Factors governing late-recurrence of disease in a cohort of early-stage breast cancer survivors

Purpose. To determine the risk of late breast cancer recurrence (5 years after treatment) in a population of women diagnosed with early-stage breast cancer at The University of Texas M.D. Anderson Cancer Center (MDACC) between 1985-2000 and to examine the effect of this population’s BMI, smoking history, reproductive history, hormone use, and alcohol intake at the time of diagnosis on risk of late recurrence.^ Methods. Patients included 1,913 members of the Early Stage Breast Cancer Repository recruited at MDACC who had survived without a recurrence for at least five years after their initial diagnosis of early stage breast cancer. Clinical and epidemiological information was ascertained twice on participants during the study—first by medical record abstraction then by patient interview at least five years after receipt of adjuvant treatment. A total of 223 late breast cancer recurrences were captured, with an average follow-up of 10.6 years. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). ^

Risk factors for inflammatory breast cancer

Background: Inflammatory breast cancer (IBC) is rare and accounts for 2.5% of all invasive breast cancers. The 5-year survival rates are significantly lower than for other types of breast cancer, highlighting the significance of cancer prevention in IBC. The comprehensive multi-disciplinary team Morgan Welch Inflammatory Breast Cancer Research Program and Clinic at University of Texas MD Anderson Cancer Center treats the largest number of Inflammatory Breast patients in a single center. Because of this unique center, large patient resources, and good medical and epidemiological records, we were able to conduct the largest single center case-control and case-case study on IBC. Methods: We identified 246 patients diagnosed with IBC and 397 cancer free patients seen at the Dan L Duncan Cancer Prevention Clinic. Breast cancer reproductive risk factors and lifestyle risk factors were compared between tumor subtypes of IBC patients (Estrogen Receptor positive (ER+) and/or Progesterone Receptor positive (PR+), Human Epidermal Growth Factor 2 positive (HER2+)), and (ER -/PR-/HER2-)) and cancer free controls. Results: Breastfeeding was the only significant risk factor (p<0.01) between tumor subtypes in IBC patients. In the case-control study that included all IBC patients and cancer free patients the descriptive statistics indicate significant difference in BMI, history of smoking, number of children, age of first pregnancy, any breastfeeding and total time breastfeeding (p<0.05). No differences were found in the frequency of other breast cancer risk factors. Conclusion: The associations determined between cancer free controls and IBC patients have identified previously unknown risk factors for IBC. The risk factors identified by the case control study suggest BMI, history of smoking, and the protective effect of breastfeeding as potential modifiable risk factors that can be used to decrease the incidence of IBC. Impact: These results highlight the importance of evaluating epidemiologic risk factors of IBC, which could lead to the identification of distinct etiologic pathways that could be targeted for prevention.^

