tbuckley/cabot-search huggingface dataset:
Abstract P538: Cardiovascular Health Benefits of Optimism are Socially Patterned: A 15-year Prospective Study
Authors: Farah Qureshi, Jackie Soo, Ying Chen, Brita Roy, Donald M Lloyd-Jones, Laura D Kubzansky, Julia K Boehm
Journal: Circulation (2020)

Introduction: Optimism is consistently associated with better cardiovascular health but underlying mechanisms are poorly understood. This study examines prospective links between optimism and lipids in adulthood, and tests possible effect modification by social factors. Hypothesis: Greater optimism will predict healthier lipid profiles. Methods: Participants were 3,016 adults (mean age=40.2) recruited in 1985-6 from the Coronary Artery Risk Development in Young Adults Study. Optimism was measured in year 15 using the 6-item Life Orientation Test-Revised. Log-transformed triglyceride levels (TG) and total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) were assessed from blood samples in years 15, 20, 25, and 30. Linear mixed models evaluated relationships between optimism and lipids controlling for relevant covariates. Stratified analyses tested associations by gender, race/ethnicity, and income. Results: On average, TG increased over time while TC/HDL-C decreased. Figure 1 shows unadjusted differences in mean lipid levels by optimism tertiles. In fully-adjusted models, higher optimism was associated with lower TG averaged over the follow-up (β=-0.028; 95% CI: -0.047, -0.010); a similar trend (though non-significant) was observed with TC/HDL-C (β=-0.024; 95% CI: -0.066, 0.018). In stratified analyses, optimism was more strongly associated with lower TG among women (vs. men), but no differences were noted by race/ethnicity or income. Associations with TC/HDL-C were stronger for women (vs. men) and white (vs. black) participants. Optimism was not related to increases in TG over time, but was associated with a slightly faster decline in TC/HDL-C (time interaction β=0.003; 95% CI: 0.001, 0.006). Declines in TC/HDL-C also varied by sex and race/ethnicity. Conclusion: Optimism contributes to lower lipid levels in adulthood, but associations vary by social status. The relationship between optimism and lipids may underlie previously noted associations with cardiovascular health.
Abstract P487: Network Stressors, Personal Stressors, And Sustained Hypertension In African American Women
Authors: Telisa Spikes, Letryce Scully, Samantha Bromfield, Miriam Van Dyke, Renee Moore, Izraelle McKinnon, Bianca Booker, Frederic Rahbari-Oskoui, Arshed Quyyumi, Viola Vaccarino, Tené Lewis
Journal: Circulation (2020)

Introduction: Stressful life events (SLE) have been associated with poor cardiovascular health but most studies have focused on stressors that directly impact the individuals under study, or personal stressors. Research suggests that women, particularly African-American women, may actually be more vulnerable to network stressors (e.g. SLE that impact important others, such as children, spouses and friends). However, few studies have examined this phenomenon. Hypothesis: We tested the hypothesis that greater exposure to network, versus personal stressors, would be associated with elevated clinic blood pressure (BP) as well as BP in daily life, assessed via 48-hour ambulatory monitoring. Methods: Participants were 395 African-American women aged 30-45 (Mean= 39.5 ±4.6 yrs) from a range of educational backgrounds recruited from a large southeastern metropolitan area. SLE were assessed using a 22-item Stressful Life Events checklist and further classified into personal (e.g. “major accident/assault/robbery happened to you”) or network (e.g. “serious physical illness, injury or drug/alcohol problem in someone family member/friend”) stressors and summed. Clinic and 48-hr ambulatory BP measurements were assessed and sustained hypertension (HTN) was defined as both clinic (≥130/80mmHg) and ambulatory HTN (≥130/80mmHg), using 2017 AHA/ACC guidelines. Logistic regression analyses were used to examine the associations between types of stressors and sustained HTN after adjusting for age, education, body mass index, and BP meds. Results: Approximately 51.2% (N=211) of women had clinic HTN and 29.9% (N=123) of women had sustained HTN (elevated in both clinic and in daily life). In unadjusted multivariable logistic regression analyses, each additional network stressor was associated with a greater likelihood of having elevated clinic (OR-1.21 [1.04-1.40]) and sustained HTN (OR- OR-1.22 [1.04-1.43]). Findings for clinic (OR-1.25, [1.06-1.48]) and sustained HTN (OR-1.23, [1.04-1.46]) remained significant after adjustment for covariates. There were no significant associations between reports of personal stressors and either clinic, or sustained HTN in unadjusted or adjusted analyses. Discussion: Network, but not personal stressors, were associated with elevated rates of HTN, both in clinic and daily life for African-American women. Future research is needed to determine whether interventions targeting stress management for network stressors specifically might impact BP in this high-risk population.
Estimating Fluid Consumption Volumes in Electronic Cigarette Use
Authors: Jody Morgan, Alison L. Jones
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Assessment of Electronic Health Record Search Patterns and Practices by Practitioners in a Large Integrated Health Care System
Authors: Halley Ruppel, Aashish Bhardwaj, Raj N. Manickam, Julia Adler-Milstein, Marc Flagg, Manuel Ballesca, Vincent X. Liu
Journal: JAMA Network Open (2020)

