tbuckley/cabot-search huggingface dataset:
Abstract PO-080: Increasing of emergency presentation on colorectal cancer patients during COVID-19 pandemic: A retrospective study on single-center academic hospital
Authors: Budhi Ida Bagus, Metria Ida Bagus, Setyawati Ida Ayu, Mastini Ida Ayu Kade
Journal: Clinical Cancer Research (2020)

Abstract Background: Colorectal cancer was the most common cancer found in the GI tract; the two most common clinical emergency presentations were intestinal obstruction and perforation on the tumor site or proximally to the distal tumor. During the COVID-19 pandemic, we must face the new condition; we should modify the clinical outpatients’ schedule, which could address the other problem, that colorectal cancer patients refuse to continue treatment planning and that elective and well-prepared operations will be decreased. Methods: We will report the clinical presentation of our colorectal cancer patients during the last 2 months from March until May 2020. All patients with emergency presentation of colorectal cancer will be included; any comorbidities will be recorded on this study. Patients with emergency colorectal cancer who could not fit for emergency operation will be excluded. Inpatient mortality and postoperative complications will be evaluated. Results: During the 2-month period, we evaluated 26 cases of emergency colorectal cancer patients. Most of the patients came with total intestinal obstruction on the emergency presentation (22 cases); the others (4 cases) came with diffuse peritonitis due to colonic perforation. All patients were reported negative for COVID-19 on rapid test. Exploratory laparotomy was done in this emergency setting; 10 patients had sigmoid colon cancer, 15 patients had rectal cancer, and 6 patients had right colonic cancer. Intestinal perforation was found on rectal cancer patients. Tumor resection and primary anastomosis were done on 18 patients, and the others had stoma diversion. Inpatient mortality reported on 4 patients of perforation cases and had cardiopulmonary complication postoperatively. Conclusion: During the COVID-19 pandemic, emergency presentation of colorectal patients increased, and intestinal perforation was the risk factor of inpatient mortality. Citation Format: Budhi Ida Bagus, Metria Ida Bagus, Setyawati Ida Ayu, Mastini Ida Ayu Kade. Increasing of emergency presentation on colorectal cancer patients during COVID-19 pandemic: A retrospective study on single-center academic hospital [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-080.
Continuous positive airway pressure in COVID-19 patients with moderate-to-severe respiratory failure
Authors: Claudia Brusasco, Francesco Corradi, Antonia Di Domenico, Francesca Raggi, Graziano Timossi, Gregorio Santori, Vito Brusasco
Journal: European Respiratory Journal (2020)

<b>CPAP can be successfully used in a number of COVID-19 patients with hypoxaemic respiratory failure and gas exchange and radiological findings similar to those generally considered to be indications for invasive mechanical ventilation</b>https://bit.ly/2GpBx6a
Idecabtagene vicleucel (ide-cel, bb2121), a BCMA-directed CAR T-cell therapy: Qualitative analyses of pretreatment patient interviews in the KarMMa trial.
Authors: Julia Braverman, Olga Moshkovich, Matthew Miera, Selam Shah, Triza Brion, Jennifer Devlen, Kristen Hege, Timothy Brandon Campbell
Journal: Journal of Clinical Oncology (2020)

