bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in anxiety and depression during the COVID-19 pandemic in the European population: A meta-analysis of changes and associations with restriction policies
Authors: Lok Veeleah , Sjöqvist Hugo , Sidorchuk Anna , Flodin Pär , Osika Walter , Daly Michael , Hyland Philip , Andersen Lars H. , Fallesen Peter , Cabrera Marcelo C. , Knudsen Ann K.S. , Wetherall Karen , Widnall Emily , Groarke Jenny M. , Armour Cherie , Dalman Christina , Hollander Anna-Clara , Niemi Maria 
Published: October 2023

Abstract

Background
Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population.

Methods
We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression.

Results
Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress.

Conclusions
Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19.
Biospecimen Repositories in Low- and Middle-Income Countries: Insights From an American University of Beirut and Memorial Sloan Kettering Collaboration
Authors: Faraj Walid , Robson Mark , Tawil Ayman , Reuter Victor , Mahfouz Rami , Cambria Roy , Saheb Nour , Ferrer Christine S. , Vemuri Shreya , Yaghi Marita , Kanso Mariam , Abdullah Abdul , El Nounou Ghina , Jabbour Mark , Muenkel Kerri , Kaufman Kristopher , Wakim Joe-Max , Badson Sandy , Wilson Roger , Houston Collette , Drobnjak Marija , Hoballah Jamal , Ziyadeh Fuad N. , Zaatari Ghazi , Brennan Murray , O'Reilly Eileen M. , Abu-Alfa Ali K. , Abou-Alfa Ghassan K. 
Published: October 2023

PURPOSE Biobanking helps source tissue and blood for studying cancer genomics. Access to biorepository resources in low- and middle-income countries is lacking. Memorial Sloan Kettering Cancer Center (MSK) and the American University of Beirut (AUB) established a joint tissue biorepository at AUB in Beirut, Lebanon. The undertaking encountered key challenges that were unanticipated. MATERIALS AND METHODS Patients age 18 years or older were eligible for enrollment at AUB. After consent, biospecimens were obtained at the time of routine diagnostic and/or therapeutic interventions. Both normal and abnormal tissue and solid and/or liquid specimens were collected from varied body sites. Early on, declining consent was frequently observed, and this was highlighted for investigation to understand potential participants reasoning. RESULTS Of 850 patients approached, 704 (70.8%) elected to consent and 293 (29.5%) declined participation. The number of declined consents led to an amendment permitting the documentation of reasons for same. Of 100 potential participants who declined to consent and to whom outreach was undertaken, 63% indicated lack of research awareness and 27% deferral to their primary physician or family member. A financial gain for AUB was cited as concern by 5%, cultural boundaries in 4%, and 1% expressed concern about confidentiality. Of the patients who elected to consent, 682 biospecimens were procured. CONCLUSION The AUB-MSK biospecimen repository has provided a unique resource for interrogation. Patient participation rate was high, and analyses of those who elected not to consent (29%) provide important insights into educational need and the local and cultural awareness and norms.
Long-Term Results of Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The Randomized Phase II OPRA Trial
Authors: Verheij Floris S. , Omer Dana M. , Williams Hannah , Lin Sabrina T. , Qin Li-Xuan , Buckley James T. , Thompson Hannah M. , Yuval Jonathan B. , Kim Jin K. , Dunne Richard F. , Marcet Jorge , Cataldo Peter , Polite Blase , Herzig Daniel O. , Liska David , Oommen Samuel , Friel Charles M. , Ternent Charles , Coveler Andrew L. , Hunt Steven , Gregory Anita , Varma Madhulika G. , Bello Brian L. , Carmichael Joseph C. , Krauss John , Gleisner Ana , Guillem José G. , Temple Larissa , Goodman Karyn A. , Segal Neil H. , Cercek Andrea , Yaeger Rona , Nash Garrett M. , Widmar Maria , Wei Iris H. , Pappou Emmanouil P. , Weiser Martin R. , Paty Philip B. , Smith J. Joshua , Wu Abraham J. , Gollub Marc J. , Saltz Leonard B. , Garcia-Aguilar Julio 
Published: October 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. To assess long-term risk of local tumor regrowth, we report updated organ preservation rate and oncologic outcomes of the OPRA trial (ClinicalTrials.gov identifier: NCT02008656 ). Patients with stage II/III rectal cancer were randomly assigned to receive induction chemotherapy followed by chemoradiation (INCT-CRT) or chemoradiation followed by consolidation chemotherapy (CRT-CNCT). Patients who achieved a complete or near-complete response after finishing treatment were offered watch-and-wait (WW). Total mesorectal excision (TME) was recommended for those who achieved an incomplete response. The primary end point was disease-free survival (DFS). The secondary end point was TME-free survival. In total, 324 patients were randomly assigned (INCT-CRT, n = 158; CRT-CNCT, n = 166). Median follow-up was 5.1 years. The 5-year DFS rates were 71% (95% CI, 64 to 79) and 69% (95% CI, 62 to 77) for INCT-CRT and CRT-CNCT, respectively ( P = .68). TME-free survival was 39% (95% CI, 32 to 48) in the INCT-CRT group and 54% (95% CI, 46 to 62) in the CRT-CNCT group ( P = .012). Of 81 patients with regrowth, 94% occurred within 2 years and 99% occurred within 3 years. DFS was similar for patients who underwent TME after restaging (64% [95% CI, 53 to 78]) and patients in WW who underwent TME after regrowth (64% [95% CI, 53 to 78]; P = .94). Updated analysis continues to show long-term organ preservation in half of the patients with rectal cancer treated with total neoadjuvant therapy. In patients who enter WW, most cases of tumor regrowth occur in the first 2 years.
Cost to Medicare from bone modifying agent overuse in castration-sensitive prostate cancer.
Authors: Mitchell Aaron Philip , Chakraborty Nirjhar , Nemirovsky David , Mishra Meza Akriti , Persaud Sonia , Farooki Azeez , Morris Michael J. 
Published: October 2023

