Temporal Trends of Subsequent CNS Malignancies Among Survivors of Childhood Cancer.

Purpose: It is not known whether temporal changes in childhood cancer therapy have reduced risk of subsequent malignant neoplasms (SMNs) of the central nervous system (CNS), a frequently fatal late effect of cancer therapy.

Methods: Five-year survivors of primary childhood cancers diagnosed between 1970-1999 in the Childhood Cancer Survivor Study with a subsequent CNS SMN were identified. Cumulative incidence rates and standardized incidence ratios (SIR) were compared among survivors diagnosed between 1970-1979 (N = 6223), 1980-1989 (N = 9680), and 1990-1999 (N = 8999).

Melanoma Among Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

Purpose: Melanoma as a subsequent malignant neoplasm has been described among childhood cancer survivors; however, the risk factors and long-term survival are not well understood.

Methods: We assessed incidence, risk factors, and outcomes for melanoma among participants in the Childhood Cancer Survivor Study cohort. Cumulative incidence and standardized incidence ratios (SIRs) were calculated, and multivariable Cox models were used to determine hazard ratios (HRs) and associated 95% CI for melanoma risk factors.

Characterization of LiF TLD-100 in carbon ion beams for remote audits.

Background: A passive dosimeter framework for the measurement of dose in carbon ion beams has yet to be characterized or implemented for regular use.

Purpose: This work determined the dose calculation correction factors for absorbed dose in thermoluminescent dosimeters (TLDs) in a therapeutic carbon ion beam. TLD could be a useful tool for remote audits, particularly in the context of clinical trials as new protocols are developed for carbon ion radiotherapy.

Changing public perceptions of alcohol, alcohol harms and alcohol policies: A multi-methods study to develop novel framing approaches.

Background And Aims: Public perceptions of alcohol and its related harms and policies are shaped by multiple discourses and can influence behaviour and policy support. As part of a FrameWorks-informed project to test framing approaches to improve public understanding and support for evidence-based alcohol policies in the UK, this research aimed to (i) summarise relevant evidence; (ii) compare how public understanding of alcohol harms differs from those of academic and charity experts; and (iii) develop novel framing approaches.

Methods: (1) a literature review including systematic, scoping and targeted components to understand previous evidence on effective framing from behaviour change, UK alcohol policy and FrameWorks literatures; (2) comparison of public views of alcohol harms and policies from four focus groups (n = 20) with those of public health experts; (3) an iterative process involving workshops and stakeholder consultation to develop 12 novel framing approaches.

Tumor specific delivery and radiation-enhanced tumor penetration of mesoporous silica nanoparticles for effective radionuclide therapy of ovarian peritoneal metastasis.

Advanced ovarian cancer with peritoneal metastasis is challenging to treat. Limited tumor delivery and penetration of the therapeutics to deep tumor regions are significant barriers to effective treatment. The rising radiopharmaceuticals offer hopes for patients through targeted delivery.

Using High-Speed Videoendoscopy to Analyze Laryngeal Closure Parameters During Normal Swallow.

Objective: This pilot study was designed to test the tolerability of a lower scope position and feasibility of custom-designed MATLAB graphical user interface (GUI) used to analyze playback review of laryngeal high-speed videoendoscopy (laryngeal HSV) during healthy volitional dry swallows. We hypothesized this method would conceptually provide time resolution for glottic closure events compared with standard (30 frames per second, fps), and enable a means to measure timing, sequence, and duration of laryngeal movements during swallowing not otherwise visualized.

Methods: A total of 14 healthy adults (4 male, 22-80 years) participated.

Infraglottal Medialization: Increasing Vocal Fold Stiffness Gradient for Improved Vocal Efficiency.

Objectives/hypothesis: Assess the impact of the infraglottal medialization technique on acoustics and the vertical stiffness gradient of the vocal fold using excised canine larynges.

Methods: Seven ex vivo canine larynges were tested in three states: 1) no implant, 2) medialized using a glottal implant, and 3) medialized fold using an infraglottal implant. Outcome measures were vocal efficiency and stiffness of the fold.

Prediction of breast cancer risk for adolescents and young adults with Hodgkin lymphoma.

Background: While female survivors of Hodgkin lymphoma (HL) have an increased risk of breast cancer (BC), no BC risk prediction model is available. We developed such models incorporating mean radiation dose to the breast or breast quadrant-specific radiation doses.

Methods: Relative risks and age-specific incidence for BC and competing events (mortality or other subsequent cancer) were estimated from 1194 Dutch five-year HL survivors, treated at ages 11-40 during 1965-2000.

Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study.

Background: The burden and functional significance of autonomic dysfunction among survivors of childhood cancer is unknown.

Objectives: We evaluated the prevalence, risk factors, and functional relevance of autonomic dysfunction in survivors.

Methods: We conducted a cross-sectional prospective evaluation of 1,041 adult survivors of childhood cancer treated with anthracyclines (31.

Late subsequent leukemia after childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS).

Background: Subsequent short-latency leukemias are well-described among survivors of childhood cancer. However, late (5-14.9 years from diagnosis, LL) and very late (≥15 years from diagnosis, VLL) subsequent leukemias have not been well studied.

Is the Imaging Radiation Oncology Core Head and Neck Credentialing Phantom an Effective Surrogate for Different Anatomic Sites?

