Racing with the industry: an interview on motorsports, esports, livestreaming and the COVID-19 pandemic

The following interview discusses two paradigmatic media sports cases during live sports lockdown in 2020. Producing online tournament responses to the COVID-19 cancellations of live events, the IndyCar First Responders 175 race and the W Series esports league both turned to esports livestreaming. Under this transition, themes of safety, gender equity, risk, and rules emerged as key topics surrounding the current and future state of esports within media sports ecosystems. As discussed by Garth Midgley (founder of GOATi Entertainment and lead developer of 22-Racing Series), Abe Stein (senior strategist with the Sports Innovation Lab), Gina Miller and Jo Diamond (Communications executives, W Series), and Emma Witkowski (senior lecturer and esports academic), these cases exemplify ascending issues in sports quick transition to online esports and networked livestreaming solutions, shoring up media sports under lockdown.

Ecmo as a Bridge to Lung Transplantation for Covid-19 Respiratory Failure: Outcomes and Risk Factors for Early Mortality

Severe COVID-19 infection can cause advanced respiratory failure requiring ECMO. In some cases, lung transplantation (LT) is a last viable treatment option. This study aims to evaluate outcomes among COVID patients bridged to LT with ECMO and identify risk factors for early mortality post-LT. Using the UNOS database, we identified 442 patients who underwent LT for COVID-19 respiratory failure between August 2020 and September 2022. Outcomes of patients requiring preoperative ECMO (n=253) were compared to those who did not require ECMO pre-LT (n=189). Survival analyses were conducted using the Kaplan-Meier survival function and Cox proportional hazards models. Risk factors for post-LT mortality were analyzed using a multivariate logistic regression model. Out of 442 patients, 253 required preoperative ECMO support for a median of 73 days (IQR 40, 119). The most common ECMO platform was veno-venous (p=0.0008). Patients requiring ECMO were younger, more frequently in an ICU, had higher LAS scores, more likely to require bilateral LT, had higher rates of tracheostomy and pre-LT dialysis, and were more likely to have ARDS etiologies of respiratory failure (all p<0.0001). At 1 and 6 months post-LT, there was no difference in survival between ECMO and non-ECMO patients (95.5% vs 97.5% at 1 month, 92.7% vs 93.4% at 6 months) (Fig 1a). However, ECMO patients had higher rates of prolonged ventilation, post-operative ECMO, new dialysis, and increased length of stay (all p<0.0001) post-LT. Risk factors for mortality included BMI (p=0.007), pan-resistant bacterial infection (p=0.01), preoperative VA ECMO (p=0.0008), prior cardiac surgery (p=0.05), and single LT procedure (p<0.0001) (Fig 1b). Our findings suggest that ECMO can safely be used as a bridge to LT in well-selected patients with COVID-19 respiratory failure despite prolonged support. Here we identify possible risk factors associated with early mortality that may require further evaluation. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

