Objective
We examined whether dynamic margin criteria margin‐to‐thickness (MTR) ratio has superior predictive value compared with the resection margin or tumour thickness alone in the survival ...outcome in oral squamous cell carcinoma (OSCC).
Design
This is a retrospective cohort study.
Setting
Oral squamous cell carcinoma patients treated in Kaohsiung Veterans General Hospital Cancer Center between January 2006 and December 2013.
Participants
A cohort of 302 patients with OSCC who had undergone surgical management.
Main Outcomes Measures
Log MTR was calculated for each patient, and survival data were analysed using a multivariable Cox regression model. Discriminative analysis was performed using chi‐square, Akaike information criterion (AIC) and Harrell's C tests.
Results
After assessing for discriminative ability, the linear trend of log MTR surpassed those of resection margin and tumour thickness in chi‐square, AIC and Harrell's C tests for the advanced pathologic T (pT) category. A multivariate Cox proportional hazard regression model revealed that log MTR <33% was associated with less favourable 5‐year disease‐specific survival (DSS) (P = 0.006) in the entire oral cancer study cohort. Other significant factors included perineural invasion (P = 0.021), pT category, (P = 0.005), pathologic N category (P < 0.001) and differentiation category (P = 0.022).
Conclusions
Log MTR < 33% may be a predictor of less favourable outcome in the DSS of OSCC. Log MTR outperformed both resection margin and tumour thickness alone in terms of discriminative analysis. Our study could help in presurgical planning for high‐risk patients and in aiding the decision‐making process for adjuvant treatment.
Applying construal level theory, this study examined how social distance (thinking of self/children), front-of-package (FOP) claim type (nutrient/health/control), and perceived importance of eating ...healthily (low/high) impact consumer responses (attitudes/purchase intent) to healthier food products through an online experiment with 171 U.S. parents from low-to-mid socio-economic households. Participants were randomly assigned to view controlled images of healthier foods with packaging that bore different claim types for real and fictitious brands. Results revealed that when choosing for themselves, consumer attitudes were more positive when the healthier food package carried a nutrient (vs. health) claim, however, control claims received the most positive evaluations. When choosing for children, attitudes were more positive when the package carried a health (vs. nutrient/control) claim. Attitudes toward healthier foods were higher for consumers with high (vs. low) perceived importance of eating healthily when the package bore a nutrient claim, however, their attitudes did not significantly differ when the package bore a health/control claim. Purchase intent for healthier foods was higher for consumers with high (vs. low) perceived importance of healthy eating when shopping for self; whereas, when shopping for children, purchase intent did not significantly differ between consumers who varied in perceived importance of eating healthily.
Abstract
Context
Transgender youth may initiate GnRH agonists (GnRHa) to suppress puberty, a critical period for bone-mass accrual. Low bone mineral density (BMD) has been reported in late-pubertal ...transgender girls before gender-affirming therapy, but little is known about BMD in early-pubertal transgender youth.
Objective
To describe BMD in early-pubertal transgender youth.
Design
Cross-sectional analysis of the prospective, observational, longitudinal Trans Youth Care Study cohort.
Setting
Four multidisciplinary academic pediatric gender centers in the United States.
Participants
Early-pubertal transgender youth initiating GnRHa.
Main Outcome Measures
Areal and volumetric BMD Z-scores.
Results
Designated males at birth (DMAB) had below-average BMD Z-scores when compared with male reference standards, and designated females at birth (DFAB) had below-average BMD Z-scores when compared with female reference standards except at hip sites. At least 1 BMD Z-score was < -2 in 30% of DMAB and 13% of DFAB. Youth with low BMD scored lower on the Physical Activity Questionnaire for Older Children than youth with normal BMD, 2.32 ± 0.71 vs. 2.76 ± 0.61 (P = 0.01). There were no significant deficiencies in vitamin D, but dietary calcium intake was suboptimal in all youth.
Conclusions
In early-pubertal transgender youth, BMD was lower than reference standards for sex designated at birth. This lower BMD may be explained, in part, by suboptimal calcium intake and decreased physical activity–potential targets for intervention. Our results suggest a potential need for assessment of BMD in prepubertal gender-diverse youth and continued monitoring of BMD throughout the pubertal period of gender-affirming therapy.
Estrogen is involved in several physiological and pathological processes through estrogen receptor (ER)-mediated transcriptional gene regulation. miRNAs (miRs), which are noncoding RNA genes, may ...respond to estrogen and serve as posttranscriptional regulators in tumorigenic progression, especially in breast cancer; however, only limited information about this possibility is available. In the present study, we identified the estrogen-regulated miR-34b and investigated its functional role in breast cancer progression.
