tbuckley/cabot-search huggingface dataset:
Quality improvement pilot of a palliative care model in an outpatient community cancer clinic setting.
Authors: Diane De Vos-Schmidt, Brian Anthony DiCarlo, Matt Katics
Journal: Journal of Clinical Oncology (2018)

138 Background: The need for outpatient based palliative care in community cancer clinics has been repeatedly identified, but poorly integrated. Cancer patients benefit from focused attention on the alleviation of symptoms related to either disease or treatment. Methods: A pilot program was developed for use in the outpatient community cancer clinic setting. This program sought to determine feasibility in this setting. It was limited to one medical oncologist and one palliative care APRN. Modifications were made in the electronic medical record to accommodate scheduling, documentation on a palliative care specific progress note and billing. Complete palliative care assessment included: symptom burden assessment, distress analysis using ESAS tool, 10 system physical exam, social, spiritual and emotional history and assessments. Ancillary services of chaplaincy and social services were also available. Home palliative care services were provided by a palliative care accredited home health agency. Initial consult visits were billed 99215, lasting 60 minutes. Follow up visits were billed 99214, lasting 30 min. Family conferences, with the patient present, were billed at the 99215. Results: Sample size was 44 patients: 23% pancreatic cancer, 13% upper gastrointestinal cancers, 13% lung cancer, 11% prostate cancer, 6% each colorectal, ovarian, and hematologic malignancies. The sample size was smaller than anticipated as not all eligible patients were referred. Reports from patients, families, and medical providers were all positive. Conclusions: The program will now be expanded to the entire San Luis Obispo Oncology and Hematology health clinic. This will include five medical oncologist and four advanced practice providers as referral sources. It is anticipated that at least one full time palliative care APRN will be needed. The model was found to be feasible with the additional support of a chaplin, clinic social services, and home health palliative care. The goal is to reduce symptom burden and improve quality of life.
A national survey of medical students and educators at Korean medical schools, examining the impact of end-of-life care education provided to Korean medical students based on their attitudes.
Authors: Do Yeun Kim, Kyong-Jee Kim, Sung Joon Shin, Dae Seog Heo, Soon-Nam Lee, Eun Mi Nam
Journal: Journal of Clinical Oncology (2018)

55 Background: This study explored the current state of end-of-life (EoL) care education provided to Korean medical students and their self-rated attitudes toward EoL-related education. Methods: An anonymous survey was given to fourth year medical s tudents and the principle EoL care educators at all 41 Korean medical schools. The medical educators were asked to identify the EoL care-related topics that they usually teach students. Both students and medical educators completed seven items regarding self-perceived attitudes. Results: In total, 23 medical educators (56.1%) and 1,545 medical students (46.3%) responded. Of nine topics related to EoL care, the most frequently taught topics were delivering bad news (100%) and managing physical symptoms (74.1%), whereas setting treatment goals was taught the least frequently (37.0%). Approximately half of the educators taught the withdrawal of life-sustaining devices (59.3%), death and dying (55.6%), and advanced directives (55.6%). When the medical students were dichotomized into groups taught at least six topics (n = 815) versus five or fewer topics (n = 729), the group taught at least six topics expressed more satisfaction with EoL care education and they considered EoL care-related issues during their clerkship rotations. They also had fewer negative answers when they were asked about their readiness to practice EoL care. Conclusions: EoL education is inadequate for Korean medical students. However, medical students who were more fully instructed in this topic reported self-rated competency regarding EoL care-related issues. Further research should develop an education system that provides sufficient knowledge and training in EoL care for Korean medical students.
Flipping the Switch: Initial Results of Genetic Targeting of the Fetal to Adult Globin Switch in Sickle Cell Patients
Authors: Erica B. Esrick, Christian Brendel, John P Manis, Myriam A Armant, Helene Negre, Colleen Dansereau, Marioara Felicia Ciuculescu, Stephanie Patriarca, Brenda Mackinnon, Heather Daley, Shanna Richard, Daniela Abriss, Renee Maxwell, Stephen Braunewell, Lauryn Christiansen, Sarah Nikiforow, Jerome Ritz, Maureen Achebe, Olivier Negre, Leslie E. Lehmann, Matthew M Heeney, Alessandra Biffi, David A. Williams
Journal: Blood (2018)
Learning to Surf
Authors: Renee Brown Harmon
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Initial Diagnostic Work-Up of Acute Leukemia: ASCO Clinical Practice Guideline Endorsement of the College of American Pathologists and American Society of Hematology Guideline
Authors: Valérie de Haas, Nofisat Ismaila, Anjali Advani, Daniel A. Arber, Raetasha S. Dabney, Dipti Patel-Donnelly, Elizabeth Kitlas, Rob Pieters, Ching-Hon Pui, Kendra Sweet, Ling Zhang
Journal: Journal of Clinical Oncology (2018)

