It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Wednesday, July 03, 2024
Australian bushfire ash is deadly for aquatic life
While the impact of wildfires on terrestrial life has been well studied, only recently has research started to examine the effects of wildfire ash on aquatic organisms. New research reveals that wildfire ash can have lethal consequences on Australian water ecosystems.
Wildfires are becoming more prevalent due to the warming and drying effects of climate change, with Australia becoming especially vulnerable to dangerous bushfires. “Therefore, many Australian species may be threatened by fires,” says Miss Jenelle McCuaig, a Masters student at the University of Alberta, Canada. “This is putting them at greater risk of endangerment and possible extinction.”
Wildfires release ash into the air, which can enter aquatic environments directly or be washed into bodies of water by rainfall. “Once in the water, ash may leach metals and organic combustion products, where they can affect organisms, acquired by ingestion through intestines or respiration through gills,” says Miss McCuaig. There are also serious consequences for humans, as we rely on healthy freshwater ecosystems for water and food.
Miss McCuaig and her team focused their research on two common Australian crustacean species, a crayfish (Cherax destructor) and a shrimp (Macrobrachium australiense).
To examine the effects of wildfire ash on the crustaceans, each species was exposed to a range of ash concentrations to determine their sensitivity and likelihood of survival. Miss McCuaig then measured their oxygen consumption using a respirometry system and took tissue samples to look at their metabolic activity.
After exposure to just 5g of ash per litre of water, Miss McCuaig found that no shrimps could survive – but it took 8 times as much ash to reach complete crayfish mortality. “The huge difference in sensitivity between the two species was much greater than I expected,” says Miss McCuaig.
This research shows that even between similar species, there can be a big difference in survival response to environmental stressors such as wildfire ash. “Differences in body shape and gill structure, as well as habitat preferences, has allowed them to fulfil different niches,” says Miss McCuaig. “Crayfish demonstrated greater resilience to the ash exposure compared to the shrimp.”
For the surviving crayfish and shrimp, the individuals exposed to the highest concentrations of ash had the highest metabolic rates, suggesting a high level of physiological stress. “This is particularly concerning during ash exposure, because increased ventilation means that the animals will be taking up more of the ash particles and leached contaminants from the water, further affecting their body systems.”
“This research will allow us to identify the species that are most threatened by fires and help to inform the development of breeding programs or relocation efforts,” says Miss McCuaig. “When it comes to wildfires, resources are limited, so we must prioritise response actions.”
Miss McCuaig adds that even though many wildfires occur naturally, humans still have a responsibility to protect the living world: “Species conservation begins with wildfire prevention in the first place - it is incredibly important to be educated about, and to implement, fire-safety into our lives to mitigate human-caused wildfires”.
This research was made possible by funding from The Company of Biologists, Natural Sciences and Engineering Research Council of Canada, and the Society for Experimental Biology, as well as collaboration of the Blewett Lab and Franklin Eco-Laboratory.
This research is being presented at the Society for Experimental Biology Annual Conference in Prague on the 2-5th July 2024.
Shark hatching success drops from 82% to 11% in climate change scenario
New experimental research shows that the combined effects of ocean warming and acidification could lead to a catastrophic decrease in embryonic shark survival by the year 2100. This research is also the first to demonstrate that monthly temperature variation plays a prominent role in shark embryo mortality.
Oceanic warming and acidification are caused by greater concentrations of CO2 dissolving into marine environments, resulting in rising water temperatures and falling pH levels. “The embryos of egg-laying species are especially sensitive to environmental conditions,” says Noémie Coulon, a PhD student at the Laboratoire de Biologie des Organismes et des Écosystèmes Aquatiques, France. “The hatching success of embryos is a crucial factor for population dynamics. In the case of skates and sharks, which have a slow pace of life, low hatching rates could be critical for population renewal.”
