Burden of lymphedema in long-term breast cancer survivors by race and age

Background: Risk assessment for breast cancer–related lymphedema has emphasized upper-limb symptoms and treatment-related risk factors. This article examined breast cancer–related lymphedema after surgery, overall and in association with broader demographic and clinical features. Methods: The Carolina Breast Cancer Study phase 3 followed participants for breast cancer–related lymphedema from baseline (on average, 5 months after breast cancer diagnosis) to 7 years after diagnosis. Among 2645 participants, 552 self-reported lymphedema cases were identified. Time-to-lymphedema curves and inverse probability weighted conditional Cox proportional hazards model were used to evaluate whether demographics and clinical features were associated with breast cancer–related lymphedema. Results: Point prevalence of breast cancer–related lymphedema was 6.8% at baseline, and 19.9% and 23.8% at 2 and 7 years after diagnosis, respectively. Most cases had lymphedema in the arm (88%-93%), whereas 14% to 27% presented in the trunk and/or breast. Beginning approximately 10 months after diagnosis, younger Black women had the highest risk of breast cancer–related lymphedema and older non-Black women had the lowest risk. Positive lymph node status, larger tumor size (>5 cm), and estrogen receptor–negative breast cancer, as well as established risk factors such as higher body mass index, removal of more than five lymph nodes, mastectomy, chemotherapy, and radiation therapy, were significantly associated with increased hazard (1.5- to 3.5-fold) of lymphedema. Conclusions: Findings highlight that hazard of breast cancer–related lymphedema differs by demographic characteristics and clinical features. These factors could be used to identify those at greatest need of lymphedema prevention and early intervention. Lay summary: In this study, the aim was to investigate breast cancer–related lymphedema (BCRL) burden. This study found that risk of BCRL differs by race, age, and other characteristics

Quenching of Weak Interactions in Nucleon Matter

We have calculated the one-body Fermi and Gamow-Teller charge-current, and vector and axial-vector neutral-current nuclear matrix elements in nucleon matter at densities of 0.08, 0.16 and 0.24 fm$^{-3}$ and proton fractions ranging from 0.2 to 0.5. The correlated states for nucleon matter are obtained by operating on Fermi-gas states by a symmetrized product of pair correlation operators determined from variational calculations with the Argonne v18 and Urbana IX two- and three-nucleon interactions. The squares of the charge current matrix elements are found to be quenched by 20 to 25 % by the short-range correlations in nucleon matter. Most of the quenching is due to spin-isospin correlations induced by the pion exchange interactions which change the isospins and spins of the nucleons. A large part of it can be related to the probability for a spin up proton quasi-particle to be a bare spin up/down proton/neutron. We also calculate the matrix elements of the nuclear Hamiltonian in the same correlated basis. These provide relatively mild effective interactions which give the variational energies in the Hartree-Fock approximation. The calculated two-nucleon effective interaction describes the spin-isospin susceptibilities of nuclear and neutron matter fairly accurately. However $\geq$ 3-body terms are necessary to reproduce the compressibility. All presented results use the simple 2-body cluster approximation to calculate the correlated basis matrix elements.Comment: submitted to PR

Granzyme A-producing T helper cells are critical for acute graft-versus-host disease

Acute graft-versus-host disease (aGVHD) can occur after hematopoietic cell transplant in patients undergoing treatment for hematological malignancies or inborn errors. Although CD4+ T helper (Th) cells play a major role in aGVHD, the mechanisms by which they contribute, particularly within the intestines, have remained elusive. We have identified a potentially novel subset of Th cells that accumulated in the intestines and produced the serine protease granzyme A (GrA). GrA+ Th cells were distinct from other Th lineages and exhibited a noncytolytic phenotype. In vitro, GrA+ Th cells differentiated in the presence of IL-4, IL-6, and IL-21 and were transcriptionally unique from cells cultured with either IL-4 or the IL-6/IL-21 combination alone. In vivo, both STAT3 and STAT6 were required for GrA+ Th cell differentiation and played roles in maintenance of the lineage identity. Importantly, GrA+ Th cells promoted aGVHD-associated morbidity and mortality and contributed to crypt destruction within intestines but were not required for the beneficial graft-versus-leukemia effect. Our data indicate that GrA+ Th cells represent a distinct Th subset and are critical mediators of aGVHD

The role of manufacturing and market managers in strategy development:lessons from three companies

According to researchers and managers, there is a lack of agreement between marketing and manufacturing managers on critical strategic issues. However, most of the literature on the subject is anecdotal and little formal empirical research has been done. Three companies are investigated to study the extent of agreement/disagreement between manufacturing and marketing managers on strategy content and process. A novel method permits the study of agreement between the two different functional managers on the process of developing strategy. The findings consistently show that manufacturing managers operate under a wider range of strategic priorities than marketing managers, and that manufacturing managers participate less than marketing managers in the strategy development process. Further, both marketing and manufacturing managers show higher involvement in the strategy development process in the latter stages of the Hayes and Wheelwright four-stage model of manufacturing’s strategic role

Measurement of the cardiac time intervals of the fetal ECG utilising a computerised algorithm: A retrospective observational study

