bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends of stroke-related mortality among patients with cancer in the United States, 1999-2020.
Authors: Memon Roha Saeed , Nasir Muhammad Moiz , Mushahid Hasan , Farhan Syed Husain , Mahmood Umar , Mohiuddin Mubashir , Ahmed Jawad , Siddiqi Rabbia , Osama Muhammad , Farhan Syed Ali , Iqbal Abdul Ghani , Waqar Syed Hamza Bin , Riaz Shahid , Hamouda Danae M. 
Published: June 2024

e24021 Background: Patients with cancer are at an increased risk of stroke and stroke-related mortality via various mechanisms such as hypercoagulability, direct tumor effects, and largely as side effects of treatments. Enhancement of thrombin release from chemotherapy induced release of extracellular vesicles and cell-free DNA, and the use of angiogenesis inhibitors are some of the proposed mechanisms for stroke development in patients with cancer. Despite this, current guidelines lack clarity in identifying patients with cancer as having moderate to high risk of mortality from stroke. Recognizing this complex relationship is pivotal for crafting comprehensive care plans that address the dual challenges of cancer and stroke risks. Hence, our CDC analysis focuses on unraveling mortality trends among patients grappling with both conditions from “1999 to 2020”. Methods: We analyzed national mortality data from the multiple causes of death files in the CDC WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 people were calculated for the total population, stratified by gender, race, urban/rural metro status, and census region. Annual percent change (APC) was calculated using the Joinpoint regression software. Results: A total of 36,648 stroke-related deaths among patients with cancer occurred between 1999 and 2020. The APC trends are as follows: a major decrease of -6.8 (95% CI: -11.8 to -1.5) from 2002 to 2009, a slight decline of -1.23 (95% CI: -13.8 to 13.2) from 2009 to 2014, a significant decrease of -6.71 (95% CI: -46.2 to 61.7) from 2014 to 2017, and an increase of 2.07 (95% CI: -26.1 to 41.1) from 2017 to 2020. Men consistently showed higher mortality rates compared to women in 1999 (AAMR Men: 1.0 vs Women: 0.63) and 2020 (AAMR Men: 0.94 vs Women: 0.69). Moreover, when stratified by race non-hispanic (NH) Black showed the highest mortality rate, followed by NH Whites, and Hispanics throughout the study period between 1999 (AAMR NH Black: 0.96 vs NH White: 0.75 vs Hispanic: 0.32) and 2020 (AAMR NH Black: 0.85 vs NH White: 0.81 vs Hispanic: 0.53). Rural areas compared to urban areas showed consistently higher mortality rates over the study period. Conclusions: Despite more than a decade-long decline, stroke-related mortality among cancer patients has significantly increased since 2015. Targeted therapy and investigations into the role of social determinants of health may improve care for these patients. Further investigation is warranted to elucidate the mechanisms for the increase in stroke-related mortality among people with cancer, particularly those with the following demographics: Men, Black or African American, and residents of rural areas and Midwestern regions.
Prevalence and clinical outcomes of acute heart failure among patients with mediastinal radiation exposure: A propensity score matched analysis.
Authors: Bekoju Kanchhi , Kansakar Sajog , Shikhrakar Shreeja , Guragain Ashish , Chudy-Onwugaje Dilichukwu , Winn Soe 
Published: June 2024