Small-spotted catsharks (Scyliorhinus canicula) are one of the most abundant shark species in Europe. “The small-spotted catshark is already experiencing habitat loss in coastal areas, particularly during the summer months when egg-laying is at its peak,” says Ms Coulon.
Ms Coulon and her team compared small-spotted catshark embryo survival in three environmental scenarios: one control scenario using baseline temperature and pH data from the years 1995 to 2014, and two using predicted climate scenarios for the year 2100 called the Shared Socioeconomic Pathways (SSPs) as outlined in the United Nations’ Intergovernmental Panel on Climate Change’s Sixth Assessment Report released in 2021.
SSP2, known as the “Middle of the Road” scenario, represents a future where slow and non-uniform progress towards tackling climate change is present but net-zero is not reached, and predicts a temperature rise of 2.7°C and drop in pH of 0.2 by the year 2100.
SSP5, known as the “Fossil-fueled Development” scenario, represents a future where fossil fuel resources continue to be more rapidly exploited across the world, and predicts a temperature rise of 4.4°C and drop in pH of 0.4 by the year 2100.
To assess the impact of these different scenarios, Ms Coulon and her team measured embryo growth and yolk consumption within small-spotted catshark eggs every week over a 4-month period, while recording hatching success and growth of surviving baby sharks for 6 months post-hatching.
While the team found a high survival rate for both the control and SSP2 scenarios (81% and 83% respectively), there was a much lower chance of survival for the SSP5 scenario. “We were shocked by the low survival rate observed in the SSP5 scenario, with only 11% of embryos hatching,” says Ms Coulon. The team indicated that the mortality was linked with lower yolk consumption rates, lower growth rates and failure to transition to internal gills.
This research also highlights the importance of seasonal temperature variation, which can significantly increase mortality during critical egg laying periods. “This mortality was most pronounced in August, coinciding with the highest temperatures (reaching 23.1°C), and during a stage of development where embryos undergo gill reabsorption,” explains Ms Coulon.
Ms Coulon and her team noticed that the surviving 11% did not exhibit the typical growth pattern of the other sharks, which may have contributed to their resistance to environmental change: “What makes these individuals special remains unclear, but by acknowledging the inter-individual variation among young marine organisms, we could better evaluate the future ecological success of species.”
This research offers both a serious caution and a beacon of hope for marine species. “Firstly, it serves as a warning about the responses of other species that may be even more sensitive to environmental change,” explains Ms Coulon. “Secondly, our findings demonstrate that the more moderate SSP2 scenario can limit the damage inflicted on species like the small-spotted catshark, which gives us a positive incentive to reduce our greenhouse gas emissions.”
This project has received funding support from the Save Our Seas Foundation. More information can be found here: https://saveourseas.com/project/bringing-up-baby-shark-embryos-and-our-warming-oceans.
This research is being presented at the Society for Experimental Biology Annual Conference in Prague on the 2-5th July 2024.
New research finds that artificial light at night (ALAN) attracts larval fish away from naturally lit habitats, while dramatically lowering their chances of survival in an “ecological trap”, with serious consequences for fish conservation and fishing stock management.
“Light pollution is a huge ongoing subject with many aspects that are still not well understood by scientists,” says Mr Jules Schligler, a PhD student at CRIOBE Laboratory (Centre de Recherches Insulaires et Observatoire de l’Environnement) in Moorea, French Polynesia.
ALAN is the product of human-related activities such as the use of electrical lights along roads, factories, residences and resorts near bodies of water. “ALAN is everywhere and marine wildlife is not exempt to its effects,” says Mr Schligler. “A quarter of the world coastline is impacted and this level is increasing every year.”
Mr Schligler and his team set out to investigate the effects of ALAN on larval recruitment in tropical fish. Larval recruitment is the number of fish that settle in their habitat and survive their juvenile years before becoming an adult. “Larval recruitment is a key life history trait for fish that impacts on stock replenishment and adult fitness,” he says. “Larval fish are also very dependent on the natural light cycle.”
