tbuckley/cabot-search huggingface dataset:
The Force of Mind or the Mental Factor in Medicine.
Journal: JAMA (1902)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
Negative association of smoking with PSA and PSA velocity.
Authors: Amit Mohan Algotar, Mitchell Sokoloff, Chiu-Hsieh Hsu, Parminder Singh, Steven Paul Stratton
Journal: Journal of Clinical Oncology (2013)

e16060 Background: Smoking and obesity have been implicated in the pathogenesis of various chronic diseases and carcinogenic processes. However, their role in prostate cancer (PCa) &amp; their association with important biomarkers such as prostate specific antigen (PSA) &amp; PSA velocity (rate of PSA change over time) remains unresolved. This study investigates the association of these risk factors with PSA &amp; PSA velocity (PSAV) in men at high risk for PCa. Methods: Data were obtained from 699 men participating in a Phase 3 clinical trial aimed at investigating the effect of selenium supplementation on incidence of PCa. During the course of this trial 73 men were diagnosed with PCa. Multiple linear regressions were used to investigate the association with PSA and mixed effects models were used to investigate the association with PSAV. Results: As compared to non-smokers, smokers demonstrated statistically significant negative association with PSA (8.0 &amp; 6.7ng/ml, p=0.02). This association was more pronounced in men diagnosed with PCa (14.7 &amp; 9.9ng/ml) as compared to those not diagnosed with PCa (4.5 &amp; 3.6ng/ml). As compared to non-obese subjects, obese subjects did not demonstrate a statistically significant association with PSA (6.8 &amp; 7.1ng/ml, p= 0.64) nor do these results change after stratifying the analysis by PCa status. Smoking was associated with statistically significant lower PSAV (p=0.008) whereas obesity was not (p=0.42). Using the standard PSA level of 4ng/ml as a cut off for conducting prostate biopsy, 14.6% of smokers in this study would not have been prescribed a prostate biopsy and thus misclassified as being negative for PCa. Conclusions: The negative association of smoking with PSA and PSA velocity could potentially be due to its negative effect on testosterone. Hence, increased vigilance may be warranted among smokers with borderline PSA to prevent the risk of delayed diagnosis and metastasis thus reducing morbidity and mortality associated with PCa.
It starts at the top: An analysis of female representation in academic medical oncology (MO), radiation oncology (RO), and surgical oncology (SO) program leadership positions.
Authors: Mudit Chowdhary, Akansha Chowdhary, Kirtesh R. Patel, Trevor J. Royce, Neilayan Sen, Parul Nafees Barry, Shikha Jain, Ruta D. Rao, Mia Alyce Levy, Miriam Knoll, Neha Vapiwala, Dian Wang, Barbara Pro, Gaurav Marwaha
Journal: Journal of Clinical Oncology (2019)

