The dot tracking script takes timelapse images of fluorescent micropatterns and determines the frame-by-frame displacement of each fluorescent dot. From these displacement values, the traction force calculation script calculates the corresponding traction force values using the known material properties of the gel being imaged, as described in Equation 2 of the main text. It can also plot either traction or displacement maps, user’s choice. Final x and y displacement vectors (taken from dot displacement script and thresholded based on the chosen displacement threshold value) are saved to the variables “x_dis_final_thresh” and “y_dis_final_thresh,” and the magnitude of these vectors is saved to “magD.” Unbalanced traction force vectors are saved to “T1” and “T2,” while balanced traction force vectors (for static equilibrium) are saved to “feX” and “feY,” respectively. The magnitudes of the unbalanced and balanced traction force vectors are saved to “magT_UB” and “magT_B,” respectively.

Home electronic incarceration, otherwise known as HEI, is an alternative to traditional incarceration. HEI allows inmates who meet certain qualifications, including stable residency, employment, and nonviolent offenses, to serve their sentence from their residence rather than in jail. Before the onset of the COVID-19 pandemic in 2020, the Albemarle-Charlottesville Regional Jail (ACRJ) maintained a restricted capacity for HEI, primarily extending this opportunity to frequent offenders who met the qualifications above (Dornfeld et al., 2023). At the advent of COVID-19, ACRJ increased their capacity and use of HEI to reduce the number of occupants in the jail and, as a result, mitigate contagion risk (Kumer, 2023). Following the expansion of the HEI program, (Dornfeld et al., 2023) discovered that HEI participants had lower reoffense rates than jail-sentenced counterparts who committed similar crimes. Currently, HEI participants are determined from information gleaned from their files or by court order (Kumer, 2023). To streamline this selection process and increase the participation of inmates benefitting from HEI, factors were investigated that correlate with HEI’s success. This research will assist jail administration in identifying candidates who will gain the most from HEI and recommend those offenders to the program.The methods consist of quantitative analysis of booking data acquired from ACRJ along with insight and guidance from contacts at Region Ten Community Services, an organization dedicated to working with those affected by mental illnesses, substance abuse, and/or developmental disabilities. Additionally, Offender and Aid Restoration- Jefferson Area Community Corrections (OAR-JACC) provided a meaningful understanding of the project. The quantitative analysis focuses on factors that may correlate with HEI violations and changes in recidivism rates including criminal history, current charge, mental health, employment, and gender.Factors were identified and analyzed that increase the likelihood of an inmate successfully completing their HEI sentence without violation, using the improved stability provided by HEI to prevent recidivism. These factors formulate sentencing recommendations for ACRJ’s decision-making process.

Vascular smooth muscle cells (VSMCs) are an integral part of blood vessels and are the focus of intensive research in vascular biology, translational research, and cardiovascular diseases. Though immortalized vascular smooth muscle cell lines are available, their use is limited, underscoring the need for primary VSMCs. There are several methods for isolating primary cells from mice. However, the isolation method from rat blood vessels requires optimization, given the differences in the aorta of mice and rats. Here we compare two methods for VSMCs isolation from rats: enzymatic digestion and the "block" method. We observed a significantly higher yield of VSMCs using the enzymatic digestion method. We further confirmed that VSMCs expressed well-established VSMC-specific markers (calponin) with both methods and observed the persistence of this marker up to 9 passages, suggesting a continuation of the secretory phenotype of VSMCs. Overall, this work compares two methods and demonstrates a practical and effective method for isolating VSMCs from rat aorta, providing vascular biologists with a valuable and reliable experimental tool.

Collagen fibers, one of the key load-bearing components of the extracellular matrix, contribute significantly to tissue integrity through their mechanical properties of strain-dependent stiffening. This study investigated the effects of bacterial collagenase on the mechanical behavior of individual bovine lung collagen fibers in the presence or absence of mechanical forces, with a focus on potential implications for emphysema, a condition associated with collagen degradation and alveolar wall rupture. Tensile tests were conducted on individual collagen fibers isolated from bovine lung tissue. The rate of degradation was characterized by the change in fiber Young’s modulus during 60 min of digestion under various mechanical conditions mimicking the mechanical stresses on the fibers during breathing. Compared to digestion without mechanical forces, a significantly larger drop of fiber modulus was observed in the presence of static or intermittent mechanical forces. Fiber yield stress was also reduced after digestion indicating compromised fiber failure. By incorporating fibril waviness obtained by scanning electron microscopic images, an analytic model allowed estimation of fibril modulus. A computational model that incorporated waviness and the results of tensile tests was also developed to simulate and interpret the data. The simulation results provided insights into the mechanical consequences of bacterial collagenase and mechanical forces on collagen fibers, revealing both fibril softening and rupture during digestion. These findings shed light on the microscale changes in collagen fiber structure and mechanics under enzymatic digestion and breathing-like mechanical stresses with implications for diseases that are impacted by collagen degradation such as emphysema.

