tbuckley/cabot-search huggingface dataset:
Heterogeneous trends in burden of heart disease mortality by subtypes in the United States, 1999-2018: observational analysis of vital statistics
Authors: Nilay S Shah, Rebecca Molsberry, Jamal S Rana, Stephen Sidney, Simon Capewell, Martin O’Flaherty, Mercedes Carnethon, Donald M Lloyd-Jones, Sadiya S Khan
Journal: BMJ (2020)

Abstract Objective To describe trends in the burden of mortality due to subtypes of heart disease from 1999 to 2018 to inform targeted prevention strategies and reduce disparities. Design Serial cross sectional analysis of cause specific heart disease mortality rates using national death certificate data in the overall population as well as stratified by race-sex, age, and geography. Setting United States, 1999-2018. Participants 12.9 million decedents from total heart disease (49% women, 12% black, and 19% &lt;65 years old). Main outcome measures Age adjusted mortality rates (AAMR) and years of potential life lost (YPLL) for each heart disease subtype, and respective mean annual percentage change. Results Deaths from total heart disease fell from 752 192 to 596 577 between 1999 and 2011, and then increased to 655 381 in 2018. From 1999 to 2018, the proportion of total deaths from heart disease attributed to ischemic heart disease decreased from 73% to 56%, while the proportion attributed to heart failure increased from 8% to 13% and the proportion attributed to hypertensive heart disease increased from 4% to 9%. Among heart disease subtypes, AAMR was consistently highest for ischemic heart disease in all subgroups (race-sex, age, and region). After 2011, AAMR for heart failure and hypertensive heart disease increased at a faster rate than for other subtypes. The fastest increases in heart failure mortality were in black men (mean annual percentage change 4.9%, 95% confidence interval 4.0% to 5.8%), whereas the fastest increases in hypertensive heart disease occurred in white men (6.3%, 4.9% to 9.4%). The burden of years of potential life lost was greatest from ischemic heart disease, but black-white disparities were driven by heart failure and hypertensive heart disease. Deaths from heart disease in 2018 resulted in approximately 3.8 million potential years of life lost. Conclusions Trends in AAMR and years of potential life lost for ischemic heart disease have decelerated since 2011. For almost all other subtypes of heart disease, AAMR and years of potential life lost became stagnant or increased. Heart failure and hypertensive heart disease account for the greatest increases in premature deaths and the largest black-white disparities and have offset declines in ischemic heart disease. Early and targeted primary and secondary prevention and control of risk factors for heart disease, with a focus on groups at high risk, are needed to avoid these suboptimal trends beginning earlier in life.
Absolute Lymphocyte Count after First Induction Is Associated with Relapse Free Survival in Acute Myeloid Leukemia
Authors: Tatiana I. Lobanova, Elena N. Parovichnikova, Irina V. Galtseva, Julia O. Davydova, Nikolay M. Kapranov, Zalina T. Fidarova, Olga A. Gavrilina, Vera V. Troitskaya, Valery Savchenko
Journal: Blood (2017)
Delivering low-dose CT screening for lung cancer: a pragmatic approach
Authors: Carolyn Horst, Jennifer L Dickson, Sophie Tisi, Mamta Ruparel, Arjun Nair, Anand Devaraj, Sam M Janes
Journal: Thorax (2020)

Lung cancer kills an estimated 35 000 people in the UK every year. Despite the improvements in treating late-stage disease, lung cancer outcomes have changed little in the last 40 years. Low-dose CT (LDCT) screening for lung cancer reduces lung cancer mortality by 20%–24% and all-cause mortality by 7%.1 2 Lung cancer screening (LCS) however remains contentious, particularly how to implement it in an efficient and efficacious way. This contention extends to the potential costs of screening—financial to the National Health Service (NHS), and physical and psychological harms to patients. These concerns are particularly relevant to how we manage both the findings we aim to detect through screening (pulmonary nodules) and those we pick up inadvertently (incidental findings). The SUMMIT Study is the largest CT screening study in Europe and a key endpoint is detailing the feasibility of delivering CT screening across a complete population within the NHS. We present here SUMMIT’s approach to nodule and incidental findings management, a pragmatic model that is neither overly burdensome nor unsafe and provides a practical solution to some of the challenges of LDCT LCS.

