tbuckley/cabot-search huggingface dataset:
The Home is the New Cancer Center
Authors: Nathan R. Handley, Justin E. Bekelman, Adam F. Binder
Journal: Journal of the National Comprehensive Cancer Network (2020)

A s oncologists in the era of coronavirus disease 2019 (COVID-19), we are tasked with caring for patients who are at high risk for adverse effects from the novel coronavirus (SARS-CoV-2). 1Patients with cancer face fear and anxiety related to their immunocompromised status, and early data suggest patients with cancer may be more susceptible to infection with SARS-CoV-2. 2 During this pandemic, a new vulnerability has arisen: how can patients receive life-sustaining treatment for cancer if they cannot get to the clinic or if the system is overwhelmed by patients with COVID-19?How can patients stay in what may be the safest place for them-the home-while still receiving high-quality care?COVID-19 provides an opportunity to recognize and improve on shortcomings in our cancer care delivery system: interacting with the health system puts already tenuous patients at risk for nosocomial infection, high-quality cancer care requires a high level of coordination that is challenging to achieve, and accessing care can be difficult or impossible for some individuals.Moving components of cancer care into the home can facilitate high-touch care, minimize risk by reducing unnecessary exposures to the health system, and improve access to treatment.Cancer care at home can augment or replace current models for clinic visits, chemotherapy, and acute care, deleveraging healthcare facilities as primary sites of care while ensuring safety for patients and providers, and improving patient-centeredness of care.Although important during a pandemic, cancer care at home can also have a lasting impact when healthcare returns to "normal operations."This commentary describes home-based approaches for clinic visits, chemotherapy, and acute care; examines concerns stakeholders have raised about implementation of these approaches; and evaluates needs for the sustainability of cancer care at home after resolution of the pandemic.
Long-term Health Consequences of COVID-19
Authors: Carlos del Rio, Lauren F. Collins, Preeti Malani
Journal: JAMA (2020)

Long-term Health Consequences of COVID-19With more than 30 million documented infections and 1 million deaths worldwide, the coronavirus disease 2019 (COVID-19) pandemic continues unabated.The clinical spectrum of severe acute respiratory syndrome coronavirus (SARS-CoV) 2 infection ranges from asymptomatic infection to life-threatening and fatal disease.Current estimates are that approximately 20 million people globally have "recovered"; however, clinicians are observing and reading reports of patients with persistent severe symptoms and even substantial end-organ dysfunction after SARS-CoV-2 infection.Because COVID-19 is a new disease, much about the clinical course remains uncertain-in particular, the possible long-term health consequences, if any. EpidemiologyCurrently, there is no consensus definition of postacute COVID-19.Based on the COVID Symptom Study, in which more than 4 million people in the US, UK and Sweden have entered their symptoms after a COVID-19 diagnosis, postacute COVID-19 is defined as the presence of VIEWPOINT
Covid-19: Leading doctors argue against local lockdowns
Authors: Jacqui Wise
Journal: BMJ (2020)

The UK government's own scientific advisers and other leading experts argued against a policy of increased restrictions in local areas to control the covid-19 pandemic, instead calling for a national short period of lockdown or "circuit breaker," documents show. The newly released documents reveal that the Scientific Advisory Group for Emergencies recommended on 21 September that such an immediate circuit breaker was the best way to control cases.1 Rumours about SAGE's advice had been circulating for some weeks,2 but the minutes were officially released only after the prime minister announced a new three tier system for England, with Liverpool facing the most stringent restrictions.3 The SAGE documents also suggested:
Jejunum lymphangioma: a rare case of obscure gastrointestinal bleeding with successful endoscopic therapy
Authors: Tung-Lung Wu, Hui-Ting Hsu, Hsu-Heng Yen
Journal: Endoscopy (2020)

