tbuckley/cabot-search huggingface dataset:
Oncologist experiences regarding patient-recorded clinical encounters: Implications for the patient-doctor relationship.
Authors: Rachel Jimenez, Andrew Johnson, Nora K. Horick, Fay J. Hlubocky, Yvonne Y. Lei, Cindy Brown Matsen, Erica L. Mayer, Deborah E. Collyar, Thomas William LeBlanc, Karen Donelan, Michelle Mello, Jeffrey M. Peppercorn
Journal: Journal of Clinical Oncology (2020)

290 Background: The high prevalence of smartphone use means that most patients can easily audio record medical consultations. Oncologists’ attitudes towards recording visits are unknown yet may impact patient care. Methods: A mail survey of oncologists practicing at 5 U.S. Alliance for Clinical Trials in Oncology sites collected information on clinicians’ beliefs, preferences, and practices regarding patient-initiated recordings, along with sociodemographic and practice characteristics. Descriptive statistics and bivariate analyses were calculated. Results: Of 523 eligible oncologists, 352 (67%) completed the survey. Median age was 47 years, 33% were female, and 86% worked in an academic setting. 53% were medical oncologists, 30% surgical oncologists, and 17% radiation oncologists. Virtually all (93%) reported experience with patients recording visits, 79% at least weekly. The majority (74%) perceived that patients record visits in order to help understand treatment choices. While 79% reported that they “always” agree to recordings, 26% reported discomfort. Nearly one-third (29%) reported concerns about liability, 26% felt recording made discussion less natural, and 18% felt recording changed the way they conveyed information. Although 86% agreed that patients have the right to record visits, nearly all felt physician permission was required and 53% reported having been previously recorded without permission. Only 51% believed recording had a positive impact on the patient-doctor relationship. One-quarter (28%) felt that recording led to a less detailed conversation and 33% felt it contributed to avoidance of difficult topics, such as prognosis. Most preferred the patient/family taking notes or having access to a written summary. Views did not vary significantly based on practice setting, specialty, or region of the country. Older age and greater years in practice were associated with both greater comfort with recording and the perception that recording has a positive impact on the patient-doctor relationship (p &lt; 0.001). Conclusions: While most oncologists report comfort with audio recording and recognize benefits for patients, a substantial minority have reservations about its impact on clinical discussions and their liability exposure. Adopting clear institutional policies about recording could help address some concerns, such as surreptitious recording, while ensuring that patients’ interests are served.
Biomineralization: An Opportunity and Challenge of Nanoparticle Drug Delivery Systems for Cancer Therapy
Authors: Weicai Wang, Xiaofan Liu, Xiangjiang Zheng, Hyung Jong Jin, Xuemei Li
Journal: Advanced Healthcare Materials (2020)

Abstract Biomineralization is a common process in organisms to produce hard biomaterials by combining inorganic ions with biomacromolecules. Multifunctional nanoplatforms are developed based on the mechanism of biomineralization in many biomedical applications. In the past few years, biomineralization‐based nanoparticle drug delivery systems for the cancer treatment have gained a lot of research attention due to the advantages including simple preparation, good biocompatibility, degradability, easy modification, versatility, and targeting. In this review, the research trends of biomineralization‐based nanoparticle drug delivery systems and their applications in cancer therapy are summarized. This work aims to promote future researches on cancer therapy based on biomineralization. Rational design of nanoparticle drug delivery systems can overcome the bottleneck in the clinical transformation of nanomaterials. At the same time, biomineralization has also provided new research ideas for cancer treatment, i.e., targeted therapy, which has significantly better performance.
Improving medication reconciliation in ambulatory cancer care.
Authors: Carissa Milley-Daigle, Celina Dara, Genevieve Bouchard-Fortier, Anet Julius, Vishal Kukreti, Ernie Mak, Lyndon Morley, Melanie Lynn Powis, Rebecca M. Prince, Jean-Pierre Bissonnette, Judy Costello, Osvaldo Espin-Garcia, Victoria Glinsky, Alyssa Macedo, Auro Viswabandya, Monika K. Krzyzanowska
Journal: Journal of Clinical Oncology (2020)

