tbuckley/cabot-search huggingface dataset:
Preoperative Modified FOLFIRINOX Treatment Followed by Capecitabine-Based Chemoradiation for Borderline Resectable Pancreatic Cancer
Authors: Matthew H. G. Katz, Qian Shi, Syed A. Ahmad, Joseph M. Herman, Robert de W. Marsh, Eric Collisson, Lawrence Schwartz, Wendy Frankel, Robert Martin, William Conway, Mark Truty, Hedy Kindler, Andrew M. Lowy, Tanios Bekaii-Saab, Philip Philip, Mark Talamonti, Dana Cardin, Noelle LoConte, Perry Shen, John P. Hoffman, Alan P. Venook
Journal: JAMA Surgery (2016)

Although consensus statements support the preoperative treatment of borderline resectable pancreatic cancer, no prospective, quality-controlled, multicenter studies of this strategy have been conducted. Existing studies are retrospective and confounded by heterogeneity in patients studied, therapeutic algorithms used, and outcomes reported.To determine the feasibility of conducting studies of multimodality therapy for borderline resectable pancreatic cancer in the cooperative group setting.A prospective, multicenter, single-arm trial of a multimodality treatment regimen administered within a study framework using centralized quality control with the cooperation of 14 member institutions of the National Clinical Trials Network. Twenty-nine patients with biopsy-confirmed pancreatic cancer preregistered, and 23 patients with tumors who met centrally reviewed radiographic criteria registered. Twenty-two patients initiated therapy (median age, 64 years [range, 50-76 years]; 55% female). Patients registered between May 29, 2013, and February 7, 2014.Patients received modified FOLFIRINOX treatment (85 mg/m2 of oxaliplatin, 180 mg/m2 of irinotecan hydrochloride, 400 mg/m2 of leucovorin calcium, and then 2400 mg/m2 of 5-fluorouracil for 4 cycles) followed by 5.5 weeks of external-beam radiation (50.4 Gy delivered in 28 daily fractions) with capecitabine (825 mg/m2 orally twice daily) prior to pancreatectomy.Feasibility, defined by the accrual rate, the safety of the preoperative regimen, and the pancreatectomy rate.The accrual rate of 2.6 patients per month was superior to the anticipated rate. Although 14 of the 22 patients (64% [95% CI, 41%-83%]) had grade 3 or higher adverse events, 15 of the 22 patients (68% [95% CI, 49%-88%]) underwent pancreatectomy. Of these 15 patients, 12 (80%) required vascular resection, 14 (93%) had microscopically negative margins, 5 (33%) had specimens that had less than 5% residual cancer cells, and 2 (13%) had specimens that had pathologic complete responses. The median overall survival of all patients was 21.7 months (95% CI, 15.7 to not reached) from registration.The successful completion of this collaborative study demonstrates the feasibility of conducting quality-controlled trials for this disease stage in the multi-institutional setting. The data generated by this study and the logistical elements that facilitated the trial's completion are currently being used to develop cooperative group trials with the goal of improving outcomes for this subset of patients.clinicaltrials.gov Identifier: NCT01821612.
A comparison of three measures for the diagnosis of borderline personality disorder [published erratum appears in Am J Psychiatry 1989 Aug;146(8):1089]
Authors: L E Angus, E Marziali
Journal: American Journal of Psychiatry (1988)

Three instruments for diagnosing borderline personality disorder were administered to 22 outpatients. There was poor concordance among the indexes for the identification of the disorder, and more than half of the sample received more than two DSM-III axis II diagnoses.
Time matters: A systemwide initiative to improve timely patient navigation through medical oncology and infusion in a comprehensive cancer center.
Authors: Deborah Scribner, Nikki E Nash, Konstantin H. Dragnev, David L Crosby
Journal: Journal of Clinical Oncology (2015)

