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Article ; Online: Acupuncture Reduces Severity of Hot Flashes in Breast Cancer: A Randomized Single-Blind Trial.

Serra, Diane / Fleishman, Stewart B / White, Carol / Leung, Tung Ming / Chadha, Manjeet

2023 Volume 37, Issue 6, Page(s) 330–336

Abstract: This study evaluated the effectiveness of traditional Chinese medicine-based therapeutic acupuncture (TA) in reducing the severity of hot flashes (HFs) in breast cancer patients and compared the effectiveness of TA to "sham" placebo acupuncture (SA). ... ...

Abstract	This study evaluated the effectiveness of traditional Chinese medicine-based therapeutic acupuncture (TA) in reducing the severity of hot flashes (HFs) in breast cancer patients and compared the effectiveness of TA to "sham" placebo acupuncture (SA). Subjects experiencing more than 10 episodes of HF/week were randomly assigned to TA or SA. The response was assessed by the Menopause-specific Quality of Life (MenQoL) scale, scoring the subject's perception of the severity of HFs. HFs were scored at baseline, after treatment, and 1-month follow-up. A total of 54 subjects enrolled (28 TA and 26 SA). Seven women withdrew from the study. A hot flash diary documented the number of HFs a subject experienced. Analysis included 47 subjects (27 TA and 20 SA). A statistically significant response in HF scores was noted in the TA group compared with the SA group (P = .0064.) On average HF scores dropped by 1.89 with TA, and only 0.16 with SA. At follow-up, TA subjects had a sustained response. TA is effective in reducing the intensity and severity of HF. With SA, no relative response/change in HF scores was noted. Larger studies and longer follow-up to assess durability of response to TA are needed.
MeSH term(s)	Humans ; Female ; Hot Flashes/drug therapy ; Breast Neoplasms/complications ; Breast Neoplasms/therapy ; Quality of Life ; Single-Blind Method ; Treatment Outcome ; Acupuncture Therapy ; Menopause
Language	English
Publishing date	2023-11-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	639032-8
ISSN	1550-5138 ; 0887-9311
ISSN (online)	1550-5138
ISSN	0887-9311
DOI	10.1097/HNP.0000000000000612
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Article ; Online: SMARCA4-deficient anaplastic carcinoma arising in a primary retroperitoneal mucinous adenocarcinoma.

Ching, Daniel / Ruba, Sukeerat / Soma, Anita / Leung, Yee Chit / Stewart, Colin J R

Pathology

2021 Volume 54, Issue 3, Page(s) 376–378

MeSH term(s)	Adenocarcinoma, Mucinous/diagnosis ; Adenocarcinoma, Mucinous/pathology ; DNA Helicases ; Humans ; Nuclear Proteins ; Transcription Factors
Chemical Substances	Nuclear Proteins ; Transcription Factors ; SMARCA4 protein, human (EC 3.6.1.-) ; DNA Helicases (EC 3.6.4.-)
Language	English
Publishing date	2021-09-10
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2021.06.118
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Article ; Online: The future of sustainable polar ship-based tourism

Liggett, Daniela / Cajiao, Daniela / Lamers, Machiel / Leung, Yu-Fai / Stewart, Emma J.

Cambridge Prisms: Coastal Futures

2023 Volume 1

Abstract: Over the last couple of decades, polar tourism has significantly grown in the number of visitors and diversified in terms of the tourism activities offered. The COVID-19 pandemic brought polar tourism to a halt and has prompted researchers, operators and ...

Abstract	Over the last couple of decades, polar tourism has significantly grown in the number of visitors and diversified in terms of the tourism activities offered. The COVID-19 pandemic brought polar tourism to a halt and has prompted researchers, operators and policy-makers alike to reflect on how Arctic and Antarctic tourism have developed, how they are being managed and governed and, importantly, how tourism operators influence polar socio-ecological systems. Given the dominance of ship-based tourism over other types of tourism in the Polar Regions, we discuss the cornerstones of how polar ship-based tourism has developed over the last 50 years and explore the relevant international and regional governance regimes in this article. We identify which positive and negative biophysical, socio-cultural and economic impacts arising from polar tourism have been identified by researchers. It is difficult, if not impossible, to disentangle impacts caused by tourism alone from those that result from the interactions of multiple pressures at all levels (local, regional and global), and more research is needed to develop reliable and effective indicators to monitor tourism impacts. In addition, a better understanding is needed about the role tourist experiences might play in potentially encouraging long-term positive behavioural changes among visitors to the Polar Regions. The COVID-19 pandemic has provided an important opportunity to review polar tourism development and management, and to ask whether an emphasis should be placed on ‘degrowth’ of the sector in the future.
Keywords	Life Science
Subject code	910
Language	English
Publishing country	nl
Document type	Article ; Online
ISSN	2754-7205
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Article ; Online: Systemic corticosteroids in fibrotic lung disease: a systematic review and meta-analysis.