224 Background: Adverse drug events are common in ambulatory oncology where care spans multiple providers and medication documentation is often poor. We undertook a QI project with the aim of having 30% of patients have a best possible medication history (BPMH) or medication reconciliation (MedRec) documented within 30 days of starting systemic therapy. Methods: An Electronic Medical record-Integrated Tool (EMITT) was developed to facilitate documentation. 2 Plan-Do-Study-Act (PDSA) cycles have been completed to date; PDSA 1 consisted of piloting EMITT in 3 clinics run by physician champions. PDSA 2 which consisted of expanding pharmacy support and addition of a 4 th clinic was impacted by care changes related to COVID. The proportion of patients with BPMH/MedRec documented in EMITT was calculated monthly for each period (PDSA 1, PDSA 2 pre-COVID and PDSA 2 post-COVID). The balancing measure of time to complete an entry was evaluated through a time motion study. Results: Between 9/9/2019 and 31/5/2020, 9.4% (233/2488) of patients had BPMH/MedRec completed; Table shows proportion of patients by month. BPMH and MedRec were most frequently performed by pharmacists followed by pharmacy students and nurses. On average, it took 5.5 minutes to complete an entry (n = 10; median number of medications per patient = 12.3). Conclusions: BPMH was documented more often than MedRec. While some usage was sustained, the changes to care as a result of COVID-19 negatively impacted ambulatory medication reconciliation. Future PDSA cycles will involve engaging patients in MedRec and extending EMITT to all ambulatory cancer clinics where medication management is a major component of care. [Table: see text]
Comparing cancer survivors' perceptions on lifestyle behaviors between adolescent-young adult (AYA) and middle-aged patients (pts).
Authors: Spencer Soberano, Lawson Eng, RuiQi Chen, Ashraf Altesha, Subiksha Nagaratnam, Sarah Rudolph-Naiberg, Simren Chotai, Wanning Wang, Lin Lu, Wei Xu, Katrina Hueniken, Catherine Brown, Geoffrey Liu
Journal: Journal of Clinical Oncology (2020)

207 Background: Lifestyle behaviours such as smoking, physical activity, and alcohol consumption are important determinants of cancer survivorship. Previous studies have compared the lifestyle behaviours of elderly and middle-aged patients (pts), yet no studies have compared these behavioural perceptions between AYA (aged 18-39 years) to those of middle-aged pts (MA, 40-64 years). Methods: Cancer pts across various tumour types at a comprehensive cancer centre were surveyed with respect to their perceptions of how their well-being was affected by smoking, physical activity and alcohol consumption after diagnosis. Univariate logistic regression models evaluated factors associated with perceptions on the effect of various adverse lifestyle behaviours on health and well-being. Results: Of 200 AYA (57% female, 43% male) and 772 MA (56% female, 44% male) pts, a positive smoking history was reported by 33% of AYA and 48% of MA (P&lt;0.001). At time of diagnosis, 55% of AYA and 59% of MA pts consumed alcohol, 16% of AYA and 16% of MA were ex-drinkers, and 28% of AYA and 25% of MA were never drinkers (P=0.62). Among AYA, 26% exercised compared to 20% in the MA group (P=0.19). The majority (72-92%) of pts perceived that smoking and lack of activity after cancer diagnosis negatively affected quality of life, survival chances, and fatigue; there were no significant differences between age groups. In contrast, both age cohorts displayed misperceptions about how alcohol affects health, which was characterized by perceiving neutral or beneficial influence on their overall well-being: Fifty-seven percent of MA pts had a borderline greater misperception versus 49% of AYA pts (P=0.06). Misperceptions regarding how alcohol affects survival were observed in 49% of AYA pts and 58% of MA pts (P=0.05). Misperception with respect to how alcohol affects fatigue was observed in 40% of AYA pts compared to 52% of MA pts (P=0.005). Furthermore, MA pts had 1.63 (95% CI 1.16–2.29) times the odds to have misperceptions regarding how alcohol affects fatigue, and 1.41 (95% CI 1.01–1.97) times the odds to have misperceptions on how alcohol affects survival compared to AYA pts. Conclusions: Both the AYA and MA population were not adequately informed about how alcohol affects cancer survivorship health; with more misperceptions in MA pts. Results from this study advocate for survivorship programs to implement emphasis on the deleterious effects of alcohol, with particular efforts tailored to the MA group.
Quantitative Testing of the Myelofibrosis Symptom Assessment Form Version 4.0, a Harmonized Patient-Reported Outcome Measure for Collecting Key Secondary Endpoint Data in Myelofibrosis Clinical Trials
Authors: Amylou C. Dueck, Chad Gwaltney, Wen-Hung Chen, Lixia Wang, Renee Pierson, Jeremiah Trudeau, Sonya Eremenco, Stephen Joel Coons, Ruben A Mesa
Journal: Blood (2017)
<i>That Dragon, Cancer</i>—Exploring End of Life Through an Unwinnable Video Game
Authors: Keegan O’Hern, David S. Lakomy, Daniel P. Mahoney
Journal: JAMA (2020)

