tbuckley/cabot-search huggingface dataset:
Visual and Patient-Reported Outcomes of a Diffractive Trifocal Intraocular Lens Compared with Those of a Monofocal Intraocular Lens
Authors: Satish Modi, Robert Lehmann, Andrew Maxwell, Kerry Solomon, Robert Cionni, Vance Thompson, Jeffrey Horn, Michael Caplan, Bret Fisher, Jerry G. Hu, Elizabeth Yeu
Journal: Ophthalmology (2020)

To evaluate the effectiveness and safety of a trifocal intraocular lens (IOL), the TFNT00 (Alcon, Fort Worth, TX), versus a monofocal IOL, the SN60AT (Alcon).Food and Drug Administration-approved, prospective, multicenter, nonrandomized, parallel-group, assessor-masked, confirmatory trial.Patients enrolled were 22 years of age or older with a diagnosis of bilateral cataract with planned removal by phacoemulsification with a clear corneal incision.Consented participants selected their preferred IOL, which was implanted sequentially into each eye of patients meeting eligibility criteria.The coprimary effectiveness outcomes were mean photopic monocular best-corrected distance visual acuity (BCDVA; 4 m) and distance-corrected near visual acuity (DCNVA; 40 cm) at 6 months after surgery. Secondary effectiveness outcomes included mean monocular distance-corrected intermediate visual acuity (DCIVA; 66 cm) and proportion of participants responding "never" to question 1 of the Intraocular Lens Satisfaction questionnaire (regarding frequency of spectacle use in the past 7 days). Safety outcomes included frequency of "severe" and "most bothersome" visual disturbances.Two hundred forty-three patients underwent cataract surgery with bilateral implantation of the TFNT00 (n = 129) or SN60AT (n = 114) and were followed up for 6 months. Noninferiority of TFNT00 to SN60AT in mean photopic monocular BCDVA (95% upper confidence limit of the difference was <0.1 logarithm of the minimum angle of resolution [logMAR] margin), and superiority in mean photopic monocular DCNVA (difference of 0.42 logMAR; P < 0.001) and DCIVA (difference of 0.26 logMAR; P < 0.001) were demonstrated. The proportion of patients never requiring glasses overall was superior for TFNT00 versus SN60AT (80.5% and 8.2%, respectively). Starbursts, halos, and glare were the most frequently rated severe symptoms with TFNT00; however, less than 5% of patients were very bothered at month 6.The TFNT00 exhibited superior monocular DCNVA and DCIVA to a spherical monofocal IOL, with comparable monocular BCDVA. Binocular visual acuity was 20/25 or better for distance to near (+0.5 D to -2.5 D), resulting in high levels of spectacle independence. Less than 5% of patients were very bothered by the photic visual disturbances associated with the TFNT00 at 6 months after surgery.
Offline: Science and the breakdown of trust
Authors: Richard Horton
Journal: The Lancet (2020)

The COVID-19 syndemic is entering its most dangerous phase. There is a mounting breakdown of trust. Not only between politicians and the public. But also among politicians and publics with science and scientists. This breach of faith with science is far more threatening. For the public is slowly turning against those who have sought to guide the political response to COVID-19. As countries face a resurgence of coronavirus transmission, scientific advisers are recommending further restrictions to our liberties.
Association of Pretreatment With P2Y12 Receptor Antagonists Preceding Percutaneous Coronary Intervention in Non–ST-Segment Elevation Acute Coronary Syndromes With Outcomes
Authors: Christian Dworeck, Björn Redfors, Oskar Angerås, Inger Haraldsson, Jacob Odenstedt, Dan Ioanes, Petur Petursson, Sebastian Völz, Jonas Persson, Sasha Koul, Dimitrios Venetsanos, Anders Ulvenstam, Robin Hofmann, Jens Jensen, Per Albertsson, Truls Råmunddal, Anders Jeppsson, David Erlinge, Elmir Omerovic
Journal: JAMA Network Open (2020)