Pitre, Tyler / Kawano-Dourado, Leticia / Kachkovski, George V / Leung, Darren / Leung, Gareth / Desai, Kairavi / Zhai, Chunjuan / Adams, Wendy / Funke-Chambour, Manuela / Kreuter, Michael / Stewart, Iain / Ryerson, Christopher J / Jenkins, Gisli / Zeraatkar, Dena

BMJ open respiratory research

2023 Volume 10, Issue 1

Abstract: Objectives: We aimed to assess the available evidence for corticosteroids in fibrotic interstitial lung disease (fILD) to inform the randomised embedded multifactorial adaptive platform ILD.: Design: Systematic review and meta-analysis.: Data ... ...

Abstract	Objectives: We aimed to assess the available evidence for corticosteroids in fibrotic interstitial lung disease (fILD) to inform the randomised embedded multifactorial adaptive platform ILD. Design: Systematic review and meta-analysis. Data sources: We searched Embase, Medline, Cochrane CENTRAL and Web of Science databases from inception to April 17 2023. Eligibility criteria: We included studies that compared corticosteroids with standard care, placebo or no treatment in adult patients with fILD. Data extraction and synthesis: We report on the change in forced vital capacity (FVC) and mortality. We used random-effects meta-analysis to estimate relative risk (RR) for dichotomous outcomes, and mean difference (MD) and standardised MDs for continuous outcomes, with 95% CIs. Results: Of the 13 229 unique citations identified, we included 10 observational studies comprising 1639 patients. Corticosteroids had an uncertain effect on mortality compared with no treatment (RR 1.03 (95% CI 0.85 to 1.25); very low certainty evidence). The effect of corticosteroids on the rate of decline in FVC (% predicted) was uncertain when compared with no treatment (MD 4.29% (95% CI -8.26% to 16.83%); very low certainty evidence). However, corticosteroids might reduce the rate of decline in FVC in patients with non-idiopathic pulmonary fibrosis (IPF) fILD (MD 10.89% (95% CI 5.25% to 16.53%); low certainty evidence), while an uncertain effect was observed in patients with IPF (MD -3.80% (95% CI -8.94% to 1.34%); very low certainty evidence). Conclusions: The current evidence on the efficacy and safety of corticosteroids in fILD is limited and of low certainty. Randomised trials are needed to address this significant research gap.
MeSH term(s)	Adult ; Humans ; Adrenal Cortex Hormones/therapeutic use ; Lung Diseases, Interstitial/drug therapy ; Vital Capacity
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2023-12-30
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2023-002008
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Article: The Psychological Distress of Food Insecurity: A Qualitative Study of the Emotional Experiences of Parents and Their Coping Strategies.

Leung, Cindy W / Laraia, Barbara A / Feiner, Christina / Solis, Karina / Stewart, Anita L / Adler, Nancy E / Epel, Elissa S

Journal of the Academy of Nutrition and Dietetics

2022 Volume 122, Issue 10, Page(s) 1903–1910.e2

Abstract: Background: Food insecurity increases the risks of diet-related chronic disease and mental health outcomes in low-income adults; however, the pathways underlying these associations have not been clearly identified. Chronic, psychological distress may ... ...

