How breast cancer therapies impact body image - real-world data from a prospective cohort study collecting patient-reported outcomes.

BACKGROUND: In breast cancer patients body image (BI) is a crucial aspect of quality of life (QoL). This study examined the postoperative impact of different surgical approaches on long-term BI analyzing real-world data to guide pre- and postoperative patient care and preserve QoL. METHODS: EORTC QLQ-BR23 BI scores were collected electronically in 325 breast cancer patients within routine clinical care for a duration of 41.5 months (11/17/2016 - 4/30/2020) at predefined time points preoperatively and repeatedly up to two years after breast-conserving surgery (BCS) (n = 212), mastectomy alone (M) (n = 27) or mastectomy with immediate breast reconstruction (MIBR) (n = 86). Higher scores indicated better BI. A linear mixed regression model was used to analyze the impact of BCS, M and MIBR, as well as non-surgical therapies on BI at treatment initiation and over time. RESULTS: BI scores deteriorated by 5 points (95%-confidence interval (CI) -8.94 to -1.57, p≈0.005) immediately after BCS, by 7 points (95%-CI -12.13 to -1.80, p≈0.008) after MIBR and by 19 points (95%-CI -27.34 to -10.34, p < 0.001) after M. The change over time after BCS (+ 0.10 points per week, 95%-CI -0.17 to 0.38), MIBR (-0.07 points per week, 95%-CI -0.35 to 0.20) and M (+ 0.14 points per week, 95%-CI -0.19 to 0.48) were not statistically significant (each p > 0.05). At treatment initiation chemotherapy was associated with a 22-point decline (95%-CI -25.39 to -17.87, p < 0.001) in BI score, while radiotherapy was associated with a 5-point increase (95%-CI 1.74 to 9.02, p≈0.004). However, over time chemotherapy was associated with a score recovery (+ 0.28 points per week, 95%-CI 0.19 to 0.37, p < 0.001), whereas for radiotherapy a trend towards BI deterioration was observed (-0.11 points per week, 95%-CI -0.23 to 0.02, p≈0.101). CONCLUSIONS: Breast cancer surgery negatively affects BI. BCS and MIBR presumably harm BI less than M in the early postoperative period. Our data suggests BI to be deteriorating in the long term after MIBR while improving after BCS or M. Radiotherapy seems to have an additional negative long-term impact on BI. These findings should be confirmed in further studies to enable evidence-based patient information as part of preoperative shared decision-making and postoperative patient care.

Effect of Additional Iron Injection to Suckling Pigs on Hematocrit Level during the Suckling Period.

Two experiments were conducted to evaluate the effects of additional iron injection to suckling piglets on hematocrit level during the suckling period. In Experiment 1, a total of 24 piglets were allotted into 3 treatments within litter based on body weight and sex at d 1 of age. Treatments were: (1) Control: a 200 mg iron-dextran intramuscular injection only at d 0 of experiment (d 1 of age), (2) Iron100: intramuscular iron-dextran injections at d 0 (200 mg iron) and 15 (11 d before weaning) of experiment (100 mg iron), and (3) Iron200: intramuscular iron-dextran injections at d 0 (200 mg iron) and 15 of experiment (200 mg iron). In Experiment 2, a total of 20 piglets were allotted into 2 treatments within litter based on body weight and sex at d 1 to 2 of age. Treatments were: (1) Iron100b: 100 mg iron-dextran intramuscular injection at d 0 of experiment (d 1 to 2 of age), and (2) Iron200b: 200 mg iron-dextran intramuscular injection at d 0 of experiment. An additional 200 mg iron-dextran was injected to all piglets intramuscularly at d 14 of experiment (11 d before weaning). In Experiment 1, there was no difference in hematocrit levels among treatments at d 15 of experiment. Both iron treatments had greater hematocrit levels than the Control treatment at d 22 and 26 of experiment (p < 0.05). The Iron200 treatment had greater hematocrit level at d 26 of experiment (p < 0.05) and tended to have a greater increase of hematocrit levels in d 22 to 26 of experiment (p = 0.09) than the Iron100 treatment. In Experiment 2, the Iron200b treatment had greater hematocrit levels than the Iron100b treatment in d 14 and 25 (p < 0.05) of experiment. Hematocrit level changes tended to be greater in the Iron200b treatment in d 0 to 14 (p = 0.08) of experiment but lower in d 14 to 25 (p < 0.05) of experiment than the Iron100b treatment. The additional iron injection to suckling piglets increased hematocrit levels with greater values at weaning in the higher injection level whereas the increase was greater when the hematocrit level was low at the time of additional injection.

