"The Last Piece of the Puzzle that Makes all the Difference in the World:" Team-Facing Medical-Legal Partnership for Reproductive Care Teams.

As reproductive freedoms in the U.S. undergo significant rollbacks, vital reproductive health services - and the care teams delivering them - face escalating legal threats and complexity. This qualitative case-control community-based participatory research study describes how legal problem-solving supports for reproductive care teams serving mothers with opioid use disorder are protective for both patients and care team members. We describe how medical legal partnerships (MLPs) can promote Reproductive Justice and argue for wider adoption of care-team facing legal supports.

Biophysical characterization of lynx-nicotinic receptor interactions using atomic force microscopy.

Nicotinic acetylcholine receptors (nAChRs) are broadly expressed in the central and peripheral nervous systems, playing essential roles in cholinergic neurotransmission. The lynx family proteins, a subset of the Ly6/uPAR superfamily expressed in multiple brain regions, have been shown to bind to nAChRs and modulate their function via allosteric regulation. The binding interactions between lynx and nAChRs, however, have not been systematically quantified and compared. In this work, we characterized the interactions between lynx1 or lynx2 and α3ß4- or α7-nAChRs using single-molecule atomic force microscopy (AFM). The AFM technique allows the quantification of the off-rate of lynx-nAChR binding and of the energetic barrier width between the bound state and transition state, providing a biophysical means to compare the selectivity of lynx proteins for nAChR subtypes. Results indicate that lynx1 has a marginal preference for α7- over α3ß4-nAChRs. Strikingly, lynx2 exhibits a two order of magnitude stronger affinity for α3ß4- compared to α7-nAChRs. Together, the AFM assay serves as a valuable tool for the biophysical characterization of lynx-nAChR binding affinities. Revealing the differential affinities of lynx proteins for nAChR subtypes will help elucidate how lynx regulates nAChR-dependent functions in the brain, including nicotine addiction and other critical pathways.

Revisiting global patterns of frontal sinus aplasia utilizing computed tomography.

While frontal sinus aplasia (agenesis, absence) has been proposed as a potential marker in forensic positive identifications, frequency rates are likely dependent upon how presence is defined. This study investigates how two methods of defining frontal sinus presence affects aplasia frequency rates. Using CT scans of 772 adult individuals from diverse geographic regions, frontal sinus presence was assessed two ways: 1) the XR-method- coded present if the sinus extended above the supra-orbital line, and 2) the CT-method- coded present with any indication of the frontal sinus. The XR-method consistently provided higher aplasia frequencies, averaging an 18.31% discrepancy with the CT-method. Method discrepancies were higher in females (averaged-sides: 24.6%) than males (averaged-sides: 13.82%). Oceanian individuals displayed the highest aplasia rates using either method, and the highest discrepancy between methods (averaged-sides: 31.30%); Europeans, displaying the lowest aplasia rates in either method, also displayed the lowest method discrepancy (average-sides: 7.37%). Fisher's Exact tests on the biologically-defined CT aplasia rates indicate females are significantly different from males for unilateral aplasia (p=0.0035); Arctic populations are significantly different from most groups (all p<0.005), exception being Oceanian. Results suggest the lower, biologically-defined CT aplasia rates are more useful in corroborating identifications than the inflated XR frequencies and illustrate the importance of citing aplasia rates from similarly-composed samples. However, due to practicality and resource availability, the XR-method may be more appropriate. Most importantly, reported aplasia rates from one method should be cited in casework utilizing the other method.

Stereotactic body radiation therapy for early-stage non-small-cell lung cancer: the pattern of failure is distant.

BACKGROUND: Stereotactic body radiation therapy (SBRT) represents a substantial paradigm shift in the treatment of patients with medically inoperable Stage I/II non-small-cell lung cancer. We reviewed our experience using either three- or five-fraction SBRT for peripheral or central tumors, respectively. METHODS AND MATERIALS: A total of 91 patients signed an institutional review board-approved consent form, were treated with SBRT, and have had > or =6 months of follow-up. Patients were referred for SBRT because of underlying comorbidities (poor performance status in 31 or poor lung function in 52) or refusal of surgery (8 patients). Of the cancers, 83 were peripheral and eight were central. Peripheral cancers received a mean dose of 18 Gy x three fractions. Cancers within 2 cm of the bronchus, esophagus, or brachial plexus were treated with 9 Gy x five fractions. RESULTS: The median follow-up duration for these patients was 18 months (range, 6-42 months). TNM staging was as follows: 58 patients with T1N0M0, 22 with T2N0M0, 2 with T3N0M0 (chest wall), and 6 with T1N0M1 cancers. The median tumor diameter was 2 cm (range, 1-5 cm). The median forced expiratory volume in 1 s was 46% (range, 17-133%) and the median carbon monoxide diffusing capacity (DLCO) was 49% (range, 15-144%). Two-year local tumor control was achieved in 86% of patients. The predominant pattern of failure was the development of distant metastasis or second lung cancer. The development of distant metastasis was the only significant prognostic factor for overall survival on multivariate analysis. CONCLUSIONS: Local tumor control was shown to be high using SBRT for non-small-cell lung cancer. Overall survival is highly coerrelated with the development of distant metastasis.