The SUMMIT study (ClinicalTrials.gov NCT03934866) is an LCS study recruiting individuals 55–77 years old at high risk of lung and other smoking-related cancers to LDCT screening. Its twin aims are to examine the performance of delivering an LDCT screening service for lung cancer to a high-risk population and to validate a cell-free nucleic acid blood test for detection of multiple cancers. The study began enrolment in April 2019 after the development of protocols for the management of pulmonary nodules and incidental findings that enabled a consistent approach to management across the entirety of the study (target recruitment of 25 000). The study aims to deliver a programme of LCS that is pragmatic, evidence-based, and practically deliverable by …
Effect of Aspirin on Cancer Incidence and Mortality in Older Adults
Authors: John J McNeil, , *Peter Gibbs, Suzanne G Orchard, Jessica E Lockery, Wendy B Bernstein, Yin Cao, Leslie Ford, Andrew Haydon, Brenda Kirpach, Finlay Macrae, Catriona McLean, Jeremy Millar, Anne M Murray, Mark R Nelson, Galina Polekhina, Christopher M Reid, Ellen Richmond, Luz Maria Rodríguez, Raj C Shah, Jeanne Tie, Asad Umar, G J van Londen, Kathlyn Ronaldson, Rory Wolfe, Robyn L Woods, John Zalcberg, Andrew T Chan
Journal: JNCI Journal of the National Cancer Institute (2020)

Abstract Background ASPirin in Reducing Events in the Elderly, a randomized, double-blind, placebo-controlled trial of daily low-dose aspirin (100 mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast, prior randomized controlled trials, mainly involving younger individuals, demonstrated a delayed cancer benefit with aspirin. We now report a detailed analysis of cancer incidence and mortality. Methods 19 114 Australian and US community-dwelling participants aged 70 years and older (US minorities 65 years and older) without cardiovascular disease, dementia, or physical disability were randomly assigned and followed for a median of 4.7 years. Fatal and nonfatal cancer events, a prespecified secondary endpoint, were adjudicated based on clinical records. Results 981 cancer events occurred in the aspirin and 952 in the placebo groups. There was no statistically significant difference between groups for all incident cancers (hazard ratio [HR] = 1.04, 95% confidence interval [CI] = 0.95 to 1.14), hematological cancer (HR = 0.98, 95% CI = 0.73 to 1.30), or all solid cancers (HR = 1.05, 95% CI = 0.95 to 1.15), including by specific tumor type. However, aspirin was associated with an increased risk of incident cancer that had metastasized (HR = 1.19, 95% CI = 1.00 to 1.43) or was stage 4 at diagnosis (HR = 1.22, 95% CI = 1.02 to 1.45), and with higher risk of death for cancers that presented at stages 3 (HR = 2.11, 95% CI = 1.03 to 4.33) or 4 (HR = 1.31, 95% CI = 1.04 to 1.64). Conclusions In older adults, aspirin treatment had an adverse effect on later stages of cancer evolution. These findings suggest that in older persons, aspirin may accelerate the progression of cancer and, thus, suggest caution with its use in this age group.
Enhanced immunotherapeutic profile of oncolytic virus-based cancer vaccination using cyclophosphamide preconditioning
Authors: Jonathan G Pol, Matthew J Atherton, Kyle B Stephenson, Byram W Bridle, Samuel T Workenhe, Natasha Kazdhan, AJ Robert McGray, Yonghong Wan, Guido Kroemer, Brian D Lichty
Journal: Journal for ImmunoTherapy of Cancer (2020)