155 Background: Outcomes remain poor in triple-class exposed (to an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 antibody) patients (pts) with relapsed and refractory multiple myeloma (RRMM), and there is no standard of care. Ide-cel, a BCMA-directed CAR T cell therapy, showed deep, durable responses in heavily pretreated RRMM pts in the pivotal phase 2 KarMMa trial ( J Clin Oncol 38:2020. Suppl; abstr 8503). Limited data are available on pts’ experience with prior therapies and expectations on ide-cel. By embedding pt interviews in KarMMa, we assessed pts’ initial knowledge of and expectations on ide-cel beyond pt-reported outcome measures prior to ide-cel therapy. Methods: This qualitative study was conducted in triple-class exposed pts refractory to their last regimen who entered the KarMMa trial (NCT03361748). Pts were invited to participate in the optional interview component that included up to 11 interviews. We present results of the first interviews that occurred between initial consent and leukapheresis. The interview topics were pts’ initial knowledge of ide-cel, decision making, expectations, hopes, and concerns, and current well-being. All interviews were recorded, transcribed, and coded. Results: Forty-seven pts from 14 clinical sites participated in the interviews. Most pts were able to describe the overall process of CAR T cell therapy and one third first heard about the therapy from their local healthcare professionals. According to patients, key decision-making factors were potential outcomes with ide-cel, recommendation from a doctor, and lack of other options. The most frequently perceived differences between ide-cel and prior treatments are shown (Table). Pt hopes were mostly focused on remission and improved quality of life. Most pts reported some restrictions on their daily activities due to the disease. Conclusions: RRMM pts need new treatment options. Most pts reported the limitations of prior therapies, expectations on ide-cel, impact of the disease, and differentiated ide-cel from other treatments. The ongoing interviews will further assess pt experience during and after ide-cel therapy. Clinical trial information: NCT03361748 . [Table: see text]
Normal values and regional differences in oesophageal impedance-pH metrics: a consensus analysis of impedance-pH studies from around the world
Authors: Daniel Sifrim, Sabine Roman, Edoardo Savarino, Serhat Bor, Albert J Bredenoord, Donald Castell, Michele Cicala, Nicola de Bortoli, Marzio Frazzoni, Sutep Gonlachanvit, Katsuhiko Iwakiri, Osamu Kawamura, Anne Krarup, Yeong Yeh Lee, Chai Soon Ngiu, Eugene Ndebia, Tanisa Patcharatraku, Ans Pauwels, Julio Pérez de la Serna, Rosa Ramos, Jose Maria Remes-Troche, Mentore Ribolsi, Alastair Sammon, Magnus Simren, Jan Tack, Radu Tutuian, Miguel Valdovinos, Yinglian Xiao, Frank Zerbib, C Prakash Gyawali
Journal: Gut (2020)

Objective Limitations of existing impedance-pH thresholds include small sample size of normative studies, inclusion of artefactual pH drops and incorrect identification of impedance reflux events. We aimed to obtain new impedance-pH thresholds from expert consensus analysis of tracings from a large number of healthy subjects. Design Of 541 studies performed worldwide using two different systems (Diversatek, USA, and Laborie, Netherlands), 150 tracings with oesophageal diagnoses, behavioural disorders and study-related artefacts were excluded. The remainder studies were subject to two reviewer consensus analysis, in-person or through video conference, consisting of editing meals and pH drops, identification of impedance reflux and postreflux swallow-induced peristaltic wave (PSPW) using strict pre-established criteria and measurement of distal mean nocturnal baseline impedance (MNBI). Results Consensus analysis was performed in 391 tracings (age 32.7 years, range 18–71, 54.2% female). Normative thresholds were significantly different between Diversatek and Laborie (total acid exposure time: 2.8% and 5%; reflux episodes: 55 and 78; MNBI at 3 cm: 1400 and 1500 ohms, at 5 cm: 1400 and 1800 ohms). Males had higher acid exposure, more reflux episodes and lower MNBI. Significant regional differences were identified, including higher PSPW scores in Western countries, and higher MNBI in Asia using Diversatek, and higher acid exposure in the Netherlands, higher MNBI in Asia and South Africa, and lower MNBI in Turkey using Laborie. Conclusion Normal impedance-pH monitoring thresholds have regional and system-related differences. Clinical interpretation needs to use normal thresholds valid for the system used and world region, following careful editing of the tracings.
Efficacy, patient-reported outcomes, and safety of the anti-granulocyte macrophage colony-stimulating factor antibody otilimab (GSK3196165) in patients with rheumatoid arthritis: a randomised, phase 2b, dose-ranging study
Authors: Christopher D Buckley, Jesus A Simón-Campos, Vyacheslav Zhdan, Brandon Becker, Katherine Davy, Elena Fisheleva, Anubha Gupta, Carol Hawkes, David Inman, Mark Layton, Nina Mitchell, Jatin Patel, Didier Saurigny, Russell Williamson, Paul P Tak
Journal: The Lancet Rheumatology (2020)
BMA should drop its opposition to assisting dying, say members in landmark poll
Authors: Ingrid Torjesen
Journal: BMJ (2020)

The BMA should drop its stance against changing the law on assisting dying, say a majority of members voting in an historic poll.

