tbuckley/cabot-search huggingface dataset:
Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study
Authors: Kao-Ping Chua, Michael A Fischer, Jeffrey A Linder
Journal: BMJ (2019)

To assess the appropriateness of outpatient antibiotic prescribing for privately insured children and non-elderly adults in the US using a comprehensive classification scheme of diagnosis codes in ICD-10-CM (international classification of diseases-clinical modification, 10th revision), which replaced ICD-9-CM in the US on 1 October 2015.
A systematic literature review and meta-analysis of real-world interventions for cognitive ageing in healthy older adults
Authors: Eleftheria Vaportzis, Malwina A. Niechcial, Alan J. Gow
Journal: Ageing Research Reviews (2019)

Activities running in community-based-settings offer a method of delivering multimodal interventions to older adults beyond cognitive training programmes. This systematic review and meta-analysis investigated the impact of randomised controlled trials (RCTs) of 'real-world' interventions on the cognitive abilities of healthy older adults. Database searches were performed between October 2016 and September 2018. Forty-three RCTs were eligible for inclusion with 2826 intervention participants and 2234 controls. Interventions to enhance cognitive ability consisted of participation in activities that were physical (25 studies), cognitive (9 studies), or mixed (i.e., physical and cognitive; 7 studies), and two studies used other interventions that included older adults assisting schoolchildren and engagement via social network sites. Meta-analysis revealed that Trail Making Test (TMT) A, p = 0.05, M = 0.43, 95% CI [-0.00, 0.86], digit symbol substitution, p = 0.05, M = 0.30, 95% CI [0.00, 0.59], and verbal fluency, p = 0.04, M = 0.31, 95% CI [0.02, 0.61], improved after specific types of interventions versus the control groups (which were either active, wait-list or passive controls). When comparing physical activity interventions against all control groups, TMT A, p = 0.04, M = 0.25, 95% CI [0.01, 0.48], and digit span forward, p = 0.05, M = 0.91, 95% CI [-0.00, 1.82], significantly improved. Results remained non-significant for all outcomes when comparing cognitive activity interventions against all control groups. Results therefore suggest that healthy older adults are more likely to see cognitive improvements when involved in physical activity interventions. In addition, TMT A was the only measure that consistently showed significant improvements following physical activity interventions. Visuospatial abilities (as measured by TMT A) may be more susceptible to improvement following physical activity-based interventions, and TMT A may be a useful tool for detecting differences in that domain.
SP0092 Us for scoring sjÖgren disease
Authors: S. Jousse-Joulin
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Sjogren’s syndrome (SS) is a chronic autoimmune inflammatory disorder of exocrine glands. Its diagnosis relies on solely a combination of clinical and laboratory findings. Recently, new imaging techniques as MRI or ultrasound, known to be less invasive than sialography have shown a good sensitivity and specificity to detect structural abnormalities in pSS. Ultrasonography of the salivary glands (SGUS) appears to be the most attractive imaging approach: it is an inexpensive commonly available noninvasive technique that does not cause complications and inconvenience to the patient, although the data are somewhat conflicting. A systematic literature review has highlighted the main keypoints to validate salivary glands ultrasonography has an outcome measure in particular, there are limited data describing a standardised scanning method and standardised definitions of US gland pathologies.<sup>1</sup> Until now, both parotid glands and submandibular glands were assessed using a scoring system first developed by de Vita et al.(,<sup>2</sup> later modified by other investigators. Five scoring systems are now published which are frequently modified by different operators<sup>2, 3–6</sup> but their reliability were not always evaluated. In order to use SGUS in clinical routine, we need to have standardisation of the US procedure to assess SG and to be capable to have a simple and reliable score to rate structural damage of each. A SGUS OMERACT task force was created in 2016 and produce consensual US definitions of the 6 major salivary glands and a semi quantitative scoring. The intra and inter reliability of this scoring between international experts showed good inter reliability and excellent intra reliability. We will present to you the definitions and the new semi quantitative scoring with a live demo. <h3>References</h3> [1] Jousse-Joulin S, et al. <i>Rheumatology (Oxford)</i>2016May;55(5):789–800. [2] De vita S, et al. J rheumatol2000May;27(5):1229–36. [3] Milic V, et al. <i>Rheumatol</i>2012Jun;51(6):1081–5. [4] Makula E, et al. Br J Rheumatol1996Oct;35(10):972–7. [5] Sallaffi F, et al. J Rheumatol2000May;27(5):1229–36. [6] Hocevar A, et al. Eur J radiol2007Sep;63(3):379–83. <h3>Disclosure of Interest</h3> None declared
Use of Gemtuzumab Ozogamicin for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia (AML) or Acute Promyelocytic Leukemia (APL) in an Expanded Access Setting at Our Cancer Consortium
Authors: Kelda M Gardner, Kathleen Shannon Dorcy, Rachele O'Leary, Donelle Rizzuto, Roland B. Walter, Carole Shaw, Sunny So, Paul C. Hendrie, Bart L Scott, Mary Beth M. Percival, Anna B. Halpern, Ryan D. Cassaday, Janis L. Abkowitz, Bethany Murphy, Niall Curley, Cody Hammer, Heather Smith, Gabrielle A Zecha, Frederick R. Appelbaum, Soheil Meshinchi, Colleen Delaney, Todd M Cooper, Katherine Tarlock, Elihu H. Estey, Pamela S. Becker
Journal: Blood (2018)
Shared decision-making in sports concussion: rise to the ‘OCAsion’ to take the heat out of on-field decision-making
Authors: Louis Holtzhausen, Hendrik Paulus Dijkstra, Jon Patricios
Journal: British Journal of Sports Medicine (2019)

