scholarly journals Heterogeneity of Minimal/Measurable Residual Disease (MRD) Practices in Adult B-Cell Precursor Acute Lymphoblastic Leukemia (BCP-ALL) in the United States

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4478-4478
Author(s):  
Juliana E. Hidalgo-Lopez ◽  
Gail J. Roboz ◽  
Brent Wood ◽  
Michael Borowitz ◽  
Elias J. Jabbour ◽  
...  
Keyword(s):  
United States ◽  
Bone Marrow ◽  
Best Practices ◽  
Stock Options ◽  
Research Funding ◽  
The United States ◽  
Bone Marrow Sample ◽  
Sample Collection ◽  
Nccn Guidelines ◽  
Privately Held

Abstract Background: MRD testing in BCP-ALL is critical for appropriate patient management, but little is known regarding sample acquisition and testing heterogeneity across clinical practice settings. These factors may impact the quality and reliability of MRD assessment. Methods: Thirty-minute online surveys were conducted in May 2021 with hematologists/oncologists (HEME/ONCs) in the United States in both academic (acad) and community (comm) settings. Respondents were licensed physicians board certified in oncology and/or hematology who treated ≥2 BCP-ALL patients/year or ≥10 patients in the past 5 years, with over 25% of time spent in the clinical setting; pediatric HEME/ONCs were excluded. Survey enrollment is ongoing, with interim results presented here; a related survey for pathologists (PATHs) is underway. Results: HEME/ONC respondents (acad n=40, comm n=57, from 29 states) had been practicing as specialists for a median of between 11-15 years (choices were ranges, eg 6-10, 11-15, min-max was 1-34 years), and typically spent over 75% of their time in the clinic; 94% of respondents had ≥5 BCP-ALL patients/year and 92% ordered MRD tests for ≥5 patients/year. Typical timepoints for MRD testing included the end of induction/suspected complete remission, the end of consolidation, and at suspected disease progression; testing after the end of consolidation was infrequent in both groups (Table). Testing for MRD at the end of consolidation was notably more frequent in the academic setting. In both settings, the HEME/ONC ordering the MRD test generally also performed the bone marrow collection procedure (acad: 78%, comm: 56%). Resources consulted on bone marrow collection best practices included UpToDate (21%), ASH and ASCO (13%), NCCN guidelines (13%), and hematology/oncology journals. About half of practices had defined institutional protocols for bone marrow collection (acad: 55%, comm: 47%), nearly all of which were developed internally. The amount of bone marrow sample collected showed high variability, ranging from 1-10 draws (median=3) and 1-30 mL sample per draw (median=5 mL). While 49% of HEME/ONCs performed <5 draws and extracted ≤6 mL per draw, 22% collected 10 mL/draw, and 10% collected 20 mL/draw; the remaining 18% reported >5 draws and/or >6 mL per draw. In both settings, the first pull was identified and labeled in 35% of procedures; in those cases, the first-pull samples were used primarily for MRD testing in 60% of cases as recommended by NCCN guidelines (vs for morphology assessment and cytogenetic studies). HEME/ONCs typically relied on the expertise of pathologists to choose MRD testing methodology.Survey results indicate that external labs (both national clinical reference labs and commercial labs) were most commonly used for MRD assessments (63%); comm HEME/ONCs were more likely to use external reference labs and acad HEME/ONCs were more likely to use in-house labs. When asked to estimate the frequency with which different MRD methods were used, mean responses were 54% flow cytometry and 40% next-generation sequencing. While all HEME/ONCs indicated that MRD results were presented clearly in lab reports, there was a desire to include more guideline information about MRD interpretation and BCP-ALL treatment. Conclusion: Interim results identified broad heterogeneity in clinical practices affecting sample collection for MRD assessment in Ph- BCP-ALL in the US, indicating several opportunities for harmonization of routine MRD assessment in BCP-ALL. These opportunities include optimization of bone marrow sample collection techniques (volume/draw and identification/use of first pull for MRD), timing/frequency of specimen collection, serial MRD surveillance after consolidation, MRD method chosen, and standardizing reports to include guideline information. There were gaps in awareness of FDA-approved methods of MRD testing for BCP-ALL. Initiatives supporting provider education and harmonization of best practices from professional guideline committees/organizations are needed to optimize outcomes of BCP-ALL patients. Figure 1 Figure 1. Disclosures Hidalgo-Lopez: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Roboz: Janssen: Research Funding; Daiichi Sankyo: Consultancy; MEI Pharma - IDMC Chair: Consultancy; Actinium: Consultancy; AbbVie: Consultancy; Mesoblast: Consultancy; Bayer: Consultancy; Blueprint Medicines: Consultancy; Jazz: Consultancy; Janssen: Consultancy; Astex: Consultancy; Celgene: Consultancy; Bristol Myers Squibb: Consultancy; Agios: Consultancy; Astellas: Consultancy; Jasper Therapeutics: Consultancy; Helsinn: Consultancy; Glaxo SmithKline: Consultancy; Novartis: Consultancy; Amgen: Consultancy; AstraZeneca: Consultancy; Otsuka: Consultancy; Pfizer: Consultancy; Roche/Genentech: Consultancy. Wood: Pfizer, Amgen, Seattle Genetics: Honoraria; Juno, Pfizer, Amgen, Seattle Genetics: Other: Laboratory Services Agreement. Borowitz: Amgen, Blueprint Medicines: Honoraria. Jabbour: Amgen, AbbVie, Spectrum, BMS, Takeda, Pfizer, Adaptive, Genentech: Research Funding. Velasco: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Elkhouly: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Adedokun: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Zaman: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Iskander: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Logan: Amgen, Pfizer, AbbVie: Consultancy; Pharmacyclics, Astellas, Jazz, Kite, Kadmon, Autolus, Amphivena: Research Funding.

