tbuckley/cabot-search huggingface dataset:
Development of a smartphone-based rapid dual fluorescent diagnostic system for the simultaneous detection of influenza A and H5 subtype in avian influenza A-infected patients
Authors: Seon-Ju Yeo, Homan Kang, Tung Duy Dao, Bui Thi Cuc, Anh Thi Viet Nguyen, Trinh Thi Thuy Tien, Nguyen Le Khanh Hang, Hoang Vu Mai Phuong, Le Thi Thanh, Le Quynh Mai, Yoonhyuk Rah, Kyoungsik Yu, Ho-Joon Shin, Chom-Kyu Chong, Hak Soo Choi, Hyun Park
Journal: Theranostics (2018)

Accurate and rapid diagnosis of highly pathogenic avian influenza A H5N1 is of critical importance for the effective clinical management of patients.Here, we developed a rapid and simultaneous detection toolkit for influenza A H5 subtype viruses in human samples based on a bioconjugate of quantum dots (QDs) assembly and a smartphone-based rapid dual fluorescent diagnostic system (SRDFDS).Methods: Two types of QDs were assembled on a latex bead to enhance the detection sensitivity and specificity of influenza A infection (QD580) and H5 subtype (QD650).The dual signals of influenza A and H5 subtype of H5N1-infected patients were detected simultaneously and quantified separately by SRDFDS equipped with two emission filters.Results: Our results showed a high sensitivity of 92.86% (13/14) and 78.57% (11/14), and a specificity of 100% (38/38, P < 0.0001) and 97.37% (37/38) for influenza A and H5 subtype detection, respectively.Conclusion: Therefore, our multiplex QD bioconjugates and SRDFDS-based influenza virus detection toolkit potentially provide accurate and meaningful diagnosis information with improved detection accuracies and sensitivities for H5N1 patients.
Changes in symptom burden associated with exposure to outpatient palliative care in an integrated health system.
Authors: Eric C. Haupt, Ishita Sharma, Huong Q Nguyen
Journal: Journal of Clinical Oncology (2018)

204 Background: Patients with serious illnesses are often referred to palliative care (PC) for symptom management, advance care planning, and goals-of-care discussions. The purpose of this analysis is to describe the symptom burden (SB) and short-term changes in patients receiving outpatient PC from nine clinics within an integrated health system in Southern California. Methods: We included 3,007 adults with cancer who completed the Edmonton Symptom Assessment System (ESAS) at the start of PC from 1/1/14 - 6/30/18. Patients were identified at baseline as having either a high SB if they scored ≥ 4 on at least two out of nine symptoms or low SB if they did not meet this threshold. We compared baseline socio-demographic and clinical characteristics between high SB and low SB patients. We also examined changes in the ESAS for patients with a follow-up survey at 30 ± 14 days after baseline. Results: Patients with high SB at presentation to PC tended to be younger and had comparable co-morbidities to patients with low SB. Availability of a follow-up ESAS was low but similar between groups (18%). Changes in the ESAS met published minimal clinically important differences (MCID) for the high SB patients whereas low SB patients showed worsening symptoms. Conclusions: We observed similar symptom burden in this community-based oncology patient population as other studies from specialized cancer centers. Greater effort is needed to standardize timing of follow-up assessments and integrating personalized symptom goals.[Table: see text]
Abstract 12142: Electrolyte Abnormalities and Risk of Sudden Death in the General Population
Authors: Audrey Uy-Evanado, Carmen Teodorescu, Kyndaron Reinier, Kumar Narayanan, Harpriya Chugh, Karen Gunson, Jonathan Jui, Sumeet S Chugh
Journal: Circulation (2015)

