tbuckley/cabot-search huggingface dataset:
Hepatocellular Carcinoma in Adults
Authors: Aducio L. Thiesen
Journal: Liver Cancer (2021)

Hepatocellular carcinomas are the most common primary neoplasia of the liver. The global distribution of hepatocellular carcinoma is related to the prevalence of hepatitis C in the population. Other major etiologic factors include alcoholic liver disease and nonalcoholic steatohepatitis. The majority of cases are discovered when screening patients with either chronic hepatitis or cirrhosis, but occasional incidental cases have been reported. Molecular markers and associated gene alterations are a work in progress. Serological markers and radiology are used to detect the disease in high-risk populations, and to monitor response to therapy in the affected patients. Even though radiologic features are specific, tissue diagnosis may be required, particularly for atypical and smaller lesions. Ancillary studies including reticulin stain and immunohistochemistry are important for confirmatory diagnosis. Liver transplantation is curative for hepatocellular carcinoma, but due to limitations in organ availability, palliative care is required, which mostly includes chemoembolization and radio-ablation.
Incidence of Access to Ambulatory Mental Health Care Prior to a Psychiatric Emergency Department Visit Among Adults in Ontario, 2010-2018
Authors: Paul Kurdyak, Sima Gandhi, Laura Holder, Mohammed Rashid, Natasha Saunders, Maria Chiu, Astrid Guttmann, Simone Vigod
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Psychiatric emergency department (ED) visits may be avoidable if individuals have access to adequate outpatient care, but the extent to which individuals use the ED itself as a key point of access is largely unknown. <h3>Objective</h3> To describe the extent to which the ED is a first point of contact for mental health care among adults, and identify key factors associated with this outcome. <h3>Design, Setting, and Participants</h3> This cohort study was conducted from 2010 to 2018 in Ontario, Canada. Using health care administrative data, all individuals aged 16 years and older with an incident psychiatric ED visit were included. Statistical analysis was performed from September 2019 to February 2021. <h3>Main Outcomes and Measures</h3> The primary outcome was no outpatient mental health or addictions contact in the 2 years preceding the incident ED visit. The study also measured predisposing (age, sex, immigrant status, comorbidity), enabling (neighborhood income, rurality, continuity of primary care), and need factors (diagnosis from incident ED visit) associated with the so-called first-contact ED visits, generating adjusted odds ratios (aORs) and 95% CIs. <h3>Results</h3> The cohort included 659 084 patients who visited the ED. Among these patients, 340 354 were female individuals (51.6%), and the mean (SD) age was 39.1 (18.5) years. The incident ED visit was a first contact for 298 924 individuals (45.4%). Patients who had increased odds of first-contact ED visits included older individuals (aged 65-84 years vs 16-24 years; aOR, 1.13; 95% CI, 1.12-1.14), male individuals (aOR, 1.14; 95% CI, 1.13-1.15), immigrants (eg, economic class immigrant vs nonimmigrant status: aOR, 1.20; 95% CI, 1.18-1.21), rural residents (aOR, 1.21; 95% CI, 1.20-1.21), and in those with minimal primary care (aOR, 1.68; 95% CI, 1.67-1.69). All diagnoses had a higher likelihood of first-contact ED visits than mood disorders, particularly substance and alcohol use disorders (aOR, 1.66; 95% CI, 1.65-1.68). <h3>Conclusions and Relevance</h3> This study's results suggest that nearly half of incident psychiatric ED visits were first-contact visits, which may be avoidable. Targeted efforts to improve outpatient access should focus on populations with risk factors for first-contact ED presentations, including men, older adults, rural residents, those with poor primary care connectivity, and those with substance-related diagnoses.
Infectious Disease Epidemiology
Journal: JAMA (2001)

