tbuckley/cabot-search huggingface dataset:
Global and regional impacts of alcohol use on public health: Emphasis on alcohol policies
Authors: Seung Ha Park, Dong Joon Kim
Journal: Clinical and Molecular Hepatology (2020)

Alcohol is a well-known risk factor for premature morbidity and mortality. The per capita alcohol consumption of the world's population rose from 5.5 L in 2005 to 6.4 L in 2010 and was still at the level of 6.4 L in 2016. Alcohol-attributable deaths and disability-adjusted life years (DALYs) declined from 2000 to 2016 by 17.9% and 14.5%, respectively. However, these gains observed in the alcohol-attributable burden have proportionally not kept pace with the total health gains during the same period. In 2016, 3.0 million deaths worldwide and 132 million DALYs were attributable to alcohol, responsible for 5.3% of all deaths and 5.0% of all DALYs. These burdens are the highest in the regions of Eastern Europe and sub-Saharan Africa. The alcohol-attributable burden is particularly heavy among young adults, accounting for 7.2% of all premature mortalities. Among the disease categories to which alcohol is related, injuries, digestive diseases, and cardiovascular diseases are the leading causes of the alcohol-attributable burden. To reduce the harmful use of alcohol in a country, the 'whole of government' and 'whole of society' approaches are required with the implementation of evidence-based alcohol control policies, the pursuit of public health priorities, and the adoption of appropriate policies over a long period of time. In this review, we summarize previous efforts to investigate the alcohol-attributable disease burden and the best ways to protect against harmful use of alcohol and promote health.
Caregiver burden: Empowering caregivers with shared decision-making strategies and skills to improve patient quality of life and outcomes.
Authors: Martha Ann Raymond, Margaret-Ann Simonetta
Journal: Journal of Clinical Oncology (2020)

142 Background: Data from the National Cancer Institute’s Surveillance, Epidemiology &amp; End Results (SEER 2016) program estimates there are 15.5 million cancer survivors in the United States who rely on cancer caregivers every day. Caregivers play an essential role throughout the care continuum greatly impacting a patient’s quality of survivorship. Methods: August 2019–March 2020 the Raymond Foundation hosted nationwide caregiver focus groups and an online survey. Primary goals were reaching caregivers and the patients they serve in rural, urban, and community oncology settings to gain perspective from diverse populations. Focus groups were held in person and online via video conferencing. Results: 1012 caregivers and the patients they care for (41% male, 59% female) participated in our focus groups and online survey: 92% reported a lack of educational resources necessary to participate in shared decision making regarding treatment protocol; 90% reported they lacked communication strategies required to effectively communicate with their healthcare team; 87% reported they would like to learn more about clinical trials but did not know where to start; 85% reported they did not feel comfortable reporting treatment adverse effects; 94% reported working toward a patient-centered, advocate based care approach would lead to enhanced quality of life and improved outcomes. Conclusions: Cancer caregivers and the patients they assist understand the importance of shared decision-making and patient centered care. Based on our focus groups and survey findings, our call to action includes developing the Cancer Caregiver Advocacy Plan. This unique educational resource will provide key information to address educational gaps and empower caregivers to become informed healthcare advocates. The Cancer Caregiver Advocacy Plan will be a companion resource to the Raymond Foundation’s 2018 Cancer Caregiver Action Plan as we continue to expand our education and outreach to minimize cancer burdens for patients and caregivers.
Systematic review and meta-analysis of incremental cost-effectiveness ratio (ICER) for new cancer drugs.
Authors: Fernanda Alves Oliveira, Eduardo Alves Oliveira, Gilberto Lopes, Joao Paulo SN Lima
Journal: Journal of Clinical Oncology (2020)

