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The southern corn rootworm, Diabrotica undecimpunctata howardiBarber, is native to the US where it is a pest of peanut, Arachis hypogaea. The banded cucumber beetle, Diabrotica balteataLeConte, is native to the neotropics, but its range has expanded and currently includes most of the US peanut production area. The purpose of this study was to: (i) define seasonal variation in adult rootworm populations in peanut fields, and (ii) determine the effect(s) of proximity to a putative early season host (i.e., corn, Zea mays) and the presence of irrigation on rootworm infestation and pod injury in peanut. Seasonal abundance of adult rootworms in commercial peanut fields in Georgia was monitored in 2021 and 2022 using plant volatile lures attached to yellow sticky traps. Traps were located at 45, 90, and 180 m from the field edge in irrigated and nonirrigated peanut fields with and without a corn border. Two peaks in abundance were observed for both species in each year. Though peak abundance for the two species occurred nearly simultaneously, D. balteatawas more abundant than D. u. howardi.Beetle abundance was highest in fields bordered by corn, but presence of irrigation was not as important for D. balteataas it was for D. u. howardi. Pod injury was greater in fields bordered by corn in both years, but there was no difference in pod injury between irrigated and nonirrigated fields. The number of beetles captured and incidence of pod injury within a field did not differ with distance from the field border.

Little is known about whether a breast or gynecologic cancer diagnosis increases long-term cardiovascular disease (CVD) risk among Black females. The purpose of this study was to determine whether a breast or gynecologic cancer diagnosis is associated with CVD risk and identify determinants of subsequent CVD risk among Black females with an incident breast or gynecologic cancer diagnosis.

IMPORTANCE: Treatment at high-volume centers (HVCs) has been associated with improved overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC); however, it is unclear how patterns of referral affect these findings. OBJECTIVE: To understand the relative contributions of treatment site and selection bias in driving differences in outcomes in patients with PDAC and to characterize socioeconomic factors associated with referral to HVCs. DESIGN, SETTING, PARTICIPANTS: A population-based retrospective review of the Oregon State Cancer Registry was performed from 1997 to 2019 with a median 4.3 months of follow-up. Study participants were all patients diagnosed with PDAC in Oregon from 1997 to 2018 (n = 8026). EXPOSURES: The primary exposures studied were diagnosis and treatment at HVCs (20 or more pancreatectomies for PDAC per year), low-volume centers ([LVCs] less than 20 per year), or both. MAIN OUTCOMES AND MEASURES: OS and treatment patterns (eg, receipt of chemotherapy and primary site surgery) were evaluated with Kaplan-Meier analysis and logistic regression, respectively. RESULTS: Eight thousand twenty-six patients (male, 4142 [52%]; mean age, 71 years) were identified (n = 3419 locoregional, n = 4607 metastatic). Patients receiving first-course treatment at a combination of HVCs and LVCs demonstrated improved median OS for locoregional and metastatic disease (16.6 [95% CI, 15.3-17.9] and 6.1 [95% CI, 4.9-7.3] months, respectively) vs patients receiving HVC only (11.5 [95% CI, 10.7-12.3] and 3.9 [95% CI, 3.5-4.3] months, respectively) or LVC-only treatment (8.2 [95% CI, 7.7-8.7] and 2.1 [95% CI, 1.9-2.3] months, respectively; all P < .001). No differences existed in disease burden by volume status of diagnosing institution. When stratifying by site of diagnosis, HVC-associated improvements in median OS were smaller (locoregional: 10.4 [95% CI, 9.5-11.2] vs 9.9 [95% CI, 9.4-10.4] months; P = .03; metastatic: 3.6 vs 2.7 months, P < .001) than when stratifying by the volume status of treating centers, indicating selection bias during referral. A total of 94% (n = 1103) of patients diagnosed at an HVC received HVC treatment vs 18% (n = 985) of LVC diagnoses. Among patients diagnosed at LVCs, later year of diagnosis and higher estimated income were independently associated with higher odds of subsequent HVC treatment, while older age, metastatic disease, and farther distance from HVC were independently associated with lower odds. CONCLUSIONS AND RELEVANCE: LVC-to-HVC referrals for PDAC experienced improved OS vs HVC- or LVC-only care. While disease-related features prompting referral may partially account for this finding, socioeconomic and geographic disparities in referral worsen OS for disadvantaged patients. Measures to improve access to HVCs are encouraged.

