tbuckley/cabot-search huggingface dataset:
Oncology consults in admitted cancer patients: The ways to reduce length of stay.
Authors: Bohdan Baralo, Muhammad Hanif, Archen Krupadev, Sabah Iqbal, Navyamani Kagita, Ruqqiya Mustaqeem, Neel S Patel, Monisha Panda, Eugene Jinkyu Choi, Rajesh Thirumaran
Journal: Journal of Clinical Oncology (2021)

e13516 Background: The cancer patients, while being admitted to the hospital often have an oncologist consult (OC) through the admission. The goal of the study is to assess, whether OC impact the length of stay (LOS) and to define the group of cancer patients in whom omitting the OC can decrease LOS. Methods: We reviewed 415 admissions of cancer patients from 1/1/2018 to 11/30/2020 to the both campuses of Mercy Catholic Medical Center. We included patients who are 18 years or older with confirmed malignancy. We excluded COVID positive, patients who died during admission, were transferred to tertiary care institutions, or were recommended hospice care, but decided to continue treatment despite poor prognosis. Patient with hematologic disorders were excluded as well. The LOS of stay in cancer patients with and without OC will be compared using two tailed unpaired t-test and Mann-Whitney test ( &lt; 20 admissions in each group, or one of the groups had a largely skewed data). Sub-analysis will be done accounting for Charlson score, spread of the disease and reason of admission (cancer vs non-cancer related). Statistical software Prism 9 will be used for analysis. Results: 290 admissions were selected using inclusion and exclusion criteria. Throughout all admission 234 admission had OC and mean LOS was 4.86 day compare to 4.23 in 56 patients, who did not have OC. Patients with non-cancer related (non-CR) admissions who had Charlson score ≤6 and no OC had shorter LOS (13 admission with median LOS 3 days) compared to those who had OC (11 admissions with LOS 7days), p 0.0462. Also, patient with non-CR admission and localized cancer tend have shorter LOS when no OC involved (15 admission with median LOS 6 days) compare to OC (16 admissions with median LOS 2.5 days), p 0.0365. No other significant difference in LOS were observed (Table). Conclusions: The cancer patients admitted for the reasons not related to their primary malignancy and who have either localized disease or Charlson score &lt; 6 have shorter length of stay when OC not done. The limitation of the current study is the small number of patients in analysis subgroups, as well as fact that patients who had OC may have more severe disease during admission, despite the fact that patient had same extend of disease and comorbidities. Study with larger number of admissions may be necessary to confirm findings of this study.[Table: see text]
Enhancing proteasomal processing improves survival for a peptide vaccine used to treat glioblastoma
Authors: Mario Fidanza, Puja Gupta, Anin Sayana, Varun Shanker, Svenja-Maria Pahlke, Brandon Vu, Fanny Krantz, Aruna Azameera, Nicollette Wong, Navya Anne, Yuanxuan Xia, Jiming Rong, Avani Anne, Stephen Skirboll, Michael Lim, Albert J. Wong
Journal: Science Translational Medicine (2021)

Increasing proteasomal processing efficiency by targeted modification of a peptide vaccine improves survival in a glioblastoma model.
Development of an aid to decision-making form (ADF) integrated into a major institutional program in oncology: A tool to support care goal identification.
Authors: Laurence Vigouret-Viant, Clemence Legoupil, Aurelie Bardet, Celine Laurent, Michel Ducreux, Sophie Laurent, Christine Mateus, Sarah Dauchy, François Blot
Journal: Journal of Clinical Oncology (2021)

