tbuckley/cabot-search huggingface dataset:
Primary tumor removal improves the prognosis in patients with stage IV breast cancer: A population-based study (cohort study)
Authors: Nan Yao, Wenqiang Li, Tong Liu, Sarah Tan Siyin, Xiufeng Chen, Weiqi Wang, Ning Duan, Yi-Tsun Chen, Jun Qu
Journal: International Journal of Surgery (2020)

Adjuvant therapy including chemotherapy, hormonal therapy, and radiotherapy were often used as a common stereotypy for female stage IV breast cancer rather than surgery. This study aimed to define the role of local surgery in metastatic breast cancer. Female metastatic breast cancer patients were identified in the Surveillance, Epidemiology, and End Results (SEER) program data (2010-2013). We compared survival time between patients who received primary tumor removal (PTR) versus those who did not. Multivariate Cox regression models and competitive risk models were built to adjust potential confounders. Of 7669 female stage IV breast cancer patients, 2704 (35.3%) had surgery on their breast tumor and 4965 (64.7%) did not. In the entire cohort, women who underwent PTR had a 45% reduced risk of breast cancer-related death (multi-adjusted hazard ratio [HR], 0.55; 95% CI, 0.50 to 0.60) compared with women who did not undergo PTR (P < 0.001). In a cause-specific hazard model (CS model), the multivariable HRs (95% CI) for the association of PTR with breast cancer related-death were 0.54 (0.50-0.60) in the multivariate-adjusted analysis. Similar results were also observed in the sub-distribution hazard function model (SD model) with corresponding multivariate HRs (95%CI) of 0.57 (0.52-0.63). Our study suggested that PTR was associated with improved survival in female stage IV breast cancer patients. The role of PTR in these patients needs to be re-evaluated.
Decreased Influenza Activity During the COVID-19 Pandemic — United States, Australia, Chile, and South Africa, 2020
Authors: Sonja J. Olsen, Eduardo Azziz-Baumgartner, Alicia P. Budd, Lynnette Brammer, Sheena Sullivan, Rodrigo Fasce Pineda, Cheryl Cohen, Alicia M. Fry
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

After recognition of widespread community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 , by mid-to late February 2020, indicators of influenza activity began to decline in the Northern Hemisphere.These changes were attributed to both artifactual changes related to declines in routine health seeking for respiratory illness as well as real changes in influenza virus circulation because of widespread implementation of measures to mitigate transmission of SARS-CoV-2.Data from clinical laboratories in the United States indicated a 61% decrease in the number of specimens submitted (from a median of 49,696 per week during September 29, 2019-February 29, 2020, to 19,537 during March 1-May 16, 2020) and a 98% decrease in influenza activity as measured by percentage of submitted specimens testing positive (from a median of 19.34% to 0.33%).Interseasonal (i.e., summer) circulation of influenza in the United States (May 17-August 8, 2020) is currently at historical lows (median = 0.20% tests positive in 2020 versus 2.35% in 2019, 1.04% in 2018, and 2.36% in 2017).Influenza data reported to the World Health Organization's (WHO's) FluNet platform from three Southern Hemisphere countries that serve as robust sentinel sites for influenza from Oceania (Australia), South America (Chile), and Southern Africa (South Africa) showed very low influenza activity during June-August 2020, the months that constitute the typical Southern Hemisphere influenza season.In countries or jurisdictions where extensive community mitigation measures are maintained (e.g., face masks, social distancing, school closures, and teleworking), those locations might have little influenza circulation during the upcoming 2020-21 Northern Hemisphere influenza season.The use of community mitigation measures for the COVID-19 pandemic, plus influenza vaccination, are likely to be effective in reducing the incidence and impact of influenza, and some of these mitigation measures could have a role in preventing influenza in future seasons.However, given the novelty of the COVID-19 pandemic and the uncertainty of continued community mitigation measures, it is important to plan for seasonal influenza circulation in the United States this fall and winter.Influenza vaccination of all persons aged ≥6 months remains the best method for influenza prevention and is especially important this season when SARS-CoV-2 and influenza virus might cocirculate (1).
An economic evaluation of the randomized controlled trial of topical corticosteroid and home‐based narrowband ultraviolet B for active and limited vitiligo (the HI‐Light Vitiligo Trial)*
Authors: T.H. Sach, K.S. Thomas, J.M. Batchelor, A. Perways, J.R. Chalmers, R.H. Haines, G.D. Meakin, L. Duley, J.C. Ravenscroft, A. Rogers, M. Santer, W. Tan, J. White, M.E. Whitton, H.C. Williams, S.T. Cheung, H. Hamad, A. Wright, J.R. Ingram, N. Levell, J.M.R. Goulding, A. Makrygeorgou, A. Bewley, M. Ogboli, J. Stainforth, A. Ferguson, B. Laguda, S. Wahie, R. Ellis, J. Azad, A. Rajasekaran, V. Eleftheriadou, A.A. Montgomery
Journal: British Journal of Dermatology (2020)

