days. The evaluated beneficial microbes improve the yield, PSPC, and polysaccharide contents, besides reducing the harvesting time in ABM culture.

Cultivable mushroom growth-promoting bacteria and their impact on Agaricus blazei productivity

The objective of this work was to identify growth-promoting bacteria isolated from Agaricus blazei and to evaluate their effect on mushroom mycelial growth and productivity. A total of 56 A. blazei-associated bacterial isolates were obtained from casing soil and identified by 16S rRNA gene sequencing. Bacteria were evaluated as to phosphate-solubilization ability, nitrogen-fixation capability, and secretion of cellulase. Superior isolates were tested for their to effect on A. blazei productivity, micelial growth, and on the contents of the polysaccharide-protein complex and of N, P, K, Ca, and Mg. Bacterial isolates were identified as actinobacteria (60%), firmicutes (20%), and proteobacteria (20%). Among them, ten isolates had phosphate-solubilization ability, eight showed nitrogen-fixation capability, and 12 isolates promoted A. blazei mycelium growth. Bacterial inoculation reduces time till harvest in up to 26 days, increases fresh mushroom yield up to 215%, and increases total polysaccharide-protein complex content twofold when compared to the non-inoculated control. The actinobacteria group is the predominant A. blazei-associated phylum.

In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis.

IMPORTANCE: There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE). OBJECTIVE: To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias. DESIGN, SETTING, AND PARTICIPANTS: Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum. INTERVENTIONS: Valve replacement during index hospitalization (early surgery) vs medical therapy. MAIN OUTCOMES AND MEASURES: In-hospital and 1-year mortality. RESULTS: Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21.2% vs 37.5%; P = .03). At 1-year follow-up, the reduced mortality with surgery was observed in the fourth (24.8% vs 42.9%; P = .007) and fifth (27.9% vs 50.0%; P = .007) quintiles of surgical propensity. CONCLUSIONS AND RELEVANCE: Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort. Further studies are needed to define the effect and timing of surgery in patients with PVE who have indications for surgery.

FTO genetic variants, dietary intake and body mass index: insights from 177,330 individuals.

FTO is the strongest known genetic susceptibility locus for obesity. Experimental studies in animals suggest the potential roles of FTO in regulating food intake. The interactive relation among FTO variants, dietary intake and body mass index (BMI) is complex and results from previous often small-scale studies in humans are highly inconsistent. We performed large-scale analyses based on data from 177,330 adults (154 439 Whites, 5776 African Americans and 17 115 Asians) from 40 studies to examine: (i) the association between the FTO-rs9939609 variant (or a proxy single-nucleotide polymorphism) and total energy and macronutrient intake and (ii) the interaction between the FTO variant and dietary intake on BMI. The minor allele (A-allele) of the FTO-rs9939609 variant was associated with higher BMI in Whites (effect per allele = 0.34 [0.31, 0.37] kg/m(2), P = 1.9 × 10(-105)), and all participants (0.30 [0.30, 0.35] kg/m(2), P = 3.6 × 10(-107)). The BMI-increasing allele of the FTO variant showed a significant association with higher dietary protein intake (effect per allele = 0.08 [0.06, 0.10] %, P = 2.4 × 10(-16)), and relative weak associations with lower total energy intake (-6.4 [-10.1, -2.6] kcal/day, P = 0.001) and lower dietary carbohydrate intake (-0.07 [-0.11, -0.02] %, P = 0.004). The associations with protein (P = 7.5 × 10(-9)) and total energy (P = 0.002) were attenuated but remained significant after adjustment for BMI. We did not find significant interactions between the FTO variant and dietary intake of total energy, protein, carbohydrate or fat on BMI. Our findings suggest a positive association between the BMI-increasing allele of FTO variant and higher dietary protein intake and offer insight into potential link between FTO, dietary protein intake and adiposity.

