tbuckley/cabot-search huggingface dataset:
Evaluating effectiveness in an urban comprehensive cancer survivorship program.
Authors: Emily Berry, Sandi Pruitt, Eric Borton, Aurelio Rodriguez, Keith Edward Argenbright
Journal: Journal of Clinical Oncology (2018)

35 Background: Advances in early detection and treatment has led to a growing cancer survivor population, many of whom have encountered devastating effects as a result of diagnosis and treatment. While this phase of care represents a distinct opportunity, evidence-based cancer survivorship programs are often only associated with large cancer centers or academic medical centers and are limited in scope because they are costly and poorly reimbursed. Moncrief Cancer Institute established its program using a community-based model to provide a patient-centered solution, offering evidence-based multidisciplinary services to survivors regardless of diagnosis, treatment provider, socioeconomic status, or insurance coverage. To improve sustainability, we intend to advance data available to insurers and policy makers to encourage service reimbursement. We are developing a comprehensive, linked data repository designed to facilitate effectiveness research for our cancer survivorship program. Methods: Focusing on patients affiliated with the safety-net health system, we use their tumor registry as the sampling frame. These data are then matched with the clinical services database for the survivorship program to create an intervention group, participants, and a matched comparison group of nonparticipants. The established cohort is then matched to electronic medical record data from JPS. Results: Data has been extracted and linked at the patient level, and scrubbed and de-identified for analysis. A total of 8,325 cancer patients were identified from the registry, of these 467 were survivorship program participants. Preliminary analysis is comparing participants to nonparticipants and characterizing program participation. Once completed, analysis will extend to surrogate measures for effectiveness, evaluating impact on healthcare utilization and screening/surveillance uptake. Conclusions: Our approach has created a tool to facilitate a better understanding of survivorship care. With this, we can provide novel evidence regarding participation in a comprehensive cancer survivorship program among urban safety-net healthcare system patients and evaluate impact at the patient and healthcare system levels.
Estrogen-induced miR-196a elevation promotes tumor growth and metastasis via targeting SPRED1 in breast cancer
Authors: Cheng-Fei Jiang, Zhu-Mei Shi, Dong-Mei Li, Ying-Chen Qian, Yi Ren, Xiao-Ming Bai, Yun-Xia Xie, Lin Wang, Xin Ge, Wei-Tao Liu, Lin-Lin Zhen, Ling-Zhi Liu, Bing-Hua Jiang
Journal: Molecular Cancer (2018)

Estrogen plays a critical role in breast cancer (BC) progression through estrogen receptor (ER)-mediated gene regulation. Emerging studies suggest that the malignant progress of BC cells is influenced by the cross talk between microRNAs (miRNAs) and ER-α signaling. However, the mechanism and functional linkage between estrogen and miRNAs remain unclear.The expression levels of miR-196a and SPRED1 in BC were tested by qRT-PCR in 46 paired BC and adjacent tissues and by the GEO datasets. The role of miR-196a in estrogen-induced BC development was examined by CCK-8 assay, wound healing assay, Matrigel invasion assay and tumorigenicity assay in nude mice. The binding site of ER-α in miR-196a promoter region was analyzed by ChIP-seq, ChIP assay and luciferase reporter assay. The potential targets of miR-196a in BC cells were explored using the luciferase reporter assay and western blot analysis, and the correlation between miR-196a and SPRED1 was analyzed by Spearman's correlation analysis in BC specimens and GEO dataset. TCGA BRCA data was used to characterize the ESR1 signatures according to MSigDB gene set.The expression levels of miR-196a were higher in ER-positive (ER+) breast tumors compared to ER-negative (ER-) tumor tissue samples. Besides, miR-196a was involved in estrogen-induced BC cell proliferation, migration and invasion. Notably, the up-regulation of miR-196a was mediated by a direct interaction with estrogen receptor α (ER-α) but not estrogen receptor β (ER-β) in its promoter region, and miR-196a expression levels were positively correlated to ER-α signature scores. Furthermore, SPRED1 was a new direct target of miR-196a which participated in miR-196a-promoted BC development and was suppressed by ligand-activated ER-α signal pathway. Finally, forced expression of miR-196a induced tumor growth of MCF7 cells, while inhibition of miR-196a significantly suppressed the tumor progress in vivo.Overall, the identification of estrogen/miR-196a/SPRED1 cascade will shed light on new molecular mechanism of estrogen signaling in BC development and therapy.
Obstetrician who delivered decapitated baby is cleared of wrongdoing by tribunal
Authors: Clare Dyer
Journal: BMJ (2018)

A consultant obstetrician whose attempt to deliver a premature baby feet first through a tight cervix ended in its decapitation will face no disciplinary sanction, after a medical practitioners tribunal found that her error of judgment did not amount to serious misconduct.

