tbuckley/cabot-search huggingface dataset:
Funding and services needed to achieve universal health coverage: applications of global, regional, and national estimates of utilisation of outpatient visits and inpatient admissions from 1990 to 2016, and unit costs from 1995 to 2016
Authors: Mark W Moses, Paola Pedroza, Ranju Baral, Sabina Bloom, Jonathan Brown, Abby Chapin, Kelly Compton, Erika Eldrenkamp, Nancy Fullman, John Everett Mumford, Vishnu Nandakumar, Katherine Rosettie, Nafis Sadat, Tom Shonka, Abraham Flaxman, Theo Vos, Chris J L Murray, Marcia R Weaver
Journal: The Lancet Public Health (2018)

To inform plans to achieve universal health coverage (UHC), we estimated utilisation and unit cost of outpatient visits and inpatient admissions, did a decomposition analysis of utilisation, and estimated additional services and funds needed to meet a UHC standard for utilisation.We collated 1175 country-years of outpatient data on utilisation from 130 countries and 2068 country-years of inpatient data from 128 countries. We did meta-regression analyses of annual visits and admissions per capita by sex, age, location, and year with DisMod-MR, a Bayesian meta-regression tool. We decomposed changes in total number of services from 1990 to 2016. We used data from 795 National Health Accounts to estimate shares of outpatient and inpatient services in total health expenditure by location and year and estimated unit costs as expenditure divided by utilisation. We identified standards of utilisation per disability-adjusted life-year and estimated additional services and funds needed.In 2016, the global age-standardised outpatient utilisation rate was 5·42 visits (95% uncertainty interval [UI] 4·88-5·99) per capita and the inpatient utilisation rate was 0·10 admissions (0·09-0·11) per capita. Globally, 39·35 billion (95% UI 35·38-43·58) visits and 0·71 billion (0·65-0·77) admissions were provided in 2016. Of the 58·65% increase in visits since 1990, population growth accounted for 42·95%, population ageing for 8·09%, and higher utilisation rates for 7·63%; results for the 67·96% increase in admissions were 44·33% from population growth, 9·99% from population ageing, and 13·55% from increases in utilisation rates. 2016 unit cost estimates (in 2017 international dollars [I$]) ranged from I$2 to I$478 for visits and from I$87 to I$22 543 for admissions. The annual cost of 8·20 billion (6·24-9·95) additional visits and 0·28 billion (0·25-0·30) admissions in low-income and lower-middle income countries in 2016 was I$503·12 billion (404·35-605·98) or US$158·10 billion (126·58-189·67).UHC plans can be based on utilisation and unit costs of current health systems and guided by standards of utilisation of outpatient visits and inpatient admissions that achieve the highest coverage of personal health services at the lowest cost.Bill & Melinda Gates Foundation.
Proximate determinants of tuberculosis in Indigenous peoples worldwide: a systematic review
Authors: Maxime Cormier, Kevin Schwartzman, Dieynaba S N'Diaye, Claire E Boone, Alexandre M dos Santos, Júlia Gaspar, Danielle Cazabon, Marzieh Ghiasi, Rebecca Kahn, Aashna Uppal, Martin Morris, Olivia Oxlade
Journal: The Lancet Global Health (2018)

