tbuckley/cabot-search huggingface dataset:
Risks and Benefits of Marijuana Use
Authors: Salomeh Keyhani, Stacey Steigerwald, Julie Ishida, Marzieh Vali, Magdalena Cerdá, Deborah Hasin, Camille Dollinger, Sodahm R. Yoo, Beth E. Cohen
Journal: Annals of Internal Medicine (2018)

Background: Despite insufficient evidence regarding its risks and benefits, marijuana is increasingly available and is aggressively marketed to the public. Objective: To understand the public's views on the risks and benefits of marijuana use. Design: Probability-based online survey. Setting: United States, 2017. Participants: 16 280 U.S. adults. Measurements: Proportion of U.S. adults who agreed with a statement. Results: The response rate was 55.3% (n = 9003). Approximately 14.6% of U.S. adults reported using marijuana in the past year. About 81% of U.S. adults believe marijuana has at least 1 benefit, whereas 17% believe it has no benefit. The most common benefit cited was pain management (66%), followed by treatment of diseases, such as epilepsy and multiple sclerosis (48%), and relief from anxiety, stress, and depression (47%). About 91% of U.S. adults believe marijuana has at least 1 risk, whereas 9% believe it has no risks. The most common risk identified by the public was legal problems (51.8%), followed by addiction (50%) and impaired memory (42%). Among U.S. adults, 29.2% agree that smoking marijuana prevents health problems. About 18% believe exposure to secondhand marijuana smoke is somewhat or completely safe for adults, whereas 7.6% indicated that it is somewhat or completely safe for children. Of the respondents, 7.3% agree that marijuana use is somewhat or completely safe during pregnancy. About 22.4% of U.S. adults believe that marijuana is not at all addictive. Limitation: Wording of the questions may have affected interpretation. Conclusion: Americans' view of marijuana use is more favorable than existing evidence supports. Primary Funding Source: National Heart, Lung, and Blood Institute.
Environmental Obesogens: Mechanisms and Controversies
Authors: Jerrold J. Heindel, Bruce Blumberg
Journal: The Annual Review of Pharmacology and Toxicology (2018)

Obesity is a worldwide pandemic in adults as well as children and adds greatly to health care costs through its association with type 2 diabetes, metabolic syndrome, cardiovascular disease, and cancers. The prevailing medical view of obesity is that it results from a simple imbalance between caloric intake and energy expenditure. However, numerous other factors are important in the etiology of obesity. The obesogen hypothesis proposes that environmental chemicals termed obesogens promote obesity by acting to increase adipocyte commitment, differentiation, and size by altering metabolic set points or altering the hormonal regulation of appetite and satiety. Many obesogens are endocrine disrupting chemicals that interfere with normal endocrine regulation. Endocrine disrupting obesogens are abundant in our environment, used in everyday products from food packaging to fungicides. In this review, we explore the evidence supporting the obesogen hypothesis, as well as the gaps in our knowledge that are currently preventing a complete understanding of the extent to which obesogens contribute to the obesity pandemic.
Impact of Hyperthyroidism and Its Correction on Vascular Reactivity in Humans
Authors: RaffaeleNapoli, BernadetteBiondi, VincenzoGuardasole, MargheritaMatarazzo, FrancescoPardo, ValentinaAngelini, SerafinoFazio, LuigiSaccà
Journal: Circulation (2001)

Background— Although thyroid hormone (TH) exerts relevant effects on the cardiovascular system, it is unknown whether TH also regulates vascular reactivity in humans. Methods and Results— We studied 8 patients with hyperthyroidism, basally (H) and 6 months after euthyroidism was restored by methimazole (EU). Thirteen healthy subjects served as control subjects (C). We measured forearm blood flow (FBF) by strain-gauge plethysmography during intrabrachial graded infusion of acetylcholine, sodium nitroprusside (SNP), norepinephrine, and L-NMMA (inhibitor of NO synthesis). Basal FBF (in mL · dL−1 · min−1) was markedly higher in H than in C (5.8±1.2 and 1.9±0.1, respectively; P<0.001) and was close to normal in EU (2.6±0.3, P<0.01 versus H). During acetylcholine infusion, FBF increased much more in H (+33±5) than in C (+14±3, P<0.01 versus H) and in EU (+20±5, P=0.01 versus H and P=NS versus C). In contrast, the response to SNP infusion was comparable in the patients and control subjects. During norepinephrine...
Abstract 12671: Left Atrial Volumes Corrected for Heart Size are Superior Echocardiographic Measures for Diagnosing Paroxysmal Atrial Fibrillation in Ischemic Stroke and Transient Ischemic Attack Patients
Authors: Kristoffer G Skaarup, Hanne Christensen, Nis Høst, Masti M Mahmoud, Christian Ovesen, Flemming J Olsen, Tor Biering-Sørensen
Journal: Circulation (2016)

