tbuckley/cabot-search huggingface dataset:
Association of Financial Integration Between Physicians and Hospitals With Commercial Health Care Prices
Authors: Hannah T. Neprash, Michael E. Chernew, Andrew L. Hicks, Teresa Gibson, J. Michael McWilliams
Journal: JAMA Internal Medicine (2015)

Financial integration between physicians and hospitals may help health care provider organizations meet the challenges of new payment models but also may enhance the bargaining power of provider organizations, leading to higher prices and spending in commercial health care markets.To assess the association between recent increases in physician-hospital integration and changes in spending and prices for outpatient and inpatient services.Using regression analysis, we estimated the relationship between changes in physician-hospital integration from January 1, 2008, through December 31, 2012, in 240 metropolitan statistical areas (MSAs) and concurrent changes in spending. Adjustments were made for patient, plan, and market characteristics, including physician, hospital, and insurer market concentration. The study population included a cohort of 7,391,335 nonelderly enrollees in preferred-provider organizations or point-of-service plans included in the Truven Health MarketScan Commercial Database during the study period. Data were analyzed from December 1, 2013, through July 13, 2015.Physician-hospital integration, measured using Medicare claims data as the share of physicians in an MSA who bill for outpatient services with a place-of-service code indicating employment or practice ownership by a hospital.Annual inpatient and outpatient spending per enrollee and associated use of health care services, with utilization measured by price-standardized spending (the sum of annual service counts multiplied by the national mean of allowed charges for the service).Among the 240 MSAs, physician-hospital integration increased from 2008 to 2012 by a mean of 3.3 percentage points, with considerable variation in increases across MSAs (interquartile range, 0.8-5.2 percentage points). For our study sample of 7,391,335 nonelderly enrollees, an increase in physician-hospital integration equivalent to the 75th percentile of changes experienced by MSAs was associated with a mean increase of $75 (95% CI, $38-$113) per enrollee in annual outpatient spending (P < .001) from 2008 to 2012, a 3.1% increase relative to mean outpatient spending in 2012 ($2407 [95% CI, $2400-$2414] per enrollee). This increase in outpatient spending was driven almost entirely by price increases because associated changes in utilization were minimal (corresponding change in price-standardized spending, $14 [95% CI, -$13 to $41] per enrollee; P = .32). Changes in physician-hospital integration were not associated with significant changes in inpatient spending ($22 [95% CI, -$1 to $46] per enrollee; P = .06) or utilization ($10 [95% CI, -$12 to $31] per enrollee; P = .37).Financial integration between physicians and hospitals has been associated with higher commercial prices and spending for outpatient care.
Abstract 2804: Expression of miR-17-92 enhances antitumor activity of T cells transduced with the anti-EGFRvIII chimeric antigen receptor in mice bearing human GBM xenografts
Authors: Masasuke Ohno, Takayuki Ohkuri, Akemi Kosaka, Carl H. June, Atsushi Natsume, Hideho Okada
Journal: Cancer Research (2014)

Abstract Background Expression of miR-17-92 confers type-1 phenotype and enhanced survival of T-cells. We have previously reported that miR-17-92 is down-regulated in T-cells derived from glioblastoma (GBM) patients. We hypothesized that transgene-derived co-expression of miR17-92 and chimeric antigen receptor (CAR) in T-cells improves the efficacy of adoptive transfer therapy against GBM. Methods We constructed novel lentiviral vectors for miR-17-92 (FG12-EF1a-miR-17/92) and a CAR consisting of epidermal growth factor receptor variant III (EGFRvIII)-specific single-chain variable fragment (scFv) coupled to the T-cell receptor CD3ζ chain signaling module and co-stimulatory motifs of CD137 (4-1BB) and CD28 in tandem (pELNS-3C10-CAR). Human T-cells were transduced with these lentiviral vectors and their anti-tumor effects were evaluated both in vitro and in vivo. Results In addition to antigen-specific and potent cytotoxic activities against U87 GBM cells stably expressing EGFRvIII (U87-EGFRvIII), CAR-transduced T-cells (CAR-T-cells) co-transduced with miR-17-92 exhibited improved survival in the presence of temozolomide (TMZ) compared with CAR-T-cells without miR-17-92 co-transduction. In mice bearing intracranial U87-EGFRvIII xenografts, CAR-T-cells with or without transgene-derived miR-17-92 expression demonstrated similar levels of potent therapeutic effects without demonstrating any uncontrolled growth of CAR-T-cells. However, when these mice were re-challenged with U87-EGFRvIII cells in the brains, mice receiving co-transduced CAR-T-cells exhibited improved protection compared with mice treated with CAR-T-cells without miR-17-92 co-transduction. Conclusion These results warrant development of novel CAR-T-cell strategies by incorporation of miR-17-92 to improve the therapeutic potency, especially in patients with GBM. Citation Format: Masasuke Ohno, Takayuki Ohkuri, Akemi Kosaka, Carl H. June, Atsushi Natsume, Hideho Okada. Expression of miR-17-92 enhances antitumor activity of T cells transduced with the anti-EGFRvIII chimeric antigen receptor in mice bearing human GBM xenografts. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2804. doi:10.1158/1538-7445.AM2014-2804
Separation on Percoll Density Gradients of Cells Derived From Malignant Ascites of Mice&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: A W Hamburger, F E Dunn, K L Tencer
Journal: JNCI Journal of the National Cancer Institute (1983)

