tbuckley/cabot-search huggingface dataset:
Real-world evidence of TNF inhibition in axial spondyloarthritis: can we generalise the results from clinical trials?
Authors: Gareth T Jones, Linda E Dean, Ejaz Pathan, Rosemary J Hollick, Gary J Macfarlane
Journal: Annals of the Rheumatic Diseases (2020)

Management guidelines assume that results from clinical trials can be generalised, although seldom is data available to test this assumption. We aimed to determine the proportion of patients commencing tumour necrosis factor inhibition (TNFi) who would have been eligible for relevant clinical trials, and whether treatment response differs between these groups and the trials themselves. The British Society for Rheumatology Biologics Register for Ankylosing Spondylitis (BSRBR-AS) recruited a real-world cohort of TNFi-naïve spondyloarthritis patients with data collection from clinical records and patient questionnaires. Participant characteristics were extracted from trials identified from a recent Health Technology Assessment of TNFi for ankylosing spondylitis/non-radiographic axial spondyloarthritis. Descriptive statistics were used to determine the differences, including treatment response, between BSRBR-AS participants who would/would not have been eligible for the clinical trials and with trial participants. Among 2420 BSRBR-AS participants, those commencing TNFi (34%) had shorter symptom duration (15 vs 22 years) but more active disease (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 6.4 vs 4.0; Bath Ankylosing Spondylitis Disease Functional Index (BASFI) 6.2 vs 3.8). Of those commencing TNFi, 41% met eligibility criteria for ≥1 of fourteen relevant trials; they reported higher disease activity (BASDAI 6.9 vs 6.1) and poorer function (BASFI 6.6 vs 6.0). 61.7% of trial participants reported a positive treatment response, vs 51.3% of BSRBR-AS patients (difference: 10.4%; 95% CI 4.4% to 16.5%). Potential eligibility for trials did not influence treatment response (difference 2.0%; -9.4% to 13.4%). Fewer patients in the real world respond to TNFi than is reported in the trial literature. This has important implications for the generalisability of trial results, and the cost-effectiveness of TNFi agents.
Abstract 17632: The Influences of Subclinical Hypothyroidism on Cardiac Structure and Systolic Dysfunction in a Large Asymptomatic Ethnic Asian Population
Authors: Wen-Hung Huang, Kuo-Tzu Sung, Jui-Peng Tsai, Chi-In Lo, Chih-Chung Hsiao, Jen-Yuan Kuo, Cheng-Huang Su, Chung-Lieh Hung
Journal: Circulation (2017)

Purpose: Hypothyroidism has been shown to be associated with increased cardiovascular risks and clinical features of heart failure, though data regarding the influences of subclinical hypothyroidis...
Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research
Authors: K Robin Yabroff, Katherine Reeder-Hayes, Jingxuan Zhao, Michael T Halpern, Ana Maria Lopez, Leon Bernal-Mizrachi, Anderson B Collier, Joan Neuner, Jonathan Phillips, William Blackstock, Manali Patel
Journal: JNCI Journal of the National Cancer Institute (2020)

Lack of health insurance coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in coverage are common among low-income populations, but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival.
<i>QuickStats:</i> Percentage of Adults Aged 18–24 Years Who Currently Smoke Cigarettes* or Who Currently Use Electronic Cigarettes,† by Year — National Health Interview Survey, United States, 2014–2018§
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

Current cigarette smokersCurrent electronic cigarette users * Defined as having smoked 100 cigarettes in their lifetime and currently smoking cigarettes every day or some days.† Defined as having ever used an electronic cigarette, even one time, and currently using electronic cigarettes every day or some days.§ Estimates are based on household interviews of a sample of the civilian, noninstitutionalized U.S. population and are derived from the National Health Interview Survey Sample Adult component.Questions on electronic cigarettes were asked of all Sample Adult respondents, regardless of cigarette-smoking status.The percentage of adults aged 18-24 years who both currently smoked cigarettes and currently used electronic cigarettes decreased from 3.3% in 2014 to 1.7% in 2018.From 2014 to 2018, the percentage of adults aged 18-24 years who currently smoked cigarettes decreased from 16.7% to 7.8%.The percentage of adults in this age group who currently used electronic cigarettes increased from 5.1% to 7.6%.
Toxoplasma gondii-specific IgG avidity testing in pregnant women
Authors: C. Garnaud, H. Fricker-Hidalgo, B. Evengård, M.J. Álvarez-Martínez, E. Petersen, L.M. Kortbeek, F. Robert-Gangneux, I. Villena, C. Costache, M. Paul, V. Meroni, E. Guy, P.L. Chiodini, M.-P. Brenier-Pinchart, H. Pelloux
Journal: Clinical Microbiology and Infection (2020)
Advances in the methodology of co-ventilation during a disaster
Authors: Charlene Irvin Babcock, Lorenzo Paladino
Journal: Thorax (2020)

