tbuckley/cabot-search huggingface dataset:
AB1464-HPR Acute effects of cold – pack applied in different ways following fatigue on postural stability, proprioception and motor performance
Authors: O Aydogdu, Z. Sarı
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> There is a lack of literature examining local cooling on postural stability, proprioception, and motor performance following fatigue. <h3>Objectives</h3> The purpose of this study was to examine the effects of cold-pack applied on knee joint following fatigue on postural stability, proprioception, and motor performance in healthy subjects. It was hypothesised that fatigue might cause deficits in measurements of postural stability, proprioception, and motor performance and cold-pack treatment applied on knee joint in different ways might prevent this deficit. <h3>Methods</h3> Sixty healthy subjects (33 female, 27 male; age=22.00±1.37 years, height=169.62±9.21 cm, weight=63.48±12.61 kg) were participated in the study. Subjects had no history of lower extremity injury, vestibular or postural stability problems, proprioception problems, hip, knee, and ankle instability. Postural stability, knee proprioception and motor performance were assessed by Pedalo Sensamove System, Biodex System Pro 4, and Stair Climbing Test, respectively. The subjects were received a clinically-used fatigue protocol on a cycle ergometer. The Modified Borg's Rate of Perceived Exertion Scale has been used for fatigue determination. All assessments were performed three times at rest, immediately after fatigue and cold-pack treatment. <h3>Results</h3> There were no significant changes in terms of postural stability and knee proprioception after fatigue and cold-pack treatment compared to the condition at rest in all groups (p&gt;0.05). However, motor performance was significantly decreased following fatigue compared to the condition at rest (p&lt;0.05). <h3>Conclusions</h3> The hypothesis of this study, that fatigue could cause a deficit in measurement of motor performance was supported. On the other hand, postural stability and proprioception did not decrease following fatigue. According to the results of our study, we concluded that the subjects do not benefit from the use of cold-pack for compensating deficit in measurement of motor performance following fatigue. <h3>Disclosure of Interest</h3> None declared
STAT3 Inhibition Enables TLR9-Driven Differentiation of Cbfb/Myh11 acute Myeloid Leukemia Cells to Antigen-Presenting Cell Phenotype In Vivo
Authors: Marcin Kortylewski, Priyanka Duttagupta, Yu-Lin SU, Tomasz Adamus, Guido Marcucci
Journal: Blood (2018)
AB1231 Efficacy and cost analysis of a systematic switch from originator infliximab to biossimilar ct-p13 of all patients with inflammatory arthritis from a single centre
Authors: A. Valido, J. Silva-Dinis, M.J. Saavedra, N. Bernardo, J.E. Fonseca
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> The aim of this study was to analyse efficacy, safety and cost savings of switching from infliximab originator (IFXor) to the biosimilar (BS) CT-P13 in single centre. <h3>Methods</h3> Eligible patients were those older than 18 years old with the diagnosis of rheumatoid arthritis (RA), spondylarthritis (SpA) and psoriatic arthritis (PsA) on treatment (Tx) with IFXor for at least 6 months and with stable disease activity. In December 2016 all eligible patients were proposed to switch to CT-P13. At the day of the last Tx with IFXor, informed consent, data and blood samples were collected. On the next Tx day, CT-P13 was administered after standard evaluation of efficacy and safety. Efficacy was measured considering change from baseline in Disease Activity Score in 28 joints (DAS28) for RA and PsA and in Ankylosing Spondylitis Disease Activity Score (ASDAS) for SpA. Disease worsening was considered when an increase of 1.2 from baseline in DAS28 or an increase of 1.1 in ASDAS occurred. A cost analysis was done based on the purchasing prices of the 2 drugs at our centre. <h3>Results</h3> In a 12 months period switch to CT-P13 was performed in 60 patients for non-medical reasons. Disease activity (DA) was stable over the observation period and similar to the values observed with IFXor. Median follow-up time was 261 days during which disease worsening occurred in 3 (5%) patients. 