Purpose To examine the prevalence of cardiovascular diseases (CVD) among breast cancer (BC) survivors.Design Cross-sectional observational study using the data from the National Health and Nutrition Examination Survey (NHANES) 2003–2018.Setting United States (US).Subjects A nationally representative sample of US women with a history of BC.Measures Self-reported CVD status (i.e., coronary artery disease (CAD), heart failure, and stroke) and time of the CVD diagnosis were used to categorize BC survivors into three groups: No CVD, preexisting CVD, and post-acquired CVD after BC diagnosis.Analysis The prevalence of CVD among BC survivors were estimated by demographic characteristics. Complex sampling design of the NHANES was accounted to estimate the population-level prevalence.Results A total of 658 BC survivors were identified, representing 3.01% (≈3.4 million) of the US women aged ≥18 years old. Of those, ≈6% (≈.2 million) had preexisting CVD and ≈11% (≈.4 million) had at least one CVD diagnosed after BC diagnosis, with an average time elapsed ranging from ≈5 years for heart failure to ≈9 years for CAD and stroke. The prevalence of CVD among BC survivors differed by demographic characteristics including age, education, marital status, menopausal, and physical activity levels.Conclusion Our findings suggest that BC survivors are at risk of suffering from CVD and public health strategies for the long-term management of CVD risk factors in this vulnerable population group is recommended.

A compact model representing the dynamics between piezoelectric voltage inputs and cantilever probe positioning, including nonlinear surface interaction forces, for atomic force microscopes (AFM) is considered. By considering relatively large cantilever stiffness, singular perturbation methods reduce complexity in the model and allows for faster responses to Van der Waals interaction forces. In this study, we outline a near-optimal feedback control approach for non-contact mode imaging designed to maintain the cantilever tip about the equilibrium point of the attraction and repulsion forces. The tracking control problem for AFM raster scanning along the lateral directions is also addressed.

ABSTRACTMetastatic pancreatic adenocarcinoma (PDAC) is a rapidly lethal disease, with less than half of patients surviving 12 months, and 5-year survival approximately 3%. These outcomes are in large part due to a lack of effective medical and surgical therapies for metastatic PDAC. Herein, we present the case of a patient with oligometastatic liver recurrence of BRCA2-mutated PDAC following a curative-intent resection. Through a combination of systemic chemotherapy, metastasectomy, radiotherapy, and subsequent targeted therapy with olaparib, the patient is asymptomatic four years following metastatic diagnosis with stable low-volume disease. This patient’s excellent outcome is attributable to the multi-disciplinary care received, all aspects of which were informed by new evidence surrounding metastasectomy for metastatic PDAC, the unique biology and medical treatment of BRCA-mutated PDAC, and the role of radiotherapy in controlling locoregional recurrence. We provide a review of this evidence, while highlighting the importance of evaluating disease biology through somatic and germline genetic testing as well as monitoring response to systemic chemotherapy.

A remarkably flexible, multifunctional, 2D coordination polymer exhibiting an unprecedented mode of reversible mechanical motion, enabling pores to open and close, is reported. Such multifunctional materials are highly sought after, owing to the potential to exploit coexisting electronic and mechanical functionalities that underpin useful technological applications such as actuators and ultrasensitive detectors. The coordination polymer, of composition Mn(F4TCNQ)(py)2(F4TCNQ = 2,3,5,6-tetrafluoro-7,7,8,8-tetracycanoquinodimethane; py = pyridine), consists of Mn(II) centers bridged by F4TCNQ dianions and coordinated by py molecules that extend above and below the 2D network. Exposure of Mn(F4TCNQ)(py)2, in its collapsed state, to carbon dioxide results in a pore-opening process at a threshold pressure for a given temperature. In addition to carbon dioxide, a variety of volatile guests may be incorporated into the pores, which are lined with electron-rich F4TCNQ dianions. The inclusion of electron-deficient guests such as 1,4-benzoquinone, nitrobenzene, maleic anhydride, and iodine into the pores is accompanied by a striking color change associated with a new host–guest charge-transfer interaction and an improvement in the semiconductor behavior, with the iodine adduct showing an increase in conductivity of almost 5 orders of magnitude. Experimental and density functional theory calculations on this remarkable multifunctional material demonstrate a reduction in the optical band gap with increasing electron affinity of the guest.

