tbuckley/cabot-search huggingface dataset:
Association of Postoperative Readmissions With Surgical Quality Using a Delphi Consensus Process to Identify Relevant Diagnosis Codes
Authors: Hillary J. Mull, Laura A. Graham, Melanie S. Morris, Amy K. Rosen, Joshua S. Richman, Jeffery Whittle, Edith Burns, Todd H. Wagner, Laurel A. Copeland, Tyler Wahl, Caroline Jones, Robert H. Hollis, Kamal M. F. Itani, Mary T. Hawn
Journal: JAMA Surgery (2018)

Postoperative readmission data are used to measure hospital performance, yet the extent to which these readmissions reflect surgical quality is unknown.To establish expert consensus on whether reasons for postoperative readmission are associated with the quality of surgery in the index admission.In a modified Delphi process, a panel of 14 experts in medical and surgical readmissions comprising physicians and nonphysicians from Veterans Affairs (VA) and private-sector institutions reviewed 30-day postoperative readmissions from fiscal years 2008 through 2014 associated with inpatient surgical procedures performed at a VA medical center between October 1, 2007, and September 30, 2014. The consensus process was conducted from January through May 2017. Reasons for readmission were grouped into categories based on International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes. Panelists were given the proportion of readmissions coded by each reason and median (interquartile range) days to readmission. They answered the question, "Does the readmission reason reflect possible surgical quality of care problems in the index admission?" on a scale of 1 (never related) to 5 (directly related) in 3 rounds of consensus building. The consensus process was completed in May 2017 and data were analyzed in June 2017.Consensus on proportion of ICD-9-coded readmission reasons that reflected quality of surgical procedure.In 3 Delphi rounds, the 14 panelists achieved consensus on 50 reasons for readmission; 12 panelists also completed group telephone calls between rounds 1 and 2. Readmissions with diagnoses of infection, sepsis, pneumonia, hemorrhage/hematoma, anemia, ostomy complications, acute renal failure, fluid/electrolyte disorders, or venous thromboembolism were considered associated with surgical quality and accounted for 25 521 of 39 664 readmissions (64% of readmissions; 7.5% of 340 858 index surgical procedures). The proportion of readmissions considered to be not associated with surgical quality varied by procedure, ranging from to 21% (613 of 2331) of readmissions after lower-extremity amputations to 47% (745 of 1598) of readmissions after cholecystectomy.One-third of postoperative readmissions are unlikely to reflect problems with surgical quality. Future studies should test whether restricting readmissions to those with specific ICD-9 codes might yield a more useful quality measure.
The importance of jointly analyzing treatment administration and toxicity associated with targeted therapies: a case study of regorafenib in soft tissue sarcoma patients
Authors: M. Longué, B. Cabarrou, J. Wallet, T. Brodowicz, H. Roché, J.M. Boher, J.P. Delord, N. Penel, T. Filleron
Journal: Annals of Oncology (2018)

