tbuckley/cabot-search huggingface dataset:
Racial/Ethnic Health Disparities Among Rural Adults — United States, 2012–2015
Authors: Cara V. James, Ramal Moonesinghe, Shondelle M. Wilson-Frederick, Jeffrey E. Hall, Ana Penman-Aguilar, Karen Bouye
Journal: MMWR Surveillance Summaries (2017)

Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States.2012-2015.Self-reported data from the 2012-2015 Behavioral Risk Factor Surveillance System were pooled to evaluate racial/ethnic disparities in health, access to care, and health-related behaviors among rural residents in all 50 states and the District of Columbia. Using the National Center for Health Statistics 2013 Urban-Rural Classification Scheme for Counties to assess rurality, this analysis focused on adults living in noncore (rural) counties.Racial/ethnic minorities who lived in rural areas were younger (more often in the youngest age group) than non-Hispanic whites. Except for Asians and Native Hawaiians and other Pacific Islanders (combined in the analysis), more racial/ethnic minorities (compared with non-Hispanic whites) reported their health as fair or poor, that they had obesity, and that they were unable to see a physician in the past 12 months because of cost. All racial/ethnic minority populations were less likely than non-Hispanic whites to report having a personal health care provider. Non-Hispanic whites had the highest estimated prevalence of binge drinking in the past 30 days.Although persons in rural communities often have worse health outcomes and less access to health care than those in urban communities, rural racial/ethnic minority populations have substantial health, access to care, and lifestyle challenges that can be overlooked when considering aggregated population data. This study revealed difficulties among non-Hispanic whites as well, primarily related to health-related risk behaviors. Across each population, the challenges vary.Stratifying data by different demographics, using community health needs assessments, and adopting and implementing the National Culturally and Linguistically Appropriate Services Standards can help rural communities identify disparities and develop effective initiatives to eliminate them, which aligns with a Healthy People 2020 overarching goal: achieving health equity.
Patients with atopic dermatitis and history of eczema herpeticum elicit herpes simplex virus–specific type 2 immune responses
Authors: Stephan Traidl, Petra Kienlin, Gabriele Begemann, Lichen Jing, David M. Koelle, Thomas Werfel, Lennart M. Roesner
Journal: Journal of Allergy and Clinical Immunology (2017)
Atypical femoral fracture in patients with malignant bone metastasis receiving denosumab therapy: Retrospective study.
Authors: Ozaki Yukinori, Momoko Takahashi, Hiromichi Nakajima, Ryosuke Ohki, Jun Masuda, Chihiro Kondoh, Yuji Miura, Yuko Tanabe, Toshimi Takano
Journal: Journal of Clinical Oncology (2017)

220 Background: While denosumab prevent skeletal-related events in patients with malignant bone metastasis, there are concerns that it may be associated with atypical femoral fracture (AFF). AFF in osteoporotic patients receiving denosumab is reported, but few data have been reported in the context of monthly denosumab therapy for patients with malignant tumor and bone metastasis. Methods: We reviewed the medical records and pharmacy database of patients who received denosumab at 120mg monthly for management of bone metastasis from May 2012 to June 2017 at our institution to analyze the incidence of AFF. To identify the risk factors and optimal management of AFF, we reviewed the clinical features and skeletal images of the patients. Results: We analyzed the data of 204 patients receiving a median of 7 doses (range; 1-60) of denosumab, and 150 (74%) patients received more than three times of denosumab. Four patients were diagnosed as AFF and incidence rate was 2.0%. Five limbs of the 4 patients were diagnosed as AFF and performed intramedullary nail fixation, and 2 limbs of the patients were diagnosed of atypical femoral stress reaction (AFSR) with surgical indication. These patients with AFF received 15, 44, 45 and 45 doses of denosumab, which showed higher doses of denosumab (median: 44.5 doses), compared to the patients without AFF or AFSR (median: 6 doses). Median age of the four patients was 59 (range: 50-66), and primary disease were breast cancer in three patients and non-small lung cell cancer in one patient. Conclusions: We experienced four AFF events among 204 patients receiving denosumab 120mg monthly and incident rate was 2.0%. More data are needed about the occurrence of AFF in these patients.
Abstract 20148: The Effect of Different Retraining Intervals on the Skill Performance of Cardiopulmonary Resuscitation in Laypeople- A Three-arm Randomized Control Study
Authors: Ming-Ju Hsieh, Chih-Wei Yang, Hio-Cheng Lam, Wen-Chu Chiang, Chih-Hao Lin, Wei-Tien Chang, Matthew Huei-Ming Ma
Journal: Circulation (2017)

