tbuckley/cabot-search huggingface dataset:
SP0040 Collaboration across health service levels - examples of norwegian projects involving primary and specialist health care
Authors: N. Østerås
Journal: Annals of the Rheumatic Diseases (2013)

In Norway, as in many other countries, there is a need to develop integrated care and smooth collaboration between health care levels. A new health sector reform is recently initiated in Norway, "The Coordination Reform", in which the main goal is that the patient should receive the proper treatment – at the right place and right time. According to the reform plan, patients with osteoarthritis (OA) should be treated in primary care. Secondary and specialised health care shall support primary care in developing care, exchanging competence, increasing competence and skills, and developing patient/treatment pathways. So far, no treatment pathway has been developed for OA patients in Norway, and research on provision and quality of health care service for Norwegian OA patients is scarce. According to members of the Norwegian Rheumatism Association, the OA patients feel there is a lack of information and support given to them by health professionals, and they are dissatisfied by the service they receive. Normally, OA patients can consult their GP, and the GP may refer the OA patient to physiotherapy treatment in primary care or to assessments in secondary care, which may include rheumatologist, orthopaedic surgeon, physiotherapists, and/or occupation therapists. The patient must be referred to occupational therapists in secondary care for individual adjustments of hand splints, whereas primary care occupational therapists, although few, perform functional assessments in the patients homes when there exist a considerable functional loss. When an OA patient has reduced walking mobility or fall problems, the GP may apply for a rehabilitation stay, which takes place in specialized rehabilitation centres or in rheumatology hospital departments. Surgical treatment in secondary care is the final option for severely affected OA patients. Treatments are reimbursed by the national welfare system except for a limited amount of "out-of-pocket" payment. Researchers from The National Research Center for Rehabilitation in Rheumatology and Department of Rheumatology (NRRK) at Diakonhjemmet Hospital have, together with researchers from Orthopaedic Section at Oslo University Hospital and University of Oslo, initiated an osteoarthritis project in collaboration with the primary health care services in Ullensaker Municipality, about 40km north-east of Oslo. The project, The Musculoskeletal Pain in Ullensaker Study (MUST), focuses on OA and includes epidemiological, clinical research, randomised controlled trials, competence exchange and development as well as OA care development. However, collaborations across the borders of health service levels may often be challenging. Experiences from this project and future plans for a couple of other Norwegian projects will be given. <h3>Disclosure of Interest</h3> None Declared
Community Mental Health Care: International Perspectives on Making it Happen
Authors: S Sussman
Journal: BMJ (1994)

Ed Christine Dean, Hugh Freeman Gaskell (Royal College of Psychiatrists), £10, pp 140 ISBN 0-902241-58-3

The 1975 white paper Better Services for the Mentally Ill established a target of 47 900 inpatient beds at the end of its planned programme of hospital closures. Between 1981 and 1991, 35 000 psychiatric beds were closed in England and Wales, with 50 000 remaining.

This trend, which was duplicated in many Western countries, was due largely to advances in psychopharmacology; but government parsimony in allocating resources to the most severely mentally ill patients, more liberal mental health …
HPV-Associated Head and Neck Cancer
Authors: Everett E. Vokes, Nishant Agrawal, Tanguy Y. Seiwert
Journal: JNCI Journal of the National Cancer Institute (2015)

Over the last two decades, it has been recognized that head and neck cancers, primarily in the oropharynx, can be a distinct entity that is causally related to human papilloma virus (HPV). Fakhry et al. established in 2008 that such tumors have a strikingly better prognosis with improved responsiveness to chemotherapy as well as chemoradiotherapy and favorable survival rates. Since then, new studies have contributed to our increased understanding of this new entity, ranging from a detailed understanding of the genetic fingerprint and risk modifiers such as smoking to successful early attempts to personalize therapy with de-escalation in the definitive intent treatment setting and specific evaluation of targeted therapies in this patient population. This Commentary seeks to summarize the state of the art of our understanding of HPV-associated head and neck cancers that has emerged since the publication of seminal findings by Fakhry et al.
Abstract 802: Cytokine profiles in bone marrow supernatant and peripheral blood of patients with multiple myeloma and Waldenström's macroglobulinemia
Authors: Ryan J. Plyler, Weixin Wang, Irene M. Ghobrial, Aldo M. Roccaro, Neha Korde, Adriana Zingone, Ola Landgren, Katherine R. Calvo
Journal: Cancer Research (2011)

