Medicine and Health Sciences Commons^™

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Ménde, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Background: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.
Objective: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.
Study design: Prospective …

Plasma Biomarkers In Neuropsychiatric Syndromes: A Narrative Review, Zahinoor Ismail, Dylan X Guan, Ganesh Babulal, James Bateman, Marc Cantillon, Byron Creese, Fabrizia D'Antonio, Corinne Fischer, Jennifer Gatchel, Chinedu Momoh

Brain and Mind Institute

Neuropsychiatric symptoms (NPS) are common features of neurodegenerative disease (NDD) but are relatively understudied compared to cognition, especially regarding biomarkers. Further, emerging evidence describes the utility of systematic assessment of NPS across the cognitive continuum, even in advance of dementia. In this narrative review, we discuss the role of plasma biomarkers in relation to NPS across the cognitive continuum of unimpaired, subjective cognitive decline, mild cognitive impairment, and dementia. While Alzheimer's disease is the primary focus, vascular, Lewy body, and frontotemporal dementia etiologies are also discussed. Literature searches included NPS and dementia-related search terms with additional literature identified based on …

Botulinum Toxin In Stiff Person Syndrome: How Useful Is It In Helping Muscle Stiffness And Spasms?, Marinos Dalakas

Department of Neurology Faculty Papers

No abstract provided.

Enhancing Surgical Understanding Of Diabetic Foot Ulcer Classification Through Anatomage Integration: A Digital Approach To Wagner Grading, Nidhin John, Hooman Mir

School of Podiatric Medicine - Student Research

Background: Diabetic foot ulcers often lead to amputation, and accurate Wagner classification requires strong spatial understanding. Anatomage, a 3D digital anatomy tool, may improve this learning.

Methods: Thirty-six surgical trainees completed a pretest, explored digitally reconstructed Wagner grade 0–5 ulcers on Anatomage, and completed a posttest. Paired-sample analysis measured changes in accuracy, comprehension, and confidence.

Results: Classification accuracy improved from 61% to 89% (p < 0.05), with the greatest gains in higher Wagner grades. Participants reported clearer visualization of wound depth, bone involvement, and infection spread.

Conclusion: Anatomage enhances understanding and diagnostic precision of Wagner ulcer classification, supporting more effective limb-preservation education

Use Of Prophylaxis For Deep Venous Thrombosis And Pulmonary Embolism In Isolated Foot And Ankle Trauma, Regina Hansen, Alexander P. Rader, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

Background: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are relatively rare after foot and ankle surgery, especially after trauma. Diagnosing DVT is difficult, and even when it is discovered it does not necessarily clinically manifest on, for example, duplex ultrasound. Thus, it is often recommended that prophylaxis use be assessed on a case-by-case basis based on risk profile rather than being uniformly given or not prescribed.

Methods: We searched the National Trauma Data Bank Trauma Quality Programs Participant Use File for patients experiencing foot and ankle trauma from 2013 to 2017. Patients were identified using the International Classification of …

Hand Swelling And Other Non-Raynaud Phenomenon Symptoms As The Initial Presentation Of Systemic Sclerosis: Prevalence And Clinical Associations In Two Us Cohorts, Iqtidar Hanif, Shervin Assassi, Maureen D Mayes, Zsuzsanna H Mcmahan, Meng Zhang, Julio Charles, John M Vanburen, Jessica S Alvey, Kimia Ghaffari, Elana J Bernstein, Flavia V Castelino, Lorinda Chung, Luke Evnin, Tracy M Frech, Jessica K Gordon, Faye N Hant, Laura K Hummers, Dinesh Khanna, Kimberly S Lakin, Dorota Lebiedz-Odrobina, Yiming Luo, Ashima Makol, Jerry A Molitor, Duncan F Moore, Carrie Richardson, Nora Sandorfi, Ami A Shah, Ankoor Shah, Victoria K Shanmugam, Virginia D Steen, Elizabeth R Volkmann, Carleigh Zahn, Brian Skaug

Faculty, Staff and Student Publications

Objective: Raynaud phenomenon (RP) is often the initial clinical manifestation of systemic sclerosis (SSc), but some patients develop other manifestations first. To help elucidate the diversity of SSc presentation in its early stages, we describe the initial clinical manifestations and antinuclear antibody (ANA) profiles of patients in two early SSc cohorts.

