Cindy Li - Three of a Kind #1

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Given that male pattern baldness is clinically observable decades earlier than prostate cancer, and that early-life sex steroid hormone levels may be more etiologically relevant for the devolvement of prostate cancer [ 27 ], male pattern baldness may serve as a potential non-invasive phenotypic attribute of long-term hormonal homeostasis.

Results from prior epidemiologic studies of associations between male pattern baldness and prostate cancer are inconclusive [ 8 , 28 - 42 ]. A majority of published studies have used a case-control study design, which relative to cohort studies, may heighten measurement errors due to increased recall time to age-specific hair-loss patterns as well as differential misclassification of exposure due to treatment-associated hair loss.

In addition, many of these studies have had a small or moderate number of cases for analysis, typically less than A recent meta-analysis of seven case-control studies [ 28 ] and two cohort studies [ 34 , 36 ] showed a positive association between male pattern baldness and prostate cancer risk.

However, this meta-analysis and the individual cohort study did not present subtype-specific analyses by aggressive prostate cancer, nor did they assess male pattern baldness at multiple ages with sufficient statistical power. To overcome the noted shortfalls, and attempt to replicate the prior association we obtained in our analysis of the PLCO Cancer Screening Trial, we assessed the relationship between male pattern baldness at age 30 years, age 45 years, and baseline in relation to the risks of overall and subtypes of prostate cancer in the VITamins And Lifestyle VITAL cohort study.

In brief, the VITAL cohort study was designed to investigate associations between supplement use and cancer risk among residents aged 50 to 76 years in the county area in western Washington State covered by the Surveillance, Epidemiology, and End Results SEER program cancer registry. During to , the baseline questionnaire was mailed to , men using a purchased commercial mailing list, with a reminder postcard sent two weeks later. Of these, 37, This resulted in a total of 32, men for analysis.

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Men completed a page self-administered baseline questionnaire covering demographics, diet, risk factors, medical history, and family history of cancer. For hair-loss patterns, men were asked to select among three sets of pictures Figure 1 that best described their hair-loss at age 30 years, age 45 years, and baseline. These three sets of pictures reflected different degrees of hair-loss: The test-retest reliability of self-reported hair-loss patterns was respectively estimated to be 0. We ascertained first primary incident cancers by annual linkage to the western Washington SEER program, as well as grade, stage, and other tumor characteristics.

The cancer registry ascertained cases through all area hospitals, state death certificates, and offices of pathologists, oncologists, and radiotherapists. Linkage is automatic for matches with high concordance, and is supplemented by visual inspections or follow-up phone calls for uncertain matches. Deaths occurring in the cohort were ascertained by linkage to the Washington state death file, using a similar linkage procedure as used for linkage to SEER. Pearson chi-square tests were used to compare categorical characteristics by male pattern baldness and by case status.

The Way Home

Spearman rank correlations were used to assess the correlation of male pattern baldness between the three time points. Follow-up of the analytic cohort started from age at baseline and continued until age at event i. For subtype-specific analyses, men who experienced a prostate cancer subtype that was not of interest were right-censored at the age of diagnosis.

We additionally adjusted for covariates that share potential pathophysiological pathway with prostate cancer i. In addition to the analysis of total incident prostate cancer, we conducted subtype-specific analyses by prostate cancer aggressiveness. In addition , we conducted sensitivity analyses: In order to evaluate more refined definitions of aggressive prostate cancer, we conducted sensitivity analyses in two sub-cohorts.

Given that Gleason patterns i. Five imputed datasets were created and analyzed individually. P -values were two-sided with 0. Correlations with hair-loss at baseline were 0. The median age at prostate cancer diagnosis was Baseline characteristics of the analytic cohort by case status and by male pattern baldness are presented in Table 1 and Supplemental table 1. Compared with non-prostate cancer participants, men with prostate cancer were more likely to be older, former smokers, married or cohabiting, have taken baby aspirin in the last ten years, have consumed more alcohol in the last year, and were less likely to be obese or have had other co-morbidities.

Furthermore, men with prostate cancer were more likely to have had a family history of prostate cancer, impotence in the last year, at least one PSA test in last two years, a history of benign prostate biopsy and benign prostatic hypoplasia. As shown in Table 2 , male pattern baldness at age 30 years, age 45 years, and baseline were not associated with total incident or subtypes of prostate cancer, each compared with little or no hair loss in unadjusted models.

Further adjustment in multivariable models did not substantially alter the HR estimates. Additional inclusion of covariates that may share physiopathologic pathways with prostate cancer, or that are related to prostate cancer detection, did not substantially alter the HR estimates data not shown. Sensitivity analyses with baseline hazard stratified by age at baseline, restricting the cohort to non-Hispanic whites, or restricting the cohort to men who had a PSA test within the two-year period prior to baseline did not substantially alter the HR estimates data not shown.