Estrogen-regulated miRNAs were identified by using a TaqMan low density array. Our in vivo Tet-On system orthotopic model revealed the tumor-suppressive ability of miR-34b. Luciferase reporter assays and chromatin immunoprecipitation assay demonstrated miR-34b were regulated by p53-ER interaction.
In this study, we identified one such estrogen downregulated miRNA, miR-34b, as an oncosuppressor that targets cyclin D1 and Jagged-1 (JAG1) in an ER+/wild-type p53 breast cancer cell line (MCF-7), as well as in ovarian and endometrial cells, but not in ER-negative or mutant p53 breast cancer cell lines (T47D, MBA-MB-361 and MDA-MB-435). There is a negative association between ERα and miR-34b expression levels in ER+ breast cancer patients. Tet-On induction of miR-34b can cause inhibition of tumor growth and cell proliferation. Also, the overexpression of miR-34b inhibited ER+ breast tumor growth in an orthotopic mammary fat pad xenograft mouse model. Further validation indicated that estrogen's inhibition of miR-34b expression was mediated by interactions between ERα and p53, not by DNA methylation regulation. The xenoestrogens diethylstilbestrol and zeranol also showed similar estrogenic effects by inhibiting miR-34b expression and by restoring the protein levels of the miR-34b targets cyclin D1 and JAG1 in MCF-7 cells.
These findings reveal that miR-34b is an oncosuppressor miRNA requiring both ER+ and wild-type p53 phenotypes in breast cancer cells. These results improve our ability to develop new therapeutic strategies to target the complex estrogenic pathway in human breast cancer progression through miRNA regulation.
Purpose of Review
This review summarizes recent literature for applying pharmacogenomics to antifungal selection and dosing, providing an approach to implementing antifungal pharmacogenomics in ...clinical practice.
Recent Findings
The Clinical Pharmacogenetics Implementation Consortium published guidelines on
CYP2C19
and voriconazole, with recommendations to use alternative antifungals or adjust voriconazole dose with close therapeutic drug monitoring (TDM). Recent studies demonstrate an association between
CYP2C19
phenotype and voriconazole levels, clinical outcomes, and adverse events. Additionally,
CYP2C19
-guided preemptive dose adjustment demonstrated benefit in two prospective studies for prophylaxis. Pharmacokinetic–pharmacodynamic modeling studies have generated proposed voriconazole treatment doses based on
CYP2C19
phenotypes, with further validation studies needed.
Summary
Sufficient evidence is available for implementing
CYP2C19
-guided voriconazole selection and dosing among select patients at risk for invasive fungal infections. The institution needs appropriate infrastructure for pharmacogenomic testing, integration of results in the clinical decision process, with TDM confirmation of goal trough achievement, to integrate antifungal pharmacogenomics into routine clinical care.
Kisspeptin (Kiss1) signaling to GnRH neurons is widely acknowledged to be a prerequisite for puberty and reproduction. Animals lacking functional genes for either kisspeptin or its receptor exhibit ...low gonadotropin secretion and infertility. Paradoxically, a recent study reported that genetic ablation of nearly all Kiss1-expressing neurons (Kiss1 neurons) does not impair reproduction, arguing that neither Kiss1 neurons nor their products are essential for sexual maturation. We posited that only minute quantities of kisspeptin are sufficient to support reproduction. If this were the case, animals having dramatically reduced Kiss1 expression might retain fertility, testifying to the redundancy of Kiss1 neurons and their products. To test this hypothesis and to determine whether males and females differ in the required amount of kisspeptin needed for reproduction, we used a mouse (Kiss1-CreGFP) that has a severe reduction in Kiss1 expression. Mice that are heterozygous and homozygous for this allele (Kiss1Cre/+ and Kiss1Cre/Cre) have ∼50% and 95% reductions in Kiss1 transcript, respectively. We found that although male Kiss1Cre/Cre mice sire normal-sized litters, female Kiss1Cre/Cre mice exhibit significantly impaired fertility and ovulation. These observations suggest that males require only 5% of normal Kiss1 expression to be reproductively competent, whereas females require higher levels for reproductive success.
The purpose of this study was to investigate food safety knowledge, training of food truck owners/managers, and perceived barriers to training in the U.S. An online survey was developed based on a ...review of the literature and qualitative interviews and distributed to members of state food truck associations. A total of 271 responses were collected and analyzed using descriptive and inferential statistics. The results of this study demonstrated a lack of food safety knowledge among the participants, with areas of improvement concerning personal hygiene, food preparation, cleaning and sanitizing, and safe chemical handling. The most common training methods utilized were one-on-one instruction and job shadowing. Perceived barriers regarding training of employees included time constraints and enough funds to cover the costs of training. This study identified the need for food safety training and education in the food truck industry.
