tbuckley/cabot-search huggingface dataset:
Emerging from the haze: Feasibility pilot of a virtual multi-dimensional psycho-educational cognitive rehabilitation intervention for cancer survivors with decreased perceived cognitive function after cancer therapy.
Authors: Arash Asher, Celina Shirazipour, Jeffrey Wertheimer, Jamie S. Myers
Journal: Journal of Clinical Oncology (2021)

276 Background: Standardized, effective cognitive rehabilitation interventions that can be widely disseminated are urgently needed for cancer-related cognitive impairment. The purpose of this single-arm pilot study was to test the feasibility/acceptability of virtual delivery of a cognitive rehabilitation intervention for participants in virtual groups. Study aims included: (1) Recruit 30 participants and achieve a 70% retention rate; (2) Demonstrate feasibility/acceptability of measures assessing determinants of behavior change (missing data &lt;25%; reliability &gt;.70); and (3) Explore interventional impact on perceived cognitive function (PCF), determinants of behavior change, and loneliness. Methods: Adult cancer survivors reporting impaired cognitive function following primary treatment were enrolled from two cancer centers and affiliates. Two cohorts (N=37) attended six weekly sessions and completed pre-/post- patient reported outcome questionnaires designed to measure PCF, loneliness, and determinants of behavior change for exercise, sleep, and mindfulness. Results: Participant retention rate was 85%. Measures of determinants of behavior change were reliable ( r &gt;.70) across all three behaviors. Post-intervention scores for PCF, determinants of behavior change, and loneliness ratings significantly improved (Table). Inverse correlation between changes in loneliness, PCF ( r= -.376 to -.452, p &lt;.05) and exercise intention ( r = -0.544, p =.001) were noted. Conclusions: Virtual delivery of cognitive rehabilitation interventions may be feasible and acceptable to cancer survivors reporting impairment in cognitive function after primary treatment. Loneliness may be an important predictor of both issues with cognitive function and intention to change behavior. [Table: see text]
Effectiveness of COVID-19 mRNA Vaccines Against COVID-19–Associated Hospitalization — Five Veterans Affairs Medical Centers, United States, February 1–August 6, 2021
Authors: Kristina L. Bajema, Rebecca M. Dahl, Mila M. Prill, Elissa Meites, Maria C. Rodriguez-Barradas, Vincent C. Marconi, David O. Beenhouwer, Sheldon T. Brown, Mark Holodniy, Cynthia Lucero-Obusan, Gilberto Rivera-Dominguez, Rosalba Gomez Morones, Alexis Whitmire, Evan B. Goldin, Steve L. Evener, Maraia Tremarelli, Suxiang Tong, Aron J. Hall, Stephanie J. Schrag, Meredith McMorrow, Miwako Kobayashi, Jennifer R. Verani, Diya Surie, Ghazal Ahmadi-Izadi, Joy Burnette, Rijalda Deovic, Lauren Epstein, Amy Hartley, Elena Morales, Tehquin Tanner, Nina Patel, Ashley Tunson, Katherine Elliot, Ilda Graham, Diki Lama, Ismael Pena, Adrienne Perea, Guerry Anabelle Perez, Johane Simelane, Sarah Smith, Gabriela Tallin, Amelia Tisi, Alonso Arellano Lopez, Miguel Covarrubias Gonzalez, Bashir Lengi, Dena Mansouri, Mariana Vanoye Tamez, Babak Aryanfar, Ian Lee-Chang, Chan Jeong, Anthony Matolek, Chad Mendoza, Aleksandra Poteshkina, Saadia Naeem, Madhuri Agrawal, Jessica Lopez, Theresa Peters, Geliya Kudryavtseva, Jordan Cates, Jennifer M. Folster, Anita Kambhampati, Anna Kelleher, Yan Li, Han Jia Ng, Ying Tao