e17517 Background: In 2012, Norris Cotton Cancer Center in Lebanon, NH, embarked on a multi-year system-wide improvement process to address poor and inconsistent performance in infusion, clinic, and pharmacy service areas. From this work, we aimed to develop a reliable, consistent, and measurable process for patient navigation through a complex system. Methods: Work followed a defined methodology – Define, Measure, Analyze, Improve, and Control (DMAIC). Four teams worked on distinct segments of patient and information flow through the system: pre-visit preparation, infusion room operations, pharmacy operations, and clinic flow. Interventions included infusion scheduling standardization by chemotherapy doses per hour, clinic capacity scheduling to allow for better level loading of clinic schedules, signing of Beacon chemotherapy orders greater than 24 hours in advance of a patient’s treatment date, and an early electronic notification by providers to pharmacy and nursing indicating patient readiness for treatment. Results: After changes were implemented, infusion scheduling was standardized by including a maximum number of 12 chemotherapy doses per hour, and our current performance to this measure is 98%; clinic scheduling was aligned for level loading, our current performance is 79%, with 100% being a completely level loaded clinic; 71% of providers signed Beacon chemotherapy orders greater than 24 hours prior to the scheduled infusion; providers used an early notification to pharmacy and infusion nursing to indicate patient readiness for treatment via EPIC software 67% of the time. In addition, pharmacy preparation times were within expected range of 45 minutes or less 73% of the time, and our infusion visits ended within 34 minutes of the expected time 75% of the time. Additional measures will be presented. Conclusions: By analyzing clinic, infusion, and pharmacy workflows, we created a system that allows for a reliable patient experience. Consistent expectations using clear guidelines and system performance monitoring over time have led to improvements in clinic utilization, order processing, pharmacy throughput, and infusion scheduling and operations.
The Physician as Sex Counselor
Authors: E Mason
Journal: JAMA (1969)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Neuroendocrine and personality variables in dysthymic disorder
Authors: A Roy, M Sutton, D Pickar
Journal: American Journal of Psychiatry (1985)

In an attempt to characterize a subgroup of depressed patients diagnosed as having dysthymic disorder, the authors gave them two commonly used biological tests for depression and several personality inventories and compared the results with those from age- and sex-matched normal control subjects. There were no significant differences between the 11 early-onset dysthymic disorder patients and the 11 controls on the dexamethasone suppression test or the thyrotropin-releasing hormone test. The personality questionnaires, however, showed that the dysthymic disorder patients were significantly more neurotic, extrapunitive, and intrapunitive and had significantly lower self-esteem than the control subjects.
Public health challenges and legacies of Japan’s response to the Ebola virus disease outbreak in West Africa 2014 to 2015
Authors: Tomoya Saito
Journal: Eurosurveillance (2015)

The largest outbreak of Ebola virus disease occurred in West Africa in 2014 and resulted in unprecedented transmission even in distant countries. In Japan, only nine individuals were screened for Ebola and there was no confirmed case. However, the government promoted the reinforcement of response measures and interagency collaboration, with training and simulation exercises conducted country-wide. The legacies included: publication of a communication policy on case disclosure, a protocol for collaboration between public health and other agencies, and establishing an expert committee to assemble the limited available expertise. There were challenges in taking proportionate and flexible measures in the management of people identified to be at high risk at entry points to Japan, in the decentralised medical response strategy, and in the medical countermeasures preparedness. The Ebola outbreak in West Africa provided a crucial opportunity to reveal the challenges and improve the preparedness for rare but high impact emerging diseases that are prone to be neglected. Efforts to uphold the lessons learnt and maintain public health preparedness should help prepare for future emerging diseases, including bioterrorist acts and pandemics.
Other factors probably explain differences in prescribing
Authors: E. Robinson
Journal: BMJ (1996)

EDITOR,—Robert P H Wilson and colleagues conclude that fundholding alters practice prescribing patterns and reduces the rate of increase in prescribing costs compared with those of non-fundholders.1 Though this may be the case in the former Mersey region, a similar study in Avon (of 156 general practitioners) has not reached the same conclusion. Using the same methods, colleagues and I found that, before the introduction of fundholding, fundholders spent on average less per weighted capitation …
PTH-098 Connecting liver and gut in psc: ccl25 expression is upregulated in colitis, correlates with inflammatory activity and facilitates effector ccr9+ lymphocyte recruitment
Authors: PJ Trivedi, T Bruns, ST Ward, M Mai, C Schmidt, G Hirschfield, C Weston, D Adams
Journal: Gut (2015)

