tbuckley/cabot-search huggingface dataset:
Infographic. Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta-analysis
Authors: Marinus Winters, Kristian Damgaard Lyng, Sinead Holden, Carolina Bryne Lura, Nicky J Welton, Deborah M Caldwell, Bill Vicenzino, Adam Weir, Michael Skovdal Rathleff
Journal: British Journal of Sports Medicine (2021)

Objective  To investigate the comparative effectiveness of all treatments for patellofemoral pain (PFP).  Design  Living systematic review with network meta-analysis (NMA).  Data sources  Sensitive search in seven databases, three grey literature resources and four trial registers.  Eligibility criteria  Randomised controlled trials evaluating any treatment for PFP with outcomes ‘any improvement’, and pain intensity.  Data extraction  Two reviewers independently extracted data and assessed risk of bias with Risk of Bias Tool V.2. We used Grading of Recommendations, Assessment, Development and Evaluation to appraise the strength of the evidence.  Primary outcome measure  ‘Any improvement’ measured with a Global Rating of Change Scale.  Results  Twenty-two trials (with forty-eight treatment arms) were included, of which approximately 10 (45%) were at high risk of bias for the primary outcome. Most comparisons had a low to very low strength of the evidence. All treatments were better than wait and see for any improvement at 3 months (education (OR 9.6, 95% credible interval (CrI): 2.2 to 48.8); exercise (OR 13.0, 95% CrI: 2.4 to 83.5); education+orthosis (OR 16.5, 95% CrI: 4.9 to 65.8); education+exercise+patellar taping/mobilisations (OR 25.2, 95% CrI: 5.7 to 130.3) and education+exercise+patellar taping/mobilisations+orthosis (OR 38.8, 95% CrI: 7.3 to 236.9)). Education+exercise+patellar taping/mobilisations, with (OR 4.0, 95% CrI: 1.5 to 11.8) or without orthosis (OR 2.6, 95% CrI: 1.7 to 4.2), were superior to education alone. At 12 months, education or education+any combination yielded similar improvement rates.  Summary/conclusion  Education combined with a physical treatment (exercise, orthoses or patellar taping/mobilisation) is most likely to be effective at 3 months. At 12 months, education appears comparable to education with a physical treatment. There was insufficient evidence to recommend a specific type of physical treatment over another. All treatments in our NMA were superior to wait and see at 3 months, and we recommend avoiding a wait-and-see approach.  PROSPERO registeration number  PROSPERO registration CRD42018079502.
Response to: ‘Relation between cartilage loss and pain in knee osteoarthritis’ by Wu<i>et al</i>and ‘Changes in synovitis and bone marrow lesions may not mediate the effect of cartilage loss on joint pain in osteoarthritis’ by Cashin<i>et al</i>
Authors: Kathryn Bacon, Michael P LaValley, S Reza Jafarzadeh, David Felson
Journal: Annals of the Rheumatic Diseases (2020)

Our paper1 was primarily focused on the small effect that preventing cartilage loss has on pain reduction. In an additional analysis, we noted that synovitis change mediated a small percentage of that effect, an effect that was not statistically significant. Cashin et al 2 suggested that our mediation results should be interpreted based on whether the 95% CIs for the indirect or mediation effects overlapped with the null (ie, was statistically significant). Like the American Statistical Association and leading methodology experts, we oppose drawing a binary conclusion based on whether a threshold is statistically significant. Crossing an arbitrary significance threshold does not convey the presence or absence of a ‘real’ effect. …
Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19
Authors: Peter Horby, Marion Mafham, Louise Linsell, Jennifer L Bell, Natalie Staplin, Jonathan R Emberson, Martin Wiselka, Andrew Ustianowski, Einas Elmahi, Benjamin Prudon, Tony Whitehouse, Timothy Felton, John Williams, Jakki Faccenda, Jonathan Underwood, J Kenneth Baillie, Lucy C Chappell, Saul N Faust, Thomas Jaki, Katie Jeffery, Wei Shen Lim, Alan Montgomery, Kathryn Rowan, Joel Tarning, James A Watson, Nicholas J White, Edmund Juszczak, Richard Haynes, Martin J Landray
Journal: New England Journal of Medicine (2020)

Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (Covid-19) on the basis of in vitro activity and data from uncontrolled studies and small, randomized trials.
Combination of CLIF-OF and CCI predicts survival in patients with cirrhosis and COVID-19
Authors: Massimo Iavarone, Roberta D'Ambrosio, Pietro Lampertico
Journal: Gut (2020)

<b>Introduction:</b> Exposure to soybean allergens and diesel exhaust particles (DEPs) have been linked to the onset of asthma and asthma exacerbations. <b>Aim:</b> Study how the combination of soybean allergens and DEPs can affect the induction or exacerbation of asthma in a murine model. <b>Methods:</b> Female BALB/c mice received intranasal instillations of saline, 3 or 5 mg protein/ml soybean hull extract (SHE), 5 consecutive days (3 weeks). Three days per week the solutions were administered in combination with 150 µg of DEPs. Airway hyperresponsiveness (AHR) was assessed using a methacholine provocation test. Bronchoalveolar lavage (BAL) was used to evaluate pulmonary inflammation and to measure levels of different Th1, Th2, Th17 cytokines. <b>Results:</b> The 3 mg protein/ml SHE solution did not induce asthma. The co exposure with DEPs resulted in a enhanced AHR (p=0.0019), eosinophilic inflammation (p=0.0079), decreased levels of IFN-γ and IL-31 and increased levels of IL-5, IL-17F and CCL20. The 5 mg protein/ml SHE is capable of enhance significantly the AHR (p=0,0002), eliciting an increase in eosinophils (p=0,0003), decreased levels of IFN-γ and increased levels of IL-4, IL-5, IL-10, IL-13, IL-17A, IL-17F and CCL20. The combination of 5 mg protein/ml SHE with DEP produce an increase in AHR and eosinophilic inflammation but a slightly different cytokine profile with lower levels of Th2 cytokines, a decrease in IL-31 besides higher levels of Th17 related cytokines. <b>Conclusions:</b> The combination of soybean allergens and DEPs is capable of triggering an asthmatic response even when soybean allergen concentration is too low to promote a response by itself. <b>Funding:</b> CP12/03101 (Instituto de Salud Carlos III) and FEDER.
Concordance Between Blood Pressure in the Systolic Blood Pressure Intervention Trial and in Routine Clinical Practice
Authors: Paul E. Drawz, Anil Agarwal, Jamie P. Dwyer, Edward Horwitz, James Lash, Kristin Lenoir, Andrew McWilliams, Suzanne Oparil, Frederic Rahbari-Oskoui, Mahboob Rahman, Mark A. Parkulo, Priscilla Pemu, Dominic S. Raj, Michael Rocco, Sandeep Soman, George Thomas, Delphine S. Tuot, Paul K. Whelton, Nicholas M. Pajewski
Journal: JAMA Internal Medicine (2020)

