Publications by authors named "Sheppard B"

Patients with metastatic pancreatic ductal adenocarcinoma survive longer if disease spreads to the lung but not the liver. Here we generated overlapping, multi-omic datasets to identify molecular and cellular features that distinguish patients whose disease develops liver metastasis (liver cohort) from those whose disease develops lung metastasis without liver metastases (lung cohort). Lung cohort patients survived longer than liver cohort patients, despite sharing the same tumor subtype.

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Background: Management of retroperitoneal liposarcoma (RPLPS) is challenging and recurrence rates remain high despite aggressive surgical resections. Preoperative radiation alone lacks definitive benefit, thus we sought to evaluate combined chemoradiotherapy with the potential to enhance local efficacy of radiation as well as control micrometastatic disease. We assessed the safety and tolerability of preoperative eribulin, a cytotoxic microtubule inhibitor approved for the treatment of advanced liposarcoma, in combination with radiation in patients with RPLPS.

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Background: Economic stability is a core social determinant of health and a necessary condition for maintaining food security, housing stability, and both physical and mental health. Using a qualitative approach, we identified barriers, facilitators, and participant perceptions about utilizing these relief measures. This study aimed to understand experiences with COVID-19 economic relief measures among low-wage worker households with children during the COVID-19 pandemic.

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Background/objectives: Pancreatic ductal adenocarcinoma (PDAC) presents significant diagnostic and prognostic challenges, as current biomarkers frequently fail to accurately stage disease, predict rapid metastatic recurrence (rPDAC), or assess response to neoadjuvant therapy (NAT). We investigated the potential for circulating neoplastic-immune hybrid cells (CHCs) as a non-invasive, multifunctional biomarker for PDAC.

Methods: Peripheral blood specimens were obtained from patients diagnosed with PDAC.

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The Millennium Cohort Study is a longitudinal study which collects self-reported data from surveys to examine the long-term effects of military service. Participant nonresponse to follow-up surveys presents a potential threat to the validity and generalizability of study findings. In recent years, predictive analytics has emerged as a promising tool to identify predictors of nonresponse.

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Asparagine synthetase (ASNS) catalyzes the biosynthesis of asparagine from aspartate and glutamine. Cells lacking ASNS, however, are auxotrophic for asparagine. Use of L-asparaginase to promote asparagine starvation in solid tumors with low ASNS levels, such as pancreatic ductal adenocarcinoma (PDAC), is a rationale treatment strategy.

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Radiologists' traditional role in the diagnostic process is to respond to specific clinical questions and reduce uncertainty enough to permit treatment decisions to be made. This charge is rapidly evolving due to forces such as artificial intelligence (AI), big data (opportunistic imaging, imaging prognostication), and advanced diagnostic technologies. A new modernistic paradigm is emerging whereby radiologists, in conjunction with computer algorithms, will be tasked with extracting as much information from imaging data as possible, often without a specific clinical question being posed and independent of any stated clinical need.

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Background: Pancreatic ductal adenocarcinoma (PDAc) is a lethal malignancy, attributed in part to high rates of rapid recurrence (rrPDAc) following resection. We sought to characterize recurrence rates over time and investigate factors predictive of rrPDAc.

Methods: A regional multi-institutional cancer registry, augmented with data from the National Surgical Quality Improvement Program database, was queried for patients with PDAc from 1996 to 2020.

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Background: Umbilical hernias are highly prevalent in patients with liver dysfunction, ascites, and cirrhosis. This patient population carries significant perioperative risk and poses significant challenges because of their comorbidities. Literature suggests that elective repair of umbilical hernias can lead to better outcomes by reducing the risk of ascitic leak and compromised bowel.

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Objective: This study investigated the feasibility of in-store signage promoting sparkling water and the impact of this signage on sparkling water sales in convenience stores.

Design: We conducted a randomized control trial.

Setting: Convenience stores in North Carolina.

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Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly intratumorally heterogeneous disease that includes several subtypes and is highly plastic. Effective gene delivery to all PDAC cells is essential for modulating gene expression and identifying potential gene-based therapeutic targets in PDAC. Most current gene delivery systems for pancreatic cells are optimized for islet or acinar cells.

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The generation of induced pluripotent stem cells (iPSCs) using transcription factors has been achieved from almost any differentiated cell type and has proved highly valuable for research and clinical applications. Interestingly, iPSC reprogramming of cancer cells, such as pancreatic ductal adenocarcinoma (PDAC), has been shown to revert the invasive PDAC phenotype and override the cancer epigenome. The differentiation of PDAC-derived iPSCs can recapitulate PDAC progression from its early pancreatic intraepithelial neoplasia (PanIN) precursor, revealing the molecular and cellular changes that occur early during PDAC progression.

