Subclinical knee extensor weakness predicts gait and balance impairment in degenerative cervical myelopathy.

Degenerative cervical myelopathy (DCM) is a leading cause of non-traumatic spinal cord disorders in older adults. Gait instability and balance dysfunction are common in DCM, even in the absence of clinically evident lower limb weakness. We hypothesized that subclinical weakness, measured through maximal voluntary isometric contractions (MVICs) of the knee extensors and ankle plantar flexors, is associated with impaired gait and balance in individuals with DCM.

Virtual reality-based training to augment recovery of hand dexterity after surgery for degenerative cervical myelopathy.

Degenerative cervical myelopathy (DCM), the leading cause of non-traumatic spinal cord injury, frequently results in impaired hand dexterity. While surgical decompression is the primary treatment, over 40% of patients report residual hand disability after surgery. There are no therapies to restore hand function after surgery for DCM.

Characteristics of Young Adults Admitted to Intensive Care Units at an Academic Health System.

Background: Young adults in intensive care units (ICUs) are a subgroup of patients who have not been adequately studied. Their health and developmental issues differ from those of children and older adults, but little is known about their specific critical care needs.

Objectives: To describe the characteristics of a cohort of young adults (18 to 39 years of age) receiving care in specialty ICUs, examine differences in this population before and during the COVID-19 pandemic, and explore associations among clinical and demographic variables and advance directives.

Quantification and Dosimetric Impact of Normal Organ Motion During Adaptive Radiation Therapy Planning Using a 1.5 Tesla Magnetic Resonance-Equipped Linear Accelerator (MR-Linac).

Purpose: Patients receiving adaptive magnetic resonance guided radiation therapy (MRgRT) undergo contour modification prior to treatment delivery, which takes 15 to over 60 minutes. We hypothesized that during the time required to create an adaptive MRgRT plan, organ movement will result in dosimetric changes to regional organs at risk (OARs). This study quantifies the dosimetric impact of OAR motion during the time required to perform adaptive MRgRT.

Serum protein biomarkers for degenerative cervical myelopathy: a prospective study.

Objective: Delays in diagnosis are common in degenerative cervical myelopathy (DCM), and there is a need for additional objective assessments of spinal cord structure and function. The objective of this study was to profile serum protein biomarkers in DCM and determine their potential diagnostic and prognostic utility.

Methods: Patients with clinically diagnosed DCM (n = 20) and scheduled to undergo decompressive surgery were prospectively enrolled from July 2022 to August 2023.

Supporting Hematopoietic Stem Cell Transplant Family Caregivers: A Pilot Study of Nurse-Led Meaning-Centered Psychotherapy for Cancer Caregivers.

Background: Family caregivers of patients undergoing hematopoietic stem cell transplantation (HSCT) experience significant challenges (e.g., witnessing suffering and experiencing loss and uncertainty) that contribute to existential distress and poor psychosocial outcomes.

Detection of potential causal pathways among social determinants of health: A data-informed framework.

Introduction: Understanding social determinants of health (SDOH) as a complex system is necessary for designing effective public health interventions. Traditional expert-driven approaches to mapping SDOH relationships, when used in isolation, are susceptible to subjective biases, incomplete knowledge, and inconsistencies across different domains of expertise. Additionally, SDOH variables often contain overlapping information, making it difficult to isolate unique SDOH constructs.

Multi-Site Retrospective Analysis of Diffusion and Perfusion MRI Correlates to Glioma Characteristics Derived from Radio-Pathomic Maps.

Introduction: This study determines the relationship between diffusion and perfusion-based MRI signatures and radio-pathomic maps of tumor pathology in a large, multi-site cohort.

Methods: This study included perfusion imaging from pre-surgical relative cerebral blood volume (rCBV) images from the UPenn-GBM dataset and pre-surgical arterial spin labeling (ASL) imaging from the UCSF-PDGM dataset. Diffusion imaging included fractional anisotropy (FA) estimates derived from diffusion tensor imaging (DTI) for each subject from each institution.

Distress thermometer problem list and distress and depression in psycho-oncology.