In an attempt to separate malignant from normal and reactive stromal cells, we fractionated ascites cells from BALB/c mice bearing a transplantable myeloma (MPC-11) by isopyknic centrifugation in continuous density gradients of povidone-coated silica gels (Percoll). Cells from different fractions were then analyzed by morphologic and immunologic criteria. The ability of cells from the different fractions to form colonies in soft agar and to produce tumors in BALB/c mice was also examined. Although most fractions contained morphologically identifiable plasma cells, colony-forming cells (CFC), derived from multiply passaged tumors, separated in a sharp peak at 1.072 g/ml. CFC peaked at 1.078-1.082 g/ml for tumors passed less than three times and were invariably markedly depleted from the low-density portions of the gradients. Cells recovered from different fractions of the gradients were cultured in soft agar and inoculated sc into syngeneic mice. In these experiments, a highly significant correlation was observed between the ability of cells to form colonies in soft agar and to form tumors in vivo. This correlation suggests that CFC and tumorigenic cells have similar distributions.
Advantages of comprehensive lung function techniques in cystic fibrosis
Authors: Cornells K Van Der Ent, Paul L P Brand
Journal: Journal of the Royal Society of Medicine (1999)

* Lung function tests could detect pathological changes in the lung at the earliest possible stage, leading to intervention early in life, and, possibly, to a better prognosis for CF patients. * Lung function tests could detect pathological change in the lung more precisely than clinical signs and symptoms, leading to better evaluation and refinement of treatment strategies, and, eventually, to a better prognosis for CF patients. * Lung function tests, as a reflection of pathological changes, could teach doctors more about the course of CF in individual patients in comparison to the general population, and enable them to identify and treat patients with a high risk of morbidity.
Bone morphogenetic protein signaling in experimental nitrofen-induced congenital diaphragmatic hernia
Authors: Martine Makanga, Céline Dewachter, Aline Vuckovic, Benoît Rondelet, Robert Naeije, Laurence Dewachter
Journal: European Respiratory Journal (2012)

Congenital diaphragmatic hernia (CDH) is a life-threatening cause of lung hypoplasia and persistent pulmonary hypertension of the newborn. As bone morphogenetic proteins (BMP) have been shown to play crucial roles in fetal lung and heart development, we explored the potential implication of this signaling pathway in an experimental model of CHD. Pregnant Sprague-Dawley rats were exposed to either 100 mg nitrofen or olive oil on embryonic day 9.5. On embryonic days 17 and 21, fetuses were delivered by caesarian section, sacrificed, checked for CDH and their lung and heart tissue were harvested for pathobiological evaluation.  Lung and heart weight-to-body weight ratios decreased by 28% and 35% (P  These results suggest that BMP signaling is downregulated in the lungs and the heart at early and late stages of nitrofen-induced CDH.
Prevalence of human parechovirus in Chinese children hospitalized for acute gastroenteritis
Authors: D.-L. Zhang, Y. Jin, D.-D. Li, W.-X. Cheng, Z.-Q. Xu, J.-M. Yu, M. Jin, S.-H. Yang, Q. Zhang, S.-X. Cui, N. Liu, Z.-J. Duan
Journal: Clinical Microbiology and Infection (2010)
Effect of hypoxia and cigarette smoke on hypoxia-inducible factor 1α (HIF-1α) and heat shock protein 72 (HSP72) system of alveolar epithelial cells
Authors: Balazs Odler, Katalin Szabo, Krisztina Gal, Erna Sziksz, Adam Vannay, Attila Szabo, Gyorgy Losonczy, Veronika Muller
Journal: European Respiratory Journal (2012)

