tbuckley/cabot-search huggingface dataset:
Measuring quality of care for all women and newborns: how do we know if we are doing it right? A review of facility assessment tools
Authors: Vanessa Brizuela, Hannah H Leslie, Jigyasa Sharma, Ana Langer, Özge Tunçalp
Journal: The Lancet Global Health (2019)

Ensuring quality of care during pregnancy and childbirth is crucial to improving health outcomes and reducing preventable mortality and morbidity among women and their newborns. In this pursuit, WHO developed a framework and standards, defining 31 quality statements and 352 quality measures to assess and improve quality of maternal and newborn care in health-care facilities. We aimed to assess the capacity of globally used, large-scale facility assessment tools to measure quality of maternal and newborn care as per the WHO framework.We identified assessment tools through a purposive sample that met the following inclusion criteria: multicountry, facility-level, major focus on maternal and newborn health, data on input and process indicators, used between 2007 and 2017, and currently in use. We matched questions in the tools with 274 quality measures associated with inputs and processes within the WHO standards. We excluded quality measures relating to outcomes because these are not routinely measured by many assessment tools. We used descriptive statistics to calculate how many quality measures could be assessed using each of the tools under review. Each tool was assigned a 1 for fulfilling a quality measure based on the presence of any or all components as indicated in the standards.Five surveys met our inclusion criteria: the Service Provision Assessment (SPA), developed for the Demographic and Health Surveys programme; the Service Availability and Readiness Assessment, developed by WHO; the Needs Assessment of Emergency Obstetric and Newborn Care developed by the Averting Maternal Death and Disability programme at Columbia University; and the World Bank's Service Delivery Indicator (SDI) and Impact Evaluation Toolkit for Results Based Financing in Health. The proportion of quality measures covered ranged from 62% for the SPA to 12% for the SDI. Although the broadest tool addressed parts of each of the 31 quality statements, 68 (25%) of 274 input and process quality measures were not measured at all. Measures of health information systems and patient experience of care were least likely to be included.Existing facility assessment tools provide a valuable way to assess quality of maternal and newborn care as one element within the national measurement toolkit. Guidance is clearly needed on priority measures and for better harmonisation across tools to reduce measurement burden and increase data use for quality improvement. Targeted development of measurement modules to address important gaps is a key priority for research.None.
Tracing Ancient Human Migrations into Sahul Using Hepatitis B Virus Genomes
Authors: Lilly K W Yuen, Margaret Littlejohn, Sebastián Duchêne, Rosalind Edwards, Sarah Bukulatjpi, Paula Binks, Kathy Jackson, Jane Davies, Joshua S Davis, Steven Y C Tong, Stephen Locarnini
Journal: Molecular Biology and Evolution (2019)

The entry point and timing of ancient human migration into continental Sahul (the combined landmass of Australia, New Guinea, and Tasmania) are subject to debate. Unique strains of hepatitis B virus (HBV) are endemic among modern-day Australian Aboriginals (HBV/C4) and Indigenous Melanesians (HBV/C3). We postulated that HBV genomes could be used to infer human population movements because the main HBV transmission route in endemic populations is via mother-to-child for genotypes B and C infections. Phylogenetic and phylogeographic analyses of HBV genomes inferred the origin of HBV/C4 to be >59 thousand years ago (ka) (95% HPD: 34-85 ka), and most likely to have occurred on the Sunda Shelf (southeast extension of the continental shelf of Southeast Asia). Our analysis further suggested an age of >51 ka (95% Highest Posterior Density (HPD): 36-67 ka) for the most recent common ancestor of HBV/C4 in Australia, correlating with the arrival time of anatomically modern humans into Australia, with the entry point suggested along a southern route via Timor. While we also inferred the origin of HBC/C3 to be on the Sunda Shelf, our analyses suggested that it was carried into Melanesia by Indigenous Melanesians who migrated through New Guinea north of the highlands. These findings reveal that HBV genomes can be used to infer ancient human population movements.
Paradox-Breaker Pan-RAF Inhibitors Induce an AML-Specific Cytotoxic Response and Synergize with Venetoclax to Display Superior Antileukemic Activity
Authors: Mahesh Tambe, Ella Karjalainen, Markus Vaha-Koskela, Caroline A Heckman, Kimmo Porkka, Krister Wennerberg
Journal: Blood (2018)
Comparable Overall Survival with Rituximab-Bendamustine (R-Benda) and Rituximab-Gemcitabine-Oxaliplatin (R-GemOx) When Used As Second-Line (2L) Treatment for Diffuse Large B-Cell Lymphoma (DLBCL): A Real-World Study Using US Veterans Health Administration Data
Authors: Raluca Ionescu-Ittu, Aijing Shang, Nancy Vander Velde, Annie Guérin, Yilu Lin, Lizheng Shi, Sherry Shi, Naseer Qayum
Journal: Blood (2018)
Early drug development in advanced gynecologic cancer based on genetic tumor profiling.
Authors: Ana C. Garrido-Castro, Guillem Argilés, Debora Moreno, Marta Vilaro, Victor Rodriguez-Freixinos, Teresa Macarulla, Cristina Cruz, Analia Azaro, Elena Élez, Maria Alsina, Jose Manuel Perez-Garcia, Jose Jimenez, Paolo Nuciforo, Ana Vivancos, Joan Seoane, Jose Maria Del Campo, Jordi Rodón, Josep Tabernero, Ana Oaknin
Journal: Journal of Clinical Oncology (2015)

