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This study explores the application of machine learning techniques, specifically principal component analysis (PCA), to analyze the influence of silica content on the physical and chemical properties of aerogels. Silica aerogels are renowned for their exceptional properties, including high porosity, large surface area, and low thermal conductivity, but their mechanical brittleness poses significant challenges. The study initially utilized cross-correlation analysis to examine the relationships between key properties such as the Brunauer-Emmett-Teller (BET) surface area, pore volume, density, and thermal conductivity. However, weak correlations prompted the application of PCA to uncover deeper insights into the data. The PCA results demonstrated that silica content has a significant impact on aerogel properties, with the first principal component (PC1) showing a strong positive correlation (R 2 = 94%) with silica content. This suggests that higher silica levels correspond to lower thermal conductivity, porosity, and BET surface area, while increasing the density and elastic modulus. Additionally, the analysis identified the critical role of thermal conductivity in the second principal component (PC2), particularly in samples with moderate to high silica content. Overall, this study highlights the effectiveness of machine learning techniques like PCA in optimizing and understanding the complex inter-relationships among the physico-chemical properties of silica aerogels.

Introduction: DESTINY B04 provided clinical meaning to a new classification of human epidermal growth factor 2 (HER2) expression in breast cancer: HER2-low. Patients with germline breast cancer type 1 gene pathogenic variants (gBRCA1) often develop triple negative breast cancer (TNBC), but the proportion who could be classified as HER2-low and qualify for an additional targeted therapy option is unknown. This study aims to characterize the proportion of gBRCA1 or germline breast cancer type 2 gene pathogenic variants patients for whom these novel targeted therapies may be an option., Methods: We performed a retrospective chart review of patients with gBRCA1/2 treated at our institution for invasive breast cancer from 2000 to 2021. Synchronous or metachronous contralateral breast cancers were recorded separately. HER2 status was determined by immunohistochemistry and fluorescence in situ hybridization. We excluded patients without complete HER2 data., Results: Among the 95 breast cancers identified in our cohort of 85 gBRCA1/2 patients, 41 (43%) were TNBC, 38 (40%) were hormone receptor positive (HR+)/HER2-negative, and 16 (17%) were HER2-positive based on standard conventions. We found that 82% of the HR+/HER2-cancers and 66% of TNBCs would be reclassified as HER2-low. After stratifying by BRCA gene status, 64% of cancers in patients with gBRCA1 and 58% of cancers in patients with germline breast cancer type 2 gene pathogenic variants were HER2-low., Conclusions: A significant portion of gBRCA1/2 patients who were previously diagnosed with TNBC or HR+/HER2- breast cancer would now be classified as HER2-low and could be considered for the use of trastuzumab deruxtecan in the metastatic setting. Outcome differences from therapy changes in this cohort should now be assessed., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aim: To examine clinical characteristics, real-world treatment patterns, and health outcomes among patients with germline BRCA1/2 -mutated, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC)., Methods: A retrospective analysis was conducted using medical records from patients with HER2-negative ABC with BRCA1/2 mutation who received cytotoxic chemotherapy. Data were stratified into groups with triple-negative breast cancer (TNBC) or hormone receptor-positive (HR+)/HER2-negative diagnoses. Time-to-event outcomes (i.e., real-world progression-free survival [rwPFS] and overall survival [OS]) were calculated to summarize health outcomes., Results: When diagnosed with ABC, most patients were younger than 60 years (mean age = 57.3 years), were white (76.4%), and had a family history of BRCA -related cancer (71.5%). A total of 305 patient records were examined; 194 patients (63.6%) had advanced TNBC, and 111 patients (36.4%) had HR+/HER2-negative ABC. Chemotherapy was primarily used as first-line treatment for both subgroups, but the TNBC subgroup received poly (ADP-ribose) polymerase (PARP) inhibitors at triple the rate as a second-line treatment and double the rate as a third-line treatment compared with the HR+/HER2-negative subgroup. Two-year OS rates were similar between the TNBC (73.9%) and the HR+/HER2-negative subgroups (77.0%), and anemia, nausea, and neutropenia were the most commonly reported toxicities across all treatments., Conclusion: Clinicians should consider the use of targeted agents such as PARP inhibitors in earlier lines of therapy for ABC given the growing evidence that PARP inhibitors may improve PFS compared with chemotherapy while potentially offering a more manageable toxicity profile and improved quality of life., Competing Interests: EO was employed at Fox Chase Cancer Center at the time of study and is presently employed at John Theurer Cancer Center and Hackensack Meridian Health; has a consulting or advisory role with Pfizer, Foundation Medicine, Puma Biotechnology, Daiichi Sankyo/Astra Zeneca, Ethos Immunomedics, Novartis, and OncLive/MJH Life Sciences; has received honoraria from Guidepoint Global; has received research funding from Merck and Genentech/Roche; has no relationships to disclose for the speakers’ bureau, patents, royalties, or other intellectual property; expert testimony; leadership, or travel accommodations, expenses; and has an immediate family member who holds stock and other ownership interests in Bristol-Myers Squibb and is a Bristol-Myers Squibb/Celgene recipient. RCP, EE, and AH are employees of RTI Health Solutions, an independent nonprofit research organization, which received funding to conduct the study presented here. BA, LSA, and AN are employees of Pfizer Inc., which funded the study presented here. KW was employed at Fox Chase Cancer Center at the time of study, is presently employed at Medstar Georgetown Cancer Institute at Washington Hospital Center, and consults for Novartis., (Copyright © 2024 Obeid, Parikh, Esterberg, Arondekar, Hitchens, Arruda, Niyazov and Whitaker.)

The application of principal component analysis (PCA) as an unsupervised learning method has been used in uncovering correlations among diverse features of aerogel-based electrocatalysts. This analytical approach facilitates a comprehensive exploration of catalytic activity, revealing intricate relationships with various physical and electrochemical properties. The first two principal components (PCs), collectively capturing nearly 70% of the total variance, attested the reliability and efficacy of PCA in unveiling meaningful patterns. This study challenges the conventional understanding that a material's reactivity is solely dictated by the quantity of catalyst loaded. Instead, it unveils a complex perspective, highlighting that reactivity is intricately influenced by the material's overall design and structure. The PCA bi-plot uncovers correlations between pH and Tafel slope, suggesting an interdependence between these variables and providing valuable insights into the complex interactions among physical and electrochemical properties. Tafel slope stands to be positively correlated with PC 1 and PC 2 , showing an evident positive correlation with the pH. These findings showed that the pH can have a positive correlation with the Tafel slope, however, it does not necessarily reflect a direct positive correlation with the overpotential. The impact of pH on current density ( j )and Tafel slope underscores the importance of adjusting pH to lower overpotential effectively, enhancing catalytic activity. Surface area (from 30 to 533 m 2 g -1 ) emerges as a key physical property, inclusively inverse correlation with overpotential, indicating its direct role in lowering overpotential and increasing catalytic activity. The introduction of PC 3 , in conjunction with PC 1 , enriches the analysis by revealing consistent trends despite a slightly lower variance (60%). This reinforces the robustness of PCA in delineating distinct characteristics of graphene aerogels, affirming their potential implications in diverse electrocatalytic applications. In summary, PCA proves to be a valuable tool for unraveling complex relationships within aerogel-based electrocatalysts, extending insights beyond catalytic sites to emphasize the broader spectrum of material properties. This approach enhances comprehension of dataset intricacies and holds promise for guiding the development of more effective and versatile electrocatalytic materials.

This study investigates the applicability of Principal Component Analysis (PCA) for distinguishing construction materials. The approach enhances data presentation, revealing distinct clusters and variable impacts on materials. This perspective provides valuable insights into concrete materials, guiding materials science and engineering practices. Our findings show the capacity of PCA to show a clear distinction between concrete and non-concrete composites. Compressive strength significantly affects certain composites, being influenced by aerogel loading. The peculiar role of aerogel density among the other factors is attributed to their possession of the smallest thermal conductivity. To address moderate total variance of PCA, segregation into concrete (C) and non-concrete (NC) categories is explored, offering a more robust distinction and higher clustering. Concrete materials show higher variance, emphasizing the effectiveness of the segregation approach. PCA highlights aerogel density's influence on thermal conductivity on concrete materials. For non-concrete materials, a moderately higher variance is noted, emphasizing the critical role of aerogel-related properties (size and density). These findings underscore the importance of aerogel characteristics in shaping material behaviour.

