Prevalence of incidental breast cancer and precursor lesions in autopsy studies: A systematic review and meta-analysis

Abstract Background Autopsy studies demonstrate the prevalence pool of incidental breast cancer in the population, but estimates are uncertain due to small numbers in any primary study. We aimed to conduct a systematic review of autopsy studies to estimate the prevalence of incidental breast cancer and precursors. Methods Relevant articles were identified through searching PubMed and Embase from inception up to April 2016, and backward and forward citations. We included autopsy studies of women with no history of breast pathology, which included systematic histological examination of at least one breast, and which allowed calculation of the prevalence of incidental breast cancer or precursor lesions. Data were pooled using logistic regression models with random intercepts (non-linear mixed models). Results We included 13 studies from 1948 to 2010, contributing 2363 autopsies with 99 cases of incidental cancer or precursor lesions. More thorough histological examination (≥20 histological sections) was a strong predictor of incidental in-situ cancer and atypical hyperplasia (OR = 126·8 and 21·3 respectively, p < 0·001), but not invasive cancer (OR = 1·1, p = 0·75). The estimated mean prevalence of incidental cancer or precursor lesion was 19·5% (0·85% invasive cancer + 8·9% in-situ cancer + 9·8% atypical hyperplasia). Conclusion Our systematic review in ten countries over six decades found that incidental detection of cancer in situ and breast cancer precursors is common in women not known to have breast disease during life. The large prevalence pool of undetected cancer in-situ and atypical hyperplasia in these autopsy studies suggests screening programs should be cautious about introducing more sensitive tests that may increase detection of these lesions

On the Periphery: Examining Women’s Exclusion from Core Leadership Roles in the “Extremely Gendered” Organization of Men’s Club Football in England

This paper frames men’s club football as an “extremely gendered” organization to explain the underrepresentation of women leaders within the industry. By analyzing women’s leadership work over a 30-year period, we find that women’s inclusion has been confined to a limited number of occupational areas. These areas are removed, in terms of influence and proximity, from the male players and the playing of football. These findings reveal a gendered substructure within club football that maintains masculine dominance in core football facing leadership roles and relegates women to a position of peripheral inclusion in leadership roles. Through a discourse analysis of gender pay gap reports, we show that men’s football clubs legitimatize women’s peripheral inclusion by naturalizing male-dominance at the organizational core. These findings are significant as they demonstrate that men’s football clubs, as masculine conferring organizations, have excluded women from core roles in order to maintain their masculine character while superficially accepting women into roles that do not challenge the association of football with hegemonic masculinity. As such, organizational change may only be possible if women are granted greater access to core organizational roles. This paper offers a new theoretical framework for “extremely gendered” organizations that can be applied to other sporting and male-dominated contexts to analyze women’s access to core leadership roles

“It’s a Concrete Ceiling; It’s Not Even Glass”: Understanding Tenets of Organizational Culture That Supports the Progression of Women as Coaches and Coach Developers

The purpose of this study was to explore what particular areas of organizational cultures facilitate the development and progression of women as football coaches and coach developers. The English Football Association provided the context for the research. Previous statistics demonstrate that recruitment, retention, and progression of women in English football coaching and tutoring are lower and slower than their male counterparts. In-depth interviews were completed with 26 women coaches and coach developers during November 2015 and February 2016 to understand their personal experiences as linked to the structure and culture of their sporting governing body, and analyzed using Schein’s theory of organizational culture. Three key tenets of organizational culture were found to be most influential on the career development of the participants: journeys and crossroads (the establishment of a learning culture), inclusive leadership, and vertical and horizontal relationships. The research demonstrates the need to identify disparities between espoused values and assumptions to enact cultural change toward supporting more women to be valued, included, and progressed in the sporting workplace

Beyond Knowledge Transfer: The Role of Coach Developers as Motivators for Lifelong Learning

