Preserving of intercostobrachial nerve relieves breast carcinoma patients from postmastectomy pain syndrome

Background: Post-mastectomy pain syndrome (PMPS) is a complication experienced by majority of the patients who undergo breast surgery for cancer. The etiology of this chronic neuropathic pain syndrome seems to be complex and it is still understood below par. Injury to the intercostobrachial (ICB) nerve is presumed to be the dominant one for developing PMPS. This prospective study was designed to appraise the effect of preservation of intercostobrachial nerve on post-mastectomy pain syndrome and also to determine the most common anatomical variation of the intercostobrachial nerve during surgery.Methods: A total of 100 patients were included in this study and were divided into 2 groups. Group A included patients with ICB nerve preserved and Group B patients with ICB nerve sectioned. The patients were evaluated for pain subjectively on the 2nd day, 1 month and in the 3rd month post-operatively by short form of McGill pain questionnaire and visual analog scale. During surgical dissection, anatomical variation of ICB nerve was ascertained each time.Results: After 3 months, 68.2% of the patients were asymptomatic in Group A (ICB nerve preservation group) and 31.8% in the Group B (nerve section group) (chi-square test was applied and p value was 0.002). We found that type 1 anatomical variation was commonest with 87%.Conclusions: Preservation of ICB nerve might greatly decrease the incidence of PMPS. Hence, the insight of the anatomical variations of this nerve is very crucial for the operating surgeons to preserve them and to prevent PMPS

Vertical propagation characteristics and seasonal variability of tidal wind oscillations in the MLT region over Trivandrum (8.5° N, 77° E): first results from SKiYMET Meteor Radar

Tidal activity in the Mesospheric Lower Thermosphere (MLT) region over Trivandrum (8.5° N, 77° E) is investigated using the observations from newly installed SKiYMET Meteor Radar. The seasonal variability and vertical propagation characteristics of atmospheric tides in the MLT region are addressed in the present communication. The observations revealed that the diurnal tide is more prominent than the semi/terdiurnal components over this latitude. It is also observed that the amplitudes of meridional components are stronger than that of zonal ones. The amplitude and phase structure shows the vertical propagation of diurnal tides with vertical wavelength of ~25 km. However, the vertical wavelength of the semidiurnal tide showed considerable variations. The vertical propagation characteristics of the terdiurnal tide showed some indications of their generating mechanisms. The observed features of tidal components are compared with Global Scale Wave Model (GSWM02) values and they showed a similar amplitude and phase structure for diurnal tides. Month-to-month variations in the tidal amplitudes have shown significant seasonal variation. The observed seasonal variation is discussed in light of the variation in tidal forcing and dissipation

Parallel Navier-Stokes computations on shared and distributed memory architectures

We study a high order finite difference scheme to solve the time accurate flow field of a jet using the compressible Navier-Stokes equations. As part of our ongoing efforts, we have implemented our numerical model on three parallel computing platforms to study the computational, communication, and scalability characteristics. The platforms chosen for this study are a cluster of workstations connected through fast networks (the LACE experimental testbed at NASA Lewis), a shared memory multiprocessor (the Cray YMP), and a distributed memory multiprocessor (the IBM SPI). Our focus in this study is on the LACE testbed. We present some results for the Cray YMP and the IBM SP1 mainly for comparison purposes. On the LACE testbed, we study: (1) the communication characteristics of Ethernet, FDDI, and the ALLNODE networks and (2) the overheads induced by the PVM message passing library used for parallelizing the application. We demonstrate that clustering of workstations is effective and has the potential to be computationally competitive with supercomputers at a fraction of the cost

Timed inhibition of CDC7 increases CRISPR-Cas9 mediated templated repair.

Repair of double strand DNA breaks (DSBs) can result in gene disruption or gene modification via homology directed repair (HDR) from donor DNA. Altering cellular responses to DSBs may rebalance editing outcomes towards HDR and away from other repair outcomes. Here, we utilize a pooled CRISPR screen to define host cell involvement in HDR between a Cas9 DSB and a plasmid double stranded donor DNA (dsDonor). We find that the Fanconi Anemia (FA) pathway is required for dsDonor HDR and that other genes act to repress HDR. Small molecule inhibition of one of these repressors, CDC7, by XL413 and other inhibitors increases the efficiency of HDR by up to 3.5 fold in many contexts, including primary T cells. XL413 stimulates HDR during a reversible slowing of S-phase that is unexplored for Cas9-induced HDR. We anticipate that XL413 and other such rationally developed inhibitors will be useful tools for gene modification