There are concerns with translating results from the Systolic Blood Pressure Intervention Trial (SPRINT) into clinical practice because the standardized protocol used to measure blood pressure (BP) may not be consistently applied in routine clinical practice.To evaluate the concordance between BPs obtained in routine clinical practice and those obtained using the SPRINT protocol and whether concordance varied by target trial BP.This observational prognostic study linking outpatient vital sign information from electronic health records (EHRs) with data from 49 of the 102 SPRINT sites was conducted from November 8, 2010, to August 20, 2015, among 3074 adults 50 years or older with hypertension without diabetes or a history of stroke. Statistical analysis was performed from May 21, 2019, to March 20, 2020.Blood pressures measured in routine clinical practice and SPRINT.Participant-level EHR data was obtained for 3074 participants (2482 men [80.7%]; mean [SD] age, 68.5 [9.1] years) with 3 or more outpatient and trial BP measurements. In the period from the 6-month study visit to the end of the study intervention, the mean systolic BP (SBP) in the intensive treatment group from outpatient BP recorded in the EHR was 7.3 mm Hg higher (95% CI, 7.0-7.6 mm Hg) than BP measured at trial visits; the mean difference between BP recorded in the outpatient EHR and trial SBP was smaller for participants in the standard treatment group (4.6 mm Hg [95% CI, 4.4-4.9 mm Hg]). Bland-Altman analyses demonstrated low agreement between outpatient BP recorded in the EHR and trial BP, with wide agreement intervals ranging from approximately -30 mm Hg to 45 mm Hg in both treatment groups. In addition, the difference between BP recorded in the EHR and trial BP varied widely by site.Outpatient BPs measured in routine clinical practice were generally higher than BP measurements taken in SPRINT, with greater mean SBP differences apparent in the intensive treatment group. There was a consistent high degree of heterogeneity between the BPs recorded in the EHR and trial BPs, with significant variability over time, between and within the participants, and across clinic sites. These results highlight the importance of proper BP measurement technique and an inability to apply 1 common correction factor (ie, approximately 10 mm Hg) to approximate research-quality BP estimates when BP is not measured appropriately in routine clinical practice.SPRINT ClinicalTrials.gov Identifier: NCT01206062.
Geriatric assessment tool to assist physicians in providing patients with quality care in rural community oncology setting.
Authors: Mari Montesano, Venus Fromwiller, Shrida Sharma, Candice Murphy, Amrita Desai
Journal: Journal of Clinical Oncology (2020)

200 Background: Currently in the USA, 60% of all cancers and 70% of cancer mortality occur s i n people aged 65 and older. However, there are significant gaps in knowledge of oncology treatment outcomes in the geriatric population. The Cancer and Aging Research Group developed a Comprehensive Geriatric Assessment (CGA) tool in 2 007 to assess the abilities of older patients to make judgments and carry out daily activities. The assessment was created to help doctors recognize issues in the geriatric population and develop comprehensive treatment plans with the aim to improve outcomes in this age group. The purpose of the study was to assess whether the CGA tool would be useful in the physician’s decision-making process and in making appropriate and timely patient referrals in a rural community oncology setting. Methods: Newly diagnosed cancer patients with non-hematological cancers above 65 years of age seeking care at the Columbia Memorial Hospital -OHSU Knight Cancer Collaborative during May to August of 2019 were consented and asked to take the CGA survey. A summary of the patient’s responses with the scores and a list of recommendations was provided to the physician at the time of the initial consultation. Along with this summary, a single question survey was given to the physician in order to assess whether the feedback was helpful in their treatment planning. Results: Of the 49 new patients seen at the CMH-OHSU Knight Cancer Collaborative who qualified to participate in the study 22 (44.8%) completed the survey,18 (36.7%) did not complete the survey, 5 (10%) did not come in for their clinic appointment, and 5 others were disqualified from the survey for other reasons. The results indicate that the survey tool aided the clinician in the majority (95%) of the cases to make overall assessments of their patient’s health and helped make management decisions. The results showed that more referrals were made to physical therapy &amp; primary care clinics in patients who took the survey as compared to the patients who did not take the survey [14% vs 5%]. Conclusions: We conclude that the oncologists at our cancer center found that the CARG assessment tool is beneficial for physicians in their decision-making process while assessing an elderly patient and helped them provide timely and more comprehensive treatment care plan.
Transcriptomic analysis identifies a tumor subtype mRNA classifier for invasive non-functioning pituitary neuroendocrine tumor diagnostics
Authors: Xinjie Bao, Gengchao Wang, Shan Yu, Jian Sun, Liu He, Hualu Zhao, Yanni Ma, Fang Wang, Xiaoshuang Wang, Renzhi Wang, Jia Yu
Journal: Theranostics (2020)

