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Pancreatic Adenocarcinoma, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.

J Natl Compr Canc Netw 2021 Apr 1;19(4):439-457. Epub 2021 Apr 1.

32National Comprehensive Cancer Network.

Pancreatic cancer is the fourth leading cause of cancer-related death among men and women in the United States. A major challenge in treatment remains patients' advanced disease at diagnosis. The NCCN Guidelines for Pancreatic Adenocarcinoma provides recommendations for the diagnosis, evaluation, treatment, and follow-up for patients with pancreatic cancer. Read More

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NCCN Guidelines® Insights: Melanoma: Cutaneous, Version 2.2021.

J Natl Compr Canc Netw 2021 Apr 1;19(4):364-376. Epub 2021 Apr 1.

32National Comprehensive Cancer Network.

Over the past few years, the NCCN Guidelines for Melanoma: Cutaneous have been expanded to include pathways for treatment of microscopic satellitosis (added in v2.2020), and the following Principles sections: Molecular Testing (added in v2.2019), Systemic Therapy Considerations (added in v2. Read More

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Kindlin for the Fire: Targeting Proline Synthesis to Extinguish Matrix Production in Pulmonary Fibrosis.

Am J Respir Cell Mol Biol 2021 Apr 12. Epub 2021 Apr 12.

National Jewish Health, Pediatrics, Denver, Colorado, United States.

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Cost-effectiveness of risk-based breast cancer screening: A systematic review.

Int J Cancer 2021 Apr 12. Epub 2021 Apr 12.

Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.

To analyse published evidence on the economic evaluation of risk-based screening (RBS), a full systematic literature review was conducted. After a quality appraisal, we compared the cost-effectiveness of risk-based strategies (low-risk, medium-risk, and high-risk) with no screening and age-based screening. Studies were also analysed for modelling, risk stratification methods, input parameters, data sources, and harms and benefits. Read More

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The high affinity IgE receptor: a signaling update.

Curr Opin Immunol 2021 Apr 7;72:51-58. Epub 2021 Apr 7.

Laboratory of Allergic Diseases, Center for Autoimmunity and Inflammation, La Jolla Institute for Immunology, La Jolla, CA 92037, USA; Department of Dermatology, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA.

Here we update receptor proximal and distant signaling events of the mast cell high affinity IgE receptor (FcεRI) launching immediate type I hypersensitivity and an inflammatory cytokine-chemokine cascade. Different physiologic antigen concentrations, their affinity, and valency for the IgE ligand produce distinct intracellular signaling events with different outcomes. Investigating mast cell degranulation has revealed a complex molecular machinery that relays proximal signaling to cytoskeletal reorganization, granule transport and membrane fusion. Read More

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Endometrial Stem/Progenitor cell (ES/PC) Marker Expression Profile in Adenosarcoma and Endometrial Stromal Sarcoma.

Cancer Treat Res Commun 2021 Mar 31;27:100363. Epub 2021 Mar 31.

Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Department of Pathology, Toronto General Hospital, Toronto, ON, Canada.

Background: The uterus is one of the most dynamic organs in the human body, and this dynamic homeostasis is supported by endometrial stem/progenitor cells (ES/PCs), which are heterogeneous in their phenotype and degree of differentiation. ES/PCs are generally localized in the endometrial stroma, the site of origin for adenosarcoma and endometrial stromal sarcoma (ESS). Subsets of ESSs and adenosarcomas harbor SUZ12 or DICER1 gene alterations, two genes with roles in embryonic stem cell biology. Read More

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Data-driven methods distort optimal cutoffs and accuracy estimates of depression screening tools: a simulation study using individual participant data.

J Clin Epidemiol 2021 Apr 7. Epub 2021 Apr 7.

Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada; Members of the DEPRESSD EPDS Group: Ying Sun, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada. Electronic address:

Objective: To evaluate, across multiple sample sizes, the degree that data-driven methods result in (1) optimal cutoffs different from population optimal cutoff and (2) bias in accuracy estimates.

Study Design And Setting: 1,000 samples of sample size 100, 200, 500 and 1,000 each were randomly drawn to simulate studies of different sample sizes from a database (N=13,255) synthesized to assess Edinburgh Postnatal Depression Scale (EPDS) screening accuracy. Optimal cutoffs were selected by maximizing Youden's J (sensitivity+specificity-1). Read More

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Publisher Correction: Pre-symptomatic Caspase-1 inhibitor delays cognitive decline in a mouse model of Alzheimer disease and aging.