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) have been shown to be highly protective against COVID-19-associated hospitalizations (1-3). Data are limited on the level of protection against hospitalization among disproportionately affected populations in the United States, particularly during periods in which the B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, predominates (2). U.S. veterans are older, more racially diverse, and have higher prevalences of underlying medical conditions than persons in the general U.S. population (2,4). CDC assessed the effectiveness of mRNA vaccines against COVID-19-associated hospitalization among 1,175 U.S. veterans aged ≥18 years hospitalized at five Veterans Affairs Medical Centers (VAMCs) during February 1-August 6, 2021. Among these hospitalized persons, 1,093 (93.0%) were men, the median age was 68 years, 574 (48.9%) were non-Hispanic Black (Black), 475 were non-Hispanic White (White), and 522 (44.4%) had a Charlson comorbidity index score of ≥3 (5). Overall adjusted vaccine effectiveness against COVID-19-associated hospitalization was 86.8% (95% confidence interval [CI] = 80.4%-91.1%) and was similar before (February 1-June 30) and during (July 1-August 6) SARS-CoV-2 Delta variant predominance (84.1% versus 89.3%, respectively). Vaccine effectiveness was 79.8% (95% CI = 67.7%-87.4%) among adults aged ≥65 years and 95.1% (95% CI = 89.1%-97.8%) among those aged 18-64 years. COVID-19 mRNA vaccines are highly effective in preventing COVID-19-associated hospitalization in this older, racially diverse population of predominately male U.S. veterans. Additional evaluations of vaccine effectiveness among various age groups are warranted. To prevent COVID-19-related hospitalizations, all eligible persons should receive COVID-19 vaccination.
JS01.4.A The neurocognitive function changes with awake craniotomy for low-grade glioma in the left hemispheric eloquent regions
Authors: Y Wang, P Ji, S Guo, J Liu, Y Zhai, N Wang, Y Qu, L Wang
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Cognitive deficit was frequently observed in glioma patients, especially for those on the eloquent area. Considering the increased life expectancy, brain mapping during awake craniotomy was preferentially applied to exacerbate neurocognitive deficits. The aim of the current study was to evaluate the neurocognitive changes during the perioperative period of resection of low-grade glioma (LGG) in the left side eloquent area with awake craniotomy in a major neurosurgical center in China for 5 years. MATERIAL AND METHODS We retrospectively analyzed patients with left-sided glioma in eloquent areas, who received awake craniotomy during 2016–2020. Montreal Cognitive Assessment Scale, BN-20, and EORTC-QLQ-C30 questionnaire were applied for neurological cognitive assessment. We performed a correlation analysis between changes in cognitive performance and tumor characteristics, including tumor location, pathological grade. Treatment-related factors were also analyzed, such as the extent of resection (EOR), preoperative and postoperative Karnofsky Performance Score (KPS), postoperative treatment strategy (chemo- and radiotherapy), progression-free survival (PFS), overall survival (OS). RESULTS 68 patients were included in our current study. For the language domain, memory domain, and executive functions, 7.4% (5/68) patients presented mild postoperative cognitive performance deterioration compared to preoperative. Tumor location was the only factor that greatly influenced the postoperative cognitive performance, while other features (EOR, KPS, pathological grades) and treatment strategy were found no effect on cognitive change. The extent of tumor resection ranged from 81% to 100%. CONCLUSION Our study underlines the importance of the application of brain mapping during awake craniotomy, which helps to maximize extent of tumor resection while preserving cognitive function in individuals with LGG in eloquent regions.