e24029 Background: Radiation therapy (RT) for malignancy in mediastinal region is associated with radiation-induced heart disease in subsequent years, including coronary, valvular, myocardial, pericardial and conduction system disease. Although increased risk of diastolic heart failure (DHF) has been established, there is limited data on the prevalence, trends and outcomes of acute DHF admissions in patients with prior mediastinal RT. Methods: We extracted data from the National Inpatient Sample (NIS) Database from 2016 to 2020. We included all admissions ≥18 years old with a principal diagnosis of acute DHF with and without history of RT for mediastinal cancer using International Classification of Diseases Tenth Revision (ICD-10) codes. Propensity score matching was performed to balance hospital characteristics, patient demographics and comorbidities between the two groups. Univariate logistic regression was performed in the balanced cohorts. The primary outcome was inpatient mortality. Analysis was performed using STATA-MP, version 14.2. Results: A total of 2,356,025 admissions for acute DHF were identified between 2016 to 2020, of which 15,435 (0.65%) had prior mediastinal RT. During the study period, we found an increasing trend in the number of admissions for acute DHF (p trend < 0.01) along with an increased proportion of patients with prior mediastinal RT. (0.55% in 2016 to 0.78% in 2020, p trend < 0.01). After propensity score matching, there was no difference in in-hospital mortality (odds ratio [OR] 1.12, 95% CI 0.79-1.58, p = 0.537), or complications such as cardiogenic shock, respiratory failure, stroke, venous thromboembolism, or acute kidney injury between the two cohorts. There was no difference in length of stay, however, cohort with history of mediastinal RT had higher hospital charges ($26,634 vs $31,511, p < 0.01). Conclusions: Exposure to mediastinal RT represents a minority but growing number of hospital admission with DHF. The mortality and complications of RT associated DHF does not differ significantly from those with traditional etiologies of DHF.
Chemotherapy in the last 30 days of life, correlation with age and palliative care referral: A 1-year retrospective gastrointestinal program experience at SQCCCRC.
Authors: Ghoche Ahmad , Abu Omar Rami , Mahmoud Amani Ismail , Al-Moundhri Mansour 
Published: June 2024

e24038 Background: Chemotherapy in the last days of life can carry unnecessary toxicities to the patient with no significant impact on survival and disease outcome. This is becoming of greater interest with the involvement of palliative care in patient’s management along with the advent of new therapeutic options with progressively increased cost of treatment. Methods: In our retrospective study, we aimed to analyze retrospectively the data of GI tumors treated at SQCCCRC over one year, by looking at the possible factors influencing the time from last treatment to death. We conducted chart review of all death that occurred between January 2023 and December 2023 in the GI cancer program at SQCCCRC. Information on demographics, type of GI cancer, type, intent and route of chemotherapy, line of chemotherapy and referral to palliative care were collected. Results: A total of 65 patients died within the GI cancer program between January 1st, 2023, to dec 31st, 2023. Most (72.7%) of the patients died of disease progression. Intent for chemotherapy was palliative in 90.9% of cases. Chemotherapy was parenteral (Intravenous) for the majority (60%, 38/63) of the patients. From all the recovered deaths, a total of 52 patients (82%) were referred to palliative team before death whereas palliative team was involved in the journey of all patients. 12 deaths out of 65 occurred in ICU. Only 11 out of 65 patients died within last 30 days of treatment: 81.8% of them were under palliative care at the time of death. For this group, the median age at diagnosis was 50 yo. Median age at death was 61 yo. 72.7% were male. Primary site of disease was colon followed by stomach. Median time from diagnosis to palliative referral was 13.5 months. 8 patients died within 3.5 days of referral to palliative care. In the logistic regression models, only age at diagnosis was a significant predictor for receiving chemotherapy in the last 30 days of life (p = 0.019). Older age was associated with lower odds of receiving chemotherapy in this period (OR = 0.94, 95% CI = 0.89-0.99). Referral to palliative chemotherapy was not associated with decreased rate of treatment administration within last 30 days of life. Conclusions: While some real-world data suggested correlation between shifting to palliative care and administration of chemotherapy in the last 30 days of life, this was not the case in our collected sample, and only the age of the patient played a role in the chemotherapy timing before death. Further studies are needed to study the reasons behind and the best way to improve patient’s centered approach.
A comprehensive analysis of portal vein thrombosis in malignancy.
Authors: Prasad Apurwa , Bartock Matthew Tyler , Gyawali Mallika , Acharya Anamol , Bhattarai Shweta , Hotwani Priya 
Published: June 2024

