Financial cost of lymphedema borne by women with breast cancer

Psycho-Oncology Published by John Wiley & Sons Ltd.Objective: Our study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors. Methods: An online national survey was conducted with 361 women who had either breast cancer without lymphedema (BC) (group 1, n = 209) or breast cancer with lymphedema (BC+LE) (group 2, n = 152). Participant recruitment was supported by the Breast Cancer Network Australia and the Australasian Lymphology Association. Results: Both breast cancer and lymphedema result in significant out-of-pocket financial costs borne by women. Of patients with BC+LE, 80% indicated that their breast cancer diagnosis had affected them financially compared with 67% in the BC group (P \u3c .020). For patients with lymphedema, over half (56%) indicated that this specific additional diagnosis to their breast cancer affected them financially and that costs increased with lymphedema severity. The cost of compression garments formed a large proportion of these costs (40.1%). The average number of attendances to a therapist each year was 5.8 (range, 0-45). Twenty-five patients (16.4%) had an episode of cellulitis in the past year. The incidence of cellulitis was 7.7% in 91 patients with subclinical or mild lymphedema compared with 29.5% of 61 patients with more extensive lymphedema (P \u3c .001). The average out-of-pocket financial cost of lymphedema care borne by women was A$977 per annum, ranging from A$207 for subclinical lymphedema to over A$1400 for moderate or severe lymphedema. Conclusions: This study identifies an additional detrimental effect of lymphedema on women in terms of financial costs

Constraining the physical properties of Type II-P supernovae using nebular phase spectra

We present a study of the nebular phase spectra of a sample of Type II-Plateau supernovae with identified progenitors or restrictive limits. The evolution of line fluxes, shapes, and velocities are compared within the sample, and interpreted by the use of a spectral synthesis code. The small diversity within the dataset can be explained by strong mixing occurring during the explosion, and by recognising that most lines have significant contributions from primordial metals in the H envelope, which dominates the total ejecta mass in these type of objects. In particular, when using the [O I] 6300, 6364 Angstrom doublet for estimating the core mass of the star, care has to be taken to account for emission from primordial O in the envelope. Finally, a correlation between the H-alpha line width and the mass of 56Ni is presented, suggesting that higher energy explosions are associated with higher 56Ni production.Comment: 18 pages, 15 figures, accepted for publication in MNRA

Spectra of supernovae in the nebular phase

When supernovae enter the nebular phase after a few months, they reveal spectral fingerprints of their deep interiors, glowing by radioactivity produced in the explosion. We are given a unique opportunity to see what an exploded star looks like inside. The line profiles and luminosities encode information about physical conditions, explosive and hydrostatic nucleosynthesis, and ejecta morphology, which link to the progenitor properties and the explosion mechanism. Here, the fundamental properties of spectral formation of supernovae in the nebular phase are reviewed. The formalism between ejecta morphology and line profile shapes is derived, including effects of scattering and absorption. Line luminosity expressions are derived in various physical limits, with examples of applications from the literature. The physical processes at work in the supernova ejecta, including gamma-ray deposition, non-thermal electron degradation, ionization and excitation, and radiative transfer are described and linked to the computation and application of advanced spectral models. Some of the results derived so far from nebular-phase supernova analysis are discussed.Comment: Book chapter for 'Handbook of Supernovae,' edited by Alsabti and Murdin, Springer. 51 pages, 14 figure

The Adaptive TreePM: An Adaptive Resolution Code for Cosmological N-body Simulations

