tbuckley/cabot-search huggingface dataset:
Study on assessment dimensions of community-based elderly care service with Delphi method
Authors: Minjie Jin, Ping Lu, Bo Gao, Yuanyuan Ge, Ji Gu, Shanshan Zhao
Journal: BMJ (2017)

Objective
To define the assessment dimensions of community-based elderly care service.


Methods
Firstly 11 assessment dimensions of elderly care service needs were teased out through literature review and group discussion, these were illness, self-care ability, vision, risk of falls, willingness/information self-expression ability, the comprehension in others′ willingness/information, depression, anxiety, family care ability, self-desires for old-age support, family-desires for old-age support. Then 37 experts were invited to reconfirm and empower theose assessment dimensions with two rounds of Delphi method.


Results
Results showed that the enthusiasm and authority degree of experts were favorable in two rounds, and the results from the second round showed strong opinion coordination. Finally, 12 assessment dimensions were confirmed, in which financial situation of the aged added and used for reference. After weight calculation, illness was weighted the highest (0.11), while vision and the degree of anxiety were weighted lowest in 11 dimensions (0.07).


Conclusion
The reliability of the assessment dimensions of the aged service needs is high. This study had positive significance on the solution of the dilemma in elderly care at the present stage.


Key words: 
Community health services; Demand for old-age provision; Delphi technique
Family building preferences among young women with invasive breast cancer.
Authors: Angelena Crown, Nadia Abdo, Ariela Noy, Cassandra Chang, Mary Gemignani, Shari Beth Goldfarb
Journal: Journal of Clinical Oncology (2020)

e24057 Background: The American Society of Clinical Oncology guidelines recommend discussing the possibility of infertility in cancer patients of childbearing age being treated with gonadotoxic therapies. This prospective study examines the reproductive history and future family building preferences of young women with breast cancer. Methods: This is an Institutional Review Board approved prospective study of women &lt; 45 years of age with non-metastatic invasive breast cancer who completed a questionnaire on reproductive history and family building preferences between April 2013 and December 2019. Questionnaires were administered at initial diagnosis and then annually. Results: Baseline questionnaires were completed by 164 women with a median age of 39 years old (range 20-45); 110 (59%) completed the 1 year follow up survey. Clinicopathologic features and treatment are shown in the table. The majority of women (n = 90, 55%) were parous and many had previous infertility (n = 60, 37%) at time of diagnosis. Most women (n = 87, 53%) wanted additional children or were unsure. Interest in embryo and/or oocyte cryopreservation was common (n = 51, 31%) as was interest in adoption (n = 52, 32%). Of the 110 women who completed the one year follow-up, 39 (35%) saw a reproductive endocrinologist, including 22 (20%) who elected embryo (n = 14) or oocyte (n = 8) cryopreservation. Overall, 88 (80%) women declined fertility preservation. The most common reasons included worrying about delay in cancer treatment (n = 10, 9%), fear of hormonal exposure (n = 7, 6%), and feeling rushed into making a decision (n = 6, 6%). Of 92 women with available data regarding satisfaction with their decision to pursue fertility preservation or not, 84% (n = 77) reported satisfaction whereas 14% (n = 15) reported mixed feelings or regret. Conclusions: Young women with breast cancer expressed a significant interest in family building options. However, pursuit of fertility preservation was uncommon despite a high rate of prior infertility in this cohort of mostly parous women. Decisional satisfaction was common. Further study of factors contributing to patient decision-making regarding fertility preservation and alternative family building options is warranted. Clinical trial information: NCT01788839 . [Table: see text]
Cytogenetic abnormalities in MM: Association with disease characteristics and treatment response.
Authors: Nadine Abdallah, Francis Buadi, Patricia T. Greipp, Morie A. Gertz, Prashant Kapoor, Angela Dispenzieri, Linda Baughn, Martha Lacy, Suzanne R. Hayman, David Dingli, Ronald S. Go, Miriam A. Hobbs, Yi Lin, Taxiarchis Kourelis, Mustaqeem Ahmad Siddiqui, Robert A. Kyle, Rhett P. Ketterling, S. Vincent Rajkumar, Leif P. Bergsagel, Shaji Kumar
Journal: Journal of Clinical Oncology (2020)

