tbuckley/cabot-search huggingface dataset:
Anesthesia Care Handovers and Risk of Adverse Outcomes
Authors: Arin L. Madenci, Kerollos N. Wanis, Tobias Kurth
Journal: JAMA (2018)

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Identification of Clonal Hematopoiesis Mutations in Solid Tumor Patients Undergoing Unpaired Next-Generation Sequencing Assays
Authors: Catherine C. Coombs, Nancy K. Gillis, Xianming Tan, Jonathan S. Berg, Markus Ball, Maria E. Balasis, Nathan D. Montgomery, Kelly L. Bolton, Joel S. Parker, Tania E. Mesa, Sean J. Yoder, Michele C. Hayward, Nirali M. Patel, Kristy L. Richards, Christine M. Walko, Todd C. Knepper, John T. Soper, Jared Weiss, Juneko E. Grilley-Olson, William Y. Kim, H. Shelton Earp, Ross L. Levine, Elli Papaemmanuil, Ahmet Zehir, D. Neil Hayes, Eric Padron
Journal: Clinical Cancer Research (2018)

Abstract Purpose: In this era of precision-based medicine, for optimal patient care, results reported from commercial next-generation sequencing (NGS) assays should adequately reflect the burden of somatic mutations in the tumor being sequenced. Here, we sought to determine the prevalence of clonal hematopoiesis leading to possible misattribution of tumor mutation calls on unpaired Foundation Medicine NGS assays. Experimental Design: This was a retrospective cohort study of individuals undergoing NGS of solid tumors from two large cancer centers. We identified and quantified mutations in genes known to be frequently altered in clonal hematopoiesis (DNMT3A, TET2, ASXL1, TP53, ATM, CHEK2, SF3B1, CBL, JAK2) that were returned to physicians on clinical Foundation Medicine reports. For a subset of patients, we explored the frequency of true clonal hematopoiesis by comparing mutations on Foundation Medicine reports with matched blood sequencing. Results: Mutations in genes that are frequently altered in clonal hematopoiesis were identified in 65% (1,139/1,757) of patients undergoing NGS. When excluding TP53, which is often mutated in solid tumors, these events were still seen in 35% (619/1,757) of patients. Utilizing paired blood specimens, we were able to confirm that 8% (18/226) of mutations reported in these genes were true clonal hematopoiesis events. The majority of DNMT3A mutations (64%, 7/11) and minority of TP53 mutations (4%, 2/50) were clonal hematopoiesis. Conclusions: Clonal hematopoiesis mutations are commonly reported on unpaired NGS testing. It is important to recognize clonal hematopoiesis as a possible cause of misattribution of mutation origin when applying NGS findings to a patient's care. See related commentary by Pollyea, p. 5790
Tuberculosis incidence rate among the homeless population: The impact of socio-demographic and health-related variables
Authors: A.L. Vieira, O. Oliveira, M. Gomes, R. Gaio, R. Duarte
Journal: Pulmonology (2018)

This work was supported by the contribution of Iceland, Liechtenstein and Norway, through the EEA Grants, under the Public Health Initiatives Programme (PT 06), grant number 138DT1. Olena Oliveira was supported by the project NORTE-08-5369-FSE-000041, financed by the Operational Program Norte 2020 and co-financed by the European Social Fund through a doctoral grant (UMINHO/BD/47/2016). Rita Gaio was partially supported by CMUP (UID/MAT/00144/2013), which is funded by FCT (Portugal) with national (MEC) and European structural funds (FEDER), under the partnership agreement PT2020
Reply to J.J. Tao et al
Authors: John D. Hainsworth, Funda Meric-Bernstam, Charles Swanton, Herbert Hurwitz, David R. Spigel, Christopher Sweeney, Howard Burris, Ron Bose, Bongin Yoo, Alisha Stein, Mary Beattie, Razelle Kurzrock
Journal: Journal of Clinical Oncology (2018)
Feasibility and acceptability of a best supportive care (BSC) checklist among clinicians.
Authors: Nathan Adam Boucher, Jonathan Nicolla, Adeboye Ogunseitan, Elizabeth Riley Kessler, Christine Ritchie, Yousuf Zafar
Journal: Journal of Clinical Oncology (2017)

