tbuckley/cabot-search huggingface dataset:
Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy
Authors: Chiara Piubelli, Michela Deiana, Elena Pomari, Ronaldo Silva, Zeno Bisoffi, Fabio Formenti, Francesca Perandin, Federico Gobbi, Dora Buonfrate
Journal: Clinical Microbiology and Infection (2020)

ObjectivesIn Italy the burden of patients with coronavirus disease 2019 (COVID-19) gradually decreased from March to the end of May. In this work we aimed to evaluate a possible association between the severity of clinical manifestations and viral load over time during the epidemiological transition from high-to low-transmission settings.MethodsWe reviewed the cases of COVID-19 diagnosed at the emergency room of our hospital, retrieving the proportion of patients admitted to the intensive care unit. A raw estimation of the viral load was done evaluating the Ct (cycle threshold) trend obtained from our diagnostic reverse transcriptase real-time PCR test.ResultsThe proportion of patients requiring intensive care significantly decreased from 6.7% (19/281) in March to 1.1% (1/86) in April, and to none in May (Fisher's test p 0.0067). As for viral load, we observed a trend of Ct increasing from a median value of 24 (IQR 19–29) to 34 (IQR 29–37) between March and May, with a statistically significant difference between March and April (pairwise Wilcoxon test with stepdown Bonferroni adjustment for multiple testing, p 0.0003).ConclusionsWe observed a reduction over time in the proportion of patients with COVID-19 requiring intensive care, along with decreasing median values of viral load. As the epidemiological context changes from high-to low-transmission settings, people are presumably exposed to a lower viral load which has been previously associated with less severe clinical manifestations.
COVID-19 Highlights the Need for More Effective Wildlife Trade Legislation
Authors: Amaël Borzée, Jeffrey McNeely, Kit Magellan, Jennifer R.B. Miller, Lindsay Porter, Trishna Dutta, Krishnakumar P. Kadinjappalli, Sandeep Sharma, Ghazala Shahabuddin, Fikty Aprilinayati, Gerard E. Ryan, Alice Hughes, Aini Hasanah Abd Mutalib, Ahmad Zafir Abdul Wahab, Damber Bista, Suchana Apple Chavanich, Ju Lian Chong, George A. Gale, Hanyeh Ghaffari, Yadav Ghimirey, Vijaya Kumaran Jayaraj, Ambika Prasad Khatiwada, Monsoon Khatiwada, Murali Krishna, Ngwe Lwin, Prakash Kumar Paudel, Chinara Sadykova, Tommaso Savini, Bharat Babu Shrestha, Colin T. Strine, Makamas Sutthacheep, Ee Phin Wong, Thamasak Yeemin, Natasha Zulaika Zahirudin, Li Zhang
Journal: Trends in Ecology & Evolution (2020)
A thermosensitive, reactive oxygen species-responsive, MR409-encapsulated hydrogel ameliorates disc degeneration in rats by inhibiting the secretory autophagy pathway
Authors: Qiangqiang Zheng, Haotian Shen, Zongrui Tong, Linxiang Cheng, Yuzi Xu, Zhiyun Feng, Shiyao Liao, Xiaojian Hu, Zongyou Pan, Zhengwei Mao, Yue Wang
Journal: Theranostics (2020)

Lumbar disc degeneration is a common cause of chronic low back pain and an important contributor to various degenerative lumbar spinal disorders. However, currently there is currently no effective therapeutic strategy for treating disc degeneration. The pro-inflammatory cytokine interleukin-1β (IL-1β) mediates disc degeneration by inducing apoptotic death of nucleus pulposus (NP) cells and degradation of the NP extracellular matrix. Here, we confirmed that extracellular secretion of IL-1β via secretory autophagy contributes to disc degeneration, and demonstrate that a thermosensitive reactive oxygen species (ROS)-responsive hydrogel loaded with a synthetic growth hormone-releasing hormone analog (MR409) can protect against needle puncture-induced disc degeneration in rats.
Precision biomarkers for mood disorders based on brain imaging
Authors: Runsen Chen, Zaixu Cui, Liliana Capitão, Gang Wang, Theodore D Satterthwaite, Catherine Harmer
Journal: BMJ (2020)

