tbuckley/cabot-search huggingface dataset:
Association Between Number of Insurers and Premium Rates in the Affordable Care Act Marketplace
Authors: Jane M. Zhu, Yuehan Zhang, Bingxiao Wu, Daniel Polsky
Journal: JAMA Internal Medicine (2017)

This study uses publicly available Marketplace health plan data from 2016 and 2017 to examine whether premium growth in monopoly markets with a declining number of insurers differs from that in markets having a stable number of insurers.
Retinopathy and Nephropathy in Patients with Type 1 Diabetes Four Years after a Trial of Intensive Therapy
Authors: John M Lachin, Saul Genuth, Patricia Cleary, Matthew D Davis, David M Nathan
Journal: New England Journal of Medicine (2000)

Among patients with type 1 diabetes mellitus, intensive therapy (with the aim of achieving near-normal blood glucose and glycosylated hemoglobin concentrations [hemoglobin A1c]) markedly reduces the risk of microvascular complications as compared with conventional therapy. To assess whether these benefits persist, we compared the effects of former and intensive conventional therapy on the recurrence and severity of retinopathy and nephropathy for four years after the end of the Diabetes Control and Complications Trial (DCCT).At the end of the DCCT, the patients in the conventional-therapy group were offered intensive therapy, and the care of all patients was transferred to their own physicians. Retinopathy was evaluated on the basis of centrally graded fundus photographs in 1208 patients during the fourth year after the DCCT ended, and nephropathy was evaluated on the basis of urine specimens obtained from 1302 patients during the third or fourth year, approximately half of whom were from each treatment group.The difference in the median glycosylated hemoglobin values between the conventional-therapy and intensive-therapy groups during the 6.5 years of the DCCT (average, 9.1 percent and 7.2 percent, respectively) narrowed during follow-up (median during 4 years, 8.2 percent and 7.9 percent, respectively, P<0.001). Nevertheless, the proportion of patients who had worsening retinopathy, including proliferative retinopathy, macular edema, and the need for laser therapy, was lower in the intensive-therapy group than in the conventional-therapy group (odds reduction, 72 percent to 87 percent, P<0.001). The proportion of patients with an increase in urinary albumin excretion was significantly lower in the intensive-therapy group.The reduction in the risk of progressive retinopathy and nephropathy resulting from intensive therapy in patients with type 1 diabetes persists for at least four years, despite increasing hyperglycemia.
Whole-tissue biopsy phenotyping of three-dimensional tumours reveals patterns of cancer heterogeneity
Authors: Nobuyuki Tanaka, Shigeaki Kanatani, Raju Tomer, Cecilia Sahlgren, Pauliina Kronqvist, Dagmara Kaczynska, Lauri Louhivuori, Lorand Kis, Claes Lindh, Przemysław Mitura, Andrzej Stepulak, Sara Corvigno, Johan Hartman, Patrick Micke, Artur Mezheyeuski, Carina Strell, Joseph W. Carlson, Carlos Fernández Moro, Hanna Dahlstrand, Arne Östman, Kazuhiro Matsumoto, Peter Wiklund, Mototsugu Oya, Ayako Miyakawa, Karl Deisseroth, Per Uhlén
Journal: Nature Biomedical Engineering (2017)
Transmembrane and Coiled-Coil Domain 1 Impairs the AKT Signaling Pathway in Urinary Bladder Urothelial Carcinoma: A Characterization of a Tumor Suppressor
Authors: Chien-Feng Li, Wen-Ren Wu, Ti-Chun Chan, Yu-Hui Wang, Lih-Ren Chen, Wen-Jeng Wu, Bi-Wen Yeh, Shih-Shin Liang, Yow-Ling Shiue
Journal: Clinical Cancer Research (2017)

