tbuckley/cabot-search huggingface dataset:
A randomized trial comparing the Tennant Biomodulator to transcutaneous electrical nerve stimulation and traditional Chinese acupuncture for the treatment of chronic pain in military service members
Authors: Kimberly S. Peacock, Erika Stoerkel, Salvatore Libretto, Weimin Zhang, Alice Inman, Michael Schlicher, John D. Cowsar, David Eddie, Joan Walter
Journal: Military Medical Research (2019)

Abstract Background The present investigation tested the efficacy of the Tennant Biomodulator, a novel pain management intervention that uses biofeedback-modulated electrical stimulation, to reduce chronic pain and its psychosocial sequelae in a sample of current and former military service members. The Tennant Biomodulator used on its most basic setting was compared to two commonly used, non-pharmacological pain treatments—traditional Chinese acupuncture and transcutaneous electrical nerve stimulation (TENS)—in a comparative efficacy, randomized, open-label trial. Methods Participants included 100 active duty and retired service men and women with chronic pain undergoing treatment at the Brooke Army Medical Center in Texas, USA, randomly assigned to receive six, weekly sessions of either Tennant Biomodulator treatment, traditional Chinese acupuncture, or TENS, in addition to usual care. Recruitment was conducted between May 2010 to September 2013. Outcome measures were collected at intake, before and after each treatment session, and at a 1-month follow-up. Intent-to-treat analyses were used throughout, with mixed models used to investigate main effects of group, time, and group × time interactions with consideration given to quadratic effects. Outcomes measured included ratings of chronic pain, pain-related functional disability, and symptoms of post-traumatic stress disorder (PTSD) and depression. Results On average, regardless of their treatment group, participants exhibited a 16% reduction in pain measured by the Brooke Army Medical Center’s Clinic Pain Log [ F (1, 335) = 55.7, P &lt; 0.0001] and an 11% reduction in pain-related disability measured by the Million Visual Analog Scale [MVAS: F (1, 84) = 28.3, P &lt; 0.0001] from baseline to the end of treatment, but no one treatment performed better than the other, and the reductions in pain and pain-related disability were largely lost by 1-month follow-up. Symptoms of PTSD and depression did not change significantly as a function of time or group. Conclusions Findings build on previous work suggesting that traditional Chinese acupuncture and TENS can reduce pain and its functional sequelae without risks associated with pharmacological pain management. The Tennant Biomodulator used on its most basic setting performs as well as these other interventions. Based on the present findings, large, randomized controlled trials on the Tennant Biomodulator are indicated. Future work should test this device using its full range of settings for pain-related psychological health. Trial registration Clincialtrials.gov ( NCT01752010 ); registered December 14, 2012.
Unintended consequences of screening for anxiety and depression among survivors of pediatric, adolescent, and young adult (P-AYA) cancer.
Authors: Linda A. Jacobs, Abigail N. Blauch, Donna A. Pucci, Steven C Palmer
Journal: Journal of Clinical Oncology (2019)

