tbuckley/cabot-search huggingface dataset:
Measurement properties of three assessments of burden used in atopic dermatitis in adults
Authors: K.R. Patel, V. Singam, P.P. Vakharia, R. Chopra, R. Sacotte, N. Patel, S. Immaneni, R. Kantor, D.Y. Hsu, J.I. Silverberg
Journal: British Journal of Dermatology (2018)

Standardized quality-of-life (QoL) assessments can provide important and clinically relevant information. There is currently a lack of standardization in QoL assessments used in atopic dermatitis (AD).To determine the content validity, construct validity, internal consistency, differential reporting, responsiveness, floor or ceiling effects and feasibility of the Dermatology Life Quality Index (DLQI), Itchy Quality of Life (ItchyQoL) and 5-dimensions (5-D) itch scales for assessing burden of AD in adults and to compare their performance.Self-administered questionnaires and skin examination were performed in 340 adults with AD in a dermatology practice setting.DLQI, ItchyQoL and 5-D all had good content validity. DLQI, mean ItchyQoL and 5-D itch all had strong correlations with frequency of AD symptoms (Patient-Oriented Eczema Measure) and intensity of itch (numerical rating scale for itch), and moderate correlations with AD severity (Eczema Area and Severity Index and Scoring Atopic Dermatitis) (Spearman correlations, P < 0·001 for all). DLQI and 5-D itch showed good internal consistency (Cronbach's alpha = 0·89 and 0·84), although ItchyQoL appeared to have several redundant items (alpha = 0·96). Uniform and nonuniform differential item functioning by age, sex and/or race/ethnicity was found for multiple items in DLQI, ItchyQoL and 5-D itch. DLQI, ItchyQoL and 5-D itch scores all demonstrated responsiveness, although ItchyQoL demonstrated the greatest responsiveness. There were no floor or ceiling effects for total scores. The median times for completion of DLQI, ItchyQoL and 5-D itch were 2 min.The DLQI, ItchyQoL and 5-D itch scales all showed good content and construct validity, and responsiveness in the assessment of AD in adults, and were feasible for use in clinical trials and practice.
Abstract 18183: Alpha1-Adrenoceptor Autoantibody Mediated Vascular Endothelial Cell Injury Partially Through Macrophage Activation
Authors: Li Yan, Fang Jie Liu, Huirong Liu, Ji-Min Cao
Journal: Circulation (2016)

Introduction: Autoantibodies against the second extracellular loop of the α1-adrenoceptor (α1-AA) exhibited sympathetic-like effects via binding to the α1-adrenoceptor, and clinical evidences showe...
Use of three-dimensional organoids and lung-on-a-chip methods to study lung development, regeneration and disease
Authors: Konstantinos Gkatzis, Sara Taghizadeh, Dongeun Huh, Didier Y.R. Stainier, Saverio Bellusci
Journal: European Respiratory Journal (2018)

Differences in lung anatomy between mice and humans, as well as frequently disappointing results when using animal models for drug discovery, emphasise the unmet need for in vitro models that can complement animal studies and improve our understanding of human lung physiology, regeneration and disease. Recent papers have highlighted the use of three-dimensional organoids and organs-on-a-chip to mimic tissue morphogenesis and function in vitro . Here, we focus on the respiratory system and provide an overview of these in vitro models, which can be derived from primary lung cells and pluripotent stem cells, as well as healthy or diseased lungs. We emphasise their potential application in studies of respiratory development, regeneration and disease modelling.
Case 30-2018: A 66-Year-Old Woman with Chronic Abdominal Pain
Authors: Anna K. Rubin, Kristine S. Burk, Kyle Staller, Hiroko Kunitake, Gregory K. Robbins, Vikram Deshpande
Journal: New England Journal of Medicine (2018)