In Georgia and the southeast region of the United States, acreage of soft red winter wheat (SRWW) (Triticum aestivumL.) has decreased in recent years. There is an urgent need to release new cultivars with high yield potential, resistance to yield‐limiting diseases and insects, and good baking quality to maximize value in regional markets. To address this, the SRWW breeding program at the University of Georgia (UGA), in collaboration with the SUNGRAINS breeding programs, developed ‘GA JT141‐14E45’ (Reg. no. CV‐1183, PI 689519), a SRWW cultivar released by the UGA College of Agricultural and Environmental Sciences and licensed to AGSouth (AGS) Genetics as AGS 3030. GA JT141‐14E45 is widely adapted to the U.S. Southeast, having high yield, good resistance to diseases such as leaf rust, stripe rust, powdery mildew, and Soil‐borne wheat mosaic virus(SBWMV) and to current biotypes of Hessian fly (Mayetiola destructorSay). It has good resistance to Fusarium head blight (FHB) or scab. GA JT141‐14E45 has good grain volume weight and acceptable milling and baking quality. GA JT141‐14E45 was derived from the cross of ‘AGS 2026’/‘Jamestown’. Jamestown was used in the cross mainly for its resistance to FHB (FHB QTL 1A‐Neuse and 1B‐Jamestown). AGS 2026 is a UGA cultivar released in 2007 with very good disease resistance to rusts (Yr17/Lr37/Sr38), Hessian fly resistance (H13), and excellent yield.

Soft red winter wheat (SRWW) (Triticum aestivumL.), historically a major crop in Georgia and the U.S. Southeast (SE) region, has been challenged by numerous biotic and abiotic constraints resulting in decreased hectarage in recent years. Hence, an urgent need exists to release new cultivars with high yield potential, good resistance to predominant diseases and insects, and acceptable quality attributes to capture and maximize value in regional markets. The SRWW breeding program at the University of Georgia (UGA), in collaboration with the Southeastern University GRAINS (SUNGRAINS) breeding programs, is responding to these challenges by developing and releasing superior SRWW cultivars adapted to Georgia and the SE wheat region. ‘GA 07353‐14E19’ (Reg. no. CV‐1179, PI 689520), a SRWW cultivar developed by the UGA small grains breeding program, was released by the UGA College of Agricultural and Environmental Sciences and licensed to Stratton Seed Company in 2017 as GO WHEAT 2032. GA 07353‐14E19 is adapted to the SE region with high yield, good resistance to prevalent diseases, including leaf and stripe rusts, Fusarium head blight, powdery mildew, and Soil‐borne wheat mosaic virus. GA 07353‐14E19 also showed good resistance to current biotypes of Hessian fly. GA 07353‐14E19 possesses the H13, Sbm1, and Yr17–Lr37–Sr38genes that protect it against the above pests. It has very good grain volume weight and good milling and baking quality as a SRWW.

Soft red winter wheat (SRWW) (Triticum aestivumL.) is a major crop in Georgia and the U.S. Southeast (SE) region. Hence, new cultivars with high yield potential, high resistance levels to predominant pests, and adequate quality parameters are required to capture and maximize regional market values. Therefore, the University of Georgia SRWW breeding program in collaboration with the SUNGRAINS breeding programs, aims to develop and release SRWW cultivars adapted to Georgia and the SE wheat region with high yield, quality, and pest resistance. ‘GA 051207‐14E53’ SRWW (Reg. no. CV‐1168, PI 689518) was developed and released by the University of Georgia and licensed to AGSouth Genetics Company in 2017 under the name AGS 3040. GA 051207‐14E53 is well adapted to Georgia and the SE region. It has high yield and high resistance to leaf rust, stripe rust, and Soil‐borne wheat mosaic virus. It has medium resistance to powdery mildew and to biotypes C and O of Hessian fly and is resistant to biotypes B and L. GA 051207‐14E53 has good Fusarium head blight resistance. GA 051207‐14E53 possesses H9, Sbm1, and the 2NS:2AS alien introgression from Aegilops ventricosaTausch, having the Yr17/Lr37/Sr38genes that protect it against these pests. Grain volume weight and milling and baking qualities of GA 051207‐14E53 are good and meet the SRWW grade standards.