1 patient had a minor adverse event (oedema of the lip). These 4 (6.7%) patients stopped the BS. One returned to IFXor and the other 3 switched to another drug. The switch to CT-P13 represented a 26.4% reduction of costs in the use of IFX Tx in these patients. <h3>Conclusions</h3> The switch in routine care of a group of RA, SpA and PsA patients from IFXor to CT-P13 did not affect efficacy and safety and reduced costs in 26.4%. <h3>Reference</h3> [1 ] Bente Glintborg,<i> et al.</i> A nationwide non-medical switch from originator infliximab to biosimilar CT-P13 in 802 patients with inflammatory arthritis: 1-year clinical outcomes from the DANBIO registry<i>. Ann Rheum Dis 2017</i>;0:1–6. <h3>Disclosure of Interest</h3> None declared
Abstract 18228: Placement of Implantable Cardioverter Defibrillator in Hypertrophic Obstructive Cardiomyopathy With Paroxysmal Ventricular Tachycardia and their Outcomes
Authors: Muhammad H Gul, Zin Mar Htun, Tin K Aung, Ayesha Banu, Manpreet Kaur, Muhammad Z Khan, Sameer Saleem, Kamran Khan, Syed T Jan, Muhammad Imran, Nauman Shaukat, Snehal Bansod, Zeeshan Mansuri
Journal: Circulation (2017)

Background: Non-Sustained Ventricular Tachycardia is an established risk factor in Hypertrophic Obstructive Cardiomyopathy (HOCM). However, the strength of evidence for placement of Implantable Car...
KIT D816 mutated/CBF-negative acute myeloid leukemia: a poor-risk subtype associated with systemic mastocytosis
Authors: Mohamad Jawhar, Konstanze Döhner, Sebastian Kreil, Juliana Schwaab, Khalid Shoumariyeh, Manja Meggendorfer, Lambert L. F. Span, Stephan Fuhrmann, Nicole Naumann, Hans-Peter Horny, Karl Sotlar, Boris Kubuschok, Nikolas von Bubnoff, Karsten Spiekermann, Michael Heuser, Georgia Metzgeroth, Alice Fabarius, Stefan Klein, Wolf-Karsten Hofmann, Hanneke C. Kluin-Nelemans, Torsten Haferlach, Hartmut Döhner, Nicholas C. P. Cross, Wolfgang R. Sperr, Peter Valent, Andreas Reiter
Journal: Leukemia (2019)

KIT D816 mutations (KIT D816mut) are strongly associated with systemic mastocytosis (SM) but are also detectable in acute myeloid leukemia (AML), where they represent an adverse prognostic factor in combination with core binding factor (CBF) fusion genes. Here, we evaluated the clinical and molecular features of KIT D816mut/CBF-negative (CBFneg) AML, a previously uncharacterized combination. All KIT D816mut/CBFneg cases (n = 40) had histologically proven SM with associated AML (SM-AML). Molecular analyses revealed at least one additional somatic mutation (median, n = 3) beside KIT D816 (e.g., SRSF2, 38%; ASXL1, 31%; RUNX1, 34%) in 32/32 (100%) patients. Secondary AML evolved in 29/40 (73%) patients from SM ± associated myeloid neoplasm. Longitudinal molecular and cytogenetic analyses revealed the acquisition of new mutations and/or karyotype evolution in 15/16 (94%) patients at the time of SM-AML. Median overall survival (OS) was 5.4 months. A screen of two independent AML databases (AMLdatabases) revealed remarkable similarities between KIT D816mut/CBFneg SM-AML and KIT D816mut/CBFneg AMLdatabases (n = 69) with regard to KIT D816mut variant allele frequency, mutation profile, aberrant karyotype, and OS suggesting underlying SM in a significant proportion of AMLdatabases patients. Bone marrow histology and reclassification as SM-AML has important clinical implications regarding prognosis and potential inclusion of KIT inhibitors in treatment concepts.