e21682 Background: Some clinical trials for advanced cancer compare experimental therapy to BSC. Usually BSC is not standardized across sites, consistent with best available evidence in palliative care practice, or described in sufficient detail. We developed a consensus-based checklist to document BSC delivery, including symptom management, decision making, and care planning. We hypothesized that BSC can be feasibly documented with this checklist consistent with Consolidated Standards Of Reporting Trials (CONSORT) statements. Methods: Clinicians at 4 academic centers were asked to complete the BSC checklist at each encounter with eligible cancer patients. Enrolled physicians completed a survey regarding use of the checklist during clinic appointments. Descriptive statistics and frequencies were generated. Results: 15 clinicians completed the checklist survey, 9 of whom were advanced practice providers. Mean age was 41 (SD = 7.9). Mean number of years in practice since fellowship for physicians was 7.2 (SD = 4.5). Represented were medical oncology (n = 8), gynecologic oncology (n = 4), palliative care (n = 2), and other (n = 1). For “overall impact on your delivery of supportive/palliative care,” 40% noted improved impact with the checklist. For “overall impact on your documentation of supportive/palliative care,” 46% noted improvement. Impact on “frequency of comprehensive symptom assessment” was 33% “increased.” Impact on “frequency with which you assessed for referral to support services” was 26% “increased.” Impact on “frequency with which you educated patients regarding goals of therapy” was 20% “increased.” No one noted decreased frequency or worsening impact. Regarding feasibility of integrating BSC in workflow, 73% agreed or strongly agreed that the BSC checklist could be easily integrated; 73% saw value in integration; and 80% found it easy to use. Conclusions: Clinicians viewed the BSC checklist favorably. While a small sample, this illustrates proof of concept, minor impact on provider workflow, and potential benefit to patients for use in a future randomized trial.
Baseline quality of life evaluation in older women with primary operable breast cancer and its relationship with different treatments.
Authors: Ross A. Zahit, Ruth M. Parks, Penny Howard, Holly Blake, Kwok-Leung Cheung
Journal: Journal of Clinical Oncology (2018)

e12601 Background: Breast cancer is common among older women. The experience may be perceived differently by them when compared to their younger counterparts, due to different concerns related to quality of life (QoL) issues. This may impact on treatment options. This study aimed to evaluate the differences between baseline QoL of older women with primary breast cancer undergoing surgery and non-operative treatment i.e. PET. Methods: As part of a wider study on older patients with primary operable breast cancer, baseline QoL was measured using the European Organisation for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ-C30), and breast cancer component (QLQ-BR23). Treatment decision was made by the clinical team independent of the study and was not guided by QoL assessment. Comparison was made between scores for the QOL questionnaires (53 questions with a total of 23 components) and whether the patient had surgery or non-surgery using the t-test for normally distributed data or otherwise the Mann-Whitney test. Results: A total of 76 women (surgery n = 51, PET n = 25) were recruited from three different centres. The mean age was 78 years (range 68-93, SD = 6.01). When compared to patients treated by surgery, patients started on PET were more likely to have the following at baseline: more trouble doing strenuous activities (p = 0.010) greater trouble taking a long (p = 0.000) or short (p = 0.000) walk increased need to stay in bed or a chair during the day (p = 0.001) feeling more tense (p = 0.050) and worry (p = 0.002) greater pain in the arm or shoulder (p = 0.012) greater difficulty with raising or moving arm sideways (p = 0.020) greater pain in the area of affected breast (p = 0.009) Binary logistic regression showed that a greater feeling of worry was an independent predictor of treatment undertaken (p = 0.047). Conclusions: Older women undergoing different treatments for a newly diagnosed primary breast cancer appear to have different baseline QoL characteristics. Further understanding may inform the use of different support measures. The study is ongoing.
Assessing key stakeholders' knowledge, needs, and preferences for cancer survivorship care plans.
Authors: Leah L. Zullig, Callie Berkowitz, Julie Miller, Katherine Ramos, Rowena Dolor, Bridget F. Koontz, Yousuf Zafar, Deborah H. Allen, Jennifer Tenhover, Hayden B Bosworth
Journal: Journal of Clinical Oncology (2018)