Introduction: Electrolyte abnormalities are a substrate for arrhythmogenesis and could be the trigger for sudden cardiac death (SCD). We sought to determine the potential role of electrolyte abnormalities, irrespective of kidney function, in the occurrence of sudden death in the community. Hypothesis: Electrolyte abnormalities increases the risk for SCD in the community regardless of kidney function. Methods: SCD cases and controls from a large population based study in Northwest US (approx 1 million population, 2002-2014) were included if age ≥18 yrs with creatinine clearance (CrCl) and serum electrolytes available for analysis. For cases, CrCl and electrolytes were required to be measured within 90 days of the SCD event. Demographics and lab results were analyzed using student t-tests and chi-square tests. Multiple logistic regression was used to estimate independent association of risk factors with SCD. Results: We evaluated 483 SCD cases (65.8% male) and 886 controls (66.4% male). Cases were more likely to be older (68.8±14.3 vs 67.2±11.3, p=0.03), of black race (9.8 vs 3.2%, p&lt;0.0001) and with worse CrCl (53.4±31.3 vs. 64.0±24.9 ml/min, p&lt;0.0001). Overall, cases had lower levels of mean Na (137.3±4.2 vs 138.3±3.4 mEq/L, p&lt;0.0001), Ca (9.0±0.7 vs 9.2±0.5 mg/dl, p&lt;0.0001) and Mg (2.0±0.5 vs 2.1±0.4 mg/dl, p=0.007); and higher mean K (4.2±0.6 vs 4.1 ±0.5mEq/L, p=0.0008). Prevalence of hyponatremia (&lt;136mEq/L), hyperkalemia (&gt;5.2mEq/L), hypocalcemia (&lt;8.5 mg/dl) and hypomagnesemia (&lt;1.7 mg/dl) were also higher in cases (27.0 vs 16.2%, p&lt;0.0001; 6.1 vs 1.4%, p&lt;0.0001; 19.7 vs 7.9%, p&lt;0.0001 and 20.4 vs 8.3%, p&lt;0.0001, respectively). Adjusting for age, race and kidney function only hyperkalemia [OR 4.65 (95% CI 1.37-15.81), p=0.01], hypocalcemia [2.94 (1.68-5.13), p=0.0001] and hypomagnesemia [2.52 (1.36-4.66), p=0.003] remained significant, conferring a more than two to five-fold increase in SCD risk. Conclusions: Electrolyte abnormalities remain independently associated with increased risk of SCD in the community, even after adjusting for renal function.
Children Present a Window of Opportunity for Promoting Health
Authors: Rodrigo Fernandez-Jimenez, Mohamed Al-Kazaz, Risa Jaslow, Isabel Carvajal, Valentin Fuster
Journal: Journal of the American College of Cardiology (2018)

Cardiovascular disease is the leading cause of death and disability in the world, largely because of risk factors modifiable by changes in behavior. There is evolving evidence that our behavior as adults has its roots in the environment that we live in from early childhood. Early sustained multicomponent educational programs focused on health promotion in children may represent a window of opportunity to potentially prevent disease in adulthood. The integration of school-based, family-based, and community-based strategies, along with the support of public policies, are likely necessary for the success of these programs. In this review, the authors describe the future of promoting health. Specifically: 1) reasons why children should be a focus for health promotion (alarming trends of risk factors, association between unhealthy factors and subclinical disease, and cost-effectiveness); 2) strategies for health promotion in children (school-based, family-based, and community-based approaches) along with legislative efforts; and 3) research gaps are discussed.
Enteric fungal microbiota dysbiosis and ecological alterations in colorectal cancer
Authors: Olabisi Oluwabukola Coker, Geicho Nakatsu, Rudin Zhenwei Dai, William Ka Kei Wu, Sunny Hei Wong, Siew Chien Ng, Francis Ka Leung Chan, Joseph Jao Yiu Sung, Jun Yu
Journal: Gut (2018)

