tbuckley/cabot-search huggingface dataset:
Implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training course in a regular endoscopy unit
Authors: Mauro Manno, Simona Deiana, Tommaso Gabbani, Matteo Gazzi, Alessandro Pignatti, Enrica Becchi, Laura Ottaviani, Sara Vavassori, Elis Sacchi, Cesare Hassan, Paola Soriani
Journal: Endoscopy (2020)

Abstract Background Several scientific societies have endorsed non-anesthesiologist sedation (NAS) during gastrointestinal endoscopy, considering it a safe procedure when administered by adequately trained personnel. This study aimed to evaluate the occurrence of adverse events after implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training program. Methods From January 2017 to August 2018, data from all consecutive endoscopic procedures in adults (≥ 18 years) performed at our endoscopy unit were collected using an electronic reporting system. Results All staff (physicians and nurses) completed the ESGE-ESGENA sedation course. In total, 12 132 patients underwent endoscopic procedures, 10 755 (88.6 %) of which were performed in a non-anesthesiological setting. Of these, about 20 % used moderate sedation with midazolam + fentanyl and 80 % used deep sedation with additional propofol. No sentinel, 5 (0.05 %) moderate risk, and 18 (0.17 %) minor risk adverse events occurred, all during moderate or deep sedation, and all managed by endoscopy staff without the need for anesthesiologist assistance. Conclusions After completing the ESGE-ESGENA sedation training program, the rate of adverse events was very low in our institution. The findings support implementation of the program in all digestive endoscopy units and inclusion in the curriculum for physicians and nurses to ensure safe endoscopic procedures.
Redefining Opioid Use Patterns After Surgical Procedures: Why a New Paradigm Is Critical
Authors: Bhiken I. Naik
Journal: JAMA Network Open (2020)

Nafisseh S. Warner, MD; Elizabeth B. Habermann, PhD; W. Michael Hooten, MD; Andrew C. Hanson, BS; Darrell R. Schroeder, MS; Jennifer L. St. Sauver, PhD; Paul M. Huddleston, MD; Mohamad Bydon, MD; Julie L. Cunningham, PharmD, RPh; Halena M. Gazelka, MD; David O. Warner, MD
Covid-19: healthcare students face unique mental health challenges
Authors: Christopher A Smith
Journal: BMJ (2020)

Investigating the exacerbating and mitigating factors that affect healthcare professionals’ mental health in pandemics is important, but Gold’s editorial overlooks a distinct subgroup in the clinical environment: healthcare students.1

Healthcare students share many risk factors with staff; they are also affected by shortages of personal protective equipment, and many have children. But students face unique problems that their professional colleagues do not.

Student income is often dependent on maintenance loans, and many report resulting financial …
Attitudes and Psychological Factors Associated With News Monitoring, Social Distancing, Disinfecting, and Hoarding Behaviors Among US Adolescents During the Coronavirus Disease 2019 Pandemic
Authors: Benjamin Oosterhoff, Cara A. Palmer
Journal: JAMA Pediatrics (2020)

