tbuckley/cabot-search huggingface dataset:
Sixty seconds on . . . sex
Authors: Zosia Kmietowicz
Journal: BMJ (2021)

Research that’s just won the IgNobel prize for medicine has found that sex can clear the nose, perhaps confirming Freud’s thought that the nose and the genitals are connected and giving a whole new meaning to the expression “hanky panky.”1

You’re too late, the study has ended. Eighteen orgasmic heterosexual healthcare workers and their partners, one or both of whom had nasal …
Pathological Electromyogram (EMG) Signal Analysis Parameters
Authors: S. M. Debbal
Journal: Clinical Cardiology and Cardiovascular Interventions (2021)

Clinical analysis of the electromyogram is a powerful tool for diagnosis of neuromuscular diseases. There fore, the detection and the analysis of electromyogram signals has he attracted much attention over the years. Several methods based on modern signal Processing techniques such as temporal analysis, spectro-temporel analysis ..., have been investigated for electromyogram signal treatment. However, many of these analysis methods are not highly successful due to their complexity and non-stationarity. The aim of this study is to analyse the EMGs signals using nonlinear analysis. This analysis can provide a wide range of information’s related to the type of signal (normal and pathological).
Inpatient chemotherapy for patients with advanced solid tumors: A single-center observational study.
Authors: Tara Soumerai, Matthew Lei, Therese Marie Mulvey
Journal: Journal of Clinical Oncology (2021)

158 Background: We sought to identify a population of patients with advanced-stage solid tumor diagnoses for whom inpatient chemotherapy is appropriate. In so doing, we endeavor to define standards of practice in addressing prognostic awareness and goals of therapy prior to treatment. Methods: We identified 124 patients with Stage IV solid tumors who were given at least one dose of inpatient chemotherapy in 2019. We performed manual chart review to collect information on patient demographics, details of cancer diagnosis and chemotherapy regimen, and dates of admission, chemotherapy administration, discharge, readmission, and death. Results: Ninety-four percent of patients studied were admitted for cancer-related reasons. The 30-day mortality for patients with Stage IV cancer given inpatient chemotherapy was 20.2%, including 12 patients (9.7%) who died during the same admission. The 30-day readmission rate was 40.2%. Median overall survival and readmission-free survival were both 15 days (range, 3-510 and 3-642, respectively). Among patients who died within 30 days, 18.2% (4/22) had a serious illness conversation documented prior to chemotherapy administration. Conclusions: This study demonstrates that there is a high mortality and readmission rate among patients with advanced solid tumor malignancies who receive inpatient chemotherapy. Standardizing the expectation of informed consent and/or goals of care discussion prior to treatment is necessary. This may prevent administration of futile chemotherapy to patients requiring hospitalization for advanced cancer.
The impact of race, education, and employment status on cost-coping strategies and patient reported benefit from interventions to mitigate financial toxicity.
Authors: Kenya Braxton, Bridgette Thom, Carol L. Brown, Francesca Gany, Fumiko Chino, Emeline Mariam Aviki
Journal: Journal of Clinical Oncology (2021)