The study by Tonetti et al 1 describes a potential configuration for the invasive ventilation of two adults on one ventilator (‘co-venting’). This is a similar configuration to those previously published in 2006 by Neyman and Irvin (four test lungs on one ventilator),2 and evaluated both in 2008 by Paladino et al 3 (using normal lungs in sheep, ventilating four on one ventilator) and again by Branson et al 4 in 2012 (with different respiratory system compliance and airways resistance in four tested lungs on one ventilator). This concept was also explored using face masks (non-invasive ventilation) in two human volunteers for 10 min by Smith and Brown in 2009.5 In 2017, Keven Menes used this previously evaluated ‘splitting’ of …
NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications
Authors: Giovanni Targher, Christopher D Byrne, Herbert Tilg
Journal: Gut (2020)

Non-alcoholic fatty liver disease (NAFLD) is a public health problem, affecting up to a third of the world's adult population. Several cohort studies have consistently documented that NAFLD (especially in its more advanced forms) is associated with a higher risk of all-cause mortality and that the leading causes of death among patients with NAFLD are cardiovascular diseases (CVDs), followed by extrahepatic malignancies and liver-related complications. A growing body of evidence also indicates that NAFLD is strongly associated with an increased risk of major CVD events and other cardiac complications (ie, cardiomyopathy, cardiac valvular calcification and cardiac arrhythmias), independently of traditional cardiovascular risk factors. This narrative review provides an overview of the literature on: (1) the evidence for an association between NAFLD and increased risk of cardiovascular, cardiac and arrhythmic complications, (2) the putative pathophysiological mechanisms linking NAFLD to CVD and other cardiac complications and (3) the current pharmacological treatments for NAFLD that might also benefit or adversely affect risk of CVD.
The microbiome in rheumatology: Where are we and where should we go?
Authors: Julia Manasson, Rebecca B Blank, Jose U Scher
Journal: Annals of the Rheumatic Diseases (2020)

From birth, humans coexist and coevolve with trillions of micro-organisms inhabiting most body surfaces and cavities, referred to as the human microbiome. Advances in sequencing technologies and computational methods have propelled the exploration of the microbiome’s contribution to human health and disease, spearheaded by massive efforts such as the Human Microbiome Project and the Europe-based MetaHit Consortium. Yet, despite the accumulated body of literature and a growing awareness among patients, microbiome research in rheumatology has not had a key impact on clinical practice. Herein, we describe some of the landmark microbiome studies in autoimmunity and rheumatology, the challenges and opportunities of microbiome research and how to navigate them, advances in related fields that have overcome these pitfalls, and future directions of harnessing the microbiome for diagnostic and therapeutic purposes.
GLP-1 Receptor Agonist Treatment in Morbid Obesity and Type 2 Diabetes Due to Pathogenic Homozygous Melanocortin-4 Receptor Mutation: A Case Report
Authors: Eva W. Iepsen, Christian T. Have, Simon Veedfald, Sten Madsbad, Jens J. Holst, Niels Grarup, Oluf Pedersen, Ivan Brandslund, Jens-Christian Holm, Torben Hansen, Signe S. Torekov
Journal: Cell Reports Medicine (2020)

