Citations

Abstract Background To determine if dose escalation improves outcomes for chondrosarcomas (CHS) of the base of the skull (BOS) and the cervical spine (CS). Methods A prospective, randomized, dose-escalation trial was designed for patients with CHS of the BOS and CS. Patients were randomly assigned to 70 Gy (RBE) or 76 Gy (RBE). The primary endpoint was local failure (LF). Secondary endpoints included overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and treatment-related toxicities. Results Between 1987 and 2007, 105 patients were randomized, median follow-up was 29.2 years (IQR, 26.7-32.4). Forty-six patients were assigned to 70 Gy (RBE) and 59 were assigned to 76 Gy (RBE). LF at 5-, 10-, and 20 years were 7%, 9%, and 11% for 70 Gy (RBE), and 10%, 15%, and 19% for 76 Gy (RBE) (P = .16). Like LF rates, there was no benefit in dose escalation for OS (P = .28) and CSS (P = .22). Progression-free survival at 5-, 10-, and 20 years was 93%, 89%, and 77% for the low-dose group and 83%, 71%, and 59% for the high-dose group (P = .069). Late RT injury ≥ grade 3 was reported in a total of 19 (18%) patients across both dose levels, with 11% in the low-dose group and 24% in the high-dose group (P = .13). Conclusions This is the first and largest trial of patients with grade I/II BOS and CS CHS evaluating dose escalation for tumor control. Proton-based RT is effective and safe for these tumors, but there is no apparent benefit in dose escalation. Clinical Trial Information NCT00592748.

ABSTRACT The concentration of cells is a key component of modern blood tests. Given the biomarker potential of extracellular vesicles (EVs) in blood, we aimed to establish reference ranges for blood cell‐derived EVs using flow cytometry. To address the orders‐of‐magnitude variability in reported EV concentrations between different flow cytometers (FCMs), we first validated a calibration methodology to enable reproducible EV concentration measurements. The methodology was evaluated in an interlaboratory comparison study and shows that calibration reduces the median absolute deviation of EV concentrations measured on 25 different FCMs from 67 % to 25 %–31 %. The calibration methodology was then used to determine reference ranges of erythrocyte‐, leukocyte‐, and platelet‐derived EVs in human blood plasma in a cohort of healthy individuals ( n = 224). This study demonstrates that calibration enables comparable concentration measurements of blood cell‐derived EVs, thereby bringing EVs one step closer to clinical applications.

Objective The purpose of this study was to determine the cumulative incidence of diagnosis switching, drug‐free remission, and initiation of a biologic or targeted synthetic disease‐modifying antirheumatic drug (b/tsDMARD) in individuals with seronegative rheumatoid arthritis (RA). Methods Adult residents of Olmsted County, Minnesota, with incident seronegative (rheumatoid factor negative/anti–cyclic citrullinated peptide antibody negative) RA meeting the 1987 and/or 2010 American College of Rheumatology classification criteria were included. Data were collected from January 1, 2005, to December 31, 2023, through manual chart review. Drug‐free remission was defined as a period of at least six months where the individual was no longer taking treatment for RA and did not have evidence of active inflammatory arthritis upon evaluation by a rheumatologist. We calculated the 10‐year cumulative incidence of a change in diagnosis, adjusting for the competing risk of death, and of drug‐free remission and initiation of a b/tsDMARD, adjusting for the competing risks of death or change in diagnosis. Results A total of 176 individuals with seronegative RA (68% women) were included. The 10‐year cumulative incidence of a change in diagnosis was 12.8% (95% confidence interval [CI] 8.7%–18.9%). The most common change in diagnosis was to spondyloarthritis (4%). The 10‐year cumulative incidence of drug‐free remission and initiation of a b/tsDMARD was 26.6% (95% CI 20.7%–34.2%) and 19.9% (95% CI 14.7%–26.9%), respectively. Over a median follow‐up of 11.8 years, 49 individuals entered drug‐free remission. Conclusion After initial diagnosis of seronegative RA, about 13% of individuals had a change in diagnosis and a quarter experienced drug‐free remission within 10 years.

