Academic Sites Research Articles

Sustainable Digital Communication in Higher Education—A Checklist for Page Loading Speed Optimisation

The changes that universities must face nowadays, especially the need for sustainable development, imply the continuous readjustment of their performance in attracting more prospective students. For the improvement of digital assets in the enrolment process, much attention has been gained, and this has become the starting point for presenting the educational offers of European universities. The concern about attracting candidates more efficiently and with long-term positive effects by using the online environment has led authors to conduct a study on the management of page loading speeds to identify the best practices in communication in post-secondary settings. In this research, a data analysis was performed with Google PSI, which measured academic sites’ page loading times, and the QS 2021 ranking for European universities in order to identify the issues that universities must take care of to increase their digital performance, improve candidates’ experiences, and achieve sustainable development.

Racial and Ethnic Disparities in Hospitalization and Clinical Outcomes Among Patients with COVID-19

IntroductionThe recent spread of coronavirus disease 2019 (COVID-19) has disproportionately impacted racial and ethnic minority groups; however, the impact of healthcare utilization on outcome disparities remains unexplored. Our study examines racial and ethnic disparities in hospitalization, medication usage, intensive care unit (ICU) admission and in-hospital mortality for COVID-19 patients.MethodsIn this retrospective cohort study, we analyzed data for adult patients within an integrated healthcare system in New York City between February 28–August 28, 2020, who had a lab-confirmed COVID-19 diagnosis. Primary outcome was likelihood of inpatient admission. Secondary outcomes were differences in medication administration, ICU admission, and in-hospital mortality.ResultsOf 4717 adult patients evaluated in the emergency department (ED), 3219 (68.2%) were admitted to an inpatient setting. Black patients were the largest group (29.1%), followed by Hispanic/Latinx (29.0%), White (22.9%), Asian (3.86%), and patients who reported “other” race-ethnicity (19.0%). After adjusting for demographic, clinical factors, time, and hospital site, Hispanic/Latinx patients had a significantly lower adjusted rate of admission compared to White patients (odds ratio [OR] 0.51; 95% confidence interval [CI] 0.34–0.76). Black (OR 0.60; 95% CI 0.43–0.84) and Asian patients (OR 0.47; 95% CI 0.25 – 0.89) were less likely to be admitted to the ICU. We observed higher rates of ICU admission (OR 2.96; 95% CI 1.43–6.15, and OR 1.83; 95% CI 1.26–2.65) and in-hospital mortality (OR 4.38; 95% CI 2.66–7.24; and OR 2.96; 95% CI 2.12–4.14) at two community-based academic affiliate sites relative to the primary academic site.ConclusionNon-White patients accounted for a disproportionate share of COVID-19 patients seeking care in the ED but were less likely to be admitted. Hospitals serving the highest proportion of minority patients experienced the worst outcomes, even within an integrated health system with shared resources. Limited capacity during the COVID-19 pandemic likely exacerbated pre-existing health disparities across racial and ethnic minority groups.

Safety and efficacy of mitapivat, an oral pyruvate kinase activator, in adults with non-transfusion dependent α-thalassaemia or β-thalassaemia: an open-label, multicentre, phase 2 study

Patients with non-transfusion-dependent thalassaemia (NTDT), although they do not require regular blood transfusions for survival, can still accrue a heavy burden of comorbidities. No approved disease-modifying therapies exist for these patients. We aimed to investigate the safety and efficacy of mitapivat (Agios Pharmaceuticals, Cambridge, MA, USA), a pyruvate kinase activator, in adults with non-transfusion-dependent (NTD) α-thalassaemia or NTD β-thalassaemia. In this open-label, multicentre, phase 2 study, patients were recruited from four academic clinical study sites in Oakland, CA, and Boston, MA, USA; Toronto, ON, Canada; and London, UK. Patients were eligible if they were aged 18 years or older, with NTDT (including β-thalassaemia with or without α-globin gene mutations, haemoglobin E β-thalassaemia, or α-thalassaemia), and a baseline haemoglobin concentration of 10·0 g/dL or lower. During a 24-week core period, mitapivat was administered orally at 50 mg twice daily for the first 6 weeks followed by an escalation to 100 mg twice daily for 18 weeks thereafter. The primary endpoint was haemoglobin response (a ≥1·0 g/dL increase in haemoglobin concentration from baseline at one or more assessments between weeks 4 and 12). Efficacy and safety were assessed in the full analysis set (ie, all patients who received at least one dose of study drug). This study is registered with ClinicalTrials.gov, NCT03692052, and is closed to accrual. Between Dec 28, 2018, and Feb 6, 2020, 27 patients were screened, of whom 20 were enrolled (15 [75%] with β-thalassaemia and five [25%] with α-thalassaemia) and received mitapivat. The median age of patients was 44 years (IQR 35-56), 15 (75%) of 20 patients were female, five (25%) were male, and ten (50%) identified as Asian. 16 (80% [90% CI 60-93]) of 20 patients had a haemoglobin response (p<0·0001), five (100%) of five with α-thalassaemia and 11 (73%) of 15 with β-thalassaemia. 17 (85%) patients had a treatment-emergent adverse event, and 13 had a treatment-emergent event that was considered to be treatment related. One serious treatment-emergent adverse event occurred (grade 3 renal impairment), which was considered unrelated to study drug, resulting in discontinuation of treatment. The most commonly reported treatment-emergent adverse events were initial insomnia (ten [50%] patients), dizziness (six [30%]), and headache (five [25%]). No patients died during the 24-week core period. These efficacy and safety results support the continued investigation of mitapivat for the treatment of both α-thalassaemia and β-thalassaemia. Agios Pharmaceuticals.