10520 Background: Female underrepresentation in academic medicine leadership is well-documented; however, oncology specific data are scarce. This study evaluates female leadership representation in academic medical oncology (MO), radiation oncology (RO) and surgical oncology (SO) programs. Furthermore, we examine the impact of female leadership on overall female faculty representation. Methods: A total of 264 (96%) Accreditation Council for Graduate Medical Education actively accredited MO [144 of 153], RO [93 of 94] and SO [27 of 27] training programs were included. The gender of overall faculty and those in leadership positions (program director and departmental chair/division chief) of each program was determined using hospital websites from 10/01/18 to 01/27/19. The chi-squared goodness-of-fit test was used to examine whether the observed proportion of females in leadership positions deviates significantly from the expected proportion based on the actual proportion of overall female faculty in MO, RO and SO. Two-sample t-tests were used to compare rates of female faculty representation across each program based on the presence/absence of female in a leadership position for MO, RO and SO. Results: Female faculty representation in MO, RO and SO was 37.1% (1,554/4,191), 30.7% (389/1,269) and 38.8% (212/546), respectively. Female representation in leadership positions was 31.5% (82/260), 17.4% (31/178) and 11.1% (5/45), respectively. The observed proportion of females in leadership positions was significantly lower than the expected proportion of females in leadership positions for RO (17.4% vs. 30.7%, p = .0001) and SO (11.1% vs. 38.8%, p = .0001), and demonstrated a trend towards significance for MO (31.5% vs. 37.1%, p = .063). 47.9%, 33% and 18.5% of MO, RO and SO programs had ≥1 female in a leadership position, respectively. Programs that had a female in a leadership position had a higher mean percentage of overall female faculty than those that did not: 41.0% vs 35.0% (p = .0006), 36.0% vs 26.0% (p = .0002) and 39.0% vs 32.0% (p = .348) for MO, RO and SO, respectively. Conclusions: Gender disparity exists in academic MO, RO and SO faculty and is magnified at the leadership level. Programs with a female physician in a leadership position are associated with a higher percentage of female faculty.
Arteriolar Neovasculogenesis and Sinusoidal Collapse Are Pathologic Features of the Hematopoietic Stem Cell Niche in Sickle Cell Disease (SCD) Mice
Authors: Shin-Young Park, Alessandro Mattè, Eun Young Anna Han, Min Liu, Jina Ryu, Lucia De Franceschi, Leslie E. Silberstein
Journal: Blood (2017)
The United Kingdom Field Epidemiology Training Programme: meeting programme objectives
Authors: Paola Dey, Jeremy Brown, John Sandars, Yvonne Young, Ruth Ruggles, Samantha Bracebridge
Journal: Eurosurveillance (2019)

Introduction Most evaluations of field epidemiology training programmes (FETP) are limited to process measures, but stakeholders may need evidence of impact. Objective To ascertain if the United Kingdom (UK) FETP met its objectives to: (i) strengthen capacity and provision of national epidemiology services, (ii) develop a network of highly skilled field epidemiologists with a shared sense of purpose working to common standards and (iii) raise the profile of field epidemiology through embedding it into everyday health protection practice. Methods The evaluation consisted of: (i) focus groups with training site staff, (ii) individual interviews with stakeholders and (iii) an online survey of FETP fellows and graduates. Findings were synthesised and triangulated across the three evaluation components to identify cross-cutting themes and subthemes. Findings Eight focus groups were undertaken with 38 staff, ten stakeholders were interviewed and 28 (76%) graduates and fellows responded to the survey. Three themes emerged: confidence, application and rigour. FETP was perceived to have contributed to the development, directly and indirectly, of a skilled workforce in field epidemiology, increasing stakeholders’ confidence in the service. Graduates applied their learning in practice, collaborating with a wide range of disciplines. Fellows and graduates demonstrated rigour by introducing innovations, supporting service improvements and helping supervisors maintain their skills and share good practice. Conclusion The UK FETP appears to have met its three key objectives, and also had wider organisational impact. FETPs should systematically and prospectively collect information on how they have influenced changes to field epidemiology practice.
Leveraging Omics Profiling to Advance the Treatment of Pediatric Obesity
Authors: Sarah Koch, Anne M. Lasinsky, Eli Puterman
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
Correction: Heterotypic CAF-tumor spheroids promote early peritoneal metastatis of ovarian cancer
Authors: Qinglei Gao, Zongyuan Yang, Sen Xu, Xiaoting Li, Xin Yang, Ping Jin, Yi Liu, Xiaoshui Zhou, Taoran Zhang, Cheng Gong, Xiao Wei, Dan Liu, Chaoyang Sun, Gang Chen, Junbo Hu, Li Meng, Jianfeng Zhou, Kenjiro Sawada, Robert Fruscio, Thomas W. Grunt, Jörg Wischhusen, Víctor Manuel Vargas-Hernández, Bhavana Pothuri, Robert L. Coleman
Journal: The Journal of Experimental Medicine (2019)
A phase Ib dose-escalation study of TRC105 (anti-endoglin antibody) in combination with capecitabine for advanced solid tumors (including patients with progressive or recurrent HER2-negative metastatic breast cancer).
Authors: Ellis Glenn Levine, Andres Forero, Tracy O'Connor, Ben K. Seon, Manoj A Jivani, Bonne J. Adams, Charles P. Theuer
Journal: Journal of Clinical Oncology (2013)