Pretreatment of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with P2Y12 receptor antagonists is a common practice despite the lack of definite evidence for its benefit.To investigate the association of P2Y12 receptor antagonist pretreatment vs no pretreatment with mortality, stent thrombosis, and in-hospital bleeding in patients with NSTE-ACS undergoing percutaneous coronary intervention (PCI).This cohort study used prospective data from the Swedish Coronary Angiography and Angioplasty Registry of 64 857 patients who underwent procedures between 2010 and 2018. All patients who underwent PCI owing to NSTE-ACS in Sweden were stratified by whether they were pretreated with P2Y12 receptor antagonists. Associations of pretreatment with P2Y12 receptor antagonists with the risks of adverse outcomes were investigated using instrumental variable analysis and propensity score matching. Data were analyzed from March to June 2019.Pretreatment with P2Y12 receptor antagonists.The primary end point was all-cause mortality within 30 days. Secondary end points were 1-year mortality, stent thrombosis within 30 days, and in-hospital bleeding.In total, 64 857 patients (mean [SD] age, 64.7 [10.9] years; 46 809 [72.2%] men) were included. A total of 59 894 patients (92.4%) were pretreated with a P2Y12 receptor antagonist, including 27 867 (43.7%) pretreated with clopidogrel, 34 785 (54.5%) pretreated with ticagrelor, and 1148 (1.8%) pretreated with prasugrel. At 30 days, there were 971 deaths (1.5%) and 101 definite stent thromboses (0.2%) in the full cohort. Pretreatment was not associated with better survival at 30 days (odds ratio [OR], 1.17; 95% CI, 0.66-2.11; P = .58), survival at 1 year (OR, 1.34; 95% CI, 0.77-2.34; P = .30), or decreased stent thrombosis (OR, 0.81; 95% CI, 0.42-1.55; P = .52). However, pretreatment was associated with increased risk of in-hospital bleeding (OR, 1.49; 95% CI, 1.06-2.12; P = .02).This cohort study found that pretreatment of patients with NSTE-ACS with P2Y12 receptor antagonists was not associated with improved clinical outcomes but was associated with increased risk of bleeding. These findings support the argument that pretreatment with P2Y12 receptor antagonists should not be routinely used in patients with NSTE-ACS.
Severe COVID-19 virus reactivation following treatment for B cell acute lymphoblastic leukemia
Authors: Guido Lancman, John Mascarenhas, Michal Bar-Natan
Journal: Journal of Hematology & Oncology (2020)

SARS-CoV-2 has infected millions of people worldwide, but little is known at this time about second infections or reactivation. Here, we report a case of a 55-year-old female undergoing treatment for CD20+ B cell acute lymphoblastic leukemia who experienced a viral reactivation after receiving rituximab, cytarabine, and dasatinib. She was initially hospitalized with COVID-19 in April and developed a high antibody titer with two negative nasal polymerase chain reaction (PCR) swabs for SARS-CoV-2 on discharge. After recovery, she resumed treatment in June for her leukemia, which included rituximab, cytarabine, and dasatinib. She promptly lost her COVID-19 antibodies, and her nasal PCR turned positive in June. She developed a severe COVID-19 pneumonia with lymphopenia, high inflammatory markers, and characteristic bilateral ground-glass opacities on chest CT, requiring high-flow nasal cannula and transfer to the intensive care unit. She received steroids, anticoagulation, and convalescent plasma, and within 48 h she was off oxygen. She was discharged home in stable condition several days later. Given the short time frame from leukemia treatment to PCR positivity and the low case rate in mid-June in New York City, reinfection appears to have been unlikely and SARS-CoV-2 reactivation is a possible explanation. This case illustrates the risks of treating recently recovered COVID-19 patients with immunosuppressive therapy, particularly lymphocyte- and antibody-depleting therapy, and raises new questions about the potential of SARS-CoV-2 reactivation.
Progress Toward Cardiac Xenotransplantation
Authors: Richard N Pierson, Jay A. Fishman, Gregory D. Lewis, David A. D’Alessandro, Margaret R. Connolly, Lars Burdorf, Joren C. Madsen, Agnes M. Azimzadeh
Journal: Circulation (2020)

Consistent survival of life-supporting pig heart xenograft recipients beyond 90 days was recently reported using genetically modified pigs and a clinically applicable drug treatment regimen. If this remarkable achievement proves reproducible, published benchmarks for clinical translation of cardiac xenografts appear to be within reach. Key mechanistic insights are summarized here that informed recent pig design and therapeutic choices, which together appear likely to enable early clinical translation.
Jan Mikulicz-Radecki (1850–1905): return of the surgeon
Authors: Bernhard Manger, Georg Schett
Journal: Annals of the Rheumatic Diseases (2020)

A medical eponym honours a scientist’s accomplishment in discovering a disease, symptom, anatomical part, procedure or principle.1 Many of them are firmly embedded in our terminology, such as Hodgkin’s disease, Babinski’s sign, Meckel’s diverticulum or Billroth’s surgery, respectively. Eponyms can be very helpful for professional communication, because they evoke characteristic images in every medical student or doctor and are usually easier to memorise than designations based on pathophysiology or their acronyms. However, the use of eponyms also has disadvantages. They may become outdated, because a progress in knowledge requires a new terminology, or worse, the name belongs to a person, whose acts or views are not in accordance with the social ethos of medical literature.1 2 Therefore, many medical eponyms that once were popular have become outdated over the course of time. In rheumatology, we are currently witnessing a rare phenomenon: an eponymous designation for a disease, which 100 years ago was frequently used in the literature, then became almost forgotten and now reappears in the context of a new immunopathology: ‘Mikulicz’s syndrome’.

