Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update.

Purpose: To provide updated guidance regarding neoadjuvant chemotherapy (NACT) and primary cytoreductive surgery (PCS) among patients with stage III-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer (epithelial ovarian cancer [EOC]).

Methods: A multidisciplinary Expert Panel convened and updated the systematic review.

Results: Sixty-one studies form the evidence base.

A Lack of Joint Line Tenderness Is Consistent With a Healed Meniscus, But Positive Clinical Examination Findings and MRI Scans Are Inconsistent in Identifying Failure After Meniscal Repair: A Systematic Review and Subgroup Meta-analysis.

Background: The number of meniscal repairs being completed each year is increasing; however, the optimal, cost-effective postoperative assessment to determine the success or failure of a meniscal repair is not well known.

Purpose/hypothesis: The purpose of this systematic review was to identify the clinical examination testing that correlates with objective magnetic resonance imaging (MRI) or second-look arthroscopy (SLA) findings to determine an optimal clinical workup for assessing postoperative meniscal repair healing. It was hypothesized that specific clinical tests would correlate with meniscal repairs that did not heal.

Long-Term Islet Graft Functional Assessments in More than 500 Patients Undergoing Total Pancreatectomy with Intraportal Islet Autotransplantation.

Background: Total pancreatectomy and intraportal islet cell auto transplantation (TPIAT) is increasingly being offered to patients with refractory chronic pancreatitis. Understanding factors that impact islet function over time is critical.

Study Design: We evaluated factors associated with islet function over 12 years post TPIAT using mixed meal tolerance testing (MMTT).

Associations of Concordant and Shared Lung Cancer Screening Decision Making with Decisional Conflict: A Multi-Institution Cross-Sectional Analysis.

Unlabelled: Many organizations recommend structured communication processes, including formal shared decision making (SDM), for patients undergoing lung cancer screening (LCS) using low-dose computed tomography (LDCT). We sought to understand if concordant and shared LCS decision making was associated with decisional conflict. In this prospective, observational study, we enrolled patients from 3 medical centers (2 Veterans Health Administration, 1 academic facility) after a decision-making interaction about undergoing LCS but before receiving the LDCT.

The association between depressive symptoms and lower urinary tract symptoms and impact among women: Investigating behavioural, cognitive and physiological pathways.

Objective: Mechanistic studies are needed to understand why depressive symptoms are associated with poorer physical health. The objective of this study was to examine whether behavioural, cognitive and physiological factors mediated an association between depressive symptoms, measured in early adulthood, and lower urinary tract symptoms (LUTS) and their impact, a composite variable measured in mid-life adulthood, among women in the Coronary Artery Risk Development in Young Adults study, conducted in four regions of the United States.

Design: Prospective cohort study.

Future Directions in the Management of Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

Context: The traditional management of classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHD) is difficult and often suboptimal.

Objective: To review improvements in the diagnosis and management of 21OHD.

Design: Literature review, synthesis, and authors' experience.

Gender and Race Differences in Rates of PTSD Service Connection: Results From a Nationally Representative Panel of OEF/OIF/OND Veterans.

Background: Department of Veterans Affairs disability benefits for post-traumatic stress disorder (PTSD), also known as "service connection," have been shown to reduce homelessness and poverty, increase mental health engagement, and improve clinical outcomes. However, gender and race disparities in PTSD service connection have been described in Vietnam and post-Vietnam era Veterans.

Methods: Post-traumatic stress disorder service connection outcomes were assessed in a nationally representative, randomly selected, gender-stratified, prospective panel of 960 Veterans who served during Operations Enduring Freedom, Iraqi Freedom, and New Dawn.

A network analysis of clinician-rated posttraumatic stress disorder and substance use disorder symptom clusters in a sample of veterans seeking outpatient treatment.

The presentation of comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) differs by substance type. The current study applied network analysis to explore the relationships between diagnostic symptom clusters by examining the strength and direction of unique associations between PTSD and SUD. Network analyses were estimated using a sample of 422 veterans diagnosed with co-occurring PTSD/SUD initiating psychotherapy for PTSD while receiving concurrent outpatient SUD treatment as part of a randomized clinical trial.

A data-driven latent variable approach to validating the research domain criteria framework.

Despite the widespread use of the Research Domain Criteria (RDoC) framework in psychiatry and neuroscience, recent studies suggest that the RDoC is insufficiently specific or excessively broad relative to the underlying brain circuitry it seeks to elucidate. To address these concerns, we employ a latent variable approach using bifactor analysis. We examine 84 whole-brain task-based fMRI (tfMRI) activation maps from 19 studies with 6192 participants.

Examining eating pathology and psychosocial functioning across subjective eating disorder recovery stages in sexual and gender minority individuals.

Subjective eating disorder (ED) recovery has important clinical relevance. However, studies have focused on the perspectives of cisgender heterosexual individuals, which is notable given that sexual and gender minority (SGM) people often describe feelings misrepresented by prevailing ED conceptualizations. We examined eating pathology and psychosocial functioning across subjective recovery stages in SGM individuals ( = 196).

Functional variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene are associated with increased risk of colorectal cancer.

Background: Individuals with cystic fibrosis (CF; a recessive disorder) have an increased risk of colorectal cancer (CRC). Evidence suggests individuals with a single CFTR variant may also have increased CRC risk.

Methods: Using population-based studies (GECCO, CORECT, CCFR, and ARIC; 53 785 CRC cases and 58 010 controls), we tested for an association between the most common CFTR variant (Phe508del) and CRC risk.

Estradiol Levels are Differentially Associated with Pulse Wave Velocity in Trauma-exposed Premenopausal Women with and without PTSD.