Abstract Jagim, AR, Dobbs, WC, Horswill, CA, Twohey, E, Fields, JB, and Jones, MT. Prevalence and magnitude weight loss among collegiate wrestlers. J Strength Cond Res 40(1): 90–97, 2026—The purpose of this study was to examine the percentage of wrestlers who compete in their minimal weight class (MWC), and the magnitude of weight loss. Data from the 2023–2024 collegiate season were retrospectively analyzed resulting in a sample of 9,638 collegiate male wrestlers from the National Association of Intercollegiate Athletics ( n = 1,904) and all 3 divisions of the National Collegiate Athletics Association ( n = 7,734). All wrestlers completed skinfold assessments for weight certification at the start of the competition season. The lowest recorded weight class (LRW) achieved by each wrestler during the season was also recorded and used to determine magnitude of weight loss. Out of the 4,605 (53.2%) of wrestlers who competed in their MWC, their average amount of weight loss was significantly higher than those who did not compete in their MWC (3.9 ± 2.5 vs. 3.2 ± 2.9 kg.; p < 0.001), yet they had an initial lower body fat percentage (12.7 ± 2.9 vs. 17.5 ± 4.8%; p < 0.001). At the time of weight certification, wrestlers weighed 8.1 ± 4.5 (95% confidence interval (CI): 8.0–8.2; effect size (ES) = 1.8) kg more than their minimal wrestling weight. The LRW was 3.6 ± 2.9 (95% CI: 3.6–3.7; ES = 1.2) kg lower than their weight at the time of weight certification. Given that slightly more than half of the male wrestlers competed in their MWC, coaches and sports practitioners should recognize that not all athletes follow the traditional assumption of cutting to the lowest possible weight class. Importantly, those who did achieve their MWC had lower initial body fat percentages, limiting the amount of weight they could safely lose. This underscores the need for individualized weight management strategies that consider body composition and health implications.

Abstract Multiple myeloma is a malignancy of clonally expanded plasma cells shaped by complex interactions with the immune microenvironment (IME). To investigate immune correlates of treatment response and disease progression, we conducted multi-omics profiling including CD138neg single-cell RNA sequencing of 243 bone marrow samples from 102 patients (631,226 cells) and CD138pos bulk RNA and whole-genome sequencing from 209 samples. In longitudinal analyses, interferon-γ signaling associated with markers of impaired T-cell memory after autologous stem cell transplant, whereas naïve B-cell abundance and immunoglobulin diversity correlated with improved progression-free survival (HR = 0.48; P = 2.3e−4). At disease progression, multiple myeloma cells upregulated cancer–testis antigens (CTAg) and immune effector genes, with concurrent B-cell depletion, enrichment of myeloid-derived suppressor cell expression, and phenotypic T-cell exhaustion. These findings highlight dynamic immune–tumor interactions, identifying naïve B-cell reconstitution as a biomarker of durable response and CTAgs as potential targets for high-risk disease at progression. Significance: Longitudinal profiling of multiple myeloma and the IME revealed dynamic immune–tumor interactions across the disease course. Altered expression in CD8+ T cells limited memory phenotype after transplant, whereas naïve B-cell recovery associated with sustained treatment response. At progression, CTAg expression associated with immunosuppression, revealing novel mechanisms of immune dysregulation.

Background: Differences in total daily energy expenditure (TDEE) across sports, sex, and skill level support the need for sport- and athlete-specific energy intake recommendations. The purpose of the current review was to examine TDEE and related markers of energy expenditure across field-based team sports. A secondary aim was to evaluate physical activity levels (PAL), calculated as TDEE divided by resting metabolic rate (RMR), and their utility in estimating energy needs within team sports. Methods: The review was limited to studies that included the field-based team sports of rugby or soccer and reported energy expenditure data using doubly labeled water (DLW). A literature review identified 11 studies meeting criteria. Weighted means (Xw) and standard deviations (SDw) were calculated for each variable when pooled across each sport category. Results: Rugby (4417 ± 654 kcal·d−1) had a higher average TDEE than soccer (3157 ± 331 kcal/day; p < 0.001). When normalized to body mass, rTDEE was similar between sports (rugby: 49.5 ± 1.3 kcal·kg−1·day−1; soccer: 49.3 ± 1.8 kcal·kg−1·day−1; p = 0.967). PAL values were significantly higher in rugby (2.2 ± 0.4) compared to soccer (1.7 ± 0.2; p = 0.004). RMR was also greater in rugby (2136 ± 322 kcal·d−1) compared to soccer (1835 ± 208 kcal·d−1; p = 0.04). Conclusions: Rugby athletes exhibited higher TDEE values than soccer athletes, reflecting greater absolute energy demands. However, similar relative TDEE values suggest that differences in body size and composition likely contribute to the observed differences in absolute expenditure. These findings underscore the importance of individualized nutrition strategies within team sports and highlight PAL as a useful metric to contextualize energy requirements.

