tbuckley/cabot-search huggingface dataset:
Magnitude of the Placebo Response Across Treatment Modalities Used for Treatment-Resistant Depression in Adults
Authors: Brett D. M. Jones, Lais B. Razza, Cory R. Weissman, Jewel Karbi, Tya Vine, Louise S. Mulsant, Andre R. Brunoni, M. Ishrat Husain, Benoit H. Mulsant, Daniel M. Blumberger, Zafiris J. Daskalakis
Journal: JAMA Network Open (2021)

<h3>Importance</h3> The placebo effect in depression clinical trials is a substantial factor associated with failure to establish efficacy of novel and repurposed treatments. However, the magnitude of the placebo effect and whether it differs across treatment modalities in treatment-resistant depression (TRD) is unclear. <h3>Objective</h3> To examine the magnitude of the placebo effect in patients with TRD across different treatment modalities and its possible moderators. <h3>Data Sources</h3> Searches were conducted on MEDLINE, Web of Science, and PsychInfo from inception to June 21, 2021. <h3>Study Selection</h3> Randomized clinical trials (RCTs) were included if they recruited patients with TRD and randomized them to a placebo or sham arm and a pharmacotherapy, brain stimulation, or psychotherapy arm. <h3>Data Extraction and Synthesis</h3> Independent reviewers used standard forms for data extraction and quality assessment. Random-effects analyses and standard pairwise meta-analyses were performed. <h3>Main Outcomes and Measures</h3> The primary outcome was the Hedges<i>g</i>value for the reported depression scales. Secondary outcomes included moderators assessed via meta-regression and response and remission rates. Heterogeneity was assessed with the<i>I</i><sup>2</sup>test, and publication bias was evaluated using the Egger test and a funnel plot. Cochrane Risk of Bias Tool was used to estimate risks. <h3>Results</h3> Fifty RCTs were included involving various types of placebo or sham interventions with a total of 3228 participants (mean [SD] age, 45.8 [6.0] years; 1769 [54.8%] female). The pooled placebo effect size for all modalities was large (<i>g</i> = 1.05; 95% CI, 0.91-1.1); the placebo effect size in RCTs of specific treatment modalities did not significantly differ. Similarly, response and remission rates associated with placebo were comparable across modalities. Heterogeneity was large. Three variables were associated with a larger placebo effect size: open-label prospective treatment before double-blind placebo randomization (β = 0.35; 95% CI, 0.11 to 0.59;<i>P</i> = .004), later year of publication (β = 0.03; 95% CI, 0.003 to 0.05;<i>P</i> = .03), and industry-sponsored trials (β = 0.34; 95% CI, 0.09 to 0.58;<i>P</i> = .007). The number of failed interventions was associated with the probability a smaller placebo effect size (β = −0.12; 95% CI, −0.23 to −0.01,<i>P</i> = .03). The Egger test result was not significant for small studies’ effects. <h3>Conclusions and Relevance</h3> This analysis may provide a benchmark for past and future clinical RCTs that recruit patients with TRD standardizing an expected placebo effect size.
Physician decision-making on use of treatments for relapsed/refractory multiple myeloma (RRMM) in later lines: What drives preferences?
Authors: Laurie Batchelder, Stephanie Philpott, Victoria Divino, Natalie Boytsov, Eric M Maiese, Cosmina Hogea, Trudy Buckingham, Chi-Chang Chen, Ana Maria Rodriguez
Journal: Journal of Clinical Oncology (2021)

