Prognostic and Predictive Significance of Eukaryotic Elongation Factor 1D (eEF1D) in Breast Cancer: A Potential Marker of Response to Endocrine Therapy

Components of the protein synthesis machinery are subjected to alterations in cancer cells. eEF1D gene, which lies within the frequently amplified 8q24 locus, is one of the subunits of the human eukaryotic elongation factor complex. This study aimed to evaluate the prognostic and predictive significance of eEF1D in breast cancer using in silico analysis tools. For this purpose, we analyzed genomic alterations of the eEF1D gene using TCGA datasets via cBioPortal. Histopathological analysis was performed on patient tissue images obtained from cBioPortal and the Human Protein Atlas. Survival analysis was carried out using the KM Plotter and the prediction of response to therapy was assessed via the ROC Plotter. We found that eEF1D was highly amplified and overexpressed in breast invasive carcinoma. Increased expression of eEF1D was correlated with increased structural disorganization and morphological alterations at the cellular level, as well as a shorter period of overall survival. Furthermore, prediction of response to therapy showed that patients with eEF1D overexpression responded significantly better to endocrine therapy. In conclusion, our results suggest a cancer-promoting role for eEF1D, associated with poor prognosis and points towards its predictive value in providing better tailored treatment options for a patient.     

Demonstrating an approach for evaluating synthetic geospatial and temporal epidemiologic data utility: results from analyzing >1.8 million SARS-CoV-2 tests in the United States National COVID Cohort Collaborative (N3C)

ObjectiveThis study sought to evaluate whether synthetic data derived from a national coronavirus disease 2019 (COVID-19) dataset could be used for geospatial and temporal epidemic analyses.Materials and MethodsUsing an original dataset (n = 1 854 968 severe acute respiratory syndrome coronavirus 2 tests) and its synthetic derivative, we compared key indicators of COVID-19 community spread through analysis of aggregate and zip code-level epidemic curves, patient characteristics and outcomes, distribution of tests by zip code, and indicator counts stratified by month and zip code. Similarity between the data was statistically and qualitatively evaluated.ResultsIn general, synthetic data closely matched original data for epidemic curves, patient characteristics, and outcomes. Synthetic data suppressed labels of zip codes with few total tests (mean = 2.9 ± 2.4; max = 16 tests; 66% reduction of unique zip codes). Epidemic curves and monthly indicator counts were similar between synthetic and original data in a random sample of the most tested (top 1%; n = 171) and for all unsuppressed zip codes (n = 5819), respectively. In small sample sizes, synthetic data utility was notably decreased.DiscussionAnalyses on the population-level and of densely tested zip codes (which contained most of the data) were similar between original and synthetically derived datasets. Analyses of sparsely tested populations were less similar and had more data suppression.ConclusionIn general, synthetic data were successfully used to analyze geospatial and temporal trends. Analyses using small sample sizes or populations were limited, in part due to purposeful data label suppression—an attribute disclosure countermeasure. Users should consider data fitness for use in these cases.     

ARTHROSCOPIC EVALUATION AND MANAGEMENT OF MENISCAL INJURIES OF THE KNEE

50 cases of isolated meniscal injuries of the knee were evaluated and managed arthroscopically. 56% of the cases were in 25–35 year age group. In 80% of the cases military training and contact sports was the mode of injury. Maximum (42%) patients reported late (> 2 years) after the injury. On presentation, they had an average Lysholm knee score of 53.76. Medial meniscal lesion was seen in 74%. Commonest pattern of tear encountered was a longitudinal tear (40%). Depending on pattern and extent of lesion, partial meniscectomy (60%), subtotal meniscectomy (14%) and total meniscectomy (26%) were performed. Patients were followed up at six months and one year. The average Lysholm score at 6 months was 83.3 and at one year 79.5. At one year, the patient satisfaction level was 82% and patients who underwent partial meniscectomy had the best results.KEY WORDS: Arthroscopy, Meniscal tear     

Satisfaction and use of a spiritually based mantram intervention for childbirth-related fears in couples

This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word) intervention in expecting couples. A mixed-methods design, experimental repeated measures with interviews at 6-month follow-up was conducted. Satisfaction was moderate to high. Mantram was used for labor pains and uncertainty. Implications include scheduling flexible classes earlier in pregnancy. A larger randomized study is needed to assess intervention effectiveness.     

Leptomeningeal metastasis: MR imaging

Seven patients with central nervous system neoplasia and leptomeningeal metastases, proved either at initial diagnosis or on follow-up with contrast material-enhanced computed tomography (CT), were evaluated with magnetic resonance (MR) imaging. In two patients, diffuse sulcal enhancement on CT scans was inapparent on T1- or T2-weighted MR images. Likewise, in four patients diffuse cisternal enhancement on CT scans was not identifiable with MR. Nodular or focal cisternal masses were identified with both CT and MR imaging in three patients; in two, however, MR imaging provided less information. Ependymal and subependymal metastases identified with CT (two patients) were indistinguishable on MR images from periventricular abnormalities of radiation therapy and/or hydrocephalus. These findings suggest that leptomeningeal metastasis may be so subtle or inapparent as to be overlooked with MR imaging alone. Thus, CT and MR imaging should be considered complementary techniques for initial diagnosis and follow-up of tumors with a propensity for leptomeningeal metastasis.