Jan Mikulicz-Radecki (from 1899 Johann Freiherr von Mikulicz-Radecki) was born in 1850 in Cernivci (then part of the Austro-Hungarian Empire, today Ukraine) as son of a Polish forest and construction official (figure 1). Initially pursuing a career in music, he began his medical training at the University of Vienna in 1869. After finishing his studies in 1875, he became voluntary assistant and later a close friend of the famous surgeon Theodor Billroth. Mikulicz’s contributions to surgery are numerous. He was the first to perform endoscopies of oesophagus and stomach and described achalasia as sphincter dysfunction. He …
Waning of SARS-CoV-2 RBD antibodies in longitudinal convalescent plasma samples within 4 months after symptom onset
Authors: Josée Perreault, Tony Tremblay, Marie-Josée Fournier, Mathieu Drouin, Guillaume Beaudoin-Bussières, Jérémie Prévost, Antoine Lewin, Philippe Bégin, Andrés Finzi, Renée Bazin
Journal: Blood (2020)
Evaluation of Cancer Care After Medicaid Expansion Under the Affordable Care Act
Authors: Michelle C. Salazar, Maureen E. Canavan, Samantha L. Walters, Jeph Herrin, Jason L. Schwartz, Michael Leapman, Daniel J. Boffa
Journal: JAMA Network Open (2020)

This cohort study evaluates different approaches for estimating the population of individuals eligible for Medicaid expansion under the Affordable Care Act in the context of researching changes in cancer care after Medicaid expansion.
Development of a novel scoring system based on endoscopic appearance for management of rectal neuroendocrine tumors
Authors: Luohai Chen, Yu Guo, Yixuan Zhang, Man Liu, Yu Zhang, Yuan Lin, Min-hu Chen, Jie Chen
Journal: Endoscopy (2020)

