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Abstract Background Breast-conserving surgery for breast cancer was developed as a method to preserve healthy breast tissue, thereby improving cosmetic outcomes. Thus far, the primary aim of breast-conserving surgery has been the achievement of tumour-free resection margins and prevention of local recurrence, whereas the cosmetic outcome has been considered less important. Large studies have reported poor cosmetic outcomes in 20-40% of patients after breast-conserving surgery, with the volume of the resected breast tissue being the major determinant. There is clear evidence for the efficacy of ultrasonography in the resection of nonpalpable tumours. Surgical resection of palpable breast cancer is performed with guidance by intra-operative palpation. These palpation-guided excisions often result in an unnecessarily wide resection of adjacent healthy breast tissue, while the rate of tumour-involved resection margins is still high. It is hypothesised that the use of intra-operative ultrasonography in the excision of palpable breast cancer will improve the ability to spare healthy breast tissue while maintaining or even improving the oncological margin status. The aim of this study is to compare ultrasound-guided surgery for palpable tumours with the standard palpation-guided surgery in terms of the extent of healthy breast tissue resection, the percentage of tumour-free margins, cosmetic outcomes and quality of life. Methods/design In this prospective multicentre randomised controlled clinical trial, 120 women who have been diagnosed with palpable early-stage (T1-2N0-1) primary invasive breast cancer and deemed suitable for breast-conserving surgery will be randomised between ultrasound-guided surgery and palpation-guided surgery. With this sample size, an expected 20% reduction of resected breast tissue and an 18% difference in tumour-free margins can be detected with a power of 80%. Secondary endpoints include cosmetic outcomes and quality of life. The rationale, study design and planned analyses are described. Conclusion The COBALT trial is a prospective, multicentre, randomised controlled study to assess the efficacy of ultrasound-guided breast-conserving surgery in patients with palpable early-stage primary invasive breast cancer in terms of the sparing of breast tissue, oncological margin status, cosmetic outcomes and quality of life. Trial Registration Number Netherlands Trial Register (NTR): NTR2579

In this study, aspects of intimate terrorism (IT) were examined in a subsample (n = 320) derived from a nationwide study on domestic violence in The Netherlands in 2008. The sample consisted of 60% women and 40% men. Three groups were distinguished: no IT, low IT, and tendency to IT. In the tendency to IT group, more men than women were found, which is in line with several studies. The use of controlling behaviors can be attributed more to men than to women. Violent behaviors (to mock/humiliate the partner, to destroy objects of the partner, and pushing and grabbing the partner) were significantly more present in the tendency to IT group than in the no IT group. These three violent behaviors contributed (10%) independently to the prediction of the dependent variable (aspects of IT). Even though our sample was not representative and the six control tactics were not selected in a self-selected Web survey sample, we tentatively conclude that indications of IT can be detected by the use of online panels and not only by registered and clinical data as stated by Johnson. [ABSTRACT FROM AUTHOR]

Objective--To compare computed tomography (CT) images of equine tarsi with cross-sectional anatomic slices and evaluate the potential of CT for imaging pathological tarsal changes in horses. Sample--6 anatomically normal equine cadaveric hind limbs and 4 tarsi with pathological changes. Procedures--Precontrast CT was performed on 3 equine tarsi; sagittal and dorsal reconstructions were made. In all limbs, postcontrast CT was performed after intra-articular contrast medium injection of the tarsocrural, centrodistal, and tarsometatarsal joints. Images were matched with corresponding anatomic slices. Four tarsi with pathological changes underwent CT examination. Results--The tibia, talus, calcaneus, and central, fused first and second, third, and fourth tarsal bones were clearly visualized as well as the long digital extensor, superficial digital flexor, lateral digital flexor (with tarsal flexor retinaculum), gastrocnemius, peroneus tertius, and tibialis cranialis tendons and the long plantar ligament. The lateral digital extensor, medial digital flexor, split peroneus tertius, and tibialis cranialis tendons and collateral ligaments could be located but not always clearly identified. Some small tarsal ligaments were identifiable, including plantar, medial, interosseus, and lateral talocalcaneal ligaments; interosseus talocentral, centrodistal, and tarsometatarsal ligaments; proximal and distal plantar ligaments; and talometatarsal ligament. Parts of the articular cartilage could be assessed on postcontrast images. Lesions were detected in the 4 tarsi with pathological changes. Conclusions and Clinical Relevance--CT of the tarsus is recommended when radiography and ultrasonography are inconclusive and during preoperative planning for treatment of complex fractures. Images from this study can serve as a CT reference, and CT of pathological changes was useful. [ABSTRACT FROM AUTHOR]

Mitochondrial form and function are closely interlinked in homeostasis and aging. Inhibiting mitochondrial translation is known to increase lifespan in C. elegans, and is accompanied by a fragmented mitochondrial network. However, whether this link between mitochondrial translation and morphology is causal in longevity remains uncharacterized. Here, we show in C. elegans that disrupting mitochondrial network homeostasis by blocking fission or fusion synergizes with reduced mitochondrial translation to prolong lifespan and stimulate stress response such as the mitochondrial unfolded protein response, UPRMT. Conversely, immobilizing the mitochondrial network through a simultaneous disruption of fission and fusion abrogates the lifespan increase induced by mitochondrial translation inhibition. Furthermore, we find that the synergistic effect of inhibiting both mitochondrial translation and dynamics on lifespan, despite stimulating UPRMT, does not require it. Instead, this lifespan-extending synergy is exclusively dependent on the lysosome biogenesis and autophagy transcription factor HLH-30/TFEB. Altogether, our study reveals the mechanistic crosstalk between mitochondrial translation, mitochondrial dynamics, and lysosomal signaling in regulating longevity., (© 2020 Liu et al.)