scholarly journals Community Versus Academic Practice in Essential Thrombocythemia and Myelofibrosis: Differences in Clinical Characteristics, Diagnosis, Treatment Patterns, and Symptom Burden (Analysis of Data from the MOST Study)

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1497-1497
Author(s):  
Roger Lyons ◽  
David Lessen ◽  
Salman Fazal ◽  
Robyn Scherber ◽  
Patricia Kalafut ◽  
...  
Keyword(s):  
Patient Education ◽  
Observational Study ◽  
Essential Thrombocythemia ◽  
Stock Options ◽  
Research Funding ◽  
Symptom Burden ◽  
The United States ◽  
Education Level ◽  
Treatment Patterns ◽  
Privately Held

Abstract Background: The Myelofibrosis and Essential Thrombocythemia Observational STudy (MOST) (NCT02953704) is an ongoing multicenter, noninterventional, longitudinal, prospective, observational study in patients with essential thrombocythemia (ET) or myelofibrosis (MF) enrolled in academic and community centers (ACs and CCs) throughout the United States. This analysis examined patient baseline characteristics, diagnosis, treatment patterns, and symptom burden in ACs vs CCs. Methods: Eligible patients had high-risk (HR) (≥60 years of age and/or thromboembolic history) or low-risk (LR) ET (if receiving ET-directed therapy [not including aspirin only]); patients with MF (≥18 years of age) had LR MF or intermediate-1 (INT-1)-risk (INT-1R) MF by reason of age >65 years alone. Baseline data regarding demographics, diagnosis, treatment, and symptom burden were collected as previously characterized (Yacoub A. Clin Lymphoma Myeloma Leuk. 2021;21:461-69); this analysis compared data from 24 ACs with those from 82 CCs. Results: In the ET cohort, 1182 of 1237 patients were evaluable for this analysis, with 273 AC (17% LR; 83% HR) and 909 CC (12% LR; 88% HR) enrollees. In the MF cohort, 203 of 232 patients were evaluable for analysis, with 92 AC (50% LR; 50% INT-1R) and 111 CC (35% LR; 65% INT-1R) enrollees. Across both the ET and MF cohorts, the mean (SD) age was significantly higher in patients enrolled at CCs vs ACs (Table 1). In the ET cohort, significant differences were observed in patient race and ethnicity (both P<0.01) and significantly higher proportions of patients were White (P<0.05) and of Hispanic or Latino ethnicity (P<0.05) in CCs vs ACs. Significant differences were also observed in patient education level (P<0.0001) and employment status (P=0.0001) between ACs vs CCs, and a significantly higher proportion of patients were retired in CCs vs ACs (P=0.0001). In the MF cohort, a significant difference in ethnicity was observed (P<0.05) and a significantly higher proportion of patients were of Hispanic or Latino ethnicity in CCs vs ACs (P<0.05). Significant differences were also observed in patient education level in ACs vs CCs (P=0.0002), and a higher proportion of patients were retired in CCs vs ACs (P>0.05). At diagnosis, the proportion of patients with ET or MF reported to have undergone bone marrow evaluation and mutation testing for myeloproliferative neoplasms in ACs vs CCs was not significantly different at the 0.05 level. At enrollment, leukopenia was significantly more common in patients with ET enrolled at ACs vs CCs (P<0.01). In the ET cohort, the proportion of HR patients who were receiving ET-directed monotherapy were similar between ACs and CCs (Table 1). Compared with ACs, higher proportions of LR and HR patients were receiving anagrelide, higher proportions of LR and HR patients were receiving hydroxyurea, and lower proportions