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Thymic stromal lymphopoietin (TSLP) is expressed primarily by epithelial cells, and induces inflammation at the time of tolerance failure in allergic disease. We found TSLP induced migration of immunocompetent cells to the disc in intervertebral disc disease by promoting the production of monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP-1α) by the intervertebral disc and these cells may be involved in the resorption of herniated disc tissue. Considering the pivotal role of TWEAK and TSLP we review our current understanding of these factors and their involvement in disc degeneration. © 2019 The Authors. JOR Spine published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society.Various functional magnetic resonance imaging (MRI) techniques have been investigated in recent years and are being used in clinical practice for the patients with low back pain (LBP). MRI is an important modality for diagnosing intervertebral disc (IVD) degeneration. In recent years, there have been several reported attempts to use MRI T2 mapping and MRI T1ρ mapping to quantify lumbar disc degeneration. MRI T2 mapping involves digitizing water content, proteoglycan content, and collagen sequence breakdown as relaxation times (T2 values) at each site. These digitized values are used to create a map, that is, then used to quantitatively evaluate the metabolite concentrations within IVD tissues. MRI T2 mapping utilizes the T2 relaxation time to quantify moisture content and the collagen sequence breakdown. MRI T1ρ mapping digitizes water molecule dispersion within the cartilaginous matrix to evaluate the degree of cartilaginous degeneration. Magnetic resonance spectroscopy is a less-invasive diagnostic test that provides biochemical information. PIK-75 PI3K inhibitor Adequate analysis of the IVD has not yet been performed, although there are indications of a relationship between the adipose content of the multifidus muscle in the low back and LBP. The ultra short TE technique has been recently used to investigate lumbar cartilaginous endplates. Unlike diagnosis based on contrast-enhanced images of the IVD, which depends on the recurrence of pain that is determined subjectively, MRI-based diagnosis is less-invasive and based on objective imaging findings. It is therefore expected to play a key role in the diagnostic imaging of IVD conditions in the future. © 2019 The Authors. JOR Spine published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society.Background There are increasing concerns about the potential impact of air pollution on chronic brain inflammation and microglia cell activation, but evidence of its carcinogenic effects is limited. Methods We used kriging interpolation and land use regression models to estimate long-term air pollutant exposures of oxides of nitrogen (NOx, NO2), kriging interpolation for ozone (O3), carbon monoxide, and particulate matter (PM2.5, PM10), and nearest monitoring station measurements for benzene for 103 308 men and women from the Multiethnic Cohort, residing largely in Los Angeles County from recruitment (1993-1996) through 2013. We used Cox proportional hazards models to examine the associations between time-varying pollutants and risk of malignant brain cancer (94 men, 116 women) and meningioma (130 men, 425 women) with adjustment for sex, race and ethnicity, neighborhood socioeconomic status, smoking, occupation, and other covariates. Stratified analyses were conducted by sex and race and ethnicity. Results Brain cancer risk in men increased in association with exposure to benzene (hazard ratio [HR] = 3.52, 95% confidence interval [CI] = 1.55 to 7.55) and PM10 (HR = 1.80, 95% CI = 1.00 to 3.23). Stronger associations with PM10 (HR = 3.02, 95% CI = 1.26 to 7.23), O3 (HR = 2.93, 95% CI = 1.09 to 7.88), and benzene (HR = 4.06, 95% CI = 1.17 to 18.2) were observed among Latino men. Air pollution was unrelated to risk of meningioma except that O3 exposure was associated with risk in men (HR = 1.77, 95% CI = 1.02 to 3.06). Brain cancer risk in women was unrelated to air pollution exposures. Conclusions Confirmation of these sex differences in air pollution-brain cancer associations and the stronger findings in Latino men in additional diverse populations is warranted. © The Author(s) 2020. Published by Oxford University Press.Background Clinical trial participation among racial and ethnic minorities remains low despite national efforts. We sought to determine how participation in clinical trials by breast surgical oncology patients has changed over time and what characteristics are associated with participation. Methods Women with breast cancer enrolled in National Cancer Institute-sponsored, cooperative-group trials from 2000 to 2012 and who underwent oncologic surgery (n = 17 125) were compared with trial-eligible women in the National Cancer Database diagnosed in 2000-2012 (n = 792 719). Race-specific trial participation was plotted over time by income and reported as a proportion of the combined cohorts. Factors associated with trial participation were estimated using logistic regression; we report odds ratios (ORs) with 95% confidence intervals (CIs). A P value less than .05 was considered statistically significant for all analyses. All tests were two-sided. Results Participation declined across all groups over time because tients. © The Author(s) 2019. Published by Oxford University Press.The DCISionRT test estimates the risk of an ipsilateral breast event (IBE) in patients with ductal carcinoma in situ (DCIS) as well as the benefit of adjuvant radiation therapy (RT). We determined the cost-effectiveness of DCISionRT using a Markov model simulating 10-year outcomes for 60-year-old women with DCIS based on nonrandomized data. Three strategies were compared no testing, no RT (strategy 1); test all, RT for elevated risk only (strategy 2); and no testing, RT for all (strategy 3). We used utilities and costs from the literature and Medicare claims to determine incremental cost-effectiveness ratios and examined the number of women irradiated per IBE prevented. In the base-case scenario, strategy 1 was the cost-effective strategy. Strategy 2 was cost-effective compared with strategy 3 when the cost of DCISionRT was less than $4588. The number irradiated per IBE prevented were 8.37 and 15.46 for strategies 2 and 3, respectively, relative to strategy 1. © The Author(s) 2020. Published by Oxford University Press.
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