As coronavirus disease 2019 (COVID-19) spreads across the world, it is critical to understand the psychological factors associated with pandemic-related behaviors. This perspecitve may be especially important to study among adolescents, who are less likely to experience severe symptoms but contribute to the spread of the virus.To examine psychological factors associated with adolescents' behaviors during the COVID-19 pandemic.This self-reported survey conducted from March 20 to 22, 2020, recruited a population-based sample of adolescents via social media to complete an anonymous survey. Participants were eligible if they had internet access, lived in the United States, and were aged 13 to 18 years.Outcomes included COVID-19 news monitoring, social distancing, disinfecting, and hoarding behaviors during the 7 days after the United States declared a national emergency. The psychological factors were attitudes about COVID-19 severity, social responsibility values, social trust, and self-interest. The a priori hypotheses were that greater attitudes about the severity of COVID-19, greater social responsibility, and greater social trust would be associated with greater news monitoring, social distancing, and disinfecting, whereas greater self-interest would be associated with more hoarding.The sample included 770 adolescents collected via convenience sampling (mean [SD] age, 16.3 [1.1] years; 575 girls [74.7%]). Many teens reported not engaging in pure social distancing (528 [68.6%]), but they were monitoring the news (688 [89.4%]) and disinfecting daily (676 [87.8%]). Some teens reported hoarding (152 [19.7%]). Attitudes about the greater severity of COVID-19 were associated with more social distancing (β = 0.18; 95% CI = 0.10 to 0.25), disinfecting (β = 0.16; 95% CI = 0.08 to 0.23), and news monitoring (β = 0.26; 95% CI = 0.18 to 0.33) but also more hoarding (β = 0.08; 95% CI = 0.01 to 0.16). Greater social responsibility was associated with more disinfecting (β = 0.24; 95% CI = 0.17 to 0.32) and news monitoring (β = 0.14; 95% CI = 0.07 to 0.22) and less hoarding (β = -0.07; 95% CI = -0.14 to -0.01). Greater self-interest values were associated with less social distancing (β = -0.08; 95% CI = -0.15 to -0.01) and more hoarding (β = 0.08; 95% CI = 0.01 to 0.15). Greater social trust was associated with less hoarding (β = -0.09; 95% CI, -0.16 to -0.02).The results of this survey study suggest that emphasizing the severity of COVID-19 and the social implications of pandemic-related behaviors may be important for teens, particularly for those who are not following preventive health behaviors or who are engaging in hoarding.
Role of mTOR As an Essential Kinase in SCLC
Authors: Jeffrey A. Kern, Jihye Kim, Daniel G. Foster, Rangnath Mishra, Eric E. Gardner, John T. Poirier, Christopher Rivard, Hui Yu, James H. Finigan, Afshin Dowlati, Charles M. Rudin, Aik-Choon Tan
Journal: Journal of Thoracic Oncology (2020)
Central Role for Adipocyte Na,K-ATPase Oxidant Amplification Loop in the Pathogenesis of Experimental Uremic Cardiomyopathy
Authors: Komal Sodhi, Xiaoliang Wang, Muhammad Aslam Chaudhry, Hari Vishal Lakhani, Mishghan Zehra, Rebecca Pratt, Athar Nawab, Cameron L. Cottrill, Brian Snoad, Fang Bai, James Denvir, Jiang Liu, Juan R. Sanabria, Zijian Xie, Nader G. Abraham, Joseph I. Shapiro
Journal: Journal of the American Society of Nephrology (2020)