of LR and HR patients were receiving interferon in the CCs. The proportion of patients with ≥1 ET-related physician-reported symptom was higher among ACs vs CCs (P=0.0001). In the MF cohort, the proportion of LR patients receiving MF-directed monotherapy was higher in ACs vs CCs, while this proportion was lower in INT-1R patients in ACs vs CCs (Table 1). Compared with ACs, a higher proportion of LR patients were receiving anagrelide and ruxolitinib, a higher proportion of INT-1R patients were receiving hydroxyurea, and a lower proportion of LR and INT-1R patients were receiving interferon in CCs. The proportion of patients with ≥1 MF-related physician-reported symptoms was similar among ACs vs CCs (P>0.05). Conclusion: These real-world data from MOST demonstrate that care was generally similar between ACs and CCs. Although there were key statistical differences in demographics (eg, age, ethnicity, and education level), disease features, and treatment history, the clinical significance of these differences remains unclear. Some of these differences (eg, demographics), however, could be attributed to the geographic location of the enrollee. Nevertheless, the older population and significant minority populations observed in CCs may represent a key population for clinical trial recruitment. Further investigation into these differences will help assess and enhance ET and MF disease management across sites. Figure 1 Figure 1. Disclosures Lessen: Astellas Pharma: Research Funding; Exact Sciences: Research Funding; Incyte Corporation: Consultancy, Research Funding, Speakers Bureau; Pfizer: Research Funding; Amgen: Speakers Bureau; Bayer: Consultancy, Speakers Bureau. Fazal: Sanofi Genzyme: Consultancy, Honoraria, Speakers Bureau; Novartis: Consultancy, Honoraria, Speakers Bureau; Karyopharm Pharmaceuticals: Consultancy, Honoraria, Speakers Bureau; Jazz Pharmaceuticals: Consultancy, Honoraria, Speakers Bureau; Janssen Oncology: Consultancy, Honoraria, Speakers Bureau; Taiho Pharmaceuticals: Consultancy, Honoraria, Speakers Bureau; Takeda: Consultancy, Honoraria, Speakers Bureau; Stemline Therapeutics: Consultancy, Honoraria, Speakers Bureau; Incyte: Consultancy, Honoraria, Speakers Bureau; Glaxo Smith Kline: Consultancy, Honoraria, Speakers Bureau; Gilead Sciences: Consultancy, Honoraria, Speakers Bureau; Bristol Myers Squibb: Consultancy, Honoraria, Speakers Bureau; AMGEN: Consultancy, Honoraria, Speakers Bureau; Agios: Consultancy, Honoraria, Speakers Bureau. Scherber: Incyte Corporation: Current Employment, Current holder of stock options in a privately-held company. Kalafut: Incyte: Current Employment, Current holder of stock options in a privately-held company. Ren: Incyte: Current Employment, Current holder of stock options in a privately-held company. Ritchie: NS Pharma: Research Funding; ARIAD Pharmaceuticals: Ended employment in the past 24 months, Speakers Bureau; Novartis: Consultancy, Honoraria, Other: travel support, Research Funding, Speakers Bureau; Takeda: Consultancy, Honoraria; Protaganist: Consultancy, Honoraria; Bristol Myers Squibb: Consultancy, Research Funding; Astellas: Consultancy, Research Funding; Celgene/BMS: Consultancy, Other: travel support, Speakers Bureau; Abbvie: Consultancy, Honoraria; Incyte: Consultancy, Honoraria, Speakers Bureau; Jazz: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding.

Industry Payments to Plastic Surgeons: What Has Changed Over the Last Six-Years Following Implementation of the Physician Payment Sunshine Act?

