TRAJECTORIES OF EMOTIONAL AND FUNCTIONAL WELL-BEING IN BREAST CANCER SURVIVORS

ABSTRACTYumeng Ren: Trajectories of Emotional and Functional Well-being in Breast Cancer Survivors(Under the direction of Marc Emerson) Background: Emotional and functional well-being are important components of mental health. Long-term and trajectories of emotional and functional well-being among breast cancer (BC) survivors have been understudied in previous research. Limited work on the impact of demographic and clinical characteristics on emotional and functional well-being change results in a lack of guidance to support BC survivors’ unmet emotional and functional needs. Methods: This project had two aims 1) to characterize long-term emotional and functional well-being overall and in association with demographic characteristics and clinical correlates; and 2) to describe trajectories of emotional and functional well-being in breast cancer survivors and explore disparities by age, race, and other characteristics. To achieve these two aims, we used data from the Carolina Breast Cancer Study Phase 3, a racially diverse population-based cohort, including 2,781 women diagnosed with invasive breast cancer between 2008 to 2013.Results: For Aim 1, 37% of our participants had improved well-being, nearly 42% had no obvious change, and 21% had decreased well-being over time since diagnosis. More advanced cancer stage and older age at diagnosis were moderately associated with well-being decrease at 84 months relative to baseline, whereas Black race and no receipt of chemotherapy were moderately associated with well-being decrease at 25 months and 84 months post diagnosis. Breast cancer recurrence was strongly associated with well-being decrease at both follow-up survey timepoints. In Aim 2, five trajectory groups were identified for emotional and functional well-being, separately. Two had consistently high/medium well-being levels during the follow-up (i.e., “good well-being” trajectories), whereas the other three had moderate/low levels, with one staying stable, one having a substantial decrease by 25 months, and another with an extremely low baseline level and only having a small increment (i.e., “poor well-being” trajectories). Younger women, Black women, women with BC recurrence, and women with lower socioeconomic status, advanced cancer stage, and more aggressive treatment modality were more likely to fall into “poor well-being” trajectories. Conclusions: Trajectories of emotional and functional well-being are associated with important demographic and clinical features.Doctor of Philosoph

New improvement to Falconer distance set problem in higher dimensions

We show that if a compact set $E\subset \mathbb{R}^d$ has Hausdorff dimension larger than $\frac{d}{2}+\frac{1}{4}-\frac{1}{8d+4}$, where $d\geq 3$, then there is a point $x\in E$ such that the pinned distance set $\Delta_x(E)$ has positive Lebesgue measure. This improves upon bounds of Du-Zhang and Du-Iosevich-Ou-Wang-Zhang in all dimensions $d \ge 3$. We also prove lower bounds for Hausdorff dimension of pinned distance sets when $\dim_H (E) \in (\frac{d}{2} - \frac{1}{4} - \frac{3}{8d+4}, \frac{d}{2}+\frac{1}{4}-\frac{1}{8d+4})$, which improves upon bounds of Harris and Wang-Zheng in dimensions $d \ge 3$.Comment: 36 page

Weighted refined decoupling estimates and application to Falconer distance set problem

We prove some weighted refined decoupling estimates. As an application, we give an alternative proof of the following result on Falconer's distance set problem by the authors in a companion work: if a compact set $E\subset \mathbb{R}^d$ has Hausdorff dimension larger than $\frac{d}{2}+\frac{1}{4}-\frac{1}{8d+4}$, where $d\geq 4$, then there is a point $x\in E$ such that the pinned distance set $\Delta_x(E)$ has positive Lebesgue measure. Aside from this application, the weighted refined decoupling estimates may be of independent interest.Comment: 28 pages. arXiv admin note: text overlap with arXiv:2309.0410

