tbuckley/cabot-search huggingface dataset:
Assessment of a Day Hospital Management Program for Children With Type 1 Diabetes
Authors: Sarah Lawson, Jacob M. Redel, Allison Smego, Melanie Gulla, Pamela J. Schoettker, Mary Jolly, Farida Mostajabi, Lindsey Hornung
Journal: JAMA Network Open (2020)

A shift in the setting of care delivery for children with a new diagnosis of type 1 diabetes led to a reorganization of treatment.To determine whether a new diagnosis of pediatric diabetes can be successfully managed in a day hospital model.This quality improvement study used retrospectively collected data on pediatric patients with a new diagnosis of diabetes who completed an inpatient program for education and insulin titration prospectively compared with patients completing a diabetes day hospital program. Baseline data were collected over 12 months (January-December 2015) and intervention data collected over 14 months (March 2016-May 2017). The study was conducted at a single institution and judged as a nonhuman participant project. The referral local base included a 100-mile radius. Patient inclusion was a new diagnosis of diabetes, age 5 years or older, and no biochemical evidence of diabetic ketoacidosis. Ninety-six patients completed the day hospital program and 192 patients completed an inpatient program.All patients received 2 consecutive days of insulin titration and education in either a day hospital or inpatient setting.Primary outcomes included the mean length of stay, patient charge, and insurance denial/reimbursement rates. The hypothesis was that a day hospital program would be associated with a reduced length of stay, which would directly affect patient charges and insurance denials.Among the 96 day hospital patients, the mean (SD) age was 12.2 (4.7) years (range 5-20.3), with no patients experiencing diabetic ketoacidosis or hypernatremia. Among the 192 inpatient patients, the mean (SD) age was 9.4 (4.7) years (range, 1.6-20.1). The mean (SD) length of stay reduction in the day hospital was 46 (14.1) to 14 (5.1) hours. The mean day hospital patient charge was $2800, compared with a mean (SD) baseline carge of $24 103 ($9401). Within the first year, there was a cumulative reduction in patient charges of more than $2.1 million.This study's findings suggest that a diabetes day hospital setting was associated with reductions in length of stay and patient charges, with an increase in insurance reimbursements and a decrease in insurance denials. This study demonstrates an effective way to streamline new-onset diabetes education, which may reduce length of stay and patient charges. Reimbursement rates for patients with a new diagnosis of diabetes increased from 52% to 72% and reimbursement denial rates decreased from 80% to 0%.
Abstract 32: Joint Associations of Peripheral Artery Disease and Objectively-measured Physical Activity With Mortality: The Hispanic Community Health Study / Study of Latinos
Authors: Yumin Gao, Simin Hua, Yejin Mok, Qibin Qi, Guochong Chen, Matthew A Allison, Robert Kaplan, Kunihiro Matsushita
Journal: Circulation (2020)

Background: Peripheral artery disease (PAD) reduces physical activity, and both PAD and lower physical activity levels have been shown to increase mortality risk. Yet, their joint contributions to mortality have not been systematically studied, especially with the objective measure of physical activity. Hypothesis: PAD and lower 1-week objectively-measured physical activity are synergistically associated with mortality. Methods: We studied 7124 Hispanic adults aged 45-74 years at baseline from the Study of Latinos who adhered to an objective measure of physical activity using wearable accelerometers. We quantified the associations of the status of PAD (ankle-brachial index [ABI] ≤0.90 [PAD], 0.91-1.39 [no PAD], and ≥1.40 [possible PAD with ankle artery calcification]) and two physical activity measures (sedentary time [tertiles] and daily physical movement counts [tertiles]) at baseline with mortality using multivariable Cox models accounting for sampling weights. Results: During a median follow-up of 7.0 years, 289 participants died. Sedentary time and daily physical movement counts were weakly correlated (r=-0.17). Both low and high ABI, longer sedentary time, and lower physical movement counts were all independently associated with increased mortality risk (marginal cells in Table ). In terms of the joint associations of PAD and physical activity with mortality, they generally demonstrated synergistic associations (e.g., hazard ratio 4.43 [95%CI, 2.44-8.03] in ABI ≤0.9 plus top tertile of sedentary time and 5.46 [2.47-12.08] in ABI ≥1.40 plus top tertile of sedentary time vs. normal ABI with shortest sedentary time) (cross-categories in Table ), with no significant interactions. Conclusions: Both low and high ABI, and lower objectively-measured physical activity levels were significantly associated with greater risk of mortality independently of each other and potential confounders. Our results suggest the importance of objectively evaluating daily physical activity levels and leg vascular condition.
Abstract P6-10-13: Associated ductal carcinoma in situ in primary operated TNBC is associated with a longer time to distant event
Authors: Jan Ardui, Hans Wildiers, Giuseppe Floris, Hava Izci, Kevin Punie, Tatjana Geukens, Els Van Nieuwenhuysen, Sileny Han, Patrick Berteloot, Annouschka Laenen, Hilde Janssens, Ann Smeets, Caroline Weltens, Ignace Vergote, Patrick Neven
Journal: Cancer Research (2020)