239 Background: Physicians consider many factors when selecting third line or greater (3L+) treatments for RRMM, such as patient age and treatment- and disease-specific factors. A greater understanding of preferences that drive treatment decision-making in RRMM in later lines is important. This study assessed treatment preferences of US hematologists/oncologists and oncologists (HemOnc/Oncs) for RRMM patients in 3L+. Methods: A targeted literature review informed a discrete choice experiment (DCE) survey aimed at identifying treatment preferences. Qualitative interviews with HemOnc/Oncs and a pilot DCE survey were then administered to test the validity of the study attributes. The three versions of the final survey varied in presented patient profiles (3L; 4L; 5L). Participating HemOnc/Oncs were presented with 20 DCE choice tasks; in each task, they were asked to choose between pairs of hypothetical treatments including varying levels for each attribute: overall survival (OS), overall response rate (ORR), progression free survival (PFS), keratopathy (corneal epithelium changes with/without symptoms), thrombocytopenia, neutropenia, steroids, preparations, mode of administration, and drug regimen frequency of administration. DCE data were analyzed using multinomial logit regression (MLR) to estimate treatment preferences for each profile; 4L and 5L data were combined (4L+) because patient profiles were comparable. Mean relative importance of the attributes were estimated. Results: The DCE survey was completed by 227 HemOnc/Oncs (N=227); 3L (n=83), 4L (n=73), or 5L (n=71). For 3L and 4L+, as predicted, OS had the highest mean relative importance of the attributes relative to other attributes (3L: 38.1%; 4L+: 36.5%) (Table); the lowest relative importance was whether the treatment required additional preparations for administration (3L: 1.3%; 4L+: 2.1%). Results of the MLR showed that physicians preferred treatments with decreased Grade 3/4 keratopathy risk of 0% compared to 25% (3L: odds ratio [OR] 1.22, p &lt; 0.0001; 4L+: OR 1.12, p &lt; 0.01); physicians also preferred treatments with decreased Grade 3/4 thrombocytopenia risk of 21% compared to 60% (3L: OR 1.16, p &lt; 0.05; 4L+: OR 1.11, p &lt; 0.05). For 4L+, physicians preferred a subcutaneously administered treatment (OR 1.10, p &lt; 0.05). Mean importance of attributes relative to other attributes when selecting patient treatments. Conclusions: In assessing treatment preferences, HemOnc/Oncs placed higher relative importance on OS, PFS, ORR, and preferred a decreased risk of Grade 3/4 keratopathy and thrombocytopenia when choosing later line therapies for RRMM.[Table: see text]
LightGBM: accelerated genomically designed crop breeding through ensemble learning
Authors: Jun Yan, Yuetong Xu, Qian Cheng, Shuqin Jiang, Qian Wang, Yingjie Xiao, Chuang Ma, Jianbing Yan, Xiangfeng Wang
Journal: Genome biology (2021)

LightGBM is an ensemble model of decision trees for classification and regression prediction. We demonstrate its utility in genomic selection-assisted breeding with a large dataset of inbred and hybrid maize lines. LightGBM exhibits superior performance in terms of prediction precision, model stability, and computing efficiency through a series of benchmark tests. We also assess the factors that are essential to ensure the best performance of genomic selection prediction by taking complex scenarios in crop hybrid breeding into account. LightGBM has been implemented as a toolbox, CropGBM, encompassing multiple novel functions and analytical modules to facilitate genomically designed breeding in crops.
Abstract 11821: Detection of Uric Acid Crystals in the Vasculature of Patients With Gout Using Dual-Energy Computed Tomography
Authors: Sharon H Barazani, Weiwei Chi, Renata Pyzik, Adam Jacobi, Tom O'Donnell, Zahi Fayad, Venkatesh Mani, Yousaf Ali
Journal: Circulation (2018)

Introduction: Many recent studies have shown an association between gout and increased cardiovascular risk, however the mechanism by which this occurs is unclear. Dual-Energy Computed Tomography (D...
COVID infection revealing factor xi deficiency in elderly patient
Authors: K. Hajar, B. Ghita, C. Wyssal, J. Nissrine, A. Wafae, M. Mouna, H. Hicham, T. M. Zoubida, A. Mohammed
Journal: HemaSphere (2021)