Significance Statement Adipocyte redox state is known to affect the systemic phenotype in obesity/metabolic syndrome models, but it has not been studied in experimental models of uremic cardiomyopathy. A peptide, NaKtide, delivered with a lentivirus vector to partially nephrectomized mice fed a western diet, inhibited Na,K-ATPase signaling and ameliorated the experimental uremic cardiomyopathy and other features of the uremic syndrome. Targeting skeletal muscle cells with the same manipulation had essentially no effect. Modulating adipocyte Na,K-ATPase signaling enabled control of the phenotype of experimental uremic cardiomyopathy, demonstrating a key role of the adipocyte in the pathogenesis. If confirmed in humans, the findings suggest a new therapeutic target. Background Oxidative stress in adipocyte plays a central role in the pathogenesis of obesity as well as in the associated cardiovascular complications. The putative uremic toxin indoxyl sulfate induces oxidative stress and dramatically alters adipocyte phenotype in vitro . Mice that have undergone partial nephrectomy serve as an experimental model of uremic cardiomyopathy. This study examined the effects on adipocytes of administering a peptide that reduces oxidative stress to the mouse model. Methods A lentivirus vector introduced the peptide NaKtide with an adiponectin promoter into the mouse model of experimental uremic cardiomyopathy, intraperitoneally. Then adipocyte-specific expression of the peptide was assessed for mice fed a standard diet compared with mice fed a western diet enriched in fat and fructose. Results Partial nephrectomy induced cardiomyopathy and anemia in the mice, introducing oxidant stress and an altered molecular phenotype of adipocytes that increased production of systemic inflammatory cytokines instead of accumulating lipids, within 4 weeks. Consumption of a western diet significantly worsened the adipocyte oxidant stress, but expression of NaKtide in adipocytes completely prevented the worsening. The peptide-carrying lentivirus achieved comparable expression in skeletal muscle, but did not ameliorate the disease phenotype. Conclusions Adipocyte-specific expression of NaKtide, introduced with a lentiviral vector, significantly ameliorated adipocyte dysfunction and uremic cardiomyopathy in partially nephrectomized mice. These data suggest that the redox state of adipocytes controls the development of uremic cardiomyopathy in mice subjected to partial nephrectomy. If confirmed in humans, the oxidative state of adipocytes may be a therapeutic target in chronic renal failure.
Comparison of efficacy and health-related quality of life of first-line haploidentical hematopoietic stem cell transplantation with unrelated cord blood infusion and first-line immunosuppressive therapy for acquired severe aplastic anemia
Authors: Limin Liu, Yanming Zhang, Wenjing Jiao, Huifen Zhou, Qingyuan Wang, Song Jin, Yifeng Cai, Liyun Zhao, Xiaohui Shangguan, Zefa Liu, Jinge Xu, Meiqing Lei, Xiaoyun Yan, Miao Miao, Depei Wu
Journal: Leukemia (2020)
Routine Revascularization Versus Initial Medical Therapy for Stable Ischemic Heart Disease
Authors: Sripal Bangalore, David J. Maron, Gregg W. Stone, Judith S. Hochman
Journal: Circulation (2020)

Background: Revascularization is often performed in patients with stable ischemic heart disease. However, whether revascularization reduces death and other cardiovascular outcomes is uncertain. Methods: We conducted PUBMED/EMBASE/Cochrane Central Register of Controlled Trials searches for randomized trials comparing routine revascularization versus an initial conservative strategy in patients with stable ischemic heart disease. The primary outcome was death. Secondary outcomes were cardiovascular death, myocardial infarction (MI), heart failure, stroke, unstable angina, and freedom from angina. Trials were stratified by percent stent use and by percent statin use to evaluate outcomes in contemporary trials. Results: Fourteen randomized clinical trials that enrolled 14 877 patients followed up for a weighted mean of 4.5 years with 64 678 patient-years of follow-up fulfilled our inclusion criteria. Most trials enrolled patients with preserved left ventricular systolic function and low symptom burden, and excluded patients with left main disease. Revascularization compared with medical therapy alone was not associated with a reduced risk of death (relative risk [RR], 0.99 [95% CI, 0.90–1.09]). Trial sequential analysis showed that the cumulative z-curve crossed the futility boundary, indicating firm evidence for lack of a 10% or greater reduction in death. Revascularization was associated with a reduced nonprocedural MI (RR, 0.76 [95% CI, 0.67–0.85]) but also with increased procedural MI (RR, 2.48 [95% CI, 1.86–3.31]) with no difference in overall MI (RR, 0.93 [95% CI, 0.83–1.03]). A significant reduction in unstable angina (RR, 0.64 [95% CI, 0.45–0.92]) and increase in freedom from angina (RR, 1.10 [95% CI, 1.05–1.15]) was also observed with revascularization. There were no treatment-related differences in the risk of heart failure or stroke. Conclusions: In patients with stable ischemic heart disease, routine revascularization was not associated with improved survival but was associated with a lower risk of nonprocedural MI and unstable angina with greater freedom from angina at the expense of higher rates of procedural MI. Longer-term follow-up of trials is needed to assess whether reduction in these nonfatal spontaneous events improves long-term survival.
Generation of model tissues with dendritic vascular networks via sacrificial laser-sintered carbohydrate templates
Authors: Ian S. Kinstlinger, Sarah H. Saxton, Gisele A. Calderon, Karen Vasquez Ruiz, David R. Yalacki, Palvasha R. Deme, Jessica E. Rosenkrantz, Jesse D. Louis-Rosenberg, Fredrik Johansson, Kevin D. Janson, Daniel W. Sazer, Saarang S. Panchavati, Karl-Dimiter Bissig, Kelly R. Stevens, Jordan S. Miller
Journal: Nature Biomedical Engineering (2020)
IL-6 promotes PD-L1 expression in monocytes and macrophages by decreasing protein tyrosine phosphatase receptor type O expression in human hepatocellular carcinoma
Authors: Wenjie Zhang, Yang Liu, Zhongyi Yan, Hui Yang, Wei Sun, Yongliang Yao, Yun Chen, Runqiu Jiang
Journal: Journal for ImmunoTherapy of Cancer (2020)

