Corewell Health Zeeland Hospital

The microbiota in individual habitats differ in both relative composition and absolute abundance. While sequencing approaches determine the relative abundances of taxa and genes, they do not provide information on their absolute abundances. Here, we developed a machine-learning approach to predict fecal microbial loads (microbial cells per gram) solely from relative abundance data. Applying our prediction model to a large-scale metagenomic dataset (n = 34,539), we demonstrated that microbial load is the major determinant of gut microbiome variation and is associated with numerous host factors, including age, diet, and medication. We further found that for several diseases, changes in microbial load, rather than the disease condition itself, more strongly explained alterations in patients' gut microbiome. Adjusting for this effect substantially reduced the statistical significance of the majority of disease-associated species. Our analysis reveals that the fecal microbial load is a major confounder in microbiome studies, highlighting its importance for understanding microbiome variation in health and disease.

The purpose of this study was to explore families’ support and influence on the educational performance of students on a faith-based campus in northern Indiana, USA. The study answered the following research question: How does families’ support influence college students’ educational performance? This research question was developed after reviewing the literature and coming to the realization that there is little research on families’ influence role in college students’ academic performance. The data was collected through in-depth interviews with 12 students who resided at the college campus. Themes recognized within the study were used to discuss families’ role in students’ academic performance. Considering the families’ role in students’ everyday life and the background support is vital to their educational performance. Themes included: (1) Frequency of contact with family, especially mother; (2) Levels of parental financial involvement; (3) Independence from family; (4) Siblings’ influence on academics; (5) Parents’ spiritual involvement; and (6) Parents’ educational background.

PURPOSE: Based on prospectively uploaded treatment plans, a comprehensive analysis of the radiation therapy (RT) in the DBCG Skagen trial 1 is presented. METHODS: From 2015 to 2021, 2963 breast cancer patients referred to adjuvant locoregional breast cancer RT after breast conserving surgery (BCS) or mastectomy were randomised to 50 Gy/25 fractions versus 40 Gy/15 fractions. Tumour-bed boost was simultaneous integrated boost (SIB). Delineated structure volumes were per ESTRO guidelines. Dosimetric data were obtained from the individual treatment plans. RESULTS: RT treatment plans from 2705 patients treated at 14 centres in 4 countries were analysed corresponding to 94 % of the per protocol patients. Overall, 1407 had BCS, 1298 had mastectomy, and 437 had SIB. The randomisation was balanced: 1329 (50 Gy) versus 1376 (40 Gy). All plans had target volume delineations per ESTRO guidelines. No significant differences were observed regarding delineated volumes nor regarding inter-centre variations per randomisation arm. Compliance to protocol constraints was generally high, however, the "hot-spot" dose compliance was higher in 50 Gy plans compared to 40 Gy plans due to stricter high dose constraints for the 40 Gy arm. The minimum coverage of target volumes was similar per randomisation arms. Respiratory gating technique was used in 83 % of the patients. When divided into subgroups per laterality and breathing technique, significantly higher lung and heart doses were detected in non-gated compared to gated plans. CONCLUSION: A high degree of protocol compliance was documented in the DBCG Skagen trial 1. No differences were observed among the treatment plans in the two randomisation arms.

TPS 761: Health effects of pollution sources and components, Johan Friso Foyer, Floor 1, August 28, 2019, 3:00 PM - 4:30 PM Background/Aim: Heavy industry emits many potentially hazardous pollutants into the air which can affect health. However, the effects of air pollution from heavy industry on lung function and respiratory symptoms have been investigated scarcely. Our aim was to investigate the associations of long-term air pollution from heavy industry with lung function and respiratory symptoms in school children. Methods: A cross-sectional lung function study was conducted among school children (7-13 years) in the vicinity of heavy industry. Lung function measurements were conducted at school. Parents of the children were asked to complete a questionnaire about the health of their children. A dispersion model was used to characterize the additional individual-level exposures to air pollutants from local industry. Associations between PM2.5 and NOx exposure with lung function and presence of respiratory symptoms were investigated by linear and logistic regression analysis respectively. Results: Participation in the lung function measurements and questionnaires was 84% (665/787) and 77% (603/787), respectively. The range of the elevated PM2.5 and NOx five years average concentrations (2008-2012) due to heavy industry were 0.04-1.59 µg/m3 and 0.74-11.33 µg/m3 respectively. Higher exposure to PM2.5 and NOx (per interquartile range of 0.56 and 7.43 µg/m3 respectively) was associated with lower percent predicted peak expiratory flow (PEF) (B -2.80%, 95%CI -5.05% to -0.55% and B -3.67%, 95% CI -6.93% to -0.42% respectively). Higher exposure to NOx (per interquartile range of 7.43 µg/m3) was also associated with lower percent predicted forced vital capacity (FVC) and percent predicted forced expiration volume in 1 second (FEV1) (B -2.30%, 95%CI -4.55% to -0.05% and B -2.73, 95%CI -5.21 to -0.25 respectively). Exposure to PM2.5 was also associated with dry cough (OR 1.40, 95%CI 1.00 to 1.94). Conclusion: Exposure to PM2.5 and NOx from industry was associated with decreased lung function. Exposure to PM2.5 was associated with dry cough.