<h3>Importance</h3> The electronic health record (EHR) is a source of practitioner dissatisfaction in part because of challenges with information retrieval. To improve data accessibility, a better understanding of practitioners' information needs within individual patient records is needed. <h3>Objective</h3> To assess EHR users' searches using data from a large integrated health care system. <h3>Design, Setting, and Participants</h3> This retrospective cross-sectional analysis used EHR search data from Kaiser Permanente Northern California, an integrated health care delivery system with more than 4.4 million members. Users' EHR search activity data were obtained from April 1, 2018, to May 15, 2019. <h3>Main Outcomes and Measures</h3> Search term frequency was grouped by user and practitioner types. Network analyses were performed of co-occurring search terms within a single search episode, and centrality measures for search terms (degree and betweenness centrality) were calculated. <h3>Results</h3> A total of 12 313 047 search activities (including 4 328 330 searches and 7 984 717 result views) conducted by 34 735 unique users within 977 160 unique patient EHRs were identified. In aggregate, users searched for 208 374 unique search terms and conducted a median of 4 searches (interquartile range, 1-28 searches). Of all 97 367 active EHR users, 34 735 (35.7%) conducted at least 1 search. However, of all 12 968 active EHR physician users, 9801 (75.6%) conducted at least 1 search, and of all 1908 active pharmacist users, 1402 (73.5%) conducted at least 1 search. The top 3 most commonly searched terms were<i>statin</i>(75 017 searches [1.7%]),<i>colonoscopy</i>(73 545 [1.7%]), and<i>pft</i>(54 990 [1.3%]). However, wide variation in top searches were noted across practitioner groups. Terms searched most often with another term in a single linked search episode included<i>statin</i>,<i>lisinopril</i>,<i>colonoscopy</i>,<i>gabapentin</i>, and<i>aspirin</i>. <h3>Conclusions and Relevance</h3> Although physicians and pharmacists were the most active users of EHR searches, search volume and frequently searched terms varied considerably by and within user role. Further customization of the EHR interface may help leverage users' search content and patterns to improve targeted information retrieval.
Thermo‐Responsive Polymer Capsules in Real‐Time One‐Step RT‐PCR for Highly Multiplex RNA Analysis
Authors: Junsun Kim, Seungwon Jung, Mi Yeon Kim, Bong Kyun Kim, Soon Hwan Kwon, Sang Kyung Kim
Journal: Advanced Healthcare Materials (2020)

Abstract Rapid and simple detection of RNA targets is in high demand due to the growing threat of pandemic viruses. One‐step real‐time, reverse transcription–polymerase chain reaction (One‐step RT‐qPCR) using a controlled release system of thermo‐responsive materials is developed in this paper to enable high‐fidelity RNA analysis as suppressing by‐products. The nanocapsules, consisting of upper critical solution temperature (UCST) material and PCR primers, carry or release the primers depending upon the temperature. The UCST nanocapsules are introduced into hydrogel microparticles incorporated with RT primers and then the target RNA is selectively amplified in the microparticle through one‐step RT‐qPCR. Severe side products are sharply subdued by separating the PCR primers from the RT process by means of the microparticles with nanocapsules. Because the one‐step assay is now implemented in a single microparticle, multiple target RNAs can be analyzed in a simple RT‐qPCR of multiple particles. Reliable 18‐plex one‐step RT‐qPCR is successfully conducted within 30 min using single‐color fluorescent optics. This work also explains the facile fabrication processes used for the thermo‐responsive nanocapsules and hydrogel microparticles by the blending polymerization method. Extensible multiplex analysis of influenza virus demonstrates the versatile uses of this one‐step RT‐qPCR platform.
Abstract 12141: J-Shaped Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Singaporeans Aged ≥60 Years: A Prospective Observational Study
Authors: Lian Qian, Tazeen H Jafar, John C Allen, Stefan Ma, Rahul Malhotra
Journal: Circulation (2018)