A 66-year-old woman from Guatemala presented to a community health center for treatment of latent tuberculosis infection. She reported a 2-month history of abdominal pain. Evaluation revealed a nonobstructing mass in the ascending colon. A diagnosis was made.
Timing of Loading Dose of Atorvastatin in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes
Authors: Renato D. Lopes, Pedro G. M. de Barros e Silva, Isabella de Andrade Jesuíno, Eliana Vieira Santucci, Lilian Mazza Barbosa, Lucas Petri Damiani, Renato Hideo Nakagawa Santos, Ligia Nasi Laranjeira, Frederico Toledo Campo Dall Orto, Pedro Beraldo de Andrade, Igor Ribeiro de Castro Bienert, John H. Alexander, Christopher B. Granger, Otavio Berwanger
Journal: JAMA Cardiology (2018)

Loading doses of atorvastatin did not show reduction on clinical outcomes in the overall population of patients with acute coronary syndrome (ACS) enrolled in the Statins Evaluation in Coronary Procedures and Revascularization (SECURE-PCI) trial, but a potential benefit was identified in patients who subsequently underwent percutaneous coronary intervention (PCI).To determine whether periprocedural loading doses of atorvastatin are associated with decreased 30-day major adverse cardiovascular events (MACE) in patients with ACS undergoing PCI according to type of ACS and timing of atorvastatin administration before PCI.Secondary analysis of a multicenter, double-blind, placebo-controlled, randomized clinical trial conducted at 53 sites that enrolled 4191 patients with ACS intended to be treated with PCI between April 18, 2012, and October 06, 2017.Patients were randomized to 2 loading doses of 80 mg of atorvastatin or matching placebo before and 24 hours after a planned PCI. By protocol, all patients (regardless of treatment group) received 40 mg of atorvastatin for 30 days starting 24 hours after the second dose of study medication.The primary outcome was MACE through 30 days, composed by all-cause mortality, myocardial infarction, stroke, and unplanned coronary revascularization. Cox regression models adjusting for key baseline characteristics were used to assess the association between atorvastatin and MACE in patients undergoing PCI.From the overall trial population, 2710 (64.7%) underwent PCI (650 women [24.0%]; mean [SD] age, 62 [11.3] years). Loading atorvastatin was associated with reduced MACE at 30 days by 28% in the PCI group (adjusted hazard ratio [HR], 0.72; 95% CI 0.54-0.97; P = .03). Loading dose of atorvastatin was administered less than 12 hours before PCI in 2548 patients (95.3%) (45.1% < 2 hours and 54.3% between 2 and 12 hours). There was no significant interaction between treatment effect and timing of study drug administration. The treatment effect of loading atorvastatin was more pronounced in patients with ST-segment elevation myocardial infarction than in patients with non-ST-segment elevation ACS (adjusted HR, 0.59; 95% CI, 0.38-0.92; P = .02; HR, 0.85; 95% CI, 0.58-1.27; P = .43, respectively).In patients with ACS undergoing PCI, periprocedural loading doses of atorvastatin appeared to reduce the rate of MACE at 30 days, most clearly in patients with ST-segment elevation myocardial infarction. This beneficial effect seemed to be preserved and consistent, irrespective of the timing of atorvastatin administration, including within 2 hours before PCI.clinicaltrials.gov Identifier: NCT01448642.
Cancer survivorship care plans time and effort.
Authors: Megan Begnoche, Camille Higel-Mcgovern, Tara Szymanski, Susan F. Korber, Mary Anne Fenton
Journal: Journal of Clinical Oncology (2018)

