Obesity and Sugar‐sweetened Beverages in African‐American Preschool Children: A Longitudinal Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93655/1/oby.2008.656.pd

No axillary surgical treatment for lymph node-negative patients after ultra-sonography [NAUTILUS]: protocol of a prospective randomized clinical trial

Abstract Background Following sentinel lymph node biopsy (SLNB), the axillary recurrence rate is very low although SLNB has a false-negative rate of 5–10%. In the ACOSOG Z0011 trial, non-sentinel positive-lymph nodes were found in more than 20% of the axillary dissection group; the SLNB only group did not have a higher axillary recurrence rate. These findings raised questions about the direct therapeutic effect of the SLNB. SLNB has post-surgical complications including lymphedema. Considering advances in imaging modalities and adjuvant therapies, the role of SLNB in early breast cancer needs to be re-evaluated. Methods The NAUTILUS trial is a prospective multicenter randomized controlled trial involving clinical stage T1–2 and N0 breast cancer patients receiving breast-conserving surgery. Axillary ultrasound is mandatory before surgery with predefined imaging criteria for inclusion. Ultrasound-guided core needle biopsy or needle aspiration of a suspicious node is allowed. Patients will be randomized (1:1) into the no-SLNB (test) and SLNB (control) groups. A total of 1734 patients are needed, considering a 5% non-inferiority margin, 5% significance level, 80% statistical power, and 10% dropout rate. All patients in the two groups will receive ipsilateral whole-breast radiation according to a predefined protocol. The primary endpoint of this trial is the 5-year invasive disease-free survival. The secondary endpoints are overall survival, distant metastasis-free survival, axillary recurrence rate, and quality of life of the patients. Discussion This trial will provide important evidence on the oncological safety of the omission of SLNB for early breast cancer patients undergoing breast-conserving surgery and receiving whole-breast radiation, especially when the axillary lymph node is not suspicious during preoperative axillary ultrasound. Trial registration ClinicalTrials.gov, NCT04303715 . Registered on March 11, 2020

Phase II randomized trial of neoadjuvant metformin plus letrozole versus placebo plus letrozole for estrogen receptor positive postmenopausal breast cancer (METEOR)

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Abstract Background Neoadjuvant endocrine therapy with an aromatase inhibitor has shown efficacy comparable to that of neoadjuvant chemotherapy in patients with postmenopausal breast cancer. Preclinical and clinical studies have shown that the antidiabetic drug metformin has anti-tumor activity. This prospective, multicenter, phase II randomized, placebo controlled trial was designed to evaluate the direct anti-tumor effect of metformin in non-diabetic postmenopausal women with estrogen-receptor (ER) positive breast cancer. Methods/Design Patients meeting the inclusion criteria and providing written informed consent will be randomized to 24 weeks of neoadjuvant treatment with letrozole (2.5 mg/day) and either metformin (2000 mg/day) or placebo. Target accrual number is 104 patients per arm. The primary endpoint will be clinical response rate, as measured by calipers. Secondary endpoints include pathologic complete response rate, breast conserving rate, change in Ki67 expression, breast density change, and toxicity profile. Molecular assays will be performed using samples obtained before treatment, at week 4, and postoperatively. Discussion This study will provide direct evidence of the anti-tumor effect of metformin in non-diabetic, postmenopausal patients with ER-positive breast cancer. Trial registration ClinicalTrials.gov Identifier NCT0158936

Phase II randomized trial of neoadjuvant metformin plus letrozole versus placebo plus letrozole for estrogen receptor positive postmenopausal breast cancer (METEOR)

This study is being supported by grant no 04-2012-0290 from the SNUH Research fund and by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIP)(No. 2013005540). Letrozole and metformin are being supplied by the pharmaceutical company, Shin Poong Pharm. Co., Ltd.Background : Neoadjuvant endocrine therapy with an aromatase inhibitor has shown efficacy comparable to that of neoadjuvant chemotherapy in patients with postmenopausal breast cancer. Preclinical and clinical studies have shown that the antidiabetic drug metformin has anti-tumor activity. This prospective, multicenter, phase II randomized, placebo controlled trial was designed to evaluate the direct anti-tumor effect of metformin in non-diabetic postmenopausal women with estrogen-receptor (ER) positive breast cancer. Methods/Design : Patients meeting the inclusion criteria and providing written informed consent will be randomized to 24 weeks of neoadjuvant treatment with letrozole (2.5 mg/day) and either metformin (2000 mg/day) or placebo. Target accrual number is 104 patients per arm. The primary endpoint will be clinical response rate, as measured by calipers. Secondary endpoints include pathologic complete response rate, breast conserving rate, change in Ki67 expression, breast density change, and toxicity profile. Molecular assays will be performed using samples obtained before treatment, at week 4, and postoperatively. Discussion : This study will provide direct evidence of the anti-tumor effect of metformin in non-diabetic, postmenopausal patients with ER-positive breast cancer. Trial registration : ClinicalTrials.gov Identifier NCT01589367Peer Reviewe

Resilience to Urban Poverty: Theoretical and Empirical Considerations for Population Health

Objectives. To better understand the trajectory that propels people from poverty to poor health, we investigated health resilience longitudinally among African American families with incomes below 250% of the federal poverty level

Number of Tumor Foci as a Risk Factor for Recurrence in Papillary Thyroid Carcinoma: Does It Improve Predictability?

