tbuckley/cabot-search huggingface dataset:
Impact of palliative care (PC) consultation on quality of end-of-life (EOL) care in advanced cancer patients receiving care at a tertiary cancer center (TCC).
Authors: Sharon Watanabe, Viane Faily, Yoko Tarumi, Robin Fainsinger, Aynharan Sinnarajah, Alexei Potapov, Vickie Baracos
Journal: Journal of Clinical Oncology (2017)

129 Background: Early integration of PC with oncological care has been shown to improve outcomes in patients with advanced cancer, including quality of life and mood. It has also been suggested to have a positive impact on quality of EOL care. The purpose of our study was to examine how occurrence and timing of PC consultation are associated with quality of EOL care in advanced cancer patients receiving care at a Canadian TCC. Methods: In this retrospective study, patients who died between April 1, 2013 and March 31, 2014, had advanced cancer while receiving care at our TCC, and lived in the catchment area of our urban comprehensive integrated PC program were eligible. Date of death, demographics, and cancer type were obtained from the cancer registry. Date of diagnosis of advanced cancer was determined from electronic medical records. Occurrence and date of PC consultation were identified from the PC database. Data on quality of EOL care indicators were retrieved from the cancer registry, including, in the last 30 days of life: emergency room visits, hospital admission, hospitalization &gt; 14 days, ICU admission, death in hospital, and chemotherapy use. Results: Of 1414 eligible patients, 1101 (77.9%) received PC consultation in hospital, outpatient clinic, or community. Patients who received PC consultation were younger than those who did not receive PC consultation (age 68.8 vs. 71.0, p = 0.01), and differed in the frequency of cancer types (p &lt; 0.001), but not sex, marital status, or income. 679 patients (48.0%) had at least 1 indicator of quality of EOL care. Patients who did and did not receive PC consultation did not differ in the frequency of any indicators of quality of EOL care. There were also no differences in frequency of quality of EOL care indicators between patients who received their first PC consultation &gt; 3 months vs. ≤3 months or &gt; 6 months vs. ≤6 months before death. Conclusions: Among advanced cancer patients receiving care at our TCC, occurrence and timing of PC consultation did not affect quality of EOL care. Methodological and healthcare system differences may explain the discrepancy between our results and those of other investigators. Further research is needed.
Pharmacokinetics of a sustained release formulation of PDGFβ-receptor directed carrier proteins to target the fibrotic liver
Authors: F. van Dijk, N. Teekamp, L. Beljaars, E. Post, J. Zuidema, R. Steendam, Y.O. Kim, H.W. Frijlink, D. Schuppan, K. Poelstra, W.L.J. Hinrichs, P. Olinga
Journal: Journal of Controlled Release (2017)

Liver fibrogenesis is associated with excessive production of extracellular matrix by myofibroblasts that often leads to cirrhosis and consequently liver dysfunction and death. Novel protein-based antifibrotic drugs show high specificity and efficacy, but their use in the treatment of fibrosis causes a high burden for patients, since repetitive and long-term parenteral administration is required as most proteins and peptides are rapidly cleared from the circulation. Therefore, we developed biodegradable polymeric microspheres for the sustained release of proteinaceous drugs. We encapsulated the drug carrier pPB-HSA, which specifically binds to the PDGFβR that is highly upregulated on activated myofibroblasts, into microspheres composed of hydrophilic multi-block copolymers composed of poly(l-lactide) and poly ethylene glycol/poly(ϵ-caprolactone), allowing diffusion-controlled release. Firstly, we estimated in mice with acute fibrogenesis induced by a single CCl4 injection the half-life of I125-labeled pPB-HSA at 40 min and confirmed the preferential accumulation in fibrotic tissue. Subsequently, we determined in the Mdr2 −/− mouse model of advanced biliary liver fibrosis how the subcutaneously injected microspheres released pPB-HSA into both plasma and fibrotic liver at 24 h after injection, which was maintained for six days. Although the microspheres still contained protein at day seven, pPB-HSA plasma and liver concentrations were decreased. This reduction was associated with an antibody response against the human albumin-based carrier protein, which was prevented by using a mouse albumin-based equivalent (pPB-MSA). In conclusion, this study shows that our polymeric microspheres are suitable as sustained release formulation for targeted protein constructs such as pPB-HSA. These formulations could be applied for the long-term treatment of chronic diseases such as liver fibrosis.
Prion seeding activity and infectivity in skin samples from patients with sporadic Creutzfeldt-Jakob disease
Authors: Christina D. Orrú, Jue Yuan, Brian S. Appleby, Baiya Li, Yu Li, Dane Winner, Zerui Wang, Yi-An Zhan, Mark Rodgers, Jason Rarick, Robert E. Wyza, Tripti Joshi, Gong-Xian Wang, Mark L. Cohen, Shulin Zhang, Bradley R. Groveman, Robert B. Petersen, James W. Ironside, Miguel E. Quiñones-Mateu, Jiri G. Safar, Qingzhong Kong, Byron Caughey, Wen-Quan Zou
Journal: Science Translational Medicine (2017)

