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Driving Collective Change: Understanding the Role of Internal Communication, Organizational Trust, and Efficacy in Employees’ Issue-Driven Collective Activism Intention Toward Police Brutality Issues
No full textThis study explored how organizations' dialogic internal communication about their stance to end police brutality toward African Americans influenced employees' issue-driven collective activism intention to address police brutality toward African Americans. An online survey was conducted to recruit 401 eligible participants. Results found that dialogic internal communication about stance on police brutality toward African American issues positively predicted employees' organizational trust which was positively associated with their self-efficacy and collective efficacy. Moreover, both employees' self-efficacy and collective efficacy mediated the relationship between their organizational trust and issue-driven collective activism intention to anti-police brutality toward African Americans. Several theoretical and practical implications are also discussed.</p
Evaluating the Performance of the Paris System in Neobladder Cytology: The Role of Cellularity and Volume Adequacy Criteria
No full textUrinary diversion (UD) including neobladder (NB) samples play a crucial role in diagnosing recurrent urothelial carcinoma (UC) following cystectomy. However, urine cytology (UCy) interpretation in this setting is challenging due to degenerative changes and a necroinflammatory background. The diagnostic performance of UCy using The Paris System (TPS) has not been well established for NB specimens. Moreover, given the distinct characteristics of NB samples compared to other urine specimens, the application of specific adequacy criteria may be necessary.
This retrospective study analyzed 442 NB urine specimens from 243 patients who underwent cystectomy with UD. One-year surgical pathology or cytology follow up was collected. All specimens were prepared using the cytospin technique, stained with Papanicolaou stain, and assessed using TPS criteria. The presence of preserved benign urothelial cells and urine volume were analyzed to determine specimen adequacy. Youden's index and likelihood ratio testing were applied to identify an optimal volume cutoff.
By applying TPS, positive cytologic diagnoses (atypical or higher) were identified in 3.39% of NB specimens. Among 139 cases with histological or cytological follow-up, UC was confirmed in 10.8%, with 86% being high-grade UC (HGUC). The sensitivity and specificity of TPS for detecting HGUC were 61.5% and 96.8%, respectively. Notably, 60.5% of NB specimens in this cohort lacked preserved urothelial cells. Redefining adequacy criteria to require the presence of at least one preserved urothelial cell markedly increased sensitivity (100%) with only modest changes in specificity and overall diagnostic accuracy. A specimen volume ≥ 45 mL emerged as the optimal cutoff for identifying atypical urothelial cells or higher TPS categories, although statistical significance remained limited (p = 0.12). Applying this threshold led to a modest improvement in the sensitivity of UD cytology (66.67%).
The diagnostic performance of TPS for NB samples was comparable to the performance of pre-TPS cytology in the UD setting, as reported by other studies. Incorporating adequacy criteria based on the presence of at least one preserved benign urothelial cell substantially improves the sensitivity of UCy in NB samples. Additionally, a minimum specimen volume of approximately 45 mL may serve as an adequacy indicator for NB cytology, although its impact on diagnostic performance is limited
Preliminary evaluation of the acceptability, appropriateness, and feasibility of an online sexual health educational video series for breast cancer patients
No full textSexual health-related side effects during breast cancer treatment are common and distressing but not always expected by patients. We created an online sexual health educational video series to increase patients' awareness of these issues. In this exploratory study, we aimed to evaluate the acceptability, appropriateness, and feasibility of the video series among newly diagnosed breast cancer patients.
This was a repeat-measure, single-arm preliminary study where eligible and interested patients completed a baseline questionnaire within one month of diagnosis or surgical evaluation. Enrolled participants accessed the online sexual health video series. A follow-up questionnaire evaluating acceptability, appropriateness, and feasibility was administered after 6 months. Descriptive statistics, paired t-tests, and thematic analysis were utilized.
Twenty-eight participants (January-June 2024) with mean age of 48 years (± 8 years) comprised the present analysis with 86%White, 4% Hispanic, 89% straight/heterosexual, 86% married/partnered, and 68% Stage I at diagnosis. Eleven participants (39%) completed the 6-month survey. Of the nine participants who reported watching the online videos, mean acceptability, appropriateness, and feasibility on a 5-point Likert scale was 4.1 (± 1.0), 4.3 (± 0.7), and 4.4 (± 0.7), respectively. Qualitative feedback showed strong endorsement for the video series and offered suggested improvements.
Breast cancer patients lack access to adequate sexual health resources during treatment, but an online educational video series has the potential to be acceptable, appropriate, and feasible as an educational resource. This video series fills a unique gap in patient care and has the potential to significantly advance the sexual health resources available to breast cancer patients and survivors.
