tbuckley/cabot-search huggingface dataset:
Treatment patterns in extensive-stage small cell lung cancer: A retrospective real-world data study.
Authors: Apar Kishor Ganti, Kenan Katranji, Brian S. Seal, Lance Brannman
Journal: Journal of Clinical Oncology (2020)

288 Background: Etoposide plus platinum-based chemotherapy (EP) was the first-line (1L) extensive stage small cell lung cancer (ES-SCLC) standard of care for many years. 1L treatment with immunotherapy (durvalumab or atezolizumab) combined with carboplatin (durvalumab, atezolizumab) or cisplatin (durvalumab) chemotherapy (CT) is now being accepted as the new standard of care in this population. This study used real-world data to describe treatment patterns of ES-SCLC patients in the United States following the introduction of immunotherapy (IO). Methods: Data for patients ≥18 years of age with an index ES-SCLC treatment from 17 October 2018 to 30 November 2019 (or no 1L treatment within 60 days of an index diagnosis during this period) were drawn from the Flatiron electronic medical records database. Proportions of patients receiving specific 1L and second-line (2L) treatments were calculated. Times from (a) index diagnosis to 1L start, (b) 1L start to 1L end (c) 1L start to 2L start, and (d) 2L start to 2L end were calculated with 95% confidence intervals (for sample sizes ≥ 30) for the CT and IO+CT treatment categories. Results: 568 patients met the inclusion/exclusion criteria: 77 (14%) were untreated 60 days after their index diagnosis; 491 received 18 different 1L treatments (1L CT: 195; 1L IO+CT: 286, other 1L therapy: 10); and 119 received 2L treatment following 1L CT or IO+CT. The table shows the most frequently occurring 1L and 2L treatments. The mean number of days [#patients, 95% confidence interval] for 1L CT and 1L IO+CT respectively were (a) index diagnosis to 1L start: 22 [194 (1 patient began 1L therapy prior to their index diagnosis); 20–26], 22 [286, 20–24]; (b) 1L start to 1L end: 58 [174, 52–66], 91 [125, 79–103]; (c) 1L start to 2L start: 115 [83, 99–133], 186 [36, 168–205]; (d) 2L start to 2L end: 55 [54, 42–69] and 36 [N = 21]. Conclusions: Most ES-SCLC patients started therapy within a month of diagnosis. Over 50% received 1L IO+CT, reflecting its rapid uptake in the US. Almost 14% patients did not receive 1L treatment and only ~25% of 1L CT and 1L IO+CT patients received 2L therapy within the study period; reasons for this warrant further investigation. [Table: see text]
Association of supratotal resection with progression-free survival, malignant transformation, and overall survival in lower-grade gliomas
Authors: Marco Rossi, Lorenzo Gay, Federico Ambrogi, Marco Conti Nibali, Tommaso Sciortino, Guglielmo Puglisi, Antonella Leonetti, Cristina Mocellini, Manuela Caroli, Susanna Cordera, Matteo Simonelli, Federico Pessina, Piera Navarria, Andrea Pace, Riccardo Soffietti, Roberta Rudà, Marco Riva, Lorenzo Bello
Journal: Neuro-Oncology (2020)

Abstract Background Supratotal resection is advocated in lower-grade gliomas (LGGs) based on theoretical advantages but with limited verification of functional risk and data on oncological outcomes. We assessed the association of supratotal resection in molecularly defined LGGs with oncological outcomes. Methods Included were 460 presumptive LGGs; 404 resected; 347 were LGGs, 319 isocitrate dehydrogenase (IDH)–mutated, 28 wildtype. All patients had clinical, imaging, and molecular data. Resection aimed at supratotal resection without any patient or tumor a priori selection. The association of extent of resection (EOR), categorized on volumetric fluid attenuated inversion recovery images as residual tumor volume, along with postsurgical management with progression-free survival (PFS), malignant (M)PFS, and overall survival (OS) assessed by univariate, multivariate, and propensity score analysis. The study mainly focused on IDH-mutated LGGs, the “typical LGGs.” Results Median follow-up was 6.8 years (interquartile range, 5–8). Out of 319 IDH-mutated LGGs, 190 (59.6%) progressed, median PFS: 4.7 years (95% CI: 4–5.3). Total and supratotal resection obtained in 39% and 35% of patients with IDH1-mutated tumors. In IDH-mutated tumors, most patients in the partial/subtotal group progressed, 82.4% in total, only 6 (5.4%) in supratotal. Median PFS was 29 months (95% CI: 25–36) in subtotal, 46 months (95% CI: 38–48) in total, while at 92 months, PFS in supratotal was 94.0%. There was no association with molecular subtypes and grade. At random forest analysis, PFS strongly associated with EOR, radiotherapy, and previous treatment. In the propensity score analysis, EOR associated with PFS (hazard ratio, 0.03; 95% CI: 0.01–0.13). MPFS occurred in 32.1% of subtotal total groups; 1 event in supratotal. EOR, grade III, previous treatment correlated to MPFS. At random forest analysis, OS associated with EOR as well. Conclusions Supratotal resection strongly associated with PFS, MPFS, and OS in LGGs, regardless of molecular subtypes and grade, right from the beginning of clinical presentation.
Use of antiemetic prophylaxis and oral breakthrough medication for highly emetogenic chemotherapy (HEC) in a large community oncology network.
Authors: Garrett Young, Stephen Matthew Schleicher, Edward Arrowsmith, Stacey McCullough, Sylvia S. Richey, Johnetta Blakely, Natalie R. Dickson, Lee S. Schwartzberg
Journal: Journal of Clinical Oncology (2020)

