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PurposeCirculating tumor DNA (ctDNA) analyses allow for postoperative risk stratification in patients with curatively treated colon and breast cancers. Use of ctDNA in esophagogastric cancers (EGC) is less characterized and could identify high-risk patients who have been treated with curative intent.MethodsIn this retrospective analysis of real-world data, ctDNA levels were analyzed in the preoperative, postoperative, and surveillance settings in patients with EGC using a personalized multiplex polymerase chain reaction-based next-generation sequencing assay. Plasma samples (n = 943) from 295 patients at > 70 institutions were collected before surgery, postoperatively, and/or serially during routine clinical follow-up from September 19, 2019, to February 21, 2022. ctDNA detection was annotated to clinicopathologic features and recurrence-free survival.ResultsA total of 295 patients with EGC were analyzed, and 212 patients with stages I-III disease were further explored. Pretreatment ctDNA was detected in 96% (23/24) of patients with preoperative time points. Postoperative ctDNA was detected in 23.5% (16/68) of patients with stage I-III EGC within 16 weeks (molecular residual disease window) after surgery without receiving systemic therapy. ctDNA detection at any time point after surgery (hazard ratio [HR], 23.6; 95% CI, 10.2 to 66.0; P < .0001), within the molecular residual disease window (HR, 10.7; 95% CI, 4.3 to 29.3; P < .0001), and during the surveillance period (HR, 17.7; 95% CI, 7.3 to 50.7; P < .0001) was associated with shorter recurrence-free survival. In multivariable analysis, ctDNA status and clinical stage of disease were independently associated with outcomes.ConclusionUsing real-world data, we demonstrate that postoperative tumor-informed ctDNA detection in EGC is feasible and allows for enhanced patient risk stratification and prognostication during curative-intent therapy.

BackgroundArteriovenous malformations (AVMs) are rare vascular anomalies involving a disorganization of arteries and veins with no intervening capillaries. In the past 10 years, radiomics and machine learning (ML) models became increasingly popular for analyzing diagnostic medical images. The goal of this review was to provide a comprehensive summary of current radiomic models being employed for the diagnostic, therapeutic, prognostic, and predictive outcomes in AVM management.MethodsA systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, in which the PubMed and Embase databases were searched using the following terms: (cerebral OR brain OR intracranial OR central nervous system OR spine OR spinal) AND (AVM OR arteriovenous malformation OR arteriovenous malformations) AND (radiomics OR radiogenomics OR machine learning OR artificial intelligence OR deep learning OR computer-aided detection OR computer-aided prediction OR computer-aided treatment decision). A radiomics quality score (RQS) was calculated for all included studies.ResultsThirteen studies were included, which were all retrospective in nature. Three studies (23%) dealt with AVM diagnosis and grading, 1 study (8%) gauged treatment response, 8 (62%) predicted outcomes, and the last one (8%) addressed prognosis. No radiomics model had undergone external validation. The mean RQS was 15.92 (range: 10–18).ConclusionWe demonstrated that radiomics is currently being studied in different facets of AVM management. While not ready for clinical use, radiomics is a rapidly emerging field expected to play a significant future role in medical imaging. More prospective studies are warranted to determine the role of radiomics in the diagnosis, prediction of comorbidities, and treatment selection in AVM management.

BackgroundRenal transplant recipients (RTRs) are at increased risk of keratinocyte cancer (KC), especially cutaneous squamous cell carcinoma (cSCC). Previous studies identified a genetic variant of the Methylenetetrahydrofolate Reductase (MTHFR) gene, C677T, which conferred a risk for diagnosis of cSCC in Irish RTRs.ObjectiveWe sought to find further genetic variation in MTHFR and overlap genes that may be associated with a diagnosis of KC in RTRs.MethodsGenotyping of a combined RTR population (n = 821) from two centres, Ireland (n = 546) and the USA (n = 275), was performed. This included 290 RTRs with KC and 444 without. Eleven single nucleotide polymorphisms (SNPs) in the MTHFR gene and seven in the overlap gene MTHFR Chloride transport protein 6 (CLCN6) were evaluated and association explored by time to event analysis (from transplant to first KC) using Cox proportional hazards model.ResultsPolymorphism at MTHFR CLCN6 (rs9651118) was significantly associated with KC in RTRs (HR 1.50, 95% CI 1.17-1.91, p