12 Background: Bone modifying agents (BMAs) prevent skeletal related events among patients with castration-resistant prostate cancer (mCRPC) and bone metastasis, but not among patients with castration sensitive prostate cancer (CSPC). However, approximately 1/3 of Medicare patients with CSPC receive BMAs unnecessarily, and the costs to Medicare resulting from this overuse have not been assessed. Methods: We used linked SEER registry and Medicare claims data for persons diagnosed with stage IV prostate adenocarcinoma during 2011-2015, identified those who subsequently received a cancer therapy used exclusively for mCRPC, and measured 1) the number of doses of zoledronic acid and denosumab received between diagnosis and initiation of mCRPC therapy and 2) presence of patient comorbidities which may warrant BMA therapy for fragility fracture prevention (eg., osteoporosis, osteopenia). We estimated excess BMA costs to Medicare by assessing the proportion of patients who received BMA therapy during their CSPC interval and did NOT have an indication for fragility fracture prevention, using the Medicare fee schedule for drug prices. We estimated adverse event costs using event frequency and costs estimates drawn from the peer-reviewed literature. The modeled outcome was the cost to Medicare from excess BMA use for the cohort of patients diagnosed with stage IV prostate cancer each calendar year. We conducted one-way sensitivity analysis for each model input by using the highest and lowest estimates available from peer-reviewed sources, monthly vs. every-three-month dosing frequencies for both drugs, and by +/-20% for all other inputs. Results: The median time from diagnosis to initiation of CRPC therapy was 387 days (IQR 253,573), during which time 42% received >=1 dose of denosumab (mean doses = 7) and 18% received >=1 dose of zoledronic acid (mean doses = 7). The estimated, annual excess BMA cost to Medicare was $45,392,377, comprised of $43,303,078 and $45,512 in drug costs for denosumab and zoledronic acid, respectively, and $1,625,869 and $419,917 in adverse event costs, respectively. The estimate was most sensitive to denosumab administration schedule (monthly vs. every-three-month) [estimate range: $29,487,144 - $101,060,692] and the duration of CSPC [estimate range: $37,853,180 - $101,754,921]. Conclusions: BMA overuse in CSPC incurs substantial cost to Medicare, largely due to denosumab drug costs. Our sensitivity analyses suggest we may overestimate costs if denosumab dosing frequency is now lower than during our observation period (eg., if more providers now use 3-month dosing), and we may underestimate costs if patients now experience CSPC for a longer duration (a plausible consequence from the introduction of ARSi therapy for CSPC in the post-LATITUDE era). Avoidable costs and toxicity may be reduced by greater adherence to guideline-concordant use of BMAs.
Real-world data on immune-checkpoint inhibitors use and immune-related adverse events in lung cancer.
Authors: Hu Xiao , Pan Stacey , Salei Yana , Lin Jeffrey , Parsons Susan K. 
Published: October 2023