Real-world reference scores for EORTC QLQ-C30 and EORTC QLQ-BR23 in early breast cancer patients.

PURPOSE: To deliver patient-reported outcome (PRO) reference data for breast cancer and various other breast diseases to facilitate the interpretation of PRO scores during routine breast cancer treatment. METHODS: To determine reference baseline values for the PRO measures EORTC QLQ-C30 and EORTC QLQ-BR23, PRO data captured in the breast cancer centre at Charité - Universitätsmedizin Berlin from 2016 to 2021 were evaluated. As part of the clinical routine, ambulatory patients were asked to answer a digital survey regarding their medical history, current health status and health-related quality of life using the aforementioned questionnaires prior to their doctor's appointment in the outpatient breast clinic. Adjusted linear and variable dispersion beta regression models were used to compare different diagnosis groups. RESULTS: A total of 3689 patients were included in the digital PRO program, of which 1478 were eligible for this study; 729 had invasive breast cancer or ductal carcinoma in situ, 270 patients were diagnosed with fibroadenoma and 479 patients had other breast diseases such as cysts, mastopathy or abscesses. Overall, patients with breast cancer reported worse scores in almost all domains except for role functioning, sexual functioning and body image. Compared to previously published reference scores for early breast cancer, the current data show a more pronounced impact on perceived emotional and cognitive functioning. CONCLUSION: The results of this study are of high value for the interpretation of PROs and facilitate their use in clinical practice and clinical trials. The scores indicate an urgent need for psychosocial support prior to treatment.

Quantification of cooling effects on basic tissue measurements and exposed cross-sectional brain area of cadaver heads from market pigs.

The objective of this project was to determine the impact of cooling on the soft tissue thickness, cranial thickness, and cross-sectional brain area of cadaver heads from market pigs. Documenting the effect of cooling on tissue dimensions of swine heads is valuable and important for future investigations of physical stunning and euthanasia methods that use cadaver heads. Scalded and dehaired cadaver heads with intact jowls were sourced from market pigs stunned with CO2 gas. After transport to the data collection location, a penetrating captive bolt (PCB) shot (Jarvis Model PAS-Type P 0.25R Caliber Captive Bolt Pistol with Medium Rod Assembly and Blue Powder Cartridges) was applied in the frontal position. Following PCB application, each head (n = 36) underwent an UNCHILLED treatment followed by CHILLED treatment. The UNCHILLED treatment involved images collected immediately after splitting each head along the bolt path, and the CHILLED treatment involved images of the same heads after storage in a walk-in cooler for 24 h at 2 to 4°C. All measurements for each treatment were collected from images of the heads on the plane of the bolt path immediately prior to and immediately after the refrigeration treatment. Measurements were performed by two observers. Across all measurements, mean interobserver coefficient of variation was 11.3 ± 0.6%. The soft tissue caudal to the bolt path was different (P = 0.0120) between treatments (CHILLED: 6.4 ± 0.2 mm; UNCHILLED: 7.2 ± 0.2 mm). The soft tissue thickness rostral to the bolt path was different (P = 0.0378) between treatments (CHILLED: 5.5 ± 0.2 mm; UNCHILLED: 6.1 ± 0.2 mm). Cranial thickness caudal to the bolt path was not different (P = 0.8659; CHILLED: 18.1 ± 0.6 mm; UNCHILLED: 18.3 ± 0.6 mm), nor was there a significant difference (P = 0.2593) in cranial thickness rostral to the bolt path between treatments (CHILLED: 16.2 ± 0.6 mm; UNCHILLED: 15.2 ± 0.6 mm). Cross-sectional brain area did not differ (P = 0.0737; CHILLED: 3633.4 ± 44.1 mm; UNCHILLED: 3519.9 ± 44.1 mm). A correction factor of 1.12 was determined from this study for cases where estimation of UNCHILLED soft tissue thickness from CHILLED soft tissue thickness is necessary.

