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The optimal treatment strategy for men with localised prostatic cancer of low and intermediate risk is an actively evolving field. It is important to strike a balance between maximal oncological control and minimal treatment-related complications, which helps preserve the patients' quality of life. MR-guided transurethral ultrasound ablation (TULSA) has emerged as a minimally invasive treatment option for this group of patients. This article aims to provide of a background on TULSA technology, a step-by-step procedural guide of MR-guided TULSA and to summarise the current evidence of TULSA in management of localised prostatic cancer, as well as other potential indications. [ABSTRACT FROM AUTHOR]

Background: Our study aims to investigate inter- and intraindividual effects of trainee teachers' perceived opportunities of participation in vocational education and training teacher training on their emotional states. Additionally, it is examined whether the subjective reason for action as in intrinsic and extrinsic motivation affects the relationship between perceived participation and emotional states. In this respect, control-value theory constitutes the guiding conceptual framework in our study. Methods: On the basis of a longitudinal design with a total of 75 trainee teachers in Germany and a maximum of 58 survey time points during 18-months of teacher training (in total 1790 individual measurements), we traced the perception of participatory opportunities, intrinsic and extrinsic motivation as well as weekly emotional states. Multilevel modeling allowed us to examine both between- as well as within-person effects of perceived participation. Results: The results of our multilevel models indicate, among other findings, statistically significant within- and between-person effects of perceived participation opportunities on enjoyment, hope, pride, as well as anger, anxiety, shame, and hopelessness. Furthermore, the attributed subjective reason for action, i.e., the intrinsic or extrinsic motivation, moderates the relationship between perceived opportunities to participate and emotional states. Discussion: The findings, which are consistent across different emotions of the same valence and for the two different types of motivation, indicate that those trainee teachers who report low values for intrinsic motivation (or high values for extrinsic motivation) in a given week react more responsively to changes with regard to opportunities for participatory influence. [ABSTRACT FROM AUTHOR]

In recent years, interventional radiologists have been increasingly involved in the management of bone fractures resulting from benign (osteoporosis and trauma), as well as malignant (tumor-related impending or pathologic fractures) conditions. Interventional techniques used to fix fractures include image-guided osteoplasty, screw-mediated osteosynthesis, or combinations of both. In the present narrative review, we highlight the most common clinical scenarios that may benefit from such interventional techniques with specific focus on spine, pelvic ring, and long bones. [ABSTRACT FROM AUTHOR]

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Purpose: To compare procedure-related variables, safety, renal function, and oncologic outcomes in patients undergoing percutaneous cryoablation (CA) of renal tumors with MRI- or CT-guidance. Materials and Methods: Patient, tumour, procedure, and follow-up data were collected and analysed. MRI and CT groups were matched using a coarsened exact approach according to patient's gender and age, tumour grade, size and location. P < 0.05 was considered statistically significant. Results: Two-hundred fifty-three patients (266 tumors) were retrospectively selected. Following the coarsened exact matching 46 patients (46 tumors) in the MRI group and 42 patients (42 tumors) in the CT group were matched. There were no significant baseline differences between the two populations except for the duration of follow-up (P = 0.002) and renal function (P = 0.002). On average MRI-guided CA lasted 21 min longer than CT-guided ones (P = 0.005). Following CA, complication rates (6.5% for MRI vs 14.3% for CT; P = 0.30) and GFR decline (mean − 13.1 ± 15.8%; range − 64.5–15.0 for MRI; mean − 8.1 ± 14.8%; range − 52.5–20.4; for CT; P = 0.13) were similar in both groups. The 5-year local progression-free, cancer-specific and overall survivals in the MRI and CT groups were 94.0% (95% CI 86.3%–100.0%) and 90.8% (95% CI 81.3%–100.0%; P = 0.55), 100.0% (95% CI 100.0%–100.0%) and 100.0% (95% CI 100.0%–100.0%; P = 1), and 83.7% (95% CI 64.0%–100.0%) and 76.2% (95% CI 62.0%–93.6%; P = 0.41), respectively. Conclusions: Apart from increased procedural times associated with MRI-guided CA of renal tumors compared to CT-guidance, both modalities demonstrate similar safety, GFR decline and oncologic outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether ablation volume difference relatively to tumoral volume, minimal distance between ablation area and necrotic tumor, or apparent diffusion coefficient (ADC) within the ablation area, measured on 1- and 3-month follow-up MRI following cryoablation of renal tumors, are associated with tumor recurrence. Materials and Methods: 136 renal tumors were retrospectively identified. Patients, tumor characteristics and follow-up MRI (1-, 3-, 6-month, and thereafter annually) were collected. Uni- and multivariate analyses were performed to assess the association between the investigated parameters and tumor recurrence. Results: Over the follow-up period (27.7 ± 21.9 months), 13 recurrences were identified at 20.5 ± 19.4 months. At 1- and 3-month, the mean volume difference between the ablation zone and the tumor volume were + 577.5 ± 511.3% vs + 251.4 ± 209.8% (p = 0.003), and + 268.8 ± 291.1% vs + 103.8 ± 94.6% (p = 0.023) in patients without and with tumor recurrence, respectively. At 1- and 3-month, the minimum distance between the necrotic tumor and the edge of the ablation area was 3.4 ± 2.5 vs 1.8 ± 1.9 mm (p = 0.019), and 2.4 ± 2.3 vs 1.4 ± 1.8 mm (p = 0.13) in patients without and with tumor recurrence, respectively. Analysis of ADC values was not associated with tumor recurrence. After performing the multivariate analysis, only volume difference of the ablation area compared to tumor volume was associated with absence of tumor recurrence at 1- (OR = 14.1; p = 0.001) and 3-month (OR = 8.2; p = 0.01). Conclusions: Evaluation of volume difference between the ablation area and tumor volume on early (≤ 3 months) MRI follow-up identifies patients at risk of tumor recurrence. [ABSTRACT FROM AUTHOR]