Methods: All patient data in the Genetics vs Environment in Scleroderma Outcomes Study (GENISOS) and Collaborative National Quality and Efficacy Registry (CONQUER) cohorts were reviewed. Both studies enrolled patients within five years of the first non-RP symptom.

Results: In GENISOS and CONQUER, respectively, 194 (44.2%) of 439 and 292 …

A House Divided: A Mixed Method Investigation Of Primary Care Interprofessional Teams Using The Core Principles And Values Of Teamwork Framework, Erin L. Kelly, Catherine Guariglia, Jeanne Felter, Dhruvi Shah, Brooke Mauriello, Amy Cunningham, Chris Arenson, Randa Sifri

Department of Family & Community Medicine Faculty Papers

Context

Primary care teams are facing increased demands, turnover, and escalating rates of burnout. A primary care team aligned in its core values and organized according to common teamwork principles is essential for delivering patient-centered, coordinated, and effective healthcare.

Methods

As part of a series of studies on workplace factors and burnout among primary care practice team members, we selected an urban practice with high rates of burnout to assess their teamwork via a practice-wide survey and six focus groups divided by role. The interview guide focused on identifying areas for potential intervention around teamwork. Transcripts were open-coded using a …

Vestibular Migraine And Ssri Withdrawal: A Case Report, Grace Fairchild, Sarah Redding, Ashley G. Flagge

Ashley Flagge Publications

Vestibular migraine (VM) has been described as a diagnosis of exclusion, with no one singular definitive assessment for diagnosis. It has been suggested that possible pharmaceutical intervention for VM can include antidepressant drugs, but this is potentially complicated by the fact that dizziness is a common side effect of both use and withdrawal for certain types of antidepressant medications. This article describes the case of a 56-year old with probable VM, who was previously diagnosed with depression and treated with the selective serotonin reuptake inhibitor (SSRI) Citalopram. Following discontinuation with no taper, the patient experienced a series of withdrawal side …

Use Of An Electronic Medical Record Tool To Ensure Tertiary Survey Compliance In Pediatric Trauma Patients, Ryan T. Davis, Erica Surman, Begum Akay, Nathan Novotny, Anthony Stallion, Pavan Brahmamdam

Conference Presentation Abstracts

Introduction:
The purpose of the tertiary survey is to ensure that traumatic injuries that may be missed during the primary and secondary survey are identified and treated accordingly. After a review, our trauma program identified a quality gap where tertiary surveys were not being documented. The purpose of this study is to evaluate whether the use of an electronic medical record tool, in conjunction with a reporting process, improved documentation of the tertiary survey in pediatric trauma patients.

Methods:
A review of the pediatric trauma database was performed. Patients < 16 years old who were admitted after level 1 or 2 activations or trauma evaluations were included. The study period was between January 2023 and January 2024. An Epicâ„¢ SmartPhrase was developed with input from the pediatric surgery team, pediatric trauma nurse manager, and the general surgery residents. The residents and pediatric surgery attendings were educated and the smartphrase was implanted July 2023. Reviews were made on a month-to-month basis and if a patient did not have a tertiary survey documented, emails to the trauma attending and residents of record were sent, notifying them of missed documentation of a tertiary survey.

Results:
Tertiary survey documentation compliance in the six months prior to …

Lymphoma Imaging In Hiv And Non-Hiv Patients: A Retrospective Cross-Sectional Study With Clinical And Pathological Correlation, Poonamjeet Loyal, Edward Chege, Jasmit Shah, Anne Mwirigi, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Background: Patients with Human Immunodeficiency Virus (HIV)have an atypical imaging pattern of lymphoma. There is paucity of literature on differences in tumor volume or burden of disease amongst HIV positive patients compared with HIV negative patients and how this correlates with clinicopathological parameters of aggressiveness and prognosis.