Purpose: Urinary bladder urothelial carcinoma (UBUC) is a common malignant disease in developed countries. Cell-cycle dysregulation resulting in uncontrolled cell proliferation has been associated with UBUC development. This study aimed to explore the roles of TMCO1 in UBUCs.Experimental Design: Data mining, branched DNA assay, immunohistochemistry, xenograft, cell culture, quantitative RT-PCR, immunoblotting, stable and transient transfection, lentivirus production and stable knockdown, cell-cycle, cell viability and proliferation, soft-agar, wound-healing, transwell migration and invasion, coimmunoprecipitation, immunocytochemistry, and AKT serine/threonine kinase (AKT) activity assays and site-directed mutagenesis were used to study TMCO1 involvement in vivo and in vitroResults: Data mining identified that the TMCO1 transcript was downregulated during the progression of UBUCs. In distinct UBUC-derived cell lines, changes in TMCO1 levels altered the cell-cycle distribution, cell viability, cell proliferation, and colony formation and modulated the AKT pathway. TMCO1 recruited the PH domain and leucine-rich repeat protein phosphatase 2 (PHLPP2) to dephosphorylate pAKT1(serine 473) (S473). Mutagenesis at S60 of the TMCO1 protein released TMCO1-induced cell-cycle arrest and restored the AKT pathway in BFTC905 cells. Stable TMCO1 (wild-type) overexpression suppressed, whereas T33A and S60A mutants recovered, tumor size in xenograft mice.Conclusions: Clinical associations, xenograft mice, and in vitro indications provide solid evidence that the TMCO1 gene is a novel tumor suppressor in UBUCs. TMCO1 dysregulates cell-cycle progression via suppression of the AKT pathway, and S60 of the TMCO1 protein is crucial for its tumor-suppressor roles. Clin Cancer Res; 23(24); 7650-63. ©2017 AACR.
Doxorubicin drug eluting beads transcatheter chemoembolization (DEB TACE) in patients with large hepatocellular carcinoma (HCC): Overall survival and a multivariate analysis (MVA) of prognostic factors.
Authors: Hasmukh J. Prajapati, James R. Spivey, Bassel F. El-Rayes, John S. Kauh, Hyun Sik Kim
Journal: Journal of Clinical Oncology (2013)

e15033 Background: To investigate the prognostic factors (PFs) associated with survival after DEB TACE in patients (pts) with at least &gt; 5cm sized index HCC (iHCC). Methods: Consecutive pts with at least &gt; 5cm sized iHCC, who received DEB TACE over last 82 months, were studied. Median overall survivals (mOSs) were analyzed according to different parameters from 1st DEB TACE. Kaplan Meier estimator by log rank test and Cox proportional Hazard model (for MVA) were used survival analyses using v20 SPSS. Results: 332 DEB TACEs (mean 3, medium 2) were performed in 112 pts (mean 62.1 years, SD 12), who had at least &gt;5cm sized iHCC (mean 9.5 cm, SD 3.7). MOS from diagnosis and DEB TACE were 14.3 months (m) and 9.4 m respectively. MOS were 31.9 m, 11.1 m and 2.8 m in pts who received &gt; 4, 2-4 and a 1 DEB TACEs respectively (p&lt;0.001). Etiological factors for HCC were hepatitis C virus (54.4%), hepatitis B virus (12.5%), chronic alcoholism (7.1%), other causes of chronic liver disease (17%) and unknown with no chronic liver disease (9%); mOS were 8.8 m, 4.4 m, 5.8 m, 27 m, and 9.4 m respectively (p=0.01). MOS in pts with Child-Pugh Class A (58.9%), B (34.8%) and C (6.3%) were 17.2 m, 5.8 m and 1.6 m respectively (p&lt;0.001). MOS in pts with BCLC stage B (17%), C (69.6%) and D (13.4%) were 20.9 m, 9.4 m, and 3.4 m respectively (p=0.003). 46.4% of pts had portal vein thrombosis (PVT) with mOS of 5.4 m vs. 17.1m in pts without PVT (p=0.006). Pts with serum alfa feto protein (sAFP) level&gt;400 ng/dl (43.7%) had mOS of 5.4 m vs. 16.6 m in pts with sAFP&lt;400ng/dl (p=0.008). 32.1% of pts received sorafenib systemic chemotherapy; mOS were 13.3m vs. 7.6m who did not receive the sorafenib (p=0.2). Pts with &gt;5 HCCs (20.5%) had mOS of 5.4m vs. 13m in pts who had &lt;5 HCCs (p=0.009). The following variables were independent significant PFs of survival on MVA: Child-Pugh class, etiology, number (no) of DEB TACEs, presence of vascular invasion and ECOG PS. Conclusions: Higher number of DEB TACE treatments correlates independently to improved OS in patients with at least &gt;5cm sized index HCC. Other independent PFs of survival were etiology, Child-Pugh class, no of HCC tumors, ECOG PS and PVT.
Image Gallery: Traumatic pseudoaneurysm of the superficial temporal artery
Authors: B. Tekin, E.S. Denli Yalvac, T. Zenginkinet
Journal: British Journal of Dermatology (2017)

