tbuckley/cabot-search huggingface dataset:
Progress Toward Measles Elimination — Western Pacific Region, 2013–2017
Authors: José E. Hagan, Jennifer L. Kriss, Yoshihiro Takashima, Kayla Mae L. Mariano, Roberta Pastore, Varja Grabovac, Alya J. Dabbagh, James L. Goodson
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

In 2005, the Regional Committee for the World Health Organization (WHO) Western Pacific Region (WPR)* established a goal for measles elimination† by 2012 (1). To achieve this goal, the 37 WPR countries and areas implemented the recommended strategies in the WPR Plan of Action for Measles Elimination (2) and the Field Guidelines for Measles Elimination (3). The strategies include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs), when required; 2) conducting high-quality case-based measles surveillance, including timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 3) establishing and maintaining measles outbreak preparedness to ensure rapid response and appropriate case management. This report updates the previous report (4) and describes progress toward measles elimination in WPR during 2013-2017. During 2013-2016, estimated regional coverage with the first MCV dose (MCV1) decreased from 97% to 96%, and coverage with the routine second MCV dose (MCV2) increased from 91% to 93%. Eighteen (50%) countries achieved ≥95% MCV1 coverage in 2016. Seven (39%) of 18 nationwide SIAs during 2013-2017 reported achieving ≥95% administrative coverage. After a record low of 5.9 cases per million population in 2012, measles incidence increased during 2013-2016 to a high of 68.9 in 2014, because of outbreaks in the Philippines and Vietnam, as well as increased incidence in China, and then declined to 5.2 in 2017. To achieve measles elimination in WPR, additional measures are needed to strengthen immunization programs to achieve high population immunity, maintain high-quality surveillance for rapid case detection and confirmation, and ensure outbreak preparedness and prompt response to contain outbreaks.
The National Resident Matching Program and Competition for Employment—Reply
Authors: Mona M. Signer, Laurie S. Curtin
Journal: JAMA (2018)

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
Contrast-enhanced ultrasound for non-invasive diagnosis of hepatocellular carcinoma: A comparison between CEUS LI-RADS and ESCULAP criteria in a large high-risk cohort of patients
Authors: A. Saviano, L. Riccardi, M.A. Zocco, T. Baumert, G.L. Rapaccini, M. Pompili, A. Gasbarrini
Journal: Journal of Hepatology (2018)
Final results of a multicenter, open-label phase 2b clinical trial to assess safety and efficacy of Myrcludex B in combination with Tenofovir in patients with chronic HBV/HDV co-infection
Authors: H. Wedemeyer, P. Bogomolov, A. Blank, L. Allweiss, M. Dandri-Petersen, B. Bremer, N. Voronkova, K. Schöneweis, A. Pathil, J. Burhenne, M. Haag, M. Schwab, W.-E. Haefeli, J.S.Z. Wiesch, A. Alexandrov, S. Urban
Journal: Journal of Hepatology (2018)
Early application of haemostatic powder added to standard management for oesophagogastric variceal bleeding: a randomised trial
Authors: Mostafa Ibrahim, Ahmed El-Mikkawy, Mohamed Abdel Hamid, Haitham Abdalla, Arnaud Lemmers, Ibrahim Mostafa, Jacques Devière
Journal: Gut (2018)

Background Acute variceal bleeding (AVB) requires early therapeutic management by experienced endoscopists that often poses logistical challenges for hospitals. We assessed a different management concept with early application of haemostatic powder—which does not require high endoscopic expertise—added to conventional management in a randomised trial. Methods Cirrhotic patients with AVB received standard medical therapy and were randomised to either immediate endoscopy with haemostatic powder application within 2 hours of admission, followed by early elective endoscopy on the next day, that is, within 12–24 hours of admission for definitive treatment (study group) or to early elective endoscopy only (control group). In both groups, failures to achieve clinical haemostasis until the time of early elective endoscopy underwent rescue endoscopy with attempted conventional haemostasis. Primary outcome was endoscopic haemostasis at the elective endoscopy. Results Of 86 randomised patients with AVB, 5/43 in the study group required rescue endoscopy for failure of controlling spurting bleeding (n=4) after powder application or for early bleeding recurrence in one patient who died before repeating rescue endoscopy. In the control group, 13/43 patients required rescue endoscopic haemostasis for failure of clinical haemostasis (12%vs30%, p=0.034). In the remaining patients, early elective endoscopic haemostasis was achieved in all 38 patients in the study group, while all remaining 30 patients in the control group had fresh gastric blood or (10%) spurting bleeding at early elective endoscopy with successful haemostasis in all of them. Six-week survival was significantly improved in the study group (7%vs30%, p=0.006). Conclusion The new concept of immediate powder application improves early clinical and endoscopic haemostasis. This simplified endoscopic approach may have an impact on early and 6-week survival. Trial registration number NCT03061604 .
Access to Syringe Services Programs — Kentucky, North Carolina, and West Virginia, 2013–2017
Authors: Danae Bixler, Greg Corby-Lee, Scott Proescholdbell, Tina Ramirez, Michael E. Kilkenny, Matt LaRocco, Robert Childs, Michael R. Brumage, Angela D. Settle, Eyasu H. Teshale, Alice Asher
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