Spatially Nonuniform Oscillations in Ferrimagnets Based on an Atomistic Model

The ferrimagnets, such as GdxFeCo(1-x), can produce ultrafast magnetic switching and oscillation due to the strong exchange field. The two-sublattices macrospin model has been widely used to explain the experimental results. However, it fails in describing the spatial nonuniform magnetic dynamics which gives rises to many important phenomenons such as the domain walls and skyrmions. Here we develop the two-dimensional atomistic model and provide a torque analysis method to study the ferrimagnetic oscillation. Under the spin-transfer torque, the magnetization oscillates in the exchange mode or the flipped exchange mode. When the Gd composition is increased, the exchange mode firstly disappears, and then appears again as the magnetization compensation point is reached. We show that these results can only be explained by analyzing the spatial distribution of magnetization and effective fields. In particular, when the sample is small, a spatial nonuniform oscillation is also observed in the square film. Our work reveals the importance of spatial magnetic distributions in understanding the ferrimagnetic dynamics. The method developed in this paper provides an important tool to gain a deeper understanding of ferrimagnets and antiferromagnets. The observed ultrafast dynamics can also stimulate the development of THz oscillators.Comment: 17 pages, 4 figure

Anomalous impact of thermal fluctuations on spintransfer torque induced ferrimagnetic switching

The dynamics of a spin torque driven ferrimagnetic (FiM) system is investigated using the two-sublattice macrospin model. We demonstrate an ultrafast switching in the picosecond range. However, we find that the excessive current leads to the magnetic oscillation. Therefore, faster switching cannot be achieved by unlimitedly increasing the current. By systematically studying the impact of thermal fluctuations, we find the dynamics of FiMs can also be distinguished into the precessional region, the thermally activated region, and the cross-over region. However, in the precessional region, there is a significant deviation between FiM and ferromagnet (FM), i.e., the FM is insensitive to thermal fluctuations since its switching is only determined by the amount of net charge. In contrast, we find that the thermal effect is pronounced even a very short current pulse is applied to the FiM. We attribute this anomalous effect to the complex relation between the anisotropy and overdrive current. By controlling the magnetic anisotropy, we demonstrate that the FiM can also be configured to be insensitive to thermal fluctuations. This controllable thermal property makes the FiM promising in many emerging applications such as the implementation of tunable activation functions in the neuromorphic computing.Comment: 27 pages, 8 figure

Branched-Chain Amino Acids and Risk of Breast Cancer

Background Circulating branched-chain amino acid (BCAA) levels reflect metabolic health and dietary intake. However, associations with breast cancer are unclear. Methods We evaluated circulating BCAA levels and breast cancer risk within the Nurses’ Health Study (NHS) and NHSII (1997 cases and 1997 controls). A total of 592 NHS women donated 2 blood samples 10 years apart. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) of breast cancer risk in multivariable logistic regression models. We conducted an external validation in 1765 cases in the Women’s Health Study (WHS). All statistical tests were 2-sided. Results Among NHSII participants (predominantly premenopausal at blood collection), elevated circulating BCAA levels were associated with lower breast cancer risk (eg, isoleucine highest vs lowest quartile, multivariable OR = 0.86, 95% CI = 0.65 to 1.13, Ptrend = .20), with statistically significant linear trends among fasting samples (eg, isoleucine OR = 0.74, 95% CI = 0.53 to 1.05, Ptrend = .05). In contrast, among postmenopausal women, proximate measures (\u3c10 years from blood draw) were associated with increased breast cancer risk (eg, isoleucine OR = 1.63, 95% CI = 1.12 to 2.39, Ptrend = .01), with stronger associations among fasting samples (OR = 1.73, 95% CI = 1.15 to 2.61, Ptrend = .01). Distant measures (10-20 years since blood draw) were not associated with risk. In the WHS, a positive association was observed for distant measures of leucine among postmenopausal women (OR = 1.23, 95% CI = 0.96 to 1.58, Ptrend = .04). Conclusions No statistically significant associations between BCAA levels and breast cancer risk were consistent across NHS and WHS or NHSII and WHS. Elevated circulating BCAA levels were associated with lower breast cancer risk among predominantly premenopausal NHSII women and higher risk among postmenopausal women in NHS but not in the WHS. Additional studies are needed to understand this complex relationship

Diagnostic accuracy of a novel optical coherence tomography-based fractional flow reserve algorithm for assessment of coronary stenosis significance