e24042 Background: Portal vein thrombosis (PVT) is a rare venous thromboembolism, is often linked to cirrhosis, infection, and malignancy. Advancements in imaging have noted an increasing incidence of PVT, particularly in solid cancers. Treating PVT with malignancy is challenging due to lack of data, poor recanalization, and substantial bleeding risk with anticoagulation. This study aims to enhance understanding of malignancy-related PVT, anticoagulation trends, and assess prognosis. Methods: We conducted a multicenter, observational retrospective analysis of patients diagnosed with PVT (ICD code 452,181) from 2013 to 2023. Inclusion criteria: age > 18 and acute portal vein thrombosis. Exclusion criteria: presence of tumor thrombosis, and thrombus in other splanchnic vessels (e.g., mesenteric vein). Data entry was performed on a study-specific REDCap database. Patients with concomitant malignancy were identified and further assessed for cancer type, anticoagulation use, bleeding outcomes, and prognosis. Proportion analysis using Z test was done to compare outcomes between groups. Results: In our study of 583 patients, 236 (40.48%) had concurrent malignancy, predominantly male (144, 61.01%),and female (92, 38.98%) mean age 65. Common malignancies included HCC (28.38%), pancreatic (24.15%), colo-rectal (11.86%), cholangiocarcinoma (8.47%), myeloproliferative neoplasm, prostate, and gynecological cancers each (2.96%), and other cancers (18.22%). 41% had metastasis to liver. Cirrhosis was present in 40%, particularly in HCC patients (89%). Of the total,163 (69%) received anticoagulation; 26.38% showed improvement or re-canalization within a year. The primary anticoagulants were Direct Oral Anticoagulants (DOACs) (57%), with an increasing trend in the last 5 years (69.44%), followed by Low-Molecular-Weight Heparin (LMWH) (19%) and warfarin (14%). Most patients initiated on heparin infusion (9.81%) transitioned to hospice care. Bleeding events in patients receiving DOAC versus LMWH + Warfarin were 36.55% and 33.33%, respectively (p = 0.69). Patients without anticoagulation demonstrated a higher one-year mortality compared to those with anticoagulation (83.56% vs. 63.19%, p value < 0.05). Overall,malignancy-associated PVT had a significantly higher case fatality rate than non-malignancy cases, regardless of anticoagulation (81.35% vs. 32.85%, p < 0.05). Conclusions: There is a significant association between malignancy and PVT, particularly in HCC and pancreatic cancer. The increased mortality in malignancy-related PVT emphasizes the critical role of anticoagulation, which has demonstrated efficacy in improving outcomes, including one-year mortality. Although DOACs have seen increased use in the last 5 years, bleeding events have remained comparable. Further research is warranted to explore patient selection for optimal anticoagulation strategies.
Safety and efficacy of low dose versus high dose corticosteroid for graft versus host disease (GVHD): A systematic review.
Authors: Khanal Pradeep , Shah Sangam 
Published: June 2024

e24047 Background: Graft-versus-host disease (GVHD) is an immune-mediated complication of allogeneic hematopoietic stem cell transplantations. Current standard dose of corticosteroids used by the most hospitals for GVHD patients is 1-2 mg/kg/day. The prednisone dose used in the treatment of a GVHD has been a matter of debate. In this systematic review, we aimed to compare low dose prednisone to high/standard dose prednisone in terms of multiple prognostic outcomes of the patients undergoing allogenic hematopoietic stem-cell transplantations. Methods: We searched the databases PubMed, Cochrane library, and clinicaltrials.gov for all studies investigating the efficacy and safety of low dose and high dose steroid for GVHD. We set the search strategy incorporating the search terms, Graft-versus-host disease," "low dose cortico-steroid," and "high dose corticosteroid", and operated using the Boolean operators ‘AND’, and ‘OR’. Thus, retrieved articles were then exported on an Excel sheet, and duplicates were removed. After selecting the study based on inclusion criteria, data on study characteristics and biomarker description was extracted on a pre-determined data extraction table on the Microsoft Excel. Results: The search revealed 547 studies and 3 studies that met the eligibility criteria of this review have been included.During relapse, chronic GVHD, mortality, and malignancy outcomes were generally similar between doses, low-dose prednisone showed benefits for leukemia-free, relapse-free, and overall survival. Overall, the randomized trial by Chang et al. found lower risks of HZV and pulmonary infections with low-dose prednisone compared to standard-dose. (Table 1) Other infections were similar between groups. Conclusions: Low-dose prednisone showed similar efficacy to standard-dose for most GVHD outcomes (relapse risk, mortality), with potential benefits on survival, reduced HZV/pulmonary infections, and reduced adverse effect of higher cumulative dose of corticosteroids. [Table: see text]
HRQoL in patients with GBM: The impact of tumor treating fields.
Authors: Patel Drashti , Thakkar Rajvi , Fleeting Chance , Ghiaseddin Ashley Parham 
Published: June 2024