66 Background: This systematic review and meta-analysis compared incremental cost-effectiveness ratios (ICERs) of cancer drugs and their relationship with society’s willingness to pay (WTP) across different countries, scenarios and indications. Methods: We sought for cost-effectiveness studies in PubMed, Embase, Cochrane and LILACS published from December 2012 to December 2017. CAR-T cell therapies were excluded given short follow-up. We converted ICERs value and respective annualized 1time the Gross Domestic Product per capita (GDP) - used as a proxy for WTP threshold - into purchase-parity-power dollars (PPP) for better economic reality comparisons. Economics data came from the International Monetary Fund website. Characteristics studied in the distribution of ICERs values were compared using the Mann-Whitney or Kruskal-Wallis U-test with multiple comparison correction and simple linear regression. The chance of ICER being below the 1x GDP threshold was expressed as odds ratio and 95% confidence interval, calculated by logistic regression. Results: We retrieved 354 drug-versus-drug different assessments. PPPconversion increased median ICER of middle-income countries ($32k to $68k;P &lt; 0.001). Median ICER was highest in USA ($154k), followed by other high-income countries ($76k; P &lt; 0.001). In multiple regression, anti-VEGF (P &lt; 0.001) and US-led (P = 0.03) studies had highest ICERs, while curative therapies (p = 0.02) had the lowest ones. 22% of studies were below the WTP bar, none of anti-VEGF, sipuleucel, anti-CD-30, castration-resistant, hepatocarcinoma, and renal cell ones. Immune checkpoint inhibition (OR 8.70; P = 0.045) and middle-income (OR 7.40; P &lt; 0.001) studies were more likely above WTP, whereas curative therapies were more likely below WTP. Conclusions: Cancer therapies’ cost exceeding the WTPs is a worldwide pattern, with some factors related to ICER variation. These findings may foster better understanding and aid stakeholders deal with the global issue of high oncology care costs.
Seroprevalence of SARS-CoV-2 immunoglobulin antibodies in Wuhan, China: part of the city-wide massive testing campaign
Authors: Yunbao Pan, Xinran Li, Gui Yang, Junli Fan, Yueting Tang, Xiaoyue Hong, Shuang Guo, Jin Li, Dongai Yao, Zhenshun Cheng, Yufeng Yuan, Yirong Li, Xinghuan Wang
Journal: Clinical Microbiology and Infection (2020)
Determining the Optimal Location for Minor Procedures—Goldilocks Medicine and the Just-Right Surgical Setting
Authors: Catherine M. Curtin
Journal: JAMA Network Open (2020)

Jessica I. Billig, MD, MS; Jacob S. Nasser, BS; Jung-Sheng Chen, MS; Yu-Ting Lu, MPH; Kevin C. Chung, MD, MS; Chang-Fu Kuo, MD, PhD; Erika D. Sears, MD, MS
Early impact of COVID-19 in cancercare: The experience of a Brazilian outpatient clinic
Authors: Cinthya Sternberg, Bianca Vivas, Thamine Lessa Andrade, Ana Paula Vila Nova, Ana Paula Fernandes, Camila Alves, Adriana Alvez, Lise Hizumi, Simone Dias, Pablicio Nobre, Aknar Calabrich, Anelisa Coutinho, Alex Pimenta
Journal: Clinical Cancer Research (2020)

