tbuckley/cabot-search huggingface dataset:
Telemonitoring at scale for hypertension in primary care: An implementation study
Authors: Vicky Hammersley, Richard Parker, Mary Paterson, Janet Hanley, Hilary Pinnock, Paul Padfield, Andrew Stoddart, Hyeon Gyeong Park, Aziz Sheikh, Brian McKinstry
Journal: PLoS Medicine (2020)

Background While evidence from randomised controlled trials shows that telemonitoring for hypertension is associated with improved blood pressure (BP) control, healthcare systems have been slow to implement it, partly because of inadequate integration with existing clinical practices and electronic records. Neither is it clear if trial findings will be replicated in routine clinical practice at scale. We aimed to explore the feasibility and impact of implementing an integrated telemonitoring system for hypertension into routine primary care. Methods and findings This was a quasi-experimental implementation study with embedded qualitative process evaluation set in primary care in Lothian, Scotland. We described the overall uptake of telemonitoring and uptake in a subgroup of representative practices, used routinely acquired data for a records-based controlled before-and-after study, and collected qualitative data from staff and patient interviews and practice observation. The main outcome measures were intervention uptake, change in BP, change in clinician appointment use, and participants' views on features that facilitated or impeded uptake of the intervention. Seventy-five primary care practices enrolled 3,200 patients with established hypertension. In an evaluation subgroup of 8 practices (905 patients of whom 427 [47%] were female and with median age of 64 years [IQR 56–70, range 22–89] and median Scottish Index of Multiple Deprivation 2012 decile of 8 [IQR 6–10]), mean systolic BP fell by 6.55 mm Hg (SD 15.17), and mean diastolic BP by 4.23 mm Hg (SD 8.68). Compared with the previous year, participating patients made 19% fewer face-to-face appointments, compared with 11% fewer in patients with hypertension who were not telemonitoring. Total consultation time for participants fell by 15.4 minutes (SD 68.4), compared with 5.5 minutes (SD 84.4) in non-telemonitored patients. The convenience of remote collection of BP readings and integration of these readings into routine clinical care was crucial to the success of the implementation. Limitations include the fact that practices and patient participants were self-selected, and younger and more affluent than non-participating patients, and the possibility that regression to the mean may have contributed to the reduction in BP. Routinely acquired data are limited in terms of completeness and accuracy. Conclusions Telemonitoring for hypertension can be implemented into routine primary care at scale with little impact on clinician workload and results in reductions in BP similar to those in large UK trials. Integrating the telemonitoring readings into routine data handling was crucial to the success of this initiative.
Infliximab for severe ulcerative colitis and subsequent SARS-CoV-2 pneumonia: a stone for two birds
Authors: Cristina Bezzio, Gianpiero Manes, Francesco Bini, Lucienne Pellegrini, Simone Saibeni
Journal: Gut (2020)

We read with interest the article by Neurath1 about the potential relationships between immunomodulating drugs for IBD and COVID-19. The infection can cause pneumonia, which in some cases leads to acute respiratory distress syndrome with multiorgan failure. These life-threatening cases are attributable to a strong upregulation of cytokine production, known as ‘cytokine storm syndrome’.2 This is why anticytokine therapies have been proposed for this condition.3 However, so far, empirical evidence supporting the use of such therapies is lacking.

Here, we report the case of a 36-year-old man who was admitted to our hospital for a severe recurrence of ulcerative colitis.