Nat Commun 2021 Apr 9;12(1):2271. Epub 2021 Apr 9.

Bloomfield Center for Research in Aging, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.

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Cross-cultural adaptation of the Perceived Risk of HIV Scale in Brazilian Portuguese.

Health Qual Life Outcomes 2021 Apr 9;19(1):117. Epub 2021 Apr 9.

Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.

Background: Valid and reliable instruments are needed to measure the multiple dimensions of perceived risk. The Perceived Risk of HIV Scale is an 8-item measure that assesses how people think and feel about their risk of infection. We set out to perform a cross-cultural adaptation of the scale to Brazilian Portuguese among key populations (gay, bisexual and other men who have sex with men and transgender/non-binary) and other populations (cisgender heterosexual men and cisgender women). Read More

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Effectiveness and safety of direct oral anticoagulants in patients with cancer associated venous thromboembolism.

Thromb Res 2021 Mar 29;202:128-133. Epub 2021 Mar 29.

Department of Medicine, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; Division of General Internal Medicine, Jewish General Hospital, Montreal, QC, Canada. Electronic address:

Introduction: Real-world evidence on the effects of direct oral anticoagulants (DOACs) in patients with cancer associated venous thromboembolism (VTE) is limited. Thus, our population-based cohort study aimed to assess the effectiveness and safety of DOACs compared to the standard of care low-molecular-weight heparin (LMWH) in this vulnerable population.

Materials And Methods: Using linked administrative healthcare databases from the province of Québec, Canada, we identified patients with incident VTE from 2012 to 2015 and a cancer diagnosis in the year before the VTE, who initiated treatment with anticoagulants within 30 days after the VTE. Read More

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Cabazitaxel versus abiraterone or enzalutamide in poor prognosis metastatic castration-resistant prostate cancer: a multicentre, randomised, open-label, phase 2 trial.

Ann Oncol 2021 Apr 6. Epub 2021 Apr 6.

Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Department of Medical Oncology, BC Cancer, Vancouver, British Columbia, Canada. Electronic address:

Purpose: Treatment for poor prognosis metastatic castration-resistant prostate cancer (mCRPC) includes taxane chemotherapy and androgen receptor pathway inhibitors (ARPI). We sought to determine optimal treatment in this setting.

Patients And Methods: This multicentre, randomised, open-label, phase 2 trial recruited patients with ARPI-naïve mCRPC and poor prognosis features (presence of liver metastases, progression to mCRPC after <12 months of androgen deprivation therapy, or ≥4 of 6 clinical criteria). Read More

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Skin-Reducing Mastectomy with Immediate Prepectoral Reconstruction: Surgical, Aesthetic, and Patient-Reported Outcomes with and without Dermal Matrices.

Plast Reconstr Surg 2021 Apr 7. Epub 2021 Apr 7.

From McGill University and the Division of Surgical Oncology, Jewish General Hospital.

Background: Prepectoral breast reconstruction is being increasingly popularized, largely because of technical advances. Patients with ptotic breasts and active cancer require mastectomies through a mastopexy excision pattern to achieve proper pocket control in a prepectoral single-stage operation. This article presents a single-surgeon experience with direct-to-implant, prepectoral reconstruction following skin-reducing mastectomies. Read More

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Reasons Older Veterans Use the Veterans Health Administration and Non-VHA Care in an Urban Environment.

J Am Board Fam Med 2021 Mar-Apr;34(2):291-300

From the Geriatric Research Education and Clinical Center (GRECC), James J Peters VA Medical Center, Bronx, NY (MRA, TM, AB-L, KB); Icahn School of Medicine at Mount Sinai, Department of Medicine, New York, NY (MRA); Icahn School of Medicine at Mount Sinai, Department of Geriatrics and Palliative Medicine, New York, NY (AB-L, KB); Community Wellness Department, Reading Hospital, Reading, PA (TM); Research Institute on Aging, The New Jewish House, New York, NY (KB).