5562 Background: The broad spectrum of actionable molecular alterations (MA) detected with new techniques has increased interest in matched targeted therapies (MTT) after failure to standard treatment. Methods: Advanced gynecologic tumor (GYNT) patients (pts) were analyzed in our Molecular Prescreening Program for MA: mutations (mt) detected with Sequenom (Sq) or VHIO Card Amplicon Seq Panel (VCASP), Notch and PI3K amplifications (amp), PTEN loss (Hscore ≤ 50) and PDL1 expression. Pts were allocated to Phase I trials with MTT based on MA. Time to treatment failure (TTF) with MTT (TTF2) was compared to TTF with the previous unmatched therapy (TTF1). Results: From Jan 2012 to Dec 2014, 129 GYNT pts (mean age: 52.6 yrs; median no. previous treatments: 3 [0-7]) were screened for MA; 87 ovarian (OC; 23 type I, 64 type II), 27 endometrial (EC; 15 type I, 12 type II) and 15 cervical (CC) cancers. Of 69 pts with MA (53.5%), 33 received MTT (47.8%) including one OC pt treated with 2 consecutive MTT. MA were identified in 15 type I and 27 type II OC pts; mt in PI3KCA (9), KRAS (7), BRAF (2), TP53 (8), amp in Notch (8) and PI3K (1), PTEN loss (18) and PDL1+ (3). In 12 type I and 9 type II EC, mt in PIK3CA (4), KRAS (8), TP53 (2), PTEN (2), FGFR1 (1), ESR1 (1) and ABL1 (1), PTEN loss (13) and PDL1+ (2) were found. KRAS (2), PI3K/AKT(2) mt and PDL1+ (2) were detected in CC. Two Sq wild-type pts tested with VCASP held TP53 mt. Of 16 PIK3CA MA pts, 6 were treated with α-specific PI3Ki, 1 with PI3K/mTORi and 3 with α-PI3Ki combined with IGFR1 or FGFRi. KRAS mt pts (17) were matched to MEKi-based combos: 7 MEK/PI3Ki, 2 MEK/AKTi and 1 MEK/IGFR1i. Multiple MA in a type I OC pt (KRAS/BRAF mt) were treated with PI3K/MEKi, a type I EC pt (PIK3CA/KRAS mt) with mTORi, and a type II EC pt (TP53/FGFR1/ABL1 mt) with MET/FGFR/AXLi. Of 10 TP53mt, 1 PTEN loss pt received PI3Ki. Notch-i was offered to 5 of 8 amp OC and anti-PD1/PDL1 agents to 3 of 6 PDL1+ GYNT. Although no differences were found between TTF1 and TTF2 (17.8 vs 15.0 wks, p = 0.156), TTF2/TTF1 was > 1.2 in 11 of 34 MTT (32.4%). Conclusions: Albeit statistical significance was not reached, TTF improved in > 30% of pts meriting further evaluation of MTT in GYNT. More time is needed to elucidate the impact of genetic/proteomic tumor profiling in drug development of GYNT.
Assessment of First-Year Use of Medicare’s Advance Care Planning Billing Codes
Authors: Kimberly Pelland, Blake Morphis, Daniel Harris, Rebekah Gardner
Journal: JAMA Internal Medicine (2019)

