tbuckley/cabot-search huggingface dataset:
Use of controlled temperature chain and compact prefilled auto-disable devices to reach 2030 hepatitis B birth dose vaccination targets in LMICs: a modelling and cost-optimisation study
Authors: Christopher P Seaman, Christopher Morgan, Jess Howell, Yinzong Xiao, C Wendy Spearman, Mark Sonderup, Olufunmilayo Lesi, Monique I Andersson, Margaret E Hellard, Nick Scott
Journal: The Lancet Global Health (2020)

Hepatitis B causes more than 800 000 deaths globally each year. Perinatal infections are a major driver of this burden but can be prevented by vaccination within 24 h of birth. Currently, only 44% of newborn babies in low-income and middle-income countries (LMICs) receive a timely birth dose. We investigated the effects and cost-effectiveness of implementing ambient storage of hepatitis B vaccines under a controlled temperature chain (CTC) protocol and the use of compact prefilled auto-disable (CPAD) devices for community births.In this mathematical modelling study of perinatal hepatitis B transmission and disease progression, we estimated the coverage impact and cost-effectiveness of implementing CTC and CPAD interventions in the six Global Burden of Disease (GBD) regions containing LMICs. Combinations of four different scenarios of birth dose delivery strategies (cold chain, CTC) and interventions (needle and syringe, CPAD) were modelled across facility or community birth locations. We also estimated the minimum cost and most cost-effective strategy to achieve the WHO 90% hepatitis B birth dose coverage target in GBD regions and in 46 LMICs with a reported coverage of less than 90%.Current delivery protocols achieved a maximum coverage of 65% (IQR 64-65) across GBD regions. Reaching 90% hepatitis B birth dose coverage across all GBD regions was estimated to cost a minimum of US$687·5 million per annum ($494·0 million more than the estimated current expenditure), of which $516·5 million (75%) was required for CTC and CPAD interventions. Reaching 90% coverage in this way was estimated to be cost saving in five of the six regions (and in 40 of 46 LMICs individually assessed) due to the disease costs averted, with the cost per disability-adjusted life-years averted being less than $83·27 otherwise.Hepatitis B birth dose coverage of 90% is unlikely to be reached under current protocols. CTC and CPAD vaccine strategies present cost-effective solutions to overcome coverage barriers.The Burnet Institute.
Use of N95, Surgical, and Cloth Masks to Prevent COVID-19 in Health Care and Community Settings: Living Practice Points From the American College of Physicians (Version 1)
Authors: Amir Qaseem, Itziar Etxeandia-Ikobaltzeta, Jennifer Yost, Matthew C. Miller, George M. Abraham, Adam J. Obley, Mary Ann Forciea, Janet A. Jokela, Linda L. Humphrey
Journal: Annals of Internal Medicine (2020)

What is the effectiveness of N95 respirators versus surgical masks versus cloth masks for the prevention of coronavirus disease 2019 (COVID-19) in addition to standard precautions (gloves + handwashing) in community settings? KEY QUESTION 2What is the effectiveness of N95 respirators versus surgical masks versus cloth masks for the prevention of COVID-19 in addition to standard precautions (gowns + gloves + handwashing) in health care settings?
Annals Graphic Medicine - Social Determinants of Health
Authors: Sharon Smile, Wayne Smile
Journal: Annals of Internal Medicine (2020)

Web Exclusives4 August 2020Annals Graphic Medicine - Social Determinants of HealthFREESharon Smile, MBBS, DM(Paeds), MSc and Wayne SmileSharon Smile, MBBS, DM(Paeds), MScHolland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada (S.S.)Search for more papers by this author and Wayne SmileNone (W.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G20-0067 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada (S.S.)None (W.S.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G20-0067.Author/Illustrator Information: Sharon Smile, MBBS, DM(Paeds), MSc (e-mail, [email protected]ca), and Wayne Smile (e-mail, [email protected]com).This article was published at Annals.org on 23 June 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 August 2020Volume 173, Issue 3Page: W64-W65KeywordsDisclosureHealth care ePublished: 23 June 2020 Issue Published: 4 August 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Severe COVID-19 in the young and healthy: monogenic inborn errors of immunity?
Authors: Shen-Ying Zhang, Qian Zhang, Jean-Laurent Casanova, Helen C. Su, Laurent Abel, Paul Bastard, Aurélie Cobat, Emmanuelle Jouanguy, Luigi Notarangelo
Journal: Nature reviews. Immunology (2020)