Funding sources: none. Conflicts of interest: none declared. Dear Editor, A 16‐year‐old boy presented with a 2‐month history of a slowly growing lump on his left temple. Six weeks before, he had been involved in a fist fight. Examination revealed a compressible, skin‐coloured mass with a palpable thrill and audible bruit on the left frontotemporal region (a). The presumptive diagnosis of pseudoaneurysm of the superficial temporal artery (STA) was reinforced by duplex ultrasonography. The dilated segment was resected, and the afferent and efferent ends were ligated (b). Given its superficial course and vicinity to the underlying bony structures, the STA is especially vulnerable to trauma.1 If left untreated, pseudoaneurysm of the STA may rupture spontaneously or with subsequent trauma.1,2
Episodic memory must be grounded in reality in order to be useful in communication
Authors: Hartmut Blank
Journal: Behavioral and Brain Sciences (2018)

Abstract The primary function of episodic memory is to provide reliable information about reality that is essential for surviving and navigating in an environment. The communicative function of episodic memory “sits on top of” this basic function but does not, in itself, explain it in its totality (but may explain particular aspects such as its sensitivity to source credibility).
Development of Antifouling and Bactericidal Coatings for Platelet Storage Bags Using Dopamine Chemistry
Authors: Narges Hadjesfandiari, Marie Weinhart, Jayachandran N. Kizhakkedathu, Rainer Haag, Donald E. Brooks
Journal: Advanced Healthcare Materials (2017)

Abstract Platelets have a limited shelf life, due to the risk of bacterial contamination and platelet quality loss. Most platelet storage bags are made of a mixture of polyvinyl chloride with a plasticizer, denoted as pPVC. To improve biocompatibility of pPVC with platelets and to inhibit bacterial biofilm formation, an antifouling polymer coating is developed using mussel‐inspired chemistry. A copolymer of N , N ‐dimethylacrylamide and N ‐(3‐aminopropyl)methacrylamide hydrochloride is synthesized and coupled with catechol groups, named DA51‐cat. Under mild aqueous conditions, pPVC is first equilibrated with an anchoring polydopamine layer, followed by a DA51‐cat layer. Measurements show this coating decreases fibrinogen adsorption to 5% of the control surfaces. One‐step coating with DA51‐cat does not coat pPVC efficiently although it is sufficient for coating silicon wafers and gold substrates. The dual layer coating on platelet bags resists bacterial biofilm formation and considerably decreases platelet adhesion. A cationic antimicrobial peptide, E6, is conjugated to DA51‐cat then coated on silicon wafers and introduces bactericidal activity to these surfaces. Time‐of‐flight second ion‐mass spectroscopy is successfully applied to characterize these surfaces. pPVC is widely used in medical devices; this method provides an approach to controlling biofouling and bacterial growth on it without elaborate surface modification procedures.
Nivolumab (Nivo) vs investigator’s choice (IC) for platinum-refractory (PR) recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN; Checkmate 141): Outcomes in first-line (1L) R/m patients and updated safety and efficacy.
Authors: Maura L. Gillison, George R. Blumenschein, Jérôme Fayette, Joel Guigay, A. Dimitrios Colevas, Lisa Licitra, Kevin Harrington, Stefan Kasper, Everett E. Vokes, Caroline Even, Francis P. Worden, Nabil F. Saba, Lara Carmen Iglesias Docampo, Robert I. Haddad, Tamara Rordorf, Naomi Kiyota, Makoto Tahara, Mark John Lynch, Justin Kopit, Robert L. Ferris
Journal: Journal of Clinical Oncology (2017)