Abstract Cytokines serve vital roles in the regulation of immune responses. In patients diagnosed with hematologic malignancies, cytokines may play a role in the tumor-host microenvironment affecting tumor survival and progression. Previous studies have quantified the variation in cytokine concentrations between malignant and normal states in patients’ serum. However the research is sparser in relation to measurement of cytokine concentrations in the bone marrow microenvironment. Multiple myeloma (MM) and Waldenström's macroglobulinemia (WM) are two such malignancies that arise in the B-lymphoid lineage and proliferate within the bone marrow (BM) microenvironment. In this study, an ultra-sensitive IL-6 and a human TH1/TH2 multiplex ELISA system were utilized to determine protein concentrations of the following cytokines: IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12 p70, IL-13, IFN-gamma, and TNF-alpha, in the BM supernatant and peripheral blood (PB) of 20 patients with WM, 16 patients with MM, and 7 controls. The BM supernatant concentration of TNF-alpha was significantly increased in MM compared to controls (10.650 pg/ml vs. 4.980 pg/ml, p=0.0158). IL-1beta was significantly decreased in the bone marrow supernatant of MM (0.038 pg/ml vs. 2.352 pg/ml, p=0.0469) and WM (0.046 pg/ml vs. 2.352 pg/ml, p=0.0435). IL-8 was also significantly decreased in the BM supernatant of patients with MM (11.520 pg/ml vs. 43.590 pg/ml, p=0.0158) and WM (7.348 pg/ml vs. 43.590 pg/ml, p=0.0036). Differences in BM supernatant concentrations of IL-6 were not significant in MM, WM, and normal controls. Analysis of PB showed IL-2, IL-5, IL-6, IL-8, IL-10, and TNF-alpha were significantly increased in both MM and WM versus controls, and IFN-gamma was significantly increased in WM. Hierarchical clustering analysis of the cytokine profiles suggested two distinct subgroups existed within both MM and WM. TNF-alpha was the only cytokine in our study that was increased in both the bone marrow and serum of MM patients. The discordant results obtained in the BM supernatant vs. PB for IL-6 and IL-8 in both MM and WM indicate that cytokine profiles vary somewhat between the PB and BM compartments. The BM supernatant and PB cytokine profiles in patients with MM and WM highlight the important role cytokines may play in the microenvironment and biology of MM and WM. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 802. doi:10.1158/1538-7445.AM2011-802
Influence of private practice setting on adjuvant chemotherapy use for elderly women with early-stage breast cancer.
Authors: DL Hershman, D Buono, RB McBride, W Tsai, AI Neugut
Journal: Cancer Research (2009)

