tbuckley/cabot-search huggingface dataset:
Prevalence and Progression of Recurrent Abdominal Pain, From Early Childhood to Adolescence
Authors: Jessica Sjölund, Agneta Uusijärvi, Navkiran T. Tornkvist, Inger Kull, Anna Bergström, Johan Alm, Hans Törnblom, Ola Olén, Magnus Simrén
Journal: Clinical Gastroenterology and Hepatology (2020)
Covid-19: challenges for people with intellectual disability
Authors: Ken Courtenay
Journal: BMJ (2020)

<h3>Objectives</h3> Although prison employees share the same tuberculosis (TB) risk environment with prisoners, the magnitude of TB problems among prison employees is unknown in most resource-limited prisons. This survey was conducted to investigate the prevalence and correlates of tuberculin skin test (TST) positivity among employees in Malaysia9s largest prison. <h3>Methods</h3> Consented, full-time prison employees were interviewed using a structured questionnaire that included sociodemographic data, history of working in the correctional system and TB-related risk. TST was placed intradermally and read after 48–72 h. Induration size of ≥10 mm was considered positive. Logistic regression analyses were conducted to explore associations with TST positivity. <h3>Results</h3> Of the 445 recruited prison employees, 420 (94.4%) had complete data. Most were young (median=30.0 years) men (88.8%) who had only worked at this prison (76.4%) for a median total employment period of 60 months (IQR 34.5–132.0). The majority were correctional officers, while civilian employees represented only 7.6% of the sample. Only 26 (6.2%) reported having ever been screened for TB since employment. Prevalence of TST positivity was 81% and was independently associated with longer (≥12 months) prison employment (AOR 4.9; 95% CI 1.5 to 15.9) and current tobacco smoking (AOR=1.9, 95% CI 1.2 to 3.2). <h3>Conclusions</h3> Latent TB prevalence was high in this sample, approximating that of prisoners in this setting, perhaps suggesting within prison TB transmission in this facility. Formal TB control programmes for personnel and prisoners alike are urgently needed within the Malaysian correctional system.
COVID-19 Outbreak Among Three Affiliated Homeless Service Sites — King County, Washington, 2020
Authors: Farrell A. Tobolowsky, Elysia Gonzales, Julie L. Self, Carol Y. Rao, Ryan Keating, Grace E. Marx, Temet M. McMichael, Margaret D. Lukoff, Jeffrey S. Duchin, Karin Huster, Jody Rauch, Hedda McLendon, Matthew Hanson, Dave Nichols, Sargis Pogosjans, Meaghan Fagalde, Jennifer Lenahan, Emily Maier, Holly Whitney, Nancy Sugg, Helen Chu, Julia Rogers, Emily Mosites, Meagan Kay
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

On March 30, 2020, Public Health - Seattle and King County (PHSKC) was notified of a confirmed case of coronavirus disease 2019 (COVID-19) in a resident of a homeless shelter and day center (shelter A). Residents from two other homeless shelters (B and C) used shelter A's day center services. Testing for SARS-CoV-2, the virus that causes COVID-19, was offered to available residents and staff members at the three shelters during March 30-April 1, 2020. Among the 181 persons tested, 19 (10.5%) had positive test results (15 residents and four staff members). On April 1, PHSKC and CDC collaborated to conduct site assessments and symptom screening, isolate ill residents and staff members, reinforce infection prevention and control practices, provide face masks, and advise on sheltering-in-place. Repeat testing was offered April 7-8 to all residents and staff members who were not tested initially or who had negative test results. Among the 118 persons tested in the second round of testing, 18 (15.3%) had positive test results (16 residents and two staff members). In addition to the 31 residents and six staff members identified through testing at the shelters, two additional cases in residents were identified during separate symptom screening events, and four were identified after two residents and two staff members independently sought health care. In total, COVID-19 was diagnosed in 35 of 195 (18%) residents and eight of 38 (21%) staff members who received testing at the shelter or were evaluated elsewhere. COVID-19 can spread quickly in homeless shelters; rapid interventions including testing and isolation to identify cases and minimize transmission are necessary. CDC recommends that homeless service providers implement appropriate infection control practices, apply physical distancing measures including ensuring resident's heads are at least 6 feet (2 meters) apart while sleeping, and promote use of cloth face coverings among all residents (1).
Strong and stringent hamstring strain science: trials and error!
Authors: Kristian Thorborg, Lasse Ishøi, Kasper Krommes
Journal: British Journal of Sports Medicine (2020)