Introduction: The underlying cause of ischemic strokes (IS) and transient ischemic attacks (TIA) is not identified in 25% of the cases. However, asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of the cryptogenic IS or TIA Hypothesis: The aim of this study was to examine if echocardiographic measures of LA volume (LAV) corrected for the left ventricular (LV) length (LAVMax/Min/LV length) could predict PAF in patients with IS and TIA. Methods: We retrospectively included 218 patients who after acute IS or TIA underwent a transthoracic echocardiographic examination in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination. Results: Patients in the PAF group were significantly older (62±13 vs. 52±14 years, p&lt;0.001), had higher CHA2DS2-VASc score (3.3±1.3 vs. 3.8±1.3, p=0.042) and higher National Institutes of Health Stroke Scale (NIHSS) score (2.9±4.9 vs. 1.4±3.3, p=0.016) than patients without PAF. Besides these, no other baseline characteristics (sex, hypertension, diabetes, cholesterol) were associated with PAF. None of the conventional echocardiographic parameters (LV ejection fraction, LV volumes, E/A-ratio, E-wave deceleration time, LAVmax) were significantly associated with PAF. However, the atrial measures corrected for LV length (LAVMax/LV length and LAVMin/LV length) were significantly higher (LAVMax/LV length: 7.6±3.3 mL/cm vs. 6.5± 2.0 mL/cm, p=0.009; LAVMin/LV length: 3.7± 2.1 mL/cm vs. 2.8±1.1 mL/cm, p&lt;0.001) in patients with PAF (Figure), even after adjustment for age, gender, CHA2DS2-VASc and NIHSS scores. Conclusion: In patients with IS and TIA, measures of LA size corrected for LV length are independently associated with the presence of PAF. Applying these may yield better risk stratification for PAF-presence in patients suffering cryptogenic IS and TIA.
Association Between 2 Angiographic Subtypes of Renal Artery Fibromuscular Dysplasia and Clinical Characteristics
Authors: SébastienSavard, OlivierSteichen, ArshidAzarine, MichelAzizi, XavierJeunemaitre, Pierre-FrançoisPlouin
Journal: Circulation (2012)

Background—Initially based on histology, the diagnosis of renal artery fibromuscular dysplasia (FMD) is now based mostly on angiographic appearance because arterial tissue samples are rarely available. This retrospective cross-sectional study aimed to assess the clinical relevance of a binary angiographic classification of FMD lesions (unifocal or multifocal) based on computed tomographic or magnetic resonance angiography. Methods and Results—Adult patients diagnosed with FMD in a single tertiary care center for hypertension management were identified by screening of electronic files. FMD lesions were reviewed and classified according to computed tomography or magnetic resonance angiography as multifocal if there were at least 2 stenoses in the same arterial segment; otherwise, they were classified as unifocal. Of 337 patients with established renal artery FMD, 276 (82%) were classified as multifocal. Patients with unifocal and multifocal lesions differed significantly in median age at diagnosis of FMD (3...
Abstract 16958: ADHERE Risk Levels Predict 60-day Death and Re-hospitalization in Clinical Trial Patients with Acute Decompensated Heart Failure
Authors: Virginia B Hebl, Susanna R Stevens, Hiroyuki Takahama, Bradley A Bart, Horng H Chen, G. M Felker, Steven R Goldsmith, Margaret M Redfield
Journal: Circulation (2014)

