tbuckley/cabot-search huggingface dataset:
Palliative care utilization in oncology patients with 30-day hospital readmission.
Authors: Chintan Pandya, Gradon Nielsen, John Hu, Jodi Ram, Cheryl Rozario, Danielle Wallace, Lauren M. Hamel, David W. Dougherty
Journal: Journal of Clinical Oncology (2017)

110 Background: Reducing the rate of hospital readmissions is an important aspect of improving quality of life and cost of care for patients with advanced cancer. Early Palliative Care (PC) has been shown to improve quality of life and downstream healthcare utilization in patients with advanced cancer. The aim of this study was to examine palliative care (PC) utilization and factors associated with 30-day readmission in cancer patients. Methods: All patients with 30 day readmissions to the inpatient oncology service at the Wilmot Cancer Institute from July 2015-June 2016 were identified. Chart reviews were conducted to determine primary cancer stage and type; reason for, length of stay and discharge disposition (e.g. discharged on hospice, deceased) for index and readmission; potential preventability of readmission; and if and when the patient had met with PC. Results: A total of thirty-nine patients experienced a 30-day readmission, with 95% of patients having stage IV disease and 77% having a primary lung or GI malignancy. Most patients (74%) had not met with PC at the time of the index admission and 49% of patients had not met with PC by the time of readmission. Forty one percent (N = 17) of patients either died during readmission or were discharged on hospice. Forty one percent (N = 7) of those that died during readmission or were discharged on hospice did not meet with palliative care. Forty four percent of readmissions were classified as potentially preventable. Conclusions: Nearly half of all advanced cancer patients had not met with PC by the time of their readmission. Upon readmission, many patients were either discharged to hospice or died, suggesting that patients with advanced cancer could benefit from earlier PC. Increased and improved patient-oncologist PC communication, including referrals to PC specialists, may reduce readmission rates for patients with advanced cancer.
QTWiST analysis to compare the benefit of maintenance Erlotinib versus pemetrexed patients with EGFR non mutated NSCLC
Authors: S. Turkar, A. Joshi, V. Noronha, V. Patil, M. Sharma, C. Vora, S. More, S. Goud, K. Prabhash
Journal: Annals of Oncology (2017)
LSR Antibody Therapy Inhibits Ovarian Epithelial Tumor Growth by Inhibiting Lipid Uptake
Authors: Kosuke Hiramatsu, Satoshi Serada, Takayuki Enomoto, Yusuke Takahashi, Satoshi Nakagawa, Satoshi Nojima, Akiko Morimoto, Shinya Matsuzaki, Takuhei Yokoyama, Tsuyoshi Takahashi, Minoru Fujimoto, Hiroshi Takemori, Yutaka Ueda, Kiyoshi Yoshino, Eiichi Morii, Tadashi Kimura, Tetsuji Naka
Journal: Cancer Research (2017)

Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy, but it still lacks effective treatment options. In this study, we utilized proteomic technology to identify lipolysis-stimulated lipoprotein receptor (LSR) as a new tumor antigen of EOC. Immunohistochemical analysis of EOC tissues in conjunction with survival analysis of EOC patients showed that high expression of LSR is associated with poor prognosis. High LSR expression also occurred in tumor metastases including to the lymph node and omentum. To evaluate the possible benefits of blocking this antigen in EOC, we raised a new monoclonal antibody (mAb) to human LSR (hLSR). In mouse xenograft models of hLSR+ EOC (cell lines or patient-derived tumors), we found that administration of anti-hLSR mAb inhibited tumor growth in a manner independent of both antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity. Mechanistic investigations showed that hLSR expression increased incorporation of very-low-density lipoprotein (VLDL) into EOC cells and that anti-hLSR mAb inhibited lipid uptake in vitro and in vivo Moreover, VLDL promoted cell proliferation in hLSR-positive EOC cells in vitro, and this effect was inhibited by anti-hLSR mAb. While the anti-hLSR mAb studied cross reacted with the mouse antigen, we observed no adverse effects on normal organs and lipid metabolism in murine hosts. Our findings suggest that hLSR plays a key functional role in EOC development and that this antigen can be therapeutically targeted by specific mAb to improve EOC treatment.Significance: These findings offer preclinical evidence of the therapeutic efficacy of a novel targeted antibody therapy against deadly epithelial ovarian cancers. Cancer Res; 78(2); 516-27. ©2017 AACR.
Abstract 15159: Association Between Duration of Resuscitation and Favorable Outcome After Out-of-Hospital Cardiac Arrest: Implications for Prolonging Resuscitation
Authors: Joshua C Reynolds, Brian E Grunau, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Clifton W Callaway
Journal: Circulation (2016)

