tbuckley/cabot-search huggingface dataset:
Value in cancer care: Regional initiative to improve care through data reporting and interventions.
Authors: Karma L. Kreizenbeck, Teah Hoopes, Lotte Steuten, Veena Shankaran, Bernardo Goulart, Gary H. Lyman, Thomas David Brown, Eric Y. Chen, Ted Conklin, John M. Corman, Matt Lonergan, Daniel Lessler, Renato Martins, Csaba Mera, John Whitelaw Rieke, Elie P. Saikaly, Julie C. Smith, F. Marc Stewart, Richard Whitten, Scott David Ramsey
Journal: Journal of Clinical Oncology (2016)

34 Background: In the context of many initiatives aimed at measuring quality and value in cancer care, the Hutchinson Institute for Cancer Outcomes Research (HICOR), partnered with community members to launch a regional, stakeholder-driven initiative to define and report value metrics for cancer care for Washington State. Region-wide Summits were held in 2014 and 2015. Participants included local healthcare delivery organizations, patient advocacy groups, payers, and policymakers. The 2014 Summit identified priority metrics; these metrics were reported at the 2015 Summit. Methods: For the 2015 Summit, HICOR staff developed algorithms to measure adherence to the community-prioritized metrics using a claims-registry linked database. Metrics spanned diagnosis, treatment, continuing, and end-of-life (EOL) phases of care. After reviewing adherence at the clinic-level and for the region, attendees were invited to attend break-out sessions for metrics where there was the largest variation: hospital and ED use during treatment, hospital and ED use at EOL, and breast cancer surveillance. Within the breakout sessions, participants were asked to identify barriers to adherence and possible interventions to improve care. After discussion, participants individually ranked the top 3 interventions and estimated expected improvement to be gained by successful implementation of the intervention Results: Table. Working groups were formed to develop detailed protocols for implementable interventions. Conclusions: Using an iterative, transparent, multi-stakeholder process, it is feasible build regional consensus to identify and prioritize value metrics in cancer care, and to develop consensus regarding approaches to improve adherence to those metrics. [Table: see text]
Pharmacodynamic assay for evaluation of first-in-class pyruvate kinase-M2 activators in tumors.
Authors: Payal Khanna, Melinda G. Hollingshead, Ralph E. Parchment, Robert J. Kinders, Joseph E. Tomaszewski, James H. Doroshow, Apurva K. Srivastava
Journal: Journal of Clinical Oncology (2014)

2551 Background: A new class of compounds targets conversion of enzymatically inactive dimeric pyruvate kinase-M2 (PKM2) to an active tetramer complex as a mechanism to tilt the balance between glycolysis and oxidative phosphorylation and reverse the metabolic advantage acquired by tumor cells. The dimer PKM2, which is also a transcription factor, diverts glucose to macromolecular biosynthesis. We developed a pharmacodynamic (PD) assay for PKM2 modulation and evaluated in vivo target engagement using an allosteric PKM2 activator (PKM2a). Methods: An experimental PKM2a [N-(4-(4-(2-methoxyphenyl)piperazine-1-carbonyl)phenyl)quinoline-8-sulfonamide] (Kung et. Al., Chem & Biol 2012) was synthesized at NCI. The PD response was determined in H1299 xenografts (n=3/group) dosed daily at 6, 20, and 60 mg/kg for 10 days; tissue samples were collected 2, 6, 24, and 48 hrs post dose 1, 3, and 10. Tumor volumes were recorded biweekly until 27 days after treatment was stopped. A sandwich immunoassay was developed that detects monomer/dimer but not tetrameric PKM2. The assay showed >80% lower PKM2 levels in tumor cell lines treated in vitro with the PKM2a. Results: PD analysis showed that the majority of PKM2 (60-80%) was detected in the nuclear fraction of tumor lysates. Compared to controls, nuclear accumulation was decreased by 30-60% between 24 and 48 hrs post dose 10 in the 60 mg/kg treatment group. Changes observed at lower doses or at earlier time points were not significant. Marginal decreases in mean tumor volume (<18%, p=NS) was observed in the 60 mg/kg dose group on 4 and 8 days after treatment. Conclusions: Our results show that PKM2 monomers/dimers accumulated in the nuclear fraction suggesting that they may play a role as transcription factors in the model we tested. PKM2 modulation was evident only at the highest dose tested after multiple administrations, and a delayed PD response was consistent with the marginal efficacy observed in this study. Together, these results suggest that sustained modulation of PKM2 with higher doses may be required to reverse the metabolic fate of cancer cells. Importantly, our PD assay provides a critical tool to guide translational studies of PKM2a.
The role of psychiatrists in the medical school admissions process
Authors: J A Talbott, R Michels
Journal: American Journal of Psychiatry (1981)