Multifocality in papillary thyroid carcinoma (PTC) increases the risk of recurrence. Some recent studies have suggested that multifocality-related parameters, such as the number of tumor foci, total tumor diameter (TTD), and bilaterality, are more useful for predicting recurrence than multifocality. However, it is still unclear if these factors can improve the accuracy of the recurrence prediction model. Between 2012 and 2019, 1288 patients with PTC underwent total thyroidectomy at Ewha Womans University Medical Center. The 5-year disease-free survival rate was 91.2% in patients with >3 tumor foci, 95.1% with 3 foci, and 97.6% with 2 foci; conversely, those with a unifocal tumor showed a 5-year recurrence-free survival rate of 98.0%. Cox proportional hazards analysis indicated that the number of tumor foci (HR for >3 foci, 3.214; HR for 3 foci, 2.473), bilaterality (HR, 2.530), or TTD (HR for >3 cm, 5.359; HR for 2–3 cm, 3.584) could be an independent predictor of recurrence. However, models using the number of tumor foci, bilaterality, and TTD did not show better overall predictability of recurrence than models based on multifocality. In conclusion, a simpler prediction model based on multifocality may be sufficient

Staphylococcus aureus-Derived Extracellular Vesicles Enhance the Efficacy of Endocrine Therapy in Breast Cancer Cells

The microbiome involved in the human estrogen metabolism is known as the estrobolome. This study aimed to show that the estrobolome can be used in breast cancer treatment. We first analyzed the blood microbiome composition of healthy controls and patients with breast cancer. In particular, we investigated the bacteria producing β−glucuronidase and/or β−galactosidase, which are involved in estrogen metabolism in the human body. Staphylococcus species were more abundant in healthy controls than in breast cancer patients and therefore were selected for further analyses. The effect of Staphylococcus aureus on endocrine therapy was analyzed by a combination treatment with tamoxifen. Analysis of the microbiome of blood samples showed that species producing β−glucuronidase were more abundant in breast cancer patients than in healthy controls. Further experiments confirmed that the efficacy of tamoxifen increased when administered in conjugation with the extracellular vesicles (EVs) of S. aureus. Based on our results, we deduced that S. aureus EVs could potentially be used as adjuvants for breast cancer treatment in the future

Optimal Precoder Selection for Spatially Multiplexed Multiple-Input Multiple-Output Systems With Maximum Likelihood Detection: Exploiting the Concept of Sphere Decoding

In this paper, a computationally efficient implementation technique for optimal precoder selection in spatially multiplexed (SM) multiple-input multiple-output (MIMO) systems with maximum-likelihood detection at the receiver is proposed. The techniques previously developed for suboptimal precoder selection were based on the lower bounds of the free distances of precoders to reduce the processing time. However, the use of these techniques leads to significant declines in error performance when the number of spatial streams approaches the number of receiving antennas. At the same time, to achieve optimal performance, the conventional optimal precoder selection technique can be employed; however, it has a long processing time due to exhaustive search. Thus, in this paper, we propose a precoder selection technique that maintains an optimal performance without the prohibitive processing time of the conventional optimal precoder selection. The processing time can be reduced by the following: (1) exploiting the symmetric structure of quadrature amplitude modulation (QAM) constellations, thereby reducing the search space; (2) adopting the concept of sphere decoding (SD); (3) eliminating the last stage of SD; and (4) performing an SD-like process in a selective manner. Both the optimal performance and reduction in the processing time realized by the proposed technique are confirmed via simulation

Effects of oxygen plasma generated in magnetron sputtering of ruthenium oxide on pentacene thin film transistors

Effects of oxygen plasma generated in a sputtering process for deposition of electrodes on pentacene thin films to configure top-contact (TC) transistors have been thoroughly investigated. Reactive oxygen species severely degraded electrical properties of pentacene films during the deposition of RuOx electrodes, leading to a failure of devices. In the off-region, the leakage current increased by about two orders of magnitude, and the subthreshold slope also increased by 6.5 times. The top surface of pentacene films was oxidized by oxygen plasma and C-O and C=O bonds awerere created. The pentacenequinone derivative was confirmed by X-ray photoelectron spectroscopy. The oxidation of pentacene films gives rise to charge traps at the pentacene/electrode interface, which produces a leakage channel between source and drain electrodes. We believe that this side effect of oxygen plasma on the fabrication of TC-devices should be considered carefully.11sciescopuskc