To investigate these effects, Mr Schligler used 48 corals that were split into two treatments: control corals with only natural light exposure, and ALAN corals that were exposed to light pollution at night of a similar intensity that beach resorts and streetlights produce. They focused on two dominant coral reef damselfish native to French Polynesia, the yellowtail dascyllus (Dascyllus flavicaudus) and the blue-green chromis (Chromis viridis).
“First, we monitored fish settlement to the corals to see if they preferred natural or artificial light conditions,” says Mr Schligler. “The fish were then subjected to a range of experiments to better understand the impact of ALAN after they had settled.” These experiments measured various aspects of development and survival such as growth, metabolic rate and risk of predation.
This research finds that many young fish actually prefer environments with artificial light, recruiting 2-3 times as many fish than naturally lit environments.
The study also reveals the harmful effects of ALAN on fish growth, metabolic rate and overall survival. “ALAN has produced an ecological trap where these fish, misled by human activity, now prefer habitats where their fitness will be lower,” says Mr Schligler. “In other words, ALAN has the potential to attract organisms to a less suitable environment, generating a peculiar anthropogenic stressor."
These results have implications for fish conservation and harvesting policies. “Marine protected areas have only started to consider light pollution in their management policy very recently,” says Mr Schligler. “To better understand fish stock replenishment and conservation, it is crucial to take into account as many factors as we can, such as the rarely considered effects of light pollution.”
This research is being presented at the Society for Experimental Biology Annual Conference in Prague on the 2-5th July 2024.
Experimental coral.
CREDIT
Jules Schligler
Pregnant fish can also get “baby brain”, but not the way that mammals do
SOCIETY FOR EXPERIMENTAL BIOLOGY
IMAGE:
BRAIN STAINING OF PREGNANT FISH. ON THE LEFT IS THE NISSL STAINING USE TO DETERMINE NEURON MORPHOLOGY AND ON THE RIGHT IS KI67 STAINING WHICH STAINS FOR CELL PROLIFERATION.
New research reveals that pregnancy-related brain impairment is present in live-bearing fish, but instead of affecting learning and memory as expected from similar research on mammals, it appears to have a stronger impact on decision-making and sensory reception.
There have been many studies into the detrimental impact of pregnancy on mammalian brains, sometimes called “baby brain” or “momnesia” in humans, revealing how the disruption of neurological processes like neurogenesis, or the creation of new neurons, can affect learning and memory - but this is the first study to examine this phenomenon in fish.
While most fish reproduce by laying eggs, some species are live-bearing, or viviparous, and carry their offspring internally before producing live young. Viviparous species include popular aquarium fish from the family Poeciliidae, such as guppy, molly and platy.
“We wanted to see if these pregnancy-related changes in cognition and neurogenesis occur in other live-bearing evolutionary lineages, particularly in a species which lacks a placenta,” says Tiffany Ernst, a PhD candidate in the field of developmental and reproductive biology at Wageningen University, Netherlands. “In mammals, the placenta is thought to help regulate pregnancy-related changes to the mother’s brain.”
“The species of fish that I work with, Poeciliopsis gracilis, is especially interesting as they are superfetatious, meaning they can be pregnant with multiple temporally overlapping broods of offspring simultaneously,” says Ms Ernst. “Essentially, my fish are almost constantly pregnant in adulthood - so any detrimental impact on cognition might be more evident in this species.”
“We hoped to learn how pregnancy might induce changes to the maternal brain in a non-mammalian live-bearing species,” says Ms Ernst. “This could help us to understand whether the evolution of a live-bearing reproductive strategy requires neurological trade-offs to adequately adapt for a healthy pregnancy.”
To examine the impact of pregnancy on cognition, pregnant and virgin fish were trained to associate a green disk with the location of food, and then perform a spatial learning task when presented with two seemingly identical disks in different locations. “Then we tested their cognitive flexibility by swapping the locations of the rewarded and non-rewarded disks to see how the fish adjusted to the new location of the food reward,” says Ms Ernst.
