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Background: Persons assigned female or intersex at birth and identify as transgender and/or gender-diverse (TGD) may undergo gender-affirming chest masculinization surgery (GACMS); however, GACMS is not considered equivalent to risk-reducing mastectomies (RRM). This study aimed to estimate the prevalence of elevated breast cancer (BC) risk in TGD persons, compare self-perceived versus calculated risk, and determine how risk impacts the decision for GACMS versus RRM. Methods: A prospective single-arm pilot educational intervention trial was conducted in individuals assigned female or intersex at birth, age ≥ 18 years, considering GACMS, without a BC history or a known pathogenic variant. BC risk was calculated using the Tyrer–Cuzik (all) and Gail models (age ≥ 35 years). Elevated risk was defined as ≥ 17%. Results: Twenty-five (N = 25) participants were enrolled with a median age of 24.0 years (interquartile range, IQR 20.0–30.0 years). All were assigned female sex at birth, most (84%) were Non-Hispanic (NH)-White, 48% identified as transgender and 40% as nonbinary, and 52% had a first- and/or second-degree family member with BC. Thirteen (52%) had elevated risk (prevalence 95% confidence interval (CI) 31.3–72.2%). Median self-perceived risk was 12% versus 17.5% calculated risk (p = 0.60). Of the 13 with elevated risk, 5 (38.5%) underwent/are scheduled to undergo GACMS, 3 (23%) of whom underwent/are undergoing RRM. Conclusions: Over half of the cohort had elevated risk, and most of those who moved forward with surgery chose to undergo RRM. A BC risk assessment should be performed for TGD persons considering GACMS. Future work is needed to examine BC incidence and collect patient-reported outcomes. Trial Registration Number ClinicalTrials.gov (No. NCT06239766). [ABSTRACT FROM AUTHOR]

Background: More than 2.5 million adults in the United States identify as transgender or gender-diverse (TGD), but little data exist on cancer screening and care for this population. We examined cancer characteristics, screening adherence, genetic testing, and provider inclusive language for TGD patients with cancer. Methods: This single institution retrospective cohort study identified TGD patients with cancer between 2000 and 2022. Demographic, clinicopathological, treatment, and screening data were collected, as well as data on gender-affirming care (GAC) and use of patients' personal pronouns in medical records. Descriptive statistics and regression analyses were used to report outcomes. Results: Sixty unique patients with 69 cancer diagnoses were included: 63.3% were transgender women, 21.7% transgender men, 6.7% nonbinary, and 8.3% were genderqueer. Sixty-five percent had a family history of cancer. Only 46.2% of those who met genetic testing criteria were referred. On review of recommended cancer screening, colorectal screening had the greatest uptake (62%), followed by breast (48.3%), lung (35.7%), cervical (33.3%), and prostate (32%); 8.5% of cancers were diagnosed on screening. Individuals with Medicare had reduced odds of screening uptake (OR 0.07, 95% CI 0.01–0.58) versus private insurance. With respect to GAC, 73.3% used gender-affirming hormone therapy and 41% had gender-affirming surgery. After initiating GAC and asserting personal pronouns, 75% were referred to by incorrect name/pronouns in provider documentation. Conclusions: Our TGD cancer patient cohort had low rates of disease-specific cancer screening and inadequate genetic referrals. Many providers did not use appropriate patient names/pronouns. Provider and patient interventions are needed to ensure inclusive preventative and oncologic care for this marginalized population. [ABSTRACT FROM AUTHOR]

Purpose of Review: Cancer-related inequities are prevalent in Wisconsin, with lower survival rates for breast, colorectal, and lung cancer patients from marginalized communities. This manuscript describes the ongoing efforts at the Medical College of Wisconsin and potential pathways of community engagement to promote education and awareness in reducing inequities in cancer care. Recent Findings: While some cancer inequities are related to aggressive disease biology, health-related social risks may be addressed through community-academic partnerships via an open dialogue between the community members and academic faculty. To develop potential pathways of community-academic partnerships, an annual Cancer Disparities Symposium concept evolved as a pragmatic and sustainable model in an interactive learning environment. Summary: In this manuscript, we describe the programmatic development and execution of the annual Cancer Disparities Symposium, followed by highlights from this year's meeting focused on geriatric oncology as discussed by the speakers. [ABSTRACT FROM AUTHOR]

