tbuckley/cabot-search huggingface dataset:
Association of Clinical Outcomes With Surgical Repair of Hip Fracture vs Nonsurgical Management in Nursing Home Residents With Advanced Dementia
Authors: Sarah D. Berry, Randi R. Rothbaum, Douglas P. Kiel, Yoojin Lee, Susan L. Mitchell
Journal: JAMA Internal Medicine (2018)

<h3>Importance</h3> The decision whether to surgically repair a hip fracture in nursing home (NH) residents with advanced dementia can be challenging. <h3>Objective</h3> To compare outcomes, including survival, among NH residents with advanced dementia and hip fracture according to whether they underwent surgical hip fracture repair. <h3>Design, Setting, and Participants</h3> We conducted a retrospective cohort study of 3083 NH residents with advanced dementia and hip fracture, but not enrolled in hospice care, using nationwide Medicare claims data linked with Minimum Data Set (MDS) assessments from January 1, 2008, through December 31, 2013. <h3>Methods</h3> Residents with advanced dementia were identified using the MDS. Medicare claims were used to identify hip fracture and to determine whether the fracture was managed surgically. Survival between surgical and nonsurgical residents was compared using multivariable Cox proportional hazards with inverse probability of treatment weighting (IPTW). All analyses took place between November 2015 and January 2018. Among 6-month survivors, documented pain, antipsychotic drug use, physical restraint use, pressure ulcers, and ambulatory status were compared between surgical and nonsurgical groups. <h3>Results</h3> Among 3083 residents with advanced dementia and hip fracture (mean age, 84.2 years; 79.2% female [n = 2441], 28.5% ambulatory [n = 879]), 2615 (84.8%) underwent surgical repair. By 6-month follow-up, 31.5% (n = 824) and 53.8% (n = 252) of surgically and nonsurgically managed residents died, respectively. After IPTW modeling, surgically managed residents were less likely to die than residents without surgery (adjusted hazard ratio [aHR], 0.88; 95% CI, 0.79-0.98). Among 2007 residents who survived 6 months, residents with surgical vs nonsurgical management had less docmented pain (29.0% [n = 465] vs 30.9% [n = 59]) and fewer pressure ulcers (11.2% [n = 200] vs 19.0% [n = 41]). In IPTW models, surgically managed residents reported less pain (aHR, 0.78; 95% CI, 0.61-0.99) and pressure ulcers (aHR, 0.64; 95% CI, 0.47-0.86). There was no difference between antipsychotic drug use and physical restraint use between the groups. Few survivors remained ambulatory (10.7% [n = 55] of surgically managed vs 4.8% [n = 1] without surgery). <h3>Conclusions and Relevance</h3> Surgical repair of a hip fracture was associated with lower mortality among NH residents with advanced dementia and should be considered together with the residents' goals of care in management decisions. Pain and other adverse outcomes were common regardless of surgical management, suggesting the need for broad improvements in the quality of care provided to NH residents with advanced dementia and hip fracture.
421Role of calcium/calmodulin-dependent protein kinase II activation in beta-adrenergic stimulation of potassium currents in canine ventricular cardiomyocytes under action potential clamp conditions
Authors: B Horvath, R Veress, D Baranyai, B Kurtan, D Kiss, Z Kovacs, N Szentandrassy, T Banyasz, J Magyar, P P Nanasi
Journal: Cardiovascular Research (2018)