Toxicity Index, Patient-Reported Outcomes, and Early Discontinuation of Endocrine Therapy for Breast Cancer Risk Reduction in NRG Oncology/NSABP B-35
Authors: N. Lynn Henry, Sungjin Kim, Ron D. Hays, Marcio A. Diniz, Michael Luu, Reena S. Cecchini, Greg Yothers, André Rogatko, Patricia A. Ganz
Journal: Journal of Clinical Oncology (2021)

PURPOSE The US National Cancer Institute Moonshot initiative calls for improving analysis and reporting of toxicity to inform treatment tolerability. We used existing clinician-reported adverse event (AE) and patient-reported outcome (PRO) questionnaire data from the randomized, double-blind NSABP B-35 clinical trial to explore reasons for anastrozole and tamoxifen discontinuation. METHODS Postmenopausal women with ductal carcinoma in situ treated with breast-conserving therapy were randomly assigned to anastrozole or tamoxifen for 5 years. The primary outcome for this analysis was time to treatment discontinuation. AEs were collected every 6 months post–random assignment from all 3,104 participants and summarized using the Toxicity Index (TI). PRO data were collected at baseline and every 6 months from 1,194 participants. Univariate and multivariable analyses of time to treatment discontinuation were performed using Cox regression models with TIs and PROs as time-dependent covariates. RESULTS Of 3,046 analyzed participants, 869 (28.5%) discontinued treatment prematurely. In multivariable analysis, when both baseline PROs and on-treatment AEs were considered, thrombosis and arthralgia AEs were associated with discontinuation of both tamoxifen and anastrozole; additional AEs associated with discontinuation varied by drug. In addition, baseline pain interference, hot flashes, and unhappiness were associated with tamoxifen discontinuation (n = 589; overall Harrell's C-statistic 0.686 [95% CI, 0.640 to 0.732]); no baseline PROs were associated with anastrozole discontinuation (n = 589; overall Harrell's C-statistic 0.656 [95% CI, 0.630 to 0.681]). When only baseline PROs were examined, pain interference, hot flashes, and unhappiness were associated with shorter time to discontinuation of tamoxifen; only hot flashes were associated with discontinuation of anastrozole. CONCLUSION Analysis of AEs using the TI yielded important insights into reasons for discontinuation of endocrine therapy that was enhanced by the addition of PRO baseline and treatment-emergent symptoms.
Adverse lifestyle behaviors among childhood cancer survivors with cognitive impairment: The Project Forward Cohort.
Authors: Ding Quan Ng, Kimberly Ann Miller, Stefanie Marie Thomas, David R. Freyer, Joel Milam, Alexandre Chan
Journal: Journal of Clinical Oncology (2021)

138 Background: Childhood cancer survivors (CCS) are often impacted by cancer-related cognitive impairment (CRCI), requiring long-term follow-up care. It is unknown whether survivors reporting CRCI are at higher likelihood to suffer from adverse lifestyle behaviors such as smoking and vaping. Using the Project Forward cohort, we analyzed the prevalence of CRCI and its association with substance abuse. Methods: The Project Forward study surveyed adolescent and young adult CCS between 2015 to 2018 to evaluate the quality of cancer follow-up care. Associations between self-reported CRCI and adverse lifestyle behaviors were examined in multivariable logistic regressions, adjusting for covariates: cancer type, treatment intensity, race/ethnicity, gender, and age at diagnosis. Stratified analysis by recency of latest cancer follow-up care was performed to examine its impact on the risk of substance abuse among CRCI patients. Results: The cohort comprised 1,106 CCS, with median ages of 25.5 years (IQR: 22, 29) at survey completion and 13 years (IQR: 7, 16) at diagnosis, with over half (n = 570, 51.5%) were being Hispanic. A total of 144 (13%) patients self-reported CRCI, with the highest prevalence observed among brain cancer (25.4%) and leukemia (13.3%) survivors. Cancer-related follow-ups were more frequently observed among survivors reporting CRCI, comparing to non-CRCI survivors (66.7% vs 56.9%, p = 0.030). After adjusting for confounders, survivors reporting CRCI were at higher odds to vape with e-cigarettes than those without CRCI (OR = 2.24, 95% CI = 1.24–4.09, p = 0.008). Among those who did not engage any recent cancer follow-up care (n = 455), CRCI was associated with 2.9 times the odds of vaping with e-cigarettes (OR = 2.9, 95% CI = 1.07–7.88, p = 0.037). No association was observed between CRCI and the use of cigarettes, alcohol, or marijuana. Conclusions: Vaping is more prevalent among CCS reporting CRCI, especially those who are less likely to attend follow-up care. Our data suggests the importance of encouraging long-term follow-ups to monitor adverse lifestyle behaviors in CCS experiencing cognitive symptoms and provide timely interventions.
