bluuebunny/crossref_metadata_2025_split huggingface dataset:
The advance directive completion rates in the hematopoietic stem cell transplant population in a major transplant cancer center.
Authors: Zachariah Finly , Popplewell Leslie , Forman Stephen J. , Gorospe Gerardo , Wong-Toh Judy , Morse Denise , Emanuel Lindsay , Ito-Hamerling Gayle , Garcia Nellie , Horak David , Kassouny Dicran , Ohanesian Priscilla , Buga Sorin , Dale William , Mooney Stefanie , Tegtmeier Bernard , Banerjee Chandana , Patel Purvi , Alvarnas Joseph C. 
Published: November 2017

16 Background: Advance Care Planning (ACP) is central to patient-centered care and helps assure treatment aligns with a patient’s goals, values, and priorities. ACP is often poorly incorporated into the hematopoietic stem cell transplantation (HSCT) population, with reported advance directive (AD) rates of 23-50%. At City of Hope National Medical Center (COH), concerted efforts to improve the overall number of ADs in HSCT was undertaken and evaluated. Methods: The Department of Supportive Care Medicine at COH, in collaboration with medical faculty and administrative support, created a patient-centered ACP program. The first two years (2013/2014) broadly focused on all new COH patients. The last two years (2015/2016) included a specific focus on patients undergoing HSCT. The primary goal was a completed AD in the electronic medical record before day 0 of transplant. In addition to provider and transplant team engagement, major time points for supportive care integration to facilitate AD completion were identified including: 1) registration, 2) new patient orientation, 3) the clinical visit when transplant was decided, 4) pre-transplant education class, 5) clinical social work psychosocial assessment visit, and 6) the pre-transplant hospital days. AD completion rates were calculated with Odds Ratio and Mantel-Haenszel Chi-Square using Epi Info StatCalc. Results: Between 2012 and 2016 at COH, 1784 transplants were performed. For HSCT patients in 2012, baseline AD capture rate before day 0 of transplant was 28.6%. With the institutional AD program, the AD capture rate before day 0 of transplant was 31.6% for 2014, compared with 2012 [odds ratio, 1.17(95% CI, 0.85-1.60); p = .33]. With both institutional and hematology specific programs, AD capture rate before day 0 was 69.5% for 2016, compared to 2014[odds ratio, 4.30 (95% CI, 3.14-5.91); p < .001]. Conclusions: Compared to 2012, the institutional AD program in 2014 insignificantly impacted HSCT AD completion rates. Improving the rate of AD completion from 28.6% to 69.5% in HSCT patients required both institutional AD efforts and a targeted program. Nevertheless, more work is needed to improve AD completion rates before transplant to 100%.
The effect of nurse-led pain education of patients with painful bone metastases on pain and quality of life: A multicenter randomized trial.
Authors: Geerling Jenske I. , Raijmakers Natasja , Mul Veronique E.M. , de Nijs Ellen JM , Oudhof Marianne A , de Bock Gertruida Hendrika , De Graeff Alexander , van der Linden Yvette M , Reyners Anna K.L. 
Published: November 2017

