Objective/Hypothesis
Research has long been acknowledged as important to successfully matriculate into an otolaryngology residency position. The objective of this study is to perform a bibliometric ...analysis to quantify the importance of scholarly productivity in the otolaryngology match process.
Study Design
Retrospective database review.
Methods
A list of all Accreditation Council for Graduate Medical Education–accredited otolaryngology residency programs were identified. Websites of programs were reviewed to identify first‐year otolaryngology residents for the 2016 to 2017 academic year and compared to two previous academic years. Research output measures were collected. Residencies were tiered 1 to 5 by departmental research output.
Results
Two hundred twenty‐two records of first‐year otolaryngology residents starting residency in 2016 were identified. After adjusting for number of total publications, number of original research articles, number of review articles, number of case reports, number of first author publications, number of otolaryngology‐related publications, highest journal impact factor, average journal impact factor, and years since publication, h‐index and number of total publications were associated with increasing tier of matriculation based on research output (P < .0001). Only number of publications correlated with increasing h‐index (B = 1.11). With regard to applicant trends, there has been an increase in scholarly productivity as measured across all research parameters in the past 3 years.
Conclusions
Research is an important component of successfully matriculating into an otolaryngology residency program. The h‐index is a reliable tool to quantify research output and predict the tier of matriculation with regard to institutional research output. There has been a steadily increasing level of scholarly output among applicants in the past 3 years.
Level of Evidence
NA
Laryngoscope, 129:1561–1566, 2019
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Moisture plays a critical role in the stability of amorphous solid dispersions (ASD) as it can lower the glass transition temperature (Tg) and thereby increase molecular mobility ...resulting in drug crystallization. A systematic study on moisture sorption by four polyvinylpyrrolidone (PVP) having different molecular weights (Kollidon® 12, 17, 30, and 90) and two related copolymers (Kollidon® VA64; Soluplus®) was conducted at 25 and 40 °C as a function of relative humidity to determine effects of absorbed moisture on Tg and potential stability of ASDs. A VTI dynamic moisture sorption analyzer was used, where experimental conditions were first established such that equilibrium was reached and there was no significant hysteresis loop between sorption and desorption isotherms. The PVPs had identical moisture sorption profiles and were highly hygroscopic, reaching 22–24% and 41–42% w/w moisture at 25 °C/60% RH and 25 °C/80% RH, respectively. Kollidon® VA64 and Soluplus® were relatively less hygroscopic, reaching, respectively, about half and one-fourth the moisture content of PVPs at 25 °C/60% RH. Moisture sorption at 40 °C was relatively lower than that at 25 °C. The high moisture sorption drastically decreased Tg of polymers, which roughly agreed with theoretical calculations based on the Gordon-Taylor/Kelley-Bueche equation, although deviation occurred, possibly due to hydrogen bonding between polymer and moisture.
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Some of the major issues with the development of FDM 3D printed tablets are slow drug release, lack of drug-polymer miscibility, high processing temperature, and poor printability. In ...this investigation, these issues were addressed by using a novel physicochemical principle called acid-base supersolubilization (ABS) previously developed in our laboratory. The aqueous solubility of a basic drug, haloperidol, was increased to ~300 mg/g of solution by adding glutaric acid, and, upon drying, the concentrated solutions produced amorphous materials. Similar amorphous systems could also be produced by heating haloperidol-glutaric acid mixtures. Filaments for 3D printing were prepared by melt extrusion of formulations containing 15% w/w haloperidol and 10.5% glutaric acid (1:2 M ratio) along with 74.5% polymers, such as Kollidon® VA64 alone or its mixtures with Affinisol™ 15cP. Filaments could be extruded and printed at low temperatures of 115 and 120 °C, respectively. Haloperidol was fully miscible in the formulations because of the acid-base interaction and formed amorphous systems even at higher drug loads. Although filaments of haloperidol-Kollidon® VA64 mixtures by themselves cannot be printed, the printability of formulation improved such that those containing glutaric acid were printable. Drug release rates from the formulations at pH 2 and 6.8 were rapid and complete.