3057 Background: CD105 (endoglin) is an endothelial cell membrane receptor highly expressed on angiogenic tumor vessels that is essential for angiogenesis and upregulated by hypoxia and VEGF inhibition. TRC105 is an anti-CD105 monoclonal antibody being studied in phase II trials that potentiates chemotherapy in preclinical models. Methods: Pts with advanced solid tumors (for purposes of dose escalation) or pts with metastatic HER2-negative breast cancer (following completion of dose escalation), ECOG PS 0-1, and normal organ function were treated with intravenously administered TRC105 wkly plus capecitabine at 1,000 mg/m 2 BID for 14 of every 21 days, and assessed for safety, PK, and response. Results: Fourteen patients (median age = 52; M:F 4:10; median of 3 prior regimens; 10 with breast and 4 with colorectal cancer) were enrolled. Dose escalation proceeded from 7.5 mg/kg TRC105 to the recommended single agent phase II dose of 10 mg/kg of TRC105 in combination with capecitabine, without development of dose limiting toxicity. Fourteen pts were treated at 7.5 mg/kg (n=4) or 10 mg/kg (n=10) TRC105 wkly + 1,000 mg/m 2 BID/14d capecitabine of repeating 21 day cycles. Patients experienced expected TRC105 related adverse events of grade 1 or grade 2 infusion reaction, epistaxis, gingival bleeding, telangiectasia, headache, rash, and fatigue. Grade 3 headache and grade 3 vomiting were each seen in one patient. Adverse events characteristic of each individual drug were not increased in frequency or severity when the two drugs were administered together. Mucocutaneous telangiectasia, a marker of TRC105 target modulation, was observed at both dose levels. A heavily pretreated male breast cancer patient remained on study for 9 months with a RECIST-defined partial response. Stable disease beyond 9 weeks was observed in three patients. Conclusions: The recommended single agent phase II dose of 10 mg/kg TRC105 wkly was well tolerated in combination with capecitabine. The combination treatment could be advanced in HER2-negative breast or colorectal cancer. Clinical trial information: NCT01326481.
Gordon Macpherson: editor who bridged the gap between <i>The BMJ</i> and the BMA
Authors: Linda Beecham
Journal: BMJ (2019)

Gordon Macpherson was born in Santa Cruz de Tenerife in the Canary Islands, where his father was working as an accountant. When Gordon was 10 his father died, but not before writing many letters to find someone to support his son at Christ’s Hospital (the famous “Blue Coat” public school in West Sussex). He was the only child of a single mother, and Christ’s Hospital had a profound influence on his life. He made lifelong friends there, and in the 1980s and ’90s he became a donation governor linked to its medical foundation, supporting three pupils.

After Christ’s he spent several terms studying science at McGill University in Montreal before starting at St Thomas’, where he met his future wife, Elizabeth, a Nightingale nurse. He did his national service at RAF Halton, working in the specialist burns unit. Having decided on a career in …
Use of advanced care directives by ambulatory chemotherapy patients with malignant disease: Likely predictors and impact of physician intervention
Authors: S. R. Hassan, D. Kilari, A. Politsmakher, S. Chakraborthy, J. Fogel, H. Dosik
Journal: Journal of Clinical Oncology (2009)