Volatile aromatic compounds (VOCs) are ubiquitous in the environment, they can be emitted from biogenic and anthropogenic sources. They can contribute to the formation of many products leading to the formation of secondary organic aerosols (SOA). The products of the gas phase reaction of 1,2-benzenediol (catechol) with ozone were studied in a simulation chamber at atmospheric pressure and 294 ± 2 K in presence of different levels of relative humidity (0-60%). The gas phase products were monitored continuously by a PTR-ToF-MS for 2 h, whereas filters samples were collected directly from the reaction chamber and analyzed by thermo-desorption gas chromatography; TD-GC-MS. This study shows the different potential chemical pathways that catechol could follow to form a variety of products under dry, low and high humidity conditions. The molecular mass 98 was found to be distinctive and appears in the gas phase when humidity in the reaction chamber is between 20 and 60%. Other new masses (m/z) such as 176, 154, 116, 68, 72, 80, 96, 108, and 124 were also detected under different experimental conditions. Furthermore, the catechol concentration has been monitored continuously by a PTR-ToF-MS from low to high humidity conditions (RH = 7.5-78.8%). The purpose of the latter is to suggest that the formation of catechol-H 2 O clusters occurs in the gas phase of the reaction chamber causing a decrease in catechol reactivity towards other gases and subsequently a decrease in the rate constant., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

This phase I, dose-escalation trial evaluates the safety of combining interferon-gamma (IFN-γ) and nivolumab in patients with metastatic solid tumors. Twenty-six patients are treated in four cohorts assessing increasing doses of IFN-γ with nivolumab to evaluate the primary endpoint of safety and determine the recommended phase two dose (RP2D). Most common adverse events are low grade and associated with IFN-γ. Three dose limiting toxicities are reported at the highest dose cohorts. We report only one patient with any immune related adverse event (irAE). No irAEs ≥ grade 3 are observed and no patients require corticosteroids. The maximum tolerated dose of IFN-γ is 75 mcg/m 2 , however based on a composite of safety, clinical, and correlative factors the RP2D is 50 mcg/m 2 . Exploratory analyses of efficacy in the phase I cohorts demonstrate one patient with a complete response, and five have achieved stable disease. Pre-planned correlative assessments of circulating immune cells demonstrate intermediate monocytes with increased PD-L1 expression correlating with IFN-γ dose and treatment duration. Interestingly, post-hoc analysis shows that IFN-γ induction increases circulating chemokines and is associated with an observed paucity of irAEs, warranting further evaluation. ClinicalTrials.gov Trial Registration: NCT02614456., (© 2023. The Author(s).)

In this study, our aim was to estimate the adsorption potential of three families of aerogels: nanocellulose (NC), chitosan (CS), and graphene (G) oxide-based aerogels. The emphasized efficiency to seek here concerns oil and organic contaminant removal. In order to achieve this goal, principal component analysis (PCA) was used as a data mining tool. PCA showed hidden patterns that were not possible to seek by the bi-dimensional conventional perspective. In fact, higher total variance was scored in this study compared with previous findings (an increase of nearly 15%). Different approaches and data pre-treatments have provided different findings for PCA. When the whole dataset was taken into consideration, PCA was able to reveal the discrepancy between nanocellulose-based aerogel from one part and chitosan-based and graphene-based aerogels from another part. In order to overcome the bias yielded by the outliers and to probably increase the degree of representativeness, a separation of individuals was adopted. This approach allowed an increase in the total variance of the PCA approach from 64.02% (for the whole dataset) to 69.42% (outliers excluded dataset) and 79.82% (outliers only dataset). This reveals the effectiveness of the followed approach and the high bias yielded from the outliers.

Water scarcity is a growing global issue, particularly in areas with limited freshwater sources, urging for sustainable water management practices to insure equitable access for all people. One way to address this problem is to implement advanced methods for treating existing contaminated water to offer more clean water. Adsorption through membranes technology is an important water treatment technique, and nanocellulose (NC)-, chitosan (CS)-, and graphene (G)- based aerogels are considered good adsorbents. To estimate the efficiency of dye removal for the mentioned aerogels, we intend to use an unsupervised machine learning approach known as "Principal Component Analysis". PCA showed that the chitosan-based ones have the lowest regeneration efficiencies, along with a moderate number of regenerations. NC2, NC9, and G5 are preferred where there is high adsorption energy to the membrane, and high porosities could be tolerated, but this allows lower removal efficiencies of dye contaminants. NC3, NC5, NC6, and NC11 have high removal efficiencies even with low porosities and surface area. In brief, PCA presents a powerful tool to unravel the efficiency of aerogels towards dye removal. Hence, several conditions need to be considered when employing or even manufacturing the investigated aerogels.

Water scarcity is a global problem affecting millions of people. It can lead to severe economic, social, and environmental consequences. It can also have several impacts on agriculture, industry, and households, leading to a decrease in human quality of life. To address water scarcity, governments, communities, and individuals must work in synergy for the sake of water resources conservation and the implementation of sustainable water management practices. Following this urge, the enhancement of water treatment processes and the development of novel ones is a must. Here, we have investigated the potential of the applicability of "Green Aerogels" in water treatment's ion removal section. Three families of aerogels originating from nanocellulose (NC), chitosan (CS), and graphene (G) are investigated. In order to reveal the difference between aerogel samples in-hand, a "Principal Component Analysis" (PCA) has been performed on the physical/chemical properties of aerogels, from one side, and the adsorption features, from another side. Several approaches and data pre-treatments have been considered to overcome any bias of the statistical method. Following the different followed approaches, the aerogel samples were located in the center of the biplot and were surrounded by different physical/chemical and adsorption properties. This would probably indicate a similar efficiency in the ion removal of the aerogels in-hand, whether they were nanocellulose-based, chitosan-based, or even graphene-based. In brief, PCA has shown a similar efficiency of all the investigated aerogels towards ion removal. The advantage of this method is its capacity to engage and seek similarities/dissimilarities between multiple factors, with the elimination of the shortcomings for the tedious and time-consuming bidimensional data visualization.

Tropical Peatlands accumulate organic matter (OM) and a significant source of carbon dioxide (CO 2 ) and methane (CH 4 ) under anoxic conditions. However, it is still ambiguous where in the peat profile these OM and gases are produced. The composition of organic macromolecules that are present in peatland ecosystems are mainly lignin and polysaccharides. As greater concentrations of lignin are found to be strongly related to the high CO 2 and CH 4 concentrations under anoxic conditions in the surface peat, the need to study the degradation of lignin under anoxic and oxic conditions has emerged. In this study, we found that the "Wet Chemical Degradation" approach is the most preferable and qualified to evaluate the lignin degradation in soils accurately. Then, we applied PCA for the molecular fingerprint consisting of 11 major phenolic sub-units produced by alkaline oxidation using cupric oxide (II) along with alkaline hydrolysis of the lignin sample presented in the investigated peat column called "Sagnes". The development of various characteristic indicators for lignin degradation state on the basis of the relative distribution of lignin phenols was measured by chromatography after CuO-NaOH oxidation. In order to achieve this aim, the so-called Principal Component Analysis (PCA) has been applied for the molecular fingerprint composed of the phenolic sub-units, yielded by CuO-NaOH oxidation. This approach aims to seek the efficiency of the already available proxies and potentially create new ones for the investigation of lignin burial along a peatland. Lignin phenol vegetation index (LPVI) is used for comparison. LPVI showed a higher correlation with PC1 rather than PC2. This confirms the potential of the application of LPVI to decipher vegetation change, even in a dynamic system as the peatland. The population is composed of the depth peat samples, and the variables are the proxies and relative contributions of the 11 yielded phenolic sub-units.