Abstract	Background: Food insecurity increases the risks of diet-related chronic disease and mental health outcomes in low-income adults; however, the pathways underlying these associations have not been clearly identified. Chronic, psychological distress may represent an important pathway between food insecurity and health. Objective: To identify types of psychological distress, experiential descriptions, and the array of emotional responses and coping strategies specific to food insecurity among parents with children DESIGN: A phenomenological qualitative study using one-on-one, in-depth interviews. Participants and setting: Forty-eight adults (parents) were recruited from the San Francisco Bay Area in 2016-17. Eligibility criteria included any experience of household food insecurity over the past 12 months, having a child aged 7 to 14 years, and both parent and child with the ability to speak English fluently. Statistical analyses: Data were analyzed using the constant comparative method to reveal emergent themes across multiple interviews. Results: Parents discussed six themes related to the psychological distress of food insecurity: stress from the logistical and financial balancing act of feeding one's family, frustration and lack of choice associated with the high costs of healthy foods, stigma of using community resources, shame of not being able to provide for one's family, sadness about their cyclical and chronic food situation, and guilt over their inability to adequately provide for their children. Coping responses included negative responses, such as sleeping and drinking to avoid thinking about food insecurity, and positive responses of relying on their friends and family for support, staying hopeful, and spending time with their children. Conclusions: The commonality of emotional responses stemming from the experience of food insecurity can increase the risk for clinical anxiety and depression. Future development of interventions and policies to alleviate food insecurity must include social support and adequate safety systems.
MeSH term(s)	Adaptation, Psychological ; Adult ; Child ; Emotions ; Food Insecurity ; Food Supply ; Humans ; Parents/psychology ; Psychological Distress ; Stress, Psychological
Language	English
Publishing date	2022-05-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2646718-5
ISSN	2212-2672
ISSN	2212-2672
DOI	10.1016/j.jand.2022.05.010
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Article ; Online: High-Density Surface Electromyography for Swallowing Evaluation in Post-Radiation Dysphagia.

Leung, Karman Ka Ying / Fong, Raymond / Zhu, Mingxing / Li, Guanglin / Chan, Jason Ying Kuen / Stewart, Michael / Ku, Peter Ka Ming / Lee, Kathy Yuet Sheung / Tong, Michael Chi Fai

The Laryngoscope

2023 Volume 133, Issue 11, Page(s) 2920–2928

Abstract: Objectives: Our study aimed to investigate the feasibility of using high-density surface electromyography (HD-sEMG) for swallowing assessment by comparing the quantitative parameters and topographic patterns of HD-sEMG between post-irradiated patients ... ...

Abstract	Objectives: Our study aimed to investigate the feasibility of using high-density surface electromyography (HD-sEMG) for swallowing assessment by comparing the quantitative parameters and topographic patterns of HD-sEMG between post-irradiated patients and healthy individuals. Methods: Ten healthy volunteers and ten post-irradiated nasopharyngeal carcinoma patients were recruited. 96-channel HD-sEMG was recorded although each participant consumed different consistencies of food (thin and thick liquid, puree, congee, and soft rice). Dynamic topography was generated from the root mean square (RMS) of the HD-sEMG signals to illustrate the anterior neck muscle function in the swallowing process. The averaged power of muscles and the symmetry of swallowing patterns were assessed by objective parameters including average RMS, Left/Right Energy Ratio, and Left/Right Energy Difference. Results: The study showed different swallowing patterns between patients with dysphagia and healthy individuals. The mean RMS values were higher in the patient group compared to the healthy group, but the difference was not statistically significant. Asymmetrical patterns were shown in patients with dysphagia. Conclusion: HD-sEMG is a promising technique that could be used to quantitatively evaluate the average power of neck muscles and the symmetry of swallowing activities in patients with swallowing difficulties. Level of evidence: Level 3 Laryngoscope, 133:2920-2928, 2023.
MeSH term(s)	Humans ; Electromyography/methods ; Deglutition Disorders/diagnosis ; Deglutition Disorders/etiology ; Deglutition/physiology ; Neck Muscles ; Muscle Contraction
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.30679
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Article ; Online: Cytoarchitecture of ex vivo midgut cultures of unfed Ixodes scapularis infected with a tick-borne flavivirus.

Ochwoto, Missiani / Offerdahl, Danielle K / Leung, Jacqueline M / Schwartz, Cindi L / Long, Dan / Rosenke, Rebecca / Stewart, Philip E / Saturday, Greg A / Bloom, Marshall E

Ticks and tick-borne diseases

2023 Volume 15, Issue 2, Page(s) 102301

Abstract: A bite from an infected tick is the primary means of transmission for tick-borne flaviviruses (TBFV). Ticks ingest the virus while feeding on infected blood. The traditional view is that the virus first replicates in and transits the tick midgut prior to ...