6019 Background: In CheckMate 141, a randomized, phase 3 trial, nivo demonstrated superior overall survival (OS) and better tolerability in patients (pts) with PR R/M SCCHN compared with IC. Pts with SCCHN progressing within 6 mos of platinum in the primary treatment setting have dismal prognosis. We report outcomes in pts who were PR in the primary or adjuvant setting, and updated results in the overall population. Methods: Pts (N = 361) with PR R/M SCCHN were randomized 2:1 to nivo 3 mg/kg every 2 weeks or weekly IC (methotrexate, docetaxel, or cetuximab). Primary endpoint was OS estimated by Kaplan-Meier method. Cox proportional hazards models were used to estimate hazard ratios (HRs) and confidence intervals (CIs). Additional endpoints include objective response rate (ORR) and safety. Outcomes were analyzed overall and post hoc in pts who were PR in the primary/adjuvant setting and received nivo/IC as 1L R/M therapy. Results: Characteristics of the 78 (21.6%) pts who received nivo (n = 52) or IC (n = 26) in the 1L R/M setting were similar to the overall population.Nivo significantly improved OS vs IC among 1L R/M pts (median [95% CI]: 7.7 mo [3.1, 13.8] vs 3.3 mo [2.1, 6.4]; HR [95% CI] = 0.56 [0.33, 0.95]); 12-mo OS rate: 39.2% vs 15.4%. ORR was 19.2% for nivo vs 11.5% for IC in this subgroup. At 11.4-mo minimum follow-up, updated efficacy and safety in the overall population were similar to the primary analysis. Median OS (95% CI) was 7.7 mo (5.7, 8.8) for nivo vs 5.1 mo (4.0, 6.2) for IC; HR (95% CI) = 0.71 (0.55, 0.90); P = 0.0048. For nivo vs IC, the 18-mo OS rate was 21.5% vs 8.3% and ORR was 13.3% vs 5.8%. Nivo doubled the median duration of response vs IC (9.7 vs 4.0 mo). Grade 3–4 treatment-related adverse event rates for nivo vs IC were 15.3% vs 36.0% overall and 27.5% vs 32.0% for 1L R/M pts; there were no new deaths due to study drug toxicity. Conclusions: Nivo significantly improved OS and increased ORR vs IC in a 1L R/M subgroup, supporting its use as 1L therapy for pts with PR R/M SCCHN. Nivo continued to show a significant survival benefit and better tolerability vs IC in pts with PR R/M SCCHN. Clinical trial information: NCT02105636.
Challenges to Biosimilar Substitution
Authors: Brian Chen, Y. Tony Yang, Charles L. Bennett
Journal: JAMA (2017)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
The antiviral effect of poly-gamma-glutamic acid (γ-PGA) in HPV-positive patients.
Authors: Jae Kwan Lee, Hyun Woong Cho, Seunghoon Kim, Min Young Park, Moon Hee Sung
Journal: Journal of Clinical Oncology (2017)

e14623 Background: Poly-gamma-glutamic acid (γ-PGA), as a signaling regulator of Toll-like receptor 4 (TLR4), has been shown to induce innate immune responses. In previous non-clinical study, we showed that γ-PGA induces signaling pathway of Type 1 interferon, which consequently eliminates various viruses such as SARS, hepatitis C virus, influenza virus, etc. To evaluate the clinical efficacy of γ-PGA, we’ve investigated the antiviral effect of γ-PGA on human. In retrospective study to evaluate, the clinical significance of g-PGA treatment for vaginal intraepithelial neoplasia (VAIN), γ-PGA may be helpful for the cytological regression and reduction of viral load in patients with high-risk HPV-positive VAIN. Since previous human studies showed the possibility of a drug, we have completed a phase I dose escalation study to determine the safety, tolerance and pharmacokinetics of γ-PGA in healthy adult male subjects. Methods: In the current study, we designed a human study of γ-PGA orally treated daily (75 mL) for 24 weeks to demonstrate the antiviral effect of γ-PGA in female HPV-positive patients. HPV viral load and cell-mediated immune responses were measured during 24 weeks to compare HPV clearance rates between the γ-PGA-treated group and the placebo-controlled group and to evaluate immunological parameters, respectively. Results: . In phase IIb clinical trial to evaluate the efficacy and safety of γ-PGA for the fertile women with cervical intraepithelial neoplasia grade 1 (CIN1) patients, regression rate by the treatment of γ-PGA was 45.65%, whereas the placebo controls were 30.23% in ITT group with statistically significance ( p= 0.0247). Conclusions: γ-PGA may be helpful for the cytological regression and reduction of viral load in patients with high-risk HPV-positive CIN I.
Next-Generation Sequencing in the Clinical Setting Clarifies Patient Characteristics and Potential Actionability
Authors: Cheyennedra C. Bieg-Bourne, Sherri Z. Millis, David E. Piccioni, Paul T. Fanta, Michael E. Goldberg, Juliann Chmielecki, Barbara A. Parker, Razelle Kurzrock
Journal: Cancer Research (2017)

