Epithelial ovarian cancer survival by race and ethnicity in an equal-access healthcare population.

BACKGROUND: Previous studies in the general population observed that compared with non-Hispanic White women, Pacific Islander and Black women have higher age-adjusted mortality rates from epithelial ovarian cancer (EOC), while Asian American patients have lower mortality. We investigated whether race and ethnicity is associated with differences in EOC survival in a United States Military population where patients have equal access to healthcare. METHODS: This retrospective study included women diagnosed with EOC between 2001 and 2018 among Department of Defense beneficiaries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models adjusting for age and year of diagnosis, histology and stage. RESULTS: In our study population of 1230 invasive EOC cases (558 non-Hispanic White, 74 non-Hispanic Black, 73 Asian, 30 Pacific Islander and 36 Hispanic cases), 63% of the women died (all-cause death) after a mean = 4.8 years (SD = 4.1) of follow-up following diagnosis. Compared with non-Hispanic White cases, Asian cases had better overall survival, HR = 0.76 (95% CI = 0.58-0.98), whereas there were no differences in survival for other racial and ethnic groups. CONCLUSIONS: These findings highlight the need to investigate how differences in access to healthcare may influence observed racial and ethnic disparities for EOC.

Airborne microplastic/nanoplastic research: a comprehensive Web of Science (WoS) data-driven bibliometric analysis.

This paper presents the landscape of research on airborne microplastics and nanoplastics (MPs/NPs) according to the bibliometric analysis of 147 documents issued between 2015 and 2021, extracted from the Web of Science database. The publications on airborne MPs/NPs have increased rapidly from 2015 onwards, which is largely due to the existence of funding support. Science of the Total Environment is one of the prominent journals in publishing related papers. China, England, the USA, and European Countries have produced a significant output of airborne MP/NP research works, which is associated with the availability of funding agencies regionally or nationally. The research hotspot on the topic ranges from the transport of airborne MPs/NPs to their deposition in the terrestrial or aquatic environments, along with the contamination of samples by indoor MPs/NPs. Most of the publications are either research or review papers related to MPs/NPs. It is crucial to share the understanding of global plastic pollution and its unfavorable effects on humankind by promoting awareness of the existence and impact of MPs/NPs. Funding agencies are vital in boosting the research development of airborne MPs/NPs. Some countries that are lacking funding support were able to publish research findings related to the field of interest, however, with lesser research output. Without sufficient fundings, some impactful publications may not be able to carry a substantial impact in sharing the findings and discoveries with the mass public.

Critical review on airborne microplastics: An indoor air contaminant of emerging concern.

Airborne Microplastics (MPs), an emerging environmental issue, have gained recent attention due to their newfound presence in indoor environments. Utilizing the Web of Science database for literature collection, the paper presents a comprehensive review of airborne MPs including emission sources, assessment methods, exposure risks, and mitigation strategies. This review delves into the diverse sources and mechanisms influencing indoor airborne MP pollution, underscoring the complex interplay between human activities, ventilation systems, and the characteristics of indoor environments. Major sources include the abrasion of synthetic textiles and the deterioration of flooring materials, with factors like carpeting, airflow, and ventilation significantly impacting MP levels. Human activities, such as increased movement in indoor spaces and the intensive use of plastic-based personal protective equipment (PPE) post-pandemic, notably elevate indoor MP concentrations. The potential health impacts of airborne MPs are increasingly concerning, with evidence suggesting their role in respiratory, immune, and nervous system diseases. Despite this, there is a scarcity of information on MPs in diverse indoor environments and the inhalation risks associated with the frequent use of PPE. This review also stresses the importance of developing effective strategies to reduce MP emissions, such as employing HEPA-filtered vacuums, minimizing the use of synthetic textiles, and enhancing indoor ventilation. Several future research directions were proposed, including detailed temporal analyses of indoor MP levels, interactions of MP with other atmospheric pollutants, the transport dynamics of inhalable MPs (≤10 µm), and comprehensive human exposure risk assessments.

Racial and ethnic differences in tumor characteristics among endometrial cancer patients in an equal-access healthcare population.

