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BACKGROUND: Variations in symptom development among breast cancer (BC) survivors are understudied. We examined: (Q1) Symptom trajectories of pain, fatigue, insomnia, breast, and arm symptoms in BC survivors, (Q2) possible patterns or cluster-like associations between trajectory classification of different symptoms, and (Q3) characteristics of survivors assigned to high-burden symptom trajectories.MATERIAL AND METHODS: Participants were 968 women (mean age = 59.6 years) treated for early-stage BC and followed across a three-year postoperative period. As part of routine follow-up procedures, patients reported symptom burden and functioning levels at each hospital visit using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and the BC-specific module (QLQ-BR-23). Growth mixture modeling (GMM) analysis was used to differentiate potential subgroups of individuals with similar longitudinal symptom patterns, i.e., symptom trajectories (Q1). With this approach, groups experiencing persistent, highly distressing cancer- and treatment-related late effects (LEs) may be identified. Latent class analysis (LCA) was used for Q2 and logistic regression analysis for Q3.RESULTS: GMM identified two relatively parallel trajectories across the tested symptoms: The majority of the sample exhibited a low-burden symptom trajectory (74.4-89.2%) and a minority by a high-burden symptom trajectory (10.8-25.6%). LCA revealed that approximately one in five women (18.8%) were likely to be members of the high-burden symptom trajectory across all tested symptoms. In addition to a high probability of being burdened over time across multiple symptoms, these women were also characterized by poorer self-reported physical and social functioning.CONCLUSION: A substantial minority followed a high-burden symptom trajectory for several years following BC treatment. Associations were found in trajectory classification across symptoms, indicating that cancer-related LEs appear in clusters of multiple concurrent symptoms.

Background: Survival rates for breast cancer (BC) are increasing, leading to growing interest in treatment-related late-effects. The aim of the present study was to explore late effects using Patient-Reported Outcome Measures in postmenopausal BC survivors in standard follow-up care. The results were compared to age- and gender-matched data from the general Danish population. Material and methods: Postmenopausal BC survivors in routine follow-up care between April 2016 and February 2018 at the Department of Oncology, Aarhus University Hospital, Denmark were asked to complete the EORTC QLQ-C30 and BR23 questionnaires together with three items on neuropathy, myalgia, and arthralgia from the PRO-CTCAE. Patients were at different time intervals from primary treatment, enabling a cross-sectional study of reported late effects at different time points after primary treatment. The time intervals used in the analysis were year ≤1, 1–2, 2–3, 3–4, 4–5 and 5+. The QLQ-C30 results were compared with reference data from the general Danish female population. Between-group differences are presented as effect sizes (ESs) (Cohen’s d). Results: A total of 1089 BC survivors participated. Compared with the reference group, BC survivors reported better global health status 2–3 and 4–5 years after surgery (d = 0.26) and physical functioning 2–3 years after (0.21). Poorer outcomes in BC survivors compared with the reference group were found for cognitive functioning (0–4 and 5+ years), fatigue (0–2 years), insomnia (1–3 years), emotional functioning (3–4 years), and social functioning (≤1 year after surgery) with ESs ranging from 0.20 to 0.41. For the remaining outcomes, no ESs exceeded 0.20. Conclusion: Only small to medium ESs were found for better global health and physical functioning and poorer outcomes for cognitive functioning, fatigue, insomnia, emotional functioning, and social functioning in postmenopausal BC survivors, who otherwise reported similar overall health-related quality of life compared with the general Danish female population.

Introduction: Xerostomia is a frequent complication after curative intended radiotherapy (RT) for head and neck squamous cell carcinoma (HNSCC). Assessment of xerostomia is commonly done by the physician. The aim of this study is to investigate the relation between patient and physician-rated xerostomia and to predict the degree of xerostomia from patients with self-reported xerostomia based on delivered doses to the oral cavity, parotid, and submandibular glands. Material and methods: During a 2-year period, consecutive HNSCC patients attending the follow-up clinic were included. All included patients had self-reported xerostomia, and completed the disease-specific EORTC QLQ-H&N35 questionnaire. The physician assessed the degree of xerostomia with the DAHANCA toxicity scale and was blinded for the EORTC score. Oral cavity, parotid, and submandibular glands (OAR) were delineated on the planning CT according to international guidelines. DVH were extracted from treatment plans. Logistic regression tested the relation between mean doses, patient characteristics, and xerostomia scores. Differences between DVH values and scoring of xerostomia were analyzed with a Kruskal–Wallis test. The relation between xerostomia and dose distributions was further investigated using principal component analysis (PCA). Results: In total, 109 patients were included in the study. A weak correlation was seen between patient and physician-rated toxicity (p =.001), however, in general patients reported more toxicity than physicians. For EORTC score ≥2, the multi-variable analysis was significant for doses to the oral cavity, tobacco status and use of xerogenic medication. Neither the DVH analysis nor the PCA found any clear distinction between xerostomia scores for EORTC or DAHANCA and investigated OARs. Conclusion: Patients tended to report higher scores of xerostomia than the physician. PCA indicated a complex relation between doses to the OAR and xerostomia scores, showing e.g., that reducing doses in one organ was on the expense of increased dose to another organ.