We have previously discovered a relationship between the low expression of protein tyrosine phosphatase, receptor type O (PTPRO) in tumor-infiltrating T cells and immunosuppression. The aim of the present study was to investigate the relationship between decreased PTPRO and increased programmed death ligand 1 (PD-L1) in both the peripheral monocytes and tumor-infiltrating macrophages of human hepatocellular carcinoma (HCC).The expression and correlation of all the indices were explored in monocytes and tumor-infiltrating macrophages within both human and mice HCC. The mechanic regulations were studied by using both in vitro and in vivo studies.We found a significant decrease in PTPRO in HCC peripheral monocytes that was associated with increased PD-L1 expression in peripheral monocytes and tumor-associated macrophages (TAMs) in HCC. Monocyte PD-L1 and PTPRO therefore could serve as valuable prognostic indicators for post-surgery patients with HCC and were associated with increased T-cell exhaustion (Tim3+T cells). A depletion of PTPRO promoted PD-L1 secretion in both monocytes and macrophages through the JAK2/STAT1 and JAK2/STAT3/c-MYC pathways. Increased IL-6 expression was associated with activation of JAK2/STAT3/c-MYC and with decreased PTPRO expression through the STAT3/c-MYC/miR-25-3 p axis. Monocytes and TAMs showed significantly increased miR-25-3 p expression, which could target the 3' untranslated region of PTPRO. The miR-25-3 p expression positively correlated with serum IL-6 levels, but inversely correlated with PTPRO in HCC monocytes. IL-6/STAT3/c-MYC activation enhanced in vitro miR-25-3 p transcription and decreased PTPRO, while further promoting PD-L1 secretion. Adoptive cell transfer of c-MYC/miR-25-3 p-modified monocytes promoted tumor growth by downregulating PTPRO and causing a PD-L1-induced immunosuppression in an orthotopic tumor transplantation model.Increased serum IL-6 downregulated PTPRO expression in HCC monocytes and macrophages by activating STAT3/c-MYC/miR-25-3 p and by further enhancing PD-L1 expression through JAK2/STAT1 and JAK2/STAT3/c-MYC signaling.
The β<sub>2</sub>‐Glycoprotein I/HLA–DR Complex As a Major Autoantibody Target in Obstetric Antiphospholipid Syndrome
Authors: Kenji Tanimura, Shigeru Saito, Mikiya Nakatsuka, Takeshi Nagamatsu, Tomoyuki Fujii, Atsushi Fukui, Masashi Deguchi, Yuki Sasagawa, Noriko Arase, Hisashi Arase, Hideto Yamada
Journal: Arthritis & Rheumatology (2020)