Psychiatrists function in various ways in the admissions process of medical schools. They serve on admissions committees, act as consultants, and provide expertise in evaluating applicants known to be at psychological risk. The authors discuss the pros and cons of broadening admissions criteria; the assessment of the diagnosis, functioning, and prognosis of an applicant; the supportive services necessary for students screened into medical school; and the avoidance of homogenization of medical students. They conclude that the participation of psychiatrists is critical to the efficient operation of the admissions process and the medical school itself.
The genomic landscape and evolution of endometrial carcinoma progression and abdominopelvic metastasis
Authors: William J Gibson, Erling A Hoivik, Mari K Halle, Amaro Taylor-Weiner, Andrew D Cherniack, Anna Berg, Frederik Holst, Travis I Zack, Henrica M J Werner, Kjersti M Staby, Mara Rosenberg, Ingunn M Stefansson, Kanthida Kusonmano, Aaron Chevalier, Karen K Mauland, Jone Trovik, Camilla Krakstad, Marios Giannakis, Eran Hodis, Kathrine Woie, Line Bjorge, Olav K Vintermyr, Jeremiah A Wala, Michael S Lawrence, Gad Getz, Scott L Carter, Rameen Beroukhim, Helga B Salvesen
Journal: Nature Genetics (2016)
Medical intelligence, security and global health: the foundations of a new health agenda
Authors: G Bowsher, C Milner, R Sullivan
Journal: Journal of the Royal Society of Medicine (2016)

Medical intelligence, security and global health are distinct fields that often overlap, especially as the drive towards a global health security agenda gathers pace. Here, we outline some of the ways in which this has happened in the recent past during the recent Ebola epidemic in West Africa and in the killing of Osama Bin laden by US intelligence services. We evaluate medical intelligence and the role it can play in global health security; we also attempt to define a framework that illustrates how medical intelligence can be incorporated into foreign policy action in order delineate the boundaries and scope of this growing field.
“Target-absent” decisions in cancer nodule detection are more efficient than “target-present” decisions!
Authors: Trevor J. Crawford, Damien Litchfield, Tim Donovan
Journal: Behavioral and Brain Sciences (2017)

Many parts of the medical image are never fixated when a radiologist searches for cancer nodules. Experts are able to use peripheral vision very efficiently. The size of the functional visual field appears to increase according to the level of expertise. However, searching a medical image diverges, in a puzzling way, from the typical search for a target feature in the laboratory.
Off-label Use of Quetiapine in Medical Inpatients and Postdischarge
Authors: Todd C. Lee, Ploa Desforges, Jennifer Murray, Ramy R. Saleh, Emily G. McDonald
Journal: JAMA Internal Medicine (2016)

LESS IS MORE Off-label Use of Quetiapine in Medical Inpatients and PostdischargeOff-label use of antipsychotic medication is increasing, particularly the use of quetiapine for sleep, owing to its sedating properties. 1 This is a cause for concern given important adverse effects, including drug-induced diabetes and parkinsonism, weight gain, neuroleptic malignant syndrome, oversedation, and risk of arrhythmia. 2 We describe quetiapine use in a prospective cohort of medical inpatients and the proportion of inhospital use that is perpetuated on discharge.Methods | In our 52-bed medical clinical teaching unit (CTU) (Royal Victoria Hospital; 417 beds, Montreal, Quebec, Canada), we prospectively enrolled all consecutive inpatients 60 years or older between December 2013 and April 2015.There were no exclusion criteria.Patient data were abstracted from medical records at discharge or death, and were analyzed in March 2016.One of us (P.D.) retrospectively reviewed all medical records for quetiapine dose and indication.In the absence of a documented comorbid psychiatric condition (eg, schizophrenia, major depressive, or bipolar affective disorder) or evidence of delirium it was inferred that once-nightly quetiapine was being given for sleep.Categorical variables were compared using χ 2 and continuous variables using Wilcoxon rank-sum or the Kruskal-Wallis test as appropriate.
Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults
Authors: Emily R. Adrion, Andrew M. Ryan, Amanda C. Seltzer, Lena M. Chen, John Z. Ayanian, Brahmajee K. Nallamothu
Journal: JAMA Internal Medicine (2016)

