tbuckley/cabot-search huggingface dataset:
Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes
Authors: Muhammad Shahzeb Khan, Noman Lateef, Tariq Jamal Siddiqi, Karim Abdur Rehman, Saed Alnaimat, Safi U. Khan, Haris Riaz, M. Hassan Murad, John Mandrola, Rami Doukky, Richard A. Krasuski
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Clinical researchers are obligated to present results objectively and accurately to ensure readers are not misled. In studies in which primary end points are not statistically significant, placing a spin, defined as the manipulation of language to potentially mislead readers from the likely truth of the results, can distract the reader and lead to misinterpretation and misapplication of the findings. <h3>Objective</h3> To determine the level and prevalence of spin in published reports of cardiovascular randomized clinical trial (RCT) reports. <h3>Data Source</h3> MEDLINE was searched from January 1, 2015, to December 31, 2017, using the Cochrane highly sensitive search strategy. <h3>Study Selection</h3> Inclusion criteria were parallel-group RCTs published from January 1, 2015, to December 31, 2017 in 1 of 6 high-impact journals (<i>New England Journal of Medicine</i>,<i>The Lancet</i>,<i>JAMA</i>,<i>European Heart Journal</i>,<i>Circulation</i>, and<i>Journal of the American College of Cardiology</i>) with primary outcomes that were not statistically significant were included in the analysis. <h3>Data Extraction and Synthesis</h3> Analysis began in August 2018. Data were extracted and verified by 2 independent investigators using a standard collection form. In cases of disagreement between the 2 investigators, a third investigators served as arbitrator. <h3>Main Outcomes and Measures</h3> The classifications of spin type, severity, and extent were determined according to predefined criteria. Primary clinical outcomes were divided into safety of treatment, efficacy of treatment, and both. <h3>Results</h3> Of 587 studies identified, 93 RCT reports (15.8%) met inclusion criteria. Spin was identified in 53 abstracts (57%; 95% CI, 47%-67%) and 62 main texts of published articles (67%; 95% CI, 57%-75%). Ten reports (11%; 95% CI, 6%-19%) had spin in the title, 35 reports (38%; 95% CI, 28%-48%) had spin in the results section, and 50 reports (54%; 95% CI, 44%-64%) had spin in the conclusions. Among the abstracts, spin was observed in 38 results sections (41%; 95% CI, 31%-51%) and 45 conclusions sections (48%; 95% CI, 38%-58%). <h3>Conclusions and Relevance</h3> This study suggests that in reports of cardiovascular RCTs with statistically nonsignificant primary outcomes, investigators often manipulate the language of the report to detract from the neutral primary outcomes. To best apply evidence to patient care, consumers of cardiovascular research should be aware that peer review does not always preclude the use of misleading language in scientific articles.
Management of postoperative nausea and vomiting
Authors: Ronan O'Leary, Sharan Wadhwani, Peter Cole
Journal: BMJ (2006)

Patients who experience postoperative nausea and vomiting describe it as the worst side effect of their surgery and remember it for longer than any other side effect. <b>Ronan O9Leary</b> and coauthors explain a stepwise approach to managing this important surgical complication
Australia runs short of rural doctors
Authors: Toby Reynolds
Journal: BMJ (2006)

When former horse breaker and truck driver Dr Tony Lian-Lloyd won Australia's rural doctor of the year award, he fitted the bill in more than one way. As a solo practitioner in the Flinders Ranges town of Quorn, South Australia (population about 1500), who dips into anaesthesia, surgery, and obstetrics in hospitals up to 90 km away, Dr Lian-Lloyd epitomised the jack of all trades outback doctor. When the Australian Broadcasting Corporation reported that he was having trouble finding a locum to cover for him so that he could collect his award, his difficulties pointed to rural Australian medicine's other outstanding feature: a lack of manpower.