Breast cancer risk factors among Mexican-American women

Introduction: The average age of onset of breast cancer among Hispanic women is 50 years, more than a decade earlier than non-Hispanic white women. Age at diagnosis is an important prognostic factor for breast cancer; younger age at onset is more likely to be associated with advanced disease, poorer prognosis, hormone receptor negative breast tumors, and a greater likelihood of hereditary breast cancer. Studies of breast cancer risk factors including reproductive risk factors, family history of breast cancer, and breast cancer subtype have been conducted predominately in non-Hispanic whites. Breast cancer is a heterogeneous disease with the presence of clinically, biologically, and epidemiologically distinct subtypes that also differ with respect to their risk factors. The associations between reproductive risk factors and family history of breast cancer have been well documented in the literature. However, only a few studies have assessed these associations with breast cancer subtype in Hispanic populations. Methods: To assess the associations between reproductive risk factors and family history of breast cancer we conducted three separate studies. First, we conducted a case-control study of 172 Mexican-American breast cancer cases and 344 age matched controls residing in Harris County, TX to assess reproductive and other risk factors. We conducted logistic regression analysis to assess differences in cases and controls adjusted for age at diagnosis and birthplace and then we conducted a multinomial logistic regression analysis to compare reproductive risk factors among the breast tumor subtypes. In a second study, we identified 139 breast cancer patients with a first- or second-degree family history of breast cancer and 298 without a family history from the ELLA Bi-National Breast Cancer Study. In this analysis, we also computed a multinomial logistic regression to evaluate associations between family history of breast cancer and breast cancer subtypes, and logistic regression to estimate associations between breast cancer screening practices with family history of breast cancer. In the final study, we employed a cross-sectional study design in 7279 Mexican-American women in the Mano a Mano Cohort Study. We evaluated associations with family history of breast cancer and breast cancer risk factors including body mass index (BMI), lifestyle factors, migration history, and adherence to American Cancer Society (ACS) guidelines. Results: In the results of our first analyses, reproductive risk factors differed in the magnitude and direction of associations when stratified by age and birthplace among cases and controls. In our second study, family history of breast cancer, and having at least one relative diagnosed at an early age (<50 years) was associated with triple negative breast cancer (TNBC). Mammography prior to receiving a breast cancer diagnosis was associated with family history of breast cancer. In our third study that assessed lifestyle factors, migration history and family history of breast cancer; we found that women with a first-degree family history of breast cancer were more overweight or obese compared with their counterparts without a family history. There was no indication that having a family history contributed to women practicing healthier lifestyle behaviors and/or adhering to the ACS guidelines for cancer prevention. Conclusions: We observed that among Mexican-American women, reproductive risk factors were associated with breast cancer where the woman was born (US or Mexico). Having a family history of breast cancer, especially having either a first- or second-degree relative diagnosed at a younger age, was strongly associated with TNBC subtype. These results are consistent with other published studies in this area. Further, our results indicate that women with strong family histories of breast cancer are more likely to undertake mammography but not to engage in healthier lifestyle behaviors.^

Evaluation of reproductive sucess and conservation strategies for Senecio coincyi (Asteraceae), a narrow and threatened species

Senecio coincyi is a threatened endemic plant of central western Spain, with a very narrow extent of occurrence. The reproductive success and germination behaviour of this species were studied. The area of occupancy, habitat types and size of 13 known subpopulations of S. coincyi were evaluated. The number of individuals that form all these subpopulations was counted. In addition, the number of flowers and cypselas per fruit head and the number of fruit heads per individual plant were recorded in a subset of subpopulations. Germination tests were carried out to evaluate the effect of temperature and light regimes on, and possible intraspecific variation in, cypsela germination. Cypselas reached very high germination percentages (90?100%) from 15?C to 30?C. However, the germination decreased (19%) at 10?C. The light conditions assayed (16-h light photoperiod and complete darkness) did not significantly affect cypsela germination. In general, there was no intraspecific variability in germination patterns of S. coincyi cypselas. Livestock is the most important factor that can be a threat for this species. S. coincyi showed high reproductive success and, therefore, its conservation problems are not due to agents related to its reproduction, but rather to other factors such as alteration of its habitat caused by the presence of livestock.

Evaluation of reproductive success and conservation strategies for Senecio coincyi (Asteraceae), a narrow and threatened species.

enecio coincyi is a threatened endemic plant of central western Spain, with a very narrow extent of occurrence. The reproductive success and germination behaviour of this species were studied. The area of occupancy, habitat types and size of 13 known subpopulations of S. coincyi were evaluated. The number of individuals that form all these subpopulations was counted. In addition, the number of flowers and cypselas per fruit head and the number of fruit heads per individual plant were recorded in a subset of subpopulations. Germination tests were carried out to evaluate the effect of temperature and light regimes on, and possible intraspecific variation in, cypsela germination. Cypselas reached very high germination percentages (90?100%) from 15°C to 30°C. However, the germination decreased (19%) at 10°C. The light conditions assayed (16-h light photoperiod and complete darkness) did not significantly affect cypsela germination. In general, there was no intraspecific variability in germination patterns of S. coincyi cypselas. Livestock is the most important factor that can be a threat for this species. S. coincyi showed high reproductive success and, therefore, its conservation problems are not due to agents related to its reproduction, but rather to other factors such as alteration of its habitat caused by the presence of livestock.

