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1.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009580

ABSTRACT

Background: Many patients with cancer (PwC) possess a suboptimal understanding of their chemotherapy treatment plan.1 Accordingly, PwC may seek information regarding both the disease and its treatment from other resources. Purpose: A freely-accessible website was curated by oncology pharmacists to provide evidence-based educational material on chemotherapy treatment plans. Objective: To use the website to deploy an online survey assessing other modes of education routinely accessed by PwC. Methods: Between February 2020 and January 2021, PwC completed an anonymous, English language survey via www.chemoexperts.com. Results: A total of 1,036 self-identified patient users began the survey. The majority were from North America (75%). Most respondents (65%) were female. PwC were asked: “If you received education from a health care professional (HCP), what type of education did you receive?” Multiple responses were allowed. Of the 820 patients who responded to this question, 77.4% (n = 635) were given printed material, 52.3% (n = 429) were taught in clinic, 8% (n = 66) were shown videos, 5.7% (n = 47) participated in an educational class outside of clinic, and 4% (n = 33) were given magazines. Roughly 37% were directed to an internet site (n = 304;92 to chemoexperts. com, 212 to other internet sites) by a HCP. Patients also reported using blogs (12.7%;n = 111/873 respondents), websites other than chemoexperts (85%;n = 742/873), support groups (28.4%;n = 248/873), and YouTube (15.1%;n = 132/873). Discussion: In-person teaching sessions are vital to understanding treatment plans. While the ongoing COVID-19 pandemic may have lowered the percentage of PwC who are offered teaching, some PwC may still not absorb or retain all there is to know during in-person sessions and seek other resources to bolster their understanding of treatment. Although the majority of users reported receiving printed material, this too may be limited in its ability to meet the needs of all individuals. Knowing PwC may seek varying modes of education, HCPs should direct patients to resources they are familiar with. Conclusions: To our knowledge, this is the first global survey to examine modes of education utilized by PwC. Although PwC may receive teaching in person, many still seek a variety of educational resources outside of clinic. Relying solely on printed material will not meet the needs of some PwC. When educating PwC in clinic, HCPs concerned about the validity of outside materials should direct patients to resources they are familiar with and trust. Reference: Almalki H, Absi A, Alghamdi A, Alsalmi M, Khan M. Analysis of Patient-Physician Concordance in the Understanding of Chemotherapy Treatment Plans Among Patients With Cancer. JAMA Netw Open. 2020 Mar 2;3(3):e200341.

2.
Journal of Public Health in Africa ; 12(SUPPL 1):40-41, 2022.
Article in English | EMBASE | ID: covidwho-1913163

ABSTRACT

MediLab Secure is an EU-funded project whose main objective is to create a framework for collaboration to promote surveillance of viral zoonoses under a One Health approach in 22 countries of the Mediterranean, Black Sea and Sahel regions. During the COVID-19 crisis the project rapidly adapted to the emergency and provided technical assistance to the beneficiary countries in terms of diagnosis and surveillance in humans and animals. To evaluate the involvement of the veterinary laboratories of our network in the sanitary crisis and estimate the degree of intersectoral collaborations, an online survey was launched in April 2021. We received responses from 19 labs, 7 of them from African countries. Of these laboratories, 3 (Morocco, Algeria and Mauritania) were not involved in SARS-CoV-2 diagnosis despite having trained staff and all the protocols implemented. In these countries the cooperation of vet labs was not requested by the Ministry of Health despite their offer to collaborate. Nevertheless, two of these labs donated equipment and reagents to their Public Health institutions to help with the overwhelming demand of diagnostic materials. Three laboratories (Egypt, Senegal and Tunisia) were involved in SARS-CoV-2 molecular and serological diagnosis but only in animal samples (pets and animal food products). Only one veterinary laboratory (Niger) established full collaboration with the Ministry of Health and was intensively involved in the molecular diagnosis of human samples from May to September 2020. Moreover, vet specialists from this lab were also involved in the disinfection of contaminated premises. The results of this survey show the willingness to help veterinary labs in North Africa and Sahel regions to face a Public Health crisis caused by a zoonotic pathogen. Although the degree of intersectoral collaboration was low in most of the countries, the successful One Health experience of Niger could be a good example for future sanitary emergencies.