Previous studies have shown that economic and political experiences influence the level of satisfaction with democracy; however, they fail to explain whether these experiences have the same effect for everyone, whether there is interindividual variance and where these differences might be rooted. In this article, we investigate these roots of interindividual variance and base our argument on the observation that early experiences in school are formative and influence the effect of economic and political experiences on satisfaction with democracy. We analyze an original representative dataset on the German population to test how school experiences, more precisely equal treatment in school, interact with economic and political experiences in later life and thereby influence satisfaction with democracy. We find that school experiences play a significant role here. Voting for the governing parties especially increases satisfaction with democracy if respondents were treated equally in school. Similarly, past experiences of unemployment in particular decrease people's levels of satisfaction with the political system if they were not treated equally in school. The findings highlight that early experiences made in school can have a relevant influence on satisfaction with democracy in later life. [ABSTRACT FROM AUTHOR]

Finally, injection within the hepatogastric ligament fails to displace the peritonealised portion of the lesser curvature of the stomach from the liver. To protect the stomach, a needle was inserted between the liver and the stomach at the level of the tumour. [Extracted from the article]

Stress in teaching and teacher training is a well-known issue and stress management during teacher training may not only be affected by individual coping efforts, but also determined by private and work-related networks the individual is integrated in. In that regard, our article aims firstly to identify sources of social support in the German teacher training system and secondly to analyze interdependencies in dyadic coping interactions based on the Actor-Partner Interdependence Model. On the basis of questionnaire data from 307 German trainees and qualified teachers from vocational and general schools, we found that mentors, partners, fellow trainees, colleagues at school, parents, and good friends were named as the most supportive reference persons during teacher training. In a follow-up survey, data from 49 sources of support were obtained, which could be assigned to the corresponding (trainee) teachers (in the sense of support recipients). These dyads thus form the basis for the analysis of dyadic coping interdependencies. The results of the moderator analyses show, among other things, that support recipients who prefer the coping strategy palliative emotion regulation tend to react rather sensitively to contrary coping strategies of the source of support with regard to their stress symptoms. Social interactions in this respect can represent both protective as well as risk factors. Therefore, a system of complex social interdependencies must be considered when analyzing relational resilience among prospective teachers. [ABSTRACT FROM AUTHOR]