Maternal death and obstetric care audits in Nigeria : a systematic review of barriers and enabling factors in the provision of emergency care

Acknowledgements We would like to thank Yutaka Osakabe for co-ordinating the retrieval of full text articles. The John D. and Catherine T. MacArthur Foundation supported this study, grant number 12-100074-000-INP

The type I BMP receptor BmprIB is essential for female reproductive function

Maintenance of female reproductive competence depends on the actions of several hormones and signaling factors. Recent reports suggest roles for bone morphogenetic proteins (BMPs) in early stages of folliculogenesis. A role for the type I BMP receptor BmprIB as a regulator of ovulation rates in sheep has been described recently, but little is known about the roles of BMP signaling pathways in other aspects of reproductive function. We report here that BMPRIB is essential for multiple aspects of female fertility. Mice deficient in BmprIB exhibit irregular estrous cycles and an impaired pseudopregnancy response. BmprIB mutants produce oocytes that can be fertilized in vitro, but defects in cumulus expansion prevent fertilization in vivo. This defect is associated with decreased levels of aromatase production in granulosa cells. Unexpectedly, levels of mRNA for cyclooxygenase 2, an enzyme required for cumulus expansion, are increased. BmprIB mutants also exhibit a failure in endometrial gland formation. The expression of BmprIB in uterine linings suggests that these defects are a direct consequence of loss of BMP signaling in this tissue. In summary, these studies demonstrate the importance of BMP signaling pathways for estrus cyclicity, estradiol biosynthesis, and cumulus cell expansion in vivo and reveal sites of action for BMP signaling pathways in reproductive tissues.

Primary structure of hepatocyte nuclear factor/forkhead homologue 4 and characterization of gene expression in the developing respiratory and reproductive epithelium.

Members of the winged helix/forkhead family of transcription factors are believed to play a role in cell-specific gene expression. A cDNA encoding a member of this family of proteins, termed hepatocyte nuclear factor/forkhead homologue 4 (HFH-4), has been isolated from rat lung and rat testis cDNA libraries. This cDNA contains an open reading frame of 421 amino acids with a conserved DNA binding domain and several potential transactivating regions. During murine lung development, a single species of HFH-4-specific transcript (2.4 kb long) is first detected precisely at the start of the late pseudoglandular stage (embryonic day 14.5) and, by in situ hybridization, is specifically localized to the proximal pulmonary epithelium. The unique temporal and spatial pattern of HFH-4 gene expression in the developing lung defines this protein as a marker for the initiation of bronchial epithelial cell differentiation and suggests that it may play an important role in cell fate determination during lung development. In addition to expression in the pulmonary epithelium, RNA blot analysis reveals 2.4-kb HFH-4 transcripts in the testis and oviduct. By using mice with genetic defects in spermatogenesis, HFH-4 expression in the testis is found to be associated with the appearance of haploid germ cells and in situ hybridization studies indicate that HFH-4 expression is confined to stages I-VII of spermatogenesis. This pattern of HFH-4 gene expression during the early stages of differentiation of haploid germ cells suggests that HFH-4 may play a role in regulating stage-specific gene expression and cell-fate determination during lung development and in spermatogenesis.

