tbuckley/cabot-search huggingface dataset:
Evaluation of the Impact of Mandating Health Care Providers to Offer Hepatitis C Virus Screening to All Persons Born During 1945–1965 — New York, 2014
Authors: Colleen A. Flanigan, Shu-Yin J. Leung, Kirsten A. Rowe, Wendy K. Levey, Andrea King, Jamie N. Sommer, Johanne E. Morne, Howard A. Zucker
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

Approximately 75% of all hepatitis C virus (HCV) infections in the United States and 73% of HCV-associated mortality occur in persons born during 1945-1965, placing this birth cohort at increased risk for liver cancer and other HCV-related liver disease (1). In the United States, an estimated 2.7 million persons are living with HCV infection, and it is estimated that up to 75% of these persons do not know their status. Since 2012, CDC has recommended that persons born during 1945-1965 receive one-time HCV testing. To increase the number of persons tested for HCV and to ensure timely diagnosis and linkage to care, in 2014, New York enacted a hepatitis C testing law that requires health care providers to offer HCV antibody screening to all persons born during 1945-1965 who are receiving services in primary care settings or as hospital inpatients, and to refer persons with positive HCV antibody tests for follow-up health care, including an HCV diagnostic test (i.e., HCV RNA).* The New York State Department of Health (NYSDOH) used survey data from clinical laboratories and Medicaid claims and encounter data, and state and New York City (NYC) HCV surveillance data to assess the number of persons tested for HCV and number of persons with newly diagnosed HCV infections who were linked to care. During the first year of the HCV law implementation, there was a 51% increase in specimens submitted for HCV testing to surveyed clinical laboratories; testing rates among active Medicaid clients increased 52%, and linkage to care among persons with newly diagnosed HCV infection increased approximately 40% in New York and 11% in NYC. These findings highlight the potential for state laws to promote HCV testing and the utility of HCV surveillance and Medicaid claims data to monitor the quality of HCV testing and linkage to care for HCV-infected persons.
Thymosin Alfa 1 Administration Improves Immune Reconstitution and Decreases Infection-Related Mortality After HLA-Matched Sibling T Cell-Depleted Stem Cell Transplantation
Authors: Katia Perruccio, Loredana Ruggeri, Silvia Moretti, Fabiana Topini, Antonella Tosti, Alessandra Carotti, Franco Aversa, Massimo F Martelli, Francesco Bistoni, Enrico Garaci, Luigina Romani, Andrea Velardi
Journal: Blood (2011)
Abstract 19105: Predictors of Poor Functional Status One Year Following Cardiac Rehabilitation
Authors: Elizabeth Gates, Shirley M Moore
Journal: Circulation (2016)

Introduction:  Functional status is known to significantly improve after participating in cardiac rehabilitation. However, even when participants adhere to rehabilitation, many individuals do not improve in their ability to perform everyday activities such as walking. The purpose of this study was to explore predictors of poor functional status in participants who participated in a cardiac rehabilitation program and 12-month cognitive-behavioral intervention study designed to support behavior change.   Methods:  Using a study arm database, a secondary analysis was performed on the 25% of participants with the lowest six-minute walk test scores (N=73). Walk scores ranged from 80 feet to 996 feet walked in six minutes. Linear regression was used to predict total feet walked during the six-minute walk. Study arm was controlled for in the analysis. Age, gender, Charlson comorbidity index score, weight, New York Heart Association (NYHA) Class, and total number of exercise hours reported were considered as potential predictors. The sample mean age was 72.6 years old ( SD =7.8,  Range =56-89). The sample consisted of 51% men, 49% women, 86% Caucasian, and 14% minority. The majority of the sample was NYHA Class I (74%). Class II made up 14%, Class III made up 11%, and Class IV was 1% of the sample.   Results:  Predictors of poor functional status were age ( β =-.343;  p  β =.338;  p  β =-.308,  p  β =-.277;  p    Conclusions:  Findings indicated that as age increased, functional status decreased. Similarly as weight increased, functional status decreased. Men were found to have better functional status than women. Furthermore, as NYHA class increased, functional status decreased. Interestingly, comorbidity score and total number of exercise hours reported were not a predictor of functional status. Study arm had no impact on functional status in regard to these variables. Further exploration of these predictors are needed to improve functional status in older patients with cardiac disease.
Graded prognostic assessment index for breast cancer patients with brain metastases (BCBM).
Authors: Vyshak Alva Venur, Saurabh Dahiya, Lingling Du, Rohan Garje, Kwabena Osei-Boateng, Paul Elson, John H. Suh, Samuel T. Chao, Manmeet Singh Ahluwalia
Journal: Journal of Clinical Oncology (2013)

