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PURPOSE: Factors associated with improving exercise in ovarian cancer survivors remain unknown. We explored characteristics associated with exercise adherence among women treated for ovarian cancer in the Women’s Activity and Lifestyle Study in Connecticut (WALC) randomized controlled trial. METHODS: We evaluated adherence among women randomized to the WALC exercise intervention (N=74). Women had to be exercising ≤ 90 min/week and post-treatment. The intervention included 25 telephone-based exercise counseling sessions over 6 months. Adherence was defined as 150 min/week of moderate/vigorous-intensity exercise. We evaluated factors associated with exercise adherence and duration using multivariate logistic and linear regression. The number of sessions sufficient to achieve 150 min/week was modeled with an unadjusted receiver operating characteristic (ROC) curve. RESULTS: Women were 57.3 ±8.8 years old and 1.7 ± 1.0 years since diagnosis. The mean exercise time over 6 months was 166.0 ± 66.1 min/week, and 64.9% of women met the 150 min/week goal. Women attended 22.8 ±3.6 (92%) counseling sessions. No cancer recurrence during the study (OR = 9.15, 95% Cl: 1.09–44.02) and greater session attendance (OR = 1.21, 95% Cl: 1.02–1.43) were related to meeting the exercise goal. Greater session attendance (P

Previous work found that lower BMI is associated with a pathologic complete response (pCR) following neoadjuvant chemotherapy for breast cancer. Relative dose intensity (RDI) of chemotherapy is an important marker of treatment tolerability. We hypothesized that patients with low BMI would have higher RDI than patients with high BMI, explaining the mechanism for the association between BMI and pCR. We conducted a retrospective study of women treated with neoadjuvant chemotherapy for stage I-III breast cancer at Yale New Haven Hospital-Smilow Cancer Hospital. We reviewed medical records to determine tumor characteristics, chemotherapy doses, and reasons for dose reductions or delays. The treatment RDI was calculated using published methods. Chi-squared analyses were conducted to determine the associations between RDI and BMI and between RDI and pCR. Our cohort (n = 237) had an average age of 53 years (SD 13) and mean BMI of 29.5 kg/m2 (SD 7.0). Fifty-eight patients (24%) received

Obesity is associated with a higher risk of mortality in women with ovarian cancer. Exercise has improved body composition among cancer survivors, yet no randomized controlled trial has explored the effect of exercise on body composition in women with ovarian cancer. In this analysis, we examined the effect of a six-month aerobic exercise intervention on body composition among ovarian cancer survivors in the Women's Activity and Lifestyle Study in Connecticut (WALC).Women with ovarian cancer (N = 144) were randomized in a 1:1 ratio to 6 months of an aerobic exercise intervention or attention-control, and body composition was measured as a secondary outcome at baseline and 6 months via dual-energy X-ray absorptiometry (DEXA). Women with at least one DEXA scan were included in the analysis (N = 103).On average, participants were 57.1 (± 8.7) years old and 1.6 (± 0.9) years since diagnosis. Women randomized to exercise maintained weight during the trial (- 0.11 kg, P = 0.82), while women in attention-control gained weight (+ 1.40 kg, P = 0.03); however, the between-group difference did not reach statistical significance (P = 0.09). We found no statistically significant differences by study arm for changes in body fat percentage, bone mineral density, or lean body mass.Weight was maintained as a result of a 6-month aerobic exercise intervention among post-treatment ovarian cancer survivors. Future exercise and healthy eating interventions should consider additional measures (e.g., computer tomography scans, DModerate-intensity aerobic exercise may help ovarian cancer survivors maintain weight.

