Open Access Publications

Permanent URI for this collectionhttp://hdl.handle.net/10342/7167

East Carolina University Libraries are committed to supporting the research, publishing, and scholarly communication activities at ECU. To reduce barriers to open access publishing and to support faculty, staff, and graduate students who choose open access publishing as the best venue for their work, ECU has established the Open Access Publishing Support Fund (OAPSF).

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Open Access
DNA methylation analyses identify an intronic ZDHHC6 locus associated with time to recurrent stroke in the Vitamin Intervention for Stroke Prevention (VISP) clinical trial
(2021-07-12) Davis Armstrong, Nicole M.; Chen, Wei-Min; Hsu, Fang-Chi; Brewer, Michael S.; Cullell, Natalia; Fernández-Cadenas, Israel; Williams, Stephen R.; Sale, Michèle M.; Worrall, Bradford B.; Keene, Keith L.
Aberrant DNA methylation profiles have been implicated in numerous cardiovascular diseases; however, few studies have investigated how these epigenetic modifications contribute to stroke recurrence. The aim of this study was to identify methylation loci associated with the time to recurrent cerebro- and cardiovascular events in individuals of European and African descent. DNA methylation profiles were generated for 180 individuals from the Vitamin Intervention for Stroke Prevention clinical trial using Illumina HumanMethylation 450K BeadChip microarrays, resulting in beta values for 470,871 autosomal CpG sites. Ethnicity-stratified survival analyses were performed using Cox Proportional Hazards regression models for associations between each methylation locus and the time to recurrent stroke or composite vascular event. Results were validated in the Vall d'Hebron University Hospital cohort from Barcelona, Spain. Network analyses of the methylation loci were generated using weighted gene coexpression network analysis. Primary analysis identified four significant loci, cg04059318, ch.2.81927627R, cg03584380, and cg24875416, associated with time to recurrent stroke. Secondary analysis identified three loci, cg00076998, cg16758041, and cg02365967, associated with time to composite vascular endpoint. Locus cg03584380, which is located in an intron of ZDHHC6, was replicated in the Vall d'Hebron University Hospital cohort. The results from this study implicate the degree of methylation at cg03584380 is associated with the time of recurrence for stroke or composite vascular events across two ethnically diverse groups. Furthermore, modules of loci were associated with clinical traits and blood biomarkers including previous number of strokes, prothrombin fragments 1 + 2, thrombomodulin, thrombin-antithrombin complex, triglyceride levels, and tissue plasminogen activator. Ultimately, these loci could serve as potential epigenetic biomarkers that could identify at-risk individuals in recurrence-prone populations.
Open Access
Clinical and radiobiological evaluation of a method for planning target volume generation dependent on organ-at-risk exclusions in magnetic resonance imaging-based prostate radiotherapy
(2019) Ruiz, Brian; Feng, Yuanming
Open Access
Risk Factors Associated with Physical and Mental Distress in People Who Report a Chronic Obstructive Pulmonary Disease (COPD) Diagnosis: Latent Class Analysis of 2016 Behavioral Risk Factor Surveillance System Data
(2019-05-09) Stellefson, Michael; Paige, Samantha R.; Barry, Adam E.; Wang, Min Qi; Apperson, Avery
Open Access
Pgrmc1 Knockout Impairs Oocyte Maturation in Zebrafish
(2018-09-24) Wu, Xin-Jun; Thomas, Peter; Zhu, Yong
Recent investigations suggest progestin receptor membrane component 1 (PGRMC1) associates with and transports a wide range of molecules such as heme, cytochromes P450, steroids with 21 carbons, membrane progestin receptor alpha (mPRα/Paqr7), epidermal growth factor receptor (EGFR), and insulin receptor. It is difficult to discriminate the true functions of PGRMC1 from the functions of its associated molecules using biochemical and pharmacological approaches. To determine the physiological function(s) of PGRMC1, we generated global knockouts for pgrmc1 (pgrmc1−/−) in zebrafish. We found a reduction in both spawning frequency and the number of embryos produced by female mutants. We also observed reduced sensitivity of fully-grown immature oocytes to a progestin hormone and a reduced number of oocytes undergone meiotic maturation both in vivo and in vitro in pgrmc1−/−. This reduced sensitivity to progestin corresponds well with significant reduced expression of mPRα, the receptor mainly responsible for mediating oocyte maturation and meiosis resumption in fish. The results provide in vivo and in vitro evidence for the physiological functions of Pgrmc1 in oocyte maturation and fertility, as well as a plausible molecular mechanism via regulation of mPRα, which in turn directly regulates oocyte maturation and affects fertility in zebrafish.
