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Article ; Online: Epigenetic modifications of cfDNA in liquid biopsy for the cancer care continuum.

Wong, Jodie / Muralidhar, Rohit / Wang, Liang / Huang, Chiang-Ching

2024 , Page(s) 100718

Abstract: This review provides a comprehensive overview of the latest advancements in the clinical utility of liquid biopsy, with a particular focus on epigenetic approaches aimed at overcoming challenges in cancer diagnosis and treatment. It begins by elucidating ...

Abstract	This review provides a comprehensive overview of the latest advancements in the clinical utility of liquid biopsy, with a particular focus on epigenetic approaches aimed at overcoming challenges in cancer diagnosis and treatment. It begins by elucidating key epigenetic terms, including methylomics, fragmentomics, and nucleosomics. The review progresses to discuss methods for analyzing circulating cell-free DNA (cfDNA) and highlights recent studies showcasing the clinical relevance of epigenetic modifications in areas such as diagnosis, drug treatment response, minimal residual disease (MRD) detection, and prognosis prediction. While acknowledging hurdles like the complexity of interpreting epigenetic data and the absence of standardization, the review charts a path forward. It advocates for the integration of multi-omic data through machine learning algorithms to refine predictive models and stresses the importance of collaboration among clinicians, researchers, and data scientists. Such cooperative efforts are essential to fully leverage the potential of epigenetic features in clinical practice.
Language	English
Publishing date	2024-03-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2698541-X
ISSN	2320-2890 ; 2320-2890
ISSN (online)	2320-2890
ISSN	2320-2890
DOI	10.1016/j.bj.2024.100718
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Article ; Online: The correlation between perceived stress and skin-picking in medical students.

Le, Jenna T / Li, Xin Ran / Huang, Chiang-Ching / Dong, Xiaowei / Agrawal, Himanshu

Journal of psychosomatic research

2024 Volume 179, Page(s) 111651

MeSH term(s)	Humans ; Students, Medical ; Surveys and Questionnaires ; Skin ; Stress, Psychological ; Self-Injurious Behavior
Language	English
Publishing date	2024-03-21
Publishing country	England
Document type	Letter
ZDB-ID	80166-5
ISSN	1879-1360 ; 0022-3999
ISSN (online)	1879-1360
ISSN	0022-3999
DOI	10.1016/j.jpsychores.2024.111651
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Article ; Online: Comparing Symmetric Dimethylarginine and Amyloid-β42 as Predictors of Alzheimer's Disease Development.

Goodman, Max J / Li, Xin Ran / Livschitz, Jennifer / Huang, Chiang-Ching / Bendlin, Barbara B / Granadillo, Elias D

Journal of Alzheimer's disease reports

2023 Volume 7, Issue 1, Page(s) 1427–1444

Abstract: Background: Physicians may soon be able to diagnose Alzheimer's disease (AD) in its early stages using fluid biomarkers like amyloid. However, it is acknowledged that additional biomarkers need to be characterized which would facilitate earlier ... ...

Abstract	Background: Physicians may soon be able to diagnose Alzheimer's disease (AD) in its early stages using fluid biomarkers like amyloid. However, it is acknowledged that additional biomarkers need to be characterized which would facilitate earlier monitoring of AD pathogenesis. Objective: To determine if a potential novel inflammation biomarker for AD, symmetric dimethylarginine, has utility as a baseline serum biomarker for discriminating prodromal AD from cognitively unimpaired controls in comparison to cerebrospinal fluid amyloid-β42 (Aβ Methods: Data including demographics, magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography scans, Mini-Mental State Examination and Functional Activities Questionnaire scores, and biomarker concentrations were obtained from the Alzheimer's Disease Neuroimaging Initiative for a total of 146 prodromal AD participants and 108 cognitively unimpaired controls. Results: Aβ Conclusions: Correlations were smaller between Aβ
Language	English
Publishing date	2023-12-29
Publishing country	Netherlands
Document type	Journal Article
ISSN	2542-4823
ISSN (online)	2542-4823
DOI	10.3233/ADR-230054
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Article ; Online: National Trends in "Going Flat" After Mastectomy.