The poll, the first ever by the BMA on its members’ views on assisted dying, found that a third (33%) of those responding supported its current position of opposing a change in the law to allow physician assisted death or physician assisted suicide (table 1). Forty per cent of respondents said the BMA should support a law change that would permit doctors to prescribe drugs to eligible patients for self-administration to bring on death, 21% said it should take a neutral stance, and 6% were undecided.

View this table:

Table 1 
Should the BMA support a change in the law to permit doctors to prescribe drugs for eligible patients to self-administer to end their own life?



John Chisholm, chair of the BMA’s medical ethics committee, emphasised that the results would not automatically change BMA policy to oppose assisted dying in all its forms. “That will only change should …
Understanding patient perspectives on window of opportunity clinical trials.
Authors: Divya Ahuja Parikh, Lisa Kody, Susie Brain, Diane Heditsian, Vivian Lee, Christina Curtis, George W. Sledge, Jennifer Lee Caswell-Jin
Journal: Journal of Clinical Oncology (2020)

181 Background: In “window of opportunity” (WOO) clinical trials, people with newly diagnosed early-stage cancer are exposed to an experimental drug during the period of time between diagnosis and definitive anti-cancer treatment. These trials allow investigators to study drug efficacy in untreated disease, which can expedite drug development. However, for trial participants, the WOO approach requires them to decide about an altruistic clinical trial during an intense time immediately after cancer diagnosis. This qualitative study aimed to understand patient perspectives on WOO clinical trials. Methods: We recruited adults newly diagnosed with early-stage breast cancer who were awaiting definitive therapy at a single academic medical center. We developed an interview guide grounded in the theoretical framework, the Theory of Planned Behavior (TPB). TBP is a well-validated decision-making model with three domains that guide behavior: (1) attitudes (2) normative factors and (3) perceived difficulty of a behavior. We conducted one-on-one semi-structured interviews that were audio-recorded and transcribed. Transcripts were analyzed to ensure interrater reliability and content analysis was performed to assess themes that emerged. Results: We interviewed 15 women (age 32-72) with early-stage breast cancer, and the majority were White (n = 12, 80%) and at least college educated (n = 12, 80%). Key themes that emerged included favorable attitudes towards participating in a WOO trial that were altruistic, including the desire to contribute to science (n = 10, 67%) and to help future breast cancer patients (n = 5, 33%). Several individuals also identified a potential benefit to themselves (n = 10, 67%), including access to a targeted drug (n = 4, 27%) and adding meaning to their diagnosis (n = 3, 20%). However, most interviewees reported concerns about drug side effects (n = 12, 80%) and whether side effects would impact other planned treatments (n = 10, 67%). Interviewees also expressed family would be an important normative factor in decision-making (n = 8, 53%). A key theme that emerged as a difficulty was the potential delay in standard treatment (n = 14, 93%). Despite this concern, at the end of the interviews, most interviewees stated they would participate in a WOO trial if offered (n = 10, 67%). Conclusions: WOO trials are becoming increasingly common in oncology research. In this qualitative study, interviewees weighed altruism against the possibility delaying or impacting other treatments. Our results may inform trial design and communication approaches in future WOO efforts.
Scientia potentia est: How the Italian world of oncology changes in the COVID19 pandemic
Authors: Zelmira Ballatore, Lucia Bastianelli, Filippo Merloni, Nicoletta Ranallo, Luca Cantini, Lorenzo Mariotti, Claudia Catani, Michela Burattini, Alessandra Lucarelli, Rossana Berardi
Journal: Clinical Cancer Research (2020)

