Blubber Cortisol Research Articles

Variation in blubber cortisol levels in a recovering humpback whale population inhabiting a rapidly changing environment

Glucocorticoids are regularly used as biomarkers of relative health for individuals and populations. Around the Western Antarctic Peninsula (WAP), baleen whales have and continue to experience threats, including commercial harvest, prey limitations and habitat change driven by rapid warming, and increased human presence via ecotourism. Here, we measured demographic variation and differences across the foraging season in blubber cortisol levels of humpback whales (Megaptera novaeangliae) over two years around the WAP. Cortisol concentrations were determined from 305 biopsy samples of unique individuals. We found no significant difference in the cortisol concentration between male and female whales. However, we observed significant differences across demographic groups of females and a significant decrease in the population across the feeding season. We also assessed whether COVID-19-related reductions in tourism in 2021 along the WAP correlated with lower cortisol levels across the population. The decline in vessel presence in 2021 was associated with a significant decrease in humpback whale blubber cortisol concentrations at the population level. Our findings provide critical contextual data on how these hormones vary naturally in a population over time, show direct associations between cortisol levels and human presence, and will enable comparisons among species experiencing different levels of human disturbance.

Blubber and serum cortisol concentrations as indicators of the stress response and overall health status in striped dolphins

The impacts of environmental changes and anthropogenic threats in marine mammals are a growing concern for their conservation. In recent years, efforts have been directed to understand how marine mammals cope with stressors and to assess and validate stress biomarkers, mainly levels of glucocorticoid hormones (e.g. cortisol) in certain body tissues. The aims of this study were to assess the impact of different causes of stranding (chronically affected and bycaught striped dolphins) on cortisol concentrations in serum and in blubber; and to evaluate the association between cortisol levels in these tissues. Blubber and blood samples were collected from striped dolphins (n = 42) stranded on the Mediterranean coast between 2012 and 2018. Cortisol concentrations were measured by using enzyme immunoassay. A high correlation was found between circulating and blubber cortisol concentrations (R2 = 0.85, p < 0.01). Necropsies and pathological studies concluded that a third of the dolphins were bycaught in fishing nets and released by fishermen (Bycaught animals group), while the other two thirds were euthanized, or died, due to a disease or chronic condition (e.g. calves separated from the mother or animals infected with dolphin morbillivirus or Brucella ceti) that impeded survival (Chronically affected animals group). Cortisol concentrations (mean ± SD) were six times higher in chronically affected animals (35.3 ± 23 ng cortisol/g blubber and 6.63 ± 3.22 μg cortisol/dl serum) compared to those bycaught in fishing nets (6.2 ± 4.3 ng cortisol/g blubber and 1.15 ± 1.51 μg cortisol/dl serum). Results suggests that serum and blubber cortisol concentrations can contribute in inferring the overall health and welfare of free-ranging cetaceans. However, further research is required to understand better the kinetics of blubber cortisol incorporation and removal, the factors involved in these processes, and the local conversion of cortisol in the blubber.

Spatiotemporal variation of ringed seal blubber cortisol levels in the Canadian Arctic.

Climate change in the Arctic has widespread and complex effects on the health of animals and their populations. We used radioimmunoassay to measure blubber cortisol in ringed seals (Pusa hispida) sampled in Ulukhaktok, Inuvialuit Settlement Region, Northwest Territories, Canada (spring, 2002, 2004–2005, 2007–2012) and Arviat, Nunavut, Canada (autumn, 2003–2012) to examine chronic stress relative to biology (age, sex, length), body condition (blubber depth), and diet (δ13C, δ15N, and isotopic niche size). Ulukhaktok ringed seals had higher cortisol concentrations overall (0.46 ± 0.04 ng/g) than Arviat ringed seals (0.36 ± 0.03 ng/g), and these higher concentrations were associated with higher muscle δ15N and lower blubber thickness. In contrast, blubber cortisol concentrations for Arviat ringed seals decreased with blubber depth and increased with age, though testing of age effects individually suggests that age-related patterns are weak. Annual mean cortisol concentration increased from 2003 to 2012 in Arviat ringed seals, but low sample sizes precluded analysis of annual patterns for Ulukhaktok ringed seals. The trend of increased cortisol over time in Arviat ringed seals suggests that they might be experiencing greater chronic stress over time, which could have implications for numerous population health metrics including reproduction and pup recruitment.