Summary: Adenia goetzei is a plant with a decorative prominent caudex. An efficient micropropagation system based on axillary shoot formation and subsequent rooting was developed. By alternating culture on a medium with 5µM BAP (a modified Murashige & Skoog (1962) medium) and a medium without BAP (Krogstrup et al., 1988), a multiplication factor of 3.93 +/- 1.16 (mean +/- SD) was achieved every 6 weeks. Approximately 61 % of the micro-cuttings rooted following a 24 day 5µM IBA treatment and 80–85% of the plants were successfully transplanted to soil. The juvenile twining growth- and leaf form reverted to a form with adult characteristics after 1–2 growth periods in soil. Using this micropropagation protocol for A. goetzei, it has been possible to produce several hundred vigorous and true-to-type plants, except for irregularly shaped caudices in contrast to the regular ones seen in seedlings.

Stable genetic transformation of embryogenic cultures of Abies nordmanniana (Nordmann fir or Caucasian fir) was achieved using the Biolistic® transformation technology, followed by regeneration of transgenic plants. Selection of the transgenic tissue was based on the antibiotic resistance induced by the neomycin phosphotransferase II gene (npt II), in combination with the antibiotic geneticin. Six transclones were recovered from a total of 215 bombardments. Expression of the β-glucuronidase gene (uidA) was confirmed by histochemical analysis, and expression of npt II was verified by quantification of NPTII protein by enzyme linked immunosorbent assay (ELISA). Both genes were still expressed in the embryogenic tissue after 5 yr of in vitro culture and in mature somatic embryos and plants produced from these cultures. The integration of npt II was confirmed by Southern hybridization in embryogenic tissue after 5 yr of culture. After 5 yr of growth, uidA was still expressed in needles from the transformed trees.

As an alternative to seed propagation, and efficient micropropagation system based on axillary shoot formation and subsequent rooting was developed for the threatened and medicinal plant species Dorstenia gigas (Moraceae). Three different basal media were tested. For the best basal medium, a modified WPM medium, different concentrations of the carbohydrates sucrose, glucose, fructose and maltose were tested. The total number of shoots was not markedly affected. For all carbohydrates but maltose, however, there was a reduction in the number of normal, healthy shoots for carbohydrate concentrations greater than 14.6 mM for the disaccharides and 27.8 mM for the monosaccharides (i.e., approximately 5 gl−1). Using 14.6 mM (5 gl−1) sucrose it has been possible to produce vigorous and true-to-type plants with a multiplication factor of approximately 2.6 per 6 wk.

The development of somatic embryos in an embryogenic suspension culture ofPicea sitchensis was followed every day for two weeks after thawing from liquid nitrogen (LN2). Only a few cells, primarily located at the periphery of the embryonic region of the embryos, survived cryopreservation in LN2. Surviving cells were classified into two groups: embryogenic cells (EC) and non-embryogenic cells (NEC), based on their morphology and embryogenic competence. The dense cytoplasmic EC underwent organized growth and differentiation with first divisions occurring after 24 h, and embryo formation 6–8 days after thawing from LN2. No evidence of asymmetrical divisions or free-nuclear stages was found during somatic embryo formation. NEC had less dense cytoplasm with numerous small vacuoles. One to five days after thawing the NEC became progressively more vacuolated and elongated. Histological examination revealed no mitotic activity in NEC, and six days after thawing NECs were seen as single cells or unorganized cell aggregates. Two weeks after thawing the appearance of the cryopreserved cultures was comparable to that of the untreated cultures.

Embryogenic suspension cultures of sitka spruce (Picea sitchensis) were successfully cryopreserved. The best method for cyropreservation as demonstrated by regrowth tests was: 1) preculture in medium containing 0.4 M sorbitol and pretreatment with 5% (v/v) DMSO (dimethylsulfoxide), 2) freezing the cultures at a cooling rate of 0.5°Cmin‐1 to —40°C followed by transfer to LN (liquid nitrogen). After thawing in a waterbath at 45°C the growth rates of cell cultures cryopreserved by this method were equal to growth rates of untreated unfrozen cultures. The cryopreserved cultures gave rise to mature somatic embryos which developed cotyledons, roots and shoots 3–4 months after thawing.