This Arts and Medicine feature reviews That Dragon, Cancer, a 2016 video game that challenges players to love and care for a 4-year-old with brain cancer whose treatment options gradually narrow and disappear.
Yaws re-emergence and bacterial drug resistance selection after mass administration of azithromycin: a genomic epidemiology investigation
Authors: Mathew A Beale, Marc Noguera-Julian, Charmie Godornes, Maria Casadellà, Camila González-Beiras, Mariona Parera, August Kapa Jnr, Wendy Houinei, James Wangi, Marc Corbacho-Monne, Roger Paredes, Fernando Gonzalez-Candelas, Michael Marks, Sheila A Lukehart, Nicholas R Thomson, Oriol Mitjà
Journal: The Lancet Microbe (2020)

In a longitudinal study assessing the WHO strategy for yaws eradication using mass azithromycin treatment, we observed resurgence of yaws cases with dominance of a single JG8 sequence type and emergence of azithromycin-resistant Treponema pallidum subspecies pertenue (T p pertenue). Here, we analyse genomic changes in the bacterial population using samples collected during the study.We did whole bacterial genome sequencing directly on DNA extracted from 37 skin lesion swabs collected from patients on Lihir Island, Papua New Guinea, between April 1, 2013, and Nov 1, 2016. We produced phylogenies and correlated these with spatiotemporal information to investigate the source of new cases and the emergence of five macrolide-resistant cases. We used deep amplicon sequencing of surveillance samples to assess the presence of minority macrolide-resistant populations.We recovered 20 whole T p pertenue genomes, and phylogenetic analysis showed that the re-emerging JG8 sequence type was composed of three bacterial sublineages characterised by distinct spatiotemporal patterns. Of five patients with resistant T p pertenue, all epidemiologically linked, we recovered genomes from three and found no variants. Deep sequencing showed that before treatment, the index patient had fixed macrolide-sensitive T p pertenue, whereas the post-treatment sample had a fixed resistant genotype, as did three of four contact cases.In this study, re-emergence of yaws cases was polyphyletic, indicating multiple epidemiological sources. However, given the genomic and epidemiological linkage of resistant cases and the rarity of resistance alleles in the general population, azithromycin resistance is likely to have evolved only once in this study, followed by onward dissemination.Wellcome and Provincial Deputation of Barcelona.
Whole-Blood Resuscitation of Injured Patients’ Plasma
Authors: Christine M. Leeper, Mark H. Yazer, Matthew D. Neal
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Racial disparities in cancer clinical trials.
Authors: Pushti Khandwala, Devashish Desai, Devika Govind Das, Aakash Desai
Journal: Journal of Clinical Oncology (2020)