Objective: COVID-19 has an increased burden on the delivery of services because the measures taken by the governments forced hospitals to cancel most of their elective procedures and led to the shutting down of outpatient clinics. This study aimed to evaluate the impact COVID-19 pandemic on the volume of radiology exams based on patient service locations and imaging modality in the North of Jordan., Methods: The imaging case volumes that were performed at the King Abdullah University Hospital (KAUH), Jordan, from 1 January 2020 to 8 May 2020, were retrospectively collected and compared to those from 1 January 2019 to 28 May 2019, to determine the impact of the pandemic of COVID-19 on the volume of radiological examinations. The 2020 study period was chosen to cover the peak of COVID-19 cases and to record the effects on imaging case volumes., Results: A total of 46,194 imaging case volumes were performed at our tertiary center in 2020 compared to 65,441 imaging cases in 2019. Overall, the imaging case volume in 2020 decreased by 29.4% relative to the same period in 2019. The imaging case volumes decreased for all imaging modalities relative to 2019. The number of nuclear images showed the highest decline (41.0%) in 2020, followed by the number of ultrasounds (33.2%). Interventional radiology was the least affected imaging modality by this decline, with about a 22.9% decline., Conclusion: The number of imaging case volumes decreased significantly during the COVID-19 pandemic and its associated lockdown. The outpatient service location was the most affected by this decline. Effective strategies must be adopted to avoid the aforementioned effect on the healthcare system in future pandemics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gharaibeh, El-Obeid, Khasawneh, Karrar, Salman, Farah, Ahmmed, Al-Omari, Elheis and Abualigah.)

Water pollution is caused by multiple factors, such as industrial dye wastewater. Dye-contaminated water can be treated using hydrogels as adsorbent materials. Recently, composite hydrogels containing metal oxide nanoparticles (MONPs) have been used extensively in wastewater remediation. In this study, we use a statistical and artificial intelligence method, based on principal component analysis (PCA) with different applied parameters, to evaluate the adsorption efficiency of 27 different MONP composite hydrogels for wastewater dye treatment. PCA showed that the hydrogel composites CTS@Fe 3 O 4 , PAAm/TiO 2 , and PEGDMA-rGO/Fe 3 O 4 @cellulose should be used in situations involving high pH, time to reach equilibrium, and adsorption capacity. However, as the composites PAAm-co-AAc/TiO 2 , PVPA/Fe 3 O 4 @SiO 2 , PMOA/ATP/Fe 3 O 4 , and PVPA/Fe 3 O 4 @SiO 2 , are preferred when all physical and chemical properties investigated have low magnitudes. To conclude, PCA is a strong method for highlighting the essential factors affecting hydrogel composite selection for dye-contaminated water treatment.

Industrial dye wastewater is one of the major water pollution problems. Adsorbent materials are promising strategies for the removal of water dye contaminants. Herein, we provide a statistical and artificial intelligence study to evaluate the adsorption efficiency of graphene oxide-based hydrogels in wastewater dye removal by applying Principal Component Analysis (PCA). This study aims to assess the adsorption quality of 35 different hydrogels. We adopted different approaches and showed the pros and cons of each one of them. PCA showed that alginate graphene oxide-based hydrogel (without polyvinyl alcohol) had better tolerance in a basic medium and provided higher adsorption capacity. Polyvinyl alcohol sulfonated graphene oxide-based hydrogels are suitable when higher adsorbent doses are required. In conclusion, PCA represents a robust way to delineate factors affecting hydrogel selection for pollutant removal from aqueous solutions.

Nowadays, acquiring a water supply for urban and industrial uses is one of the greatest challenges facing humanity for ensuring sustainability. Membrane technology has been considered cost-effective, encompasses lower energy requirements, and at the same time, offers acceptable performance. Electrospun nanofibrous membranes (ENMs) are considered a novel and promising strategy for the production of membranes that could be applied in several treatment processes, especially desalination and ion removal. In this study, we apply an unsupervised machine-learning strategy, the so-called principal component analysis (PCA), for the purpose of seeking discrepancies and similarities between different ENMs. The main purpose was to investigate the influence of membrane fabrication conditions, characteristics, and process conditions in order to seek the relevance of the application of different electrospun nanofibrous membranes (ENMs). Membranes were majorly classified into single polymers/layers, from one side, and dual multiple layer ENMs, from another side. For both classes, variables related to membrane fabrication conditions were not separated from membrane characterization variables. This reveals that membranes' characteristics not only depend on the chemical composition, but also on the fabrication conditions. On the other hand, the process conditions of ENM fabrication showed an extensive effect on membranes' performance.

Competing Interests: Kristen WhitakerConsulting or Advisory Role: Novartis Elias ObeidEmployment: Bristol Myers Squibb/CelgeneStock and Other Ownership Interests: Bristol Myers Squibb/CelgeneHonoraria: Guidepoint GlobalConsulting or Advisory Role: Pfizer, Foundation Medicine, Puma, Daiichi Sankyo/Astra Zeneca, Ethos Immunomedics, Novartis, OncLive/MJH Life SciencesResearch Funding: Merck, Genentech/Roche Michael J. HallResearch Funding: InVitae, Foundation Medicine, Caris Life Sciences, Myriad Genetics, AstraZeneca, Ambry GeneticsPatents, Royalties, Other Intellectual Property: I share a patent with several Fox Chase investigators for a novel method to investigate hereditary CRC genesTravel, Accommodations, Expenses: Caris Life Sciences, Myriad Genetics, AstraZenecaOther Relationship: Myriad Genetics, Foundation Medicine, Invitae, Caris Life SciencesNo other potential conflicts of interest were reported.

To better understand the etiology of inflammatory breast cancer (IBC) and identify potential therapies, we studied genomic alterations in IBC patients. Targeted, next-generation sequencing (NGS) was performed on cell-free DNA (cfDNA) ( n = 33) and paired DNA from tumor tissues ( n = 29) from 32 IBC patients. We confirmed complementarity between cfDNA and tumor tissue genetic profiles. We found a high incidence of germline variants in IBC patients that could be associated with an increased risk of developing the disease. Furthermore, 31% of IBC patients showed deficiencies in the homologous recombination repair (HRR) pathway (BRCA1, BRCA2, PALB2, RAD51C, ATM, BARD1) making them sensitive to poly (ADP-ribose) polymerase (PARP) inhibitors. We also characterized the tumor-infiltrating lymphocytes (TILs) in tumor tissue biopsies by studying several markers (CD4, CD8, FoxP3, CD20, PD-1, and PD-L1) through immunohistochemistry (IHC) staining. In 7 of 24 (29%) patients, tumor biopsies were positive for PD-L1 and PD-1 expression on TILs, making them sensitive to PD-1/PD-L1 blocking therapies. Our results provide a rationale for considering PARP inhibitors and PD-1/PDL1 blocking immunotherapy in qualifying IBC patients.

SLC25A42 is the main transporter of coenzyme A (CoA) into mitochondria. To date, 15 individuals have been reported to have one of two bi-allelic homozygous missense variants in the SLC25A42 as the cause of mitochondrial encephalomyopathy, of which 14 of them were of Saudi origin and share the same founder variant, c.871A > G:p.Asn291Asp. The other subject was of German origin with a variant at canonical splice site, c.380 + 2 T > A. Here, we describe the clinical manifestations and the disease course in additional six Saudi patients from four unrelated consanguineous families. While five patients have the Saudi founder p.Asn291Asp variant, one subject has a novel deletion. Functional analyses on fibroblasts obtained from this patient revealed that the deletion causes significant decrease in mitochondrial oxygen consumption and ATP production compared to healthy individuals. Moreover, extracellular acidification rate revealed significantly reduced glycolysis, glycolytic capacity, and glycolytic reserve as compared to control individuals. There were no changes in the mitochondrial DNA (mtDNA) content of patient fibroblasts. Immunoblotting experiments revealed significantly diminished protein expression due to the deletion. In conclusion, we report additional patients with SLC25A42-associated mitochondrial encephalomyopathy. Our study expands the molecular spectrum of this condition and provides further evidence of mitochondrial dysfunction as a central cause of pathology. We therefore propose that this disorder should be included in the differential diagnosis of any patient with an unexplained motor and speech delay, recurrent encephalopathy with metabolic acidosis, intermittent or persistent dystonia, lactic acidosis, basal ganglia lesions and, especially, of Arab ethnicity. Finally, deep brain stimulation should be considered in the management of patients with life altering dystonia., Competing Interests: The authors have no conflicts of interest to declare., (© 2021 The Authors. JIMD Reports published by John Wiley & Sons Ltd on behalf of SSIEM.)