Open Access
Top-down pulses reduce prey population sizes and persistence
(2018-06-19) Hamman, Elizabeth A.; McCoy, Michael W.
Resource pulses are well documented and have important consequences for population dynamics relative to continuous inputs. However, pulses of top-down factors (e.g. predation) are less explored and appreciated in the ecological literature. Here, we use a simple differential equation population model to show how pulsed removals of individuals from a population alter population size relative to continuous dynamics. Pulsed removals result in lower equilibrium population sizes relative to continuous removals, and the differences are greatest at low population growth rates, high removal rates, and with large, infrequent pulses. Furthermore, the timing of the removal pulses (either stochastic or cyclic) affects population size. For example, cyclic removals are less likely than stochastic removals to result in population eradication, but when eradication occurs, the time until eradication is shorter for cyclic than with stochastic removals.
Open Access
Variation in pigmentation gene expression is associated with distinct aposematic color morphs in the poison frog Dendrobates auratus
(2019-04-18) Stuckert, Adam M. M.; Moore, Emily; Coyle, Kaitlin P.; Davison, Ian; MacManes, Matthew D.; Roberts, Reade; Summers, Kyle
Abstract Background Color and pattern phenotypes have clear implications for survival and reproduction in many species. However, the mechanisms that produce this coloration are still poorly characterized, especially at the genomic level. Here we have taken a transcriptomics-based approach to elucidate the underlying genetic mechanisms affecting color and pattern in a highly polytypic poison frog. We sequenced RNA from the skin from four different color morphs during the final stage of metamorphosis and assembled a de novo transcriptome. We then investigated differential gene expression, with an emphasis on examining candidate color genes from other taxa. Results Overall, we found differential expression of a suite of genes that control melanogenesis, melanocyte differentiation, and melanocyte proliferation (e.g., tyrp1, lef1, leo1, and mitf) as well as several differentially expressed genes involved in purine synthesis and iridophore development (e.g., arfgap1, arfgap2, airc, and gart). Conclusions Our results provide evidence that several gene networks known to affect color and pattern in vertebrates play a role in color and pattern variation in this species of poison frog.
Open Access
Innovative Controller Design for a 5MW Wind Turbine Blade
(2018-06-29) Agarwala, Ranjeet; Chin, Robert
The development and evaluation of a nonlinear pitch controller for wind turbine blades and the design and modeling of an associated actuator and controller was examined. The pitch actuator and controller were modeled and analyzed using Pneumatically Actuated Muscles (PAMs) for actively pitching the wind turbine blade. PAMs are very light and have a high specific work and a good contraction ratio. Proportional Integral and Derivative (PID) controllers were envisaged for the wind turbine pitching system at the blade tip due to its routine usage in the wind turbine industry. Deployment of controllers enables effective pitch angle tracking for power abatement at various configurations. The controller was subjected to four pitch angle trajectory signals. PID controllers were tuned to achieve satisfactory performance when subjected to the test signal. Low pitch angle errors resulted in satisfactory blade pitch angle tracking. Deployment of these controllers enhances wind turbine performance and reliability. The data suggest that the pitch system and actuator that was modeled using PAMs and PID controllers is effective providing robust pitch angle trajectory tracking. The results suggest that the proposed design can be successfully integrated into the family of wind turbine blade pitch angle controller technologies.
Open Access
The effects of an afterschool STEM program on students’ motivation and engagement
(2017-06-12) Chittum, Jessica R.; Jones, Brett D.; Akalin, Sehmuz; Schram, Asta B.