148 Background: Screening for psychosocial issues has been mandated to identify survivors in need of assistance and improve outcomes. Although screening identifies some individuals at risk for difficulties, many who screen positively ultimately decline intervention. Moreover, screening has the potential to "miss" patients who desire intervention but screen negatively for psychosocial need. We explored these issues among a sample of adult survivors of P-AYA cancer. Methods: Survivors of P-AYA cancer &gt; 2 years from end of treatment completed an assessment including the Hospital Anxiety and Depression Scale (HADS) and desire for assistance with Anxiety and Depression following a survivorship visit. HADS subscale scores of &gt; 8 indicated at least mild symptoms. Results: Participants (N = 237) were predominately white (89%), college educated (76%), single (63%), and had an annual income of &gt; $60,000 (69%). A plurality had diagnoses of leukemia (30%) or Hodgkin's lymphoma (29%) treated 17 years previously. Treatment included surgery (35%), chemotherapy (91%), XRT (59%), and BMT (17%). Anxiety (M = 6.02; SD = 3.07) and depression (M = 2.54; SD = 2.85) scores were low and below the cutpoint of 8 (all t &lt; -7.8; p &lt; .001 ), although 21% and 9% screened positively for anxiety or depression, respectively. Screening positive for anxiety was associated with a desire for intervention (X2 = 20.77; p &lt; .001 ), while screening positively for depression was not (p &gt; 0.05). Among those screening positively for anxiety, 50% desired intervention, while among those screening positively for depression only 38% desired intervention. Moreover, among those desiring intervention for anxiety or depression, 36% and 68% screened negatively for symptoms, respectively. Conclusions: Many P-AYA survivors screening positively for anxiety or depression do not desire intervention. As well, screening would exclude between 36%-68% of those desiring intervention, representing a missed opportunity to potentially improve outcomes. Screening without assessing desire for intervention likely over identifies individuals who do not desire help while missing a relatively large number of those who do wish for assistance.
Characteristics and Outcomes of Patients Receiving Bridging Therapy While Awaiting Manufacture of Standard of Care Axicabtagene Ciloleucel CD19 Chimeric Antigen Receptor (CAR) T-Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma: Results from the US Lymphoma CAR-T Consortium
Authors: Michael D. Jain, Miriam T. Jacobs, Loretta J. Nastoupil, Jay Y. Spiegel, Gao Feng, Yi Lin, Matthew A. Lunning, Saurabh Dahiya, Lazaros J Lekakis, Patrick M Reagan, Olalekan O. Oluwole, Joseph P. McGuirk, Abhinav Deol, Andre Goy, Brian T. Hill, Javier Munoz, Julio Chavez, Aaron P. Rapoport, Julie M Vose, David B Miklos, Sattva S Neelapu, N. Nora Bennani, Charalambos Andreadis, Alison R. Sehgal, Armin Ghobadi, Frederick L. Locke
Journal: Blood (2019)
A retrospective analysis of the association between perioperative, post adjuvant carcinoembryonic antigen level and prognosis in stage III colorectal cancer
Authors: R. Kozuki, E. Shinozaki, H. Osumi, T. Wakatuki, M. Suenaga, M. Ogura, T. Suzuki, I. Nakayama, D. Takahari, K. Chin, T. Nagasaki, T. Konishi, S. Nagayama, Y. Fukunaga, M. Ueno, K. Yamaguchi
Journal: Annals of Oncology (2019)
Derivation and implementation of a machine learning approach to prompt serious illness conversations among outpatients with cancer.
Authors: Ravi Bharat Parikh, Chris Manz, Corey Chivers, Susan B Regli, Jennifer Braun, Joshua Adam Jones, Ronac Mamtani, Michael Draugelis, Justin E. Bekelman, Amol S. Navathe, Mitesh S. Patel, Lawrence N. Shulman, Lynn Mara Schuchter, Nina O'Connor
Journal: Journal of Clinical Oncology (2019)

131 Background: Machine learning (ML) algorithms can accurately identify patients with cancer at risk of short-term mortality and facilitate timely conversations about treatment and end-of-life preferences. We developed, validated, and implemented a ML algorithm to predict mortality in a general oncology setting, using electronic health record (EHR) data prior to a clinic visit. Methods: Our cohort consisted of patients aged ≥18 years who had an encounter in outpatient oncology practices within a large academic health system between February 1st and July 1st, 2016. We randomly split the sample into training (70%) and validation (30%) cohorts at the patient-encounter level. We trained three ML algorithms to predict 180-day mortality and describe performance in the holdout validation cohort. From October 2018 to February 2019, we used the best-performing algorithm to generate weekly lists of high-risk patients at a single community oncology practice and studied the impact on rates of documented serious illness conversations (SICs). Results: Among 62,377 encounters used to train the algorithms, 7.4% involved a patient who died within 180 days. Gradient boosting and/or random forest outperformed logistic regression in all metrics (Table), and the gradient boosting model had superior discrimination and calibration. In the gradient boosting model, observed 180-day mortality was 45.5% (95% CI 39.0-52.3%) in the high-risk group vs. 3.3% (95% CI 2.9-3.7%) in the low-risk group. In a survey of oncology clinicians, 59% of patients flagged as high-risk were appropriate for a serious illness conversation in the upcoming week (response rate 52%). Five months after implementing the intervention, average monthly documented SICs increased by 23% (31.7 to 39). Conclusions: A ML algorithm based on EHR data accurately identified patients with cancer at risk of short-term mortality, was concordant with oncologists’ assessments, and was associated with more SICs. [Table: see text]
Guidance for Using Tafenoquine for Prevention and Antirelapse Therapy for Malaria — United States, 2019
Authors: Julia C. Haston, Jimee Hwang, Kathrine R. Tan
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