Background: Genetic counseling (GC) presents an opportunity to address modifiable cancer risk factors, such as obesity, which is impacted by non-adherence to physical activity (PA) guidelines. Adherence to PA guidelines has not been assessed among men undergoing GC for prostate cancer (PCA). We conducted a targeted analysis of men undergoing PCA GC to assess adherence to PA recommendations., Methods: Using a cross-sectional design, a total of 158 men from the Genetic Evaluation of Men (GEM) study at two academic cancer centers with a diagnosis or at risk for PCA completed a structured lifestyle survey, including questions about the number of days and intensity of PA over the past year. One-sample t tests assessed adherence of participants to PA recommendations. Chi-square analyses compared differences in PA adherence by PCA status, aggressiveness, family history, and body mass index. Logistic regression analyses identified predictors of PA adherence., Results: High proportions of GEM participants were overweight (44.9%) or obese (38.0%, p = 0.002). Men with PCA engaged in less moderate (p = 0.019) and vigorous (p = 0.005) aerobic activity than men without PCA. Higher education was predictive of adherence to light (p = 0.008), moderate (p = 0.019), and vigorous (p = 0.002) intensity PA. Older age (p = 0.015) and higher education (p = 0.001) were predictive of adherence to strength-based recommendations., Conclusions: High proportions of men receiving PCA GC were overweight/obese and lacked adherence to PA recommendations. GC represents a teachable moment to address PA to reduce cancer risk and promote cancer survivorship.

Introduction: Neighborhood socioeconomic (nSES) factors have been implicated in prostate cancer (PCa) disparities. In line with the Precision Medicine Initiative that suggests clinical and socioenvironmental factors can impact PCa outcomes, we determined whether nSES variables are associated with time to PCa diagnosis and could inform PCa clinical risk assessment., Materials and Methods: The study sample included 358 high risk men (PCa family history and/or Black race), aged 35-69 years, enrolled in an early detection program. Patient variables were linked to 78 nSES variables (employment, income, etc.) from previous literature via geocoding. Patient-level models, including baseline age, prostate specific antigen (PSA), digital rectal exam, as well as combined models (patient plus nSES variables) by race/PCa family history subgroups were built after variable reduction methods using Cox regression and LASSO machine-learning. Model fit of patient and combined models (AIC) were compared; p-values<0.05 were significant. Model-based high/low nSES exposure scores were calculated and the 5-year predicted probability of PCa was plotted against PSA by high/low neighborhood score to preliminarily assess clinical relevance., Results: In combined models, nSES variables were significantly associated with time to PCa diagnosis. Workers mode of transportation and low income were significant in White men with a PCa family history. Homeownership (%owner-occupied houses with >3 bedrooms) and unemployment were significant in Black men with and without a PCa family history, respectively. The 5-year predicted probability of PCa was higher in men with a high neighborhood score (weighted combination of significant nSES variables) compared to a low score (e.g., Baseline PSA level of 4ng/mL for men with PCa family history: White-26.7% vs 7.7%; Black-56.2% vs 29.7%)., Discussion: Utilizing neighborhood data during patient risk assessment may be useful for high risk men affected by disparities. However, future studies with larger samples and validation/replication steps are needed., Competing Interests: The authors of this manuscript have read the journal's policy and have the following competing interests: EO serves on advisory or research steering committees for Pfizer, Incyte, Daiichi Sankyo, Foundation Medicine, OncLive and Ethos Immunomedics. EO had an educational engagement with PUMA. EO has also received grant funding from Merck, Inc, Genentech, and the following foundations: American Cancer Society, Eileen Jacoby Foundation, National Comprehensive Cancer Network Foundation Young Investigator Award, and Newtown Foundation. VG has stock ownership in Novopyxis and speaker agreements with Janssen and Invitae. SL is a consultant for Beautycounter and has received career development funding from the Department of Defense for pancreatic cancer research (grant #W81XWH-17-1-0276). EH, MD, EB, CR, LB and KS have no conflicts to disclose. The disclosures mentioned are unrelated to this study and were not involved in the funding or design, data collection, analysis or manuscript preparation of this study. The above-stated relationships do not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Background: Characterization of breast cancer phenotypes has improved our ability to predict breast cancer behavior. Triple-negative (TN) breast cancers have higher and earlier rates of distant events. It has been suggested that this behavior necessitates treating TNs faster than others, including use of neoadjuvant chemotherapy (NACT) if time to surgery is not rapid., Methods: A review of women diagnosed with non-inflammatory, invasive breast cancer was conducted using the National Cancer Database for patients not having NACT, diagnosed between 2010 and 2014. Changes in overall survival due to delay were measured by phenotype., Results: Overall, 351,087 patients met the inclusion criteria, including 36,505 (10.4%) TNs, 77.9% hormone receptor-positive (HR+) and 11.7% human epidermal growth factor receptor 2 (HER2)-enriched (HER2+). Phenotype, among other factors, was predictive of treatment delays. Adjusted median days from diagnosis to surgery and chemotherapy were 29.9, 31.6 and 31.5 (p< 0.001), and 72.7, 78.0 and 74.4 (p< 0.001) for TNs, HR+ and HER2+ cancers, respectively. After diagnosis, OS declined for all patients per month of preoperative delay (hazard ratio 1.104; p< 0.001). In models separating or combining surgery and chemotherapy, this survival decline did not vary by breast cancer phenotype (p > 0.3)., Conclusions: Delays cause small but measurable effects overall, but the effect on survival does not differ among breast cancer phenotypes. Our data suggest that urgency between diagnosis and surgery or chemotherapy is similar for breast cancers of different subtypes. Although NACT is sometimes advocated solely to avoid treatment delays, this study does not suggest a greater surgical urgency for TNs compared with other breast cancer phenotypes.

We studied genomic alterations in 19 inflammatory breast cancer (IBC) patients with advanced disease using samples of tissue and paired blood serum or plasma (cell-free DNA, cfDNA) by targeted next generation sequencing (NGS). At diagnosis, the disease was triple negative (TN) in eleven patients (57.8%), ER+ Her2- IBC in six patients (31.6%), ER+ Her2+ IBC in one patient (5.3%), and ER- Her2+ IBC in one other patient (5.3%). Pathogenic or likely pathogenic variants were frequently detected in TP53 (47.3%), PMS2 (26.3%), MRE11 (26.3%), RB1 (10.5%), BRCA1 (10.5%), PTEN (10.5%) and AR (10.5%); other affected genes included PMS1 , KMT2C , BRCA2 , PALB2 , MUTYH , MEN1 , MSH2 , CHEK2 , NCOR1 , PIK3CA , ESR1 and MAP2K4. In 15 of the 19 patients in which tissue and paired blood were collected at the same time point, 80% of the variants detected in tissue were also detected in the paired cfDNA. Higher concordance between tissue and cfDNA was found for variants with higher allele fraction in tissue (AF tissue ≥ 5%). Furthermore, 86% of the variants detected in cfDNA were also detected in paired tissue. Our study suggests that the genetic profile measured in blood cfDNA is complementary to that of tumor tissue in IBC patients.

