tbuckley/cabot-search huggingface dataset:
Abstract 12661: Respiratory Muscle Weakness is an Independent Determinant for Decreased Parasympathetic Activity in Patients With Chronic Heart Failure
Authors: Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Yumi Kamada, Kanae Yabu, Takeshi Nakamura, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
Journal: Circulation (2016)

Background: Decreased parasympathetic activity and respiratory muscle weakness are known as indicators for poor outcome in patients with chronic heart failure (CHF). Although the effect of respiratory modulation on autonomic system has been documented, the relationship between respiratory muscle strength and parasympathetic activity is still unknown. The present study aimed to investigate the influence of respiratory muscle weakness on parasympathetic activity in CHF patients. Methods: We studied 254 patients with compensated CHF (60.3±12.0 years, 202 males) who received cardiac rehabilitation during hospitalization and after hospital discharge. Maximal inspiratory pressure (PI max ) was measured as a respiratory muscle strength using a spirometer 2 months after the discharge. Patients received symptom limited cardiopulmonary exercise test (CPX) and then heart rate recovery (HRR) during the first minute after the cessation of CPX was assessed as a parasympathetic activity. HRR of ≤18 /min was determined as a decreased parasympathetic activity. Patients were divided into three groups based on the tertile of PI max : low PI max (PI max &lt;58.7 cmH 2 O), moderate PI max (58.7≤ PI max &lt;83.6 cmH 2 O) and high PI max (PI max ≥83.6 cmH 2 O) groups. We compared the HRR among the three groups and identified the determinant for HRR of ≤18 /min using a multivariate logistic regression analysis. Results: Ninety-four patients among the studied patients, 47 in the low PI max group, 28 in the moderate PI max group and 19 in the high PI max group, showed HRR of ≤18 /min. The low PI max group showed significantly lower HRR as compared with the other two groups (P=0.001 and &lt;0.001, respectively). The multivariate logistic regression analysis identified the PI max as a significant independent determinant for HRR of ≤18 /min (odds ratio=0.832, P=0.008, Figure). Conclusion: Respiratory muscle weakness was an independent determinant for decreased parasympathetic activity in patients with CHF.
P2.07-034 Health Status in Patients with Small-Cell Lung Cancer Treated with Nivolumab Alone or Combined with Ipilimumab: CheckMate 032
Authors: A. Ardizzoni, A. Farago, A. Atmaca, E. Calvo, F. Taylor, B. Bennett, G. Selvaggi, A. Pieters, J. Penrod, Y. Yuan, D. Ross Camidge
Journal: Journal of Thoracic Oncology (2017)
Biomarker analysis of randomized controlled trial (RCT) of adjuvant chemotherapy (CT) using plasma EBV DNA to identify patients (pts) at higher risk of relapse after radiotherapy (RT) or chemoradiation (CRT) in nasopharyngeal cancer (NPC)
Authors: E.P. Hui, A.T.C. Chan, R.K.C. Ngan, S.Y. Tung, A.C.K. Cheng, W.T. Ng, V.H. Lee, B. Ma, H.C. Cheng, F.C.S. Wong, H.H. Loong, M. Tong, D.M. Poon, A.T. Ahuja, A.D. King, K. Wang, F. Mo, B.C. Zee, K.C.A. Chan, Y.M.D. Lo
Journal: Annals of Oncology (2017)
Gender and cardiovascular disease: are sex-biased microRNA networks a driving force behind heart failure with preserved ejection fraction in women?
Authors: Barend W Florijn, Roel Bijkerk, Eric P van der Veer, Anton Jan van Zonneveld
Journal: Cardiovascular Research (2017)