Johnson, Morgan K / Cortina, Chandler S / Hsu, Tzu-Lun / Huang, Shane / Frebault, Julia / Huang, Chiang-Ching / Kong, Amanda L

Annals of surgical oncology

2023 Volume 30, Issue 11, Page(s) 6374–6382

Abstract: Introduction: The "Going Flat" movement became widely publicized in 2016 and provides information and support to women who choose to forego post-mastectomy breast reconstruction (PMBR). The objectives of this study were to evaluate temporal trends in ... ...

Abstract	Introduction: The "Going Flat" movement became widely publicized in 2016 and provides information and support to women who choose to forego post-mastectomy breast reconstruction (PMBR). The objectives of this study were to evaluate temporal trends in PMBR to ascertain the potential impact of this movement and assess which factors are associated with going flat. Methods: A retrospective cohort analysis was performed using the NCDB of women with non-metastatic breast cancer who underwent mastectomy between 2004 and 2019. Trends in going flat after mastectomy were examined and stratified by age (< 50, 50-69, ≥ 70). A multivariate logistic regression model was used to identify factors associated with going flat. Results: 650,983 patients met the inclusion criteria: 244,201 (37.5%) underwent PMBR and 406,782 (62.5%) went flat. Among women < 70, rates of going flat steadily decreased from 2004 to 2015 and then stabilized after 2015, coinciding with the rise of the "Going Flat" movement. In multivariate analysis, non-White race, older age, increasing comorbidities, government provided insurance, treatment at a community program, radiotherapy, and adjuvant chemotherapy were associated with a higher likelihood of going flat (p < 0.001). Conclusion: In the first 2 years after the "Going Flat" movement, the number of women going flat after mastectomy has stabilized in women < 70 for the first time in over a decade. These trends suggest that the social and cultural impact of this movement may have contributed to the stabilization of PMBR rates.
MeSH term(s)	Humans ; Female ; Mastectomy ; Retrospective Studies ; Breast Neoplasms/surgery ; Mammaplasty ; Cohort Studies
Language	English
Publishing date	2023-07-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-023-13845-1
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Article ; Online: Building a Program of Expanded Peer Support for the Entire Health Care Team: No One Left Behind.

Klatt, Timothy E / Sachs, Jessica F / Huang, Chiang-Ching / Pilarski, Alicia M

Joint Commission journal on quality and patient safety

2021 Volume 47, Issue 12, Page(s) 759–767

Abstract: Background: Medical errors can cause second victim syndrome (SVS) in caregivers. Literature describing the development of effective peer support programs is limited. This article describes the implementation of a peer support program for an entire ... ...

Abstract	Background: Medical errors can cause second victim syndrome (SVS) in caregivers. Literature describing the development of effective peer support programs is limited. This article describes the implementation of a peer support program for an entire health care system. Methods: The research team initially trained 52 supporters representing all clinical areas throughout an urban academic quaternary care campus. Each then supported at-risk colleagues, raised awareness of SVS, and recruited others for training. Triggers for peer support expanded to include medical errors, unanticipated patient outcomes, inability to stop the progression of medical conditions, medical emergencies of colleagues, aggressive behavior by a patient/family member, and COVID-19 events. Data reporting supporters' efforts were summarized. After the initial 5-hour session, training was condensed into 2.5 hours. The effectiveness of these training sessions was assessed. The Second Victim Experience and Support Tool (SVEST) was used to assess program effectiveness three and nine months after implementation. Results: By 18 months, a blended program was achieved with 149 supporters: 81 medical college and 68 hospital personnel. Providers received 46.5% of support efforts and hospital personnel 47.9%. The most common event supported was inability to stop the progression of medical conditions (24.5%). Both training sessions improved attendees' knowledge of SVS and improved their comfort with teaching others how to support a second victim. Both SVEST surveys showed that nonwork and supervisor support rated highest, followed by colleague support. Institution support rated lowest. Conclusion: The team successfully implemented a peer support program with trained supporters from various clinical disciplines for distressing events beyond medical errors.
MeSH term(s)	COVID-19 ; Counseling ; Humans ; Medical Errors/prevention & control ; Patient Care Team ; SARS-CoV-2
Language	English
Publishing date	2021-08-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1189890-2
ISSN	1938-131X ; 1549-425X ; 1553-7250 ; 1070-3241 ; 1549-3741
ISSN (online)	1938-131X ; 1549-425X
ISSN	1553-7250 ; 1070-3241 ; 1549-3741
DOI	10.1016/j.jcjq.2021.08.010
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Article ; Online: Social determinants of health correlations and resource usefulness at a Milwaukee free clinic for uninsured individuals: A cross-sectional study.