Background: Mutations in BRCA2 cause a higher risk of early-onset aggressive prostate cancer (PrCa). The IMPACT study is evaluating targeted PrCa screening using prostate-specific-antigen (PSA) in men with germline BRCA1/2 mutations., Objective: To report the utility of PSA screening, PrCa incidence, positive predictive value of PSA, biopsy, and tumour characteristics after 3 yr of screening, by BRCA status., Design, Setting, and Participants: Men aged 40-69 yr with a germline pathogenic BRCA1/2 mutation and male controls testing negative for a familial BRCA1/2 mutation were recruited. Participants underwent PSA screening for 3 yr, and if PSA > 3.0 ng/ml, men were offered prostate biopsy., Outcome Measurements and Statistical Analysis: PSA levels, PrCa incidence, and tumour characteristics were evaluated. Statistical analyses included Poisson regression offset by person-year follow-up, chi-square tests for proportion t tests for means, and Kruskal-Wallis for medians., Results and Limitations: A total of 3027 patients (2932 unique individuals) were recruited (919 BRCA1 carriers, 709 BRCA1 noncarriers, 902 BRCA2 carriers, and 497 BRCA2 noncarriers). After 3 yr of screening, 527 men had PSA > 3.0 ng/ml, 357 biopsies were performed, and 112 PrCa cases were diagnosed (31 BRCA1 carriers, 19 BRCA1 noncarriers, 47 BRCA2 carriers, and 15 BRCA2 noncarriers). Higher compliance with biopsy was observed in BRCA2 carriers compared with noncarriers (73% vs 60%). Cancer incidence rate per 1000 person years was higher in BRCA2 carriers than in noncarriers (19.4 vs 12.0; p =  0.03); BRCA2 carriers were diagnosed at a younger age (61 vs 64 yr; p =  0.04) and were more likely to have clinically significant disease than BRCA2 noncarriers (77% vs 40%; p =  0.01). No differences in age or tumour characteristics were detected between BRCA1 carriers and BRCA1 noncarriers. The 4 kallikrein marker model discriminated better (area under the curve [AUC] = 0.73) for clinically significant cancer at biopsy than PSA alone (AUC = 0.65)., Conclusions: After 3 yr of screening, compared with noncarriers, BRCA2 mutation carriers were associated with a higher incidence of PrCa, younger age of diagnosis, and clinically significant tumours. Therefore, systematic PSA screening is indicated for men with a BRCA2 mutation. Further follow-up is required to assess the role of screening in BRCA1 mutation carriers., Patient Summary: We demonstrate that after 3 yr of prostate-specific antigen (PSA) testing, we detect more serious prostate cancers in men with BRCA2 mutations than in those without these mutations. We recommend that male BRCA2 carriers are offered systematic PSA screening., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Women who inherit a BRCA1 or BRCA2 mutation have an increased risk of breast cancer. Preliminary evidence suggests they may also have defects in bone marrow function. To test this hypothesis, we conducted a multicenter, retrospective, matched cohort study, comparing women with localized breast cancer requiring cytotoxic chemotherapy who carried an inherited BRCA1 or BRCA2 mutation to similar wild-type patients treated between 1995 and 2017 and matched based on age, race, site, and chemotherapy regimen. The proportion who developed specific hematologic toxicities, timing of these toxicities, and patterns of blood count fluctuations over time were compared among BRCA1 carriers vs matched wild-type patients and among BRCA2 carriers vs matched wild-type patients. 88 BRCA1 carriers and 75 BRCA2 carriers were matched to 226 and 242 wild-type patients, respectively. The proportions and timing of experiencing any grade or grade 3/4 cytopenias during chemotherapy were not significantly different for BRCA1 carriers or BRCA2 carriers vs matched wild-type patients. Proportions requiring treatment modifications and time to first modification were also similar. Patterns of blood count fluctuations over time in mutation carriers mirrored those in wild-type patients overall and by the most common regimens. Women with an inherited mutation in BRCA1 or BRCA2 experience similar frequency, severity, and timing of hematologic toxicities during curative intent breast cancer chemotherapy as matched wild-type patients. Our findings suggest that BRCA1 or BRCA2 haploinsufficiency is sufficient for adequate bone marrow reserve in the face of short-term repetitive hematopoietic stressors., (© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background: The management of small skin-involved (SI) invasive breast cancers is controversial because although they are considered unresectable, their prognosis is far better than their stage III classification. This study was undertaken to determine how SI lesions are treated in the United States and to discern the benefit of systemic therapy., Patients and Methods: Data of patients diagnosed with stage I-III breast cancer in the National Cancer Data Base between 2004 and 2011 were reviewed. Treatment patterns were examined and overall survival assessed., Results: A total of 3485 patients had SI and 456,287 patients had non-SI breast cancers. Chemotherapy was administered to 68.5% of SI and 45.9% of non-SI tumors (P < .001), including 77.2% of SI and 33% of non-SI tumors < 2 cm (P < .001). After adjusting for patient and tumor characteristics, SI patients were 19.4% more likely to receive chemotherapy than non-SI patients. Radiotherapy was provided to 61.1% of SI and 64.3% of non-SI tumors (P < .001), including 65.5% of SI and 66.5% non-SI tumors < 2 cm (P = .711). After adjusting for patient and tumor characteristics, SI patients were 76.6% more likely to receive radiotherapy than non-SI patients. Chemotherapy and radiotherapy provided an overall survival benefit for stage II and III SI and non-SI tumors., Conclusion: Despite controversy regarding staging and prognosis of SI tumors, the majority of patients are provided systemic therapy and radiotherapy. Varied patterns of chemotherapy administration for SI tumors suggests that further treatment guidance and standardization are required, especially because chemotherapy and radiotherapy are equally efficacious in SI and non-SI tumors alike., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Genetic counseling (GC) and genetic testing (GT) for prostate cancer (PCA) is a rapidly growing, affording opportunity for healthy lifestyle promotion in men aligned with cancer survivorship and cancer prevention goals. We conducted a targeted dietary analysis of men undergoing GC/GT for PCA for adherence to the United States Department of Agriculture (USDA) Food Pattern recommendations which align with preventing cancer and recurrences in the Genetic Evaluation of Men (GEM) study at two academic centers to inform future strategies for diet intervention., Methods: Participants of GEM with PCA or at-risk for PCA completed a structured food frequency questionnaire indicating number of servings consumed per day or per week of fruits, vegetables, red meat, seafood, processed meat, and foods high in saturated fat. Adherence to the USDA recommendations was assessed for the total sample and by PCA status and aggressiveness, family history, and body mass index (BMI) through χ 2 contingency analyses. One-sample t tests were used to compare the dietary behaviors of men to USDA Recommendations. Levels of α were set a priori at P < 0.05., Results: Of 239 males undergoing GC on the study, surveys were completed by 197 men (82.4%), and complete survey data was available on 113 men (47.3%). By the Centers for Disease Control and Prevention BMI classification, 82.3% of the cohort was overweight (45.1%) or obese (37.2%). GEM participants reported consuming less fruits (P = 0.015), less vegetables ( P < 0.001), less seafood ( P < 0.001), more processed meats ( P < 0.001), and more foods high in saturated fats ( P < 0.001) than recommended., Conclusion: A high proportion of men receiving GC/GT for PCA were overweight and/or obese with lack of adherence to national diet recommendations for cancer risk and recurrence, affording a teachable moment and supporting the systematic focus of introducing nutrition intervention during GC to promote survivorship., (© 2019 Wiley Periodicals, Inc.)

Purpose: To establish a cohort of high-risk women undergoing intensive surveillance for breast cancer. Experimental Design: We performed dynamic contrast-enhanced MRI every 6 months in conjunction with annual mammography (MG). Eligible participants had a cumulative lifetime breast cancer risk ≥20% and/or tested positive for a pathogenic mutation in a known breast cancer susceptibility gene., Results: Between 2004 and 2016, we prospectively enrolled 295 women, including 157 mutation carriers (75 BRCA1 , 61 BRCA2 ); participants' mean age at entry was 43.3 years. Seventeen cancers were later diagnosed: 4 ductal carcinoma in situ (DCIS) and 13 early-stage invasive breast cancers. Fifteen cancers occurred in mutation carriers (11 BRCA1 , 3 BRCA2 , 1 CDH1 ). Median size of the invasive cancers was 0.61 cm. No patients had lymph node metastasis at time of diagnosis, and no interval invasive cancers occurred. The sensitivity of biannual MRI alone was 88.2% and annual MG plus biannual MRI was 94.1%. The cancer detection rate of biannual MRI alone was 0.7% per 100 screening episodes, which is similar to the cancer detection rate of 0.7% per 100 screening episodes for annual MG plus biannual MRI. The number of recalls and biopsies needed to detect one cancer by biannual MRI were 2.8 and 1.7 in BRCA1 carriers, 12.0 and 8.0 in BRCA2 carriers, and 11.7 and 5.0 in non- BRCA1/2 carriers, respectively., Conclusions: Biannual MRI performed well for early detection of invasive breast cancer in genomically stratified high-risk women. No benefit was associated with annual MG screening plus biannual MRI screening.See related commentary by Kuhl and Schrading, p. 1693., (©2018 American Association for Cancer Research.)

Despite conflicting guidelines, a significant subset of high-risk men decide to undergo routine prostate cancer screening. Yet, there is a scarcity of available programs, and no studies evaluating interventions to support men in dealing with the psychosocial impact of screening. In this study, one of the first to explore the responses of high-risk men enrolling in a Prostate Cancer Risk Assessment Program ( N = 128), patients underwent a prostate cancer risk counseling visit immediately followed by either a cognitive-affective preparation session designed to help them process the information they received or a general health education session. All men in this self-selected sample chose to participate in prostate cancer screening. Men were assessed 3 weeks and 6 months post-counseling. The impact of the enhanced counseling condition on knowledge, perceived risk, expectancies, and intrusive ideation was a function of racial and coping style group. Implications for tailored interventions to maximize preparedness for risk and screening counseling are discussed.