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Article Synopsis
  • - Pancreatic cancer treatment is challenging due to limited options and the aggressive nature of the disease, leading researchers to explore the compound juglone as a potential therapy that can inhibit tumor growth and induce cancer cell death.
  • - To reduce juglone's toxicity and enhance its effectiveness, researchers developed polymeric micelles using Poloxamer 407 and D-α-Tocopherol polyethylene glycol 1000 succinate, which showed promising results in lab studies by decreasing cancer cell proliferation and increasing apoptosis without toxicity in animal models.
  • - In vivo tests indicated that juglone delivered via micelles significantly reduced tumor growth in mice and also altered the tumor microenvironment to boost immune responses, highlighting its potential as a targeted treatment
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Closely related species with ecological similarity often aggressively compete for a common, limited resource. This competition is usually asymmetric and results in one species being behaviorally dominant over the other. Trade-offs between traits for behavioral dominance and alternative strategies can result in different methods of resource acquisition between the dominant and subordinate species, with important consequences for resource partitioning and community structure.

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Background: Pancreatic ductal adenocarcinoma (PDAC) has an overall 5-year survival rate of just 12.5% and thus is among the leading causes of cancer deaths. When detected at early stages, PDAC survival rates improve substantially.

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Background: Patterns of survey response and the characteristics associated with response over time in longitudinal studies are important to discern for the development of tailored retention efforts aimed at minimizing response bias. The Millennium Cohort Study, the largest and longest running cohort study of military personnel and veterans, is designed to examine the long-term health effects of military service and experiences and thus relies on continued participant survey responses over time. Here, we describe the response rates for follow-up survey data collected over 15 years and identify characteristics associated with follow-up survey response and mode of response (paper vs.

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Background: Neoadjuvant treatment with nab-paclitaxel and gemcitabine for potentially operable pancreatic adenocarcinoma has not been well studied in a prospective interventional trial and could down-stage tumors to achieve negative surgical margins.

Methods: A single-arm, open-label phase 2 trial (NCT02427841) enrolled patients with pancreatic adenocarcinoma deemed to be borderline resectable or clinically node-positive from March 17, 2016 to October 5, 2019. Patients received preoperative gemcitabine 1000 mg/m and nab-paclitaxel 125 mg/m on Days 1, 8, 15, every 28 days for two cycles followed by chemoradiation with 50.

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Background: Pancreatic adenocarcinoma (PDAC) often impinges on the biliary tree and obstruction necessitates stent placement increasing the risk of surgical site infections (SSIs). We sought to explore the impact of neoadjuvant therapy on the biliary microbiome and SSI risk in patients undergoing resection.

Methods: A retrospective analysis was performed on 346 patients with PDAC who underwent resection at our institution from 2008 to 2021.

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Background: Pancreatic acinar cell carcinoma (PACC) is a rare exocrine tumor of the pancreas. We evaluated the effect disease stage, surgical intervention, and institutional volume status plays in survival.

Methods: We queried the Oregon State Cancer Registry for patients with PACC from 1997 to 2018.

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This study examined Oregon's early intervention (EI) and early childhood special education (ECSE) pipelines as a function of children's intersecting ethnicity and home language(s) with a focus on children from Latino/a backgrounds with communication disorders. We found differences in children's referral source and age of referral, likelihood of evaluation and placement, and type of placement for conditions related to communication, including autism spectrum disorder and hearing impairment. Results showed differences in EI and ECSE; however, disproportionality appeared greatest among Spanish-speaking Latino/a children and non-Latino/a children who spoke languages other than English compared to non-Latino/a English-speaking counterparts.

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Background And Objectives: Primary resection and debulking of liver metastases have been associated with improved survival in pancreatic neuroendocrine tumors (PNETs). The treatment patterns and outcomes differences between low-volume (LV) institutions and high-volume (HV) institutions remains unstudied.

Methods: A statewide cancer registry was queried for patients with nonfunctional PNET from 1997 to 2018.

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Background: Pancreatic ductal adenocarcinoma (PDAC) is often diagnosed at a locally advanced stage with vascular involvement which was previously viewed as a contraindication to resection. However, high-volume centers are increasingly capable of resecting complex tumors. We aimed to explore patterns of treatment that are uncharacterized on a population level.

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Importance: The US arrival of the Omicron variant led to a rapid increase in SARS-CoV-2 infections. While numerous studies report characteristics of Omicron infections among vaccinated individuals or persons with previous infection, comprehensive data describing infections among adults who are immunologically naive are lacking.

Objectives: To examine COVID-19 acute and postacute clinical outcomes among a well-characterized cohort of unvaccinated and previously uninfected adults who contracted SARS-CoV-2 during the Omicron (BA.

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