Sarcopenia during neoadjuvant therapy for oesophageal cancer: characterising the impact on muscle strength and physical performance

Purpose Preoperative chemo(radio)therapy for oesophageal cancer (OC) may have an attritional impact on body composition and functional status, impacting postoperative outcome. Physical decline with skeletal muscle loss has not been previously characterised in OC and may be amenable to physical rehabilitation. This study characterises skeletal muscle mass and physical performance from diagnosis to post-neoadjuvant therapy in patients undergoing preoperative chemo(radio)therapy for OC. Methods Measures of body composition (axial computerised tomography), muscle strength (handgrip), functional capacity (walking distance), anthropometry (weight, height and waist circumference), physical activity, quality-of-life and nutritional status were captured prospectively. Sarcopenia status was defined as pre-sarcopenic (low muscle mass only), sarcopenic (low muscle mass and low muscle strength or function) or severely sarcopenic (low muscle mass and low muscle strength and low muscle function). Results Twenty-eight participants were studied at both time points (mean age 62.86 ± 8.18 years, n = 23 male). Lean body mass reduced by 4.9 (95% confidence interval 3.2 to 6.7) kg and mean grip strength reduced by 4.3 (2.5 to 6.1) kg from pre- to postneoadjuvant therapy. Quality-of-life scores capturing gastrointestinal symptoms improved. Measures of anthropometry, walking distance, physical activity and nutritional status did not change. There was an increase in sarcopenic status from diagnosis (presarcopenic n=2) to post-treatment (pre-sarcopenic n = 5, severely sarcopenic n = 1). Conclusions Despite maintenance of body weight, functional capacity and activity habits, participants experience declines in muscle mass and strength. Interventions involving exercise and/or nutritional support to build muscle mass and strength during preoperative therapy, even in patients who are functioning normally, are warranted

Measuring the Impact of Oesophagectomy on Physical Functioning and Physical Activity Participation: a Prospective Study

Background: Oesophagectomy remains the only curative intervention for oesophageal cancer, with defined nutritional and health-related quality of life (HR-QOL) consequences. It follows therefore that there is a significant risk of decline in physical wellbeing with oesophagectomy however this has been inadequately quantified. This study prospectively examines change in physical functioning and habitual physical activity participation, from presurgery through 6-months post-oesophagectomy. Methods: Patients scheduled for oesophagectomy with curative intent were recruited. Key domains of physical functioning including exercise tolerance (six-minute walk test (6MWT)) and muscle strength (hand-grip strength), and habitual physical activity participation, including sedentary behaviour (accelerometry) were measured presurgery (T0) and repeated at 1-month (T1) and 6-months (T2) post-surgery. HR-QOL was measured using the EORTC-QOL C30. Results: Thirty-six participants were studied (mean age 62.4 (8.8) years, n = 26 male, n = 26 transthoracic oesophagectomy). Mean 6MWT distance decreased significantly from T0 to T1 (p = 0.006) and returned to T0 levels between T1 and T2 (p \u3c 0.001). Percentage time spent sedentary increased throughout recovery (p \u3c 0.001) and remained significantly higher at T2 in comparison to T0 (p = 0.003). In contrast, percentage time spent engaged in either light or moderate-to-vigorous intensity activity, all reduced significantly (p \u3c 0.001 for both) and remained significantly lower at T2 in comparison to T0 (p = 0.009 and p = 0.01 respectively). Patients reported deficits in multiple domains of HR-QOL during recovery including global health status (p = 0.04), physical functioning (p \u3c 0.001) and role functioning (p \u3c 0.001). Role functioning remained a clinically important 33-points lower than preoperative values at T2. Conclusion: Habitual physical activity participation remains significantly impaired at 6-months postoesophagectomy. Physical activity is a measurable and modifiable target for physical rehabilitation, which is closely aligned with patient-reported deficits in role functioning. Rehabilitation aimed at optimising physical health in oesophageal cancer survivorship is warranted