Australia's rural areas are short of doctors, and the problem is getting worse. Unless something …
Abstract 18206: Patient Factors but not the use of Novel Anticoagulants or Warfarin are associated With Internal Jugular Vein access site Hematoma After Right Heart Catheterization
Authors: Osama Dasa, Qaiser Shafiq, Mohammed Ruzieh, Khaled Shunnar, Maen Al-Dabbas, Luai Alhazmi, Samer Khouri, George V Moukarbel
Journal: Circulation (2016)

Introduction: Right heart catheterization (RHC) is routinely performed to assess hemodynamics. Generally, anticoagulants are held prior to the procedure. At our center, anticoagulants are continued...
Response to: ‘Antinuclear antibodies: mitotic patterns and their clinical associations’ by Betancur and Gómez-Puerta
Authors: Jan Damoiseaux, Luis Eduardo Coelho Andrade
Journal: Annals of the Rheumatic Diseases (2019)

It is very much appreciated that the correspondence of Betancur and Gomez-Puerta1 calls for attention for the clinical relevance of mitotic patterns observed in HEp-2 indirect immunofluorescence assays (IIFA). Indeed, in the recent publication of the International Consensus on ANA Patterns (ICAP) consortium, it is concluded that the clinical relevance of the mitotic patterns is limited.2 With exception of the Nuclear Mitotic Apparatus (NuMA)-like pattern (anti-cellular (AC)-26), there is not much available evidence that these patterns clearly hint at a particular clinical manifestation. For the NuMA-like pattern, there is formal evidence that approximately one-half of the patients have clinical features of a systemic autoimmune disease, especially Sjogren’s syndrome, polymyalgia rheumatica, systemic lupus erythematosus, polymyositis and autoimmune hepatitis.3 ICAP initially defined 28 patterns ordered in a classification tree based on nuclear, cytoplasmic or mitotic reactivity of autoantibodies on HEp-2 cells.4 Subsequently, the nuclear Topo I-like pattern (AC-29) was added,5 and the codes AC-0 and AC-XX were given to negative results or undefined patterns, respectively.6 The international consensus, as defined in the …
Abstract 15003: Impact of Intensive Care Unit and Acute Care Unit Length of Stay on Total Length of Stay Following Congenital Heart Surgery: A Joint PC4 and PAC3 Multicenter Analysis
Authors: Stephen A Hart, Ronn E Tanel, Alaina K Kipps, Amanda Hoerst, Margaret Graupe, Steven C Cassidy, Anthony M Hlavacek, Martha L Clabby, Lauren Bush, Wenying Zhang, Mousumi Banerjee, Sara K Pasquali, Michael G Gaies, Nicolas Madsen
Journal: Circulation (2018)

Introduction: Length of stay (LOS), an important quality metric and cost driver, is known to vary widely across hospitals following congenital heart surgery. Whether this variability is influenced ...
Abstract 19140: Early Repolarization Syndrome Caused by a de novo KCND3 Gain-of-Function Mutation
Authors: Koichiro Takayama, Seiko Ohno, Wei-Guang Ding, Hiroaki Kise, Minako Hoshiai, Hiroshi Matsuura, Minoru Horie
Journal: Circulation (2017)

Background: Early repolarization syndrome (ERS) is characterized by J-point elevation in the ECG and ventricular fibrillation (VF). Although mutations in genes encoding potassium, sodium, or calciu...
Nischarin Regulates Secretion of Exosomes and Cancer Progression
Authors: Kathleen M. McAndrews, Raghu Kalluri
Journal: Cancer Research (2019)

Abstract The intercellular exchange of exosomes may play a regulatory function in tumor progression and metastasis. Maziveyi and colleagues demonstrated that Nischarin regulated the secretion of exosomes from breast cancer cells. Loss of Nischarin expression increased exosome production and promoted tumor cell growth and migration, supporting that Nischarin can influence the behavior of surrounding cancer cells. This study identified a novel function of the tumor suppressor Nischarin in exosome biology and cancer progression. See related article by Maziveyi et al., p. 2152
Abstract 19031: Amino Acid Pathways are Altered in Cardiovascular Complications of Pregnancy
Authors: Erin P Ferranti, Jennifer K Frediani, Elizabeth J Corwin, Anne L Dunlop
Journal: Circulation (2017)