Smoking is the main risk factor of alvolar destruction in emphyseama/COPD. In COPD airway obstruction causes hypoventilated areas in the lung leading to alveolar hypoxia. HIF-1 α plays a key role in the defense against hypoxic cellular damage. The inducible HSP72 has a central role in the maintenance of cell integrity, apoptosis and cellular immunity. It is unknown, what role HIF-1α and HSP72 play in cell damage caused by hypoxia and cigarette smoke.  HIF1α and HSP72 mRNA expression using RT-PCR of immortalized alveolar epithelial cells (A549) was analyzed using hypoxia (FiO2 20,9% (control); 13±1%; 6±1%; 1±1%) and treatment with cigarette smoke extract (CSE).  Under hypoxic conditions cell count grew significantly (FiO2 13±1%: 13,33x105; FiO2 6±1%:13,2x105; FiO2 1±1%: 12,86x105 vs. normoxia FiO2 20,9%: 7,73x105; p  Hypoxia increases, whereas CSE treatment decreases alveolar epithelial cell count. HSP72 mRNA decreases following hypoxic or CSE induced cellular stress, while severe hypoxia and CSE treatment decreases HIF-1α mRNA expression of A549 cells.
Tuberculosis (TB) notifications in healthcare workers (HCW) in Liverpool, UK
Authors: Nicholas Coombes, Syed M.H. Kazmi, Sean Mackin, Clifford Bisacre, Peter Davies
Journal: European Respiratory Journal (2012)

BACKGROUND   The number of overseas HCW in Liverpool has grown sharply in recent years. In 2005, an audit demonstrated a rise in the number of TB notifications in HCW (mainly from overseas) in the previous 24 months, and suggested the need for vigilant new entrant screening. We aimed to look at the trend of HCW TB notifications 6 years later to assess the impact of improved TB screening.   METHOD   TB notification data for the calendar year 2011 was collected from the Liverpool TB service. We compared this data with results from the previous audits.   RESULTS   See table  All but one were non-UK born and average time spent in the UK was more than five years. No positive contacts were detected and 1 case required an incident report meeting.   CONCLUSION   Our results show that the proportion of HCW TB notifications has halved. There is also a decrease in the number of smear positive cases, and the average time spent in the UK before contracting TB disease was longer than in previous years. Although clinically significant, we were unable to show statistical significance most likely due to type II error.  Nonetheless, this demonstrates that with efficient and organized screening especially among HCW, the high risk cases can be identified earlier and treated for latent disease (when necessary) thus preventing development of pulmonary TB.
Late-breaking abstract: New algorithm of lung cancer diagnosis by analysis of exhaled breath with electronic nose and multifactorial logistic regression method
Authors: Maris Bukovskis, Normunds Jurka, Gunta Strazda, Ainis Pirtnieks, Uldis Kopeika, Madara Tirzite, Immanuels Taivans
Journal: European Respiratory Journal (2014)