Abstract Abstract #5096 Background:&amp;#x2028; For elderly women with breast cancer (BC), the decision to undergo treatment with adjuvant chemotherapy may be associated with non-medical factors, such as physician and practice characteristics. Since physicians influence medical decision-making, we evaluated the association between oncologist characteristics and receipt of adjuvant chemotherapy in elderly women at both high and low-risk for breast cancer recurrence.&amp;#x2028; Methods:&amp;#x2028; We used the SEER-Medicare database to identify women &amp;gt;65 years, diagnosed with stages I-III BC, between 1992-2002, and used the Physician Unique Identification Number linked to the American Medical Association Masterfile to obtain information on oncologists. We investigated the association of patient demographic, tumor, and oncologist-related factors with receipt of chemotherapy for both women with high and low risk of recurrence, using Generalized Estimating Equations to control for clustering. We defined patients as low-risk who had hormone sensitive, stage I/II cancer, and high-risk if they were hormone receptor negative and stage II/III.&amp;#x2028; Results:&amp;#x2028; Of 42,544 women with stage I-III BC, 8,714 (20%) were treated with adjuvant chemotherapy. The proportion of women with high-risk tumors treated was 61% while the proportion with low risk cancers was 15%. Patients who received chemotherapy were younger, of higher SES, and had less favorable tumor characteristics. They were also more likely to be married, diagnosed more recently and have fewer comorbid conditions. In a multivariable analysis, women who underwent chemotherapy were more likely be treated by an oncologists who was primarily employed in a private practice (OR=1.40; 95%CI 1.23-1.59), and completed training after 1975 (OR=1.12; 95%CI 1.01-1.26), and were less likely to have an oncologist who trained in the United States (OR=0.83; 95%CI 0.74-0.93), than oncologists of patients who did not receive chemotherapy. The association between oncologists in private practice and receipt of chemotherapy was slightly stronger for patients who were at high-risk (OR=1.55) than those for low-risk (OR=1.35) for cancer recurrence.&amp;#x2028; Conclusions:&amp;#x2028; After controlling for confounding variables, elderly women with both high risk and low risk BC treated by oncologists who were primarily employed in a private practice were more likely to receive adjuvant chemotherapy. Other oncologists characteristics, such as gender, patient volume and type of degree were not independent predictors of receipt of chemotherapy. Efforts to differentiate whether these associations reflect experience, practice setting, insurance type, or other economic incentives are warranted. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5096.
AB0510 Monitoring disease activity and response through power doppler ultrasonography in rheumatoid arthritis patients treated with rituximab – correlations with antibodies pannel
Authors: A. Musetescu, P. Ciurea, A. Rosu, I. Cojocaru-Gofita, F. Vreju, M. Florea, C. Hoanca
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Rituximab is a a chimeric anti-CD20 monoclonal antibody approved to reduce the signs and symptoms of moderately to severely active rheumatoid arthritis (RA) in patients with inadequate response to first line TNF inhibitors. Debating evidence regard the efficacy of rituximab on rheumatoid factor (RF) and anti-CCP antibodies dynamics in patients with active RA. <h3>Objectives</h3> The aim of the study was to investigate possible correlations between the levels of serum RF and anti-CCP antibodies and disease activity in patients with established RA, assessed in a dual manner – using validated DAS28 with four variables and a simplified twelve-joint Power Doppler ultrasonographic assessment of joint inflammation after 24 weeks (first course) <h3>Methods</h3> The study group consisted of 34 patients with established active RA (DAS28 &gt;5.1) who failed at least one TNF inhibitor. All patients underwent standard clinical and biological evaluation, including RF and anti-CCP antibodies, with disease activity evaluation through DAS28 with four variables and using a twelve-joint simplified Power Doppler ultrasonographic assessment. PDUS was performed by the same rheumatologist, unaware of the clinical and laboratory findings, 24 synovial sites from 12 joints being investigated using a MyLab25 Gold scanner (Esaote, Italy), with a multifrequency linear array transducer (10-18MHz). Synovial fluid, synovial proliferation and power Doppler signal (hipervascularity) were scored semiquantitatively on a scale 0-3 in all sites prior to the rituximab infusion and after 24 weeks, before receiving a subsequent course <h3>Results</h3> Patients studied had a high disease activity score expressed through a mean DAS 28 of 5.6 (± 1.6 SD), as well as increased mean values of RF and anti-CCP antibodies. 94.11% of patients were RF positive and 91.17% anti-CCP positive. After 24 weeks of treatment we observed a good response in 64.70% of patients according to EULAR and a moderate response in 35.29% of patients as well as a mean decrease from baseline in DAS28 significantly correlating with decrease in both RF (p&lt;0.0001) and anti-CCP (p&lt;0.001) titers. Significant decrease of RF (p=0.0001) and anti-CCP (p=0.001) antibodies was correlated with the decrease of the PDUS scores (for effusion, synovial hypertrophy, PD signal) after 24 weeks from the first course <h3>Conclusions</h3> The study revealed the significant correlation between the decrease of the disease activity measured thorough DAS28 and PDUS scores for effusion, synovial proliferation and hipervascularity and the parallel decrease of the RF and anti-CCP titers after a first course of rituximab therapy in active rheumatoid arthritis <h3>Disclosure of Interest</h3> None Declared
Efficacy of Aerosolized Tobramycin in Patients with Cystic Fibrosis
Authors: Bonnie W. Ramsey, Henry L. Dorkin, Jay D. Eisenberg, Ronald L. Gibson, Ivan R. Harwood, Richard M. Kravitz, Daniel V. Schidlow, Robert W. Wilmott, Susan J. Astley, Mary Ann McBurnie, Kim Wentz, Arnold L. Smith
Journal: New England Journal of Medicine (1993)

