tbuckley/cabot-search huggingface dataset:
Acceptability judgments still matter: Deafness and documentation
Authors: Matthew L Hall, Rachel I Mayberry, Victor S Ferreira
Journal: Behavioral and Brain Sciences (2017)

Abstract The target article's call to end reliance on acceptability judgments is premature. First, it restricts syntactic inquiry to cases were a semantically equivalent alternative is available. Second, priming studies require groups of participants who are linguistically homogenous and whose grammar is known to the researcher. These requirements would eliminate two major research areas: syntactic competence in d/Deaf individuals, and language documentation. (We follow the convention of using deaf to describe hearing levels, Deaf to describe cultural identity, and d/Deaf to include both. Our own work has focused on Deaf signers, but the same concerns could apply to other deaf populations.)
A communication strategy using a video support tool and structured family meetings for relatives of patients dying in the ICU.
Authors: Ramy Sedhom, Jasmet Bajaj, Vadim Finklestein, Mindy Tanpiengco, David Barile
Journal: Journal of Clinical Oncology (2017)

81 Background: Death in the ICU is an extraordinarily stressful event. Qualitative and quantitative studies have identified effective communication between caregivers and families to be important throughout the decision making process. In many ICUs, the end-of-life family conference is an opportunity to ask questions, express concerns, and confront painful emotions with the help of compassionate professionals. Methods: A prospective study in a single ICU center. The ICU physician, palliative care team, and research nurse interviewed surrogate decision makers. The only criterion for inclusion in the study was anticipated death in one year. Patients younger than 18 were excluded from the study, as were those unable to speak English. Prior to the family meeting, families were offered an opportunity to watch a video on EOL decision-making made by the research team. The meeting itself followed a script, guided by four steps:establish diagnosis, share prognosis, elicit goals of care, recommend treatment. The investigators recorded ICU and patient characteristics on standardized forms. Results: 22 families were included. A decision to forego life-sustaining treatment and transition to comfort care or hospice was pursued by 77% of families. There were few non-beneficial interventions, such as CRRT or use of artificial nutrition; withdrawal of mechanical ventilation and vasopressors was common. Qualitative commentary suggested that time spent by providers were sufficient and the video support tool was clear and easy to understand. Conclusions: EOL family conferences improve communication between ICU staff and family members and assist families in decision making, especially for cancer syndromes. The structured family meetings offered opportunities to discuss patient’s wishes, alleviate feelings of guilt, and understand the goals of care. Patients received few non-beneficial treatments and families were likely to accept realistic goals of care. This highlights the potential role for video-support tools in advance care planning. Future studies reporting overall LOS and bereavement data are important quality markers and pending in a future report.
Managing conflict during home hospice nursing visits: Communication between nurses, cancer patients, and spouse caregivers.
Authors: Maija Reblin, Janella Hudson, Margaret F. Clayton, Lee Ellington
Journal: Journal of Clinical Oncology (2017)

39 Background: Many hospice cancer patients and their spouse caregivers experience conflict as roles change and patients decline. Nurses can be asked to mediate conflicts during home visits. Our objective is to describe patient-caregiver conflict and nurse responses in home hospice communication. Methods: A secondary, qualitative analysis was conducted on transcripts of nurse visits to home hospice cancer patients and their spouse caregivers. Transcripts were selected based on high caregiver and patient emotion, identified by interaction analysis coding in primary analysis. Using an iterative process of constant comparison, coders inductively categorized nurse and dyad communication behavior during conflict into overarching themes. Results: 19 visits were identified for analysis. Nurses (from 7 hospice agencies) were all female and averaged 13 years nursing experience (SD = 11). Patient-caregiver dyads were all white, heterosexual, married an average 36 years (SD = 20). 84% of patients were male and average age was 72 years (SD = 9). Caregiver average age was 68 years (SD = 11). Patient-caregiver conflict fell under two major content themes 1) negotiating transitions in patient level of independence and 2) navigating patient/caregiver emotions (e.g. frustration, sadness). When not explicitly asked for input during conflict, nurses occasionally did not engage. Nurse response to transition conflict included problem-solving, mediating, or facilitating dyadic discussion about conflicts/concerns raised with her independently. Nurse response to emotional conflict included validation and reassurance. Conclusions: Little research has been conducted on couples’ conflict resolution in cancer home hospice. However, unresolved conflict can impact the quality of care and has been linked to poor bereavement adjustment. Nurses are sometimes asked to take on the role of mediator, often with little training. Our findings provide insight into home hospice patient and caregiver conflict communication with hospice nurses and could be used during nursing education. Further research could address specific patient and caregiver outcomes associated with nurse communication strategies.
Outcomes of paclitaxel and ifosfamide following surgery for early and advanced stage uterine carcinosarcoma: A single institution experience
Authors: K. Sudo, Y. Ohtake, T. Nishikawa, T. Uehara, H. Shimizu, M. Ishikawa, T. Kato, A. Shimomura, E. Noguchi, K. Yonemori, C. Shimizu, K. Tamura
Journal: Annals of Oncology (2017)
Leukemia-specific delivery of mutant NOTCH1 targeted therapy
Authors: Giovanni Roti, Jun Qi, Samuel Kitara, Marta Sanchez-Martin, Amy Saur Conway, Anthony C. Varca, Angela Su, Lei Wu, Andrew L. Kung, Adolfo A. Ferrando, James E. Bradner, Kimberly Stegmaier
Journal: The Journal of Experimental Medicine (2017)