An 84-year-old woman with a history of diabetes and hypertension was admitted to the cardiology ward for endovascular therapy for peripheral arterial occlusive disease. Following the procedure, she had tarry stool passage, and subsequent upper endoscopy did not find the source of the bleeding. She received esomeprazole, but the bleeding persisted, requiring daily blood transfusions. After a repeated upper endoscopy did not reveal the bleeder, capsule endoscopy ([Fig. 1]; [Video 1]) was performed. Active bleeding was found in the proximal jejunum, and enteroscopy was performed for endoscopic therapy. On enteroscopy, a whitish polypoid lesion with active bleeding was found ([Fig. 2]; [Video 1]). Endoscopic resection and clipping of the polyp resulted in hemostasis ([Fig. 3]). The pathology showed proliferation of variable-sized and irregularly shaped lymphatic channels in the lamina propria ([Fig. 4]) and submucosa. D2–40 immunostaining highlighted bland endothelial cells. The elastin stain revealed no malformed blood vessels. From these results, a diagnosis of bleeding jejunum lymphangioma was made.
Real-world practice patterns in follicular lymphoma (FL) care at community oncology centers.
Authors: Paul M. Barr, Taral Patel, Servillano E. Dela Cruz, Maen A. Hussein, Michael J. Castine, Breanne Y Farris, Rebecca R Crawford, Jeffrey D. Carter, Tamar Sapir
Journal: Journal of Clinical Oncology (2020)

231 Background: Though FL generally has good outcomes, patients with high risk FL have poorer outcomes; proper risk stratification for early intervention has been shown to improve overall benefit in some patients. In a quality improvement (QI) initiative conducted in 4 community oncology systems, we assessed practice patterns involving prognostication and the integration of patient-disease-and treatment-related factors to improve decision-making for patients with FL. Methods: Between 10/17/2019 and 3/4/2020, we surveyed hematology/oncology health care professionals (HCP; N=59) to assess challenges, barriers, and self-reported performance of quality FL care. Electronic medical records (EMR) of 100 patients were audited for demographics, disease characteristics, risk stratification, treatment, and patient-centered metrics. To address suboptimal guideline-aligned care, teams participated in audit-feedback sessions to develop action plans for resolving identified gaps. Results: The EMR audit demonstrated low levels of documentation of staging, grade, and criteria required by risk stratification models (Table). Despite 92% of HCP indicating the use of risk stratification or prognostic models to determine treatment choice, only 23% of charts indicated use of a model for risk stratification. 55% of HCP indicated testing for t(14;18), though no patients had documented evidence of t(14;18) testing results. Survey findings indicated low confidence integrating patient-related factors to determine appropriate risk group (24%). Treatment choice was aligned with guidelines. In surveys, providers reported uncertainty about when to initiate treatment (13%), which treatments are most appropriate for each patient (23%), and engaging patients in shared decision-making (28%) as top barriers to care. During audit-feedback sessions, teams created action plans to improve documentation for variables of risk stratification, patient symptoms, molecular results, and shared decision-making. Further, teams identified the need for improved resources and personnel. Conclusions: These findings reveal important challenges to providing individualized FL care in community settings, such as documentation of clinically important metrics, care coordination, and engaging patients in shared decision-making. These gaps may inform future QI and implementation science initiatives. [Table: see text]
COVID-19 risk stratification algorithms based on sTREM-1 and IL-6 in emergency department
Authors: Mathias Van Singer, Thomas Brahier, Michelle Ngai, Julie Wright, Andrea M. Weckman, Clara Erice, Jean-Yves Meuwly, Olivier Hugli, Kevin C. Kain, Noémie Boillat-Blanco
Journal: Journal of Allergy and Clinical Immunology (2020)
The Hepatic Microenvironment Uniquely Protects Leukemia Cells through Induction of Growth and Survival Pathways Mediated by LIPG
Authors: Haobin Ye, Mohammad Minhajuddin, Anna Krug, Shanshan Pei, Chih-Hsing Chou, Rachel Culp-Hill, Jessica Ponder, Erik De Bloois, Björn Schniedewind, Maria L. Amaya, Anagha Inguva, Brett M. Stevens, Daniel A. Pollyea, Uwe Christians, H. Leighton Grimes, Angelo D'Alessandro, Craig T. Jordan
Journal: Cancer Discovery (2020)

Abstract Due to the disseminated nature of leukemia, malignant cells are exposed to many different tissue microenvironments, including a variety of extramedullary sites. In the present study, we demonstrate that leukemic cells residing in the liver display unique biological properties and also contribute to systemic changes that influence physiologic responses to chemotherapy. Specifically, the liver microenvironment induces metabolic adaptations via upregulating expression of endothelial lipase in leukemia cells, which not only stimulates tumor cell proliferation through polyunsaturated fatty acid–mediated pathways, but also promotes survival by stabilizing antiapoptotic proteins. Additionally, hepatic infiltration and tissue damage caused by malignant cells induces release of liver-derived enzymes capable of degrading chemotherapy drugs, an event that further protects leukemia cells from conventional therapies. Together, these studies demonstrate a unique role for liver in modulating the pathogenesis of leukemic disease and suggest that the hepatic microenvironment may protect leukemia cells from chemotherapeutic challenge. Significance: The studies presented herein demonstrate that the liver provides a microenvironment in which leukemia cells acquire unique metabolic properties. The adaptations that occur in the liver confer increased resistance to chemotherapy. Therefore, we propose that therapies designed to overcome liver-specific metabolic changes will yield improved outcomes for patients with leukemia. This article is highlighted in the In This Issue feature, p. 211
Diagnostic Imaging for Kidney Stones
Authors: Ralph C. Wang, Marshall L. Stoller, Rebecca Smith-Bindman
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Relationship between clinical work intensity, hopefulness and well-being among medical oncologists.
Authors: Matthew F. Hudson, Mark Allen O'Rourke, Dawn W. Blackhurst, Jennifer D. Caldwell, David B. Feldman, Benjamin W. Corn, Ronnie D. Horner
Journal: Journal of Clinical Oncology (2020)

46 Background: Oncology providers’ well-being particularly concerns administrators, as projections suggest a shortfall in number of providers available to care for an increasing cancer survivor population. This pilot study solicited medical oncologists’ ratings on Clinical Work Intensity (CWI), well-being, and hope constructs: agency (goal-directed determination) and pathways (planning ways to meet goals), to understand relationships between clinical work intensity, hopefulness and well-being. Methods: Eleven providers (8 = MD and 3 = NP) practicing in three distinct community-based oncology sites completed the CWI measure, NASA-TLX, immediately following an office visit, for 20 separate visits. Each provider also completed one well-being index and one Adult Hope Scale that included agency and pathways subscales after the 20 visits. Lower well-being scores indicated higher well-being; higher hope scores indicated greater hopefulness. Results: Clinical work intensity positively correlates with well-being (Spearman rho = 0.16; p = 0.02). Clinical work intensity was inversely related to the total hopefulness score (Spearman rho = -0.25; p &lt; 0.001) and Hope construct subcomponents of perceived pathway to goal achievement (Spearman rho = -0.24; p &lt; 0.001), and determination to meet goals (agency) (Spearman rho = -0.15; p &lt; 0.001). Favorable provider well-being was also related to agency (Spearman rho = -0.71; p &lt; 0.0001). Conclusions: Higher provider-rated work intensity in sampled clinical encounters correlates, albeit weakly, with less favorable well-being scores. Higher CWI also correlates with lower hope scale scores. Thus, providers’ perceptions of their mental workload in clinical care are potentially related to their sense of well-being and hopefulness. Results also suggest provider determination to meet goals (agency) is also reflected in sense of well-being. These findings support further investigation using larger, more diverse samples to affirm observed relationships. Future research may also elucidate intervention targets through which to abate provider distress portending burnout. Insights gleaned from future work may inform improvements to the work life of oncology care providers.
Interleukin-10 Prevents Pathological Microglia Hyperactivation following Peripheral Endotoxin Challenge
Authors: Anat Shemer, Isabelle Scheyltjens, Gal Ronit Frumer, Jung-Seok Kim, Jonathan Grozovski, Serkalem Ayanaw, Bareket Dassa, Hannah Van Hove, Louise Chappell-Maor, Sigalit Boura-Halfon, Dena Leshkowitz, Werner Mueller, Nicola Maggio, Kiavash Movahedi, Steffen Jung
Journal: Immunity (2020)
Effects of antiandrogens on prolactin levels among transgender women on estrogen therapy: A systematic review
Authors: Lisa M. Wilson, Kellan E. Baker, Ritu Sharma, Vadim Dukhanin, Kristen McArthur, Karen A. Robinson
Journal: International Journal of Transgender Health (2020)

