Single-cell multi-omic analysis of fibrolamellar carcinoma reveals rewired cell-to-cell communication patterns and unique vulnerabilities.

Fibrolamellar carcinoma (FLC) is a rare malignancy disproportionately affecting adolescents and young adults with no standard of care. FLC is characterized by thick stroma, which has long suggested an important role of the tumor microenvironment. Over the past decade, several studies have revealed aberrant markers and pathways in FLC.

Evaluating surgeon communication of pancreatic cancer prognosis using the VitalTalk ADAPT framework.

Background And Objectives: Few data exist to guide optimal communication practices for surgical oncologists. VitalTalk, an evidence-based communication skills training model for clinicians, offers the five-step ADAPT tool for discussing prognosis. This study aimed to characterize surgeon communication of pancreatic cancer prognosis using VitalTalk's ADAPT framework.

Pilot study of humanized glypican-3-targeted zirconium-89 immuno-positron emission tomography for hepatocellular carcinoma.

Purpose: Glypican-3 (GPC3)-targeted radioisotope immuno-positron emission tomography (immunoPET) may lead to earlier and more accurate diagnosis of hepatocellular carcinoma (HCC), thus facilitating curative treatment, decreasing early recurrence, and enhancing patient survival. We previously demonstrated reliable HCC detection using a zirconium-89-labeled murine anti-GPC3 antibody (89Zr-αGPC3M) for immunoPET. This study evaluated the efficacy of the humanized antibody successor (αGPC3H) to further clinical translation of a GPC3-based theranostic for HCC.

Reversing immunosuppression in the tumor microenvironment of fibrolamellar carcinoma via PD-1 and IL-10 blockade.

Fibrolamellar carcinoma (FLC) is a rare liver tumor driven by the DNAJ-PKAc fusion protein that affects healthy young patients. Little is known about the immune response to FLC, limiting rational design of immunotherapy. Multiplex immunohistochemistry and gene expression profiling were performed to characterize the FLC tumor immune microenvironment and adjacent non-tumor liver (NTL).

Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment.

Background & Aims: Autoimmune pancreatitis (AIP) is an immune-mediated disease of the pancreas with distinct pathophysiology and manifestations. Our aims were to characterize type 1 AIP in a large pan-European cohort and study the effectiveness of current treatment regimens.

Methods: We retrospectively analyzed adults diagnosed since 2005 with type 1 or not-otherwise-specified AIP in 42 European university hospitals.

Organotypic Models for Functional Drug Testing of Human Cancers.

In the era of personalized oncology, there have been accelerated efforts to develop clinically relevant platforms to test drug sensitivities of individual cancers. An ideal assay will serve as a diagnostic companion to inform the oncologist of the various treatments that are sensitive and insensitive, thus improving outcome while minimizing unnecessary toxicities and costs. To date, no such platform exists for clinical use, but promising approaches are on the horizon that take advantage of improved techniques in creating human cancer models that encompass the entire tumor microenvironment, alongside technologies for assessing and analyzing tumor response.

Emerging interleukin targets in the tumour microenvironment: implications for the treatment of gastrointestinal tumours.

The effectiveness of antitumour immunity is dependent on intricate cytokine networks. Interleukins (ILs) are important mediators of complex interactions within the tumour microenvironment, including regulation of tumour-infiltrating lymphocyte proliferation, differentiation, migration and activation. Our evolving and increasingly nuanced understanding of the cell type-specific and heterogeneous effects of IL signalling has presented unique opportunities to fine-tune elaborate IL networks and engineer new targeted immunotherapeutics.

HPV Vaccine Communication Competency Scale for Medical Trainees: Interdisciplinary Development Study.

Background: Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States. High-risk HPV strains are associated with cancer of the cervix, oropharynx, anus, rectum, penis, vagina, and vulva. To combat increasing HPV-related cancers, the 9-valent HPV vaccine Gardasil was developed.

Single-centre review of the management of intra-thoracic oesophageal perforation in a tertiary oesophageal unit: paradigm shift, short- and long-term outcomes over 15 years.

Background: Oesophageal perforation is an uncommon surgical emergency associated with high morbidity and mortality. The timing and type of intervention is crucial and there has been a major paradigm shift towards minimal invasive management over the last 15 years. Herein, we review our management of spontaneous and iatrogenic oesophageal perforations and assess the short- and long-term outcomes.

Safe Surgery During the COVID-19 Pandemic.

Purpose Of Review: Coronavirus Disease-2019 (COVID-19) has had an enormous impact on all aspects of healthcare, but its effect on patients needing surgery and surgeons has been disproportionate. In this review, we aim to understand the impact of the pandemic on surgical patients and teams. We compiled the emerging data on pre-operative screening methods, vaccinations, safe-surgery pathways and surgical techniques and make recommendations for evidence-based safe-surgical pathways.

Recognizing and treating endometriosis.

Endometriosis, defined as endometrium-like tissue located outside the uterine cavity, is a chronic and frequently painful disease that affects about 10% of reproductive-aged women worldwide. The ectopic endometrial tissue, which is still hormonally responsive, generates a chronic inflammatory state resulting in an array of sometimes debilitating symptoms as well as subfertility. Despite its prevalence and significant effect on a woman's health and quality of life, receiving a diagnosis of endometriosis often takes years.

