tbuckley/cabot-search huggingface dataset:
Deep learning and artificial intelligence in radiology: Current applications and future directions
Authors: Koichiro Yasaka, Osamu Abe
Journal: PLoS Medicine (2018)

Radiological imaging diagnosis plays important roles in clinical patient management.Deep learning with convolutional neural networks (CNNs) is recently gaining wide attention for its high performance in recognizing images.If CNNs realize their promise in the context of radiology, they are anticipated to help radiologists achieve diagnostic excellence and to enhance patient healthcare.Here, we discuss very recent developments in the field, including studies published in the current PLOS Medicine Special Issue on Machine Learning in Health and Biomedicine, with comment on expectations and planning for artificial intelligence (AI) in the radiology clinic.Chest radiographs are one of the most utilized radiological modalities in the world and have been collected into a number of large datasets currently available to machine learning researchers.In this Special Issue, three groups of researchers applied deep learning to radiological imaging diagnosis using this modality.In the first, Pranav Rajpurkar and colleagues found that deep learning models detected clinically important abnormalities (e.g., edema, fibrosis, mass, pneumonia, and pneumothorax) on chest radiography, at a performance level comparable to practicing radiologists [1].In a similar study, Andrew Taylor and colleagues developed deep learning models that detected clinically significant pneumothoraces on chest radiography with excellent performance on data from the same site-with areas under the receiver operating characteristic curve (AUC) of 0.94-0.96[2].Meanwhile, Eric Oermann and colleagues investigated how well deep learning models that detected pneumonia on chest radiography generalized across different hospitals.They found that models trained on pooled data from sites with different pneumonia prevalence performed well on new pooled data from these same sites (AUC of 0.93-0.94)but significantly less well on external data (AUC 0.75-0.89);additional analyses supported the interpretation that deep learning models diagnosing pneumonia on chest radiography are able to exploit confounding information that is associated with pneumonia prevalence [3].Also in this Special Issue, Nicholas Bien and colleagues applied deep learning techniques to detect knee abnormalities on magnetic resonance (MR) imaging and found that the trained model showed near-human-level performance [4].Taking these four studies together, we can interpret that deep learning is currently able to diagnose a number of conditions using radiological data, but such diagnostic models may not be robust to a change in location.These Special Issue studies join a growing number of applications of deep learning to radiological images from various modalities that can aid with detection, diagnosis, staging, and subclassification of conditions.Cerebral aneurysms can be detected on MR angiography with
Efficacy of Endoscopic Dilation of Gastroduodenal Crohn’s Disease Strictures: A Systematic Review and Meta-Analysis of Individual Patient Data
Authors: Dominik Bettenworth, Marcus M. Mücke, Rocio Lopez, Amandeep Singh, Weiming Zhu, Feilong Guo, Toshiyuki Matsui, Theodore W. James, Hans Herfarth, Martin Goetz, Ren Mao, Satya Kurada, Jochen Hampe, Katja Matthes, John Gásdal Karstensen, Piero V. Valli, Marjolijn Duijvestein, Geert D’Haens, Vipul Jairath, Tian Bai Qiu, Nik Sheng Ding, Gerhard Rogler, Florian Rieder
Journal: Clinical Gastroenterology and Hepatology (2018)