e20520 Background: Cytogenetic abnormalities detected by FISH are found in the majority of multiple myeloma (MM) patients. Although their prognostic value has been studied extensively, less is known about their association with disease characteristics and treatment response. Methods: To address these questions, we designed a retrospective study including 2031 Mayo Clinic patients diagnosed with MM from 2004 to 2018. We compared baseline characteristics and treatment outcomes between primary cytogenetic groups: t(11;14), t(4;14), t(14;16), (14;20), t(6;14), unknown IgH translocation/del and trisomy (without IgH translocation). These included 373, 177, 78, 20, 18, 228 and 791 patients respectively. Kruskal-Wallis and Fisher’s exact tests were used for categorical and continuous variables respectively. Time to next treatment (TTNT) was estimated using Kaplan-Meier method and compared using Log-Rank test. Results: t(4;14), t(14;16), t(6;14) and t(14;20) groups were associated with hemoglobin &lt; 10 g/dL, beta2microglobulin &gt; 5.5 µg/ml, ISS stage 3 and ≥50% bone marrow plasma cells. The latter 3 groups were also associated with renal dysfunction (Cr ≥2 mg/dL) and higher urinary monoclonal protein. t(4;14) was associated with IgA isotype, serum monoclonal protein ≥1g/dL and plasma cell labeling index ≥1%. Light chain myeloma was more prevalent in patients with t(11;14). Overall response rate (ORR) to proteasome inhibitor (PI) induction was higher for those with IgH translocations (any) compared to trisomies (85% vs 77% P = 0.02), while ORR was higher for those with trisomies with immunomodulatory drug (IMiD) induction (90% vs 78% P &lt; 0.01). The rate of ≥ very good partial response was higher for patients with high risk IgH translocations [t(4;14), t(14;16) or t(14;20)] compared to standard risk with PI-IMiD combination treatment (88% vs 65% P &lt; 0.01). Otherwise, response rates did not differ between these 2 groups. TTNT was longer in patients with trisomies compared to those with IgH translocation with IMiD or PI-IMiD treatments (32.2 vs 19 and 44 vs 27.4 months, respectively P &lt; 0.01). For all cytogenetic groups, better treatment responses and longer TTNT were seen with PI-IMiD combinations compared to other treatments. Conclusions: t(4;14), t(14;16), t(6;14), and t(14;20) are associated with high risk disease characteristics. Patients with IgH translocations may have better response to PI induction compared to those with trisomies, while those with trisomies may have better response to IMiD treatment, with best outcomes for both seen with PI-IMiD combinations.
Quality of life (QOL) for the treatment sequence of abiraterone acetate plus prednisone (AAP) followed by enzalutamide (ENZ) versus the opposite sequence for metastatic castration-resistant prostate cancer (mCRPC): Results from a phase II randomized clinical trial.
Authors: Daniel J Khalaf, Katherine Sunderland, Bernhard J. Eigl, Daygen L. Finch, Conrad D. Oja, Joanna Vergidis, Muhammad Zulfiqar, Christian K. Kollmannsberger, Martin Gleave, Kim N. Chi
Journal: Journal of Clinical Oncology (2020)