Introduction: The optimal retraining interval of cardiopulmonary resuscitation (CPR) remains unknown, although more frequent retraining than standard intervals of 12 or 24 months was suggested by t...
Human trafficking and exploitation: A global health concern
Authors: Cathy Zimmerman, Ligia Kiss
Journal: PLoS Medicine (2017)

Labor migration is an economic and social mobility strategy that benefits millions of people around the world, yet human trafficking and the exploitation of low-wage workers is pervasive.• The negative health consequences of human trafficking-and labor exploitation more generally-are sufficiently prevalent and damaging that they comprise a public health problem of global magnitude.• Human trafficking and labor exploitation are substantial health determinants that need to be treated as preventable, drawing on public health intervention approaches that target the underlying drivers of exploitation before the harm occurs.• Exploitative practices are commonly sustained by business models that rely on disposable labor, labyrinthine supply chains, and usurious labor intermediaries alongside weakening labor governance and protections, and underpinned by deepening social and economic divisions.• Initiatives to address human trafficking require targeted actions to prevent the drivers of exploitation across each stage of the labor migration cycle to stop the types of harm that can lead to generational cycles of disability and disenfranchisement.
Heterozygous Carriage of the Alpha1-antitrypsin PiZ Variant Increases the Risk to Develop Liver Fibrosis
Authors: Pavel Strnad, David Scholten, Thomas Berg, Jonas Rosendahl, Monika Ridinger, Mattias Mandorfer, Stefan Brueckner, Matthias C. Reichert, Arndt Vogel, Marsha Y. Morgan, Michael Soyka, Sebastian Hinz, Holger Hinrichsen, Jochen Hampe, Mohamad Karim Hamesch, Marla Gutberlet, Silke Marhenke, Christian Trautwein, Johann von Felden, Elmar Aigner, Martin Schlattjan, Pierre Deltenre, Frank Lammert, Greta Burmeister, Janett Fischer, Michael H. Trauner, Andrew McQuillin, Witigo von Schoenfels, Michael J. Way, Mario Brosch, Thomas Weber, Felix M. Braun, Christoph Sarrazin, Norbert Wodarz, Sabina Janciauskiene, Bence Sipos, Marcin Krawczyk, Marcella Rietschel, Andreas Teufel, Katharina Sosnowsky, Hans Dieter Nischalke, Clemens Schafmayer, Claus Hellerbrand, Felix Stickel, Stephan Buch, Renate Schmelz, Ali Canbay, Christian Datz
Journal: Hepatology (2017)
Glutathione Peroxidase 3 Delivered by hiPSC-MSCs Ameliorated Hepatic IR Injury via Inhibition of Hepatic Senescence
Authors: Xiang Qi, Kevin Tak-Pan Ng, Qizhou Lian, Chang Xian Li, Wei Geng, Chang Chun Ling, Wai Ho Yeung, Yuen Yuen Ma, Xiao Bing Liu, Hui Liu, Jiang Liu, Xin Xiang Yang, Chung Mau Lo, Kwan Man
Journal: Theranostics (2017)

Background and Aims: Down-regulation of GPx3 accelerated hepatic senescence, which further caused overwhelming inflammation and severe liver graft injury.MSCs derived from human induced pluripotent stem cells (hiPSC-MSCs) have been developed as more efficient delivery vehicle with the property of injury tropism.Here, we aimed to explore the suppressive role of GPx3 in hepatic IR injury using novel delivery system of hiPSC-MSCs. Methods:The mice IR injury model with partial hepatectomy was established.The engineered hiPSC-MSCs delivering GPx3 was constructed.All the mice were segregated into three groups.hiPSC-MSC-GPx3, hiPSC-MSC-pCDH (vector control) or PBS were injected via portal vein after reperfusion.Liver injury was evaluated by histological and serological test.Hepatic apoptosis was detected by Tunel staining and remnant liver regeneration was assessed by Ki67 staining.The role of hepatic senescence in liver graft injury was evaluated in rat orthotopic liver transplantation model.The suppressive effect of GPx3 on hepatic senescence was examined in mice IR injury model and confirmed in vitro.Hepatic senescence was detected by SA-β-Gal and P 16/ink4a staining.Results: GPx3 can be successfully delivered by hiPSC-MSCs into liver tissues.Histological examination showed that hiPSC-MSC-GPx3 treatment significantly ameliorated hepatic IR injury post-operation.Significantly lower LDH (891.43±98.45mU/mL, P<0.05) and AST (305.77±36.22IU/L, P<0.01) were observed in hiPSC-MSC-GPx3 group compared with control groups.Less apoptotic hepatocytes were observed and the remnant liver regeneration was more active in hiPSC-MSC-GPx3 group.In rat orthotopic liver transplantation model, more senescent hepatocytes were observed in small-for-size liver graft, in which GPx3 expression was significantly compromised.In mice IR injury model, hiPSC-MSC-GPx3 significantly suppressed hepatic senescence.In addition, rGPx3 inhibited cellular senescence of liver cells in a dose dependent manner.Four candidate genes (CD44, Nox4, IFNG, SERPERINB2) were identified to be responsible for suppressive effect of GPx3 on hepatic senescence.Conclusion: Engineered hiPSC-MSCs delivering GPx3 ameliorated hepatic IR injury via inhibition of hepatic senescence.
Sexual exploitation of unaccompanied migrant and refugee boys in Greece: Approaches to prevention
Authors: Julie Freccero, Dan Biswas, Audrey Whiting, Khaled Alrabe, Kim Thuy Seelinger
Journal: PLoS Medicine (2017)