3.
Hong Kong Med J ; 28(1): 91-92, 2022 02.
Article in English | MEDLINE | ID: covidwho-1847733
4.
Molecular Immunology ; 141:212-213, 2022.
Article in English | Web of Science | ID: covidwho-1801497
5.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-328526

ABSTRACT

The SARS-CoV-2 protein Nsp2 has been implicated in a wide range of viral processes, but its exact functions, and the structural basis of those functions, remain unknown. Here, we report an atomic model for full-length Nsp2 obtained by combining cryo-electron microscopy with deep learning-based structure prediction from AlphaFold2. The resulting structure reveals a highly-conserved zinc ion-binding site, suggesting a role for Nsp2 in RNA binding. Mapping emerging mutations from variants of SARS-CoV-2 on the resulting structure shows potential host-Nsp2 interaction regions. Using structural analysis together with affinity tagged purification mass spectrometry experiments, we identify Nsp2 mutants that are unable to interact with the actin-nucleation-promoting WASH protein complex or with GIGYF2, an inhibitor of translation initiation and modulator of ribosome-associated quality control. Our work suggests a potential role of Nsp2 in linking viral transcription within the viral replication-transcription complexes (RTC) to the translation initiation of the viral message. Collectively, the structure reported here, combined with mutant interaction mapping, provides a foundation for functional studies of this evolutionary conserved coronavirus protein and may assist future drug design.