PURPOSE: HCC incidence has been continuously rising in the US for past 30 years. To understand the increase in HCC risk, we conducted a case-control study in Connecticut, New Jersey and part of New York City. METHODS: Through rapid case ascertainment and random digit dialing, we recruited 673 incident HCC patients and 1,166 controls. Information on demographic and anthropometric characteristics, lifestyle factors, medical and family cancer histories, were ascertained through telephone interviews using a structured questionnaire. Saliva specimens were collected for testing hepatitis C virus (HCV) antibodies. Unconditional logistic regression models were utilized to calculate odds ratio (OR) and 95% confidence interval (CI) to determine HCC associations with risk factors. RESULTS: The study confirmed that HCV infection and obesity were important risk factors for HCC, ORs=110 (95%CI: 59.2–204) and 2.13 (95%CI: 1.52–3.00), respectively. High BMI and HCV infection had synergy in association with elevated HCC risk. Patients both obese and infected with HCV had HCC detected on average nearly 10 years earlier than those with neither factor. Diabetes, cigarette smoking and heavy alcohol intake were all associated with increased risk of HCC, whereas aspirin and other NSAID use were associated with reduced risk. HCC cases tended to attain less education, with lower household incomes, unmarried, and to have had more sexual partners than the controls. CONCLUSIONS: Individuals at risk of HCC in the US comprise a unique population with low socioeconomic status and unhealthy lifestyle choices. Given the multifactorial nature, a comprehensive approach is needed in HCC prevention.

We reviewed 12 studies in which the researcher taught problem-solving strategies, such as self-questioning and visual imagining, to children and adolescents with and without disabilities to facilitate the learning of math, spelling, play/social, and communication skills. We analyzed these studies in terms of types of problem-solving strategies, the multiple control involved in problem solving, the extent to which problem solving occurred at the overt or covert level. In addition to suggesting limitations of the literature, we recommend areas for future research and practice.

Some studies suggest that telomere shortening may be associated with increased breast cancer risk and mortality. Obesity is also associated with increased breast cancer risk and mortality. Few studies have examined changes in telomere length in overweight or obese breast cancer survivors. The purpose of our study was to examine the effect of a 6-month diet- and exercise-induced weight loss intervention versus usual care on telomere length in breast cancer survivors. 151 breast cancer survivors with body mass index (BMI) ≥ 25 kg/m2 were randomly assigned to a 6-month weight loss intervention (n = 93) or to usual care (n = 58). Fasting blood samples, height, weight, physical activity, and diet were measured at baseline and 6-months. Relative telomere length (RTL) was measured by quantitative-polymerase chain reaction (qPCR) done on buffy coat-extracted genomic DNA. Mean baseline to 6-month changes were compared between groups (intention-to-treat) using generalized estimating equations. Complete telomere data were available in 125 participants. Women were 58 ± 8 years, with BMI 33.0 ± 6.2 kg/m2 and were 2.9 ± 2.5 years from diagnosis; 90% were non-Hispanic white, and 76% had stage 0/I breast cancer. After 6 months, women randomized to weight loss had 3% telomere lengthening compared to 5% shortening in the usual care group (p = 0.12). Among women with stage 0/I, the intervention group experienced 7% telomere lengthening compared to 8% shortening in the usual care group (p = 0.01). No intervention effect was observed in women with stage II/III breast cancer. Our findings suggest a weight loss intervention in stage 0 and 1 breast cancer survivors may lead to telomere lengthening, compared to a shortening in their usual care counterparts.

Up to 50 % of postmenopausal breast cancer survivors taking aromatase inhibitors (AIs) experience AI-associated arthralgias, or joint pain, which causes many to stop taking AIs and may inhibit exercise, despite known health benefits. We thus evaluated exercise adherence and factors associated with better exercise adherence in breast cancer survivors experiencing AI-induced arthralgia in the (HOPE) year long randomized controlled trial. We included 61 HOPE women randomized to exercise (150 min/week of moderate-intensity aerobic exercise and twice-weekly supervised strength training). Our main outcomes were aerobic exercise measured with daily activity logs, attendance at supervised exercise sessions, and changes in cardiorespiratory fitness, measured maximal oxygen consumption (VO2max). We examined means and standard deviations (SDs) for exercise adherence by demographic and medical characteristics and used the t test for mean differences. We also examined predictors of adherence using linear regression. On average, at the end of the year long trial, women reported 119 (SD 78) min/week of moderate-intensity aerobic exercise and participated in 70 % of supervised exercise training sessions. After adjustment for other factors that influence adherence, at 6 months postrandomization, only baseline VO2max was associated with higher aerobic exercise levels and at 12 months, only older age predicted better supervised exercise training attendance. Breast cancer survivors taking AIs and experiencing arthralgia are able to initiate and maintain a year long exercise program, regardless of other factors that influence activity levels. Breast cancer survivors can exercise at levels that have been shown to improve AI-associated arthralgia.

