tbuckley/cabot-search huggingface dataset:
Documentation of goals of care discussions: Lessons from the Improving Goal Concordant Care Collaborative.
Authors: Kristen K. McNiff Landrum, Akhila Sunkepally Reddy, Tom Ross, Jack Kolosky
Journal: Journal of Clinical Oncology (2021)

166 Background: Patients with advanced cancer do not reliably receive care consistent with their goals and values. Goal-concordant care requires effective, efficient and timely communications between patients and their providers, as well as systems to capture patient goals and ensure future accessibility. Currently, electronic health records (EHR) in most oncology settings do not adequately support structured documentation that is most relevant to goals of cancer care. Methods: The Alliance of Dedicated Cancer Centers (ADCC) initiated the Improving Goal Concordant Care (IGCC) Initiative in 2019. ADCC members are 10 U.S. freestanding, academic cancer hospitals, which are also the IGCC participants. In 2019 and 2020, we convened palliative care and oncology experts in the IGCC’s planning phase, via a series of structured consensus building sessions. We employed modified Delphi processes - including literature review, brainstorming, voting, and refinement - in conceptualization four core components considered essential to improving goal concordant care for cancer patients. One of these core components is EHR documentation of GOC discussions; an additional EHR workgroup created detailed recommendations. The three-year IGCC implementation phase launched in September 2020. Results: We achieved consensus on minimum desired fields for GOC documentation: intent of the current treatment, physician's estimated prognosis, prognosis disclosed/discussed with patient, patient prognostic awareness, patient goals, recommendations. Further, GOC documentation must be discrete and structured whenever possible to ease entry and facilitate retrieval/reporting. As GOC discussions evolve over time, documentation may be iterated over multiple encounters. GOC documentation is distinct from, but may rely on, advance directives or other ACP documentation, such as code status, POLST/MOLST, and healthcare agents. At IGCC collaborative launch, none of the 10 cancer hospitals had EHRs that were fully compliant. Progress toward development, training, and use of structured GOC documentation is ongoing. Conclusions: Establishing feasible and useful expectations for electronic documentation of GOC discussions by oncologists presented unique challenges for the IGCC. Ongoing and planned work in this area includes: Facilitating collaborative learning and promoting sharing of best practices; Measuring the presence of GOC documentation among priority patients, as well as other measures including patient and family reported outcomes; Assessing quality of the GOC documentation; Ongoing engagement of patient and family advisors, including regarding patient access to records containing GOC documentation; Potential application of natural language processing/artificial intelligence in prompting GOC documentation and facilitating retrieval.
Improving hematology/oncology clinical research recruitment via universal prescreening: The VA Connecticut (VACT) Cancer Center experience.
Authors: Jenny Jing Xiang, Alicia Roy, Christine Summers, Monica Delvy, Jessica Lee O'Donovan, John Christensen, Lydia Perry, Donna Connery, Michal G. Rose, Herta H. Chao
Journal: Journal of Clinical Oncology (2021)

79 Background: Patient-trial matching is a critical step in clinical research recruitment that requires extensive review of clinical data and trial requirements. Prescreening, defined as identifying potentially eligible patients using select eligibility criteria, may streamline the process and increase study enrollment. We describe the real-world experience of implementing a standardized, universal clinical research prescreening protocol within a VA cancer center and its impact on research enrollment. Methods: An IRB approved prescreening protocol was implemented at the VACT Cancer Center in March 2017. All patients with a suspected or confirmed diagnosis of cancer are identified through tumor boards, oncology consults, and clinic lists. Research coordinators perform chart review and manually enter patient demographics, cancer type and stage, and treatment history into a REDCap (Research Electronic Data Capture) database. All clinical trials and their eligibility criteria are also entered into REDCap and updated regularly. REDCap generates real time lists of potential research studies for each patient based on his/her recorded data. The primary oncologist is alerted to a patient’s potential eligibility prior to upcoming clinic visits and thus can plan to discuss clinical research enrollment as appropriate. Results: From March 2017 to December 2020, a total of 2548 unique patients were prescreened into REDCAP. The mean age was 71.5 years, 97.5% were male, and 15.5% were African American. 32.57 % patients had genitourinary cancer, 17.15% had lung cancer, and 46.15% were undergoing malignancy workup. 1412 patients were potentially eligible after prescreening and 556 patients were ultimately enrolled in studies. The number of patients enrolled on therapeutic clinical trials increased after the implementation of the prescreening protocol (35 in 2017, 64 in 2018, 78 in 2019, and 55 in 2020 despite the COVID19 pandemic). Biorepository study enrollment increased from 8 in 2019 to 15 in 2020. The prescreening protocol also enabled 200 patients to be enrolled onto a lung nodule liquid biopsy study from 2017 to 2019. Our prescreening process captured 98.57% of lung cancer patients entered into the cancer registry during the same time period. Conclusions: Universal prescreening streamlined research recruitment operations and was associated with yearly increases in clinical research enrollment at a VA cancer center. Our protocol identified most new lung cancer patients, suggesting that, at least for this malignancy, potential study patients were not missed. The protocol was integral in our program becoming the top accruing VA site for NCI’s National Clinical Trial Network (NCTN) studies since 2019.
An Organic Nanotherapeutic Agent Self‐Assembled from Cyanine and Cu (II) for Combined Photothermal and Chemodynamic Therapy
Authors: Xiaojing Li, Dongmei Xi, Mingwang Yang, Wen Sun, Xiaojun Peng, Jiangli Fan
Journal: Advanced Healthcare Materials (2021)