Objectives This report describes the use of an Everolimus-eluting stent (Xience Skypoint stent) for the treatment of medically-refractory ICAD.Design Retrospective, case-seriesSetting In-hospital patientsParticipants All patients in this report had a history of stroke secondary to ICAD. All patients failed aggressive medical treatments and had recurrence of symptoms despite anticoagulation or dual-antiplatelet therapy plus a statin. Diagnostic angiogram in each case showed severe vessel stenosis, therefore patients were recommended for intracranial artery stenting.Main outcome measures Technical feasibility of deploying Xience Skypoint stent for treatmet of ICAD.Results The Xience Skypoint stent was safely and effectively deployed in the vertebral artery (x1) and the internal carotid artery (x2) using trans-ulnar (x1), trans-radial (x1), and trans-femoral (x1) approaches without the use of an intermediate catheter.Conclusion Second-generation EES such as Xience Skypoint may be utilized for treatment of medically-refractory ICAD. This technical report serves as a proof of concept for further studies analysing long-term safety and efficacy of such stents for treatment of ICAD.

We explored children's physical activity level and psychosocial outcomes in a service-learning program. The program, taught by preservice physical educators, engages children in fun activities within a mastery motivational climate (MMC). Forty-two children in grades K-4 wore accelerometers during two 90-min sessions, resulting in 84 data points. Forty-three children age 8 and up completed a postprogram survey assessing motivational climate, perceived competence, and personal and social responsibility. Of those, 27 completed a presurvey as well. On average, children were engaged in light activity for 38.6% and moderate-to-vigorous activity for 26.0% of the program time. Social responsibility improved from pre- to postassessment. Children perceived a high MMC, and regression analyses showed that MMC was positively related to perceived competence, personal responsibility, and social responsibility at the end of the program. Results suggest this program was effective in using an MMC to promote social responsibility while engaging students in light, moderate, and vigorous physical activity.

Outdoor recreation professionals have long sought to impact environmental behavior of participants. Mindfulness and nature connection have recently been explored as possible constructs to impact environmental behavior. The purpose of this study was to better understand the impact of mindful outdoor recreation trips on college students' nature connectedness and ecological behavior. We used explanatory mixed methods approach to explore the relationship between mindfulness, nature connection, and ecological behavior. Quantitative findings suggest that being mindfully outdoors has a positive effect on the degree to which nature is included in the sense of self and on ecological behavior. Qualitative findings support the quantitative findings and suggest that students use mindfulness to connect with nature and to care more for the environment. These findings suggest that the use of mindfulness interventions in outdoor education programming may improve nature connection and ecological behavior.

Abstract Background We designed and implemented the Brigham and Women’s Wellness Initiative (B-Well), a single-arm study to examine the feasibility of a workplace program that used individual and team-based financial incentives to increase physical activity among sedentary hospital employees. Methods We enrolled sedentary, non-clinician employees of a tertiary medical center who self-reported low physical activity. Eligible participants formed or joined teams of three members and wore Fitbit Flex activity monitors for two pre-intervention weeks followed by 24 weeks during which they could earn monetary rewards. Participants were rewarded for increasing their moderate-to-vigorous physical activity (MVPA) by 10% from the previous week or for meeting the Centers for Disease Control and Prevention (CDC) physical activity guidelines (150 min of MVPA per week). Our primary outcome was the proportion of participants meeting weekly MVPA goals and CDC physical activity guidelines. Secondary outcomes included Fitbit-wear adherence and factors associated with meeting CDC guidelines more consistently. Results B-Well included 292 hospital employees. Participants had a mean age of 38 years (SD 11), 83% were female, 38% were obese, and 62% were non-Hispanic White. Sixty-three percent of participants wore the Fitbit ≥4 days per week for ≥20 weeks. Two-thirds were satisfied with the B-Well program, with 79% indicating that they would participate again. Eighty-six percent met either their personal weekly goal or CDC physical activity guidelines for at least 6 out of 24 weeks, and 52% met their goals or CDC physical activity guidelines for at least 12 weeks. African Americans, non-obese subjects, and those with lower impulsivity scores reached CDC guidelines more consistently. Conclusions Our data suggest that a financial incentives-based workplace wellness program can increase MVPA among sedentary employees. These results should be reproduced in a randomized controlled trial. Trial registration Clinicaltrials.gov, NCT02850094 . Registered July 27, 2016 [retrospectively registered].