Introduction:  Little evidence guides the duration of resuscitation (CPR-DUR) in OHCA. We estimated the impact of CPR-DUR on the probability of favorable neurologic outcome at hospital discharge (mRS 0-3) in OHCA using a large, multi-center cohort.   Hypothesis:  CPR-DUR is associated with mRS 0-3, and this association is modified by case features.   Methods:  Secondary analysis of multi-center clinical trial (ROC-PRIMED) of adult, atraumatic, EMS-treated, OHCA. Primary exposure was CPR-DUR (professional CPR to ROSC or termination). Primary outcome was mRS 0-3. Subjects were also classified as survival with poor outcome (mRS 4-5), ROSC without survival (mRS 6), or no ROSC. We plotted subject accrual as a function of CPR-DUR, and estimated dynamic probabilities of mRS 0-3 for the whole cohort and subject phenotypes (shockable rhythm [VF/VT], witnessed [WIT], bystander CPR [bCPR]). Adjusted logistic regression models tested associations between CPR-DUR and mRS 0-3 with interaction terms for VF/VT, WIT, and bCPR.   Results:  Primary cohort was 11,368 subjects (69 [IQR: 56-81] years; 63% male; 47% WIT; 38% bCPR; 22% VF/VT; 85% advanced airway; 14% induced hypothermia; 31% cardiac catheterization). Of these, 4,023 (35.4%) had ROSC, 1,232 (10.8%) survived to discharge, and 905 (8.0%) had mRS 0-3. Distribution of CPR-DUR differed by outcome (p   Conclusions:  CPR-DUR was associated with mRS 0-3 at hospital discharge. Subjects with favorable phenotypes had resilience to prolonged resuscitation, warranting either continued efforts or early consideration of novel therapies.
Robert Cleghorn Robb
Authors: Sheila Martin, Rona Clayton-Robb
Journal: BMJ (2017)

Robert Cleghorn Robb was born in Newmains, Lanarkshire, Scotland. He was educated locally and studied medicine at the University of Glasgow. After qualifying in 1946, he took up a position as house physician at the Western General Hospital in Glasgow. Later that year he joined the Royal Air Force to take up his national service commission, which became permanent in 1948.

He continued to study and gained diplomas in physical medicine, public health and industrial health. He became a member …
Increased Echocardiographic Pulmonary Pressure in HIV-infected and -uninfected Individuals in the Veterans Aging Cohort Study
Authors: Evan L. Brittain, Meredith S. Duncan, Joyce Chang, Olga V. Patterson, Scott L. DuVall, Cynthia A. Brandt, Kaku A. So-Armah, Matthew Goetz, Kathleen Akgun, Kristina Crothers, Courtney Zola, Joon Kim, Cynthia Gibert, Margaret Pisani, Alison Morris, Priscilla Hsue, Hilary A. Tindle, Amy Justice, Matthew Freiberg
Journal: American Journal of Respiratory and Critical Care Medicine (2017)

The epidemiology and prognostic impact of increased pulmonary pressure among HIV-infected individuals in the antiretroviral therapy era is not well described.To examine the prevalence, clinical features, and outcomes of increased echocardiographic pulmonary pressure in HIV-infected and -uninfected individuals.This study evaluated 8,296 veterans referred for echocardiography with reported pulmonary artery systolic pressure (PASP) estimates from the Veterans Aging Cohort study, an observational cohort of HIV-infected and -uninfected veterans matched by age, sex, race/ethnicity, and clinical site. The primary outcome was adjusted mortality by HIV status.PASP was reported in 2,831 HIV-infected and 5,465 HIV-uninfected veterans (follow-up [mean ± SD], 3.8 ± 2.6 yr). As compared with uninfected veterans, HIV-infected veterans with HIV viral load greater than 500 copies/ml (odds ratio, 1.27; 95% confidence interval [CI], 1.05-1.54) and those with CD4 cell count less than 200 cells/μl (odds ratio, 1.28; 95% CI, 1.02-1.60) had a higher prevalence of PASP greater than or equal to 40 mm Hg. As compared with uninfected veterans with a PASP less than 40 mm Hg, HIV-infected veterans with a PASP greater than or equal to 40 mm Hg had an increased risk of death (adjusted hazard ratio, 1.78; 95% CI, 1.57-2.01). This risk persisted even among participants without prevalent comorbidities (adjusted hazard ratio, 3.61; 95% CI, 2.17-6.01). The adjusted risk of mortality in HIV-infected veterans was higher at all PASP values than in uninfected veterans, including at values currently considered to be normal.HIV-infected people with high HIV viral loads or low CD4 cell counts have a higher prevalence of increased PASP than uninfected people. Mortality risk in HIV-infected veterans increases at lower values of PASP than previously recognized and is present even among those without prevalent comorbidities. These findings may inform clinical decision-making regarding screening and surveillance of pulmonary hypertension in HIV-infected individuals.
High prevalence of TB disease in contacts of adults with extrapulmonary TB
Authors: Tom Wingfield, Peter MacPherson, Paul Cleary, L Peter Ormerod
Journal: Thorax (2017)