The refugee and migrant crisis in Europe has drawn international attention to the issue of sexual exploitation of unaccompanied and separated refugee boys, requiring humanitarian actors and service providers to quickly develop responses in the absence of an established evidence base.• Although adolescent boys comprise a substantial majority of the population of unaccompanied and separated children, they are rarely the focus of policy discussions and are consistently left out of gender-based violence prevention and response efforts.Gender-specific research, policy guidance, and evidence of best practices related to interventions preventing the sexual exploitation of boys are extremely limited.• Three prevention approaches have been heavily debated in Greece among policy makers and practitioners: high-security shelter models, life skills education, and cash transfer programming.While lessons can be drawn from evidence of these interventions in other contexts or among other target populations, research on the impact of these approaches on vulnerability to sexual exploitation among unaccompanied refugee and migrant boys is urgently needed to inform policy and program design.• A combination of approaches, addressing risk factors at multiple levels, such as building individual-level knowledge and skills, providing community-or family-level protection in the absence of traditional support mechanisms, and structural interventions to address economic vulnerability, is likely needed in order to significantly reduce the vulnerability of unaccompanied and separated boys to sexual exploitation.• Rigorous evaluation of current pilot approaches is critical to building the gendered evidence base, guidance, and resources practitioners urgently require.
Clinical Significance of a Solitary Cold Thyroid Nodule in the Setting of Graves Disease
Authors: Dwight M. Achong
Journal: Clinical Nuclear Medicine (2017)

Abstract 123 I-NaI thyroid uptake and scan in a 46-year-old woman with symptomatic hyperthyroidism demonstrated marked, diffusely increased uptake consistent with Graves disease, as well as a solitary hypofunctioning (“cold”) nodule. Pathologic evaluation following total thyroidectomy and selective neck dissection revealed invasive multifocal papillary thyroid carcinoma in a background of Graves disease and 5 of 36 lymph nodes positive for metastatic disease. This case serves as a reminder that when present a cold nodule in the setting of Graves disease warrants further evaluation for underlying malignancy.
Specific serum antibody binding to phosphorylated and non-phosphorylated tau in non-cognitively impaired, mildly cognitively impaired, and Alzheimer’s disease subjects: an exploratory study
Authors: Andrea C. Klaver, Mary P. Coffey, David A. Bennett, David A. Loeffler
Journal: Translational Neurodegeneration (2017)

Tau vaccination and administration of anti-tau antibodies can prevent pathology and cognitive impairment in transgenic mouse models of tauopathy, suggesting that therapies which increase anti-tau antibodies might slow the development and/or progression of Alzheimer's disease (AD). The extent to which individuals with no cognitive impairment (NCI) possess serum anti-tau antibodies, and whether their concentrations of these antibodies differ from anti-tau antibody levels in persons with mild cognitive impairment (MCI) or AD, are unclear. Previous studies measuring these antibodies did not account for antibody polyvalent binding, which can be extensive, nor that antibody binding to phosphorylated tau peptides could be due to binding to non-phosphorylated epitopes on those peptides. An ELISA controlling for these factors was used to measure the specific binding of serum IgG and IgM to phosphorylated ("pTau;" phosphorylated at Serine-199 and Serine-202) and non-phosphorylated ("non-pTau") tau 196-207 in subjects with NCI, MCI, or AD (n = 10/group). Between-group differences in these antibody levels were evaluated for statistical significance, and correlations were examined in pooled data from all subjects between these antibody levels and subject age, global cognitive functioning, and NFT counts. Specific IgG binding to pTau and non-pTau was detected in all subjects except for one NCI control. Specific IgM binding was detected to pTau in all subjects except for two AD patients, and to non-pTau in all subjects. Mean pTau IgG was increased in MCI subjects by 53% and 70% vs. AD and NCI subjects respectively (both p < 0.05), while no significant differences were found between groups for non-pTau IgG (p = 0.052), pTau IgM, or non-pTau IgM. Non-pTau IgG was negatively associated with global cognition (Spearman rho = -0.50). Specific binding of serum IgG and IgM to phosphorylated and non-phosphorylated tau may be present in older persons regardless of their cognitive status. Serum IgG to phosphorylated tau may be increased in individuals with MCI, but this unexpected finding requires confirmation. The approach used in this study to measure specific serum antibodies to phosphorylated tau should be useful for measuring antibodies to other post-translationally-modified proteins that are of relevance to neurodegenerative disorders.
Abstract 21366: Atrial Fibrillation Adversely Affects Readmission Outcomes for Heart Failure: Observations From the Nationwide Readmissions Database
Authors: Parijat S Joy, Brian Olshansky, Rakesh Gopinathannair
Journal: Circulation (2017)

Introduction: Atrial fibrillation(AF) and heart failure (HF) often coexist. Readmissions in HF is a rising concern. Hypothesis: AF affects 90-day readmissions following admission for HF. Methods: The Nationwide Readmissions Database (NRD) for 2013 was analyzed for the first readmission within 90-days following discharge with a diagnosis of AF and HF. Clinical Classification Software (CCS) from the Health Care Utilization Project (HCUP) was utilized to investigate leading diagnoses and procedures for readmissions. ICD-9-CM codes were used to identify diagnoses not classified in the CCS. All estimates were weighted using the weight variable provided by HCUP for stratified sampling. Results: In 2013, 885,270 adults were admitted with a primary diagnosis of HF of which 364,447(41%) had AF. After discharge, 90-day all-cause readmission rates were significantly higher in HF patients with coexisting AF (41% vs 38%, p&lt;0.001). Multivariate regression analysis showed that AF was independently associated with an increased likelihood of 90-day readmission after discharge for HF (OR: 1.18, CI: 1.14-1.21). In HF patients with coexisting AF, the primary readmission diagnoses were HF (36%), renal failure (4%), AF (4%), sepsis (4%) and respiratory failure (3%) and the most common procedures performed were cardioversion (16 %), echocardiogram (12 %), coronary revascularization (7%), blood transfusion (6%) and hemodialysis (5%). Mean length of stay during readmission in patients with and without coexisting AF was 5.0 vs 5.5 days (p&lt;0.000, t-test). Mean cost of readmission during readmission in patients with and without coexisting AF was $8693 vs $9386 (p&lt;0.000, t-test). Conclusion: In patients with HF, coexisting AF is associated with higher likelihood of 90-day readmission. Most common causes for such readmissions are decompensated HF, AF and renal failure. Adequately controlled AF may reduce readmissions in HF patients.
Biomarker prevalence in high grade glioma patients from Siloam Hospital Karawaci Indonesia
Authors: G. Prayogi, Z.G. Wuisan, D. Budiharko, T.P. Putra, N. Masykura, P.D. Prasetiyo, J. July, E.J. Wahjoepramono, A.R. Utomo
Journal: Annals of Oncology (2017)
Reconciling Competence and Consent in Opioid-Dependence Research: The Value of Vulnerability Rhetoric
Authors: Michael O. S. Afolabi, Stephen O. Sodeke
Journal: The American Journal of Bioethics (2017)

Central to addiction is a complex interplay between the erosion of the will to refrain from harmful behavior such as psychotropic drug use and how changes in human brain neurocircuitry continuously...
Understanding AVATAR therapy: who, or what, is changing?
Authors: Ben Alderson-Day, Nev Jones
Journal: The Lancet Psychiatry (2017)

The experience of persistent, distressing auditory verbal hallucinations (known as hearing voices) can be highly debilitating, and provision of better support for those affected is a priority for mental health services. A prominent and innovative approach is AVATAR therapy, in which staff help voice-hearers to design an audio-visual representation of the heard voice to facilitate a therapeutic dialogue, with the AVATAR voice being controlled by the therapist. After an initially promising pilot trial,1 Tom Craig and colleagues2 report encouraging evidence of AVATAR therapy's effectiveness in The Lancet Psychiatry.
Association of Environment With the Risk of Developing Psychotic Disorders in Rural Populations
Authors: Lucy Richardson, Yasir Hameed, Jesus Perez, Peter B. Jones, James B. Kirkbride
Journal: JAMA Psychiatry (2017)