Sensitivity analysis stratified models by age at baseline suggested no significant interaction between classes of baldness and age at baseline for overall or subtypes of prostate cancer data not shown.

In this analysis, male pattern baldness at age 30 years, age 45 years, and baseline were not associated with overall prostate cancer risk or with aggressive prostate cancer, despite assessment of three different definitions for the latter endpoint. The classifications of aggressive and nonaggressive prostate cancer were similar in the analytic cohort and sub-cohort 1, despite use of different staging schemes. Nevertheless, we found similarly null associations in all three cohorts. Results from previous epidemiologic studies on the association of male pattern baldness with prostate cancer are inconclusive [ 8 , 29 - 42 ] due to different study designs, modest sample size, as well as different baldness measurements with respect to baldness classification, time window age and examination types trained observers versus self-report.

Four of such studies used self-reported baldness at younger ages with inconsistent results [ 29 , 30 , 39 , 41 ]. However, age-specific baldness in relation to prostate cancer risk was not presented in this meta-analysis due to lack of uniformity in ages assessed. Only one of these prior studies used the same balding classification as our study. The inverse relationship may be subject to potential recall and selection bias, as suggested by the authors [ 39 ].

A more recent case-control study in U. Cohort studies that have assessed male pattern baldness and prostate cancer risk are sparse but have suggested a positive association. However, the median of baseline age was about 55 years, when baldness was assessed, and therefore baldness at younger age was not evaluated with sufficient statistical power.

This study also suggested that vertex balding at 40 years was associated with an average three-year earlier age at prostate cancer diagnosis [ 36 ]. However, male pattern baldness was self-assessed after prostate cancer diagnosis, and men with aggressive prostate cancer were more likely to dropout from follow-up resulting in differentially missing self-reported hair-loss patterns. But this book was not about action and suspense, or even the steam that we've gotten in Gerard's previous books. And I did not mind one bit. What we did get was a wonderful and emotional story that I enjoyed from beginning to finish.

View all 20 comments. The set up It's been over three years since Jess Albert was widowed when her husband J. While she's moved on with her life, she hasn't done so romantically until Ty Brown suddenly showed up on her doorstep again. She hasn't seen him in the eighteen months since she helped him and his brother one night by supplying them with emergency weapons to take down a master criminal.

He promised to come back and see her but never contacted her again. He's there on a l The set up It's been over three years since Jess Albert was widowed when her husband J. He's there on a leap of faith that there may be something for the two of them to explore. The issues Meanwhile, as Jess and Ty move forward and deepen their relationship, a young Afghan woman, Rabia, finds an American soldier along the roadside who is severely injured.

She spends the next months nursing him back to health as he also struggles to remember who he is and his past.

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It is extremely dangerous for Rabia and her family as they can be executed by the Taliban for harboring and aiding an American. As Jess finally finds happiness after all this time, her husband is fighting to regain his health and memory and figure out a way home with Rabia's help. It is tragic and at the same time lovely to see them gather strength and deepen these relationships, knowing the heartaches destined ahead.

Jess is an incredible woman, self sufficient and independent.

Rabia has the same qualities and is even more courageous by being so in the midst of a war and the Taliban who consider women chattel. You want to root for all of them but a happy ending for all seems futile. There's a level of tension underlying the story, both romantic and dangerous as discovery by the Taliban is a constant threat and J. I had so many mixed emotions from start to end and I didn't want to ever walk away from the story. What was missing Absolutely nothing. The bottom line Loved the story, the characters and the writing.

There are no wasted words or imagery and I easily transitioned from the Afghan village to the Minnesota lakeside at will. I felt like I was witnessing the covert extraction operation, plugged into the action and communications. This is an exciting series and a must read. I received an ARC from Edelweiss View all 7 comments. Because of the cover, I almost passed this book.

Yes, there is a holiday vibe to it, but if you read the blurb, you are immediately struck by a heady dose of angst and heartbreak. I thought I was ready for this book. But I never expected it to touch me so deeply. Cindy Gerard is the master of Romantic Suspense. She simply excels when it comes to writing action-packed Because of the cover, I almost passed this book. She simply excels when it comes to writing action-packed scenes that are highly detailed and infused with passion and fun.

Well, there actually is a different vibe to it. There are highly detailed and often tragic scenes of the action, but Gerard also further explores the angst that has been so popular in stories today. Jess is a sweetheart heroine. Her husband was killed in Afghanistan four years ago. For too long, she hurt and I could understand her need to distance herself from that. Though cautious at first, their romance soon blooms into something magical under the gentle care of this alpha male.