Miller, Jessica / Doucas, Adrianna / Karra, Hamsitha / Thareja, Suma K / Bowie, Owen / Dong, Xiaowei / Terrell, Jennifer / Hernandez, Samuel / Corujo-Ramirez, Ana Mia / Xia, Nicole / Qi, Sabrina / Huang, Chiang-Ching / Lundh, Rebecca / Young, Staci A

Journal of clinical and translational science

2024 Volume 8, Issue 1, Page(s) e71

Abstract: Introduction: Addressing social determinants of health (SDOH) is fundamental to improving health outcomes. At a student-run free clinic, we developed a screening process to understand the SDOH needs and resource utilization of Milwaukee's uninsured ... ...

Abstract	Introduction: Addressing social determinants of health (SDOH) is fundamental to improving health outcomes. At a student-run free clinic, we developed a screening process to understand the SDOH needs and resource utilization of Milwaukee's uninsured population. Methods: In this cross-sectional study, we screened adult patients without health insurance ( Results: Access to dental care (64.7%) and health insurance (51.3%) were the most frequently endorsed needs. We found significant correlations ( Conclusions: Understanding prominent SDOH needs can inform resource offerings and interventions, addressing root causes that burden under-resourced patients. In this study, patient-reported data about resource usefulness prompted the curation of new resources and volunteer roles. This proof-of-concept study shows how longitudinally tracking SDOH needs at low-resource clinics can inform psychosocial resources.
Language	English
Publishing date	2024-04-25
Publishing country	England
Document type	Journal Article
ISSN	2059-8661
ISSN (online)	2059-8661
DOI	10.1017/cts.2024.503
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Article ; Online: Appendiceal Incidentalomas: Prevalence, Radiographic Characteristics, Management, and Outcomes.

Kelly, Adam / O'Connor, Stacy / Kane, Diana / Huang, Chiang-Ching / Mogal, Harveshp

Annals of surgical oncology

2022 Volume 29, Issue 13, Page(s) 8265–8273

Abstract: Background: Radiographically detected incidental appendiceal abnormalities, in this report termed "appendiceal incidentalomas" (AIs), are an ill-defined entity with an unknown prevalence of neoplasm. This study aimed to describe the prevalence, ... ...