Infectious prions can be detected in the skin of patients with sporadic Creutzfeldt-Jakob disease.
Interesting molecular alteration of lung adenocarcinoma in the Thai population
Authors: T. Reungwetwattana, N. Trachu, S. Detarkom, P. Incharoen, S. Pramyothin, W. Klaisuban, A. Jinawath, N. Iemwimangsa, S. Aiempradit, A. Charoenyingwattana, W. Pairoj, I. Senson, N. Monnamo, P. Janchompoo, C. Srichunrusami, K. Kampreresart, O. Trachoo, V. Tangsujaritvijit, M. Ngodnbamthaweesuk, W. Chantratita
Journal: Annals of Oncology (2017)
P3.02b-124 Efficacy of Osimertinib in Patients with Non-Small-Cell Lung Cancer (NSCLC) and Pleural Effusion
Authors: Saki Manabe, Masafumi Sata, Shuji Murakami, Tetsuro Kondo, Terufumi Kato, Haruhiro Saito, Akimasa Sekine, Takashi Ogura, Kouzo Yamada
Journal: Journal of Thoracic Oncology (2017)
Raising all boats in supportive oncology: Initial impact of the Coleman Supportive Oncology Collaborative (CSOC).
Authors: James Gerhart, Christine B. Weldon, William Dale, Urjeet Patel, Paramjeet Khosla, Shelly S. Lo, Carol Newsom, Patricia A. Robinson, Joanna Martin, Desiree Azizoddin, Eileen Knightly, Rosa Berardi, Aidnag Diaz, Teresa Lillis, Julia Rachel Trosman, Frank J. Penedo
Journal: Journal of Clinical Oncology (2017)

150 Background: The Institute of Medicine (IOM) and Commission on Cancer (CoC) recommend systematic delivery of supportive oncology and survivorship care to all cancer patients. CSOC aims to improve the quality of supportive care across Chicago-area providers. Methods: 35 CSOC participating institutions (cancer centers, support centers, hospice) formed care delivery design teams - Distress, Survivorship and Palliative. Teams collaboratively developed solutions to supportive oncology gaps: patient screening tools, care delivery processes, provider training, and quality metrics to assess supportive oncology quality and the CSOC impact. Six implementation centers (2 safety-net, 3 academic &amp; 1 public) reviewed charts at baseline (2014 diagnoses) and after the initial implementation period (2015 diagnoses), compared by frequencies and Fisher’s exact test. Results: Eight metrics contained patient data at 2 time points; improvements were seen in 7/8 metrics. (See Table). Conclusions: CSOC developed supportive oncology screening, and care processes aligned with IOM and CoC standards. Significant improvements were shown after implementation across diverse settings. Ongoing work will further evaluate the impact of CSOC efforts on patient care. [Table: see text]
Tumour histology and primary site but not MDM2 amplification levels are prognostic for clinical outcomes in well differentiated and dedifferentiated liposarcoma
Authors: W.H.W. Chew, J.Y. Chan, W.L. Goh, J.H.C. Lim, S.H. Tan, N. Somasundaram, E.Y.L. Poon, A.S.T. Lim, M.H. Tan, K.C. Soo, M. Teo, T.K.Y. Tay, S. Selvarajan, K. Sittampalam, R. Quek
Journal: Annals of Oncology (2017)
Amino-bisphosphonates, γδT cells, and their roles in Rheumatoid Arthritis
Authors: Wen-Xiu Mo, Shan-Shan Yin, Hua Chen, Xuan Zhang
Journal: Annals of the Rheumatic Diseases (2017)

