tbuckley/cabot-search huggingface dataset:
Factors Associated With Sputum Culture-Negative vs Culture-Positive Diagnosis of Pulmonary Tuberculosis
Authors: Minh-Vu H. Nguyen, Natalie S. Levy, Shama D. Ahuja, Lisa Trieu, Douglas C. Proops, Jacqueline M. Achkar
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Recognition of active tuberculosis (TB) in its earliest stages could reduce morbidity and prevent advancement to transmissible disease. Little is published about the occurrence and presentation of sputum culture-negative pulmonary TB (PTB), an early paucibacillary but often underrecognized disease state. <h3>Objective</h3> To assess differences between culture-negative and culture-positive PTB regarding occurrence, clinical presentation, radiographic findings, demographics, and comorbidities. <h3>Design, Setting, and Participants</h3> Cross-sectional study in which surveillance data of adult patients with PTB reported to the New York City Department of Health in New York, New York, from 2011 through 2013, ie, years for which demographic, clinical, and radiographic data were collected. Patients were aged 18 years or older, had signs of pulmonary disease, and had mycobacterial sputum culture results; those with HIV coinfection or a TB diagnosis within 2 years prior to presentation were excluded. Culture-negative PTB was defined as clinical and radiographic presentation consistent with TB, 3 negative results on sputum culture, and improvement with antituberculous treatment. The analyses were performed between 2015 and 2016; notably, the proportion of reported patients with culture-negative PTB has remained consistent during the past 2 decades. <h3>Main Outcomes and Measures</h3> The occurrence of culture-negative PTB among all patients with PTB was calculated, and demographics, comorbidities, symptoms, and radiographic findings were compared between culture-negative and culture-positive PTB. <h3>Results</h3> Of the 796 patients with PTB (median [interquartile range] age, 41 [29-54] years; 499 [63%] men) who met criteria for analysis, 116 (15%) had negative results on sputum culture. Patients with culture-negative PTB compared with culture-positive PTB were less frequently male (53% vs 64%;<i>P</i> = .03) and presented with a significantly lower frequency of cough (68% vs 89%;<i>P</i> &lt; .001), weight loss (39% vs 51%;<i>P</i> = .03), and cavitation on both chest radiograph (7% vs 28%;<i>P</i> &lt; .001) and chest computed tomographic scan (26% vs 59%;<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> Given the lack of criterion-standard test confirmation and the relative paucity of symptoms and radiological abnormalities, culture-negative PTB is likely underdiagnosed and its occurrence underestimated globally. Awareness of these findings, enhanced diagnostic approaches, and, ideally, better biomarkers could improve detection and treatment of this early disease and reduce the development of transmissible TB.
Perceptual suboptimality: Bug or feature?
Authors: Christopher Summerfield, Vickie Li
Journal: Behavioral and Brain Sciences (2018)

Abstract Rahnev &amp; Denison (R&amp;D) argue that whether people are “optimal” or “suboptimal” is not a well-posed question. We agree. However, we argue that the critical question is why humans make suboptimal perceptual decisions in the first place. We suggest that perceptual distortions have a normative explanation – that they promote efficient coding and computation in biological information processing systems.
Chemoradiation-induced alteration of programmed death-ligand 1 and CD8+ tumor-infiltrating lymphocytes in rectal cancer.
