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ects in increasing access to maternal health services. Emphasis on other accessibility barriers and service delivery challenges alongside user fee removal policies should be addressed to realise maximum benefits in maternal health utilisation.Using administrative data on all Veterans who enter Department of Veterans Affairs (VA) medical centres throughout the USA, this paper uses artificial intelligence (AI) to predict mortality rates for patients with COVID-19 between March and August 2020. First, using comprehensive data on over 10 000 Veterans' medical history, demographics and lab results, we estimate five AI models. Our XGBoost model performs the best, producing an area under the receive operator characteristics curve (AUROC) and area under the precision-recall curve of 0.87 and 0.41, respectively. We show how focusing on the performance of the AUROC alone can lead to unreliable models. Second, through a unique collaboration with the Washington D.C. VA medical centre, we develop a dashboard that incorporates these risk factors and the contributing sources of risk, which we deploy across local VA medical centres throughout the country. Our results provide a concrete example of how AI recommendations can be made explainable and practical for clinicians and their interactions with patients.The year 2020 marked the thirtieth anniversary of the Nobel Prize in Medicine awarded to E. Donnall Thomas for the development of allogeneic hematopoietic stem cell transplantation (allo-HSCT) to treat hematologic malignancies and other blood disorders. Dr. Thomas, "father of bone marrow transplantation", first developed and reported this technique in 1957, and in the ensuing decades, this seminal study has impacted fundamental work in hematology and cancer research, including advances in hematopoiesis, stem cell biology, tumor immunology, and T cell biology. As the first example of cancer immunotherapy, understanding the mechanisms of anti-tumor biology associated with allo-HSCT has given rise to many of the principles used today in the development and implementation of novel transformative immunotherapies. Here we review the historical basis underpinning the development of allo-HSCT as well as advances in knowledge obtained by defining mechanisms of allo-HSCT activity. We review how these principles have been translated to novel immunotherapies currently utilized in clinical practice and describe potential future applications for allo-HSCT in cancer research and development of novel therapeutic strategies.Type II diabetes is associated with poor breast cancer prognosis. To study the association between a diabetes risk reduction diet (DRRD) and survival following breast cancer, we followed 8,482 women with breast cancer from two large cohort studies. Information on diet and other factors was repeatedly measured in validated questionnaires every two to four years. The DRRD includes 9 components higher intakes of cereal fiber, coffee, nuts, whole fruits and polyunsaturated/saturated fat ratio; and lower glycemic index, trans fat, sugar-sweetened beverages, and red meat. buy Epacadostat Cumulative average DRRD score was calculated using repeated measures of postdiagnostic diet. Deaths were assessed by family members or via National Death Index. Multivariable-adjusted HRs and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. During a median of 14 years of follow-up since diagnosis, 2,600 deaths occurred among participants, 1,042 of which were due to breast cancer. Women with higher postdiagnostic DRRD score had a 20% lower risk of breast cancer-specific mortality (top vs. bottom quintile HR = 0.80; 95% CI = 0.65-0.97; P trend = 0.02) and 34% lower risk of all-cause mortality (HR = 0.66; 95% CI = 0.58-0.76; P trend less then 0.0001). Compared with women who consistently had lower score (≤median) before and after diagnosis, those whose score improved from low to high had a lower risk of breast cancer-specific mortality (HR = 0.77; 95% CI = 0.62-0.95) and overall mortality (HR = 0.85; 95% CI = 0.74-0.97). These findings demonstrate that greater adherence to DRRD was associated with better survival, suggesting postdiagnosis dietary modification consistent with type II diabetes prevention may be important for breast cancer survivors. SIGNIFICANCE This study suggests that greater adherence to the diabetes risk reduction diet after diagnosis associates with improved survival outcomes among a large number of breast cancer survivors.

White blood cell (WBC) DNA may contain methylation patterns that are associated with subsequent breast cancer risk. Using a high-throughput array and samples collected, on average, 1.3 years prior to diagnosis, a case-cohort analysis nested in the prospective Sister Study identified 250 individual CpG sites that were differentially methylated between breast cancer cases and noncases. We examined five of the top 40 CpG sites in a case-control study nested in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) Cohort.

We investigated the associations between prediagnostic WBC DNA methylation in 297 breast cancer cases and 297 frequency-matched controls. Two WBC DNA specimens from each participant were used a proximate sample collected 1 to 2.9 years and a distant sample collected 4.2-7.3 years prior to diagnosis in cases or the comparable timepoints in controls. WBC DNA methylation level was measured using targeted bisulfite amplification sequencing. We used logistic regression to obtain ORs and 95% confidence intervals (CI).

A one-unit increase in percent methylation in

in proximate WBC DNA was associated with increased breast cancer risk (adjusted OR = 1.29; 95% CI, 1.06-1.57). However, a one-unit increase in percent methylation in

in distant WBC DNA was inversely associated with breast cancer risk (adjusted OR = 0.83; 95% CI, 0.69-0.98). None of the other ORs met the threshold for statistical significance.

There was no convincing pattern between percent methylation in the five CpG sites and breast cancer risk.

The link between prediagnostic WBC DNA methylation marks and breast cancer, if any, is poorly understood.

The link between prediagnostic WBC DNA methylation marks and breast cancer, if any, is poorly understood.

