tbuckley/cabot-search huggingface dataset:
Latent tuberculosis screening and treatment among asylum seekers: a mixed-methods study
Authors: Ineke Spruijt, Dawit Tesfay Haile, Jeanine Suurmond, Susan van den Hof, Marga Koenders, Peter Kouw, Natascha van Noort, Sophie Toumanian, Frank Cobelens, Simone Goosen, Connie Erkens
Journal: European Respiratory Journal (2019)

Introduction Evidence on conditions for implementation of latent tuberculosis infection (LTBI) screening and treatment among asylum seekers is needed to inform tuberculosis (TB) control policies. We used mixed-methods to evaluate the implementation of an LTBI screening and treatment programme among asylum seekers in the Netherlands. Methods We offered voluntary LTBI screening to asylum seekers aged ≥12 years living in asylum seeker centres from countries with a TB incidence &gt;200 per 10 000 population. We calculated LTBI screening and treatment cascade coverage, and assessed associated factors with Poisson regression using robust variance estimators. We interviewed TB care staff (seven group interviews) and Eritrean clients (21 group and 21 individual interviews) to identify programme enhancers and barriers. Results We screened 719 (63% of 1136) clients for LTBI. LTBI was diagnosed among 178 (25%) clients; 149 (84%) initiated LTBI treatment, of whom 129 (87%) completed treatment. In-person TB and LTBI education, the use of professional interpreters, and collaboration with partner organisations were enhancers for LTBI screening uptake. Demand-driven LTBI treatment support by TB nurses enhanced treatment completion. Factors complicating LTBI screening and treatment were having to travel to public health services, language barriers and moving from asylum seeker centres to the community during treatment. Conclusion LTBI screening and treatment of asylum seekers is feasible and effective when high quality of care is provided, including culture-sensitive TB education throughout the care cascade. Additionally, collaboration with partner organisations, such as agencies responsible for reception and support of asylum seekers, should be in place.
Yin Yang 1 protein ameliorates diabetic nephropathy pathology through transcriptional repression of TGFβ1
Authors: Pan Gao, Liliang Li, Liu Yang, Dingkun Gui, Jiarong Zhang, Junfeng Han, Jiajia Wang, Niansong Wang, Junxi Lu, Suzhen Chen, Liping Hou, Honglin Sun, Liping Xie, Jian Zhou, Chao Peng, Yan Lu, Xuemei Peng, Cunchuan Wang, Ji Miao, Umut Ozcan, Yu Huang, Weiping Jia, Junli Liu
Journal: Science Translational Medicine (2019)

Transforming growth factor-β1 (TGFβ1) has been identified as a major pathogenic factor underlying the development of diabetic nephropathy (DN). However, the current strategy of antagonizing TGFβ1 has failed to demonstrate favorable outcomes in clinical trials. To identify a different therapeutic approach, we designed a mass spectrometry-based DNA-protein interaction screen to find transcriptional repressors that bind to the TGFB1 promoter and identified Yin Yang 1 (YY1) as a potent repressor of TGFB1. YY1 bound directly to TGFB1 promoter regions and repressed TGFB1 transcription in human renal mesangial cells. In mouse models, YY1 was elevated in mesangial cells during early diabetic renal lesions and decreased in later stages, and knockdown of renal YY1 aggravated, whereas overexpression of YY1 attenuated glomerulosclerosis. In addition, although their duration of diabetic course was comparable, patients with higher YY1 expression developed diabetic nephropathy more slowly compared to those who presented with lower YY1 expression. We found that a small molecule, eudesmin, suppressed TGFβ1 and other profibrotic factors by increasing YY1 expression in human renal mesangial cells and attenuated diabetic renal lesions in DN mouse models by increasing YY1 expression. These results suggest that YY1 is a potent transcriptional repressor of TGFB1 during the development of DN in diabetic mice and that small molecules targeting YY1 may serve as promising therapies for treating DN.
Effect of Vaginal Mesh Hysteropexy vs Vaginal Hysterectomy With Uterosacral Ligament Suspension on Treatment Failure in Women With Uterovaginal Prolapse
Authors: Charles W. Nager, Anthony G. Visco, Holly E. Richter, Charles R. Rardin, Rebecca G. Rogers, Heidi S. Harvie, Halina M. Zyczynski, Marie Fidela R. Paraiso, Donna Mazloomdoost, Scott Grey, Amaanti Sridhar, Dennis Wallace
Journal: JAMA (2019)