Abstract Enhancements in clinical-grade next-generation sequencing (NGS) have fueled the advancement of precision medicine in the clinical oncology field. Here, we survey the molecular profiles of 1,113 patients with diverse malignancies who successfully underwent clinical-grade NGS (236–404 genes) in an academic tertiary cancer center. Among the individual tumors examined, the majority showed at least one detectable alteration (97.2%). Among 2,045 molecular aberrations was the involvement of 302 distinct genes. The most commonly altered genes were TP53 (47.0%), CDKN2A (18.0%), TERT (17.0%), and KRAS (16.0%), and the majority of patients had tumors that harbored multiple alterations. Tumors displayed a median of four alterations (range, 0–29). Most individuals had at least one potentially actionable alteration (94.7%), with the median number of potentially actionable alterations per patient being 2 (range, 0–13). A total of 1,048 (94.2%) patients exhibited a unique molecular profile, with either genes altered or loci within the gene(s) altered being distinct. Approximately 13% of patients displayed a genomic profile identical to at least one other patient; although genes altered were the same, the affected loci may have differed. Overall, our results underscore the complex heterogeneity of malignancies and argue that customized combination therapies will be essential to optimize cancer treatment regimens. Cancer Res; 77(22); 6313–20. ©2017 AACR.
Tumor's flare-up and patterns of recurrence in patients (pts) with recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with anti-PD1/PD-L1 inhibitors.
Authors: Esma Saada-Bouzid, Cecile Defaucheux, Andy Karabajakian, Virginia Palomar Coloma, Vincent Servois, Xavier Paoletti, Caroline Even, Jerome Fayette, Joel Guigay, Delphine Loirat, Emanuela Romano, Christophe Le Tourneau
Journal: Journal of Clinical Oncology (2016)

6072 Background: About 20% of R/M HNSCC pts have an objective response with anti-PD1/PD-L1 inhibitors after platinum failure. Some pts, however, experience a rapid flare-up during treatment. We evaluated the relationship between a flare-up occurence and the patterns of recurrence in R/M HNSCC pts treated with anti-PD1/PD-L1. Methods: Data from R/M HNSCC pts treated with anti-PD1/PD-L1 in 4 French Cancer Centers between 09/2012 and 09/2015 were retrospectively collected. Pts had an imaging performed at least 2 weeks prior to baseline imaging to estimate tumor growth kinetics (TGK) before and on immunotherapy. TGK before starting immunotherapy (TGKPRE ) was defined as the difference of the sum of the largest diameters of the target lesions (according to RECIST) per unit of time between pre-baseline and baseline imaging, while TGK on immunotherapy (TGKPOST ) was defined as the same difference between baseline and last imaging performed on treatment. The TGK ratio (TGKR ) was defined as TGKPOST / TGKPRE . A flare-up was defined as a TGKR > 1, while 0 < TGKR ≤ 1 and TGKR < 1 indicated tumor deceleration and tumor shrinkage, respectively. An exact Fisher test was used for statistical comparison. Results: Thirty-five pts with available pre-baseline imaging and evaluable disease were identified. Median age was 63 years [35-84], 28 pts were male (80%). Primary tumor location was oral cavity, oropharynx, larynx, and hypopharynx in 12 (34%), 12 (34%), 5 (14%), and 6 (17%) pts, respectively. Patterns of recurrence included exclusive distant metastases in 11 pts (31%), exclusive loco-regional recurrence in 14 pts (40%), and both in 10 pts (29%). Ten pts (29%) experienced a flare-up, while 8 pts (23%) had tumor shrinkage and 17 pts (49%) a deceleration of tumor growth. Interestingly, a flare-up was observed in none of the 11 pts (0%) with exclusive distant metastases, in 5/14 pts (36%) with exclusive loco-regional recurrence, and in 5/10 pts (50%) with loco-regional recurrence and distant metastases (p = 0.06). Conclusions: Our preliminary results suggest that anti-PD1/PDL1 should be used cautiously in R/M HNSCC pts with loco-regional recurrence.
Rapid blood test could speed up myocardial infarction diagnosis
Authors: Jacqui Wise
Journal: BMJ (2017)

A new blood test could potentially help to rule out myocardial infarction more quickly than the current troponin tests, finds a study in Circulation .1

The new test analyses concentrations of a biomarker called cardiac myosin binding protein C (cMyC). Concentrations of this protein increase more rapidly after a myocardial infarction and to a higher extent than troponin, which means the test could potentially rule out myocardial infarction in a higher proportion of patients straight away.

Over two thirds of people who attend hospital emergency departments with chest pain have not had a myocardial infarction. The UK researchers said that this new biomarker could mean such patients could …
It’s All in the Game—The Uses of Gamification to Motivate Behavior Change
Authors: Ichiro Kawachi
Journal: JAMA Internal Medicine (2017)

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 Internal Medicine 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 Internal Medicine journal