Indigenous peoples worldwide carry a disproportionate tuberculosis burden. There is an increasing awareness of the effect of social determinants and proximate determinants such as alcohol use, overcrowding, type 1 and type 2 diabetes, substance misuse, HIV, food insecurity and malnutrition, and smoking on the burden of tuberculosis. We aimed to understand the potential contribution of such determinants to tuberculosis in Indigenous peoples and to document steps taken to address them.We did a systematic review using seven databases (MEDLINE, Embase, CINAHL, Global Health, BIOSIS Previews, Web of Science, and the Cochrane Library). We identified English language articles published from Jan 1, 1980, to Dec 20, 2017, reporting the prevalence of proximate determinants of tuberculosis and preventive programmes targeting these determinants in Indigenous communities worldwide. We included any randomised controlled trials, controlled studies, cohort studies, cross-sectional studies, case reports, and qualitative research. Exclusion criteria were articles in languages other than English, full text not available, population was not Indigenous, focused exclusively on children or older people, and studies that focused on pharmacological interventions.Of 34 255 articles identified, 475 were eligible for inclusion. Most studies confirmed a higher prevalence of proximate determinants in Indigenous communities than in the general population. Diabetes was more frequent in Indigenous communities within high-income countries versus in low-income countries. The prevalence of alcohol use was generally similar to that among non-Indigenous groups, although patterns of drinking often differed. Smoking prevalence and smokeless tobacco consumption were commonly higher in Indigenous groups than in non-Indigenous groups. Food insecurity was highly prevalent in most Indigenous communities evaluated. Substance use was more frequent in Indigenous inhabitants of high-income countries than of low-income countries, with wide variation across Indigenous communities. The literature pertaining to HIV, crowding, and housing conditions among Indigenous peoples was too scant to draw firm conclusions. Preventive programmes that are culturally appropriate targeting these determinants appear feasible, although their effectiveness is largely unproven.Indigenous peoples were generally reported to have a higher prevalence of several proximate determinants of tuberculosis than non-Indigenous peoples, with wide variation across Indigenous communities. These findings emphasise the need for community-led, culturally appropriate strategies to address smoking, food insecurity, and diabetes in Indigenous populations as important public health goals in their own right, and also to reduce the burden of tuberculosis.Canadian Institutes of Health Research.
Abstract 14923: Is the Ross Procedure a Riskier Operation? - Perioperative Outcome Comparison With Mechanical Aortic Valve Replacement in a Propensity-Matched Cohort
Authors: Pierre-Emmanuel Noly, Ismail Bouhout, Louis-Mathieu Stevens, Raymond Cartier, Nancy Poirier, Denis Bouchard, Philippe Demers, Michel Carrier, Michel Pellerin, Louis Perrault, Ismail El-Hamamsy
Journal: Circulation (2015)

Introduction: Despite reports of improved long-term survival after the Ross procedure, concerns remain regarding increased surgical complexity and potential morbidity compared to standard aortic valve replacement (AVR). Hypothesis: The aim of this study was to compare perioperative outcomes in young adults following a Ross procedure versus mechanical AVR in the current era. Patients and methods: From 2007 to 2015, 337 elective isolated mechanical AVRs and 137 Ross procedures were performed in young adults (&lt;65 years) at our center. The Ross cohort includes the learning curve. Patients with concomitant ascending aorta replacement were included (78 (57%) in the Ross group and 58 (17%) in the AVR group). Using a 1:1 propensity score match analysis, 164 patients were included in the study (n=82 in each group). Mean age was 48±11 years and Euroscore II was 1.1±0.6%. Perioperative outcomes were defined using STS guidelines. Results: There were no mortalities in the two groups. Mean cardiopulmonary bypass and crossclamp times were longer in the Ross cohort (210+/-28 and 185+/-24 min vs 82+/-29 and 62+/-21 min respectively; p&lt; 0.001). There were no differences in the incidence of myocardial injury (0% overall), neurological complications (0.6% overall) or intubation times (p=NS). Three (3.7%) reinterventions for bleeding were reported in the Ross cohort and 4 (4.9%) in the mechanical AVR cohort (p&gt;0.99). A significant increase in serum creatinine (&gt;2-fold increase) was more commonly observed after the Ross procedure (11% versus 0%; p=0. 003), but there was no significant difference in the rate of temporary dialysis (p=0.25). Six of 9 patients (67%) with increased creatine levels occurred in the first tertile of the Ross cohort. Thirty patients (37%) required ≥1 blood product transfusion in the Ross group compared to 26 patients (32%) in the mechanical AVR group (p=0.5). Median hospital length of stay was similar in both groups (6 days in each; p=0.99). Conclusion: There are no differences in mortality or major perioperative outcomes in adults undergoing a Ross procedure or mechanical AVR. Acute renal injury in the Ross cohort was closely linked to the learning curve. Further follow-up is required to evaluate long-term outcomes in these cohorts.
GNAQ Mutations in Diffuse and Solitary Choroidal Hemangiomas
Authors: Jasmine H. Francis, Tatyana Milman, Hans Grossniklaus, Daniel Albert, Robert Folberg, Gregory Levitin, Sarah Coupland, Federica Catalanotti, David Rabady, Cyriac Kandoth, Klaus Busam, David Abramson
Journal: Ophthalmology (2018)
Current clinical management of smoke inhalation injuries: a reality check
Authors: Arietta Spinou, Nikolaos G. Koulouris
Journal: European Respiratory Journal (2018)