97 Background: Cancer-related mortality has been found to be disproportionately higher in racial minorities and medically underserved populations.[1] This necessitates adequate representation of these subgroups in clinical trials for these practices to become an acceptable benchmark for all.However, this has been historically challenging and various studies have failed to show the equitable representation of various ethnic groups in these trials that ultimately guide clinical practice. Methods: We reviewed all abstracts presented at the 2020 ASCO Virtual meeting, from which we selected abstracts discussing results from phase III trials. Of these, we included phase III studies that provided explicit information on the demographic distribution of the clinical trial participants with respect to their race/ethnicity. We then extracted information on the demographic data of participants in the clinical trial using the slides or posters available on the ASCO website. Further, we utilized descriptive statistics to analyze and compare the clinical trial population with the general cancer population using the 2020 ACS Cancer statistics. However, our analysis was potentially limited by the absence of full demographic distribution when previously described elsewhere and the lack of uniform reporting of different ethnicities among these abstracts. Results: Of the total 476 abstracts studied, 120 described phase III studies. Among these, 23 did provide detailed demographic (race/ethnicity) distribution. However, 98 studies did not include standardized subgroups (White, African American, and Others) and 6 studies provided data only on Whites. A total of 9 studies were included in the final analysis. Overall, the following was found: White 7083 (76.8%), African Americans 675 (7.3%), and “Others” 1466 (15.9%). Meanwhile, a comparison of cancer demographic data from the American Cancer Society (ACS) demonstrates the overall cancer incidence rates from 2012-2017 was found to be 464.6/100,000 in non-Hispanic whites and a comparable 460/100,000 in Non-Hispanic Blacks. However, our analysis shows that these ethnic minorities continue to be severely underrepresented in these phase III clinical trials. Conclusions: Despite several efforts, health care disparities persist and racial minorities continue to be underrepresented in cancer clinical trials. Further measures are needed to ensure adequate representation, healthcare equity and the generalizable nature of these “practice-changing” trials. References: 1. https://seer.cancer.gov/csr/1975_2017/results_merged/topic_race_ethnicity.pdf .
Demographic, socioeconomic, and clinical factors associated with oncology patient experience in the Ontario cancer system.
Authors: Mary Mahler, Brett Nicholls, Catherine Chan, Narges Nazeri-Rad, Kelvin K. Chan, Simron Singh
Journal: Journal of Clinical Oncology (2020)

160 Background: Your Voice Matters (YVM) is an electronic real time Patient Reported Experience Measure (PREM) collected on all adult patients accessing cancer services in Ontario by Cancer Care Ontario/Ontario Health. To our knowledge, this is the largest oncology PREM dataset worldwide. A total of 25 Items are assessed including care coordination, wait times, access to care and satisfaction with healthcare providers. We attempted to identify demographic, socioeconomic and disease factors that predict for a positive patient experience. Methods: Responses were collated from 18 individual cancer centers between Jan 2017 and Dec 2019. Each item was dichotomized into positive/negative experiences. Multivariable logistic regression was constructed for each of the 25 items. Results: Demographics are described in table. Males (OR=1.11, p=0.0032), genitourinary patients (OR=1.30, p=0.0031) and those receiving radiation (OR=1.39, p=&lt;0.0001) were more likely to have a positive experience. Patients aged 18-39 (OR=0.74, p=&lt;0.0001), receiving chemotherapy (OR=0.76, p=0.0002), and with central nervous system or lung cancer (OR= 0.56, p=&lt;0.001; OR=0.79 p=0.0059, respectively) were more likely to have a negative experience. Lowest income patients were more likely to have a negative experience with healthcare providers (OR=0.83, p=0.0119) and patients from the highest immigration areas had a worse quality experience (OR=0.82, p=0.0029). Conclusions: Age, sex, disease site, visit type, income and immigration status significantly influence patients cancer care experience. This information helps promote equity and the use of PREM data to improve cancer care delivery. [Table: see text]
Could Polygenic Risk Scores Be Useful in Psychiatry?
Authors: Graham K. Murray, Tian Lin, Jehannine Austin, John J. McGrath, Ian B. Hickie, Naomi R. Wray
Journal: JAMA Psychiatry (2020)