<h3>Importance</h3> Patients' out-of-pocket spending for major health care expenses, such as inpatient care, may result in substantial financial distress. Limited contemporary data exist on out-of-pocket spending among nonelderly adults. <h3>Objectives</h3> To evaluate out-of-pocket spending associated with hospitalizations and to assess how this spending varied over time and by patient characteristics, region, and type of insurance. <h3>Design, Setting, and Participants</h3> A retrospective analysis of medical claims for 7.3 million hospitalizations using 2009-2013 data from Aetna, UnitedHealthcare, and Humana insurance companies representing approximately 50 million members was performed. Out-of-pocket spending was evaluated by age, sex, type of insurance, region, and principal diagnosis or procedure for hospitalized adults aged 18 to 64 years who were enrolled in employer-sponsored and individual-market health insurance plans from January 1, 2009, to December 31, 2013. The study was conducted between July 1, 2015, and March 1, 2016. <h3>Main Outcomes and Measures</h3> Primary outcomes were total out-of-pocket spending and spending attributed to deductibles, copayments, and coinsurance for all hospitalizations. Other outcomes included out-of-pocket spending associated with 7 commonly occurring inpatient diagnoses and procedures: acute myocardial infarction, live birth, pneumonia, appendicitis, coronary artery bypass graft, total knee arthroplasty, and spinal fusion. <h3>Results</h3> From 2009 to 2013, total cost sharing per inpatient hospitalization increased by 37%, from $738 in 2009 (95% CI, $736-$740) to $1013 in 2013 (95% CI, $1011-$1016), after adjusting for inflation and case-mix differences. This rise was driven primarily by increases in the amount applied to deductibles, which grew by 86% from $145 in 2009 (95% CI, $144-$146) to $270 in 2013 (95% CI, $269-$271), and by increases in coinsurance, which grew by 33% over the study period from $518 in 2009 (95% CI, $516-$520) to $688 in 2013 (95% CI, $686-$690). In 2013, total cost sharing was highest for enrollees in individual market plans ($1875 per hospitalization; 95% CI, $1867-$1883) and consumer-directed health plans ($1219; 95% CI, $1216-$1223). Cost sharing varied substantially across regions, diagnoses, and procedures. <h3>Conclusions and Relevance</h3> Mean out-of-pocket spending among commercially insured adults exceeded $1000 per inpatient hospitalization in 2013. Wide variability in out-of-pocket spending merits greater attention from policymakers.
A New Prognostic Model for Elderly Patients with Diffuse Large B-Cell Lymphoma Treated with R-CHOP
Authors: Katsuhiro Miura, Jun Konishi, Takaaki Miyake, Makita Masanori, Atsuko Hojo, Yasufumi Masaki, Masatoshi Uno, Jun Ozaki, Chikamasa Yoshida, Daigo Niiya, Koichi Kitazume, Yoshinobu Maeda, Jun Takizawa, Rika Sakai, Yuichiro Nawa, Tomofumi Yano, Kazuhiko Yamamoto, Kazutaka Sunami, Yasushi Hiramatsu, Kazutoshi Aoyama, Hideki Tsujimura, Yoshihiro Hatta, Masatoshi Kanno
Journal: Blood (2015)
Weeding Through Marijuana’s Effects on the Brain
Authors: Francesca M. Filbey
Journal: JAMA Psychiatry (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
Using the IRB Harmonization and Reliance Document Can Reduce Review and Regulatory Delays for the Benefit of All
Authors: Stephen Sodeke
Journal: The American Journal of Bioethics (2016)

In “IRB and Research Regulatory Delays Within the Military Health Care Setting: Do They Really Matter? And If So, Why and for Whom?,” Freed and colleagues (Freed et al. 2016) proposed four areas of...
Government looks into claims of discrimination against UK scientists since Brexit
Authors: Adrian O’Dowd
Journal: BMJ (2016)

The UK government has created a unit to gather evidence of bias against scientists and researchers in the United Kingdom after the national referendum decision to leave the European Union, “Brexit.”

During an evidence session of the House of Commons Science and Technology committee held on 13 July, MPs heard that a science minister had taken steps to deal with concerns that scientists and researchers were facing discrimination. 