Background: One significant factor in facilitating students’ career intentions and persistence in STEM (science, technology, engineering, and mathematics) fields is targeting their interests and motivation before eighth grade. To reach students at this critical stage, a design-based afterschool STEM program, titled Studio STEM, was implemented to foster motivation and engagement in STEM topics and activities. The purpose of this study is twofold: (a) to investigate how Studio STEM affected students’ beliefs about science and whether these beliefs differed from their peers who did not participate in the program, and (b) to examine a case study of one Studio STEM implementation to investigate elements of the curriculum that motivated students to engage in the program. Results: After completing two Studio STEM programs, participants’ ratings of their values for science and science competence were higher than those of non participants. In addition, the Studio STEM participants’ motivational beliefs about science and intentions to pursue a college degree were more resilient over time than their peers. We also found that students could be motivated in a voluntary afterschool program (Studio STEM) in which they grappled with STEM concepts and activities, and could verbalize specific program elements that motivated them. Conclusions: Through this study, we found that students could be motivated in Studio STEM and that the experience had a positive impact on their perceptions about science as a field. Importantly, Studio STEM appeared to halt the decline in these students’ motivational beliefs about science that typically occurs during the middle school years, indicating that after school programs can be one way to help students maintain their motivation in science. Studying the program features that the students found motivating may help educators to make connections between research and theory, and their classroom instruction to motivate their students.
Open Access
Seasonal home range dynamics and sex differences in habitat use in a threatened, coastal marsh bird
(2016-12-22) Kolts, Jaan Runyon; McRae, Susan B.
A comprehensive understanding of spatiotemporal ecology is needed to develop conservation strategies for declining species. The king rail (Rallus elegans) is a secretive marsh bird whose range historically extended across the eastern United States. Inland migratory populations have been greatly reduced with most remaining populations inhabiting the coastal margins. Our objectives were to determine the migratory status of breeding king rails on the mid-Atlantic coast and to characterize home range size, seasonal patterns of movement, and habitat use. Using radiotelemetry, we tracked individual king rails among seasons, and established that at least a segment of this breeding population is resident. Mean (±SE) home range size was 19.8 ± 5.0 ha (95% kernel density) or 2.5 ± 0.9 (50% kernel density). We detected seasonal variation and sex differences in home range size and habitat use. In the nonbreeding season, resident male home ranges coincided essentially with their breeding territories. Overwintering males were more likely than females to be found in natural emergent marsh with a greater area of open water. Females tended to have larger home ranges than males during the nonbreeding season. We report for the first time the use of wooded natural marsh by overwintering females. Brood-rearing king rails led their young considerable distances away from their nests (average maximum distance: ~600 ± 200 m) and used both wooded natural and impounded marsh. King rails moved between natural marsh and managed impoundments during all life stages, but the proximity of these habitat types particularly benefitted brood-rearing parents seeking foraging areas with shallower water in proximity to cover. Our results demonstrate the importance of interspersion of habitat types to support resident breeders. Summer draining of impounded wetlands that are seasonally flooded for wintering waterfowl allows regrowth of vegetation and provides additional habitat at a critical time for wading birds.
Open Access
A high-efficiency CRISPR/Cas9 system for targeted mutagenesis in Cotton (Gossypium hirsutum L.)
(2017-03-03) Zhang, Baohong; Li, Chao; Unver, Turgay
The complex allotetraploid genome is one of major challenges in cotton for repressing gene expression. Developing site-specific DNA mutation is the long-term dream for cotton breeding scientists. The clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) system is emerging as a robust biotechnology for targeted-DNA mutation. In this study, two sgRNAs, GhMYB25-like-sgRNA1 and GhMYB25-like-sgRNA2, were designed in the identical genomic regions of GhMYB25-like A and GhMYB25-like D, which were encoded by cotton A subgenome and the D subgenome, respectively, was assembled to direct Cas9-mediated allotetraploid cotton genome editing. High proportion (14.2–21.4%) CRISPR/Cas9-induced specific truncation events, either from GhMYB25-like A DNA site or from GhMYB25-like D DNA site, were detected in 50% examined transgenic cotton through PCR amplification assay and sequencing analyses. Sequencing results also demonstrated that 100% and 98.8% mutation frequency were occurred on GhMYB25-like-sgRNA1 and GhMYB25-like-sgRNA2 target site respectively. The off-target effect was evaluated by sequencing two putative off-target sites, which have 3 and 1 mismatched nucleotides with GhMYB25-like-sgRNA1 and GhMYB25-like-sgRNA2, respectively; all the examined samples were not detected any off-targetcaused mutation events. Thus, these results demonstrated that CRISPR/Cas9 is qualified for generating DNA level mutations on allotetraploid cotton genome with high-efficiency and high-specificity.
Open Access
A Content Analysis of Psychological Resilience Among First Responders and the General Population
(2017-03) Crowe, Allison; Glass, J. Scott; Lancaster, Mandee F.; Raines, Justin M.; Waggy, Megan R.