Introduction: Several studies report a J-shaped association of systolic (SBP) and diastolic blood pressure (DBP) with mortality among adults, with greater likelihood of mortality at both lower and ...
Bacterial Group II Intron Genomic Neighborhoods Reflect Survival Strategies: Hiding and Hijacking
Authors: Justin Waldern, Nicholas J Schiraldi, Marlene Belfort, Olga Novikova
Journal: Molecular Biology and Evolution (2020)

Abstract Group II (gII) introns are mobile retroelements that can spread to new DNA sites through retrotransposition, which can be influenced by a variety of host factors. To determine if these host factors bear any relationship to the genomic location of gII introns, we developed a bioinformatic pipeline wherein we focused on the genomic neighborhoods of bacterial gII introns within their native contexts and sought to determine global relationships between introns and their surrounding genes. We found that, although gII introns inhabit diverse regions, these neighborhoods are often functionally enriched for genes that could promote gII intron retention or proliferation. On one hand, we observe that gII introns are frequently found hiding in mobile elements or after transcription terminators. On the other hand, gII introns are enriched in locations in which they could hijack host functions for their movement, potentially timing expression of the intron with genes that produce favorable conditions for retrotransposition. Thus, we propose that gII intron distributions have been shaped by relationships with their surrounding genomic neighbors.
RNA Splicing Alterations Induce a Cellular Stress Response Associated with Poor Prognosis in Acute Myeloid Leukemia
Authors: Govardhan Anande, Nandan P. Deshpande, Sylvain Mareschal, Aarif M.N. Batcha, Henry R. Hampton, Tobias Herold, Soren Lehmann, Marc R. Wilkins, Jason W.H. Wong, Ashwin Unnikrishnan, John E. Pimanda
Journal: Clinical Cancer Research (2020)

RNA splicing is a fundamental biological process that generates protein diversity from a finite set of genes. Recurrent somatic mutations of splicing factor genes are common in some hematologic cancers but are relatively uncommon in acute myeloid leukemia (AML, < 20% of patients). We examined whether RNA splicing differences exist in AML, even in the absence of splicing factor mutations.We developed a bioinformatics pipeline to study alternative RNA splicing in RNA-sequencing data from large cohorts of patients with AML.We have identified recurrent differential alternative splicing between patients with poor and good prognosis. These splicing events occurred even in patients without any discernible splicing factor mutations. Alternative splicing recurrently occurred in genes with specific molecular functions, primarily related to protein translation. Developing tools to predict the functional impact of alternative splicing on the translated protein, we discovered that approximately 45% of the splicing events directly affected highly conserved protein domains. Several splicing factors were themselves misspliced and the splicing of their target transcripts were altered. Studying differential gene expression in the same patients, we identified that alternative splicing of protein translation genes in ELNAdv patients resulted in the induction of an integrated stress response and upregulation of inflammation-related genes. Finally, using machine learning techniques, we identified a splicing signature of four genes which refine the accuracy of existing risk prognosis schemes and validated it in a completely independent cohort.Our discoveries therefore identify aberrant alternative splicing as a molecular feature of adverse AML with clinical relevance.See related commentary by Bowman, p. 3503.
Survival After Coronary Revascularization With Paclitaxel-Coated Balloons
Authors: Bruno Scheller, Davor Vukadinovic, Raban Jeger, Tuomas T. Rissanen, Sean S. Scholz, Robert Byrne, Franz X. Kleber, Azeem Latib, Yvonne P. Clever, Sebastian Ewen, Michael Böhm, Yiping Yang, Alexandra Lansky, Felix Mahfoud
Journal: Journal of the American College of Cardiology (2020)
The Secret About Achieving Your Dreams
Authors: Adam Philip Stern
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Sparse Epistatic Patterns in the Evolution of Terpene Synthases
Authors: Aditya Ballal, Caroline Laurendon, Melissa Salmon, Maria Vardakou, Jitender Cheema, Marianne Defernez, Paul E O’Maille, Alexandre V Morozov
Journal: Molecular Biology and Evolution (2020)