In fact, he has no idea that he has a wife back home waiting for him. As Jeff recovers as much as a warrior can, he is aided by Rabia, an Afghani woman hiding from the Taliban. As you can expect, there is a ton of angst, but it makes this book so much more heartfelt and moving. I questioned how I would feel about the two couples: How would Gerard fit two romances in one book? Would it be potent enough? Would it be too much? Would I care about one couple more than the other?

Honestly, the whole thing exceeded my expectations. View all 4 comments. Finally decided that this snowy day in Oklahoma was the day to read Gerard's heartbreakingly beautiful story of the costs of war and the ravaging results on the human body and soul. I was entranced from start to finish with this bittersweet dual love story. The characters, both main and secondary, new and old, brought smiles as well as tears to my eyes. I love how CG brings each of her characters to life on the pages and leaves this reader feeling like I'm sitting right in the middle of the grou Finally decided that this snowy day in Oklahoma was the day to read Gerard's heartbreakingly beautiful story of the costs of war and the ravaging results on the human body and soul.

I love how CG brings each of her characters to life on the pages and leaves this reader feeling like I'm sitting right in the middle of the group.

Another wonderful and memorable story from one of my favorites! View all 3 comments. Jun 28, Dee rated it it was amazing Shelves: I am not ashamed to say I cried as this had some very sad and emotional parts but it also had love, it had understanding, but most of all it had a very happy ending! Several months later Ty goes back as he never forgot her and it seems she never forgot him, but she was scared to take the risk in h I am not ashamed to say I cried as this had some very sad and emotional parts but it also had love, it had understanding, but most of all it had a very happy ending!

Several months later Ty goes back as he never forgot her and it seems she never forgot him, but she was scared to take the risk in having a relationship with another military man as she had lost her husband in Afghanistan nearly four years ago. Eventually Ty wins her over and they fall in love and plan to marry, then they hear that her husband is alive after all. We do get to read some action but the focus of the story is on the love between the characters and the journey they have to travel in order to find their HEA. The journey of J. Ms Gerard is a fantastic writer and I would recommend her every time, she knows how to extract almost every single emotion from you as you are reading.

Her stories grip you from beginning to end and leave you wanting more….. View all 11 comments. Sep 26, Beth rated it it was amazing Shelves: The Way Home is a must read for the up coming holiday season! Wrapped in the cover of a sweet and tender romance you will also find an intense, pulse pounding, heart wrenching story that will stick with you long after you finish reading. Jess Albert is trying to make her way in the world after she is told her high school sweet heart and husband, Jeff, will never be coming home.

Jeff was killed in action. Now running her family store when Tyler Brown, former military hero, comes waltzing back into The Way Home is a must read for the up coming holiday season! Now running her family store when Tyler Brown, former military hero, comes waltzing back into her life. He's come to make his feeling for Jess known. Just when Jess finally accepts her life without Jeff and a future with Ty, Jeff is discovered alive and on the run from the Taliban.

This was such a surprising story of friendship and love. I did not anticipate the outcome. I found myself utterly and completely emotionally invested in these two individual stories that collide at the end. The Way Home is one of the most heart warming and exciting holiday story I've ever read. This book is set for publication October 29, One-Eyed Jacks Sequence in Series: Gallery Books Publication Date: October 29, ISBN Adult Find out more at: Cindy Gerard's Website Find this book on: View all 8 comments.

Sep 26, Mei rated it it was amazing Shelves: I received this book from Netgalley for my honest review. I simply love how Ms. Gerard writes her books! I have not enough words of prise to write for her! Here the focal point is the uselessness of the war. The utter destruction of everything that makes us human. The 4 MCs' stroies are intertwined tightly. One in the USA and one in Afghanistan. I love all four of them! Jess, the widow of a KIA soldier is sweet and lives an almost freezed life since her husband died, but I received this book from Netgalley for my honest review. Jess, the widow of a KIA soldier is sweet and lives an almost freezed life since her husband died, but is not bitter and angry at the whole world.

She knows that life must go on and when Ty comes into her life, she's ready to live again. Sweet, tender, wonderful Ty!!! So funny and so incredibly open to love.

The Adventures of Cindy Li

He knows that Jess is his from the start and he does everything to convince her in a very sweet way. I felt so sorry for him and all he suffered. And I felt deeply when he fall in love with Rabia because even if he knew he coudln't and shouldn't love her he just couldn't resist her and her heartfelt offer of tenderness and love in a place where almost all hope and humanity has died.

It was bitter-sweet and heart-wrenching. Rabia was great too for her selflessness and her honest desire to help Jeff. Her faith was pure and her heart was loving and nutruring. Gerard stories there's scorching heat, but here I felt a hear warming tenderness instead and it was sweet!

Also, the suspense was missing too. You know eveything that is happening to everybody, but this too was good! A great book that will speak to your heart! View all 12 comments. Jun 11, Sunny rated it it was amazing Shelves: Boy, she can tell a story! Sep 29, Jess rated it really liked it Shelves: Happily Ever After - Reads Blog rating: It was that moment when she met Tyler Brown and even with that quick meeting, she never got the man out of her head.

He managed to finally escape but is in no physical condition to do anything.

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He stays with Rabia for months, initially having no memory of who he is or what happened to him. Slowly the memories come back but only so far back as the explosion. She cares for him, helps him regain some of his strength and they become closer over the weeks as his memory starts to come to him in bits and pieces. I love these guys so much, anytime they show up for a mission, I get giddy with excitement. They make up the team that goes out to rescue Jeff and secure Rabia and her father, taking them to safety as well.

Not all goes smoothly, of course, and we get to see Crystal and B. Gerard is an author whose stories I always have an easy time falling into and thoroughly enjoying and The Way Home is no exception. I loved Tyler to pieces and his relationship was Jess was full of heart, heat and love.

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I was also satisfied with the relationship between Jeff and Jess and where their lives take them post-rescue. You can never go wrong with a story in the Black Ops world and I enjoyed the romances for these two different couples, very much. Sep 15, Jacqueline rated it liked it Shelves: I enjoyed this book but I didn't love it. There were two romances here and I didn't think the author did either of them justice.

It seemed to me that the only person I really knew well was the husband being held prisoner in Afghanistan. I just don't think there was time to develop the four people involved enough to really get the reader involved. It wasn't as poignant as it could have been since you knew from the start what the outcome would be.

The author made a choice that for me negates the a I enjoyed this book but I didn't love it. The author made a choice that for me negates the angst and drama in a big way. It would have been a much more powerful story if she had really still loved him not just felt obligated with a lingering fondness for her childhood sweetheart.

Okay I can live with that sorta. But then she dies and he says what the heck let's go see if that other girl is the love of my life. That feels like a lame way to give them something in common and doesn't really give me much respect for the hero. I thing it's worth reading especially for a fan but I would have preferred either a longer book or two closely allied books. Still looking forward to CG's next book because I generally enjoy them very much. Jun 29, Michelle the Romance Witch rated it it was amazing Shelves: When I began this story I had an idea that things would be different than normal, but I never expected just how heartwarming and heart-wrenching this story would be by turns.

I cried often seeing all the trauma and fears that the two couples had to overcome.

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Circumstances and their own decisions led both couples to make unexpected decisions, but in the end everyone found their happiness and were able to embrace this new idea of their new family. Jess, Ty, Rabia, and Jeffery were all wonderful ch When I began this story I had an idea that things would be different than normal, but I never expected just how heartwarming and heart-wrenching this story would be by turns. Jess, Ty, Rabia, and Jeffery were all wonderful characters, full of depth, intensity, and all the emotional confusion that lead both couples to find their bliss in unexpected ways.

It was great to get to see some of the characters from previous books and catch up with them, but the beauty of this story was definitely in the emotions between these couples. The best lesson we can take from this story is that love can come in many forms and at any time, if only we open ourselves to the emotions and embrace those that would offer the chance at love. Gerard for one of the best stories of the year, but you owe me a few boxes of tissues now. Nov 05, Cheri rated it liked it.

Not as good as her Ops series. I liked Ty from that series and his brother Mike but this book was to slow for me. Not enough action or an intense plot. This was the hardest book I have ever read in my life, which makes this author amazing! Knowing the whole time what's going to happen, makes it worse! It is so sad at t This was the hardest book I have ever read in my life, which makes this author amazing!

Thank God it all worked out in the end, because I would have thrown my kindle across the room if it didn't I have gone to a few different club meetings, so I have a sense of which ones I want to involve myself in, based on my interests and the overall vibe of the environment. Moreover, through these activities, I can create connections and form friendships.

Community service and volunteering are important because you are working to help others. It is nice and rewarding when you benefit others and not just yourself. The Honors Program promotes this service and requires that we complete at least 15 hours of community service per year and attend one cultural event per semester. I think that this will encourage us to be more active and more involved within our community. In addition, it would help us to become more well-rounded individuals. Therefore, these requirements help push us to find something outside of schoolwork that we would find enjoyable and worthwhile.

There is more to experience in college life than strictly studying academically. It is critical to understand that our service and involvement in our community are also a part of who we are. I am currently still 17 years old at the time of this post. Growing up in a suburban neighborhood, I have always yearned to explore and experience the city life.

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