tbuckley/cabot-search huggingface dataset:
Cost-health literacy training in fellowship: A QI initiative.
Authors: Katrina Fischer, Sidharth Anand, Anne M. Walling, Sarah Marie Larson, John Glaspy
Journal: Journal of Clinical Oncology (2020)

80 Background: Limited cost-health literacy is a significant factor in the physicians ability to discuss and navigate patient financial concerns. Because these skills are not formally taught during training, the cost-health literacy of graduate medical trainees is unknown. This study describes a QI initiative to measure and improve upon the cost-health literacy skills of oncology fellows as it pertains to objective knowledge and self-perceived cost communication practices. Methods: All oncology fellows (n = 19) at the University of California, Los Angeles were invited to participate in QI project during the fall of 2019. Fellows participated in a case-based curriculum over three months, consisting of a group didactic on financial toxicity (45 minutes) and an interactive case based learning scenario that highlighted financial toxicity risk factors and areas for intervention (30 minutes). We concluded with a group discussion (30 minutes) to review and consolidate strategies, identfying internal and external resources that enable physicians to navigate financial toxicity in direct patient care. A cost-health literacy survey was administered at baseline and at the conclusion of the curriculum to evaluate the impact of the program. Results: Of 19 participants, 17 participated and 16 completed both the pre and post survey. These 16 were included in the analysis. After the intervention, participants were more likely to report comfort discussing out of pocket costs (50% v 19%, p = 0.005) and to feel they could help a patient experiencing financial toxicity (62% v 6%, p = 0.005). Fellows were more likely to report awareness of resources that were available to them to help patients manage financial toxicity (69% v 19%, p 0.003) but were no more likely to report asking patients about their subjective distress due to treatment related costs (57% v 50%, p = 0.759). Conclusions: We can teach and improve upon cost-health literacy skills through participation in a targeted, brief curriculum. Further studies are warranted to determine how this approach can be applied in other settings and how it objectively impacts cost communication practices.
Reducing medical oncology infusion no-show rate by improving patient and intra-clinic communication.
Authors: Radhika Kainthla, Bryana Anderson, Sarah Culver, Amy Little Jones
Journal: Journal of Clinical Oncology (2020)

47 Background: Parkland Health and Hospital System (PHHS) is the safety-net health system for Dallas County. In a resource-limited health care system, no-shows create waste and delay care. We sought to decrease the no-show rate (NSR) for patients scheduled for infusions, transfusions, and injections in the PHHS medical oncology infusion center by 33% in a 4-month period. Methods: A multidisciplinary team reviewed the NSR from January 2020 to May 2020. The reasons for missed appointments were investigated via chart review to better develop an intervention for meaningful change. A telephone follow-up protocol by the infusion nurses with standardized documentation and communication with the clinic and scheduling teams (intra-clinic communication) was implemented for each missed infusion appointment starting in February 2020. Results: The infusion center had a 16.4% NSR in January 2020. Of the 306 missed appointments, there was no documented reason for 44% (159). 19% (70) were related to change in plan-of-care; 19% (67) were in patients who had been admitted. Patient-related issues (transportation, illness, work/family obligations, etc.) were 13% of no-shows. Only 40 (11%) of the no-shows had a follow-up call. After implementation of follow-up telephone calls, the NSR was 11.2% by May 2020, a 32% decrease. 57.8% (204/1822) of patients who no-showed received a follow-up call to document reason for the missed appointment. Conclusions: We decreased the NSR in the PHHS medical oncology infusion center by 32% over a 4-month period, nearly reaching our goal, by implementing standardized post-no-show follow-up calls. Through our process, we discovered that communication, with the patient and intra-clinic, accounted for the most missed appointments rather than patient-related or other factors. Perhaps confounding our results were changes brought about by the COVID-19 pandemic, including mandatory telephone screening of patients prior to infusion appointments. Next steps include integrating pre-appointment calls into the workflow, standardizing change-in-plan communication, and cost analysis of interventions in our resource-limited setting.
Cost savings of biosimilars in oncology: A single institution experience.
Authors: Megan Mullalley, Whitney Mortensen, Phillip Barnette, Bradley Hunter, Terence Duane Rhodes, Derrick S. Haslem, David Michael Gill
Journal: Journal of Clinical Oncology (2020)