Purpose: This study examines the relationship between specific problem categories endorsed by patients with cancer seeking psycho-oncology services and their levels of distress and depression. Additionally, we investigate the potential associations between demographic and clinical characteristics and the endorsement of specific problem categories.

Methods: A non-randomised interventional study was conducted with adult patients referred for psycho-oncology services.

A Commensurate Prior Model With Random Effects for Survival and Competing Risk Outcomes to Accommodate Historical Controls.

Clinical trials (CTs) often suffer from small sample sizes due to limited budgets and patient enrollment challenges. Using historical data for the CT data analysis may boost statistical power and reduce the required sample size. Existing methods on borrowing information from historical data with right-censored outcomes did not consider matching between historical data and CT data to reduce the heterogeneity.

Dual-center retrospective cohort analysis of high-risk cutaneous squamous cell carcinoma tumors.

High-risk cutaneous squamous cell carcinoma (hr-cSCC) tumors exhibit aggressive behavior, leading to local recurrence, metastasis, and mortality. The management of hr-cSCC tumors is not well-defined. To clarify the impact of clinical risk factors and management strategies on disease-related outcomes (DROs) in patients with hr-cSCCs.

Adult zymosan re-exposure exacerbates the molecular alterations in the brainstem rostral ventromedial medulla of rats with early life zymosan-induced cystitis.

Recent evidence suggests that the descending modulatory pathways from the brainstem rostral ventromedial medulla (RVM) are important for bladder inflammatory pain. This study aimed to identify the long-term molecular changes in RVM neurons due to early life cystitis during neuronal development and the effect of reexposure later in adulthood. RVM tissues from two treatment protocols were used: (1) neonatal zymosan exposures with acute adult rechallenge (RC) and (2) only neonatal zymosan exposures (NRC).

Neuropathic pain has sex-specific effects on oxycodone-seeking and non-drug-seeking ensemble neurons in the dorsomedial prefrontal cortex of mice.

Approximately 50 million Americans suffer from chronic pain, and nearly a quarter of chronic pain patients have reported misusing opioid prescriptions. Repeated drug seeking is associated with reactivation of an ensemble of neurons sparsely scattered throughout the dorsomedial prefrontal cortex (dmPFC). Prior research has demonstrated that chronic pain increases intrinsic excitability of dmPFC neurons, which may increase the likelihood of reactivation during drug seeking.

Effect of sagittal alignment on spinal cord biomechanics in the stenotic cervical spine during neck flexion and extension.

Spinal cord stress and strain contribute to degenerative cervical myelopathy (DCM), while cervical kyphosis is known to negatively impact surgical outcomes. In DCM, the relationship between spinal cord biomechanics, sagittal alignment, and cord compression is not well understood. Quantifying this relationship can guide surgical strategies.

Impact of postsurgical rehabilitation on outcomes for degenerative cervical myelopathy.

Objective: Despite widespread use, there is limited evidence to support postsurgical rehabilitation to enhance neurological recovery after surgery for degenerative cervical myelopathy (DCM). Outcomes research for DCM seldom accounts for the effect of postsurgical rehabilitation. The aim of this study was to quantify the impact of postsurgical rehabilitation on outcomes after surgery for DCM.

Stay on Track: A Pilot Randomized Control Trial on the Feasibility of a Diet and Exercise Intervention in Patients with Breast Cancer Receiving Radiotherapy.

Purpose: Among patients with breast cancer undergoing radiotherapy, posttreatment cardiovascular disease and worsened quality of life (QoL) are leading causes of morbidity and mortality. To overcome these negative radiotherapy effects, this prospective, randomized clinical trial pilots a 12-week Stay on Track exercise and diet intervention for overweight patients with nonmetastatic breast cancer undergoing whole-breast radiotherapy.

Experimental Design: The intervention group (n = 22) participated in three personal exercise and dietary counseling sessions, and received three text reminders/week to adhere to recommendations.

Noninvasive Autopsy-Validated Tumor Probability Maps Identify Glioma Invasion Beyond Contrast Enhancement.