e20544 Background: Despite their poor prognosis, few cancer patients have advanced care directives (ACD). Most often, ACD is discussed in an inpatient setting, when the patient is acutely ill and often nearing the end of life. Timely and thoughtful discussion would be better accomplished for both the patient and the family before such hospitalization. Methods: Interviews were done in 108 outpatients in an ambulatory chemotherapy center. A questionnaire noted whether ACD was executed or not, demographics (including education, religion and insurance status), performance status, characteristics of their cancer, and family status. All patients without ACD were counseled on the importance of ACD. The presence of an ACD was documented at each visit. Statistical comparison of patients with and without ACD at each visit was done. Results: The following variables were significantly associated with having an ACD at the first visit. Patients living alone could not be included in the logistic regression model, as none had advanced directives. However ACD execution differed significantly in patients living alone, compared with those living with family (0/33 vs 15/75; p=0.005). An additional 42 patients executed an ACD by the third visit. At the third visit, only living with family vs living alone remained significantly associated with having ACD. [OR=3.17 95% CI: 1.34, 7.50; p=0.009]. Conclusions: The following findings are noteworthy. Only 15/108 (14%) cancer outpatients had ACD. This disturbingly low rate increased to 55/108 (51%) after physician- initiated discussion. The following characteristics predicted not having ACD before intervention: younger age, absence of metastasis, better performance status, lower education status and living alone. After several physician interventions, only living alone remained a significant barrier to ACD execution by cancer outpatients. These results provide new insights and strategies to encourage improved advanced directive execution. [Table: see text] No significant financial relationships to disclose.
Phase I Study of Rapid Alternation of Sunitinib and Regorafenib for the Treatment of Tyrosine Kinase Inhibitor Refractory Gastrointestinal Stromal Tumors
Authors: César Serrano, Alessandro Leal, Yanan Kuang, Jeffrey A. Morgan, Constance M. Barysauskas, Jillian Phallen, Olivia Triplett, Adrián Mariño-Enríquez, Andrew J. Wagner, George D. Demetri, Victor E. Velculescu, Cloud P. Paweletz, Jonathan A. Fletcher, Suzanne George
Journal: Clinical Cancer Research (2019)

Polyclonal emergence of KIT secondary mutations is a main mechanism of imatinib progression in gastrointestinal stromal tumor (GIST). Approved KIT inhibitors sunitinib and regorafenib have complementary activity against KIT resistance mutations. Preclinical evidence suggests that rapid alternation of sunitinib and regorafenib broadens the spectrum of imatinib-resistant subclones targeted.Phase Ib study investigating continuous treatment with cycles of sunitinib (3 days) followed by regorafenib (4 days) in patients with tyrosine kinase inhibitor (TKI)-refractory GIST. A 3+3 dosing schema was utilized to determine the recommended phase II dose (RP2D). Plasma samples were analyzed for pharmacokinetics and circulating tumor DNA (ctDNA) studies using targeted error correction sequencing (TEC-seq) and droplet digital PCR (ddPCR).Of the 14 patients enrolled, 2 experienced dose-limiting toxicities at dose level 2 (asymptomatic grade 3 hypophosphatemia). Sunitinib 37.5 mg/day and regorafenib 120 mg/day was the RP2D. Treatment was well-tolerated and no unexpected toxicities resulted from the combination. Stable disease was the best response in 4 patients, and median progression-free survival was 1.9 months. Combined assessment of ctDNA with TEC-seq and ddPCR detected plasma mutations in 11 of 12 patients (92%). ctDNA studies showed that KIT secondary mutations remain the main mechanism of resistance in TKI-refractory GIST, revealing effective suppression of KIT-mutant subpopulations in patients benefiting from the combination.Sunitinib and regorafenib combination is feasible and tolerable. Rapid alternation of TKIs with complementary activity might be effective when combining drugs with favorable pharmacokinetics, potentially allowing active doses while minimizing adverse events. Serial monitoring with ctDNA may guide treatment in patients with GIST.
HIV/AIDS pandemic (AP) in Africa: Chronicle of a missed opportunity
Authors: C. K. Williams
Journal: Journal of Clinical Oncology (2009)

