tbuckley/cabot-search huggingface dataset:
Short-Term Progression of Multiterritorial Subclinical Atherosclerosis
Authors: Beatriz López-Melgar, Leticia Fernández-Friera, Belén Oliva, José Manuel García-Ruiz, Fátima Sánchez-Cabo, Héctor Bueno, José María Mendiguren, Enrique Lara-Pezzi, Vicente Andrés, Borja Ibáñez, Antonio Fernández-Ortiz, Javier Sanz, Valentín Fuster
Journal: Journal of the American College of Cardiology (2020)

Atherosclerosis progression predicts cardiovascular events; however, progression of multiterritorial subclinical atherosclerosis is incompletely understood. This study sought to study short-term progression of atherosclerosis using different noninvasive imaging techniques and their relationship with cardiovascular risk. The study included 3,514 PESA (Progression of Early Subclinical Atherosclerosis) study participants (45.7 ± 4.2 years of age; 63% men). Participants underwent 2-dimensional vascular ultrasound (2DVUS) of abdominal aorta, carotid, iliac, and femoral territories to determine a plaque number score; 3DVUS to quantify carotid and femoral plaque volume; and coronary artery calcium score (CACS) at baseline and 2.8 years later. The authors calculated the rate of new disease incidence and changes in disease extent. Logistic regression models were used to evaluate associations of progression rates with baseline cardiovascular risk factors and estimated 10-year risk. Imaging detected short-term (3-year) atherosclerosis progression in 41.5% of participants (26.4% by 2DVUS, 21.3% by 3DVUS, and 11.5% by CACS), particularly in peripheral territories examined by vascular ultrasound. New atherosclerosis onset accounted for approximately one-third of total progression, also more frequently by 2DVUS and 3DVUS (29.1% and 16.6%, respectively), than by CACS (2.9%). Participants with baseline disease by all 3 modalities (n = 432) also showed significant atherosclerosis progression (median: 1 plaque [interquartile range (IQR): −1 to 3 plaques] by 2DVUS; 7.6 mm3 [IQR: −32.2 to 57.6 mm3] by 3DVUS; and 21.6 Agatston units [IQR: 4.8 to 62.6 Agatston units] by CACS). Age, sex, dyslipidemia, hypertension, smoking, and family history of premature cardiovascular disease contributed to progression, with dyslipidemia the strongest modifiable risk factor. Although disease progression correlated with cardiovascular risk, progression was detected in 36.5% of participants categorized as low risk. With this multimodal and multiterritorial approach, the authors detected short-term progression of early subclinical atherosclerosis in a substantial proportion (41.5%) of apparently healthy middle-aged men and women, more frequently by peripheral 2D/3DVUS than by CACS. Disease progression, as defined in this study, correlated with almost all cardiovascular risk factors and estimated risk. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318)
COVID-19: Peer Support and Crisis Communication Strategies to Promote Institutional Resilience
Authors: Albert W. Wu, Cheryl Connors, George S. Everly
Journal: Annals of Internal Medicine (2020)

A n infectious disease physician in Milan described his work caring for patients with the novel coronavirus (COVID-19):It is an impossible-to-understand situation, with people intubated in the hall, not enough ventilators, ethical decisions regarding who to intubate, shortage of masks and gloves, confusion and exhaustion.Hell is probably like this.I have no time to understand, to think about and to express emotions.
Mepolizumab in a population with severe eosinophilic asthma and corticosteroid dependence: results from a French early access programme
Authors: Camille Taillé, Pascal Chanez, Gilles Devouassoux, Alain Didier, Christophe Pison, Gilles Garcia, Jeremy Charriot, Stéphane Bouée, Alina Gruber, Celine Pribil, Arnaud Bourdin, Marc Humbert
Journal: European Respiratory Journal (2020)