BackgroundGender-affirming hormone therapy for transgender women includes estrogen and antiandrogens (cyproterone acetate, spironolactone, or gonadotropin-releasing hormone agonists). Both estrogen and antiandrogens are reported to increase prolactin levels. The objective is to systematically review the evidence of the effects of antiandrogens on prolactin levels, hyperprolactinemia, and prolactinomas among transgender women on estrogen therapy.MethodsWe searched PubMed, Embase, and PsycInfo up to May 2020. We included studies with at least 3 months follow-up that evaluated the effects of antiandrogens among transgender women and reported on prolactin levels, hyperprolactinemia, or image-confirmed prolactinomas. Two reviewers independently screened studies for eligibility, serially abstracted data, and independently assessed risk of bias and graded strength of evidence.FindingsWe included 17 studies (16 publications): 8 prospective cohorts, 8 retrospective cohorts, and 1 cross-sectional study, each with a moderate to serious risk of bias. Among transgender women on estrogen, prolactin levels increased by over 100% with cyproterone acetate and by up to 45% with spironolactone. However, we were unable to isolate the effects of antiandrogens from estrogen therapy. We were unable to draw conclusions about effects of antiandrogens on hyperprolactinemia and prolactinomas.InterpretationProlactin levels may be increased in transgender women who are taking both estrogens and an antiandrogen. Future research is needed to determine the effects of different antiandrogens on prolactin levels separately from estrogen therapy. Ideally, future studies would be prospective, provide either a comparison of two different antiandrogens or compare combination of estrogen and antiandrogen therapy to estrogen alone, and control for possible confounders.
Evidence for secondary-variant genetic burden and non-random distribution across biological modules in a recessive ciliopathy
Authors: Maria Kousi, Onuralp Söylemez, Aysegül Ozanturk, Niki Mourtzi, Sebastian Akle, Irwin Jungreis, Jean Muller, Christopher A. Cassa, Harrison Brand, Jill Anne Mokry, Maxim Y. Wolf, Azita Sadeghpour, Kelsey McFadden, Richard A. Lewis, Michael E. Talkowski, Hélène Dollfus, Manolis Kellis, Erica E. Davis, Shamil R. Sunyaev, Nicholas Katsanis
Journal: Nature Genetics (2020)
Risk estimation of SARS-CoV-2 transmission from bluetooth low energy measurements
Authors: Felix Sattler, Jackie Ma, Patrick Wagner, David Neumann, Markus Wenzel, Ralf Schäfer, Wojciech Samek, Klaus-Robert Müller, Thomas Wiegand
Journal: npj Digital Medicine (2020)

Digital contact tracing approaches based on Bluetooth low energy (BLE) have the potential to efficiently contain and delay outbreaks of infectious diseases such as the ongoing SARS-CoV-2 pandemic. In this work we propose a machine learning based approach to reliably detect subjects that have spent enough time in close proximity to be at risk of being infected. Our study is an important proof of concept that will aid the battery of epidemiological policies aiming to slow down the rapid spread of COVID-19.
A novel humanoid-robot simulator for colonoscopy
Authors: Masashi Fujii, Takumi Onoyama, Yuichiro Ikebuchi, Kazutake Uehara, Atsuro Koga, Masaru Ueki, Hajime Isomoto
Journal: Endoscopy (2020)

