Real-world utilization and outcomes of docetaxel among older men with metastatic prostate cancer: a retrospective population-based cohort study in Canada.

Background: The adoption of docetaxel for systemic treatment of metastatic prostate cancer (PCa), in both castration-sensitive (mCSPC) and castration-resistant (mCRPC) settings, is poorly understood. This study examined the real-world utilization of docetaxel in these patients and their outcomes.

Methods: A retrospective population-based study used administrative data from Ontario, Canada, to identify men aged ≥66 years who were diagnosed with de novo mCSPC or mCRPC between 2014 and 2019 and received docetaxel.

Prostate cancer risk stratification improvement across multiple ancestries with new polygenic hazard score.

Background: Prostate cancer risk stratification using single-nucleotide polymorphisms (SNPs) demonstrates considerable promise in men of European, Asian, and African genetic ancestries, but there is still need for increased accuracy. We evaluated whether including additional SNPs in a prostate cancer polygenic hazard score (PHS) would improve associations with clinically significant prostate cancer in multi-ancestry datasets.

Methods: In total, 299 SNPs previously associated with prostate cancer were evaluated for inclusion in a new PHS, using a LASSO-regularized Cox proportional hazards model in a training dataset of 72,181 men from the PRACTICAL Consortium.

Safety and efficacy of a novel robotic transcranial doppler system in subarachnoid hemorrhage.

Delayed cerebral ischemia (DCI) secondary to vasospasm is a determinate of outcomes following non-traumatic subarachnoid hemorrhage (SAH). SAH patients are monitored using transcranial doppler (TCD) to measure cerebral blood flow velocities (CBFv). However, the accuracy and precision of manually acquired TCD can be operator dependent.

Noninvasive brain stimulation to augment language therapy for poststroke aphasia.

Behavioral language treatment approaches represent the standard of care for persons with aphasia (PWA), but the benefits of these treatments are variable. Moreover, due to the logistic and financial limitations on the amount of behavioral therapy available to patients, it is often infeasible for PWA to receive behavioral interventions with the level of frequency, intensity, or duration that would provide significant and lasting benefit, underscoring the need for novel, effective treatment approaches. Noninvasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have emerged as promising neurally-based tools to enhance language abilities for PWA following stroke.

Retrospective Evaluation of the Antibody Prevalence in Epilepsy and Encephalopathy (APE2) Score.

Background: Autoimmune encephalitis (AE) is a rare collection of disorders that present with a diverse and often nebulous set of clinical symptoms. Indiscriminate use of multi-antibody panels decreases their overall utility and predictive value. Application of a standardized scoring system may help reduce the number of specimens that generate misleading or uninformative results.

A Novel Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) Biomarker-Anti-DSG2-Is Absent in Athletes With Right Ventricular Enlargement.

Background: Right ventricular (RV) enlargement is common in endurance athletes. It is usually considered to be physiological, but it is possible that this remodelling is adverse, manifesting as a variant of arrhythmogenic right ventricular cardiomyopathy (ARVC), termed "exercise-induced ARVC." A novel biomarker (anti-desmoglein-2 [anti-DSG2] antibody) has been shown to indicate ARVC with high sensitivity and specificity and may be an immune response to breakdown of RV desmosomes.

Robotic RPLND for stage IIA/B nonseminoma: the Princess Margaret Experience.

Purpose: Retroperitoneal lymph node dissection (RPLND) is a treatment option for men in a primary and post-chemotherapy setting. The aim of this review was to explore the published data looking at feasibility, safety and outcomes of robotic RPLND for CSI/II NSGCT but we will in particular highlight how we have approached adoption of robotic RPLND at the Princess Margaret.

Methods: A review and summary of the published data to date was performed regarding the role of robotic RPLND for stage IIA/B nonseminoma.

Context-Dependent Risk & Benefit Sensitivity Mediate Judgments About Cognitive Enhancement.

Opinions about cognitive enhancement (CE) are context-dependent. Prior research has demonstrated that factors like peer pressure, the influence of authority figures, competition, moral relevance, familiarity with enhancement devices, expertise, and the domain of CE to be enhanced can influence opinions. The variability and malleability of patient, expert, and public attitudes toward CE is important to describe and predict because these attitudes can influence at-home, clinical, research, and regulatory decisions.

Hyperspectral microscopy of subcutaneously released silver nanoparticles reveals sex differences in drug distribution.

