tbuckley/cabot-search huggingface dataset:
Shortcomings in cardiac unit at St George’s hospital linked to 67 deaths
Authors: Clare Dyer
Journal: BMJ (2020)

Significant shortcomings in the care given to heart surgery patients at St George’s Hospital in London “probably, most likely, or definitely” contributed to 67 deaths between April 2013 and December 2018, an independent panel of experts has concluded.1

NHS Improvement convened the panel of 12 assessors after St George’s University Hospitals NHS Foundation Trust fell below national safety levels for heart surgery from April 2013 to March 2017.2

The review follows an investigation in 2018 by former NHS England deputy medical director Mike Bewick, which found a “persistent toxic atmosphere,” with surgeons “working in camps” and displaying “tribal-like activity.” …
Intranasal corticosteroids in allergic rhinitis in COVID‐19 infected patients: An ARIA‐EAACI statement
Authors: Jean Bousquet, Cezmi A. Akdis, Marek Jutel, Claus Bachert, Ludger Klimek, Ioana Agache, Ignacio J. Ansotegui, Anna Bedbrook, Sinthia Bosnic‐Anticevich, G. Walter Canonica, Tomas Chivato, Alvaro A. Cruz, Wienczyslawa Czarlewski, Stefano Del Giacco, Hui Du, Joao A. Fonseca, Yadong Gao, Tari Haahtela, Karin Hoffmann‐Sommergruber, Juan‐Carlos Ivancevich, Nikolaï Khaltaev, Edward F. Knol, Piotr Kuna, Desiree Larenas‐Linnemann, Joaquim Mullol, Robert Naclerio, Ken Ohta, Yoshitaka Okamoto, Liam O’Mahony, Gabrielle L. Onorato, Nikos G. Papadopoulos, Oliver Pfaar, Boleslaw Samolinski, Jürgen Schwarze, Sanna Toppila‐Salmi, Maria-Teresa Ventura, Arunas Valiulis, Arzu Yorgancioglu, Torsten Zuberbier, Ruby Pawankar
Journal: Allergy (2020)
Predicting fitness for chemotherapy in older cancer patients [Conference Abstract]
Authors: Damien Thomson, Alexandra McCarthy, Patsy Yates, Helen Skerman, Euan Walpole
Journal: Journal of Clinical Oncology (2013)

Background: The Vulnerable Elders Survey-13 (VES-13) is increasingly used to screen for older patients who can proceed to intensive chemotherapy without further comprehensive assessment. This study compared the VES-13 determination of fitness for treatment with the oncologist's assessments of fitness. Method: Sample: Consecutive series of solid tumour patients ≥65 years (n=175; M=72; range=65-86) from an Australian cancer centre. Patients were screened with the VES-13 before proceeding to usual treatment. Blinded to screening, oncologists concurrently predicted patient fitness for chemotherapy. A sample of 175 can detect, with 90% power, kappa coefficients of agreement between VES-13 and oncologists’ assessments >0.90 (almost perfect agreement). Separate backward stepwise logistic regression analyses assessed potential predictors of VES-13 and oncologists’ ratings of fitness. Results: Kappa coefficient for agreement between VES-13 and oncologists’ ratings of fitness was 0.41 (p<0.001). VES-13 and oncologists’ assessments agreed in 71% of ratings. VES-13 sensitivity = 83.3%; specificity = 57%; positive predictive value = 69%; negative predictive value = 75%. Logistic regression modelling indicated that the odds of being vulnerable to chemotherapy (VES-13) increased with increasing depression (OR=1.42; 95% CI: 1.18, 1.71) and decreased with increased functional independence assessed on the Bartel Index (OR=0.82; CI: 0.74, 0.92) and Lawton instrumental activities of daily living (OR=0.44; CI: 0.30, 0.65); RSquare=.65. Similarly, the odds of a patient being vulnerable to chemotherapy, when assessed by physicians, increased with increasing age (OR=1.15; CI: 1.07, 1.23) and depression (OR=1.23; CI: 1.06, 1.43), and decreased with increasing functional independence (OR=0.91; CI: 0.85, 0.98); RSquare=.32. Conclusions: Our data indicate moderate agreement between VES-13 and clinician assessments of patients’ fitness for chemotherapy. Current ‘one-step’ screening processes to determine fitness have limits. Nonetheless, screening tools do have the potential for modification and enhanced predictive properties in cancer care by adding relevant items, thus enabling fit patients to be immediately referred for chemotherapy.
Abstract 395: State-Level CPR Education Legislation Associated With Higher Survival After Out-Of-Hospital Cardiac Arrest in Older Adults
Authors: David G Buckler, Megan Barnes, Tyler D Alexander, Marissa Lang, Alexis M Zebrowski, Douglas J Wiebe, Benjamin S Abella, Brendan G Carr
Journal: Circulation (2019)

