tbuckley/cabot-search huggingface dataset:
Do mental health professionals use diagnostic classifications the way we think they do? A global survey
Authors: Michael B. First, Tahilia J. Rebello, Jared W. Keeley, Rachna Bhargava, Yunfei Dai, Maya Kulygina, Chihiro Matsumoto, Rebeca Robles, Anne‐Claire Stona, Geoffrey M. Reed
Journal: World Psychiatry (2018)

We report on a global survey of diagnosing mental health professionals, primarily psychiatrists, conducted as a part of the development of the ICD-11 mental and behavioural disorders classification. The survey assessed these professionals' use of various components of the ICD-10 and the DSM, their attitudes concerning the utility of these systems, and usage of "residual" (i.e., "other" or "unspecified") categories. In previous surveys, most mental health professionals reported they often use a formal classification system in everyday clinical work, but very little is known about precisely how they are using those systems. For example, it has been suggested that most clinicians employ only the diagnostic labels or codes from the ICD-10 in order to meet administrative requirements. The present survey was conducted with clinicians who were members of the Global Clinical Practice Network (GCPN), established by the World Health Organization as a tool for global participation in ICD-11 field studies. A total of 1,764 GCPN members from 92 countries completed the survey, with 1,335 answering the questions with reference to the ICD-10 and 429 to the DSM (DSM-IV, DSM-IV-TR or DSM-5). The most frequent reported use of the classification systems was for administrative or billing purposes, with 68.1% reporting often or routinely using them for that purpose. A bit more than half (57.4%) of respondents reported often or routinely going through diagnostic guidelines or criteria systematically to determine whether they apply to individual patients. Although ICD-10 users were more likely than DSM-5 users to utilize the classification for administrative purposes, other differences were either slight or not significant. Both classifications were rated to be most useful for assigning a diagnosis, communicating with other health care professionals and teaching, and least useful for treatment selection and determining prognosis. ICD-10 was rated more useful than DSM-5 for administrative purposes. A majority of clinicians reported using "residual" categories at least sometimes, with around 12% of ICD-10 users and 19% of DSM users employing them often or routinely, most commonly for clinical presentations that do not conform to a specific diagnostic category or when there is insufficient information to make a more specific diagnosis. These results provide the most comprehensive available information about the use of diagnostic classifications of mental disorders in ordinary clinical practice.
Intermittent Fasting Confers Protection in CNS Autoimmunity by Altering the Gut Microbiota
Authors: Francesca Cignarella, Claudia Cantoni, Laura Ghezzi, Amber Salter, Yair Dorsett, Lei Chen, Daniel Phillips, George M. Weinstock, Luigi Fontana, Anne H. Cross, Yanjiao Zhou, Laura Piccio
Journal: Cell Metabolism (2018)
Cost per median month of progression-free survival for daratumumab plus bortezomib and dexamethasone compared with carfilzomib plus dexamethasone in relapsed/refractory multiple myeloma.
Authors: Eric Maiese, Christopher N. Graham, Emma Hawe, Jean-Gabriel Le Moine
Journal: Journal of Clinical Oncology (2018)

e20037 Background: New treatments for relapsed/refractory multiple myeloma have recently been FDA approved in the United States (US). For FDA approval, these treatments are compared to historic standards of care in randomized controlled trials (RCTs), therefore, limited information regarding safety/efficacy comparisons between newer treatments is available to utilize in comparisons of costs. We sought to compare the average cost per median month of progression-free survival (PFS) for daratumumab plus bortezomib and dexamethasone (DVd) compared with carfilzomib plus dexamethasone (Kd) in patients who have received at least one prior line of therapy. Methods: PFS for DVd was estimated via parametric survival analysis of patient-level data from the CASTOR RCT. PFS for Kd was estimated by applying the PFS hazard ratio (HR) for DVd vs. Kd (HR = 0.59), calculated through a network meta-analysis (NMA), to the best-fit DVd PFS curve. Treatment duration was estimated by applying the ratio of median duration of treatment and reported median PFS from the trials to the median PFS calculated via the survival analysis and NMA. HRs, dosing amounts, dosing schedules, relative dose intensity, and adverse event (AE) incidence were extracted from the CASTOR and ENDEAVOR RCTs. Wholesale acquisition costs and administration costs were based on standard US sources. AE costs were sourced from published literature. Results: Median PFS estimates from the analysis for DVd and Kd were 16.9 and 10.0 months, respectively. Total costs were similar between the two treatments. However, average cost per median month of PFS was lower for DVd than for Kd. Results are presented in Table 1. Conclusions: Based on this analysis, average monthly cost per median month of PFS is lower for DVd compared to Kd in the treatment of multiple myeloma patients with at least one prior line of therapy. Cost Category DVd Kd Total drug acquisition $183,903 $161,753 Total adverse event $4,616 $3,265 Total administration $7,237 $5,393 Total Costs $195,755 $170,411 Calculated median PFS (months) 16.9 10.0 Cost per median month of PFS $11,597 $16,984
Convergent Evolution at the Pathway Level: Predictable Regulatory Changes during Flower Color Transitions
Authors: Maximilian Larter, Amy Dunbar-Wallis, Andrea E Berardi, Stacey D Smith
Journal: Molecular Biology and Evolution (2018)