Research investigating coach education and development has grown significantly over the past three decades. Most of these efforts have focused on establishing how coaches learn; yet the actual impact of specific coach education and development interventions has received considerably less attention. Moreover, the role of coach developers in facilitating this impact remains largely unknown. To address this knowledge gap, this study used a realist evaluation approach to engage in a detailed exploration of a large-scale, multi-annual coach education and development intervention with high school coaches in the Philippines. Using interviews and focus groups at two different time points with multiple stakeholders, this study established a series of context, mechanism and outcome configurations that provide a nuanced perspective on how coach education and development works. More specifically, this paper offers a novel interpretation of the role of coach developers as ‘motivators for lifelong learning’ established through three key mechanisms: 1) being available, approachable, and supportive; 2) creating a sense of belonging; and 3) raising coaches’ aspirations by increasing their sense of purpose and duty. Practical guidelines for the education of coach developers, as well as future coach education and development programmes are provided

Deletion of the protein tyrosine phosphatase PTPN22 for adoptive T cell therapy facilitates CTL effector function but promotes T cell exhaustion

Background Adoptive cell therapy (ACT) is a promising strategy for treating cancer, yet it faces several challenges such as lack of long term protection due to T cell exhaustion induced by chronic TCR stimulation in the tumor microenvironment. One benefit of ACT, however, is that it allows for cellular manipulations, such as deletion of the phosphotyrosine phosphatase non-receptor type 22 (PTPN22), which improves CD8+ T cell anti-tumor efficacy in ACT. We tested whether Ptpn22KO cytolytic T cells (CTL) were also more effective than Ptpn22WT CTL in controlling tumors in scenarios that favor T cell exhaustion. Methods Tumor control by Ptpn22WT and Ptpn22KO CTL was assessed following adoptive transfer of low numbers of CTL to mice with subcutaneously implanted MC38 tumors. Tumor infiltrating lymphocytes were isolated for analysis of effector functions. An in vitro assay was established to compare CTL function in response to acute and chronic re-stimulation with antigen-pulsed tumor cells. The expression of effector and exhaustion-associated proteins by Ptpn22WT and Ptpn22KO T cells was followed over time in vitro and in vivo using the ID8 tumor model. Finally, the effect of PD-1 and TIM-3 blockade on Ptpn22KO CTL tumor control was assessed using monoclonal antibodies and CRISPR/Cas9-mediated knockout. Results Despite having improved effector function at the time of transfer, Ptpn22KO CTL became more exhausted than Ptpn22WT CTL, characterized by more rapid loss of effector functions, and earlier and higher expression of inhibitory receptors (IRs), particularly the terminal exhaustion marker TIM-3. TIM-3 expression, under the control of the transcription factor NFIL3, was induced by IL-2 signaling which was enhanced in Ptpn22KO cells. Anti-tumor responses of Ptpn22KO CTL were improved following PD-1 blockade in vivo, yet knockout or antibody-mediated blockade of TIM-3 did not improve but further impaired tumor control, indicating TIM-3 signaling itself did not drive the diminished function seen in Ptpn22KO CTL. Conclusions This study questions whether TIM-3 plays a role as an IR and highlights that genetic manipulation of T cells for ACT needs to balance short term augmented effector function against the risk of T cell exhaustion in order to achieve longer term protection. What is already known on this topic • T cell exhaustion in the tumor microenvironment is a major factor limiting the potential success of adoptive cell therapy (ACT) in the treatment of solid tumors. • Deletion of the phosphatase PTPN22 in CD8+ T cells improves their response to tumors, but it is not known whether this influences development of exhaustion. What this study adds • Under conditions which promote exhaustion, CTL lacking PTPN22 exhaust more rapidly than WT cells, despite displaying enhanced effector function in their initial response to antigen. • Ptpn22KO CTL express high levels of the inhibitory receptor TIM-3, but TIM-3 signaling does not directly contribute to Ptpn22KO CTL dysfunction. • Ptpn22KO T cells are more responsive to IL-2 through JAK-STAT signaling, which induces TIM-3 expression via the transcription factor NFIL3. How this study might affect research, practice or policy • Strategies aimed at augmenting T cell effector function for ACT should balance improved responses against an increased risk of T cell exhaustion