Assessment of First-Year Use of Medicare's Advance Care Planning Billing CodesAdvance care planning (ACP) conversations occur infrequently among patients and their health care professionals, and when they do occur, the context is often a stressful clinical situation. 1,2 Advance care planning conversations that occur too late (or not at all) can result in care that is invasive, expensive, and not aligned with patients' wishes.To encourage health care professionals to initiate ACP discussions, Medicare began reimbursing for ACP services on January 1, 2016, under a separate billing code.Our study aims to characterize the first year of ACP code use and to describe beneficiary characteristics associated with receipt of ACP services.Methods | For this retrospective observational analysis, we used Medicare fee-for-service Parts A and B claims, the Medicare coverage and denominator files, and US Census Bureau data.All beneficiaries in New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) continuously enrolled in Parts A and B in 2016 were included in this sample.Beneficiaries who died during the study year were included until their death.The authors have access to Medicare claims data under an agreement between Healthcentric Advisors and the Centers for Medicare & Medicaid Services for use of these data to evaluate improvement in care quality.Institutional review board review is not required in these circumstances, per organizational policy.Our primary outcome was the number of Medicare feefor-service beneficiaries with an ACP claim in 2016.Secondary outcomes included beneficiary-level estimates of having a claim and the number of beneficiaries whose ACP service occurred during their annual wellness visit.We used χ 2 tests to compare beneficiary characteristics by ACP claim status.Using multivariable logistic regression, we identified variables associated with a beneficiary having any ACP claim, adjusting for age, sex, race/ethnicity, state of residence, dual-eligibility status (for Medicare and Medicaid), median income of resi-dence, and the presence of certain chronic conditions.Findings were considered significant at P < .05(2-sided).
Increased bone remodeling on patients treated with a CTLA-4 inhibitor: First report of an unknown autoimmune reaction.
Authors: Arpit Rao, Joshua Mansour, Helen Nordquist, Montaser F. Shaheen, Olivier Rixe
Journal: Journal of Clinical Oncology (2015)

e14027 Background: Ipilimumab, an antibody that blocks the inhibitory receptors of cytotoxic T-lymphocytes, including that of cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), is currently FDA approved for patients with metastatic melanoma. However, the T-cell activation may result in other autoimmune adverse reactions (diarrhea, skin rash and thyroid dysfunction). When these T-cell inhibitory pathways are blocked, subsequent T-cell activation allows for release of cytokines and osteoprotegerin ligands (such as RANK-L) that stimulate osteoclasts. This increase in abnormal osteoclastic response and bone resorption leads to an increase in osteoblastic response and ensuing release of alkaline phosphatase (ALP). Through this increased bone turnover, patients may theoretically experience bone pain throughout treatment with CTLA-4 inhibitors. Methods: In order to investigate bone remodeling in patients treated with a CTLA-4 inhibitor, we conducted a retrospective analysis of 39 patients with stage III/IV melanoma treated at UNMCC between April of 2010 and July of 2014 with a median follow-up time of 364 days. Results: During the first three months of treatment with ipilimumab, 16 of these patients (41%) presented with complaints of diffuse bone pain. Four of these 16 patients had an initial ALP value within the normal limits and developed a subsequent increase in ALP, during the period of our study observation, with no further bone metastasis progression or new bony lesions observed on CT scan. Conclusions: Physicians should be alerted to the bone remodeling effects of T-cell stimulation when using CTLA-4 inhibitors. This increase in ALP following treatment may serve as a marker for increased bone turnover in patients undergoing therapy. We are currently investigating the role of ALP as a marker of efficacy and its potential long-term toxicity on bone structure. Modulators of other T-cell inhibitory pathways should be further explored and possible treatment with RANK-L inhibitors may be beneficial in combination with these immune modulators.
Lentiviral interferon: A novel method for gene therapy in bladder cancer.
Authors: Sharada Mokkapati, Jonathan J Duplisea, Devin Plote, Vikram M Narayan, Amy Lim, Michael J. Metcalfe, Kenneth Dunner, Bogdan Czerniak, Tiina Nieminen, Tommi Heikura, Seppo Yla-Herttuala, Nigel Parker, Kimberly Schluns, David James McConkey, Colin P.N. Dinney
Journal: Journal of Clinical Oncology (2019)