253 Background: Prophylaxis for highly emetogenic chemotherapy (HEC) is well established in clinical guidelines, but real-world treatment patterns are unclear. Today, consistent use of prophylaxis is more easily accomplished due to the incorporation of ordering premeds into the workflow prior to administration of intravenous chemotherapy. However, prescription of oral agents for treatment of breakthrough chemotherapy induced nausea and vomiting (CINV) is less consistent and standardized and has a scant evidence base. In an effort to standardize utilization, we evaluated the use of prophylaxis and oral breakthrough medications in a large national community oncology network. Methods: Data from electronic medical records at five practices comprising over 100 clinic sites was analyzed to examine the frequency of guideline-recommended triplet 5-HT3 receptor antagonist, NK-1 receptor antagonist, and corticosteroid use for prophylaxis prior to the administration of HEC agents. Oral breakthrough medication use and preference was also analyzed. Data was collected and analyzed at the practice level. Results: We identified 2645 patients that received HEC between 1/1/2019 and 5/8/2020. We found consistently high utilization of guideline-concordant triplet prophylaxis regimens for patients receiving HEC, ranging from 90-100% at each of the five practices. In addition, most patients (mean 83%, range 67% - 94%) received a prescription for at least one oral breakthrough medication, but the agent(s) utilized varied widely across practices (Table). Ondansetron was the most commonly prescribed oral breakthrough medication (mean 68%, range 53% - 88%), while olanzapine use for either prophylaxis or breakthrough CINV across practices ranged from 1% - 4%. Conclusions: In this national community oncology network, standard recommended triplet agent prophylaxis for HEC was delivered successfully. However, opportunity exists to increase appropriate use of olanzapine and reduce variation of oral breakthrough antiemetic medications in order to optimize clinical care. [Table: see text]
Clinical Decision Support in Statin Prescription—What We Can Learn From A Negative Outcome
Authors: Thomas M. Maddox
Journal: JAMA Cardiology (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Cardiology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Cardiology journal
Is It Lawful and Ethical to Prioritize Racial Minorities for COVID-19 Vaccines?
Authors: Harald Schmidt, Lawrence O. Gostin, Michelle A. Williams
Journal: JAMA (2020)

