No abstract

Background Advances in cancer treatments continue to reduce the incidence of lymphedema. Yet, many breast cancer survivors still face long-term post-operative challenges as a result of developing lymphedema. The purpose of this study was to preliminarily evaluate The-Optimal-Lymph-Flow program, a patient-centered education and behavioral program focusing on self-care strategies to enhance lymphedema risk reduction by promoting lymph flow and optimize body mass index. Methods A prospective, longitudinal, quasi-experimental design with repeated-measures was used. The study outcomes included lymph volume changes by infra-red perometer and body mass index by a bioimpedance device at pre-surgery baseline, 2-4 weeks after surgery, 6-month, and 12-month follow-up. A total of 140 patients were recruited and participated in The-Optimal-Lymph-Flow program; 134 patients completed the study with 4% attrition rate. Results Fifty-eight percent patients had axillary node dissection and 42% had sentinel lymph node biopsy. The majority (97%) of patients maintained and improved their preoperative limb volume and body mass index at the study endpoint of 12 months following cancer surgery. Cumulatively, 2 patients with sentinel lymph node biopsy and 2 patients with the axillary lymph node dissection had measurable lymphedema (>10% limb volume change). At 12-month follow-up, among the 4 patients with measurable lymphedema, 2 patients' limb volume returned to pre-operative level without compression therapy but by maintaining The-Optimal-Lymph-Flow exercises to promote daily lymph flow. Conclusions This educational and behavioral program is effective to enhance lymphedema risk reduction. The study provided initial evidence for emerging change in lymphedema care from treatment-focus to proactive risk reduction.

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease manifested by overtly scarred peripheral and basilar regions and more normal-appearing central lung areas. Lung tissues from macroscopically normal-appearing (IPFn) and scarred (IPFs) areas of explanted IPF lungs were analyzed by RNASeq and compared with healthy control (HC) lung tissues. There were profound transcriptomic changes in IPFn compared with HC tissues, which included elevated expression of numerous immune-, inflammation-, and extracellular matrix-related mRNAs, and these changes were similar to those observed with IPFs compared to HC. Comparing IPFn directly to IPFs, elevated expression of epithelial mucociliary mRNAs was observed in the IPFs tissues. Thus, despite the known geographic tissue heterogeneity in IPF, the entire lung is actively involved in the disease process, and demonstrates pronounced elevated expression of numerous immune-related genes. Differences between normal-appearing and scarred tissues may thus be driven by deranged epithelial homeostasis or possibly non-transcriptomic factors.

The incidence of DVT and PE in lung transplant recipients is high. Posttransplant surveillance and treatment based on findings are warranted.

The role of collinear facilitation was investigated to test predictions of a model for traveling waves of dominance during binocular rivalry (H. Wilson, R. Blake, & S. Lee, 2001). In Experiment 1, we characterized traveling wave dynamics using a recently developed technique called periodic perturbation (M.-S. Kang, D. Heeger, & R. Blake, 2009). Results reveal that the propagation speed of waves for a collinear stimulus increased regardless of whether that stimulus was suppressed (replicating earlier work) or dominant; this latter finding is contrary to the model’s prediction. In Experiment 2, we measured perceptual dominance durations within a localized region in the center of two rival stimuli that varied in degree of collinearity. Results reveal that increased collinearity did not change average dominance durations regardless of the rivalry phase of the stimulus, again contrary to the model’s prediction. Incorporating pattern-dependent modulation of adaptation rate into the model accounted for results from both experiments. Using model simulations, we show how interactions between collinear facilitation and pattern-dependent adaptation may influence the dynamics of binocular rivalry. We also discuss alternative interpretations of our findings, including the possible role of surround suppression.