Breast cancer risk reduction:is it feasible to initiate a randomised controlled trial of a lifestyle intervention programme (ActWell) within a national breast screening programme?

BackgroundBreast cancer is the most commonly diagnosed cancer and the second cause of cancer deaths amongst women in the UK. The incidence of the disease is increasing and is highest in women from least deprived areas. It is estimated that around 42% of the disease in post-menopausal women could be prevented by increased physical activity and reductions in alcohol intake and body fatness. Breast cancer control endeavours focus on national screening programmes but these do not include communications or interventions for risk reductionThis study aimed to assess the feasibility of delivery, indicative effects and acceptability of a lifestyle intervention programme initiated within the NHS Scottish Breast Screening Programme (NHSSBSP).MethodsA 1:1 randomised controlled trial (RCT) of the 3 month ActWell programme (focussing on body weight, physical activity and alcohol) versus usual care conducted in two NHSSBSP sites between June 2013 and January 2014. Feasibility assessments included recruitment, retention, and fidelity to protocol. Indicative outcomes were measured at baseline and 3 month follow-up (body weight, waist circumference, eating and alcohol habits and physical activity. At study end, a questionnaire assessed participant satisfaction and qualitative interviews elicited women¿s, coaches and radiographers¿ experiences. Statistical analysis used Chi squared tests for comparisons in proportions and paired t tests for comparisons of means. Linear regression analyses were performed, adjusted for baseline values, with group allocation as a fixed effectResultsA pre-set recruitment target of 80 women was achieved within 12 weeks and 65 (81%) participants (29 intervention, 36 control) completed 3 month assessments. Mean age was 58¿±¿5.6 years, mean BMI was 29.2¿±¿7.0 kg/m2 and many (44%) reported a family history of breast cancer.The primary analysis (baseline body weight adjusted) showed a significant between group difference favouring the intervention group of 2.04 kg (95%CI ¿3.24 kg to ¿0.85 kg). Significant, favourable between group differences were also detected for BMI, waist circumference, physical activity and sitting time. Women rated the programme highly and 70% said they would recommend it to others.ConclusionsRecruitment, retention, indicative results and participant acceptability support the development of a definitive RCT to measure long term effects.Trial registrationThe trial was registered with Current Controlled Trials (ISRCTN56223933)

Gluonic and leptonic decays of heavy quarkonia and the determination of αs(mc)\alpha_s(m_c) and αs(mb)\alpha_s(m_b)

QCD running coupling constant $\alpha_s(m_c)$ and $\alpha_s(m_b)$ are determined from heavy quarkonia $c\overline{c}$ and $b\overline{b}$ decays. The decay rates of $V\rightarrow 3g$ and $V\rightarrow e^+ e^-$ for $V=J/\psi$ and $\Upsilon$ are estimated by taking into account both relativistic and QCD radiative corrections. The decay amplitudes are derived in the Bethe-Salpeter formalism, and the decay rates are estimated by using the meson wavefunctions which are obtained with a QCD-inspired inter-quark potential. For the $V\rightarrow 3g$ decay we find the relativistic correction to be very large and to severely suppress the decay rate. Using the experimental values of ratio R_g\equiv \frac {\Gamma (V\longrightarrow 3g)}% {\Gamma (V\longrightarrow e^{+}e^{-})}\approx 10,~32 for $V=J/\psi, ~\Upsilon$ respectively, and the calculated widths , we find $\alpha_{s}(m_c)=0.29\pm 0.02$ and $\alpha_s(m_b)=0.20\pm 0.02$. These values for the QCD running coupling constant are substantially enhanced, as compared with the ones obtained without relativistic corrections, and are consistent with the QCD scale parameter $\Lambda_{\overline {MS}}^{(4)}$. We also find that these results are mainly due to kinematic corrections and not sensitive to the dynamical models.Comment: 15 pages in Late

Scaling laws near the conformal window of many-flavor QCD

We derive universal scaling laws for physical observables such as the critical temperature, the chiral condensate, and the pion decay constant as a function of the flavor number near the conformal window of many-flavor QCD in the chiral limit. We argue on general grounds that the associated critical exponents are all interrelated and can be determined from the critical exponent of the running gauge coupling at the Caswell-Banks-Zaks infrared fixed point. We illustrate our findings with the aid of nonperturbative functional Renormalization Group (RG) calculations and low-energy QCD models.Comment: 18 pages, 4 figures, references added and discussion expanded (matches JHEP version

Pseuduscalar Heavy Quarkonium Decays With Both Relativistic and QCD Radiative Corrections

We estimate the decay rates of $\eta_c\rightarrow 2\gamma$, $\eta_c'\rightarrow 2\gamma$, and $J/\psi\rightarrow e^+ e^-$, $\psi^\prime\rightarrow e^+e^-$, by taking into account both relativistic and QCD radiative corrections. The decay amplitudes are derived in the Bethe-Salpeter formalism. The Bethe-Salpeter equation with a QCD-inspired interquark potential are used to calculate the wave functions and decay widths for these $c\bar{c}$ states. We find that the relativistic correction to the ratio $R\equiv \Gamma (\eta_c \rightarrow 2\gamma)/ \Gamma (J/ \psi \rightarrow e^+ e^-)$ is negative and tends to compensate the positive contribution from the QCD radiative correction. Our estimate gives $\Gamma(\eta_c \rightarrow 2\gamma)=(6-7) ~keV$ and $\Gamma(\eta_c^\prime \rightarrow 2\gamma)=2 ~keV$, which are smaller than their nonrelativistic values. The hadronic widths $\Gamma(\eta_c \rightarrow 2g)=(17-23) ~MeV$ and $\Gamma(\eta_c^\prime \rightarrow 2g)=(5-7)~MeV$ are then indicated accordingly to the first order QCD radiative correction, if $\alpha_s(m_c)=0.26-0.29$. The decay widths for $b\bar b$ states are also estimated. We show that when making the assmption that the quarks are on their mass shells our expressions for the decay widths will become identical with that in the NRQCD theory to the next to leading order of $v^2$ and $\alpha_s$.Comment: 14 pages LaTex (2 figures included