<b>Smoke inhalation injury is a complex clinical condition and respiratory clinicians need to have a good understanding of its current clinical management. However, evidence derives mostly from retrospective cohorts and case series. Is this enough?</b>http://ow.ly/PrtT30mJcYD
Artificial intelligence-based decision-making for age-related macular degeneration
Authors: De-Kuang Hwang, Chih-Chien Hsu, Kao-Jung Chang, Daniel Chao, Chuan-Hu Sun, Ying-Chun Jheng, Aliaksandr A. Yarmishyn, Jau-Ching Wu, Ching-Yao Tsai, Mong-Lien Wang, Chi-Hsien Peng, Ke-Hung Chien, Chung-Lan Kao, Tai-Chi Lin, Lin-Chung Woung, Shih-Jen Chen, Shih-Hwa Chiou
Journal: Theranostics (2018)

Artificial intelligence (AI) based on convolutional neural networks (CNNs) has a great potential to enhance medical workflow and improve health care quality. Of particular interest is practical implementation of such AI-based software as a cloud-based tool aimed for telemedicine, the practice of providing medical care from a distance using electronic interfaces. Methods: In this study, we used a dataset of labeled 35,900 optical coherence tomography (OCT) images obtained from age-related macular degeneration (AMD) patients and used them to train three types of CNNs to perform AMD diagnosis. Results: Here, we present an AI- and cloud-based telemedicine interaction tool for diagnosis and proposed treatment of AMD. Through deep learning process based on the analysis of preprocessed optical coherence tomography (OCT) imaging data, our AI-based system achieved the same image discrimination rate as that of retinal specialists in our hospital. The AI platform's detection accuracy was generally higher than 90% and was significantly superior (p < 0.001) to that of medical students (69.4% and 68.9%) and equal (p = 0.99) to that of retinal specialists (92.73% and 91.90%). Furthermore, it provided appropriate treatment recommendations comparable to those of retinal specialists. Conclusions: We therefore developed a website for realistic cloud computing based on this AI platform, available at https://www.ym.edu.tw/~AI-OCT/. Patients can upload their OCT images to the website to verify whether they have AMD and require treatment. Using an AI-based cloud service represents a real solution for medical imaging diagnostics and telemedicine.
ROS1 Gene Rearrangements Are Associated With an Elevated Risk of Peridiagnosis Thromboembolic Events
Authors: Terry L. Ng, Derek E. Smith, Rao Mushtaq, Tejas Patil, Anastasios Dimou, Shuo Yang, Qian Liu, Xuefei Li, Caicun Zhou, Robert T. Jones, Megan M. Tu, Flora Yan, I. Alex Bowman, Stephen V. Liu, Siera Newkirk, Joshua Bauml, Robert C. Doebele, Dara L. Aisner, Dexiang Gao, Shengxiang Ren, D. Ross Camidge
Journal: Journal of Thoracic Oncology (2018)
Immunoglobulin G4 Levels
Authors: Sajan Jiv Singh Nagpal, Suresh T. Chari
Journal: JAMA (2018)

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
Plasmablasts With a Mucosal Phenotype Contribute to Plasmacytosis in Systemic Lupus Erythematosus
Authors: Henrik E. Mei, Stefanie Hahne, Andreas Redlin, Bimba F. Hoyer, Kaiyin Wu, Lisa Baganz, Anna R. Lisney, Tobias Alexander, Birgit Rudolph, Thomas Dörner
Journal: Arthritis & Rheumatology (2017)