Authors: Marina Baretti, Wei Fu, Hao Wang, Robert A Anders, Nilofer Saba Azad, Qingfeng Zhu
Journal: Journal of Clinical Oncology (2019)

570 Background: DNA damage and subsequent neoantigen formation has been hypothesized as a mechanismfor radiotherapy and PD-1/PD-L1 pathway inhibition to synergize in an antitumor immune response. We investigated neoadjuvant chemoradiotherapy (nCRT)-induced changes in CD8+ tumor infiltrating lymphocyte, PD-L1 and mucin expression in rectal cancer patients as compared to patients who did not receive nCRT. Methods: Tumor samples were collected from rectal adenocarcinoma patients who had undergone resection between 2008-2014 with (n = 62) or without (n = 17) nCRT treatment. Tissue sections were stained with CD8 and PD-L1 antibodies for immunohistochemistry. Whole slides images were acquired at 20x magnification. The prevalence of positive CD8 stained cells was recorded in tumor, interface tumor side, interface background rectal side. Image analysis (HALO Indica Labs) was used to determine the density (# of cells/surface area analyzed) of CD8 expressing lymphocytes. The percentage of PD-L1 membranous expression was manually counted in tumor cells (TC), tumor stroma (TS) and invasive front (IF). Mucin expression was determined as the percentage of the mucin area in the whole tumor mass area. Results: PD-L1 expression on TCs was identified in 7.7 % (6/78) of specimens. All 6 cases had received nCRT (p = 0.33). 80% and 75.5% of the nCRT cases showed PD-L1 expression on TS and IF respectively, versus 20% (p = 0.55) and 24.5% (p = 0.56) in non-nCRT cases. The median densities of CD8+ infiltrating T lymphocytes in tumor, interface tumor side, interface background rectal side did not differ significantly between the two groups (p = 0.79, p = 0.47, p = 0.22). No nCRT-changes in mucin expression observed in the 28 evaluable cases (p = 0.25). Conclusions: nCRT exposure was associated with a non-significant difference in PD-L1 expression on TS and IF cells in patients with rectal adenocarcinoma as compared to non-nCRT case, possibly due to sample size limitations. Further mechanistic investigations and comprehensive analysis of other immune checkpoints are needed to understand nCRT-induced immunologic shift in rectal cancer and to expand the potential applicability of checkpoint inhibitors in this setting.
Right Ventricular Load and Function in Chronic Thromboembolic Pulmonary Hypertension: Differences between Proximal and Distal Chronic Thromboembolic Pulmonary Hypertension
Authors: Dieuwertje Ruigrok, Lilian J. Meijboom, Berend E. Westerhof, Anna Huis in ’t Veld, Cathelijne E. E. van der Bruggen, J. Tim Marcus, Esther J. Nossent, Anton Vonk Noordegraaf, Petr Symersky, Harm-Jan Bogaard
Journal: American Journal of Respiratory and Critical Care Medicine (2019)
Outcomes of a Citywide Campaign to Reduce Medicaid Hospital Readmissions With Connection to Primary Care Within 7 Days of Hospital Discharge
Authors: Dawn Wiest, Qiang Yang, Carter Wilson, Natasha Dravid
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Previous research suggests the important role of timely primary care follow-up in reducing hospital readmissions, although effectiveness varies by program design and patients' readmission risk level. <h3>Objective</h3> To evaluate the outcomes of the 7-Day Pledge program to reduce readmissions by increasing access to timely primary care appointments after hospitalization. <h3>Design, Setting, and Participants</h3> Retrospective cohort study of hospital readmissions among Medicaid patients 18 years or older hospitalized from January 1, 2014, to April 30, 2016, in Camden, New Jersey. To assess each patient's hospital use before and after hospital discharge, all-payer claims data from 4 health care systems were linked to insurers' lists of patients assigned to Camden-based primary care practices. A total of 1531 records were categorized by timing of a primary care appointment after discharge. Discharges followed by a primary care appointment within 7 days (treatment group) were matched by propensity scores to those with less timely or no primary care follow-up (nontreatment pool). <h3>Interventions</h3> Targeted patient enrollment during hospital admission, primary care practice engagement, patient incentives to overcome barriers to keeping an appointment, and reimbursements to practices for prioritizing patients recently discharged from the hospital. <h3>Main Outcomes and Measures</h3> The primary outcome was the number of hospital discharges followed by a readmission within 30 days. The secondary outcome was the number of hospital discharges followed by a readmission within 90 days. <h3>Results</h3> There were 2580 hospitalizations of patients 18 years and older included on the patient lists from January 1, 2014, to April 30, 2016. Of these, 1531 records categorized by timing of a primary care appointment after discharge were studied. The treatment group consisted of 450 discharged patients (mean [SD] age, 48.7 [14.7] years; 289 [64.2%] female; 203 [45.1%] black, non-Hispanic). The nontreatment pool consisted of 1081 discharged patients (mean [SD] age, 48.1 [14.9] years; 599 [55.4%] female; 526 [48.7%] black, non-Hispanic). Among this cohort, the number of discharges followed by any readmission was lower for patients with a primary care visit within 7 days of hospital discharge than for their matched referents at 30 days (57 of 450 [12.7%] vs 78.8 of 450 [17.5%];<i>P</i> = .03) and 90 days (126 of 450 [28.0%] vs 174 of 450 [38.7%];<i>P</i> = .002) after discharge. <h3>Conclusions and Relevance</h3> Facilitated receipt of primary care follow-up within 7 days of hospital discharge was associated with fewer Medicaid readmissions. The findings illuminate the importance of reducing barriers that patients and providers face during care transitions.