30 Background: Survivorship care plans (SCPs) are individualized documents that summarize cancer treatment received and provide guidelines for monitoring and maintaining survivors’ health. While SCPs are intended to facilitate care coordination, they are rarely used in the primary care setting. We aimed to understand the informational needs and delivery preferences of PCPs, cancer survivors, cancer specialists, and nurses related to SCPs. Methods: We conducted semi-structured interviews with a purposeful sample of PCPs (n = 10), cancer specialists (n = 5), nurses (n = 5), and cancer survivors (n = 5). After reviewing a sample SCP based on the published ASCO template, participants were asked about acceptability, appropriateness, feasibility, fidelity, implementation, and sustainability. De-identified transcripts were qualitatively analyzed using NVivo software. Results: 25 interviews were completed (RR 45%). Emergent themes included informational needs and delivery preferences. Informational needs include clarifying roles and responsibilities of allied professionals; the roles of the PCP for follow-up care should be clear, outlined and with content summarizing their responsibilities regarding screening, and surveillance. Additionally, SCPs should emphasize side and late effects of cancer treatment for the benefit of patients and providers. Delivery preferences include using sustainable and accessible electronic formats to improve provider communication and streamlining documentation for the intended audience. Electronic SCPs could be frequently updated with pertinent information about patient needs and care over time. Conclusions: Understanding the needs and preferences of PCPs may address current limitations of SCPs in coordinating survivor care. Future SCPs may be electronic and accessible, with content and guidance targeted to the PCP’s role.
Updosing of bilastine is effective in moderate to severe chronic spontaneous urticaria: A real‐life study
Authors: K. Weller, M. K. Church, T. Hawro, S. Altrichter, L. Labeaga, M. Magerl, M. Metz, T. Zuberbier, M. Maurer
Journal: Allergy (2018)

Karsten Weller is or recently was a speaker and/or advisor for Dr. Pfleger, Uriach, UCB, Moxie and Novartis. Martin Church has been a speaker or consultant for Almirall, FAES FARMA S.A., Menarini, Moxie, MSD, Novartis, UCB Pharma, Sanofi-Aventis and Uriach. Tomasz Hawro has no conflict of interest. Sabine Altrichter has conducted studies for Allakos, GSK, Moxie and Novartis. Luis Labega is a member of the medical department of FAES FARMA S.A. Markus Magerl is or recently was a speaker and/or advisor for Moxie and Novartis. Martin Metz has been a speaker and/or consultant for Bayer Pharma, Moxie, Novartis and Uriach. Torsten Zuberbier has consulted and had research grants and/or honoraria from AstraZeneca, AbbVie, ALK, Almirall, Astellas, Bayer Health Care, Bencard, Berlin Chemie, FAES FARMA S.A, HAL, Henkel, Kryolan, Leti, L'Oreal, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes, Takeda, Teva and UCB. Marcus Maurer is or recently was a speaker and/or advisor for and/or has received research funding from Allakos, Aralez, Genentech, GSK, Menarini, Merckle Recordati, Moxie, Novartis, Sanofi, MSD and Uriach.
Abstract 165: Coronary Artery Dilatation in Kawasaki Disease is Associated with Anatomical Coronary Dominance: An Angiography-Based Study
Authors: Baher M Hanna, Chantale Lapierre, Frédérick Trinh Tan, Larent Desjardins, Anne Fournier, Nagib Dahdah
Journal: Circulation (2015)