Abstract Purpose We studied presence of accompanying ductal adenoma in situ (accom-DCIS) in a consecutive series of primary operated TNBC for distant time-to-event outcome. Methods A retrospective cohort study (diagnosis 1/1/2000 - 31/12/2017) of prospectively registered primary operated TNBC patients in UZ Leuven. Only TNBC of no special type were included. We compared patient (age, BMI, symptomatic/screening-detected) and tumor related factors (Nottingham Prognostic Index (NPI), Lymphovascular Involvement (LVI)) for accom-DCIS and analyzed the effect of accom-DCIS on distant time to event outcome using the Cox proportional hazards model. Multivariate models were used to correct for possible confounders. Results We included 524 patients. Median follow-up was 102 months. Mean age of patient was 57.3 [26-90] years and 361 had accom-DCIS (68,9 %); demographics, clinical-pathological characteristics and postoperative chemo- and radiotherapy were similar in patients with and without accom-DCIS; only LVI was significantly more likely to be present in accom-DCIS cases (p=&amp;lt;0.001). There were no differences in distant relapse rate (16.6% in accom-DCIS group vs 12.9% in no DCIS group [HR = 1.350, 95% CI (0.817;2.248) p=0.239]. Time to distant event was later if accom-DCIS was present: Mean time to distant event was 2.72yrs in the accom-DCIS group and 1.61yrs in the group with absent DCIS. In accom-DCIS 20/63 (31.8%) distant relapses occurred after 3 years while only 1/21 distant relapse (4.8%) occurred after 3 years in the non-DCIS group [HR =6.667, 95% CI (0.952-46.705) p=0,029]. Conclusion In our series of TNBCs, patients with and without accom-DCIS had similar distant relapse rates. Significantly more distant relapse occurred after 3 years in patients with accom-DCIS compared to patients without accom-DCIS. Citation Format: Jan Ardui, Hans Wildiers, Giuseppe Floris, Hava Izci, Kevin Punie, Tatjana Geukens, Els Van Nieuwenhuysen, Sileny Han, Patrick Berteloot, Annouschka Laenen, Hilde Janssens, Ann Smeets, Caroline Weltens, Ignace Vergote, Patrick Neven. Associated ductal carcinoma in situ in primary operated TNBC is associated with a longer time to distant event [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-10-13.
Transmission routes of 2019-nCoV and controls in dental practice
Authors: Xian Peng, Xin Xu, Yuqing Li, Lei Cheng, Xuedong Zhou, Biao Ren
Journal: International Journal of Oral Science (2020)

A novel β-coronavirus (2019-nCoV) caused severe and even fetal pneumonia explored in a seafood market of Wuhan city, Hubei province, China, and rapidly spread to other provinces of China and other countries. The 2019-nCoV was different from SARS-CoV, but shared the same host receptor the human angiotensin-converting enzyme 2 (ACE2). The natural host of 2019-nCoV may be the bat Rhinolophus affinis as 2019-nCoV showed 96.2% of whole-genome identity to BatCoV RaTG13. The person-to-person transmission routes of 2019-nCoV included direct transmission, such as cough, sneeze, droplet inhalation transmission, and contact transmission, such as the contact with oral, nasal, and eye mucous membranes. 2019-nCoV can also be transmitted through the saliva, and the fetal-oral routes may also be a potential person-to-person transmission route. The participants in dental practice expose to tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to saliva, blood, and other body fluids, and the handling of sharp instruments. Dental professionals play great roles in preventing the transmission of 2019-nCoV. Here we recommend the infection control measures during dental practice to block the person-to-person transmission routes in dental clinics and hospitals.
Risk Stratification of Prostate Cancer Through Quantitative Assessment of PTEN Loss (qPTEN)
Authors: Tamara Jamaspishvili, Palak G Patel, Yi Niu, Thiago Vidotto, Isabelle Caven, Rachel Livergant, Winnie Fu, Atsunari Kawashima, Nathan How, John B Okello, Liana B Guedes, Veronique Ouellet, Clarissa Picanço, Madhuri Koti, Rodolfo B Reis, Fred Saad, Anne-Marie Mes-Masson, Tamara L Lotan, Jeremy A Squire, Yingwei P Peng, D Robert Siemens, David M Berman
Journal: JNCI Journal of the National Cancer Institute (2020)