91 Background: As patient financial toxicity increases with the cost of cancer healthcare, patient outcomes and quality of life may be impaired. We sought to evaluate sociodemographic factors associated with use of cost-coping strategies, as well as strategies to mitigate financial toxicity. Methods: We conducted a survey of consecutive patients in an urban outpatient gynecologic cancer clinic waiting room over 2 weeks in August 2019. The survey included patient demographics, disease characteristics, the Comprehensive Score for Financial Toxicity (COST; scored 0-44, lower scores indicate worse outcomes), assessment of cost-coping strategies, and patient-reported anticipated benefit from possible interventions. Patients were categorized by race/ethnicity (non-Hispanic white, Hispanic white, black, Asian, other) and employment and education status. Kruskal-Wallis and Fisher’s exact tests were used to assess differences between groups. Results: Of 101 patients, 75 completed the survey. Most patients were non-Hispanic white (60%), retired (45%), and had at minimum a bachelor’s degree (65%). The median COST score was 32 (range 6-44). For cost-coping strategies, among renters (n=48), black and other race patients compared to white patients more often indicated skipping a rent payment (25% and 50% vs 0%; p&lt;.01). Employed patients compared to retired patients more often indicated reducing leisure spending (58% vs 27%; p=.02). Patients with less than a bachelor’s degree compared to those with a bachelor’s degree or higher more often indicated borrowing money to pay for medical bills (24% vs 6%; p=.04). For proposed interventions to lessen financial toxicity, non-Hispanic white and Asian patients compared to black patients more often indicated they wanted to know the cost of their healthcare upfront (38% and 33% vs 0%; p =.26). Employed patients compared to unemployed and retired patients more often indicated that minimizing copays would be beneficial (36% vs 13% and 12%, p=.05). Patients with less than a bachelor’s degree compared to those with a bachelor’s degree or higher more often indicated that transportation assistance would be helpful (76% vs 24%; p&lt;.01). Conclusions: As the needs of different sociodemographic groups vary, so do their cost-coping strategies and preferred interventions to ameliorate financial toxicity. Varying patient needs should be considered when developing interventions to mitigate financial toxicity. Next steps should assess the benefit of targeted interventions on coping strategies in specific sociodemographic groups.
Trends in end-of- life (EOL) systemic oncologic treatment in contemporary clinical practice: Insights from real-world data.
Authors: Maureen Canavan, Xiaoliang Wang, Mustafa Ascha, Rebecca A. Miksad, Timothy N Showalter, Gregory Sampang Calip, Cary Philip Gross, Kerin B. Adelson
Journal: Journal of Clinical Oncology (2021)

253 Background: Among patients with cancer, receipt of systemic oncolytic therapy near the end-of-life (EOL) does not improve outcomes and worsens patient and caregiver experience. Accordingly, the ASCO/NQF measure, Proportion Receiving Chemotherapy in the Last 14 Days of Life, was published in 2012. Over the last decade there has been exponential growth in high cost targeted and immune therapies which may be perceived as less toxic than traditional chemotherapy. In this study, we identified rates and types of EOL systemic therapy in today’s real-world practice; these can serve as benchmarks for cancer care organizations to drive improvement efforts. Methods: Using data from the nationwide Flatiron Health electronic health record (EHR)-derived de-identified database we included patients who died during 2015 through 2019, were diagnosed after 2011, and who had documented cancer treatment. We identified the use of aggressive EOL systemic treatment (including, chemotherapy, immunotherapy, and combinations thereof) at both 30 days and 14 days prior to death. We estimated standardized EOL rates using mixed-level logistic regression models adjusting for patient and practice-level factors. Year-specific adjusted rates were estimated in annualized stratified analysis. Results: We included 57,127 patients, 38% of whom had documentation of having received any type of systemic cancer treatment within 30 days of death (SD: 5%; range: 25% - 56%), and 17% within 14 days of death (SD: 3%; range: 10% - 30%). Chemotherapy alone was the most common EOL treatment received (18% at 30 days, 8% at 14 days), followed by immunotherapy (± other treatment) (11% at 30 days, 4% at 14 days). Overall rates of EOL treatment did not change over the study period: treatment within 30 days (39% in 2015 to 37% in 2019) and within 14 days (17% in 2015 to 17% in 2019) of death. However, the rates of chemotherapy alone within 30 days of death decreased from 24% to 14%, and within 14 days, from 10% to 6% during the study period. In comparison, rates for immunotherapy with chemotherapy (0%-6% for 30 days, 0% -2% for 14 days), and immunotherapy alone or with other treatment types (4%-13% for 30 days, 1%-4% for 14 days) increased over time for both 30 and 14 days. Conclusions: End of life systemic cancer treatment rates have not substantively changed over time despite national efforts and expert guidance. While rates of traditional chemotherapy have decreased, rates of costly immunotherapy and targeted therapy have increased, which has been associated with higher total cost of care and overall healthcare utilization. Future work should examine the drivers of end-of-life care in the era of immune-oncology.
Childhood acute myeloid leukemia shows a high level of germline predisposition
Authors: Saumya E. Samaraweera, Paul P. S. Wang, Ka Leung Li, Debora A. Casolari, Jinghua Feng, Mark Pinese, Kyaw Ze Ya Maung, Paul Leo, Mark Cowley, Kelly Perkins, Amanda M. Smith, Jonathan Ellis, Amilia Wee, Devendra K. Hiwase, Hamish S. Scott, Andreas W. Schreiber, Anna L. Brown, Andrew J. Deans, David M. Ross, Andrew S. Moore, Thomas J. Gonda, Christopher N. Hahn, Richard J. D’Andrea
Journal: Blood (2021)
EZETIMIBE DOES NOT INCREASE FASTING GLUCOSE LEVELS MORE THAN STATINS ALONE IN NON-DIABETIC, HYPERCHOLESTEROLEMIC PATIENTS
Authors: Peter P. Toth, Alberico Catapano, Michel Farnier, JoAnne Foody, Joanne Tomassini, Erin Jensen, Adam Polis, Thomas Musliner, Andrew Tershakovec
Journal: Journal of the American College of Cardiology (2015)
Conjunctival Kaposi’s Sarcoma
Authors: Filipe Gouveia-Moraes, Nuno Campos
Journal: New England Journal of Medicine (2021)

