tbuckley/cabot-search huggingface dataset:
Variability of Brain Death Policies in the United States
Authors: David M. Greer, Hilary H. Wang, Jennifer D. Robinson, Panayiotis N. Varelas, Galen V. Henderson, Eelco F. M. Wijdicks
Journal: JAMA Neurology (2015)

Brain death is the irreversible cessation of function of the entire brain, and it is a medically and legally accepted mechanism of death in the United States and worldwide. Significant variability may exist in individual institutional policies regarding the determination of brain death. It is imperative that brain death be diagnosed accurately in every patient. The American Academy of Neurology (AAN) issued new guidelines in 2010 on the determination of brain death.To evaluate if institutions have adopted the new AAN guidelines on the determination of brain death, leading to policy changes.Fifty-two organ procurement organizations provided US hospital policies pertaining to the criteria for determining brain death. Organizations were instructed to procure protocols specific to brain death (ie, not cardiac death or organ donation procedures). Data analysis was conducted from June 26, 2012, to July 1, 2015.Policies were evaluated for summary statistics across the following 5 categories of data: who is qualified to perform the determination of brain death, what are the necessary prerequisites for testing, details of the clinical examination, details of apnea testing, and details of ancillary testing. We compared these data with the standards in the 2010 AAN update on practice parameters for brain death.A total of 508 unique hospital policies were obtained, representing the majority of hospitals in the United States that would be eligible and equipped to evaluate brain death in a patient. Of these, 492 provided adequate data for analysis. Although improvement with AAN practice parameters was readily apparent, there remained significant variability across all 5 categories of data, such as excluding the absence of hypotension (276 of 491 policies [56.2%]) and hypothermia (181 of 228 policies [79.4%]), specifying all aspects of the clinical examination and apnea testing, and specifying appropriate ancillary tests and how they were to be performed. Of the 492 policies, 163 (33.1%) required specific expertise in neurology or neurosurgery for the health care professional who determines brain death, and 212 (43.1%) stipulated that an attending physician determine brain death; 150 policies did not mention who could perform such determination.Hospital policies in the United States for the determination of brain death are still widely variable and not fully congruent with contemporary practice parameters. Hospitals should be encouraged to implement the 2010 AAN guidelines to ensure 100% accurate and appropriate determination of brain death.
PCSK6-mediated corin activation is essential for normal blood pressure
Authors: Shenghan Chen, Pengxiu Cao, Ningzheng Dong, Jianhao Peng, Chunyi Zhang, Hao Wang, Tiantian Zhou, Junhua Yang, Yue Zhang, Elizabeth E Martelli, Sathyamangla V Naga Prasad, Rachel E Miller, Anne-Marie Malfait, Yiqing Zhou, Qingyu Wu
Journal: Nature Medicine (2015)
Suicide-related discussions with depressed primary care patients in the USA: gender and quality gaps. A mixed methods analysis
Authors: Steven D Vannoy, Lynne S Robins
Journal: BMJ (2011)

Objective: To characterise suicide-risk discussions in depressed primary-care patients. Design: Secondary analysis of recordings and self reports by physicians and patients. Descriptive statistics of depression and suicide-related discussion, with qualitative extraction of disclosure, enquiry and physician response. Setting: 12 primary-care clinics between July 2003 and March 2005.
Sensitive and specific monoclonal antibody recognition of human lung cancer antigen on preserved sputum cells: a new approach to early lung cancer detection.
Authors: M S Tockman, P K Gupta, J D Myers, J K Frost, S B Baylin, E B Gold, A M Chase, P H Wilkinson, J L Mulshine
Journal: Journal of Clinical Oncology (1988)