Blubber cortisol in four Canadian beluga whale populations is unrelated to diet

Changing conditions in the Arctic have had severe consequences for many marine mammals. In this study, we examined blubber cortisol using radioimmunoassay in 4 Canadian beluga whaleDephinapterus leucaspopulations. The endangered Cumberland Sound population had higher cortisol levels (mean ± SE: 0.65 ± 0.11 ng g-1) than populations not at risk: Eastern Beaufort Sea (0.31 ± 0.03 ng g-1; p &lt; 0.001), Eastern High Arctic-Baffin Bay (0.32 ± 0.09 ng g-1; p = 0.004), and Western Hudson Bay (0.44 ± 0.04 ng g-1; p = 0.004). To evaluate if measured cortisol differences were due to differences in diet, we compared stable isotope ratios of carbon and nitrogen (δ13C and δ15N) and dietary fatty acids among populations. Beluga whales from Eastern Beaufort Sea had lower δ13C (p ≤ 0.017) and higher δ15N (p &lt; 0.001) values than other measured populations, while Western Hudson Bay beluga dietary fatty acid profiles differed from other measured populations (p &lt; 0.001). Population and sex were significant predictors of blubber cortisol (p ≤ 0.017). Females exhibited higher cortisol than males. Despite diet differences among populations, neither stable isotopes nor fatty acids were significant predictors of cortisol, suggesting differences in cortisol levels were unrelated to diet. Other factors, such as increased risk of predation, hunting pressure, vessel traffic, or differences in baseline blubber cortisol concentrations may be contributing to elevated cortisol levels in Cumberland Sound beluga whales. Measuring blubber cortisol in combination with chemical indicators of diet provides a useful method for monitoring population health and can be used to inform management and conservation.

Blubber Cortisol-Based Approach to Explore the Endocrine Responses of Indo-Pacific Humpback Dolphins (Sousa chinensis) to Diet Shifts and Contaminant Exposure.

The detrimental effects of contaminant exposure and changes in the availability of food resources are still of concern for Indo-Pacific humpback dolphins (Sousa chinensis) of the Pearl River Estuary (PRE). Here, we validated and applied a blubber cortisol biomarker approach to assess the physiological responses of PRE dolphins to various pollutants and diet changes during 2008-2018 (n = 70). For calves, generalized additive models (GAMs) revealed that cortisol levels varied significantly by month and were positively correlated with the body length, owing to significant maternal transfer of hormones. The significantly positive correlation between length-adjusted cortisol levels in calf and the annual calf mortality ratios suggested that during years of high calf mortality, these animals were highly stressed before they die. For noncalves, blubber cortisol levels in diseased animals were significantly higher than those in "healthy" ones. Chromium (Cr) and dichlorodiphenyltrichloroethanes displayed a significant and positive relationship with blubber cortisol levels, suggesting that contaminant-mediated endocrine disruption effects may have occurred in noncalves. The GAMs indicated a decreasing trend of noncalf's blubber cortisol levels over an 11-year span, which can be explained by their declining contaminant accumulation levels due to a significant dietary shift from eating highly contaminated fishes to less polluted ones.

Influence of sample location on blubber cortisol concentration in striped dolphins (Stenella coeruleoalba): The importance of the reference denominator

Influence of sample location on blubber cortisol concentration in striped dolphins (<scp><i>Stenella coeruleoalba</i></scp>): The importance of the reference denominator

Stress and reproductive events detected in North Atlantic right whale blubber using a simplified hormone extraction protocol.

