bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Strauss ECG criteria as predictor of response in patients undergoing cardiac resynchronization therapy
Authors: Shoman Khaled Ashraf , Eldamanhory Hayam Mohammed , Fakhry Emad Effat , Badran Haitham Abdelfatah 
Published: September 2022

Abstract
Background
Cardiac resynchronization therapy (CRT) is a standard treatment in patients with heart failure; however, approximately 20–40% of recipients of (CRT) do not respond to it based on the current patients’ selection criteria. The purpose of this study was to identify the baseline parameters that predict the CRT response and how the ECG morphology can affect the outcome. The study aimed to evaluate the Strauss ECG criteria as a predictor of response in patients undergoing cardiac resynchronization therapy.

Results
Out of 70 patients, 3 patients missed the 6-month follow-up after CRT implantation, so the study enrolled 67 patients that have been classified according to ECG morphology of LBBB to 37 patients with non-Strauss ECG criteria—one of whom died after 4 months—and 30 patients with Strauss ECG criteria. The number of responders in the study was 50 patients with percentage 75.8%; 52% of CRT responder (26 patients) had non-Strauss ECG criteria, while 48% of CRT responders (24 patients) had Strauss ECG criteria with P value = 0.463. While there was no statistical significance of overall CRT response nor 6-month hospitalization and mortality between patients of Strauss and non-Strauss ECG criteria, there was a significant improvement in NYHA class, EF assessed by biplane Simpson’s, end-systolic volume, global longitudinal strain and global circumferential strain by speckle tracking echocardiography in patients with Strauss ECG criteria of LBBB.

Conclusions
There is no statistical significance in overall CRT response nor the 6-month hospitalization and mortality after 6 months of follow-up between patients with Strauss and non-Strauss ECG criteria of LBBB; however, patients with Strauss ECG criteria have better improvement in NYHA class, echocardiographic parameters such as EF and ESV and speckle tracking parameters (GLS and GCS).
Anticancer cytotoxicity and antifungal abilities of green-synthesized cobalt hydroxide (Co(OH)2) nanoparticles using Lantana camara L.
Authors: Ravi Lokesh , Sreenivas B. K. Anirudh , Kumari G. R. Shree , Archana O. 
Published: September 2022

Abstract
Background
Green synthesis of metal nanoparticles with pharmaceutical applications is the current focus in the field of nanomedicine. This study aims at use of Lantanacamara L as a source of green reducing agent toward synthesis of cobalt nanoparticles.

Results
Fe3+-reducing assay demonstrated that Lantana camara methanol extract (LCM) has significant electron transfer potential. Gas chromatography mass spectroscopy (GC–MS) analysis of the crude extracts revealed the presence of 7 known and 17 unknown phytochemicals in LCM. Synthesis of cobalt nanoparticles was confirmed based on color change of reaction mixture from light brown to dark brown. UV–visible spectrometry analysis showed that the synthesized particles had a λmax at 267.5 nm. Based on the two theta (2θ) and Miller indices (hkl) values obtained in XRD analysis, the particles were confirmed to be cobalt hydroxide (Co(OH)2) nanoparticles. Further dynamic light scattering (DLS) analysis showed that the average size of the Co(OH)2 nanoparticles is 180 nm. SEM image analysis of the particles revealed that they are spherical mass of feather-like structure, contributing toward increased surface area of the particles. Further, the pharmaceutical potential of the Co(OH)2 nanoparticles was evaluated against eukaryotic cancer and fungal cells. MTT cytotoxicity analysis showed that Co(OH)2 nanoparticles have selective toxicity toward HCT-116 cancer cells with an IC50 value of 25 µg/ml and reduced cytotoxicity to non-cancerous VERO cells with an IC50 value of 200 µg/ml suggesting that the particles possess selective anti-cancerous cytotoxicity. Additionally, the particles demonstrated significant antifungal activity against 5 human fungal pathogens.

Conclusions
Results of this study conclude that green-synthesized Co(OH)2 nanoparticles using Lantanacamara L possess excellent eukaryotic cytotoxicity against cancer cells and fungal pathogens.
Identifying visual sensitive areas: an evaluation of view corridors to support nature-culture heritage conservation in Chiang Mai historic city
Authors: Sukwai Janjira , Mishima Nobuo , Srinurak Nattasit 
Published: September 2022