Purpose: The Imaging Radiation Oncology Core (IROC) head and neck (H&N) phantom is used to credential institutions for intensity modulated radiation therapy delivery for all anatomic sites where delivery of modulated therapy is a primary challenge. This study evaluated how appropriate the use of this phantom is for varied clinical anatomy by evaluating how closely the IROC H&N phantom described clinical dose errors from beam modeling compared with various anatomic sites.

Methods And Materials: The multileaf collimator (MLC) offset, transmission, percent depth dose, and 7 additional beam modeling parameters for a Varian accelerator were modified in RayStation to match community data at the 2.

Keratinocyte carcinomas in survivors of childhood cancer: A report from the childhood cancer survivor study.

Background: Childhood cancer survivors (CCS) are at increased risk for keratinocyte carcinomas (KC) however, the long-term incidence of single and multiple KC is not well established.

Objective: Identify risk factors and quantify KC cumulative incidence and multiple-incidence burden in CCS.

Methods: KC were identified among Childhood Cancer Survivor Study participants, a cohort of 5-year cancer survivors diagnosed <21 years of age between 1970 and 1999 in North America.

Bariatric and general surgical procedures in obese patients with a history of venous thromboembolism and concurrent anticoagulation therapy.

Objective: The objective of this study was to examine the use and outcomes of perioperative anticoagulation (AC) in obese patients with a known history of venous thromboembolism event (VTE).

Method: A retrospective review of a prospective database for patients with a VTE history undergoing bariatric and general surgery at a single center (1/2008-12/2017) was performed. Factors assessed included demographics, surgical details, and outcomes.

Neurocognitive outcomes and functional independence in adult survivors of childhood medulloblastoma diagnosed over 3 decades.

Background: Treatment of childhood medulloblastoma has evolved to reduce neurotoxicity while improving survival. However, the impact of evolving therapies on late neurocognitive outcomes and adult functional independence remains unknown.

Methods: Adult survivors of childhood medulloblastoma (n = 505; median [minimum-maximum] age, 29 [18-46] years) and sibling controls (n = 727; 32 [18-58] years) from the Childhood Cancer Survivor Study completed surveys assessing neurocognitive problems and chronic health conditions (CHCs).

Early vocational rehabilitation and psychological support for trauma patients to improve return to work (the ROWTATE trial): study protocol for an individually randomised controlled multicentre pragmatic trial.

Background: Moderately severe or major trauma (injury severity score (ISS) > 8) is common, often resulting in physical and psychological problems and leading to difficulties in returning to work. Vocational rehabilitation (VR) can improve return to work/education in some injuries (e.g.

Bifunctional Molecules That Induce Both Targeted Degradation and Transcytosis of Extracellular Proteins in Brain Cells.

Targeted protein degradation (TPD) has emerged as an effective therapeutic strategy for a wide range of diseases; however, the blood-brain barrier (BBB) limits access of degraders into the central nervous system (CNS). Here, we present a new class of bifunctional small molecules, called TransMoDEs (cytosis-inducing lecular egraders of xtracellular proteins), capable of both (1) removal of target protein via lysosomal proteolysis and (2) transcytosis of protein targets across brain endothelial cells. TransMoDEs are derived from Angiopep-2, a peptide motif previously employed as a covalent tag to facilitate receptor-mediated transcytosis across the BBB.

Chromatic bleaching and fractionation effects on optically stimulated luminescent dosimeter reuse.

Background: Optically stimulated luminescent dosimeters (OSLDs) can be bleached and reused, but questions remain about the effects of repeated bleaching and fractionation schedules on OSLD performance.

Purpose: The aim of this study was to investigate how light sources with different wavelengths and different fractionation schemes affect the performance of reused OSLDs.

Methods: OSLDs (N = 240) were irradiated on a cobalt-60 beam in different step sizes until they reached an accumulated dose of 50 Gy.

Pancreatic Epithelial IL17/IL17RA Signaling Drives B7-H4 Expression to Promote Tumorigenesis.

IL17 is required for the initiation and progression of pancreatic cancer, particularly in the context of inflammation, as previously shown by genetic and pharmacological approaches. However, the cellular compartment and downstream molecular mediators of IL17-mediated pancreatic tumorigenesis have not been fully identified. This study examined the cellular compartment required by generating transgenic animals with IL17 receptor A (IL17RA), which was genetically deleted from either the pancreatic epithelial compartment or the hematopoietic compartment via generation of IL17RA-deficient (IL17-RA-/-) bone marrow chimeras, in the context of embryonically activated or inducible Kras.

The Ability of Primary Care Practices to Measure and Report on Care Quality.

Background: Creating useful clinical quality measure (CQM) reports in a busy primary care practice is known to depend on the capability of the electronic health record (EHR). Two other domains may also contribute: supportive leadership to prioritize the work and commit the necessary resources, and individuals with the necessary health information technology (IT) skills to do so. Here we describe the results of an assessment of the above 3 domains and their associations with successful CQM reporting during an initiative to improve smaller primary care practices' cardiovascular disease CQMs.

Cricopharyngeus muscle dysfunction: a poorly defined disorder from diagnosis to treatment.

Purpose: Cricopharyngeus muscle dysfunction (CPMD) is a common clinical occurrence with very few clear diagnostic criteria and multiple pathways for treatment. Incidence of CPMD is not known, but some data suggest around 25% of people with dysphagia experience some degree of CPMD, which negatively impacts swallowing safety and efficiency. Workup and treatment of CPMD can require multidisciplinary collaboration across laryngologists, speech-language pathologists with training in dysphagia management, and gastroenterologists.