tbuckley/cabot-search huggingface dataset:
Financial Loss for Inpatient Care of Medicaid-Insured Children
Authors: Jeffrey D. Colvin, Matt Hall, Jay G. Berry, Laura M. Gottlieb, Jessica L. Bettenhausen, Samir S. Shah, Evan S. Fieldston, Patrick H. Conway, Paul J. Chung
Journal: JAMA Pediatrics (2016)

<h3>Importance</h3> Medicaid payments tend to be less than the cost of care. Federal Disproportionate Share Hospital (DSH) payments help hospitals recover such uncompensated costs of Medicaid-insured and uninsured patients. The Patient Protection and Affordable Care Act reduces DSH payments in anticipation of fewer uninsured patients and therefore decreased uncompensated care. However, unlike adults, few hospitalized children are uninsured, while many have Medicaid coverage. Therefore, DSH payment reductions may expose extensive Medicaid financial losses for hospitals serving large absolute numbers of children. <h3>Objectives</h3> To identify types of hospitals with the highest Medicaid losses from pediatric inpatient care and to estimate the proportion of losses recovered through DSH payments. <h3>Design, Setting, and Participants</h3> This retrospective cross-sectional analysis evaluated Medicaid-insured hospital discharges of patients 20 years and younger from 23 states in the 2009 Kids' Inpatient Database. The dates of the analysis were March to September 2015. Hospitals were categorized as freestanding children's hospitals (FSCHs), children's hospitals within general hospitals, non–children's hospital teaching hospitals, and non–children's hospital nonteaching hospitals. Financial records of FSCHs in the data set were used to estimate the proportion of Medicaid losses recovered through DSH payments. <h3>Main Outcomes and Measures</h3> Hospital financial losses from inpatient care of Medicaid-insured children (defined as the reimbursement minus the cost of care) were compared across hospital types. For our subsample of FSCHs, Medicaid-insured inpatient financial losses were calculated with and without each hospital's DSH payment. <h3>Results</h3> The 2009 Kids' Inpatient Database study population included 1485 hospitals and 843 725 Medicaid-insured discharges. Freestanding children's hospitals had a higher median number of Medicaid-insured discharges (4082; interquartile range [IQR], 3524-5213) vs non–children's hospital teaching hospitals (674; IQR, 258-1414) and non–children's hospital nonteaching hospitals (161; IQR, 41-420). Freestanding children's hospitals had the largest median Medicaid losses from pediatric inpatient care (−$9 722 367; IQR, −$16 248 369 to −$2 137 902). Smaller losses were experienced by non–children's hospital teaching hospitals (−$204 100; IQR, −$1 014 100 to $14 700]) and non–children's hospital nonteaching hospitals (−$28 310; IQR, −$152 370 to $9040]). Disproportionate Share Hospital payments to FSCHs reduced their Medicaid losses by almost half. <h3>Conclusions and Relevance</h3> Estimated financial losses from pediatric inpatients covered by Medicaid were much larger for FSCHs than for other hospital types. For children's hospitals, small anticipated increases in insured children are unlikely to offset the reductions in DSH payments.
Does Ex Vivo CD34+ Cell Selection Change the Outcome of Systemic Sclerosis Patients Treated with Autologous Hematopoietic Stem Cell Transplantation (AHSCT), an Adwp EBMT Study?
Authors: Maria Carolina Oliveira, Myriam Labopin, Jörg Henes, John Moore, Nicoletta Del Papa, Ricca Stanciu, Ioanna Sakellari, Roland Schroers, Hans Ulrich Scherer, Slawomira Kyrcz-Krzemien, Thomas Daikeler, Tobias Alexander, Jürgen Finke, Manuela Badoglio, John A Snowden, Dominique Farge
Journal: Blood (2014)
Hyperpolarized <sup>13</sup> C Metabolic MRI of the Human Heart
Authors: Charles H. Cunningham, Justin Y.C. Lau, Albert P. Chen, Benjamin J. Geraghty, William J. Perks, Idan Roifman, Graham A. Wright, Kim A. Connelly
Journal: Circulation Research (2016)

