Stereoselective convergent total synthesis of oxylipins.

We synthesized stereoselectively four stereoisomers of oxylipins (1a-d) by a convergent approach based on chiral catalysis. The synthetic approach involved sequential assembly of two key fragments - ene-diol and allyl alcohol - for an intended convergent cross-metathesis reaction to join these fragments. The key steps include Sharpless kinetic resolution, asymmetric dihydroxylation and Grubbs cross-metathesis. The characterization of the synthesized oxylipins revealed spectroscopic data that were consistent with previously reported values.

Cleavage of natural rubber by rubber oxygenases in Gram-negative bacteria.

Bacterial degradation of natural rubber (NR) in an oxic environment is initiated by oxidative cleavage of double bonds in the NR-carbon backbone and is catalyzed by extracellular haem-containing rubber oxygenases. NR-cleavage products of sufficiently low molecular mass are taken up by the cells and metabolized for energy and biomass formation. Gram-negative and Gram-positive NR-degrading bacteria (usually) employ different types of rubber oxygenases such as RoxA and/or RoxB (most Gram-negative NR-degraders) or latex clearing protein Lcp (most Gram-positive NR-degraders). In order to find novel orthologues of Rox proteins, we have revisited databases and provide an update of Rox-like proteins. We describe the putative evolution of rubber oxygenases and confirm the presence of a third subgroup of Rox-related proteins (RoxCs), the biological function of which remains, however, unclear. We summarize the knowledge on the taxonomic position of Steroidobacter cummioxidans 35Y and related species. Comparison of genomic and biochemical features of strain 35Y with other species of the genus Steroidobacter suggests that strain 35Y represents a species of a novel genus for which the designation Aurantibaculum gen. nov. is proposed. A short summary on the capabilities of NR-degrading consortia, that could be superior in biotechnological applications compared to pure cultures, is also provided. KEY POINTS: • Three types of rubber oxygenases exist predominantly in Gram-negative microbes • S. cummioxidans 35Y contains RoxA and RoxB which are superior in activity • S. cummioxidans 35Y represents a species of a novel genus.

Spinal fusion surgery use among adults with low back pain enrolled in a digital musculoskeletal program: an observational study.

OBJECTIVES: To compare 12-month spinal fusion surgery rates in the setting of low back pain among digital musculoskeletal (MSK) program participants versus a comparison cohort who only received usual care. STUDY DESIGN: Retrospective cohort study with propensity score matched comparison cohort using commercial medical claims data representing over 100 million commercially insured lives. METHODS: All study subjects experienced low back pain between January 2020 and December 2021. Digital MSK participants enrolled in the digital MSK low back program between January 2020 and December 2021. Non-participants had low back pain related physical therapy (PT) between January 2020 and December 2021. Digital MSK participants were matched to non-participants with similar demographics, comorbidities and baseline MSK-related medical care use. Spinal fusion surgery rates at 12 months post participation were compared. RESULTS: Compared to non-participants, digital MSK participants had lower rates of spinal fusion surgery in the post-period (0.7% versus 1.6%; p < 0.001). Additionally, in the augmented inverse probability weighting (AIPW) model, digital MSK participants were found to have decreased odds of undergoing spinal fusion surgery (adjusted odds ratio: 0.64, 95% CI: 0.51-0.81). CONCLUSIONS: This study provides evidence that participation in a digital MSK program is associated with a lower rate of spinal fusion surgery.

Utilization of inpatient palliative care services among adolescents and young adults with cancer: Evidence from National Inpatient Sample 2016-2019.

