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The role of postmastectomy chest-wall irradiation in patients with breast cancer classified as pN1 (with involvement of one to three axillary nodes) or pN0 (pathologically node negative) with additional risk factors is uncertain. In this international, phase 3, randomized trial, we evaluated the omission of chest-wall irradiation in women with \"intermediate-risk\" breast cancer - defined as cancer that was stage pT1N1, pT2N1, or pT3N0 or stage pT2N0 with a histologic grade of 3, lymphovascular invasion, or both (tumor size: T1, ≤2 cm; T2, >2 cm to 5 cm; or T3, >5 cm) - that was treated with mastectomy, an axillary procedure, and systemic therapy. Patients were assigned to undergo chest-wall irradiation (40 to 50 Gy; the irradiation group) or not to undergo chest-wall irradiation (the no-irradiation group). The primary end point was overall survival, with 10 years of follow-up. Chest-wall recurrence, regional recurrence, disease-free survival, distant metastasis-free survival, causes of death, and radiation-related adverse events were also assessed. The intention-to-treat population included 808 patients in the irradiation group and 799 in the no-irradiation group. The median follow up was 9.6 years. Overall survival was 81.4% with chest-wall irradiation and 81.9% with no chest-wall irradiation according to 10-year Kaplan-Meier estimates (hazard ratio for death, 1.04; 95% confidence interval [CI], 0.82 to 1.30; P = 0.80). A total of 29 patients had a chest-wall recurrence - 9 (1.1%) in the irradiation group and 20 (2.5%) in the no-irradiation group (between-group difference, <2 percentage points; hazard ratio, 0.45; 95% CI, 0.20 to 0.99). Disease-free survival was 76.2% in the irradiation group and 75.5% in the no-irradiation group (hazard ratio for recurrence or death, 0.97; 95% CI, 0.79 to 1.18), and distant metastasis-free survival was 78.2% and 79.2%, respectively (hazard ratio for distant metastasis or death, 1.06; 95% CI, 0.86 to 1.31). In this trial, chest-wall irradiation did not result in higher overall survival than no chest-wall irradiation among patients with intermediate-risk, early breast cancer treated with mastectomy and contemporary adjuvant systemic therapy. (Funded by the Medical Research Council and others; SUPREMO ISRCTN Clinical Study Registry number, 61145589.).

Whether it's not being able to break bread during Sunday services or missing the experience of clinking glasses for a toast, the COVID-19 pandemic lays bare how vital and tenuous social connections can be. Curious about the food-related disruptions brought on by the pandemic, Solorzano et al recently reached for their phones. For a week in mid-April 2020, they collected photos of their pandemic foodscapes. They adopt Norah Mackendrick's (2014) definition of foodscape: \"the places and spaces where people acquire food, prepare food, talk about food, or generally gather some sort of meaning from food.\" From three different countries and four different perspectives, these foodscapes capture a sense of what it means to connect through food during a pandemic.

Background A randomised phase II trial demonstrated that the addition of olaratumab to doxorubicin significantly increased overall survival (OS) in patients with advanced soft tissue sarcomas (STS) compared to doxorubicin alone. The recently presented phase III study of doxorubicin and olaratumab in advanced soft tissue sarcoma was discordant with this finding. Methods We performed a retrospective analysis of adult patients with advanced-/metastatic STS treated with at least two cycles of doxorubicin and olaratumab at eight sarcoma units across England and Northern Ireland between May 2017 and March 2019. Results 172 patients were evaluable and 40 patients (23.3%) had died at the time of analysis. Median ECOG performance status (PS) was 1. Median progression free survival (PFS) was 6.8 months (95% CI 5.9–7.7 months). Leiomyosarcoma was the most common histological subtype (75 patients, 43.6%), followed by liposarcomas (19, 11.0%). The mean number of cycles was 5 (doxorubicin range 2–6; olaratumab range 2–23). Two patients (1.2%) had a complete response and 34 (19.8%) had a partial response. 79 (45.9%) had stable and 58 (33.7%) progressive disease. 57 patients (33.1%) experienced grade ≥ 3 neutropenia and 7 patients (4.1%) grade ≥ 3 febrile neutropenia. Grade ≥ 3 anaemia was seen in 21 patients (12.2%). Grade ≥ 3 non-haematological toxicities were seen in 35 patients (20.3%). A clinically significant drop in left ventricular ejection fraction was seen in 6 patients (3.5%). 48 patients (27.9%) required a dose reduction. Overall survival (OS) is pending. Conclusions Our results are in keeping with the phase III study findings: response rate, PFS and OS were similar to those reported in the phase III ANNOUNCE trial.