2021 ◽  
Author(s):  
Rowland W Pettit ◽  
Jordan Kaplan ◽  
Matthew M Delancy ◽  
Edward Reece ◽  
Sebastian Winocour ◽  
...  
Keyword(s):  
United States ◽  
User Interface ◽  
Stock Options ◽  
Data Interpretation ◽  
The United States ◽  
Inclusion Criteria ◽  
Physician Payment ◽  
The Past ◽  
To Receive ◽  
Open Payments

Abstract Background The Open Payments Program, as designated by the Physician Payments Sunshine Act is the single largest repository of industry payments made to licensed physicians within the United States. Though sizeable in its dataset, the database and user interface are limited in their ability to permit expansive data interpretation and summarization. Objectives We sought to comprehensively compare industry payments made to plastic surgeons with payments made to all surgeons and all physicians to elucidate industry relationships since implementation. Methods The Open Payments Database was queried between 2014 and 2019, and inclusion criteria were applied. These data were evaluated in aggregate and for yearly totals, payment type, and geographic distribution. Results 61,000,728 unique payments totaling $11,815,248,549 were identified over the six-year study period. 9,089 plastic surgeons, 121,151 surgeons, and 796,260 total physicians received these payments. Plastic surgeons annually received significantly less payment than all surgeons (p=0.0005). However, plastic surgeons did not receive significantly more payment than all physicians (p = 0.0840). Cash and cash equivalents proved to be the most common form of payment; Stock and stock options were least commonly transferred. Plastic surgeons in Tennessee received the most in payments between 2014-2019 (mean $ 76,420.75). California had the greatest number of plastic surgeons to receive payments (1,452 surgeons). Conclusions Plastic surgeons received more in industry payments than the average of all physicians but received less than all surgeons. The most common payment was cash transactions. Over the past six years, geographic trends in industry payments have remained stable.

scholarly journals Efficacy of rFVIIIFc for First-Time Immune Tolerance Induction (ITI) Therapy: Final Results from the Global, Prospective VerITI-8 Study

Blood ◽  
2021 ◽  
Vol 138 (Supplement 2) ◽  
pp. LBA-5-LBA-5
Author(s):  
Lynn Malec ◽  
An Van Damme ◽  
Anthony Chan ◽  
Mariya Spasova ◽  
Nisha Jain ◽  
...  
Keyword(s):  
Half Life ◽  
Stock Options ◽  
Research Funding ◽  
Hemophilia A ◽  
High Titer ◽  
High Dose ◽  
Severe Hemophilia ◽  
First Time ◽  
Inhibitor Titer ◽  
Privately Held

