The effectiveness of an interactive theatre intervention on improving patient adherence to self-management regimens for breast cancer-related lymphedema

Breast cancer survivors are at lifetime risk for the development of breast cancer-related lymphedema (BCRL), a chronic, potentially-debilitating, and -disfiguring condition that requires life-long symptom management. Adherence to BCRL self-management is critical to preventing BCRL progression and complications; however, barriers to effective self-management, including complexities of treatment, can negatively affect adherence. Preliminary work for this study has identified physiological, psychological, and psychosocial barriers to successful BCRL self-management. One of the main barriers identified was lack of BCRL education and support for both patients and health care providers, suggesting a need for alternative methods of providing education and support. Currently, printed information is commonly used for patient education and support. This randomized study compared printed information about BCRL to printed information about BCRL and attendance at an Interactive Theatre (IT) performance (n = 36 participants; 19/17). Circumferential and perometric measures were taken at baseline to document BCRL status and valid, reliable questionnaires relevant to symptom management, self-efficacy, and self-regulation were administered pre- and post-intervention. An interactive approach to BCRL education and support with self-management has potential to improve patient outcomes of adherence and coping with BCRL

Bowel Perforation in the Emergency Department Related to Bevacizumab Therapy and Recurrent Ovarian Cancer

Case Presentation: We describe the presentation to the emergency department of a patient with recurrent ovarian cancer treated with bevacizumab with the complication of bowel perforation. Discussion: We review the frequency and outcomes of bevacizumab-related bowel perforation. We also report the patient’s imaging findings, including the radiologic presentation of free intraperitoneal air and portal venous gas, both indicative of bowel perforation and the need for emergent surgical evaluation. Our case also illustrates the potentially catastrophic side effects of bevacizumab and other targeted oncologic therapies of which emergecny physicians may not be aware

Strong Interactions of Single Atoms and Photons near a Dielectric Boundary

Modern research in optical physics has achieved quantum control of strong interactions between a single atom and one photon within the setting of cavity quantum electrodynamics (cQED). However, to move beyond current proof-of-principle experiments involving one or two conventional optical cavities to more complex scalable systems that employ N >> 1 microscopic resonators requires the localization of individual atoms on distance scales < 100 nm from a resonator's surface. In this regime an atom can be strongly coupled to a single intracavity photon while at the same time experiencing significant radiative interactions with the dielectric boundaries of the resonator. Here, we report an initial step into this new regime of cQED by way of real-time detection and high-bandwidth feedback to select and monitor single Cesium atoms localized ~100 nm from the surface of a micro-toroidal optical resonator. We employ strong radiative interactions of atom and cavity field to probe atomic motion through the evanescent field of the resonator. Direct temporal and spectral measurements reveal both the significant role of Casimir-Polder attraction and the manifestly quantum nature of the atom-cavity dynamics. Our work sets the stage for trapping atoms near micro- and nano-scopic optical resonators for applications in quantum information science, including the creation of scalable quantum networks composed of many atom-cavity systems that coherently interact via coherent exchanges of single photons.Comment: 8 pages, 5 figures, Supplemental Information included as ancillary fil

Detecting single viruses and nanoparticles using whispering gallery microlasers

Detection and characterization of individual nano-scale particles, virions, and pathogens are of paramount importance to human health, homeland security, diagnostic and environmental monitoring[1]. There is a strong demand for high-resolution, portable, and cost-effective systems to make label-free detection and measurement of individual nanoparticles, molecules, and viruses [2-6]. Here, we report an easily accessible, real-time and label-free detection method with single nanoparticle resolution that surpasses detection limit of existing micro- and nano-photonic devices. This is achieved by using an ultra-narrow linewidth whispering gallery microlaser, whose lasing line undergoes frequency splitting upon the binding of individual nano-objects. We demonstrate detection of polystyrene and gold nanoparticles as small as 15 nm and 10 nm in radius, respectively, and Influenza A virions by monitoring changes in self-heterodyning beat note of the split lasing modes. Experiments are performed in both air and aqueous environment. The built-in self-heterodyne interferometric method achieved in a microlaser provides a self-reference scheme with extraordinary sensitivity [7,8], and paves the way for detection and spectroscopy of nano-scale objects using micro- and nano-lasers.Comment: Main Text: 14 pages, 5 figures, 27 references. Supplement: 26 pages, 12 figures, 26 reference

Anogenital distance in human male and female newborns: a descriptive, cross-sectional study

BACKGROUND: In animal studies of the effects of hormonally active agents, measurement of anogenital distance (AGD) is now routine, and serves as a bioassay of fetal androgen action. Although measurement of AGD in humans has been discussed in the literature, to our knowledge it has been measured formally in only two descriptive studies of females. Because AGD has been an easy-to-measure, sensitive outcome in animals studies, we developed and implemented an anthropometric protocol for measurement of AGD in human males as well as females. METHODS: We first evaluated the reliability of the AGD measures in 20 subjects. Then measurements were taken on an additional 87 newborns (42 females, 45 males). All subjects were from Morelos, Mexico. RESULTS: The reliability (Pearson r) of the AGD measure was, for females 0.50, and for males, 0.64. The between-subject variation in AGD, however, was much greater than the variation due to measurement error. The AGD measure was about two-fold greater in males (mean, 22 mm) than in females (mean, 11 mm), and there was little overlap in the distributions for males and females. CONCLUSION: The sexual dimorphism of AGD in humans comprises prima facie evidence that this outcome may respond to in utero exposure to hormonally active agents