Murine monoclonal antibodies (Mabs) to a glycolipid antigen of small-cell (SCC) and a protein antigen of non-small-cell lung cancer (NSCC) were applied to preserved sputum specimens from individuals who participated in The Johns Hopkins Lung Project (JHLP). In that study, undertaken in 1973 to evaluate the efficacy of sputum cytology screening, half of the high-risk participants (5,226 men, greater than or equal to 45 years of age, currently smoking greater than or equal to 1 pack of cigarettes per day) were randomly assigned to produce specimens for cytopathological analysis. During regular screenings over the next 5 to 8 years, 626 (12%) showed moderate (or greater) atypia. Sixty-nine of these (26 who progressed to cancer, 43 who did not) were randomly selected for a blinded improved Mab immunostaining protocol in the present study. Satisfactory specimens with morphologic atypia immunostained positively in 14 of the 22 patients who eventually progressed to cancer (sensitivity 64%), and were nonreactive in 35 of the 40 patients who did not progress to lung cancer (specificity 88%). Review of the true positive specimens (14/22 atypias) showed that they were collected 24 months in advance of diagnosis. In contrast, the 8/22 false negative atypias (failure to stain) showed that they were collected for an average of 57 months preceding the diagnosis of cancer. Subsequent specimens (average, 26 months before cancer) from participants who were originally considered "false negative" did stain positively improving sensitivity to 91% among specimens collected for an average of 2 years in advance of the clinical appearance of lung cancer. Specificity remained at 88%. Recognition of neoplastic antigen expression 2 years in advance of clinical cancer may be a valuable intermediate end point in studies of lung cancer prevention, detection, and therapy.
NICE recommendations: why no disinvestment recommendations to offset investment decisions?
Authors: D. A. Hughes, E. M. Wood, L. Tuersley
Journal: BMJ (2015)

Growing demand, alongside ever increasing costs, means that funding arrangements for new treatments are a major concern. The NHS in England and Wales is legally obliged to fund and resource interventions recommended by National Institute for Health and Care Excellence (NICE) technology appraisals, but NICE has no budgetary responsibilities over its recommendations.1

Other activities have to be displaced to fund new interventions. NICE …
2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative
Authors: Tuhina Neogi, Tim L Th A Jansen, Nicola Dalbeth, Jaap Fransen, H Ralph Schumacher, Dianne Berendsen, Melanie Brown, Hyon Choi, N Lawrence Edwards, Hein J E M Janssens, Frédéric Lioté, Raymond P Naden, George Nuki, Alexis Ogdie, Fernando Perez-Ruiz, Kenneth Saag, Jasvinder A Singh, John S Sundy, Anne-Kathrin Tausche, Janitzia Vaquez-Mellado, Steven A Yarows, William J Taylor
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objective</h3> Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. <h3>Methods</h3> An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multi-criterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. <h3>Results</h3> The entry criterion for the new classification criteria requires the occurrence of at least one episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (ie, synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy CT, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). <h3>Conclusions</h3> The new classification criteria, developed using a data-driven and decision-analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout.
Smoking and interstitial lung diseases
Authors: Elzbieta Puscinska, Anna Goljan-Geremek, Elzbieta Radzikowska, Anna Soszka, Dorota Wyrostkiewicz, Michal Bednarek, Dorota Gorecka
Journal: European Respiratory Journal (2013)