Rationale: Altered cardiac energetics is known to play an important role in the progression toward heart failure. A noninvasive method for imaging metabolic markers that could be used in longitudinal studies would be useful for understanding therapeutic approaches that target metabolism. Objective: To demonstrate the first hyperpolarized 13 C metabolic magnetic resonance imaging of the human heart. Methods and Results: Four healthy subjects underwent conventional proton cardiac magnetic resonance imaging followed by 13 C imaging and spectroscopic acquisition immediately after intravenous administration of a 0.1 mmol/kg dose of hyperpolarized [1- 13 C]pyruvate. All subjects tolerated the procedure well with no adverse effects reported ≤1 month post procedure. The [1- 13 C]pyruvate signal appeared within the chambers but not within the muscle. Imaging of the downstream metabolites showed 13 C-bicarbonate signal mainly confined to the left ventricular myocardium, whereas the [1- 13 C]lactate signal appeared both within the chambers and in the myocardium. The mean 13 C image signal:noise ratio was 115 for [1- 13 C]pyruvate, 56 for 13 C-bicarbonate, and 53 for [1- 13 C]lactate. Conclusions: These results represent the first 13 C images of the human heart. The appearance of 13 C-bicarbonate signal after administration of hyperpolarized [1- 13 C]pyruvate was readily detected in this healthy cohort (n=4). This shows that assessment of pyruvate metabolism in vivo in humans is feasible using current technology. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02648009.
Transitioning to Country Ownership of HIV Programs in Rwanda
Authors: Agnes Binagwaho, Ida Kankindi, Eugenie Kayirangwa, Jean Pierre Nyemazi, Sabin Nsanzimana, Fernando Morales, Rose Kadende-Kaiser, Kirstin Woody Scott, Veronicah Mugisha, Ruben Sahabo, Cyprien Baribwira, Leia Isanhart, Anita Asiimwe, Wafaa M. El-Sadr, Pratima L. Raghunathan
Journal: PLoS Medicine (2016)

In 2009, after 5 years of expanding HIV services to achieve universal access to antiretroviral treatment, Rwanda and PEPFAR embarked on a sustainability and country ownership phase
The impact of infarct location and extent on left ventricular motion patterns: Implications for dyssynchrony assessment
Authors: Brecht Steelant, Ivan Stankovic, Ine Roijakkers, Marit Aarones, Jan Bogaert, Walter Desmet, Svend Aakhus, Jens-Uwe Voigt
Journal: JACC. Cardiovascular imaging (2016)
P0033 : Prospective evaluation of intraoperative porto-caval gradient after major hepatectomy
Authors: M.-A. Allard, O. Ciacio, G. Pittau, M. Gelli, R. Memeo, A. Sa-Cunha, D. Castaing, D. Cherqui, R. Adam, E. Vibert
Journal: Journal of Hepatology (2015)
Mandatory publication in India: setting quotas for research output could encourage scientific fraud
Authors: Roosy Aulakh
Journal: BMJ (2016)

It does nothing to incentivise high quality research and may weaken the evidence base

A report this year that highlighted the poor research output from most medical institutions in India has sparked debate in the Indian and global media.1 2 3 It showed that about 60% of the country’s 579 medical institutions have not published any research in a decade.1 This led the Medical Council of India (MCI), which is presently under close parliamentary scrutiny, to update its guidelines to require at least four research publications to attain a post of associate professor and eight for the post of …
Characterization of the Specificity, Functionality, and Durability of Host T‐Cell Responses Against the Full‐Length Hepatitis E Virus
Authors: Anthony Brown, John S. Halliday, Leo Swadling, Richie G. Madden, Richard Bendall, Jeremy G. Hunter, James Maggs, Peter Simmonds, Donald B. Smith, Louisa Vine, Cara McLaughlin, Jane Collier, David Bonsall, Katie Jeffery, Susanna Dunachie, Paul Klenerman, Jacques Izopet, Nassim Kamar, Harry R. Dalton, Eleanor Barnes
Journal: Hepatology (2016)