203 Background: Radiotherapy (RT) is an effective treatment for painful bone metastases, although pain is not always sufficiently controlled. Pain management education may improve patient empowerment and, consequently, reduce pain intensity. The effect of nurse-led education (NLE) in patients undergoing RT for painful bone metastases was investigated as compared to care as usual (CAU). Primary endpoint was pain intensity at 12 weeks, secondary outcome was quality of life (QoL). Methods: In this multicentre, randomised phase 3 study, patients referred for short schedule RT, with uncontrolled pain (a score of ≥5 on a 0-10 numeric rating scale (NRS)), were randomised between NLE or CAU before start of RT. The NLE consisted of a structured interview including assessment of pain knowledge, verbal and written education on all aspects of pain and follow-up phone calls at 1, 4, 8 & 12 weeks to address pain-related questions. Patients in CAU received leaflets on RT, cancer pain and opioid use. Patient characteristics were assessed at baseline. Pain intensity and QoL were evaluated with the Brief Pain Inventory, EORTC QLQ-C15-PAL and EORTC QLQ-BM22 at baseline, and week 1, 4, 8 & 12. Power calculation showed that there were 89 patients per arm needed to detect a 10% difference in number of patients with a NRS < 5 at 12 weeks(1-sided α = 0.05; β 0.8). Results: Between May 2011-April 2016, 354 patients were randomised (176 NLE, 178 CAU), 38 were excluded (30 NRS < 5 at baseline, 7 no short schedule RT, 1 missing informed consent). At twelve weeks, 185 (NLE 95) had completed follow-up (72 stopped filling out questionnaires, 59 died prematurely). Baseline characteristics were similar in both groups; mean age 65 years, 56% men. At week 12, more patients in NLE than in CAU had controlled pain (NRS < 5; respectively 66% and 52%, p = 0.036). Moreover, patients in NLE reached faster a pain score < 5 than patients in CAU (31 versus 54 days respectively, p = 0.026). On all time points, no significant differences in QoL were found between both groups. Conclusions: Controlled pain, i.e. a pain intensity < 5, was reached faster and by more patients with painful bone metastases undergoing RT by the addition of nurse-led pain education. Clinical trial information: NCT01358539.
Barriers to online patient portal adoption among adult oncology patients.
Authors: Siegel Craig , Gill Ammara , Esteghamat Naseem , Tu Yifan , Rodin Miriam B. 
Published: November 2017

44 Background: Recent research shows tele-health and remote access technology enhances patient-provider communication. Among oncology patients, studies demonstrate that electronic access promotes improved treatment adherence and symptom management and provides better continuity of care and patient satisfaction. In a previous audit, we found only 26% of our oncology patients had activated our EHR (EPIC) online patient portal. MyChart facilitates communication by allowing patients to see results and email providers through a secure network. We undertook this study to discover patient opinions about MyChart and barriers to wider adoption. Methods: A short, self-administered questionnaire was distributed to a convenience sample of patients in waiting areas or the infusion center of the outpatient oncology clinic. Results: 76/108 patients knew of MyChart; 32 did not. 54/76 (71.1%) of patients who knew of MyChart had used it. 81.5% of 54 users were very or somewhat satisfied with it. Users rated features of MyChart on a 5 point scale: certain their confidentiality is protected 4.7,ability to track tests 4.4,receiving faster answers 3.0,and ease of contacting providers 2.8. 21 non-users gave several reasons for not using MyChart: preference to speak with a live person 38.1%, discomfort with the internet 23.8%, not having internet 19.0%, concern about personal information on the internet 14.3%, and too complicated 9.5%. Among 32patients not previously aware of MyChart, 43.7% said they would definitely or probably start using it.56.3% thought MyChart would make it easier to contact providers and 53.1%cited convenience over telephone.However, 28.1%,preferred speaking to a live person; 12.5% were uncomfortable with the internet, and 9.4% expressed concern with their information on the internet. Conclusions: In this sample, 50% of respondents used MyChart. Patients using MyChart were generally satisfied, specifically with confidentiality and ability to monitor their care. Barriers to increased use included a desire to speak directly to providers and lack of internet skill or access. While those using MyChart were confident that it was secure and confidential, those not using expressed concern about this issue.
Problem areas identified by cancer patients with a positive distress screen in the medical clinic.
Authors: Deshields Teresa L. , Ruhland Mary Jane 
Published: November 2017