The elucidation of mechanisms to modulate the properties of multifunctional electroactive, conductive, and magnetic porous materials is desirable to aid their future application. The synthesis and characterization of a two-dimensional (2D) mixed-valence metal–tetraoxolene coordination polymer containing a redox-active dication, (PhenQ)[Fe2(Clan)3]·solvent (1; Clann–= deprotonated 3,6-dichloro-2,5-dihydroxy-1,4-benzoquinone; PhenQ2+= 5,6-dihydropyrazino[1,2,3,4-lmn][1,10]-phenanthrolindiium), are reported. The PhenQ2+cation in 1introduces additional accessible framework redox states and effectively directs the localization of ligand valence states. Static and dynamic magnetic susceptibility measurements demonstrated that the dimethylformamide (DMF) solvate, 1b, undergoes spontaneous magnetization below Tc= 31 K, with variable-temperature electrical conductivity measurements revealing that 1bis a modest semiconductor with a conductivity of σ295K= 4.9 × 10–4S cm–1(Ea= 0.249(2) eV). In concert, these results demonstrate that introducing noncovalent interactions between anionic metal–tetraoxolene frameworks and redox-active cations is an effective method to alter the electronic structure and properties of these porous frameworks. Moreover, they forecast the synthesis of new anionic metal–tetraoxolene compounds with diverse electronic and magnetic properties using this hitherto unused strategy.

Black breast cancer patients delay and underutilize adjuvant breast cancer therapies; yet, very few studies have specifically examined Black women's attitudes toward breast cancer therapy. This study observed the influence of self-reported interpersonal processes of care (e.g. self-efficacy) clinical and sociodemographic factors and sociocultural (e.g. religiosity), related to Black breast cancer patients' attitudes toward radiation and systemic therapies (chemotherapy and adjuvant endocrine therapy – “AET”).

Neonatal epilepsy occurs for many reasons. Infants may present shortly after birth with seizure activity or seizures may occur later in the neonatal period. Seizures that are refractory to treatment can be difficult to manage and because of different presentations, there may be a delay in diagnosing the exact etiology. Prompt intervention is necessary and developing a plan of care can be done while exploring the etiology. There are several genetic mutations, including the SCN2Asodium ion channelopathy, that can result in a wide array of epileptic conditions, ranging from mild to severe. This case review focuses on diagnosis and management of SCN2Arefractory seizures.

Like proteins, some RNAs fold to compact structures. We can model functional RNAs as a series of short, rigid, base-paired elements, connected by non-base-paired nucleotides that serve as junctions. These connecting regions bend and twist, facilitating the formation of tertiary contacts that stabilize compact states. Here, we explore the roles of salt and junction sequence in determining the structures of a ubiquitous connector: an asymmetric internal loop. We focus on the J5/5a junction from the widely studied P4–P6 domain of the Tetrahymenaribozyme. Following the addition of magnesium ions to fold P4–P6, this junction bends dramatically, bringing the two halves of the RNA domain together for tertiary contact engagement. Using single-molecule fluorescence resonance energy transfer (smFRET), we examine the role of sequence and salt on model RNA constructs that contain these junction regions. We explore the wild-type J5/5a junction as well as two sequence variants. These junctions display distinct, salt-dependent conformations. Small-angle X-ray scattering (SAXS) measurements verify that these effects persist in the full-length P4–P6 domain. These measurements underscore the importance of junction sequence and interactions with ions in facilitating RNA folding.

