Radiographic Assessment of the Nasal Septum and Trends in Donor Cartilage Availability.

Objective: To compare the harvestable donor septal cartilage among patients. Background: Trends in donor septal cartilage anatomy are not well quantified in the literature. Methods: Harvestable septal cartilage area and length (preserving a 1-cm L-strut) were measured on fine-cut maxillofacial computed tomography (CT) for 200 patients in four self-described racial/ethnic groups: African American, Asian American, European American, and Latin American. Height, sex, and age were recorded. Demographic variables were modeled by multivariate logistic regression to determine characteristics predictive of harvestable septal cartilage. Results: Older age, shorter height, African American or Asian American self-described race, and female sex were independently associated with smaller harvestable area and shorter length (all p < 0.05). On multivariate regression, Asian American [odds ratio (OR) 5.23, p = 0.005] and African American (OR 3.75, p = 0.015) patients were more likely than Latin American or European Americans patients have a smaller harvestable area. Age (OR 1.02, p = 0.043) and height (OR 0.94, p = 0.029) were also correlated with smaller cartilage area and length, respectively. Conclusions: CT scan and demographic characteristics predicted donor septal cartilage availability.

Clinical Research Professional Providing Care Coordination Support: A Study of Hawaii Minority/Underserved NCORP Community Site Trial Participants.

PURPOSE: Although effective care coordination (CC) is recognized as a vital component of a patient-centered, high-quality cancer care delivery system, CC experiences of patients who enroll and receive treatment through clinical trials (CTs) are relatively unknown. Using mixed methods, we examined perceptions of CC among patients enrolled onto therapeutic CTs through the Hawaii Minority/Underserved National Cancer Institute Community Oncology Research Program. METHODS: The Care Coordination Instrument, a validated instrument, was used to measure patients' perceptions of CC among CT participants (n = 45) and matched controls (n = 45). Paired t-tests were used to compare overall and three CC domain scores (Communication, Navigation, and Operational) between the groups. Semistructured focus group interviews were conducted virtually with 14 CT participants in 2020/2021. RESULTS: CT participants reported significantly higher total CC scores than non-CT participants (P = .0008). Similar trends were found for Navigation and Operational domain scores (P = .007 and .001, respectively). Twenty-nine percent of CT participants reported receiving high-intensity CC assistance from their clinical research professionals (CRPs). Content analysis of focus group discussions revealed that nearly half of the focus group discussions centered on CRPs (47%), including CC support provided by CRPs (26%). Other key themes included general CT experiences (22%) and CRP involvement as an additional benefit to CT participation (15%). CONCLUSION: Our results show that patients on CTs in this study had a more positive CC experience. This may be attributable in part to CC support provided by CRPs. These findings highlight both the improved experience of treatment for patients participating in a trial and the generally unrecognized yet integral role of CRPs as part of a cancer CT care team.

Understanding Attitudes and Roles of Oncology Advanced Practitioners in the Setting of Cancer Clinical Trials: A Pilot Study.

PURPOSE: Oncology advanced practitioners (APs), including nurse practitioners, physician assistants, clinical nurse specialists, and pharmacists, are skilled health-care providers who contribute significantly to quality cancer care. However, little is known about how APs function within the clinical trials arena. With low rates of clinical trial enrollment among the adult oncology patient population, APs could play an important role in improving clinical trial enrollment. METHODS: A descriptive cross-sectional study was conducted based on a 57-item survey of oncology APs' attitudes, beliefs, and roles in relation to cancer clinical trials. RESULTS: To assess validity and internal consistency of the survey, a pilot data collection was completed on 14 respondents from Hawaii. The survey's internal consistency across the subscales was moderate to very high, with Cronbach's alpha ranging between 0.55 and 0.86. The majority of oncology APs were interested in being more involved in the clinical trials process, and many are registered as investigators through the National Cancer Institute (NCI). However, few respondents reported being involved in recruitment, consenting, protocol development, or being actively involved with a research base. CONCLUSIONS: This survey was found to be a valid tool to measure APs' attitudes and roles in regards to clinical trials. This survey is just the beginning of data collection in regards to clinical trials among this group of health-care professionals. RECOMMENDATIONS: To gain further insight into oncology APs and their roles in clinical trials, it is recommended that this survey be implemented on a national level as a first step in moving this issue forward.

Beauty is in the eye of the follower: Facial aesthetics in the age of social media.

BACKGROUND: The advent of social media has influenced the relationship between aesthetic surgeons and their patients, as well as the motivations of such patients to seek cosmetic surgery. AIMS & OBJECTIVES: To determine how the cephalometric proportions of modern social media models fit with historical canons of beauty. MATERIALS & METHODS: Frontal and lateral photographs of 20 high-influence female Instagram models were obtained and evaluated for cephalometric measures. The means of these measures were compared with previous reports in the literature. RESULTS: Cephalometric measurements of social media models were in agreement with historical ideals of beauty for Nostril axis (120.7°), Goode's ratio (0.6), Nasofacial angle (35.7°), Nasofrontal angle (130.9°), and the horizontal thirds. Results were discrepant from historical ideals for the Nasolabial angle (82.6°) and the vertical facial fifths. CONCLUSION: Cephalometric measurements of social media models in the digital age closely resemble the ideal values proposed by previous authors. Due to a preference for larger or altered lip profiles, nostril axis is a more reliable measure of nasal tip rotation than nasolabial angle.