Cosmological N-Body simulations are used for a variety of applications. Indeed progress in the study of large scale structures and galaxy formation would have been very limited without this tool. For nearly twenty years the limitations imposed by computing power forced simulators to ignore some of the basic requirements for modeling gravitational instability. One of the limitations of most cosmological codes has been the use of a force softening length that is much smaller than the typical inter-particle separation. This leads to departures from collisionless evolution that is desired in these simulations. We propose a particle based method with an adaptive resolution where the force softening length is reduced in high density regions while ensuring that it remains well above the local inter-particle separation. The method, called the Adaptive TreePM, is based on the TreePM code. We present the mathematical model and an implementation of this code, and demonstrate that the results converge over a range of options for parameters introduced in generalizing the code from the TreePM code. We explicitly demonstrate collisionless evolution in collapse of an oblique plane wave. We compare the code with the fixed resolution TreePM code and also an implementation that mimics adaptive mesh refinement methods and comment on the agreement, and disagreements in the results. We find that in most respects the ATreePM code performs at least as well as the fixed resolution TreePM in highly over-dense regions, from clustering and number density of haloes, to internal dynamics of haloes. We also show that the adaptive code is faster than the corresponding high resolution TreePM code.Comment: 18 pages, 11 figures. Accepted for publication in the MNRA

Evaluation of the genetic basis of familial-associated early-onset hematologic cancers in an ancestral/ethnically diverse population

Genetic predisposition to hematologic malignancies has historically been addressed utilizing patients recruited from clinical trials and pedigrees constructed at major treatment centers. Such efforts leave unexplored the genetic basis of variations in risk by race/ethnic group shown in population-based surveillance data where cancer registration, compulsory by law, delivers universal enrollment. To address this, we performed exome sequencing on DNA isolated from newborn bloodspots derived from sibling pairs with early-onset cancers across California in which at least one of the siblings developed a hematologic cancer, using unbiased recruitment from the full state population. We identified pathogenic/likely pathogenic (P/LP) variants among 1172 selected cancer genes that were private or present at low allele frequencies in reference populations. Within 64 subjects from 32 families, we found 9 LP variants shared between siblings, and an additional 7 such variants in singleton children (not shared with their sibling). In eight of the shared cases, the ancestral origin of the local haplotype that carries P/LP variants matched the dominant global ancestry of study participant families. This was the case for Latino sibling pairs on FLG and CBLB, non-Latino White sibling pairs in TP53 and NOD2, and a shared GATA2 variant for a non-Latino Black sibling pair. A new inherited mutation in HABP2 was identified in a sibling pair, one with diffuse large B-cell lymphoma and the other with neuroblastoma. Overall, the profile of P/LP germline variants across ancestral/ethnic groups suggests that rare alleles contributing to hematologic diseases originate within their race/ethnic origin parental populations, demonstrating the value of this discovery process in diverse, population-based registries

Modelling the spectral energy distribution of galaxies. V. The dust and PAH emission SEDs of disk galaxies

We present a self-consistent model of the spectral energy distributions (SEDs) of spiral galaxies from the ultraviolet (UV) to the mid-infrared (MIR)/far-infrared (FIR)/submillimeter (submm) based on a full radiative transfer calculation of the propagation of starlight in galaxy disks. This model predicts not only the total integrated energy absorbed in the UV/optical and re-emitted in the infrared/submm, but also the colours of the dust emission based on an explicit calculation of the strength and colour of the UV/optical radiation fields heating the dust, and incorporating a full calculation of the stochastic heating of small dust grains and PAH molecules. The geometry of the translucent components of the model is empirically constrained using the results from the radiation transfer analysis of Xilouris et al. on spirals in the middle range of the Hubble sequence, while the geometry of the optically thick components is constrained from physical considerations with a posteriori checks of the model predictions with observational data. These geometrical constraints enable the dust emission to be predicted in terms of a minimum set of free parameters: the central face-on dust opacity in the B-band tau^f_B, a clumpiness factor F for the star-forming regions, the star-formation rate SFR, the normalised luminosity of the old stellar population old and the bulge-to-disk ratio B/D. We show that these parameters are almost orthogonal in their predicted effect on the colours of the dust/PAH emission. The results of the calculations are made available in the form of a large library of simulated dust emission SEDs spanning the whole parameter space of our model, together with the corresponding library of dust attenuation calculated using the same model. (see full abstract in the paper)Comment: 39 pages; accepted for publication in Astronomy & Astrophysics; For a higher resolution version of Fig.1 and Fig.20 see http://www.star.uclan.ac.uk/~ccp/index.shtm