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 IA-018: Molecular landmarks of tumor hypoxia across cancer types
Authors: Vinayak Bhandari, Christianne Hoey, Lydia Liu, Emilie Lalonde, Jessica Ray, Julie Livingstone, Robert Lesurf, Yu-Jia Shiah, Tina Vujcic, Xiaoyong Huang, Shadrielle M.G. Espiritu, Lawrence E. Heisler, Fouad Yousif, Vincent Huang, Takafumi N. Yamaguchi, Cindy Q. Yao, Veronica Y. Sabelnykova, Michael Fraser, Melvin L.K. Chua, Theodorus van der Kwast, Stanley K. Liu, Paul C. Boutros, Robert G. Bristow
Journal: Clinical Cancer Research (2021)

Abstract Many primary tumor sub-regions have low levels of molecular oxygen, termed hypoxia. Hypoxic tumors are at elevated risk for local failure and distant metastasis, but the molecular hallmarks of tumor hypoxia remain poorly defined. To fill this gap, we quantified hypoxia in 8,006 tumors across 19 tumor types. In ten tumor types, hypoxia was associated with elevated genomic instability. In all 19 tumor types, hypoxic tumors exhibited characteristic driver mutation signatures. We observed widespread hypoxia-associated dysregulation of miRNAs across cancers and functionally validated miR-133a-3p as a hypoxia-modulated miRNA. In localized prostate cancer, hypoxia was associated with elevated rates of chromothripsis, allelic loss of PTEN and shorter telomeres. These associations are particularly enriched in polyclonal tumors, representing a constellation of features resembling tumor nimbosus – an aggressive cellular phenotype. Overall, this work establishes that tumor hypoxia may drive aggressive molecular features across cancers and shape the clinical trajectory of individual tumors. Citation Format: Vinayak Bhandari, Christianne Hoey, Lydia Liu, Emilie Lalonde, Jessica Ray, Julie Livingstone, Robert Lesurf, Yu-Jia Shiah, Tina Vujcic, Xiaoyong Huang, Shadrielle M.G. Espiritu, Lawrence E. Heisler, Fouad Yousif, Vincent Huang, Takafumi N. Yamaguchi, Cindy Q. Yao, Veronica Y. Sabelnykova, Michael Fraser, Melvin L.K. Chua, Theodorus van der Kwast, Stanley K. Liu, Paul C. Boutros, Robert G. Bristow. Molecular landmarks of tumor hypoxia across cancer types [abstract]. In: Proceedings of the AACR Virtual Special Conference on Radiation Science and Medicine; 2021 Mar 2-3. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(8_Suppl):Abstract nr IA-018.
Diagnostic accuracy and reliability of sideline concussion evaluation: a prospective, case-controlled study in college athletes comparing newer tools and established tests
Authors: Kimberly G Harmon, Bridget M Whelan, Douglas F Aukerman, Adam D Bohr, J Matthew Nerrie, Heather A Elkinton, Marissa Holliday, Sourav K Poddar, Sara P D Chrisman, Matthew B McQueen
Journal: British Journal of Sports Medicine (2021)

To assess diagnostic accuracy and reliability of sideline concussion tests in college athletes.Athletes completed baseline concussion tests including Post-Concussion Symptom Scale, Standardised Assessment of Concussion (SAC), modified Balance Error Scoring System (m-BESS), King-Devick test and EYE-SYNC Smooth Pursuits. Testing was repeated in athletes diagnosed acutely with concussion and compared to a matched teammate without concussion.Data were collected on 41 concussed athletes and 41 matched controls. Test-retest reliability for symptom score and symptom severity assessed using control athletes was 0.09 (-0.70 to 0.88) and 0.08 (-1.00 to 1.00) (unweighted kappa). Intraclass correlations were SAC 0.33 (-0.02 to 0.61), m-BESS 0.33 (-0.2 to 0.60), EYE-SYNC Smooth Pursuit tangential variability 0.70 (0.50 to 0.83), radial variability 0.47 (0.19 to 0.69) and King-Devick test 0.71 (0.49 to 0.84). The maximum identified sensitivity/specificity of each test for predicting clinical concussion diagnosis was: symptom score 81%/94% (3-point increase), symptom severity score 91%/81% (3-point increase), SAC 44%/72% (2-point decline), m-BESS 40%/92% (5-point increase), King-Devick 85%/76% (any increase in time) and EYE-SYNC Smooth Pursuit tangential variability 48%/58% and radial variability 52%/61% (any increase). Adjusted area under the curve was: symptom score 0.95 (0.89, 0.99), symptom severity 0.95 (95% CI 0.88 to 0.99), SAC 0.66 (95% CI 0.54 to 0.79), m-BESS 0.71 (0.60, 0.83), King-Devick 0.78 (0.69, 0.87), radial variability 0.47 (0.34, 0.59), tangential variability 0.41 (0.30, 0.54) CONCLUSION: Test-retest reliability of most sideline concussion tests was poor in uninjured athletes, raising concern about the accuracy of these tests to detect new concussion. Symptom score/severity had the greatest sensitivity and specificity, and of the objective tests, the King-Devick test performed best.
Haemoglobin thresholds to define anaemia in a national sample of healthy children and adolescents aged 1–19 years in India: a population-based study
Authors: Harshpal Singh Sachdev, Akash Porwal, Rajib Acharya, Sana Ashraf, Sowmya Ramesh, Nizamuddin Khan, Umesh Kapil, Anura V Kurpad, Avina Sarna
Journal: The Lancet Global Health (2021)