UK guidelines no longer recommend routine screening of household contacts of adult patients with extrapulmonary TB (EPTB). From 27 March 2012 to 28 June 2016, we investigated the prevalence of active TB disease in household contacts of 1023 EPTB index cases in North West England, and compared estimates with: published new entrant migrant screening programme prevalence (~147/100 000 person-years); London-based contact screening data (700/100 000 contacts screened); and National Institute for Health and Care Excellence (NICE) new entrant TB screening thresholds (TB prevalence &gt;40/100 000 people). Active TB disease prevalence in EPTB contacts was 440/100 000 contacts screened, similar to UK new entrant screening programmes, London EPTB contact prevalence and &gt;10 times NICE’s threshold for new entrant screening. The decision to no longer recommend routine screening of EPTB contacts should be re-evaluated and cost-effectiveness analyses of screening strategies for EPTB contacts should be performed.
Sensitivity of Preference-Based Quality-of-Life Measures for Economic Evaluations in Early-Stage Melanoma
Authors: Mbathio Dieng, Nadine A. Kasparian, Anne E. Cust, Daniel S. J. Costa, Anh Tran, Phyllis N. Butow, Scott W. Menzies, Graham J. Mann, Rachael L. Morton
Journal: JAMA Dermatology (2017)

<h3>Importance</h3> The diagnosis of a life-threatening disease like melanoma can affect all aspects of a person's life, including health-related quality of life (HRQOL) and psychological aspects of melanoma such as fear of cancer recurrence (FCR). Economic evaluations of psychological interventions require preference-based (utility) instruments that are sensitive to changes in well-being and HRQOL; however, very few studies have evaluated the sensitivity of these instruments when used for people with melanoma. <h3>Objective</h3> To compare utility scores from the multiple-attribute instrument Assessment of Quality of Life—8-Dimension Scale (AQoL-8D) with the mapped utility scores of the Functional Assessment of Cancer Therapy–Melanoma (FACT-M) and to investigate the sensitivity of both instruments in identifying the influence of FCR on HRQOL. <h3>Design, Setting, and Participants</h3> This assessment of data from a randomized clinical trial of a psychoeducational intervention to reduce FCR, conducted at 3 high-risk melanoma clinics in Australia, evaluated 164 patients with early-stage melanoma and a high risk of developing a second primary melanoma. <h3>Main Outcomes and Measures</h3> The FACT-M and AQoL-8D were used to assess HRQOL and FCR among the study participants. Concurrent validity was assessed by comparing the total and subdomain scores of the 2 instruments, and the strength of associations was assessed using Pearson correlation coefficient. Convergent validity was assessed by comparing participants' HRQOL, demographic, and clinical characteristics using the χ<sup>2</sup>test and<i>F</i>statistic. Both the FACT-M and AQoL-8D utilities were regressed on FCR Inventory (FCRI) severity scores to estimate the effect of elevated FCR on HRQOL. <h3>Results</h3> A total of 164 participants completed the baseline questionnaires, but only 163 met all inclusion criteria and underwent the full analysis: 72 were women; 91 were men; and mean (SD) age was 58.2 (12.1) years. Both the AQoL-8D and FACT-M instruments showed good concurrent validity and could differentiate between relevant subgroups including level of FCRI severity. The AQoL-8D and FACT-M utilities were strongly correlated (<i>r2</i> = 0.57). Respondents had a mean (SD) AQoL-8D utility of 0.77 (0.2), and a mean (SD) FACT-M utility score of 0.76 (0.07). High levels of FCRI severity were associated with a decrease in utility of 0.12 (95% CI, −0.19 to −0.05) as measured by AQoL-8D, and a decrease of 0.03 (95% CI, −0.05 to −0.01) as measured by the FACT-M. <h3>Conclusions and Relevance</h3> For economic evaluations of psychological interventions in melanoma, the AQoL-8D and FACT-M are valid measures of utility; however, the AQoL-8D demonstrates greater sensitivity to FCRI severity. Our results suggest a significant association between FCR and HRQOL.
CRISPR/Cas9-mediated targeted chromosome elimination
Authors: Erwei Zuo, Xiaona Huo, Xuan Yao, Xinde Hu, Yidi Sun, Jianhang Yin, Bingbing He, Xing Wang, Linyu Shi, Jie Ping, Yu Wei, Wenqin Ying, Wei Wei, Wenjia Liu, Cheng Tang, Yixue Li, Jiazhi Hu, Hui Yang
Journal: Genome biology (2017)

