tbuckley/cabot-search huggingface dataset:
Abstract 19090: Ventricular Fibrillation Waveform Analysis to Predict Defibrillation Success in Out-of-Hospital Cardiac Arrest: Can the Amplitude Spectrum Area Be Used Throughout the Entire Resuscitation?
Authors: Joris Nas, Judith L Bonnes, Roeliene Starreveld, Jos Thannhauser, Gjerrit Meinsma, Pierre van Grunsven, Joep L Smeets, Menko Jan de Boer, Marc A Brouwer
Journal: Circulation (2016)

Introduction: Characteristics of the ventricular fibrillation (VF) waveform have been studied to guide timing of defibrillation during out-of-hospital cardiac arrest (OHCA). The Amplitude Spectrum ...
Association of Prenatal Maternal Depression and Anxiety Symptoms With Infant White Matter Microstructure
Authors: Douglas C. Dean, Elizabeth M. Planalp, William Wooten, Steven R. Kecskemeti, Nagesh Adluru, Cory K. Schmidt, Corrina Frye, Rasmus M. Birn, Cory A. Burghy, Nicole L. Schmidt, Martin A. Styner, Sarah J. Short, Ned H. Kalin, H. Hill Goldsmith, Andrew L. Alexander, Richard J. Davidson
Journal: JAMA Pediatrics (2018)

<h3>Importance</h3> Maternal depression and anxiety can have deleterious and lifelong consequences on child development. However, many aspects of the association of early brain development with maternal symptoms remain unclear. Understanding the timing of potential neurobiological alterations holds inherent value for the development and evaluation of future therapies and interventions. <h3>Objective</h3> To examine the association between exposure to prenatal maternal depression and anxiety symptoms and offspring white matter microstructure at 1 month of age. <h3>Design, Setting, and Participants</h3> This cohort study of 101 mother-infant dyads used a composite of depression and anxiety symptoms measured in mothers during the third trimester of pregnancy and measures of white matter microstructure characterized in the mothers' 1-month offspring using diffusion tensor imaging and neurite orientation dispersion and density imaging performed from October 1, 2014, to November 30, 2016. Magnetic resonance imaging was performed at an academic research facility during natural, nonsedated sleep. <h3>Main Outcomes and Measures</h3> Brain mapping algorithms and statistical models were used to evaluate the association between maternal depression and anxiety and 1-month infant white matter microstructure as measured by diffusion tensor imaging and neurite orientation dispersion and density imaging findings. <h3>Results</h3> In the 101 mother-infant dyads (mean [SD] age of mothers, 33.22 [3.99] years; mean age of infants at magnetic resonance imaging, 33.07 days [range, 18-50 days]; 92 white mothers [91.1%]; 53 male infants [52.5%]), lower 1-month white matter microstructure (decreased neurite density and increased mean, radial, and axial diffusivity) was associated in right frontal white matter microstructure with higher prenatal maternal symptoms of depression and anxiety. Significant sex × symptom interactions with measures of white matter microstructure were also observed, suggesting that white matter development may be differentially sensitive to maternal depression and anxiety symptoms in males and females during the prenatal period. <h3>Conclusions and Relevance</h3> These data highlight the importance of the prenatal period to early brain development and suggest that the underlying white matter microstructure is associated with the continuum of prenatal maternal depression and anxiety symptoms.
How to reduce the waiting time for the first consultation with the rheumatologist as a first step for a timely treatment
Authors: Omar Valenzuela, Sebastián E Ibáñez Vodnizza
Journal: Annals of the Rheumatic Diseases (2018)

In Chile, the guaranteed therapy for rheumatoid arthritis did not consider biological drugs until 2015, when Law 20850 was promulgated.1 The criteria to start biological treatment and the follow-up periods differ from validated treat to target (T2T) strategies,2 allowing access only to patients who remain with a disease activity Score-28 with erythrocite sedimentation rate (DAS28-ESR) >5.1 despite 6 months of treatment with three non-biological disease-modifying antirheumatic drugs (DMARDs).3 Our results of the application of this law during the first year were recently published.4 

The implementation of this law allowed us to identify difficulties to implement a successful T2T strategy: (1) access to the rheumatologist; (2) impossibility of carrying out an early control because of absence of medical hours; (3) limitation in the therapeutic …
Abstract 15941: The Predictive Value of Low Grade Inflammation and Endothelial Function in Patients Presenting With Chest Pain
Authors: Evangelos Oikonomou, Antigoni Miliou, Alexis Antonopoulos, Gerasimos Siasos, Nikolaos Papageorgiou, Georgios Hatzis, Kostas Mourouzis, Harilila Ververeli, Fay Zacharia, Georgia Vogiatzi, Georgios Angelos Papamikroulis, Dimitris Tousoulis
Journal: Circulation (2016)

