Academic U.S. Radiation Oncology Department Chairs: Who are They?

PURPOSE/OBJECTIVE(S)

Historically, there has been a gender imbalance in the composition of the academic radiation oncology (RO) workforce. Given the increasing diversity of patients treated by academic radiation oncologists across the US, sufficient representation of women in academic RO, especially in leadership, is of paramount importance. In this study, we sought to better understand the characteristics of individuals currently serving as academic RO chairpersons whose departments are affiliated with ACGME-accredited RO residency training programs.

MATERIALS/METHODS

We created a comprehensive database of academic RO chairpersons in the US by utilizing information from publicly available sources, including residency training program websites, hospital/institutional websites, Doximity, LinkedIn, the American Society of Radiation Oncology (ASTRO) website, the American College of Radiation Oncology (ACRO) website, and the National Plan and Provider Enumeration System National Provider Identifier Registry. We used the Mann-Whitney U test and two-proportion z tests to evaluate for statistical significance among medians and proportions, respectively.

RESULTS

We identified 85/90 chairpersons (94.4%) whose departments are affiliated with an ACGME-accredited RO residency program. 4/85 (4.7%) chairpersons hold interim positions and were excluded from further analyses. Of the remaining 81 chairpersons in permanent positions, 10 (12.3%) are females and 71 (87.7%) are males (p < 0.01). 77 (95.1%) chairpersons are full professors and 19 (23.5%) hold dual MD-PhD degrees. 33 (40.7%) chairpersons hold an official leadership role, such as "director" or "chair," in the cancer institution affiliated with their institution; while such titles are more common among male than female chairpersons, the difference is not statistically significant (43.7% vs 20%, p = 0.15). 74/81 chairpersons secured their current positions a median of 16 years (range 6-33 years) after completing RO residency, with no statistically significant difference between male and female chairpersons (median 16 vs 18 years, respectively; p = 0.38). 36 (44.4%) chairpersons were promoted to chair from another position at their respective institutions (men 70.0% vs females 40.8%, p = 0.08). The majority of chairpersons are ASTRO Fellows (61.7%); notably fewer are ASTRO (3.7%) or ACRO (2.5%) Gold Medalists. There are no statistical differences among male and female chairpersons in the proportion who have received an ASTRO Fellow designation (60.6% vs 70.0%, p = 0.57) or ASTRO (4.2% vs 0.0%, p = 0.51) or ACRO (2.8% vs 0.0%, p = 0.59) Gold Medal.

CONCLUSION

In our benchmark study of the characteristics of current academic US RO chairpersons, we found that significantly more men than women currently serve as RO chairpersons. Future interventions that promote the recruitment, retention, and promotion of talented female academic RO physicians through the academic pipeline are warranted.

Age-specific habitat preference, carrying capacity, and landscape structure determine the response of population spatial variability to fishing-driven age truncation

Understanding the mechanisms underlying spatial variability of exploited fish is critical for the sustainable management of fish stocks. Empirical studies suggest that size-selective fishing can elevate fish population spatial variability (i.e., more heterogeneous distribution) through age truncation, making the population less resilient to changing environment. However, species differ in how their spatial variability responds to age truncation and the underlying mechanisms remain unclear.We hypothesize that age-specific habitat preference, together with environmental carrying capacity and landscape structure, determines the response of population spatial variability to fishing-induced age truncation. To test these hypotheses, we design an individual-based model of an age-structured fish population on a two-dimensional landscape under size-selective fishing. Individual fish reproduces and survives, and moves between habitats according to age-specific habitat preference and density-dependent habitat selection.Population spatial variability elevates with increasing age truncation, and the response is stronger for populations with stronger age-specific habitat preference. On a gradient landscape, reducing carrying capacity elevates the relative importance of density dependence in habitat selection, which weakens the response of spatial variability to age truncation for populations with strong age-specific habitat preference. On a fragmented landscape, both populations with strong and weak age-specific habitat preferences are restricted at local optimal habitats, and reducing carrying capacity weakens the responses of spatial variability to age truncation for both populations. Synthesis and applications. We demonstrate that to track and predict the changes in population spatial variability under exploitation, it is essential to consider the interactive effects of age-specific habitat preference, carrying capacity, and landscape structure. To improve spatial management in fisheries, it is crucial to enhance empirical and theoretical developments in the methodology to quantify age-specific habitat preference of marine fish, and to understand how climatic change influences carrying capacity and landscape continuity.

