Disparities in Fertility-Sparing Treatment and Use of assisted Reproductive Technology after a Diagnosis of Cervical, Ovarian, or Endometrial Cancer

OBJECTIVE: to assess the presence of sociodemographic and clinical disparities in fertility-sparing treatment and assisted reproductive technology (ART) use among patients with a history of cervical, endometrial, or ovarian cancer. METHODS: We conducted a population-based cohort study of patients aged 18-45 years who were diagnosed with cervical cancer (stage IA, IB), endometrial cancer (grade 1, stage IA, IB), or ovarian cancer (stage IA, IC) between January 1, 2000, and December 31, 2015, using linked data from the CCR (California Cancer Registry), the California Office of Statewide Health Planning and Development, and the Society for Assisted Reproductive Technology. The primary outcome was receipt of fertility-sparing treatment , defined as surgical or medical treatment to preserve the uterus and at least one ovary. The secondary outcome was fertility preservation , defined as ART use after cancer diagnosis. Multivariable logistic regression analysis was used to estimate odds ratios and 95% CIs for the association between fertility-sparing treatment and exposures of interest: age at diagnosis, race and ethnicity, health insurance, socioeconomic status, rurality, and parity. RESULTS: We identified 7,736 patients who were diagnosed with cervical, endometrial, or ovarian cancer with eligible histology. There were 850 (18.8%) fertility-sparing procedures among 4,521 cases of cervical cancer, 108 (7.2%) among 1,504 cases of endometrial cancer, and 741 (43.3%) among 1,711 cases of ovarian cancer. Analyses demonstrated nonuniform patterns of sociodemographic disparities by cancer type for fertility-sparing treatment, and ART. Fertility-sparing treatment was more likely among young patients, overall, and of those in racial and ethnic minority groups among survivors of cervical and ovarian cancer. Use of ART was low (n=52) and was associated with a non-Hispanic White race and ethnicity designation, being of younger age (18-35 years), and having private insurance. CONCLUSION: This study demonstrates that clinical and sociodemographic disparities exist in the receipt of fertility-sparing treatment and ART use among patients with a history of cervical, endometrial, or ovarian cancer

Tom L. Jarmon 1967

Student field notes from zoology classes in 196

A Study of the Motivations and Expectations of African American Families Engaged in the Integration of Nashville Public Schools in 1957

This study presented a qualitative analysis of selected events that resulted in the integration of the Nashville Public School System in 1957. In an effort to understand the participants\u27 perception of their experience in the process of integrating the schools, the study provided a critical analysis of why a small group of African American parents, who were a subset of the original group of 126 eligible parents, opted to take advantage of the opportunities afforded them and thier children as a result of the Brown v. Board of Education decision. It utilized the theoretical framework of Hoover-Dempsey and Sandler (2005, revised) and Spencer\u27s (1995) A Phenomenological Variant of Ecological Systems Theory (PVEST), as informed by Bronfenbrenner, to explore elements of parent involvement for these parents-relative to contemporary parent involvement-especially in urban schools. The three primary sources of evidence for this study were structured interviews, image elicitation, and document analysis; these were analyzed through the development of individual narrative cases for each participant, which resulted in a cross-case analysis narrative depicting the study\u27s findings. The study\u27s results indicated three dominant themes for the parents\u27 motivations and expectations for their participation in the school integration process: the option to attend the school closest to their home; the notion of attending a school that offered better educational outcomes; and the belief that the process of integration was overdue, and the time and opportunity for change was present. Obeying the law emerged, but was not part of a prevailing theme. Further, evidence from these parents\u27 involvement in the school suggested implications towards impacting student achievement. The study concluded that in the context of engaging in the desegregation process, parent involvement was critical to students\u27 success and was fraught with the same issues in 1957 as parents face today in urban schools. This study provided insight into practices schools and communities can employ to engage parents today. It highlighted implications for parent involvement for parents, students, school practitioners and policymakers

Guidelines for Conducting Text Based Interviews in Virtual Worlds

Interviews are a staple data collection tool in social science research and in recent decades have been increasingly formalised and systematised. However, due to the specific affordances and constraints of virtual worlds, researchers cannot simply replicate traditional interview techniques in virtual worlds without careful consideration of the specific features of the technology. For example the prominent use of text as the medium for communication, role of the avatar, interview location and inworld objects have implications for all inworld research interviews. Building on the foundation of traditional interviews in educational research and the current literature on inworld interviews, this chapter focuses on the use of text communication tools in both one-to-one and group interviews inworld. Based on previous research by the authors the opportunities, implications, constraints and techniques for conducting text based interviews inworld are discussed. The chapter concludes with a set of guidelines for researchers considering the use of inworld text based interviews

Development of a CRISPRi Human Retinal Pigmented Epithelium Model for Functional Study of Age-Related Macular Degeneration Genes

Age-related macular degeneration (AMD) is a blinding disease characterised by dysfunction of the retinal pigmented epithelium (RPE) which culminates in disruption or loss of the neurosensory retina. Genome-wide association studies have identified >60 genetic risk factors for AMD; however, the expression profile and functional role of many of these genes remain elusive in human RPE. To facilitate functional studies of AMD-associated genes, we developed a human RPE model with integrated CRISPR interference (CRISPRi) for gene repression by generating a stable ARPE19 cell line expressing dCas9-KRAB. We performed transcriptomic analysis of the human retina to prioritise AMD-associated genes and selected TMEM97 as a candidate gene for knockdown study. Using specific sgRNAs, we showed that knockdown of TMEM97 in ARPE19 reduced reactive oxygen species (ROS) levels and exerted a protective effect against oxidative stress-induced cell death. This work provides the first functional study of TMEM97 in RPE and supports a potential role of TMEM97 in AMD pathobiology. Our study highlights the potential for using CRISPRi to study AMD genetics, and the CRISPRi RPE platform generated here provided a useful in vitro tool for functional studies of AMD-associated genes