tbuckley/cabot-search huggingface dataset:
Transmissão inter-humana do virus A/H7N7 da gripe aviar, Países Baixos, 2003
Authors: M Du Ry van Beest Holle, A Meijer, M Koopmans, C M de Jager
Journal: Eurosurveillance (2005)

Nos Paises Baixos em 2003, ocurreu um surto de gripe aviar muito patogeno de tipo A e subtipo H7N7 numa quinta avicola. A infeccao pelo virus foi detectado por RT-PCR (reverse transcriptase-polymerase chain reaction) em 86 trabalhadores da quinta e em tres contatos familiares. A maioria das infeccoes estava associada com uma conjuntivite. Para determinar a amplitude e os factores de risco para a transmissao interhumana de gripe A/H7N7 nos Paises Baixos, foi levado a cabo um estudo de cohorte retrospectivo nas familias dos empregados da quinta infectados pelo virus. Em tudo, 33 (58,9%) dos 56 (entre 62) participantes que tinham dado amostras de sangue tinham uma serologia positiva para o virus H7. Os testes foram realizados num so amostra obtida pelo menos tres semanas depois do inicio de sintomas no caso indice. Oito membros familiares foram sintomaticos (conjuntivite e/ou sindrome gripal), e quatro sobre cinco (80%) eram seropositivos. Nas analises univariadas, os factores de risco para seropositividade incluiam ter pelo menos duas casas de banho, um passaro na casa, e usar lencos de tecido. Foi impossivel obter um modelo estavel de regressao binomial para estudiar a infeccao por A/H7N7. Deveria-se realizar mais estudios de seroprevalencia nos contactos de casos H7 asintomaticos.
Factors That Contribute to Indeterminate Results From the QuantiFERON-TB Gold In-Tube Test in Patients With Inflammatory Bowel Disease
Authors: Manreet Kaur, Prianka Singapura, Neeharika Kalakota, Guillermina Cruz, Richa Shukla, Sidra Ahsan, Aylin Tansel, Aaron P. Thrift, Hashem B. El-Serag
Journal: Clinical Gastroenterology and Hepatology (2017)
Association of Defective Regulation of Autoreactive Interleukin‐6–Producing Transitional B Lymphocytes With Disease in Patients With Systemic Sclerosis
Authors: Taher E. Taher, Voon H. Ong, Jonas Bystrom, Sophie Hillion, Quentin Simon, Christopher P. Denton, Jacques‐Olivier Pers, David J. Abraham, Rizgar A. Mageed
Journal: Arthritis & Rheumatology (2017)

Objective Systemic sclerosis ( SS c) has the highest case‐specific mortality of any rheumatic disease, and no effective therapy is available. A clear manifestation of SS c is the presence of autoantibodies. However, the origin of autoantibody‐producing B lymphocytes, their mechanisms of activation and autoantibody production, and their role remain unclear. This study was undertaken to identify mechanisms that contribute to pathogenic B cell generation and involvement in SS c and to assess the altered distribution and function of B cells in SS c patients. Methods Multicolor flow cytometry was performed to determine B cell subset distribution, cytokine production, and tolerance induction in SS c patients and healthy controls. Cytokine production following stimulation of the cells ex vivo was determined by multiplex assay. Results A range of defects in B lymphocyte tolerance and cytokine production in SS c were noted. There was evidence of altered distribution of transitional B cell subsets, increased production of interleukin‐6 ( IL ‐6) and IL ‐8, and defective tolerance induction in SS c B cells. In addition, B cells from SS c patients had a reduced ability to produce IL ‐10 when stimulated through innate immune pathways. In contrast to healthy individuals, tolerance checkpoints in SS c patients failed to suppress the emergence of B cells that produce autoantibodies with specificity to the Scl‐70 antigen, which is strongly associated with SS c. These defects were paralleled by altered intracellular signaling and apoptosis following B cell receptor engagement. Conclusion Our findings provide new insights into mechanisms underlying defective B lymphocyte responses in patients with SS c and their contribution to disease.
Children begin with the same start-up software, but their software updates are cultural
Authors: Jennifer M Clegg, Kathleen H Corriveau
Journal: Behavioral and Brain Sciences (2017)

Abstract We propose that early in ontogeny, children's core cognitive abilities are shaped by culturally dependent “software updates.” The role of sociocultural inputs in the development of children's learning is largely missing from Lake et al.'s discussion of the development of human-like artificial intelligence, but its inclusion would help move research even closer to machines that can learn and think like humans.
Explaining the enjoyment of negative emotions evoked by the arts: The need to consider empathy and other underlying mechanisms of emotion induction
Authors: Jonna K. Vuoskoski, Tuomas Eerola
Journal: Behavioral and Brain Sciences (2017)