PURPOSE: There are racial and ethnic differences in endometrial cancer incidence and mortality rates; compared with Non-Hispanic White women, Black women have a similar incidence rate for endometrial cancer, but their mortality is higher. Pacific Islander women may also have worse outcomes compared to their White counterparts. We assessed tumor characteristics and adjuvant therapy by racial and ethnic group among endometrial cancer patients treated within the Military Health System, an equal access healthcare organization. METHODS: We retrospectively identified women diagnosed with invasive endometrial cancer among US Department of Defense beneficiaries reported in the Automated Central Tumor Registry database (year of diagnosis: 2001-2018). We compared tumor characteristics and receipt of adjuvant therapy across racial and ethnic groups using Chi-square or Fisher tests. Hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of all cause mortality were calculated using Cox proportional hazards regression models adjusting for age at diagnosis, adjuvant therapy, histology and stage. RESULTS: The study included 2574 endometrial cancer patients [1729 Non-Hispanic White, 318 Asian, 286 Black, 140 Pacific Islander and 101 Hispanic women]. Among all cases, a higher proportion of Black patients had non-endometrioid histology (46.5% versus ≤ 29.3% in other groups, P < 0.01) and grade 3-4 tumors (40.1% versus ≤ 29.3% in other groups, P < 0.01). In multivariable Cox models, compared with Non-Hispanic White cases, Black endometrial cancer patients had a higher mortality risk (HR 1.43, 95% CI, 1.13-1.83). There was no difference in mortality risk for other racial and ethnic groups. CONCLUSION: Black patients with endometrial cancer presented with more aggressive tumor features and they had worse overall survival compared with patients in other racial and ethnic groups. Further study is needed to better direct preventive and therapeutic efforts in order to correct endometrial cancer disparities in the future.

Acute eosinophilic pneumonia: a fatal reaction to ado-trastuzumab.

Ado-trastuzumab emtansine (T-DM1) is a monoclonal antibody drug conjugate approved for the treatment of HER2-positive breast cancers. Presented here is a case report of a patient who developed fatal pulmonary toxicity in the form of acute eosinophilic pneumonia while undergoing treatment with T-DM1. Prior to beginning T-DM1 therapy, this patient had been treated with two HER2-targeted agents (trastuzumab, pertuzumab) per National Comprehensive Cancer Network (NCCN) guidelines. This case represents a novel presentation of toxicity associated with T-DM1 while perhaps demonstrating additive toxicity associated with multiple lines of HER2 targeted therapies.

The Effect of Total Motion Release on Functional Movement Screen Composite Scores: A Randomized Controlled Trial.

CONTEXT: The Functional Movement Screen (FMS™) provides clinicians with objective criteria to assess movement patterns and overall movement quality. A relationship between low FMS™ composite scores and increased risk of injury has been reported, and researchers have begun to test the effect of interventions to improve FMS™ composite scores. Total Motion Release (TMR®), a novel active movement intervention, has been found to produce improvements in range of motion, as well as patient-reported pain and dysfunction. The effect of TMR® on movement patterns or movement quality is unknown. OBJECTIVE: To assess the effect of a single treatment application of TMR® on FMS™ composite scores in participants with low baselines FMS™ composite scores. DESIGN: Single-blind randomized controlled study. SETTING: Athletic training laboratory. PARTICIPANTS: Twenty-four participants (12 males and 12 females) with FMS™ composite scores of 13 or lower were randomly assigned to either a treatment group or control group. The FMS™ screening procedure was completed on all participants in a pretest and posttest design. INTERVENTIONS: In between FMS™ testing sessions, participants assigned to the treatment group completed the TMR® FAB 6-treatment protocol, whereas the control group participants did not receive an intervention. Following the treatment period (ie, 20 min), participants again completed the FMS™. MAIN OUTCOME MEASURE: FMS™ composite scores. RESULTS: The improvement in FMS™ composite scores was significantly better (P ≤ .001, Cohen's d = 1.69) in the TMR® group (mean change = 3.7 [2.2]) compared with the control group (mean change = 0.7 [1.2]). CONCLUSIONS: A single application of the TMR® FAB 6 protocol produced immediate acute improvements in FMS™ composite scores in a young, physically active population compared with no intervention. CLINICAL RELEVANCE: Research evidence exists to suggest impaired or dysfunctional movement patterns or movement quality increases risk of injury. The FMS™ is commonly utilized to assess movement quality and risk of injury. This study provides initial evidence that the use of TMR® rapidly produces acute improvements in movement quality, as measured by the FMS™.

VSIG-3 as a ligand of VISTA inhibits human T-cell function.