Inhibition of ATG3 ameliorates liver steatosis by increasing mitochondrial function
Authors: Natália da Silva Lima, Marcos F. Fondevila, Eva Nóvoa, Xabier Buqué, Maria Mercado-Gómez, Sarah Gallet, Maria J. González-Rellan, Uxia Fernandez, Anne Loyens, Maria Garcia-Vence, Maria del Pilar Chantada-Vazquez, Susana B. Bravo, Patricia Marañon, Ana Senra, Adriana Escudero, Magdalena Leiva, Diana Guallar, Miguel Fidalgo, Pedro Gomes, Marc Claret, Guadalupe Sabio, Marta Varela-Rey, Teresa C. Delgado, Rocio Montero-Vallejo, Javier Ampuero, Miguel López, Carlos Diéguez, Laura Herrero, Dolors Serra, Markus Schwaninger, Vincent Prevot, Rocio Gallego-Duran, Manuel Romero-Gomez, Paula Iruzubieta, Javier Crespo, Maria L. Martinez-Chantar, Carmelo Garcia-Monzon, Agueda Gonzalez-Rodriguez, Patricia Aspichueta, Ruben Nogueiras
Journal: Journal of Hepatology (2021)

Autophagy-related gene 3 (ATG3) is an enzyme mainly known for its actions in the LC3 lipidation process, which is essential for autophagy. Whether ATG3 plays a role in lipid metabolism or contributes to non-alcoholic fatty liver disease (NAFLD) remains unknown.By performing proteomic analysis on livers from mice with genetic manipulation of hepatic p63, a regulator of fatty acid metabolism, we identified ATG3 as a new target downstream of p63. ATG3 was evaluated in liver samples from patients with NAFLD. Further, genetic manipulation of ATG3 was performed in human hepatocyte cell lines, primary hepatocytes and in the livers of mice.ATG3 expression is induced in the liver of animal models and patients with NAFLD (both steatosis and non-alcoholic steatohepatitis) compared with those without liver disease. Moreover, genetic knockdown of ATG3 in mice and human hepatocytes ameliorates p63- and diet-induced steatosis, while its overexpression increases the lipid load in hepatocytes. The inhibition of hepatic ATG3 improves fatty acid metabolism by reducing c-Jun N-terminal protein kinase 1 (JNK1), which increases sirtuin 1 (SIRT1), carnitine palmitoyltransferase 1a (CPT1a), and mitochondrial function. Hepatic knockdown of SIRT1 and CPT1a blunts the effects of ATG3 on mitochondrial activity. Unexpectedly, these effects are independent of an autophagic action.Collectively, these findings indicate that ATG3 is a novel protein implicated in the development of steatosis.We show that autophagy-related gene 3 (ATG3) contributes to the progression of non-alcoholic fatty liver disease in humans and mice. Hepatic knockdown of ATG3 ameliorates the development of NAFLD by stimulating mitochondrial function. Thus, ATG3 is an important factor implicated in steatosis.
The temporal course of T- and B-cell responses to vaccination with BNT162b2 and mRNA-1273
Authors: Robert Markewitz, Daniela Pauli, Justina Dargvainiene, Katja Steinhagen, Sarah Engel, Victor Herbst, Dorinja Zapf, Christina Krüger, Shahpour Sharifzadeh, Benjamin Schomburg, Frank Leypoldt, Jan Rupp, Siegfried Görg, Ralf Junker, Klaus-Peter Wandinger
Journal: Clinical Microbiology and Infection (2021)
Impact of an automatic palliative care consultation trigger on healthcare use in patients with relapsed/refractory acute myeloid leukemia.