Severe COVID-19 is rare in previously healthy individuals who are less than 50 years of age, affecting probably no more than 1 in 1,000 such infected individuals. We suggest that these patients may become critically ill because of monogenic inborn errors that disrupt protective immunity to SARS-CoV-2. Why do some young and previously healthy individuals develop severe COVID-19? In this Comment, Casanova and colleagues suggest that monogenic inborn errors of immunity may be responsible based on lessons from other viral infections.
Medical cannabis: campaigner calls on home secretary to deliver on access promises
Authors: Jacqui Wise
Journal: BMJ (2020)

The mother of Alfie Dingley has called on the home secretary to finally deliver appropriate access to medical cannabis on the NHS, saying that the covid-19 pandemic has exacerbated the situation for many families.

Dingley has intractable epilepsy and made headlines after he was denied cannabis treatment in the UK that had been available to him in …
Use of aerosolised medications at home for COVID-19
Authors: Arzu Ari
Journal: The Lancet Respiratory Medicine (2020)

of NIV versus invasive mechanical ventilation, as well as intubation timing and criteria.Future research should aim to clarify the best ventilation strategy for individual patients (eg, phenotypes and response to PEEP), to describe disease mechanisms associated with the pathophysiological patterns and clinical course of COVID-19 (eg, early vs late presentation; vascular vs parenchymal), to identify biomarkers (eg, cytokines, ferritin, D-dimer, or procalcitonin) that could help to guide management, and to establish the efficacy and optimum timing of promising therapeutics.In the meantime, in an era of big data and large databases, it would be worth using machine learning and other approaches to try to identify the link between observed patterns of physiology, interventions, and outcomes before clinical trials have been completed.
Tryptophanyl-tRNA Synthetase, a Novel Damage-Induced Cytokine, Significantly Increases the Therapeutic Effects of Endometrial Stem Cells
Authors: Se-Ra Park, Soo-Rim Kim, Jae-Been Im, Soyi Lim, In-Sun Hong
Journal: Molecular Therapy (2020)

The major challenges of most adult stem cell-based therapies are their weak therapeutic effects caused by the loss of multilineage differentiation capacity and homing potential. Recently, many researchers have attempted to identify novel stimulating factors that can fundamentally increase the differentiation capacity and homing potential of various types of adult stem cells. Tryptophanyl-tRNA synthetase (WRS) is a highly conserved and ubiquitously expressed enzyme that catalyzes the first step of protein synthesis. In addition to this canonical function, we found for the first time that WRS is actively released from the site of injury in response to various damage signals both in vitro and in vivo and then acts as a potent nonenzymatic cytokine that promotes the self-renewal, migratory, and differentiation capacities of endometrial stem cells to facilitate the repair of damaged tissues. Furthermore, we also found that WRS, through its functional receptor cadherin-6 (CDH-6), activates major prosurvival signaling pathways, such as Akt and extracellular signal-regulated kinase (ERK)1/2 signaling. Our current study provides novel and unique insights into approaches that can significantly enhance the therapeutic effects of human endometrial stem cells in various clinical applications.
Knowledge Across Reference Frames: Cognitive Maps and Image Spaces
Authors: Roberto Bottini, Christian F. Doeller
Journal: Trends in Cognitive Sciences (2020)