To assess the effect on fish neurology, Ms Ernst and the team removed the brains of the pregnant and virgin females and used cell staining to identify areas of new cell proliferation - an indicator of which areas of the brain were producing new cells.This study is the first to map the areas of brain cell proliferation in this species in a “brain atlas”.
Ms Ernst and her team found that while both pregnant and virgin fish were equally successful in both cognitive tasks, pregnant fish were much more hesitant when choosing which disk to approach.
“We also found no difference in cell proliferation in the regions of the brain most responsible for learning and memory,” says Ms Ernst. “However, we were surprised to see that pregnant females exhibited decreased cell proliferation in the regions which contribute to maternal olfactory reception.”
This surprising result suggests that pregnancy compromises the fish’s ability to interpret scent in the water, which may contribute to their choice-aversion in the cognitive tests. “For P. gracilis, reduced choice-propensity during pregnancy might be an adaptive strategy wherein females do not take the risk of foraging for food when the reward is not guaranteed, thus conserving energy for reproduction,” says Ms Ernst.
“Our research indicates that pregnancy may impact maternal cognition and alters brain cell proliferation, but not in the same ways as we would expect from mammals,” says Ms Ernst. “This implies that pregnancy across different evolutionary lineages has an impact on the maternal brain which in turn, affects how mothers cognitively and physiologically adapt to the burdens of live-bearing reproduction.”
This research is being presented at the Society for Experimental Biology Annual Conference in Prague on the 2-5 th July 2024.
Starfish skeleton inspires new 4D morphing structure
SOCIETY FOR EXPERIMENTAL BIOLOGY
IMAGE:
MORPHING STRUCTURE HOLDING POT PLANT, DEMONSTRATING ITS CAPACITY FOR FLEXIBILITY AND STRENGTH.
Researchers have recently developed a flexible-yet-sturdy morphing structure inspired by the starfish skeleton that exhibits 4D morphing features with promising applications for robotics, aviation, and medical devices.
“Starfish possess the remarkable ability to effortlessly hold themselves in any body posture by changing the stiffness of their endoskeleton,” says Raman, a PhD student in the Biological Structures and Biomimetics workgroup at Hochschule Bremen - City University of Applied Sciences Bremen, Germany.
Ossicles are calcite microstructures inside starfish bodies that are connected in a network by collagen fibres to form the endoskeleton. This strong but simple structure allows them to hold a wide variety of body postures with minimal energy use.
“We became fascinated with this biological solution to a complex engineering problem,” says Mr Raman. "Our goal was to unlock the secrets of their intricate skeleton and translate those principles into a novel material with similar remarkable properties."
Mr Raman and his team used a multidisciplinary approach for this project. By using high resolution X-ray CT scans, they visualised the starfish skeletal structures and used mathematical models (Finite Element Analysis and Multibody Simulations) to understand the complex interlinked mechanics of the skeletal components.
“For the first time, we are able to show the complex 3D structure of the starfish skeleton and the fine ultrastructure of the small ossicles,” says Mr Raman. “We have now used these insights for the biomimetic design process of our own morphing structure, incorporating rapid prototyping techniques for fabrication.”
Mr Raman and his team have used 3D printing to produce different working prototypes that can accomplish an impressive range of physical challenges. “Our patented starfish-inspired morphing structure shows self-locking, continuous bending, self-healing, and shape memory features,” says Mr Raman.
The scalability, low cost and relative ease of manufacture of this morphing structure provides many opportunities for industry applications, including robotics, aviation, and biomedical devices such as prosthetics and implants.
This study was funded by the German Federal Ministry of Education and Research (BMBF) FHprofUnt 2018 program, project number 13FH150PX8 (JHD, SL) and the Hochschule Bremen PhD scholarship (R).