At admission, he had been taking mesalazine in both oral and topical formulations and he reported up to 12 bowel movements with blood. Laboratory tests showed mild normocytic anaemia (haemoglobin, 123 g/L), neutrophilic leucocytosis (neutrophils, 9420/μL), increased C reactive protein (CRP) (17.1 mg/dL; normal values <0.5 mg/dL) and hypoalbuminaemia (3.2 g/dL). Colonoscopy showed widely …
Primary cell cultures for the personalized therapy in aggressive thyroid cancer of follicular origin
Authors: Poupak Fallahi, Silvia Martina Ferrari, Giusy Elia, Francesca Ragusa, Armando Patrizio, Sabrina Rosaria Paparo, Gianni Marone, Maria Rosaria Galdiero, Giovanni Guglielmi, Rudy Foddis, Alfonso Cristaudo, Alessandro Antonelli
Journal: Seminars in Cancer Biology (2020)
Pickering emulsions with ethiodized oil and nanoparticles for slow release of intratumoral anti-CTLA4 immune checkpoint antibodies
Authors: Lambros Tselikas, Thierry de Baere, Thomas Isoardo, Sandrine Susini, Karine Ser-Le Roux, Mélanie Polrot, Julien Adam, Mathieu Rouanne, Laurence Zitvogel, Laurence Moine, Fréderic Deschamps, Aurélien Marabelle
Journal: Journal for ImmunoTherapy of Cancer (2020)

Intratumorous immunotherapy for cancer is currently thriving. The aim of such local strategy is to improve the therapeutic index of these treatments, for higher on-target/on-tumor activity and less on-target/off-tumor adverse events. Strategies allowing for slow release of anti-CTLA4 in the tumor microenvironment could improve their clinical efficacy.The purpose of the study was to develop a radiopaque delivery platform to improve the targeting and exposure of intratumorous anti-CTLA4 antibodies for cancer immunotherapy.Pickering emulsions of anti-CTLA4 antibodies were formulated with radiopaque ethiodized oil and poly-lactic-co-glycolic acid (PLGA) nanoparticles. We characterized the microscopic aspect and stability of such emulsions using Turbiscan. We monitored the release of anti-CTLA4 over time from these emulsions and evaluated their structure using mass spectrometry. We then tested the functionality of the released antibodies by preforming ex vivo competitive binding assays. Finally, we assessed the in vivo efficacy of intratumorous anti-CTLA4 Pickering emulsions.Pickering emulsions of ethiodized oil and PLGA nanoparticles (PEEPs) resulted in a radiopaque water-in-oil emulsion with average internal phase droplet size of 42±5 µm at day 7. Confocal microscopy showed that anti-CTLA4 antibodies were effectively encapsulated by ethiodized oil with PLGA nanoparticles located at the interface between the aqueous and the oily phase. Turbiscan analysis showed that emulsions were stable with continuous and progressive release of anti-CTLA4 antibodies reaching 70% at 3 weeks. Structural and functional analysis of the released antibodies did not show significant differences with native anti-CTLA4 antibodies. Finally, intratumorous anti-CTLA4 PEEPs were able to eradicate tumors and cure mice in a syngeneic immunocompetent preclinical tumor model.Pickering emulsions of ethiodized oil and PLGA is an innovative radiopaque delivery platform that does not alter the functionality of anti-CTLA4 immune checkpoint antibodies. Beyond local anti-CTLA4 applications, these emulsions might be used with other therapeutic molecules for optimal intratumorous or intra-arterial delivery of novel cancer immunotherapies.
Children with COVID-19 at a specialist centre: initial experience and outcome
Authors: Richard W Issitt, John Booth, William A Bryant, Anastasia Spiridou, Andrew M Taylor, Pascale du Pré, Pad Ramnarayan, John Hartley, Maria Cortina-Borja, Karyn Moshal, Helen Dunn, Harry Hemingway, Neil J Sebire
Journal: The Lancet Child & Adolescent Health (2020)
Resurgence of sport in the wake of COVID-19: cardiac considerations in competitive athletes
Authors: Aaron Baggish, Jonathan A Drezner, Jonathan Kim, Matthew Martinez, Jordan M Prutkin
Journal: British Journal of Sports Medicine (2020)