Adherence to guideline-based preoperative and intraoperative care during risk-reducing bilateral salpingo-oophorectomy among gynecologist-oncologists compared to general gynecologists (335)

<b>Objectives:</b> Risk-reducing Bilateral Salpingoopherectomy (rrBSO) is the only intervention proven to reduce mortality from epithelial ovarian cancer in patients with hereditary breast and ovarian cancer (HBOC)-associated gene mutations. Optimal surgical technique for rrBSO includes five steps outlined in 2005 by the Society of Gynecologic Oncology and the American College of Obstetrics and Gynecology. These five steps include: <i>1)</i> Abdominal survey; <i>2)</i> Peritoneal washings; <i>3)</i> Entering retroperitoneal space and creating pedicle 2cm from the ovary; <i>4)</i> Dividing pedicle at the uterus; and <i>5)</i> Removal in an endoscopic bag. rrBSO can be performed by both general gynecologists (GYN) and gynecologist oncologists (GO). We aimed to evaluate adherence to surgical guidelines for rrBSO when performed by GO compared to GYN and assess the utility of preoperative (preop) CA-125 and pelvic ultrasound as predictors of malignancy identified at the time of rrBSO. <b>Methods:</b> A retrospective review of patients who underwent rrBSO from October 1, 2015, to December 31, 2020, by faculty and privately employed physicians at three high volume academic sites within a healthcare system was performed. The primary outcome was compliance with all five steps of rrBSO as dictated by a surgeon. Secondary outcomes included the presence of a pre-malignant or malignant lesion at the time of rrBSO and association with preoperative imaging or CA-125. Patient demographics and clinical characteristics were collected. Descriptive statistics for continuous variables were calculated. Univariable logistic regression was used to screen variables with a p-value criterion of p < 0.05 for entry into the model selection procedure. Multivariate regression was used to identify differences in practice patterns. <b>Results:</b> A total of 236 patients were included. Among them, 122 (52%) cases were performed by a GO. Among the cases documented by GO, 27 (22%) performed all five steps of the procedure, 65 (53%) performed four steps, 26 (21%) performed three steps, four (3%) performed two steps, and none performed only one step. Among the 114 cases by GYN, four (4%) performed all five steps, 17 (15%) performed four steps, 50 (44%) performed three steps, 40 (35%) performed two steps, and three (3%) performed only one step. Univariable analysis demonstrated no association between demographic variables and procedure compliance. GO were significantly more likely to adhere to all five recommended surgical steps, (OR: 7.816, 95% CI: 2.640-23.138, p=0.0002). In total, five patients (2.12%) had pre-malignant or malignant lesions diagnosed at the time of rrBSO. None of the five patients had documented preop CA-125 or preop imaging, and all five cases occurred in patients undergoing surgery with GYN. <b>Conclusions:</b> Our results show a statistically significant difference in compliance to procedural steps of rrBSO between GYN and GO. This demonstrates a need for institution-wide education and implementation of procedural standards and standardized nomenclature for dictations to ensure provider adherence to rrBSO guidelines. Fig. 1

Italian Historical Developments of Teaching and Museum Valorization of Mechanism Models

This paper presents an historical analysis of developments for the creation and usage of models of mechanisms in academic teaching fields, with the aim of re-evaluating the interest and usefulness of models in teaching and research, and of promoting their merits as a cultural heritage worthy of being preserved. The historical analysis is focused on developments in Italy, with specific attention given to physical models created and used for training young engineers in Italian engineering schools, using commercial products, but also original Italian creations. Examples are reported from the main Italian academic sites, where examples of such models of mechanisms have been preserved or have survived, also, as first attempts at museum valorization in terms of historical memorabilia of educational developments on mechanism design issues.

