tbuckley/cabot-search huggingface dataset:
Wasteful Health Care Spending in the United States
Authors: John W. Urwin, Peter J. Pronovost, Amol S. Navathe
Journal: JAMA (2020)

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Abstract MP66: Excessive Gestational Weight Gain is Associated With Maternal Inflammation and Diabetes Risk but Not Dyslipidemia in Midlife Women- The Study of Womens Health Across the Nation
Authors: Franya Hutchins, Samar R El Khoudary, Janet M Catov, Alicia Colvin, Robert Krafty, Emma Barinas-Mitchell, Maria M Brooks
Journal: Circulation (2020)

Introduction: Excessive gestational weight gain (GWG) is associated with long-term increased risk of maternal obesity. However, the literature on whether excessive GWG contributes to an adverse cardiovascular risk profile is minimal and conflicting. Hypothesis: We hypothesized that a history of excessive GWG would be associated with maternal cardiovascular risk factors representing inflammation, glucose dysregulation, and dyslipidemia at midlife among parous women. Methods: This analysis included 1351 participants in the multiethnic cohort Study of Women’s Health Across the Nation with one or more live, singleton births. Excessive GWG in past pregnancies was determined by self-report of prepregnancy weight and GWG, and defined according to Institute of Medicine guidelines. Outcomes were CRP, LDL-C, HDL-C, fasting glucose, diabetes, blood pressure, and medication use, dichotomized based on 2019 ACC/AHA clinical guidelines as applicable. Outcomes were assessed at the baseline visit when women were age 42 to 53. We estimated relative risk between ever-having excessive GWG and each outcome in separate generalized linear regressions. Multivariable models adjusted for demographic, behavioral, and reproductive characteristics including parity and pregnancy complications. Results: Of the 1351 participants, 554 (41.0%) experienced excessive GWG. In unadjusted models, excessive GWG was associated with increased relative risk of high CRP, hypertension, low HDL-C, high glucose, and diabetes at midlife, but not high LDL-C (see Table). After adjusting for confounders, only risk of high CRP (RR= 1.34; 95% CI= 1.17, 1.54) and diabetes (RR=2.62; 95% CI=1.14, 5.98) remained statistically significant. Conclusions: A history of excessive GWG was linked with an increased risk of inflammation and diabetes but not dyslipidemia, hypertension, or high glucose in parous midlife women, independent of parity, pregnancy complications, and other factors. Table. Risk Ratios of Cardiovascular Risk Factors by Excessive GWG
Student-Reported School Safety Perceptions, Connectedness, and Absenteeism Following a Multiple-Fatality School Shooting — Broward County, Florida, February 14–21, 2018
Authors: Catherine N. Rasberry, Ganna Sheremenko, Catherine A. Lesesne, India D. Rose, Susan Hocevar Adkins, Lisa C. Barrios, Kristin M. Holland, Valerie Sims, Kevin O’Connor, Dominic J. Grasso, Sebrina R. James, Thomas R. Simon
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

From July 2009 to June 2018, the rates of multiple-victim, school-associated homicides in the United States fluctuated substantially, with evidence of a significant increase in recent years (1). Data on the effects of such incidents on students' school attendance and perceptions of safety and connectedness are limited (2,3) but important. This study used data from a neighboring within-district school before and after a multiple-fatality shooting at Marjory Stoneman Douglas High School in Parkland, Florida, on February 14, 2018. Self-administered questionnaires were completed by one group of students on February 14 just before the shooting (575) and another group during February 15-21 (502); demographics for these groups appeared similar. Linear and logistic regression analyses controlling for demographic characteristics explored differences between groups for safety-related perceptions or experiences, school connectedness, and absenteeism. Compared with students surveyed before the shooting, students surveyed in the days immediately following the shooting had lower odds of feeling safe at school, higher odds of absenteeism, and higher school connectedness scores. Findings suggest the shooting had an immediate, sizeable effect on safety perceptions and absenteeism among students in a neighboring school. Findings also suggest higher school connectedness following the shooting. Further study of school connectedness, including how to enhance and sustain it, might help schools and communities better respond to traumatic events in the community.
Predictors of Distant Metastases in Triple-Negative Breast Cancer Without Pathologic Complete Response After Neoadjuvant Chemotherapy
Authors: William R. Kennedy, Christopher Tricarico, Prashant Gabani, Ashley A. Weiner, Michael B. Altman, Laura L. Ochoa, Maria A. Thomas, Julie A. Margenthaler, Souzan Sanati, Lindsay L. Peterson, Cynthia X. Ma, Foluso O. Ademuyiwa, Imran Zoberi
Journal: Journal of the National Comprehensive Cancer Network (2020)

