tbuckley/cabot-search huggingface dataset:
Early Postoperative Mortality Among Patients Aged 75 Years or Older With Stage II/III Rectal Cancer
Authors: Helmneh M. Sineshaw, K. Robin Yabroff, V. Liana Tsikitis, Ahmedin Jemal, Timur Mitin
Journal: Journal of the National Comprehensive Cancer Network (2020)

Background: Elderly patients with rectal cancer have been excluded from randomized studies, thus little is known about their early postoperative mortality, which is critical for informed consent and treatment decisions. This study examined early mortality after surgery in elderly patients with locally advanced rectal cancer (LARC). Methods: Using the National Cancer Database, we identified patients aged ≥75 years, diagnosed with clinical stage II/III rectal cancer who underwent surgery in 2004 through 2015. Descriptive analyses determined proportions and trends and multivariable logistic regression analyses were performed to determine factors associated with early mortality after rectal cancer surgery. Results: Among 11,794 patients with rectal cancer aged ≥75 years, approximately 6% underwent local excision and 94% received radical resection. Overall 30-day, 90-day, and 6-month postoperative mortality rates were 4.2%, 7.8%, and 11.5%, respectively. Six-month mortality varied by age (8.4% in age 75–79 years to 18.3% in age ≥85 years), and comorbidity score (10.1% for comorbidity score 0 to 17.7% for comorbidity score ≥2). Six-month mortality declined from 12.3% in 2004 through 2007 to 10.2% in 2012 through 2015 ( P trend =.0035). Older age, higher comorbidity score, and lower facility case volume were associated with higher 6-month mortality. Patients treated at NCI-designated centers had 30% lower odds of 6-month mortality compared with those treated at teaching/research centers. Conclusions: Six-month mortality rates after surgery among patients aged ≥75 years with LARC have declined steadily over the past decade in the United States. Older age, higher comorbidity score, and care at a low-case-volume facility were associated with higher 6-month mortality after surgery. This information is necessary for informed consent and decisions regarding optimal management of elderly patients with LARC.
Chronic thromboembolic disease following pulmonary embolism: more work ahead
Authors: Stavros V. Konstantinides
Journal: European Respiratory Journal (2020)

The comment by C. McCabe and colleagues provides thoughtful insights into the late sequalae of pulmonary embolism. The authors' views and suggestions, based on their clinical experience and expertise, may prove helpful in the ongoing process of reliably (and meaningfully) distinguishing chronic thromboembolic pulmonary hypertension (CTEPH) from chronic thromboembolic disease (CTED) without pulmonary hypertension at rest. From acute to chronic pulmonary embolism <http://bit.ly/3893ubd>
Genomic heterogeneity in bladder cancer: challenges and possible solutions to improve outcomes
Authors: Joshua J. Meeks, Hikmat Al-Ahmadie, Bishoy M. Faltas, John A. Taylor, Thomas W. Flaig, David J. DeGraff, Emil Christensen, Benjamin L. Woolbright, David J. McConkey, Lars Dyrskjøt
Journal: Nature Reviews Urology (2020)
CDCP1 overexpression drives prostate cancer progression and can be targeted in vivo
Authors: Abdullah Alajati, Mariantonietta D’Ambrosio, Martina Troiani, Simone Mosole, Laura Pellegrini, Jingjing Chen, Ajinkya Revandkar, Marco Bolis, Jean-Philippe Theurillat, Ilaria Guccini, Marco Losa, Arianna Calcinotto, Gaston De Bernardis, Emiliano Pasquini, Rocco D’Antuono, Adam Sharp, Ines Figueiredo, Daniel Nava Rodrigues, Jonathan Welti, Veronica Gil, Wei Yuan, Tatjana Vlajnic, Lukas Bubendorf, Giovanna Chiorino, Letizia Gnetti, Verónica Torrano, Arkaitz Carracedo, Laura Camplese, Susumu Hirabayashi, Elena Canato, Gianfranco Pasut, Monica Montopoli, Jan Hendrik Rüschoff, Peter Wild, Holger Moch, Johann De Bono, Andrea Alimonti
Journal: Journal of Clinical Investigation (2020)

