6501 research outputs found
Sort by
Efficacy of Infliximab Versus Vedolizumab in the Management of Immune Checkpoint Inhibitor-Induced Colitis: A Systematic Review and Meta-Analysis.
No full textBACKGROUND: Immune checkpoint inhibitors (ICIs) can cause severe gastrointestinal immune-related adverse events (irAEs), often leading to treatment interruption and increased morbidity. Immune-mediated colitis (IMC) ranges from mild diarrhea to life-threatening colitis, sometimes requiring urgent intervention. While corticosteroids are the first-line treatment, selective immunosuppressive therapy (SIT) with either infliximab or vedolizumab is used for steroid-refractory or dependent cases. However, standardized practices are lacking, and treatment decisions are largely left to provider discretion. This study compares infliximab and vedolizumab for IMC, focusing on remission rates, recurrence, SIT dosing, and systemic steroid exposure duration.
METHODS: We identified six retrospective cohort studies that compared infliximab with vedolizumab in the treatment of IMC through a systematic search of PubMed, EMBASE, Cochrane Library, Scopus, CINAHL, Google Scholar, and Web of Science in English from inception until October 2024. From the identified literature, we extracted pertinent data such as remission and recurrence of IMC. Pooled analysis and heterogeneity analysis were performed using R Studio version 4.4.1. The risk of bias was assessed using the Newcastle-Ottawa Scale.
RESULTS: A total of six studies with 645 patients were included. In ICI-associated colitis, vedolizumab was associated with lower recurrence rates (odds ratio (OR): 0.29, 95% confidence interval (CI): 0.15 - 0.54) and shorter systemic steroid exposure (mean difference (MD): -16.88 days, 95% CI: -20.47 to -13.30) compared to infliximab. While vedolizumab showed improved remission, there was no statistically significant difference in remission rates between vedolizumab and infliximab monotherapy (OR: 3.16, 95% CI: 0.29 - 34.01). Remission was achieved with fewer doses of infliximab than vedolizumab (MD: 1.16, 95% CI: 0.09 - 2.22). The mean number of vedolizumab doses was 2.57 (raw mean score (MRAW): 2.57, 95% CI: 1.43 - 2.71), while the mean number of infliximab doses was 1.36 (MRAW: 1.36, 95% CI: 0.69 - 2.02).
CONCLUSIONS: Among patients with ICI-induced colitis, vedolizumab demonstrated superiority over infliximab by being associated with lower rates of colitis recurrence and decreased systemic steroid exposure, although it required a higher number of doses compared to infliximab
A Qualitative Analysis of the Lived Experience of Active-Duty Servicewomen Receiving Perinatal Care Within the Military Health System.
No full textOBJECTIVES: We explored the lived experiences of active-duty servicewomen (ADSW) accessing and receiving care during the perinatal period (from discovery of pregnancy to 1 year postpartum) within the Military Health System.
STUDY DESIGN: Using qualitative methods, we conducted semi-structured interviews between September 2022 and February 2023 with 23 ADSW participants who were pregnant or within their first year postpartum. Data were analyzed using inductive coding and thematic analysis techniques.
RESULTS: Participants reported bureaucratic hurdles and long wait times for accessing care, too little choice in providers, and inadequate coordination between civilian and military care providers. Those who experienced perinatal complications perceived that the military health system did not adequately address their concerns. Some participants described disjointed and depersonalized perinatal care, whereas others reported positive experiences with their providers.
CONCLUSIONS: Opportunities exist for the Military Health System to improve the perinatal care experience by increasing access to perinatal care, providing more autonomy to ADSW in choosing providers and birth settings, and developing policies and procedures to improve inter-specialty communication
Intentions of Attrition of Colombian Women in Engineering: A Quantitative Analysis of Organizational, Career and Identity Factors
No full textWomen remain underrepresented and face persistent challenges in engineering professions, with high attrition undermining diversity and innovation. Understanding factors driving attrition is key to designing interventions that promote retention. Grounded in Social Cognitive Career Theory, Engineering Identity, and Career Change Theory, this dissertation developed and tested a theoretical model of engineers’ turnover intentions using data from Colombian women engineers, a group facing systemic barriers that impact their career trajectories. Three studies were conducted. Study 1 translated and culturally adapted five scales into Spanish, including Engineering Role Identity, and developed a new scale on Outcome Expectations. Study 2 tested psychometric properties of ten scales through factor analyses. Study 3 tested the theoretical model using structural equation modeling to examine how personal and organizational factors interact to influence turnover intentions. Results show Engineering Identity, Outcome Expectations, Career satisfaction and Organizational Support negatively predicted turnover intentions. Conversely, organizational barriers weakened those protective factors, linking discrimination, bias, and work-family conflict to attrition risk. This dissertation contributes to engineering education research and career development theory while offering tools for organizations and policymakers to build inclusive environments that support the persistence of women engineers and advance gender diversity in engineering
Effects of Maackia amurensis Seed Lectin (MASL) on OSCC Cell Morphology, PDPN Expression, Growth, and Motility in a Phase 1 Clinical Trial
No full textBACKGROUND: Podoplanin (PDPN) has emerged as a functionally relevant biomarker and chemotherapeutic target expressed by OSCC cells. PDPN signaling can directly increase tumor cell invasion and metastasis, and also inhibit host lymphocyte activation and immune response. Accordingly, antibodies and Maackia amurensis seed lectin (MASL) can target the PDPN receptor to inhibit OSCC cell migration and viability. However, the effects of MASL on OSCC cells in oral cancer patients has not yet been reported.