e18646 Background: For cancer patients, life-threatening complications may be difficult to anticipate, leading to complex medical decision-making processes. Since 2015, the Gustave Roussy Cancer Center has implemented a major institutional program including a Decision-Aid Form (ADF), outlining the anticipation of appropriate care for patient in case of worsening evolution. Methods: Between January and May 2017, all patients transferred from Site 1 to Site 2 of the hospital were prospectively included. In this study, we assessed the acceptability of the ADF, its using and its impact on the patient’s becoming. Results: Out of 206 patients included, 89.3% had an ADF. The planned stratification of care was notified in practically all cases. Conversely, the involvement of the palliative care team was notified in only 29% of the ADF. The value of the WHO/ECOG Performance Status was limited, varying between physicians. Finally, the field “information for patients and relatives” was insufficiently completed. Although a possible transfer to Intensive Care Unit was initially proposed in two-thirds of the patients, the majority (76%) of the 35 patients experiencing an acute event received exclusive medical or palliative care. The level of therapeutic commitment suggested by the ADF was never upgraded, and often revised towards less aggressive care, and especially without excess mortality for the patients who were initially designated to be eligible for intensive care. Moreover, the patient's survival at 6 months seems to be correlated with the anticipated level of care recorded on the FAD (Log-rank P value &lt; 0,0001). Conclusions: The results of our study suggest that setting up a care stratification file in advance is possible in a French cultural setting and it could be helpful for clarifying prognosis assessment. To achieve complete acculturation, our extensive institutional program remains a cornerstone for the development of advance care planning. Since 2017, this program has widely spreaded ADF which is now integrated into the electronic medical record. Each physician can complete and modify the patient's ADF at any stage of the patient's disease course.
Characteristics of e-Cigarette Use Behaviors Among US Youth, 2020
Authors: Teresa W. Wang, Andrea S. Gentzke, Linda J. Neff, Emily V. Glidden, Ahmed Jamal, Eunice Park-Lee, Chunfeng Ren, Karen A. Cullen, Brian A. King, Karen A. Hacker
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Comprehensive surveillance of e-cigarette use behaviors among youth is important for informing strategies to address this public health epidemic. <h3>Objective</h3> To characterize e-cigarette use behaviors among US youth in 2020. <h3>Design, Setting, and Participants</h3> The 2020 National Youth Tobacco Survey, a nationally representative, cross-sectional, school-based survey of middle school (grades 6-8) and high school (grades 9-12) students, was conducted from January 16, 2020, to March 16, 2020. A total of 14 531 students from 180 schools participated in the 2020 survey, yielding a corresponding student-level participation rate of 87.4% and school-level participation rate of 49.9%. The overall response rate, a product of the school-level and student-level participation rates, was 43.6%. <h3>Exposures</h3> Current (past 30-day) e-cigarette use. <h3>Main Outcomes and Measures</h3> Self-reported current e-cigarette use behaviors (frequency of use, usual e-cigarette brand, and access source) by school level and flavored e-cigarette use and flavor types among current e-cigarette users by school level and device type. Prevalence estimates were weighted to account for the complex survey design. <h3>Results</h3> Overall, 14 531 students completed the survey, including 7330 female students and 7133 male students with self-reported grade level and sex. In 2020, 19.6% (95% CI, 17.2%-22.2%) of high school students and 4.7% (95% CI, 3.6%-6.0%) of middle school students reported current e-cigarette use. Among them, 38.9% (95% CI, 35.2%-42.6%) of high school users and 20.0% (95% CI, 16.0%-24.8%) of middle school users reported e-cigarette use on 20 to 30 days within the past 30 days. Among current users, JUUL was the most commonly reported usual brand (high school: 25.4%; 95% CI, 18.8%-33.4%; middle school: 35.1%; 95% CI, 27.9%-43.1%). Among current users, the most common source of obtaining e-cigarettes was from a friend (high school: 57.1%; 95% CI, 52.6%-61.4%; middle school: 58.9%; 95% CI, 51.4%-66.1%). Among current users, 84.7% (95% CI, 82.2%-86.9%) of high school students and 73.9% (95% CI, 66.9%-79.8%) of middle school students reported flavored e-cigarette use. Fruit-flavored e-cigarettes were the most commonly reported flavor among current exclusive e-cigarette users of prefilled pods or cartridges (67.3%; 95% CI, 60.9%-73.0%), disposable e-cigarettes (85.8%; 95% CI, 79.8%-90.3%), and tank-based devices (82.7%; 95% CI, 68.9%-91.1%), followed by mint-flavored e-cigarettes. <h3>Conclusions and Relevance</h3> These results suggest that although current e-cigarette use decreased during 2019 to 2020, overall prevalence, frequent use, and flavored e-cigarette use remained high. Continued actions are warranted to prevent and reduce e-cigarette use among US youth.
Impact of a deep learning model to reduce variation and costs of federally mandated breast density legislation.
Authors: Katherine Cavallo Hom, Brian Nicholas Dontchos, Sarah Mercaldo, Pragya Dang, Leslie Lamb, Constance Dobbins Lehman
Journal: Journal of Clinical Oncology (2021)

