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ErbB3, a member of the ErbB family of receptor tyrosine kinases, is a potent activator of phosphatidyl inositol-3 kinase (PI3K) and mammalian target of rapamycin (mTOR) signaling, driving tumor cell survival and therapeutic resistance in breast cancers. In luminal breast cancers, ErbB3 upregulation following treatment with the antiestrogen fulvestrant enhances PI3K/mTOR-mediated cell survival. However, the mechanism by which ErbB3 is upregulated in fulvestrant-treated cells is unknown. We found that ErbB3 protein levels and cell surface presentation were increased following fulvestrant treatment, focusing our attention on proteins that regulate ErbB3 at the cell surface, including Nrdp1, NEDD4 and LRIG1. Among these, only LRIG1 correlated positively with ERα, but inversely with ErbB3 in clinical breast cancer data sets. LRIG1, an estrogen-inducible ErbB downregulator, was decreased in a panel of fulvestrant-treated luminal breast cancer cells. Ectopic LRIG1 expression from an estrogen-independent promoter uncoupled LRIG1 from estrogen regulation, thus sustaining LRIG1 and maintaining low ErbB3 levels in fulvestrant-treated cells. An LRIG1 mutant lacking the ErbB3 interaction motif was insufficient to downregulate ErbB3. Importantly, LRIG1 overexpression improved fulvestrant-mediated growth inhibition, whereas cells expressing the LRIG1 mutant were poorly sensitive to fulvestrant, despite effective ERα downregulation. Consistent with these results, LRIG1 expression correlated positively with increased disease-free survival in antiestrogen-treated breast cancer patients. These data suggest that ERα-dependent expression of LRIG1 dampens ErbB3 signaling in luminal breast cancer cells, and by blocking ERα activity with fulvestrant, LRIG1 is decreased thus permitting ErbB3 accumulation, enhanced ErbB3 signaling to cell survival pathways and blunting therapeutic response to fulvestrant.

Background: Optimal maternal nutrition is associated with better pregnancy and infant outcomes. Culinary nutrition programmes have potential to improve diet quality during pregnancy. Therefore, this research aimed to understand the experiences of cooking and the wants and needs of pregnant women regarding a cooking and food skills programme in the United Kingdom (UK) and Republic of Ireland (ROI)., Methods: Online focus group discussions with pregnant women and those who had experienced a pregnancy in the UK or ROI were conducted between February and April 2022. Two researchers conducted a thematic analysis. Seven focus groups with ROI participants (n = 24) and six with UK participants (n = 28) were completed., Results: Five themes were generated. These were (1) cooking during pregnancy: barriers, motivators and solutions; (2) food safety, stress and guilt; (3) need for cooking and food skills programmes and desired content; (4) programme structure; (5) barriers and facilitators to programme participation. Overall, there was support for a programme focusing on broad food skills, including planning, food storage, using leftovers and to manage pregnancy-specific physiological symptoms such as food aversions. Participants emphasised the importance of inclusivity for a diverse range of people and lifestyles for programme design and content., Conclusions: Current findings support the use of digital technologies for culinary nutrition interventions, potentially combined with in-person sessions using a hybrid structure to enable the development of a support network., (© 2024 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: Prepectoral tissue expander (TE) placement for two-stage postmastectomy reconstruction is usually performed in conjunction with insertion of acellular dermal matrix (ADM). However, the effects of ADM use on TE loss or other early complications remain unknown. Therefore, the aim of this study was to compare early postoperative complications in patients who underwent prepectoral breast implant reconstruction with or without ADM use., Methods: The authors performed a retrospective cohort study of all patients at their institution who underwent prepectoral breast reconstruction from January of 2018 to June of 2021. The primary outcome was TE loss within 90 days of surgery; secondary outcomes included other complications such as infection, TE exposure, mastectomy skin flap necrosis requiring revision, and seroma., Results: Data on 714 patients with 1225 TEs (1060 with ADM and 165 without) were analyzed. Baseline demographics did not differ by ADM use, although mastectomy breast tissue weight was higher in patients without ADM (750.3 g versus 540.8 g; P < 0.001). Rates of TE loss were similar in reconstructions with (3.8%) ADM and without (6.7%; P = 0.09). We also did not find differences in the rates of secondary outcomes between cohorts., Conclusions: ADM use had no statistically significant effect on early complication rates among patients undergoing breast reconstruction with prepectoral TEs. Still, this study was underpowered, and data trended toward statistical significance; thus, larger studies are required in the future. Additional research and randomized studies should focus on larger cohorts and examine long-term complications such as capsular contracture and implant malposition., Clinical Question/level of Evidence: Therapeutic, III., (Copyright © 2023 by the American Society of Plastic Surgeons.)