The Appalachian region of the United States is experiencing a large increase in hepatitis C virus (HCV) infections related to injection drug use (IDU) (1). Syringe services programs (SSPs) providing sufficient access to safe injection equipment can reduce hepatitis C transmission by 56%; combined SSPs and medication-assisted treatment can reduce transmission by 74% (2). However, access to SSPs has been limited in the United States, especially in rural areas and southern and midwestern states (3). This report describes the expansion of SSPs in Kentucky, North Carolina, and West Virginia during 2013-August 1, 2017. State-level data on the number of SSPs, client visits, and services offered were collected by each state through surveys of SSPs and aggregated in a standard format for this report. In 2013, one SSP operated in a free clinic in West Virginia, and SSPs were illegal in Kentucky and North Carolina; by August 2017, SSPs had been legalized in Kentucky and North Carolina, and 53 SSPs operated in the three states. In many cases, SSPs provide integrated services to address hepatitis and human immunodeficiency virus (HIV) infection, overdose, addiction, unintended pregnancy, neonatal abstinence syndrome, and other complications of IDU. Prioritizing development of SSPs with sufficient capacity, particularly in states with counties vulnerable to epidemics of hepatitis and HIV infection related to IDU, can expand access to care for populations at risk.
Active Epilepsy and Seizure Control in Adults — United States, 2013 and 2015
Authors: Niu Tian, Michael Boring, Rosemarie Kobau, Matthew M. Zack, Janet B. Croft
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

Approximately 3 million American adults reported active epilepsy* in 2015 (1). Active epilepsy, especially when seizures are uncontrolled, poses substantial burdens because of somatic, neurologic, and mental health comorbidity; cognitive and physical dysfunction; side effects of antiseizure medications; higher injury and mortality rates; poorer quality of life; and increased financial cost (2). Thus, prompt diagnosis and seizure control (i.e., seizure-free in the 12 months preceding the survey) confers numerous clinical and social advantages to persons with active epilepsy. To obtain recent and reliable estimates of active epilepsy and seizure control status in the U.S. population, CDC analyzed aggregated data from the 2013 and the 2015 National Health Interview Surveys (NHISs). Overall, an annual estimated 2.6 million (1.1%) U.S. adults self-reported having active epilepsy, 67% of whom had seen a neurologist or an epilepsy specialist in the past year, and 90% of whom reported taking epilepsy medication. Among those taking epilepsy medication, only 44% reported having their seizures controlled. A higher prevalence of active epilepsy and poorer seizure control were associated with low family income, unemployment, and being divorced, separated, or widowed. Use of epilepsy medication was higher among adults who saw an epilepsy specialist in the past year than among those who did not. Health care and public health should ensure that adults with uncontrolled seizures have appropriate care and self-management support in order to promote seizure control, improve health and social outcomes, and reduce health care costs.
Gene signature of HDV-associated hepatocellular carcinoma (HCC): differences with HCC associated with other hepatitis viruses
Authors: G. Diaz, R.E. Engle, A. Nice, M. Melis, S. Montenegro, J. Rodriguez-Canale, J. Hanson, M.R. Emmert-Buck, F. Zamboni, S. Govindarajan, D.E. Kleiner, P. Farci
Journal: Journal of Hepatology (2018)
Clinical Implementation of Pharmacogenetic Decision Support Tools for Antidepressant Drug Prescribing
Authors: Zane Zeier, Linda L. Carpenter, Ned H. Kalin, Carolyn I. Rodriguez, William M. McDonald, Alik S. Widge, Charles B. Nemeroff
Journal: American Journal of Psychiatry (2018)