Although the combination of photothermal/chemodynamic therapy (PTT/CDT) based on various inorganic nanomaterials has promising anticancer effects, poor biocompatibility and biodegradability of inorganic nanoplatforms pose obstacles to their use in clinic. On the contrary, nanoscale metal-organic particles are considered to be a promising platform because of their biocompatibility and efficient metabolism. Herein, HA@Cy-Cu NPs are prepared using the coordination-driven assembly of cyanine dyes with Cu2+ ions. HA@Cy-Cu NPs demonstrate excellent synergistic PTT/CDT, a high photothermal conversion efficiency (43%), and enhanced photostability. Moreover, Cu2+ in the NPs can be reduced to Cu+ by glutathione (GSH) and can transform H2 O2 to •OH, which down-regulates intracellular GSH levels and up-regulates significant oxidative damage. Therefore, promising in vivo tumor ablation is observed at a low dose of HA@Cy-Cu, suggesting that the combination of PTT/CDT greatly improved the antitumor performance. HA@Cy-Cu can further improve organic nano-systems for anti-tumor therapy by integrating PTT and CDT.
Clinical and pathologic correlation of cutaneous COVID-19 vaccine reactions including V-REPP: A registry-based study
Authors: Devon E. McMahon, Carrie L. Kovarik, William Damsky, Misha Rosenbach, Jules B. Lipoff, Anisha Tyagi, Grace Chamberlin, Ramie Fathy, Rosalynn M. Nazarian, Seemal R. Desai, Henry W. Lim, Bruce H. Thiers, George J. Hruza, Lars E. French, Kimberly Blumenthal, Lindy P. Fox, Esther E. Freeman
Journal: Journal of the American Academy of Dermatology (2021)

Cutaneous reactions after COVID-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations have not been well characterized.We evaluated for a history of skin biopsy all reports of reactions associated with COVID-19 vaccination identified in an international registry. When histopathology reports were available, we categorized them by reaction patterns.Of 803 vaccine reactions reported, 58 (7%) cases had biopsy reports available for review. The most common histopathologic reaction pattern was spongiotic dermatitis, which clinically ranged from robust papules with overlying crust, to pityriasis rosea-like eruptions, to pink papules with fine scale. We propose the acronym "V-REPP" (vaccine-related eruption of papules and plaques) for this spectrum. Other clinical patterns included bullous pemphigoid-like (n = 12), dermal hypersensitivity (n = 4), herpes zoster (n = 4), lichen planus-like (n = 4), pernio (n = 3), urticarial (n = 2), neutrophilic dermatosis (n = 2), leukocytoclastic vasculitis (n = 2), morbilliform (n = 2), delayed large local reactions (n = 2), erythromelalgia (n = 1), and other (n = 5).Cases in which histopathology was available represented a minority of registry entries. Analysis of registry data cannot measure incidence.Clinical and histopathologic correlation allowed for categorization of cutaneous reactions to the COVID-19 vaccine. We propose defining a subset of vaccine-related eruption of papules and plaques, as well as 12 other patterns, following COVID-19 vaccination.
Assessment of Online Food Ordering and Delivery in Singapore During the COVID-19 Pandemic
Authors: Sumit Agarwal, Peiying Huang, Chenxi Luo, Yu Qin, Changwei Zhan
Journal: JAMA Network Open (2021)