Abstract Any model aiming to explain the enjoyment of negative emotions in the context of the arts should consider how works of art are able to induce emotional responses in the first place. For instance, research on empathy and the arts suggests that the psychological processes that mediate the enjoyment of sadness and horror may be fundamentally different.
Level of burden of supportive care-relevant pharmacogenetic markers in general population.
Authors: Howard L. McLeod, Jai Narendra Patel, Min Wei, Zeil Rosenberg
Journal: Journal of Clinical Oncology (2017)

221 Background: Precision medicine has become part of oncology, with implications for therapy selection, treatment avoidance, dosing, and risk prediction. The presence of clinically predictive germline variants has also opened the hope that objective predictors of patient toxicity will be in the future. This is an opportunity for oncology, where selection from amongst apparently equal supportive care treatment options can be subjective. Methods: The incidence of genetic risk for untoward drug effect was characterized in 1193 consecutive patients submitted for clinical pharmacogenetics testing using a 50 gene panel. Not all were cancer patients, so this reflects a potential patient population. For each patient, the need to stop/avoid, adjust dose, and select an alternate medication was determined for the treatment of pain (CYP2D6, CYP1A2, OPRM1), nausea/vomiting (CYP2D6), antifungal prophylaxis (CYP2C19) or depression (CYP2D6, CYP2C`9). It is recognized that there are many sources of variation in the response and toxicity to these classes of medications. Results: Of the 1193 patients, 173 (14.5%) would have a recommendation to avoid oxycodone, codeine, or tramadol therapy and a non-standard dosage for 893 patients (75%). A change in antiemetic would be suggested for 35 patients (3%). If voriconazole antifungal prophylaxis was clinical required, 289 (24%) would need a dose increase, while 45 (3.8%) should be switched to a different regimen. The majority (759 patients; 64%) should avoid some of the commonly used agents for depression because of lack of efficacy or heightened risk of toxicity, while 195 patients would need a dose adjustment. Conclusions: Pharmacogenetics markers that put patients at risk for lack of efficacy or toxicity to supportive care medications was commonly observed. Thankfully there are many options for most supportive care areas, allowing genetic information to help focus treatment selection. In addition, for number of supportive care medications we do not know the sources of variable response, genetic or otherwise. There are opportunities to apply precision oncology principles to patient management now, while research helps toward the goal of objective medication selection.
Abstract 15489: Impact of Cpap on Arterial Stiffness in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis
Authors: Marcio S Bittencourt, Sintya Chalegre, Thais C Lustosa, Marcus V França, Tarcya L Couto, Luciano F Drager, Geraldo Lorenzi-Filho, Rodrigo P Pedrosa
Journal: Circulation (2017)

Introduction:  Obstructive sleep apnea (OSA) is a major cause of hypertension, which is tightly associated with arterial stiffness, a marker of target organ damage and cardiovascular risk. Although continuous positive airway pressure (CPAP) is considered an effective treatment for OSA, its impact on arterial stiffness is controversial.   Hypothesis:  CPAP has a positive effect on arterial stifness in patients with OSA.   Methods:  We systematically searched databases for randomized clinical trials (RCT) evaluating the changes in arterial stiffness comparing CPAP vs. controls in individuals with OSA.   Results:  We included 7 RCT with 463 patients, 3 with data on pulse wave velocity (PWV) and 6 with data on augmentation index (Aix). The use of CPAP was associated with a lower post-treatment PWV, and a 0.44 (95%CI: 0.76 - 0.11) reduction difference between pre-and-post treatment standardized mean PWV when compared to controls (p   Conclusions:  OSA treatment with CPAP, when compared to controls, is associated with a significant improvement in arterial stiffness measured by either pulse wave velocity or augmentation index.
Prevalence and clinical profile of microcephaly in South America pre-Zika, 2005-14: prevalence and case-control study
Authors: Iêda M Orioli, Helen Dolk, Jorge S Lopez-Camelo, Daniel Mattos, Fernando A Poletta, Maria G Dutra, Flavia M Carvalho, Eduardo E Castilla
Journal: BMJ (2017)