Methods: This was a retrospective cross-sectional study of patients with non-Hodgkin lymphoma which were categorized into HIV positive and HIV negative. The tumor burden, disease sites, international prognostic score and Ki-67 index were recorded. Continuous variables were analyzed using the Kruskal Wallis test and categorical variables with Fisher’s Exact test.

Results …

Not All That Hurts Is Malignant: A Painful Case Of Focal Nodular Hyperplasia, Zamanali Khakhar, Abdullahi Abdigafar Yunis, Dayib Buthul, Khadija Warfa, Soraiya Manji, Rajiv Patel, Sayed Ali Raza Bukhari

Imaging & Diagnostic Radiology, East Africa

Focal nodular hyperplasia (FNH) is a benign hepatic lesion most often detected incidentally during imaging studies. While typically asymptomatic, a small subset of patients may present with abdominal pain or discomfort. Clinically and radiologically, FNH can mimic malignant liver tumors, occasionally resulting in unnecessary invasive procedures. This case report describes a 45-year-old woman with symptomatic FNH who was placed on routine imaging surveillance and managed conservatively. This case underscores the importance of accurately distinguishing this benign condition from hepatic malignancies. It further highlights the diagnostic challenges associated with achieving a definitive diagnosis.

A Rare Case Of Ogilvie’S Syndrome In A Pediatric Patient With A Complex Medical History, Kirby Lampe, Victoria Sarata, Aileen Har

Posters

Acute colonic pseudo-obstruction (ACPO) or Ogilvie’s syndrome is an acute dilatation of the small or large bowel without an obstructive lesion. Symptoms include abdominal distension, nausea and vomiting, constipation and occasional dyspnea. The disorder most commonly involves the cecum and right colon and is most frequently seen in male patients above the age of 60 (1). It is rare for Ogilvie’s to occur in the pediatric population though some infrequent instances have been reported. Here, we report a case of a patient with significant abdominal distension and gaseous distension seen on x-ray, which was diagnosed and treated as Ogilvie’s syndrome. …

A Case Report: Ansa Pancreatica As A Cause Of Recurrent Pancreatitis, Chase Branstetter, Elizaveta Khenner, Victoria Sarata, Nadia Ibrahimi

Posters

No abstract provided.

Challenges And Opportunities With Providing Genetic Testing And Counseling For Mucopolysaccharidosis Type Ii In Kenya, Lucy Mungai, Charles Njeru, Allan Njoroge, Michuki Maina, Syokau Ilovi, Dalton Wamalwa, Ruth Nduati, Beatrice Odongkara, Danny Miller

Pathology, East Africa

Background Limited or absent genetic counseling and testing resources in low- and medium-income countries lead to missed or late diagnoses for treatable metabolic conditions with irreversible complications. In some communities, misunderstanding about the etiology of a genetic condition may lead women whose children are affected to be viewed as a bad omen and become stigmatized or ostracized from their community. Mucopolysaccharidosis type II (MPS II), or Hunter syndrome, is a lysosomal storage disorder in which deficiency or inactivity of the enzyme iduronate-2-sulfatase leads to accumulation of glycosaminoglycans throughout the body. The diagnosis can be made through clinical assessment, enzyme activity …

Mortality Among Transgender Persons: A Taiwan Matched-Population And Sibling-Comparison Cohort Study, Chih-Wei Hsu, Yang-Chieh Brian Chen, Liang-Jen Wang, Mu-Hong Chen, Yao-Hsu Yang, Chih-Sung Liang, Po-Yen Chen, Edward Chia-Cheng Lai

Children’s Nutrition Research Center Staff Publications

Background: Transgender persons have been reported to experience excess mortality, but evidence is dominated by Western cohorts and seldom addresses familial confounding.