WHO's haemoglobin cutoffs to define anemia were based on five studies of predominantly White adult populations, done over 50 years ago. Therefore, a general re-examination of the existing haemoglobin cutoffs is warranted for global application, in representative healthy populations of children and adults. Such data are scarce in low-income and middle-income countries; however, a 2019, large-scale, nationally representative survey of children and adolescents aged 0-19 years in India (Comprehensive National Nutrition Survey [CNNS]) offered an opportunity for this re-examination. Using this survey, we aimed to assess the age-specific and sex-specific percentiles of haemoglobin and cutoffs to define anaemia in the CNNS population.
The Near-Term Future of Health Care Reform
Authors: Ezekiel J. Emanuel
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
Diversity and complexity of mouse allergens in urine, house dust, and allergen extracts assessed with an immuno‐allergomic approach
Authors: Samuel T. Mindaye, Carl Sun, Sayyed Amin Zarkesh Esfahani, Elizabeth C. Matsui, Michael J. Sheehan, Ronald L. Rabin, Jay E. Slater
Journal: Allergy (2021)

Mouse allergy is an important cause of indoor asthma and allergic rhinoconjunctivitis. The major mouse allergen, Mus m 1, is a complex of homologous pheromone-binding lipocalins called major urinary proteins (MUPs).We analyzed the proteome of MUPs in mouse urine, commercial mouse epithelial extracts, and environmental samples using several approaches. These include as follows: two-dimensional electrophoresis and immunoblotting; liquid chromatography-high-resolution mass spectrometry (LC/HRMS); multiple reaction monitoring (MRM) mass spectrometry; and LC/HRMS analysis of glycans at the N-66 residue of MUP3.Albumin is predominant in the extracts, while MUPs are predominant in urine. LC/HRMS of 4 mouse allergen extracts revealed surprising heterogeneity. Of 22 known mouse MUPs, only 6 (MUP3, MUP4, MUP5, MUP13, MUP20, and MUP21) could be identified with MRM using unique peptides. Assessment of MUP content in urine, extracts, and dust samples showed good correlation between MRM and other methods working with different detection principles. All 6 identifiable MUPs were found in electrophoretically separated urine bands, but only MUP3 and MUP20 were above LOQ in unseparated mouse urine, and only MUP3, MUP4, and MUP20 were found in mouse epithelial extracts. Glycan heterogeneity was noted among 4 individual inbred mice: of 13 glycan structures detected, 8 were unique to one mouse, and only 2 glycan modifications were present in all 4 mice.Using mass spectrometry and MRM, mouse allergen extracts and urine samples are shown to be complex and heterogeneous. The efficacy and safety of commercial mouse allergen extracts will be improved with better controls of allergen content.
Development and Validation of a Machine Learning Model to Estimate Bacterial Sepsis Among Immunocompromised Recipients of Stem Cell Transplant
Authors: Margaret L. Lind, Stephen J. Mooney, Marco Carone, Benjamin M. Althouse, Catherine Liu, Laura E. Evans, Kevin Patel, Phuong T. Vo, Steven A. Pergam, Amanda I. Phipps
Journal: JAMA Network Open (2021)

