tbuckley/cabot-search huggingface dataset:
Effect of 3-Dimensional Virtual Reality Models for Surgical Planning of Robotic-Assisted Partial Nephrectomy on Surgical Outcomes
Authors: Joseph D. Shirk, David D. Thiel, Eric M. Wallen, Jennifer M. Linehan, Wesley M. White, Ketan K. Badani, James R. Porter
Journal: JAMA Network Open (2019)

Planning complex operations such as robotic-assisted partial nephrectomy requires surgeons to review 2-dimensional computed tomography or magnetic resonance images to understand 3-dimensional (3-D), patient-specific anatomy.To determine surgical outcomes for robotic-assisted partial nephrectomy when surgeons reviewed 3-D virtual reality (VR) models during operative planning.A single-blind randomized clinical trial was performed. Ninety-two patients undergoing robotic-assisted partial nephrectomy performed by 1 of 11 surgeons at 6 large teaching hospitals were prospectively enrolled and randomized. Enrollment and data collection occurred from October 2017 through December 2018, and data analysis was performed from December 2018 through March 2019.Patients were assigned to either a control group undergoing usual preoperative planning with computed tomography and/or magnetic resonance imaging only or an intervention group where imaging was supplemented with a 3-D VR model. This model was viewed on the surgeon's smartphone in regular 3-D format and in VR using a VR headset.The primary outcome measure was operative time. It was hypothesized that the operations performed using the 3-D VR models would have shorter operative time than those performed without the models. Secondary outcomes included clamp time, estimated blood loss, and length of hospital stay.Ninety-two patients (58 men [63%]) with a mean (SD) age of 60.9 (11.6) years were analyzed. The analysis included 48 patients randomized to the control group and 44 randomized to the intervention group. When controlling for case complexity and other covariates, patients whose surgical planning involved 3-D VR models showed differences in operative time (odds ratio [OR], 1.00; 95% CI, 0.37-2.70; estimated OR, 2.47), estimated blood loss (OR, 1.98; 95% CI, 1.04-3.78; estimated OR, 4.56), clamp time (OR, 1.60; 95% CI, 0.79-3.23; estimated OR, 11.22), and length of hospital stay (OR, 2.86; 95% CI, 1.59-5.14; estimated OR, 5.43). Estimated ORs were calculated using the parameter estimates from the generalized estimating equation model. Referent group values for each covariate and the corresponding nephrometry score were summed across the covariates and nephrometry score, and the sum was exponentiated to obtain the OR. A mean of the estimated OR weighted by sample size for each nephrometry score strata was then calculated.This large, randomized clinical trial demonstrated that patients whose surgical planning involved 3-D VR models had reduced operative time, estimated blood loss, clamp time, and length of hospital stay.ClinicalTrials.gov identifiers (1 registration per site): NCT03334344, NCT03421418, NCT03534206, NCT03542565, NCT03556943, and NCT03666104.
Complex Coronary Artery Lesion Morphology Influences Results of Stress Echocardiography
Authors: ChunzengLu, EugenioPicano, AlessandroPingitore, RosaSicari, RossanaTongiani, MarcoBaratto, CataldoPalmieri, MarioMarzilli, AntonioL’Abbate
Journal: Circulation (1995)

Background The likelihood of a positive response with dipyridamole stress echocardiography (DSE) is directly related to the extent and severity of angiographically assessed coronary artery disease. Whether coronary lesion morphology—a known predictor of adverse cardiac events—may also modulate stress echo results remains unknown. The objective of our study was to assess the relation between stenosis lesion morphology and stress echocardiographic results. Methods and Results High-dose (up to 0.84 mg/kg over 10 minutes) DSE and coronary angiographic data of 68 in-hospital patients (39 with stable angina, 29 with angina at rest) with nonoccluding, single-vessel disease at angiography and no previous myocardial infarction were analyzed. DSE was performed in all patients within 3 days of coronary angiography. An angiographic lesion was considered complex when irregular borders and/or intraluminal lucencies suggestive of ulcer and/or thrombus were present. According to angiographic lesion morphology, two groups...
Innately Adaptive or Truly Autoimmune: Is There Something Unique About Systemic Juvenile Idiopathic Arthritis?
Authors: Christoph Kessel, Christian M. Hedrich, Dirk Foell
Journal: Arthritis & Rheumatology (2019)