Methods: We conducted a nationwide, retrospective cohort study using two prespecified comparison designs: matched population controls (1:4, matched on legal sex and birth date) and within-family cisgender sibling comparisons. Transgender persons were identified by ≥2 psychiatrist-recorded gender identity disorder diagnoses during 2001-2021; cohort entry required age ≥6 years. Participants were followed until death or December 31, 2022. We compared all-cause, external-cause (suicide and accidents), and internal-cause mortality using Cox regression adjusted for sociodemographics and medical comorbidity.

Findings: Among …

Concerns Regarding The Standard Deviation Of Individual Responses For Assessing Treatment Response Heterogeneity, Aaron R Caldwell, David B Allison, Andrew W Brown, Gary L Gadbury, Thirupathi Reddy Mokalla, R Drew Sayer, Andrew D Vigotsky

Children’s Nutrition Research Center Staff Publications

The estimation of treatment response heterogeneity (TRH) is increasingly important as medicine moves toward personalized approaches. While various statistical methods have been proposed to quantify TRH in parallel-group trials, the standard deviation of individual responses (SDIR) has gained prominence within physiological research. This method is intended to quantify individual response variation by comparing standard deviations of change scores between intervention and control groups. We acknowledge that SDIR represents an improvement over many other flawed approaches that often involve responder counting. However, SDIR has critical limitations: 1) it cannot overcome the fundamental problem of causal inference because the correlation between potential …

Prevalent Vertebral Fracture Is Associated With Incident Cardiovascular Disease Events In Older Individuals Referred For Bone Densitometry, John T. Schousboe, Barret A. Monchka, J. Michael Davidson, Douglas Kimelman, Syed Zulqarnain Gilani, Zaid Ilyas, Siobhan Reid, Joshua R. Lewis, William D. Leslie

Research outputs 2022 to 2026

Background: It is unknown if prevalent vertebral fracture (PVFx) captured on bone density vertebral fracture assessment (VFA) images predicts incident CVD events. Methods: 11,760 individuals (mean [SD] age 75.7 [6.8] years, 94 % female) had VFA contemporaneously with bone densitometry in Manitoba, Canada, between February 2010 and December 2017, of whom 1919 (16.3 %) had ≥1 PVFx. This cohort was followed over a mean (SD) 3.8 (2.3) years for Major Adverse Cardiovascular Events (MACE, composite of hospitalization for myocardial infarction, non-hemorrhagic stroke, or all-cause mortality) and other CVD events (hospitalization for coronary artery disease, congestive heart failure, peripheral vascular disease, …

Factors Influencing Breast Cancer Screening Among Reproductive Age Women In Lesotho: Analysis Of The 2023-24 Demographic And Health Survey Using The Andersen Behavioral Model, Mesfin Abebe, Yordanos Sisay Asgedom, Amanuel Yosef Gebrekidan, Tsion Mulat Tebeje

Research outputs 2022 to 2026

Background Breast cancer is the leading cause of cancer-related deaths in women globally and a significant public health burden in sub-Saharan Africa, which accounts for approximately 15% of all cancer-related mortality. In sub-Saharan Africa, breast cancer incidences increased by 247% from 1990 to 2019. In Lesotho, breast cancer is the second most common cancer affecting women, a situation worsened by a fragile healthcare system and low screening rates. Despite its high morbidity and mortality, there is limited understanding of the factors influencing breast cancer screening among women of reproductive age. This study aims to identify these factors by utilizing the …

Uptake Of Covid-19 Vaccination And Associated Factors Among Patients Attending Oncology Services At The Ocean Road Cancer Institute In Dar Es Salaam, Tanzania: Insights From Mixed Design Methods’ Trajectory, David Makoko, Anthony Kapesa, Micheal Mugerwa, Mamsau Ngoma, Mark Mseti, Mary Lyimo, Lucy Kisaka, Ntuli Kapologwe, Jeremiah Seni

School of Nursing & Midwifery, East Africa

Background

COVID-19 vaccination campaigns have reduced disease severity and fatalities around the globe. Global data shows that 67.7% of the general population are vaccinated, and Tanzania has reported appealing findings of over 70% coverage among individuals over 18 years of age. However, a group-specific assessment of vaccination coverage is needed in sub-Saharan Africa. This study aimed at assessing the COVID-19 vaccination uptake and associated factors among cancer patients owing to their vulnerability.