On-target drug delivery remains a challenge in cancer precision medicine; it is difficult to deliver a targeted therapy to cancer cells without incurring toxicity to normal tissues. The SERCA (sarco-endoplasmic reticulum Ca2+ ATPase) inhibitor thapsigargin inhibits mutant NOTCH1 receptors compared with wild type in T cell acute lymphoblastic leukemia (T-ALL), but its administration is predicted to be toxic in humans. Leveraging the addiction of ALL to folic acid, we conjugated folate to an alcohol derivative of thapsigargin via a cleavable ester linkage. JQ-FT is recognized by folate receptors on the plasma membrane and delivered into leukemia cells as a potent antileukemic agent. In mechanistic and translational models of T-ALL, we demonstrate NOTCH1 inhibition in vitro and in vivo. These proof-of-concept studies support the further optimization of this first-in-class NOTCH1 inhibitor with dual selectivity: leukemia over normal cells and NOTCH1 mutants over wild-type receptors. Furthermore, tumor-specific disruption of Notch signaling may overcome legitimate concerns associated with the tumor suppressor function of nontargeted Notch pathway inhibitors.
How to: identify non-tuberculous Mycobacterium species using MALDI-TOF mass spectrometry
Authors: F. Alcaide, J. Amlerová, G. Bou, P.J. Ceyssens, P. Coll, D. Corcoran, M.-S. Fangous, I. González-Álvarez, R. Gorton, G. Greub, G. Hery-Arnaud, J. Hrábak, A. Ingebretsen, B. Lucey, I. Marekoviċ, C. Mediavilla-Gradolph, M.R. Monté, J. O'Connor, J. O'Mahony, O. Opota, B. O'Reilly, D. Orth-Höller, M. Oviaño, J.J. Palacios, B. Palop, A.B. Pranada, L. Quiroga, D. Rodríguez-Temporal, M.J. Ruiz-Serrano, G. Tudó, A. Van den Bossche, J. van Ingen, B. Rodriguez-Sanchez
Journal: Clinical Microbiology and Infection (2017)
Abstract 21321: Heart Rate During Pulseless Electrical Activity as a Marker for Successful Resuscitation and Neurological Outcome in a Rodent Model of Cardiac Arrest
Authors: Hamidreza Abbasi, Matine Azadian, Afsheen Bazrafkan, Kajal K Bains, Zijia Huang, Tin J Dinh, Stephanie H Kim, Tyler Nixon, Guilian Tian, Yama Akbari
Journal: Circulation (2017)