OBJECTIVES: Palliative care can improve the quality of life of adolescents and young adults (AYA) with cancer. However, little is known about the utilization of palliative care among AYA cancer patients. Identifying factors associated with the utilization of palliative care could inform efforts to improve palliative care access among AYA patients living with cancer. METHODS: Using data from the National Inpatient Sample 2016-2019, a representative sample of US hospitalizations, we examined palliative care encounters and associated characteristics among hospitalizations of AYA with cancer and high inpatient mortality risk. Survey design-adjusted bivariate and multivariable logistic regression models were used to examine associations of patient- and hospital-level characteristics with palliative care. RESULTS: Of 10,979 hospitalizations by AYA cancer patients with high mortality risk, 19.9% received palliative care services between 2016 and 2019. After adjusting for all characteristics, independent predictors of palliative care use were as follows: older age (25-39 years old vs. 25-39 years; odds ratio [OR] 1.31, 95% confidence interval [CI] 1.15-1.49), Hispanic/Latinx (vs. non-Hispanic White; OR 1.16, 95% CI 1.01-1.34), female (vs. male; OR 1.27, 95% CI 1.14-1.41), public insurance (vs. private insurance; OR 1.23, 95% CI 1.10-1.38), hospital location in the US South (vs. Northeast; OR 0.78, 95% CI 0.66-0.94), and a large hospital (vs. small; OR 0.83, 95% CI 0.72-0.96). SIGNIFICANCE OF RESULTS: Less than 20% of AYAs with cancer and high risk of mortality received inpatient palliative care services. Further research is needed to explore the reasons for lower palliative care utilization in the younger age groups.

Palladium-catalyzed anti-Markovnikov oxidative acetalization of activated olefins with iron(III) sulphate as the reoxidant.

This paper discloses the efficient palladium-catalyzed anti-Markovnikov oxidative acetalization of activated terminal olefins with iron(III) sulfate as the reoxidant. This methodology requires mild reaction conditions and shows high regioselectivity toward anti-Markovnikov products and compatibility with a wide range of functional groups. Iron(III) sulphate was the sole reoxidant used in this method. Various olefins like vinylarenes, aryl-allylethers, aryl or benzyl acrylates and homoallylic alcohols all reacted well providing anti-Markovnikov acetals, some of which represent orthogonally functionalized 1,3- and 1,4-dioxygenated compounds.

Case Report: Atypical Presentation of Neuroretinitis in a Middle-aged Woman with Pre-existing Maculopathy.

SIGNIFICANCE: Neuroretinitis classically presents with sudden vision loss, disc edema, and macular star formation. However, the classical triad may not always be seen, especially in the case of a pre-existing macular disorder. A thorough clinical examination may still clinch the appropriate diagnosis and prevent unwarranted treatment. PURPOSE: This study aimed to report a case of neuroretinitis in an adult woman with pre-existing type 2 macular telangiectasia where the classical pattern of exudation could not be seen. CASE REPORT: A 48-year-old woman, type 2 diabetic and hypertensive, presented with sudden painless blurring of vision in the right eye for the past 1 week. Macula in both eyes had loss of transparency and intraretinal crystalline deposits and pigments. The right eye had hyperemic edematous disc with peripapillary retinal hemorrhages and hard exudates. Color vision was grossly abnormal, and a centrocecal scotoma was noted on visual field analysis in the right eye. After a normal systemic evaluation, a diagnosis of right eye neuroretinitis and coexistent bilateral type 2 macular telangiectasia (nonproliferative type) was made. Unilateral painless visual loss, severe dyschromatopsia, and peripapillary hard exudates pointed to the correct diagnosis of neuroretinitis. Observation was advised, and visual acuity improved spontaneously. The disc edema resolved with consequent optic atrophy. CONCLUSIONS: Absence of the classical "macular star" appearance does not refute the diagnosis of neuroretinitis when pre-existing maculopathy is present.

Comparison of home-based pencil push-up therapy and office-based orthoptic therapy in symptomatic patients of convergence insufficiency: a randomized controlled trial.

PURPOSE: To assess and compare the effectiveness of home-based pencil push-up therapy (PPT) and office-based orthoptic therapy (OBOT) in patients with convergence insufficiency. METHODS: In this randomized clinical trial, 176 symptomatic patients with convergence insufficiency, aged between 9 to 30 years, were randomly assigned to receive 6 weeks of home-based PPT (Group I) or OBOT (Group II) after determining refractive error, near point of convergence (NPC), convergence insufficiency symptom survey (CISS) score, near phoria and positive fusional vergences (PFV) at near. The participants of Group I underwent home-based PPT (pencil push-ups exercises15 minutes per day, daily for 6 weeks) and those of Group II OBOT (convergence fusional exercises on synoptophore for 20 min per day, 3 days a week, for 6 weeks) without home reinforcement. Patients were re-examined at 3 and 6 weeks after initiation of treatment. NPC and CISS score were the primary and secondary outcome measures, respectively. Statistical analysis was performed with the independent samples t-test, Friedman test and the analysis of variance (ANOVA). Statistical significance was indicated by p-value < 0.05. RESULTS: Participants of both the groups had statistically significant improvement in NPC, CISS score, PFV and near phoria (p < 0.001), but there was no statistically significant difference between the two groups (p > 0.05). However, patients of Group II had significantly better PFV after final visit than those of Group I (p < 0.001). CONCLUSION: Home-based PPT with good suppression control and with compliance ensured by log book entries, is a simple, cheap, less time consuming and comparably effective alternative to more expensive OBOT for patients suffering from CI. CTRI registration number: REF/2016/11/012,732, Date of registration 25/04/ 2016, Retrospectively Registered.

