At all three gestational time points an imbalance in the MMP-2:TIMP-1 ratio was found in patients who subsequently developed preeclampsia. We speculate that increased net MMP-2 activity may contribute to the endothelial dysfunction that is central to the pathophysiology of preeclampsia.

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BACKGROUND Although the incidence of gastric cancer has been decreasing, recent reports suggest an increased rate in select populations. We sought to evaluate trends in gastric cancer incidence to identify high risk populations. METHODS Gastric cancer incidence rates from 1992 to 2011 were computed using the Surveillance, Epidemiology and End Results (SEER) registry. We evaluated trends in incidence rates by calculating annual percent change (APC) across 3 age groups (20–49, 50–64, ≥65) and 4 racial/ethnic groups (Hispanics, non-Hispanic Whites, Blacks, and Asian/Pacific Islanders). RESULTS We identified 41,428 patients with gastric cancer. For the entire cohort over the study period, the APC was decreased. When patients were grouped according to sex, APC was flat or decreased in women regardless of age or race/ethnicity. APC was also flat or decreased for all men except young Hispanic males (20–49 years), who had an increased APC of nearly 1.6% per year (1.55%, 95% CI:0.26 to 2.86%). Furthermore, young Hispanic males were the only group to have increased incidence of Stage 4 disease (APC 4.34%, 95% CI:2.76 to 5.94%) and poorly differentiated tumors (APC 2.08%, 95% CI:0.48 to 3.70%). CONCLUSIONS The APC of young Hispanic male gastric cancer places it among the top cancers with rising incidence in the United States. This is concomitant with increased incidence of advanced disease at presentation. This major public health concern warrants additional research to determine the etiology of the increasing incidence in this group.

Our data suggest that donation has a beneficial effect on the bereavement process.

The majority of patients received PC within 2 years of death. A larger number of days of PC was associated with a greater reduction in aggressive EOLC.

Purpose Older cancer survivors are among the most vulnerable to the negative effects of COVID-19 and may need specific survivorship supports that are unavailable/restricted during the pandemic. The objective of this study was to explore how older adults (≥ 60 years) who were recently (≤ 12 months) discharged from the care of their cancer team were coping during the pandemic. Methods We used a convergent mixed method design (QUAL+quan). Quantitative data were collected using the Brief-COPE questionnaire. Qualitative data were collected using telephone interviews to explore experiences and strategies for coping with cancer-related concerns. Results The mean sample age (n = 30) was 72.1 years (SD 5.8, range 63–83) of whom 57% identified as female. Participants’ Brief-COPE responses indicated that they commonly used acceptance (n = 29, 96.7%), self-distraction (n = 28, 93.3%), and taking action (n = 28, 93.3%) coping strategies. Through our descriptive thematic analysis, we identified three themes: (1) drawing on lived experiences, (2) redeploying coping strategies, and (3) complications of cancer survivorship in a pandemic. Participants’ coping strategies were rooted in experiences with cancer, other illnesses, life, and work. Using these strategies during the pandemic was not new—they were redeployed and repurposed—although using them during the pandemic was sometimes complicated. These data were converged to maximize interpretation of the findings. Conclusions Study findings may inform the development or enhancement of cancer and non-cancer resources to support coping, particularly using remote delivery methods within and beyond the pandemic. Clinicians can engage a strengths-based approach to support older cancer survivors as they draw from their experiences, which contain a repository of potential coping skills.

Objectives (1) To investigate the effects of plasma from non-pregnant, normal pregnant and pre-eclamptic women on myogenic tone and endothelium-dependent relaxation; (2) To investigate the role of matrix metalloproteinases (MMPs) in these parameters of vascular function. Design Analysis of the effects of plasma from non-pregnant, normal pregnant and pre-eclamptic women on myogenic tone and endothelium-dependent relaxation, and the effects of MMP inhibition on these parameters. Setting University of Alberta, Edmonton, Alberta, Canada.Samples Pooled plasma from non-pregnant (n ¼ 9), normal pregnant (n ¼ 6) and pre-eclamptic women (n ¼ 12).Methods Mesenteric arteries from virgin female C57BL/6J mice were exposed to pooled plasma from nonpregnant, normal pregnant and pre-eclamptic women in the absence and presence of GM6001 (5 AM; MMP inhibitor), and arterial function was assessed. Main outcome measures Myogenic tone and endothelium-dependent relaxation.Results Plasma of women with pre-eclampsia, and interestingly, plasma of non-pregnant women, significantly enhanced myogenic tone at pressures !70 mmHg (P < 0.001) and blunted the maximum relaxation to methacholine (P < 0.001; P < 0.005) in isolated arteries. GM6001 altered response only in vessels exposed to the plasma of women with pre-eclampsia; however, contrary to our hypothesis, this further enhanced myogenic tone and further abrogated relaxation. Conclusions The strikingly similar vascular function profiles of vessels incubated in the plasma of nonpregnant and pre-eclamptic women suggest that pre-eclampsia may be due, in part, to the lack of a necessary adaptation to pregnancy. Despite these similarities, however, there are differential effects of MMP inhibition, suggesting that MMPs play a greater role in the vasculature of women with pre-eclampsia compared with non-pregnant and normal pregnant women.

Purpose: Although the year after cancer treatment is challenging for all cancer survivors, older adults (≥60 years) face additional challenges due to age-related decline and high rates of comorbidity. There is a paucity of research on how health service interruptions from the COVID-19 pandemic have impacted the experience of older cancer survivors. In this study we explore older cancer survivors' reflections on the pandemic and their suggestions for future care delivery when traditionally offered resources are not available. Methods: We conducted 1:1 telephone interviews with adults 60 years and older previously diagnosed with breast and colorectal cancer and recently (≤12 months) discharged from their cancer care team. We analyzed the data using descriptive thematic analysis. Results: The mean sample (n = 30) age was 72.1 years (SD 5.8, Range 63-83) of whom 57% identified as female. Participants described personal and societal implications of the pandemic. that affected their ability to navigate social support, and public and clinical landscapes. These reflections informed their suggestions for future health care delivery, such as how they could have been better prepared to selfmanage their post-cancer treatment journey. Participants recommendations were grouped into four sub-themes: 1) enhanced baseline information; 2) facilitate caregiver support and engagement; 3) greater technology integration; and 4) sustained use and public appreciation of personal protective equipment. Conclusion: Older cancer survivors appreciate the needed shift to virtual appointments and services during the COVID-19 pandemic. Specific strategies to bolster older adults existing strengths and improve their readiness to engage in these measures are critical.