Background  Exhaled breath of lung cancer patients contains unique pattern of volatile organic compounds (VOCs) which can be distinguished by analysis with electronic nose.  Objective  The aim of our study was to develop optimal diagnostic algorithm by multifactorial logistic regression (MLRA) analysis and test its diagnostic potential in patients with lung cancer.  Methods  Exhaled breath of lung cancer patients (cancer group) and mixed group of patients (COPD, asthma, pneumonia) and healthy volunteers (no cancer group) was examined. Exhaled air was collected using standardized method and sampled by electronic nose (Cyranose 320). Optimal detector parameter combination and mathematical model for discrimination of lung cancer was computed by MLRA backward step-wise method in smokers, ex-smokers and nonsmokers. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of the algorithms in the training sample of each group was calculated.  Results  Total 474 patients, out of them 282 lung cancer patients and 192 patients with different lung diseases and healthy volunteers were recruited in the study. 129 were nonsmokers, 135 ex-smokers and 210 smokers.  Conclusions  Finding of optimal detector parameter combination and splitting of patients in smokers, ex-smokers and nonsmokers gives very high lung cancer prediction accuracy.  Acknowledgements  Study was sponsored by ERAF activity 2.1.1.1.0 Project Nb. 2010/0303/2DP/2.1.1.1.0/10/APIA/VIAA/043/
Impact of carbapenem resistance on clinical and economic outcomes among patients with Acinetobacter baumannii infection in Colombia
Authors: E.V. Lemos, F.P. de la Hoz, N. Alvis, T.R. Einarson, E. Quevedo, C. Castañeda, Y. Leon, C. Amado, O. Cañon, K. Kawai
Journal: Clinical Microbiology and Infection (2013)
Psychiatric Morbidity in Adults with Hypopituitarism
Authors: S Lynch, S Merson, S A Beshyah, E Skinner, P Sharp, R G Priest, D G Johnston
Journal: Journal of the Royal Society of Medicine (1994)

Forty-one adults with established hypopituitarism and deficiency of growth hormone (GHD) were compared to an age and sex-matched group with another chronic metabolic disorder (diabetes mellitus) using standardized psychiatric rating and diagnostic measures. Nineteen (46%) of the GHD group were identified as definite psychiatric cases compared with 10 (24%) of the diabetics (odds ratio 1:9:1). The most frequent DSM III-R axis I psychiatric diagnoses were major depression (32% GHD patients and 10% of diabetic patients) and dysthymia. The risk of being a psychiatric case showed an association with duration of illness in the diabetic group, but not in the GHD group. Biochemical indices were not related to the risk of being a case in either group. Hypopituitarism is associated with a higher prevalence of psychiatric disturbance than can be attributed solely to the presence of a chronic disorder.
Analysis of immunological and clinical data resulting from four phase I and II trials of MVA-5T4 in colorectal cancer patients
Authors: R. Harrop, W. H. Shingler, M. Goonewardena, J. de Belin, M. Kelleher, N. Drury, P. Treasure, S. Naylor
Journal: Journal of Clinical Oncology (2009)

3058 Background: The attenuated vaccinia virus MVA has been engineered to deliver the tumor antigen 5T4 (MVA-5T4; TroVax). 5T4 is a surface glycoprotein expressed by most solid tumors. MVA-5T4 has been tested in one phase I/II and three phase II clinical trials in colorectal cancer patients. All trials demonstrated that MVA-5T4 was well tolerated when administered alone (1 trial), as adjuvant/neoadjuvant to surgery (1 trial), or in combination with chemotherapy (FOLFOX or FOLFIRI; 2 trials). We have now collated data from all four trials, determined the incidence of immune responses across trials, and looked for associations with improved survival. Methods: Patients with histologically proven CRC were recruited to 4 independent trials in which 3 to 6 vaccinations of MVA-5T4 were scheduled to be administered either as a monotherapy, as adjuvant/neoadjuvant to surgery for respectable liver metastases or alongside treatment with FOLFIRI or FOLFOX. Antibody responses specific for 5T4 and MVA were monitored by ELISA. Survival data were collated from each hospital site. Immunological and survival data were analyzed using proportional hazards regression adjusting for age and gender. Results: Survival and immunological response data were available for 73 patients (median age 63), who received a median of 5 MVA-5T4 vaccinations (range 1–6). Of 69 patients tested for antibody responses post-vaccination (4 patients had no post-vaccination blood sample available), 54 (78%) and 65 (94%) showed positive responses for 5T4 and MVA respectively. Exploratory analyses demonstrated significant associations between immune responses and overall survival across trials. Indeed, a Cox proportional hazards model showed that a doubling in the geometric mean 5T4 antibody titre (injections 1 to 3) was associated with a 19.9% reduction in relative risk, adjusted for age and gender (p&lt;1%). Conclusions: MVA-5T4 induced 5T4-specific immune responses in the majority of patients. Although the studies described here were uncontrolled, there were encouraging signs of activity which associated with the presence of 5T4-specific immune responses. [Table: see text]
A randomized study of bronchoscopic blockade of the affected part of a lung as a part the complex treatment of patients with drug-resistant pulmonary tuberculosis
Authors: Sergey Sklyuev, Denis Krasnov
Journal: European Respiratory Journal (2012)