The first confirmed case of coronavirus disease 2019 (COVID-19) in Latin America was reported on February 25th,2020, in Brazil  As COVID19 disease incidence escalated in the country, management of cancer patients requiredimmediate action and oncology clinics were urged to establish a contingency plan  We were the first oncology clinicin Brazil to install a COVID-19 Management Committee to elaborate and implement best practices to assist canceroutpatients as well as to provide a safe environment for clinical staff and other employees at the outpatient clinics We started monitoring our staff and employees on March 13th, a day after we installed a contingency plan forCOVID-19 management and WHO declared COVID-19 a pandemic  So far, out of 1,022 staff and employees of ourgroup, we have registered 12 3% suspected and 3 8% confirmed COVID-19 cases, and only 1 case severe enoughto require hospitalization  As COVID-19 testing is not widely available, not all patients were tested and/or we did nothave access to results, as tests might have been conducted somewhere other than the clinic  Out of 98 patients withsuspected COVID-19 being monitored by SCIA (ranging from 29 to 90yo), 68% were tested and 43% of these werepositive  As for the monitored population (n=98), 62 6% were undergoing treatment, 31 8% tested positive, and9 9% died due to COVID-19 (31% of the confirmed cases, matching literature data)  All deaths by COVID-19 (n=9)occurred in patients above 68yo, and 77% (n=6) were undergoing cancer treatment  To the best of our knowledge, this is the first report of COVID-19 incidence in cancer patients in Brazil  The challenges of cancer treatment in themidst of a global pandemic highlight the importance of a rapid response by institutions, where organizationalstructure, strategic planning, agility in guidelines implementation, and alternative ways to protect and support clinicalstaff, employees, and patients may be the keys to mitigate pandemic effects
Revisiting the use of remission criteria for rheumatoid arthritis by excluding patient global assessment: an individual meta-analysis of 5792 patients
Authors: Ricardo J O Ferreira, Paco M J Welsing, Johannes W G Jacobs, Laure Gossec, Mwidimi Ndosi, Pedro M Machado, Désirée van der Heijde, Jose A P Da Silva
Journal: Annals of the Rheumatic Diseases (2020)

Objectives To determine the impact of excluding patient global assessment (PGA) from the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission criteria, on prediction of radiographic and functional outcome of rheumatoid arthritis (RA). Methods Meta-analyses using individual patient data from randomised controlled trials testing the efficacy of biological agents on radiographic and functional outcomes at ≥2 years. Remission states were defined by 4 variants of the ACR/EULAR Boolean definition: (i) tender and swollen 28-joint counts (TJC28/SJC28), C reactive protein (CRP, mg/dL) and PGA (0–10=worst) all ≤1 (4V-remission); (ii) the same, except PGA &gt;1 (4V-near-remission); (iii) 3V-remission (i and ii combined; similar to 4V, but without PGA); (iv) non-remission (TJC28 &gt;1 and/or SJC28 &gt;1 and/or CRP &gt;1). The most stringent class achieved at 6 or 12 months was considered. Good radiographic (GRO) and functional outcome (GFO) were defined as no worsening (ie, change in modified total Sharp score (ΔmTSS) ≤0.5 units and ≤0.0 Health Assessment Questionnaire–Disability Index points, respectively, during the second year). The pooled probabilities of GRO and GFO for the different definitions of remission were estimated and compared. Results Individual patient data (n=5792) from 11 trials were analysed. 4V-remission was achieved by 23% of patients and 4V-near-remission by 19%. The probability of GRO in the 4V-near-remission group was numerically, but non-significantly, lower than that in the 4V-remission (78 vs 81%) and significantly higher than that for non-remission (72%; difference=6%, 95% CI 2% to 10%). Applying 3V-remission could have prevented therapy escalation in 19% of all participants, at the cost of an additional 6.1%, 4.0% and 0.7% of patients having ΔmTSS &gt;0.0, &gt;0.5 and &gt;5 units over 2 years, respectively. The probability of GFO (assessed in 8 trials) in 4V-near-remission (67%, 95% CI 63% to 71%) was significantly lower than in 4V-remission (78%, 74% to 81%) and similar to non-remission (69%, 66% to 72%). Conclusion 4V-near-remission and 3V-remission have similar validity as the original 4V-remission definition in predicting GRO, despite expected worse prediction of GFO, while potentially reducing the risk of overtreatment. This supports further exploration of 3V-remission as the target for immunosuppressive therapy complemented by patient-oriented targets.
Lenalidomide Acts As a Positive Immunomodulator through Modulating the Functions of Human Plasmacytoid Dendritic Cells
Authors: Tomoki Ito, Kayoko Kibata, Muneo Inaba, Yoshiko Azuma, Yukie Tsubokura, Hideaki Yoshimura, Masaaki Hotta, Takahisa Nakanishi, Shinya Fujita, Aya Nakaya, Atsushi Satake, Kazuyoshi Ishii, Shosaku Nomura
Journal: Blood (2017)
Persistence and decay of human antibody responses to the receptor binding domain of SARS-CoV-2 spike protein in COVID-19 patients
Authors: Anita S. Iyer, Forrest K. Jones, Ariana Nodoushani, Meagan Kelly, Margaret Becker, Damien Slater, Rachel Mills, Erica Teng, Mohammad Kamruzzaman, Wilfredo F. Garcia-Beltran, Michael Astudillo, Diane Yang, Tyler E. Miller, Elizabeth Oliver, Stephanie Fischinger, Caroline Atyeo, A. John Iafrate, Stephen B. Calderwood, Stephen A. Lauer, Jingyou Yu, Zhenfeng Li, Jared Feldman, Blake M. Hauser, Timothy M. Caradonna, John A. Branda, Sarah E. Turbett, Regina C. LaRocque, Guillaume Mellon, Dan H. Barouch, Aaron G. Schmidt, Andrew S. Azman, Galit Alter, Edward T Ryan, Jason B. Harris, Richelle C. Charles
Journal: Science Immunology (2020)