The clinical manifestations of antiphospholipid syndrome (APS) include vascular thrombosis and pregnancy morbidity as well as recurrent pregnancy loss (RPL). However, in more than half of patients with RPL, the cause is never determined. Recently, β2 -glycoprotein I (β2 GPI) complexed with HLA class II molecules (β2 GPI/HLA-DR) was found to be a major autoantibody target in APS. The present study was undertaken to assess the serum levels of autoantibodies against the β2 GPI/HLA II complex as a potential risk factor for RPL in women.Serum levels of antiphospholipid antibodies (aPLs), including IgG/IgM anticardiolipin antibodies, IgG/IgM anti-β2 GPI antibodies, and lupus anticoagulant as well as anti-β2 GPI/HLA-DR antibodies, were measured in 227 women with RPL. In this prospective, multicenter, cross-sectional study, women with RPL and their partners underwent HLA-DR immunotyping and analysis to identify potential causes and risk factors associated with RPL. The normal range for anti-β2 GPI/HLA-DR antibody levels was determined using serum samples obtained from a control population of female subjects (208 women of childbearing potential).Of the 227 women with RPL, aPL antibodies were detected in 19.8%, and 52 (22.9%) tested positive for anti-β2 GPI/HLA-DR antibodies. Among the 227 women, 121 (53.3%) had no risk factors for RPL, and among these women with unexplained RPL, 24 (19.8%) were positive for anti-β2 GPI/HLA-DR antibodies. Of the 112 women who had clinical symptoms of APS but did not have levels of aPLs that met the diagnostic criteria for APS, 21 (18.8%) were positive for anti-β2 GPI/HLA-DR antibodies.The anti-β2 GPI/HLA-DR antibody is frequently associated with RPL. Detection of these autoantibodies is useful in understanding the pathogenesis of RPL. Our findings may provide potential new therapeutic strategies for addressing RPL in patients with obstetric APS.
Reduced mitochondrial resilience enables non-canonical induction of apoptosis after TNF receptor signaling in virus-infected hepatocytes
Authors: Sandra Lampl, Marianne K. Janas, Sainitin Donakonda, Marcus Brugger, Kerstin Lohr, Annika Schneider, Katrin Manske, Laura E. Sperl, Susan Kläger, Bernhard Küster, Jennifer Wettmarshausen, Constanze Müller, Melanie Laschinger, Daniel Hartmann, Norber Hüser, Fabiana Perocchi, Philippe Schmitt-Kopplin, Franz Hagn, Lars Zender, Veit Hornung, Christoph Borner, Andreas Pichlmair, Hamid Kashkar, Martin Klingenspor, Marco Prinz, Sabrina Schreiner, Marcus Conrad, Philipp J. Jost, Hans Zischka, Katja Steiger, Martin Krönke, Dietmar Zehn, Ulrike Protzer, Mathias Heikenwälder, Percy A. Knolle, Dirk Wohlleber
Journal: Journal of Hepatology (2020)
Prevalence and risk factors of small airway dysfunction, and association with smoking, in China: findings from a national cross-sectional study
Authors: Dan Xiao, Zhengming Chen, Sinan Wu, Kewu Huang, Jianying Xu, Lan Yang, Yongjian Xu, Xiangyan Zhang, Chunxue Bai, Jian Kang, Pixin Ran, Huahao Shen, Fuqiang Wen, Wanzhen Yao, Tieying Sun, Guangliang Shan, Ting Yang, Yingxiang Lin, Jianguo Zhu, Ruiying Wang, Zhihong Shi, Jianping Zhao, Xianwei Ye, Yuanlin Song, Qiuyue Wang, Gang Hou, Yumin Zhou, Wen Li, Liren Ding, Hao Wang, Yahong Chen, Yanfei Guo, Fei Xiao, Yong Lu, Xiaoxia Peng, Biao Zhang, Zuomin Wang, Hong Zhang, Xiaoning Bu, Xiaolei Zhang, Li An, Shu Zhang, Zhixin Cao, Qingyuan Zhan, Yuanhua Yang, Lirong Liang, Zhao Liu, Xinran Zhang, Anqi Cheng, Bin Cao, Huaping Dai, Kian Fan Chung, Jiang He, Chen Wang, Chen Wang, Jiang He, Jianying Xu, Lan Yang, Yongjian Xu, Xiangyan Zhang, Chenxue Bai, Jian Kang, Pixin Ran, Huahao Shen, Fuqiang Wen, Kewu Huang, Wanzhen Yao, Guangliang Shan, Ting Yang, Yingxiang Lin, Sinan Wu, Jianguo Zhu, Ruiying Wang, Zhihong Shi, Jianping Zhao, Xianwei Ye, Yuanlin Song, Dong Yang, Qiuyue Wang, Gang Hou, Yumin Zhou, Wen Li, Liren Ding, Chun Wan, Ting Yang, Hao Wang, Yahong Chen, Yanfei Guo, Fei Xiao, Yong Lu, Xiaoxia Peng, Biao Zhang, Dan Xiao, Zuomin Wang, Xiaoning Bu, Hong Zhang, Xiaolei Zhang, Li An, Shu Zhang, Zhixin Cao, Qingyuan Zhan, Yuanhua Yang, Bin Cao, Huaping Dai, Lirong Liang, Chaolong Wang, Xunliang Tong, Tangchun Wu, Haidong Kan, Renjie Chen, Hua Cai, Weining Xiong, Pengjun Zhang, Yong Li, Wenquan Niu, Chung-Shiuan Chen, Guodong Xu, Xinran Zhang, Xiaoying Gu, Fen Dong, Zhao Liu, Anqi Cheng, Zhengcun Pei, Hongtao Niu, Ke Huang, Simiao Chen, Kian Fan Chung, Zhengming Chen
Journal: The Lancet Respiratory Medicine (2020)
Prevalence of Infective Endocarditis in Streptococcal Bloodstream Infections Is Dependent on Streptococcal Species
Authors: Sandra Chamat-Hedemand, Anders Dahl, Lauge Østergaard, Magnus Arpi, Emil Fosbøl, Jonas Boel, Louise Bruun Oestergaard, Trine K. Lauridsen, Gunnar Gislason, Christian Torp-Pedersen, Niels Eske Bruun
Journal: Circulation (2020)