Background: Specific metabolites have been associated with cardiovascular complications of pregnancy, however studies in African American (AA) women are lacking. Objectives: The purpose of this study was to investigate metabolomics pathways in early gestation that associate with a later diagnosis of a cardiovascular complications of pregnancy, including gestational hypertension and preeclampsia, in AA women. Methods: We conducted a retrospective analysis of pregnant AA women 18-40 years of age who had cardiovascular complications of pregnancy (preeclampsia - n=9; gestational hypertension (gHTN) - n=9) and who had uncomplicated, full-term pregnancies (n=86). Participants had serum samples collected between 8-14 weeks gestation and had medical chart abstraction following pregnancy to identify cardiovascular complications. High-resolution liquid chromatography mass spectrometry (LC-MS) was used to measure serum metabolites. Statistical tests of significance included t-tests with Benjamini-Hochberg correction...
Swindon man sets new record for longest hospital wait on a trolley
Authors: Karen Hebert
Journal: BMJ (2003)

The Guinness Book of World Records created an official new category of world record in January, that of “the longest hospital trolley wait duration.”



The unenviable title was awarded to Tony Collins, a 40 year old diabetic care worker from Swindon. Collins, a father of two, spent 77 hours and 30 minutes on a hospital trolley in the Princess Margaret Hospital in Swindon.

Officials from the Guinness Book of World Records have checked and …
Corrections to “Soft tissue and visceral sarcomas: ESMO–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up”
Authors: P.G. Casali, N. Abecassis, H.T. Aro, S. Bauer, R. Biagini, S. Bielack, S. Bonvalot, I. Boukovinas, J V M G Bovee, T. Brodowicz, J.M. Broto, A. Buonadonna, E. De Álava, A.P. Dei Tos, X.G. Del Muro, P. Dileo, M. Eriksson, A. Fedenko, V. Ferraresi, A. Ferrari, S. Ferrari, A.M. Frezza, S. Gasperoni, H. Gelderblom, T. Gil, G. Grignani, A. Gronchi, R.L. Haas, B. Hassan, P. Hohenberger, R. Issels, H. Joensuu, R.L. Jones, I. Judson, P. Jutte, S. Kaal, B. Kasper, K. Kopeckova, D.A. Krákorová, A. Le Cesne, I. Lugowska, O. Merimsky, M. Montemurro, M.A. Pantaleo, R. Piana, P. Picci, S. Piperno-Neumann, A.L. Pousa, P. Reichardt, M.H. Robinson, P. Rutkowski, A.A. Safwat, P. Schöffski, S. Sleijfer, S. Stacchiotti, K. Sundby Hall, M. Unk, F. Van Coevorden, W.T.A. van der Graaf, J. Whelan, E. Wardelmann, O. Zaikova, J.Y. Blay
Journal: Annals of Oncology (2018)
Randomized phase III KEYNOTE-045 trial of pembrolizumab versus paclitaxel, docetaxel, or vinflunine in recurrent advanced urothelial cancer: results of &gt;2 years of follow-up
Authors: Y. Fradet, J. Bellmunt, D.J. Vaughn, J.L. Lee, L. Fong, N.J. Vogelzang, M.A. Climent, D.P. Petrylak, T.K. Choueiri, A. Necchi, W. Gerritsen, H. Gurney, D.I. Quinn, S. Culine, C.N. Sternberg, K. Nam, T.L. Frenkl, R.F. Perini, R. de Wit, D.F. Bajorin
Journal: Annals of Oncology (2019)

