ervations that RV function and RV and left ventricular volumes predict mortality, RV function and volumes also predict clinical worsening. This study provides a strong rationale for considering CMR as a clinically relevant endpoint for trials of PAH therapies.

The purpose of our study was to identify factors that predict 1-year incident hip and major osteoporotic non-hip fractures (ie, wrist, spine, pelvis, humerus) for home care recipients while accounting for the competing risk of death.

We conducted a retrospective cohort study with linked population data.

All home care recipients in Ontario, Canada, receiving services for more than 6months with an admission assessment between April 1, 2011, and March 31, 2015, were included.

Clinical data from the Resident Assessment Instrument Home Care were linked to fracture data from the Discharge Abstract Database and the National Acute Care Reporting System. Competing risk proportional hazard regressions using the Fine and Grey method were performed to model the association between potential risk factors and fracture.

Previous fall, previous fracture, cognitive impairment, unsteady gait, alcohol use, tobacco use, and Parkinson disease were consistently associated with all fracture types. Cognitive impairment (haacture.

Describe how the availability of assisted living (AL) and dementia-specific AL vary across counties and correlate with demographic and socioeconomic characteristics.

Maps, univariate statistics, and standardized mean differences show the differences between counties with high and low levels of AL market penetration, and between counties with and without dementia-specific AL.

Data collected from state agencies on licensed AL communities, capacity, and geographic location, and population characteristics from the Area Health Resource file. We include novel and previously undescribed data on dementia-specific AL licenses in 21 states.

AL market penetration is reported as the number of AL units or beds per 1000 persons over age 65years in a county.

In comparison to counties with the lowest AL penetration, high-penetration counties had higher high school and college education attainment (mean 25.3% vs 18.5%) and median annual income ($56,000 vs $46,800), and lower poverty (12.8% vs 17.3%) and unemploymentthat Medicaid enrollees may be reluctant to move out of their neighborhoods.

Large socioeconomic disparities persist among counties without any AL or low penetration of AL in their borders in comparison to those with high AL penetration, as well as between counties with and without dementia-specific AL communities. There may be a mismatch in need and availability of residential care options for older adults with Alzheimer’s disease and related dementias that contributes to the disproportionate share of racial/ethnic minorities with dementia in nursing homes. Lack of available AL beds in the communities where Medicaid individuals reside could make rebalancing efforts doubly difficult, in that Medicaid enrollees may be reluctant to move out of their neighborhoods.

Hospitalizations are common among long-stay nursing home (NH) residents, but the role of rurality in hospitalization is understudied. This study examines the relationships between rurality, NH, and market characteristics and NH quarterly risk-adjusted hospitalization rates of long-stay residents over 10 quarters (2011 Q2-2013 Q3).

The longitudinal associations of NH and market factors and hospitalization rates were modeled separately on urban, micropolitan, and rural NHs using generalized estimating equation models and a fully interacted model of all NH and market characteristics with micropolitan and rural indicators to test significance of differences compared with urban NHs.

In total, 14,600 unique NHs.

Risk-adjusted hospitalization rates were calculated from 2011 to 2013 national Medicare claims and NH Minimum Data Set 3.0. see more Rurality was defined based on the 2010 Rural Urban Commuting Area codes. NH and market characteristics were extracted from Certification and Survey Provider Enhanced Reporting talization should target factors unique to micropolitan/rural NHs which adopt strategies appropriate to their setting.

Rurality is not associated with hospitalization rates of long-stay residents, but NH and market factors (eg, payer distribution, staffing, and population income) may affect hospitalization differently in micropolitan/rural NHs than urban NHs. Future intervention on hospitalization should target factors unique to micropolitan/rural NHs which adopt strategies appropriate to their setting.

Breast cancer survivors are at increased risk of developing unrelated primary cancers, particularly lung cancer. Evidence indicates that sex hormones as well as a deregulation of DNA-repair pathways may contribute to lung cancer onset. We investigated whether the hormone status and expression of markers involved in DNA repair (BRCA1/2, ERCC1, and P53R2), synthesis (TS and RRM1), and cell division (TUBB3) might be linked to lung cancer risk.

Thirty-seven breast cancer survivors with unrelated lung cancer and 84 control subjects comprising women with breast cancer (42/84) or lung cancer (42/84) were enrolled. Immunohistochemistry on tumor tissue was performed. Geometric mean ratio was used to assess the association of marker levels with patient groups.

Estrogen receptor was expressed in approximately 90% of the breast cancer group but was negative in the majority of the lung cancer group, a result similar to the lung cancer control group. Likewise, ER isoform β was weakly expressed in the lung cancer group. Protein analysis of breast cancer versus control had a significantly lower expression of BRCA1, P53R2, and TUBB3. Likewise, a BRCA1 reduction was observed in the lung cancer group concomitant with a BRCA2 increase. Furthermore, BRCA2 and TUBB3 increased in ipsilateral lung cancer in women who had previously received radiotherapy for breast cancer.

The decrease of DNA-repair proteins in breast cancer could make these women more susceptible to therapy-related cancer. The increase of BRCA2 and TUBB3 in lung cancer from patients who previously received radiotherapy for breast cancer might reflect a tissue response to exposure to ionizing radiation.

The decrease of DNA-repair proteins in breast cancer could make these women more susceptible to therapy-related cancer. The increase of BRCA2 and TUBB3 in lung cancer from patients who previously received radiotherapy for breast cancer might reflect a tissue response to exposure to ionizing radiation.