tbuckley/cabot-search huggingface dataset:
AB0099 Aberrant basal and TLR-stimulated expression of TSLP in rheumatoid synovial fibroblasts
Authors: N.W. Kam, M. Bombardieri, A. Filter, C. Buckley, C. Pitzalis
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Thymic stromal lymphopoietin (TSLP) is an interleukin-7-like cytokine, which strongly activated dendritic cells for Th2 polarization. Previous collagen-induced arthritis model demonstrated its role in exacerbating disease severity via T-cell dependent mechanism. <h3>Objectives</h3> Here we investigated TSLP and its receptor (TSLPR) expression in the synovium of rheumatoid arthritis (RA) patients and in rheumatoid synovial fibroblasts (RASF), osteoarthritis fibroblast (OASF, to dissect disease specificity) as well as paired RA dermal fibroblasts (RADF, to investigate site specificity) in basal conditions and upon stimulation with Toll-like receptors (TLR) ligands. <h3>Methods</h3> mRNA and protein (cytoplasmic and soluble) expression of TSLP in RASF, OASF and RADF, stimulated with or without TLR agonists: bLP (TLR2 ligand), PIC (TLR3 ligand) and LPS (TLR4 ligand), was assessed by Taqman PCR (QT-PCR), immunocytochemistry and ELISA. TSLP and TSLPR expression in 40 synovium of RA patients was investigated by QT-PCR and immunohistochemistry. <h3>Results</h3> RASF and, to a lesser extent OASF, constitutively displayed higher TSLP mRNA (∼8-16 fold) compared to RADF. In vitro stimulation of TLR3 and TLR4, but not TLR2 on RASF led to strong induction of TSLP mRNA expression (∼20-fold increase with TLR3), which peaked early at 8h. Cytoplasmic staining of TSLP was increased in TLR3-activated RASF but not RADF, while soluble TSLP was time-dependently released in the supernatant of TLR3-stimulated RASF (∼100pg/ml) and undetectable in RADF. TSLP mRNA was observed in all the RA samples examined while TSLPR was significantly increased in patients with follicular synovitis. <h3>Conclusions</h3> Overall, our data strongly support a pivotal role for RASF in the dysregulated production of pro-arthritogenic/inflammatory TSLP in the rheumatoid synovium, suggesting that the TSLP/TSLPR pathway contributes to chronic inflammation in RA. <h3>References</h3> Koyama K, Ozawa T, Hatsushika K, Ando T, Takano S, Wako M, et al. A possible role for TSLP in inflammatory arthritis. Biochem Biophys Res Commun2007 May 25;357(1):99-104. Ozawa T, Koyama K, Ando T, Ohnuma Y, Hatsushika K, Ohba T, et al. Thymic stromal lymphopoietin secretion of synovial fibroblasts is positively and negatively regulated by Toll-like receptors/nuclear factor-kappaB pathway and interferon-gamma/dexamethasone. Mod Rheumatol2007;17(6):459-63. <h3>Disclosure of Interest</h3> None Declared
Be more radical, vocal, and bold to improve patient safety, conference hears
Authors: C. White
Journal: BMJ (2011)

The NHS still lacks an effective “patient safety culture” and must overcome its reluctance to improve outcomes and save much needed cash, leading clinicians have warned.

Speaking on 10 November at the Patient Safety 2011 conference in London, Rowan Hillson, England’s national clinical director for diabetes, said that one in 10 of the UK population is expected to have diabetes by 2020 but that current care was variable and inconsistent.

Less than a third of patients with type 1 diabetes and less than half of those with type 2 diabetes currently receive all the basic care processes set out in the National Institute for Health and Clinical Excellence’s quality standard for diabetes, she told the conference, …
3-D PRINTING OF BIOLOGICAL TISSUE-MIMICKING AORTIC ROOT USING A NOVEL META-MATERIAL TECHNIQUE: POTENTIAL CLINICAL APPLICATIONS
Authors: Zhen Qian, Kan Wang, Yung-Hang Chang, Chuck Zhang, Ben Wang, Vivek Rajagopal, Christopher Meduri, James Kauten, Venkateshwar Polsani, Xiao Zhou, Randolph Martin, Helene Houle, Mani Vannan, Tomamaso Mansi
Journal: Journal of the American College of Cardiology (2016)
Up to two thirds of the 100 trusts yet to reach foundation status will not make it
Authors: I. Torjesen
Journal: BMJ (2012)

More than 100 NHS trusts have yet to achieve foundation status, but up to two thirds are unlikely to get there alone and will need to merge, be taken over by another organisation, or even close, a conference at the King’s Fund has been told.