Background Mepolizumab was available in France as part of an early access programme for patients with severe eosinophilic asthma (nominative autorisation temporaire d'utilisation [temporary use authorisation] (nATU)) before its commercialisation. This study aimed to characterise patients who received mepolizumab in the nATU. Methods This retrospective, observational study analysed data from the hospital medical records of patients up to 24 months after treatment initiation. Study objectives were to describe patient baseline characteristics, the evolution of disease severity and treatment modifications during follow-up; safety was also investigated. Findings Overall, 146 patients who received ≥1 dose of mepolizumab were included. At inclusion, patients had a mean age of 58.2 years with a mean severe asthma duration of 13.4 years, and 37.0% had respiratory allergies. Patients experienced, on average, 5.8 exacerbations per patient per year at baseline, 0.6 and 0.5 of which required hospitalisation and emergency department visits, respectively. These values improved to 0.6, 0.1 and 0.1 exacerbations per patient per year, respectively, at 24 months of follow-up. Most patients (92.8%) were using oral corticosteroids at baseline, compared with 34.7% by 24 months of follow-up. Moreover, mean blood eosinophil counts improved from 722 cells·µL −1 at baseline to 92 cells·µL −1 at 24 months of follow-up; lung function and asthma control followed a similar trend. Interpretation Results confirm findings from clinical trials, demonstrating that mepolizumab is associated with important improvements in several clinically meaningful outcomes and has a favourable safety profile in a population with severe eosinophilic asthma, outside of the controlled environment of a clinical trial.
Medicaid Managed Care's Effects on Costs, Access, and Quality: An Update
Authors: Daniela Franco Montoya, Puneet Kaur Chehal, E. Kathleen Adams
Journal: Annual Review of Public Health (2020)

Medicaid is integral to public health because it insures one in five Americans and half of the nation's births. Nearly two-thirds of all Medicaid recipients are currently enrolled in a health maintenance organization (HMO). Proponents of HMOs argue that they can lower costs while maintaining access and quality. We critically reviewed 32 studies on Medicaid managed care (2011–2019). Authors reported state-specific cost savings and instances of increased access or quality with implementation or redesign of Medicaid managed-care programs. Studies on high-risk populations (e.g., disabled) found improvements in quality specific to a state or a high-risk population. A unique model of managed care (i.e., the Oregon Health Plan) was associated with reduced costs and improved access and quality, but results varied by comparison state. New trends in the literature focused on analysis of auto-assignment algorithms, provider networks, and plan quality. More analysis of costs jointly with access/quality is needed, as is research on managing long-term care among elderly and disabled Medicaid recipients.
Abstract 138: Defining System of Care Best Practices for Out-Of-Hospital Cardiac Arrest Survival
Authors: Mahshid Abir, Timothy C Guetterman, Sydney Fouche, Samantha Iovan, Jessica L Lehrich, Wilson Nham, Peter J Mendel, Christopher Nelson, Michael D Fetters, Teri Shields, Robert W Neumar, Antony P Hsu, Bill Forbush, Robert A Swor, Brian O’Neil, Brahmajee K Nallamothu
Journal: Circulation (2019)

Introduction: EMS system factors key to improved survival for out-of-hospital cardiac arrest (OHCA) have not been well elucidated. This study explores factors associated with sustained return of spontaneous circulation (ROSC) in the field with pulse upon arrival to the ED-a measure of high quality of prehospital care-across the chain of survival. Methods: This sequential mixed methods study used data from the Michigan Cardiac Arrest Registry to Enhance Survival (MI-CARES) to evaluate variation in OHCA outcomes across EMS agencies. Sites were sampled based on geography, rurality, population density, and survival rate. We visited 1 low-, 1 middle-, and 3 high-survival EMS systems. At each site, we conducted key informant interviews with field staff, mid-level managers, and leadership from EMS, police, fire, and dispatch, as well as multidisciplinary focus groups. Transcripts were coded using a structured codebook and analyzed using thematic analysis. Results: An integrated multidisciplinary approach was critical for timely OHCA care coordination across the chain of survival. Themes that emerged across all stakeholders included: 1) OHCA education and multidisciplinary training; 2) shared awareness of roles in the chain of survival and system-wide response; 4) multidisciplinary QI; and 5) leadership and initiative (Table 1). Conclusions: Recognizing the critical role of each level in the chain of survival, this study identified specific practices from EMS system stakeholders that were associated with improved survival. The next phase of this work will include validating the factors associated with increased survival identified through a statewide survey of EMS agencies in Michigan. The final product of this work will include a toolkit of best practices and an implementation guide.
Importance of pathology review to complement clinical management of melanoma
Authors: Meghan Beatson, Misty G. Eleryan, Jeave Reserva, Bridget Kaufman, Bridget Connelly, Elizabeth M. Dugan, Arash Radfar, Patricia Lucey, Jeff Harvell, Jag Bhawan, Sekwon Jang, Suraj Venna
Journal: Journal of the American Academy of Dermatology (2020)
SAVED BY THE VEST: A CASE OF POSTPARTUM CARDIOMYOPATHY AND SPONTANEOUS CORONARY ARTERY DISSECTION
Authors: Sananda Moctezuma, Saman Setareh-Shenas, Paul Leis, Syed Haider, Scott Kaplin, Robert Kornberg, Eyal Herzog
Journal: Journal of the American College of Cardiology (2020)
Testing the Hand Eczema Severity Index
Authors: J.A.F. Oosterhaven, M.L.A. Schuttelaar
Journal: British Journal of Dermatology (2020)

