tbuckley/cabot-search huggingface dataset:
Influence of Cardiovascular Risk Communication Tools and Presentation Formats on Patient Perceptions and Preferences
Authors: Ann Marie Navar, Tracy Y. Wang, Xiaojuan Mi, Jennifer G. Robinson, Salim S. Virani, Veronique L. Roger, Peter W. F. Wilson, Anne C. Goldberg, Eric D. Peterson
Journal: JAMA Cardiology (2018)

<h3>Importance</h3> Practice guidelines recommend that clinicians engage patients in treatment decisions and explain atherosclerotic cardiovascular disease (ASCVD) risk but do not describe how to communicate this risk most effectively. <h3>Objective</h3> To determine how the ASCVD risk time horizon, outcome, and presentation format influence risk perceptions and treatment preferences. <h3>Design, Setting, and Participants</h3> From May 27, 2015, through November 12, 2015, participants from the Patient and Provider Assessment of Lipid Management Registry at 140 US cardiology, primary care, and endocrinology practices were presented 3 independent scenarios (representing the same hypothetical patient) and asked to rate their perceived risk and willingness to take medication to lower risk in light of (1) a 15% 10-year ASCVD event risk, (2) a 4% 10-year cardiovascular disease (CVD) death risk, and (3) a 50% lifetime ASCVD event risk. <h3>Exposures</h3> Participants were randomized to receive risk estimates using numbers only, a bar graph, or a face pictogram. <h3>Results</h3> Of 3566 eligible participants, 2708 (76.9%) responded (median age, 67 years [interquartile range, 61-76 years]; 280 [10.3%] African American; 1491 men [55.1%]). When shown the lifetime ASCVD risk, respondents were more likely to consider the risk “high to very high” than when presented the 10-year ASCVD risk or the CVD death risk (70.1% vs 31.4% vs 25.7%, respectively; both<i>P</i> &lt; .001). Treatment willingness was also the highest for lifetime ASCVD risk (77.9% very willing) followed by 10-year ASCVD risk (68.1%) and 10-year CVD death risk (63.1%; both<i>P</i> &lt; .001). Compared with participants who were shown a bar graph or no graphic, those who were shown the risk information with a pictogram had the lowest perception of disease severity and the lowest willingness to consider therapy. These findings were robust across demographic and socioeconomic subgroups. <h3>Conclusions and Relevance</h3> The format, time horizon, and outcome used for risk estimation influence patient perceptions and should be considered when designing risk communication tools. When shown lifetime risk estimates, patients had higher risk perception and willingness for therapy than when shown 10-year estimates. Pictogram risk displays may decrease risk perception and consideration for treatment.
A New Tool to Capture Patients’ Perceptions of the Effects of Lung Transplantation
Authors: Jeffrey J. Swigris
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

than women (5).Humoral and cellular antiviral immune responses are stronger in women.However, this could also increase aberrant responses such as autoimmunity in women relative to men.Ghosh, and colleagues (5) have reviewed the mechanisms involved for these sexrelated differences.Of course there are the hormonal influences.And it turns out that many immune response genes are encoded on the X chromosome.One of the two X chromosomes is inactivated in female cells.Thus, a loss-of-function mutation in one of these X-linked immune response genes would be expressed in one-half of the cells in women, but all the cells in men, resulting in increased X-linked immunodeficiency in men.We know that inflammation can be both good and bad.Good is controlling infection; bad is contributing to the symptoms and tissue damage in influenza.Although men are less able than women to mount an immune defense against the influenza virus, the findings of Rebuli and colleagues suggest that men have increased expression of inflammation-related genes in the nasal mucosa relative to women at baseline, and further increase inflammatory gene responses to LAIV infection with prior exposure to wood smoke.Thus, men have more difficulty than women in fighting off influenza, and prior wood smoke exposure may enhance the inflammatory response, and hence the severity, of influenza.There are important limitations to this study.We do not know the degree to which the sex differences in gene expression observed by Rebuli and colleagues in response to wood smoke and LAIV are the result of shifts in the type of cells recovered from the nose.We are not provided with a differential cell count for the nasal lavage, but it is likely that the observed changes in gene expression reflect in part an influx of inflammatory cells into the nose in response to these combined challenges, rather than just changes in gene expression of resident nasal epithelial cells.Also, it needs to be kept in mind that this study was not optimally designed to examine sex differences.Such a study would ideally include equal and sufficient numbers of men and women, with restricted, balanced randomization by sex to wood smoke versus filtered air.Perhaps the biggest problem is the relatively small number of subjects in each exposure group; for example, 8 men exposed to wood smoke and 9 to filtered air.This increases the possibility of spurious results that may not hold up in a larger study.Thus, these findings should be considered hypothesis generating, and not definitive.Despite these limitations, Rebuli and colleagues have made important contributions to our understanding of interactions among a pollutant exposure, influenza virus infection, and sex.Their data remind us that males differ from females, sometimes with opposing effects that may "cancel" each other in aggregate analyses.Sex needs to be considered in study design, especially with regard to immune and inflammatory responses.
Metabolic Risk Factors in Hepatocellular Carcinoma
Authors: Andra-Iulia Suceveanu, Laura Mazilu, Andreea-Daniela Gheorghe, Anca Pantea Stoian, Felix Voinea, Adrian-Paul Suceveanu
Journal: Liver Cancer (2018)

