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Fardeen Bhimani,1,&ast; Sophie Lin,1,&ast; Maureen McEvoy,1,2 Arianna Cavalli,2 Liane Obaid,2 Yu Chen,1 Anjuli Gupta,1,2 Jessica Pastoriza,1,2 Areej Shihabi,1 Sheldon Feldman1,2 1Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, Bronx, New York, USA; 2Albert Einstein College of Medicine, Bronx, New York, USA&ast;These authors contributed equally to this workCorrespondence: Sheldon Feldman, Department of Surgery, Division of Breast Surgery, Montefiore Medical Center, 1250 Waters Place, 7th Floor, Hutch Tower 1, Bronx, NY, USA, Email sfeldman@montefiore.orgBackground: Positive margins on lumpectomy specimens are associated with a twofold increased risk of local breast tumor recurrence. Prior literature has demonstrated various techniques and modalities for assessing margin status to reduce re-excision rates. However, there is paucity of literature analyzing which margin contributes to the highest re-excision rates. Therefore, the primary aim of the study was to investigate whether the nipple-ward margins resulted in a higher rate of re-excision in our patient population.Methods: A retrospective chart review was performed on patients who had re-excision surgery. Nipple-ward margin was identified by correlating radiological and pathological reports. A cut-off of more than 25% was used to demonstrate correlation between nipple-ward margin and re-excision rate.Results: A total of 98 patients’ data were analyzed, with 41 (41.8%), 14 (14.3%), 5 (5.1%), and 38 (38.8%) diagnosed with DCIS, IDC, ILC, and mixed pathology on their margins, respectively. Overall, 48% (n=47) of the positive margins were nipple-ward, with 44.7% (n=21) reporting DCIS. Upon stratification, 45 (45.9%) cases were single-margin positive, with 26 (57.8%) being nipple-ward. Furthermore, the remaining 53 (54.1%) patients had multiple positive margins, with 21 (39.6.7%) nipple-ward cases.Conclusion: Positive nipple-ward margins significantly contribute to a higher re-excision rate p < 0.001; 48% of re-excision surgeries had positive nipple-ward margins, and 57.8% of positive single-margin cases were nipple-ward. Taking an additional shave during initial lumpectomy decreases re-excision rates. However, planning a lumpectomy procedure with a more elliptical rather than a spherical resection with additional cavity shave (ie, larger volume) in the nipple-ward direction and minimizing the remaining cavity shaves so the total volume resected remains unchanged. Nevertheless, future studies with larger sample sizes are required to bolster our findings.Keywords: nipple-ward, breast cancer, re-excision, nipple-ward positive breast cancer, Shave trial, positive margins

Douglas S Kalman, Samantha Feldman, Adam Samson, Diane R Krieger Miami Research Associates, Miami, FL, USA Purpose: The purpose of this study was to characterize the pharmacokinetics (PKs) and pharmacodynamics (PDs) of an oral inositol-stabilized arginine silicate dietary supplement. Subjects and methods: Ten healthy males, 26.7±5.4 years, took three 500 mg arginine silicate capsules (active product) for 14 days. The subjects attended test visits on Days 1 and 14. Fasting blood and saliva collections were performed predose and at 0.5 hours, 1 hour, 1.5 hours, 2 hours, 3 hours, 4 hours, 5 hours, and 6 hours postdose for plasma arginine, serum silicon, and salivary nitric oxide (NO) + nitrite. Results: Day 1 PK parameters (adjusted for body weight) for arginine were peak serum concentration (CMax) 30.06±7.80 µg/mL, time it takes to reach peak serum concentration (tMax) 1.13±0.52 hours, and time required to reach half its original concentration (t1/2) 15.93±9.55 hours and for silicon were CMax 2.99±0.63 µg/mL, tMax 2.44±2.05 hours, and t1/2 34.56±16.56 hours. After Day 1 dose, arginine levels increased at 0.5 hours, 1 hour, 1.5 hours, 2 hours, 3 hours, and 5 hours (P

This document provides a summary of a study on the use of tofacitinib in patients with psoriasis and a history of psoriatic arthritis (PsA). The study found that tofacitinib, at both 5mg and 10mg doses, resulted in significant improvements in skin disease, itch, joint pain, morning stiffness, and depressive symptoms compared to a placebo. The safety profile of tofacitinib was consistent with previous reports. The study suggests that these findings can inform clinical practice and the scientific community. The limitations of the study include the reliance on patient reports for PsA history. The study was sponsored by Pfizer, and the authors disclosed various conflicts of interest. [Extracted from the article]

Associations among 53 primiparous women's Adult Attachment Interview classifications (secure-autonomous vs. insecure-dismissing) and physiological and self-reported responses to infant crying were explored. Heart rate, skin conductance levels, and respiratory sinus arrhythmia (RSA) were recorded continuously. In response to the cry, secure-autonomous women demonstrated RSA declines, consistent with approach-oriented responses. Insecure-dismissing women displayed RSA and electrodermal increases, consistent with behavioral inhibition. Furthermore, insecure-dismissing women rated the cries as more aversive than secure-autonomous women. Nine months postpartum, secure-autonomous women, who prenatally manifested an approach-oriented response to the unfamiliar cry stimulus, were observed as more sensitive when responding to their own distressed infant, whereas women classified prenatally as insecure-dismissing were observed as less sensitive with their own infants. (Contains 3 tables and 2 figures.)