The current study examined how first responders and the general population described the concept of resilience. Categories of resilience were coded a priori using Stemler’s content analysis. For the general population, positive coping was the most frequently occurring category followed by social support and adaptability. The next most frequently occurring terms were societal resources and personal competence. Consistent with the general population, first responders described resilience most frequently with positive coping. Social support was the next most frequently occurring category, followed by personal competence, perseverance, emotional regulation, and physical fitness. Although both the general population and first responder participants highlighted the importance of having a support network, first responders suggested that dealing with traumatic experiences was more of an individual process, and seeking professional help was not common practice. Implications for mental health professionals and future directions for research are offered.
Open Access
Nearshore mixing and nutrient delivery along the western Antarctic Peninsula
(2017) Corbett, D. Reide (David Reide), 1971-; Crenshaw, Jared; Null, Kimberly; Peterson, Richard N.; Peterson, Leigha E.; Lyons, W. Berry
The surface waters of the Southern Ocean play a key role in the global climate and carbon cycles by promoting growth of some of the world’s largest phytoplankton blooms. Several studies have emphasized the importance of glacial and sediment inputs of Fe that fuel the primary production of the Fe-limited Southern Ocean. Although the fertile surface waters along the shelf of the western Antarctic Peninsula (WAP) are influenced by large inputs of freshwater, this freshwater may take multiple pathways (e.g. calving, streams, groundwater discharge) with different degrees of water-rock interactions leading to variable Fe flux to coastal waters. During the summers of 2012–13 and 2013–14, seawater samples were collected along the WAP, near Anvers Island, to observe water column dynamics in nearshore and offshore waters. Tracers (223,224Ra, 222Rn, 18O, 2H) were used to evaluate the source and transport of water and nutrients in coastal fjords and across the shelf. Coastal waters are compared across two field seasons, with increased freshwater observed during 2014. Horizontal mixing rates of water masses along the WAP ranged from 110–3600 m2 s-1. These mixing rates suggest a rapid transport mechanism for moving meltwater offshore.
Open Access
Biophysical Mechanisms Mediating Fibrin Fiber Lysis
(2017-05-28) Hudson, Nathan E.
The formation and dissolution of blood clots is both a biochemical and a biomechanical process. While much of the chemistry has been worked out for both processes, the influence of biophysical properties is less well understood. This review considers the impact of several structural and mechanical parameters on lytic rates of fibrin fibers. The influences of fiber and network architecture, fiber strain, FXIIIa cross-linking, and particle transport phenomena will be assessed. The importance of the mechanical aspects of fibrinolysis is emphasized, and future research avenues are discussed.
Open Access
Resolving power of diffraction imaging with an objective: a numerical study
(2017-05) Wang, Wenjin; Liu, Jing; Lu, Jun Q.; Ding, Junhua; Hu, Xin-Hua
Diffraction imaging in the far-field can detect 3D morphological features of an object for its coherent nature. We describe methods for accurate calculation and analysis of diffraction images of scatterers of single and double spheres by an imaging unit based on microscope objective at non-conjugate positions. A quantitative study of the calculated diffraction imaging in spectral domain has been performed to assess the resolving power of diffraction imaging. It has been shown numerically that with coherent illumination of 532 nm in wavelength the imaging unit can resolve single spheres of 2 μm or larger in diameters and double spheres separated by less than 300 nm between their centers.
Open Access
The effects of elevated temperature and dissolved ρCO2 on a marine foundation species
(2017-04) Speights, Cori J.; Silliman, Brian R.; McCoy, Michael W.
Understanding how climate change and other environmental stressors will affect species is a fundamental concern of modern ecology. Indeed, numerous studies have documented how climate stressors affect species distributions and population persistence. However, relatively few studies have investigated how multiple climate stressors might affect species. In this study, we investigate the impacts of how two climate change factors affect an important foundation species. Specifically, we tested how ocean acidification from dissolution of CO2 and increased sea surface temperatures affect multiple characteristics of juvenile eastern oysters (Crassostrea virginica). We found strong impacts of each stressor, but no interaction between the two. Simulated warming to mimic heat stressed summers reduced oyster growth, survival, and filtration rates. Additionally, we found that CO2-induced acidification reduced strength of oyster shells, which could potentially facilitate crab predation. As past studies have detected few impacts of these stressors on adult oysters, these results indicate that early life stages of calcareous marine organisms may be more susceptible to effects of ocean acidification and global warming. Overall, these data show that predicted changes in temperature and CO2 can differentially influence direct effects on individual species, which could have important implications for the nature of their trophic interactions.