Rationale: The invasive behavior of non-functioning pituitary neuroendocrine tumors (NF-PitNEts) presents obstacles for complete surgical resection and is indicative of poor prognosis. Therefore, developing reliable diagnostic tools for identifying invasive PitNEts would be helpful in guiding surgical decisions and, in particular, the follow-up treatment. Methods: We analyzed differential gene expression profiles between 39 non-invasive and 22 invasive NF-PitNEts by high-throughput sequencing, gene co-expression, and functional annotation. Twenty-one transcripts were further validated by Taqman-qPCR in another 143 NF-PitNEt samples. The histological expression and serum-exosomal mRNA of three candidate genes were examined by tissue microarray and droplet digital PCR. Results: Non-invasive and invasive NF-PitNEts were clustered into distinct groups with a few outliers because of their gonadotroph, corticotroph, or null cell lineages. The gene signature with strong invasive potential was enriched in 'Pathways in cancers' and 'MAPK pathway', with significantly higher in situ INSM1 and HSPA2 protein expression in invasive NF-PitNEts. Further integration of the 20 qPCR-validated differentially expressed genes and pituitary cell lineages provided a gene-subtype panel that performed 80.00-90.24% diagnostic accuracy for the invasiveness of NF-PitNEts. Conclusion: Our approach defined new characteristics in the core molecular network for patients at risk for invasive NF-PitNEt, representing a significant clinical advance in invasive PitNEt diagnostics.
Ivacaftor in Infants Aged 4 to &lt;12 Months with Cystic Fibrosis and a Gating Mutation. Results of a Two-Part Phase 3 Clinical Trial
Authors: Jane C. Davies, Claire E. Wainwright, Gregory S. Sawicki, Mark N. Higgins, Daniel Campbell, Christopher Harris, Paul Panorchan, Eric Haseltine, Simon Tian, Margaret Rosenfeld
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Rationale: We previously reported that ivacaftor was safe and well tolerated in cohorts aged 12 to <24 months with cystic fibrosis and gating mutations in the ARRIVAL study; here, we report results for cohorts aged 4 to <12 months.Objectives: To evaluate the safety, pharmacokinetics, and pharmacodynamics of ivacaftor in infants aged 4 to <12 months with one or more gating mutations.Methods: ARRIVAL is a single-arm phase 3 study. Infants received 25 mg or 50 mg ivacaftor every 12 hours on the basis of age and weight for 4 days in part A and 24 weeks in part B.Measurements and Main Results: Primary endpoints were safety (parts A and B) and pharmacokinetics (part A). Secondary/tertiary endpoints (part B) included pharmacokinetics and changes in sweat chloride levels, growth, and markers of pancreatic function. Twenty-five infants received ivacaftor, 12 in part A and 17 in part B (four infants participated in both parts). Pharmacokinetics was consistent with that in older groups. Most adverse events were mild or moderate. In part B, cough was the most common adverse event (n = 10 [58.8%]). Five infants (part A, n = 1 [8.3%]; part B, n = 4 [23.5%]) had serious adverse events, all of which were considered to be not or unlikely related to ivacaftor. No deaths or treatment discontinuations occurred. One infant (5.9%) experienced an alanine transaminase elevation >3 to ≤5× the upper limit of normal at Week 24. No other adverse trends in laboratory tests, vital signs, or ECG parameters were reported. Sweat chloride concentrations and measures of pancreatic obstruction improved.Conclusions: This study of ivacaftor in the first year of life supports treating the underlying cause of cystic fibrosis in children aged ≥4 months with one or more gating mutations.Clinical trial registered with clinicaltrials.gov (NCT02725567).
Treating critically ill anemic patients with erythropoietin: less is more
Authors: Simon Oczkowski, Akshay Shah, Cécile Aubron, Marije Wijnberge, Alexander P. J. Vlaar, Sanne de Bruin, Massimo Antonelli, Philippe Aries, Jacques Duranteau, Nicole P. Juffermans, Jens Meier, Gavin J. Murphy, Riccardo Abbasciano, Marcella Muller, Anders Perner, Sofie Rygaard, Timothy S. Walsh, Joanna C. Dionne, Gordon Guyatt, Maurizio Cecconi
Journal: Intensive Care Medicine (2020)
A pilot study to increase adherence to ASCO Choosing Wisely recommendations for breast cancer surveillance at community clinics.
Authors: Karma L. Kreizenbeck, Tracy Wong, Barbara Jagels, Julie C. Smith, Blair Billings Irwin, Barbara Jensen, Kathryn Egan, Heather Noble, Scott David Ramsey
Journal: Journal of Clinical Oncology (2020)