Purpose: Historically, robotic-assisted radical prostatectomy is accompanied by an inpatient hospital admission. The COVID-19 pandemic necessitated a transition to same-day discharge robotic-assisted radical prostatectomy in some centers to free up critically needed inpatient beds. This study aims to compare complications, total health care costs, and patient satisfaction for same-day discharge vs inpatient robotic-assisted radical prostatectomy., Materials and Methods: We compared 392 consecutive robotic-assisted radical prostatectomies performed as same-day discharge (n = 206) vs inpatient (n = 186) from February 2020 to November 2022 at 2 academic medical centers. We utilized propensity score analysis to assess the impact of same-day discharge vs inpatient robotic-assisted radical prostatectomy on 30-day complications (primary outcome). Time-driven activity-based costing analysis was applied to compare total costs of robotic-assisted radical prostatectomy care, and we administered a validated Patient Satisfaction Outcome Questionnaire to compare satisfaction scores., Results: Inpatient robotic-assisted radical prostatectomy patients were more likely to be older, self-reported Black race or Hispanic ethnicity, and have higher American Society of Anesthesiologists classification. Complication rates were nonsignificantly lower for same-day discharge vs inpatient robotic-assisted radical prostatectomy (OR 0.87, 95% CI 0.35 to 2.21; P = .8). Same-day discharge vs inpatient robotic-assisted radical prostatectomy demonstrated a $2106 (19%) overall cost reduction. Median satisfaction survey scores were similar, and a clinically significant difference can be excluded., Conclusions: Same-day discharge robotic-assisted radical prostatectomy is cost-effective and should be the preferred approach in appropriately selected patients.

Background: This novel study forms part of a larger research programme seeking an improved understanding of aspects of the owned dog population in Ireland. Dog welfare organisations (DWOs) in Ireland are recognised as an instrumental pillar of the animal welfare sector with some receiving substantial public funding. We conducted a survey of DWOs in Ireland (n = 39) to gain a better understanding of their role and function, including their policies and procedures and the rehoming of dogs to other regions. In addition, we wanted to get a better understanding of the challenges experienced by DWOs in fulfilling their role and their perspectives on potential solutions to these challenges. The survey questions consisted of closed and open-ended items. Closed items were analysed quantitively; open-ended items were analysed thematically., Results: Most DWOs (> 80%) had written protocols for important welfare actions including rehoming procedures, assessment of owner suitability and euthanasia. DWOs sent dogs to Northern Ireland (13%), Great Britain (38.5%) and to other countries outside the United Kingdom (36%, including Germany, Sweden, Italy, the Netherlands and Czechia). Reported challenges included a general lack of funding, limited public awareness of the importance of dog welfare and insufficient capacity to handle dog numbers. To address these challenges, the DWOs highlighted the potential contribution of subsidised programmes and access to resources to educate potential owners. In a further qualitative evaluation to capture perceptions of appropriate solutions by DWOs, several themes emerged, relating to legislation, education, an overwhelmed workforce, and funding., Conclusions: This study provides important insights into the roles and functions of DWOs and challenges they experience in Ireland. It is hoped that the findings from this research will inform future research investigating potential solutions to these challenges as well as the development of policy in Ireland., (© 2023. Veterinary Ireland.)