The predictability of evolution, or whether lineages repeatedly follow the same evolutionary trajectories during phenotypic convergence remains an open question of evolutionary biology. In this study, we investigate evolutionary convergence at the biochemical pathway level and test the predictability of evolution using floral anthocyanin pigmentation, a trait with a well-understood genetic and regulatory basis. We reconstructed the evolution of floral anthocyanin content across 28 species of the Andean clade Iochrominae (Solanaceae) and investigated how shifts in pigmentation are related to changes in expression of seven key anthocyanin pathway genes. We used phylogenetic multivariate analysis of gene expression to test for phenotypic and developmental convergence at a macroevolutionary scale. Our results show that the four independent losses of the ancestral pigment delphinidin involved convergent losses of expression of the three late pathway genes (F3′5′h, Dfr, and Ans). Transitions between pigment types affecting floral hue (e.g., blue to red) involve changes to the expression of branching genes F3′h and F3′5′h, while the expression levels of early steps of the pathway are strongly conserved in all species. These patterns support the idea that the macroevolution of floral pigmentation follows predictable evolutionary trajectories to reach convergent phenotype space, repeatedly involving regulatory changes. This is likely driven by constraints at the pathway level, such as pleiotropy and regulatory structure.
First pediatric experience of SL-401, a CD123-targeted therapy, in patients with blastic plasmacytoid dendritic cell neoplasm: report of three cases
Authors: Weili Sun, Huaying Liu, Young Kim, Nicole Karras, Anna Pawlowska, Debbie Toomey, Wade Kyono, Paul Gaynon, Joseph Rosenthal, Anthony Stein
Journal: Journal of Hematology & Oncology (2018)

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a highly aggressive hematological malignancy with extremely poor outcome. The median overall survival for adult patients is 9–13 months. Pediatric patients are exceedingly rare with an unclear clinical course. Currently, no standardized therapy has been established, although an acute lymphoblastic leukemia type of treatment appears to be more effective in those patients who are able to tolerate aggressive chemotherapy. SL-401 is a targeted therapy directed to CD123, a protein ubiquitously expressed at high level on the surface of BPDCN blasts. In adult phase 2 trials, it has demonstrated efficacy with 90% overall response rate. No pediatric patients with BPDCN using SL-401 have been reported. Here, we report the first pediatric experience of three children with BPDCN treated with SL-401 at our institution. All patients tolerated SL-401 without significant toxicities. One patient with multiply relapsed and refractory disease had no response. The other two cases had significant and rapid clinical improvement after the two courses of treatment. However, the response was transient, and growth of soft tissue mass was observed in-between cycles in both patients with large tumor burden. This is the first report of SL-401 in pediatric patients with BPDCN. Sl-401 was well tolerated and can produce a promising response. Further testing this agent in children is warranted.
The Wind Reminds
Authors: Carol Snyder Halberstadt
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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
Predicting pathological complete response (pCR) to neoadjuvant trastuzumab in patients with breast cancer using HER2 mass spectrometry.
Authors: Elisa Gasparini, Fabiola Cecchi, Roberto di Cicilia, Elisabetta Kuhn, Giuseppe Falco, Guglielmo Ferrari, Moira Foroni, Ione Tamagnini, Cristina Bassano, Yuan Tian, Stephen Charles Benz, Todd A. Hembrough, Alessandra Bisagni
Journal: Journal of Clinical Oncology (2018)