The 2018 FIFA World Cup again emphasised the challenge of on-field management of a concussed athlete; there was no shortage of disagreement among expert commentators and claims of questionable medical decisions.1 

Team physicians often insist on having the sole decision-making responsibility in removing a player with suspected sport-related concussion from play. This is frequently met with resistance from other concerned parties, including the coach and the athlete.2 Good progress has been made to address this problem with the introduction of the SCAT protocol,3 legislation, policies and education across sports, leagues and countries, such as World Rugby and sport in general in the USA. However, in our experience, even with policies in place, compliance remains poor in several sports and many parts of the world, especially in non-professional sport. This became evident when two experienced clinician authors (LH and JP) were tasked to implement a sport-related concussion programme in soccer (football) leagues in Qatar. Despite FIFA guidelines on concussion care, low levels of knowledge and negative attitudes were encountered from at least some people at management, player and medical levels. It became clear that engagement and education at several levels of the sport would be required for successful implementation of effective concussion care.

We explore four factors that contribute to this complex issue and propose a three-part approach to the removal of players with suspected concussion from the field of play to improve this aspect of concussion care.

Shared decision-making is usually done by a team consisting of the patient as central figure, the medical care provider and significant others. In Sport and Exercise Medicine (SEM), the team typically consists of the patient, the sports medicine physician and/or physiotherapist, and the coach/manager,4 with possible input from the agent. In youth sport, parental input is also relevant. Until now, …
Abstract 14991: Dantrolene Cannot Inhibit Aberrant Ca <sup>2+</sup> Release and Arrhythmias Without Calmodulin in Pressure Overload Heart Failure
Authors: Go Fukui, Takeshi Yamamoto, Takayoshi Kato, Takako Maeda, Shigehiko Nishimura, Akihiro Hino, Takeshi Suetomi, Makoto Ono, Mamoru Mochizuki, Tetsuro Oda, Shinichi Okuda, Shigeki Kobayashi, Masafumi Yano
Journal: Circulation (2015)

