tbuckley/cabot-search huggingface dataset:
Abstract 17194: Intrastate Variation in Treatment and Outcome Measures for Out-of-Hospital Cardiac Arrest
Authors: Ryan A Coute, Theresa A Shields, James A Cranford, Sardar Ansari, M. Hakam Tiba, Robert W Neumar
Journal: Circulation (2016)

Background: Variations in out-of-hospital cardiac arrest (OHCA) system performance and outcomes have been previously described across North America. We hypothesized that the same level of variation...
PTU-073 Title: is portal vein diameter being reported in abdominal ultrasound scans of decompensated liver cirrhosis patients?
Authors: T Coysh, S Zonoozi, N Jayasooriya, Z Cargill, A Burn-Murdoch, M Yalchin, M Hussein, A Alisa, K Besherdas
Journal: Gut (2017)

Introduction  Haemmorhage from ruptured oesophageal varices is a major complication of portal hypertension due to liver cirrhosis, and is associated with a high mortality rate. Variceal bleeding accounts for 10%–30% of all cases of upper gastrointestinal bleeding. Early diagnosis of varices and prevention and treatment of bleeding improves survival.  International normalised ratio (INR) score >1.5, portal vein diameter of >13 mm, and thrombocytopenia have been found to be predictive of the likelihood of varices being present in cirrhotics. Patients with cirrhosis often undergo ultrasonography, however, following our observation that the portal vein diameter (PVD) was rarely reported, we performed an audit of our practice on the reporting of PVD in cirrhotics.  Method  A single centre, retrospective analysis of abdominal/liver ultrasound reports for all decompensated liver cirrhosis patients admitted between December 2015 – February 2016 and April – June 2016 to a large district general hospital in North London.  Results  53 patients were included within the study.  Conclusion  This study demonstrates that in cirrhotics, measurement of PVD, despite being a predictor of presence of varices, is not being reported in 89.58% of ultrasound scans. This may delay the diagnosis and management of varices. We recommend interventions to enhance the reporting of PVD to include:  1) doctors ordering ultrasound scan on cirrhotics to specifically request PVD as standard within the request form  2) ultrasonographers to specifically mention PVD as standard within their reports in cirrhotics.  Disclosure of Interest  None Declared
Antibody drug improves desensitisation with oral immunotherapy in children with multifood allergy, study finds
Authors: Susan Mayor
Journal: BMJ (2017)

Pretreatment with the anti-immunoglobulin E (IgE) antibody omalizumab improved the efficacy of oral immunotherapy in children with multiple food allergies, results from a small phase 2 trial have shown.1

Around 30% of people with food allergies are allergic to multiple foods. But, although several previous studies have shown improvements with oral immunotherapy in people allergic to single foods, few have investigated multifood allergy.

The new study investigated omalizumab, which reduces blood levels of free IgE, together with oral immunotherapy. This combination was chosen because previous studies have shown the …
Effect of health literacy and exercise interventions on glycated haemoglobin levels in Chinese patients with type 2 diabetes: a cluster-randomised controlled trial
Authors: Xiaona Liu, Hong Fang, Qinghua Xia, Yingyao Chen, Peng Zhou, Yujie Yan, Junling Gao, Yu Jiang, Baodong Yao, Russell L Rothman, Wang Hong Xu
Journal: The Lancet (2017)
Noninvasive Ablation of Ventricular Tachycardia
Authors: Roy M. John, William G. Stevenson
Journal: New England Journal of Medicine (2017)