Direct aerosol delivery of aminoglycosides such as tobramycin to the lower airways of patients with cystic fibrosis may control infection with Pseudomonas aeruginosa and improve pulmonary function, with low systemic toxicity. We conducted a randomized crossover study to evaluate the safety and efficacy of aerosolized tobramycin in patients with cystic fibrosis and P. aeruginosa infections.Seventy-one patients with stable pulmonary status were recruited from seven U.S. centers for the treatment of cystic fibrosis and randomly assigned to one of two crossover regimens. Group 1 received 600 mg of aerosolized tobramycin for 28 days, followed by half-strength physiologic saline (placebo) for two 28-day period. Group 2 received placebo for 28 days, followed by tobramycin for two 28-day periods. Pulmonary function, the density of P. aeruginosa in sputum, ototoxicity, nephrotoxicity, and the emergence of tobramycin-resistant P. aeruginosa were monitored.In the first 28-day period, treatment with tobramycin was associated with an increase in the percentage of the value predicted for forced expiratory volume in one second (9.7 percentage points higher than the value for placebo; P < 0.001), forced vital capacity (6.2 percentage points higher than the value for placebo; P = 0.014), and forced expiratory flow at the midportion of the vital capacity (13.0 percentage points higher than the value for placebo; P < 0.001). A decrease in the density of P. aeruginosa in sputum by a factor of 100 (P < 0.001) was found during all periods of tobramycin administration. Neither ototoxicity nor nephrotoxicity was detected. The frequency of the emergence of tobramycin-resistant bacteria was similar during both tobramycin and placebo administration.The short-term aerosol administration of a high dose of tobramycin in patients with clinically stable cystic fibrosis is an efficacious and safe treatment for endobronchial infection with P. aeruginosa.
Transanal endoscopic operations: A safe and effective alternative to tems
Authors: H Koh, S Magill, M Vella, A Renwick
Journal: Endoscopy (2012)

Introduction: Rectal surgery is perhaps the? easiest conduit for NOTES. Traditional TEMS was the technique of choice for small rectal lesions. More recently the transanal endoscopic operation (TEO) technique has gained a foothold as it is cheaper than TEMS, and surgeons have more refined laparoscopic skills. We report our early experience with TEO's in our unit.
MB-15 * ACTIVATED Wnt SIGNALING TARGETS Sox2+ TREATMENT-REFRACTORY Shh-DEPENDENT MEDULLOBLASTOMA STEM CELLS
Authors: B. Manoranjan, C. Venugopal, S. Mahendram, S. Moreira, R. Hallett, T. Vijayakumar, D. Bakhshinyan, N. McFarlane, J. Hassell, B. Doble, S. Singh
Journal: Neuro-Oncology (2015)

Medulloblastoma (MB) represents the most frequent malignant pediatric brain tumor.Since MBs characterized by activated sonic hedgehog (Shh) signaling continue to pose significant challenges due to treatment resistance, we aimed to prospectively identify, characterize, and target treatment-refractory Overall survival
Abstract P4-11-05: Optimal age to start preventive measures in women with BRCA1/2 mutations or high familial breast cancer risk
Authors: MMA Tilanus-Linthorst, H Lingsma, GD Evans, R Kaas, P Manders, MJ Hooning, CJ van Asperen, D Thompson, R Eeles, JC Oosterwijk, MO Leach, EJ Steyerberg
Journal: Cancer Research (2012)