<b>Objective</b>&nbsp;To describe the prevalence and clinical spectrum of microcephaly in South America for the period 2005-14, before the start of the Zika epidemic in 2015, as a baseline for future surveillance as the Zika epidemic spreads and as other infectious causes may emerge in future. <b>Design</b>&nbsp;Prevalence and case-control study. <b>Data sources</b>&nbsp;ECLAMC (Latin American Collaborative Study of Congenital Malformations) database derived from 107 hospitals in 10 South American countries, 2005 to 2014. Data on microcephaly cases, four non-malformed controls per case, and all hospital births (all births for hospital based prevalence, resident within municipality for population based prevalence). For 2010-14, head circumference data were available and compared with Intergrowth charts. <b>Results</b>&nbsp;552 microcephaly cases were registered, giving a hospital based prevalence of 4.4 (95% confidence interval 4.1 to 4.9) per 10 000 births and a population based prevalence of 3.0 (2.7 to 3.4) per 10 000. Prevalence varied significantly between countries and between regions and hospitals within countries. Thirty two per cent (n=175) of cases were prenatally diagnosed; 29% (n=159) were perinatal deaths. Twenty three per cent (n=128) were associated with a diagnosed genetic syndrome, 34% (n=189) polymalformed without a syndrome diagnosis, 12% (n=65) with associated neural malformations, and 26% (n=145) microcephaly only. In addition, 3.8% (n=21) had a STORCH (syphilis, toxoplasmosis, other including HIV, rubella, cytomegalovirus, and herpes simplex) infection diagnosis and 2.0% (n=11) had consanguineous parents. Head circumference measurements available for 184/235 cases in 2010-14 showed 45% (n=82) more than 3 SD below the mean, 24% (n=44) between 3 SD and 2 SD below the mean, and 32% (n=58) larger than −2 SD. <b>Conclusion</b>&nbsp;Extrapolated to the nearly 7 million annual births in South America, an estimated 2000-2500 microcephaly cases were diagnosed among births each year before the Zika epidemic began in 2015. Clinicians are using more than simple metrics to make microcephaly diagnoses. Endemic infections are important enduring causes of microcephaly.
Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis
Authors: José A López-López, Jonathan A C Sterne, Howard H Z Thom, Julian P T Higgins, Aroon D Hingorani, George N Okoli, Philippa A Davies, Pritesh N Bodalia, Peter A Bryden, Nicky J Welton, William Hollingworth, Deborah M Caldwell, Jelena Savović, Sofia Dias, Chris Salisbury, Diane Eaton, Annya Stephens-Boal, Reecha Sofat
Journal: BMJ (2017)

Objective To compare the efficacy, safety, and cost effectiveness of direct acting oral anticoagulants (DOACs) for patients with atrial fibrillation.Design Systematic review, network meta-analysis, and cost effectiveness analysis. Data sources Medline, PreMedline, Embase, and The Cochrane Library.Eligibility criteria for selecting studies Published randomised trials evaluating the use of a DOAC, vitamin K antagonist, or antiplatelet drug for prevention of stroke in patients with atrial fibrillation.Results 23 randomised trials involving 94 656 patients were analysed: 13 compared a DOAC with warfarin dosed to achieve a target INR of 2.0-3.0. Apixaban 5 mg twice daily (odds ratio 0.79, 95% confidence interval 0.66 to 0.94), dabigatran 150 mg twice daily (0.65, 0.52 to 0.81), edoxaban 60 mg once daily (0.86, 0.74 to 1.01), and rivaroxaban 20 mg once daily (0.88, 0.74 to 1.03) reduced the risk of stroke or systemic embolism compared with warfarin. The risk of stroke or systemic embolism was higher with edoxaban 60 mg once daily (1.33, 1.02 to 1.75) and rivaroxaban 20 mg once daily (1.35, 1.03 to 1.78) than with dabigatran 150 mg twice daily. The risk of all-cause mortality was lower with all DOACs than with warfarin. Apixaban 5 mg twice daily (0.71, 0.61 to 0.81), dabigatran 110 mg twice daily (0.80, 0.69 to 0.93), edoxaban 30 mg once daily (0.46, 0.40 to 0.54), and edoxaban 60 mg once daily (0.78, 0.69 to 0.90) reduced the risk of major bleeding compared with warfarin. The risk of major bleeding was higher with dabigatran 150 mg twice daily than apixaban 5 mg twice daily (1.33, 1.09 to 1.62), rivaroxaban 20 mg twice daily than apixaban 5 mg twice daily (1.45, 1.19 to 1.78), and rivaroxaban 20 mg twice daily than edoxaban 60 mg once daily (1.31, 1.07 to 1.59). The risk of intracranial bleeding was substantially lower for most DOACs compared with warfarin, whereas the risk of gastrointestinal bleeding was higher with some DOACs than warfarin. Apixaban 5 mg twice daily was ranked the highest for most outcomes, and was cost effective compared with warfarin.Conclusions The network meta-analysis informs the choice of DOACs for prevention of stroke in patients with atrial fibrillation. Several DOACs are of net benefit compared with warfarin. A trial directly comparing DOACs would overcome the need for indirect comparisons to be made through network meta-analysis.Systematic review registration PROSPERO CRD 42013005324.
Dangers of fatigue
Authors: Fiona Godlee
Journal: BMJ (2017)