Statin Therapy Alters Lipid Storage in Diabetic Skeletal Muscle

While statins significantly reduce cholesterol levels and thereby reduce the risk of cardiovascular disease, the development of myopathy with statin use is a significant clinical side-effect. Recent guidelines recommend increasing inclusion criteria for statin treatment in diabetic individuals; however, the impact of statins on skeletal muscle health in those with diabetes (who already suffer from impairments in muscle health) is ill-defined. Here we investigate the effects of Fluvastatin treatment on muscle health in wild-type and streptozotocin (STZ)-induced diabetic mice. Wild-type and STZ-diabetic mice received diet enriched with 600 mg/kg Fluvastatin or control chow for 24 days. Muscle morphology, intra and extracellular lipid levels, and lipid transporter content was investigated. Our findings indicate that short-term Fluvastatin administration induced a myopathy that was not exacerbated by the presence of STZ-induced diabetes. Fluvastatin significantly increased ectopic lipid deposition within the muscle of STZ-diabetic animals, findings that were not seen with diabetes or statin treatment alone. Consistent with this observation, only Fluvastatin-treated diabetic mice downregulated protein expression of lipid transporters FAT/CD36 and FABPpm in their skeletal muscle. No differences in FAT/CD36 or FABPpm mRNA content were observed. Altered lipid compartmentalization resultant of a downregulation in lipid transporter content in STZ-induced diabetic skeletal muscle was apparent in the current investigation. Given the association between ectopic lipid deposition in skeletal muscle and the development of insulin-resistance, our findings highlight the necessity for more thorough investigations into the impact of statins in humans with diabetes

Scoping Review: Physical Activity and Social Functioning in Young People With Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) affects ~1 in 59 people in North America and diagnoses continue to rise (Center for Disease Control and Prevention, 2018). Unfortunately, the exact cause of ASD is unknown and therapy remains the primary means of intervention. People with ASD experience social and behavioral deficits associated with the disorder, which affect all aspects of life such as academics, relationships, and physical activity. Research has shown a relationship between physical activity and social skills in typically developing individuals; however, this relationship is less understood in people with ASD. The purpose of this scoping review was to uncover what is known about ASD, physical activity, and social functioning. The authors searched four databases and included 40 primary research articles in the review, most of which demonstrated a relationship between physical activity and social functioning for people with ASD. The relationship appears bidirectional: social functioning influences physical activity (to a lesser extent) and physical activity influences social functioning (to a greater extent). Regrettably, there were many limitations in these articles, such as small sample sizes and the under-representation of females and adults. Therefore, the review highlights several directions for future research

Silicon redistribution, acid site loss and the formation of a core-shell texture upon steaming SAPO-34 and their impact on catalytic performance in the methanol-to-olefins (MTO) reaction