In dairy farming, mastitis treatment is the most common reason for antimicrobial use. The overuse or misuse of antibiotics in agriculture has been associated with the development and spread of antimicrobial resistance (AMR). Traditionally, blanket dry cow therapy (BDCT), in which all cows receive antibiotic treatment, was used prophylactically to prevent and manage disease spread. In recent years, there has been a move toward selective dry cow therapy (SDCT), in which only clinically infected cows are treated with antibiotics. This study aimed to explore farmer attitudes toward antibiotic use (ABU), using the COM-B (Capability-Opportunity-Motivation-Behavior) model as a framework, to identify predictors of changing behavior toward SDCT and suggest interventions to encourage its uptake. Participant farmers (n = 240) were surveyed online between March and July 2021. Five items were found to be significant predictors of farmers having stopped BDCT: (1) having lower knowledge of AMR, (2) greater awareness of AMR and ABU (Capability), (3) feeling social pressure to reduce ABU (Opportunity), and (4) having greater professional identity, and (5) having positive emotions associated with stopping BDCT (Motivation). Direct logistic regression found that these 5 factors explained between 22 and 34.1% of the variance in making changes to BDCT practices. Additionally, objective knowledge was not correlated with current positive antibiotic practices, and farmers often perceived their antibiotic practices as more responsible than they actually were. A multifaceted approach, encompassing each of the predictors highlighted, should be taken to encourage farmer behavior change in relation to stopping BDCT. Additionally, as farmers' perceptions of their own behaviors may not align with their actual practices, awareness raising of what constitutes "responsible" behavior should be targeted at dairy farmers to motivate them to take action and adopt more responsible antibiotic practices., (The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Background: In the coming years, major governance changes in the form of policy directives and regulations will catalyse major top-down change with respect to animal health on European farms in an effort to combat the OneHealth threat of antimicrobial resistance. This top-down approach must be met with bottom-up strategies to ensure target actors (namely, farmers and vets) are supported and motivated to change their practices, thus, avoiding unintended consequences of forced change. Although much behavioural research has explored the factors influencing antimicrobial practices on farms, a gap exists translating these findings into evidence-based behaviour change interventions that can be put into practice. The current study aims to fill this gap. It provides insights into identifying, understanding, and changing the behaviours of farmers and veterinarians with respect to the responsible use of antimicrobials in farming., Results: Through an inter-disciplinary and multi-actor approach, the study combines scientific knowledge from the behavioural sciences and animal health sciences, coupled with tacit knowledge from a co-design, participatory approach to recommend seven behaviour change interventions that can help to support good practices amongst farmers and vets, with respect to animal health, and reduce the use of antimicrobials on farms. The behaviour change interventions include message framing; OneHealth awareness campaign; specialised communications training; on-farm visual prompts and tools; social support strategies (for both farmers and vets); and antimicrobial use monitoring. The study details each intervention with respect to their evidence base and scientific concept, grounded in behavioural science, along with stakeholder feedback on design and delivery of the interventions., Conclusions: These behaviour change interventions can be taken, adapted, and put into practice by the agri-food community to support good animal health practices and responsible antimicrobial use on farms., (© 2023. The Author(s).)

Employing a theoretical model of human behaviour (COMB), the current study explores the factors influencing veterinarians' engagement with antibiotic use stewardship on Irish dairy farms. One-to-one semi structured interviews were carried out by telephone with 12 veterinarians whose daily work focused on dairy cattle. A thematic analysis approach was undertaken. The identified themes and sub-themes were then mapped to the COM-B model. This study identified challenges faced by veterinarians when trying to prescribe responsibly which included lack of training to encourage farmer behaviour change, issues with laboratory testing, pressures from farmers to prescribe antimicrobials, concern for animal welfare and farmers going elsewhere for prescriptions. Having a good knowledge of AMR, peers as an advice source, potential financial benefits for farmers as a result of reduced antimicrobial costs and accepting a shared responsibility for AMR, facilitate veterinarians in their role as antimicrobial stewards. The barriers and facilitators identified as influencing veterinarians' capability, opportunity and motivation to responsibly prescribe antimicrobials formed the basis for a number of practical recommendations which should be considered by advisory and policy making teams. Recommendations include; continuous training for veterinarians on AMR and alternatives to overcome the barriers faced when trying to promote reduced AMU, veterinarian peer support groups to improve confidence in their knowledge and decision making to minimise the effect of client pressures/expectations, setting up collaborative farmer and veterinarian working groups to promote a transparent working relationship and the development of affordable and efficient diagnostic and susceptibility testing., Competing Interests: Declaration of Competing Interest None to disclose., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This novel qualitative study identifies challenges and opportunities to improve dog welfare in Ireland, as perceived by dog welfare organisations (DWOs), a previously underutilised stakeholder. This study sought the views of this predominantly voluntary sector of the next steps for policy and action in dog welfare, in light of the effects of the "puppy pandemic", increased costs and COVID-19 restrictions. An integrated online focus group and interview design involving DWOs was analysed using inductive thematic analysis. Thematic analysis identified 2 key themes: (1) Key challenges and solutions in general dog welfare and (2) Challenges and opportunities in the welfare organisation sector. DWOs perceived poor public awareness of appropriate dog-husbandry, inadequate legislation enforcement, negative impact of puppy farms, and increased financial and volunteer burden. DWOs helped construct a best practice rehoming pathway, identified how overall standards could be improved and recommendations to enhance dog welfare. The DWOs perceived an increased numbers of households acquiring dogs, difficulties in rehoming, and financial challenges as threatening their viability as organisations and Irish dog welfare. Greater enforcement of legislation, greater communication between organisations and the government, and more media awareness were seen as helpful by the DWOs to improve dog welfare standards and their organisations.