Background: Atrial fibrillation (AF) is a common arrhythmia with high risk for systemic embolism.This depends on left atrial (LA) mechanical and haematological factors.The inflammation enhances platelet activation, endothelial damage and interaction between platelets and neutrophils.Inflammatory markers as pentraxin 3 (PTX3) are elevated in patients with dilated LA with poorly functioning left atrial appendage (LAA).Many clinical schemes were proposed to assess risk of stroke as CHA2DS2-VASc.However, they need to be refined with incorporation of some echocardiographic and laboratory parameters.Objectives: To compare the sensitivity and specificity of CHA2DS2-VASc score alone, with addition of serum PTX3 and with addition of serum PTX3 and LAA tissue Doppler velocity.Patients and Methods: The study included 80 patients with non-valvular AF (NVAF) were enrolled.CHA2DS2-VASc score was calculated for every patient.Serum PTX3 was measured within 1 week before the transesophageal echocardiographic examination.LA size and volume and LAA tissue Doppler velocity were measured by trans-thoracic echocardiography (TTE).LAA thrombi were reported by trans-esophageal echocardiography (TEE).Results: The mean age was 59.268.3 years with 47 patients (58.8%) were males.By TEE, 13 patients (16.25%) were found to have LAA thrombi.Using ROC statistic, a cut-off value of 11.98 mg/dl for serum PTX3 (sensitivity: 92%, specificity: 55%) and 8.4 cm/sec.for LAA tissue Doppler velocity (sensitivity: 53.8%, specificity: 88%) were set.According to CHA2DS2-VASc score, 31 patients (38.75%) were considered to be at high risk for stroke (sensitivity: 92%, specificity: 55%).Combining the above three parameters improves both sensitivity (99%) and specificity (100%).Conclusion: Adding some echocardiographic and laboratory parameters as serum PTX3 to the clinical risk score CHA2DS2-VASc will improve both sensitivity and specificity in predicting high risk patients.This will better guide anti-thrombotic therapy in NVAF patients.
18F-FDG PET/CT in Anti-NMDA Receptor Encephalitis
Authors: Abdenasser Moubtakir, Sébastien Dejust, François Godard, Leila Messaoud, David Morland
Journal: Clinical Nuclear Medicine (2018)

We report the case of a 28-year-old woman presenting behavior disorders of subacute onset. She was referred in our institution for a suspicion of limbic encephalitis. F-FDG PET/CT did not show any mesiotemporal abnormality but depicted a decreased uptake of bilateral parietal and occipital lobes. This atypical pattern was compatible with an anti-N-methyl-D-aspartate receptor encephalitis that was later confirmed.
Economics of Palliative Care for Hospitalized Adults With Serious Illness
Authors: Peter May, Charles Normand, J. Brian Cassel, Egidio Del Fabbro, Robert L. Fine, Reagan Menz, Corey A. Morrison, Joan D. Penrod, Chessie Robinson, R. Sean Morrison
Journal: JAMA Internal Medicine (2018)

