tbuckley/cabot-search huggingface dataset:
Identifying high-risk features for readmission in patient with metastatic solid tumor malignancies at an academic community hospital.
Authors: Nathan Reuben Teich, Alexander A. Hindenburg
Journal: Journal of Clinical Oncology (2020)

217 Background: Readmission of oncology patients to hospitals is an undesirable outcome for both the patient and healthcare system. These can lead to delays in treatment and increased resource utilization. 30-day readmission have been a target of multiple national quality initiatives. Adverse outcomes have been associated with readmission in multiple patient populations. The aim of this study was to perform a qualitative and quantitative analysis on inpatient solid tumor medical oncology readmissions to an academic community hospital. Additionally, identifying additional risk factors for readmission such as need for fluid drainage and rate of palliative care involvement were assessed. Methods: Using ICD-10 codes, 183 patients were identified as being readmitted within 30 days with a known oncological diagnosis from January 2019-Decemember 2019. Only the most recent readmission was included for review. 54 of these patients were selected at random for manual chart review to generate data. Results: In the 54 patients who underwent detailed review, 21 were identified as having stage IV metastatic sold tumor disease primarily under the care of a medical oncology team. Common factors identified for readmission included malignant abdominal ascites (6 patients), thoracic pleural effusions requiring drainage (5 patients), CNS/spinal metastases (4 patients). Palliative care was consulted in the index admission in 48% of cases analyzed. In patients with metastatic solid tumor disease, 17/21 (81%) of patients were discharged on a weekday. Examples of preventable readmissions identified included inadequately treated hypercalcemia of malignancy and cerebral edema due to brain metastases discharged with insufficient corticosteroid dosing. Conclusions: The high-risk features identified (e.g. recurrent malignant ascites) may benefit from novel systems-based approaches (i.e. EMR alerts, daily oncology/palliative care team huddle to discuss high risk patients). Most patients readmitted to the oncology service with metastatic disease were not discharged on a weekend day. This analysis also revealed under-utilization of palliative care during the index admissions for these oncology patients with known metastatic disease. Further quality initiatives will be directed at creation of a risk score for readmission in this subset of patients with high disease burden.
Quality of Evidence of Individual Trials in Systematic Review of Brief Suicide Prevention Interventions—Reply
Authors: Stephanie K. Doupnik, Cadence F. Bowden, Steven C. Marcus
Journal: JAMA Psychiatry (2020)

In Reply We thank Zaderenko for his Letter and welcome the opportunity to address questions about 2 possible sources of bias in our systematic review and meta-analysis of brief suicide prevention interventions1: (1) inclusion of nonrandomized studies and (2) use of nonblinded outcomes assessment.
In vivo degradation and endothelialization of an iron bioresorbable scaffold
Authors: Wenjiao Lin, Hongjie Zhang, Wanqian Zhang, Haiping Qi, Gui Zhang, Jie Qian, Xin Li, Li Qin, Haifeng Li, Xiang Wang, Hong Qiu, Xiaoli Shi, Wei Zheng, Deyuan Zhang, Runlin Gao, Jiandong Ding
Journal: Bioactive Materials (2020)

Detection of in vivo biodegradation is critical for development of next-generation medical devices such as bioresorbable stents or scaffolds (BRSs). In particular, it is urgent to establish a nondestructive approach to examine in vivo degradation of a new-generation coronary stent for interventional treatment based on mammal experiments; otherwise it is not available to semi-quantitatively monitor biodegradation in any clinical trial. Herein, we put forward a semi-quantitative approach to measure degradation of a sirolimus-eluting iron bioresorbable scaffold (IBS) based on optical coherence tomography (OCT) images; this approach was confirmed to be consistent with the present weight-loss measurements, which is, however, a destructive approach. The IBS was fabricated by a metal-polymer composite technique with a polylactide coating on an iron stent. The efficacy as a coronary stent of this new bioresorbable scaffold was compared with that of a permanent metal stent with the name of trade mark Xience, which has been widely used in clinic. The endothelial coverage on IBS was found to be greater than on Xience after implantation in a rabbit model; and our well-designed ultrathin stent exhibited less individual variation. We further examined degradation of the IBSs in both minipig coronary artery and rabbit abdominal aorta models. The present result indicated much faster iron degradation of IBS in the rabbit model than in the porcine model. The semi-quantitative approach to detect biodegradation of IBS and the finding of the species difference might be stimulating for fundamental investigation of biodegradable implants and clinical translation of the next-generation coronary stents.
Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association
Authors: Billy A. Caceres, Carl G. Streed, Heather L. Corliss, Donald M. Lloyd-Jones, Phoenix A. Matthews, Monica Mukherjee, Tonia Poteat, Nicole Rosendale, Leanna M. Ross
Journal: Circulation (2020)