Abstract Introduction: Inhibitor development is a major complication of factor VIII (FVIII) replacement therapy, affecting approximately 30% of people with severe hemophilia A (Peyvandi et al Lancet 2016). Inhibitor eradication is the standard of care to restore responsiveness to FVIII; however, ITI regimens often require frequent high-dose factor injections over a long period (DiMichele et al Haemophilia 2007; Carcao et al Haemophilia 2021). Median (interquartile range [IQR]) time (months) to negative titer in the International ITI Study with high-dose FVIII was 4.6 (2.8-13.8) (n=31); negative titer to normal recovery was 6.9 (3.5-12.0) (n=23); and normal recovery to tolerance was 10.6 (6.3-20.5) (n=22) (Hay and DiMichele Blood 2012). Recombinant factor VIII Fc fusion protein (rFVIIIFc) is an extended half-life (EHL) FVIII that showed potential benefits for ITI in retrospective clinical data and case reports (Malec et al Haemophilia 2016; Groomes et al Pediatr Blood Cancer 2016; Carcao et al Haemophilia 2021). VerITI-8 (NCT03093480) is the first prospective study of rFVIIIFc in first-time ITI and follows on from the reITIrate (NCT03103542) study of rFVIIIFc for rescue ITI (Königs et al Res Pract Thromb Haemost, ISTH 2021). Aim: Describe outcomes in the verITI-8 study of first-time ITI with rFVIIIFc over 48 weeks in subjects with severe hemophilia A and high-titer inhibitors. Methods: VerITI-8 is a prospective, single-arm, open-label, multicenter study exploring efficacy of rFVIIIFc for first-time ITI in people with severe hemophilia A with high-titer inhibitors. Initial screening was followed by an ITI period in which all subjects received rFVIIIFc 200 IU/kg/day until tolerization or 48 weeks had elapsed (Figure). This was followed by tapered dose reduction to standard prophylaxis and follow-up. Key inclusion criteria included males with severe hemophilia A, high-titer inhibitors (historical peak ≥5 Bethesda units [BU]/mL), and prior treatment with any plasma-derived or recombinant standard half-life or EHL FVIII. Key exclusion criteria included coagulation disorder(s) other than hemophilia A and previous ITI. The primary endpoint was time to tolerization (successful ITI) with rFVIIIFc defined by inhibitor titer <0.6 BU/mL, incremental recovery (IR) ≥66% of expected IR (IR ≥1.32 IU/dL per IU/kg) (both at 2 consecutive visits), and t ½ ≥7 hours (h) within 48 weeks. Secondary endpoints included number of subjects achieving ITI success, annualized bleed rates (ABR), and adverse events (AEs). Results: Sixteen subjects were enrolled and received ≥1 rFVIIIFc dose. Median (range) age at baseline was 2.1 (0.8-16.0) years, and historical peak inhibitor titer was 22.4 (6.2-256.0) BU/mL (Table). Twelve (75%), 11 (69%), and 10 (63%) subjects, respectively, achieved a negative inhibitor titer, an IR >66%, and a t½ ≥7 h (ie, tolerance) within 48 weeks. Median (IQR) times in weeks to achieve these markers of success were 7.4 (2.2-17.8), 6.8 (5.4-22.4), and 11.7 (9.8-26.2) (ie, 2.7 [2.3-6.0] months to tolerance), respectively. One subject achieved partial success (negative inhibitor titer and IR ≥66%), and 5 subjects failed ITI, of which 2 had high inhibitors throughout, 2 experienced an increase in inhibitor levels, and 1 recorded a negative inhibitor titer at 282 days. Most bleeds occurred in the ITI period when median (IQR) ABRs (n=13) were 3.8 (0-10.1) overall, 0 (0-2.6) for spontaneous, 1 (0-4) for traumatic, and 0 (0-3.1) for joint. During tapering, median (IQR) ABRs (n=10) were overall, 0 (0-2.4); spontaneous, 0 (0-0); traumatic, 0 (0-1.3); and joint, 0 (0-0). All 16 subjects experienced ≥1 treatment-emergent AE (TEAE), the most frequent of which was pyrexia in 7 subjects (44%). One subject reported ≥1 related TEAE (injection site pain). Nine subjects (56%) experienced ≥1 treatment-emergent serious AE (TESAE). TESAEs occurring in ≥2 subjects included vascular device infection, contusion, and hemarthrosis. No treatment-related TESAEs, discontinuations due to AEs, or deaths were reported. Conclusions: rFVIIIFc is the first EHL FVIII with prospective data for first-time ITI in patients with severe hemophilia A with historical high-titer inhibitors. Evaluated within a 48-week timeframe, rFVIIIFc offered rapid time to tolerization (median 11.7 weeks; 2.7 months) with durable responses in almost two-thirds of subjects and was well tolerated. Optimizing ITI to eradicate inhibitors remains a priority. Figure 1 Figure 1. Disclosures Malec: CSL Behring: Consultancy; Genentech: Consultancy; HEMA Biologics: Consultancy; Pfizer: Consultancy; Sanofi: Consultancy, Research Funding; Takeda: Consultancy; Bioverativ: Consultancy, Research Funding, Speakers Bureau; Shire: Consultancy; Bayer: Consultancy. Van Damme: Pfizer: Consultancy; Shire: Consultancy; Bayer: Consultancy. Chan: Bioverativ: Consultancy. Jain: Sanofi: Ended employment in the past 24 months; Takeda: Current Employment, Current holder of stock options in a privately-held company. Sensinger: Sanofi: Current Employment, Current holder of stock options in a privately-held company. Dumont: Sanofi: Current Employment, Current holder of stock options in a privately-held company. Lethagen: Sobi: Current Employment, Current holder of stock options in a privately-held company. Carcao: Bayer, Bioverativ/Sanofi, CSL Behring, Novo Nordisk, Octapharma, Pfizer, Roche, and Shire/Takeda: Research Funding; Bayer, Bioverativ/Sanofi, CSL Behring, Grifols, LFB, Novo Nordisk, Pfizer, Roche, and Shire/Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees. Peyvandi: Roche: Consultancy, Honoraria; Sanofi: Consultancy, Honoraria; Sobi: Consultancy, Honoraria; Takeda: Consultancy, Honoraria; Ablynx, Grifols, Kedrion, Novo Nordisk, Roche, Shire, and Sobi: Other: Personal Fees. OffLabel Disclosure: adheres to routine clinical practice

scholarly journals Creating and Using Data Portals to Support Ocean Planning: Challenges and Best Practices from the Northeast United States and Elsewhere