Abstract 14940: Effects of Aldosterone Hormone on Endothelial Function With Carotid Intima-media Thickness Among Resistant and Early Onset Hypertension Patients
Authors: Ahmet Demirkiran, Ali Elitok, Peter Van De Ven, Henk Everaars, Refik Tanakol, Mustafa Ozcan
Journal: Circulation (2017)

Introduction: Recent studies indicated that the percentage of Primary aldosteronism (PA) among resistant hypertension patients is higher than expected. Additionally, a close association between car...
Letter by Schomburg and Melander Regarding Article, “Selenoprotein P Promotes the Development of Pulmonary Arterial Hypertension: A Possible Novel Therapeutic Target”
Authors: Lutz Schomburg, Olle Melander
Journal: Circulation (2019)

We read with interest the article by Kikuchi et al, 1 which presents experimental evidence for an involvement of selenoprotein P (SELENOP) in controlling pulmonary artery smooth muscle cells.The researchers studied SELENOP expression in hypertensive rats, transgenic mice, pulmonary artery smooth muscle cells, and clinical samples.Hypertensive patients and control subjects were compared and used to relate survival odds to serum SELENOP concentrations exceeding or not exceeding 26.9 mg/L (Figure 1K).This fascinating report is characterized by a selection of most appropriate in vitro and in vivo models combined with high-quality analytical techniques and a scholarly performed discussion.However, in our opinion, the SELENOP concentrations reported appear unphysiologically high.Biosynthesis of SELENOP ceases once a replete selenium status is achieved, 2 and supplementation studies indicate maximal concentrations of 6 to 7 mg/L. 2,3With 51 kDa and 7.5 selenium atoms per SELENOP, a concentration of 7 mg/L corresponds to 137 nmol/L SELENOP, equivalent to 1.0 µmol/L SELENOP-associated selenium.In view that SELENOP contributes ≈50% to circulating Se levels in humans, this concentration is equivalent to 2.0 µmol/L total serum selenium and accords with the majority of clinical studies.Kikuchi et al 1 report SELENOP concentrations as high as 100 mg/L, equivalent to 2 µmol/L SELENOP and translating into SELENOP-associated serum selenium exceeding 14 µmol/L and total serum selenium concentrations consequently exceeding 25 µmol/L.This value is far above the highest concentrations ever reported, even compared with a recent supplementation trial for assessing the maximum tolerated selenium dose in human patients. 4e assume that the commercial assay used is not suitable for quantifying human SELENOP from clinical samples.Unfortunately, suppliers of antibodies or immune assays rarely characterize their products in sufficient detail and leave the researchers in the uncomfortable situation of purchasing the expensive material and validating the analytical performance.Unreliable assays have already led to reports of SELENOP concentrations in healthy subjects differing by 10 000-fold, as highlighted recently. 5Notably, these studies usually fail to present a positive correlation of total selenium and SELENOP in the study cohort, which would constitute a suitable test for data quality.Besides this problematic issue of the fine study presented by Kikuchi et al, 1 we fully appreciate the comprehensive experimental approach of the colleagues, the wealth of valuable results presented, and the timely quest for an accessible and eagerly awaited biomarker for this life-threatening condition.