Introduction: Endothelial dysfunction and proinflammatory mediators are strongly related with atherosclerosis development. Routine assessment of plasma inflammatory biomarkers and endothelial funct...
Practice pattern changes and improvements in hematopoietic cell transplantation for primary immunodeficiencies
Authors: Rebecca A. Marsh, Kyle M. Hebert, Daniel Keesler, Jaap J. Boelens, Christopher C. Dvorak, Michael J. Eckrich, Neena Kapoor, Suhag Parikh, Mary Eapen
Journal: Journal of Allergy and Clinical Immunology (2018)
Type 2 Poliovirus Detection after Global Withdrawal of Trivalent Oral Vaccine
Authors: Isobel M. Blake, Margarita Pons-Salort, Natalie A. Molodecky, Ousmane M. Diop, Paul Chenoweth, Ananda S. Bandyopadhyay, Michel Zaffran, Roland W. Sutter, Nicholas C. Grassly
Journal: New England Journal of Medicine (2018)

Mass campaigns with oral poliovirus vaccine (OPV) have brought the world close to the eradication of wild poliovirus. However, to complete eradication, OPV must itself be withdrawn to prevent outbreaks of vaccine-derived poliovirus (VDPV). Synchronized global withdrawal of OPV began with serotype 2 OPV (OPV2) in April 2016, which presented the first test of the feasibility of eradicating all polioviruses.
Exome Analysis Reveals Genomic Markers Associated with Better Efficacy of Nivolumab in Lung Cancer Patients
Authors: Corentin Richard, Jean-David Fumet, Sandy Chevrier, Valentin Derangère, Fanny Ledys, Aurélie Lagrange, Laure Favier, Bruno Coudert, Laurent Arnould, Caroline Truntzer, Romain Boidot, François Ghiringhelli
Journal: Clinical Cancer Research (2018)

Abstract Purpose: Immune checkpoint inhibitors revolutionized the treatment of non-small cell lung cancer (NSCLC). However, only one-quarter of patients benefit from these new therapies. PD-L1 assessment and tumor mutational burden (TMB) are available tools to optimize use of checkpoint inhibitors but novel tools are needed. Exome sequencing could generate many variables but their role in identifying predictors of response is unknown. Experimental Design: We performed somatic and constitutional exome analyses for 77 patients with NSCLC treated with nivolumab. We studied: one-tumor-related characteristics: aneuploidy, CNA clonality, mutational signatures, TMB, mutations in WNT, AKT, MAPK, and DNA repair pathways, and two-immunologic characteristics: number of intratumoral TCR clones, HLA types, and number of neoantigens; and six clinical parameters. Results: A high TMB per Mb, a high number of neoantigens, mutational signatures 1A and 1B, mutations in DNA repair pathways, and a low number of TCR clones are associated with greater PFS. Using a LASSO method, we established an exome-based model with nine exome parameters that could discriminate patients with good or poor PFS (P &amp;lt; 0.0001) and overall survival (P = 0.002). This model shows better ability to predict outcomes compared with a PD-L1 clinical model with or without TMB. It was externally validated on two cohorts of patients with NSCLC treated with pembrolizumab or with nivolumab and ipilimumab as well as in urothelial tumors treated with atezolizumab. Conclusions: Altogether, these data provide a validated biomarker that predicts the efficacy of nivolumab or pembrolizumab in patients with NSCLC. Our biomarker seems to be superior to PD-L1 labeling and TMB models.
Risk of Treatment Failure: Response to Czobor and Volavka
Authors: Jari Tiihonen, Antti Tanskanen, Heidi Taipale
Journal: American Journal of Psychiatry (2018)