Abstract Fields, JB, Jones, MT, Kitts, SE, King, EL, and Jagim, AR. Relationships between disordered eating, body dissatisfaction, and low energy availability in women collegiate athletes. J Strength Cond Res 40(2): e164–e171, 2026—Women collegiate student-athletes face unique challenges regarding nutrition, body image, and athletic performance, increasing their risk for low energy availability (LEA), disordered eating (DE), and body dissatisfaction (BID). However, limited data exist exploring LEA, DE, and BID across a variety of women's sports. Therefore, the purpose of this study was to evaluate the prevalence of and relationships among LEA risk, DE behaviors, and BID in women collegiate athletes from multiple sports. Division I, II, and III women student-athletes ( n = 115) participated in this cross-sectional, descriptive study. Athletes completed the low energy availability for females questionnaire (LEAF-Q), eating attitudes test (EAT-26), muscularity-oriented eating test (MOET), and body dissatisfaction items from the eating disorder examination questionnaire (EDE-Q) to assess LEA risk, DE behaviors, and BID, respectively. Sixty-four percentages of athletes were at risk for LEA, with the highest prevalence in volleyball (100%), wrestling (68%), lacrosse (67%), and cross country (57%). However, only 8% of athletes were classified at risk for eating disorders. Notably, 81 and 84% of athletes reported body weight and shape dissatisfaction, respectively, which was strongly associated with disordered eating behaviors (EAT-26: r = 0.707; MOET: r = 0.723, p < 0.001). These results show a high prevalence of LEA risk and BID across athletes, with DE behaviors strongly linked to body image concerns. Despite a high LEA risk among athletes, clinical eating disorder risk remained low, suggesting that undereating may often be unintentional. Targeted interventions focused on nutritional education, body image, and psychological support are critical for improving health and performance outcomes among collegiate women student-athletes.

Abstract Mitigating impact injuries is crucial in race car driving, requiring adherence to stringent safety standards. Helmets and head-neck support devices are essential for reducing the risk of concussions and serious injuries. The sport's high-risk nature demands a deep understanding of injury types, with attention to common areas such as the spine, shoulders, and knees. Continuous safety innovation focused on factors like posture, race duration, and physiologic response is imperative. Safety advancements have significantly reduced fatalities, with comprehensive protocols and specialized equipment ensuring rapid crash response. Medical and safety measures, including roll bars, harness systems, and heat-resistant clothing, protect drivers, while tailored regulations for different race car categories ensure specific safety needs are met. Overall, the intricate focus on safety balances the thrill of racing with driver well-being.

Abstract Pancreatic ductal adenocarcinoma (PDAC), the most common subtype of pancreatic cancer, is a deadly disease with a complex tumor microenvironment (TME). How chemotherapy alters the TME, and whether these changes drive chemoresistance, is poorly understood. We examined matched pre- and post-treatment tissue specimens and found near-universal enrichment of axonal guidance genes in cancer-associated fibroblasts (CAFs) after treatment. These CAFs were enriched near sites of perineural invasion, coinciding with regions of increased tumor cell proliferation, and were enriched in tumor areas distant from nerves after chemotherapy. Metastatic recurrence lesions had the highest prevalence of these CAFs versus primary tumors and untreated metastasis. These CAFs showed elevated non-canonical Wnt mediators and axonal guidance genes, which complemented matching cognate binding partners in tumor epithelial cells, suggesting a role in tumor-stroma crosstalk. Our findings implicate fibroblast-derived axonal-guidance genes in promoting PDAC invasion and point to a promising target for this disease. Statement of Significance Therapeutic resistance remains a major challenge in pancreatic cancer. Our findings shed light on the changes in the complex tumor microenvironment in response to chemotherapy and identify fibroblasts high in axonal-guidance genes that may drive tumor progression and chemoresistance, thus uncovering a potential avenue for targeting pancreatic cancer.