<h3>Importance</h3> Vaginal hysterectomy with suture apical suspension is commonly performed for uterovaginal prolapse. Transvaginal mesh hysteropexy is an alternative option. <h3>Objective</h3> To compare the efficacy and adverse events of vaginal hysterectomy with suture apical suspension and transvaginal mesh hysteropexy. <h3>Design, Setting, Participants</h3> At 9 clinical sites in the US Pelvic Floor Disorders Network, 183 postmenopausal women with symptomatic uterovaginal prolapse were enrolled in a randomized superiority clinical trial between April 2013 and February 2015. The study was designed for primary analysis when the last randomized participant reached 3 years of follow-up in February 2018. <h3>Interventions</h3> Ninety-three women were randomized to undergo vaginal mesh hysteropexy and 90 were randomized to undergo vaginal hysterectomy with uterosacral ligament suspension. <h3>Main Outcomes and Measures</h3> The primary treatment failure composite outcome (re-treatment of prolapse, prolapse beyond the hymen, or prolapse symptoms) was evaluated with survival models. Secondary outcomes included operative outcomes and adverse events, and were evaluated with longitudinal models or contingency tables as appropriate. <h3>Results</h3> A total of 183 participants (mean age, 66 years) were randomized, 175 were included in the trial, and 169 (97%) completed the 3-year follow-up. The primary outcome was not significantly different among women who underwent hysteropexy vs hysterectomy through 48 months (adjusted hazard ratio, 0.61 [95% CI, 0.37-1.02];<i>P</i> = .06; 36-month adjusted failure incidence, 24% vs 36%). Mean (SD) operative time was lower in the hysteropexy group vs the hysterectomy group (111.5 [39.7] min vs 156.7 [43.9] min; difference, −45.2 [95% CI, −57.7 to −32.7];<i>P</i> = &lt;.001). Adverse events in the hysteropexy vs hysterectomy groups included mesh exposure (8% vs 0%), ureteral kinking managed intraoperatively (0% vs 7%), granulation tissue after 12 weeks (1% vs 11%), and suture exposure after 12 weeks (3% vs 21%). <h3>Conclusions and Relevance</h3> Among women with symptomatic uterovaginal prolapse undergoing vaginal surgery, vaginal mesh hysteropexy compared with vaginal hysterectomy with uterosacral ligament suspension did not result in a significantly lower rate of the composite prolapse outcome after 3 years. However, imprecision in study results precludes a definitive conclusion, and further research is needed to assess whether vaginal mesh hysteropexy is more effective than vaginal hysterectomy with uterosacral ligament suspension. <h3>Trial Registration</h3> ClinicalTrials.gov Identifier:NCT01802281
Role of Transbronchial Cryobiopsy in Interstitial Lung Diseases: An Ongoing Tale
Authors: Ori Wand, Avraham Unterman, Gali Epstein Shochet, David Shitrit
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

definition; 2) the definition of sepsis will likely continue to evolve, and we developed the temperature trajectory subphenotypes to be generalizable to past and future definitions; and 3) temperature trajectories derived only from patients with organ dysfunction on presentation would exclude patients with infection who later developed sepsis during hospitalization; because the development of organ dysfunction due to infection is likely in part related to the immune response, we did not want to exclude these patients from our analysis.On the suggestion of Dr. Maitra and Dr. Bhattacharjee, we tested the association between temperature trajectory membership and mortality adjusting for the Sequential Organ Failure Assessment (SOFA) score instead of the quick SOFA score.In logistic regression, when we controlled for age, comorbidities, SOFA, and time to antibiotics, membership in the "hyperthermic, fast resolvers" group remained associated with decreased mortality risk (odds ratio, 0.55; 95% confidence interval, 0.42-0.72;P , 0.001) compared with the "normothermic" group.Membership in the "hypothermic" group was associated with increased mortality risk (odds ratio, 1.56, 95% confidence interval, 1.30-1.88;P , 0.001).These results are similar to those we obtained in the primary analyses presented in our paper.Although the metric used to determine the accuracy of sepsis definitions is often risk of mortality, definitions developed based on that outcome may not capture the heterogeneity of the sepsis syndrome (2, 3).Developing a trajectory model based on body temperature (a biologically relevant clinical measurement) allowed us to establish subphenotypes that were disentangled from but still predictive of the outcome.Further studies are required to establish the precise biological significance of the temperature trajectory subphenotypes.
Influence of Diabetes Complications on HbA1c Treatment Goals Among Older U.S. Adults: A Cost-effectiveness Analysis
Authors: Hui Shao, Ji Lin, Xiaohui Zhuo, Deborah B. Rolka, Edward W. Gregg, Ping Zhang
Journal: Diabetes Care (2019)