Individuals with obesity due to pathogenic heterozygous melanocortin 4 receptor (MC4R) mutations can be treated efficiently with the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide. Here, we report the effect of 16 weeks of liraglutide 3 mg/day treatment in a woman with morbid obesity and type 2 diabetes (T2D) due to homozygous pathogenic MC4R mutation. The body weight loss was 9.7 kg, similar to weight loss in heterozygous MC4R mutation carriers and common obesity. In addition, the treatment led to clinically relevant decreases in fasting glucose, triglycerides, systolic blood pressure, and normalization of glucose tolerance. We conclude that liraglutide reduces body weight and blood glucose levels in hetero- and homozygous MC4R mutation carriers. This serves as proof-of-concept that MC4Rs are not required for the body weight and glucose lowering effects of GLP-1 RAs and that liraglutide may be used as part of the treatment of obesity and T2D due to MC4R mutations.
Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study
Authors: Yongze Li, Di Teng, Xiaoguang Shi, Guijun Qin, Yingfen Qin, Huibiao Quan, Bingyin Shi, Hui Sun, Jianming Ba, Bing Chen, Jianling Du, Lanjie He, Xiaoyang Lai, Yanbo Li, Haiyi Chi, Eryuan Liao, Chao Liu, Libin Liu, Xulei Tang, Nanwei Tong, Guixia Wang, Jin-an Zhang, Youmin Wang, Yuanming Xue, Li Yan, Jing Yang, Lihui Yang, Yongli Yao, Zhen Ye, Qiao Zhang, Lihui Zhang, Jun Zhu, Mei Zhu, Guang Ning, Yiming Mu, Jiajun Zhao, Weiping Teng, Zhongyan Shan
Journal: BMJ (2020)

Abstract Objective To assess the prevalence of diabetes and its risk factors. Design Population based, cross sectional study. Setting 31 provinces in mainland China with nationally representative cross sectional data from 2015 to 2017. Participants 75 880 participants aged 18 and older—a nationally representative sample of the mainland Chinese population. Main outcome measures Prevalence of diabetes among adults living in China, and the prevalence by sex, regions, and ethnic groups, estimated by the 2018 American Diabetes Association (ADA) and the World Health Organization diagnostic criteria. Demographic characteristics, lifestyle, and history of disease were recorded by participants on a questionnaire. Anthropometric and clinical assessments were made of serum concentrations of fasting plasma glucose (one measurement), two hour plasma glucose, and glycated haemoglobin (HbA 1c ). Results The weighted prevalence of total diabetes (n=9772), self-reported diabetes (n=4464), newly diagnosed diabetes (n=5308), and prediabetes (n=27 230) diagnosed by the ADA criteria were 12.8% (95% confidence interval 12.0% to 13.6%), 6.0% (5.4% to 6.7%), 6.8% (6.1% to 7.4%), and 35.2% (33.5% to 37.0%), respectively, among adults living in China. The weighted prevalence of total diabetes was higher among adults aged 50 and older and among men. The prevalence of total diabetes in 31 provinces ranged from 6.2% in Guizhou to 19.9% in Inner Mongolia. Han ethnicity had the highest prevalence of diabetes (12.8%) and Hui ethnicity had the lowest (6.3%) among five investigated ethnicities. The weighted prevalence of total diabetes (n=8385) using the WHO criteria was 11.2% (95% confidence interval 10.5% to 11.9%). Conclusion The prevalence of diabetes has increased slightly from 2007 to 2017 among adults living in China. The findings indicate that diabetes is an important public health problem in China.
Single Cell RNA Sequencing in Atherosclerosis Research
Authors: Jesse W. Williams, Holger Winkels, Christopher P. Durant, Konstantin Zaitsev, Yanal Ghosheh, Klaus Ley
Journal: Circulation Research (2020)

Technological advances in characterizing molecular heterogeneity at the single cell level have ushered in a deeper understanding of the biological diversity of cells present in tissues including atherosclerotic plaques. New subsets of cells have been discovered among cell types previously considered homogenous. The commercial availability of systems to obtain transcriptomes and matching surface phenotypes from thousands of single cells is rapidly changing our understanding of cell types and lineage identity. Emerging methods to infer cellular functions are beginning to shed new light on the interplay of components involved in multifaceted disease responses, like atherosclerosis. Here, we provide a technical guide for design, implementation, assembly, and interpretations of current single cell transcriptomics approaches from the perspective of employing these tools for advancing cardiovascular disease research.
Implementing lung health interventions in low- and middle-income countries: a FRESH AIR systematic review and meta-synthesis
Authors: Evelyn A. Brakema, Debbie Vermond, Hilary Pinnock, Christos Lionis, Bruce Kirenga, Pham Le An, Talant Sooronbaev, Niels H. Chavannes, M. J. J. Rianne van der Kleij
Journal: European Respiratory Journal (2020)