Purpose of review: The purpose of this review is to provide an overview of ten unique breast cancer subtypes and their clinicopathologic features and treatment implications. Recent findings: Recent findings show that while many subtypes (mucinous, papillary, tubular, apocrine) have favorable biology, with better overall survival than invasive ductal carcinoma, some (metaplastic, adenoid cystic) are more aggressive portending worse prognosis for patients. Summary: The differences in histology represented in these breast cancer subtypes often impacts biology, behavior, and prognosis. Due to their rarity, additional research is needed to implement clear treatment protocols for each subtype. [ABSTRACT FROM AUTHOR]

Purpose: Neoadjuvant chemotherapy (NAC) for triple-negative breast cancer (TNBC) allows for assessment of tumor pathological response and has survival implications. In 2017, the CREATE-X trial demonstrated survival benefit with adjuvant capecitabine in patients TNBC and residual disease after NAC. We aimed to assess national rates of NAC for cT1–2N0M0 TNBC before and after CREATE-X and examine factors associated with receiving NAC vs adjuvant chemotherapy (AC). Methods: A retrospective cohort study of women with cT1-2N0M0 TNBC diagnosed from 2014 to 2019 in the National Cancer Database (NCDB) was performed. Variables were analyzed via ANOVA, Chi-squared, Fisher Exact tests, and a multivariate linear regression model was created. Results: 55,633 women were included: 26.9% received NAC, 52.4% AC, and 20.7% received no chemotherapy (median ages 53, 59, and 71 years, p < 0.01). NAC utilization significantly increased over time: 19.5% in 2014–15 (n = 3,465 of 17,777), 27.1% in 2016–17 (n = 5,140 of 18,985), and 33.6% in 2018–19 (n = 6,337 of 18,871, p < 0.001). On multivariate analysis, increased NAC was associated with younger age (< 50), non-Hispanic white race/ethnicity, lack of comorbidities, cT2 tumors, care at an academic or integrated-network cancer program, and diagnosis post-2017 (p < 0.05 for all). Patients with government-provided insurance were less likely to receive NAC (p < 0.01). Women who traveled > 60 miles for treatment were more likely to receive NAC (p < 0.01). Conclusion: From 2014 to 2019, NAC utilization increased for patients with cT1–2N0M0 TNBC. Racial, socioeconomic, and access disparities were observed in who received NAC vs AC and warrants interventions to ensure equitable care. [ABSTRACT FROM AUTHOR]

Background: Endocrine resistant metastatic disease develops in ~ 20–25% of hormone-receptor-positive (HR+) breast cancer (BC) patients despite endocrine therapy (ET) use. Upregulation of HER family receptor tyrosine kinases (RTKs) represent escape mechanisms in response to ET in some HR+ tumors. Short-term neoadjuvant ET (NET) offers the opportunity to identify early endocrine escape mechanisms initiated in individual tumors. Methods: This was a single arm, interventional phase II clinical trial evaluating 4 weeks (± 1 week) of NET in patients with early-stage HR+/HER2-negative (HER2-) BC. The primary objective was to assess NET-induced changes in HER1-4 proteins by immunohistochemistry (IHC) score. Protein upregulation was defined as an increase of ≥ 1 in IHC score following NET. Results: Thirty-seven patients with cT1-T3, cN0, HR+/HER2- BC were enrolled. In 35 patients with evaluable tumor HER protein after NET, HER2 was upregulated in 48.6% (17/35; p = 0.025), with HER2-positive status (IHC 3+ or FISH-amplified) detected in three patients at surgery, who were recommended adjuvant trastuzumab-based therapy. Downregulation of HER3 and/or HER4 protein was detected in 54.2% of tumors, whereas HER1 protein remained low and unchanged in all cases. While no significant volumetric reduction was detected radiographically after short-term NET, significant reduction in tumor proliferation rates were observed. No significant associations were identified between any clinicopathologic covariates and changes in HER1-4 protein expression on multivariable analysis. Conclusion: Short-term NET frequently and preferentially upregulates HER2 over other HER family RTKs in early-stage HR+/HER2- BC and may be a promising strategy to identify tumors that utilize HER2 as an early endocrine escape pathway. Clinical trial registry: Trial registration number: NCT03219476. [ABSTRACT FROM AUTHOR]