146 Background: The Lifespan Cancer Institute (LCI) is one program based at three hospitals in the Lifespan healthcare system, a main teaching affiliate of Brown Medical School. All sites are ASCO QOPI certified. In 2017, 1,742 patients from radiation, surgical, and medical oncology were diagnosed and/or treated for cancer. The Commission on Cancer guidelines specify patients with a new diagnosis of cancer treated with curative intent receive a survivorship care plan (SCP) within one year of diagnosis extended to 18 months for those receiving hormone therapy. Methods: The LCI Quality team is a multidisciplinary group comprised of nursing, leadership, physicians, midlevel providers, administrative assistants, and tumor registry staff. Our Quality Improvement Project for 2017 was generation and distribution of survivorship care plans to 50% of eligible patients. Our project underwent 5 plan/do/study/act cycles (PDSA). Prior to the intervention only 271 care plans were prepared and delivered for 2016 diagnoses. Results: For the total 2017 diagnoses, 843 eligible patients were treated within the LCI (medical and radiation oncology). Survivorship Care plans completed by midlevel providers were generated and distributed to 100% of LCI patients during January -April 2018 (244 in total), a 37% increase compared to the same timeframe, one year previous. The electronic medical record provides tools for SCP preparation including auto population of demographics and chemotherapy plan. Staging, radiation, and surgery are manually entered. On average, each SCP required 1 hour to complete for approximately 244 hours of midlevel provider time for January -April 2018. This abstract’s time and effort does not include the time for patient calls, survivorship visits or administrative monitoring. Conclusions: Survivorship care plans provide patients and primary care providers a summary of the treatment plan and recommendations for follow up/survivorship goals in transitions of care. Significant time and effort is required to generate an individual SCP therefore the goal should be to increase electronic efficiencies within the medical record, and focus on the clinically relevant patient population who are most likely to survive 5 years and be impacted by diagnosis and treatment.
SAFE Initiative: A step closer to a positive safety culture and improved patient experience.
Authors: Cherie Walters, Caitlin Byler, Melissa Hyatt, Claudine Jreissaty, Timisha Joe, April Thomas, Jennefer Mejicanos, Regina F. Smith, Victor Hassid
Journal: Journal of Clinical Oncology (2018)

249 Background: A positive safety culture is a major characteristic of a high reliability organization (HRO). At The University of Texas MD Anderson Cancer Center, safety is our leading service excellence standard, and because of this, creating a positive safety culture throughout the institution is a top priority. At MD Anderson Sugar Land, we sought to create, improve, and foster a culture of safety throughout all levels of our campus by implementing a new initiative. Methods: The Safe, Attentive, Focused, Engaged (SAFE™) initiative was conceptualized by our leadership team at MD Anderson Sugar Land to improve our safety culture. Improvements were measured by the number of reported safety events, the amount of employee engagement at our weekly safety meetings, and participation in and scores from MD Anderson’s institutional Culture of Safety survey. Results: The SAFE initiative was implemented in April 2017. During the 12 months before its implementation, the average monthly number of reported safety events for our campus was 7.17. During the 12 months after implementation, the average monthly number of reported safety events for our campus was 12.75, a 78% increase over the previous 12 months. An increase in the number of reported events is a key indicator of our move toward a more positive safety culture. Qualitatively, we saw a noticeable increase in attendance and participation in our weekly safety meetings. Furthermore, in February 2018, an institution-wide Culture of Safety survey was distributed, and MD Anderson Sugar Land had 100% participation compared with 87% across MD Anderson as a whole. MD Anderson Sugar Land scored above national benchmarks in 10 of the 14 domains surveyed. Conclusions: A positive safety culture is a requirement for health care organizations to be considered HROs. Identification of methods to achieve that goal can be challenging and time-consuming. At MD Anderson Sugar Land, we implemented an initiative that proved to have a meaningful impact on creating a positive safety culture. Limitations and challenges are continuously being identified, discussed, and addressed among our entire workforce with the goal of improving our culture of safety.
Comparison of Populations Served in Hospital Service Areas With and Without Comprehensive Primary Care Plus Medical Homes
Authors: Taressa K. Fraze, Elliott S. Fisher, Marisa R. Tomaino, Kristen A. Peck, Ellen Meara
Journal: JAMA Network Open (2018)

