Welcome to the SUNY Open Access Repository

• 

  Role of Cytoreductive Nephrectomy in Metastatic Clear Cell Renal cell Carcinoma in the Era of immunotherapy: An Analysis of the National Cancer Database

  Niforatos, Stephanie; Arunachalam, Swathi; Jamaspishvili, Tamara; Wong, Roger; Bratslavsky, Gennady; Jacob, Joseph; Ross, Jeffrey; Shapiro, Oleg; Goldberg, Hanan; Basnet, Alina; et al. (Elsevier, 2024-09-13)

  Background: The effectiveness of the clinical outcome of CN (Cytoreductive Nephrectomy) in cases of mccRCC (Metastatic Clear Cell Renal cell Carcinoma) is still uncertain despite two trials, SURTIME and CARMENA. These trials, conducted with Sunitinib as the standard treatment, did not provide evidence supporting the use of CN. Methods: We queried the NCDB for stage IV mccRCC patients between the years of 2004 to 2020, who received (immunotherapy) IO with or without nephrectomy. Overall survival (OS) was calculated among three groups of IO alone, IO followed by CN (IOCN), CN followed by IO (CNIO). Cox models compared OS by treatment group after adjusting for sociodemographic, health, and facility variables. Results: From 1,549,101 renal cancer cases, 7983 clear and nonclear cell renal cell carcinoma cases were identified. After adjusting for sociodemographic and health covariates, patients who received IO followed by CN or CN followed by IO had a respective 64% (adjusted Hazard Ratio [aHR] = 0.36, 95% CI = 0.30-0.43, P = .006] and 47% (aHR = 0.53, 95% CI = 0.49-0.56, P = .001) mortality risk reduction respectively compared to patients who received IO alone. Compared to White adults, individuals who identified as Black exhibited 17% higher risk mortality (aHR = 1.17, 95% CI = 1.06-1.30, P = .002). Patients who received CN prior to IO had a 59% associated mortality risk compared to patients who received IO followed by CN who had a lower risk, 35.7% (P < .001). Conclusions: Patients receiving CN regardless of sequence with IO did better than IO alone in this national registry-based adjusted analysis for mccRCC. Presently available data indicates that the combination of CN and IO holds promise for enhancing clinical results in patients with mRCC.
• 

  Northern Sunfish Restoration Activities in Lower Tonawanda Creek and the Adjacent Erie Canal in 2023 and 2024

  Haynes, James M. (NYS Department of Environmental Conservation, Bureau of Fisheries., Rare Fish Unit, 2024)

  : The Northern Sunfish (Lepomis peltastes), a threatened species in NY state, was caught in lower Tonawanda Creek and a wide water slough of the Erie Canal (study area) from 1974 to 2009. It was not caught at these locations after 2009 and was assumed to be extirpated. This study began the process of testing the hypothesis that the absence of Northern Sunfish (NS) after 2009 was caused by removal of two-thirds of the NS caught in the study area from 2006-2009 for the purpose of obtaining brood stock to establish a pond population that would preserve the study area population and be used for stocking elsewhere in NYS. In May 2023, more than 3,000 descendants of study area NS were stocked into the study area. Follow-up sampling by boat and backpack electrofishing caught 43, 12 and 9 stocked fish in July and September 2023 and June 2024, respectively. Many of the stocked fish and fish caught in June 2024 were gravid, but it was too soon to find evidence of recruitment. Sampling in the study area is recommended in June 2025 to ascertain continuing presence of stocked NS and look for evidence of recruitment of progeny from NS stocked in 2023.
• Functional contributions of ON and OFF pathways to human vision

  Poudel, Sabina (2024)