The HNRNPA2B1-MST1R-Akt axis contributes to epithelial-to-mesenchymal transition in head and neck cancer.

The deregulation of splicing factors and alternative splicing are increasingly viewed as major contributory factors in tumorigenesis. In this study, we report overexpression of a key splicing factor, heterogeneous nuclear ribonucleoprotein A2B1 (HNRNPA2B1), and thereby misregulation of alternative splicing, which is associated with the poor prognosis of head and neck cancer (HNC). The role of HNRNPA2B1 in HNC tumorigenesis via deregulation of alternative splicing is not well understood. Here, we found that the CRISPR/Cas9-mediated knockout of HNRNPA2B1 results in inhibition of HNC cells growth via the misregulation of alternative splicing of MST1R, WWOX, and CFLAR. We investigated the mechanism of HNRNPA2B1-mediated HNC cells growth and found that HNRNPA2B1 plays an important role in the alternative splicing of a proto-oncogene, macrophage stimulating 1 receptor (MST1R), which encodes for the recepteur d'origine nantais (RON), a receptor tyrosine kinase. Our results indicate that HNRNPA2B1 mediates the exclusion of cassette exon 11 from MST1R, resulting in the generation of RON∆165 isoform, which was found to be associated with the activation of Akt/PKB signaling in HNC cells. Using the MST1R-minigene model, we validated the role of HNRNPA2B1 in the generation of RON∆165 isoform. The depletion of HNRNPA2B1 results in the inclusion of exon 11, thereby reduction of RON∆165 isoform. The decrease of RON∆165 isoform causes inhibition of Akt/PKB signaling, which results in the upregulation of E-cadherin and downregulation of vimentin leading to the reduced epithelial-to-mesenchymal transition. The overexpression of HNRNPA2B1 in HNRNPA2B1 knockout cells rescues the expression of the RON∆165 isoform and leads to activation of Akt/PKB signaling and induces epithelial-to-mesenchymal transition in HNC cells. In summary, our study identifies HNRNPA2B1 as a putative oncogene in HNC that promotes Akt/PKB signaling via upregulation of RON∆165 isoform and promotes epithelial to mesenchymal transition in head and neck cancer cells.

Early Performance of Hospital Value-based Purchasing Program in Medicare: A Systematic Review.

BACKGROUND: Under the Affordable Care Act, the Centers for Medicare and Medicaid Services has greatly expanded inpatient fee-for-value programs including the Hospital Value-based Purchasing (HVBP) program. Existing evidence from the HVBP program is mixed. There is a need for a systematic review of the HVBP program to inform discussions on how to improve the program's effectiveness. OBJECTIVE: To review and summarize studies that evaluated the HVBP program's impact on clinical processes, patient satisfaction, costs and outcomes, or assessed hospital characteristics associated with performance on the program. DESIGN: We searched the MEDLINE/PubMed, Scopus, ProQuest database for literature published between January 2013 and July 2019 using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS: Of 988 studies reviewed, 33 studies that met the selection criteria were included. A small group of studies (n=7) evaluated the impact of the HVBP program, and no impact on processes or patient outcomes was reported. None of the included studies evaluated the effect of HVBP program on health care costs. Other studies (n=28) evaluated the hospital characteristics associated with HVBP performance, suggesting that safety-net hospitals reportedly performed worse on several quality and cost measures. Other hospital characteristics' associations with performance were unclear. CONCLUSIONS: Our findings suggest that the current HVBP does not lead to meaningful improvements in quality of care or patient outcomes and may negatively affect safety-net hospitals. More rigorous and comprehensive adjustment is needed for more valid hospital comparisons.