6.
Blood ; 138:4023, 2021.
Article in English | EMBASE | ID: covidwho-1582390

ABSTRACT

BACKGROUND: Autologous stem cell transplantation (ASCT) for multiple myeloma (MM) entails sudden life changes including acute symptom burden, changes in physical function, and shifting caregiver dynamics. Several studies have shown that anxiety, insomnia, and distress rise in the initial weeks following ASCT before slowly recovering. Long-term consequences of these acute exacerbations include persistent quality of life (QOL) impairments (El-Jawahri 2016), post-traumatic stress disorder (Griffith 2020), and the usage of potentially inappropriate medications (PIMs) for symptom management (Banerjee 2021). We have recently completed a pilot study of digital life coaching (DLC), whereby life coaches work with patients via phone calls and text messages to provide longitudinal support, education, and accountability to meet wellbeing-related goals. Our pilot study of 15 patients demonstrated the feasibility of DLC during this period, with bidirectional patient-coach engagement occurring every 5-7 days even during index hospitalizations for ASCT (Banerjee 2021). Based on these positive results, we have now launched a randomized Phase 2 study of DLC versus usual care among patients with MM undergoing ASCT. STUDY DESIGN: Our study is registered at clinicaltrials.gov as NCT04589286. We plan to enroll 60 adult patients with MM undergoing first ASCT at our institution. Inclusion criteria include English language proficiency and ownership of a personal cellphone. However, neither smartphones nor specific mobile apps are required for study participation. All patients, including those in the control arm, receive brief wellness-related tips with each request for PRO data as outlined below. As shown in the Figure, patients in the DLC arm are paired with a trained life coach beginning at Day -10 before ASCT. Coaches use structured frameworks to assist patients longitudinally with identifying and accomplishing wellbeing-related goals. Specific coaching topics can vary from week to week and are set by each patient. In addition to weekly coach-led phone calls, patients are encouraged to maintain bidirectional communication via phone/text/email as often as desired. Patients in the control arm do not receive access to DLC. Our primary endpoint is the total usage of sedative-class PIMs - including lorazepam, temazepam, zolpidem, and other similar medications - prescribed for anxiety or insomnia during each of 4 four-week study subperiods identified in the Figure. Secondary endpoints include patient-reported outcome (PRO) assessments of QOL (PROMIS Global Health), distress (NCCN Distress Thermometer), and insomnia (PROMIS Sleep Disturbances 4A). PRO assessments are collected exclusively using automated REDCap emails every 1-2 weeks as shown in the Figure. PROGRESS TO DATE: As of the data cutoff (7/31/21), 19 patients have enrolled onto our study and 5 have completed all follow-up. The median age of enrolled patients is 62 (range: 31-77), with 26% of patients aged 70 or older. As shown in our pilot study (Banerjee 2021), PRO collection via automated REDCap emails is feasible. Specifically, of 93 email-based requests for PRO assessments as of the data cutoff, 92 (99%) have been completed. Analyses of PRO assessment responses and PIM usage will be conducted after study completion. DISCUSSION: Improving patient wellbeing during the acute peri-ASCT period is an unmet need in multiple myeloma. Published supportive strategies during this time include music therapy (Bates 2017), acupuncture (Deng 2018), palliative care (El-Jawahri 2017), and programmed hospital room lighting (Valdimarsdottir 2018). DLC may offer unique advantages given its easy accessibility and unified patient-facing interface across hospital/clinic/home transitions. These strengths may be particularly relevant in light of the COVID-19 pandemic, where home-based follow-up after ASCT has become more common. That being said, broadening the accessibility of DLC to include patients with limited English proficiency or patients without personal cell phones are important priorities for fu ure studies. In summary, our randomized Phase 2 study of DLC versus usual care is ongoing. If shown to reduce PIM prescription rates while improving wellbeing-related PRO trajectories longitudinally, DLC may become a standard of care for patients with hematologic malignancies undergoing ASCT. [Formula presented] Disclosures: Banerjee: Pack Health: Research Funding;SparkCures: Consultancy;Sanofi: Consultancy. Knoche: Amgen: Honoraria. Brassil: Abbvie: Research Funding;Astellas: Research Funding;BMS: Research Funding;Daiichi Sankyo: Research Funding;Genentech: Research Funding;GSK: Research Funding;Sanofi: Research Funding;Pack Health: Current Employment. Jackson: Pack Health: Current Employment. Patel: Pack Health: Current Employment. Lo: Oncopeptides: Consultancy;EUSA Pharma: Consultancy. Chung: Caelum: Research Funding. Wong: Amgen: Consultancy;Genentech: Research Funding;Fortis: Research Funding;Janssen: Research Funding;GloxoSmithKlein: Research Funding;Dren Biosciences: Consultancy;Caelum: Research Funding;BMS: Research Funding;Sanofi: Membership on an entity's Board of Directors or advisory committees. Wolf: Adaptive Biotechnologies: Consultancy;Teneobio: Consultancy;Sanofi: Consultancy;Amgen: Consultancy. Martin: Oncopeptides: Consultancy;Sanofi: Research Funding;Amgen: Research Funding;Janssen: Research Funding;GlaxoSmithKline: Consultancy. Shah: Bluebird Bio: Research Funding;GSK: Consultancy;Janssen: Research Funding;Indapta Therapeutics: Consultancy;BMS/Celgene: Research Funding;CareDx: Consultancy;CSL Behring: Consultancy;Kite: Consultancy;Nektar: Research Funding;Karyopharm: Consultancy;Amgen: Consultancy;Oncopeptides: Consultancy;Poseida: Research Funding;Precision Biosciences: Research Funding;Sanofi: Consultancy;Sutro Biopharma: Research Funding;Teneobio: Research Funding.

7.
Transplant International ; 34:396-397, 2021.
Article in English | Web of Science | ID: covidwho-1395986
8.
Blood ; 136:2-3, 2020.
Article in English | EMBASE | ID: covidwho-1348286