Abstract Cardiovascular disease (CVD) is the primary cause of death among men and women worldwide. Nevertheless, our comprehension of how CVD progresses in women and elicits clinical outcomes is lacking, leading CVD to be under-diagnosed and under-treated in women. A clear example of this differential presentation of CVD pathophysiologies in females is the strikingly higher prevalence of heart failure with preserved ejection fraction (HFpEF). Women with a history of pre-eclampsia or those who present with co-morbidities such as obesity, hypertension, and diabetes mellitus are at increased risk of developing HFpEF. Long understood to be a critical CVD risk factor, our understanding of how gender differentially affects the development of CVD has been greatly expanded by extensive genomic and transcriptomic studies. These studies uncovered a pivotal role for differential microRNA (miRNA) expression in response to systemic inflammation, where their co-ordinated expression forms a post-transcriptional regulatory network that instigates microcirculation defects. Importantly, the potential sex-biased expression of the given miRNAs may explain sex-specific cardiovascular pathophysiologies in women, such as HFpEF. Sex-biased miRNAs are regulated by oestrogen (E2) in their transcription and processing or are expressed from loci on the X-chromosome due to incomplete X-chromosome inactivation. Interestingly, while E2-induced miRNAs predominantly appear to serve protective functions, it could be argued that many X-linked miRNAs have been found to challenge microvascular and myocardial integrity. Therefore, menopausal E2 deficiency, resulting in protective miRNA loss, and the augmentation of X-linked miRNA expression, may well contribute to the molecular mechanisms that underlie the female-specific cardiovascular aetiology in HFpEF.
The gendered effects of foreign investment and prolonged state ownership on mortality in Hungary: an indirect demographic, retrospective cohort study
Authors: Gábor Scheiring, Dénes Stefler, Darja Irdam, Mihaly Fazekas, Aytalina Azarova, Irina Kolesnikova, János Köllő, Vladimir Popov, Ivan Szelenyi, Michael Marmot, Michael Murphy, Martin McKee, Martin Bobak, Lawrence King
Journal: The Lancet Global Health (2017)

Research on the health outcomes of globalisation and economic transition has yielded conflicting results, partly due to methodological and data limitations. Specifically, the outcomes of changes in foreign investment and state ownership need to be examined using multilevel data, linking macro-effects and micro-effects. We exploited the natural experiment offered by the Hungarian economic transition by means of a multilevel study designed to address these gaps in the scientific literature.For this indirect demographic, retrospective cohort study, we collected multilevel data related to Hungary between 1995 and 2004 from the PrivMort database and other sources at the town, company, and individual level to assess the relation between the dominant company ownership of a town and mortality. We grouped towns into three ownership categories: dominant state, domestic private, and foreign ownership. We did population surveys in these towns to collect data on vital status and other characteristics of survey respondents' relatives. We assessed the relation between dominant ownership and mortality at the individual level. We used discrete-time survival modelling, adjusting for town-level and individual-level confounders, with clustered SEs.Of 83 eligible towns identified, we randomly selected 52 for inclusion in the analysis and analysed ownership data from 262 companies within these towns. Additionally, between June 16, 2014, and Dec 22, 2014, we collected data on 78 622 individuals from the 52 towns, of whom 27 694 were considered eligible. After multivariable adjustment, we found that women living in towns with prolonged state ownership had significantly lower odds of dying than women living in towns dominated by domestic private ownership (odds ratio [OR] 0·74, 95% CI 0·61-0·90) or by foreign investment (OR 0·80, 0·69-0·92).Prolonged state ownership was associated with protection of life chances during the post-socialist transformation for women. The indirect economic benefits of foreign investment do not translate automatically into better health without appropriate industrial and social policies.The European Research Council.
2017 Roadmap for Innovation—ACC Health Policy Statement on Healthcare Transformation in the Era of Digital Health, Big Data, and Precision Health
Authors: Sanjeev P. Bhavnani, Kapil Parakh, Ashish Atreja, Regina Druz, Garth N. Graham, Salim S. Hayek, Harlan M. Krumholz, Thomas M. Maddox, Maulik D. Majmudar, John S. Rumsfeld, Bimal R. Shah
Journal: Journal of the American College of Cardiology (2017)
How do clinics perform across multiple end of life metrics?
Authors: Laura Elizabeth Panattoni, Catherine R. Fedorenko, Mikael Anne Greenwood-Hickman, Qin Sun, Julia Rose Walker, Karma L. Kreizenbeck, Cara L. McDermott, Ted Conklin, Bruce Smith, Gary H. Lyman, Scott David Ramsey
Journal: Journal of Clinical Oncology (2017)