Introduction: State-level legislation requiring CPR education prior to high school graduation (CPR Legislation) is associated with an increased likelihood of community-level CPR training. CPR Legislation has also been shown to be associated with increased bystander CPR. We hypothesized that states with recent CPR Legislation would be associated with higher survival in older adults following out-of-hospital cardiac arrest (OHCA). Methods: Utilizing 2014 Medicare Claims data for emergency department (ED) visits and inpatient stays, we identified OHCA via ICD-9-CM code. CPR Legislation data was collected through online statute review. Exposure to CPR Legislation was assessed using the patient state of residence reported on the first claim. Patient dispositions were coded as home, SNF, death/hospice, rehab or other. All categories were considered survival to discharge except for death/hospice. Associations between categorical variables were assessed by chi-squared test. Multiple logistic regression was used to calculate the odds ratio associated with OHCA survival and CPR Legislation, controlling for patient age and sex. Results: In 2014, 256,277 OHCAs were identified. Mean age was 79 ±8 y, 48% were female, 23% were non-white, and survival to discharge was 22%. Prior to 2013, 4 states had passed CPR Legislation and 6 others passed legislation in 2013. These states account for 12% of OCHA for the study year. States that passed CPR Legislation in 2013 had the highest survival compared to states with earlier passage or no CPR Legislation (22.2% vs 20.6% vs. 21.8%, respectively, p &lt; 0.001). Among those who survived to discharge, more patients were discharged home from states with 2013 CPR Legislation, than earlier or no legislation (50.8% vs. 41.3% vs. 42.8%, p &lt;0.001). Results of the multiple logistic regression showed CPR Legislation passed in 2013 was associated with a 12% increase in the odds of survival to discharge compared to states with CPR Legislation prior to 2013 (OR: 1.12, p &lt;0.001). Conclusion: States with CPR Legislation passed in 2013 were associated with higher survival to discharge and discharge to home, compared to earlier adopters and states with no legislation. Further work is needed to assess the mechanisms underlying this relationship.
Sustainable care for children with cancer: a Lancet Oncology Commission
Authors: Rifat Atun, Nickhill Bhakta, Avram Denburg, A Lindsay Frazier, Paola Friedrich, Sumit Gupta, Catherine G Lam, Zachary J Ward, Jennifer M Yeh, Claudia Allemani, Michel P Coleman, Veronica Di Carlo, Eva Loucaides, Elizabeth Fitchett, Fabio Girardi, Susan E Horton, Freddie Bray, Eva Steliarova-Foucher, Richard Sullivan, Joanne F Aitken, Shripad Banavali, Agnes Binagwaho, Patricia Alcasabas, Federico Antillon, Ramandeep S Arora, Ronald D Barr, Eric Bouffet, Julia Challinor, Soad Fuentes-Alabi, Thomas Gross, Lars Hagander, Ruth I Hoffman, Cristian Herrera, Tezer Kutluk, Karen J Marcus, Claude Moreira, Kathy Pritchard-Jones, Oscar Ramirez, Lorna Renner, Leslie L Robison, Jaime Shalkow, Lillian Sung, Allen Yeoh, Carlos Rodriguez-Galindo
Journal: The Lancet Oncology (2020)
Abstract P2-16-14: HER2-positive breast cancer: Combined 18F-FDG PET and CGFL/Curie nomogram to predict pathologic complete response after preoperative chemotherapy with trastuzumab
Authors: Laura Vincent, Clémentine Jankowski, Marion Cortet, Laurent Arnould, Sylvain Ladoire, Bruno Coudert, Isabelle Desmoulins, Céline Charron-Barra, Françoise Beltjens, Roman Rouzier, Fabien Reyal, Olivier Humbert, Alexandre Cochet, Charles Coutant
Journal: Cancer Research (2020)

