tbuckley/cabot-search huggingface dataset:
Transforming Mental Health Care Delivery Through Implementation Science and Behavioral Economics
Authors: Rinad S. Beidas, Alison M. Buttenheim, David S. Mandell
Journal: JAMA Psychiatry (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 Psychiatry 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 Psychiatry journal
AB0284 COMBINATION THERAPY WITH RITUXIMAB AND BELIMUMAB IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: A. Mesnyankina, E. Aseeva, N. Nikishina, A. Torgashina
Journal: Annals of the Rheumatic Diseases (2021)

Objectives: To assess the efficacy of combined therapy with rituximab (RTM) and belimumab (BLM) in patients with active systemic lupus erythematosus (SLE). Methods: The study included 12 SLE pts (1М/11F) with severe (SLEDAI2K≥10 – 8pts.) and moderate (SLEDAI2K&lt;10- 4pts.) disease activity; out of them 5 patients had lupus nephritis, vasculitis and 7 had predominantly mucocutaneous and articular manifestations of SLE. The dose of oral GC was: 60 mg in one patient with vasculitis, LN, cerebrovasculitis; in 9 patients from 10 to 5 mg; in 2 patients without oral glucocorticoids. All patients with SLE with kidney damage, CNS, and vasculitis received cytostatics. All patients with vasculitis, LN, etc. received mycophenolate mofetil or cyclophosphamide. Rituximab (RTM) was administered at 500-2000 mg, with subsequent adding of Belimumab (BLM) 1-6 months later at a standard dosing regimen 10 mg/kg once a month a total of 7 infusions. The following parameters were evaluated: the effectiveness of therapy, the concentration of autoantibodies, the dose of oral corticosteroids initially at the time of RTM administration and then every 3 months after the initiation of BLM therapy. Results: 8 pts demonstrated the decrease in clinical and laboratory SLE activity, starting from 3mo of follow-up. After the start of BLM infusions, a decrease in SLE activity was observed in all patients. Among them, 9 had SLEDAI-2K activity of less than 4 points (SLEDAI-2k Me 12 [9,5;17], after treatment of RTM and BLM 4[2;4]). Only one patient (№4) had a relapse of SLE, due to the omission of the BLM infusion. He was receiving standard GC doses. In dynamics, a decrease anti-double DNA titres (Me 101 [39;250]U/ml vs 19 [9;70] U/ml), С3 (0,44 [0,39;0,59]g/l vs 0,81 [0,72;0,87] g/l), С4 (0,06 [0,031;0,1] g/l vs 0,14 [0,13;0,14] g/l) was registered. The GC dose was reduced in most patients (tab. 1), but the previously prescribed immunosuppressive therapy continued. There were no cases of severe infection. Conclusion: Combination therapy allows to gain control over disease activity in short time, due to the effect of RTM, while added BLM provides further prolongation of the effect achieved, minimizing the risk of flare. The use of such therapy contributes to a rapid and effective reduction in the activity of the disease, normalization of laboratory markers of SLE (at to ds-DNA, C3, C4), the use of lower doses of oral GCs. This combination may be used as a method of choice in pts with severe SLE involving vital organs, and in persistent cutaneous-articular disease and high immunological activity. Table 1. Dose of oral glucocorticoids (prednisone), mg № patient Before the introduction of RTM, mg 1st 7th injection of of BLM, mg 7th injection of BLM, mg 1 20 20 15 ↓ 2 7,5 5 5 ↓ 3 5 5 5 = 4 10 10 10 ↓ 5 5 5 5 = 6 60 7,5 2,5 ↓↓↓ 7 10 2,5 0 ↓↓↓ 8 10 10 5 ↓ 9 2,5 2,5 2,5 = 10 10 10 5 ↓ 11 0 0 0 = 12 0 0 0 = Disclosure of Interests: None declared
AB0605 ACTIGRAPHY-BASED PHYSICAL ACTIVITY MONITORING IN PATIENTS WITH KNEE OSTEOARTHRITIS AND COMORBID FIBROMYALGIA
Authors: O. Dzekan
Journal: Annals of the Rheumatic Diseases (2021)