Influence of habitat on nest location and reproductive output of Montagu’s Harriers breeding in natural vegetation

We examined distribution and breeding success of semi-colonial Montagu’s Harriers (Circus pygargus) in relation to habitat in Castellón province (eastern Spain). Breeding areas used by harriers at a 1-km2 scale were characterised by having intermediate percentages of scrub cover, their nesting habitat, and also had intermediate coverage of herbaceous crops and non-irrigated orchards. Out of all habitat variables considered, only the percentage of herbaceous crops within 500 m from individual nests had a positive and significant effect on breeding output of the species, suggesting that this habitat may be efficiently used by harriers to forage. Breeding output was also related to laying date and number of breeding neighbours within 500 m around nests, with pairs laying later and having a higher number of breeding neighbours showing lower fledged brood sizes. Number of neighbours (but not laying date) was positively related to scrub cover within 500 m and to cover of herbaceous crops within 2,000 m. Conservation actions for Montagu’s Harrier in the study area should be aimed at preserving areas of scrub with nearby presence of herbaceous crops or natural grasslands. However, habitat improvement for semi-colonial species such as Montagu’s Harrier may not result in a change of species distribution area, and good habitat areas may remain unoccupied, as social factors like presence of conspecifics play an important role in breeding area selection for these species.

Is the potential of Coccidoxenoides perminutus, a mealybug parasitoid, limited by climatic or nutritional factors?

The encyrtid Coccidoxenoides perminutus is a widely distributed parasitoid of citrus mealybug (Planococcus citri). Worldwide, it has been implicated in successful biocontrol in only a few widely separated localities. C perminutus contributes little to control P. citri in field situations in south-east Queensland, Australia, but invades insectary cultures and reduces mealybug populations considerably under these controlled conditions. This discrepancy between poor field performance and good performance under controlled conditions was investigated to establish whether climatic factors inhibit the field performance of this species in the biological control of P. citri. Subsequent laboratory examination of the influence of varied humidities and temperatures on the activity levels and survival of C perminutus revealed a low tolerance for high saturation deficits (i.e., low % RH at high T degreesC) with reduced reproductive output. The influence of different food sources on adult survival and reproduction was also quantified, to establish if the adverse effects of climate could be overcome by supplementing adult diet. Neither honeydew from their mealybug hosts nor nectar from Alphitonia flowers significantly enhanced parasitoid survival. A subsequent test of five nectar species revealed a significant difference in their influence on C. perminutus survival and reproduction, with only Alpinia zerumbet proving to be as suitable as honey. The floral species that proved suitable in the laboratory need to be checked for their attractiveness to C perminutus in the field and for their ability to enhance the survival and reproductive output of parasitoids. This information suggests that the prevailing dry conditions in south-east Queensland citrus-growing areas apparently impede successful biological control of P. citri by C perminutus, but possibilities are available for habitat manipulation (by providing suitable nectar sources for adult parasitoids) to conserve and enhance C perminutus activity in the field. (C) 2004 Elsevier Inc. All rights reserved.

Factors affecting akinete differentiation in Cylindrospermopsis raciborskii (Nostocals, Cyanobacteria)

1. Cylindrospermopsis raciborskii is a potentially toxic freshwater cyanobacterium which can produce akinetes (reproductive spores) that on germinating can contribute to future populations. To further understand factors controlling the formation of these specialised cells, the effects of diurnal temperature fluctuations (magnitude and frequency), in combination with different light intensities and phosphorus concentrations were investigated under laboratory conditions. 2. Akinete differentiation was affected by the frequency of temperature fluctuations. Maximum akinete concentrations were observed in cultures that experienced multiple diurnal temperature fluctuations. 3. Akinete concentrations increased with increasing magnitude of temperature fluctuation. A maximum akinete concentration was achieved under multiple diurnal temperature fluctuations with a magnitude of 10degreesC (25degreesC to 15degreesC). 4. A fourfold increase in light intensity (25-100 mumol m(-2) s(-1)) resulted in an approximate 14-fold increase in akinete concentration. 5. High filterable reactive phosphorus (FRP) concentrations (> 70 mug L-1) in the medium, combined with a multiple diurnal temperature fluctuation of 10degreesC, supported the development of the highest akinete concentration.

