tbuckley/cabot-search huggingface dataset:
Effect of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China: a modelling study
Authors: Tim K Tsang, Peng Wu, Yun Lin, Eric H Y Lau, Gabriel M Leung, Benjamin J Cowling
Journal: The Lancet Public Health (2020)

When a new infectious disease emerges, appropriate case definitions are important for clinical diagnosis and for public health surveillance. Tracking case numbers over time is important to establish the speed of spread and the effectiveness of interventions. We aimed to assess whether changes in case definitions affected inferences on the transmission dynamics of coronavirus disease 2019 (COVID-19) in China.We examined changes in the case definition for COVID-19 in mainland China during the first epidemic wave. We used exponential growth models to estimate how changes in the case definitions affected the number of cases reported each day. We then inferred how the epidemic curve would have appeared if the same case definition had been used throughout the epidemic.From Jan 15 to March 3, 2020, seven versions of the case definition for COVID-19 were issued by the National Health Commission in China. We estimated that when the case definitions were changed, the proportion of infections being detected as cases increased by 7·1 times (95% credible interval [CrI] 4·8-10·9) from version 1 to 2, 2·8 times (1·9-4·2) from version 2 to 4, and 4·2 times (2·6-7·3) from version 4 to 5. If the fifth version of the case definition had been applied throughout the outbreak with sufficient testing capacity, we estimated that by Feb 20, 2020, there would have been 232 000 (95% CrI 161 000-359 000) confirmed cases in China as opposed to the 55 508 confirmed cases reported.The case definition was initially narrow and was gradually broadened to allow detection of more cases as knowledge increased, particularly milder cases and those without epidemiological links to Wuhan, China, or other known cases. These changes should be taken into account when making inferences on epidemic growth rates and doubling times, and therefore on the reproductive number, to avoid bias.Health and Medical Research Fund, Hong Kong.
Erratum: Corrigendum: Targeting CASP8 and FADD-like apoptosis regulator ameliorates nonalcoholic steatohepatitis in mice and nonhuman primates
Authors: Pi-Xiao Wang, Yan-Xiao Ji, Xiao-Jing Zhang, Ling-Ping Zhao, Zhen-Zhen Yan, Peng Zhang, Li-Jun Shen, Xia Yang, Jing Fang, Song Tian, Xue-Yong Zhu, Jun Gong, Xin Zhang, Qiao-Fang Wei, Yong Wang, Jing Li, Lu Wan, Qingguo Xie, Zhi-Gang She, Zhihua Wang, Zan Huang, Hongliang Li
Journal: Nature Medicine (2017)
Evaluation and Care of Patients with Diabetic Retinopathy
Authors: Lee M. Jampol, Adam R. Glassman, Jennifer Sun
Journal: New England Journal of Medicine (2020)

Diabetic retinopathy is a leading cause of both moderate and severe vision loss worldwide. Over the past decade, advances in technology have dramatically improved the evaluation, treatment, and visual outcomes of patients with diabetic retinopathy. Current approaches are reviewed.
Association Between Mode of First Delivery and Subsequent Fecundity and Fertility
Authors: Kristen H. Kjerulff, Ian M. Paul, Carol S. Weisman, Marianne M. Hillemeier, Ming Wang, Richard S. Legro, John T. Repke
Journal: JAMA Network Open (2020)