As studies quantifying steroid hormones in marine mammal blubber progress, methodological refinements may improve the utility and consistency of blubber hormone measurements. This study advances blubber extraction methodologies by testing a simplified extraction protocol that reduces time and complexity compared to a protocol widely used in cetacean blubber studies. Using blubber samples archived from remote biopsy (n = 21 live whales) and necropsy collection (n = 7 dead whales) of North Atlantic right whales (NARW; Eubalaena glacialis) of known life history states, we performed analytical and biological validations to assess the feasibility of measuring reproductive (testosterone, progesterone) and glucocorticoid (cortisol) hormones in blubber via enzyme immunoassay following the simplified extraction. Analytical validations (parallelism, accuracy, extraction efficiency, repeatability) showed the simplified extraction produced similar results to the extended protocol, offering a more efficient and consistent technique. In live, apparently healthy whales, blubber testosterone concentrations (mean ± SE) were significantly higher in males (2.02 ± 0.36ng/g) compared to females (0.81 ± 0.15ng/g). Blubber progesterone was highest in a confirmed pregnant female (60.3ng/g), which was 12-fold greater than the mean concentration of non-pregnant females (4.56 ± 0.88ng/g). Blubber cortisol concentrations in whales that died from anthropogenic causes averaged 5.31 ± 2.28ng/g, whereas most live, healthy whales had cortisol values below 1ng/g. Among living whales, a whale actively entangled in fishing gear had the highest blubber cortisol measurement (3.51ng/g), exhibiting levels similar to whales that died from acute entanglement (2.88 ± 0.42ng/g). Overall, the highest blubber cortisol concentration (18.0ng/g) was measured in a dead whale with a severe chronic entanglement, approximately 30-fold greater than mean blubber cortisol of apparently healthy whales (0.58 ± 0.11ng/g). The methodological approach presented here provides a reference for researchers interested in an alternative, streamlined technique for hormone extraction of cetacean blubber and contributes to the diverse tool set for stress and reproductive assessments of endangered NARWs.

Blubber cortisol levels in humpback whales (Megaptera novaeangliae): A measure of physiological stress without effects from sampling

Baleen whales are vulnerable to environmental impacts due to low fecundity, capital breeding strategies, and their reliance on a large amount of prey resources over large spatial scales. There has been growing interest in monitoring health and physiological stress in these species but, to date, few measures have been validated. The purpose of this study was to examine whether blubber cortisol could be used as a measure of physiological stress in humpback whales. Cortisol concentrations were initially compared between live, presumably ‘healthy’ whales (n = 187) and deceased whales (n = 35), which had died after stranding or entanglement, or washed ashore as a carcass. Deceased whales were found to have significantly higher cortisol levels (mean ± SD; 5.47 ± 4.52 ng/g) than live whales (0.51 ± 0.14 ng/g; p < 0.001), particularly for those animals that had experienced prolonged trauma (e.g. stranding) prior to death. Blubber cortisol levels in live whales were then examined for evidence of life history-related, seasonal, or sampling-related effects. Life history group and sampling-related factors, such as encounter time and the number of biopsy sampling attempts per animal, were found to be poor predictors of blubber cortisol levels in live whales. In contrast, blubber cortisol levels varied seasonally, with whales migrating north towards the breeding grounds in winter having significantly higher levels (0.54 ± 0.21 ng/g, p = 0.016) than those migrating south towards the feeding grounds in spring (0.48 ± 1.23 ng/g). These differences could be due to additional socio-physiological stress experienced by whales during peaks in breeding activity. Overall, blubber cortisol appears to be a suitable measure of chronic physiological stress in humpback whales.

Evidence for cortisol-cortisone metabolism by marine mammal blubber.

Blubber, a specialized hyperdermic adipose tissue found in marine mammals, has been identified as a useful tissue for the assessment of steroid hormone homeostasis in cetaceans. However, blubber cortisol measurements are not quantitatively predictive of circulating cortisol concentrations in bottlenose dolphins. In other mammals, adipose tissue metabolizes steroid hormones. Thus, it is proposed that the disagreement between blubber and blood cortisol in bottlenose dolphins could be due in part to metabolism of corticosteroids in blubber. The purpose of this study is to characterize the ability of blubber to interconvert cortisol and cortisone using an in vitro design. Results demonstrate that bottlenose dolphin blubber microsomes interconvert cortisol and cortisone, an effect that is abated by denaturing the microsomes, indicating this is an enzymatic process. These findings lead to the conclusion that blubber is likely a site of active steroid metabolism, which should be considered in future studies utilizing blubber as a matrix for endocrine assessment.

Comprehensive endocrine response to acute stress in the bottlenose dolphin from serum, blubber, and feces

Several hormones are potential indicators of stress in free-ranging animals and provide information on animal health in managed-care settings. In response to stress, glucocorticoids (GC, e.g. cortisol) first appear in circulation but are later incorporated into other tissues (e.g. adipose) or excreted in feces or urine. These alternative matrices can be sampled remotely, or by less invasive means, than required for blood collection and are especially valuable in highly mobile species, like marine mammals. We characterized the timing and magnitude of several hormones in response to a stressor in bottlenose dolphins (Tursiops truncatus) and the subsequent incorporation of cortisol into blubber, and its metabolites excreted in feces.We evaluated the endocrine response to an acute stressor in bottlenose dolphins under managed care. We used a standardized stress protocol where dolphins voluntarily beached onto a padded platform and remained out of water for two hours; during the stress test blood samples were collected every 15 min and blubber biopsies were collected every hour (0, 60, and 120 min). Each subject was studied over five days: voluntary blood samples were collected on each of two days prior to the stress test; 1 and 2 h after the conclusion of the out-of-water stress test; and on the following two days after the stress test. Fecal samples were collected daily, each afternoon.The acute stressor resulted in increases in circulating ACTH, cortisol, and aldosterone during the stress test, and each returned to baseline levels within 2 h of the dolphin’s return to water. Both cortisol and aldosterone concentrations were correlated with ACTH, suggesting both corticosteroids are at least partly regulated by ACTH. Thyroid hormone concentrations were generally unaffected by the acute stressor. Blubber cortisol increased during the stress test, and fecal GC excretion was elevated on the day of the stress test. We found that GCs in bottlenose dolphins can recover within hours of acute stress, and that cortisol release can be detected in alternate matrices within a few hours—within 2 h in blubber, and 3.5–5 h in fecal samples.

Using blubber explants to investigate adipose function in grey seals: glycolytic, lipolytic and gene expression responses to glucose and hydrocortisone

Adipose tissue is fundamental to energy balance, which underpins fitness and survival. Knowledge of adipose regulation in animals that undergo rapid fat deposition and mobilisation aids understanding of their energetic responses to rapid environmental change. Tissue explants can be used to investigate adipose regulation in wildlife species with large fat reserves, when opportunities for organismal experimental work are limited. We investigated glucose removal, lactate, glycerol and NEFA accumulation in media, and metabolic gene expression in blubber explants from wild grey seals. Glycolysis was higher in explants incubated in 25 mM glucose (HG) for 24 h compared to controls (C: 5.5 mM glucose). Adipose-derived lactate likely contributes to high endogenous glucose production in seals. Lipolysis was not stimulated by HG or high hydrocortisone (HC: 500 nM hydrocortisone) and was lower in heavier animals. HC caused NEFA accumulation in media to decrease by ~30% relative to C in females, indicative of increased lipogenesis. Lipolysis was higher in males than females in C and HG conditions. Lower relative abundance of 11-β-hydroxysteroid dehydrogenase 1 mRNA in HG explants suggests glucose involvement in blubber cortisol sensitivity. Our findings can help predict energy balance responses to stress and nutritional state in seals, and highlight the use of explants to study fat tissue function in wildlife.

Initial validation of blubber cortisol and progesterone as indicators of stress response and maturity in an otariid; the California sea lion (Zalophus californianus)

Chronic stress can have detrimental effects on an individual’s health and reproductive success. The use of cortisol quantification as an indicator of stress in free-ranging cetaceans and phocids is increasing but no studies have applied this technique on blubber in otariids. We measured cortisol concentrations in blubber samples obtained from California sea lions, Zalophus californianus, stranded in San Diego County and those incidentally killed in the California drift gillnet fishery. We also measured progesterone concentrations to assess female reproductive status and, in males, as a potential secondary measure of adrenal steroid production. Blubber cortisol and progesterone values were compared across demographic groups (sex and maturity), season, and proportion blubber lipid extracted. Stranded animals (247.3±70.767SEng/gblubber) had significantly higher cortisol concentrations compared to fishery bycaught (8.1±2.108SEng/gblubber) animals. These findings are likely driven by inherent differences in the cause of death and associated nutritional state coupled with the mean duration of expiration for these two groups of animals (i.e., the duration from an animal’s initial perception of the threat-to-self until death). The duration of transition from healthy state to death in stranded animals is on the order of many hours to weeks while in fishery bycaught animals, this transition occurs much more rapidly (i.e., seconds to tens of minutes). The presumed longer duration of the mortality event in stranded animals gives sufficient time for elevated cortisol to diffuse into the blubber. No significant differences between demographic groups, or season were found. However, blubber cortisol declined inversely with proportion blubber lipid extracted, suggesting utility in assessing long-term nutritional status. Blubber progesterone was significantly higher in mature females than immature females (153.8±54.546SEng/gblubber and 9.7±3.60SEng/gblubber respectively), containing on average 15 times more progesterone, irrespective of pregnancy state. Additionally, a significant relationship between mean cortisol and progesterone was found in males with >35% blubber lipid (p<0.0001). This study is an initial step in validating blubber cortisol and progesterone concentrations as a potential marker of stress response and reproductive state, respectively, in otariids. Especially when paired with dart biopsying, this approach could represent a relatively rapid way to assess baseline stress, nutritional status and reproductive states in otariids while minimizing the effects of sampling.

Persistent Organic Pollutant and Hormone Levels in Harbor Porpoise with B Cell Lymphoma.

B-cell lymphoma, a common morphologic variant of non-Hodgkin lymphoma, has been associated with persistent pollutants in humans, but this association is not well-characterized in top-level predators sharing marine resources with humans. We characterized and compared blubber contaminants and hormones of a pregnant harbor porpoise (Phocoena phocoena) with B-cell lymphoma, with those in two presumed healthy fishery by-caught porpoises with no lymphoma: a pregnant adult and female juvenile. Common historic use compounds, including polychlorinated biphenyls, polybrominated diphenyl ethers, and pesticides, were evaluated in blubber samples from three porpoises. In addition, blubber cortisol and progesterone levels (ng/g) were determined in all three animals. Total pollutant concentrations were highest in the juvenile porpoise, followed by the lymphoma porpoise and the nonlymphoma adult. Blubber cortisol concentrations were 191% greater in the pregnant with lymphoma porpoise compared with the pregnant no lymphoma porpoise, and 89% greater in the juvenile female compared with the pregnant no lymphoma porpoise. Although both adults were pregnant, progesterone levels were substantially greater (90%) in the healthy compared with the lymphoma adult. Health monitoring of top-level marine predators, such as porpoise, provides a sentinel measure of contaminants that serve as indicators of potential environmental exposure to humans.

Blubber cortisol qualitatively reflects circulating cortisol concentrations in bottlenose dolphins

AbstractStress hormones, released into circulation as a consequence of disturbance, are classically assayed from blood samples but may also be detected in a variety of matrices. Blubber and fecal samples can be remotely collected from free‐ranging cetaceans without the confounding hormone elevations associated with chase, capture, and handling required to collect blood samples. The relationship between cortisol concentrations in circulation with that of blubber and feces, however, is unknown. To assess these associations, we elevated cortisol by orally administering hydrocortisone for five days in five bottlenose dolphins. Voluntary blood and fecal samples were collected daily; blubber biopsies were collected on day one, just prior to hydrocortisone administration, and days three and five of hydrocortisone administration. We evaluated subsequent changes in several circulating stress hormones as well as cortisol and glucocorticoid metabolites in blubber and feces, respectively. There was a significant association between cortisol levels in serum and in blubber (F1,12.7 = 14.3, P &lt; 0.01, mR2 = 0.57) despite substantial variability in blubber cortisol levels. Counterintuitively, fecal cortisol metabolite levels were inversely related to serum cortisol. The relationship between serum and blubber cortisol levels suggests blubber samples from remote sampling may be useful to detect stress loads in this species.

Seasonal variation in harbour seal (Phoca vitulina) blubber cortisol - A novel indicator of physiological state?

Cortisol is one of the main glucocorticoid hormones involved in both the mammalian stress response, and in fat metabolism and energy regulation, making it of increasing interest as a biomarker for stress, health and overall physiological state. However, transient stress responses to animal handling and sampling may be important sources of measurement artefact when investigating circulating concentrations of this hormone in wildlife. Here, cortisol concentrations were measured in the plasma and, for the first time, in the blubber of live captured adult harbour seals (Phoca vitulina). Plasma cortisol concentrations were positively correlated with capture time, suggesting that they were largely driven by a stress response to the capture event. In contrast, blubber cortisol concentrations were shown not to be significantly affected by capture time and varied significantly by sex and by season, with higher concentrations during natural fasting periods of their life cycle, particularly during the moult. These results suggest that cortisol may play a key role in increased fat metabolism during highly energetically demanding periods, and that blubber concentrations have the potential to be used as physiological state indicators in phocid seals.

