Empty Promises? How State Procedural Rules Block LGBT Minors from Vindicating Their Substantive Rights

This article discusses the unique situations LGBT adolescents face and how a right of access to courts would help these minors, The United States Supreme Court jurisprudence regarding parents\u27 rights and minors\u27 rights, and how to resolve conflicts between the two, and discusses the current legal treatment of adolescence and the mature minor doctrine

Oncofertility program implementation increases access to fertility preservation options and assisted reproductive procedures for breast cancer patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/136021/1/jso24418.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/136021/2/jso24418_am.pd

Dynamic microRNA activity identifies therapeutic targets in trastuzumab‐resistant HER2+ breast cancer

MicroRNAs (miRNAs) are implicated in numerous physiologic and pathologic processes, such as the development of resistance to chemotherapy. Determining the role of miRNAs in these processes is often accomplished through measuring miRNA abundance by polymerase chain reaction, sequencing, or microarrays. We have developed a system for the large‐scale monitoring of dynamic miRNA activity and have applied this system to identify the contribution miRNA activity to the development of trastuzumab resistance in a cell model of HER2+ breast cancer. MiRNA activity measurements identified significantly different activity levels between BT474 cells (HER2+ breast cancer) and BT474R cells (HER2+ breast cancer cells selected for resistance to trastuzumab). We created a library of 32 miRNA reporter constructs, which were delivered by lentiviral transduction into cells, and miRNA activity was quantified by bioluminescence imaging. Upon treatment with the bioimmune therapy, trastuzumab, the activity of 11 miRNAs were significantly altered in parental BT474 cells, and 20 miRNAs had significantly altered activity in the therapy‐resistant BT474R cell line. A combination of statistical, network and classification analysis was applied to the dynamic data, which identified miR‐21 as a controlling factor in trastuzumab response. Our data suggested downregulation of miR‐21 activity was associated with resistance, which was confirmed in an additional HER2+ breast cancer cell line, SKBR3. Collectively, the dynamic miRNA activity measurements and analysis provided a system to identify new potential therapeutic targets in treatment‐resistant cancers.MicroRNAs (miRNAs) are often dysrgulated in cancer and can give rise to drug resistance. Identifying the mechanisms for resistance may lead to new This work used an array of miRNA activity reporters to identify miR‐21 as a mediator of trastuzumab resistance in breast cancer.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146392/1/bit26791.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146392/2/bit26791_am.pd

Microporous scaffolds loaded with immunomodulatory lentivirus to study the contribution of immune cell populations to tumor cell recruitment in vivo

Metastases are preceded by stochastic formation of a hospitable microenvironment known as the premetastatic niche, which has been difficult to study. Herein, we employ implantable polycaprolactone scaffolds as an engineered premetastatic niche to independently investigate the role of interleukin‐10 (IL10), CXCL12, and CCL2 in recruiting immune and tumor cells and impacting breast cancer cell phenotype via lentiviral overexpression. Lentivirus delivered from scaffolds in vivo achieved sustained transgene expression for 56 days. IL10 lentiviral expression, but not CXCL12 or CCL2, significantly decreased tumor cell recruitment to scaffolds in vivo. Delivery of CXCL12 enhanced CD45+ immune cell recruitment to scaffolds while delivery of IL10 reduced immune cell recruitment. CCL2 did not alter immune cell recruitment. Tumor cell phenotype was investigated using conditioned media from immunomodulated scaffolds, with CXCL12 microenvironments reducing proliferation, and IL10 microenvironments enhancing proliferation. Migration was enhanced with CCL2 and reduced with IL10‐driven microenvironments. Multiple linear regression identified populations of immune cells associated with tumor cell abundance. CD45+ immune and CD8+ T cells were associated with reduced tumor cell abundance, while CD11b+Gr1+ neutrophils and CD4+ T cells were associated with enhanced tumor cell abundance. Collectively, biomaterial scaffolds provide a tool to probe the formation and function of the premetastatic niche.Metastases are preceded by stochastic formation of a hospitable microenvironment known as the premetastatic niche, which has been difficult to study. Herein, we employ implantable polycaprolactone scaffolds as an engineered premetastatic niche to independently investigate the role of interleukin‐10 (IL10), CXCL12, and CCL2 in recruiting immune and tumor cells and impacting breast cancer cell phenotype via lentiviral overexpression.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153114/1/bit27179.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153114/2/bit27179_am.pd

Patient and provider factors associated with the noninitiation of tamoxifen for young women at high-risk for the development of breast cancer

We sought to identify factors associated with disparities in tamoxifen utilization among young patients at high- risk for developing breast cancer. We identified 67 premenopausal, high- risk women age 35- 45, without surgical prophylaxis, who did not initiate tamoxifen. Factors associated with noninitiation were examined. About 37% of patients had no documented provider- based discussion regarding initiation. Type of high- risk diagnosis was the only factor associated with a provider- based discussion (P = .03). For patients offered tamoxifen, primary reasons for noninitiation were perceived minimal benefit (66.7%), fertility concerns (16.7%), and concerns about side effects (7.1%). Implementation of comprehensive educational strategies regarding the benefits of tamoxifen should be facilitated to improve initiation among young high- risk patients.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/1/tbj13528_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/2/tbj13528.pd

