tbuckley/cabot-search huggingface dataset:
Adolescent and young adult cancer patients' health insurance experiences, expectations, and literacy.
Authors: Austin R. Waters, Karely Mann, Echo L. Warner, Perla L. Vaca Lopez, Heydon K. Kaddas, Nicole Ray, Tomoko Tsukamoto, Douglas Beaty Fair, Mark Andrew Lewis, Giselle K. Perez, Elyse R. Park, Anne C. Kirchhoff
Journal: Journal of Clinical Oncology (2020)

65 Background: Adolescent and young adult (AYA) cancer patients (15-39 years of age) often report health insurance concerns and financial toxicity due to their life-saving treatment. AYAs often have limited experience with healthcare prior to their diagnosis, which may limit their understanding of health insurance concepts, coverage, and costs. To describe AYA health insurance experiences, expectations, and literacy, we conducted semi-structured interviews with AYA cancer patients and survivors. Methods: Eligible participants were 18-39 years, diagnosed with cancer, and insured. Participants were recruited through an AYA cancer navigation program in Utah from 10/2019-03/2020. Participants were purposively sampled to achieve equal age strata (18-25 vs. 26-39), as patients under 26 often remain on their parents policy. Individual interviews were recorded, transcribed, and analyzed. Inductive qualitative analysis was conducted to describe their experiences with and understanding of their insurance. We calculated descriptive statistics of demographics and the Health Insurance Literacy Measure (HILM), a continuous measure ranging from 0-84 (higher scores indicate higher comfortability and literacy). Associations of age (18-25 vs. 26-39) and policy holder (yes vs. no) with HILM score were evaluated with t-tests. Results: AYAs (N = 24) were nearly even by gender, female (58%), primarily heterosexual (92%), Non-Hispanic White (79%), and had at least some college (92%). Less than half of participants were policy holders (41.7%). Three themes emerged from analysis: 1) Lack of knowledge and experiential learning throughout treatment, 2) Unclear expectations of health insurance, and 3) Difficulties navigating coverage and the complex systems. Most AYAs were unaware of the specifics of their coverage and how their insurance plan impacted their costs. Most AYAs were surprised at the lack of coverage and high costs they encountered during treatment. Most AYAs experienced substantial difficulty navigating coverage issues, particularly the appeals process. The mean HILM score was 55.63 (SD = 10.06), no differences by age group or policy holder status. Conclusions: AYAs with cancer report substantial difficulty navigating the complex health insurance system and demonstrate low levels of health insurance literacy. Health insurance education focusing on insurance concepts (e.g., cost-sharing mechanisms) may help AYAs better manage costs and enable them to make informed health insurance decisions despite being at higher risk for financial toxicity.
Overcoming bacterial physical defenses with molecule-like ultrasmall antimicrobial gold nanoclusters
Authors: Kaiyuan Zheng, Magdiel I. Setyawati, David Tai Leong, Jianping Xie
Journal: Bioactive Materials (2020)

The size of metal nanoparticles (NPs) is crucial in their biomedical applications. Although abundant studies on the size effects of metal NPs in the range of 2-100 nm have been conducted, the exploration of the ultrasmall metal nanoclusters (NCs) of ~1 nm in size with unique features is quite limited. We synthesize three different sized gold (Au) NCs of different Au atom numbers and two bigger sized Au NPs protected by the same ligand to study the size influence on antimicrobial efficacy. The ultrasmall Au NCs can easily traverse the cell wall pores to be internalized inside bacteria, inducing reactive oxygen species generation to oxidize bacterial membrane and disturb bacterial metabolism. This explains why the Au NCs are antimicrobial while the Au NPs are non-antimicrobial, suggesting the key role of size in antimicrobial ability. Moreover, in contrast to the widely known size-dependent antimicrobial properties, the Au NCs of different atom numbers demonstrate molecule-like instead of size-dependent antimicrobial behavior with comparable effectiveness, indicating the unique molecule-like feature of ultrasmall Au NCs. Overcoming the bacterial defenses at the wall with ultrasmall Au NCs changes what was previously believed to harmless to the bacteria instead to a highly potent agent against the bacteria.
Whole-Blood Resuscitation of Injured Patients’ Plasma
Authors: Olivier Richard, Charlotte Chollet-Xemard, Benoît Vivien
Journal: JAMA Surgery (2020)