10 Background: Biosimilar medications have increasingly gained regulatory approvals in recent years. Numerous conditions in the fields of hematology, oncology, rheumatology, and endocrinology have a biosimilar treatment option available. Some biosimilar agents can be obtained at a significantly lower cost than reference medications. Methods: Intermountain Healthcare Oncology Pharmacy and Therapeutics (P&amp;T) committee manages and maintains the formulary of accepted drugs. The committee consists of pharmacists, medical oncologists and oncology nurses. Biosimilar medications were approved in place of reference medications for the following: pegfilgrastim, bevacizumab, trastuzumab, and rituximab. Results: Annually, we administer about 6,450 combined doses of pegfilgastrim, bevacizumab, trastuzumab, and rituximab. Assuming 70% conversion from the reference medication to biosimilar agent, transitioning from the above listed reference medications to biosimilar would save an estimated $6.3 million annually (Table). This includes a $1.75 million savings from transitioning to rituximab alone. In addition, transitioning trastuzumab from a single dose vial to multi-dose vials is estimated to save an addition $730,000. Conclusions: Biosimilar agents can reduce the cost of oncology care to patients treated at our institution. We are utilizing biosimilar agents as part of our ongoing mission to decrease the financial toxicity of treatment for patients with cancer. [Table: see text]
Regional differences in ACE2 expression in the sinonasal mucosa of adult Chinese patients with chronic rhinosinusitis
Authors: Hai Wang, Jia Song, Li Pan, Yi‐Ke Deng, Yin Yao, Zhi‐Chao Wang, Bo Liao, Jin Ma, Ming Zeng, Zheng Liu
Journal: Allergy (2020)

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
An integrated peach genome structural variation map uncovers genes associated with fruit traits
Authors: Jian Guo, Ke Cao, Cecilia Deng, Yong Li, Gengrui Zhu, Weichao Fang, Changwen Chen, Xinwei Wang, Jinlong Wu, Liping Guan, Shan Wu, Wenwu Guo, Jia-Long Yao, Zhangjun Fei, Lirong Wang
Journal: Genome biology (2020)

Abstract Background Genome structural variations (SVs) have been associated with key traits in a wide range of agronomically important species; however, SV profiles of peach and their functional impacts remain largely unexplored. Results Here, we present an integrated map of 202,273 SVs from 336 peach genomes. A substantial number of SVs have been selected during peach domestication and improvement, which together affect 2268 genes. Genome-wide association studies of 26 agronomic traits using these SVs identify a number of candidate causal variants. A 9-bp insertion in Prupe.4G186800 , which encodes a NAC transcription factor, is shown to be associated with early fruit maturity, and a 487-bp deletion in the promoter of PpMYB10.1 is associated with flesh color around the stone. In addition, a 1.67 Mb inversion is highly associated with fruit shape, and a gene adjacent to the inversion breakpoint, PpOFP1 , regulates flat shape formation. Conclusions The integrated peach SV map and the identified candidate genes and variants represent valuable resources for future genomic research and breeding in peach.
The Importance of Considering Clinical Inertia and Implementation Science When Addressing Medication Adherence
Authors: Hayden B. Bosworth
Journal: JAMA Network Open (2020)

Iwan Barankay, PhD; Peter P. Reese, MD, MSCE; Mary E. Putt, PhD, ScD; Louise B. Russell, PhD; George Loewenstein, PhD; David Pagnotti, MS; Jiali Yan, MS; Jingsan Zhu, MS, MBA; Ryan McGilloway, BA; Troyen Brennan, MD, JD, MPH; Darra Finnerty, MPH; Karen Hoffer, MA; Sakshum Chadha, ML; Kevin G. Volpp, MD, PhD
Utilization of a multisite financial reimbursement program to promote racial/ethnic diversity and inclusion in therapeutic cancer clinical trials: The iMPACT Study.
Authors: Hala Borno, Sylvia Zhang, Elena Nieves, Dana Dornsife, Robert G. Johnson, Darcy V. Spicer
Journal: Journal of Clinical Oncology (2020)

85 Background: A lack of racial/ethnic diversity among cancer therapeutic clinical trial (TCT) participants remains a critical problem. The significance of costs, both direct and indirect, associated with cancer TCT participation are increasingly understood. Here, we report findings observed in the IMproving Patient Access to Cancer clinical Trials (IMPACT) study, a pilot feasibility study investigating the feasibility and efficacy of offering a financial reimbursement program (FRP) during cancer TCT discussion with or without additional outreach in improving enrollment and diversity. Methods: Participants for this study were recruited at two Comprehensive Cancer Centers (CCCs) from April to September 2019. Patients were randomized 1:1 to receive a brochure about a FRP at time of consent for a TCT or receive brochure and outreach through a scripted follow-up phone call regarding the FRP. Results: No difference in TCT enrollment was observed between study arms. Among 170 patients approached to participate, 132 (78%) provided consent. The participant mean age was 57 years old (std dev = 14 years). Among participants 57% were male and 49% were white. The remaining major racial/ethnic groups were Black (5%) Asian (13%) and Hispanic (26%). The proportion of non-whites was greater among IMPACT study (43%) compared to CCC TCT (28%) participants. Among FRP participants, 24% reported a household income &lt; $25,000 and 14% from $25,001 to $56,000. Conclusions: This study observed that offering an FRP as part of TCT discussion is feasible and effective at CCCs. An outreach phone call is not required in order to influence enrollment in TCT. FRP recipients are racially/ethnically diverse and low socioeconomic status.
Fast diagnostic test for familial Mediterranean fever based on a kinase inhibitor
Authors: Flora Magnotti, Tiphaine Malsot, Sophie Georgin-lavialle, Fatima Abbas, Amandine Martin, Alexandre Belot, Maxime Fauter, Muriel Rabilloud, Mathieu Gerfaud-Valentin, Pascal Sève, Agnes Duquesne, Arnaud Hot, Stephane Durupt, Léa Savey, Irina Giurgea, Gilles Grateau, Thomas Henry, Yvan Jamilloux
Journal: Annals of the Rheumatic Diseases (2020)