Identification of biomarkers could facilitate earlier diagnosis and better treatment, say Runsen Chen and colleagues Mood disorders are a global public health problem because of their high prevalence, chronicity, and recurrence throughout the lifespan as well as increased risk of mortality.123 They also impose a heavy economic burden on society because of lost work productivity (occupational disability) and increased use of health services.4 Early diagnosis and effective treatment are therefore essential. Mood disorders are characterised by a significant change in a person’s state of mood and include two main subtypes: depressive disorders (major depressive episode and dysthymia) and bipolar disorders (hypomania, mania, or cyclothymia—that is, cycling between depressed and manic states). In 2015, over 300 million people were living with major depressive disorder worldwide, representing 4.4% of the global population.5 A world mental health survey reported that the lifetime and 12 month prevalences of bipolar disorders in the general population were 2.4% and 1.5%, respectively.6 Mood disorders are associated with a widespread cognitive dysfunction, involving higher-order executive function,7 reward processing,8 and emotional regulation (fig 1, box 1).10 These deficits are associated with abnormalities in both the structure and function of specific brain circuits. Interest is growing in developing precision biomarkers for mood disorders based on a deeper understanding of their biological bases by integrating multilevels of data, such as brain imaging, clinical symptoms, and cognitive behaviours.1112 Fig 1 Brain regions underlying executive function, emotional regulation, and reward processing. The figure was made with reference from Wang and Olson9 Box 1 ### Key termsRETURN TO TEXT
AB0011 The estimation of synovial fluid immunological parameters in rheumatoid arthritis
Authors: VV Bazarniy, NS Petrovich, SV Tsvirenko, GA Tsaur
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> <h3>Objectives</h3> Laboratory synovial fluid (SF) tests are often held for joints condition, stage and acuteness of the inflammatory processes estimation. Immunological exams of SF is not routine procedure in clinical practice. We have studied the opportunity of immunological tests used in diagnostics of rheumatoid arthritis (RA). <h3>Methods</h3> 44 patients (24 females and 20 males) with RA, diagnosed according to the American Colleges of Rheumatology criteries (1987) were examined. 29 of them have been seropositive. SF was taken by standard knee arthrocentesis. An immunological SF testing included determination of the levels of immunoglobulins A, M, G(IgA, IgM, IgG); C-reactive protein; circulating immune complex; complement proteins; interleukin-1beta (IL-1beta) and tumour necrosis factor alpha TNF-alpha); rheumatoid factor (RF); phagocyte activity tests. These parameters were also determined in the venous blood of the RA patients. <h3>Results</h3> In patients with RA the significant increasing of SF immunoglobulins, especially IgG, circulating immune complexes, complement proteins, IL-1 beta and TNF-alpha was found. C-reactive protein was relatively low. There was no significant serum IgG, phagocyte activity, IL-1 beta and TNF-alpha elevation. RF at the RA onset was higher in SF, than in serum. In RA seronegative patients was determined exclusively in the SF in low quantity. <h3>Conclusion</h3> We concluded that immunological investigation of SF is important tool for RA diagnosis, especially in activity processes estimation.
Mechanisms of acute ankle syndesmosis ligament injuries in professional male rugby union players: a systematic visual video analysis
Authors: Eamonn Delahunt, Garreth Farrell, Andrew Boylan, Fearghal Kerin, Peter Tierney, Hugh Hogan, Colin Boreham
Journal: British Journal of Sports Medicine (2020)