In human and non-human animals, conceptual knowledge is partially organized according to low-dimensional geometries that rely on brain structures and computations involved in spatial representations. Recently, two separate lines of research have investigated cognitive maps, that are associated with the hippocampal formation and are similar to world-centered representations of the environment, and image spaces, that are associated with the parietal cortex and are similar to self-centered spatial relationships. We review evidence supporting cognitive maps and image spaces, and we propose a hippocampal-parietal network that can account for the organization and retrieval of knowledge across multiple reference frames. We also suggest that cognitive maps and image spaces may be two manifestations of a more general propensity of the mind to create low-dimensional internal models.
Sirolimus as combination rescue therapy with tumor necrosis alpha inhibitors for severe, refractory hidradenitis suppurativa
Authors: Thomas Bettuzzi, Laure Frumholtz, Marie Jachiet, Clémence Lepelletier, Mourad Djermane, Florence Cordoliani, Anne Saussine, Jean-David Bouaziz, Hervé Bachelez
Journal: Journal of the American Academy of Dermatology (2020)
Treatment of Locally Advanced Esophageal Carcinoma: ASCO Guideline
Authors: Manish A. Shah, Erin B. Kennedy, Daniel V. Catenacci, Dana C. Deighton, Karyn A. Goodman, Narinder K. Malhotra, Christopher Willett, Brendon Stiles, Prateek Sharma, Laura Tang, Bas P. L. Wijnhoven, Wayne L. Hofstetter
Journal: Journal of Clinical Oncology (2020)

To develop an evidence-based clinical practice guideline to assist in clinical decision making for patients with locally advanced esophageal cancer.ASCO convened an Expert Panel to conduct a systematic review of the more recently published literature (1999-2019) on therapy options for patients with locally advanced esophageal cancer and provide recommended care options for this patient population.Seventeen randomized controlled trials met the inclusion criteria. Where possible, data were extracted separately for squamous cell carcinoma and adenocarcinoma.Multimodality therapy for patients with locally advanced esophageal carcinoma is recommended. For the subgroup of patients with adenocarcinoma, preoperative chemoradiotherapy or perioperative chemotherapy should be offered. For the subgroup of patients with squamous cell carcinoma, preoperative chemoradiotherapy or chemoradiotherapy without surgery should be offered. Additional subgroup considerations are provided to assist with implementation of these recommendations. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines.
Associations Between Built Environment, Neighborhood Socioeconomic Status, and SARS-CoV-2 Infection Among Pregnant Women in New York City
Authors: Ukachi N. Emeruwa, Samsiya Ona, Jeffrey L. Shaman, Amy Turitz, Jason D. Wright, Cynthia Gyamfi-Bannerman, Alexander Melamed
Journal: JAMA (2020)

This cross-sectional study investigates associations of residential building characteristics and markers of neighborhood socioeconomic status (SES) with screen-detected SARS-CoV-2 prevalence among pregnant women delivering in 2 New York City hospitals.
Variation in Ventilator Allocation Guidelines by US State During the Coronavirus Disease 2019 Pandemic
Authors: Gina M. Piscitello, Esha M. Kapania, William D. Miller, Juan C. Rojas, Mark Siegler, William F. Parker
Journal: JAMA Network Open (2020)