Scar-related ventricular tachycardia (VT) is an important cause of sudden death and morbidity in patients with heart disease. Myocardial infarction, or replacement fibrosis in nonischemic cardiomyopathies, is a common source of scarring. Myocardial bundles that course through or around the fibrotic tissue provide pathways for reentry. Once established, this structural substrate is robust, recurrent episodes of VT are common, and placement of an implantable cardioverter–defibrillator (ICD) is usually warranted. ICDs provide an effective safety net, since they terminate sustained VT when it occurs, but VT episodes may still cause disturbing symptoms, and ICD shocks decrease quality of life, can lead . . .
A Bivalent Meningococcal B Vaccine in Adolescents and Young Adults
Authors: Lars Ostergaard, Timo Vesikari, Judith Absalon, Johannes Beeslaar, Brian J. Ward, Shelly Senders, Joseph J. Eiden, Kathrin U. Jansen, Annaliesa S. Anderson, Laura J. York, Thomas R. Jones, Shannon L. Harris, Robert O’Neill, David Radley, Roger Maansson, Jean-Louis Prégaldien, John Ginis, Nina B. Staerke, John L. Perez
Journal: New England Journal of Medicine (2017)

MenB-FHbp is a licensed meningococcal B vaccine targeting factor H-binding protein. Two phase 3 studies assessed the safety of the vaccine and its immunogenicity against diverse strains of group B meningococcus.We randomly assigned 3596 adolescents (10 to 18 years of age) to receive MenB-FHbp or hepatitis A virus vaccine and saline and assigned 3304 young adults (18 to 25 years of age) to receive MenB-FHbp or saline at baseline, 2 months, and 6 months. Immunogenicity was assessed in serum bactericidal assays that included human complement (hSBAs). We used 14 meningococcal B test strains that expressed vaccine-heterologous factor H-binding proteins representative of meningococcal B epidemiologic diversity; an hSBA titer of at least 1:4 is the accepted correlate of protection. The five primary end points were the proportion of participants who had an increase in their hSBA titer for each of 4 primary strains by a factor of 4 or more and the proportion of those who had an hSBA titer at least as high as the lower limit of quantitation (1:8 or 1:16) for all 4 strains combined after dose 3. We also assessed the hSBA responses to the primary strains after dose 2; hSBA responses to the 10 additional strains after doses 2 and 3 were assessed in a subgroup of participants only. Safety was assessed in participants who received at least one dose.In the modified intention-to-treat population, the percentage of adolescents who had an increase in the hSBA titer by a factor of 4 or more against each primary strain ranged from 56.0 to 85.3% after dose 2 and from 78.8 to 90.2% after dose 3; the percentages of young adults ranged from 54.6 to 85.6% and 78.9 to 89.7%, after doses 2 and 3, respectively. Composite responses after doses 2 and 3 in adolescents were 53.7% and 82.7%, respectively, and those in young adults were 63.3% and 84.5%, respectively. Responses to the 4 primary strains were predictive of responses to the 10 additional strains. Most of those who received MenB-FHbp reported mild or moderate pain at the vaccination site.MenB-FHbp elicited bactericidal responses against diverse meningococcal B strains after doses 2 and 3 and was associated with more reactions at the injection site than the hepatitis A virus vaccine and saline. (Funded by Pfizer; ClinicalTrials.gov numbers, NCT01830855 and NCT01352845 ).
What’s in a Name—Dermoscopy vs Dermatoscopy
Authors: Juliana Berk-Krauss, Mary E. Laird
Journal: JAMA Dermatology (2017)

Dermoscopy improves diagnostic accuracy by uncovering dimensions of skin morphologic characteristics imperceptible to the naked eye. While the practice of dermoscopy has become common among dermatologists only in recent years, microscopic examination of the skin is actually a centuries-old practice.
Beyond sensorimotor imitation in the neonate: Mentalization psychotherapy in adulthood
Authors: Martin Desseilles
Journal: Behavioral and Brain Sciences (2017)

Abstract Despite the persuasiveness of Keven &amp; Akins' (K&amp;A) review, we argue that mentalization, or the ability to interpret the mental states of oneself and others, is required to construct the neonate mind, going far beyond sensorimotor imitation. This concept, informed by certain psychoanalytic and attachment theories, has produced a form of therapy called mentalization-based psychotherapy , which aims to improve emotional regulation. Our aim here is to shed light on a form of neonatal imitation that goes beyond sensorimotor imitation.
Indian hedgehog signaling in osteosarcoma: Co-expression of GLI1, PTCH1, and IHH
Authors: Winnie Lo, Jay Wunder, Nalan Gokgoz, Robert Parkes, Benjamin Alman, Irene Andrulis
Journal: Cancer Research (2007)