The College of American Pathologists (CAP) and the American Society of Hematology (ASH) developed an evidence-based guideline on the initial diagnostic work-up of acute leukemia (AL). Because of the relevance of this topic to the ASCO membership, ASCO reviewed the guideline and applied a set of procedures and policies for endorsing clinical practice guidelines that have been developed by other professional organizations.The CAP-ASH guideline on initial diagnostic work-up of AL was reviewed for developmental rigor by methodologists. Then, an ASCO Endorsement Expert Panel updated the literature search and reviewed the content and recommendations.The ASCO Expert Panel determined that the recommendations from the guideline, published in 2016, are clear, thorough, and based on the most relevant scientific evidence. ASCO fully endorsed the CAP-ASH guideline on initial diagnostic work-up of AL and included some discussion points according to clinical practice and updated literature.Twenty-seven guideline statements were reviewed. Some discussion points were included to better assess CNS involvement in leukemia and to provide novel insights into molecular diagnosis and potential markers for risk stratification and target therapy. These discussions are categorized into four sections: (1) initial diagnosis focusing on basic diagnostics and determination of risk parameters, (2) molecular markers and minimal residual disease detection, (3) context of referral to another institution with expertise in the management of AL, and (4) reporting and record keeping for better outlining and follow-up discussion. Additional information is available at: www.asco.org/hematologic-malignancies-guidelines .
Glucose-Sensitive Myokine/Cardiokine MG53 Regulates Systemic Insulin Response and Metabolic Homeostasis
Authors: Hong-Kun Wu, Yan Zhang, Chun-Mei Cao, Xinli Hu, Meng Fang, Yuan Yao, Li Jin, Gengjia Chen, Peng Jiang, Shuo Zhang, Ruisheng Song, Wei Peng, Fenghua Liu, Jiaojiao Guo, Lifei Tang, Yanyun He, Dan Shan, Jin Huang, Zhuan Zhou, Dao Wen Wang, Fengxiang Lv, Rui-Ping Xiao
Journal: Circulation (2019)

Mitsugumin 53 (MG53 or TRIM72), a striated muscle-specific E3 ligase, promotes ubiquitin-dependent degradation of the insulin receptor and insulin receptor substrate-1 and subsequently induces insulin resistance, resulting in metabolic syndrome and type 2 diabetes mellitus (T2DM). However, it is unknown how MG53 from muscle regulates systemic insulin response and energy metabolism. Increasing evidence demonstrates that muscle secretes proteins as myokines or cardiokines that regulate systemic metabolic processes. We hypothesize that MG53 may act as a myokine/cardiokine, contributing to interorgan regulation of insulin sensitivity and metabolic homeostasis.Using perfused rodent hearts or skeletal muscle, we investigated whether high glucose, high insulin, or their combination (conditions mimicking metabolic syndrome or T2DM) alters MG53 protein concentration in the perfusate. We also measured serum MG53 levels in rodents and humans in the presence or absence of metabolic diseases, particularly T2DM. The effects of circulating MG53 on multiorgan insulin response were evaluated by systemic delivery of recombinant MG53 protein to mice. Furthermore, the potential involvement of circulating MG53 in the pathogenesis of T2DM was assessed by neutralizing blood MG53 with monoclonal antibodies in diabetic db/db mice. Finally, to delineate the mechanism underlying the action of extracellular MG53 on insulin signaling, we analyzed the potential interaction of MG53 with extracellular domain of insulin receptor using coimmunoprecipitation and surface plasmon resonance assays.Here, we demonstrate that MG53 is a glucose-sensitive myokine/cardiokine that governs the interorgan regulation of insulin sensitivity. First, high glucose or high insulin induces MG53 secretion from isolated rodent hearts and skeletal muscle. Second, hyperglycemia is accompanied by increased circulating MG53 in humans and rodents with diabetes mellitus. Third, systemic delivery of recombinant MG53 or cardiac-specific overexpression of MG53 causes systemic insulin resistance and metabolic syndrome in mice, whereas neutralizing circulating MG53 with monoclonal antibodies has therapeutic effects in T2DM db/db mice. Mechanistically, MG53 binds to the extracellular domain of the insulin receptor and acts as an allosteric blocker.Thus, MG53 has dual actions as a myokine/cardiokine and an E3 ligase, synergistically inhibiting the insulin signaling pathway. Targeting circulating MG53 opens a new therapeutic avenue for T2DM and its complications.
Finding the Balance Between Benefits and Harms When Using Statins for Primary Prevention of Cardiovascular Disease
Authors: Henock G. Yebyo, Hélène E. Aschmann, Milo A. Puhan
Journal: Annals of Internal Medicine (2018)

Many guidelines use expected risk for cardiovascular disease (CVD) during the next 10 years as a basis for recommendations on use of statins for primary prevention of CVD. However, how harms were considered and weighed against benefits is often unclear.To identify the expected risk above which statins provide net benefit.Quantitative benefit-harm balance modeling study.Network meta-analysis of primary prevention trials, a preference survey, and selected observational studies.Persons aged 40 to 75 years with no history of CVD.10 years.Clinicians and guideline developers.Low- or moderate-dose statin versus no statin.The 10-year risk for CVD at which statins provide at least a 60% probability of net benefit, with baseline risk, frequencies of and preferences for statin benefits and harms, and competing risk for non-CVD death taken into account.Younger men had net benefit at a lower 10-year risk for CVD than older men (14% for ages 40 to 44 years vs. 21% for ages 70 to 75 years). In women, the risk required for net benefit was higher (17% for ages 40 to 44 years vs. 22% for ages 70 to 75 years). Atorvastatin and rosuvastatin provided net benefit at lower 10-year risks than simvastatin and pravastatin.Most alternative assumptions led to similar findings.Age-specific data for some harms were not available.Statins provide net benefits at higher 10-year risks for CVD than are reflected in most current guidelines. In addition, the level of risk at which net benefit occurs varies considerably by age, sex, and statin type.Swiss Government Excellence Scholarship Office, Béatrice Ederer-Weber Foundation, and North-South Cooperation at the University of Zurich.
SITC 2018 workshop report: Immuno-Oncology Biomarkers: State of the Art
Authors: Lisa H. Butterfield, Mary L. Disis, Bernard A. Fox, David R. Kaufman, Samir N. Khleif, Ena Wang
Journal: Journal for ImmunoTherapy of Cancer (2018)

Identification of biomarkers in cancer immunotherapy that predict therapeutic response and/or limit adverse events are a critical need in the field. To address recent progress and hurdles around cancer biomarker development and utilization, the Society for Immunotherapy of Cancer (SITC) convened a workshop, "Immuno-Oncology Biomarkers: State of the Art," on May 16–17, 2018. Topics discussed included challenges in handling biospecimens, identification and validation of new biomarkers, data sharing, and collaborating across disciplines to advance biomarker development. Panel discussions followed session presentations to help foster participant conversation and discuss future projects and collaborations. The results of the Workshop include the development of new initiatives for the SITC Biomarkers Committee.
18F-Choline PET/CT in Leptomeningeal Breast Cancer Metastases
Authors: Lea Cuppari, Pasquale Reccia, Marta Burei, Anna Rita Cervino, Laura Evangelista
Journal: Clinical Nuclear Medicine (2018)

We describe a case of 47-year-old woman affected by human epidermal growth factor receptor-2-positive breast cancer with a diffuse leptomeningeal carcinomatosis. An intense uptake of F-choline was reported at fused PET/MRI images in the brain, compatible with a diffuse leptomeningeal disease. This case highlights that F-choline PET would be used for the identification of leptomeningeal involvement in patients affected by breast cancer, as a support of MRI images.
Updated Safety and Efficacy from the Copanlisib CHRONOS-1 Trial in Patients with Relapsed or Refractory Indolent B-Cell Lymphoma: Low Incidence of Late-Onset Severe Toxicities
Authors: Martin Dreyling, Armando Santoro, Luigina Mollica, Sirpa Leppa, George Follows, Georg Lenz, Won Seog Kim, Arnon Nagler, Panayiotis Panayiotidis, Judit Demeter, Muhit Ozcan, Marina Kosinova, Krimo Bouabdallah, Franck Morschhauser, Don A Stevens, David Trevarthen, Massimo Magagnoli, Tatiane Ishida, Cindy Lu, Florian Hiemeyer, Ashok Miriyala, Jose Garcia-Vargas, Barrett H. Childs, Pier Luigi Zinzani
Journal: Blood (2017)
Abstract 14965: Subclinical Coronary Plaque Volumes Are Associated With the Strength of Sibling History in Families With Early-Onset Coronary Disease
Authors: Brian G Kral, Lisa R Yanek, Dhananjay Vaidya, Taryn F Moy, Elliot K Fishman, Lewis C Becker, Diane M Becker
Journal: Circulation (2013)

Background: A sibling history of early onset coronary artery disease (CAD) is a potent risk factor for future clinically manifest CAD. We examined whether healthy persons from families with early onset CAD, without known CAD themselves, but with a greater number of siblings affected with CAD (strong sib history, defined as ≥50% of siblings in the family) have higher subclinical coronary plaque volumes compared to those with a lesser sib history (only the proband or <50% of siblings affected in the family). Methods: Apparently healthy participants in GeneSTAR (N=338) with at least one affected sibling with CAD <60 years of age provided pedigree and family history information and were screened for CAD risk factors, and coronary plaque using advanced dual-source CT angiography. Non-calcified and calcified plaque volumes (mm3) were quantified using automated methods and summed for total plaque volume (TP). A multivariate GEE regression model controlled for age, sex, race, current smoking, hypertension, diabet...
Sorafenib with or without concurrent transarterial chemoembolization in patients with advanced hepatocellular carcinoma: The phase III STAH trial
Authors: Joong-Won Park, Yoon Jun Kim, Do Young Kim, Si-Hyun Bae, Seung Woon Paik, Youn-Jae Lee, Hwi Young Kim, Han Chu Lee, Sang Young Han, Jae Youn Cheong, Oh Sang Kwon, Jong Eun Yeon, Bo Hyun Kim, Jaeseok Hwang
Journal: Journal of Hepatology (2018)

Sorafenib is first-line standard of care for patients with advanced hepatocellular carcinoma (HCC), yet it confers limited survival benefit. Therefore, we aimed to compare clinical outcomes of sorafenib combined with concurrent conventional transarterial chemoembolization (cTACE) vs. sorafenib alone in patients with advanced HCC.In this investigator-initiated, multicenter, phase III trial, patients were randomized to receive sorafenib alone (Arm S, n = 169) or in combination with cTACE on demand (Arm C, n = 170). Sorafenib was started within 3 days and cTACE within 7-21 days of randomization. The primary endpoint was overall survival (OS).For Arms C and S, the median OS was 12.8 vs. 10.8 months (hazard ratio [HR] 0.91; 90% CI 0.69-1.21; p = 0.290); median time to progression, 5.3 vs. 3.5 months (HR 0.67; 90% CI 0.53-0.85; p = 0.003); median progression-free survival, 5.2 vs. 3.6 months (HR 0.73; 90% CI 0.59-0.91; p = 0.01); and tumor response rate, 60.6% vs. 47.3% (p = 0.005). For Arms C and S, serious (grade ≥3) adverse events occurred in 33.3% vs. 19.8% (p = 0.006) of patients and included increased alanine aminotransferase levels (20.3% vs. 3.6%), hyperbilirubinemia (11.8% vs. 3.0%), ascites (11.8% vs. 4.2%), thrombocytopenia (7.2% vs. 1.2%), anorexia (7.2% vs. 1.2%), and hand-foot skin reaction (10.5% vs. 11.4%). A post hoc subgroup analysis compared OS in Arm C patients (46.4%) receiving ≥2 cTACE sessions to Arm S patients (18.6 vs. 10.8 months; HR 0.58; 95% CI 0.40-0.82; p = 0.006).Compared with sorafenib alone, sorafenib combined with cTACE did not improve OS in patients with advanced HCC. However, sorafenib combined with cTACE significantly improved time to progression, progression-free survival, and tumor response rate. Sorafenib alone remains the first-line standard of care for patients with advanced HCC.For patients with advanced hepatocellular carcinoma requiring sorafenib therapy, co-administration with conventional transarterial chemoembolization did not improve overall survival compared to sorafenib alone. Therefore, sorafenib alone remains the first-line standard of care for patients with advanced hepatocellular carcinoma. Clinical Trial Number: NCT01829035.
The Origin and Population History of the Endangered Golden Snub-Nosed Monkey (<i>Rhinopithecus roxellana</i>)
Authors: Wei-Min Kuang, Chen Ming, Hai-Peng Li, Hong Wu, Laurent Frantz, Christian Roos, Ya-Ping Zhang, Cheng-Lin Zhang, Ting Jia, Jing-Yuan Yang, Li Yu
Journal: Molecular Biology and Evolution (2018)