Background Economic evidence for vitiligo treatments is absent. Objectives To determine the cost-effectiveness of (i) handheld narrowband ultraviolet B (NB-UVB) and (ii) a combination of topical corticosteroid (TCS) and NB-UVB compared with TCS alone for localized vitiligo. Methods Cost-effectiveness analysis alongside a pragmatic, three-arm, placebo-controlled randomized controlled trial with 9 months' treatment. In total 517 adults and children (aged ≥ 5 years) with active vitiligo affecting < 10% of skin were recruited from secondary care and the community and were randomized 1: 1: 1 to receive TCS, NB-UVB or both. Cost per successful treatment (measured on the Vitiligo Noticeability Scale) was estimated. Secondary cost–utility analyses measured quality-adjusted life-years using the EuroQol 5 Dimensions 5 Levels for those aged ≥ 11 years and the Child Health Utility 9D for those aged 5 to < 18 years. The trial was registered with number ISRCTN17160087 on 8 January 2015. Results The mean ± SD cost per participant was £775 ± 83·7 for NB-UVB, £813 ± 111.4 for combination treatment and £600 ± 96·2 for TCS. In analyses adjusted for age and target patch location, the incremental difference in cost for combination treatment compared with TCS was £211 (95% confidence interval 188–235), corresponding to a risk difference of 10·9% (number needed to treat = 9). The incremental cost was £1932 per successful treatment. The incremental difference in cost for NB-UVB compared with TCS was £173 (95% confidence interval 151–196), with a risk difference of 5·2% (number needed to treat = 19). The incremental cost was £3336 per successful treatment. Conclusions Combination treatment, compared with TCS alone, has a lower incremental cost per additional successful treatment than NB-UVB only. Combination treatment would be considered cost-effective if decision makers are willing to pay £1932 per additional treatment success.
Revascularization in Patients With Left Main Coronary Artery Disease and Left Ventricular Dysfunction
Authors: Sangwoo Park, Jung-Min Ahn, Tae Oh Kim, Hanbit Park, Do-Yoon Kang, Pil Hyung Lee, Yeong Jin Jeong, Junho Hyun, Junghoon Lee, Ju Hyeon Kim, Yujin Yang, Kyungjin Choe, Seung-Jung Park, Duk-Woo Park
Journal: Journal of the American College of Cardiology (2020)
Regular mass screening for SARS-CoV-2 infection in care homes already affected by COVID-19 outbreaks: Implications of false positive test results
Authors: Shamez N. Ladhani, J. Yimmy Chow, Sara Atkin, Kevin E. Brown, Mary E. Ramsay, Paul Randell, Frances Sanderson, Cornelia Junghans, Kate Sendall, Rawlda Downes, David Sharp, Neil Graham, David Wingfield, Rob Howard, Robert McLaren, Nicola Lang
Journal: Journal of Infection (2020)
Association of body mass index (BMI) with critical COVID-19 and in-hospital mortality: A dose-response meta-analysis
Authors: Yanbin Du, Yuan Lv, Wenting Zha, Nan Zhou, Xiuqin Hong
Journal: Metabolism (2020)