1010  Objectives: The Hedgehog (Hh) signaling pathway is crucial in the developmental processes of numerous tissues and organs by influencing the transcription of many target genes. Hedgehog signaling deregulation has been associated with several cancers. Indian Hedgehog (IHH) signals through the transmembrane proteins patched (PTCH) and smoothened (SMO) to activate GLI mediated transcription, including GLI1 and PTCH1. This exerts a feedback mechanism to regulate further IHH signaling. We characterized the expression of IHH, PTCH1, and GLI1 in both osteosarcoma cell lines and primary tumor specimens to determine the activity of Hedgehog signaling in osteosarcoma. The hedgehog antagonist, cyclopamine, was used to determine the proliferative role of hedgehog signaling in osteosarcoma cell lines.  Methods: Fresh frozen tumor specimens were obtained from 43 patients with high grade osteosarcoma of the extremity, including 11 who presented with metastases at diagnosis (MetDx), and 32 who had no systemic disease at presentation (NoMetDx). Six osteosarcoma cell lines obtained from ATCC (U-2 OS, Saos-2, MG-63, MNNG/HOS, HOS, and KHOS/NP) were studied. RNA was extracted and real time PCR was used to assess the expression level of IHH, GLI1, and PTCH1. Satterthwaite9s t-test for unequal variance was used for tests comparing outcome groups. Non-parametric tests (Wilcoxon for binary and Jonkheere-Terpstra for continuous variables) were used to assess the association between expression levels and selected clinical and demographic variables. A bromodeoxyuridine incorporation assay was utilized to determine changes in osteosarcoma cell growth upon treatment with cyclopamine.  Results: We observed a strong positive association of GLI1, IHH, and PTCH1 with each other. The pairwise correlation coefficient between GLI1 and IHH was +0.442 (p=0.003), between GLI1 and PTCH1 was +0.751 (p  Conclusions: We have demonstrated that the expression levels of genes in the Hedgehog pathway are positively correlated with each other. Overexpression of these genes may result in Hedgehog pathway deregulation, which may lead to the progression of osteosarcoma. Cell culture systems are being used to further elucidate the proliferative role of this pathway in osteosarcoma. We are currently investigating the relationship between GLI1, PTCH1, IHH, and survival.
Chronic hepatitis E in patients with indolent lymphoma after treatment with rituximab and bendamustine
Authors: Khaled Alnuaimi, Julie Lavolé, Caroline Lascoux‐Combes, Anne‐Marie Roque Afonso, Philippe Sogni, Stanislas Pol, Vincent Mallet
Journal: Hepatology (2017)

Alnuaimi, Khaled; Lavolé, Julie; Lascoux‐Combes, Caroline; Roque Afonso, Anne‐Marie; Sogni, Philippe; Pol, Stanislas; Mallet, Vincent Author Information
Characteristics and outcomes of patients with advanced sarcoma enrolled in early phase immunotherapy trials
Authors: Roman Groisberg, David S. Hong, Amini Behrang, Kenneth Hess, Filip Janku, Sarina Piha-Paul, Aung Naing, Siqing Fu, Robert Benjamin, Shreyaskumar Patel, Neeta Somaiah, Anthony Conley, Funda Meric-Bernstam, Vivek Subbiah
Journal: Journal for ImmunoTherapy of Cancer (2017)

