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Long-Term Quality of Life following Treatment in Head and Neck Cancer Survivors with Feeding Tubes
Get PDFBackground: There is limited research on patients requiring long-term feeding tubes after head and neck cancer (HNC) treatment, despite the significant impact on post-treatment quality of life (QoL). Our study addresses this gap by assessing long-term feeding tube and long-term QoL (6 months and 1-year post-treatment).
Methods: This is a retrospective study of patients diagnosed with HNC. All patients were offered FACT-HN at baseline, and 6 months to 1 year after completion of treatment. The FACT-HN (outcome variable) is a patient reported outcome measure for well-being. Higher scores indicate better quality of life. The exposure variable is the presence of a feeding tube at 6 months to 1 year after completion. Kruskal-Wallis tests were used to compare QoL at 6 months to 1 year according to the presence or absence of feeding tube.
Results: There were significant differences between patients with or without feeding tube in terms of functional wellbeing (16.5 vs. 22.0; P=0.037), head and neck specific concerns (19.0 vs. 28.0; P=0.021), and total FACT-HN score (98 vs 122; P=0.035) with patients having feeding tubes demonstrating worse quality of life for all domains.
Conclusion: In patients with HNC, continued presence of a feeding tube 6 months to 1 year following treatment was associated with worse functional wellbeing, head and neck related quality of life, and overall QoL. These findings demonstrate the areas of continued need for patients with longer standing feeding tubes and can help guide future support strategies for patients with swallowing dysfunction following treatment of HNC
Progress and Plateaus: Female Representation in Interventional Radiology Training, 2008–2024
Get PDFPurpose:
Gender disparity in interventional radiology (IR) has been a longstanding issue. This study evaluated trends in female representation in IR training programs from 2008 to 2024, focusing on changes after the establishment of the Integrated IR residency program in 2016-2017.
Materials and Methods:
A retrospective review of residency and fellowship application data from the Electronic Residency Application Service (ERAS) and active resident data from the Accreditation Council for Graduate Medical Education (ACGME) was conducted. Linear regression assessed trends from 2008 to 2024. Segmented (piecewise) regression compared trends before and after 2021. T-tests analyzed gender proportions in Integrated IR applicants. Statistical significance was set at alpha = 0.05.
Results:
Female representation in IR training increased significantly from 10.8% in 2008 to 21.4% in 2024 (p = 0.000001). The Integrated IR pathway showed the largest growth, from 15.4% in 2017 to 22.4% in 2024 (p = 0.0021). In contrast, representation in the Independent IR pathway stagnated from 16.3% in 2017 to 16.1% in 2023 (p = 0.78). No significant increase in female representation was observed in Integrated IR trainees after 2021 (p = 0.2409).
Conclusion:
While female representation in IR training has increased significantly since 2008, the trend has plateaued in recent years since 2021. SIR initiatives, including WIR, the WIR Champion Award, and Mentor Match, offer promising strategies to address this plateau and foster continued progress
Paradigm shifts in medicine
Get PDFImplications for history of science, scientific revolutions and paradigm shifts in the context of rapidly developing artificial intelligence
Epistemic Injustice in Marginalised Patient Populations: Reconceptualising Health Inequities Through the Lens of Social Epistemology
Get PDFThis paper examines epistemic injustice in healthcare settings and its implications for health services research and clinical practice. Epistemic injustice, the systematic devaluation of patients\u27 knowledge and experiences, particularly affects marginalized populations. Drawing on empirical studies and theoretical literature, we analyse how this phenomenon manifests in clinical encounters, impacts health outcomes, and perpetuates health disparities. Our findings indicate that epistemic injustice contributes to misdiagnosis, delayed treatment, and reduced patient engagement, ultimately affecting healthcare quality and effectiveness. We explore the implications for patient-centred care, health equity, and quality improvement, discussing how recognizing epistemic injustice can inform research methodologies, clinical guidelines, and healthcare policy. Potential mitigation strategies are identified, including enhanced clinician training and more inclusive approaches to medical knowledge production. This work provides health services researchers, clinicians, and policymakers with insights into the dynamics underlying health inequities and suggests pathways for creating more equitable healthcare systems
Fluid Life and Sympoietic Death: The Posthuman Perspective in Korean Sci-Fi
No full textThis article explores the posthuman perspective on life and death through an analysis of three short stories by Kim Cho-yeop, a female science fiction writer from Korea. The stories explore fundamental philosophical questions about life’s continuation and the nature of death in a rapidly evolving technological world. The first story redefines life’s extension through technology combined with human connection, while the second story examines the isolating effects of technology in the absence of care, making death an ambiguous and unresolved state. The third story presents the fluidity of life and death through the continual transfer of identity and memory. By examining themes of care, symbiosis, and fluidity, this article demonstrates how Kim Cho-yeop’s works provide a nuanced reflection on human and nonhuman relationships in a posthuman context
Paternal Origin of Yi People in Southwestern China: Insights from Phylogeographics of Founder Lineage
No full textThe Yi people in southwestern China are renowned for their unique history, social structure, and customs. However, due to extensive genetic admixture during their formative period, the early origin and evolutionary trajectory of the Yi people remain unclear. In this study, we identify four paternal founder lineages of Yi people and generate a highly revised phylogenetic tree for these four lineages with 66 sequences. Furthermore, the geographic distribution of four lineages within China is summarized, based on 465 individuals identified among 60,009 Chinese males. The divergence topology indicates that among all Tibeto-Burman-speaking populations, the Naxi, Bai, and Burmese populations exhibit the closest genetic affinity with the Yi people. The distribution of four founder lineages shows similar higher frequency in the Yunnan-Guizhou Plateau, the center of the Yi people’s inhabited area. We conduct an in-depth analysis of the possible origin, migration patterns, and roles of these four components in the demographic history of the Yi people
The Uncanny, The October 7 Massacre, and the Folktale “The Wolf and the Kids” (ATU 123)
Get PDFFollowing Freud’s claim that folktales do not necessarily evoke uncanny experiences, this essay presents a case in which a folktale brought to life in the form of real-world events evokes uncanny experiences. The essay examines testimonies from the October 7 events in light of the folktale identified as “The Wolf and the Kids” (ATU 123) and proposes that beyond the horrors that occurred in the massacre, the comparative discussion reveals an additional level of terror, related to the way fairy tale experiences take on flesh and bone
Reclaiming Sapphic Vampire Narrative in the Twilight Renaissance
No full textThe late 2010s saw the revitalization of the Twilight fandom, known as the “Twilight Renaissance,” during which it revisited the heteronormative vampires of Stephenie vampires and queer theory as well as by examples from the Twilight Renaissance. This article aims to expand the conversation on how queer communities create their own narratives in response to the lack of desired representation in mainstream culture. Meyer’s Twilight saga with a sapphic and de-sanitized lens. The Twilight Renaissance, especially on Tumblr, is one example of how fandom retellings facilitate queer reclamation and representation. These points are supported by scholarship on literary vampires and queer theory as well as by examples from the Twilight Renaissance. This article aims to expand the conversation on how queer communities create their own narratives in response to the lack of desired representation in mainstream culture