B7 family members and their receptors play a central role in the regulation of T-cell responses through T-cell co-stimulation and co-inhibition pathways that constitute attractive targets for the development of immunotherapeutic drugs. In this study, we report that VSIG-3/IGSF11 is a ligand of B7 family member VISTA/PD-1H and inhibits human T-cell functions through a novel VSIG-3/VISTA pathway. An extensive functional ELISA binding screening assay reveals that VSIG-3 binds to the new B7 family member VISTA but does not interact with other known members of the B7 family. Under the same experimental conditions, we did not observe any significant interaction between VSIG-8 and VISTA. In addition, VSIG-3 inhibits human T-cell proliferation in the presence of T-cell receptor signaling. Furthermore, VSIG-3 significantly reduces cytokine and chemokine production by human T cells including IFN-γ, IL-2, IL-17, CCL5/Rantes, CCL3/MIP-1α, and CXCL11/I-TAC. Anti-VISTA neutralization antibodies attenuate the binding of VSIG-3 and VISTA, as well as VSIG-3-induced T-cell inhibition. Hence, we have identified a novel ligand for VISTA that is able to inhibit human T-cell proliferation and cytokine production. This unique VSIG-3/VISTA co-inhibitory pathway may provide new strategies for the treatment of human cancers, autoimmune disorders, infection, and transplant rejection and may aid in the design of better vaccines.

Coil embolization of intralobar pulmonary sequestration - an alternative to surgery: a case report.

BACKGROUND: Pulmonary sequestration is a congenital lung disease characterized by nonfunctioning pulmonary tissue that lacks normal communication with the bronchial tree and is supplied by a nonpulmonary systemic artery. Symptomatic bronchopulmonary sequestration is uncommon, seen more frequently in the pediatric population than in adults. It has traditionally been treated with surgical resection; however, a limited but growing number of cases have been treated with angiographic embolization. Given the inherent risks of cardiothoracic surgery, embolization of the anomalous vessel is an enticing alternative treatment. We present a case of a 56-year-old woman with known, symptomatic, intralobar pulmonary sequestration that was successfully treated with coil embolization. CASE PRESENTATION: A 56-year-old Pacific Islander woman with a history of chronic myeloid leukemia was admitted to the hospital with an episode of hemoptysis. Computed tomography of the chest demonstrated left lower lobe intralobar pulmonary sequestration fed by a large tortuous vessel branching off of the descending thoracic aorta. Surgical resection of the sequestration is the current standard treatment strategy of symptomatic intralobar pulmonary sequestration. The cardiothoracic surgeon noted that given the size and location of arterial blood supply, intervention would involve thoracotomy and lobectomy. The interventional radiologist offered embolization of the lesion as an alternative to surgery. Multiple coils, 6-13 mm in size, were used to embolize the sequestration. No considerable flow distal to the coils was noted postembolization. CONCLUSIONS: Intralobar pulmonary sequestration is a rare condition that typically requires surgical management. This case demonstrates the efficacy of coil embolization as an alternative management strategy. To date, limited case reports of adults treated with endovascular embolization exist. Treatment of symptomatic pulmonary sequestration with embolization can be considered as an alternative to surgical resection.

Systemic Mastocytosis: The Difficult Patient with a Rare Disease. Case Presentation and Brief Review.

Mastocytosis is a rare process involving the activation and accumulation of clonal mast cells categorized by cutaneous or systemic involvement. Although the diagnosis of cutaneous disease can be straightforward and confirmed via skin biopsy, systemic disease mimics more common disease processes making diagnosis a challenge. The widespread physiologic distribution of mast cells causes a variety of symptoms with aberrant expression including fatigue, headache, depression, dyspnea, dyspepsia, nausea, and abdominal pain. We present a patient with a three-year history of multiple, non-specific complaints prompting extensive evaluation at significant financial and emotional cost without therapeutic relief. This case presentation illustrates some of the pitfalls of evaluation and management of mastocytosis when symptoms are treated in isolation. Ultimately, our patient was diagnosed with indolent systemic mastocytosis (ISM), which has a good overall prognosis but no curative treatment. Providers must maintain a high index of suspicion for mastocytosis in order to make the diagnosis and facilitate appropriate treatment and screening.

Characterizations of Clinical and Therapeutic Histories for Men With Prostate Cancer-Specific Mortality.