The interplay between host antiviral immunity and immunopathology during hepatitis E virus (HEV) infection determines important clinical outcomes. We characterized the specificity, functionality, and durability of host T‐cell responses against the full‐length HEV virus and assessed a novel “Quantiferon” assay for the rapid diagnosis of HEV infection. Eighty‐nine volunteers were recruited from Oxford, Truro (UK), and Toulouse (France), including 44 immune‐competent patients with acute HEV infection, 18 HEV‐exposed immunosuppressed organ‐transplant recipients (8 with chronic HEV), and 27 healthy volunteers. A genotype 3a peptide library (616 overlapping peptides spanning open reading frames [ORFs] 1‐3) was used in interferon‐gamma (IFN‐γ) T‐cell ELISpot assays. CD4 + /CD8 + T‐cell subsets and polyfunctionality were defined using ICCS and SPICE analysis. Quantification of IFN‐γ used whole‐blood stimulation with recombinant HEV‐capsid protein in the QuantiFERON kit. HEV‐specific T‐cell responses were detected in 41/44 immune‐competent HEV exposed volunteers (median magnitude: 397 spot‐forming units/10 6 peripheral blood mononuclear cells), most frequently targeting ORF2. High‐magnitude, polyfunctional CD4 and CD8 + T cells were detected during acute disease and maintained to 12 years, but these declined over time, with CD8 + responses becoming more monofunctional. Low‐level responses were detectable in immunosuppressed patients. Twenty‐three novel HEV CD4 + and CD8 + T‐cell targets were mapped predominantly to conserved genomic regions. QuantiFERON testing demonstrated an inverse correlation between IFN‐γ production and the time from clinical presentation, providing 100% specificity, and 71% sensitivity (area under the receiver operator characteristic curve of 0.86) for HEV exposure at 0.3 IU/mL. Conclusion: Robust HEV‐specific T‐cell responses generated during acute disease predominantly target ORF2, but decline in magnitude and polyfunctionality over time. Defining HEV T‐cell targets will be important for the investigation of HEV‐associated autoimmune disease. (H epatology 2016;64:1934‐1950).
Optimizing Adjuvant Chemotherapy and Surgery for Early- and Late-Stage Breast Cancer
Authors: Ines Vaz-Luis, Harold J. Burstein
Journal: JAMA Oncology (2016)

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 Oncology 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 Oncology journal
Survival Analyses of Patients With Metastatic Renal Cancer Treated With Targeted Therapy With or Without Cytoreductive Nephrectomy: A National Cancer Data Base Study
Authors: Nawar Hanna, Maxine Sun, Christian P. Meyer, Paul L. Nguyen, Sumanta K. Pal, Steven L. Chang, Guillermo de Velasco, Quoc-Dien Trinh, Toni K. Choueiri
Journal: Journal of Clinical Oncology (2016)

The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) has become unclear since the introduction of targeted therapies (TT). We sought to evaluate contemporary utilization rates of CN and to examine the survival benefit of CN compared with non-CN patients treated with TT.We used the National Cancer Data Base to identify patients with clinical mRCC treated with TT between 2006 and 2013. The intervention of interest was CN. Multivariable logistic regression predicting receipt of CN was performed. Overall survival (OS) was examined using Cox regression models and incremental survival analyses were performed. Sensitivity analyses using propensity scores were conducted.Of 15,390 patients treated with TT, 5,374 (35%) underwent CN between 2006 and 2013. Patients who were younger, privately insured, treated at an academic center, and had lower tumor stage and cN0 disease were more likely to undergo CN. The median OS of CN versus non-CN patients was 17.1 (95% CI, 16.3 to 18.0 months) versus 7.7 months (95% CI, 7.4 to 7.9 months; P < .001). In sensitivity analyses using propensity scores adjustment in addition to other available covariates, CN patients had a lower risk of any death (hazard ratio, 0.45; 95% CI, 0.40 to 0.50; P < .001). The survival benefit of CN was +0.7 and +3.6 months in patients who survived ≤ 6 and ≤ 24 months, respectively, versus no CN.CN is performed in three of 10 patients with mRCC who are receiving TT. Several patient and sociodemographic characteristics were associated with receipt of CN. When feasible, CN may offer an OS benefit when combined with TT.
The impact of a history of asthma on long-term outcomes of people with newly diagnosed chronic obstructive pulmonary disease: A population study
Authors: Tetyana Kendzerska, Teresa M. To, Shawn D. Aaron, M. Diane Lougheed, Mohsen Sadatsafavi, J. Mark FitzGerald, Andrea S. Gershon
Journal: Journal of Allergy and Clinical Immunology (2016)
P3-065: A lead-in safety study of erlotinib combined with sutinib for the treatment of metastatic non-small cell lung cancer (NSCLC)
Authors: George Blumenschein, F Robert, O Melnyk, Kristin C. Sutherland, Lesley Tye, Erjian Wang, Richard Chao, Frank V. Fossella
Journal: Journal of Thoracic Oncology (2007)
Diffuse large B-cell lymphoma with renal involvement: Outcome and risk of central nervous system relapse
Authors: D. Villa, J. M. Connors, L. H. Sehn, K. J. Savage
Journal: Journal of Clinical Oncology (2008)