Peer victimization, especially appearance-related bullying, is a highly stressful experience for a young person and is associated with significant negative outcomes. Perhaps, the most common consequence of peer victimization in adolescence is lowered self-esteem. Evidence supports the role of low self-esteem as a non-specific risk factor and high self-esteem as a protective factor in the development of mental disorders and social problems in adolescence. Moreover, the literature indicates a robust negative relationship between avoidant coping (i.e. distracting oneself, wishing the situation would go away) and psychological well-being. In this paper, we test a mediational model of the associations between appearance-related victimization, avoidance coping and self-esteem in young Australian adolescents. Boys (N = 194) and girls (N = 185) with a mean age of 11 years completed measures assessing self-esteem, appearance-related victimization and styles of coping. The results showed that avoidant coping partially mediates the association between appearance-related bullying problems and self-esteem among young adolescents. This finding provides a specific target for psychosocial interventions in schools.

An Australian study of parent-adolescent communication about sexuality revealed complex meanings inherent in the understanding of "openness". These included willingness to answer questions while not keeping a spotlight on the topic; having an open-minded attitude; balancing openness with privacy; and being responsive to characteristics of the child. Various constraints applied to the application of open communication in this sensitive area. Given the range of meanings encompassed by "openness", the authors recommend that social scientists limit their application of this term in the study of communication in families, and that sex educators take care to be more specific in recommending openness in communication about sexuality.

Sexual behaviors and attitudes of female adolescents were studied as a function of age of boyfriend. Boyfriend's age was dichotomized: similar-aged was defined as within 2 years of the girls' age; older aged was 3 or more years older than the girl. A school-based, ethnically diverse sample of 9th-grade girls (N = 146) who had been in a serious romantic relationship was surveyed on 5 dimensions of sexual attitudes, 2 classes of sexual motives, 7 normative sexual behaviors, and 3 types of risky sexual practices. Results showed that in terms of behavior, girls with older boyfriends were more likely than girls with similar-aged boyfriends to engage in all forms of sexual intimacy, to have sex under the influence of alcohol or drugs, and to experience sexual coercion. In terms of sexual attitudes, girls with older boyfriends were more likely to endorse beliefs that guys are sexually driven, that sex "just happens" and is spontaneous, and that sex is related to maturity. These results are discussed in terms of a potential power differential that emerges when girls date older boys.

In this study, 229 high school students and 261 college students evaluated the acceptability of lying to parents under 19 different circumstances where a person's motive for lying differed. Students also indicated the frequency with which they had lied to their parents about diverse issue such as friends, dates, and money. Results indicated that adolescents and emerging adults quite commonly lied to their parents, and that in part they framed lying to parents as a way to assert the right to autonomy. Emerging adults were less accepting of lying and reported less frequent lying, compared to adolescents. Results also showed the association of sex, personality (self-restraint and tolerance of deviance), and family environment (control and cohesion) upon adolescents' and emerging adults' acceptance of lying to parents and lying behavior.

Investigated the effects of sociopolitical upheaval on Bulgarian youths' adaptation and perceptions of supportive environment, particularly the stability and change of schools as a protective factor in this process. High school students, surveyed twice over 2 years, perceived supportive environments as either stable or improved; saw declines in their optimism, relative stability of depression, and problem behavior; and perceived improved social maturity. (Contains references.) (SM)

Discusses the difficulties experienced by fathers in carrying out what they accept as their parental responsibility to communicate with their children about sexuality. Includes examples from interviews with fathers, their wives, and their adolescent children. Finds that fathers' difficulties result from conflicts between traditional masculinity and involved fatherhood. (Author/SD)

Examined parents' and teenagers' evaluations of parents as sex educators; convergence among evaluations; and relevant communication factors. Found that teens evaluated mothers more positively than fathers, daughters evaluated mothers more positively than did sons, and parents evaluated themselves more positively than did their children. Concluded that to improve parents' effectiveness as sex educators, their communication skills should be improved. (Author/KB)

Examined whether relationship seriousness influenced youths' sexual behaviors and attitudes. Found that interpersonal context influenced sexual timetables of whites more than other groups. Some ethnic differences in sexual timetables were diminished when sociodemographic factors were controlled. Youth generally began sexual activities with a partner they did not know well, but considered sexual exploration more acceptable with a serious partner. (Author/KB)

High schoolers (N=298) completed surveys describing the frequency and importance of mother and father communication about 20 different sex-related topics. Adolescents reported infrequent communication that varied by domain and gender of parent and teen. When communication occurred, it was most frequently about development and societal concern or sexual safety. (Author/MKA)