Candace Imison, deputy director of policy at the King’s Fund, told attendees at an event called “NHS Providers: is Bigger Better?” on 28 June that of the 248 trusts that were originally eligible for foundation status more than 100 have not yet attained that status.

“Actually the FT [foundation trust] pipeline has almost dried up. There have only been seven authorisations per year in the last two years,” she said. “And of that 100, 20 have actually declared that they can’t …
PATIENTS’ PERCEIVED VERSUS PREDICTED CARDIOVASCULAR DISEASE RISK: CHALLENGES FOR SHARED DECISION-MAKING IN CHOLESTEROL MANAGEMENT
Authors: Ann Marie Navar Boggan, Tracy Wang, Shuang Li, Michael Pencina, Judith Stafford, Anne Goldberg, Jennifer Robinson, Veronique Roger, Salim Virani, Peter Wilson, Joseph Elassal, L. Veronica Lee, Eric Peterson
Journal: Journal of the American College of Cardiology (2016)
Group-level expression encoded in the individual
Authors: Paul Ibbotson
Journal: Behavioral and Brain Sciences (2014)

Abstract Smaldino proposes a conceptual extension to the theory of cultural evolution to include emergent group-level traits as a unit of selection. It is important to recognize the role that group-level traits have played in the evolution of human culture. However, the emergent group-level trait of division of labor provides an illustrative example that is implementable within the existing framework of cMLS theory and may not even need a departure from the standard model.
Response to chemotherapy predicts longer survival in an individual patient meta-analysis of 1205 patients with mesothelioma
Authors: DA Fennell, GL Ceresoli, B Castagneto, P Scullin, M O'Brien, M Parker, B Hasan, R Sylvester, R Rudd, J Steele, C Porta, L Mutti, KJ O'Byrne, R Gaafar, P Baas, Jan Van Meerbeeck
Journal: Journal of Thoracic Oncology (2009)
Treatment of Septic Shock with the Tumor Necrosis Factor Receptor:Fc Fusion Protein
Authors: Charles J. Fisher, Jan M. Agosti, Steven M. Opal, Stephen F. Lowry, Robert A. Balk, Jerald C. Sadoff, Edward Abraham, Roland M.H. Schein, Ernest Benjamin
Journal: New England Journal of Medicine (1996)

A recombinant, soluble fusion protein that is a dimer of an extracellular portion of the human tumor necrosis factor (TNF) receptor and the Fc portion of IgG1 (TNFR:Fc) binds and neutralizes TNF-α and prevents death in animal models of bacteremia and endotoxemia.
P4-12-15: Cancer Survivor Care: An Evaluation of a Group Visit Model of Care for Breast Cancer Survivors at Duke Cancer Center.
Authors: KJ Trotter, S Schneider
Journal: Cancer Research (2011)

