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e19152 Background: Cancer treatment is becoming more complex, necessitating subspecialty expertise and multidisciplinary approaches to treatment planning. Simultaneously, there is increasing demand to provide care as close to home as possible. While tumor boards have long been an institutional backbone to providing high-quality multidisciplinary care in tertiary facilities, connecting several hospitals and dozens of cancer specialists in a large integrated healthcare system is unique and potentially transformational for smaller facilities and communities. Methods: Using highly-secure, network firewall-protected Cisco Telepresence and WebEx capabilities, 11 disease specific tumor boards (Breast, GI, Sarcoma, GU, Thoracic, Head/Neck, Melanoma, Neuro, Heme, Hepatobiliary, Gyn) were organized across Intermountain Healthcare’s 24 geographically and medically diverse hospitals spanning over 500 miles. Meetings for each of these disease-specific tumor boards have been held at least every 1-2 weeks, at set times and days since July 2019. Cases are submitted to the appropriate tumor board by individual providers from anywhere in the system. Submitted cases are reviewed by a designated subspeciality leader. Cases are either added to the system-wide agenda, or at times, the clinical decision can be resolved immediately. Included cases’ records including pathology, radiology and pertinent medical history are obtained for display and discussion. After each tumor board, recommendations and conclusions are recorded by nurse navigators for future review and consultation. Results: From July 2019 to February 2020, 1,598 patient cases were discussed. Just as relevant, 293 unique oncology providers (surgeons, medical oncologists, radiation oncologists, genetic counselors, nurse navigators, and therapists) participated in tumor board discussions. These deliberations provided insight, experience and recommendations directly related to patient care. Conclusions: Our system-wide, disease-specific, multi-disciplinary tumor boards are useful in connecting oncology providers and subspecialists. This effort has led to better collaboration, coordination and delivery of high-quality cancer care to patients throughout a large healthcare system that includes thousands of patients and dozens of cancer providers in smaller/rural communities. In addition, provider engagement has improved. Work is ongoing to prospectively evaluate the effects on treatment decisions and clinical outcomes.

Proprioceptive deficits occur with knee osteoarthritis (OA) and improving proprioception may slow joint degeneration by allowing more appropriate joint loading. Stochastic resonance (SR) stimulation improves balance and the sensitivity of specific mechanoreceptors. Our purpose was to evaluate the effects of SR electrical stimulation combined with a knee sleeve on proprioception in subjects with knee OA. Joint position sense (JPS) was measured in 38 subjects with knee OA during four conditions in both a partial weight-bearing (PWB) and non weight-bearing (NWB) task: no electrical stimulation/no sleeve, no electrical stimulation/sleeve, 50 μA-RMS stimulation/sleeve, and 75 μA-RMS stimulation/sleeve. Subjects also reported their knee pain, stiffness, functionality (WOMAC), and instability. Repeated measures ANOVA and Spearman correlations were performed to investigate differences between the conditions and relationships among the outcome measures. JPS during the 75 μA-RMS stimulation/sleeve and sleeve alone conditions was significantly improved compared to the control condition in the PWB task. However, the 75 μA-RMS stimulation/sleeve and the sleeve alone conditions did not differ from each other. A moderate correlation was found between the improvements with the 75 μA-RMS stimulation/sleeve condition compared to the JPS of the control condition in the PWB task. No differences in JPS were found between the four conditions in the NWB task. Significant correlations were found between the control JPS and WOMAC indices (p

Unicameral bone cysts (UBCs) were first described by Virchow in 18761. They are commonly found in the proximal part of the humerus in males between eleven and twenty years of age2,3. While some cysts are discovered incidentally after radiographs are taken for other reasons, most patients present with arm pain, with or without fracture through the cyst2. In clinical situations consistent with UBC of the proximal part of the humerus, radiographs are sufficient for diagnosis, and additional imaging usually is not recommended4. The patient and his parents were informed that data concerning the case would be submitted for publication, and they provided consent. A nine-year-old boy had experienced left shoulder pain after playing football. Because the pain had persisted, his primary care provider had obtained a radiograph; this radiograph had demonstrated a cystic lesion of the proximal part of the left humerus without fracture (Fig. 1). Subsequent magnetic resonance imaging (MRI) had been consistent with a benign bone cyst, which was likely a UBC (Fig. 2), without an associated soft-tissue mass. He had been referred to an orthopaedic oncology surgeon for management, and he had been followed for six months as the pain resolved. Fig. 1 At presentation, the anteroposterior radiograph was consistent with a UBC. Coronal short tau inversion recovery ( Fig. 2-A ), coronal T1-weighted ( Fig. 2-B ), coronal T2-weighted ( Fig. 2-C ), and sagittal T2-weighted ( Fig. 2-D ) MRI at presentation did not show a soft-tissue mass. Fig. 2-A Fig. 2-B Fig. 2-C Fig. 2-D Twelve months after the original presentation, the arm pain had returned. After repeat radiographs had confirmed an unchanged benign bone cyst, surgical aspiration and injection of autograft bone marrow and demineralized allograft bone matrix had been performed. At the time of contrast dye injection into the cyst, intraoperative fluoroscopy had not shown a noteworthy soft-tissue mass, thus confirming the diagnosis of UBC (Fig. 3). Fig. 3 Intraoperative fluoroscopic image of the humerus. Twelve months after the injection, follow-up radiographs had shown healing of the cyst. The patient …