Little is known about the effects of endoscopic balloon dilation (EBD) for strictures of the upper gastrointestinal (UGI) tract in patients with Crohn's disease (CD). We performed a pooled analysis of the efficacy and safety of EBD for UGI CD-associated strictures.We searched Embase, Medline, and the Cochrane library, as well as bibliographies of relevant articles, for cohort studies of adults with CD and strictures of the stomach or duodenum (up to the ligament of Treitz) who underwent EBD through December 2016. We obtained data from 7 international referral centers on 94 patients who underwent 141 EBDs. We performed a patient-level meta-analysis of data from published and unpublished cohort studies to determine mechanical and clinical success. We performed a time-to-event analysis to assess symptom recurrence and need for redilation or surgery. The patients analyzed had strictures of the duodenum (n = 107), stomach (n = 30), or spanning both (n = 4).The rate of technical success for EBD was 100%, with 87% short-term clinical efficacy; major complications arose from 2.9% of all procedures. During a median follow-up period of 23.1 months, 70.5% of patients had a recurrence of symptoms, 59.6% required redilation, and 30.8% required surgical intervention. Patients whose disease was located in the small bowel had a higher risk for symptom recurrence (hazard ratio [HR], 2.1; P = .003). Asian race (HR, 2.8; P < .001) and location of disease in the small bowel (HR, 1.9; P = .004) increased the need for redilation. Prestenotic dilation was a risk factor for needing surgery earlier (HR, 1.9; P = .001).In a meta-analysis, we found EBD for CD-associated strictures of the UGI to be an effective alternative to surgery, with a high rate of short-term technical and clinical success, moderate long-term efficacy, and an acceptable rate of complications.
Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1–2 trial
Authors: Frederick L Locke, Armin Ghobadi, Caron A Jacobson, David B Miklos, Lazaros J Lekakis, Olalekan O Oluwole, Yi Lin, Ira Braunschweig, Brian T Hill, John M Timmerman, Abhinav Deol, Patrick M Reagan, Patrick Stiff, Ian W Flinn, Umar Farooq, Andre Goy, Peter A McSweeney, Javier Munoz, Tanya Siddiqi, Julio C Chavez, Alex F Herrera, Nancy L Bartlett, Jeffrey S Wiezorek, Lynn Navale, Allen Xue, Yizhou Jiang, Adrian Bot, John M Rossi, Jenny J Kim, William Y Go, Sattva S Neelapu
Journal: The Lancet Oncology (2018)
AMTRA: An ambulatory and tailored symptom management and intervention system in patients with cancer initiating treatment.
Authors: Marika Anna Rasschaert, Sven De Keersmaecker, Kathleen Vandenborne, Christof Vulsteke, Stefanie Dias, Vincent Verschaeve, Peter Vuylsteke, Marc Peeters
Journal: Journal of Clinical Oncology (2018)

142 Background: The purpose of this non-randomized prospective cohort analysis was to implement and validate a tailored symptom management and intervention system, which integrates tailored education and advice for improving symptom self-management among cancer patients. We hypothesized that improved symptom self-management allows for early symptom control, better compliance, better dose intensity and reduce the necessity for extra visits / ER-visits. Methods: Patients initiating systemic therapy for malignant disease used a pre-programmed device in order to register compliance (in case of oral treatment), 12 clinical symptoms and 2 biometrics (weight and temperature). These real time data were collected onto a central platform, stratified according to different grades based on the PRO Common Terminology Criteria for Adverse Events (PRO-CTCAE ); and processed by an algorithm to render personalized advise when necessary. In case of severe (≥ Gr III) toxicity a dedicated nurse would intervene. Our primary outcome was symptom burden assessed via patient report tool. Secondary outcomes included relative dose intensity. Results: 168 Cancer patients were recruited from June 1 st 2017 to December 31 st 2017 across 4 sites, 76 men and 92 women. The median age 63 years (range 23-88 yr). 8275 Registrations were analyzed, pain was most frequently scored and loss of appetite was the most frequent gr III PROM. 108 patients scored toxicities (1413) requiring follow up or intervention by a dedicated nurse; resulting in 99 extra interventions: 34 extra consultations and 15 hospitalizations. Supportive treatment was adapted in 2, supportive advice given in 40 and in 12 instances no registration of the action was retrieved. Conclusions: The ambulatory follow up of patients with anti-cancer treatment appears feasible and reliable. Further effort to provide at home symptom management is warranted and requires both a logistic framework, as well as continuous education of motivated caregivers and patients. Evaluation on dose intensity and compliance of treatment will follow.
Strategies for promoting advocacy engagement in the Bay Area Physical Sciences Oncology Center (PS-OC) setting.
Authors: Susan Samson, Linda V. Vincent, Hannah Klein Connolly, Irene Acerbi, Valerie Weaver, Hope S. Rugo
Journal: Journal of Clinical Oncology (2012)