Background: The Acute Decompensated Heart Failure National Registry (ADHERE) risk levels are a validated tool to assess the risk of in-hospital mortality in patients with acute decompensated heart failure (ADHF). The objective of this study is to determine if the risk levels predict 60-day outcomes in well-defined ADHF patients from NIH Heart Failure Clinical Research Network (HFCRN) trials. Methods: Our study cohort included 835 unique patients with ADHF enrolled in 3 NIH HFCRN trials: Diuretic Optimization Strategies Evaluation (DOSE), CARdiorenal REScue Study in Acute Decompensated Heart Failure (CARRESS-HF), and Renal Optimization Strategies Evaluation (ROSE). ADHERE risk level was assigned, as previously described, by baseline BUN (&lt;43 vs. ≥43 mg/dL), Cr (&lt;2.2 vs. ≥2.2, a modification from 2.75 mg/dL used in ADHERE due the Cr distribution in our study population), and systolic BP (≥ 115 vs &lt; 115 mmHg). Baseline characteristics and outcomes were compared between risk levels. Results: Of the 835 patients enrolled in DOSE (308), CARRESS-HF (188), and ROSE (360), an ADHERE risk level could be assigned to 830, with 62 (8%) high, 521 (63%) intermediate, 247 (30%) low risk. Baseline characteristics (Table 1) and outcomes (Table 2), including combined 60-day death and re-hospitalization (hazard ratio 1.94, high risk versus low risk, p&lt;0.01), varied by ADHERE risk level. Conclusion: ADHERE risk levels predict 60-day death and re-hospitalization rates in patients with ADHF. These results extend the utility of the ADHERE risk levels, by informing longer-term clinical decisions regarding advanced heart failure treatment, care transition strategies and clinical trial design.
BMA urges new health secretary to “get a grip” on staffing crisis as vacancies increase
Authors: Abi Rimmer
Journal: BMJ (2018)

Data from NHS Digital show that almost 29 000 NHS jobs were advertised in England in March this year, up from just over 26 000 advertised in the same month in 2015.

Anthea Mowat, chair of the BMA’s representative body, said that the figures showed that the previous health secretary for England, Jeremy Hunt, had let NHS staffing “spiral out of control.” She said that Matt Hancock, the new secretary of state for health and social care, must “get a firm grip” on the staffing crisis “if he truly wants to put the NHS on …
Exploratory study examining the at-home feasibility of a wearable tool for social-affective learning in children with autism
Authors: Jena Daniels, Jessey N. Schwartz, Catalin Voss, Nick Haber, Azar Fazel, Aaron Kline, Peter Washington, Carl Feinstein, Terry Winograd, Dennis P. Wall
Journal: npj Digital Medicine (2018)

Abstract Although standard behavioral interventions for autism spectrum disorder (ASD) are effective therapies for social deficits, they face criticism for being time-intensive and overdependent on specialists. Earlier starting age of therapy is a strong predictor of later success, but waitlists for therapies can be 18 months long. To address these complications, we developed Superpower Glass, a machine-learning-assisted software system that runs on Google Glass and an Android smartphone, designed for use during social interactions. This pilot exploratory study examines our prototype tool’s potential for social-affective learning for children with autism. We sent our tool home with 14 families and assessed changes from intake to conclusion through the Social Responsiveness Scale (SRS-2), a facial affect recognition task (EGG), and qualitative parent reports. A repeated-measures one-way ANOVA demonstrated a decrease in SRS-2 total scores by an average 7.14 points ( F (1,13) = 33.20, p = &lt;.001, higher scores indicate higher ASD severity). EGG scores also increased by an average 9.55 correct responses ( F (1,10) = 11.89, p = &lt;.01). Parents reported increased eye contact and greater social acuity. This feasibility study supports using mobile technologies for potential therapeutic purposes.
Prediction of Life-Threatening Ventricular Arrhythmia in Patients With Arrhythmogenic Cardiomyopathy
Authors: Øyvind H. Lie, Christine Rootwelt-Norberg, Lars A. Dejgaard, Ida Skrinde Leren, Mathis K. Stokke, Thor Edvardsen, Kristina H. Haugaa
Journal: JACC. Cardiovascular imaging (2018)