456 Background: Gene therapy for bladder cancer (BLCA) is rapidly evolving. We reported that intravesical adenoviral interferon-alpha (Ad-IFNα) produced a complete response in 35% of patients with BCG-unresponsive BLCA enrolled in a Phase II trial. Lentivirus (LV) is another potential vector for intravesical delivery of IFNα. Unlike the adenovirus, LV can infect non-dividing cells and integrate into the host’s genome, making it one of the most efficient gene delivery vectors. The objective of this study was to investigate lentiviral interferon-alpha (LV-IFNα) BLCA gene therapy in preclinical models. Methods: Murine BLCA cell lines were transduced in-vitro with LV-IFNα using a multiplicity of infection (MOI) of 2:1. IFNα levels were measured by ELISA. Cell viability was assessed using Trypan blue dye exclusion. qPCR was used to identify expression of IFNα target genes. A LV-βGalactosidase reporter construct was delivered intravesically, and urinary IFNα levels were measured in mice treated with LV-IFNα or control virus to assess gene transfer. To assess survival benefit, p53+/- C57/B6 mice were exposed to N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) to induce CIS and then treated with LV-IFNα or control virus, and sacrificed when moribund. Results: Efficient LV-IFNα transduction of BLCA cells was observed at an MOI of 2:1, resulting in increased expression of IFNα and its target genes PDL-1, TRAIL, and IRF7 (p&lt;0.001), and reduced cell viability vs. controls (p&lt;0.001). Mechanistically, TRAIL dependent cytotoxicity in the LV-IFNα cells was rescued by Caspase 8 inhibition. βGal expression confirmed efficient transduction of murine urothelium. Urinary IFNα levels were elevated in mice receiving LV-IFNα compared with control virus. BBN mice treated with LV-IFNα had longer overall survival than mice treated with control virus (p=0.04). LV-IFNα induced intratumoral CD8+ T cell infiltration, high expression of PD-L1, and inhibited angiogenesis. Conclusions: LV-IFNα effectively upregulated IFNα target genes, was cytotoxic to murine BLCA cells, and improved the survival of BBN tumor-bearing mice. LV appears to be a promising vector for intravesical gene delivery.
TROPHY-U-01: A phase II open-label study of sacituzumab govitecan (IMMU-132) in patients with advanced urothelial cancer after progression on platinum-based chemotherapy and/or anti-PD-1/PD-L1 checkpoint inhibitor therapy.
Authors: Scott T. Tagawa, Daniel Peter Petrylak, Petros Grivas, Neeraj Agarwal, Cora N. Sternberg, Chris Hernandez, Peggy Siemon-Hryczyk, Trishna Goswami, Yohann Loriot
Journal: Journal of Clinical Oncology (2019)

TPS3153 Background: Patients (pts) with advanced urothelial cancer (UC) who progress after checkpoint inhibitor (CPI) therapy (following failure of or ineligibility for platinum-based chemotherapy) have limited options. Trop-2 is an epithelial cell surface antigen overexpressed in UC (Avellini. Oncotarget 2017). Sacituzumab govitecan (SG) is an antibody-drug conjugate that targets Trop-2 and delivers the active metabolite SN38 of the topoisomerase I inhibitor irinotecan to tumor cells (Starodub. Clin Cancer Res 2015). In a phase 1/2 trial, pts with advanced cancers received SG on days 1 and 8 of a 21-day cycle. In the UC cohort, 45 evaluable pts received SG 10 mg/kg with a median of 2 (range 1–6) prior therapies. Objective response rate (ORR) was 31%; median duration of response was 12.9 mo. Grade ≥3 adverse events in ≥5% of pts were neutropenia/neutrophil count decreased (38%), anemia (13%), hypophosphatemia (11%), diarrhea (9%), fatigue (9%), and febrile neutropenia (7%). Median progression-free survival (PFS) was 7.3 mo and overall survival (OS) 16.3 mo (Tagawa 2019 ASCO Genitourinary Cancers Symposium). These results warrant further investigation in a dedicated phase 2 trial. Methods: TROPHY-U-01 (NCT03547973) is a single-arm, global phase 2 trial evaluating the antitumor activity of SG (10 mg/kg on days 1 and 8 of a 21-day cycle) in 140 pts with advanced UC and measurable disease. Patients are also required to have an Eastern Cooperative Oncology Group Performance Status score of 0 or 1 and creatinine clearance ≥30 mL/min. The pivotal cohort (Cohort 1: progression after both platinum chemotherapy and CPI) will enroll 100 evaluable pts in a Simon 2-stage design with &gt; 90% power accounting for dropouts to exclude the null hypothesis or ORR &lt; 12%; an exploratory cohort (Cohort 2: 40 pts) includes platinum-ineligible pts who progress after prior CPI. The primary objective is ORR per RECIST 1.1, assessed by central review. Secondary objectives include response duration, PFS, and OS. Adverse events, pharmacokinetics, and tissue correlates will also be assessed. Enrollment began August 2018. Clinical trial information: NCT03547973.
<i>JAMA Neurology—</i>The Year in Review, 2018
Authors: S. Andrew Josephson
Journal: JAMA Neurology (2019)