18 Background: ASCO 2012 Choosing Wisely recommends against serum tumor marker tests and advanced imaging for breast cancer survivors who are asymptomatic for recurrence. Our pilot aimed to measure and raise adherence to this recommendation through a patient video at regional community clinics. Methods: Eligibility for study included patients with 1+ long-term follow-up visit within 3 months of end of treatment in the pre- or post-intervention period: Clinic tumor registries were queried for stage I-IIIA breast cancer patients treated with curative intent. The intervention included 1) academic detailing for oncologists at a regular meeting and 2) a video about the recommendation shown to patients at end of active treatment. Surveillance data was manually abstracted. We define adherence as no asymptomatic tests in the first 13 months of surveillance. Results: Advanced imaging adherence was high before and after the intervention (99-100%). Tumor marker (TM) adherence is in the table. Six of seven providers with low (&lt;60%) TM adherence before the intervention maintained low TM adherence after. One provider with low TM adherence and all 3 providers with moderate (60-90%) TM adherence increased to high TM adherence (&gt;90%). TM adherence was better among patients who viewed the video (130 of 145, 90%) than those who did not (452 of 556, 81%) in the post-intervention period. The higher TM adherence among patients who viewed the video and the wide range in adherence among providers suggest that tumor marker use may be both patient- and provider-driven. Population characteristics may explain some of the variation in adherence. Conclusions: While adherence to recommendations regarding high-cost imaging was high, wide variation in tumor marker adherence among providers and high baseline adherence for advanced imaging suggests that interventions targeting surveillance testing may wish to focus primarily on tumor markers and provider outreach. [Table: see text]
Blurring the picture in leaky gut research: how shortcomings of zonulin as a biomarker mislead the field of intestinal permeability
Authors: Lucas Massier, Rima Chakaroun, Peter Kovacs, John T. Heiker
Journal: Gut (2020)

With great interest we read the work by Talley et al 1 reporting the inadequacy of zonulin as a biomarker due to its failure to identify the irritable bowel syndrome, functional dyspepsia and non-coeliac wheat sensitivity. Zonulin as a biomarker is highly disputed.2 A recent study showed that zonulin-mediated intestinal barrier integrity is an important mechanism by which gut microbial dysbiosis affects the transition from asymptotic autoimmunity to inflammatory disease associated with increased circulating zonulin in patients with arthritis.3 In all of these studies, zonulin measurements are based on commercial ELISA.