Background: Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) for triple-negative breast cancer (TNBC) predicts decreased distant metastasis. However, most patients do not experience pCR, and other risk factors for distant metastasis after NAC are poorly characterized. This study investigated factors predictive of distant metastasis in TNBC without pCR after NAC. Methods: Women with TNBC treated with NAC, surgery, and radiation therapy in 2000 through 2013 were reviewed. Freedom from distant metastasis (FFDM) was compared between patients with and without pCR using the Kaplan-Meier method. In patients without pCR, univariate and multivariable Cox analyses were used to determine factors predictive of distant metastasis. Results: We identified 153 patients with median follow-up of 4.0 years (range, 0.5–14.0 years). After NAC, 108 had residual disease (pCR, 29%). Five-year FFDM was 98% and 55% in patients with and without pCR, respectively ( P &lt;.001). Factors independently predicting FFDM in patients without pCR were pathologic nodal positivity (hazard ratio, 3.08; 95% CI, 1.54–6.14; P =.001) and lymphovascular space invasion (hazard ratio, 1.91; 95% CI, 1.07–3.43; P =.030). Patients with a greater number of factors had worse FFDM; 5-year FFDM was 76.5% for patients with no factors (n=38) versus 54.9% and 27.5% for patients with 1 (n=44) and 2 factors (n=26), respectively ( P &lt;.001). Conclusions: Lack of pCR after NAC resulted in worse overall survival and FFDM, despite trimodality therapy. In patients with residual disease after NAC, pathologic lymph node positivity and lymphovascular space invasion predicted worse FFDM.
The target genes research for diagnosis, therapy and prognosis in cases with ovarian cancer
Authors: E. V. Bakhidze, A. V. Malek, A. V. Belyaeva
Journal: Journal of Clinical Oncology (2007)

16060 Background: Epithelial ovarian cancer has one of the worst prognoses among gynecologic malignancies. Molecular genetic analyses of ovarian cancers have uncovered genetic alterations of several genes. Normal tissues were readily distinguished from tumor tissues. These studies identified several genes, such as High mobility group A2 (HMG A2) proteins. The expression of HMG A2 gene is detected in foetal stage of human development and stopped in normal adult tissues. Elevation of the HMG A2 gene expression was shown for several human malignant tumours. Targeted supression of HMG A2 protein synthesis can be one of important directions for anti-tumour therapy in cases of ovarian cancer Methods: The HMG A2 gene expression was searched in 48 flash-frozen samples of ovarian serous papillary adenocarcinoma and 12 samples of normal ovarian tissue. The HMG A2 gene expression was investigated by RNA in situ hybridisation. Results: High and middle level of HMG A2 gene expression was shown in 37 from 48 (77%) ovarian cancer samples. HMG A2 mRNA was not detected in normal ovarian surface epithelium. Low grade tumour differentiation (G3) was detected in 24 cases from 37 (64,9%), middle differentiation (G2) was detected in 12 cases (32,4%) and high grade differentiation (G1) was detected in 1 case (2,7%). Conclusions: HMG A2 high expression is a typical and important feature of serouse type of ovarian carcinoma. High level of HMG A2 gene expression correlate with low grade tumour differentiation. No significant financial relationships to disclose.
Abstract MP25: Diet Quality And Resilience: Examining Age Differences In A Cross-sectional Analysis Of The Well For Life Study
Authors: Sparkle Springfield, Kristen Cunanan, Katy Peng, Christopher D Gardner
Journal: Circulation (2020)