2096 Background: The Graded Prognostic Assessment (GPA) is a commonly used prognostic index based on RTOG protocols in patients with brain metastases (BM). The purpose of this study was to evaluate prognostic factors to predict for overall survival (OS) in breast cancer BM (BCBM) treated at a single tertiary care center. Methods: After obtaining IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify BCBM who were treated in the recent years (2000-12). A proportional hazards model was used to assess OS, which was measured from the date of diagnosis of brain metastases to death or last follow-up. Results: 161 BCBM (160 females) median age 52 years (range 27-84) were included for analysis. 48% of patients were ER positive, 31% were PR positive, 50% were HER2 positive while 31% of patients were triple negative. The median number of BM was 2 (range, 1-15). Karnofsky Performance Scale (KPS) of the patient was 90-100 in 50%, 70-80 in 47%) and &lt;70 in 43%. Extracranial Metastases was present in 85% of patients. Overall 85% of patients had died at the time of analysis; median OS was 19.0 months (95% C.I. 15.7-23.2). Breast GPA that includes age, KPS and subtype was 0-1.0 in 5%, 1.5-2 in 31%, 2.5-3 in 35% and 3.5-4 in 29% of patients. Although GPA was statistically significant (p=0.002), some but not all of the factors used to derive it were significant (KPS [p=0.05],subtype [p=0.003] age [p=0.50]). Factors noted to be independently prognostic for OS (multivariable Cox proportional hazards model) included location of BM, number of extracranial metastases and uncontrolled primary tumor (Table). Conclusions: New GPA based on a set of independent prognostic factors is proposed. [Table: see text]
Durability of Protection Afforded by Fewer Doses of the HPV16/18 Vaccine: The CVT Trial
Authors: Mahboobeh Safaeian, Joshua N. Sampson, Yuanji Pan, Carolina Porras, Troy J. Kemp, Rolando Herrero, Wim Quint, Leen Jan van Doorn, John Schussler, Douglas R. Lowy, John Schiller, Mark T. Schiffman, Ana Cecilia Rodriguez, Mitchell H. Gail, Allan Hildesheim, Paula Gonzalez, Ligia A. Pinto, Aimée R. Kreimer, González Paula, Rolando Herrero, Silvia E. Jiménez, Carolina Porras, Ana Cecilia Rodríguez, Allan Hildesheim, Aimée R. Kreimer, Douglas R. Lowy, Mark Schiffman, John T. Schiller, Mark Sherman, Sholom Wacholder, Ligia A. Pinto, Troy J. Kemp, Mary K. Sidawy, Wim Quint, Leen-Jan van Doorn, Linda Struijk, Joel M. Palefsky, Teresa M. Darragh, Mark H. Stoler
Journal: JNCI Journal of the National Cancer Institute (2017)