The coronavirus disease 2019 (COVID-19) pandemic presents an unprecedented health crisis to the entire world. As reported, the body mass index (BMI) may play an important role in COVID-19; however, this still remains unclear. The aim of this study was to explore the association between BMI and COVID-19 severity and mortality.The Medline, PubMed, Embase and Web of science were systematically searched until August 2020. Random-effects models and dose-response meta-analysis were used to synthesize the results. Combined odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated, and the effect of covariates were analyzed using subgroup analysis and meta-regression analyses.A total of 16 observational studies involving 109,881 patients with COVID-19 were included in the meta-analysis. The pooled results showed that patients with a BMI ≥ 30 kg/m2 had a 2.35-fold risk (OR = 2.35, 95%CI = 1.64-3.38, P < 0.001) for critical COVID-19 and a 2.68-fold risk for COVID-19 mortality (OR = 2.68, 95%CI = 1.65-4.37, P < 0.001) compared with patients with a BMI <30 kg/m2. Subgroup analysis results showed that patients with obesity and age > 60 years was associated with a significantly increased risk of critical COVID-19 (OR = 3.11, 95%CI = 1.73-5.61, P < 0.001) and COVID-19 mortality (OR = 3.93, 95%CI = 2.18-7.09, P < 0.001). Meta-regression analysis results also showed that age had a significant influence on the association between BMI and COVID-19 mortality (Coef. = 0.036, P = 0.048). Random-effects dose-response meta-analysis showed a linear association between BMI and both critical COVID-19(Pnon-linearity = 0.242) and mortality (Pnon-linearity = 0.116). The risk of critical COVID-19 and mortality increased by 9%(OR = 1.09, 95%CI = 1.04-1.14, P < 0.001) and 6%(OR = 1.06, 95%CI = 1.02-1.10, P = 0.002) for each 1 kg/m2 increase in BMI, respectively.Evidence from this meta-analysis suggested that a linear dose-response association between BMI and both COVID-19 severity and mortality. Further, obesity (BMI ≥ 30 kg/m2) was associated with a significantly increased risk of critical COVID-19 and in-hospital mortality of COVID-19.
The yin and yang of retinoic acid signaling in kidney diseases
Authors: Qingqing Wei, Zheng Dong
Journal: Journal of Clinical Investigation (2020)

Retinoic acid (RA) signaling is involved in various physiological and pathological conditions, including development, tumorigenesis, inflammation, and tissue damage and repair. In kidneys, the beneficial effect of RA has been reported in multiple disease models, such as glomerulosclerosis, renal fibrosis, and acute kidney injury. In this issue of the JCI, Chen et al. report a pathway activated by RA signaling that is mediated by the retinoic acid receptor responder protein 1 (RARRES1). Specifically, RARRES1, which is proteolytically cleaved to release the extracellular domain, was endocytosed by podocytes to induce apoptosis and glomerular dysfunction kidney disease. These findings unveil the contrasting aspects, a Janus face, of RA signaling that may guide its therapeutic use.
Long-Term Follow-Up of Ibrutinib Monotherapy in Symptomatic, Previously Treated Patients With Waldenström Macroglobulinemia
Authors: Steven P. Treon, Kirsten Meid, Joshua Gustine, Guang Yang, Lian Xu, Xia Liu, Christopher J. Patterson, Zachary R. Hunter, Andrew R. Branagan, Jacob P. Laubach, Irene M. Ghobrial, M. Lia Palomba, Ranjana Advani, Jorge J. Castillo
Journal: Journal of Clinical Oncology (2020)