Biomaterials have a great potential to improve human health, however in vitro and in vivo studies are necessary to provide information on their efficacy and safety. This study reports on a comprehensive evaluation of core-shell electrospun fibers loaded with silver nanoparticles (Ag NP) where the delivery rate was controlled by different sizes of Ag NP and thermoresponsive poly(n-isopropylacrylamide) (PNIPAM) hydrogel particles. Fiber meshes also contain zinc oxide nanoparticles (ZnO NP), to improve pore structure for controlled release of Ag NP.

EFFECT OF RETINAL THICKNESS VARIABILITY ON VISUAL OUTCOMES AND FLUID PERSISTENCE IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: A Post Hoc Analysis of the HAWK and HARRIER Studies.

Purpose: To determine the association between central subfield thickness (CST) variability and visual outcomes in eyes with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapies.

Methods: In this post hoc, treatment-agnostic analysis, patients (N = 1,752) were grouped into quartiles of increasing CST variation. The association between CST variability and best-corrected visual acuity was measured from baseline, or from the end of the loading phase, until the end of the study using a multilevel modeling for repeated-measures model.

Semen and serum platinum levels in cisplatin-treated survivors of germ cell cancer.

Background: Testicular cancer survivors often have impaired gonadal function possibly related to chemotherapy. Platinum is a heavy metal that can be detected at low levels in serum many years after treatment, it is not known whether platinum also persists in semen and if platinum persistence in semen is associated with impaired fertility.

Methods: Adult cisplatin-treated testicular cancer survivors were enrolled.

Diagnosing Mild Cognitive Impairment Among Racially Diverse Older Adults: Comparison of Consensus, Actuarial, and Statistical Methods.

Background: Actuarial and statistical methods have been proposed as alternatives to conventional methods of diagnosing mild cognitive impairment (MCI), with the aim of enhancing diagnostic and prognostic validity, but have not been compared in racially diverse samples.

Objective: We compared the agreement of consensus, actuarial, and statistical MCI diagnostic methods, and their relationship to race and prognostic indicators, among diverse older adults.

Methods: Participants (N = 354; M age = 71; 68% White, 29% Black) were diagnosed with MCI or normal cognition (NC) according to clinical consensus, actuarial neuropsychological criteria (Jak/Bondi), and latent class analysis (LCA).

Coronary Artery Fistulae in Adult: Two Decades of Experience in Clinical Presentation, Angiographic Feature, and Management.

Coronary artery fistula (CAF) in adults is a rare but significant coronary artery anomaly. Main data on that rare disease were mostly obtained from case reports and small studies. In presented study, we share our two-decade experience on the clinical and angiographic characteristics of CAF.

Management of stage I testicular cancer.

Purpose Of Review: Testicular cancer is the most common solid malignancy amongst young men, and a large proportion present with stage I disease. The options for management following radical orchiectomy are multifold. We review here approaches to treatment in this setting, providing an update on recent publications.

Feasibility and effectiveness appraisal of a neurology residency health equities curriculum.

Background: Despite increasing awareness of inequities in healthcare in neurology, health equity is not a core competency of neurology training. To meet this need, we implemented a health equities curriculum for neurology residents at the Hospital of the University of Pennsylvania.

Methods: A seven-lecture health equities curriculum was implemented during the 2019-2020 academic year.

Nursing student experiences in turmoil: A year of the pandemic and social strife during final clinical rotations.

Background: The duration and magnitude of the coronavirus (COVID-19) posed unique challenges for nursing students, whose education was altered because of the pandemic.

Purpose: To explore the perceptions and experiences of nursing students whose clinical rotations were abruptly interrupted by COVID-19's initial surge in the United States.

Methods: This qualitative study was conducted at a midwestern, academic medical center to elicit senior nursing students' experiences.

Rebooting the ambulatory enterprise in a community medical group in Kentucky following the initial surge of COVID-19.

The novel coronavirus disease 2019 (COVID-19) pandemic has intensified globally since its origin in Wuhan, China in December 2019. Many medical groups across the United States have experienced extraordinary clinical and financial pressures due to COVID-19 as a result of a decline in elective inpatient and outpatient surgical procedures and most nonurgent elective physician visits. The current study reports how our medical group in a metropolitan community in Kentucky rebooted our ambulatory and inpatient services following the guidance of our state's phased reopening.