Soft red winter wheat (SRWW) (Triticum aestivumL.) is a major crop in Georgia and the southeastern region of the United States. Despite a decrease of wheat acreages in this region, about 100,000 ha were grown to SRWW in Georgia in 2015. To capture and maximize regional market value of wheat, the new released cultivars must have high yield potential, excellent resistance levels to predominant diseases and insects, and good quality. Therefore, the major goal of the SRWW breeding program at the University of Georgia (UGA) is to develop and release SRWW cultivars adapted to the southeastern wheat region with high yield, quality, and pest resistance. ‘Savoy’ (Reg. No. CV‐1135, PI 676043) is a SRWW cultivar developed by the small grains breeding program at UGA in cooperation with the SUNGRAINS and released by the UGA College of Agricultural and Environmental Sciences in 2015. Savoy was subsequently licensed to CPS DYNA‐GRO Seed Company. Savoy was released because it is widely adapted to Georgia and the US Southeast. It has high grain yield, good resistance to races of leaf rust and stripe rust predominant in Georgia and the Southeast. Savoy possesses the H13gene that confers resistance to predominant biotypes of Hessian fly in Georgia and the Southeast. It has good resistance to powdery mildew and Soil‐borne wheat mosaic virus. Savoy is moderately susceptible to Fusarium head blight, or scab. It also has high grain volume weight and acceptable SRWW milling and baking quality.

A pair of coordination polymers of composition (NBu4)2[M2(fan)3] (fan = fluoranilate; M = Fe and Zn) were synthesized and structurally characterized. In each case the compound consists of a pair of interpenetrating three-dimensional, (10,3)-anetworks in which metal centers are linked by chelating/bridging fluoranilate ligands. Tetrabutylammonium cations are located in the spaces between the two networks. Despite the structural similarity, significant differences exist between (NBu4)2[Fe2(fan)3] and (NBu4)2[Zn2(fan)3] with respect to the oxidation states of the metal centers and ligands. For (NBu4)2[Fe2(fan)3] the structure determination as well as Mössbauer spectroscopy indicate the oxidation state for the Fe is close to +3, which contrasts with the +2 state for the Zn analogue. The differences between the two compounds extends to the ligands, with the Zn network involving only fluoranilate dianions, whereas the average oxidation state for the fluoranilate in the Fe network lies somewhere between −2 and −3. Magnetic studies on the Fe compound indicate short-range ordering. Electrochemical and spectro-electrochemical investigations indicate that the fluoranilate ligand is redox-active in both complexes; a reduced form of (NBu4)2[Fe2(fan)3] was generated by chemical reduction. Conductivity measurements indicate that (NBu4)2[Fe2(fan)3] is a semiconductor, which is attributed to the mixed valency of the fluoranilate ligands.

Soft red winter wheat (SRWW) (Triticum aestivumL.) is a major crop in the southeastern region of the United States and in Georgia. Although wheat acreages have been decreasing in Georgia and the SE region in recent years, more than 100,000 ha were grown to SRWW in 2015. Newly released cultivars must have high yield potential, excellent resistance levels to predominant diseases and insects, and good quality to capture and maximize regional market value. One objective of the SRWW breeding program at the University of Georgia (UGA) is to develop and release SRWW cultivars adapted to the SE wheat region with high yield, quality, and pest resistance. ‘GA 03564‐12E6’ (Reg. No. CV‐1122, PI 677366) SRWW was developed by the UGA small grains breeding program and the SUNGRAINS cooperative and released by the UGA College of Agricultural and Environmental Sciences and licensed to Limagrain Cereal Seeds as L11544 in 2015. GA 03564‐12E6 was released primarily for its wide adaptation to the SE region with high grain yield, excellent Hessian fly resistance, and excellent grain volume weight. Additionally, GA 03564‐12E6 has good resistance to races of leaf rust and stripe rust predominant in Georgia and the SE United States. It has good resistance to powdery mildew (caused by Blumeria graminisf. sp. tritici) and Soil‐borne wheat mosaic virusand has acceptable SRWW milling and baking quality. However, it is susceptible to Fusarium head blight (FHB) or scab [caused by Fusarium graminearumSchwabe; teleomorph Gibberella zeae(Schwein.) Petch].