Vaishnavy Vilvanathan Laxman, 43, was nearing the end of a 24 hour split shift at Ninewells Hospital in Dundee in March 2014 when she was called to deal with a 30 year old first time mother, named only as Patient A, whose membranes had broken at 25 weeks’ gestation.

The baby was positioned feet first, the placenta was low, the mother was bleeding from the vagina, and the cervix was no more than 4 cm dilated and clamped around the baby’s calves.

Early in the …
Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society
Authors: Andrew M.D. Wolf, Elizabeth T.H. Fontham, Timothy R. Church, Christopher R. Flowers, Carmen E. Guerra, Samuel J. LaMonte, Ruth Etzioni, Matthew T. McKenna, Kevin C. Oeffinger, Ya‐Chen Tina Shih, Louise C. Walter, Kimberly S. Andrews, Otis W. Brawley, Durado Brooks, Stacey A. Fedewa, Deana Manassaram‐Baptiste, Rebecca L. Siegel, Richard C. Wender, Robert A. Smith
Journal: CA A Cancer Journal for Clinicians (2018)

Abstract In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC. Results from modeling analyses identified efficient and model‐recommendable strategies that started screening at age 45 years. The ACS Guideline Development Group applied the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria in developing and rating the recommendations. The ACS recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high‐sensitivity stool‐based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy. The recommendation to begin screening at age 45 years is a qualified recommendation . The recommendation for regular screening in adults aged 50 years and older is a strong recommendation . The ACS recommends ( qualified recommendations ) that: 1) average‐risk adults in good health with a life expectancy of more than 10 years continue CRC screening through the age of 75 years; 2) clinicians individualize CRC screening decisions for individuals aged 76 through 85 years based on patient preferences, life expectancy, health status, and prior screening history; and 3) clinicians discourage individuals older than 85 years from continuing CRC screening. The options for CRC screening are: fecal immunochemical test annually; high‐sensitivity, guaiac‐based fecal occult blood test annually; multitarget stool DNA test every 3 years; colonoscopy every 10 years; computed tomography colonography every 5 years; and flexible sigmoidoscopy every 5 years. CA Cancer J Clin 2018;68:250–281 . © 2018 American Cancer Society .
Journals retract four articles criticising vaccines by author who used a pseudonym
Authors: Nigel Hawkes
Journal: BMJ (2018)

A paper claiming a possible link between human papillomavirus (HPV) vaccine and a rise in cervical cancer has been retracted by the Indian Journal of Medical Ethics .1

The paper, drawing on publicly available data on cervical cancer incidence in Sweden, had been submitted by a scientist calling himself Lars Andersson and claiming a connection with the Karolinska Institute in Stockholm. After it was published on 30 April 2018, the institute denied knowledge of Andersson, who admitted when questioned by the journal that he had used a pseudonym.

The journal’s editors published a statement online on 9 May saying that the deception was unacceptable but did not retract …
Effects of water-aging for 6 months on the durability of a novel antimicrobial and protein-repellent dental bonding agent
Authors: Ning Zhang, Ke Zhang, Michael D. Weir, David J. Xu, Mark A. Reynolds, Yuxing Bai, Hockin H. K. Xu
Journal: International Journal of Oral Science (2018)

Biofilms at the tooth-restoration bonded interface can produce acids and cause recurrent caries. Recurrent caries is a primary reason for restoration failures. The objectives of this study were to synthesize a novel bioactive dental bonding agent containing dimethylaminohexadecyl methacrylate (DMAHDM) and 2-methacryloyloxyethyl phosphorylcholine (MPC) to inhibit biofilm formation at the tooth-restoration margin and to investigate the effects of water-aging for 6 months on the dentin bond strength and protein-repellent and antibacterial durability. A protein-repellent agent (MPC) and antibacterial agent (DMAHDM) were added to a Scotchbond multi-purpose (SBMP) primer and adhesive. Specimens were stored in water at 37 °C for 1, 30, 90, or 180 days (d). At the end of each time period, the dentin bond strength and protein-repellent and antibacterial properties were evaluated. Protein attachment onto resin specimens was measured by the micro-bicinchoninic acid approach. A dental plaque microcosm biofilm model was used to test the biofilm response. The SBMP + MPC + DMAHDM group showed no decline in dentin bond strength after water-aging for 6 months, which was significantly higher than that of the control (P < 0.05). The SBMP + MPC + DMAHDM group had protein adhesion that was only 1/20 of that of the SBMP control (P < 0.05). Incorporation of MPC and DMAHDM into SBMP provided a synergistic effect on biofilm reduction. The antibacterial effect and resistance to protein adsorption exhibited no decrease from 1 to 180 d (P > 0.1). In conclusion, a bonding agent with MPC and DMAHDM achieved a durable dentin bond strength and long-term resistance to proteins and oral bacteria. The novel dental bonding agent is promising for applications in preventive and restorative dentistry to reduce biofilm formation at the tooth-restoration margin.
UMI-count modeling and differential expression analysis for single-cell RNA sequencing
Authors: Wenan Chen, Yan Li, John Easton, David Finkelstein, Gang Wu, Xiang Chen
Journal: Genome biology (2018)