63 Background: NCCN has been advocating for distress screening since the inaugural Distress Management Guidelines in 1999. ASCO’s Quality Oncology Practice Initiative incorporated an indicator of patients’ emotional well-being in 2009. The ACoS Commission on Cancer established mandatory distress screening as an accreditation requirement for cancer programs in January 2015. This latter requirement dramatically increased the number of cancer programs doing routine distress screening. We examined distress screening results at a comprehensive cancer center. Methods: Results of distress screening were reviewed in the following clinical areas: medical oncology, radiation oncology, gynecologic oncology, and otolaryngology. Distress screening was completed verbally as a part of the vitals assessment, using the NCCN Distress Thermometer and Problem List. Only patients with a positive screen ( < 6 on 0-10 rating scale) completed the Problem List, identifying relevant problem areas (Emotional, Family, Practical, Physical, Spiritual and Other). The MA or RN doing the distress screening entered the distress rating and the endorsed problem area(s) in the electronic medical record. Results: In the first 5 months of 2017, 11,155 screening results were entered into the medical record. The percent of positive screens ranged from 5.7 to 8.6%, with X = 6.6% of screens being positive for distress. The most common problem areas were Emotional, endorsed with X = 72.5% of positive screens (range = 33.5-96.6%); Physical, endorsed with X = 67.52% of positive screens (range = 42.8-86.4%); and Practical, endorsed with X = 43.1% of positive screens (range = 20.1-59.9%). Conclusions: While some cancer centers use a psychologically-focused screening method (e.g. PHQ-9, BDI), distress is a bio-psychosocial construct, which requires a screening method that includes multiple domains. Furthermore, the triage related to distress screening may best be accomplished by the cancer team at the clinic visit, so that physical problems can be further assessed and addressed during the visit. The medical team can also make referrals to social work or psychological services to address related problem areas, when identified by patients.
Randomized, Multicenter, Placebo-Controlled Clinical Trial of Duloxetine Versus Placebo for Aromatase Inhibitor–Associated Arthralgias in Early-Stage Breast Cancer: SWOG S1202
Authors: Henry N. Lynn , Unger Joseph M. , Schott Anne F. , Fehrenbacher Louis , Flynn Patrick J. , Prow Debra M. , Sharer Carl W. , Burton Gary V. , Kuzma Charles S. , Moseley Anna , Lew Danika L. , Fisch Michael J. , Moinpour Carol M. , Hershman Dawn L. , Wade James L. 
Published: November 2017

Purpose Adherence to aromatase inhibitor (AI) therapy for early-stage breast cancer is limited by AI-associated musculoskeletal symptoms (AIMSS). Duloxetine is US Food and Drug Administration approved for treatment of multiple chronic pain disorders. We hypothesized that treatment of AIMSS with duloxetine would improve average joint pain compared with placebo. Methods This randomized, double-blind, phase III trial included AI-treated postmenopausal women with early-stage breast cancer and who had average joint pain score of ≥ 4 out of 10 that developed or worsened since AI therapy initiation. Patients were randomly assigned 1:1 to duloxetine or placebo for 13 weeks. The primary end point was average joint pain through 12 weeks, examined using multivariable linear mixed models, adjusted for stratification factors (baseline pain score of 4 to 6 v 7 to 10 and prior taxane use). Clinically significant change in average pain was defined as a ≥ 2-point decrease from baseline. Results Of 299 enrolled patients, 127 patients treated with duloxetine and 128 who received placebo were evaluable for the primary analysis. By 12 weeks, the average joint pain score was 0.82 points lower for patients who received duloxetine compared with those who received placebo (95% CI, −1.24 to −0.40; P = .0002). Similar patterns were observed for worst joint pain, joint stiffness, pain interference, and functioning. Rates of adverse events of any grade were higher in the duloxetine-treated group (78% v 50%); rates of grade 3 adverse events were similar. Conclusion Results of treatment with duloxetine for AIMSS were superior to those of placebo among women with early-stage breast cancer, although it resulted in more frequent low-grade toxicities.
Safety and Effectiveness of a Novel Facemask for Positive Pressure Ventilation
Authors: Brown Tod A. , Szabo Tamas A. , Bridges Kathryn H. , Sabbagh Michel J. , Hand William R. , Wolf Bethany J. , Warters Robert D. 
Published: November 2017

