tbuckley/cabot-search huggingface dataset:
Continuing education curriculums and outcomes on progressive metastatic colorectal cancer treatment.
Authors: Kinjal Parikh, Davecia Ragoonath Cameron, Pan Chen, Brittany Cain, Ann Carothers
Journal: Journal of Clinical Oncology (2021)

137 Background: The treatment armamentarium for patients with metastatic colorectal cancer (mCRC) has expanded significantly and treatment options for progressive disease remain limited. As data from clinical trials or subgroup analyses become available, landmark trials are published, and guideline recommendations or clinical utility of these therapies change, continuing medical education (CME) for oncologists is necessary to ensure that eligible patients continue to receive effective therapies. Methods: A series of 7 activities launched from 2016-2020 to reach a global oncology audience in the care of patients with mCRC. The educational activities included multi-modality approaches with didactics, cases, simulations, and panel discussions. Educational effectiveness was assessed with repeated paired pre/post assessment where learners served as their own controls to measure changes in knowledge, competence, confidence, and performance. Oncologists who completed both the pre- and post-CME questions or who made relevant clinical decisions in the simulation activity were included in analysis and McNemar’s tests were conducted to assess statistical significance of the results with p &lt; .05 being considered significant. The first activity launched on 6/8/2016 and the data reported were collected through 7/20/20. Results: As of 7/20/2020, 59,595 learners participated in the activities, including 18,634 total physician learners with 5,862 oncologists. Significant improvements in knowledge, competence, and confidence among oncologists, measured as relative % changes in correct responses or confidence from pre- to post-CME, were seen (n=60-214) [% pre, % post, p value]: 11%: knowledge regarding therapies for progressive disease in mCRC (83; 92; p &lt; .05); 17%: knowledge of clinical trials assessing impact of patient/disease specific aspects on treatment selection (63; 74; p &lt; .001); 11%: competence selecting therapy (55; 61; p &lt; .05); 41%: confidence selecting therapy (34; 48; p &lt; .001); 24%: confidence addressing communication barriers in mCRC (50; 62; p &lt; .01). Significant improvement in performance of oncologists, measured as absolute % changes in pre- to post-CME correct responses were seen (n = 46) [% pre, % post, p value]: 28%: starting preferred treatment options (24; 52; p &lt; .01); 18%: prescribing regorafenib (24; 43; p &lt; .01); 9%: prescribing trifluridine + tipiracil (0; 9; p &lt; .05). Conclusions: This series of online, expert-led, CME-certified educational activities resulted in significant improvement in knowledge, competence, confidence, and performance among learners regarding the management of patients with progressive metastatic colorectal cancer over time. These results demonstrate the effectiveness of on-demand education as new data emerge and indications expand to reinforce existing knowledge, close persistent gaps, and increase confidence in managing these patients.
Trends in mortality of hospitalised COVID-19 patients: A single centre observational cohort study from Spain
Authors: Carolina Garcia-Vidal, Alberto Cózar-Llistó, Fernanda Meira, Gerard Dueñas, Pedro Puerta-Alcalde, Catia Cilloniz, Nicole Garcia-Pouton, Mariana Chumbita, Celia Cardozo, Marta Hernández, Verónica Rico, Marta Bodro, Laura Morata, Pedro Castro, Alex Almuedo-Riera, Felipe García, Josep Mensa, José Antonio Martínez, Gemma Sanjuan, Antoni Torres, JM Nicolás, Alex Soriano
Journal: The Lancet Regional Health - Europe (2021)

We aimed to describe changes in characteristics and treatment strategies of hospitalised patients with COVID-19 and detail the mortality trend over time.
How is the pandemic affecting non-covid services?
Authors: Gareth Iacobucci
Journal: BMJ (2021)

How is the pandemic affecting non-covid services?As NHS hospitals struggle to find enough beds for patients with covid-19, Gareth Iacobucci examines the strain this is placing on other services Gareth Iacobucci"One of the operating suites that normally does routine surgery has been converted into a 12 bed intensive care unit.We're doing very little routine work, and we're struggling to try to get some of the cancer work done.On a day to day basis, we very rarely get intensive care beds at the moment."Like many doctors, consultant anaesthetist Helgi Johannsson was moved from working in planned surgery to the intensive care unit because of the high volume of covid admissions.And he expects to remain there for several months."Although [covid cases are] flattening off a little bit, it certainly hasn't reached the stage where we're emptying intensive care beds," he told The BMJ.
Double disparities in patients with gastric cancer: Clinicopathology and survival of older adults in a Hispanic-rich population.
Authors: Madison H. Williams, Ryan A. Williams, Brian Hernandez, Joel Michalek, Sukeshi Patel Arora
Journal: Journal of Clinical Oncology (2021)