Background: Factor XI deficiency, acquired or constitutional, constitutes a pathology moderate hemostasis The hemorrhagic symptomatology of factor XI deficiency varies between patients and even in the same patient, and requires a triggering factor. Coagulation disturbances are commonly seen in patients with COVID19. If thrombosis is a clinical feature predominantly of COVID 19 contributing to visceral failures, events bleeding is infrequent and is probably related to vascular coagulation disseminated. Aims: We report the case of an 84-year-old subject in whom a covid 19 would have allowed the late revelation of a constitutional factor XI deficiency. Methods: We report the case of an 84-year-old subject in whom a covid 19 would have allowed the late revelation of a constitutional factor XI deficiency. Results: An 84-year-old patient was admitted to an intensive care unit for the management of acute respiratory distress. He does not report any history of hemorrhage and no similar case in the family. The clinical examination on admission found signs respiratory struggle, 90% saturation in ambient air, a syndrome mucocutaneous hemorrhagic disease consisting of clot hematuria, epistaxis and a extensive hematoma of the rectus abdominis muscles measuring 14 cm / 6 cm, the chest scanner suggested pneumonia COVID type classified CORADS 5 extended over 50-75% of lung surface associated with right proximal pulmonary embolism. an isolated prolongation of the activated partial thromboplastin time at 1.38 without thrombocytopenia, elevation of dimers or consumption of fibrinogen. Wilbrand factor antigen and activity were normales. The exploration of coagulation factors of the endogenous pathway has objectified a factor XI deficiency estimated at 36%. The hypothesis of a constitutional factor XI deficiency decompensated by SARS cov 2 infection was therefore raised The treatment was based on symptomatic treatment with oxygen therapy and replacement with fresh plasma frozen. The evolution was marked, after regression of the SARS cov 2 pneumonia, by the control and the absence of recurrence of hemorrhagic manifestations. Summary/Conclusion: Constitutional factor XI deficiency is a rare deficiency in coagulation but its incidence remains underestimated, as it is rarely responsible for a hemorrhagic syndrome and requires a triggering factor for the hemorrhagic syndrome. In our patient, infection with Covid 19 was the viral infection responsible for triggering hemmoragic syndrome secondary to factor XI deficiency.
Outcomes in breast cancer from the patient perspective: Development of an innovative, user-centered platform for collection and reporting of patient-reported data.
Authors: Elena Tsangaris, Rakasa Pattanaik, Joanna O'Gorman, Jessica Means, Noah Sarucia, Elizabeth Frank, Laura Stewart Dominici, Michael J. Hassett, Maria Edelen, Andrea Pusic
Journal: Journal of Clinical Oncology (2021)

188 Background: Transition towards a patient-centered healthcare model has been recognized as an important step towards improving the quality and coordination of breast cancer care. Although evidence suggests that patient self-reporting of quality of life improves clinical care, there are significant barriers to successful collection and use of patient-reported data (PRD) including a lack of a technology designed to fully engage patients and providers, limited electronic health record (EHR) integration, and suboptimal clinical implementation strategies. To address this, our team developed imPROVE, an innovative and customizable patient-reported data (PRD) collection platform consisting of a patient web-application and a clinician portal. Methods: This study was performed as a quality improvement initiative at Dana-Farber Cancer Institute (DFCI) and Brigham and Women’s Hospital (BWH). Multiple perspectives were sought from key stakeholders to ensure that the content and design of the platform target the needs of the end-users and garners the latest in technological advances. Development and testing were performed using best practices in user-centered design and agile development, and iterative programming sprints followed by stakeholder feedback and testing. Content was evaluated using probing questions about relevance, comprehensiveness, and clarity. Design was assessed through feedback about the look and feel of the platform and its usability. Results: A multidisciplinary team of 28 stakeholders in the field of breast cancer care, patient-reported outcomes research and value-based healthcare was assembled. Recurring group meetings (n = 8), individual patient interviews (n = 23), and two focus groups with the DF/HCC Breast Cancer Advocacy Group, were conducted. The resultant application is a hybrid mHealth application that is supported by iOS and Android and is comprised of five screens (myCare, myStory, myResources, myCommunity, myNotes). Patients are provided written and graphical displays of their PRD as well as tailored resources that are customized depending on their type and stage of treatment. The clinician portal is comprised of an overview table listing all patients enrolled for each individual clinician, as well as individual patient profiles demonstrating demographic, clinical, and outcomes data. Conclusions: imPROVE has the potential to create a paradigm shift in the delivery of care for breast cancer patients. Next steps will include implementation of imPROVE within the breast oncology and plastic surgery services at DFCI and BWH.
Evidence for the Ethics of Incentivizing Clinical Trial Enrollment?
Authors: Sang Ngo, Anthony S. Kim, Winston Chiong
Journal: JAMA Internal Medicine (2021)

