Publications by authors named "Schultz N"

Background: Acute type A aortic dissection (ATAAD) has a high mortality, and acute aortic repair is the only curative treatment. In patients treated with factor Xa (FXa) inhibitors, the risk of severe disease-related complications such as cardiac tamponade and hemodynamic shock must be balanced against the potential for severe perioperative bleeding. The aim was to study intraoperative changes in plasma levels of the FXa inhibitor apixaban when using hemoadsorption during acute thoracic aortic repair.

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Importance: Although differences in the prevalence of key cancer-specific somatic mutations as a function of genetic ancestry among patients with cancer has been well-established, few studies have addressed the practical clinical implications of these differences for the growing number of biomarker-driven treatments.

Objective: To determine if the approval of precision oncology therapies has benefited patients with cancer from various ancestral backgrounds equally over time.

Design, Setting, And Participants: A retrospective analysis of samples from patients with solid cancers who underwent clinical sequencing using the integrated mutation profiling of actionable cancer targets (MSK-IMPACT) assay between January 2014 and December 2022 was carried out.

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Nearly all pancreatic adenocarcinomas (PDAC) are genomically characterized by KRAS exon 2 mutations. Most patients with PDAC present with advanced disease and are treated with cytotoxic therapy. Genomic biomarkers prognostic of disease outcomes have been challenging to identify.

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Purpose: Perihilar cholangiocarcinoma (pCCA) is a rare malignancy requiring resection of extrahepatic bile ducts with or without hepatectomy. Prognostic models for post-operative outcomes in pCCA are unusable in pre-operative decision-making as most are based on post-operative variables. Additionally, no pre-operative models include futile laparotomy or benign hilar stenosis (BHS) as possible outcomes.

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High-Grade Serous Ovarian Cancer (HGSOC) originates from fallopian tube (FT) precursors. However, the molecular changes that occur as precancerous lesions progress to HGSOC are not well understood. To address this, we integrated high-plex imaging and spatial transcriptomics to analyze human tissue samples at different stages of HGSOC development, including p53 signatures, serous tubal intraepithelial carcinomas (STIC), and invasive HGSOC.

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The canonical model of tumor suppressor gene (TSG)-mediated oncogenesis posits that loss of both alleles is necessary for inactivation. Here, through allele-specific analysis of sequencing data from 48,179 cancer patients, we define the prevalence, selective pressure for, and functional consequences of biallelic inactivation across TSGs. TSGs largely assort into distinct classes associated with either pan-cancer (Class 1) or lineage-specific (Class 2) patterns of selection for biallelic loss, although some TSGs are predominantly monoallelically inactivated (Class 3/4).

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Article Synopsis
  • The study analyzed postoperative outcomes for patients with perihilar cholangiocarcinoma (pCCA) in a high-volume center, highlighting significant survival rates over 1, 3, and 5 years post-resection.
  • Key factors like portal vein embolization (PVE), lymph node metastasis (LNM), and higher Clavien-Dindo complication scores were linked to poorer overall survival (OS).
  • The findings indicate that further research is essential to enhance pre-operative detection of high-risk patients to improve surgical outcomes.
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Expanded polystyrene (EPS) remains a popular packaging material despite environmental concerns such as pollution, difficulty to recycle, and toxicity to wildlife. The goal of this study is to evaluate the potential of an ecofriendly alternative to traditional EPS composed of a mycelium biocomposite grown from agricultural waste. In this material, the mycelium spores are incorporated into cellulosic waste, resulting in a structurally sound biocomposite completely enveloped by mycelium fibers.

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Purpose: Mutational data from multiple solid and liquid biospecimens of a single patient are often integrated to track cancer evolution. However, there is no accepted framework to resolve if individual samples from the same individual share variants due to common identity versus coincidence.

Experimental Design: Utilizing 8,000 patient tumors from The Cancer Genome Atlas across 33 cancer types, we estimated the background rates of co-occurrence of mutations between discrete pairs of samples across cancers and by cancer type.

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Objectives: The study aimed to extract online comments of otolaryngologists in the 20 most populated cities in the United States from healthgrades.com, develop and validate a natural language processing (NLP) logistic regression algorithm for automated text classification of reviews into 10 categories, and compare 1- and 5-star reviews in directly-physician-related and non-physician-related categories.

Methods: 1977 1-star and 12,682 5-star reviews were collected.

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Purpose: The Management of Post-transplant Infections in Collaborating Hospitals (MATCH) programme, initiated in 2011 and still ongoing, was created to 1) optimise the implementation of existing preventive strategies against viral infections in solid organ transplant (SOT) recipients and allogenic haematopoietic stem-cell transplant (HSCT) recipients and 2) advance research in the field of transplantation by collecting data from a multitude of sources.

Participants: All SOT and HSCT recipients at Copenhagen University Hospital, Rigshospitalet, are followed in MATCH. By February 2021, a total of 1192 HSCT recipients and 2039 SOT recipients have been included.

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Databases that link molecular data to clinical outcomes can inform precision cancer research into novel prognostic and predictive biomarkers. However, outside of clinical trials, cancer outcomes are typically recorded only in text form within electronic health records (EHRs). Artificial intelligence (AI) models have been trained to extract outcomes from individual EHRs.

