Oxidative stress, a condition characterized by an imbalance between pro-oxidant molecules and antioxidant defense systems, is increasingly recognized as a key contributor to cancer development. This is because the reactive oxygen species (ROS) generated during oxidative stress can damage DNA, proteins, and lipids to facilitate mutations and other cellular changes that promote cancer growth. Antioxidant supplementation is a potential strategy for decreasing cancer incidence; by reducing oxidative stress, DNA damage and other deleterious cellular changes may be attenuated. Several clinical trials have been conducted to investigate the role of antioxidant supplements in cancer prevention. Some studies have found that antioxidant supplements, such as vitamin A, vitamin C, and vitamin E, can reduce the risk of certain types of cancer. On the other hand, some studies posit an increased risk of cancer with antioxidant supplement use. In this review, we will provide an overview of the current understanding of the role of oxidative stress in cancer formation, as well as the potential benefits of antioxidant supplementation in cancer prevention. Additionally, we will discuss both preclinical and clinical studies highlighting the potentials and limitations of preventive antioxidant strategies.

756 Background: The incidence of pancreatic cancer among young adults has sharply risen over the past decade. Young adults often utilize online educational media, such as YouTube videos, for information about their disease. These may be subject to a high degree of bias and misinformation; previous analyses have demonstrated low quality of other cancer-related YouTube videos. Thus, we sought to determine if patients can rely on YouTube videos for accurate information about pancreatic cancer, and we compared relevant YouTube videos with those published by NCI-designated cancer centers (CCs). Methods: We designed a novel search query and inclusion/exclusion criteria based on published studies evaluating YouTube user tendencies. These criteria were used to identify videos most likely watched by patients, which composed our “Patient-Focused” (PF) group. We compared PF videos with those uploaded by CCs by manually searching each CC’s affiliated YouTube and applying the same inclusion/exclusion criteria. Data were summarized by descriptive statistics. Videos were evaluated based on two well-known criteria, the DISCERN and JAMA tools, as well as a tool published by Sahin et al to analyze the contents of colorectal cancer videos. A score of ≥ 6 on the Sahin scale correlated with high quality information. We used t-test and Chi-squared test to analyze differences between groups. Results: 39 videos met inclusion criteria within the PF sample and 19 videos within the CC sample, total sample of 58 videos. The PF sample had mean Sahin scores of 4.24 ± 2.21, DISCERN scores of 2.15 ± 0.47, and JAMA scores of 1.77 ± 0.60. CC videos had mean Sahin scores of 3.84 ± 2.70, DISCERN scores of 2.25 ± 0.63, and JAMA scores of 2.00 ± 0.0. Perceived speakers’ ethnicity was 75% White (n=77), 21% Asian (n=21), and 4% Hispanic (n=4). There were no Black speakers. Most videos uploaded were fair or poor quality. 16.4% (n=27) were of average or high quality by the Sahin criteria, with 1 video receiving a perfect score. 9.6% (n=5) and 90.4% (n=47) were average or high quality by DISCERN and JAMA criteria, respectively. 8.6% (n=5) of videos discussed palliative care and 10.3% (n=6) discussed staging. Independent samples t-test revealed no significant differences between PF and CC videos for the Sahin criteria (p=0.429) and DISCERN criteria (p=0.387). The mean JAMA score was higher for CCs (2.0 ± 0.0) than the PF group (1.8 ± 0.6) (p=0.001). Chi-squared test revealed that CC and PF videos had similar speaker ethnic diversity (p=0.381). Conclusions: Educational pancreatic cancer YouTube videos demonstrate low to moderate quality information with limited speaker ethnic diversity. Given ongoing trends in the spread of misinformation through social media, CCs and other patient educators should be mindful of their role in producing high quality, comprehensive information for patients and their caregivers.

Patient: Female, 90-year-old Final Diagnosis: Cerebrovascular infarction Symptoms: Unknown symptoms – post-mortem anatomical study Medication:— Clinical Procedure: — Specialty: Anatomy • Neurology Objective: Unknown etiology Background: Hyperostosis frontalis interna is a boney overgrowth of the inner side of the frontal bone of the skull caused by overgrowth of the endocranial surface. It is most often found in women after menopause. It is also associated with hormonal imbalance, being overweight, history of headaches, and neurocognitive degenerative conditions. Female gender, advanced age, extended estrogen stimulation, and elevated leptin levels may also play a role. The thickening is usually confined to the frontal bone, but it can spread as far as the anterior parietal and temporal bones. Case Report: During a medical school dissection course, an extensive boney overgrowth in the frontal regions covering the inside of the frontal bone of the skull of a 90-year-old female donor, who died of a cerebrovascular infarction, was identified. This boney overgrowth was mainly confined within the frontal region, but there was some boney overgrowth that extended to the temporal bones. The overgrowth in the endocranium of the temporal bone was not as severe as the overgrowth of the frontal bone. The morphology of the overgrowth was rigid, uneven, and bumpy. Based upon the physical characteristics, we concluded that this presentation was consistent with hyperostosis frontalis interna. Conclusions: Our female donor was found to exhibit a phenomenon which could be clinically underdiagnosed due to its internal nature and asymptomatic presentation. Insight into the potential causes of HFI and its identification during clinical evaluation offers a path for future research to better identify and manage cases of HFI.