Knowledge on how to optimise rehabilitation of athletes after an acute hamstring strain is progressing.1 Within the last 6 years, eight randomised controlled trials (RCTs) on this topic have emerged—conducted by many eminent clinician-scientists.1

Recent clinically relevant RCTs show that specific exercise-based interventions reduce time to return to sport and risk of re-injuries.1 In particular, lengthening contraction exercises compared with conventional exercises without such emphasis reduce time to return to sport,1 whereas a criteria-based programme including a more running-specific exercise focus, compared with the lengthening approach, seems promising for reducing the risk of re-injury.1 Furthermore, platelet-rich plasma injections provided no additional benefit to current exercise-based rehabilitation.1 This emphasises the importance of specific mechanical loading and progressive running exercises in athletes with hamstring strains—but can we rest on these laurels?

This editorial points out common methodological shortcomings in the existing clinical hamstring trial literature that may help guide and improve scientific robustness of future trials. Based on these, we suggest four practical steps to advance the field by eliminating common errors:

> “The aim of science is not to open the door to infinite wisdom, but to set a limit to infinite …
Adolescent Obesity and Early-Onset Type 2 Diabetes
Authors: Gilad Twig, Inbar Zucker, Arnon Afek, Tali Cukierman-Yaffe, Cole D. Bendor, Estela Derazne, Miri Lutski, Tammy Shohat, Ofri Mosenzon, Dorit Tzur, Orit Pinhas-Hamiel, Shmuel Tiosano, Itamar Raz, Hertzel C. Gerstein, Amir Tirosh
Journal: Diabetes Care (2020)

OBJECTIVE Type 2 diabetes (T2D) is increasingly diagnosed at younger ages. We investigated the association of adolescent obesity with incident T2D at early adulthood. RESEARCH DESIGN AND METHODS A nationwide, population-based study evaluated 1,462,362 adolescents (59% men, mean age 17.4 years) during 1996–2016. Data were linked to the Israeli National Diabetes Registry. Weight and height were measured at study entry. Cox proportional models were applied. RESULTS During 15,810,751 person-years, 2,177 people (69% men) developed T2D (mean age at diagnosis 27 years). There was an interaction among BMI, sex, and incident T2D (Pinteraction = 0.023). In a model adjusted for sociodemographic variables, the hazard ratios for diabetes diagnosis were 1.7 (95% CI 1.4–2.0), 2.8 (2.3–3.5), 5.8 (4.9–6.9), 13.4 (11.5–15.7), and 25.8 (21.0–31.6) among men in the 50th–74th percentile, 75th–84th percentile, overweight, mild obesity, and severe obesity groups, respectively, and 2.2 (1.6–2.9), 3.4 (2.5–4.6), 10.6 (8.3–13.6), 21.1 (16.0–27.8), and 44.7 (32.4–61.5), respectively, in women. An inverse graded relationship was observed between baseline BMI and mean age of T2D diagnosis: 27.8 and 25.9 years among men and women with severe obesity, respectively, and 29.5 and 28.5 years among low-normal BMI (5th–49th percentile; reference), respectively. The projected fractions of adult-onset T2D that were attributed to high BMI (≥85th percentile) at adolescence were 56.9% (53.8–59.9%) and 61.1% (56.8–65.2%) in men and women, respectively. CONCLUSIONS Severe obesity significantly increases the risk for incidence of T2D in early adulthood in both sexes. The rise in adolescent severe obesity is likely to increase diabetes incidence in young adults in coming decades.
Risk of hospitalization and death from COVID-19 infection in patients with chronic plaque psoriasis receiving a biologic treatment and renal transplant recipients in maintenance immunosuppressive treatment
Authors: Paolo Gisondi, Gianluigi Zaza, Micol Del Giglio, Mattia Rossi, Valentina Iacono, Giampiero Girolomoni
Journal: Journal of the American Academy of Dermatology (2020)
Physical drug delivery enhancement for aged skin, UV damaged skin and skin cancer: Translation and commercialization
Authors: Miko Yamada, Tarl W. Prow
Journal: Advanced Drug Delivery Reviews (2020)