<h3>Importance</h3> During the coronavirus disease 2019 pandemic, there may be too few ventilators to meet medical demands. It is unknown how many US states have ventilator allocation guidelines and how these state guidelines compare with one another. <h3>Objective</h3> To evaluate the number of publicly available US state guidelines for ventilator allocation and the variation in state recommendations for how ventilator allocation decisions should occur and to assess whether unique criteria exist for pediatric patients. <h3>Evidence Review</h3> This systematic review evaluated publicly available guidelines about ventilator allocation for all states in the US and in the District of Columbia using department of health websites for each state and internet searches. Documents with any discussion of a process to triage mechanical ventilatory support during a public health emergency were screened for inclusion. Articles were excluded if they did not include specific ventilator allocation recommendations, were in draft status, did not include their state department of health, or were not the most up-to-date guideline. All documents were individually assessed and reassessed by 2 independent reviewers from March 30 to April 2 and May 8 to 10, 2020. <h3>Findings</h3> As of May 10, 2020, 26 states had publicly available ventilator guidelines, and 14 states had pediatric guidelines. Use of the Sequential Organ Failure Assessment score in the initial rank of adult patients was recommended in 15 state guidelines (58%), and assessment of limited life expectancy from underlying conditions or comorbidities was included in 6 state guidelines (23%). Priority was recommended for specific groups in the initial evaluation of patients in 6 states (23%) (ie, Illinois, Maryland, Massachusetts, Michigan, Pennsylvania, and Utah). Many states recommended exclusion criteria in adult (11 of 26 states [42%]) and pediatric (10 of 14 states [71%]) ventilator allocation. Withdrawal of mechanical ventilation from a patient to give to another if a shortage occurs was discussed in 22 of 26 adult guidelines (85%) and 9 of 14 pediatric guidelines (64%). <h3>Conclusions and Relevance</h3> These findings suggest that although allocation guidelines for mechanical ventilatory support are essential in a public health emergency, only 26 US states provided public guidance on how this allocation should occur. Guidelines among states, including adjacent states, varied significantly and could cause inequity in the allocation of mechanical ventilatory support during a public health emergency, such as the coronavirus disease 2019 pandemic.
Dying of Traumatic Brain Injury—Palliative Care too Soon, or too Late?
Authors: Anne C. Mosenthal
Journal: JAMA Surgery (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Covid-19: social distancing or social isolation?
Authors: Rajeev Gupta, Rajinder K Dhamija
Journal: BMJ (2020)

<h3>Abstract</h3> Sustained and elevated activity during the working memory delay period has long been considered the primary neural correlate for maintaining information over short time intervals. This idea has recently been reinterpreted in light of findings generated from multiple neural recording modalities and levels of analysis. To further investigate the sustained or transient nature of activity, the temporal-spectral evolution (TSE) of delay period activity was examined in humans with high density EEG during performance of a Sternberg working memory paradigm with a relatively long six second delay and with novel scenes as stimuli. Multiple analyses were conducted using different trial window durations and different baseline periods for TSE computation. Sensor level analyses revealed transient rather than sustained activity during delay periods. Specifically, the consistent finding among the analyses was that high amplitude activity encompassing the theta range was found early in the first three seconds of the delay period. These increases in activity early in the delay period correlated positively with subsequent ability to distinguish new from old probe scenes. Source level signal estimation implicated a right parietal region of transient early delay activity that correlated positively with working memory ability. This pattern of results adds to recent evidence that transient rather than sustained delay period activity supports visual working memory performance. The findings are discussed in relation to synchronous and desynchronous intra- and inter-regional neural transmission, and choosing an optimal baseline for expressing temporal-spectral delay activity change.
Withdrawal of Life-supporting Treatment in Severe Traumatic Brain Injury
Authors: Theresa Williamson, Marc D. Ryser, Peter A. Ubel, Jihad Abdelgadir, Charis A. Spears, Beiyu Liu, Jordan Komisarow, Monica E. Lemmon, Aladine Elsamadicy, Shivanand P. Lad
Journal: JAMA Surgery (2020)