Abstract 14505: An Early Transcriptomic Signature Predicts Poor Outcome After Out-of-hospital Cardiac Arrest
Authors: Renaud Tissier, Hakim Hocini, Nicolas Tchitchek, Nicolas Deye, Stéphane Legriel, Nicolas Pichon, Cedric Daubin, Olivier Hermine, Pierre Carli, Benoit Vivien, Jean-Marc Tréluyer, Cécile Lefebvre, Pascaline Tisserand, Jean-Luc Dubois-Randé, Alain Berdeaux, Bijan Ghaleh, Jean-Daniel Lelièvre, Yves Levy, Alain Cariou
Journal: Circulation (2017)

Introduction: Early prognostication is a major challenge in comatose survivors of OHCA. Hypothesis: We hypothesized that a wide analysis of the transcriptome could offer new prognostic tools and research axes. Methods: Patients were enrolled from an ancillary study of the clinical trial NCT00999583 that tested the effect of a high dose of erythropoietin (EPO) after OHCA. Blood samples were collected in comatose survivors of cardiac arrest at hospital admission and at days 1 and 3. Whole-blood RNA was purified, and processed to be hybridized on an Illumina HumanHT-12 V4 gene expression BeadChip, allowing a follow up of more than 34000 genes. Transcriptome profiles were compared between patients with favorable vs poor outcome (Cerebral performance category [CPC] 1-2 vs CPC>2) and treated or not by EPO (fold change >1.3; p<0.05). Results: Blood collection was performed in 69 patients. Among them, 33 and 36 patients were treated by EPO or not, respectively. The outcome was not different between these two grou...
Comparison of Systematic Video Documentation With Narrative Operative Report in Colorectal Cancer Surgery
Authors: Floyd W. van de Graaf, Marilyne M. Lange, Jolanda I. Spakman, Wilhelmina M. U. van Grevenstein, Daan Lips, Eelco J. R. de Graaf, Anand G. Menon, Johan F. Lange
Journal: JAMA Surgery (2019)

<h3>Importance</h3> Despite ongoing advances in the field of colorectal surgery, the quality of surgical treatment is still variable. As an intrinsic part of surgical quality, the technical information regarding the surgical procedure is reflected only by the narrative operative report (NR), which has been found to be subjective and regularly omits important information. <h3>Objective</h3> To investigate systematic video recording (SVR) as a potential improvement in quality and safety with regard to important information in colorectal cancer surgery. <h3>Design, Setting, and Participants</h3> The Imaging for Quality Control Trial was a prospective, observational cohort study conducted between January 12, 2016, and October 30, 2017, at 3 centers in the Netherlands. The study group consisted of 113 patients 18 years or older undergoing elective laparoscopic surgery for colorectal cancer. These patients were case matched and compared with cases from a historical cohort that received only an NR. <h3>Interventions</h3> Among study cases, participating surgeons were requested to systematically capture predefined key steps of the surgical procedure intraoperatively on video in short clips. <h3>Main Outcomes and Measures</h3> The SVRs and NRs were analyzed for adequacy with respect to the availability of important information regarding the predefined key steps. Adequacy of the reported information was defined as the proportion of key steps with available and sufficient information in the report. Adequacy of the SVR and NR was compared between the study and control groups, with the SVR alone and as an adjunct to the NR in the study group vs NR alone in the control group. <h3>Results</h3> Of the 113 study patients, 69 women (61.1%) were included; mean (SD) age was 66.3 (9.8) years. In the control group, a mean (SD) of 52.5% (18.3%) of 631 steps were adequately described in the NR. In the study group, the adequacy of both the SVR (78.5% [16.5%],<i>P</i> &lt; .001) and a combination of the SVR with NR (85.1% [14.6%],<i>P</i> &lt; .001) was significantly superior to NR alone. The only significant difference between the study and historical control groups regarding postoperative and pathologic outcomes was a shorter postoperative mean (SD) length of stay in favor of the study group (8.0 [7.7] vs 8.6 [6.8] days;<i>P</i> = .03). <h3>Conclusions and Relevance</h3> Use of SVR in laparoscopic colorectal cancer surgery as an adjunct to the NR might be superior in documenting important steps of the operation compared with NR alone, adding to the overall availability of necessary intraoperative information and contributing to quality control and objectivity.