The importance of mating system in translocation programs: reproductive success of released male bridled nailtail wallabies

Translocation is an important tool for the conservation of species that have suffered severe range reductions. The success of a translocation should be measured not only by the survival of released animals, but by the reproductive output of individuals and hence the establishment of a self-sustaining population. The bridled nailtail wallaby is an endangered Australian macropod that suffered an extensive range contraction to a single remaining wild population. A translocated population was established and subsequently monitored over a four year period. The aim of this study was to measure the reproductive success of released males using genetic tools and to determine the factors that predicted reproductive success. Captive-bred and wild-caught animals were released and we found significant variation in male reproductive success among release groups. Variation in reproductive success was best explained by individual male weight, survival and release location rather than origin. Only 26% of candidate males were observed to sire an offspring during the study. The bridled nailtail wallaby is a sexually dimorphic, polygynous macropod and reproductive success is skewed toward large males. Males over 5800 g were six times more likely to sire an offspring than males below this weight. This study highlights the importance of considering mating system when choosing animals for translocation. Translocation programs for polygynous species should release a greater proportion of females, and only release males of high breeding potential. By maximizing the reproductive output of released animals, conservation managers will reduce the costs of translocation and increase the chance of successfully establishing a self-sustaining population. (C) 2004 Elsevier Ltd. All rights reserved.

Embryonic mortality in buffaloes synchronized and mated by AI during the seasonal decline in reproductive function

The aim was to determine the factors that contribute to embryonic mortality in buffaloes mated by AI during a period of increasing day length which corresponds to a natural decline in reproductive activity. Italian Mediterranean buffalo cows (n = 243) showing regular estrous cycles were synchronized using the Ovsynch-TAI program and mated by AI at 16 and 40 h after the second injection of GnRH. Blood samples were collected on Days 10 and 20 after the first AI and assayed for progesterone (P-4). Pregnancy diagnosis was undertaken on Days 26 and 40 after the first AI using rectal ultrasonography. Buffaloes with a conceptus on Day 26 but not on Day 40 were judged to have undergone embryonic mortality and for these animals uterine fluid was recovered by flushing and analysed for common infectious agents. Estrus synchronization was achieved in 86% of buffaloes and the pregnancy rate on Day 40 was 34%. Embryonic mortality between Days 26 and 40 occurred in 45% of buffaloes and was associated with the presence of significant infectious agents in only 10 buffaloes (8%). Concentrations of P-4 on Day 10 after AI were higher (P < 0.05) in buffaloes that established a pregnancy than in buffaloes that showed embryonic mortality that was not associated with infectious agents. Similarly, on Day 20 after AI P-4 concentrations were higher (P < 0.01) in pregnant buffaloes compared with non-pregnant buffaloes and buffaloes that had embryonic mortality. It is concluded that a reduced capacity for P-4 secretion can explain around 50% of embryonic mortalities in buffaloes synchronised and mated by AI during a period of low reproductive activity and that other as yet unidentified factors also have a significant effect on embryonic survival. (c) 2004 Elsevier Inc. All rights reserved.

Risk factors for pregnancy and childbearing in single young women: Evidence from the Australian Longitudinal Study on Women's Health

This study investigated psychosocial predictors of early pregnancy and childbearing in single young women, consistent with the Eriksonian developmental perspective. Two mail-out surveys assessing reproductive behaviour and sociodemographic, education/competence, psychosocial well-being, and aspiration factors were completed 4 years apart by 2635 young women, aged 18 to 20 when first surveyed. Young women in the emerging adulthood'' developmental period were selected from the Australian Longitudinal Study on Women's Health. Longitudinally, lower investment in education over low-status paid work, experiencing unemployment, greater psychosocial distress, stress and alcohol use, and high family aspirations combined with low vocational aspirations were risk factors for early single pregnancy and childbearing. Several mediational relationships also existed between these predictor variables. It was concluded that psychosocial factors play an important role in understanding early pregnancy and childbearing in single young Australian women, and that the findings provide some support for investigating early pregnancy and childbearing from an Eriksonian developmental perspective.