Phosphatase and tensin homolog (PTEN) loss has long been associated with adverse findings in early prostate cancer. Studies to date have yet to employ quantitative methods (qPTEN) for measuring of prognostically relevant amounts of PTEN loss in postsurgical settings and demonstrate its clinical application.PTEN protein levels were measured by immunohistochemistry in radical prostatectomy samples from training (n = 410) and validation (n = 272) cohorts. PTEN loss was quantified per cancer cell and per tissue microarray core. Thresholds for identifying clinically relevant PTEN loss were determined using log-rank statistics in the training cohort. Univariate (Kaplan-Meier) and multivariate (Cox proportional hazards) analyses on various subpopulations were performed to assess biochemical recurrence-free survival (BRFS) and were independently validated. All statistical tests were two-sided.PTEN loss in more than 65% cancer cells was most clinically relevant and had statistically significant association with reduced BRFS in training (hazard ratio [HR] = 2.48, 95% confidence interval [CI] = 1.59 to 3.87; P < .001) and validation cohorts (HR = 4.22, 95% CI = 2.01 to 8.83; P < .001). The qPTEN scoring method identified patients who recurred within 5.4 years after surgery (P < .001). In men with favorable risk of biochemical recurrence (Cancer of the Prostate Risk Assessment - Postsurgical scores <5 and no adverse pathological features), qPTEN identified a subset of patients with shorter BRFS (HR = 5.52, 95% CI = 2.36 to 12.90; P < .001) who may be considered for intensified monitoring and/or adjuvant therapy.Compared with previous qualitative approaches, qPTEN improves risk stratification of postradical prostatectomy patients and may be considered as a complementary tool to guide disease management after surgery.
Abstract P318: Prevalence and Trends of Type 2 Diabetes Mellitus and Prediabetes Among Community-Dwelling Heart Failure Patients in the U.S. 2005-2016: A National Health and Nutrition Examination Survey (NHANES) Analysis
Authors: Yuta Ishikawa, Richard D Lewis, Emma M Laing, Alex K Anderson, Donglan Zhang, Arshed A Quyyumi, Sandra B Dunbar, Rupal Trivedi, Elisabeth L Sattler
Journal: Circulation (2020)

Introduction: Recent scientific statements highlight the importance of understanding the effects of the coexistence of heart failure (HF) and type 2 diabetes mellitus (T2DM) on disease management decisions and patient outcomes. Various prevalence estimates of the T2DM burden among HF patients have been reported; however, national estimates are not available. The objective of the study was to assess the prevalence and trends of T2DM (total, diagnosed, and undiagnosed) and prediabetes among community-dwelling HF patients using nationally representative data. Methods: We included 473 participants (20+ years) with a diagnosis of HF using data from the 2005-2016 NHANES survey cycles. Diagnosed T2DM was defined by self-report of a previous physician diagnosis. Undiagnosed T2DM was defined by the absence of a physician diagnosis and the presence of ≥ 1 of 3 criteria: 1) Two-hour plasma glucose (2hPG) after oral glucose tolerance test (OGTT) ≥ 200 mg/dL, 2) Hemoglobin A1c (HbA1c) ≥ 6.5%, 3) Fasting plasma glucose (FPG) ≥ 126 mg/dL. Total T2DM was defined as having diagnosed or undiagnosed T2DM. Prediabetes was defined by the absence of T2DM and the presence of ≥ 1 of 3 criteria: 1) 2hPG after OGTT of 140 mg/dL to 199 mg/dL, 2) HbA1c of 5.7% to 6.4%, 3) FPG of 100 mg/dL to 125mg/dL. We stratified estimates by age-standardized socio-demographic characteristics. Trends of the prevalence of T2DM and prediabetes were examined using logistic regressions. Results: The prevalence rates of total, diagnosed, and undiagnosed T2DM and prediabetes among HF patients were 51.4% (95% CI, 46.0%-56.7%), 37.5% (31.7%-43.6%), 13.8% (10.0%-18.2%), and 36.0% (30.2%-42.1%), respectively. The prevalence of T2DM and prediabetes did not significantly change across individual survey cycles. Conclusion: Rates of T2DM and prediabetes among community-dwelling HF patients in the U.S have been persistently high over the past decade. These findings support the need for the prevention and targeted intervention of T2DM in HF patients.
MICROBIOTA INSIGHTS IN CLOSTRIDIUM DIFFICILE INFECTION AND INFLAMMATORY BOWEL DISEASE
Authors: C. Rodríguez, E. Romero, L. Garrido-Sanchez, G. Alcaín-Martínez, RJ. Andrade, B. Taminiau, G. Daube, E. García-Fuentes
Journal: Gut Microbes (2020)

Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation that includes Crohn´s disease (CD) and ulcerative colitis (UC). Although the etiology is still unknown, some specific factors have been directly related to IBD, including genetic factors, abnormal intestinal immunity, and/or gut microbiota modifications. Recent findings highlight the primary role of the gut microbiota closely associated with a persistent inappropriate inflammatory response. This gut environment of dysbiosis in a susceptible IBD host can increasingly worsen and lead to colonization and infection with some opportunistic pathogens, especially Clostridium difficile. C. difficile is an intestinal pathogen considered the main cause of antibiotic-associated diarrhea and colitis and an important complication of IBD, which can trigger or worsen an IBD flare. Recent findings have highlighted the loss of bacterial cooperation in the gut ecosystem, as well as the pronounced intestinal dysbiosis, in patients suffering from IBD and concomitant C. difficile infection (CDI). The results of intestinal microbiota studies are still limited and often difficult to compare because of the variety of disease conditions. However, these data provide important clues regarding the main modifications and interrelations in the complicated gut ecosystem to better understand both diseases and to take advantage of the development of new therapeutic strategies. In this review, we analyze in depth the gut microbiota changes associated with both forms of IBD and CDI and their similarity with the dysbiosis that occurs in CDI. We also discuss the metabolic pathways that favor the proliferation or decrease in several important taxa directly related to the disease.
Abstract P382: Impact Of Autoimmune Disease On Acute Venous Thromboembolism Incidence After Pregnancy
Authors: Rob F Walker, Susan M Mason, Neil A Zakai, Richard F Maclehose, Faye L Norby, Alvaro Alonso, Pamela L Lutsey
Journal: Circulation (2020)

Introduction: Venous thromboembolism (VTE) is a leading cause of mortality in the postpartum period. Several autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus and Crohn’s disease, have been found to increase risk of VTE by upregulating the body’s procoagulants while decreasing physiologic anticoagulants via systemic inflammation. No existing studies have estimated the association of these risk factors exclusively among postpartum women. Hypothesis: Presence of autoimmune disease will be associated with increased risk of VTE among postpartum women. Methods: We identified a cohort of 755,722 women ages 15-45 with an international classification of disease code (ICD) for delivery in the 2011-2017 U.S. MarketScan Commercial administrative database. The exposure of prevalent autoimmune disease, represented by 29 endocrine, antibody positive, digestive and vascular diseases, was identified by two or more inpatient or outpatient ICD codes occurring before a woman’s delivery date. VTE events between the delivery hospital discharge and 12 weeks postpartum were defined using validated algorithms of ICD codes and confirmatory evidence of anticoagulant prescriptions. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) adjusted for age, hypertension, gestational diabetes, preeclampsia, multiple gestation and antepartum hemorrhage. Associations were also evaluated separately by specific autoimmune disease category (endocrine, antibody positive, digestive, vascular). Results: The average age of women was 30.7 years (SD: 5.4 years) and 27,322 out of the 755,722 deliveries (3.6%) occurred among women with prevalent autoimmune disease. Of these, 10,555 were endocrine diseases (1.4%), 12,851 were antibody positive diseases (1.7%), 4,634 were digestive diseases (0.6%) and 353 were vascular diseases (0.1%). There were 3,502 postpartum VTE events; among them 235 (6.7%) occurred in women with prevalent autoimmune disease. In the adjusted model, women with autoimmune disease had higher postpartum rate of VTE (HR: 1.54; 95%CI: 1.25, 1.90) relative to those without. When evaluating the subgroups separately, the rate of VTE was elevated among women with digestive (HR: 1.73; 95%CI: 1.09, 2.76) and antibody positive (HR: 1.82; 95%CI: 1.38, 2.39) autoimmune diseases. Conclusions: Women with autoimmune disease were at 50% greater risk of postpartum VTE as compared to women without these conditions. The association was more pronounced for women with digestive and antibody positive autoimmune disease. Given the importance of maternal mortality as an outcome, these findings suggest value for increasing VTE awareness among women with these autoimmune conditions and their healthcare providers.
Abstract #4996: Combined genome and transcriptome analysis of single disseminated EpCAM-positive tumor cells from the bone marrow of prostate cancer patients
Authors: Miodrag GuEvić, Andreas Blana, Bernhard Polzer, Matthias Maneck, Rainer Spang, Christoph Klein
Journal: Cancer Research (2009)