Background: This study aimed to introduce a novel optical coherence tomography-derived fractional flow reserve (FFR) computational approach and assess the diagnostic performance of the algorithm for assessing physiological function. Methods: The fusion of coronary optical coherence tomography and angiography was used to generate a novel FFR algorithm (AccuFFRoct) to evaluate functional ischemia of coronary stenosis. In the current study, a total of 34 consecutive patients were included, and AccuFFRoct was used to calculate the FFR for these patients. With the wire-measured FFR as the reference standard, we evaluated the performance of our approach by accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: Per vessel accuracy, sensitivity, specificity, PPV, and NPV for AccuFFRoct in identifying hemodynamically significant coronary stenosis were 93.8%, 94.7%, 92.3%, 94.7%, and 92.3%, respectively, were found. Good correlation (Pearson’s correlation coefficient r = 0.80, p < 0.001) between AccuFFRoct and FFR was observed. The Bland-Altman analysis showed a mean difference value of –0.037 (limits of agreement: –0.189 to 0.115). The area under the receiver-operating characteristic curve (AUC) of AccuFFRoct in identifying physiologically significant stenosis was 0.94, which was higher than the minimum lumen area (MLA, AUC = 0.91) and significantly higher than the diameter stenosis (%DS, AUC = 0.78). Conclusions: This clinical study shows the efficiency and accuracy of AccuFFRoct for clinical implementation when using invasive FFR measurement as a reference. It could provide important insights into coronary imaging superior to current methods based on the degree of coronary artery stenosis

Influenza vaccine uptake among children and older adults in China: a secondary analysis of a quasi-experimental study.

BACKGROUND: Influenza vaccination is the key to prevent influenza-related disease, especially among high-risk populations. However, influenza vaccine uptake in China is low. This secondary analysis of a quasi-experimental trial aimed to understand factors associated with influenza vaccine uptake among children and older people stratified by funding context. METHODS: A total of 225 children (aged 0.5-8 years) and 225 older people (aged 60 years or above) were recruited from three clinics (rural, suburban and urban) in Guangdong Province. Participants were allocated into two groups based on funding contexts: a self-paid group (N = 150, 75 children and 75 older adults) in which participants paid full price for their vaccination; and a subsidized group (N = 300, 150 children and 150 older adults) in which varying levels of financial support was provided. Univariate and multivariable logistic regressions were conducted stratified by funding contexts. RESULTS: Overall, 75.0% (225/300) of participants in the subsidized group and 36.7% (55/150) in the self-paid group got vaccinated. Older adults had lower vaccination rates than children in both funding groups, while both age groups showed much higher uptake in the subsidized group than in the self-paid group (aOR = 5.96, 95% CI: 3.77-9.42, p = 0.001). In the self-paid group, having prior influenza vaccination history of children (aOR:2.61, 95%CI: 1.06-6.42) or older people (aOR:4.76, 95%CI: 1.08-20.90) was associated with increased influenza vaccine uptake compared to those who had no prior vaccination experiences in the family. While in the subsidized group, participants who got married or lived with partners (aOR = 0.32, 0.10-0.98) had lower vaccination uptake than single ones. Trust in providers' advice (aOR = 4.95, 95%CI:1.99, 12.43), perceived effectiveness of the vaccine (aOR: 12.18, 95%CI: 5.21-28.50), and experienced influenza-like illnesses in the family in the past year (aOR = 46.52, 4.10, 533.78) were associated with higher vaccine uptake. CONCLUSIONS: Older people had suboptimal vaccine uptake compared to children in both contexts and need more attention to enhance influenza vaccination. Tailoring interventions to different vaccine funding contexts may help improve influenza vaccination: In self-paid context, motivating people to accept their first ever influenza vaccination may be a promising strategy. In subsidized context, improving public confidence in vaccine effectiveness and providers' advice would be useful

The association of long-term trajectories of BMI, its variability, and metabolic syndrome: a 30-year prospective cohort study