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Slow drug release, low drug-polymer miscibility, poor printability of polymers used, and high processing temperature are major challenges in developing FDM 3D-printed tablets. These ...challenges were addressed in this investigation by having a model basic drug, haloperidol (mp: 151.5 °C), interact with a weak acid, malic acid (mp: 130 °C), during the melt extrusion of formulations into filaments used for 3D-printing. Malic acid was selected as it was previously reported that it did not form any crystalline salt with haloperidol but its addition to aqueous media could greatly increase the solubility of haloperidol from ∼ 1 µg/mL to > 1 g per mL of water by acid-base supersolubilization. Concentrated solutions of haloperidol-malic acid mixtures produced amorphous materials upon drying. It has been observed in the present investigation that similar interaction between haloperidol and malic acid may also occur in the absence of water. Upon heating, haloperidol-malic acid mixtures at 1:1 and 1:2 molar ratios turned amorphous starting at ∼ 50 °C, which is much below the melting point of either component. When Kollidon® VA64, a brittle and non-printable polymer, was used as the polymeric carrier, the acid-base interaction greatly reduced the melt viscosity of haloperidol-malic acid-Kollidon® VA64 ternary mixtures. Consequently, melt extrusion of filaments and printing of tablets using such mixtures could be performed at much lower temperatures than those with haloperidol-Kollidon® VA64 binary mixtures. The filaments containing 15 % and 30 % haloperidol along with malic acid and Kollidon® VA64 could be printed into tablets at relatively low temperatures of 125 and 100 °C, respectively, thus making Kollidon® VA64 not only printable but also doing so at low temperatures. Up to 50 % w/w drug load in filaments was achieved without any crystallization of haloperidol or malic acid. Drug release at pH 2 and 6.8 from printed tablets with 100 % infill was 80 % in < 30 min. Thus, the acid-base interaction can successfully resolve multiple development challenges encountered with FDM 3D-printed tablets.
While technologies for administering radiation therapies have been rapidly advancing, there has been less progress in reducing side effects. ...identifying patients with the greatest potential ...benefits from therapy is vital. ...the application of genomic data to radiation therapy remains a promising area ofstudy, with room for development ofnew treatment strategies and risk assessment tools. Author Contributions: All authors confirmed they have contributed to the intellectual content ofthispaper and have met the following 3 requirements: (a) significant contribution to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval ofthe published article.
Moisture sorption by polymeric carriers used for the development of amorphous solid dispersions (ASDs) plays a critical role in the physical stability of dispersed drugs since moisture may decrease ...glass transition temperature (T
) and thereby increase molecular mobility of drugs leading to their crystallization. To assist the selection of appropriate polymers for ASDs, we conducted moisture sorption by five types of cellulosic polymers, namely, hydroxypropyl cellulose (HPC), hydroxypropyl methyl cellulose (HPMC), hydroxypropyl methyl cellulose acetate succinate (HPMCAS), hydroxypropyl methyl cellulose phthalate (HPMCP), and ethyl cellulose (EC), as functions of relative humidity (10 to 90% RH) and temperature (25 and 40 °C). The moisture sorption was in the order of HPC>HPMC>HPMCP>HPMCAS>EC, and there was no significant effect of the molecular weights of polymers on moisture uptake. There was also less moisture sorption at 40 °C than that at 25 °C. Glass transition temperatures (T
) of the polymers decreased with the increase in moisture content. However, the plasticizing effect by moisture on HPC could not be determined fully since, despite being amorphous, there were very little baseline shifts in DSC scans. There was also very shallow baseline shift for HPMC at >1% moisture content. In contrast, T
of HPMCAS and HPMCP decreased in general agreement with the Gordon-Taylor/Kelley-Bueche equation, and EC was semicrystalline having both T
and melting endotherm, with only minor effect of moisture on T
. The results of the present investigation would lead to a systematic selection of polymeric carriers for ASDs.
