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Breastfeeding is the gold standard for early nutrition. Metabolites from the one-carbon metabolism pool are crucial for infant development. The aim of this study is to compare the breast-milk one-carbon metabolic profile to other biofluids where these metabolites are present, including cord and adult blood plasma as well as cerebrospinal fluid. Breast milk (n = 142), cord blood plasma (n = 23), maternal plasma (n = 28), aging adult plasma (n = 91), cerebrospinal fluid (n = 92), and infant milk formula (n = 11) samples were analyzed by LC-MS/MS to quantify choline, betaine, methionine, S-adenosylmethionine, S-adenosylhomocysteine, total homocysteine, and cystathionine. Differences between groups were visualized by principal component analysis and analyzed by Kruskal-Wallis test. Correlation analysis was performed between one-carbon metabolites in human breast milk. Principal component analysis based on these metabolites separated breast milk samples from other biofluids. The S-adenosylmethionine (SAM) concentration was significantly higher in breast milk compared to the other biofluids and was absent in infant milk formulas. Despite many significant correlations between metabolites in one-carbon metabolism, there were no significant correlations between SAM and methionine or total homocysteine. Together, our data indicate a high concentration of SAM in breast milk, which may suggest a strong demand for this metabolite during infant early growth while its absence in infant milk formulas may indicate the inadequacy of this vital metabolic nutrient.

Objectives: To review our two institutional experiences regarding the historical referral patterns of bladder cancer patients to receive radiation therapy, characteristics of these referred patients, and their treatment outcomes.Methods: A retrospective review was performed analyzing patients who underwent radiation therapy for bladder cancer from 2005 to 2015 (n = 69) at two regional referral institutions. The age-adjusted Charlson comorbidity index (AACCI) was calculated for each patient. Patients were divided into three groups: definitive concurrent chemoradiation (CCR), aggressive radiation (AR) alone ≥ 50 Gy, or palliative radiation alone (PR) < 50 Gy. Gastrointestinal (GI) and genitourinary (GU) acute toxicities were recorded.Results: The median overall AACCI score was 7, which correlates to a two-year expected survival of 55% ± 11%. Thirty-five (50.7%) patients received CCR, 19 (27.5%) received AR, and 15 (21.7%) received PR. Patients presented with hematuria (n = 43, 62%), pain (n = 18, 26%), or obstruction (n = 12, 17%). Of symptomatic patients, treatment improved hematuria in 86%, pain in 75%, and obstruction in 42%. Twenty-two recurrences (32%) were identified at follow-up. Local, regional, and distant recurrences developed in 20%, 14%, and 17% of patients who received CCR. There were two grade 3 GU toxicities and one grade 3 GI toxicity; all grade 3 toxicities were in patients receiving CCR.Conclusions: Bladder preservation is possible with chemoradiation therapy; however, urologists rarely refer patients for consideration of chemoradiation. The limited patients who are referred for radiation generally have limited life expectancy, significant comorbidities, or have advanced disease amenable only to palliation. Palliative radiation improves symptoms with minimal toxicity.

Objectives: To review our two institutional experiences regarding the historical referral patterns of bladder cancer patients to receive radiation therapy, characteristics of these referred patients, and their treatment outcomes.Methods: A retrospective review was performed analyzing patients who underwent radiation therapy for bladder cancer from 2005 to 2015 (n = 69) at two regional referral institutions. The age-adjusted Charlson comorbidity index (AACCI) was calculated for each patient. Patients were divided into three groups: definitive concurrent chemoradiation (CCR), aggressive radiation (AR) alone ≥ 50 Gy, or palliative radiation alone (PR) < 50 Gy. Gastrointestinal (GI) and genitourinary (GU) acute toxicities were recorded.Results: The median overall AACCI score was 7, which correlates to a two-year expected survival of 55% ± 11%. Thirty-five (50.7%) patients received CCR, 19 (27.5%) received AR, and 15 (21.7%) received PR. Patients presented with hematuria (n = 43, 62%), pain (n = 18, 26%), or obstruction (n = 12, 17%). Of symptomatic patients, treatment improved hematuria in 86%, pain in 75%, and obstruction in 42%. Twenty-two recurrences (32%) were identified at follow-up. Local, regional, and distant recurrences developed in 20%, 14%, and 17% of patients who received CCR. There were two grade 3 GU toxicities and one grade 3 GI toxicity; all grade 3 toxicities were in patients receiving CCR.Conclusions: Bladder preservation is possible with chemoradiation therapy; however, urologists rarely refer patients for consideration of chemoradiation. The limited patients who are referred for radiation generally have limited life expectancy, significant comorbidities, or have advanced disease amenable only to palliation. Palliative radiation improves symptoms with minimal toxicity.