Anatomising the impact of ResearchGate followers and followings on influence identification

Influence analysis, derived from Social Network Analysis (SNA), is extremely useful in academic literature analytic. Different Academic Social Network Sites (ASNS) have been widely examined for influence analysis in terms of co-authorship and co-citation networks. The impact of other network-based features, such as followers and followings, provided by ASNS such as ResearchGate (RG) and Academia is yet to be anatomised. As proven in ingrained social theories, the followers and followings have significant impact in influence prorogation. This research aims at examining the same in one of the widely adopted ASNS, RG. The rendering process is developed to render real-time RG information, which is modelled into graph. Standard centrality measures are implemented to identify influential users from the constructed RG graph. Each centrality measure gives a list of top- k influential RG users. The results are compared with RGScore and Total Research Interest (TRI) to discover the most effective centrality measure. Betweenness and closeness centrality measures have shown the outperforming results compared with others. A procedure is established to discover influential RG users that are commonly present in all top- k centrality results to identify dominant skills, affiliations, departments and locations from the rendered data.

Профориентационные ориентиры одаренных детей в системе дополнительного образования на примере опыта Центра эстетического воспитания г. о. Одинцово

The article presents a system of work with gifted children in the artistic orientation of additional education, reveals the model of the "Socio-cultural space of success" developed at the academic site of the Academy of Social Management, consistently presents the structure, areas of activity and stages of work on the construction of the model.

Use of Academic Social Networking Sites by Academic Community at National Institute of Fashion Technology Centers in India

&#x0D; Academic social networking sites (ASNS) are trending in academics and play a significant role in disseminating knowledge. The study aims to explore the usage of ASNS by the faculty members and researchers of NIFT Centers across India. An online questionnaire method used to collect the primary data from 17 NIFT Centers. According to the results of the data analysis, the majority of respondents were aware of and utilised academic social networking sites (ASNS) in NIFT Centers. Google Scholar achieved the highest level of awareness and usage (34.98 %), followed by ResearchGate (27.09 %), Linkedin (18.23 %), and Academia.edu (17.24 %). The findings indicate that faculty members and researchers use ASNS primarily to access freely available millions of research papers, slightly less for communicating in a new way with researchers, and very rarely for increasing citations of research papers. Finally, the results reveal a positive attitude towards using famous academic social networking sites. NIFT should organise workshops and seminars on ASNS platforms to raise awareness and visibility of their research.

Academician V.N. Tonkov: outstanding domestic anatomist, teacher, scientist and organizer of medical service

Prominent Russian and Soviet anatomist Vladimir Nikolaevich Tonkov (18721954) made a significant contribution to anatomical science and education. He is the founder of the theory of collateral circulation. For the first time, he established the patterns of blood supply to the intervertebral nodes, nerves, and lymph nodes, identified the source of the development of the spleen, and are a pioneer in the use of X-rays to study the structure of the human body. He prepared an original textbook on normal human anatomy, which went through six editions, and organized anatomical museums at Kazan University and the Military Medical Academy. The name V.N. Tonkov is associated with major social events. He was the first president of the Military Medical Academy in Soviet times. After the revolution, he headed the work of the commission to improve the life of scientists, was elected deputy of various government bodies, and was awarded many orders and medals. During the Great Patriotic War, together with the Military Medical Academy, he evacuated to Samarkand, where, in addition to teaching, he headed the faculty of training doctors during his stay in evacuation. He was one of the organizers of the All-Union Scientific Society of Anatomists, Histologists, and Embryologists, was repeatedly elected its chairman, and created the first in the Soviet Union and numerous anatomical schools. For his significant contribution to science in 1944, V.N. Tonkov was awarded the high title of a full member of the USSR Academy of Medical Sciences. The life and work of V.N. Tonkov became the property of the history of science, and his works, which have passed the strictest test of time, continue in the school he created through the efforts of many generations of his students and their followers. V.N. Tonkov lived for 82 years ― this is a beautiful, worthy life of a great scientist, an example of high service to the people and science, and an example of a bright purposeful personality. He died in 1954 and is buried at the academic site of the theological cemetery. In memory of this outstanding scientist, the Department of Normal Anatomy of the Military Medical Academy has been named after him since 1997.

Preliminary Reproducibility Evaluation of a Phage Susceptibility Testing Method Using a Collection of Escherichia coli and Staphylococcus aureus Phages.