The purpose of this study was to explore the relationship between coping styles and feelings of burden among caregivers of a family member with Alzheimer's disease or related dementia. This study examined perceptions of the role of caregiving and how the giver of care copes with related stressors. The 26 participants included 21 female and 5 male caregivers who were attending a caregiver support group through the Alzheimer's Association of Orange County. Participants completed a three-part self-administered questionnaire, which consisted of respondent demographics, coping strategies, and level of burden. Participants identified problem solving coping strategies as the most commonly used method of reducing distress. Seeking social support was recognized as the second most popular strategy, while avoidance coping was the strategy least used. Avoidance coping was significantly associated with higher levels of burden. Community resources that aid in caregiving were used infrequently. Social workers and others serving this population should implement clinical, case management, and advocacy services designed to maximize the coping skills of caregivers of family members with Alzheimer's disease or related dementia. Future studies should use larger, more diverse samples and longitudinal designs.

In the post-World War II era, social relations in California's prisons underwent a significant transformation. In the early post-war years, convicts espoused the thieves code, or convict code—which demanded convict class loyalty in opposition to prison officers and administrators. Prisoners began to organize collective protests and work stoppages aimed at challenging prison policy and demanding prisoner rights. Starting in the 1960s, violent prison gangs—mapped onto racial and geographical divisions—emerged to rival this growth in collective action. At first, gangs provided simply an alternative form of prisoner solidarity, but by the late 1970s, they had supplanted the convict class as prisoners' principle mode of social organization and effectively redefined the convict code. From Con-Boss to Gang Lord analyzes how and why the base for prisoner social relations transmuted from collective convict solidarity to antagonistic divisions along various axes—race being the most pervasive—from 1943–1983. I argue that factors both within and beyond prison walls contributed to this change. I demonstrate the role of both institutional changes and external political changes on prisoners' social organization, while at the same time foregrounding prisoners' own struggle with a dialectic between convict and gang solidarity. Finally, I show how changes in prisoner social relations played a role in the shift, by the 1970s, to a punitive model of prison administration. My dissertation provides the first historical narrative of the transformation of prisoner social relations and culture in the post World War II era. Historians have primarily focused on earlier periods, centering their inquires around the formation and transformation of the penal institution while emphasizing the contributions of reformers to these changes. Sociologists and criminologists examine prisons in the twentieth century, but largely provide case studies of one prison over a limited period of time. Their works contribute useful analytical concepts, rather than a synthetic and historical account of penal systems. My work dissects the transformation of race, state, and punishment in postwar California and helps us understand how California prisons became the gang-ridden, hyper-violent, and racially divided institutions that they are today.

\"The Deadliest Catch\" it's not, but the results of a research project in Seward might be just as intriguing to skippers of the rugged Bering Sea crab fleet as the next installment of the adrenalin-pumping television show. After all, the goal of the Alaska King Crab Research, Rehabilitation and Biology (AKCRRAB) program is to fill king crab pots throughout Alaska.

Production of the juvenile crab has allowed several other projects to move forward, including research by scientists at the NMFS Alaska Fisheries Science Center Behavioral Ecology Lab in Newport, Ore., into predation by rock sole and Pacific cod, substrate preference of juvenile red and blue king crab, juvenile crab nutrition, enhancement release strategies, tagging experiments and studies that examine the interaction between wild and hatchery produced juveniles.

Purpose Extracorporeal membrane oxygenation (ECMO) is a life-saving critical care technology that presents significant risks of medical device-associated thrombosis. We developed a complete method for collecting membrane oxygenators (membrane lung) from patients receiving ECMO treatment and quantitatively analyzing the distribution of thrombus formation within the membrane. Methods We collected used membrane oxygenators from patients for processing and imaging with microcomputed tomography (microCT). We reconstructed the microCT data and performed image segmentation to identify regions of thrombus formation within these oxygenators. We performed density mapping to quantify thrombus volume across different regions of each oxygenator and within multiple oxygenator models. Results Our method yields two-dimensional and three-dimensional visualization and quantification of thrombus deposition in ECMO. Analysis of the spatial distribution of platelet deposition, red blood cell entrapment, and fibrin formation within the fouled device provides insights into the structural patterns of oxygenator thrombosis. Conclusions This method can enable quantification of oxygenator thrombosis which can be used for evaluating the effect of new biomaterial or pharmacological approaches for mitigating vascular device-associated thrombosis during ECMO.