The accrual and analysis of genomic sequencing data have identified specific genetic variants that are associated with major depressive disorder. Moreover, substantial investigations have been devoted to identifying gene-drug interactions that affect the response to antidepressant medications by modulating their pharmacokinetic or pharmacodynamic properties. Despite these advances, individual responses to antidepressants, as well as the unpredictability of adverse side effects, leave clinicians with an imprecise prescribing strategy that often relies on trial and error. These limitations have spawned several combinatorial pharmacogenetic testing products that are marketed to physicians. Typically, combinatorial pharmacogenetic decision support tools use algorithms to integrate multiple genetic variants and assemble the results into an easily interpretable report to guide prescribing of antidepressants and other psychotropic medications. The authors review the evidence base for several combinatorial pharmacogenetic decision support tools whose potential utility has been evaluated in clinical settings. They find that, at present, there are insufficient data to support the widespread use of combinatorial pharmacogenetic testing in clinical practice, although there are clinical situations in which the technology may be informative, particularly in predicting side effects.
Single-cell mRNA sequencing to characterize circulating tumor cells in hepatocellular carcinoma
Authors: D. D’avola, C. Villacorta, S.N. Martins-Filho, A. Craig, I. Labgaa, J.V. Felden, A. Kimaada, A. Bonaccorso, P. Tabrizian, B.M. Hartmann, R. Sebra, M. Schwartz, A. Villanueva
Journal: Journal of Hepatology (2018)
<i>EGFR</i> mutations in advanced non-small cell lung cancer patients in Serbia: 3 year-experience of central testing and gefitinib therapy response.
Authors: Radmila Jankovic, Milena Cavic, Jelena Spasic, Ana Krivokuca, Ksenija Brotto, Katarina Jovanovic, Ivana Boljevic, Miljana Tanic, Emina Malisic, Bojan Zaric, Branislav Perin, Davorin Z. Radosavljevic, Sinisa Radulovic
Journal: Journal of Clinical Oncology (2015)

e19111 Background: EGFR mutation testing of advanced non-small cell lung cancer patients for targeted therapy with small tyrosine kinase inhibitors became obligatory in 2011 in Serbia. The aim of this study was to determine the frequency and types of EGFR mutations in Serbian lung cancer patients so far and to explore the influence of patient (gender, age at diagnosis, smoking and performance status) and tumor (EGFR mutation type, TNM, localization of metastases) characteristics on the outcome of gefitinib therapy. Methods: A total of 1874 consecutive chemonaïve lung adenocarcinoma patients (stage IIIB and IV, performance status 0 or 1) were included in the analysis from June 2011 until December 2014. The group comprised of 1146 males (61.2%) and 728 females (38.8%) of Caucasian descent, patient age range 20-88 years (median 62 years). EGFR mutations were analyzed by real-time PCR and patients harbouring mutations were treated with gefitinib in the first line until progression. Statistical analysis was performed using Chi-square, Fisher’s exact, Wilcoxon’s and Log-Rank tests; p < 0.05 was considered significant. Results: EGFR mutations were detected in 190 patients (10.1%), of which 127 were female (67%) and 63 male (33%) (p < 0.001). Apart from del19 (55%) and L858R (32%), 2 patients had L861Q, 8 had G719X, 5 had an insertion in exon 20 and we found 5 double mutants (1 L861Q/ G719X and 4 G719X/S768I). From this group, 46 patients (30 female and 16 male) were treated with gefitinib at our Institute. The follow up period was 2-27 months (median 8 months). Overall survival (OS) median was not reached and progression free survival (PFS) rate was 37.5% after 1 year and 20% after 2 years, with a median of 8 months (95% CI, 6-16 months). Female patients had significantly longer PFS (median 15 vs. 4 months, p = 0.01) and OS (median not reached vs. 19 months, p = 0.04) than males. Other patient and tumor characteristics did not show statisticaly significant influence on gefitinib therapy outcome. Conclusions: In Serbian EGFR mutated lung cancer patients, the female gender proved to be the main determinant of favorable outcome of gefitinib therapy.
Considering Whether the Dismissal of Vaccine-Refusing Families Is Fair to Other Clinicians
Authors: Michael J. Deem, Mark C. Navin, John D. Lantos
Journal: JAMA Pediatrics (2018)