TRANSLATING EVIDENCE-BASED PRACTICES FOR ADOLESCENT SUBSTANCE USE DISORDERS IN RURAL SYSTEMS OF CARE

Objectives: Evidence-based practices bring hope for improved outcomes for adolescents and their families living in rural areas who are impacted by substance use disorders. However, many rural youths do not receive needed services, and systems of care face challenges to providing these services. Methods: Presenters with experience delivering services in rural areas will review the relevant literature and summarize key evidence-based practices. They will use case-based methods, explain opportunities and challenges, and describe recent programs addressing adolescent substance use in several rural areas. Sandi Kazura, MD, will provide background with summaries of the epidemiology of youth substance use and risk factors, a list of evidence-based interventions, and results of a literature search on rural-specific interventions. Kaye McGinty, MD, will describe the evolution of mental health/substance use services within a large rural health system during a rapid need of increase in the context of the COVID-19 pandemic. Catherine Martin, MD, will describe the findings from a telehealth tobacco treatment program in Kentucky, including a focus on adolescent/grandparent dyads and lessons learned about telepsychiatry in urban vs rural sites. Susan Therese Garrett, MD, will discuss how claims data and restrictions on data sharing inform payor care management and youth transitions of care. John Diamond, MD, will summarize the findings with expert commentary and facilitation of Q&A with the audience and presenters. Results: Adolescent substance use is a large problem in rural areas, with multiple challenges to provision of evidence-based services, including workforce shortages, training needs, cultural factors, and data needs. The current pandemic amplified the existing service needs and inspired creative solutions. Thoughtful qualitative and quantitative data collection and communications of findings is needed to expand the knowledge base about successful programs. Conclusions: Clinical science has developed interventions that can improve outcomes for adolescents with substance use disorders living in rural communities. Systems of care face opportunities and challenges in making this happen. SUD, RP, EBP

Safety and efficacy of VIP152, a CDK9 inhibitor, in patients with double-hit lymphoma (DHL)

Background: PTEFb/CDK9-mediated transcription of short-lived anti-apoptotic survival proteins and oncogenes like MCL-1 and MYC plays a critical role in a variety of cancers. VIP152 (formerly BAY 1251152), a potent and highly selective CDK9 inhibitor, has been evaluated in a Phase 1 dose-escalation study in patients with advanced cancer. The maximum tolerated dose was 30 mg once weekly administered in consecutive 21-day cycles, based on neutropenia as the dose-limiting toxicity (JCO 2018;36:2507;NCT02635672). DHL is defined as dual rearrangement of the MYC gene and either the BCL2 or BCL6 genes;the resulting overexpression of MYC and BCL2/BCL6 make it particularly difficult to treat. Patients with DHL have a poor prognosis and no standard of care. Considering the impact of CDK9 inhibition on MYC, an exploratory cohort of patients with DHL was added to the study. Methods: Patients with refractory or relapsed DHL were eligible. VIP152 was administered once weekly as a 30-minute IV infusion on Days 1, 8 and 15 of a 21-day cycle. Tumor response was assessed according to the revised Cheson criteria (2007). Results: To date a total of 7 patients have been enrolled and were evaluable at the time of data cutoff (24NOV2020). The patients were mostly men (6/7 pts, 86%) with a median (range) age of 70 (58-84) years. All patients received ≥2 prior therapies, including 2 patients with bone marrow transplant. Three of 7 patients (29%) had ≥3 prior therapies. The median time on treatment was 22 days (range 8-1361 days). The most common adverse events of any grade were: constipation, fatigue, nausea (each 3/7 pts, 43%) and abdominal pain, diarrhea, lymphocyte count decrease, neutrophil count decrease, skin infection, tumor pain, and vomiting (each 2/7 pts, 29%). Most were Grade 1 and Grade 2. The Grade 3 adverse events were fatigue, lymphocyte count decrease, neutrophil count decrease (each 1/7 pts, 14%) and tumor pain (2/7 pts, 29%). One Grade 4 lymphocyte count decrease was reported. Two patients had a serious adverse event (Grade 3 syncope and Grade 3 tumor pain). Two patients had dosing held for an adverse event;however, no patient withdrew from treatment due to any adverse events. One death occurred due to disease progression. Pharmacodynamic biomarker analysis showed significant reduction of MYC, PCNA, and MCL-1 mRNA in all patients across multiple timepoints. Antitumor activity consisted of 2 complete metabolic responses in 7 patients (29%) based on investigator-assessed FDG-PET scans. Due to the COVID pandemic, the patients withdrew consent after 3.7 and 2.3 years, respectively, of treatment. Both patients were in complete metabolic response. Conclusions: VIP152 had a manageable safety profile, on-target pharmacodynamic activity and signs of durable monotherapy antitumor activity in patients with DHL. These encouraging results warrant further evaluation of VIP152 in patients with MYCdriven lymphoma and solid tumors.