Introduction: During cardiac arrest (CA), a major goal of responders is to ascertain the likelihood of successful cardiopulmonary resuscitation (CPR) and optimize efforts accordingly to achieve return of spontaneous circulation (ROSC). Pulseless electrical activity (PEA), a common form of CA in inpatient settings, often allows monitoring of heart rate (HR) immediately preceding cardiopulmonary resuscitation (CPR). We were interested in assessing the role of HR during PEA in outcome of CPR. To evaluate this in a controlled setting, we used a rodent model of asphyxial CA with electrocardiogram (ECG) recordings and neurological testing. We hypothesized that more severe bradycardia may be associated with failure to achieve ROSC and worse neurological outcome if ROSC is achieved. Methods: Adult male Wistar rats (n=25) were anesthetized, intubated, and placed under mechanical ventilation. Needle electrodes were inserted into the rats to obtain continuous ECG data. Rats then underwent 8 minutes of asphyxial CA followed by CPR accompanied with intravenous epinephrine and bicarbonate injections. Neurological deficit scale (NDS) testing was conducted at 24hrs post-ROSC. Results: Of 25 rats that underwent CA, 4 failed to achieve ROSC. HR was measured after 7.5 minutes of asphyxia (i.e. 30 sec. prior to CPR), when the systolic blood pressure was &lt;10-20mmHg, which is presumed to be a “pulseless” equivalent in humans. Rats failing to achieve ROSC had a significantly lower HR in comparison to rats achieving ROSC (26.6±8.4 vs. 46.2±16.9; p&lt; 0.05). Interestingly, among survivors, HR immediately pre-CPR was inversely correlated with NDS scores (r=-0.655, p&lt; 0.05). No association was found between groups in pre-CA arterial blood gas measurements (e.g. pH, CO2, electrolytes). Conclusions: In a rodent asphyxial model of CA mimicking a PEA state, rats failing to achieve ROSC had lower HR immediately prior to CPR. However, in rats achieving ROSC, slower pre-CPR HR is associated with better neurological outcome. These findings appear to be independent of respiratory acidosis. We propose a model and future experimentation that may help define underlying mechanisms. Validation is needed in human studies to assess potential translational implications in a clinical setting.
Patient engagement with a smartphone mobile app for adherence to oral chemotherapy.
Authors: Molly Ream, Jamie M. Jacobs, Joel N Fishbein, Nicole Pensak, Lauren Ellen Nisotel, James J MacDonald, Joanne S. Buzaglo, Inga Tolin Lennes, Steven A. Safren, William F. Pirl, Jennifer S. Temel, Joseph Greer
Journal: Journal of Clinical Oncology (2017)

243 Background: Patients prescribed oral chemotherapy receive minimal supervision and support for adherence. We developed a smartphone mobile app consisting of medication reminders, symptom reporting, clinician communication, and educational resources for improving adherence and symptom management. In this study, we sought to identify potential correlates of app usage. Methods: From 12/2014 to 08/2016, 181 patients with diverse malignancies prescribed oral chemotherapy enrolled in a randomized trial to test the efficacy of a smartphone mobile app to improve adherence and symptoms. Medication adherence was monitored using electronic pill caps (MEMScaps). At baseline and 12 weeks, participants completed a measure of treatment satisfaction (FACIT-TS). We gathered clinical and treatment data from the electronic health record. Through the app we collected data on engagement: total number of minutes, days of usage, and number of completed symptom reports. We calculated Pearson correlations to identify associations between app engagement, using a latent variable for overall engagement, with adherence, treatment satisfaction and healthcare utilization. Results: 91 patients were randomly assigned to receive the mobile app. Over the 12-week study period, participants used the mobile app for a mean of 59 minutes (SD = 68) and 21.75 discrete days (SD = 21.24 days), completing 15.92 symptom reports (SD = 14.15) on average. Higher app engagement was associated with having a lower proportion of missed doses (r = -.248, p = .035) over the study period. Patients who became less satisfied with their communication with physicians (r = -.278, p = .019) and nurses (r = -.238, p = .047) used the app more. Higher app engagement was associated with fewer emergency department visits resulting in hospitalizations (r = -.252, p = .029). Conclusions: Among patients prescribed oral chemotherapy, higher usage of a mobile app targeting adherence was related to fewer missed doses and ED visits leading to hospitalization. Fostering patient engagement with the app may also serve to buffer difficulties in patient-clinician communication about care. Clinical trial information: NCT02157519.
Characteristics of patients referred for psychology services by a palliative care inpatient consult team.
Authors: Sujin Ann-Yi, Angelique Wong, Karen Baumgartner, Cindy L. Carmack, Debra Castro, Diana Guzman, Manju P Joy, Leela Kuriakose, Kyu-Hyoung Lim, Kevin Madden, John M Najera, Imelda Pangemanan, Sabeena Qasim Rajani, Monica Raznahan, Holly A Stewart, Kimberson Cochien Tanco, Kimmie Tallie, Qi Wei, Eduardo Bruera, Donna S. Zhukovsky
Journal: Journal of Clinical Oncology (2017)