Hepatocellular carcinoma (HCC) is the most frequent primary malignancy of the liver and it is one of the leading causes of cancer-related deaths worldwide. The global burden of hepatocellular carcinoma is growing nowadays. Most cases of hepatocellular carcinoma develop in the background of chronic hepatitis C and B and liver cirrhosis‑well-known risk factor. But despite the reducing incidence of chronic hepatitis infections, an increase in the incidence of hepatocellular carcinoma was observed in the last decades. This could be explained by the increasing prevalence of obesity, type 2 diabetes mellitus, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), which are becoming important risk factors in hepatocellular carcinoma. Regular surveillance, as performed for patients with viral hepatitis, is required for patients with metabolic risk factors.
Incorporating the societal cost of greenhouse gases into the price of foods could save lives from cardiovascular disease and cancer in England: a comparative risk assessment modelling study
Authors: A Briggs, A Kehlbacher, R Tiffin, T Garnett, M Rayner, P D Scarborough
Journal: PLoS Medicine (2013)

Background Climate change has been described as ‘the biggest global health threat of the 21st century’. Taxation based on greenhouse gas (GHG) emissions is a potential mechanism for internalising the wider costs of climate change to society. We ask whether such a tax on UK food and drink would have a positive impact on climate change and UK population health, and what revenue it would raise.   Methods and Findings The Living Costs and Food Survey (LCF) is used to derive baseline UK consumption data and food prices. Food specific GHG emissions are taken from a World Wildlife Fund report; cross- and own-price elasticities derived from LCF data are used to model changes in consumption following application of taxes. Health outcomes are modelled by a comparative risk assessment model.  Two tax scenarios are modelled, where taxation levels are based on a UK governmental agriculture marginal abatement cost curve: (a)	a tax of £2.72/tonne carbon dioxide equivalents (tCO2e)/100g product applied to all food and drink groups with above average emissions. (b)	as with scenario (a) but food groups with emissions below average are subsidised to create a tax neutral scenario.  Scenario (a) results in 6,750 (95% credible intervals: 6,150 to 7,350) deaths averted and a reduction in GHG emissions of 18,800 (14,700 to 23,000) ktCO2e per year. Annual revenue generated from this tax scenario is £2.03 (1.98 to 2.07) billion.  Scenario (b) results in 3,720 (2,980 to 4,460) extra deaths and a reduction in GHG emissions of 16,100 (12,000 to 20,400) ktCO2¬e per year.    Conclusions Incorporating the societal cost of greenhouse gases into the price of foods could save nearly 7,000 lives in the UK each year, reduce food-related GHG emissions, and generate substantial tax revenue. The revenue neutral scenario (b) demonstrates that sustainability and health goals are not always aligned.
Including practical issues and patient perspectives in Rapid Recommendations
Authors: Anja Fog Heen, Per Olav Vandvik, Thomas Agoritsas
Journal: BMJ (2018)

Treatment burden is an often ignored but crucial element in guidelines and clinical decision making.1 We would like to point out some recent advances.

Treatment burden could be appraised in a broader framework of “practical issues” related to how a treatment or test will affect a patient’s daily life. These include issues related to drug routine, the need for subsequent tests, …
Moving Precision Oncology Forward Amid Myths and Misconceptions
Authors: Filip Janku, Kenneth R. Hess, Timothy A. Yap
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
Prognostic impact of regression in patients with primary cutaneous melanoma &gt;1 mm in thickness
Authors: Simone Ribero, Francesca Galli, Simona Osella-Abate, Luca Bertero, Laura Cattaneo, Barbara Merelli, Carlo Tondini, Laura Ghilardi, Vincenzo De Giorgi, Marcella Occelli, Pietro Quaglino, Paola Cassoni, Giuseppe Palmieri, Daniela Massi, Mario Mandala, Paola Queirolo, Ignazio Stanganelli, Gerardo Botti, Corrado Caracò, Vanna Chiarion Sileni, Anna Maria Di Giacomo
Journal: Journal of the American Academy of Dermatology (2018)
Establishment of a patient-derived xenograft (PDX) model with malignant pleural effusion and its application
Authors: S. Chen, C.-P. Huang, H.-H. Lai, Y.-H. Lin, C.-T. Su, S.-J. Wu, C.-H. Chang, C.-C. Tsao, Y.-C. Chen, S.-C. Wang, Y.-H. Liu, S.-B. Lin, T.-H. Chen
Journal: Annals of Oncology (2018)
Abstract 15081: Determinants of Improvement in Renal Function Among Patients With Chronic Kidney Disease Who Participated in Cardiac Rehabilitation
Authors: Tetsuo Arakawa, Reon Kumasaka, Michio Nakanishi, Kazuyasu Nakao, Shigefumi Fukui, Takahiro Ohara, Masanobu Yanase, Teruo Noguchi, Satoshi Yasuda, Hisao Ogawa, Yoichi Goto
Journal: Circulation (2015)

Background: The safety and efficacy of cardiac rehabilitation (CR) in patients with chronic kidney disease (CKD) have not been established. There are conflicting reports about the effects of exercise on renal function in CKD patients, and there have been no studies about the determinants of change in renal function. The aims of this study are 1) to clarify the effect of CR and 2) to investigate the determinants of change in renal function in cardiac patients with CKD. Methods: A total of 759 consecutive cardiac patients with CKD (estimated glomerular filtration rate (eGFR) &lt;60 ml/min/1.73 m2) who participated in CR were studied. All patients underwent measurements of eGFR and peak oxygen uptake (PVO2) before and 3 months after CR. Patients were divided into quartiles based on their change in eGFR. We compared the characteristics of patients in the first quartile (improved eGFR group) and the fourth quartile (worsened eGFR group). Results: Overall, after 3-months CR program, eGFR (47.4 to 49.8 ml/min/1.73 m2, p&lt;0.0001) and PVO2 (1108 to 1237 ml/min, p&lt;0.0001) increased and BNP decreased (253 to 195pg/ml, p&lt;0.0001) significantly. The improved eGFR patients (n=190, eGFR 48.4 to 62.3 ml/min/1.73m 2 ) were younger (65.5 vs. 71.4 years, p&lt;0.0001). They also had higher body mass index (BMI, 23.2 vs. 22.3 kg/m2, p&lt;0.0001), higher LVEF (44% vs 39%, p&lt;0.001), higher PVO2 (73.2% vs. 65.4%, p&lt;0.0001), and lower BNP (206 pg/ml vs. 297 pg/ml, p&lt;0.0001) than the worsened eGFR group (n=190, eGFR 48.4 to 41.6 ml/min/1.73 m2). A lower proportion of the improved eGFR group had heart failure (13% vs. 39%, p&lt;0.001). There were similar levels of statistically significant improvement in PVO2 after CR in both groups. In the multiple regression analysis, younger age, higher BMI, higher baseline PVO2, lower baseline eGFR, and greater improvement in PVO2 after CR were independent determinants of eGFR improvement. Conclusion: In cardiac patients with CKD, CR improved exercise tolerance without worsening renal function. Greater improvement in PVO2 was associated with greater improvement in eGFR after CR, suggesting that CR has a protective effect on the kidney in these patients.
Characterization of Genomic Landscape and Risk Stratification of De Novo Cytogenetically Normal Acute Myeloid Leukaemia
Authors: Sze Pui Tsui, Tommy W.F. Tang, Ho-Wan Ip, Jason Chi Chiu So, Chun Hang Au, Edmond S. K. Ma, Chris TL Chan, Margaret Ng, Kelvin C K Cheng, Kit Fai Wong, Lisa L.P. Siu, Sze Fai Yip, Sy Lin, Szeman June Lau, T.H. Luk, Harold K K Lee, Chi Kuen Lau, Bonnie Kho, Chunxiao Zhang, Yok Lam Kwong, Anskar Y.-H. Leung
Journal: Blood (2018)
Abstract 15207: Impact of Monitor Watchers on Nurses’ Knowledge of Electrocardiographic Monitoring and Accuracy of Arrhythmia Detection in the PULSE Trial
Authors: Marjorie Funk, Krista Knudson, Kristopher Fennie, Kimberly Stephens
Journal: Circulation (2017)

Introduction: Electrocardiographic (ECG) telemetry monitors are ubiquitous in hospitals. In some units, dedicated monitor watchers continuously observe for ECG abnormalities. These monitor watchers...
JAK2V617F but not CALR mutations confer increased molecular responses to interferon-α via JAK1/STAT1 activation
Authors: Julia Czech, Sabrina Cordua, Barbora Weinbergerova, Julian Baumeister, Assja Crepcia, Lijuan Han, Tiago Maié, Ivan G. Costa, Bernd Denecke, Angela Maurer, Claudia Schubert, Kristina Feldberg, Deniz Gezer, Tim H. Brümmendorf, Gerhard Müller-Newen, Jiri Mayer, Zdenek Racil, Blanka Kubesova, Trine Knudsen, Anders L. Sørensen, Morten Holmström, Lasse Kjær, Vibe Skov, Thomas Stauffer Larsen, Hans C. Hasselbalch, Nicolas Chatain, Steffen Koschmieder
Journal: Leukemia (2018)
Association Between Black Race and Presentation and Liver-Related Outcomes of Patients With Autoimmune Hepatitis
Authors: Ynto S. de Boer, Alessio Gerussi, Floris F. van den Brand, Guan-Wee Wong, Neil Halliday, Rodrigo Liberal, Joost P.H. Drenth, Douglas Thorburn, Gerd Bouma, Michael A. Heneghan, N.M. van Gerven, U. Beuers, K.J. van Erpecum, H.R. van Buuren, J.W. den Ouden, J.T. Brouwer, J.M. Vrolijk, R.C. Verdonk, B. van Hoek, G.H. Koek, M.M.J. Guichelaar, E. Bloemena, C.M.J. van Nieuwkerk, T.C.M.A. Schreuder, E.J. van der Wouden, J.J.M. van Meyel, L.C. Baak, P.H.G.M. Stadhouders, M. Klemt-Kropp, M.A.M.T. Verhagen, A. Bhalla, J.Ph. Kuijvenhoven
Journal: Clinical Gastroenterology and Hepatology (2018)
Abstract 13364: Carotid Artery Wave Intensity Measured in Mid- to Late-Life Predicts Future Cognitive Decline: The Whitehall II Study
Authors: Scott T Chiesa, Stefano Masi, Martin Shipley, Elizabeth A Ellins, Alan G Fraser, Alun D Hughes, Ashraf W Khir, Julian P Halcox, Archana Singh-Manoux, Mika Kivimaki, David S Celermajer, John E Deanfield
Journal: Circulation (2018)

Introduction: Accumulating evidence suggests that vascular risk factors may contribute to the development of dementia. Increased pulse pressure (PP) is hypothesized to impair cognitive function due...
Abstract 15416: Evaluation of the Association Between Aortic Dimensions, Biophysical Properties and Plasma Biomarkers in Children and Adult Patients With Marfan Syndrome
Authors: Kevin C Harris, Jason Z Cui, Leslie A Raffin, James E Potts, Astrid De Souza, Zsuzsanna Hollander, Heidi Paine, Bruce M McManus, Cornelis Van Breemen, Mitra Esfandiarei, George G Sandor
Journal: Circulation (2017)

Introduction: Clinical management in Marfan syndrome (MFS) patients is based on the severity of aortic root dilatation that is associated with abnormal aortic biophysical properties. Circulating tr...
Author Correction: Neuroimmune disorders of the central nervous system in children in the molecular era
Authors: Elizabeth Wells, Yael Hacohen, Amy Waldman, Jan M. Tillema, Ariane Soldatos, Beau Ances, Susanne Benseler, Bibi Bielekova, Russel C. Dale, Josep Dalmau, William Gaillard, Mark Gorman, Benjamin Greenberg, Ann Hyslop, Carlos A. Pardo, Robert C. Tasker, E. Ann Yeh, Amit Bar-Or, Sean Pittock, Adeline Vanderver, Brenda Banwell
Journal: Nature Reviews Neurology (2018)
Association of Nurse Workload With Missed Nursing Care in the Neonatal Intensive Care Unit
Authors: Heather L. Tubbs-Cooley, Constance A. Mara, Adam C. Carle, Barbara A. Mark, Rita H. Pickler
Journal: JAMA Pediatrics (2018)

Quality improvement initiatives demonstrate the contribution of reliable nursing care to gains in clinical and safety outcomes in neonatal intensive care units (NICUs); when core care is missed, outcomes can worsen.To evaluate the association of NICU nurse workload with missed nursing care.A prospective design was used to evaluate associations between shift-level workload of individual nurses and missed care for assigned infants from March 1, 2013, through January 31, 2014, at a 52-bed level IV NICU in a Midwestern academic medical center. A convenience sample of registered nurses who provided direct patient care and completed unit orientation were enrolled. Nurses reported care during each shift for individual infants whose clinical data were extracted from the electronic health record. Data were analyzed from January 1, 2015, through August 13, 2018.Workload was assessed each shift with objective measures (infant-to-nurse staffing ratio and infant acuity scores) and a subjective measure (the National Aeronautics and Space Administration Task Load Index [NASA-TLX]).Missed nursing care was measured by self-report of omission of 11 essential care practices. Cross-classified, multilevel logistic regression models were used to estimate associations of workload with missed care.A total of 136 nurses provided reports of shift-level workload and missed nursing care for 418 infants during 332 shifts of 12 hours each. When workload variables were modeled independently, 7 of 12 models demonstrated a significant worsening association of increased infant-to-nurse ratio with odds of missed care (eg, nurses caring for ≥3 infants were 2.51 times more likely to report missing any care during the shift [95% credible interval, 1.81-3.47]), and all 12 models demonstrated a significant worsening association of increased NASA-TLX subjective workload ratings with odds of missed care (eg, each 5-point increase in a nurse's NASA-TLX rating during a shift was associated with a 34% increase in the likelihood of missing a nursing assessment for his or her assigned infant[s] during the same shift [95% credible interval, 1.30-1.39]). When modeling all workload variables jointly, only 4 of 12 models demonstrated significant association of staffing ratios with odds of missed care, whereas the association with NASA-TLX ratings remained significant in all models. Few associations of acuity scores were observed across modeling strategies.The workload of NICU nurses is significantly associated with missed nursing care, and subjective workload ratings are particularly important. Subjective workload represents an important aspect of nurse workload that remains largely unmeasured despite high potential for intervention.
Evolutionary dynamics of residual disease in human glioblastoma
Authors: I. Spiteri, G. Caravagna, G.D. Cresswell, A. Vatsiou, D. Nichol, A. Acar, L. Ermini, K. Chkhaidze, B. Werner, R. Mair, E. Brognaro, R.G.W. Verhaak, G. Sanguinetti, S.G.M. Piccirillo, C. Watts, A. Sottoriva
Journal: Annals of Oncology (2018)

BackgroundGlioblastoma is the most common and aggressive adult brain malignancy against which conventional surgery and chemoradiation provide limited benefit. Even when a good treatment response is obtained, recurrence inevitably occurs either locally (∼80%) or distally (∼20%), driven by cancer clones that are often genomically distinct from those in the primary tumour. Glioblastoma cells display a characteristic infiltrative phenotype, invading the surrounding tissue and often spreading across the whole brain. Cancer cells responsible for relapse can reside in two compartments of residual disease that are left behind after treatment: the infiltrated normal brain parenchyma and the sub-ventricular zone. However, these two sources of residual disease in glioblastoma are understudied because of the difficulty in sampling these regions during surgery.Patient and methodsHere, we present the results of whole-exome sequencing of 69 multi-region samples collected using fluorescence-guided resection from 11 patients, including the infiltrating tumour margin and the sub-ventricular zone for each patient, as well as matched blood. We used a phylogenomic approach to dissect the spatio-temporal evolution of each tumour and unveil the relation between residual disease and the main tumour mass. We also analysed two patients with paired primary-recurrence samples with matched residual disease.ResultsOur results suggest that infiltrative subclones can arise early during tumour growth in a subset of patients. After treatment, the infiltrative subclones may seed the growth of a recurrent tumour, thus representing the 'missing link' between the primary tumour and recurrent disease.ConclusionsThese results are consistent with recognised clinical phenotypic behaviour and suggest that more specific therapeutic targeting of cells in the infiltrated brain parenchyma may improve patient's outcome.