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
Real-time unblinding for validation of a new CADe tool for colorectal polyp detection
Authors: Pieter Sinonquel, Tom Eelbode, Cesare Hassan, Giulio Antonelli, Federica Filosofi, Helmut Neumann, Ingrid Demedts, Philip Roelandt, Frederik Maes, Raf Bisschops
Journal: Gut (2020)

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In this prospective multicentre …
p50 suppresses cytotoxic T lymphocyte effector function to regulate tumor immune escape and response to immunotherapy
Authors: Chunwan Lu, John D Klement, Alyssa D Smith, Dafeng Yang, Jennifer L Waller, Darren D Browning, David H Munn, Kebin Liu
Journal: Journal for ImmunoTherapy of Cancer (2020)

Background NF-κB is a key link between inflammation and cancer. Previous studies of NF-κB have largely focused on tumor cells, and the intrinsic function of NF-κB in T cells in tumor development and response to immunotherapy is largely unknown. We aimed at testing the hypothesis that NF-κB1 (p50) activation in T cells underlies human colon cancer immune escape and human cancer non-response to anti-PD-1 immunotherapy. Methods We screened NF-κB activation in human colon carcinoma and used mouse models to determine p50 function in tumor cells and immune cells. RNA-Seq was used to identify p50 target genes. p50 binding to target gene promoters were determined by electrophoresis mobility shift assay and chromatin immunoprecipitation. A p50 activation score was generated from gene expression profiling and used to link p50 activation to T-cell activation and function pre-nivolumab and post-nivolumab immunotherapy in human patients with cancer. Results p50 is the dominant form of NF-κB that is highly activated in immune cells in the human colorectal carcinoma microenvironment and neighboring non-neoplastic colon epithelial cells. Tumor cell intrinsic p50 signaling and T-cell intrinsic p50 signaling exert opposing functions in tumor growth control in vivo. Deleting Nfkb1 in tumor cells increased whereas in T cells decreased tumor growth in preclinical mouse models. Gene expression profiling identified Gzmb as a p50 target in T cells. p50 binds directly to a previously uncharacterized κB sequence at the Gzmb promoter in T cells, resulting in repression of Gzmb expression in tumor-infiltrating cytotoxic T lymphocytes (CTLs) to induce a dysfunctional CTL phenotype to promote tumor immune escape. p50 activation is inversely correlated with both GZMB expression and T-cell tumor infiltration in human colorectal carcinoma. Furthermore, nivolumab immunotherapy decreased p50 activation and increased GZMB expression in human patients with melanoma. Conclusions Inflammation activates p50 that binds to the Gzmb promoter to repress granzyme B expression in T cells, resulting in CTL dysfunction to confer tumor immune escape and decreased response to anti-PD-1 immunotherapy.
Abstract 10646: Effects of High Intensity Interval Training on Endothelial Function in Breast Cancer Patients Undergoing Anthracycline Chemotherapy
Authors: Kyuwan Lee, Irene Kang, Joanne Mortimer, Christina M Dieli-Conwright
Journal: Circulation (2018)