SummaryHand eczema is an inflammation of the skin of the hands, which can cause the skin to itch or develop painful cracks. It is a common skin disease that affects about one in every ten people.The Hand Eczema Severity Index (HECSI) is a much used scoring system to measure how severe a person's hand eczema is. It gives a score from 0‐360, but it is not yet known what these scores exactly mean, or if the instrument can pick up changes when the severity of the hand eczema changes.Researchers from The Netherlands have studied this. They scored the hands of 294 patients with hand eczema with the HECSI and also compared the hands with photographs showing various stages of hand eczema severity. After 4‐12 weeks they did this again.The researchers found that the HECSI score improved and worsened when, according to the photographs, the hand eczema did. This means that the HECSI is able to pick up changes in hand eczema severity.They also found that the following HECSI scores were comparable to the photographic stages of severity: clear, 0; almost clear, 1‐16; moderate, 17‐37; severe, 38‐116; very severe, ≥117.Finally, the researchers found that an improvement of 41 points on the HECSI was the minimal improvement a patient had to make to be an important, true improvement. With these scores, doctors and researchers can more easily use the HECSI in daily practice and in studies on hand eczema patients.This is a summary of the study: Responsiveness and interpretability of the Hand Eczema Severity Index
Chronic thromboembolic disease following pulmonary embolism: time for a fresh look at old clot
Authors: Colm McCabe, Konstantinos Dimopoulos, Alex Pitcher, Elizabeth Orchard, Laura C. Price, Aleksander Kempny, S. John Wort
Journal: European Respiratory Journal (2020)

<b>Chronic thromboembolic disease diagnosed following acute pulmonary embolism warrants refinement of its definition and further evaluation of optimal anticoagulation strategies</b>http://bit.ly/38SQXc0
Use of Antihyperglycemic Medications in U.S. Adults: An Analysis of the National Health and Nutrition Examination Survey
Authors: Phuc Le, Alexander Chaitoff, Anita D. Misra-Hebert, Wen Ye, William H. Herman, Michael B. Rothberg
Journal: Diabetes Care (2020)

1) To examine trends in the use of diabetes medications and 2) to determine whether physicians individualize diabetes treatment as recommended by the American Diabetes Association (ADA).We conducted a retrospective, cross-sectional analysis of 2003-2016 National Health and Nutrition Examination Survey (NHANES) data. We included people ≥18 years who had ever been told they had diabetes, had an HbA1c >6.4%, or had a fasting plasma glucose >125 mg/dL. Pregnant women and patients aged <20 years receiving only insulin were excluded. We assessed trends in use of ADA's seven preferred classes from 2003-2004 to 2015-2016. We also examined use by hypoglycemia risk (sulfonylureas, insulin, and meglitinides), weight effect (sulfonylureas, thiazolidinediones [TZDs], insulin, and meglitinides), cardiovascular benefit (canagliflozin, empagliflozin, and liraglutide), and cost (brand-name medications and insulin analogs).The final sample included 6,323 patients. The proportion taking any medication increased from 58% in 2003-2004 to 67% in 2015-2016 (P < 0.001). Use of metformin and insulin analogs increased, while use of sulfonylureas, TZDs, and human insulin decreased. Following the 2012 ADA recommendation, the choice of drug did not vary significantly by older age, weight, or presence of cardiovascular disease. Patients with low HbA1c, or HbA1c <6%, and age ≥65 years were less likely to receive hypoglycemia-inducing medications, while older patients with comorbidities were more likely. Insurance, but not income, was associated with the use of higher-cost medications.Following ADA recommendations, the use of metformin increased, but physicians generally did not individualize treatment according to patients' characteristics. Substantial opportunities exist to improve pharmacologic management of diabetes.
Sixty seconds on . . . sofas
Authors: Abi Rimmer
Journal: BMJ (2020)

The BMJ Sofas?! What I'd give to sit down for five minutesWell, now maybe you can because two furniture retailers have been donating sofas to hospitals.Isn't that amazing? Don't couch your wordsSorry, I got carried away.But Made and the DFS Group-which includes DFS, Sofology, Dwell, and Sofa Workshop-have donated sofas, sofabeds, and other items such as crockery to hospitals around the UK for staff to use when they are able to take a break.
Ancestral germen/soma distinction in microbes: Expanding the disposable soma theory of aging to all unicellular lineages
Authors: Jérôme Teulière, Debashish Bhattacharya, Eric Bapteste
Journal: Ageing Research Reviews (2020)