An estimated 219 million cases of malaria occurred worldwide in 2017, causing approximately 435,000 deaths (1). Malaria is caused by intraerythrocytic protozoa of the genus Plasmodium transmitted to humans through the bite of an infective Anopheles mosquito. Five Plasmodium species that regularly cause illness in humans are P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi (2). The parasite first develops in the liver before infecting red blood cells. Travelers to areas with endemic malaria can prevent malaria by taking chemoprophylaxis. However, most antimalarials do not kill the liver stages of the parasite, including hypnozoites that cause relapses of disease caused by P. vivax or P. ovale. Therefore, patients with these relapsing species must be treated with two medications: one for the acute infection, and another to treat the hypnozoites (antirelapse therapy). Until recently, primaquine was the only drug available worldwide to kill hypnozoites. Tafenoquine, a long-acting 8-aminoquinoline drug related to primaquine, was approved by the Food and Drug Administration (FDA) on July 20, 2018, for antirelapse therapy (Krintafel) and August 8, 2018, for chemoprophylaxis (Arakoda) (3,4). This report reviews evidence for the efficacy and safety of tafenoquine and provides CDC guidance for clinicians who prescribe chemoprophylaxis for travelers to areas with endemic malaria and treat malaria.
Cost-effectiveness of Finger Replantation Compared With Revision Amputation
Authors: Alfred P. Yoon, Tanvi Mahajani, David W. Hutton, Kevin C. Chung
Journal: JAMA Network Open (2019)

Traumatic digit amputation is the most common type of amputation injury, but the cost-effectiveness of its treatments is unknown.To assess the cost-effectiveness of finger replantation compared with revision amputation.This economic evaluation was conducted using data from the Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness (FRANCHISE), a retrospective, multicenter cohort study at 19 centers in the United States and Asia that enrolled participants from August 1, 2016, to April 12, 2018. Model variables were based on the FRANCHISE database, Centers for Medicare & Medicaid Services, and published literature. A total of 257 participants with unilateral traumatic finger amputations treated with revision amputation or replantation distal to the metacarpophalangeal joint and at least 1 year of follow-up after treatment were included in the analysis.Revision amputation or replantation of traumatic finger amputations.Main outcome measures were quality-adjusted life-years (QALYs), total costs (in US dollars), and incremental cost-effectiveness ratios (ICERs). A willingness-to-pay threshold of $100 000 per QALY was used to assess cost-effectiveness.Of the 257 study participants (mean [SD] age, 46.7 [15.9] years; 221 [86.0%] male), 178 underwent finger replantation and 79 underwent revision amputation. In a base case of a 46.7-year-old patient, replantation was associated with QALY gains of 0.30 (95% credible interval [CrI], -0.72 to 1.38) for single-finger (not thumb), 0.39 (95% CrI, -1.00 to 1.90) for thumb, 1.69 (95% CrI, -0.13 to 3.76) for multifinger excluding thumb, and 1.27 (95% CrI, -2.21 to 5.04) for multifinger including thumb injury patterns. Corresponding ICERs for replantation compared with revision amputation were $99 157 per QALY for single-finger (not thumb), $66 278 per QALY for thumb, $18 388 per QALY for multifinger excluding thumb, and $21 528 per QALY for multifinger including thumb injury patterns. Sensitivity analysis revealed that age at time of injury, life expectancy, postinjury utility, wages, and time off work for recovery had the strongest associations with cost-effectiveness. Probabilistic sensitivity analysis revealed the following chances of replantation being cost-effective: 47% in single-finger (not thumb), 52% in thumb, 78% in multifinger excluding thumb, and 64% in multifinger including thumb injury patterns.With proper patient selection, replantation of all finger amputation patterns, whether single-finger or multifinger injuries, may be cost-effective compared with revision amputation. Multifinger replantations had a higher probability of being cost-effective than single-finger replantations. Cost-effectiveness may depend on injury pattern and patient factors and thus appears to be important for consideration when patients and surgeons are deciding whether to replant or amputate.
Obscure GI bleeding in a young man
Authors: Fady Daniel, Roni Aoun, Rayan Rammal
Journal: Gut (2019)

