Mejerchang0568

Among patients undergoing hysterectomy, AAPI women had a lower mortality compared with NHW women for cancer stage I/II/III, and a 28% reduction for type I (grade 1 or 2 endometrioid cancers) disease (aHR = 0.72; 95% CI, 0.64-0.81). Among AAPI subgroups, Pacific Islanders had the worst survival across different cancer stage and disease type.

AAPI women are diagnosed with uterine cancer at a younger age and have more aggressive histologic subtypes and advanced stage than their White counterparts. They have a similar level of quality-of-care as NHW women, and an improved survival for early stage and type I disease.

AAPI women are diagnosed with uterine cancer at a younger age and have more aggressive histologic subtypes and advanced stage than their White counterparts. They have a similar level of quality-of-care as NHW women, and an improved survival for early stage and type I disease.

To quantify the radial and lateral extents of femoral cam lesions in FAI patients relative to the alpha angle and correlate with clinical data.

Retrospective study of 81 hips with femoral cam morphology that underwent arthroscopic surgery between 2017 and 2019. At each hour over the clockface, the alpha angle (α) (abnormal defined as > 55°), radial extent, and lateral extent of cam lesions were measured on CT. These measurements were correlated with clinical and arthroscopic data. Statistics included independent samples t-test and chi-squared test with Bonferroni correction and multivariate logistic regression.

Larger α at 1200-400 in males vs females (56.6-63.4° vs 44.3-58.5°, P < 0.001) and at 200-400 with elite sports participation vs without (56.7-70.9° vs 49.6-61.1°, P ≤ 0.004). Independent risk factors for radial extent beyond 1200-300 were male sex (OR 4.82, 95% CI [1.46, 15.85], P=0.010), BMI > 25 (OR 4.74, 95% CI [1.61, 14.00], P=0.005), and elite sports participation (OR 3.28, 95% CI [1.09, 9.82], P=0.034). Lateral extent increased at 100-400 in males vs females (7.8-18.6 mm vs 1.6-9.1 mm, P < 0.0001). A 16% prevalence of distal cam lesions was found at locations with normal α, resulting in underestimation of radial extent by an average of 1.7 hours.

There is a positive correlation between the alpha angle, lateral extent, and radial extent of cam lesions. FAI patients who were male, participated in elite level sports, and had a BMI > 25 had larger cam lesions. A larger alpha angle is a risk factor for cartilage damage. Metabolism inhibitor Patients may have distal cam lesions at locations with normal alpha angles, though their significance is unknown.

25 had larger cam lesions. A larger alpha angle is a risk factor for cartilage damage. Patients may have distal cam lesions at locations with normal alpha angles, though their significance is unknown.

Over the past decade, technological advances have provided new tools for radiologists. However, the effect of these technological advances on radiologist workload and detecting pathologies needs to be assessed.

The purpose of this study is to assess the workload, including non-interpretative tasks, associated with Computed Tomography Angiogram (CTA) of Aorta exams performed in the Emergency Department (ED) over a 10-year period and their relationship to detection of aortic pathology.

This is a retrospective analysis of CTAs of Aorta performed on adults with suspected acute aortic pathology within the ED at an academic level I quaternary care hospital from January 1, 2005, through December 31, 2015. Data assessed included (1) Interpretive tasks total number of images, number of reformat series, number of radiology reports with positive aortic pathologies; and (2) Non-interpretative tasks recommendations and documentation of verbal communication with requesting providers. Statistical analyses were performs of CTA workloads, non-interpretive tasks such as radiologist recommendations and verbal communications should also be included.

During a 10-year period, CTAs performed in the ED for suspected aortic pathology were associated with a significant increase in images created, reformat series generated, recommendations, and verbal communications with ordering providers without a concomitant increase in the rate of aortic pathologies. To completely capture the complexities of CTA workloads, non-interpretive tasks such as radiologist recommendations and verbal communications should also be included.

Overutilization of imaging in radiology increases costs without improvement in patient outcomes. As a part of the regular quality measures, the Centers for Medicare and Medicaid Services deemed our institution to be overutilizing abdomen and abdominopelvic computer tomography (CT) with and without intravenous (IV) contrast. We implemented a quality improvement (QI) effort to reduce use of abdomen CT with and without IV contrast.

We found high use of abdomen CT with and without IV contrast for liver imaging and implemented an intervention from July 2018 to June 2020. The intervention included updating the liver imaging protocols in alignment with LI-RADS guidelines and hosting educational sessions with the clinical and radiology team to review the updates. Control charts were generated to display changes in the number of CT examinations over time with phase variables indicating two averages, pre- and post-intervention.

Guidelines combined with targeted educational and engaged interventions with providers demonstrated a downshift in the use of abdomen CT with and without IV contrast and upshift in the concurrent abdomen CT with IV contrast only for liver imaging.

Our quality improvement effort suggests that a combination of national quality metrics guidelines and radiology-led interventions such as education and engagement can reduce overutilization.

Our quality improvement effort suggests that a combination of national quality metrics guidelines and radiology-led interventions such as education and engagement can reduce overutilization.

