Rural Disparities in Cancer Care: A Review of Its Implications and Possible Interventions

Cancer care has greatly improved in the last few decades, as evidenced by a 22% decline in the overall cancer-related death rate in the United States since 1991. However, the question presents itself whether rural residents, for whom the latest advancements are not as accessible, are also realizing these benefits as much as their urban counterparts. The aim of this study is to provide are view of the literature regarding the disparities in cancer care facing rural Appalachia and specifically West Virginia (WV) as well as possible solutions towards bridging this gap. We find that WV has a higher cancer incidence and mortality rate with fewer oncologists per resident, while rural areas in general have lower clinical trial participation and different treatment regimens. Though programs have been put in place such as mobile mammography clinics and local outreach, more work can be done in WV in the realms of teleoncology, virtual tumor boards, patient support groups, and physician training programs

Total Parenteral Nutrition in Patients Following Pancreaticoduodenectomy: Lessons from 1184 Patients

Poster presented at Sigma XI Student Research Day at Thomas Jefferson University. Background: Total parenteral nutrition (TPN) has historically been used conservatively in the management of patients after pancreaticoduodenectomy (PD). In this study, we evaluate the indications for and outcomes associated with TPN use in a high-volume pancreatic surgery center.https://jdc.jefferson.edu/surgeryposters/1007/thumbnail.jp

Lymphocytic Hypophysitis

A 59 year-old female presented with visual problems in 2006, and was initially diagnosed with a pituitary macroadenoma on MRI (Figure 1). Preoperatively, the pituitary lesion decreased in size after the patient was started on steroids, raising the possibility of lymphoma and inflammatory conditions. Ultimately, endoscopic trans-nasal biopsy of the pituitary lesion revealed lymphocytic hypophysitis. She was treated with steroids for two years and developed several side effects from chronic steroid use, including Cushingoid features, diabetes, cataracts, weight-gain and osteopenia. As a result, she was subsequently treated with methotrexate and gradual weaning of the steroids

Work-Related Mental Health and Job Performance: Can Mindfulness Help?

Work-related mental health issues such as work-related stress and addiction to work impose a significant health and economic burden to the employee, the employing organization, and the country of work more generally. Interventions that can be empirically shown to improve levels of work-related mental health – especially those with the potential to concurrently improve employee levels of work performance – are of particular interest to occupational stakeholders. One such broad-application interventional approach currently of interest to occupational stakeholders in this respect is mindfulness-based interventions (MBIs). Following a brief explication of the mindfulness construct, this paper critically discusses current research directions in the utilization of mindfulness in workplace settings and assesses its suitability for operationalization as an organization-level work-related mental health intervention. By effecting a perceptual-shift in the mode of responding and relating to sensory and cognitive-affective stimuli, employees that undergo mindfulness training may be able to transfer the locus of control for stress from external work conditions to internal metacognitive and attentional resources. Therefore, MBIs may constitute cost-effective organization-level interventions due to not actually requiring any modifications to human resource management systems and practises. Based on preliminary empirical findings and on the outcomes of MBI studies with clinical populations, it is concluded that MBIs appear to be viable interventional options for organizations wishing to improve the mental health of their employees

COMFormer: classification of maternal-fetal and brain anatomy using a residual cross-covariance attention guided transformer in ultrasound

Monitoring the healthy development of a fetus requires accurate and timely identification of different maternal-fetal structures as they grow. To facilitate this objective in an automated fashion, we propose a deep-learning-based image classification architecture called the COMFormer to classify maternal-fetal and brain anatomical structures present in two-dimensional fetal ultrasound images. The proposed architecture classifies the two subcategories separately: maternal-fetal (abdomen, brain, femur, thorax, mother's cervix, and others) and brain anatomical structures (trans-thalamic, trans-cerebellum, trans-ventricular, and non-brain). Our proposed architecture relies on a transformer-based approach that leverages spatial and global features by using a newly designed residual cross-variance attention (R-XCA) block. This block introduces an advanced cross-covariance attention mechanism to capture a long-range representation from the input using spatial (e.g., shape, texture, intensity) and global features. To build COMFormer, we used a large publicly available dataset (BCNatal) consisting of 12, 400 images from 1,792 subjects. Experimental results prove that COMFormer outperforms the recent CNN and transformer-based models by achieving 95.64% and 96.33% classification accuracy on maternal-fetal and brain anatomy, respectively

Pre-mRNA Splicing Modulation by Antisense Oligonucleotides

Pre-mRNA splicing, a dynamic process of intron removal and exon joining, is governed by a combinatorial control exerted by overlapping cis-elements that are unique to each exon and its flanking intronic sequences. Splicing cis-elements are usually 4-to-8-nucleotide-long linear motifs that provide binding sites for specific proteins. Pre-mRNA splicing is also influenced by secondary and higher order RNA structures that affect accessibility of splicing cis-elements. Antisense oligonucleotides (ASOs) that block splicing cis-elements and/or affect RNA structure have been shown to modulate splicing in vivo. Therefore, ASO-based strategies have emerged as a powerful tool for therapeutic manipulation of splicing in pathological conditions. Here we describe an ASO-based approach to increase the production of the full-length SMN2 mRNA in spinal muscular atrophy patient cells