Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy.

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

A COMPARISON OF ON- AND OFF-DUTY PHYSICAL ACTIVITY IN CAREER FIREFIGHTERS

Allison M. Barry1,2, Katie J. Lyman2, Nathan D. Dicks2, Kassiann D. Landin2, Christi R. McGeorge3, Tanis J. Walch4 1Department of Health, Human Performance, and Recreation, Pittsburg State University, Pittsburg, KS; 2Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND; 3Department of Human Development and Family Science, North Dakota State University, Fargo, ND; 4Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND. Physical inactivity coupled with increasing obesity levels in firefighters play a critical role in accumulating cardiovascular events. PURPOSE: To examine differences in career firefighters’ objectively measured physical activity (PA) levels while on- and off-duty. METHODS: Twenty-nine career firefighters (age: 34.45±7.15 yr; BMI: 28.97±2.52 kg · m-2) participated in a non-experimental, within-subjects study. Firefighters wore an accelerometer during waking hours of their nine-day tour, which included three, 24-hour on-duty days and six, off-duty days. Accelerometers assessed PA intensity using Freedson (1998) cut-points and step count. Height and weight were also measured to calculate BMI. Dependent t-tests, independent t-tests, and Pearson product-moment correlations were used to analyze the data in SPSS (v24). RESULTS: Firefighters (overweight=20; obese=9; normal weight=0) met the ACSM PA guidelines more often while on-duty (n=17) compared to when they were off-duty (n=9). While on-duty, firefighters attained an average of 35.51± 19.22 minutes of moderate-to-vigorous physical activity (MVPA) compared to 27.82 ± 18.91 minutes (p=0.055, d=0.40) when off duty. Firefighters engaged in significantly more light PA during on-duty days (351.11±59.90) compared to off-duty days (315.83±86.90) (p=0.026; d=0.47). There were significant correlations between on- and off-dutys days for sedentary behavior (r = -0.53), moderate PA (r =0.37), and MVPA (r =0.41). CONCLUSION: As a group, the firefighters in this study did not meet ACSM PA guidelines, which places them at greater risk for a cardiac event. Firefighters must rely on their cardiovascular health to perform the physiologically demanding tasks that their job requires. In the future, researchers need to collaborate with fire departments across the country to develop and assess ways to enhance PA levels in firefighters with the goal of improving their overall health and well-being, which ultimately will decrease the risk of cardiac events. ACKNOWLEDGEMENTS: Northland ACSM Innovative Student Research Gran

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

Answer ALS, a large-scale resource for sporadic and familial ALS combining clinical and multi-omics data from induced pluripotent cell lines.

Answer ALS is a biological and clinical resource of patient-derived, induced pluripotent stem (iPS) cell lines, multi-omic data derived from iPS neurons and longitudinal clinical and smartphone data from over 1,000 patients with ALS. This resource provides population-level biological and clinical data that may be employed to identify clinical-molecular-biochemical subtypes of amyotrophic lateral sclerosis (ALS). A unique smartphone-based system was employed to collect deep clinical data, including fine motor activity, speech, breathing and linguistics/cognition. The iPS spinal neurons were blood derived from each patient and these cells underwent multi-omic analytics including whole-genome sequencing, RNA transcriptomics, ATAC-sequencing and proteomics. The intent of these data is for the generation of integrated clinical and biological signatures using bioinformatics, statistics and computational biology to establish patterns that may lead to a better understanding of the underlying mechanisms of disease, including subgroup identification. A web portal for open-source sharing of all data was developed for widespread community-based data analytics