Intramolecular subtleties in indole azo dyes revealed by multidimensional potential energy surfaces.

Despite their wide use as molecular photoswitches, the mechanistic photophysics of azo dyes are complex and nuanced, and therefore under-explored. To understand the complex electronic interactions that govern the photoisomerization and thermal reversion of two phenyl-azo-indole dyes that differ by R-sterics near the azo bond, potential energy surfaces that combine the dihedral rotation of the azo bond and the aryl inversion on each side of the azo bond were calculated with density functional theory and time-dependent density functional theory. These multidimensional singlet surfaces provide insights into the correlated rotation and inversion pathways allowing for detailed understanding of both photoisomerization, governed by the excited-state surfaces, and thermal reversion, governed by the ground-state surface, mechanisms to be developed.

Mapping the value of commercial fishing and potential costs of offshore wind energy on the U.S: West Coast: Towards an assessment of resource use tradeoffs.

The West Coast of the U.S. has a vast offshore wind energy (OWE) electricity generation potential with value on the order of billions of USD, and pressure is mounting to develop large OWE projects.

De-escalation for Human Papillomavirus-Positive Oropharyngeal Cancer: A Look at the Prospective Evidence.

Purpose Of Review: Although it is now firmly established that the presence of human papillomavirus (HPV) expression in oropharyngeal cancer is associated with a favorable prognosis, the implications with respect to treatment remain uncertain. However, the recognition that HPV-positive oropharyngeal cancer is exquisitely sensitive to radiation and chemotherapy has raised questions regarding the appropriateness of historical treatment paradigms, and clinical trials have been conducted to assess whether patients can be treated with less intensive regimens. The fundamental goal of de-escalation is to preserve the high rates of cure and survival from traditional approaches while reducing the incidence of both short- and long-term side effects.

CNS Outcomes of Osimertinib Plus Chemotherapy in Patients With EGFR Mutation Positive Lung Cancer Beyond Osimertinib Progression.

Background: Central nervous system (CNS) metastases are common among patients with epidermal growth factor receptor (EGFR) mutation positive non-small cell lung cancer (NSCLC). Osimertinib in combination with chemotherapy beyond osimertinib progression may minimize CNS progression.

Method: In this retrospective analysis, patients with advanced EGFR mutation positive NSCLC and brain metastases who received platinum-based chemotherapy (PbChT) after disease progression on osimertinib were enrolled.

Barriers to health equity in the United States of America: can they be overcome?

Health equity-defined by the Centers for Disease Control and Prevention as " the state in which everyone has a fair and just opportunity to attain their highest level of health-" represents one of the most critical issues facing modern societies. While seemingly an increasing focus of policymakers in recent years, this concept is hardly a novel one. In 1948, the inaugural Constitution of the newly founded World Health Organization clearly stated that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.

Murine gut microbiota dysbiosis via enteric infection modulates the foreign body response to a distal biomaterial implant.

Unlabelled: The gut microbiota influences systemic immunity and the function of distal tissues, including the brain, liver, skin, lung, and muscle. However, the role of the gut microbiota in the foreign body response (FBR) and fibrosis around medical implants is largely unexplored. To investigate this connection, we perturbed the homeostasis of the murine gut microbiota via enterotoxigenic (ETBF) infection and implanted the synthetic polymer polycaprolactone (PCL) into a distal muscle injury.

Circulating Tumor HPV-DNA in the Management of HPV-Positive Oropharyngeal Carcinoma: A Systematic Review.

Purpose: Blood-borne, cell-free DNA has been proposed as a means of individualizing the management of human papillomavirus (HPV)-positive oropharyngeal carcinoma.

Methods And Materials: This study was designed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. A comprehensive literature search of peer-reviewed publications from January 2013 to January 2024 was undertaken to identify prospective studies pertaining to the use of circulating HPV-DNA for oropharyngeal carcinoma.

Same-Day Access for Head and Neck Cancer: Effect on Patient Outcome and Quality-Related Benchmarks.

