tbuckley/cabot-search huggingface dataset:
Impact of cancer on physical and mental activities of daily living in young adult (YA) survivors.
Authors: Tyler Garrett Ketterl, Mary S. McCabe, Donald L. Rosenstein, Linda A. Jacobs, Steven C Palmer, Patricia A. Ganz, Jacqueline N. Casillas, Betsy C Risendal, Linda Overholser, Ann H. Partridge, Karen L Syrjala, Kevin Scott Baker
Journal: Journal of Clinical Oncology (2019)

11517 Background: Young Adult (YA) survivors face challenges unique from those survivors of childhood cancer or of middle and older age adults. The potential impact of cancer, its treatment or the lasting effects on daily mental and physical tasks are not fully understood. Methods: Eligibility included diagnosis of malignancy between ages 18-39, 1-5 years from diagnosis and ≥1 year from therapy completion. Participants were randomly selected from tumor registries of 7 academic institutions. Enrolled participants were asked to complete an online patient reported outcomes (PRO) survey related to the effects of cancer and its treatment on daily functionality, finances, and cancer-related distress. All enrolled subjects had diagnostic and treatment information abstracted by a standardized protocol and entered into a database. Results: Enrollment and the online PRO survey was completed by 872 survivors (43.5% of eligible survivors). Survivors were 72.3% female, 90% non-Hispanic or Latino and the most common cancer for males and females were testicular and breast cancer respectively. Cancer, its treatment or the lasting effects limited the kind or amount of instrumental activities of daily living (IADLs) in 649 (76.3%) of survivors. Exposure to chemotherapy was associated with a 3.2-fold increased odds of interference with IADLs (CI 2.08-4.83, p &lt; 0.01) after controlling for diagnosis, age, gender, radiation and surgery exposure. This impairment lasted longer than 1 year in 268 (41.3%) of survivors. Cancer, its treatment or the lasting effects interfered with their ability to perform any mental tasks as part of their IADLs in 454 (53.3%) of survivors. Exposure to chemotherapy was associated with a 2.8-fold increased odds of interference with mental impairment of IADLs (CI 1.94-3.96, p &lt; 0.01) after controlling for diagnosis, age, gender, radiation and surgery exposure. Exposure to radiation was also associated with an increased odds of interference with mental impairment of daily activities (CI 1.05-1.91, p &lt; 0.01) after controlling for diagnosis, age, gender, chemotherapy and surgery exposure. Conclusions: In YA cancer survivors, cancer, its treatment or the lasting effects of treatment commonly impact the daily physical and mental IADLs and many survivors report ongoing limitations &gt; 1 year from therapy completion.
Effect of Sequential or Active Choice for Colorectal Cancer Screening Outreach
Authors: Shivan J. Mehta, Vikranth Induru, David Santos, Catherine Reitz, Timothy McAuliffe, Charles Orellana, Kevin G. Volpp, David A. Asch, Chyke A. Doubeni
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Colonoscopy and fecal immunochemical testing (FIT) are considered top-tier tests for colorectal cancer (CRC) screening. Behavioral economic insights about "choice architecture" suggest that participation could be influenced by how people are presented test options. <h3>Objective</h3> To investigate response rates for offering colonoscopy only compared with sequential choice (colonoscopy and then FIT) or active choice (colonoscopy or FIT) through mailed outreach. <h3>Design, Setting, and Participants</h3> Three-arm pragmatic randomized clinical trial conducted between November 14, 2017, and May 14, 2018. The setting was primary care practices at an academic health system. Patients aged 50 to 74 years with at least 2 primary care visits in the 2-year preenrollment period were included if they were eligible but not up to date on CRC screening. <h3>Interventions</h3> Eligible patients received mailed outreach about CRC screening. Equal numbers of eligible patients were randomly assigned to 3 outreach groups to receive mailings about CRC screening with the following options: (1) direct phone number to call for scheduling colonoscopy (colonoscopy only), (2) direct phone number to call for colonoscopy and a mailed FIT kit if no response within 4 weeks (sequential choice), or (3) direct phone number to call for colonoscopy and a mailed FIT kit offered at the same time (active choice). <h3>Main Outcomes and Measures</h3> The primary outcome was CRC screening completion (FIT or colonoscopy) within 4 months of initial outreach. The secondary outcomes were CRC screening completion within 6 months of outreach and the choice of colonoscopy as a screening test. <h3>Results</h3> In total, 438 patients were included in the intent-to-treat analysis, with a median age of 56 years (interquartile range, 52-63 years); 55.0% were women. At 4 months, the CRC screening completion rates were 14.4% (95% CI, 8.7%-20.1%) in the colonoscopy-only arm, 17.1% (95% CI, 11.0%-23.2%) in the sequential choice arm, and 19.9% (95% CI, 13.4%-26.4%) in the active choice arm. Neither choice arm achieved a screening rate statistically greater than that in the colonoscopy-alone arm. Among those who completed CRC screening at 4 months, 90.5% (95% CI, 78.0%-103.0%) chose colonoscopy in the colonoscopy-only arm, which was significantly higher than the 52.0% (95% CI, 32.4%-71.6%;<i>P</i> = .005) and 37.9% (95% CI, 20.2%-55.6%;<i>P</i> &lt; .001) in the sequential choice and active choice arms, respectively. <h3>Conclusions and Relevance</h3> There was no significant increase in CRC screening when offering sequential or active choice, but there was a lower rate of colonoscopy in the choice arms than in the colonoscopy-only arm. Subtle changes in sequencing or defaults can alter patient decision making related to preventive health. <h3>Trial Registration</h3> ClinicalTrials.gov identifier:NCT03246438
Publisher Correction: Mapping exclusive breastfeeding in Africa between 2000 and 2017
Authors: Natalia V. Bhattacharjee, Lauren E. Schaeffer, Laurie B. Marczak, Jennifer M. Ross, Scott J. Swartz, James Albright, William M. Gardner, Chloe Shields, Amber Sligar, Megan F. Schipp, Brandon V. Pickering, Nathaniel J. Henry, Kimberly B. Johnson, Celia Louie, Michael A. Cork, Krista M. Steuben, Alice Lazzar-Atwood, Dan Lu, Damaris K. Kinyoki, Aaron Osgood-Zimmerman, Lucas Earl, Jonathan F. Mosser, Aniruddha Deshpande, Roy Burstein, Lauren P. Woyczynski, Katherine F. Wilson, John D. VanderHeide, Kirsten E. Wiens, Robert C. Reiner, Ellen G. Piwoz, Rahul Rawat, Benn Sartorius, Nicole Davis Weaver, Molly R. Nixon, David L. Smith, Nicholas J. Kassebaum, Emmanuela Gakidou, Stephen S. Lim, Ali H. Mokdad, Christopher J. L. Murray, Laura Dwyer-Lindgren, Simon I. Hay
Journal: Nature Medicine (2019)