Polygenic risk scores (PRS) are predictors of the genetic susceptibility to diseases, calculated for individuals as weighted counts of thousands of risk variants in which the risk variants and their weights have been identified in genome-wide association studies. Polygenic risk scores show promise in aiding clinical decision-making in many areas of medical practice. This review evaluates the potential use of PRS in psychiatry.On their own, PRS will never be able to establish or definitively predict a diagnosis of common complex conditions (eg, mental health disorders), because genetic factors only contribute part of the risk and PRS will only ever capture part of the genetic contribution. Combining PRS with other risk factors has potential to improve outcome prediction and aid clinical decision-making (eg, determining follow-up options for individuals seeking help who are at clinical risk of future illness). Prognostication of adverse physical health outcomes or response to treatment in clinical populations are of great interest for psychiatric practice, but data from larger samples are needed to develop and evaluate PRS.Polygenic risk scores will contribute to risk assessment in clinical psychiatry as it evolves to combine information from molecular, clinical, and lifestyle metrics. The genome-wide genotype data needed to calculate PRS are inexpensive to generate and could become available to psychiatrists as a by-product of practices in other medical specialties. The utility of PRS in clinical psychiatry, as well as ethical issues associated with their use, should be evaluated in the context of realistic expectations of what PRS can and cannot deliver. Clinical psychiatry has lagged behind other fields of health care in its use of new technologies and routine clinical data for research. Now is the time to catch up.
Baveno VI criteria and spleen stiffness measurement rule out high-risk varices in virally suppressed HBV-related cirrhosis
Authors: Haiyu Wang, Biao Wen, Xianyi Chang, Qiaoping Wu, Weiqun Wen, Fuyuan Zhou, Yabing Guo, Yali Ji, Yixiu Gu, Qintao Lai, Qinjun He, Junying Li, Jinjun Chen, Jinlin Hou
Journal: Journal of Hepatology (2020)
Integrative analysis of long extracellular RNAs reveals a detection panel of noncoding RNAs for liver cancer
Authors: Yumin Zhu, Siqi Wang, Xiaochen Xi, Minfeng Zhang, Xiaofan Liu, Weina Tang, Peng Cai, Shaozhen Xing, Pengfei Bao, Yunfan Jin, Weihao Zhao, Yinghui Chen, Huanan Zhao, Xiaodong Jia, Shanshan Lu, Yinying Lu, Lei Chen, Jianhua Yin, Zhi John Lu
Journal: Theranostics (2020)

Rationale: Long extracellular RNAs (exRNAs) in plasma can be profiled by new sequencing technologies, even with low abundance. However, cancer-related exRNAs and their variations remain understudied. Methods: We investigated different variations (i.e. differential expression, alternative splicing, alternative polyadenylation, and differential editing) in diverse long exRNA species (e.g. long noncoding RNAs and circular RNAs) using 79 plasma exosomal RNA-seq (exoRNA-seq) datasets of multiple cancer types. We then integrated 53 exoRNA-seq datasets and 65 self-profiled cell-free RNA-seq (cfRNA-seq) datasets to identify recurrent variations in liver cancer patients. We further combined TCGA tissue RNA-seq datasets and validated biomarker candidates by RT-qPCR in an individual cohort of more than 100 plasma samples. Finally, we used machine learning models to identify a signature of 3 noncoding RNAs for the detection of liver cancer. Results: We found that different types of RNA variations identified from exoRNA-seq data were enriched in pathways related to tumorigenesis and metastasis, immune, and metabolism, suggesting that cancer signals can be detected from long exRNAs. Subsequently, we identified more than 100 recurrent variations in plasma from liver cancer patients by integrating exoRNA-seq and cfRNA-seq datasets. From these datasets, 5 significantly up-regulated long exRNAs were confirmed by TCGA data and validated by RT-qPCR in an independent cohort. When using machine learning models to combine two of these validated circular and structured RNAs (SNORD3B-1, circ-0080695) with a miRNA (miR-122) as a panel to classify liver cancer patients from healthy donors, the average AUROC of the cross-validation was 89.4%. The selected 3-RNA panel successfully detected 79.2% AFP-negative samples and 77.1% early-stage liver cancer samples in the testing and validation sets. Conclusions: Our study revealed that different types of RNA variations related to cancer can be detected in plasma and identified a 3-RNA detection panel for liver cancer, especially for AFP-negative and early-stage patients.