Patient-Provider Discussion About Cancer Treatment Costs and Out-of-Pocket Spending: Implications for Shared Decision Making in Cancer Care.

OBJECTIVES: Patient-provider discussion about treatment costs has been recognized as a key component of shared clinical decision making in cancer care. This study examined the association of patient-provider cost discussion with out-of-pocket spending among cancer survivors. METHODS: Using data from the 2016-2017 Medical Expenditure Panel Survey-Experiences with Cancer Survivorship Supplement, cancer survivors in the United States who reported having a detailed discussion about treatment costs were identified. Multivariable generalized linear model with gamma distribution and log-link was fitted to analyze average total out-of-pocket spending between those who had the discussion and those who did not. We also examined whether having the cost discussion is associated with the likelihood of reporting receipt of all cancer care they believed was necessary using a multivariable logistic regression model. All analyses controlled for patient socioeconomic and health-related characteristics. RESULTS: Among 1525 individuals, representing 14.6 million cancer survivors in the United States (mean age, 65.5 years; 59% women; 80.4% white), only 10.4% (95% confidence interval [CI], 8.7%-12.1%) reported having the detailed cost discussion with their providers during their cancer care. Having a cost discussion was associated with a -33.8% reduction in (95% CI, -38.2% to -29.6%; an absolute difference of -$478) average total out-of-pocket spending. The probability of receiving all necessary patient-reported cancer care was not different between those who had the discussion and those who did not. CONCLUSION: Detailed patient-provider cost discussions were associated with lower average total out-of-pocket spending. Patients who had detailed cost discussions with providers did not seem to sacrifice the appropriate utilization of necessary cancer treatments.

Advances in Cu and Ni-catalyzed Chan-Lam-type coupling: synthesis of diarylchalcogenides, Ar2-X (X = S, Se, Te).

Organochalcogenides are an important class of compounds encountered in organic synthesis, chemical biology and materials chemistry. The development of the Ar2-S/Se/Te bond formation, mostly in the synthesis of diarylchalcogenides, has garnered considerable attention in recent years. Transition metal catalysis is one of the most used methods for the synthesis of diarylchalcogenides via the traditional cross-coupling strategy. Recently, the Chan-Lam coupling has been valued to be the best alternative for the traditional cross-coupling due to the mild and effective reaction conditions. The review summarizes the strategies adopted for the synthesis of diarylchalogenides (Ar2X, X = S, Se, Te) by Chan-Lam-type coupling using Cu or Ni catalysis and comprises diverse approaches based on different sources of arylsulfur donors like thiols, diaryldisulfides, molecular sulfur, diheteroaryldisulfides and similar sources of Se and Te.

The health care cost of palliative care for cancer patients: a systematic review.

OBJECTIVES: Several delivery models of palliative care are currently available: hospital-based, outpatient-based, home-based, nursing home-based, and hospice-based. Weighing the differences in costs of these delivery models helps to advise on the future direction of expanding palliative care services. The objective of this review is to identify and summarize the best available evidence in the US on cost associated with palliative care for patients diagnosed with cancer. METHODS: The systematic review was carried out of studies conducted in the US between 2008 and 2018, searching PubMed, Medline, the Cochrane library, CINAHL, EconLit, the Social Science Citation Index, Embase, and Science Citation Index, using the following terms: palliative, cancer, carcinoma, cost, and reimbursement. RESULTS: The initial search identified 748 articles, of which 16 met the inclusion criteria. Eight studies (50%) were inpatient-based, four (25%) were combined outpatient/inpatient, two (12.5%) reported only on home-based palliative services, and two (12.5%) were in multiple settings. Most included studies showed that palliative care reduced the cost of health care by $1285-$20,719 for inpatient palliative care, $1000-$5198 for outpatient and inpatient combined, $4258 for home-based, and $117-$400 per day for home/hospice, combined outpatient/inpatient palliative care. CONCLUSION: Receiving palliative care after a cancer diagnosis was associated with lower costs for cancer patients, and remarkable differences exist in cost saving across different palliative care models.

Intragenic DNA methylation and BORIS-mediated cancer-specific splicing contribute to the Warburg effect.