A 27-year-old healthy man presented with a 3-week history of melena along with iron-deficiency anaemia (haemoglobin: 60 g/L). Upper endoscopy and colonoscopy were performed and were normal. The patient was referred for enteroscopy after capsule endoscopy revealed the presence of blood in the proximal jejunum without visualisation of an underlying lesion.

On further questioning, patient denies having any GI or extraintestinal symptoms prior to onset of melena. He denied having weight changes and had no recent history of non-steroidal anti-inflammatory drugs use.

Push enteroscopy was performed using a PENTAX paediatric colonoscope. At 90 cm beyond the pylorus, note was made of a semicircumferential mass occupying three to …
Response to: ‘Non-causal association of gut microbiome on the risk of rheumatoid arthritis: a Mendelian randomisation study’ by Inamo
Authors: Deshire Alpizar Rodriguez, Till Robin Lesker, Benoît Gilbert, Till Strowig, Axel Finckh
Journal: Annals of the Rheumatic Diseases (2019)

We are grateful to Dr Inamo1 for his interest in our article. We agree and acknowledged in our manuscript that our study design did not allow us to assess a causal association. Our study described an increased relative abundance in Prevotella spp. in individuals in ‘preclinical rheumatoid arthritis (RA) stages’ using participants enrolled in a first-degree relatives of patients with RA (FDR-RA) cohort.2 The microbiota of individuals in preclinical RA stages were significantly altered compared with FDR-RA controls. In particular, bacteria of the Prevotellaceae family and associated taxa were enriched among individuals in preclinical stages of RA.

Dr …
Unravelling the Complexities of Hedgehog Mediated Signal Transduction in Acute Myeloid Leukaemia and Normal Haematopoiesis
Authors: Victoria Campbell, Anuradha Tarafdar, Edwina Dobbin, Gillian A. Horne, Laura Park, Colin Nixon, John R. Goodlad, Helen Wheadon, Mhairi Copland
Journal: Blood (2016)
Transitioning Cognitive Aids for Training to Tools for Rescue in Clinical Practice
Authors: Muneera R. Kapadia, Srinivas J. Ivatury
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Abstract 15268: Genetic Information Helps Diagnosis of End-Stage Hypertrophic Cardiomyopathy Among Dilated Cardiomyopathy-Like Hearts
Authors: Hiroshi Miyawaki, Tomohito Ohtani, Youhei Miyashita, Ayako Takuwa, Kaoruko Sengoku, Misato Chimura, Shozo Konishi, Kei Nakamoto, Fusako Sera, Yasumasa Tsukamoto, Hidetaka Kioka, Yoshihiro Asano, Yasushi Sakata
Journal: Circulation (2018)