Systemic juvenile idiopathic arthritis (JIA) is a form of arthritis in childhood that is initially dominated by innate immunity-driven systemic inflammation and is thus considered a polygenic autoinflammatory disease. However, systemic JIA can progress toward an adaptive immunity-driven afebrile arthritis. Based on this observation of biphasic disease progression, a "window of opportunity" for optimal, individualized and target-directed treatment has been proposed. This hypothesis requires testing, and in this review we summarize current evidence regarding molecular factors that may contribute to the progression from an initially predominantly autoinflammatory disease phenotype to autoimmune arthritis. We consider the involvement of innately adaptive γδ T cells and natural killer T cells that express γδ or αβ T cell receptors but cannot be classified as either purely innate or adaptive cells, versus classic B and T lymphocytes in this continuum. Finally, we discuss our understanding of how and why some primarily autoinflammatory conditions can progress toward autoimmune-mediated disorders over the disease course while others do not and how this knowledge may be used to offer individualized treatment.
Statin use is associated with a reduced risk of colon cancer recurrence
Authors: D. M. Anderson, J. Jackson, A. Butani, S. Asche, C. Rolnick
Journal: Journal of Clinical Oncology (2007)

4114 Background: A significant body of data suggests that statin use reduces the risk of developing colon and other cancers, although other data have not confirmed these findings. We examined whether statin use helps prevent recurrence of colon cancer in patients with resected disease. Methods: We conducted a retrospective analysis of patients treated for stage I, II, and III colon cancer in a Minneapolis/St. Paul health system. Incident cases of colon cancer between 1995 and the present were identified through a hospital tumor registry. All identified cases were then cross-checked against an HMO membership database. Data regarding statin use was pulled from the HMO outpatient pharmacy database. For each patient all available data from a 5-year window prior to first diagnosis of cancer until either recurrence or most recent data available was obtained. Demographic data and survival data from the tumor registry were then combined with pharmacy data regarding statin use in a single database for analysis. Recurrence and time to recurrent disease were compared in statin users and non-users. Results: A total of 358 colon cancer cases were available for analysis. Median follow up of patients after diagnosis of colon cancer was 49 months. 89 patients (24.9%) used statin drugs for some period of time with a median of 780 days of use. Median age of all patients enrolled was 69 (range 24–95). Statin use was higher in patients ages 61–75 (33%) than in those aged 24–60 (22%) or those aged 76–95 (19%) (p=0.02). There was no association between statin use and stage at diagnosis. 6 of 89 patients (6.7%) with any statin use relapsed as opposed to 43 of 269 (16%) of patients with no statin use (Fisher’s exact p=0.03). Kaplan-Meier analysis of relapse curves found a significant difference in relapse between groups with a two year recurrence rate of 3.7% among statin users and 10.1% among non users (Log Rank p=0.03, using age stratification). Conclusions: Statin use was associated with a decreased risk of recurrence in patients diagnosed with stages I-III colon cancer in this study. Further study of statin use in the prevention of colon cancer recurrence is warranted. No significant financial relationships to disclose.
Abstract 15250: Vascular Smooth Muscle Cell-Derived Inflammatory Cells Contribute to Aortic Inflammation in Murine Aortic Aneurysms
Authors: Nicolas H Pope, Morgan Salmon, William F Johnston, Akshaya M Meher, Guanyi Lu, Gary K Ownes, Gilbert R Upchurch, Gorav Ailawadi
Journal: Circulation (2013)

Introduction: Macrophages thought to be derived from circulating leukocytes play a critical role in inflammation in aortic aneurysms (AA). Vascular smooth muscle cells (SMCs) are known to modulate ...
In Hot, Humid Weather, Fans Benefit Health and Environment
Authors: Rita Rubin
Journal: JAMA (2019)

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
Nutrition in medical education: a systematic review
Authors: Jennifer Crowley, Lauren Ball, Gerrit Jan Hiddink
Journal: The Lancet Planetary Health (2019)