Aberrant alternative splicing and epigenetic changes are both associated with various cancers, but epigenetic regulation of alternative splicing in cancer is largely unknown. Here we report that the intragenic DNA methylation-mediated binding of Brother of Regulator of Imprinted Sites (BORIS) at the alternative exon of Pyruvate Kinase (PKM) is associated with cancer-specific splicing that promotes the Warburg effect and breast cancer progression. Interestingly, the inhibition of DNA methylation, BORIS depletion, or CRISPR/Cas9-mediated deletion of the BORIS binding site leads to a splicing switch from cancer-specific PKM2 to normal PKM1 isoform. This results in the reversal of the Warburg effect and the inhibition of breast cancer cell growth, which may serve as a useful approach to inhibit the growth of breast cancer cells. Importantly, our results show that in addition to PKM splicing, BORIS also regulates the alternative splicing of several genes in a DNA methylation-dependent manner. Our findings highlight the role of intragenic DNA methylation and DNA binding protein BORIS in cancer-specific splicing and its role in tumorigenesis.

Dietary-phytochemical mediated reversion of cancer-specific splicing inhibits Warburg effect in head and neck cancer.

BACKGROUND: The deregulated alternative splicing of key glycolytic enzyme, Pyruvate Kinase muscle isoenzyme (PKM) is implicated in metabolic adaptation of cancer cells. The splicing switch from normal PKM1 to cancer-specific PKM2 isoform allows the cancer cells to meet their energy and biosynthetic demands, thereby facilitating the cancer cells growth. We have investigated the largely unexplored epigenetic mechanism of PKM splicing switch in head and neck cancer (HNC) cells. Considering the reversible nature of epigenetic marks, we have also examined the utility of dietary-phytochemical in reverting the splicing switch from PKM2 to PKM1 isoform and thereby inhibition of HNC tumorigenesis. METHODS: We present HNC-patients samples, showing the splicing-switch from PKM1-isoform to PKM2-isoform analyzed via immunoblotting and qRT-PCR. We performed methylated-DNA-immunoprecipitation to examine the DNA methylation level and chromatin-immunoprecipitation to assess the BORIS (Brother of Regulator of Imprinted Sites) recruitment and polII enrichment. The effect of dietary-phytochemical on the activity of denovo-DNA-methyltransferase-3b (DNMT3B) was detected by DNA-methyltransferase-activity assay. We also analyzed the Warburg effect and growth inhibition using lactate, glucose uptake assay, invasion assay, cell proliferation, and apoptosis assay. The global change in transcriptome upon dietary-phytochemical treatment was assayed using Human Transcriptome Array 2.0 (HTA2.0). RESULTS: Here, we report the role of DNA-methylation mediated recruitment of the BORIS at exon-10 of PKM-gene regulating the alternative-splicing to generate the PKM2-splice-isoform in HNC. Notably, the reversal of Warburg effect was achieved by employing a dietary-phytochemical, which inhibits the DNMT3B, resulting in the reduced DNA-methylation at exon-10 and hence, PKM-splicing switch from cancer-specific PKM2 to normal PKM1. Global-transcriptome-analysis of dietary-phytochemical-treated cells revealed its effect on alternative splicing of various genes involved in HNC. CONCLUSION: This study identifies the epigenetic mechanism of PKM-splicing switch in HNC and reports the role of dietary-phytochemical in reverting the splicing switch from cancer-specific PKM2 to normal PKM1-isoform and hence the reduced Warburg effect and growth inhibition of HNC. We envisage that this approach can provide an effective way to modulate cancer-specific-splicing and thereby aid in the treatment of HNC.

Genetic Testing for Cancer Risk and Perceived Importance of Genetic Information Among US Population by Race and Ethnicity: a Cross-sectional Study.