Previously, we demonstrated similar human papillomavirus (HPV)16/18 vaccine efficacy estimates and stable HPV16/18 antibody levels four years postvaccination in a nonrandomized analysis of women who received a varying number of doses of the bivalent HPV16/18 vaccine. Here we extend data to seven years following initial vaccination. We evaluated HPV16/18-vaccinated women who received one (n = 134), two (n0/1 = 193, n0/6 = 79), or three doses (n = 2043) to a median of 6.9 years postvaccination. Cervical HPV DNA was measured with the SPF10- DEIA-LiPA PCR system; HPV16/18-specific antibody levels were measured using enzyme-linked immunosorbent assays (n = 486). Infection and immunological measures were compared across vaccine dose groups. Prevalent HPV infection at year 7 was also compared with an unvaccinated control group (UCG). All statistical tests were two-sided. Among women in the three-dose, two-dose0/6, two-dose0/1, and one-dose groups, cumulative incident HPV16/18 infection rates (No. of events/No. of individuals) were 4.3% (88/2036, 95% confidence interval [CI] = 3.5% to 5.3%), 3.8% (3/78, 95% CI = 1.0% to 10.1%), 3.6% (7/192, 95% CI = 1.6% to 7.1%), and 1.5% (2/133, 95% CI = 0.3% to 4.9%; P = 1.00, .85, .17 comparing the two-dose0/6, two-dose0/1, and one-dose groups to the three-dose group, respectively). The prevalence of other carcinogenic and noncarcinogenic HPV types, excluding HPV16/18/31/33/45, were high and not statistically different among all dose groups, indicating that the low incidence of HPV16/18 in the one- and two-dose groups was not due to lack of exposure. At seven years, 100% of participants in all dose groups remained HPV16 and HPV18 seropositive. A non–statistically significant decrease in the geometric mean of the HPV16 antibody levels between years 4 and 7 was observed among women in the three-dose group: –10.8% (95% CI = –25.3% to 6.6%); two-dose (0/6 months) group: –17.3% (95% CI = –39.3% to 12.8%), two-dose (0/1 month) group: –6.9% (95% CI = –22.1% to 11.2%), and one-dose group: –5.5% (95% CI = –29.7% to 27.0%); results were similar for HPV18. At an average of seven years of follow-up, we observed similar low rates of HPV16/18 infections and slight, if any, decreases in HPV16/18 antibody levels by dose group.
Creating a data resource: what will it take to build a medical information commons?
Authors: Patricia A. Deverka, Mary A. Majumder, Angela G. Villanueva, Margaret Anderson, Annette C. Bakker, Jessica Bardill, Eric Boerwinkle, Tania Bubela, Barbara J. Evans, Nanibaa’ A. Garrison, Richard A. Gibbs, Robert Gentleman, David Glazer, Melissa M. Goldstein, Hank Greely, Crane Harris, Bartha M. Knoppers, Barbara A. Koenig, Isaac S. Kohane, Salvatore La Rosa, John Mattison, Christopher J. O’Donnell, Arti K. Rai, Heidi L. Rehm, Laura L. Rodriguez, Robert Shelton, Tania Simoncelli, Sharon F. Terry, Michael S. Watson, John Wilbanks, Robert Cook-Deegan, Amy L. McGuire
Journal: Genome Medicine (2017)

National and international public–private partnerships, consortia, and government initiatives are underway to collect and share genomic, personal, and healthcare data on a massive scale. Ideally, these efforts will contribute to the creation of a medical information commons (MIC), a comprehensive data resource that is widely available for both research and clinical uses. Stakeholder participation is essential in clarifying goals, deepening understanding of areas of complexity, and addressing long-standing policy concerns such as privacy and security and data ownership. This article describes eight core principles proposed by a diverse group of expert stakeholders to guide the formation of a successful, sustainable MIC. These principles promote formation of an ethically sound, inclusive, participant-centric MIC and provide a framework for advancing the policy response to data-sharing opportunities and challenges.
The effect of intracoronary infusion of bone marrow‐derived mononuclear cells on all‐cause mortality in acute myocardial infarction: rationale and design of the <scp>BAMI</scp> trial
Authors: Anthony Mathur, Roman Arnold, Birgit Assmus, Jozef Bartunek, Ann Belmans, Halvard Bönig, Filippo Crea, Stefanie Dimmeler, Sheik Dowlut, Francisco Fernández‐Avilés, Manuel Galiñanes, David Garcia‐Dorado, Juha Hartikainen, Jonathan Hill, Annette Hogardt‐Noll, Christian Homsy, Stefan Janssens, Petr Kala, Jens Kastrup, John Martin, Philippe Menasche, Roman Miklik, Abdul Mozid, J. Alberto San Román, Ricardo Sanz‐Ruiz, Michal Tendera, Wojtek Wojakowski, Seppo Ylä‐Herttuala, Andreas Zeiher
Journal: European Journal of Heart Failure (2017)

Over the past 13 years bone marrow‐derived mononuclear cells ( BM‐MNCs ) have been widely investigated for clinical efficacy in patients following acute myocardial infarction ( AMI ). These early phase II trials have used various surrogate markers to judge efficacy and, although promising, the results have been inconsistent. The phase III BAMI trial has therefore been designed to demonstrate that intracoronary infusion of BM‐MNCs is safe and will significantly reduce the time to first occurrence of all‐cause death in patients with reduced left ventricular ejection fraction after successful reperfusion for ST ‐elevation AMI (powered with the aim of detecting a 25% reduction in all‐cause mortality). This is a multinational, multicentre, randomized, open‐label, controlled, parallel‐group phase III study aiming to enrol approximately 3000 patients in 11 European countries with at least 17 sites. Eligible patients who have impaired left ventricular ejection (≤45%) following successful reperfusion for AMI will be randomized to treatment or control group in a 1:1 ratio. The treatment group will receive intracoronary infusion of BM‐MNCs 2–8 days after successful reperfusion for AMI added on top of optimal standard of care. The control group will receive optimal standard of care. The primary endpoint is time from randomization to all‐cause death. The BAMI trial is pivotal and the largest trial to date of BM‐MNCs in patients with impaired left ventricular function following AMI . The aim of the trial is to provide a definitive answer as to whether BM‐MNCs reduce all‐cause mortality in this group of patients.
Recent advances in the effects of microwave radiation on brains
Authors: Wei-Jia Zhi, Li-Feng Wang, Xiang-Jun Hu
Journal: Military Medical Research (2017)