Introduction: End-stage hypertrophic cardiomyopathy (ES-HCM) causes worse clinical outcome than that of idiopathic dilated cardiomyopathy (iDCM). However, similar morphology and few clinical histor...
The Underappreciated Influence of Elisabeth Kübler-Ross on the Development of Palliative Care for Children
Authors: Bryan A. Sisk, Justin N. Baker
Journal: The American Journal of Bioethics (2019)

In the history of palliative care, all roads lead back to Dame Cicely Saunders, a remarkable social worker/nurse/physician who promoted the concept of total pain and founded the first modern hospic...
Defining a new immune deficiency syndrome: MAN2B2-CDG
Authors: Jan Verheijen, Sunnie Y. Wong, Jared H. Rowe, Kimiyo Raymond, Jennifer Stoddard, Ottavia M. Delmonte, Marita Bosticardo, Kerry Dobbs, Julie Niemela, Enrica Calzoni, Sung-Yun Pai, Uimook Choi, Yasuhiro Yamazaki, Anne Marie Comeau, Erin Janssen, Lauren Henderson, Melissa Hazen, Gerard Berry, Sergio D. Rosenzweig, Hasan Hamdan Aldhekri, Miao He, Luigi D. Notarangelo, Eva Morava
Journal: Journal of Allergy and Clinical Immunology (2019)
David Oliver: Rationing care by delaying decisions
Authors: David Oliver
Journal: BMJ (2019)

Practitioners at the interface between the NHS and adult social care can see in plain, daily sight a silent truth that’s often invisible to outsiders: care rationing, by delay, gaming, arbitrary rules, and bureaucracy. We need to speak its name and blow its cover to the wider public.

The officially reported data on the scale of delayed transfers of care from hospital make for grim reading about our under-resourced community health and social care services.1 But, as the National Audit Office reported in 2016, the real number of people waiting is often far higher.2

Here are some anecdotal examples I’ve seen. Patients are referred for social work assessment, and it may take a week or more for a social worker to be allocated. After assessment the social worker has to make repeated requests for more information from …
Psychosocial outcomes and care utilization among rural and nonrural cancer patients.
Authors: Angela E Usher, Janice Bell, Laurel A Beckett, Jill G Joseph, Brad J. Zebrack, Frederick J. Meyers
Journal: Journal of Clinical Oncology (2019)

79 Background: Approximately 20% of people diagnosed with cancer in the U.S. travel from rural areas to urban cancer centers for treatment. Rural cancer patients face unique challenges which may contribute to greater psychosocial distress when compared to urban-dwelling patients. While up to half of all cancer patients screen positive for psychosocial distress, only 25-44% of distressed patients utilize psychosocial care. Patients from rural areas may face greater barriers to utilization of psychosocial care compared to patients from urban areas. To date, few studies have focused on these concerns. Methods: Three-years of data were collected from newly diagnosed patients screened between 2015 and 2017, including the Patient Health Questionnaire-2 and the NCCN Distress Thermometer (n = 4,865). Adjusted multi-variable logistic regression, chi-square, and negative binomial regression were used to assess relationships among psychosocial outcomes and care utilization, rurality, and distance to treatment in driving miles, controlling for socio-demographic and clinical covariates. Distance to treatment based on driving miles computed in ArcGIS v10.5. Stata v15 was used for all statistical analyses, significance set at ≤.05. Results: Higher odds of depressive symptoms were detected among people living in rural areas compared to urban areas. The odds of psychosocial distress were higher in patients from rural areas and further distances from treatment compared to local distance. Patients from rural areas had lower odds of psychosocial care utilization compared to patients in urban areas. Distance to treatment had independent effects, over and above rurality, for lower odds of psychosocial care utilization. Conclusions: Distance to treatment and rurality appear to be risk factors with independent effects on depressive symptoms and psychosocial distress and appear to be associated with lower odds of psychosocial care use among cancer patients with self-reported distress when compared to patients from urban and local areas. Findings support improved detection of and response to patient reported psychosocial outcomes, and further research designed to better understand the mechanisms underlying the reported associations.