Arterial stiffness is a well-known risk factor for cardiovascular disease. Although estradiol (E2) is known to be cardioprotective, the available data point to a growing cardiovascular disease risk in women before menopause due to post-traumatic stress disorder (PTSD). The present study aimed to investigate the effects of E2 on arterial compliance in trauma-exposed premenopausal women, with and without a clinical diagnosis PTSD.

Effects of HMG CoA reductase (HMGCR) deficiency on skeletal muscle development.

Pathogenic variants in HMGCR were recently linked to a limb-girdle muscular dystrophy (LGMD) phenotype. The protein product HMG CoA reductase (HMGCR) catalyzes a key component of the cholesterol synthesis pathway. The two other muscle diseases associated with HMGCR, statin-associated myopathy (SAM) and autoimmune anti-HMGCR myopathy, are not inherited in a Mendelian pattern.

Phenotypic variability and the gender paradox in the R363C variant of Fabry disease.

Fabry disease is an X-linked lysosomal disease caused by variants in the gene. Although Fabry disease is X-linked, gene variants in females can exhibit a wide range of symptoms, challenging the traditional view of Fabry as an X-linked recessive disease. A family is presented here with a 36-year-old female who is symptomatic with chronic kidney disease and her oligosymptomatic 70-year-old father, both of whom have a heterozygous and hemizygous GLA pathogenic variant, respectively, c.

Moving toward Interprofessional Teaching in the Intensive Care Unit: A Mixed Methods Study.

Background: There is an evolving focus on interprofessional education (IPE) to promote teamwork and collaboration in health professions education. Studies in medical students have shown that exposure to IPE leads to perceived improvements in interprofessional communication, effective work in healthcare teams, and understanding of professional limitations. Most research focuses on IPE in undergraduate medical education; less is known about how this functions in graduate medical education.

Hospital Boarding Creates Critical Shortcomings in Disaster Preparedness.

Hospital patient boarding in emergency departments has reached unprecedented crisis levels over the past 4 years. Boarding and crowding has been demonstrated by prior literature to have adverse effects on patient care as well as increased associated costs. Importantly, the increase in hospital patient boarding has created critical shortcomings in disaster preparedness by limiting the capacity of emergency departments to respond to mass casualty incidents due to space and staffing constraints.

Colophony in Dentistry: Routes of Exposure and Reported Reactions.

Colophony is a solid form of resin derived from coniferous trees that has both adhesive and water-resistant properties. For these reasons, this allergen is incorporated into many personal care products, medications, and occupational materials, and is thus commonly implicated in allergic contact dermatitis. Dedicated "dental" allergen series often include colophony, but dermatologists are likely not well-versed on its use in a dental setting.

Non-Operative Management of Cholecystitis in Pregnant Patients Remains Common.

Cholecystectomy is the recommended treatment for acute cholecystitis in pregnancy, leading to fewer pregnancy-related complications than non-operative management. However, past research demonstrated high rates of non-operative management despite these recommendations. Rates of cholecystostomy tube usage and outcomes in pregnancy are not well described.

Manipulation of mitochondrial poly(A) polymerase family proteins in impacts mRNA termini processing.

RNA-specific nucleotidyltransferases (rNTrs) add nontemplated nucleotides to the 3 end of RNA. Two noncanonical rNTRs that are thought to be poly(A) polymerases (PAPs) have been identified in the mitochondria of trypanosomes - KPAP1 and KPAP2. KPAP1 is the primary polymerase that adds adenines (As) to trypanosome mitochondrial mRNA 3 tails, while KPAP2 is a non-essential putative polymerase whose role in the mitochondria is ambiguous.

Hand dominance shift during sleep in sexsomnia: a clue to pathophysiology?

Study Objectives: To elucidate whether awake handedness in sexsomnia is retained during sleep to uncover potential clues about the underlying neurophysiologic mechanisms.

Methods: Participants' and observers' self-reported handedness during sexsomnia events.

Results: Case 1: A 22 y/o right-handed female with an eight-year history of nocturnal sleep-related masturbatory behavior (SMB) involving the left hand (LH) exclusively.

A Modified Procedure to Improve Pancreatic Drainage in Chronic Pancreatitis with Pancreatic Head Dominant Disease.

Objectives: Chronic pancreatitis is a debilitating and progressive inflammatory disease with an altered quality of life due to severe abdominal pain. Pancreaticoduodenectomy is a surgical option for patients with bulky disease involving the head of the pancreas, especially when this disease has progressed to stricture of the bile duct, duodenum, or both. A long term issue associated with this procedure is stricture of the pancreatic anastomosis.

Sexual minority stressors and disordered eating behaviors in daily life: a daily diary study of sexual minority cisgender female couples.

Young cisgender sexual minority women (e.g. lesbian, queer) in the U.

Rib and Sternum Nonunions: Diagnosis and Treatment and Awareness of Other Potential Posttraumatic Pathology.

As the operative management of acute, chest wall, skeletal injury escalates throughout the world, it has become commonplace for patients with posttraumatic conditions to present with clinical reconstructive challenges as well. In addition, it is becoming clear that rib nonunions are not rare, likely more than 5% of rib fractures. No subspecialty is better equipped to address such painful conditions than orthopaedic surgery.

Discussion of Surgical Indications: The Black, White, and Gray.

Chest wall trauma is rapidly evolving and now represents a multidisciplinary field with incredible growth in research and surgical intervention; however, even with more than 800 publications on chest wall trauma to date, surgical indications are not black and white. Injury patterns need to be better defined and outcome measurements need to evolve for accurate longer term functional assessment of patients if this field of surgery is to move beyond historical indications for operative intervention. This essay will communicate what is known about operative indications in a way that stratifies the need for surgery.