Background: Antimicrobial resistance (AMR 1 ) is of increasing concern in livestock production as usage has been linked to the emergence of resistant bacteria in humans. The intricacies of the UK pig production system alongside limited research into farmers' perceptions has highlighted the need to investigate farmers' perceptions and attitudes to gain an understanding of the factors that influence antimicrobial use (AMU 2 ). Therefore, this study aimed to qualitatively explore pig farmers' views of AMU, AMR, and to identify the specific factors that influence antibiotic administration practices in the UK pig industry., Methods: Fifteen semi-structured interviews were conducted with independent pig farmers in Northern Ireland and vertically integrated pig farmers in England, eliciting perceptions towards AMU and AMR and exploring administration practices. The interviews were professionally transcribed and coded using thematic analysis., Results: At the outset, AMU practices were ascertained creating the first major theme: (1) current AMU practices. Three major themes were identified as influencing pig farmers' practices and behaviour towards AMR: (2) awareness and attitudes towards AMR; (3) perceived alternatives to AMU and (4) barriers to changing current farming practices., Conclusions: Our findings highlight the complexity of the UK pork industry and the myriad of factors that drive AMU. AMU in the pork sector is multifactorial as drivers of administration are diverse and differ between farms. Therefore, it is recommended that farms are assessed on an individual basis in collaboration with a veterinarian to determine the most effective tailor-made antibiotic reduction techniques., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (Crown Copyright © 2022. Published by Elsevier B.V. All rights reserved.)

Increasing awareness of antimicrobial resistance (AMR) has raised concerns surrounding antimicrobial use (AMU) in food-producing animals and has focused attention towards livestock production free from antibiotic use. As antibiotic-free livestock production proliferates in the UK, there is an increasing need to implement a system, such as the use of a QR code, to provide consumers with reliable antibiotic information while ensuring that animal welfare standards are upheld. Subsequently, this study aims to explore UK consumers' perceptions and purchase intention towards QR code labelled pork, and to identify determinants of its purchase, incorporating various theoretical constructs from the Theory of Planned Behaviour. Based on results, consumers' perceptions, perceived control, and attitudes towards QR code labelled pork are the main determinants of purchase intention. QR code labelled pork may offer a suitable alternative to antibiotic-free labelling as it provides consumers with antibiotic information without inadvertently communicating that conventionally produced pork is unsafe., (© 2022. Crown.)