A 50-year-old man presented with a red lesion in his left eye and purple plaques on his skin. A test for infection with HIV type 1 was positive. Kaposi’s sarcoma with conjunctival involvement was diagnosed on skin biopsy.
direct evidence of redox mediation between a poly(aniline-co-n-propanesulfonic acid aniline) and 2,5-dimercapto-1,3,4-thiadiazole by uv-visible reflectance spectroscopy
Authors: A Buttry Daniel, Torresi Susana I. Córdoba de, M Torresi Roberto
Journal: British Journal of Dermatology (2002)
Identifying opportunities to improve equity in breast cancer care for uninsured Hispanic patients in underserved communities.
Authors: Gehan Botrus, Natalie Ertz -Archambault, Heidi E. Kosiorek, Nellie Nafissi, Miguel Gonzales, Brenda Ernst, Donald W. Northfelt
Journal: Journal of Clinical Oncology (2021)

132 Background: Enhancing equitable oncologic care is an increasingly emphasized priority. Our study aims to identify aspects of breast cancer (BC) care in which differences exist based on insurance coverage. Methods: We performed a retrospective, case control study, (from 2014-2020); 39 Hispanic ethnicity uninsured patients (UP) from underserved communities with newly diagnosed BC and 119 insured patients (IP) diagnosed at Mayo Clinic Arizona (MCA). Patients were matched 3:1 for age, stage, year of diagnosis, estrogen receptors and HER-2 status. Demographic information, clinical variables, and zip code level specific socioeconomic information were compared. Continuous variables were compared by Wilcoxon rank-sum test and categorical variables by chi-square test. All patients were treated at MCA. Results: Similar treatment patterns with radiotherapy, chemotherapy and surgery were observed between groups. Primary language was Spanish for 94% of UP and English for 97.5% of IP. The majority of UP were of Hispanic ethnicity (97.4%); IP were 83.2% non-Hispanic White, 9.2% Hispanic, 3.4% African American. Zip code level information reflected more unemployment with a median of 10.6% versus 6.9% p &lt; 0.001, percent of high school or lower (53.0 % v 23.2 %, p &lt; 0.001), and lower income for UP (33733.5 v 64728.0 p values &lt; 0.001).BMI was significantly higher for UP (30.6 V 24.7, p = 0.005), with presence of more co-morbidities; diabetes (28.2% v 5.0%, p &lt; 0.001), hypertension (35.9 % v 20.2%, p = 0.046), dyslipidemia (28.2% v 12.6%, p = 0.023), metabolic syndrome (p 23.7% v 8.5, p = 0.013), and tobacco use (17.9% v 2.5%, p &lt; 0.001). Genetics consultation was performed for 62.2% IP versus 35.9% UP (p = 0.004), lower acceptance of nutrition consultation for UP (29.4% vs 7.4%, p = 0.024). Median time from mammogram to biopsy (25.5 days vs. 14 days, p = 0.056), and interval from diagnosis to treatment (62 days vs. 39 days) (p = 0.001) were less favorable for UP compared to IP. Conclusions: In comparing the status of UP and IP with newly diagnosed BC, we identified greater prevalence of co-morbidities and adverse social determinants of health in the former group. We identified access to genetic counseling, nutrition consultation, and timeliness of diagnostic biopsy and initiation of treatment as disparate features in the care pathway. These observations allowed development of tailored interventions to achieve greater equity in delivery of BC care at Mayo Clinic.
Abrogation of survival disparity between insured and uninsured individuals after the USPSTF's 2012 prostate-specific antigen-based prostate cancer screening recommendation.
Authors: Isaac Elijah Kim, Daniel D. Kim, Sinae Kim, Eric A. Singer, Thomas L. Jang, Saum Ghodoussipour, Monish Aron, Isaac Yi Kim
Journal: Journal of Clinical Oncology (2021)