Familial Mediterranean fever (FMF) is the most frequent hereditary autoinflammatory disease. Its diagnosis relies on a set of clinical criteria and a genetic confirmation on identification of biallelic pathogenic MEFV variants. MEFV encodes pyrin, an inflammasome sensor. Using a kinase inhibitor, UCN-01, we recently identified that dephosphorylation of FMF-associated pyrin mutants leads to inflammasome activation. The aim of this study was to assess whether quantifying UCN-01-mediated inflammasome activation could discriminate FMF patients from healthy donors (HD) and from patients with other inflammatory disorders (OID).Real-time pyroptosis and IL-1β secretion were monitored in response to UCN-01 in monocytes from FMF patients (n=67), HD (n=71) and OID patients (n=40). Sensitivity and specificity of the resulting diagnostic tests were determined by receiver operating characteristic curve analyses.Inflammasome monitoring in response to UCN-01 discriminates FMF patients from other individuals. Pyroptosis assessment leads to a fast FMF diagnosis while combining pyroptosis and IL-1β dosage renders UCN-01-based assays highly sensitive and specific. UCN-01-triggered monocytes responses were influenced by MEFV gene dosage and MEFV mutations in a similar way as clinical phenotypes are.UCN-01-based inflammasome assays could be used to rapidly diagnose FMF, with high sensitivity and specificity.
Minimal Residual Disease in Acute Myeloid Leukemia
Authors: Deepa Jeyakumar, Susan O’Brien
Journal: JAMA Oncology (2020)

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Associations between perceptions of care experiences and receipt of mental health care among older adults with cancer.
Authors: Lisa M Lines, Daniel H Barch, Diana Zabala, Michael T. Halpern, Paul Jacobsen, Michelle Mollica
Journal: Journal of Clinical Oncology (2020)

175 Background: Older adults with cancer and worse self-rated mental health report worse care experiences. We hypothesized that, controlling for health and demographic characteristics, older adults with cancer who received care for anxiety or mood disorders would report better care experiences. Methods: We used SEER-CAHPS data to identify Medicare beneficiaries, aged 66 and over, diagnosed from August 2006 through December 2013 with one of the 10 most prevalent solid tumor malignancies. To identify utilization for anxiety or mood disorders (screening, diagnosis, or treatment), we analyzed inpatient, outpatient, home health, physician, and prescription drug claims from 12 months before through up to 5 years after cancer diagnosis. Outcomes of interest were global care experience ratings (Overall Care, Personal Doctor, and Specialist; rated on a 0-10 scale) and composite measures (Getting Needed Care, Getting Care Quickly, and Doctor Communication; scored from 0-100). We estimated linear regression models and also used a Bayesian Model Averaging approach, adjusting for standard case-mix adjustors (including sociodemographics and self-reported general health and mental health status [MHS]) and other characteristics, including cancer site and stage at diagnosis. We also included interaction terms between mental health care utilization and MHS. Results: Approximately 22% of the overall sample (n = 4,998) had both cancer and a claim for an anxiety or mood disorder, and of those individuals, 18% reported fair/poor MHS. Only 7% of those in the cancer-only cohort reported fair/poor MHS. Before adjusting for mental health utilization, worse MHS was significantly associated with worse experience of care. After accounting for anxiety/mood disorder-related utilization, linear regression models showed no significant associations between fair/poor MHS and worse care experiences, while Bayesian models found that reliable associations remained between worse MHS and lower global ratings of Overall Care and Specialist. Conclusions: Utilization for anxiety/mood disorders mediates the association between fair/poor MHS and worse care experiences. Although MHS is a case-mix adjustor for CAHPS public reporting, it is important to recognize that care for anxiety or mood disorders may improve care experiences among seniors with cancer.
Synchronizing Brain Rhythms to Improve Cognition
Authors: Shrey Grover, John A. Nguyen, Robert M.G. Reinhart
Journal: Annual Review of Medicine (2020)