OBJECTIVE Guidelines on the standard care of diabetes recommend that glycemic treatment goals for older adults consider the patient’s complications and life expectancy. In this study, we examined the influence of diabetes complications and associated life expectancies on the cost-effectiveness (CE) of HbA1c treatment goals. RESEARCH DESIGN AND METHODS We used data from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) to generate nationally representative subgroups of older individuals with diabetes with various health states. We used the Centers for Disease Control and Prevention–RTI International diabetes CE model to estimate the long-term consequences of two treatment goals—a stringent control goal (HbA1c &amp;lt;7.5%) and a moderate control goal (HbA1c &amp;lt;8.5%)—on health and cost. Our simulation population represented typical patients, and all individuals in each health subgroup had average characteristics, which did not account for person-level variations. The CE study was conducted from a health system perspective and followed the study samples over a lifetime. We used $50,000 per quality-adjusted life year (QALY) as the incremental CE threshold. RESULTS A stringent goal was, on average, cost-effective for individuals with no complications ($10,007 per QALY) or only microvascular complications (excluding renal failure; $19,621 per QALY), but it was not cost-effective for individuals with one or more macrovascular complications (all &amp;gt;$82,413 per QALY). Further, a stringent goal was not cost-effective when an individual had less than 7 years of life remaining. CONCLUSIONS Our findings support the guideline recommendation that glycemic goals for older adults should consider the complexity of their complications and their life expectancy from a CE perspective.
Closure of mesenteric defects is associated with a higher incidence of small bowel obstruction due to adhesions after laparoscopic antecolic Roux-en-y gastric bypass: A retrospective cohort study
Authors: Frederiek Nuytens, Mathieu D'Hondt, Frank Van Rooy, Franky Vansteenkiste, Hans Pottel, Mohammed Abasbassi, Ann Servaege, Dirk Devriendt
Journal: International Journal of Surgery (2019)
Endoscopic removal of an extraluminal, intrapancreatic dislocated common bile duct stone
Authors: Thomas Billiet, Annelies Holvoet, Sofie Decock, Joris Arts, Jean-Marc Gillardin, Philippe Van Hootegem, Wim Laleman
Journal: Endoscopy (2019)

We present the case of a 57-year-old woman who was referred for the treatment of an intrapancreatic dislocated common bile duct (CBD) stone ([Video 1]).
The psychosocial and financial burden on caregivers of young-onset colorectal cancer patients.
Authors: Kim Lynn Newcomer, N Y Board, Ronit Yarden
Journal: Journal of Clinical Oncology (2019)

11627Background: The Colorectal Cancer Alliance launched a survey for caregivers of young-onset colorectal cancer (CRC) patients and survivors. A caregiver of young-onset CRC is an unpaid or paid m...
Healthcare is not universal if undocumented migrants are excluded
Authors: Helena Legido-Quigley, Nicola Pocock, Sok Teng Tan, Leire Pajin, Repeepong Suphanchaimat, Kol Wickramage, Martin McKee, Kevin Pottie
Journal: BMJ (2019)