  "The human visual system processes light and dark stimuli with separate ON and OFF neuronal pathways that originate in the retina, at the first synapse of the visual system, and remain segregated in the rest of the brain. In animal models, ON and OFF pathways are differently modulated by the spatiotemporal properties of stimuli. In my thesis, I investigate the stimulus modulations of these two pathways in humans and the possible clinical implications of their functional differences. In the first chapter, I record visual images and visuomotor activity in human subjects performing two visual tasks, reading and walking indoors, while wearing Tobii Pro Glasses 2. Reading and walking are known to pose different risks of myopia progression, a visual disorder that blurs vision at far distances. However, the stimulus parameters driving myopia progression remain unclear. To investigate this question, I quantify the visual input to the retina and visuomotor activity during the two tasks. I demonstrate pronounced task differences in the stimulation balance of ON and OFF visual pathways. My results demonstrate that reading reduces central visual stimulation of ON visual pathways and decreases visuomotor activity and reflexes dominated by ON visual pathways. These results support the hypothesis that reading drives myopia progression by under-stimulating ON visual pathways. In the second chapter, I use electroretinography (ERG) to measure the contrast response functions of ON and OFF retinal pathways in humans and further investigate if the two pathways are differently affected by myopia. We have previously demonstrated that ON and OFF pathways have different contrast sensitivity in visual cortex, and that the difference increases with luminance range (defined as the difference between maximum and minimum luminance in an image). Here, I demonstrate that these ON-OFF differences are already present in the human retina and are affected by myopia. I show that myopia is associated with a deficit in ON retinal pathway function that reduces the retinal ability at signaling low contrast and regulating retinal illuminance in bright environments. In the third chapter, I measure spatial frequency tuning of retinal ON and OFF pathways in humans using pattern ERG. Previous studies from our lab demonstrated that, in carnivores and non-human primates, ON and OFF cortical pathways have different spatial frequency tuning. My results demonstrate that these ON-OFF tuning differences are also present in the human retina. I show that retinal responses to light stimuli are tuned to higher spatial frequencies than retinal responses to dark stimuli. High spatial frequencies drive stronger responses from retinal ON pathways whereas low spatial frequencies drive stronger responses from retinal OFF pathways. Overall, my results reveal new insights on the function of ON and OFF retinal pathways in humans, and add to the growing research effort to understand the link between retinal circuitry and myopia. My research may also help to explain why outdoor activity and reading have opposite effects on myopia progression, and lead to novel approaches for myopia control. "
• 

  Imbalanced specialty representation of USMLE and NBME test writers

  Mahoney, Mary T.; Linkowski, Lauren C.; Mix, Michael D.; Wong, Roger; Sim, Austin J.; Hoffe, Sarah E.; Sura, Karna T. (Springer Nature, 2024-09-09)

  Purpose: The United States Medical Licensing Examination (USMLE) is an examination series required for allopathic physician licensure in the United States (US). USMLE content is created and maintained by the National Board of Medical Examinations (NBME). The specialty composition of the USMLE and NBME taskforce members involved in the creation of examination content is currently unknown. Methods: Using the 2021 USMLE and 2021 NBME Committees and Task Forces documents, we determined each member's board-certified primary specialty and involvement in test material development committees who we dubbed "test writers". Total active physicians by primary specialty were recorded from the 2020 Physician Specialty Data Report published by the Association of American Medical Colleges (AAMC). Descriptive statistics and chi-square analysis were used to analyze the cohorts. Results: The USMLE and NBME test writer primary specialty composition was found to be significantly different compared to the US active physician population (USMLE χ2 [32]=172, p<.001 and NBME χ2 [32]=200, p<.001). Only nineteen specialties were represented within USMLE test writers, with three specialties being proportionally represented. Two specialties were represented within NBME test writers. Obstetrics and Gynecology physicians were proportionally represented in USMLE but not within NBME test writers. Internal Medicine (IM) accounts for the largest percentage of all USMLE test writers (60/197, 30%) with an excess representation of 31 individuals. Conclusions: There is an imbalance in the specialty representation of USMLE and NBME test writers compared to the US active physician population. These findings may have implications for the unbiased and accurate portrayal of topics in such national examinations; thus, future investigation is warranted.
• Past vs. present: A survey of the fish parasites of the tributaries of Oneida Lake, NY

  Whitcomb, Hannah (2024)

  In 1934, Van Cleave and Mueller completed a study of the parasite fauna of the fish in Oneida Lake and its tributaries, where they documented over eighty species of parasites, thirty-three of which were new descriptions. Since 1934, the lake has undergone many environmental changes which have impacted the invertebrate fauna, mollusks in particular. The present study is a fish parasite survey of twelve tributaries of Oneida Lake undertaken to compare our results to Van Cleave and Mueller’s survey. The methods of this study included the collection of thirty-three fish species via backpack shocking, e-boat and hook and line fishing, partial necropsy of fish to collect parasites and the mounting of parasites for identification using light and scanning microscopes. During the recent survey of the lake, certain species of trematodes that had been reported by Van Cleave and Mueller were considered ‘missing’. Some of the missing species of parasites were found in the survey of the tributaries. For example, we encountered the trematode Bunodera sacculata in seven of twenty-six Perca flavescens. Bunodera sacculata uses a native clam as its first intermediate host, which is thought to have been extirpated from the lake due to invasive species. Additionally, thirty-two species were documented from three other major groups. This survey fills a knowledge gap on the fish parasite data in the tributaries and will add to the current survey knowledge of the lake system. Through an extensive survey of the fish parasites in Oneida Lake’s tributaries, the comparison of my results to Van Cleave and Mueller’s study demonstrates the parasite community in the tributaries are differs from those found in the lake because of several years of change to the watershed.

View more