Background: Older veterans in urban settings rely less on the Veterans Health Administration (VHA) health care, suggesting deficits of access and services for aging veterans. We aimed to identify reasons for VHA and non-VHA use across the health status of older, urban-dwelling veterans.

Methods: We examined open-ended responses from 177 veterans who were enrolled in primary care at the Bronx VA Medical Center, used non-VHA care in prior 2 years, and completed baseline interviews in a care coordination trial from March 2016 to August 2017. Read More

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Bloom syndrome in a Mexican American family with rhabdomyosarcoma: evidence of a Mexican founder mutation.

Cold Spring Harb Mol Case Stud 2021 Apr 8;7(2). Epub 2021 Apr 8.

Greehey Children's Cancer Research Institute, UT Health San Antonio, San Antonio, Texas 78229, USA.

Bloom syndrome is a rare autosomal recessive disorder with less than 300 cases reported in the literature. Bloom syndrome is characterized by chromosome instability, physical stigmata, growth deficiency, immunodeficiency, and a predisposition to cancer, most commonly leukemias, although solid tumors are reported as well. Bloom syndrome occurs in multiple ethnic groups with a higher incidence in persons of Ashkenazi Jewish origin. Read More

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Periostin loss-of-function protects mice from post-traumatic and age-related osteoarthritis.

Arthritis Res Ther 2021 04 8;23(1):104. Epub 2021 Apr 8.

Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital MS 8233, 425 South Euclid Avenue, St. Louis, MO, 63110, USA.

Background: Elevated levels of periostin (Postn) in the cartilage and bone are associated with osteoarthritis (OA). However, it remains unknown whether Postn loss-of-function can delay or prevent the development of OA. In this study, we sought to better understand the role of Postn in OA development and assessed the functional impact of Postn deficiency on post-traumatic and age-related OA in mice. Read More

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Genomic Landscape of Malignant Peripheral Nerve Sheath Tumor-like Melanoma.

J Invest Dermatol 2021 Apr 5. Epub 2021 Apr 5.

Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.

Malignant peripheral nerve sheath tumor (MPNST)-like melanoma is a rare malignancy with overlapping characteristics of both neural sarcoma and melanoma. Although the genomics of cutaneous melanoma have been extensively studied, those of MPNST-like melanoma have not. To characterize the genomic landscape of MPNST-like melanoma, we performed a single-center, retrospective cohort-study at a tertiary academic cancer centre. Read More

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Multicenter comparison of high-dose cytarabine-based regimens versus liposomal daunorubicin and cytarabine (CPX-351) in patients with secondary acute myeloid leukemia.

Leuk Lymphoma 2021 Apr 8:1-9. Epub 2021 Apr 8.

Michigan Medicine, Ann Arbor, MI, USA.

Liposomal daunorubicin/cytarabine (CPX-351) gained FDA approval for secondary AML after demonstrating improved outcomes over daunorubicin and cytarabine (7 + 3). A number of study limitations prompted a comparison of safety/efficacy of CPX-351 against regimens containing a purine analogue and high-dose cytarabine (HIDAC). This retrospective study compared complete response rates with/without count recovery (CR/CRi) between HIDAC-based regimens and CPX-351 in 169 patients with newly diagnosed sAML. Read More

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Age-Dependent Associations Between 25-Hydroxy Vitamin D Levels and COPD Symptoms: Analysis of SPIROMICS.

Chronic Obstr Pulm Dis 2021 Apr 6. Epub 2021 Apr 6.

Division on Pulmonary Diseases and Critical Care Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States.

Introduction: Age and vitamin D levels may affect symptom burden in chronic obstructive pulmonary disease (COPD). We used the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) to determine independent associations between vitamin D levels and COPD symptoms in different age strata.

Methods: Serum 25-hydroxy(OH)-vitamin D levels were modeled continuously and categorically (<20 ng/ml vs. Read More

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Shared-Task Worklists Improve Clinical Trial Recruitment Workflow in an Academic Emergency Department.

Appl Clin Inform 2021 Mar 7;12(2):293-300. Epub 2021 Apr 7.

Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, United States.

Background:  Clinical trials performed in our emergency department at Barnes-Jewish Hospital utilize a centralized infrastructure for alerting, screening, and enrollment with rule-based alerts sent to clinical research coordinators. Previously, all alerts were delivered as text messages via dedicated cellular phones. As the number of ongoing clinical trials increased, the volume of alerts grew to an unmanageable level. Read More

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Impaired driving and legalization of recreational cannabis.