Background: Streptococci frequently cause infective endocarditis (IE), yet the prevalence of IE in patients with bloodstream infections (BSIs) caused by different streptococcal species is unknown. We aimed to investigate the prevalence of IE at species level in patients with streptococcal BSIs. Methods: We investigated all patients with streptococcal BSIs, from 2008 to 2017, in the Capital Region of Denmark. Data were crosslinked with Danish nationwide registries for identification of concomitant hospitalization with IE. In a multivariable logistic regression analysis, we investigated the risk of IE according to streptococcal species adjusted for age, sex, ≥3 positive blood culture bottles, native valve disease, prosthetic valve, previous IE, and cardiac device. Results: Among 6506 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men) the IE prevalence was 7.1% (95% CI, 6.5–7.8). The lowest IE prevalence was found with Streptococcus pneumoniae ( S pneumoniae ) 1.2% (0.8–1.6) and Spyogenes 1.9% (0.9–3.3). An intermediary IE prevalence was found with Sanginosus 4.8% (3.0–7.3), Ssalivarius 5.8% (2.9–10.1), and Sagalactiae 9.1% (6.6–12.1). The highest IE prevalence was found with Smitis/oralis 19.4% (15.6–23.5), Sgallolyticus (formerly Sbovis ) 30.2% (24.3–36.7), Ssanguinis 34.6% (26.6–43.3), Sgordonii 44.2% (34.0–54.8), and Smutans 47.9% (33.3–62.8). In multivariable analysis using S pneumoniae as reference, all species except S pyogenes were associated with significantly higher IE risk, with the highest risk found with S gallolyticus odds ratio (OR) 31.0 (18.8–51.1), S mitis/oralis OR 31.6 (19.8–50.5), S sanguinis OR 59.1 (32.6–107), S gordonii OR 80.8 (43.9–149), and S mutans OR 81.3 (37.6–176). Conclusions: The prevalence of IE in streptococcal BSIs is species dependent with S mutans, S gordonii, S sanguinis, S gallolyticus , and S mitis/oralis having the highest IE prevalence and the highest associated IE risk after adjusting for IE risk factors.