Introduction: Breast cancer patients who receive chemotherapy have a 1.7-fold higher risk of cardiovascular disease (CVD) mortality than those who receive only radiotherapy or endocrine therapy. An...
Stage-specific trends in primary therapy and survival in follicular lymphoma: a nationwide population-based analysis in the Netherlands, 1989–2016
Authors: Manette A. W. Dinnessen, Marjolein W. M. van der Poel, Sanne H. Tonino, Otto Visser, Nicole M. A. Blijlevens, Daphne de Jong, King H. Lam, Marie José Kersten, Pieternella J. Lugtenburg, Avinash G. Dinmohamed
Journal: Leukemia (2020)
Systemic Anti–PD-1 Immunotherapy Results in PD-1 Blockade on T Cells in the Cerebrospinal Fluid
Authors: Jana Portnow, Dongrui Wang, M. Suzette Blanchard, Vivi Tran, Darya Alizadeh, Renate Starr, Ramsinh Dodia, Vivian Chiu, Alfonso Brito, Julie Kilpatrick, Paige McNamara, Stephen J. Forman, Behnam Badie, Timothy W. Synold, Christine E. Brown
Journal: JAMA Oncology (2020)

Little is known about the penetration and bioactivity of systemically administered programmed cell death 1 (PD-1) antibodies in the central nervous system. Such information is critical for advancing checkpoint antibody therapies for treatment of brain tumors.To evaluate pembrolizumab concentrations and PD-1 blockade on T cells in the cerebrospinal fluid (CSF) after intravenous administration.Cerebrospinal fluid and blood samples were collected from 10 adult patients with high-grade gliomas who were participating in clinical trials of intracranially administered chimeric antigen receptor (CAR) T cells and intravenous pembrolizumab at City of Hope in Duarte, California, from 2017 through 2019. Neuropharmacokinetic and immunologic correlative studies were performed on CSF and serum samples.Pembrolizumab, 200 mg, was given intravenously every 3 weeks with a median of 2 cycles (range, 1-8). CAR T cells were administered intracranially every 1 to 4 weeks. Cerebrospinal fluid and blood samples were collected on the day of CAR T-cell administration and then 24 hours later for a total of 100 paired samples.Pembrolizumab concentrations were measured by enzyme-linked immunosorbent assay, PD-1 blocking on T cells by flow cytometry, and results of PD-1 blockade on CAR T-cell function by in vitro tumor rechallenge assays.Of the 10 patients included in this study, the mean (SD) age was 45.7 (11.0) years, and 6 (60%) were women. Steady-state pembrolizumab concentrations in the CSF were achieved by 24 hours after initial intravenous administration, with a mean CSF:serum ratio of 0.009 (95% CI, 0.004-0.014). The CSF concentrations of pembrolizumab effectively blocked PD-1 on both endogenous T cells and intracranially administered CAR T cells in the CSF, with flow cytometric detection of surface PD-1 on the T cells decreasing from a mean (SD) of 39.3% (20.2%) before pembrolizumab to a mean (SD) of 3.8% (5.8%) 24 hours after pembrolizumab infusion. Steady-state concentrations in the CSF were maintained throughout the 21-day cycle of pembrolizumab, as was the PD-1 blocking effect, evidenced by no increase in detectable surface PD-1 on T cells in the CSF during that time period. Incubation of PD-1-expressing T cells with CSF samples from patients treated with pembrolizumab also resulted in PD-1 blockade.Results of this study demonstrate steady-state concentrations of pembrolizumab in CSF after intravenous administration as well as CSF concentrations that are sufficient for blocking PD-1 on endogenous and adoptively transferred T cells. This provides mechanistic insight regarding the ability of systemically administered PD-1 blocking antibodies to modulate T-cell activity in the brain.
Emotional impact of COVID-19 preparations on metro and regional cancer workforces in Queensland Australia: "We are all in this together<i>"</i>.
Authors: Natasha Anne Roberts, Bryan Chan, Elizabeth Stephanie Ahern, Harry Michael Gasper, Glen Kennedy, Brett Gordon Maxwell Hughes, David Wyld, Melissa A. Eastgate, Zarnie Lwin
Journal: Journal of Clinical Oncology (2020)