Gravitational Lensing at Millimeter Wavelengths

With today's millimeter and submillimeter instruments observers use gravitational lensing mostly as a tool to boost the sensitivity when observing distant objects. This is evident through the dominance of gravitationally lensed objects among those detected in CO rotational lines at z>1. It is also evident in the use of lensing magnification by galaxy clusters in order to reach faint submm/mm continuum sources. There are, however, a few cases where millimeter lines have been directly involved in understanding lensing configurations. Future mm/submm instruments, such as the ALMA interferometer, will have both the sensitivity and the angular resolution to allow detailed observations of gravitational lenses. The almost constant sensitivity to dust emission over the redshift range z=1-10 means that the likelihood for strong lensing of dust continuum sources is much higher than for optically selected sources. A large number of new strong lenses are therefore likely to be discovered with ALMA, allowing a direct assessment of cosmological parameters through lens statistics. Combined with an angular resolution <0.1", ALMA will also be efficient for probing the gravitational potential of galaxy clusters, where we will be able to study both the sources and the lenses themselves, free of obscuration and extinction corrections, derive rotation curves for the lenses, their orientation and, thus, greatly constrain lens models.Comment: 69 pages, Review on quasar lensing. Part of a LNP Topical Volume on "Dark matter and gravitational lensing", eds. F. Courbin, D. Minniti. To be published by Springer-Verlag 2002. Paper with full resolution figures can be found at ftp://oden.oso.chalmers.se/pub/tommy/mmviews.ps.g

Simulation techniques for cosmological simulations

Modern cosmological observations allow us to study in great detail the evolution and history of the large scale structure hierarchy. The fundamental problem of accurate constraints on the cosmological parameters, within a given cosmological model, requires precise modelling of the observed structure. In this paper we briefly review the current most effective techniques of large scale structure simulations, emphasising both their advantages and shortcomings. Starting with basics of the direct N-body simulations appropriate to modelling cold dark matter evolution, we then discuss the direct-sum technique GRAPE, particle-mesh (PM) and hybrid methods, combining the PM and the tree algorithms. Simulations of baryonic matter in the Universe often use hydrodynamic codes based on both particle methods that discretise mass, and grid-based methods. We briefly describe Eulerian grid methods, and also some variants of Lagrangian smoothed particle hydrodynamics (SPH) methods.Comment: 42 pages, 16 figures, accepted for publication in Space Science Reviews, special issue "Clusters of galaxies: beyond the thermal view", Editor J.S. Kaastra, Chapter 12; work done by an international team at the International Space Science Institute (ISSI), Bern, organised by J.S. Kaastra, A.M. Bykov, S. Schindler & J.A.M. Bleeke

Cytosolic delivery of siRNA by ultra-high affinity dsRNA binding proteins

Abstract Protein-based methods of siRNA delivery are capable of uniquely specific targeting, but are limited by technical challenges such as low potency or poor biophysical properties. Here, we engineered a series of ultra-high affinity siRNA binders based on the viral protein p19 and developed them into siRNA carriers targeted to the epidermal growth factor receptor (EGFR). Combined in trans with a previously described endosome-disrupting agent composed of the pore-forming protein Perfringolysin O (PFO), potent silencing was achieved in vitro with no detectable cytotoxicity. Despite concerns that excessively strong siRNA binding could prevent the discharge of siRNA from its carrier, higher affinity continually led to stronger silencing. We found that this improvement was due to both increased uptake of siRNA into the cell and improved pharmacodynamics inside the cell. Mathematical modeling predicted the existence of an affinity optimum that maximizes silencing, after which siRNA sequestration decreases potency. Our study characterizing the affinity dependence of silencing suggests that siRNA-carrier affinity can significantly affect the intracellular fate of siRNA and may serve as a handle for improving the efficiency of delivery. The two-agent delivery system presented here possesses notable biophysical properties and potency, and provide a platform for the cytosolic delivery of nucleic acids