e12643 Background: Around 40% of HER2-positive (HER2+) breast cancer patients who receive trastuzumab-based neoadjuvant therapy (TNT) achieve pCR (the FDA-recommended outcome measure in this setting). The ability to predict which patients will respond to TNT could support decisions regarding selection neoadjuvant agents or combinations. We previously quantified tumor expression of HER2 with mass spectrometry in archived biopsies of breast cancer patients who received adjuvant trastuzumab; HER2 levels > 2200 amol/ug of tumor protein were associated with superior disease-free and overall survival. We hypothesized that this HER2 protein cutoff would predict pCR in a HER2+ neoadjuvant population treated with TNT. Methods: Formalin-fixed, paraffin-embedded tumor biopsies from patients with breast cancer were microdissected and solubilized for proteomic profiling with multiplexed mass spectrometry. Patients were dichotomized using the pre-specified HER2 cutoff of 2200 amol/ug. Relationships between pre-treatment HER2 expression and pCR following TNT were assessed with Fisher’s exact test. Results: Of 65 evaluable patients, 18 achieved pCR (overall pCR rate 28%). In patients with HER2 expression above the 2200 cutoff (n = 30), the pCR rate was approximately 3 times higher than that of lower HER2 expressors (n = 35) (43% vs. 14%; [odds ratio = 4.47; [95% CI: 1.23-18.94], p = 0.013). Among the lower HER2 expressors, 86% did not achieve pCR. HER3 protein was co-expressed in 29 of 65 patient tumors including 50% of non-pCR samples. Conclusions: In patients diagnosed as HER2+ using standard methods, a quantitative HER2 cutoff identified a subset of low HER2 expressors in which 86% did not achieve pCR on TNT. Quantitative proteomic testing may be more useful than standard HER2 assessment methods in predicting response to TNT. Multiplexed proteomic analysis of HER2 and HER3 co-expression could potentially inform treatment decisions regarding dual therapy with pertuzumab.
TCT-100 Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves: Results from the Global Valve-in-Valve Registry
Authors: Danny Dvir, John Webb, Miralem Pasic, Sabine Bleiziffer, Ron Waksman, Ulrich Schäfer, Antonio Colombo, Josep Rodes-Cabau, Hendrik Treede, David Hildick-Smith, Fleur Descoutures, Thomas Walther, Christian Hengstenberg, Henrik Nissen, Raffi Bekeredjian, Enrico Ferrari, Stephan Windecker, Stephen Brecker, Jean-Claude Laborde, Ran Kornowski
Journal: Journal of the American College of Cardiology (2012)
Long-term consequences of exenterative surgery for people with pelvic cancer.
Authors: Jane Young, Michael Solomon, Daniel Steffens, Cherry Koh
Journal: Journal of Clinical Oncology (2018)