Aim :The relationship of smoking with some interstitial lung diseases (ILDs) has been published.The aim of the study was to evaluate smoking habits among our ILDs patients(pts). Methods :Consecutive pts admitted to the hospital were divided into two groups; sarcoid-group1, other ILDs-group2. Results :236 pts were studied.Group1-177pts(98M /79F) vs 59pts(27M/32F) - group2.The average age was 49±12.1y.In group1,103pts(58%) were ever smokers(ES), 26(14%) current smokers(CS), in group2, 37pts(63%)were ES, 4(7%) CS.The average age of smoking initiation was 18.7±3,4y in group1 and 18.5±4.2y in group2,p=ns.In group1 women started smoking later than men (19.8±3.4y vs 17.9±3.1),p>0.05.In group2 the mean number of cigarettes per day was 13.4±8.1 for women vs 19.5±8.2 for men,p>0.05.The average age of sarcoid smokers was significantly lower vs to non-smokers; 46.11± 12.02y vs 52±11.06y,p>0.05.The average age of CS was significantly lower than ex-smokers(XS) 41±13.3y vs 49±11.3y,p>0.05.Among CS, smoking exposure was longer vs XS 20.3±8.9y vs 13.4±8.6y,p>0.05.In group1 150 pts(89 smokers(S)/61 never smokers(NS) were exposed to secondhand smoke(shs) at home, 108(68 S /40 NS) at work vs 45(29 S/16 NS) were exposed to shs at home, 36(22 S/14 NS) at work from group2.Smokers (90) exposed to shs at work vs smokers (50) not exposed, smoked longer 19.3 vs 13.7 y,p>0.05 and smoked in average more cigarettes per day 14.7 vs 12.1,p>0.05.Sarcoid smokers (68) exposed to shs at work, smoked more cigarettes per day vs those who were not exposed (35), 14.1 vs 11.0,p>0.05. Conclusions :The prevalence of smoking was high among pts with ILDs.Exposure to shs must be taken into account regardless of whether a patient is a smoker himself.SHS may affect smoking habits.
Adjuvant or Palliative Chemotherapy for Colorectal Cancer in Patients 70 Years or Older
Authors: R. A. Popescu, A. Norman, P. J. Ross, B. Parikh, D. Cunningham
Journal: Journal of Clinical Oncology (1999)

PURPOSE: The surgical treatment of colorectal cancer (CRC) in elderly patients (age 70 years or older) has improved, but data on adjuvant and palliative chemotherapy tolerability and benefits in this growing population remain scarce. Elderly patients are underrepresented in clinical trials, and results for older patients are seldom reported separately. PATIENTS AND METHODS: Using a prospective database, we analyzed demographics, chemotherapy toxicity, response rates, failure-free survival (FFS), and overall survival (OS) of CRC patients receiving chemotherapy at the Royal Marsden Hospital. The cutoff age was 70 years. RESULTS: A total of 844 patients received first-line chemotherapy with various fluorouracil (5-FU)-containing regimens or raltitrexed for advanced disease, and 543 patients were administered adjuvant, protracted venous infusion 5-FU or bolus 5-FU/folinic acid (FA) chemotherapy. Of the 1,387 patients, 310 were 70 years or older. There was no difference in overall or severe (Common Toxicity Criteria III to IV) toxicity between the two age groups, with the exception of more frequent severe mucositis in older patients receiving adjuvant bolus 5-FU/FA. For patients receiving palliative chemotherapy, no difference in response rates (24% v 29%, P = .19) and median FFS (164 v 168 days) were detected when the elderly were compared with younger patients. Median OS was 292 days for the elderly group and 350 days for the younger patients (P = .04), and 1-year survival was 44% and 48%, respectively. The length of inpatient hospital stay was identical. CONCLUSION: Elderly patients with good performance status tolerated adjuvant and palliative chemotherapy for CRC as well as did younger patients and had similar benefits from palliative chemotherapy.
Tumor mica status predicts the efficacy of immunotherapy with cytokine-induced killer cells for patients with gastric cancer
Authors: Yu Chen, Zhi-feng Zhou, Wei-feng Zhu, Gang Chen, Yi Shi, Wan-song Lin, Zeng-qing Guo, Yun-bin Ye
Journal: Journal for ImmunoTherapy of Cancer (2015)

Meeting abstracts Accumulating evidence has demonstrated that cytokine-induced killer (CIK) cell immunotherapy may improve outcomes when used as an adjuvant to current standard treatment. Previous studies showed that cell signaling through MHC I-related Chain A (MICA)-Natural killer group 2, member
Do ITPA gene variants provide insight to detecting patients infected with HCV 2/1 recombinant strains?
Authors: Enrico Galmozzi, Roberta D'Ambrosio
Journal: Hepatology (2015)

