Exploration of an adaptive proton therapy strategy using CBCT with the concept of digital twins.

This study aims to develop a digital twin (DT) framework to achieve adaptive proton prostate stereotactic body radiation therapy (SBRT) with fast treatment plan selection and patient-specific clinical target volume (CTV) setup uncertainty. Prostate SBRT has emerged as a leading option for external beam radiotherapy due to its effectiveness and reduced treatment duration. However, interfractional anatomy variations can impact treatment outcomes.

Surgical correction of a chin-on-abdomen deformity due to ankylosing spinal deformity and obesity: illustrative case.

Background: Kyphotic spinal deformity is a complication of ankylosing spondylitis (AS). In rare cases, particularly in obese patients, the deformity might extend to the cervicothoracic spine, resulting in a severe "chin-on-abdomen" deformity. This condition severely impairs quality of life by affecting gaze, swallowing, and causing chronic pain.

Trastuzumab Plus Pertuzumab Versus Cetuximab Plus Irinotecan in Patients With Wild-Type, HER2-Positive, Metastatic Colorectal Cancer (S1613): A Randomized Phase II Trial.

Purpose: overexpression/amplification in wild-type (WT) metastatic colorectal cancer (mCRC; human epidermal growth factor receptor 2 [HER2]-positive mCRC) appears to be associated with limited benefit from anti-EGFR antibodies and promising responses to dual-HER2 inhibition; however, comparative efficacy has not been investigated. We conducted a randomized phase II trial to evaluate efficacy and safety of dual-HER2 inhibition against standard-of-care anti-EGFR antibody-based therapy as second/third-line treatment in HER2-positive mCRC.

Methods: Patients with -WT mCRC after central confirmation of HER2 positivity (immunohistochemistry 3+ or 2+ and in situ hybridization amplified [HER2/CEP17 ratio >2.

Randomized Trial of Enhanced Versus Standard Navigation to Promote Timely Initiation of Adjuvant Radiotherapy for Head and Neck Cancer.

Purpose: National Comprehensive Cancer Network Guidelines recommend initiating postoperative radiation therapy (PORT) within 6 weeks of surgery for patients with head and neck squamous cell carcinoma (HNSCC), but delays affect 50% of patients, disproportionately burden minoritized groups, and contribute to worse oncologic outcomes. This trial evaluates the efficacy of Navigation for Disparities and Untimely Radiation thErapy (NDURE), an enhanced navigation-based intervention, relative to usual care (UC) patient navigation for starting timely PORT.

Methods: Adults with locally advanced HNSCC planning to undergo surgery and PORT were randomly assigned 1:1 to standard multidisciplinary head and neck oncology care and either NDURE, a multilevel navigation-based intervention to enhance key processes of care and overcome barriers to timely PORT, or UC, which consisted of standard patient navigation.

Structure-Activity Relationship Studies of an Autophagy Inhibitor That Targets the ATG14L-Beclin1 Protein-Protein Interaction Reveal Modifications That Improve Potency and Solubility and Maintain Selectivity.

Autophagy, a recycling process in eukaryotes, contributes to tumor growth and metastasis by alleviating cellular stress and facilitating survival and chemoresistance. The development of small molecules that selectively inhibit this pathway has proven challenging and is required to determine if autophagy inhibition can be harnessed as an effective therapeutic strategy in cancer. Compound 19 was previously identified as a selective autophagy inhibitor that targets the ATG14L-Beclin1 protein-protein interaction, which regulates the formation, localization, and function of VPS34 Complex I to initiate autophagy.

Patient Factors Influence Minimal Clinically Important Difference for the SNOT-22 in Medically Treated Chronic Rhinosinusitis.

Background: The present study explores the effect of sociodemographics and comorbidities on the calculated minimal clinically important difference (MCID) for 22-item Sinonasal Outcome Test (SNOT-22) scores in patients with medically treated chronic rhinosinusitis (CRS). The importance of delineating a threshold to indicate clinically meaningful changes perceived by a patient is well acknowledged, yet the influence of patient-specific factors on MCID has not been fully elucidated.

Methods: Patients with CRS (n = 221) presenting to a tertiary care practice reported their change in disease burden with anchor questions following CRS-directed medical treatment.

Synthesis of Oxabicyclo[3.2.1]octan-3-ol Scaffold via Burgess Reagent Mediated Cyclodehydration of δ-Diols under Acidic Conditions.

Dehydrative cyclization of δ-diols was achieved by using the Burgess reagent under mild conditions to furnish a novel oxabicyclo[3.2.1]octan-3-ol scaffold.

Evaluating the ingress of total polycyclic aromatic hydrocarbons (PAHs) specifically naphthalene through firefighter hoods and base layers.

Structural firefighters are exposed to an array of polycyclic aromatic hydrocarbons (PAHs) as a result of incomplete combustion of both synthetic and natural materials. PAHs are found in both the particulate and vapor phases in the firefighting environment and are significantly associated with acute and chronic diseases, including cancer. Using a fireground exposure simulator (FES) and standing mannequins dressed in four different firefighter personal protective equipment (PPE) conditions, each with varying levels of protective hood interface and particulate-blocking features, the efficacy of the hoods was assessed against the ingress of PAHs (specifically, naphthalene).