156 Background: Immune-checkpoint inhibitors (ICIs) have revolutionized lung cancer therapy. The data on the use of ICIs in underrepresented populations with lung cancer (older patients, patients with autoimmune disease (ADs), and patients with poor performance status) are limited from trials. The real-world pattern of immune-related adverse effects (irAEs) and the association between the occurrence of irAEs and prognosis remain unclear. Methods: Patients with lung cancer newly started on ICIs from 10/01/2018 to 09/30/2021 were identified in the Tufts Medical Center cancer registry. Patient information, disease characteristics, treatment history, and outcomes were collected from the electronic health record. Time to ICI treatment initiation (TTI) was analyzed via log-rank tests. Multivariable Cox regression was used to assess the impact of the occurrence of irAEs on overall survival (OS). Results: 125 lung cancer patients were identified with a median age of 70 (range 50-80) years old at time of ICIs initiation. 68 (54.4%) were males and 103 (82.4%) were White. Most of the patients were past or current smokers (95.2%). 16 (12.8%) had a history of ADs and 44 (35.2%) had an ECOG status >1. Most of the cohort had non-small cell lung cancer (80.8%) and advanced-stage diseases (stage III 20.8%, stage IV 77.6%). 37.6% had PD-L1 expression and 25.6% had detected molecular alterations. ICIs were mostly used in frontline settings (65.6%) and for palliative intent (86.4%). Pembrolizumab was used most frequently (64%), followed by durvalumab, atezolizumab, nivolumab, and ipilimumab plus nivolumab. About half (49.6%) of ICIs were delivered concurrently with chemotherapy. A total of 50 irAEs occurred in 39 (31.2%) individuals. The most common irAEs were pneumonitis, thyroid disorders, dermatitis, and gastrointestinal toxicity. TTIs were similar comparing those ≥65 vs <65 years old (median TTI: 1.4m vs 1.17m, p=0.82), those with vs without ADs (median TTI: 1.53m vs 1.27m, p=0.53), and those with ECOG >1 vs ≤1 (median TTI: 1.6m vs 1.17m, p=0.06) in newly diagnosed stage IV lung cancer patients (N=62). After adjusting for age, BMI, stage, histology, performance status, and comorbidities, no differences were found in OS between those with irAEs and those without (HR=0.84, p=0.65). Conclusions: Our findings suggested that in the real world, older patients, patients with ADs, and patients with poor performance had no significant delays in ICIs initiation. The pattern of irAEs was similar to that reported in clinical trials without erosion of OS among those with irAEs.
Feasibility of the geriatric assessment in older caregivers of older adults with cancer to guide supportive care.
Authors: Kadambi Sindhuja G , Stupia Lisa , Wang Lu , Cacciatore Jenna , Kehoe Lee , Gilmore Nikesha , Norton Sally , Mohile Supriya Gupta , Magnuson Allison 
Published: October 2023

224 Background: Older caregivers of older patients with cancer are at high risk for adverse physical and psychological outcomes. Performing a caregiver geriatric assessment (GA) may help identify caregivers at increased risk of adverse outcomes and guide supportive care strategies. In this study, we aimed to determine the feasibility of a GA to evaluate age-related conditions, and physical and emotional health of both patients and caregivers. Methods: Caregivers aged 65+ and patients aged 65+ with diagnosis of cancer receiving a new line of cancer treatment and caregivers aged 65+ were recruited (Goal 60 dyads; current N=40). Patient and caregiver physical and emotional health was captured using the GA which included assessment of physical function (activities of daily living [ADLs], instrumental activities of daily living [IADLs], Short Physical Performance Battery [SPPB], fall history), comorbidity, psychological health (Geriatric Depression Scale [GDS], General Anxiety Disorder-7 [GAD-7]), cognition (Montreal Cognitive Assessment [MOCA] or Blessed Orientation Memory Concentration [BOMC]), Social Support (Older Americans Resources and Services [OARS] Social Support), polypharmacy, nutrition, caregiver Environmental Mastery, and Modified Caregiver Strain Index. Results: Of 40 dyads who have consented, 17 dyads (42%) completed the GA, 14 dyad GAs are pending (35%), eight have withdrawn (20%), and one was lost to follow-up (2.5%). Mean time for caregivers to complete self-reported GA assessment was 47 minutes (range 20-120 minutes) and return to study staff was 5 days (range 0-22 days). Caregivers had mean age 78 years (range 65-85), 100% white, 94% female, and 94% spouses. Caregivers had high prevalence of age-related conditions, including comorbidities (mean 3.7), impairments in ADLs (24%), IADLs (31%), and physical function (55%). More patients than caregivers screened positive for depression (29% vs 12%) and anxiety (17% vs 6%). Caregivers reported high mastery (Ryff subscale, mean 38, range 26-49) and low strain (4.4, range 0-16). Conclusions: The GA is feasible to use in older cancer caregivers to help identify aging related conditions that may influence caregiving ability. Future work should identify how GA in older cancer caregivers can be used to identify intervention strategies to optimize caregiving abilities and improve outcomes in both older adults with cancer and their caregivers. Clinical trial information: NCT05244915 .[Table: see text]
Feasibility of screening for and matching adolescents and young adults with cancer to a community-partnered financial and health-related social needs navigation intervention.
Authors: Beauchemin Melissa P , Solomon Samrawit , Gallagher Kathleen D. , Angove Rebekah SM , Kahn Justine , Hershman Dawn L. 
Published: October 2023