Different methods have been proposed to analyze adverse events (AEs) associated with targeted therapies. While these AEs lead to dose adjustments for many patients, conventional reporting methods do not take drug administration into consideration. This paper underlines the importance of jointly reporting AEs and drug administration using prevalence, and proposes a complementary approach to reporting.The prevalence method estimates the probability of progression-free patients being in a particular health state (state 1: AEs with full dose; state 2: AEs with reduced dose; state 3: no AEs with reduced dose) at different time points. To take into account the impact of dose adjustments on efficacy, the weighted prevalence method can be used by assigning utility weights to the different health states. The benefit of these methods was illustrated using data from a phase II trial of regorafenib.Only 4.6% of progression-free patients developed mucositis/stomatitis (grade ≥2) at 3 months. The prevalence of patients not experiencing this AE but whose dose was reduced or treatment interrupted was 58.1%. The weighted prevalence of the regorafenib toxicity profile and dose reduction was higher in the control arm.This case study confirms the importance of jointly analyzing AEs and drug administration. The weighted prevalence approach is an average score that incorporates the dimension of drug administration into AE assessment. This can be helpful for regulatory agencies as well as for clinicians to evaluate the benefit-risk ratio of therapies in their treatment choice.NCT01900743.
Hepatocellular carcinoma (HCC) after direct-acting antivirals (DAA) does not show differences at diagnosis compared with HCC after IFN-based treatments. Results of a national HCC Registry in Spain
Authors: C. Rodríguez de Lope, M.T. Ferrer, M. Sala, S. Pascual, A.M. Matilla, I. Ortiz, P. Rendon, B. Figueruela, J. Fuentes, D.E.M. Arraez, A.G. Moya, A. Lué, B. Minguez, M.R. Alemany, F.M. Blazquez, C. Gónzalez Muñoz, F.P. Renedo, A. Raga, C. Fernández Marcos, J.M.R. Zabal, J.L. Lledó, C. Muñoz Codoceo, S. Montoliu, G. Pacheco del Rio, J.M.C. Suaña, G.J.S. Rodriguez, T.H. Alsina, I.E. Apestegui, M.J.D. Medina, A. Ortega-Alonso, G.D.L.R. Bellvis, A.G. Ramirez, I. Castello, L.C. Garcia, M. Varela
Journal: Journal of Hepatology (2018)
Publication and Dissemination of Results in Clinical Trials of Neurology
Authors: Anirudh Sreekrishnan, David Mampre, Cora Ormseth, Laura Miyares, Audrey Leasure, Joseph S. Ross, Kevin N. Sheth
Journal: JAMA Neurology (2018)

This review of interventional neurology trials registered in ClinicalTrials.gov classifies trials and compares publication rates and time to publication between 2007 and 2014.
Association of Pharmaceutical Industry Marketing of Opioid Products to Physicians With Subsequent Opioid Prescribing
Authors: Scott E. Hadland, Magdalena Cerdá, Yu Li, Maxwell S. Krieger, Brandon D. L. Marshall
Journal: JAMA Internal Medicine (2018)

Adam L. Ackerman, MD; Patrick G. O'Connor, MD, MPH; Deirdre L. Doyle, MSN, MHA; Sheyla M. Marranca, MS; Carolyn L. Haight, BSN; Christine E. Day, BS; Robert L. Fogerty, MD, MPH
Elafibranor and nitazoxanide synergize to reduce fibrosis in a NASH model
Authors: R. Walczak, B. Carole, N. Benoit, E. Descamps, D. Nathalie, S. Megnien, D. Hum, B. Staels, S. Friedman, R. Loomba, S. Harrison
Journal: Journal of Hepatology (2018)
Making the Opioid Public Health Emergency Effective
Authors: Rebecca L. Haffajee, Richard G. Frank
Journal: JAMA Psychiatry (2018)

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 Psychiatry 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 Psychiatry journal
P485Monocyte subset distribution predicts survival in patients with acute heart failure
Authors: K A Krychtiuk, M Lenz, L Wutzlhofer, B Bauer, D F Draxler, K Huber, J Wojta, G Heinz, W S Speidl
Journal: Cardiovascular Research (2018)