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Abstract 14119: Contrasting Effects of Exercise Training After Acute Myocardial Infarction versus Aortic Stenosis Depend Critically on the Regulation of Endothelial Nitric Oxide Synthase
Authors: Yanti Octavia, Elza D van Deel, Monique de Waard, Martine de Boer, Dirk J Duncker
Journal: Circulation (2015)

Introduction: The cardiovascular benefits of exercise training (EX) are widely appreciated. Previously we found that the cardiac effects of EX critically depend on the underlying cause of heart disease. Hypothesis: The underlying etiology determines how EX affects the endothelial nitric oxide (NO) synthase (eNOS)-mediated balance between NO and superoxide (O2-). Methods: Mice were subjected to sham surgery, myocardial infarction (MI) or transverse aortic constriction (TAC), and subsequently exposed to 8 weeks of voluntary wheel running or sedentary housing. Left ventricular (LV) function was assessed by echocardiography and hemodynamic measurements; fibrosis by Picro-sirius Red staining; peroxynitrite (ONOO-) and O2- production by luminol- and lucigenin-enhanced chemiluminescence respectively, with or without the NOS inhibitor L-NAME; eNOS uncoupling and eNOS S-glutathionylation by western blot and coimmunoprecipitation, respectively; cardiac NO by the Griess reaction. Results: EX ameliorated LV dysfunction and fibrosis in MI but not TAC (Table 1). Strikingly, O2- generation was blunted by EX in MI, but exacerbated by EX in TAC, which was largely NOS-dependent. Accordingly, eNOS uncoupling and eNOS S-glutathionylation were corrected by EX in MI but aggravated in TAC mice. In parallel, ONOO- levels was attenuated by EX in MI but aggravated by EX in TAC. Cardiac NO levels were reduced in MI and TAC and normalized by EX in MI. Conclusions: The contrasting effects of EX in MI vs TAC can be explained by the highly divergent effects of EX on eNOS regulation, resulting in blunted vs aggravated oxidative stress by EX in MI vs TAC.
Incremental benefit of interdisciplinary care in resource identification in an adolescent and young adult (AYA) oncology care model.
Authors: Amanda Marie Parkes, Cathy Lee-Miller
Journal: Journal of Clinical Oncology (2021)

228 Background: Conventional health care models inadequately address the complex needs of adolescents and young adults (AYAs, defined as patients aged 15-39) with cancer, thus necessitating AYA programs. While grounded in the integration of medical and psychosocial care, the best AYA care model has not been identified. We sought to evaluate the comparative impact of one-on-one AYA clinic visits versus interdisciplinary team care on AYA-specific resource identification. Methods: We identified patients seen at the University of Wisconsin (UW) AYA Oncology program between 1/21/2021-5/13/2021. Patients in this program have a one-on-one clinic visit with an AYA physician followed four days later by case presentation at an AYA interdisciplinary team (IDT) meeting. We conducted retrospective chart review to evaluate novel resources identified by the AYA IDT meeting versus those previously identified during the one-on-one AYA clinic visit. Resources identified had to be novel from those already used by or identified for the patient. Results: We identified 32 patients seen by the UW AYA Oncology program. Prior to their AYA clinic visit, patients saw an average of 2.0 AYA-specific services (range 0-6, defined as those services listed in table). As seen in table, an average of 2.8 novel AYA-specific resources were identified for each patient (range 0-5) during the one-on-one AYA clinic visit. Following the AYA IDT meeting, additional novel resources were identified in 100% of patients, with an average of 2.6 additional resources identified per patient (range 1-7). Considering all resources identified by the AYA Oncology program (clinic visit + IDT), an average of 5.4 novel resources were identified per patient (range 2-10). AYA-Specific Resource Identification (n=32). Conclusions: Supporting the importance of dedicated AYA care models, we found that all patients in our study had novel AYA-specific resources identified by the UW AYA Oncology program. Resources identified by the physician-led one-on-one AYA clinic visit were not comprehensive as additional resources were identified for each patient at the AYA IDT meeting only four days later. These objective data support the critical importance of AYA interdisciplinary care as well as the use of an AYA IDT meeting model as a method to include interdisciplinary team care in AYA programs despite possible resource constraints.[Table: see text]
A narrative review of the epidemiology and economics of chronic wounds
Authors: N. Graves, C.J. Phillips, K. Harding
Journal: British Journal of Dermatology (2021)