<h3>Importance</h3> More than 20% of births globally are by cesarean delivery, including more than 30% in the US. Prior studies have reported lower rates of childbearing after cesarean delivery, but it is not clear if this is due to maternal choice or lower conception rates. <h3>Objective</h3> To investigate the association between mode of first delivery and subsequent conceptions and live births. <h3>Design, Setting, and Participants</h3> The First Baby Study was a multicenter prospective cohort study of women aged 18 to 35 years with singleton pregnancies, enrolled and interviewed before first childbirth, who delivered in Pennsylvania from 2009 to 2011 and were followed up for 36 months after delivery (until April 2014). Data analysis for this study took place between May and July 2019 and in January 2020. <h3>Exposures</h3> Mode of first delivery (cesarean or vaginal). <h3>Main Outcomes and Measures</h3> Rates of subsequent conceptions and live births. Discrete-time Cox proportional hazard regression models were used to compare the rate of subsequent conception (vaginal vs cesarean) among those who completed the 36-month survey, accounting for reported months of unprotected intercourse during the follow-up period and adjusting for relevant covariates. A log binomial regression was used to compare the age-adjusted rate of subsequent live birth (vaginal vs cesarean) among those who completed the 36-month survey. <h3>Results</h3> The study population consisted of 2423 women who were retained to the 36-month survey (mean [SD] age at baseline was 27.2 [4.4] years and 712 [29.4%] delivered by cesarean). There were 2046 women who had unprotected intercourse during the follow-up period, 2021 of whom provided data on months of unprotected intercourse. Cesarean delivery was associated with lower rates of conception after unprotected intercourse during the follow-up period (413 of 599 [68.9%]) compared with vaginal delivery (1090 of 1422 [76.7%]) (adjusted hazard ratio, 0.85; 95% CI, 0.74-0.96). Cesarean delivery was also associated with reduced likelihood of a subsequent live birth (305 women [42.8%]) compared with vaginal delivery (857 women [50.1%]), with an age-adjusted risk ratio of 0.83 (95% CI, 0.75-0.92). <h3>Conclusions and Relevance</h3> In the 3 years following first childbirth, women who delivered their first child by cesarean had lower rates of conception after unprotected intercourse, and fewer of these women had a second child than those who delivered vaginally.
Low-cost, easy-to-build noninvasive pressure support ventilator for under-resourced regions: open source hardware description, performance and feasibility testing
Authors: Onintza Garmendia, Miguel A. Rodríguez-Lazaro, Jorge Otero, Phuong Phan, Alexandrina Stoyanova, Anh Tuan Dinh-Xuan, David Gozal, Daniel Navajas, Josep M. Montserrat, Ramon Farré
Journal: European Respiratory Journal (2020)

Aim Current pricing of commercial mechanical ventilators in low-/middle-income countries (LMICs) markedly restricts their availability, and consequently a considerable number of patients with acute/chronic respiratory failure cannot be adequately treated. Our aim was to design and test an affordable and easy-to-build noninvasive bilevel pressure ventilator to allow a reduction in the serious shortage of ventilators in LMICs. Methods The ventilator was built using off-the-shelf materials available via e-commerce and was based on a high-pressure blower, two pressure transducers and an Arduino Nano controller with a digital display (total retail cost &lt;75 USD), with construction details provided open source for free replication. The ventilator was evaluated, and compared with a commercially available device (Lumis 150 ventilator; Resmed, San Diego, CA, USA): 1) in the bench setting using an actively breathing patient simulator mimicking a range of obstructive/restrictive diseases; and b) in 12 healthy volunteers wearing high airway resistance and thoracic/abdominal bands to mimic obstructive/restrictive patients. Results The designed ventilator provided inspiratory/expiratory pressures up to 20/10 cmH 2 O, respectively, with no faulty triggering or cycling; both in the bench test and in volunteers. The breathing difficulty score rated (1–10 scale) by the loaded breathing subjects was significantly (p&lt;0.005) decreased from 5.45±1.68 without support to 2.83±1.66 when using the prototype ventilator, which showed no difference with the commercial device (2.80±1.48; p=1.000). Conclusion The low-cost, easy-to-build noninvasive ventilator performs similarly to a high-quality commercial device, with its open-source hardware description, which will allow for free replication and use in LMICs, facilitating application of this life-saving therapy to patients who otherwise could not be treated.
Is ethnicity linked to incidence or outcomes of covid-19?
Authors: Kamlesh Khunti, Awadhesh Kumar Singh, Manish Pareek, Wasim Hanif
Journal: BMJ (2020)