Abstract Background The aim of this study was to compare the value of 18F-fluorodesoxyglucose positron emission tomography (18F-FDG PET/CT) with CGFL/Curie nomogram to predict a pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in women with human epidermal growth factor 2 (HER2)-positive breast cancer treated by trastuzumab. Methods Fifty-one women with HER2-positive breast cancer treated with trastuzumab plus taxane-based NAC, were retrospectively included from January 2005 to December 2015. For 18F-FDG PET/CT, the analyzed predictor was the maximum standardized uptake value of the primary tumor and axillary nodes after the first course of NAC (PET2.SUVmax). pCR was defined by no residual infiltrative tumor but in situ tumor was accepted. Accuracy of CGFL/Curie nomogram and PET2.SUVmax was evaluated measuring sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV). For each predictor, receiver operating characteristic (ROC) curve was created. To evaluate the correlation between predictors, the Spearman coefficient was calculated. Combined prediction was evaluated testing predictor’s associations. Results For CGFL/Curie nomogram’s performances, Se, Sp, PPV and NPV were respectively: 76% (CI95%: 58-90%), 57% (CI95%: 43-66%), 55% (CI95%: 42-65), 77% (CI95%: 59-90%). For PET2.SUVmax’s performances, Se, Sp, PPV and NPV were respectively: 67% (CI95%: 48-81%), 77% (CI95%: 64-97%), 67% (CI95%: 48-82%), 77% (CI95%: 64-87%). ROC curves for these predictors were similar; the areas under the curve were 0.6 (CI95%: 0.56-0.64) for PET2.SUVmax and 0.55 (CI95%: 0.50-0.59) for CGFL/Curie nomogram. Spearman coefficient was 0.23. Combined prediction was more efficient with Se at 80%, VPN at 76%, Sp at 78% and VPP at 81 %. Conclusions CGFL/Curie nomogram and PET2.SUVmax were two efficient predictors of pCR in patients with HER2-positive breast cancer. Combined prediction has an improved accuracy. Citation Format: Laura Vincent, Clémentine Jankowski, Marion Cortet, Laurent Arnould, Sylvain Ladoire, Bruno Coudert, Isabelle Desmoulins, Céline Charron-Barra, Françoise Beltjens, Roman Rouzier, Fabien Reyal, Olivier Humbert, Alexandre Cochet, Charles Coutant. HER2-positive breast cancer: Combined 18F-FDG PET and CGFL/Curie nomogram to predict pathologic complete response after preoperative chemotherapy with trastuzumab [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-16-14.
Traumatic Injuries Associated With Standing Motorized Scooters
Authors: Frank Bauer, Jeffrey D. Riley, Karen Lewandowski, Kaveh Najafi, Helen Markowski, John Kepros
Journal: JAMA Network Open (2020)

This cross-sectional study assesses the incidence and severity of traumatic injuries associated with motorized scooters, as well as the associated use of protective devices and intoxicants.
Abstract P5-04-27: The relationship between tumour associated macrophage markers and tumour, demographic &amp; behavioural factors in breast cancer
Authors: Urvashi Singh, John Castle, Sophie Greenhalgh, Umar Hussain, Tine Descamps, Sarah Nash, Mary Wilson, Roger Hunt, Cliona C Kirwan
Journal: Cancer Research (2020)