Background: Genetic testing (GT) for prostate cancer (PCA) is rising, with limited insights regarding genetic counseling (GC) needs of males. Genetic Evaluation of Men (GEM) is a prospective multigene testing study for inherited PCA. Men undergoing GC were surveyed on knowledge of cancer risk and genetics (CRG) and understanding of personal GT results to identify GC needs., Methods: GEM participants with or high-risk for PCA were recruited. Pre-test GC was in-person, with video and handout, or via telehealth. Post-test disclosure was in-person, by phone, or via telehealth. Clinical and family history data were obtained from participant surveys and medical records. Participants completed measures of knowledge of CRG, literacy, and numeracy pre-test and post-test. Understanding of personal genetic results was assessed post-test. Factors associated with knowledge of CRG and understanding of personal genetic results were examined using multivariable linear regression or McNemar's test., Results: Among 109 men who completed pre- and post-GT surveys, multivariable analysis revealed family history meeting hereditary cancer syndrome (HCS) criteria was significantly predictive of higher baseline knowledge (P = 0.040). Of 101 men who responded definitively regarding understanding of results, 13 incorrectly reported their result (McNemar's P < 0.001). Factors significantly associated with discordance between reported and actual results included having a variant of uncertain significance (VUS) (P < 0.001) and undergoing GC via pre-test video and post-test phone disclosure (P = 0.015)., Conclusions: While meeting criteria for HCS was associated with higher knowledge of CRG, understanding of personal GT results was lacking among a subset of males with VUS. A more exploratory finding was lack of understanding of results among men who underwent GC utilizing video and phone. Studies optimizing GC strategies for males undergoing multigene testing for inherited PCA are warranted., (© 2018 Wiley Periodicals, Inc.)

PurposeThe application of genomic sequencing to investigate unexplained death during early human development, a form of lethality likely enriched for severe Mendelian disorders, has been limited.MethodsIn this study, we employed exome sequencing as a molecular autopsy tool in a cohort of 44 families with at least one death or lethal fetal malformation at any stage of in utero development. Where no DNA was available from the fetus, we performed molecular autopsy by proxy, i.e., through parental testing.ResultsPathogenic or likely pathogenic variants were identified in 22 families (50%), and variants of unknown significance were identified in further 15 families (34%). These variants were in genes known to cause embryonic or perinatal lethality (ALPL, GUSB, SLC17A5, MRPS16, THSD1, PIEZO1, and CTSA), genes known to cause Mendelian phenotypes that do not typically include embryonic lethality (INVS, FKTN, MYBPC3, COL11A2, KRIT1, ASCC1, NEB, LZTR1, TTC21B, AGT, KLHL41, GFPT1, and WDR81) and genes with no established links to human disease that we propose as novel candidates supported by embryonic lethality of their orthologs or other lines of evidence (MS4A7, SERPINA11, FCRL4, MYBPHL, PRPF19, VPS13D, KIAA1109, MOCS3, SVOPL, FEN1, HSPB11, KIF19, and EXOC3L2).ConclusionOur results suggest that molecular autopsy in pregnancy losses is a practical and high-yield alternative to traditional autopsy, and an opportunity for bringing precision medicine to the clinical practice of perinatology.

Background/aim: African Americans (AA) have the highest incidence and mortality of any racial/ethnic group in the US for most cancer types. Heterogeneity in the molecular biology of cancer, as a contributing factor to this disparity, is poorly understood. To address this gap in knowledge, we explored the molecular landscape of colorectal cancer (CRC), non-small cell lung cancer (NSCLC) and high-grade glioma (HGG) from 271 AA and 636 Caucasian (CC) cases., Materials and Methods: DNA from formalin-fixed paraffin-embedded tumors was sequenced using next-generation sequencing. Additionally, we evaluated protein expression using immunohistochemistry. The Exome Aggregation Consortium Database was evaluated for known ethnicity associations., Results: Considering only pathogenic or presumed pathogenic mutations, as determined by the American College of Medical Genetics and Genomics guidelines, and using Bonferroni and Benjamini-Hochberg corrections for multiple comparisons, we found that CRC tumors from AA patients harbored significantly more mutations of phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) than those from CC patients. CRC tumors in AA patients also appeared to harbor more mutations of mitogen-activated protein kinase kinase 1 (MAP2K1/MEK1), MPL proto-oncogene (MPL), thrombo-poietin receptor, and neurofibromin 1 (NF1) than those from CC patients. In contrast, CRCs from AA patients were likely to carry fewer mutations of ataxia-telangiectasia mutated (ATM), as well as of proto-oncogene B-Raf (BRAF), including the V600E variant, than those from CC patients. Rates of immunohistochemical positivity for epidermal growth factor receptor (EGFR) and DNA topoisomerase 2-alpha (TOP2A) tended to be higher in CRCs from AA patients than in CC patients. In NSCLC adenocarcinoma, BRAF variants appeared to be more frequent in the AA than in the CC cohort, whereas in squamous cell lung carcinoma, programmed death-ligand 1 (PD-L1) expression tended to be lower in the AA than in CC group. Moreover, HGG tumors from AA patients showed a trend toward harboring more mutations of protein tyrosine phosphatase non-receptor 11 (PTPN11), than HGG tumors from the CC cohort. In contrast, mutations of phosphatase and tensin homolog (PTEN) and tumor protein 53 (TP53) appeared to be higher in HGG tumors in CC patients than in their AA counterparts., Conclusion: Our data revealed significant differences and trends in molecular signatures of the three cancer types in AA and CC cohorts. These findings imply that there may be differences in carcinogenesis between AA and CC patients and that race may be a factor that should be considered regarding cancer incidence and outcome., (Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

This corrects the article DOI: 10.1038/bjc.2017.429.

Purpose Guidelines are limited for genetic testing for prostate cancer (PCA). The goal of this conference was to develop an expert consensus-driven working framework for comprehensive genetic evaluation of inherited PCA in the multigene testing era addressing genetic counseling, testing, and genetically informed management. Methods An expert consensus conference was convened including key stakeholders to address genetic counseling and testing, PCA screening, and management informed by evidence review. Results Consensus was strong that patients should engage in shared decision making for genetic testing. There was strong consensus to test HOXB13 for suspected hereditary PCA, BRCA1/2 for suspected hereditary breast and ovarian cancer, and DNA mismatch repair genes for suspected Lynch syndrome. There was strong consensus to factor BRCA2 mutations into PCA screening discussions. BRCA2 achieved moderate consensus for factoring into early-stage management discussion, with stronger consensus in high-risk/advanced and metastatic setting. Agreement was moderate to test all men with metastatic castration-resistant PCA, regardless of family history, with stronger agreement to test BRCA1/2 and moderate agreement to test ATM to inform prognosis and targeted therapy. Conclusion To our knowledge, this is the first comprehensive, multidisciplinary consensus statement to address a genetic evaluation framework for inherited PCA in the multigene testing era. Future research should focus on developing a working definition of familial PCA for clinical genetic testing, expanding understanding of genetic contribution to aggressive PCA, exploring clinical use of genetic testing for PCA management, genetic testing of African American males, and addressing the value framework of genetic evaluation and testing men at risk for PCA-a clinically heterogeneous disease.

Introduction: Acute radiation oesophagitis (ARO) is frequently experienced by patients receiving concurrent chemo-radiation therapy (cCRT) for non-small-cell lung cancer (NSCLC). We investigated ARO symptoms (CTCAE v3.0), radiation dose and oesophageal FDG PET/CT uptake., Method: Candidates received cCRT (60 Gy, 2 Gy/fx) and sequential FDG PET/CT (baseline FDG 0 , FDG wk2 and FDG wk4 ). Mean and maximum standardized uptake value (SUVmean and SUVmax) and radiation dose (O mean and O max ) were calculated within the whole oesophagus and seven sub-regions (5-60 Gy)., Results: Forty-four patients underwent FDG 0 and FDG wk2 , and 41 (93%) received FDG wk4 , resulting in 129 PET/CT scans for analysis. Of 29 (66%) patients with ≥ grade 2 ARO, SUVmax (mean ± SD) increased from FDG 0 to FDG wk4 (3.06 ± 0.69 to 3.83 ± 1.27, P = 0.0019) and FDG wk2 to FDG wk4 (3.10 ± 0.75 to 3.83 ± 1.27, P = 0.0046). Radiation dose (mean ± SD) was higher in grade ≥2 patients; O mean (47.5 ± 20 vs 53.9 ± 10.2, P = 0.0061), O max (13.7 ± 9.6 vs 20.1 ± 10.6, P = 0.0009) and V40 Gy (8.0 ± 8.2 vs 11.9 ± 7.3, P = 0.0185)., Conclusions: FDG wk4 SUVmax and radiation dose were associated with ≥ grade 2 ARO. Compared to subjective assessments, future interim FDG PET/CT acquired for disease response assessment may also be utilized to objectively characterize ARO severity and image-guided oesophageal dose constraints., (© 2017 The Royal Australian and New Zealand College of Radiologists.)