Nasal Skin and Soft Tissue Thickness Variation Among Differing Races and Ethnicities: An Objective Radiographic Analysis.

Importance: Nasal skin and soft tissue envelope (SSTE) thickness has considerable effects on procedural planning and postoperative outcomes in rhinoplasty surgery. Objective understanding of relative SSTE thickness in patients is essential to optimal outcomes in rhinoplasty, and knowledge of its variation by demographic group is of aid to surgeons. Objective: To measure and compare nasal SSTE thickness across different races and nasal subsites and to determine whether objective variability exists for these parameters. Design, Setting, Participants: Retrospective cross-sectional radiographic analysis was carried out on 200 adult patients, without nasal deformity, presenting to an academic otolaryngology clinic at a tertiary care academic referral center. Blinded evaluators measured nasal SSTE thickness at six sites on maxillofacial computed tomography (CT) scans and comparisons were made based on patient-reported race/ethnicity categories available in the electronic medical record. Intervention: N/A Main Outcomes and Measures: Nasal SSTE thickness was measured at six predefined anatomic sites using high-resolution CT imaging. Statistical comparisons between races/ethnicities were made based on these measurements. Results: Mean age of patients was 48.8 years, and 47% were male. Nasal SSTE showed thicker soft tissue at the sellion in Latin American (LA; mean (SD) 6.1 (1.8) mm) and white (5.8 (1.8) mm) patients vs. African American (AfA) and Asian American (AsA) patients. The supratip was thicker in AfA patients (5.2 (1.3) mm) vs. all other races. The tip SSTE was thinner in white patients (2.4 (0.7) mm) vs. all other races. Composite nasal SSTE thickness was thinner in AsA patients (3.22 (0.8) mm) relative to AfA and LA patients. Conclusions and Relevance: SSTE thickness influences surgical planning and postoperative outcomes in rhinoplasty patients. This study supports varied thickness of the nasal SSTE among patients of different races. These data are foundational in providing a framework for developing treatment strategies specific to the SSTE properties of a multicultural patient population.

Impact of Surgery on Relationship Quality in Patients With Ulcerative Colitis and Their Partners.

BACKGROUND: Although social support is important for quality of life in patients undergoing surgery for ulcerative colitis, the impact of surgery on patient relationships is not known. OBJECTIVE: We examined relationship parameters in patients with ulcerative colitis and their partners before and 6 months after surgery. DESIGN: This was a prospective cohort in which we performed an exploratory analysis. SETTINGS: Patients were enrolled from an academic medical center. PATIENTS: Surgical patients with ulcerative colitis and their partners were invited to participate. INTERVENTIONS: Patients underwent proctocolectomy in 1, 2, or 3 stages. MAIN OUTCOME MEASURES: We measured quality of life and sexual function in patients, as well as relationship quality, empathy, and sexual satisfaction in patients and partners before and 6 months after surgery using validated questionnaires. RESULTS: The study sample consisted of 74 participants, including 37 patients (25 men and 12 women) and their opposite-sex partners. Quality of life improved significantly in male and female patients after surgery. Sexual function scores also improved after surgery in male and female patients; however, the changes reached statistical significance in male patients only. Sexual satisfaction scores improved significantly after surgery in female patients and their partners. There was little change in relationship quality or empathy after surgery, with the exception of slightly improved relationship quality reported by male partners. In general, patients and partners reported levels of relationship quality and empathy similar to normative populations. LIMITATIONS: This study included a small, highly selected sample. CONCLUSIONS: Male and female patients with ulcerative colitis have high-quality relationships that are not negatively affected by surgical treatment. Changes in sexual function do not necessarily coincide with changes in sexual satisfaction in this patient population. Future studies should evaluate the effect of high-quality relationships on surgical outcomes.

Comparative analysis on determinants of self-rated health among non-Hispanic White, Hispanic, and Asian American older adults.

The purpose of the study is (1) to compare the effects of factors on self-rated health (SRH) among older non-Hispanic Whites (NHW), Hispanic, and Asian Californians and (2) to provide estimated influence size of each factor on SRH. This study analyzed secondary data drawn from the 2005 California Health Interview Survey. Binary logit regressions were used to analyze data with the Jackknife replication sampling weights. Significant differences were found in SRH among the three groups. Hispanics and Asians reported poorer health than NHW. Socioeconomic status, acculturation, and health access significantly accounted for an association between ethnicity and SRH. However, the magnitudes of their effects on SRH varied across the groups and by the factors examined. This study discusses and concludes with some recommendations on the opportunities presented by the Affordable Care Act and Healthy People 2020.