2018 ◽  
Author(s):  
SeaPlan
Keyword(s):  
United States ◽  
Best Practices ◽  
Natural Resources ◽  
Spatial Data ◽  
Planning Process ◽  
The United States ◽  
Management Plan ◽  
Management Decision ◽  
Data Accessibility ◽  
Data Portal

As more ocean plans are developed and adopted around the world, the importance of accessible, up-to-date spatial data in the planning process has become increasingly apparent. Many ocean planning efforts in the United States and Canada rely on a companion data portal–a curated catalog of spatial datasets characterizing the ocean uses and natural resources considered as part of ocean planning and management decision-making.Data portals designed to meet ocean planning needs tend to share three basic characteris- tics. They are: ocean-focused, map-based, and publicly-accessible. This enables planners, managers, and stakeholders to access common sets of sector-speci c, place-based information that help to visualize spatial relationships (e.g., overlap) among various uses and the marine environment and analyze potential interactions (e.g., synergies or con icts) among those uses and natural resources. This data accessibility also enhances the transparency of the planning process, arguably an essential factor for its overall success.This paper explores key challenges, considerations, and best practices for developing and maintaining a data portal. By observing the relationship between data portals and key principles of ocean planning, we posit three overarching themes for data portal best practices: accommodation of diverse users, data vetting and review by stakeholders, and integration with the planning process. The discussion draws primarily from the use of the Northeast Ocean Data Portal to support development of the Northeast Ocean Management Plan, with additional examples from other portals in the U.S. and Canada.

scholarly journals Bleeding Complications in Patients with Cancer and COVID 19- Analysis from the COVID 19and Cancer Consortium (CCC19) Registry

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4997-4997
Author(s):  
Surbhi Shah ◽  
Shuchi Gulati ◽  
Ang Li ◽  
Julie Fu ◽  
Vaibhav Kumar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Board Of Directors ◽  
Stock Options ◽  
Research Funding ◽  
Tumor Board ◽  
Bleeding Complications ◽  
Advisory Committees ◽  
Icu Admission ◽  
Patients With Cancer ◽  
Privately Held

Abstract Background : Patients (pts) with COVID-19 are reported to have increased risk of venous thromboembolism yet bleeding has been an under recognized complication. Rates of bleeding remain unexamined in all patients especially in pts with cancer and COVID-19. Aim: To estimate the incidence of bleeding complication in patients with cancer and COVID 19 Methods: The CCC19 international registry (NCT04354701) aims to investigate complications of COVID-19 in pts with cancer. Our aim was to investigate the frequency of bleeding in hospitalized adult pts with cancer andCOVID-19, enrolled between March 16, 2020 and Feb 8, 2021. The incidence of bleeding complications was captured as defined by CCC19 and included both major and non major bleeding . Associated baseline clinic-pathologic prognostic factors and outcomes such as need for mechanical ventilation, intensive care unit (ICU) admission and mortality rates were assessed Results :3849 pts met analysis inclusion criteria. Bleeding was reported in 276 (7%) pts with median age of 70years; incidence was 6.6 % in females and 7.6 % in males, 6.5% in non-Hispanic white pts, 8.2 % in non-Hispanic Black pts, and 7.8 % in Hispanic pts. 74% had solid cancer and 29% had hematologic malignancies, 33% had received anti-cancer therapy in preceding 30 days, and 8% had surgery within 4weeks. In pts taking antiplatelet or anticoagulant medications at baseline, 7.2% developed bleeding. Need for mechanical ventilation, ICU admission, 30-day mortality, and total mortality were significantly higher in those with bleeding complications compared to those without, p<0.05 Conclusion : We describe the incidence of bleeding in a large cohort of pts with cancer and COVID-19. Bleeding events were observed in those with adverse outcomes including mechanical ventilation, ICU admission, and high mortality; the overall mortality of 43% in patients with bleeding complications is especially notable. This important complication may reflect underlying COVID-19 pathophysiology as well as iatrogenic causes. Figure 1 Figure 1. Disclosures Kumar: Diagnostica Stago: Honoraria. Zon: AMAGMA AND RLZ: Consultancy, Current holder of individual stocks in a privately-held company. Byeff: Pfizer, BMS, Takeda,Teva, Merck, United health: Consultancy, Current equity holder in publicly-traded company, Current holder of stock options in a privately-held company. Nagaraj: Novartis: Research Funding. Hwang: astrazaneca,Merck,bayer, Genentech: Consultancy, Research Funding. McKay: Myovant: Consultancy; Bayer: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees; Exelixis: Consultancy, Membership on an entity's Board of Directors or advisory committees; Calithera: Membership on an entity's Board of Directors or advisory committees; Tempus: Research Funding; Merck: Consultancy, Membership on an entity's Board of Directors or advisory committees; Tempus: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Consultancy, Membership on an entity's Board of Directors or advisory committees; Sanofi: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Dendreon: Consultancy; Caris: Other: Serves as a molecular tumor board ; Vividion: Consultancy; Sorrento Therapeutics: Consultancy; Bayer: Research Funding. Warner: Westat, Hemonc.org: Consultancy, Current holder of stock options in a privately-held company. Connors: Pfizer: Honoraria; CSL Behring: Research Funding; Alnylam: Consultancy; Bristol-Myers Squibb: Honoraria; takeda: Honoraria; Abbott: Consultancy. Rosovsky: Janssen: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Inari: Consultancy, Membership on an entity's Board of Directors or advisory committees; Dova: Consultancy, Membership on an entity's Board of Directors or advisory committees.