THU0504 Utilisation of anti-osteoporotic drugs in real-world data: a study of gender-related differences
Authors: V. Orlando, V.M. Monetti, F. Guerriero, V. Russo, A. Moretti, A. Piscitelli, R. Piscitelli, G. Iolascon, E. Menditto
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Osteoporosis is mostly defined as the disease of women, because the prevalence and fracture rates are much higher in postmenopausal women than in older men. However, there has been increasing recognition that male osteoporosis also represents an important burden as a common cause of morbidity, mortality and health care expenditure. Also, men are more likely than women to have osteoporosis that is undiagnosed and undertreated. Moreover, bone fracture are important factors of high mortality and morbidity rates in osteoporotic patients. Lack of persistence is common among subjects using oral anti-osteoporotic drugs, and leads to increased risk of fragility fracture. <h3>Objectives</h3> The aim of this study is to perform gender specific analysis regarding the persistence to antiosteoporosis drugs. <h3>Methods</h3> We conducted a retrospective cohort study using administrative data from four local health authorities in the Abruzzo Region (Central Italy), which comprise about 9 00 000 inhabitants (68% of the overall regional population). Patients 60 years of age or older were included if at least one prescription for any antiosteoporosis drugs had been filled in between January 1, 2006 and December 31, 2006. Persistence estimates over time (discontinuation rates were assessed at 365 days) were derived using Kaplan–Meier survival analysis, stratifying for gender, considering treatment discontinuation as failure event and comparing differences using Log-rank test (1 degree of freedom). <h3>Results</h3> The final cohort consisted of a total of 7867 patients (87.2% women). The mean patient age for both genders at the index date was 74.5 years. The crude analysis of long-term gender persistence showed a significant difference between women and men: the relative number of persistence patients after 1 year was 66.4% in men and 44.7% in women. The Kaplan Meier plots of time to persistence start to differ for men vs women approximately 60 days after treatment start (figure 1). <h3>Conclusions</h3> The results showed that gender influences adherence to therapy and this is an issue that could be taken in strong consideration in tailor intervention to improve adherence. <h3>References</h3> [1] Cawthon PM. Gender differences in osteoporosis and fractures. Clinical Orthopaedics and Related Research2011;469(7):1900–1905. [2] Bor A, Matuz M, Gyimesi N, et al. Gender inequalities in the treatment of osteoporosis. Maturitas2015;80:162–169. [3] Christopher J, et al. Sex and gender considerations in male patients with osteoporosis. Clinical Orthopaedics and Related Research2011;469(7):1906–1912. <h3>Disclosure of Interest</h3> None declared
Characteristics and Outcome of DAT-Negative Autoimmune Hemolytic Anemia: Results from a French Multicentre Observational Study
Authors: Caroline Morbieu, Thierry Leblanc, Marion Malphettes, Charlotte Petitditdier, Julie Durin, Corinne Haioun, Guillaume Le guenno, Mikael Ebbo, Olivier Fain, Loic Garcon, Aline Floch, Btissam Chami, France Pirenne, Laetitia Languille, Bertrand Godeau, Marc Michel
Journal: Blood (2018)
FRI0264 Role of p-gp in pathogenic conversion of th17 cells in lupus nephritis leading to glucocorticoid resistance
Authors: A. Jaiswal, M.K. Rai, V. Agarwal, N. Prasad
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Th17 cells and cytokine IL-17 are mainly involved in autoimmunity. Recently IL-17/IFN-g double-positive Th17 cell were found to be allied with inflammatory diseases. P-glycoprotein (P-gp) +ve Th17 cells are refractory to steroid. P-gp on lymphocyte effluxes out steroid and prevents its action. We conducted this study with hypothesis that P-gp positive IL-17/IFN-g double +ve Th17 are one of key pharmacokinetic and pharmacodynamic modulator liable for steroid resistance in lupus nephritis (LN). <h3>Objectives</h3> We planned to study the frequency of P-gp expressing pathogenic Th17 cells