As a recent addition to the UK market, it is unknown how 'raised without antibiotics' labelled products are perceived or how they influence consumer food choice. Understanding consumers' perceptions towards the 'raised without antibiotics' label can determine knowledge of the label and what drives them to purchase products raised without antibiotics. Subsequently, using an online questionnaire with 1000 participants aged 18-92 years old, this study explored UK consumers' perceptions and willingness to buy 'raised without antibiotics' labelled pork, and examined their knowledge of antimicrobial use and antimicrobial resistance (AMR 1 ). Cross-sectional data were collected investigating consumer perceptions and willingness to purchase 'raised without antibiotics' labelled pork and hierarchical multiple regression analyses were conducted. Respondents had high levels of knowledge towards EU regulations however, their awareness of AMR was limited. Behavioural beliefs concerning animal welfare and product quality were the main predictors of consumers' willingness to buy 'raised without antibiotics' labelled pork, followed by pork purchasing habits based on animal welfare qualities. Additionally, consumers who were more concerned that AMR would personally affect them, as well as those who favoured antimicrobial use for the preservation of animal welfare were willing to buy this product. Perceptions towards animal antimicrobial use acceptance, beliefs that 'raised without antibiotics' labelled pork is expensive, and a lack of consideration for extrinsic qualities when purchasing pork i.e., appearance, had a negative influence on willingness to buy. Moderate perceptions towards 'raised without antibiotics' labelled pork, lack of knowledge of agricultural antimicrobial use, and the subsequent confusion surrounding this label suggests that it is necessary to explore other labelling options to provide consumers with the information they desire while also safeguarding animal welfare., (Crown Copyright © 2022. Published by Elsevier Ltd. All rights reserved.)

There has been increased public interest and concerns in issues such as farm animal welfare (FAW) on the island of Ireland, stoked in part by political and governance changes, such as Brexit and COVID-19. Front-of-pack food labelling represents a primary information channel for many people. In advance of considering formalised food labelling schemes, specifically relating to FAW, it is important to ensure an up-to-date understanding of current consumer perceptions of FAW. With this aim, the current study utilised a mixed methodology. Nine focus group discussions ( n = 41) and an online survey ( n = 972) with food consumers in Ireland and Northern Ireland explored perceptions of FAW. Results suggest that overall perceptions of FAW are high, and consumers perceive FAW to have improved in the last decade. Quantitative (ANOVA) and qualitative results show variations in perception of FAW between sectors. Results from the focus group discussions identified factors underlying consumers' perception of FAW: the living conditions of the animal, size and intensity of the farm, national standards and schemes, and visibility. Information insufficiencies and knowledge gaps were identified. The findings are discussed in relation to policy implications for the role of public engagement, front-of-pack welfare labelling, and quality assurance schemes.

Cooking interventions are emphasised as promising methods for changing children's food-related preferences, attitudes and behaviours. However, criticisms remain, including relatively weak intervention designs; lack of validated tools, and limited underpinning theory. Therefore, this research aimed to assess the effectiveness of a theory-driven co-created children's cooking intervention with underpinning rationale for the content, using a validated measure. 'Cook Like A Boss' was a one week, controlled cooking camp style intervention. Thirty two children aged 10-12 years participated. The intervention was developed using the Cook-Ed model for planning, implementing and evaluating cooking programs and was underpinned by Social Learning theory and Experiential Learning theory. The intervention content was developed in a co-creation process with the research team, a chef and the children. The underlying developmental skills required for the recipes were assessed to ensure they were age-appropriate. Children completed pre and post measurements including perceived cooking competence. Process evaluations were also gathered. There was a significant increase in perceived cooking competence after the intervention (P < 0.05) and a significant difference between the intervention and control group (P < 0.001). Additionally, process evaluations found the intervention to have high fidelity and dose received and that it was received extremely positively. The 'Cook Like A Boss' children's cooking camp was an effective multidisciplinary co-created intervention with a vulnerable group, e.g. children, guided by a model and underpinned by theory. The content was developed to ensure it was age-appropriate and achievable for the children. This approach could act as a template for future children's cooking interventions., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Selective dry cow therapy (SDCT) is widely promoted in dairy farming as a method to reduce antimicrobial usage. New legislation introduced by the European Union will restrict and regulate the prophylactic and metaphylactic use of antibiotics from January 2022. Blanket dry cow therapy continues to be a practice engaged in by many farmers in Ireland and for many of these farmers, moving towards SDCT would require a significant infrastructural, behavioural and/or cultural change on their farm. Existing research has reported the important need to understand farmers' motivations to initiate any substantial behaviour change. However, it is currently unknown what farmers know, think and believe about SDCT in Ireland. The aim of this study was to use qualitative methods to explore what barriers and facilitators farmers perceived to exist with SDCT and explore if they had chosen to implement SDCT after voluntarily participating in a funded dry cow consult with a trained veterinarian, with the objective of maximising the dry period udder health performance and moving safely to SDCT., Results: In this study, 19 farmers were contacted, and telephone interviews were conducted regarding farmers' beliefs about the consequences of SDCT. Audio recordings were professionally transcribed verbatim and analysed qualitatively using an inductive thematic analysis. The analysis identified 6 barriers and 6 facilitators to implementing SDCT. A significant fear of increasing mastitis incidence was evident that caused reluctance towards SDCT and reliance on antibiotics. Mixed perceptions on SDCT, infrastructure limitations, a perceived lack of preventive advice as well as peer influence were presented as barriers to SDCT. Farmers can build confidence when a graded approach to SDCT is implemented, which could help overcome the fear of SDCT and reliance on antibiotics. Regulatory pressure, high standards of farm hygiene and use of targeted veterinary consults were found to facilitate SDCT. Education was suggested to motivate farmers in the future uptake of SDCT. Despite cited negative influences, peer influence can be utilised to encourage the farming community., Conclusions: This study prioritises areas to facilitate the major behaviour change required as a dairy industry in order to move from blanket dry cow therapy to SDCT., (© 2021. The Author(s).)

