Promoting Team-Based Exercise Among African American Breast Cancer Survivors

Physical activity benefits the health and well-being of breast cancer survivors (BCS). Yet, many African American survivors do not routinely exercise and have increased risk of poor outcomes. The purpose of this mixed-method study was to identify motivational factors compelling African American BCS to participate in a 14-week team walking program and to intend to continue exercise after the intervention concluded. Focus groups were held with participants (n = 12) before and after training. Content analysis discovered themes before the intervention: Not wanting to go at it alone, exercise not a life or treatment priority, cancer treatment affected activity, advocates to exercise, and can exercise really help? Four themes postintervention themes included: In the same boat, changed mind-set, improved weight and activity, and overcoming barriers. Physical data verified improvements. Results suggest that a team-based exercise training program may assist in overcoming a sedentary behavior tendency and subsequently improve health among survivors

Survivors Speak: A Qualitative Analysis of Motivational Factors Influencing Breast Cancer Survivors’ Participation in a Sprint Distance Triathlon

Aims and Objectives To examine motivational factors influencing breast cancer survivors to participate in triathlon training, complete a triathlon and maintain an exercise thereafter. Background Routine exercise has been shown to improve quality of life and reduce recurrence for breast cancer survivors. Yet physical and psychological factors present barriers for initiating and maintaining an exercise routine. Research is limited in exploring factors of exercise motivation from the survivor\u27s perspective. Design Qualitative design using focus groups and individual follow-up phone interviews to explore motivation for exercise initiation and maintenance. Methods One to two weeks after completing a triathlon, 11 breast cancer survivors who trained together participated in one of three focus groups to discuss their experience. Five months post triathlon 6 of the 11 participants were successfully contacted and phone interviews were conducted to explore exercise maintenance. Focus groups and interviews were analysed using content and thematic analysis. Results Five themes emerged (1) Champion for Exercise, (2) Part of a Team, (3) Everyone Had a Story, (4) Not Really Exercise and (5) What Do We Do Now? Overall, survivors recognised their need for lifestyle change (e.g. moving from a sedentary lifestyle to a more active one). More importantly, they identified the team approach to exercise initiation was crucial in their success in sustaining a behavioural change. Conclusions Emphasis needed on developing team exercise training programmes for survivors. Nurses can play a critical role in discussing with survivors, the benefits of exercise initiation and maintenance. Relevance to clinical practice Breast cancer survivors are hesitant to initiate routine exercise. Training with women who share a common lived experience increases the likelihood of success. Nurses are in a position to encourage breast cancer survivors to participate in group exercise programmes as a way to improve quality of life

A rank-3 network representation for single-affiliation systems

Single-affiliation systems are observed across nature and society. Examples include collaboration, organisational affiliations, and trade-blocs. The study of such systems is commonly approached through network analysis. Multilayer networks extend the representation of network analysis to include more information through increased dimensionality. Thus, they are able to more accurately represent the systems they are modelling. However, multilayer networks are often represented by rank-4 adjacency tensors, resulting in a N2M2 solution space. Single-affiliation systems are unable to occupy the full extent of this space leading to sparse data where it is difficult to attain statistical confidence through subsequent analysis. To overcome these limitations, this paper presents a rank-3 tensor representation for single-affiliation systems. The representations is able to maintain full information of single-affiliation networks in directionless networks, maintain near full information in directed networks, reduce the solution space it resides in (N2M) leading to statistically significant findings, and maintain the analytical capability of multilayer approaches. This is shown through a comparison of the rank-3 and rank-4 representations which is performed on two datasets: the University of Bath departmental journal co-authorship 2000-2017 and an Erdos-Renyi network with random single-affiliation. The results demonstrate that the structure of the network is maintained through both representations, while the rank-3 representation provides greater statistical confidence in node-based measures, and can readily show inter- and intra-affiliation dynamics.Comment: 17 pages, 11 figure

The costs of infection and resistance as determinants of West Nile virus susceptibility in Culex mosquitoes

<p>Abstract</p> <p>Background</p> <p>Understanding the phenotypic consequences of interactions between arthropod-borne viruses (arboviruses) and their mosquito hosts has direct implications for predicting the evolution of these relationships and the potential for changes in epidemiological patterns. Although arboviruses are generally not highly pathogenic to mosquitoes, pathology has at times been noted. Here, in order to evaluate the potential costs of <it>West Nile virus </it>(WNV) infection and resistance in a primary WNV vector, and to assess the extent to which virus-vector relationships are species-specific, we performed fitness studies with and without WNV exposure using a highly susceptible <it>Culex pipiens </it>mosquito colony. Specifically, we measured and compared survival, fecundity, and feeding rates in bloodfed mosquitoes that were (i) infected following WNV exposure (susceptible), (ii) uninfected following WNV exposure (resistant), or (iii) unexposed.</p> <p>Results</p> <p>In contrast to our previous findings with a relatively resistant <it>Cx. tarsalis </it>colony, WNV infection did not alter fecundity or blood-feeding behaviour of <it>Cx. pipiens</it>, yet results do indicate that resistance to infection is associated with a fitness cost in terms of mosquito survival.</p> <p>Conclusions</p> <p>The identification of species-specific differences provides an evolutionary explanation for variability in vector susceptibility to arboviruses and suggests that understanding the costs of infection and resistance are important factors in determining the potential competence of vector populations for arboviruses.</p

Zone-DR: Discovery Radiomics via Zone-level Deep Radiomic Sequencer Discovery for Zone-based Prostate Cancer Grading using Diffusion Weighted Imaging

Prostate cancer is the most commonly diagnosed cancer in men, however prognosis is relatively good given sufficiently early diagnosis. This motivates the need for fast and reliable prostate cancer&nbsp;grading. In this study, we investigate the efficacy of a discovery radiomics strategy for prostate zone-based cancer grading using a deep radiomic sequencer discovered from diffusion weighted imaging (DWI) data. More specifically, we propose Zone-DR, a discoveryradiomics approach based on zone-level deep radiomic sequencer discovery that discover radiomic feature directly from DWI data. Experimental results using 12, 466 pathology-verified zones obtainedfrom DWI data of 101 patients showed that the proposed Zone-DR approach achieved higher accuracy than a threshold-based approach for both ADC and CHB-DWI.&nbsp;Furthermore, the results also showed that the trade-off between sensitivity and specificity can be based approach and Zone-DR optimized based on the particular clinical scenario we wish to employ Zone-DR for, such as clinical screening versus surgical planning

The Price of Palliative Care: Towards a Complete Accounting of Costs and Benefits

The costs and benefits of hospice and palliative care have recently received attention for many compelling reasons. First, the cost of medical care over a lifetime is largely expended near the end-of-life. The impending demographic bulge of aging baby boomers will only heighten concerns about costs. Second, hospice and palliative care have been offered as potential vehicles for reducing late-in-life spending. Third, palliative care has gained legitimacy as a distinct medical specialty, having as it does a characteristic philosophy, specialized skill sets, and specific service delivery needs. This philosophy of care is consistent with and, to some degree, builds on the philosophy of care that geriatrics also promotes. In this article, currently accepted standards for cost-benefit analysis of health care interventions are outlined, and a framework to evaluate palliative care within these standards is provided. Recent publications on the economic implications of palliative care are reviewed, which are only the ‘‘tip of the iceberg’’ of the potential costs and benefits. Using this framework, the authors offer guidelines for performing comprehensive cost-benefit analyses of palliative care and conclude that many of the issues beneath the surface may be substantial and deserving of closer scrutiny. Methods for gathering relevant cost-benefit information are detailed, along with potential obstacles to implementation. This approach is applicable to palliative care in general, including palliative care for elders

The Business of Employing People with Disabilities: Four Case Studies

This exploratory study examines employer attitudes towards people with disabilities in the labor market. Through in-depth, semi-structured interviews with senior management, human resources staff, directors of diversity, and hiring managers at four corporations, it pinpoints reasons why businesses chose to hire people with disabilities, investigates the perceived benefits and barriers to hiring people with disabilities, and identifies strategies for successfully hiring and retaining workers with disabilities. It fills a gap in examining the attitudes and decision-making processes of U.S. companies that have been leaders in hiring people with disabilities, as well as delving into the special issues of small businesses that may lack exposure to disability employment. It closes with directions for future studies that could extend our understanding of employment of people with disabilities