The origin and population history of the endangered golden snub-nosed monkey (Rhinopithecus roxellana) remain largely unavailable and/or controversial. We here integrate analyses of multiple genomic markers, including mitochondrial (mt) genomes, Y-chromosomes, and autosomes of 54 golden monkey individuals from all three geographic populations (SG, QL, and SNJ). Our results reveal contrasting population structures. Mt analyses suggest a division of golden monkeys into five lineages: one in SNJ, two in SG, and two in QL. One of the SG lineages (a mixed SG/QL lineage) is basal to all other lineages. In contrast, autosomal analyses place SNJ as the most basal lineage and identify one QL and three SG lineages. Notably, Y-chromosome analyses bear features similar to mt analyses in placing the SG/QL-mixed lineage as the first diverging lineage and dividing SG into two lineages, while resembling autosomal analyses in identifying one QL lineage. We further find bidirectional gene flow among all three populations at autosomal loci, while asymmetric gene flow is suggested at mt genomes and Y-chromosomes. We propose that different population structures and gene flow scenarios are the result of sex-linked differences in the dispersal pattern of R. roxellana. Moreover, our demographic simulation analyses support an origin hypothesis suggesting that the ancestral R. roxellana population was once widespread and then divided into SNJ and non-SNJ (SG and QL) populations. This differs from previous mt-based "mono-origin (SG is the source population)" and "multiorigin (SG is a fusion of QL and SNJ)" hypotheses. We provide a detailed and refined scenario for the origin and population history of this endangered primate species, which has a broader significance for Chinese biogeography. In addition, this study highlights the importance to investigate multiple genomic markers with different modes of inheritance to trace the complete evolutionary history of a species, especially for those exhibiting differential or mixed patterns of sex dispersal.
Femtosecond Lasers for Ophthalmic Surgery Enabled by Chirped-Pulse Amplification
Authors: Daniel Palanker
Journal: New England Journal of Medicine (2018)

This year's Nobel Prize in Physics, awarded to Donna Strickland and Gérard Mourou, recognizes their invention that enabled the development of femtosecond lasers. These lasers have revolutionized ophthalmic surgery.
Nanogel‐Tectonic Materials: Nanogel Tectonics for Tissue Engineering: Protein Delivery Systems with Nanogel Chaperones (Adv. Healthcare Mater. 23/2018)
Authors: Yoshihide Hashimoto, Sada‐atsu Mukai, Yoshihiro Sasaki, Kazunari Akiyoshi
Journal: Advanced Healthcare Materials (2018)

Amphiphilic polysaccharide self-assembled (SA) nanogels are attractive nanocarriers for biologics owing to their chaperone-like activity by nano-encapsulating biologics inside their polymer network in the isolated state. Recently, nanogel-tectonic materials that integrate SA nanogels as building blocks have been designed as new hydrogel biomaterials. In article number 1800729, Kazunari Akiyoshi and co-workers describe recent progress and applications of SA nanogel tectonic materials as protein delivery systems for tissue engineering.