CMAJ 2021 Apr;193(14):E481-E485

Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que.

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Fertility treatments and breast cancer risk in Jewish Israeli BRCA mutation carriers.

Fertil Steril 2021 Apr 3. Epub 2021 Apr 3.

Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel.

Objective: To determine whether fertility treatments impact the risk of breast cancer in Jewish Israeli BRCA1/2 mutation carriers.

Design: Historical cohort study.

Setting: University-affiliated tertiary medical center. Read More

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SMART approaches for genome-wide analyses of skeletal muscle stem and niche cells.

Crit Rev Biochem Mol Biol 2021 Apr 7:1-17. Epub 2021 Apr 7.

Department of Human Genetics, McGill University, Montreal, Canada.

Muscle stem cells (MuSCs) also called satellite cells are the building blocks of skeletal muscle, the largest tissue in the human body which is formed primarily of myofibers. While MuSCs are the principal cells that directly contribute to the formation of the muscle fibers, their ability to do so depends on critical interactions with a vast array of nonmyogenic cells within their niche environment. Therefore, understanding the nature of communication between MuSCs and their niche is of key importance to understand how the skeletal muscle is maintained and regenerated after injury. Read More

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First-episode psychosis in the ultra-Orthodox Jewish population.

Transcult Psychiatry 2021 Apr 6:13634615211001706. Epub 2021 Apr 6.

Tel Aviv University.

Few if any methodologically robust studies of first-episode psychosis have been carried out in the ultra-Orthodox Jewish population. The opening of an inpatient psychiatry department within an ultra-Orthodox neighborhood in Israel offered the unique opportunity to study the specifics of first -episode psychosis in this subpopulation. Medical records of 60 ultra-Orthodox male Jewish patients with first-episode psychosis were examined over the first 18 months of the new department's operation. Read More

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From the Editor-in-Chief: Issue at a Glance.

Am J Hypertens 2021 Apr;34(3):229-230

The American Journal of Hypertension, Lady Davis Institute for Medical Research, and Department of Medicine, Sir Mortimer B. Davis, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

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Neuroblastoma of the lumbar spine.

World Neurosurg 2021 Apr 2. Epub 2021 Apr 2.

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287; Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Queens, NY USA 11040. Electronic address:

Neuroblastoma is a primitive, small round blue cell tumor predominately found in pediatric patients. Few cases of neuroblastoma involving the adult spine have been reported. Herein we present the case of a healthy 34-year-old man treated for a large neuroblastoma involving the L3-5 vertebral bodies and prevertebral great vessels. Read More

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Crystallographic analysis of TarI and TarJ, a cytidylyltransferase and reductase pair for CDP-ribitol synthesis in Staphylococcus aureus wall teichoic acid biogenesis.

J Struct Biol 2021 Apr 2:107733. Epub 2021 Apr 2.

Department of Biochemistry and Molecular Biology and Centre for Blood Research, The University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada. Electronic address:

The cell wall of many pathogenic Gram-positive bacteria contains ribitol-phosphate wall teichoic acid (WTA), a polymer that is linked to virulence and regulation of essential physiological processes including cell division. CDP-ribitol, the activated precursor for ribitol-phosphate polymerization, is synthesized by a cytidylyltransferase and reductase pair known as TarI and TarJ, respectively. In this study, we present crystal structures of Staphylococcus aureus TarI and TarJ in their apo forms and in complex with substrates and products. Read More

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Technology-Based Psychological Interventions for Young Adults With Early Psychosis and Cannabis Use Disorder: Qualitative Study of Patient and Clinician Perspectives.

JMIR Form Res 2021 Apr 5;5(4):e26562. Epub 2021 Apr 5.

Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.

Background: The persistence of cannabis use disorder (CUD) in young adults with first-episode psychosis (FEP) is associated with poor clinical and functional outcomes. Face-to-face psychological interventions are effective in treating CUD. However, their use in early intervention services (EISs) for psychosis is inconsistent because of barriers, including high workload and heterogeneity in training of clinicians and lack of motivation for treatment among patients. Read More

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