Chronic wounds have a debilitating effect on the quality of life of many individuals, and the large economic impact on health system budgets warrants greater attention in policy making and condition management than is currently evident. The aim of this narrative review is to summarize the nature and extent of the chronic wound problem that confronts health systems across the world. The first section is used to highlight the underlying epidemiology relating to chronic wounds, while the second explores the economic costs associated with them and the relative efficiency of measures designed to manage them.
Patient-reported unfair treatment within the health care system.
Authors: Nicole E. Caston, Courtney Williams, Kathleen D. Gallagher, Rebekah Angove, Eric Anderson, Alan James Balch, Gabrielle Betty Rocque
Journal: Journal of Clinical Oncology (2021)

115 Background: Patients with cancer who perceive discrimination and unfair treatment from the health care system are at risk for lower health-related quality of life. This study seeks to better understand the characteristics of under-resourced patients who report unfair treatment from the health care system and providers. Methods: This cross-sectional analysis used data from a nationwide survey distributed in December 2020 by Patient Advocate Foundation (PAF), a US non-profit organization providing case management and financial aid to individuals with chronic illness. The survey was fielded via email to those who received PAF services from July 2019-April 2020. Inclusion criteria included a valid e-mail address, aged ≥ 19, and either current or previous cancer treatment. Respondents reported unfair treatment in connection to their health care. Age, sex, race/ethnicity, and annual household income were abstracted from the PAF database. The validated Group-Based Medical Mistrust Scale was used to assess respondents’ level of mistrust in medical providers as it relates to their ethnic group. Scores range from 12-60 and were categorized based on tertiles as high mistrust (scores ≥ 29), neutral (21-28), and low mistrust (≤ 20). Frequencies and percentages were calculated for categorical variables. Results: There were a total of 429 survey respondents with cancer. Most respondents were female (73%) and aged 56-75 (57%); 31% were Black, Indigenous, or Persons of Color (BIPOC). The most common cancer types were hematologic (33%) and breast (33%). Overall, 20% (n = 86) of respondents reported having received unfair treatment. Of those reporting unfair treatment, 56% reported receipt from their doctor, nurse, or health care provider, 51% insurance company, 38% the health care system, and 14% pharmacist. When asked why they felt unfairly treated, the most common responses were related to insurance status (51%), disease or condition (45%), and income (35%). Notably, unfair treatment due to race/ethnicity (6%), sex (9%), and sexual orientation/gender expression (3%) were uncommon. When compared to those who reported objective treatment, respondents reporting unfair treatment were more often unemployed/other (28% vs 11%), privately insured (38% vs 27%), having income &lt; $23,000 (40% vs 25%), having 3+ comorbidities (40% vs 23%) and reporting more mistrust in medical providers (53% vs 27%). There did not appear to be a difference in reporting of unfair treatment by race/ethnicity. Of BIPOC respondents, 51% reported high mistrust in medical providers. Conclusions: This under-resourced population of respondents with cancer reported unfair treatment related to their finances, insurance, and disease status. Our data suggest health care-associated discrimination may occur based on socioeconomic resources. This work identifies a novel equity consideration warranting further evaluation.
The Supreme Court, the Texas Abortion Law (SB8), and the Beginning of the End of <i>Roe v Wade</i>?
Authors: I. Glenn Cohen, Eli Y. Adashi, Lawrence O. Gostin
Journal: JAMA (2021)

This Viewpoint discusses SB8, the recent law passed in Texas that essentially prohibits abortion after 6 weeks of gestational age, and the effect this will have on persons seeking pregnancy termination as well as the future of constitutional protection of abortion services.
Stroke in Africa: profile, progress, prospects and priorities
Authors: Rufus O. Akinyemi, Bruce Ovbiagele, Olaleye A. Adeniji, Fred S. Sarfo, Foad Abd-Allah, Thierry Adoukonou, Okechukwu S. Ogah, Pamela Naidoo, Albertino Damasceno, Richard W. Walker, Adesola Ogunniyi, Rajesh N. Kalaria, Mayowa O. Owolabi
Journal: Nature Reviews Neurology (2021)