Rising to the challenge: designing, implementing and reporting exercise oncology trials in understudied populations

This is an accepted manuscript of an article published by Springer Nature in British Journal of Cancer on 21/05/2020, available online: https://doi.org/10.1038/s41416-020-0868-9 The accepted version of the publication may differ from the final published version.© 2020, Cancer Research UK. Exercise can improve cancer-related fatigue, quality of life and physical fitness, but is understudied in less common cancers such as multiple myeloma. Studying less common cancers and the adoption of novel study designs and open-science practices would improve the generalisability, transparency, rigour, credibility and reproducibility of exercise oncology research.Published versio

Nonlinear internal waves over New Jersey's continental shelf

Author Posting. © American Geophysical Union, 2011. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 116 (2011): C03022, doi:10.1029/2010JC006332.Ship and mooring data collected off the coast of New Jersey are used to describe the nonlinear internal wave (NLIW) field and the background oceanographic conditions that formed the waveguide on the shelf. The subinertial, inertial, and tidal circulation are described in detail, and the background fluid state is characterized using the coefficients of the extended Korteweg–de Vries equation. The utility of this type of analysis is demonstrated in description of an amplitude-limited, flat wave. NLIWs observed over most of the month had typical displacements of −8 m, but waves observed from 17–21 August were almost twice as large with displacements near −15 m. During most of the month, wave packets occurred irregularly at a fixed location, and often more than one packet was observed per M2 tidal period. In contrast, the arrival times of the large-amplitude wave groups observed over 17–21 August were more closely phased with the barotropic tide. The time span in which the largest NLIWs were observed corresponded to neap barotropic conditions, but when the shoreward baroclinic energy flux was elevated. During the time of large NLIWs, near-inertial waves were a dominate contributor to the internal motions on the shelf and apparently regulated wave formation, as destructive/constructive modulation of the M2 internal tide by the inertial wavefield at the shelf break corresponded to stronger/weaker NLIWs on the shelf.This work was funded by the Office of Naval Research

Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

<p>Abstract</p> <p>Background</p> <p>Some patients with mild or moderate thoracic scoliosis (Cobb angle <50-60 degrees) suffer disproportionate impairment of pulmonary function associated with deformities in the sagittal plane and reduced flexibility of the spine and chest cage. Long-term improvement in the clinical signs and symptoms of childhood onset scoliosis in an adult, without surgical intervention, has not been documented previously.</p> <p>Case presentation</p> <p>A diagnosis of thoracic scoliosis (Cobb angle 45 degrees) with pectus excavatum and thoracic hypokyphosis in a female patient (DOB 9/17/52) was made in June 1964. Immediate spinal fusion was strongly recommended, but the patient elected a daily home exercise program taught during a 6-week period of training by a physical therapist. This regime was carried out through 1992, with daily aerobic exercise added in 1974. The Cobb angle of the primary thoracic curvature remained unchanged. Ongoing clinical symptoms included dyspnea at rest and recurrent respiratory infections. A period of multimodal treatment with clinical monitoring and treatment by an osteopathic physician was initiated when the patient was 40 years old. This included deep tissue massage (1992-1996); outpatient psychological therapy (1992-1993); a daily home exercise program focused on mobilization of the chest wall (1992-2005); and manipulative medicine (1994-1995, 1999-2000). Progressive improvement in chest wall excursion, increased thoracic kyphosis, and resolution of long-standing respiratory symptoms occurred concomitant with a >10 degree decrease in Cobb angle magnitude of the primary thoracic curvature.</p> <p>Conclusion</p> <p>This report documents improved chest wall function and resolution of respiratory symptoms in response to nonsurgical approaches in an adult female, diagnosed at age eleven years with idiopathic scoliosis.</p

Australian Aboriginal Ethnometeorology and Seasonal Calendars

This paper uses a cultural anthropological approach to investigate an indigenous Australian perspective on atmospheric phenomena and seasons, using data gained from historical records and ethnographic fieldwork. Aboriginal people believe that the forces driving the weather are derived from Creation Ancestors and spirits, asserting that short term changes are produced through ritual. By recognizing signals such as wind direction, rainfall, temperature change, celestial movements, animal behaviour and the flowering of plants, Aboriginal people are able to divide the year into seasons. Indigenous calendars vary widely across Australia and reflect annual changes within Aboriginal lifestyles

Frequency of skeletal-related events and associated healthcare resource use and costs in US patients with multiple myeloma

<p><b>Objective:</b></p> <p>A potential complication for all new multiple myeloma (MM) patients is the clinical presentation of osteolytic lesions which increase the risk for skeletal-related events (SREs). However, the contribution of SREs to the overall economic impact of MM is unclear. The impact of SREs on healthcare resource utilization (HCRU) and costs for US patients with MM was analyzed in Truven Health Marketscan Commercial Claims and Medicare Supplemental Databases.</p> <p><b>Methods:</b></p> <p>Adults diagnosed with MM between January 1, 2005 and December 31, 2010 with ≥2 claims ≥30 days apart (first claim = index date) were included. SREs included: hypercalcemia, pathologic fracture, surgery for the prevention and treatment of pathologic fractures or spinal cord compression, and radiation for bone pain. Rates of HCRU (outpatient [OP], inpatient [IP], emergency room [ER], orthopedic consultation [OC], and ancillary) and healthcare costs were compared between MM patients with and without SREs. Inverse propensity weighting was applied to adjust for potential bias.</p> <p><b>Results:</b></p> <p>Of 1028 MM patients (mean age = 67, standard deviation = 13.2), 596 patients with ≥1 SRE and 432 without SREs were assessed. HCRU rates in IP, ER, and ancillary (<i>p</i> < 0.01) and mean total costs of OP, IP, and ER were significantly higher (<i>p</i> < 0.05) for patients with vs without SREs during follow-up. HCRU rates also increased with SRE frequency (<i>p</i> < 0.05 in OP, IP, ER, OC, and ancillary), as did mean total healthcare costs, except for OC (<i>p</i> < 0.001).</p> <p><b>Limitations:</b></p> <p>A broad assessment of pharmacotherapy for the treatment of MM was not an objective of the current study. Bisphosphonate use was evaluated; however, results were descriptively focused on frequency of utilization only and were not included in the broader cost and HCRU analysis.</p> <p><b>Conclusions:</b></p> <p>Among US patients with MM, higher SRE frequency was associated with a significant trend of higher HCRU and total healthcare costs in several settings.</p