Abstract	Background: Radiographically detected incidental appendiceal abnormalities, in this report termed "appendiceal incidentalomas" (AIs), are an ill-defined entity with an unknown prevalence of neoplasm. This study aimed to describe the prevalence, radiographic characteristics, and outcomes of patients with a diagnosis of AI. Methods: The study reviewed the electronic health records for patients at a single institution undergoing abdominopelvic computed tomography and magnetic resonance imaging (MRI) from 2000 to 2020 for non-appendix-related complaints with mention of appendix abnormality in the radiology report. The suggested diagnosis at the index imaging was recorded. Outcomes were compared between the operative and non-operative patients. Results: Of 5197 records, 484 were identified as reports of AIs (9 % of screened patients). Neoplasms were suggested radiographically in 16 % (n = 79) of the records, 59 % (47/79) of which were resected. Pathologically, 32 of the abnormalities were confirmed as neoplasms, yielding a diagnostic accuracy of 68 %. Compared with the non-operative patients, the operative patients had AIs with a larger mean diameter (22.7 ± 13.0 vs. 17.8 ±7.7 mm; p = 0.04), a higher colonoscopy rate (51 % vs. 22 %; p = 0.01), and diagnosis at a younger age (55.8 ± 15.6 vs. 67.2 ± 16.0 years; p = 0.003). The postoperative complications were minor (Clavien-Dindo grade 1 or 2) in 26 % and major (grades 3-5) in 4 % of the cases. During a median follow-up period of 28.3 months, 94 % of the patients were alive without disease, and 6 % died of other causes. The 32 non-operative suggested neoplastic AIs had a median follow-up period of 20.9 months. At this writing, 59 % of the operative patients are alive with a stable abnormal appendix, 13 % had no appendix abnormality at last follow-up visit, and 28 % have died of other causes. Conclusion: Neoplastic AIs are an uncommon finding and radiographically diagnosed with relatively high accuracy. Larger appendiceal diameter and younger age predict operative intervention. Although surgery is associated with favorable outcomes and minimal risk of postoperative complications, observation of suspected neoplastic AIs may be a safe alternative for select patients undergoing follow-up longitudinal imaging.
MeSH term(s)	Humans ; Prevalence ; Appendix/pathology ; Appendix/surgery ; Tomography, X-Ray Computed/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/pathology ; Appendiceal Neoplasms/diagnostic imaging ; Appendiceal Neoplasms/epidemiology ; Appendiceal Neoplasms/surgery
Language	English
Publishing date	2022-08-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-022-12362-x
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Article ; Online: Associations Between Hospital Volume and Overall Survival After Surgery in Older Patients with Breast Cancer.

Thalji, Sam Z / Cortina, Chandler S / Frebault, Julia / Cho, Youngjoo / Thorgerson, Abigail / Bergom, Carmen R / Huang, Chiang-Ching / Kong, Amanda L

Annals of surgical oncology

2023 Volume 30, Issue 11, Page(s) 6462–6470

Abstract: Background: High-volume hospitals (HVHs) are associated with improved overall survival (OS) following surgery for breast cancer compared with low-volume hospitals (LVHs). We examined this association in patients age ≥ 80 years and described patient and ... ...

Abstract	Background: High-volume hospitals (HVHs) are associated with improved overall survival (OS) following surgery for breast cancer compared with low-volume hospitals (LVHs). We examined this association in patients age ≥ 80 years and described patient and treatment characteristics associated with HVHs. Patients and methods: The National Cancer Database was queried for women age ≥ 80 years who underwent surgery for stage I-III breast cancer between 2005 and 2014. Hospital volume was defined as the average number of cases during the year of the patient's index operation and the year prior. Hospitals were categorized into HVHs and LVHs using penalized cubic spline analysis of OS. A cutoff of ≥ 270 cases/year defined HVHs. Results: Among 59,043 patients, 9110 (15%) were treated at HVHs and 49,933 (85%) at LVHs. HVHs were associated with more non-Hispanic Black and Hispanic patients, earlier stage disease (stage I 54.9% vs. 52.6%, p < 0.001), higher rates of breast-conserving surgery (BCS) (68.3% vs. 61.4%, p < 0.001), and adjuvant radiation (37.5% vs. 36.1%, p = 0.004). Improved OS was associated with surgery at a HVH (HR 0.85, CI 0.81-0.88), along with receipt of adjuvant chemotherapy (HR 0.73, CI 0.69-0.77), endocrine therapy (HR 0.70, CI 0.68-0.72), and radiation (HR 0.66, CI 0.64-0.68). Conclusions: Among patients with breast cancer age ≥ 80 years, undergoing surgery at a HVH was associated with improved OS. Patients who completed surgery at HVHs had earlier stage disease and more commonly received adjuvant radiation when appropriate. Processes of care at HVHs should be identified to improve outcomes in all settings.
MeSH term(s)	Humans ; Female ; Aged ; Aged, 80 and over ; Breast Neoplasms/surgery ; Hospitals, Low-Volume ; Hospitals, High-Volume
Language	English
Publishing date	2023-06-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-023-13725-8
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Article ; Online: Does Neoadjuvant Chemotherapy in Clinical T1-T2 N0 Triple-Negative Breast Cancer Increase the Extent of Axillary Surgery?