<h3>Background</h3> Immunotherapies, specifically those based on immune checkpoint inhibitors, have shown promising activity in multiple tumor types. Other than mifamurtide (MEPACT®) for osteosarcoma approved by European Medicines Agency, there are no approved immunotherapies for sarcomas. <h3>Methods</h3> We analyzed medical records of patients with advanced sarcoma who were referred to Phase 1 clinic at MD Anderson and received an immunotherapy (checkpoint inhibitors, vaccines, or cytokine based therapies). Clinical parameters including demographics, clinical history, toxicity, and response were abstracted. <h3>Results</h3> Among 50 patients enrolled in immunotherapy trials (Bone 10; Soft-tissue 40) we found 14 different subtypes of sarcomas. Royal Marsden Hospital (RMH) prognostic score was &lt;2 (86%). Performance status (PS) was 0–1 in 48 patients (96%); median number of prior therapies was 3 (0–12). Immunotherapy consisted of checkpoint inhibitors (82%: PD1 = 7, PD-L1 = 11, CTLA4 = 22, other = 1) of which 42% were combinations, as well as vaccines (14%), and cytokines (4%). Median overall survival (OS) was 13.4&nbsp;months (11.2&nbsp;months: not reached). Median progression free survival (PFS) was 2.4&nbsp;months (95% CI = 1.9–3.2&nbsp;months). Best response was partial response (PR) in 2 patients with alveolar soft part sarcoma (ASPS) and stable disease (SD) in 11 patients (3 GIST, 3 liposarcomas (2 DDLS, 1 WDLS), 2 ASPS, 2 leiomyo, 1 osteo). PFS was 34% (23%, at 50%) at 3&nbsp;months, 16% (8%, 30%) at 6&nbsp;months, and 6% (2%, 20%) at 1&nbsp;year. Pseudo-progression followed by stable disease was observed in 2 patients (4%). Grade 3/4 adverse events included rash (10%), fever (6%), fatigue (6%), and nausea/vomiting (6%). <h3>Conclusion</h3> Immunotherapies were well tolerated in advanced sarcoma patients enrolled in trials. All four ASPS patients had clinical benefit with checkpoint inhibitors and this was the only subtype experiencing partial response. Further evaluation of checkpoint inhibitors in ASPS is warranted.
Patient centred diagnosis of dementia: we must listen to patients’ wishes
Authors: Mike Devine
Journal: BMJ (2017)

Berger and colleagues discuss conversations around shared decision making.1 Patient centred diagnosis in old age psychiatry covers not only which investigations to do but also what to conclude from the results. Increased awareness of and treatment options for dementia over the past 15 years have resulted in patients being referred to memory services at an ever earlier …
Rapid and comprehensive discovery of unreported shellfish allergens using large-scale transcriptomic and proteomic resources
Authors: Roni Nugraha, Sandip D. Kamath, Elecia Johnston, Kyall R. Zenger, Jennifer M. Rolland, Robyn E. O'Hehir, Andreas L. Lopata
Journal: Journal of Allergy and Clinical Immunology (2017)
TIME Trial: Effect of Timing of Stem Cell Delivery Following ST-Elevation Myocardial Infarction on the Recovery of Global and Regional Left Ventricular Function
Authors: Jay H. Traverse, Timothy D. Henry, Carl J. Pepine, James T. Willerson, Atul Chugh, Phillip C. Yang, David X.M. Zhao, Stephen G. Ellis, John R. Forder, Emerson C. Perin, Marc S. Penn, Antonis K. Hatzopoulos, Jeffrey C. Chambers, Kenneth W. Baran, Ganesh Raveendran, Adrian P. Gee, Doris A. Taylor, Lem Moyé, Ray F. Ebert, Robert D. Simari
Journal: Circulation Research (2017)