Caracterização físico-morfológica de frutos de microtangerinas (Citrus spp.) de potencial utilização como porta-enxertos

O presente trabalho objetivou caracterizar espécies e variedades de Citrus do grupo das microtangerinas de valor potencial como porta-enxertos, de modo a propiciar maior conhecimento desse grupo de plantas e oferecer subsídios para futuras pesquisas. Um total de 14 variedades/clones foram descritas, incluindo as seguintes espécies: C. reshni Hort. ex Tan., C. sunki Hort. ex Tan, C. pectinifera Tan., C. crenatifolia Lush., C. amblycarpa Och., C. tachibana Tan., C. lycopersicaeformis Hort. ex Tan., C. keraji Hort. ex Tan. e C. reticulata Blanco. A pesquisa foi conduzida no Departamento de Horticultura da FCA-Unesp, Botucatu-SP e os frutos foram obtidos dos BAGs de Citros da FCA-Unesp-SP, e do CCSM-IAC, Cordeirópolis-SP. Descritores físicos e morfológicos de frutos indicaram diferenças entre espécies/variedades. As microtangerinas apresentaram características semelhantes quanto ao pequeno tamanho dos frutos, forma oblata e coloração laranja dos frutos. C. amblycarpa, C. sunki e C. tachibana produziram os frutos de menor tamanho e espessura de casca. Elevado número de sementes por fruto foi encontado nas tangerinas 'Cleópatra', 'Sun Chu Sha Kat', 'Suen Kat' e 'Heennaran', enquanto 'Sunki' apresentou elevado número de sementes abortadas. Parece discutível a posição botânica de 'Suen Kat', ao que se propõe considerar a mesma como uma variedade de C. sunki.

Produtividade e qualidade dos frutos da laranjeira 'Pêra' clone IAC em 16 porta-enxertos na região de Bebedouro-SP

Avaliou-se a influência de 16 porta-enxertos na produtividade, nas características físicas e químicas (sólidos solúveis totais-°Brix; acidez; ratio; porcentagem de suco; índice tecnológico e tamanho dos frutos) dos frutos da laranjeira 'Pêra' [Citrus sinensis (L.) Osbeck] e na incidência e severidade da clorose variegada dos citros (CVC). O plantio do experimento foi realizado em julho de 1993, com espaçamento de 6,0 m entre linhas e 3,5 m entre plantas (476 plantas/ha). O experimento foi conduzido sem irrigação. O delineamento experimental foi em blocos ao acaso, duas plantas por parcela, três repetições e 16 tratamentos, constituídos pelas seguintes cultivares porta-enxertos: tangerineira 'Sun Chu Sha Kat' (Citrus reticulata Blanco), tangerineira 'Pectinífera' (C. reticulata), 'Shekwasha' (C. depressa Hayata), tangerineira 'Pectinífera/Shekwasha' (C. depressa Hayata), tangerineira 'Batangas' (C. reticulata), tangerineira 'Oneco' (C. reticulata), citrangor [citrange (Poncirus trifoliata Raf. x C. sinensis) x C. sinensis], citrandarin [C.sunki hort. Ex Tanaka) x Poncirus trifoliata (L.) Raf. cv. English, tangerineira 'Sunki' (C. sunki), tangerineira 'Suen-Kat' (C. sunki), tangerineira 'Nasnaran' (C. amblycarpa Ochse), tangerineira 'Venezuela' (C. reticulata), tangerineira Heen Naran (C. lycopersicaeformis hort. ex Tan. ), limoeiro 'Cravo' (C. limonia Osbeck) x tangerineira 'Cleópatra' (C. reshni hort ex Tanaka), limoeiro 'Cravo' (C. limonia), tangerineira 'Cleópatra' (C. reshni). A intensidade da clorose variegada dos citros variou em função dos porta-enxertos e não se relacionou com a produção de frutos até a quarta safra. Os porta-enxertos estudados, com exceção da tangerineira Nasnaran, proporcionaram qualidade e produções iniciais de frutos similares aos do limoeiro 'Cravo'.