in steroid responsive and non-responsive steroid patients. <h3>Methods</h3> We analysed the frequency of pathogenic IL-17/IFN-g double-positive Th17 lymphocytes and P-gp expression on their surface by flowcytometry in responsive (n=52; mean age 34.06±10.84) and non-responsive (n=25; mean age 37.29±13.73) patients. We also included 10 age and sex matched healthy controls. All patients were biopsy proven LN. <h3>Results</h3> We found a significant increase in the frequency of Th1 (p=0.001); Th17 (p=0.006) and IL-17/IFN-g double positive Th17 (p=0.006) and IL-17/IFN-g doublepositive Th17 (&lt;0.001) cells in non-responsive as compared to responsive patients and healthy controls (p&lt;0.001). Of the total Th1; Th17 and pathogenic Th17; 78.45%; 72.37% and 95.8% cells expressed P-gp on their surface in nonresponsive;45.0%; 30.27% and 30.1% cells expressed P-gp in responsive group; and 30.91%; 15.51% and 15.62% in healthy control respectively. <h3>Conclusions</h3> Higher frequency of IL-17/IFN-g doublepositive Th17 cell with P-gp expression may be associated immunological and pharmacological factor for steroid resistance in LN. <h3>Disclosure of Interest</h3> None declared
Machine Learning–Based Prediction of Clinical Outcomes for Children During Emergency Department Triage
Authors: Tadahiro Goto, Carlos A. Camargo, Mohammad Kamal Faridi, Robert J. Freishtat, Kohei Hasegawa
Journal: JAMA Network Open (2019)

While machine learning approaches may enhance prediction ability, little is known about their utility in emergency department (ED) triage.To examine the performance of machine learning approaches to predict clinical outcomes and disposition in children in the ED and to compare their performance with conventional triage approaches.Prognostic study of ED data from the National Hospital Ambulatory Medical Care Survey from January 1, 2007, through December 31, 2015. A nationally representative sample of 52 037 children aged 18 years or younger who presented to the ED were included. Data analysis was performed in August 2018.The outcomes were critical care (admission to an intensive care unit and/or in-hospital death) and hospitalization (direct hospital admission or transfer). In the training set (70% random sample), using routinely available triage data as predictors (eg, demographic characteristics and vital signs), we derived 4 machine learning-based models: lasso regression, random forest, gradient-boosted decision tree, and deep neural network. In the test set (the remaining 30% of the sample), we measured the models' prediction performance by computing C statistics, prospective prediction results, and decision curves. These machine learning models were built for each outcome and compared with the reference model using the conventional triage classification information.Of 52 037 eligible ED visits by children (median [interquartile range] age, 6 [2-14] years; 24 929 [48.0%] female), 163 (0.3%) had the critical care outcome and 2352 (4.5%) had the hospitalization outcome. For the critical care prediction, all machine learning approaches had higher discriminative ability compared with the reference model, although the difference was not statistically significant (eg, C statistics of 0.85 [95% CI, 0.78-0.92] for the deep neural network vs 0.78 [95% CI, 0.71-0.85] for the reference; P = .16), and lower number of undertriaged critically ill children in the conventional triage levels 3 to 5 (urgent to nonurgent). For the hospitalization prediction, all machine learning approaches had significantly higher discrimination ability (eg, C statistic, 0.80 [95% CI, 0.78-0.81] for the deep neural network vs 0.73 [95% CI, 0.71-0.75] for the reference; P < .001) and fewer overtriaged children who did not require inpatient management in the conventional triage levels 1 to 3 (immediate to urgent). The decision curve analysis demonstrated a greater net benefit of machine learning models over ranges of clinical thresholds.Machine learning-based triage had better discrimination ability to predict clinical outcomes and disposition, with reduction in undertriaging critically ill children and overtriaging children who are less ill.