1550 Background: Dense breast tissue is an independent risk factor for malignancy and can mask cancers on mammography. Yet, radiologist-assessed mammographic breast density is subjective and varies widely between and within radiologists. Our deep learning (DL) model was implemented into routine clinical practice at an academic breast imaging center and was externally validated at a separate community practice, with both sites demonstrating high clinical acceptance of the model’s density predictions. The aim of this study is to demonstrate the influence our DL model has on prospective radiologist density assessments in routine clinical practice. Methods: This IRB-approved, HIPAA-compliant retrospective study identified consecutive screening mammograms without exclusion performed across three clinical sites, over two time periods: pre-DL model implementation (January 1, 2017 through September 30, 2017) and post-DL model implementation (January 1, 2019 through September 30, 2019). Clinical sites were as follows: Site A (the academic practice where the DL model was developed and was implemented in late 2017); Site B (an affiliated community practice which implemented the DL model in late 2017 and was used for external validation); and Site C (an affiliated community practice which was never exposed to the DL model). Patient demographics and radiologist-assessed mammographic breast densities were compared over time and across sites. Patient characteristics were evaluated using Wilcoxon test and Pearson’s chi-squared test. Multivariable logistic regression models evaluated the odds of a dense breast classification as a function of time period (pre-DL vs post-DL), race (White vs non-White) and site. Results: A total of 85,865 consecutive screening mammograms across the three clinical sites were identified. After controlling for age and race, adjusted odds ratios (aOR) of a mammogram being classified as dense at Site C compared to Site B before the DL model was implemented was 2.01 (95% CI 1.873, 2.157, p&lt;0.001). This increased to 2.827 (95% CI 2.636, 3.032, p&lt; 0.001) after DL implementation. The aOR of a mammogram being classified as dense at Site A after implementation compared to before implementation was 0.924 (95% CI 0.885, 0.964, p&lt;0.001). Conclusions: Our findings suggest implementation of the DL model influences radiologist’s prospective density assessments in routine clinical practice by reducing the odds of a screening exam being categorized as dense. As a result, clinical use of our model could reduce downstream costs of supplemental screening tests and limit unnecessary high-risk clinic evaluations.[Table: see text]
Immune-related histologic phenotype in pretreatment tumor biopsy predicts pathologic response to neoadjuvant anti-PD-1 treatment in squamous lung cancer.
Authors: Pei Yuan, Changyuan Guo, Lin Li, Yun Ling, Lei Guo, Junling Li, Jianming Ying
Journal: Journal of Clinical Oncology (2021)

e20540 Background: The neoadjuvant platform affords a rich and valuable resource for understanding the responses to therapy and carrying out reverse translation, including pathologic morphology. We aimed to develop a pretreatment histologic scoring system reflecting the preexisting immune response to predict the efficacy of neoadjuvant immunotherapy based on the morphological changes we mastered in the pathologic assessment after neoadjuvant immunotherapy. Methods: Surgical specimens from the 31 squamous cell lung cancer patients recruited in a phase Ib study of neoadjuvant anti-PD-1 therapy and eligible paired pretreatment biopsies from 15 of them were included in this study. The posttreatment surgical specimens were assessed according to the immune-related pathologic response criteria. Immune-related histologic phenotype assessment criteria (irHPC) were developed based on the pathologic features identified after neoadjuvant anti-PD-1 treatment. Three pathologists trained for irHPC independently scored the HE slides of the 15 pretreatment tumor biopsies according to irHPC. Results: Whether necrosis was included in the calculation of percent of residual viable tumor (%RVT) or not had almost no effect on the consistency of pathologic assessment ( P= 0.811) and the histological response grouping. The inter-pathologist variability of assessing %RVT with immune-activated phenotype was not statistically significant ( P= 0.480). Four immune-related features of pretreatment biopsies were included for calculating the predictive score, including three positive features (tumor-infiltrating lymphocytes, tumor-infiltrating eosinophils and dense plasma cells in stroma) and one negative feature (tumor-infiltrating neutrophils) according to the developed irHPC scoring system. The trained pathologist accurately predicted 6 out of 8 patients in the cPR/MPR group and 5 out of 7 patients in the non-cPR/MPR group according to irHPC. For inter-observer reproducibility using “2 points” as the cut-off point, the overall percent agreement (OPA) was 77.8%. The reliability between pathologists for a binary tumor evaluation showed “moderate” agreement (κ = 0.54). Conclusions: The irHPC scoring system reflecting the preexisting immune response could be used to predict the pathologic response of neoadjuvant immunotherapy, but still needs the larger trails to verify.
Phase II trial of the IDO pathway inhibitor indoximod plus pembrolizumab for the treatment of patients with advanced melanoma
Authors: Yousef Zakharia, Robert R McWilliams, Olivier Rixe, Joseph Drabick, Montaser F Shaheen, Kenneth F Grossmann, Ravindra Kolhe, Rafal Pacholczyk, Ramses Sadek, Lucinda L Tennant, Christopher M Smith, Eugene P Kennedy, Charles J Link Jr, Nicholas N Vahanian, Jiayi Yu, Steven S Shen, Erik L Brincks, Gabriela R Rossi, David Munn, Mohammed Milhem
Journal: Journal for ImmunoTherapy of Cancer (2021)