Patient and provider factors associated with the noninitiation of tamoxifen for young women at high-risk for the development of breast cancer

We sought to identify factors associated with disparities in tamoxifen utilization among young patients at high- risk for developing breast cancer. We identified 67 premenopausal, high- risk women age 35- 45, without surgical prophylaxis, who did not initiate tamoxifen. Factors associated with noninitiation were examined. About 37% of patients had no documented provider- based discussion regarding initiation. Type of high- risk diagnosis was the only factor associated with a provider- based discussion (P = .03). For patients offered tamoxifen, primary reasons for noninitiation were perceived minimal benefit (66.7%), fertility concerns (16.7%), and concerns about side effects (7.1%). Implementation of comprehensive educational strategies regarding the benefits of tamoxifen should be facilitated to improve initiation among young high- risk patients.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/1/tbj13528_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/2/tbj13528.pd

Inherent change in MammoSite applicator three-dimensional geometry over time

Accelerated partial breast irradiation is commonly done with the MammoSite applicator, which requires symmetry to treat the patient. This paper describes three cases that were asymmetric when initially placed and became symmetric over time, without manipulation

Simple multi-level microchannel fabrication by pseudo-grayscale backside diffused light lithography

Photolithography of multi-level channel features in microfluidics is laborious and/or costly. Grayscale photolithography is mostly used with positive photoresists and conventional front side exposure, but the grayscale masks needed are generally costly and positive photoresists are not commonly used in microfluidic rapid prototyping. Here we introduce a simple and inexpensive alternative that uses pseudo-grayscale (pGS) photomasks in combination with backside diffused light lithography (BDLL) and the commonly used negative photoresist, SU-8. BDLL can produce smooth multi-level channels of gradually changing heights without use of true grayscale masks because of the use of diffused light. Since the exposure is done through a glass slide, the photoresist is cross-linked from the substrate side up enabling well-defined and stable structures to be fabricated from even unspun photoresist layers. In addition to providing unique structures and capabilities, the method is compatible with the "garage microfluidics" concept of creating useful tools at low cost since pGS BDLL can be performed with the use of only hot plates and a UV transilluminator: equipment commonly found in biology labs. Expensive spin coaters or collimated UV aligners are not needed. To demonstrate the applicability of pGS BDLL, a variety of weir-type cell traps were constructed with a single UV exposure to separate cancer cells (MDA-MB-231, 10-15 ??m in size) from red blood cells (RBCs, 2-8 ??m in size) as well as follicle clusters (40-50 ??m in size) from cancer cells (MDA-MB-231, 10-15 ??m in size)close1

In Vivo Capture and Label-Free Detection of Early Metastatic Cells

Breast cancer is a leading cause of death for women, with mortality resulting from metastasis. Metastases are often detected once tumour cells affect the function of solid organs, with a high disease burden limiting effective treatment. Here we report a method for the early detection of metastasis using an implanted scaffold to recruit and capture metastatic cells in vivo, which achieves high cell densities and reduces the tumour burden within solid organs 10-fold. Recruitment is associated with infiltration of immune cells, which include Gr1hiCD11b+cells. We identify metastatic cells in the scaffold through a label-free detection system using inverse spectroscopic optical coherence tomography, which identifies changes to nanoscale tissue architecture associated with the presence of tumour cells. For patients at risk of recurrence, scaffold implantation following completion of primary therapy has the potential to identify metastatic disease at the earliest stage, enabling initiation of therapy while the disease burden is low

The Safe Use of a PTEN Inhibitor for the Activation of Dormant Mouse Primordial Follicles and Generation of Fertilizable Eggs

Primordial ovarian follicles, which are often present in the ovaries of premature ovarian failure (POF) patients or are cryopreserved from the ovaries of young cancer patients who are undergoing gonadotoxic anticancer therapies, cannot be used to generate mature oocytes for in vitro fertilization (IVF). There has been very little success in triggering growth of primordial follicles to obtain fertilizable oocytes due to the poor understanding of the biology of primordial follicle activation.We have recently reported that PTEN (phosphatase and tensin homolog deleted on chromosome ten) prevents primordial follicle activation in mice, and deletion of Pten from the oocytes of primordial follicles leads to follicular activation. Consequently, the PTEN inhibitor has been successfully used in vitro to activate primordial follicles in both mouse and human ovaries. These results suggest that PTEN inhibitors could be used in ovarian culture medium to trigger the activation of primordial follicle. To study the safety and efficacy of the use of such inhibitors, we activated primordial follicles from neonatal mouse ovaries by transient treatment with a PTEN inhibitor bpV(HOpic). These ovaries were then transplanted under the kidney capsules of recipient mice to generate mature oocytes. The mature oocytes were fertilized in vitro and progeny mice were obtained after embryo transfer.Long-term monitoring up to the second generation of progeny mice showed that the mice were reproductively active and were free from any overt signs or symptoms of chronic illnesses. Our results indicate that the use of PTEN inhibitors could be a safe and effective way of generating mature human oocytes for use in novel IVF techniques