Novel second-line treatments are needed for patients with advanced urothelial cancer (UC). Interim analysis of the phase III KEYNOTE-045 study showed a superior overall survival (OS) benefit of pembrolizumab, a programmed death 1 inhibitor, versus chemotherapy in patients with advanced UC that progressed on platinum-based chemotherapy. Here we report the long-term safety and efficacy outcomes of KEYNOTE-045.Adult patients with histologically/cytologically confirmed UC whose disease progressed after first-line, platinum-containing chemotherapy were enrolled. Patients were randomly assigned 1 : 1 to receive pembrolizumab [200 mg every 3 weeks (Q3W)] or investigator's choice of paclitaxel (175 mg/m2 Q3W), docetaxel (75 mg/m2 Q3W), or vinflunine (320 mg/m2 Q3W). Primary end points were OS and progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1) by blinded independent central radiology review (BICR). A key secondary end point was objective response rate per RECIST v1.1 by BICR.A total of 542 patients were enrolled (pembrolizumab, n = 270; chemotherapy, n = 272). Median follow-up as of 26 October 2017 was 27.7 months. Median 1- and 2-year OS rates were higher with pembrolizumab (44.2% and 26.9%, respectively) than chemotherapy (29.8% and 14.3%, respectively). PFS rates did not differ between treatment arms; however, 1- and 2-year PFS rates were higher with pembrolizumab. The objective response rate was also higher with pembrolizumab (21.1% versus 11.0%). Median duration of response to pembrolizumab was not reached (range 1.6+ to 30.0+ months) versus chemotherapy (4.4 months; range 1.4+ to 29.9+ months). Pembrolizumab had lower rates of any grade (62.0% versus 90.6%) and grade ≥3 (16.5% versus 50.2%) treatment-related adverse events than chemotherapy.Long-term results (>2 years' follow-up) were consistent with those of previously reported analyses, demonstrating continued clinical benefit of pembrolizumab over chemotherapy for efficacy and safety for treatment of locally advanced/metastatic, platinum-refractory UC.ClinicalTrials.gov: NCT02256436.
Leading US academic tells Student BMJ Ritalin use in students is acceptable
Authors: Upasana Tayal
Journal: BMJ (2003)

A leading US academic, Professor Martha Farah, told the Student BMJ that it is acceptable for students to take the prescription medicine Ritalin to get a study boost.

Illegal use of Ritalin is on the rise across US campuses, with more and more students reporting taking the stimulant. The drug, best known for treating people with attention deficit hyperactivity disorder (ADHD), enhances attention and increases the ability to focus and ignore distractions. Possible side effects include insomnia, night terrors, and tremors, as well as dependence and tolerance.

But Professor Farah, director of the …
The Tyranny of Health: Doctors and the Regulation of Lifestyle
Authors: Andrew Moscrop
Journal: BMJ (2001)

“The key event in catalysing the transformation of general practice into an interventionist agency of social control was the election of the New Labour government in May 1997,” asserts Michael Fitzpatrick in his new critique of medical practice and policy in modern Britain.

The benign GP an agent of social control? And Tony Blair responsible? Read on. The author argues convincingly that the government is exploiting the medical profession to promote its popularity and increase its authority over the public.

Fitzpatrick begins his readable and thought provoking polemic …
Combination Antiplatelet and Oral Anticoagulant Therapy in Patients With Coronary and Peripheral Artery Disease
Authors: Paul A. Gurbel, Keith A.A. Fox, Udaya S. Tantry, Hugo ten Cate, Jeffrey I. Weitz
Journal: Circulation (2019)

