Factors Influencing Uptake of Risk-Reducing Salpingo-Oophorectomy by BRCA1 and BRCA2 Mutation Carriers

Germline mutations in the BRCA1 and BRCA2 genes are associated with significantly increased risks for ovarian cancer. The National Comprehensive Cancer Network (NCCN) currently recommends that female BRCA mutation carriers undergo risk-reducing salpingo-oophorectomy (RRSO) after age 35; however, not all women elect this option. The purpose of this study was to prospectively survey women with BRCA mutations currently undergoing ovarian cancer screening about their intention to have an RRSO and the various factors influencing their decision. Of the 26 women who completed our survey, 26 (100%, CI: 86.8-100) plan to undergo an RRSO in their lifetime. The average woman reported 6.7 motivations and 2.9 barriers to RRSO, indicating that in our population women tend to have more reasons for electing, rather than avoiding, this surgery. We further found that while most women appeared to share the same motivations for surgery, they often had unique barriers that were not common to others. The most important reasons in favor of surgery included a desire to reduce one’s risk for ovarian cancer and live longer for family members. The most important barrier to RRSO was fear of the symptoms related to menopause. We believe these results will assist healthcare providers when discussing the option of RRSO with BRCA mutation carriers undergoing ovarian cancer screening

The Role of Estrogen Receptor Beta in Neonatal Oocyte Development

Establishment of the pool of primordial follicles is essential for reproduction. Shortly after their formation, female germ cells undergo a series of incomplete cell divisions resulting in clusters called cysts. After birth, mouse germ cell cysts break down into individual oocytes (a process referred to as cyst breakdown) that are surrounded by somatic pre-granulosa cells to form primordial follicles. During the process of cyst breakdown, a subset of oocytes in each cyst dies with only a third of the initial number of oocytes surviving. The mechanisms controlling cyst breakdown and programmed cell death are unknown. Previous studies have focused on the treatment of neonatal mice with estrogenic compounds and the effect this has in the adult ovary. Estrogen signals are received by two receptors: Estrogen receptor alpha (ERα) and Estrogen receptor beta (ERβ). The purpose of my thesis is to try to understand the role of estrogen signaling through ERβ in the neonatal ovary. Mutant mice lacking ERβ were obtained and examined for defects in cyst breakdown, germ cell death and follicle development. Ovaries were gathered from neonates during cyst breakdown of wild type B6 control (+/+), and ER heterozygous (+/-) and homozygous mutant knockout mice (-/-). ERβ knockout mice exhibited no detrimental effect in cyst breakdown or total oocyte numbers. Follicle development results were inconclusive and further analysis is necessary. These data add to the understanding of mechanisms of cyst breakdown. Ultimately, we hope this will provide a better understanding of oocyte development

The revolution before the Revolution? A Material Culture Approach to Consumerism at George Washington’s Mount Vernon, VA

Before the American Revolutionary War (1775-1783) profoundly impacted the lives of colonial Americans, another revolution of sorts was taking place. This one occurred in the realm of the daily lives of all colonial Americans – free and enslaved, poor and wealthy. What made the 40-year period before the American Revolution unique was that access to consumer goods appears to have opened up for larger segments of the colonial population through a more sophisticated and far-reaching system of distribution for imported items. But just how equal was this access? What can be learned about colonial culture and the maintenance of power relationships if this issue of equality of access to the material world is thoroughly and systematically investigated? This dissertation begins most simply with the question, what comprised the world of goods for individuals living in the upper Chesapeake region in the decades before the American Revolution? The research then progresses towards a set of questions that penetrates issues of power and access inherent in material culture. How was this world of goods different for individuals of separate socio-economic and racial categories? Why did individuals like George Washington maintain a commitment to the consignment system when stores offered the ease and convenience of local shopping? Who had access to which objects and what implications did this have for how material culture was employed or deployed towards the maintenance or destabilization of the colonial social order? I triangulate between three primary sources – Washington’s orders to and invoices from his agents in England; the store inventories from a local Scottish-owned retail outlet to answer these questions; and the archaeological record at Mount Vernon – to address these questions using a material culture approach that draws upon these compatible datasets on historical consumerism

