Objective To evaluate early lessons from a remote patient monitoring engagement and education technology solution for patients with COVID-19 symptoms. Materials and Methods A COVID-19-specific remote patient monitoring solution (GetWell Loop) was offered to patients with COVID-19 symptoms. The program engaged patients and provided educational materials and the opportunity to share concerns. Alerts were resolved through a virtual care workforce of providers and medical students. Results Between March 18 and April 20, 2020, 2,255 of 3,701 (60.93%) patients with COVID-19 symptoms enrolled resulting in over 2,303 alerts, 4,613 messages, 13 hospital admissions, and 91 emergency room visits. A satisfaction survey was given to 300 patient respondents, 74% of whom would be extremely likely to recommend their doctor. Discussion This program provided a safe and satisfying experience for patients while minimizing COVID-19 exposure and in-person healthcare utilization. Conclusion Remote patient monitoring appears to be an effective approach for managing COVID-19 symptoms at home.

Mechanical unloading of the heart with a left ventricular assist device (LVAD) significantly decreases mortality in patients with heart failure. Moreover, it provides a human model to define the critical regulatory genes governing myocardial remodeling in response to significant reductions in wall stress. Statistical analysis of a gene expression library of 19 paired human heart samples harvested at the time of LVAD implant and again at explant revealed a set of 22 genes that were downregulated and 85 genes that were upregulated in response to mechanical unloading with a false discovery rate of less than 1%. The analysis revealed a high percentage of genes involved in the regulation of vascular networks including neuropilin-1 (a VEGF receptor), FGF9, Sprouty1, stromal-derived factor 1, and endomucin. Taken together these findings suggest that mechanical unloading alters the regulation of vascular organization and migration in the heart. In addition to vascular signaling networks, GATA-4 binding protein, a critical mediator of myocyte hypertrophy, was significantly downregulated following mechanical unloading. In summary, these findings may have important implications for defining the role of mechanical stretch and load on autocrine/paracrine signals directing vascular organization in the failing human heart and the role of GATA-4 in orchestrating reverse myocardial remodeling. This unbiased gene discovery approach in paired human heart samples has the potential to provide critical clues to the next generation of therapeutic treatments aimed at heart failure.

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Objective The study aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on head and neck oncologic care at a tertiary care facility. Study Design This was a cross-sectional study conducted between March 18, 2020, and May 20, 2020. The primary planned outcome was the rate of treatment modifications during the study period. Secondary outcome measures were tumor conference volume, operative volume, and outpatient patient procedure and clinic volumes. Setting This single-center study was conducted at a tertiary care academic hospital in a large metropolitan area. Methods The study included a consecutive sample of adult subjects who were presented at a head and neck interdepartmental tumor conference during the study period. Patients were compared to historical controls based on review of operative data, outpatient procedures, and clinic volumes. Results In total, 117 patients were presented during the review period in 2020, compared to 69 in 2019. There was an 8.4% treatment modification rate among cases presented at the tumor conference. There was a 61.3% (347 from 898) reduction in outpatient clinic visits and a 63.4% (84 from 230) reduction in procedural volume compared to the prior year. Similarly, the operative volume decreased by 27.0% (224 from 307) compared to the previous year. Conclusion Restrictions related to the COVID-19 pandemic resulted in limited treatment modifications. Transition to virtual tumor board format observed an increase in case presentations. While there were reductions in operative volume, there was a larger proportion of surgical cases for malignancy, reflecting the prioritization of oncologic care during the pandemic.

Objective We investigated gay and bisexual men’s willingness to self-administer an anal cancer screening test at home. Methods We conducted two national, online cross-sectional surveys of self-identified gay and bisexual men: Study I in 2009 with men ages 20–59 (n=306) and Study II in 2013 with men ages 18–26 (n=428). We used multivariate logistic regression analyses to determine variables associated with willingness to self-administer the screening test. Results Most men were willing to self-administer an anal cancer screening test (78% Study I; 67% Study II). In Study I, willingness was higher among men who trusted anal Paps to find treatable cancer (adjusted odds ratio [aOR]=1.47, 95% CI 1.04–2.09) and who believed that men who have sex with men should be screened for anal cancer between one and three years vs. other intervals (aOR=2.19, 95% CI 1.17–4.10). In Study II, willingness was higher among men who perceived greater likelihood of anal cancer (aOR=1.57, 95% CI 1.12–2.20). Their most common concerns were not performing the test correctly and inaccuracy of results. Conclusions Many gay and bisexual men were willing to self-administer anal cancer screening tests at home. If routine screening is warranted, self-collected home testing could improve participation.

<b><i>Introduction:</i></b> The study objective was to identify practice patterns in oropharyngeal cancer management from 2010 to 2016 among human papillomavirus (HPV)-associated and non-HPV-associated oropharyngeal squamous-cell carcinoma (OPSCC) patients. <b><i>Methods:</i></b> The National Cancer Database was utilized to identify OPSCC patients from 2010 to 2016. Frequency distributions and multivariable analyses were generated to identify practice patterns and predictors of treatment modality. <b><i>Results:</i></b> A total of 35,956 patients with nonmetastatic OPSCC were included. HPV status was not associated with a treatment modality preference. At academic centers, the proportion of HPV-associated OPSCC patients versus non-HPV-associated OPSCC patients undergoing surgical management was similar (35.7%; 35.9%). Community cancer programs treated patients less often surgically but with no significant treatment preference based on HPV status. Within each facility type, HPV status was not a predictor of surgical or nonsurgical management. <b><i>Conclusion:</i></b> HPV association does not appear to significantly influence treatment modality preference among OPSCC patients. The proportion of OPSCC patients undergoing surgical treatment declined from 2010 to 2016.

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