Health systems in the northern hemisphere are gearing up for winter. In the UK this brings traditional prognostications of doom, which were heightened last week by an unprecedented public call for more money from NHS England’s chief executive (doi:10.1136/bmj.j5251). Our own veteran reporter of winter crises, Nigel Hawkes, wonders whether this time the NHS really will fall over, not from sudden collapse but from slow strangulation (doi:10.1136/bmj.j5203). With “winter” pressures now apparent all year round, the cause is not more patients arriving at hospitals, he says, …
Abstract 20970: Atrial Fibrillation and Intra-Arterial Treatment of Acute Ischemic Stroke: Is the Romance Deeper Than Embolism?
Authors: Muhammad A Saleem, Suhail Shaikh, Safi U Khan
Journal: Circulation (2017)

Introduction: Recent evidence remains inconclusive about the impact of atrial fibrillation (AF) on prognosis after intravenous thrombolysis and/or intra-arterial (IA) acute stroke treatment (AIS). Hypothesis: AF (either first episode or chronic) adversely affects stroke outcomes in patients undergoing IA treatment for AIS. Methods: We analyzed data from the 434 subjects in the IA treatment arm of Interventional Management of Stroke (IMS) III trial. The trial included AIS patients who were eligible for IV rtPA infusion within three hours after stroke onset. The subjects that were randomized to the IA treatment arm later received a protocol approved endovascular treatment. Demographics, vascular risk factors, and outcome measures were compared between patients with and without atrial fibrillation. The main outcomes considered were early neurological deterioration and hemorrhagic complications, excellent (mRS: scores of 0-2) functional outcome at 3 months, and good quality of life (EQ-5D index 0.5-1.0) at one year from randomization. Adjusted logistic regression analysis was performed to compare these outcomes. Results: Of the 434 patients who were studied (mean ± SD age, 66.3 ± 12.3 years, with 50.2% of patients being men), 153 had AF either chronic or diagnosed at baseline EKG and 281 had no AF. The patients with AF were significantly older (age 71.2±8.2 vs. 63.6±13.3 years), had more severe strokes (NIHSS&gt;=20) at baseline assessment (40.5% vs. 24.9%). The subjects with AF had higher adjusted odds of early neurological deterioration (OR 1.3, 95%CI 0.6-1.9, p=0.81), symptomatic intracranial hemorrhage (OR 1.7; 95% CI 0.7-3.8; p=0.27), and subarachnoid hemorrhage (OR 1.4; 95% CI 0.7-2.7; p=0.31). The subjects with AF had lower odds of having good functional outcome 3 months after randomization (OR 0.8; 95% CI 0.4-1.1; p=0.06). The two groups did not differ in their adjusted odds of symptomatic ICH, parenchymal hematomas, 90 days mortality, and quality of life after one year. Conclusions: In the patients undergoing IA treatment for AIS, AF may adversely impact early recovery in neurological function and long-term functional outcomes but not the rates of hemorrhagic complications, mortality, or good quality of life.
CDC Grand Rounds: Improving the Lives of Persons with Sickle Cell Disease
Authors: Mary Hulihan, Kathryn L. Hassell, Jean L. Raphael, Kim Smith-Whitley, Phoebe Thorpe
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