Colorectal cancer is curable if diagnosed early and treated properly. Black and Hispanic patients with colorectal cancer are more likely to experience treatment delays and/or receive lower standards of care. Socioeconomic deprivation may contribute to these disparities, but this has not been extensively quantified. We studied the interrelationship between patient race/ethnicity and neighborhood socioeconomic status (nSES) on receipt of timely appropriate treatment among patients with colorectal cancer in California.

White, Black, and Hispanic patients (26,870) diagnosed with stage I-III colorectal cancer (2009-2013) in the California Cancer Registry were included. Logistic regression models were used to examine the association of race/ethnicity and nSES with three outcomes undertreatment, >60-day treatment delay, and >90-day treatment delay. Joint effect models and mediation analysis were used to explore the interrelationships between race/ethnicity and nSES.

Hispanics and Blacks were at increasedethnic disparities in colorectal cancer.

Lung cancer screening (LCS) with low-dose CT (LDCT) was implemented in the United States following the National Lung Screening Trial (NLST). The real-world benefits of implementing LCS are yet to be determined with outcome-oriented data. The study objective is to investigate the characteristics and outcomes of screening-detected lung cancers.

This single-institution retrospective study included LCS patients between June 2014 and December 2019. Patient demographics, number of screening rounds, imaging features, clinical workup, disease extent, histopathology, treatment, complications, and mortality outcomes of screening-detected lung cancers were extracted and compared with NLST data.

LCS LDCTs (7,480) were performed on 4,176 patients. The cancer detection rate was 3.8%, higher than reported by NLST (2.4%,

< 0.0001), and cancers were most often found in patients ≥65 years (62%), older than those in NLST (41%,

< 0.0001). The patients' ethnicity was similar to NLST,

= 0.87. Most LCS-detected cancers were early stage I tumors (71% vs. 54% in NLST,

< 0.0001). Two thirds of cancers were detected in the first round of screening (67.1%) and were multifocal lung cancers in 15%. As in NLST, the complication rate after invasive workup or surgery was low (24% vs. 28% in NLST,

= 0.32). Over a median follow-up of 3.3 years, the mortality rate was 0.45%, lower than NLST (1.33%,

< 0.0001).

LCS implementation achieved a higher cancer detection rate, detection of early-stage cancers, and more multifocal lung cancers compared with the NLST, with low complications and mortality.

The real-world implementation of LCS has been successful for detection of lung cancer with favorable outcomes.

The real-world implementation of LCS has been successful for detection of lung cancer with favorable outcomes.Background High-frequency jet ventilation (HFJV) is primarily used in neonates but may also have a role in the treatment of infants with congenital heart disease and severe respiratory failure. We hypothesized HFJV would result in improved gas exchange in these infants.Methods We retrospectively reviewed the records of all pediatric subjects with complex congenital heart disease treated HFJV in the pediatric cardiac ICU between 2014 and 2018. Subjects in whom HFJV was started while on ECMO were excluded. We extracted data on demographics, pulmonary mechanics, gas exchange, subsequent need for ECMO, use of inhaled nitric oxide, and outcomes. Results We included 27 subjects (weight 4.4 [3.3-5.4] kg; age 2.5 [0.3-5.4] months), 22 (82%) of whom had cyanotic heart disease. Thirteen subjects (48%) survived and 6 (22%) required ECMO. HFJV was started after a median of 8.4 (2.1-26.3) days of conventional mechanical ventilation. Subjects spent a median of 1.2 (0.5-2.8) days on HFJV. Pre-HFJV blood gas results (n=25) were pH 7.22 (7.17-7.31), PaCO2 69 (51-77) mmHg, and PaO2 51 (41-76) mmHg. Initial HFJV settings were peak inspiratory pressure 45 (36-50) cmH2O, rate 360 (360-380) bpm, and inspiratory time 0.02 (0.02-0.03) seconds. Compared to conventional mechanical ventilation, at 4 to 6 hours post HFJV initiation, there were significant improvements in median pH (7.22 vs.7.34, p=0.001) and PaCO2 (69 vs. 50 mmHg, p=0.001), respectively, but no difference in median PaO2 (51 vs. 53 mmHg, p=0.97). Conclusion HFJV was associated with a decrease in PaCO2 and an increase in pH in infants with congenital heart disease remaining on HFJV 4 to 6 hours after initiation.An investigational agent that inhibits RAD51-mediated homologous recombination DNA repair has shown preliminary signs of activity. In a phase I trial, CYT-0851 elicited three responses in patients with relapsed/refractory hematologic malignancies and advanced solid tumors and was associated with only mild side effects.

Over 1 billion individuals worldwide experience some form of sleep apnoea, and this number is steadily rising. Obstructive sleep apnoea (OSA) can negatively influence one's quality of life and potentially increase mortality risk. However, the association between OSA and mortality has not been reliably estimated. This meta-analysis estimates the risk of all-cause and cardiovascular mortality in individuals with OSA.

Systematic review and meta-analysis.

MEDLINE, Cochrane Library, Scopus and Joanna Briggs Institute Evidence-Based Practice databases were searched from inception through 1 January 2020.

We included observational studies assessing the association of sudden deaths in individuals with and without OSA.

Two independent reviewers (AES and ESH) extracted data and assessed the risk of bias using the Newcastle-Ottawa Scale quality assessment tool. Data were pooled using the random-effects models and reported as risk ratios (RRs) with 95% CIs. Heterogeneity was quantified with I

statistic.

We identified 22 observational studies (n=42 099 participants).