Objective To analyze the composition of known plasmacytosis in systemic lupus erythematosus (SLE) to obtain further insight into the nature of underlying mechanisms. Methods Plasmablasts from patients with active SLE, patients with inactive/treated SLE, and healthy controls were characterized by flow cytometry, enzyme‐linked immunospot assay, and Transwell migration assays and compared to vaccination‐induced plasmablasts. Serum cytokine levels were analyzed by Luminex assay, and histologic analysis of kidney biopsy specimens was performed. Results Circulating plasmablasts in SLE expressed markers of mucosal immune reactions. IgA, CCR10, and β7 integrin were expressed by 48%, 40%, and 38% of plasmablasts, respectively, with varying coexpression patterns. Consistent with mucosal homing, some SLE plasmablasts migrated toward the mucosal chemokine CCL28 and secreted polymeric IgA. SLE plasmablasts shared phenotypic characteristics with antigen‐specific plasmablasts induced by oral, but not parenteral, vaccinations. Autoreactive antibody–secreting cells of the IgG and IgA isotypes were detectable, but only the emergence of phenotypically mucosal plasmablasts was positively associated with serum interleukin‐2 and platelet‐derived growth factor BB levels. Conclusion Our data suggest that distinct plasmablast differentiation pathways jointly contribute to peripheral plasmacytosis in SLE, i.e., a cytokine‐amplified mucosal “steady‐state” plasmablast response, and an autoreactive plasmablast response, representing conventional autoimmunity. Our results indicate an overly activated mucosal immune system in patients with SLE, with both immunologic and clinical implications.
Declaration of Astana Emphasizes Primary Care as Key to World Health
Authors: M.J. Friedrich
Journal: JAMA (2018)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Surgeon’s suspension for sexually motivated behaviour is overturned because of “procedural unfairness”
Authors: Clare Dyer
Journal: BMJ (2018)

A consultant orthopaedic surgeon who was suspended from the UK medical register for three months for sexually motivated behaviour towards a patient has won a High Court appeal against the ruling.

Mohammed Suhaib Sait’s hearing was “procedurally unfair” owing to a “remarkable” failure to cross examine him about his alleged sexual motivation, Mr Justice Mostyn said.

Sait, a consultant at Darent Valley Hospital in Kent, who also practised privately at BMI Fawkham Manor Hospital, was accused over his conduct towards two patients, referred to as A and …
The WNT10B Network Is Associated with Survival and Metastases in Chemoresistant Triple-Negative Breast Cancer
Authors: Ikbale El Ayachi, Iram Fatima, Peter Wend, Jackelyn A. Alva-Ornelas, Stephanie Runke, William L. Kuenzinger, Julio Silva, Wendy Silva, Joseph K. Gray, Stephan Lehr, Hilaire C. Barch, Raisa I. Krutilina, Andrew C. White, Robert Cardiff, Lisa D. Yee, Lily Yang, Ruth M. O'Regan, William E. Lowry, Tiffany N. Seagroves, Victoria Seewaldt, Susan A. Krum, Gustavo A. Miranda-Carboni
Journal: Cancer Research (2018)

Triple-negative breast cancer (TNBC) commonly develops resistance to chemotherapy, yet markers predictive of chemoresistance in this disease are lacking. Here, we define WNT10B-dependent biomarkers for β-CATENIN/HMGA2/EZH2 signaling predictive of reduced relapse-free survival. Concordant expression of HMGA2 and EZH2 proteins is observed in
Compound BCR-ABL1 Kinase Domain Mutants: Prevalence, Spectrum and Correlation with Tyrosine Kinase Inhibitor Resistance in a Prospective Series of Philadelphia Chromosome-Positive Leukemia Patients Analyzed By Next Generation Sequencing
Authors: Simona Soverini, Luana Bavaro, Margherita Martelli, Caterina De Benedittis, Alessandra Iurlo, Nicola Orofino, Livio Pagano, Marianna Criscuolo, Massimiliano Bonifacio, Luigi Scaffidi, Simona Sica, Federica Sorà, Elena Maino, Michela Rondoni, Maria Antonella Laginestra, Francesca Lunghi, Anna Ermacora, Mariella D'adda, Gabriele Gugliotta, Fausto Castagnetti, Gianantonio Rosti, Cristina Papayannidis, Giovanni Marconi, Antonio Curti, Maria Cristina Miggiano, Sara Galimberti, Antonio Percesepe, Fabio Stagno, Rosaria Sancetta, Mario Annunziata, Franca Falzetti, Isabella Capodanno, Patrizia Pregno, Margherita Maffioli, Tamara Intermesoli, Eros Di Bona, Giovanni Caocci, Imma Attolico, Gianni Binotto, Monica Bocchia, Emanuele Angelucci, Nicola Sgherza, Luigiana Luciano, Flavio Mignone, Stefano A. Pileri, Giovanni Martinelli, Michele Cavo
Journal: Blood (2018)
Human Rhinovirus Impairs the Innate Immune Response to Bacteria in Alveolar Macrophages in Chronic Obstructive Pulmonary Disease
Authors: Lydia J. Finney, Kylie B. R. Belchamber, Peter S. Fenwick, Samuel V. Kemp, Michael R. Edwards, Patrick Mallia, Gavin Donaldson, Sebastian L. Johnston, Louise E. Donnelly, Jadwiga A. Wedzicha
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