183 Background: From Jan 2013 to Dec 2015, only 23% of inpatient palliative care consults were referred for psychology (PSY) services. In an effort to better understand referral practices, we compared those who were referred for PSY services to those who were not. Methods: A retrospective chart review of 930 consecutive patients from Jan 2013 to Dec 2015 was conducted to collect demographic and clinical variables. 455 patients who had at least one PSY contact and 475 patients who had no PSY contact were randomly selected. In an effort to control for age, we selected 330 patients 18-39 years, 300 patients 40-64 years, and 300 patients 65 and older. Descriptive, univariate and logistic regression analyses were conducted. Results: Patients referred to PSY services (N = 455) included 267(59%) females. Majority were White(60%) and English speaking(93%). Majority were married(62%) and parents(79%). The largest cancer type was GI(20%) followed by hematological(15%). Majority had ECOG status of 3(39%) and CAGE-AID negative (82%). Patients with no psychology consult(N = 475) included 50% females. Majority were White(60%) and English speaking(79%). Majority were married(56%) and parents(70%). This sample also had majority GI cancers(18%) followed by hematological(15%). Majority had ECOG status of 3(34%) and was CAGE-AID negative(75%). Univariate variables significant for those referred for PSY services included: Female(p = .01), English language(p = .018), ECOG score of 3(p = .006), psychiatric history(p = .008), higher MEDD(p = .001) and several ESAS subscales including depression(p = .000), anxiety(p = .000), shortness of breath(p = .017), sleep (p. = .029) and spiritual pain(p = .001). Logistic regression identified psychiatric history and ESAS depression scores as significant predictors of PSY referral. Conclusions: Several univariate factors were significantly associated with referral to PSY services. Psychiatric history and ESAS depression score showed to be strong independent predictors. These results help us to understand how palliative care providers determine those they consult for PSY services. More research is needed to investigate who may benefit most from PSY referrals.
Simethicone improves bowel cleansing with low-volume polyethylene glycol: a multicenter randomized trial
Authors: Shenghong Zhang, Danping Zheng, Jinping Wang, Jianwei Wu, Pingguang Lei, Qi Luo, Liping Wang, Beiping Zhang, Hong Wang, Yi Cui, Minhu Chen
Journal: Endoscopy (2017)

Abstract Background and study aims For bowel preparation, using a reduced volume of polyethylene glycol (PEG) solution without influencing its effectiveness would be preferable. While simethicone shows great potential as an adjunctive agent, data on its use are limited. We aimed to clarify whether simethicone added to low-volume PEG solution improved bowel cleansing. Patients and methods Consecutive adult patients registered for colonoscopy were recruited from seven medical centers in South China between 15 April and 15 July 2015 and prospectively randomized into two groups: 2 L PEG (conventional group) and 2 L PEG plus simethicone (simethicone group). The primary endpoint was the effectiveness of bowel cleansing according to the Boston Bowel Preparation Scale (BBPS). Secondary endpoints included cecal intubation time, adenoma detection rate (ADR), patient safety and compliance, and adverse events. Results We included 290 and 289 patients in the conventional and simethicone groups, respectively, for analysis. The proportion with acceptable bowel cleansing (BBPS ≥ 6) was significantly higher in the simethicone group than in the conventional group (88.2 % vs. 76.6 %; P &lt; 0.001). The mean (SD) BBPS score was significantly lower in the conventional group (6.5 [1.8] vs. 7.3 [1.7]; P &lt; 0.001), as was the bubble score (2.5 [0.7] vs. 2.8 [0.5]; P &lt; 0.001). The average cecal intubation time was significantly shorter in the simethicone group (6.3 [3.1] vs. 7.5 [5.1] minutes; P &lt; 0.001). The ADR in the right colon was higher in the simethicone group than in the conventional group (16.6 % vs. 10.3 %; P = 0.03). Safety and compliance, including the taste, smell, and dosage of PEG, were similar for both groups. Conclusions Simethicone added to low-volume PEG solution improves bowel-cleansing efficacy, with similar safety and compliance, shorter cecal intubation time, and higher ADR.
Priority of lymphadenectomy for each station in elderly patients with middle to distal advanced gastric cancer
Authors: M. Nakazono, T. Hayashi, T. Yamada, H. Osakabe, K. Hara, S. Nagasawa, Y. Kumazu, Y. Rino, M. Masuda, T. Ogata, T. Yoshikawa
Journal: Annals of Oncology (2017)
Impact of immune checkpoint inhibitors on subsequent chemotherapy
Authors: H. Watanabe, T. Kubo, K. Kudo, D. Minami, T. Murakami, N. Ochi, T. Ninomiya, D. Harada, M. Yasugi, H. Takeda, E. Ichihara, K. Ohashi, K. Hotta, M. Tabata, Y. Maeda, K. Kiura
Journal: Annals of Oncology (2017)
Parental response to baby cry involves brain circuits for negative emotion Distancing-Embracing
Authors: James E. Swain, S. Shaun Ho
Journal: Behavioral and Brain Sciences (2017)

Abstract The “art form” of parent-infant bonding critically involves baby conveying negative emotions – literally compelling parents to respond and provide care. Current research on the brain basis of parenting is combining brain imaging with social, cognitive, and behavioral analyses to understand how parental brain circuits regulate thoughts and behavior in mental health, risk, and resilience. Understanding the parental brain may contribute to solving the long-standing paradox of self-sought hedonic exposure to negative emotions in art reception.
Practice patterns in radiation therapy for bone metastases in multiple histologies.
Authors: Trent N Taylor, Catherine Lee Kinchen, Candice Aitken Johnstone, Jared R. Robbins
Journal: Journal of Clinical Oncology (2017)