Background: Psychological resilience (resilience), defined as the self-reported ability to bounce back from stress, has been associated with diet quality. Despite the importance of resilience to successful aging, few studies have examined the relationship between resilience and diet quality across different age groups. Objective: To examine the relationship between diet quality and resilience while adjusting for perceived stress, sociodemographic information, and other diet-related health factors within the youngest, middle-aged, and oldest age groups in the Well for Life (WELL) study. Design: Cross-sectional analysis of survey data from the WELL study. A total of 4,309 adults predominantly drawn from the San Francisco Bay Area, completed the WELL survey, which included lifestyle, stress, and resilience domains. The WELL Diet Score, calculated from 12 diet-related items, ranged from 0-120. A higher score indicates better diet quality. Perceived stress was assessed by an adapted version of A Global Measure of Perceived Stress. Resilience was assessed by an adapted version of the Brief Resilience Scale for assessing the Ability to Bounce Back and the Connor-Davidson Resilience Scale. Perceived stress and resilience both ranged from 0-10. Higher scores indicate more perceived stress and resilience. All of the above measures were modeled as continuous. Linear regression analysis was used to evaluate the association between the WELL Diet Score and resilience within the following age tertiles: youngest [18-29], middle-aged [30-49], and oldest [50-64+]. Results: Across all age groups, WELL participants were predominately white females, college-educated, maintained healthy lifestyle practices, and had moderately high levels of perceived stress and resilience. Mean WELL Diet Scores were highest in the oldest group [79.4 out of 120 ± sd:81.6], followed by the middle-aged [72.2 out of 120 ± sd:18.1], and the youngest [63.6 out of 120 ± sd:18.0]. In the fully adjusted model, WELL Diet Scores demonstrated a positive and significant association with resilience within the youngest age group only [β=0.14 ± sd:0.34, p=0.02; (middle-aged) β=0.02 ± sd:0.34, p=0.63; (oldest) β=-0.001 ± sd:0.34, p=0.98]. In the model adjusted for perceived stress and sociodemographics only, diet quality demonstrated a positive and significant association with resilience within all age groups [(youngest) β=0.15 ± sd:0.32, p=0.001; (middle-aged) β=0.12 ± sd:0.35, p=0.001; (oldest) β=0.9 ± sd:0.34, p=0.01]. Conclusions: Diet quality may be positively associated with resilience in young adults. Our findings might warrant further investigation into whether assessing and potentially intervening to improve resilience could help to increase the effectiveness of dietary interventions targeting younger populations.
TOLL-LIKE RECEPTOR 3 AND 7/8 FUNCTION IS IMPAIRED IN HCV PATIENTS WITH RAPID FIBROSIS PROGRESSION POST LIVER TRANSPLANTATION
Authors: Jessica Howell, Rohit Sawhney, Narelle Skinner, Paul Gow, Peter W Angus, Dilip Ratnam, Adam Testro, Kumar Visvanathan
Journal: Hepatology (2011)
A New Assay to Measure Intestinal Crypt Survival after Irradiation: Challenges and Opportunities
Authors: Ruth J. Muschel, Ester M. Hammond, Mark W. Dewhirst
Journal: Cancer Research (2020)

Abstract Radiotherapy is a critical component of many current, curative cancer treatments, yet it is accompanied by unavoidable irradiation of normal tissues. Abdominal and pelvic radiation almost always results in some dose delivered to the bowel with deleterious effects to the small and large intestines. While the likelihood of enteritis is dose dependent, there is also considerable variation between patients in both the extent of symptoms of enteritis as well as their duration. In this article, Martin and colleagues hypothesized that the radiation sensitivity of intestinal organoids could predict the sensitivity of individual patients to enteritis and have taken the first steps to develop such an assay. See related article by Martin et al., p. 1219
Possible Modifiers of the Association Between Change in Weight Status From Child Through Adult Ages and Later Risk of Type 2 Diabetes
Authors: Lise G. Bjerregaard, Niko Wasenius, Rozenn Nedelec, Line K. Gjærde, Lars Ängquist, Karl-Heinz Herzig, Gorm B. Jensen, Erik L. Mortensen, Merete Osler, Kim Overvad, Tea Skaaby, Anne Tjønneland, Thorkild I.A. Sørensen, Marjo-Riitta Järvelin, Johan G. Eriksson, Sylvain Sebert, Jennifer L. Baker
Journal: Diabetes Care (2020)