44 Background: Australia has achieved a “flattening of the curve” with a sustained COVID-19 roadmap to recovery in place. We explored the emotional impact of COVID-19 on our cancer workforce, during the preparation phase of the pandemic. Methods: We developed and pilot-tested an online survey to capture the emotional impact on cancer care staff during the COVID-19 health system response. Two large cancer centres were identified for study sample, one metropolitan and one regional, in Queensland, Australia. All cancer care staff with patient-facing roles were invited via all-staff email to participate on a weekly basis, uniquely also including ancillary and administrative workers. The final survey questionnaire included qualitative domains with open text responses for reflections on difficult decisions and subsequent emotional impacts. At the same time, a prospective diary of organizational developments was independently maintained by two investigators in order to contextualize changing survey responses over time. Qualitative data analyses by four investigators included independent, multiple cross-coding, memos, dataset review and member-checking to ensure methodological rigour. Data were synthesised into key themes utilising the Framework Method (Gale, 2013). Results: 117 metropolitan and 59 regional staff were surveyed over a 6-week period. Participants were medical, nursing, allied health, administrative and ancillary staff, working across inpatient and outpatient oncology services. Four key themes were emergent across the trajectory of the COVID preparation phase; ‘Strategies for protection’ (self-isolation, using PPE, protecting patients, families and each other), ‘Navigating rules and keeping up’ (compliance, exceptions, conflict and complex decision fatigue), ‘Tempered optimism’ (this is grief, strategies for coping, pride in one’s place), and ‘Framing the new normal’ (using new technology, second wave, uncertainty). At different time points, one theme dominated more than others. Conclusions: Despite rapid adaptations to system changes, staff responses highlight that it was their sense of connectedness that had the greatest influence on their reflections during the COVID-19 pandemic, but also underpinned the humanistic aspects of their responses. Staff perceptions of feeling supported and prepared, permeated through the duration of the survey. Results from the recovery phase are awaited.
Demographic Characteristics, Cigarette Smoking, and e-Cigarette Use Among US Adults
Authors: Margaret Mayer, Carolyn Reyes-Guzman, Rachel Grana, Kelvin Choi, Neal D. Freedman
Journal: JAMA Network Open (2020)

Additionally, 23.1% of e-cigarette users reported never smoking, and most were younger than 35 years.In addition to the potential health effects of vaping, 3 the young age of many users is concerning, particularly as nicotine is highly addictive and can negatively affect brain development, which continues until age 25 years. 4mitations of this study include a cross-sectional design and self-reported data.Strengths of these analyses include recency of the data and a large nationally representative sample, which makes the findings generalizable.e-Cigarettes are now used by large numbers of never, former, and current cigarette smokers in the US population.Given the rapidly changing e-cigarette marketplace and recent increases in the prevalence of use among youth 5 and young adults, 6 continued surveillance is needed.
Missed work, lost income, and job loss in survivors of colorectal cancer and their partners: A dyadic study.
Authors: Christine M Veenstra, Paul Abrahamse, Arden M. Morris, Sarah T. Hawley
Journal: Journal of Clinical Oncology (2020)