*[Correction added March 21, 2016, after original publication: second author Roberta D'Ambrosio, M.D., erroneously left off of the original byline, was added.] Potential conflict of interest: Nothing to report. To the Editor: I read with interest the article by Hedskog et al.1 reporting on the characterization of 12 novel genotype 2/1 hybrids of hepatitis C virus (HCV) and their response to sofosbuvir plus ribavirin (SOF/RBV) treatment. In this study, INNO‐LiPA results and nonstructural (NS)5B sequencing showed a genotype discordance in 0.5% of all cases (12 out of 2363), where all genotypes were classified as genotype 2 by INNO‐LiPA assay and genotype 1 by NS5B sequencing. Sustained viral response was achieved only in three out of 11 patients (27%) infected with 2/1 recombinant strains and treated with SOF/RBV. This led the authors to conclude that SOF/RBV treatment with a regimen for genotype 2 was suboptimal in patients with intergenotypic 2/1 recombinant viruses. However, any drug regimen showing different efficacy between genotype 2 and other genotypes may present this problem. Therefore, it is likely that failure to prior pegylated interferon (pegIFN)/RBV therapy in HCV genotype 2 patients may represent an additional risk factor in the presence of recombinant strains. In fact, 58% of patients with 2/1 hybrid genotypes in the Hedskog study1 were treatment experienced (TE) in addition to being intravenous drug users (IVDUs). To support these observations, I performed NS5B sequencing in 67 HCV patients with genotype 2 by INNO‐LiPA assay, including 20 TE patients, also characterized for inosine triphosphatase (ITPA) and IL28B polymorphisms, and 47 treatment naïve (TN) patients. No genotype discordance was found in the TN group that included two IVDUs, whereas 10% genotype discordance (two out of 20, one of which was an IVDU) was observed in the TE cases, all classified as genotype 1b by NS5B sequencing. Of note, the INNO‐LiPA/NS5B genotype discordances belong to the only two patients from the prior relapsed subgroup (n = 14), carriers of ITPA rs1127354, a variant entailing a moderate ITPase deficiency.2 Interestingly, a recent study3 has shown that reduced ITPase activity was associated with a lower risk of relapse in HCV patients with genotypes 2 and 3. In summary, I suggest that among the HCV genotype 2 TE patients eligible to SOF/RBV treatment, those relapsed to prior pegIFN/RBV therapy carrying the ITPA rs1127354 variant represent a small group of subjects that should be considered for NS5B sequencing following the INNO‐LiPA assay. Moreover, because RBV will remain a component of direct‐acting antiviral regimens, with the associated risk of anemia, the role of ITPA variants deserves investigation as well.
Diagnostic stability in adolescents followed up 2 years after hospitalization
Authors: J J Mattanah, D F Becker, K N Levy, W S Edell, T H McGlashan
Journal: American Journal of Psychiatry (1995)

The authors examined the stability of DSM-III-R disorders and groups of disorders in adolescent inpatients followed up 2 years after hospitalization.Seventy hospitalized adolescents were reliably assessed by using structured diagnostic interviews for DSM-III-R disorders. Two years later the subjects were independently assessed with the same interviews. Diagnostic stability was measured by determining both the percentage of persisting cases and the kappa statistic.Internalizing disorders had the highest percentage of persisting cases (59%) but an insignificant kappa due to many new cases at follow-up. Externalizing disorders had a lower percentage of stable cases (39%) but a significant kappa because of fewer new cases. Substance use disorders were fairly stable (53%) and had a significant kappa, indicating that this may be the most stable group of disorders in adolescents. Personality disorder clusters were relatively unstable, especially clusters A and C.Diagnostic stability in these hospitalized adolescents was less than that reported for adults. This may indicate that DSM-III-R diagnoses in adolescents have poor construct validity, but it may also reflect the different paths for development of psychopathology during adolescence. For axis I, externalizing disorders appear most specific to adolescence, with some persistence but decreasing incidence over time. Existing cases of internalizing disorders tend to be even more persistent, but the high incidence of new cases during adolescence contributes to lower overall stability. Substance use disorders appear to be most stable, and personality disorders appear to be least stable, in adolescents.
Injectable insulin-lysozyme-loaded nanogels with enzymatically-controlled degradation and release for basal insulin treatment: In vitro characterization and in vivo observation
Authors: Hao-Syun Chou, Mikael Larsson, Meng-Hsuan Hsiao, Yi-Chieh Chen, Magnus Röding, Magnus Nydén, Dean-Mo Liu
Journal: Journal of Controlled Release (2015)
Ion Channel Macromolecular Complexes in Cardiomyocytes: Roles in Sudden Cardiac Death
Authors: Hugues Abriel, Jean-Sébastien Rougier, José Jalife
Journal: Circulation Research (2015)