Is It Lawful and Ethical to Prioritize Racial Minorities for COVID-19 Vaccines?Coronavirus disease 2019 (COVID-19) has disproportionately affected racial minorities in the United States resulting in higher rates of infection, hospitalization, and death.With a limited supply after the initial approval of a safeandeffectivevaccine,difficultlegalandethicalchoices will have to be made on priority access for individuals.The National Academies of Sciences, Engineering, and Medicine (NASEM) has recommended prioritization of racial minorities who are "worse off" socioeconomically and epidemiologically. 1 The World Health Organization (WHO) similarly cautioned that "colorblind" allocation frameworks could perpetuate or exacerbate existing injustices.Both NASEM and WHO urge policy makers to allocate vaccines in ways that reduce unjust health disparities. 2 The ethics and legality of racebased policies in the United States have been fraught with controversy. 3This Viewpoint considers how COVID-19 vaccine priority allocations could be implemented ethically and legally. COVID-19 and Communities of ColorCompared with the rate of COVID-19-related deaths among non-Hispanic White individuals (mortality rate, 38/100 000) and adjusting for age, the mortality rate relative to population size is 3.4-fold higher among Black individuals (mortality rate, 131/100 000), 3.3-fold higher among Indigenous and Latino communities (mortality rate for both, 125/100 000), 2.9-fold higher among Pacific Islander individuals (mortality rate, 111/100 000), and 1.3 higher among Asian populations (mortality rate, 50/100 000). 4These elevated death rates are unlikely to be explained by biological differences 1 but more likely are influenced by social determinants of health, including economic privation and systemic bias.To avoid further compounding these disparities, the NASEM expressly includes "mitigation of health inequities" as 1 of the 3 foundational principles of its framework.
COVID-19-Induced ARDS Is Associated with Decreased Frequency of Activated Memory/Effector T Cells Expressing CD11a++
Authors: Moritz Anft, Krystallenia Paniskaki, Arturo Blazquez-Navarro, Adrian Doevelaar, Felix S. Seibert, Bodo Hölzer, Sarah Skrzypczyk, Eva Kohut, Julia Kurek, Jan Zapka, Patrizia Wehler, Sviatlana Kaliszczyk, Sharon Bajda, Constantin J. Thieme, Toralf Roch, Margarethe Justine Konik, Marc Moritz Berger, Thorsten Brenner, Uwe Kölsch, Toni L. Meister, Stephanie Pfaender, Eike Steinmann, Clemens Tempfer, Carsten Watzl, Sebastian Dolff, Ulf Dittmer, Mohamed Abou-El-Enein, Timm H. Westhoff, Oliver Witzke, Ulrik Stervbo, Nina Babel
Journal: Molecular Therapy (2020)

Preventing the progression to acute respiratory distress syndrome (ARDS) in COVID-19 is an unsolved challenge. The involvement of T cell immunity in this exacerbation remains unclear. To identify predictive markers of COVID-19 progress and outcome, we analyzed peripheral blood of 10 COVID-19-associated ARDS patients and 35 mild/moderate COVID-19 patients, not requiring intensive care. Using multi-parametric flow cytometry, we compared quantitative, phenotypic, and functional characteristics of circulating bulk immune cells, as well as SARS-CoV-2 S-protein-reactive T cells between the two groups. ARDS patients demonstrated significantly higher S-protein-reactive CD4+ and CD8+ T cells compared to non-ARDS patients. Of interest, comparison of circulating bulk T cells in ARDS patients to non-ARDS patients demonstrated decreased frequencies of CD4+ and CD8+ T cell subsets, with activated memory/effector T cells expressing tissue migration molecule CD11a++. Importantly, survival from ARDS (4/10) was accompanied by a recovery of the CD11a++ T cell subsets in peripheral blood. Conclusively, data on S-protein-reactive polyfunctional T cells indicate the ability of ARDS patients to generate antiviral protection. Furthermore, decreased frequencies of activated memory/effector T cells expressing tissue migratory molecule CD11a++ observed in circulation of ARDS patients might suggest their involvement in ARDS development and propose the CD11a-based immune signature as a possible prognostic marker.
Efficient and Robust Instrument Segmentation in 3D Ultrasound Using Patch-of-Interest-FuseNet with Hybrid Loss
Authors: Hongxu Yang, Caifeng Shan, Arthur Bouwman, Alexander F. Kolen, Peter H.N. de With
Journal: Medical Image Analysis (2020)