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Access to colorectal cancer screening and treatment: Rural-urban disparity in availability of gastroenterologists, surgeons, and oncologists.
Authors: Jonathan K Aboagye, Heather E Kaiser, Jeremiah William Hayanga
Journal: Journal of Clinical Oncology (2013)

e17534 Background: Although early detection of colorectal cancer using colonoscopy and its treatment can improve outcomes, geographic proximity may influence access to these services. We sought to examine disparities that may exist in colon cancer screening and treatment by comparing the distribution of providers for these services in rural and urban counties in the United States (US). Methods: A retrospective analysis was performed using the Health Resources and Services Administration’s Area Resource File 2009 data. Counties in the US were categorized into “rural” or “urban” using rural-urban continuum codes. The proportion of gastroenterologists, general surgeons and radiation oncologists per 100,000 people in a county was estimated. Multivariate linear regression analysis adjusting for socioeconomic variables was used to estimate the differences in proportions of gastroenterologists, general surgeons and radiation oncologists within these geographic areas. Results: A total of 3220 counties were identified comprising 1,807 “rural” and 1,413 “urban” counties. An unadjusted analysis showed an increased number of gastroenterologists, general surgeons and radiation oncologists per 100,000 of the population in urban counties as compared to rural counties. A multivariable analysis revealed 1.55 [95%CI (1.33-1.77), P&lt;0.0001] more GI specialists, 2.03 [95% CI (1.31-2.76), p&lt;0.0001] more general surgeons and 0.69 [95%CI (0.6-0.78), p&lt;0.0001] more radiation oncologists per 100,000 people living in “urban” compared to “rural “counties. Conclusions: A rural-urban disparity exists in the density of gastroenterologists, general surgeons and radiation oncologists who traditionally provide colorectal cancer screening services or treatment. This might serve to affect access to these services and negatively influence outcomes for colorectal cancer in rural areas.
Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles
Authors: Jonathan R. Bull, Simon P. Rowland, Elina Berglund Scherwitzl, Raoul Scherwitzl, Kristina Gemzell Danielsson, Joyce Harper
Journal: npj Digital Medicine (2019)

