Percutaneous sentinel node removal using a vacuum-assisted needle biopsy in women with breast cancer:a feasibility and acceptability study

AIMS: To assess the feasibility and acceptability of large-gauge percutaneous removal of the axillary sentinel lymph node (SLN) using dual gamma probe and ultrasound guidance.MATERIALS AND METHODS: Technetium nanocolloid was administered the day before surgery. On the day of surgery, potential SLNs were identified with gamma probe and ultrasound scanning. A 7 G vacuum-assisted biopsy (VAB) device was inserted percutaneously deep to the target node and the node(s) removed. The gamma probe was used to confirm removal of radiolabelled tissue. At surgery, any residual radiolabelled or blue nodes were removed. Morbidity was assessed via (1) a pain questionnaire immediately after the percutaneous procedure, (2) relevant items from the FACT B+4 questionnaire 7-10 days after surgery, and (3) case note review 1 month after surgery.RESULTS: Twenty-two patients consented and 20 patients underwent the procedure. Radiolabelled nodal tissue was obtained in 18/20 (90%). The mean procedure time was 11 minutes. Four of 18 patients had metastatic disease identified in the VAB excision tissue with 100% sensitivity for axillary metastasis. At axillary surgery, additional intact SLN or fragments were found in 14 patients. No additional metastatic disease was found at surgery. One patient suffered a pneumothorax during instillation of local anaesthetic. The median pain score was 10/100 by visual analogue scale. Immediate post-procedure haematoma was common (14 of 20) and prolonged manual compression frequent.CONCLUSION: VAB removal of sentinel nodes using dual scanning is feasible. Although preliminary sensitivity and specificity levels are encouraging, complications may discourage widespread implementation.</p

Sexed up: theorizing the sexualization of culture

This paper reviews and examines emerging academic approaches to the study of ‘sexualized culture’; an examination made necessary by contemporary preoccupations with sexual values, practices and identities, the emergence of new forms of sexual experience and the apparent breakdown of rules, categories and regulations designed to keep the obscene at bay. The paper maps out some key themes and preoccupations in recent academic writing on sex and sexuality, especially those relating to the contemporary or emerging characteristics of sexual discourse. The key issues of pornographication and democratization, taste formations, postmodern sex and intimacy, and sexual citizenship are explored in detail. </p

Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy for Primary Breast Cancer Comparing Interim Ultrasound, Shear Wave Elastography and MRI

Abstract Background Prediction of pathological complete response (pCR) of primary breast cancer to neoadjuvant chemotherapy (NACT) may influence planned surgical approaches in the breast and axilla. The aim of this project is to assess the value of interim shear wave elastography (SWE), ultrasound (US) and magnetic resonance imaging (MRI) after 3 cycles in predicting pCR. Methods 64 patients receiving NACT had baseline and interim US, SWE and MRI examinations. The mean lesion stiffness at SWE, US and MRI diameter was measured at both time points. We compared four parameters with pCR status: a) Interim mean stiffness ≤ or &gt; 50 kPa; b) Percentage stiffness reduction; c) Percentage US diameter reduction and d) Interim MRI response using RECIST criteria. The Chi square test was used to assess significance. Results Interim stiffness of ≤ or &gt; 50 kPa gave the best prediction of pCR with pCR seen in 10 of 14 (71 %) cancers with an interim stiffness of ≤ 50 kPa, compared to 7 of 50 (14 %) of cancers with an interim stiffness of &gt; 50 kPa, (p &lt; 0.0001) (sensitivity 59 %, specificity 91 %, PPV 71 %, NPV 86 % and diagnostic accuracy 83 %). Percentage reduction in stiffness was the next best parameter (sensitivity 59 %, specificity 85 %, p &lt; 0.0004) followed by reduction in MRI diameter of &gt; 30 % (sensitivity 50 % and specificity 79 %, p = 0.03) and % reduction in US diameter (sensitivity 47 %, specificity 81 %, p = 0.03). Similar results were obtained from ROC analysis. Conclusion SWE stiffness of breast cancers after 3 cycles of NACT and changes in stiffness from baseline are strongly associated with pCR after 6 cycles.</jats:p

Multilingual gendered identities: female undergraduate students in London talk about heritage languages