Background: We have been reported that dantrolene (DAN) binds to N-terminal domain of the cardiac ryanodine receptor (RyR2) and corrects the aberrant Ca 2+ leak. We have been also reported that DAN enhances binding affinity of Calmodulin (CaM) to RyR2 in failing cardiomyocytes. In this study, we investigated whether CaM is essential for the anti-arrhythmogenic effect of DAN using pressure-overload heart failure induced by transverse aortic constriction (TAC). Methods and results: Pressure overload to 12 weeks old mice was induced by TAC using a 27-gauge needle. Cardiomyocytes isolated from mice 8 weeks after TAC operation were used in the present study. The survival rate of our TAC mice at 8 weeks after TAC operation was 32 %. LV end-diastolic dimension was significantly enlarged and LV ejection fraction was significantly decreased. Lethal arrhythmias were frequently observed after 2 mg epinephrine infusion in TAC mice, but not in Sham mice. All following experiments were done under 1 μM of KN93 to avoid the effect of CaMKII. The Ca 2+ spark frequency (SpF: s -1 ·100 μm -1 ; by fluo3) was much higher in TAC than in Sham cardiomyocytes {TAC (n=10): 7.6±4.7; Sham (n=5): 5.7±1.9; p&lt;0.01}. Addition of DAN to saponin-permeabilized TAC cells normalize Ca 2+ spark frequency {(n=5): 5.6±1.4}. This effect of DAN disappeared after suramin, CaM remover from RyR2, treatment {(n=4): 7.2±3.2}. Spontaneous Ca 2+ transients (SCaT) were measured during sequential pacing of intact cardiomyocytes from 1 Hz to 5 Hz. SCaT was rarely observed in Sham cells even at 5 Hz pacing, whereas it was observed in 20 % of TAC cells. Pre-incubation with DAN to intact TAC cells normalize inceidence of SCaT (11 %). After suramin incorporation, effect of DAN was abolished (19 %). Conclusions: In conclusion, CaM is essential for the channel stabilization effect of DAN. DAN corrects the aberrant domain-domain interaction, and as the result, CaM binding affinity to the RyR2 improves. These are the possible mechanism underlying anti-arrhythmogenic effect of DAN.
Dosing Patterns of Dasatinib Use in Simplicity, an Observational Study in Chronic Phase Chronic Myeloid Leukemia (CP-CML) Patients (pts) in Routine Clinical Practice
Authors: Jorge E. Cortes, Clara Chen, Michael J. Mauro, Ginny P Sen, Srikanth Gajavelli, Catherine Davis, Stuart L. Goldberg
Journal: Blood (2018)
Anti‐tumour necrosis factor‐associated cutaneous leishmaniasis: a single‐institution experience
Authors: A. Martínez‐Doménech, M. García‐Legaz‐Martínez, J. Magdaleno‐Tapial, M. Torrecillas, P. Hernández‐Bel, M.D. Ocete Mochón, A. Pérez‐Ferriols, V. Alegre Miquel
Journal: British Journal of Dermatology (2019)
Neutrophils disturb pulmonary microcirculation in sepsis-induced acute lung injury
Authors: Inwon Park, Mingyo Kim, Kibaek Choe, Eunjoo Song, Howon Seo, Yoonha Hwang, Jinhyo Ahn, Seung-Hyo Lee, Jae Hyuk Lee, You Hwan Jo, Kyuseok Kim, Gou Young Koh, Pilhan Kim
Journal: European Respiratory Journal (2019)