The mechanisms by which prostate cancer shifts from an indolent castration-sensitive phenotype to lethal castration-resistant prostate cancer (CRPC) are poorly understood. Identification of clinically relevant genetic alterations leading to CRPC may reveal potential vulnerabilities for cancer therapy. Here we find that CUB domain-containing protein 1 (CDCP1), a transmembrane protein that acts as a substrate for SRC family kinases (SFKs), is overexpressed in a subset of CRPC. Notably, CDCP1 cooperates with the loss of the tumor suppressor gene PTEN to promote the emergence of metastatic prostate cancer. Mechanistically, we find that androgens suppress CDCP1 expression and that androgen deprivation in combination with loss of PTEN promotes the upregulation of CDCP1 and the subsequent activation of the SRC/MAPK pathway. Moreover, we demonstrate that anti-CDCP1 immunoliposomes (anti-CDCP1 ILs) loaded with chemotherapy suppress prostate cancer growth when administered in combination with enzalutamide. Thus, our study identifies CDCP1 as a powerful driver of prostate cancer progression and uncovers different potential therapeutic strategies for the treatment of metastatic prostate tumors.
Quality improvement into practice
Authors: Adam Backhouse, Fatai Ogunlayi
Journal: BMJ (2020)

What you need to know• Thinking of quality improvement (QI) as a principle-based approach to change provides greater clarity about (a) the contribution QI offers to staff and patients, (b) how to differentiate it from other approaches, (c) the benefits of using QI together with other change approaches• QI is not a silver bullet for all changes required in healthcare: it has great potential to be used together with other change approaches, either concurrently (using audit to inform iterative tests of change) or consecutively (using QI to adapt published research to local context)• As QI becomes established, opportunities for these collaborations will grow, to the benefit of patients.The benefits to front line clinicians of participating in quality improvement (QI) activity are promoted in many health systems.QI can represent a valuable opportunity for individuals to be involved in leading and delivering change, from improving individual patient care to transforming services across complex health and care systems. 1 However, it is not clear that this promotion of QI has created greater understanding of QI or widespread adoption.QI largely remains an activity undertaken by experts and early adopters, often in isolation from their peers. 2There is a danger of a widening gap between this group and the majority of healthcare professionals.This article will make it easier for those new to QI to understand what it is, where it fits with other approaches to improving care (such as audit or research), when best to use a QI approach, making it easier to understand the relevance and usefulness of QI in delivering better outcomes for patients. How this article was madeAB and FO are both specialist quality improvement practitioners and have developed their expertise working in QI roles for a variety of UK healthcare organisations.The analysis presented here arose from AB and FO's observations of the challenges faced when introducing QI, with healthcare providers often unable to distinguish between QI and other change approaches, making it difficult to understand what QI can do for them.
Computational Modeling of Neuropsychological Test Performance to Disentangle Impaired Cognitive Processes in Cancer Patients
Authors: Joost A Agelink van Rentergem, Ivar E Vermeulen, Philippe R Lee Meeuw Kjoe, Sanne B Schagen
Journal: JNCI Journal of the National Cancer Institute (2020)

There is a need to better identify impaired cognitive processes to increase our understanding of cognitive dysfunction caused by cancer and cancer treatment and to improve interventions. The Trail Making Test is frequently used for evaluating information-processing speed (part A) and executive function (part B), but interpretation of its outcomes is challenging because performance depends on many cognitive processes. To disentangle processes, we collected high-resolution data from 192 non-central nervous system cancer patients who received systemic therapy and 192 cancer-free control participants and fitted a Shifted-Wald computational model. Results show that cancer patients were more cautious than controls (Cohen d = 0.16). Patients were cognitively slower than controls when the task required task switching (Cohen d = 0.16). Our results support the idea that cancer and cancer treatment accelerate cognitive aging. Our approach allows more precise assessment of cognitive dysfunction in cancer patients and can be extended to other instruments and patient populations.
Factors Associated with Low Lung Function in Different Age Bins in the General Population
Authors: Robab Breyer-Kohansal, Rosa Faner, Marie-Kathrin Breyer, Alina Ofenheimer, Andrea Schrott, Michael Studnicka, Emiel F. M. Wouters, Otto C. Burghuber, Sylvia Hartl, Alvar Agusti
Journal: American Journal of Respiratory and Critical Care Medicine (2020)
Artificial intelligence versus clinicians
Authors: Vanessa Rampton
Journal: BMJ (2020)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Artificial intelligence versus clinicians Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Primary stratification and identification of suspected Corona virus disease 2019 (COVID-19) from clinical perspective by a simple scoring proposal
Authors: Ting-Ting Zhou, Feng-Xian Wei
Journal: Military Medical Research (2020)