This research is being presented at the Society for Experimental Biology Annual Conference in Prague on the 2-5th July 2024.
Eating more soy foods could improve thinking and attention in kids
Study strengthens evidence for health benefits of isoflavone-rich soy foods
AMERICAN SOCIETY FOR NUTRITION
Chicago (July 2, 2024) — A new study found that school-aged children who consumed more isoflavones from soy foods exhibited better thinking abilities and attention. These findings pave the way for future research aimed at unraveling how soy foods can positively impact children's cognitive abilities.
Isoflavones are naturally occurring compounds found in various plants, particularly soybeans and soy products. Although previous research in adults has suggested that soy isoflavones can improve memory, the benefits haven’t been studied well in children.
“Soy foods are often not a regular part of children’s diets in the United States,” said Ajla Bristina, a neuroscience doctoral student at the University of Illinois Urbana-Champaign. “Our study adds evidence of the importance of nutrients found in soy foods for childhood cognition.”
Bristina will present the findings at NUTRITION 2024, the flagship annual meeting of the American Society for Nutrition held June 29–July 2 in Chicago.
To examine the potential benefits of soy isoflavones, the researchers examined previously available data from a cross-sectional study that included 128 children ages 7 to 13. They used information from 7-day diet records to calculate each child’s average dietary intake, including the amounts of macronutrients, micronutrients, vitamins and isoflavones consumed. To assess the children’s general intellectual ability, the researchers used a set of pencil and paper tests adjusted for grade level. They also measured attentional abilities using a computerized task known as the flanker task while electroencephalographic (EEG) activity was recorded and used to measure information processing speed and attention.
“No other studies have examined the association between soy isoflavones and attentional abilities using EEG or similar measures to record electrical activity generated by the brain,” said Bristina.
Overall, the analysis revealed that the children in the study tended to consume low amounts of isoflavone-containing soy foods. However, those who did consume more soy foods showed faster responses during the attentional tasks and exhibited faster processing speed. No association was observed between soy isoflavone intake and general intellectual ability.
“The children in our study consumed an average of 1.33 mg of isoflavones per day, which while relatively low, aligns with previously reported values for the United States,” said Bristina. “Soy consumption for individual participants ranged from 0 to 35 mg/day. To put this into perspective, an 8 fl. oz serving of soy milk provides about 28 mg of isoflavones, a serving of tofu provides about 35 mg and half a cup of steamed edamame provides about 18 mg of isoflavones.”
Bristina says that snacks like roasted edamame, soynuts or soymilk are a good way to incorporate more soy into the diet. Tofu, tempeh or soy-based nuggets are also good options for meals.
“Correlational studies like this are only the first step,” said Bristina. “To better understand the effects of eating soy foods on children’s cognitive abilities and the precise amount of isoflavone intake necessary to elicit faster response times will require intervention approaches.” To find out more, the research team recently began a clinical trial examining the effects of soy foods on thinking abilities, sex hormones, metabolic health and gut health.
Bristina will present this research at 8:12-8:24 a.m. CDT on Tuesday, July 2, during the Nutritional Neuroscience: Nutritional Effects on Cognition and Disease Severity Across the Lifespan session in McCormick Place (abstract;presentation details).
Please note that abstracts presented at NUTRITION 2024 were evaluated and selected by a committee of experts but have not generally undergone the same peer review process required for publication in a scientific journal. As such, the findings presented should be considered preliminary until a peer-reviewed publication is available.