Economics of care for adults with serious illness is a policy priority worldwide. Palliative care may lower costs for hospitalized adults, but the evidence has important limitations. To estimate the association of palliative care consultation (PCC) with direct hospital costs for adults with serious illness. Systematic searches of the Embase, PsycINFO, CENTRAL, PubMed, CINAHL, and EconLit databases were performed for English-language journal articles using keywords in the domains of palliative care (eg, palliative, terminal) and economics (eg, cost, utilization), with limiters for hospital and consultation. For Embase, PsycINFO, and CENTRAL, we searched without a time limitation. For PubMed, CINAHL, and EconLit, we searched for articles published after August 1, 2013. Data analysis was performed from April 8, 2017, to September 16, 2017. Economic evaluations of interdisciplinary PCC for hospitalized adults with at least 1 of 7 illnesses (cancer; heart, liver, or kidney failure; chronic obstructive pulmonary disease; AIDS/HIV; or selected neurodegenerative conditions) in the hospital inpatient setting vs usual care only, controlling for a minimum list of confounders. Eight eligible studies were identified, all cohort studies, of which 6 provided sufficient information for inclusion. The study estimated the association of PCC within 3 days of admission with direct hospital costs for each sample and for subsamples defined by primary diagnoses and number of comorbidities at admission, controlling for confounding with an instrumental variable when available and otherwise propensity score weighting. Treatment effect estimates were pooled in the meta-analysis. Total direct hospital costs. This study included 6 samples with a total 133 118 patients (range, 1020-82 273), of whom 93.2% were discharged alive (range, 89.0%-98.4%), 40.8% had a primary diagnosis of cancer (range, 15.7%-100.0%), and 3.6% received a PCC (range, 2.2%-22.3%). Mean Elixhauser index scores ranged from 2.2 to 3.5 among the studies. When patients were pooled irrespective of diagnosis, there was a statistically significant reduction in costs (-$3237; 95% CI, -$3581 to -$2893; P < .001). In the stratified analyses, there was a reduction in costs for the cancer (-$4251; 95% CI, -$4664 to -$3837; P < .001) and noncancer (-$2105; 95% CI, -$2698 to -$1511; P < .001) subsamples. The reduction in cost was greater in those with 4 or more comorbidities than for those with 2 or fewer. The estimated association of early hospital PCC with hospital costs may vary according to baseline clinical factors. Estimates may be larger for primary diagnosis of cancer and more comorbidities compared with primary diagnosis of noncancer and fewer comorbidities. Increasing palliative care capacity to meet national guidelines may reduce costs for hospitalized adults with serious and complex illnesses.
TCTAP A-057 Clinical and CT Angiographic Predictors of the Development of Coronary Chronic Total Occlusions
Authors: Jeehoon Kang, JinJu Park, Si-Hyuck Kang, Young Jin Cho, Yeonyee E. Yoon, Chang-Hwan Yoon, Jung-Won Suh, Young-Seok Cho, Tae Jin Youn, In-Ho Chae, Dong-Ju Choi
Journal: Journal of the American College of Cardiology (2018)
Diabetes, Plasma Glucose, and Incidence of Fatty Liver, Cirrhosis, and Liver Cancer: A Prospective Study of 0.5 Million People
Authors: Yuanjie Pang, Christiana Kartsonaki, Iain Turnbull, Yu Guo, Robert Clarke, Yiping Chen, Fiona Bragg, Ling Yang, Zheng Bian, Iona Y. Millwood, Juanzhi Hao, Xianyong Han, Yajing Zang, Junshi Chen, Liming Li, Michael V. Holmes, Zhengming Chen
Journal: Hepatology (2018)

The prevalence of diabetes is increasing rapidly in China. However, evidence is limited about its effects on chronic liver diseases and liver cancer. We examined the associations of diabetes with chronic liver diseases and liver cancer and of random plasma glucose (RPG) with these liver diseases among participants without diabetes in Chinese adults and the possible interaction by hepatitis B virus (HBV) infection. The prospective China Kadoorie Biobank recruited 512,891 adults. During 10 years of follow‐up, 2,568 liver cancer, 2,082 cirrhosis, 1,298 hospitalized nonalcoholic fatty liver disease (NAFLD), and 244 hospitalized alcoholic liver disease (ALD) cases were recorded among 503,993 participants without prior history of cancer or chronic liver diseases at baseline. Cox regression was used to estimate hazard ratios (HRs) for each disease by diabetes status (previously diagnosed or screen‐detected) and, among those without previously diagnosed diabetes, by levels of RPG. Overall 5.8% of participants had diabetes at baseline. Compared to those without diabetes, individuals with diabetes had adjusted HRs of 1.49 (95% confidence interval 1.30‐1.70) for liver cancer, 1.81 (1.57‐2.09) for cirrhosis, 1.76 (1.47‐2.16) for NAFLD, and 2.24 (1.42‐3.54) for ALD. The excess risks decreased but remained elevated in those with longer duration. Among those without previously diagnosed diabetes, RPG was positively associated with liver diseases, with adjusted HRs per 1 mmol/L higher RPG of 1.04 (1.03‐1.06) for liver cancer, 1.07 (1.05‐1.09) for cirrhosis, 1.07 (1.05‐1.10) for NAFLD, and 1.10 (1.05‐1.15) for ALD. These associations did not differ by HBV infection. Conclusion: In Chinese adults, diabetes and higher blood glucose levels among those without known diabetes are associated with higher risks of liver cancer and major chronic liver diseases.
Comparison of Rates of Firearm and Nonfirearm Homicide and Suicide in Black and White Non-Hispanic Men, by U.S. State
Authors: Corinne A. Riddell, Sam Harper, Magdalena Cerdá, Jay S. Kaufman
Journal: Annals of Internal Medicine (2018)