Molecular tools increasingly reveal cryptic lineages and species that were previously unnoticed by traditional taxonomy. The discovery of cryptic species in sympatry prompts the question of how they coexist in the apparent absence of ecological divergence. However, this assumes first that the molecular taxonomy used to identify cryptic lineages delimits species boundaries accurately. This issue is important, because many diversity studies rely heavily or solely on data from mitochondrial DNA sequences for species delimitation, and several factors may lead to poor identification of species boundaries. We used a multilocus population genetics approach to show that three mtDNA-defined cryptic lineages of the fig wasp Pleistodontes imperialis Saunders, which pollinate Port Jackson figs (Ficus rubiginosa) in north-eastern Australia, represent reproductively isolated species. These species coexist locally, with about 13% of figs (where mating occurs) containing wasps from two or three species. However, there was no evidence for gene flow between them. Confirmed cases of coexisting cryptic species provide excellent opportunities for future studies of the ecological and evolutionary forces shaping both species coexistence and fig/pollinator coevolution.

Plasmodium vivax is a major public health burden, responsible for the majority of malaria infections outside Africa. We explored the impact of demographic history and selective pressures on the P. vivax genome by sequencing 182 clinical isolates sampled from 11 countries across the globe, using hybrid selection to overcome human DNA contamination. We confirmed previous reports of high genomic diversity in P. vivax relative to the more virulent Plasmodium falciparum species; regional populations of P. vivax exhibited greater diversity than the global P. falciparum population, indicating a large and/or stable population. Signals of natural selection suggest that P. vivax is evolving in response to antimalarial drugs and is adapting to regional differences in the human host and the mosquito vector. These findings underline the variable epidemiology of this parasite species and highlight the breadth of approaches that may be required to eliminate P. vivax globally.

Female hormones play a significant role in the etiology and treatment of many women’s health conditions. This article focuses on the common uses of hormonal therapy. When prescribing estrogen-containing regimens throughout the span of a woman’s life, the risks are similar (ie, cardiovascular risk and venous thromboembolism), but the degree of risk varies significantly depending on a woman’s particular set of risk factors and the details of the hormone regimen. In addition to estrogens and progestogens, this article also touches on the use of selective steroid receptor modulators in emergency contraception and in treatment of menopause symptoms.

The increasing awareness of RNA’s central role in biology calls for a new understanding of how RNAs, like proteins, recognize biological partners. Because RNA is inherently flexible, it assumes a variety of conformations. This conformational flexibility can be a critical aspect of how RNA attracts and binds molecular partners. Structurally, RNA consists of rigid basepaired duplexes, separated by flexible non-basepaired regions. Here, using an RNA system consisting of two short helices, connected by a single-stranded (non-basepaired) junction, we explore the role of helix length and junction sequence in determining the range of conformations available to a model RNA. Single-molecule Förster resonance energy transfer reports on the RNA conformation as a function of either mono- or divalent ion concentration. Electrostatic repulsion between helices dominates at low salt concentration, whereas junction sequence effects determine the conformations at high salt concentration. Near physiological salt concentrations, RNA conformation is sensitive to both helix length and junction sequence, suggesting a means for sensitively tuning RNA conformations.

Oral contraception (OC) remains a popular noninvasive, readily reversible approach for pregnancy prevention and, largely off label, for control of acne, hirsutism, dysmenorrhea, irregular menstruation, menorrhagia, and other menstrual-related symptoms. Many OC formulations exist, with generics offering lower cost and comparable efficacy. Certain medical conditions, including hypertension, migraine, breast cancer, and risk of venous thromboembolism (VTE), present contraindications. Blood pressure measurement is the only physical examination or testing needed before prescription. Although no OC is clearly superior to others, OCs containing the second-generation progestin levonorgestrel have been associated with lower VTE risk than those containing other progestins.