Abstract Background: Women from high risk breast cancer families consider preventive measures including screening. Guidelines on screening differ considerably regarding starting age. We investigated whether age at diagnosis in affected family members is predictive for age at diagnosis of a relative. Methods: We analyzed the age of breast cancer detection of 1304 first and second degree relatives of 314 BRCA1, 164 BRCA2 and 244 high-risk participants of the Dutch MRI-SCreening study. The within and between family variance in age at diagnosis was analyzed with a random effect linear regression model. We compared the starting age of screening based on risk-group (25 years for BRCA1, 30 years for BRCA2 and 35 years for familial risk), on family history, and on the model, which combines both. The findings were validated in 63 families from the UK- MARIBS study. Results: Mean age at diagnosis in the family varied between families; 95% range of mean family ages was 35–55 in BRCA1−, 41–57 in BRCA2− and 44–60 in high-risk families.14% of the variance in age at diagnosis was explained by family history, 7% by risk group. Approaches to determining start of screening based on the model and on risk-group were similar in terms of cancers missed and years of screening. The approach based on familial history only, missed more cancers and required more screening years in both the Dutch and UK datasets. Conclusion: Age at breast cancer diagnosis is in part dependent on family history which may assist planning starting age for preventive measures. Keywords: BRCA1, BRCA2, breast cancer, prevention, age at onset Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-11-05.
Abstract 210: GPR56 regulates the turnover of tissue transglutaminase and tumor growth in melanoma.
Authors: Liquan Yang, Sonali Mohanty, Nancy Corson, Lei Xu
Journal: Cancer Research (2013)

Biochemical and biophysical properties of extracellular matrix (ECM) regulate multiple aspects of cancer cell behavior during tumor progression. The mechanisms of these regulations are not well defined. We previously reported that an atypical G protein-coupled receptor (GPCR), GPR56, inhibited melanoma growth and metastasis and its N-terminus binds to tissue transglutaminase, TG2, a major cross-linking enzyme in ECM. We thus postulated that GPR56 might suppress melanoma progression by influencing ECM properties through its interaction with TG2. To test this, we examined the effects of GPR56 on melanoma growth in the presence or absence of TG2, using the immunodeficient Tg2+/+ or Tg2−/− mice. Our results showed that the crosslinking enzyme, TG2, promoted melanoma growth, but this tumor-promoting effect was antagonized by GPR56. The mechanisms of this antagonism were revealed through a series of immunohistochemical and biochemical analyses. In GPR56-expressing cells, the extracellular TG2 was internalized by GPR56 and subsequently degraded in a lysome-dependent manner, resulting in a down-regulation of TG2 in ECM. This down-regulation of TG2 by GPR56 led to changes in the deposition of TG2 and other matrix proteins in melanomas and a reduction in melanoma growth. Taken together, we present evidence that a surface receptor on melanoma cells, GPR56, regulates the turnover of the crosslinking enzyme, TG2, in the tumor microenvironment, leading to changes in ECM deposition and melanoma progression.Citation Format: Liquan Yang, Sonali Mohanty, Nancy Corson, Lei Xu. GPR56 regulates the turnover of tissue transglutaminase and tumor growth in melanoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 210. doi:10.1158/1538-7445.AM2013-210Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.
Are species intelligent?
Authors: Jonathan Schull
Journal: Behavioral and Brain Sciences (1990)

Abstract Plant and animal species are information-processing entities of such complexity, integration, and adaptive competence that it may be scientifically fruitful to consider them intelligent. The possibility arises from the analogy between learning (in organisms) and evolution (in species), and from recent developments in evolutionary science, psychology and cognitive science. Species are now described as spatiotemporally localized individuals in an expanded hierarchy of biological entities. Intentional and cognitive abilities are now ascribed to animal, human, and artificial intelligence systems that process information adaptively, and that manifest problem-solving abilities. The structural and functional similarities between such systems and species are extensive, although they “are usually obscured by population-genetic metaphors that have nonetheless contributed much to our understanding of evolution. In this target article, I use Sewall Wright's notion of the “adaptive landscape” to compare the performances of evolving species to those of intelligent organisms. With regard to their adaptive achievements and the kinds of processes by which they are achieved, biological species compare very favorably to intelligent animals by virtue of interactions between populations and their environments, between ontogeny and phylogeny, and between natural, interdemic, organic, and species selection. Addressing the question of whether species are intelligent could help to refine our ideas about species, evolution, and intelligence, and could open new lines of empirical and theoretical inquiry in many disciplines.