bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning what matters in allogeneic transplant: Insights into older patient preferences in an age-friendly multidisciplinary clinic.
Authors: Braun Adam , Dale William , Moreno Jeanine , Curtin Peter T. , Dadwal Sanjeet , Hung Terence , Huynh Nini , Al Malki Monzr M. , Nakamura Ryotaro , Forman Stephen J. , Artz Andrew S. 
Published: June 2023

e24029 Background: HCT is increasingly being considered for older adults (60+) with blood cancers, with emerging data suggesting HCT imparts a survival benefit for eligible patients (pts). HCT-related morbidity and mortality remains significant in older adults, with no consensus on how to best prospectively evaluate HCT versus other approaches. Shared decision making (SDM) may help reconcile such treatment options for older adults. Understanding pts preferences (PP) and values is a cornerstone of SDM, yet no data exist in how to elicit and apply PP for older adults facing this treatment choice. Methods: We analyzed documented PP among the first 40 older adults from an ongoing IRB-approved prospective protocol enrolling HCT candidates ≥60 years to participate in a multi-disciplinary optimization clinic, the Aging & Blood Cancers (ABC) clinic. The ABC clinic is comprised of pre-HCT consultations with a geriatrician, HCT physician, physical therapist, dietician and social worker and an ID physician. We reviewed the primary treating team documentation relative to the ABC clinic documentation, notes reviewed from HLA typing orders or documented plan for HCT. Categorization of PP consisted of any of the following: (1) care goals after HCT (e.g. cure, disease control, functional recovery, spending time with family/friends, attending life events), (2) toxicity concerns, and (3) pt rationale for proceeding to HCT. We included PP when summarized in the advanced care planning (ACP) documents if signed by a team member or referenced in their note. Findings were extracted by one physician and then reviewed by a second physician to adjudicate assignment as a PP. P-values were derived from incidence rates and chi-squared testing. Results: Among 40 pts with a median age of 74 yrs (range 60-), 856 notes and 38 ACP documents were reviewed. We found PP in 26 notes (2.9%) in 19 pts (47.5%). Of pts with PP documented, the primary team accounted for 4, compared to 14 pts in the ABC clinic (p < 0.02). Notably, the primary team documented a risk:benefit discussion about HCT in 31 patients (p < 0.0001). Among total PP (n = 19) the most common included functional recovery (73.6%), spending time with family or specific people (73.6%) and minimizing toxicity (42.1%). Less common PP were disease control/cure (31.6%) or avoiding the need for future disease treatments (15.8%). Conclusions: To our knowledge, this is the first study to document older adult PPs before HCT, finding them to be rarely documented. The older adult specific HCT clinic enhanced preference documentation, yet still in less than half of pts. Future studies to develop tools to better elicit and incorporate pt preferences should be prioritized to facilitate shared decision making for HCT among older adults.
Dual language interview guide to improve understanding of risk perception among newly diagnosed breast cancer patients who are limited English proficient (LEP).
Authors: Schiaffino Melody Karen 
Published: June 2023

e24031 Background: In the U.S. 60% of those diagnosed with cancer are over age 65. This group is also larger, living longer, and more diverse than previous generations. This diversity includes increased proportions of older adults who are limited English proficient (LEP) which is defined as speaking English less than “very well” as measure by the U.S. Census. Access to language services is a protected right both via Title VI of the Civil Rights Act of 1964, the 2000 Executive Order 19166 mandating language services and the 2010 Patient Protection and Affordable Care Act. However, research remains limited in addressing linguistic and cognitive barriers experienced by LEP patients. Methods: Using an adapted forward-translation method from the World Health Organization the goal is for conceptual equivalence not direct translation. This approach includes multiple independent forward translations, a bilingual adjudicator with content expertise and community and expert reviewers. This approach allows for codification of divergence of semantic, conceptual, and normative equivalence. Semantic relates to words and equivalence or eloquence, conceptual refers to the general idea and normative relates to the social-cultural relevance or appropriateness of the topic itself (Pan, de la Puente, 2005). Two trained interpreters conducted forward translations, a third adjudicated. The interview guide was reviewed by two radiation oncologists and tested with a bilingual breast cancer survivor. Results: Semantic and conceptual equivalence were confirmed with expert panel review and are the equivalent of previously used “back-translation” however, we were also able to ensure normative equivalence, or the socio-cultural relevance to our study participants which were LEP Latina breast cancer patients. A final semi-structured interview guide was finalized and approved by the UCSD IRB to be fielded in March 2023. Conclusions: Adapting existing validated instruments requires more than just consideration of terminology, an understanding of semantic, conceptual, and normative equivalence is critical for improving culturally and linguistically appropriate research among minoritized and LEP geriatric oncology populations.