AbstractThe visual integrity of mountains contributing to cultural landscapes as nature-culture attributes is often obscured by the vertical intrusive built environment, especially in buffer areas of protected heritage zones. Therefore, this study argued that even low/medium-rise buildings that inappropriately appear in the horizontal visual plane could be a factor increasing sensitivity to this panoramic view.An integrative tool – visual sensitivity assessment – consists of Viewshed and Skyline analysis considering the pedestrian’s visual limitation in identifying the sensitive areas of the mountain view corridor in the historic city of Chiang Mai. The visible mountain areas (VMAs) were determined as a baseline, and their relationship with the visible building areas (VBAs) was then examined using statistical correlation to define a strong negative relationship as the visual sensitive areas in five zones. The results showed that the buffer zone was found to have more areas with visual sensitivity values, but this varies depending on the characteristics of buildings and the assessment from the view corridor. Meanwhile, in height-restricted areas, such as historic area zone 5, there are some concerns about the visual intrusion, which necessitates continuous monitoring using the assessment result as a guideline.Incorporating the results into implementation could support cultural landscape conservation in Chiang Mai city. The method is applicable in historic cities with similar settings to produce the baseline for the built environment that is harmonious with the cultural and historical characteristics of the city and with respect to its broader setting.
Financial toxicity of front-line platinum etoposide plus atezolizumab versus durvalumab in extensive-stage small-cell (ES-SCLC) lung cancer.
Authors: Harrison Bradley , Keith Nicole , Verbyla Allison , Mileham Kathryn Finch 
Published: September 2022

23 Background: With the continued advent of new therapeutics, burgeoning costs and financial toxicity are more frequently a complication in comprehensive cancer care. At Levine Cancer Institute (LCI), a multidisciplinary Financial Toxicity Tumor Board has driven $55-60 million in cost savings for patients annually, and presented patient cases can serve as a continual impetus for iterative quality improvement and cost-savings research. One such example highlights the augmented risk of financial toxicity resultant from increasing utilization of front-line chemoimmunotherapy (chemo-IO) in ES-SCLC. Both atezolizumab and durvalumab in concert with platinum-etoposide chemotherapy separately portend an overall survival benefit. Retrospective analyses have failed to demonstrate a PFS or OS advantage between the two regimens. Amidst comparable efficacy, we sought to ascertain institutional variance in cost profiles and financial toxicity. Methods: Billing and demographic data for patients with ES-SCLC who received chemo-IO with durvalumab or atezolizumab in an LCI hospital-based outpatient infusion center were queried. Treatment dates encompassed October 1, 2019 through April 30, 2022. Patient costs were compared and exploratory analyses were performed related to patient demographics, patient geography (with financial characteristics per Census data) and bad debt proportions. Results: 211 patients received chemo-IO with atezolizumab, and 108 patients received chemo-IO with durvalumab. Medicare (+/- supplementary insurance), Medicare Advantage, and commercial insurance constituted 85% of payors. Institutional covenants restrict publication of commercial and supplementary insurance data; for compliance and generalizability, reported is the Medicare-only population. Medicare allowables of $6791 and $8429 were utilized per dose of atezolizumab 1200 mg and durvalumab 1500 mg, respectively. Amidst 20% patient responsibility with Medicare, durvalumab patient cost was $327.60 higher per cycle. Incorporating observed mean number of cycles of 5.20 for atezolizumab and 5.31 for durvalumab, an average course of durvalumab was $1836.56 more expensive. Assessing the entire population, 24% of patients in both groups met criteria for bad debt; however, mean quantity of bad debt was 62% higher with durvalumab ($8988.77) than with atezolizumab ($5555.11). Bad debt was disproportionately congregated in lower income zip codes (data to be displayed pictorally). Conclusions: Chemo-IO with durvalumab was $1834.56 more expensive per treatment course in ES-SCLC, with 62% increase in quantity of bad debt relative to atezolizumab. Future directions may focus on institutional interventions to mitigate financial toxicity related to therapy choice and geographic allocation of resources, as well as the assessment of cost variance in other solid tumors.
The use of adjuvant chemotherapy in resected stage IB-IIIA non–small cell lung cancer (NSCLC) and comparison to the TriNetX database.
Authors: Shameem Ayesha , Jubelirer Steven , Annie Frank , Welch Christine A. 
Published: September 2022