The article discusses the development and success of the interventional radiology (IR) department at Hopitaux Civils de Colmar in France. Prior to the arrival of a full-time IR in 2018, the department primarily performed small procedures under local anesthesia. However, with the addition of a full-time IR, the department saw a significant increase in activity, performing over 4,100 procedures by the end of 2021. The article highlights key factors in building a successful IR department, including easy access for clinicians, collaboration with nearby university hospitals, strong relationships with the anesthesia department, increasing competence through hiring and visiting practitioners, creating a positive work environment, and investing in the future through residency programs. The article emphasizes the importance of teamwork, patient care, and a multidisciplinary approach. Overall, the article provides insights into the strategies and considerations involved in building and sustaining a high-volume IR department. [Extracted from the article]

Purpose: To describe the guidewire technique to perform hydrodistension and create artificial ascites during liver microwave ablation (MWA) of tumors located in the hepatic dome and evaluate the effectiveness of repartition of peritoneal fluid along segments VII and VIII with this technique. Materials and methods: A retrospective review of all 18 consecutive patients who benefited from MWA combined with hydrodistension causing artificial ascites performed with the guidewire technique was conducted. The technique involves inserting a 20G spinal needle in the liver parenchyma and catheterizing the peritoneum with a 0.018 nitinol guidewire while retrieving the needle from the liver. Technical success was defined by the successful insertion of a sheath over the wire in the peritoneal cavity and identification of peritoneal fluid on CT images, with repartition of ascites around segments VII and VIII. Results: Target tumors were located in segments VII and VIII and had a mean size of 27.7 mm with a mean distance from the diaphragm of 1.7 mm. Technical success of artificial ascites was 14/18 (78%). In the four cases where artificial ascites failed, patients had undergone previous liver surgery. In the 14 cases for which artificial ascites were successful, complete separation of the diaphragm from the ablation zone was noted in 9/14 cases and partial separation in 5/14 cases. Conclusion: Hydrodistension with the guidewire technique is effective and safe to accomplish artificial ascites. The extent of repartition of peritoneal fluid is variable, especially in the peritoneal recess in contact with the bare area where diffusion of fluid was variable. [ABSTRACT FROM AUTHOR]

Purpose: To assess efficacy and safety of percutaneous cryoablation (CA) for advanced and refractory extra-abdominal desmoid tumors. Materials and methods: This retrospective study reviewed 30 consecutive patients with symptomatic desmoid tumors evolving after "wait and watch" periods, and despite medical treatment, treated by CA between 2007 and 2019. Progression free survival (PFS), objective response rate, pain reduction (decreased of visual analogic scale pain (VAS) ≥ 3 or disappearance of pain), total volume lesion (TVL) and complications were documented. Kaplan Meier method was used to outline PFS. Paired sample t test was used to compare volume of tumors before treatment and at 1 and 3 year. Results: With a median follow-up of 18.5 months (range 6–93 months, interquartile range (IQR): 12–55), the PFS was 85.1% at 1 year and 77.3% at 3 years. Objective response was obtained for 80% of patients with a complete response for 43% patients. Pain reduction was obtained for 96.7% (95% confidence interval (95% CI): 90.3, 100) of patients. Median volume of desmoid tumor before treatment was 124.1cm3 (range 2–1727cm3, IQR: 54–338cm3). Median change of TLV after ablation was 66.6% (95% CI: 37.2, 72.3; p = 0.002) at 1 year and 76.4% (95% CI: 59.1, 89.8; p = 0.002) at 3 year. Adverse events rate was 36.6%, the most common was edema and temporary increase of pain in the days following CA. Four patients experienced a major complication (13.3%): 2 skin necrosis, 1 infection and 1 brachial plexopathy. Conclusion: CA is an effective treatment for advanced and refractory extra-abdominal desmoid tumor, that induces durable responses. [ABSTRACT FROM AUTHOR]