86 Background: National bodies have proposed a number of metrics to measure quality of care at the end of life (EOL). MACRA legislation allows clinics to select the metrics they report to CMS. The self-selection of reported metrics leaves open questions about how representative certain measures, particularly in isolation, may be of overall EOL care in community settings. We examined the consistency of clinical-level performance across three common EOL metrics. Methods: We linked cancer registry records for solid tumor cancer patients diagnosed in Washington State from 2013-2016 with claims from two regional commercial insurers. Representing national recommendations, we compiled 3 EOL quality metrics for each clinic: 1) Chemotherapy in last 14 days of life (DoL); 2) More than 1 ED visit in last 30 DoL; and 3) Admission to ICU in last 30 DoL. Consistency was measured by comparing performance in the top and bottom 3 rd across metrics. We compared consistency based on unadjusted rates and risk-standardized rates calculated following CMS methods. Results: The study included 1,535 patients across 12 clinics (median 110 [IQR: 54 – 199] patients/clinic). The clinic rates are below. (See Table.) According to both unadjusted and adjusted rankings, no clinics ranked in the top 3 rd across all metrics. Half of clinics (6 of 12) simultaneously ranked in the top 3 rd and bottom 3 rd of a metric, i.e. high/low performers. The number of high/low performers varied when examining discrete pairs of metrics. The overall pattern was mainly driven by inconsistency between performance in the chemotherapy and ED metrics. Of the other discrete pairs, ICU/Chemo and ICU/ED, clinics were more consistent in performance. Conclusions: We found that clinic performance was not consistently in the highest or lowest tertile across common EOL metrics, suggesting that requiring clinics to report a standard set of metrics may provide a more accurate indication of quality. Furthermore, different population management strategies may be required to improve care targeted by each measure. Future work should focus on the development of multi-dimensional EOL quality performance measures. [Table: see text]
Chronic Health Conditions and Neurocognitive Function in Aging Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study
Authors: Yin Ting Cheung, Tara M Brinkman, Chenghong Li, Yasmin Mzayek, Deokumar Srivastava, Kirsten K Ness, Sunita K Patel, Rebecca M Howell, Kevin C Oeffinger, Leslie L Robison, Gregory T Armstrong, Kevin R Krull
Journal: JNCI Journal of the National Cancer Institute (2017)

Neurocognitive impairment in survivors of childhood cancer may be associated with direct neurotoxicity, as well as indirect effects of systemic health complications. We evaluated associations among treatment exposures, chronic health conditions, and neurocognitive outcomes in adult survivors of childhood cancer. Participants included 5507 adult survivors of childhood cancer (47.1% male; mean [SD] age = 31.8 [7.6] years at evaluation; 23.1 [4.5] years postdiagnosis) in the Childhood Cancer Survivor Study who completed a self-report measure of neurocognitive function. Cardiac, pulmonary, and endocrine chronic health conditions were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03). Structural equation modeling was used to examine a priori hypothesized causal pathways among cancer treatment, subsequent chronic health conditions, and neurocognitive outcomes. Multivariable models were used to estimate relative risk for associations of treatments and chronic conditions on neurocognitive function. All statistical tests were two-sided. One-third of survivors with a grade 2 or higher chronic condition reported impairments in task efficiency and memory. In addition to direct effects of cranial radiation, path analyses and multivariable models demonstrated direct effects of cardiopulmonary (β = 0.10, P = .002; relative risk [RR] = 1.27, 95% confidence interval [CI] = 1.12 to 1.44) and endocrine (β = 0.07, P = .04; RR = 1.14, 95% CI = 1.02 to 1.28) conditions on impaired task efficiency. We identified similar effects of cardiopulmonary condition on memory (P = .01) and emotional regulation (P = .01). Thoracic radiation was associated with impaired task efficiency (P = .01) and emotional regulation (P = .01) through endocrine morbidity. Non-neurotoxic exposures, such as thoracic radiation, can adversely impact survivors' neurocognitive function through chronic conditions. Management of chronic diseases may mitigate neurocognitive outcomes among aging survivors of childhood cancer.
Response to: ‘Acquiring new <i>N-</i>glycosylation sites in variable regions of immunoglobulin genes by somatic hypermutation is a common feature of autoimmune diseases’ by Visser <i>et al</i>
Authors: Rochelle D Vergroesen, Linda M Slot, Lise Hafkenscheid, Marvyn T Koning, Hans U Scherer, René E M Toes
Journal: Annals of the Rheumatic Diseases (2017)