Inclusive Christian education is not simply about changing who enrolls in a school or what supports are provided to teachers and children to make that happen. This inclusive education is also about changing the very culture of a school community. At Zeeland Christian School, inclusion of students with diverse learning characteristics led to changes in relationships, in experiences of school community as an interdependent body made up of many parts, and in instruction designed to meet the needs of all students.

The Copenhagen Hospital Biobank-chronic inflammatory disease-inflammatory bowel disease (CHB-CID: IBD) cohort contributes to genetic research in inflammatory bowel disease, including Crohn's disease and ulcerative colitis. Of the 327,084 enrolled and genotyped individuals in the cohort, 10,626 have been diagnosed with IBD as of May 2023. The CHB-CID: IBD cohort includes both patients without IBD and healthy blood donors as control groups. Clinical data is collected from Danish registries and patient records, including details on hospital contacts, co-morbidities, medication, surgical procedures, and laboratory investigations. The cohort features a wide age range (> 18 years), extensive population coverage representative of Danish adults, and validated IBD diagnoses. Finally, the cohort benefits from continuous recruitment and regular updates of clinical information. The aim is to enhance IBD management and ultimately improve patients' quality of life.

<h2>Abstract</h2><h3>Purpose/Objective</h3> Partial breast irradiation (PBI) is standard for selected relatively low-risk breast cancer patients, aiming to minimise late effects while maintaining local control. The Danish Breast Cancer Group (DBCG) RT Natural trial investigated whether PBI could be safely omitted in selected patients. Here, we report the radiotherapy quality assurance in the trial, evaluating target coverage and doses to organs of interest against protocol criteria. <h3>Material/Methods</h3> Eligible patients were women ≥ 60 years with T ≤ 20 mm, unilateral, unifocal, node-negative, hormone receptor–positive, HER2-negative non-lobular invasive breast cancer. Patients were randomised 1:1 to PBI (40 Gy in 15 fractions) versus no radiotherapy. Treatment plans for all patients treated with PBI were prospectively collected in a centralised DICOM-RT database and evaluated for protocol compliance. <h3>Results</h3> Data from the 238 patients receiving PBI were analysed. Dose coverage was high, with median V95% of 100% for the tumour bed and CTVp_PBI and 98% for the PTVp_PBI. Only 1% had a CTVp_PBI V95% below the intended 95%, whereas 22% had a PTVp_PBI V95% <95%. No patients exceeded 110% of the prescribed dose. Dose conformity was good with median whole-breast V40Gy of 21%. Ipsilateral median mean lung dose was 1.5 Gy, and median mean heart dose 0.25 Gy left / 0.12 Gy right with no violation of dose guidance. Respiratory gating did not significantly affect lung or heart doses. <h3>Conclusion</h3> PBI in the DBCG RT Natural trial provided robust target coverage with minimal high-dose volumes, and maintained low cardiac and pulmonary doses, consistent with protocol planning objectives.

Dissemination and Implementation (D&I) science increasingly recognizes the importance of equitable community engagement; yet, few models fully integrate community leadership and contextual knowledge throughout the research translation process. This paper introduces the Integrated Knowledge, Dissemination, and Action (IKDA) Framework, a novel model that combines the Knowledge to Action (K2A) Framework and Brownson's Model for Dissemination of Research, to guide the co-creation, dissemination and practice, and institutionalization of health information in community settings. Together, the IKDA Framework supports community-engaged approaches to collaboratively translate evidence into culturally resonant, actionable products and practices through multi-phased, iterative stages that leads to sustained utilization. The IKDA Framework's utility is demonstrated through two public health initiatives: the Health Promotion Through Environmental Design (HPTED) project and the National Network to Innovate for COVID-19 and Adult Vaccine Equity (NNICE). These case studies focus on research and dissemination phases of the IKDA and illustrate how community-driven dissemination strategies-such as tailored digital tools, infographics, and training-enhanced community awareness, trust, and engagement. Our use of the IKDA Framework within these projects is ongoing to facilitate continued implementation and institutionalization. The IKDA Framework moves beyond traditional knowledge dissemination to foster co-ownership, ethical community engagement, and long-term community-academic partnerships. It provides both researchers and practitioners with a structured yet flexible roadmap to support equitable, sustainable community-based health improvements. As public health continues to address complex, place-based challenges, the IKDA Framework offers a scalable and responsive approach to bridging research with community practice to facilitate real-world, positive community impact.

Abstract Date Presented 04/04/2025 There are differing ideas on how best to treat sensory processing difficulties among young children. Data from a recent study suggest best-practice considerations in early intervention from the perspective of OTPs. Primary Author and Speaker: Kelsey Wallace Additional Authors and Speakers: Patricia A. Henton