Sepsis disproportionately affects recipients of allogeneic hematopoietic cell transplant (allo-HCT), and timely detection is crucial. However, the atypical presentation of sepsis within this population makes detection challenging, and existing clinical sepsis tools have limited prognostic value among this high-risk population.To develop a full risk factor (demographic, transplant, clinical, and laboratory factors) and clinical factor-specific automated bacterial sepsis decision support tool for recipients of allo-HCT with potential bloodstream infections (PBIs).This prognostic study used data from adult recipients of allo-HCT transplanted at the Fred Hutchinson Cancer Research Center, Seattle, Washington, between June 2010 and June 2019 randomly divided into 70% modeling and 30% validation data sets. Tools were developed using the area under the curve (AUC) optimized SuperLearner, and their performance was compared with existing clinical sepsis tools: National Early Warning Score (NEWS), quick Sequential Organ Failure Assessment (qSOFA), and Systemic Inflammatory Response Syndrome (SIRS), using the validation data set. Data were analyzed between January and October of 2020.The primary outcome was high-sepsis risk bacteremia (culture confirmed gram-negative species, Staphylococcus aureus, or Streptococcus spp bacteremia), and the secondary outcomes were 10- and 28-day mortality. Tool discrimination and calibration were examined using accuracy metrics and expected vs observed probabilities.Between June 2010 and June 2019, 1943 recipients of allo-HCT received their first transplant, and 1594 recipients (median [interquartile range] age at transplant, 54 [43-63] years; 911 [57.2%] men; 1242 individuals [77.9%] identifying as White) experienced at least 1 PBI. Of 8131 observed PBIs, 238 (2.9%) were high-sepsis risk bacteremia. Compared with high-sepsis risk bacteremia, the full decision support tool had the highest AUC (0.85; 95% CI, 0.81-0.89), followed by the clinical factor-specific tool (0.72; 95% CI, 0.66-0.78). SIRS had the highest AUC of existing tools (0.64; 95% CI, 0.57-0.71). The full decision support tool had the highest AUCs for PBIs identified in inpatient (0.82; 95% CI, 0.76-0.89) and outpatient (0.82; 95% CI, 0.75-0.89) settings and for 10-day (0.85; 95% CI, 0.79-0.91) and 28-day (0.80; 95% CI, 0.75-0.84) mortality.These findings suggest that compared with existing tools and the clinical factor-specific tool, the full decision support tool had superior prognostic accuracy for the primary (high-sepsis risk bacteremia) and secondary (short-term mortality) outcomes in inpatient and outpatient settings. If used at the time of culture collection, the full decision support tool may inform more timely sepsis detection among recipients of allo-HCT.
Abstract PO-099: Overexpression of proinflammatory chemokines CCL5 and CCL17 after gene electrotransfer to murine tumors modifies their cytokine expression profile and leads to tumor cures in combination with tumor irradiation
Authors: Gregor Sersa, Tim Bozic, Boštjan Markelc, Maja Cemazar, Simona Kranjc Brezar
Journal: Clinical Cancer Research (2021)