Vortex Solid-Liquid Transition in Bi2_{2}Sr2_{2}CaCu2_{2}O8+δ_{8+\delta} with a High Density of Strong Pins

The introduction of a large density of columnar defects in %underdoped Bi$_{2}$Sr$_{2}$CaCu$_{2}$O$_{8+\delta}$ crystals does not, at sufficiently low vortex densities, increase the irreversibility line beyond the first order transition (FOT) field of pristine crystals. At such low fields, the flux line wandering length $r_{w}$ behaves as in pristine %Bi$_{2}$Sr$_{2}$CaCu$_{2}$O$_{8+\delta}$ crystals. Next, vortex positional correlations along the $c$--axis in the vortex Bose glass at fields above the FOT are smaller than in the low--field vortex solid. Third, the Bose-glass-to-vortex liquid transition is signaled by a rapid decrease in c-axis phase correlations. These observations are understood in terms of the ``discrete superconductor'' model.Comment: 4 pages, 4 figures Submitted to Phys. Rev. B Rapid Comm. 16-1-2004 Revised version 18-3-200

Large-scale collective motion of RFGC galaxies

We processed the data about radial velocities and HI linewidths for 1678 flat edge-on spirals from the Revised Flat Galaxy Catalogue. We obtained the parameters of the multipole components of large-scale velocity field of collective non-Hubble galaxy motion as well as the parameters of the generalized Tully-Fisher relationship in the "HI line width - linear diameter" version. All the calculations were performed independently in the framework of three models, where the multipole decomposition of the galaxy velocity field was limited to a dipole, quadrupole and octopole terms respectively. We showed that both the quadrupole and the octopole components are statistically significant. On the basis of the compiled list of peculiar velocities of 1623 galaxies we obtained the estimations of cosmological parameters Omega_m and sigma_8. This estimation is obtained in both graphical form and as a constraint of the value S_8=sigma_8(Omega_m/0.3)^0.35 = 0.91 +/- 0.05.Comment: Accepted for publication in Astrophysics and Space Scienc

Minimal configurations and sandpile measures

We give a new simple construction of the sandpile measure on an infinite graph G, under the sole assumption that each tree in the Wired Uniform Spanning Forest on G has one end almost surely. For, the so called, generalized minimal configurations the limiting probability on G exists even without this assumption. We also give determinantal formulas for minimal configurations on general graphs in terms of the transfer current matrix.Comment: 16 pages; the introduction has been expanded and minor corrections have been mad

Decoupling and decommensuration in layered superconductors with columnar defects

We consider layered superconductors with a flux lattice perpendicular to the layers and random columnar defects parallel to the magnetic field B. We show that the decoupling transition temperature Td, at which the Josephson coupling vanishes, is enhanced by columnar defects by an amount ~B^2 relative to Td. Decoupling by increasing field can be followed by a reentrant recoupling transition for strong disorder. We also consider a commensurate component of the columnar density and show that its pinning potential is renormalized to zero above a critical long wavelength disorder. This decommnesuration transition may account for a recently observed kink in the melting line.Comment: 5 pages, Revte

Changing consumption of resources for respiratory support and short-term outcomes in four consecutive geographical cohorts of infants born extremely preterm over 25 years since the early 1990s

