tbuckley/cabot-search huggingface dataset:
Added Sugar Labeling
Authors: Elizabeth A. Magnuson, Paul S. Chan
Journal: Circulation (2019)

ardiovascular mortality rates have declined significantly in the latter half of the 20th century; however, this decline has decelerated since 2000. 1 Although the earlier sharp decline was attributed to improved risk factor control and pharmacological and technological advances in the management of coronary heart disease and stroke, this rate of decline has plateaued in recent years because of more incremental advances in prevention and treatment and the increasing prevalence of obesity and type 2 diabetes mellitus. 2ncreased sugar intake has paralleled the recent rise in obesity and type 2 diabetes mellitus prevalence.In the National Health and Nutrition Examination Survey, the prevalence of adult obesity increased from 22.9% in 1988-1994 to 34.9% in 2011-2012, 3,4 and the prevalence of diabetes mellitus nearly tripled, from 2.5% in 1990 to 7.2% in 2013. 1 Between 1970 and 2000, total caloric intake increased by an average of 150-300 calories per day, with approximately 50% of the increase coming from liquid calories, primarily sugar-sweetened beverages (SSBs). 5,6SSBs promote weight gain because they fail to trigger the physiological satiety mechanism and contribute to increased risk of type 2 diabetes mellitus through weight gain and independently through the glycemic effects of consuming large amounts of rapidly absorbable sugars.In both adults and children, intake of SSBs has been linked to weight gain and obesity, and randomized trials in children demonstrate reductions in obesity when SSBs are replaced with noncaloric beverages. 7 As a result, the American Heart Association in 2006 recommended minimizing the dietary intake of beverages and food with added sugar and in 2009 recommended consuming no more than 100 and 150 calories per day from added sugars. 5,8The effect of these recommendations has led to a reduction in the mean added sugar content in foods for 2009-2010 and 2011-2012 as compared with 2007-2008. 9 In 1990, the Nutrition Labeling and Education Act mandated the placement of the Nutrition Facts panel on packaged foods.A recently published meta-analysis of 60 studies published between 1990 and 2014 found that food labeling had significantly reduced consumer dietary intake of total calories and total fat, increased consumption of vegetables, and decreased the sodium and trans fat content in food formulations, 10 underscoring the impact of public policy on food and diet.On May 20, 2016, the Food and Drug Administration (FDA) announced a new Nutrition Facts label regulation for packaged foods with a particular focus on added sugars, in grams and as a percentage of daily value.The new label policy also requires that the number of calories and the number of servings and serving size be presented in bolder type, as well as reporting of serving sizes to closely reflect amounts actually eaten.This policy was originally slated to go into effect in July 2018; however, following feedback from industry and consumer groups, the manufacturers' com-
Avoidable harm: a blind spot in checking patient consent for surgery
Authors: Bhaskar Saha, Khaled Mohamed Hassan
Journal: BMJ (2019)

Donaldson and colleagues discuss avoidable harm in healthcare.1 The system of developing patient safety is ever evolving, and adoption of the World Health Organization checklist has helped reduce patient harm, but as perioperative physicians we think there is a major blind spot in our theatre systems.

In March 2019 a …
Impact of the Affordable Care Act on early-stage diagnosis and treatment for women with ovarian cancer.
Authors: Anna Jo Smith, Amanda Nickels
Journal: Journal of Clinical Oncology (2019)