Abstract Background: The number of cancer survivors is growing, currently with about 2.5 million breast cancer survivors. (ACS, 2010). The Institute of Medicine report on survivor care stressed care coordination along with attention to survivor concerns as key issues in improving follow-up care. Group visits have been shown to improve access, health outcomes and health care utilization rates, as well as self-management skills. Purpose: This prospective program evaluation measured patients opinions about participation in a group visit clinic. Methods: A new model of breast cancer survivor care was designed and piloted at Duke Cancer Center. Breast cancer survivors who were three years post diagnosis attended the clinic together in groups of six. An interdisciplinary group visit format in the initial part of the appointment provided surveillance, education and support, as well as formation of an individualized survivorship care plan to be shared with the primary care provider. The first hour included review of their personal care plan and a 45-minute facilitated discussion. Afterwards, individual visits with the nurse practitioner, and dietitian, physical therapist or social worker occurred. A 22-item questionnaire designed to ascertain opinions regarding logistics and the style and function of care delivered is being administered to participants. The evaluation tool was approved by a panel of experts; pilot tested and has a reading level of 7.8. Data collection will be complete July 1, 2011. 103 surveys have been collected with a 91% response rate. Preliminary analysis shows high satisfaction with the group visit format. What participants liked most about the program was sharing with other survivors. 86% of participants indicate that they will share the survivorship care plan with their PCP. Only 10% responded that they were not sure they needed this type of follow up now and expressed that it would be more helpful immediately after finishing treatment. Final data will be presented. Barriers and facilitators to implementing this type of care model will be presented. Conclusions: The group visit model applied to a breast cancer survivor clinic appears feasible and highly satisfactory to participants. Implications for practice: Group visits can be considered one option for survivor care. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-12-15.
Abstract P2-09-32: Estrogen Receptor-Related Genes Are Important Predictors of Response to Neo-Adjuvant Chemotherapy in Breast Cancer
Authors: Y Chen, C Chen, Q Xu, X Ye, X Meng, B Morgin, J. Wu
Journal: Cancer Research (2010)

Abstract Background: Clinical data suggest a contribution of estrogen receptor (ER) to chemotherapy response. However, ER status alone is not perfectly predictive, and there is an urgent need for more reliable markers of chemotherapy responsiveness. In this study, we set out to find novel ER-related genes in predicting chemotherapy response by microarrays, hoping to provide more robust multi-variable prediction to chemotherapy. Material and Methods: One hundred and ten patients with stage II-III breast cancer were included, receiving preoperative four cycles of weekly PCb (paclitaxel plus carboplatin) regimen. Pretreatment gene expression profiling was performed with gene microarrays on core biopsy specimens. 55 training cases were used for marker discovery and to identify any ER-related genes that might be associated with response (“training cases”), and the other 55 patients were available as an independent validation set (“validation cases”) to test whether the ER-related genes do predict pCR in protein levels by immunohistochemistry (IHC). Results: In the training cases, the yield of total RNA was insufficient to assay in 16 patients and 8 chips failed in the quality check (QC) process. Therefore, gene expression profile from 31 samples were available for this study. The overall pCR rate in the 86 patients was 19.7% (n=17, 6 cases of pCR in training set and 11 pCR in validation set). In the training set, by Significance Analysis of Microarrays (SAM), 300 probes (231 genes) were identified as differentially expressed between pCR versus non-pCR when fold change &amp;gt; 2. There were 20 differentially expressed genes, setting fold change &amp;gt; 3. Among these 20 genes, TFF1, ESR1, GATA3, TFF3 were found as ER-related. In 55 independent validation cases, univariate analysis indicated that clinical variables and ER-related genes, including ER, PR, GATA3, TFF1 and TFF3 were all significantly associated with pCR (Pearson x2, P&amp;lt;0.001, P=0.013, P&amp;lt;0.001, P&amp;lt;0.001, P&amp;lt;0.001). Multivariate logistic regression model showed that ER (P=0.016) remained significantly associated with complete remission. In spearman analysis, these 5 ER-related genes were significantly correlated with each other (P&amp;lt;0.05). It was found that pCR rate was as high as 80% (4/5) when these 5 factors were all negative. In contrast, these 5 factors were all positive in 7 of 9 PD/SD patients. Discussion: ER combined with ER-related genes expression status may provide important predictive value of response to neoadjuvant chemotherapy and allows to identify a subgroup of patients who might highly benefit from chemotherapy and who might be resistant to it. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-09-32.
Abstract 884: Enhancing cultural communication to reduce cancer disparities
Authors: Gwendolyn P. Quinn, Julio Jimenez Chavez, Vani N. Simmons, Eida Castro, Clement K. Gwede, Susan T. Vadaparampil, Teresita M. Antonia, Cathy Meade, Thomas Brandon
Journal: Cancer Research (2010)