169 Background: Gastric cancer incidence increases with advancing age with a median age at diagnosis of 68. However, older adults (age ≥65) are underrepresented in clinical trials. Additionally, Hispanic populations have a higher incidence of gastric cancer compared with non-Hispanic patients and there is evidence that this population has worse outcomes. Given this double disparity in older Hispanic adults, we evaluated the differences in disease characteristics at diagnosis and survival outcomes in older adults compared to younger adults with gastric cancer at our South Texas cancer center serving a predominantly Hispanic population. Methods: We performed a retrospective analysis of patients with a diagnosis of gastric cancer from 2000 – 2018, who had follow-up at Mays Cancer Center, San Antonio, TX. Older patients were defined as ≥65 years and younger patients were defined as &lt;65 years. Median overall survival (mOS) was estimated from Kaplan-Meier curves and groups were compared using the log-rank test. Results: A total of 190 patients met criteria for analysis. Patients were predominantly younger (age &lt;65), with 128 (67.4%) young and 62 (32.6%) older. Most patients were Hispanic (66.4% of younger and 64.5% of older) and male (51.6% of younger and 66.1% of older). The majority of patients had an ECOG performance status of 0-2, including 61.7% and 64.5% (p = 0.55) of younger and older patients, respectively. At baseline, there was no significant difference in location of primary tumor, grade, stage at diagnosis, or histologic classification between younger and older patients (Table). There was also no significant difference between the two groups in H. pylori status, location of metastases, or HER2 status. Of the 109 patients with follow-up for survival, the mOS was 17 months (95% CI: 15-55) for younger patients versus 14 months (95% CI: 13-NR) for older patients (p = 0.19). Conclusions: In this retrospective analysis of predominantly Hispanic patients with gastric cancer, we found that there were no statistically significant differences in clinicopathologic features at diagnosis or in survival between younger versus older adults. Our study was approximately 2/3 Hispanic, a population for which there is a paucity of data, especially in older adults. Given the limited published research available to guide the management of older patients with gastric cancer, including Hispanics, further prospective real-world studies are needed to evaluate toxicity and quality of life in order to improve the care of older adults with gastric cancer. [Table: see text]
PPIs and anti-TNF in patients with IBD: a forbidden combination?
Authors: Judith Wellens, João Sabino, Séverine Vermeire
Journal: Gut (2021)

With great interest, we read the report of Lu et al on the influence of proton pomp inhibitor (PPI) therapy on the outcome of infliximab therapy in inflammatory bowel disease (IBD).1 The authors analysed patient-level data from five randomised controlled trials (RCTs) of patients with IBD treated with infliximab. A total of 1036 patients were enrolled, of whom 147 on PPI therapy. They found that patients on PPI were less likely to achieve remission compared with patients not taking PPIs (OR 0.45, p<0.001) and conclude that PPIs negatively affects outcome in patients with IBD treated with infliximab and PPIs should be prescribed with caution.

We like to congratulate the authors to study the effect of frequently prescribed drugs on the outcome of anti-tumor necrosis factor therapy, since the knowledge on drug–drug interactions is scarce and based on observational research, …
Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study
Authors: Greta Hsu, Balázs Kovács
Journal: BMJ (2021)

Abstract Objective To examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates. Design Panel regression methods. Setting 812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017. Participants The study used US mortality data from the Centers for Disease Control and Prevention combined with US census data and data from Weedmaps.com on storefront dispensary operations. Data were analyzed at the county level by using panel regression methods. Main outcome measure The main outcome measures were the log transformed, age adjusted mortality rates associated with all opioid types combined, and with subcategories of prescription opioids, heroin, and synthetic opioids other than methadone. The associations of medical dispensary and recreational dispensary counts with age adjusted mortality rates were also analyzed. Results County level dispensary count (natural logarithm) is negatively related to the log transformed, age adjusted mortality rate associated with all opioid types (β=−0.17, 95% confidence interval −0.23 to −0.11). According to this estimate, an increase from one to two storefront dispensaries in a county is associated with an estimated 17% reduction in all opioid related mortality rates. Dispensary count has a particularly strong negative association with deaths caused by synthetic opioids other than methadone (β=−0.21, 95% confidence interval −0.27 to −0.14), with an estimated 21% reduction in mortality rates associated with an increase from one to two dispensaries. Similar associations were found for medical versus recreational storefront dispensary counts on synthetic (non-methadone) opioid related mortality rates. Conclusions Higher medical and recreational storefront dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl. While the associations documented cannot be assumed to be causal, they suggest a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates. This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.
Systolic blood pressure and 6-year mortality in South Africa: a country-wide, population-based cohort study
Authors: Alpha Oumar Diallo, Mohammed K Ali, Pascal Geldsetzer, Emily W Gower, Trasias Mukama, Ryan G Wagner, Justine Davies, Maarten J Bijlsma, Nikkil Sudharsanan
Journal: The Lancet Healthy Longevity (2021)