Comparative studies of colorectal cancer (CRC) according to the age of onset have found differences between early-onset CRC (EOCRC) and late-onset CRC (LOCRC). Using this as a starting point, we wished to determine whether intermediate-onset CRC (IOCRC) might also be considered as an independent group within CRC. We performed a retrospective comparative study of the clinicopathological and familial features, as well as of the symptoms and their duration, of a total of 272 subjects diagnosed with CRC classified into three groups according to the age-of-onset (98 EOCRC, 83 IOCRC and 91 LOCRC). The results show that from a clinicopathological point of view, IOCRC shared certain features with EOCRC (gender, prognosis), and with LOCRC (multiple primary CRCs), whereas it also had characteristics that were specific for IOCRC (mean number of associated polyps). A gradual progression was observed from EOCRC to LOCRC from a greater family aggregation to sporadic cases, in parallel with a change of Lynch Syndrome cases to the sporadic microsatellite instability pathway, with the IOCRC being a boundary group that is more related to EOCRC. With respect to symptoms, duration and correlation with stages, IOCRC appeared more similar to EOCRC. Clinically, IOCRC behaves as a transitional group between EOCRC and LOCRC, with features in common with both groups, but also with IOCRC-specific features. Excluding cases with familial cancer history, the awareness for EOCRC diagnosis should be extended to IOCRC.

To analyze the possible clonal origin of a part of Synchronous colorectal cancer (SCRC), we studied 104 paired‐SCRCs from 52 consecutive patients without hereditary forms of CRC. We used a Single‐Nucleotide Polymorphism array to characterize the genomic profiles, and subsequently used a statistical application to define them according to clonality within the same individual. We categorized the ensuing groups according to colonic location to identify differential phenotypes. The SCRC Monoclonal group (M) (19 cases) was divided into Monosegmental (MM) and Pancolonic (MP) groups. The SCRC Polyclonal group (P) (33 cases) was also divided into Monosegmental (PM) and Pancolonic (PP), the first exhibiting preference for left colon. The MM group showed a high rate of mucinous tumors, the lowest mean‐number of tumors and associated‐polyps, and the worst prognosis. The MP group included the largest mean‐number of associated‐polyps, best prognosis and familial cancer component. The PM group seemed to be a “frontier” group. Finally, the PP group also exhibited a mucin component, the highest mean‐number of tumors (4.6) compared with the mean‐number of polyps (7.7), poor prognosis and sporadic cases. Most relevant differential genomic regions within M groups were gains on 1q24 and 8q24, and deletions on 1p21 and 1p23 for MM, while within P were the gains on 7q36 and deletions on 1p36 for PM. The statistical application employed seems to define clonality more accurately in SCRC ‐more likely to be polyclonal in origin‐, and together with the tumor locations, helped us to configure a classification with prognostic and clinical value.