Abstract An alliance between a patient's cultural identity and a physician's cultural competency can improve patient physician communication and ultimately reduce health disparities[1]. However, communication barriers in the patient-physician relationship contribute to health disparities in the cancer care setting.[2] Providers are often unaware of their skill level and perceptions and may believe they do not need improvement. 2 This study sought to develop and evaluate a brief intervention for oncology care providers to improve cultural communication related to Hispanic patients and families. Oncologists at a major cancer center were surveyed to identify which of the nine AHRQ cultural competency techniques they desired to receive more training (n= 72). 66% selected, “I am interested in receiving information on how to communicate difficult issues such as terminal illness and controversial diagnosis, in a way that is respectful to Hispanic culture.” A workshop was held for 55 staff containing a didactic lecture from an Hispanic provider addressing culture, terminal illness, and communication strategies. A panel of interpreters, translators, and bi-lingual providers answered questions from the audience and a group discussion was held. A seven item pre-test was administered prior to the workshop, followed by a three item post-test. 62% agreed the panel discussion was helpful in developing techniques for communicating bad news to Spanish speaking patients. At baseline 20% of participants felt very comfortable with their cultural communication skills, however, only 3% felt very comfortable after attending the intervention. At pre-test 25% reported having very little knowledge about the cultural context of breaking bad news to Hispanic patients, yet at post-test 0% reported having very little knowledge. These data suggest the training was successful overall, as well as aiding in identifying providers who previously had a high level of comfort based on misperceptions of good cultural communication and through the workshop realized they needed improvement. [1] Brach, Cindy, Fraser, Irene Can Cultural Competency Reduce Racial And Ethnic Health Disparities? A Review And Conceptual Model Med Care Res Rev 2000 57: 181-217 [2] Saha, Somnath, Arbelaez, Jose J., Cooper, Lisa A. Patient-Physician Relationships and Racial Disparities in the Quality of Health Care Am J Public Health 2003 93: 1713-1719 Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 884.
P280 Reducing Non-Attendance at a Difficult Asthma Clinic – Are Phone Calls Futile?
Authors: BJ McDonough, S Mault, H Burhan
Journal: Thorax (2012)

<h3>Background</h3> Missed outpatient appointment cost NHS hospitals in the region of £600 million per year.<sup>1</sup> There is some evidence that ‘did-not-attend’ (DNA) rates are particularly high for primary care asthma reviews<sup>2</sup>. Increasing demand for our weekly difficult asthma clinic means that routine appointments are at a premium. This led us to attempt to reduce the DNA rate. Our asthma specialist nurses began to interview patients that failed to attend over the telephone within a week of their scheduled appointment. <h3>Aim</h3> To ascertain whether telephoning patients that DNA clinic leads to an attendance at the next scheduled clinic appointment. <h3>Methods</h3> Review of database generated from contacting patients that DNA asthma clinic between April 2011 and March 2012. <h3>Results</h3> There were a total of 153 missed appointments. We attempted to contact the patient following their missed appointment in 101 cases. We were able to contact 51 patients, of these 20 (39%) attended their next appointment. We tried but failed to contact 50 patients of whom 5 (10%) attended their next appointment. We did not contact 52 patients for various reasons, 10 (19%)attended their next appointment. <h3>Conclusions</h3> Telephoning patients that DNA asthma clinic led to a two fold increase in attendance at subsequent clinics. Each phone call lasted approximately ten minutes and there were often several attempts required before contact was made. The patient’s asthma control was assessed during the call and the outcome was recorded in the case notes. Despite that fact that telephoning patients led to a reduction in subsequent missed appointments, this is a time consuming and therefore costly exercise and 24/51 (47%) of patients missed their subsequent appointment despite having been contacted. Non-attendance may be a reflection of poor concordance which in itself may be contributing to the patients’ difficult asthma. <h3>References</h3> www.drfosterhealth.co.uk/features/outpatient-appointment-no-shows.aspx van Baar JD, Joosten H, Car J, Freeman, GK, Partridge MR, van Weel C, Sheikh A. Understanding reasons for asthma outpatient (non)-attendance and exploring the role of telephone and e-consulting in facilitating access to care: exploratory qualitative study Qual Saf Health Care 2006; 15:191–195.
Occult Pulmonary Artery
Authors: RAND CONFER, GEORGE BURKE, VINCENT JB ROBINSON
Journal: Clinical Nuclear Medicine (1996)