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Background: Postoperative morbidity can reduce quality of life, physical performance, and tolerability of postoperative chemotherapy in patients with colorectal liver metastases (CRLM). Exercise can improve these outcomes in some cancer populations. However, it remains unknown whether exercise can be delivered in the early postoperative period following surgery for CRLM without increasing the risk of harms.

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Article Synopsis
  • Researchers are merging unstructured patient data with structured health records to create the MSK-CHORD dataset, consisting of varied cancer types from nearly 25,000 patients at Memorial Sloan Kettering Cancer Center.
  • This dataset allows for in-depth analysis of cancer outcomes using advanced techniques like natural language processing, revealing new relationships that smaller datasets may not show.
  • Using MSK-CHORD for machine learning models, findings suggest that incorporating features from these unstructured texts can better predict patient survival than relying solely on genomic data or cancer staging.
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Obesity is a risk factor for cancer, but whether obesity is linked to specific genomic subtypes of cancer is unknown. We examined the relationship between obesity and tumor genotype in two clinicogenomic corpora. Obesity was associated with specific driver mutations in lung adenocarcinoma, endometrial carcinoma and cancers of unknown primaries, independent of clinical covariates, demographic factors and genetic ancestry.

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Background: The aim of this study was to investigate the perioperative outcomes of robotic liver surgery (RLS) and Open liver surgery (OLS) in a centre with a high number of operations.

Methods: A 1:1 propensity score matched (PSM) analysis of a retrospective database of RLS and OLS was performed. Cumulative sum (CUSUM) analysis was performed to identify learning curves.

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  • Gallbladder cancer (GBC) is a highly lethal cancer with low overall incidence but higher prevalence in specific regions like Chile; this study compares clinical and molecular features of GBC patients from Chile and the US.
  • The study involved 260 patients, revealing a significantly higher rate of gallstones in the Chilean cohort and similar genetic alteration prevalence between the two groups, with overall alterations found in 14% of patients.
  • Patients with GBC having genetic alterations showed better overall survival rates, suggesting they may benefit from targeted therapies, highlighting the necessity for broader genomic analysis in regions with high GBC rates.
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  • High-Grade Serous Ovarian Cancer (HGSOC) develops from precursors in the fallopian tubes, yet the molecular changes during this progression are poorly understood.
  • Researchers used advanced imaging and spatial transcriptomics to analyze tissue samples from different stages of HGSOC, revealing critical immune modulating mechanisms and molecular alterations associated with the disease's progression.
  • Findings indicate a shift from immune surveillance to immune suppression in the tumor microenvironment, offering insights into potential biomarkers and therapeutic targets for early detection and intervention in HGSOC.
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  • The tumor microenvironment (TME) significantly impacts the progression of colorectal cancer (CRC), particularly affecting the differences between mismatch repair deficient (dMMR) and proficient (pMMR) tumors.
  • This study utilizes a spatially enhanced version of cBioPortal to analyze the TME and discovers that around 20% of pMMR tumors have T cell infiltration levels similar to dMMR, leading to better survival outcomes.
  • The findings suggest that these T cell-infiltrated pMMR tumors could also benefit from immune checkpoint inhibitor (ICI) therapy, highlighting that factors beyond mutational burden influence immune activity in CRC.
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Nematodes pose significant challenges for the fish processing industry, particularly in white fish. Despite technological advances, the industry still depends on manual labor for the detection and extraction of nematodes. This study addresses the initial steps of automatic nematode detection and differentiation from other common defects in fish fillets, such as skin remnants and blood spots.

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  • Hepatic artery infusion (HAI) chemotherapy combined with systemic treatment shows promising long-term results for patients with intrahepatic cholangiocarcinoma (IHC), suggesting improved disease control and overall survival rates.
  • A phase II clinical trial and a retrospective analysis revealed a median progression-free survival (PFS) of 11.8 months and overall survival (OS) of 26.8 months among a subset of patients, with particular genomic alterations indicating worse outcomes.
  • The study indicates that HAI with floxuridine (FUDR) alongside systemic therapies can provide durable disease control in locally advanced IHC, while molecular changes, particularly in the TP53 pathway, might help predict patient response to treatment.
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Objective: The objective of this study was to evaluate the long-term oncological outcomes of patients with colorectal liver metastasis (CRLM) randomized for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) or 2-stage hepatectomy (TSH).

Introduction: For advanced CRLM, TSH or ALPPS may be needed for tumor freedom. The randomized, controlled, multicenter trial LIGRO showed an increased resection rate in patients who underwent ALPPS but no difference in morbidity or mortality.

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Brain metastasis, a serious complication of cancer, hinges on the initial survival, microenvironment adaptation, and outgrowth of disseminated cancer cells. To understand the early stages of brain colonization, we investigated two prevalent sources of cerebral relapse, triple-negative (TNBC) and HER2+ (HER2BC) breast cancers. Using mouse models and human tissue samples, we found that these tumor types colonize the brain, with a preference for distinctive tumor architectures, stromal interfaces, and autocrine programs.

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