IBM has received funding from the Engineering and Physical Sciences Research Council (EPSRC, Centre for Doctoral Training in Critical Resource Catalysis, EP/I017008/1) and Scotland's Chemistry departments (ScotCHEM). IBM also received a scholarship from the SCI and Santander. Johnson Matthey is thanked for in-kind contributions and hosting IBM in their R&D labs. ABN gratefully acknowledges support from the EPSRC (grants EP/L017008/1 and EP/R023751/1). The research data supporting this publication can be accessed at: https://doi.org/10.17630/09ddc03e-f121-4e79-9b55-674f64d9c8c4 [62].SAPO-34 is a commercially-implemented silicoaluminophosphate catalyst for selective high yield production of ethene and propene from methanol, but high temperature regeneration in the presence of steam leads to its deactivation. A comprehensive investigation of the effect of prolonged hydrothermal treatment on the structure and properties of SAPO 34 explains the changes in its catalytic methanol-to-olefins (MTO) performance. Microcrystalline powdered SAPO-34 (ca. 3 µm crystals, Al17.1P15.6Si3.3O72) and two batches of larger single crystals of SAPO-34 of different Si concentration (20-100 µm; Al17.3P14.7Si4.0O72 and Al17.7P12.3Si5.9O72 ) were steamed (pH2O = 0.95 atm) at 873–1023 K for up to 240 h. The acidity (NH3-TPD), crystallinity (PXRD), framework cation environment (solid-state 27Al, 29Si and 31P MAS NMR) and porosity were followed for all materials; larger crystals were amenable to single crystal X-ray diffraction, FIB-SEM and synchrotron IR microspectroscopy, including operando study during methanol and dimethyl ether conversions. Some level of steaming improved the lifetime of all SAPO-34 materials in MTO catalysis without affecting their olefin selectivity, although more severe conditions led to the formation of core-shell structures, microporosity loss and eventually at 1023 K, recrystallization to a dense phase. All these irreversible changes occurred faster in crystals with higher Si contents. The initial increase in catalytic lifetime results from an activated reduction in acid site density (Eact = 146(18) kJ mol⁻1), a result of redistribution of Si within the SAPO framework without porosity loss. Operando IR with online product analysis during methanol conversion suggests similar reaction pathways in calcined and steamed crystals, but with greatly reduced methoxy group densities in the latter. The gradual development of optically dark crystal cores upon progressive steaming was shown by FIB-SEM to be due to the formation of regions with meso- and macropores, and these were shown by IR mapping to possess low hydroxyl densities.PostprintPostprintPeer reviewe

Risk factors for malaria infection prevalence and household vector density between mass distribution campaigns of long-lasting insecticidal nets in North-western Tanzania.

BACKGROUND: Long-lasting insecticidal nets (LLINs) are the most widely deployed vector control intervention in sub-Saharan Africa to prevent malaria. Recent reports indicate selection of pyrethroid insecticide resistance is widespread in mosquito vectors. This paper explores risk factors associated with malaria infection prevalence and vector density between mass distribution campaigns, changes in net coverage, and loss of protection in an area of high pyrethroid resistance in Northwest Tanzania. METHODS: A cross sectional malaria survey of 3456 children was undertaken in 2014 in Muleba district, Kagera region west of Lake Victoria. Vector density was assessed using indoor light traps and outdoor tent traps. Anophelines were identified to species using PCR and tested for Plasmodium falciparum circumsporozoite protein. Logistic regression was used to identify household and environmental factors associated with malaria infection and regression binomial negative for vector density. RESULTS: LLIN use was 27.7%. Only 16.9% of households had sufficient nets to cover all sleeping places. Malaria infection was independently associated with access to LLINs (OR: 0.57; 95% CI 0.34-0.98). LLINs less than 2 years old were slightly more protective than older LLINs (53 vs 65% prevalence of infection); however, there was no evidence that LLINs in good condition (hole index < 65) were more protective than LLINs, which were more holed. Other risk factors for malaria infection were age, group, altitude and house construction quality. Independent risk factors for vector density were consistent with malaria outcomes and included altitude, wind, livestock, house quality, open eaves and LLIN usage. Indoor collections comprised 4.6% Anopheles funestus and 95.4% Anopheles gambiae of which 4.5% were Anopheles arabiensis and 93.5% were Anopheles gambiae sensu stricto. CONCLUSION: Three years after the mass distribution campaign and despite top-ups, LLIN usage had declined considerably. While children living in households with access to LLINs were at lower risk of malaria, infection prevalence remained high even among users of LLINs in good condition. While effort should be made to maintain high coverage between campaigns, distribution of standard pyrethroid-only LLINs appears insufficient to prevent malaria transmission in this area of intense pyrethroid resistance