<h3>Importance</h3> There are limited data on which factors affect the critical and complex decision to withdraw life-supporting treatment (LST) in patients with severe traumatic brain injury (sTBI). <h3>Objective</h3> To determine demographic and clinical factors associated with the decision to withdraw LST in patients with sTBI. <h3>Design, Setting, and Participants</h3> This retrospective analysis of inpatient data from more than 825 trauma centers across the US in the American College of Surgeons Trauma Quality Improvement Program database from January 2013 to December 2015 included adult patients with sTBI and documentation of a decision regarding withdrawal of LST (WLST). Data analysis was conducted in September 2019. <h3>Main Outcomes and Measures</h3> Factors associated with WLST in sTBI. <h3>Results</h3> A total of 37931 patients (9817 women [25.9%]) were included in the multivariable analysis; 7864 (20.7%) had WLST. Black patients (4806 [13.2%]; odds ratio [OR], 0.66; 95% CI, 0.59-0.72;<i>P</i> &lt; .001) and patients of other race (4798 [13.2%]; OR, 0.83; 95% CI, 0.76-0.91;<i>P</i> &lt; .001) were less likely than white patients (26 864 [73.7%]) to have WLST. Patients from hospitals in the Midwest (OR, 1.12; 95% CI, 1.04-1.20;<i>P</i> = .002) or Northeast (OR, 1.23; 95% CI, 1.13-1.34;<i>P</i> &lt; .001) were more likely to have WLST than patients from hospitals in the South. Patients with Medicare (OR, 1.55; 95% CI, 1.43-1.69;<i>P</i> &lt; .001) and self-pay patients (OR, 1.36; 95% CI, 1.25-1.47;<i>P</i> &lt; .001) were more likely to have WLST than patients with private insurance. Older patients and those with lower Glasgow Coma Scale scores, higher Injury Severity Scores, or craniotomy were generally more likely to have WLST. Withdrawal of LST was more likely for patients with functionally dependent health status (OR, 1.30; 95% CI, 1.08-1.58;<i>P</i> = .01), hematoma (OR, 1.19; 95% CI, 1.12-1.27;<i>P</i> &lt; .001), dementia (OR, 1.29; 95% CI, 1.08-1.53;<i>P</i> = .004), and disseminated cancer (OR, 2.82; 95% CI, 2.07-3.82;<i>P</i> &lt; .001) than for patients without these conditions. <h3>Conclusions and Relevance</h3> Withdrawal of LST is common in sTBI and socioeconomic factors are associated with the decision to withdraw LST. These results highlight the many factors that contribute to decision-making in sTBI and demonstrate that in a complex and variable disease process, variation based on race, payment, and region presents as a potential challenge.
Translating Idiopathic pulmonary fibrosis guidelines into clinical practice
Authors: C. Robalo-Cordeiro, A. Morais
Journal: Pulmonology (2020)

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic interstitial lung disease of unknown cause, which predominantly manifests in older males. IPF diagnosis is a complex, multi-step process and delay in diagnosis cause a negative impact on patient survival. Additionally, a multidisciplinary team of pulmonologists, radiologists and pathologists is necessary for an accurate IPF diagnosis. The present study aims to assess how diagnosis and treatment of IPF are followed in Portugal, as well as the knowledge and implementation of therapeutic guidelines adopted by the Portuguese Society of Pulmonology. Seventy-eight practicing pulmonologists were enrolled (May–August 2019) in a survey developed by IPF expert pulmonologists comprised of one round of 31 questions structured in three parts. The first part was related to participant professional profile, the second part assessed participant level of knowledge and practice agreement with national consensus and international guidelines for IPF as well as their access to radiology and pathology for IPF diagnosis, and the third part was a self-evaluation of the guidelines adherence for diagnosis and treatment in their daily practice. Participants represented a wide spectrum of pulmonologists from 14 districts of Portugal and autonomous regions of Azores and Madeira. The majority were female (65%), with 5–19 years of experience (71%) and working in a public clinical center (83%). Importantly, the majority of pulmonologists follow their IPF patients (n = 45) themselves, while 26% referred IPF patients to ILD experts in the same hospital and 22% to another center. Almost all pulmonologists (98%) agreed or absolutely agreed that multidisciplinary discussion is recommended to accurately diagnose IPF. No pulmonologists considered pulmonary biopsy as absolutely required to establish an IPF diagnosis. However, 87% agreed or absolutely agree with considering biopsy in a possible/probable UIP context. If a biopsy is necessary, 96% of pulmonologists absolutely agree or agree with considering criobiopsy as an option for IPF diagnosis. Regarding IPF treatment, 98% absolutely agreed or agreed that antifibrotic therapy should be started once the IPF diagnosis is established. Finally, 76% stated that 6 months is the recommended time for follow-up visit in IPF patients. Portuguese pulmonologists understand and agree with national consensus and international guidelines for IPF treatment but their implementation in Portugal is heterogeneous.