A 1-month old infant girl was noted to have a right-sided aortic arch on chest x-ray. Nuclear perfusion examination showed markedly decreased flow to the left lung. Given the presence of pulmonary vasculature on the chest film, occult pulmonary artery was suspected and confirmed by angiography.
Utility of EUS for detection and follow-up of Intraductal papillary mucinous neoplasms
Authors: K Kamata
Journal: Endoscopy (2011)

Background: Intraductal papillary mucinous neoplasms (IPMNs) are often accompanied with invasive ductal pancreatic cancers (IDPCs). IPMN-related carcinomas consist of two types; IDPCs derived and distinct from IPMNs. We employed EUS including contrast-enhanced harmonic EUS (CEH-EUS) for diagnosis and follow-up of IPMNs, and evaluated its role in detection of mural nodules and concomitant IDPCs as well as their characterization. Patients and Methods: Between April 1999 and March 2010, EUS was performed in 317 patients who had been suspected of having IPMNs. Surgical resection was performed in 13 patients with main duct IPMNs, or 28 patients with the presence of mural nodules or symptoms in branch duct IPMNs. Forty-one patients with IPMNs (hyperplasia, n=1; adenomas, n=24; non-invasive carcinomas, n=6; invasive carcinomas, n=7; derived carcinomas, n=3) underwent surgery after EUS, MDCT and MRCP. Ninety-eight branch duct-type IPMNs without mural nodules were selected for periodic follow-up without surgical procedure as outpatients. Examinations for follow-up were EUS in combination with CT scan and/or MRCP (every 6 monthes). CEH-EUS was also perfomed from 2007. We evaluated patients in terms of the ability to depict mural nodules of IPMNs and IDPCs distinct from IPMNs by EUS, MDCT and MRCP, the height of mural nodules of non-carcinoma and carcinoma, and the prognosis in the follow-up group. Results: EUS, MDCT and MRCP achieved depiction of mural nodules in 92%, 26% and 16% of cases with surgical resection, respectively. Thirty-five lesions depicted by EUS included 22 benign lesions (hyperplasia, adenoma) and 13 carcinomas (non-invasive, invasive). Twenty-five lesions were detected only by EUS, 6 cases of which were carcinomas. The average height of mural nodules measured preoperatively by EUS was 4 ± 3mm and 10 ± 4mm in non-carcinoma and carcinoma, respectively. The height of mural nodules in carcinoma was significantly higher than in non-carcinoma. When the cut off value of the diagnosis of cancer was set to 7mm in ROC curve, the sensitivity, specificity, and accuracy were 85%, 86%, and 86%, respectively. Among 93 patients who were followed up, no IDPCs derived from IPMNs occurred but 3 IDPCs distinct from IPMNs were complicated during follow-up period. They were detected only by EUS at an operable stage. Conclusion: EUS is useful to detect mural nodules of IPMNs and IDPCs distinct from them. Height of mural nodules of IPMN measured by EUS indicates the malignant potential of IPMNs. Periodic follow-up by EUS in patients with IPMNs plays an important role in early detection of IDPCs.
Paraneoplastic Cerebellar Ataxia Due to Autoantibodies against a Glutamate Receptor
Authors: Peter Sillevis Smitt, Ayae Kinoshita, Bertie De Leeuw, Wiebe Moll, Michiel Coesmans, Dick Jaarsma, Sonja Henzen-Logmans, Charles Vecht, Chris De Zeeuw, Naohiro Sekiyama, Shigetada Nakanishi, Ryuichi Shigemoto
Journal: New England Journal of Medicine (2000)

There are many types of cerebellar ataxia, including ataxia due to congenital or metabolic disorders and a paraneoplastic form in patients with gynecologic cancer, breast cancer, lung cancer, or Hodgkin's disease.1 This paraneoplastic syndrome is the only type of cerebellar ataxia associated with autoantibodies against neuronal antigens. Often, the neuronal antigens are aberrantly expressed by the tumor cells.2–4 The antineuronal autoantibodies are believed to cause cerebellar ataxia, but this is unproved.5,6 In Hodgkin's disease, the lymphoma precedes the ataxia by months to years in 80 percent of patients, and ataxia often occurs during a prolonged complete remission.4 Among . . .