Abstract In this Commentary, we would like to comment on the article titled “A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)” as a featured article in Military Medical Research . In the guideline, except for “confirmed cases”, “suspected cases”, “close contact” and “suspicious exposure” were defined by clinical perspective based on epidemiological risk, clinical symptoms and auxiliary examination. Combined with our experience, we introduced a simple scoring proposal additionally based on not only CT imaging as strongly recommended by the guideline but also blood routine test, especially for primary screening of such patients in the out-patient department.
Past, present, and future of allergen immunotherapy vaccines
Authors: Yulia Dorofeeva, Igor Shilovskiy, Inna Tulaeva, Margarete Focke‐Tejkl, Sabine Flicker, Dmitriy Kudlay, Musa Khaitov, Antonina Karsonova, Ksenja Riabova, Alexander Karaulov, Roman Khanferyan, Winfried F. Pickl, Thomas Wekerle, Rudolf Valenta
Journal: Allergy (2020)

Allergen-specific immunotherapy (AIT) is an allergen-specific form of treatment for patients suffering from immunoglobulin E (IgE)-associated allergy; the most common and important immunologically mediated hypersensitivity disease. AIT is based on the administration of the disease-causing allergen with the goal to induce a protective immunity consisting of allergen-specific blocking IgG antibodies and alterations of the cellular immune response so that the patient can tolerate allergen contact. Major advantages of AIT over all other existing treatments for allergy are that AIT induces a long-lasting protection and prevents the progression of disease to severe manifestations. AIT is cost effective because it uses the patient´s own immune system for protection and potentially can be used as a preventive treatment. However, broad application of AIT is limited by mainly technical issues such as the quality of allergen preparations and the risk of inducing side effects which results in extremely cumbersome treatment schedules reducing patient´s compliance. In this article we review progress in AIT made from its beginning and provide an overview of the state of the art, the needs for further development, and possible technical solutions available through molecular allergology. Finally, we consider visions for AIT development towards prophylactic application.
Associations of Benzodiazepines, Z-Drugs, and Other Anxiolytics With Subsequent Dementia in Patients With Affective Disorders: A Nationwide Cohort and Nested Case-Control Study
Authors: Merete Osler, Martin Balslev Jørgensen
Journal: American Journal of Psychiatry (2020)