Objectives Bacteriome and virome alterations are associated with colorectal cancer (CRC). Nevertheless, the gut fungal microbiota in CRC remains largely unexplored. We aimed to characterise enteric mycobiome in CRC. Design Faecal shotgun metagenomic sequences of 184 patients with CRC, 197 patients with adenoma and 204 control subjects from Hong Kong were analysed (discovery cohort: 73 patients with CRC and 92 control subjects; validation cohort: 111 patients with CRC, 197 patients with adenoma and 112 controls from Hong Kong). CRC-associated fungal markers and ecological changes were also validated in additional independent cohorts of 90 patients with CRC, 42 patients with adenoma and 66 control subjects of published repository sequences from Germany and France. Assignment of taxonomies was performed by exact k-mer alignment against an integrated microbial reference genome database. Results Principal component analysis revealed separate clusters for CRC and control (p&lt;0.0001), with distinct mycobiomes in early-stage and late-stage CRC (p=0.0048). Basidiomycota:Ascomycota ratio was higher in CRC (p=0.0042), with increase in Malasseziomycetes (p&lt;0.0001) and decrease in Saccharomycetes (p&lt;0.0001) and Pneumocystidomycetes (p=0.0017). Abundances of 14 fungal biomarkers distinguished CRC from controls with an area under the receiver-operating characteristic curve (AUC) of 0.93 and validated AUCs of 0.82 and 0.74 in independent Chinese cohort V1 and European cohort V2, respectively. Further ecological analysis revealed higher numbers of co-occurring fungal intrakingdom and co-exclusive bacterial–fungal correlations in CRC (p&lt;0.0001). Moreover, co-occurrence interactions between fungi and bacteria, mostly contributed by fungal Ascomycota and bacterial Proteobacteria in control, were reverted to co-exclusive interplay in CRC (p=0.00045). Conclusions This study revealed CRC-associated mycobiome dysbiosis characterised by altered fungal composition and ecology, signifying that the gut mycobiome might play a role in CRC.
Endoscopic ultrasound measurements for detection of residual disease after neoadjuvant chemoradiotherapy for esophageal cancer
Authors: Ruben van der Bogt, Bo Noordman, Kausilia Krishnadath, Carlijn Roumans, Erik Schoon, Liekele Oostenbrug, Peter Siersema, Frank Vleggaar, J. van Lanschot, Manon Spaander
Journal: Endoscopy (2018)

Abstract Background Endoscopic ultrasound (EUS) measurements of residual thickness and residual area have been suggested to correlate with histopathological residual tumor after neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer. This study assessed the predictive value of EUS-based measurements using tumor thickness and tumor area before nCRT, and residual thickness and residual area 6 and 12 weeks after completion of nCRT for detection of residual disease. Methods This was a substudy of the diagnostic multicenter preSANO trial. The primary end point of the current study was the percentage of tumor regression grade (TRG) 3 – 4 (&gt; 10 % vital tumor cells) residual disease that was detected using EUS-based measurements. Associations of absolute measurements of residual thickness/area and proportional change compared with baseline were evaluated. In the case of a statistically significant association, optimal cut-offs to distinguish TRG3 – 4 residual disease from TRG1 (no vital tumor cells) were determined using Youden’s J index. Results 138 patients were included. Residual thickness and residual area were statistically significantly associated with TRG3 – 4 residual disease 12 weeks after completion of nCRT (odds ratio 1.36, P &lt; 0.01 and 1.64, P = 0.02, respectively). The cut-off for residual thickness was 4.5 mm, which correctly detected 87 % of TRG3 – 4 residual disease and 52 % of TRG1. The cut-off for residual area was 0.92 cm2, which detected 89 % of TRG3 – 4 residual disease and 40 % of TRG1. Conclusions EUS measurements of residual thickness and residual area adequately detected TRG3 – 4 residual disease with a sensitivity of almost 90 % 12 weeks after completion of nCRT. Hence, residual thickness and residual area may aid in the restaging of esophageal cancer after nCRT.
Changes in the US Burden of Chronic Kidney Disease From 2002 to 2016
Authors: Benjamin Bowe, Yan Xie, Tingting Li, Ali H. Mokdad, Hong Xian, Yan Yan, Geetha Maddukuri, Ziyad Al-Aly
Journal: JAMA Network Open (2018)

