tbuckley/cabot-search huggingface dataset:
Well-Child Visits for Early Detection and Management of Maternal Postpartum Hypertensive Disorders
Authors: Farah H. Amro, Kim C. Smith, Syed S. Hashmi, Michelle S. Barratt, Rachel Carlson, Kristen Mariah Sankey, Michal Fishel Bartal, Sean C. Blackwell, Suneet P. Chauhan, Baha M. Sibai
Journal: JAMA Network Open (2024)

Importance Innovative approaches are needed to address the increasing rate of postpartum morbidity and mortality associated with hypertensive disorders. Objective To determine whether assessing maternal blood pressure (BP) and associated symptoms at time of well-child visits is associated with increased detection of postpartum preeclampsia and need for hospitalization for medical management. Design, Setting, and Participants This is a pre-post quality improvement (QI) study. Individuals who attended the well-child visits between preimplementation (December 2017 to December 2018) were compared with individuals who enrolled after the implementation of the QI program (March 2019 to December 2019). Individuals were enrolled at an academic pediatric clinic. Eligible participants included birth mothers who delivered at the hospital and brought their newborn for well-child check at 2 days, 2 weeks, and 2 months. A total of 620 individuals were screened in the preintervention cohort and 680 individuals were screened in the QI program. Data was analyzed from March to July 2022. Exposures BP evaluation and preeclampsia symptoms screening were performed at the time of the well-child visit. A management algorithm—with criteria for routine or early postpartum visits, or prompt referral to the obstetric emergency department—was followed. Main Outcome and Measures Readmission due to postpartum preeclampsia. Comparisons across groups were performed using a Fisher exact test for categorical variables, and t tests or Mann-Whitney tests for continuous variables. Results A total of 595 individuals (mean [SD] age, 27.2 [6.1] years) were eligible for analysis in the preintervention cohort and 565 individuals (mean [SD] age, 27.0 [5.8] years) were eligible in the postintervention cohort. Baseline demographic information including age, race and ethnicity, body mass index, nulliparity, and factors associated with increased risk for preeclampsia were not significantly different in the preintervention cohort and postintervention QI program. The rate of readmission for postpartum preeclampsia differed significantly in the preintervention cohort (13 individuals [2.1%]) and the postintervention cohort (29 individuals [5.6%]) ( P = .007). In the postintervention QI cohort, there was a significantly earlier time frame of readmission (median [IQR] 10.0 [10.0-11.0] days post partum for preintervention vs 7.0 [6.0-10.5] days post partum for postintervention; P = .001). In both time periods, a total of 42 patients were readmitted due to postpartum preeclampsia, of which 21 (50%) had de novo postpartum preeclampsia. Conclusions and Relevance This QI program allowed for increased and earlier readmission due to postpartum preeclampsia. Further studies confirming generalizability and mitigating associated adverse outcomes are needed.
Electron transport chain inhibition increases cellular dependence on purine transport and salvage
Authors: Zheng Wu, Divya Bezwada, Feng Cai, Robert C. Harris, Bookyung Ko, Varun Sondhi, Chunxiao Pan, Hieu S. Vu, Phong T. Nguyen, Brandon Faubert, Ling Cai, Hongli Chen, Misty Martin-Sandoval, Duyen Do, Wen Gu, Yuanyuan Zhang, Yuannyu Zhang, Bailey Brooks, Sherwin Kelekar, Lauren G. Zacharias, K. Celeste Oaxaca, Joao S. Patricio, Thomas P. Mathews, Javier Garcia-Bermudez, Min Ni, Ralph J. DeBerardinis
Journal: Cell Metabolism (2024)