The lung is highly vulnerable during sepsis, yet its functional deterioration accompanied by disturbances in the pulmonary microcirculation is poorly understood. This study aimed to investigate how the pulmonary microcirculation is distorted in sepsis-induced acute lung injury (ALI) and reveal the underlying cellular pathophysiologic mechanism. Using a custom-made intravital lung microscopic imaging system in a murine model of sepsis-induced ALI, we achieved direct real-time visualisation of the pulmonary microcirculation and circulating cells in vivo . We derived the functional capillary ratio (FCR) as a quantitative parameter for assessing the fraction of functional microvasculature in the pulmonary microcirculation and dead space. We identified that the FCR rapidly decreases in the early stage of sepsis-induced ALI. The intravital imaging revealed that this decrease resulted from the generation of dead space, which was induced by prolonged neutrophil entrapment within the capillaries. We further showed that the neutrophils had an extended sequestration time and an arrest-like dynamic behaviour, both of which triggered neutrophil aggregates inside the capillaries and arterioles. Finally, we found that Mac-1 (CD11b/CD18) was upregulated in the sequestered neutrophils and that a Mac-1 inhibitor restored the FCR and improved hypoxaemia. Using the intravital lung imaging system, we observed that Mac-1-upregulated neutrophil aggregates led to the generation of dead space in the pulmonary microcirculation that was recovered by a Mac-1 inhibitor in sepsis-induced ALI.
AB0708 The use of temporal artery biopsies (TAB) in diagnosis and management of patients with giant cell arteritis (GCA)- a re-audit in rheumatology in the belfast health and social care trust (BHSCT)
Authors: U.A. Laverty, E. Banks, M. McHenry
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients should meet at least 3/5 American College of Rheumatology (ACR) criteria for a diagnosis of GCA. British Society of Rheumatology (BSR) guidelines on the management of GCA from 2010 emphasise the importance of early referral for specialist management. TAB should be considered depending on local experience and availability of other imaging modalities. Biopsy should be at least 10 mm in length and ideally done within 14 days of presentation. TABs performed in BHSCT over a three-year period were audited in 2014. <h3>Objectives</h3> We re-audited the Rheumatology TAB referrals in the BHSCT from August 2016 to August 2017 to assess how biopsies influenced the management of patients with GCA in comparison to the previous audit. <h3>Methods</h3> Histopathology based LabCentre search detected 36 TABs within the given period. A retrospective audit was carried out with the use of Electronic Care Record and 16 of these patients were Rheumatology based TAB referrals. A proforma was used to aid data collection. <h3>Results</h3> Female:Male ratio was 2.2:1, age range was 61–91 with a mean age of 76. 94% of patients presented with headache. Of those patients referred for biopsy, 100% already fulfilled 2 of ACR criteria, compared with only 80% in previous audit. TAB was positive in 25%. In those with a positive biopsy, 75% had an ESR &gt;50. All patients were on steroid treatment at the time of biopsy. In 42% of patients with a negative biopsy, steroids were rapidly reduced. 100% of patients with a positive biopsy continued on steroids. 68% of biopsies were greater than 10 mm compared with 38% in the previous audit. 68% of patients had a TAB within 14 days of commencing on steroids, with 31% having biopsy within 7 days of commencing steroids. 63% of patients developed steroid related complications. In 56% of patients the biopsy result changed patient management. <h3>Conclusions</h3> The percentage of appropriate referrals for biopsy (based on the ACR criteria) has improved compared with the previous audit. The length of biopsy improved. 32% of patients were waiting longer than 2 weeks for biopsy but some of these patients presented late to the rheumatology team. Biopsy results changed management in 56% of patients. Areas for consideration include improvement in time to biopsy and biopsy length. <h3>Reference</h3> [1] BSR and BHPR guidelines for management of giant cell arteritis. Bhaskar Dasgupta, et al. Rheumatology, Volume 49, Issue 8, 1 August 2010, Pages 1594–1597. Published: 05 April 2010 <h3>Disclosure of Interest</h3> None declared
FRI0583 Clinical utility of ana-elia vs ana-immunofluorescence in connective tissue disease
Authors: O. Alsaed, L. Alamilah, O. Al-Radideh, M. Elkhalifa, A.-W. Al-Allaf
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Antinuclear antibody (ANA) detection by indirect immunofluorescence technique (ANA-IIF) is the standard test for connective tissue disease (CTD) screening for last 5 decades, which has low specificity and it is labour intensive. ANA detection by fluoroenzyme immunoassay (ANA-Elia) has been developed recently as an alternative method to include 17 ANA-targeted recombinant antigens. <h3>Objectives</h3> Compare the sensitivity and specificity of the new ANA-Elia with conventional ANA-IIF. <h3>Methods</h3> Randomly selected 1458 patient's sera from primary and secondary health care were tested for both the standard ANA-IIF (Diasorin S.P.A, saluggia, Italy) and the new ANA-Elia (Phadia GMbH, Ferieiburg, Germany). ANA-Elia is fluoroenzyme immunoassay performed on the Phadia-250 automated platform. It contains 17 ANA-targeted recombinant antigens; dsDNA, Sm-D, Rib-P, PCNA, U1-RNP (70, A, C), SS-A/Ro (52 and 60), SS-B/La, Centromere B, Scl-70, Fibrillarin, RNA Polymerase III, Jo-1, Mi-2, and PMscl. Result with ratio &gt;1.0 considered positive for the new technique. For ANA-IIF our lab cut off for positive test is ≥1:80. Patients were evaluated in our rheumatology clinic for fulfilling the correspondent international clinical criteria for various connective tissue diseases. <h3>Results</h3> 75.7% were females with mean age of 43±13 years. 201 (11.5%) patients confirmed to have clinical CTD as follow: 142 SLE, 24 Sjogren's syndrome, 15 scleroderma, 7 MCT, 10 Myositis and 10 undifferentiated CTD. The specificity of ANA-Elia at cut off ratio of &gt;1 and ANA-IIF at titer of ≥1:80 was almost equal, 88.5% and 87.6% respectively. However, ANA-Elia has higher sensitivity (74.5%) as compared to ANA-IIF (61.6%). At a higher cut off ratio of &gt;2 and titer of ≥1:160, the specificity improved to 93.6%–92.6% respectively. <h3>Conclusions</h3> The ANA testing with the newly developed, use friendly, fully automated and less labour intense method of ANA-Elia can replace the standard conventional ANA-IIF with better specificity. <h3>Disclosure of Interest</h3> None declared
SP0012 Novel therapies that may make it into the clinic in systemic sclerosis
Authors: D. Furst
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Introduction</h3> Many therapies have been tested in systemic sclerosis (SSC), often failing but new approaches to measuring effect may improve the probability of success. The Combined Response Index for Systemic Sclerosis (CRI SS) combines measurement of the skin, lungs, activities of daily living and global assessments of disease activity into a single number. Like the DAS 28, this measure may be more powerful than any single outcome measure such as modified Rodnan skin score (mRSS) or forced vital capacity (FVC). Novel approaches: Multiple therapies are being tested which modify the immune system and the vascular pathogenetic node underlying the pathogenesis of SSC. Among these are tocializumab (an IL-6 inhibitor), abatacept (affecting CD8 receptors) and rituximab (a CD20 inhibitor), all of whom are being tested in late phase studies and for whom results can be expected soon. A more novel approach involves inhibition of tyrosine kinases which, in turn, affect TGF-beta, PDGF, FGF beta and VEGF. Among these are nintedanib and a nanoparticle preparation delivering imatinib selectively. Encouraging animal studies and early human studies are resulting in larger studies in SSC patients. Other drugs affecting fibrosis and inflammation are also being tested, including a cannabinoid which has shown encouraging early results. While hematopoietic stem cell therapy will soon become a standard of care, other cellular therapies such as adipose derived mesenchymal cells and mesenchymal products such as exosomes and microparticles are being tested in systemic sclerosis. There may or may not be enough time to discuss even more novel approaches to treating systemic sclerosis, with good rationale and some early results ,which may reach the clinic. Overall, this is an encouraging time for novel therapies to treat systemic sclerosis. <h3>Disclosure of Interest</h3> None declared
Reduced non–rapid eye movement sleep is associated with tau pathology in early Alzheimer’s disease
Authors: Brendan P. Lucey, Austin McCullough, Eric C. Landsness, Cristina D. Toedebusch, Jennifer S. McLeland, Aiad M. Zaza, Anne M. Fagan, Lena McCue, Chengjie Xiong, John C. Morris, Tammie L. S. Benzinger, David M. Holtzman
Journal: Science Translational Medicine (2019)