Background: The extent to which differences in homicide and suicide rates in black versus white men vary by U.S. state is unknown. Objective: To compare the rates of firearm and nonfirearm homicide and suicide in black and white non-Hispanic men by U.S. state and to examine whether these deaths are associated with state prevalence of gun ownership. Design: Surveillance study. Setting: 50 states and the District of Columbia, 2008 to 2016. Cause-of-death data were abstracted by using the Centers for Disease Control and Prevention's WONDER (Wide-ranging Online Data for Epidemiologic Research) database. Participants: Non-Hispanic black and non-Hispanic white males, all ages. Measurements: Absolute rates of and rate differences in firearm and nonfirearm homicide and suicide in black and white men. Results: During the 9-year study period, 84 113 homicides and 251 772 suicides occurred. Black–white differences in rates of firearm homicide and suicide varied widely across states. Relative to white men, black men had between 9 and 57 additional firearm homicides per 100 000 per year, with black men in Missouri, Michigan, Illinois, Indiana, and Pennsylvania having more than 40 additional firearm homicides per 100 000 per year. White men had between 2 fewer and 16 more firearm suicides per 100 000 per year, with the largest inequalities observed in southern and western states and the smallest in the District of Columbia and densely populated northeastern states. Limitations: Some homicides and suicides may have been misclassified as deaths due to unintentional injury. Survey data on state household gun ownership were collected in 2004 and may have shifted during the past decade. Conclusion: The large state-to-state variation in firearm homicide and suicide rates, as well as the racial inequalities in these numbers, highlights states where policies may be most beneficial in reducing homicide and suicide deaths and the racial disparities in their rates. Primary Funding Source: McGill University and the National Institutes of Health.
Multimodal and sequential treatmente for hepatocellular carcinoma: how “real-life” complies with international recommendations
Authors: M. Triolo, A. Sangiovanni, M. Iavarone, L.V. Forzenigo, A. Nicolini, G. Rossi, V. La Mura, M. Colombo, P. Lampertico
Journal: Journal of Hepatology (2018)
CAPG enhances breast cancer metastasis by competing with PRMT5 to modulate STC-1 transcription
Authors: Sheng Huang, Yayun Chi, Yi Qin, Ziliang Wang, Bingqiu Xiu, Yonghui Su, Rong Guo, Liang Guo, Hefen Sun, Chujia Zeng, Shuling Zhou, Xin Hu, Sheng Liu, Zhimin Shao, Zhaohui Wu, Wei Jin, Jiong Wu
Journal: Theranostics (2018)

Macrophage-capping protein (CAPG) has been shown to promote cancer cell metastasis, although the mechanism remains poorly understood.Methods: Breast cancer (BC) tissue microarray was used to test the role of CAPG in the prognosis of BC patients.Xenograft mice model was used to validate the metastasis promotion role of CAPG in vivo.Gene expression array, chromatin immunoprecipitation and luciferase report assay were performed to search for the target genes of CAPG.Protein immunoprecipitation, MS/MS analysis, tissue microarray and histone methyltransferase assay were used to explore the mechanism of CAPG regulating stanniocalcin 1 (STC-1) transcription. Results:We demonstrate a novel mechanism by which CAPG enhances BC metastasis via promoting the transcription of the pro-metastatic gene STC-1, contributing to increased metastasis in BC.Mechanistically, CAPG competes with the transcriptional repressor arginine methyltransferase 5 (PRMT5) for binding to the STC-1 promoter, leading to reduced histone H4R3 methylation and enhanced STC-1 transcription.Our study also indicates that both CAPG and PRMT5 are independent prognostic factors for BC patient survival.High CAPG level is associated with poor survival, while high PRMT5 expression favors a better prognosis in BC patients.Conclusion: Our findings identify a novel role of CAPG in the promotion of BC metastasis by epigenetically enhancing STC-1 transcription.
Left Ventricular Thrombus After Acute Myocardial Infarction
Authors: Cian P. McCarthy, Muthiah Vaduganathan, Killian J. McCarthy, James L. Januzzi, Deepak L. Bhatt, John W. McEvoy
Journal: JAMA Cardiology (2018)