Mitochondria house many metabolic pathways required for homeostasis and growth. To explore how human cells respond to mitochondrial dysfunction, we performed metabolomics in fibroblasts from patients with various mitochondrial disorders and cancer cells with electron transport chain (ETC) blockade. These analyses revealed extensive perturbations in purine metabolism, and stable isotope tracing demonstrated that ETC defects suppress de novo purine synthesis while enhancing purine salvage. In human lung cancer, tumors with markers of low oxidative mitochondrial metabolism exhibit enhanced expression of the salvage enzyme hypoxanthine phosphoribosyl transferase 1 (HPRT1) and high levels of the HPRT1 product inosine monophosphate. Mechanistically, ETC blockade activates the pentose phosphate pathway, providing phosphoribosyl diphosphate to drive purine salvage supplied by uptake of extracellular bases. Blocking HPRT1 sensitizes cancer cells to ETC inhibition. These findings demonstrate how cells remodel purine metabolism upon ETC blockade and uncover a new metabolic vulnerability in tumors with low respiration.
Valid Analysis of Brain-Specific Progression-Free Survival
Authors: Stephanie Armbruster, Ethan B. Ludmir, Lee-Jen Wei
Journal: JAMA Oncology (2024)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal
A 5-Year Follow-up Clinical Study of the B-cell Maturation Antigen Chimeric Antigen Receptor T-cell Therapy HDS269B in Patients with Relapsed or Refractory Multiple Myeloma
Authors: Dongjian Chen, Yu Zhu, Zhi Chen, Songfu Jiang, Haiyan He, Wanting Qiang, Fang Xiang, Xuedong Sun, Juan Du
Journal: Clinical Cancer Research (2024)

Abstract Purpose: This study aimed to report the 5-year clinical outcomes of anti–B-cell maturation antigen chimeric antigen receptor (CAR) T-cell (HDS269B) therapy in patients with relapsed/refractory multiple myeloma (RRMM), including those with poor performance status [Eastern Cooperative Oncology Group (ECOG) scores 3 to 4], and to identify factors influencing long-term outcomes. Patients and Methods: Forty-nine patients with RRMM enrolled from 2016 to 2020 received HDS269B (9 × 106 cells/kg) after receiving a conditioning chemotherapy consisting of cyclophosphamide and fludarabine. The overall response, long-term outcomes, and safety were assessed, as were their associations with clinical and disease characteristics. Results: With a median follow-up of 59.0 months, the overall response rate was 77.55%. The median progression-free survival (PFS) and overall survival (OS) were 9.5 months [95% confidence interval (CI), 5.01–13.99] and 20.0 months (95% CI, 11.26–28.74), respectively. The 5-year PFS and OS rates were 21.3% (95% CI, 12.3%–36.7%) and 34.1% (95% CI, 22.7%–51.3%), respectively. Patients with ECOG 0 to 2 had marked longer survival, with a median PFS of 11.0 months and a median OS of 41.8 months. Early minimal residual disease negativity, higher and persistent CAR T-cell expansion, and the absence of extramedullary disease were associated with better survival outcomes. No new CAR T-cell therapy–associated toxicities were observed. Importantly, ECOG scores 0 to 2, prior therapy lines &amp;lt;4, and CAR T-cell persistence at ≥6 months were independently associated with longer OS. Conclusions: HDS269B is effective and safe, especially for patients with ECOG scores 0 to 2. Early CAR T-cell intervention may improve prognosis in patients with RRMM.
Home Time Among Older Adults With Acute Myeloid Leukemia Following Chemotherapy
Authors: Daniel R. Richardson, Xi Zhou, Katherine Reeder-Hayes, Christopher E. Jensen, Jessica Islam, Kah Poh Loh, Arjun Gupta, Ethan Basch, Antonia V. Bennett, John F. P. Bridges, Stephanie B. Wheeler, William A. Wood, Christopher D. Baggett, Jennifer L. Lund
Journal: JAMA Oncology (2024)

Patients with acute myeloid leukemia (AML) recognize days spent at home (home time) vs in a hospital or nursing facility as an important factor in treatment decision making. No study has adequately described home time among older adults with AML.
Investigating the mediating role of mental adjustment in the relationship between perceived stress and quality of life in patients with cancer.
Authors: Maria-Chidi Christiana Onyedibe, Runcie C. W. Chidebe
Journal: Journal of Clinical Oncology (2024)