This review analyses physical drug delivery enhancement technologies with a focus on improving UV damaged skin, actinic keratoses and non-melanoma skin cancer treatment. In recent years, physical drug delivery enhancement has been shown to enhance cosmeceutical and skin cancer treatment efficacy, but there are pros and cons to each approach which we discuss in detail. Mechanisms of action, clinical efficacy, experimental design, outcomes in academic publications, clinical trial reports and patents are explored to evaluate each technology with a critical, translation focused lens. We conclude that the commercial success of cosmeceutical applications, e.g. microneedles, will drive further innovation in this arena that will impact how actinic keratoses and non-melanoma skin cancers are clinically managed.
Mercury exposure and premature mortality in the Grassy Narrows First Nation community: a retrospective longitudinal study
Authors: Aline Philibert, Myriam Fillion, Donna Mergler
Journal: The Lancet Planetary Health (2020)

BackgroundLittle is known about the influence of toxic exposures on reduced life expectancy in First Nations people in Canada. The Grassy Narrows First Nation community have lived with the consequences of one of the worst environmental disasters in Canadian history. In the early 1960s, 10 000 kg of mercury (Hg) was released into their aquatic ecosystem. Although Hg concentration in fish, their dietary staple, decreased over time, it remains high. We aimed to examine whether elevated Hg exposure over time contributes to premature mortality (younger than 60 years) in this community.MethodsWe did longitudinal and case-control analyses with data for individuals of the Grassy Narrows First Nation community. In 2019, the community obtained their historical Hg biomarker data from a government surveillance programme, which was then shared with the authors. A matched-pair approach allowed us to compare longitudinal hair Hg concentration between cases (individuals who died aged younger than 60 years) and controls (individuals who lived beyond 60 years). Matching criteria included year of birth (allowing 2 years either side), sex, and a minimum of four hair Hg concentration measures, of which at least two were in the same year. Analyses included change-point detection, interrupted time series, mixed models, and Cox survival models.FindingsWe analysed data collected between Jan 1, 1970, and Jan 31, 1997, for 657 individuals (319 women and 338 men, born between 1884 and 1991) for whom we assembled a retrospective database of yearly measures of hair Hg concentration (n=3603). Hair Hg concentration decreased over time. A subgroup of 222 individuals (107 women and 115 men) reached or could have reached 60 years old by August, 2019. There was an increased risk of dying at a younger age among those with at least one hair Hg measure of 15 μg/g or more (adjusted hazard ratio 1·55, 95% CI 1·11–2·16; p=0·0088). Among the deceased individuals (n=154), longevity decreased by 1 year with every 6·25 μg/g (4·35–14·29) increase in hair Hg concentration. Analyses of 36 matched pairs showed that hair Hg concentration of those who died aged younger than 60 years was 4·7 μg/g higher (3·4–5·9) than controls.InterpretationThe consistent findings between our different analyses support an association between long-term Hg exposure from freshwater fish consumption and premature mortality in this First Nation community. There is a need to do risk-benefit analyses of freshwater fish consumption in environmentally contaminated regions.FundingCanadian Institutes of Health Research.
Cooperative repression and methylation of Cancer-Testis antigen genes by DNMT1 and DNMT3b
Authors: Smitha R. James, Petra A. Link, Adam R. Karpf
Journal: Cancer Research (2005)