Predictive factors of early death in older women with gynecological cancer: A prospective cohort study.
Authors: Telles O. Lima Jurema , Sales Letícia telles , Lima Emanuel P. B. , Gonçalves MAria Eduarda M. , Costa Jose Iran , Gonsioroski Lucas P. , Rebello Mirella , Cavalcanti Zilda , Mello Maria Julia Gonçalves ,   BLOGG
Published: June 2023

e24034 Background: Comprehensive geriatric assessment (CGA) correlate with risk of early mortality in older adult patients. Methods: a prospective cohort study. older woman with a recent diagnosis of gynecological cancer were from eight community hospitals and cancer center in Northeast Brazil and were recruited during their first medical appointment at the outpatient oncologic clinic. A basal CGA was done before the treatment decision (ADL, Charlson Comorbidity Index- CCI, Karnofsky Performance status – KPS, GDS15, IPAQ, MMSE, MNA, MNA-SF, PS, PPS, Polipharmacy, QLQc30, TUG). During the follow up of six months, information about the treatments performed, the targeted interventions and early death was collected. Overall survival was estimated using the Kaplan–Meier method, and survival curves were compared using the Log rank test for categorical variables. A multivariate Cox proportional hazards model was used to select early death risk factors. Results: 274 patients with a median age of 72 years, 13.5% died within 180 days. 29,7% cervical cancer, 122 (44,5%),endometrial cancer, 53(19,3%) ovary cancer and 17( 6,2%) vulvar cancer. The mean global QL was higher among survivors and the probability of survival was higher in patients who had better QL (p < 0.001). After adjustments for risk factors (cervical cancer topography, metastatic disease and Karnofsky ≤ 50), Global QoL was a protective factor (HR = 0.99; 95%CI 0.98-1.00; p = 0.031). Cervical cancer topography 95%CI HR = 2.28 1.18-4.40 p = 0.014). MNA < 17 95 %CIHR = 9.72 (3.85-24.50 , p < 0.001) TUG ( HR = 3,87 ; 95 % CI 1,93 - 7,74 p = 0.004). Conclusions: A better score in the Global QoL assessment , a good nutritional status by MNA and low risk of falls by TUG were protective factor for early death in older women with gynecological cancer.Cervical cancer is the highest risk of early death topography. Risk factors for early death can be identified in the admission of older women with gynecological cancer, allowing better care planning.
Efficacy of BNT162b2 vaccine and its correlation with serum vitamin D in staff at the national comprehensive cancer center in slovakia.
