Publications by authors named "Roach J"

Article Synopsis
  • Length of stay (LOS) in healthcare is important, as longer stays can lead to more complications; this study focuses on factors related to extended LOS (eLOS) in children and young adults after craniotomy for tumor removal.
  • Over 1,200 patients were analyzed, finding that those with eLOS (more than 7 days) tended to be younger, experienced longer ICU stays, and had specific tumor types and surgical conditions linked to eLOS.
  • The study provides insights beneficial for preoperative discussions, preparation by neurosurgical teams, and improving healthcare delivery by identifying factors that influence LOS in pediatric patients undergoing these procedures.
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Objectives: Home-based hematopoietic stem cell transplantation (HCT) is a novel approach that has the potential to improve outcomes, however, the impact of transplant location on the gut microbiome remains uncharacterized. We hypothesized that patients randomized to undergo home HCT would have higher gut taxonomic diversity and lower antimicrobial resistance (AMR) gene abundance compared to those undergoing standard hospital HCT.

Methods: We identified 28 patients enrolled in Phase II randomized trials of home (n=16) v.

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As large clinical and multiomics datasets and knowledge resources accumulate, they need to be transformed into computable and actionable information to support automated reasoning. These datasets range from laboratory experiment results to electronic health records (EHRs). Barriers to accessibility and sharing of such datasets include diversity of content, size and privacy.

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  • This study focuses on understanding African American women's breastfeeding rates and the social influences surrounding these rates in the Mississippi Gulf Coast.
  • It finds that community-based peer support significantly boosts breastfeeding prevalence in African American networks compared to white networks, despite generally low awareness and support among the African American community.
  • The research highlights the importance of social contexts and community practices in promoting breastfeeding, suggesting that strong peer support can lead to better lactation outcomes for African Americans.
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Background: The Joint Commission defines a sentinel event as "surgery or other invasive procedure performed at the wrong site, on the wrong patient, or that is the wrong (unintended) procedure for a patient regardless of the type of procedure or the magnitude of the outcome." At our institution, we observed a low but consistent rate of incorrect surgical line placement for pediatric patients with cancer.

Study Design: Following quality improvement methodology and using the resources available on a large academic medical campus we designed and implemented a new multi-factorial process to schedule and place surgical central lines for pediatric patients with cancer.

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Introduction: Autosomal dominant retinitis pigmentosa type 17 (adRP, type RP17) is caused by complex structural variants (SVs) affecting a locus on chromosome 17 (chr17q22). The SVs disrupt the 3D regulatory landscape by altering the topologically associating domain (TAD) structure of the locus, creating novel TAD structures (neo-TADs) and ectopic enhancer-gene contacts. Currently, screening for RP17-associated SVs is not included in routine diagnostics given the complexity of the variants and a lack of cost-effective detection methods.

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Purpose: Socioeconomic deprivation is associated with an increased incidence of sight-loss. To inform potential developments in eyecare, General Ophthalmic Service (GOS) sight-testing activity was explored in relation to deprivation for GOS contractors submitting National Health Service (NHS) claims in England.

Methods: Data on NHS sight-test claims for the financial year 2022-2023 were sought from NHS England (NHSE), including number of sight-tests by GOS contractors, their unique Organisation Data Service codes and postcodes and age-bands of patients accessing sight-testing.

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Article Synopsis
  • Surgical biopsy (SB) has traditionally been used for diagnosing pediatric solid tumors, but newer image-guided techniques like core needle biopsy (CNB) show promise due to lower risks and similar diagnostic accuracy.
  • A systematic review of studies from 2010 to 2023 included 27 studies with nearly 2,500 pediatric patients and compared complication rates and diagnostic efficacy of CNB versus SB across various tumor types.
  • Results indicated that while CNB had a 90.8% diagnostic success rate and much lower complication rate (2.9%) compared to SB (21.4% complication rate), the overall diagnostic success was notably higher for SB (98.8%).
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  • A 3-year-old boy had a serious liver cancer called hepatoblastoma that spread to different parts of his body.
  • After treatment with strong medicine and radiation, he got a new liver from another person.
  • Unfortunately, his cancer came back a few times, and doctors had to do a special surgery to remove the tumor and fix parts of his veins.
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Synoptic operative notes for pediatric surgical oncology provide standardized and structured documentation of surgical procedures performed on pediatric patients with cancer. These reports capture essential details such as preoperative diagnosis, intraoperative findings, surgical technique, and tumor characteristics in a concise and uniform format. By promoting consistency, accuracy, and completeness in reporting, synoptic operative notes facilitate effective communication among multidisciplinary healthcare teams, enhance quality assurance efforts, and streamline data extraction for research purposes.