Objective: To report our experience of percutaneous image-guided cryoablation of renal tumors located within 10 mm of the pyeloureteric junction (PUJ) and/or ureter, with hydrodissection as a stand-alone thermoprotective technique. Materials and methods: All patients who were offered combined hydrodissection and cryoablation of the PUJ/ureter to treat stage-1 renal cell carcinoma were retrospectively reviewed. Data regarding patients, lesions, and outcomes were collected. Results: Twenty tumors in 20 patients (13 males:7 females) with a mean age of 74.4 ± 7.5 were included. Mean tumor size was 27.6 ± 6.4 mm. Nearby vulnerable structure(s) were identified as the ureter in 5/20 cases, the PUJ in 8/20 cases and both the PUJ and the ureter in the remaining 7/20 cases (35%) cases. Mean minimal distance between the tumor and the vulnerable organ(s) was 4.8 ± 2.6 mm (range 0–10). A mean of 1.7 ± 0.6 spinal needles were used per intervention with a mean time to complete hydrodissection of 18.6 ± 13.4 min. Primary and secondary technical efficacy rates were 90% and 95%, respectively. Mean follow-up was 23.1 ± 9.2 months. There were no immediate or delayed complications, in particular no urothelial strictures. Two tumor recurrences occurred during follow-up, with a time to disease progression of 13 and 31 months, respectively. Conclusion: hydrodissection of the PUJ/ureter to prevent thermal injury during cryoablation is an effective technique and does not seem to compromise the efficacy of ablation at short or mid-term follow-up. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively analyze our interventional radiology outpatient clinics (IROC) for referral patterns, impact on interventional practice, and patient satisfaction. Materials and Methods: Consultations performed between 2011 and 2019 were extracted. The two consecutive years with the highest number of consultations (n2018 = 1426; n2019 = 1595) were compared for unattended consultations (i.e., scheduled consultations with patients not showing-up); initial/follow-up consultations; hospital clinician/general practitioner referrals; initial consultations with radiologists not recommending interventions; procedural conversion rate (PCR; i.e., No. initial consultations resulting in interventions over the total number of initial consultations performed for the same clinical indication). A survey was conducted in 159 patients to determine their satisfaction. Results: Consultations increased from 2011 to 2019 by 130%. In 2018–2019, the number of unattended consultations was stable (7.0% vs 6.6%; P =.68). The referrals were for back pain (42.2%), interventional oncology (40.5%), and arteriovenous malformations (9.0%). For back pain, in 2019, there were fewer consultations with radiologists not recommending interventions and increased PCR compared to 2018 (11.9% vs. 17.7%; 88.1% vs. 82.3%; respectively; P =.01). For interventional oncology, follow-up consultations and general practitioner referrals increased in 2019 compared to 2018 (43.0% vs 35.3%; P =.01; 24.4% vs. 12.7%; P <.01; respectively). No other changes were noted. Cumulative 2018–2019 PCR was ≥ 85.4%. 99.2% responders highly appreciated their IROC experience. Quality of secretarial and medical services were the main aspects evaluated to rate the experience with IROC. Conclusion: IROC results in high PCR. Recent changes in referral/impact on IR practice were noted with patients referred for back pain and interventional oncology. Level of Evidence IV: Level 4, Case Series. [ABSTRACT FROM AUTHOR]

The osseous pelvis is a frequent site of metastases. Alteration of bone integrity may lead to pain but also to functional disability and pathological fractures. Percutaneous image-guided minimally invasive procedures, such as cementoplasty and screw fixation, have emerged as a viable option to provide bone reinforcement and fracture fixation, as stand-alone or combined techniques. Understanding the biomechanics of the osseous pelvis is paramount to tailor the treatment to the clinical situation. The purpose of the present review is to present the biomechanics of the osseous pelvis and discuss its implication for the choice of the optimal consolidative treatment. [ABSTRACT FROM AUTHOR]

Purpose: To report the retro-sternal space hydrodissection technique used to displace the heart and the pericardium posteriorly for thermoprotection ahead of sternal cryoablation (CA). Methods and materials: Between May 2015 and March 2020, hydrodissection of the retro-sternal space was performed in 5 consecutive patients (5 female; mean age 55.2 ± 9.3 years, range 41–65) who underwent percutaneous image-guided cryoablation of the sternum. The number of needles required, the implemented approach, volume of injectate to achieve hydrodissection, hydrodissection procedure time, distance between the lesion and the pericardium before and after hydrodissection, distance between the ice-ball and the pericardium, technical success and complications were retrospectively assessed. Results: Technical success, defined as the completion of a full dual freeze protocol without contact between the ice-ball and the pericardium, was achieved in all cases (5/5, 100%). One to two needles were used to perform hydrodissection via a perpendicular (3/5) or an anterior oblique approach (2/5) and a mean hydrodissection procedure time of 10.4 ± 2.6 min (range 8–14). Minimum distance between the lesion and the pericardium increased from mean 5.8 ± 3.8 mm (range 0–10) before hydrodissection to a mean 22.2 ± 5.8 mm (range 18–32) after, with a mean distance between the final ice-ball and the pericardium of 11.6 ± 8.7 mm (range 7–27). A mean of 198 ± 79.8 mL (range 90–290) of iodinated contrast was injected. There were no immediate, short- or medium-term complication noted. Conclusion: Hydrodissection of the retro-sternal space is a feasible technique for sternal cryoablation in order to protect the pericardium from freezing for sternal cryoablation. [ABSTRACT FROM AUTHOR]