Colorectal cancer (CRC) with CpG island methylator phenotype (CIMP) is recognized as a subgroup of CRC that shows association with particular genetic defects and patient outcomes. We analyzed CIMP status of 229 individuals with CRC using an eight-marker panel (CACNA1G, CDKN2A, CRABP1, IGF2, MLH1, NEUROG1, RUNX3 and SOCS1); CIMP-(+) tumors were defined as having ≥ 5 methylated markers. Patients were divided into individuals who developed a “unique” CRC, which were subclassified into early-onset CRC (EOCRC) and late-onset CRC (LOCRC), and patients with multiple primary CRCs subclassified into synchronous CRC (SCRC) and metachronous CRC (MCRC). We found 9 (15.2%) CIMP-(+) EOCRC patients related with the proximal colon (p = 0.008), and 19 (26.8%) CIMP-(+) LOCRC patients associated with tumor differentiation (p = 0.045), MSI status (p = 0.021) and BRAF mutation (p = 0.001). Thirty-five (64.8%) SCRC patients had at least one CIMP-(+) tumor and 20 (44.4%) MCRC patients presented their first tumor as CIMP-(+). Thirty-nine (72.2%) SCRC patients showed concordant CIMP status in their simultaneous tumors. The differences in CIMP-(+) frequency between groups may reflect the importance of taking into account several criteria for the development of multiple primary neoplasms. Additionally, the concordance between synchronous tumors suggests CIMP status is generally maintained in SCRC patients.

Outlines the New York State Nursing Home Health Information Technology Demonstration Project; variations in organizational aims in adopting HIT, perceived or real effects, and resulting quality improvement efforts; and considerations for replication.

Outlines the New York State Nursing Home Health Information Technology Demonstration Project; variations in organizational aims in adopting HIT, perceived or real effects, and resulting quality improvement efforts; and considerations for replication.

Outlines the New York State Nursing Home Health Information Technology Demonstration Project; variations in organizational aims in adopting HIT, perceived or real effects, and resulting quality improvement efforts; and considerations for replication.

Outlines the New York State Nursing Home Health Information Technology Demonstration Project; variations in organizational aims in adopting HIT, perceived or real effects, and resulting quality improvement efforts; and considerations for replication.

The Chattahoochee Review was a literary journal that published new works of fiction, non-fiction, poetry and visual arts. This volume features the following entries: "Brother's Keeper (fiction)", "The Rocks (nonfiction)", "Relay Operator", "Mary Toft of Hayden Park High School", "No Life Stories, Please", "Reach", "An Unfinished Man", "A Requiem of Sorts", "Jumping Up and Down on the Bed", "What Age Invents", "On Her Body", "Pieces of an Argument", "What the Couple Did", "You Wanted Peaches", "Yellow Jacket", "Tim's First Day in Argentina", "With A Hellish Splash", "Double Mississippi Elegy", "My Father in the Showroom", "Light", "Still Life with Turkey Buzzards (Cathartes aura) and Turkey Tail Mushrooms (Trametes versicolor)", "Still Life with Wisteria Syndrome and Marula", "fantome d'un jour", "ghost of a day", "corps a corps", "body to body", "breakng off the rhyme", "Speak English, Please", "The Renters", "If My Mother Were a Poet", "Murky Waters", "Artist's Statement", "1 to Penn Station", "I Spy the Alligator Man", "What's Imagined Is Real: Songwriter Robert Harrison (Cotton Mother and Future Clouds & Radar) Discusses the Writer's Life with Poet and Guitarist Harold Whit Williams", "Stella Vinitchi Radelescu's I Scrape the Window of Nothingness: A Poetics of Voice", "A Review of Alice Friman's The View from Saturn", "Reports rom the Interior: A Review of True Stories, Well Told", ""The Fallout Brothers": A Review of Fat Man and Little Boy".