In 2020, the COVID-19 outbreak was declared to be a pandemic. Governments implemented various measures, such as social distancing, quarantine, and lockdowns, to minimize the spread and effects of COVID-19. Previous studies1,2 based on questionnaires showed that respondents reported unhealthier eating habits during lockdown. Unhealthy eating behavior formed during the pandemic could result in undesirable long-term health consequences, such as coronary heart disease,3,4 chronic diseases,5 and Alzheimer disease.6
Physiologic Regulation of Systemic Klotho Levels by Renal CaSR Signaling in Response to CaSR Ligands and pHo
Authors: Joonho Yoon, Zhenan Liu, Eunyoung Lee, Liping Liu, Silvia Ferre, Johanne Pastor, Jianning Zhang, Orson W. Moe, Audrey N. Chang, R. Tyler Miller
Journal: Journal of the American Society of Nephrology (2021)

The kidney is the source of sKlotho and kidney-specific loss of Klotho leads to a phenotype resembling the premature multiorgan failure phenotype in Klotho-hypomorphic mice ( kl/kl mice). Klotho and the Ca-sensing receptor (CaSR) are highly expressed in the distal convoluted tubule (DCT). The physiologic mechanisms that regulate sKlotho levels are unknown.
Dynamic Myocardial Perfusion CT for the Detection of Hemodynamically Significant Coronary Artery Disease
Authors: Fay M.A. Nous, Tobias Geisler, Mariusz B.P. Kruk, Hatem Alkadhi, Kakuya Kitagawa, Rozemarijn Vliegenthart, Michaela M. Hell, Jörg Hausleiter, Patricia K. Nguyen, Ricardo P.J. Budde, Konstantin Nikolaou, Cezary Kepka, Robert Manka, Hajime Sakuma, Sachin B. Malik, Adriaan Coenen, Felix Zijlstra, Ernst Klotz, Pim van der Harst, Christoph Artzner, Admir Dedic, Francesca Pugliese, Fabian Bamberg, Koen Nieman
Journal: JACC. Cardiovascular imaging (2021)

In this international, multicenter study, using third-generation dual-source computed tomography (CT), we investigated the diagnostic performance of dynamic stress CT myocardial perfusion imaging (CT-MPI) in addition to coronary CT angiography (CTA) compared to invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR).
Native joint infections in Iceland 2003–2017: an increase in postarthroscopic infections
Authors: Signý Lea Gunnlaugsdóttir, Helga Erlendsdóttir, Kristján Orri Helgason, Árni Jón Geirsson, Valtýr Thors, Sigurður Guðmundsson, Magnús Gottfreðsson
Journal: Annals of the Rheumatic Diseases (2021)

Objectives Nationwide study on the epidemiology, clinical characteristics and outcomes among patients with native joint infection (NJI) in Iceland, 2003–2017. Methods All positive synovial fluid culture results in Iceland were identified and medical records reviewed. Results A total of 299 NJI (40 children and 259 adults) were diagnosed in Iceland in 2003–2017, with a stable incidence of 6.3 cases/100 000/year, but marked gender difference among adults (33% women vs 67% men, p&lt;0.001). The knee joint was most commonly affected, and Staphylococcus aureus was the most common isolate in both adults and children, followed by various streptococcal species in adults and Kingella kingae in children. NJI was iatrogenic in 34% of adults (88/259) but comprised 45% among 18–65 years and a stable incidence. Incidence of infections following arthroscopic procedures in adults increased significantly compared with the previous decade (9/100 000/year in 1990–2002 vs 25/100 000/year in 2003–2017, p&lt;0.01) with no significant increase seen in risk per procedure. The proportion of postarthroscopic NJI was 0.17% overall but 0.24% for knee arthroscopy. Patients with postarthroscopic infection were more likely to undergo subsequent arthroplasty when compared with other patients with NJI (p=0.008). Conclusions The incidence of NJI in Iceland has remained stable. The proportion of iatrogenic infections is high, especially among young adults, with an increase seen in postarthroscopic infections when compared with the previous decade. Although rare, NJI following arthroscopy can be a devastating complication, with significant morbidity and these results, therefore, emphasise the need for firm indications when arthroscopic treatment is considered.
Empagliflozin Improves Cardiovascular and Renal Outcomes in Heart Failure Irrespective of Systolic Blood Pressure
Authors: Michael Böhm, Stefan D Anker, Javed Butler, Gerasimos Filippatos, João Pedro Ferreira, Stuart J Pocock, Felix Mahfoud, Martina Brueckmann, Waheed Jamal, Anne Pernille Ofstad, Elke Schüler, Piotr Ponikowski, Christoph Wanner, Faiez Zannad, Milton Packer, EMPEROR-Reduced Trial Committees, Investigators
Journal: Journal of the American College of Cardiology (2021)

