Individualized Prediction for Risk of Recurrence in Stage I/II Melanoma Patients With Negative Sentinel Lymph Node.

Background: Despite the favorable prognosis of AJCC stage I/II melanoma patients, up to 20%-30% will develop metastases. Our objective is to predict long-term risk (probability) of recurrence in early-stage melanoma patients.

Methods: A Risk Score to predict long-term recurrence was developed using Cox regression based on 2668 patients.

Are Nomograms Useful for Predicting Sentinel Lymph Node Status in Melanoma Patients?

Background And Objectives: Clinical nomograms have been developed to predict sentinel lymph node (SLN) status in early-stage melanoma patients, but the clinical utility of these tools remains debatable. We created and validated a nomogram using data from a randomized clinical trial and assessed its accuracy against the well-validated Melanoma Institute Australia (MIA) nomogram.

Methods: We developed our model to predict SLN status using logistic regression on clinicopathological patient data from the Multicenter Selective Lymphadenectomy Trial-I.

Implications of tumor-positive sentinel lymph nodes in single vs multiple nodal basins in melanoma.

Background: Melanoma patients' prognosis is based on the primary tumor characteristics and the tumor status of the regional lymph nodes. The advent of lymphoscintigraphy with SLN biopsy (SLNB) has shown that melanoma can drain to multiple nodal basins but the significance of multiple basins (vs. one basin) with tumor-positive sentinel lymph node(s) (+SLN) of similar tumor burden has not been shown.

Socially vulnerable patients are more likely to fail outpatient management of symptomatic cholelithiasis.

Background: Symptomatic cholelithiasis is a common surgical problem, with many patients requiring multiple gallstone-related emergency department (ED) visits before cholecystectomy. The Social Vulnerability Index (SVI) identifies vulnerable patient populations. This study aimed to assess the association between social vulnerability and outpatient management of symptomatic cholelithiasis.

Is therapeutic lymph node dissection of value for lymph node recurrence in melanoma?

Background: Therapeutic lymphadenectomy (TLND) is still performed in most melanoma patients to treat nodal recurrences after initial negative lymph node biopsy (-SLNB), despite the lack of evidence for survival benefit. We sought to compare melanoma-specific survival (MSS) and distant metastasis-free survival (DMFS) of patients who underwent TLND versus no TLND using our institutional and MSTL-1 databases.

Methods: We identified 146 patients with nodal recurrence following -SLNB: 132 underwent TLND and 14 did not.

Age-related next-generation sequencing mutational analysis in 1196 melanomas.

Background And Objectives: Melanoma mutational burden is high and approximately 50% have oncogenic mutations in BRAF. We sought to evaluate age-related mutational differences in melanoma.

Methods: We analyzed melanoma samples in the Genomics Evidence Neoplasia Information Exchange database.

The 31-gene expression profile test informs sentinel lymph node biopsy decisions in patients with cutaneous melanoma: results of a prospective, multicenter study.

Background: The 31-gene expression profile test (Class 1A: low-risk; 1B/2A: intermediate-risk; 2B: high-risk) is validated to identify patients with cutaneous melanoma who can safely forego sentinel lymph node biopsy (SLNB). The objective of the current study is to quantify SLNB reduction by clinicians using 31-GEP.

Methods: Patients with T1-T2 tumors eligible for SLNB were seen by surgical oncologists (89.

Treatment Utilization and Outcomes for Locally Advanced Rectal Cancer in Older Patients.

Importance: The number of older patients (80 years and older) diagnosed with locally advanced rectal cancer (LARC) is expected to increase. Although current guidelines recommend neoadjuvant chemoradiation therapy (NACRT) followed by resection, little is known about management and outcomes in this older population.

Objective: To assess the trends in management of older patients diagnosed with LARC who had a surgical resection.

Evolving management of early stage pancreatic adenocarcinoma in older patients.

Background: Due to the aging population, the number of older patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) will continue to rise.

Study Design: Utilizing the NCDB from 2010 to 2016, patients with early stage, clinically node negative PDAC who were ≥70 years old and had a Whipple were identified. Multivariable logistic regressions were used to determine independent factors for R0 resection and NAT.

Predicting Regional Lymph Node Recurrence in the Modern Age of Tumor-Positive Sentinel Node Melanoma: The Role of the First Postoperative Ultrasound.

Background: The Multicenter Selective Lymphadenectomy Trial II (MSLT-II) led to a change in the management of tumor-positive sentinel lymph nodes (SLNs) from completion node dissection (CLND) to nodal observation. This study aimed to evaluate prognostic factors for predicting sentinel node basin recurrence (SNBR) using data from MSLT-II trial participants.

Methods: In MSLT-II, 1076 patients were treated with observation.

Four Immune Modulating Genes in Primary Melanoma That Predict Metastatic Potential.