Increasing antimicrobial resistance combined with a lagging pipeline of novel antimicrobial compounds have resulted in a resurgence of interest in phage therapy. To select optimal phage or phage combinations for patients for whom phage therapy is considered, assessment of activity of a panel of phages against the patients' bacterial isolate(s) should ideally be performed. Classical phage susceptibility testing methods (i.e., agar overlay) may be laborious, with expertise outside of normal training and competency of medical laboratory science staff needed. Adaptive Phage Therapeutics™ leveraged a commercially available phenotyping system (Biolog OmniLog®) to generate the PhageBank Susceptibility Test™, which uses a custom data analysis pipeline (PhageSelect™) to measure the delay in reaching log-phase metabolic activity ("hold time") when a given isolate is challenged with a specific phage. The goal of this study was to preliminarily assess reproducibility of this approach by testing 2 bacterial species at 2 sites, APT and an academic site. Nineteen Escherichia coli phages were tested against 18 bacterial isolates, and 21 Staphylococcus aureus phages, against 11 bacterial isolates. Result comparisons were statistically excellent for E. coli (κ = 0.7990) and good/fair for S. aureus (κ = 0.6360). The described method provides good/fair to excellent statistical reproducibility for assessment of phage susceptibility of 2 commonly encountered bacterial species.

P1182: REAL-WORLD CHARACTERISTICS AND CLINICAL OUTCOMES IN RELAPSE/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA PATIENTS WHO RECEIVED CAR-T THERAPY

Background: A significant proportion of patients diagnosed with diffuse large B-cell lymphoma (DLBCL) experience refractory or relapse (RR) disease. Approval of chimeric antigen receptor T-cell (CAR-T) therapies has resulted in a novel therapeutic option for eligible patients with RR-DLBCL. However, progressive disease post CAR-T remains a common scenario as patient identification, timing, and effectiveness of CAR-T in the real-world setting is still evolving. Aims: To further understand clinical outcomes of standard of care CAR-T in RR-DLBCL in clinical practice. Methods: This retrospective analysis identified adult patients diagnosed with RR-DLBCL [01/01/2014 – 03/31/2021] who received CAR-T therapy. COTA’s Real World Evidence (RWE) database is comprised of longitudinal, HIPAA-compliant data abstracted from the electronic health records (EHR) of healthcare provider sites, representing diverse treatment U.S settings from over 200 sites of care; roughly 60% of patients are seen at academic sites and 40% are seen at community sites. Patients were categorized as having received CAR-T therapy in 2L, 3L, 4L, or 5L. Baseline characteristics was reported for CAR-T patients. Best response rate, treatment failure, and overall survival (OS) were reported by line of therapy. Disease characteristics were derived from the EHR, including the presence of high-grade lymphoma (positive rearrangement in C-MYC and BCL-2 or BCL-6 biomarkers) and primary refractory disease (2L started within 6 months not due to patient preference, drug shortage, insurance reasons, toxicity, or pandemic reasons). CAR-T treatment failure was defined as the earliest of death, initiation of subsequent line of therapy, or documented progression event after CAR-T. Results: A total of 97 CAR-T patients were identified whereby 17 received CAR-T therapy in a clinical trial setting and were excluded from this real-world evidence study. Of the 80 patients that remained, 10 (13%) received CAR-T in 2L, 31 (39%) in 3L, 24 (30%) in 4L, and 15 (19%) in 5L+. CAR-T patients had a mean age of 57 years, most were male (58%), 16% were diagnosed with high-grade lymphoma, and 60% were primary refractory. Median time from diagnosis to initiation of CAR-T was 15 months. Overall, 38% of patients achieved a complete response with a decrease in response in later lines (2L: 70%, 3L: 58%, 4L: 29%, 5L+: 33%). Within a median follow up of 13.5 months (2L: 13.5 mo, 3L: 15.2 mo, 4L: 12.8 mo, 5L+: 9.5 mo), treatment failure occurred in 45% of patients, with an increase in later lines (2L: 20%, 3L: 48%, 4L: 63%, 5L+: 80%). Median OS was 31.2 months (Not reached (NR); 2L: NR, 3L: NR, 4L: 26.3 mo, 5L+: 13.5 mo) with unequal survival probabilities across lines of therapy (Log-rank test: p=0.004) (Figure 1). Image:Summary/Conclusion: CAR T-cell therapies are considered a major advance in DLBCL, yet over half of those patients eventually fail. Outcomes are inferior in later lines with a decrease in complete response rates and shorter survival by line of therapy, thus, highlighting the need to provide CAR T-cell therapies in earlier settings.