Introduction: Coronary artery (CA) dilatation in Kawasaki disease (KD) is best determined by elevated Z-scores. Z-score equations, do not take into account anatomical CA dominance. We hypothesize that, except for CA aneurysms, CA dominance influences dilatation status in KD (Z-score &gt; 2.5). Material and Methods: We retrospectively analyzed CA status in KD patients followed at our institution for persistent CA dilatation. All patients who had a diagnostic catheterization between 2002 and 2012 were considered. Serial echocardiographic dimensions of LCA, RCA, and LAD upon diagnosis, 1 week, 2 weeks, 4 weeks, 2 months, 3-6 months, and 9-12 months later were normalized to BSA using published CA Z-score equations. Data were contrasted with CA angiography description of CA dominance: right or left dominance was adopted when the respective CA supplies both diaphragmatic LV free wall and posterior inter ventricular septum (IVS); Co-dominance was when posterior IVS was supplied by RCA and diaphragmatic LV free wall by LCA. Results: Of 69 potential patients, 16 were excluded (9 never presented a CA dilatation and 7 had CA aneurysms). The interval between acute onset and selective CA angiography of the remaining 53 patients was 69.5±52.8months at 9.2±5.2years old. Of the latter, 20(37.7%) had LCA-dominance, 31(58.5%) RCA-dominance, and 2(3.8%) Co-dominance. Upon KD onset, the LCA-dominant subset had 14/20(70%) ipsilateral dilatation vs. 6/20(30%) contralateral dilatation. Similarly, RCA-dominant dilatation was ipsilateral in 21/31(68%) vs. 10/31(32%) contralateral dilatation (p=0.89). On late follow-up, persistent CA dilatation was similar between LCA-dominance 6/14(43%) and RCA-dominance 10/21(47%) (p=0.94). The interval between onset and normalizing CA Z-score was 1.16±1.65 vs. 2.45±3.6years in ispilateral vs. contralateral subsets (p=0.19). From the inflammatory perspective, serum albumin was significantly lower in patients with contralateral CA dilatation (p=0.02). Nevertheless, other inflammatory markers did not show a significant difference. Conclusion: Transitory CA dilatation following KD is closely related to anatomical dominance. This may be a reflection of vasodilation during immune carditis rather than coronary vasculitis.
The impact of global environmental change on vector-borne disease risk: a modelling study
Authors: Rachel Lowe
Journal: The Lancet Planetary Health (2018)

BackgroundVector-borne diseases, such as dengue virus, Zika virus, and malaria, are highly sensitive to environmental changes, including variations in climate and land-surface characteristics. The emergence and spread of vector-borne diseases is also exacerbated by anthropogenic activities, such as deforestation, mining, urbanisation, and human mobility, which alter the natural habitats of vectors and increase vector–host interactions. Innovative epidemiological modelling tools can help to understand how environmental conditions interact with socioeconomic risk factors to predict the risk of disease transmission. In recent years, climate-health modelling has benefited from computational advances in fitting complex mathematical models; increasing availability of environmental, socioeconomic, and disease surveillance datasets; and improved ability to understand and model the climate system. Climate forecasts at seasonal time scales tend to improve in quality during El Niño-Southern Oscillation events in certain regions of the tropics. Thus, climate forecasts provide an opportunity to anticipate potential outbreaks of vector-borne diseases from several months to a year in advance. The aim of this study was to develop a framework to incorporate seasonal climate forecasts in predictive disease models to understand the future risk of vector-borne diseases, with a focus on dengue fever in Latin America.MethodsA Bayesian spatiotemporal model framework that quantifies the extent to which environmental and socioeconomic indicators can explain variations in disease risk was designed to disentangle the effects of climate from other risk factors using multi-source data and random effects, which account for unknown and unmeasured sources of spatial, seasonal, and inter-annual variation. The model was used to provide probabilistic predictions of monthly dengue incidence and the probability of exceeding outbreak thresholds, which were established in consultation with public health stakeholders.FindingsThis disease model framework, combined with seasonal climate forecasts, successfully produced real-time, probabilistic estimates of dengue outbreak risk ahead of a mass gathering in Brazil in June, 2014, for all 550 microregions. Additionally, the model predicted dengue outbreak risk after a major El Niño event in southern coastal Ecuador from January to November, 2016. Forecasts from the new model framework did better than those from benchmark models based on historical seasonal dengue averages.InterpretationThis flexible model framework can be adapted to predict any climate-sensitive disease at various spatiotemporal scales and in diverse ecological settings. Incorporating sub-seasonal and seasonal climate forecasts in disease prediction models could support public health decision makers in implementing timely disease-control and prevention strategies months in advance to mitigate the risk of imminent disease epidemics and emerging disease threats.FundingRoyal Society Dorothy Hodgkin Fellowship.
Impact of the biological definition of Alzheimer’s disease using amyloid, tau and neurodegeneration (ATN): what about the role of vascular changes, inflammation, Lewy body pathology?
Authors: S. Gauthier, H. Zhang, K. P. Ng, T.A. Pascoal, P. Rosa-Neto
Journal: Translational Neurodegeneration (2018)