Authors: Slopovsky Jan , Cingelova Silvia , Svobodova Alena , Skokanova-Krempaska Lucia , Rejlekova Katarina , Babela Robert , Drgona Lubos , Mego Michal , Vulganova Martina , Pechan Juraj , Palacka Patrik 
Published: June 2023

e24037 Background: With established efficacy and safety, BNT162b2 was one of the first licensed mRNA vaccines against SARS-CoV-2. However, it is unclear whether vitamin D serum concentrations affect vaccine efficacy after three doses. Methods: This prospective, single-center study included 273 staff members (85.4% females) of the National Cancer Comprehensive Center in Slovakia. Median age of participants was 47 years (range: 22–80) and median body mass index (BMI) was 24.8 (16.3–44.6) kg/m2. The primary objective was to determine the efficacy of BNT162b2 defined as no Covid-19 disease ≥7 days after its administration. The secondary objective was to monitor IgG neutralizing antibodies and total vitamin D in serum after vaccination and test the hypothesis on correlation of total vitamin D concentrations with the vaccine efficacy. If appropriate, results were stratified by gender (males vs females) and BMI ( < 30 vs ≥30 kg/m2). Results: At median follow-up of 4.7 (2.9–5.0) months, vaccine efficacy was 86.1%. The most common adverse events (AEs) were injection site pain (73.3%), fatigue (44.0%), and limb pain (33.0%). No grade 3/4 AEs were observed. Median time from vaccine administration to measurement of IgG and vitamin D concentrations was 3.4 (2.1-4.8) months. IgG concentrations were significantly higher in males compared to females, as well as in subjects with high vs low BMI ( p< 0.0004 and p< 0.0001, respectively). Total vitamin D concentrations were significantly lower in individuals with high vs low BMI ( p< 0.0144). No differences in the rate of Covid-19 positivity were identified based on gender, BMI, and total vitamin D concentrations. Conclusions: This study confirmed high efficacy of third dose of the BNT162b2 vaccine with an acceptable safety profile. The vaccine efficacy was not affected by gender, BMI, and total vitamin D concentrations. These results suggest that serum vitamin D monitoring after third BNT162b2 dose is not beneficial for an estimation of its efficacy. This study was supported by the National Cancer Institute, Bratislava, Slovakia & OncoReSearch, Rovinka, Slovakia. Keywords: BNT162b2; total vitamin D; efficacy; safety profile; IgG.
Patient understanding of immunotherapy and its side effects for women with triple negative breast cancer.
Authors: Canning Madison , Liu Yi , Aldrich Jeffrey , Switchenko Jeffrey M. , Bhave Manali A. 
Published: June 2023

e24046 Background: Immunotherapy (IO) is now an integral part of treatment for most patients with triple negative breast cancer (TNBC). The mechanism of action and associated side effects of IO differ significantly from conventional chemotherapy and patient comprehension of these novel treatments can be difficult to assess. Previous research has demonstrated that patient understanding of anti-cancer treatments is hindered by multiple barriers including education level and healthcare literacy. Standardized educational tools to improve patient comprehension of immunotherapy are integral to improving patient engagement with their treatment plan and providing informed consent. Methods: This is a prospective pilot study investigating the efficacy of standardized educational materials (2 animated videos and 1 pamphlet) to improve patient comprehension of IO. Patients with TNBC were recruited from Emory University between 2021-2022 and were asked three questions related to their understanding of the immune system, immunotherapy, and IO-related side effects before and after viewing the educational tools. Audio-recordings of the patients’ answers were coded as correct or incorrect by two independent reviewers using the video’s definitions as the standard. Clopper-Pearson method and exact McNemar’s test were used to calculate pre- and post-education correct definition rates and paired rates, respectively. Multivariate analyses were conducted investigating the impact of age, highest level of education, and race on patient comprehension. Results: 46 patients with TNBC were enrolled with mean age of 57 years (range 27-84 years). The majority of patients were Black (65%), while the remaining patients were Non-Hispanic White (30%) or unknown (5%). Highest level of education was reported as high school (13%), undergraduate (61%), and graduate school (26%). Comprehension of the terms "immune system" and "immunotherapy" significantly improved after viewing the patient educational material with an increase in correctly defining these terms from 50% to 89.1% (p-value < 0.01) and 41.3% to 82.6% (p-value < 0.01), respectively. Patients' ability to describe two or more side effects of IO also increased from 11% to 87% post-education (p-value < 0.01). Patients with graduate degrees had a 4.24 times greater odds of correctly answering the questions compared to those with undergraduate or high school degrees (p-value 0.057). There were no differences in patient comprehension by race or age. Conclusions: Patient education on novel therapeutics in cancer care including immunotherapy presents a challenge to providers given time constraints in clinic and lack of standardized educational resources. Through easily implemented patient education, we were able to significantly improve patient comprehension of immunotherapy and IO-related side effects in a diverse population of patients with TNBC.
The sit to stand test in cancer patients and survivors.
