tbuckley/cabot-search huggingface dataset:
Abstract 20053: Strong Regenerative Potential of Autologous Vascularized Matrix for Atrial Patch Replacement
Authors: Serghei Cebotari, Igor Tudorache, Sawa Kostin, Matthias Karck, Tanja Meyer, Omke Teebken, Christine Fegbeutel, Christoph Bara, Samir Sarikouch, Andres Hilfiker, Axel Haverich
Journal: Circulation (2014)

Background:  Several patch materials are used to replace diseased cardiac tissue segments. Most of these conduits represent either non-viable materials or bio-artificial grafts with high susceptibility to infection, tissue degeneration and calcification. Hereby, we present our experience of using autologous vascularized matrix (AutoVaM) as a viable graft for myocardial tissue repair.   Methods and Results:  AutoVaM patches based on small bowel segments without mucosa with adjacent jejunal artery and vein were used for the replacement of right atrial (RA) defects (2x3 cm) in pigs (n=6).  The AutoVaMs were revascularized by connecting jejunal vessels to the right internal thoracic artery and vein. Intraoperative angiography revealed regular blood perfusion of the patches. Autologous pericardium grafts were used as controls (N=6). Complications such as bleeding, graft rupture or dislodgement did not occur. Histological investigations (up to 6 months) by using Nkx 2.5 and myosin heavy chain revealed newly formed cardiomyocytes inside of AutoVaM explants mostly localized in a disseminated pattern in close proximity to mesenteric capillaries. With increasing time these cells showed strong tendency to form islets and to communicate with each other via Connexin 43 containing gap-junctions. In contrast, pericardial patches appeared as a fibrotic tissue with no evidence of myocytes inside the patch.  Based on these experimental results, 2 patients, one with myocardial sarcoma and one with thymus-carcinoma with atrial involvement underwent subtotal resection of the RA. Resulting defects were grafted using AutoVaM. No signs of thromboembolic complications or endocarditis were observed. Follow-up angiography revealed patent jejunal vessels and permeable capillary bed of the cardiac neo-chamber. Transesophageal Echocardiography (TEE) revealed systolic and diastolic motion of the graft along with the left atrium during the cardiac cycle. In one patient 2 years follow-up TEE showed an RA ejection fraction of 25%.   Conclusion:  RA replacement with vascularized intestinal graft is more superior then pericardium in terms of higher regenerative potential by repopulation with cardiomyocytes. The procedure is clinically safe and promising.
Can acute care utilization be reduced by a risk score-based intervention alone?
Authors: Valerie Pracilio Csik, Adam F Binder, Nathan Handley, Michael Li, Megan Croyle, Lauren Waldman, Brooke Worster
Journal: Journal of Clinical Oncology (2021)

e13523 Background: Acute care utilization (ACU), encompassing both emergency department visits and hospitalizations, is common in patients with cancer, with nearly three quarters of patients with advanced disease hospitalized at least once in the year after their diagnosis. From a population health perspective, focusing on the highest risk patients is likely to identify the top 5% while the next 30% can be considered rising risk and are likely to need care management support. Many risk scoring systems have been developed, but few have demonstrated effective integration in clinical practice. We sought to evaluate if a risk assessment tool alone was adequate to determine an appropriate patient outreach strategy that results in reduced ACU. Methods: We utilized the REDUCE score (Reducing ED Utilization in the Cancer Experience - see 2020 ASCO Quality Abstract 208) to develop an intervention conducted in two phases. Phase I included a chart review and targeted outreach to high risk patients identified by REDUCE by a nurse navigator. Outreach resulted in communication of patient needs to the care team. Phase II involved initial identification by REDUCE followed by further screening assessment with a distress screen. Those who were high risk and had high distress (score ≥4) were discussed by an interdisciplinary team (supportive medicine physicians, social work, nurses, nurse practitioners) to determine an intervention. Results: Of the patients in phase I (N = 138), 26.1% had ACU afterward, while in phase II (N = 169) 7.1% had ACU. The average distress score among all patients in the phase II group was 6.0 and the REDUCE score was 2.87, while the subset of patients who experienced ACU had an average distress score of 6.4 and a REDUCE score of 3.22. These findings indicate that there is a directional correlation between REDUCE score and distress screening results. Conclusions: The REDUCE score may be a valuable tool to assist in identifying patients at risk for ACU, but the significantly less ACU in phase II compared to phase I suggests that the risk score combined with a biopsychosocial screening, such as distress as required by the Commission on Cancer, may prove more valuable than the risk score alone. To identify the most impactful intervention, and to fully understand the implications of a patient’s specific REDUCE score within the high risk category, additional assessment would be beneficial. These preliminary results highlight that directionally correlated measures obtained from a biopsychosocial screening in combination with a risk score gives a more complete picture of patient’s overall risk of ACU.
Survival Among Acute Lymphocytic Leukemia Patients Conditional on Years Already Survived and Relative to the General Population in the United States
Authors: Raffi Tchekmedyian, Aziz Nazha, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Matt Kalaycio, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, Sudipto Mukherjee
Journal: Blood (2017)
Non-fatal self-injury after a diagnosis of cancer: A population-based study.
Authors: Christopher Noel, Antoine Eskander, Rinku Sutradhar, Alyson Mahar, Simone Vigod, Elie Isenberg-Grzeda, James Bolton, Julie Deleemans, Wing Chan, Victoria Zuk, Barbara Haas, Stephanie Mason, Natalie G. Coburn, Julie Hallet
Journal: Journal of Clinical Oncology (2021)