Foot Posture and Plantar Loading With Ankle Bracing.

Context: Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk.

The Design and Validation of a Low-Cost Foot Measurement System.

It is estimated that approximately 40% of the population suffers from abnormal foot posture, specifically high arched or low arched feet. While the evaluation of foot posture can involve many aspects, it commonly requires the measurement of basic dimensions of the foot. Clinicians and researchers often rely on the use of specialized devices or three-dimensional (3D) scanners to evaluate specific aspects of a patient's foot posture.

Physical Performance Improves With Time and a Functional Knee Brace in Athletes After ACL Reconstruction.

Background: Athletes who return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) often have reduced physical performance and a high reinjury rate. Additionally, it is currently unclear how physical performance measures can change during the RTS transition and with the use of a functional knee brace.

Purpose/hypothesis: The purpose of this study was to examine the effects of time since surgery (at RTS and 3 months after RTS) and of wearing a brace on physical performance in patients who have undergone ACLR.

The management of adult appendicitis during the COVID-19 pandemic: an interim analysis of a UK cohort study.

Background: Acute appendicitis (AA) is the most common general surgical emergency. Early laparoscopic appendicectomy is the gold-standard management. SARS-CoV-2 (COVID-19) brought concerns of increased perioperative mortality and spread of infection during aerosol generating procedures: as a consequence, conservative management was advised, and open appendicectomy recommended when surgery was unavoidable.

Student Self-Assessments and Peer Assessments of Video Recordings of Physical Examination Practicums in a Physical Diagnosis Course.

Purpose: Self-assessments and peer assessments of video recordings of performance have been used in a variety of educational and professional training programs; however, there is no literature on the application of such performance assessments in physician assistant (PA) education. The purpose of this pilot study was to both explore the feasibility of adding video recordings of existing practicum examinations to a physical diagnosis course and evaluate students' self-assessments and peer assessments of the activity.

Methods: Fifty first-semester students who were enrolled in a 7-semester PA program participated.

Sex-based differences in landing mechanics vary between the drop vertical jump and stop jump.

The purpose of the present study was to compare landing mechanics between the stop jump (SJ) and drop vertical jump (DVJ) and to compare sex-based differences in landing mechanics between tasks. 50 healthy recreational athletes were recruited and each participant completed seven SJs and seven DVJs. Peak knee flexion and abduction angle, knee flexion and ab/adduction range of motion (ROM), peak vertical and posterior ground reaction force (GRF), peak internal knee extension and knee adduction moment were computed for the dominant limb during the first landing of both tasks.

A novel method for measuring asymmetry in kinematic and kinetic variables: The normalized symmetry index.

Gait and movement asymmetries are important variables for assessing locomotor mechanics in humans and other animals and as a predictor of injury risk and success of clinical interventions. The four indices used most often to assess symmetry are not well designed for different variable types, perform poorly when presented with cases of high asymmetry or when variables are of low magnitude, and are easily influenced by small variation in the signal. The purpose of the present study was to test the performance of these indices on previously unpublished data on ACL-R patients and to propose a new index to resolve some of these limitations.

The Liverpool duodenum-and spleen-preserving near-total pancreatectomy can provide long-term pain relief in patients with end-stage chronic pancreatitis.

Purpose: Total pancreatectomy may improve symptoms in patients with severe end-stage chronic pancreatitis. This might be achieved whilst preserving both the duodenum- and spleen-(DPSPTP). Mature clinical outcomes of this approach are presented.

Language impairment in adults with end-stage liver disease: application of natural language processing towards patient-generated health records.

End-stage liver disease (ESLD) is associated with cognitive impairment ranging from subtle alterations in attention to overt hepatic encephalopathy that resolves after transplant. Natural language processing (NLP) may provide a useful method to assess cognitive status in this population. We identified 81 liver transplant recipients with ESLD (4/2013-2/2018) who sent at least one patient-to-provider electronic message pre-transplant and post-transplant, and matched them 1:1 to "healthy" controls-who had similar disease, but had not been evaluated for liver transplant-by age, gender, race/ethnicity, and liver disease.

Differentiation of Autoimmune Pancreatitis from Pancreatic Cancer Remains Challenging.

Background: Autoimmune pancreatitis (AIP) is an uncommon form of chronic pancreatitis. Whilst being corticosteroid responsive, AIP often masquerades radiologically as pancreatic neoplasia. Our aim is to appraise demographic, radiological and histological features in our cohort in order to differentiate AIP from pancreatic malignancy.

An interprofessional education approach to fall prevention: preparing members of the interprofessional healthcare team to implement STEADI into practice.

An aging population benefits from healthcare providers trained in the care of older adults. Interprofessional education (IPE) and service-learning activities focused on geriatric conditions like falls may address this need. A fall prevention IPE activity using the Centers for Disease Control and Prevention (Stopping Elderly Accidents, Deaths & Injuries (STEADI) initiative was implemented to prepare health sciences students to manage older adult falls.