AB1352 Evaluation of mri ramris score and clinical response in patients with acpa positive undifferentiated arthritistreated with infliximab versus placebo
Authors: T. Kirchgesner, B. Vande Berg, T. Sokolova, L. Meric de Bellefon, A. Nzeusseu, M. Stoenoiu, P. Durez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients (Pts) with Undifferentiated Arthritis (UA), positive for ACPA antibodies are at high risk of progressing to Rheumatoid Arthritis (RA). TNF play a key role in the pathogenesis of RA. Very early treatment with the combination of Methotrexate and Infliximab (IFX) in a small cohort of UA showed a benefit in clinical symptoms and reduction of MRI evidence of synovitis and erosions. <h3>Objectives</h3> To assess whether IFX as a monotherapy is more effective than placebo (Pbo) in UA pts positive for ACPA. Here we evaluate the clinical response, the MRI RAMRIS score MRI and the risk to develop RA. <h3>Methods</h3> This was a randomised, double-blind, Pbo-controlled, two-arm parallel design study of 12 months to the primary endpoint (proportion of pts who developed <sup>RA by ARA 2007</sup> criteria). Pts with UA and symptomatic clinical synovitis of ≥1 joints and ACPA positivity were randomised 1:1 to IFX (3 mg/kg) or Pbo at week 0, 2, 6, 14 and 22, after which treatment was terminated. NSAIDs/stable low-dose oral corticosteroid (≤5 mg/day prednisone or equivalent) were permitted but no DMARDs. Disease activity measures (DAS28-CRP) were evaluated at BL, Wks 2 and 4, and every 4 wks until Wk 52. OMERACT RAMRIS scores (components: erosion, osteitis, synovitis, tenosynovitis) and peritendinitis scores were evaluated at BL and Mth 4. Pts who developed RA at any time were discontinued and could receive standard of care. <h3>Results</h3> 28 pts were randomised (mean age: 48±12 years; mean duration of arthritis: 0.34±0.53 year; mean CRP level: 1.67±2.23 mg/dL). By 1 year, 11/15 (73%) pts treated with IFX developed RA vs 10/15 (67%) Pbo-treated pts (Kaplan Meier, log rank p=0.868). At wk 14, ACR 20, 50, 70 responses were observed respectively in 71.4%, 42.9%, 28.6% pts treated with IFX vs 21.4%, 0%, 0% treated with Pbo. Remission DAS28CRP rate was observed in 50% in the IFX group vs 21.4% in the Pbo group. Pts in the IFX arm experienced significantly greater improvements in RAMRIS score versus pbo at wk 16 (see graph). No severe safety issues was observed except one case of severe hepatotoxicity induced by Isoniazid. <h3>Conclusions</h3> In this small randomised cohort of UA ACPA positive pts, we noted a significant difference in the RAMRIS scoring after 4 months in the IFX group vs PBo. This is the first study to report a worsening of disease activity based on the RAMRIS scores in the PBo group but changes were minimal and not observed in all pts. IFX has higher efficacy but did not prevent the progression to definite RA. Further analyses are ongoing to determine MRI predictors for severity. <h3>Reference</h3> [1] Quinn MA, et al. Arthritis Rheum2005; 52(1):27–35. <h3>Disclosure of Interest</h3> None declared
Molecular Characteristics of Diffuse Large B-Cell Lymphoma and Correlation with Baseline Metabolic Tumor Volume (MTV), Interim Positron Emission Tomography (iPET) and Outcome in the PETAL Trial
Authors: Julia Richter, Andreas Hüttmann, Jan Rekowski, Christine Schmitz, Selina Gärtner, Claudia Ose, Andreas Rosenwald, Martin-Leo Hansmann, Sylvia Hartmann, Peter Moeller, Hans-Heinrich Wacker, Alfred Feller, Christoph Thorns, Stefan P. Müller, Ulrich Duehrsen, Wolfram Klapper
Journal: Blood (2018)
Oligoclonal Expansion and T-Cells Subpopulations in Patients with Aplastic Anemia at Different Stages of the Disease
Authors: Anastasia V. Abramova, Elena A. Mikhaylova, Zalina T. Fidarova, Yuliya O. Davydova, Nikolay M. Kapranov, Tatiana I. Lobanova, Anton V. Luchkin, Alina E. Krasilnikova, Roman V. Tivikov, Vera V. Troitskaya, Irina V. Galtseva, Elena N. Parovichnikova, Valery G. Savchenko
Journal: Blood (2018)
Reducing Unfair Out-of-Network Billing — Integrated Approaches to Protecting Patients
Authors: Mark A. Hall, Loren Adler, Paul B. Ginsburg, Erin Trish
Journal: New England Journal of Medicine (2019)

Interview with Prof. Mark Hall on strategies for addressing inadequate provider networks and surprise medical bills. (09:01)Download High charges for out-of-network care are demonstrably unfair when health plans have inadequate networks and when patients are treated by providers they don't choose. An integrated approach for addressing both circumstances could involve streamlined dispute resolution.