The TIME trial (Timing in Myocardial Infarction Evaluation) was the first cell therapy trial sufficiently powered to determine if timing of cell delivery after ST-segment-elevation myocardial infarction affects recovery of left ventricular (LV) function.To report the 2-year clinical and cardiac magnetic resonance imaging results and their modification by microvascular obstruction.TIME was a randomized, double-blind, placebo-controlled trial comparing 150 million bone marrow mononuclear cells versus placebo in 120 patients with anterior ST-segment-elevation myocardial infarctions resulting in LV dysfunction. Primary end points included changes in global (LV ejection fraction) and regional (infarct and border zone) function. Secondary end points included changes in LV volumes, infarct size, and major adverse cardiac events. Here, we analyzed the continued trajectory of these measures out to 2 years and the influence of microvascular obstruction present at baseline on these long-term outcomes. At 2 years (n=85), LV ejection fraction was similar in the bone marrow mononuclear cells (48.7%) and placebo groups (51.6%) with no difference in regional LV function. Infarct size and LV mass decreased ≥30% in each group at 6 months and declined gradually to 2 years. LV volumes increased ≈10% at 6 months and remained stable to 2 years. Microvascular obstruction was present in 48 patients at baseline and was associated with significantly larger infarct size (56.5 versus 36.2 g), greater adverse LV remodeling, and marked reduction in LV ejection fraction recovery (0.2% versus 6.2%).In one of the longest serial cardiac magnetic resonance imaging analyses of patients with large anterior ST-segment-elevation myocardial infarctions, bone marrow mononuclear cells administration did not improve recovery of LV function over 2 years. Microvascular obstruction was associated with reduced recovery of LV function, greater adverse LV remodeling, and more device implantations. The use of cardiac magnetic resonance imaging leads to greater dropout of patients over time because of device implantation in patients with more severe LV dysfunction resulting in overestimation of clinical stability of the cohort.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00684021.
Higher blood urea nitrogen is associated with increased risk of incident diabetes mellitus
Authors: Yan Xie, Benjamin Bowe, Tingting Li, Hong Xian, Yan Yan, Ziyad Al-Aly
Journal: Kidney International (2017)

Experimental evidence suggests that higher levels of urea may increase insulin resistance and suppress insulin secretion. However, whether higher levels of blood urea nitrogen (BUN) are associated with increased risk of incident diabetes mellitus in humans is not known. To study this, we built a national cohort of 1,337,452 United States Veterans without diabetes to characterize the association of BUN and risk of incident diabetes. Over a median follow-up of 4.93 years, there were 172,913 cases of incident diabetes. In joint risk models of estimated glomerular filtration rate (eGFR) and BUN. there was no association between eGFR and the risk of incident diabetes in those with a BUN of 25 mg/dl or less. However, the risk was significantly increased in those with a BUN over 25 mg/dl at all eGFR levels, even in those with an eGFR of 60 ml/min/1.73m2 or more (hazard ratio 1.27; confidence interval 1.24-1.31). The risk of incident diabetes was highest in those with BUN over 25 mg/dL and an eGFR under 15 ml/min/1.73m2 (1.68; 1.51-1.87). Spline analyses of the relationship between BUN and risk of incident diabetes showed that risk was progressively higher as BUN increased. In models where eGFR was included as a continuous covariate, compared to a BUN of 25 mg/dl or less, a BUN over 25 mg/dl was associated with increased risk of incident diabetes (1.23; 1.21-1.25). Every 10 ml/min/1.73m2 decrease in eGFR was not associated with risk of incident diabetes (1.00; 1.00-1.01). Two-stage residual inclusion analyses showed that, independent of the impact of eGFR, every 10 mg/dL increase in BUN concentration was associated with increased risk of incident diabetes (1.15; 1.14-1.16). Thus, higher levels of BUN are associated with increased risk of incident diabetes mellitus.
Automatic spinal cord localization, robust to MRI contrasts using global curve optimization
Authors: Charley Gros, Benjamin De Leener, Sara M. Dupont, Allan R. Martin, Michael G. Fehlings, Rohit Bakshi, Subhash Tummala, Vincent Auclair, Donald G. McLaren, Virginie Callot, Julien Cohen-Adad, Michaël Sdika
Journal: Medical Image Analysis (2017)
Interleukin-1β induces human cementoblasts to support osteoclastogenesis
Authors: Nam C-N Huynh, Vincent Everts, Prasit Pavasant, Ruchanee S Ampornaramveth
Journal: International Journal of Oral Science (2017)