Purpose: Multigene panels are commercially available for the evaluation of prostate cancer (PCA) predisposition, which necessitates tailored genetic counseling (GC) for men. Here we describe emerging results of Genetic Evaluation of Men, prospective multigene testing study in PCA to inform personalized genetic counseling, with emerging implications for referrals, cancer screening, and precision therapy., Patients and Methods: Eligibility criteria for men affected by or at high risk for PCA encompass age, race, family history (FH), and PCA stage/grade. Detailed demographic, clinical, and FH data were obtained from participants and medical records. Multigene testing was conducted after GC. Mutation rates were summarized by eligibility criteria and compared across FH data. The 95% CI of mutation prevalence was constructed by using Poisson distribution., Results: Of 200 men enrolled, 62.5% had PCA. Eleven (5.5%; 95% CI, 3.0% to 9.9%) had mutations; 63.6% of mutations were in DNA repair genes. FH of breast cancer was significantly associated with mutation status ( P = .004), and FH that met criteria for hereditary breast and ovarian cancer syndrome was significantly associated with PCA (odds ratio, 2.33; 95% CI, 1.05 to 5.18). Variants of uncertain significance were reported in 70 men (35.0%). Among mutation carriers, 45.5% had personal/FH concordant with the gene. A tailored GC model was developed based on emerging findings., Conclusion: Multigene testing for PCA identifies mutations mostly in DNA repair genes, with implications for precision therapy. The study highlights the importance of comprehensive genetic evaluation for PCA beyond metastatic disease, including early-stage disease with strong FH. Detailed FH is important for referrals of men for genetic evaluation. The results inform precision GC and cancer screening for men and their male and female blood relatives., Competing Interests: Inherited Mutations in Men Undergoing Multigene Panel Testing for Prostate Cancer: Emerging Implications for Personalized Prostate Cancer Genetic EvaluationThe following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or po.ascopubs.org/site/ifc.Veda N. GiriStock and Other Ownership Interests: Novopyxis (I)Elias ObeidConsulting or Advisory Role: Merck Sharp & Dohme Research Funding: Merck, Myriad Genetics, GenentechLaura GrossNo relationship to discloseLisa BealinNo relationship to discloseColette HyattNo relationship to discloseSarah E. HegartyNo relationship to discloseSusan MontgomeryNo relationship to discloseAndrea FormanConsulting or Advisory Role: Invitae Speakers’ Bureau: InvitaeRuth BinglerNo relationship to discloseWilliam K. KellyNo relationship to discloseAdam P. DickerConsulting or Advisory Role: Glenview Consulting, Agios, EMD SeronoStephanie WinheldNo relationship to discloseEdouard J. TrabulsiConsulting or Advisory Role: GenomeDxDavid Y.T. ChenEmployment: Tenet Healthcare (I) Stock and Other Ownership Interests: Pfizer (I) Consulting or Advisory Role: Argos Therapeutics Travel, Accommodations, Expenses: Argos TherapeuticsCostas D. LallasNo relationship to discloseBrian A. AllenEmployment: Myriad Genetics Stock and Other Ownership Interests: Myriad GeneticsMary B. DalyNo relationship to discloseLeonard G. GomellaPatents, Royalties, Other Intellectual Property: NuView (Inst), NuView Travel, Accommodations, Expenses: AbbVie, Bayer AG, Astellas Pharma, Janssen Pharmaceuticals, (© 2017 by American Society of Clinical Oncology.)

Purpose: Glucocorticoid receptor (GR) overexpression is associated with poor prognosis ER-negative breast cancer. GR antagonism with mifepristone increases chemotherapy-induced breast cancer cell death, therefore we conducted a phase I clinical trial of mifepristone and nab-paclitaxel in advanced breast cancer., Methods: A novel randomized phase I design was used to assess the effect of mifepristone on nab-paclitaxel pharmacokinetics and toxicity. Patients were randomized to placebo or mifepristone for the first cycle; mifepristone was given to all for subsequent cycles., Results: Nine patients were enrolled. All were found to have a twofold or greater increase in serum cortisol after mifepristone administration, reflecting effective GR inhibition. Neutropenia occurred at both nab-paclitaxel dose levels studied (100 and 80 mg/m(2)), and was easily managed with dose reduction and/or growth factor administration. Pharmacokinetic data suggest an interaction between nab-paclitaxel and mifepristone in some patients. Two patients had complete responses (CR), three partial responses (PR), one stable disease (SD), and three progressive disease (PD). Immunohistochemical staining for GR found six of nine tumors were GR-positive. All six GR-positive tumors were triple-negative at the time of recurrence. Of these six patients, two had CRs, two PRs, one SD, and one PD., Conclusions: GR appears to be a promising target in TNBC, and GR inhibition plus chemotherapy produces manageable toxicity. While neutropenia was observed in some, a nab-paclitaxel dose of 100 mg/m(2) plus mifepristone 300 mg was found to be tolerable, and a randomized phase II trial of nab-paclitaxel with/without mifepristone is planned in GR-positive advanced TNBC.

The gas-phase reactions of five methoxyphenols (three disubstituted and two trisubstituted) with nitrate radicals were studied in an 8000 L atmospheric simulation chamber at atmospheric pressure and 294 ± 2 K. The NO3 rate constants were investigated with the relative kinetic method using PTR-ToF-MS and GC-FID to measure the concentrations of the organic compounds. The rate constants (in units of cm(3) molecule(-1) s(-1)) determined were: 2-methoxyphenol (guaiacol; 2-MP), k(2-MP) = (2.69 ± 0.57 × 10(-11); 3-methoxyphenol (3-MP), k(3-MP) = (1.15 ± 0.21) × 10(-11); 4-methoxyphenol (4-MP), k(4-MP) = (13.75 ± 7.97) × 10(-11); 2-methoxy-4-methylphenol, k(2-M-4-MeP) = (8.41 ± 5.58) × 10(-11) and 2,6-dimethoxyphenol (syringol; 2,6-DMP), k(2,6-DMP) = (15.84 ± 8.10) × 10(-11). The NO3 rate constants of the studied methoxyphenols are compared with those of other substituted aromatics, and the differences in the reactivity are construed regarding the substituents (type, number and position) on the aromatic ring. This study was also supplemented by a theoretical approach of the methoxyphenol reactions with nitrate radicals. The upper limits of the NO3 overall rate constants calculated were in the same order of magnitude than those experimentally determined. Theoretical calculations of the minimum energies of the adducts formed from the reaction of NO3 radicals with the methoxyphenols were also performed using a DFT approach (M06-2X/6-31G(d,p)). The results indicate that the NO3 addition reactions on the aromatic ring of the methoxyphenols are exothermic, with energy values ranging between -13 and -21 kcal mol(-1), depending on the environment of the carbon on which the oxygen atom of NO3 is attached. These energy values allowed identifying the most suitable carbon sites for the NO3 addition on the aromatic ring of the methoxyphenols: at the exception of the 3-MP, the NO3 ipso-addition to the hydroxyl group is one of the favored sites for all the studies compounds.

Prostate cancer disproportionately affects Black men, who may also encounter barriers to participation in prostate cancer risk assessment. The Prostate Risk, Education and Assessment in the Community with Help (REACH) project was a community-based extension of a comprehensive prostate cancer risk assessment program at a comprehensive cancer center. The goals of the REACH project were the following: (1) establish a community prostate cancer risk assessment clinic, (2) conduct targeted recruitment, and (3) provide navigation services including follow-up for uninsured men. Key implementation steps included the following: (1) choosing a clinic site, (2) establishing patient access procedures, (3) establishing navigator services, (4) developing subsidy fund use guidelines, and (5) designing recruitment and promotion. Through community-based promotion, 64 men inquired about the program and 26 (41 %) participated. Of those screened, 46 % had abnormal results, and 2 men were diagnosed with prostate cancer. Here, we describe a unique demonstration project to implement a comprehensive prostate cancer risk assessment program in an underserved Black community and describe successes and challenges to inform future efforts to promote access to underserved men.