ABSTRACT

BACKGROUND: Patients undergoing autologous stem cell transplantation (ASCT) for multiple myeloma (MM) face sudden exacerbations of anxiety, insomnia, and other symptoms within the initial weeks following ASCT. Even as these symptoms abate in subsequent months, long-term consequences include post-traumatic stress disorder (Griffith 2020), quality of life (QOL) impairments (El-Jawahri 2016), and chronic reliance on higher-risk medications such as benzodiazepines (Banerjee 2020). These findings are particularly relevant to MM patients given their older age at diagnosis, longer expected post-ASCT survival, and poorer QOL at baseline compared with other cancer patients (Kent 2015). Compared to other integrative interventions in the peri-ASCT setting, life coaching transcends a symptomatic focus while directly addressing the root determinants of impaired QOL. Life coaches work with patients using structured frameworks (Figure 1A) to provide longitudinal support, education, and accountability to meet patient-identified wellness goals. Digital life coaching (DLC) combines the strengths of life coaching with the capabilities of digital health by channeling patient-coach communication through patients' personal phones. Compared to in-person coaching, DLC is location-agnostic and allows patients to work their coaches more conveniently and frequently. DLC is feasible among ASCT survivors (Chen 2016) but has not yet been studied in the active peri-ASCT setting. We are conducting a pilot study of a 16-week DLC subscription to assess its feasibility and effects on QOL during an intensive period spanning from pre-ASCT hospitalization through Day +100 after ASCT. If successful, we plan to then pursue a randomized Phase II study comparing DLC versus usual care in the peri-ASCT setting. METHODS: Our study is registered at clinicaltrials.gov as NCT04432818. We plan to enroll 27 adult patients with MM undergoing first ASCT at our institution. Inclusion criteria include English language proficiency and ownership of a personal cellphone. Notably, neither ownership of a smartphone nor installation of a specific mobile app is required for patient enrollment. Enrolled patients will receive unlimited access to a certified life coach beginning at Day -5 before ASCT;bidirectional communication is encouraged via phone, text, or email. The life coaches will reach out at least once per week to help patients accomplish self-identified goals such as symptom management, stress reduction, and physical activity. Our study's primary endpoint is ongoing patient engagement, defined as least one patient-initiated outreach to their coach during each of four 4-week study subperiods. Our study's secondary endpoints include patient-reported outcome (PRO) assessments of QOL, distress, and sleep disturbances (to be collected using electronic surveys every 1-2 weeks as shown in Figure 1B). Exploratory endpoints include benzodiazepine usage and rates of electronic/phone communication with patients’ treatment teams. We will analyze endpoints using descriptive methods, including stratification of secondary & exploratory endpoints by DLC usage and specific 4-week study subperiod. PROGRESS TO DATE: Of 18 approached patients as of the data cutoff (8/1/20), 15 (83%) have expressed interest. Reasons for non-enrollment include skepticism about the value of interactions with coaches who do not themselves have MM. Of the 15 patients who have expressed interest in the study, the median age is 65 (range: 50-81) and all but one patient report owning a personal smartphone. All 6 patients with finalized ASCT hospitalization dates have been enrolled and paired with life coaches. Adherence to weekly electronic PRO assessments has been 100% (n = 9 timepoints) to date, consistent with previous studies (Wood 2013). CONCLUSIONS: Our pilot study is ongoing. Our findings to date suggest that certain MM patients are phone-savvy and would be interested in digital health tools, which will continue to gain prominence in light of the ongoing COVID-19 pandemic. Strengths of DLC include it scalability across institutional lines and its ability to reach patients at home in an integrative manner. Results of this study will inform innovative approaches to support the wellbeing of patients with hematologic malignancies, both in the peri-transplantation setting and beyond. [Formula presented] Disclosures: Brassil: Pack Health: Current Employment. Patel: Pack Health: Current Employment. Jackson: Pack Health: Current Employment. Wong: Janssen: Research Funding;Roche: Research Funding;Amgen: Consultancy;Sanofi: Membership on an entity's Board of Directors or advisory committees;GSK: Research Funding;Bristol Myers Squibb: Research Funding;Fortis: Research Funding. Wolf: Adaptive: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Martin: Seattle Genetics: Research Funding;AMGEN: Research Funding;GSK: Consultancy;Sanofi: Research Funding;Janssen: Research Funding. Shah: BMS, Janssen, Bluebird Bio, Sutro Biopharma, Teneobio, Poseida, Nektar: Research Funding;GSK, Amgen, Indapta Therapeutics, Sanofi, BMS, CareDx, Kite, Karyopharm: Consultancy.