Methods

A cross-sectional analytical study design was conducted in September 2022 at Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. A multistage sampling approach was employed …

Detection Of Left Ventricular Thrombus In Newly Diagnosed Heart Failure Patients: Diagnostic Accuracy Of 2d Transthoracic Echocardiography Compared With Cardiac Mri In A Kenyan Cohort, Barbara Karau, Nadeem Kassam, Mohamed Varwani, Jeilan Mohamed, Kevin Ombati, James Orwa, Mzee Ngunga

Internal Medicine, East Africa

Background Left ventricular thrombus (LVT) is a recognized complication of severe left ventricular (LV) systolic dysfunction. While cardiac magnetic resonance (CMR) Imaging is considered the gold standard due to its high sensitivity and specificity for detecting LVT, its availability remains limited in Sub-Saharan Africa. In contrast, 2D transthoracic echocardiography (TTE) is more accessible and commonly used in clinical practice. This study aimed to determine the incidence of LVT in patients with a left ventricular ejection fraction (LVEF) of less than 35% from any etiology, and to compare the diagnostic accuracy of TTE against CMR for its detection.

Methods This prospective, …

Implementation And Evaluation Of Infection Prevention And Control Training In Sub-Saharan Africa, David Odada, James Ndai, Ruth Thuku, Philip Adebayo

Internal Medicine, East Africa

No abstract provided.

Bridging The Gap: An Educational Intervention For The Early Introduction Of Peanut Protein In Pediatric Care, Rachel Gilson Dnp, Rnc-Ob, C-Onqs, Fnp-C, Parkview Health

Nursing Publications, Posters, & Presentations

Presented at the 6th Annual Parkview Nursing Research and Evidence-Based Practice Symposium. Theme: “From Paper to Practice: The Art of Implementation Science,” at the Parkview Mirro Center for Research and Innovation.

The primary aim of this Doctor of Nursing Practice (DNP) project was to improve provider adherence to the NIAID guidelines for the early introduction of peanut protein in infants under one year of age. The project intended to address identified knowledge and practice gaps through a targeted educational intervention at Fort Wayne Pediatrics (FWP).

Perceived Prejudice Or Discrimination In Medical Care Among Us Adults, Inimfon Jackson, Robert Yu, Joël Fokom Domgue, Sanjay Shete

Faculty, Staff and Student Publications

No abstract provided.

Use Of Robotic And Laparoscopic Surgery For Right Colectomies In Rural Areas: Are The Advantages Over Open Surgery Comparable To Those Reported In Urban Centers? An Analysis Using The Healthcare Cost And Utilization Project (Hcup) Michigan Inpatient Sample, Ryan T. Davis, Ibrahim B. Baida, Jacob A. Applegarth, Nathan M. Novotny

Conference Presentation Abstracts

Introduction: Surgical robotics have become more accessible in rural healthcare centers across Michigan, driving a growing demand for clinical outcomes data in these areas. National studies have shown that robotic colectomies reduce postoperative complications compared to open procedures, but data specific to rural settings remain limited. This study aims to compare postoperative complications following open, laparoscopic, and robotic right colectomies in rural Michigan.
Methods: The Healthcare Cost and Utilization Project (HCUP) Michigan inpatient database (2016-2018) was used to analyze postoperative complications after right colectomies in urban and rural hospitals. Complications analyzed included: prolonged ileus, pneumonia, surgical site infection, septicemia, hemorrhage/hematoma, …

Redefining Central Nervous System Multiple Myeloma: From Rare Phenomenon To Emerging Entity, Ian Landry, Adam F. Binder, Marc Yorker, Sarah Ramirez

Department of Medical Oncology Faculty Papers

BACKGROUND: Central nervous system involvement in multiple myeloma (CNS-MM) is considered a rare but devastating manifestation of extra-medullary disease (EMD) associated with aggressive biology and dismal outcomes. Treatment advances over the past few decades have improved survival in patients with MM, however, it has not translated into a similar survival benefit for those with CNS-MM. Early recognition and targeted management of CNS-MM remain major clinical challenges.