BACKGROUND:
Manual positive pressure ventilation is an essential skill in a variety of clinical situations. The C&E technique is commonly used with standard facemasks to provide effective ventilation. The Tao mask is a novel design that allows a more ergonomic grip. A seal between the mask and face is made with downward pressure of the palm, centered on the mask, and jaw lift is achieved with 4 fingers centered under the mandible. The purpose of this study was to evaluate the safety and effectiveness of the Tao mask compared to a standard mask before and after the administration of neuromuscular blockade (NMB) using 2 previously established ventilation scales.

METHODS:
One hundred fifty-two patients >18 years of age who were scheduled for general anesthesia were recruited. All care team members were shown a brief instructional video on the use of the Tao mask. After induction of general anesthesia with a standardized protocol, each patient was ventilated with both the standard (Vital Signs #082510) and Tao masks and effectiveness was measured using the Han and Warters scales. This process was repeated after NMB. The sequence of masks was determined with a random-number generator.

RESULTS:
Tao mask ventilation scores were significantly better than standard mask scores on both the Han scale and the Warters scale before the administration of NMB (P < .001 for both). Tao mask scores were also significantly better than standard mask scores on the Warters scale after the administration of NMB (P < .001). However, there was no significant difference on the Han scale between the 2 mask types after NMB (P = .180). On the Warters scale, there were significantly fewer patients who were difficult to ventilate with the Tao mask than the standard mask before NMB (18 vs 40; P < .001) and after NMB (8 vs 17; P = .005). No adverse events were reported with either mask.

CONCLUSIONS:
Our results indicate that the Tao mask demonstrated equivalent safety and superior effectiveness compared to a standard mask. The study design favored the standard mask because all participating practitioners had multiple years of experience with the standard mask and no prior experience with the Tao mask. Since the incidence of inadequate mask ventilation goes up significantly with inexperienced operators, the improved effectiveness of the Tao mask could be even more profound with novice operators.
RNAi targeting Caenorhabditis elegans α-arrestins has little effect on lifespan
Authors: Park Sangsoon , Jung Yoonji , An Seon Woo A. , Son Heehwa G. , Hwang Wooseon , Lee Dongyeop , Artan Murat , Park Hae-Eun H. , Jeong Dae-Eun , Lee Yujin , Lee Seung-Jae V. 
Published: November 2017

Background: α-arrestins are a family of proteins that are implicated in multiple biological processes, including metabolism and receptor desensitization. Methods: Here, we sought to examine the roles of α-arrestins in the longevity of Caenorhabditis elegans through an RNA interference screen. Results: We found that knocking down each of 24 out of total 29 C. elegans α-arrestins had little effect on lifespan. Thus, individual C. elegans α-arrestins may have minor effects on longevity. Conclusions: This study will provide useful information for future research on the functional role of α-arrestins in aging and longevity.
Perturbation of PALB2 function by the T413S mutation found in small cell lung cancer
Authors: Bleuyard Jean-Yves , Butler Rosie M. , Esashi Fumiko 
Published: November 2017

