Growing evidence points to a disruption of cortico-thalamo-cortical circuits in schizophrenia (SZ) and bipolar disorder (BD). Clues for a specific involvement of the thalamic reticular nucleus (TRN) come from its unique neuronal characteristics and neural connectivity, allowing it to shape thalamo-cortical information flow. A direct involvement of the TRN in SZ and BD has not been tested thus far. We used a combination of human postmortem and rodent studies to test the hypothesis that neurons expressing parvalbumin (PV neurons), a main TRN neuronal population, and associated Wisteria floribunda agglutinin-labeled perineuronal nets (WFA/PNNs) are altered in SZ and BD, and that these changes may occur early in the course of the disease as a consequence of oxidative stress. In both disease groups, marked decreases of PV neurons (immunoreactive for PV) and WFA/PNNs were observed in the TRN, with no effects of duration of illness or age at onset. Similarly, in transgenic mice with redox dysregulation, numbers of PV neurons and WFA/PNN+PV neurons were decreased in transgenic compared with wild type mice; these changes were present at postnatal day (P) 20 for PV neurons and P40 for WFA/PNN+PV neurons, accompanied by alterations of their firing properties. These results show profound abnormalities of PV neurons in the TRN of subjects with SZ and BD, and offer support for the hypothesis that oxidative stress may play a key role in impacting TRN PV neurons at early stages of these disorders. We put forth that these TRN abnormalities may contribute to disruptions of sleep spindles, focused attention and emotion processing in these disorders.

Purpose: The purpose of this study was to evaluate the reliability and educational content of YouTube videos concerning injuries to the posterior cruciate ligament (PCL) of the knee. Methods: The first 50 videos specific to the PCL identified through the YouTube query posterior cruciate ligament were evaluated by a method of video selection demonstrated to be feasible in prior YouTube studies. Videos were classified by content and upload source. Video reliability was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (score range 0-5). Video educational content was assessed using the Global Quality Score (GQS) (range 0-4) and the PCL Score (PCLS) (score range 0-18). Analysis of variance was used to determine differences in video reliability and educational content quality based on video content and upload source. Multivariate linear regressions were used to identify predictors of video reliability and educational content quality. Results: The mean number of views per video was 50,477.9 AE 15,036. Collectively, the 50 videos were viewed 14,141,285 times. Video content was classified primarily as information about disease (62.0%). The most common upload sources were physicians (24.0%) and nonphysician health care providers (26.0%). Significant between-group interactions were found between video source and the JAMA score, with physicians and medical sources having significantly higher mean JAMA scores (P ¼ 0.037). Videos uploaded by physicians were an independent positive predictor of greater JAMA scores (b:1.27; P ¼ 0.008). Videos uploaded by a medical source (b:2.06; P ¼ 0.038) were an independent positive predictor of a greater GQS. There were no independent associations between video content category or upload source and the PCLS. Conclusions: Videos concerning the PCL were frequently viewed on YouTube, but the educational quality and reliability of these videos were low. Clinical Relevance: Physicians and health care providers treating PCL pathology should take the initiative to counsel patients about which outside resources are reliable to better inform patients about their treatment decisions. With regard to YouTube videos specifically, providers should caution their patients that this source of information may be unreliable.

For osteosarcoma, staging criteria, prognosis estimates, and surgical recommendations have not yet changed to reflect increasingly sensitive computed tomography (CT) imaging. However, the frequent identification of micronodules (<5 mm) on presentation leaves clinicians in a difficult position regarding the need to biopsy, resect, or follow the lesions and whether to consider the patient metastatic or non-metastatic. Our objective was to compare the 5-year overall survival rates of patients with osteosarcoma with non-surgically resected lung micronodules on presentation to patients without micronodules to guide community oncologists faced with this common dilemma. We collected data retrospectively on all newly diagnosed osteosarcoma patients, aged less than 50, treated at Rush University Hospital over 25 years without pulmonary nodules >10 mm or pulmonary surgical intervention. Kaplan–Meier curves showed there was no difference in 5-year overall survival in patients with any size nodule <5 mm compared to patients with no nodules. Additionally, our study showed a survival advantage for those who presented with 0 or 1 nodule (90%) compared to ≥2 nodules (53%). Our data suggest surgery may not be necessary for singular nodules <5 mm identified on presentation, and that these patients behave more like “localized” patients than metastatic patients.

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Background: The impact of sarcopenia on the outcome of esophageal cancer patients remains unknown in North American populations. The current study aims to investigate if sarcopenia at the time of esophagectomy for locally-advanced esophageal cancer (LAEC) is associated with survival.Methods: Patients who underwent induction therapy followed by esophagectomy for LAEC between 2010-2018 at a single institution were identified. Exclusion criteria included follow-up less than 90 days and distant metastatic disease at the time of surgery. Demographic, treatment, and outcome data were retrospectively collected. Computed tomography (CT) scans following induction therapy were analyzed to calculate skeletal muscle index (SMI). Overall survival (OS) and disease-free survival (DFS) were examined using Kaplan-Meier and Cox Proportional Hazard regression analysis.Results: Overall, 52 patients met inclusion criteria with a median BMI of 25 (IQR, 22.4-29.1) kg/m 2 and age of 65 (IQR, 57-70) years. Sarcopenia was present in 75% (39/52) of patients at the time of surgery. Sarcopenic patients had a lower median BMI and higher median age when compared to non-sarcopenic patients. There was no difference in gender, race, stage, operative technique, post-operative complications, or hospital length of stay between sarcopenic and non-sarcopenic patients. With a median follow-up of 24.9 months, patients with sarcopenia at the time of esophagectomy had worse OS [median 24.3 (IQR, 9.9-34.5) vs. 50.9 (IQR, 25.6-50.9) months, P=0.0292] and DFS [median 11.7 (IQR,) months, P=0.0387] compared to non-sarcopenic patients.Conclusions: Sarcopenia is associated with reduced overall and DFS in patients undergoing esophagectomy for LAEC.