Metastatic lobular breast carcinoma infiltrating a uterine leiomyoma.

Metastatic breast cancer is rarely identified in a uterine leiomyoma. Herein is reported the case of a 53-year-old patient with untreated left-sided breast cancer who later manifested abdominal symptoms and metrorrhagia. After hysterectomy, pathologic analysis revealed metastatic lobular breast carcinoma involving the uterine fundus and a leiomyoma.

A low band gap iron sulfide hybrid semiconductor with unique 2D [Fe(16)S(20)](8-) layer and reduced thermal conductivity.

A low band gap iron sulfide hybrid semiconductor with unique layered structure and unusual iron coordination exhibits significantly reduced thermal conductivity.

A population-based, descriptive analysis of malignant intraductal papillary mucinous neoplasms of the pancreas.

BACKGROUND: Intraductal papillary mucinous neoplasms (IPMN) are distinct precursor lesions that can progress to pancreatic adenocarcinoma; thus, it has been of particular interest to cancer prevention researchers. We set out to do a population-based analysis of malignant IPMNs compared with other pancreatic subtypes to better delineate its characteristics and explore implications for prevention and management. METHODS: We conducted a case-only analysis of California Cancer Registry data (2000-2007), including descriptive analysis of relevant clinical variables. Overall survival univariate analyses were conducted using the Kaplan-Meier method. Multivariate survival analyses were done using Cox proportional hazards ratios. RESULTS: Overall, 15,296 pancreatic cancer cases were identified, including incident cases of 10,186 adenocarcinomas, 880 mucinous tumors, 568 endocrine tumors, 3,619 carcinoma not otherwise specified tumors, and 43 malignant IPMNs. Thirty-three (80.5%) IPMN cases had localized disease at presentation, eight had regional disease (19.5%), and no IPMNs were identified with distant disease (two were unstaged). Five-year overall survival was better for malignant IPMN cases (65%) compared with pancreatic endocrine tumors (30%), mucinous tumors (5%), carcinoma not otherwise specified (2%), and adenocarcinoma cases (2%). Compared with adenocarcinoma cases, malignant IPMN cases (hazard ratio = 0.19; 95% CI, 0.10-0.35), endocrine tumors (hazard ratio=0.28; 95% CI, 0.25-0.32), and mucinous tumors (hazard ratio=0.84; 95% CI, 0.77-0.90) had higher overall survival in a multivariate survival analysis after adjustment for age, gender, stage, race, socioeconomic status, surgery, chemotherapy, and radiation therapy. CONCLUSIONS: Pancreatic malignant IPMNs represent an uncommon pancreatic tumor subtype, uniquely characterized by early stage at presentation and better survival.

Race, socioeconomic status, treatment, and survival time among pancreatic cancer cases in California.

BACKGROUND: Poor survival in pancreatic adenocarcinoma is associated with African-American race and also with low socioeconomic status (SES). However, it is not known whether the observed poor survival of African-American pancreatic adenocarcinoma cases is due to SES itself and/or treatment disparities. We set out to determine this using the large, population-based California Cancer Registry (CCR) database as a model. METHODS: We conducted a case-only analysis of CCR data (1989-2003), including descriptive analysis of relevant clinical variables and SES. The SES variable used has been derived from principle component analysis of census block level CCR data linked to census data to address seven major indicators of SES. Overall survival univariate analyses were conducted using the Kaplan-Meier method. Multivariate survival analyses were done using Cox proportional hazards ratios (HR). RESULTS: Incident cases of pancreatic cancer (24,735) were analyzed. Among adenocarcinomas, after adjustment for age, year of diagnosis, and gender, African-Americans [HR, 1.14; 95% confidence interval (95% CI), 1.08-1.21] and Hispanics (HR, 1.06; 95% CI, 1.01-1.11) had an increased risk of death compared with Caucasians. These differences persisted after adjustment for stage. However, after further adjustment for SES, surgery, radiation, and chemotherapy, the risk of death for African-Americans (HR, 1.00; 95% CI, 0.94-1.06) and Hispanics (HR, 0.97; 95% CI, 0.93-1.02) was not statistically different from Caucasians. CONCLUSIONS: Differences in treatment and SES likely account for the observed poor survival of African-Americans and Hispanics among pancreatic adenocarcinoma cases. These data highlight the importance of improving access to care for ethnic minority pancreatic cancer patients.

Acculturation, communication patterns, and self-esteem among Asian and Caucasian American adolescents.

This study examined level of acculturation, openness in communication with parents, peer interaction, and self-esteem in two ethnic groups-Asian and Caucasian American adolescents who grew up in the same neighborhood. The findings provide evidence of significant ethnic differences in behavioral patterns, peer networks, family contexts, and levels of self-esteem. In general, Asian adolescents expressed more difficulty discussing problems with their parents when compared to their Caucasian counterparts. Further, self-esteem was found to be significantly lower among Asians than Caucasians. Implications for the provision of mental health services are discussed.