Background: Low physical activity (PA) levels are common in patients with diseases associated with pain syndrome, such as osteoarthritis (OA) of the knee joints. Recent studies show that OA may be accompanied by concomitant fibromyalgia (FM) – a chronic pain syndrome associated with sedentary behavior [1]. As far as low PA levels are associated with poor quality of life and higher all-cause mortality, PA measurement in patients with knee OA and concomitant FM is of considerable interest [2,3]. Objectives: The aim of this study was to investigate and compare physical activity measured by an actigraph in knee OA patients with and without comorbid FM. Methods: A total of 70 patients with painful knee osteoarthritis (OA) – 35 subjects - (30 females and 5 males) with concomitant fibromyalgia (FM) aged 59.8±14.9 (M±SD) years and 35 patients (30 females and 5 males) without concomitant FM aged 58.5±15.7 (M±SD) years were enrolled in the study. 35 healthy controls of the same age and gender underwent the same investigation. OA diagnosis was established according to ACR 1986 Osteoarthritis Knee Criteria. FM was diagnosed if both modified 2010 ACR diagnostic criteria and 2016 Fibromyalgia Diagnostic Criteria were met. All participants wore an actigraph (GT3X model accelerometer) on the wrist for the period of 5 working days. Average daily minutes in light, moderate and vigorous PA were calculated. Results: All OA patients with and without FM spent significantly less time in vigorous PA compared to controls. Obtained results did not indicate significant difference between time in vigorous activity in OA patients with and without FM. Patients with OA alone showed insignificant decrease in time in moderate activity in comparison with healthy subjects. OA patients with comorbid FM showed significantly less time in moderate activity compared to OA patients without FM and healthy individuals. Conclusion: Our study results revealed that patients with painful knee OA and comorbid FM have greater activity limitations than patients with painful knee OA alone and healthy individuals. References: [1]Mahgoub MY, Elnady BM, Abdelkader HS, Abdelhalem RA, HassanWA. Comorbidity of Fibromyalgia in Primary Knee Osteoarthritis: Potential Impact on Functional Status and Quality of Life. Open Access Rheumatol. 2020;12: 55—63. [2]Ali K. Q. Al-Rubaye, Klara Johansson, Laith Alrubaiy. The association of health behavioral risk factors with quality of life in northern Sweden—A cross-sectional survey. J Gen Fam Med. 2020 Sep; 21(5): 167–177. [3]GBD 2017 Mortality Collaborators. Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1684–735. pmid:30496102 Disclosure of Interests: None declared.
The Challenge of Knowing
Authors: Jessica Kalender-Rich
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
OP0079 LIMB GIRDLE MUSCULAR DYSTROPHY TYPE 2B - A RARE MYOSITIS MIMIC
Authors: A. Merriman, S. Boyle
Journal: Annals of the Rheumatic Diseases (2021)

Background: Proximal muscle weakness with associated raised creatine kinase (CK) commonly leads to referral to Rheumatology for the investigation of Idiopathic Inflammatory Myopathy (IIM). Some genetic myopathies can have a similar presentation with investigations that suggest inflammatory disease, leading to difficulty with accurate diagnosis (Amato &amp; Brown, 2011; Harlan &amp; Mammen, 2019). Objectives: To describe the case of a patient with Limb Girdle Muscular Dystrophy Type 2B (LGMD2B), whose initial presentation mimicked an inflammatory myopathy. Methods: Case report. Results: A 43-year-old patient was reviewed by Rheumatology due to proximal muscle weakness with a raised CK. Muscle biopsy was suggestive of inflammatory myopathy. Therefore, he was started on treatment with corticosteroids. Corticosteroid treatment resulted in no improvement in his weakness or CK. His diagnosis was reviewed, and he was referred to the Neurology and Genetics services. Following molecular genetic analysis, a diagnosis of Limb Girdle Muscular Dystrophy Type 2B was made. Conclusion: Muscle biopsies can suggest an inflammatory aetiology in some genetic myopathies (Amato &amp; Brown, 2011; Harlan &amp; Mammen, 2019). If a patient with suspected IIM presents with atypical features, or they do not respond as expected to treatment, then consider a genetic myopathy such as LGMD2B as a cause and involve the Neurology and Genetics services in the case. References: [1]Amato, A. A., &amp; Brown, R. H., Jr. (2011). Dysferlinopathies. Handb Clin Neurol , 101 , 111-118. https://doi.org/10.1016/b978-0-08-045031-5.00007-4 [2]Harlan, M &amp; Mammen A. L (2019). Myositis Mimics: The Differential Diagnosis of Myositis. In: R. Aggarwal and C. V. Oddis (Eds.) Managing Myositis (pp. 209-223). Springer, Cham. Disclosure of Interests: None declared
Analysis of reasons for emergency department (ED) visits and resulting hospital admissions in breast cancer patients: A retrospective study from rural cancer center in Maine.
Authors: Anannya Patwari, Vineel Bhatlapenumarthi, Courtnery Brann, Jackson Waldrip, Victoria Caruso, Adam Curtis, Catherine Chodkiewicz
Journal: Journal of Clinical Oncology (2021)