Antiplatelet therapy is the mainstay for the treatment of acute and chronic arterial disease involving the coronary and peripheral beds. However, questions remain about optimal antithrombotic therapy for long-term treatment of chronic vascular disease. The observation that dual antiplatelet therapy with acetylsalicylic acid and clopidogrel was associated with lower thrombotic event rates than acetylsalicylic acid monotherapy in patients with acute coronary syndromes and those undergoing percutaneous coronary intervention changed the treatment paradigm. Moreover, the demonstration that more pharmacodynamically potent P2Y 12 inhibitors than clopidogrel were associated with fewer thrombotic event occurrences further solidified the dual antiplatelet therapy approach. However, recurrent thrombotic events occur in ≈1 in 10 patients in the first year following an acute coronary syndrome event, despite treatment with the most potent P2Y 12 inhibitors, a limitation that has stimulated interest in exploring the efficacy and safety of approaches using anticoagulants on top of antiplatelet therapy. These investigations have included treatment with very-low-dose oral anticoagulation, and even its replacement of acetylsalicylic acid in the presence of a P2Y 12 inhibitor, in patients stabilized after an acute coronary syndrome event. Recent basic and translational studies have suggested noncanonical effects of coagulation factor inhibition that may further modulate clinical benefits. This in-depth review will discuss developments in our understanding of the roles that platelets and coagulation factors play in atherothrombosis and review the rationale and clinical evidence for combining antiplatelet and oral anticoagulant therapy in patients with coronary and peripheral artery disease.
Abstract 9779: Abdominal Aortic Aneurysm Formation was Suppressed by an Agonist for α7 Nicotinic Acetylcholine Receptor via NF-kB Inactivation
Authors: Hiroshi Kojima, Tomotake Tokunou, Aya Watanabe, Toshihiro Ichiki, Kenji Sunagawa
Journal: Circulation (2015)

Background: Previously we reported that activation of vagal nerve by acetylcholinesterase inhibitors attenuated atherogenesis via suppression of inflammatory responses. α7 nicotinic acetylcholine receptor (nAchR) plays an important role in vagal nerve activation. We sought to determine whether AR-R17779, a selective agonist of α7 nAchR, affects the development of abdominal aortic aneurysm (AAA). Methods and Results: AAA was induced by topical application of calcium chloride (CaCl2) to abdominal aorta (AAA group). NaCl (0.9%) was substituted for CaCl2 as a sham operation (SHAM group). AR-R17779 was administered in drinking water (AAA/AR-R group). One and 6 weeks after the operation, aortic tissue was excised for histological and molecular analyses. Aortic diameter and macrophage infiltration into the aortic adventitia were increased in AAA group compared with SHAM group at 6 weeks. Treatment with AR-R17779 reduced the diameter of the aorta (0.73±0.10 mm vs. 1.07±0.15 mm in AAA, p&lt;0.01) and macrophage infiltration compared with AAA group. Wavy morphology of the elastic lamellae was lost in AAA group while it was preserved in AAA/AR-R group. Expression of inflammatory cytokines (IL-1β, IL-6, MCP-1) and matrix metalloproteinase (MMP)-2 and 9 activities were enhanced in AAA group, which was suppressed in AAA/AR-R group. AR-R17779 treatment suppressed CaCl2-induced expression of cytokines, activities of MMPs and NF-κB activation (p65 phosphorylation) at 1 week when aortic dilatation had not been developed. Conclusion: Treatment with AR-R17779 prevented the enlargement of abdominal aorta induced by CaCl2 in association with reduced inflammation and extracellular matrix disruption via NF-kB inactivation. These findings suggest a therapeutic potential of α7nAchR activation for prevention of AAA development.
Thermal imaging may help catch terrorists
Authors: Deboshree Basu-Choudhuri
Journal: BMJ (2002)

A revolutionary new lie detector, incorporating a high definition thermal imaging camera that can detect thermal pattern changes around the eyes, has been developed ( Nature 2002;415:35).

To test the camera 20 volunteers were asked to commit a mock crime--to stab a mannequin and grab $20 from its hand--and then to proclaim their innocence. The camera imaged their faces while they were questioned (figure). Volunteers in a control group were not aware of the crime. …
Exercising in the afternoon is better than the morning
Authors: Karen Hebert
Journal: BMJ (2003)

Phyllis Zee, a neurologist from Northwestern University, has challenged the view that morning workouts are better than exercising in the afternoon.

“The best time to workout is in the late afternoon,” Zee told US television channel CNN. “The reason for that is that your muscle strength is at its peak, its highest. You are going to …
Suicide report attacks men's magazines
Authors: Siân Knight
Journal: BMJ (2000)

Magazines aimed at the male youth market may be partly responsible for the rising suicide rate among young men, according to a report published last month by the Men's Health Forum.