Life has persisted for about 3.5 billion years (Gy) despite fluctuating environmental pressures and the aging and mortality of individuals. The disposable soma theory (DST) notoriously contributes to explain this persistence for lineages with a clear soma/germen distinction. Beyond such lineages however, the phylogenetic scope of application of the DST is less obvious. Typically, the DST is not expected to explain the survival of microbial species that comprise single-celled organisms apparently lacking a germen/soma distinction. Here, we present an evolutionary argument that generalizes the explanatory scope of DST to the entire microbial world and provides a novel characterization of the deep molecular and evolutionary roots supporting this expanded disposable soma theory of aging. Specifically, we argue that the germen/soma distinction arose early in evolution and identify DNA semi-conservative replication as a critical process through which two forms of rejuvenation could have evolved in the first microbes. Our hypothesis has fundamental and practical implications. First, whereas unicellular organisms were long thought of as potentially immortal, we suggest instead that all unicellular individuals (prokaryotes or protists alike) are very likely to age, either replicatively or physiologically, or both. Second, our theory introduces a profound reconsideration of microbial individuality, whereby, all microbial individuals, as seen by natural selection, present an obligate transient germen/soma distinction during their life cycles. Third, our work promotes the study of cellular division in prokaryotes and in protist mitosis to illuminate the evolutionary origin of the soma and germen division, traditionally studied in animals. These ideas set the stage for progress in the evolutionary theory of aging from a heretofore overlooked microbial perspective.
Anticoagulation for Stroke Prevention in Patients With Atrial Fibrillation and End-Stage Renal Disease—First, Do No Harm
Authors: Emilie P. Belley-Cote, John W. Eikelboom
Journal: JAMA Network Open (2020)

Mandeep S. Randhawa, MD; Rohanlal Vishwanath, BSc; Manoj P. Rai, MD; Ling Wang, PhD; Amritpal K. Randhawa, MD; George Abela, MD; Gaurav Dhar, MD
Towards a “fourth 90”: A population-based analysis of post-tuberculosis pulmonary function testing in British Columbia, Canada, 1985–2015
Authors: C. Andrew Basham, Victoria J. Cook, James C. Johnston
Journal: European Respiratory Journal (2020)

<b>Post-tuberculosis lung disease is a growing concern globally. In a Canadian sample, only 3% of respiratory TB cases underwent pulmonary function testing within 90 days of treatment end. Benchmarks for post-TB pulmonary function testing are needed.</b>https://bit.ly/2WX3tVf
Targeted Retreatment of Incompletely Recovered Chronic Obstructive Pulmonary Disease Exacerbations with Ciprofloxacin. A Double-Blind, Randomized, Placebo-controlled, Multicenter, Phase III Clinical Trial
Authors: Andrew I. Ritchie, Simon E. Brill, Ben H. Vlies, Lydia J. Finney, James P. Allinson, Luana Alves-Moreira, Dexter J. Wiseman, Paul P. Walker, Emma Baker, Sarah L. Elkin, Patrick Mallia, Martin Law, Gavin C. Donaldson, Peter M. A. Calverley, Jadwiga A. Wedzicha
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Rationale: Chronic obstructive pulmonary disease (COPD) exacerbations are prone to nonrecovery, but there are no data about the effectiveness of retreatment for these prolonged events. We examined whether further therapy with ciprofloxacin for incompletely resolved COPD exacerbations prolonged the time until the next event.Objectives: To assess whether incompletely recovered COPD exacerbations benefit from additional treatment with ciprofloxacin, at Day 14.Methods: In a multicenter, randomized double-blind placebo-controlled trial, we studied retreatment with oral ciprofloxacin 500 mg or matched placebo twice daily for 7 days in patients with Global Initiative for Chronic Obstructive Lung Disease stage II–IV COPD and persistent symptoms and/or serum C-reactive protein ≥8 mg/L initiated 14 (±3) days after an index COPD exacerbation. The primary outcome was the time to the next exacerbation within a 90-day period.Measurements and Main Results: Among 826 patients screened at four centers, 144 eligible participants with incomplete recovery were randomized to receive ciprofloxacin (n = 72) or placebo (n = 72). Within 90 days of randomization, 57% of the patients in the ciprofloxacin group and 53% in the placebo group experienced one or more exacerbations. The median time to the next exacerbation was 32.5 days (interquartile range 13–50) in the placebo arm and 34 days (interquartile range 17–62) in the ciprofloxacin arm, which was not significantly different (adjusted hazard ratio, 1.07; 95% confidence interval, 0.68–1.68; P = 0.76). No significant differences were seen in quality-of-life scores or lung function between the treatment groups.Conclusions: In patients with persistent symptoms and/or raised C-reactive protein 14 days after a COPD exacerbation, an additional course of ciprofloxacin resulted in no additional benefit compared with placebo. This suggests that nonrecovered exacerbations are not driven by ongoing bacterial infection and may potentially be targeted with antiinflammatory therapy.Clinical trial registered with www.clinicaltrials.gov (NCT02300220).
The Oral Gonadotropin-releasing Hormone Receptor Antagonist Relugolix as Neoadjuvant/Adjuvant Androgen Deprivation Therapy to External Beam Radiotherapy in Patients with Localised Intermediate-risk Prostate Cancer: A Randomised, Open-label, Parallel-group Phase 2 Trial
Authors: David P. Dearnaley, Daniel R. Saltzstein, John E. Sylvester, Lawrence Karsh, Bryan A. Mehlhaff, Christopher Pieczonka, James L. Bailen, Hongliang Shi, Zhan Ye, Hélène M. Faessel, Huamao Lin, Yanyan Zhu, Fred Saad, David B. MacLean, Neal D. Shore
Journal: European Urology (2020)