<h3>Introduction</h3> Recruitment of mucosal T-cells to the liver in response to aberrantly expressed homing signals drives hepatobiliary inflammation in primary sclerosing cholangitis (PSC). This is exemplified by the ‘gut-homing’ chemokine CCL25, which recruits intestinal CCR9<sup>+</sup>effector cells to the PSC liver. However, previous studies report CCL25 expression as being confined to the small bowel whereas PSC is typically associated with colonic inflammation. Our aim was to determine whether CCL25 and CCR9 are expressed in the inflamed human colon in patients with colitis. <h3>Method</h3> Mucosal biopsies were obtained during surveillance colonoscopy (n = 40) and colonic tissue from patients undergoing surgical resection for colitis (n = 6), or non-colitis-associated cancer (n = 5). CCL25 mRNA was evaluated by qRT-PCR (relative to GUSb) and protein expression confirmed using western blotting and tissue-ELISA. Lymphocyte CCR9 expression was quantified by flow cytometry, and the ability of sorted a4b7<sup>+</sup>CCR9<sup>+</sup>and a4b7<sup>+</sup>CCR9<sup>-</sup>T-cells to transmigrate across hepatic sinusoidal endothelium (HSEC) investigated in flow-based adhesion assays. <h3>Results</h3> CCL25 mRNA and protein were absent from normal colon but present in colitis. CCL25 mRNA expression correlated with endoscopic Mayo score (p = 0.001) and tissue levels of TNFa (Spearman’s rho 0.811; p &lt; 0.0001) as indices of inflammatory activity (Figure 1). In colitis, &gt;90% of CD3<sup>+</sup>CD4<sup>+</sup>and &gt;15% of CD8<sup>+</sup>T-cells expressed CCR9 (6% and 2% in normal colon; p = 0.01 and 0.03) and were predominantly CD127<sup>+</sup>effector lymphocytes. a4b7<sup>+</sup>CCR9<sup>+</sup>T-cells showed enhanced adhesion and transendothelial migration across HSEC compared with a4b7<sup>+</sup>CCR9<sup>-</sup>T-cells (p &lt; 0.05). <h3>Conclusion</h3> CCL25 is expressed in the inflamed human colon, correlates with inflammatory activity and is associated with high frequencies of CCR9<sup>+</sup>tissue-infiltrating lymphocytes. These findings lend further support to the mucosal lymphocyte homing hypothesis of PSC and show how it can be applied to patients with colitis. <h3>Disclosure of interest</h3> None Declared.
Limited prolonged effects of rifaximin treatment on irritable bowel syndrome-related differences in the fecal microbiome and metabolome
Authors: Natalia Zeber-Lubecka, Maria Kulecka, Filip Ambrozkiewicz, Agnieszka Paziewska, Krzysztof Goryca, Jakub Karczmarski, Tymon Rubel, Wojciech Wojtowicz, Piotr Mlynarz, Lukasz Marczak, Roman Tomecki, Michal Mikula, Jerzy Ostrowski
Journal: Gut Microbes (2016)

Irritable bowel syndrome (IBS) is a chronic functional disorder and its development may be linked, directly and indirectly, to intestinal dysbiosis. Here we investigated the interactions between IBS symptoms and the gut microbiome, including the relation to rifaximin (1200 mg daily; 11.2 g per a treatment). We recruited 72 patients, including 31 with IBS-D (diarrhea), 11 with IBS-C (constipation), and 30 with IBS-M (mixed constipation and diarrhea) and 30 healthy controls (HCs). Of them, 68%, 64%, and 53% patients with IBS-D, IBS-C, and IBS-M, respectively, achieved 10-12 week-term improvement after the rifaximin treatment. Stool samples were collected before and after the treatment, and fecal microbiotic profiles were analyzed by deep sequencing of 16S rRNA, while stool metabolic profiles were studied by hydrogen 1-nuclear magnetic resonance ((1)H-NMR) and gas chromatography-mass spectrometry (GC-MS). Of 26 identified phyla, only Bacteroidetes, Firmicutes, Proteobacteria, and Actinobacteria were consistently found in all samples. Bacteroidetes was predominant in fecal samples from HCs and IBS-D and IBS-M subjects, whereas Firmicutes was predominant in samples from IBS-C subjects. Species richness, but not community diversity, differentiated all IBS patients from HCs. Metabolic fingerprinting, using NMR spectra, distinguished HCs from all IBS patients. Thirteen metabolites identified by GC-MS differed HCs and IBS patients. However, neither metagenomics nor metabolomics analyses identified significant differences between patients with and without improvement after treatment.
SP0189 Meta-Analysis Presentation, Interpretation and Relevance
Authors: L. Carmona
Journal: Annals of the Rheumatic Diseases (2015)