The idea of regulatory impact of purinergic signaling in the functioning of different type of cells and in this way in the pathogenesis of many diseases is now very popular and finds confirmations in different investigations.The aim of the study was to compare subsets of peripheral T-lymphocytes and the expression on their surface ectonucleotidases CD39 and CD73 in patients with severe and mild aortic stenosis and to assume the involvement of T-cell immunity in valve calcification process.We examined 33 patients with severe calcified aortic stenosis (AS) undergoing surgical heart valve replacement (Median of flow gradient was 48.3 (44.0;54.9))(1 group), 47 patients with moderate AS (Median of flow gradient was 20.5 (14.0;28.0))(2 group) and 42 healthy volunteers (3 group).Median age in the first group was 62.5 (57.0;66.0), in the second -58.0 (45.0;66.0), in the third -48.5 (43.0;53.0)years.The relative number of peripheral naı ¨ve (N, CD45RAþCD62Lþ), central memory (CM, CD45RA-CD62Lþ), effector memory (EM, CD45RA-CD62L-) and terminally differentiated CD45RA-positive effector memory (TEMRA, CD45RAþCD62L-) CD45þCD3þCD4þ (Th), CD45þCD3þCD8þ (Tcyt) and CD45þCD3þCD4þCD25bright (Treg) cells as well as the percentages of CD39-and CD73-positive cell within above-mentioned T cell subsets were measured using multicolor flow cytometry.The levels of Tcyt (p¼0.04) and TEMRA Tcyt (p¼0.007) were increased in patients with severe stenosis comparing with mild stenosis.Meanwhile level of Naı ¨ve Treg (p¼0.01) and TEMRA Treg (p<0.001) were decreased.Analyzing the total expression level of ectonucleotidases on T-cells we found that level of CD73þCD39-was decreased in patients with mild stenosis comparing with severe (p<0.001) and with healthy donors (p<0.001).Changes in peripheral T-cells subpopulations in patients with severe aortic stenosis were more pronounced than in healthy donors and patients with moderate stenosis.Taking all the data together we propose that patients with severe stenosis have overexpressed proinflammatory status than the patients with moderate stenosis.Meanwhile decreased number of CD73þCD39-(anti-inflammatory) T-cells in the case of mild stenosis proves this statement and indicates the participation of purinergic signaling in regulation of T-cells inflammation.
P578Integrative functional annotation of 52 genetic loci influencing myocardial mass
Authors: D Hemerich, J Pei, V Tragante, M Harakalova, T Treibel, J Van Den Velden, M Mokry, P Van Der Harst, J Moon, F W Asselbergs
Journal: Cardiovascular Research (2018)

Introduction: Cell damage causes the release of a significant amount of ATP and subsequent activation of purinergic system.Purinergic signaling is involved in the regulation of a variety of physiological processes, including inflammation, cell proliferation and migration.A specific set of activated pathways is mainly determined by the expression of target receptors and ectonucleotidases, which regulate levels of extracellular ATP and its metabolic products, primarily adenosine.Clarification of the role of purinergic signaling in the vascular wall response to injury is important for understanding of the fine mechanisms of atherosclerotic plaque formation and restenosis development.Purpose: The aim of the study was to determine temporal expression profiles of genes involved in purinergic signaling during the healing response to arterial injury in rat.Methods: Total RNA was isolated from the rat carotid arteries at seven timepoints ranging from 2 hours to 12 weeks after balloon injury.Transcriptome profiling was performed using microarrays.Results: Several ectonucleotidases, participating in the balance of extracellular ATP and its metabolic products, showed differential expression.In particular, CD39 catabolizing pro-inflammatory ATP to ADP and AMP, decreased from 20 hours of observation.CD73, which metabolizes AMP to anti-inflammatory adenosine, and adenosine deaminase, which destructs extracellular adenosine, increased at 20 hours and remain upregulated until day 2 and day 5, respectively.Several purinergic receptors of ATP and ADP from P2X and P2Y families demonstrate differential expression.Specifically, P2X1, known as regulator of vSMC contractile phenotype, decreased from 20 hours of observation, while P2Y2 and P2Y6, known as regulators of vSMC synthetic phenotype, upregulated immediately after injury.Low-affinity adenosine receptors A2b and A3 were upregulated from day 2 to day 5. Several downstream targets of purinergic signaling also showed differential expression.Among them protein kinase A, involved in vSMC proliferation, and genes associated with inflammatory response -NLRP3 subunit of inflammasome and its targets IL1b and IL18, as well as adhesion molecules ICAM1 and VCAM1.Conclusions: Analysis of time-course expression profiles demonstrated that purinergic signaling pathways are dynamically controlled at mRNA level in rat carotid artery balloon injury model.This indicates the potential involvement of purinergic signaling in the regulation of local inflammation and vSMC phenotype during response to vascular injury.
Effect of Bronchodilation, Exercise Training, and Behavior Modification on Symptoms and Physical Activity in Chronic Obstructive Pulmonary Disease
Authors: Thierry Troosters, François Maltais, Nancy Leidy, Kim L. Lavoie, Maria Sedeno, Wim Janssens, Judith Garcia-Aymerich, Damijan Erzen, Dorothy De Sousa, Lawrence Korducki, Alan Hamilton, Jean Bourbeau
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

