An epigenetically distinct breast cancer cell subpopulation promotes collective invasion

Tumor cells can engage in a process called collective invasion, in which cohesive groups of cells invade through interstitial tissue. Here, we identified an epigenetically distinct subpopulation of breast tumor cells that have an enhanced capacity to collectively invade. Analysis of spheroid invasion in an organotypic culture system revealed that these “trailblazer” cells are capable of initiating collective invasion and promote non-trailblazer cell invasion, indicating a commensal relationship among subpopulations within heterogenous tumors. Canonical mesenchymal markers were not sufficient to distinguish trailblazer cells from non-trailblazer cells, suggesting that defining the molecular underpinnings of the trailblazer phenotype could reveal collective invasion-specific mechanisms. Functional analysis determined that DOCK10, ITGA11, DAB2, PDFGRA, VASN, PPAP2B, and LPAR1 are highly expressed in trailblazer cells and required to initiate collective invasion, with DOCK10 essential for metastasis. In patients with triple-negative breast cancer, expression of these 7 genes correlated with poor outcome. Together, our results indicate that spontaneous conversion of the epigenetic state in a subpopulation of cells can promote a transition from in situ to invasive growth through induction of a cooperative form of collective invasion and suggest that therapeutic inhibition of trailblazer cell invasion may help prevent metastasis.     

The Ascending Reticular Activating System in a Patient With Severe Injury of the Cerebral Cortex: A Case Report

We reported on the ascending reticular activating system (ARAS) finding of a patient in whom severe injury of the cerebral cortex was detected following a hypoxic-ischemic brain injury (HIBI).A 67-year-old female patient who suffered from HIBI induced by cardiac arrest after surgery for lumbar disc herniation underwent cardiopulmonary resuscitation approximately 20 to 30 minutes after cardiac arrest. The patient exhibited impaired alertness, with a Glasgow Coma Scale (GCS) score of 4 (eye opening: 2, best verbal response: 1, and best motor response: 1). Approximately 3 years after onset, she began to whimper sometimes and showed improved consciousness, with a GCS score of 10 (eye opening: 4, best verbal response: 2, and best motor response: 4) and Coma Recovery Scale-Revised score of 9 (auditory function: 1, visual function: 1, motor function: 2, verbal function: 2, communication: 1, and arousal: 2).Results of diffusion tensor tractography for the upper connectivity of the ARAS showed decreased neural connectivity to each cerebral cortex in both hemispheres. The right lower ARAS between the pontine reticular formation and the thalamic intralaminar nuclei (ILN) was thinner compared with the left side.Severe injury of the upper portion of the ARAS between the thalamic ILN and cerebral cortex was demonstrated in a patient with some level of consciousness.     

The Effects of Experienced Uncertainty and Patients’ Assessments of Cancer-Related Information-Seeking Experiences on Fatalistic Beliefs and Trust in Physicians

Using the 2013 HINTS 4 Cycle 2 data representing a general population sample, this study investigates the effects of patients’ experiences of uncertainty about prostate cancer during doctor–patient communication, as well as patients’ positive assessments of their cancer-related information-seeking experiences, on their fatalistic beliefs regarding cancer and their trust in physicians. Our tests show significant differences in trust in physicians among men who do and do not experience uncertainty about the prostate-specific antigen (PSA) test during doctor–patient communication. The analysis also indicates that individuals with experiences of uncertainty about the PSA test are more likely than those without such experiences of uncertainty to place their trust in doctors. However, no apparent difference or association exists when there are uncertainties relating to treatment choices regarding slow-growing cancer or treatment side effects. Nevertheless, as hypothesized, individuals who positively evaluate their cancer-related information-seeking experiences are less likely to have fatalistic beliefs about cancer. Furthermore, patients’ positive assessments are highly predictive of their levels of trust in their physicians. Additionally, tests of interaction effects show that individuals’ levels of education moderate the association between uncertainty experiences about the PSA test and both cancer fatalism and trust in physicians. Further implications and limitations of the study are discussed.     

Parental beliefs on children's play: comparison among mainland Chinese,Chinese immigrants in the USA,and European-Americans

The current study surveyed parental play beliefs among the three groups of parents: the mainland Chinese, Chinese immigrants in the USA, and European-Americans. Limited comparison studies on parental play beliefs were previously reported for these three populations in the literature. Two measures, the Chinese child-rearing ideology and parental play beliefs scale, were used in this study. Responses from 144 responses were collected. The mainland Chinese parents reported similar scores both in the Chinese child-rearing ideology and in play beliefs as to the European-American parents. Surprisingly, the Chinese immigrant parents reported the highest scores in the Chinese child-rearing ideology and the lowest scores in the parental play beliefs among the three groups. This indicated that the surveyed Chinese immigrant parents held more traditional Chinese child-rearing ideology and were less positive towards children's play.