Psychologist Trefor Lloyd, a Forum executive, blamed the magazines for celebrating a “laddish” culture in a society where such behaviour is out-dated. “For the first time, next year women will make up 51% of the workforce. Men have had to cope with losing their role as the only breadwinners, rising unemployment and a …
Correction to: Comprehensive benchmarking and ensemble approaches for metagenomic classifiers
Authors: Alexa B. R. McIntyre, Rachid Ounit, Ebrahim Afshinnekoo, Robert J. Prill, Elizabeth Hénaff, Noah Alexander, Samuel S. Minot, David Danko, Jonathan Foox, Sofia Ahsanuddin, Scott Tighe, Nur A. Hasan, Poorani Subramanian, Kelly Moffat, Shawn Levy, Stefano Lonardi, Nick Greenfield, Rita R. Colwell, Gail L. Rosen, Christopher E. Mason
Journal: Genome biology (2019)

Following publication of the original article [1], the authors would like to highlight the following two corrections.
Epidermal autophagy and beclin 1 regulator 1 and loricrin: a paradigm shift in the prognostication and stratification of the American Joint Committee on Cancer stage I melanomas
Authors: R. Ellis, D. Tang, B. Nasr, A. Greenwood, A. McConnell, M.E. Anagnostou, M. Elias, S. Verykiou, D. Bajwa, T. Ewen, N.J. Reynolds, P. Barrett, E. Carling, G. Watson, J. Armstrong, A.J. Allen, S. Horswell, M. Labus, P.E. Lovat
Journal: British Journal of Dermatology (2019)

BackgroundThe updated American Joint Committee on Cancer (AJCC) staging criteria for melanoma remain unable to identify high‐risk stage I tumour subsets.
Nightclubs said to be cause of serious TB outbreak
Authors: Helen Barratt
Journal: BMJ (2001)

Last month the Daily Mail reported that young people in crowded nightclubs were spreading tuberculosis (TB) and causing a serious “outbreak.” The London Evening Standard also stated that, according to experts, “the hot, sweaty conditions of nightclubs and busy bars are ideal places for bacteria to breed. The disease can be spread by the saliva of a TB sufferer, either through kissing or sharing a drink.”



A spokesperson from the Department of Health confirmed that around 60 cases of the isoniazid-resistant TB had been seen over the past six years in Greater London. However, …
Etanercept biosimilar SB4 in the treatment of plaque‐type psoriasis and psoriatic arthritis: a single‐centre, observational, retrospective, real‐life study
Authors: A. Giunta, V. Manfreda, M. Esposito, E. Del Duca, L. Bianchi
Journal: British Journal of Dermatology (2019)

The approval of the etanercept biosimilar SB4 (Brenzys, Benepali; Samsung Bioepis Co., Ltd.) for psoriasis and psoriatic arthritis (PsA) was automatically obtained on the basis of the demonstration of quality, biological activity, efficacy, safety, and immunogenicity similarity to the reference etanercept in the treatment of rheumatoid arthritis (1, 2). Being the development of biosimilars a significant opportunity to decrease medical care cost and increase treatment options (3), extrapolation of clinical data from other indications determined an intense scientific debate on the interchangeability between originator and biosimilar in real-life, and recently reports on efficacy and safety of the biosimilar SB4 in plaque-type psoriasis have been published (4, 5). The aim of our observational, retrospective, single-center, study was to investigate the etanercept biosimilar SB4 in patients affected by plaque-type psoriasis and PsA. This article is protected by copyright. All rights reserved.
Abstract 15313: Effect of Omega-3 Fatty Acids on Cardiovascular Outcomes in High Risk Patients With Mild Hypertriglyceridemia: A Meta-Analysis
Authors: Hammad U Rahman, Safi U Khan, Tehseen Hammad, Edo Kaluski
Journal: Circulation (2018)

Background: The efficacy of Ω-3 fatty acids in high risk patients (history of coronary artery disease or hypercholesterolemia) with mild hypertriglyceridemia (150-199 mg/dl) remains unclear. Object...