9.
Journal of Clinical Oncology ; 39(15 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1339304

ABSTRACT

Background: Patients with multiple myeloma (MM) experience acute quality of life (QOL) exacerbations following autologous stem cell transplantation (ASCT) that can lead to long-term complications. Life coaching can improve QOL in a structured & personalized manner. We investigated the feasibility of a digital life coaching (DLC) platform, where coaching is accomplished through phone calls and text messages, for patients with MM during ASCT. Methods: Our pilot study (clinicaltrials.gov ID: NCT04432818) enrolled adult patients with MM, English proficiency, and cellphone ownership (smartphone not required). The 16-week DLC program, beginning at Day -5 before ASCT, included unlimited digital access to a certified life coach to help with identifying and accomplishing wellness-related goals. Our primary outcome was ongoing DLC engagement (≥ 1 bidirectional conversation every 4 weeks). Secondary outcomes were ePRO assessments of QOL (PROMIS Global Health), insomnia (PROMIS Sleep Disturbances), and distress (NCCN DT). Electronic patient-reported outcome (ePRO) assessments were delivered via automated REDCap emails every 1-2 weeks. Results: Of 18 screened patients, 15 (83%) enrolled in our study;2 patients dropped out before initiating DLC (including 1 who was unable to connect with her coach between Day -5 and 0). Of 13 remaining patients, median age was 65 (range 50-81) and 23% had an ECOG performance status of 1 (remainder 0). DLC conversations occurred a mean of every 7.6 days (range 3-28) overall and every 6.5 days (range 2.8-14) during the initial 28- day period including high-dose melphalan and hospitalization. 80% of patients maintained ≥ 1 conversation every 4 weeks. Selected ePRO results (mean ± standard error) are shown in the table. Conclusions: Certain MM patients are able to engage digitally with a life coach and complete email-based ePRO assessments during and after ASCT. Limitations of our study include selection bias and the Day -5 start date, which may be too late logistically and symptom-wise (given our ePRO findings suggestive of peak distress pre- ASCT). DLC may play an innovative and scalable role given the emphasis on remotely delivered care during the COVID-19 pandemic. A Phase II randomized study of DLC versus usual care is under way (clinicaltrials.gov ID:.

10.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-8952

ABSTRACT

The SARS-CoV-2 protein Nsp2 has been implicated in a wide range of viral processes, but its exact functions, and the structural basis of those functions, remain unknown. Here, we report an atomic model for full-length Nsp2 obtained by combining cryo-electron microscopy with deep learning-based structure prediction from AlphaFold2. The resulting structure reveals a highly-conserved zinc ion-binding site, suggesting a role for Nsp2 in RNA binding. Mapping emerging mutations from variants of SARS-CoV-2 on the resulting structure shows potential host-Nsp2 interaction regions. Using structural analysis together with affinity tagged purification mass spectrometry experiments, we identify Nsp2 mutants that are unable to interact with the actin-nucleation-promoting WASH protein complex or with GIGYF2, an inhibitor of translation initiation and modulator of ribosome-associated quality control. Our work suggests a potential role of Nsp2 in linking viral transcription within the viral replication-transcription complexes (RTC) to the translation initiation of the viral message. Collectively, the structure reported here, combined with mutant interaction mapping, provides a foundation for functional studies of this evolutionary conserved coronavirus protein and may assist future drug design.

11.
Knowledge Management Research and Practice ; 2021.
Article in English | Scopus | ID: covidwho-1228361

ABSTRACT

The coronavirus pandemic (COVID-19) represents an unprecedented challenge for the survival of various organisations around the world. The resilience of an organisation depends predominantly on its ability to respond in a timely manner by leveraging optimal decisions, as supported by dynamic knowledge management in assessing rapidly evolving external uncertainties while evaluating real options. Such a capability can be enhanced by a risk-based approach through collaboration among organisations under public health policy directives to implement concerted control measures in a responsive manner. An integrative framework is developed to illustrate an underlying system that embraces dynamic knowledge management to mitigate limitations in the conventional approach based on a single organisation’s perspective. The case of Hong Kong, a highly populated city in Asia, is illustrated to explore the interinstitutional dynamics of knowledge transfer to external stakeholders in protecting public health under an exposed system. Implications for postpandemic management system development for institutional sustainability are articulated. © Operational Research Society 2021.

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