Home Electronic Incarceration (HEI) is a tech-enabled alternative allowing the Albemarle-Charlottesville Regional Jail (ACRJ) to monitor individuals outside the correctional facility. Carefully selected individuals are allowed to serve their sentences within the boundaries of an approved location. In response to the COVID-19 pandemic, local courts and ACRJ adjusted sentencing and incarceration practices to reduce jail occupancy and limit the spread of coronavirus (N. Goodloe, personal communication, September 12, 2022). We wish to explore whether the increased use of HEI affected the return to custody (RTC) at ACRJ.These methods consist of comprehensive, quantitative analysis of booking data provided by ACRJ, in conjunction with continued insight and guidance from Region Ten Community Services (locally known as "R10", a provider of mental health resources), Offender and Aid Restoration- Jefferson Area Community Corrections (OAR-JACC) and the Blue Ridge Area Coalition for the Homeless (BRACH). This paper presents results of ACRJ inmate outcomes within two areas of focus: HEI sentences pre- vs. post-COVID and HEI vs. non-HEI individuals during and since the onset of COVID. In addition to this analysis, we have collaborated with key community stakeholders to better understand the state of the Albemarle-Charlottesville criminal justice system as it recovers from the pandemic.We found that prior to the onset of the pandemic, HEI was reserved for frequent offenders who typically were serving felony charges. After the beginning of the pandemic, ACRJ began placing individuals on HEI who were more representative of the jail population as a whole in terms of prior criminal history and the mix of misdemeanor and felony offenders. We also demonstrated that individuals on HEI are incarcerated for significantly extended periods for comparable offenses than those who serve their sentence in ACRJ, as individuals in jail can get days off of their sentence for good behavior, while HEI participants are ineligible for such time credits. Finally, our analysis of RTC rates at ACRJ shows that HEI results in lower RTC rates than traditional jail sentences, pre- and post-COVID, and when split between misdemeanor and felony offenses. This analysis provides strong evidence for the efficacy of HEI as an alternative to incarceration in our local community, which may give an example for other jurisdictions to adopt or expand HEI usage in the future.

Abstract The current early childhood caries (ECC) case definition contains a substantial degree of clinical heterogeneity, and to address this, we sought to identify clinical subtypes of the disease. We used tooth surface-level dental caries experience from a discovery and 3 replication community-based cohorts of 3-to-5-year-old children (N=226,471). We identified five disease subtypes with distinct patterns of caries lesion intraoral distribution that largely replicated across cohorts. These subtypes were associated with established caries risk factors (e.g., history of nighttime bottle-feeding), showed familial concordance and microbiome differences, and predicted dental caries experience 7 years after subtype assignment. Notably, classification of children in these subgroups can be achieved by inspecting small sets of easily examinable tooth surfaces with reasonable accuracy. Collectively, our findings provide evidence for generalizable and clinically recognizable subtypes of ECC. Etiology, targeted prevention, and optimal management of these subtypes should be systematically investigated in future studies.

In epithelia, breakdown of tensional homeostasis is closely associated with E-cadherin dysfunction and disruption of tissue function and integrity. In this study, we investigated the effect of E-cadherin mutations affecting distinct protein domains on tensional homeostasis of gastric cancer cells. We used micropattern traction microscopy to measure temporal fluctuations of cellular traction forces in AGS cells transfected with the wild-type E-cadherin or with variants affecting the extracellular, the juxtamembrane, and the intracellular domains of the protein. We focused on the dynamic aspect of tensional homeostasis, namely the ability of cells to maintain a consistent level of tension, with low temporal variability around a set point. Cells were cultured on hydrogels micropatterned with different extracellular matrix (ECM) proteins to test whether the ECM adhesion impacts cell behavior. A combination of Fibronectin and Vitronectin was used as a substrate that promotes the adhesive ability of E-cadherin dysfunctional cells, whereas Collagen VI was used to test an unfavorable ECM condition. Our results showed that mutations affecting distinct E-cadherin domains influenced differently cell tensional homeostasis, and pinpointed the juxtamembrane and intracellular regions of E-cadherin as the key players in this process. Furthermore, Fibronectin and Vitronectin might modulate cancer cell behavior towards tensional homeostasis.