e18682 Background: Reducing ED visits in patients with cancer is cost saving and is particularly relevant during the COVID pandemic. Methods: We analyzed the number of ED visits occurred in our breast cancer population between July 1 2019 and August 31 2020 including demographics, stage distribution, treatment type within the month of ED visit, reason, time of the day, day of the week the visit occurred. Results: A total of 101 patients had 162 visits. 38 (38%) had more than 1 ED visit. Majority (36%) had stage 4 disease at the time of ED visit. The top 5 reasons for ED visits were fall and injury (N=30), GI (N=24), cardiac (N=17), respiratory symptoms (N=14) and cancer related pain (N=11). The median age in patients with ED visit due to fall injury/pain was 75 and non-fall injury/pain was 55 years. The most common reasons for chemotherapy induced ED visits were GI related (N=8) and Neutropenic fever (N=7). Cyclophosphamide/doxorubicin was the common regimen associated with neutropenic fever. A total of 72 (44%) visits resulted in hospital admissions. Most common symptom categories requiring hospital admissions were cardiac (82.3%), sepsis/cellulitis (81.8%), respiratory (64%), cancer related pain (54.5%) and GI (50%). Most were on endocrine therapy at the time of their visit (N= 59) and 31 were on no treatment at all. Falls were unrelated to disease or treatment and occurred in patients above age 70. Visits occurred during working hours from 6AM to 5PM, with peak incidence on Mondays and Fridays. Conclusions: Reducing ED visit in cancer patients is a worthwhile endeavor particularly in the context of the COVID pandemic. The main reason for ED visits were falls and injuries that were unrelated to disease or treatment in breast cancer patients. As a result, we are implementing systematic physical therapy assessment for our breast cancer population over age of 60 at our cancer center and call us first campaign, to get an opportunity to intervene prior to going to the ED as majority of the ED visits occurred during working hours.[Table: see text]
The functional significance of ATM phosphorylation of Bub3 on Serine 135 in sensitivity to DNA damaging agents.
Authors: Siyue Zhang, Mingming Xiao, Zhuang Liu, Yaqi Mo, Hong Liu, Bo Xu
Journal: Journal of Clinical Oncology (2021)

e15048 Background: Identification of biomarkers to assess and modify the sensitivity of cancer cells to radiotherapy and chemotherapy is critical to improve cancer treatment outcome. Budding uninhibited by benzimidazoles 3 (Bub3) is a mitotic checkpoint protein, and it is frequently overexpressed in many cancers and associated with low survival rates. Bub3 is involved in the repair of DNA damage induced by radiotherapy and chemotherapy. We recently identified that the ATM kinase phosphorylated Bub3 on Serine 135 (S135) via the stable isotope labeled amino acid in cell culture -mass spectrometry analysis. This study aims to explore the mechanism of ATM-phosphorylated Bub3 in the DNA damage response (DDR) and its effect on tumor sensitivity to DNA damaging agents. Methods: The radiosensitivity of the cells was detected by clonal formation assay, the proliferation ability of the cells was detected by the MTS assay. The expression of DDR protein γ-H2AX in the nucleus was detected by immunofluorescence assay. Genomic instability was observed by multinuclear formation. Co-immunoprecipitation and Western Blot were used to explore the internal mechanism of ATM phosphorylation of Bub3 in DDR. Results: We showed that ionizing radiation (IR) could induce Bub3 S/TQ (the specific ATM consensus motif) phosphorylation in an ATM dependent manner. Mutation of Bub3 Serine 135 to alanine (S135A) led to a phosphorylation defect. Phenotypic experiments showed hypersensitivity to IR in cells expressing Bub3 S135A. Bub3 S135A prolonged existence of γ-H2AX foci and increased the proportion of cells containing micronuclei. Further, we found that Ku70 and Ku80 showed a significant increase after IR in their interactions with Bub3, while Bub3 S135A mutation significantly reduced the interaction, leading to impaired DNA repair. Conclusions: We demonstrate that Bub3 S135 phosphorylation mediated by ATM is essential for an optimal DDR and disruption of this pathway increases tumor sensitivity to DNA damaging agents.
Tracheostomy in Infants after Cardiac Surgery: Indications, Timing and Outcomes
Authors: Ujjwal Chowdhury
Journal: Clinical Cardiology and Cardiovascular Interventions (2021)