77 Background: In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA)-based screening for prostate cancer. Studies have found that insured patients with prostate cancer have better outcomes than uninsured patients. We examined the recommendation’s effects on survival disparities based on insurance status as well as socioeconomic quintile, marital status, and housing (urban/rural). Methods: Using the SEER18 database, we examined prostate cancer-specific survival (PCSS) based on diagnostic time period and one of four factors: insurance status, socioeconomic quintile, marital status, and housing (urban/rural). The SEER-designated socioeconomic quintile was based on variables including median household income and education index. Patients were designated as belonging to the pre-USPSTF era if diagnosed in 2010-2012 or post-USPSTF era if diagnosed in 2014-2016. Disparities were measured with the Cox proportional hazards model. Results: We identified 282,994 patients diagnosed with prostate cancer. During the pre-USPSTF era, uninsured patients experienced worse PCSS compared to insured patients (adjusted HR 1.29, 95% CI 1.06-1.58, p = 0.01). This survival disparity narrowed during the post-USPSTF era as a result of decreased PCSS among insured patients combined with unchanged PCSS among uninsured patients. Moreover, the survival disparity was no longer observed during the post-USPSTF era (aHR 0.91, 95% CI 0.61-1.38, p = 0.67). The survival disparity based on socioeconomic quintile also narrowed but remained significant. In contrast, the survival disparity based on marital status widened, while housing status was not associated with survival disparities in either era. Conclusions: From the pre- to the post-USPSTF era, insured patients with prostate cancer observed a significant decrease in survival that made their survival outcomes similar to that of uninsured patients. Although the underlying reasons are not clear, the USPSTF’s 2012 PSA screening recommendation may have hindered insured patients from being regularly screened for prostate cancer and selectively led to worse outcomes for insured patients without improving the survival of uninsured patients.[Table: see text]
Suboptimal clinician awareness of appropriate NTRK fusion testing and TRK inhibitor use in solid tumors.
Authors: Ryan P. Topping, Krista Marcello, Terrence Fagan, Timothy A. Quill, Todd Michael Bauer, Alexander E. Drilon, George D. Demetri
Journal: Journal of Clinical Oncology (2021)

229 Background: Since late 2018, 2 TRK inhibitors—larotrectinib and entrectinib—have been approved by the EMA and FDA for treating patients with advanced solid tumors harboring an NTRK fusion and progressive disease or no therapeutic alternatives. It is recommended that testing for NTRK fusions occur as early as possible after a diagnosis of advanced disease in patients with solid tumors to inform potential use of TRK inhibitors. Methods: Between April 2018 and April 2021, we conducted multiple live and online educational activities for oncology healthcare professionals (HCPs) on NTRK fusion testing and/or TRK inhibitor treatment for varied solid tumors. Each activity included polling questions designed to assess HCP knowledge and practice patterns. In this analysis, we assessed HCP responses to these questions to evaluate awareness of expert recommendations on NTRK fusion testing and the selection of TRK inhibitor therapy for appropriate patients. Results: In 6 live and online activities with data from April 2018 to April 2021, 29% of HCPs (n = 844) indicated that they ordered molecular profiling to test for NTRK fusions in all solid tumors in their current practice. Of note, low rates of testing were reported in TRK inhibitor/ NTRK testing-focused activities throughout this time period, with no significant increase over time. In assessing different patient cases across 8 activities where experts recommended TRK inhibitor therapy as optimal, many HCPs did not select a TRK inhibitor, with considerable variance by tumor type (Table). *For all cases, experts selected larotrectinib and/or entrectinib as optimal treatment. † HCP respondents. GBM, glioblastoma; GI, gastrointestinal; MSI-H, microsatellite instability-high; PD, progressive disease; PTC, papillary thyroid cancer.Conclusions: The rate of broad testing for NTRK fusions across patients with solid tumors remains low, and many HCPs lack awareness of when to consider a TRK inhibitor. Educational activities designed to address these deficiencies would be of clear benefit to HCPs treating patients with advanced solid tumors. A detailed analysis of HCP trends will be presented.[Table: see text]
Use of Medicare’s New Reimbursement Codes for Cognitive Assessment and Care Planning, 2017-2018
Authors: Jing Li, Caroline Andy, Susan Mitchell
Journal: JAMA Network Open (2021)