Approximately 100,000 Americans have sickle cell disease (SCD), a group of recessively inherited red blood cell disorders characterized by abnormal hemoglobin, called hemoglobin S or sickle hemoglobin, in the red blood cells. Persons with hemoglobin SS or hemoglobin Sß0 thalassemia, also known as sickle cell anemia (SCA), have the most severe form of SCD. Hemoglobin SC disease and hemoglobin Sß+ thalassemia are other common forms of SCD. Red blood cells that contain sickle hemoglobin are inflexible and can stick to vessel walls, causing a blockage that slows or stops blood flow. When this happens, oxygen cannot reach nearby tissues, leading to attacks of sudden, severe pain, called pain crises, which are the clinical hallmark of SCD. The red cell sickling and poor oxygen delivery can also cause damage to the brain, spleen, eyes, lungs, liver, and multiple other organs and organ systems. These chronic complications can lead to increased morbidity, early mortality, or both. Tremendous strides in treating and preventing the complications of SCD have extended life expectancy. Now, nearly 95% of persons born with SCD in the United States reach age 18 years (1); however, adults with the most severe forms of SCD have a life span that is 20-30 years shorter than that of persons without SCD (2).
The architecture challenge: Future artificial-intelligence systems will require sophisticated architectures, and knowledge of the brain might guide their construction
Authors: Gianluca Baldassarre, Vieri Giuliano Santucci, Emilio Cartoni, Daniele Caligiore
Journal: Behavioral and Brain Sciences (2017)

Abstract In this commentary, we highlight a crucial challenge posed by the proposal of Lake et al. to introduce key elements of human cognition into deep neural networks and future artificial-intelligence systems: the need to design effective sophisticated architectures. We propose that looking at the brain is an important means of facing this great challenge.
Intertemporal impulsivity can also arise from persistent failure of long-term plans
Authors: Nisheeth Srivastava, Narayanan Srinivasan
Journal: Behavioral and Brain Sciences (2017)

Abstract We suggest that steep intertemporal discounting in individuals of low socioeconomic status (SES) may arise as a rational metacognitive adaptation to experiencing planning and control failures in long-term plans. Low SES individuals' plans fail more frequently because they operate close to budgetary boundaries, in turn because they consistently operate with limited budgets of money, status, trust, or other forms of social utility.
P2.03a-039 ABOUND.70+: Interim Quality of Life (QoL) Results of nab-Paclitaxel/Carboplatin Treatment of Elderly Patients With NSCLC
Authors: Jared Weiss, Edward Kim, Kathy Amiri, Eric Anderson, Shaker Dakhil, Daniel Haggstrom, Robert Jotte, Kartik Konduri, Manuel Modiano, Teng Ong, Alexandra Sanford, David Smith, Matei Socoteanu, Jonathan W. Goldman, Corey Langer
Journal: Journal of Thoracic Oncology (2017)
Evolocumab Reduces Cardiovascular Risk Regardless of Diabetes Status
Authors: Anita Slomski
Journal: JAMA (2017)

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Segmental Sclerosis and Extracapillary Hypercellularity Predict Diabetic ESRD
Authors: Amy K. Mottl, Adil Gasim, Fernanda Payan Schober, Yichun Hu, Askia K. Dunnon, Susan L. Hogan, J. Charles Jennette
Journal: Journal of the American Society of Nephrology (2017)

Pathogenetic markers of diabetic kidney disease (DKD) progression to ESRD are lacking. We characterized the prognostic value of histologic findings in DKD for time to ESRD in native kidney specimens from biopsies performed from 1995 to 2011 with diabetic glomerulosclerosis as the only glomerular disease diagnosis (n=109). Biopsy specimens were analyzed according to standard methods, including determination of diabetic nephropathy class, as defined by the Renal Pathology Society. Clinical data were extracted from electronic medical records. We used competing risk models, with death as the competing risk, to estimate subdistribution hazard ratios (HRs) for ESRD. All multivariable models included age, sex, black race, baseline eGFR, and baseline proteinuria. Pathologic characteristics achieving P<0.1 were added into successively complex models. ESRD occurred in 56% of patients, and 26% of patients died before reaching ESRD. In univariate analyses, diabetic nephropathy class was not statistically significant in predicting time to ESRD. The final multivariable model (n=106) showed a borderline association between mild mesangial expansion and decreased risk for ESRD (subdistribution HR, 0.64; 95% confidence interval, 0.40 to 1.00). Poor prognostic factors in the final model included segmental sclerosis and extracapillary hypercellularity (subdistribution HR, 2.04; 95% confidence interval, 1.36 to 3.05; and subdistribution HR, 2.21; 95% confidence interval, 1.19 to 4.11, respectively). In conclusion, we identified segmental sclerosis and extracapillary hypercellularity as novel, poor prognostic indicators of time from DKD to ESRD. Whether these indicators represent a distinct pathogenetic phenotype of DKD will require a large study with a broad spectrum of disease severity.