<h3>Introduction</h3> Over the past 15 years, changes in demographic, social, and epidemiologic trends occurred in the United States. These changes likely contributed to changes in chronic kidney disease (CKD) epidemiology. <h3>Objective</h3> To describe the change in burden of CKD at the US state level from 2002 to 2016. <h3>Design, Setting, and Participants</h3> This systematic analysis used data and methodologies from the 2016 Global Burden of Disease study in the United States. Data on CKD from 2002 to 2016 were examined at the state level. <h3>Main Outcomes and Measures</h3> Disability-adjusted life years (DALYs) and death due to CKD. <h3>Results</h3> In this analysis of data from individuals in the United States, from 2002 to 2016, CKD DALYs increased by 52.6%, from 1 269 049 DALYs (95% uncertainty interval [UI], 1 154 521-1 387 008) to 1 935 954 DALYs (95% UI, 1 747 356-2 124 795). Death due to CKD increased by 58.3%, from 52 127 deaths (95% UI, 51 082-53 076) to 82 539 deaths (95% UI, 80 298-84 652). All states exhibited increases in CKD burden, but the rate of change (2002-2016) and the burden in 2016 varied by state. States in the southern United States (including Mississippi and Louisiana) exhibited more than twice the burden seen in other states (eg, the age-standardized CKD DALY rate in Vermont was 321 [95% UI, 281-363] per 100 000 population, whereas the rate in Mississippi was 697 [95% UI, 620-779] per 100 000 population). In the United States, the increase in CKD DALYs was attributable to increased risk exposure (40.3%), aging (32.3%), and population growth (27.4%). Age-standardized CKD DALY rates increased by 18.6% where increases in metabolic, and to a lesser extent dietary, risk factors contributed 93.8% and 5.3% of this change, respectively. Chronic kidney disease due to diabetes was the primary contributor for the 26.8% increased probability of death due to CKD among the population aged 20 to 54 years; among the population aged 55 to 89 years, the probability of death due to CKD increased by 25.6% and was driven by CKD due to diabetes and decreased probability of death from causes other than CKD. Improvement in sociodemographic development was coupled with an increase in age-standardized CKD DALY rates that occurred at a faster pace than that of other noncommunicable diseases in the United States. <h3>Conclusions and Relevance</h3> Our findings revealed that between 2002 and 2016, the burden of CKD in the United States appeared to be increasing and variable among states. These changes may be associated with increased risk exposure and demographic expansion leading to increased probability of death due to CKD, especially among young adults. The findings suggest that an effort to target the reduction of CKD through greater attention to metabolic and dietary risks, especially among younger adults, is necessary.
Celebrating the best in South Asian healthcare: who won a BMJ award?
Authors: Jeetha D’Silva
Journal: BMJ (2018)

region's healthcare heroes is over-for this year, as Jeetha D'Silva reports from Chennai Jeetha D'Silva MumbaiOn 1 December the best of the region's medical community gathered in Chennai to honour the doctors and teams that showed innovativeness and excellence in healthcare at the BMJ Awards South Asia 2018.Competition for the awards, now in their fifth year, was intense, with 1575 nominations from nine countries-Afghanistan, Bangladesh, Bhutan, India, the Maldives, Myanmar, Nepal, Pakistan, and Sri Lanka-for 10 award categories (table).
Posterior, Anterior, and Periurethral Surgical Reconstruction of Urinary Continence Mechanisms in Robot-assisted Radical Prostatectomy: A Description and Video Compilation of Commonly Performed Surgical Techniques
Authors: André N. Vis, Henk G. van der Poel, Annebeth E.C. Ruiter, Jim C. Hu, Ashutosh K. Tewari, Bernardo Rocco, Vipul R. Patel, Sanjay Razdan, Jakko A. Nieuwenhuijzen
Journal: European Urology (2018)
Effects of interleukin-6 and tocilizumab on statin-induced apoptosis in melanoma cells.
Authors: Christoph Minichsdorfer, Christine Wasinger, Bihter Atil, Evelyn Sieczkowski, Martin Hohenegger
Journal: Journal of Clinical Oncology (2014)