Fruit quality of 'Tahiti' lime (Citrus latifolia Tanak) grafted on twelve different rootstocks

In the present work, the effect of twelve rootstocks on fruit quality of the nucellar clone IAC-5 of 'Tahiti' lime, (Citrus latifolia Tanaka) and the influence of fruit position on tree in fruit quality was evaluated in the Citrus Experimental Station of Bebedouro (EECB), located in the Bebedouro county, state of São Paulo, Brazil. A 8.0 x 5.0m planting frame was utilized. The evaluated rootstocks were: 'Carrizo' citrange (C. sinensis (L.) Osbeck x Poncirus trifoliata (L.) Raf.); the hybrids 'Rangpur' lime x 'Swingle' citrumello (C. limonia Osbeck x P. trifoliata Raf) and 'Changsha' x 'English Small'(C. sunki Hort. ex Tan. x P. trifoliata Raf.); the mandarins 'Sun Chu Sha Kat' (C. reticulata Blanco) and 'Sunki' (C. sunki Hort. ex Tanaka); the 'Rangpur' limes 'Cravo Limeira' and ' Cravo FCAV' (C. limonia Osbeck); the 'Swingle' citrumello (P. trifoliata Raf. x C. paradisi Macf.); the 'Orlando' tangelo (C. reticulata Blanco x C. paradisi Macf.) and the trifoliates cvs. 'Rubidoux', 'FCAV' and 'Flying Dragon' (P. trifoliata Raf.). The experiment was arranged in a randomized block design, with twelve treatments, six replicates and one plant per plot. The rootstocks induced differences in fruit quality; however, all the evaluated quality characteristics were within the values considered as normal and acceptable for the variety, constituting good alternative rootstocks for the 'Rangpur' lime. Additionally, the fruit position in the plant (northeastern or southwestern) had a significant influence on the external fruit color regardless of the rootstock.

A systems view of risk factors for knee osteoarthritis reveals insights into the pathogenesis of the disease.

Early detection of osteoarthritis (OA) remains a critical yet unsolved multifaceted problem. To address the multifaceted nature of OA a systems model was developed to consolidate a number of observations on the biological, mechanical and structural components of OA and identify features common to the primary risk factors for OA (aging, obesity and joint trauma) that are present prior to the development of clinical OA. This analysis supports a unified view of the pathogenesis of OA such that the risk for developing OA emerges when one of the components of the disease (e.g., mechanical) becomes abnormal, and it is the interaction with the other components (e.g., biological and/or structural) that influences the ultimate convergence to cartilage breakdown and progression to clinical OA. The model, applied in a stimulus-response format, demonstrated that a mechanical stimulus at baseline can enhance the sensitivity of a biomarker to predict cartilage thinning in a 5 year follow-up in patients with knee OA. The systems approach provides new insight into the pathogenesis of the disease and offers the basis for developing multidisciplinary studies to address early detection and treatment at a stage in the disease where disease modification has the greatest potential for a successful outcome.

Genome-wide association study of kidney function decline in individuals of European descent.

Genome-wide association studies (GWASs) have identified multiple loci associated with cross-sectional eGFR, but a systematic genetic analysis of kidney function decline over time is missing. Here we conducted a GWAS meta-analysis among 63,558 participants of European descent, initially from 16 cohorts with serial kidney function measurements within the CKDGen Consortium, followed by independent replication among additional participants from 13 cohorts. In stage 1 GWAS meta-analysis, single-nucleotide polymorphisms (SNPs) at MEOX2, GALNT11, IL1RAP, NPPA, HPCAL1, and CDH23 showed the strongest associations for at least one trait, in addition to the known UMOD locus, which showed genome-wide significance with an annual change in eGFR. In stage 2 meta-analysis, the significant association at UMOD was replicated. Associations at GALNT11 with Rapid Decline (annual eGFR decline of 3 ml/min per 1.73 m(2) or more), and CDH23 with eGFR change among those with CKD showed significant suggestive evidence of replication. Combined stage 1 and 2 meta-analyses showed significance for UMOD, GALNT11, and CDH23. Morpholino knockdowns of galnt11 and cdh23 in zebrafish embryos each had signs of severe edema 72 h after gentamicin treatment compared with controls, but no gross morphological renal abnormalities before gentamicin administration. Thus, our results suggest a role in the deterioration of kidney function for the loci GALNT11 and CDH23, and show that the UMOD locus is significantly associated with kidney function decline.Kidney International advance online publication, 10 December 2014; doi:10.1038/ki.2014.361.