12106 Background: Cancer patients undergo a multifaceted journey fraught with substantial psychological distress and coping hurdles, profoundly influencing their overall well-being. The intricate nexus between perceived stress and diminished Health-Related Quality of Life (HRQoL) in this population has garnered significant attention. However, the pivotal role played by mental adjustment to cancer (MAC) as a potential mediator in this intricate relationship remains inadequately explored. Given the paramount importance of understanding the psychological dynamics inherent to cancer care, our study sought to delve into the mediating influence exerted by MAC on the association between perceived stress and HRQoL among individuals grappling with cancer. Methods: The study enrolled 214 cancer patients (74 male, 140 female, mean age = 50.57, SD= 13.07) from a University Teaching Hospital in South-West Nigeria. Participants completed assessments utilizing the Impact of Event Scale, Mental Adjustment to Cancer, and Health-Related Quality of Life (measured by the Functional Assessment of Cancer Therapy–General). The study utilized a cross-sectional design, and data analysis was performed using mediation analysis with PROCESS procedures in SPSS. Results: Results indicated that perceived stress was associated with lower HRQoL (β = -.71, p &lt; .001, CI, -1.02, -.39). Among the five dimensions of MAC, three sub-dimensions: helplessness (β = -.49, p &lt; .05, CI, -.95, -.02), anxious occupation (β = -1.45, p &lt; .05, CI, -1.92, -.96) and cognitive avoidance (β = 1.43, p &lt; .001, CI, .61 – 2.25) were significantly associated with HRQoL. Mediation analysis showed that only two dimensions—helplessness and anxious preoccupation —mediated the relationship between cancer-related stress and HRQoL. The indirect effect for both helplessness (β = -.14, SE = .069, CI -.24, -.01) and anxious preoccupation (β = -.31, SE = .09, CI -.51, -.15) were significant. The findings indicate that stress related to cancer may lead to elevated levels of helplessness and anxious preoccupation, subsequently contributing to a decrease in Health-Related Quality of Life (HRQoL). Conclusions: This study provides valuable insights into the intricate relationship between perceived stress, mental adjustment to cancer, and HRQoL, offering implications for targeted interventions aimed at enhancing the well-being of individuals grappling with the challenges of cancer diagnosis and treatment. By tailoring interventions to address these nuanced dynamics, healthcare providers can foster improved overall well-being and adaptive capacities in individuals navigating the complexities of cancer care. Key words: Cancer patients, mental adjustment to cancer, perceived stress, health-related quality of life
Examining patient preferences in the delivery of healthcare education.
Authors: Tomas Dvorak, Lauren Skinner, Leticia Valentin, Julio Hajdenberg
Journal: Journal of Clinical Oncology (2024)

12113 Background: Important component of patient-centered care includes providing patient education. While traditionally provided on paper, electronic methods are becoming increasingly common. In this study, we evaluated a socially assistive robot (SAR Robot) delivering education information to patients via narration of a video, compared with same information provided via a paper-based brochure (Brochure). Methods: The study was a 2-arm, unblinded, randomized trial with a cross-over design, approved by local IRB. Arm 1 was Brochure first, followed by SAR Robot, and Arm 2 was SAR Robot first, followed by a paper Brochure. Questionnaires were completed after each step. The education information provided was on "Diet and Cancer", and the Brochure and the SAR Robot video were adapted from the same script developed by the study authors. Likert scale was used to assess effectiveness of each method and the enjoyment of the SAR Robot experience. Statistics were performed to assess for significance. Results: Between 2021 and 2023, 129 patients were enrolled at Orlando Health Cancer Institute, randomized to Arm 1 (n=64) vs Arm 2 (n=65); 122 patients were analyzable. There were no differences in demographics. Brochure was judged to be Very Effective by 50% in Arm 1 (Brochure first) and 63% in Arm 2 (Brochure second). SAR Robot was judged to be Very Effective by 60% in Arm 1 and 60% in Arm 2. Composite rates of Effective or Very Effective were 97% for Brochure and 88% for Robot SAR. Patients and guests preferred Brochure in 27% in Arm 1 and 17% in Arm 2. They preferred the SAR Robot in 39% in Arm 1 and 42% in Arm 2. They preferred both in 34% and 42%, and of these majority preferred the SAR Robot for explanation and Brochure to take home. There was no statistical difference between arms in effectiveness. There were no differences across demographics. Answering the "My experience with the SAR Robot today was enjoyable" question, 47% of patients responded Strongly Agree, and further 41% responded Agree, 11% were Neutral, and only 1% responded Disagree. There was a significant correlation between enjoying the SAR Robot experience and effectiveness of the SAR Robot; there was no correlation between enjoying the SAR Robot experience and effectiveness of the Brochure. There was no statistical correlation between enjoying the SAR Rabot experience and demographics. Conclusions: Patient reported no significant difference in effectiveness of obtaining education information via a standard paper brochure or from a socially assisted robot. However, they preferred to receive that information from the socially assisted robot, or in combination with the paper brochure to take home. Significant majority of them (88%) enjoyed the socially assisted robot experience during their visit. Providing patient education materials via socially assisted robots may improve patient experience during their clinic visit, without compromising the quality of their education.
Exploring the structure of psychological distress and its symptoms: A psychometric network analysis.
Authors: Alessandro Rossi, Maria Marconi, Stefania Mannarini, Andrea Calcaterra, Luigi De Cicco, Claudio Verusio, Giuseppe Di Lucca
Journal: Journal of Clinical Oncology (2024)