Abstract	A bite from an infected tick is the primary means of transmission for tick-borne flaviviruses (TBFV). Ticks ingest the virus while feeding on infected blood. The traditional view is that the virus first replicates in and transits the tick midgut prior to dissemination to other organs, including salivary glands. Thus, understanding TBFV infection in the tick midgut is a key first step in identifying potential countermeasures against infection. Ex vivo midgut cultures prepared from unfed adult female Ixodes scapularis ticks were viable and remained morphologically intact for more than 8 days. The midgut consisted of two clearly defined cell layers separated by a basement membrane: an exterior network of smooth muscle cells and an internal epithelium composed of digestive generative cells. The smooth muscle cells were arranged in a stellate circumferential pattern spaced at regular intervals along the long axis of midgut diverticula. When the cultures were infected with the TBFV Langat virus (LGTV), virus production increased by two logs with a peak at 96 hours post-infection. Infected cells were readily identified by immunofluorescence staining for the viral envelope protein, nonstructural protein 3 (NS3) and dsRNA. Microscopy of the stained cultures suggested that generative cells were the primary target for virus infection in the midgut. Infected cells exhibited an expansion of membranes derived from the endoplasmic reticulum; a finding consistent with TBFV infected cell cultures. Electron microscopy of infected cultures revealed virus particles in the basolateral region between epithelial cells. These results demonstrated LGTV replication in midgut generative cells of artificially infected, ex vivo cultures of unfed adult female I. scapularis ticks.
MeSH term(s)	Female ; Animals ; Ixodes ; Flavivirus/genetics ; Encephalitis Viruses, Tick-Borne/genetics ; Salivary Glands ; Microscopy, Electron ; RNA, Double-Stranded
Chemical Substances	RNA, Double-Stranded
Language	English
Publishing date	2023-12-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541872-5
ISSN	1877-9603 ; 1877-959X
ISSN (online)	1877-9603
ISSN	1877-959X
DOI	10.1016/j.ttbdis.2023.102301
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Article ; Online: Predictors of endometrial carcinoma in patients with atypical endometrial hyperplasia at a tertiary gynaecological cancer centre in Western Australia.

Rajadurai, Vinita Angeline / Chivers, Paola / Ayres, Chloe / Mohan, Ganendra Raj / Stewart, Colin John Reid / Leung, Yee Chit / Wan, King Man / Cohen, Paul Andrew

The Australian & New Zealand journal of obstetrics & gynaecology

2021 Volume 61, Issue 2, Page(s) 275–283

Abstract: Aim: Our objective was to assess clinical and pathological factors associated with a final diagnosis of endometrial carcinoma in patients with atypical endometrial hyperplasia with a particular emphasis on the grading of atypia.: Materials and methods! ...

Abstract	Aim: Our objective was to assess clinical and pathological factors associated with a final diagnosis of endometrial carcinoma in patients with atypical endometrial hyperplasia with a particular emphasis on the grading of atypia. Materials and methods: A retrospective review over five years on patients (N = 97) who underwent hysterectomy for a diagnosis of atypical endometrial hyperplasia at a statewide public tertiary gynaecologic oncology centre. Clinical and pathological characteristics were obtained. Results: The rate of concurrent endometrial carcinoma was 34% (n = 33) with most being stage 1A endometrioid. A significant group difference was reported for age at diagnosis (t = -2.20 P = 0.031 d = 0.43) with carcinoma patients on average older (M Conclusion: Severe atypical hyperplasia and postmenopausal status were significant predictors of concurrent endometrial carcinoma in patients with atypical endometrial hyperplasia. The grading of atypical hyperplasia may be utilised by gynaecologic oncologists in the triage and referral process of managing these patients; however, the grading system requires external validation in larger prospective studies.
MeSH term(s)	Endometrial Hyperplasia/epidemiology ; Endometrial Hyperplasia/surgery ; Endometrial Neoplasms/epidemiology ; Endometrial Neoplasms/surgery ; Female ; Humans ; Hysterectomy ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Western Australia
Language	English
Publishing date	2021-01-06
Publishing country	Australia
Document type	Journal Article
ZDB-ID	390815-x
ISSN	1479-828X ; 0004-8666
ISSN (online)	1479-828X
ISSN	0004-8666
DOI	10.1111/ajo.13300
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Article ; Online: The Paradox of Readmission Prevention Interventions: Missing Those Most in Need.

Hoyer, Erik H / Golden, Blair / Dougherty, Geoff / Richardson, Melissa / Lepley, Diane / Leung, Curtis / Deutschendorf, Amy / Brotman, Daniel J / Stewart, Rosalyn W

The American journal of medicine

2021 Volume 134, Issue 9, Page(s) 1142–1147

Abstract: Background: Post-hospitalization transition interventions remain a priority in preventing rehospitalization. However, not all patients referred for readmission prevention interventions receive them. We sought to 1) define patient characteristics ... ...