Under political competition, bureaucrats who wish to maintain their jobs and salaries must continue to stimulate demand for their agency's services in order to secure funding. This paper suggests that one way a bureau can do so is by creating avenues for private entities to collect rents through entrepreneurial action. The Federal Student Aid office in the U.S. Department of Education and their Free Application for Federal Student Aid (FAFSA) can serve as an example. By getting students to fill out a FAFSA application, colleges obtain the detailed financial information of students and families. Colleges can then use this information to price discriminate. The bureau's derived benefits from this behavior are two-fold: (1) Private interests groups can lobby political sponsors to continue funding the agency. Using data obtained from lobbying reports filed with the federal government, we find that there is a positive relationship between lobbying expenditures and the implementation of regulations that enhance the value of the rents associated with the FAFSA. (2) The source of the rents can be used as a performance indicator to meet the demands of political sponsors. Drawing from the 5-year strategic plans from the Department of Education and the Federal Student Aid office, we find that these bureaus can benefit from engaging in such behavior. [ABSTRACT FROM AUTHOR]

Purpose of Review: A chest wall recurrence after mastectomy for breast cancer requires multimodality treatment. In this article, we review local and systemic therapy treatments for recurrent chest wall disease. Recent Findings: There appears to be a survival benefit for patients who can undergo local resection in combination with radiation therapy. Retrospective series have shown an overall benefit with minimal risk of re-irradiation. The success of performing a sentinel lymph node biopsy after a mastectomy and after a previous sentinel node biopsy has been reported. Overall, there is limited data on systemic therapy options; however, there is no benefit to adjuvant chemotherapy compared to endocrine therapy alone with the non-metastatic hormone-receptor-positive disease. Summary: Local resection may require a comprehensive surgical team to achieve negative margins and reconstruct defects. Radiation therapy should be considered, even if the setting of previous radiation and systemic therapy is based on receptor status and previous systemic treatment. [ABSTRACT FROM AUTHOR]

Background: Primary breast neuroendocrine tumors (BNETs) represent < 1% of breast cancers. Diagnosing BNETs can be challenging, and a limited amount of cohort data currently exists in literature. We aimed to describe primary BNET characteristics, treatment modalities, and survival outcomes through the National Cancer Database (NCDB). Methods: A retrospective cohort analysis was performed using the NCDB from 2004 to 2017. BNET cases were compared with patients with invasive ductal carcinoma (IDC). A matched IDC cohort was created by matching patient age, race, and disease stage. Kaplan–Meier analysis was performed, and hazard ratios (HR) were calculated through the bootstrap sampling method. Results: A total of 1389 BNET and 1,967,401 IDC cases were identified. When compared with IDC patients, BNET patients were older, had more comorbidities, and were more often male (p < 0.01). BNETs were larger, higher grade, and more frequently hormone receptor negative (p < 0.01). While BNET patients were treated with surgery and radiotherapy (p < 0.01) less often compared with IDC patients, they presented at later disease stage (p < 0.001) and received systemic treatment more frequently (53.5% vs. 40%, p < 0.01). Patients with BNET had increased mortality compared with the matched IDC cohort: stage 1 HR 1.8, stage 2 HR 2.0, stage 3 HR 1.8, and stage 4 HR 1.5 (p < 0.001 for all). Conclusion: Patients with BNET tend to present at higher clinical stages, are more frequently hormone receptor negative, and have inferior overall survival compared with patients with IDC. Further treatment strategies and studies are needed to elucidate optimal therapies to maximize patient outcomes. [ABSTRACT FROM AUTHOR]

The Society of Surgical Oncology is committed to reducing health disparities adversely affecting sexual and gender minorities. Transgender persons represent a socially disadvantaged group who frequently experience discrimination and receive disparate care, resulting in suboptimal cancer outcomes. The rate of breast cancer development in transgender individuals differs from rates observed in their cisgender counterparts, however there is little evidence to quantify these differences and guide evidence-based screening and prevention. There is no consensus for breast cancer screening guidelines in transgender patients. In this review, we discuss barriers to equitable breast cancer care, risk factors for breast cancer development, and existing data to support breast cancer screening in transgender men and women. [ABSTRACT FROM AUTHOR]