Contingency Management Programs in Corrections: Another Panacea?

2018 ◽  
Vol 34 (1) ◽  
pp. 35-46 ◽  
Author(s):  
Paul Gendreau ◽  
Shelley J. Listwan
Keyword(s):  
United States ◽  
Decision Making ◽  
Best Practices ◽  
Contingency Management ◽  
The United States ◽  
Community Corrections ◽  
Theory And Practice ◽  
Track Record ◽  
Highly Skilled ◽  
Skilled Staff

The mantra of best practices in corrections, while well intended, may lead to iatrogenic consequences. Community corrections and prisons are under increasing pressures to manage their caseloads; moreover, the current accountability and get-tough agenda in corrections demands offenders take on more responsibility for their behaviors. As a consequence, we predict more episodes of “panaceaphilia” or quick fix solutions because corrections jurisdictions in the United States are under tremendous pressure to handle their populations at this point in time. In this article, we focus on contingency management programs as the potential next panacea, not because they do not have a proven track record of success, but because they require highly skilled staff and make great demands upon correctional agencies’ decision-making practices. To help counteract panaceaphilia from happening with contingency management, we describe the theory and practice of contingency management, the demands they place on programmers, the type of research needed to evaluate their effectiveness, and how to prevent these programs from turning into punitive punishment regimes.

3D Dead

2021 ◽  
Vol 4 (3–4) ◽  
Author(s):  
Gwen Robbins Schug ◽  
Kristina Killgrove ◽  
Alison Atkin ◽  
Krista Baron
Keyword(s):  
United States ◽  
Best Practices ◽  
Case Studies ◽  
Digital Technologies ◽  
The United States ◽  
3D Scanning ◽  
Skeletal Remains ◽  
Social Dimensions ◽  
Human Skeletal Remains ◽  
3D Scanners

Humans have interacted with the remains of our dead for aesthetic and ritual purposes for millennia, and we have utilized them for medical, educational, and scholarly pursuits for several centuries. Recently, it has become possible to use digital technologies such as 3D scanners and printers for reconstructing, representing, and disseminating bodies. At the same time, there is growing interest among academics and curators in taking a more reflexive approach to the ethical and social dimensions of conservation. This paper considers theoretical and practical aspects of ethics as they apply to the 3D scanning and printing of human skeletal remains for curation or dissemination, provides case studies from our work in the United States, and suggests guidelines for best practices.   Los seres humanos hemos interactuado con los restos humanos de nuestros muertos por razones estéticas y rituales por milenios. Asimismo, estos restos han sido utilizados para conducir investigaciones médicas, educativas, y académicas por varios siglos. Recientemente, con la ayuda de la tecnología digital de los escáneres e impresoras 3D ha sido posible reconstruir, representar, y difundir estos cuerpos. Al mismo tiempo, los académicos y los conservadores proponen ser más reflexivos al lidiar con las dimension eséticas y sociales del campo de la conservación. Este artículo considera los aspectos teóricos y prácticos de la ética de los escaneos e impresiones 3D de restos óseos humanos para su conservación y diseminación, aporta casos prácticos de nuestros trabajos investigativos en los Estados Unidos como ejemplos, y sugiere normas para una práctica adecuada. 