Objective: There is little consensus on the indications and optimal timing of tracheostomy in the pediatric population. Our primary aim was to determine if early tracheostomy improves patient outcomes (between 10th and 15th postoperative day). Methods: A retrospective review of 84 neonates and infants requiring tracheostomy after cardiac surgery between January 1997 and December 2019 was performed. Indications and timings for tracheostomy, and risk factors for mortality were analyzed using Cox regression analysis. The receiver operating characteristic curve analysis, Youden’s index, sensitivity and specificity plot were performed to determine the optimal cut-off point of the timing of tracheostomy. Results: Twenty-five (29.76%) neonates and 59 (70.23%) infants with a median weight 7.6 kg (IQR: 3.1-9.25 kg) were studied. Extubation failure and unsuccessful weaning from ventilator occurred in 45 (53.6%) and 39 (46.4%) patients respectively. The timing of tracheostomy of 15 days as the optimal cut-off point was associated with a sensitivity of 73% and a specificity of 84% and a Youden’s index of 0.60. Early tracheostomy was associated with decreased mortality (p&lt;0.001), morbidity (p&lt;0.001), decreased duration of ventilation (p&lt;0.001), ICU length of stay (p&lt;0.001) and decreased time of decannulation (p&lt;0.001). The hazard of death was 5.26 times (95% CI: 1.47-20.36) higher in patients undergoing late tracheostomy. At a median follow-up of 166 (IQR: 82.5-216) months, the actuarial survival was 86.61%±0.04%. Conclusions: Early tracheostomy within 15th postoperative day was associated with lower perioperative and late mortality, morbidity and ICU stay compared with tracheostomy between 15-30 days, and confers significant long-term advantages.
Association of elevated serum CEA with visceral metastasis and distinctive circulating tumor DNA alterations in castrate-resistant prostate cancer.
Authors: Alexander Bray, Pannaga G. Malalur, Leylah Drusbosky, Theodore Stewart Gourdin, Michael B. Lilly
Journal: Journal of Clinical Oncology (2021)

e17023 Background: Serum carcinoembryonic antigen (CEA) is elevated in certain subtypes of castrate resistant prostate cancer (CRPC) such as aggressive variant prostate cancer (AVPC). Independent association of CEA expression with clinical stage and specific tumor gene variants could enable its use as a prognostic indicator and non-invasive biomarker of therapeutic response. Methods: Circulating tumor DNA (ctDNA) alterations in a commercially available panel of genes (Guardant Health) and serum CEA from 178 CRPC patients were retrospectively analyzed. These patients were defined as AVPC or non-AVPC based on the presence of 1 or more of the published Aparicio criteria (Aparicio et al, 2013). Clinical characteristics and ctDNA alterations were compared in patients with elevated and normal CEA. AVPC and non-AVPC patients were then compared to evaluate the uniqueness of CEA associated findings. Results: Patients with CRPC and elevated serum CEA were more likely to have liver (36.1% vs 12.0%, p = 0.002) and lung metastasis (19.4% vs 6.4%, p = 0.0441) compared to patients with normal CEA. When ctDNA profiles were analyzed there were no significant differences in rates of single nucleotide variants (SNVs) between patients with elevated and normal CEA. In contrast, patients with elevated CEA were significantly more likely to harbor copy number amplifications (CNAs) in BRAF, CDK6, FGR1, MET, CCNE1, MYC, KIT, CCND2, PIK3CA, RAF1, and KRAS. Of these, only PIK3CA and KRAS were significantly elevated in AVPC patients compared to non-AVPC patients. Relative to non-AVPC CRPC, patients with AVPC were significantly more likely to have clonal SNVs in TP53, PTEN, or RB (p = 0.0131). They were also more likely to have clonal SNVs in TP53 (p = 0.06). Conclusions: 1.) Elevated serum CEA is independently associated with visceral metastases in patients with CRPC. 2.) Elevated serum CEA in CRPC is associated with specific gene amplifications which are detectable by ctDNA analysis and not associated with AVPC as a whole. 3.) The ctDNA findings in patients with AVPC mirror previous tissue-based studies which documented recurrent genetic variations in TP53, PTEN, and RB (Aparicio et al, 2016). Together these findings outline a potential role for ctDNA profiling and serum CEA as non-invasive biomarkers in CRPC. They also suggest that elevated serum CEA may be associated with a genetically distinct subtype of AVPC.
Tandem versus single autologous stem cell transplant: A patient-reported outcome.
Authors: Thomas H. Molina, Nathan W. Sweeney, Nolan Cole, Jenny Ahlstrom
Journal: Journal of Clinical Oncology (2021)