5578 Background: A randomized cross-over phase II trial (Lancet Oncol 20(12):1730, 2019) showed the sequence of AAP followed by ENZ is associated with a better time to PSA progression compared with the opposite sequence and superior 2 nd line activity of ENZ. It is unknown whether one treatment sequence is associated with better QOL than the other. Methods: 202 Patients were randomized (1:1) to receive either AAP followed by ENZ at PSA progression (arm A) or the opposite sequence of ENZ followed by AAP (arm B). FACT-P questionnaires were completed at baseline, cross-over and every 4 weeks on treatment. Time to QOL deterioration (TTQOLD) for the treatment sequence was determined from start of 1 st line treatment to first questionnaire with a clinically meaningful decrease from baseline and compared between arms using the log-rank test. TTQOLD was also determined for 1 st line and 2 nd line separately. The proportion of patients with QOL deterioration for total FACT-P score and FACT-P subscores from baseline to week 12 of 1 st and 2 nd line treatment was compared between arms using X 2 test. Results: Median follow-up for 1 st and 2 nd line and whole sequence were 9.3, 6.6 and 22.0 months (mos) respectively and questionnaire completion rate was 81%. TTQOLD for total FACT-P score for the whole sequence for arm A vs B was 10.5 mo (95% CI 5.0-15.5) vs 10.8 mo (5.5-13.1), p = 0.74. For 1st-line AAP vs ENZ, median TTQOLD was 15.5 mo (5.5-21.2) vs 11.0 (5.5-13.3) respectively (p = 0.23). For 2 nd line ENZ vs ABI, median TTQOLD was 3.7 mo (2.0-5.4) vs 5.8 (2.8-12.1), p = 0.13. There was a higher rate of deterioration in physical well-being (PWB) for 1 st line ENZ (arm B) and 2 nd line ENZ (arm A) (Table). Conclusions: There was no difference in TTQOLD between the two treatment sequences of AAP and ENZ. Although treatment with second line ENZ has been associated with greater anti-cancer effects, ENZ was associated worse PWB QOL scores. Clinical trial information: NCT02125357 . [Table: see text]
Green waste compost as potential reservoirs of Legionella in the Netherlands
Authors: A. Huss, L.A.N. Derks, D.J.J. Heederik, I.M. Wouters
Journal: Clinical Microbiology and Infection (2020)

ObjectivesLegionella is a bacterial species able to cause influenza-like illness (Pontiac fever) or severe pneumonia (Legionnaires disease, LD). We assessed Legionella presence and concentration in composting facilities in The Netherlands.MethodsA total of 142 samples from 23 green waste composting facilities were screened for Legionella DNA using qPCR.ResultsOf 142 samples, Legionella spp. DNA was detected in 97 (68%), and the subspecies L. pneumophila and L. longbeachae in 33 (23%) and one (0.7%) samples, respectively. Legionella was observed in samples from all composting facilities. The concentration of Legionella spp. DNA ranged from 103 to 105 genomic units (GU)/gram. Compost temperature was negatively correlated with the presence (odds ratio 0.67, 95% CI 0.50–0.92 per 10 degrees increase) and concentration (geometric mean ratio 0.90, 95% CI 0.83–0.97 per 10 degrees) of Legionella spp. Average humidity in the week prior to sampling was negatively correlated with the L. pneumophila concentration (geometric mean ratio 0.73, 95% CI 0.56–0.96 per increase in 10% of humidity).DiscussionThis study suggests that composting facilities can be regarded as reservoirs of Legionella in The Netherlands, but additional studies should target if such facilities represent a human health risk.
Smart Oral Administration of Polydopamine‐Coated Nanodrugs for Efficient Attenuation of Radiation‐Induced Gastrointestinal Syndrome
Authors: Yushuo Zhang, Lu Wang, Meiyun Xu, Tongxin Zhao, Liangju Kuang, Daoben Hua
Journal: Advanced Healthcare Materials (2020)