Colorectal cancer is the cancer with the third-highest incidence worldwide [1]. Colonoscopy is a useful imaging modality that has a high sensitivity and can reduce mortality from colorectal cancer [2]. Although diminutive adenomas pose a lower risk of malignancy than larger ones, an increase in adenoma detection rates may contribute to decreasing the risk of colorectal cancer [3]. However, operator proficiency has been a difficult hurdle to overcome. Basic insertion skills are required to perform a standardized colonoscopy. As observing the whole lumen with as few blind spots as possible is a basic prerequisite for qualified endoscopic diagnosis, subjective factors or limited levels of ability in the endoscopists may lead to missed lesions. Endoscopic training is expensive in both time and costs, and there is also a lack of realistic simulators for trainees. For these reasons, we developed a humanoid-robot simulator, called a "mikoto," that allows endoscopists to insert the scope in a way that feels comparable to performing a colonoscopy in the human body ([Fig. 1]).
A NOVEL SMALL MOLECULE, LAS0811, DECREASES ALCOHOL-INDUCED INJURY VIA INCREASING ANTIOXIDANT RESPONSE ELEMENT IN VL-17A CELLS
Authors: Tae-Hun Kim, Senthil K. Venugopal, Ming Zhu, Derick Lau, Kit S. Lam, Dohn L. Clemens, Mark Zern
Journal: Hepatology (2018)
Myxoid tissue in stent restenosis may be a provisional tissue in which active cell migration and synthesis of extracellular matrix (ECM) occur
Authors: I. M. Chung, Y. Jang, S. J. Park, S. Y. n Cho, S. W. Park, C. W. Lee, S. H. Cho, P. Heldin, H. K. Gold, S. M. Schwartz
Journal: Journal of the American College of Cardiology (2000)
Role of CC chemokine receptor 9 in the progression of murine and human non-alcoholic steatohepatitis
Authors: Rei Morikawa, Nobuhiro Nakamoto, Takeru Amiya, Po-sung Chu, Yuzo Koda, Toshiaki Teratani, Takahiro Suzuki, Yutaka Kurebayashi, Akihisa Ueno, Nobuhito Taniki, Kentaro Miyamoto, Akihiro Yamaguchi, Shunsuke Shiba, Tadashi Katayama, Kosuke Yoshida, Yoshiaki Takada, Rino Ishihara, Hirotoshi Ebinuma, Michiie Sakamoto, Takanori Kanai
Journal: Journal of Hepatology (2020)
Novel, non-invasive imaging approach to identify patients with advanced non-small cell lung cancer at risk of hyperprogressive disease with immune checkpoint blockade
Authors: Pranjal Vaidya, Kaustav Bera, Pradnya D Patil, Amit Gupta, Prantesh Jain, Mehdi Alilou, Mohammadhadi Khorrami, Vamsidhar Velcheti, Anant Madabhushi
Journal: Journal for ImmunoTherapy of Cancer (2020)

Hyperprogression is an atypical response pattern to immune checkpoint inhibition that has been described within non-small cell lung cancer (NSCLC). The paradoxical acceleration of tumor growth after immunotherapy has been associated with significantly shortened survival, and currently, there are no clinically validated biomarkers to identify patients at risk of hyperprogression.A total of 109 patients with advanced NSCLC who underwent monotherapy with Programmed cell death protein-1 (PD1)/Programmed death-ligand-1 (PD-L1) inhibitors were included in the study. Using RECIST measurements, we divided the patients into responders (n=50) (complete/partial response or stable disease) and non-responders (n=59) (progressive disease). Tumor growth kinetics were used to further identify hyperprogressors (HPs, n=19) among non-responders. Patients were randomized into a training set (D1=30) and a test set (D2=79) with the essential caveat that HPs were evenly distributed among the two sets. A total of 198 radiomic textural patterns from within and around the target nodules and features relating to tortuosity of the nodule associated vasculature were extracted from the pretreatment CT scans.The random forest classifier using the top features associated with hyperprogression was able to distinguish between HP and other radiographical response patterns with an area under receiver operating curve of 0.85±0.06 in the training set (D1=30) and 0.96 in the validation set (D2=79). These features included one peritumoral texture feature from 5 to 10 mm outside the tumor and two nodule vessel-related tortuosity features. Kaplan-Meier survival curves showed a clear stratification between classifier predicted HPs versus non-HPs for overall survival (D2: HR=2.66, 95% CI 1.27 to 5.55; p=0.009).Our study suggests that image-based radiomics markers extracted from baseline CTs of advanced NSCLC treated with PD-1/PD-L1 inhibitors may help identify patients at risk of hyperprogressions.