There is mounting evidence that lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) adults experience disparities across several cardiovascular risk factors compared with their cisgender heterosexual peers. These disparities are posited to be driven primarily by exposure to psychosocial stressors across the life span. This American Heart Association scientific statement reviews the extant literature on the cardiovascular health of LGBTQ adults. Informed by the minority stress and social ecological models, the objectives of this statement were (1) to present a conceptual model to elucidate potential mechanisms underlying cardiovascular health disparities in LGBTQ adults, (2) to identify research gaps, and (3) to provide suggestions for improving cardiovascular research and care of LGBTQ people. Despite the identified methodological limitations, there is evidence that LGBTQ adults (particularly lesbian, bisexual, and transgender women) experience disparities across several cardiovascular health metrics. These disparities vary by race, sex, sexual orientation, and gender identity. Future research in this area should incorporate longitudinal designs, elucidate physiological mechanisms, assess social and clinical determinants of cardiovascular health, and identify potential targets for behavioral interventions. There is a need to develop and test interventions that address multilevel stressors that affect the cardiovascular health of LGBTQ adults. Content on LGBTQ health should be integrated into health professions curricula and continuing education for practicing clinicians. Advancing the cardiovascular health of LGBTQ adults requires a multifaceted approach that includes stakeholders from multiple sectors to integrate best practices into health promotion and cardiovascular care of this population.
Would dermoscopic photographs help triage teledermatology consults in the COVID-19 era?
Authors: Myles R. McCrary, Tova Rogers, Howa Yeung, Loren Krueger, Suephy C. Chen
Journal: Clinical Cancer Research (2020)

Background: The coronavirus pandemic led to a rapid transition to telemedicine across medical specialties Dermatologists can utilize digital images to remotely manage skin diseases, including determining the urgency withwhich patients need to be seen in person  Accurately triaging urgent cases can be impacted by imaging modality Dermoscopy is the examination of the skin with polarized light, which for some providers can increase theirdiagnostic accuracy and confidence in managing potential skin cancers  It has been increasingly viewed as astandard adjunct for examining skin lesions  Dermoscopic photographs have been shown to improve providers'abilities to correctly diagnose telemedicine consults  However, this has only been studied with a limited subset ofskin neoplasms and is limited to a workflow involving a photographer with a dermatoscopic imaging capability  In thepandemic, the ability of patients to access dermoscopy is exceedingly limited  This study aims to assess the impactof dermoscopy on decision-making by dermatologists, including confidence, diagnostic accuracy, and triagingurgency  Our premise is that if dermoscopy is impactful, innovative means to increase accessibility to dermoscopywould be valuable for cancer management during COVID  Methods: Twenty sets of clinical and dermoscopic photographs were selected as representative of commonly seenskin pathologies in our teledermatology consults  Study participants were first shown a clinical photograph andasked to determine their diagnoses, management decisions, level of urgency, and confidence in their triagedecisions  The responses were scaled ranging from non-neoplastic to malignant, 0-100% confidence, and non-urgent (1) to emergent (3), respectively  They were then asked to answer the same questions after viewing theassociated dermoscopic image  Results: Twenty-six physicians participated in the study: 16 dermatology attendings and 10 residents  The majorityreported using dermoscopy in ≥25% of their clinical practice  Fifty-nine percent rated themselves as “somewhatconfident” in their dermoscopic abilities  Providers correctly diagnosed 45 3% of study cases using clinical imagesalone  This increased to 53 6% after viewing the associated dermoscopic images (p=0 02)  The greatest increase was for malignant neoplasms (31% vs  54%, p=0 0007)  Dermoscopy significantly reduced triage urgency scores forboth non-neoplastic (mean 1 6 vs  1 2, p<0 001) and benign neoplastic (mean 1 43 vs  1 35, p=0 01) pathologies Dermoscopy significantly increased urgency scores for malignant neoplasms (mean 1 47 vs  1 64, p=0 01)  There was a 7 6% increase in providers' confidence in their management decisions with dermoscopy (p<0 0001)  Conclusions: Dermoscopic photographs improve providers' abilities to correctly diagnose and prioritize skinlesions  In the COVID-19 era, innovative means to make dermoscopy available to patients at risk for skin cancerwould be valuable
Racial disparities in adolescent and young adult cancer clinical trial enrollment.
Authors: Elizabeth Siembida, Holli Ann Loomans-Kropp, Neha Trivedi, Archie Bleyer, Michael Roth
Journal: Journal of Clinical Oncology (2020)