Abstract High‐dose ionizing radiation can lead to death from the unrecoverable damage of the gastrointestinal tract, especially the small intestine. Until now, the lack of predilection for the small intestine and rapid clearance by digestive fluids limit the effects of conventional radioprotective formulations. Herein, an innovative radioprotective strategy is developed for attenuating gastrointestinal syndrome by smart oral administration nanodrugs. The nanodrug is first engineered by encapsulating thalidomide into chitosan‐based nanoparticles, and then coated with polydopamine. The behaviors of gastric acid‐resistance, and pH‐switchable controlled release in the small intestine enhance the oral bioavailability of the pyroptosis inhibitor thalidomide. In a mouse model, nanodrugs demonstrate prolonged small intestinal residence time and accessibility to the crypt region deep in the mucus. Furthermore, the nanodrugs ameliorate survival rates of C57BL/6J mice irradiated by 14 Gy of subtotal body irradiation and also maintain their epithelial integrity. This work may provide a promising new approach for efficiently attenuating lethal radiation‐induced gastrointestinal syndrome and add insights into developing nanodrug‐based therapies with improved efficacy and minimum side effects.
Impact of a multidisciplinary tumor board in the treatment of genitourinary tumors: Real-world data from a referral center in Mexico.
Authors: Carlos Eduardo Salazar-Mejía, Omar Zayas-Villanueva, Blanca Otilia Wimer-Castillo, Daniel Alberto Gallegos-Arguijo, Rafael Piñeiro-Retif, Gustavo Arrambide-Gutiérrez, Adrián Gutiérrez-González, Matías Salinas-Chapa, David Hernández-Barajas, Oscar Vidal-Gutiérrez, Juan Francisco González-Guerrero, Francisco Emilio Vera Badillo
Journal: Journal of Clinical Oncology (2020)

e19248 Background: International guidelines for genitourinary cancers recommend treatment decisions by a multidisciplinary tumor board (MTB). The benefits of a MTB include greater accuracy in staging and in the probability of receiving care in compliance with international clinical practice guidelines, greater access to clinical trials, better communication between treating physicians and cost-effective care with greater patient satisfaction, which could translate into better outcomes. Our objective was to assess the impact of a MTB in the management of patients with genitourinary tumors in a tertiary referral university center of México. Methods: We performed a retrospective analysis of all cases presented to the Genitourinary Tumor Committee of our hospital from March to August 2019. Results: A total of 84 patients were included in the analysis; of these 80% were men with a median age of 61 years. Of all the cases, 68% were first-time presentations with a median time from evaluation to presentation of 4 days. The most frequently discussed diagnoses were prostate, urothelial and renal cancer, each corresponding to about 28% of the sample. Forty-six percent of the cases presented were in metastatic disease. The median time for discussion of each case after its presentation was 10 minutes. Changes were made in the clinical stage and treatment plan proposed by the most responsible physician in 4% and 46% of the cases, respectively, achieving a unanimous consensus in 88%. After the MTB session, 29 patients were lost to medical follow-up and were not subsequently evaluated. Among the 55 patients who underwent reassessment, the recommendations of the MTB were applied in 92%. Conclusions: Discussion of urologic oncology cases at the MTB led to a change in the treatment plan in almost half of the patients. Although MTBs are an increasingly common practice in Mexico, this is the first study that describes the impact that these sessions have on the management of genitourinary tumors in our population. The high rate of loss to medical follow-up remains an important problem in developing countries, negatively affecting the prognosis of these patients.
Cross-site concordance evaluation for the CIMAC-CIDC network to establish QC metrics enabling reliable generation of WES and RNA-seq data.
Authors: Ignacio Ivan Wistuba
Journal: Journal of Clinical Oncology (2020)