<h3>Importance</h3> Left ventricular (LV) thrombus is a complication of acute myocardial infarction (MI) and is associated with systemic thromboembolism. With randomized clinical trials investigating the optimal antithrombotic regimen in patients with MI who require concomitant chronic anticoagulation and with the emergence of the direct-acting oral anticoagulants, treatment options for post-MI LV thrombus have become more complicated. Herein, we review the epidemiology, pathogenesis, diagnosis, prevention, and treatment of LV thrombus after acute MI. <h3>Observations</h3> Contemporary epidemiologic data suggest the incidence of LV thrombus, detected using optimal imaging modalities, may be as high as 15% in patients with ST-segment elevation MI and up to 25% in patients with anterior MI. While a standard transthoracic echocardiogram is commonly used for screening, it is limited by low sensitivity for LV thrombus detection, necessitating the addition of contrast (unless contraindicated) and/or use of cardiac magnetic resonance imaging when pretest probability is high. To our knowledge, there are no existing randomized clinical trials evaluating the safety and efficacy of anticoagulation in the prevention or treatment of LV thrombus after MI, and clinicians must rely on available epidemiologic and trial-generated data from related entities to guide treatment. Randomized clinical trials have confirmed that triple therapy increases bleeding rates compared with less potent antithrombotic regimens after MI, and observational data suggest that triple therapy regimens may not prevent LV thrombus formation. On the other hand, if an LV thrombus is detected, anticoagulation is essential to prevent systemic thromboembolism. We offer 1 approach to treatment, grounded in the best available data. <h3>Conclusions and Relevance</h3> Uncertainties remain regarding the optimal screening pathway, frequency of follow-up imaging, candidate selection for thromboprophylaxis, and treatment strategies for post-MI LV thrombus. Ongoing studies from related therapeutic areas of varying antithrombotic regimens will continue to inform the optimal approach to treatment; however, more dedicated study of this clinical conundrum is also needed.
Nintedanib Is Active in Malignant Pleural Mesothelioma Cell Models and Inhibits Angiogenesis and Tumor Growth <i>In Vivo</i>
Authors: Viktoria Laszlo, Zsuzsanna Valko, Ildiko Kovacs, Judit Ozsvar, Mir Alireza Hoda, Thomas Klikovits, Dora Lakatos, Andras Czirok, Tamas Garay, Alexander Stiglbauer, Thomas H. Helbich, Marion Gröger, Jozsef Tovari, Walter Klepetko, Christine Pirker, Michael Grusch, Walter Berger, Frank Hilberg, Balazs Hegedus, Balazs Dome
Journal: Clinical Cancer Research (2018)