<h3>Importance</h3> Little is known about the types of primary care practices that have chosen to participate in the Comprehensive Primary Care Plus (CPC+) program or about how participation could affect disparities. <h3>Objective</h3> To describe practices that joined the CPC+ model and compare hospital service areas with and without CPC+ practices. <h3>Design, Setting, and Participants</h3> This comparative cross-sectional study identified 2647 CPC+ practices in round 1 (from January 1, 2017; round 1 is ongoing through 2021). Using IMS Health Care Organization Services data, ownership and characteristics of health systems and practices were extracted. Practices participating in the CPC+ program were compared with practices with similar proportions of primary care physicians (&gt;85%) within the 14 regions designated as eligible to participate by the Centers for Medicare &amp; Medicaid Services. Within eligible regions, hospital service areas with (n = 434) and without (n = 322) 1 or more CPC+ practice were compared. Characteristics compared included area-level population demographics (from the US Census Bureau), health system characteristics (from the IMS Health Care Organization Services), and use of health services by Medicare fee-for-service enrollees (Dartmouth Atlas). <h3>Main Outcomes and Measures</h3> Area-level characteristics of all eligible CPC+ regions, areas without a CPC+ practice, and areas with 1 or more CPC+ practices. <h3>Results</h3> Of 756 eligible service areas, 322 had no CPC+ practices and 434 had at least 1 CPC+ practice. Of 2647 CPC+ practices, 579 (21.9%) had 1 physician and 1791 (67.7%) had 2 to 10 physicians. In areas without CPC+ practices, the population had a lower median income ($43 197 [interquartile range, $42 170-$44 224] vs $57 206 [interquartile range, $55 470-$58 941]), higher mean share of households living in poverty (17.8% [95% CI, 17.2%-18.4%] vs 14.4% [95% CI, 13.9%-15.0%]), higher mean educational attainment of high school or less (52.7% [95% CI, 51.7%-53.6%] vs 43.1% [95% CI, 42.1%-44.2%]), higher mean proportion of disabled residents (17.7% [95% CI, 17.3%-18.2%] vs 14.2% [13.8%-14.6%]), higher mean participation in Medicare (21.9% [95% CI, 21.3%-22.4%] vs 18.8% [95% CI, 18.3%-19.1%]) and Medicaid (22.2% [95% CI, 21.5%-22.9%]) vs 18.5% [95% CI, 17.8%-19.2%]), and higher mean proportion of uninsured residents (12.4% [95% CI, 11.9%-12.9%] vs 10.3% [95% CI, 9.9%-10.7%]) (<i>P</i>&lt; .001 for all) compared with areas that had a CPC+ practice. <h3>Conclusions and Relevance</h3> According to this study, although a diverse set of practices joined the CPC+ program, practices in areas characterized by patient populations with greater advantage were more likely to join, which may affect access to advanced primary care medical home models such as CPC+, by vulnerable populations.
Quantifying the burden of stillbirths before 28 weeks of completed gestational age in high-income countries: a population-based study of 19 European countries
Authors: Lucy K Smith, Ashna D Hindori-Mohangoo, Marie Delnord, Mélanie Durox, Katarzyna Szamotulska, Alison Macfarlane, Sophie Alexander, Henrique Barros, Mika Gissler, Béatrice Blondel, Jennifer Zeitlin, Gerald Haidinger, Sophie Alexander, Rumyana Kolarova, Urelija Rodin, Theopisti Kyprianou, Petr Velebil, Laust Mortensen, Luule Sakkeus, Mika Gissler, Béatrice Blondel, Günther Heller, Nicholas Lack, Aris Antsaklis, István Berbik, Helga Sól Ólafsdóttir, Sheelagh Bonham, Marina Cuttini, Janis Misins, Jelena Isakova, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Kari Klungsøyr, Katarzyna Szamotulska, Henrique Barros, Mihai Horga, Jan Cap, Natasa Tul, Francisco Bolúmar, Karin Gottvall, Karin Källén, Sylvan Berrut, Mélanie Riggenbach, Alison Macfarlane
Journal: The Lancet (2018)
Association of Same-Day Discharge After Elective Percutaneous Coronary Intervention in the United States With Costs and Outcomes
Authors: Amit P. Amin, Duane Pinto, John A. House, Sunil V. Rao, John A. Spertus, Mauricio G. Cohen, Samir Pancholy, Adam C. Salisbury, Mamas A. Mamas, Nathan Frogge, Jasvindar Singh, John Lasala, Frederick A. Masoudi, Steven M. Bradley, Jason H. Wasfy, Thomas M. Maddox, Hemant Kulkarni
Journal: JAMA Cardiology (2018)