Authors: Jenny Jing Xiang, Elizabeth Horn Prsic, Kerin B. Adelson, Rosemary Ozyck, Thomas Prebet
Journal: Journal of Clinical Oncology (2021)

224 Background: Patients with relapsed/refractory acute myeloid leukemia (AML) have poor outcomes and high levels of healthcare use at end of life. Palliative care remains underused in hematology and questions remain on how best to integrate palliative care for high-risk patients. We conducted a prospective cohort study evaluating palliative care consultation triggers for patients admitted to a tertiary academic center with advanced AML. Methods: Criteria were developed for all hospitalized patients with hematologic malignancy on the inpatient hematology floors and included: 1) persistent disease after ≥ 2 lines of therapy, 2) length of stay (LOS) &gt; 7 days for symptom management, 3) ECOG performance status &gt; 2, and 4) refractory GVHD ≥ 3 lines of therapy. Patients with relapsed/refractory AML were included if they met criteria 1. A nurse coordinator performed chart review of admitted patients 1-2 times/week from June to December 2020 on the inpatient hematology floor at Smilow Cancer Hospital and contacted the primary team when patients met eligibility. Patient characteristics and healthcare outcomes were compared with patients with AML meeting criteria 1 admitted pre-intervention (June to December 2019) using Fisher t-tests. Results: A total 110 admitted patients were eligible (64 pre-intervention and 46 post-intervention). Baseline patient and disease characteristics were similar, including mean age at admission (60.4 vs 60.9 years, p = 0.848), gender (64% vs 59% male, p = 0.691), prior transplant (56% vs 52%, p = 0.702), and AML risk stratification (67% vs 78% adverse risk, p = 0.283). In the post-intervention group, 61% of eligible patients were screened. Of the screened patients, 54% received a palliative care consult, 18% were declined by the primary team, 14% were marked as not eligible, and 14% did not have consult with reason unspecified. Overall, palliative care consults increased in the post-intervention group (22% vs 43%, p = 0.021). There was a significant increase in advance care planning and/or advanced directive documentation post-intervention (13% vs 28%, p = 0.049). There was no differences in pre- and post-intervention groups in LOS (12.13 vs 12.33 days, p = 0.941), 30-day readmissions (52% vs 39%, p = 0.557), critical/intermediate care escalation (22% vs 13%, p = 0.318) and non-palliative chemotherapy post-discharge (48% vs 39%, p = 0.246). Conclusions: A triggered palliative care referral intervention is feasible and doubled palliative care use in patients with relapsed/refractory AML, a group with high mortality and high healthcare utilization. Our intervention improved documentation of advance care planning. Although there were directional reductions in other healthcare use measures, the differences were not statistically significant, likely from the small sample sizes leading to the study being underpowered.
Publisher Correction: The janus-kinase inhibitor ruxolitinib in SARS-CoV-2 induced acute respiratory distress syndrome (ARDS)
Authors: Andreas Neubauer, Johannes Johow, Elisabeth Mack, Andreas Burchert, Damaris Meyn, Andrea Kadlubiec, Iuliu Torje, Hinnerk Wulf, Claus F. Vogelmeier, Joachim Hoyer, Chrysanthi Skevaki, Ralf Michael Muellenbach, Christian Keller, Carmen Schade-Brittinger, Caroline Rolfes, Thomas Wiesmann
Journal: Leukemia (2021)
Syngeneic hematopoietic stem cell transplantation for acute myeloid leukemia: a propensity score-matched analysis
Authors: Shuhei Kurosawa, Shohei Mizuno, Yasuyuki Arai, Masayoshi Masuko, Junya Kanda, Kentaro Kohno, Daishi Onai, Takahiro Fukuda, Yukiyasu Ozawa, Yuta Katayama, Masatsugu Tanaka, Kazuhiro Ikegame, Naoyuki Uchida, Tetsuya Eto, Shuichi Ota, Junji Tanaka, Tatsuo Ichinohe, Yoshiko Atsuta, Masamitsu Yanada
Journal: Blood Cancer Journal (2021)

The present study evaluated outcomes and prognostic factors in adult patients with acute myeloid leukemia (AML) after syngeneic hematopoietic stem cell transplantation (HSCT). Among patients in first complete remission (CR1), outcomes of syngeneic HSCT (Syn) were compared with those of autologous HSCT (Auto), allogeneic HSCT from human leukocyte antigen (HLA)-matched sibling donor (MSD), or allogeneic HSCT from HLA-matched unrelated donor (MUD). Among 11,866 patients receiving first HSCT, 26 in the Syn group were analyzed. The 5-year overall survival (OS) rate, the cumulative incidence of relapse, and the cumulative incidence of non-relapse mortality (NRM) were 47.8%, 59.6%, and 4.6%, respectively. The OS was significantly better in patients in CR1 (n = 13) than in patients in non-CR1 (P = 0.012). Furthermore, 39 patients in CR1 each were assigned to the Auto, MSD, and MUD groups using propensity score matching. The 5-year OS in the Syn (68.4%) was not significantly different from those in the Auto (55.9%, P = 0.265), MSD (62.4%, P = 0.419), or MUD (63.7%, P = 0.409) groups. A higher relapse in the Syn than in the MSD and MUD groups was offset by lower NRM. In summary, syngeneic HSCT might be an alternative option for AML patients in CR1.