The vast majority of patients with chronic respiratory disease live in low- and middle-income countries (LMICs). Paradoxically, relevant interventions often fail to be effective particularly in these settings, as LMICs lack solid evidence on how to implement interventions successfully. Therefore, we aimed to identify factors critical to the implementation of lung health interventions in LMICs, and weigh their level of evidence.This systematic review followed Cochrane methodology and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) reporting standards. We searched eight databases without date or language restrictions in July 2019, and included all relevant original, peer-reviewed articles. Two researchers independently selected articles, critically appraised them (using Critical Appraisal Skills Programme (CASP)/Meta Quality Appraisal Tool (MetaQAT)), extracted data, coded factors (following the Consolidated Framework for Implementation Research (CFIR)), and assigned levels of confidence in the factors (via Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual)). We meta-synthesised levels of evidence of the factors based on their frequency and the assigned level of confidence (PROSPERO:CRD42018088687).We included 37 articles out of 9111 screened. Studies were performed across the globe in a broad range of settings. Factors identified with a high level of evidence were: 1) "Understanding needs of local users"; 2) ensuring "Compatibility" of interventions with local contexts (cultures, infrastructures); 3) identifying influential stakeholders and applying "Engagement" strategies; 4) ensuring adequate "Access to knowledge and information"; and 5) addressing "Resource availability". All implementation factors and their level of evidence were synthesised in an implementation tool.To conclude, this study identified implementation factors for lung health interventions in LMICs, weighed their level of evidence, and integrated the results into an implementation tool for practice. Policymakers, non-governmental organisations, practitioners, and researchers may use this FRESH AIR (Free Respiratory Evaluation and Smoke-exposure reduction by primary Health cAre Integrated gRoups) Implementation tool to develop evidence-based implementation strategies for related interventions. This could increase interventions' implementation success, thereby optimising the use of already-scarce resources and improving health outcomes.
Interaction Between the Microbiota, Epithelia, and Immune Cells in the Intestine
Authors: Hisako Kayama, Ryu Okumura, Kiyoshi Takeda
Journal: Annual Review of Immunology (2020)

The gastrointestinal tract harbors numerous commensal bacteria, referred to as the microbiota, that benefit host health by digesting dietary components and eliminating pathogens. The intestinal microbiota maintains epithelial barrier integrity and shapes the mucosal immune system, balancing host defense and oral tolerance with microbial metabolites, components, and attachment to host cells. To avoid aberrant immune responses, epithelial cells segregate the intestinal microbiota from immune cells by constructing chemical and physical barriers, leading to the establishment of host-commensal mutualism. Furthermore, intestinal immune cells participate in the maintenance of a healthy microbiota community and reinforce epithelial barrier functions. Perturbations of the microbiota composition are commonly observed in patients with autoimmune diseases and chronic inflammatory disorders. An understanding of the intimate interactions between the intestinal microbiota, epithelial cells, and immune cells that are crucial for the maintenance of intestinal homeostasis might promote advances in diagnostic and therapeutic approaches for various diseases.
Dissecting racial disparities in multiple myeloma—clues from differential immunoglobulin levels
Authors: C. M. Bunce, M. T. Drayson
Journal: Blood Cancer Journal (2020)

authors recently revisited the longstanding conundrum of racial disparities in the incidence of multiple myeloma (MM), particularly the greater risk of MM in individuals that identify themselves as Black (Blood Cancer Journal (2020) 10:19) 1 .This is an important issue not only in terms of awareness of a population at greater risk of an incurable and devastating blood cancer, but also for the understanding of the molecular and cellular origins, and biology of MM as a whole.As highlighted by Marinac et al., MM is always preceded by a pre-existing plasma cell dyscrasia termed monoclonal gammopathy of undetermined significance (MGUS) 2,3 .The risk of MGUS in Black populations is also greater than in white populations 4,5 and is evident at an earlier age 6 .It is therefore possible to surmise that increased susceptibility to MM amongst Black populations relates more to the initiating events that set a B-cell clone on the path to MM occurring more frequently and/or earlier in Black populations, rather than their progression rates being greater.Marinac et al. discuss factors that may underpin this greater risk including socioeconomic factors, genetics and differences in exposure to MGUS and MM risk factors, highlighting the complexity of this issue.A series of studies spanning three decades from the mid-1960s to the mid-1990s used emerging technologies to measure immunoglobulin levels in populations and how they varied with race, age, gender, life style choices and disease states [7][8][9][10][11][12][13] .Collectively these studies identified significantly greater immunoglobulin levels in Black compared with White populations.All studies identified increased IgG in Blacks compared to Whites.One study investigated IgG subtypes and identified increases in IgG1,
Single-nucleus transcriptomics of the prefrontal cortex in major depressive disorder implicates oligodendrocyte precursor cells and excitatory neurons
Authors: Corina Nagy, Malosree Maitra, Arnaud Tanti, Matthew Suderman, Jean-Francois Théroux, Maria Antonietta Davoli, Kelly Perlman, Volodymyr Yerko, Yu Chang Wang, Shreejoy J. Tripathy, Paul Pavlidis, Naguib Mechawar, Jiannis Ragoussis, Gustavo Turecki
Journal: Nature Neuroscience (2020)
Novel endoscopic ligation with O-ring closure involving muscle layer of a gastric artificial defect
Authors: Noriko Nishiyama, Hideki Kobara, Nobuya Kobayashi, Taiga Chiyo, Shintaro Fujihara, Tatsuo Yachida, Tsutomu Masaki
Journal: Endoscopy (2020)