Despite a sizeable body of research, the efficacy of therapeutic cancer vaccines remains limited when applied as sole agents. By using a prime:boost approach involving two viral cancer vaccines, we were able to generate large tumor-specific CD8+ T-cell responses in a murine model of disseminated pulmonary melanoma. Significant increases in the number and quality of circulating effector T-cells were documented when low-dose cyclophosphamide (CTX) was administered pre-vaccination to tumor-bearing but not tumor-free hosts. Interestingly, tumor-bearing mice receiving CTX and co-primed with a melanoma differentiation antigen together with an irrelevant control antigen exhibited significantly enhanced immunity against the tumor, but not the control antigen, in secondary lymphoid organs. This result highlighted an increased cancer-specific reactivity of vaccine-induced T-cell responses following CTX preconditioning. Additionally, an acute reduction of the frequency of peripheral regulatory T-cells (Tregs) was noticeable, particularly in the proliferating, presumably tumour-reactive, subset. Enhanced infiltration of lungs with multifunctional T-cells resulted in overt reduction in metastatic burden in mice pretreated with CTX. Despite doubling the median survival in comparison to untreated controls, most vaccinated mice ultimately succumbed to cancer progression. However, preconditioning of the virus-based vaccination with CTX resulted in a remarkable improvement of the therapeutic activity leading to complete remission in the majority of the animals. Collectively, these data reveal how CTX can potentiate specific cellular immunity in an antigen-restricted manner that is only observed in vaccinated tumor-bearing hosts while depleting replicating Tregs. A single low dose of CTX enhances antitumor immunity and the efficacy of this potent prime:boost platform by modulating the kinetics of the vaccine-specific responses. Clinical assessment of CTX combined with next-generation cancer vaccines is indicated.
COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force
Authors: Martijn A. Spruit, Anne E. Holland, Sally J. Singh, Thomy Tonia, Kevin C. Wilson, Thierry Troosters
Journal: European Respiratory Journal (2020)

Patients with COVID-19 or post-COVID-19 will most probably have a need for rehabilitation during and directly after the hospitalisation. Data on safety and efficacy are lacking. Healthcare professionals cannot wait for published randomised controlled trials before they can start these rehabilitative interventions in daily clinical practice, as the number of post-COVID-19 patients increases rapidly. The Convergence of Opinion on Recommendations and Evidence process was used to make interim recommendation for the rehabilitation in the hospital and post-hospital phase in COVID-19 and post-COVID-19 patients, respectively.
Increased mortality in patients with severe SARS-CoV-2 infection admitted within seven days of disease onset
Authors: Elie Azoulay, Muriel Fartoukh, Michael Darmon, Guillaume Géri, Guillaume Voiriot, Thibault Dupont, Lara Zafrani, Lola Girodias, Vincent Labbé, Martin Dres, Alexandra Beurton, Antoine Vieillard-Baron, Alexandre Demoule
Journal: Intensive Care Medicine (2020)
More on Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China
Authors: Lynne M Mofenson, Andrea Ciaranello, Nicole LaHood
Journal: New England Journal of Medicine (2020)

More on Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, ChinaTo the Editor: Chen and colleagues (June 18 issue) 1 reported data, obtained from the reporting system of the National Health Commission of China, regarding 118 pregnant women with coronavirus disease 2019 (Covid-19) at 50 hospitals in Wuhan, China, from December 8, 2019, through March 20, 2020.Since January 2020, an additional 27 publications have described pregnancy outcomes among women with Covid-19 at one or more of the same hospitals in Wuhan, with dates that overlap with those covered in the report by Chen et al.If we count all the patients described in these reports as separate patients, then the reports include data on 446 pregnant women with Covid-19 (of whom 45 are still pregnant), as well as 401 births and 293 throat or nasopharyngeal swabs from infants (see the table in the Supplementary Appendix, available with the full text of this letter at NEJM.org).Of the infant swabs, 10 were reported as positive for the virus, with the infant's age at testing ranging from less than 24 hours to 2 days.Chen et al. reported that only 8 of 70 newborns were tested, with no positive results.We assume that the report by Chen et al. encompasses data from previous reports and are concerned about this discrepancy regarding infant test results, given the 10 positive tests reported in previous publications.Greater clarity is needed regarding overlap and inconsistencies with respect to other reports.
Sequencing Systemic Therapy Pathways for Advanced Hepatocellular Carcinoma: A Cost Effectiveness Analysis
Authors: Christopher Sherrow, Kristopher Attwood, Kehua Zhou, Sarbajit Mukherjee, Renuka Iyer, Christos Fountzilas
Journal: Liver Cancer (2020)