The CRISPR/Cas9 system has become an efficient gene editing method for generating cells carrying precise gene mutations, including the rearrangement and deletion of chromosomal segments. However, whether an entire chromosome could be eliminated by this technology is still unknown. Here we demonstrate the use of the CRISPR/Cas9 system to eliminate targeted chromosomes. Using either multiple cleavages induced by a single-guide RNA (sgRNA) that targets multiple chromosome-specific sites or a cocktail of multiple sgRNAs, each targeting one specific site, we found that a sex chromosome could be selectively eliminated in cultured cells, embryos, and tissues in vivo. Furthermore, this approach was able to produce a targeted autosome loss in aneuploid mouse embryonic stem cells with an extra human chromosome and human induced pluripotent stem cells with trisomy 21, as well as cancer cells. CRISPR/Cas9-mediated targeted chromosome elimination offers a new approach to develop animal models with chromosome deletions, and a potential therapeutic strategy for human aneuploidy diseases involving additional chromosomes.
In patients with proteinuric IgA nephropathy, benefits of methylprednisolone were offset by harms
Authors: Chi-yuan Hsu
Journal: Annals of Internal Medicine (2017)

Source Citation Lv J, Zhang H, Wong MG, et al; TESTING Study Group. Effect of oral methylprednisolone on clinical outcomes in patients with IgA nephropathy: The TESTING randomized clinical trial. JAMA. 2017;318:432-42. 28763548
Curative salvage liver transplantation in patients with cirrhosis and hepatocellular carcinoma: An intention‐to‐treat analysis
Authors: Robbert J. de Haas, Chetana Lim, Prashant Bhangui, Chady Salloum, Philippe Compagnon, Cyrille Feray, Julien Calderaro, Alain Luciani, Daniel Azoulay
Journal: Hepatology (2017)

The salvage liver transplantation (SLT) strategy was conceived for initially resectable and transplantable (R&amp;T) hepatocellular carcinoma (HCC) patients, to try to obviate upfront liver transplantation, with the “safety net” of SLT in case of postresection recurrence. The SLT strategy is successful or curative when patients are recurrence free following primary resection alone, or after SLT for recurrence. The aim of the current study was to determine the SLT strategy's potential for cure in R&amp;T HCC patients, and to identify predictors for its success. From 1994 to 2012, all R&amp;T HCC patients with cirrhosis were enrolled in the SLT strategy. An intention‐to‐treat (ITT) analysis was used to determine this strategy's outcomes and predictors of success according to the above definition. In total, 110 patients were enrolled in the SLT strategy. Sixty‐three patients (57%) had tumor recurrence after initial resection, and in 30 patients SLT could be performed (recurrence transplantability rate = 48%). From the time of initial resection, ITT 5‐year overall and disease‐free survival rates were 69% and 60%, respectively. The SLT strategy was successful in 60 patients (56%), either by resection alone (36%), or by SLT for recurrence (19%). Preresection predictors of successful SLT strategy at multivariate analysis included Model for End‐Stage Liver Disease (MELD) score &gt;10, and absence of neoadjuvant transarterial chemoembolization (TACE). Additional postresection predictive factors were absence of postresection morbidity, and T‐stage 1‐2 at the resection specimen. Conclusion: The SLT strategy is curative in only 56% of cases. Higher MELD score at inception of the strategy and no pre‐resection TACE are predictors of successful SLT strategy. (H epatology 2018;67:204‐215).
Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program
Authors: Divyajot Sadana, Ariella Pratzer, Lauren J. Scher, Harry S. Saag, Nicole Adler, Frank M. Volpicelli, Moises Auron, Steven M. Frank
Journal: JAMA Internal Medicine (2017)

Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized. We review the most recent transfusion practice guidelines and the evidence supporting these guidelines. We also discuss several medical societies' Choosing Wisely campaigns to reduce or eliminate overuse of transfusions. A blueprint is presented for developing a patient blood management program, which includes discussion of specific methods for optimizing transfusion practice.
Simultaneous Brain and Lung Histiocytic Sarcoma Revealed on 18F-FDG PET/CT
Authors: Yu Pan, Yifan Zhang
Journal: Clinical Nuclear Medicine (2017)