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
Coronary artery bypass grafting is associated with significant perturbation of circulating dendritic cell populations
Authors: Alexis J. Perros, Kelly Rooks, Fenny Chong, Arlanna Esguerra-Lallen, Sanne Engkilde-Pedersen, Rishendran Naidoo, John-Paul Tung, John F. Fraser, Peter Tesar, Marc Ziegenfuss, Susan Smith, Donalee O’Brien, Robert L. Flower, Melinda M. Dean
Journal: Blood (2017)
Abstract 20508: Pulmonary Artery Pressure and Arterial Oxygen Saturation in High-Altitude Dwellers Suffering From Chronic Mountain Sickness: Systematic Review and Meta-Analysis
Authors: Rodrigo Soria, Théo A Meister, Nicole Bender, Emrush Rexhaj, Stefano F Rimoldi, Urs Scherrer
Journal: Circulation (2017)

Introduction: More than 140 million people are living at high altitude worldwide. An increase of pulmonary artery pressure (PAP) is a hallmark of high-altitude exposure and, if pronounced, may be a...
Abstract MP09: Black-White Differences in the Association Between Sleep Duration and Incident Stroke: The REGARDS Study
Authors: Megan E Petrov, George Howard, Michael A Grandner, Dawn Kleindorfer, Jennifer R Molano, Virginia J Howard
Journal: Circulation (2016)

Introduction: Short and long sleep durations are associated with incident stroke. Few studies have investigated these associations by race despite prevalent inequities in stroke between non-Hispanic black and white adults. The aim of this study was to investigate the relationship between sleep duration and incident stroke in a US cohort of blacks and whites. Methods: Within the REasons for Geographic And Racial Differences in Stroke study, 15,941 black and white adults (≥45yrs) with no history of stroke or sleep apnea were studied. Participants self-reported their habitual sleep duration. Suspected stroke events were identified every 6 months, and associated medical records were retrieved and physician adjudicated. Proportional hazards analysis was used to estimate hazard ratios for incident stroke associated with sleep duration (&lt;6, 6.0-6.9, 7.0-7.9, 8.0-8.9[reference group], 9+hrs) controlling for sociodemographics, stroke risk factors, and depressive symptoms. Results: At baseline, 11.2% of the sample was very short sleepers (&lt;6hrs) and 6.7% were long sleepers (9+hrs). Over an average follow-up of 4.7 ± 1.4 years, 321 stroke events occurred (blacks=114; whites=207). After adjustment, shorter sleep duration was associated with increased risk for incident stroke (6.0-6.9hr: OR=1.41, 95%CI 1.02-1.94; 7.0-7.9hr: OR=1.36, 95%CI 1.01-1.83). The interaction between sleep duration and race was significant ( p =0.02). In stratified analyses, shorter sleep duration was associated with increased risk for stroke in whites but not blacks (see table). Discussion: Among middle-aged to older, white adults with no history of stroke or sleep apnea, shorter sleep duration was associated with increased risk for stroke. There was no association among blacks. Resilience to insufficient sleep as a risk factor for stroke may differ for blacks and whites. Adjusted for age, sex, education, income, depressive symptoms, hypertension, diabetes, atrial fibrillation, left ventricular hypertrophy, heart disease, and smoking status