Cancer of the prostate is the most frequently diagnosed cancer in males and the third leading cause of cancer deaths. Clinical progression of prostate cancer is variable and difficult to predict. Death from prostate cancer is often due to metastases arising years after surgery, with the bone being the preferred site of metastasis in 80% of metastatic patients. Detection of early disseminated tumor cells (DTC) in bone marrow (BM) of carcinoma patients without distant metastasis is associated with poor prognosis. Since DTC comprise putative precursor cells of later arising metastasis, they are likely targets for adjuvant therapies. DTC are extremely rare and can be detected using antibodies against epithelial markers, such as cytokeratins (CK) and EpCAM. Since EpCAM is expressed on cancer stem cells of various cancers, we aimed to comprehensively characterize EpCAM+ DTC from the BM of prostate cancer patients. We have screened the BM of prostate cancer patients using immunofluorescent staining against EpCAM and markers associated with stemness in prostate cancer, CD44 and CD133. Single EpCAM+ DTC were isolated using a micromanipulator. From these single cells we have isolated and separated total mRNA and genomic DNA, which were subjected to global amplification. Gene expression profiles of single cells were examined using DNA oligonucleotide microarrays, while genomic aberrations were assessed using comparative genomic hybridization. Within the EpCAM+ cells stained for CD44 or CD133, we found equal distribution of EpCAM+/CD44+ and EpCAM+/CD44- cells, and 70% of EpCAM+/CD133- and 30% of EpCAM+/CD133+ cells, respectively. Gene expression analysis of different subpopulations of DTC is currently underway, aiming to determine the expression status of genes regulating tumor dormancy, EMT, tumor aggressiveness and proliferation. So far, the observed phenotypic and genetic heterogeneity suggests the existence of different functional states of DTC.Comprehensive molecular characterization of EpCAM+ DTC might also reveal novel molecular targets for adjuvant therapy.  Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 4996.
Radiation dose is significantly associated with overall survival in patients with stage III non-small cell lung cancer treated with combined radiation and chemotherapy
Authors: L. Wang, L. Zhao, J. Hayman, G. Kalemkerian, F. Kong
Journal: Journal of Clinical Oncology (2007)

18074 Background: Radiation dose is an independent prognostic factor for survival in patients with early stage non-small cell lung cancer (NSCLC). We hypothesized that radiation dose is also a significant independent factor associated with survival in patients with stage III disease treated with combined radiation and chemotherapy. Methods: This is an Institutional Review Board approved retrospective study. Eligible subjects included those with stage III NSCLC registered in the radiation oncology database at University of Michigan Hospital between January 1992 and July 2004. Radiation was given using 3-dimensional conformal technique with doses ranging from 30 to 102.9 Gy, corresponding to a bioequivalent dose (BED) of 39 to 124.5Gy. Median age was 65 years (range, 36–89). There were 80 males and 67 females. Median follow-up was 13.0 months (range, 2.7–145.9). Results: For patients treated with radiation alone (n=40), sequential chemoradiation (n=42), and concurrent chemoradiation (n=65), median survival was 8.6 (95% CI: 5.7–11.5), 12.8 (95% CI: 9.5–16.0) and 15.4 (95% CI: 12.7–18.0) months, respectively (P =0 .011). Multivariate Cox-regression analysis showed that BED (HR=0.96, 95% CI: 0.95–0.97, P&lt;0.001) and administration of chemotherapy (HR=0.44, 95% CI: 0.28–0.70, P=0.001) were independent prognostic factors associated with the risk of death. T stage was marginally significant (P=0.065). Age, gender and N stage were not independent factors (P&gt;0.05). To isolate the BED effect, multivariate analysis was performed separately in patients treated with and without chemotherapy: the hazard ratios of BED for the risk of death were 0.97 (95% CI: 0.95–0.99, P=0 .013) and 0.95 (95% CI: 0.93–0.98, P=0.001), respectively. BED also remained a significant independent prognostic factor in patients treated with chemotherapy and radiation in the dose range of 60–66 Gy (HR=0.91, 95% CI: 0.84–0.99, P=0.041). Conclusions: Radiation dose is significantly associated with survival in patients with stage III NSCLC treated with combined radiation and chemotherapy. No significant financial relationships to disclose.