Study Objectives: Schools are an important setting to teach and reinforce positive health behaviors such as sleep, however, research that incorporates the student perspective of school-based sleep promotion initiatives is limited. This study explored student's perceptions of sleep behavior (how they understood and valued positive and negative sleep behaviors) and determined if and how students translate school-based sleep promotion to the home., Methods: Forty-five grade 4 and 5 children (aged 9-11 years) were purposefully sampled from 3 schools participating in the Alberta Project Promoting healthy Living for Everyone in schools (APPLE) in Edmonton, Canada. Using focused ethnography as the method and photovoice as a data generating strategy, qualitative in-depth information was generated through photo-taking and one-on-one interviews. Data were analyzed in an iterative, cyclical process using latent content analysis techniques., Results: Four themes related to students' perception of sleep behavior within the context of a school-based sleep promotion initiative were identified: sleep is "healthy for your body and brain," sleep habits are rooted in the home environment, school experiences shape positive sleep habits at home, and students translate sleep promotion home if they think it is useful or would be acceptable to the family., Conclusion and Implications: School-based sleep promotion interventions that are grounded in the comprehensive school health (CSH) approach hold promise for successfully shaping student sleep behavior. To promote health and academic success in children, future interventions should include home-school partnerships that address child sleep across multiple critical learning environments., (Copyright © 2021 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Covid-19 is a OneHealth crisis with far-reaching and unexpected impacts on many aspects of society. Previous OneHealth issues, such as antimicrobial resistance (AMR), have not received a similar level of attention or action from the public despite representing significant public health and economic threats to society. The current study aimed to explore whether the Covid-19 pandemic may act as a catalyst to increase public awareness related to OneHealth issues, in particular, AMR. This short paper presents overview findings from a survey carried out in September 2020 with a representative sample of food consumers on the island of Ireland ( n = 972). The survey revealed Covid-19 had increased awareness of AMR amongst 47% of respondents; increased awareness of connected animal and human health amongst 43% of respondents; and increased awareness of animal welfare information on food labels amongst 34% of respondents. A cluster analysis revealed five distinct consumer segments impacted differently by Covid-19. These segments differed in their levels of objective and subjective knowledge of antibiotic use practises in farming, AMR risk perception, and attributions of responsibility for action on AMR. Findings are discussed with respect to future efforts by the agri-food sector to communicate with the public about AMR and responsible antibiotic use in farming, with particular emphasis on the implications for strategies that incorporate front-of-pack labelling., 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 © 2021 Regan, Sweeney, McKernan, Benson, Hyland and Dean.)

Abstract: Each year, hundreds of thousands of women undergo aesthetic or reconstructive breast implant surgery. Clinicians and patients must be aware of the benefits and risks of this surgery. Recently, the FDA suggested a recall of certain textured breast implants because of a link between these implants and a rare form of lymphoma, now referred to as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). This malignancy has an indolent course and an excellent prognosis when detected and treated early. This article reviews BIA-ALCL, addresses public safety advisories, and emphasizes protocol that all clinicians should follow when encountering a patient with textured breast implants., (Copyright © 2021 American Academy of Physician Assistants.)