Introduction: Renal transplant recipients are at increased risk of keratinocyte skin cancers with a tendency to have multiple, aggressive and difficult to treat tumours. The eye and the skin share the same embryological ectoderm. Iris pattern has recently been reported as a predictive risk factor for skin cancer in non‐immunosuppressed Southern European (Grigore et al., J Eur Acad Dermatol Venereol, 2018, 1662) and Irish populations (Ridge et al., J Eur Acad Dermatol Venereol, 2022, e542). Aims: To analyse if an individual's iris pattern is an independent risk factor for the development of keratinocyte skin cancers in renal transplant recipients. Methods: Iris patterns of 110 renal transplant recipients were evaluated using the Simionescu visual three‐step technique (iris periphery, colarette and iris freckling [Simionescu et al., Ann Res Rev Biol, 2014, 2525]). Established risk factors for skin cancer in transplant patients were recorded as confounding factors. Results: Observational cross‐sectional study including 110 renal transplant population. Thirty‐one participants had skin cancer. In the skin cancer group, iris periphery was blue/grey in 74.3% (p = 0.053, OR 2.5), the colarette was light brown in 57.1% (p < 0.0043) and iris freckles were present in 55%(p = 0.044). Dark brown and blue colarettes were observed in controls. Binary Logistic Regression analysis showed light brown colarette is a significant independent risk factor for skin cancer (OR 4.54, p < 0.02, CI 1.56–10.57). Conclusion: Within this renal transplant population a blue iris periphery, light brown colarette and presence of freckling confers an independent risk for keratinocyte skin cancer. Iris pattern is a useful tool for identification of transplant patients at risk of keratinocyte skin cancer and an easy‐to‐use technique for risk evaluation in this cohort. This is the first study looking at iris pattern and keratinocyte skin cancer risk in renal transplant population. [ABSTRACT FROM AUTHOR]

Social-Cognitive Theory (Bandura, 1986, 1999) served as the framework to explore overweight children's perceptions of different physical activity settings. Participants were children (n = 67) enrolled in an after-school and summer program for overweight African-American and Hispanic-American children from low-income families. To gain insight into the children's thoughts encompassing their participation in both the after school/summer program and their physical education classes at their respective elementary schools, all of the children individually participated in semistructured interviews. Children enjoyed their involvement in the after-school/summer program and described social, physical, and cognitive benefits related to their participation. Interview data also revealed children's ideas and suggestions for adapting physical education to enhance participation in physical activity. Based on these results, instructional and management strategies focusing on promoting a nurturing environment in physical activity settings for all children (overweight and nonoverweight) are presented and discussed.

Fun & Fit is a program designed to create positive physical activity experiences and to promote healthy lifestyle choices among overweight children from low-income African American and Hispanic American families. The program is a collaborative project between Texas Tech University and the Lubbock Independent School District funded through a grant received from the United States Department of Education. The primary goals of Fun & Fit, Phase I were to (1) have participants experience fun and success in physical activities, (2) provide multiple occasions for the children to engage in moderate-to-vigorous physical activity, (3) increase participants' knowledge about nutrition and wellness, and (4) give Texas Tech University students opportunities to hone their teaching skills through participation in a university service-learning course. This article describes the development and implementation of the Fun & Fit program. (Contains 2 figures.)

This investigation examined the effect of model similarity on girls' acquisition, retention, transfer, and transfer strategies of a novel motor task. Forty girls (mean age = 10 years) were randomly assigned to conditions in a 2 (model skill level) 3 2 (model sex) factorial design using four treatment groups: (a) male skilled, (b) male learning, (c) female skilled, and (d) female learning. Quantitative data were collected throughout all phases of the investigation. ANOVA results for transfer strategies revealed a significant main effect for model skill level and model sex. Participants observing a female model or a learning model transferred significantly more learning strategies than did participants observing a male or skilled model. After quantitative data collection, qualitative data were obtained via structured interviews and assessed through content analysis. Results from the interview analyses underscored the need to include models of similar sex, as well as learning models, when instructing girls in motor skills.