LBA5563 Background: The 2010 Affordable Care Act (ACA) expanded access to insurance and care for many Americans. Our objective was to evaluate the impact of the ACA on stage at diagnosis and time to treatment for women with ovarian cancer. Methods: We utilized a difference-in-differences (DD) approach to assess stage at diagnosis and time to treatment before and after the 2010 ACA among women with ovarian cancer ages 21-64 years compared to women ages 65 years and older. We used the National Cancer Database with the 2004-2009 surveys as the pre-reform years and the 2011-2014 surveys as the post-reform years. Outcomes were analyzed for women overall and by insurance type, adjusting for patient race, living in a rural area, area-level household income and education level, Charlson co-morbidity score, distance traveled for care, Census region, and care at an academic center. Results: A total of 35,842 ovarian cancer cases pre-reform and 37,145 post-reform were identified for women 21-64 years compared with 28,895 cases pre-reform and 30,604 post-reform for women 65 years and older. The ACA was associated with increased early-stage diagnosis for women 21-64 years compared to women 65 and older with ovarian cancer (DD=1.7%, p-for-trend=0.001). Additionally, the ACA was associated with more women receiving treatment within 30 days of ovarian cancer diagnosis (DD=1.6%, p&lt;0.001). Specifically, among women with public insurance, the ACA was associated with a significant improvement in early-stage diagnosis and receipt of treatment within 30 days of diagnosis (DD=2.5%, p=0.003 and DD=2.5%, p=0.006). Improvements in stage at diagnosis and time to treatment were seen across race, income, and education groups. Conclusions: Under the Affordable Care Act, women with ovarian cancer were more likely to be diagnosed at an early stage and receive treatment within 30 days of diagnosis. As stage and treatment are major determinants of survival, these gains under the ACA may have long-term impacts on women with ovarian cancer.
Early detection of skin cancer by skin self‐examination
Authors: S.J. Ersser, A. Effah, J. Dyson, I. Kellar, S. Thomas, E. McNichol, E. Caperon, C. Hewitt, A.J. Muinonen‐Martin
Journal: British Journal of Dermatology (2019)

Skin cancer is increasing in many countries, including in the UK. For example, in the USA in 2017, over 87,000 people had been diagnosed with a dangerous type of skin cancer (melanoma); of these it was expected that nearly 10,000 would die from the condition. We are a U.K based research team that conducted a review of scientific papers from across the world. Our aim was to examine and pool the existing research on whether the different approaches to helping people to examine their own skin, to detect skin cancer early, are effective or not. This review identified all the relevant published articles for available research studies up to April 2018. The identified relevant studies totalled 18 in number, which we then summarised. These approaches included education, such as teaching and reminding people (sometimes using technology, for example, using computers and mobile phones) to examine their skin and quickly report any suspicious changes to their doctor. We found that the various approaches used had a positive effect on peoples’ likelihood and ability to examine their skin, especially in the short‐term. More studies targeted people at higher risk of skin cancer, such as those with a previous diagnosis of skin cancer, compared to people at no greater risk. Of the research we looked at, two thirds of the studies were poorly designed. Skin specialists should raise awareness and support people to routinely examine their skin for skin cancer, especially those at high risk.
Codon usage optimization in pluripotent embryonic stem cells
Authors: Susanne Bornelöv, Tommaso Selmi, Sophia Flad, Sabine Dietmann, Michaela Frye
Journal: Genome biology (2019)

The uneven use of synonymous codons in the transcriptome regulates the efficiency and fidelity of protein translation rates. Yet, the importance of this codon bias in regulating cell state-specific expression programmes is currently debated. Here, we ask whether different codon usage controls gene expression programmes in self-renewing and differentiating embryonic stem cells. Using ribosome and transcriptome profiling, we identify distinct codon signatures during human embryonic stem cell differentiation. We find that cell state-specific codon bias is determined by the guanine-cytosine (GC) content of differentially expressed genes. By measuring the codon frequencies at the ribosome active sites interacting with transfer RNAs (tRNA), we further discover that self-renewing cells optimize translation of codons that depend on the inosine tRNA modification in the anticodon wobble position. Accordingly, inosine levels are highest in human pluripotent embryonic stem cells. This effect is conserved in mice and is independent of the differentiation stimulus. We show that GC content influences cell state-specific mRNA levels, and we reveal how translational mechanisms based on tRNA modifications change codon usage in embryonic stem cells.
Abstract 18466: Angiopoietin-2 as a Predictive Biomarker of Atrial Fibrillation in Patients With Stage 5 Chronic Kidney Disease
Authors: Jack Bontekoe, Justin Lee, Vinod Bansal, Mushabbar Syed, Debra Hoppensteadt, Paula Maia, Amanda Walborn, Jeff Liles, Jawed Fareed
Journal: Circulation (2017)

Introduction: Angiopoietin-2 (Ang-2) is a 55 kDa growth factor glycoprotein which is involved in angiogenesis, endothelial dysfunction, and inflammatory processes. Plasma Ang-2 levels are upregulat...
Lack of Standardized Terminology in Ultrasound Reports for Ovarian Cysts—Reply
Authors: Rebecca Smith-Bindman, Diana Miglioretti
Journal: JAMA Internal Medicine (2019)