METHODS: We conducted a Phase 1 human clinical trial to examine the effects of a single 100 mg oral dose of MASL on OSCC cell morphology, PDPN expression, and immune cell infiltration in lesions in oral cancer patients. We also examined the effects of MASL on the PDPN expression, motility, and viability of cells cultured from these patient lesions. In addition, we examined the ability of antibodies to target PDPN and kill OSCC cells by near-infrared photoimmunotherapy.
RESULTS: MASL administration was found to be safe and did not produce any adverse effects in any patients. While this single dose did not affect OSCC cell morphology in lesions in situ, it did appear to increase lymphocyte infiltration into tumor fields in one patient by over 5 fold (p \u3c 0.01). In addition, MASL inhibited the growth and motility of all OSCC cells cultured from these patient lesions in a dose responsive manner in vitro (p \u3c 0.05 in all cases) We also report that antibodies can target PDPN on OSCC cells obtained from these patients to destroy them by near-infrared photoimmunotherapy (NIR-PIT).
CONCLUSION: These results suggest that protocols using MASL and photoimmunotherapies that target PDPN can be developed to effectively treat OSCC lesions in oral cancer patients
ABERRANT BEHAVIOR AND MEDIAL PREFRONTAL CORTEX ACTIVITY IN THE TGF344-AD RAT MODEL OF ALZHEIMER’S DISEASE
No full textPrior to the extensive accumulation of the canonical neuropathological markers of AD (β-amyloid plaques and neurofibrillary tangles), human AD patients show behavioral deficits. As AD diagnoses are expected to dramatically increase, the behavioral consequences of early-AD will rapidly become apparent and demand a thorough understanding of the disease for effective treatment prior to the devasting loss of memory. A novel rat model (Tg-F344-AD) that expresses mutant amyloid precursor protein and overexpresses presenilin-1 exhibits age-dependent AD pathology (plaques, tau pathology, and neuronal loss) and closely recapitulates the progression of human AD. These AD rats have not only deficits in flexible behavior and motivation but also alterations in the medial prefrontal cortex (mPFC) by 6 months of age. mPFC neural encoding of reward-predictive cues during learning is necessary for and can predict a rat’s ability to flexibly shift behavior. Here, using a combination of behavioral and neurophysiological techniques, we have uncovered pathological mPFC neurophysiological signatures of adult AD rats (5-7 months old) that are associated with various behavioral deficits, including flexible behavior and motivation. The work may prove invaluable to characterizing the neurophysiological signature of early disease and informing future AD therapies
Disclosing That Which Has Been Made Invisible: Collective Ontological Inquiry with Vanessa Machado de Oliveira, Dorothy Cococinno LadybugBoss, Aiden Cinnamon Tea, and Aiden Senior
No full textAn unconventional and collaboratively written text begun as a Book Review that expands into a hybrid Book Review-Notes From The Field-Article as we sought to do justice to our encounter with three provocative books that elicit ontological inquiry inside and outside our classrooms, inquiry that challenges us, confuses us, confronts us to unlearn and loosen the grip of ontological constraints we were thrown into within modernity and our embeddedness within the everyday life. Our reading of these books elicits much needed hope for the precarious times we are living through with this earth
Occupation, Displacement, and Violence in the West Bank: A Retrospective Analysis of Data from 2014-2024
No full textIsraeli settlement expansion in the West Bank has intensified violence in the occupied Palestinian territories (oPt). This violence escalated after attacks by Hamas on Israel on 7 October 2023 and the subsequent military campaign in Gaza. This study examines the possible impacts of military and land occupation on displacement, injuries, and deaths in the West Bank. This cross-sectional observational study analyses casualties and displacement data in the West Bank and Israel from May 1, 2014, to June 30, 2024. Sources include the United Nations Office of Coordination of Humanitarian Affairs, Statista, and the Palestinian Central Bureau of Statistics. Death and injury rates per 100,000 person-years were calculated and compared across populations. Interrupted time-series analysis compared observed Palestinian deaths, injuries, and displacement to expected levels since October 2023. Chi-square analysis examined demolition patterns by West Bank area. GIS mapping methods visualized spatial variations in