Studies on the use of academic social networking sites by academics and researchers: a review

The present review is an endeavour to understand the use of Academic Social Networking (ASN) sites by academics and researchers during the 2001-2020. The literature indicates existence of disciplinary differences in choice of ASN platforms as well as frequency of use of a particular platform by users belonging to a particular discipline. The strong disciplinary influence could be attributed to variations in social and cultural practices of a particular discipline. The review finds professional visibility as one of the outstanding motivating factors for academics and researchers to join ASN sites. Seeking scholarly answer, accruing citations, seeking expert, sharing research literature by availing self-archiving facilities of ASN sites, exploring collaborative research avenues and job seeking are some other important motivators. The review noticed that alternative metrics have become a strong contender for measuring research impact. The review also found age and gender discrimination, snooping, academic cyber bullying, flooding of ASN sites with substandard literature as some concerns which need concerted attention and suggests more research in these fronts and accordingly modification of ASN interfaces to make them more responsive to user’s needs.

Efficacy of Integrated Social Cognitive Remediation vs. Neurocognitive Remediation in Improving Functional Outcome in Schizophrenia: Concept and Design of a Multicenter, Single-Blind RCT (The ISST Study).

BackgroundAlthough clinically effective treatment is available for schizophrenia, recovery often is still hampered by persistent poor psychosocial functioning, which in turn is limited by impairments in neurocognition, social cognition, and social behavioral skills. Although cognitive remediation has shown general efficacy in improving cognition and social functioning, effects still need to be improved and replicated in appropriately powered, methodologically rigorous randomized controlled trials (RCTs). Existing evidence indicates that effects can most likely be optimized by combining treatment approaches to simultaneously address both social cognitive and social behavioral processes.ObjectivesTo assess whether Integrated Social Cognitive and Behavioral Skill Therapy (ISST) is more efficacious in improving functional outcome in schizophrenia than the active control treatment Neurocognitive Remediation Therapy (NCRT).MethodsThe present study is a multicenter, prospective, rater-blinded, two-arm RCT being conducted at six academic study sites in Germany. A sample of 180 at least partly remitted patients with schizophrenia are randomly assigned to either ISST or NCRT. ISST is a compensatory, strategy-based program that targets social cognitive processes and social behavioral skills. NCRT comprises mainly drill and practice-oriented neurocognitive training. Both treatments consist of 18 sessions over 6 months, and participants are subsequently followed up for another 6 months. The primary outcome is all-cause discontinuation over the 12-month study period; psychosocial functioning, quality of life, neurocognitive and social cognitive performance, and clinical symptoms are assessed as secondary outcomes at baseline before randomization (V1), at the end of the six-month treatment period (V6), and at the six-month follow-up (V12).DiscussionThis RCT is part of the German Enhancing Schizophrenia Prevention and Recovery through Innovative Treatments (ESPRIT) research network, which aims at using innovative treatments to enhance prevention and recovery in patients with schizophrenia. Because this study is one of the largest and methodologically most rigorous RCTs on the efficacy of cognitive remediation approaches in schizophrenia, it will not only help to identify the optimal treatment options for improving psychosocial functioning and thus recovery in patients but also allow conclusions to be drawn about factors influencing and mediating the effects of cognitive remediation in these patients.Trial RegistrationClinicalTrials.gov NCT 02678858, German Study Register DRKS 00010033

Factors associated with DCIS treatment patterns in a large cancer center network.

e18589 Background: There remains variability in management of DCIS, particularly with radiation therapy (RT) and hormone therapy (HT). Little is known about DCIS treatment patterns according to patient characteristics. We examined associations between patient characteristics, treating center location and DCIS therapy received. Methods: We performed a retrospective registry review of all patients diagnosed and treated with DCIS from 2018-2019, collected from the UPMC network, an NCI designated cancer center, serving western and central Pennsylvania. Demographics and administered treatments were compiled from cancer registry records. Descriptive statistics and logistic regression were used for analysis. Treatment centers throughout the network were dichotomized to academic (academic practice) or community (non-academic) sites, race was divided into two groups, Black and White/Other. Neighborhood deprivation index (NDI) was dichotomized to median level at &gt; = 59% vs. &lt; 59% and extremes &gt; = 75% vs. &lt; 75%. Results: A total of 941 patients treated for DCIS;29 patients were not eligible for surgery because of trial enrollment randomizing away from surgery. Of the remaining 912 patients, 506 patients were from academic sites and 406 patients from community sites. Median patient age was 63 years old (range: 24-90 years). There were no treatment differences noted for age, race, or NDI. For treatment, 80 patients refused recommended HT; 46 patients refused recommended RT. The likelihood of receiving RT was similar between academic and community sites (64.3% vs. 67.2%; p= 0.47). Of those having surgery, 25% had mastectomy (231 of 912), more likely at academic sites (29% vs. 21%; p= 0.0045). Among patients with lumpectomy, community patents had greater HT utilization than academic patients (82% vs. 68%; p &lt; 0.001), while ER status was not different. Conclusions: Within the UPMC network, variability in the management of DCIS did not differ based on age, race, or NDI. However, academic practice locations had higher levels of mastectomy, while greater HT utilization was observed in community sites. Further qualitative information is under examination from patients and clinicians to better understand how treatment decisions are framed and completed in the context of patient centered care for DCIS.