Delays in cancer treatment are detrimental across nearly every disease site in oncology including head and neck cancer. This study aimed to evaluate the impact of same-day access for patients with newly diagnosed head and neck cancer referred for radiation therapy consultation. From March 2021 to March 2023, a total of 50 consecutive patients who completed curative treatment were matched to a control subject who did not use the same-day initiative based on age, gender, histology, performance status, primary tumor site, stage, p16 status, treatment, and smoking history.

Access improvement in healthcare: a 12-step framework for operational practice.

Background: Access improvement is a fundamental component of value-based healthcare as it inherently promotes quality by eliminating chokepoints, redundancies, and inefficiencies which could hinder the provisioning of timely care. The purpose of this review is to present a 12-step framework which offers healthcare organizations a practical, thematic-based foundation for thinking about access improvement.

Methods: This study was designed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement.

Developing a New Paradigm for Healthcare Delivery: Lessons Learned from Same-Day Access.

Goal: Excessively lengthy wait times for appointments with clinicians are a major source of frustration for patients, and difficulties with access represent a public health problem facing populations across all societies. As delays in care have been associated with inferior outcomes, same-day appointments have been proposed as a patient-centric means of improving healthcare delivery. However, this paradigm represents a radical shift from conventional scheduling tactics, and skepticism has long existed regarding its feasibility and real-world applicability to clinical practice.

Chemoradiation for human papillomavirus positive oropharyngeal cancer in smokers: A single-institutional experience.

Purpose: To determine how smoking intensity impacts the prognosis of patients with human papillomavirus (HPV)-positive oropharyngeal cancer treated by chemoradiation.

Methods And Materials: The medical records of 32 patients with histologically proven squamous cell carcinoma of the oropharynx and a prior smoking history were retrospectively reviewed. All patients were treated with intensity-modulated radiotherapy to a median dose of 70 Gy (range 63 to 72 Gy) with concurrent cisplatin.

The epidemic of human papillomavirus virus-related oropharyngeal cancer: current controversies and future questions.

The incidence of human papillomavirus (HPV) associated oropharyngeal cancer has increased to epidemic-like proportions in the United States and other industrialized nations. While significant progress has been made in the understanding of this disease with respect to its underlying biology and clinical behavior, numerous questions persist regarding treatment. It is now firmly established that patients with HPV-positive oropharyngeal cancer have a significantly improved prognosis as a result of their exquisite radiosensitivity compared to their HPV-negative counterparts and thus can be targeted with de-escalated approaches using reduced doses of radiation and/or chemotherapy.

Opponent control of reinforcement by striatal dopamine and serotonin.

The neuromodulators dopamine (DA) and serotonin (5-hydroxytryptamine; 5HT) powerfully regulate associative learning. Similarities in the activity and connectivity of these neuromodulatory systems have inspired competing models of how DA and 5HT interact to drive the formation of new associations. However, these hypotheses have not been tested directly because it has not been possible to interrogate and manipulate multiple neuromodulatory systems in a single subject.

Socioeconomic and demographic factors predictive of same day access utilization in outpatient radiation oncology.

Purpose: Access to medical care extends to not only the timely and appropriate receipt of services but also addresses inclusivity and underlying determinants of health. Given that patients from disadvantaged backgrounds have been shown to be more likely to experience delays in care, a same day access scheduling initiative was proposed to address this equity issue. Therefore, this study aims to evaluate our experience, focusing on identifying socioeconomic and demographic patterns of same day access utilization.

Machine learning modeling of patient health signals informs long-term survival on immune checkpoint inhibitor therapy.

System-level patient health signals, as captured by treatment-emergent adverse events (TEAEs), might contain correlates of immune checkpoint inhibitor (ICI) therapy response. Using all TEAEs and a novel machine learning modeling approach, we derived a composite signature predictive of, and potentially specific to, the response to the anti-PD-L1 ICI durvalumab in patients with non-small-cell lung cancer (NSCLC). We trained on data from the durvalumab arm and chemotherapy arm in the MYSTIC clinical trial and tested on data from four independent durvalumab-containing NSCLC trials using only the first 60 days' TEAEs.