This study concerns the effects of microwave on health because they pervade diverse fields of our lives. The brain has been recognized as one of the organs that is most vulnerable to microwave radiation. Therefore, in this article, we reviewed recent studies that have explored the effects of microwave radiation on the brain, especially the hippocampus, including analyses of epidemiology, morphology, electroencephalograms, learning and memory abilities and the mechanisms underlying brain dysfunction. However, the problem with these studies is that different parameters, such as the frequency, modulation, and power density of the radiation and the irradiation time, were used to evaluate microwave radiation between studies. As a result, the existing data exhibit poor reproducibility and comparability. To determine the specific dose-effect relationship between microwave radiation and its biological effects, more intensive studies must be performed.
Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta‐analysis
Authors: Davy Vancampfort, Joseph Firth, Felipe B. Schuch, Simon Rosenbaum, James Mugisha, Mats Hallgren, Michel Probst, Philip B. Ward, Fiona Gaughran, Marc De Hert, André F. Carvalho, Brendon Stubbs
Journal: World Psychiatry (2017)

People with severe mental illness (schizophrenia, bipolar disorder or major depressive disorder) die up to 15 years prematurely due to chronic somatic comorbidities. Sedentary behavior and low physical activity are independent yet modifiable risk factors for cardiovascular disease and premature mortality in these people. A comprehensive meta-analysis exploring these risk factors is lacking in this vulnerable population. We conducted a meta-analysis investigating sedentary behavior and physical activity levels and their correlates in people with severe mental illness. Major electronic databases were searched from inception up to April 2017 for articles measuring sedentary behavior and/or physical activity with a self-report questionnaire or an objective measure (e.g., accelerometer). Random effects meta-analyses and meta-regression analyses were conducted. Sixty-nine studies were included (N=35,682; 39.5% male; mean age 43.0 years). People with severe mental illness spent on average 476.0 min per day (95% CI: 407.3-545.4) being sedentary during waking hours, and were significantly more sedentary than age- and gender-matched healthy controls (p=0.003). Their mean amount of moderate or vigorous physical activity was 38.4 min per day (95% CI: 32.0-44.8), being significantly lower than that of healthy controls (p=0.002 for moderate activity, p<0.001 for vigorous activity). People with severe mental illness were significantly less likely than matched healthy controls to meet physical activity guidelines (odds ratio = 1.5; 95% CI: 1.1-2.0, p<0.001, I2 =95.8). Lower physical activity levels and non-compliance with physical activity guidelines were associated with male gender, being single, unemployment, fewer years of education, higher body mass index, longer illness duration, antidepressant and antipsychotic medication use, lower cardiorespiratory fitness and a diagnosis of schizophrenia. People with bipolar disorder were the most physically active, yet spent most time being sedentary. Geographical differences were detected, and inpatients were more active than outpatients and those living in the community. Given the established health benefits of physical activity and its low levels in people with severe mental illness, future interventions specifically targeting the prevention of physical inactivity and sedentary behavior are warranted in this population.
Phase II study of erlotinib in advanced non-small cell lung cancer patients with leptomeningeal metastasis.
Authors: Kaname Nosaki, Yoshimasa Shiraishi, Fumihiko Hirai, Taishi Harada, Daisuke Himeji, Takeshi Kitazaki, Noriyuki Ebi, Akinobu Hamada, Takeharu Yamanaka, Mitsuhiro Takenoyama, Kenji Sugio
Journal: Journal of Clinical Oncology (2016)