Impaired cognition is common in many neuropsychiatric disorders and severely compromises quality of life. Synchronous electrophysiological rhythms represent a core mechanism for sculpting communication dynamics among large-scale brain networks that underpin cognition and its breakdown in neuropsychiatric disorders. Here, we review an emerging neuromodulation technology called transcranial alternating current stimulation that has shown remarkable early results in rapidly improving various domains of human cognition by modulating properties of rhythmic network synchronization. Future noninvasive neuromodulation research holds promise for potentially rescuing network activity patterns and improving cognition, setting groundwork for the development of drug-free, circuit-based therapeutics for people with cognitive brain disorders.
Conditional expression of HGAL leads to the development of diffuse large B-cell lymphoma in mice
Authors: Javier Raboso-Gallego, Ana Casado-García, Xiaoyu Jiang, Marta Isidro-Hernández, Andrew J. Gentles, Shuchun Zhao, Yaso Natkunam, Oscar Blanco, Verónica Domínguez, Belén Pintado, Diego Alonso-López, Javier De Las Rivas, Carolina Vicente-Dueñas, Izidore S. Lossos, Isidro Sanchez-Garcia
Journal: Blood (2020)
NCCN Guidelines Insights: Colorectal Cancer Screening, Version 2.2020
Authors: Dawn Provenzale, Reid M. Ness, Xavier Llor, Jennifer M. Weiss, Benjamin Abbadessa, Gregory Cooper, Dayna S. Early, Mark Friedman, Francis M. Giardiello, Kathryn Glaser, Suryakanth Gurudu, Amy L. Halverson, Rachel Issaka, Rishi Jain, Priyanka Kanth, Trilokesh Kidambi, Audrey J. Lazenby, Lillias Maguire, Arnold J. Markowitz, Folasade P. May, Robert J. Mayer, Shivan Mehta, Swati Patel, Shajan Peter, Peter P. Stanich, Jonathan Terdiman, Jennifer Keller, Mary A. Dwyer, Ndiya Ogba
Journal: Journal of the National Comprehensive Cancer Network (2020)

The NCCN Guidelines for Colorectal Cancer (CRC) Screening describe various colorectal screening modalities as well as recommended screening schedules for patients at average or increased risk of developing sporadic CRC. They are intended to aid physicians with clinical decision-making regarding CRC screening for patients without defined genetic syndromes. These NCCN Guidelines Insights focus on select recent updates to the NCCN Guidelines, including a section on primary and secondary CRC prevention, and provide context for the panel’s recommendations regarding the age to initiate screening in average risk individuals and follow-up for low-risk adenomas.
A compromised specific humoral immune response against the SARS-CoV-2 receptor-binding domain is related to viral persistence and periodic shedding in the gastrointestinal tract
Authors: Fengyu Hu, Fengjuan Chen, Zhihua Ou, Qinghong Fan, Xinghua Tan, Yaping Wang, Yuejun Pan, Bixia Ke, Linghua Li, Yujuan Guan, Xiaoneng Mo, Jian Wang, Jinlin Wang, Chun Luo, Xueliang Wen, Min Li, Peidi Ren, Changwen Ke, Junhua Li, Chunliang Lei, Xiaoping Tang, Feng Li
Journal: Cellular and Molecular Immunology (2020)

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been redetected after discharge in some coronavirus disease 2019 (COVID-19) patients. The reason for the recurrent positivity of the test and the potential public health concern due to this occurrence are still unknown. Here, we analyzed the viral data and clinical manifestations of 289 domestic Chinese COVID-19 patients and found that 21 individuals (7.3%) were readmitted for hospitalization after detection of SARS-CoV-2 after discharge. First, we experimentally confirmed that the virus was involved in the initial infection and was not a secondary infection. In positive retests, the virus was usually found in anal samples (15 of 21, 71.4%). Through analysis of the intracellular viral subgenomic messenger RNA (sgmRNA), we verified that positive retest patients had active viral replication in their gastrointestinal tracts (3 of 16 patients, 18.7%) but not in their respiratory tracts. Then, we found that viral persistence was not associated with high viral titers, delayed viral clearance, old age, or more severe clinical symptoms during the first hospitalization. In contrast, viral rebound was associated with significantly lower levels of and slower generation of viral receptor-binding domain (RBD)-specific IgA and IgG antibodies. Our study demonstrated that the positive retest patients failed to create a robust protective humoral immune response, which might result in SARS-CoV-2 persistence in the gastrointestinal tract and possibly in active viral shedding. Further exploration of the mechanism underlying the rebound in SARS-CoV-2 in this population will be crucial for preventing virus spread and developing effective vaccines.