e15240 Background: Whole-exome sequencing (WES) and RNA-sequencing (RNA-seq) have become key components of cancer genomics, and analysis to provide comprehensive evaluation of spectrum somatic alterations and changes in gene expression present in cancer samples. To test the ability to generate comparable data for these genomic assays across CIMAC-affiliated sequencing centers, the CIDC performed a cross-site harmonization effort at two CIMAC sites (MD Anderson [MDACC] and DFCI/Broad Institute) and the MoCha Lab (MoCha) at the National Cancer Institute. Fresh frozen (FF) and FFPE samples from 8 non-small cell lung carcinoma (NSCLC) tumors were provided by MDACC, and processed for DNA and RNA extraction, aliquoted, and sent by MDACC to MoCha, MDACC and DFCI/Broad to be processed as replicates. Two reference samples,pools of 10 HapMap cell lines were sent for WES processing. Methods: WES analysis was carried out using center-specific pipelines as and central workflows that included: coverage metrics (target-based and genome-wide), variant calls (somatic and germline), variant annotations, tumor purity and clonality. Only minimal differences in somatic mutation calls were found between different replicates and centers for the HapMap samples, and technical differences were much smaller than biological differences between the patient tumors. For both sets of data, when focusing on reads at &gt; 50X common coverage and events with variant allele frequency (VAF) &gt; 5%, the different centers achieved high precision ( &gt; 98%) and recall ( &gt; 87%).Further, ISA for patient samples ranged from 0.667-0.875, while that for HapMap samples ranged from 0.817-0.827. Results: The RNA-seq analysis pipeline used the tools STAR for read mapping, RSEQC for quality control, SALMON for transcript quantification and LIMMA for batch removal on log transformed TPM values. Our analysis revealed that a DV200 of 24- 30% was a reasonable cutoff to achieve consistent quality in RNA-seq data generation. In addition, a medTIN cutoff value of 50% was found to be effective in determining the quality of the samples. Using these criteria, the Spearman correlation of log(TPM) among all the FF samples from the same tumor were higher than 0.976, and among all FFPE samples from the same tumor were higher than 0.942. Conclusions: In summary,cross-center concordance evaluation has identified the factors that introduce variability in the analyses, while also demonstrating the ability to provide comparable results across CIMAC sites by using a centralized analysis pipeline.
The impact of prior chemotherapy (PrC) on immunotherapy outcomes in non-small cell lung cancer (NSCLC) patients: Real data from a mono-institutional study.
Authors: Marianna Macerelli, Simona Rizzato, Marco Giavarra, Francesca Valent, Monica Cattaneo, Francesco Cortiula, Giada Targato, Ciro Rossetto, Claudia Bozza, Carla Corvaja, Roberto Fioraso, Gianpiero Fasola
Journal: Journal of Clinical Oncology (2020)

e21639 Background: Immunotherapy has changed the paradigm on NSCLC treatment. No widespread and reproducible predictive biomarkers have been established. We analyzed how PrC could affect ICI outcomes. Methods: We conducted a retrospective observational study and analyzed all NSCLC patients (pts) treated with ICI (nivolumab or atezolizumab or pembrolizumab) in our institution from 2015 to 2018 and followed until January 2020. All pts had received at least one PrC. We recorded clinical features of pts both before and after ICI treatment. Results: A total of 83 pts were included, with a median age of 69 (range, 47-82). Sixty pts (73%) were male, 74 (89%) were smokers and 81 (97%) had ECOG PS 0-1. Thirteen (15.7%) pts had a immune-related toxicity (iRT, G1-G2 76.9% and G3-G4 23.1%) and 21 (25.3%) continued ICI therapy beyond progression disease (PD). Patients with a PD as best response to PrC had more probability to reach a PD with ICI (p = 0.06). Median Progression-Free Survival (PFS) on ICI was 2.9 months (interquartile range, 1.9-9.4) with no statistical difference between pts with oligo- or diffuse progression (≤ or &gt; 5 metastasis) during PrC (p = 0.42). Corticosteroids use was associated with worse PFS (p &lt; 0.01). Median Overall Survival (OS) was 9.1 months (interquartile range, 3.3-26.5), with a benefit for pts with a stable disease (SD) or partial response (PR) to PrC (p = 0.02), for pts who experimented iRT (p = 0.04) and who didn’t receive corticosteroids (p &lt; 0.01). In multivariate analysis liver or brain metastases (HR 8.8, 95% CI 2.9-26.8 and HR 2.2, 95% CI 0.6-8.1), coticosteroids use (HR 3.7, 95% CI 1.3-10.5) or previous cisplatin-based chemotherapy (HR 8.4, 95% CI 2.3-30.1) were associated with worse OS. Instead, pts whit iRT (HR 0.4, 95% CI 0.1-1.3) and PR as best response to PrC (HR 0.8, 95% CI 0.3-2.0) had a better OS. Conclusions: Our study confirms literature data and suggests that PrC could affect ICI outcomes. Tumor burden seems not to influence ICI outcomes, unlike response rate to PrC. Systemic corticosteroids use and iRT predicts ICI outcomes.
Detection of islet autoantibody in new-onset diabetic patients with unprovoked ketosis
Authors: 张冬梅, 周智广, 黄干, 王建平, 金萍, 魏佳莉, 胡白瑛
Journal: BMJ (2005)