Abstract BACKGROUND: Tumour associated macrophages (TAMs) are prognostic markers in breast cancer, however the influence of patient demographic and behavioural factors on these inflammatory markers has not been fully appreciated. METHODS: In 201 invasive breast cancer and 58 ductal carcinoma in-situ (DCIS) patients, TAM density (percentage % CD68 [IHC-immunohistochemistry] positive cells) was correlated with tumour factors (grade, proliferation (Ki67), ER, HER2); demographic factors (age, menopausal status, breast density, BMI, diabetes) and behavioural factors (smoking, alcohol). RESULTS: TAM density was increased in invasive breast cancer, compared to DCIS, and normal tissue distant from the tumour (59%, 41% and 6% respectively; p&amp;lt;0.001). In invasive cancer, TAM density increased with increasing tumour grade (Grade 1: 42%, Grade 2: 58%, Grade 3: 72%; p=0.006), high Ki67 (71% vs. 47%; p=0.004), ER negativity (70% vs. 51%; p=0.02) and HER2 (HER2 positive 77% vs. HER2 negative 55%; p=0.055). TAM density was higher in high compared to low/intermediate DCIS (44% % vs 31% respectively). In terms of demographic factors, TAM density did not correlate with age, menopausal status, breast density (BIRADs), BMI or history of diabetes. TAM density was not increased in patients who smoked; however, it was increased in patients who self-reported alcohol intake (non-drinker 43% vs. drinker 62%; p=0.01). CONCLUSION: TAM density shows utility in identifying aggressive breast cancer sub-types. The association reported between TAM density and alcohol intake suggests a possible mechanism for alcohol as a risk factor for breast cancer. Citation Format: Urvashi Singh, John Castle, Sophie Greenhalgh, Umar Hussain, Tine Descamps, Sarah Nash, Mary Wilson, Roger Hunt, Cliona C Kirwan. The relationship between tumour associated macrophage markers and tumour, demographic &amp; behavioural factors in breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-04-27.
Abstract P2-08-26: Cardiovascular events and mortality in a population-based cohort treated for ductal carcinoma in situ
Authors: Tae-Kyung Yoo, Byung Joo Chae, Kyung Do Han, DaHye Kim, Juneyoung Ahn, Woo-Chan Park, Se Jeong Oh
Journal: Cancer Research (2020)

Abstract Background: Ductal carcinoma in situ (DCIS) patients are mostly diagnosed through cancer screening programs, suggesting that this population may have a healthy screenee effect of being more health-conscious, have lower comorbidity and belong to a higher socio-economic class. In this population-based cohort, we assessed the likelihood of cardiovascular events and mortality in DCIS patients, comparing with a control group of non-DCIS patients. Methods: Using the Korean National Health Insurance Service database, 13,740 women who were diagnosed of DCIS between 2007 and 2013 were analyzed. Control group matched by age was selected three times the number of DCIS cases (n=41,200). Follow-up for comorbidities and survival was performed up to 2016. Cox proportional hazard regression analysis was used to evaluate the association between DCIS and myocardial infarction (MI) risk, cerebrovascular stroke risk and mortality rate. The DCIS group was divided into pure DCIS patients and DCIS patients with subsequent invasive breast cancer for analysis. Results: Compared to the control group, patients with DCIS history were more likely to have hypertension, diabetes mellitus, dyslipidemia and the Charlson’s Comorbidity Index score was significantly higher. Patients with DCIS history also had higher income and were more likely to live in urban districts. Despite of higher comorbidity rate, pure DCIS patients had a trend of lower MI risk (HR 0.710; 95% CI 0.448 - 1.125) and significantly lower stroke risk (HR 0.708; 95% CI 0.492 - 1.019). Whereas, DCIS patients with subsequent invasive breast cancer had a significantly lower MI risk (HR 0.582; 95% CI, 0.371 - 0.913) and trend of lower stroke risk (HR 0.815; 95% CI 0.610 - 1.108). Mortality rate was similar between control group and pure DCIS patients, but was higher in DCIS patients with subsequent invasive breast cancer (HR 1.629; 95% CI 1.339 - 1.983). The trend of lower risk for cardiovascular events was sustained when adjusting for age, income and comorbidities (hypertension, diabetes mellitus and dyslipidemia). Conclusion: DCIS patients had a lower risk for MI and stroke compared to the control group despite of higher rate of comorbidities, which may reflect socioeconomic differences. DCIS patients with subsequent invasive breast cancer had higher mortality rate, whereas pure DCIS patients had similar survival rate compared to the control group. Citation Format: Tae-Kyung Yoo, Byung Joo Chae, Kyung Do Han, DaHye Kim, Juneyoung Ahn, Woo-Chan Park, Se Jeong Oh. Cardiovascular events and mortality in a population-based cohort treated for ductal carcinoma in situ [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-08-26.
Abstract C19: Impaired adaptation to negative energy balance in pancreatic cancer-associated wasting
Authors: Heike Mendez, Xinxia Zhu, Brennan Olsen, Daniel L. Marks, Aaron J. Grossberg
Journal: Cancer Research (2019)