e22235 Background: AP unlike HTLV-I associated diseases arrived late in parts of Africa, including Nigeria, where retroviral research was already ongoing in collaboration with the US National Cancer Institute (USNCI), thus providing unique preventive interventional opportunity. A World Health Organization sponsored study of the role of sexual behavior in retroviral transmission in Nigeria was performed 1985–86. Methods: Using an ELISA and an investigational Western blot (IWB) assay, a small survey of the seroprevalence rate (SPR%) of HTLV-I and HIV was conducted in 3 regions of the country among 5 population groups with differing sexual behaviors: normal blood donors (NBD), female commercial sex workers (FCSW), sexually transmitted diseases patients, and religious male/female celibates. 204 samples were re-tested with recombinant enhanced “Singapore” HIV-1/2 WB (SWB) in 1994, in view of earlier HIV-1 IWB negativity. All serological tests were done at USNCI. Results: HTLV-I SPR varied by region and lifestyle, highest in eastern region (ER) (p=0.0000095), FCSW of ER (p=0.0006), and frequency of male heterosexual activity (p=0.024). HIV-1 was undetectable by IWB, while SWB revealed 2/204 HIV-1+ for countrywide SPR: ∼1.0; Western NBD: 1/100 (1.0); Western/Northern NBD: 1/184 (0.54): non-high risk Nigerians: 2/237 (0.84); FCSW: 0/46; celibates: 0/71, adult general Nigerian population (AGNP): ∼0.5–1.0, and translating to (∼240–480)x10 3 HIV-1+ AGNP. Assuming 20 HIV-1+ = 1 case of AIDS death, SWB- determined SPR predicted (∼12–24)×10 3 AIDS deaths among 48×10 6 AGNP in 1985–86, ∼5 of (2.4- 4.8)×10 3 (&lt;0.2%) of whom presented with clinical AIDS features (CAF) at Nigeria's premier health institution (NPHI). Conclusions: In 1985–86, when patients with CAF rarely presented at NPHI and HIV-1 SPR was ≤1.0 in AGNP and FCSW, Nigerian health authority was advised on AP risk, unlike Uganda where it arrived unanticipated. Reports of SPR of 7.7 and 60.0 in AGNP and FCSW in 1996–2000 contrast against contemporary Ugandan SPR (14.0 down to 6.1) and Senegalese (0.4 up to 0.9), probably resulting from varying knowledge gap and angst-related inertia, illustrating mixed fortunes of AP in Africa, transcontinental variation in AP control capability, and providing lessons for the management of future public health challenges. No significant financial relationships to disclose.
Impact of comorbidities on recurrence rates and survival in patients with endometrial cancer.
Authors: Nadire Kucukoztas, Omer Dizdar, Samed Rahatli, Cagla Tarhan, Nihan Haberal, Polat Dursun, Selim Yalcin, Ozlem Ozen, Ferah Yildiz, Ozden Altundag, Ali Ayhan
Journal: Journal of Clinical Oncology (2013)

e16528 Background: The aim was to determine the clinical characteristics, comorbidities, tumor features, and survival outcomes in patients with uterine carcinoma treated in our institution. Methods: Charecteristics of 410 patients underwent initial abdominal surgery for primary endometrial cancer in our institution between 2006 and 2012 were reviewed. Demographic features, histologic types, stage, type of surgery, comorbidities, treatment modalities and patient outcomes in terms of relapse-free survival (RFS) and overall survival (OS) were assessed. Results: Patient characteristics are shown in the Table. Nearly all patients (97%) were initially treated surgically with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Median follow up was 26 mos. 3 year RFS was 90%. 3 year RFS was 97% at stage 1, 80% at stage 2, 62% at stage 3 and 4. 3 year OS was 91%. 3 year OS was 96% at stage 1, 85% at stage 2, 64% at stage 3-4. The only significant independent predictor of RFS was disease stage (HR 5.7, 95% CI 2.1-15.3, p&lt;0.0001) while histologic grade also bordered significance (HR 2.3, 95% CI ,8-6.4, p=0.085). Independent predictors of OS was age (HR 4.5, 95% CI 1.5-13.7, p&lt;0.007), presence of diabetes mellitus (HR 4.5, 95% CI %1.1-6.7, p=0.019) and stage (HR 5.2, 95% CI 2.2-12.6, p&lt;0.0001). Conclusions: Our data shows that older age (&gt;60 years) and advanced stage patients with endometrial cancer have significantly decreased overall survival. Presence of diabetes mellitus is not associated with recurrence rates but is associated with worse overall survival. Stage and grade are considered independent risk factors for recurrence [Table: see text]