145 Background: Many survivors of colorectal cancer face long-term job loss stemming from their diagnosis. However, little is known about employment outcomes among their partners and virtually nothing is known about employment impacts among survivor-partner dyads. Methods: In 2019-20 we surveyed 1150 patients who, in 2014-18, underwent resection of Stage III colorectal cancer and were seen at a community oncology practice, academic cancer center, or reported to Georgia SEER (51% RR). Patients gave a separate survey to their partner. 299 partners (73% RR) completed surveys. Patients and partners were asked about employment consequences of the patient’s cancer. Availability of job support benefits and prevalence of adverse employment outcomes were described among partners. Descriptive statistics were generated to identify trends in job loss within dyads. Results: Among partners, 56% were &lt;age 65, 63% female, 86% white, 27% had &lt; high school education. 61% were employed at time of patient’s diagnosis. Among these, 15% had no job support benefits. 33% had paid sick leave, 47% had flexible work schedule, 28% had unpaid time off. Due to the patient’s cancer, 43% missed 7-30 days work and 13% missed &gt;1 month. Due to the patient’s cancer, 18% lost $2000-$10,000 in income and 11% lost &gt;$10,000. 27% were no longer working at the time of survey. In 47% of dyads, both patient and partner were working before patient’s diagnosis. Among those, in 29% only 1 member of dyad was still working at time of survey and in 11% neither member of dyad was still working. In 15% of dyads, only the partner was working before patient’s diagnosis. Among those, in 50% the partner was no longer working at time of survey. In 16% of dyads, only the patient was working before diagnosis. Among those, in 48% the patient was no longer working at time of survey. Job loss in dyads was associated with older age, lower annual income, and lack of flexible work schedule. Conclusions: Missed work and loss of income are common among partners of patients with colorectal cancer. Job loss affects nearly half of dyads in the survivorship period. Employer accommodations such as flexible scheduling may help mitigate job loss among survivors and their partners. [Table: see text]
A deep-learning system for the assessment of cardiovascular disease risk via the measurement of retinal-vessel calibre
Authors: Carol Y. Cheung, Dejiang Xu, Ching-Yu Cheng, Charumathi Sabanayagam, Yih-Chung Tham, Marco Yu, Tyler Hyungtaek Rim, Chew Yian Chai, Bamini Gopinath, Paul Mitchell, Richie Poulton, Terrie E. Moffitt, Avshalom Caspi, Jason C. Yam, Clement C. Tham, Jost B. Jonas, Ya Xing Wang, Su Jeong Song, Louise M. Burrell, Omar Farouque, Ling Jun Li, Gavin Tan, Daniel S. W. Ting, Wynne Hsu, Mong Li Lee, Tien Y. Wong
Journal: Nature Biomedical Engineering (2020)
High frequency of variants in genes associated with primary immunodeficiencies in patients with rheumatic diseases with secondary hypogammaglobulinaemia
Authors: Georgios Sogkas, Natalia Dubrowinskaja, Ignatius Ryan Adriawan, Manfred Anim, Torsten Witte, Reinhold E Schmidt, Faranaz Atschekzei
Journal: Annals of the Rheumatic Diseases (2020)

Treatment of rheumatic diseases requires immunomodulatory agents which can compromise antibody production. However, even in case of agents directly targeting B cells, a minority of patients develop hypogammaglobulinaemia, suggesting a genetic predisposition, which has not been investigated so far. The phenotypic overlap between primary immunodeficiency disorders (PIDs) and rheumatic diseases suggests a shared genetic basis, especially in case of patients with rheumatic diseases with hypogammaglobulinaemia.1008 patients with rheumatic diseases visiting the outpatient clinics of the Hannover University Hospital were screened for hypogammaglobulinaemia. Those with persistent hypogammaglobulinaemia and an equal number of patients without it underwent targeted next-generation sequencing, searching for variations in genes linked with hypogammaglobulinaemia in the context of PIDs.We identified 33 predicted pathogenic variants in 30/64 (46.9%) patients with persistent secondary hypogammaglobulinaemia. All 33 variants were monoallelic and 10 of them in 10/64 (15.6%) patients were found in genes associated with autosomal dominant PIDs. 2/64 (3.1%) patients harboured variants which were previously reported to cause PIDs. In the group without hypogammaglobulinaemia we identified seven monoallelic variants in 7/64 (10.9%), including a variant in a gene associated with an autosomal dominant PID.Approximately half of patients with persistent secondary hypogammaglobulinaemia harboured at least a variant in a PID gene. Despite the fact that previous immunomodulatory treatment is an exclusion criterion in the diagnosis of PIDs, we identified genetic variants that can account for PID in patients with clear rheumatic phenotypes who developed hypogammaglobulinaemia after the introduction of immunomodulatory treatment. Our data suggest the common genetic causes of primary and secondary hypogammaglobulinaemia.