91 Background: African American/Black (Black) patients have historically been underrepresented in cancer clinical trials (CCTs); additionally, adolescents and young adults (AYAs; diagnosis between 15-39 years) enroll on CCTs at alarmingly low rates. However, few studies have explored the participation of Black AYAs in CCTs. Therefore, we aimed to assess Black AYA CCT enrollment onto National Cancer Institute (NCI)-sponsored CCTs and compare enrollment of Black AYAs to enrollment of Black children (&lt; 15 years) and adults (40+ years). Methods: Utilizing data from the Cancer Therapy Evaluation Program, we examined Black AYA enrollment onto CCTs from 2000-2016. We described the total Black AYA enrollments and the proportion of Black AYA enrollments by age (15-19, 20-29, 30-39 years) and sex. We also compared the proportion of Black AYA enrollments to the proportion of Black children and adult enrollments. Enrollment proportion was defined as Black enrollments over total age group enrollment. The χ² test was used to assess differences in proportional enrollment between groups. P values &lt; 0.05 were considered statistically significant. Results: From 2000-2016, 3,893 Black AYAs enrolled onto NCI-sponsored CCTs. Black AYA enrollment was lowest among 20-29 year-old AYAs (N=719) compared to 15-19 year-old (N=1,074) and 30-39 year-old AYAs (N=1,408). The proportion of enrollments of Black AYA patients age 15-19 was significantly higher than enrollments for AYAs age 20-29 and 30-39 (12.6% vs. 10.9% vs 10.9%, respectively, both p's &lt;0.003). The proportion of male Black AYA enrollments decreased by age, with 61.8%, 40.9%, and 22.6% male enrollment for patients age 15-19, 20-29, 30-39, respectively. Despite a significantly higher incidence of cancer in AYAs compared with children, 20.5% more Black children enrolled on trials compared with Black AYAs. The proportion of Black AYA enrollment was marginally higher than Black children (11.3% vs. 10.6%, p = .04), and significantly higher than Black adults (11.3% vs. 8.0%, p &lt; .001). The proportion of Black AYA enrollments did not significantly change between 2000-2007 and 2008-2015 (10.9% vs 11.8%, p=0.33). Conclusions: Racial disparities exist within AYA enrollment on CCTs, with Black AYAs age 20-29 and Black male AYAs least likely to enroll. Despite an increasing focus on improving CCT enrollment of underrepresented groups, enrollment of Black AYAs has not increased. Future studies are needed to elucidate barriers and facilitators to CCT enrollment and guide future intervention development.
What is the Association Between Depression and Cardiovascular Disease?—Reply
Authors: Selina Rajan, Martin Mckee, Salim Yusuf
Journal: JAMA Psychiatry (2020)