Purpose: Malignant pleural mesothelioma (MPM) is an aggressive thoracic tumor type with limited treatment options and poor prognosis. The angiokinase inhibitor nintedanib has shown promising activity in the LUME-Meso phase II MPM trial and thus is currently being evaluated in the confirmatory LUME-Meso phase III trial. However, the anti-MPM potential of nintedanib has not been studied in the preclinical setting.Experimental Design: We have examined the antineoplastic activity of nintedanib in various in vitro and in vivo models of human MPM.Results: Nintedanib's target receptors were (co)expressed in all the 20 investigated human MPM cell lines. Nintedanib inhibited MPM cell growth in both short- and long-term viability assays. Reduced MPM cell proliferation and migration and the inhibition of Erk1/2 phosphorylation were also observed upon nintedanib treatment in vitro Additive effects on cell viability were detected when nintedanib was combined with cisplatin, a drug routinely used for systemic MPM therapy. In an orthotopic mouse model of human MPM, survival of animals receiving nintedanib per os showed a favorable trend, but no significant benefit. Nintedanib significantly reduced tumor burden and vascularization and prolonged the survival of mice when it was administered intraperitoneally. Importantly, unlike bevacizumab, nintedanib demonstrated significant in vivo antivascular and antitumor potential independently of baseline VEGF-A levels.Conclusions: Nintedanib exerts significant antitumor activity in MPM both in vitro and in vivo These data provide preclinical support for the concept of LUME-Meso trials evaluating nintedanib in patients with unresectable MPM. Clin Cancer Res; 24(15); 3729-40. ©2018 AACR.
Inkjet–Spray Hybrid Printing for 3D Freeform Fabrication of Multilayered Hydrogel Structures
Authors: Sejeong Yoon, Ju An Park, Hwa‐Rim Lee, Woong Hee Yoon, Dong Soo Hwang, Sungjune Jung
Journal: Advanced Healthcare Materials (2018)

Abstract Here, a new bioprinting process by combining drop‐on‐demand inkjet printing with a spray‐coating technique, which enables the high‐resolution, high‐speed, and freeform fabrication of large‐scale cell‐laden hydrogel structures is reported. Hydrogel structures with various shapes and composed of different materials, including alginate, cellulose nanofiber, and fibrinogen, are fabricated using the inkjet–spray printing. To manufacture cell‐friendly hydrogel structures with controllable stiffness, gelatine methacryloyl is saponified to stabilize jet formation and is subsequently mixed with sodium alginate to prepare blend inks. The hydrogels crosslinked from the blend inks are characterized by assessing physical properties including the microstructure and mechanical stiffness and cellular responses including the cell viability, metabolic activity, and functionality of human dermal fibroblasts within the hydrogel. Cell‐laden hydrogel structures are generated on a large scale and collagen type I secretion and spreading of cells within the hydrogels are assessed. The results demonstrate that the inkjet–spray printing system will ensure the formation of a cell‐laden hydrogel structure with high shape fidelity in a rapid and reliable manner. Ultimately, the proposed printing technique and the blend bioink to be used to fabricate 3D laminated large‐scale tissue equivalents that potentially mimic the function of native tissues is expected.
Gluten-Sensitive Enteropathy
Authors: Aubrey J. Katz, Z. Myron Falchuk, Warren Strober, Harry Shwachman
Journal: New England Journal of Medicine (1976)

Gluten-sensitive enteropathy is a disease characterized by villous atrophy related to the ingestion of wheat protein, gluten. In the present series of studies it was shown that gluten ingestion in affected patients is promptly followed by a local immune reaction involving the production of antigluten antibodies. An in vitro model of gluten enteropathy involving the organ culture of biopsy tissue has been developed which has led to the conclusion that gluten is not directly toxic to the gastrointestional mucosa but, instead, brings about tissue damage through the activation of an endogenous mechanism, presumably the immune system. An additional insight into the pathogenesis of gluten-sensitive enteropathy is afforded by the fact that some 90% of patients carry the HL-A8 histocompatibility type. This may be a marker for the presence of an abnormal immune response gene or may determine the presence of abnormal gluten-protein receptor sites on epithelial cells. Either of these abnormalities could result in a propensity to respond immunologically to gluten, with destructive consequences.
In type 2 diabetes, weekly semaglutide reduced HbA1c and increased weight loss more than weekly exenatide ER
Authors: Eleni Bekiari, Thomas Karagiannis, Apostolos Tsapas
Journal: Annals of Internal Medicine (2018)

Source Citation Ahmann AJ, Capehorn M, Charpentier G, et al. Efficacy and safety of once-weekly semaglutide versus exenatide ER in subjects with type 2 diabetes (SUSTAIN 3): a 56-week, open-label, randomized clinical trial. Diabetes Care. 2018;41:258-66. 29246950