March 2021.SAS version 9.4 (SAS Institute) was used for all data analyses. ResultsOur study population included 5 980 271 Medicare patients, and 895 726 of the patients (15.0%) had ADRD and 8355 of the patients (0.14%) had at least 1 CACP claim in either 2017 or 2018 (Table 1).Among patients with ADRD, 390 116 (43.5%) were aged 85 years or older, 358 500 (40.0%)resided in the South, 234 638 (26.2%) were Medicaid eligible, and 565 042 (63.1%) had at least 5 chronic conditions other than ADRD (Table 2).
<i>MYC</i> Levels Regulate Metastatic Heterogeneity in Pancreatic Adenocarcinoma
Authors: Ravikanth Maddipati, Robert J. Norgard, Timour Baslan, Komal S. Rathi, Amy Zhang, Asal Saeid, Taku Higashihara, Feng Wu, Angad Kumar, Valli Annamalai, Saurav Bhattacharya, Pichai Raman, Christian A. Adkisson, Jason R. Pitarresi, Maximilian D. Wengyn, Taiji Yamazoe, Jinyang Li, David Balli, Michael J. LaRiviere, Tuong-Vi C. Ngo, Ian W. Folkert, Ian D. Millstein, Jonathan Bermeo, Erica L. Carpenter, John C. McAuliffe, Maja H. Oktay, Rolf A. Brekken, Scott W. Lowe, Christine A. Iacobuzio-Donahue, Faiyaz Notta, Ben Z. Stanger
Journal: Cancer Discovery (2021)

Abstract The degree of metastatic disease varies widely among patients with cancer and affects clinical outcomes. However, the biological and functional differences that drive the extent of metastasis are poorly understood. We analyzed primary tumors and paired metastases using a multifluorescent lineage-labeled mouse model of pancreatic ductal adenocarcinoma (PDAC)—a tumor type in which most patients present with metastases. Genomic and transcriptomic analysis revealed an association between metastatic burden and gene amplification or transcriptional upregulation of MYC and its downstream targets. Functional experiments showed that MYC promotes metastasis by recruiting tumor-associated macrophages, leading to greater bloodstream intravasation. Consistent with these findings, metastatic progression in human PDAC was associated with activation of MYC signaling pathways and enrichment for MYC amplifications specifically in metastatic patients. Collectively, these results implicate MYC activity as a major determinant of metastatic burden in advanced PDAC. Significance: Here, we investigate metastatic variation seen clinically in patients with PDAC and murine PDAC tumors and identify MYC as a major driver of this heterogeneity. This article is highlighted in the In This Issue feature, p. 275
Single‐base editing of rs12603332 on chromosome 17q21 with a cytosine base editor regulates ORMDL3 and ATF6α expression
Authors: Ning Weng, Marina Miller, Alexa K. Pham, Alexis C. Komor, David H. Broide
Journal: Allergy (2021)

Genetic association studies have demonstrated that the SNP rs12603332 located on chromosome 17q21 is highly associated with the risk of the development of asthma.To determine whether SNP rs1260332 is functional in regulating levels of ORMDL3 expression, we used a Cytosine Base Editor (CBE) plasmid DNA or a CBE mRNA to edit the rs12603332 C risk allele to the T non-risk allele in a human lymphocyte cell line (i.e., Jurkat cells) and in primary human CD4 T cells that carry the C risk alleles.Jurkat cells with the rs12603332 C risk allele expressed significantly higher levels of ORMDL3 mRNA, as well as the ORMDL3 regulated gene ATF6α as assessed by qPCR compared to Jurkat clones with the T non-risk allele. In primary human CD4 T cells, we edited 90 ± 3% of the rs12603332-C risk allele to the T non-risk allele and observed a reduction in ORMDL3 and ATF6α expression. Bioinformatic analysis predicted that the non-risk allele rs12603332-T could be the central element of the E-box binding motif (CANNTG) recognized by the E47 transcription factor. An EMSA assay confirmed the bioinformatics prediction demonstrating that a rs12603332-T containing probe bound to the transcription factor E47 in vitro.SNP rs12603332 is functional in regulating the expression of ORMDL3 as well as ORMDL3 regulated gene ATF6α expression. In addition, we demonstrate the use of CBE technology in functionally interrogating asthma-associated SNPs using studies of primary human CD4 cells.