External beam radiotherapy (EBRT) with neoadjuvant/adjuvant androgen deprivation therapy (ADT) is an established treatment option to prolong survival for patients with intermediate- and high-risk prostate cancer (PCa). Relugolix, an oral gonadotropin-releasing hormone (GnRH) receptor antagonist, was evaluated in this clinical setting in comparison with degarelix, an injectable GnRH antagonist.
Oral vasodilator treatment and liver transplantation for portopulmonary hypertension : systematic review and meta-analysis of hemodynamic response and prognosis
Authors: Rebecca Deroo, Michel De Pauw, Eric Trepo, Tom Holvoet, Anja Geerts, Xavier Verhelst, Isabelle Colle, Hans Van Vlierberghe, Sarah Raevens
Journal: Hepatology (2019)
Bacteria-Induced Group 2 Innate Lymphoid Cells in the Stomach Provide Immune Protection through Induction of IgA
Authors: Naoko Satoh-Takayama, Tamotsu Kato, Yasutaka Motomura, Tomoko Kageyama, Naoko Taguchi-Atarashi, Ryo Kinoshita-Daitoku, Eisuke Kuroda, James P. Di Santo, Hitomi Mimuro, Kazuyo Moro, Hiroshi Ohno
Journal: Immunity (2020)
Specific gut microbiome signature predicts the early-stage lung cancer
Authors: Yajuan Zheng, Zhaoyuan Fang, Yun Xue, Jian Zhang, Junjie Zhu, Renyuan Gao, Shun Yao, Yi Ye, Shihui Wang, Changdong Lin, Shiyang Chen, Hsinyi Huang, Liang Hu, Ge-Ning Jiang, Huanlong Qin, Peng Zhang, Jianfeng Chen, Hongbin Ji
Journal: Gut Microbes (2020)

Alterations of gut microbiota have been implicated in multiple diseases including cancer. However, the gut microbiota spectrum in lung cancer remains largely unknown. Here we profiled the gut microbiota composition in a discovery cohort containing 42 early-stage lung cancer patients and 65 healthy individuals through the 16S ribosomal RNA (rRNA) gene sequencing analysis. We found that lung cancer patients displayed a significant shift of microbiota composition in contrast to the healthy populations. To identify the optimal microbiota signature for noninvasive diagnosis purpose, we took advantage of Support-Vector Machine (SVM) and found that the predictive model with 13 operational taxonomic unit (OTU)-based biomarkers achieved a high accuracy in lung cancer prediction (area under curve, AUC = 97.6%). This signature performed reasonably well in the validation cohort (AUC = 76.4%), which contained 34 lung cancer patients and 40 healthy individuals. To facilitate potential clinical practice, we further constructed a 'patient discrimination index' (PDI), which largely retained the prediction efficiency in both the discovery cohort (AUC = 92.4%) and the validation cohort (AUC = 67.7%). Together, our study uncovered the microbiota spectrum of lung cancer patients and established the specific gut microbial signature for the potential prediction of the early-stage lung cancer.