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Introduction: Predicted 1-year survival of children with trisomy 18 (T18) has increased to 59.3%. We aimed to systematically review the characteristics, management, and outcomes of children with T18 and hepatoblastoma.

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Two percent of pediatric malignancies arise primarily in the liver; roughly 60% of these cancers are hepatoblastoma (HB). Despite the rarity of these cases, international collaborative efforts have led to the consistent histological classification and staging systems, which facilitate ongoing clinical trials. Other primary liver malignancies seen in children include hepatocellular carcinoma (HCC) with or without underlying liver disease, fibrolamellar carcinoma (FLC), undifferentiated embryonal sarcoma of the liver (UESL), and hepatocellular neoplasm not otherwise specified (HCN-NOS).

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Article Synopsis
  • Adrenocortical carcinoma (ACC) is a rare and aggressive tumor in children, and the study analyzed its clinical characteristics and management between 2004 and 2019 using the National Cancer Database.
  • Out of 78 children studied, most underwent surgery (84.6%), with chemotherapy given to 56.4%, and the overall survival rates at 1, 3, and 5 years were found to be 87%, 62%, and 60.1%, respectively.
  • The findings indicated that metastasis at diagnosis significantly worsens survival rates, and for nonmetastatic cases, older age is linked to lower overall survival outcomes.
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Objective: To explore the association between intraoperative methadone use, postoperative pain, and opioid consumption after coronary artery bypass grafting (CABG) surgery.

Design: Retrospective cohort study.

Setting: Single academic medical center.

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Background: Pediatric-type diffuse high-grade glioma (pHGG) is the most frequent malignant brain tumor in children and can be subclassified into multiple entities. Fusion genes activating the MET receptor tyrosine kinase often occur in infant-type hemispheric glioma (IHG) but also in other pHGG and are associated with devastating morbidity and mortality.

Methods: To identify new treatment options, we established and characterized two novel orthotopic mouse models harboring distinct MET fusions.

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Background: Despite advances in glaucoma management, topical eyedrop treatment has been paramount, with prostaglandin analogues (PGAs) being first-line agents. While late presentation is linked with deprivation, there is no recent research examining associations between deprivation and prescribing within primary care.

Aim: To explore PGA prescribing in general practice over a 6-year timeline, assessing associations with deprivation.

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Background And Objectives: The management of blunt cerebrovascular injuries (BCVIs) remains an important topic within trauma and neurosurgery today. There remains a lack of consensus within the literature and significant variation across institutions. The purpose of this study was to evaluate management of BCVI at a large, tertiary referral trauma center.

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Purpose: Our objectives were to compare overall survival (OS) and pulmonary relapse between patients with metastatic Ewing sarcoma (EWS) at diagnosis who achieve rapid complete response (RCR) and those with residual pulmonary nodules after induction chemotherapy (non-RCR).

Patients And Methods: This retrospective cohort study included children under 20 years with metastatic EWS treated from 2007 to 2020 at 19 institutions in the Pediatric Surgical Oncology Research Collaborative. Chi-square tests were conducted for differences among groups.

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Purpose: Pediatric-type diffuse high-grade gliomas are the leading cause of cancer-related morbidity and mortality in children. More than 30% of diffuse hemispheric gliomas (DHG) in adolescents harbor histone H3 G34 mutations and are recognized by the World Health Organization as a distinct tumor entity. By reporting bibliometric characteristics of the most cited publications on H3 G34-mutant DHG (H3 G34 DHG), we provide an overview of emerging literature and speculate where future research efforts may lead.

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Purpose: Exercise is beneficial for people living with and beyond cancer (LWBC); however, many people LWBC fail to meet the exercise guidelines. Having an identity related to exercise, a component of one's self-concept, correlates with exercising more frequently in general adult populations. Understanding how exercise identity influences exercise behaviors in people LWBC is warranted due to the many barriers people LWBC face in relation to physical activity.

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Background: Undifferentiated embryonal sarcoma of the liver (UESL) is a rare tumor for which there are few evidence-based guidelines. The aim of this study was to define current management strategies and outcomes for these patients using a multi-institutional dataset curated by the Pediatric Surgical Oncology Research Collaborative.

Methods: Data were collected retrospectively for patients with UESL treated across 17 children's hospitals in North America from 1989 to 2019.

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Inherited macular dystrophies (iMDs) are a group of genetic disorders, which affect the central region of the retina. To investigate the genetic basis of iMDs, we used single-molecule Molecular Inversion Probes to sequence 105 maculopathy-associated genes in 1352 patients diagnosed with iMDs. Within this cohort, 39.

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