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"Allen, M."
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Shifting stories : history, gossip, and lore in narratives from Tang dynasty China
\"Explores the tale literature of eighth- and ninth-century China to show how the written tales we have today grew out of a fluid culture of hearsay that circulated within elite society. The author focuses on two main types of tales, those based in gossip about recognizable public figures and those developed out of lore concerning the occult\"--Provided by the publisher.
Book
Barriers to health equity in the United States of America: can they be overcome?
Health equity—defined by the Centers for Disease Control and Prevention as \" the state in which everyone has a fair and just opportunity to attain their highest level of health—” represents one of the most critical issues facing modern societies. While seemingly an increasing focus of policymakers in recent years, this concept is hardly a novel one. In 1948, the inaugural Constitution of the newly founded World Health Organization clearly stated that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” Yet nearly a century later, it is arguable how much progress society has made in achieving health equity, particularly in the United States of America where numerous factors at both the level of the individual and population contribute to significant complexity with respect to healthcare access and delivery. The purpose of this review is to thus outline the barriers to health equity so that thoughtful discourse can be promoted to create a more even playing field for the lives of the disadvantaged and underserved in the future.
Journal Article
Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group
- Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose.
- To provide updated, practical guidelines for the pathologic diagnosis of MM.
- Pathologists involved in the International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks.
- There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohistochemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10% is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.
Journal Article
Review: Control of feed intake by hepatic oxidation in ruminant animals: integration of homeostasis and homeorhesis
Feed intake is controlled through a combination of long- and short-term mechanisms. Homeorhetic mechanisms allow adaptation to changes in physiological states in the long term, whereas homeostatic mechanisms are important to maintain physiological equilibrium in the short term. Feed intake is a function of meal size and meal frequency that are controlled by short-term mechanisms over the timeframe of minutes that are modulated by homeorhetic signals to adapt to changes in the physiological state. Control of feed intake by hepatic oxidation likely integrates these mechanisms. Signals from the liver are transmitted to brain feeding centers via vagal afferents and are affected by the hepatic oxidation of fuels. Because fuels oxidized in the liver are derived from both the diet and tissues, the liver is able to integrate long- and short-term controls. Whereas multiple signals are integrated in brain feeding centers to ultimately determine feeding behavior, the liver is likely a primary sensor of energy status.
Journal Article
Socioeconomic factors predictive of access delays in oncology
Purpose
To identify demographic and socioeconomic factors predictive of access delays in patients referred for radiation oncology services.
Methods and materials
A prospective data registry of consecutive patients referred for initial consultation from October 2018 to April 2022 was reviewed. To evaluate access, the number of business days from referral to consultation was calculated. Demographic characteristics recorded included age, gender, race, language preference, and insurance status. Zip code data linked to a patient’s residential address was used to classify socioeconomic status (SES) based on publicly available data on median household income. Descriptive statistics were presented to identify factors predictive of delays in the time from referral to consultation.
Results
A total of 9,241 consecutive patients were referred and logged into the database during the 4-year period, of which 5,321 were scheduled, registered, and seen in the outpatient setting. Delays in access were associated with low SES and Black race (
p
< 0.05, for both). Three hundred and seventeen of the 1,203 patients (26%) in the lowest SES quartile had their appointments scheduled greater than 21 days from the time of referral compared to 482 of the 4,118 patients (12%) in the non-lowest quartile SES group (
p
< 0.001). Black patients were significantly less likely to have their appointments within 5 days compared to non-Black patients (17% versus 24%,
p
= 0.01). On multivariate analysis, the only variable independently associated with higher odds of appointment delays was SES (low-SES quartile versus non-low-SES quartile (OR = 3.98, 95% CI [2.01–7.92],
p
< 0.001).
Conclusions
SES factors related to geographical zip code predict for access delays in radiation oncology care. Targeted interventions are urgently warranted for low SES groups residing in underserved communities.
Journal Article
Genomic correlates of response to immune checkpoint blockade
Despite impressive durable responses, immune checkpoint inhibitors do not provide a long-term benefit to the majority of patients with cancer. Understanding genomic correlates of response and resistance to checkpoint blockade may enhance benefits for patients with cancer by elucidating biomarkers for patient stratification and resistance mechanisms for therapeutic targeting. Here we review emerging genomic markers of checkpoint blockade response, including those related to neoantigens, antigen presentation, DNA repair, and oncogenic pathways. Compelling evidence also points to a role for T cell functionality, checkpoint regulators, chromatin modifiers, and copy-number alterations in mediating selective response to immune checkpoint blockade. Ultimately, efforts to contextualize genomic correlates of response into the larger understanding of tumor immune biology will build a foundation for the development of novel biomarkers and therapies to overcome resistance to checkpoint blockade.
Responders and non-responders to cancer immunotherapy can be identified through a range of genomic markers.
Journal Article