Cryo-FIB preparation of whole cells and tissue for cryo-TEM: use of high-pressure frozen specimens in tubes and planchets

The desire to study macromolecular complexes within their cellular context requires the ability to produce thin samples suitable for cryo‐TEM (cryo‐transmission electron microscope) investigations. In this paper, we discuss two similar approaches, which were developed independently in Utrecht (the Netherlands) and Albany (USA). The methods are particularly suitable for both tissue samples and cell suspensions prepared by a high‐pressure freezer (HPF). The workflows are explained with particular attention to potential pitfalls, while underlying principles are highlighted (‘why to do so’). Although both workflows function with a high success rate, full execution requires considerable experience and remains demanding. In addition, throughput is low. We hope to encourage other research groups worldwide to take on the challenge of improving the HPF– cryo‐FIB‐SEM – cryo‐TEM workflow. We discuss a number of suggestions to this end.

Lay Description

Life is ultimately dictated by the interaction of molecules in our bodies. Highly complex equipment is being used and further developed to study these interactions. The present paper describes methods to prepare small, very thin lamellae (area of 5×5 µm², thickness 50–300 nm) of a cell to be studied in a cryo‐transmission electron microscope (cryo‐TEM). Special care must be taken to preserve the natural state of molecules in their natural environment. In the case of cryo‐TEM, the samples must be frozen and kept frozen to be compatible with the vacuum conditions in the microscope. The frozen condition imposes technical challenges which are addressed. Two approaches to obtain the thin lamellae are described. Both make use of a focused ion beam (FIB) microscope. The FIB allows removal of material with nanometre precision by focusing a beam of ionised atoms (gallium ions) onto the sample. Careful control of the FIB allows cutting out of the required thin lamellae. In both strategies, the thin lamellae remain attached to the original sample, and the ensemble of sample with section and sample holder is transported from the FIB microscope to the TEM while being kept frozen.

A systematic review and meta-analysis of cancer patients affected by a novel coronavirus

BACKGROUND

Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population.

MATERIALS AND METHODS

A systematic search of PubMed/MEDLINE, Embase, Cochrane Central, Google Scholar, and MedRxiv was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio and forest plots were constructed for both primary and secondary outcomes. The random-effects model was used to account for heterogeneity between studies.

RESULTS

This systematic review of 31 studies and meta-analysis of 181,323 patients from 26 studies involving 23,736 cancer patients is the largest meta-analysis to the best of our knowledge assessing outcomes in cancer patients affected by COVID-19. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (odds ratio, OR 2.54), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated, although ICU admission rates were not statistically significant. Among cancer subtypes, the mortality was highest in hematological malignancies (OR 2.43) followed by lung cancer (OR 1.8). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients. Despite the heterogeneity of studies and inconsistencies in reported variables and outcomes, these data could guide clinical practice and oncologic care during this unprecedented global health pandemic.

CONCLUSION

Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.

547 Point-of-care cardiac assessment using machine learning to guide image acquisition

Funding Acknowledgements

Bay Labs, Inc; San Francisco, CA

Background/Introduction: When used by experienced examiners, the utility of point-of-care (POC) ultrasound for assessing cardiac anatomy and function has been well established. However, in some clinical circumstances (Primary Care offices, Intensive Care Unit, some Emergency Rooms, or in remote settings) in which a rapid assessment of cardiac anatomy and dynamics can facilitate patient care, an examiner experienced at POC scanning may not be immediately available.

Purpose

To help novice users acquire clinically useful standard cardiac views using novel machine learning (ML) software.

Methods

We used an investigational device that employs ML software to provide real-time adaptive guidance of transducer position and orientation to help novice users acquire tomographic views of the heart. We tested the utility of this approach when 4 nurses with no prior training in sonography performed POC studies on 16 subjects (10 healthy, 6 with cardiac abnormalities; 9 men; body mass index normal in 6, overweight in 6, and obese in 4 subjects). Each nurse underwent didactic training and 4 hours of supervised practice using the ML program. Each nurse scanned each study subject using a scanner equipped with ML software to acquire 10 digital two-dimensional image clips, including: parasternal long axis, short axis at the aortic valve, mitral valve, and mid-left ventricle (LV), apical 2-, 4-, and 5-chamber, subcostal 4-chamber, and longitudinal views of the inferior vena cava (IVC). All video clips (n = 640) were later reviewed independently by 5 level 3-trained cardiologists who were blinded to subject, scanner, and each other"s assessments. The expert readers reviewed each set of 10 clips to determine if the following variables could be assessed qualitatively: LV size and function; right ventricular (RV) size and function; aortic, mitral and tricuspid valves; pericardial effusion; left atrial size; IVC size.