We thank Visser et al 1 for their interesting correspondence to our recently published letter entitled ‘B-cell receptor sequencing of anticitrullinated protein antibody (ACPA) IgG-expressing B cells indicates a selective advantage for the introduction of N -glycosylation sites during somatic hypermutation’.2 Visser et al performed a meta-analysis on publicly available datasets to analyse acquired N -glycosylation sites in the variable region of B cell receptors (BCRs) derived from patients with different autoimmune diseases. BCR sequences of antigen-specific B cells isolated after vaccination or infection and BCR sequences of healthy donors (HD) served as comparison. The meta-analysis showed acquired N -glycosylation sites in 9% of BCR sequences derived from patients with autoimmune diseases and in 2.3% and 2.7% of sequences derived from HD and vaccine/infection-induced B cells, respectively. This enhanced frequency of acquired N -glycosylation sites (compared with controls) was observed for all autoimmune diseases, with the exception of ankylosing spondylitis (AS, 3%) …
Chronic sun exposure is associated with distinct histone acetylation changes in human skin
Authors: S. Ding, J. Chen, Q. Zeng, J. Lu, L. Tan, A. Guo, J. Kang, S. Yang, Y. Xiang, C. Zuo, J. Huang
Journal: British Journal of Dermatology (2017)

Photoageing is attributed to continuous sunlight or artificial ultraviolet exposure and manifests as clinical and histological changes in skin. Epigenetic changes have been found to be involved in the pathogenesis of photoageing. However, the underlying mechanisms are unclear.To analyse histone modification patterns in sun-exposed and nonexposed skin, and to identify the abnormally histone-modified genes related to photoageing.Skin biopsies were collected from both the outer forearm (sun-exposed area) and the buttock (sun-protected area) in 20 healthy middle-aged female volunteers. Global histone H3/H4 acetylation and H3K4/H3K9 methylation statuses were assessed by enzyme-linked immunosorbent assay. Expression levels of histone acetyltransferases and histone deacetylases were measured by reverse-transcriptase quantitative polymerase chain reaction (qPCR) and Western blot. Chromatin immunoprecipitation combined with DNA microarray (ChIP-chip) assay with anti-acetyl-histone H3 antibody in a sun-exposed pool (combining six sun-exposed skin samples) and a nonexposed pool (combining six nonexposed skin samples) was conducted to explore the abnormally acetylated histone H3 genes related to photoageing; ChIP-qPCR was then used to verify the results of ChIP-chip.We observed higher global histone H3 acetylation levels increased EP300 and decreased HDAC1 and SIRT1 expression in sun-exposed skin compared with matched nonexposed skin. Furthermore, the ChIP-chip assay showed that 227 genes displayed significant hyperacetylation of histone H3, and 81 genes displayed significant hypoacetylation of histone H3 between the two groups. Histone H3 acetylation levels on the promoters of PDCD5, ITIH5, MMP1 and AHR were positively correlated with the mRNA expression of the corresponding gene.Chronic sun exposure-induced histone H3 hyperacetylation may play a critical role in the pathogenesis of skin photoageing.
Respiratory adverse effects of opioids for breathlessness: a systematic review and meta-analysis
Authors: Cindy A. Verberkt, Marieke H.J. van den Beuken-van Everdingen, Jos M.G.A. Schols, Sushma Datla, Carmen D. Dirksen, Miriam J. Johnson, Sander M.J. van Kuijk, Emiel F.M. Wouters, Daisy J.A. Janssen
Journal: European Respiratory Journal (2017)

Previous studies have shown that opioids can reduce chronic breathlessness in advanced disease. However, physicians remain reluctant to prescribe opioids for these patients, commonly due to fear of respiratory adverse effects. The aim of this study was to systematically review reported respiratory adverse effects of opioids in patients with advanced disease and chronic breathlessness. PubMed, Embase, the Cochrane Central Register of Controlled Trials, CINAHL, ClinicalTrials.gov and the reference lists of relevant systematic reviews were searched. Two independent researchers screened against predefined inclusion criteria and extracted data. Meta-analysis was conducted where possible. We included 63 out of 1990 articles, describing 67 studies. Meta-analysis showed an increase in carbon dioxide tension (0.27 kPa, 95% CI 0.08–0.45 kPa,) and no significant change in oxygen tension and oxygen saturation (both p&gt;0.05). Nonserious respiratory depression (definition variable/not stated) was described in four out of 1064 patients. One cancer patient pretreated with morphine for pain needed temporary respiratory support following nebulised morphine for breathlessness (single case study). We found no evidence of significant or clinically relevant respiratory adverse effects of opioids for chronic breathlessness. Heterogeneity of design and study population, and low study quality are limitations. Larger studies designed to detect respiratory adverse effects are needed.
A qualitative exploration of companion involvement in the presurgical consent visit for patients undergoing major surgery for advanced cancer.
Authors: Sarina Isenberg, Debra Roter, Jennifer L Wolff, Thomas J. Smith, Katherine Clegg Smith, Rebecca Aslakson
Journal: Journal of Clinical Oncology (2017)