e22212 Background: Statins induce apoptosis in tumour cells in vitro. Melanoma cells are especially susceptible to statin induced cell death. IL-6 can impair the growth of early stage melanoma, whereas metastatic melanoma cells are mostly resistant to the anti-proliferative effects of IL-6. Methods: We investigated the effects of IL-6 and the anti IL-6R antibody, tocilizumab, on advanced (A375, 518A2) and early (WM 35) melanoma cell lines. Secretion of IL-6 was measured with ELISA. The activity of caspase 3 after statin treatment was checked by cleavage of specific fluorescent caspase substrates. The induction of apoptosis was investigated by using AnnexinV/PI staining. Phsophorylation of Stat3 and the regulation of pro- (Bax, Bak) and anti-apoptotic proteins (Bcl-2, Bxl-XL) was studied by western blot. Proliferation was measured with cell cycle analysis using PI staining. Results: WM 35 do not secrete high amounts of IL-6 into their culture medium in contrast to A375 and 518A2 cells. Phosphorylation of Stat-3 was seen in all cell lines upon IL-6 stimulation, indicating that signalling ivia the IL-6 receptor is intact. Strikingly, WM35 cells are more resistant to simvastatin induced caspase 3 activation than A375 and 518A2 cells. The EC50values were 0,52μM (518A2) and 1,7μM (A375) in contrast to WM35 cells (16,7µM). Interestingly, co-treatment with IL-6 enhanced the statin induced apoptosis in WM35 cells, seen with AnnexinV/PI staining and caspase 3 activation. Furthermore it led to a decrease in the amount of Bcl-XL in WM35 cells, which may be responsible for the increased activation of apoptosis. These changes were not seen in A375 and 518A2 cells. The amount of Bax, Bak and Bcl-2 was unchanged in all cell lines upon IL-6 treatment. Finally the interruption of IL-6 signalling with tocilizumab had no effect on proliferation of 518A2, A375 and WM 35cells. Moreover the simvastatin induced caspase 3 activation was not changes by blocking the IL-6R in all three cell lines. Conclusions: Our final results prove the stage dependent effects of IL-6 on statin induced apoptosis in three different melanoma cell lines.IL-6 shows pro-apoptotic effects by down-regulation of Bcl-XL in WM 35, these effects are absent in advanced melanoma cell lines.
Association of Baseline Peptidylarginine Deiminase 4 Autoantibodies With Favorable Response to Treatment Escalation in Rheumatoid Arthritis
Authors: Erika Darrah, Fang Yu, Laura C. Cappelli, Antony Rosen, James R. O'Dell, Ted R. Mikuls
Journal: Arthritis & Rheumatology (2018)