118 Background: For people with recurrent or locally advanced pelvic cancer with no evidence of metastatic spread, pelvic exenteration (PE) surgery that achieves clear (R0) resection margins is the only potentially curative treatment option. This extensive, radical surgery can involve removal of the pelvic organs, muscles, nerves and bone, resulting in significant impairment for patients. The aim of this study is to describe the long-term quality of life outcomes for this procedure, specifically to investigate levels of pain, vitality, depression and ability to achieve personal goals among survivors three or more years after surgery. Methods: The Royal Prince Alfred Hospital in Sydney is a national referral center for PE in Australia. Patient-reported outcome measures, including generic (SF36) and colorectal cancer-specific (FACT-C) measures of quality of life (QoL), pain, vitality, depression and self-reported ability to achieve personal goals are assessed pre-surgery, every six months to three years and then annually. Consecutive patients who were three or more years after PE comprised the sample for this study. Trajectories for patient reported outcomes were plotted and the proportion of survivors who experienced ongoing pain, vitality and depression at each time point were calculated. Results: Among 241 patients who were 3 years post-PE, 63 (26%, 95% CI: 21-32%) had died and 3-year QoL assessments were completed by 65 (51%) of survivors. Three years after surgery, mean QoL scores were similar to baseline and remained fairly stable among survivors to 5 years. There was a small decrease over time in the proportion of survivors reporting ongoing pain. From 3 years onwards, approximately 70% (95% CI: 58-79%) of survivors reported ongoing pain and 44% (95% CI: 34-57%) reported some level of depression. However, SF-36 vitality scores increased slightly from a mean of 46.2 pre-PE to 54.0 at 3 years. Conclusions: Despite the extensive nature of PE surgery, the majority of survivors achieved reasonable long-term quality of life. However, high levels of chronic pain and depression indicate ongoing needs for supportive care in this patient group.
Improved Outcome by Adding Concurrent Chemotherapy to Cetuximab and Radiotherapy for Locally Advanced Head and Neck Carcinomas: Results of the GORTEC 2007-01 Phase III Randomized Trial
Authors: Yungan Tao, Anne Auperin, Christian Sire, Laurent Martin, Cedric Khoury, Philippe Maingon, Etienne Bardet, Marie-Christine Kaminsky, Michel Lapeyre, Thierry Chatellier, Marc Alfonsi, Yoann Pointreau, Eric Jadaud, Bernard Géry, Ayman Zawadi, Jean-Marc Tourani, Brigitte Laguerre, Alexandre Coutte, Séverine Racadot, Ali Hasbini, Emanuelle Malaurie, Christian Borel, Nicolas Meert, Alexandre Cornely, Nathalie Ollivier, Odile Casiraghi, Xu Shan Sun, Jean Bourhis
Journal: Journal of Clinical Oncology (2018)

Purpose To investigate the effect of adding concurrent chemotherapy (CT) to cetuximab plus radiotherapy (RT; CT-cetux-RT) compared with cetuximab plus RT (cetux-RT) in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Patients and Methods In this phase III randomized trial, patients with N0-2b, nonoperated, stage III or IV (nonmetastatic) LA-SCCHN were enrolled. Patients received once-daily RT up to 70 Gy with weekly cetuximab or with weekly cetuximab and concurrent carboplatin and fluorouracil (three cycles). To detect a hazard ratio (HR) of 0.64 for progression-free survival (PFS) with 85% power at a two-sided significance level of P = .05, 203 patients needed to be included in each arm. Results Four hundred six patients were randomly assigned to either CT-cetux-RT or cetux-RT. Patient and tumor characteristics were well balanced between arms, including p16 status. With a median follow-up of 4.4 years, the HR for PFS favored the CT-cetux-RT arm (HR, 0.73; 95% CI, 0.57 to 0.94; P = .015), with 3-year PFS rates of 52.3% and 40.5% and median PFS times of 37.9 and 22.4 months in the CT-cetux-RT and cetux-RT arms, respectively. The HR for locoregional control was 0.54 (95% CI, 0.38 to 0.76; P &lt; .001) in favor of CT-cetux-RT. These benefits were observed regardless of p16 status for oropharynx carcinomas. Overall survival (HR, 0.80; P = .11) and distant metastases rates (HR, 1.19; P = .50) were not significantly different between the two arms. The CT-cetux-RT arm, compared with cetux-RT, had a higher incidence of grade 3 or 4 mucositis (73% v 61%, respectively; P = .014) and of hospitalizations for toxicity (42% v 22%, respectively; P &lt; .001). Conclusion The addition of concurrent carboplatin and fluorouracil to cetux-RT improved PFS and locoregional control, with a nonsignificant gain in survival. To our knowledge, this is the first evidence of a clinical benefit for treatment intensification using cetux-RT as a backbone in LA-SCCHN.
RCGP urges home secretary to act swiftly to enable foreign GPs to work in NHS
Authors: Gareth Iacobucci
Journal: BMJ (2018)

The Royal College of General Practitioners has urged Sajid Javid to act swiftly to change the UK’s current immigration rules to allow foreign GPs to take up positions that they have been offered in the NHS.