The use of apps that record detailed menstrual cycle data presents a new opportunity to study the menstrual cycle. The aim of this study is to describe menstrual cycle characteristics observed from a large database of cycles collected through an app and investigate associations of menstrual cycle characteristics with cycle length, age and body mass index (BMI). Menstrual cycle parameters, including menstruation, basal body temperature (BBT) and luteinising hormone (LH) tests as well as age and BMI were collected anonymously from real-world users of the Natural Cycles app. We analysed 612,613 ovulatory cycles with a mean length of 29.3 days from 124,648 users. The mean follicular phase length was 16.9 days (95% CI: 10-30) and mean luteal phase length was 12.4 days (95% CI: 7-17). Mean cycle length decreased by 0.18 days (95% CI: 0.17-0.18, R2 = 0.99) and mean follicular phase length decreased by 0.19 days (95% CI: 0.19-0.20, R2 = 0.99) per year of age from 25 to 45 years. Mean variation of cycle length per woman was 0.4 days or 14% higher in women with a BMI of over 35 relative to women with a BMI of 18.5-25. This analysis details variations in menstrual cycle characteristics that are not widely known yet have significant implications for health and well-being. Clinically, women who wish to plan a pregnancy need to have intercourse on their fertile days. In order to identify the fertile period it is important to track physiological parameters such as basal body temperature and not just cycle length.
Dipeptidyl Peptidase 4 Inhibitors and Risk of Inflammatory Bowel Disease: Real-world Evidence in U.S. Adults
Authors: Tiansheng Wang, Jeff Y. Yang, John B. Buse, Virginia Pate, Huilin Tang, Edward L. Barnes, Robert S. Sandler, Til Stürmer
Journal: Diabetes Care (2019)

OBJECTIVE A recent study raises concerns that dipeptidyl peptidase 4 inhibitors (DPP4i) are associated with increased risk of inflammatory bowel disease (IBD). We evaluated the association between new use of DPP4i and IBD risk compared with other second-line antihyperglycemics. RESEARCH DESIGN AND METHODS We implemented an active-comparator, new-user cohort design using two U.S. administrative claims databases for commercially insured (MarketScan) and older adult (Medicare fee-for-service, 20% random sample) patients from January 2007 to December 2016. We identified patients, aged ≥18 years, who initiated DPP4i versus sulfonylureas (SUs) or initiated DPP4i versus thiazolidinediones (TZDs) and were without prior diagnosis, treatment, or procedure for IBD. The primary outcome was incident IBD, defined by IBD diagnosis preceded by colonoscopy and biopsy and followed by IBD treatment. We performed propensity score weighting to control for measured baseline confounding, estimated adjusted hazard ratios (aHRs [95% CI]) using weighted Cox proportional hazards models, and used random-effects meta-analysis models to pool aHRs across cohorts. RESULTS We identified 895,747 eligible patients initiating DPP4i, SU, or TZD; IBD incidence rates ranged from 11.6 to 32.3/100,000 person-years. Over a median treatment duration of 1.09–1.69 years, DPP4i were not associated with increased IBD risk across comparisons. The pooled aHRs for IBD were 0.82 (95% CI 0.41–1.61) when comparing DPP4i (n = 161,612) to SU (n = 310,550) and 0.76 (0.46–1.26) when comparing DPP4i (n = 205,570) to TZD (n = 87,543). CONCLUSIONS Our population-based cohort study of U.S. adults with diabetes suggests that short-term DPP4i treatment does not increase IBD risk.
Chemotherapy-induced suppression of serum holotranscobalamin
Authors: G. Tisman, S. J. Kutik, Y. A. Khan
Journal: Journal of Clinical Oncology (2009)