OBJECTIVE: This literature review summarizes the current literature on epidemiology, risk factors, clinical features, diagnostic modalities, and therapeutic approaches to CNS-MM. It focuses on emerging biomarkers and new treatment options that may affect the …

Single-Cell-Driven Design Of Logic-Gated Car Circuits For Enhanced Solid Tumor Immunotherapy, Sanna Madan, Tian-Gen Chang, Alexandra Harris, Huaitian Liu, Andrew Martinez, Saugato Dhruba, Binbin Wang, Padma Rajagopal, Sanju Sinha, Shahin Sayed

Pathology, East Africa

Background Chimeric antigen receptor (CAR) T-cell therapy has revolutionized cancer immunotherapy for hematological malignancies but faces critical barriers in solid tumors due to tumor antigen heterogeneity and on-target, off-tumor toxicities. Logic-gated multi-antigen targeting using Boolean operators (AND, OR, NOT) represents an emerging precision immunotherapy engineering approach to overcome these challenges.

Methods We developed LogiCAR designer, a genetic algorithm-based computational framework that systematically identifies optimal logic-gated antigen combinations (i.e., ‘circuits’) from single-cell transcriptomics data. The algorithm identifies CAR circuits consisting of 1-5 antigens from 2,758 cell surface proteins, optimizing tumor-targeting efficacy while maintaining stringent safety requirements in normal tissues. …

Who Classification Of Skin Tumours: Key Updates In The Fifth Edition, Gabrielle Goldman-Lévy, Raymond Barnhill, Boris Bastian, Werner Kempf, David Elder, Pedram Gerami, Wayne Grayson, Dmitry Kazakov, Daniela Massi, Shahin Sayed

Pathology, East Africa

The 5th edition of the World Health Organization Classification of Tumours (WCT) serves as a foundation for global diagnostic standards in tumour pathology. Similar to other volumes in this series, the Skin Tumours (Skin5) edition follows a standardized approach. This edition introduces two new chapters: ‘Tumours of the nail unit’ and ‘Metastases to skin’, along with new entities across relevant chapters. This review article provides an overview of the updates in Skin5 based on currently published evidence, with emphasis on newly introduced chapters and newly described entities that involve the skin, in particular, epidermal, melanocytic and appendageal tumours.

Microbial Signals In Primary And Metastatic Brain Tumors, Golnaz Morad, Ashish V Damania, Brenda Melendez, Bharat B Singh, Fabiana J Veguilla, Rebecca A Soto, Yasmine M Hoballah, Pranoti V Sahasrabhojane, Matthew C Wong, Mona M Ahmed, Rene N Rico, Kaitlyn N Lewis, Khalida Wani, Diana D Shamsutdinova, Rossana N Lazcano Segura, Davis R Ingram, Eric A Goethe, Abderrahman Day, Ivonne I Flores, Lauren K Mcdaniel, Manoj Chelvanambi, Sarah B Johnson, Florentia Dimitriou, Pravesh Gupta, Shivangi Oberai, M Anna Zal, Phoebe Doss, Mohamed A Jamal, Eiko Hayase, Chetna Wathoo, Lisa M Norberg, Stephanie L Jenkins, Sara Nass, Joy Gumin, Lihong Long, Jing Yang, Gina R Bradley, Mahesh Prasad Bekal, Antonio G Dono, Pavel S Pichardo-Rojas, Samuel W Andrewes, Leomar Y Ballester, Jillian S Losh, Jiyong Liang, Longfei Huo, Douglas C Nielsen, Brittany C Parker Kerrigan, Priscilla K Brastianos, Natalie Wall Fowlkes, Chia-Chi Chang, Robert R Jenq, Candelaria Gomez-Manzano, Jason T Huse, Michael A Davies, Alexander J Lazar, Krishna P Bhat, Nitin Tandon, Yoshua Esquenazi, Christine B Peterson, Vinay K Puduvalli, Frederick F Lang, Christopher D Johnston, Susan Bullman, Nadim J Ajami, Sherise D Ferguson, Jennifer A Wargo

