MARVEL analysis of high-resolution rovibrational spectra of 16O12C18O.

Empirical rovibrational energy levels are presented for the third most abundant, asymmetric carbon dioxide isotopologue, 16O12C18O, based on a compiled dataset of experimental rovibrational transitions collected from the literature. The 52 literature sources utilized provide 19,438 measured lines with unique assignments in the wavenumber range of 2-12,676 cm-1. The MARVEL (Measured Active Rotational-Vibrational Energy Levels) protocol, which is built upon the theory of spectroscopic networks, validates the great majority of these transitions and outputs 8786 empirical rovibrational energy levels with an uncertainty estimation based on the experimental uncertainties of the transitions. Issues found in the literature data, such as misassignment of quantum numbers, typographical errors, and misidentifications, are fixed before including them in the final MARVEL dataset and analysis. Comparison of the empirical energy-level data of this study with those in the line lists CDSD-2019 and Ames-2021 shows good overall agreement, significantly better for CDSD-2019; some issues raised by these comparisons are discussed.

High Level Immunoglobulin Gene Expression and Reduced Intra-tumoral Bacteria Associated With the Transition from Initial to Progressive Diffuse Intrinsic Pontine Glioma.

BACKGROUND/AIM: In the past decade, diffuse intrinsic pontine glioma (DIPG), the most common childhood brainstem glioma, has benefitted from an increase in tissue-based research because of improved biopsy collection techniques. However, the adaptive immune receptor (IR) features represented by tumor material and tumor infiltrating lymphocytes have remained poorly understood. MATERIALS AND METHODS: Herein, we characterized the adaptive immune parameters of DIPG through the recovery of IR recombination reads from RNAseq files representing initial and progressive DIPG samples. RESULTS: An elevated level of immunoglobulin gene expression in the progressive DIPG sample files and a reduced number of bacterial sequencing read recoveries in comparison to RNAseq files representing the initial form of DIPG, was found. Furthermore, the RNAseq files representing both initial and progressive DIPG samples had significant numbers of reads representing Cutibacterium acnes, a bacterium previously linked to prostate cancer development. Results also indicated an opportunity to distinguish overall survival probabilities based on IGL complementarity determining region-3 amino acid sequence physicochemical parameters. CONCLUSION: Genomics analyses allow for a better understanding of adaptive IR features and bacterial infections in the DIPG setting.

TCR CDR3-CMV Antigen Chemical Complementaries Are Associated With a Worse Outcome for Renal Cell Carcinoma.

BACKGROUND/AIM: Due to still unresolved questions regarding viruses as either a primary cause or a comorbidity in cancer, we examined a potential immune response to cytomegalovirus (CMV) in the renal cell carcinoma (RCC) setting using genomics and bioinformatics approaches. MATERIALS AND METHODS: Specifically, we assessed chemical complementarity scores (CSs) for solid tissue normal resident, T-cell receptor (TCR) complementarity determining region 3 (CDR3s) and CMV antigens and determined whether higher or lower CS groups were associated with a higher or lower survival probability. RESULTS: This was indeed the case, with all such analyses consistently indicating a lower overall and progression-free survival for the cases representing the higher TCR CDR3-CMV antigen chemical CSs. This basic result was obtained for two separate RCC datasets and multiple CMV antigens. CONCLUSION: The results raise the question, to what extent a systemic CMV infection may represent an important co-morbidity for RCC.

Effect of Radiotherapy on Activating the Pyroptotic Cell Death Pathway in Breast Cancer Patients: The Role of Serum GSDMD-CT, NLRP3 and IL-18.