There is no doubt about the clinical relevance of studies addressing the relation between intestinal permeability and inflammatory diseases. Zonulin, precisely pre-haptoglobin 2 (preHP2), was identified as a human homologue to a second Vibrio cholerae enterotoxin regulating tight junction permeability and subsequently has gained …
Germline <i>PAX5</i> mutation predisposes to familial B-cell precursor acute lymphoblastic leukemia
Authors: Nicolas Duployez, Laura A. Jamrog, Vincent Fregona, Camille Hamelle, Laurène Fenwarth, Sophie Lejeune, Nathalie Helevaut, Sandrine Geffroy, Aurélie Caillault, Alice Marceau-Renaut, Stéphanie Poulain, Catherine Roche-Lestienne, Laetitia Largeaud, Naïs Prade, Stéphanie Dufrechou, Sylvie Hébrard, Céline Berthon, Brigitte Nelken, José Fernandes, Céline Villenet, Martin Figeac, Bastien Gerby, Eric Delabesse, Claude Preudhomme, Cyril Broccardo
Journal: Blood (2020)
Improving timeliness of care for breast, GYN, and aerodigestive cancer patients with nurse navigators in a safety net hospital.
Authors: Christine Rehr, Teralyn Carter, Eric Flenaugh, Zhensheng Wang, Gail Ohaegbulam, Roland Matthews, Pooja Mishra, Jamil Facdol, Susan Coples, Dana Thomas, Rosalyn Garrett, Sheryl G. A. Gabram
Journal: Journal of Clinical Oncology (2020)

183 Background: The Georgia Cancer Center for Excellence (GCCE) at Grady received a 5-year MERCK Patient Centered Grant in 2017 that focuses on improving care to vulnerable cancer patients (pts) through the introduction of nurse (RN) navigators, a dietician and a part time exercise coach. A review of the literature shows improved patient outcomes and satisfaction with decreased time to treatment for breast and lung cancer pts. [1-2] RN navigation has been shown to expedite care and one of our goals for the MERCK grant was to study the effect of introducing RN navigation in a safety net hospital for three cancer sites. Methods: Three RN navigators were hired for the Breast, GYN and Aerodigestive cancer programs since 2017. RN navigators meet all newly diagnosed cancer pts during clinic and track their progression of care, often intervening for timeliness of work up and treatment. Each RN navigator keeps a record of pts navigated. An audit of this prospectively collected data measuring time from diagnosis to treatment for breast, GYN and aerodigestive cancer pts took place for 2018 and 2019. Inclusion criteria: diagnosed and treated at Grady, navigated by RN, and not Stage IV disease. Results: The total numbers of cancer pts navigated over the past two years were 244 breast, 131 GYN, and 265 aerodigestive pts. Using the inclusion criteria described in the methods section, the time from diagnosis to treatment decreased for these three cancer sites (see Table). Conclusions: Implementation of RN navigators within the cancer program trended towards decreases in time from diagnosis to treatment for our breast, GYN, and aerodigestive cancer patients. These measurable improvements over three cancer sites are largely attributed to RN navigation and suggest that cancer outcomes will improve over time for our patients treated in our safety net hospital. We plan to study patients who were retained in the system or were adherent to care to better understand the importance of RN navigation in our system. References: (1)Bleicher RJ, Ruth K, Sigurdson ER, et al. Time to Surgery and Breast Cancer Survival in the US. JAMA Oncol 2016;2(3):330–339. (2) Olsson JK, Schultz EM, Gould MK. Timeliness of care in patients with lung cancer. Thorax 2009;64:749-756. [Table: see text]
Adolescent with COVID-19 as the Source of an Outbreak at a 3-Week Family Gathering — Four States, June–July 2020
Authors: Noah G. Schwartz, Anne C. Moorman, Anna Makaretz, Karen T. Chang, Victoria T. Chu, Christine M. Szablewski, Anna R. Yousaf, Marie M. Brown, Ailis Clyne, Amanda DellaGrotta, Jan Drobeniuc, Jacqueline Korpics, Adam Muir, Cherie Drenzek, Utpala Bandy, Hannah L. Kirking, Jacqueline E. Tate, Aron J. Hall, Tatiana M. Lanzieri, Rebekah J. Stewart
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

There is increasing evidence that children and adolescents can efficiently transmit SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1-3). During July-August 2020, four state health departments and CDC investigated a COVID-19 outbreak that occurred during a 3-week family gathering of five households in which an adolescent aged 13 years was the index and suspected primary patient; 11 subsequent cases occurred.