In this paper I explore how a group of female university students, mostly British Asian and in their late teens and early twenties, perform femininities in talk about heritage languages. I argue that analysis of this talk reveals ways in which the participants enact ‘culturally intelligible’ gendered subject positions. This frequently involves negotiating the norms of ‘heteronormativity’, constituting femininity in terms of marriage, motherhood and maintenance of heritage culture and language, and ‘girl power’, constituting femininity in terms of youth, sassiness, glamour and individualism. For these young women, I ask whether higher education can become a site in which they have the opportunities to explore these identifications and examine other ways of imagining the self and what their stories suggest about ‘doing being’ a young British Asian woman in London

Sacco and Vanzetti, Mary Donovan and transatlantic radicalism in the 1920s

In 1927 the Italian anarchists Nicola Sacco and Bartolomeo Vanzetti were executed in Boston following a murder trial that was widely denounced for its anti-labour and anti-immigrant bias. From 1921 the campaign to save the two men powerfully mobilised labour internationalism and triggered waves of protests across the world. This article examines the important contributions made by Irish and Irish-American radicals to the Sacco-Vanzetti campaign. Mary Donovan was a leading member of the Sacco-Vanzetti Defense Committee, and a second-generation Irish union organiser and member of Boston's James Connolly Club. In the 1920s she travelled to Ireland twice and appealed to Irish and Irish American labour to support the campaign. At the same time, Donovan and many of the activists considered here held ambiguous personal and political relationships with Ireland. Transnational Irish radicalism in the early-twentieth century is most commonly considered in nationalist terms. Taking a distinctly non-Irish cause - the Sacco-Vanzetti case of 1920-7 - allows us to look from a different perspective at the global Irish Revolution and reveals how radical labour currents reached into Irish and Irish-American circles during the revolutionary era, though the response to the campaign also indicates a receding internationalism in the immediate aftermath of Irish independence

Liquid-core microcapsules: A mechanism for the recovery and purification of selected molecules in different environments

Liquid-core microcapsules can be described as miniature sized particles ( 1.2 l/hr of microspheres and > 2 l/hr of liquid-core microcapsules, and this can be easily and naturally elevated to higher volumes by increasing the number of nozzles on the encapsulator. Firstly the microcapsules were used as an innovative technique (known as capsular perstraction) to recover the commonly found pharmaceutically active compounds; sulfamethoxazole, metoprolol, furosemide, carbamazepine, clofibric acid, warfarin and diclofenac from water. The approach of preparing capsules with different solvents within their cores and combining them in water, contaminated with pharmaceuticals, enabled a rapid recovery of the drugs from this sphere. In addition the uptake of warfarin was examined to assess the conditions affecting mass transfer of the molecules into the capsules. It was subsequently determined that the stagnant organic layer was the main limiting factor. This part of the study emphasized how the characteristics (size and membrane thickness) of capsules can affect the removal rate of compounds into the liquid-core and also how the rate of extraction can be simply controlled by varying these parameters during the capsule manufacturing process. In a second application, the capsular extraction technology was further developed by adopting it as an aide for the recovery and purification of the antibiotic geldanamycin from Bennett’s medium. From this work it was shown how a small quantity of capsules was capable of rapidly extracting the molecule from the culture medium. Again the limitations to mass transfer were accessed, and it was discovered that the main rate limiting step was the external resistance outside of the capsules, which can be governed by controlling the outer turbulence. In a further development the capsules showed their potential to be used as a mechanism for concentrating, purifying and enabling crystallization of the extractant, using a very simplistic and straightforward procedure, which was not destructive to the microcapsules, hence enabling their continuous re-use. Finally the capsules were applied to a real-time situation, in order to examine the feasibility of using the simple, non-toxic and sterile technology as a novel in-situ product recovery technique, to improve the production and recovery yield of geldanamycin in cultures containing the bacterium Streptomyces hygroscopicus. Implementation of this approach resulted in the rapid removal of the metabolite from an environment which was causing its break-down and seriously affecting recovery yields. Extraction enabled the molecule to be transferred into a stable and secure domain, where it was protected from external influences. This removal improved overall net production by 30% compared to fermentations containing no capsules. Most importantly however, the capsule-facilitated recovery process acted as a methodology, which enabled high recoveries (> 53%) of the fermented geldanamycin to be obtained as highly purified crystals (> 97%) using a facile, inexpensive and reproducible process, which should be easily implemented at a lab-scale or industrial-level