We investigated the association between changes in weight status from childhood through adulthood and subsequent type 2 diabetes risks and whether educational attainment, smoking, and leisure time physical activity (LTPA) modify this association.Using data from 10 Danish and Finnish cohorts including 25,283 individuals, childhood BMI at 7 and 12 years was categorized as normal or high using age- and sex-specific cutoffs (<85th or ≥85th percentile). Adult BMI (20-71 years) was categorized as nonobese or obese (<30.0 or ≥30.0 kg/m2, respectively). Associations between BMI patterns and type 2 diabetes (989 women and 1,370 men) were analyzed using Cox proportional hazards regressions and meta-analysis techniques.Compared with individuals with a normal BMI at 7 years and without adult obesity, those with a high BMI at 7 years and adult obesity had higher type 2 diabetes risks (hazard ratio [HR]girls 5.04 [95% CI 3.92-6.48]; HRboys 3.78 [95% CI 2.68-5.33]). Individuals with a high BMI at 7 years but without adult obesity did not have a higher risk (HRgirls 0.74 [95% CI 0.52-1.06]; HRboys 0.93 [95% CI 0.65-1.33]). Education, smoking, and LTPA were associated with diabetes risks but did not modify or confound the associations with BMI changes. Results for 12 years of age were similar.A high BMI in childhood was associated with higher type 2 diabetes risks only if individuals also had obesity in adulthood. These associations were not influenced by educational and lifestyle factors, indicating that BMI is similarly related to the risk across all levels of these factors.
17-Gene Genomic Prostate Score Test Results in the Canary Prostate Active Surveillance Study (PASS) Cohort
Authors: Daniel W. Lin, Yingye Zheng, Jesse K. McKenney, Marshall D. Brown, Ruixiao Lu, Michael Crager, Hilary Boyer, Maria Tretiakova, James D. Brooks, Atreya Dash, Michael D. Fabrizio, Martin E. Gleave, Suzanne Kolb, Michael Liss, Todd M. Morgan, Ian M. Thompson, Andrew A. Wagner, Athanasios Tsiatis, Andrea Pingitore, Peter S. Nelson, Lisa F. Newcomb
Journal: Journal of Clinical Oncology (2020)

The 17-gene Oncotype DX Genomic Prostate Score (GPS) test predicts adverse pathology (AP) in patients with low-risk prostate cancer treated with immediate surgery. We evaluated the GPS test as a predictor of outcomes in a multicenter active surveillance cohort.Diagnostic biopsy tissue was obtained from men enrolled at 8 sites in the Canary Prostate Active Surveillance Study. The primary endpoint was AP (Gleason Grade Group [GG] ≥ 3, ≥ pT3a) in men who underwent radical prostatectomy (RP) after initial surveillance. Multivariable regression models for interval-censored data were used to evaluate the association between AP and GPS. Inverse probability of censoring weighting was applied to adjust for informative censoring. Predictiveness curves were used to evaluate how models stratified risk of AP. Association between GPS and time to upgrade on surveillance biopsy was evaluated using Cox proportional hazards models.GPS results were obtained for 432 men (median follow-up, 4.6 years); 101 underwent RP after a median 2.1 years of surveillance, and 52 had AP. A total of 167 men (39%) upgraded at a subsequent biopsy. GPS was significantly associated with AP when adjusted for diagnostic GG (hazards ratio [HR]/5 GPS units, 1.18; 95% CI, 1.04 to 1.44; P = .030), but not when also adjusted for prostate-specific antigen density (PSAD; HR, 1.85; 95% CI, 0.99 to 4.19; P = .066). Models containing PSAD and GG, or PSAD, GG, and GPS may stratify risk better than a model with GPS and GG. No association was observed between GPS and subsequent biopsy upgrade (P = .48).In our study, the independent association of GPS with AP after initial active surveillance was not statistically significant, and there was no association with upgrading in surveillance biopsy. Adding GPS to a model containing PSAD and diagnostic GG did not significantly improve stratification of risk for AP over the clinical variables alone.
How Should Surveillance Systems Account for Concurrent Intravascular Catheters?
Authors: Leonard A. Mermel
Journal: JAMA Network Open (2020)

William C. Dube, MPH; Jesse T. Jacob, MD; Ziduo Zheng, MS; Yijian Huang, PhD; Chad Robichaux, MPH; James P. Steinberg, MD; Scott K. Fridkin, MD
Abstract P459: Milk Intake, Host LCT Genotype and Gut Bifidobacteria in Relation to Obesity: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Jee-Young Moon, Zheng Wang, Mykhaylo Usyk, Yoshiki Vazquez-baeza, Carmen R Isasi, Yasmin Mossavar-Rahmani, Daniel McDonald, Daniela Sotres-Alvarez, Martha L DAVIGLUS, Jianwen Cai, Rob Knight, Robert Kaplan, Qibin Qi, Robert D Burk
Journal: Circulation (2020)