Barriers and Facilitators to Quality Healthcare for African Americans with Incarceration Histories.

Background: Prior research has shown that African American men and women are more likely to receive lower quality healthcare compared to their white counterparts, which is exacerbated in jail and prison healthcare systems.

Objective: The purpose of this study is to explore barriers and facilitators to quality healthcare among African American men and women released from Illinois State Prisons or Cook County Jail by examining their opinions and experiences with overall healthcare and cancer screening during and after incarceration.

Design: Four focus groups (n = 25 "co-researchers") were conducted to understand how formerly incarcerated African American men and women perceive and describe their experience of accessing, understanding, and utilizing healthcare during and after incarceration.

Mucin5AC promotes breast cancer brain metastasis through cMET/CD44v6.

Purpose: Breast cancer (BC) brain metastasis (BrM) remains a significant clinical problem. Mucins have been implicated in metastasis; however, if they are also involved in BCBrM remains unknown. We queried BrM patient databases and found Mucin 5AC (MUC5AC) to be upregulated and therefore sought to define the role of MUC5AC in BCBrM.

Genomic analysis of surgical patients to identify patients at risk for postoperative sepsis and surgical site infection.

Background: Early and accurate diagnosis of sepsis and the ensuing organ dysfunction remain a challenge in the postoperative setting. Susceptibility to infections, as well as the subsequent immunological response, are driven to some extent by the genetic predisposition of the patient. The purpose of this study was to identify novel genetic variants associated with postoperative sepsis (POS) and surgical site infections (SSIs).

The Hallmarks of Predictive Oncology.

As the field of artificial intelligence evolves rapidly, these hallmarks are intended to capture fundamental, complementary concepts necessary for the progress and timely adoption of predictive modeling in precision oncology. Through these hallmarks, we hope to establish standards and guidelines that enable the symbiotic development of artificial intelligence and precision oncology.

Patient and provider perspectives on pain management during manual vacuum aspiration.

Manual vacuum aspiration (MVA) is a painful procedure often conducted without analgesia. The World Health Organization (WHO) recommends a paracervical block (PCB) as the mode of pain relief during MVA. Few studies have assessed patient perspectives on pain control during MVA.

Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience.

Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce.

Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels.

Genomic Introgression Between Critically Endangered and Stable Species of Darwin's Tree Finches on the Galapagos Islands.

Natural hybridisation among rare or endangered species and stable congenerics is increasingly topical for the conservation of species-level diversity under anthropogenic impacts. Evidence for beneficial genes being introgressed into or selected for in hybrids raises concurrent questions about its evolutionary significance. In Darwin's tree finches on the island of Floreana (Galapagos Islands, Ecuador), the Critically Endangered medium tree finch () undergoes introgression with the stable small tree finch (), and hybrids regularly backcross with Earlier studies in 2005-2013 documented an increase in the frequency of hybridisation on Floreana using field-based and microsatellite data.

Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities.

Societal and structural inequities have resulted in longstanding health care disparities among Black, Latino/a/e, and low-income preschool children with developmental delays and disabilities (PCw/DD), depriving them of educational and therapeutic services that improve future academic, economic, and health outcomes. To address this issue, we developed Preschool and Me (PreM), a community-clinical linkage (CCL) implemented within healthcare settings serving historically marginalized communities. This novel CCL, an educational-medical linkage model, aims to increase access to school-based services for PCw/DD.

Clinical Implications of Skin Cancer in Kidney Transplant Recipients in the Era of Immune Checkpoint Inhibitors.

Long-term survival has improved in kidney transplant recipients (KTRs) due to effective surgical techniques and anti-rejection therapies. Chronic immunosuppression associated with it has led to several types of skin cancers leading to substantial morbidity and mortality. Structured patient education including sun protective behaviors, regular dermatological surveillance, nicotinamide, long-chain omega-3 polyunsaturated fatty acids (PUFAs), early switch to mammalian target of rapamycin inhibitors (mTORis), combining them with low-dose calcineurin inhibitors (CNIs), can decrease the cancer risk.

An Interdisciplinary Perspective on Improving Cancer Care in the State of Mississippi as an Example of Cancer Care Improvements in the Global South.

Cancer disparities, a critical public health issue, particularly in states such as Mississippi, where socioeconomic factors significantly influence health outcomes, require our collective attention. This paper delves into the multifaceted nature of cancer disparities through a macro-level analysis of cancer data, specifically focusing on Mississippi as a microcosm of broader national and global trends. Two key indices, the Socio-Demographic Index (SDI) and the Social Deprivation Index (SDeI), provide valuable insights.

Serotype Distribution Among US Adults Hospitalized With Community-Acquired Pneumonia, 2019-2020.

Background: Serotype-specific urinary antigen detection (UAD) assay results can be used to estimate the serotype contribution among adults with pneumococcal community-acquired pneumonia (CAP) and to guide recommendations regarding higher-valency pneumococcal conjugate vaccines (PCVs).

Methods: Adults aged ≥18 years hospitalized with radiographic evidence of CAP were prospectively enrolled in 4 US cities from November 2019 to December 2020, overlapping the coronavirus disease 2019 (COVID-19) pandemic. Data were collected by patient interview and medical chart review.