Hepatocellular carcinoma (HCC) is the most common form of liver cancer worldwide and carries a poor prognosis. Historically, sorafenib was the only available systemic treatment for advanced HCC. However, in recent years, 6 new treatments have been approved by the US Food and Drug Administration (FDA): regorafenib, lenvatinib, cabozantinib, pembrolizumab, ramucirumab, and nivolumab. Data are lacking regarding the most appropriate sequencing pathway for these agents. Our objective was to conduct a comprehensive cost effectiveness analysis (CEA) of different 1st- and 2nd-line treatment pathways for HCC reflecting all new drug approvals, and then use our data to provide guidance for clinicians on which pathway is the most cost-effective.Markov models were used to evaluate the cost effectiveness of 8 different 1st- and 2nd-line treatment sequences. The model allowed for 9 possible states. Cost effectiveness ratios (CER) and incremental CER (ICER) were calculated to compare costs between different pathways and against a willingness-to-pay (WTP) threshold. Efficacy and toxicity data were extracted from the landmark trials for each agent. All agents except ramucirumab were included. The cost of each agent was based on the wholesale acquisition cost (WAC) in USD as of June 2019. Monte-Carlo methods were used to simulate the experience of 1,000,000 patients per treatment sequence for a 12-month period.The pathway with the lowest CER was sorafenib, followed by pembrolizumab (USD 227,741.03/quality-adjusted life year [QALY]). ICER analysis supported implementing 2nd-line pembrolizumab-based pathways at a higher WTP threshold of 300,000/quality-adjusted life year. Sensitivity analysis did not substantially change these results.The most cost-effective strategy was 1st-line tyrosine kinase inhibitor therapy followed by 2nd-line immunotherapy. All pathways exceeded a commonly accepted WTP of USD 100-150,000/QALY. Our preliminary results warrant further studies to best inform real-world practices.
Active Margins, Plexitis, and Granulomas Increase Postoperative Crohn’s Recurrence: Systematic Review and Meta-analysis
Authors: Parul Tandon, Gurpreet Malhi, Daniyal Abdali, Elahn Pogue, John K. Marshall, Anthony de Buck van Overstraeten, Robert Riddell, Neeraj Narula
Journal: Clinical Gastroenterology and Hepatology (2020)
Does the Spraino low-friction shoe patch prevent lateral ankle sprain injury in indoor sports? A pilot randomised controlled trial with 510 participants with previous ankle injuries
Authors: Filip Gertz Lysdal, Thomas Bandholm, Janne Schurmann Tolstrup, Mikkel Bek Clausen, Stephanie Mann, Pelle Baggesgaard Petersen, Thor Buch Grønlykke, Uwe G Kersting, Eamonn Delahunt, Kristian Thorborg
Journal: British Journal of Sports Medicine (2020)

Background Lateral ankle sprains are common in indoor sports. High shoe–surface friction is considered a risk factor for non-contact lateral ankle sprains. Spraino is a novel low-friction patch that can be attached to the outside of sports shoes to minimise friction at the lateral edge, which could mitigate the risk of such injury. We aimed to determine preliminary effectiveness (incidence rate and severity) and safety (harms) of Spraino to prevent lateral ankle sprains among indoor sport athletes. Methods In this exploratory, parallel-group, two-arm pilot randomised controlled trial, 510 subelite indoor sport athletes with a previous lateral ankle sprain were randomly allocated (1:1) to Spraino or ‘do-as-usual’. Allocation was concealed and the trial was outcome assessor blinded. Match and training exposure, number of injuries and associated time loss were captured weekly via text messages. Information on harms, fear-of-injury and ankle pain was also documented. Results 480 participants completed the trial. They reported a total of 151 lateral ankle sprains, of which 96 were categorised as non-contact, and 50 as severe. All outcomes favoured Spraino with incidence rate ratios of 0.87 (95% CI 0.62 to 1.23) for all lateral ankle sprains; 0.64 (95% CI 0.42 to 0.98) for non-contact lateral ankle sprains; and 0.47 (95% CI 0.25 to 0.88) for severe lateral ankle sprains. Time loss per injury was also lower in the Spraino group (1.8 vs 2.8 weeks, p=0.014). Six participants reported minor harms because of Spraino. Conclusion Compared with usual care, athletes allocated to Spraino had a lower risk of lateral ankle sprains and less time loss, with only few reported minor harms. Trial registration number NCT03311490 .
A cognitive approach to cumulative technological culture is useful and necessary but only if it also applies to other species
Authors: Thibaud Gruber
Journal: Behavioral and Brain Sciences (2020)