Abstract Proinflammatory chemokines are small signaling proteins, with the ability to induce migration of different types of immune cells. The degree and type of immune cell infiltrate in the tumor microenvironment often correlates with the outcome of immunotherapies in cancer patients. Therefore, combining chemokines with classical, but immune response activating therapy, such as irradiation presents one of the potential approaches in cancer immunotherapy. Through the use of plasmid DNA encoding either proinflammatory chemokine CCL5 or CCL17 we studied their effects on cytokine expression profile in vitro and in vivo in murine breast (4T1, E0771) and colon (CT26, MC38) cancer models. While in vitro plasmid DNA was introduced in the cells using lipofection, gene electrotransfer was utilized in case of tumors in vivo. Viability of all cell lines 48 h after lipofection remained above 80%. Using qRT-PCR expression of 11 cytokines was determined 48 h after lipofection, which showed significantly increased expression of CCL5, CCL17 demonstrating successful transfection. Moreover, increased levels of IL-6 and CXCL10 were also observed in the surviving cells. Gene electrotransfer after intratumoral injection of plasmid DNA encoding either CCL5 or CCL17 in CT26 and 4T1 murine tumor model (animal license: U34401-1/2015/43) resulted in minor tumor growth delay. Concurrent expression analysis of 7 cytokines after gene electrotransfer in tumors showed overexpression of both chemokines, while levels of proinflammatory cytokines IL-6, IL-12 and IFNγ were modestly increased. Obtained altered expression profile, both in vitro and in vivo, is typical for inflammation. Furthermore, irradiation of CT26 and 4T1 tumors combined with gene electrotransfer of plasmids encoding CCL5 or CCL17 resulted in significant tumor growth delay and even tumor cures. Therefore, based on changes in tumor microenvironment after therapy future experiments will be focused towards elucidating the mechanisms of immune response and determining the optimal time window for combined tumor irradiation and gene electrotransfer of plasmids encoding chemokines CCL5 and CCL17. Citation Format: Gregor Sersa, Tim Bozic, Boštjan Markelc, Maja Cemazar, Simona Kranjc Brezar. Overexpression of proinflammatory chemokines CCL5 and CCL17 after gene electrotransfer to murine tumors modifies their cytokine expression profile and leads to tumor cures in combination with tumor irradiation [abstract]. In: Proceedings of the AACR Virtual Special Conference on Radiation Science and Medicine; 2021 Mar 2-3. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(8_Suppl):Abstract nr PO-099.
The Rapid Transition to Telemedicine and Its Effect on Access to Care for Patients With Type 1 Diabetes During the COVID-19 Pandemic
Authors: Daniel R. Tilden, Karishma A. Datye, Daniel J. Moore, Benjamin French, Sarah S. Jaser
Journal: Diabetes Care (2021)

OBJECTIVE We compared the uptake of telemedicine for diabetes care across multiple demographic groups during the coronavirus disease 2019 pandemic to understand the impact of telemedicine adoption on access to care. RESEARCH DESIGN AND METHODS The study analyzed demographic information of patients with type 1 diabetes seen between 1 January 2018 and 30 June 2020 at a single center. We compared the odds of completing a visit via telemedicine across multiple demographic characteristics. RESULTS Among 28,977 patient visits, the odds of completing a visit via telemedicine were lower among non-English-speaking (1.7% vs. 2.7%; adjusted odds ratio [aOR] 0.45, 95% CI 0.26–0.79) and Medicaid-insured (32.0% vs. 35.9%; aOR 0.83, 95% CI 0.72–0.95) pediatric patients. No clinically significant differences were observed for other demographic factors. CONCLUSIONS Rapid transition to telemedicine did not significantly impact access to diabetes care for most demographic groups. However, disparities in access to care for historically marginalized groups merit close attention to ensure that use of telemedicine does not exacerbate these inequities.
Granulocyte Colony-Stimulating Factor Administration at 1 Hour Before 18F-FDG PET Does Not Increase Bone Marrow FDG Accumulation
Authors: Kazuna Kawabata, Makoto Hosono, Hiroki Tanaka, Mizuki Hyuga, Mitsunori Kanagaki
Journal: Clinical Nuclear Medicine (2021)

Abstract A 74-year-old man with diffuse large B-cell lymphoma underwent 18 F-FDG PET/CT to evaluate the response to chemotherapy. Although granulocyte colony-stimulating factor was incidentally administered 1 hour before FDG administration, bone marrow FDG accumulation did not increase compared with the previous 18 F-FDG PET/CT examination without granulocyte colony-stimulating factor administration. The mean SUV max of 12 thoracic and 5 lumbar vertebrae was 2.55 (range, 2.14–3.36) and 3.19 (range, 2.49–4.28) in the present and previous examinations, respectively.