Rationale: Human rhinovirus (HRV) is a common cause of chronic obstructive pulmonary disease (COPD) exacerbations. Secondary bacterial infection is associated with more severe symptoms and delayed recovery. Alveolar macrophages clear bacteria from the lung and maintain lung homeostasis through cytokine secretion. These processes are defective in COPD. The effect of HRV on macrophage function is unknown.Objectives: To investigate the effect of HRV on phagocytosis and cytokine response to bacteria by alveolar macrophages and monocyte-derived macrophages (MDM) in COPD and healthy control subjects.Methods: Alveolar macrophages were obtained by bronchoscopy and MDM by adherence. Macrophages were exposed to HRV16 (multiplicity of infection 5), polyinosinic:polycytidylic acid (poly I:C) 30 μg/ml, IFN-β 10 μg/ml, IFN-γ 10 μg/ml, or medium control for 24 hours. Phagocytosis of fluorescently labeled Haemophilus influenzae or Streptococcus pneumoniae was assessed by fluorimetry. CXCL8 (IL-8), IL-6, TNF-α (tumor necrosis factor-α), and IL-10 release was measured by ELISA.Measurements and Main Results: HRV significantly impaired phagocytosis of H. influenzae by 23% in MDM (n = 37; P = 0.004) and 18% in alveolar macrophages (n = 20; P < 0.0001) in COPD. HRV also significantly reduced phagocytosis of S. pneumoniae by 33% in COPD MDM (n = 20; P = 0.0192). There was no effect in healthy control subjects. Phagocytosis of H. influenzae was also impaired by poly I:C but not IFN-β or IFN-γ in COPD MDM. HRV significantly reduced cytokine responses to H. influenzae. The IL-10 response to H. influenzae was significantly impaired by poly I:C, IFN-β, and IFN-γ in COPD cells.Conclusions: HRV impairs phagocytosis of bacteria in COPD, which may lead to an outgrowth of bacteria. HRV also impairs cytokine responses to bacteria via the TLR3/IFN pathway, which may prevent resolution of inflammation leading to prolonged exacerbations in COPD.
Analysis of 3D genomic interactions identifies candidate host genes that transposable elements potentially regulate
Authors: Ramya Raviram, Pedro P. Rocha, Vincent M. Luo, Emily Swanzey, Emily R. Miraldi, Edward B. Chuong, Cédric Feschotte, Richard Bonneau, Jane A. Skok
Journal: Genome biology (2018)

The organization of chromatin in the nucleus plays an essential role in gene regulation. About half of the mammalian genome comprises transposable elements. Given their repetitive nature, reads associated with these elements are generally discarded or randomly distributed among elements of the same type in genome-wide analyses. Thus, it is challenging to identify the activities and properties of individual transposons. As a result, we only have a partial understanding of how transposons contribute to chromatin folding and how they impact gene regulation.Using PCR and Capture-based chromosome conformation capture (3C) approaches, collectively called 4Tran, we take advantage of the repetitive nature of transposons to capture interactions from multiple copies of endogenous retrovirus (ERVs) in the human and mouse genomes. With 4Tran-PCR, reads are selectively mapped to unique regions in the genome. This enables the identification of transposable element interaction profiles for individual ERV families and integration events specific to particular genomes. With this approach, we demonstrate that transposons engage in long-range intra-chromosomal interactions guided by the separation of chromosomes into A and B compartments as well as topologically associated domains (TADs). In contrast to 4Tran-PCR, Capture-4Tran can uniquely identify both ends of an interaction that involve retroviral repeat sequences, providing a powerful tool for uncovering the individual transposable element insertions that interact with and potentially regulate target genes.4Tran provides new insight into the manner in which transposons contribute to chromosome architecture and identifies target genes that transposable elements can potentially control.
Asfotase alfa for infants and young children with hypophosphatasia: 7 year outcomes of a single-arm, open-label, phase 2 extension trial
Authors: Michael P Whyte, Jill H Simmons, Scott Moseley, Kenji P Fujita, Nicholas Bishop, Nada J Salman, John Taylor, Dawn Phillips, Mairead McGinn, William H McAlister
Journal: The Lancet Diabetes & Endocrinology (2018)