Background The mechanisms of acute ankle syndesmosis ligament injuries in professional rugby union are not well understood. Aim To describe the mechanisms of acute ankle syndesmosis ligament injuries in male professional rugby union players using systematic visual video analysis. Methods All time-loss acute ankle syndesmosis ligament injuries identified via retrospective analysis of the Leinster Rugby injury surveillance database across the 2013/2014 to 2017/2018 seasons were considered as potentially eligible for inclusion. Three Chartered Physiotherapists (analysts) independently assessed all videos with a final consensus meeting convened to describe the injury mechanisms. One of the analysts developed a qualitative description of each injury mechanism. Results Thirteen acute ankle syndesmosis injuries were included in this study. The most common biomechanical presentation of the injured limb was characterised by hip flexion, knee flexion, knee valgus, ankle dorsiflexion, pronation and external rotation of the foot. Six of the included injuries (46%) were the result of an external load application to the injured limb (ie, direct contact injuries). In the other seven instances (54%), the injury was the result of a collapse of the injured player’s body mass over the injured ankle joint, while tackling or being tackled, without direct contact to the injured limb (ie, indirect contact injuries). Conclusion Injuries incurred while tackling were exclusively the result of suboptimal tackle mechanics. A majority of injuries incurred while being tackled involved a posterior tackle, which often resulted in a posterior collapse of the injured player’s centre of mass over a fixed externally rotated foot.
Child Abuse and Neglect Contributing to Youth Suicide—Reply
Authors: Cynthia A. Fontanella, John V. Campo
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
Palliative care referrals in patients with advanced cancer on early-phase cancer clinical trials (EP-CTs).
Authors: Megan Healy, Rachel Jimenez, Ryan David Nipp, Jennifer Adrienne Shin, Andrew Johnson, Virginia Capasso, Casandra McIntyre, Barbara J. Cashavelly, Dejan Juric, Debra Lundquist
Journal: Journal of Clinical Oncology (2020)

29 Background: EP-CTs investigate novel therapeutic approaches for patients with cancer, but little is known about the utilization of supportive care services, specifically palliative care (PC), in this population. Methods: We conducted a retrospective review of consecutive patients enrolled on EP-CTs at the MGH Cancer Center from 2017-2019. Sociodemographic and clinical variables, including utilization of PC services, were obtained via chart review. Details of the PC evaluation were compared between patients who received first referral to PC while enrolled on an EP-CT versus those who received a PC referral at any point after diagnosis. Results: Among 426 patients enrolled on EP-CTs (median age 63 years; 44% male), 249 (59%) received a PC referral at any time following a diagnosis of cancer (median age 57 years, 58% male). Eighty-six (35%) were referred prior to enrollment on EP-CT, 44 (18%) were referred while on EP-CT, and 119 (48%) were referred post-EP-CT. Patients referred on EP-CT were younger (median 56 vs 63 years, p &lt; 0.0001) than those enrolled on EP-CTs. For patients referred while on EP-CT, 48% had a PC consult within 30 days of enrollment (range: 0-530 days); median number of PC visits was 3 (range: 0-37); median time from first PC consult to death or termination of EP-CT was 32 days (range: 1-213). Of 44 patients referred on EP-CT, 2 (5%) died while on EP-CT. Of the remaining patients, median time from first PC consult to date of death was 79 days (IQR: 45-178 days). Most common reasons for referral included pain (22, 50%), non-pain symptoms (21, 48%), and goals of care/advanced care planning (20, 45%). Of these referrals, 13 (30%) were initiated as inpatients versus 31 (70%) as outpatients. Pain was most commonly cited for outpatient referral (35%), followed by non-pain symptoms (25%) and goals of care (23%). Non-pain symptoms (40%) and goals of care (36%) were most commonly cited reasons for inpatient referral, followed by pain (24%). Of referrals while on EP-CT, 23 (52%) were made by EP-CT staff, including MD and APP, 7 (16%) from the primary oncologist, and 1 (2%) was self-referral. 26 (57%) of patients referred to PC during trial were also referred to hospice, with a median time from last PC consult to hospice referral of 24 days (range: -2-322). Conclusions: A majority of patients with advanced cancer enrolled on EP-CTs received a PC referral. The timeline and method of referral varied, but most patients did not receive a referral until or following enrollment on an EP-CT. Future work will focus on developing a standard referral protocol for patients enrolled on EP-CTs.
Identification of a distinct luminal subgroup diagnosing and stratifying early stage prostate cancer by tissue-based single-cell RNA sequencing
Authors: Xiaoshi Ma, Jinan Guo, Kaisheng Liu, Lipeng Chen, Dale Liu, Shaowei Dong, Jinquan Xia, Qiaoyun Long, Yongjian Yue, Pan Zhao, Fengyan Hu, Zhangang Xiao, Xinghua Pan, Kefeng Xiao, Zhiqiang Cheng, Zunfu Ke, Zhe-Sheng Chen, Chang Zou
Journal: Molecular Cancer (2020)

The highly intra-tumoral heterogeneity and complex cell origination of prostate cancer greatly limits the utility of traditional bulk RNA sequencing in finding better biomarker for disease diagnosis and stratification. Tissue specimens based single-cell RNA sequencing holds great promise for identification of novel biomarkers. However, this technique has yet been used in the study of prostate cancer heterogeneity.
An unconventional view of COVID-19 T cell immunity
Authors: Hui-Fern Koay, Thomas S. Fulford, Dale I. Godfrey
Journal: The Journal of Experimental Medicine (2020)

In this issue of JEM, Jouan et al. (https://doi.org/10.1084/jem.20200872) report the activation and skewed function of unconventional T cells in severe COVID-19 patients. This may reflect a role in COVID-19 immunity or pathogenesis and potentially identifies new therapeutic targets for this disease.
Mitogenomes Reveal Alternative Initiation Codons and Lineage-Specific Gene Order Conservation in Echinoderms
Authors: Zheng Bin Randolph Quek, Jia Jin Marc Chang, Yin Cheong Aden Ip, Yong Kit Samuel Chan, Danwei Huang
Journal: Molecular Biology and Evolution (2020)

Abstract The mitochondrial genetic code is much more varied than the standard genetic code. The invertebrate mitochondrial code, for instance, comprises six initiation codons, including five alternative start codons. However, only two initiation codons are known in the echinoderm and flatworm mitochondrial code, the canonical ATG and alternative GTG. Here, we analyzed 23 Asteroidea mitogenomes, including ten newly sequenced species and unambiguously identified at least two other start codons, ATT and ATC, both of which also initiate translation of mitochondrial genes in other invertebrates. These findings underscore the diversity of the genetic code and expand upon the suite of initiation codons among echinoderms to avoid erroneous annotations. Our analyses have also uncovered the remarkable conservation of gene order among asteroids, echinoids, and holothuroids, with only an interchange between two gene positions in asteroids over ∼500 Ma of echinoderm evolution.
Response by Kazi et al to Letter Regarding Article, “Cost-Effectiveness of Tafamidis Therapy for Transthyretin Amyloid Cardiomyopathy”
Authors: Dhruv S. Kazi, Brandon K. Bellows, John A. Spertus, Suzanne J. Baron, Changyu Shen, David J. Cohen, Robert W. Yeh, Suzanne V. Arnold, Brett W. Sperry, Mathew S. Maurer, Sanjiv J. Shah
Journal: Circulation (2020)
Multisite quality improvement initiative to repair incomplete electronic medical record documentation as one contributor to provider burnout.
Authors: Carolyn Russo, Lauren Raney, Joanne McManaman, Mohamed Elsaid, Jennifer Morgan, Ronda Marie Bowman, Ashraf Mahmoud Mohamed
Journal: Journal of Clinical Oncology (2020)