At the present time in Russia, there are 60% of TB patients with unsatisfactory results of treatment by standard chemotherapy regimens with anti-TB drugs, and therefore there is permanent search for new treatment approaches to these patients.  Scope and purpose: To assess and to analyze the impact of endobronchial-valve therapy on pulmonary function. According to the existing hypothesis, the implantation of an endobronchial valve and exclusion of the affected part from the tidal volume of the lung do not decrease pulmonary function indices.  Methods: We have compared the efficacy of endobronchial-valve therapy with a standard therapy. Changes in rates of FEV1 were the reference points for the study. Of 68 enrolled patients, 33 were randomly assigned to receive endobronchial valves (EBV group) and 35 to receive standard medical care (control group).  Results: Before procedures the initial level of FEV1 in the EBV group was 84.18%. In control group it was 85.74% (p = 0.749). After 1 month, there was a slight decline in FEV1 up to 81.12% in the EBV group, in comparison to the control group with maintaining the level of FEV1 equal to 84.34%. Thus, the difference of mean values between the groups was 3.22% (p = 0.187). After 8 months of treatment (after removal of endobronchial valves), FEV1 in the group of EBV was restored to 83.82% compared to 83.31% of the control group (p = 0.606).  Conclusions: Endobronchial-valve treatment does not reduce pumonary function during the complex treatment of patients with drug-resistant pulmonary tuberculosis.
Gastroenteropancreatic Neuroendocrine Tumors (Gepnet) Registry: Update from an International Collaboration
Authors: S. Yalcin, S. Glasberg, H. Abali, F. Aykan, L. Bai, J. Kattan, H.Y. Lim, Y.S. Park, H. Raef, J. Ramos, K. Rau, S. Saglam, S. Serdengecti, A. Sevinc, Y. Shan, Y. Shyr, V. Sriuranpong, S.N. Turhal, K. Yeh, T. Hwang
Journal: Annals of Oncology (2014)
Neurotrophin TrkB receptor mediates the epithelial to mesenchymal transition in lung adenocarcinoma cells
Authors: Alberto Ricci, Luca Tabbì, Davide Scozzi, Rita Mancini, Claudia De Vitis, Pierdonato Bruno, Salvatore Mariotta
Journal: European Respiratory Journal (2013)

Lung cancer represents the leading cause of cancer-related mortality worldwide. Recent evidence indicates that tumors contain a small population of cancer stem cells that are responsible for tumor maintenance and spreading, the cancer stem cells (CSCs). Neurotrophins (NTs) are growth factor molecules that regulate the biology of embryonic stem cells and cancer cells, but still little is known about NTs and the onset of lung cancer . W e investigate the role of the NTs and their receptors using as study system primary cell cultures, derived from malignant pleural effusions of patients with adenocarcinoma of the lung. We assessed the expression of NT and NT receptor expression in differentiated cells and spheroids enriched in cancer stem cell (CSC) markers. We also evaluated the inhibitory properties of K252a, a selective inhibitor of the tyrosine protein kinase activity of the Trk family. We observed that in spheroid cultures there are an higher expression of TrkB, both at the mRNA and protein level. This effect was confirmed by measuring the serial propagation of spheroids in quantitative spheroid forming assays. Interestingly, treatment with NTs ligands reverted the inhibitory effect of k252a in maintenance and formation of spheroids. Furthermore, loss of E-cadherin increase, after siRNA TrkB transfected spheroid cells indicates that the TrkB receptor may have a role in the epithelial to mesenchymal transition suggesting that TrkB may address cancer cell biology, phenotype and metastasis.
Evaluation of CEA in Patients with known Residual Disease after Resection of Colonic Cancer
Authors: J O Lawton, G R Giles, E H Cooper
Journal: Journal of the Royal Society of Medicine (1980)

Serial carcinoembryonic antigen (CEA) levels were measured in 43 patients following incomplete excision of colorectal cancer. Twenty-seven patients received chemotherapy. In the majority the subsequent elevation of CEA could be related to clinical progression, but some patients receiving chemotherapy may have a suppressed rate of CEA rise and may have a more prolonged survival.The clinical application of serial CEA estimations remains of dubious value. However, one area which may be worthy of study is to determine whether suppression of the CEA slope by chemotherapy is attended by clinical control and an improved survival.