e18577 Background: Psychological distress is a key construct of patient-centred cancer care. While an increased risk of suicide for cancer patients has been reported, more frequent consequences of distress after a cancer diagnosis, such as non-fatal self-injury (NFSI), remain largely unknown. We examined the risk for NFSI after a cancer diagnosis. Methods: Using linked administrative databases we identified adults diagnosed with cancer between 2007-2019. Cumulative incidence of NFSI, defined as emergency department presentation of self-injury, was computed accounting for the competing-risk of death from all causes. Factors associated with NFSI were assessed using multivariable Fine and Gray models. Results: Of 806,910 included patients, 2,482 had NFSI and 182 died by suicide. 5-year cumulative incidence of NFSI was 0.27% [95%CI 0.25-0.28%]. After adjusting for key confounders, prior severe psychiatric illness whether requiring inpatient care (sub-distribution hazard ratio (sHR) 12.6, [95% CI 10.5-15.2]) or outpatient care (sHR 7.5, 95% CI 6.48-8.84), and prior self-injury (sHR 6.6 [95% CI 5.5-8.0]) were associated with increased risk of NFSI. Young adults (age 18-39) had the highest NFSI rates, relative to individuals &gt;70 (sHR 5.4, [95% CI 4.5-6.5]). The magnitude of association between prior severe psychiatric illness and NFSI was greatest for young adults (interaction term p &lt; 0.01). Certain cancer subsites were also at increased risk, including head and neck (sHR1.52, [95%CI 1.19-1.93]). Conclusions: Patients with cancer have higher incidence of NFSI than suicide after diagnosis. Younger age, prior severe psychiatric illness, and prior self-injury were independently associated with NFSI. These exposures act synergistically, placing young adults with a prior mental health history at greatest risk for NFSI events. Those factors should be used to identify at-risk patients for psycho-social assessment and intervention.
Cancer diagnosis and adverse financial events: Evidence from credit reports.
Authors: Veena Shankaran, Li Li, Catherine R. Fedorenko, Hayley Sanchez, Yuxian Du, Sara Khor, Karma L. Kreizenbeck, Scott David Ramsey
Journal: Journal of Clinical Oncology (2021)