Same-day discharge (SDD) after elective percutaneous coronary intervention (PCI) is associated with lower costs and preferred by patients. However, to our knowledge, contemporary patterns of SDD after elective PCI with respect to the incidence, hospital variation, trends, costs, and safety outcomes in the United States are unknown.To examine (1) the incidence and trends in SDD; (2) hospital variation in SDD; (3) the association between SDD and readmissions for bleeding, acute kidney injury (AKI), acute myocardial infarction (AMI), or mortality at 30, 90, and 365 days after PCI; and (4) hospital costs of SDD and its drivers.This observational cross-sectional cohort study included 672 470 patients enrolled in the nationally representative Premier Healthcare Database who underwent elective PCI from 493 hospitals between January 2006 and December 2015 with 1-year follow-up.Same-day discharge, defined by identical dates of admission, PCI procedure, and discharge.Death, bleeding requiring a blood transfusion, AKI and AMI at 30, 90, or 365 days after PCI, and costs from hospitals' perspective, inflated to 2016.Among 672 470 elective PCIs, 221 997 patients (33.0%) were women, 30 711 (4.6%) were Hispanic, 51 961 (7.7%) were African American, and 491 823 (73.1%) were white. The adjusted rate of SDD was 3.5% (95% CI, 3.0%-4.0%), which increased from 0.4% in 2006 to 6.3% in 2015. We observed substantial hospital variation for SDD from 0% to 83% (median incidence rate ratio, 3.82; 95% CI, 3.48-4.23), implying an average (median) 382% likelihood of SDD at one vs another hospital. Among SDD (vs non-SDD) patients, there was no higher risk of death, bleeding, AKI, or AMI at 30, 90, or 365 days. Same-day discharge was associated with a large cost savings of $5128 per procedure (95% CI, $5006-$5248), driven by reduced supply and room and boarding costs. A shift from existing SDD practices to match top-decile SDD hospitals could annually save $129 million in this sample and $577 million if adopted throughout the United States. However, residual confounding may be present, limiting the precision of the cost estimates.Over 2006 to 2015, SDD after elective PCI was infrequent, with substantial hospital variation. Given the safety and large savings of more than $5000 per PCI associated with SDD, greater and more consistent use of SDD could markedly increase the overall value of PCI care.
First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer
Authors: Leora Horn, Aaron S Mansfield, Aleksandra Szczęsna, Libor Havel, Maciej Krzakowski, Maximilian J Hochmair, Florian Huemer, György Losonczy, Melissa L Johnson, Makoto Nishio, Martin Reck, Tony Mok, Sivuonthanh Lam, David S Shames, Juan Liu, Beiying Ding, Ariel Lopez-Chavez, Fairooz Kabbinavar, Wei Lin, Alan Sandler, Stephen V Liu
Journal: New England Journal of Medicine (2018)

Enhancing tumor-specific T-cell immunity by inhibiting programmed death ligand 1 (PD-L1)–programmed death 1 (PD-1) signaling has shown promise in the treatment of extensive-stage small-cell lung cancer. Combining checkpoint inhibition with cytotoxic chemotherapy may have a synergistic effect and improve efficacy.
Abstract 12124: Vitamin D Replacement Ameliorates Serum Lipoprotein Functions, Adipokine Profile and Subclinical Atherosclerosis in Pre-menopausal Women
Authors: Duygu Kocyigit, Daniela Greco, Maria P Adorni, Cinzia Marchi, Nicoletta Ronda, Franco Bernini, Kadri M Gurses, Hande Canpinar, Seda H Oguz, Dicle Guc, Alper Gurlek, Lale Tokgozoglu, Francesca Zimetti
Journal: Circulation (2017)