Primary headache disorders, including migraine, are some of the most common neurological disorders presenting to hospital. Episodic syndromes that may be associated with migraine, including recurrent gastrointestinal disturbances such as abdominal migraine and cyclic vomiting, often pre-date or co-occur with the onset of migraine in a child who is at risk of developing the headache condition. The purpose of this review is to evaluate the two most common episodic syndromes, abdominal migraine and cyclic vomiting syndrome, including their pathophysiology, common presentations, and diagnostic criteria. Differential diagnosis and "red flag" features are outlined, and an approach to diagnostic work-up is offered. Finally, we provide an evidence-based review of management options and long-term prognosis. Future research should include randomized trials for the acute and preventive treatment of these disorders, as well as research as to whether early intervention can prevent progression to migraine and/or mitigate migraine severity.

Background Magnesium oxide nanoparticles (MgO nanoparticles, with average size of 20 nm) have considerable potential as antimicrobial agents in food safety applications due to their structure, surface properties, and stability. The aim of this work was to investigate the antibacterial effects and mechanism of action of MgO nanoparticles against several important foodborne pathogens. Results Resazurin (a redox sensitive dye) microplate assay was used for measuring growth inhibition of bacteria treated with MgO nanoparticles. The minimal inhibitory concentrations of MgO nanoparticles to 104 colony-forming unit/ml (CFU/ml) of Campylobacter jejuni, Escherichia coli O157:H7, and Salmonella Enteritidis were determined to be 0.5, 1 and 1 mg/ml, respectively. To completely inactivate 108−9 CFU/ml bacterial cells in 4 h, a minimal concentration of 2 mg/ml MgO nanoparticles was required for C. jejuni whereas E. coli O157:H7 and Salmonella Enteritidis required at least 8 mg/ml nanoparticles. Scanning electron microscopy examination revealed clear morphological changes and membrane structural damage in the cells treated with MgO nanoparticles. A quantitative real-time PCR combined with ethidium monoazide pretreatment confirmed cell membrane permeability was increased after exposure to the nanoparticles. In a cell free assay, a low level (1.1 μM) of H2O2 was detected in the nanoparticle suspensions. Consistently, MgO nanoparticles greatly induced the gene expression of KatA, a sole catalase in C. jejuni for breaking down H2O2 to H2O and O2. Conclusions MgO nanoparticles have strong antibacterial activity against three important foodborne pathogens. The interaction of nanoparticles with bacterial cells causes cell membrane leakage, induces oxidative stress, and ultimately leads to cell death.

Animal and laboratory studies suggest that long-chain omega-3 (n-3) fatty acids, a type of polyunsaturated fat found in fatty fish, may protect against carcinogenesis, but human studies on dietary intake of polyunsaturated fats and fish with endometrial cancer risk show mixed results.We evaluated the associations between endometrial cancer risk and intake of fatty acids and fish in a population-based sample of 556 incident cancer cases and 533 age-matched controls using multivariate unconditional logistic regression methods.Although total n-3 fatty acid intake was not associated with endometrial cancer risk, higher intakes of eicosapentaenoic (EPA 20:5) and docosahexaenoic (DHA 22:6) fatty acids were significantly associated with lower risks (OR = 0.57, 95 % CI: 0.39-0.84; OR = 0.64, 95 % CI: 0.44-0.94; respectively) comparing extreme quartiles. The ratio of n-3:n-6 fatty acids was inversely associated with risk only on a continuous scale (OR = 0.84, 95 % CI: 0.71-0.99), while total fish intake was not associated with risk. Fish oil supplement use was significantly associated with reduced risk of endometrial cancer: OR = 0.63 (95 % CI: 0.45-0.88).Our results suggest that dietary intake of the long-chain polyunsaturated fatty acids EPA and DHA in foods and supplements may have protective associations against the development of endometrial cancer.