Introduction:Breast cancer (BC) treatment toxicity contributes to elevated rates of cardiovascular morbidities, such as reduced exercise capacity, a risk factor for long-term cardiovascular disease (CVD) and mortality. Past studies have shown that Black women experience greater cardiotoxicity after BC treatment than white women. No studies have investigated racial differences in exercise capacity. The lack of longitudinal data leaves uncertainty as to whether greater declines in exercise capacity are experienced by Black BC survivors.Methods:This cohort was comprised of 236 women with stage I-III BC (80% white; 20% Black) and 130 cancer-free controls in the UPBEAT (NCT02791581) and DETECT (NCT01719562) studies. Submaximal exercise capacity was obtained via 6-Minute Walk Distance (6MWD, meters [m]) at baseline (pre-treatment) and 3 months. Linear regression was used to examine associations of race with baseline 6MWD and changes in 6MWD.Results:Mean age [SD] of BC survivors was 55.7 [10.9] years. Mean [SD] total meters walked pre-treatment was lower in Black women with BC (423 m [81.0]) than white women with BC (475 m [87.7]; p=0.01), and lower than Black women without BC (471 m [76.9]; p=0.07). Black BC survivors experienced a greater mean decline from baseline to 3-months in 6MWD (30 m [68.5]) than white BC survivors (21.7 m [86.6]; Table 1; p=0.02) or Black women without BC (9.2 m [67.3]; p=0.001), translating to a mean difference of 60 m between Black and white BC survivors during BC treatment.Conclusions:This is the first study to suggest racial differences in submaximal exercise capacity during BC treatment. Black BC survivors experienced a greater reduction in exercise capacity than white BC survivors after cancer treatment as early as 3-months post-diagnosis. This clinically-meaningful difference in exercise capacity warrants further investigation, particularly to determine interventions to reverse the loss of exercise capacity.

Introduction:Breast cancer and lymphoma survivors who have received doxorubicin are at risk of experiencing a decline in left ventricular ejection fraction (LVEF), yet whether socioeconomic factors further impact this decline is unknown.Methods:We performed a secondary analysis of data from a double-blinded clinical trial (NCT01988571) in breast cancer and lymphoma survivors that determined the impact of statin use on LVEF 6- and 24-months following initiation of doxorubicin. LVEF was measured via magnetic resonance imaging. Socioeconomic factors were collected via survey. Linear regression models assessed relationships between socioeconomic variables and change in LVEF from baseline to 24 months by individuals blinded to treatment group. Results:Of the 279 survivors included in this analysis, a majority were white (82.8%) (13.6% Black, 3.6% other races), college educated (56.3%), and employed (63.8%). Mean LVEF at baseline was 62.2% (SD=6.01) and mean LVEF declines at 6- and 24-months were 4.72% (SD=7.30) and 5.11% (SD=7.20), respectively. In the multivariable model, after controlling for age, race, body mass index, and smoking, patients who made >$75k per year had a significantly smaller LVEF drop (3.36, 95% CI: -0.53, 7.25) at 6-months than patients making less than <$35k per year (8.66, 95% CI: 4.87, 12.45), p=0.003. Employed patients making >$75k per year had significantly smaller LVEF declines (mean=5.00, 95% CI: 0.14, 9.86) than employed patients making less than 35k per year (mean=9.43, 95% CI: 4.30, 14.56), p=0.033. Lastly, employed patients making >75k had a marginally significantly lower EF drop than unemployed patients making >75k per year (mean=7.83, 95%CI: 3.32, 12.34), p=0.092. These findings occurred independent of statin use.Conclusions:Findings from this study highlight a need to understand how one’s socioeconomic status (SES), or in terms of social determinants of health, economic stability, may serve as a protective factor regarding LVEF decline during treatment with doxorubicin for breast cancer and lymphoma. Future work should also consider examining the association between SES and care delivery and how that may potentially impact LVEF decline.