Healthcare is not universal if undocumented migrants are excludedHelena Legido-Quigley and colleagues examine the barriers that migrants face in accessing healthcare and argue they are counterproductive for host countries
DAPK1 (death associated protein kinase 1) mediates mTORC1 activation and antiviral activities in CD8+ T cells
Authors: Zhengping Wei, Pingfei Li, Ran He, Huicheng Liu, Na Liu, Yu Xia, Guoyu Bi, Qiuyang Du, Minghui Xia, Lei Pei, Jing Wang, Guihua Wang, Zhao-Hui Tang, Xiang Cheng, Huabin Li, Zhuoya Li, Lilin Ye, Arian Laurence, Youming Lu, Xiang-Ping Yang
Journal: Cellular and Molecular Immunology (2019)
Finding the Right Words to Stop Cancer Screening in Older Adults
Authors: Rebecca Voelker
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
TCR–pMHC bond conformation controls TCR ligand discrimination
Authors: Dibyendu K. Sasmal, Wei Feng, Sobhan Roy, Peter Leung, Yanran He, Chufan Cai, Guoshuai Cao, Huada Lian, Jian Qin, Enfu Hui, Hans Schreiber, Erin J. Adams, Jun Huang
Journal: Cellular and Molecular Immunology (2019)

Abstract A major unanswered question is how a TCR discriminates between foreign and self-peptides presented on the APC surface. Here, we used in situ fluorescence resonance energy transfer (FRET) to measure the distances of single TCR–pMHC bonds and the conformations of individual TCR–CD3ζ receptors at the membranes of live primary T cells. We found that a TCR discriminates between closely related peptides by forming single TCR–pMHC bonds with different conformations, and the most potent pMHC forms the shortest bond. The bond conformation is an intrinsic property that is independent of the binding affinity and kinetics, TCR microcluster formation, and CD4 binding. The bond conformation dictates the degree of CD3ζ dissociation from the inner leaflet of the plasma membrane via a positive calcium signaling feedback loop to precisely control the accessibility of CD3ζ ITAMs for phosphorylation. Our data revealed the mechanism by which a TCR deciphers the structural differences among peptides via the TCR–pMHC bond conformation.
The heterogeneity of prolonged ICU hospitalisations
Authors: Elizabeth Marie Viglianti, Jacqueline M Kruser, Theodore Iwashyna
Journal: Thorax (2019)

Prolonged intensive care unit (ICU) hospitalisations are costly, increasing in prevalence and strain ICU resources.1–4 One-year mortality is high and the recovery for survivors of prolonged ICU hospitalisations is typically long and marked by new morbidities.3 4 Thus, with advances in critical care technology, patients with prolonged ICU hospitalisations, their families and physicians are challenged to make complex, high-stakes decisions without clear guidance about long-term prognosis.

Recent work has focused on who these patients are and why they remain in the ICU for prolonged periods of time.5–8 Commonly measured patient characteristics on admission such as age and comorbidities have not consistently been associated with the need for prolonged ICU hospitalisations. (Of note, other premorbid patient characteristics, such as frailty, have not been studied as a risk factor for persistent critical illness.) These findings have challenged preconceived beliefs that prolonged ICU hospitalisations only occur for older patients or those with multiple comorbidities.5 8 Instead, observational data suggest the development of new organ dysfunctions not present on admission contributes to the development of prolonged ICU hospitalisations.6 7 This finding moves our understanding of prolonged ICU hospitalisations beyond the prototype of chronic critical illness—a patient with unresolving respiratory failure—and towards a more complete picture of how prolonged ICU hospitalisations emerge over time in the ICU.3 (figure 1)



Figure 1 
New framework of prolonged ICU hospitalisations.