This Viewpoint assesses the ethical and practical implications of a 2016 resolution by the American Academy of Pediatrics on the acceptability of dismissing vaccine-refusing parents from pediatric clinical practices.
Assessing Baveno VI criteria with a new point-shear wave elastography technique: The BAVElastPQ study
Authors: M. Garcovich, G. Gibiino, B.E. Annicchiarico, M.E. Ainora, L. Riccardi, M. Siciliano, M. Pompili, M.A. Zocco, A. Gasbarrini
Journal: Journal of Hepatology (2018)
Epidemiology and treatment of high-grade gastrointestinal neuroendocrine tumors (HG-GI-NETs).
Authors: Olatunji B. Alese, Renjian Jiang, Walid Labib Shaib, Christina Sing-Ying Wu, Mehmet Akce, Madhusmita Behera, Bassel F. El-Rayes
Journal: Journal of Clinical Oncology (2018)

421 Background: High grade neuroendocrine tumors of the gastrointestinal tract are rare tumors. Management strategies are modeled after small cell lung cancer (SCLC). Treatment patterns and outcomes have not been studied. Methods: Data were obtained from all US hospitals that contributed to the National Cancer Database (NCDB) between 2004 and 2013. Univariate and multivariate testing was done to identify factors associated with patient outcome. Kaplan-Meier analysis and Cox proportional hazards models were used to assess the association between patient characteristics and survival. Results: A total of 1,861 patients were identified for the 10 years of the study. The mean age was 63 years (SD±13), with a male preponderance (53.3%). The vast majority of patients (78.1%) were non-Hispanic Whites. The most common primary sites were pancreas (PNET = 19.4%), large intestine (18.1%), esophagus (17.8%) and rectum (15.5%). About 27.9% of the cases were resectable at the time of diagnosis, and distribution across stages 1-IV was 6.6%, 10.5%, 18% and 64.6% consecutively. Liver was a common site of metastases (50.4%), followed by bone (11.3%) and lungs (10.8%). Only 3.5% of the patients had brain metastases. On univariable analysis, age &lt; 65years (HR 0.72; 0.66-0.8; p &lt; 0.001) and treatment at an academic center (HR 0.88; 0.79-0.99; p &lt; 0.034) were associated with improved survival. Multivariable analysis confirmed prognostic advantage of treatment at an academic center. Patients treated with chemotherapy had a median overall survival (OS) of 11.2 months, compared with 1.7 months for those who did not. The median OS for high grade PNET was 6 months, compared to 9.9 months for other HG-GI-NETs. One year and 5-year survival rates were 27.5% vs. 41% and 4.5% vs. 12.3% respectively. Conclusions: This is the largest series of HG-GI-NET. Almost two-thirds of the cases present with metastatic disease. Pattern of metastasis differs from SCLC. Survival is short. Treatment at high volume academic center, younger age and use of chemotherapy are associated with improved survival.
Evaluation of the Xpert fingerstick HCV viral load assay
Authors: F. Lamoury, S. Bajis, B. Hajarizadeh, A. Marshall, M. Martinello, E. Ivanova, B. Catlett, Y. Mowat, P. Marks, J. Amin, J. Smith, N. Ezard, V. Cock, J. Hayllar, D. Persing, M. Kleman, P. Cunningham, G. Dore, T. Applegate, J. Grebely
Journal: Journal of Hepatology (2018)
Phenformin-Induced Mitochondrial Dysfunction Sensitizes Hepatocellular Carcinoma for Dual Inhibition of mTOR
Authors: Sónia R. Veiga, Xuemei Ge, Carol A. Mercer, María I. Hernández-Álvarez, Hala Elnakat Thomas, Javier Hernandez-Losa, Santiago Ramón y Cajal, Antonio Zorzano, George Thomas, Sara C. Kozma
Journal: Clinical Cancer Research (2018)

