Association of Aerobic Fitness and Metabolic Syndrome in Male Firefighters

Association of Aerobic Fitness and Metabolic Syndrome in Male Firefighters. Durcan, C.M.*, S.E. Martin‡, B.S. Lambert†, N.P. Greene†, J.M. Markos†, A.F. Carbuhn†, J.S. Green‡, FACSM and S.F. Crouse‡, FACSM. Department of Health and Kinesiology, Texas A&M University, College Station, TX. Metabolic syndrome has been shown in numerous studies to be related to a higher incidence of coronary artery disease. A study by R. Jurca et.al., in Med. Sci. Sports Exerc 36(38), found a relationship between aerobic fitness and the prevalence of metabolic syndrome in a group of men enrolled in the Aerobics Center Longitudinal Study. Information on this relationship in male firefighters is currently lacking. Purpose: To determine the association of metabolic syndrome and aerobic fitness in male fire fighters. Methods: As part of an annual physical exam, 213 male fire fighters (average age = 37) underwent evaluation of risk factors associated with metabolic syndrome as defined by NCEP III. These include the presence of three or more of the following: Waist circumference \u3e 40 , HDL Cholesterol \u3c 40 mg/dL, Triglycerides \u3e 150 mg/dL, Blood Glucose \u3e 110 mg/dL, and resting blood pressure \u3e 130/85 mm Hg. Aerobic Fitness was determined by estimating VO2max from time on treadmill during a Bruce protocol. Results: The subjects were ranked and divided into quartiles based on VO2max. All data were analyzed using a Chi Square test (p \u3c .05). Prevalence of metabolic syndrome increased significantly across quartiles as aerobic fitness declined. Conclusion: The data suggest that as aerobic fitness improves, the likelihood of male firefighters having metabolic syndrome decreases. These data are similar to the results found by R. Jurca et.al

Local recurrence and breast oncological surgery in young women with breast cancer: The POSH observational cohort study

Objective: To assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH). Background: Emerging data suggest young age is a predictor of increased local recurrence. Methods: POSH is a prospective cohort of 3024 women of 18 to 40 years with breast cancer. Cohort characteristics were grouped by mastectomy or BCS. Endpoints were local-recurrence interval (LRI), distant disease-free interval (DDFI), and overall survival (OS); described using cumulative-hazard and Kaplan-Meier plots and multivariable analyses by Flexible Parametric and Cox regression models. Results: Mastectomy was performed in 1464 patients and breast-conserving surgery (BCS) in 1395. Patients undergoing mastectomy had larger tumors and higher proportions of positive family history, estrogen receptor+, progesterone receptor+, and/or human epidermal growth factor receptor 2+ tumors. Local events accounted for 15% of recurrences. LRI by surgical type varied over time with LRI similar at 18 months (1.0% vs 1.0%, P = 0.348) but higher for BCS at 5 and 10 years (5.3% vs 2.6%, P < 0.001; and 11.7% vs 4.9%, P < 0.001, respectively). Similar results were found in the adjusted model. Conversely, distant-metastases and deaths were lower for BCS but not after adjusting for prognostic factors. After mastectomy chest-wall radiotherapy was associated with improved LRI (hazard ratio, HR = 0.46, P = 0.015). Positive surgical margins, and development of local recurrence predicted for reduced DDFI (HR = 0.50, P < 0.001; and HR = 0.29, P = 0.001, respectively). Conclusions: Surgical extent appears less important for DDFI than completeness of excision or, where appropriate, chest-wall radiotherapy. Despite higher local-recurrence rates for BCS, surgical type does not influence DDFI or OS after adjusting for known prognostic factors in young breast cancer patients

Ex vivo experimental investigations and modelling of the layer-dependent, anisotropic, visco-hyperelastic behaviour of the human oesophagus

As a mechanical organ, the material properties of the oesophagus are integral to its function. The quantification of these properties is necessary to investigate the organ’s pathophysiology and is required for a range of applications including medical device design, surgical simula-tions and tissue engineering. However, according to a systematic review of mechanical exper-imentation conducted on the gastrointestinal organs, the discrete layer-dependent properties of the oesophagus have not been investigated using human tissue, especially regarding its vis-coelastic and stress-softening behaviour. Therefore, extensive experimentation was conducted to determine the time, layer and direction-dependent material response of the oesophagus us-ing cadaveric human tissue. The residual strains of the organ were also considered via opening angle experiments. Overall, the results showed distinct properties in each layer, highlighting the importance of treating the oesophagus as a multi-layered composite material. Furthermore, a strong anisotropy was exhibited across both layers, where the longitudinal directions were much stiffer than the circumferential directions. Due to the COVID-19 pandemic, fresh human cadavers were not available from the anatomy laboratory for a considerable amount of time. Therefore, mechanical testing was first completed on embalmed human tissue and then, once available, on fresh human tissue. This unforeseen circumstance, through comparison of the two preservation states, allowed for an interesting discussion on the role of the tissue’s con-stituents on its complex material behaviour. In addition, histological analysis was carried out to determine the density of the oesophagus’ most mechanically relevant fibres: collagen and elastin. This knowledge was then used to inform constitutive modelling of the soft tissue’s behaviour, the outcome of which was able to capture the anisotropy, visco-hyperelasticity and stress-softening observed in the experimental data

Germline variation in ADAMTSL1 is associated with prognosis following breast cancer treatment in young women

To identify genetic variants associated with breast cancer prognosis we conduct a meta-analysis of overall survival (OS) and disease-free survival (DFS) in 6042 patients from four cohorts. In young women, breast cancer is characterized by a higher incidence of adverse pathological features, unique gene expression profiles and worse survival, which may relate to germline variation. To explore this hypothesis, we also perform survival analysis in 2315 patients agedPeer reviewe

Challenges and opportunities for ex-offender support through community nursing

This study was a qualitative case study underpinned by “The Silences Framework” aimed at mapping the ex-offender health pathway towards identifying “touch points” in the community for the delivery of a nurse-led intervention. Participants meeting the study inclusion criteria were quantitatively ranked based on poor health. Participants scoring the lowest and endorsing their ranking through a confirmation of a health condition were selected as cases and interviewed over 6 months. Individuals in the professional networks of offenders contextualized emergent themes. The study indicated that pre-release, offenders were not prepared in prison for the continuity in access to healthcare in the community. On release, reintegration preparation did not routinely enquire whether offenders were still registered with a general practitioner or had the agency to register self in the community. Participants identified the site of post-release supervision as the “touch point” where a nurse-led intervention could be delivere