Authors: Cristian Adrian 
Published: June 2023

e24058 Background: The sit to stand test in 30 seconds has been used to measure power, strength, endurance, and balance. It has also been described as a useful tool in identifying presence of sarcopenia. Methods: Retrospective chart review of cancer patients and survivors referred to cancer rehabilitation clinic over a 5-year period from 1/1/2018-12/31/2022 at a large cancer institute in the southeastern part of the United States. Patients were assessed at their initial evaluation using the sit to stand test in 30 seconds (STS-30). Scoring for the sit to stand score was divided into 2 groups (impaired and good scores) based on age and gender specific normative data. Data was also collected for patients/survivors with different body mass index (BMI) ranges: underweight: (BMI < 18.5); normal weight (BMI 18.5-24.99); overweight (BMI: 25.-29.99), obese ( > 30) as well as stages of cancer (stage 0-4). Results: 1406 cancer patients and survivors underwent STS-30 at their initial evaluation in cancer rehabilitation clinic. This included cancers of breast, GI, GU, lung, gynecologic, brain/spine, hematologic, head and neck, musculoskeletal, endocrine and skin. 749/1406 (53.27%) had impaired STS-30 with an average score of 6.45 repetitions in 30 seconds and 657/1406 (46.73%) had good scores with an average of 14.75 repetitions in 30 seconds. BMI and STS-30: 1,298 patients had BMI data available. 912/1298 (70.3%) were overweight or obese. 501/912 (54.93%) had an impaired STS-30 with an average of 6.76 repetitions in 30 seconds. 411/912 (45.07%) had a good STS-30 with an average of 14.66 repetitions in 30 seconds. 386/1298 (29.7%) had a normal BMI or were underweight. 173/386 (44.82%) had an impaired STS-30 with an average of 6.57 repetitions in 30 seconds. 213/386 (55.18%) had a good STS-30 with an average of 15.06 repetitions in 30 seconds. Stage of cancer and STS-30: The stage of cancer was known for 647 patients/survivors. 462/647 (71.4%) had stage 0-3 cancer. 218/462 (47.2%) had an impaired STS-30 with an average of 6.91 repetitions in 30 seconds.244/462(52.8%) of them had a good STS-30 with an average of 14.54 repetitions in 30 seconds. 185/647 (28.6%) had stage 4 cancer. 114/185 (61.62%) had an impaired STS-30 with an average of 6.04 repetitions in 30 seconds. 71/185 (38.38%) had a good STS-30 score with an average of 14.27 repetitions in 30 seconds. Conclusions: The STS-30 was impaired in a significant percentage of cancer patients and survivors across all stages, implying the possible presence of sarcopenia in this population. Stage 4 cancer patients and overweight/obese patients were at especially high risk of having an impaired STS-30. Clinicians should utilize the STS-30 to screen cancer patients and survivors and if scores are impaired, further assess for presence of sarcopenia and introduce interventions to address it.
Subjective and objective hearing loss among US adult cancer survivors: A national cross-sectional study.
Authors: Wang Qian , Jiang Changchuan , Wen Chi , Xie Hui , Li Yannan , Zhang Yaning , Mady Leila Jean , Bruno Debora S. , Dutcher Giselle , Chiec Lauren , Dowlati Afshin , Hsu Melinda Laine 
Published: June 2023

e24059 Background: Approximately 13% of adults had some degree of hearing loss (HL), and the prevalence is higher among adults aged 65 and over (30.9%). Approximately 50-80% of the childhood, adolescent and young adult cancer survivor population report HL following treatment with high-dose platinum-based chemotherapy, head or brain radiotherapy. We aimed to 1) estimate the prevalence of subjective and objective hearing loss (HL) among cancer survivors and compare to the general population; 2) assess the performance of subjective HL questions in detecting HL by audiometry among cancer survivors. Methods: Adults aged 20-80 years old were selected from the National Health and Nutrition Examination Survey. The weighted prevalence of subjective HL (having troublesome hearing and tinnitus) and objective HL (speech-frequency HL and high-frequency HL) by audiometry test was calculated. Chi-square test and multi-adjusted logistic regression models were used to compare HL between cancer survivors and the general