29 Background: Adjuvant cisplatin-based chemotherapy (AC) is the standard of care for completely resected stage IB (tumor size > 4cm), II, and IIIA non small cell lung cancer (NSCLC) patients. Several randomized clinical trials have shown varying levels of survival benefit for patients treated with AC compared to surgery alone. Methods: A retrospective study was performed regarding the use of adjuvant chemotherapy comparing Charleston Area Medical Center (CAMC) patients to those in the TriNetX database in the years 1998-2017. Inclusion criteria were patients > 18 years of age, completely resected (R0), stage IB (tumor size > 4 cm) through stage IIIA (R0) NSCLC. SAS 9.3 was used for data analysis. Results: The populations included two hundred and thirty-six (CAMC) and 4,364 (TriNetX) patients. The CAMC population was 98% Caucasian, 63% male with an average age of 65±10 years. The TriNetX population was 66% Caucasian, 57% male with an average age of 67±10 years. The 5-year overall survival (OS) in the CAMC database between chemotherapy and non-chemotherapy groups was not statistically significant (49.5% vs 49.8%, p = 0.8, respectively). In the TriNetX database, the 5-year OS for the chemotherapy group was significantly higher compared to the non-chemotherapy groups (61.2% vs 54.0%, p < 0.05, respectively). Cox proportional hazards model was used to determine the factors influencing 5-year OS in the CAMC population. Results showed that patients >65 years of age were 2.2 times (95% CI: 1.53-3.2) more likely to be dead in 5-years. With each increase in stage patients were 1.3 times (95% CI: 1.0-1.8) more likely to be dead in 5-years. Moreover, patients without coronary artery disease were 1.7 times (95% CI: 1.2-2.4) more likely to be dead in 5-years. Conclusions: Regardless of treatment, about half of CAMC patients were alive at 5 years, while a higher OS was seen in the TriNetX chemotherapy group. Regression analysis of the CAMC population showed that chemotherapy was not a significant variable in 5-year OS. Differences in survival between CAMC and TriNetX could be due to the large number of comorbidities in the CAMC population, patient refusal to chemotherapy, particularly those >65 years, and incomplete planned dose due to side effects of adjuvant chemotherapy. We conclude that several barriers may impact the use of adjuvant chemotherapy in non-trial settings in the CAMC population.
Implementation of an innovative multidisciplinary survivorship clinic: The OWLS (Oncology, Wellness, Lifestyle and Survivorship) experience.
Authors: Duffy Christine Mary , Higel-Mcgovern Camille , Dizon Don S. 
Published: September 2022

34 Background: Cancer survivors have complex medical and psychosocial needs and report difficulty accessing specialty care for short and long-term effects of treatment. We created an innovative multi-specialty survivorship clinic to address the medical and psychosocial consequences of cancer and to promote wellness and healthy lifestyle changes. Methods: The “Oncology, Wellness, Lifestyle and Survivorship” (OWLS) clinic was implemented 12/2020 for breast and gyn cancer survivors and extended to all cancer types in 111/2021. Patients complete pre and post-clinic survey to their medical and psychosocial concerns. OWLS is led by an internist and NP expert in survivorship with nurse navigator, physical activity coach, massage therapist on-site. A multidisciplinary team of providers experienced in survivorship care from hem/onc, cardiology, pulmonary, rheumatology, nephrology, dermatology, endocrinology, neurology, psychiatry, sexual health, physical therapy, nutrition, and lifestyle medicine meet monthly to create a comprehensive care management plan presented to survivors at their follow up visit and shared with their PCP and oncologist. Results: The OWLS team has seen 91 patients as of May 2022 and had 12 MDC meetings. Mean survivor age was 50 and the majority were white (80%) had breast cancer(76%) with non-metastatic disease 80%. Most frequent referrals were nutrition, physical therapy, gastroenterology and sexual health. At 6 mos f/u survey almost all were v.satisfied/satisfied with care. All OWLS MDC providers rated it as valuable. Conclusions: The OWLS clinic is an innovate, multi-specialty program that provides a comprehensive survivorship plan for cancer survivors at any stage of their disease. Areas for future growth include extending onsite services, expanding the number of male survivors serviced, and increasing outreach to non-white, non-commercially insured patients.[Table: see text]
Impacts on breast cancer screening by targeting high-risk individuals through the utilization of allied health members in rural India.
Authors: Menakuru Sasmith 
Published: September 2022

38 Background: Currently, screening in rural India is done in most instances by utilizing mobile detection units that the government of India sets up to reduce the barrier of accessibility. These screening camps infrequently occur and manage to screen around 100-150 people a day. Screening even with a positive result is ultimately useless without follow-up care. Breast cancer, which is often diagnosed late in presentation, is widely screened for by utilizing mobile mammography screening units. The authors propose that instead of recruiting patients randomly, patients should be chosen prior to the set-up of camps by using accredited social health workers (ASHAs), community health leaders (CHL), and other allied health professionals (AHP) based on risk factors. Methods: Mobile health screening camps were deployed in rural Andhra Pradesh, India, where for 2 screening sessions, females were recruited either a day before or just before set up. These results were compared to another 2 screening sessions where females were recruited for 2 weeks prior to being set up by ASHAs, CHLs, and other AHPs. They recruited patients at risk of breast cancer, including those with a family history, who were smokers, who felt a lump on self-examination, who had a prior history of cancer, and those with a BMI over 25. They explained about mammography, the need for them to be screened, and the need for follow-up care. Both data sets were compared to check for positivity rates on mammography and establishment of the initial follow-up appointment. Results: It was found that the screening camps where recruitment took place on the same day or the day before had a more significant number of patients who were recruited to get screened. In total, 267 people were screened that day. Out of those 267, mammography was positive in 21 patients; however, only 1 of those 21 patients established care at a follow-up visit. In the screening camps where ASHAs, CHL, and other AHPs were recruited to recruit patients based on high-risk factors, a total of 138 people were screened. Of those 138 people, 37 people had positive findings on mammography. Out of the 37 people, 29 patients established follow-up care. It was found that due to the decreased number of mammograms performed, the overall cost went down even with the need to allocate funding for recruitment. Conclusions: This study showed that it is beneficial to establish the recruitment process before setting up mammography camps by utilizing ASHAs, CHLs, and other AHPs to screen for high-risk individuals. Despite a more significant number of patients screened using the current widely utilized method of randomly recruiting patients in India, the follow-up rates were poor. By targeting high-risk women for mammography, the follow-up rates improve, and the overall cost of the screening camp decreases.
Strategic team engagement for successful documentation of pain management.
Authors: Bates Christine , Crum Erin , Brooks Donald J. , Andres Grant 
Published: September 2022