Purpose: To ascertain the performance of a new blunt-tip needle (HydroGuard®), which allows injection of fluids during needle advancement in order to safely approach, displace and insulate nearby critical structures during thermal ablation (TA).Materials and Methods: This study included 27 consecutive patients treated by TA [cryoablation (CA), radiofrequency (RFA), and microwave MWA)] between April 2018 and January 2019. During TA, hydro- or gas dissection was performed with HydroGuard® needle to displace and protect critical structures close to the tumor (< 10 mm). Technical and clinical success, distance between critical structure and tumor before and after hydro/gas dissection and complications were recorded.Results: Eighteen patients were treated by CA (66.7%), 7 by MWA (25.9%) and 2 by RFA (7.4%). Majority of patients were treated with a curative intent (24/27; 88.8%). Adjacent critical structures include vessels (n = 3), nerves (n = 10), ureter/renal pelvis (n = 3), bowel/rectum (n = 10), stomach: (n = 3), diaphragm (n = 2), and pleura (n = 1). Technical success was 100%. Clinical success was 88% (24/27). Median minimum distance to adjacent critical structures before hydro/gas dissection was 1 mm (range 0-9 mm; IQR: 0-3 mm) versus 10.5 mm (range 4-47 mm; IQR: 9.7-18 mm) after displacement. Of the 27 patients treated, four developed complications (14.8%; 95% CI: 1.4-28.2): 1 major (3.7%; 95% CI: 0-10.8) and 3 minors (11.1%; 95% CI: 0-23). Only one minor complication was related to inadequate hydro-dissection, resulting in close proximity of the critical structure to the ablation zone.Conclusion: HydroGuard® is a safe and effective needle when used to approach, displace and insulate nearby critical structures during TA. [ABSTRACT FROM AUTHOR]

The combination of MWA and IRE is not technically demanding, provided that the IRE needles are left in the tumor to simplify the planning for the insertion of the MW antennas. To the Editor: Irreversible electroporation (IRE) is a non-thermal ablation modality whereby cell death is achieved by the irreversible opening of pores within the cellular membrane. IRE is therefore better suited for the management of central liver tumors, as it preserves the architecture of the bile ducts, thereby decreasing the risk of subsequent biliary perforation and stricture [[2]]. [Extracted from the article]

To the editor, Thermal injury to surrounding organs is a rare but potentially devastating complication following percutaneous thermal ablation of peripheral liver lesions. B Same view following levering of the stomach using two 15-G blunt-tip needles (black arrowheads) and subsequent hydrodissection shows that a clear gap between the edge of the left liver lobe (black dotted line) and the gastric wall (white dotted line) has been achieved. [Extracted from the article]

Unbiased identification of organisms by PCR reactions using universal primers followed by DNA sequencing assumes positive amplification. We used six universal loci spanning 48 plant species and quantified the bias at each step of the identification process from end point PCR to next-generation sequencing. End point amplification was significantly different for single loci and between species. Quantitative PCR revealed that Cq threshold for various loci, even within a single DNA extraction, showed 2,000-fold differences in DNA quantity after amplification. Next-generation sequencing (NGS) experiments in nine species showed significant biases towards species and specific loci using adaptor-specific primers. NGS sequencing bias may be predicted to some extent by the Cq values of qPCR amplification. [ABSTRACT FROM AUTHOR]