FLT3L Release by Natural Killer Cells Enhances Response to Radioimmunotherapy in Preclinical Models of HNSCC
Authors: Thomas E. Bickett, Michael Knitz, Laurel B. Darragh, Shilpa Bhatia, Benjamin Van Court, Jacob Gadwa, Shiv Bhuvane, Miles Piper, Diemmy Nguyen, Hua Tu, Laurel Lenz, Eric T. Clambey, Kevin Barry, Sana D. Karam
Journal: Clinical Cancer Research (2021)

Natural killer (NK) cells are type I innate lymphoid cells that are known for their role in killing virally infected cells or cancer cells through direct cytotoxicity. In addition to direct tumor cell killing, NK cells are known to play fundamental roles in the tumor microenvironment through secretion of key cytokines, such as FMS-like tyrosine kinase 3 ligand (FLT3L). Although radiotherapy is the mainstay treatment in most cancers, the role of radiotherapy on NK cells is not well characterized.
Veterans Affairs hematology/oncology clinic video telehealth experience.
Authors: Nikesh Shah, Savan Shah, Gopi Kesaria Prithviraj
Journal: Journal of Clinical Oncology (2021)

281 Background: Many of the 40,000 veterans annually diagnosed with cancer have limited access to Hematology/Oncology care. An existing method to improve access in the Veterans Affairs (VA) system is the e-consultation, which allows text-based consultation by specialty services. However, many patients require more in-depth care than is feasible by e-consult. Amidst the COVID-19 pandemic, the James A. Haley VA (JAHVA) Hematology/Oncology department implemented VA video connect (VVC) telehealth visits to allow providers to connect with patients in their homes. Our aim was to assess the implementation of this novel telehealth service and assess provider perceptions via questionnaires. Methods: We reviewed charts of patients seen via VVC by the JAHVA Hematology/Oncology department. We gathered data including patient demographics, zip code, primary visit diagnosis, and date of visit. We adapted a previously validated telehealth usability questionnaire by Parmanto et al. Providers were surveyed about perceptions of VVCs prior to implementation and 1 year later. Responses were assessed via 5-point Likert scale. Results: From May 2020 to April 2021, 1290 VVCs were conducted. Median VVCs per month was 106 (range 26 to 161), with peak in June 2020. 71% of patients were ³65 years, 24% were 45-64 years, and 5% were &lt;45 years. 77% of patients were white, 16% African American, 3% other, and 4% declined to answer or were of unknown race. 87% of patients were male. 12.5% of visits were for new consults. 41% of visits were for primary neoplasm-related diagnoses, 27% for hematologic diagnoses, and 32% for other. The mean residential distance from our clinic was 37.2 miles (range 0-212.7 miles). Sixteen Hematology/Oncology providers (faculty, fellows, advanced practice providers) completed the initial questionnaire, and 12 completed the follow-up questionnaire. See table for selected results. Conclusions: VVCs are a feasible method to provide remote access to care for patients. Utilization peaked in summer 2020, at the height of the COVID-19 pandemic. Providers were overall satisfied with video visits, though preference for in-person visits increased with time. Provider concern regarding personal and patient exposure to COVID-19 may have impacted perceptions regarding VVCs. Utilizing the PDSA cycle, future steps include identifying specific patient diagnoses and identifying reasons for VVC failure and using this data to optimize the experience for pati ent and providers.[Table: see text]