Introduction:AHA/ACC hypertension guidelines do not clearly address pharmacological treatment of increases in blood pressure (BP) in women receiving potentially cardiotoxic chemotherapy for treatment of breast cancer.Methods and Results:Magnetic resonance measures of left ventricular ejection fraction (LVEF) were performed in women with stage I-III breast cancer prior to and three months after initiating potentially cardiotoxic chemotherapy. Measurements of brachial BP were collected according to AHA recommendations. Using multivariable analysis, we assessed the association between change in LVEF and pre-existing ACC/AHA stages of hypertension (HTN) after accounting for pre-treatment LVEF, diabetes status, age, and body mass index (BMI). All analyses were performed by those blinded to all participant identifiers.Participants (n=259, female) were aged 56±11 (Mn+SD) years and were 76% white & 19% black (NCT02791581 and NCT01719562). Cancer therapies included combinations of anthracyclines (23%), trastuzumab (10%), paclitaxel (22%) and cyclophosphamide (30%). After accounting for pre-treatment LVEF, diabetes status, age, and BMI, participants with stage 2 HTN experienced a significant decline (p=0.037, Figure) in LVEF relative to individuals with normal blood pressure.Conclusion:Relative to women with normal blood pressure, women with stage 2 HTN experienced a larger decline in LVEF (p=0.037) three months after initiating potentially cardiotoxic chemotherapy for breast cancer. This finding raises the possibility that lower blood pressure targets among women receiving adjuvant treatment for breast cancer may be associated with improved preservation of LVEF.

Introduction:Hypertension (HTN) may increase the risk of cardiovascular (CV) events among breast cancer (BC) survivors, particularly in Black women. Limited information is available about factors associated with the presence of HTN at the time of BC diagnosis among Black versus White women.Methods:In a secondary analysis of data from a longitudinal cohort of Black and White women diagnosed with hormone receptor positive (HR+) BC, post initiation of adjuvant endocrine therapy (AET), medical records were used to determine HTN status and other clinical factors (stage, AET type, CV comorbidities). In the same cohort, psychosocial and quality of life data were collected via surveys. Logistic regression models evaluated factors associated with increased odds of HTN at baseline.Results:Women with BC (n=243) were mostly White (66.7%), mean (SD) aged 61.6 (10.9) years, with borderline obesity (BMI: 29.9 (6.6)). Comorbidities and tamoxifen use were reported by 40.7% and 28.4% of women, respectively. HTN was present in 140 (57.6%) women (38% Black, 62% White). Relative to their White counterparts, Black women with HTN were significantly younger, (61.5 vs. 67.5 years of age, p<0.01) more overweight (BMI, 32.8 vs 29.3, p=<.01), received chemotherapy more frequently (44.4% vs 22.1%, p<0.01), were more likely to have experienced discrimination (35.2% vs 7%, p<0.01) and more often to possess CV comorbidities (61.1% vs 37.2%, p<0.01). Multivariable logistic regression showed that the odds of having HTN increased significantly with age by 10% per year (OR: 1.10, 95% CI: 1.06-1.14; p<.0001), with Black women having a 2-fold greater risk of having HTN (OR: 2.02, 1.02-4.03; p=.044) than White women. Additionally, a 1-unit increase in BMI was associated with 6% higher odds of having HTN (OR: 1.06, 95% CI: 1.03-1.11; p=0.0390) while Tamoxifen use, presence of CV comorbidities and worse social well-being were not associated with more frequent HTN in women with BC.Conclusions:A high proportion of women diagnosed with HR+ BC have HTN with Black vs White women experiencing more HTN. These results raise the possibility that Black women with BC may benefit from focused HTN management strategies to reduce potential CV events.

"Calcifying epithelioma" does not occur in the index of practically all English texts. An example of this entity recently came to our attention and is herewith described. REPORT OF A CASE Miss R. F., aged 30, white, a school teacher, consulted Dr. Richard L. Sutton Sr., on April 15, 1933. She complained of a small tumor on the radial aspect of the dorsum of the right forearm. This lesion was a hard, round nodule the size of a hazelnut (about 1 cm. in diameter) projecting as a red, flattened hemisphere about 3 mm. above the level of the surface of the arm. The skin overlying it was thin and shining, and of pale cherry color with a few dilated capillaries running over the protuberance. The margin curved gently into the surrounding normal tissue, and the redness faded abruptly at the edge. On palpation (and the finger-tips tell as much as

Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety.