tbuckley/cabot-search huggingface dataset:
Preoperative Visceral Adiposity and Muscularity Predict Poor Outcomes after Hepatectomy for Hepatocellular Carcinoma
Authors: Yuhei Hamaguchi, Toshimi Kaido, Shinya Okumura, Atsushi Kobayashi, Hisaya Shirai, Siyuan Yao, Shintaro Yagi, Naoko Kamo, Satoru Seo, Kojiro Taura, Hideaki Okajima, Shinji Uemoto
Journal: Liver Cancer (2018)

Visceral adiposity, defined as a high visceral-to-subcutaneous adipose tissue area ratio (VSR), has been shown to be associated with poor outcomes in several cancers. However, in the surgical field, the significance of visceral adiposity remains controversial. The present study investigated the impact of visceral adiposity as well as sarcopenic factors (low muscularity) on outcomes in patients undergoing hepatectomy for hepatocellular carcinoma (HCC).This retrospective study analyzed data from 606 patients undergoing hepatectomy for HCC at our institution between April 2005 and March 2016. Using preoperative plain computed tomography imaging at the level of the third lumbar vertebra, visceral adiposity, skeletal muscle mass, and muscle quality were evaluated by the VSR, skeletal muscle mass index (SMI), and intramuscular adipose tissue content (IMAC), respectively. The impact of these parameters on outcomes after hepatectomy for HCC was analyzed.The overall survival rate was significantly lower among patients with a high VSR (p < 0.001) than among patients with a normal VSR. Similarly, the recurrence-free survival rate was significantly lower among patients with a high VSR (p = 0.016). A high VSR, low SMI, and high IMAC contributed to an increased risk of death (p < 0.001) and HCC recurrence (p < 0.001) in an additive manner. Multivariate analysis showed that not only preoperative low muscularity but also visceral adiposity was a significant risk factor for mortality (hazard ratio [HR] = 1.566, p < 0.001) and HCC recurrence (HR = 1.329, p = 0.020) after hepatectomy for HCC.Preoperative visceral adiposity, as well as low muscularity, was closely related to poor outcomes after hepatectomy for HCC. It is crucial to establish a new strategy including perioperative nutritional interventions with rehabilitation for better outcomes after hepatectomy for HCC.
Fear of cancer recurrence and associations with mental health status and individual characteristics among cancer survivors: Findings from a nationally representative sample.
Authors: Sarah C. Reed, Janice Bell, Larissa Nekhlyudov, Nathan Fairman, Jill G. Joseph, Diana L Miglioretti
Journal: Journal of Clinical Oncology (2018)

147 Background: Fear of cancer recurrence (FCR) and related constructs are experienced by many cancer survivors and are consistently identified as important areas of need. This study adds to sparse literature on this topic by describing the prevalence of FCR and testing its associations with mental health status measures in a US sample of cancer survivors. Methods: Using the Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (n = 1,032), we examined socio-demographic, health and mental health characteristics of cancer survivors by their level of fear of cancer recurrence (none, low, high). Survey-weighted population-based estimates describe the prevalence of key variables. Multinomial logistic regression was used to test associations between validated measures of mental health status and individual characteristics, and levels of FCR in models unadjusted and controlling for socio-demographic and health characteristics. MEPS survey weights were applied in all analyses to account for the survey design. Results: Overall, 34% of cancer survivors reported no FCR, 54% reported low FCR, and 11% reported high FCR. Cancer survivors were at increased risk of reporting high FCR relative to no FCR if they had a low 12-item Short Form Health Survey (SF-12) Mental Component Summary (MCS) score (≤48) compared to high scores (odds ratio = 2.89; 95% confidence interval (CI) = 1.58, 5.32). Reporting depressive symptoms or psychological distress did not significantly increase the risk of reporting high or low FCR relative to no FCR. Conclusions: This study is the first to provide US population-based estimates of associations between FCR and individual, health and mental characteristics. Our results also provide valuable information on which survivors are most at-risk for FCR, and add to a new and growing literature supporting FCR as a multidimensional construct distinct from depression and distress. Future research is needed to more clearly differentiate FCR from other constructs, specifically anxiety disorders, and to identify clinically significant levels of FCR to better target survivors with the highest needs.
Ridesharing and Text Messaging for Patients With Medicaid—Further Information
Authors: Lisa K. Sharp
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Exposures Related to House Dust Microbiota in a U.S. Farming Population
Authors: Mi Kyeong Lee, Megan U. Carnes, Natasha Butz, M. Andrea Azcarate-Peril, Marie Richards, David M. Umbach, Peter S. Thorne, Laura E. Beane Freeman, Shyamal D. Peddada, Stephanie J. London
Journal: Environmental Health Perspectives (2018)

Background: Environmental factors can influence the house dust microbiota, which may impact health outcomes. Little is known about how farming exposures impact the indoor microbiota. Objective: We aimed to identify exposures related to bacterial communities in house dust in a U.S. farming population. Methods: We used 16S rRNA amplicon sequencing to characterize bacterial communities in vacuumed dust samples from the bedrooms of a subset of 879 households of farmers and farmers' spouses enrolled in the Agricultural Lung Health Study (ALHS), a case–control study of asthma nested within the Agricultural Health Study (AHS) in North Carolina and Iowa. Information on current farming (past 12 mo), including both crop and animal farming, and other potential microbial sources was obtained via questionnaires. We used linear regression to evaluate associations between exposures and bacterial diversity within each sample, analysis of similarity (ANOSIM), and permutational multivariate analysis of variance (PERMANOVA) to identify exposures related to diversity between samples, and analysis of composition of microbiome to examine whether exposures related to diversity were also related to differential abundance of specific operational taxonomic units (OTUs). Results: Current farming was positively associated with bacterial diversity in house dust, with or without adjustment for nonfarm exposures related to diversity, including presence of indoor pets, home condition, and season of dust collection. Many taxa exhibited differential abundance related to farming. Some taxa in the phyla Chloroflexi and Verrucomicrobia were associated [false discovery rate (FDR)<0.05] with farming but not with other nonfarm factors. Many taxa correlated with the concentration of house dust of endotoxin, commonly studied as a general marker of exposure to the farming environment. Conclusions: In this farming population, house dust microbiota differed by current farming status. Understanding the determinants of the indoor microbiota is the first step toward understanding potential relationships with health outcomes. https://doi.org/10.1289/EHP3145
Abstract 14003: Low-Intensity Pulsed Ultrasound Improves Endothelial Function in Leg Circulation in Patients with Peripheral Arterial Disease
Authors: Shinsuke Mikami, Yukihito Higashi, Kensuke Noma, Tatsuya Maruhashi, Yumiko Iwamoto, Masato Kajikawa, Takeshi Matsumoto, Ayumu Nakashima, Yasuki Kihara
Journal: Circulation (2012)

Background: Low-intensity pulsed ultrasound (LIPUS) induces osteogenesis and angiogenesis. The purpose of this study was to evaluate the effect of LIPUS on clinical symptoms and endothelial function in patients with peripheral arterial disease (PAD). Methods and Results: We assessed clinical symptoms and flow-mediated vasodilation (FMD) in leg circulation during a 24-week period of LIPUS irradiation in 25 patients with PAD, including 12 patients with Buerger disease and 13 patients with atherosclerotic PAD. Twenty-five patients who did not receive LIPUS irradiation served as controls. This was a double-blinded, randomized, active and inactive LIPUS study. Treatment with LIPUS for 24 weeks improved popliteal artery FMD from 7.3±1.8% to 10.2±2.9% in Buerger disease patients and from 5.8±1.7% to 9.3±3.2% in atherosclerotic PAD patients (P=0.01 and P=0.03, respectively). Nitroglycerine-induced vasodilation was similar in any treatment periods in all of the groups. LIPUS increased the number of and migration of circulating progenitor cells (Buerger disease: 1158±420 to 1716±512/mL (P=0.01), 79±34 to 121±51/hpf (P=0.02); atherosclerotic PAD:612±280 to 1018±476/mL (P=0.01), 43±19 to 71±39/hpf (P=0.01)). There were significant relationships between the number of and migration of circulating progenitor cells and FMD (r=0.48 and r=0.33, P=0.0001 and P=0.02, respectively) in all patients. In both Buerger disease and atherosclerotic PAD patients, visual analog pain score was significantly decreased after 24-week LIPUS treatment. No severe adverse effects were observed in any of the patients who underwent LIPUS treatment.
Where Is the Discussion About Choline and Fetal Alcohol Exposure?
Authors: Carl C. Bell, Jessie Ajula
Journal: American Journal of Psychiatry (2018)

was not maintained in the meta-analysis.We are encouraged that the relationship reported by the meta-analysis is in the same direction as the relationship we observed despite these differences.Future analyses exploring these conditions are needed to fully understand the association between genotype and treatment outcome in depression.We also agree there are inherent limitations to relatively small candidate gene studies in racially nonhomogeneous populations, including confounding by genetic ancestry.Although we acknowledge this limitation in our original publication ( 9), there are several reasons we believe it does not explain the observed effect size.First, remission rates did not differ significantly between participants who identified as Caucasian, black, or Asian in the iSPOT-D sample (44%, 40%, and 47%, respectively, analysis of variance p50.52), making it unlikely that differing remission rates are driving the observed association.We agree, however, that incorporating principal components based on ancestry is a valuable approach when genetic homogeneity cannot be attained in a sample.Although this could not be performed in the iSPOT sample, we did perform a principal components-adjusted analysis for the PReDICT sample.Critically, while it increased the degrees of freedom of the model and therefore increased the p values slightly, the effect of genotype remained, leading us to believe that the effect of singlenucleotide polymorphism was not driven by population stratification.In summary, we agree that collaboration is essential to progress in the field of psychiatric genetics, and we believe that the work of Fabbri et al. exemplifies an important step in assessing the generalizability of new findings.We advocate for further meta-analyses like theirs to further characterize the role of corticotropin-releasing hormone binding protein in antidepressant response.
Performance-Enhancing Drugs, Sport, and the Ideal of Natural Athletic Performance
Authors: Sigmund Loland
Journal: The American Journal of Bioethics (2018)