e11096 Background: Bay Area physical sciences researchers, supported by funding from the National Cancer Institute (NCI), encourage broad thinking to tackle the variability of breast cancer and to address data gaps in breast cancer prevention, emergence, behavior, and treatment. Methods: In this transdisciplinary innovation focused scientific arena, the Bay Area PS-OC also established the groundwork work for engaging advocates in the research programs. Results: Emerging results of this research collaboration: (1) Promote the integration of advocates into PSOC culture:Engage the perspectives of advocates to sensitize researchers to patient needs/concerns, and to encourage disruptive change in the interests of saving lives. Encourage front end inclusion of advocates in program planning and research design. (2) Create new pathways for the translation and dissemination of information: Utilize new internet technology and transdisciplinary collaboration models to help promote science literacy and communicate the implications of a mechanics-centric view of cancer. Reconfigure consumer expectations regarding the benefits of physical sciences approaches and highlight how this cutting edge science informs translational research in both cancer prevention and therapeutics. (3) Pilot an Advocate Mentor Program: Train the next generation of professionals, and specifically engage advocates in cross sector convergence collaborations with scientists, post-doctoral fellows, students, and clinicians. Conclusions: Some of the most exciting transdisciplinary engagement lies at the intersection of disciplines when all stakeholders (scientists, clinicians, and advocates) collectively consider new approaches and strategic processes that point to synergies of interest, thorny issues, capacity building, metrics and measures, and new engagement theories. Supported by: grant U54CA143836-01 from the NCI to VMW and JL; NCI SPORE P50 CA058207 to VMW, CP, &amp; SH; U01 ES019458-02 to ZW.
Delivery of miR-212 by chimeric peptide-condensed supramolecular nanoparticles enhances the sensitivity of pancreatic ductal adenocarcinoma to doxorubicin
Authors: Wei Chen, Yue Zhou, Xiao Zhi, Tao Ma, Hao Liu, Brayant Wei Chen, Xiaoxiao Zheng, Shangzhi Xie, Bin Zhao, Xinhua Feng, Xiaowei Dang, Tingbo Liang
Journal: Biomaterials (2018)

Pancreatic ductal adenocarcinoma (PDAC) is a destructive cancer with poor prognosis. Both novel therapeutic targets and approaches are needed to improve the overall survival of PDAC patients. MicroRNA-212 (miR-212) has been reported as a tumor suppressor in multiple cancers, but its definitive role and exact mechanism in the progression of pancreatic cancer is unclear. In this study, we developed a new chimeric peptide (PL-1) composed of plectin-1-targeted PDAC-specific and arginine-rich RNA-binding motifs which could condense miRNA to self-assemble supramolecular nanoparticles. These nanoparticles could deliver miR-212 into PDAC cells specifically and efficiently which also showed good stability in RNase and serum. Moreover, we demonstrated that PL-1/miR-212 nanoparticles could dramatically enhance the chemotherapeutic effect of doxorubicin for PDAC both in vitro and in vivo. In terms of mechanism, combined miR-212 intervention by PL-1/miR-212 nanoparticles resulted in obvious decrease of USP9X expression (ubiquitin specific peptidase 9, X-linked, USP9X) and eventually enhanced the doxorubicin induced apoptosis and autophagy of PDAC cells. These findings provide a new promising anti-cancer strategy via PL-1/miR-212 nanoparticles and identify miR-212/USP9X as a new potential target for future systemic therapy against human PDAC.
THU0079 Adiponectin aggravates bone erosion by promoting osteopontin production in synovial tissue of rheumatoid arthritis
Authors: J. Qian, L. Xu, X. Sun, Y. Wang, W. Xuan, Q. Zhang, P. Zhao, Q. Wu, R. Liu, N. Che, F. Wang, W. Tan, M. Zhang
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> We have previously reported that adiponectin (AD), an adipokine that is secreted by adipocytes, correlates closely with progressive bone erosion in rheumatoid arthritis (RA). The exact mechanism of AD towards promoting joint destruction remain unclear. <h3>Objectives</h3> Osteopontin (OPN) is required for osteoclast recruitment. We hypothesised that AD exacerbates bone erosion by inducing OPN expression in synovial tissue. This study aimed to evaluate a novel role for AD in RA. <h3>Methods</h3> The serum levels of AD and OPN were determined in 38 RA, 40 osteoarthritis (OA) patients, and 20 healthy controls using enzyme-linked immunosorbent assay (ELISA). AD and OPN production were measured by double immunofluorescence of RA and OA synovial tissue. Quantitative real-time PCR and immunofluorescence were used to evaluate the mRNA and protein expression levels of OPN in RA synovial fibroblasts (RASFs) and OA synovial fibroblasts after preincubation with AD, respectively. Migration of the RAW264.7 osteoclast precursors cell line was assessed using the Transwell migration assay and co-culture system. Bone destruction and osteoclastogenesis were assessed by immunohistochemistry, microcomputed tomography, and tartrate-resistant acid phosphatase (TRAP) staining in AD-treated collagen-induced arthritis (CIA) mice with or without OPN silencing. The expression levels of OPN and integrin α<sub>v</sub>β<sub>3</sub> in the ankle joint tissues of the mice were examined by double immunofluorescence. <h3>Results</h3> Our results indicated that the AD and OPN expression levels increased noticeably and were associated with each other in the RA serum. The AD distribution was coincident with that of OPN in the RA synovial tissue. AD stimulation of RASFs increased OPN production in a dose-dependent manner. AD-treated RASFs promoted RAW264.7 cell migration, and the effect was blocked with a specific antibody against OPN. Silencing of OPN using lentiviral-OPN short hairpin RNA reduced the number of TRAP-positive osteoclasts and the extent of bone erosion in the AD-treated CIA mice. When bound to integrin α<sub>v</sub>β<sub>3</sub>, OPN functions as a mediator of AD and osteoclasts. <h3>Conclusions</h3> Our study provides new evidence of AD involvement in bone erosion. AD induces the expression of OPN, which recruits osteoclasts and initiates bone erosion. These data highlight AD as a novel target for RA treatment. <h3>Disclosure of Interest</h3> None declared
Long‐term outcomes in chronic hypersensitivity pneumonitis
Authors: Iñigo Ojanguren, Ferran Morell, María‐Antonia Ramón, Ana Villar, Christian Romero, María Jesús Cruz, Xavier Muñoz
Journal: Allergy (2018)

