Publications by authors named "Rossetti S"

Objectives: Home health care (HHC) serves more than 5 million older adults annually in the United States, aiming to prevent unnecessary hospitalizations and emergency department (ED) visits. Despite efforts, up to 25% of patients in HHC experience these adverse events. The underutilization of clinical notes, aggregated data approaches, and potential demographic biases have limited previous HHC risk prediction models.

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  • The study focuses on the effectiveness and safety of second-line treatment options (docetaxel vs. alternative ARSI) for patients aged 75 and older who have metastatic castration-resistant prostate cancer (mCRPC) after failing first-line androgen receptor signaling inhibitors (ARSIs).
  • Researchers analyzed a group of 122 elderly patients, finding no significant differences in overall survival or progression-free survival when comparing those who received docetaxel to those who received an alternative ARSI.
  • The results suggest that both treatment options are similar for elderly patients, providing useful insights despite the limitations of a small and retrospective study design.
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: The PI3K/AKT/mTOR (PAM) pathway is frequently activated in gynecological cancers. Many PAM inhibitors selectively target single PAM pathway nodes, which can lead to reduced efficacy and increased drug resistance. To address these limitations, multiple PAM pathway nodes may need to be inhibited.

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Endometrial cancer incidence and related mortality are on the rise due to aging demographics. This population often presents with unfavorable features, such as myometrial invasion, non-endometrioid histology, high-grade tumors, worse prognosis, etc. The role of age as an independent prognostic factor is still debated, and screening tools addressing frailty emerge as pivotal in guiding treatment decisions; however, they are still underutilized.

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Purpose: Studies looking into the concordance between late effects reported by physicians vs. those reported by Hodgkin lymphoma (HL) survivors are missing.

Methods: A Life Situation Questionnaire focusing on late effects collected data from 1230 HL survivors (median follow-up 14.

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Objectives: Conducting simulation testing with end-users is essential for facilitating successful implementation of new health information technologies. This study designed a standardized simulation testing process with a system prototype prior to implementation to help study teams identify the system's interpretability and feasibility from the end-user perspective and to effectively integrate new innovations into real-world clinical settings and workflows.

Materials And Methods: A clinical simulation model was developed to test a new Clinical Decision Support (CDS) system outside of the clinical environment while maintaining high fidelity.

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  • Penile cancer is a rare type of cancer that affects the penis, with an estimated 2,100 new cases and 500 deaths in the U.S. in 2024.
  • Surgery has traditionally been used as the main treatment, but new studies suggest that less invasive options may work just as well without requiring major surgeries.
  • It's really important to help patients cope with the emotional effects of the disease, as losing part of the penis can impact their mental health and quality of life, so therapies and support are key.
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Background: Health professions trainees (trainees) are unique as they learn a chosen field while working within electronic health records (EHR). Efforts to mitigate EHR burden have been described for the experienced health professional (HP), but less is understood for trainees. EHR or documentation burden (EHR burden) affects trainees, although not all trainees use EHRs, and use may differ for experienced HPs.

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  • Managing metastatic castration-resistant prostate cancer (mCRPC) in men aged 75 and older is difficult due to limited research, but common first-line treatments include abiraterone acetate plus prednisone (AA) and enzalutamide (Enza).
  • A study analyzed 337 patients aged 75+ who started AA or Enza and found no significant differences in survival rates or adverse effects between those who previously used docetaxel (D) and those who only received androgen deprivation therapy (ADT).
  • The results imply that elderly men with mCRPC can expect similar outcomes and side effect profiles from AA or Enza, irrespective of prior D treatment, though the study's retrospective nature
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  • The study aims to determine factors that predict sensitivity to nivolumab in patients with metastatic renal cell carcinoma (mRCC) by analyzing immune cell profiles, specifically peripheral blood NK cells and regulatory T-cells (Tregs).
  • A total of 57 mRCC patients and 62 healthy donors were analyzed for various immune cell characteristics over the first year of treatment, using statistical methods to identify key predictors.
  • Results indicated that KIR2DL2/DL3+ NK cells and Helios+ Tregs at pretreatment serve as important predictors of nivolumab response, with specific thresholds related to overall survival (OS) and progression-free survival (PFS) showing their potential significance in treatment outcomes.
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Objectives:  Efforts to reduce documentation burden (DocBurden) for all health professionals (HP) are aligned with national initiatives to improve clinician wellness and patient safety. Yet DocBurden has not been precisely defined, limiting national conversations and rigorous, reproducible, and meaningful measures. Increasing attention to DocBurden motivated this work to establish a standard definition of DocBurden, with the emergence of excessive DocBurden as a term.