Wildlife sampling for habitat selection often combines a random background sample with a random sample of used sites, because the background sample could contain too few used sites to be informative for rare species. This approach is referred to as use-availability sampling. Two variants are considered where there is: (1) a random background sample including used and unused sites augmented with a sample of used sites, and (2) a sample of used sites augmented with a contaminated background sample, i.e. use is not recorded. A weighted estimator first proposed by Manski and Lerman (Econometrica 45(8):1977–1988, 1977) forms the basis for our suggested approach. The weighted estimator has been shown to perform better than the usual unweighted approach with uncontaminated data and mis-specified logit models (Xie and Manski in Sociol Methods Res 17(3):283–302, 1989). A weighted EM algorithm is developed for use with contaminated background data. We show that the weighted estimator continues to perform well with contaminated data and maintains its robustness to model mis-specification. The weighted estimator has not been previously used for use-availability sampling due to reliance on the assumption that only the intercept is biased, which is valid for a correct logit model. We show that adjusting the intercept may not eliminate the bias with an incorrect logit model. In this case, the weighted estimator is a relatively simple and effective alternative.

For any analytical system the population mean (μ) number of entities (e.g., cells or molecules) per tested volume, surface area, or mass also defines the population standard deviation\( (\sigma = \sqrt {\mu } ) \). For a preponderance of analytical methods, σ is very small relative to μ due to their large limit of detection (>102 per volume). However, in theory at least, DNA-based detection methods (real-time, quantitative or qPCR) can detect ≈ 1 DNA molecule per tested volume (i.e., μ ≈ 1) whereupon errors of random sampling can cause sample means (\( \overline x \)) to substantially deviate from μ if the number of samplings (n), or “technical replicates”, per observation is too small. In this work the behaviors of two measures of sampling error (each replicated fivefold) are examined under the influence of n. For all data (μ = 1.25, 2.5, 5, 7.5, 10, and 20) a large sample of individual analytical counts (x) were created and randomly assigned into N integral-valued sub-samples each containing between 2 and 50 repeats (n) whereupon N × n = 322 to 361. From these data the average μ-normalized deviation of σ from each sub-sample’s standard deviation estimate \(\left( {s_j ;\;j = 1\;{\hbox{to}}\;N;\;N = 7\;\left[ {n = 50} \right]\;{\hbox{to}}\;180\;\left[ {n = 2} \right]} \right)\) was calculated (Δ). Alternatively, the average μ-normalized deviation of μ from each sub-sample’s mean estimate (\( {\overline x_{\rm{j}}} \)) was also evaluated (Δ′). It was found that both of these empirical measures of sampling error were proportional to \( \sqrt[{ - 2}]{{n \cdot \mu }} \). Derivative (∂/∂n · Δ or Δ′) analyses of our results indicate that a large number of samplings \( (n \approx {33}\pm {3}.{1}) \) are requisite to achieve a nominal sampling error for samples with a μ ≈ 1. This result argues that pathogen detection is most economically performed, even using highly sensitive techniques such as qPCR, when some form of organism cultural enrichment is utilized and which results in a binomial response. Thus, using a specific gene PCR-based (+ or −) most probable number (MPN) assay one could detect anywhere from 0.2 to 105 CFU mL−1 using 6 to 48 reactions (i.e., 8 dilutions × 6 replicates per dilution) depending on the initial concentration of the pathogen and volume sampled.

To examine predictors of exercise adherence in breast cancer survivors. Seventy-five breast cancer survivors were randomly assigned to exercise (n = 37) or usual care (n = 38). Demographic, prognostic, physiologic, and psychosocial information was collected at baseline and 6 months. The exercise goal was 30 min of exercise 5 days/week for 6 months. Women randomized to exercise participated in moderate-intensity recreational exercise for 123 ± 52 min/week (81% of the prescribed 150 min/week) over 6 months. Baseline variables associated with better adherence were lower body mass index (BMI), smaller waist circumference, higher amounts of physical activity 6 months prior to enrollment, being in the preparation vs. contemplation Stage of Change and higher FACT-B breast cancer subscale score. After adjusting for these variables, lower BMI and higher Stage of Change continued to be associated with better adherence (p