On 3 June Javid pledged to review the UK’s current restrictions on the number of foreign doctors coming to work under a tier 2 visa,1 after mounting pressure on …
Baseline anemia in patients with biliary tract cancer (BTC) and its association with survival: A retrospective cohort study.
Authors: Mark Doherty, Stephanie Moignard, Gonzalo Sapisochin, Grainne M. O'Kane, Mairead Geraldine McNamara, Anne M. Horgan, Raymond Woo-Jun Jang, David W. Hedley, Neesha C. Dhani, Jennifer J. Knox
Journal: Journal of Clinical Oncology (2018)

426 Background: The prognostic significance of anemia in BTC is unknown, but is common and may be multifactorial; data regarding its causes are limited. This study interrogated a large institutional database to examine the effect of anemia on overall survival (OS) in BTC, and explore factors associated with anemia. Methods: This Princess Margaret Cancer Centre cohort study included patients with BTC with available baseline hemoglobin (Hb) (1987-2016). Anemia was defined as Hb &lt; 132 mg/dL for men &gt; 60 years, &lt; 137mg/dL for men aged 20-59, and &lt; 122mg/dL in women. Additional relevant covariates were included in multivariable Cox regression for OS, and linear regression for association with Hb. Results: Of 1398 patients included, 711 (51%) were anemic at baseline (mean Hb 112 mg/dL). Anemic versus non-anemic patients were older (median age 66 vs 64 yrs, p = 0.006), had worse ECOG PS (12% ECOG 2-3 vs 6%, p &lt; .001), BMI &lt; 20 (31% vs 27%, p = 0.006) and elevated neutrophil:lymphocyte ratio (NLR), (64% vs 47%, p &lt; .001), but cancer staging was not significantly different. Anemia was associated with shorter OS on univariate (HR 1.35, p &lt; .001) and multivariable (HR 1.39, p &lt; .001) regression (Table). Factors associated with lower Hb included older age, male gender, worse ECOG PS, tumor site, thrombocytopenia, elevated NLR. Conclusions: Baseline anemia was associated with shorter survival following diagnosis of BTC, independent of tumor stage or ECOG PS. Clinicians should be aware of this prognostic marker; validation in prospective datasets is warranted. [Table: see text]
Abstract 9819: Comparison of Optical Coherence Tomography and Histopathology Findings Following Paclitaxel-Coating Balloon in Porcine In-Stent Stenosis Model
Authors: Arihiro Sumida, Alexander Nikanorov, Toshiro Shinke, Jinsheng Li, Jaipal Singh, Spencer King, Nicolas Chronos, Dongming Hou
Journal: Circulation (2011)

Background: Paclitaxel-Coating balloon (PCB) has shown efficacy for treatment of coronary artery disease. Optical coherence tomography (OCT) is a promising endovascular imaging devise and has been reported to have a high correlation with histomorphometric measurement. However, the association of in-stent stenosis (ISR) by OCT and histopathology response is still not fully addressed. The current study was designed to compare the OCT and histopathological findings following PCB treatment in a porcine ISR model. Materials and Methods: Thirty-two coronary arteries (LAD: n=12, LCX: n=11, RCA: n=9) of 24 Yorkshire pigs were assigned to two (2) groups randomly. PCB (SeQuent, length 20mm, n=16) or non-coating balloon (NCB, length 20mm n=16) were inflated for 60 seconds with B:A 1.2:1 followed by BMS (length 12mm) implantation (S/A 1.5:1) within the target region. At 28 days, animals underwent OCT and histopathology evaluation. Results: There were no significant differences between groups among parameters measured by OCT. The thickness of neointimal hyperplasia on stent strut and the percent of ISR were 585 ± 277 μ m, 46.8 ± 19.0 % for PCB, and 661 ± 237 μ m, 52.4 ± 15.3 % for NCB (p=NS, respectively). However, inflammation (PEB: 3.40 ± 0.84, NCB: 2.27 ± 1.18, p=0.003) and fibrin deposition scores (PCB: 2.31 ± 0.93, NCB: 0.81 ± 0.86, p&lt;0.001) were significantly higher in PCB compared to NCB. The OCT ISR% was positively correlated with inflammation score (PCB: r=0.62, and NCB: r=0.85; p&lt;0.05 respectively). Interestingly, fibrin deposition score only in PCB was negatively correlated with the OCT ISR% (r=-0.68, p=0.005). OCT also showed an uncovered (33.3%) and insufficient non-uniformed neointima (13.3%) in PCB group (p=0.008 vs NCB). Conclusions: OCT can be used as a valuable imaging tool to evaluate vessel wall histopathological changes in vivo. The higher inflammation and fibrin deposition scores in PCB may indicate a delayed healing response in the current experimental setting.