8580 Background: Renal involvement is uncommon in diffuse large B-cell lymphoma. In a recent study, our group found that renal involvement was an independent risk factor for central nervous system (CNS) relapse (Villa, ASCO 2007). We reviewed the clinical features, risk of CNS involvement, and survival for an expanded cohort of patients. Methods: All patients with DLBCL and renal extranodal involvement diagnosed from January 1, 1982 to August 1, 2007 at the British Columbia Cancer Agency were retrospectively identified in the Lymphoid Cancer Database. Patients were included if they were >16 years old, had advanced stage (stage III /IV, or stage I /II with B symptoms or bulky (>10cm)) disease, were treated with curative intent and were free of CNS involvement at diagnosis. CNS relapse was diagnosed by CSF cytology, radiology or clinically. Results: There were 46(2%) patients with DLBCL with renal involvement at diagnosis and the following characteristics n(%): M:F 2.3:1; median age 59 y; 19(41) had bilateral renal involvement; 42(91) had stage IV disease; 43(94) IPI 3,4 or 5; 7(15) had GFR <30mL/min; 39(85) had high LDH. Nine(20) patients received CHOP plus rituximab (CHOPR), 27(59) received CHOP-like regimens and only 8(17) received intrathecal prophylaxis. In total, 15 patients (33%) have had a CNS relapse (leptomeninges 9; brain parenchyma 5; both 1). The median time to CNS relapse was 5.6 mos. There was no significant difference in presenting clinical features between those who had a CNS relapse and those who did not. The addition of rituximab did not reduce the risk of CNS relapse (6/19 32% CHOPR vs 9/27 33% CHOP-like, p=.90) or time to CNS relapse (p=.49). The addition of intrathecal chemotherapy was not protective. The 5y overall and progression-free survivals for the whole cohort were 29% and 28%, respectively, suggesting that salvage therapies are ineffective. Patients receiving CHOPR chemotherapy had improved 5y progression free (43% vs 18%, p=.12) and overall (49% vs 19%, p=.04) survival. Conclusion: There is an exceptionally high incidence of CNS relapse in patients with DLBCL and kidney involvement at diagnosis. The addition of rituximab appears to improve overall survival in this poor risk population, likely through improved control of systemic disease. No significant financial relationships to disclose.
Rituximab in B-Lineage Adult Acute Lymphoblastic Leukemia
Authors: Sébastien Maury, Sylvie Chevret, Xavier Thomas, Dominik Heim, Thibaut Leguay, Françoise Huguet, Patrice Chevallier, Mathilde Hunault, Nicolas Boissel, Martine Escoffre-Barbe, Urs Hess, Norbert Vey, Jean-Michel Pignon, Thorsten Braun, Jean-Pierre Marolleau, Jean-Yves Cahn, Yves Chalandon, Véronique Lhéritier, Kheira Beldjord, Marie C Béné, Norbert Ifrah, Hervé Dombret
Journal: New England Journal of Medicine (2016)