This study aimed to identify clinical, electrocardiographic (ECG) and cardiac imaging predictors of first-time life-threatening ventricular arrhythmia in patients with arrhythmogenic cardiomyopathy (AC).The role of clinical, electrocardiographic, and cardiac imaging parameters in risk stratification of patients without ventricular arrhythmia is unclear.We followed consecutive AC probands and mutation-positive family members with no documented ventricular arrhythmia from time of diagnosis to first event. We assessed clinical, electrocardiographic, and cardiac imaging parameters according to Task Force Criteria of 2010 in addition to left ventricular (LV) and strain parameters. High-intensity exercise was defined as >6 metabolic equivalents.We included 117 patients (29% probands, 50% female, age 40 ± 17 years). During 4.2 (interquartile range [IQR]: 2.4 to 7.4) years of follow-up, 18 (15%) patients experienced life-threatening ventricular arrhythmias. The 1-, 2-, and 5-year incidence was 6%, 9%, and 22%, respectively. History of high-intensity exercise, T-wave inversions ≥V3, and greater LV mechanical dispersion were the strongest risk markers (adjusted hazard ratio [HR]: 4.7 [95% confidence interval (CI): 1.2 to 17.5]; p = 0.02, 4.7 [95% CI: 1.6 to 13.9]; p = 0.005), and 1.4 [95% CI: 1.2 to 1.6] by 10-ms increments; p < 0.001, respectively). Median arrhythmia-free survival in patients with all risk factors was 1.2 (95% CI: 0.4 to 1.9) years, compared with an estimated 12.0 (95% CI: 11.5 to 12.5) years in patients without any risk factors.History of high-intensity exercise, electrocardiographic T-wave inversions ≥V3, and greater LV mechanical dispersion were strong predictors of life-threatening ventricular arrhythmia. Patients without any of these risk factors had minimal risk, whereas ≥2 risk factors increased the risk dramatically. This may help to make decisions on primary preventive implantable cardioverter defibrillator (ICD) therapy.
An Adventure in Open Payments
Authors: Helen Chen
Journal: Annals of Internal Medicine (2018)

Letters17 July 2018An Adventure in Open PaymentsHelen Chen, MDHelen Chen, MDHebrew SeniorLife, Boston, Massachusetts (H.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0204 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Since I have drawn a line in the sand regarding not meeting with pharmaceutical representatives for years, I, like Barry (1), was surprised to see that I “accepted” a lunch in 2013 from a drug company selling a chemotherapeutic agent. I believe that I know the oncologist this should have been assigned to who practices in a different state. As a geriatrician, the odds of my using this agent are nearly nonexistent; I doubt I would have been a target for detailing/education. However, that physicians who received $0.02 are on the list as well as those who ...Reference1. Barry MJ. Let the sun shine in! An adventure in open payments. Ann Intern Med. 2018;168:151-2. [PMID: 29335735]. doi:10.7326/M17-1911 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Hebrew SeniorLife, Boston, Massachusetts (H.C.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0204. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLet the Sun Shine In! An Adventure in Open Payments Michael J. Barry An Adventure in Open Payments Michael J. Barry An Adventure in Open Payments Michael Ribadeneyra Metrics 17 July 2018Volume 169, Issue 2Page: 135KeywordsChemotherapeutic agentsConflicts of interestDisclosureDrugs ePublished: 17 July 2018 Issue Published: 17 July 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Evaluation of the reliability and validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) in paediatric cutaneous lupus among paediatric dermatologists and rheumatologists
Authors: C.J. Kushner, M. Tarazi, R.G. Gaffney, R. Feng, K. Ardalan, H.A. Brandling‐Bennett, L. Castelo‐Soccio, J.C. Chang, Y.E. Chiu, S. Gmuca, R.D. Hunt, P.J. Kahn, A.M. Knight, J. Mehta, D.R. Pearson, J.R. Treat, J. Wan, A.C. Yeguez, J.S.S. Concha, B. Patel, J. Okawa, L.M. Arkin, V.P. Werth, Donald Goldsmith, Svetlana Lvovich, Megan L. Curran, Marisa Klein‐Gitelman, Yasmine Kirkorian, Sarah Sertial
Journal: British Journal of Dermatology (2018)

The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a reliable outcome measure for cutaneous lupus erythematosus (CLE) in adults used in clinical trials. However, it has not been validated in children, limiting clinical trials for paediatric CLE. This study aimed to validate the CLASI in paediatrics. Eleven paediatric patients with CLE, six dermatologists and six rheumatologists participated. The physicians were trained to use the CLASI and Physician's Global Assessment (PGA), and individually rated all patients using both tools. Each physician reassessed two randomly selected patients. Within each physician group, the intraclass correlation coefficient (ICC) was calculated to assess the reliability of each measure. CLASI activity scores demonstrated excellent inter‐ and intrarater reliability (ICC > 0·90), while the PGA activity scores had good inter‐rater reliability (ICC 0·73–0·77) among both specialties. PGA activity scores showed excellent (ICC 0·89) and good intrarater reliability (ICC 0·76) for dermatologists and rheumatologists, respectively. Limitations of this study include the small sample size of patients and potential recall bias during the physician rerating session. CLASI activity measurement showed excellent inter‐ and intrarater reliability in paediatric CLE and superiority over the PGA. These results demonstrate that the CLASI is a reliable and valid outcome instrument for paediatric CLE.
GABA <sub>A</sub> receptor availability is not altered in adults with autism spectrum disorder or in mouse models
Authors: Jamie Horder, Max Andersson, Maria A. Mendez, Nisha Singh, Ämma Tangen, Johan Lundberg, Antony Gee, Christer Halldin, Mattia Veronese, Sven Bölte, Lars Farde, Teresa Sementa, Diana Cash, Karen Higgins, Debbie Spain, Federico Turkheimer, Inge Mick, Sudhakar Selvaraj, David J. Nutt, Anne Lingford-Hughes, Oliver D. Howes, Declan G. Murphy, Jacqueline Borg
Journal: Science Translational Medicine (2018)