Objective To determine if the baseline presence of autoantibodies to peptidylarginine deiminase 4 ( PAD 4) predicts therapeutic response to biologic and conventional disease‐modifying antirheumatic drugs ( DMARD s) in patients with rheumatoid arthritis ( RA ) in whom methotrexate ( MTX ) monotherapy was unsuccessful. Methods Baseline serum from 282 RA patients in whom MTX monotherapy was unsuccessful was screened for the presence of anti‐ PAD 4 antibodies by immunoprecipitation. Clinical response to either triple DMARD ( MTX , sulfasalazine, and hydroxychloroquine) or MTX /etanercept combination therapy was determined at 24 and 48 weeks post–treatment initiation. Disease activity was measured using the Disease Activity Score 28‐joint assessment ( DAS 28), and erosive disease was quantified using the Sharp/van der Heijde scoring method. Generalized estimating equations ( GEE s) were used to model the clinical responses to treatment in patients with and those without baseline anti‐ PAD 4 antibodies. Results Anti‐ PAD 4 antibody positivity was associated with male sex, a history of never smoking, and anti–citrullinated protein antibodies. At baseline, patients with anti‐ PAD 4 antibodies had longer disease duration and significantly more radiographic joint damage than anti‐ PAD 4–negative patients, but did not differ in disease activity according to the DAS 28. In unadjusted analyses and multivariable GEE models, patients with anti‐ PAD 4 antibodies exhibited greater improvements in DAS 28 (adjusted P = 0.02 and P = 0.008, respectively) and less radiographic progression (adjusted P = 0.01 and P = 0.002, respectively) compared to anti‐ PAD antibody–negative patients, independent of treatment received. Conclusion Although anti‐ PAD 4 antibodies were associated with worse baseline radiographic joint damage, suggesting a history of active or undiagnosed disease, treatment escalation therapy was more effective in reducing disease activity and slowing the progression of joint damage in this patient subset.
Empagliflozin Reduced Mortality and Hospitalization for Heart Failure Across the Spectrum of Cardiovascular Risk in the EMPA-REG OUTCOME Trial
Authors: David Fitchett, Silvio E. Inzucchi, Christopher P. Cannon, Darren K. McGuire, Benjamin M. Scirica, Odd Erik Johansen, Steven Sambevski, Stefan Kaspers, Egon Pfarr, Jyothis T. George, Bernard Zinman
Journal: Circulation (2019)

In the EMPA-REG OUTCOME trial (BI 10773 [Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) in patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease, in comparison with placebo, empagliflozin reduced the risks of 3-point major adverse cardiovascular events (3-point MACE), cardiovascular and all-cause death, and hospitalization for heart failure. We investigated whether these effects varied across the spectrum of baseline cardiovascular risk.
How family caregivers assist with upstream health care decision making by community-dwelling persons with advanced cancer: A qualitative study.
Authors: J Nicholas Dionne-Odom, Deborah Ejem, Rachel Wells, Amber Barnato, Richard Taylor, Gabrielle Betty Rocque, Yasemin E. Turkman, Thomas Ramsey, Matthew Kenny, Nataliya Ivankova, Marie Bakitas, Michelle Y. Martin
Journal: Journal of Clinical Oncology (2018)

13 Background: In the palliative care context, the family caregiver role in patients’ healthcare decision-making has focused on being a surrogate decision-maker at end of life. Less is known about family caregiver’s role in supporting upstream patient decision-making in advanced cancer. Methods: Qualitative descriptive study consisting of one-on-one, semi-structured interviews with persons with metastatic cancer and their family caregivers. We elicited family members’ perspectives on how they assist their relatives with any current and prospective healthcare decisions. Transcribed interviews were analyzed using a thematic analysis approach. Co-investigators reviewed and refined themes. Results: Caregivers (n = 20) averaged 56 years of age and were mostly female (95%), White (85%), and the patient’s partner/spouse (70%). Patients (n = 18) averaged 58 years of age and were mostly male (67%) in “fair” or “poor” health (50%) with genitourinary (33%), lung (17%), and hematologic (17%) cancers. Themes describing family member roles in supporting patients’ decision-making were: 1) seeking information about the cancer, its trajectory, and different treatments options; 2) identifying treatment and disease decision points, including decisions about seeking emergent care; 3) ensuring family members have a common understanding of the patient’s plan of care; 4) initiating and facilitating conversations with patients about coping, values, beliefs, and “what if” scenarios about current and potential future health states and treatments; 5) implementing choices (e.g., providing transportation) and addressing “spillover” decisions (e.g., work arrangements) resulting from medical treatment choices; and 6) making upstream healthcare decisions on behalf of patients who preferred to have decisions made by their family caregivers. Conclusions: These data highlight a previously unreported and understudied set of critical decision partnering roles that cancer family caregivers play in patient healthcare decision-making. Optimizing these roles may represent novel targets for early palliative care decision support interventions for family caregivers.