BACKGROUND: Breast cancer (BC) is the most common form of cancer among women and the second leading cause of cancer-related death worldwide. Several malignancies can be successfully treated with radiation (RT), although radioresistance is still a major contributor to radiotherapy failure. Ionizing radiation (IR) induces pyroptosis in cancer cells. Pyroptosis is a designed method of death connected to routine immunity and directly related to the body ROS content. Objective for the study: The aim of this work was to investigate the role of serum GSDMD-CT, nucleotide-binding domain and leucine-rich-repeat-containing family pyrin 3 (NLRP3) and IL-18 as predictors of pyroptotic cell death mechanism induced by radiotherapy in breast cancer patients. SUBJECTS AND METHODS: The 70 female participants in this study were divided into two groups: Group (I): 40 breast cancer patients treated with radiotherapy. Group (II): a control group of 30 healthy volunteers with similar ages and sex. Patients with breast cancer received radiation, with a dose of 44 Gray administered over the course of 16 days in five daily fractions of 2.75 Gray each. Two blood samples were taken from breast cancer patients: one before radiotherapy and the other after radiotherapy. While one blood sample was taken from healthy controls. The levels of the circulating pyroptosis biomarkers IL-18, NLRP3, and GSDMD-CT were measured using the ELISA method. RESULTS: Our results showed that, there was a significant increase in serum pyroptosis markers GSDMD-CT, NLRP3 and IL-18 in BC Patients after RT when compared to before radiotherapy. CONCLUSION: Radiotherapy induced pyroptosis in breast cancer patients as a new cell death mechanism. GSDMD-CT, NLRP3 and IL-18 are biomarkers of pyroptosis that significantly increased post irradiation highlighting enhanced ROS and pyroptosis induction.

MARVEL analysis of high-resolution rovibrational spectra of 13 C 16 O 2 .

A set of empirical rovibrational energy levels, obtained through the MARVEL (measured active rotational-vibrational energy levels) procedure, is presented for the 13 C 16 O 2 isotopologue of carbon dioxide. This procedure begins with the collection and analysis of experimental rovibrational transitions from the literature, allowing for a comprehensive review of the literature on the high-resolution spectroscopy of 13 C 16 O 2 , which is also presented. A total of 60 sources out of more than 750 checked provided 14,101 uniquely measured and assigned rovibrational transitions in the wavenumber range of 579-13,735 cm - 1 . This is followed by a weighted least-squares refinement yielding the energy levels of the states involved in the measured transitions. Altogether 6318 empirical rovibrational energies have been determined for 13 C 16 O 2 . Finally, estimates have been given for the uncertainties of the empirical energies, based on the experimental uncertainties of the transitions. The detailed analysis of the lines and the spectroscopic network built from them, as well as the uncertainty estimates, all serve to pinpoint possible errors in the experimental data, such as typos, misassignment of quantum numbers, and misidentifications. Errors found in the literature data were corrected before including them in the final MARVEL dataset and analysis.

IGL CDR3 Hydropathy and Antigen Chemical Complementarity Associated with Greater Disease-Free Survival in Lung Adenocarcinoma: Implications for Gender Disparities.

With lung cancer remaining a challenging disease, new approaches to biomarker discovery and therapy development are needed. Recent immunogenomics, adaptive immune receptor approaches have indicated that it is very likely that B cells play an important role in mediating better overall outcomes. As such, we assessed physicochemical features of lung adenocarcinoma resident IGL complementarity determining region-3 (CDR3) amino acid (AA) sequences and determined that hydrophobic CDR3 AA sequences were associated with a better disease-free survival (DFS) probability. Further, using a recently developed chemical complementarity scoring algorithm particularly suitable for the evaluation of large patient datasets, we determined that IGL CDR3 chemical complementarity with certain cancer testis antigens was associated with better DFS. Chemical complementarity scores for IGL CDR3-MAGEC1 represented a gender bias, with an overrepresentation of males among the higher IGL-CDR3-CTA complementarity scores that were in turn associated with better DFS (logrank p < 0.065). Overall, this study pointed towards potential biomarkers for prognoses that, in some cases are likely gender-specific; and towards biomarkers for guiding therapy, e.g., IGL-based opportunities for antigen targeting in the lung cancer setting.

Valorization of chicken feather waste using recombinant bacillus subtilis cells by solid-state fermentation for soluble proteins and serine alkaline protease production.

Feather waste, a by-product of the poultry industry, is rich in proteins, peptides, and amino acids. Improper disposal of feathers can cause environmental pollution. Solid-state fermentation (SSF) is a viable alternative to submerged fermentation due to its simplicity, productivity, and lower cost. The study goal is a biorefinery of chicken feather waste supplemented with wheat bran using a recombinant Bacillus subtilis strain to produce soluble proteins and a serine alkaline protease. Plackett-Burman Design and Central Composite Design were utilized in a statistical-mathematical model to optimize the process. Multi-factorial design optimization resulted in 80 % substrate degradation efficiency, an alkaline protease with dual activities (1423 proteolytic units and 190 keratinolytic units), 214 mg soluble proteins/g substrate, and 87 % model validation. Scaling up the SSF process to 50 g of substrate significantly enhanced the end products of feather biodegradation to 1616 proteolytic units, 2844 keratinolytic units, and 127 mg soluble proteins/g substrate. AIM AND SCOPE OF THE MANUSCRIPT: The aim of the present study is to utilize chicken feather waste (alone or supplemented with other materials) through recombinant Bacillus subtilis cells using solid state fermentation (SSF) at a laboratory scale. The plan study provides a promising waste management in the environmental field concerning biodegradation of such recalcitrant keratinous wastes supplemented with agricultural residues via recombinant microorganism. On semi-pilot scale, high production and quality of soluble protein, protease, and keratinase activity were produced according to the statistically optimised first stage fermentation in the laboratory scale. The bioconversion process took place as a major goal to obtain valuable products, with low utilities and energy requirements. Therefore, this will consider as an economically feasible and environmentally friendly alternative. Moreover, this study is considered as first step fermentation for feather waste to pave the road for directing it to a second step fermentation for biogas production and bioenergy generation through bio-electrochemical systems (Manuscript under publication).

Chemical Complementarity of Tumor Resident, Adaptive Immune Receptor CDR3s and Previously Defined Hepatitis C Virus Epitopes Correlates with Improved Outcomes in Hepatocellular Carcinoma.

To better understand how adaptive immune receptors (IRs) in hepatocellular carcinoma (HCC) microenvironments are related to disease outcomes, we employed a chemical complementarity scoring algorithm to quantify electrostatic complementarity between HCC tumor TRB or IGH complementarity-determining region 3 (CDR3) amino acid (AA) sequences and previously characterized hepatitis C virus (HCV) epitopes. High electrostatic complementarity between HCC-resident CDR3s and 12 HCV epitopes was associated with greater survival probabilities, as indicated by two distinct HCC IR CDR3 datasets. Two of the HCV epitopes, HCV*71871 (TRB) and HCV*13458 (IGH), were also determined to represent significantly larger electrostatic CDR3-HCV epitope complementarity in HCV-positive HCC cases, compared with HCV-negative HCC cases, with the CDR3s representing yet a third, independent HCC dataset. Overall, the results indicated the utility of CDR3 AA sequences as biomarkers for HCC patient stratification and as potential guides for the development of therapeutic reagents.

Preparedness of Citizens in Al-Madinah City to Deliver Seizure First Aid Measures.