Results

The majority of expert readers concurred, independently, that the sets of images acquired by nurses using ML guidance allowed qualitative assessment of LV size and function in 98%, pericardial effusion in 98%, RV size and function in 92%, and aortic and mitral valve anatomy and dynamics in 94-97% of cases. Qualitative assessment of LA size was feasible in 95%. Images of the IVC were judged as adequate for assessment in 58%.

Conclusion

This preliminary study suggests the potential value of novel ML software by demonstrating that nurses with limited training can acquire tomographic images useful for qualitative assessment of the cardiac chambers and valves in more than 90% of the subjects examined. This approach might be useful when timely POC cardiac assessment is indicated in settings where an experienced examiner is not available. Further refinements in the guiding software are needed to improve the success rate of IVC imaging, since IVC size can be a useful indicator of volume status.

BioTIME: A database of biodiversity time series for the Anthropocene

MOTIVATION

The BioTIME database contains raw data on species identities and abundances in ecological assemblages through time. These data enable users to calculate temporal trends in biodiversity within and amongst assemblages using a broad range of metrics. BioTIME is being developed as a community-led open-source database of biodiversity time series. Our goal is to accelerate and facilitate quantitative analysis of temporal patterns of biodiversity in the Anthropocene.

MAIN TYPES OF VARIABLES INCLUDED

The database contains 8,777,413 species abundance records, from assemblages consistently sampled for a minimum of 2 years, which need not necessarily be consecutive. In addition, the database contains metadata relating to sampling methodology and contextual information about each record.

SPATIAL LOCATION AND GRAIN

BioTIME is a global database of 547,161 unique sampling locations spanning the marine, freshwater and terrestrial realms. Grain size varies across datasets from 0.0000000158 km2 (158 cm2) to 100 km2 (1,000,000,000,000 cm2).

TIME PERIOD AND GRAIN

BioTIME records span from 1874 to 2016. The minimal temporal grain across all datasets in BioTIME is a year.

MAJOR TAXA AND LEVEL OF MEASUREMENT

BioTIME includes data from 44,440 species across the plant and animal kingdoms, ranging from plants, plankton and terrestrial invertebrates to small and large vertebrates.

SOFTWARE FORMAT

.csv and .SQL.

MicroRNA-383 located in frequently deleted chromosomal locus 8p22 regulates CD44 in prostate cancer

A major genomic alteration in prostate cancer (PCa) is frequent loss of chromosome (chr) 8p with a common region of loss of heterozygosity (LOH) at chr8p22 locus. Genomic studies implicate this locus in the initiation of clinically significant PCa and with progression to metastatic disease. However, the genes within this region have not been fully characterized to date. Here we demonstrate for the first time that a microRNA component of this region –miR-383- is frequently downregulated in prostate cancer, plays a critical role in determining tumor initiating potential and is involved in prostate cancer metastasis via direct regulation of CD44, a ubiquitous marker of PCa tumor initiating cells (TICs)/ stem cells. Expression analyses of miR-383 in PCa clinical tissues established that low miR-383 expression is associated with poor prognosis. Functional data suggests that miR-383 regulates PCa tumor initiating/ stem-like cells via CD44 regulation. Ectopic expression of miR-383 inhibited tumor initiating capacity of CD44+ PCa cells. Also, ‘anti-metastatic’ effects of ectopic miR-383 expression were observed in a PCa experimental metastasis model. In view of our results, we propose that frequent loss of miR-383 at chr8p22 region leads to tumor initiation and prostate cancer metastasis. Thus, we have identified a novel finding that associates a long observed genomic alteration to PCa stemness and metastasis. Our data suggests that restoration of miR-383 expression may be an effective therapeutic modality against PCa. Importantly, we identified miR-383 as a novel PCa tissue diagnostic biomarker with a potential that outperforms that of serum PSA.