Abstract Background The clinical significance of the endoscopic appearance of rectal neuroendocrine tumors (NETs) is poorly understood. We aimed to develop a novel scoring system based on endoscopic appearances to predict endoscopically advanced disease in patients with rectal NETs when initially diagnosed. Methods Patients diagnosed with well-differentiated rectal NETs between January 2005 and December 2019 were retrospectively included. Logistic regression analyses were applied to study the relationship between endoscopic appearance and advanced disease. The whole dataset was randomly divided into training and validation sets, which were used to develop and validate a novel scoring system, respectively. Results 309 patients were included. The endoscopic appearance of rectal NETs was significantly associated with advanced disease (P &lt; 0.001). A novel scoring system was developed based on endoscopic appearance, including tumor size, tumor shape, and mucosal surface, using the training set. The area under curve (AUC) of the scoring system to predict advanced disease was 0.953 (95 % confidence interval [CI] 0.915 – 0.991; P &lt; 0.001) and 0.960 (95 %CI 0.905 – 1.000; P &lt; 0.001) in the training and validation sets, respectively. Furthermore, the scoring system was significantly associated with tumor grade. Patients with high scores had significantly worse disease-free and overall survival than patients with low scores (P &lt; 0.001). Conclusion This novel scoring system based on the endoscopic appearance of the primary tumor can help to accurately identify patients with endoscopically advanced disease who are not suitable for endoscopic resection. In addition, it is of great value in monitoring tumor recurrence and overall survival in patients with rectal NETs.
Re: Hiten D. Patel, Farzana A. Faisal, Bruce J. Trock, et al. Effect of Pharmacologic Prophylaxis on Venous Thromboembolism After Radical Prostatectomy: The PREVENTER Randomized Clinical Trial. Eur Urol 2020;78:360–8
Authors: Christian D. Fankhauser, Matthew G. Parry, Noel W. Clarke
Journal: European Urology (2020)
Oxidized DNA Precursors Cleanup by NUDT1 Contributes to Vascular Remodeling in Pulmonary Arterial Hypertension
Authors: Géraldine Vitry, Roxane Paulin, Yann Grobs, Marie-Claude Lampron, Tsukasa Shimauchi, Sarah-Eve Lemay, Eve Tremblay, Karima Habbout, Charifa Awada, Alice Bourgeois, Valérie Nadeau, Renée Paradis, Sandra Breuils-Bonnet, Florence Roux-Dalvai, Mark Orcholski, François Potus, Steeve Provencher, Olivier Boucherat, Sébastien Bonnet
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Rationale: Pulmonary arterial hypertension (PAH) is a life-threatening condition characterized by abnormally elevated pulmonary pressures and right ventricular failure. Excessive proliferation and resistance to apoptosis of pulmonary artery smooth muscle cells (PASMCs) is one of the most important drivers of vascular remodeling in PAH, for which available treatments have limited effectiveness.Objectives: To gain insights into the mechanisms leading to the development of the disease and identify new actionable targets.Methods: Protein expression profiling was conducted by two-dimensional liquid chromatography coupled to tandem mass spectrometry in isolated PASMCs from controls and patients with PAH. Multiple molecular, biochemical, and pharmacologic approaches were used to decipher the role of NUDT1 (nudrix hyrolase 1) in PAH.Measurements and Main Results: Increased expression of the detoxifying DNA enzyme NUDT1 was detected in cells and tissues from patients with PAH and animal models. In vitro, molecular or pharmacological inhibition of NUDT1 in PAH-PASMCs induced accumulation of oxidized nucleotides in the DNA, irresolvable DNA damage (comet assay), disruption of cellular bioenergetics (Seahorse), and cell death (terminal deoxynucleotidyl transferase dUTP nick end labeling assay). In two animal models with established PAH (i.e., monocrotaline and Sugen/hypoxia-treated rats), pharmacological inhibition of NUDT1 using (S)-Crizotinib significantly decreased pulmonary vascular remodeling and improved hemodynamics and cardiac function.Conclusions: Our results indicate that, by overexpressing NUDT1, PAH-PASMCs hijack persistent oxidative stress in preventing incorporation of oxidized nucleotides into DNA, thus allowing the cell to escape apoptosis and proliferate. Given that NUDT1 inhibitors are under clinical investigation for cancer, they may represent a new therapeutic option for PAH.
CDK4/6 inhibition enhances antitumor efficacy of chemotherapy and immune checkpoint inhibitor combinations in preclinical models and enhances T-cell activation in patients with SCLC receiving chemotherapy
Authors: Anne Y Lai, Jessica A Sorrentino, Konstantin H Dragnev, Jared M Weiss, Taofeek K Owonikoko, Julie A Rytlewski, Jill Hood, Zhao Yang, Rajesh K Malik, Jay C Strum, Patrick J Roberts
Journal: Journal for ImmunoTherapy of Cancer (2020)

Background Combination treatment with chemotherapy and immune checkpoint inhibitors (ICIs) has demonstrated meaningful clinical benefit to patients. However, chemotherapy-induced damage to the immune system can potentially diminish the efficacy of chemotherapy/ICI combinations. Trilaciclib, a highly potent, selective and reversible cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor in development to preserve hematopoietic stem and progenitor cells and immune system function during chemotherapy, has demonstrated proof of concept in recent clinical trials. Furthermore, CDK4/6 inhibition has been shown to augment T-cell activation and antitumor immunity in preclinical settings. Therefore, addition of trilaciclib has the potential to further enhance the efficacy of chemotherapy and ICI combinations. Methods In murine syngeneic tumor models, a schedule of 3 weekly doses of trilaciclib was combined with chemotherapy/ICI regimens to assess the effect of transient CDK4/6 inhibition on antitumor response and intratumor T-cell proliferation and function. Peripheral T-cell status was also analyzed in patients with small cell lung cancer (SCLC) treated with chemotherapy with or without trilaciclib to gain insights into the effect of transient exposure of trilaciclib on T-cell activation. Results Preclinically, the addition of trilaciclib to chemotherapy/ICI regimens enhanced antitumor response and overall survival compared with chemotherapy and ICI combinations alone. This effect is associated with the modulation of the proliferation and composition of T-cell subsets in the tumor microenvironment and increased effector function. Transient exposure of trilaciclib in patients with SCLC during chemotherapy treatment both preserved and increased peripheral lymphocyte counts and enhanced T-cell activation, suggesting that trilaciclib not only preserved but also enhanced immune system function. Conclusions Transient CDK4/6 inhibition by trilaciclib was sufficient to enhance and prolong the duration of the antitumor response by chemotherapy/ICI combinations, suggesting a role for the transient cell cycle arrest of tumor immune infiltrates in remodeling the tumor microenvironment. These results provide a rationale for combining trilaciclib with chemotherapy/ICI regimens to improve antitumor efficacy in patients with cancer.
Endoscopic ultrasound-directed transgastric ERCP facilitating extensive ampullectomy in Roux-en-Y gastric bypass patient
Authors: Petr Vaněk, Martin L. Freeman, Guru Trikudanathan
Journal: Endoscopy (2020)