The output and size distribution of aerosols from dry powder inhalers are dependent on the flow rate through the device. Therefore, in an in vivo study, we examined the flow-dependency of the effect of formoterol when delivered from a dry powder inhaler, the Aerolizer, in a flow range relevant to schoolchildren. In a preliminary study comprising 126 asthmatic children aged 3-10 yrs, the relationship between age and peak inspiratory flow (PIF) rate through the Aerolizer was determined. Mean PIF was 104 L.min-1 and all children aged &gt; 5 yrs performed a PIF &gt; 60 L.min-1. Sixteen children aged 8-15 yrs with exercise-induced asthma (EIA) took part in the main trial comparing the protective effect of 12 micrograms formoterol inhaled at 60 and 120 L.min-1. The effect from high and low inspiratory flow was judged from the protective effect against EIA 12 h after drug administration. The decrease in forced expiratory volume in one second (FEV1) after exercise was 34% on the placebo day, but only 15% when formoterol was inhaled at the high flow rate. This difference was statistically significant. The decrease in FEV1 was 23% after treatment with formoterol inhaled at the low flow rate, that was not significantly different from placebo or from high-flow formoterol treatment. These clinical findings correspond with the in vitro findings of flow-dependent fine particle mass from the Aerolizer, and corroborate the relationship between fine particle mass of aerosol and clinical effect. The results indicate a flow-dependent effect of formoterol dry powder inhaled from the Aerolizer, within the range of inspiratory flow rate obtainable by school-children. This questions its applicability in children with asthma.
Neutralizing Antibodies Protect against Oral Transmission of Lymphocryptovirus
Authors: Swati Singh, Leah J. Homad, Nicholas R. Akins, Claire M. Stoffers, Stefan Lackhar, Harman Malhi, Yu-Hsin Wan, David J. Rawlings, Andrew T. McGuire
Journal: Cell Reports Medicine (2020)

Epstein-Barr virus (EBV) is a cancer-associated pathogen for which there is no vaccine. Successful anti-viral vaccines elicit antibodies that neutralize infectivity; however, it is unknown whether neutralizing antibodies prevent EBV acquisition. Here we assessed whether passively delivered AMMO1, a monoclonal antibody that neutralizes EBV in a cell-type-independent manner, could protect against experimental EBV challenge in two animal infection models. When present prior to a high-dose intravenous EBV challenge, AMMO1 prevented viremia and reduced viral loads to nearly undetectable levels in humanized mice. AMMO1 conferred sterilizing immunity to three of four macaques challenged orally with rhesus lymphocryptovirus, the EBV ortholog that infects rhesus macaques. The infected macaque had lower plasma neutralizing activity than the protected animals. These results indicate that a vaccine capable of eliciting adequate titers of neutralizing antibodies targeting the AMMO1 epitope may protect against EBV acquisition and are therefore highly relevant to the design of an effective EBV vaccine.
Successful Outcomes of Newly Diagnosed T Lymphoblastic Lymphoma: Results From Children’s Oncology Group AALL0434
Authors: Robert J. Hayashi, Stuart S. Winter, Kimberly P. Dunsmore, Meenakshi Devidas, Zhiguo Chen, Brent L. Wood, Michelle L. Hermiston, David T. Teachey, Sherrie L. Perkins, Rodney R. Miles, Elizabeth A. Raetz, Mignon L. Loh, Naomi J. Winick, William L. Carroll, Stephen P. Hunger, Megan S. Lim, Thomas G. Gross, Catherine M. Bollard
Journal: Journal of Clinical Oncology (2020)