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Abstract 19508: Mid-term Results of the Ross Procedure in Children: A Reappraisal of the Subannular Implantation Technique
Authors: Ryo Torii, Patricia Cornejo, Phan-Kiet Tran, Karin Tran-Lundmark, Tain-Yen Hsia, Martin Kostolny, Marina Hughes, Victor Tsang
Journal: Circulation (2015)

Dilatation of the pulmonary autograft is an ongoing concern in the paediatric population. Unlike those of the aortic valve leaflets, those of the pulmonary valve are directly attached to the right ventricular muscular outflow tract, and therefore at the time of the Ross procedure the pulmonary root needs to be placed within the left ventricular outflow (LVOT) tract for support. Between 1998 and 2012, 74 children were operated with the subannular technique with interrupted sutures, at the median age of 10.2 years (range 5 months to 18 years). Mean follow up time was 5.2 years (range 3 days to 13.2 years). There were no deaths, but 3 reinterventions on the autograft for regurgitation and 2 resections of LVOT obstruction. Mean freedom from autograft and LVOT reintervention time was 12.1 years (95% CI 11.0 - 13.2). There were no significant autograft stenosis, and freedom from moderate to severe autograft regurgitation was 95% and 87.5% at 5 and 10 years, respectively. Z-scores at latest follow-up were at the annulus 0.23 (range -2.9 to +3.2), sinus of Valsalva 2.6 (range -3.1 to +5.4), and the sinotubular junction 2.9 (range -1.2 to +6.0). As expected, the correlation between time after surgery and the increase in Z-score of the root structures were positive at the level of the sinus of Valsalva (r=+0.39, p=0.003) and at the sinotubular junction (r=+0.27, p=0.049), but was negative at the annulus (r=-0.26, p=0.054). Average rate of change in Z-score was significantly lower at the annulus compared to the sinus of Valsalva (0.19 vs 0.46 Z-score/year, p &lt; 0.001). Our data confirms the importance of subannular support of the pulmonary autograft in the LVOT with limited annular dilatation and autograft regurgitation, and delayed need for autograft reintervention.
Successful endoscopic transpapillary gallbladder stenting using a new easily maneuverable guidewire: a report of two cases
Authors: Katsuyuki Miyabe, Akihisa Kato, Go Asano, Yasuki Hori, Michihiro Yoshida, Itaru Naitoh, Kazuki Hayashi
Journal: Endoscopy (2019)

Endoscopic transpapillary gallbladder drainage has a poor technical success rate (80 % – 90 %) [1] [2] [3] [4]. The technique is sometimes challenging when the guidewire cannot be advanced through the cystic duct into the gallbladder because of ductal tortuosity or obstruction [5] ([Fig. 1]). This report describes a new, easily maneuverable guidewire (approved by the review board of Nagoya City University Graduate School of Medical Sciences; approval No. 46-18-0012), which was successfully advanced into the gallbladders of two patients in whom a conventional guidewire could not be advanced ([Fig. 2], [Video 1]).
Phase III MONALEESA-7 trial of premenopausal patients with HR+/HER2− advanced breast cancer (ABC) treated with endocrine therapy ± ribociclib: Overall survival (OS) results.
Authors: Sara A. Hurvitz, Seock-Ah Im, Yen-Shen Lu, Marco Colleoni, Fabio Andre Franke, Aditya Bardia, Nadia Harbeck, Louis Chow, Joohyuk Sohn, Keun Seok Lee, Saul Campos Gomez, Rafael Villanueva, Kyung Hae Jung, Arunava Chakravartty, Gareth Hughes, Ioannis Gounaris, Karen Rodriguez-Lorenc, Tetiana Taran, Debu Tripathy
Journal: Journal of Clinical Oncology (2019)