Empagliflozin reduces the risk of cardiovascular death or heart failure (HF) hospitalization in patients with reduced ejection fraction. Its interplay with systolic blood pressure (SBP) is not known. The goal of this study was to evaluate the interplay of SBP and the effects of empagliflozin in EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction). Study patients (N = 3,730) were randomly assigned to groups according to SBP at baseline (<110 mm Hg, n = 928; 110-130 mm Hg, n = 1,755; >130 mm Hg, n = 1,047). This study explored the influence of SBP on the effects of empagliflozin on cardiovascular death or HF hospitalization (primary outcome), as well as on total HF hospitalizations, rate of decline in estimated glomerular filtration rate, renal outcomes, and empagliflozin’s effects and significance on SBP. Over a median of 16 months considering only patients receiving placebo, baseline SBP and the risk of cardiovascular death or hospitalization for HF (P trend = 0.0015) were inversely related. Corrected for placebo, a slight early increase was observed in SBP at <110 mm Hg, no change at 110-130 mm Hg, and a slight reduction at >130 mm Hg. These between-group differences were of borderline significance (P for interaction trend = 0.05-0.10) after 4 and 12 weeks but were not significant later. SBP at baseline did not influence the effect of empagliflozin to reduce the risk of HF events or renal endpoints. When treated with empagliflozin, patients with SBP <110 mm Hg did not have an increased rate of symptomatic hypotension. Empagliflozin was effective and safe, with no meaningful interaction between SBP and the effects of empagliflozin in the EMPEROR-Reduced trial. (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction [EMPEROR-Reduced]; NCT03057977)
Combine and conquer: manganese synergizing anti-TGF-β/PD-L1 bispecific antibody YM101 to overcome immunotherapy resistance in non-inflamed cancers
Authors: Ming Yi, Mengke Niu, Jing Zhang, Shiyu Li, Shuangli Zhu, Yongxiang Yan, Ning Li, Pengfei Zhou, Qian Chu, Kongming Wu
Journal: Journal of Hematology & Oncology (2021)

Our previous work showed that the anti-TGF-β/PD-L1 bispecific antibody YM101 effectively overcame anti-PD-L1 resistance in immune-excluded tumor models. However, in immune-desert models, the efficacy of YM101 was limited. Bivalent manganese (Mn
Langerhans cell histiocytosis with lung involvement in isolation and multisystem disease: Staging, natural history, and comparative survival
Authors: Antonious Z. Hazim, Gordon J. Ruan, Marie Hu, Aishwarya Ravindran, Karen L. Rech, Jason R. Young, Christian W. Cox, Jithma P. Abeykoon, Caleb Scheckel, Robert Vassallo, Jay H. Ryu, W. Oliver Tobin, Matthew J. Koster, N. Nora Bennani, Mithun V. Shah, Gaurav Goyal, Ronald S. Go
Journal: American Journal of Hematology (2021)