Impact of trial site selection on minority patient recruitment in prostate cancer trials.

1558 Background: Historically, minority patients have been underrepresented in clinical cancer trials. Despite recognition of this problem, trials in the early 2000’s showed a decrease from 10.5% to 6.2% in African American trial participation when compared to trials from the early 1990’s. The drop in trial participation is also reflected in prostate cancer trials, although Black men have a 1.76 higher prostate cancer incidence rate than White men. Using prostate cancer as an example, we investigated the impact of trial site selection on potential minority patient recruitment; thus, overcoming a major system-level barrier to trial access. Methods: We created a prostate cancer cohort by filtering our real-world data sources (CancerLinQ, Electronic Medical Office Logistics) for adult male patients with ICD10 CM code C61* or ICD9 CM code 185 on 1/1/2015 or later (cohort #1). As a pre-requisite for computing site level prostate cancer patient counts, we used claims data to attribute missing site information. Finally, to identify the most promising sites for minority trial recruitment, we ranked sites by the proportion of Black patients and the overall cohort patient count. We repeated the above steps for a subset of cohort #1, which was based on the criteria for trial NCT00887198 investigating the prostate cancer drug abiraterone (cohort #2). Results: The prostate cancer cohort (#1) had 151,261 patients, of which 99,152 (65.6%) were attributed to sites. The percentage of Black patients being treated at the top ten sites ranged from 33.0% to 66.4%, with a median of 45.2% (see table). All ten sites had participated in an interventional cancer trial, and eight had participated in prostate cancer trials. Half of them were community, and half were academic sites. The abiraterone cohort (#2) had 1,267 patients, of which 1,174 (92.7%) were attributed to sites. Among the top ten sites the Black patient percentages ranged from 23.8% to 85.7%, with a median of 39.3%. Conclusions: In an analysis of 17 recent FDA drug registration trials for prostate cancer, Black trial participation ranged from only 1.4% to 6.2%, with a median of 3.0%. In contrast, Black patients being treated at the top sites in our data ranged from 33.0% to 66.4%, with a median of 45.2% (cohort #1). The percentages for the abiraterone cohort (#2) were similar, suggesting that even after applying trial criteria the Black patient percentages remain in the double-digits at top sites. Our results demonstrate that informed trial site selection could have a substantial positive impact on minority patient recruitment. [Table: see text]

Exploring the Influence of Gender on Surgical Clerkship Grades and Test Scores: A Single Institution, Multisite Comparison

General surgery remains a male-dominated specialty. Women constitute 54% of medical students at the University of Washington, but only 3.4% of full professors within the Department of Surgery. Many believe surgical attrition and "the leaky pipeline" starts during medical school clerkships, but the exact deterrents remain undefined. This study examined the impact of gender on grading during the third-year surgical clerkship. Retrospective analysis of confidential final clerkship grades, examination scores and subjective clerkship grades was conducted. These were compared by gender, time period, and type of clerkship site. Chi-square analyses were performed. Clerkship sites across multiple academic (n = 6) and nonacademic (n = 14) locations. All third-year medical students undergoing a core surgical clerkship over 2 time periods-2007 to 2010 (period 1) and 2016 to 2019 (period 2)-were included. There were 539 medical students in period 1 and 792 in period 2. The percentage of women was stable over time (52.0% vs 54.2%, p = 0.43). Final clerkship grades of Honors increased significantly from period 1 to 2 (22.3% vs 44.3%, p < 0.0001) and was similarly distributed by gender (women: 21.4% vs 48.0%, p < 0.0001; men 23.2% vs 39.9%, p < 0.0001). Honors on examinations remained stable over time and did not differ by gender. Women earned more final clerkship honors than men at academic sites in period 2 (48.4% vs 30.9%, p < 0.001). This finding was not identified in period 1, nor at nonacademic sites. There was a significant increase in surgical clerkship honors over the past decade, independent of gender. Women attained more clinical and final clerkship honors than men and similar exam grades as time progressed, suggesting that gender bias in the subjective grading of women at this institution does not directly contribute to the loss of talented women as they progress from medical student to faculty within the department, with said gender imbalance not related to clerkship evaluations.