12112 Background: Psychological research is currently surging in oncological settings, with the construct of psychological distress gaining significant attention. Several studies have demonstrated that psychological distress can have profound adverse effects on adherence, therapy compliance, medical treatments, and overall quality of life (NCCN, 2015). However, it remains a challenging endeavor to attain a clear understanding of the implications of psychological distress in the daily lives of oncology patients. To address this gap, our study aimed to identify the central symptoms of psychological distress and elucidate their relationships. Methods: Oncological outpatients (N = 504; mean age = 67.15, SD = 10.16; 50% females) were recruited at the Presidio Ospedaliero of Saronno, ASST Valle Olona, Italy. The Psychological Distress Inventory-Revised (PDI-R; Rossi et al., 2022), utilized to measure internal, external, and general distress, demonstrated high internal consistency in assessing patients' psychological distress. As a preliminary step before conducting confirmatory factor analysis, we employed an analysis to assess the structural validity of the PDI-R. Subsequently, we performed a Psychometric Network Analysis with the EBICglasso algorithm (5000 bootstrap) to uncover the network structure of psychological distress and identify nodes with greater strength and expected influence. Results: The preliminary analysis indicated that the factorial structure demonstrates excellent fit indices [RMSEA = 0.055; CFI = 0.997; SRMR = 0.041]. Additionally, the Psychometric Network Analysis showed a high accuracy (CS-coefficient = 0.75). Psychological distress symptoms spontaneously clustered into internal and external distress, as per the model, with all symptoms showing noteworthy interconnections. Notably, the strongest connections were observed within the 'external distress' facet. On one hand, the Network Analysis revealed that item #7 (External distress: 'diminished interest in the world'; z = 1.480), item #2 (Internal distress: 'moments of dejection or depression'; z = 1.141), and item #8 (External distress: 'the illness has negatively influenced your relationships with others'; z = 0.542) were identified as nodes with both the highest strength and expected influence. Conclusions: These findings have meaningful implications for clinical practice, as clinical interventions should prioritize addressing symptoms that exhibit the strongest connections within the network. Given that these central nodes have the potential to influence all other connected symptoms, they represent crucial focal points for clinicians. Tailoring more targeted and efficient therapeutic approaches to address these central symptoms can have beneficial effects on medical treatments and enhance the overall quality of life for patients.
Comparative analysis of efficacy and safety profiles between conventional pegfilgrastim and its biosimilar agents in patients receiving cytotoxic chemotherapy: A systemic review and meta-analysis.
Authors: Saad Nasir, Insia Ali, Mohammad Saad Salim Naviwala, Zayan Alidina, Hiba Idrees, Munira Moosajee
Journal: Journal of Clinical Oncology (2024)