Abstract	Background: Post-hospitalization transition interventions remain a priority in preventing rehospitalization. However, not all patients referred for readmission prevention interventions receive them. We sought to 1) define patient characteristics associated with non-receipt of readmission prevention interventions (among those eligible for them), and 2) determine whether these same patient characteristics are associated with hospital readmission at the state level. Methods: We used state-wide data from the Maryland Health Services Cost Review Commission to determine patient-level factors associated with state-wide readmissions. Concurrently, we conducted a retrospective analysis of discharged patients referred to receive 1 of 3 post-discharge interventions between January 2013 and July 2019-a nurse transition guide, post-discharge phone call, or follow-up appointment in our post-discharge clinic-to determine patient-level factors associated with not receiving the intervention. Multivariable generalized estimating equation logistic regression models were used to calculate the odds of not accepting or not receiving the interventions. Results: Older age, male gender, black race, higher expected readmission rate, and lower socioeconomic status were significantly associated with 30-day readmission in hospitalized Maryland patients. Most of these variables (age, sex, race, payer type [Medicaid or non-Medicaid], and socioeconomic status) were also associated with non-receipt of intervention. Conclusions: We found that many of the same patient-level characteristics associated with the highest readmission risk are also associated with non-receipt of readmission reduction interventions. This highlights the paradox that patients at high risk of readmission are least likely to accept or receive interventions for preventing readmission. Identifying strategies to engage hard-to-reach high-risk patients continues to be an unmet challenge in readmission prevention.
MeSH term(s)	Aftercare/methods ; Aftercare/organization & administration ; Aftercare/statistics & numerical data ; Aged ; Continuity of Patient Care ; Female ; Humans ; Male ; Maryland/epidemiology ; Patient Acceptance of Health Care/statistics & numerical data ; Patient Discharge ; Patient Readmission/statistics & numerical data ; Patient Transfer/methods ; Patient Transfer/statistics & numerical data ; Preventive Health Services/methods ; Risk Assessment ; Sex Factors ; Socioeconomic Factors
Language	English
Publishing date	2021-05-07
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2021.04.006
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Article ; Online: Systemic corticosteroids in fibrotic lung disease

Michael Kreuter / Dena Zeraatkar / Iain Stewart / Gisli Jenkins / Leticia Kawano-Dourado / Christopher J Ryerson / Kairavi Desai / Manuela Funke-Chambour / Tyler Pitre / Gareth Leung / Chunjuan Zhai / George V Kachkovski / Darren Leung / Wendy Adams

BMJ Open Respiratory Research, Vol 10, Iss

a systematic review and meta-analysis

2023 Volume 1

Abstract: Objectives We aimed to assess the available evidence for corticosteroids in fibrotic interstitial lung disease (fILD) to inform the randomised embedded multifactorial adaptive platform ILD.Design Systematic review and meta-analysis.Data sources We ... ...

Abstract	Objectives We aimed to assess the available evidence for corticosteroids in fibrotic interstitial lung disease (fILD) to inform the randomised embedded multifactorial adaptive platform ILD.Design Systematic review and meta-analysis.Data sources We searched Embase, Medline, Cochrane CENTRAL and Web of Science databases from inception to April 17 2023.Eligibility criteria We included studies that compared corticosteroids with standard care, placebo or no treatment in adult patients with fILD.Data extraction and synthesis We report on the change in forced vital capacity (FVC) and mortality. We used random-effects meta-analysis to estimate relative risk (RR) for dichotomous outcomes, and mean difference (MD) and standardised MDs for continuous outcomes, with 95% CIs.Results Of the 13 229 unique citations identified, we included 10 observational studies comprising 1639 patients. Corticosteroids had an uncertain effect on mortality compared with no treatment (RR 1.03 (95% CI 0.85 to 1.25); very low certainty evidence). The effect of corticosteroids on the rate of decline in FVC (% predicted) was uncertain when compared with no treatment (MD 4.29% (95% CI −8.26% to 16.83%); very low certainty evidence). However, corticosteroids might reduce the rate of decline in FVC in patients with non-idiopathic pulmonary fibrosis (IPF) fILD (MD 10.89% (95% CI 5.25% to 16.53%); low certainty evidence), while an uncertain effect was observed in patients with IPF (MD −3.80% (95% CI −8.94% to 1.34%); very low certainty evidence).Conclusions The current evidence on the efficacy and safety of corticosteroids in fILD is limited and of low certainty. Randomised trials are needed to address this significant research gap.
Keywords	Medicine ; R ; Diseases of the respiratory system ; RC705-779
Subject code	610
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
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