LBA1008 Background: The phase III MONALEESA-7 study (NCT02278120) is the first dedicated trial of endocrine therapy (ET) ± a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor in premenopausal patients (pts) with hormone receptor–positive (HR+)/HER2− ABC. The study met its primary endpoint of significantly longer progression-free survival (PFS) with ribociclib (RIB; a CDK4/6 inhibitor) + ET vs placebo (PBO) + ET (median, 23.8 vs 13.0 mo; HR, 0.55; P &lt; 0.0001; Tripathy D, et al. Lancet Oncol. 2018). Methods: Premenopausal pts (N=672) with HR+/HER2− ABC were treated with RIB or PBO + goserelin and either a nonsteroidal aromatase inhibitor (NSAI; letrozole or anastrozole) or tamoxifen. This is the 2nd of 3 protocol-specified OS analyses (scheduled to occur after ≈ 189 deaths [75% of the planned total events]). OS was evaluated by Kaplan-Meier methods, and statistical comparison was made by 1-sided stratified log-rank test, with a protocol-defined Lan-DeMets (O’Brien-Fleming) stopping boundary of p &lt; 0.01018 for superior efficacy. Results: The data cutoff for this prespecified interim analysis was Nov 30, 2018, and the median follow-up was 34.6 mo (min, 28.0 mo). At cutoff, 173 pts were continuing study treatment (RIB, n=116; PBO, n=57), and OS was evaluated after 192 deaths (RIB, n=83; PBO, n=109). RIB + ET demonstrated a significantly longer OS than PBO + ET (median, not reached vs 40.9 mo [95% CI, 37.80 mo-not evaluable]; HR, 0.712 [95% CI, 0.54-0.95]; p = 0.00973). The result crossed the prespecified stopping boundary for superior efficacy. Estimated OS rates with RIB + ET vs PBO + ET at 42 mo were 70.2% vs 46.0%, respectively. In pts who received an NSAI (n=495), RIB + ET demonstrated a consistent OS improvement vs PBO + ET (HR, 0.699 [95% CI, 0.50-0.98]). Posttreatment therapy use was balanced between treatment arms (RIB, 68.9%; PBO, 73.2%). Conclusions: RIB + ET demonstrated a clinically and statistically significant longer OS than ET alone in premenopausal pts with HR+/HER2− ABC. This is the first time that a CDK4/6 inhibitor or any targeted agent + ET has demonstrated significantly longer OS vs ET alone as initial endocrine-based therapy. Clinical trial information: NCT02278120.
Evaluation of Colorado oncology providers on the use of medical marijuana.
Authors: Ashley Elizabeth Glode, Garth C. Wright, Stephen Leong
Journal: Journal of Clinical Oncology (2019)

10511 Background: There is a lack of knowledge regarding medical marijuana use in cancer patients. More information is needed due to increase in both state approvals and access to medical marijuana. We hypothesized that variation in provider knowledge, attitudes, and behaviors exists across all professions in oncology, which contributes to a lack of both provider awareness of patient use and patient education on marijuana use. Methods: A survey was distributed to oncology providers in the state of Colorado. The primary objective was to describe provider knowledge, attitudes, and behaviors regarding medical marijuana use in cancer patients. Other objectives were identifying educational needs for oncology providers to feel comfortable recommending medical marijuana and reporting provider interest in future marijuana studies. Results: We received responses from 172 oncology providers; 48 advanced practice providers, 47 physicians, 53 registered nurses, 17 pharmacists, and 7 other. Most providers (73.3%) believe marijuana provides a medical benefit to cancer patients, and 81.5% believe it should be available as a prescription drug. Yet, 60.1% had not recommend its use to any cancer patient in the past 6 months, and 54.3% are not comfortable recommending or suggesting it to a patient to manage cancer related symptoms. Major concerns included uncertain dosing (83%), limited knowledge of available products and where to get them (73.1%), and interactions with other medications (64.9%). Providers reported that educational programs for healthcare providers (79.3%), more clinical data (74%), and endorsed clinical guidelines (67.5%) would increase their comfort level in recommending medical marijuana. The areas of research most interesting or important were specific product information and doses (77.6%), efficacy for specific side effects (77.6%), and drug-drug interactions (74.7%). Conclusions: Regardless of profession, the majority of oncology providers in Colorado do not recommend and do not feel comfortable recommending or suggesting medical marijuana to a cancer patient, yet most believe it provides medical benefit. Providers believe there is a need for education and research on the use of medical marijuana in oncology patients.
18F-Fluorocholine Uptake by a Head and Neck Meningeal Inflammatory Pseudotumor
Authors: Giordano Savelli, Mauro Morassi, Milena Cobelli, Antonella Stefanelli, Alberto Zaniboni
Journal: Clinical Nuclear Medicine (2019)