Obstetrician/gynecologists and gynecologic oncologists serve an integral role in the care of women at increased hereditary risk of cancer. Their contribution includes initial identification of high risk patients, screening procedures like bimanual exam, trans-vaginal ultrasound and endometrial biopsy, prophylaxis via TAH and/or BSO, and chemoprevention. Further, gynecologists also serve a central role in the management of the secondary repercussions of efforts to mitigate increased cancer risks, including vasomotor symptoms, sexual function, bone health, cardiovascular disease, and mental health. The past several years has seen multiple new high and moderate penetrance genes introduced into the clinical care of women at increased risk of gynecologic malignancy. Awareness of these new genes and the availability of new multi-gene panel tests is critical for providers on the front-line of women's health., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The kinetic reactions of 1,2-benzenediol (catechol) and 2-methoxyphenol (guaiacol) with ozone were studied in a simulation chamber (8 m(3)) under dark conditions. The rate coefficients were measured at 294 ± 2 K, atmospheric pressure and dry conditions (relative humidity, RH < 1%), except for 1,2-benzenediol where they were also measured as a function of relative humidity (RH = 1-80%). The concentrations of organic compounds were followed by a PTR-ToF-MS for a continuous monitoring of gas-phase species. The O3 rate coefficients were obtained using both the pseudo-first-order and relative rate methods. The values (in cm(3) molecule(-1) s(-1)) determined for catechol and guaiacol under dry conditions are (13.5 ± 1.1) × 10(-18) and (0.40 ± 0.31) × 10(-18), respectively. The rate coefficient of catechol was found to be independent of RH below 20% and above 60%, whereas for RH between 20% and 60% it decreases with increasing RH. The determined rate coefficients have been used to evaluate the atmospheric lifetime of each compound with respect to O3. To our knowledge, this study represents the first determination of the ozone rate coefficient with guaiacol and is also the first kinetic investigation for the influence of the relative humidity on the oxygenated aromatic ozonolysis.

A new kind of electrochemical catalyst based on a Pt porous catalyst film deposited on a β″-Al2O3 ceramic Ag(+) conductor was developed and evaluated during propane oxidation. It was observed that, upon anodic polarization, the rate of propane combustion was significantly electropromoted up to 400%. Moreover, for the first time, exponential increase of the catalytic rate was evidenced during galvanostatic transient experiment in excellent agreement with EPOC equation.

It is well established that the tumor microenvironment plays a major role in the aggressive behavior of malignant solid tumors. Among cell types associated with tumor microenvironment, tumor-associated macrophages (TAMs) are the most influential for tumor progression. Breast cancer is characterized by having a large population of TAMs, and experimental models have exposed multiple mechanisms by which TAMs interact with and influence the surrounding tumor cells. The process of metastasis involves tumor cells gaining access to the tissue outside the immediate tumor environment and invading the confining extracellular matrix (ECM). Supporting this process, TAMs secrete proangiogenic factors such as VEGF to build a network of vessels that provide nutrition for tumor cells, but also function as channels of transport into the ECM. Additionally, TAMs release factors to decrease the local pro-inflammatory antitumor response, suppressing it and providing a means of escape of the tumor cells. Similarly, hypoxia in the tumor microenvironment stimulates macrophages to further produce VEGF and suppress the T-cell immune responses, thus, enhancing the evasion of tumor cells and ultimately metastasis. Given the multiple roles of TAMS in breast cancer progression and metastasis, therapies targeting these cells are in development and demonstrate promising results.

Background: Germline TP53 mutations predispose to early onset breast cancer in women and are associated with Li-Fraumeni syndrome. Published data on the pathological characteristics of breast cancer among women with TP53 mutations is limited., Methods: We retrospectively reviewed the clinical records of women who underwent genetic testing for suspected germline TP53 mutations and who were diagnosed with breast cancer between 2000 and 2011. The pathological characteristics of the breast tumors from patients testing positive for a mutation (cases) were compared with those testing negative (controls)., Results: Patients who tested positive for germlineTP53 mutations (n = 30) were compared with controls (n = 79). Human epidermal growth factor receptor 2 (HER2) amplification and/or overexpression was found in 67% of the tumors from the cases, compared with 25% for the controls (P = .0001). Among patients with a mutation, 70% had estrogen receptor- and/or progesterone receptor-positive tumors, compared with 68% in the control group (P = .87). After adjusting for age at breast cancer diagnosis, having a HER2-positive tumor increased the odds of testing positive for a germline TP53 mutation (odds ratio, 6.9; 95% confidence interval, 2.6-18.2). For each yearly increment in age at breast cancer diagnosis, there was decreased likelihood of having a TP53 mutation of 5% (odds ratio, 0.95; 95% confidence interval0.91-0.99)., Conclusions: This study suggests an association between germline TP53 mutations and early onset HER2-positive breast cancer. If confirmed in a larger cohort, these results could guide genetic testing strategies, lead to chemoprevention trials incorporating HER2-targeted therapies, and elucidate some of the molecular pathways involved in breast cancer., (Copyright © 2011 American Cancer Society.)

Inroduction: Of the "top ten" sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are ranked second and fifth, respectively, worldwide., Aim: The aim of this study was to screen the pregnant women for C. trachomatis and N. gonorrhoeae infections and to detect antimicrobial resistance pattern of N. gonorrhoeae., Materials and Methods: This study was a prospective, hospital-based analysis of a random sample of pregnant women visiting the antenatal clinic of a tertiary hospital in eastern Saudi Arabia. Endocervical and high vaginal swabs were collected both from pregnant women and female patients attending gynecology clinic with lower genital tract infection (control group). C. trachomatis antigen was detected using enzyme-linked immunosorbent assay (ELISA). N. gonorrhoeae was detected by culture and identification of isolates, and antimicrobial susceptibility testing was performed. Statistical Package for Social Sciences (SPSS) version 13.0 and Chi-square test were used for statistical analysis., Results: C. trachomatis antigen was detected in 10.5% (10/95) and 34.4% (35/102) of pregnant women and control group, respectively (P < 0.001). The isolation rate of N. gonorrhoeae among pregnant women was 0.0% compared to 7.8% (8/102) among the control group (P < 0.01). N. gonorrhoeae were resistant to penicillin (62.5%), tetracycline (50%), ampicillin (25%), amoxycillin-clavulinic acid (25%) and ciprofloxacin (37.5%), while they were susceptible to cefepime, ceftriaxone, ceftazidime, spectinomycin, and cefuroxime., Conclusion: Screening of pregnant women for C. trachomatis infection should be included in the antenatal care in this area. The detection rate of both organisms among the control group highlights the importance of preventive strategies. Certain antibiotics previously used in treating gonorrhea are no longer effective.

Dislocation after total knee arthroplasty is a difficult problem and is even more challenging if it occurs following revision. We report the case of a 82 year old male presenting after a frank posterior dislocation (Cam Jump) in a posterior stabilized revision knee arthroplasty without trauma. Flexion space instability with extensor insufficiency was presumed to be the cause of the dislocation without significant trauma. The possibility of worsening collateral stability with high flexion ranges following knee replacement is also explored.

We studied the mechanical properties of cartilage from the apparently unaffected compartment of knees with unicompartmental osteoarthritis (OA). Plugs of cartilage and subchondral bone, 8 mm in diameter, were obtained from the tibial plateau of seven patients treated by total knee replacement. Control specimens were obtained from eight cadaver knees of similar age. Specimens were loaded by a plane-ended indentor in a hydraulic materials testing machine; we measured thickness, 'softness', rate of creep, and compressive strength of the articular cartilage. We found that the 'unaffected' cartilage from OA knees was significantly thinner and softer than control cartilage, and it was slightly, although not significantly, weaker. We conclude that the apparently unaffected cartilage in knees with unicompartmental OA is mechanically inferior to normal cartilage, even although clinically, radiologically and morphologically it appears to be sound.