The novel disease covid-19, caused by severe acute respiratory syndrome coronavirus SARS-CoV-2, is now a pandemic with devastating implications for populations, healthcare systems, and economies globally.Systematic reviews of ethnically homogenous cohorts from China suggest that the key risk factors for hospital admission include age, male sex, and comorbidities such as cardiovascular disease, hypertension, and diabetes. 1The UK is the first country in the covid-19 surge with an ethnically diverse population and can therefore contribute to our understanding of the disease's effects in different ethnic groups, particularly those of South Asian or African Caribbean heritage.The ethnic minority population of the UK was around 13% at the time of the last census in 2011.
Visible or invisible atypical form of microscopic colitis with giant cells: for the endoscopist, that is the question
Authors: Andrey P. Kiryukhin, Pavel V. Pavlov, Alexander A. Fedorenko, Alexander S. Tertychnyy, Tatiana L. Lapina
Journal: Endoscopy (2020)

A 64-year-old woman was admitted to the hospital with complaints of recurrent non-intensive abdominal pain without watery diarrhea; she also complained of hand tremors and dizziness. The patient had a medical history of chronic primary adrenal insufficiency for 22 years. She was on steroid replacement therapy (hydrocortisone, fludrocortisone) at the time of presentation. Physical examination was unremarkable. Laboratory test results showed only a low level serum iron (4.1 micromole/L); others (including hemoglobin, C-reactive protein) were within normal limits. Human immunodeficiency virus serology and fecal culture were negative. Upper gastrointestinal (GI) endoscopy revealed atrophic gastritis features. Colonoscopy examination showed normal ileum mucosa with local erythematous spots of mucosa in the ascending colon ([Video 1], [Fig. 1]); a biopsy was performed simultaneously. Histopathological examination of the biopsy demonstrated an increased number of intraepithelial lymphocytes and normal crypt architecture with no clearly thickened subepithelial collagen layer. In addition, subepithelial multinucleated giant cells were present ([Fig. 2 a, b]). No true granulomas, foreign material, or microorganisms were seen. Special stains for fungi and acid-fast bacilli were negative. An atypical form of microscopic colitis with giant cells was confirmed.
Sexual Misconduct in Academic Medicine
Authors: Julie Ann Freischlag, Katherine Files
Journal: JAMA (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Covid-19: UK pledges to reintroduce contact tracing to fight virus
Authors: Gareth Iacobucci
Journal: BMJ (2020)

The government is to reintroduce contact tracing of people who have had symptoms of covid-19, England’s health secretary, Matt Hancock, said last week.

Hancock told MPs on the health select committee that the planned increase in testing capacity (the government has promised to conduct 100 000 tests a day by the end of April) would enable it to restart a policy that it stopped in March when the prevalence of the virus began to increase in the UK.

He said, “Community testing is part of the strategy, and we will be introducing it when we can. It wasn’t possible when we had small numbers of tests, but as we have expanding numbers of tests it will be possible.”

Hancock said that a central team would be set up to implement the strategy, which includes an app for people to trace and report their contacts themselves, alongside more traditional methods such as using health professionals to proactively contact and trace people.

“That [central team] brings together teams from NHSX, who are leading on the app, with a huge array of partners that are working within that, [and] from Public Health England, who are the experts on what we refer to as external contact tracing,” Hancock said.

Hancock said the app …
Development and validation of a deep neural network model to predict postoperative mortality, acute kidney injury, and reintubation using a single feature set
Authors: Ira S. Hofer, Christine Lee, Eilon Gabel, Pierre Baldi, Maxime Cannesson
Journal: npj Digital Medicine (2020)