Characteristics of long-surviving patients with multiple myeloma: Over 12 years of follow-up in the Connect MM Registry.

8027 Background: The Connect MM Registry is a large, US, multicenter, prospective observational cohort study of pts with newly diagnosed multiple myeloma (NDMM) and one of the largest, longest running MM registries. Long-term survivors (LTS), defined as patients (pts) who have ≥ 8 years of follow-up, comprise a large portion of the Connect MM Registry. The purpose of this analysis was to assess LTS demographic and clinical characteristics. Methods: Adult pts with NDMM (N = 3011) were enrolled from 250 community, academic, and government sites: Cohort 1 from 2009 – 2011 and Cohort 2 from 2012 – 2016. As 99% of LTS were enrolled in Cohort 1, only pts from Cohort 1 were included in this analysis. Pt data were unevaluable if there were missing treatments, disease assessments, or large gaps in activity during follow-up (n = 28). Baseline characteristics, treatment patterns, and quality of life (QoL) form completion rates were examined. Results: At data cutoff (5/17/21), of the 1493 pts in Cohort 1 with evaluable data, 279 were LTS and 1186 were non-LTS. LTS were generally younger and had better performance status at enrollment (Table). Most (66%) LTS received stem cell transplants and few experienced progression within the first 6 months (3%). Top first-line (1L) regimen for LTS was lenalidomide/bortezomib/dexamethasone (31%) vs bortezomib/dexamethasone (22%) in non-LTS. At data cutoff, 73% of LTS were still on treatment at their most recent visit. LTS underwent disease assessments more frequently (2.0 vs 1.3 per year) and had a higher QoL completion rate by year 5 (58% vs 46%). This analysis showed an estimated 8-year survival of 36% vs an observed 8-year survival of 39% from the SEER database. Additional analyses are ongoing. Conclusions: LTS were younger and healthier than non-LTS. Most LTS received triplets at induction, stem cell transplants in 1L, and were less likely to relapse within the first 6 months of treatment than non-LTS. These findings are consistent with what has been observed in MM clinical trials. Further, this analysis demonstrates the value of longitudinal data in the CONNECT MM Registry and provides insights on long surviving pts with MM. Clinical trial information: NCT01081028. [Table: see text]

DELFI-L101: Development of a blood-based assay that evaluates cell-free DNA fragmentation patterns to detect lung cancer.

TPS3164 Background: Despite longstanding national recommendations, uptake of lung cancer screening in the US remains low. Barriers include access to lung cancer screening, costs, and concerns over potential harms like false-positives and radiation exposure. The DELFI technology evaluates fragmentation patterns of cfDNA using supervised machine learning to distinguish cancer from non-cancer [PMID30943338; 34417454; 31142840]. Methods: The DELFI-L101 is a case-control observational study (NCT04825834) prospectively enrolling at academic and community sites. Eligible participants (≥50 years of age) are individuals who currently smoke or previously smoked, with smoking histories of ≥20 pack-years. Individuals are ineligible if they had cancer treatment in the prior year or a history of hematologic malignancies or myelodysplasia. Cases are individuals with pathologically confirmed cancers (group A – lung, group C – non-lung). Controls are those without cancer (group B) as determined by low-dose computed tomography screening completed within 6 weeks of enrollment. Cases and controls are identified among enrollees from all participating sites. Total enrollment is estimated to be ̃2500 participants across all groups. Blood samples are collected at enrollment for DELFI analyses, which involves cfDNA isolation from plasma, low-coverage, whole-genome, next-generation sequencing, and machine learning methods. Clinical data (medical history, demographics, and diagnostic, surgery, imaging, and pathology reports, and/or other diagnostic information) are collected at enrollment and at 12 months post-enrollment. The primary objective is to train and test a classifier for the detection of lung cancer using the DELFI technology with other biomarkers and clinical features. Secondary objectives include the evaluation of classifiers to distinguish lung cancer from other cancers, modeling benefits and harms using performance estimates of these classifiers, and description of the analytical performance (eg, repeatability and reproducibility) of the DELFI technology and classifiers. The primary endpoint is the accuracy of lung cancer detection as measured by sensitivity, specificity, and the area under the receiver operating characteristic curve. Secondary endpoints include accuracy of tissue of origin classification, and adverse events associated with blood sample collection. The training and performance characterization of a DELFI classifier will further the development of an affordable, accessible, blood-based cancer detection tool with potential to overcome barriers to lung cancer screening. Clinical trial information: NCT04825834.