Increased blubber cortisol in ice-entrapped beluga whales (Delphinapterus leucas)

Entrapments of whales in sea ice occur occasionally in the Arctic and often last several weeks or months, resulting in emaciation or death of whales. These events provide a unique opportunity for investigating the physiological response to a prolonged or chronic stress in an otherwise healthy population of marine mammals. By measuring cortisol in blubber, a peripheral tissue, we expect to see a reflection of long-term or chronic stress rather than short-term or acute stress. Adipose tissue should be less subject to rapid changes compared to blood cortisol, reflecting stressors experienced over a longer period of time, and should not be affected by potential stress associated with sampling. We measured blubber cortisol of 29 beluga whales (Delphinapterus leucas) entrapped in November 2006 in Husky Lakes basin and 26 whales from the same population (Eastern Beaufort Sea) during regular seasonal harvests in July of 2006 and 2007. Mean cortisol concentrations (±SEM) were seven times higher in blubber from entrapped whales (1.76 ± 0.32 ng/g wet weight) compared to whales from regular seasonal harvests (0.26 ± 0.042 ng/g wet weight) and appeared to increase with whale age. Our results provide a measure of blubber cortisol from a prolonged stress and demonstrate blubber cortisol as a useful indicator of longer-term exposure to stress in beluga whales.

Blubber cortisol: a potential tool for assessing stress response in free-ranging dolphins without effects due to sampling.

When paired with dart biopsying, quantifying cortisol in blubber tissue may provide an index of relative stress levels (i.e., activation of the hypothalamus-pituitary-adrenal axis) in free-ranging cetacean populations while minimizing the effects of the act of sampling. To validate this approach, cortisol was extracted from blubber samples collected from beach-stranded and bycaught short-beaked common dolphins using a modified blubber steroid isolation technique and measured via commercially available enzyme immunoassays. The measurements exhibited appropriate quality characteristics when analyzed via a bootstraped stepwise parallelism analysis (observed/expected = 1.03, 95%CI: 99.6 – 1.08) and showed no evidence of matrix interference with increasing sample size across typical biopsy tissue masses (75–150mg; r2 = 0.012, p = 0.78, slope = 0.022ngcortisol deviation/ultissue extract added). The relationships between blubber cortisol and eight potential cofactors namely, 1) fatality type (e.g., stranded or bycaught), 2) specimen condition (state of decomposition), 3) total body length, 4) sex, 5) sexual maturity state, 6) pregnancy status, 7) lactation state, and 8) adrenal mass, were assessed using a Bayesian generalized linear model averaging technique. Fatality type was the only factor correlated with blubber cortisol, and the magnitude of the effect size was substantial: beach-stranded individuals had on average 6.1-fold higher cortisol levels than those of bycaught individuals. Because of the difference in conditions surrounding these two fatality types, we interpret this relationship as evidence that blubber cortisol is indicative of stress response. We found no evidence of seasonal variation or a relationship between cortisol and the remaining cofactors.

Influence of sample degradation and tissue depth on blubber cortisol in beluga whales

Cortisol concentrations in a variety of biological tissues have been used to obtain short-term to long-term estimates of activation of the physiological stress response. In recent years, blubber has been demonstrated to be a good candidate tissue from which to extract steroid hormones, but no method for extracting cortisol from blubber of any marine mammal has been published and the effects of sample storage and variation in blubber depth on cortisol concentrations are unknown. The objectives of this study were to identify a method for extracting cortisol from blubber in beluga whales (Delphinapterus leucas) and to evaluate the concentration of hormones in relation to blubber depth and degradation from long-term storage using samples collected and archived over the past 30years. Cortisol was extracted from blubber of beluga whales by modifying an existing progesterone-blubber extraction method. Cortisol concentrations were lower in degraded samples, but time in storage did not affect cortisol after controlling for sample quality. Cortisol concentrations increased with blubber depth, with highest concentrations in blubber closest to the muscle. These results show that although cortisol in blubber samples collected and archived prior to extraction may be degraded, high quality samples without visible degradation after long-term storage can still yield useful measures of cortisol. Additionally, sample depth should be controlled for during sample collection. These findings provide necessary information for developing accurate sampling protocols for extracting cortisol from blubber of marine mammals, including sampling by biopsy dart.