Slow wave activity during non–rapid eye movement sleep decreases with disease progression in patients with Alzheimer’s disease.
Spatial filtering pipeline evaluation of cortically coupled computer vision system for rapid serial visual presentation
Authors: Zhengwei Wang, Graham Healy, Alan F. Smeaton, Tomas E. Ward
Journal: Brain-Computer Interfaces (2018)

Rapid Serial Visual Presentation (RSVP) is a paradigm that supports the application of cortically coupled computer vision to image search. In RSVP, images are presented to participants which can evoke Event-related Potentials (ERPs) in their Electroencephalogram (EEG). Supervised spatial filtering techniques are often applied to enhance the discriminative information in the EEG. In this paper, we make two primary contributions: 1) We propose a novel spatial filtering method called Multiple Time Window LDA Beamformer (MTWLB); 2) We provide a comprehensive comparison of nine spatial filtering pipelines using three spatial filtering schemes, namely, MTWLB, xDAWN, Common Spatial Pattern (CSP) and three linear classification methods Linear Discriminant Analysis (LDA), Bayesian Linear Regression (BLR) and Logistic Regression (LR). The results reveal that MTWLB and xDAWN enhance the classification performance but CSP does not. The results also support the conclusion that LR can be effective for a RSVP-based BCI if discriminative features are available.
Mapping Physical Tumor Microenvironment and Drug Delivery
Authors: Hadi T. Nia, Lance L. Munn, Rakesh K. Jain
Journal: Clinical Cancer Research (2019)

The physical microenvironment of pancreatic tumors is highly abnormal, and this causes significant challenges for drug delivery through multiple mechanisms. Measurements of tissue elasticity could be used as a physical biomarker to assess aberrant drug delivery, and potentially guide stroma-targeting treatment strategies and patient stratification.See related article by Wang et al., p. 2136.