Hermans et al describe the long-term mortality and morbidity of patients with prolonged ICU hospitalisations who are matched to short-stayers (patients who remained in the ICU for <8 days).9 The authors created three different matched cohorts to evaluate long-term mortality (total and post-28-day 5-year mortality) and morbidity. The authors performed a re-analysis of prospectively collected data of the EPaNIC-trial, which was a randomised control trial conducted in seven …
Epidemiological and Clinical Characteristics of Monoclonal Gammopathy of Renal Significance (MGRS) in South America
Authors: Camila Peña, Gonzalo P Mendez, Natalia Paola Schutz, Eloisa Riva, Ricardo Valjalo, Hernán López-Vidal, Alejandro Majlis, Vivianne Lois, Daniela Zamora, Jose T Gonzalez, Dorotea Beatriz Fantl
Journal: Blood (2018)
Immune correlates of the Thai RV144 HIV vaccine regimen in South Africa
Authors: Glenda E. Gray, Ying Huang, Nicole Grunenberg, Fatima Laher, Surita Roux, Erica Andersen-Nissen, Stephen C. De Rosa, Britta Flach, April K. Randhawa, Ryan Jensen, Edith M. Swann, Linda-Gail Bekker, Craig Innes, Erica Lazarus, Lynn Morris, Nonhlanhla N. Mkhize, Guido Ferrari, David C. Montefiori, Xiaoying Shen, Sheetal Sawant, Nicole Yates, John Hural, Abby Isaacs, Sanjay Phogat, Carlos A. DiazGranados, Carter Lee, Faruk Sinangil, Nelson L. Michael, Merlin L. Robb, James G. Kublin, Peter B. Gilbert, M. Juliana McElrath, Georgia D. Tomaras, Lawrence Corey
Journal: Science Translational Medicine (2019)

In South Africans, the RV144 HIV vaccine regimen elicited robust immune responses that have been associated with vaccine efficacy.
Courtesy Authorship in Academic Surgery Publications
Authors: John M. McClellan, Neel Mansukhani, Donald Moe, Michael Derickson, Stephen Chiu, Melina R. Kibbe, Matthew J. Martin
Journal: JAMA Surgery (2019)

<h3>Importance</h3> Courtesy authorship is defined as including an individual who has not met authorship criteria as an author. Although most journals follow strict authorship criteria, the current incidence of courtesy authorship is unknown. <h3>Objective</h3> To assess the practices related to courtesy authorship in surgical journals and academia. <h3>Design, Setting, and Participants</h3> A survey was conducted from July 15 to October 27, 2017, of the first authors and senior authors of original articles, reviews, and clinical trials published between 2014 and 2015 in 8 surgical journals categorized as having a high or low impact factor. <h3>Main Outcomes and Measures</h3> The prevalence of courtesy authorship overall and among subgroups of authors in high impact factor journals and low impact factor journals and among first authors and senior authors, as well as author opinions regarding courtesy authorship. <h3>Results</h3> A total of 203 first authors and 254 senior authors responded (of 369 respondents who provided data on sex, 271 were men and 98 were women), with most being in academic programs (first authors, 116 of 168 [69.0%]; senior authors, 173 of 202 [85.6%]). A total of 17.2% of respondents (42 of 244) reported adding courtesy authors for the surveyed publications: 20.4% by first authors (32 of 157) and 11.5% by senior authors (10 of 87), but 53.7% (131 of 244) reported adding courtesy authorship on prior publications and 33.2% (81 of 244) had been added as a courtesy author in the past. Although 45 of 85 senior authors (52.9%) thought that courtesy authorship has decreased, 93 of 144 first authors (64.6%) thought that courtesy authorship has not changed or had increased (<i>P</i> = .03). There was no difference in the incidence of courtesy authorship for low vs high impact factor journals. Both first authors (29 of 149 [19.5%]) and senior authors (19 of 85 [22.4%]) reported pressures to add courtesy authorship, but external pressure was greater for low impact factor journals than for high impact factor journals (77 of 166 [46.4%] vs 60 of 167 [35.9%];<i>P</i> = .04). More authors in low impact factor journals than in high impact factor journals thought that courtesy authorship was less harmful to academia (55 of 114 [48.2%] vs 34 of 117 [29.1%]). Overall, senior authors reported more positive outcomes with courtesy authorship (eg, improved morale and avoided author conflicts) than did first authors. <h3>Conclusions and Relevance</h3> Courtesy authorship use is common by both first and senior authors in low impact factor journals and high impact factor journals. There are different perceptions, practices, and pressures to include courtesy authorship for first and senior authors. Understanding these issues will lead to better education to eliminate this practice.
U=U is a blessing: but only for patients with access to HIV treatment: an essay by Tamás Bereczky
Authors: Tamás Bereczky
Journal: BMJ (2019)

Fear of transmission is a major barrier to accepting people with HIV, writes <b>Tamás Bereczky</b>, but the U=U campaign message—that an undetectable viral load makes HIV untransmittable—is cold comfort for people lacking diagnostics and antiretroviral drugs