A 71-year-old woman with a history of BRCA2 + ovarian cancer and Roux-en-Y gastric bypass was incidentally found to have transiently elevated cholestatic liver function tests. Magnetic resonance cholangiopancreatography (MRCP) demonstrated intra- and extrahepatic dilatation to the level of the pancreatic head but no apparent stone or mass. A contrast-enhanced abdominal computed tomography (CT) scan identified a 26-mm ampullary neoplasm ([Fig. 1]). When reviewed in retrospect, the lesion was present on her positron emission tomography (PET) scan 3 years ago with a mild increase in size.
Design and clinical implementation of an open-source bionic leg
Authors: Alejandro F. Azocar, Luke M. Mooney, Jean-François Duval, Ann M. Simon, Levi J. Hargrove, Elliott J. Rouse
Journal: Nature Biomedical Engineering (2020)

In individuals with lower-limb amputations, robotic prostheses can increase walking speed, and reduce energy use, the incidence of falls and the development of secondary complications. However, safe and reliable prosthetic-limb control strategies for robust ambulation in real-world settings remain out of reach, partly because control strategies have been tested with different robotic hardware in constrained laboratory settings. Here, we report the design and clinical implementation of an integrated robotic knee-ankle prosthesis that facilitates the real-world testing of its biomechanics and control strategies. The bionic leg is open source, it includes software for low-level control and for communication with control systems, and its hardware design is customizable, enabling reduction in its mass and cost, improvement in its ease of use and independent operation of the knee and ankle joints. We characterized the electromechanical and thermal performance of the bionic leg in benchtop testing, as well as its kinematics and kinetics in three individuals during walking on level ground, ramps and stairs. The open-source integrated-hardware solution and benchmark data that we provide should help with research and clinical testing of knee-ankle prostheses in real-world environments.
Symptom Characterization and Outcomes of Sailors in Isolation After a COVID-19 Outbreak on a US Aircraft Carrier
Authors: Gadiel R. Alvarado, Benjamin C. Pierson, Eric S. Teemer, Hector J. Gama, Ronald D. Cole, Samuel S. Jang
Journal: JAMA Network Open (2020)

d Defined as oral temperature greater than 100 °F.e Admission diagnoses included coronavirus disease 2019 pneumonia for 5 sailors and chest pain evaluation for 1 sailor.
Recent endemic coronavirus infection is associated with less-severe COVID-19
Authors: Manish Sagar, Katherine Reifler, Michael Rossi, Nancy S. Miller, Pranay Sinha, Laura F. White, Joseph P. Mizgerd
Journal: Journal of Clinical Investigation (2020)

Four different endemic coronaviruses (eCoVs) are etiologic agents for the seasonal common cold, and these eCoVs share extensive sequence homology with human SARS coronavirus 2 (SARS-CoV-2). Here, we show that individuals with, as compared with those without, a recent documented infection with eCoV were tested at greater frequency for respiratory infections but had a similar rate of SARS-CoV-2 acquisition. Importantly, the patients with a previously detected eCoV had less-severe coronavirus disease 2019 (COVID-19) illness. Our observations suggest that preexisting immune responses against endemic human coronaviruses can mitigate disease manifestations from SARS-CoV-2 infection.
Continuous Pulse Oximetry Monitoring in Bronchiolitis Patients Not Receiving Oxygen
Authors: Jessica Keim-Malpass, Brynne A. Sullivan, J. Randall Moorman
Journal: JAMA (2020)

To the Editors Dr Bonafide and colleagues found variability among hospitals in the use of pulse oximetry after discontinuation of oxygen therapy in children hospitalized for bronchiolitis.1 They suggested that oxygen monitoring should be deimplemented. We have 3 concerns.
Benralizumab for Chronic Spontaneous Urticaria
Authors: Jonathan A Bernstein, Umesh Singh, Marepalli B Rao, Karen Berendts, Xiang Zhang, Diya Mutasim
Journal: New England Journal of Medicine (2020)

Benralizumab for Chronic Spontaneous Urticaria Benralizumab, an anti–interleukin-5-receptor antibody, was evaluated in a 24-week study involving 12 patients with chronic spontaneous urticaria. The ...