In many countries, doctors are recommended to provide nutrition care to patients to improve the dietary behaviours of individuals and populations. Here, we present a systematic review that aims to critically synthesise literature on nutrition education provided to medical students.In this systematic review, a literature search was done between May 1 and July 1, 2018, for articles on medical students' nutrition knowledge, skills, and confidence to counsel patients, from Nov 1, 2012, to Dec 31, 2018. Search terms related to medical students included "nutrition in medical education", "medical nutrition education", and "undergraduate medical nutrition education". Search terms for topic of interest included "nutrition", "knowledge", "skills", "nutrition counselling", "confidence", "nutrition care", or "nutrition education". Included studies examined any aspect of recently graduated (ie, ≤4 years) or current medical students' nutrition knowledge, attitudes, skills, or confidence (or all three) in nutrition or nutrition counselling; evaluated nutrition curriculum initiatives for medical students; or assessed recently graduated or current medical students' perceptions of nutrition education. Quality assessment appraisal of the studies was done using a Mixed Methods Appraisal Tool. Curriculum initiatives were also appraised.66 studies were identified by the search and 24 were eligible for full-text analysis. 16 quantitative studies, three qualitative studies, and five curriculum initiatives from the USA (n=11), Europe (n=4), the Middle East (n=1), Africa (n=1), and Australasia (n=7) met the inclusion criteria. Our analysis of these studies showed that nutrition is insufficiently incorporated into medical education, regardless of country, setting, or year of medical education. Deficits in nutrition education affect students' knowledge, skills, and confidence to implement nutrition care into patient care. A modest positive effect was reported from curriculum initiatives.Despite the centrality of nutrition to healthy lifestyle, medical students are not supported to provide high-quality, effective nutrition care. Medical education can be enhanced by institutional commitment to make nutrition education compulsory in medical training, establishment of nutrition competencies to provide a benchmark for nutrition knowledge and skills to be included in curricula, and supported by funding for innovative curriculum initiatives. These initiatives will improve nutrition in medical training to support future doctors for the 21st century.Sir John Logan Campbell Medical Fellowship 2017, and an Australian National Health and Medical Research Council Fellowship.
Abstract 10641: Infections Associated With Resterilized Pacemakers and Defibrillators in Low- and Middle-Income Countries A Multicenter Comparative Study
Authors: Thomas F Khairy, Marie-Andrée Lupien, Santiago Nava, Frank Valdez Baez, Fernando Solares Ovalle, Nery E Linarez Ochoa, Gerardo Sosa Mendoza, Cesar A Carrazco, Richard Cartier, Denis Roy, Mario Talajic, Marc Dubuc, Bernard Thibault, Peter G Guerra, Lena Rivard, Katia Dyrda, Blandine Mondésert, Rafik Tadros, Julia Cadrin-Tourigny, Laurent Macle, Paul Khairy
Journal: Circulation (2018)

Introduction: Millions of people in low- and middle-income countries (LMICs) die every year due to a lack of access to pacemakers or defibrillators. Uncertainties regarding infection risks associated with device resterilization and reuse prevail, thereby limiting widespread implementation of such pr
Myocardial KATP Channels in Preconditioning
Authors: BrianO’Rourke
Journal: Circulation Research (2000)

Abstract—We are on the brink of harnessing the cell’s natural defenses against ischemia and reperfusion injury after years of research into the destructive and protective mechanisms involved. Since the discovery of ischemic preconditioning, the surface receptors and signal transduction pathways underlying this phenomenon have been clarified, but many questions remain about the downstream targets that ultimately protect the cell. ATP-sensitive K+ (KATP) channels are thought to play a role in protection, but their mechanism of action has been unclear. Accumulating evidence now suggests that the location of the KATP channels relevant to cytoprotection may be on the mitochondrial inner membrane instead of on the sarcolemma of the cardiac cell. This review discusses recent findings and unanswered questions about the role of KATP channels in preconditioning and protection.
Human mesenchymal stem cell morphology, migration, and differentiation on micro and nano-textured titanium
Authors: Emily G. Long, Merve Buluk, Michelle B. Gallagher, Jennifer M. Schneider, Justin L. Brown
Journal: Bioactive Materials (2019)

Orthopedic implants rely on facilitating a robust interaction between the implant material surface and the surrounding bone tissue. Ideally, the interface will encourage osseointegration with the host bone, resulting in strong fixation and implant stability. However, implant failure can occur due to the lack of integration with bone tissue or bacterial infection. The chosen material and surface topography of orthopedic implants are key factors that influence the early events following implantation and may ultimately define the success of a device. Early attachment, rapid migration and improved differentiation of stem cells to osteoblasts are necessary to populate the surface of biomedical implants, potentially preventing biofilm formation and implant-associated infection. This article explores these early stem cell specific events by seeding human mesenchymal stem cells (MSCs) on four clinically relevant materials: polyether ether ketone (PEEK), Ti6Al4V (smooth Ti), macro-micro rough Ti6Al4V (Endoskeleton®), and macro-micro-nano rough Ti6Al4V (nanoLOCK®). The results demonstrate the incorporation of a hierarchical macro-micro-nano roughness on titanium produces a stellate morphology typical of mature osteoblasts/osteocytes, rapid and random migration, and improved osteogenic differentiation in seeded MSCs. Literature suggests rapid coverage of a surface by stem cells coupled with stimulation of bone differentiation minimizes the opportunity for biofilm formation while increasing the rate of device integration with the surrounding bone tissue.
Dilution of Molecular–Pathologic Gene Signatures by Medically Associated Factors Might Prevent Prediction of Resection Status After Debulking Surgery in Patients With Advanced Ovarian Cancer
Authors: Florian Heitz, Stefan Kommoss, Roshan Tourani, Anthony Grandelis, Locke Uppendahl, Constantin Aliferis, Alexander Burges, Chen Wang, Ulrich Canzler, Jinhua Wang, Antje Belau, Sonia Prader, Lars Hanker, Sisi Ma, Beyhan Ataseven, Felix Hilpert, Stephanie Schneider, Jalid Sehouli, Rainer Kimmig, Christian Kurzeder, Barbara Schmalfeldt, Elena I. Braicu, Philipp Harter, Sean C. Dowdy, Boris J. Winterhoff, Jacobus Pfisterer, Andreas du Bois
Journal: Clinical Cancer Research (2019)