Background: Germline mutations in the PALB2 gene are associated with the genetic disorder Fanconi anaemia and increased predisposition to cancer. Disease-associated variants are mainly protein-truncating mutations, whereas a few missense substitutions are reported to perturb its interaction with breast cancer susceptibility proteins BRCA1 and BRCA2, which play essential roles in homology-directed repair (HDR). More recently, PALB2 was shown to associate with active genes independently of BRCA1, and through this mechanism, safeguards these regions from DNA replicative stresses. However, it is unknown whether PALB2 tumour suppressor function requires its chromatin association. Methods: Mining the public database of cancer mutations, we identified four potentially deleterious cancer-associated missense mutations within the PALB2 chromatin association motif (ChAM). To assess the impact of these mutations on PALB2 function, we generated cell lines expressing PALB2 variants harbouring corresponding ChAM mutations, and evaluated PALB2 chromatin association properties and the cellular resistance to camptothecin (CPT). Additionally, we examined the accumulation of γH2A.X and the RAD51 recombinase as readouts of DNA damage signalling and HDR, respectively. Results: We demonstrate that a small-cell lung cancer (SCLC)-associated T413S mutation in PALB2 impairs its chromatin association and confers reduced resistance to CPT, the only FDA-approved drug for relapsed SCLC. Unexpectedly, we found a less efficient γH2A.X nuclear foci formation in PALB2 T413S expressing cells, whereas a near-normal level of RAD51 nuclear foci was visible. Conclusions: These findings support the importance of PALB2 chromatin association in the suppression of tumours, including SCLC, an unusually aggressive type of cancer with poor prognosis. PALB2 T413S has little impact on RAD51 recruitment, likely due to its intact interaction with BRCA1 and BRCA2. However, this mutant shows inefficient DNA stress signalling. This finding sheds new light on the function of PALB2, playing a role in efficient DNA stress signalling through constitutive chromatin association.
The Effect of Organizational Atypicality on Reference Group Selection and Performance Evaluation
Authors: Smith Edward Bishop , Chae Heewon 
Published: November 2017

Recent research shows that audiences sometimes respond to organizational performance in ways that seem anomalous according to prior theory. In this paper we propose that variations in the extent to which an organization conforms to the norms and expectations of a known organizational category can affect the way evaluators construct reference groups, and subsequently shape their responses to organizational performance. In an experiment on investing in and evaluating the performance of a certain kind of financial organization, we show that organizational atypicality increases an evaluator’s likelihood of choosing a nonconforming referent for the purpose of making (enhancing) evaluations of the organization’s performance. Evaluators’ ex ante feelings of commitment toward the organization further moderate this relationship. Our results have several implications for research related to organizational and categorical identity, performance evaluation, and judgment and decision making. The online appendix is available at https://doi.org/10.1287/orsc.2017.1154 .
Addressing the Perfect Storm: Biomarkers in Obesity and Pathophysiology of Cardiometabolic Risk
Authors: Aleksandrova Krasimira , Mozaffarian Dariush , Pischon Tobias 
Published: November 2017

AbstractBACKGROUNDThe worldwide rise of obesity has provoked intensified research to better understand its pathophysiology as a means for disease prevention. Several biomarkers that may reflect various pathophysiological pathways that link obesity and cardiometabolic diseases have been identified over the past decades.CONTENTWe summarize research evidence regarding the role of established and novel obesity-related biomarkers, focusing on recent epidemiological evidence for detrimental associations with cardiometabolic diseases including obesity-related cancer. The reviewed biomarkers include biomarkers of glucose–insulin homeostasis (insulin, insulin-like growth factors, and C-peptide), adipose tissue biomarkers (adiponectin, omentin, apelin, leptin, resistin, and fatty-acid-binding protein-4), inflammatory biomarkers (C-reactive protein, interleukin 6, tumor necrosis factor α), and omics-based biomarkers (metabolites and microRNAs).SUMMARYAlthough the evidence for many classical obesity biomarkers, including adiponectin and C-reactive protein (CRP), in disease etiology has been initially promising, the evidence for a causal role in humans remains limited. Further, there has been little demonstrated ability to improve disease prediction beyond classical risk factors. In the era of “precision medicine,” there is an increasing interest in novel biomarkers, and the extended list of potentially promising biomarkers, such as adipokines, cytokines, metabolites, and microRNAs, implicated in obesity may bring new promise for improved, personalized prevention. To further evaluate the role of obesity-related biomarkers as etiological and early-disease-prediction targets, well-designed studies are needed to evaluate temporal associations, replicate findings, and test clinical utility of novel biomarkers. In particular, studies to determine the therapeutic implications of novel biomarkers beyond established metabolic risk factors are highly warranted.