Abstract 18 F-Fluoro-ethyl-choline ( 18 F-FCH) PET/CT is widely used to study patients affected by prostate cancer. However, 18 F-FCH may be taken-up by other neoplastic diseases, infections, and non-infective inflammatory processes. While this behavior may be an opportunity to study different diseases, on the other hand, this condition brings with it the source of error in the evaluation of the images. Here we present the case of a meningeal inflammatory pseudotumor evidenced by 18 F-FCH.
Kenya’s president sets target to end FGM by 2022
Authors: Zosia Kmietowicz
Journal: BMJ (2019)

Campaigners have called on global leaders to commit to ending female genital mutilation/cutting (FGM/C) after Kenya’s president, Uhuru Kenyatta, vowed to end the practice in his country by 2022, eight years ahead of the sustainable development goal.

At the opening of the Women Deliver conference to end gender inequality held in Vancouver, Canada on 3 June, Kenyatta promised to work towards empowering women in Kenya by making secondary education compulsory for all children, which he said would help to discourage child marriage. The campaign group Girls not Brides says that one …
Affordable Care Act (ACA) Medicaid expansion impact on racial disparities in time to cancer treatment.
Authors: Blythe J.S. Adamson, Aaron B. Cohen, Melissa Estevez, Kelly Magee, Erin Williams, Cary Philip Gross, Neal J. Meropol, Amy J. Davidoff
Journal: Journal of Clinical Oncology (2019)

LBA1 Background: Racial disparities in cancer outcomes remain a societal challenge. The ACA sought to improve equity in healthcare access and outcomes by permitting states to expand Medicaid and providing subsidies for purchase of private insurance. We assessed the impact of Medicaid expansions on racial disparities in time to treatment among patients (pts) with advanced cancer. Methods: We selected pts ages 18-64 years with advanced or metastatic cancer (NSCLC, breast, urothelial, gastric, colorectal, renal cell, prostate, and melanoma), diagnosed between Jan 1, 2011 and Dec 31, 2018, from the nationwide Flatiron Health electronic health record-derived database. We assigned expansion status based on whether the pts’ state of residence had expanded Medicaid as of the diagnosis date. We estimated Medicaid expansion-related changes in the rate of “timely treatment,” an outcome defined as first-line treatment start within 30 days of advanced or metastatic diagnosis. Regression model covariates included race (White, African American, Asian, and Other race), age, sex, practice type, cancer type, stage, and unemployment rate, using time and state fixed-effects. Regression results present predictive margins. Results: The study included 34,067 pts (median age 57 years; 12% African American). Racial disparities were observed pre-expansion: African American pts were 4.9 percentage points (%pt) less likely to receive timely treatment (Table). Regardless of race, Medicaid expansion trended toward an increase in timely treatment overall (p = 0.05). Expansion was associated with a differential benefit for African American vs white pts (6.9 %pt and 1.8 %pt). Prior racial disparities were no longer observed after Medicaid expansion. Conclusions: Implementation of Medicaid expansions as part of the ACA differentially improved African American cancer pts’ receipt of timely treatment, reducing racial disparities in access to care.[Table: see text]
Abstract 12671: Predictors of Appropriate Interventions in Children With Hypertrophic Cardiomyopathy and a Primary Prevention Defibrillator: An International Multi-Center Study
Authors: Seshadri Balaji, DiLorenzo Michael, Frank Fish, Susan P Etheridge, Peter F Aziz, Mark W Russell, Svjetlana Tisma-Dupanovic, Andreas Pflaumer, Narayanswami Sreeram, Peter Kubus, Ian H Law, Michal J Kantoch, Naomi J Kertesz, Margaret Strieper, Christopher C Erickson, Jeremy P Moore, Stephanie J Nakano, Harinder R Singh, Philip Chang, Mitchell Cohen, Anne Fournier, Maria V Ilina, Richard T Smith, Frank Zimmermann, Michaela Horndasch, Walter Li, Anjan Batra, Leonardo Liberman, Robert Hamilton, Christopher M Janson, Shubhayan Sanatani, Ilana Zeltser, George McDaniel, Andrew D Blaufox, Jason M Garnreiter, Hannah Katcoff, Maully Shah
Journal: Circulation (2018)

Introduction: Primary prevention (PP) ICD are increasingly placed in children with Hypertrophic Cardiomyopathy (HCM) to prevent SCD using adult criteria. The reliability of PPICD to prevent SCD is ...