The objective of this study was to analyze mortality, possible predictors of long-term survival, and health-related quality of life of a large chronic hypersensitivity pneumonitis (CHP) patient sample.Longitudinal study in patients diagnosed with CHP during 2004-2013, followed for at least 1 year. Patients remaining alive and consenting to participate had a follow-up visit during 2015, including a complete pulmonary function study and the EuroQol-5D and Beck Depression and Anxiety Inventories.Out of the 160 patients finally included, 87 remained alive. Seventy-three had died or underwent lung transplantation at the time of the study with a median survival of 7.0 (4.4-14.5) years. A Cox proportional risk model showed that factors associated with lower survival were as follows: increased age, a low percentage of lymphocytes in bronchoalveolar lavage (BAL), a decreased transfer factor of the lung for carbonmonoxide (DLCO), presence of honeycomb in the high-resolution chest scan (HRCT), and the usual interstitial pneumonia (UIP) histologic pattern. At follow-up, all patients presented an EuroQol-5D score <0.8 and 21(50%) and 9(28.6%) subjects presented a probable anxiety and depressive syndrome, respectively.CHP is a severe disease with a bad mid-term prognosis. Lymphocyte values in BAL and DLCO values at baseline, presence of honeycomb in HRCT, and UIP histologic pattern were found to be predictors of survival. Early accurate diagnosis of the disease is fundamental for prompt initiation of antigen avoidance.
Pollution control for a healthier Chinese population
Authors: Peixing Wan, Erping Long
Journal: The Lancet Planetary Health (2018)