e20596 Background: Leptomeningeal metastases (LM) occur in almost 5% of non-small cell lung cancer (NSCLC) patients and are associated with a poor prognosis (the median survival ranges from 4 to 6 weeks). The cumulative incidence of CNS involvement in EGFR-mutant (mt) NSCLC is up to 60% and higher than that of EGFR-wild (wt) NSCLC. To date, no prospective study has identified active chemotherapy for NSCLC patients with LM and therapeutic options in such patients remain limited. In retrospective studies, EGFR-TKI treatment is reported to be effective for the treatment of LM. Erlotinib (ERL) cerebrospinal fluid (CSF) concentrations are higher than those of gefitinib or afatinib. Methods: We conducted a multi-center, single-arm phase II trial to evaluate the efficacy of ERL in patients with LM. NSCLC patients with cytologically confirmed LM were eligible. The primary endpoint was the overall cytological response rate (ORR), which was defined as "the number of patients who achieved complete remission in the CSF/number of all patients". Under the null hypothesis, the regimen would be rejected if the confirmed ORR was 5% or less. This study was registered with UMIN (number 000007020). Results: From Dec 2011 to May 2015, 21 patients were enrolled: the mean age was 64 years (range 51 - 77 years), M/F: 8/13, ECOG PS 1/2/3: 2/7/12, all had adenocarcinoma, and EGFR mt/wt: 17/4. All patients were EGFR T790M negative in the CSF examination. The ORR according to the central test was 47.6% (95%CI 25.7 - 70.2%, P < 0.001) and the ORR according to the institutional test was 23.8% (95%CI 8.2 - 47.2%, P = 0.0032). The median time to progression (TTP) was 2.2 months (95%CI 1.0 - 5.1). The median overall survival (OS) was 3.4 months (95%CI 2.0 - 6.3). A significantly longer TTP and OS were observed in EGFR-mt than in EGFR-wt (P = 0.01 and P = 0.0054, respectively). Most toxicities were grades 1 - 2 and manageable. Conclusions: ERL treatment for LM is well-tolerated and active, especially in EGFR-mt. Recently, high-dose weekly ERL therapy is reported to be an attractive option for LM treatment. Standard-dose ERL therapy may be an option for selected LM patients. Additional PK data will be presented at the meeting. Clinical trial information: 000007020.
Preclinical efficacy of new investigational drug ONC201 and analogs ONC212 and ONC206 against patient-derived pancreatic cancer cell lines.
Authors: Avital Lev, Jessica Wagner, Amriti R. Lulla, David T. Dicker, Wafik S. El-Deiry
Journal: Journal of Clinical Oncology (2016)

e15752 Background: Pancreatic cancer is one of the deadliest cancers with a 5-yr survival rate of ~6%. The disease remains largely incurable. At diagnosis, most patients already have locally advanced or metastatic disease that is therapy-refractory. Therefore, new effective treatments are urgently needed. ONC201 is a first-in-class small molecule that selectively targets a broad range of tumor types. The compound is currently in phase I/II clinical trials for select advanced solid and hematopoietic tumors. We report efficacy evaluation of ONC201 and analogs ONC212 and ONC206 in pancreatic cancer. Methods: Efficacy of drugs was evaluated on a panel of seven pancreatic cancer cell lines and nine low-passage patient-derived cell lines by measuring cell viability (CellTiterGlo assay). Dose-response curves were generated to calculate GI50 values. Western blot analysis of signaling molecules was performed to compare analogs to ONC201. The expression of receptor tyrosine kinases (RTKs) was determined in order to assess the potential to combine ONC201 or its analogs with FDA-approved small molecules targeting RTKs. Combination treatments were tested by measuring cell viability. Combination indices were determined using CompuSyn software. Results: Only four out of the sixteen pancreatic cancer cell lines tested showed high sensitivity to ONC201 with GI50s of 1-4 uM. By contrast, all cell lines showed high sensitivity to ONC212 with IC50s of 1-40 uM. ONC206 had no in vitro improvements over ONC201 or ONC212. We found a correlation between high expression levels of RTKs and decreased sensitivity to ONC201. Our preliminary data indicates that c-MET inhibitor, crizotinib, shows synergy with ONC201 and ONC212. Conclusions: ONC212 has therapeutic potential for pancreatic cancer cell lines compared to ONC201. Ongoing experiments are further evaluating the efficacy of ONC212 vs ONC201 using in vivo models for pancreatic cancer. Our goal is to establish the rationale for ONC212 as mono-agent and/or combination treatment strategies with either ONC201/ONC212 for pancreatic cancer patients.