To investigate the association between physical activity (PA) and mammographic density in the year before diagnosis in a population-based sample of 474 women diagnosed with stage 0-IIIA breast cancer and enrolled in the Health, Eating, Activity, and Lifestyle Study.We collected information on PA during an interview administered at a baseline visit scheduled within the first year after diagnosis. Participants recalled the type, duration, and frequency of different PAs for the year prior to their diagnosis. Dense area and percent density were estimated, from mammograms imaged approximately 1 year before diagnosis, as a continuous measure using a computer-assisted software program. Analysis of covariance methods were used to obtain mean density across PA tertiles adjusted for confounders. We stratified analyses by menopausal status and body mass index (BMI) because these factors strongly influence density.We observed a statistically significant decline in mammographic dense area (p for trend = 0.046) and percent density (p for trend = 0.026) with increasing level of sports/recreational PA in postmenopausal women with a BMIor = 30 kg/m2. Conversely, in premenopausal women with a BMI30 kg/m2, we observed a statistically significant increase in percent density with increasing level of sports/recreational PA (p for trend = 0.037).Both mammographic dense area and percent density are inversely related to level of sports/recreational PA in obese postmenopausal women. Increasing PA among obese postmenopausal women may be a reasonable intervention approach to reduce mammographic density.

For objective interpretation of results of comparative studies of lipids, performed for many years at Institute of Evolutionary Physiology and Biochemistry, it is essentially important to use modern methods of analysis, first of all, polythetic methods of cluster analysis. Using the unweighed pair group method of the mean values, it has been shown that the dendrograms constructed on the basis of analysis of characters of molecular organization of the carbohydrate part of the ganglioside molecule correspond on the whole to the tree of classical taxonomy of vertebrates. Carbohydrate components of glycoconjugates, including gangliosides, play an important role in intercellular interactions, in processes of cell adhesion, recognition, and apoptosis. It may be suggested that changes of the carbohydrate component of the ganglioside molecule in the course of evolution of vertebrates contribute to achievement of a qualitatively new level of biochemical organization of organs and tissues, providing a possibility of aromorphic modifications of organization of animals, which are essential for the appearance of new classes. On the contrary, analysis of the data on molecular organization of a fatty acid component of vertebrate brain gangliosides by the same method could not reveal any relation of the species position on the dendrogram to its taxonomic belonging. At the same time, it was found out that the content of various fatty acids (FA) of brain gangliosides of ectothermic vertebrates correlated statistically significantly with the environmental temperature, positively in the case of saturated acids and negatively in the case of unsaturated ones. This agrees with the previously obtained data on the significance of differences in FA composition of warm-water and cold-water stenothermic species of teleosts. Changes of the FA composition of brain gangliosides seem to contribute to processes of idioadaptations to environmental temperature in various groups of ectothermic vertebrates, these adaptations aimed at maintaining properties of cell membranes, which are optimal for their vital activity.

Synthetic genes were designed to encode analogs of the two proteins of Nephila clavipes dragline silk, spidroins 1 and 2. The genes were constructed of tandem repeats of relatively long (more than 300 bp) DNA sequences assembled from synthetic oligonucleotides, and encoded proteins of high molecular mass (65-163 kDa). Both analogs were produced efficiently in Escherichia coli. The yield and homogeneity of the products of longer genes were limited by premature termination of synthesis, probably as a result of processivity errors in protein synthesis. Average termination rates were determined to be 1 in 1100 codons to 1 in 300 codons, depending on the length and synonymous codon choices of the gene. Both analog proteins could be induced to form stable aqueous solutions without denaturants. Circular dichroism spectra of the purified proteins in dilute solution resembled spectra of redissolved natural dragline silk in reflecting a largely disordered structure in water and more ordered structures in mixed solvents with methanol and trifluoroethanol.

We carried out a postal survey of randomly selected orthopaedic surgeons in the North East of England, enquiring about outpatient follow-up patterns after primary total hip replacement. The aim was to compare and contrast the number and timing of appointments as well as assess the involvement of orthopaedic nurse practitioners (ONP). The number of visits in the first post-operative year varied between two and five. The average duration before the first, second and third follow-up was 5 weeks, 4 months and 13 months respectively. Ninety-three percent of the consultants follow their patients indefinitely. For the patients who are followed for life, 71% are seen in the ONP clinic and 29% in the consultant clinic. Fifty percent of the consultants sub-specialising in lower limb arthroplasty follow their patients up to 1 year, after which the care is taken over by an orthopaedic nurse practitioner, compared to 70% of the general orthopaedic consultants. With increasing number of total hip replacement operations being performed, guidelines and consistency would be desirable in order to make the follow-up of patients efficient in terms of the time and cost.