Pollution control has for the first time been highlighted as one of the top priorities in China's strategy for national economic and social development in 2016–20, outlined in the 13th 5-year plan made by the Chinese Government.1XinhuaChina's 13th Five-Year Plan.http://www.xinhuanet.com/english/2016-03/16/c_135194463.htmDate: March 16, 2016Date accessed: April 16, 2018Google Scholar Among all issues, water and air pollution were the predominant problems that got major nationwide attention. Environmental policies could not only boost the development of relevant research in China, but also construct a sustainable environment for a healthier Chinese population as well. Water pollution poses a serious health risk for rural populations because Chinese grain production relies heavily on irrigation. The results of the 4th UN World Water Development Report showed that as one of the 13 water-deficient countries in the world, China has less than a quarter of the average access to fresh water.2World Water Assessment ProgrammeThe United Nations world water development report 4: Managing water under uncertainty and risk. UNESCO, Paris2012Google Scholar The scarcity of irrigation water results in lower production of grain, which is the staple food source for most of China's population. Meanwhile, excessive heavy metals, toxic compounds, Vibrio cholerae bacteria, dysentery-causing contaminants, and parasites exist in polluted water.3Wang M Webber M Finlayson B Barnett J Rural industries and water pollution in China.J Environ Manage. 2008; 86: 648-659Crossref PubMed Scopus (213) Google Scholar Although sewage treatment and purification are used, drinking water still poses a great threat to human health. Over the past three decades, the incidence of lung cancer and chronic-obstructive disease are rapidly increasing because of the heavy air pollution.4Yang G Wang Y Zeng Y et al.Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010.Lancet. 2013; 381: 1987-2015Summary Full Text Full Text PDF PubMed Scopus (1509) Google Scholar Air pollution control should therefore be implemented immediately to reduce the burden of environment-related disease. A serious political initiative in tackling pollution is a good start. China, however, needs to clearly define accountability to accomplish its environmental goals. We are looking forward to witnessing substantial actions to reduce pollution emissions and ease the environmental disease burden on the Chinese population. We declare no competing interests.
Abstract 19080: Risk Stratification in Arch Surgery: When High Risk is Too High? Implications for Open or Endovascular Repair From a 15-Years Survey on Over 350 Patients
Authors: Mauro Iafrancesco, Aaron M Ranasinghe, Vamsidhar Dronavalli, Donald J Adam, Martin W Claridge, Peter J Riley, Ian J McCafferty, Domenico Pagano, Jorge Mascaro
Journal: Circulation (2014)

Introduction: At present, there are not risk scoring tools to predict in-hospital mortality for total aortic arch replacement (TAR), Hypothesis: To assess if Logistic Euroscore (LogES) is a useful tool for risk assessment in aortic arch surgery and which other operative factors may help to better identify high-risk patients. Methods: All patients who underwent open arch procedure between 1998 and 2013 were identified from our prospectively collected database which include 93 preoperative variables. Results: Three-hundred-fifty-seven open arch procedures were identified. Two-hundred-forty-two patients underwent TAR, 199 with conventional technique and 43 with frozen elephant trunk (FET) technique. Patients with higher LogES had higher in-hospital mortality (see table 1). Patient with a LogEs &lt;20, 20-60 and &gt;60 were classified as low-, high- or very high-risk, respectively. Complexity of surgery, defined as need for aortic root replacement (ARR) and/or mitral valve repair/replacement (MVR), increased significantly the risk of operation (27% vs. 4.2%, p:0.004) only in conventional TAR in high-risk patients. Low-risk patients were associated with low mortality regardless the extent of surgery whilst very high risk-patients had a high-risk of death even with simple operations. Mortality risk in FET was not increased by need for ARR/MVR. Rate of permanent neurological deficit remained low in all category of patients. Spinal cord injury (SCI) did not occur in any conventional TAR. Conclusions: Open surgery should remain the treatment of choice for patients with low/moderate LogES and high LogES without need for ARR/MVR. Patient with very-high LogES who do not need ARR/MVR should be consider for endovascular repair. Patient with high and very-high LogES and need for ARR/MVR cannot undergo endovascular treatment and remain a significant challenge. FET remains a procedure with an increase risk of death and SCI.
Association Between the Liaison Committee on Medical Education’s Diversity Standards and Changes in Percentage of Medical Student Sex, Race, and Ethnicity
Authors: Dowin H. Boatright, Elizabeth A. Samuels, Laura Cramer, Jeremiah Cross, Mayur Desai, Darin Latimore, Cary P. Gross
Journal: JAMA (2018)

This study examines the change in matriculant sex, race, and ethnicity in US medical schools after the 2009 implementation of diversity standards from the Liaison Committee on Medical Education (LCME) meant to broaden diversity among qualified applicants.
A Parental Perspective on Strengthening Knowledge After Acute Flaccid Myelitis
Authors: Riley Bove, Heather Werdal, Erin Olivera
Journal: JAMA Pediatrics (2018)

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