Langerhans cell histiocytosis (LCH) is a histiocytic neoplasm that can involve the lungs as single system (LCH-SSL) or multisystem disease (LCH-MSL). The role of full-body radiographic staging to determine whether patients have LCH-SSL or LCH-MSL is unclear. Long-term outcomes of LCH-SSL versus LCH-MSL and multisystem without lung involvement (LCH-MSNL) are unknown. A retrospective study of adult LCH patients seen at our center from January 2000 to 2020 was performed. In Part 1, we addressed utility of whole-body staging imaging among those presenting with isolated pulmonary signs or symptoms. Staging was defined as fluorodeoxyglucose positron emission tomography-computed tomography (CT) or whole-body CT obtained within 3 months of diagnosis. In Part 2, we examined the frequency of developing extra-pulmonary disease over time and mortality in patients with LCH-SSL. In Part 3, we compared the overall survival of LCH-SSL, LCH-MSL, and LCH-MSNL. Part 1: 240 patients with LCH were identified. A total of 112 (47%) had pulmonary signs or symptoms at presentation. Thirty-four (30%) underwent radiographic staging and only one showed evidence of extra-pulmonary disease. Part 2: 108 (45%) were LCH-SSL. Median follow-up duration of 4.5 years (95% confidence interval [CI]: 2.9-6.0). None developed extra-pulmonary disease. Part 3: 5-year survival: 94% (95% CI: 84%-98%) for LCH-SSL, 78% (95% CI: 59%-90%) for LCH-MSL, and 75% (95% CI: 53%-89%) for LCH-MSNL. LCH patients presenting with isolated pulmonary signs or symptoms rarely have extra-pulmonary involvement at the time of diagnosis and generally do not develop extra-pulmonary progression. LCH-SSL has the best overall survival, while LCH-MSL and LCH-MSNL have similar clinical outcomes.
Covid-19 infection in multiple myeloma patients - Czech experience
Authors: J. Radocha, L. Pour, T. Jelinek, I. Spicka, A. Jungova, J. Minarik, A. Heindorfer, J. Ullrychova, P. Kessler, M. Wrobe, J. Obernauerova, M. Sykora, L. Stejskal, V. Maisnar, R. Hajek
Journal: HemaSphere (2021)

Background: COVID-19 disease caused by SARS-CoV-2 coronavirus has affected millions of people worldwide. The mortality of this infection varies with age and comorbidities up to more than 10% in very elderly population. The aim of our study was to determine the mortality rate and healthcare utilization among multiple myeloma patients and describe the potential risk factors for death. Aims: The aim of our study was to determine the mortality rate and healthcare utilization among multiple myeloma patients and describe the potential risk factors for death. Methods: We retrospectively analyzed entries in the Czech Registry of Monoclonal Gammopathies from patients who were infected with SARS-CoV-2 from March 2020 until January 2021. Demographic data, treatment patterns, comorbidities, symptoms of COVID-19, treatment modalities and healthcare utilization was compared in survivors and non-survivors. Results: Overall, 158 patients with MM and COVID-19 with known outcome of the infection were identified. There were 72.8% (115/158) survivors and 27.2% (43/158) deceased patients. Both groups were balanced in gender, ECOG, M protein isotype, ISS stage and comorbidities. Non-survivors were significantly older (median 71.5 years vs 67.9 years, p=0.046). There were no differences between previous treatment lines in either group. Patients received median one prior line of therapy (range 0-6, p=0.994). 95% of patients were exposed to IMiDs (150/158), 89.9% to proteasome inhibitors (142/158) and 18.4% (29/158) to anti-CD38 antibody. Autologous stem cell transplantation was used in 36.7% (58/158) of patients. There were no differences in administered treatment in both groups. Inpatient treatment due to COVID-19 was required in 46.8% (74/158) of patients. Survivors hospitalization rate was 31.3% (36/115) and 88.4% (38/43) in non-survivors. In-hospital mortality was 51.4% (38/74). Non-survivors had more intensive care unit stays (4.3% vs 55.8%, p<0.0001) and needed more ventilation support (0.9 % vs 23.3%, p<0.0001). Mortality of patients who needed ICU was 82.8% (24/29 ICU stays) and 32.7% (16/49 ward stays) in patients who needed standard ward inpatient therapy. Mortality of patients needing artificial ventilation was 90.9% (1/11). Mortality of patients needing non-invasive ventilation or high flow nasal oxygen and 85.0% (17/20). Mortality of patients needing Summary/Conclusion: The mortality of MM patients with COVID-19 was very high especially in patients in need of any type of ventilation support. Healthcare utilization was high with almost half of the infected myeloma patients needing inpatient treatment. No apparent risk factors in terms of disease status or previous treatment were identified. Supported by MH CZ - DRO (UHHK, 00169906) and by the program PROGRES Q40/8.