Point/Counterpoint: Do We De-escalate Treatment of HPV-Associated Oropharynx Cancer Now? And How?

HPV-positive (HPV+) oropharyngeal carcinoma (OPC) continues to increase in incidence across the globe. Multimodality treatment offers a high likelihood of cure in HPV+ OPC but comes at a high cost of treatment-related morbidity. As a result, de-escalation of treatment to limit toxicity without compromising high cure rates has emerged as a major trend in head and neck cancer clinical research.

Changing Incidence and Nature of Injuries Caused by Falls From Skateboards in the United States.

Since 2000, the number of emergency department visits and hospital admissions for children who have sustained a fall from a skateboard has undergone a noticeable decline. One possible explanation for this decline is that children today lead a more sedentary lifestyle and are not as engaged in outdoor physical activities as were children in previous generations. The profile of patients injured in skateboarding-related accidents has also changed since 2000.

Psychosocial and Human Factors During a Trial of a Hybrid Closed Loop System for Type 1 Diabetes Management.

Background: Hybrid closed loop (HCL) systems are designed to automate insulin delivery to improve type 1 diabetes (T1D) outcomes and reduce user burden and distress. Because the systems only automate some aspects of diabetes care, psychosocial and human factors remain an important consideration in their use. Thus, we examined whether psychosocial and human factors (i.

Belief in Social Mobility Mitigates Hostility Resulting From Disadvantaged Social Standing.

Comparing economically unfavorably with similar others has detrimental consequences for an individual, ultimately resulting in low physical health, delinquency, and hostility. In four studies ( N = 2,032), we examined whether believing in a mobile society-one offering fair chances and opportunity-mitigates hostile emotions resulting from disadvantaged social standing. We find that with increasing mobility belief, negative comparisons have gradually less impact on hostility.

Perceptions of Pediatric Residents Regarding Counseling About Use of Social Networking Sites.

Increasing use of social networking sites (SNS) among youth prompted professional organizations to urge pediatricians to promote healthy media use. Electronic questionnaires were distributed to 76 pediatric residents at one academic center measuring attitudes, practices, and familiarity with SNS. Of 43 respondents (response rate = 57%), most reported personal SNS use (98%) and familiarity with SNS used by youth (72%), and 88% agreed that pediatricians should provide counseling on SNS use.

Retroareolar masses and intraductal abnormalities detected on screening ultrasound: can biopsy be avoided?

Unlabelled: To investigate the malignancy rate of retroareolar masses and intraductal abnormalities discovered in asymptomatic females during screening whole breast ultrasound (US-S) and determine if biopsy can be avoided.

Methods:: This is a HIPAA compliant retrospective study. Our radiology electronic medical records were searched for the phrases "retroareolar mass" or "intraductal mass" combined with "screening whole breast ultrasound" performed between 10/1/2009 and 5/30/2015.

Race influences parent report of concerns about symptoms of autism spectrum disorder.

Racial differences in parent report of concerns about their child's development to healthcare providers may contribute to delayed autism spectrum disorder diagnoses in Black children. We tested the hypotheses that compared to White parents, Black parents of children with autism spectrum disorder would report fewer concerns about autism symptoms and would be more likely to report concerns about disruptive behaviors. A sample of 18- to 40-month-old toddlers ( N = 174) with autism spectrum disorder and their parent participated.

White Look-Alikes: Mainstream Culture Adoption Makes Immigrants "Look" Phenotypically White.

White Americans generally equate "being American" with "being White." In six studies, we demonstrate that White Americans perceive immigrants who adopt American mainstream culture as racially White and, reciprocally, perceive White-looking immigrants as assimilating more. In Studies 1 and 2, participants visually represented immigrants who adopted U.

Injuries Caused by Falls From Playground Equipment in the United States.

The objective of this study is to document the incidence of falls from playground equipment in the United States over time and to provide a detailed profile of the individuals injured in playground falls using several state and national databases. During the past decade, there has been a steep decline in the number of injuries treated in emergency departments caused by falls from playground equipment in the United States. Males, children between the ages of 5 to 9 years, and individuals from lower economic strata are overrepresented among those suffering an injury.

Defining Social Class Across Time and Between Groups.

We examined changes over four decades and between ethnic groups in how people define their social class. Changes included the increasing importance of income, decreasing importance of occupational prestige, and the demise of the "Victorian bargain," in which poor people who subscribed to conservative sexual and religious norms could think of themselves as middle class. The period also saw changes (among Whites) and continuity (among Black Americans) in subjective status perceptions.

Clinical Progress in the Management of Tetralogy of Fallot in the Dominican Republic: A Case Series.

Background: Definitive surgical interventions for Dominican children with congenital heart disease, like those of other low- and middle-income countries, have been historically limited.

Methods: We undertook review of a case series focusing on the surgical correction of complex forms of tetralogy of Fallot at a single center, CEDIMAT Centro Cardiovascular, in the Dominican Republic, over a 30-month period.

Results: According to our criteria, 43 cases were determined to be complex tetralogy of Fallot repairs from the two-year period.