Abstract The debate on cumulative technological culture (CTC) is dominated by social-learning discussions, at the expense of other cognitive processes, leading to flawed circular arguments. I welcome the authors' approach to decouple CTC from social-learning processes without minimizing their impact. Yet, this model will only be informative to understand the evolution of CTC if tested in other cultural species.
Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy
Authors: Vincenzo Montesarchio, Roberto Parella, Chiara Iommelli, Antonella Bianco, Elio Manzillo, Fiorentino Fraganza, Cristiana Palumbo, Gaetano Rea, Patrizia Murino, Rosanna De Rosa, Luigi Atripaldi, Maurizio D’Abbraccio, Marcello Curvietto, Domenico Mallardo, Egidio Celentano, Antonio Maria Grimaldi, Marco Palla, Claudia Trojaniello, Maria Grazia Vitale, Samuel Lewis Million-Weaver, Paolo Antonio Ascierto
Journal: Journal for ImmunoTherapy of Cancer (2020)

Background The inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing. Study description In this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease. Conclusions This observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.
Missing in action: Tool use is action based
Authors: Jeffrey J. Lockman, Catherine S. Tamis-LeMonda, Karen E. Adolph
Journal: Behavioral and Brain Sciences (2020)

Abstract In this commentary on Osiurak and Reynaud's target article, we argue that action is largely missing in their account of the ascendance of human technological culture. We propose that an action-based developmental account can help to bridge the cognitive-sociocultural divide in explanations of the discovery, production, and cultural transmission of human tool use.
Consent for elective surgery: audiovisual devices could be used
Authors: Federica Foti, Giuseppe Vetrugno, Fabio De-Giorgio, Michela Cicconi
Journal: BMJ (2020)

Sokol and Dattani ask how to obtain consent now that hospitals are resuming elective surgery.1 The use of paper leaflets is already known to have potential side effects, but there is an additional problem specifically related to covid-19. The subscription and storage of paper consent forms could facilitate the circulation of the virus, as it …
Global variations in the prevalence, treatment, and impact of atrial fibrillation in a multi-national cohort of 153 152 middle-aged individuals
Authors: Philip G Joseph, Jeffrey S Healey, Parminder Raina, Stuart J Connolly, Quazi Ibrahim, Rajeev Gupta, Alvaro Avezum, Antonio L Dans, Patricio Lopez-Jaramillo, Karen Yeates, Koon Teo, Reuben Douma, Ahmad Bahonar, Jephat Chifamba, Fernando Lanas, Gilles R Dagenais, Scott A Lear, Rajesh Kumar, Andre P Kengne, Mirac Keskinler, Viswanathan Mohan, Prem Mony, Khalid F Alhabib, Hugo Huisman, Thomas Iype, Katarzyna Zatonska, Rosnah Ismail, Khawar Kazmi, Annika Rosengren, Omar Rahman, Afzalhussein Yusufali, Li Wei, Andres Orlandini, Shofiqul Islam, Sumathy Rangarajan, Salim Yusuf
Journal: Cardiovascular Research (2020)

Abstract Aims To compare the prevalence of electrocardiogram (ECG)-documented atrial fibrillation (or flutter) (AF) across eight regions of the world, and to examine antithrombotic use and clinical outcomes. Methods and results Baseline ECGs were collected in 153 152 middle-aged participants (ages 35–70 years) to document AF in two community-based studies, spanning 20 countries. Medication use and clinical outcome data (mean follow-up of 7.4 years) were available in one cohort. Cross-sectional analyses were performed to document the prevalence of AF and medication use, and associations between AF and clinical events were examined prospectively. Mean age of participants was 52.1 years, and 57.7% were female. Age and sex-standardized prevalence of AF varied 12-fold between regions; with the highest in North America, Europe, China, and Southeast Asia (270–360 cases per 100 000 persons); and lowest in the Middle East, Africa, and South Asia (30–60 cases per 100 000 persons) (P &amp;lt; 0.001). Compared with low-income countries (LICs), AF prevalence was 7-fold higher in middle-income countries (MICs) and 11-fold higher in high-income countries (HICs) (P &amp;lt; 0.001). Differences in AF prevalence remained significant after adjusting for traditional AF risk factors. In LICs/MICs, 24% of participants with AF and a CHADS2 score ≥1 received antithrombotic therapy, compared with 85% in HICs. AF was associated with an increased risk of stroke [hazard ratio (HR) 2.29; 95% confidence interval (CI) 1.49–3.52] and death (HR 2.97; 95% CI 2.25–3.93); with similar rates in different countries grouped by income level. Conclusions Large variations in AF prevalence occur in different regions and countries grouped by income level, but this is only partially explained by traditional AF risk factors. Antithrombotic therapy is infrequently used in poorer countries despite the high risk of stroke associated with AF.