Benzodiazepines and Z-drugs are two of the most prescribed agents worldwide. However, because of their cognitive side effects, the question of their influence on the risk of dementia has been raised. The authors examined the association of benzodiazepines, Z-drugs, and other anxiolytics with incident dementia in patients with affective disorders.The authors conducted a cohort and nested case-control study of 235,465 patients over age 20 who were identified in the Danish National Patient Registry as having had a first-time hospital contact for an affective disorder between 1996 and 2015. From the Danish National Prescription Registry, information was obtained on all prescriptions for benzodiazepines, Z-drugs, and other anxiolytics, and patients were followed for incident dementia (defined by hospital discharge diagnosis or acetylcholinesterase inhibitor use). Cox proportional hazards and conditional logistic regression models were used to calculate hazard ratios and odds ratios with adjustment for sociodemographic and clinical variables.A total of 75.9% (N=171,287) of patients had any use of benzodiazepines or Z-drugs, and during the median follow-up of 6.1 years (interquartile range, 2.7-11), 9,776 (4.2%) patients were diagnosed with dementia. Any use of benzodiazepines or Z-drugs showed no association with dementia after multiple adjustments in either the cohort analysis or a nested case-control design. In the cohort analysis, the number of prescriptions and the cumulated dose of benzodiazepines or Z-drugs at baseline were not associated with dementia. In the nested case-control study, where prescriptions were counted from 1995 until 2 years before the index date, there was a slightly higher odds ratio of dementia in patients with the lowest use of benzodiazepines or Z-drugs (odds ratio=1.08, 95% CI=1.01, 1.15) compared with no lifetime use. However, patients with the highest use had the lowest odds of developing dementia (odds ratio=0.83, 95% CI=0.77, 0.88).This large cohort study did not reveal associations between use of benzodiazepines or Z-drugs and subsequent dementia, even when exposures were cumulated or divided into long- and short-acting drugs. Some results were compatible with a protective effect.
The preceding root system drives the composition and function of the rhizosphere microbiome
Authors: Yi Zhou, David R. Coventry, Vadakattu V. S. R. Gupta, David Fuentes, Andrew Merchant, Brent N. Kaiser, Jishun Li, Yanli Wei, Huan Liu, Yayu Wang, Shuheng Gan, Matthew D. Denton
Journal: Genome biology (2020)

Abstract Background The soil environment is responsible for sustaining most terrestrial plant life, yet we know surprisingly little about the important functions carried out by diverse microbial communities in soil. Soil microbes that inhabit the channels of decaying root systems, the detritusphere, are likely to be essential for plant growth and health, as these channels are the preferred locations of new root growth. Understanding the microbial metagenome of the detritusphere, and how it responds to agricultural management such as crop rotations and soil tillage, is vital for improving global food production. Results This study establishes an in-depth soil microbial gene catalogue based on the living-decaying rhizosphere niches in a cropping soil. The detritusphere microbiome regulates the composition and function of the rhizosphere microbiome to a greater extent than plant type: rhizosphere microbiomes of wheat and chickpea were homogenous (65–87% similarity) in the presence of decaying root (DR) systems but were heterogeneous (3–24% similarity) where DR was disrupted by tillage. When the microbiomes of the rhizosphere and the detritusphere interact in the presence of DR, there is significant degradation of plant root exudates by the rhizosphere microbiome, and genes associated with membrane transporters, carbohydrate and amino acid metabolism are enriched. Conclusions The study describes the diversity and functional capacity of a high-quality soil microbial metagenome. The results demonstrate the contribution of the detritusphere microbiome in determining the metagenome of developing root systems. Modifications in root microbial function through soil management can ultimately govern plant health, productivity and food security.
Laura and the Terrible, Horrible, No Good, Very Bad Day
Authors: Laura K. Rock
Journal: Annals of Internal Medicine (2020)

On Being a Doctor7 April 2020Laura and the Terrible, Horrible, No Good, Very Bad DayLaura K. Rock, MDLaura K. Rock, MDHarvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts (L.K.R.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3443 Audio Reading - “Laura and the Terrible, Horrible, No Good, Very Bad Day” Audio. Virginia Hood, MD, reads “Laura and the Terrible, Horrible, No Good, Very Bad Day” by Laura K. Rock, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail It's my birthday, and my spouse is traveling. I forgot where because I am doing the working mom thing alone quite often, and who can keep track?I'm tired because I stayed up late finishing my son's papier-mâché ski mountain school project and getting into a yelling match with my other son about Snapchat and being on his phone for more than 6 hours in 1 day.I check my e-mail and find that my most recent manuscript submission was rejected with no review.I go downstairs to make my kids their 2-course breakfast and find that my sweet dog ... Author, Article, and Disclosure InformationAffiliations: Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts (L.K.R.)Corresponding Author: Laura K. Rock, MD, 330 Brookline Avenue, KSB-23, Boston, MA 02215; e-mail, [email protected]harvard.edu. PreviousarticleNextarticle Advertisement Audio Reading - “Laura and the Terrible, Horrible, No Good, Very Bad Day” Audio. Virginia Hood, MD, reads “Laura and the Terrible, Horrible, No Good, Very Bad Day” by Laura K. Rock, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 7 April 2020Volume 172, Issue 7Page: 499KeywordsCoffeeDiagnostic radiologyEmotionsHeadachesIntensive care unitsNursesOxygenRespiratory failureRespiratory system proceduresWalking ePublished: 7 April 2020 Issue Published: 7 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Undetectable Tumor Cell-Free DNA in a Patient With Metastatic Breast Cancer With Complete Response and Long-Term Remission
Authors: Natasha Hunter, Sarah Croessmann, Karen Cravero, Daniel Shinn, Paula J. Hurley, Ben Ho Park
Journal: Journal of the National Comprehensive Cancer Network (2020)

