The ACHIEVE Program: Bringing Chicago Youth and Community Organizations Together to Impact Local Disparities.

To evaluate the Advancing Community Health and Individual leadership through a noVel Educational (ACHIEVE) program uniting Chicago high school and undergraduate students (scholars) and community organizations to empower youth to meaningfully impact communities while enhancing organizational capacity. Between 2020 and 2022, the ACHIEVE program engaged cohorts of youth in classroom-based learning and community-based projects targeting health and education disparities. Pre and post-program surveys were administered to scholars to assess knowledge about disparities, skills, and self-efficacy. Semi-structured interviews were conducted with community organization leaders to examine programmatic impact. Descriptive and thematic analyses were performed. Across four cohorts (March 2020; September 2020-May 2021; September-November 2021; March-May 2022), 85 students participated in the ACHIEVE program. Scholars supported 19 community-based projects that increased awareness of local issues and resources and evaluated programs. Scholars reported advancement in their knowledge and skills as well as interest in sustaining their community engagement. Leaders shared several benefits at the organizational and community levels from collaborating with scholars. The ACHIEVE program enabled bidirectional learning between scholars and organizations. It also demonstrated that youth can contribute positively to addressing disparities while supporting local organizations and communities.

Prolonged Survival of NUT Midline Carcinoma and Current Approaches to Treatment.

NUT midline carcinoma is a rare malignancy most commonly seen in adolescents and young adults. The disease presents most often in the lung or head and neck area but can be seen occasionally elsewhere. The diagnosis can be difficult and requires a high degree of suspicion with demonstration of the classic fusion rearrangement mutation of the NUTM1 gene with one of a variety of partners by immunohistochemistry, fluorescent in situ hybridization, or genomic analysis. Survival is usually only a number of months with few long-term survivors. Here we report one of the longest-known survivors of this disease treated with surgery and radiation without additional therapy. Systemic treatment approaches including the use of chemotherapy and BET and histone deacetylase inhibitors have yielded modest results. Further studies of these, as well as p300 and CDK9 inhibitors and combinations of BET inhibitors with chemotherapy or CDK 4/6 inhibitors, are being evaluated. Recent reports suggest there may be a role for immune checkpoint inhibitors, even in the absence of high tumor mutation burden or PD-L1 positivity. RNA sequencing of this patient's tumor demonstrated overexpression of multiple potentially targetable genes. Given the altered transcription that results from the causative mutation multi-omic evaluation of these tumors may uncover druggable targets for treatment.

The not-so-hidden costs of surgical site infections.

Surgical site infections (SSIs) adversely affect approximately 500,000 patients annually, causing immense human suffering and taking a huge financial toll on patients, hospitals, insurance companies, and the government. National organizations have made recommendations for reducing SSIs, and many advances have been made in evidence-based practice recommendations that result in fewer SSIs. Reusable electrocardiogram (ECG) lead wires can be a significant source of infection. One medical center near Richmond, VA, began using a disposable ECG lead wire set and wireless transceiver system and subsequently experienced a 40% decrease in SSIs.

Modified total body irradiation as a planned second high-dose therapy with stem cell infusion for patients with bone-based malignancies.

PURPOSE: To estimate the maximum tolerated dose of hyperfractionated total marrow irradiation (TMI) as a second consolidation after high-dose chemotherapy with autologous or syngeneic blood stem cell transfusion for patients with bone/bone marrow-based malignant disease. PATIENTS AND METHODS: Fifty-seven patients aged 3-65 years (median, 45 years), including 21 with multiple myeloma, 24 with breast cancer, 10 with sarcoma, and 2 with lymphoma, were treated with 1.5 Gy administered twice daily to a total dose of 12 Gy (n = 27), 13.5 Gy (n = 12), and 15 Gy (n = 18). Median time between the 2 transplants was 105 days (range, 63-162 days). RESULTS: All patients engrafted neutrophils (median, Day 11; range, Day 9-23) and became platelet independent (median, Day 9; range, Day 7-36). There were 5 cases of Grade 3-4 regimen-related pulmonary toxicity, 1 at 12 Gy, and 4 at 15 Gy. Complete responses, partial responses, and stabilizations were achieved in 33%, 26%, and 41% of patients, respectively. Kaplan-Meier estimates of 5-year progression-free survival and overall survival for 56 evaluable patients are 24% and 36%, respectively. Median time of follow-up among survivors was 96 months (range, 77-136 months). CONCLUSION: Total marrow irradiation as a second myeloablative therapy is feasible. The estimated maximum tolerated dose for TMI in a tandem transplant setting was 13.5 Gy. Because 20% of patients are surviving at 8 years free of disease, further studies of TMI are warranted.