Background The indoleamine 2,3-dioxygenase (IDO) pathway is a key counter-regulatory mechanism that, in cancer, is exploited by tumors to evade antitumor immunity. Indoximod is a small-molecule IDO pathway inhibitor that reverses the immunosuppressive effects of low tryptophan (Trp) and high kynurenine (Kyn) that result from IDO activity. In this study, indoximod was used in combination with a checkpoint inhibitor (CPI) pembrolizumab for the treatment for advanced melanoma. Methods Patients with advanced melanoma were enrolled in a single-arm phase II clinical trial evaluating the addition of indoximod to standard of care CPI approved for melanoma. Investigators administered their choice of CPI including pembrolizumab (P), nivolumab (N), or ipilimumab (I). Indoximod was administered continuously (1200 mg orally two times per day), with concurrent CPI dosed per US Food and Drug Administration (FDA)-approved label. Results Between July 2014 and July 2017, 131 patients were enrolled. (P) was used more frequently (n=114, 87%) per investigator’s choice. The efficacy evaluable population consisted of 89 patients from the phase II cohort with non-ocular melanoma who received indoximod combined with (P). The objective response rate (ORR) for the evaluable population was 51% with confirmed complete response of 20% and disease control rate of 70%. Median progression-free survival was 12.4 months (95% CI 6.4 to 24.9). The ORR for Programmed Death-Ligand 1 (PD-L1)-positive patients was 70% compared with 46% for PD-L1-negative patients. The combination was well tolerated, and side effects were similar to what was expected from single agent (P). Conclusion In this study, the combination of indoximod and (P) was well tolerated and showed antitumor efficacy that is worth further evaluation in selected patients with advanced melanoma.
Abstract 16465: Empiric Substrate Ablation in Patients With Right Atrial Myopathies is Safe and Effective for Elimination of Unmappable Atrial Arrhythmias
Authors: Alexis Z Tumolo, Amneet Sandhu, Jehu S Mathew, Ryan T Borne, Matthew M Zipse, Joseph D Kay, Amber D Khanna, William H Sauer, Duy T Nguyen
Journal: Circulation (2017)

Introduction: Unmappable atrial tachyarrhythmias (ATs) in patients with right atrial myopathies (RAM), including those with congenital heart disease, pulmonary hypertension, and others, can be chal...
Abstract 88: Changes in Chest Compression Force Required to Achieve Adequate Compression Depth Throughout a Cardiac Arrest Resuscitation Event
Authors: Elizabeth Retzer, Joar Eilevstjønn, Trevor C Yuen, Noah J Swann, Deborah Walsh, Terry L Vanden Hoek, Dana P Edelson
Journal: Circulation (2010)

Background: A recent study demonstrated decreases in compression depth over time suggesting rescuer performance decay, but remodeling of the chest secondary to compressions has not been excluded as...
TRG as indicator of efficacy of FLOT versus FOLFOX in perioperative chemotherapy for resectable gastric cancer patients (single institution experience).
Authors: Natalia P. Beliak, Rashida Orlova, Svetlana Kutukova, Natalia V. Zhukova, Pavel Balashov, Nazif Usmanov
Journal: Journal of Clinical Oncology (2021)