Angiosperms, http://name.umdl.umich.edu/IC-HERB00IC-X-1359671%5DMICH-V-1359671, https://quod.lib.umich.edu/cgi/i/image/api/thumb/herb00ic/1359671/MICH-V-1359671/!250,250, The University of Michigan Library provides access to these materials for educational and research purposes. Some materials may be protected by copyright. If you decide to use any of these materials, you are responsible for making your own legal assessment and securing any necessary permission. If you have questions about the collection, please contact the Herbarium professional staff: herb-dlps-help@umich.edu. If you have concerns about the inclusion of an item in this collection, please contact Library Information Technology: libraryit-info@umich.edu., https://www.lib.umich.edu/about-us/policies/copyright-policy

Angiosperms, http://name.umdl.umich.edu/IC-HERB00IC-X-1359671%5DMICH-V-1359671, https://quod.lib.umich.edu/cgi/i/image/api/thumb/herb00ic/1359671/MICH-V-1359671/!250,250, The University of Michigan Library provides access to these materials for educational and research purposes. Some materials may be protected by copyright. If you decide to use any of these materials, you are responsible for making your own legal assessment and securing any necessary permission. If you have questions about the collection, please contact the Herbarium professional staff: herb-dlps-help@umich.edu. If you have concerns about the inclusion of an item in this collection, please contact Library Information Technology: libraryit-info@umich.edu., https://www.lib.umich.edu/about-us/policies/copyright-policy

Angiosperms, http://name.umdl.umich.edu/IC-HERB00IC-X-1401400%5DMICH-V-1401400, https://quod.lib.umich.edu/cgi/i/image/api/thumb/herb00ic/1401400/MICH-V-1401400/!250,250, The University of Michigan Library provides access to these materials for educational and research purposes. Some materials may be protected by copyright. If you decide to use any of these materials, you are responsible for making your own legal assessment and securing any necessary permission. If you have questions about the collection, please contact the Herbarium professional staff: herb-dlps-help@umich.edu. If you have concerns about the inclusion of an item in this collection, please contact Library Information Technology: libraryit-info@umich.edu., https://www.lib.umich.edu/about-us/policies/copyright-policy

Angiosperms, http://name.umdl.umich.edu/IC-HERB00IC-X-1401400%5DMICH-V-1401400, https://quod.lib.umich.edu/cgi/i/image/api/thumb/herb00ic/1401400/MICH-V-1401400/!250,250, The University of Michigan Library provides access to these materials for educational and research purposes. Some materials may be protected by copyright. If you decide to use any of these materials, you are responsible for making your own legal assessment and securing any necessary permission. If you have questions about the collection, please contact the Herbarium professional staff: herb-dlps-help@umich.edu. If you have concerns about the inclusion of an item in this collection, please contact Library Information Technology: libraryit-info@umich.edu., https://www.lib.umich.edu/about-us/policies/copyright-policy

Las proteínas de choque térmico (HSPs), particularmente la proteína inducible Hsp72, tienen un papel importante en el favorecimiento de una respuesta antitumoral, transportando péptidos inmunogénicos o actuando como inmunoestimulantes, induciendo la activación y maduración de células dendríticas (DC). La función básica de estas proteínas, como chaperonas moleculares dependientes de ATP, incrementa la sobrevivencia celular bajo cualquier tipo de estrés. La función chaperona es natural para la estructura de las proteínas de la familia Hsp70, las cuales tienen un dominio C-terminal que une proteínas no-plegadas y péptidos y adicionalmente tiene un N-terminal con atividad ATPasa que controla la apertura y cierre del surco de unión al péptido. Su papel inmunoestimulante podría antagonizar con su actividad protectora contra la muerte celular inducida por estrés o agentes citotóxicos. La Hsp70 inducible está implicada en llevar a cabo estas dos funciones, los cuales son el propósito de esta revisión. Además, es posible que otros miembros de la familia Hsp70 estén implicados, pero en diferentes formas: induciendo respuesta inmuneo como promotores del crecimiento tumoral inhibiendo la apoptosis. La comprensión de los mecanismosque regulan las dos actividades, es crucial en el desarrollo de una terapia efectiva antitumoral a través de la búsqueda de sustancias que, preservando su potencial inmunogénico, no incrementen la resistencia del tumor a la terapia antitumoral clásica.