Introduction: Histologic characteristics cannot adequately predict which patients are at risk of developing metastatic disease after excision of primary cutaneous melanoma. The aim of this study was to identify immunomodulatory genes in primary tumors associated with development of distant metastases.

Materials And Methods: Thirty-seven patients with primary melanoma underwent surgical excision.

Semicircular canal size constrains vestibular function in miniaturized frogs.

Miniaturization has evolved repeatedly in frogs in the moist leaf litter environments of rainforests worldwide. Miniaturized frogs are among the world's smallest vertebrates and exhibit an array of enigmatic features. One area where miniaturization has predictable consequences is the vestibular system, which acts as a gyroscope, providing sensory information about movement and orientation.

The OneFlorida Data Trust: a centralized, translational research data infrastructure of statewide scope.

The OneFlorida Data Trust is a centralized research patient data repository created and managed by the OneFlorida Clinical Research Consortium ("OneFlorida"). It comprises structured electronic health record (EHR), administrative claims, tumor registry, death, and other data on 17.2 million individuals who received healthcare in Florida between January 2012 and the present.

Soma-Targeted Imaging of Neural Circuits by Ribosome Tethering.

Neuroscience relies on techniques for imaging the structure and dynamics of neural circuits, but the cell bodies of individual neurons are often obscured by overlapping fluorescence from axons and dendrites in surrounding neuropil. Here, we describe two strategies for using the ribosome to restrict the expression of fluorescent proteins to the neuronal soma. We show first that a ribosome-tethered nanobody can be used to trap GFP in the cell body, thereby enabling direct visualization of previously undetectable GFP fluorescence.

The association between facility volume and overall survival in patients with Merkel cell carcinoma.

Background: Merkel cell carcinoma is an uncommon malignancy often requiring multidisciplinary management. The purpose of this study was to determine whether high-volume facilities have improved outcomes in patients with Merkel cell carcinoma relative to lower-volume facilities.

Methods: A total of 5304 patients from the National Cancer Database with stage I-III Merkel cell carcinoma undergoing surgery were analyzed.

Sustained NPY signaling enables AgRP neurons to drive feeding.

Artificial stimulation of Agouti-Related Peptide (AgRP) neurons promotes intense food consumption, yet paradoxically during natural behavior these cells are inhibited before feeding begins. Previously, to reconcile these observations, we showed that brief stimulation of AgRP neurons can generate hunger that persists for tens of minutes, but the mechanisms underlying this sustained hunger drive remain unknown (Chen et al., 2016).

Diagnostic utility of dual 5-hydroxymethylcytosine/Melan-A immunohistochemistry in differentiating nodal nevus from metastatic melanoma: An effective first-line test for the workup of sentinel lymph node specimen.

Background: Distinguishing benign nodal nevus from metastatic melanoma can be diagnostically challenging, with important clinical consequences. Recently, the loss of epigenetic marker, 5-hydroxymethylcytosine (5-hmC) expression by immunohistochemistry has been found in melanomas and atypical melanocytic neoplasms.

Methods: About 41 metastatic melanomas and 20 nodal nevi were retrieved.

Objectively measured pediatric obesity prevalence using the OneFlorida Clinical Research Consortium.

We characterized the prevalence of obesity among Florida children 2-19years old using electronic health records (EHRs). The obesity prevalence for 331,641 children was 16.9%.

Characterization of adult obesity in Florida using the OneFlorida clinical research consortium.

Introduction: With obesity rates and obesity-related healthcare costs increasing, policy makers must understand the scope of obesity across populations.

Objective: This study sought to characterize adult obesity using electronic health records (EHRs) available from a statewide clinical data research network, the OneFlorida Clinical Research Consortium, which contains claims and EHR data from over 12 million patients in Florida. The primary aim was to compare EHR-based Florida obesity rates with those rates obtained from the Behavioural Risk Factor Surveillance System (BRFSS).

Identification of discrete, intermingled hypocretin neuronal populations.

Neurons in the lateral hypothalamic area that express hypocretin (Hcrt) neuropeptides help regulate many behaviors including wakefulness and reward seeking. These neurons project throughout the brain, including to neural populations that regulate wakefulness, such as the locus coeruleus (LC) and tuberomammilary nucleus (TMN), as well as to populations that regulate reward, such as the nucleus accumbens (NAc) and ventral tegmental area (VTA). To address the roles of Hcrt neurons in seemingly disparate behaviors, it has been proposed that Hcrt neurons can be anatomically subdivided into at least two distinct subpopulations: a "medial group" that projects to the LC and TMN, and a "lateral group" that projects to the NAc and VTA.

Dynamics of Gut-Brain Communication Underlying Hunger.

Communication between the gut and brain is critical for homeostasis, but how this communication is represented in the dynamics of feeding circuits is unknown. Here we describe nutritional regulation of key neurons that control hunger in vivo. We show that intragastric nutrient infusion rapidly and durably inhibits hunger-promoting AgRP neurons in awake, behaving mice.