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33. Centering Community: Enacting Culturally Responsive-Sustaining YPAR during COVID-19

Author

Marciano, Joanne E., Peralta, Lee Melvin, Lee, Ji Soo, Rosemurgy, Hannah, Holloway, Lillian, and Bass, Justice

Abstract

Purpose: This paper aims to provide insights for educators seeking to enact culturally responsive-sustaining education and research in the midst of the COVID-19 global pandemic. The authors examine what happened when the community-based Youth Participatory Action Research (YPAR) initiative they engaged with traditionally marginalized high school students was interrupted as a result of physical distancing necessitated by COVID-19. Design/methodology/approach: Data for this inquiry were taken from a broader on-going ethnography of youth's participation in the YPAR project and included audio and video recordings from meetings of the YPAR initiative and messages exchanged between and among authors and youth. Authors used components of culturally responsive-sustaining education and theories related to student voice as an analytic frame through which they considered how the COVID-19 pandemic influenced their work. Findings: Three findings are examined in this paper. They consider: how youth participants and the authors stayed connected after they were no longer able to meet in person; how youth chose to center the needs of the subsidized housing community where they lived while continuing their work; and how youth and authors navigated the uncertainties they encountered in looking ahead to future possibilities for their study as the pandemic continued. Originality/value: This study provides urgently needed insights for educators and researchers grappling with how they may enact culturally responsive-sustaining education and research during the COVID-19 global pandemic and beyond.

Published
2020
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42. The Oncological Stress Test of Neoadjuvant Therapy: A Systematic Review in Outcomes of Neoadjuvant Therapy Compared to Upfront Resection Approach for Borderline Resectable Pancreatic Adenocarcinoma

Author

Ross, Sharona B., Popover, Jesse, Sucandy, Iswanto, Christodoulou, Maria, Pattilachan, Tara M., and Rosemurgy, Alexander S.

Abstract

Pancreatic adenocarcinoma, increasingly diagnosed in the United States, has a disheartening initial resection rate of 15%. Neoadjuvant therapy, particularly FOLFIRINOX and gemcitabine-based regimens, is gaining favor for its potential to improve resectability rates and achieving microscopically negative margins (R0) in borderline resectable cases, marked by intricate arterial or venous involvement. Despite surgery being the sole curative approach, actual benefit of neoadjuvant therapy remains debatable. This study scrutinizes current literature on oncological outcomes post-resection of borderline resectable pancreatic cancer. A MEDLINE/PubMed search was conducted to systematically compare oncological outcomes of patients treated with either neoadjuvant therapy with intent of curative resection or an “upfront resection” approach. A total of 1293 studies were initially screened and 30 were included (n = 1714) in this analysis. All studies included data on outcomes of patients with borderline resectable pancreatic adenocarcinoma being treated with neoadjuvant therapy (n = 1387) or a resection-first approach (n = 356). Patients treated with neoadjuvant therapy underwent resection 52% of the time, achieving negative margins of 43% (n = 601). Approximately 77% of patients who received an upfront resection underwent a successful resection, with 39% achieving negative margins. Neoadjuvant therapy remains marginally efficacious in treatment of borderline resectable pancreatic adenocarcinoma, as patients undergo an operation and successful resection less often when treated with neoadjuvant therapy. Rates of curative resection are comparable, despite neoadjuvant therapy being a primary recommendation in borderline resectable cases and employed more often than upfront resection. Upfront resection may offer improved resection rates by intention-to-treat, which can provide more patients with paths to curative resection.

Published
2024
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43. Treatment of locally advanced pancreatic cancer using localized trans-arterial micro perfusion of gemcitabine: combined analysis of RR1 and RR2.

Author

Hatoum, Hassan, Rosemurgy, Alexander, Bastidas, J Augusto, Zervos, Emmanuel, Muscarella, Peter, Edil, Barish H, Cynamon, Jacob, Johnson, D Thor, Thomas, Christopher, Swinson, Bradley M, Nordgren, Aaron, Vitulli, Paul, Nutting, Charles, Gipson, Matthew, Tsobanoudis, Alex, and Agah, Ramtin

Subjects
PATIENT safety, RESEARCH funding, CLINICAL trials, CHEMORADIOTHERAPY, DESCRIPTIVE statistics, PANCREATIC tumors, CANCER chemotherapy, GEMCITABINE, DRUG efficacy, PERFUSION, CONFIDENCE intervals, OVERALL survival
Abstract

Background Locally advanced pancreatic cancer (LAPC) comprises 40% of pancreatic cancer diagnoses and has a relatively poor prognosis. Trans-arterial micro perfusion (TAMP)-mediated chemotherapy delivery to the primary tumor is a novel approach worthy of investigation. The RR1 (dose escalation) and RR2 (observational) studies examined the safety and preliminary efficacy of TAMP-delivered gemcitabine for LAPC. Patients and Methods RR1 and RR2 data were pooled. Both studies enrolled patients with LAPC with histologically confirmed adenocarcinoma. Participant data, including age, sex, race, stage, previous treatments, toxicity, disease progression, and death, were collected. Median number of cycles and average treatment dosage were calculated. Overall survival (OS) was determined for the whole group and separately for patients who received and did not receive previous treatments. Aims of the analysis were to assess procedure safety, OS, and evaluate factors associated with OS. Results The median age of the 43 patients enrolled in RR1 and RR2 was 72 years (range, 51-88 years). Median OS for the 35 eligible patients with stage III disease was 12.6 months (95% CI, 2.1-54.2 months). Previous chemoradiation was associated with significantly longer OS [27.1 months (95% CI, 8.4-40.6 months)] compared to previous systemic chemotherapy [14.6 months (95% CI, 6.4-54.2 months)] or no prior treatment [7.0 months (95% CI, 2.1-35.4 months)] (P  < .001). The most common adverse events were GI related (abdominal pain, emesis, and vomiting); the most common grade 3 toxicity was sepsis. Conclusion Study results indicate that TAMP-mediated gemcitabine delivery in patients with LAPC is potentially safe, feasible, and provides potential clinical benefits. Clinical Trial Registration NCT02237157 (RR1) and NCT02591082 (RR2). [ABSTRACT FROM AUTHOR]

Published
2024
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44. Robotic Heller Myotomy

Author

Ross, Sharona B., Downs, Darrell, Sucandy, Iswanto, Rosemurgy, Alexander S., Tsuda, Shawn, editor, and Kudsi, Omar Yusef, editor

Published
2019
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