We thank Dr Rossini and colleagues1 for their interesting comments on our manuscript.2

Aminobisphosphonates (N-BPs), the analogue of isopentenyl pyrophosphate, promote the activation and proliferation of peripheral γδ T cells, specifically Vγ9/Vδ2 T cells,3 which are the cells we showed that play an important role in the pathogenesis of rheumatoid arthritis (RA).2 We fully agree that γδ T cells are one of the major factors that may contribute to N-BPs-related acute phase response …
SERUM HBSAG LEVELS DURING PEGINTERFERON ALFA-2A TREATMENT IN HBEAG-POSITIVE CHRONIC HEPATITIS B: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL
Authors: Bo Hyun Kim, Won Kim, Eun Young Song, Myoung Hee Park, Youn Jae Lee, Eun Uk Jung, Yoon Jun Kim, Hyo-Suk Lee, Donghee Kim, Sung Jae Park, Jung-Hwan Yoon
Journal: Hepatology (2010)
Government shops will sell recreational marijuana in Ontario and Quebec
Authors: Owen Dyer
Journal: BMJ (2017)

Canada’s two biggest provinces will create public monopolies to manage chains of shops that will sell recreational marijuana to the public after it becomes legal in July 2018.

Five provinces have now laid out provisional business plans to ready themselves for a policy shift mandated by Canada’s federal parliament. Draft legislation from Quebec—the latest province to do so—adopts a similar approach to Ontario, which in early November named the first 14 cities and towns that will host these shops.

Both provinces have public …
Abstract 20061: Ambulatory Arrhythmia Detection With ZIO® XT Patch in Pediatric Patients
Authors: Jeffrey A Robinson, Karen Tsung, Eric Lu, Jill K Shivapour, Christopher S Snyder
Journal: Circulation (2016)

Introduction: Ambulatory electrocardiogram (ECG) monitoring devices are used for 24-72 hours to detect arrhythmias. A novel device, ZIO® XT Patch (ZIO), can be utilized for ECG monitoring for 14 da...
The risk of hepatocellular carcinoma in cirrhotic patients with hepatitis C and sustained viral response: Role of the treatment regimen
Authors: Hamish Innes, Stephen T. Barclay, Peter C. Hayes, Andrew Fraser, John F. Dillon, Adrian Stanley, Andy Bathgate, Scott A. McDonald, David Goldberg, Heather Valerio, Ray Fox, Nick Kennedy, Pete Bramley, Sharon J. Hutchinson
Journal: Journal of Hepatology (2017)
Results of implementing a novel supportive oncology screening tool for comprehensive evaluation of distress and other supportive care needs.
Authors: Paramjeet Khosla, Julia Rachel Trosman, James Gerhart, Urjeet Patel, Shelly S. Lo, Frank J. Penedo, Patricia A. Robinson, Aidnag Diaz, Teresa Lillis, Harry Miranda, Erika K. Radeke, Betty Roggenkamp, Mary Pasquinelli, Lawrence Eric Feldman, Joanna Martin, Sheetal Mehta Kircher, Sofia F. Garcia, Rosa Berardi, Christine B. Weldon
Journal: Journal of Clinical Oncology (2017)

61 Background: The Institute of Medicine (IOM) 2013 Report recommends that supportive oncology care start at cancer diagnosis; the Commission on Cancer (CoC) Standard 3.2 requires distress screening and indicated action. Screening tools are not standardized and often address only a portion of patients’ supportive oncology needs. Methods: A collaborative of 100+ clinicians, funded by The Coleman Foundation, developed a patient-centric screening tool adapted from NCCN Distress Problem List, IOM report and CoC standards, with validated sub-tools: PHQ-4 for anxiety and depression and PROMIS short forms for pain, fatigue and physical function. Novel treatment/care and other concerns were included. The screening tool was implemented at 4 cancer centers (2 academic, 1 public &amp; 1 safety-net). End points included correlation of PHQ-4 score with other supportive oncology needs. Descriptive statistics, Fisher’s exact test were used. Results: 2805 patients were screened. Average scores were: PHQ4 – Anxiety and Depression 1.8 (mild &gt; 3), Pain 4.5 (mild &gt; 4), Fatigue 8.8 (mild &gt; 6), Physical Function 20.2 (mild &lt; 20), see table for additional items. Higher scores on the PHQ-4 were significantly associated with each of the following: greater pain, fatigue, , nutritional and specific treatment/care concerns, and lower physical function (p&lt;.0001). (See Table). Conclusions: Patients with higher anxiety and depression also have many other supportive oncology concerns. Our results support the use of a comprehensive tool capturing a spectrum of each patient’s unique concerns. This may enable earlier interventions and personalized delivery of supportive care. [Table: see text]
A epidemiologia da infecção meningocócica em Inglaterra e Gales, 1996 e 1997
Authors: M E Ramsay, M Collins, M Rush, E Kaczmarksi
Journal: Eurosurveillance (1997)

A vigilância da infeccao meningococica em Inglaterra e Pais de Gales assenta em tres fontes de informacao. 
Os medicos estao obrigados a fazer a notificacao dos casos de meningite meningococica diagnosticados clinicamente e, desde 1989, os de septicemia meningococica (na ausencia de meningite) para a autoridade local no controlo das doencas transmissiveis (CDCC).
P2.03b-052 XRCC1 Arg399Gln and Rad51 G135C Gene Polymorphisms in Advanced Lung Adenocarcinoma in Serbia
Authors: Jelena Spasic, Nemanja Stanic, Davorin Radosavljevic, Ana Krivokuca, Mira Kuburovic, Bojan Zaric, Branislav Perin, Sinisa Radulovic, Radmila Jankovic, Milena Cavic
Journal: Journal of Thoracic Oncology (2017)
Half of doctors from other EEA countries working in UK may leave, poll shows
Authors: Gareth Iacobucci
Journal: BMJ (2017)

Almost half of doctors from other European Economic Area countries working in the UK are considering leaving in the wake of the EU referendum result, with almost a fifth having already made solid plans to relocate, a BMA survey has found.

Healthcare leaders expressed deep concern at the results of the poll and urged the government to offer certainty to the estimated 12 000 EEA doctors working in the NHS, who make up 7.7% of the UK medical workforce.

The BMA said that recruitment from elsewhere in Europe had been a crucial means of dealing with staff shortages and warned that NHS services would struggle …
The association between paternal and adolescent depressive symptoms: evidence from two population-based cohorts
Authors: Gemma Lewis, Martha Neary, Ela Polek, Eirini Flouri, Glyn Lewis
Journal: The Lancet Psychiatry (2017)

Incidence of depression increases markedly around age 13 years, and nearly three-quarters of adults report that their mental health problems started in adolescence. Although maternal depression is a risk factor for adolescent depression, evidence about the association between paternal and adolescent depression is inconclusive, and many studies have methodological limitations. We aimed to assess the association between paternal and adolescent depressive symptoms in two large population-based cohort studies.We used data for two-parent families from two representative prospective cohorts in Ireland (Growing up in Ireland [GUI]) and the UK (Millennium Cohort Study [MCS]). Parental depressive symptoms were measured with the Centre for Epidemiological Studies Depression Scale in the GUI cohort when children were 9 years old, and the Kessler six-item psychological distress scale in the MCS cohort when children were 7 years old. Adolescent depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) at age 13 years in the GUI cohort and age 14 years in the MCS cohort. We analysed data using linear regression models, before and after adjustment for confounders, in both multiply imputed and complete case samples.There were 6070 families in GUI and 7768 in MCS. After all adjustments, a 1 SD (three-point) increase in paternal depressive symptoms was associated with an increase of 0·24 SMFQ points (95% CI 0·03-0·45; p=0·023) in the GUI cohort and 0·18 SMFQ points (0·01-0·36; p=0·041) in the MCS cohort. This association was independent of, and not different in magnitude to, the association between maternal and adolescent depressive symptoms (Wald test p=0·435 in the GUI cohort and 0·470 in the MCS cohort).Our results show an association between depressive symptoms in fathers and depressive symptoms in their adolescent offspring. These findings support the involvement of fathers as well as mothers in early interventions to reduce the prevalence of adolescent depression, and highlight the importance of treating depression in both parents.Department of Children and Youth Affairs and Economic and Social Research Council.
Association of the Hospital Readmissions Reduction Program With Surgical Readmissions
Authors: Tudor Borza, Mary K. Oerline, Ted A. Skolarus, Edward C. Norton, Andrew M. Ryan, Chad Ellimoottil, Justin B. Dimick, Vahakn B. Shahinian, Brent K. Hollenbeck
Journal: JAMA Surgery (2017)

<h3>Importance</h3> Readmissions after surgery lead to poor patient outcomes and increased costs. The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals with excess readmissions after specified medical and surgical discharges. <h3>Objective</h3> To evaluate the association of the HRRP with readmissions after major joint surgery (targeted) and procedures with historically high rates not under its purview (nontargeted). <h3>Design, Setting, and Participants</h3> In this population-based analysis using a 20% Medicare sample, a retrospective cohort study was performed of patients undergoing one of 5 major surgical procedures between January 1, 2006, and November 30, 2014. The study included 507 663 patients with targeted (total knee arthroplasty and total hip arthroplasty) and 164 472 patients with nontargeted (abdominal aortic aneurysm repair, colectomy, and lung resection) procedures performed at 2773 hospitals. <h3>Exposure</h3> Implementation of the HRRP policy. <h3>Main Outcomes and Measures</h3> Hospital-level 30-day risk-adjusted rates of readmission and observation stays were calculated using multivariable logistic regression models. Changes in these rates were analyzed for 3 distinct periods (prepolicy [January 1, 2006, to June 30, 2010], performance [July 1, 2010, to June 30, 2013], and penalty [July 1, 2013, to November 30, 2014]) corresponding to the HRRP implementation timeline for major joint surgery using interrupted time series. <h3>Results</h3> Among 672 135 Medicare beneficiaries 66 years or older treated at 2773 hospitals, readmissions for all procedures decreased significantly over the study period. Readmission rates after targeted procedures decreased faster during the performance period (slope, −0.060; 95% CI, −0.079 to −0.041) compared with the prepolicy period (slope, −0.012; 95% CI, −0.027 to 0.034) (<i>P</i> &lt; .002). For the nontargeted procedures, readmission rates were decreasing during the prepolicy period (slope, −0.200; 95% CI, −0.240 to −0.160) but stabilized during the performance period (slope, 0.008; 95% CI, −0.049 to 0.066 (<i>P</i> &lt; .001). The use of observation stays increased slightly, accounting for 11% of the decrease in readmissions. <h3>Conclusions and Relevance</h3> The HRRP effectively decreased readmissions for targeted procedures. There were no associated spillover effects for common nontargeted procedures. A better understanding of differences in the association of the policy with medical and surgical discharges will be necessary to further enhance its generalizability.
The impact of the difference in total diameter of metastatic tumor as a prognostic factor for advanced gastric cancer treated with systemic chemotherapy
Authors: Y. Sasaki, J. Hirota, J. Konno
Journal: Annals of Oncology (2018)