Improving hypertension control is an important global health priority yet, to our knowledge, there is no direct evidence on the blood pressure (BP)-mortality relationship in sub-Saharan Africa. We investigate the BP-mortality relationship in South Africa and assess the comparative effectiveness of different care targets for clinical care and population-wide hypertension management efforts.
Physician Performance in the Medicare Merit-based Incentive Payment System—Reply
Authors: Kenton J. Johnston, Jason M. Hockenberry, Karen E. Joynt Maddox
Journal: JAMA (2021)

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
Abstract 12648: Anticoagulation in Patients With Atrial Fibrillation After a Transcatheter Aortic Valve Replacement: A Systematic Review
Authors: Jason Galo, Fahad Al Halban, Sharde Chambers, Eduardo de Marchena, Garly Rushler Saint Croix, Brett Milford, Odunayo Olorunfemi
Journal: Circulation (2019)

Background: Transcatheter aortic valve replacement is the treatment of choice for patients with severe aortic stenosis. A significant portion of TAVR patients have concomitant atrial fibrillation l...
In situ immunogenic clearance induced by a combination of photodynamic therapy and rho-kinase inhibition sensitizes immune checkpoint blockade response to elicit systemic antitumor immunity against intraocular melanoma and its metastasis
Authors: Seohyun Kim, Seong A Kim, Gi-Hoon Nam, Yeonsun Hong, Gi Beom Kim, Yoonjeong Choi, Seokyoung Lee, Yuri Cho, Minsu Kwon, Cherlhyun Jeong, Sehoon Kim, In-San Kim
Journal: Journal for ImmunoTherapy of Cancer (2021)