6504 Background: Increasing evidence shows that cancer patients (pts) experience financial hardships after diagnosis. Few studies, however, have used objective financial data to estimate the relative risk of adverse financial events (AFEs) in cancer pts versus individuals without cancer. Using a retrospective case-control design, we investigated whether cancer pts are at increased risk of new AFEs, as measured by their credit reports. Methods: Western Washington Surveillance Epidemiology and End Results (SEER) cancer registry (cases) and voter registry (controls) records from 2013 to 2018 were linked to quarterly credit records from TransUnion (2012-2020), one of the 3 largest national credit agencies. Controls were age and sex matched to cases and assigned an index date corresponding to the diagnosis (dx) date of the matched case. Individuals with evidence of any AFE in the credit report closest to index/dx date or did not survive to 24 months were excluded. Cases and controls experiencing any of the following AFEs within 24 months were compared, using two-sample z tests: severe (3 rd party collections, charge-offs), more severe (tax liens, delinquent mortgage payments), and most severe (foreclosures, repossessions). Multivariate logistic regression models were used to evaluate the association between cancer dx and AFE, adjusting for age, sex, dx year, and available credit 6 months before the index/dx date. Results: A total of 332,825 individuals (84,185 cases and 248,640 controls, mean age 66 (SD 13), 52.7% female) were included. The mean available line of credit in the year before index/dx date was $12,303. AFEs were more common in cases versus controls (Table). After adjusting for age, sex, available credit above or below $12,303, and dx year, cancer dx was significantly associated with any AFE (OR 1.77, 95% CI 1.7-1.85, p&lt;0.0001), severe AFEs (OR 1.94, 95% CI 1.85-2.03, p&lt;0.0001), more severe AFEs (OR 1.23, 95% CI 1.12-1.36, p&lt;0.0001), and most severe AFEs (OR 1.46, 95% CI 1.16-1.86, p=0.0016). Age &gt;65 and higher available baseline credit were associated with decreased risk of any and each category of AFE. Conclusions: Within 24 months from dx, significantly higher proportions of cancer pts experienced AFEs relative to controls. Such events on credit reports have serious and long-lasting consequences on financial status. Studies that link clinical and financial data to investigate the impacts of these events on treatment decisions, quality of life, and clinical outcomes are needed.[Table: see text]
Impact of adding plinabulin to pegfilgrastim for the prevention of TAC chemotherapy (Chemo) induced neutropenia (CIN), on patient quality of life (QoL).
Authors: Ramon Mohanlal, Yvette Lelorier, Dominic Mitchell, Lan Huang, Douglas W. Blayney
Journal: Journal of Clinical Oncology (2021)

e24031 Background: Plinabulin is a novel non-G-CSF small molecule being developed for the prevention of chemotherapy in conjunction with pegfilgrastim and is administered via 30 min IV infusion, 30 min after chemo on Day (D) 1. The QoL was analyzed using the Functional Assessment of Cancer Therapy - General questionnaire (FACT-G) as part of a phase 3 (Ph3) clinical trial comparing pegfilgrastim alone versus pegfilgrastim and plinabulin for the prevention of neutropenia in newly diagnosed breast cancer patients being treated with Docetaxel (75 mg/m 2 ), Doxorubicin (50 mg/m 2 ), and Cyclophosphamide (500 mg/m 2 ) (TAC) on D1 for four 21 D cycles and study treatment. Methods: The FACT-G was administered to patients in China and Ukraine using an ePRO app downloaded onto patients' phones as part of the Phase 3 PROTECTIVE-2 trial (NCT0329457) with TAC. Patients completed the FACT-G during each chemo cycle at D-1, D1, D8 and D15. Patients received reminders 1 hour before the required completion time and all entries were time stamped. The FACT-G measured the impact of cancer on four categories: Physical wellbeing, Social wellbeing, Emotional wellbeing and Functional wellbeing. Results: Compared to pegfilgrastim alone, patients on plinabulin + pegfilgrastim performed significantly better for Physical wellbeing on D8 and D15 of Cycle 2 (p &lt; 0.0589 and p &lt; 0.0039 respectively) and Cycle 3 (p &lt; 0.0360 and p &lt; 0.0343 respectively). Further analysis of the sub questions showed that both energy levels “I have a lack of energy” and pain”(I have pain” were significantly better for the plinabulin + pegfilgrastim combination versus pegfilgrastim alone (p &lt; 0.0377 and p &lt; 0.0420 respectively). Overall FACT-G completion compliance for the trial was 91%. Conclusions: The Physical wellbeing (in particular, pain and for energy levels) of patients receiving plinabulin in combination with pegfilgrastim for the prevention of TAC CIN, was significantly less impacted by chemo dosing compared to the pegfilgrastim alone arm. In addition, the results suggest that patients receiving the combination therapy recovered their pre-chemo Physical wellbeing levels more rapidly. Clinical trial information: NCT03531099.
QuickStats: Age-Adjusted Death Rates* for Motor Vehicle Traffic Injury — United States, 2019
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

7 8.0-11.1 <8.0 DC Abbreviation: DC = District of Columbia.* Age-adjusted death rates (deaths per 100,000 standard population) were calculated using the direct method and the 2000 U.S. standard population.The 2019
Characteristics of neurotoxicity associated with idecabtagene vicleucel (ide-cel, bb2121) in patients with relapsed and refractory multiple myeloma (RRMM) in the pivotal phase II KarMMa study.
Authors: Salomon Manier, Ankit J. Kansagra, Larry D. Anderson, Jr, Jesus G. Berdeja, Sundar Jagannath, Yi Lin, Sagar Lonial, Nina Shah, Noopur S. Raje, David Samuel DiCapua Siegel, Albert Oriol, Anna Truppel-Hartmann, Everton Rowe, Payal Patel, Amit Agarwal, Timothy B. Campbell, Paula Rodríguez-Otero, Nikhil C. Munshi
Journal: Journal of Clinical Oncology (2021)

8036 Background: Ide-cel, a BCMA-directed CAR T cell therapy, showed promising efficacy in patients (pts) with RRMM in the KarMMa study with an ORR of 73% and a CRR of 33% across target doses of 150–450 × 10 6 CAR+ T cells (Munshi NC, et al. J Clin Oncol 2020;38[suppl 15]. Abstract 8503). Associations of neurotoxicity (NT) with pt and disease characteristics, pt management, and impact on outcomes in the KarMMa study are reported here. Methods: Enrolled pts were triple-class exposed and refractory to their last regimen, with ide-cel given at target doses of 150, 300, or 450 × 10 6 CAR+ T cells after lymphodepletion (NCT03361748). Investigator-identified NT events were captured under the single preferred term of neurotoxicity and graded according to NCI CTCAE v4.03. Events were managed with corticosteroids (CS), anakinra (ANR), and tocilizumab (Toci) as needed. Results: Of 128 pts treated with ide-cel, NT was reported in 23 (18%); 12 pts (9%) had maximum grade (gr) 1 NT, 7 (5%) had gr 2, and 4 (3%) had gr 3. No gr 4 or 5 NT occurred. Most baseline characteristics were similar in pts with and without NT, including stage III disease (22% and 15%), high-risk cytogenetics (39% and 34%), and extramedullary disease (35% and 40%); exceptions were high tumor burden (65% and 48%) and sex (48% and 62% men). NT (any gr/gr 3) occurred in 0%/0%, 17%/1%, and 20%/6% of pts at doses of 150, 300, and 450 × 10 6 CAR+ T cells. Median time to onset was similar regardless of gr, and there were no late-onset events (Table). NT was managed with CS in 10 pts (43%), Toci in 3 (13%), and ANR in 1 (4%). Median (range) time to first use of CS was 2 d (1–6). ORR and DOR were similar in pts with and without NT (Table). All NT occurred in the proximity of cytokine release syndrome (CRS) events with the start date of NT events either overlapping with or occurring within 1 wk of the start of a CRS event. Conclusions: NT occurred early in the KarMMa study, was generally of short duration, and was mostly gr 1/2 with no gr ≥4 events. All NT was proximal to CRS. Pts with NT had a favorable ORR after ide-cel treatment. These results continue to demonstrate the durable efficacy and tolerability of ide-cel in pts with RRMM. Clinical trial information: NCT03361748. [Table: see text]
Estimated Cardiorespiratory Hospitalizations Attributable to Influenza and Respiratory Syncytial Virus Among Long-term Care Facility Residents
Authors: Elliott Bosco, Robertus van Aalst, Kevin W. McConeghy, Joe Silva, Patience Moyo, Melissa N. Eliot, Ayman Chit, Stefan Gravenstein, Andrew R. Zullo
Journal: JAMA Network Open (2021)