Introduction: In a previous study, patients with resectable gastric cancer and enlarged lymph nodes that had a diameter ≥ 15 mm preoperatively were found to have worse outcomes. However, data on the significance of metastatic tumor diameter for stage IV gastric cancer treated with systemic chemotherapy are not available. Methods: This is a retrospective review of patients who received chemotherapy with fluoropyrimidine and platinum for stage IV gastric cancer at our institution between June 2009 and February 2017. Tumor lesions with long-axis diameters ≥ 10 mm and lymph nodes with short-axis diameters ≥ 15 mm as measured on CT scan before chemotherapy were regarded as measurable lesions. Patients were divided into groups based on the total diameters of all measurable lesions. Patient characteristics, toxicities, and survival were compared between the groups. Results: Among the 104 patients who received fluoropyrimidine and platinum based chemotherapy for stage IV gastric cancer, 62 had measurable lesions. The median total diameter was 54 mm, and 55 mm was set as the cut-off value for grouping patients into large (≥55 mm) and small Conclusion: A total metastatic tumor diameter ≥ 55 mm was a negative prognostic factor for advanced gastric cancer treated with systemic chemotherapy.
Maternal hypothyroidism in the perinatal period and childhood asthma in the offspring
Authors: X. Liu, S. L. Andersen, J. Olsen, E. Agerbo, V. Schlünssen, S. C. Dharmage, T. Munk‐Olsen
Journal: Allergy (2017)

There is increasing interest in the possible link between maternal hypothyroidism in the perinatal period and childhood asthma risk. We explored this in this study while accounting for the timing of hypothyroidism diagnosis. Further, we evaluated whether the risk was moderated by thyroid hormone treatment during pregnancy.We conducted a population-based cohort study using Danish national registers. All live-born singletons in Denmark from 1998 to 2007 were identified. Maternal hypothyroidism and asthma in the children were defined by data from the Patient Register and Prescription Registry. We estimated incidence rate ratios (IRRs) of asthma among children born to hypothyroid mothers versus children born to mothers with no recorded thyroid dysfunction using Poisson regression models.Of 595 669 children, 3524 children were born to mothers with hypothyroidism diagnosed before delivery and 4664 diagnosed after delivery. Overall, 48 990 children received treatment for asthma. The IRRs of asthma was 1.16 (95% confidence interval (CI): 1.03-1.30) and 1.12 (95% CI: 1.02-1.24) for children born to mothers with hypothyroidism diagnosed before and after delivery, compared to children born to mothers with no thyroid dysfunction. The highest risk was observed among children born to mothers with hypothyroidism diagnosed before delivery who did not receive thyroid hormone treatment during pregnancy (IRR=1.37, 95% CI: 1.04-1.80).Our findings suggest that maternal hypothyroidism, especially when it is untreated, increases childhood asthma risk. Early detection and appropriate treatment of hypothyroidism in pregnant women may be an area for possible prevention of childhood asthma.
Children need single point of access to talking therapies, says children’s commissioner
Authors: Abi Rimmer
Journal: BMJ (2017)

Like adults, young people should have a single point of access to talking therapies, the children’s commissioner for England has said.

Speaking to MPs on the House of Commons Health Committee on 21 November, Anne Longfield said that children should be able to access a service similar to the Improving Access to Psychological Therapies (IAPT) programme available to adults, which was designed to provide faster access to talking therapies for people with depression and anxiety disorders. The health committee is conducting an inquiry into the availability of child and adolescent mental health services.

Longfield said, “I went online and looked at the IAPT system …
Glycosylation Repurposes Alpha-1 Antitrypsin for Resolution of Community-acquired Pneumonia
Authors: Cormac McCarthy, Danielle M. Dunlea, Radka Saldova, Michael Henry, Paula Meleady, Oliver J. McElvaney, Brian Marsh, Pauline M. Rudd, Emer P. Reeves, Noel G. McElvaney
Journal: American Journal of Respiratory and Critical Care Medicine (2017)