190 Background: Provider burnout is a challenge adversely affecting the quality, safety, and cost of health care. We measured burnout among pediatric oncology providers in the St. Jude Affiliate network and used a Plan-Do-Study-Act (PDSA) improvement cycle to address one of the factors contributing to burnout. Methods: Within the framework of the American Society of Clinical Oncology (ASCO) Thematic Quality Training Program (QTP) we sent the Mini Z 2.0 Survey to 47 pediatric oncology providers. Applying a fishbone diagram and Pareto chart we analyzed potential causes of provider burnout. Based on the analysis, we used a PDSA approach to address documentation of oral chemotherapy adherence for children with acute lymphoblastic leukemia to mitigate burnout among providers. Results: The burnout survey response rate was 44.6%. Burnout was identified in 42.9% of providers. Documentation in the electronic medical record (EMR) was cited as the second most common contributor to burnout, and it was this issue we chose to address based on a priority matrix. We improved the completeness of oral chemotherapy documentation from a baseline of 13% compliance to 87% compliance within 3 months. The improved compliance was achieved by standardizing the documentation process in the EMR for content and location. Conclusions: The EMR was one of the contributing factors in the burnout survey of the pediatric oncology providers in the St. Jude Affiliate network. A PDSA improvement model to improve clinical research documentation was successful in addressing one of several contributing factors to provider burnout.
Fasting Blood Glucose and COVID-19 Severity: Nonlinearity Matters
Authors: Barrak Alahmad, Abdullah A. Al-Shammari, Abdullah Bennakhi, Fahd Al-Mulla, Hamad Ali
Journal: Diabetes Care (2020)

OBJECTIVE Fasting blood glucose (FBG) could be an independent predictor for coronavirus disease 2019 (COVID-19) morbidity and mortality. However, when included as a predictor in a model, it is conventionally modeled linearly, dichotomously, or categorically. We comprehensively examined different ways of modeling FBG to assess the risk of being admitted to the intensive care unit (ICU). RESEARCH DESIGN AND METHODS Utilizing COVID-19 data from Kuwait, we fitted conventional approaches to modeling FBG as well as a nonlinear estimation using penalized splines. RESULTS For 417 patients, the conventional linear, dichotomous, and categorical approaches to modeling FBG missed key trends in the exposure-response relationship. A nonlinear estimation showed a steep slope until about 10 mmol/L before flattening. CONCLUSIONS Our results argue for strict glucose management on admission. Even a small incremental increase within the normal range of FBG was associated with a substantial increase in risk of ICU admission for COVID-19 patients.
Improving vaccine administration in patients with solid malignancies in the outpatient setting.
Authors: Mariam Alexander, Matthew Stuart, Jose Nahun Galeas, Roy Browne, Jim McCarthy, Stuart H. Packer
Journal: Journal of Clinical Oncology (2020)

194 Background: Pneumococcal and influenza vaccinations are recommended for all patients with any malignancy in accordance with the Infectious Disease Society of America. Patients undergoing chemotherapy for solid tumors have a 40-50 fold higher risk for the development of invasive pneumococcal disease compared to healthy adults with a case fatality rate of 35% and should receive the sequential 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23). In the outpatient setting, lack of provider knowledge, complexity of the pneumococcal vaccine regimen and disruption in work-flow of a busy clinic can lead to low rates of administration. Towards this end, we conducted a quality project to improve administration of both pneumococcal and influenza vaccines by at least 50% at one of our outpatient oncology clinics at Montefiore Medical Center in Bronx, NY during a 4 month period. Methods: We first provided provider and nursing education with regard to safety and efficacy of the vaccines in both the clinic as well as the infusion setting. Nurses were then prompted to screen patients and offer the vaccines during intake prior to all infusions and clinic visits. We created bulk orders which allowed nurses greater control of releasing vaccine orders previously entered by the director of the clinic. We also posted “cheat-sheets” on optimal timing, safety and sequence of administration of the vaccines in every patient room and nursing station. After our first cycle, we identified that there was a delay in work-flow in the outpatient clinic with delivery of the vaccines to the clinic from the pharmacy. We therefore obtained a secure vaccine fridge that was placed at the nursing station, which allowed nurses easy access to the vaccines. Results: When vaccine administration during the 2018-2019 influenza season was compared to the 2019-2020 influenza season, we found that these interventions improved the administration of the influenza vaccine by 70%. There was a dramatic increase in the number of PCV-13 vaccines administered by 350% (more than 5-fold) and increase in PPVS-23 by 12.5%. No immediate adverse reactions during this cycle were reported to our nurse manager. Conclusions: A simple intervention of improved work-flow of vaccine administration and increased education of providers and nurses translated to a dramatic improvement in the administration of influenza and PCV-13 vaccines in a busy outpatient oncology clinic.