e20639 Purpose: Chemotherapy-induced damage to the stomach and small intestine may inhibit the absorption of vitamin B12. To assess the risk of chemotherapy causing acute vitamin B12 deficiency, we primarily measured the active form of vitamin B12, holotranscobalamin, but also total serum B12, methylmalonic acid, and total homocysteine. Experimental Design: We studied 21 patients that were actively on chemotherapy and recorded values for holotranscobalamin, total serum B12, methylmalonic acid, total homocysteine, and cystatin-c. Measurements were taken both before and after four doses of chemotherapy. T-tests were employed to determine statistical significance. Results: There was a statistically significant drop in holotranscobalamin after chemotherapy in eighteen out of twenty-one patients (p = 2.64x10–3). Three patients were vitamin B12 deficient as defined by total B12 &lt; 300 pg/ml. Neither methylmalonic acid (p = 3.95x10–1), nor total homocysteine (p = 4.34x10–1), showed any significant changes. Conclusions: Chemotherapy caused an acute deficiency of the only metabolically active form of vitamin B12, holotranscobalamin, despite B12 supplementation. We suggest monitoring patients for changes in holotranscobalamin to ensure that prolonged deficiency does not occur. The clinical implications of acute lowering of holotranscobalamin remain unknown. No significant financial relationships to disclose.
Persistence of disseminated tumor cells (DTC) in bone marrow (BM) of breast cancer patients predicts increased risk for relapse—Results of pooled European data
Authors: W. J. Janni, G. Wiedswang, T. Fehm, J. Jueckstock, E. Borgen, B. Rack, S. Braun, H. Sommer, K. Pantel, B. Naume
Journal: Journal of Clinical Oncology (2006)

10083 Background: The prognostic significance of DTC in the BM of breast cancer patients at the time of primary diagnosis has recently been confirmed by a large pooled analysis. If the persistence of DTC after adjuvant therapy confers a similar risk for relapse, there might be an indication for secondary adjuvant treatment. Methods: We analyzed BM aspirates of 697 patients from academic breast cancer units in Oslo (n=356), Munich (n=228) and Tuebingen (n=113) during recurrence-free follow-up at a median interval of 32.4 months (standard deviation [std] 19.4 mon) after primary diagnosis of breast cancer pT1–4, pN0–3 pM0. Carcinoma cells were detected using a standardized immunoassay with the monoclonal antibodies A45-B/B3 (Munich, Tuebingen), or AE1 and AE3 (Oslo), directed against cytokeratin (CK). Patients were followed for a median of 54.2 months (std 24.5 mon) after primary diagnosis. Results: Persistent DTC in the BM were detected in 15.6% of the patients (n=109). The Kaplan-Meier estimate for mean distant relapse-free survival estimate was 155.6 mon (142.4 - 168.9 95%CI) in patients with negative and 102.3 mon (93.6 - 111.0, 95% CI, p&lt; .0001, log rank test) in patients with positive BM status. Patients without evidence of persistent DTC had a significantly longer overall survival (164.4 [155.6 - 173.3]), than patients with positive BM status (101.7 mon [89.4 - 113.9], p&lt; .0001). In multivariate Cox regression analysis, allowing for bone marrow status, tumor size, nodal status, histopathological grading and hormone receptor status, DTC was of higher independent prognostic significance for subsequent reduced breast cancer specific survival (RR 5.9, 2.8 - 12.8, 95% CI, p&lt; .0001), than nodal status at time of primary diagnosis (RR 1.2, 1.0 - 1.3, 95% CI, p=.014). Conclusion: Evidence of persistent DTC in breast cancer patients indicates an increased risk for subsequent relapse, and may serve for monitoring in future clinical trials. Such trials might investigate the benefit of individualized secondary adjuvant treatment or extended adjuvant therapy of patients with DTC. No significant financial relationships to disclose.
CXCR4 signaling directs Igk recombination and the molecular mechanisms of late B lymphopoiesis
Authors: Malay Mandal, Michael K. Okoreeh, Domenick E. Kennedy, Mark Maienschein-Cline, Junting Ai, Kaitlin C. McLean, Natalya Kaverina, Margaret Veselits, Iannis Aifantis, Fotini Gounari, Marcus R. Clark
Journal: Nature Immunology (2019)
A Surgeon's Pocket Book.
Journal: JAMA (1933)

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
Anti-EpCAM XmAb antibodies with improved cytotoxicity
Authors: O. Vafa, S. Kharki, J. Vielmetter, A. Chamberlain, P. Hammond, W. Dang, D. Carmichael, L. Kunkel, M. Barbosa, J. Desjarlais
Journal: Journal of Clinical Oncology (2006)