BACKGROUND: Genetic testing can help determine the risk of many cancers and guide cancer prevention and treatment plans. Despite increasing concern about disparities in precision cancer medicine, public knowledge and cancer genetic testing by race and ethnicity have not been well investigated. METHODS: We analyzed data from the 2020 Health Information National Trends Survey in 2022. Self-reported cancer genetic testing (e.g., Lynch syndrome, BRCA1/2) knowledge and utilization were compared by race and ethnicity. Perceived importance of genetic information for cancer care (prevention, detection, and treatment) was also examined in relation to the uptake of cancer genetic testing. Multivariable logistic regression models were employed to examine factors associated with knowledge and genetic testing to calculate predicted probability of undergoing genetic testing by race and ethnicity. RESULTS: Of 3551 study participants, 37.8% reported having heard of genetic testing for cancer risk and 3.9% stated that they underwent cancer genetic testing. Being non-Hispanic Black (OR=0.47, 95% CI=0.30-0.75) or Hispanic (OR=0.56, CI=0.35-0.90) was associated with lower odds of genetic testing knowledge. Although Hispanic or non-Hispanic Black respondents were more likely to perceive higher importance of genetic information versus non-Hispanic Whites, they had a lower predicted probability of cancer genetic testing. CONCLUSION: Non-Hispanic Black and Hispanic adults had lower knowledge and were less likely to undergo cancer genetic testing than non-Hispanic Whites. Further research is needed on sources of genetic testing information for racial and ethnic minorities and the barriers to accessing genetic testing to inform the development of effective cancer risk genetic testing promotion.

A study of disability before and after radiotherapy among head and neck cancer patients residing around atomic power plant.

Background: Head and neck cancer (HNC) is a profoundly distressing condition that can have significant psychological implications. It has the potential to impact various fundamental aspects of an individual's life, resulting in functional impairments and structural deformities depending on the location, size, and route of spread, therefore causing significant disability. Yet, this has not been adequately studied. People residing around areas around the atomic radiation power plant are exposed to radiation, and also, contamination of water sources, including the Chambal River, which is a major source of water needs of this area, may have a role in the pathogenesis and prognosis of cancer patients. Aim: This study aimed to study disability in patients with head and neck cancer before and after radiotherapy. Materials and Methods: This prospective observational study was conducted in association with the Department of Radiotherapy of a tertiary care hospital in Rajasthan. Fifty consecutive HNC patients aged 18 to 65 years fulfilling inclusion criteria, specifically laid down for the study, constituted the sample of the study. The World Health Organization Disability Assessment Schedule version 2.0 (WHODAS-2.0) was used. Results: The mean age of patients was 49.62 years. A statistically significant improvement after radiotherapy was found in disability scores in domains of cognition (2.39 vs. 1.88), self-care (2.39 vs. 1.78), and getting along with people domain (2.38 vs. 1.83). Conclusion: Disability improved significantly in patients after radiotherapy in the domains of self-care, getting along with people, and cognition.

Stress and coping strategy among coaching and non-coaching students in Kota: A comparative study.

Background: About 1.5 lakh students study in over 100 coaching centers in Kota. There is a highly competitive environment, and students often land up in stress and even suicide. So, the estimation of the magnitude of this problem and timely intervention can be of great value to students. Aim: This study aimed to assess and compare stress and coping strategies used by coaching and non-coaching students studying in Kota. Material and Methods: This cross-sectional study included 90 coaching and 90 non-coaching students fulfilling inclusion criteria that were specifically laid down for the study. A semi-structured specially designed pro forma, Scale of Academic Stress (SAS), and Coping Strategies Scale (CSS)-Hindi version were used. Appropriate statistical methods were then used to classify, tabulate, and analyze the collected data. Results: In this study, it was found that of all coaching students, 44.45% were suffering from high levels of academic stress, 34.44% suffered from average and 21.11% reported suffering from low levels of academic stress. Likewise, among non-coaching students, 70% were suffering from low academic stress, 26.67% from average, and 3.33% from high levels of academic stress. It was also evident that the majority of both coaching and non-coaching students used a low level of active coping strategy (cognitive approach, behavioral approach, and cognitive behavioral approach) and a high level of avoidance coping strategy (cognitive avoidance and behavioral avoidance). Conclusion: There is a significantly high prevalence of stress among coaching students as compared to non-coaching students. Stress levels of greater severity were found to be more prevalent in female students, 12th-class students, those belonging to urban and middle-class backgrounds, and those whose stream was chosen by their parents. Both coaching and non-coaching students used the same type of coping strategies to cope with stress.

Opioid Use Behaviors Among People With Disability in the United States: An Analysis of the National Survey on Drug Use and Health.

