Medical Student Research Forum Posters

Melanoma is the 5th most common cancer in the United States and is curable if detected early. Identifying disparities in melanoma incidence may guide public health initiatives and improve outcomes.Melanoma is most common in non-Hispanic White (NHW) patients, but other racial and ethnic groups are more often diagnosed at late-stage disease and experience higher mortality than NHW patients.Higher melanoma incidence has been reported in rural than in urban settings, but the intersection of rurality with race and ethnicity has not been thoroughly explored.This study examines melanoma incidence, stratified by rural-urban residence and race and ethnicity, to identify populations experiencing disproportionately heightened melanoma burden.

Spinal cord injury (SCI) is a devasting disease with no effective cure. We have shown that placental mesenchymal stromal cells (PMSCs) applied in utero improve ambulatory function in an ovine model of spina bifida and have begun the first-inhuman clinical trial for fetal spina bifida. PMSCs and extracellular vesicles (EVs)have neuroprotective properties and we hypothesized that PMSCs and PMSC-EVs would provide a similar neuroprotective effect in SCI.

Language barriers make it difficult for surgical teams to engage in the discussion of important aspects of pre- and post-operative patient care with patients who are non-Englishspeakers.

Radiation induced malignancy is a late side effect of radiation therapy and can create a significant morbidity burden on patients. Radiation therapy has become partof the gold standard of treatment among patients diagnosed with HPV+ oropharyngeal cancers. In this study, we aimed to investigate the characteristics of head and neck second primary malignancies (SPMs) that can potentially be attributed to radiation therapy received as part of the treatment course for HPV+ oropharyngeal cancer.

Assess whether race and insurance type are associated with differences in long-term remission of obesity-related comorbidities following bariatric surgery, as measured by AOMC scores.

Major vascular surgery, including open aortic procedures, is associated with having a 30-day mortality rate greater than 6% and a perioperative complication rate greater than 50%. Published literature suggests that patients undergoing high-risk procedures benefit from having a care plan in place to not only maximize quality of life but also to ensure medical interventions align with care goals. Currently, there is a paucity of published data on the prevalence of goals of care conversations, advance care planning documentation, and palliative care evaluations in patients undergoing high-risk vascular operations. 

Evaluate the Assessment of ObesityrelatedMetabolic Comorbidities (AOMC) system tostratify diabetes response to RYGB compared todiabetes definitions by medication use and HbA1c.

Breast cancer is the second leading cause of cancer death in women after lung cancer1. Obesity, personal history, and family history are well-known factors associated with increased risk of breast cancer2. The American Cancer Society recommends all women with increased risk for breast cancer to begin screening with mammograms at the latest by age 403. Previous studies have shown conflicting data on the likelihood of obese women undergoing routine breast cancer screening.

Soft tissue sarcomas (STS) are heterogenous malignancies with an unmet need for novel immunotherapies. Tumor infiltrating lymphocytes (TILs) have previously been linked with favorable outcomes in STS patients, though the contribution of natural killer (NK) cell subsets, including NKp46 and CD56bright/dim, has yet to be investigated in detail. Despite the known role of MHC-I on immunoregulation of NK and T cells, limited data exist characterizing the spatial relationship of NK cells to MHC-I+/- cells and T cells in the STS tumor microenvironment (TME). Using STS specimens from 130 patients, we evaluated intratumoral NK cell subsets by immunohistochemistry (IHC), flow cytometry, and immunofluorescence (IF) to assess their impact on overall survival (OS) and metastasis-free survival (MFS). We also assessed the spatial localization of NK and T cells by multiplex IF in the TME, specifically analyzing the effects of MHC-I expression status on NK and T cell clustering. High intratumoral NKp46 expression was associated with improved OS by IHC (P=0.04) and IF (P=0.02). CD56dim NK cells were associated with a survival benefit (P=0.05), while higher infiltrates of CD56bright NK cells predicted worse prognosis (P=0.05). CD3-CD56+ NK cells demonstrated a significant inverse relationship with CD3+ T cells by both flow cytometry and IF. Spatial analyses showed NK cells preferentially clustering close to other NK cells with sparse CD3+ T and CD8+ T cells in range (P<0.0001). Additionally, CD3+ T and CD8+ T cells showed significantly greater co-localization with MHC-I+ cells, compared to NKp46+ NK cells (P<0.0001). Intratumoral NK cell subsets, including NKp46+ and CD56bright/dim NK cells, are prognostic in STS and localize closer to MHC-I- cells than they do to T cells or MHC-I+ cells. Although both NK and T cells are associated with improved survival in STS, their differential distribution in the TME based on MHC-I expression status reinforces inherent opposite but interconnected roles for these cells in anti-tumor surveillance.

Healthcare disparities exist in surgicalmedicine and several factors contribute tothem, including the systemic effects ofstructural racism as well as implicit biascarried by providers. Complications arisingfrom harmful institutional structures, SocialDeterminants of Health, and lack of culturalcompetency are appropriately named“Cultural Complications.” In this paper, wereview the literature for strategies surgicalresidency programs have utilized to combatboth staff and patient exposure to CulturalComplications. In addition, we introduce thenovel UC Davis Department of Surgery’sCultural Complications M&M series.