Postfeminism, men, masculinities and work: a research agenda for gender and organization studies scholars

Mobilizing the concept of postfeminism as a sensibility, this article invites organization and gender scholars to examine how postfeminist masculinities are discursively constituted and performed by men within contemporary work contexts. Acknowledging that women are interpellated within postfeminist discourses as empowered and autonomous subjects whose lives are shaped by individual choice, this article explores the implications for men, in particular how men variously perform postfeminist masculinities and the implications for addressing gendered inequalities within the workplace. Developing a research agenda, this article outlines three research trajectories: 1) problematizing a gender binary in which women are depicted as empowered at work and men in a state of crisis; 2) interrogating signs of ‘new’ postfeminist masculinities coded as inclusive in the workplace and; 3) examining how different types of men perform postfeminist masculinities at work. This article concludes by providing examples of research questions to generate future organizational scholarship in these areas

Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer?

Shear wave elastography (SWE) shows promise as an adjunct to greyscale ultrasound examination in assessing breast masses. In breast cancer, higher lesion stiffness on SWE has been shown to be associated with features of poor prognosis. The purpose of this study was to assess whether lesion stiffness at SWE is an independent predictor of lymph node involvement. Patients with invasive breast cancer treated by primary surgery, who had undergone SWE examination were eligible. Data were retrospectively analysed from 396 consecutive patients. The mean stiffness values were obtained using the Aixplorer(®) ultrasound machine from SuperSonic Imagine Ltd. Measurements were taken from a region of interest positioned over the stiffest part of the abnormality. The average of the mean stiffness value obtained from each of two orthogonal image planes was used for analysis. Associations between lymph node involvement and mean lesion stiffness, invasive cancer size, histologic grade, tumour type, ER expression, HER-2 status and vascular invasion were assessed using univariate and multivariate logistic regression. At univariate analysis, invasive size, histologic grade, HER-2 status, vascular invasion, tumour type and mean stiffness were significantly associated with nodal involvement. Nodal involvement rates ranged from 7 % for tumours with mean stiffness <50 kPa to 41 % for tumours with a mean stiffness of >150 kPa. At multivariate analysis, invasive size, tumour type, vascular invasion, and mean stiffness maintained independent significance. Mean stiffness at SWE is an independent predictor of lymph node metastasis and thus can confer prognostic information additional to that provided by conventional preoperative tumour assessment and staging

Mothers behaving badly: chaotic hedonism and the crisis of neoliberal social reproduction

This article focuses on the significance of the plethora of representations of mothers ‘behaving badly’ in contemporary anglophone media texts, including the films Bad Moms, Fun Mom Dinner and Bad Mom’s Christmas, the book and online cartoons Hurrah for Gin and the recent TV comedy dramas Motherland, The Let Down and Catastrophe. All these media texts include representations of, first, mothers in the midst of highly chaotic everyday spaces where any smooth routine of domesticity is conspicuous by its absence; and second, mothers behaving hedonistically, usually through drinking and partying, behaviour that is more conventionally associated with men or women without children. After identifying the social type of the mother behaving badly (MBB), the article locates and analyses it in relation to several different social and cultural contexts. These contexts are: a neoliberal crisis in social reproduction marked by inequality and overwork; the continual if contested role of women as ‘foundation parents’; and the negotiation of longer-term discourses of female hedonism. The title gestures towards a popular British sitcom of the 1990s, Men Behaving Badly, which popularized the idea of the ‘new lad’; and this article suggests that the new lad’s counterpart, the ladette, is mutating into the mother behaving badly, or the ‘lad mom’. Asking what work this figure does now, in a later neoliberal context, it argues that the mother behaving badly is simultaneously indicative of a widening and liberating range of maternal subject positions and symptomatic of a profound contemporary crisis in social reproduction. By focusing on the classed and racialised dynamics of the MBB – by examining who exactly is permitted to be hedonistic, and how – and by considering the MBB’s limited and partial imagining of progressive social change, the article concludes by emphasizing the urgency of creating more connections between such discourses and ‘parents behaving politically’