The movement of ions across specific channels embedded on the membrane of individual cardiomyocytes is crucial for the generation and propagation of the cardiac electric impulse. Emerging evidence over the past 20 years strongly suggests that the normal electric function of the heart is the result of dynamic interactions of membrane ion channels working in an orchestrated fashion as part of complex molecular networks. Such networks work together with exquisite temporal precision to generate each action potential and contraction. Macromolecular complexes play crucial roles in transcription, translation, oligomerization, trafficking, membrane retention, glycosylation, post-translational modification, turnover, function, and degradation of all cardiac ion channels known to date. In addition, the accurate timing of each cardiac beat and contraction demands, a comparable precision on the assembly and organizations of sodium, calcium, and potassium channel complexes within specific subcellular microdomains, where physical proximity allows for prompt and efficient interaction. This review article, part of the Compendium on Sudden Cardiac Death, discusses the major issues related to the role of ion channel macromolecular assemblies in normal cardiac electric function and the mechanisms of arrhythmias leading to sudden cardiac death. It provides an idea of how these issues are being addressed in the laboratory and in the clinic, which important questions remain unanswered, and what future research will be needed to improve knowledge and advance therapy.
ECF in Gastric Cancer
Authors: Paul J. Ross, Mark E. Hill, Andrew Norman, David Cunningham
Journal: Journal of Clinical Oncology (2000)

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2000.18.22.3874 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11078502 ECF in Gastric Cancer Paul J. RossxPaul J. RossSearch for articles by this author , Mark E. HillxMark E. HillSearch for articles by this author , Andrew NormanxAndrew NormanSearch for articles by this author , David CunninghamxDavid CunninghamSearch for articles by this author Show More Royal Marsden Hospital London and Sutton, United Kingdom https://doi.org/10.1200/JCO.2000.18.22.3874 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical Oncology
Cell surface glycoengineering improves selectin-mediated adhesion of mesenchymal stem cells (MSCs) and cardiosphere-derived cells (CDCs): Pilot validation in porcine ischemia-reperfusion model
Authors: Chi Y. Lo, Brian R. Weil, Beth A. Palka, Arezoo Momeni, John M. Canty, Sriram Neelamegham
Journal: Biomaterials (2015)
Principles of optimization of anti-inflammatory therapy in COPD patients (pts) due to C-reactive protein (CRP) level
Authors: Bogdana Basina, Tetyana Pertseva, Lyudmyla Konopkina
Journal: European Respiratory Journal (2013)

Aim . To optimized treatment therapy in COPD pts (in accordance with anti-inflammatory effects of inhalation corticosteroids (ICS) and bronchodilators) it’s very important to establish the phenotypes of COPD due to the severity of systemic inflammation (SI), and so to determine those markers, which may be demonstrative.   Materials and methods . We studied 25 pts in stable phase (age – 63.3±4.1 yrs), divided into the groups according to the stage of COPD. All pts received an adequate therapy (due to GOLD). Measurements included clinical status, spirometry, CRP-level in plasma.   Results.  CRP-level in pts with COPD II was similar to the control, but in pts with COPD III and IV it was significantly higher.  In those time regardless of FEV 1 -level there were selected two subgroups of COPD pts due to CRP-level: 1 st  subgroup– with normal level of CRP ( nd  – with more higher one (>7.0 mg/l).   Conclusion : CRP-level may be used to optimize anti-inflammatory therapy (including ICS) in COPD pts; also it may be a marker of early using of ICS by COPD pts. II stage, who have high CRP-level.