Background: Management of axillary lymph nodes in breast cancer has undergone significant change over the past decade through landmark clinical trials. This study aimed to assess national practice patterns in axillary management in patients undergoing upfront mastectomy and examines what guides provider recommendations. Methods: A national case-based survey study was performed of surgeons and radiation oncologists from July to August 2020. Surgeons were identified through the American Society of Breast Surgeons (ASBrS) after review and approval by the ASBrS Research Committee, and radiation oncologists were identified through an institutional database. Both descriptive and comparative statistical analyses were performed. Results: Overall, 994 providers responded—680 surgeons and 314 radiation oncologists. Surgeons were older and in practice longer (p < 0.05) and treated a higher percentage of breast patients (81% vs. 40%, p < 0.001). Most surgeons were hospital-employed (43%), whereas most radiation oncologists were in private practice (40%; p < 0.001). Fifty-two percent of surgeons routinely send sentinel lymph nodes (SLNs) for frozen section (52%) during mastectomy, of which 78% proceed directly to axillary lymph node dissection (ALND) if positive. There was significant variability in treatment recommendations between the two groups among the hypothetical cases (p < 0.001). In the setting of low disease burden in the SLNs, > 30% of surgeons recommended ALND, while radiation oncologists recommend axillary radiotherapy over axillary clearance (p < 0.001). Conclusion: There is significant heterogeneity in the management of the axilla in mastectomy patients with pathologically positive SLNs, both between and among surgeons and radiation oncologists. Efforts should be made to assist both groups in identifying de-escalation opportunities to ensure that mastectomy patients with positive SLNs are treated appropriately. [ABSTRACT FROM AUTHOR]

Purpose of Review: There are over 1.4 million individuals who identify as transgender in the USA, and these individuals are frequently treated with cross-sex hormonal therapy (CSH) to acquire their desired phenotype. Simultaneously, breast cancer is one of the most common cancers in the USA, and there are mixed data on how CSH may influence breast cancer development in transgender individuals. Here, we review the barriers that exist to health access in this population, the current evidence of breast cancer risk in transgender individuals, and breast cancer screening guidelines for both transgender women and men. Recent Findings: A large portion of the transgender population report barriers that exist to accessing appropriate healthcare, some of which are directly related to poor interactions with healthcare providers. From both systemic reviews and large retrospective studies, it appears that while transgender females have a lower rate of breast cancer development compared to cis-gender females, transgender males have a higher rate of breast cancer development compared to cis-gender males. While several organizations have released screening guidelines for transgender persons, there is a lack of consensus on optimal screening regimens. In addition, there are no formal recommendations by the American Cancer Society or the United States Preventative Task Force for breast cancer screening in transgender persons. Summary: The risk of breast cancer development in transgender individuals is different compared to that of the cis-gender population. Further prospective data are needed to appropriately quantify these risks and to assess what is the appropriate breast cancer screening recommendations for this population. [ABSTRACT FROM AUTHOR]

Purpose of Review: Over the past decade, prospective clinical trials and retrospective data have changed clinical guidelines for the treatment of older patients, most notably those patients with early, hormone receptor-positive, clinically node-negative breast cancer. Here is a comprehensive review of the literature supporting de-escalation of local-regional therapy in older patients with breast cancer. Recent Findings: The de-escalation of treatment in elderly patients includes minimizing surgical interventions and adjuvant radiation therapy. Current Choosing Wisely® guidelines recommend considering the omission of surgical staging of the axilla in patients ≥ 70 with early-stage, hormone receptor-positive breast cancer. Primary endocrine therapy may be a suitable option for older patients with hormone receptor-positive breast cancer and short life-expectancy. The long-term results of the CALGB 9343 clinical trial reveal that radiotherapy omission is not associated with a survival benefit in patients ≥ 70 with early-stage, hormone receptor-positive, node-negative breast cancer, who receive 5 years of adjuvant endocrine therapy. The results of the RAPID trial support that shorter courses of radiation therapy are non-inferior to standard therapy and may be of significant value to older patients who require radiation. In addition, intraoperative radiotherapy may be useful in older patients with mobility issues who have higher-risk tumors and the current TARGIT-E aims to assess IORT in patients ≥ 70 with hormone receptor-positive tumors. Summary: Select older patients with breast cancer may benefit from the omission of axillary staging, less aggressive breast surgery, and shorter courses or total omission of radiation therapy. Current studies aim to continue to define the appropriate criteria for which older patients can benefit from de-escalation of local-regional therapy. [ABSTRACT FROM AUTHOR]

