The Edward Via College of Osteopathic Medicine (VCOM) is a private medical school on the campus of Virginia Tech in Blacksburg, Virginia (VCOM-Virginia), with branch campuses in Spartanburg, South Carolina (VCOM-Carolinas), Auburn, Alabama (VCOM-Auburn) and Monroe, Louisiana (VCOM-Monroe). VCOM also recently added Bluefield University to its list of campuses. Founded in 2002, VCOM graduated its first class of 139 students in June 2007.According to the U.S. News & World Report, VCOM is currently the second largest medical school in the U.S., with a total enrollment of 2,122 students among its four campuses.VCOM is one of a growing number of osteopathic medical schools in the United States, which grant the Doctor of Osteopathic Medicine degree (DO), and one of four located in the Appalachian region. VCOM is fully accredited by the American Osteopathic Association's Commission on Osteopathic College Accreditation.
: Chronic tendinopathy affects approximately 30
The cGAS-STING pathway plays a central role in controlling tumor progression through nucleic acid sensing and type I Interferon production. Here, we identify Poly(rC) Binding Protein 1 as a tumor suppressor that amplifies cGAS-STING signaling in breast cancer. Using patient datasets and a transgenic mouse model with conditional PCBP1 knockout in mammary epithelial cells, we show that PCBP1 expression correlates with improved survival, reduced tumor burden, increased type I Interferon and Interferon Stimulated Gene expression, and elevated cytotoxic T cell infiltration. Mechanistically, PCBP1 binds cytosine-rich single-stranded motifs via its KH domains and increases cGAS affinity to these nucleic acids. Mutation of PCBP1's conserved GXXG loops impairs nucleic acid binding and cGAS activation. Although cGAS is a double-stranded DNA sensor with no intrinsic sequence specificity, we uncover that the single-stranded nucleic-acid binding protein PCBP1 enhances cGAS sensing by engaging sequence-specific motifs, acting as a nucleic acid co-sensor that impairs tumorigenesis.
Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) characterized by distinctive chronic cutaneous manifestations. Although immune-mediated and microvascular mechanisms are well established, the role of metabolic dysfunction, particularly hyperglycemia, is underexplored in dermatological conditions. This review synthesizes mechanistic, clinical, and translational evidence to explore the relationship between dysglycemia and cutaneous disease severity in DM. Hyperglycemia is associated with oxidative stress, advanced glycation end-product formation, endothelial injury, and proinflammatory cytokine signaling. These processes may plausibly amplify DM-associated vasculopathy, impair wound healing, and worsen cutaneous inflammation. Limited DM-specific studies demonstrate increased insulin resistance and a higher prevalence of diabetes compared with healthy controls. Meanwhile, case reports suggest that poor glycemic control can exacerbate cutaneous disease. Evidence from other inflammatory dermatoses supports a biologically plausible role for dysglycemia in increasing flare frequency, infection risk, and delayed tissue repair. Dietary patterns characterized by high glycemic index and coexisting metabolic syndrome may further intensify systemic and cutaneous inflammation. Collectively, these findings suggest hyperglycemia as a biologically plausible contributor to cutaneous disease severity in DM that warrants further investigation. These observations highlight the need for future studies to evaluate whether metabolic screening, dietary patterns, and interdisciplinary care influence cutaneous disease activity and wound healing in DM. Prospective clinical investigation is needed to determine whether targeted glycemic optimization is associated with changes in cutaneous and systemic outcomes in DM.
Non-receipt of guideline-concordant treatment (GCT) in pancreatic ductal adenocarcinoma (PDAC) is associated with worse outcomes. Studies have identified associated factors, but less is known about how these factors co-occur within patient subgroups at the time of presentation to oncology care. We conducted a retrospective cohort study of patients with PDAC treated at two academic centers. Candidate variables available at presentation were selected a priori across demographic, clinical, socioeconomic, and healthcare utilization domains. Classification and regression tree (CART) models were used to identify conditionally defined subgroups associated with non-receipt of GCT. Models were developed using an 80/20 training/test split with repeated cross-validation. Of 1040 patients, 337 (32.4
BackgroundShared decision making is widely endorsed as the gold standard for patient-centered care, yet in the context of cancer, patients often describe surgery as a nonchoice. This narrative review explores the concept of patient-perceived nonchoice decision making in cancer surgery.MethodsThis narrative review was guided by the Scale for the Assessment of Narrative Review Articles (SANRA) criteria. Studies examining nonchoice surgical decision making in adult patients with resectable solid-organ malignancies were identified through manual screening, citation searching, and a targeted PubMed search. Descriptive themes were developed through inductive analysis and iterative discussions among authors. Findings were synthesized using a structured narrative approach.ResultsSeventeen studies met inclusion criteria. Three themes emerged: 1) surgery as the only choice offered by the surgeon, 2) choosing surgery did not feel like a choice, and (3) patient preference to relinquish decision making. According to patients, surgery was often framed as the sole viable treatment option with minimal discussion of alternatives. External social and societal pressures, combined with the belief that surgery equated to survival, further reinforced this perception. Patients who felt overwhelmed or had little medical knowledge often chose to relinquish decision-making responsibility. Collectively, these dynamics limited patients' ability to engage in meaningful deliberation.ConclusionsDespite the emphasis on shared decision making in cancer care, many patients undergoing surgery for resectable solid-organ malignancy face constrained decision making shaped by clinical realities, social context, and psychological stressors. Addressing the perception of surgery as a nonchoice is critical to promote meaningful patient engagement. Future research should aim to identify and mitigate modifiable factors that contribute to nonchoice mindsets, ultimately supporting value-concordant surgical decisions.HighlightsMany patients with cancer perceive surgery as their only option, rather than an active decision.Surgeons often frame surgery for cancer as inevitable, limiting discussions of alternatives and undermining shared decision making.Even when surgeons explicitly present surgical and nonsurgical options to patients, many patients still do not perceive a choice.Some patients intentionally defer decision making to surgeons, either out of trust in clinical expertise or a desire to avoid the emotional burden of choice.Understanding how nonchoice dynamics arise can help clinicians better support informed, values-based surgical decisions.
