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s. Copyright © 2020, Parajuli et al.BACKGROUND In obstetrical health care, disparities have been documented in different aspects of maternal care and outcomes. Prior epidemiological studies have shown that labor analgesia is underused in African-American and Hispanic groups, which means there may be inadequate labor pain control in these groups. Differences in usage have been attributed primarily to insurance, educational levels and perceptional influences such as fear of paralysis and chronic low back pain. In cesarean section deliveries, race and ethnicity affect the choice of anesthesia considered. How race and ethnicity affect maternal outcomes in cesarean sections with epidural placements generally has been unexplored. Disparities in health care utilization are shown to contribute to the disparities in health outcomes. METHODS This is a retrospective analysis using data from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project (AHRQ-HCUP), the National Inpatient Sample (NIS) database from January 2003 to Dwarranted to determine the biological or perception etiologies that are contributing to these disparities. Copyright © 2020, Hsieh et al.BACKGROUND AND AIM Assessment of dentofacial asymmetries and other discrepancies that can affect the horizontal reference lines should be considered initially as a part of the esthetic diagnosis. Some variations of facial asymmetry are not considered an esthetic liability. So the aim of the present study is to determine a layperson's preference regarding transverse occlusal plane (TOP) orientation in fabrication of a complete denture. MATERIALS AND METHODS A total of 100 subjects who are edentulous and have enrolled for complete denture fabrication were selected. Photograph of the patient's face was obtained from the frontal perspective on the day of try-in. The image obtained was edited to orient the occlusal plane in three different cants, zero degree, two degrees, and four degrees to the inter-pupillary line (IL) and presented to the patient. The obtained results were statistically analyzed. RESULTS  The observed data was analyzed using Friedman's test and Wilcoxon test was used for comparing ordinal data between groups. There was a statistically significant difference in acceptance depending on angulation, χ2(2) = 183.2, p = 0.0001. CONCLUSION A cant of two degrees is not perceived by the subject but some subjects' preference of occlusal plane may be altered according to the commissural canting which cannot be incorporated in complete denture fabrication. Copyright © 2020, K et al.Evaluation of undifferentiated pediatric abdominal pain presents a unique set of challenges, especially in the setting of inconclusive and limited diagnostic imaging. In this case report, a female child presented to the emergency department with persistent abdominal pain, normal lab studies, and unusual trans-abdominal pelvic ultrasound findings. Urgent exploratory laparoscopy was completed, demonstrating a torsed adnexa rotated around a very large, mature teratoma, with irregular masses consistent with fully developed teeth. Early recognition of atypical pediatric abdominal pain in the setting of equivocal diagnostic imaging findings and collaboration with surgical colleagues resulted in a positive outcome for this patient. Copyright © 2020, Chang et al.Background Lung cancer is estimated to be 12% of all new cases of cancer. It is one of the most common cancers in men and women, and it is the main cause of cancer-related death in the United States of America. More than 90% of small cell lung cancer (SCLC) patients are elderly, with a current or past history of smoking. In Saudi Arabia, lung cancer incidence is low as compared to the global incidence. In 2013, the age-standardized ratio (ASR) was 1.8 per 100,000 for females and 5.5 per 100,000 for males. In our study, we aimed to assess the outcomes of SCLC at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Methods This retrospective cohort study included all patients aged 14 years and older with a diagnosis of SCLC from 2007 to 2017 using electronic medical records at KAUH. Tyrphostin B42 purchase Data analysis was performed using Stata SE, version 15.0 (StataCorp LLC, TX). The primary outcome of this study was the survival of patients diagnosed with SCLC. Survival was defined as the time the patient lived in montors, and to formulate a comprehensive survivorship care plan are required to develop better outcomes in survival and to improve the overall quality of life to pretreatment levels. Copyright © 2020, Alhejaili et al.Simultaneously having two pathologically distinct neoplastic lesions causing critical spinal stenosis is exceedingly rare. When such lesions are near one another but occupy different spinal compartments, significant challenges arise. We present the case of a patient with metastatic non-small cell carcinoma to the thoracic spine and an intradural meningioma occurring two spinal segments from each other. A 66-year-old female presented with one month of progressive mechanical back pain and two days of lower extremity weakness and urinary retention. She was found to have a left upper lobe lung mass. An urgent biopsy demonstrated non-small cell lung carcinoma. MRI of her thoracic spine demonstrated a T9 intradural-extramedullary enhancing lesion simultaneously with a destructive lesion of the T11 vertebral body extending into the anterior epidural space with significant cord compression at T9 and T11. The patient was taken for an urgent posterior decompression from T9 to T11, T9 left-sided pediculectomy with resection of intradural tumor, T11 corpectomy with anterior cage reconstruction, and instrumented fixation from T7 to L2. The pathology from the T9 lesion demonstrated