We measured plasma and/or serum antibody responses to the receptor-binding domain (RBD) of the spike (S) protein of SARS-CoV-2 in 343 North American patients infected with SARS-CoV-2 (of which 93% required hospitalization) up to 122 days after symptom onset and compared them to responses in 1548 individuals whose blood samples were obtained prior to the pandemic. After setting seropositivity thresholds for perfect specificity (100%), we estimated sensitivities of 95% for IgG, 90% for IgA, and 81% for IgM for detecting infected individuals between 15 and 28 days after symptom onset. While the median time to seroconversion was nearly 12 days across all three isotypes tested, IgA and IgM antibodies against RBD were short-lived with median times to seroreversion of 71 and 49 days after symptom onset. In contrast, anti-RBD IgG responses decayed slowly through 90 days with only 3 seropositive individuals seroreverting within this time period. IgG antibodies to SARS-CoV-2 RBD were strongly correlated with anti-S neutralizing antibody titers, which demonstrated little to no decrease over 75 days since symptom onset. We observed no cross-reactivity of the SARS-CoV-2 RBD-targeted antibodies with other widely circulating coronaviruses (HKU1, 229 E, OC43, NL63). These data suggest that RBD-targeted antibodies are excellent markers of previous and recent infection, that differential isotype measurements can help distinguish between recent and older infections, and that IgG responses persist over the first few months after infection and are highly correlated with neutralizing antibodies.
Implantable PEKK/tantalum microparticles composite with improved surface performances for regulating cell behaviors, promoting bone formation and osseointegration
Authors: Xinglong Hu, Shiqi Mei, Fan Wang, Jun Qian, Dong Xie, Jun Zhao, Lili Yang, Zhaoying Wu, Jie Wei
Journal: Bioactive Materials (2020)

Polyetherketoneketone (PEKK) exhibits admirable biocompatibility and mechanical performances but bioinert while tantalum (Ta) possesses excellent osteogenesis and osseointegration but high elastic modulus and density, and processing is too difficult and expensive. In the present study, combining of the advantages of both PEKK and Ta, implantable composites of PEKK/Ta were fabricated by blending PEKK with Ta microparticles of 20 v% (PT20) and 40 v% (PT40) content. In comparison with PT20 and PEKK, the surface hydrophilicity, surface energy, roughness and proteins adsorption as well as mechanical performances of PT40 significantly increased because of the higher Ta particles content in PEKK. Furthermore, PT40 exhibited the mechanical performances (e.g., compressive strength and modulus of elasticity) close to the cortical bone of human. Compared with PT20 and PEKK, PT40 with higher Ta content remarkably enhanced the responses (including adhesion, proliferation and osteogenic differentiation) of MC3T3-E1 cells in vitro. Moreover, PT40 markedly improved bone formation as well as osseointegration in vivo. In short, incorporation of Ta microparticles into PEKK created implantable composites with improved surface performances, which played key roles in stimulating cell responses/bone formation as well as promoting osseointegration. PT40 might have great potential for bear-loading bone substitute.
COVID-19 pandemic and its effect on the psychological status of cancer patients and oncologists
Authors: Gabriella Pravettoni
Journal: Clinical Cancer Research (2020)