2741  Cancer Testis (CT) antigens are a medically important group of tumor-associated antigens that provoke autologous, MHC-restricted, T-cell responses in cancer patients. In this study, we investigated the contribution of individual DNA methyltransferase enzymes to CT antigen gene repression and methylation in human colon cancer cells. As expected based on previous work, treatment of previously non-CT antigen expressing colon cancer cell lines with the DNA methyltransferase inhibitor 5-aza-2`-deoxycytidine (DAC) robustly activates CT antigen gene expression. Dual treatment of DAC with the histone deacetylase inhibitor Trichostatin A enhanced this effect. As determined by sodium bisulfite genomic DNA sequencing, genetic disruption of DNA methyltransferase(DNMT) 1 in HCT116 colon cancer cells has a moderate effect on promoter methylation of CT antigen genes (n=3) (64% of control), while disruption of DNMT3b has a lesser effect (83% of control). However, neither of the individual DNMT knockouts significantly induces CT antigen gene expression, including MAGE-A1, NY-ESO-1, or XAGE-1. In contrast, dual disruption of DNMT1 and DNMT3b dramatically reduces methylation levels at CT antigen promoters (24% of control) and robustly induces the expression of MAGE-A1, NY-ESO-1, and XAGE-1. Thus, DNMT1 and DNMT3b cooperatively repress CT antigen gene expression and synergistically catalyze CT antigen promoter DNA methylation. We used a novel mass spectrometry assay to determine the global content of 5-methyldeoxycytosine (5mdC) in DNMT single knockout cell lines and found that 5mdC concentrations are either slightly reduced (DNMT1 knockout cells) or unaffected (DNMT3b knockout cells). In contrast, in the double knockout cells, genomic DNA methylation is greatly reduced (approximately 25% of control). This result supports the earlier suggested model that CT antigen expression is linked to global losses in genomic DNA methylation. We also investigated the modification status of histone H3 tail lysines in chromatin present at active and inactive CT antigen gene promoters. There is an increased prevalence of dimethylated lysine 9 (me-H3K9) and a decreased prevalence of dimethylated lysine 4 (me-H3K4) at inactive CT antigen promoter regions, such as that found in the parental HCT116 cell line. This modification pattern is reversed in the DNMT1/DNMT3b dual knockout cells, where there is an increased prevalence of me-H3K4 and decreased prevalence of me-H3K9 at CT antigen promoters. In conclusion, our data demonstrate that DNMT1 and DNMT3b cooperatively regulate CT antigen gene expression, promoter DNA methylation, and histone H3 methylation. Future studies will examine whether selective targeting of specific DNMT enzymes can enhance the efficacy of CT antigen-targeted immunotherapy.
Abstract 14: Echocardiographic Evaluation of Left Ventricular Recovery After Refractory Out-Of-Hospital Cardiac Arrest
Authors: Rajat Kalra, Jason Bartos, Marinos Kosmopoulos, Claire Carlson, Ranjit John, Andrew Shaffer, Cindy M Martin, Ganesh Raveendran, Demetris Yannopoulos
Journal: Circulation (2019)

Introduction: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used to treat cardiogenic shock and refractory cardiac arrest. However, the degree and mechanisms of myocardial recovery remain unclear. Methods: We retrospectively evaluated myocardial recovery and parameters of myocardial loading with decreasing VA-ECMO support in patients with refractory ventricular tachycardia/ventricular fibrillation (VT/VF) out-of-hospital cardiac arrest treated with the Minnesota Resuscitation Consortium protocol. Results: Of 158 consecutive patients, 58 had interpretable echocardiographic images on &gt; 1 echocardiographic evaluations (age, 54.7±19.3 years). Decannulation was successful in 50 patients (86%); 8 patients (14%) could not be decannulated. Left ventricular ejection fraction (LVEF) was 43.4±14.0% at 10.5±18.0 days after admission in successfully decannulated patients vs 18.1±22.4% at 4.1±2.9 days in patients who were not decannulated ( P &lt;0.001). Echocardiographic turndown studies showed significantly higher LVEF values in decannulated patients vs those who were not decannulated at the initial turndown (P=), during the final turndown (P&lt;0.001), and at the last echocardiogram of the hospital stay ( P &lt;0.001). As VA-ECMO support decreased during the final turndown echocardiogram, LV end-diastolic diameter increased by 0.8±4.4 mm in patients who were subsequently decannulated and decreased by 3.1±4.7 mm in patients who could not be decannulated ( P =0.04). Differences regarding change in LVEF, LV end-systolic diameter, and fractional shortening were not significant (Figure). Conclusion: Patients with refractory VT/VF cardiac arrest who are treated with VA-ECMO experience significant recovery of ventricular function. Changes in myocardial loading patterns suggest that this may occur via decreased transpulmonary flow and left ventricular preload, with little echocardiographic evidence of change in afterload.
Amged El-Hawrani
Authors: Adrian Thompson
Journal: BMJ (2020)

The death of Amged El-Hawrani from covid-19 family, colleagues and the wider ENT community. It became evident during the pandemic that ENT doctors were at particular risk of covid-19 infection. Amged died after three traumatic weeks in critical care. He was considered by the NHS to be one of the first UK frontline doctors to die during the pandemic.