Instrument segmentation plays a vital role in 3D ultrasound (US) guided cardiac intervention. Efficient and accurate segmentation during the operation is highly desired since it can facilitate the operation, reduce the operational complexity, and therefore improve the outcome. Nevertheless, current image-based instrument segmentation methods are not efficient nor accurate enough for clinical usage. Lately, fully convolutional neural networks (FCNs), including 2D and 3D FCNs, have been used in different volumetric segmentation tasks. However, 2D FCN cannot exploit the 3D contextual information in the volumetric data, while 3D FCN requires high computation cost and a large amount of training data. Moreover, with limited computation resources, 3D FCN is commonly applied with a patch-based strategy, which is therefore not efficient for clinical applications. To address these, we propose a POI-FuseNet, which consists of a patch-of-interest (POI) selector and a FuseNet. The POI selector can efficiently select the interested regions containing the instrument, while FuseNet can make use of 2D and 3D FCN features to hierarchically exploit contextual information. Furthermore, we propose a hybrid loss function, which consists of a contextual loss and a class-balanced focal loss, to improve the segmentation performance of the network. With the collected challenging ex-vivo dataset on RF-ablation catheter, our method achieved a Dice score of 70.5%, superior to the state-of-the-art methods. In addition, based on the pre-trained model from ex-vivo dataset, our method can be adapted to the in-vivo dataset on guidewire and achieves a Dice score of 66.5% for a different cardiac operation. More crucially, with POI-based strategy, segmentation efficiency is reduced to around 1.3 seconds per volume, which shows the proposed method is promising for clinical use.
Tazemetostat in advanced epithelioid sarcoma with loss of INI1/SMARCB1: an international, open-label, phase 2 basket study
Authors: Mrinal Gounder, Patrick Schöffski, Robin L Jones, Mark Agulnik, Gregory M Cote, Victor M Villalobos, Steven Attia, Rashmi Chugh, Tom Wei-Wu Chen, Thierry Jahan, Elizabeth T Loggers, Abha Gupta, Antoine Italiano, George D Demetri, Ravin Ratan, Lara E Davis, Olivier Mir, Palma Dileo, Brian A Van Tine, Joseph G Pressey, Trupti Lingaraj, Anand Rajarethinam, Laura Sierra, Shefali Agarwal, Silvia Stacchiotti
Journal: The Lancet Oncology (2020)
Factors Influencing Risk for COVID-19 Exposure Among Young Adults Aged 18–23 Years — Winnebago County, Wisconsin, March–July 2020
Authors: Rebecca F. Wilson, Andrea J. Sharma, Sarahjean Schluechtermann, Dustin W. Currie, Joan Mangan, Brian Kaplan, Kimberly Goffard, Julia Salomon, Sue Casteel, Ashley Mukasa, Niki Euhardy, Andrew Ruiz, Gregory Bautista, Erika Bailey, Ryan Westergaard, Douglas Gieryn
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

† The COVID-19 data provided in this report are specific to the Winnebago County Health Department (WCHD) jurisdiction.Data for the portions of the City of Menasha or City of Appleton that fall within Winnebago County are not included.Data provided on the Wisconsin Department of Health Services website might be different than the information provided by WCHD because the state reports data for the entire county, which includes those portions of Menasha and Appleton.§ Percentage of population includes persons aged 18-24 years in Winnebago County, Wisconsin, and were obtained using the U.S. Census
Quantifying treatment preferences and their association with financial toxicity in women with breast cancer.
Authors: Courtney Williams, Kathleen D. Gallagher, Katie Deehr, Monica S. Aswani, Andres Azuero, Casey L. Daniel, Eric W Ford, Stacey A. Ingram, Alan James Balch, Gabrielle Betty Rocque
Journal: Journal of Clinical Oncology (2020)

141 Background: This study sought to understand treatment preferences and their association with financial toxicity in breast cancer patients served by Patient Advocate Foundation (PAF). Methods: This cross-sectional study used survey data from a nationwide sample of women with breast cancer who received assistance from PAF. Choice-based conjoint analysis elicited patient preferences and trade-offs. Latent class analysis segmented respondents into distinct preference groups. The Comprehensive Score for Financial Toxicity (COST) tool captured financial toxicity (range 0-44, lower scores indicate worse financial toxicity). Cramer’s V determined magnitude of relationships in bivariate associations. COST score differences by preference archetype was estimated by least square means and naïve 95% confidence intervals (CI) from adjusted generalized linear models. Results: Of 220 respondents (65% response rate), median age was 58 years (interquartile range [IQR] 49-66) and 60% had household incomes &lt; $40,000. Most respondents were diagnosed with early stage cancer (91%), with 41% diagnosed within the past 2 years; 38% had recurred. Almost two-thirds (61%) were on active treatment. Treatment choice was most affected by preferences related to affordability and impact on activities of daily living (ADLs). Two distinct treatment preference archetypes emerged. The “Cost-Prioritizing Group” (75% of respondents) was most concerned about affordability, impact on ADLs, and burdening care partners. The “Functional Independence-Prioritizing Group” (25% of respondents) was most concerned about ability to work, physical side effects, and interference with important life events. Cost- vs. functional independence-prioritizing respondents were more often diagnosed with an early stage cancer (88% vs. 78%; V = .22), white (78% vs. 56%; V = .21), or privately insured (45% vs. 36%; V = .12). Functional independence- vs. cost-prioritizing respondents more often had household incomes &lt; $40,000 (76% vs. 54%; V = .20), identified as Hispanic/Latino (20% vs. 9%; V = .15), or had Medicaid (15% vs. 7%; V = .12). COST scores were similar between archetypes in adjusted models (Cost-Prioritizing COST = 12, 95% CI 9-14; Functional Independence-Prioritizing COST = 11, 95% CI 9-13). Conclusions: Patients with breast cancer prioritized affordability or maintaining functional independence when making treatment decisions. Because of this variability, preference evaluation during treatment decision-making could optimize patients’ treatment experiences.
Myocarditis and inflammatory cardiomyopathy: current evidence and future directions
Authors: Carsten Tschöpe, Enrico Ammirati, Biykem Bozkurt, Alida L. P. Caforio, Leslie T. Cooper, Stephan B. Felix, Joshua M. Hare, Bettina Heidecker, Stephane Heymans, Norbert Hübner, Sebastian Kelle, Karin Klingel, Henrike Maatz, Abdul S. Parwani, Frank Spillmann, Randall C. Starling, Hiroyuki Tsutsui, Petar Seferovic, Sophie Van Linthout
Journal: Nature Reviews Cardiology (2020)
Intentional endoscopic nasopancreatic drainage to a pancreatic fistula in the treatment of disconnected pancreatic duct syndrome
Authors: Yasuki Hori, Kazuki Hayashi, Itaru Naitoh, Michihiro Yoshida, Hiromi Kataoka
Journal: Endoscopy (2020)