We report the long-term findings and final analysis of a pivotal multicenter trial of ibrutinib monotherapy in previously treated patients with Waldenström macroglobulinemia (WM).Sixty-three symptomatic patients with median prior therapies of two (range, one to nine therapies), of whom 40% were refractory to their previous therapy, received ibrutinib at 420 mg/d. Dose reduction was permitted for toxicity.The median follow-up was 59 months, and overall and major response rates were 90.5% and 79.4%, respectively. At best response, median serum immunoglobulin M declined from 3,520 to 821 mg/dL, bone marrow disease involvement declined from 60% to 20%, and hemoglobin rose from 10.3 to 14.2 g/dL (P < .001 for all comparisons). Responses were impacted by mutated (Mut) MYD88 and CXCR4 status. Patients with MYD88Mut, wild-type (WT) CXCR4 showed higher major (97.2% v 68.2%; P < .0001) and very good partial (47.2% v 9.1%; P < .01) response rates and a shorter time to major response (1.8 v 4.7 months; P = .02) versus patients with MYD88MutCXCR4Mut. Conversely, four patients who had MYD88WT disease showed no major responses. The median 5-year progression-free survival (PFS) rate for all patients was not reached, and was 70% and 38% for those with MYD88MutCXCR4WT and MYD88MutCXCR4Mut WM, respectively (P = .02). In patients with MYD88WT, the median PFS was 0.4 years (P < .01 for three-way comparisons). The 5-year overall survival rate for all patients was 87%. Grade ≥ 3 adverse events in more than one patient at least possibly related included neutropenia (15.9%), thrombocytopenia (11.1%), and pneumonia (3.2%). Eight patients (12.7%) experienced atrial arrhythmia, and seven of the eight continued therapy with medical management.Ibrutinib is highly active and produces long-term disease control in previously treated patients with WM. Treatment is tolerable. Response depth, time to major response, and PFS are impacted by MYD88 and CXCR4 mutation status.
Audio Interview: Operation Warp Speed and Covid-19 Therapeutics
Authors: Eric J. Rubin, Lindsey R. Baden, Stephen Morrissey
Journal: New England Journal of Medicine (2020)

Operation Warp Speed and Covid-19 Therapeutics In this audio interview conducted on September 16, 2020, the editors look beyond Operation Warp Speed’s work in SARS-CoV-2 vaccine development to its ...
Mary Watson Hendry
Authors: Louise Hendry
Journal: BMJ (2020)

Mary Watson Hendry (nee Gibson) was born and educated in Bo’ness. She attended Bo’ness Academy, where she became both head and dux girl, although her proudest moment was being crowned Bo’ness Fair Queen in 1954. Unsure of her future path, she applied to study medicine in Edinburgh and to join the Women's Royal Naval Service (WRNS). Edinburgh replied first and the Royal Navy’s loss was medicine’s gain. She graduated in 1960 and headed to Fife to complete her house jobs before taking up a prestigious post at Stoke Mandeville Hospital. However, George Hendry had other ideas and finally persuaded her that …
Association of Fine Particulate Matter and Risk of Stroke in Patients With Atrial Fibrillation
Authors: Zachary J. Rhinehart, Ellen Kinnee, Utibe R. Essien, Melissa Saul, Emily Guhl, Jane E. Clougherty, Jared W. Magnani
Journal: JAMA Network Open (2020)