e16061 Background: Based on results German FLOT-4 study, the FLOT regimen could be considered the new standard chemotherapy regimen for perioperative strategy of resectable GC. Since more and more patients have received neoadjuvant treatment,the efficacy and side effect must be weighted before performing NACT. Two-drug regimens were preferred according to the NCCN guidelines in principle because of their lower toxicity. And three-drug regimens may be applied in medically fit patients with access to frequent evaluation during treatment, to ensure that they can still tolerate surgery after NACT. Methods: We analyzed the data of 79 patients with resectable locally advanced gastric cancer who received the FLOT or FOLFOX regimen as NACT. The group of patients with NAСT FLOT included 44 patients, including 32 men, 12 women. Age in the first group varied from 28 to 80 years, the median age was 59.0 (95% CI 54.1-62.0) The group of patients with the FOLFOX chemotherapy regimen included 35: 17 (48.6%) men and 18 women (51.4%). Age in the second group varied from 60 to 75 years, the median age in the second group was 67.5 (95% CI 62.2-71.0). The second group included significantly older patients U = 137.0; p = 0.0001. Results: The severity of drug pathomorphosis was assessed in a standard way according to the Mandard system, in the first group there were 5 patients - TRG1 (11.4%), 7 patients - TRG2 (15.9%), 9 patients - TRG3 (20.5%), 15 patients TRG4 (34.0%), 5 patients - TRG5 (11.4%), 3 patients it was not evaluated (6.8%). In the second group, 6 patients - TRG1 (17.1%), 2 patients - TRG2 (5.7%), 2 patients - TRG3 (5.7%), 16 patients - TRG4 (45.8 %), 7 patients - TRG5 (20.0%), for 2 patients it was not evaluated (5.7%). Complete pathomorphosis was not statistically different in both groups (p = 0.47). TRG 2 was not statistically different (p = 0.16). The number of registered cases of TRG3 in the first group exceeded (p = 0.06). The frequency of TRG4 and TRG 5 did not differ (p = 0.29). Major pathological regression (TRG1 + TRG2) was 27.3% in the first group and 22.8% (p = 0.65). A decrease in the stage in the first group occurred in 22 patients (50.0%), and in the second group - in 19 patients (54.3%), p = 0.70. yp≤ T2 was diagnosed in 21 out of 79 patients (26.6%), in the first group in 11 patients (25%), in the second group in 10 (28.6%), p = 0.72. Conclusions: the FOLFOX regimen showed similar efficacy in the tumor response grade rate compared to the FLOT regimen, therefore, these two regimes are interchangeable, especially among patients of the older age group or in patients with high risks of a four-component regimen.
A microRNA expression and regulatory element activity atlas of the mouse immune system
Authors: Samuel A. Rose, Aleksandra Wroblewska, Maxime Dhainaut, Hideyuki Yoshida, Jonathan M. Shaffer, Anela Bektesevic, Benjamin Ben-Zvi, Andrew Rhoads, Edy Y. Kim, Bingfei Yu, Yonit Lavin, Miriam Merad, Jason D. Buenrostro, Brian D. Brown, Oscar Aguilar, Rhys Allan, Janice Arakawa-Hoyt, Jilian Astarita, K. Frank Austen, Nora Barrett, Alev Baysoy, Christophe Benoist, Matthew Buechler, Jason Buenrostro, Maria Acebes Casanova, Kyunghee Choi, Kaitavjeet Chowdhary, Marco Colonna, Ty Crowl, Tianda Deng, Jigar V. Desai, Fiona Desland, Jiarui Ding, Claudia Dominguez, Daniel Dwyer, Michela Frascoli, Shani Gal-Oz, Ananda Goldrath, Ricardo Grieshaber-Bouyer, Baosen Jia, Tim Johanson, Stefan Jordan, Joonsoo Kang, Varun Kapoor, Ephraim Kenigsberg, Joel Kim, Ki wook Kim, Evgeny Kiner, Mitchell Kronenberg, Lewis Lanier, Catherine Laplace, Caleb Lareau, Andrew Leader, Jisu Lee, Assaf Magen, Barbara Maier, Alexandra Maslova, Diane Mathis, Adelle McFarland, Etienne Meunier, Paul Monach, Sara Mostafavi, Soren Muller, Christoph Muus, Hadas Ner-Gaon, Quyhn Nguyen, Peter A. Nigrovic, Kouta Niizuma, German Novakovsky, Stephen Nutt, Kayla Omilusik, Adriana Ortiz-Lopez, Mallory Paynich, Vincent Peng, Marc Potempa, Rachana Pradhan, Sara Quon, Ricardo Ramirez, Deepshika Ramanan, Gwendalyn Randolph, Aviv Regev, Kumba Seddu, Tal Shay, Avishai Shemesh, Justin Shyer, Christopher Smilie, Nick Spidale, Ayshwarya Subramanian, Katelyn Sylvia, Julie Tellier, Shannon Turley, Brinda Vijaykumar, Amy Wagers, Chendi Wang, Peter L. Wang, Liang Yang, Aldrin Yim
Journal: Nature Immunology (2021)
Uptake of oxidized lipids by the scavenger receptor CD36 promotes lipid peroxidation and dysfunction in CD8+ T cells in tumors
Authors: Shihao Xu, Omkar Chaudhary, Patricia Rodríguez-Morales, Xiaoli Sun, Dan Chen, Roberta Zappasodi, Ziyan Xu, Antonio F.M. Pinto, April Williams, Isabell Schulze, Yagmur Farsakoglu, Siva Karthik Varanasi, Jun Siong Low, Wenxi Tang, Haiping Wang, Bryan McDonald, Victoria Tripple, Michael Downes, Ronald M. Evans, Nada A. Abumrad, Taha Merghoub, Jedd D. Wolchok, Maxim N. Shokhirev, Ping-Chih Ho, Joseph L. Witztum, Brinda Emu, Guoliang Cui, Susan M. Kaech
Journal: Immunity (2021)