Endoscopic closure of a gastrointestinal artificial defect effectively reduces the incidence of postoperative adverse events [1], especially delayed bleeding due to antithrombotic drugs. However, although several closure techniques have been developed, including endoloop [2], multiple clip-and-line [3], and hand suturing [4], there is still no convenient and reliable closure technique for the stomach because of the thick gastric wall. One important issue is that limited mucosal suturing results in the formation of a mucosal bridge and cavity, leading to mucosal dehiscence at an early stage. We describe a novel gastric artificial defect closure method named endoscopic ligation with O-ring closure (E-LOC).
Oscillometry improves earlier than spirometry after benralizumab initiation in severe asthma
Authors: Toshihiro Shirai, Taisuke Akamatsu, Keita Hirai, Hirofumi Watanabe, Kanami Tamura, Yutaro Kishimoto, Mika Saigusa
Journal: Allergy (2020)

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One ventilator for two patients: feasibility and considerations of a last resort solution in case of equipment shortage
Authors: Tommaso Tonetti, Alberto Zanella, Giacinto Pizzilli, Charlene Irvin Babcock, Sergio Venturi, Stefano Nava, Antonio Pesenti, V Marco Ranieri
Journal: Thorax (2020)

The present emergency caused by the spread of the COVID-19 infection is putting enormous pressure on the healthcare systems worldwide and especially on intensive care units (ICUs).

One of the main fears in this regard is that we may run out of ventilators, a possibility which is getting more and more likely as the pandemic spreads throughout the world and the ICUs are overloaded with ventilated patients.

Many authors have already investigated the possibility of manipulating a ventilator circuit in order to ventilate up to four patients with a single machine. Neyman and Ervin first performed a bench study demonstrating the technical feasibility of ventilating four patients with one ventilator and one modified circuit.1 The same circuit configuration was used in 2008 by Paladino et al in an animal model, resulting in substantial differences in oxygenation and decarboxylation between subjects during the ventilation period.2 In 2012 Branson et al tested in vitro the Neyman and Ervin system simulating different conditions of compliance and resistance between the simultaneously ventilated test lungs. They observed wide variability in measured tidal volume (Vt) and end-expiratory lung volume, so they concluded that the technique should be avoided because of potential danger.3 Accordingly, the authors argued that the stockpiling of ventilators should be the first-line solution when massive emergencies are forecast; only after their depletion, strategies such as the ‘double circuit’ should be implemented for the shortest possible duration.4 5 

On 20 February 2020, the first case of COVID-19 emerged in the Lombardy region, northern Italy. As of 17 March, a total of 1069 patients had been admitted …
Severe Acute Respiratory Syndrome–Coronavirus-2 Infection and Patients With Lung Cancer: The Potential Role of Interleukin-17 Target Therapy
Authors: Stefano Cafarotti
Journal: Journal of Thoracic Oncology (2020)

The coronavirus disease 2019 outbreak is evolving rapidly worldwide. The lungs are the target of the primary infection and patients with lung cancer seem to have a poor prognosis. To our knowledge, this is the first reported investigation of a possible role of interleukin-17 target therapy in patients with lung cancer and concomitant severe acute respiratory syndrome–coronavirus-2 infection.