Background Uveal melanoma (UM) is the most frequent intraocular malignancy and is resistant to immunotherapy. Nearly 50% of patients with UM develop metastatic disease, and the overall survival outcome remains very poor. Therefore, a treatment regimen that simultaneously targets primary UM and prevents metastasis is needed. Here, we suggest an immunotherapeutic strategy for UM involving a combination of local photodynamic therapy (PDT), rho-kinase (ROCK) inhibitor, and PD-1/PD-L1 immune checkpoint blockade. Methods The antitumor efficacy and immune response of monotreatment or combinational treatment were evaluated in B16F10-bearing syngeneic mouse models. Abscopal antitumor immune responses induced by triple-combinational treatment were validated in syngeneic bilateral B16F10 models. After each treatment, the immune profiles and functional examinations were assessed in tumors and tumor draining lymph nodes by flow cytometry, ELISA, and immunofluorescence assays. In orthotopic intraocular melanoma models, the location of the immune infiltrate in the tumor microenvironment (TME) was evaluated after each treatment by multiplex immunohistochemistry and metastatic nodules were monitored. Results PDT with Ce6-embedded nanophotosensitizer (FIC-PDT) elicited immunogenic cell death and stimulated antigen-presenting cells. In situ immunogenic clearance induced by a combination of FIC-PDT with ripasudil, a clinically approved ROCK inhibitor, stimulated antigen-presenting cells, which in turn primed tumor-specific cytotoxic T cells. Moreover, local immunogenic clearance sensitized PD-1/PD-L1 immune checkpoint blockade responses to reconstruct the TME immune phenotypes of cold tumors into hot tumors, resulting in recruitment of robust cytotoxic CD8 + T cells in the TME, propagation of systemic antitumor immunity to mediate abscopal effects, and prolonged survival. In an immune-privileged orthotopic intraocular melanoma model, even low-dose FIC-PDT and ripasudil combined with anti-PD-L1 antibody reduced the primary tumor burden and prevented metastasis. Conclusions A combination of localized FIC-PDT and a ROCK inhibitor exerted a cancer vaccine-like function. Immunogenic clearance led to the trafficking of CD8 + T cells into the primary tumor site and sensitized the immune checkpoint blockade response to evoke systemic antitumor immunity to inhibit metastasis, one of the major challenges in UM therapy. Thus, immunogenic clearance induced by FIC-PDT and ROCK inhibitor combined with anti-PD-L1 antibody could be a potent immunotherapeutic strategy for UM.
SAT0090 Correlation between proximal femur bone mineral density and hip osteoarthritis: preliminary data
Authors: N Malavolta, P Mastrapasqua, L Lisi, M Frigato, MG Prandin, S Gnudi
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Osteoarthritis (OA) is a very frequent disease in postmenopausal women. The question whether high bone mineral density (BMD) plays a role in the development of this disease is under investigation. <h3>Objectives</h3> Here we report the preliminary data of a study aimed at investigating the relationship between the BMD of healthy women and women with OA of the hip. <h3>Methods</h3> Exclusion criteria included all diseases and drugs known to cause BMD loss. Till now 136 age matched women have entered the study: 46 with OA (mean age 65.76, SD 8.07) and 92 healthy individuals (mean age 65.60, SD 8.12). All subjects underwent Dual Energy X-ray Absorptiometry (DEXA-XR 36 Norland) measurements of the femoral neck, trochanter, Ward?s and the lumbar spine (L2-L4). Age, age of menopause, height and weight were also collected. Data were analysed using the Anova test to compare groups. The ability of selected parameters to discriminate the two groups of patients was tested by logistic regression. <h3>Results</h3> Weight (p = 0.003) and femoral neck BMD (p = 0.045) were significantly higher in women with OA than in healthy women. None of the other variables were significantly different in the two groups. At the logistic regression both age corrected &nbsp;weight (OR: 1.05; 95% CI: 1.01–1.09) and age corrected femoral neck BMD (OR: 1.01; 95% CI: 1.00–1.03) were able to significantly discriminate the two groups of women. Both variables correctly classified 13.04% of OA while 93.48% of healthy women were correctly classified by the variable weight and 97.83% the femoral neck BMD. <h3>Conclusion</h3> Our data suggest that the body weight and femoral neck BMD are the main risk factors for OA of the hip. The fact that at the trochanter and at the Ward?s (where BMD measurement does not discriminate between the two groups) the cortical component of bone is lower than at the femoral neck should indicate that high cortical bone density is a marker of OA.
Proposed global prognostic score for systemic mastocytosis: a retrospective prognostic modelling study
Authors: Javier I Muñoz-González, Iván Álvarez-Twose, María Jara-Acevedo, Roberta Zanotti, Cecelia Perkins, Mohamad Jawhar, Wolfgang R Sperr, Khalid Shoumariyeh, Juliana Schwaab, Georg Greiner, Ana Henriques, Carolina Caldas, Carlos Fernández-Giménez, Laura Sánchez-Muñoz, Andrea Mayado, Alba Pérez-Pons, Annette Schmitt-Graeff, Justus Duyster, Ilaria Tanasi, Francesco Olivieri, Elvira Mora-Casterá, Irene Luna, Leonor Senent, Maria-Helena Bañas, Amanda Nuñez-García, Manuel Jurado-Chacón, Guillermo Martín-Sánchez, Enrique Colado, Blanca Xicoy, Georgina Gener-Ricós, Jason Gotlib, Patrizia Bonadonna, Andreas Reiter, Peter Valent, Andrés C García-Montero, Alberto Orfao
Journal: The Lancet Haematology (2021)
Complexity of the simplest species tree problem
Authors: Tianqi Zhu, Ziheng Yang
Journal: Molecular Biology and Evolution (2021)

Abstract The multispecies coalescent model provides a natural framework for species tree estimation accounting for gene-tree conflicts. Although a number of species tree methods under the multispecies coalescent have been suggested and evaluated using simulation, their statistical properties remain poorly understood. Here, we use mathematical analysis aided by computer simulation to examine the identifiability, consistency, and efficiency of different species tree methods in the case of three species and three sequences under the molecular clock. We consider four major species-tree methods including concatenation, two-step, independent-sites maximum likelihood, and maximum likelihood. We develop approximations that predict that the probit transform of the species tree estimation error decreases linearly with the square root of the number of loci. Even in this simplest case, major differences exist among the methods. Full-likelihood methods are considerably more efficient than summary methods such as concatenation and two-step. They also provide estimates of important parameters such as species divergence times and ancestral population sizes,whereas these parameters are not identifiable by summary methods. Our results highlight the need to improve the statistical efficiency of summary methods and the computational efficiency of full likelihood methods of species tree estimation.