The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study.

Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age- and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to ~2.8M SNPs with BMI and WHRadjBMI in four strata (men &#8804;50y, men >50y, women &#8804;50y, women >50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR<5%) age-specific effects, of which 11 had larger effects in younger (<50y) than in older adults (&#8805;50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may provide further insights into the biology that underlies weight change with age or the sexually dimorphism of body shape.

Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the International Collaboration of Endocarditis-Prospective Cohort Study.

BACKGROUND: The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. METHODS: Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. RESULTS: EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). CONCLUSIONS: In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.

L'insatisfaction des besoins en soins de support chez les patients atteints d'un cancer du poumon en fonction du genre, de l'âge et du tabagisme : étude descriptive corrélationnelle transversale

Les patients atteints d'un cancer du poumon souffrent de différents troubles physiques et psychosociaux sévères causés par la maladie et son traitement. Ces troubles engendrent plusieurs besoins en soins de support chez les patients. Afin de satisfaire leurs besoins et de leur offrir la meilleure qualité de soins possible, l'identification des besoins en soins de support des patients devient primordiale. But : Le but de l'étude est, dans un premier temps, d'identifier et de décrire les besoins insatisfaits en soins de support pour les patients souffrant d'un cancer du poumon pendant la phase de chimiothérapie dans un Centre Hospitalier Universitaire en Suisse (CHU). Dans un second temps, le but de l'étude est également d'explorer l'éventuelle existence de différences quant au degré d'insatisfaction, tel qu'exprimé par les patients, notamment en fonction de l'âge, du genre et du tabagisme des patients. Cadre théorique : La présente étude se base sur la théorie du déficit d'auto-soin de Dorothea Orem. Méthode : Le travail de recherche s'est basé sur un devis descriptif corrélationnel transversal. L'échantillon, composé de 26 patients atteints d'un cancer du poumon, a été recruté selon la méthode non probabiliste accidentelle dans le service d'oncologie ambulatoire du CHU. Le recueil des données a été effectué à travers deux questionnaires auto-administrés aux patients (Supportive Care Needs Survey Short Form 34 et un questionnaire socio-démographique). Les données médicales ont été recueillies par l'étudiant chercheur à travers la consultation des dossiers médicaux. Résultats : Les résultats montrent que les besoins les plus insatisfaits chez les patients se regroupent surtout autour des besoins liés aux aspects psychologiques et physiques/vie quotidienne. Les patients expriment aussi un degré d'insatisfaction par rapport aux besoins en information ainsi qu'aux soins et au soutien prodigués par les soignants. Les deux besoins le plus fréquemment (65,38 %) exprimés comme insatisfaits par les patients ont été : « être informé de ce que vous pouvez faire vous-même pour aller mieux » et « l'incertitude face à l'avenir ». Les différences des degrés d'insatisfaction, tel qu'exprimés par les patients, en fonction de l'âge, du genre du tabagisme ont permis de poser des hypothèses quant aux relations entre ces variables et le degré d'insatisfaction : les femmes seraient plus insatisfaites de toutes les dimensions liées aux besoins en soins de support ; les patients d'âge égal ou supérieur à 65 ans seraient plus insatisfaits quant aux besoins physiques/vie quotidienne, psychologiques et de soutien; les patients d'âge inférieur à 65 ans seraient plus insatisfaits quant aux besoins liés à la sexualité; les non-fumeurs avant le diagnostic seraient plus insatisfaits quant aux besoins physiques/vie quotidienne, d'information et sexuels ; les patients qui arrêtent de fumer après le diagnostic seraient plus insatisfaits quant aux besoins physique/vie quotidienne, psychologique et de soutien. Conclusion : Cette étude met en évidence le fait que, pendant la phase de chimiothérapie, les patients atteints d'un cancer du poumon expriment de l'insatisfaction par rapport à plusieurs besoins en soins de support. Afin d'améliorer la qualité des soins et de mieux répondre aux besoins des patients, les infirmières et les équipes interdisciplinaires présentes au sein des services d'oncologie du CHU sont appelés à prendre en considération l'insatisfaction exprimée par les patients.