Injury of the periodontium followed by inflammatory response often leads to root resorption. Resorption is accomplished by osteoclasts and their generation may depend on an interaction with the cells in direct contact with the root, the cementoblasts. Our study aimed to investigate the role of human cementoblasts in the formation of osteoclasts and the effect of interleukin (IL)-1β hereupon. Extracted teeth from healthy volunteers were subjected to sequential digestion by type I collagenase and trypsin. The effect of enzymatic digestion on the presence of cells on the root surface was analyzed by histology. Gene expression of primary human cementoblasts (pHCB) was compared with a human cementoblast cell line (HCEM). The pHCBs were analyzed for their expression of IL-1 receptors as well as of receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG). In a co-culture system consisting of osteoclast precursors (blood monocytes) and pHCBs, the formation of osteoclasts and their resorptive activity was assessed by osteo-assay and ivory slices. The cells obtained after a 120 min enzyme digestion expressed the highest level of bone sialoprotein, similar to that of HCEM. This fraction of isolated cells also shared a similar expression pattern of IL-1 receptors (IL1-R1 and IL1-R2). Treatment with IL-1β potently upregulated RANKL expression but not of OPG. pHCBs were shown to induce the formation of functional osteoclasts. This capacity was significantly stimulated by pretreating the pHCBs with IL-1β prior to their co-culture with human blood monocytes. Our study demonstrated that cementoblasts have the capacity to induce osteoclastogenesis, a capacity strongly promoted by IL-1β. These results may explain why osteoclasts can be formed next to the root of teeth. An investigation into the interaction between tooth root cells and an inflammatory protein sheds light on root degradation following injury. Osteoclast cells digest old bone to release nutrients and recycle bone tissues in a vital process called bone resorption. Cementum, the mineral substance covering tooth roots, is not usually resorbed, but injury to the tissues surrounding roots often triggers inflammation followed by root degradation. To understand this phenomenon better, Ruchanee Salingcarnboriboon Ampornaramveth at Chulalongkorn University in Bangkok, Thailand, and co-workers investigated whether cementum cells can promote the formation of osteoclasts. They found that when cementum cells were treated with interleukin 1 beta, an inflammatory protein expressed at high levels in tissues following injury, levels of another protein needed for osteoclast formation increased. This boosted osteoclast formation around roots, resulting in root resorption
Eplerenone Reduces Atrial Fibrillation Burden Without Preventing Atrial Electrical Remodeling
Authors: Yoshio Takemoto, Rafael J. Ramirez, Kuljeet Kaur, Oscar Salvador-Montañés, Daniela Ponce-Balbuena, Roberto Ramos-Mondragón, Steven R. Ennis, Guadalupe Guerrero-Serna, Omer Berenfeld, José Jalife
Journal: Journal of the American College of Cardiology (2017)
Is evidence-based medicine relevant to the developing world? Systematic reviews have yet to achieve their potential as a resource for practitioners in developing countries
Authors: P Chinnock, N Siegfried, M Clarke
Journal: PLoS Medicine (2005)

Although there is still some resistance to the evidence-based medicine movement, evidence-based health care has now become widely accepted and adopted. Systematic reviews of the effectiveness of health care interventions are the engine room of evidence-based health care; much has been written about how these reviews should be conducted and what they can achieve [1,2]. If the case for the use of systematic reviews is good in developed countries—and we think it is—then the case is even stronger in the developing world. Wherever health care is provided and used, it is essential to know which interventions work, which do not work, and which are likely to be harmful. This is especially important in situations where health problems are severe and the scarcity of resources makes it vital that they are not wasted [3].

But are the systematic reviews that have so far been published relevant and of practical use to those who provide health care in “the majority world” (i.e., in developing countries? In our view, the relevance of systematic reviews to frontline health care workers in developing countries has so far been limited, for a number of reasons.