Systematic reviews (SR) are a type of clinical research, and thus they follow the hypothetical-deductive or scientific method. Their objective is to answer clinical questions and they do it based on a specific structure (protocol) and working through inferences. Interestingly, a SR is a type of study design that can answer all types of questions, from efficacy to incidence. They manage the information from previous studies in a pre-established reproducible way, as unbiased as possible. They provide quick answers. However, they should be performed and interpreted with caution: A poor systematic review is much worse than a narrative review, as it gives the false impression of “science”. This is even worse if the studies were combined in a meta-analysis. In this session, we will review the protocol of a SR, the importance of rephrasing the question, the search strategy, selection criteria, procedures of studies selection, primary endpoints, and quality and risk of bias. The last part of any SR is the analysis, which is always qualitative, supported by the evidence table, and following a synthetic discourse with the PICO order, and sometimes quantitative (meta-analysis). We will review some methods to evaluate publication bias, to combine results, and to explore heterogeneity. In this sense, it is essential to note that if we cannot find a valid explanation for heterogeneity, our results may not be valid. <h3>Disclosure of Interest</h3> None declared
Extensive hyperplastic recurrence after complete R0 resection by endoscopic submucosal dissection of a gastric hyperplastic polyp with dysplasia
Authors: Bérénice Petit, Jérôme Rivory, Isabelle Lienhart, Adriane Lesne, Valérie Hervieu, Thierry Ponchon, Mathieu Pioche
Journal: Endoscopy (2015)

Endoscopic submucosal dissection (ESD) is an effective, safe technique for treating gastric lesions [1]. Hyperplastic polyps have an underestimated risk for malignancy, which has been reported to be 3.7 % in 809 lesions measuring more than 1 cm [2]. Thus, complete en bloc resection with ESD is an option to avoid local recurrence [3], particularly when hyperplasia is associated with dysplasia.
Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)
Authors: Birgitte Bytoft, Sine Knorr, Zuzana Vlachova, Rikke B. Jensen, Elisabeth R. Mathiesen, Henning Beck-Nielsen, Claus H. Gravholt, Dorte M. Jensen, Tine D. Clausen, Erik L. Mortensen, Peter Damm
Journal: Diabetes Care (2016)

Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association with maternal HbA1c.Offspring of a prospectively followed cohort of women with type 1 diabetes (n = 277) participated in a follow-up examination at the age of 13-19 years. A control group from the background population was identified (n = 301). Cognitive function was evaluated using Reynolds Intellectual Assessment Scales and classified into indices of composite intelligence, verbal and nonverbal intelligence, and composite memory. Frequencies of reading and writing problems and attendance to classes for children with learning difficulties were assessed.Offspring of women with type 1 diabetes scored lower in all normalized and standardized intelligence indices compared with controls: composite intelligence (95.7 vs. 100, P = 0.001), verbal intelligence (96.2 vs. 100, P = 0.004), nonverbal intelligence (96.4 vs. 100, P = 0.008), and composite memory (95.7 vs. 100, P = 0.001). A higher frequency of diabetes-exposed offspring had parent-reported learning difficulties in primary school. Differences between groups remained after adjustment for confounders and potential mediators. We found no direct association between maternal HbA1c and offspring cognitive function in the exposed group.Adolescent offspring of women with type 1 diabetes had lower cognitive function compared with a control group, also after adjustment for confounders and potential mediators. These differences may reflect direct harmful effects of maternal diabetes on neurodevelopment in the offspring.
Web: Games without frontiers
Authors: Naomi Marks
Journal: BMJ (2006)

For those promoting peace, the world of videogames might seem one to give as wide a berth as possible.