Introduction Telomere length plays important roles in maintaining genome stability and regulating cell replication and death. Telomerase has functions not only to extend telomere length but also to repair DNA damage. Studies have shown that telomerase may increase cancer cell resistance to DNA-damaging anticancer agents; tamoxifen may suppress telomerase expression in breast cancer cells. This study aimed to investigate the role of telomere length and telomerase activity in breast cancer prognosis. Methods qPCR and qRT-PCR were used to analyze telomere length and telomerase expression, respectively, in tumor samples of 348 breast cancer patients. Cox regression analysis was performed to examine telomere length and telomerase expression in association with disease-free survival and cause-specific mortality. Results Telomere length had no relation to tumor features or disease outcomes. Telomerase expression was detected in 53% of tumors. Larger tumors or aggressive disease were more likely to have telomerase expression. Among patients treated with chemotherapy, high telomerase was found to be associated with increased risk of death (hazard ratio (HR) = 3.15; 95% CI: 1.34 to 7.40) and disease recurrence (HR = 2.04; 95% CI: 0.96 to 4.30) regardless of patient age, disease stage, tumor grade, histological type or hormone receptor status. Patients treated with endocrine therapy had different results regarding telomerase: high telomerase appeared to be associated with better survival outcomes. Telomerase expression made no survival difference in patients who received both chemotherapy and endocrine therapy. Conclusions Overall, telomerase expression was not associated with disease outcome, but this finding may be masked by adjuvant treatment. Patients with high telomerase expression responded poorly to chemotherapy in terms of disease-free and overall survival, but fared better if treated with endocrine therapy.

An enzyme has been isolated fromPseudomonas marginalis (a pathogen responsible for the spoilage of fruits and vegetables in storage) that degrades the exopolysaccharide (mw>2×106 Da) produced by this organism. The mechanism of degradation has been determined to be a depolymerization that results from glucosidic cleavage. The product of depolymerization is a polysaccharide of ca. 2.5×105 Da. The enzyme has a molecular weight of approximately 28 kDa, a pH optimum of 6.5, pI=9.1, and an apparent Km of 1.95×10−7±3.5×10−8M. Native and enzyme-treated marginalan supported no or very limited growth of the bacterium respectively.

This paper presents a computational framework for the optimization and sensitivity analysis of a process whose state depends upon several parameter functions. Assuming that the process is described by a system of quasilinear, parabolic, partial differential equations, we show how determining the problem parameters so as to improve an associated objective functional is directly related to knowing the state function sensitivities. An expression for the gradient of the objective functional in terms of the solutions of an adjoint system enables one to bypass the calculation of state function sensitivities. These concepts are illustrated for a simple model of cooperative processes in chemical kinetics. Since sensitivity analysis and model optimization are important tools for investigating parameter dependence and validating mathematical models, research developments in such diverse fields as optimal design theory, chemical kinetics, and parameter identification are important motivations for this paper.

A case report of a systemic mastocytosis in a 55-year-old black man. The clinical, radiological and pathological features of this disorder and its five forms are discussed

THE varied secretory abnormalities in fibrocystic disease of the pancreas in which elevated sweat electrolytes and deficient pancreatic enzymes are linked to viscid mucus glycoproteins and increased parotid secretory rate suggest an underlying mechanism of overstimulation of exocrine glands with cholinergic innervation1–6. Roberts5 further hypothesizes that excessive exocrine gland stimulation might result should acetylcholine (ACH), released at secretory nerve endings, persist owing to defective enzymic breakdown by cholinesterase, or, alternatively, to excessive quantities released. It seemed to us that a stimulating neurohumor not completely inactivated at its site of release might be found in the secretion of the gland it stimulates. Thus we examined sweat, a secretion abnormal in fibrocystic disease, for evidence of any characteristic neurohumoral activity. We have found in thermal sweat well-defined levels of a free choline-ester indistinguishable from acetylcholine. The activity was detected in sweat samples from normal individuals as well, but appeared to be of a significantly higher order in the fibrocystic.