The ability to serially monitor tumor-derived cell-free DNA (cfDNA) brings with it the potential to measure response to anticancer therapies and detect minimal residual disease (MRD). This report describes a patient with HER2-positive metastatic breast cancer with an exceptional response to trastuzumab and nab-paclitaxel who remains in complete remission several years after cessation of therapy. Next-generation sequencing of the patient's primary tumor tissue showed several mutations, including an oncogenic hotspot PIK3CA mutation. A sample of cfDNA was collected 6 years after her last therapy and then analyzed for mutant PIK3CA using digital PCR. No detectable mutations associated with the primary tumor were found despite assaying >10,000 genome equivalents, suggesting that the patient had achieved a molecular remission. Results of this case study suggest that serial monitoring of MRD using liquid biopsies could provide a useful method for individualizing treatment plans for patients with metastatic disease with extreme responses to therapy. However, large-scale clinical studies are needed to validate and implement these techniques for patient care.
Sample Pooling as a Strategy to Detect Community Transmission of SARS-CoV-2
Authors: Catherine A. Hogan, Malaya K. Sahoo, Benjamin A. Pinsky
Journal: JAMA (2020)

Yan Bai, MD; Lingsheng Yao, MD; Tao Wei, MD; Fei Tian, MD; Dong-Yan Jin, PhD; Lijuan Chen, PhD; Meiyun Wang, MD, PhD
Proteome analysis of malignant pleural effusion
Authors: K. Lee, J. Bang, K. Kim
Journal: Journal of Clinical Oncology (2009)

e22194 Background: Because pleural effusion contains proteins of potential diagnostic value, a comprehensive proteomic analysis of the pleural effusion is worthy to discover a new biomarker. Malignant pleural effusion and tuberculous pleural effusion are sometimes diagnositc challenge due to their similarity like lymphocyte-dominant effusion. Herein, we tried to identify differentially expressed proteins in both effusion using proteomic anlaysis. Methods: Twenty microliters of pleural effusions(PEs) from 3 patients with non-small cell lung cancer(NSCLC) and 3 patients with tuberculous pleurisy(TBC) were used for proteome analysis. After depletion of high abundant proteins including albumin, IgG with MARS Hu-6(Agilent), proteins were separated by SDS-PAGE and subject to in-gel tryptic digestion. The resulting peptides were analyzed by liquid chromatography/tandem mass spectrometry (LC/MS/MS). The MS/MS spectra were analyzed by Spectrum Mill against normal and reversed human protein databases. Results: In the total of 6 samples, 90 proteins were identified with more than 2 peptides and less than 1% of false positive rate. Among the identified pleural proteins, 57 proteins were detected both in PEs of NSCLS and TBC, 19 and 14 proteins were identified only in the PE of NSCLC and TBC, respectively. We analysed molecular functions, molecular composition and molecular processes of identified proteins with FindGo software. Among the identified proteins, we found the biomarker candidates that significantly have different expression levels in malignant effusion; apolipoprotein B precursor, vitronectin, complement factor B, histidine-rich glycoprotein precursor, coagulation factor II precursor variant. Conclusions: We found that several pleural effusion proteins may serve as potential biomarker candidates for differential diagnosis between maligant and tuberculous pleural effusion. We'll confirm these proteins through the proteomic method(MRM) and immunological method(Western bolt). No significant financial relationships to disclose.