e20026 Background: Whether tandem autologous stem cell transplant (ASCT) is superior to single ASCT for new diagnosed multiple myeloma (MM) patients remains a subject of discussion in the era of novel agents. This project analyzed patient-reported outcomes to single ASCT and tandem ASCT utilizing an online patient-centered platform. Methods: We analyzed patient-reported treatment outcomes pertaining to tandem ASCT and single ASCT from HealthTree Cure Hub ( www.healthtree.org ). In this study, we examined whether patients reported a reduction or no reduction in their myeloma after their tandem or single ASCT. The association between stem cell transplant and myeloma outcome was compared by chi-squared test. Results: In this retrospective analysis of 945 MM patients, we compared two groups, those that reported receiving a tandem ASCT (n = 75) and those that reported receiving a single ASCT (n = 870). Our analysis revealed an association between patients who reported receiving a tandem ASCT and a reduction of their myeloma (chi-square (1) = 3.87, p = .04), compared to patients who reported receiving a single ASCT. Conclusions: Tandem ASCT was perceived by patients to be superior over single ASCT in regard to myeloma reduction for the HealthTree patient population. A more in-depth analysis of the patient-provided health data from HealthTree could aid in determining factors related to survival as well as help to quickly answer lingering questions related to tandem ASCT, such as timing, genetic factors, progression free survival, and more.[Table: see text]
HGG-19. 5-AMINOLEVULINIC ACID (5-ALA)-GUIDED RESECTION OF PEDIATRIC BRAIN TUMORS
Authors: Michael Schwake, Ann-Katrin Bruns, Michael Müther, Stephanie Schipmann, Walter Stummer
Journal: Neuro-Oncology (2021)

Abstract Between tumor and normal brain, allowing a higher degree of resection, and improved patient outcomes. In recent years, several reports have emerged regarding the use of 5-ALA in other brain tumor entities, including pediatric brains tumors. Since gross total resection (GTR) of many brain tumors in children is crucial, the role of 5-ALA-guided resection requires elucidation. Methods A systematic literature review of EMBASE and MEDLINE/PubMed databases revealed 20 eligible publications encompassing 186 5-ALA-guided operations on pediatric brain tumors. To reduce bias, publications were revised independently by two authors. Results 5-ALA-guided resection enabled the surgeons to identify the tumor more easily and was considered helpful mainly in cases of glioblastoma (GBM, 21/27, 78%), anaplastic ependymoma WHO grade III (10/14, 71%), and anaplastic astrocytoma (4/6, 67%). In contrast, cases of pilocytic astrocytomas (PAs) and medulloblastomas 5-ALA-guided surgery did not show consistent fluorescent signals and 5-ALA was considered helpful only in 12% and 22% of cases, respectively. Accumulation of fluorescent porphyrins seems to depend on WHO tumor grading. In case fluorescence signal was considered helpful, it was associated with a greater degree of resection. One study showed an association between visible fluoresce signal and concentration of protopophyrin IX (PPIX) concentration. A threshold of 4μg/ml was required in order to visualize the fluorescence signal. The rate of adverse events related to 5-ALA was negligible, especially new postoperative sequelae. Conclusion 5-ALA could play a role in resection of malignant, contrast enhancing, supratentorial pediatric brain tumors. At present, we are conducting a prospective phase I-II multicenter clinical trial to evaluate side effects and feasibility of 5-ALA guided surgery.