On the 11th of March, the Word Health Organization declared COVID-19 a pandemic  This unprecedentedemergency caused some unexpected effects on the health care system  During the pandemic, the attention focusedon keeping cancer patients safe from COVID-19  This infection could have a detrimental effect on the physical andmental health of cancer patients;patients who have a suspension of cancer care suffer more from anxiety and/ordepression  One of the worst side effects of COVID-19 is the fact that family members could not visit patients;socialsupport in cancer patients is an important factor for a healthy mental condition  With no social support, their normalcoping strategies have to adapt and the feeling of helplessness is overwhelming  These aspects are highlighted by acase report of a European Institute of Oncology patient  After a surgical intervention due to oral tongue cancer, he was diagnosed with COVID-19 infection and this caused anxiety and depression symptoms  During the pandemic, health care professionals' (HCP) role has been pivotal: HCP had to cope with a stressful working environment, facing physical and psychological challenges  Oncologists, in particular, in their daily practice are at risk ofdeveloping burnout symptoms and post-traumatic stress disorder symptoms and this could be exacerbated by thepandemic  During pandemic phase 1, we evaluated emotional distress and mental health of oncologists all over theworld  Our results showed a low mental health status and distress regarding emotional status;oncologists revealedthat fear is one of the most diffuse emotions during pandemic  They are afraid for their patients during the hospitalhours, and, when they leave the hospital ward, they feel fear for their family members and cohabitants, in a never-ending feeling of dread  This condition, if prolonged, could be a stressor that could lead to burnout syndrome andpost-traumatic stress disorder  For these reasons, it is important to care for the oncologists who had cared for theirpatients, often prioritizing it over their own well-being  In these particular times, new technologies can help bothpatients and oncologists  In this complex scenario, the role of the oncologists becomes more and more important;new technologies' output must be interpreted and technologies have to be at the service of humans, not vice versa This should help oncologists to perform the integration of a big amount of diverse data otherwise impossible to puttogether meaningfully
Disparities in utilization of oral anticancer agents and related costs in elderly patients with metastatic renal cell carcinoma in the United States.
Authors: Lauren E Wilson, Lisa Spees, Jessica Pritchard, Melissa A. Greiner, Charles D. Scales, Chris Baggett, Deborah Kaye, Daniel J. George, Tian Zhang, Stephanie B. Wheeler, Michaela Ann Dinan
Journal: Journal of Clinical Oncology (2020)