Background: Learning cooking skills during childhood and adolescence is associated with positive dietary outcomes in adulthood as well as being tracked from adolescence to adulthood. In addition studies have found that perceived competence to be a greater motivator to perform a behaviour than actual competence. However, a lack of validated tools that effectively measure behavioural and dietary changes including cooking confidence in children is a limitation. Therefore, this research aimed to develop and validate age-appropriate perceived cooking competence measures for younger and older primary school aged children., Methods: Two measures of perceived Cooking Competence (CooC11 and CooC7) for older (8-12 years) and younger (6-7 years) children were developed from a critical evaluation of publically available recommendations and expert consultation. The cooking skills within the measures were illustrated by a graphic designer in consultation with a chef and reviewed in an iterative manner by the research team. The measures were piloted for clarity, ease of use and initial face validity. Multiple studies were used for both CooC11 and CooC7 to establish psychometric properties of the measures, temporal stability, internal consistency reliability, construct validity, as well as responsiveness to change for CooC11. Analysis included Exploratory Factor Analysis, Confirmatory Factor Analysis, Intraclass Correlation Coefficients, Pearson's Correlations, ANOVAs and Cronbach's Alphas., Results: Both measures had high levels of face validity and received positive user feedback. Two factors were shown in both measures with the measures showing excellent temporal stability (ICC > 0.9) and good internal consistency (Cronbach's Alphas > 0.7). Both measures showed initial discriminant validity, with significant differences (P< 0.001) between those who reported assisting their parents with dinner preparation and those who did not. Additionally, CooC11 was significantly correlated with an adult cooking measure and had a significant responsiveness to change (P< 0.01)., Conclusions: The CooC11 and CooC7 are the first validated age-appropriate measures for assessing children's perceived Cooking Competence for ages 8-12 and 6-7 years respectively. They can be used to evaluate the efficacy of children's cooking intervention studies or school nutrition education programmes.

Purpose: The trace element iodine is a vital constituent of thyroid hormones. Iodine requirements increase during pregnancy, when even mild deficiency may affect the neurocognitive development of the offspring. Urinary iodine concentration (UIC) is the means of assessing iodine status in population surveys; a median UIC of 100-199 µg/L is deemed sufficient in a non-pregnant population. Milk is the main dietary source of iodine in the UK and Ireland., Methods: We surveyed the iodine status of 903 girls aged 14-15 years in seven sites across the island of Ireland. Urine iodine concentration was measured in spot-urine samples collected between March 2014 and October 2015. Food group intake was estimated from iodine-specific food-frequency questionnaire. Milk-iodine concentration was measured at each site in summer and winter., Results: The median UIC overall was 111 µg/L. Galway was the only site in the deficient range (median UIC 98 µg/L). All five of the Republic of Ireland sites had UIC ≤ 105 µg/L. In the two sites surveyed twice, UIC was lower in summer vs winter months [117 µg/L (IQR 76-165) vs 130 µg/L (IQR 91-194) (p < 0.01)]. Milk samples collected from Galway and Roscommon had a lower mean iodine concentration than those from Derry/Londonderry (p < 0.05). Milk intake was positively associated with UIC (p < 0.001)., Conclusions: This is the largest survey of its kind on the island of Ireland, which currently has no iodine-fortification programme. Overall, the results suggest that this young female population sits at the low end of sufficiency, which has implications if, in future, they enter pregnancy with borderline status.

Objective: Sedentary behaviours, physical inactivity, and poor diets in Canadian children are a major public health problem. Comprehensive school health (CSH) recognizes the importance of school and home collaboration; however, it is unknown how health behaviours promoted in school are adopted at home. The purpose of this research was to explore student perceptions of the translation of an intervention taking a CSH approach in Alberta, Canada, into the home environment., Methods: The guiding method was focused ethnography, using photovoice as the data generation strategy. Grades 5 and 6 students were purposively sampled (n = 25), and asked to take photos of what CSH looks like in their home environment. Subsequent one-on-one interviews were conducted as part of the photovoice process to gain a deeper understanding of student perceptions., Results: Two main themes emerged: students embraced the CSH philosophy, and students are driving change to create a healthy home culture. The underlying concept of leadership and independence was necessary for students to impact their health and the health of family members. Results demonstrated that students are catalyzing positive changes in the home environment by supporting changes in the home food environment, trying new things, facilitating improvements to healthy eating and active living, and monitoring unhealthy behaviours., Conclusion: This study illustrates students' abilities to positively impact the home environment as a result of their involvement in CSH. Student leadership and independence should be promoted and emphasized in CSH to facilitate transition of health behaviours into the home environment.