Cortina, Chandler S / Lloren, Jan Irene / Rogers, Christine / Johnson, Morgan K / Cobb, Adrienne N / Huang, Chiang-Ching / Kong, Amanda L / Singh, Puneet / Teshome, Mediget

Annals of surgical oncology

2024 Volume 31, Issue 5, Page(s) 3128–3140

Abstract: Background: Current management strategies for early-stage triple-negative breast cancer (TNBC) include upfront surgery to determine pathologic stage to guide chemotherapy recommendations, or neoadjuvant chemotherapy (NAC) to de-escalate surgery, ... ...

Abstract	Background: Current management strategies for early-stage triple-negative breast cancer (TNBC) include upfront surgery to determine pathologic stage to guide chemotherapy recommendations, or neoadjuvant chemotherapy (NAC) to de-escalate surgery, elucidate tumor response, and determine the role of adjuvant chemotherapy. However, patients who receive NAC with residual pathological nodal (pN) involvement require axillary lymph node dissection (ALND) as they are Z11/AMAROS ineligible. We aimed to evaluate the impact of NAC compared with upfront surgery on pN status and ALND rates in cT1-2N0 TNBC. Methods: The National Cancer Database (NCDB) was queried for women with operable cT1-2N0 TNBC from 2014 to 2019. Demographic, clinicopathologic, and treatment data were collected. Multivariable linear regression analysis was performed to assess the odds of pN+ disease and undergoing ALND. Results: Overall, 55,624 women were included: 26.9% (n = 14,942) underwent NAC and 73.1% (n = 40,682) underwent upfront surgery. The NAC cohort was younger (mean age 52.9 vs. 61.3 years; p < 0.001) with more cT2 tumors (71.6% vs. 31.0%; p < 0.001), and had lower ALND rates (4.3% vs. 5.5%; p < 0.001). The upfront surgery cohort was more likely to have one to three pathologically positive nodes (12.1% vs. 6.5%; odds ratio [OR] 2.37, 95% confidence interval (CI) 2.17-2.58; p < 0.001) but there was no difference in the likelihood of ALND (OR 1.1, 95% CI 0.99-1.24; p = 0.08). Conclusion: Patients who underwent upfront surgery were more likely to be pN+; however, ALND rates were similar between the two cohorts. Thus, the use of NAC does not result in a higher odds of ALND and the decision for NAC should be individualized and based on modern guidelines and systemic therapy benefits.
MeSH term(s)	Humans ; Female ; Middle Aged ; Neoadjuvant Therapy ; Triple Negative Breast Neoplasms/drug therapy ; Triple Negative Breast Neoplasms/surgery ; Triple Negative Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Lymph Node Excision ; Chemotherapy, Adjuvant ; Axilla ; Sentinel Lymph Node Biopsy ; Lymph Nodes/surgery ; Lymph Nodes/pathology
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-024-14914-9
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Article: Bioinformatics Analysis for Circulating Cell-Free DNA in Cancer.

Huang, Chiang-Ching / Du, Meijun / Wang, Liang

Cancers

2019 Volume 11, Issue 6

Abstract: Molecular analysis of cell-free DNA (cfDNA) that circulates in plasma and other body fluids represents a "liquid biopsy" approach for non-invasive cancer screening or monitoring. The rapid development of sequencing technologies has made cfDNA a promising ...

Abstract	Molecular analysis of cell-free DNA (cfDNA) that circulates in plasma and other body fluids represents a "liquid biopsy" approach for non-invasive cancer screening or monitoring. The rapid development of sequencing technologies has made cfDNA a promising source to study cancer development and progression. Specific genetic and epigenetic alterations have been found in plasma, serum, and urine cfDNA and could potentially be used as diagnostic or prognostic biomarkers in various cancer types. In this review, we will discuss the molecular characteristics of cancer cfDNA and major bioinformatics approaches involved in the analysis of cfDNA sequencing data for detecting genetic mutation, copy number alteration, methylation change, and nucleosome positioning variation. We highlight specific challenges in sensitivity to detect genetic aberrations and robustness of statistical analysis. Finally, we provide perspectives regarding the standard and continuing development of bioinformatics analysis to move this promising screening tool into clinical practice.
Language	English
Publishing date	2019-06-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers11060805
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