TPS599 Background: A growing body of data support that the key to generating anti-tumor immune responses triggered by administration of immuno-oncology (IO) agents, is the activation and invasion of T lymphocytes. Checkpoint inhibitors (CPIs) are being actively explored in the neoadjuvant setting of MIBC. CPIs documented 30-40% pathologic complete response-rates (ypT0N0) in previous trials. Increasingly, novel IO agents are being developed in combinations with anti PD(L)-1 therapies. Understanding the changes in the tumor microenvironment that occur with the addition of novel immunomodulating agents to PD(L)-1 inhibitors can help inform whether a compound is viable for further development. The OPTIMUS trial is a window of opportunity, neoadjuvant platform design study in MIBC patients that are cisplatin-ineligible. The study investigates the addition of the indoleamine 2, 3-dioxygenase 1 (IDO1) inhibitor epacadostat to the PD-1 inhibitor retifanlimab. The platform design allows for investigation of other novel immune-modulating combinations. Methods: This is an open-label, randomized, Phase 2, multi-treatment group, window-of-opportunity, platform study for participants with MIBC undergoing radical cystectomy who refuse or are not eligible for cisplatin-based neoadjuvant chemotherapy (NCT04586244). Participants are randomized based on tumor tissue PD-L1 CPS ≥ 10 or PD-L1 CPS < 10 to one of the following treatment groups: Treatment Group A (epacadostat + retifanlimab); Treatment Group B (retifanlimab monotherapy); Treatment Group C (epacadostat monotherapy). 18 patients will be enrolled in each of Treatment Groups A and B. 9 patients will be enrolled into Treatment Group C. Total treatment duration is a maximum of 10 weeks. The platform study design allows for addition of future treatment groups. Pre-treatment biopsy is obtained through transurethral resection of bladder tumor (TURBT), followed by neoadjuvant treatment, followed by radical cystectomy. In all treatment groups, tissue from the surgical specimen(s) is collected and compared with the initial pre-treatment samples. The primary endpoint is the change from baseline in CD8+ lymphocytes within resected tumor. Secondary endpoints include safety and tolerability, rates of ypT0N0 response, and major pathologic response. Exploratory analyses include tumoral changes in gene cell expression profile, immune-cell protein and metabolic marker levels, and spatial relationships between cell types. Plasma is also collected and will be investigated for changes in cytokines and other inflammatory or metabolic markers. Clinical trial information: NCT04586244.

Micropattern traction microscopy allows control of the shape of single cells and cell clusters. Furthermore, the ability to pattern at the micrometer length scale allows the use of these patterned contact zones for the measurement of traction forces, as each micropatterned dot allows for the formation of a single focal adhesion that then deforms the soft, underlying hydrogel. This approach has been used for a wide range of cell types, including endothelial cells, smooth muscle cells, fibroblasts, platelets, and epithelial cells. This review describes the evolution of techniques that allow the printing of extracellular matrix proteins onto polyacrylamide hydrogels in a regular array of dots of prespecified size and spacing. As micrometer-scale patterns are difficult to directly print onto soft substrates, patterns are first generated on rigid glass coverslips that are then used to transfer the pattern to the hydrogel during gelation. First, the original microcontact printing approach to generate arrays of small dots on the coverslip is described. A second step that removes most of the pattern to leave islands of small dots is required to control the shapes of cells and cell clusters on such arrays of patterned dots. Next, an evolution of this approach that allows for the generation of islands of dots using a single subtractive patterning step is described. This approach is greatly simplified for the user but has the disadvantage of a decreased lifetime for the master mold needed to make the patterns. Finally, the computational approaches that have been developed for the analysis of images of displaced dots and subsequent cell-generated traction fields are described, and updated versions of these analysis packages are provided.