281 Background: Adolescents and young adult (AYAs, defined by the NCI as aged 15-39) cancer survivors experience high rates of financial toxicity, and the risk for and severity of financial toxicity are associated with unmet health-related social needs (HRSN: e.g., difficulty affording housing, food, transportation, insurance). Financial navigation may be an effective intervention to reduce financial toxicity and improve health outcomes. We have adapted an AYA- and caregiver-informed intervention to reduce financial burden among English- and Spanish-speaking AYAs on active cancer treatment. We report on the preliminary feasibility of a baseline financial and HRSN assessment among AYAs and navigating AYAs with unmet needs to the Patient Advocate Foundation (PAF), our community-partner, at a large, urban comprehensive cancer center. Methods: AYAs aged 15-39 years who speak English or Spanish and are receiving curative-intent treatment for cancer completed a baseline needs assessment that assessed financial and HRSN. The following indicates a positive screen for financial or HRSN: Comprehensive Score for Financial Toxicity (COST, AYA) score < 22 or Personal Financial Wellness Scale (PFWS, caregiver) ≤ 4; Any food, housing, transportation, utility insecurity or uninsurance. Participants are also distinctly offered connection to our community partner regardless of screening response. Participants with a positive screen will receive a needs navigation intervention in partnership with PAF for 6 months. We report the initial uptake, rates of baseline assessment completion, and reasons for screening positive in preparation for the next wave of recruitment. Results: Of 12 AYAs approached, eleven participated in the baseline assessment: one was completed by a parent proxy, and seven caregivers concurrently completed a dyadic assessment. In total, of the 11 AYAs, six screened positive for one or more unmet needs, thus meeting criteria to receive the financial and HRSN navigation intervention. Additionally, one AYA and caregiver dyad requested connection to the intervention in the absence of a positive screen. Unmet needs included housing insecurity (n=3), transportation (n=2), utilities (n=1); all six AYAs who screened positive met criteria for financial toxicity. Among dyadic responses, 5 of 6 were concordant. Conclusions: Preliminary data support the feasibility of screening AYAs for and matching them to a financial and HRSN navigation intervention. Next steps will include recruitment and expansion to demonstrate feasibility of the intervention and explore impact on financial and HRSN as well as health outcomes.
Community driven support platform BlueHQ: An innovative solution to address the needs of patients with colorectal cancer.
Authors: Newcomer Kim , Fenstermacher David , Riedesel Monica ,   Never Too Young Task Force
Published: October 2023

330 Background: Colorectal cancer (CRC) is the third-most commonly diagnosed cancer and the second-leading cause of cancer death in men and women combined in the United States. In efforts to manage the disease, patients and caregivers turn to various tools and resources for financial assistance, information dissemination, emotional and peer support, and treatment planning, among other critical issues and needs they face. The Colorectal Cancer Alliance (the Alliance) created BlueHQ to provide patients and caregivers with a resource solution that encompasses all potential areas of need. Methods: A survey aimed at understanding needs, barriers, and quality improvement opportunities was disseminated via the Alliance's Blue Hope Nation community for two weeks and by email. One hundred sixty-seven colorectal cancer patients and forty caregivers of colorectal cancer patients completed the survey. Results: Patients and caregiver respondents report reliance on external tools and resources to manage disease and support information. Of the support methods, patient respondents reported using social media (46.11%); notebooks, journals, and planners (45.41%); online articles (44.91%); the Blue Hope Nation Facebook group (41.32%); cancer discussion boards (35.33%); and spiritual or religious advice (29.94%). To minimize diagnosis-related stressors, patients reported seeking financial assistance, local peer support and groups, and mental health help. To provide more efficient care and limit stress, the community suggested financial help, communication and support from other patients and caregivers, and informational resources. Conclusions: These survey results are consistent with other published learnings about patient and caregiver reliance on support tools and highlight the myriad resources that patients and caregivers currently use for managing CRC. BlueHQ is a support solution that provides patients and caregivers with access to information and resources tailored to users’ specified profiles, including molecular characteristics of the tumor. Users can also store documents and information from healthcare encounters, creating a longitudinal record and tracking disease progression. In the age of precision oncology, BlueHQ ensures patients and users are presented with personalized educational materials and multimedia resources to help manage their disease and bridge the gaps in patient support. BlueHQ was explicitly designed to connect the CRC community to the latest therapeutic and clinical research resources to improve outcomes and quality of life for all CRC patients.