BACKGROUND: Careful descriptions of men with prostate cancer (PCa)-specific mortality are scant in nontrial settings. The present retrospective review describes the clinical characteristics, timelines, and treatment histories from initial presentation to death in a cohort of men with metastatic, castrate-resistant PCa (mCRPC). Unique to the present study is the unequivocal attribution of PCa death by a single experienced clinician. PATIENTS AND METHODS: A total of 119 patients who had been treated at Tulane Cancer Center and had died of mCRPC from 2008 to 2015 were studied through a retrospective review of the medical records. RESULTS: The median age at diagnosis was 65 years (range, 40-85 years), and 34.4% of the patients presented with metastatic disease (stage M1). Of these patients, 56% had received definitive primary therapy, all had received androgen-deprivation therapy, and 52% had received docetaxel. The patients had received a median of 7 (1-14) systemic therapies before death. Most were secondary hormonal manipulations after the diagnosis of mCRPC (median, 4; range, 0-9). The median survival was 69 months (range, 5-270 months) after diagnosis, and the median age at death was 73 years (range, 47-95 years). The presence of metastases at diagnosis was a significant predictor of early death (hazard ratio, 4.33; P < .001), and definitive primary therapy was a significant predictor of longer survival (P < .001). The median survival for patients presenting with metastases was 39 months (range, 5-235 months) compared with 100 months (range, 6-270 months) for those with localized disease (P < .001). The median age at diagnosis between the docetaxel- and non-docetaxel-treated patients was significantly different at 62 and 71 years, respectively (P = .002). CONCLUSION: The present retrospective analysis provides initial views clarifying the clinical characteristics of men dying of mCRPC and the therapies they received before death. Additional data are needed in multi-institutional settings to confirm these findings.

Perspectives of zebrafish models of epilepsy: what, how and where next?

Epilepsy is a complex brain disorder with multiple underlying causes and poorly understood pathogenetic mechanisms. Animal models have been indispensable tools in experimental epilepsy research. Zebrafish (Danio rerio) are rapidly emerging as a promising model organism to study various brain disorders. Seizure-like behavioral and neurophysiological responses can be evoked in larval and adult zebrafish by various pharmacological and genetic manipulations, collectively emphasizing the growing utility of this model for studying epilepsy. Here, we discuss recent developments in using zebrafish models to study the seizure-like behavior involved in epilepsy, outlining current challenges and strategies for further translational research in this field.

A fetal variant in the GCM1 gene is associated with pregnancy induced hypertension in a predominantly hispanic population.

The aim of the study was to determine whether polymorphism in the GCM1 gene is associated with pregnancy induced hypertension (PIH) in a case-control study of mother-baby dyads. Predominantly Hispanic women, ages 15-45, with (n=136) and without (n=169) PIH were recruited. We genotyped four polymorphisms in the GCM1 gene and examined the association with PIH using both logistic regression and likelihood expectation maximization (LEM) to adjust for intra-familial correlation between genotypes. Maternal genotype was not associated with PIH for any polymorphisms examined. Fetal genotype, however, was associated with maternal risk of PIH. Mothers carrying a fetus with ≥1 copy of the minor (C) allele for rs9349655 were less likely to develop PIH than women carrying a fetus with the GG genotype (parity-adjusted OR=0.44, 95% Cl: 0.21, 0.94). The trend of decreasing risk with increasing C alleles was also statistically significant (OR(trend)=0.41 95% Cl: 0.20, 0.85). The minor alleles for the other three SNPs also appear to be associated with protection. Multilocus analyses of fetal genotypes showed that the protective effect of carrying minor alleles at rs9349655 and rs13200319 (non-significant) remained unchanged when adjusting for genotypes at the other loci. However, the apparent (non-significant) effect of rs2816345 and rs2518573 disappeared when adjusting for rs9349655. In conclusion, we found that a fetal GCM1 polymorphism is significantly associated with PIH in a predominantly Hispanic population. These results suggest that GCM1 may represent a fetal-effect gene, where risk to the mother is conferred only through carriage by the fetus.

Maternal and fetal variants in the TGF-beta3 gene and risk of pregnancy-induced hypertension in a predominantly Latino population.

OBJECTIVE: We sought to determine whether polymorphisms in the transforming growth factor (TGF)-beta3 gene are associated with risk of pregnancy-induced hypertension (PIH) in case-control mother-baby dyads. STUDY DESIGN: Patients (n = 136) and control subjects (n = 169) were recruited from our hospital. We genotyped 4 TGF-beta3 polymorphisms and examined association with PIH using logistic regression, adjusting for parity, maternal age, gestational age at delivery, fetal (or maternal) genotypes for the polymorphism in question, and the 3 other polymorphisms within the TGF-beta3 gene. RESULTS: Only 1 of the TGF-beta3 polymorphisms (rs11466414) was associated with PIH. Mothers who carried a baby with a minor allele were at decreased risk (odds ratio(multi-locus adj), 0.32; 95% confidence interval, 0.14-0.77). Maternal TGF-beta3 variants had no effect on risk of PIH. CONCLUSION: A fetal TGF-beta3 polymorphism (rs11466414) is associated with PIH in a predominantly Hispanic population.