Treatment Toxicity: Radiation

Radiation exposures, both intentional and unintentional, have influence on normal tissue function. Short-term and long-term injuries can occur to all cell systems of both limited and rapid self-renewal potential. Radiation effects can last a lifetime for a patient and can produce complications for all organs and systems. Often invisible at the time of exposure, the fingerprints for cell damage can appear at any timepoint after. Health-care providers will need comprehensive knowledge and understanding of the acute and late effects of radiation exposure and how these interrelate with immediate and long-term care

Acquisition and Management of Data for Translational Science in Oncology

Oncology clinical trials provide opportunity to advance care for patients with cancer. Bridging basic science with bedside care, cancer clinical trials have brought new and updated scientific knowledge at a rapid pace. Managing subject data in translation science requires a sophisticated informatics infrastructure that will enable harmonized datasets across all areas that could influence outcomes. Successful translational science requires that all relevant information be made readily available in a digital format that can be queried in a facile manner. Through a translational science prism, we look at past issues in cancer clinical trials and the new National Institutes of Health/National Cancer Institute initiative to address the need of database availability at an enterprise level

Distributed leadership in organizations: A review of theory and research

The aim of this paper is to review conceptual and empirical literature on the concept of distributed leadership (DL) in order to identify its origins, key arguments, and areas for further work. Consideration is given to the similarities and differences between DL and related concepts including ‘shared’, ‘collective’, ‘collaborative’, ‘emergent’, ‘co-‘ and ‘democratic’ leadership. Findings indicate that whilst there are some common theoretical bases, the relative usage of these concepts varies over time, between countries and between sectors. In particular, DL is a notion that has seen a rapid growth in interest since the year 2000 but research remains largely restricted to the field of school education and of proportionally more interest to UK than US-based academics. Several scholars are increasingly going to lengths to indicate that in order to be ‘distributed’ leadership need not necessarily be widely ‘shared’ or ‘democratic’ and in order to be effective there is a need to balance different ‘hybrid configurations’ of practice. The article highlights a number of areas for further attention, including three factors relating to the context of much work on DL (power and influence; organisational boundaries and context; and ethics and diversity), and three methodological and developmental challenges (ontology; research methods; and leadership development, reward and recognition). It is concluded that descriptive and normative perspectives that dominate the literature should be supplemented by more critical accounts that recognise the rhetorical and discursive significance of DL in (re)constructing leader-follower identities, mobilising collective engagement and challenging or reinforcing traditional forms of organisation

When Will the Bus Arrive?

Public transportation decreases the amount of cars on the road and potentially provides a cleaner and more economic way of travel. With the many benefits of public transportation, some problems arise, mainly the predictability of bus arrival times. We collected bus arrival times through a real-time bus-tracker and weather predictions. Our main goal was to determine if we could predict when buses would arrive based on the weather. We then used the data to train a ridge regression model to predict lateness. Our models had some predictive power, but weather was not as useful a predictor as we initially thought it would be

A rare case of extensive synovial chondromatosis of the knee with arthroscopic synovectomy and evacuation: A case report

Case: Synovial chondromatosis is a rare, benign condition characterized by metaplasia of the synovial membrane with formation of multiple cartilaginous nodules within the synovium. This case is of a 58-year-old male who initially presented with right knee pain. The patient was ultimately found to have extensive synovial chondromatosis. The diagnosis was confirmed by histopathologic evaluation and treated with loose body removal and radical synovectomy via an arthroscopic approach. Conclusion: Fully arthroscopic approaches described have been shown to decrease patient morbidity while providing adequate synovial resection and thorough joint debridement. Here we describe the clinical presentation, pathophysiology, diagnostic modalities, and management options synovial chondromatosis of the knee

RADIATION THERAPY QUALITY IN CCG/POG INTERGROUP 9961: IMPLICATIONS FOR CRANIOSPINAL IRRADIATION AND THE POSTERIOR FOSSA BOOST IN FUTURE MEDULLOBLASTOMA TRIALS

Purpose: Associations of RT deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose CSI and chemotherapy. The aim of this study is to evaluate the quality of RT on CCG/POG 9961 and analyze associations of RT deviations with outcome.Methods and Materials: Major volume deviations were assessed based on the distance from specified anatomical region to field edge. We investigated associations of RT deviations with progression-free survival (PFS), overall survival (OS), and explored associations with demographics and clinical variables.Results: Of the 308 patients who were evaluable for volume deviations, 101 patients (33%) did not have any. Of the remaining 207 patients, 50% had only minor deviations, 29% had only major deviations, and 21% had both minor and major deviations. Of the patients with major deviations, 73% had a single major deviation. The most common major deviation was in the cribriform plate region, followed by the posterior fossa; posterior fossa deviations resulted from treating less than whole posterior fossa. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of radiation therapy delivered in COG institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of posterior fossa volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome