tbuckley/cabot-search huggingface dataset:
Robotic Inguinal vs Transabdominal Laparoscopic Inguinal Hernia Repair
Authors: Ajita S. Prabhu, Alfredo Carbonell, William Hope, Jeremy Warren, Rana Higgins, Brian Jacob, Jeffrey Blatnik, Ivy Haskins, Hemasat Alkhatib, Luciano Tastaldi, Aldo Fafaj, Chao Tu, Michael J. Rosen
Journal: JAMA Surgery (2020)

Despite rapid adoption of the robotic platform for inguinal hernia repair in the US, to date, no level I trials have ever compared robotic inguinal hernia repair to laparoscopic repair. This multicenter randomized clinical trial is the first to compare the robotic platform to laparoscopic approach for minimally invasive inguinal hernia repair.To determine whether the robotic approach to inguinal hernia repair results in improved postoperative outcomes compared with traditional laparoscopic inguinal hernia repairs.This multicenter, single-blinded, prospective randomized clinical pilot study was conducted from April 2016 to April 2019, with a follow-up duration of 30 days in 6 academic and academic-affiliated sites. Enrolled in this study were 113 patients with a unilateral primary or recurrent inguinal hernia. After exclusions 102 remained for analysis.Standard laparoscopic transabdominal preperitoneal repair or robotic transabdominal preperitoneal repair.Main outcomes included postoperative pain, health-related quality of life, mobility, wound morbidity, and cosmesis. Secondary outcomes included cost, surgeon ergonomics, and surgeon mental workload. A primary outcome was not selected because this study was designed as a pilot study. The hypothesis was formulated prior to data collection.A total of 102 patients were included in the study (54 in the laparoscopic group, mean [SD] age, 57.2 [13.3] years and 48 [88.9%] male; 48 in the robotic group, mean [SD] age, 56.1 [14.1] years and 44 [91.6%] male). There were no differences at the preoperative, 1-week, or 30-day points between the groups in terms of wound events, readmissions, pain as measured by the Visual Analog Scale, or quality of life as measured by the 36-Item Short Form Health Survey. Compared with traditional laparoscopic inguinal hernia repair, robotic transabdominal preperitoneal repair was associated with longer median (interquartile range) operative times (75.5 [59.0-93.8] minutes vs 40.5 [29.2-63.8] minutes, respectively; P < .001), higher median (interquartile range) cost ($3258 [$2568-$4118] vs $1421 [$1196-$1930], respectively; P < .001), and higher mean (SD) frustration levels on the NASA Task Load Index Scale (range, 1-100, with lower scores indicating lower cognitive workload) (32.7 [23.5] vs 20.1 [19.2], respectively; P = .004). There were no differences in ergonomics of the surgeons between the groups as measured by the Rapid Upper Limb Assessment instrument.Results of this study showed no clinical benefit to the robotic approach to straightforward inguinal hernia repair compared with the laparoscopic approach. The robotic approach incurred higher costs and more operative time compared with the laparoscopic approach, with added surgeon frustration and no ergonomic benefit to surgeons.ClinicalTrials.gov Identifier: NCT02816658.
Integrating patients’ values into decisions to enroll in phase I trials: A feasibility study.
Authors: Kristopher A Hendershot, Tehseen Dossul, Louise Wall, Taofeek Kunle Owonikoko, R Donald Harvey, Cheryl B Thomas, Jennifer B McCormick, Fadlo Raja Khuri, Rebecca D. Pentz
Journal: Journal of Clinical Oncology (2013)

e20608 Background: The American Society of Clinical Oncology recommends that physicians (MDs) assess the treatment goals and preferences of patients (pts) with advanced stage cancer. Available data, however, shows that pts’ values are not always well prioritized when making a treatment plan. Therefore, we iteratively developed a values tool containing 16 belief domains to inform MDs during conversations with their pts about the pts’ current priorities as they plan the next step in care. The purpose of this study was to determine the feasibility of using this values tool (defined as half of the tools having at least one value checked and half of the MDs discussing at least one value) in a phase I clinic setting. Methods: We audio-taped initial MD-pt conversations about potential enrollment in a phase I clinical trial at two academic medical centers (Emory and Mayo). The pts completed the values tool by selecting the 4 most important considerations for their next stage of care and were instructed to give the completed tool to the MD. The MDs were informed through the consent process but not specifically coached on use of the tool. The recorded conversations were coded using standard qualitative methodology to determine if a value from the tool was discussed. Results: There were 23 recorded encounters. All of the completed tools had at least one value checked and 19 of 23 (83%) completed tools were delivered to the MDs by the pts, as instructed. Of those who received the tool, 12 (63%) MDs discussed one or more of the values. The average satisfaction scores on a 5-point Likert scale were 3.9, 4.0, and 4.0, respectively, for tool clarity, ease of understanding, and benefit for pts who are offered a phase 1 trial (22/23 pts completed the evaluation). Average satisfaction scores from the 19 MDs who completed evaluations were 4.2 and 4.6, respectively, for influence of the tool on their treatment recommendation and accurate reflection of pts’ desires. Conclusions: The study met the predefined feasibility threshold and provides a strong rationale for future efficacy testing, including coaching of MDs. The tool was well accepted by both MDs and pts, and failure to deliver the completed tool by the pt was identified as a potential barrier to its effectiveness.
A MULTIDISCIPLINARY APPROACH TO REDUCING BLEEDING COMPLICATIONS IN THE CATH LAB OF AN ACADEMIC MEDICAL CENTER
Authors: Kellie Gumersell, Ashley Boltrek, Michael Davison, John Dervan, Brittany Kickel, Pamela Kostic, Yvonne Leippert, Kimberly O'Neill, Robert Pyo, Alison Rowe, Jay Thompson, Lisa Wilbert
Journal: Journal of the American College of Cardiology (2020)
TRANSIENT BOWEL ISCHEMIA FROM MIGRATION OF AN AXILLARY INTRA-AORTIC BALLOON PUMP
Authors: Kyla Lara-Breitinger, Andrew Rosenbaum, Stephanie El Hajj, Edwin Takahashi, Mohamad Adnan Alkhouli, Atta Behfar, Courtney Bennett
Journal: Journal of the American College of Cardiology (2020)
Microtransplantation in older patients with <scp>AML</scp>: A pilot study of safety, efficacy and immunologic effects
Authors: Anthony D. Sung, Shekeab Jauhari, Sharareh Siamakpour‐Reihani, Arati V. Rao, Janet Staats, Cliburn Chan, Everett Meyer, Vijayakrishna K. Gadi, Andrew B. Nixon, Jing Lyu, Jichun Xie, Lauren Bohannon, Zhiguo Li, Christopher S. Hourigan, Laura W. Dillon, Hong Yuen Wong, Rebecca Shelby, Louis Diehl, Carlos de Castro, Thomas LeBlanc, Danielle Brander, Harry Erba, Ahmed Galal, Alexandra Stefanovic, Nelson Chao, David A. Rizzieri
Journal: American Journal of Hematology (2020)

Abstract Older AML patients have low remission rates and poor survival outcomes with standard chemotherapy. Microtransplantation (MST) refers to infusion of allogeneic hematopoietic stem cells without substantial engraftment. MST has been shown to improve clinical outcomes compared with chemotherapy alone. This is the first trial reporting on broad correlative studies to define immunologic mechanisms of action of MST in older AML patients. Older patients with newly diagnosed AML were eligible for enrollment, receiving induction chemotherapy with cytarabine (100 mg/m2) on days 1‐7 and idarubicin (12 mg/m2) on days 1‐3 (7 + 3). MST was administered 24 hours later. Patients with complete response (CR) were eligible for consolidation with high dose cytarabine (HiDAC) and a second cycle of MST. Responses were evaluated according to standard criteria per NCCN. Immune correlative studies were performed. Sixteen patients were enrolled and received 7 + 3 and MST (median age 73 years). Nine (56%) had high‐risk and seven (44%) had standard‐risk cytogenetics. Ten episodes of CRS were observed. No cases of GVHD or treatment‐related mortality were reported. Event‐free survival (EFS) was 50% at 6 months and 19% at 1 year. Overall survival (OS) was 63% at 6 months and 44% at 1 year. Donor microchimerism was not detected. Longitudinal changes were noted in NGS, TCR sequencing, and cytokine assays. Addition of MST to induction and consolidation chemotherapy was well tolerated in older AML patients. Inferior survival outcomes in our study may be attributed to a higher proportion of very elderly patients with high‐risk features. Potential immunologic mechanisms of activity of MST include attenuation of inflammatory cytokines and emergence of tumor‐specific T cell clones.
APPROPRIATE USE CRITERIA FOR TRANSTHORACIC ECHOCARDIOGRAPHY AND PATIENT OUTCOMES IN VALVULAR HEART DISEASE
Authors: Jennifer Amadio, Zachary Bouck, Atul Sivaswamy, Cherry Chu, Gillian Nesbitt, Amer Johri, Kibar Yared, Jeremy Edwards, Mark Hansen, Paaladinesh Thavendiranathan, Jacob Udell, Harry Rakowski, Rory B. Weiner, Peter Austin, Sacha Bhatia
Journal: Journal of the American College of Cardiology (2020)
Fatigue, Cardiovascular Decline, and Events after Breast Cancer Treatment
Authors: Jennifer H. Jordan, PhD, MS, Ralph B. D’Agostino, Jr., PhD, Nancy E. Avis, PhD, Shannon L. Mihalko, PhD, Peter H. Brubaker, PhD, Dalane Kitzman, MD, Karen M. Winkfield, MD, PhD, Cynthia K. Suerkin, MS, Kerryn W. Reding, PhD, MPH, RN, Heidi D. Klepin, MD, MS, Glenn J. Lesser, MD, W. Gregory Hundley, MD
Journal: JACC CardioOncology (2020)

Although survival rates for stage I to III breast cancer have greatly increased, in part due to improved treatment options, this progress is threatened by increased cardiovascular (CV) events for survivors. More than 35% of women experience CV injury, left ventricular (LV) dysfunction, exercise
Adverse event profile by therapy cycle for vintafolide plus pegylated liposomal doxorubicin (PLD) versus PLD alone in platinum-resistant ovarian cancer.
Authors: James Thomas Symanowski, Elzbieta Kutarska, Mariusz Bidzinski, Binh Nguyen, Reshma A. Rangwala, R. Wendel Naumann
Journal: Journal of Clinical Oncology (2013)

5572 Background: Vintafolide (EC145), a folic acid/desacetylvinblastine conjugate, binds with high affinity to folate receptors expressed in epithelial ovarian cancers. This analysis evaluated the incidence of adverse events (AEs) by treatment cycle and as a percent of total treatment cycles administered in the PRECEDENT trial, a randomized open-label study of subjects with platinum-resistant ovarian cancer receiving either vintafolide+PLD or PLD alone. Methods: Women ≥18 years old with ECOG status 0-2 and exposure to ≤2 prior systemic cytotoxic regimens were randomized 2:1 to vintafolide (2.5 mg IV tiw, weeks 1 and 3, q28 days)+PLD (50 mg/m 2 IV day 1, q28 days) or PLD alone (same dose + schedule). AEs in the safety population (received at least 1 dose of study drug) were evaluated by cycle. Results: 157 patients received a total of 720 treatment cycles (518 vintafolide+PLD, 202 PLD alone). AEs (all grades, vintafolide+PLD vs PLD alone): 85.9% and 80.2% of cycles. Anemia, neutropenia, and thrombocytopenia were observed in 16.6% (vs 10.4% administered PLD alone), 19.1% (vs 10.4%), and 2.7% (vs 3.0%) of all cycles, respectively. Febrile neutropenia was observed in 0.2% (vs 0.5%) of cycles, respectively. Stomatitis and hand-foot syndrome (HFS) occurred in 16.6% (vs 22.8%) and 19.1% (vs 15.8%) of cycles, respectively. Peripheral sensory, motor, or sensorimotor neuropathy or polyneuropathy occurred in 10.1% (vs 2.5%) of cycles, and constipation and small intestinal obstruction/ileus were observed in 12.7% (vs 10.4%) and 2.9% (vs 4.0%) of cycles, respectively. Fatigue was similar between arms—15.8% of vintafolide+PLD vs 14.9% of PLD cycles. All AEs were noncumulative except for HFS, which for both arms increased in frequency through Cycle 6 compared with Cycles 1 and 2. Grade 3/4 AEs (vintafolide+PLD vs PLD alone): 29.3% vs 18.3% of cycles. Conclusions: After the number of treatment cycles was accounted for, anemia, neutropenia, and neuropathy were numerically greater in patients on vintafolide+PLD. Thrombocytopenia, constipation, small intestinal obstruction/ileus, fatigue, and HFS were similar. Stomatitis was numerically greater in patients administered PLD alone. Clinical trial information: NCT00722592.
The predictive value of baseline fluoro-deoxy-glucose positron emission tomography (FDG-PET) standardized uptake value (SUV) for overall survival in patients (pts) with locally advanced esophageal and gastroesophageal junction (GEJ) cancer
Authors: R. M. Abou-Jawde, L. Rybicki, B. Bybel, T. Rice, M. Carroll, T. Mekhail, G. Videtic, D. J. Adelstein
Journal: Journal of Clinical Oncology (2006)

4062 Background: The predictive value of FDG-PET SUV in pts with esophageal and GEJ cancer has been subject of recent interest. The heterogeneity of disease stages and treatments made interpretation of reported data difficult.We evaluated the value of baseline FDG-PET SUV in a homogeneous patient (pt) population treated in a uniform fashion. Methods: Retrospective analysis of 71 pts with stages II-IVa esophageal and GEJ cancer treated on 2 phase 2 trials at the Cleveland Clinic Foundation. Data was collected on baseline pt and tumor characteristics, baseline SUV uptake, and outcomes. Results: All pts were treated with preoperative concurrent fluorouracil/cisplatin chemoradiotherapy (CRT); 69 pts proceeded to esophagectomy and 58 pts received additional postoperative adjuvant CRT. Median pt age was 60 (range 33–75) years, 86% were male, 89% had adenocarcinoma, 35%, 41% and 24% had stage II, III and IVa disease respectively. Pts have been followed for a median of 14 (range 3–50) months. All pts underwent a baseline FDG-PET scan with a mean primary site SUV of 8.9 (range 0–28.2). Pathological response (complete or partial) was achieved after induction CRT in 54% and was more likely in those with a baseline primary site SUV ≥ 7.3 (OR: 3.95, 1.43–10.9, P=0.008). Recurrence developed in 33 pts (46.5%) with distant metastases identified in 31 of these 33. The Kaplan-Meier 2-year projected overall survival for all 71 pts is 58% with a median of 31 months. Mortality was less in pts with baseline SUV ≥ 5.0 (HR: 0.44, 0.20–0.94, P = 0.033). After adjusting for clinical stage at diagnosis, tumor location and histology, baseline SUV ≥ 5 was still predictive of improved survival in multivariate analysis (HR: 0.35, 0.15–0.85, P = 0.02). Conclusions: In this retrospective analysis, esophageal and GEJ cancer pts with a higher baseline primary site SUV were more likely to respond to induction CRT and had better overall survival. This observation suggests that the subset of pts with more metabolically active tumor may derive greater benefit from multimodality treatments that include CRT. A prospectively designed trial would be required to confirm this hypothesis. No significant financial relationships to disclose.
GEOGRAPHICAL VARIATION IMPACTS COST AND MODE OF TRANSPORT AMONG CARDIOGENIC SHOCK IN MEDICARE BENEFICIARIES, 2014-2017
Authors: Chau Truong, Randa Hamden, Trudy M. Krause, David Aguilar, Soumya Patnaik, Poyee Tung, Savitri E. Fedson, Vijay Nambi, Jaime Hernandez Montfort
Journal: Journal of the American College of Cardiology (2020)
Survival and prognostic factors in patients with epithelial ovarian cancer receiving paclitaxel and carboplatin as first-line chemotherapy in Japanese women: A multi-center retrospective study
Authors: H. Kajiyama, F. Kikkawa, M. Kawai, K. Mizuno, I. Kobayashi, Y. Kinoshita, K. Matsuzawa, N. Kamiya, T. Inoue, T. Sakakibara
Journal: Journal of Clinical Oncology (2006)

15022 Background: The aim of this retrospective study was to re-evaluate, multi-analytically, survival and prognostic factors of patients with epithelial ovarian cancer (EOC) receiving the combination of paclitaxel and carboplatin (PC). Methods: Between 1/00 and 12/04, a total of 335 cases with EOC of FIGO stage I-IV are registered in a multi-institutional series. All patients received cytoreductive surgery and combination chemotherapy of paclitaxel 180 mg/m 2 /3 hr and carboplatiion AUC = 5 for a total of 6 cycles. We retrospectively analyzed progression-free survival (PFS) and overall survival (OS) of these patients by stratification of assumable several prognostic factors and second-line regimen. Survival probabilities were estimated by Kaplan-Meier methods, and prognostic factors for survival were evaluated by a COX proportional hazard model. Results: Median age was 54 ± 11 years (range 9–81). The 3-, 4- and 5-year OS in patients was 67.0%, 53.9% and 50.6%, respectively. In a COX analysis, FIGO stage, histological type and residual tumor (2 cm &lt; vs. 2 cm &gt;; P = 0.0007, HR; 2.4, 95% CI = 1.4–4.0) were found to be independent significant factors for OS. The stratification analysis revealed that stage III-IV patients with clear cell and mucinous carcinoma have poorer prognosis than those with other histological types ( Table ). In contrast, no differences in histological grade (G1 vs. G2; P = 0.82, HR; 0.9, 95% CI = 0.5–1.6, G1 vs. G3; P = 0.65, HR; 0.9, 95% CI = 0.4–1.6) and kinds of second-line regimen were noticed for PFS and OS. Conclusions: Optimal surgical debulking, clinical stage, and histology appear to be important prognostic factors of survival in patients with EOC. This retrospective study suggests that PC may still have an impact on outcome. However, further strategy will be needed for improving survival of mucinous and clear-cell type EOC, especially with advanced stage. [Table: see text] No significant financial relationships to disclose.
Abstract 15615: Pulmonary Arterial Compliance Based on the Pulmonary Arterial Volume is a Noble Hemodynamic Parameter in Fontan Circulation
Authors: Jun Muneuchi, Mamie Watanabe, Yuichiro Sugitani, Naoki Kawaguchi, Ryouhei Matsuoka, Shunsuke Fujii, Yusuke Ando, Yoshie Ochiai
Journal: Circulation (2018)

Introduction: Both pulmonary arterial resistance (Rp) and compliance (Cp) are important to assess the pulmonary circulation in patients with single ventricle physiology. Hypothesis: We aim whether ...
Cytidine deaminase 2 is required for <i>VLRB</i> antibody gene assembly in lampreys
Authors: Ryo Morimoto, Connor P. O’Meara, Stephen J. Holland, Inês Trancoso, Ahmed Souissi, Michael Schorpp, Danièle Vassaux, Norimasa Iwanami, Orlando B. Giorgetti, Guillaume Evanno, Thomas Boehm
Journal: Science Immunology (2020)

The antibodies of jawless vertebrates consist of leucine-rich repeat arrays encoded by somatically assembled VLRB genes. It is unknown how the incomplete germline VLRB loci are converted into functional antibody genes during B lymphocyte development in lampreys. In Lampetra planeri larvae lacking the cytidine deaminase CDA2 gene, VLRB assembly fails, whereas the T lineage-associated VLRA and VLRC antigen receptor gene assemblies occur normally. Thus, CDA2 acts in a B cell lineage-specific fashion to support the somatic diversification of VLRB antibody genes. CDA2 is closely related to activation-induced cytidine deaminase (AID), which is essential for the elaboration of immunoglobulin gene repertoires in jawed vertebrates. Our results thus identify a convergent mechanism of antigen receptor gene assembly and diversification that independently evolved in the two sister branches of vertebrates.
Racial disparities and survival with non-small lung cancer (NSCLC) at an urban safety net hospital.
Authors: David J. Ernst
Journal: Journal of Clinical Oncology (2013)

e19102 Background: Disparities in cancer outcomes have been documented for many tumor types. This study aims to investigate the influence of race on clinical presentation, treatment and outcome of non-small cell lung cancer at a safety net hospital. Methods: A retrospective review of all patients with NSCLC diagnosed at an urban safety net hospital was done. Demographic data, diagnostic approach, primary therapy, and survival were analyzed. Results: There were 359 patients with NSCLC who met study inclusion criteria. There were 179 Caucasian, 177 African American, and 3 Asian patients. Nearly half of all patients had metastatic disease at the time of diagnosis (Stage I 15%, Stage II 5%, Stage III 28%, and Stage IV 49%). Treatment varied by disease stage, but not by race, 35.2% Caucasians and 39.5% African Americans were treated with radiation, 42.5% Caucasians and 44.6% African Americans were treated with chemotherapy, and 26.3% Caucasians and 20.9% African Americans were treated with surgery. Median survival was very short and again, did not vary by race: for Caucasians diagnosed with any stage of NSCLC was 6.439 months, whereas in African Americans it was 7.852 months. Conclusions: In a safety net hospital setting, there were no disparities in treatment based on race and median survival in this study was uniformly poor. Significant comorbidity was likely and will be investigated further.
Predicting ultrahigh risk multiple myeloma by molecular profiling: an analysis of newly diagnosed transplant eligible myeloma XI trial patients
Authors: Vallari Shah, Amy L. Sherborne, David C. Johnson, Sidra Ellis, Amy Price, Farzana Chowdhury, Jack Kendall, Matthew W. Jenner, Mark T. Drayson, Roger G. Owen, Walter M. Gregory, Gareth J. Morgan, Faith E. Davies, Gordon Cook, David A. Cairns, Richard S. Houlston, Graham Jackson, Martin F. Kaiser
Journal: Leukemia (2020)

The prognosis for newly diagnosed multiple myeloma (NDMM) has improved with the advent of new agents, but outcome in some patients remains very poor.Identifying patients with high-risk disease early opens up the prospect of stratified treatment [1][2][3].Biomarkers including chromosomal aberrations t(4;14), t(14;16), and t(14;20) translocations, gain of 1q and deletion of 17p, detected by fluorescence in situ hybridization (FISH) or multiplex ligation-dependent probe amplification (MLPA) and qRT-PCR-based translocation detection, have been associated with adverse outcome and co-occurrence of ≥2 such aberrations (a double-hit) is predictive of especially aggressive MM [4,5].Multiple gene expression profiles (GEP) have been reported to be associated with outcome, but so far only EMC92 and UAMS GEP70 have been developed into validated clinical tests, marketed as SKY92 MMprofiler and MyPRS, respectively [6][7][8][9].To examine the combined predictive value of high-risk chromosomal abnormalities and SKY92 risk GEP we studied 329 NDMM patients from the NCRI Myeloma XI trial (ISRCTN49407852) who received intensive therapy (Supplementary Table 1) and validated findings in Medical Research Council (MRC) Myeloma IX trial patients (Supplementary Methods) [10,11].In both cohorts of patients purified (>95%) CD138-positive tumor cells were immunomagnetically selected and DNA and RNA were extracted using QIAGEN (Hilden, Germany) Allprep kits.Chromosomal aberrations, including high-risk lesions t(4;14), t(14;16), t(14;20), gain(1q), and del(17p), were assessed using qRT-PCR (Thermo Fisher, Darford, UK) and MLPA (MRC Holland, Amsterdam, The Netherlands), as previously reported (Supplementary Methods) [4].GEP risk status was determined on a diagnostic Affymetrix GeneChip 3000 Dx v2.0 system (Thermo Fisher) using the SKY92 MMProfiler (SkylineDx, Rotterdam, The Netherlands) (Supplementary Methods).
What are the appropriate axioms of rationality for reasoning under uncertainty with resource-constrained systems?
Authors: Harald Atmanspacher, Irina Basieva, Jerome R. Busemeyer, Andrei Y. Khrennikov, Emmanuel M. Pothos, Richard M. Shiffrin, Zheng Wang
Journal: Behavioral and Brain Sciences (2020)

Abstract When constrained by limited resources, how do we choose axioms of rationality? The target article relies on Bayesian reasoning that encounter serious tractability problems. We propose another axiomatic foundation: quantum probability theory, which provides for less complex and more comprehensive descriptions. More generally, defining rationality in terms of axiomatic systems misses a key issue: rationality must be defined by humans facing vague information.