OBJECTIVES:Detection and removal of adenomas and clinically significant serrated polyps (CSSPs) is critical to the effectiveness of colonoscopy in preventing colorectal cancer. Although longer withdrawal time has been found to increase polyp detection, this association and the use of withdrawal time as a quality indicator remains controversial. Few studies have reported on withdrawal time and serrated polyp detection. Using data from the New Hampshire Colonoscopy Registry, we examined how an endoscopist's withdrawal time in normal colonoscopies affects adenoma and serrated polyp detection.METHODS:We analyzed 7,996 colonoscopies performed in 7,972 patients between 2009 and 2011 by 42 endoscopists at 14 hospitals, ambulatory surgery centers, and community practices. CSSPs were defined as sessile serrated polyps and hyperplastic polyps proximal to the sigmoid. Adenoma and CSSP detection rates were calculated based on median endoscopist withdrawal time in normal exams. Regression models were used to estimate the association of increased normal withdrawal time and polyp, adenoma, and CSSP detection.RESULTS:Polyp and adenoma detection rates were highest among endoscopists with 9 min median normal withdrawal time, and detection of CSSPs reached its highest levels at 8-9 min. Incident rate ratios for adenoma and CSSP detection increased with each minute of normal withdrawal time above 6 min, with maximum benefit at 9 min for adenomas (1.50, 95% confidence interval (CI) (1.21, 1.85)) and CSSPs (1.77, 95% CI (1.15, 2.72)). When modeling was used to set the minimum withdrawal time at 9 min, we predicted that adenomas and CSSPs would be detected in 302 (3.8%) and 191 (2.4%) more patients. The increase in detection was most striking for the CSSPs, with nearly a 30% relative increase.CONCLUSIONS:A withdrawal time of 9 min resulted in a statistically significant increase in adenoma and serrated polyp detection. Colonoscopy quality may improve with a median normal withdrawal time benchmark of 9 min. [ABSTRACT FROM AUTHOR]

Most studies of attention-deficit hyperactivity disorder (ADHD) youth have obtained data from the perspective of either children or parents, but not both simultaneously. The purpose of this study was to examine child and parent perspectives on parenting in a large community-based sample of children with and without ADHD. We identified children in grades 4-6 and their parents through surveys administered to a random sample of public schools. We used multivariable logistic regression to determine independent associations between child and parent characteristics and the presence of ADHD while controlling for covariates and clustering by school. Sufficient data were achieved for 2,509 child/parent dyads. Ten percent of youths ( n = 240) had been diagnosed with ADHD. Compared with those without ADHD, those with ADHD were more commonly male (67.9 vs. 48.0 %, p < .001) and age 12 or over (16.3 vs. 10.3 %). After adjusting for covariates and clustering, compared to children without ADHD, children with ADHD were significantly more likely to report lower self-regulation (OR = 0.68, 95 % CI = 0.53, 0.88) and higher levels of rebelliousness (OR = 2.00, 95 % CI = 1.52, 2.69). Compared with parents whose children did not have ADHD, parents of children with ADHD rated their overall parental efficacy substantially lower (OR = 0.23, 95 % CI = 0.15, 0.33). However, child assessment of parenting style was similar by ADHD. Despite the internal challenges community-based youth with ADHD face, many parents of ADHD youth exhibit valuable parental skills from the perspective of their children. Feedback of this information to parents may improve parental self-efficacy, which is known to be positively associated with improved ADHD outcomes. [ABSTRACT FROM AUTHOR]

The genus Cistus is a widespread family growing around the Mediterranean area. There is a unique natural population of C. heterophyllus subsp. carthaginensis in Europe (Murcia, Spain) containing 22 individuals. Morphology of these plants suggests the co-occurrence of two distinct types within the population. One type would resemble C. heterophyllus, and a second type would be the result of hybridization events between this endangered population and the locally abundant Cistus albidus. These hybrids have been described in Africa as C. × clausonis. We have analyzed sequences of the chloroplast genes trnK- matK, rbcL, rpoB, rpoC1 and two intergenic regions, trnL-F and trnH- psbA. Surprisingly, we observed heteroplasmy for rpoB and rpoC1 genes in C. heterophyllus and the local C. × clausonis, but not in C. albidus or C. monspeliensis. We found two distinct alleles of rpoB, one present in all species and a second present only in C. heterophyllus and the local C. × clausonis. We also detected two alleles of rpoC1, one common to all species analyzed and a second present only in the local C. × clausonis. Our results show that there is a distinctive rpoB allele common to C. heterophyllus and C. × clausonis from Africa and Europe. The unique rpoC1 allele found in the local C. × clausonis indicates a different origin of this small population, indicating it is not a hybrid formed with the C. albidus or C. heterophyllus currently present in this location. [ABSTRACT FROM AUTHOR]