151 Background: Radiation therapy (RT) is a common palliative treatment for bone metastasis. Despite copious evidence of palliative equipoise between single and multiple fractions, practice patterns vary widely amongst physicians. We evaluate practice patterns and the impact of treatment regimens on percentage of remaining life spent receiving RT (PRLSRT) and overall survival. Methods: Patients with metastases from Prostate, Lung, Breast, and Kidney to the bone who received RT were identified from the National Cancer Database. The percentage of remaining life spent receiving RT (PRLSRT) was calculated by dividing the elapse days of RT by the number of days they survive from starting RT to death. Results: 43516 patients met the inclusion criteria. The majority were non-small cell lung (64.7%), while breast (13.5%), prostate (11.0%), and kidney (10.8%) had almost equal amounts. Median patient age was 67 years old (18-90). Treated metastatic sites included the spine (61.9%), hip/pelvis (11.2%), and extremity (8.13%). A higher percentage of patients had a PRLSRT over 50% depending on the primary site of their cancer: Lung was the highest (14.4%), followed by kidney (8.9%), breast (6.2%), and prostate (1.4%). Prostate cancer was most often treated with 11+ treatments (38.4%), followed by breast (34.1%), Kidney (33.1%), and finally lung (28.5%) PRLSRT was highest in those who received multiple treatments, with 11.4% of patients receiving 11+ fractions and 11.5% of those receiving 6-10 treatments with a PRLSRT above 50% compared to 1.2% of those receiving a single treatment. Conclusions: Despite the increased burden on patients with more fractions of therapy and the lack of clinical benefit, multiple fractionations remains a common practice , which can impact the way patients spend the end of their lives. More care should be taken to reduce fractionation whenever possible to allow for patient comfort and autonomy.
Mobile lung cancer testing in supermarket car parks is to be expanded
Authors: Jacqui Wise
Journal: BMJ (2017)

A successful pilot scheme to detect lung cancer at an early stage by offering smokers and former smokers computerised tomography scanning in shopping area car parks is to be rolled out more widely.

Simon Stevens, chief executive of NHS England, announced the expansion of the scheme at the Economist’s War on Cancer conference in London on 21 November.

“One of the main things the NHS needs to focus on is early diagnosis in order to improve outcomes,” he told the conference. “The Manchester pilot scheme offering mobile CT scans in community supermarkets found that one in 33 people who walked in off the street had early cancer.”

The pilot scheme sited mobile, low dose CT scanners in three deprived areas of …
RASGRP1 mutation in autoimmune lymphoproliferative syndrome-like disease
Authors: Huawei Mao, Wanling Yang, Sylvain Latour, Jing Yang, Sarah Winter, Jian Zheng, Ke Ni, Minmin Lv, Chenjing Liu, Hongmei Huang, Koon-Wing Chan, Pamela Pui-Wah Lee, Wenwei Tu, Alain Fischer, Yu-Lung Lau
Journal: Journal of Allergy and Clinical Immunology (2017)

Autoimmune lymphoproliferative syndrome (ALPS) is a genetic disorder of lymphocyte homeostasis due to impaired apoptosis. It was initially regarded as a very rare disease, but recent studies show that it may be more common than previously thought. Defects in a couple of genes have been identified in a proportion of patients with ALPS, but around one-third of such patients remain undefined genetically.We describe 2 siblings presenting with ALPS-like disease. This study aimed to identify the genetic cause responsible for this phenotype.Whole-exome sequencing and molecular and functional analyses were used to identify and characterize the genetic defect. Clinical and immunological analysis was also performed and reported.The 2 patients presented with chronic lymphadenopathy, hepatosplenomegaly, autoimmune hemolytic anemia, immune thrombocytopenia, and the presence of antinuclear autoantibody and other autoantibodies, but normal double-negative T cells. They also suffered from recurrent infections. Novel compound heterozygous mutations of RASGRP1 encoding Ras guanyl nucleotide releasing protein 1 were identified in the 2 siblings. The mutations impaired T-cell receptor signaling, leading to defective T-cell activation and proliferation, as well as impaired activation-induced cell death of T cells.This study shows for the first time that RASGRP1 mutation should be considered in patients with ALPS-like disease. We also propose to investigate the intracellular proteins involved in the T-cell receptor signaling pathway in similar patients but with unknown genetic cause.