About NUTRITION 2024
NUTRITION 2024 is the flagship meeting of the American Society for Nutrition and the premier educational event for nutritional professionals around the globe. NUTRITION brings together lab scientists, practicing clinicians, population health researchers, and community intervention investigators to identify solutions to today’s greatest nutrition challenges. Our audience also includes rising leaders in the field – undergraduate, graduate, and medical students. NUTRITION 2024 will be held June 29–July 2, 2024 in Chicago. https://nutrition.org/N24 #Nutrition2024
About the American Society for Nutrition (ASN)
ASN is the preeminent professional organization for nutrition research scientists and clinicians around the world. Founded in 1928, the society brings together the top nutrition researchers, medical practitioners, policy makers and industry leaders to advance our knowledge and application of nutrition. ASN publishes four peer-reviewed journals and provides education and professional development opportunities to advance nutrition research, practice, and education. Since 2018, the American Society of Nutrition has presented NUTRITION, the leading global annual meeting for nutrition professionals. http://www.nutrition.org
Soybean seed hardness, a key factor in consumer acceptance and vegetable soybean quality, has been elucidated through a comprehensive study. Researchers identified the genetic and molecular mechanisms influencing this trait, focusing on differential gene expression during seed development. The discovery of the GmSWEET2 gene as a significant regulator of hardness offers a pathway to enhance soybean texture, potentially revolutionizing the market with customized varieties to suit diverse consumer preferences.
Vegetable soybeans are valued for their taste and nutritional benefits, but consumer preferences for seed hardness vary across regions. Chinese consumers prefer softer seeds, while African consumers favor moderately hard seeds. Despite its importance, research on the factors influencing seed hardness has been limited, especially for vegetable soybeans. Addressing these regional preferences requires an in-depth understanding of the genetic and biochemical mechanisms that determine seed hardness. Due to these challenges, there is a pressing need for a comprehensive study to enhance soybean quality and marketability.
A collaborative study (DOI: 10.1093/hr/uhae084) from Nanjing Agricultural University, published in Horticulture Research, illuminates the genome-wide transcriptome, pinpointing key regulatory networks and genes associated with seed hardness in vegetable soybeans. This research sheds light on the intricate processes that determine soybean seed texture.
The study revealed significant genetic differences between the two soybean landraces during seed development. Key findings include the differential expression of genes involved in starch synthesis, protein storage, and fatty acid metabolism. The GmSWEET2 gene emerged as a critical regulator of seed hardness; its overexpression in Pixiansilicao led to increased seed hardness, confirming its pivotal role. Additionally, the study identified stages S3 and S4 of seed development as crucial periods where these genetic differences significantly influenced the accumulation of seed storage components. During these stages, genes involved in cell proliferation and cell wall formation also showed differential expression, impacting seed hardness. These findings highlight the importance of understanding genetic regulation during specific developmental stages to manipulate seed hardness effectively, providing valuable insights for soybean breeding programs aimed at improving seed texture and quality.
Dr. Han Xing, a leading researcher, commented, "Our discovery of the GmSWEET2 gene's role in seed hardness provides valuable insights into soybean breeding. By manipulating this gene, we can develop soybean varieties with tailored seed textures to meet various consumer preferences, enhancing market appeal."
This research paves the way for breeding programs aimed at improving the quality and consumer acceptance of vegetable soybeans. The identification of GmSWEET2 and other key genes offers new targets for genetic modification, allowing for the development of soybean varieties with optimized seed hardness, thus catering to diverse global markets.
This work was supported by the Key Research and Development Program (Modern Agriculture) of Jiangsu Province (BE2023348), the National Key R&D Program of China (2021YFD1201605), Zhongshan Biological Breeding Laboratory (ZSBBL) (BM2022008-01 and ZSBBL-KY2023-03), the ‘JBGS’ Project of Seed Industry Revitalization in Jiangsu Province (JBGS(2021)059), China Agriculture Research System of MOF and MARA (CARS-04), National Natural Science Foundation of China (31471519), the Fundamental Research Funds for the Central Universities (XUEKEN2023022), the Jiangsu Agriculture Science and Technology Innovation Fund (CX(22)5004 and CX(20)2015), the Key R&D project of Jiangsu Province (BE2019376), Jiangsu Collaborative Innovation Center for Modern Crop Production and Cyrus Tang Innovation Center for Seed Industry.