Endoscopic transpapillary stenting and/or transluminal drainage is recommended for disconnected pancreatic duct syndrome (DPDS). Transpapillary stenting can be considered, preferably with the stent bridging the disruption in the main pancreatic duct (MPD) [1] [2]. Such treatment is currently feasible for patients with partial, but not complete, MPD disruption [3] [4]. If this treatment fails, surgery is an alternative in patients with either partial or complete disruption – but the majority of these patients go on to develop diabetes mellitus [5]. For this reason, if possible, endoscopic treatment is preferred in order to preserve pancreatic function. We report a successful stent bridging technique for DPDS with complete MPD disruption after intentional endoscopic insertion of a nasopancreatic drainage (ENPD) tube into a pancreatic fistula.
Single-cell transcriptomic analysis reveals key immune cell phenotypes in the lungs of patients with asthma exacerbation
Authors: Hui Li, Huaqi Wang, Leon Sokulsky, Shaoxia Liu, Rui Yang, Xiaojie Liu, Lujia Zhou, Juan Li, Chun Huang, Fangfang Li, Xu Lei, Hongxia Jia, Jiuling Cheng, Fuguang Li, Ming Yang, Guojun Zhang
Journal: Journal of Allergy and Clinical Immunology (2020)
Reduced COVID-19 Mortality With Sitagliptin Treatment? Weighing the Dissemination of Potentially Lifesaving Findings Against the Assurance of High Scientific Standards
Authors: Michael A. Nauck, Juris J. Meier
Journal: Diabetes Care (2020)

In this issue of Diabetes Care , two reports from northern Italy provide preliminary evidence that treatment with dipeptidyl peptidase 4 (DPP-4) inhibitors in patients with type 2 diabetes hospitalized for coronavirus disease 2019 (COVID-19) reduce mortality. Solerte et al. (1) report on a retrospective case-control study describing a more than 50% reduction in mortality in 338 patients with type 2 diabetes hospitalized with pneumonia and impaired gas exchange during the initial wave of COVID-19 if they received sitagliptin treatment on top of insulin-based regimens as compared with insulin treatment alone. Mirani et al. (2) analyzed baseline conditions and outcomes in 385 patients hospitalized for COVID-19, 90 of whom had type 2 diabetes. In addition to predictors of mortality already described in previous studies (hypertension, coronary artery disease, chronic kidney disease, etc.), they found preexisting insulin treatment to be associated with worse outcomes (threefold higher mortality). Conversely, treatment with DPP-4 inhibitors was found to be associated with substantially and significantly lower mortality (hazard ratio 0.13 [95% CI 0.02–0.92] after adjustment for age and sex).

It is obvious that such a marked therapeutic effect will receive widespread attention given the paucity of therapeutic approaches associated with convincing success. Certainly, such a prominent reduction in mortality has not been described with antiviral, glucocorticoid, or any other treatments. Therefore, the question arises, are the conclusions drawn from the present reports sufficiently robust to justify immediate changes in the treatment of patients with severe COVID-19 infections? Therefore, it is crucial to carefully consider the limitations and shortcomings of the reports by Solerte et al. and by Mirani et al.

In the study of Solerte et al. (1), there was no random assignment to the treatment with sitagliptin, nor was there a placebo control or any attempt at blinded treatment. In fact, the use of …