Purpose of Review: Enhanced recovery after surgery (ERAS) protocols have become common for patients undergoing breast reconstruction, catalyzed by the recent opioid crisis. Here, we review standard ERAS protocol structure and the supporting evidence. Recent Findings: A perioperative multidisciplinary team and multimodal pain management appropriately are the two critical factors for ERAS success. Preoperative counseling, both antibiotic and venous thromboembolic prophylaxis, and multimodal antiemetics are crucial to optimize results. Regional nerve blocks provide an alternative to oral and intravenous opioids. Intraoperative minimization of inhaled anesthetics and complete IV analgesia is recommended along with team communication. A postoperative opioid-sparing approach with medications such as acetaminophen, NSAIDs, and gabapentin is needed along with an early diet, patient mobilization, and IV fluid and Foley catheter discontinuation. Summary: ERAS protocols for breast reconstruction have shown a decrease in length of stay, intraoperative and postoperative narcotic use, and perioperative costs while simultaneously increasing patient satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of bile duct injury (BDI) during laparoscopic cholecystectomy has not changed significantly in the past 2 decades despite increased operative experience and technical refinement. We sought to evaluate surgeon-specific factors associated with BDI and to assess how surgeons manage injuries.Methods: An online survey was sent to surgeons belonging to the Society of American Gastrointestinal and Endoscopic Surgeons via e-mail. Survey items included personal experience with BDI and how injuries were addressed. Statistical analysis was performed to identify factors associated with BDI.Results: The survey was sent to 3411 surgeons with 559 complete responses (16.5%). The mean age of respondents was 48.7 years with an average time in practice of 16.1 years. Most respondents (61.2%) had fellowship training. Forty-seven percent of surgeons surveyed experienced a BDI in their career with 17.1% of surgeons experiencing multiple BDIs. The majority of BDIs were identified in the operating room (64.5%); most injuries (66.9%) were repaired immediately. When repair was undertaken immediately, 77.4% of these repairs were performed in an open technique. A majority of surgeons (57.7%) felt that BDIs could theoretically be repaired laparoscopically and 25% of those surgeons had done so in practice. In multivariate logistic regression, any type of fellowship training was associated with a decreased risk of BDI (OR 0.51, 95% CI 0.34-0.76). Compared with those in non-academic practice, surgeons in academic practice were at a significantly decreased risk of having experienced a BDI (OR 0.62, 95% CI 0.42-0.92).Conclusion: Nearly half of those surveyed, experienced a BDI during a laparoscopic cholecystectomy. Community and private practice setting were associated with an increased risk of BDI, while fellowship training and academic practice setting conferred a protective effect. A majority of surgeons felt that BDI could be repaired laparoscopically and 25% had done so in practice. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this study are to characterize magneto-endosymbiont (ME) labeling of mammalian cells and to discern the subcellular fate of these living contrast agents. MEs are novel magnetic resonance imaging (MRI) contrast agents that are being used for cell tracking studies. Understanding the fate of MEs in host cells is valuable for designing in vivo cell tracking experiments.Procedures: The ME's surface epitopes, contrast-producing paramagnetic magnetosomal iron, and genome were studied using immunocytochemistry (ICC), Fe and MRI contrast measurements, and quantitative polymerase chain reaction (qPCR), respectively. These assays, coupled with other common assays, enabled validation of ME cell labeling and dissection of ME subcellular processing.Results: The assays mentioned above provide qualitative and quantitative assessments of cell labeling, the subcellular localization and the fate of MEs. ICC results, with an ME-specific antibody, qualitatively shows homogenous labeling with MEs. The ferrozine assay shows that MEs have an average of 7 fg Fe/ME, ∼30 % of which contributes to MRI contrast and ME-labeled MDA-MB-231 (MDA-231) cells generally have 2.4 pg Fe/cell, implying ∼350 MEs/cell. Adjusting the concentration of Fe in the ME growth media reduces the concentration of non-MRI contrast-producing Fe. Results from the qPCR assay, which quantifies ME genomes in labeled cells, shows that processing of MEs begins within 24 h in MDA-231 cells. ICC results suggest this intracellular digestion of MEs occurs by the lysosomal degradation pathway. MEs coated with listeriolysin O (LLO) are able to escape the primary phagosome, but subsequently co-localize with LC3, an autophagy-associated molecule, and are processed for digestion. In embryos, where autophagy is transiently suppressed, MEs show an increased capacity for survival and even replication. Finally, transmission electron microscopy (TEM) of ME-labeled MDA-231 cells confirms that the magnetosomes (the MRI contrast-producing particles) remain intact and enable in vivo cell tracking.Conclusions: MEs are used to label mammalian cells for the purpose of cell tracking in vivo, with MRI. Various assays described herein (ICC, ferrozine, and qPCR) allow qualitative and quantitative assessments of labeling efficiency and provide a detailed understanding of subcellular processing of MEs. In some cell types, MEs are digested, but the MRI-producing particles remain. Coating with LLO allows MEs to escape the primary phagosome, enhances retention slightly, and confirms that MEs are ultimately processed by autophagy. Numerous intracellular bacteria and all endosymbiotically derived organelles have evolved molecular mechanisms to avoid intracellular clearance, and identification of the specific processes involved in ME clearance provides a framework on which to develop MEs with enhanced retention in mammalian cells. [ABSTRACT FROM AUTHOR]