The NIA-AA research framework proposes a biological definition of Alzheimer's disease, where asymptomatic persons with amyloid deposition would be considered as having this disease prior to symptoms.Notwithstanding the fact that amyloid deposition in isolation is not associated with dementia, even the combined association of amyloid and tau pathology does not inevitably need to dementia over age 65. Other pathological factors may play a leading or an accelerating role in age-associated cognitive decline, including vascular small vessel disease, neuroinflammation and Lewy Body pathology.Research should aim at understanding the interaction between all these factors, rather than focusing on them individually. Hopefully this will lead to a personalized approach to the prevention of brain aging, based on individual biological, genetic and cognitive profiles.
Peripheral Neuropathy, Sensory Processing, and Balance in Survivors of Acute Lymphoblastic Leukemia
Authors: Mitra Varedi, Lu Lu, Carrie R. Howell, Robyn E. Partin, Melissa M. Hudson, Ching-Hon Pui, Kevin R. Krull, Leslie L. Robison, Kirsten K. Ness, Raymond F. McKenna
Journal: Journal of Clinical Oncology (2018)

Purpose To compare peripheral nervous system function and balance between adult survivors of childhood acute lymphoblastic leukemia (ALL) and matched controls and to determine associations between peripheral neuropathy (PN) and limitations in static balance, mobility, walking endurance, and quality of life (QoL) among survivors. Patients and Methods Three hundred sixty-five adult survivors of childhood ALL and 365 controls with no cancer history completed assessments of PN (modified Total Neuropathy Score [mTNS]), static balance (Sensory Organization Test [SOT]), mobility (Timed Up and Go), walking endurance (6-minute walk test), QoL (Medical Outcomes Study 36-Item Short Form Survey), and visual-motor processing speed (Wechsler Adult Intelligence Scale). Results PN, but not impairments, in performance on SOT was more common in survivors than controls (41.4% v 9.5%, respectively; P &lt; .001). In multivariable models, higher mTNS scores were associated with longer time to complete the Timed Up and Go (β = 0.15; 95% CI, 0.06 to 0.23; P &lt; .001), shorter distance walked in 6 minutes (β = −4.39; 95% CI, −8.63 to −0.14; P = .04), and reduced QoL (β = −1.33; 95% CI, −1.79 to −0.87; P &lt; .001 for physical functioning; β = −1.16; 95% CI, −1.64 to −0.67; P &lt; .001 for role physical; and β = −0.88; 95% CI, −1.34 to −0.42; P &lt; .001 for general health). Processing speed (β = 1.69; 95% CI, 0.98 to 2.40; P &lt; .001), but not mTNS score, was associated with anterior-posterior sway on the SOT. Conclusion PN in long-term ALL survivors is associated with movement, including mobility and walking endurance, but not with static standing balance. The association between processing speed and sway suggests that static balance impairment in ALL survivors may be influenced by problems with CNS function, including the processing of sensory information.
<i>Notes from the Field:</i> Outbreak of Severe Illness Linked to the Vitamin K Antagonist Brodifacoum and Use of Synthetic Cannabinoids — Illinois, March–April 2018
Authors: Erin Moritz, Connie Austin, Michael Wahl, Carol DesLauriers, Livia Navon, Kelly Walblay, Monica Hendrickson, Angie Phillips, Janna Kerins, Audrey F. Pennington, Amy M. Lavery, Tharwat El Zahran, Judy Kauerauf, Luke Yip, Jerry Thomas, Jennifer Layden
Journal: MMWR Morbidity and Mortality Weekly Report (2018)