In epithelia, breakdown of tensional homeostasis is closely associated with E-cadherin dysfunction and disruption of tissue function and integrity. In this study, we investigated the effect of E-cadherin mutations affecting distinct protein domains on tensional homeostasis of gastric cancer cells. We used micropattern traction microscopy to measure temporal fluctuations of cellular traction forces in AGS cells transfected with the wild-type E-cadherin or with variants affecting the extracellular, the juxtamembrane, and the intracellular domains of the protein. We focused on the dynamic aspect of tensional homeostasis, namely the ability of cells to maintain a consistent level of tension, with low temporal variability around a set point. Cells were cultured on hydrogels micropatterned with different extracellular matrix (ECM) proteins to test whether the ECM adhesion impacts cell behavior. A combination of Fibronectin and Vitronectin was used as a substrate that promotes the adhesive ability of E-cadherin dysfunctional cells, whereas Collagen VI was used to test an unfavorable ECM condition. Our results showed that mutations affecting distinct E-cadherin domains influenced differently cell tensional homeostasis, and pinpointed the juxtamembrane and intracellular regions of E-cadherin as the key players in this process. Furthermore, Fibronectin and Vitronectin might modulate cancer cell behavior towards tensional homeostasis.

Drs Humphrey and Cyron wrote a commentary regarding our review article entitled "Tensional homeostasis at different length scales" that was published in Soft Matter, 2020, 16, 6946-6963. These authors brought up some valid concerns to which we would like to respond. Their first concern is related to our remark regarding equations that we used to describe homeostasis in blood vessels, where we stated that those equations were limited only to linearly elastic materials. We were wrong, and we agree with the authors that these equations hold for all cylindrical vessels regardless of their material properties. Their second concern is related to tensional homeostasis at the subcellular level. Drs Humphrey and Cyron disagree with our substantiated claim that tensional homeostasis breaks down at the level of focal adhesions (FAs) of a living cell. In our reply, we provided several pieces of evidence that demonstrate that tensional homeostasis depends upon FA size, FA maturity and FA force dynamics and thus, tensional homeostasis cannot hold in all FAs across a cell. In summary, we are grateful for the opportunity to reply to the commentary of Drs Humphrey and Cyron. Moreover, we are excited that this topic has become an important focus in the biomechanics and mechanobiology communities, and we feel strongly that critical feedback is necessary to move this field forward.

The United States is the world's leading country in incarceration. American citizens constitute five percent of the global population, but 20% of the world's inmates [5]. Those suffering from mental illnesses are disproportionately affected. According to a 2017 study by the Department of Justice, 64% of inmates in local jails have a history of mental health problems, and 60% are actively experiencing symptoms [2]. To lower the number of Americans behind bars, effective mental health treatment needs to be provided to those in need within the criminal justice system. This project, supported by the Jefferson Area Community Criminal Justice Board, is the continuation of a decade of research into the intersection between mental illness and incarceration in the Central Virginia. The primary goal was to evaluate the efficacy of the Brief Jail Mental Health Screener (BJMHS) used by the region's two jails to determine whether an inmate needs further mental health evaluation following their release. Data was obtained from both jails: the Albemarle-Charlottesville Regional Jail (ACRJ) and the Central Virginia Regional Jail (CVRJ), as well as two community programs that provide services to former inmates, Offender's Aid and Restoration (OAR) and Region Ten Community Services (R10). The BJMHS was found to predominantly identify people who had already received treatment. The screener's effectiveness was also found to vary by the location it was given and by the recipient's demographics: Females tended to make up a statistically significantly larger proportion of the screened-in population than expected, and black individuals a smaller proportion. When people took the screener multiple times at different locations (ACRJ, CVRJ, or OAR) and were changing their answers to therapeutic questions, they were more likely to acknowledge they were previously hospitalized for mental health treatment at OAR than they were at either jail. Additionally, of the cohort of inmates screening in multiple times at ACRJ, it was found that as their number of arrests increased, so did the proportion of the group that screened in and group that matched with R10. The findings of this paper will be used to improve the screener process and ideally increase its ability to correctly identify those who require mental health services.

Tumour progression relies on the ability of cancer cells to penetrate and invade neighbouring tissues. E-cadherin loss is associated with increased cell invasion in gastric carcinoma, and germline mutations of the E-cadherin gene are causative of hereditary diffuse gastric cancer. Although E-cadherin dysfunction impacts cell–cell adhesion, cell dissemination also requires an imbalance of adhesion to the extracellular matrix (ECM). To identify ECM components and receptors relevant for adhesion of E-cadherin dysfunctional cells, we implemented a novel ECM microarray platform coupled with molecular interaction networks. The functional role of putative candidates was determined by combining micropattern traction microscopy, protein modulation and in vivo approaches, as well as transcriptomic data of 262 gastric carcinoma samples, retrieved from the cancer genome atlas (TCGA). Here, we show that E-cadherin mutations induce an abnormal interplay of cells with specific components of the ECM, which encompasses increased traction forces and Integrin β1 activation. Integrin β1 synergizes with E-cadherin dysfunction, promoting cell scattering and invasion. The significance of the E-cadherin-Integrin β1 crosstalk was validated in Drosophila models and found to be consistent with evidence from human gastric carcinomas, where increased tumour grade and poor survival are associated with low E-cadherin and high Integrin β1 levels. Integrin β1 is a key mediator of invasion in carcinomas with E-cadherin impairment and should be regarded as a biomarker of poor prognosis in gastric cancer.

Aim or purpose: This research aims to examine the supportive dental needs of patients with head and neck cancer by focusing on access to dental care, oral health impact and subsequent quality of life implications. Methods: This acute cross-sectional study was conducted over a period of 4 months at the Andrew Love Cancer Centre and Peter MacCallum Cancer Centre in Victoria, Australia. The study included a questionnaire with demographic questions as well the Oral Health Impact Profile (OHIP-14) and the option to take part in an interview. A semi-structured interview further explored the QoL of consenting participants. Ethics approval was obtained from the Peter MacCallum Cancer Centre's Human Research Ethics Committee. Results: 60% of patients had seen a dentist before cancer treatment with 32% of them receiving specific advice of how to manage their mouth during their cancer journey. A significant number of participants (36%) did not see a dentist after treatment.Qualitative data from the interviews were transcribed, coded and analysed using thematic analysis. Conclusion: The research was able to highlight that not all patients have the same level of access to dental care following cancer treatment. The findings are likely to provide a platform on which current protocols can be improved for the management of HNC patients.

About a third of current inmates in the United States prisons and jails suffer from severe mental illness (Collier, 2014). For most of these inmates, their untreated mental health needs contribute to their return to custody within the criminal justice system. A 2011 study reported that approximately 68% of inmates with an untreated mental illness and substance abuse diagnoses return to custody at least once within 4 years of the initial release, compared to 60% of those who do not suffer from either mental illness or substance abuse diagnoses (Bronson et al., 2017). This project extends over a decade of prior research examining current mental health services available to those released from the Albemarle-Charlottesville Regional Jail (ACRJ). The primary objective of this project was to identify individuals within the ACRJ, which serves jurisdictions in Charlottesville, Albemarle, and Nelson County who were recommended for services following screening through the Brief Jail Mental Health Screener (BJMHS) to answer questions surrounding the return to custody rate of those linked vs not linked to services.To examine the demographics of inmates screened, types of charges, and length of stay in the criminal justice system, data sets were obtained from Region Ten Community Services Board (R10), ACRJ, Offender Aid and Restoration (OAR), and the Thomas Jefferson Area Coalition for the Homeless (TJACH) after each member of the team completed a training on protecting personally identifiable information (PII) and signing a nondisclosure agreement (NDA). The research team analyzed 60 months of data spanning from July 2015 through June 2020. The data include individuals booked into ACRJ and individuals who received mental health, substance abuse, and intake/access/emergency services from R10. The data from ACRJ, the BJMHS, and R10 were merged to form a single data set compiling relevant information for each individual in ACRJ, such as booking details, BJMHS screener scores, and services received from R10.According to the merged data, of the individuals who took the BJMHS when they were booked into ACRJ, 26% screened in, meaning their BJMHS results indicated they should be referred for further mental health evaluation. The team analyzed the cohort of individuals who screened-in and were available to receive services from R10 following their release from custody. The key findings and outcomes of the study included:•From the ACRJ dataset from 2015 to 2019, 913 individuals screened-in for referral to mental health services. This is 26% of the total inmates who were screened at ACRJ.•Individuals who received services from R10 were more likely to return to custody (19%) within 12 months than screened-in individuals who did not receive these services (11%).

Tensional homeostasis is a phenomenon of fundamental importance in mechanobiology. It refers to the ability of organs, tissues, and cells to respond to external disturbances by maintaining a homeostatic (set point) level of mechanical stress (tension). It is well documented that breakdown in tensional homeostasis is the hallmark of progression of diseases, including cancer and atherosclerosis. In this review, we surveyed quantitative studies of tensional homeostasis with the goal of providing characterization of this phenomenon across a broad range of length scales, from the organ level to the subcellular level. We considered both static and dynamics approaches that have been used in studies of this phenomenon. Results that we found in the literature and that we obtained from our own investigations suggest that tensional homeostasis is an emergent phenomenon driven by collective rheostatic mechanisms associated with focal adhesions, and by a collective action of cells in multicellular forms, whose impact on tensional homeostasis is cell type-dependent and cell microenvironment-dependent. Additionally, the finding that cadherins, adhesion molecules that are important for formation of cell-cell junctions, promote tensional homeostasis even in single cells, demonstrates their relevance as a signaling moiety.

Closure of psychiatric hospitals in favor of community-based treatment methods (Torrey, 1997), resulted in jails and prisons becoming the “new asylums” of the United States (National Institute of Corrections, 2014). Over the past decade, research teams in Charlottesville, Virginia, have studied data from the region to better understand the nature and extent of the individuals in the criminal justice system who suffer from severe mental illnesses (Boland et al., 2019). The work presented here extends this prior research by enlarging the study population to cover a longer time period, by characterizing the dynamic paths individuals follow through various periods of incarceration, mental health services, homelessness, and probation/supervision, and by incorporating geocoding to explore whether proximity to treatment centers has an impact on linkage to mental health services.Under an approved Institutional Review Board (IRB) protocol, the research team partnered with multiple local criminal justice agencies and community service providers (CSPs) to share data. These agencies interact through the Albemarle-Charlottesville Evidence Based Decision Making (EBDM) Policy Team, where regular monthly meetings are held to discuss issues in the criminal justice system. The research team analyzed data across 48 months from July 2015 to June 2019. These data comprise 8,332 individuals booked into Albemarle/Charlottesville Regional Jail (ACRJ), 13,340 individuals who received Region Ten Community Services Board (R10) mental health or substance abuse services, 2,117 individuals in a locally maintained database of homeless individuals, and 4,345 individuals who received services from Offender Aid and Restoration (OAR), which supervises individuals on local probation. Of the individuals booked into ACRJ, 18 percent “screened in” for referral for mental health services according to the Brief Jail Mental Health Screener (BJMHS). Key findings and outcomes of this study include:•Of the 8,332 individuals booked into ACRJ, 5,499 individuals (67%;) were administered the BJMHS.•Of those 5,499 individuals administered the BJMHS, 1,534 screened in for referral to mental health services, which is 28%; of individuals who received the screener and 18%; of all individuals at ACRJ.These findings support the results of prior research with greater statistical confidence. New findings include:•Individuals who associate their current legal trouble with drugs and alcohol have a 12%; higher screening-in rate than those who do not.•63%; of individuals in ACRJ who screened in and were available to be treated once released ultimately were linked to R10 services.In previous years, BJMHS results showed that there were nearly three times as many people with severe mental illness in jail than previously estimated by the state, and that linkage to mental health services could be improved. These findings led to the development of the Therapeutic Docket, an alternative to the standard judicial process for individuals with severe mental illness (Jefferson Area Community Corrections, 2018). New findings continue to help members of the Thomas Jefferson Area Community Criminal Justice Board and the EBDM Policy Team gain insight into the needs of the region’s mentally ill inmate population, ultimately leading to more evidence-based decision-making regarding the treatment of these individuals within and beyond their periods of incarceration.

Immunoglobulin (Ig) therapy is increasingly being used for secondary antibody deficiency (SAD) in cancer patients with haematological malignancies. The aetiology of SAD can be attributed to the underlying condition or to the expanding range of treatments now available that target the immune system. Most often, immunodeficiency is clinically diagnosed as hypogammaglobulinaemia in patients with haematological malignancies and results in these patients being at a greater risk of acquiring an infection. The administration of Ig therapy to improve immunity in these patients has traditionally been intravenous and in hospital. However, subcutaneous Ig therapy is an innovative and alternative approach that can be more widely implemented in cancer centres and has the potential to allow home self-administration. This article reviews current Ig practice in adults with SAD and the subsequent implications on nurses and patients in Australia.