During the perioperative period patients often suffer complications, including acute kidney injury (AKI), reintubation, and mortality. In order to effectively prevent these complications, high-risk patients must be readily identified. However, most current risk scores are designed to predict a single postoperative complication and often lack specificity on the patient level. In other fields, machine learning (ML) has been shown to successfully create models to predict multiple end points using a single input feature set. We hypothesized that ML can be used to create models to predict postoperative mortality, AKI, reintubation, and a combined outcome using a single set of features available at the end of surgery. A set of 46 features available at the end of surgery, including drug dosing, blood loss, vital signs, and others were extracted. Additionally, six additional features accounting for total intraoperative hypotension were extracted and trialed for different models. A total of 59,981 surgical procedures met inclusion criteria and the deep neural networks (DNN) were trained on 80% of the data, with 20% reserved for testing. The network performances were then compared to ASA Physical Status. In addition to creating separate models for each outcome, a multitask learning model was trialed that used information on all outcomes to predict the likelihood of each outcome individually. The overall rate of the examined complications in this data set was 0.79% for mortality, 22.3% (of 21,676 patients with creatinine values) for AKI, and 1.1% for reintubation. Overall, there was significant overlap between the various model types for each outcome, with no one modeling technique consistently performing the best. However, the best DNN models did beat the ASA score for all outcomes other than mortality. The highest area under the receiver operating characteristic curve (AUC) models were 0.792 (0.775-0.808) for AKI, 0.879 (0.851-0.905) for reintubation, 0.907 (0.872-0.938) for mortality, and 0.874 (0.864-0.866) for any outcome. The ASA score alone achieved AUCs of 0.652 (0.636-0.669) for AKI, 0.787 (0.757-0.818) for reintubation, 0.839 (0.804-0.875) for mortality, and 0.76 (0.748-0.773) for any outcome. Overall, the DNN architecture was able to create models that outperformed the ASA physical status to predict all outcomes based on a single feature set, consisting of objective data available at the end of surgery. No one model architecture consistently performed the best.
Corrigendum to “World Health Organization declares Global Emergency: A review of the 2019 Novel Coronavirus (COVID-19)” [Int. J. Surg. 76 (2020) 71–76]
Authors: Catrin Sohrabi, Zaid Alsafi, Niamh O'Neill, Mehdi Khan, Ahmed Kerwan, Ahmed Al-Jabir, Christos Iosifidis, Riaz Agha
Journal: International Journal of Surgery (2020)
Abstract 16706: The Use of a Precision Medicine Blood Test in a Rural Setting May Reduce the Need for Unnecessary Patient Travel to Undergo Advanced Cardiac Testing
Authors: Nicolas Chronos, Leigh Ann Wilson, Todd Mc Allister, Pafe Poteh, Sallie Coke, Lin Huang, Andrea Johnson, Jane Z Kuo, Mark Monane, Pejman Azarmina
Journal: Circulation (2018)

Introduction: Patients in the rural setting have been shown to have less access to specialist care. More effective tactics are needed to evaluate symptomatic patients with suspected obstructive coronary artery disease (CAD) in this setting. A blood-based age/sex/gene expression score (ASGES) incorporating key features of precision medicine has shown clinical validity with a 96% negative predictive value and 89% sensitivity in estimating a symptomatic patient’s current likelihood of obstructive CAD. Objective: The objective of this retrospective study was to evaluate the use of an ASGES and its effects on unnecessary testing and patient travel burden for rural patients with suspected ischemic heart disease. Methods: Medical records of 112 symptomatic patients with no previous advanced cardiac testing were analyzed at a single, rural-based cardiology clinic from 2014 to 2016. Demographics, clinical characteristics, and ASGES (predefined as low &lt; 15 and elevated &gt; 15) results, as well as follow-up for major adverse cardiac events (MACE) and coronary artery revascularizations were collected for analysis (median follow-up of 389 days). Mileage is calculated as the cumulative distance from a patient’s zip code to the care center using Google map. Patients who had concomitant diagnoses outside of intended use were excluded. Results: Among 112 patients, 58 (52%) had a low score of ≤15, with an average ASGES of 7 (interquartile range 3.5 -11). Of the 58 patients with low scores, the average age was 59 (±13), 54 (93%) were women, 47 (81%) were white, and 49 (84%) had typical angina symptoms. With respect to a decrease in travel burden, the majority of low score patients (59%) made more than one trip following the initial workup, traveling a median of 325 miles. Among the 112 patients, MACE/revascularization was found in 2 patients (2 events) with low ASGES compared to 4 patients (9 events) in the elevated ASGES group. Conclusions: This study highlights the potential utility of a simple blood test in the rural setting to rule out obstructive CAD and avoid unnecessary travel burden for advanced cardiac testing. Almost half of the eligible patients had a low score and were at low current likelihood for obstructive CAD, thus they were unlikely to benefit from further testing.
JAK2 Mutations at Exon 12 and 14 in Polycythemia Vera and Idiopathic Erythrocytosis: Incidence and Correlation with Clinical Characteristics.
Authors: Carlos Besses, Luz Martínez-Avilés, Alberto Alvarez-Larrán, Francisco Cervantes, Juan Carlos Hernández-Boluda, Dolors Colomer, Lourdes Florensa, Sergi Serrano, Beatriz Bellosillo
Journal: Blood (2007)
Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
Authors: Milena A Gianfrancesco, Kimme L Hyrich, Laure Gossec, Anja Strangfeld, Loreto Carmona, Elsa F Mateus, Paul Sufka, Rebecca Grainger, Zachary Wallace, Suleman Bhana, Emily Sirotich, Jean Liew, Jonathan S Hausmann, Wendy Costello, Philip Robinson, Pedro M Machado, Jinoos Yazdany
Journal: The Lancet Rheumatology (2020)