He was born in Sudan in 1964, the son of a doctor and the second of six boys. …
The COVID-19 Pandemic
Authors: Blake Thomson
Journal: Circulation (2020)

risk factors Blake Thomson , DPhil O ver the past several months, the coronavirus disease 2019 (COVID-19) outbreak has rapidly grown to become a global pandemic.Countries, regions, and localities have taken varied and, in many cases, drastic approaches to limit the impact of COVID-19.Governments across the world have issued stay-athome orders to all of those who are not essential to the conduct of everyday life.Routines have been radically disrupted, with global society undergoing tremendous changes in a very short period of time.Some disruptions may last months, even years.Others may lead to permanent changes in the way we live after this pandemic is over.The worldwide response to the COVID-19 pandemic may be the first truly global natural experiment of the modern, big data era.Although our actions are intended to combat a single infectious disease, they may have serious consequences for many cardiovascular and other noncommunicable conditions.Natural experiments are defined by a shift in exposure that was caused by forces outside the researchers' control, but which may be used to infer the causal impact of these changes.(It was this type of study that famously led John Snow to the realization that cholera was spread through contaminated drinking water).The repercussions of such changes may be extremely broad, impacting the economy, environment, and health, among other aspects of life.Natural experiments commonly occur in ordinary life, allowing for temporary, cyclic, or permanent shifts in exposures to be studied.For example, the introduction of policies like increased tax on tobacco products, or the expansion of health insurance coverage, can lead to changes in the prevalence of behaviors, disease incidence, and death rates.Seasonal variation of sunlight and temperature may allow for the study of changes in levels of vitamin D and blood pressure.Economic shocks and natural disasters may result in especially rapid societal changes in exposures and resulting outcomes: A spike in cardiac deaths has been observed on the same day an earthquake occurred, possibly because of stress. 1 Given the devastating circumstances of the CO-VID-19 pandemic, I describe 3 examples from other moments of hardship in history to illustrate what can be learned during periods of austerity, and in their aftermath.The fall of the Soviet Union in 1991 led to economic collapse and widespread desperation.As a consequence, there were substantial increases in hazardous drinking across Russia, resulting in a sharp decrease in life expectancy among men (6 years) and women (3 years) between 1990 and 1994. 2 These declines were driven largely by increased rates of mortality attributable to vascular disease, accidents, violence, and alcohol poisoning.Over the period 1987 to 1994, spanning the years before and after the crisis, male age-standardized mortality rates more than quadrupled for alcohol-related diseases, more than doubled for accidents and violence, and increased by 30% for circulatory disease (the largest absolute increase).
Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis
Authors: Sung Hoon Jung, Jai Hoon Yoon, Hyuk Soon Choi, Seung-Joo Nam, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Yil Sik Hyun, Chan Hyuk Park, Hang Lak Lee
Journal: Endoscopy (2020)

Abstract Background The comparative efficacy of bariatric endoscopic procedures has not been completely elucidated. We aimed to comprehensively evaluate the efficacy of bariatric endoscopic procedures. Methods We searched for randomized controlled trials investigating the efficacy of bariatric endoscopic procedures, including the use of an intragastric balloon, duodenal-jejunal bypass liner (DJBL), aspiration therapy, primary obesity surgery endoluminal (POSE) procedure, and botulinum toxin injection to the stomach. Network meta-analyses were performed to determine the percentage of weight loss (%weight loss) and percentage of excess weight loss (%EWL). Results 22 studies with 2141 patients were included in the meta-analysis. Most endoscopic procedures showed superior efficacy in terms of %weight loss compared with the control (mean difference [MD] [95 % confidence interval (CI)]: aspiration therapy 10.4 % [7.0 % to 13.7 %]; fluid-filled balloon 5.3 % [3.4 % to 7.2 %]; POSE 4.9 % [1.7 % to 8.2 %]; and DJBL 4.5 % [1.4 % to 7.7 %]). In terms of %EWL, aspiration therapy, fluid-filled balloon, POSE, and DJBL were superior to the control (MD [95 %CI]: 27.3 % [15.3 % to 39.3 %]; 22.4 % [15.4 % to 29.4 %]; 15.3 % [2.5 % to 28.0 %]; and 13.0 % [4.9 % to 21.2], respectively). The gas-filled balloon and botulinum toxin injection did not show a significant difference in %weight loss or %EWL compared with the control. For the fluid-filled balloon, the %EWL and %weight loss tended to decrease after balloon removal at 6 months after the procedure. Conclusion All bariatric endoscopic procedures, except for gas-filled balloon and botulinum toxin injection to the stomach, showed superior short-term efficacy in terms of %weight loss or %EWL compared with lifestyle modification.