Abstract Purpose: Hepatocellular carcinoma (HCC) ranks second in cancer mortality and has limited therapeutic options. We recently described the synergistic effect of allosteric and ATP-site competitive inhibitors against the mTOR for the treatment of HCC. However, such inhibitors induce hyperglycemia and increase mitochondrial efficiency. Here we determined whether the mitochondrial complex I inhibitor phenformin could reverse both side effects, impose an energetic stress on cancer cells, and suppress the growth of HCC. Experimental Design: Human HCC cell lines were used in vitro to access the signaling and energetic impact of mTOR inhibitors and phenformin, either alone or in combination. Next, the therapeutic utility of these drugs alone or in combination was investigated preclinically in human orthotopic tumors implanted in mice, by analyzing their impact on the tumor burden and overall survival. Results: We found phenformin caused mitochondrial dysfunction and fragmentation, inducing a compensatory shift to glycolysis. In contrast, dual inhibition of mTOR impaired cell growth and glycolysis, while increasing mitochondrial fusion and efficiency. In a mouse model of human HCC, dual inhibition of mTOR, together with phenformin, was highly efficacious in controlling tumor burden. However, more strikingly, pretreatment with phenformin sensitized tumors to dual inhibition of mTOR, leading to a dramatic improvement in survival. Conclusions: Treatment of HCC cells in vitro with the biguanide phenformin causes a metabolic shift to glycolysis, mitochondrial dysfunction and fragmentation, and dramatically sensitizes orthotopic liver tumors to dual inhibition of mTOR. We therefore propose this therapeutic approach should be tested clinically in HCC. Clin Cancer Res; 24(15); 3767–80. ©2018 AACR.
439Exercise training fails to improve cardiac dysfunction in DNA-repair deficient Xpg mice
Authors: M De Boer, M Te Lintel Hekkert, JHJ Hoeijmakers, D J Duncker
Journal: Cardiovascular Research (2018)

Background: Moderate-intensity exercise (MIE) is recommended as a primary prevention for cardiovascular diseases in type-2 diabetic individuals.Unfortunately, current clinical guideline does not specify which exercise intensity is effective to prevent microvascular remodeling for diabetic individuals with or without pre-existing cardiac dysfunction.Hence, controversial effects of MIE were reported.Therefore, the impact of MIE on diabetic individuals with various prognoses remains to be established.Purpose: To assess the effect of MIE on collateral growth and microRNA-126/VEGF pathway in db/db mice with or without established cardiac dysfunction, independently.Methods: 8-week old diabetic db/db mice without cardiac dysfunction (Pre-CD) or 16-week old db/db mice with established cardiac dysfunction (Post-CD) were subjected to MIE or no exercise.Age-matched non-diabetic db/þ mice with normal cardiac function were used as controls.Mice were subjected to exercise for 5 consecutive days a week for 8 weeks.Each daily exercise consisted of 10 bouts of 5 minutes run interspersed by 2 minutes of rest.Cardiac function was measured at baseline and endpoint using echocardiography.Heart tissues were harvested to assess myocardial angiogenic properties by quantifying (i) arterioles density and functional capillaries using immunohistochemistry, (ii) microRNA-126 using real-time PCR and (iii) its indirect target vascular endothelial growth factor (VEGF) using western blot.Results: Body weight and HbA1c remain unaltered in all mice.Ejection fraction and E/A ratio were impaired in Pre-and Post-CD diabetic controls at the end of 8-week study.Arteriole density and functional capillaries were significantly reduced in both groups of diabetic control, indicating microvascular rarefaction and poor myocardial perfusion.These structural changes were associated with down-regulations of pro-angiogenic factors -microRNA-126 and VEGF protein.Interestingly, MIE prevented deterioration of cardiac function in Pre-CD mice but MIE did not attenuate cardiac dysfunction in Post-CD mice.Amelioration of cardiac function in Pre-CD mice was associated with increased microvascular density, suggesting enhanced myocardial perfusion.This structural adaptation was also partly contributed by preserved microRNA-126 expression and VEGF protein, suggesting a normal angiogenic property.In contrast, microRNA-126 and VEGF level was not restored by MIE, resulting in cardiac microangiopathy and cardiac dysfunction in Post-CD mice.Conclusion: Our data supports current clinical guidelines that MIE is effective as a primary prevention for cardiovascular disease, provided an early intervention is initiated in uncomplicated diabetic individuals.This data also provides a translational evidence for future clinical study that patient's prognosis should be taken into consideration in order to maximize the clinical benefits of MIE in diabetic patients.