Calcium alginate (Ca-alginate) beads have attracted considerable attention as carriers for the controlled release of volatile compounds due to their biocompatibility and tunable properties. This ...study aimed to compare the release of ethylene and carbon dioxide gas from Ca-alginate beads. Ca-alginate beads were prepared from a sodium alginate solution containing ethephon and calcium carbonate as the gas-forming agent. The resulting solution was then extruded into a calcium chloride solution. The gas release behavior was studied by monitoring the concentration of released gases over time using gas detectors. Extrusion tip diameter, alginate concentration and gas-releasing agent concentration were systematically varied to assess their effect on the gas release rate. The results indicated distinct release patterns for ethylene and carbon dioxide gas. Ethylene gas exhibited a relatively slower and sustained release, while carbon dioxide gas exhibited a more rapid release. Moreover, the bead size influenced the gas release, with larger beads displaying faster release rates for ethylene and carbon dioxide gas. The concentration of alginate also played a role in modulating the release kinetics, with higher alginate concentration resulting in slower gas release. The findings have implications for designing and optimizing Ca-alginate-based systems for agricultural applications, including plant hormone delivery and modified atmosphere packaging.
PurposeThis study aims to investigate how domestic and international undergraduate students from a university in Ontario, Canada, defined locally grown food and examined the factors behind their ...locally grown food purchase intentions.Design/methodology/approachQuestionnaires were distributed in the School of Hospitality, Food, and Tourism Management undergraduate classes. A total of 196 complete surveys were returned. Using multiple regression analysis and theory of planned behavior (TPB) as a theoretical framework with an additional construct, moral norm, proposed hypotheses were tested.FindingsDomestic students narrowly defined locally grown food based on distance (e.g. food grown/raised within 100 km of where a person lives) compared to international students (e.g. food grown in Canada). The multiple regression analysis revealed that 36% of variance in purchase intention is explained by the four independent variables (i.e. student status, attitude, perceived product availability and moral norm), with perceived product availability as the strongest predictor of intention to purchase locally grown food.Research limitations/implicationsThe convenience sampling method limitations are as follows. First, the sample size was small for international students. Second, there was a possibility of underrepresentation of certain origins of international student populations. Third, the undergraduate respondents were from the School of Hospitality, Food and Tourism. Finally, another limitation is that the four variables in this study (i.e. attitudes, subjective norms, perceived product availability, and moral norm) only explained 36% of the variance of this model.Practical implicationsPerceived product availability, moral norm and attitude constructs positively influenced the locally grown food purchase intention. A perceived product availability construct revealed the strongest influence in locally grown food purchase intention of students. Particularly, five key questions were created based on the major research findings of this study, which can be used as a guideline for locally grown food providers and farmers when promoting locally grown food to students. These questions include: Where can I find it? When can I find it? Who grows it? How can I benefit others? Why is it good for me?Social implicationsThe results of this study shown that which factors influence locally grown food purchase intention of students. Hence, local restaurateurs and university dining facilities may incorporate these factors in their marketing message to serve students population better who might be interested in buying food products using locally grown ingredients. Research results also allow local farmers to communicate and inform their current and potential student consumers about the advantages of locally grown food. Overall, findings can contribute to economy and business of local community.Originality/valueCurrent research findings verified that there is a significant use of a moral norm construct to predict locally grown food purchase intention of students. The moral norm construct positively influenced the locally grown food purchase intention in this study, and this construct seemed useful to predict locally grown food purchase intention of students. Additionally, the research discovered that there were differences in domestic and international undergraduate students' perception in the locally grown food definition.
Objective
Admission committees use multiple sources of information to select residents. However, the way in which faculty members use each data source remains unclear and highly context-specific. The ...present study seeks to understand how faculty members use various sources of information about candidates to make admission decisions to a National Psychiatry Residency Program.
Methods
The theory of core competencies was used as a foundation for this qualitative study. Framework analysis was used to structure the project and data presentation. Twenty key informants from the faculty were purposefully sampled in accordance with the initial theory. Open-ended semi-structured interviews were conducted to obtain their views about the essential competencies of psychiatrists and the ways in which these competencies could be reliably gauged.
Results
Participants described numerous competencies that they believed were essential to becoming competent psychiatrists. These competencies fell within the six core competencies of the Accreditation Council for Graduate Medical Education framework. However, several non-competency attributes (such as perseverance, empathy, and compassion) were also relevant in the selection process. To reduce the impact of self-presentation bias, to which these attributes were vulnerable, the faculty relied heavily on sources of information obtained from third parties, such as feedback from co-workers with first-hand experience of the candidate during their clinical placements.
Conclusion
Faculty members place importance on informal informant-derived information about a candidate’s non-competency attributes in addition to core competencies when deciding whether or not to select a candidate for admission into a residency training program.
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