We explore sequence determinants of enzyme activity and specificity in a major enzyme family of terpene synthases. Most enzymes in this family catalyze reactions that produce cyclic terpenes-complex hydrocarbons widely used by plants and insects in diverse biological processes such as defense, communication, and symbiosis. To analyze the molecular mechanisms of emergence of terpene cyclization, we have carried out in-depth examination of mutational space around (E)-β-farnesene synthase, an Artemisia annua enzyme which catalyzes production of a linear hydrocarbon chain. Each mutant enzyme in our synthetic libraries was characterized biochemically, and the resulting reaction rate data were used as input to the Michaelis-Menten model of enzyme kinetics, in which free energies were represented as sums of one-amino-acid contributions and two-amino-acid couplings. Our model predicts measured reaction rates with high accuracy and yields free energy landscapes characterized by relatively few coupling terms. As a result, the Michaelis-Menten free energy landscapes have simple, interpretable structure and exhibit little epistasis. We have also developed biophysical fitness models based on the assumption that highly fit enzymes have evolved to maximize the output of correct products, such as cyclic products or a specific product of interest, while minimizing the output of byproducts. This approach results in nonlinear fitness landscapes that are considerably more epistatic. Overall, our experimental and computational framework provides focused characterization of evolutionary emergence of novel enzymatic functions in the context of microevolutionary exploration of sequence space around naturally occurring enzymes.
Abstract 47: Changes in Gut-microbial Metabolite L-carnitine and Improvements in Atherogenic Lipoprotein Metabolism in Overweight and Obese Individuals: The POUNDS Lost Trial
Authors: Yoriko Heianza, Tao Zhou, Joseph A DiDonato, George A Bray, Frank M Sacks, Lu Qi
Journal: Circulation (2020)

Introduction: Atherogenic lipoproteins, apolipoproteins (apo), and lipoprotein subspecies with apo CIII are risk factors for cardiovascular disease (CVD). A gut-microbiota related metabolite L-carnitine has been found to promote atherosclerosis and may be related to an increased risk of CVD. Associations of L-carnitine with atherogenic lipid metabolism have not been clarified. Hypothesis: We tested a hypothesis that diet-induced changes in L-carnitine might contribute to improving atherogenic lipid profiles among overweight and obese adults. Methods: A total of 510 participants had data on blood levels of L-carnitine and lipid markers in a 2-year weight-loss dietary intervention trial. We measured 35 specialized lipid profiles including apo B and cholesterol concentrations in lipoprotein fractions (defined by the presence or absence of apo C-III) in 279 participants. Results: Higher baseline L-carnitine levels were significantly associated with elevated concentrations of triglycerides (p=0.0048) and lower HDL cholesterol (p=0.01) levels. Higher L-carnitine levels were also associated with elevated concentrations of cholesterol and apo B in lipoprotein fractions with apo CIII, such as cholesterol in VLDL with apo CIII (p=0.02), cholesterol in LDL with apo CIII (p=0.0056), apo B in HDL with apo CIII (p=0.01), apo B in VLDL with apo CIII (p=0.0008), and apo B in LDL with apo CIII (p=0.0038). We found that people with 6-month decreases in L-carnitine after the dietary intervention (median change: -3.4 μM) had significantly reduced LDL cholesterol levels over 2 years (p &amp;lt; 0.05; Fig, A). Also, people with greater increases in L-carnitine (median change: 3.2 μM) showed 2-year increases in cholesterol in VLDL with apo CIII or in LDL with apo CIII (p &amp;lt; 0.05 for both) (Fig, B). Conclusions: Diet-induced decreases in gut-microbiota-related metabolite L-carnitine may have significant influences on long-term improvements in atherogenic lipid profiles among obese patients in a dietary intervention.
Helen Salisbury: Whose record is it anyway?
Authors: Helen Salisbury
Journal: BMJ (2020)

From April 2020, patients will have full online access to prospective data from their patient record, including the free text of consultations. While I welcome the move towards shared medicine and the openness that it signals, I have misgivings and concerns that GPs are not prepared for this change.

When I first started in general practice, computers were fairly new. Although current consultations were documented on screen, staff would pull out all paper files for patients booked into a clinic, as we’d often need to look up previous visits or hospital records. One of my colleagues had such illegible handwriting that I …