Extracellular Mitochondrial DNA Is Generated by Fibroblasts and Predicts Death in Idiopathic Pulmonary Fibrosis.

Rationale: Idiopathic pulmonary fibrosis (IPF) involves the accumulation of α-smooth muscle actin-expressing myofibroblasts arising from interactions with soluble mediators such as transforming growth factor-β1 (TGF-β1) and mechanical influences such as local tissue stiffness. Whereas IPF fibroblasts are enriched for aerobic glycolysis and innate immune receptor activation, innate immune ligands related to mitochondrial injury, such as extracellular mitochondrial DNA (mtDNA), have not been identified in IPF.

Objectives: We aimed to define an association between mtDNA and fibroblast responses in IPF.

Informal Care Networks in the Context of Multimorbidity: Size, Composition, and Associations With Recipient Psychological Well-Being.

Objective: We evaluate how the size and composition of care networks change with increasing morbidity count (i.e., multimorbidity) and how larger care networks relate to recipient psychological well-being.

Comparison of Two Types of Meditation on Patients' Psychosocial Responses During Radiation Therapy for Head and Neck Cancer.

Objectives: Radiation treatment for head and neck cancer introduces adaptive demands and subjects patients to significant and unique psychosocial challenges. There is growing evidence that meditation is useful in lessening anxiety and depression in cancer patients. This study compared the effects of two types of meditation training on the psychological responses of patients with head and neck cancer during radiation therapy.

Glucose Outcomes with the In-Home Use of a Hybrid Closed-Loop Insulin Delivery System in Adolescents and Adults with Type 1 Diabetes.

Background: The safety and effectiveness of the in-home use of a hybrid closed-loop (HCL) system that automatically increases, decreases, and suspends insulin delivery in response to continuous glucose monitoring were investigated.

Methods: Adolescents (n = 30, ages 14-21 years) and adults (n = 94, ages 22-75 years) with type 1 diabetes participated in a multicenter (nine sites in the United States, one site in Israel) pivotal trial. The Medtronic MiniMed 670G system was used during a 2-week run-in phase without HCL control, or Auto Mode, enabled (Manual Mode) and, thereafter, with Auto Mode enabled during a 3-month study phase.

Characterizing Patients with Very-Low-Level HIV Viremia: A Community-Based Study.

Objective: Very-low-level viremia (VLLV) is a relatively new concept in the realm of human immunodeficiency virus (HIV) care. Newer generation assays are now able to detect plasma HIV RNA Viral Load (VL) levels as low as 20 copies/mL. The authors characterized patients with VLLV (VL between 20 and 50 copies/mL) in order to identify possible risk factors associated with virologic failure and poor clinical outcomes.

The Influence of Cyclic Hormonal Contraception on Expression of Premenstrual Syndrome.

Background: Some women who use cyclic hormonal contraception (CHC) suffer from premenstrual symptoms; whether their symptoms differ from women who do not use CHC is not clear.

Objective: To compare women who use or do not use CHC on perimenstrual symptom timing and change severity.

Study Design: We analyzed daily symptom ratings from women who requested participation in (Screened Cohort: 103 used CHC and 387 did not) or were randomized in (Randomized Cohort: 41 used CHC and 211 did not) a clinical trial for premenstrual syndrome.

Quality Improvement Initiatives Need Rigorous Evaluation: The Case of Pressure Ulcers.

The Partnership for Patients (PfP) and the Agency for Healthcare Research and Quality (AHRQ) have reported a 23.5% decline in hospital-acquired pressure ulcers (HAPU) over 4 years resulting in a cumulative cost savings of more than $10 billion and 49 000 averted deaths, claiming that this significant decline may have been spurred in part by Medicare payment incentives associated with severe (stage 3 or 4) HAPUs. Hospitals with a high rate of severe HAPUs have a payment penalty imposed, creating a financial disincentive to report severe HAPUs, possibly contributing to the magnitude of the reported decline.

Distress and quality of life in an ethnically diverse sample awaiting breast cancer surgery.

Poor breast cancer-related quality of life is associated with flattened cortisol rhythms and inflammation in breast cancer survivors and women with advanced disease. We explored the associations of cancer-specific distress (Impact of Events Scale), mood (Profile of Mood States), activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient) and cortisol (diurnal slope) circadian rhythms, and inflammation (interleukin-6) with quality of life (Functional Assessment of Cancer Therapy-Breast) among patients awaiting breast cancer surgery ( N = 57). Models were adjusted for differences in age and cancer stage.

Stigmatizing Reactions Versus General Negative Reactions to Partner Violence Disclosure as Predictors of Avoidance Coping and Depression.

Despite increased attention to the relation between negative social reactions to intimate partner violence (IPV) disclosure and poorer mental health outcomes for victims, research has yet to examine whether certain types of negative social reactions are associated with poorer mental health outcomes more so than others. Furthermore, research is scarce on potential mediators of this relationship. To fill these gaps, the current study examines whether stigmatizing reactions to IPV disclosure, such as victim-blaming responses and minimizing experiences of IPV, are a specific type of negative social reaction that exerts greater influence on women's depressive symptoms than general negative reactions, such as being angry at the perpetrators of IPV.