53 Background: Pain is experienced by a majority of cancer patients, often having a significant negative impact on their quality of life. Effective documentation of pain scores and plan of care provide care teams with data for decision-making to improve pain management. In Q2 of 2021 documentation deficiencies were identified. Process improvement interventions were initiated through the remainder of 2021 to support clinical teams. Methods: Over the course of twelve months our practice sought to improve documentation of pain management through a multi-pronged approach. Execution began with initiation of the Quality and Safety Committee early in 2021 to engage key stakeholders. Our Chain of Command Project identified strategic members of the administrative and clinical leadership teams at the individual clinic level who initiated monthly meetings to promote quality awareness and engagement. Quality measures associated with pain management, MIPS 143 and 144, were examined with assistance from our Value Based Care Transformation Team. Monthly provider scorecard distribution commenced Q2 to identify documentation inconsistencies related to pain management. Providers, medical assistants, and scribes were provided education and training related to appropriate pain management documentation workflows. Follow up audits were performed by the Quality team. In Q3 and Q4 the Quality team collaborated with Human Resources to identify new employees and facilitate education on quality metric capture within a month of hire. Results: The data above is a representation of all clinics and patients treated. The interventions resulted in improved metrics from 2020 to 2022 YTD: MIPS 143 +5.5%, MIPS 144 +27.3%, and PIMSH4 +6.3%. Conclusions: Effective change management occurred from the top down with additional engagement of administrative and clinical members. Analysis of the internal structure and deficiencies was needed with implementation of metric training. Data transparency helped with engagement and managing documentation of MIPS 143 and 144. Next steps include leveraging the current documentation processes to improve PIMSH4, ultimately improving the quality of life for patients.[Table: see text]
Associations of delays in care due to transportation barriers and care utilization, and cause-specific mortality risk among the U.S. adults with a cancer history.
Authors: Jiang Changchuan , Deng Lei , Perimbeti Stuthi , Wang Qian , Yabroff K. Robin Robin , Han Xuesong 
Published: September 2022

70 Background: Cancer survivors have greater comorbidity burden, health care use, and mortality risk than individuals without a cancer history. Cancer survivors are also more likely to experience transportation barriers to care in the US. This study examines associations between transportation barriers and cancer survivors' care utilization and outcomes in a nationally representative sample. Methods: We identified cohorts of cancer survivors (n = 28,606) and adults without a cancer history (n = 469,860) from the 2000-2018 National Health Interview Survey (NHIS) linked to the recently released NHIS Mortality Files. Transportation barriers were measured as medical care delays during the past 12 months due to lack of transportation. Outcomes included lack of routine place for care, emergency room (ER) use during the past 12 months, all-cause, and cancer-specific mortality. Their association with transportation barriers was estimated using weighted multivariable logistic, and Cox’s proportional hazards regressions, respectively. Models were adjusted for age, sex, race, educational attainment, comorbidities, region, year of survey, and functional limitations, as well as time since cancer diagnosis, and cancer types (breast, colorectal, prostate, and others). Health insurance coverage was added sequentially to models. Results: 2.8% of cancer survivors and 1.7% of adults without cancer history reported delays in care due to transportation barriers. Cancer survivors with transportation barriers had the strongest associations with lack of routine place for care and ER use; followed by survivors without transportation barriers; and adults without a cancer history with and without transportation barriers (Table). Similarly, transportation barriers were associated with the highest risk of all-cause and cancer-specific mortality risk among cancer survivors. Further adjustment for health insurance reduced the magnitude of association between transportation barriers and mortality. Conclusions: Cancer survivors who delayed care due to lack of transportation were more likely to use the ER. They also had the highest risks of all-cause and cancer-specific mortality. Efforts are needed to mitigate transportation barriers in the rapidly growing but vulnerable cancer survivor community.[Table: see text]