Introduction Epilepsy is a neurologic disease that causes a predisposition to recurrent seizure attacks. It affects a large number of people around the world and in Saudi Arabia. Seizures can be a source of distress for both the affected person and those witnessing them. Thus, being able to deliver first aid is important, as it improves safety and decreases the burden of visits to the emergency room that are unnecessary, since many attacks of seizure can be managed in the community. Weak knowledge regarding seizure first aid measures is reported many times across Saudi Arabia, with a high prevalence of misconceptions. Methods This study employed a descriptive cross-sectional design, utilizing a questionnaire-based approach. The data was collected from a sample of 1871 individuals residing in Al-Madinah City, Saudi Arabia. The participants completed a self-administered online questionnaire and ensured anonymity. The questionnaire used in this study was previously validated and used in another study. We used descriptive statistics to summarize the data, and Chi-square test was employed to establish the association between sociodemographic data and knowledge of seizure first aid. Results Most of the participants were females (70.0%, N=1310), and the majority (76.1%, N=1423) fell within the 18-30 age group. A high percentage were single (71.6%, N=1339), college graduates (64.3%, N=1201), and unemployed (58.7%, N=1099). The study results revealed that 31.9% (N=597) had a good knowledge level of epilepsy, while 68.1% (N=1274) had poor knowledge. Nearly half (48.4%, N=905) believed that epilepsy was caused by genetic factors, and 61.4% (N=1149) of the respondents reported loss of consciousness as the most common clinical symptom of epilepsy. With regards to correct action during seizures, 48.0% (N=899) knew to place the patient on their side, and 85.0% (N=1591) thought calling 997 ("the ambulance") was necessary if seizures lasted over five minutes. The study showed a statistically significant association between the level of education, employment, and knowledge of epilepsy first aid management (p=0.001 and p=0.003, respectively). However, no significant associations were found between gender, age, marital status, and knowledge of epilepsy first aid management (p>0.005). Conclusion The study unveiled poor overall epilepsy knowledge among Al-Madinah City residents, with only 31.9% (N=597) demonstrating good knowledge. This indicates the community's limited ability to respond to seizures. Most citizens were unfamiliar with seizure first-aid, lacking the capability to provide assistance. A significant association was found between education, employment, and epilepsy first aid knowledge. Respondents with higher education had better epilepsy knowledge. Attending epilepsy education courses is vital for enhancing overall awareness and readiness to provide seizure first aid.

Memory T Cells Discrepancies in COVID-19 Patients.

The immune response implicated in Coronavirus disease 2019 (COVID-19) pathogenesis remains to be fully understood. The present study aimed to clarify the alterations in CD4+ and CD8+ memory T cells' compartments in SARS-CoV-2-infected patients, with an emphasis on various comorbidities affecting COVID-19 patients. Peripheral blood samples were collected from 35 COVID-19 patients, 16 recovered individuals, and 25 healthy controls, and analyzed using flow cytometry. Significant alterations were detected in the percentage of CD8+ T cells and effector memory-expressing CD45RA CD8+ T cells (TEMRA) in COVID-19 patients compared to healthy controls. Interestingly, altered percentages of CD4+ T cells, CD8+ T cells, T effector (TEff), T naïve cells (TNs), T central memory (TCM), T effector memory (TEM), T stem cell memory (TSCM), and TEMRA T cells were significantly associated with the disease severity. Male patients had more CD8+ TSCMs and CD4+ TNs cells, while female patients had a significantly higher percentage of effector CD8+CD45RA+ T cells. Moreover, altered percentages of CD8+ TNs and memory CD8+CD45RO+ T cells were detected in diabetic and non-diabetic COVID-19 patients, respectively. In summary, this study identified alterations in memory T cells among COVID-19 patients, revealing a sex bias in the percentage of memory T cells. Moreover, COVID-19 severity and comorbidities have been linked to specific subsets of T memory cells which could be used as therapeutic, diagnostic, and protective targets for severe COVID-19.

Using chitosan nanoparticles and N-acetyl thiazolidine 4-carboxylic acid for olive trees efficiency raising, improving fruits properties and oil quality.