目的 探讨谷氨酸脱羧酶抗体(GAD-Ab)、酪氨酸磷酸酶抗体(IA2-Ab)和胰岛素自身抗体(IAA)在以自发酮症起病的新发糖尿病患者中的分布规律及其与起病状况、胰腺β细胞功能的关系.方法对161例以自发酮症起病的新发糖尿病患者,以放射配体法测定GAD-Ab、IA2-Ab和IAA.比较胰岛自身抗体在不同发病年龄组、不同体重指数(BMI)组、不同程度酮症组及不同空腹C肽(FCP)水平组的阳性率,比较胰岛自身抗体阳性与阴性组起病状况和胰腺β细胞功能的差异.结果 161例患者中,共68例(42.2%)被检出存在1种或多种胰岛自身抗体,其中胰岛自身抗体在起病年龄≤20岁、BMI≤18.5、FCP水平较低患者中阳性率较高;与胰岛自身抗体阴性组相比,抗体阳性组存在发病年龄较轻、BMI较低、发病时酮症程度较严重、胰岛分泌功能较差等特点.结论在以自发酮症起病的糖尿病患者中,发病年龄较小、BMI较低、C肽水平较低的患者胰岛自身抗体的阳性率较高,属于1A型糖尿病的可能性较大,属于1B型或2型糖尿病的可能性较小.胰岛自身抗体阳性的患者β细胞分泌功能较差,应尽早予胰岛素治疗。
Feasibility of olanzapine at reduced dose in highly emetogenic chemotherapy: A randomised controlled trial against aprepitant in triple therapy (FORESIGHT).
Authors: Michelle Chen, Isabelle Baron, Stephanie Beaulieu, Annick Dufour, Nathalie Letarte, Catherine C. M. Prady
Journal: Journal of Clinical Oncology (2020)

12087 Background: Olanzapine is used as an adjunct antiemetic in oncology as salvage therapy and in four-drug prophylaxis. Growing literature supports its effectiveness in initial three-drug prophylaxis in highly emetogenic chemotherapy (HEC). Methods: This prospective, multi-centre, open-label study evaluated the feasibility of a large-scale randomized controlled trial comparing the effectiveness and tolerability of 5 mg olanzapine once daily for four days (starting the night before chemotherapy) versus standard dose aprepitant (in tritherapy with standard ondansetron and dexamethasone) in treatment-naive patients receiving the first cycle of a HEC. Secondary outcomes included: complete response (no nausea, no emesis, no use of rescue medication), complete remission (no emesis, no rescue medication), intensity of patient-reported nausea and emesis on a visual analog scale, quality of life (scored with the Functional Living Index Emesis [FLIE]), and incidence of adverse events. Results: We randomized 30 patients in an intent-to-treat analysis. The large-scale trial was deemed not feasible without support from a research centre. Complete response rates were significantly higher in the olanzapine group in the delayed phase (24-120h post-chemotherapy) (86,7% v 21,4%, p &lt; 0,001) and overall phase (0-120h post-chemotherapy) (60,0% v 21,4%, p = 0,04). Similar results were observed for complete remission. Intensity of patient-reported nausea was significantly lower in the olanzapine group in the delayed phase (p = 0,001). FLIE scores were significantly lower for the nausea domain (mean 62,3 v 60,9, p = 0,004) and overall score (124,3 v 108,8, p = 0,006). Depression on the ESAS-R was more common in the aprepitant group (0% v 38%, p = 0,01). Other adverse events were not significantly different. Conclusions: Support from a research centre must be ensured for study feasibility. Tritherapy olanzapine significantly improved complete response and remission in the delayed and overall phases post-chemotherapy among patients receiving HEC. It was also associated with higher quality of life and a reassuring safety profile. This feasibility trial, despite its small sample size, is one of the first prospective randomised trials to suggest similar efficacy of 5 mg olanzapine to aprepitant and to measure a difference in patient quality of life with this regimen. Clinical trial information: NCT04075955 .