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  • Metastatic castration-resistant prostate cancer (mCRPC) often shows loss of sensitivity to androgen receptors and activation of the PI3K/AKT/mTOR pathway, making treatment difficult due to feedback mechanisms that lead to drug resistance.
  • The study suggests that gedatolisib, a potent multi-target inhibitor of the PI3K pathway and mTORC1/2, is more effective than single-node PAM inhibitors for treating prostate cancer cells, regardless of their PTEN/PIK3CA status.
  • Gedatolisib's superior effectiveness arises from its ability to impact critical cell functions, and it is currently in a clinical trial combined with darolutamide for patients with mCRPC.
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Burnout and workforce shortages are having a negative impact on nurses globally, particularly after the COVID-19 pandemic. Within the United States, excessive documentation burden (DocBurden) has been linked to nurse burnout. The experience of a system or system-imposed process inhibiting patient care is a core focus area of nursing informatics research.

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  • Late predictions of patient deterioration in hospitals can lead to delays in treatment; the CONCERN Early Warning System addresses this by identifying risks up to 42 hours earlier using nursing documentation patterns.
  • The study tested the hypothesis that patients with care teams informed by CONCERN would experience lower mortality rates and shorter hospital stays compared to those not using the system.
  • The trial involved over 60,000 patient encounters across two large U.S. health systems, and results showed a 35.6% decreased risk of in-hospital mortality for patients monitored by the CONCERN EWS.
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The documented treatment-induced excess mortality in Hodgkin lymphoma (HL) has spurred important treatment changes over recent decades. This study aimed to examine mortality among young HL patients treated with contemporary strategies, including historical data comparison. This nationwide study included 1348 HL patients, diagnosed in 1995-2015 and aged 15-40 at diagnosis.

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  • The PAM pathway, often disrupted in breast cancer, involves interlinked signaling that supports tumor growth, and current treatments typically target only one part of this pathway.
  • Researchers propose that gedatolisib, a pan-PI3K/mTOR inhibitor, could be more effective than single-node PAM inhibitors by addressing multiple targets, potentially reducing drug resistance in breast cancer cells.
  • In laboratory tests, gedatolisib showed superior anti-cancer effects compared to other PAM inhibitors by decreasing cell survival and invasive behavior across various breast cancer cell lines, leading to further clinical evaluation in a Phase 3 study.
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Background:  Studies have shown that documentation burden experienced by clinicians may lead to less direct patient care, increased errors, and job dissatisfaction. Implementing effective strategies within health care systems to mitigate documentation burden can result in improved clinician satisfaction and more time spent with patients. However, there is a gap in the literature regarding evidence-based interventions to reduce documentation burden.

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  • The study investigates the gap between order-based and clinically perceived nursing workloads to better understand the factors contributing to nurse burnout and shortages.
  • Using a retrospecitve cohort study design, the research analyzes data on patient flow, nurse assignments, and workload intensity to quantify these factors.
  • Findings reveal that over half of the samples show that clinically perceived workload exceeds order-based workload, influenced by factors like shift timing, patient admission stages, and patient demographics, indicating a need for targeted workload management interventions.
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  • The plastisphere is a community of tiny living things that grow on plastic waste in water, and it’s important to study because it affects the environment and our health.
  • Scientists found many different types of microorganisms living on plastics, but some can be harmful to humans and other creatures.
  • Better technologies are helping researchers learn more about how these microorganisms work and how we can manage plastic pollution in freshwater to keep our waters clean and safe.
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Background:  Nurses are at the frontline of detecting patient deterioration. We developed Communicating Narrative Concerns Entered by Registered Nurses (CONCERN), an early warning system for clinical deterioration that generates a risk prediction score utilizing nursing data. CONCERN was implemented as a randomized clinical trial at two health systems in the Northeastern United States.

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Addressing the simultaneous removal of multiple coexisting groundwater contaminants poses a significant challenge, primarily because of their different physicochemical properties. Indeed, different chemical compounds may necessitate establishing distinct, and sometimes conflicting, (bio)degradation and/or removal pathways. In this work, we investigated the concomitant anaerobic treatment of toluene and copper in a single-chamber bioelectrochemical cell with a potential difference of 1 V applied between the anode and the cathode.

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  • The study aimed to assess if having a family history of unexplained heart failure (HF) in first-degree relatives increases the likelihood of developing unexplained HF themselves.
  • An analysis of Danish nationwide registry data from 1978 to 2017 found that first-degree relatives of probands with unexplained HF had a significantly higher incidence rate of HF, particularly among siblings and when the proband was diagnosed at a younger age.
  • The findings suggest that relatives of individuals with early-onset unexplained HF should be screened more closely due to the increased risk of developing the condition themselves.
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Background:  Narrative nursing notes are a valuable resource in informatics research with unique predictive signals about patient care. The open sharing of these data, however, is appropriately constrained by rigorous regulations set by the Health Insurance Portability and Accountability Act (HIPAA) for the protection of privacy. Several models have been developed and evaluated on the open-source i2b2 dataset.

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