WE-G-217A-09: Phase Imaging Measurement of Static Magnetic Field Homogeneity

PURPOSE

The ACR MRI accreditation program requires measurement of the magnetic field homogeneity (MFH) in the annual QA. Full implementation of vendor methods can be very time consuming and incorporates techniques not available to clinical physicists. Conversely, many of the less involved techniques proposed tend to be less inaccurate and/or precise. Here, we propose a robust approach to MFH analysis using a simple phase mapping acquisition which is a time efficient compromise.

METHODS

The root mean square (r.m.s.) for MFH measurement is commonly used over multiple slices (∼24). In regions with high SNR, the MR signal can be reasonably assumed Gaussian distributed. Therefore, the standard deviation of phase values in ROI is equivalent to the r.m.s. of those. The standard deviations of phases in x, y and z are assumed uncorrelated. Thus, only axial, sagittal and coronal planes need to be acquired to approximate the MFH as opposed to a full 3D acquisition. To investigate this concept, phase images were acquired on four 1.5T clinical scanners and one 3.0 clinical scanner (MAGNETOM Espree, Siemens Medical Systems, Signa Excite HD 1.5T, and 3.0T GE Healthcare Technologies). The manufacturer phantoms were scanned using two echo times (delta_TE=TE2-TE1<5ms) using a simple 2D gradient echo acquisition to produce phase images. After acquiring phase difference images in three orthogonal planes, the standard deviation was calculated in three circular ROIs (Diameter=10, 20 and 30cm) in each plane, respectively, to estimate the MFH for the effective DSV.

RESULTS

The MFH values in five scanners using this method were within vendor specifications for the DSV. Additionally, the measured MFH values compared favorably with vendor planned maintenance records with <0.1 ppm discrepancy.

CONCLUSIONS

This proposed method may be a reliable and practical for regular MFH measurement in QA programs and providing an independent check of the vendor measurement.

Role of matrix metalloproteinase-8 in the modulation of systemic 5-fluorouracil pharmacokinetics by local irradiation

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Background: Concurrent chemoradiation with 5-fluorouracil (5-FU) is widely accepted for cancer treatment. However, the interactions between radiation and 5-FU remain unclear. We evaluated the influence of local irradiation on the pharmacokinetics of 5-FU in rats.

Methods: The single-fraction radiation was delivered to the whole pelvic fields of Sprague-Dawley rats from a linear accelerator after computerized tomography-based planning. 5-FU at 100 mg/kg was intravenously infused 24 hours after radiation. A high-performance liquid chromatography system equipped with a UV detector was used to measure 5-FU in the blood. Matrix metalloproteinase-8 (MMP-8) inhibitor I was administered to the rats to examine whether or not RT modulation of 5-FU pharmacokinetic parameters could be blocked.

Results: Compared with sham-irradiated controls, whole pelvic irradiation reduced the area under the concentration versus time curve (AUC) of 5-FU in plasma and, in contrast, increased the AUC in bile in a radiation dose-dependent manner. Based on protein array analysis, the amount of plasma MMP-8 was increased by whole pelvic irradiation (2.8-fold by 0.5 Gy and 5.3-fold by 2 Gy) in comparison with controls. Pretreatment with MMP-8 inhibitor reversed the effect of irradiation on AUC of 5-FU in plasma.

Conclusions: Local irradiation may modulate the systemic pharmacokinetics of 5-FU through stimulating the release of MMP-8. This unexpected influence is worthy of further investigation and for consideration in clinical practice of radiotherapy for cancer.

No significant financial relationships to disclose.

Effect of interfacial shallow traps on polaron transport at the surface of organic semiconductors

The photo-induced electron and hole transfer across the semiconductor-dielectric interface in trap-dominated p-type organic field-effect transistors has been investigated. It has been observed that the transfer of electrons into the dielectric results in a decrease of the field-effect mobility of polarons, suggesting that additional shallow traps are generated in the conduction channel. Using this effect, the dependence of the field-effect mobility on the density of shallow traps, mu(N), has been measured, which allowed us to estimate the average polaron trapping time, tau_{tr}=50+/-10 ps, and the density of shallow traps, N0=(3+/-0.5) x 10(11) cm(-2), in the channel of single-crystal tetracene devices.