Faculty, Staff and Student Publications

Gliomas and brain metastases are associated with poor prognosis, necessitating a deeper understanding of brain tumor biology and the development of effective therapeutic strategies. Although our group and others have demonstrated microbial presence in various tumors, recent controversies regarding cancer-type-specific intratumoral microbiota emphasize the importance of rigorous, orthogonal validation. This prospective, multi-institutional study included a total of 243 samples from 221 patients, comprising 168 glioma and brain metastases samples and 75 non-cancerous or tumor-adjacent tissues. Using stringent fluorescence in situ hybridization, immunohistochemistry and high-resolution spatial imaging, we detected intracellular bacterial 16S rRNA and lipopolysaccharides in both glioma and brain metastases …

Colorectal-Specific Radiation Dose And Chemotherapy Risk For Subsequent Colorectal Malignancies In Childhood Cancer Survivors: A Childhood Cancer Survivor Study (Ccss) Report, Constance A Owens, Ethan B Ludmir, Qi Liu, Weiyu Qiu, Aashish C Gupta, Susan A Smith, Bastien Rigaud, Kristy K Brock, James E Bates, Taylor G Meyers, Arnold C Paulino, Christine B Peterson, Stephen F Kry, Jop C Teepen, Cécile M Ronckers, Joseph P Neglia, Wendy M Leisenring, Kevin C Oeffinger, Paul C Nathan, Lucie M Turcotte, David C Hodgson, Melissa M Hudson, Leslie L Robison, Chaya S Moskowitz, Gregory T Armstrong, Tara O Henderson, Yutaka Yasui, Rebecca M Howell

Faculty, Staff and Student Publications

Purpose: Among childhood cancer survivors, we evaluated not previously explored relationships between colorectal subsequent malignant neoplasm (SMN) incidence and colorectum-specific radiation dose metrics currently used in radiation therapy (RT) planning and expanded upon previously reported chemotherapy associations.

Methods: The Childhood Cancer Survivor Study (CCSS) includes 5-year survivors of childhood cancer diagnosed between 1970 and 1999. RT was assessed as mean colorectal dose (MCD) and the percent volume (VX Gy) receiving ≥5, 10, 20, 30, and 40 Gy. Chemotherapy was assessed as cumulative doses for procarbazine and platinum agents, cyclophosphamide-equivalent doses for alkylating agents, and doxorubicin-equivalent doses for anthracyclines. Piecewise-exponential models …

Intentional Creation Of Suboptimal, Realistic Dose Distributions, Skylar S Gay, Mary P Gronberg, Raymond Mumme, Beth M Beadle, Anuja Jhingran, Tze Yee Lim, Zhiqian H Yu, Christine Chung, Meena Khan, Chelsea Pinnix, Sanjay Shete, Brent Parker, Tucker J Netherton, Carlos E Cardenas, Laurence E Court

Faculty, Staff and Student Publications

Background: Radiation oncology residents report a lack of understanding and confidence in assessing radiotherapy plan quality. A contributing factor is the environment in which plan review is taught during residency, that is, routine clinical practice, which does not provide ample time for self-guided practice in a low-stakes setting. Expertise in plan review requires diverse case presentation and many examples, which are often not achievable in smaller programs and for less common cancer types. As plan quality affects patient outcomes, it is important to address these pitfalls in the education of residents on plan review.

Purpose: To address the identified pitfalls …