A 52-year-old man with intermittent head motor tics, aphasia and right upper extremity weakness had an F-FDG avid left front lobe brain lesion, and a left upper lobe lung lesion on PET/CT. The brain lesion was surgically resected, and was diagnosed pathologically as a histiocytic sarcoma (HS). The lung lesion was also a HS via bronchial biopsy. HS is rare and generally involves nodes as shown on PET/CT in a few case reports. The current case with simultaneous brain and lung HS lesions adds new imaging pattern information of the disease to the literature.
Abstract 21029: Achieving High Retention in Mobile Health Research Using Design Principles Adopted From Widely Popular Consumer Mobile Apps
Authors: Geoffrey H Tison, Kaiyu Hsu, Johnson T Hsieh, Brandon M Ballinger, Mark J Pletcher, Gregory M Marcus, Jeffrey E Olgin
Journal: Circulation (2017)

Introduction: While mHealth platforms can enable rapid participant recruitment, the first 5 ResearchKit apps retained less than 10% of daily participants after the first 90 days, whereas well-optimized consumer mobile apps like Instagram and Twitter retain 31% and 48%, respectively. We proposed to apply design principles from the world of consumer internet to achieve high engagement and retention in a mHealth study. Methods: We enrolled 14,011 users of Cardiogram for Apple Watch app into the Health eHeart Study, an IRB-approved study at UCSF. We applied 3 key design principles to drive engagement and retention. First, give valuable insights back to user—e.g., notify users of abnormal heart rate spikes, and show when exercise caused a lower resting heart rate trend—using Gottman’s ratio: for every negative insight, give 5 positive ones. Second, minimize latency so users’ data updates many times per day. Third, use simple user interfaces that easily visualize trends and provide insights in small digestible formats. Results: Mean age was 42.3 ± 12.1, 31% were women. Seven days after app install, 64% of participants were active; 63% were active after 30 days, and 54% after 90 days. Retention was consistent across age groups—day 90 retention was 52% for 20-40 y.o., 55% for 40-60, and 49% for above 60. Refreshing data as frequently as possible had the highest impact on user engagement—in A/B testing, where heart rate visualizations were updated less frequently, we saw 20.9% drop in daily active users (51951 to 41094) within 7 days. The ratio of daily to monthly active users, a key measure of engagement, is 69.8% in our study, while average mHealth app is 8%. Conclusions: By applying design techniques from consumer mobile apps, we achieved day 90 retention 5x higher than the best ResearchKit app, showing that mHealth studies can retain large cohorts of participants and collect unique ambulatory health data with high engagement, improving the impact of mobile health interventions.
Hidradenitis Suppurativa
Authors: Ditte Marie Lindhardt Saunte, Gregor Borut Ernst Jemec
Journal: JAMA (2017)

Hidradenitis suppurativa (HS) is relatively common, with the prevalence of 0.05% to 4.10%, yet many patients receive inadequate treatment.To review the diagnosis, epidemiology, and treatment of HS with an emphasis on advances in the last 5 years.A literature search was conducted using PubMed, MEDLINE (Medical Subject Headings [MeSH]), and EMBASE to include recently published treatment studies (searched from September 1, 2011, to May 1, 2017). Reviews, guidelines, conference abstracts, and studies with less than 10 patients were excluded. Furthermore, internet searches for guidelines on hidradenitis suppurativa using Baidu, Bing, Google, and Qwant browsers were performed.The diagnosis of HS is made by lesion morphology (nodules, abscesses, tunnels, and scars), location (axillae, inframammary folds, groin, perigenital, or perineal), and lesion progression (2 recurrences within 6 months or chronic or persistent lesions for ≥3 months). HS is more common than was previously thought based on epidemiological analysis (0.05%-4.10%). Disability from HS can be significant. Patients with HS may have significant comorbidities (eg, obesity, metabolic syndrome, diabetes, and arthritis) and increased all-cause mortality (incidence rate ratio, 1.35 [95% CI, 1.15-1.59]). Antibiotic treatment with combinations of clindamycin and rifampicin, or ertapenem followed by combination rifampicin, moxifloxacin, and metronidazole for 6 months is effective. Adalimumab is effective in a significant proportion of patients and treatment with IL-1 and IL-12 receptor subunit beta 1 (Rb1) antibodies may also be useful. Tissue-sparing surgical techniques and carbon dioxide laser treatments also are available, but the evidence on clinical outcomes with these approaches is limited.Hidradenitis suppurativa is more common than previously thought and may be treated by an array of pharmacological and surgical techniques. Hidradenitis suppurativa should be considered in the differential diagnosis of nodular lesions or sinus tracts present in the axillae, groin, perineal, and mammillary fold regions.