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Outcomes by race for cancer patients hospitalized with SARS-CoV-2 infection
Authors: Steven S. Chang, Clara Hwang, Mohamed A. Elshaikh, Amy Tang, Christine M. Neslund-Dudas, Albert M. Levin, Laila M. Poisson, Benjamin A. Rybicki
Journal: Clinical Cancer Research (2020)

Purpose: Disparities in COVID-19 outcomes have been widely reported, with disproportionate negative impacts onthe African American (AA) population  The purpose of this study was to evaluate the impact of race on COVID-19outcomes for cancer patients hospitalized in a large Michigan health care system  Methods: A cohort of hospitalized, laboratory-confirmed SARS-CoV-2 positive patients was identified through theHenry Ford Health System Institutional COVID prospective patient registry between March 1st-May 2020  Those with a diagnosis of cancer were identified using our institutional tumor registry and electronic health record (EHR) Patient self-reported race/ethnicity data were extracted from the system's centralized EHR, as were otherdemographic and clinical covariates  Racial differences in cumulative incidence of mortality and hospital discharge were tested  To further evaluate the effect of race on the mortality, Fine-Gray competing-risks model was performed with discharge alive as a competing event  A P<0 05 was considered statistically significant  Results: Out of the 204 COVID+ cancer patients hospitalized in our health care system, 69 6% were AA (N=142) AA patients were slightly younger than non-AA patients (70 35 v  74 58, p=0 023)  No difference in mean BMI wasdetected (30 33 AA v  29 87 non-AA, p = 0 68)  A smaller proportion of AA patients had active cancer (36 6% v 40 3%, p = 0 73)  Outcomes were generally inferior in the AA cohort, although these differences were notstatistically significant  The rate of ICU admission was 41 5% in AA and 37 1% in non-AA (p=0 659)  34 5% of AApatients required intubation compared to 25 8% of non-AA patients (p=0 288)  In our model, older age was the onlyvariable that significantly increased the risk of death (standard hazard ratio SHR 1 05, p = 0 002)  The risk of death was higher for AA patients (SHR 1 92, p=0 068) and males (SHR 1 62, p = 0 078) but did not meet statisticalsignificance
Obesity Impairs Short-Term and Working Memory through Gut Microbial Metabolism of Aromatic Amino Acids
Authors: María Arnoriaga-Rodríguez, Jordi Mayneris-Perxachs, Aurelijus Burokas, Oren Contreras-Rodríguez, Gerard Blasco, Clàudia Coll, Carles Biarnés, Romina Miranda-Olivos, Jèssica Latorre, José-Maria Moreno-Navarrete, Anna Castells-Nobau, Mònica Sabater, María Encarnación Palomo-Buitrago, Josep Puig, Salvador Pedraza, Jordi Gich, Vicente Pérez-Brocal, Wifredo Ricart, Andrés Moya, Xavier Fernández-Real, Lluís Ramió-Torrentà, Reinald Pamplona, Joaquim Sol, Mariona Jové, Manuel Portero-Otin, Rafael Maldonado, José Manuel Fernández-Real
Journal: Cell Metabolism (2020)
MHCII-independent CD4+ T cells protect injured CNS neurons via IL-4
Authors: James T. Walsh, Sven Hendrix, Francesco Boato, Igor Smirnov, Jingjing Zheng, John R. Lukens, Sachin Gadani, Daniel Hechler, Greta Gölz, Karen Rosenberger, Thomas Kammertöns, Johannes Vogt, Christina Vogelaar, Volker Siffrin, Ali Radjavi, Anthony Fernandez-Castaneda, Alban Gaultier, Ralf Gold, Thirumala-Devi Kanneganti, Robert Nitsch, Frauke Zipp, Jonathan Kipnis
Journal: Journal of Clinical Investigation (2015)
Bioinspired biliverdin/silk fibroin hydrogel for antiglioma photothermal therapy and wound healing
Authors: Qing Yao, Qing-Hua Lan, Xinyu Jiang, Chu-Chu Du, Yuan-Yuan Zhai, Xiaohan Shen, He-Lin Xu, Jian Xiao, Longfa Kou, Ying-Zheng Zhao
Journal: Theranostics (2020)