e24049 Background: Glioblastoma (GBM) is the most common malignant glioma with a dismal prognosis. Patients experience a range of progressively worsening symptoms, including headaches, nausea, seizures, and cognitive deficits throughout their disease course. Initial treatment for newly diagnosed patients consists of maximal safe surgical resection followed by fractionated radiation treatment with concomitant temozolomide. Presently, there are two approved adjuvant treatment modalities following chemoradiation: temozolomide and tumor-treating fields (TTFields). In this poster, we explore the impact of TTFields on the quality of life, assessed through health-related quality of life (HRQoL), in patients with GBM. Methods: Using PubMed, Medline-indexed articles were collected using this structured query: Glioblastoma[MeSH] AND (("Electric Stimulation Therapy*"[MeSH]) OR ("Transcranial Direct Current Stimulation*"[MeSH]) OR "Tumor Treating Fields" OR "TTF") NOT "RAT" This yielded 233 results before the search date (2023). Collected sources were uploaded to Covidence to allow for multi-reviewer screening, review, and extraction. For completeness, limited forward and back citations using the ResearchRabbit tool and limited addition of non-Medline indexed articles via unstructured query yielded four additional results. Sources were filtered by study type and included/excluded based on accessibility, sample population, design, outcome measures, and interventions. Five randomized control studies remained. From this subset, bias, effect size, I2-index, and forest analysis with random effect model estimation were calculated. Results: Data analysis showed that TTFields therapy has demonstrated associations with increased progression-free survival and enhanced overall survival rates without negative effects on HRQoL. Some patients have reported improvement in mobility, self-care, and carrying out regular activities. One notable side effect observed in these patients was increased skin itchiness, which was expected due to the use of transducer arrays. Conclusions: This project identified a research gap in standardizing the assessment of quality of life in patients treated with TTFields. A significant limitation in research on TTFields is an overall lack of HRQoL data, often due to patients failing to follow-up with surveys. Future research should prioritize patient follow-up to obtain more comprehensive and precise longitudinal data on HRQoL while considering disease and treatment characteristics.
Network pharmacology-based strategy for screening active compounds and significant pathways of huachansu capsule on cancerous pain.
Authors: Cao Luchang , Wang Xinmiao , Li Jie 
Published: June 2024

e24054 Background: Cancerous pain (CP) is a troublesome symptom which can not be adequately controlled. It is reported by several clinical studies that Huachansu can help to relieve CP. However, its mechanism is unclear. In this study, we try to use network pharmacology to explore the underlying mechanism of Huachansu capsule (a capsule form of Huachansu) in the treatment of CP. Methods: Firstly, we collected Huachansu capsule’s active compounds from the literature. And then DrugBank and SwissTargetPrediction were used to obtain the drug targets. Genecards, OMIM, Drugbank, CTD, TTD and DisGeNET were used to gather CP-related genes. Cytoscape 3.7.2 was applied to construct the PPI network. The candidate genes were screened according to betweenness centrality (BC), closeness centrality (CC), degree centrality (DC) and local average connectivity (LAC). A PPI enrichment analysis was performed by MCODE. GO and KEGG analysis were carried out by Metascape. Results: In this study, we collected 11 active compounds and 235 CP-related targets of Huachansu capsule. Go analysis showed that the main related-biological functions included immune response, cytokine-mediated signaling, hypoxia. The main related-KEGG pathways included MAPK, AMPK, mTOR, erbB, Chemokine, TNF, HIF-1, toll-like receptor, PI3K-Akt, cAMP and NF-Kappa B signaling pathway. Conclusions: This study provides a systematic view of the polypharmacological characteristics of Huachansu capsule for pain treatment. Nevertheless, it still need to be verified by in vitro or in vivo studies.
Body and mind and self-consciousness awareness workshops: Improving quality of life in patients with cancer.
Authors: Levy Bar , Margalit Fraidy , Shachar Eliya , Adar Lyri , Pantovitz Lee , Rahmian Shani , Shani Omer , Wolf Ido , Safra Tamar 
Published: June 2024