<h3>Importance</h3> Air pollution is associated with cardiovascular outcomes. Specifically, fine particulate matter measuring 2.5 μm or less (PM<sub>2.5</sub>) is associated with thrombosis, stroke, and myocardial infarction. Few studies have examined particulate matter and stroke risk in individuals with atrial fibrillation (AF). <h3>Objective</h3> To assess the association of residential-level pollution exposure in 1 year and ischemic stroke in individuals with AF. <h3>Design, Setting, and Participants</h3> This cohort study included 31 414 individuals with AF from a large regional health care system in an area with historically high industrial pollution. All participants had valid residential addresses for geocoding and ascertainment of neighborhood-level income and educational level. Participants were studied from January 1, 2007, through September 30, 2015, with prospective follow-up through December 1, 2017. Data analysis was performed from March 14, 2018, to October 9, 2019. <h3>Exposures</h3> Exposure to PM<sub>2.5</sub>ascertained using geocoding of addresses and fine-scale air pollution exposure surfaces derived from a spatial saturation monitoring campaign and land-use regression modeling. Exposure to PM<sub>2.5</sub>was estimated annually across the study period at the residence level. <h3>Main Outcomes and Measures</h3> Multivariable-adjusted stroke risk by quartile of residence-level and annual PM<sub>2.5</sub>exposure. <h3>Results</h3> The cohort included 31 414 individuals (15 813 [50.3%] female; mean [SD] age, 74.4 [13.5] years), with a median follow-up of 3.5 years (interquartile range, 1.6-5.8 years). The mean (SD) annual PM<sub>2.5</sub>exposure was 10.6 (0.7) μg/m<sup>3</sup>. A 1-SD increase in PM<sub>2.5</sub>was associated with a greater risk of stroke after both adjustment for demographic and clinical variables (hazard ratio [HR], 1.08; 95% CI, 1.03-1.14) and multivariable adjustment that included neighborhood-level income and educational level (HR, 1.07; 95% CI, 1.00-1.14). The highest quartile of PM<sub>2.5</sub>exposure had an increased risk of stroke relative to the first quartile (HR, 1.36; 95% CI, 1.18-1.58). After adjustment for clinical covariates, income, and educational level, risk of stroke remained greater for the highest quartile of exposure relative to the first quartile (HR, 1.21; 95% CI, 1.01-1.45). <h3>Conclusions and Relevance</h3> This large cohort study of individuals with AF identified associations between PM<sub>2.5</sub>and risk of ischemic stroke. The results suggest an association between fine particulate air pollution and cardiovascular disease and outcomes.
Abstract 11298: Arterial Pressure Volume Index and Arterial Velocity Pulse Index for Heart Failure With Preserved Ejection Fraction in Hypertensive Patients
Authors: Jindong Wan, Sen Liu, Yi Yang, Dan Wang, Fei Ran, Siwei Xia, Peng Zhou, Peijian Wang
Journal: Circulation (2019)

Background: Arterial pressure volume index (API) and arterial velocity pulse index (AVI) have recently become available to development of vascular damage and cardiovascular disease. However, there ...
Merqury: reference-free quality, completeness, and phasing assessment for genome assemblies
Authors: Arang Rhie, Brian P. Walenz, Sergey Koren, Adam M. Phillippy
Journal: Genome biology (2020)

Abstract Recent long-read assemblies often exceed the quality and completeness of available reference genomes, making validation challenging. Here we present Merqury, a novel tool for reference-free assembly evaluation based on efficient k-mer set operations. By comparing k-mers in a de novo assembly to those found in unassembled high-accuracy reads, Merqury estimates base-level accuracy and completeness. For trios, Merqury can also evaluate haplotype-specific accuracy, completeness, phase block continuity, and switch errors. Multiple visualizations, such as k-mer spectrum plots, can be generated for evaluation. We demonstrate on both human and plant genomes that Merqury is a fast and robust method for assembly validation.
Covid-19: Reward healthcare staff for pandemic work, says BMA
Authors: Abi Rimmer
Journal: BMJ (2020)

Doctors and healthcare staff who have worked during the covid-19 pandemic should be rewarded to reflect their personal sacrifice, BMA representatives have said.An overwhelming majority of doctors attending the association's annual representative meeting, held virtually on Tuesday 15 September, voted in favour of a motion commending the work of healthcare staff.It said that staff have worked outside their specialties, worked additional hours, and worked at increased risk to their health.
An intervention to optimise coach-created motivational climates and reduce athlete willingness to dope (CoachMADE): a three-country cluster randomised controlled trial
Authors: Nikos Ntoumanis, Eleanor Quested, Laurie Patterson, Stella Kaffe, Susan H Backhouse, George Pavlidis, Lisa Whitaker, Vassilis Barkoukis, Brendan J Smith, Helen R Staff, Daniel F Gucciardi
Journal: British Journal of Sports Medicine (2020)