106 Background: Although survival among patients with metastatic renal cell carcinoma (mRCC) has improved with the introduction of targeted therapies, substantial disparities in mRCC survival persist. The purpose of this study was to identify patient characteristics associated with differential adoption of emerging oral anticancer agents (OAAs) and related costs in the management of mRCC. Methods: SEER-Medicare patients diagnosed with mRCC aged 65 years or older from 2007-2015 continuously enrolled in Medicare Part D benefits for at least 1 year after diagnosis or until death were included. Associations between patient-level characteristics and OAA receipt were analyzed using univariable and multivariable log-binomal regression; associations between patient characteristics, OAA receipt, and total, cancer-specific, and OAA-specific costs in the 12 months following diagnosis were modeled as relative cost ratios using generalized linear regression with a gamma link. Reported costs were adjusted to 2015 dollars. Results: 2,792 patients with mRCC met inclusion criteria; 32.4% received an OAA in the 12 months following diagnosis. The majority of patients receiving an OAA used either sunitinib or pazopanib. Receipt increased slightly over the study period from 2007 (31% of patients) to 2015 (37%). In multivariable-adjusted models, patients of advanced age ( &gt; 80 years RR 0.50; 95% CI 0.42-0.60) or residing in the Southern US (RR 0.83 95% CI 0.70-0.98) were less likely to receive OAAs. Married patients were 20% more likely (RR 1.19; 95% CI 1.04-1.37) to receive OAAs. After multivariable adjustment, receipt of OAAs was associated with higher total and cancer-specific costs, as was Hispanic ethnicity. Among patients receiving an OAA, the cost of OAAs to Medicare increased approximately 7% per year (95% CI 4%-9%), while patient out-of-pocket spending for OAAs decreased approximately 10% per year (95% CI 7%-14%). Out-of-pocket OAA costs were consistently lower for Black, Hispanic, and Other patient race/ethnicity categories compared to the White Non-Hispanic category. Conclusions: Patient characteristics including age at metastatic diagnosis, marital status, geographic region, and certain comorbidities are related to the likelihood of receiving OAAs. Future research is warranted to investigate if such differences in OAA use lead to differences in survival.
Multiregion whole-exome sequencing of intraductal papillary mucinous neoplasms reveals frequent somatic <i>KLF4</i> mutations predominantly in low-grade regions
Authors: Kohei Fujikura, Waki Hosoda, Matthäus Felsenstein, Qianqian Song, Johannes G Reiter, Lily Zheng, Violeta Beleva Guthrie, Natalia Rincon, Marco Dal Molin, Jonathan Dudley, Joshua D Cohen, Pei Wang, Catherine G Fischer, Alicia M Braxton, Michaël Noë, Martine Jongepier, Carlos Fernández-del Castillo, Mari Mino-Kenudson, C Max Schmidt, Michele T Yip-Schneider, Rita T Lawlor, Roberto Salvia, Nicholas J Roberts, Elizabeth D Thompson, Rachel Karchin, Anne Marie Lennon, Yuchen Jiao, Laura D Wood
Journal: Gut (2020)

Intraductal papillary mucinous neoplasms (IPMNs) are non-invasive precursor lesions that can progress to invasive pancreatic cancer and are classified as low-grade or high-grade based on the morphology of the neoplastic epithelium. We aimed to compare genetic alterations in low-grade and high-grade regions of the same IPMN in order to identify molecular alterations underlying neoplastic progression.We performed multiregion whole exome sequencing on tissue samples from 17 IPMNs with both low-grade and high-grade dysplasia (76 IPMN regions, including 49 from low-grade dysplasia and 27 from high-grade dysplasia). We reconstructed the phylogeny for each case, and we assessed mutations in a novel driver gene in an independent cohort of 63 IPMN cyst fluid samples.Our multiregion whole exome sequencing identified KLF4, a previously unreported genetic driver of IPMN tumorigenesis, with hotspot mutations in one of two codons identified in >50% of the analyzed IPMNs. Mutations in KLF4 were significantly more prevalent in low-grade regions in our sequenced cases. Phylogenetic analyses of whole exome sequencing data demonstrated diverse patterns of IPMN initiation and progression. Hotspot mutations in KLF4 were also identified in an independent cohort of IPMN cyst fluid samples, again with a significantly higher prevalence in low-grade IPMNs.Hotspot mutations in KLF4 occur at high prevalence in IPMNs. Unique among pancreatic driver genes, KLF4 mutations are enriched in low-grade IPMNs. These data highlight distinct molecular features of low-grade and high-grade dysplasia and suggest diverse pathways to high-grade dysplasia via the IPMN pathway.