FOLFIRI in advanced biliary tract cancers.
Authors: Jonathan Mizrahi, Valerie Gunchick, Kabir Mody, Lianchun Xiao, Phani Keerthi Surapaneni, Rachna T. Shroff, Vaibhav Sahai
Journal: Journal of Clinical Oncology (2019)

451 Background: Gemcitabine plus platinum (GP) is the standard of care first-line treatment for advanced biliary tract cancers (BTC). There is no established second-line therapy, and retrospective reviews report progression-free survival (PFS) for second-line treatment to be &lt; 3 months. 5-Fluorouracil plus irinotecan (FOLFIRI) is a commonly used regimen in patients (pts) with BTC who have progressed on GP, though there is a paucity of data regarding its efficacy in this population. Methods: We retrospectively evaluated pts with advanced BTC who were treated with FOLFIRI at MD Anderson, University of Michigan and Mayo Clinic in Jacksonville. Data were obtained on pt demographics, type of BTC, PFS, and overall survival (OS). Results: Ninety-eight pts were included of which 74 (76%) had metastatic disease at the time of treatment with FOLFIRI. The median age was 59 (range, 22 to 86) years. The number of pts with extrahepatic cholangiocarcinoma (CCA)/gall bladder (GB)/intrahepatic CCA were 10, 17, and 71. FOLFIRI was used as 1 st , 2 nd , 3 rd or 4 th – N th lines in 8, 50, 36, and 4 pts, respectively. Of the 65 pts whose best responses were documented, 23 (35%) had stable disease and 7 (11%) had a partial response per RECIST v1.1. Median duration on FOLFIRI was 2.2 months. The median PFS and OS were 2.4 (95% CI 1.7 to 3.1) and 6.6 (95% CI 4.7 to 8.4) months, respectively. Median PFS for pts treated with FOLFIRI in 1 st , 2 nd , 3 rd or 4 th – N th lines were 3.1, 2.5, 2.3 and 1.5 months, respectively. Eighteen pts received concurrent bevacizumab (13) or EGFR-targeted therapy (5) with FOLFIRI, and both of groups exhibited a median PFS of 2.7 months. Eastern Cooperative Oncology Group performance status (PS) of 0-1 was associated with improved OS (P = 0.006) compared to PS of 2-3. Conclusions: In this multi-institution retrospective review of 98 pts with BTC treated with FOLFIRI, efficacy of this regimen appears to be modest. While PFS and OS outcomes were similar to what has been previously reported, the 46% disease control rate in this group of predominantly pretreated pts is encouraging. Given the lack of other standard therapies, FOLFIRI may still have a role in this pt population, but these results emphasize the need for more effective treatment options for pts with advanced, pretreated BTC.
Exploration of patients with gastric cancer who benefit from apatinib: An updated real-world study.