Social determinants are important risk factors for the development of first-episode psychosis (FEP); their effects in rural areas are largely unknown.To investigate neighborhood-level factors associated with FEP in a large, predominantly rural population-based cohort.This study extracted data on referrals for treatment of potential FEP at 6 Early-Intervention Psychosis services from the Social Epidemiology of Psychoses in East Anglia naturalistic cohort study data set, which covered a population of more than 2 million people in a rural area in the East of England for a period of 3.5 years. All individuals aged 16 to 35 years who presented to Early-Intervention Psychosis services and met diagnostic criteria for first episodes of nonaffective psychoses and affective psychoses (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnostic codes F20-33) were included (n = 631). Persons whose disorders had an organic basis (diagnostic codes F06.X) and those meeting the criteria for substance-induced psychosis (diagnostic codes F1X.5) were excluded. We derived 4 neighborhood-level exposures from a routine population data set using exploratory factor analysis (racial/ethnic diversity, deprivation, urbanicity, and social isolation) and investigated intragroup racial/ethnic density and fragmentation.Multilevel Poisson regression was performed to determine associations between incidence rates and neighborhood-level factors, after adjustment for individual factors. Results were reported as incidence rate ratios (IRRs).The study included 631 participants who met criteria for FEP and whose median age at first contact was 23.8 years (interquartile range, 19.6-27.6 years); 416 of 631 (65.9%) were male. Crude incidence of FEP was calculated as 31.2 per 100 000 person-years (95% CI, 28.9-33.7). Incidence varied significantly between neighborhoods after adjustment for age, sex, race/ethnicity, and socioeconomic status. For nonaffective psychoses, incidence was higher in neighborhoods that were more economically deprived (IRR, 1.13; 95% CI, 1.06-1.20) and socially isolated (IRR, 1.11; 95% CI, 1.04-1.19). It was lower in more racially/ethnically diverse neighborhoods (IRR, 0.94; 95% CI, 0.87-1.00). Higher intragroup racial/ethnic density (IRR, 0.97; 95% CI, 0.94-1.00) and lower intragroup racial/ethnic fragmentation (IRR, 0.98; 95% CI, 0.96-1.00) were associated with a reduced risk of affective psychosis.Spatial variation in the incidence of nonaffective and affective psychotic disorders exists in rural areas. This suggests that the social environment contributes to psychosis risk across the rural-urban gradient.
Abstract 15147: Derivation and Internal Validation of a Mortality Prediction Tool for Initial Survivors of Pediatric In-Hospital Cardiac Arrest
Authors: Mathias J Holmberg, Ari Moskowitz, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Alexis A Topjian, Anne V Grossestreuer, Michael W Donnino, Lars W Andersen
Journal: Circulation (2017)

Introduction:  While several models exist for predicting mortality following return of spontaneous circulation after in-hospital cardiac arrest in adult patients, there is a paucity of clinically useful prediction models for the pediatric population.   Methods:  Using the Get With The Guidelines-Resuscitation registry, we included pediatric patients (   Results:  Patient and event characteristics for the derivation cohort (n = 3893) and validation cohort (n = 1297) were similar. Seventeen variables associated with the outcome remained in the final reduced model after backwards elimination. Predictors of in-hospital mortality included age, illness category, pre-event characteristics, arrest location, day of the week, non-shockable pulseless rhythm, duration of chest compressions, and interventions in place at time of arrest. The c-statistic for the final score was 0.77 (95%CI: 0.75, 0.78) in the derivation cohort and 0.77 (95%CI: 0.74, 0.79) in the validation cohort. The expected vs. observed mortality plot and Hosmer-Lemeshow goodness-of-fit test indicated good calibration in both the derivation (p = 0.07) and validation (p = 0.14) cohort. The score showed a stepwise increase in mortality with an observed mortality of   80% for scores ≥ 25. The model also performed well in sensitivity analyses for events within the past five years, patients with a loss of pulse, and patients without a loss of pulse.   Conclusions:  We developed and internally validated a prediction score for initial survivors of pediatric in-hospital cardiac arrest. This prediction score may be useful for prognostication following cardiac arrest, stratifying patients for research, and guiding quality improvement initiatives.