casualties and demolitions. Death and injury rates were substantially higher for Palestinians than Israelis: RR = 5.72 (95% CI 2.38, 13.75; p \u3c 0.001) for deaths and RR = 16.47 (6.86, 39.56; p \u3c 0.001) for injuries. Refugee camps had increased death rates: IRR = 7.91 (5.26, 11.89; p \u3c 0.0001) compared to non-refugee camp populations. Since October 2023, West Bank deaths were 25% higher than expected: RR = 1.25 (1.15, 1.36; p \u3c 0.0001) and displacement 17% higher: RR = 1.17 (1.12, 1.21; p \u3c 0.0001). Nablus and Jenin recorded the highest fatalities. Jabal al-Mukkabir in East Jerusalem experienced the highest number of demolitions. Our study confirms a significant disparity in rates of conflict-related traumatic injuries and deaths between Palestinians and Israelis. The findings emphasize the need to limit military force against civilians, to hold the Israeli government accountable for demolitions and displacement, and to instigate protective measures in refugee communities. Policy efforts should prioritize conflict de-escalation, including reaching a sustainable political solution
A Broad Examination of Sleep Issues in Pediatric Multiple Sclerosis and other conditions
No full textBackground: Poor sleep hygiene can lead to serious health consequences, including the development of health disorders and the worsening of chronic illnesses. Poor sleep quality or duration has been linked to neurocognitive changes such as inattention and lower IQ scores. Sleep disorders are especially prevalent among pediatric patients with neurologic and neuropsychiatric conditions; for example, children with epilepsy and ADHD exhibit higher rates of parasomnias, while patients with multiple sclerosis (MS) experience REM sleep behavior disorder and insomnia more often than the general population. Additionally, co-existing obstructive sleep apnea (OSA) and epilepsy can worsen seizure control, and uncontrolled epilepsy can be a risk factor for OSA. Sleep disorders may present as daytime drowsiness, fatigue, or insomnia and are thought to worsen underlying neurological disorders.
Methods: In this study, we analyze sleep disturbances through questionnaires in 70 pediatric patients aged 5–17 years with MS, epilepsy, or migraine seen at Robert Wood Johnson University Hospital Pediatric Neurology Clinic.
Results: Analysis through SPSS revealed significant differences in sleep disturbances between epilepsy and MS, and between epilepsy and migraine, but not between migraine and MS.
Discussion: Our findings support previous studies indicating higher rates of sleep disorders in patients with migraines. Since epilepsy is a non-inflammatory condition, this may contribute to the significant differences observed, though further studies are needed.
Limitations: A limitation of our study is the uneven distribution of sample sizes among diagnoses.
Conclusion: Overall, sleep disorders are common among children with neurological comorbidities, and assessing sleep history is recommended for improved management
White Students\u27 Perceptions of Campus Racial Climate and White Racial Identity Development at a Predominately White Liberal Arts Institution
No full textThe purpose of the study is to examine the perceptions of White students about campus racial climate at a predominantly White liberal arts college in connection with students’ White racial identity development and liberal arts curriculum. The research study aims to promote a better understanding of campus racial climate at PWIs from the perspective of White students to provide insights on ways to improve campus racial climate, specifically for students of color. The data for this project were primarily collected through semi-structured qualitative interviews with White students. Quantitative data was also collected in the form of a racial attitudes assessment called the White Racial Identity Attitude Scale, renamed for the study as the Social Attitudes Scale. Students demonstrated White racial identity development in connection to their liberal arts curriculum when they mentioned things like systemic racism or White privilege, and recognized how different lived experiences can lead to a difference in perception of the same phenomenon. These findings suggest that a diverse, liberal arts curriculum can aid in White racial identity development, which assists White students in examining their White privilege and developing a healthy, anti-racist White identity. An examination of White privilege at the individual level is needed to ensure an inclusive and positive campus racial climate for all, especially for students of color in predominantly White institutions