The MPs asked about reports that some scientists in the UK who were already part of a consortium were being asked to leave or were made to feel unwelcome because some scientists in other European countries assumed that the UK no longer wanted to be part of Horizon 2020, …
In Vivo MRI and X‐Ray Bifunctional Imaging of Polymeric Composite Supplemented with GdPO<sub>4</sub>·H<sub>2</sub>O Nanobundles for Tracing Bone Implant and Bone Regeneration
Authors: Jing Huang, Zhongwen Lv, Yu Wang, Zongliang Wang, Tianlin Gao, Ning Zhang, Min Guo, Haifeng Zou, Peibiao Zhang
Journal: Advanced Healthcare Materials (2016)

Homogeneous and monodisperse GdPO4·H2O nanobundles are successfully synthesized via a solvothermal method. Then, GdPO4·H2O are incorporated into the composite of hydroxyapatite and poly(lactic-co-glycolic acid) to obtain a biodegradable and traceable bone implant. After implanted, the GdPO4·H2O/HA/PLGA implant and the newly formed bone can be easily traced and observed through the combination of magnetic resonance imaging and X-ray imaging. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Post Hoc Analysis of the Phase II/III APRIL‐SLE Study: Association Between Response to Atacicept and Serum Biomarkers Including BLyS and APRIL
Authors: Caroline Gordon, David Wofsy, Stephen Wax, Yong Li, Claudia Pena Rossi, David Isenberg
Journal: Arthritis & Rheumatology (2016)

To assess the relationship between treatment response, baseline biomarker levels, and atacicept exposure in patients with systemic lupus erythematosus (SLE) in the phase II/III APRIL-SLE study.We performed a post hoc analysis of patients who received placebo, atacicept 75 mg, or atacicept 150 mg in a randomized, controlled, 52-week trial. Serum levels of BlyS and APRIL were measured at baseline, and serum levels of Ig and the numbers of naive B cells and plasma cells were measured at baseline and during treatment. Atacicept exposure was determined by assessment of the serum trough concentrations throughout the 52-week trial period. Associations between these parameters, treatment response (reduction in British Isles Lupus Assessment Group A or B flare), and infection rates were explored.Recurrent high baseline levels of both BLyS (≥1.6 ng/ml) and APRIL (≥2.2 ng/ml) correlated with a greater treatment response (flare rate 75.7% with placebo, and 50.0% and 32.0% with atacicept 75 mg and atacicept 150 mg, respectively) compared with lower baseline levels of both. Increased atacicept exposure correlated with reduced flare rates (60.5% with placebo; 63.4%, 61.0%, 48.8%, and 29.3% in the 4 quartiles, from lowest to highest atacicept exposure). Greater pharmacodynamic responses (reduced Ig levels and naive B cell and plasma cell numbers) were associated with greater reductions in the flare rate. Infection rates were similar regardless of biomarker levels at baseline or at the time of atacicept exposure.These post hoc analyses demonstrate a dose-response relationship between atacicept concentrations, reduced Ig levels, and reduced flare rates and suggest that baseline biomarkers such as elevated serum levels of BLyS and APRIL may help to identify the patients who are most likely to benefit from atacicept treatment.
Global helium crisis deflates after discovery of African reserve
Authors: Owen Dyer
Journal: BMJ (2016)

A growing shortage of the element helium, needed for magnetic resonance imaging (MRI), has been solved almost overnight by the discovery of a vast gas field in Tanzania.

The find, of roughly 1.53 billion cubic metres (54 billion cubic feet), is nearly three times the quantity now held in the US National Helium Reserve, a giant underground tank in Texas which holds most of the world’s current stocks.