Examining the absolute risk of treatment failure using the Kaplan-Meier survival functions in the four antipsychotic discontinuation groups (see Figure 2 in the original article), we find that the risk fails to increase with increasing duration of antipsychotic exposures.In fact, the survival functions show that until approximately 10 years of followup, the absolute risk of treatment failure decreases with longer prior antipsychotic exposures.Overall, these data do not support the conclusion that discontinuation is more difficult when antipsychotic exposure has been longer.The apparent increase of relative risk of treatment failure with increasing antipsychotic exposures before discontinuation may be partly due to the "depletion of susceptibles," which represents a differential attrition of those subjects from the risk set who are susceptible to the outcome of interest.In Tiihonen et al.'s study, antipsychotic continuers who were susceptible to relapse (perhaps those receiving ineffective treatment) were increasingly likely to discontinue with the passage of time.Confounding due to depletion of susceptibles may have been enhanced by the study design: patients who were rehospitalized before matching were excluded.Inspection of the survival functions suggests that the relative risk increases with time were not due to increases in relapse rates among discontinuers but were mostly driven by the progressively lower risks of relapse in the control (continuers) group.Potential long-term improvers also require consideration.About 30% of the early discontinuers were not rehospitalized.Perhaps 20%230% of patients with schizophrenia improve and then maintain remission for sustained periods after discontinuing antipsychotics (2).Nevertheless, the analyses made no provision for the possibility that some non-rehospitalized patients may have remitted.The standard Cox proportional hazards model that was used fails to account for this.Two emerging classes of survival models, the "cure" and the "frailty" models, make provisions for individuals who will never experience the outcome ("cures") or who will experience it only after a long time ("the less frail").Tiihonen et al.'s overall conclusion that the risk of treatment failure or relapse after discontinuation of antipsychotics does not decrease as a function of time might be strengthened or modified by such models.
Abstract 17732: Pulseless Electrical Activity in Middle Age: Is There a Connection to Obesity?
Authors: Carmen Teodorescu, Kyndaron Reinier, Audrey Uy-Evanado, Ronald Mariani, Karen Gunson, Jonathan Jui, Sumeet S Chugh
Journal: Circulation (2015)

Introduction: Sudden cardiac arrest (SCA) presenting with pulseless electrical activity (PEA) has a significantly higher mortality than ventricular fibrillation/tachycardia (VF/VT). Due to the lack of data in middle aged SCA cases, we evaluated predictors of PEA in in this age group. Methods: Out-of-hospital SCA cases were identified from a large ongoing population-based study in a Northwest US metro area (population approx. 1 million), and confirmed by a process of in-house adjudication. Presenting rhythms were identified from review of first responder reports and electrocardiographic recordings. Pearson’s x2 test and independent samples t-test were used for univariate comparisons of middle-aged (35.0-59.9 years) vs. older adults among PEA and VF/VT groups. Logistic regression was used to evaluate significant factors associated with middle-aged vs. older group. Results: A total of 151 middle-aged and 398 older adults presented with PEA. Middle-aged cases were more likely to be male (72.9% vs. 56.0%, p=0.0003), of African American race (14.1% vs. 7.5%, p=0.008), arrest in public locations (22.5% vs. 9.3%, p=0.0004), be unwitnessed (34.4% vs. 23.7%, p=0.02) and have higher survival to hospital discharge (9.3% vs. 4.8%, p=0.05). There was no difference in the response time and bystander CPR (p≥0.11). Middle-aged PEA cases had a lower comorbidity index compared to older PEA (p&lt;0.0001). Obesity was significantly more common among middle-aged compared to older adults in the PEA group (49.0% vs. 35.5%, p=0.02) and remained a significant determinant after multivariable adjustment [OR 1.91 (95% CI 1.14-3.19, p=0.01)]. Among the VF/VT group, the demographic and resuscitation characteristics followed a similar pattern between middle-aged vs. older adults as in the PEA group. However, in the VF/VT group there was no significant difference in the obesity prevalence (p=0.10). Conclusion: Middle-aged cases presenting with PEA were independently associated with obesity. Given the current epidemic of obesity, these findings have significant public health implications and warrant further detailed investigation.
Socioeconomic Status and Cardiovascular Outcomes
Authors: William M. Schultz, Heval M. Kelli, John C. Lisko, Tina Varghese, Jia Shen, Pratik Sandesara, Arshed A. Quyyumi, Herman A. Taylor, Martha Gulati, John G. Harold, Jennifer H. Mieres, Keith C. Ferdinand, George A Mensah, Laurence S. Sperling
Journal: Circulation (2018)