Bronchodilation and exercise training (ExT) improve exercise tolerance in patients with chronic obstructive pulmonary disease (COPD); however, behavior modification is required to impact daily physical activity (PA).To assess whether tiotropium/olodaterol, with or without ExT, would improve exercise endurance time (EET) and PA compared with placebo in patients participating in a self-management behavior-modification (SMBM) program.This was a 12-week, randomized, partially double-blind, placebo-controlled, parallel-group trial in patients with COPD (PHYSACTO; NCT02085161). All patients were enrolled into SMBM and randomized 1:1:1:1 to once-daily placebo, tiotropium 5 μg, tiotropium/olodaterol 5/5 μg, or tiotropium/olodaterol 5/5 μg plus 8 weeks ExT. EET, measured by endurance shuttle walk test after 8 weeks, was the primary endpoint. Additional endpoints assessed downstream effects on PA (measured via accelerometry), and activity-related dyspnea and difficulty (using validated patient-reported questionnaires).SMBM plus tiotropium/olodaterol, with or without ExT, significantly improved EET at Week 8 versus SMBM plus placebo (treatment ratio vs. placebo: with ExT, 1.46; 95% confidence interval, 1.20-1.78; P = 0.0002; without ExT, 1.29; 95% confidence interval, 1.06-1.57; P = 0.0109). No significant increases in steps per day from baseline were observed over SMBM plus placebo at Week 12 (increase of 1,098) when other therapies were added. Adding tiotropium/olodaterol, with or without ExT, to SMBM reduced activity-related dyspnea versus placebo, whereas adding tiotropium/olodaterol plus ExT reduced activity-related difficulty.Tiotropium/olodaterol, with or without ExT, improved EET in patients with COPD taking part in an SMBM program. Combination bronchodilation, with or without ExT, did not provide additional increases in objective PA compared with SMBM alone but did reduce PA-related dyspnea and difficulty. Clinical trial registered with www.clinicaltrials.gov (NCT02085161).
Test urine before prescribing antibiotics for most UTIs, says NICE
Authors: Susan Mayor
Journal: BMJ (2018)

Healthcare professionals should ask patients about the severity and frequency of their symptoms before considering antibiotics for lower urinary tract infections (UTIs) and should send a midstream urine sample for antibiotic susceptibility testing in most cases, draft guidance from the National Institute for Health and Care Excellence (NICE) recommends.1

“Urinary infections can make people feel very uncomfortable and unwell, and in some cases may become serious,” said Tessa Lewis, a GP in Blaenavon, Wales, and chair of the NICE guidance committee on managing common infections. “It is important that we treat these infections with an …
C-Peptide Decline in Type 1 Diabetes Has Two Phases: An Initial Exponential Fall and a Subsequent Stable Phase
Authors: Beverley M. Shields, Timothy J. McDonald, Richard Oram, Anita Hill, Michelle Hudson, Pia Leete, Ewan R. Pearson, Sarah J. Richardson, Noel G. Morgan, Andrew T. Hattersley, Bart O. Roep, Tim I. Tree, Suzy Hammersley, Robert Bolt, Anita V. Hill
Journal: Diabetes Care (2018)