Older adults residing in long-term care facilities (LTCFs) are at a high risk of being infected with respiratory viruses, such as influenza and respiratory syncytial virus (RSV). Although these infections commonly have many cardiorespiratory sequelae, the national burden of influenza- and RSV-attributable cardiorespiratory events remains unknown for the multimorbid and vulnerable LTCF population. To estimate the incidence of cardiorespiratory hospitalizations that were attributable to influenza and RSV among LTCF residents and to quantify the economic burden of these hospitalizations on the US health care system by estimating their associated cost and length of stay. This retrospective cohort study used national Medicare Provider Analysis and Review inpatient claims and Minimum Data Set clinical assessments for 6 respiratory seasons (2011-2017). Long-stay residents of LTCFs were identified as those living in the facility for at least 100 days (index date), aged 65 years or older, and with 6 months of continuous enrollment in Medicare Part A were included. Follow-up occurred from the resident's index date until the first hospitalization, discharge from the LTCF, disenrollment from Medicare, death, or the end of the study. Residents could re-enter the sample; thus, long-stay episodes of care were identified. Data analysis was performed between January 1 and September 30, 2020. Seasonal circulating pandemic 2009 influenza A(H1N1), human influenza A(H3N2), influenza B, and RSV. Cardiorespiratory hospitalizations (eg, asthma exacerbation, heart failure) were identified using primary diagnosis codes. Influenza- and RSV-attributable cardiorespiratory events were estimated using a negative binomial regression model adjusted for weekly circulating influenza and RSV testing data. Length of stay and costs of influenza- and RSV-attributable events were then estimated. The study population comprised 2 909 106 LTCF residents with 3 138 962 long-stay episodes and 5 079 872 person-years of follow-up. Overall, 10 939 (95% CI, 9413-12 464) influenza- and RSV-attributable cardiorespiratory events occurred, with an incidence of 215 (95% CI, 185-245) events per 100 000 person-years. The cost of influenza- and RSV-attributable cardiorespiratory events was $91 055 393 (95% CI, $77 885 316-$104 225 470), and the length of stay was 56 858 (95% CI, 48 757-64 968) days. This study found that many cardiorespiratory hospitalizations among LTCF residents in the US were attributable to seasonal influenza and RSV. To minimize the burden these events place on the health care system and residents of LTCFs and to prevent virus transmission, additional preventive measures should be implemented.
Polymeric Micro/Nanomotors and Their Biomedical Applications
Authors: Ziying Liang, Yingfeng Tu, Fei Peng
Journal: Advanced Healthcare Materials (2021)

Abstract Since their naissance in the 2000s, various micro or nanomotors with powerful functions have been proposed. Among them, polymer‐based micro or nanomotors stand out for the easy processing and facile functionalization, holding immense potential for bioapplications. In this review, fabrication of polymer‐based micro or nanomotors and their applications in biomedical areas are covered. Classic manufacturing approaches as well as cutting‐edge techniques are discussed with representative works highlighted. Current challenges and future prospects are presented in the hope of pointing new research directions to facilitate practical translations of micro/nanomotors.
Clinical-Pathologic Challenges in the Classification of Pulmonary Neuroendocrine Neoplasms and Targets on the Horizon for Future Clinical Practice
Authors: Jules L. Derks, Nicole Rijnsburger, Bregtje C.M. Hermans, Laura Moonen, Lisa M. Hillen, Jan H. von der Thüsen, Michael A. den Bakker, Robert J. van Suylen, Ernst-Jan M. Speel, Anne-Marie C. Dingemans
Journal: Journal of Thoracic Oncology (2021)

Diagnosing a pulmonary neuroendocrine neoplasm (NEN) may be difficult, challenging clinical decision making. In this review, the following key clinical and pathologic issues and informative molecular markers are being discussed: (1) What is the preferred outcome parameter for curatively resected low-grade NENs (carcinoid), for example, overall survival or recurrence-free interval? (2) Does the WHO classification combined with a Ki-67 proliferation index and molecular markers, such as OTP and CD44, offer improved prognostication in low-grade NENs? (3) What is the value of a typical versus atypical carcinoid diagnosis on a biopsy specimen in local and metastatic disease? Diagnosis is difficult in biopsy specimens and recent observations of an increased mitotic rate in metastatic carcinoid from typical to atypical and high-grade NEN can further complicate diagnosis. (4) What is the (ir)relevance of morphologically separating large cell neuroendocrine carcinoma (LCNEC) SCLC and the value of molecular markers (RB1 gene and pRb protein or transcription factors NEUROD1, ASCL1, POU2F3, or YAP1 [NAPY]) to predict systemic treatment outcome? (5) Are additional diagnostic criteria required to accurately separate LCNEC from NSCLC in biopsy specimens? Neuroendocrine morphology can be absent owing to limited sample size leading to missed LCNEC diagnoses. Evaluation of genomic studies on LCNEC and marker studies have identified that a combination of napsin A and neuroendocrine markers could be helpful. Hence, to improve clinical practice, we should consider to adjust our NEN classification incorporating prognostic and predictive markers applicable on biopsy specimens to inform a treatment outcome-driven classification.