Recently exposure of olive trees to many stresses particularly oil varieties led to decline in the olive yield. The target of the study is to improve vegetative growth and increase olive fruits quality as well as the fruit oil % and oil quality by applying chitosan nanoparticles (CHNPs) and N-acetyl thiazolidine 4-carboxylic acid (N-ATCA) under the conditions of Egypt. The experiment was carried out in the seasons of 2021 and 2022 on Arbosana olive trees 8 years old and 4×6 m apart the trees sprayed three times on 15th Sept., 1st Oct. and 15th Oct. with (CHNPs at 500, 1000 and 1500 ppm), (N-ATCA at 50, 100 and 150 ppm) and a combination between them and evaluate the vegetative growth of trees, fruit physiochemical characteristics, and oil properties during both study seasons. The application of CHNPs and N-ATCA and a combination of them led to increasing leaf area, total chlorophyll and proline content also increment fruit weight, flesh weight, oil color and oil % moreover improving the quality of produced oil. The improvement in growth, fruit quality, oil % and oil quality, were associated with increasing concentrations of CHNPs, N-ATCA and a combination of them especially (CHNPs at 1500 ppm + N-ATCA at 100 ppm and CHNPs at 1500 ppm + N-ATCA at 150 ppm). Spraying (CHNPs at 1500 ppm + N-ATCA at 150 ppm) is recommended to improve the tree growth, fruit quality, oil % and quality of Arbosana olive.

Phenotypical changes of hematopoietic stem and progenitor cells in COVID-19 patients: Correlation with disease status.

Hematopoietic stem cells (HSCs) and hematopoietic progenitor cells (HPCs) play a crucial role in the context of viral infections and their associated diseases. The link between HSCs and HPCs and disease status in COVID-19 patients is largely unknown. This study aimed to monitor the kinetics and contributions of HSCs and HPCs in severe and non-severe COVID-19 patients and to evaluate their diagnostic performance in differentiating between healthy and COVID-19 patients as well as severe and non-severe cases. Peripheral blood (PB) samples were collected from 48 COVID-19 patients, 16 recovered, and 27 healthy controls and subjected to deep flow cytometric analysis to determine HSCs and progenitor cells. Their diagnostic value and correlation with C-reactive protein (CRP), D-dimer, and ferritin levels were determined. The percentages of HSCs and common myeloid progenitors (CMPs) declined significantly, while the percentage of multipotent progenitors (MPPs) increased significantly in COVID-19 patients. There were no significant differences in the percentages of megakaryocyte-erythroid progenitors (MEPs) and granulocyte-macrophage progenitors (GMPs) between all groups. Severe COVID-19 patients had a significantly low percentage of HSCs, CMPs, and GMPs compared to non-severe cases. Contrarily, the levels of CRP, D-dimer, and ferritin increased significantly in severe COVID-19 patients. MPPs and CMPs showed excellent diagnostic performance in distinguishing COVID-19 patients from healthy controls and severe from non-severe COVID-19 patients, respectively. Collectively, our study indicated that hematopoietic stem and progenitor cells are significantly altered by COVID-19 and could be used as therapeutic targets and diagnostic biomarkers for severe COVID-19.

TRB CDR3 chemical complementarity with HBV epitopes correlates with increased hepatocellular carcinoma, disease-free survival.

The liver is a site of immune privilege, compared with the bladder and skin, for example. To study this attenuation of the immune response in the cancer setting, we compared quantities and features of adaptive immune receptor (IR) recombination reads obtained from hepatocellular carcinoma (HCC) and six other cancers. Of these cancers, HCC had the lowest numbers of IR recombination reads and was the only cancer with a greater number immunoglobulin rather than T-cell receptor recombination reads. To better understand the role of adaptive IRs obtained from the tumor microenvironment in shaping the outcome of HCC cases, we quantified the chemical complementarity between HCC tumor TRB and IGH complementarity determining region-3 (CDR3) amino acid (AA) sequences, and known hepatitis B virus (HBV) epitopes. High chemical complementarity between HCC-resident CDR3s and three HBV epitopes correlated with increased survival probabilities, for two sources of CDR3s representing different CDR3 recovery algorithms. These results suggest the potential of CDR3 AA sequences as biomarkers for HCC patient stratification and as guides for future development of therapeutics.

Exploiting big data survival information to unify risk-stratification related, adaptive immune receptor parameters for multiple myeloma.