Background And Objectives: This study identified a clinically significant subset of patients with glioma with tumor outside of contrast enhancement present at autopsy and subsequently developed a method for detecting nonenhancing tumor using radio-pathomic mapping. We tested the hypothesis that autopsy-based radio-pathomic tumor probability maps would be able to noninvasively identify areas of infiltrative tumor beyond traditional imaging signatures.

Methods: A total of 159 tissue samples from 65 subjects were aligned to MRI acquired nearest to death for this retrospective study.

Stat5 induces androgen receptor () gene transcription in prostate cancer and offers a druggable pathway to target AR signaling.

Androgen receptor (AR) drives prostate cancer (PC) growth and progression, and targeting AR signaling is the mainstay of pharmacological therapies for PC. Resistance develops relatively fast as a result of refueled AR activity. A major gap in the field is the lack of understanding of targetable mechanisms that induce persistent AR expression in castrate-resistant PC (CRPC).

Radio-pathomic maps of glioblastoma identify phenotypes of non-enhancing tumor infiltration associated with bevacizumab treatment response.

Background: Autopsy-based radio-pathomic maps of glioma pathology have shown substantial promise inidentifying areas of non-enhancing tumor presence, which may be able to differentiate subsets of patients that respond favorably to treatments such as bevacizumab that have shown mixed efficacy evidence. We tested the hypthesis that phenotypes of non-enhancing tumor fronts can distinguish between glioblastoma patients that will respond favorably to bevacizumab and will visually capture treatment response.

Methods: T1, T1C, FLAIR, and ADC images were used to generate radio-pathomic maps of tumor characteristics for 79 pre-treatment patients with a primary GBM or high-grade IDH1-mutant astrocytoma for this study.

Radio-pathomic maps of glioblastoma identify phenotypes of non-enhancing tumor infiltration associated with bevacizumab treatment response.

Background: Autopsy-based radio-pathomic maps of glioma pathology have shown substantial promise inidentifying areas of non-enhancing tumor presence, which may be able to differentiate subsets of patients that respond favorably to treatments such as bevacizumab that have shown mixed efficacy evidence. We tested the hypthesis that phenotypes of non-enhancing tumor fronts can distinguish between glioblastoma patients that will respond favorably to bevacizumab and will visually capture treatment response.

Methods: T1, T1C, FLAIR, and ADC images were used to generate radio-pathomic maps of tumor characteristics for 79 pre-treatment patients with a primary GBM or high-grade IDH1-mutant astrocytoma for this study.

Environmental Enrichment during Abstinence Reduces Oxycodone Seeking and c-Fos Expression in a Subpopulation of Medial Prefrontal Cortex Neurons.

Background: Several preclinical studies have demonstrated that environmental enrichment (EE) during abstinence reduces drug seeking for psychostimulant and opioid drugs. Drug seeking is dependent on activity within the dorsomedial prefrontal cortex, and enrichment has been able to reduce drug seeking-associated increases in c-Fos in this region. In this study, we tested the hypothesis that EE during abstinence from oxycodone self-administration would reduce drug seeking and c-Fos immunoreactivity within the prefrontal cortex in a cell-type specific manner.

Associations of prior concussion severity with brain microstructure using mean apparent propagator magnetic resonance imaging.

Magnetic resonance imaging (MRI) diffusion studies have shown chronic microstructural tissue abnormalities in athletes with history of concussion, but with inconsistent findings. Concussions with post-traumatic amnesia (PTA) and/or loss of consciousness (LOC) have been connected to greater physiological injury. The novel mean apparent propagator (MAP) MRI is expected to be more sensitive to such tissue injury than the conventional diffusion tensor imaging.

Characterization of an oligometastatic state in patients with metastatic pancreatic adenocarcinoma undergoing systemic chemotherapy.

Purpose/objectives: Most patients with pancreatic adenocarcinoma (PDAC) will present with distant metastatic disease at diagnosis. We sought to identify clinical characteristics associated with prolonged overall survival (OS) in patients presenting with metastatic PDAC.

Materials/methods: Patients presenting with metastatic PDAC that received treatment at our institution with FOLFIRINOX or gemcitabine-based chemotherapies between August 1, 2011 and September 1, 2017 were included in the study.