Authors: Guo-ping Sun, Dongliang Li, Zhongliang Ning, Yifu He, Fenglin Zhang, Jiacong Chang, Yunsheng Cheng, Changjun Yu, Wanren Peng, Bin Hu, Liming Xia, Congqiao Jiang, Zi'an Wang, Yong Zhao, Yingying Du, Guihe Wang, Nianqing Zhang, Hui Liang, Daoqin Wang, Wenjun Hu
Journal: Journal of Clinical Oncology (2019)

161 Background: A real-world study to observe the efficacy and safety of apatinib treatment in clinical practice, and explored patients (pts) who could benefit from apatinib. Methods: This is an open-label, prospective, observational study, pts (age ≥ 18 yrs) with pathologically or histologically diagnosed GC who were given apatinib treatment met the inclusion criteria. Results: From September 1, 2017 to September 1, 2018. 954 pts were enrolled. 679 pts received palliative treatment were included in the analysis. 499 (73.6%) were males. The age of the pts was (63.1 ± 10.8) yrs. Pts with ECOG PS 0/1 accounted for 78.1%. Pts received first-line treatment, second-line treatment, third-line treatment or above , respectively were 42.2%, 30.5%, 27.3%. 509 (75.1%) pts were treated with apatinib at dose of 500 mg. There were 375 pts available for efficiency evaluation. Among them, 1 achieved CR, 35 achieved PR, 198 had SD, and 57 had PD, resulting in an ORR of 11.9% and a DCR of 77.4%. The mPFS is 4.2 m (95% CI: 3.5-4.8), OS data was still in follow-up. This study showed its efficacy for pts with monotherapy compared with combined chemotherapy (3.3 m vs. 5.0 m, P = 0.003). The mPFS for patients with hypertension were longer than without hypertension (7.1m vs. 3.7m, P = 0.038). And pts also had longer mPFS with good ECOG PS (0-1) compared to those with poor ECOG PS (2-4) (4.7 m vs. 2.9 m, P = 0.003). The incidence of AEs was 402 (88.2%) and the grade 3/4 treatment-related AEs was 14.7%. The most common treatment-related AEs were debilitation (31.2%), hand-foot syndrome (27.5%), hypertension (25.3%), anorexia (11.5%), diarrhea (10.3%), albumin decreased (38.5%), uric acid elevated (31.6%), and total bilirubin increased (29.1%). Conclusions: In the real world, apatinib is confirmed to be effective and safe for GC pts. Factors associated with better prognosis were apatinib combined chemotherapy, ECOG PS 0/1 and occurrence of hypertension. Further analysis is needed to identify pts who benefit from apatinib treatment. Preliminary results of the study were released in ESMO 2018 Congress (683P). Clinical trial information: NCT 03333967.
A Photo‐Crosslinkable Kidney ECM‐Derived Bioink Accelerates Renal Tissue Formation
Authors: Mohamed Ali, Anil Kumar PR, James J. Yoo, Faten Zahran, Anthony Atala, Sang Jin Lee
Journal: Advanced Healthcare Materials (2019)

Abstract 3D bioprinting strategies in tissue engineering aim to fabricate clinically applicable tissue constructs that can replace the damaged or diseased tissues and organs. One of the main prerequisites in 3D bioprinting is finding an appropriate bioink that provides a tissue‐specific microenvironment supporting the cellular growth and maturation. In this respect, decellularized extracellular matrix (dECM)‐derived hydrogels have been considered as bioinks for the cell‐based bioprinting due to their capability to inherit the intrinsic cues from native ECM. Herein, a photo‐crosslinkable kidney ECM‐derived bioink (KdECMMA) is developed that could provide a kidney‐specific microenvironment for renal tissue bioprinting. Porcine whole kidneys are decellularized through a perfusion method, dissolved in an acid solution, and chemically modified by methacrylation. A KdECMMA‐based bioink is formulated and evaluated for rheological properties and printability for the printing process. The results show that the bioprinted human kidney cells in the KdECMMA bioink are highly viable and mature with time. Moreover, the bioprinted renal constructs exhibit the structural and functional characteristics of the native renal tissue. The potential of the tissue‐specific ECM‐derived bioink is demonstrated for cell‐based bioprinting that could enhance the cellular maturation and eventually tissue formation.