The Children's Oncology Group (COG) protocol AALL0434 evaluated the safety and efficacy of multi-agent chemotherapy with Capizzi-based methotrexate/pegaspargase (C-MTX) in patients with newly diagnosed pediatric T-cell lymphoblastic lymphoma (T-LL) and gained preliminary data using nelarabine in high-risk patients.
Remotely Produced and Axon-Derived Netrin-1 Instructs GABAergic Neuron Migration and Dopaminergic Substantia Nigra Development
Authors: Sara Brignani, Divya D.A. Raj, Ewoud R.E. Schmidt, Özge Düdükcü, Youri Adolfs, Anna A. De Ruiter, Mateja Rybiczka-Tesulov, Marieke G. Verhagen, Christiaan van der Meer, Mark H. Broekhoven, Juan A. Moreno-Bravo, Laurens M. Grossouw, Emilie Dumontier, Jean-François Cloutier, Alain Chédotal, R. Jeroen Pasterkamp
Journal: Neuron (2020)
Gas-blasting nanocapsules to accelerate carboplatin lysosome release and nucleus delivery for prostate cancer treatment
Authors: Shunli Fu, Shuang Liang, Dandan Jiang, Rui Yang, Zipeng Zhang, Lili Chang, Xinke Zhang, Yongjun Liu, Na Zhang
Journal: Asian Journal of Pharmaceutical Sciences (2020)

To improve therapeutic effect and reduce severely side effects of carboplatin (CBP), the gas-generating nanocapsules were developed to accelerate CBP lysosome release and nucleus delivery. CBP/SB-NC was prepared by co-loading CBP and NaHCO3 (SB) in nanocapsules using w/o/w emulsification solvent evaporation. They exhibited vesicle-like spherical morphology, uniform particle size and negative zeta potential. Reaching the tumor site with a relatively high concentration is the first step for CBP delivery and the results showed that CBP/SB-NC could effectively increase drug accumulation at tumor site. After that, the drug delivery carriers need to be internalized into tumor cells and the in vitro cellular uptake ability results showed CBP/SB-NC could be internalized into RM-1 cells more efficient than CBP solution. After internalized by RM-1 cells, the gas-blasting release process was tested in acid environment. It was demonstrated that 5 mg/ml NaHCO3 was optimal to achieve pH-responsive gas-blasting release. In vitro release results showed that CBP significantly rapid release in acid environment (pH 5.0) compared to neutral pH (pH 7.4) (P < 0.05). Meanwhile, TEM and the change of the concentration of H+ results exhibited that the explosion of CBP/SB5-NC was more easily happened in lysosome acid environment (pH 5.0). The blasting release can accelerate CBP lysosome release to cytoplasm. Furthermore, the nucleus delivery results showed CBP/SB5-NC can promote pH-triggered rapid nucleus delivery. And the results of Pt-DNA adduct assay showed that the binding efficiency between CBP and DNA of CBP/SB5-NC was higher than CBP solution. At last, in vitro and in vivo anti-tumor efficacy proved that CBP/SB5-NC could enhance anti-tumor activity for prostate cancer therapy. CBP/SB5-NC also showed superior safety in vitro and in vivo by hemolysis assay and histopathological study. All of the results demonstrate that CBP/SB5-NC would be an efficient gas-blasting release formulation to enhance prostate cancer treatment.
Abstract 14641: Neurodevelopmental Challenges in Adults Operated for Septal Defects in Childhood
Authors: Benjamin Asschenfeldt, Johan Heiberg, Simon Eskildsen, Leif Østergaard, Lars Evald, Vibeke Hjortdal
Journal: Circulation (2018)

Introduction: Neurodevelopmental outcome is impaired in young adults with complex congenital heart disease. It is unknown whether the same holds for atrial (ASD) and ventricular septal defects (VSD...
Abstract A37: Early change in circulating tumor DNA as a potential predictor of response to chemotherapy in patients with metastatic colorectal cancer
Authors: Hitoshi Zembutsu, Hiroki Osumi, Eiji Shinozaki, Kensei Yamaguchi
Journal: Clinical Cancer Research (2020)

Abstract The impact of the change in ctDNA levels after chemotherapy on the clinical outcomes of patients with metastatic colorectal cancer (mCRC) remains unclear. The present study evaluated the clinical implications of the early change in ctDNA levels as a predictor of objective response and the clinical outcome in mCRC patients who received chemotherapy. We investigated the effects of after/before ratio of ctDNA levels 2 and 8 weeks after initiation of second-line chemotherapy on objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). ctDNA was detected using amplicon-based deep sequencing with a molecular barcode that includes &amp;gt;240 hotspot mutations in 14 colon cancer-related genes. Patients with lower ctDNA level (≤ 50%) 8 weeks after initiation of chemotherapy compared to baseline showed significantly longer PFS and OS than the patients with higher (&amp;gt; 50%) ctDNA level in multivariate analysis. In patients achieving partial response or stable disease, the after/before ratio of ctDNA level 8 weeks after initiation of chemotherapy was significantly lower than those in patients with progressive disease. The present study suggests that an early change in the ctDNA level might serve as a biomarker to predict the chemotherapeutic efficacy and clinical outcomes in patients with mCRC. Citation Format: Hitoshi Zembutsu, Hiroki Osumi, Eiji Shinozaki, Kensei Yamaguchi. Early change in circulating tumor DNA as a potential predictor of response to chemotherapy in patients with metastatic colorectal cancer [abstract]. In: Proceedings of the AACR Special Conference on Advances in Liquid Biopsies; Jan 13-16, 2020; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(11_Suppl):Abstract nr A37.
Author Correction: Integrative molecular and clinical modeling of clinical outcomes to PD1 blockade in patients with metastatic melanoma
Authors: David Liu, Bastian Schilling, Derek Liu, Antje Sucker, Elisabeth Livingstone, Livnat Jerby-Arnon, Lisa Zimmer, Ralf Gutzmer, Imke Satzger, Carmen Loquai, Stephan Grabbe, Natalie Vokes, Claire A. Margolis, Jake Conway, Meng Xiao He, Haitham Elmarakeby, Felix Dietlein, Diana Miao, Adam Tracy, Helen Gogas, Simone M. Goldinger, Jochen Utikal, Christian U. Blank, Ricarda Rauschenberg, Dagmar von Bubnoff, Angela Krackhardt, Benjamin Weide, Sebastian Haferkamp, Felix Kiecker, Ben Izar, Levi Garraway, Aviv Regev, Keith Flaherty, Annette Paschen, Eliezer M. Van Allen, Dirk Schadendorf
Journal: Nature Medicine (2020)

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Endoscopic radiofrequency ablation of a cholangiocarcinoma with targeted intraductal cholangioscopic access
Authors: Lidia Marti Romero, Vanesa Martínez Escapa, Inmaculada Castelló Miralles, German Lacal Gutierrez, Carmen Ivars Párraga, Gloria Alemany Perez, Jose Manuel Querol Ribelles
Journal: Endoscopy (2020)

Radiofrequency ablation (RFA) is a technique that has been used during endoscopic retrograde cholangiopancreatography (ERCP) for palliation of locally advanced biliary malignancies [1]. Direct cholangioscopy can be useful for confirming a successful response to therapy [2]. We present a case evaluating the feasibility of intraductal RFA using cholangioscopy (SpyGlass DS System) in a malignant biliary stricture [3].
Mesenchymal stem cell-derived extracellular vesicle-based therapies protect against coupled degeneration of the central nervous and vascular systems in stroke
Authors: Abolfazl Rahmani, Kiarash Saleki, Nima Javanmehr, Javad Khodaparast, Payam Saadat, Hamid Reza Nouri
Journal: Ageing Research Reviews (2020)
Educational nurse-led telephone intervention shortly before colonoscopy as a salvage strategy after previous bowel preparation failure: a multicenter randomized trial
Authors: Marco Antonio Alvarez-Gonzalez, Miguel Ángel Pantaleón Sánchez, Belén Bernad Cabredo, Ana García-Rodríguez, Santiago Frago Larramona, Oscar Nogales, Pilar Díez Redondo, Ignasi Puig del Castillo, Cristina Romero Mascarell, Noemí Caballero, Iván Romero Sánchez-Miguel, Rocío Pérez Berbegal, Domingo Hernández Negrín, Gema Bujedo Sadornill, Alicia Pérez Oltra, Gemma Casals Urquiza, Jaume Amorós Martínez, Agustín Seoane Urgorri, Inés Ana Ibáñez Zafón, Antonio Z. Gimeno-García
Journal: Endoscopy (2020)