Health care restructuring and family physician care for those who died of cancer

BACKGROUND: During the 1990s, health care restructuring in Nova Scotia resulted in downsized hospitals, reduced inpatient length of stay, capped physician incomes and restricted practice locations. Concurrently, the provincial homecare program was redeveloped and out-of-hospital cancer deaths increased from 20% (1992) to 30% (1998). These factors all pointed to a transfer of end-of-life inpatient hospital care to more community-based care. The purpose of this study was to describe the trends in the provision of Family Physician (FP) visits to advanced cancer patients in Nova Scotia (NS) during the years of health care restructuring. METHODS: Design Secondary multivariate analysis of linked population-based datafiles including the Queen Elizabeth II Health Sciences Centre Oncology Patient Information System (NS Cancer Registry, Vital Statistics), the NS Hospital Admissions/Separations file and the Medical Services Insurance Physician Services database. Setting Nova Scotia, an eastern Canadian province (population: 950,000). Subjects: All patients who died of lung, colorectal, breast or prostate cancer between April 1992 and March 1998 (N = 7,212). Outcome Measures Inpatient and ambulatory FP visits, ambulatory visits by location (office, home, long-term care facility, emergency department), time of day (regular hours, after hours), total length of inpatient hospital stay and number of hospital admissions during the last six months of life. RESULTS: In total, 139,641 visits were provided by family physicians: 15% of visits in the office, 10% in the home, 5% in the emergency department (ED), 5% in a long-term-care centre and 64% to hospital inpatients. There was no change in the rate of FP visits received for office, home and long-term care despite the fact that there were 13% fewer hospital admissions, and length of hospital stay declined by 21%. Age-sex adjusted estimates using negative binomial regression indicate a decline in hospital inpatient FP visits over time compared to 1992–93 levels (for 1997–98, adjusted RR = 0.88, 95%CI = 0.81–0.95) and an increase in FP ED visits (for 1997–98, adjusted RR = 1.18, 95%CI = 1.05–1.34). CONCLUSION: Despite hospital downsizing and fewer deaths occurring in hospitals, FP ambulatory visits (except for ED visits) did not rise correspondingly. Although such restructuring resulted in more people dying out of hospital, it does not appear FPs responded by providing more medical care to them in the community

Evidence for stratospheric sudden warming effects on the upper thermosphere derived from satellite orbital decay data during 1967–2013

We investigate possible impact of stratospheric sudden warmings (SSWs) on the thermosphere by using long-term data of the global average thermospheric total mass density derived from satellite orbital drag during 1967–2013. Residuals are analyzed between the data and empirical Global Average Mass Density Model (GAMDM) that takes into account density variability due to solar activity, season, geomagnetic activity, and long-term trend. A superposed epoch analysis of 37 SSW events reveals a density reduction of 3–7% at 250–575 km around the time of maximum polar vortex weakening. The relative density perturbation is found to be greater at higher altitudes. The temperature perturbation is estimated to be −7.0 K at 400 km. We show that the density reduction can arise from enhanced wave forcing from the lower atmosphere

Vertical stratification of the air microbiome in the lower troposphere

The troposphere constitutes the final frontier of global ecosystem research due to technical challenges arising from its size, low biomass, and gaseous state. Using a vertical testing array comprising a meteorological tower and a research aircraft, we conducted synchronized measurements of meteorological parameters and airborne biomass (n = 480) in the vertical air column up to 3,500 m. The taxonomic analysis of metagenomic data revealed differing patterns of airborne microbial community composition with respect to time of day and height above ground. The temporal and spatial resolution of our study demonstrated that the diel cycle of airborne microorganisms is a ground-based phenomenon that is entirely absent at heights >1,000 m. In an integrated analysis combining meteorological and biological data, we demonstrate that atmospheric turbulence, identified by potential temperature and high-frequency three-component wind measurements, is the key driver of bioaerosol dynamics in the lower troposphere. Multivariate regression analysis shows that at least 50% of identified airborne microbial taxa (n = ∼10,000) are associated with either ground or height, allowing for an understanding of dispersal patterns of microbial taxa in the vertical air column. Due to the interconnectedness of atmospheric turbulence and temperature, the dynamics of microbial dispersal are likely to be impacted by rising global temperatures, thereby also affecting ecosystems on the planetary surface