With the improvement of treatment options, multiple myeloma related life expectancy has been prolonged, but the disease remains largely incurable. Immunotherapy is a growing field that shows promise in advancements for treatment, and recent work has demonstrated an opportunity to use immune receptor, complementarity determining region-3 (CDR3)-candidate antigen chemical complementarity scores to identify survival distinctions among subgroups of patients. Here, we have applied the complementarity scoring algorithm to identify multiple myeloma related, CDR3-cancer testis antigen (CTA) relationships associated with survival distinctions. Furthermore, we have overlapped these immune receptor features with a previous study that showed a dramatic survival distinction based on T-cell receptor, V- and J-gene segment usage, HLA allele combinations, whereby 100% of the patients in certain combination groups had no mortality related to multiple myeloma, during the study period. This overlap evaluation was consistent with the idea that there are likely considerable constraints on productive TRB-antigen-HLA combinations but more flexibility, and unpredictability, for the TRA-antigen-HLA combinations. Also, the approaches in this reported indicated the potential importance of the CTA, IGSF11, as a multiple myeloma antigen, an antigen previously, independently considered as a vaccine candidate in other settings.

Chemical features of melanoma tumor resident TRG CDR3s associated with better survival probabilities.

We assessed the T-cell receptor gamma (TRG) recombination reads from the cancer genome atlas melanoma tumor exome files and the TRG recombination reads from an independent, melanoma exome file dataset, from the Moffitt Cancer Center. TRG complementarity determining region-3 (CDR3) amino acid (AA) sequences were assessed for chemical complementarity to cancer testis antigens, with such complementarity for FAM133A and CRISP2 associated with better survival probabilities for both datasets. These results, along with related TRG CDR3 AA chemical feature assessments provided in this report, have indicated opportunities for melanoma patient stratifications based on the recovery of TRG recombination reads from both tumor and blood samples, and the results may point towards novel, effective melanoma antigens.

The presence of intratumoral Porphyromonas gingivalis correlates with a previously defined pancreatic adenocarcinoma, immune cell expression phenotype and with tumor resident, adaptive immune receptor features.

The association between pancreatic adenocarcinoma (PAAD) and the pancreatic microbiome is not fully understood, although bacteria may decrease the effectiveness of chemotherapy and lead to anti-apoptotic, pro-inflammatory microenvironments. To better understand the relationship between the PAAD microbiome and the microenvironment, we identified Porphyromonas gingivalis-positive PAAD samples and found a strong association between intratumoral P. gingivalis and: (i) an immune cell gene expression phenotype previously defined by others as gene program 7; and (ii) recovery of immunoglobulin recombination, sequencing reads. We applied a novel chemical complementarity scoring algorithm, suitable for a big data setting, and determined that the previously established P. gingivalis antigen, rpgB had a reduced chemical complementarity with T-cell receptor (TCR) complementarity-determining region-3 amino acid sequences recovered from PAAD samples with P. gingivalis in comparison to TCR-rpgB chemical complementarity represented by the PAAD samples that lacked P. gingivalis. This finding strengthens the existing body of evidence correlating P. gingivalis with PAAD, which may have implications for the treatment and prognosis of patients. Furthermore, demonstrating the correlation of P. gingivalis and gene program 7 raises the question of whether P. gingivalis infection is responsible for the gene program 7 subdivision of PAAD?

Effect of amla and ginger powders on quality criteria of African catfish (Clarias gariepinus) fingers.