e24081 Background: Cancer patients, commonly experience disease and treatment related stress, anxiety and difficulties coping with life. Data suggests that body and mind are interrelated and can influences patients' quality of life (QOL). Objectives: The study aimed to evaluate the impact of patients body and mind work developing self consciousness awareness and changing behavioral patterns of women’s cancer patients, on quality of life and coping abilities. By evaluation of QOL, sleep disorders and anxiety tests done during and following our workshop. Methods: The study conducted at the Women's Cancer Center of Tel Aviv Sourasky Medical Center in Tel Aviv Israel between 2022-2024. Female cancer patients and survivors, were enrolled in workshops teaching self consciousness awareness development according to the Metaism methodology. Each workshop with groups of 10-15 patients was conducted weekly for three months, The groups were led by dedicated moderators and supervised by a psychiatrist. Patients completed a validated QOL questionnaire, sleep disorder evaluation and anxiety questionnaires, upon enrollment and every month during the workshop and up to a year from completion of the workshop. Results: one-hundred and twofemale patients diagnosed with cancer and treated at multiple cancer centers were included in the study. Patient mean age was 57 (26-75) years. Patient diagnoses included breast, ovarian, uterine, cervical, and other cancers (58%, 22%, 7%, 5%, respectively). Significant improvement was observed in the QOL assessment at the 5th week of the workshop, overall educational well-being indicator at the 3rd week of the workshop, emotional well being at the 3rd week of the workshop, physical well-being at the end of follow up. Conclusions: The study demonstrated that integrating the metaism methodology of self consciousness awareness development workshops significantly improved patient coping ability and QOL. Further investigation of larger cohorts is warranted.
A qualitative analysis on the awareness of surrogacy as an alternative parenting option for people diagnosed with cancer.
Authors: Steckler Alexa M. , Dizon Don S. , Higel-Mcgovern Camille , Duffy Christine Mary 
Published: June 2024

e24097 Background: ASCO guidelines recommend counseling about the impact of cancer treatment on fertility, preservation options, and referral to a reproductive specialist when indicated. However, other family-building options, such as surrogacy have not been specifically included in the guidance. Very little has been reported on counseling and use of surrogacy among people treated for cancer despite it being a viable option for parenthood in those with cancer-induced infertility. Objective: The Counseling and Use of Surrogacy Among Cancer Survivors (CUSACS) is aimed to be the first nationwide survey to examine the proportion of patients who received surrogacy information as part of fertility counseling at diagnosis, as well as interest and participation in surrogacy. As part of survey development, we conducted qualitative interviews and here, we report the thematic analysis from those conversations. Methods: We created an internet-based REDCap survey on fertility and surrogacy counseling and vetted it with four national cancer organizations: Young Survival Coalition (YSC), Cervivor, the Chick Mission, and For the Breast of Us. We conducted 17 survivor interviews from these organizations focusing on survey content, language, and usability. Authors analyzed interview transcripts separately and through consensus. Results: Three major themes emerged with representative quotes in Table 1: Identity, Self-sufficiency, and Regret. Iterative changes were made to the survey to incorporate feedback. Conclusions: Survivor interviews provided insight into important themes regarding fertility and surrogacy counseling. Our survey will be distributed through the partnering organizations and will be the first national survey to explore surrogacy counseling at cancer diagnosis. [Table: see text]