Looking through the QCD conformal window with perturbation theory

We study the conformal window of QCD using perturbation theory, starting from the perturbative upper edge and going down as much as we can towards the strongly coupled regime. We do so by exploiting the available five-loop computation of the $overline{{m MS}}$ $eta$-function and employing Borel resummation techniques both for the ordinary perturbative series and for the Banks-Zaks conformal expansion. Large-$n_f$ results are also used. We argue that the perturbative series for the $overline{{m MS}}$ $eta$-function is most likely asymptotic and non-Borel resummable, yet Borel resummation techniques allow to improve on ordinary perturbation theory. We find substantial evidence that QCD with $n_f=12$ flavours flows in the IR to a conformal field theory. Though the evidence is weaker, we find indications that also $n_f=11$ might sit within the conformal window. We also compute the value of the mass anomalous dimension $gamma$ at the fixed point and compare it with the available lattice results. The conformal window might extend for lower values of $n_f$, but our methods break down for n_f<11, where we expect that non-perturbative effects become important. A similar analysis is performed in the Veneziano limit

Communication between family carers and health professionals about end-of-life care for older people in the acute hospital setting: a qualitative study

This paper focuses on communication between hospital staff and family carers of patients dying on acute hospital wards, with an emphasis on the family carers’ perspective. The age at which people in the UK die is increasing and many continue to die in the acute hospital setting. Concerns have been expressed about poor quality end of life care in hospitals, in particular regarding communication between staff and relatives. This research aimed to understand the factors and processes which affect the quality of care provided to frail older people who are dying in hospital and their family carers

Experimental Evaluation of Seed Limitation in Alpine Snowbed Plants

Background: The distribution and abundance of plants is controlled by the availability of seeds and of sites suitable for establishment. The relative importance of these two constraints is still contentious and possibly varies among species and ecosystems. In alpine landscapes, the role of seed limitation has traditionally been neglected, and the role of abiotic gradients emphasized. Methodology/Principal Findings: We evaluated the importance of seed limitation for the incidence of four alpine snowbed species (Achillea atrata L., Achillea clusiana Tausch, Arabis caerulea L., Gnaphalium hoppeanum W. D. J. Koch) in local plant communities by comparing seedling emergence, seedling, juvenile and adult survival, juvenile and adult growth, flowering frequency as well as population growth rates lambda of experimental plants transplanted into snowbed patches which were either occupied or unoccupied by the focal species. In addition, we accounted for possible effects of competition or facilitation on these rates by including a measure of neighbourhood biomass into the analysis. We found that only A. caerulea had significantly lower seedling and adult survival as well as a lower population growth rate in unoccupied sites whereas the vital rates of the other three species did not differ among occupied and unoccupied sites. By contrast, all species were sensitive to competitive effects of the surrounding vegetation in terms of at least one of the studied rates. Conclusions/Significance: We conclude that seed and site limitation jointly determine the species composition of these snowbed plant communities and that constraining site factors include both abiotic conditions and biotic interactions. The traditional focus on abiotic gradients for explaining alpine plant distribution hence appears lopsided. The influence of seed limitation on the current distribution of these plants casts doubt on their ability to readily track shifting habitats under climate change unless seed production is considerably enhanced under a warmer climate

Does Sex-Selective Predation Stabilize or Destabilize Predator-Prey Dynamics?

Background: Little is known about the impact of prey sexual dimorphism on predator-prey dynamics and the impact of sexselective harvesting and trophy hunting on long-term stability of exploited populations. Methodology and Principal Findings: We review the quantitative evidence for sex-selective predation and study its longterm consequences using several simple predator-prey models. These models can be also interpreted in terms of feedback between harvesting effort and population size of the harvested species under open-access exploitation. Among the 81 predator-prey pairs found in the literature, male bias in predation is 2.3 times as common as female bias. We show that long-term effects of sex-selective predation depend on the interplay of predation bias and prey mating system. Predation on the ‘less limiting’ prey sex can yield a stable predator-prey equilibrium, while predation on the other sex usually destabilizes the dynamics and promotes population collapses. For prey mating systems that we consider, males are less limiting except for polyandry and polyandrogyny, and male-biased predation alone on such prey can stabilize otherwise unstable dynamics. On the contrary, our results suggest that female-biased predation on polygynous, polygynandrous or monogamous prey requires other stabilizing mechanisms to persist. Conclusions and Significance: Our modelling results suggest that the observed skew towards male-biased predation might reflect, in addition to sexual selection, the evolutionary history of predator-prey interactions. More focus on these phenomena can yield additional and interesting insights as to which mechanisms maintain the persistence of predator-prey pairs over ecological and evolutionary timescales. Our results can also have implications for long-term sustainability of harvesting and trophy hunting of sexually dimorphic species