Predicting surgical outcome could improve individualizing treatment strategies for patients with advanced ovarian cancer. It has been suggested earlier that gene expression signatures (GES) might harbor the potential to predict surgical outcome.Data derived from high-grade serous tumor tissue of FIGO stage IIIC/IV patients of AGO-OVAR11 trial were used to generate a transcriptome profiling. Previously identified molecular signatures were tested. A theoretical model was implemented to evaluate the impact of medically associated factors for residual disease (RD) on the performance of GES that predicts RD status.A total of 266 patients met inclusion criteria, of those, 39.1% underwent complete resection. Previously reported GES did not predict RD in this cohort. Similarly, The Cancer Genome Atlas molecular subtypes, an independent de novo signature and the total gene expression dataset using all 21,000 genes were not able to predict RD status. Medical reasons for RD were identified as potential limiting factors that impact the ability to use GES to predict RD. In a center with high complete resection rates, a GES which would perfectly predict tumor biological RD would have a performance of only AUC 0.83, due to reasons other than tumor biology.Previously identified GES cannot be generalized. Medically associated factors for RD may be the main obstacle to predict surgical outcome in an all-comer population of patients with advanced ovarian cancer. If biomarkers derived from tumor tissue are used to predict outcome of patients with cancer, selection bias should be focused on to prevent overestimation of the power of such a biomarker.See related commentary by Handley and Sood, p. 9.
Pancreatic cancer and intake of meat, fish, eggs and fats
Authors: Furong Wang, Elizabeth A. Holly
Journal: Cancer Research (2005)

5820   Background: Intake of meat and fats has been linked to increased risk for many cancers. However, their association with pancreatic cancer has been examined in few studies. Methods: In a population-based case-control study in the San Francisco Bay Area, California, 532 cases and 1701 age and sex-matched controls were examined to determine the relation between dietary intake and pancreatic cancer. Data on dietary factors was collected using the Harvard 131-item food-frequency questionnaire during in-person interviews. No proxy interviews were conducted. Intake of total fat and types of fat were computed from the food-frequency questionnaire. Unconditional logistic regression models were used to compute odds ratios (OR) as estimates of the relative risk (hereafter called risk) and to compute 95% confidence intervals (CI). Energy intake, sex, cigarette smoking, Body Mass Index and physical activity were evaluated as confounders. Results: The estimated risk of pancreatic cancer was related to total meat consumption with ORs of 1.0, 1.2, 1.2, and 1.4 (p-for-trend=0.06) from the lowest to the highest quartile of intake. Red meat (i.e. pork, beef, lamb) significantly increased the risk (OR=1.8, 95% CI=1.3-2.5), whereas white meat (i.e. turkey, chicken) lowered the risk (OR=0.68, 95% CI=0.50-0.91) for the highest quartile of intake. Egg intake showed a 1.6-fold increased risk (95% CI: 1.1-2.3) for the highest quartile. There was no association with fish consumption. Analysis of fats and types of fat revealed a positive trend of risk with increasing total fat intake (OR=1.0, 1.2, 1.6, and 1.8 from the lowest to highest quartiles; p-for-trend
Sixty seconds on . . . data hubs
Authors: Gareth Iacobucci
Journal: BMJ (2019)

Not quite. The UK government is launching its latest foray into big data with a new scheme aimed at using patient data to drive UK medical research. Seven new centres will be launched across the country next month.

That’s the plan. Patients, researchers, clinicians, and industry will be afforded access to an “unprecedented” bank …
Evidence for Mitochondrial K+ Channels and Their Role in Cardioprotection
Authors: BrianO’Rourke
Journal: Circulation Research (2004)

Twenty years after the discovery of sarcolemmal ATP-sensitive K+ channels and 12 years after the discovery of mitochondrial KATP (mitoKATP) channels, progress has been remarkable, but many questions remain. In the case of the former, detailed structural information is available, and it is well accepted that the channel couples bioenergetics to cellular electrical excitability; however, in the heart, a clear physiological or pathophysiological role has yet to be defined. For mitoKATP, structural information is lacking, but there is abundant evidence linking the opening of the channel to protection against ischemia-reperfusion injury or apoptosis. This review updates recent progress in understanding the physiological role of mitoKATP and highlights outstanding questions and controversies, with the intent of stimulating additional investigation on this topic.