On its own, the new find is enough to sustain current use levels for nearly a decade, or to fill 1.2 million …
High-affinity, noninhibitory pathogenic C1 domain antibodies are present in patients with hemophilia A and inhibitors
Authors: Glaivy Batsuli, Wei Deng, John F. Healey, Ernest T. Parker, W. Hunter Baldwin, Courtney Cox, Brenda Nguyen, Joerg Kahle, Christoph Königs, Renhao Li, Pete Lollar, Shannon L. Meeks
Journal: Blood (2016)
PPD4-2-6: Feasibility of Adjuvant carboplatin/docetaxel (C/D) in patients (pts) resected stage I-IIIB non-small cell lung cancer (NSCLS): Preliminary report of a phase II trial
Authors: Thomas E. Stinchcombe, Mark A. Socinski, Harry D. Harper, Thomas A. Hensing, Dominic T. Moore, Jeffrey M. Crane, James N. Atkins, Ellen M. Willard, Maureen T. Tynan, Sara E. Gulino
Journal: Journal of Thoracic Oncology (2007)
ErbB2 and p38γ MAPK mediate alcohol-induced increase in breast cancer stem cells and metastasis
Authors: Mei Xu, Zhenhua Ren, Xin Wang, Ashley Comer, Jacqueline A. Frank, Zun-ji Ke, Yi Huang, Zhuo Zhang, Xianglin Shi, Siying Wang, Jia Luo
Journal: Molecular Cancer (2016)

Both epidemiological and experimental studies suggest that excessive alcohol exposure increases the risk for breast cancer and enhances metastasis/recurrence. We have previously demonstrated that alcohol enhanced the migration/invasion of breast cancer cells and cancer cells overexpressing ErbB2/HER2 were more sensitive to alcohol exposure. However, the underlying mechanisms remain unclear. This study was designed to investigate the mechanisms underlying alcohol-enhanced aggressiveness of breast cancer. Cancer stem cells (CSCs) play a critical role in cancer metastasis and recurrence.We evaluated the effect of chronic alcohol exposure on mammary tumor development/metastasis in MMTV-neu transgenic mice and investigated the cell signaling in response to alcohol exposure in breast cancer cells overexpressing ErbB2/HER2. RESULTS AND DISCUSSION: Chronic alcohol exposure increased breast cancer stem cell-like CSC population and enhanced the lung and colon metastasis in MMTV-neu transgenic mice. Alcohol exposure caused a drastic increase in CSC population and mammosphere formation in breast cancer cells overexpressing ErbB2/HER2. Alcohol exposure stimulated the phosphorylation of p38γ MAPK (p-p38γ) which was co-localized with phosphorylated ErbB2 and CSCs in the mammary tumor tissues. In vitro results confirmed that alcohol activated ErbB2/HER2 and selectively increased p-p38γ MAPK as well as the interaction between p38γ MAPK and its substrate, SAP97. However, alcohol did not affect the expression/phosphorylation of p38α/β MAPKs. In breast cancer cell lines, high expression of ErbB2 and p-p38γ MAPK was generally correlated with more CSC population. Blocking ErbB2 signaling abolished heregulin β1- and alcohol-stimulated p-p38γ MAPK and its association with SAP97. More importantly, p38γ MAPK siRNA significantly inhibited an alcohol-induced increase in CSC population, mammosphere formation and migration/invasion of breast cancer cells overexpressing ErbB2.p38γ MAPK is downstream of ErbB2 and plays an important role in alcohol-enhanced aggressiveness of breast cancer. Therefore, in addition to ErbB2/HER2, p38γ MAPK may be a potential target for the treatment of alcohol-enhanced cancer aggressiveness.
Housing instability and homelessness among rural schizophrenic patients
Authors: R E Drake, M A Wallach, G B Teague, D H Freeman, T S Paskus, T A Clark
Journal: American Journal of Psychiatry (1991)

The authors examined housing instability among treated schizophrenic patients in a rural area and compared the findings with those from their previous study of urban patients.Seventy-five patients with schizophrenia or schizoaffective disorder who were treated in a rural mental health center were assessed with research interviews and ratings by their clinical case managers. The patients were followed for 1 year to identify episodes of psychiatric hospitalization, incarceration, and literal homelessness.Of the 75 patients, 19 (25%) had housing situations characterized as unstable by their case managers. For the majority, housing instability signified tenuousness of living arrangements rather than literal homelessness. Noncompliance with medications, alcohol use, and negative symptoms accounted for 30% of the variance in unstable housing. During follow-up, the unstably housed patients, compared to those in stable living situations, were no more likely to be rehospitalized but were somewhat more likely to be jailed and significantly more likely to be literally homeless.In the authors' previous study of urban psychiatric patients, unstably housed patients were more likely to be literally homeless, highly symptomatic, and rehospitalized during follow-up than the rural patients with unstable housing. Better outcomes in the rural area appeared to be related to the greater availability of housing alternatives and to intensive case management. For patients with unstable housing in both settings, noncompliance with medications and substance abuse, as well as housing arrangements, should be assertively addressed.