Background: After COVID-19 was declared a pandemic by the World Health Organization, a response from theItalian Health System to react to an unprecedented condition became necessary and sudden  COVID- 19 pandemicrequired oncologists to redefine clinical organization and management of cancer patients  The aim of our study wasto take a picture of the situation of Italian oncologies and to evaluate the difficulties in patients' management  Methods: Between 18th March and 9th April 2020 we conducted an online survey (Google Forms)  It consisted of45 questions ranging from individual perception of pandemic management by oncologic centers to physicians' andnurses' psychological distress and patient care  The survey was anonymous and broadcast to oncology healthworkers by mailing contacts, word of mouth, and social networks  Results: A total of 383 oncology health workers participated in the survey  The majority was female (72%) and fromcentral Italy (46%)  Impressively, a total of 357 (93%) participants declared the Oncologic Department reorganizedroutine clinical activity, but only 41% were adequately trained about the required procedures  20% of the surveyattendees thought they had not received adequate and timely protective devices with respect to clinical needs, andaccording to 58% the supply of these devices was only partial  34% of professionals declared that they did not haveor know a defined common guideline to reschedule patients' treatments  More than 80% of interviewees declaredfeeling worried about being at greater risk of contagion than the general population, and 92% feared to transmitvirus to family members  Deferring treatments has caused fear/anxiety in 228 of the interviewed (60%)  Symptomsof stressful situations emerged with a deterioration in sleep quality in 62% of professionals, worsening of mood(69%), and lower concentration ability (49%)  Conclusions: Our survey demonstrated the flexibility of oncologic teams  However, the emergency response qualityhas been heterogeneous, and several drawbacks emerged from this first analysis  Information, protection, testing, and training of health care professionals are keywords that should be kept in mind to encourage recovery after thistragedy and to be ready to face a similar emergency in the near future
Effects of Wnt signaling on epithelial to mesenchymal transition in chronic rhinosinusitis with nasal polyp
Authors: Jun-Sang Bae, Gwanghui Ryu, Ji Hye Kim, Eun Hee Kim, Yun Hee Rhee, Young-Jun Chung, Dae Woo Kim, Suha Lim, Phil-Sang Chung, Hyun-Woo Shin, Ji-Hun Mo
Journal: Thorax (2020)

Background Epithelial to mesenchymal transition (EMT) is associated with the pathophysiology of chronic rhinosinusitis with nasal polyp (CRSwNP). Wnt signaling is causative for EMT, whereas the mechanism in CRSwNP is not fully understood. Objective We sought to evaluate the role of Wnt signaling in EMT of CRSwNP using a murine nasal polyp (NP) model and human tissues. Methods Inflammatory markers and EMT-related molecules were evaluated in NP models using adenomatosis polyposis coli (Apc) Min/+ mice with activated Wnt signaling and NP models treated with Wnt signaling inhibitor, indocyanine green-001 (ICG-001). EMT markers and Wnt signaling-associated mediators were analysed using human sinonasal tissues from control subjects and CRSwNP patients. Results Apc Min/+ mice-induced NPs exhibited more frequent polypoid lesions and upregulation of Wnt-related molecules, including nuclear β-catenin, WNT3A and cyclin D1. Markers of EMT were significantly overexpressed in the Apc Min/+ NP mice (p&lt;0.001 for E-cadherin and α-smooth muscle actin), and interleukin (IL)-17A + cells and neutrophilic infiltration were increased in Apc Min/+ NP mice (p&lt;0.001). Inhibition of Wnt signaling via ICG-001 resulted in significantly decreased nasal polypoid lesions (p&lt;0.001), EMT-related markers (p=0.019 for E-cadherin and p=0.002 for vimentin) and the mRNA levels of IL-4 (p&lt;0.001) and IL-17A (p=0.004) compared with the positive control group. Finally, nuclear β-catenin (p=0.042) was significantly increased compared with the control, and the expression levels of Wnt ligands and receptors were upregulated in human NP tissues (p=0.045 for WNT3A and p=0.042 for FZD2), suggesting increased Wnt signaling and EMT in CRSwNP. Conclusion Wnt signaling may contribute to the pathogenesis of NPs through EMT. Therefore, inhibition of Wnt signaling may be a potential therapeutic strategy for patients with CRSwNP.
Comparison of Safety and Insurance Payments for Minor Hand Procedures Across Operative Settings
Authors: Jessica I. Billig, Jacob S. Nasser, Jung-Sheng Chen, Yu-Ting Lu, Kevin C. Chung, Chang-Fu Kuo, Erika D. Sears
Journal: JAMA Network Open (2020)