ClinicalTrials.gov, Registration No. NCT06121258, Registration Date: 11/7/2023
Obrixtamig (BI 764532) in patients (pts) with relapsed/refractory delta-like ligand 3 (DLL3)-high expressing extrapulmonary neuroendocrine carcinoma (epNEC): Dose expansion part of the phase II DAREON-5 trial
No full textTPS648 Background: Pts with relapsed/refractory epNEC have poor outcomes with currently available therapies. DLL3 is expressed on the surface of many epNEC cells, offering a promising therapeutic target. Obrixtamig (BI 764532) is a DLL3/CD3 IgG-like T-cell engager that binds simultaneously to CD3 on T-cells and DLL3 on tumor cells, resulting in immune-mediated tumor cell lysis. In an ongoing first-in-human Phase I trial (NCT04429087), obrixtamig monotherapy had promising efficacy in pts with DLL3+ SCLC, epNEC or large-cell NEC of the lung (LCNEC-L) and a manageable toxicity profile, justifying further clinical investigation. The Phase II DAREON-5 trial (NCT05882058) is a dose selection and expansion trial of obrixtamig monotherapy in pts with histologically confirmed relapsed/refractory SCLC, epNEC or LCNEC-L after prior standard of care. The completed dose selection part evaluated the safety and efficacy of two obrixtamig doses. We describe the design of the expansion part of the study that is currently enrolling. Methods: The expansion part of DAREON-5 is assessing obrixtamig antitumor activity at the selected dose for expansion in pts with centrally assessed DLL3-high expressing epNEC; defined as ≥50% of evaluable tumor cells with moderate to strong membrane and/or cytoplasmic DLL3 staining using the VENTANA DLL3 (SP347) assay. Eligible pts have relapsed/refractory, advanced/metastatic, histologically confirmed epNEC after prior platinum-based chemotherapy (≥1 lines of therapy). Pts will receive IV obrixtamig infusions as step-up doses followed by the target dose. Primary endpoint is objective response per RECIST v1.1, assessed by blinded independent central review. Secondary endpoints include duration of objective response, PFS, disease control, overall survival, treatment-emergent AEs, and patient-reported outcomes. The planned enrollment for the expansion cohort is ~50 pts recruited from the following countries: Belgium, China, Germany, Japan, Portugal, South Korea, Spain, UK and USA. Previously presented at ESMO, FPN (Final publication Number): 1731TiP, Pavel et al. Reused with permission. Clinical trial information: NCT05882058
Prospective, non-randomized, controlled investigation of prostate (P) artery embolization (E) compared to holmium (Ho) laser enucleation of prostate for the treatment of symptomatic benign prostatic hyperplasia with prostate volume 80-250 cc: the hope trial outcome at 1 year
No full textBackground To compare outcomes of Prostate Artery Embolization (PAE) with Holmium Laser Enucleation of Prostate (HoLEP) for management of symptomatic benign prostate hyperplasia in men with prostate volume 80 to 250 cc. Methods In this open-label prospective clinical-trial, 45 patients were enrolled in a 2:1 ratio to undergo PAE and HoLEP, respectively. The voiding parameter, sexual function, and complications were evaluated at 1, 3, 6, and 12-months. The primary endpoint was a reduction in the International Prostate Symptom Score (IPSS) at 3 months. Secondary-outcomes were change in the International Index of Erectile Function-15 (IIEF-15), International Consultation on Incontinence Questionnaire-urinary incontinence (ICIQ-UI), Quality-of-Life (QoL), IPSS, uroflow (Qmax) and Prostate Specific Antigen (PSA). Adverse-events were recorded and graded using the Clavien-Dindo Adverse-event (CD-AE) classification. Results No significant difference in median IPSS and quality of life improvement was observed at any follow-up point. PAE had significantly better IIEF-15 and ICIQ-UI outcomes than HoLEP at 1 and 3 months. HoLEP outperformed PAE in PSA reduction, Qmax, and post-void residual (PVR) improvement at 3 and 12-months. However, PAE had shorter hospital stays and avoided catheterization. No major adverse events (Clavien-Dindo >= grade 3) occurred in either group. Conclusion In men with BPH and prostate sizes 80-250gm, PAE and HoLEP produce similar IPSS and QoL improvement at medium-term follow-up. PAE had better IIEF-15 and ICIQ-UI, in addition to the advantage of avoiding catheterization and reduced hospital stay. HoLEP performed better in PSA reduction, Qmax, and PVR improvement at 3 and 12 months. No serious adverse events occurred in either treatment group. Small sample size and short-term follow-up were important limitations.</p
Diabetic Retinopathy as a Risk Factor for Ocular Hypertension or Primary Open-Angle Glaucoma in a United States-based Cohort Study
No full textAssess the association between diabetic retinopathy (DR) and the risk of ocular hypertension (OHT) or primary open-angle glaucoma (POAG) in patients with type 1 (T1DM) or type 2 diabetes mellitus (T2DM).