Whose Trash is it, Anyway? A Stratigraphic and CeramicAnalysis of the South Grove Midden (44FX762/17), MountVernon, Virginia

Throughout the twenty-year history of professional archaeological excavations at George Washington\u27s Mount Vernon, a single refuse feature represents the only deposit unearthed that can speak to the material manifestations of changes in the Washington households within a pre-Revolutionary War context. With the discovery of the large, oval-shaped feature that came to be known as the South Grove Midden (44FX762/17), Mount Vernon archaeologists realized they had uncovered a stratified deposit that could link the successive Washington households with their material culture. This paper asks: whose trash is it, anyway? To answer this question, I employ the methodology of increasingly specific seriation analyses on groupings of ceramics to view stratigraphic variations in ceramic use and discard. The interpretive framework of household archaeology unites the archaeological record with the historical context of household cycles at pre-1775 Mount Vernon. This paper concludes that the bulk of the midden represents those household goods purchased by Lawrence Washington, and used and discarded by his and young George Washington\u27s households

Aberrant intervertebral motion in patients with treatment‑resistant nonspecific low back pain: a retrospective cohort study and control comparison

Purpose Intervertebral kinematic assessments have been used to investigate mechanical causes when back pain is resistant to treatment, and recent studies have identified intervertebral motion markers that discriminate patients from controls. However, such patients are a heterogeneous group, some of whom have structural disruption, but the effects of this on intervertebral kinematics are unknown.Methods Thirty-seven patients with treatment-resistant back pain referred for quantitative fluoroscopy were matched to an equal number of pain-free controls for age and sex. All received passive recumbent flexion assessments for intervertebral motion sharing inequality (MSI), variability (MSV), laxity and translation. Comparisons were made between patient sub-groups, between patients and controls and against normative levels from a separate group of controls.Results Eleven patients had had surgical or interventional procedures, and ten had spondylolisthesis or pars defects. Sixteen had no disruption. Patients had significantly higher median MSI values (0.30) than controls (0.27, p = 0.010), but not MSV (patients 0.08 vs controls 0.08, p = 0.791). Patients who received invasive procedures had higher median MSI values (0.37) than those with bony defects (0.30, p = 0.018) or no disruption (0.28, p = 0.0007). Laxity and translation above reference limits were not more prevalent in patients.Conclusion Patients with treatment-resistant nonspecific back pain have greater MSI values than controls, especially if the former have received spinal surgery. However, excessive laxity, translation and MSV are not more prevalent in these patients. Thus, MSI should be investigated as a pain mechanism and for its possible value as a prognostic factor and/or target for treatment in larger patient populations

An evaluation of exercises for the development of word recognition and word meaning in grade five

Thesis (Ed.M.)--Boston Universit

Field testing of two prestressed concrete girders

"November 25, 1962.""Authorized Reprint from Highway Research Board Bulletin 307 National Academy of Sciences National Research Council Publication 937, pages 42-63, 1961.""This paper presents the procedures used and the results obtained in a cooperative research project designed to obtain field data to determine the actual behavior during construction and in service of one of the first prestressed concrete structures designed by the Missouri State Highway Department. During the initial planning stage of a pedestrian bridge across the Mark Twain Expressway in metropolitan St. Louis, it was decided to use prestressed, post-tensioned concrete girders. In discussing the design and specifications for the girders, it was suggested that worthwhile technical information could be obtained with a relatively low-cost field observation program. The program was initiated with the design and manufacture of an instrumentation system which would meet the rugged demands of field service condition and yet provide reasonable accuracy. University of Missouri research personnel supervised the installation of all instrumentation appurtenances in the various elements of the structure, and collected all field data. Measurements were made before, during, and after the post-tensioning operations, before and after all major construction operations, and at appropriate time intervals following completion of the structure. To provide the additional information needed for interpretation of the field measurements, a companion test program was undertaken to measure the actual physical properties of representative samples of the materials used in the construction of this structure."--Page 42

An evaluation of exercises for the development of word recognition and word meaning in grade five

Thesis (Ed.M.)--Boston Universit

Transients influencing rocket engine ignition and popping Interim report

Engine design and operating parameters studied for effects on rocket engine ignition and poppin