<h3>Importance</h3> Surgical procedures can be performed in different settings, but the association between the operative setting and patient safety and cost to the patient and payer is unknown. <h3>Objective</h3> To examine differences in complications, total payments, and out-of-pocket (OOP) spending for minor hand surgical procedures performed in office, ambulatory surgery center (ASC), and hospital outpatient department (HOPD) operative settings. <h3>Design, Setting, and Participants</h3> A retrospective, population-based cohort study was conducted using deidentified claims data from private employer-sponsored health insurance from January 1, 2009, to December 31, 2017. Patients aged 18 years or older undergoing carpal tunnel release, trigger finger release, excision of wrist ganglion, and excision of small hand masses (N = 468 365) were included. <h3>Exposures</h3> Operative setting, defined as procedures performed in the clinic setting, ASC, and HOPD. <h3>Main Outcomes and Measures</h3> Complications during the 90-day postoperative period, total payments (total facility and payer reimbursement), and OOP spending. <h3>Results</h3> Of the 468 365 patients, 296 378 women (63.3%) and 171 987 men (36.7%) underwent minor hand surgical procedures from 2009 to 2017, with 284 889 procedures (60.8%) performed in HOPDs, 158 659 procedures (33.9%) performed in ASCs, and 24 817 procedures (5.3%) performed in the office setting. Ninety-day complications occurred in 3.4% of procedures performed in HOPDs, 3.3% in ASCs, and 2.9% in office settings (<i>P</i> &lt; .001). After controlling for patient characteristics, procedures performed outside of the office had higher odds of complications (HOPDs: odds ratio [OR], 1.32; 95% CI, 1.22-1.43; ASCs: OR, 1.24; 95% CI, 1.14-1.34). Compared with the office setting, procedures performed in HOPDs incurred an extra $1216 in total payments (95% CI, $1184-$1248) and $115 in OOP expenses (95% CI, $109-$121). Procedures performed in ASCs cost an additional $709 (95% CI, $676-$741) and $140 in OOP expenses (95% CI, $134-$146). Transitioning ASC and HOPD procedures to the office setting could have saved an estimated $6 million annually in OOP expenses during the study period. <h3>Conclusions and Relevance</h3> The findings of this study suggest that minor hand surgery performed in the office setting is safe and less costly compared with ambulatory and hospital-based operations. Shifting minor surgical procedures to the office setting may lead to substantial cost savings for payers and patients without compromising care quality.
Financial toxicity, financial well-being, and quality of life among bladder cancer patients.
Authors: Reginald Tucker-Seeley, Weizhou Tang, Leora Steinberg, Stephanie Banks, Hilma Bolton, Sumeet Bhanvadia
Journal: Journal of Clinical Oncology (2020)

133 Background: Due to a long course of surveillance, and for some patients, multimodal therapy with chemotherapy and surgery, bladder cancer (BC) can present a financial burden to the household. Yet, there are several terms used to describe this burden such as financial hardship and financial toxicity (FT); and it is unclear whether different measures of financial circumstances are correlated and whether they are associated with quality of life (QOL). The goal of this study was to determine whether FT and financial well-being (FWB) were correlated and to determine whether FT and FWB were similarly associated with QOL among BC patients. Methods: Patients that had BC treatment in the last 2 years were recruited from two NCI designated cancer centers for our study (N = 100). The Comprehensive Score for Financial Toxicity (COST) was used to assess FT, the Consumer Financial Protection Bureau’s (CFPB) FWB measure was used to assess FWB, and a BC-specific Functional Assessment of Cancer Therapy (FACT) questionnaire was used to assess physical, social, emotional, and functional domains of QOL. Bivariate analyses were conducted to determine the association among FT, FWB, and QOL; and separate logistic regression analyses predicting FT and FWB were used to determine the association between FT and FWB and each domain of QOL. Results: Bivariate results showed that FT and FWB were highly negatively correlated (r = -.76; p &lt; .0001); however, only FWB was correlated with the total QOL score (p &lt; .05). FT was correlated with physical (p &lt; .01), emotional (p &lt; .05), and functional (p &lt; .05) QOL; and FWB was correlated with physical (p &lt; .05) and functional (p &lt; .05) QOL. Logistic regression models adjusted for socioeconomic and demographic characteristics showed that those reporting higher physical QOL (OR = 1.18; CI: 1.04-1.35) and higher functional QOL (OR = 1. 15; CI: 1.03-1.28) had higher odds of reporting high FWB. Conclusions: Given the surveillance and treatment processes for BC patients, it is important to better understand their financial circumstances as they are navigating and managing care. Our results suggest that physical and functional QOL is relevant for predicting FWB, but after considering socioeconomic and demographic characteristics, no domain of QOL was a significant predictor of FT among BC patients.