The effect of creep feed and diet complexity on growth performance in suckling and weaned pigs / Efecto de la dieta de pre-iniciación y su complejidad sobre el crecimiento de cerdos lactantes y destetados / Efeito da dieta pré-iniciada e sua complexidade no crescimento de porcos lactantes e desmamados

Abstract Background: Creep feed is offered to suckling piglets to introduce solid feed and provide extra nutrients in late lactation. However, the effect of creep feed is inconsistent; there is little information about the effect of creep diet complexity on piglet performance. Objective: Two experiments were conducted to evaluate the effect of creep feed and its complexity on growth performance of suckling and weaned pigs. Methods: In Exp. 1, eight litters (average 19.9 ± 1.1 d of age; initial piglet weight: 6.74 ± 1.2 kg) were allotted to two dietary treatments considering breed, litter size and weight, as follows: no creep feed (n=3) and creep feed (n=5; offered for 8 days before weaning). At weaning (d 28 of age), the pigs were divided into three treatments (6 pigs/pen, 3 replicates; initial body weight: 9.66 ± 0.34 kg) balanced by gender, body weight, and breed, as follows: creep feed eaters, creep feed non-eaters, and no creep feed. In Exp. 2, two different types of creep feed were offered to suckling piglets (initial piglet weight: 3.79 ± 0.55 kg) in seven litters from d 12 of age (average 12.0 ± 1.3 d of age) to weaning (d 25 of age). Treatments were: HCF (n=4): highly-complex creep diet containing 3% fish meal, 2.4% blood meal, and 15% whey; and 2) LCF (n=3): lowly-complex creep diet without the mentioned ingredients. At weaning, only eater pigs were divided into 2 treatments (6 pigs/pen, 3 replicates; initial body weight: 7.53 ± 0.97 kg) balanced by gender, breed and body weight as follows: HCF eaters and LCF eaters. In both experiments, creep feed was mixed with 1% Cr2O3 to measure fecal color for eater/non-eater categorization and the pigs were fed a common nursery diet for 21 days. Results: In both experiments, there were no differences on piglet weaning weight and overall nursery growth performance among the treatments. In Exp. 2, the creep feed intake and percentage of eaters per litter were not different between the HCF and LCF treatments, whereas the HCF eaters tended to have a greater average daily gain (p=0.08) and gain to feed ratio (p=0.09) than the LCF eaters during d 7-14 postweaning. Conclusion: Creep feed did not affect overall piglet growth in suckling and nursery phases, but its complexity might affect pig growth in the early nursery phase.

Resumen Antecedentes: El alimento de pre-iniciación se ofrece a los lechones lactantes para introducir la alimentación sólida y proporcionar nutrientes adicionales durante la lactancia tardía. Sin embargo, sus efectos son inconsistentes y hay poca información sobre el efecto de la complejidad de la dieta de pre-iniciación sobre el rendimiento de los cerdos. Objetivo: Se realizaron dos experimentos para evaluar el efecto del suministro de pre-iniciador y la complejidad del mismo sobre el crecimiento de lechones y cerdos destetados. Métodos: En el Exp. 1, ocho camadas (promedio 19,9 ± 1.1 d de edad; peso inicial: 6,74 ± 1,2 kg) se asignaron a dos tratamientos con base en raza, tamaño de camada, y peso, de la siguiente manera: sin suministro (n=3) y con suministro de pre-iniciador (n = 5; ofrecido durante 8 días antes del destete). Al destete (d 28 de edad) los cerdos se dividieron en 3 tratamientos (6 cerdos/corral y 3 réplicas; peso inicial: 9,66 ± 0,34 kg) balanceados por género, peso y raza, de la siguiente manera: consumidores de pre-iniciador, no consumidores de pre-iniciación, y sin suministro de pre-iniciación. En el Exp. 2 se ofrecieron dos tipos diferentes de pre-iniciador a los cerditos lactantes (peso inicial del lechón: 3,79 ± 0,55 kg) en siete camadas desde el día 12 de edad (promedio 12,0 ± 1,3 días de edad) hasta el destete (día 25 de edad). Los tratamientos fueron: HCF (n=4): dieta de pre-iniciación de alta complejidad conteniendo 3% de harina de pescado, 2,4% de harina de sangre y 15% de suero de leche; y 2) LCF (n=3): dieta de pre-iniciación de baja complejidad, sin esos ingredientes. Al destete, solo los cerdos que consumieron pre-iniciador se dividieron en 2 tratamientos (6 cerdos/corral, 3 repeticiones; peso corporal inicial: 7,53 ± 0,97 kg) balanceados por género, raza y peso, de la siguiente manera: consumidores de HCF o de LCF. En ambos experimentos el pre-iniciador se mezcló con Cr2O3 al 1% para medir el color fecal y categorizar los consumidores/ no consumidores, y los cerdos se alimentaron con una dieta común de iniciación durante 21 días. Resultados: En ambos experimentos no hubo diferencias en el peso al destete de los lechones y el rendimiento general de crecimiento en re-cría entre tratamientos. En el Exp. 2, la ingesta de pre-iniciador y el porcentaje de cerdos consumidores por camada no fueron diferentes entre los HCF y LCF, mientras que los consumidores de HCF tendieron a tener mayor ganancia diaria (p=0,08) y mayor relación ganancia/alimento (p=0,09) que los consumidores de LCF durante los días 7-14 pos-destete. Conclusión: el pre-iniciador no afecta el crecimiento general de los lechones en las fases de lactancia y re-cría, pero la complejidad de la dieta podría afectar el crecimiento de los cerditos al inicio de la re-cría.

