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Objectives: Otomatch.comis an online forum for residency applicants to discuss the otolaryngology match process including academic metrics. The purpose of this study is to assess the accuracy of self-reported match data on Otomatch relative to official data reported by the National Residency Match Program (NRMP) and the Association of American Medical Colleges (AAMC).Methods: Data was collected from publicly editable Otomatch forums (2017-2018, 2018-2019, 2019-2020) and curated Otomatch survey responses (2018-2019, 2019-2020) whose results are released after Match Day. Aggregated data was collected from the NRMP 2018 and 2020 Charting Outcomes in the Match and AAMC Report on Residents (2017-2018, 2018-2019). Measures of interest included Step 1 scores, Step 2 CK scores, publications, number of interview invitations, number of interviews attended, and AOA status. ANOVA and 2 tailed Ttests were performed to compare variables within each match year.Results: Average Step 2 CK score was significantly higher on publicly editable Otomatch forums than AAMC in 2017-2018 (257vs 253, P< .05) and 2018-2019 (258vs 252, P< .05). Interviews attended were significantly higher on Otomatch survey responses than the publicly editable forum in 2019-2020 (13vs 9, P-value < .05). Step 1 scores, interview invitations, and AOA status were not statistically significantly different when data was available.Conclusion: Applicant statistics from online forums, online surveys, NRMP, and AAMC are consistent, except for Step 2 CK scores. Self-reported data on the Otomatch forum is an accurate estimate of academic metrics of otolaryngology residency applicants.

IMPORTANCE: There is epidemiologic evidence that the increasing incidence of thyroid cancer is associated with subclinical disease detection. Evidence for a true increase in thyroid cancer incidence has also been identified. However, a true increase in disease would likely be heralded by an increased incidence of thyroid-referable symptoms in patients presenting with disease. OBJECTIVES: To evaluate whether modes of detection (MODs) used to identify thyroid nodules for surgical removal have changed compared with historic data and to determine if MODs vary by geographic location. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective analysis of pathology and medical records of 1328 patients who underwent thyroid-directed surgery in 16 centers in 4 countries: 4 centers in Canada, 1 in Denmark, 1 in South Africa, and 12 in the US. The participants were the first 100 patients (or the largest number available) at each center who had thyroid surgery in 2019. The MOD of the thyroid finding that required surgery was classified using an updated version of a previously validated tool as endocrine condition, symptomatic thyroid, surveillance, or without thyroid-referable symptoms (asymptomatic). If asymptomatic, the MOD was further classified as clinician screening examination, patient-requested screening, radiologic serendipity, or diagnostic cascade. MAIN OUTCOMES AND MEASURES: The MOD of thyroid nodules that were surgically removed, by geographic variation; and the proportion and size of thyroid cancers discovered in patients without thyroid-referable symptoms compared with symptomatic detection. Data analyses were performed from April 2021 to February 2022. RESULTS: Of the 1328 patients (mean [SD] age, 52 [15] years; 993 [75%] women; race/ethnicity data were not collected) who underwent thyroid surgery that met inclusion criteria, 34% (448) of the surgeries were for patients with thyroid-related symptoms, 41% (542) for thyroid findings discovered without thyroid-referable symptoms, 14% (184) for endocrine conditions, and 12% (154) for nodules with original MOD unknown (under surveillance). Cancer was detected in 613 (46%) patients; of these, 30% (183 patients) were symptomatic and 51% (310 patients) had no thyroid-referable symptoms. The mean (SD) size of the cancers identified in the symptomatic group was 3.2 (2.1) cm (median [range] cm, 2.6 [0.2-10.5]; 95% CI, 2.91-3.52) and in the asymptomatic group, 2.1 (1.4) cm (median [range] cm, 1.7 [0.05-8.8]; 95% CI, 1.92-2.23). The MOD patterns were significantly different among all participating countries. CONCLUSIONS AND RELEVANCE: This retrospective analysis found that most thyroid cancers were discovered in patients who had no thyroid-referable symptoms; on average, these cancers were smaller than symptomatic thyroid cancers. Still, some asymptomatic cancers were large, consistent with historic data. The substantial difference in MOD patterns among the 4 countries suggests extensive variations in practice.

Purpose: The purpose of this book launch speech is to introduce the book I author, Can Hong Kong exceptionalism last? Dilemmas of governance and public administration over five decades 1970s-2020(2021). The book critically reviews the governance and public administration from 1970s to 2020, identifying strengths and capabilities as well as constraints and dilemmas. Design/methodology/approach: The book is based on my decades of academic observations and personal political experience by interpreting and re-interpreting the Hong Kong journey, with reflections on past assumptions and raising new questions. Findings: This book identifies five exceptional aspects: (a) Under British rule Hong Kong was governed as an atypical colony; (b) It was one of the Four Little Dragons as part of the East Asian Miracle; (c) In the 1990s, it was one of the regional pioneers in public sector reform; (d) The unique constitutional status of post-1997 Hong Kong as a Special Administrative Region (SAR) of China; (e) After reunification, the SAR government, though only semi-democratic, is checked by balancing and monitoring mechanisms no less vigorous than some developed democracies. It also examines various governance problems faced in the post-1997 period. Originality/value: Hong Kong is again in times of uncertainty and volatility. The city has entered a ‘second transition’ after 2020, and it is undergoing a bigger test than in 1997. After reviewing the past, I opine in the book that Hong Kong has to identify its niche areas, not only in economics. It needs a paradigm shift in how it relates to the Mainland within ‘One Country’ and how it relates to the world as a global metropolis.

Purpose: The purpose of this paper is to identify the underlying problems of the recent socio-political disturbance originated from the amendments of extradition law in Hong Kong. Design/methodology/approach: The perspectives of politics and governance are adopted to analyze the current situation. Findings: Three underlying problems are identified, including the existential crisis under “One Country, Two Systems”, the politics of “fear of losing” and the institutional weakness to reform and change under the current system of “Hong Kong people governing Hong Kong”. Originality/value: The Hong Kong Special Administrative Region Government should take initiatives to address the above problems.

The immunosuppressive transmembrane protein PD-L1 was shown to traffic via the multivesicular body (MVB) and to be released on exosomes. A high-content siRNA screen identified the endosomal sorting complexes required for transport (ESCRT)-associated protein ALIX as a regulator of both EGFR activity and PD-L1 surface presentation in basal-like breast cancer (BLBC) cells. ALIX depletion results in prolonged and enhanced stimulation-induced EGFR activity as well as defective PD-L1 trafficking through the MVB, reduced exosomal secretion, and its redistribution to the cell surface. Increased surface PD-L1 expression confers an EGFR-dependent immunosuppressive phenotype on ALIX-depleted cells. An inverse association between ALIX and PD-L1 expression was observed in human breast cancer tissues, while an immunocompetent mouse model of breast cancer revealed that ALIX-deficient tumors are larger and show an increased immunosuppressive environment. Our data suggest that ALIX modulates immunosuppression through regulation of PD-L1 and EGFR and may, therefore, present a diagnostic and therapeutic target for BLBC.

Évaluer les options pharmacologiques et non pharmacologiques actuellement offertes pour le déclenchement de l'ovulation chez les femmes atteintes d'un syndrome des ovaires polykystiques (SOPK).