Estrogen receptor-α positive (ERα+) breast cancer accounts for approximately 70-80% of the nearly 25,0000 new cases of breast cancer diagnosed in the US each year. Endocrine-targeted therapies (those that block ERα activity) serve as the first line of treatment in most cases. Despite the proven benefit of endocrine therapies, however, ERα+ breast tumors can develop resistance to endocrine therapy, causing disease progression or relapse, particularly in the metastatic setting. Anti-apoptotic Bcl-2 family proteins enhance breast tumor cell survival, often promoting resistance to targeted therapies, including endocrine therapies. Herein, we investigated whether blockade of anti-apoptotic Bcl-2 family proteins could sensitize luminal breast cancers to anti-estrogen treatment. We used long-term estrogen deprivation (LTED) of human ERα+ breast cancer cell lines, an established model of sustained treatment with and acquired resistance to aromatase inhibitors (AIs), in combination with Bcl-2/Bcl-xL inhibition (ABT-263), finding that ABT-263 induced only limited tumor cell killing in LTED-selected cells in culture and in vivo. Interestingly, expression and activity of the Bcl-2-related factor Mcl-1 was increased in LTED cells. Genetic Mcl-1 ablation induced apoptosis in LTED-selected cells, and potently increased their sensitivity to ABT-263. Increased expression and activity of Mcl-1 was similarly seen in clinical breast tumor specimens treated with AI + the selective estrogen receptor downregulator fulvestrant. Delivery of Mcl-1 siRNA loaded into polymeric nanoparticles (MCL1 si-NPs) decreased Mcl-1 expression in LTED-selected and fulvestrant-treated cells, increasing tumor cell death and blocking tumor cell growth. These findings suggest that Mcl-1 upregulation in response to anti-estrogen treatment enhances tumor cell survival, decreasing response to therapeutic treatments. Therefore, strategies blocking Mcl-1 expression or activity used in combination with endocrine therapies would enhance tumor cell death.

An estimated 40,000 deaths will be attributed to breast cancer in 2016, underscoring the need for improved therapies. Evading cell death is a major hallmark of cancer, driving tumor progression and therapeutic resistance. To evade apoptosis, cancers use antiapoptotic Bcl-2 proteins to bind to and neutralize apoptotic activators, such as Bim. Investigation of antiapoptotic Bcl-2 family members in clinical breast cancer datasets revealed greater expression and more frequent gene amplification of MCL1 as compared with BCL2 or BCL2L1 (Bcl-xL) across three major molecular breast cancer subtypes, Luminal (A and B), HER2-enriched, and Basal-like. While Mcl-1 protein expression was elevated in estrogen receptor α (ERα)-positive and ERα-negative tumors as compared with normal breast, Mcl-1 staining was higher in ERα + tumors. Targeted Mcl-1 blockade using RNAi increased caspase-mediated cell death in ERα + breast cancer cells, resulting in sustained growth inhibition. In contrast, combined blockade of Bcl-2 and Bcl-xL only transiently induced apoptosis, as cells rapidly acclimated through Mcl-1 upregulation and enhanced Mcl-1 activity, as measured in situ using Mcl-1/Bim proximity ligation assays. Importantly, MCL1 gene expression levels correlated inversely with sensitivity to pharmacologic Bcl-2/Bcl-xL inhibition in luminal breast cancer cells, whereas no relationship was seen between the gene expression of BCL2 or BCL2L1 and sensitivity to Bcl-2/Bcl-xL inhibition. These results demonstrate that breast cancers rapidly deploy Mcl-1 to promote cell survival, particularly when challenged with blockade of other Bcl-2 family members, warranting the continued development of Mcl-1-selective inhibitors for targeted tumor cell killing. Implications: Mcl-1 levels predict breast cancer response to inhibitors targeting other Bcl-2 family members, and demonstrate the key role played by Mcl-1 in resistance to this drug class. Mol Cancer Res; 15(3); 259-68. ©2016 AACR ., (©2016 American Association for Cancer Research.)