There are no alterations in GABA A receptor availability in adults with autism spectrum disorder or in commonly used rodent models of the condition.
Anal Carcinoma, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology
Authors: Al B. Benson, Alan P. Venook, Mahmoud M. Al-Hawary, Lynette Cederquist, Yi-Jen Chen, Kristen K. Ciombor, Stacey Cohen, Harry S. Cooper, Dustin Deming, Paul F. Engstrom, Jean L. Grem, Axel Grothey, Howard S. Hochster, Sarah Hoffe, Steven Hunt, Ahmed Kamel, Natalie Kirilcuk, Smitha Krishnamurthi, Wells A. Messersmith, Jeffrey Meyerhardt, Mary F. Mulcahy, James D. Murphy, Steven Nurkin, Leonard Saltz, Sunil Sharma, David Shibata, John M. Skibber, Constantinos T. Sofocleous, Elena M. Stoffel, Eden Stotsky-Himelfarb, Christopher G. Willett, Evan Wuthrick, Kristina M. Gregory, Deborah A. Freedman-Cass
Journal: Journal of the National Comprehensive Cancer Network (2018)

The NCCN Guidelines for Anal Carcinoma provide recommendations for the management of patients with squamous cell carcinoma of the anal canal or perianal region. Primary treatment of anal cancer usually includes chemoradiation, although certain lesions can be treated with margin-negative local excision alone. Disease surveillance is recommended for all patients with anal carcinoma because additional curative-intent treatment is possible. A multidisciplinary approach including physicians from gastroenterology, medical oncology, surgical oncology, radiation oncology, and radiology is essential for optimal patient care.
The Utility of MR Elastography to Differentiate Nodular Regenerative Hyperplasia from Cirrhosis
Authors: Patrick J. Navin, Moira B. Hilscher, Christopher L. Welle, Taofic Mounajjed, Michael S. Torbenson, Patrick S. Kamath, Sudhakar K. Venkatesh
Journal: Hepatology (2018)

Navin, Patrick J.; Hilscher, Moira B.; Welle, Christopher L.; Mounajjed, Taofic; Torbenson, Michael S.; Kamath, Patrick S.; Venkatesh, Sudhakar K. Author Information
5-Hydroxymethylome in Circulating Cell-Free DNA as A Potential Biomarker for Non-Small-Cell Lung Cancer
Authors: Ji Zhang, Xiao Han, Chunchun Gao, Yurong Xing, Zheng Qi, Ruijuan Liu, Yueqin Wang, Xiaojian Zhang, Yun-Gui Yang, Xiangnan Li, Baofa Sun, Xin Tian
Journal: Genomics Proteomics & Bioinformatics (2018)

Abstract Non-small-cell lung cancer (NSCLC), the most common type of lung cancer accounting for 85% of the cases, is often diagnosed at advanced stages owing to the lack of efficient early diagnostic tools. 5-Hydroxymethylcytosine (5hmC) signatures in circulating cell-free DNA (cfDNA) that carries the cancer-specific epigenetic patterns may represent the valuable biomarkers for discriminating tumor and healthy individuals, and thus could be potentially useful for NSCLC diagnosis. Here, we employed a sensitive and reliable method to map genome-wide 5hmC in the cfDNA of Chinese NSCLC patients and detected a significant 5hmC gain in both the gene bodies and promoter regions in the blood samples from tumor patients compared with healthy controls. Specifically, we identified six potential biomarkers from 66 patients and 67 healthy controls (mean decrease accuracy &amp;gt;3.2, P &amp;lt; 3.68E−19) using machine-learning-based tumor classifiers with high accuracy. Thus, the unique signature of 5hmC in tumor patient’s cfDNA identified in our study may provide valuable information in facilitating the development of new diagnostic and therapeutic modalities for NSCLC.