Socioeconomic status (SES) has a measurable and significant effect on cardiovascular health. Biological, behavioral, and psychosocial risk factors prevalent in disadvantaged individuals accentuate the link between SES and cardiovascular disease (CVD). Four measures have been consistently associated with CVD in high-income countries: income level, educational attainment, employment status, and neighborhood socioeconomic factors. In addition, disparities based on sex have been shown in several studies. Interventions targeting patients with low SES have predominantly focused on modification of traditional CVD risk factors. Promising approaches are emerging that can be implemented on an individual, community, or population basis to reduce disparities in outcomes. Structured physical activity has demonstrated effectiveness in low-SES populations, and geomapping may be used to identify targets for large-scale programs. Task shifting, the redistribution of healthcare management from physician to nonphysician providers in an effort to improve access to health care, may have a role in select areas. Integration of SES into the traditional CVD risk prediction models may allow improved management of individuals with high risk, but cultural and regional differences in SES make generalized implementation challenging. Future research is required to better understand the underlying mechanisms of CVD risk that affect individuals of low SES and to determine effective interventions for patients with high risk. We review the current state of knowledge on the impact of SES on the incidence, treatment, and outcomes of CVD in high-income societies and suggest future research directions aimed at the elimination of these adverse factors, and the integration of measures of SES into the customization of cardiovascular treatment.
Abstract 20583: Prehospital Electrocardiogram Transmission is Associated With Decreased First Medical Contact to Device Time in a Large Urban Emergency Medical Services System
Authors: Christopher Richards, Ken Pearlman, Leslee Stein-Spencer, Kathleen O’Neill, Adhir Schroff, Yanina Purim-Shem-Tov, Eddie Markul, Joseph Weber, Art Miller, Kathleen Magurany, Shirley Weller, Gary Schaer
Journal: Circulation (2014)

Introduction: Early recognition and rapid revascularization is associated with improved outcomes in patients with STEMI. Increasingly, prehospital providers acquire ECGs, transport patients to PCI-ready hospitals, and activate interventional cardiology teams in advance of arrival (“door time”). Therefore, the time from first medical contact (FMC) with either EMS providers or the emergency department may be an important metric for overall system performance in the care of patients with STEMI. Hypothesis: A prehospital ECG transmission program will be associated with a decreased median FMC to revascularization device deployment time. Methods: A retrospective cohort study of Action Registry-GWTG data in Chicago was performed. The Chicago Fire Department implemented a 12-lead ECG program in 2012. Patients with confirmed STEMI from January through December 2013 were included. A baseline median FMC to device time was determined for the third quarter of 2012, at the start of the ECG program. Descriptive statistics were used for analysis. Results: Over the study period, 322 patients experiencing STEMI were treated in 9 hospitals. Patients were predominantly male (66%), and 50% arrived by ambulance. The average median FMC to device time during the study was 83 minutes, which decreased from an initial baseline of 104 minutes. The median time from FMC to door and from catheterization laboratory arrival to device remained constant over the study period (24 minutes and 22 minutes respectively), but the median time from door to catheterization laboratory decreased from 42 minutes to 33 minutes. Conclusions: Implementation of a prehospital ECG transmission program was associated with a decreased median FMC to device time in a large city, with FMC to device times consistently less than 90 minutes. The median door to device time for all patients regardless of arrival mode decreased too suggesting improved care processes for all patients with STEMI.
David Oliver: What’s behind the reported rise in sepsis deaths?
Authors: David Oliver
Journal: BMJ (2018)

and former director of its Doctor Foster Unit-which sends real time mortality rate alerts to hospitals-shared headline data with the BBC from an analysis of deaths from sepsis in the NHS."Hospital sepsis deaths 'jump by a third,'" was the BBC's headline. 1The story was widely reported by the broadcaster and was picked up in other media outlets.
Abstract P058: Men with Impaired Glucose Tolerance Have Lower Self-rated Health Than Men with Impaired Fasting Glucose, an Association Mediated by Physical Activity
Authors: Sven G Diurlin, Maria C Eriksson, Bledar Daka, Ulf Lindblad, Charlotte A Larsson, Margareta I Hellgren
Journal: Circulation (2016)