OBJECTIVE: People with disability (PWD) often experience chronic pain, and opioid is widely used prescription medication. However, population-based evidence of opioid use behaviors among PWD is lacking. This study examined the prevalence of opioid use behaviors by sociodemographic and health-related characteristics among PWD compared with people without disability (PWoD). METHODS: This cross-sectional study used data from 2015-2019 National Survey on Drug Use and Health. Three types of opioid use behaviors (any use, misuse, and use disorder) were defined and compared by disability status. Five self-reported disability types were measured, including hearing, vision, cognitive, mobility, and complex activity limitations. Complex survey design-adjusted descriptive and logistic regression models were used for statistical analysis. RESULTS: Of 201,376 respondents aged 18 years or older, 34.6% reported any opioid use, 4.2% opioid misuse, and 0.8% opioid use disorder. Compared with PWoD, PWD had higher prevalence of any opioid use (49.7% vs 30.7%), misuse (6.2% vs 3.7%), and use disorder (1.7% vs 0.8%). In adjusted analysis, PWD with mobility limitation (odds ratio [OR], 1.95; 95% confidence interval, 1.81-2.11) or multiple limitations (OR, 1.92; 95% CI, 1.83-2.02) were almost 2 times more likely to report any opioid use than PWoD. The likelihood of reporting any opioid use (ORs, 1.42-2.50), misuse (ORs, 1.24-2.41), and disorder (ORs, 1.38-2.54) increased as the number of limitations increased. CONCLUSIONS: People with vision, cognitive, or multiple limitations had higher rates of opioid misuse and disorder than PWoD. Development of more inclusive opioid abuse prevention strategies for PWD is warranted.

Oncolytic immunovirotherapy for high-grade gliomas: A novel and an evolving therapeutic option.

Glioblastoma is one of the most difficult tumor types to manage, having high morbidity and mortality with available therapies (surgery, radiotherapy and chemotherapy). Immunotherapeutic agents like Oncolytic Viruses (OVs), Immune Checkpoint Inhibitors (ICIs), Chimeric Antigen Receptor (CAR) T cells and Natural Killer (NK) cell therapies are now being extensively used as experimental therapies in the management of glioblastoma. Oncolytic virotherapy is an emerging form of anti-cancer therapy, employing nature's own agents to target and destroy glioma cells. Several oncolytic viruses have demonstrated the ability to infect and lyse glioma cells by inducing apoptosis or triggering an anti-tumor immune response. In this mini-review, we discuss the role of OV therapy (OVT) in malignant gliomas with a special focus on ongoing and completed clinical trials and the ensuing challenges and perspectives thereof in subsequent sections.

Sociodemographic factors associated with major depressive episodes and suicidal ideation among emerging adults with diabetes in the U.S.

Background: Research focused on disparities related to mental health comorbidities, especially among emerging adults with diabetes, is limited. Identifying associated factors of disparities could inform policy decisions to make diabetes-related interdisciplinary care more accessible for vulnerable groups. Method: Using data from the National Survey on Drug Use and Health (2015-2019), we examined disparities in presence of major depressive episode (MDE) and suicidal ideation among emerging adults with diabetes. Survey design-adjusted bivariate and multivariable logistic regression models were used for statistical analyses. Results: The study included 1,125 emerging adults (18-25 years old), with a history of type 1 diabetes (T1D) or type 2 diabetes (T2D). After controlling for sociodemographic and health-related characteristics, we found lower odds of having past-year major MDE for non-Hispanic Black (AOR, 0.42, p=0.032) compared to their non-Hispanic White counterparts. Females were 3.02 times more likely to have past-year MDE than males (AOR, 3.02, p=0.004). The odds of having past-year MDE were 1.96 times higher among individuals who identified as LGB (lesbian, gay, bisexual) (AOR, 1.96, P=0.038). There were no statistically significant disparities in suicidal ideation related to race/ethnicity, sex, education, and family income. However, individuals who identified as LGB had significantly higher likelihood of suicidal ideation than their heterosexual counterparts (AOR, 2.47, P=0.004). Conclusion: Significant disparities related to MDE and suicidal ideation exist based on race/ethnicity, gender, and sexual orientation. Integration of a mental health professional into the multidisciplinary diabetes care team is critical for effective management of comorbid mental health conditions in younger patients with diabetes.