Purpose: Magneto-endosymbionts (MEs) show promise as living magnetic resonance imaging (MRI) contrast agents for in vivo cell tracking. Here we characterize the biomedical imaging properties of ME contrast agents, in vitro and in vivo.Procedures: By adapting and engineering magnetotactic bacteria to the intracellular niche, we are creating magneto-endosymbionts (MEs) that offer advantages relative to passive iron-based contrast agents (superparamagnetic iron oxides, SPIOs) for cell tracking. This work presents a biomedical imaging characterization of MEs including: MRI transverse relaxivity (r 2) for MEs and ME-labeled cells (compared to a commercially available iron oxide nanoparticle); microscopic validation of labeling efficiency and subcellular locations; and in vivo imaging of a MDA-MB-231BR (231BR) human breast cancer cells in a mouse brain.Results: At 7T, r 2 relaxivity of bare MEs was higher (250 s-1 mM-1) than that of conventional SPIO (178 s-1 mM-1). Optimized in vitro loading of MEs into 231BR cells yielded 1-4 pg iron/cell (compared to 5-10 pg iron/cell for conventional SPIO). r 2 relaxivity dropped by a factor of ~3 upon loading into cells, and was on the same order of magnitude for ME-loaded cells compared to SPIO-loaded cells. In vivo, ME-labeled cells exhibited strong MR contrast, allowing as few as 100 cells to be detected in mice using an optimized 3D SPGR gradient-echo sequence.Conclusions: Our results demonstrate the potential of magneto-endosymbionts as living MR contrast agents. They have r 2 relaxivity values comparable to traditional iron oxide nanoparticle contrast agents, and provide strong MR contrast when loaded into cells and implanted in tissue. [ABSTRACT FROM AUTHOR]