Open Access
Health effects following subacute exposure to geogenic dust collected from active drainage surfaces (Nellis Dunes Recreation Area, Las Vegas, NV)
(2017-12-08) DeWitt, Jamie C.; Buck, Brenda J.; Goossens, Dirk; Teng, Yuanxin; Pollard, James; McLaurin, Brett T.; Gerads, Russell; Keil, Deborah E.
The specific health effects of directinhalation of fine minerogenic dusts generated by natural soil surfaces remain poorly known and relatively little researched. To learn more about this exposure and its contribution to human health effects, we surveyed surface sediment and characterized dust from the Nellis Dunes Recreation Area (NDRA) in Clark County, Nevada, a popular off-road vehicle (ORV) recreational site. Dry drainage systems at NDRA are commonly used as natural trail systems for ORV recreation; these surfaces also are characterized by high concentrations of heavy metals. Geogenic dust with a median diameter of 4.05 m, collected from drainage surfaces at NDRA contained a total elemental concentration of aluminum (79,651 g/g), vanadium (100 g/g), chromium (54 g/g), manganese (753 g/g), iron (33,266 g/g), cobalt(14 g/g), copper (37 g/g) zinc (135 g/g), arsenic (71 g/g), strontium (666 g/g), cesium (15 g/g), lead (34 g/g), and uranium (54.9 g/g).Adultfemale B6C3F1 mice exposed via oropharyngeal aspiration to 0.01–100 mg dust/kg body weight, four times, a week apart, for 28-days, were evaluated for immuno- and neurotoxicological outcomes 24 h after the last exposure. Antigen-specific IgM responses were dose-responsively suppressed at 0.1, 1.0, 10 and 100 mg/kg. Splenic lymphocytic subpopulations, hematological and clinical chemistry parameters were affected. In brain tissue, antibodies against NF-68, and GFAP were not affected, whereas IgM antibodies against MBP were reduced by 26.6% only in the highest dose group. A lowest observed adverse effect level (LOAEL) of 0.1 mg/kg/day and a no observed adverse effect level (NOAEL) of 0.01 mg/kg/day were derived based on the antigen primary IgM responses after subacute exposure to this geogenic dust.
Open Access
A 14-year longitudinal study of the impact of clean indoor air legislation on state smoking prevalence, USA, 1997-2010
(2017) Becker, Craig M.; Lee, Joseph G. L.; Hudson, Suzanne; Hoover, Jeanne K.; Civils, Donald
While clean indoor air legislation at the state level is an evidence-based recommendation, only limited evidence exists regarding the impact of clean indoor air policies on state smoking prevalence. Using state smoking prevalence data from 1997 to 2010, a repeated measures observational analysis assessed the association between clean indoor air policies (i.e., workplace, restaurant, and bar) and state smoking prevalence while controlling for state cigarette taxes and year. The impacts from the number of previous years with any clean indoor air policy, the number of policies newly in effect during the current year, and the number of policies in effect the previous year were analyzed. Findings indicate a smoking prevalence predicted decrease of 0.13 percentage points (p = 0.03) for each additional year one or more clean indoor air policies were in effect, a predicted decrease of 0.12 percentage points (p = 0.09) for each policy newly in effect in the current year, and a predicted decrease of 0.22 percentage points (p = 0.01) for each policy in effect in the previous year on the subsequent year. Clean indoor air policies show measurable associations with reductions in smoking prevalence within a year of implementation above and beyond taxes and time trends. Further efforts are needed to diffuse clean indoor air policies across states and provinces that have not yet adopted such policies.
Open Access
A possible dose–response association between distance to farmers’ markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States
(2017-01) Jilcott Pitts, Stephanie Bell; Hinkley, Jedediah; Wu, Qiang; McGuirt, Jared T.; Lyonnais, Mary Jane; Rafferty, Ann P.; Whitt, Olivia R.; Winterbauer, Nancy L.; Phillips, Lisa
Background: The association between farmers’ market characteristics and consumer shopping habits remains unclear. Our objective was to examine associations among distance to farmers’ markets, amenities within farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and body mass index (BMI). We hypothesized that the relationship between frequency of farmers’ market shopping and BMI would be mediated by fruit and vegetable consumption. Methods: In 15 farmers’ markets in northeastern North Carolina, July–September 2015, we conducted a crosssectional survey among 263 farmers’ market customers (199 provided complete address data) and conducted farmers’ market audits. To participate, customers had to be over 18 years of age, and English speaking. Dependent variables included farmers’ market shopping frequency, fruit and vegetable consumption, and BMI. Analysis of variance, adjusted multinomial logistic regression, Poisson regression, and linear regression models, adjusted for age, race, sex, and education, were used to examine associations between distance to farmers’ markets, amenities within farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and BMI. Results: Those who reported shopping at farmers’ markets a few times per year or less reported consuming 4.4 (standard deviation = 1.7) daily servings of fruits and vegetables, and those who reported shopping 2 or more times per week reported consuming 5.5 (2.2) daily servings. There was no association between farmers’ market amenities, and shopping frequency or fruit and vegetable consumption. Those who shopped 2 or more times per week had a statistically significantly lower BMI than those who shopped less frequently. There was no evidence of mediation of the relationship between frequency of shopping and BMI by fruit and vegetable consumption. Conclusions: More work should be done to understand factors within farmers’ markets that encourage fruit and vegetable purchases.
Open Access
Applying Community-Based Participatory Research Partnership Principles to Public Health Practice-Based Research Networks
(2016) Winterbauer, Nancy L.; Bekemeier, Betty; VanRaemdonck, Lisa; Hoover, Anna G.
With real-world relevance and translatability as important goals, applied methodological approaches have arisen along the participatory continuum that value context and empower stakeholders to partner actively with academics throughout the research process. Community-based participatory research (CBPR) provides the gold standard for equitable, partnered research in traditional communities. Practice-based research networks (PBRNs) also have developed, coalescing communities of practice and of academics to identify, study, and answer practice-relevant questions. To optimize PBRN potential for expanding scientific knowledge, while bridging divides across knowledge production, dissemination, and implementation, we elucidate how PBRN partnerships can be strengthened by applying CBPR principles to build and maintain research collaboratives that empower practice partners. Examining the applicability of CBPR partnership principles to public health (PH) PBRNs, we conclude that PH-PBRNs can serve as authentic, sustainable CBPR partnerships, ensuring the co-production of new knowledge, while also improving and expanding the implementation and impact of research findings in real-world settings.
Open Access
The Short-Term Effect of Weight Loss Surgery on Volumetric Breast Density and Fibroglandular Volume
(2016-10-26) Vohra, Nasreen A.; Kachare, Swapnil D.; Vos, Paul; Schroeder, Bruce F.; Schuth, Olga; Suttle, Dylan; Fitzgerald, Timothy L.; Wong, Jan H.; Verbanac, Kathryn M.
Purpose: Obesity and breast density are both associated with an increased risk of breast cancer and are potentially modifiable. Weight loss surgery (WLS) causes a significant reduction in the amount of body fat and a decrease in breast cancer risk. The effect of WLS on breast density and its components has not been documented. Here, we analyze the impact of WLS on volumetric breast density (VBD) and on each of its components (fibroglandular volume and breast volume) by using three-dimensional methods. Materials and Methods: Fibroglandular volume, breast volume, and their ratio, the VBD, were calculated from mammograms before and after WLS by using Volpara™ automated software. Results: For the 80 women included, average body mass index decreased from 46.0 ± 7.22 to 33.7 ± 7.06 kg/m2. Mammograms were performed on average 11.6 ± 9.4 months before and 10.1 ± 7 months after WLS. There was a significant reduction in average breast volume (39.4 % decrease) and average fibroglandular volume (15.5 % decrease), and thus, the average VBD increased from 5.15 to 7.87 % (p < 1 × 10−9) after WLS. When stratified by menopausal status and diabetic status, VBD increased significantly in all groups but only perimenopausal and postmenopausal women and non-diabetics experienced a significant reduction in fibroglandular volume. Conclusions: Breast volume and fibroglandular volume decreased, and VBD increased following WLS, with the most significant change observed in postmenopausal women and non-diabetics. Further studies are warranted to determine how physical and biological alterations in breast density components after WLS may impact breast cancer risk.

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