ObjectivesOtitis media (OM) is a ubiquitous pediatric disease leading to a significant health care burden. There is no medication beneficial to resolving COM fluid, highlighting the need for research in the field. Crucially, current human middle ear epithelial cell models are transformed cells not recapitulating physiological functions. Herein, we describe a new method to proliferate and differentiate pediatric primary middle ear epithelial cells (pMEEC) from patients as a physiological model for the study of OM.MethodsWe adapted a cell reprogramming protocol using irradiated fibroblast feeder medium in addition to Rho kinase inhibitor to proliferate pMEEC collected during cochlear implant surgery. Cells were plated on transwell membranes, proliferated with conditionally reprogrammed culture medium, and transferred to air–liquid interface (ALI). Cultures were maintained for 4 weeks at ALI, photos were taken and cell lysates and secretions were collected over time for characterization analysis using quantitative polymerase chain reaction, Western bolt, and proteomics. Keratins, MUC5B and MUC5AC mucins, and beta tubulin (TUBB) were analyzed at the mRNA and protein level.ResultsCultures took a mean of 2 weeks to proliferate before transwell plating and forming a tight epithelium at ALI from 2 to 4 weeks. Although mRNA expression of MUC5B, MUC5AC, TUBB, and keratin 5 (KRT5) were variable depending on the differentiation stage and the patient, both TUBB and KRT5 proteins were detected until week 2.ConclusionWe demonstrate a novel method to proliferate and differentiate pMEECs that express epithelial markers and that are able to secrete mucins for the study of OM.Level of EvidenceNA
Background: Oral cavity cancer (OCC) and laryngeal cancer (LC) are among the most common cancers worldwide. This study investigated survival in non-Hispanic (NH) Black, NH White, Asian, and Hispanic OCC and LC patients of low, intermediate, and high neighborhood socioeconomic status (nSES). Methods: We used data from the SEER 18 Census Tract-level SES and Rurality Database of the National Cancer Institute to create cohorts of OCC and LC patients from 2013-2018. Univariate survival analysis was performed with KM curves and log-rank p-values by nSES and then the cross-classification of race, ethnicity, and nSES. We used Cox proportional hazards regression model for multivariable analysis. Results: Higher nSES was associated with better OCC survival for NH White, NH Black, and Asian patients, and better LC survival for NH White, NH Black, Hispanic, and Asian patients. In the multivariable analyses of both OCC and LC survival, NH Black patients had worse survival than NH White patients in the high nSES tertile. NH Black patients with OCC were at higher risk of death than NH White patients at all nSES levels. Conversely, Asian patients with LC demonstrated better survival than other races within the high nSES. Conclusion: Overall survival differs between racial and ethnic groups of similar nSESs. These health disparities in OCC and LC patients reflect broader inequities in the cancer control continuum. Impact: The cross-classification of race,ethnicity, and nSES revealed disparities in the 5-year overall survival of OCC and LC patients, highlighting the importance of intersectionality in the discussion of health equity.
Objective. To systematically review the literature to determine the prevalence and risk of the free flap and postoperative complications in scalp-free tissue reconstruction with synthetic mesh cranioplasty.Data Sources. Search strategies created with a medical librarian were implemented using multiple databases in May 2021.Review Methods. Two reviewers independently performed the review, data extraction, and quality assessment. Cohort studies of patients with scalp-free tissue reconstruction with or without mesh cranioplasty were included. Studies that did not report whether mesh was used or did not separate outcomes by mesh use were excluded. The primary outcomes were free flap failure and postoperative complications. A random-effects model was used for the metaanalysis to estimate prevalence and prevalence ratios (PRs).Results. A total of 28 studies and 440 cases of scalp-free tissue reconstruction were included. The pooled prevalence of free flap failures and postoperative complications in patients with mesh cranioplasty was estimated at 7% (95% confidence interval [CI], 3%-17%; p = .85, I 2 = 0%) and 21% (95% CI, 14%-31%; p = .44, I 2 = 0%), respectively. In a subgroup analysis, mesh cranioplasty was not associated with a significantly increased risk of free flap failure or postoperative complications when compared to cases without mesh cranioplasty; pooled PR 1.21 (95% CI, 0.50-2.88; p = .90, I 2 = 0%) for free flap failure and PR 1.85 (95% CI, 0.89-3.85; p = .28, I 2 = 19) for postoperative complications.Conclusion. Synthetic mesh cranioplasty does not significantly increase the risk of free flap compromise or postoperative complications. A higher prevalence of postoperative recipient site complications was observed in patients with mesh cranioplasty.
Given the importance of proactively supporting women trainees in medicine to address gender inequities, we draw on the experience of a well-established professional development initiative to provide a framework for other institutions seeking to create similar trainee-focused programs.
<p>Hazard ratios, 95% confidence intervals, and p-values of oral cavity and larynx cancer patients in a multivariable analysis.</p>
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