findings consistent with a meningioma while the T11 lesion confirmed metastatic non-small cell lung adenocarcinoma. The patient improved neurologically postoperatively and regained the ability to ambulate within one week of surgery. Pathologically distinct spinal lesions in close anatomic proximity, but in two separate compartments are exceptionally rare. We performed a simultaneous posterior approach for resection of the T9 meningioma and a T11 corpectomy for the metastatic lesion with rapid neurologic recovery. Copyright © 2020, Rai et al.Allosaurus, from the Late Jurassic of North America and Europe, is a model taxon for Jurassic basal tetanuran theropod dinosaurs. It has achieved an almost iconic status due to its early discovery in the late, 19th century, and due to the abundance of material from the Morrison Formation of the western U.S.A., making Allosaurus one of the best-known theropod taxa. Despite this, various aspects of the cranial anatomy of Allosaurus are surprisingly poorly understood. Here, we discuss the osteology of the cheek region, comprised by the jugal, maxilla, and lacrimal. This region of the skull is of importance for Allosaurus taxonomy and phylogeny, particularly because Allosaurus has traditionally been reconstructed with an unusual cheek configuration, and because the European species Allosaurus europaeus has been said to be different from North American material in the configuration of these bones. Based on re-examination of articulated and disarticulated material from a number of repositories, we show that the jugal participates in the antorbital fenestra, contradicting the common interpretation. The jugal laterally overlies the lacrimal, and forms an extended antorbital fossa with this bone. Furthermore, we document previously unrecorded pneumatic features of the jugal of Allosaurus. © 2020 Evers et al.Mind-body medicine is an evidence-based approach to health and healing that focuses on interactions between the mind, body, and behavior. It encompasses a wide range of interventions that are similar yet different in meaningful ways. Mindfulness and relaxation practices are 2 mind-body techniques that have similarities and differences; however, these techniques are often used or discussed interchangeably, such that the differences between them become obscured. A greater understanding of the unique facets of mindfulness and relaxation is needed for researchers and clinicians to make informed decisions when selecting an approach. The purpose of the current article is to offer an evidence-informed perspective on similarities and differences between mindfulness and relaxation. Specifically, mindfulness and relaxation practices are compared and contrasted in terms of theoretical foundation, intention, and psychological and physiological effects and mechanisms. Implications for clinical practice and suggestions for future research are discussed. © The Author(s) 2020.Although anti-programmed death-1 (PD-1) treatment has shown remarkable anti-tumor efficacy, immune-related adverse events (irAEs) develop with heterogeneous clinical manifestations. However, the immunological understanding of irAEs is currently limited. In the present study, we analyzed peripheral blood T cells obtained from cancer patients who received anti-PD-1 treatment to determine the immunological characteristics of irAEs. This study included 31 patients with refractory thymic epithelial tumor (TET) who were enrolled in a phase II trial of pembrolizumab (NCT02607631) and 60 patients with metastatic non-small cell lung cancer (NSCLC) who received pembrolizumab or nivolumab. T-cell profiling was performed by multicolor flow cytometry using peripheral blood obtained before treatment and 7 days after the first dose of anti-PD-1 antibodies. irAEs developed in 21 TET patients and 24 NSCLC patients. Severe (≥ grade 3) irAEs occurred in 7 TET patients (22.6%) and 6 NSCLC patients (10.0%). Patients with severe irAEs exhibited a significantly lower fold increase in the frequency of effector regulatory T (eTreg) cells after anti-PD-1 treatment, a higher ratio of T helper-17 (Th17) and T helper-1 cells at baseline, and a higher percentage of Ki-67+ cells among PD-1+CD8+ T cells posttreatment. In clustering analysis using the T-cell parameters, patients with irAEs were grouped into four distinct subtypes Th17-related, TNF-related, CD8-related Treg-compensated, and CD8-related Treg-uncompensated. The T-cell parameters showed a predictive value for the development of each subtype of severe irAEs. In conclusion, severe irAEs after anti-PD-1 treatment were clustered into four immunological subtypes, and potential biomarkers for early prediction of severe irAEs were proposed. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.The immune checkpoint blockade (ICB) immunotherapy has prolonged overall survival for cancer patients but the response rates are low. The resistance to ICB is likely due to compensatory upregulation of additional immune inhibitory molecules. In this study, we first systematically examined Tim-3 expression in immune cells in mouse tumors and found that Tim-3 was specifically up-regulated in a large number of Treg, conventional CD4+, CD8+ T cells, dendritic cell 1 (DC1), and macrophage 1 (M1) in the tumor microenvironment (TME). Interestingly, Tim-3+ T cells in the TME were phenotypically effector but not "exhausted" T cells because Tim-3+ PD-1+ CD8+ T cells had a higher number of mitochondria, greater levels of glycolysis, and higher tumor-specific cytolytic activities compared to Tim-3- PD-1- CD8+ T cells. The combination treatment with Tim-3 and PD-1 mAbs resulted in a synergistic antitumor activity but also increased the expression of Lag-3 and GITR in TIL, demonstrating cross-regulation between multiple checkpoint molecules.