The molecular factors involved in the development of Post-Traumatic Stress Disorder (PTSD) remain poorly understood. Previous transcriptomic studies investigating the mechanisms of PTSD apply targeted approaches to identify individual genes under a cross-sectional framework lack a holistic view of the behaviours and properties of these genes at the system-level. Here we sought to apply an unsupervised gene-network based approach to a prospective experimental design using whole-transcriptome RNA-Seq gene expression from peripheral blood leukocytes of U.S. Marines (N=188), obtained both pre- and post-deployment to conflict zones. We identified discrete groups of co-regulated genes (i.e., co-expression modules) and tested them for association to PTSD. We identified one module at both pre- and post-deployment containing putative causal signatures for PTSD development displaying an over-expression of genes enriched for functions of innate-immune response and interferon signalling (Type-I and Type-II). Importantly, these results were replicated in a second non-overlapping independent dataset of U.S. Marines (N=96), further outlining the role of innate immune and interferon signalling genes within co-expression modules to explain at least part of the causal pathophysiology for PTSD development. A second module, consequential of trauma exposure, contained PTSD resiliency signatures and an over-expression of genes involved in hemostasis and wound responsiveness suggesting that chronic levels of stress impair proper wound healing during/after exposure to the battlefield while highlighting the role of the hemostatic system as a clinical indicator of chronic-based stress. These findings provide novel insights for early preventative measures and advanced PTSD detection, which may lead to interventions that delay or perhaps abrogate the development of PTSD. [ABSTRACT FROM AUTHOR]

Three tissue-equivalent cylindrical wound phantoms with varying activities of DU metal imbedded at varying depths were used to compare the efficiencies of a bismuth germinate (BGO) detector, a sodium iodide (NaI), and two identical wound probes with smaller sodium iodide crystals. Our results show that the BGO detector had the highest efficiency (1.0·10-3) and the lowest minimum detectable activity (MDA = 5.8 kBq) for the shallow depth DU phantom, relative to the other detectors. The BGO detector also had the highest peak efficiencies (1.7·10-3 and 5.8·10-4) and the lowest MDAs (3.5 and 10.0 kBq) for the medium and deep phantoms, respectively. Other detectors' performance data are presented. [ABSTRACT FROM AUTHOR]

In leaf derived callus cultures of Solanum laciniatum Ait. both phenolics and solasodine concentrations increased when medium phosphate or nitrogen concs. were reduced to one-eighth or when sucrose concentration was increased from 3 to 4-8 %. Under these conditions growth was reduced and final FW:DW fell. Growth was inhibited by sucrose depletion and nitrogen supple -mentation. On additional nitrogen the concentrations of phenolics and protein significantly increased, FW:DW was reduced and solasodine concentration was unaffected. In seedling derived cultures phosphate depletion resulted in a significant increase in phenolics concentration, an inhibition of growth and a rise in solasodine concentration. [ABSTRACT FROM AUTHOR]

Callus and suspension cultures, established from seedling and leaf explants of Solanum laciniatum Ait were analysed for solasodine using a spectrophotometric assay. Solasodine concentration in both types of culture ranged from 0.5 - 1.0 mg/g dry wt., with a small number of callus explants containing higher concentrations. There was no overall fall in concentration as a result of serial subculture, and in suspension cultures the level remained constant throughout a single passage. Solasodine concentration was enhanced by the induction of organogenesis in both primary leaf explants and callus. ABA, added at 0.04 mg 1, increased solasodine yield in callus cultures whilst CEPA, at concentrations of 10 mg 1 and higher, inhibited production. Dark grown callus contained significantly more solasodine than light grown. [ABSTRACT FROM AUTHOR]

Cefoxitin-resistant clinical isolates of Enterobacter spp. demonstrated inducible β-lactamase activity in 31 of 47 (65.9%) disk approximation tests and in 32 of 52 (63.5%) agar dilution induction tests. Agreement between the two results was only 72.3%, and 80.9% of the strains were positive in at least one induction test. Lack of valid interpretive criteria preclude their routine use in the clinical laboratory. [ABSTRACT FROM AUTHOR]

Models predicting the occurrence of area-sensitive bird species in forests were developed from bird survey data from 499 forests in Prince George's County, Maryland. The predicted probabilities of occurrence for species were integrated with forest cover data for the County in a Geographic Information System (GIS). This information was used incombination with local zoning and forest conservation requirements to develop a preliminary forest conservation plan for the watershed ofthe Western Branch of the Patuxent River. We identify forests patches most likely to support breeding populations of area-sensitive birds, and use the GIS to devise ways to consolidate and link them. Forests that do not contribute significantly to the integrity of these priority forests are designated as sites in which development could occur. The resulting conservation plan will maintain and enhance breeding habitat for area-sensitive forest birds, while still allowing for additional development as human populations increase. [ABSTRACT FROM AUTHOR]