Introduction: Low vitamin D (vitD) status has been linked to increased cardiovascular (CV) risk, but the effects of vitD supplementation on CV disease and its determinants, such as lipid metabolism, are not entirely clarified. Hypothesis: We hypothesized that vitD may modulate lipoprotein functions, such as the HDL cholesterol efflux capacity (CEC), which is inversely correlated to CV risk, and the pro-atherogenic serum cholesterol loading capacity (CLC). We evaluated the impact of vitD status normalization on HDL CEC, serum CLC, adipokine profile and subclinical atherosclerosis in premenopausal women. Methods: Healthy premenopausal women with vitD deficiency (n=31) were scheduled for vitD replacement. HDL CEC was measured by a radioisotopic assay and serum CLC by cholesterol fluorimetric quantification in macrophages. Serum adipokines were measured by ELISA. Subclinical atherosclerosis was evaluated by flow-mediated dilation (FMD), pulse wave velocity (PWV) and augmentation index (AI), measured with stan...
Daratumumab-based therapy in patients with heavily-pretreated AL amyloidosis
Authors: Jithma P. Abeykoon, Saurabh Zanwar, Angela Dispenzieri, Morie A. Gertz, Nelson Leung, Taxiarchis Kourelis, Wilson Gonsalves, Eli Muchtar, David Dingli, Martha Q. Lacy, Suzanne R. Hayman, Francis Buadi, Rahma Warsame, Robert A. Kyle, Vincent Rajkumar, Shaji Kumar, Prashant Kapoor
Journal: Leukemia (2018)
Improving quality care through IT/analytics for team-based care interventions.
Authors: Georgina T. Rodgers, Jacob Lindberg
Journal: Journal of Clinical Oncology (2018)

316 Background: Team based care is essential to achieve coordinated, high-quality care. We recognized a responsibility to identify new treatment patients to provided targeted, team based interventions. Previous attempts at identifying new patients were difficult, manual, and delayed. Our aim was to provide personnel with the appropriate means to identify new patients for services such as patient education, financial navigation, social work assessments and outreach calls for care coordination. As a result of multiple barriers and challenges, only 51% of our new patients were being identified. This project fit well in the larger context of the transformation of health care delivery through our participation in the Oncology Care Model, which places an emphasis on team based care. Methods: We used the Plan-Do-Study-Act continuous improvement model to develop an automated data set to identify new treatment patients across the oncology service line and leveraged our Information Technology (IT) Analytics team. A report was established based utilizing logic to identify the first appointment scheduled within the department and a secondary tab to look back at new patients within a three week time frame. Information is housed within a business intelligence software system that is easy for end users to see and understand. The initial report was validated for accuracy at an identification rate of 93% and the 3 week “look back” report gives the ability to identify the remaining patients. Results: We have seen marked improvements metrics as a result of the utilization of this report. Our Financial Navigators have been able to improve out of pocket estimate calls to 98% in April of 2018. Social Work initial patient assessments have improved by 40%, post chemotherapy outreach calls from RN Care Coordinators have improved 12%, and we have seen a 20% increase in the number of documented oncology patient education encounters. Conclusions: This project demonstrates the value of using IT/Data Analytics for continuous quality improvement projects related to patient centered team based care. The cross collaboration of stakeholders in data analysis should be explored as a mechanism to transform care through key services and interventions.
Associations between 24 hour movement behaviours and global cognition in US children: a cross-sectional observational study
Authors: Jeremy J Walsh, Joel D Barnes, Jameason D Cameron, Gary S Goldfield, Jean-Philippe Chaput, Katie E Gunnell, Andrée-Anne Ledoux, Roger L Zemek, Mark S Tremblay
Journal: The Lancet Child & Adolescent Health (2018)