This retrospective cohort study utilized the TriNetX US Collaborative Network, including 166,471 patients with T1DM and 5,745,652 patients with T2DM, categorized by DR status, ages ≥ 18 years. International Classification of Diseases 10th Revision (ICD-10) codes identified T1DM, T2DM, and DR. Propensity score matching (PSM) adjusted for age, sex, race/ethnicity, body mass index (BMI), relevant medical history, blood markers, glycemic-controlling medications, intravitreal injections, and ophthalmic service visits. The primary outcome was the development of coded OHT or POAG over 10 years and lifetime, expressed as adjusted hazard ratios (aHR).
DM patients with DR exhibited a significantly heightened risk of developing coded OHT or POAG. T1DM patients showed a 4.966 fold increased lifetime risk of developing OHT (95% confidence interval (CI): 2.178-11.325) and 4.262 fold increased lifetime risk of developing POAG (95% CI: 1.435-13.255), while T2DM patients had a 2.651 fold increased lifetime risk of developing OHT (95% CI: 2.412-2.915) and 2.62 fold POAG (95% CI: 2.37-2.89). This risk remained high in our sub-analysis, and patients with PDR were at a higher risk compared to those with any stage of NPDR. Sensitivity analyses confirmed these findings across various demographic and clinical variables.
DR is significantly associated with OHT and POAG, particularly in T1DM. These findings emphasize the need for vigilant screening and comprehensive management of diabetic patients with coexisting DR.
Diabetic retinopathy in diabetic patients significantly increases the risk of ocular hypertension and primary open angle glaucoma, with the highest risk in type 1 diabetics as high as 5-fold compared to those without diabetic retinopathy
Multivariate Spatiotemporal Analysis Of Genetic Testing Utilization In Cardiovascular Precision Medicine: Labcorp Genetics Analysis From The REIMAGINE-HF Investigators
No full textThe comparative impact of body mass index on outcomes following minimally invasive versus open surgery for grade 1 spondylolisthesis: 2-year follow-up from the Quality Outcomes Database
No full textBoth minimally invasive (MI) and open surgical approaches can be effective for the treatment of degenerative lumbar spondylolisthesis (DLS). However, comparative effectiveness might be influenced by body mass index (BMI). The authors aimed to determine if there is a differential impact of open versus MI approaches on patient outcomes based on BMI.
The authors performed a retrospective analysis of the prospective Quality Outcomes Database, identifying patients surgically treated for grade 1 DLS between July 2014 and June 2016. BMI was dichotomized into 2 groups: nonobese (BMI < 30 kg/m2) and obese (BMI ≥ 30 kg/m2) in accordance with the Centers for Disease Control and Prevention definition. The primary outcome was a minimal clinically important difference (MCID) in the Oswestry Disability Index (ODI). Secondary outcomes included an MCID in the EQ-5D, the North American Spine Society patient satisfaction index, an MCID in the numeric rating scale for leg pain (NRS-LP) and back pain (NRS-BP), surgical complications, discharge disposition, and reoperation. These variables were compared between surgical approaches and after subgrouping by BMI group. A nonroutine discharge was defined as discharge to any location other than home.
Six hundred eight patients with grade 1 DLS were identified. Five hundred seventeen (85%) had 2-year follow-up for the primary outcome. There were 285 nonobese and 232 obese patients, and 216 patients underwent an MI approach and 301 underwent an open approach. Four hundred two patients (77.8%) underwent instrumented fusion, whereas 115 (22.2%) underwent decompression alone. Instrumented fusion was performed more frequently in the open group (81.7% vs 72.2%, χ2 = 6.03, p = 0.014) and in obese patients (83.6% vs 73.0%, χ2 = 7.76, p < 0.01). Regardless of surgical approach or BMI, 2-year (2Y) ODI (mean difference [MD] -23.4 ± 20.38, p < 0.001), NRS-LP scores (MD -3.81 ± 3.82, p < 0.001), and NRS-BP scores (MD -3.32 ± 3.43, p < 0.0001), and EQ-5D scores (MD 0.21 ± 0.24, p < 0.0001) improved from baseline. Among obese patients, the proportion attaining an MCID in 2Y ODI (73.3% vs 56.34%, χ2 = 6.11, p = 0.013) and EQ-5D (53.33% vs 37.32%, χ2 = 4.32, p = 0.038) was larger after MI than after open surgery; however, no differences were seen between MI and open surgery in the nonobese patients. There were no differences between MI and open approaches in either BMI group for the remaining secondary outcomes.
Regardless of approach, patients improved following surgery for grade 1 DLS. Patients with BMI ≥ 30 kg/m2 had better long-term outcomes when treated with an MI surgical approach versus open surgery. This difference in outcomes between MI and open surgery was not observed among patients with BMI < 30 kg/m2
56 - Burned scalp/forehead and brow
No full textThe upper third of the face is composed of the eyebrow, forehead, and scalp. These anatomic units play a significant role in an individual’s appearance and relationship to society. Facial burns should be definitively managed only after the patient is stabilized from the acute burn insult. At this point, successful aesthetic and functional repair can be achieved through an individualized approach employing the reconstructive ladder. Standard plastic surgical techniques encompass grafts, flaps, and tissue expansion