Background Limited data exists on how early-life weight changes relate to metabolic syndrome (MetS) risk in midlife. This study examines the association between long-term trajectories of body mass index (BMI), its variability, and MetS risk in Chinese individuals. Methods In the Hanzhong Adolescent Hypertension study (March 10, 1987–June 3, 2017), 1824 participants with at least five BMI measurements from 1987 to 2017 were included. Using group-based trajectory modeling, different BMI trajectories were identified. BMI variability was assessed through standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV). Logistic regression analyzed the relationship between BMI trajectory, BMI variability, and MetS occurrence in midlife (URL: https://www.clinicaltrials.gov; Unique identifier: NCT02734472). Findings BMI trajectories were categorized as low-increasing (34.4%), moderate-increasing (51.8%), and high-increasing (13.8%). Compared to the low-increasing group, the odds ratios (ORs) [95% CIs] for MetS were significantly higher in moderate (4.27 [2.63–6.91]) and high-increasing groups (13.11 [6.30–27.31]) in fully adjusted models. Additionally, higher BMI variabilities were associated with increased MetS odds (ORs for SDBMI, VIMBMI, and ARVBMI: 2.30 [2.02–2.62], 1.22 [1.19–1.26], and 4.29 [3.38–5.45]). Furthermore, BMI trajectories from childhood to adolescence were predictive of midlife MetS, with ORs in moderate (1.49 [1.00–2.23]) and high-increasing groups (2.45 [1.22–4.91]). Lastly, elevated BMI variability in this period was also linked to higher MetS odds (ORs for SDBMI, VIMBMI, and ARVBMI: 1.24 [1.08–1.42], 1.00 [1.00–1.01], and 1.21 [1.05–1.38]). Interpretation Our study suggests that both early-life BMI trajectories and BMI variability could be predictive of incident MetS in midlife

Prediction of protein assemblies, the next frontier: The CASP14-CAPRI experiment

We present the results for CAPRI Round 50, the fourth joint CASP-CAPRI protein assembly prediction challenge. The Round comprised a total of twelve targets, including six dimers, three trimers, and three higher-order oligomers. Four of these were easy targets, for which good structural templates were available either for the full assembly, or for the main interfaces (of the higher-order oligomers). Eight were difficult targets for which only distantly related templates were found for the individual subunits. Twenty-five CAPRI groups including eight automatic servers submitted ~1250 models per target. Twenty groups including six servers participated in the CAPRI scoring challenge submitted ~190 models per target. The accuracy of the predicted models was evaluated using the classical CAPRI criteria. The prediction performance was measured by a weighted scoring scheme that takes into account the number of models of acceptable quality or higher submitted by each group as part of their five top-ranking models. Compared to the previous CASP-CAPRI challenge, top performing groups submitted such models for a larger fraction (70–75%) of the targets in this Round, but fewer of these models were of high accuracy. Scorer groups achieved stronger performance with more groups submitting correct models for 70–80% of the targets or achieving high accuracy predictions. Servers performed less well in general, except for the MDOCKPP and LZERD servers, who performed on par with human groups. In addition to these results, major advances in methodology are discussed, providing an informative overview of where the prediction of protein assemblies currently stands.Cancer Research UK, Grant/Award Number: FC001003; Changzhou Science and Technology Bureau, Grant/Award Number: CE20200503; Department of Energy and Climate Change, Grant/Award Numbers: DE-AR001213, DE-SC0020400, DE-SC0021303; H2020 European Institute of Innovation and Technology, Grant/Award Numbers: 675728, 777536, 823830; Institut national de recherche en informatique et en automatique (INRIA), Grant/Award Number: Cordi-S; Lietuvos Mokslo Taryba, Grant/Award Numbers: S-MIP-17-60, S-MIP-21-35; Medical Research Council, Grant/Award Number: FC001003; Japan Society for the Promotion of Science KAKENHI, Grant/Award Number: JP19J00950; Ministerio de Ciencia e Innovación, Grant/Award Number: PID2019-110167RB-I00; Narodowe Centrum Nauki, Grant/Award Numbers: UMO-2017/25/B/ST4/01026, UMO-2017/26/M/ST4/00044, UMO-2017/27/B/ST4/00926; National Institute of General Medical Sciences, Grant/Award Numbers: R21GM127952, R35GM118078, RM1135136, T32GM132024; National Institutes of Health, Grant/Award Numbers: R01GM074255, R01GM078221, R01GM093123, R01GM109980, R01GM133840, R01GN123055, R01HL142301, R35GM124952, R35GM136409; National Natural Science Foundation of China, Grant/Award Number: 81603152; National Science Foundation, Grant/Award Numbers: AF1645512, CCF1943008, CMMI1825941, DBI1759277, DBI1759934, DBI1917263, DBI20036350, IIS1763246, MCB1925643; NWO, Grant/Award Number: TOP-PUNT 718.015.001; Wellcome Trust, Grant/Award Number: FC00100