29 Background: The decision to undergo non-emergent cancer surgery is complicated by risk of mortality and diminished quality of life weighed against potential benefits of extended life and symptom management. Sometimes, unanticipated clinical information or quality of life considerations (“disruptions”) arise during these pre-surgical visits, which can lead to to the surgery’s reconsideration, postponement, or cancelation. Little is known about disruptions. This paper explores case studies of how patients, companions, and surgeons negotiate surgical plan disruptions. Methods: This study is based on secondary analysis of pre-surgical recordings with 61 patients and nine surgeons. Patients were recruited at nine surgical oncology clinics at an academic tertiary care hospital from July 2015-September 2016. Qualitative analysis incorporated existing theory and inductively developed codes. Results: Four of the 61 pre-surgical visits were identified as having a disruption. Each case study explores the presentation of the disruption, patient reaction to the disruption, companion involvement and role in the encounter, and resolution of the disruption. While each disruption involves a nuanced approach to decision making, there are cross cutting themes across the cases. Specifically, analysis of these visits explored companion roles, including: patient autonomy-enhancing behaviors and patient autonomy-detracting behaviors. This analysis also addressed variation and similarities in surgeons’ behaviors, including examples of collaborative, facilitative, and informative behaviors. Conclusions: As more high risk surgeries are performed on sicker and older patients, decision making regarding whether to pursue surgery may become increasingly complex, and lend itself more frequently to disruptions. Disruption reflects the engagement and mutual influence of multi-party participants in treatment decision making. By enhancing our understanding of disruptions, we hope to assist in the delicate communication and shared decision making needed for a patient and family centered resolution. Clinical trial information: NCT02489799.
Case 36-2017
Authors: Gurpreet Dhaliwal, Amirkasra Mojtahed, Annemarie E. Fogerty, Stephan Kadauke, Johnathan P. Mack
Journal: New England Journal of Medicine (2017)

A 30-year-old man presented with fatigue, rash, anemia, and thrombocytopenia. Three years earlier, after an automobile accident, abdominal-wall hematomas, anemia, thrombocytopenia, and hematuria had developed but spontaneously resolved. A diagnostic test was performed.
P2.03-057 Effectiveness of Icotinib on Uncommon EGFR Exon 20 Insert Mutations: A763_Y 764insFQEA in Non-Small-Cell Lung Cancer
Authors: C. Xu, W. Wang, W. Zhuang, Z. Song, R. Chen, Y. Guan, X. Yi, G. Chen, M. Fang, T. Lv, Y. Song
Journal: Journal of Thoracic Oncology (2017)
Nasopharyngeal bacterial colonization in asthmatic children and healthy controls
Authors: E Roumpedaki, P Xepapadaki, A Doudoulakakis, E Lebessi, M Passioti, C Skevaki, P Taprantzi, M Tsakanikos, M Tsolia, T Dutre, Claus Bachert, L Lindholm, H Lukkarinen, T Jarti, F Albert, A Graser, W Geissdoerfer, C Bogdan, T Zimmermann, S Finotto, A Sobanska, ML Kowalski, NG Papadopoulos
Journal: Allergy (2013)
Prognostic impact of gene mutations in myelodysplastic syndromes with ring sideroblasts
Authors: Iván Martín, Esperanza Such, Blanca Navarro, Eva Villamón, Ana Vicente, Elvira Mora, Laia Pedrola, Mariam Ibáñez, María López-Pavía, Mar Tormo, Alicia Serrano, Miguel Ángel Sanz, José Cervera, Guillermo Sanz
Journal: Blood Cancer Journal (2017)
Consequences of Reductions in Hospital Readmissions
Authors: Gregg C. Fonarow, Clyde W. Yancy
Journal: JAMA (2017)

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