Objectives Coach-centred antidoping education is scarce. We tested the efficacy of a motivationally informed antidoping intervention for coaches, with their athletes’ willingness to dope as the primary outcome. Methods We delivered a cluster randomised controlled trial in Australia, the UK and Greece. This study was a parallel group, two-condition, superiority trial. Participants were 130 coaches and 919 athletes. Coaches in the intervention group attended two workshops and received supplementary information to support them in adopting a motivationally supportive communication style when discussing doping-related issues with their athletes. Coaches in the control condition attended a standard antidoping workshop that provided up-to-date information on antidoping issues yet excluded any motivation-related content. Assessments of willingness to dope (primary outcome) and other secondary outcomes were taken at baseline, postintervention (3 months) and at a 2-month follow up. Results Compared with athletes in the control group, athletes in the intervention group reported greater reductions in willingness to take prohibited substances (effect size g=0.17) and psychological need frustration (g=0.23) at postintervention, and greater increases in antidoping knowledge (g=0.27) at follow-up. Coaches in the intervention group reported at postintervention greater increases in efficacy to create an antidoping culture (g=0.40) and in perceived effectiveness of need supporting behaviours (g=0.45) to deal with doping-related situations. They also reported greater decreases in doping attitudes (g=0.24) and perceived effectiveness of need thwarting behaviours (g=0.35). Conclusions Antidoping education programmes should consider incorporating principles of motivation, as these could be beneficial to coaches and their athletes. We offer suggestions to strengthen these programmes, as most of the effects we observed were not sustained at follow-up. Trial registration number This trial has been registered with the Australian New Zealand Clinical Trials Registry ( https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371465&amp;isReview=true ).
Harnessing the bioresponsive adhesion of immuno-bioglue for enhanced local immune checkpoint blockade therapy
Authors: Kye Il Joo, Yeonsu Jeong, Sung-Min Hwang, Mincheol Shin, Jaeyun Lee, Garima Sharma, Haena Lee, Sin-Hyeog Im, Hyung Joon Cha
Journal: Biomaterials (2020)
Usefulness of sheath lifting after saline injection technique for colorectal endoscopic submucosal dissection
Authors: Taiji Yoshimoto, Tomoatsu Yoshihara, Kenichiro Motozato, Masanao Uraoka, Hiroshi Takihara, Taro Inoue, Akira Asano
Journal: Endoscopy (2020)

Although colorectal endoscopic submucosal dissection (ESD) enables high en bloc resection regardless of tumor size, it is still a challenging procedure because of its technical difficulties, relatively long procedure time, and high rates of perforation [1] [2] [3]. One of the most important things to prevent perforation during colonic ESDs is to maintain the cutting direction of the ESD knife parallel to the muscle layer to avoid dissecting into this layer. In clinical practice, however, the angulated, narrow colon and peristalsis can make it difficult to keep the cutting direction parallel to the muscle layer. The "sheath lifting after saline injection" technique involves using the sheath of the ESD knife to lift the submucosal layer away from the muscle layer just after injecting normal saline into the submucosal layer ([Fig. 1]). This technique has three steps. First, normal saline is injected into the submucosal layer via ESD knives that have a water jet function, such as the FlushKnife BT-S (Fujifilm Co., Tokyo, Japan) [4]. Second, the sheath of the ESD knife is inserted into the submucosal layer and the length of the ESD knife is adjusted [5]. Third, the submucosal layer is lifted with the sheath and then cut towards the larger space of the colonic lumen. [Video 1] shows a colonic ESD case using this technique. After mucosal incision, we found that the cutting direction of the ESD knife was toward the muscle layer because the muscle layer seemed to be going upward. To overcome this, we performed the sheath lifting after saline injection technique ([Fig. 2]).