Resumo Antecedentes: A alimentação por fluência é oferecida aos leitões para introduzir alimentos sólidos e fornecer nutrientes extras no final da lactação. No entanto, o efeito ainda é inconsistente e há poucas informações sobre o efeito da complexidade da dieta de fluência no desempenho dos leitões. Objetivo: Dois experimentos foram conduzidos para avaliar o efeito da alimentação por fluência e a complexidade da dieta no desempenho do crescimento de porcos em aleitamento e desmame. Métodos: Em Exp. 1, oito ninhadas (média de 19,9 ± 1,1 d de idade; peso inicial do leitão: 6,74 ± 1,2 kg) foram distribuídos em 2 tratamentos com base na raça, tamanho e peso da ninhada, da seguinte forma: ausência de ração (n=3) e ração por creep (n=5; oferecido por 8 dias antes do desmame). No desmame (d 28 anos de idade), os porcos foram divididos em 3 tratamentos (6 porcos/caneta, 3 repetições; peso corporal inicial: 9,66 ± 0,34 kg) balanceados com gênero, peso corporal e raça, como a seguir: comedores de ração, creep feed não comedores, e creep feed. Em Exp. 2, foram oferecidos dois tipos diferentes de ração para leitões (peso inicial dos leitões: 3,79 ± 0,55 kg) em sete ninhadas de 12 anos de idade (média 12,0 ± 1,3 dias) até o desmame (25 anos). Os tratamentos foram: HCF (n=4): dieta de fluência de alta complexidade contendo 3% de farinha de peixe, 2,4% de farinha de sangue e 15% de soro de leite; e 2) LCF (n=3): dieta de fluência de baixa complexidade sem esses ingredientes. No desmame, apenas os porcos comedores foram divididos em 2 tratamentos (6 porcos/caneta, 3 repetições; peso corporal inicial: 7,53 ± 0,97 kg) balanceados com gênero, raça e peso corporal da seguinte forma: comedores de HCF e comedores de LCF. Em ambos os experimentos, a alimentação fluida foi misturada com 1% de Cr2O3 para medir a cor fecal para categorização de comedor/ não comedor e os porcos foram alimentados com uma dieta comum durante 21 dias. Resultados: Nos dois experimentos, não houve diferenças no peso ao desmame dos leitões e no desempenho geral do crescimento do viveiro entre os tratamentos. Em Exp. 2, o consumo de ração por creep e a porcentagem de comedores por ninhada não foram diferentes entre os tratamentos de HCF e LCF, enquanto os comedores de HCF tenderam a ter um maior ganho médio diário (p=0,08) e uma taxa de ganho para alimentação (p=0,09) do que os comedores de LCF durante d 7-14 pós-desmame. Conclusão: A alimentação por fluência não afetou o crescimento geral de leitões nas fases de amamentação e viveiro, mas a complexidade da dieta pode afetar o crescimento de leitões na fase inicial do viveiro.

Phytoremediation of MTBE with hybrid poplar trees.

This research investigates the fate and transport of methyl tert-butyl ether (MTBE) in phytoremediation, particularly the uptake and volatilization of MTBE in lab-scale hydroponic systems. The research reveals that MTBE was taken up by hybrid poplar cuttings and volatilized to the atmosphere. Volatilization of MTBE occurred through both stems and leaves. The concentration of MTBE in the transpiration stream declined exponentially with height, indicating that the uptake and volatilization along the stems are an important removal mechanism of MTBE in phytoremediation. Volatilization, via diffusion from the stems, has not been directly measured previously. No volatile MTBE metabolites were detected; however, mass balance closure and metabolite detection were not primary objectives of this study. The greatest amount of MTBE in plant biomass was associated with the woody stems from the previous year's growth, owing in part to the large biomass of stems. MTBE in the plant tissues appears to reach a steady state concentration and there does not appear to be an accumulation process that could lead to highly elevated concentrations relative to the groundwater source.