Background: The recent decline in US breast cancer incidence rates has been attributed to the marked reduction in use of postmenopausal hormone therapy (HT). An alternative explanation is that women who are not routinely seeking medical care to renew HT prescriptions may be less adherent to recommendations for mammographic screening. To investigate the latter possibility, we compared mammographic intervals according to HT use.Methods: Using data (1995-2007) from the New Hampshire Mammography Network (NHMN), a state-based mammography registry, we assessed mammographic intervals corresponding to HT use or nonuse among postmenopausal women. We used linear mixed effects models to assess whether the length of screening mammogram intervals differed according to HT use.Results: A total of 310,185 mammograms, representing 76,192 postmenopausal women and 319,353 person-years of screening, were included in the analysis. The median screening interval corresponding to HT use overall was 13.0 months (interquartile range: 12.4-15.1) and for nonuse was 13.1 (interquartile range: 12.4-15.8). Virtually, all screening mammograms occurred within a 2-year interval regardless of HT use or nonuse (98.5 and 98.1%, respectively).Conclusions: Our findings indicate that screening mammography intervals are similar whether or not women are using HT. Thus, reduced utilization of screening mammography is unlikely to account for the decrease in breast cancer incidence seen soon after the WHI report. [ABSTRACT FROM AUTHOR]

In order to improve our understanding of floral size control we characterised three mutants of Antirrhinum majus with different macroscopic floral phenotypes. The recessive mutant compacta ähnlich has smaller flowers affected mainly in petal lobe expansion, the dominant mutant Grandiflora has overall larger organs, whilst the semidominant mutation Nitida exhibits smaller flowers in a dose-dependent manner. We developed a cell map in order to establish the cellular phenotypes of the mutants. Changes in organ size were both organ- and region-specific. Nitida and compacta ähnlich affected cell expansion in proximal and distal petal regions, respectively, suggesting differential regulation between petal lobe regions. Although petal size was smaller in compacta ähnlich than in wild type, conical cells were significantly bigger, suggesting a compensation mechanism involved in petal development. Grandiflora had larger cells in petals and increased cell division in stamens and styles, suggesting a relationship between genes controlling organ size and organ identity. The level of ploidy in petals of Grandiflora and coan was found to be equivalent to wild type petals and leaves, ruling out an excess of growth via endoreduplication. We discuss our results in terms of current models about control of lateral organ size. [ABSTRACT FROM AUTHOR]