OBJECTIVE The decline in C-peptide in the 5 years after diagnosis of type 1 diabetes has been well studied, but little is known about the longer-term trajectory. We aimed to examine the association between log-transformed C-peptide levels and the duration of diabetes up to 40 years after diagnosis. RESEARCH DESIGN AND METHODS We assessed the pattern of association between urinary C-peptide/creatinine ratio (UCPCR) and duration of diabetes in cross-sectional data from 1,549 individuals with type 1 diabetes using nonlinear regression approaches. Findings were replicated in longitudinal follow-up data for both UCPCR (n = 161 individuals, 326 observations) and plasma C-peptide (n = 93 individuals, 473 observations). RESULTS We identified two clear phases of C-peptide decline: an initial exponential fall over 7 years (47% decrease/year [95% CI −51, −43]) followed by a stable period thereafter (+0.07%/year [−1.3, +1.5]). The two phases had similar durations and slopes in patients above and below the median age at diagnosis (10.8 years), although levels were lower in the younger patients irrespective of duration. Patterns were consistent in both longitudinal UCPCR (n = 162; ≤7 years duration: −48%/year [−55, −38]; &amp;gt;7 years duration −0.1% [−4.1, +3.9]) and plasma C-peptide (n = 93; &amp;gt;7 years duration only: −2.6% [−6.7, +1.5]). CONCLUSIONS These data support two clear phases of C-peptide decline: an initial exponential fall over a 7-year period, followed by a prolonged stabilization where C-peptide levels no longer decline. Understanding the pathophysiological and immunological differences between these two phases will give crucial insights into understanding β-cell survival.
The sociobiology of sociopathy : An integrated evolutionary model. Author's reply
Authors: L. Mealey, Sf Stoltenberg, Jl Hernandez Cruz, J. Stein
Journal: Behavioral and Brain Sciences (1997)

Sociopaths are outstanding members of society in two senses: politically, they draw our attention because of the inordinate amount of crime they commit, and psychologically, they hold our fascination because most of us cannot fathom the cold, detached way they repeatedly harm and manipulate others. Proximate explanations from behavior genetics, child development, personality theory, learning theory, and social psychology describe a complex interaction of genetic and physiological risk factors with demographic and micro environmental variables that predispose a portion of the population to chronic antisocial behavior. More recent, evolutionary and game theoretic models have tried to present an ultimate explanation of sociopathy as the expression of a frequency-dependent life strategy which is selected, in dynamic equilibrium, in response to certain varying environmental circumstances. This paper tries to integrate the proximate, developmental models with the ultimate, evolutionary ones, suggesting that two developmentally different etiologies of sociopathy emerge from two different evolutionary mechanisms. Social strategies for minimizing the incidence of sociopathic behavior in modern society should consider the two different etiologies and the factors that contribute to them.
Response to Comment on Chan et al. FGF23 Concentration andAPOL1Genotype Are Novel Predictors of Mortality in African Americans With Type 2 Diabetes. Diabetes Care 2018;41:178–186
Authors: Jasmin Divers, Barry I. Freedman
Journal: Diabetes Care (2018)

We thank Drs. Zheng and Wang for their comments (1) regarding fibroblast growth factor 23 (FGF23) compared with serum phosphorus concentration for prediction of mortality in the African American–Diabetes Heart Study (AA-DHS). Mildly elevated mean serum phosphorus concentrations and calcium-phosphorus products, well within their normal ranges, are cardiovascular disease risk factors and predict death in populations without chronic kidney disease (CKD) (2,3). The AA-DHS cohort permitted investigation of novel and conventional risk factors for cardiovascular disease and mortality in those with recent African ancestry at increased risk based upon the presence of type 2 diabetes (4). AA-DHS participants did not have advanced nephropathy at recruitment (median [25th, 75th percentile] estimated glomerular filtration rate 91.3 [76.4, 111.3] mL/min/1.73 m2), permitting analyses with low …
Poor maternal health explains high child mortality in England, comparison with Sweden finds
Authors: Susan Mayor
Journal: BMJ (2018)

Higher rates of premature births, lower birth weights, and more congenital abnormalities explain the much higher child mortality in England than in Sweden despite the two countries’ similar levels of economic development and universal healthcare, a comparative study has suggested.1

“While child deaths are still rare, the UK has one of the highest child mortality rates in western Europe,” said the lead author, Ania Zylbersztejn, from UCL Great Ormond Street Institute of Child Health in London, UK.

She added, “Babies born prematurely or with low birth weight have an increased risk of early death, and those …
Among patients being treated in addiction center, alcohol consumption increases the risk of hepatitis C seroconversion and the severity of hepatic fibrosis in those seropositive for hepatitis C virus
Authors: M. Doffoël, F. Habersetzer, T. Baumert, F.D. Nino, L. Jean-Philippe, E. Florence, H. Carmen, C. Frederic
Journal: Journal of Hepatology (2018)