Aim: Previous studies have shown that individuals with type 2 diabetes (T2D) and impaired glucose tolerance (IGT) have lower self-rated health than normoglycemic individuals. Less is known about individuals with impaired fasting glucose (IFG). The aim of this study was to examine differences in self-rated health between individuals with IGT and those with IFG, taking into account the mediating effect of lifestyle. Methods: In 2002-2005, a total of 2816 individuals 35-74 years were randomly selected for a population-based study in the southwest of Sweden (The Skaraborg Project). All participants performed an oral glucose tolerance test (OGTT) and had anthropometric measurements and blood pressure taken. Fasting venous blood samples were drawn and validated questionnaires on lifestyles were completed. Self-rated health (SRH) was ranked on a five-graded scale, and dichotomized into “good or very good” (1-2) or “fair, bad or very bad” (3-5). Leisure time physical activity (LTPA) was reported on a four-graded scale and dichotomized into sedentary/low LTPA or moderate/high LTPA. At baseline, 213 individuals with IGT and 129 with IFG were detected and used for further analyses in this cross-sectional study. Results: Individuals with IGT were found to have lower self-rated health than individuals with IFG (OR=1.62, CI: 1.01-2.60, p=0.047). There was a borderline interaction between sex and IGT/IFG considering self-rated health (p=0.055) and the difference in self-rated health was seen particularly in men when adjusted for age and BMI (OR=2.13, CI: 1.13-4.02, p=0.020). The results remained significant when also adjusting for smoking, history of CVD and lack of sleep, but became insignificant when including physical activity in the model (OR=1.8, CI: 0.91-3.58, p=0.094). Individuals with IGT reported a lower level of physical activity than those with IFG (OR=2.2, CI: 1.30-3.75, p=0.004) when adjusting for age, BMI and history of CVD. No significant differences were seen in alcohol consumption (P=0.209) or smoking (p=0.150). Conclusion: This study shows that individuals with IGT had significantly worse self-rated health than individuals with IFG and also a less physically active lifestyle. These results indicate that physical inactivity might be an important explanatory factor behind the observed association between low self-rated health and IGT. These findings are important to consider in care-taking and treatment of patients with IGT and IFG in primary care.
The Lancet series on low back pain: reflections and clinical implications
Authors: Kieran O’Sullivan, Peter B O’Sullivan, Mary O’Keeffe
Journal: British Journal of Sports Medicine (2018)

The Lancet series of papers on low back pain (LBP)1–3 received considerable academic and media attention, and helpfully reinforced key messages from international guidelines. Box 1 highlights some of the series' key messages. The series illustrated international, multidisciplinary consensus on management of LBP. The series provides the reader with a comprehensive review of the most promising solutions, ranging from stratified care according to clinical risk profiling, through integrated health and occupational care, changes to payment systems and legislation, as well as public health and prevention strategies. This is important as all too often, guidelines and systematic reviews focus on the effectiveness, or lack thereof, of particular treatment options in isolation, without considering the broader context within which treatments are delivered. Here, we reflect on three issues from the series and discuss the clinical implications. Box 1 ### Lessons from the Lancet low back series
Cancer Risks for <i>PMS2</i>-Associated Lynch Syndrome
Authors: Sanne W. ten Broeke, Heleen M. van der Klift, Carli M.J. Tops, Stefan Aretz, Inge Bernstein, Daniel D. Buchanan, Albert de la Chapelle, Gabriel Capella, Mark Clendenning, Christoph Engel, Steven Gallinger, Encarna Gomez Garcia, Jane C. Figueiredo, Robert Haile, Heather L. Hampel, Liselotte van Hest, John L. Hopper, Nicoline Hoogerbrugge, Magnus von Knebel Doeberitz, Loic Le Marchand, Tom G.W. Letteboer, Mark A. Jenkins, Annika Lindblom, Noralane M. Lindor, Arjen R. Mensenkamp, Pål Møller, Polly A. Newcomb, Theo A.M. van Os, Rachel Pearlman, Marta Pineda, Nils Rahner, Egbert J.W. Redeker, Maran J.W. Olderode-Berends, Christophe Rosty, Hans K. Schackert, Rodney Scott, Leigha Senter, Liesbeth Spruijt, Verena Steinke-Lange, Manon Suerink, Stephen Thibodeau, Yvonne J. Vos, Anja Wagner, Ingrid Winship, Frederik J. Hes, Hans F.A. Vasen, Juul T. Wijnen, Maartje Nielsen, Aung Ko Win
Journal: Journal of Clinical Oncology (2018)

Lynch syndrome due to pathogenic variants in the DNA mismatch repair genes MLH1, MSH2, and MSH6 is predominantly associated with colorectal and endometrial cancer, although extracolonic cancers have been described within the Lynch tumor spectrum. However, the age-specific cumulative risk (penetrance) of these cancers is still poorly defined for PMS2-associated Lynch syndrome. Using a large data set from a worldwide collaboration, our aim was to determine accurate penetrance measures of cancers for carriers of heterozygous pathogenic PMS2 variants.
How <i>Homo economicus</i> lost her mind and how we can revive her
Authors: Peter DeScioli
Journal: Behavioral and Brain Sciences (2018)

The target article by Boyer &amp; Petersen (B&amp;P) contributes a vital message: that people have folk economic theories that shape their thoughts and behavior in the marketplace. This message is all the more important because, in the history of economic thought, Homo economicus was increasingly stripped of mental capacities. Intuitive theories can help restore the mind of Homo economicus.