Endothelial dysfunction has been suggested as a potential mechanism contributing to the development and progression of heart failure (HF). Levels of circulating endothelial cells (CECs), endothelial progenitor cells (EPCs), and hematopoietic stem and progenitor cells (HSPCs) have been recognized as useful markers of vascular damage and endothelial repair in response to tissue injury.

To evaluate the circulating levels of EPCs, CECs, and HSPCs among patients with HF with reduced ejection fraction (HFrEF).

In 82 individuals (42 patients with HFrEF and 42 age-matched subjects without established cardiovascular disease), peripheral blood was drawn and levels of EPCs, CECs, and HSPCs were quantified by flow cytometry.

Patients with HFrEF showed lower levels of circulating EPCs (5.28×10

± 6.83×10

 % vs. 7.76×10

± 4.91×10

 %, p ≤0.001) and CECs (5.11×10

± 7.87×10

 % vs. 6.51×10

± 5.21×10

 %, p=0.005) when compared to the age-matched group. Circulating levels of HSPCs were not significantly different between groups (p=0.590). Additionally, the number of EPCs and CECs was significantly higher in HFrEF patients with overweight/obesity (n=24) compared to patients with normal weight (n=17).

Circulating levels of EPCs and CECs were significantly decreased in patients with HFrEF in comparison to age-matched subjects without established cardiovascular disease, suggesting that the levels of CECs and EPCs may be potential biomarkers of the cellular response to vascular injury in patients with HFrEF.

Circulating levels of EPCs and CECs were significantly decreased in patients with HFrEF in comparison to age-matched subjects without established cardiovascular disease, suggesting that the levels of CECs and EPCs may be potential biomarkers of the cellular response to vascular injury in patients with HFrEF.The retrosplenial cortex (RC) is a brain structure crucial for spatial navigation and memory. It contains neurons such as head direction cells, border cells, as well as other cells supporting spatial and contextual encoding. How such complex and diverse neuronal properties are generated by RC microcircuitry and how they jointly orchestrate subsequent behavior remains enigmatic. Here, we consider recent findings that extend current knowledge about how the RC modulates spatial navigation and spatial cognition. We argue that the integrative properties of RC allow the combination of idiothetic cues, spatial relations (allocentric and egocentric), and environmental features (landmarks, boundaries, etc.) into a spatial map that can dynamically support goal-directed navigation. Furthermore, the mnemonic functions of RC suggest its possible role in autobiographical information storage.The field of paleolimnology has made tremendous progress in reconstructing past biotic and abiotic environmental conditions of aquatic ecosystems based on sediment records. This, together with the rapid development of molecular technologies, provides new opportunities for studying evolutionary processes affecting lacustrine communities over multicentennial to millennial timescales. From an evolutionary perspective, such analyses provide important insights into the chronology of past environmental conditions, the dynamics of phenotypic evolution, and species diversification. Here, we review recent advances in paleolimnological, paleogenetic, and molecular approaches and highlight how their integrative use can help us better understand the ecological and evolutionary responses of species and communities to environmental change.

Among the different mechanisms of acquired resistance to EGFR tyrosine kinase inhibitors (TKIs) reported in EGFR-mutated lung adenocarcinoma (EGFR-LUAD) patients, histological transformation into small cell carcinoma (SCLC) occurs in 3-14% of resistant cases, regardless of the generation of EGFR-TKI. In recent studies, bi-allelic inactivation of TP53 and RB1 has been identified in a vast majority of transformed SCLCs. However, the molecular mechanisms driving this histologic transformation remain largely unknown, mainly due to the rarity of samples.

Out of an initial cohort of 64 patients, tumor tissues of adequate quality and quantity for whole exome sequencing (WES) analysis were available for nine tumors for six patients paired pre- and post-SCLC transformation samples for three Patients and post-SCLC transformation samples for three other patients.

Mutational analyses showed concurrent TP53 mutations and Rb pathway alterations in five of the six patients analyzed, confirming their suggested role as ution patterns, in addition to p53 and Rb pathways alterations, TERT amplification emerged as another common genetic mechanism of EGFR-LUAD to SCLC transformation in our cohort, and could represent a candidate therapeutic target in this subset of SCLC tumors.

The purpose of this study was to review the evaluation of strangulation victims assessed by a sexual assault nurse examiner (SANE) service. The primary objective was to produce observational results on documented injury frequency and secondarily to explore advanced imaging use, outcomes, signs/symptoms, and documentation.

This was a retrospective analysis of a cohort of 130 consecutive strangled patients over a 42-month period evaluated by a SANE consult service in a metropolitan area. A single investigator extracted medical records for demographics, history, imaging, injuries, disposition, and both presence and documentation of a number of signs/symptoms. A second investigator independently extracted greater than 30% of the total charts with universal agreement. Data were analyzed with descriptive statistics.

Patients were primarily female (1291) and their age averaged 30.6 years. Time from event to presentation varied. There were no major brain or neck injuries detected (0%; 95 confidence interval, 0-2.