UX (User Experience)-Driven Website Design Utilizing Analytic Hierarchy Process (AHP) Multi-Attribute Decision Modeling

2018 ◽  
pp. 121-135
Author(s):  
Ron Cheek ◽  
Martha Sale ◽  
Colleen Carraher Wolverton
Keyword(s):  
United States ◽  
Best Practices ◽  
Analytic Hierarchy Process ◽  
The United States ◽  
Website Design ◽  
Analytic Hierarchy ◽  
Robust Model ◽  
Social Media Tools ◽  
Come Into The Market ◽  
Hierarchy Process

The success of an organization's website is determined by the user's experience (UX). Yet many organizations continue to struggle to find tools to strategically analyze the UX's satisfaction with their websites and overall online presence. While there have been numerous studies offering “best practices” for website design, most of these are dated and do not take into consideration UX's experience and social media tools that come into the market. In this chapter, over 900 surveys were conducted on Inc. Magazine's Top 500 list (2011-13) of fastest growing companies in the United States. The analysis of these surveys resulted in a list of shared elements (best practices) common to the websites surveyed. Through the use of the analytic hierarchy process (AHP) multi-attribute decision model, the authors developed a measure by which companies can assess their customer's experience and compare it to these best practices model. This model provides an internally consistent, robust model against which to measure an organization's website based on the user's experience (UX).

Leveraging Intergenerational Diversity to Meet Business Goals

2012 ◽  
pp. 386-402 ◽  
Author(s):  
Sherita L. Jackson
Keyword(s):  
United States ◽  
Graduate Students ◽  
Best Practices ◽  
The United States ◽  
Generational Cohorts ◽  
Organizational Leaders ◽  
Multigenerational Workforce ◽  
Generational Diversity ◽  
Business Goals ◽  
Age Cohort

In recent years, the concept of generational diversity has gained increasing recognition in the United States. Each generation is shaped by historical, social, and cultural events that are unique to that particular age cohort. The purpose of this chapter is to help scholars, researchers, organizational leaders, practitioners, and graduate students understand diversity among generational cohorts and employ practices to utilize the wealth of knowledge that exists within today’s multigenerational workforce. This chapter will describe the four generations in today’s workplace and discuss gaps that can cause conflict. This chapter also provides tips and best practices for leveraging intergenerational diversity as well as scenarios and examples that demonstrate best practices. The result is a cohesive and productive workplace that respects multigenerational perspectives.

Digital Government and Citizen Participation in the United States

2011 ◽  
pp. 306-319 ◽  
Author(s):  
Marc Holzer ◽  
Lung-Teng Hu ◽  
Seok-Hwi Song
Keyword(s):  
United States ◽  
Best Practices ◽  
Citizen Participation ◽  
The United States ◽  
Digital Citizenship ◽  
Government Accountability ◽  
Digital Government ◽  
Potential Problems ◽  
Customer Satisfaction Survey ◽  
The Relationship

This chapter addresses the topic of citizen participation via digital government in several sections: first, we discuss the relationship between digital government and citizen participation from the academic literature. Second, we introduce some best practices of citizen participations through digital government in the United States; third, we offer some principles and implications from these best practices; and fourth, we discuss several potential problems of digitized citizen participation in terms of further research. The best practices described in this chapter include Minnesota’s Department Results and Online Citizen Participation Opportunities, Santa Monica’s Budget Suggestions, California’s California Scorecard, Virginia Beach’s EMS Customer Satisfaction Survey and others. We extract some common features from these best practices, such as citizen as customer, recognizing a citizen’s capacity, and direct participation. Further, we recommend principles for designing digitized citizen participation: operationalize direct policy involvement, enable the citizen to influence policy priorities, enhance government accountability, encourage participatory deliberation and shape digital citizenship.

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