12115 Background: While pegfilgrastim forms the cornerstone in chemotherapy-induced neutropenia prophylaxis, its newer biosimilar agents show potential as compelling options. However, despite head-to-head randomized clinical trials (RCTs) demonstrating comparable efficacy between these biosimilar agents of pegfilgrastim and the conventional pegfilgrastim, a lack of evidence exists to suggest definite clinical benefit. This could be attributed to the low statistical power in the clinical trials. Our systemic review and meta-analysis aim to pool the available evidence and provide a comprehensive understanding of the landscape in the prevention of chemotherapy-induced neutropenia. Methods: A literature search was conducted on online databases including, MEDLINE (PubMed), Embase, SCOPUS, and the Cochrane CENTRAL from their inception to October 2023 to identify phase II or III RCTs comparing the efficacy and safety profiles of the conventional pegfilgrastim and its biosimilar agents. Included studies reported at least one key outcome: the duration of severe neutropenia (DSN) in days after the first cycle of chemotherapy (primary outcome), incidence of febrile neutropenia (FN), and bone pain. Pooled risk ratios (RR) and weighted mean difference (WMD) with 95% confidence interval (CI) were calculated using a random-effects model. Heterogeneity was assessed using I 2 statistics. Results: We identified 10 RCTs involving 2237 patients. Our analysis showed a statistically significant and favorable outcome for biosimilar agents in reducing DSN (WMD -0.08 days, 95% CI, -0.15, -0.01, P=0.03, I 2 =0%). No significant differences were observed in the incidence of FN (RR: 0.98, 95% CI, 0.62, 1.53, I 2 =0%) or bone pain (RR: 0.98, 95% CI, 0.82, 1.17, I 2 =0%). In the subgroup analysis based on the subtype of biosimilar agents, eflapegrastim had a statistically significant impact in decreasing DSN compared to the conventional pegfilgrastim (WMD -0.13 days, 95% CI -0.24, -0.03, P=0.01, I 2 =0%). Conclusions: Growing evidence supports cost-effective biosimilars of pegfilgrastim as comparable in efficacy and safety. Eflapegrastim emerges as a promising alternative, demonstrating a clinically meaningful benefit over the conventional pegfilgrastim.
Association between psychological distress and treatment efficacy in patients with newly diagnosed SCLC.
Authors: Fang Wu, Shuxing Wang, Yue Zeng, Yurong Peng, Junqi Liu, Xinyu Tian, Shijiao Yao, Aoxi Liang, Chao Deng, Zhenhua Qiu, Fang Ma, Xianling Liu, Chunhong Hu
Journal: Journal of Clinical Oncology (2024)

12107 Background: Small cell lung cancer (SCLC) is a highly aggressive neuroendocrine malignancy known for its rapid doubling time and high growth fraction. Despite advancements, treating SCLC remains challenging, necessitating improved strategies. Prior research indicates that psychological distress can impact cancer treatment efficacy, with severe psychological distress correlating with poorer prognosis. Our study delves into the psychological distress distribution among SCLC patients and identifies potential treatment targets. Methods: Patients newly diagnosed with SCLC, receiving either chemotherapy or immunotherapy as first-line treatment, were enrolled. Psychological distress, encompassing depression and anxiety symptoms, was assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. Psychological distress hormone levels, including serum cortisol and adrenocorticotropic hormone (ACTH), were measured using ELISA kits before treatment initiation. Objective response rate (ORR) and median progression-free survival (PFS) were determined through chi-square tests, Kaplan-Meier analysis, and Cox regression methods. Results: A total of 97 patients diagnosed with SCLC were included in the study, with an average age of 61.5 years. Among them, 70 cases (72.1%) were classified as extensive stage, while 27 cases (27.8%) were limited stage. Psychological distress was present in 53 patients (54.0%). Patients experiencing psychological distress exhibited a significantly lower objective response rate (ORR) compared to those without distress (50.9% vs. 72.7%; P = 0.037), along with a shorter median progression-free survival (PFS) (8.40 vs. 19.47 months; 95% CI 7.84-12.96; P = 0.004). Furthermore, elevated serum cortisol levels (P &lt; 0.001) were observed in patients with psychological distress. In addition, higher serum cortisol concentration (P = 0.011) was associated with a poorer response to chemotherapy and immunotherapy. Conclusions: Psychological distress is prevalent among patients with SCLC. Notably, those experiencing psychological distress tend to exhibit poorer responses to chemotherapy and immunotherapy. Our investigation has uncovered a potential mechanism involving neuroendocrine hormone resistance to treatment modalities. Clinical trial information: NCT05477979 .