Rationale: Photothermal therapy employs the photoabsorbers to generate heat under the near-infrared (NIR) irradiation for thermal tumor ablation. However, NIR irradiation might damage the adjacent tissue due to the leakage of the photoabsorbers and the residual materials after treatment might hinder the local healing process. A bifunctional hydrogel that holds both photothermal property and potent pro-healing ability provides a viable option to resolve this issue. Methods: In this study, we developed a bioinspired green hydrogel (BVSF) with the integration of bioproduct biliverdin into natural derived silk fibroin matrix for antiglioma photothermal therapy and wound healing. Results: The BVSF hydrogel possessed excellent and controllable photothermal activity under NIR irradiation and resulted in effective tumor ablation both in vitro and in vivo. Additionally, the BVSF hydrogel exerted anti-inflammatory effects both in vitro and in vivo, and stimulated angiogenesis and wound healing in a full-thickness defect rat model. Conclusion: Overall, this proof-of-concept study was aimed to determine the feasibility and reliability of using an all-natural green formulation for photothermal therapy and post-treatment care.
A double-edged sword: Prolongeddetection of SARS-COV-2 in patients receiving cancer-directed therapy
Authors: Winston Wong, Claire Brevia, Michael May, Susan Whittier, Eldad Hod, Ilenia Pellicciotta, Gary K. Schwartz, Maura Abbott, Gulam A. Manji
Journal: Clinical Cancer Research (2020)

Introduction: SARS-CoV2 (S-2) infection duration (S-2-D) and its impact on patients with cancer and mild tomoderate COVID-19 undergoing cancer-directed therapy (CDT), especially in the underserved population, is notwell described  We conducted a retrospective study to analyze S-2 positive (+) patients on CDT to describe the S-2-D and its impact on CDT  Methods: 299 patients with cancer were tested with nasopharyngeal (NP) S-2 PCR assay at Columbia UniversityMedical Irving Center (CUIMC), a Minority-NCI Community Oncology site, of whom 77(26%) tested positive  Weretrospectively analyzed 25 S-2 (+) patients with mild to moderate COVID-19 receiving CDT  NP PCR wererepeated every one to two weeks until two successive negative (-) PCRs were obtained prior to restarting CDT  Timeto two (-) PCR and serology results were recorded  Cycling thresholds (Ct) were obtained for S-2 specific targetsand represented an indirect measure of viral load  Results: Demographics of N=25 patients included Hispanic (N=17, 68%), Black (N=1, 4%), White (N=6, 24%), andundeclared (N=1, 4%)  Among the tumor histologies represented, gastrointestinal (N = 9, 36%), breast (N = 4, 16%), sarcoma (N = 3, 12%), and myeloma (N=2, 8%) were most common  Median time in days (d) to two (-) PCR was 24(6-69)  Nine (36%) patients were persistently (+) for more than six weeks  20 patients had CDT interruption with amedian time of 55 days off CDT  Two (10%) patients experienced disease progression during CDT interruption  13patients had >1 sequential (+) PCR  The mean time between 1st and 2nd NP S-2 PCR was 16d  There was a non-statistically significant trend towards a higher S-2 specific Ct on the 2nd NP S-2 PCR as compared to the 1st (31 21vs 22 31, p=0 10)  One patient was noted to be PCR (+) despite having developed S-2-specific IgG  Conclusion: Patients with cancer receiving CDT appear to have prolonged detectable S-2 by PCR, which can leadto interruption of CDT and POD in patients  Patients from underserved communities may be at greater risk givenhealth care disparities  Further data are needed to help select patients with mild to moderate COVID-19 who cansafely continue CDT while balancing the risk of worsening infection and risk of spread  The increased Ct over time inour patients suggest a decrease in viral load and infectious probability  Our lack of statistical significance is likelydue to small sample size  Ct along with serology can be tools to help guide when and which patients can restartCDT  However, these tests need further investigation for applicability and validity