Expelled Cochrane director to set up new institute for “integrity in science”
Authors: Melanie Newman
Journal: BMJ (2019)

Peter Gotzsche, who was expelled from the Cochrane collaboration last year,1 plans to found a new Institute for Scientific Freedom. The new organisation, whose goal is “to preserve honesty and integrity in science,” will be launched on 9 March at an international symposium in Copenhagen.

Gotzsche, who was a member of Cochrane’s board until his sacking last autumn, told The BMJ that the institute will be financed by crowdfunding. It will focus on lobbying for improvements in healthcare research quality as well as producing its own research.

“Lobbying will be a big part of what we do,” he explained. Gotzsche …
AB0213 Correlation between components of the das28 score and health assessment questionnaire in early rheumatoid arthritis
Authors: C. Thurston, S. Rizvi, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The health assessment questionaire (HAQ) in rheumatoid arthritis (RA) has been widely validated as a patient reported outcome measure (PROM). In the United Kingdom regulatory bodies such as the national institute of healthcare and clinical excellence (NICE) have been using improvement in HAQ as a surrogate for efficacy of drugs in RA and has informed their calculation of quality adjusted life year, and calculating health costs using incremental costs effectiveness ratios. Most clinical trials in RA report their primary outcome as improvement in clinical parameteers such as swollen and tender joints, inflammatory markers and patient and physician global assessment of disease. What is not clear how the two sets of parametes interact. Some reports<sup>1</sup> indicate that there is a strong correlation in early disease, but this has not been validated. <h3>Objectives</h3> We set out to determine the relationship bewteen HAQ scores and clinical paremeters of the Disaese activity score (DAS28) in addition to physician global. <h3>Methods</h3> Patients were recruited from a single centre from the RAMS study in the North west of England. This is a study of patients with early newly diagnosed RA commencing methotrexate A subset of patients filled in the HAQ questionanire and this as used as an outcome variable using linear regression and the swollen joints, tender joints, patient global assessment of disease as well as physician assessment of disease in addition to inflammatory markers were used as explanatory variables. These were then adjusted for age. <h3>Results</h3> 81 patients were included in the analysis. median age was 63.1 years (IQR 52.9,72.5). 50 (61.7%) were female. the median HAQ score at baseline was 1 (IQR 0.5,1.5) the median DAS28 score 5.3 (IQR 4.5,6.3). Tender joints at baseline correlated well with HAQ score Beta=0.058 95% CI, 0.04,0.08 (p&lt;0.01). Swollen joints did not correlate with the HAQ beta=0.000 (95%CI −0.3,0.3). Physician global correlated well with disease beta=0.014 (95%CI 0.005,0.022). Patient global assessment also correlated well with HAQ (beta 0.014 95% CI 0.008,0.020). CRP did not correlate with HAQ (beta 0.00261 95% CI −0.002,0.007) <h3>Conclusions</h3> In this small study, patient and physician related outcome measures correlate with HAQ scores at baseline more than measures of joint swelling and inflammatory markers. This indicates that using HAQ as an outcome measure underestimates the effect of treatment. When assessing the efficacy of drugs using HAQ this should be taken into account. Validity of the approach needs to be reviewed. <h3>Reference</h3> [1] Ann Rheum Dis. 2000Mar;59(3):223–6. <h3>Disclosure of Interest</h3> None declared