In the realm of diabetes research, considerable attention has been directed toward elucidating the intricate interplay between the gastrointestinal tract and glucose regulation. The gastrointestinal ...tract, once exclusively considered for its role in digestion and nutrient assimilation, is presently acknowledged as a multifaceted ecosystem with regulatory supremacy over metabolic homeostasis and glucose metabolism. Recent studies indicate that alterations in the composition and functionality of the gut microbiota could potentially influence the regulation of glucose levels and glucose homeostasis in the body. Dysbiosis, characterized by perturbations in the equilibrium of gut microbial constituents, has been irrevocably linked to an augmented risk of diabetes mellitus (DM). Moreover, research has revealed the potential influence of the gut microbiota on important factors, like inflammation and insulin sensitivity, which are key contributors to the onset and progression of diabetes. The key protagonists implicated in the regulation of glucose encompass the gut bacteria, gut barrier integrity, and the gut-brain axis. A viable approach to enhance glycemic control while concurrently mitigating the burden of comorbidities associated with diabetes resides in the strategic manipulation of the gut environment through adapted dietary practices.
This review aimed to provide a deep understanding of the complex relationship between gut health, glucose metabolism, and diabetes treatment.
This study has presented an exhaustive overview of dietary therapies and functional foods that have undergone extensive research to explore their potential advantages in the management of diabetes. It looks into the role of gut health in glucose regulation, discusses the impact of different dietary elements on the course of diabetes, and evaluates how well functional foods can help with glycemic control. Furthermore, it investigates the mechanistic aspects of these therapies, including their influence on insulin sensitivity, β-cell activity, and inflammation. It deliberates on the limitations and potential prospects associated with integrating functional foods into personalized approaches to diabetes care.
Background
Using next‐generation sequencing (NGS) to guide cancer therapy has created challenges in analyzing and reporting large volumes of genomic data to patients and caregivers. Specifically, ...providing current, accurate information on newly approved therapies and open clinical trials requires considerable manual curation performed mainly by human “molecular tumor boards” (MTBs). The purpose of this study was to determine the utility of cognitive computing as performed by Watson for Genomics (WfG) compared with a human MTB.
Materials and Methods
One thousand eighteen patient cases that previously underwent targeted exon sequencing at the University of North Carolina (UNC) and subsequent analysis by the UNCseq informatics pipeline and the UNC MTB between November 7, 2011, and May 12, 2015, were analyzed with WfG, a cognitive computing technology for genomic analysis.
Results
Using a WfG‐curated actionable gene list, we identified additional genomic events of potential significance (not discovered by traditional MTB curation) in 323 (32%) patients. The majority of these additional genomic events were considered actionable based upon their ability to qualify patients for biomarker‐selected clinical trials. Indeed, the opening of a relevant clinical trial within 1 month prior to WfG analysis provided the rationale for identification of a new actionable event in nearly a quarter of the 323 patients. This automated analysis took <3 minutes per case.
Conclusion
These results demonstrate that the interpretation and actionability of somatic NGS results are evolving too rapidly to rely solely on human curation. Molecular tumor boards empowered by cognitive computing could potentially improve patient care by providing a rapid, comprehensive approach for data analysis and consideration of up‐to‐date availability of clinical trials.
Implications for Practice
The results of this study demonstrate that the interpretation and actionability of somatic next‐generation sequencing results are evolving too rapidly to rely solely on human curation. Molecular tumor boards empowered by cognitive computing can significantly improve patient care by providing a fast, cost‐effective, and comprehensive approach for data analysis in the delivery of precision medicine. Patients and physicians who are considering enrollment in clinical trials may benefit from the support of such tools applied to genomic data.
Next‐generation sequencing (NGS) has emerged as an affordable and reproducible means to query tumors for somatic genetic anomalies. To help interpret somatic NGS data, many institutions have created a molecular tumor board to analyze the results of NGS and make recommendations. This article evaluates the utility of cognitive computing systems to analyze data for clinical decision‐making.
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