population. To evaluate the performance of subjective HL questions as a tool to screen for objective HL by audiometry, area under the curve (AUC) were estimated using age-and gender- adjusted logistic regression. Results: Compared to the general population, cancer survivors had a statistically significantly higher prevalence of troublesome hearing (aOR = 1.43; 95%CI:1.22-1.68), tinnitus (aOR = 1.28; 95%CI:1.08-1.53), speech-frequency HL (SFHL) (aOR = 1.44; 95%CI:1.20-1.73) and high-frequency HL (HFHL) (aOR = 1.74; 95%CI:1.45-2.09). The sensitivity and specificity of the combined subjective questions “whether having troublesome hearing and/or tinnitus” in detecting HL was shown in Table. The age- and gender- adjusted AUC for detecting SFHL and HFHL using combined questions was 0.88 and 0.90. Conclusions: Cancer survivors have a significantly higher prevalence of both subjective and objective HL, but a lack of hearing examination. Two subjective HL questions could accurately identify those have true HL and provide a simple and efficient screening tool for providers. Cancer survivors and their families should be educated and encouraged to discuss hearing concerns, and providers should facilitate raising awareness and provide early screening and timely referral when HL is identified.[Table: see text]
Survivorship in patients with cardiac metastases defined by cardiac magnetic resonance imaging in relation to lesion hypoperfusion.
Authors: Jain Raina , Liberman Nicole , Agoglia Hannah , Park Michael , Park Robert , Jessurun Jose , Tap William D. , Kim Jiwon , Steingart Richard , Liu Jennifer , Weinsaft Jonathan W. , Chan Angel 
Published: June 2023

e24070 Background: Cardiac metastases (CMET) can occur in late-stage cancer, but limited data exists on prognostic implications in context of current day cancer care. Cardiac magnetic resonance imaging (CMR) provides a new, well validated, means to identify CMET in vivo, and assess magnitude of lesion vascularity – which can vary in relation to tumor etiology and be compromised with tumor necrosis. Survivorship in pts with CMET and modifying impact of lesion vascularity are unknown. Methods: The population comprised adult (≥18yo) pts with metastatic cancer derived from a dual site CMR registry, including pts with and without CMET on CMR. CMR was performed via a uniform protocol for which CMET was defined using established criteria as a cardiac mass with late gadolinium enhancement; lesion vascularity was measured on perfusion-CMR. Cancer type was categorized by pathological review and follow-up was performed for all-cause mortality. Results: 330 pts (59±15 yo; 55% M) were studied, inclusive of CMET and controls matched for cancer etiology/stage. Among pts with CMET, cancer etiology varied (sarcoma 24% | GI 18% | GU 13% | lymphoma 13% | lung 10% | skin/melanoma 7% |); cases and controls were similar with respect to age, sex, anti-cancer regimen, and cardiac function on CMR (all p = NS). Median duration of post-CMR follow-up was 19 months [IQR 11.9 – 43.6]; 92% had clinical follow-up ≥ 1 year or mortality within this interval, including an aggregate 1-year mortality in pts with CMET of 53% (43% in CMET - controls; p = 0.09). Among cancer categories, pts with lymphoma were at decreased risk for death (HR 0.44 [0.26 – 0.75], p = 0.002); risk was increased in pts with GI malignancies (1.63 [1.12 – 2.37], p = 0.01) or those treated with antimetabolites or kinase inhibitors (both p < 0.05): Neither age, sex, cardiac risk factors nor function granted increased risk for death (all p = NS). Regarding Cmet tissue characteristics, decreased lesion perfusion conferred increased mortality risk irrespective of whether assessed as a continuous variable (HR 1.29 [1.08 – 1.56]) or via graded tertiles (HR 1.32 [1.05 – 1.66]) of hypoperfusion (both p < 0.05). Decreased CMET perfusion conferred increased mortality risk (1.30 [1.03 – 1.64], p = 0.03) independent of cancer type or anticancer regimen. Conclusions: Among systemic cancer pts with CMET, survivorship varies and nearly half are alive ≥1 year post cardiac MRI diagnosis. Prognosis in pts with CMET varies inversely to lesion perfusion, with low vascularity lesions conferring increased mortality risk.[Table: see text]