Abstract Purpose/Objectives: The disease-associated wasting condition cachexia is a common complication of pancreatic ductal adenocarcinoma (PDAC) that impacts quality of life and portends poor survival. Undernutrition is a major driver of wasting in PDAC, yet cachexia remains refractory to nutritional supplementation. By modifying nutritional challenges at different stages of cachexia development, we sought to understand the relative contributions of undernutrition and metabolic reprogramming on adipose and skeletal muscle wasting. Materials/Methods: Adult mice received orthotopic PDAC tumor injections (KrasG12D; p53R172H/+; Pdx1-cre) or sham injections. Mice were fasted or food restricted at different times during tumor growth in a series of 2x2 factorial studies. Anthropometrics, voluntary wheel running activity, and body composition were measured throughout study. Blood glucose and ketones were measured by glucometer and ketometer. Ketogenic potential was assessed using octanoate challenge after fasting. Liver mRNA levels were measured using qPCR. Hepatic IL-6 signaling was assessed using qPCR and ELISA for plasma IL-6. Results: PDAC mice maintained food intake and wheel running for 8 days after tumor injection, before progressive decline. Loss of adipose mass in PDAC mice occurred only in the context of decreased nutrition, whereas loss of lean mass preceded decreases in food intake. Overnight fasting mitigated differences in fat mass between groups, whereas the effect of fasting on skeletal muscle loss was similar in PDAC and control mice. Fasting blood glucose and ketogenic potential were lower in PDAC mice, suggesting impaired hepatic response to metabolic stress. In the liver, glycolytic genes were increased, whereas gluconeogenic and ketogenic genes were decreased in PDAC mice. Wasting and hepatic reprogramming occurred independently of hepatic IL-6 signaling. Conclusions: Undernutrition drives PDAC-associated adipose wasting, yet muscle wasting occurs prior to changes in food intake and in the absence of systemic inflammation. Hepatic macronutrient partitioning and metabolic gene expression are altered in PDAC, implicating impaired adaptive responses to negative energy balance in PDAC-associated cachexia. Citation Format: Heike Mendez, Xinxia Zhu, Brennan Olsen, Daniel L. Marks, Aaron J. Grossberg. Impaired adaptation to negative energy balance in pancreatic cancer-associated wasting [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2019 Sept 6-9; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2019;79(24 Suppl):Abstract nr C19.
Gut-Resident Lactobacilli Activate Hepatic Nrf2 and Protect Against Oxidative Liver Injury
Authors: Bejan J. Saeedi, Ken H. Liu, Joshua A. Owens, Sarah Hunter-Chang, Mary C. Camacho, Richard U. Eboka, Bindu Chandrasekharan, Nusaiba F. Baker, Trevor M. Darby, Brian S. Robinson, Rheinallt M. Jones, Dean P. Jones, Andrew S. Neish
Journal: Cell Metabolism (2020)
Long-term Visual Outcomes after Release from Protocol in Patients who Participated in the Inhibition of VEGF in Age-related Choroidal Neovascularisation (IVAN) Trial
Authors: Rebecca N. Evans, Barnaby C. Reeves, Dawn Phillips, Katherine Alyson Muldrew, Chris Rogers, Simon P. Harding, Usha Chakravarthy
Journal: Ophthalmology (2020)