Horticulture Research is an open access journal of Nanjing Agricultural University and ranked number one in the Horticulture category of the Journal Citation Reports ™ from Clarivate, 2022. The journal is committed to publishing original research articles, reviews, perspectives, comments, correspondence articles and letters to the editor related to all major horticultural plants and disciplines, including biotechnology, breeding, cellular and molecular biology, evolution, genetics, inter-species interactions, physiology, and the origination and domestication of crops.
Genome-wide transcriptome analysis reveals key regulatory networks and genes involved in the determination of seed hardness in vegetable soybean
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Changes in emergency contraceptive fills after Massachusetts’ statewide standing order
JAMA NETWORK
About The Study:
The Massachusetts statewide standing order policy was associated with a 32% increase in emergency contraceptive fills at pharmacies versus comparison states. After the policy, fills for prescription-only ulipristal more than doubled and accounted for the observed increases in fills for emergency contraceptives.
Corresponding Author: To contact the corresponding author, Dima M. Qato, Pharm.D., M.P.H., Ph.D., email qato@usc.edu.
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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Media advisory: This study is being presented at the AcademyHealth 2024 Annual Research Meeting.
"Despite an upward trend in reconstruction, AI/AN women continue to be less likely to undergo breast reconstruction," comments Jane Hui, MD, MS, of University of Minnesota, Minneapolis. "While our findings point to some possible approaches to reducing this disparity, it will be essential to also determine Native women's opinions related to breast reconstruction."
Focus on factors affecting breast reconstruction in AI/AN women
Using data from the National Cancer Database, the researchers identified 1,980 AI/AN women and 414,036 non-Hispanic White women who underwent mastectomy for breast cancer between 2004 and 2017. Annual breast reconstruction rates were compared between groups, along with factors associated with decisions about reconstruction.
The two groups differed in some important characteristics. American Indian/Alaska Native women had higher rates of other medical diagnoses (comorbidity), 20% versus 12%; were more likely to have public health insurance, 49% versus 20%; and more likely to undergo single-breast (unilateral) mastectomy.
Over the 13-year study period, breast reconstruction increased in both groups: from 13% to 47% for AI/AN women and from 29% to 62% from non-Hispanic White women. After adjustment for other factors, AI/AN women remained nearly one-half less likely to undergo reconstruction.
Other factors associated with lower reconstruction rates included older age, earlier year of diagnosis, more advanced cancer, unilateral mastectomy, public insurance, and living in an area of lower educational attainment. Within the AI/AN group, reconstruction was more likely for younger women; those with more recent diagnosis, less-advanced cancer, and less comorbidity; and those living in urban areas or areas with a higher level of educational attainment.
Insights for addressing breast reconstruction disparity in Native women
Breast reconstruction after mastectomy has known benefits for some, including improved quality of life and body image. However, breast reconstruction is a personal decision – there is "no optimal proportion" of patients who should opt for reconstruction, Dr. Hui and colleagues note.
American Indian/Alaska Native women face a wide range of health disparities and barriers to medical care, including elevated rates of chronic health conditions, later diagnosis and higher mortality from breast cancer. "Complicating the healthcare environment in which AI/AN receive medical care is chronic underfunding of the Indian Health Service (IHS), implicit bias against AI/AN, and fraught relationships between physicians and AI/AN patients," the researchers write.
Their study offers insights into factors associated with the lower rate of breast reconstruction for AI/AN women with breast cancer. "Multidisciplinary efforts to improve care delivery to AI/AN women may continue to minimize disparities through earlier diagnosis and treatment," Dr. Hui and coauthors conclude. "Simultaneously, qualitative research into AI/AN perspectives on breast cancer care could improve shared decision-making between physicians and AI/AN patients, empowering AI/AN women to choose post-mastectomy reconstruction if they so desire."
Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health.
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About Wolters Kluwer
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