Background: Previous studies in Europeans found that gut Bifidobacterium genus was elevated in lactose intolerant individuals. However, the interrelationship between milk intake, host lactase ( LCT ) genotypes and different Bifidobacteria species, and their implications for human diseases have not been well-studied. Methods: This study included 2141 participants aged 23-83 years with microbiome, genetics and 24 hour dietary recall data from the HCHS/SOL, a population-based cohort of US Hispanics/Latinos. Stool samples were analyzed by shotgun metagenomics sequencing. Results: A GWAS on Bifidobacterium genus confirmed the genome-wide significant LCT locus (rs4988235, P =3.7х10 –21 ) ( Fig A ), and 3 major Bifidobacteria species were also significantly associated with LCT ( B. longum P = 4.4х10 –17 , B. adolescentis P=2.9х10 –13 , B. bifidum P=3.1х10 –5 ). 779 adults with lactose tolerant genotype (GG) had higher milk intake but lower Bifidobacteria compared to 1372 lactose intolerant adults (AA/AG). There was a significant interaction between milk intake and LCT variant on Bifidobacterium (P int =0.0003), with a positive association between milk intake and Bifidobacterium only in lactose intolerant but not in tolerant people ( Fig B ). The association of Bifidobacterium with obesity was also modified by LCT genotype. In lactose intolerant people, higher Bifidobacterium was associated with lower BMI, waist circumference and fat mass index, whereas in tolerant people higher Bifidobacterium was associated with higher obesity measures ( Fig C ). Species-level analyses indicated that B. longum may account for the positive association with milk intake and inverse associations with obesity measures in lactose intolerant people, while other major species, B. adolescentis and B. bifidum , may contribute to the positive association with obesity measures in lactose tolerant people. Conclusion: Our data indicate that diet and LCT genotype may alter the Bifidobacterium composition in gut, with different associations with obesity.
Drug survival of adalimumab, ustekinumab and secukinumab in patients with psoriasis: a prospective cohort study from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)
Authors: Z.Z.N. Yiu, K.J. Mason, P.J. Hampton, N.J. Reynolds, C.H. Smith, M. Lunt, C.E.M. Griffiths, R.B. Warren
Journal: British Journal of Dermatology (2020)

Real‐world biologic drug survival is an important proxy measure for effectiveness. Predictors of drug survival may help patients with psoriasis choose between biologic therapies. (i) To assess the relative drug survival of adalimumab, ustekinumab and secukinumab in patients with psoriasis. (ii) To investigate predictors of biologic drug survival. A prospective cohort study was performed in the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) between November 2007 and August 2019. We performed survival analysis and fitted a flexible parametric survival model for biologic discontinuation due to ineffectiveness. In total 9652 patients were included: 5543 starting on adalimumab (57·4%), 991 on secukinumab (10·3%) and 3118 on ustekinumab (32·3%). The overall drug survivals of adalimumab, secukinumab and ustekinumab in year 1 were 0·78 [95% confidence interval (CI) 0·77–0·79], 0·88 (95% CI 0·86–0·91) and 0·88 (95% CI 0·87–0·89), respectively. The adjusted hazard ratios (adjHRs) for discontinuation of adalimumab and secukinumab compared with ustekinumab were 2·11 (95% CI 1·76–2·54) and 0·67 (95% CI 0·40–1·11), respectively. The presence of psoriatic arthritis predicted for survival in the adalimumab and secukinumab cohorts (adjHR 0·67, 95% CI 0·51–0·88 and 0·70, 95% CI 0·40–1·24, respectively), but for discontinuation in the ustekinumab cohort (adjHR 1·42, 95% CI 1·12–1·81). Previous exposure to biologic therapies predicted for discontinuation in the ustekinumab and secukinumab cohorts (adjHR 1·54, 95% CI 1·26–1·89 and 1·49, 95% CI 0·91–2·45, respectively) and for survival in the adalimumab cohort (adjHR 0·71, 95% CI 0·55–0·92). Secukinumab and ustekinumab have similar sustained drug survival, while adalimumab has a lower drug survival in patients with psoriasis. Psoriatic arthritis and previous biologic experience were predictors with differential effects between the biologic therapies. What is already known about this topic? There is conflicting evidence over the real‐world drug survival of secukinumab in patients with psoriasis. Data from registries to date suggest that secukinumab has a lower drug survival than that reported from clinical trials. What does this study add? This study found that secukinumab and ustekinumab had similar sustained drug survival in the real world, while the drug survival of adalimumab was lower, suggesting that the real‐world drug survival of secukinumab is higher than previously reported. We found that psoriatic arthritis and previous biologic experience had differential effects on drug discontinuation in the three biologic cohorts. These predictors may help patients and clinicians choose the most appropriate biologic therapy. Linked Comment:Veysey. Br J Dermatol 2020; 183:204–205.