Read counting and unique molecular identifier (UMI) counting are the principal gene expression quantification schemes used in single-cell RNA-sequencing (scRNA-seq) analysis. By using multiple scRNA-seq datasets, we reveal distinct distribution differences between these schemes and conclude that the negative binomial model is a good approximation for UMI counts, even in heterogeneous populations. We further propose a novel differential expression analysis algorithm based on a negative binomial model with independent dispersions in each group (NBID). Our results show that this properly controls the FDR and achieves better power for UMI counts when compared to other recently developed packages for scRNA-seq analysis.
Durvalumab (MEDI4736) concurrent with nab-paclitaxel and dose dense doxorubicin cyclophosphamide (ddAC) as neoadjuvant therapy for triple negative breast cancer (TNBC).
Authors: Lajos Pusztai, Erin Wysong Hofstatter, Gina G. Chung, Nina Ruth Horowitz, Donald R. Lannin, Brigid K. Killelea, Anees B. Chagpar, Michael DiGiovanna, Courtney Frederick, Trisha Burello, Malini Harigopal
Journal: Journal of Clinical Oncology (2018)

586 Background: The goal of this Phase I/II trial is to assess the safety and efficacy of concurrent administration of durvalumab with weekly nab-paclitaxel (100 mg/m2) x 12 followed by dd AC x 4 as neoadjuvant therapy for stage I-III TNBC. The primary efficacy endpoint is pathologic complete response (ypT0 ypN0, pCR). Methods: The Phase I portion of the trial assessed two dose levels of durvalumab; 3 mg/kg and 10 mg/kg iv every 2 weeks in combination with chemotherapy, dose limiting toxicities (DLT) were evaluated over the entire 20 weeks of therapy. The Phase II portion follows Simon’s two step design, with early stopping for futility if < 7 patients achieve pCR among the first 22. Results: No DLT were encountered during the Phase I portion of the trial; the 10 mg/kg was recommended as the phase II dose. Thirty-two patients are enrolled in the trial 14 are still receiving therapy, 16 have completed treatment and underwent surgery and 1 patient withdraw consent. Nine patients (56%, 95% CI: 32%-78%) achieved pCR, 2 of the 4 patients at the 3 mg/kg dose level and 7 of the 12 at the 10 mg/kg dose. Eight patients (25%) experienced grade 3 adverse events including 3 patients with neutropenia (1 neutropenic fever), and one patient each with fatigue, dyspnea, line infection, transaminitis, hypertension/skin rash. No perioperative adverse events were seen. Conclusions: Concomitant administration of durvalumab with weekly nab-paclitaxel and sequential ddAC neoadjuvant chemotherapy is safe and the pCR rates appear to be higher than what is expected with chemotherapy alone. Clinical trial information: NCT02489448.
Colorectal cancer: US guidelines urge screening from age 45 as incidence soars in younger adults
Authors: Owen Dyer
Journal: BMJ (2018)

New guidelines from the American Cancer Society (ACS) recommend lowering the starting age for routine colorectal cancer screening by five years to age 45, driven by a relentless climb in incidence among younger adults in recent decades even as the disease has become rarer overall.1

Colorectal cancer was falling in all age groups until the mid-1980s, when it began to climb in young patients while continuing to fall in those over 55. Colorectal cancers have increased by 51% since 1994 among adults under 50, the society said. And this rise in risk is most striking in the youngest adults.

In adults …
Folliculitis decalvans: Effectiveness of therapies and prognostic factors in a multicenter series of 60 patients with long-term follow-up
Authors: Laura Miguel-Gómez, Ana R. Rodrigues-Barata, Ana Molina-Ruiz, Antonio Martorell-Calatayud, Pablo Fernández-Crehuet, Ramón Grimalt, Didac Barco, Salvador Arias-Santiago, Cristina Serrano-Falcón, Francisco M. Camacho, David Saceda-Corralo, Pedro Jaén-Olasolo, Sergio Vañó-Galván
Journal: Journal of the American Academy of Dermatology (2018)
Excluding Observation Stays from Readmission Rates — What Quality Measures Are Missing
Authors: Amber K. Sabbatini, Brad Wright
Journal: New England Journal of Medicine (2018)