The use of certain performance-enhancing drugs (PED) is banned in sport. I discuss critically standard justifications of the ban based on arguments from two widely used criteria: fairness and harms to health. I argue that these arguments on their own are inadequate, and only make sense within a normative understanding of athletic performance and the value of sport. In the discourse over PED, the distinction between "natural" and "artificial" performance has exerted significant impact. I examine whether the distinction makes sense from a moral point of view. I propose an understanding of "natural" athletic performance by combining biological knowledge of training with an interpretation of the normative structure of sport. I conclude that this understanding can serve as moral justification of the PED ban and enable critical and analytically based line drawing between acceptable and nonacceptable performance-enhancing means in sport.
Tailoring Adjuvant Endocrine Therapy for Premenopausal Breast Cancer
Authors: Prudence A. Francis, Olivia Pagani, Gini F. Fleming, Barbara A. Walley, Marco Colleoni, István Láng, Henry L. Gómez, Carlo Tondini, Eva Ciruelos, Harold J. Burstein, Hervé R. Bonnefoi, Meritxell Bellet, Silvana Martino, Charles E. Geyer, Matthew P. Goetz, Vered Stearns, Graziella Pinotti, Fabio Puglisi, Simon Spazzapan, Miguel A. Climent, Lorenzo Pavesi, Thomas Ruhstaller, Nancy E. Davidson, Robert Coleman, Marc Debled, Stefan Buchholz, James N. Ingle, Eric P. Winer, Rudolf Maibach, Manuela Rabaglio-Poretti, Barbara Ruepp, Angelo Di Leo, Alan S. Coates, Richard D. Gelber, Aron Goldhirsch, Meredith M. Regan
Journal: New England Journal of Medicine (2018)

In the Suppression of Ovarian Function Trial (SOFT) and the Tamoxifen and Exemestane Trial (TEXT), the 5-year rates of recurrence of breast cancer were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression than among those who received tamoxifen plus ovarian suppression. The addition of ovarian suppression to tamoxifen did not result in significantly lower recurrence rates than those with tamoxifen alone. Here, we report the updated results from the two trials.
Risk for osteoporosis in gastric cancer survivorship.
Authors: Sumin Jeong, Dong Wook Shin, Ji Eun Lee
Journal: Journal of Clinical Oncology (2018)

121 Background: Gastrectomy is a risk factor for low bone mass. We aimed to investigate the relative risk for osteoporosis in gastric cancer survivorship compared to general population. Methods: Using Korea National Health and Nutrition Examination Survey (KNHANES III-IV), 2008-2011, we identified the 8,156 individuals over 50 years old who have been tested the dual-energy X-ray absorptiometry (DXA). Gastric cancer survivors (n = 103) who had a history of gastric cancer in questionnaire were defined as case. Control subjects were matched to case subjects by age (plus or minus 1 year) and sex with 1:5 ratio. Osteopenia ( -2.5 &lt; T-score &lt; -1.0 ) and osteoporosis (T-score ≤ -2.5) were used to define the status of bone mass. We performed multinominal logistic regression to compare the risk for osteopenia and osteoporosis between case and control. Results: After adjusting for sex, age, body mass index, smoking status, alcohol consumption, physical activity and bone health related history (history of fracture or family history of osteoporosis), there was a significant high risk for osteopenia (adjusted relative risk (RR) = 2.90; 95% confidence interval (CI) 1.16–7.25) and osteoporosis (adjusted RR = 4.63; 95% CI 1.12–13.3) in gastric cancer survivor. The risk for osteoporosis was most prominent for femur total in gastric cancer survivors (adjusted RR = 16.3; 95% CI 3.35–82.6). In addition, the serum Vitamin D level was lower in gastric cancer survivors (20.3 ± 0.5 IU vs 17.5 ± 1.2 IU, p-value = 0.011). Conclusions: Gastric cancer survivors showed significantly high risk for osteoporosis. Our finding clinically implies the importance of managing osteoporosis in gastric cancer survivors.[Table: see text]
Cardiovascular disease-related chronic conditions among Veterans Affairs colorectal cancer survivors: A matched case-control analysis.
Authors: Leah L. Zullig, Valerie Smith, Jennifer Lindquist, Christina D. Williams, Morris Weinberger, Dawn Provenzale, George L. Jackson, Michael J. Kelley, Susanne Danus, Hayden B Bosworth
Journal: Journal of Clinical Oncology (2018)

4 Background: The growing number of colorectal cancer (CRC) survivors often have multiple chronic conditions. Comparing CRC survivors and matched non-cancer controls, our objectives were to determine the odds of CRC survivors being diagnosed with CVD-related chronic conditions and their likelihood of control during the year after CRC diagnosis. Methods: We retrospectively identified patients diagnosed with non-metastatic CRC in the Veterans Affairs (VA) healthcare system from fiscal years 2009-2012 and matched each with up to 3 non-cancer control patients. We used logistic regression to assess differences in the likelihood of being diagnosed with CVD-related chronic conditions and control between CRC survivors and non-cancer controls. Results: We identified 9,758 CRC patients and matched them to 29,066 non-cancer controls. At baseline, 69.4% of CRC survivors and their matched controls were diagnosed with hypertension, 52.4% with hyperlipidemia, and 36.7% with diabetes. Compared to matched non-cancer controls, CRC survivors had 57% higher odds of being diagnosed with hypertension (OR = 1.57, 95% CI = 1.49-1.64) and 12% higher odds of poor blood pressure control (OR = 1.12, 95% CI 1.06-1.18) in the subsequent year. Compared to matched non-cancer control patients, CRC survivors had half the odds of being diagnosed with hyperlipidemia (OR = 0.50, 95% CI = 0.48-0.52) and higher odds of LDL control (OR 1.14, 95% CI 1.06-1.23). There were no significant differences between groups for diabetes diagnoses or control. Conclusions: Compared to non-cancer controls, CRC survivors have: 1) greater likelihood of being diagnosed with hypertension and worse blood pressure control in the year following diagnosis; 2) lower likelihood of being diagnosed with hyperlipidemia or LDL control; and 3) comparable diabetes diagnoses and control. There may be a need for hypertension control interventions targeting cancer survivors.
Aberrant expression of grem1 leads to ectopic stem cells capable of multilineage potential
Authors: S Biswas, H Davis, M Jansen, D Treanor, S Leedham
Journal: Gut (2017)

Introduction  The stereotypical architecture of the intestinal wall is a strict organisational hierarchy with stem cells residing at the crypt base, progenitor cells just above proliferating rapidly in the transit amplifying compartment, and differentiated cells at the luminal surface. This is controlled by strictly regulated polarised gradients of Wnt and Bone Morphogenetic Proten (BMP) signalling.  Our laboratory has shown that aberrant BMP signalling can promote stem cell activity away from the crypt base. Human hereditary mixed polyposis syndrome (HMPS) is an autosomal dominant condition, characterised morphologically by the development of ectopic crypt foci (ECF). HMPS is caused by a 40 kb duplication upstream of the BMP antagonist GREM1, which results in a compartmental expression switch of this secreted protein - from a restricted mesenchymal gradient to epithelial expression. A transgenic mouse (Vil1-Grem1) modelling this switch developed an HMPS phenotype, with expansion of Lgr5-negative and Sox9-positive progenitors in ECF which proliferate and accumulate somatic mutations. We wished to determine whether these ECF contained stem cells, as evidenced by cellular renewal and multilineage differentiation.  Method  A Vil1-Grem1; Sox9CreERT2; Rosa26YFP model was created to allow recombination in Sox9 positive cells in both crypt base and ECF cells after tamoxifen injection and to mark their progeny. Serial images stained for YFP were scanned and 3D reconstruction performed to track the origins of clonal ribbons and allow full visualisation throughout polyps.  Results  Lineage tracing revealed that as well as crypt basal cells, cells contained within intravillus ECF gave rise to clonal ribbons, indicative of stem cell function. These ribbons contained all the enteric cell lineages as confirmed on staining, suggesting ectopic stem cells are multipotential.  Conclusion  Aberrant GREM1 expression causes cell fate disruption and accumulation of proliferating stem/progenitor cells within ectopic crypts. Ectopic crypt progenitor cells on the villus are capable of self-renewal and tissue-specific differentiation – properties suggestive of true stem cell potential. This evidence argues against an obligate unidirectional tissue organisational hierarchy in the intestine, and suggests that abnormally proliferating cells in the ectopic crypts may retain stem cell potential, yet are situated outside the protected environment of the crypt base stem cell niche. Consequently they may be more prone to mutation, due to atypical DNA damage response or due to altered mesenchymal microenvironment of the ectopic crypts.  Reference  . Davis H, Irshad S, Bansal M, et al. Aberrant epithelial GREM1 expression initiates colonic tumorigenesis from cells outside the stem cell niche. Nat Med. 2015Jan;21(1):62–70  Disclosure of Interest  None Declared