The Price of Palliative Care: Towards a Complete Accounting of Costs and Benefits

The costs and benefits of hospice and palliative care have recently received attention for many compelling reasons. First, the cost of medical care over a lifetime is largely expended near the end-of-life. The impending demographic bulge of aging baby boomers will only heighten concerns about costs. Second, hospice and palliative care have been offered as potential vehicles for reducing late-in-life spending. Third, palliative care has gained legitimacy as a distinct medical specialty, having as it does a characteristic philosophy, specialized skill sets, and specific service delivery needs. This philosophy of care is consistent with and, to some degree, builds on the philosophy of care that geriatrics also promotes. In this article, currently accepted standards for cost-benefit analysis of health care interventions are outlined, and a framework to evaluate palliative care within these standards is provided. Recent publications on the economic implications of palliative care are reviewed, which are only the ‘‘tip of the iceberg’’ of the potential costs and benefits. Using this framework, the authors offer guidelines for performing comprehensive cost-benefit analyses of palliative care and conclude that many of the issues beneath the surface may be substantial and deserving of closer scrutiny. Methods for gathering relevant cost-benefit information are detailed, along with potential obstacles to implementation. This approach is applicable to palliative care in general, including palliative care for elders

Survivin as potential mediator to support autoreactive cell survival in myasthenia gravis: A human and animal model study

The mechanisms that underlie the development and maintenance of autoimmunity in myasthenia gravis are poorly understood. In this investigation, we evaluate the role of survivin, a member of the inhibitor of apoptosis protein family, in humans and in two animal models. We identified survivin expression in cells with B lymphocyte and plasma cells markers, and in the thymuses of patients with myasthenia gravis. A portion of survivin-expressing cells specifically bound a peptide derived from the alpha subunit of acetylcholine receptor indicating that they recognize the peptide. Thymuses of patients with myasthenia gravis had large numbers of survivin-positive cells with fewer cells in the thymuses of corticosteroid-treated patients. Application of a survivin vaccination strategy in mouse and rat models of myasthenia gravis demonstrated improved motor assessment, a reduction in acetylcholine receptor specific autoantibodies, and a retention of acetylcholine receptor at the neuromuscular junction, associated with marked reduction of survivin-expressing circulating CD20+ cells. These data strongly suggest that survivin expression in cells with lymphocyte and plasma cell markers occurs in patients with myasthenia gravis and in two animal models of myasthenia gravis. Survivin expression may be part of a mechanism that inhibits the apoptosis of autoreactive B cells in myasthenia gravis and other autoimmune disorders

A Comparative Study Between Apparent Diffusion Imaging and Correlated Diffusion Imaging for Prostate Cancer

Prostate cancer is the second most common cancer in men world-wide, with approximately 174,650 new cases diagnosed in 2019 inthe U.S. [1]. However, prognosis is relatively good given sufficientlyearly detection during the non-metastatic stage, motivating the needfor fast and reliable cancer screening methods. Diffusion weightedimaging is a magnetic resonance imaging technique that is gainingtraction as a noninvasive method for cancer screening. In 2013, anew form of diffusion weighted imaging called correlated diffusionimaging (CDI) was introduced as a potential candidate modality forbuilding computer-aided clinical decision support systems [2]. Weperform a large scale study, across 101 patient cases with full PI-RADS score and histopathology, to compare the performance ofcorrelated diffusion imaging in prostate cancer detection and localization to apparent diffusion coefficient maps, the most commonlyused diffusion weighted imaging-derived imaging modality in can-cer grading. Using threshold-based classification, experimental results showed that CDI achieves higher specificity at high sensitivityvalues of 90% and 95%, suggesting that CDI is well suited for scenarios where high sensitivity is crucial, such as cancer screening