Control of organ size is the product of coordinated cell division and expansion. In plants where one of these pathways is perturbed, organ size is often unaffected as compensation mechanisms are brought into play. The number of founder cells in organ primordia, dividing cells, and the period of cell proliferation determine cell number in lateral organs. We have identified the Antirrhinum FORMOSA ( FO) gene as a specific regulator of floral size. Analysis of cell size and number in the fo mutant, which has increased flower size, indicates that FO is an organ-specific inhibitor of cell division and activator of cell expansion. Increased cell number in fo floral organs correlated with upregulation of genes involved in the cell cycle. In Arabidopsis the AINTEGUMENTA ( ANT) gene promotes cell division. In the fo mutant increased cell number also correlates with upregulation of an Antirrhinum ANT-like gene ( Am-ANT) in inflorescences that is very closely related to ANT and shares a similar expression pattern, suggesting that they may be functional equivalents. Increased cell proliferation is thought to be compensated for by reduced cell expansion to maintain organ size. In Arabidopsis petal cell expansion is inhibited by the BIGPETAL ( BPE) gene, and in the fo mutant reduced cell size corresponded to upregulation of an Antirrhinum BPE-like gene ( Am-BPE). Our data suggest that FO inhibits cell proliferation by negatively regulating Am-ANT, and acts upstream of Am-BPE to coordinate floral organ size. This demonstrates that organ size is modulated by the organ-specific control of both general and local gene networks. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To prospectively calculate and validate a conversion factor in healthy volunteers that allows accurate nonsedated, transoral (TO) Bravo capsule placement after transnasal (TN) manometry, and to evaluate the ease and safety of nonendoscopic Bravo placement compared with endoscopic placement. METHODS: Part 1. Twenty-five healthy volunteers underwent sequential TN and TO esophageal manometry to measure the distance to the lower esophageal sphincter (LES). A TN to TO conversion factor was calculated from these measurements. Part 2. Twenty volunteers underwent TN manometry followed by unsedated TO Bravo capsule placement using the conversion factor calculated in part 1. TN endoscopy then measured the location of the Bravo capsule in relationship to the squamocolumnar junction (SCJ). Part 3. During an 18-month period, 370 consecutive patients referred for a Bravo procedure underwent nonendoscopic, unsedated TO placement (308 patients) or standard endoscopically assisted placement (62 patients). RESULTS: Part 1. All 25 volunteers completed TN and TO manometry; a conversion factor of 4 cm was calculated. Part 2. Using the calculated conversion factor of 4 cm, a Bravo capsule was deployed TO 5 cm above the proximal border of the LES. The mean ± standard deviation (SD) TN endoscopic distance to the capsule was 6.0 cm (±0.3 cm) above the SCJ. Part 3. A total of 333 patients completed the entire study (90%). Analysis of 48-h pH measurements did not reveal any significant differences between the two groups. CONCLUSIONS: A reliable and valid conversion factor of 4 cm following TN manometry permits accurate TO placement of the Bravo capsule without endoscopy. TO, unsedated Bravo placement is safe, well tolerated, and may minimize costs and potential risks associated with endoscopy. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate known breast cancer risk factors in relation to breast density.Methods: We examined factors in relation to breast density in 144,018 New Hampshire (NH) women with at least one mammogram recorded in a statewide mammography registry. Mammographic breast density was measured by radiologists using the BI-RADS classification; risk factors of interest were obtained from patient intake forms and questionnaires.Results: Initial analyses showed a strong inverse influence of age and body mass index (BMI) on breast density. In addition, women with late age at menarche, late age at first birth, premenopausal women, and those currently using hormone therapy (HT) tended to have higher breast density, while those with greater parity tended to have less dense breasts. Analyses stratified on age and BMI suggested interactions, which were formally assessed in a multivariable model. The impact of current HT use, relative to nonuse, differed across age groups, with an inverse association in younger women, and a positive association in older women (p < 0.0001 for the interaction). The positive effects of age at menarche and age at first birth, and the inverse influence of parity were less apparent in women with low BMI than in those with high BMI (p = 0.04, p < 0.0001 and p = 0.01, respectively, for the interactions). We also noted stronger positive effects for age at first birth in postmenopausal women (p = 0.004 for the interaction). The multivariable model indicated a slight positive influence of family history of breast cancer.Conclusions: The influence of age at menarche and reproductive factors on breast density is less evident in women with high BMI. Density is reduced in young women using HT, but increased in HT users of age 50 or more. [ABSTRACT FROM AUTHOR]

Type I interferons (IFN) are being rediscovered as potent anti-tumoral agents. Activation of the STimulator of INterferon Genes (STING) by DMXAA (5,6-dimethylxanthenone-4-acetic acid) can induce strong production of IFNα/β and rejection of transplanted primary tumors. In the present study, we address whether targeting STING with DMXAA also leads to the regression of spontaneous MMTV-PyMT mammary tumors. We show that these tumors are refractory to DMXAA-induced regression. This is due to a blockade in the phosphorylation of IRF3 and the ensuing IFNα/β production. Mechanistically, we identify TGFβ, which is abundant in spontaneous tumors, as a key molecule limiting this IFN-induced tumor regression by DMXAA. Finally, blocking TGFβ restores the production of IFNα by activated MHCII+ tumor-associated macrophages, and enables tumor regression induced by STING activation. On the basis of these findings, we propose that type I IFN-dependent cancer therapies could be greatly improved by combinations including the blockade of TGFβ. Interferons have been shown to mediate tumour rejection. Here, in a spontaneous mouse model of breast cancer, the authors show that this is disrupted owing to high levels of TGFβ produced in the tumour. [ABSTRACT FROM AUTHOR]

Studies the genetic control of flower development in Arabidopsis. Analysis of plant growth; Identification of tree breeding; Manipulation of transgene strategies in plants.

A response by Brian E. Lacy and colleagues to a letter to the editor about their article that describes transoral placement of the Bravo capsule after transnasal manometry in a previous issue is presented.