Treatment with rituximab has improved the outcome for patients with non-Hodgkin's lymphoma. Patients with B-lineage acute lymphoblastic leukemia (ALL) may also have the CD20 antigen, which is targeted by rituximab. Although single-group studies suggest that adding rituximab to chemotherapy could improve the outcome in such patients, this hypothesis has not been tested in a randomized trial.We randomly assigned adults (18 to 59 years of age) with CD20-positive, Philadelphia chromosome (Ph)-negative ALL to receive chemotherapy with or without rituximab, with event-free survival as the primary end point. Rituximab was given during all treatment phases, for a total of 16 to 18 infusions.From May 2006 through April 2014, a total of 209 patients were enrolled: 105 in the rituximab group and 104 in the control group. After a median follow-up of 30 months, event-free survival was longer in the rituximab group than in the control group (hazard ratio, 0.66; 95% confidence interval [CI], 0.45 to 0.98; P=0.04); the estimated 2-year event-free survival rates were 65% (95% CI, 56 to 75) and 52% (95% CI, 43 to 63), respectively. Treatment with rituximab remained associated with longer event-free survival in a multivariate analysis. The overall incidence rate of severe adverse events did not differ significantly between the two groups, but fewer allergic reactions to asparaginase were observed in the rituximab group.Adding rituximab to the ALL chemotherapy protocol improved the outcome for younger adults with CD20-positive, Ph-negative ALL. (Funded by the Regional Clinical Research Office, Paris, and others; ClinicalTrials.gov number, NCT00327678 .).
Longer-Term Therapy for Symptoms Attributed to Lyme Disease
Authors: Stefan Erb, Hanni Bartels, Manuel Battegay
Journal: New England Journal of Medicine (2016)

To the Editor: In the placebo-controlled trial by Berende et al. (March 31 issue) 1 involving patients with persistent symptoms attributed to Lyme disease, all the patients received an initial 2-week course of intravenous ceftriaxone.Among the patients who subsequently received placebo, was the 12.6% reduction from baseline in the fatigue score the result of the initial 2-week course of ceftriaxone?The results from other studies that have involved patients with post-treatment symptoms of Lyme disease may help answer this question.In two separate studies, the effect of an intravenous placebo on fatigue was assessed over a 6-month period with the use of an 11-item fatigue-severity scale.In one study, a 9.1% reduction from baseline in the fatigue score was observed in the placebo group, 2 and in the second study, a 14.5% reduction from baseline was observed in the placebo group. 3Thus, the fact that the magnitude of reduction in fatigue score among the participants who were given placebo in other studies of post-treatment Lyme disease symptoms was similar to that observed in the trial by Berende et al. 1 suggests that the 2-week course of ceftriaxone in this trial probably provided no therapeutic benefit with respect to fatigue.
Recovery after Acute Kidney Injury
Authors: John A. Kellum, Florentina E. Sileanu, Azra Bihorac, Eric A. J. Hoste, Lakhmir S. Chawla
Journal: American Journal of Respiratory and Critical Care Medicine (2016)

Little is known about how acute kidney injury (AKI) resolves, and whether patterns of reversal of renal dysfunction differ among patients with respect to ultimate recovery.We sought to examine different patterns for AKI reversal that are found in patients and assess how they relate to postdischarge outcomes.We studied 16,968 critically ill patients with Kidney Disease Improving Global Outcomes stage 2 or 3 AKI, using an electronic database. Reversal of AKI was defined as alive and no longer meeting criteria for even stage 1. Recovery was defined as reversal at hospital discharge.We observed five patterns. The most common (4,508; 26.6%) was early reversal that was sustained through discharge, but almost as many patients (4,496; 26.5%) had no reversal at all. The remaining patients had late reversal after Day 7 (9.7%); early reversal with one or more relapses, but with ultimate recovery (22.5%); and relapsing without recovery (14.7%). Outcomes for patients with these phenotypes were quite different, with age-adjusted 1-year survival varying from more than 90% for early reversal to less than 40% for patients never reversing. Relapses are common (37.3%), especially in the first 72 hours after reversal, and are associated with a fivefold increased risk for death by 1 year compared with early sustained reversal.We have identified five distinct recovery phenotypes on the basis of the clinical course over the first week after AKI manifestation. These phenotypes may identify patients amenable to therapeutic intervention. Long-term outcomes are associated with recovery status at hospital discharge.
Porphyria and Vampirism—A Myth, Sensationalized
Authors: Eric Laurent Maranda, Robert Heifetz, William A. Estes, Jacqueline Cortizo, Shahjahan Shareef, Joaquin J. Jimenez
Journal: JAMA Dermatology (2016)

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 Dermatology 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 Dermatology journal