More often than not encouraging players to indulge in fast paced, point scoring action and see the world from one perspective only, videogames have a seemingly deserved reputation for fostering a war mongering and violent mind set in the young people who find them so compelling. Certainly, this entertainment medium seems inherently at odds with the world of conflict resolution—where the slower the pace, the greater the ability to see the world through others' eyes, and the more focused on the long term, the more likely a “win” is to be achieved.

Those working in the highly charged Middle East region in particular might have good reason to question what videogame technology can offer. After all, not so long ago a videogame from Hezbollah, Special Force, featuring simulated attacks on the Israeli army, was the top must-have game for the youngsters of Beirut's Shiite neighbourhoods.

As for what has been available to the “other side,” America dominates the videogame market and a rash of anti-Arab ones in particular have been released since “9/11.”

ImpactGames's Asi Burak and Eric Brown, however, are hoping to market a game with a difference—a simulation game tackling the Israeli-Palestinian conflict in a progressive way. Their creation, PeaceMaker (www.peacemakergame.com), asks players to first assume either the role of the Israeli prime minister or the Palestinian president. They must then interact in their virtual world with eight other “actors”—political leaders and social groups—as well as react to events such as peace negotiations, military attacks, and suicide bombs. The aim is to reach a stable resolution by the end of their prime ministerial or presidential term of office.

The game has three levels of difficulty—calm, tense, or violent—though a provocative incident confronts players from the start of the game whichever level is chosen. Onscreen action takes place using a high resolution map of Israel, the West Bank, and the Gaza strip, and the use of a library of video footage of news events makes it a more real experience for players.

Burak and Brown claim that PeaceMaker allows “what if” scenarios to be explored and events to be seen from alternative perspectives. It also opens the door to further debate, they say.

The game started life as a student project at Carnegie Mellon University's Entertainment Technology Center but the international support it has received has seen it developed into a commercial project.

Brown says: “In a sense, peacemaking can be more complicated, sophisticated, and rewarding than war making. We tried to shed light on how challenging it is for a leader to gain trust and understanding in the face of constant violence. How difficult it is to execute concessions, while your own population is under stress or feeling despair.”
Endoscopic Resection of a Juxtapapillary Gangliocytic Paraganglioma
Authors: P.  Hengstler, J.  Binek, C.  Meyenberger
Journal: Endoscopy (2003)

A 63-year-old man was hospitalized for work-up of noncardiac chest pain. Laboratory data on admission showed hypochromia (25pg; normal range 27-31pg) and microcytosis (79fl; normal range 80-95fl), with a normal hemoglobin level of 14.4 g/dl (normal range 14-18 g/dl). An upper gastrointestinal endoscopic examination revealed a submucosal polypoid lesion adjacent to the major papilla (Figure [1]). Biopsy specimens from the mucosa overlying this lesion showed normal duodenal mucosa. An endosonographic examination was also carried out, and it showed a round, well-demarcated, hypoechoic, submucosal tumor in the third layer just distal to the papilla of Vater (Figure [2]). There was no invasion of the muscularis propria. There were no pathological lymph nodes around the duodenum and celiac trunk.
Further Studies on the Susceptibility of Hybrid Mice to Induced and Spontaneous Tumors
Authors: H. B. Andervont
Journal: JNCI Journal of the National Cancer Institute (1940)

Further Studies on the Susceptibility of Hybrid Mice to Induced and Spontaneous Tumors Get access H. B. Andervont H. B. Andervont senior biologist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 1, Issue 2, October 1940, Pages 135–145, https://doi.org/10.1093/jnci/1.2.135 Published: 01 October 1940
Feasibility and efficacy of 223Ra-dichloride (223Ra) to treat bone metastases in patients (pts) with castration resistant prostate cancer (mCRPC)
Authors: A. Farnesi, S. Mazzarri, G. Boni, L. Galli, C. Cianci, E. Borso', R. Marconcini, E. Biasco, L. Derosa, A. Sbrana, A. Antonuzzo, S. Ricci, D. Volterrani, A. Falcone
Journal: Annals of Oncology (2015)