12506 Background: The epithelial cell adhesion molecule (EpCAM), also known as epithelial protein 2 (EGP-2) or 17–1A antigen, is a trans-membrane protein expressed on the surfaces of most carcinomas, including those of pancreatic, colorectal, prostate, breast, kidney, lung, and ovarian origins. Moderate affinity antibodies (Abs) such as 17–1A (Kd ∼ 10 −7 nM) have been safe in humans albeit with limited clinical efficacy. Attempts to improve clinical efficacy by enhancing antigen affinity (Kd ∼ 10 −9 nM) have led to serious clinical toxicity, including pancreatitis. These observations raise the question of whether a moderate affinity Ab with enhanced effector function will be both safe and clinically efficacious. Methods: We applied our proprietary XmAb™ technologies to humanize the 17–1A variable domain and engineer a human IgG1 Fc domain to increase affinity for the activating receptor FcγRIIIa. Ab binding to Ep-CAM or to Fc receptors was tested with Biacore and/or AlphaScreen binding assays. In vitro cytotoxic activity against representative cancer cell lines was measured with Antibody Dependent Cell-mediated Cytotoxicity (ADCC) assays, using human PBMC as effector cells. Results: Humanized anti-EpCAM Abs have affinity for EpCAM similar to the parent 17–1A. Affinity for the activating FcγRIIIa was increased 100-fold relative to a control Ab with an IgG1 Fc domain. As expected, these Abs exhibit dramatically enhanced ADCC against multiple cancer cell lines relative to 17–1A and IgG1 control Abs. Despite their moderate affinity for EpCAM, these novel Abs have in vitro cytotoxicity comparable to the high affinity Ab ING-1. CDC activities of these Abs were similar to chimeric 17–1A. Conclusions: We have demonstrated that antibodies with moderate affinity for EpCAM and increased FcγRIIIa affinity exhibit superior cancer cell killing via an ADCC mechanism. The humanized nature and the increased cytotoxicity of anti-EpCAM XmAb™ antibodies make them promising candidates for clinical development of a novel pan-carcinoma Ab that is superior to 17–1A. [Table: see text]
IBI303, a biosimilar to adalimumab, for the treatment of patients with ankylosing spondylitis in China: a randomised, double-blind, phase 3 equivalence trial
Authors: Huji Xu, Zhijun Li, Jian Wu, Qian Xing, Guixiu Shi, Juan Li, Xu Liu, Lijun Wu, Xiaomei Li, Wenfeng Tan, Dongyi He, Liqi Bi, Hongbin Li, Zhengyu Xiao, Zongwen Shuai, Xiaoxia Li, Yongfu Wang, Li Luo, Yi Zheng, Weiguo Xiao, Xin Wu, Ling Zhou, Ting Li, Lei Qian, Hui Zhou, Shujie Lu, Shirui Zheng, Yan Xiong, Xiong Wang, Yanqi Wang, Xinjiang Wu
Journal: The Lancet Rheumatology (2019)
Physicians’ Trust in Patients—Reply
Authors: David Meyers, Gwen Darien, Rachel Grob
Journal: JAMA (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 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
Gasdermin D in peripheral myeloid cells drives neuroinflammation in experimental autoimmune encephalomyelitis
Authors: Sheng Li, Yuqing Wu, Dongxue Yang, Chunyan Wu, Chunmei Ma, Xue Liu, Paul N. Moynagh, Bingwei Wang, Gang Hu, Shuo Yang
Journal: The Journal of Experimental Medicine (2019)

The NLRP3 inflammasome is critical for EAE pathogenesis; however, the role of gasdermin D (GSDMD), a newly identified pyroptosis executioner downstream of NLRP3 inflammasome, in EAE has not been well defined. Here, we observed that the levels of GSDMD protein were greatly enhanced in the CNS of EAE mice, especially near the areas surrounding blood vessels. GSDMD was required for the pathogenesis of EAE, and GSDMD deficiency in peripheral myeloid cells impaired the infiltration of immune cells into the CNS, leading to the suppression of neuroinflammation and demyelination. Furthermore, the loss of GSDMD reduced the activation and differentiation of T cell in the secondary lymphoid organs and prevented T cell infiltration into CNS of EAE. The administration of inflammasome-related cytokines partially rescued the impairment of pathogenesis of EAE in GSDMD KO mice. Collectively, these findings provide the first demonstration of GSDMD in peripheral myeloid cells driving neuroinflammation during EAE pathogenesis.