Individuals with inflammatory rheumatic disease require special consideration with regard to coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many of these individuals are considered at-risk for serious infections due to their immunocompromised state resulting from their underlying immune conditions and use of targeted immune-modulating therapies such as biologics.1–4 However, some disease-modifying drugs commonly used to treat rheumatic diseases, such as hydroxychloroquine, are being investigated as potential therapies for COVID-19.
Striatal Kir2 K+ channel inhibition mediates the antidyskinetic effects of amantadine
Authors: Weixing Shen, Wenjie Ren, Shenyu Zhai, Ben Yang, Carlos G. Vanoye, Ananya Mitra, Alfred L. George, D. James Surmeier
Journal: Journal of Clinical Investigation (2020)

Levodopa-induced dyskinesia (LID) poses a significant health care challenge for Parkinson's disease (PD) patients. Amantadine is currently the only drug proven to alleviate LID. Although its efficacy in treating LID is widely assumed to be mediated by blockade of N-methyl-D-aspartate (NMDA) glutamate receptors, our experiments demonstrate that at therapeutically relevant concentrations, amantadine preferentially blocks inward-rectifying K+ channel type 2 (Kir2) channels in striatal spiny projection neurons (SPNs) - not NMDA receptors. In so doing, amantadine enhances dendritic integration of excitatory synaptic potentials in SPNs and enhances - not antagonizes - the induction of long-term potentiation (LTP) at excitatory, axospinous synapses. Taken together, our studies suggest that the alleviation of LID in PD patients is mediated by diminishing the disparity in the excitability of direct- and indirect-pathway SPNs in the on state, rather than by disrupting LTP induction. This insight points to a pharmacological approach that could be used to effectively ameliorate LID and improve the quality of life for PD patients.
Publisher Correction: Blocking elevated p38 MAPK restores efferocytosis and inflammatory resolution in the elderly
Authors: Roel P. H. De Maeyer, Rachel C. van de Merwe, Rikah Louie, Olivia V. Bracken, Oliver P. Devine, Daniel R. Goldstein, Mohib Uddin, Arne N. Akbar, Derek W. Gilroy
Journal: Nature Immunology (2020)
Intramucosal true perineurioma of the sigmoid: endoscopic and pathological features of an infrequent lesion
Authors: Andrey P. Kiryukhin, Pavel V. Pavlov, Alexander A. Fedorenko, Alexander S. Tertychnyy
Journal: Endoscopy (2020)

A 59-year-old woman was admitted to our hospital with complaints of recurrent non-intensive pain in the right side, constipation, and abdominal distension. The patient had a medical history of dolichocolon. Her physical examination and laboratory test results were unremarkable. Abdominal ultrasonography showed moderate diffuse parenchymal changes in the liver (liver steatosis) and pancreas. Colonoscopy revealed redundant colon with a non-epithelial lesion of the sigmoid that had a diameter of 0.6 cm with a smooth surface and regular capillary pattern ([Fig. 1]; [Video 1]), which was biopsied during the procedure.