Baseline preferences for digital information engagement in patients with breast cancer by age and status of diagnosis.

e24119 Background: The need for improvement in education and decision-making support for patients with breast cancer is well documented. Digital health applications offer potential to address these needs through widely available smartphone technology. Understanding patients’ baseline preferences for information sources, breast cancer-related topics of interest, and current use of smartphones and how these interests may differ based on demographic and clinical factors can inform the development of a patient-centered digital navigation tool. Methods: As part of a pilot trial of the Outcomes4Me breast cancer navigation app, we conducted a baseline cross-sectional survey of patients presenting for routine breast cancer care at an academic medical center and community-based sites. Eligible patients had invasive breast cancer of any stage and were actively in treatment. Survey-specific questions addressed sources of cancer information and informational needs. Analysis is descriptive with statistical comparisons based on Fisher’s exact test. Results: Ninety out of 107 patients in the pilot trial completed the survey items of interest. The majority of patients were over age 50 (59%) and 35% had stage IV disease. Baseline reported uses for mobile devices included text (67%), email (61%), phone (47%), social media (41%), accessing the internet (18%), and apps (12%). Only 7% of patients noted using mobile apps for navigating disease and treatment options. When asked to rank the importance of cancer information sources, 88% and 42% of patients reported relying heavily on their oncologist and the rest of the care team, respectively. Forty percent of patients relied at least moderately on the internet for health information and 27% on online support groups, with patients &lt; age 50 more likely than those &gt; age 50 to rely on online support groups for health information (41% vs 17%, P = 0.02). The most common educational needs reported were side effects (79%), followed by prognosis (72%), healthy lifestyle (71%), treatment options (70%), general breast cancer news and research (67%), information about their current cancer status (59%), potential clinical trials (44%), and costs of treatment (14%). Patients with metastatic breast expressed greater interest in information about clinical trials compared to those without metastatic disease (64% vs 36%, P = 0.01), and less interest in information about prognosis (54% vs. 81%, P = 0.01). Conclusions: Despite reliance on their oncologist and oncology team for information, patients report multiple unmet educational needs related to their disease and treatment options. While a substantial percentage of patients with breast cancer turn to the internet for information, there is untapped potential to use mobile devices to improve patient education and awareness of treatment options, including clinical trials.

LCMC LEADER neoadjuvant screening trial: LCMC4 evaluation of actionable drivers in early-stage lung cancers.

TPS8596 Background: Comprehensive genomic profiling (CGP) has transformed the care of patients with advanced non-small cell lung cancer (NSCLC), giving many patients access to precision targeted treatment and immunotherapy with remarkable improvements in outcomes. Studies show that patients with lung cancers with oncogenic drivers are the least likely group to benefit from checkpoint inhibitors and are better served by enrollment in studies of targeted therapies. Early-stage NSCLC is now poised to benefit from these precision approaches with the regulatory approval of the first tyrosine kinase inhibitors and checkpoint inhibitors for the adjuvant treatment of resected NSCLC, each requiring testing for precision biomarkers. Neoadjuvant precision therapy for NSCLC has the potential to further improve treatment outcomes. Methods: The LCMC4 Evaluation of Actionable Drivers in EaRly Stage Lung Cancer (LEADER) Neoadjuvant Screening Trial (NCT04712877) is a collaborative diagnostic study developed by the Lung Cancer Mutation Consortium (LCMC), supported by the Thoracic Surgery Oncology Group and the Lung Cancer Research Foundation. The primary objective is to determine the proportion of patients with stage IA2-III lung cancers who possess actionable oncogenic drivers, defined as 1 of 11 actionable genomic alterations: mutations in EGFR, BRAFV600E, MET exon 14, KRAS G12C, and HER2, rearrangements in ALK, RET, NTRK, and ROS1, and amplification of MET and HER2. The study will also assess the feasibility of CGP to detect actionable oncogenic drivers in patients with suspected early-stage lung cancers scheduled to undergo biopsies to establish the diagnosis of lung cancer. The protocol will enroll 1000 patients with operable stage IA2-III (TNM 8th edition) lung cancer who will undergo CGP utilizing the Foundation Medicine 324 gene assay as well as paired liquid biopsy analysis. Results will enable selection of neoadjuvant therapy and enrollment onto independent therapeutic trials with genomically matched neoadjuvant treatment, standard therapies, or other trials if no driver is detected. The approach will be considered feasible if &gt;35% of non-squamous NSCLCs have 1 of the 11 actionable alterations. Tumor mutational burden and PD-L1 IHC will be assessed. Plasma specimens collected pre- and post neoadjuvant treatment and post-surgery will be used for research to study the ability of circulating tumor DNA to assess neoadjuvant treatment response and minimal residual disease. 26 academic sites in the US plan to enroll patients. Clinical trial information: NCT04712877.