Catfish (Clarias gariepinus) meat isn't preferred by consumers in compared to other fish species meat, thus to enhance the use of catfish meat, ready to eat catfish fingers were prepared with some plants additives (amla and ginger powder). The mean objective of this study was to assess the impact of amla and ginger powder on catfish finger qualities in terms of physical, chemical, microbiological, and sensorial parameters under stored at a low temperature (5 ± 1 °C). The obtained results were compared with those of a control sample (basic formula) and a sample containing the synthetic antioxidant. During the storage period, the levels of pH, thiobarbituric acid, total volatile basic nitrogen, trimethylamine, total bacteria count, psychrophilic bacteria, molds and yeasts counts increased dramatically, although the values remained within acceptable ranges. The findings also revealed, that amla and ginger powder considerably (p < 0.05) reduced the changes in quality parameters, as well as there was a considerable increase in the quality parameter in all treated samples than in the control. Finally, amla and ginger powder can be a substitute for synthetic antioxidants and antimicrobials. These findings suggest that the powder of amla and ginger are suitable for use as a natural antioxidants and antimicrobials to extend the shelf-life of animal products.

Bacterial Sequencing Reads in Blood Exome Files from Melanoma and Cervical Cancer Patients are Associated with Cancer Recurrence.

Bacteremia poses great risk for morbidity and mortality for immunocompromised cancer patients. Although the presence of bacteria within solid tumors is gaining greater attention, few studies have analyzed species of bacteria in the blood and their effect on cancer clinical outcomes. Using the Kraken 2 taxonomic profiling tool, we classified bacteria present in blood and primary tumors of cervical cancer and melanoma cases. The Cancer Genome Atlas (TCGA) melanoma blood exome files with Pseudomonas species were found to represent a worse disease-free survival (DFS) probability, while a worse overall survival (OS) result was evidenced for both the TCGA and Moffitt Cancer Center melanoma datasets. Cervical cancer cases with reads representing the Bradyrhizobium genus and Bradyrhizobium sp. BTAi1 found in blood and tumor exome files were found to have lower DFS. Additionally, reduced DFS and OS were observed for cervical cancer cases positive for Bacteroides species including Bacteroides fragilis. This study provides novel evidence and a novel approach for indicating that bacteria in blood is associated with cancer recurrence. These findings may guide the development of more efficient prognostic and screening tools related to bacterial blood infections of melanoma and cervical cancer patients.

Virtual clinics progress and outcome during the Covid-19 pandemic.

AIM: To assess progress and outcome of the Virtual clinics during the Covid-19 Pandemic. METHODS: We used Excel sheet to collect and anlyse data including number of call attempts for answer, duration of the calls, success in talking to the carers and the outcome of consulttion. RESULTS: One-hundred-sixty-seven calls were made for 117 patients. Average of 1.3 calls per patient. 94/115 (81.7%) calls were eventually answered. 65% (71) parents answered the call from a single attempt (71/110). 18% (21/110) of parents answered the call on the second attempt. The average call duration was 9 min (range 21-5 min). We discharged 11% (11/103) of patients, while 33% (34/103) patients required a face-to-face physical review. A follow-up appointment was scheduled for 54% patients (58/103). DISCUSSION/CONCLUSION: With careful patients' selection, virtual outpatient clinics represent a feasible means of delivering outpatient care from a clinician perspective.

TCR gene segment usage and HLA alleles that are associated with cancer survival rates also represent racial disparities.

Understanding racial disparities in cancer outcomes continues to be a challenge, with likely many factors at play, including socioeconomic factors and genetic polymorphisms impacting basic cellular and molecular functions. Additionally, it is possible that specific combinations of environment and genetics have specific impacts. T-cell receptor (TCR) gene segment usage, HLA allele combinations have been associated with autoimmune and infectious disease courses, and more recently, TCR gene segment usage, HLA allele combinations have been associated with distinct survival outcomes in cancer as well. We examined several such, previously reported cancer-related TCR gene segment usage, HLA allele combinations for evidence of racial disparities, with regard to the prevalence of the combination in different racial groups. Results indicated that TCR gene segment usage, potentially reflecting environmental factors related to previous pathogen exposure, in combination with certain HLA alleles or independently, may represent a novel explanation for racial disparities in cancer outcomes. Overall, at this point, a genetic connection to racial disparities in cancer outcomes is detectable but remains modest, suggesting that other factors, such as socioeconomic factors, remain as important considerations.