Physician turnover rates and job stability in interventional spine and pain practices: Results of an IPSIS survey study.

Background: Physician turnover and job instability have profound implications for healthcare systems, private facilities, and patient outcomes. High physician turnover disrupts continuity of care, impedes establishment of patient-physician relationships, and may compromise overall healthcare quality.

Objective: This survey study explores the rate of job turnover in the field of Interventional Spine and Pain Medicine, based on a 2022 survey of physicians of the International Pain and Spine Intervention Society.

Hypofractionated radiation therapy alone for human papillomavirus-related oropharyngeal cancer.

Purpose: To report a single-institutional experience with hypofractionated radiation therapy alone for human papillomavirus (HPV)-positive oropharyngeal cancer.

Methods And Materials: A total of 101 consecutive patients were treated by radiation therapy alone using a regimen of 66 Gy in 30 fractions (60 patients) or 70 Gy in 33 fractions (41 patients) for newly diagnosed p16-positive squamous cell carcinoma of the oropharynx. Sixty-seven patients (67%) were never smokers.

Language barriers in head and neck cancer: Matched pair analysis of outcomes between non-English speaking and English-speaking patients.

Purpose: As society grows in cultural diversity, an increasing proportion of patients are expected to be from non-English speaking backgrounds. This study sought to compare the clinical outcomes between non-English speakers and English speakers treated by radiation therapy for head and neck cancer.

Methods And Materials: Seventy-five non-English speaking patients with squamous cell carcinoma of the head and neck were matched to English-speaking controls based on patient and disease variables; clinical outcomes were compared.

Using Separate Single-Outcome Risk Presentations Instead of Integrated Multioutcome Formats Improves Comprehension in Discrete Choice Experiments.

Introduction: Despite decades of research on risk-communication approaches, questions remain about the optimal methods for conveying risks for different outcomes across multiple time points, which can be necessary in applications such as discrete choice experiments (DCEs). We sought to compare the effects of 3 design factors: 1) separated versus integrated presentations of the risks for different outcomes, 2) use or omission of icon arrays, and 3) vertical versus horizontal orientation of the time dimension.

Methods: We conducted a randomized study among a demographically diverse sample of 2,242 US adults recruited from an online panel (mean age 59.

De-escalated radiation for human papillomavirus virus-related oropharyngeal cancer: Who, why, what, where, when, how, how much…and what next?

The emergence of treatment de-escalation as a feasible option for patients with newly diagnosed human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma has generated considerable excitement among both providers and patients alike. Since HPV-positive oropharyngeal carcinoma has been shown to be a unique entity with distinct clinical and molecular characteristics, the rationale for customizing treatment for patients with this disease is compelling. Indeed, evidence has accumulated demonstrating that patients with HPV-positive oropharyngeal cancer have a significantly improved prognosis as a result of their exquisite radiosensitivity compared to their HPV-negative counterparts and thus might possibly be targeted with de-escalated approaches.

Translational risk-adapted approaches to de-escalated radiation for human papillomavirus-positive oropharyngeal cancer: Past, present, and future.

Interest in the use of de-escalated radiation to treat patients with newly diagnosed human papillomavirus (HPV)-positive oropharyngeal cancer has grown dramatically with the publication of prospective trials demonstrating the efficacy of such an approach. While the rationale for de-escalation--- namely to decrease treatment-related toxicity while maintaining the excellent rates of disease control historically observed in patients with this disease-is inherently obvious, uncertainty exists regarding how to best select patients for de-escalation. Consequently, risk-adapted strategies using a variety of translational and clinical platforms have been increasingly popularized to better refine treatment.

Genome organization around nuclear speckles drives mRNA splicing efficiency.

The nucleus is highly organized, such that factors involved in the transcription and processing of distinct classes of RNA are confined within specific nuclear bodies. One example is the nuclear speckle, which is defined by high concentrations of protein and noncoding RNA regulators of pre-mRNA splicing. What functional role, if any, speckles might play in the process of mRNA splicing is unclear.