.ObjectiveEstablish whether the reliable measurement of cardiac time intervals of the fetal ECG can be automated and to address whether this approach could be used to investigate large datasets.DesignRetrospective observational study.SettingTeaching hospitals in London UK, Nottingham UK and New York USA.ParticipantsSingleton pregnancies with no known fetal abnormality.MethodsArchived fetal ECG's performed using the MonicaAN24 monitor. A single ECG (PQRST) complex was generated from 5000 signal-averaged beats and electrical cardiac time intervals measured in an automated way and manually.Main Outcome measureValidation of a newly developed algorithm to measure the cardiac time intervals of the fetal ECG.Results188/236 (79.7%) subjects with fECGs of suitable signal:noise ratio were included for analysis comparing manual with automated measurement. PR interval was measured in 173/188 (92%), QRS complex in 170/188 (90%) and QT interval in 123/188 (65.4%). PR interval was 107.6 (12.07) ms [mean(SD)] manual vs 109.11 (14.7) ms algorithm. QRS duration was 54.72(6.35) ms manual vs 58.34(5.73) ms algorithm. QT-interval was 268.93 (21.59) ms manual vs 261.63 (36.16) ms algorithm. QTc was 407.5(32.71) ms manual vs 396.4 (54.78) ms algorithm. The QRS-duration increased with gestational age in both manual and algorithm measurements.ConclusionAccurate measurement of fetal ECG cardiac time intervals can be automated with potential application to interpretation of larger datasets

Coping with the effects of fear of failure in young elite athletes

Coping with stress is an important element in effective functioning at the elite level in sports, and fear of failure (FF) is an example of a stressor that athletes experience. Three issues underpin the present preliminary study. First, the prevalence of problems attributed to FF in achievement settings. Second, sport is a popular and significant achievement domain for children and adolescents. Third, there is a lack of research on FF in sport among this population. Therefore, the objectives of the study were to examine the effects of FF on young athletes and to find out their coping responses to the effects of FF. Interviews were conducted individually with nine young elite ath­letes (5 males, 4 females; ages 14-17 years). It was inferred from the data that FF affected the athletes' well-being, interpersonal behavior, sport performance, and schoolwork. The athletes employed a combination of problem-focused, emotion-fo­cused, and avoidance-focused coping strategies, with avoidance strategies being the most frequently reported

ALMA Reveals Strong [C II] Emission in a Galaxy Embedded in a Giant Lyα Blob at z = 3.1

We report the result from observations conducted with the Atacama Large Millimeter/submillimeter Array (ALMA) to detect [C ii] 158 μm fine structure line emission from galaxies embedded in one of the most spectacular Lyα blobs (LABs) at z = 3.1, SSA22-LAB1. Of three dusty star-forming galaxies previously discovered by ALMA 860 μm dust continuum survey toward SSA22-LAB1, we detected the [C ii] line from one, LAB1-ALMA3 at z = 3.0993 ± 0.0004. No line emission was detected, associated with the other ALMA continuum sources or from three rest-frame UV/optical selected zspec sime 3.1 galaxies within the field of view. For LAB1-ALMA3, we find relatively bright [C ii] emission compared to the infrared luminosity (L[C ii]/LIR ≈ 0.01) and an extremely high [C ii] 158 μm and [N ii] 205 μm emission line ratio (L[C ii]/L[N ii] > 55). The relatively strong [C ii] emission may be caused by abundant photodissociation regions and sub-solar metallicity, or by shock heating. The origin of the unusually strong [C ii] emission could be causally related to the location within the giant LAB, although the relationship between extended Lyα emission and interstellar medium conditions of associated galaxies is yet to be understand

Strategies to acquire and use phosphorus in phosphorus-impoverished and fire-prone environments

Published online: 19 May 2022Background Unveiling the diversity of plant strategies to acquire and use phosphorus (P) is crucial to understand factors promoting their coexistence in hyperdiverse P-impoverished communities within fire-prone landscapes such as in cerrado (South America), fynbos (South Africa) and kwongan (Australia). Scope We explore the diversity of P-acquisition strategies, highlighting one that has received little attention: acquisition of P following fires that temporarily enrich soil with P. This strategy is expressed by fire ephemerals as well as fast-resprouting perennial shrubs. A plant’s leaf manganese concentration ([Mn]) provides significant clues on P-acquisition strategies. High leaf [Mn] indicates carboxylatereleasing P-acquisition strategies, but other exudates may play the same role as carboxylates in P acquisition. Intermediate leaf [Mn] suggests facilitation of P acquisition by P-mobilising neighbours, through release of carboxylates or functionally similar compounds. Very low leaf [Mn] indicates that carboxylates play no immediate role in P acquisition. Release of phosphatases also represents a P-mining strategy, mobilising organic P. Some species may express multiple strategies, depending on time since germination or since fire, or on position in the landscape. In severely P-impoverished landscapes, photosynthetic P-use efficiency converges among species. Efficient species exhibit rapid rates of photosynthesis at low leaf P concentrations. A high P-remobilisation efficiency from senescing organs is another way to use P efficiently, as is extended longevity of plant organs. Conclusions Many P-acquisition strategies coexist in P-impoverished landscapes, but P-use strategies tend to converge. Common strategies of which we know little are those expressed by ephemeral or perennial species that are the first to respond after a fire. We surmise that carboxylate-releasing P-mobilising strategies are far more widespread than envisaged so far, and likely expressed by species that accumulate metals, exemplified by Mn, metalloids, such as selenium, fluorine, in the form of fluoroacetate, or silicon. Some carboxylate-releasing strategies are likely important to consider when restoring sites in biodiverse regions as well as in cropping systems on P-impoverished or strongly P-sorbing soils, because some species may only be able to establish themselves next to neighbours that mobilise P.Hans Lambers, Patrícia de Britto Costa, Gregory R. Cawthray, Matthew D. Denton, Patrick M. Finnegan, Patrick E. Hayes, Rafael S. Oliveira, Simon C. Power, Kosala Ranathunge, Qi Shen, Xiao Wang, Hongtao Zhon