OBJECTIVES:It is unclear how newer methods of respiratory support for infants born extremely preterm (EP; 22-27 weeks gestation) have affected in-hospital sequelae. We aimed to determine changes in respiratory support, survival and morbidity in EP infants since the early 1990s. DESIGN:Prospective longitudinal cohort study. SETTING:The State of Victoria, Australia. PARTICIPANTS:All EP births offered intensive care in four discrete eras (1991-1992 (24 months): n=332, 1997 (12 months): n=190, 2005 (12 months): n=229, and April 2016-March 2017 (12 months): n=250). OUTCOME MEASURES:Consumption of respiratory support, survival and morbidity to discharge home. Cost-effectiveness ratios describing the average additional days of respiratory support associated per additional survivor were calculated. RESULTS:Median duration of any respiratory support increased from 22 days (1991-1992) to 66 days (2016-2017). The increase occurred in non-invasive respiratory support (2 days (1991-1992) to 51 days (2016-2017)), with high-flow nasal cannulae, unavailable in earlier cohorts, comprising almost one-half of the duration in 2016-2017. Survival to discharge home increased (68% (1991-1992) to 87% (2016-2017)). Cystic periventricular leukomalacia decreased (6.3% (1991-1992) to 1.2% (2016-2017)), whereas retinopathy of prematurity requiring treatment increased (4.0% (1991-1992) to 10.0% (2016-2017)). The average additional costs associated with one additional infant surviving in 2016-2017 were 200 (95% CI 150 to 297) days, 326 (183 to 1127) days and 130 (70 to 267) days compared with 1991-1992, 1997 and 2005, respectively. CONCLUSIONS:Consumption of resources for respiratory support has escalated with improved survival over time. Cystic periventricular leukomalacia reduced in incidence but retinopathy of prematurity requiring treatment increased. How these changes translate into long-term respiratory or neurological function remains to be determined.Jeanie L Y Cheong, Joy E Olsen, Li Huang, Kim M Dalziel, Rosemarie A Boland, Alice C Burnett ... et al

Search for lepton-flavor violation at HERA

A search for lepton-flavor-violating interactions $e p \to \mu X$ and $e p\to \tau X$ has been performed with the ZEUS detector using the entire HERA I data sample, corresponding to an integrated luminosity of 130 pb^{-1}. The data were taken at center-of-mass energies, $\sqrt{s}$, of 300 and 318 GeV. No evidence of lepton-flavor violation was found, and constraints were derived on leptoquarks (LQs) that could mediate such interactions. For LQ masses below $\sqrt{s}$, limits were set on $\lambda_{eq_1} \sqrt{\beta_{\ell q}}$, where $\lambda_{eq_1}$ is the coupling of the LQ to an electron and a first-generation quark $q_1$, and $\beta_{\ell q}$ is the branching ratio of the LQ to the final-state lepton $\ell$ ($\mu$ or $\tau$) and a quark $q$. For LQ masses much larger than $\sqrt{s}$, limits were set on the four-fermion interaction term $\lambda_{e q_\alpha} \lambda_{\ell q_\beta} / M_{\mathrm{LQ}}^2$ for LQs that couple to an electron and a quark $q_\alpha$ and to a lepton $\ell$ and a quark $q_\beta$, where $\alpha$ and $\beta$ are quark generation indices. Some of the limits are also applicable to lepton-flavor-violating processes mediated by squarks in $R$-Parity-violating supersymmetric models. In some cases, especially when a higher-generation quark is involved and for the process $e p\to \tau X$, the ZEUS limits are the most stringent to date.Comment: 37 pages, 10 figures, Accepted by EPJC. References and 1 figure (Fig. 6) adde

Multijet production in neutral current deep inelastic scattering at HERA and determination of alpha_s

Multijet production rates in neutral current deep inelastic scattering have been measured in the range of exchanged boson virtualities 10 < Q2 < 5000 GeV2. The data were taken at the ep collider HERA with centre-of-mass energy sqrt(s) = 318 GeV using the ZEUS detector and correspond to an integrated luminosity of 82.2 pb-1. Jets were identified in the Breit frame using the k_T cluster algorithm in the longitudinally invariant inclusive mode. Measurements of differential dijet and trijet cross sections are presented as functions of jet transverse energy E_{T,B}{jet}, pseudorapidity eta_{LAB}{jet} and Q2 with E_{T,B}{jet} > 5 GeV and -1 < eta_{LAB}{jet} < 2.5. Next-to-leading-order QCD calculations describe the data well. The value of the strong coupling constant alpha_s(M_Z), determined from the ratio of the trijet to dijet cross sections, is alpha_s(M_Z) = 0.1179 pm 0.0013(stat.) {+0.0028}_{-0.0046}(exp.) {+0.0064}_{-0.0046}(th.)Comment: 22 pages, 5 figure