Background The most important predictor of unsuccessful bowel preparation is previous failure. For those patients with previous failure, we hypothesized that a nurse-led educational intervention by telephone shortly before the colonoscopy appointment could improve cleansing efficacy. Methods We performed a multicenter, endoscopist-blinded, randomized controlled trial. Consecutive outpatients with previous inadequate bowel preparation were enrolled. Both groups received the same standard bowel preparation protocol. The intervention group also received reinforced education by telephone within 48 hours before the colonoscopy. The primary outcome was effective bowel preparation according to the Boston Bowel Preparation Scale. Intention-to-treat (ITT) analysis included all randomized patients. Per-protocol analysis included patients who could be contacted by telephone and the control cases. Results 657 participants were recruited by 11 Spanish hospitals. In the ITT analysis, there was no significant difference between the intervention and control groups in the rate of successful bowel preparation (77.3 % vs. 72 %; P = 0.12). In the intervention group, 267 patients (82.9 %) were contacted by telephone. Per-protocol analysis revealed significantly improved bowel preparation in the intervention group (83.5 % vs. 72.0 %; P = 0.001). Conclusion Among all patients with previous inadequate bowel preparation, nurse-led telephone education did not result in a significant improvement in bowel cleansing. However, in the 83 % of patients who could be contacted, bowel preparation was substantially improved. Phone education may therefore be a useful tool for improving the quality of bowel preparation in those cases.
Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions — United States, January–May 2020
Authors: Samantha J. Lange, Matthew D. Ritchey, Alyson B. Goodman, Taylor Dias, Evelyn Twentyman, Jennifer Fuld, Laura A. Schieve, Giuseppina Imperatore, Stephen R. Benoit, Aaron Kite-Powell, Zachary Stein, Georgina Peacock, Nicole F. Dowling, Peter A. Briss, Karen Hacker, Adi V. Gundlapalli, Quanhe Yang
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

On March 13, 2020, the United States declared a national emergency in response to the coronavirus disease 2019 (COVID-19) pandemic. Subsequently, states enacted stay-at-home orders to slow the spread of SARS-CoV-2, the virus that causes COVID-19, and reduce the burden on the U.S. health care system. CDC* and the Centers for Medicare & Medicaid Services (CMS)† recommended that health care systems prioritize urgent visits and delay elective care to mitigate the spread of COVID-19 in health care settings. By May 2020, national syndromic surveillance data found that emergency department (ED) visits had declined 42% during the early months of the pandemic (1). This report describes trends in ED visits for three acute life-threatening health conditions (myocardial infarction [MI, also known as heart attack], stroke, and hyperglycemic crisis), immediately before and after declaration of the COVID-19 pandemic as a national emergency. These conditions represent acute events that always necessitate immediate emergency care, even during a public health emergency such as the COVID-19 pandemic. In the 10 weeks following the emergency declaration (March 15-May 23, 2020), ED visits declined 23% for MI, 20% for stroke, and 10% for hyperglycemic crisis, compared with the preceding 10-week period (January 5-March 14, 2020). EDs play a critical role in diagnosing and treating life-threatening conditions that might result in serious disability or death. Persons experiencing signs or symptoms of serious illness, such as severe chest pain, sudden or partial loss of motor function, altered mental state, signs of extreme hyperglycemia, or other life-threatening issues, should seek immediate emergency care, regardless of the pandemic. Clear, frequent, highly visible communication from public health and health care professionals is needed to reinforce the importance of timely care for medical emergencies and to assure the public that EDs are implementing infection prevention and control guidelines that help ensure the safety of their patients and health care personnel.