To describe visual outcomes, frequency of treatment and monitoring visits, and anti-vascular endothelial growth factor drugs used in usual care in participants who exited a trial in which treatment for neovascular age-related macular degeneration (nAMD) was initiated with bevacizumab or ranibizumab.Multicenter cohort study up to 7 years after trial exit.Patients enrolled in the Inhibition of VEGF in Age-related choroidal Neovascularisation (IVAN) trial; after excluding participants from 2 sites and who died or withdrew during the trial, 537 were included in this follow-up cohort.Data were collected between May 26, 2016, and August 24, 2017. Distance visual acuity (DVA) (letters read) in both eyes and treatments for nAMD administered to either eye at all usual care visits were extracted from medical records of all participants until the point of data collection (duration of study eye monitoring).Rate of change of DVA during active surveillance of the study eye (study eye monitoring), estimated using a multivariable linear random effects model. Other outcome measures were visit and treatment frequency and switches in anti-vascular endothelial growth factor (VEGF) drug.Data were obtained for 99% (532/537) of eligible participants. The median duration of study eye monitoring after IVAN exit was 3.3 years (interquartile range [IQR], 1.3-4.7), and median DVA was 58.0 letters (IQR, 34.0-73.0). Study eye DVA deteriorated by 4.3 (95% confidence interval [CI], 3.7-4.9) letters per year. Injection rate did not influence the rate of change in DVA after adjusting for key covariates. After IVAN exit, 174 participants (32%) received no treatment; 332 of 358 (93%) were treated first with ranibizumab, 78 (23%) of whom switched to aflibercept. The DVA was similar among participants who switched or did not switch at the end of study monitoring.Approximately 5 years after the IVAN study finished, with unprecedented completeness of follow-up for such a trial, the trajectory of functional decline in the study eye was shown to be greater than that previously reported for incomplete trial cohorts. Anti-VEGF injection rates and treatment switches were not important factors in determining visual acuity outcomes.
Smoking ban in cars protects children, but is vaping ‘The Elephant in the Car’?
Authors: Christabella Ng, Alan Robert Smyth
Journal: Thorax (2020)

In March 2006, smoking in public places was banned in Scotland. The following year a similar ban was introduced in England—the last of the UK home nations to adopt this policy. At the time, some suggested that the ban might paradoxically increase children’s exposure to environmental tobacco smoke (ETS) in the home. Parents who were unable to smoke in public places, such as pubs or restaurants, might instead smoke at home, thereby increase their children’s exposure to ETS. This was termed the ‘displacement hypothesis’.1 However, a systematic review of studies analysing the effects, on children’s ETS exposure, of banning smoking in public places concluded …
Only strict quarantine measures can curb the coronavirus disease (COVID-19) outbreak in Italy, 2020
Authors: Henrik Sjödin, Annelies Wilder-Smith, Sarah Osman, Zia Farooq, Joacim Rocklöv
Journal: Eurosurveillance (2020)

Several Italian towns are under lockdown to contain the COVID-19 outbreak. The level of transmission reduction required for physical distancing interventions to mitigate the epidemic is a crucial question. We show that very high adherence to community quarantine (total stay-home policy) and a small household size is necessary for curbing the outbreak in a locked-down town. The larger the household size and amount of time in the public, the longer the lockdown period needed.
Filaggrin gene defects are associated with eczema, wheeze, and nasal disease during infancy: Prospective study
Authors: Kaninika Basu, Sarah K. Inglis, Stephen A. Bremner, Rebecca Ramsay, Ali Abd, Heike Rabe, Elizabeth Strange, Veronica Phillips, Paul Seddon, Roger Tavendale, Anjum Memon, Colin N.A. Palmer, Katy Fidler, Somnath Mukhopadhyay
Journal: Journal of Allergy and Clinical Immunology (2020)