Readmission rates are broadly accepted by payers and policymakers as a measure of hospital quality. But with providers increasingly relying on observation stays as an alternative to inpatient care, readmission measures may be omitting a key part of the quality equation.
Abstract 19678: Anderson-Fabry Disease in Patients With Hypertrophic Cardiomiopathy: Differential Diagnosis
Authors: Guilherme A Athayde, Gustavo A Silva, Fernanda P Trovão, Edileide B Correia, Renato Borges, Marcos Vasconcellos, Fabiano C Albrecht
Journal: Circulation (2016)

Introduction:  Anderson-Fabry disease (AFD) is a rare pathology which is inherited by the X chromosome. It is caused by mutations of the gene that encodes the α-galactosidase A lysosomal enzyme. It is associated with multisystemic disorders, including renal, cutaneous, neurological and cardiac manifestations. The isolated cardiac form is even rarer, with few reports in the literature. The differential diagnosis with Hypertrophic Cardiomyopathy (HC) is hard, although it is essential because AFD has a specific treatment.   Hypothesis:  We assessed the prevalence of AFD and the factors related to its diagnosis in patients initially diagnosed with HC.   Methods:  We randomly selected a cohort of 106 patients with an initial diagnosis of HC, and applied genetic and/or enzymatic testing for AFD, during the period of January 2013 to January 2016. All patients had only cardiac manifestations. We assigned patients into 2 groups (positive Vs. negative test for AFD) and evaluated them clinically, demographically, echocardiographically and electrocardiographically. Univariate analyzes were performed using the chi-square and Fisher tests.   Results:  Three patients presented positive genetic and/or enzymatic testing for AFD (2.8%). The presence of three or more risk factors for sudden death (SD) was a significant factor for the diagnosis of AFD (p = 0.001) as well as the indication of Implantable Cardioverter Defibrillator (ICD) (p = 0.017), right anterior fascicular block (RAFB) in the electrocardiogram (p = 0.047), septal thickness > 25mm (p=0.04) and left ventricular mass (LVM) > 400g (p =0.022). The diagnosis of AFD was not correlated statistically to gender, race, thickness of the LV posterior wall, but there was a trend for association with left atrial enlargement (p = 0.055) and SD in relatives under 40 years old (p = 0.074).   Conclusions:  The differential diagnosis of HC and AFD can be done by considering factors such as: septal thickness > 25 mm, the presence of three or more risk factors for SD, LVM > 400 g, indication of ICD and RAFB in the electrocardiogram, which in this study were statistically associated with the diagnosis of AFD. The prevalence of AFD in a random cohort of patients initially diagnosed with MH was similar to that found in other studies in the literature (2.8%).
A discrete choice experiment to examine the preferences of patients with cancer and their willingness to pay for different types of health care appointments.
Authors: Shu Fen Wong, Richard Norman, Trisha L Dunning, David M Ashley, Mustafa Khasraw, Paula K Lorgelly
Journal: Journal of Clinical Oncology (2015)

6527 Background: Little comparative data exist on how patients with cancer make choices about accessing health care appointments. Our study used a discrete choice experiment (DCE) to better understand patient preferences regarding their cancer care and potential trade-offs between health care appointment characteristics. Methods: Patients diagnosed with cancer at 3 hospitals were recruited to complete a self-administered DCE. Each version of the questionnaire (n = 16) had 8 paired choice scenarios where each health care appointment scenario described 6 attributes (identified through qualitative analysis): expertise of the doctor; familiarity of the doctor with their medical history; waiting time for an appointment; permitted accompaniment by family/friends; travel times to appointments and out-of-pocket costs. Patient preferences were estimated using logistic regression; willingness to pay (WTP) estimates for different aspects were then derived. Results: 185 out of 512 patients (36%) returned the questionnaire. Mean age was 61 yrs (22–92 yrs), and the majority was female (60%). Mean time since cancer diagnoses was 34 mths, 90% had received cancer treatment and 61% had early stage disease. The most important attributes for determining patient preferences were the expertise and familiarity of the doctor with their medical history; distance travelled was least likely to influence patient preferences. The WTP analysis found that patients were willing to pay $705 to consult specialists with higher expertise, $572 to consult doctors familiar with their medical history, $464 for shorter waiting times for appointments, $410 to be accompanied by family/friends and $342 for shorter travelling times to appointments. Conclusions: Our study could guide the development of patient-centered health care models, with an emphasis on the most important appointment characteristics; models should improve patient access to experienced doctors, and support the role of primary care providers in the community. Interventions to reduce waiting and travel times for appointments and to accommodate medical escorts still influenced patient choices, but to a lesser degree.
Immune-Related Adverse Events—A Novel Prediction of Nivolumab Efficacy?—Reply
Authors: Koji Haratani, Hidetoshi Hayashi, Kazuhiko Nakagawa
Journal: JAMA Oncology (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 Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal