tbuckley/cabot-search huggingface dataset:
Nonfatal Drug Overdoses Treated in Emergency Departments — United States, 2016–2017
Authors: Alana M. Vivolo-Kantor, Brooke E. Hoots, Lawrence Scholl, Cassandra Pickens, Douglas R. Roehler, Amy Board, Desiree Mustaquim, Herschel Smith, Stephanie Snodgrass, Stephen Liu
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

In 2017, drug overdoses caused 70,237 deaths in the United States, a 9.6% rate increase from 2016 (1). Monitoring nonfatal drug overdoses treated in emergency departments (EDs) is also important to inform community prevention and response activities. Analysis of discharge data provides insights into the prevalence and trends of nonfatal drug overdoses, highlighting opportunities for public health action to prevent overdoses. Using discharge data from the Healthcare Cost and Utilization Project's (HCUP) Nationwide Emergency Department Sample (NEDS), CDC identified nonfatal overdoses for all drugs, all opioids, nonheroin opioids, heroin, benzodiazepines, and cocaine and examined changes from 2016 to 2017, stratified by drug type and by patient, facility, and visit characteristics. In 2017, the most recent year for which population-level estimates of nonfatal overdoses can be generated, a total of 967,615 nonfatal drug overdoses were treated in EDs, an increase of 4.3% from 2016, which included 305,623 opioid-involved overdoses, a 3.1% increase from 2016. From 2016 to 2017, the nonfatal overdose rates for all drug types increased significantly except for those involving benzodiazepines. These findings highlight the importance of continued surveillance of nonfatal drug overdoses treated in EDs to inform public health actions and, working collaboratively with clinical and public safety partners, to link patients to needed recovery and treatment resources (e.g., medication-assisted treatment).
Specialist laboratory networks as preparedness and response tool - the Emerging Viral Diseases-Expert Laboratory Network and the Chikungunya outbreak, Thailand, 2019
Authors: Giulietta Venturi, Stephan W Aberle, Tatjana Avšič-Županc, Luisa Barzon, Christoph Batejat, Elisa Burdino, Fabrizio Carletti, Rémi Charrel, Iva Christova, Jeff Connell, Victor Max Corman, Mary Emmanouil, Anne J Jääskeläinen, Ivan Kurolt, Yaniv Lustig, Miguel J Martinez, Marion Koopmans, Orsolya Nagy, Trung Nguyen, Anna Papa, Mercedes Pérez-Ruiz, Martin Pfeffer, Jelena Protic, Johan Reimerink, Giada Rossini, María Paz Sánchez-Seco Fariñas, Jonas Schmidt-Chanasit, Sandra Söderholm, Bertrand Sudre, Marjan Van Esbroeck, Chantal B Reusken
Journal: Eurosurveillance (2020)

We illustrate the potential for specialist laboratory networks to be used as preparedness and response tool through rapid collection and sharing of data. Here, the Emerging Viral Diseases-Expert Laboratory Network (EVD-LabNet) and a laboratory assessment of chikungunya virus (CHIKV) in returning European travellers related to an ongoing outbreak in Thailand was used for this purpose. EVD-LabNet rapidly collected data on laboratory requests, diagnosed CHIKV imported cases and sequences generated, and shared among its members and with the European Centre for Disease Prevention and Control. Data across the network showed an increase in CHIKV imported cases during 1 October 2018–30 April 2019 vs the same period in 2018 (172 vs 50), particularly an increase in cases known to be related to travel to Thailand (72 vs 1). Moreover, EVD-LabNet showed that strains were imported from Thailand that cluster with strains of the ECSA-IOL E1 A226 variant emerging in Pakistan in 2016 and involved in the 2017 outbreaks in Italy. CHIKV diagnostic requests increased by 23.6% between the two periods. The impact of using EVD-LabNet or similar networks as preparedness and response tool could be improved by standardisation of the collection, quality and mining of data in routine laboratory management systems.
Locally Informed Simulation to Predict Hospital Capacity Needs During the COVID-19 Pandemic
Authors: Gary E. Weissman, Andrew Crane-Droesch, Corey Chivers, ThaiBinh Luong, Asaf Hanish, Michael Z. Levy, Jason Lubken, Michael Becker, Michael E. Draugelis, George L. Anesi, Patrick J. Brennan, Jason D. Christie, C. William Hanson, Mark E. Mikkelsen, Scott D. Halpern
Journal: Annals of Internal Medicine (2020)

The coronavirus disease 2019 (COVID-19) pandemic challenges hospital leaders to make time-sensitive, critical decisions about clinical operations and resource allocations.To estimate the timing of surges in clinical demand and the best- and worst-case scenarios of local COVID-19-induced strain on hospital capacity, and thus inform clinical operations and staffing demands and identify when hospital capacity would be saturated.Monte Carlo simulation instantiation of a susceptible, infected, removed (SIR) model with a 1-day cycle.3 hospitals in an academic health system.All people living in the greater Philadelphia region.The COVID-19 Hospital Impact Model (CHIME) (http://penn-chime.phl.io) SIR model was used to estimate the time from 23 March 2020 until hospital capacity would probably be exceeded, and the intensity of the surge, including for intensive care unit (ICU) beds and ventilators.Using patients with COVID-19 alone, CHIME estimated that it would be 31 to 53 days before demand exceeds existing hospital capacity. In best- and worst-case scenarios of surges in the number of patients with COVID-19, the needed total capacity for hospital beds would reach 3131 to 12 650 across the 3 hospitals, including 338 to 1608 ICU beds and 118 to 599 ventilators.Model parameters were taken directly or derived from published data across heterogeneous populations and practice environments and from the health system's historical data. CHIME does not incorporate more transition states to model infection severity, social networks to model transmission dynamics, or geographic information to account for spatial patterns of human interaction.Publicly available and designed for hospital operations leaders, this modeling tool can inform preparations for capacity strain during the early days of a pandemic.University of Pennsylvania Health System and the Palliative and Advanced Illness Research Center.
Commercially available molecular tests for human papillomaviruses: a global overview
Authors: M. Poljak, A. Oštrbenk Valenčak, G. Gimpelj Domjanič, L. Xu, M. Arbyn
Journal: Clinical Microbiology and Infection (2020)

Molecular tests for detection of human papillomaviruses (HPVs) play a crucial role in the prevention of cervical cancer, including recently announced elimination efforts. HPV testing is a recommended approach for cervical cancer screening of women over 30 and for management of those with precancerous cervical lesions. In addition, they are widely used in epidemiological studies, HPV surveillance and vaccination impact monitoring.The aim was to provide an updated 2020 inventory of commercial molecular HPV tests available on the market.Data were retrieved from internal files, and a detailed search using Medline/Pubmed, Web of Science, Scopus, Google Scholar, Google and Bing, without language or period restrictions, was performed in September 2019 and again in January 2020.We identified 254 distinct commercial HPV tests and at least 425 test variants available on the global market in 2020, which represents a 31% and 235% increase in the number of distinct tests and variants, respectively, compared with the previous inventory performed in 2015. Although the proportion of commercially available HPV tests with at least one peer-reviewed publication has increased over the past decade, 60% of the HPV tests on the global market are still without a single peer-reviewed publication. Furthermore, 82% of tests lack any published analytical and/or clinical evaluation, and over 90% are not evaluated in line with consensus requirements that ensure safe use in clinical settings.Significant challenges and scope for improvement still exist for both the HPV scientific community and the manufacturers of HPV tests. The latter must put more effort into validating their products, in agreement with standardized procedures, including all steps of HPV testing and various clinical specimens. High throughput capacity and point-of-care HPV tests are needed, both with affordable prices.
Clinical Features and Prognostic Impact of RUNX1 and PTPN11 Mutations in Pediatric Acute Myeloid Leukemia—the Jccg Study, JPLSG AML-05-
Authors: Genki Yamato, Norio Shiba, Kenichi Yoshida, Yusuke Hara, Kentaro Ohki, Jun Okubo, Myoung-Ja Park, Manabu Sotomatsu, Tomohiko Taki, Hirokazu Arakawa, Nobutaka Kiyokawa, Daisuke Tomizawa, Souichi Adachi, Takashi Taga, Keizo Horibe, Seishi Ogawa, Yasuhide Hayashi
Journal: Blood (2017)
Urinary detection of lung cancer in mice via noninvasive pulmonary protease profiling
Authors: Jesse D. Kirkpatrick, Andrew D. Warren, Ava P. Soleimany, Peter M. K. Westcott, Justin C. Voog, Carmen Martin-Alonso, Heather E. Fleming, Tuomas Tammela, Tyler Jacks, Sangeeta N. Bhatia
Journal: Science Translational Medicine (2020)

Lung cancer is the leading cause of cancer-related death, and patients most commonly present with incurable advanced-stage disease. U.S. national guidelines recommend screening for high-risk patients with low-dose computed tomography, but this approach has limitations including high false-positive rates. Activity-based nanosensors can detect dysregulated proteases in vivo and release a reporter to provide a urinary readout of disease activity. Here, we demonstrate the translational potential of activity-based nanosensors for lung cancer by coupling nanosensor multiplexing with intrapulmonary delivery and machine learning to detect localized disease in two immunocompetent genetically engineered mouse models. The design of our multiplexed panel of sensors was informed by comparative transcriptomic analysis of human and mouse lung adenocarcinoma datasets and in vitro cleavage assays with recombinant candidate proteases. Intrapulmonary administration of the nanosensors to a Kras- and Trp53-mutant lung adenocarcinoma mouse model confirmed the role of metalloproteases in lung cancer and enabled accurate detection of localized disease, with 100% specificity and 81% sensitivity. Furthermore, this approach generalized to an alternative autochthonous model of lung adenocarcinoma, where it detected cancer with 100% specificity and 95% sensitivity and was not confounded by lipopolysaccharide-driven lung inflammation. These results encourage the clinical development of activity-based nanosensors for the detection of lung cancer.
Defining Clinical Subgroups in Relapsing Polychondritis: A Prospective Observational Cohort Study
Authors: Marcela Ferrada, Casey A. Rimland, Kaitlin Quinn, Keith Sikora, Jeff Kim, Clint Allen, Arlene Sirajuddin, Wendy Goodspeed, Marcus Chen, Peter C. Grayson
Journal: Arthritis & Rheumatology (2020)

Objective Relapsing polychondritis ( RP ) is a systemic disease. Failure to recognize RP can lead to diagnostic delay and further complications, including death. This study was undertaken to identify clinical patterns in a prospective cohort of patients with RP . Methods Patient subgroups were identified using latent class analysis based on 8 clinical variables: saddle‐nose deformity, subglottic stenosis, tracheomalacia, bronchomalacia, ear chondritis, tenosynovitis/synovitis, inflammatory eye disease, and audiovestibular disease. Model selection was based on Akaike's information criterion. Results Seventy‐three patients were included in this study. Patients were classified into 1 of 3 subgroups: type 1 RP (14%), type 2 RP (29%), and type 3 RP (58%). Type 1 RP was characterized by ear chondritis (100%), tracheomalacia (100%), saddle‐nose deformity (90%), and subglottic stenosis (80%). These patients had the shortest median time to diagnosis (1 year), highest disease activity, and greatest frequency of admission to the intensive care unit and tracheostomy. Type 2 RP was characterized by tracheomalacia (100%) and bronchomalacia (52%), but no saddle‐nose deformity or subglottic stenosis. These patients had the longest median time to diagnosis (10 years) and highest percentage of work disability. Type 3 RP was characterized by tenosynovitis/synovitis (60%) and ear chondritis (55%). There were no significant differences in sex, race, or treatment strategies between the 3 subgroups. Conclusion Our findings indicate that there are 3 subgroups of patients with RP , with differences in time to diagnosis, clinical and radiologic characteristics, and disease‐related complications. Recognizing a broader spectrum of clinical patterns in RP , beyond cartilaginous involvement of the ear and upper airway, may facilitate more timely diagnosis.
18F-Fluorodeoxyglucose Uptake in Patient With Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (Coronavirus Disease 2019) Referred to Positron Emission Tomography/Computed Tomography for NSCLC Restaging
Authors: Giulia Polverari, Vincenzo Arena, Francesco Ceci, Ettore Pelosi, Annarita Ianniello, Elena Poli, Alberto Sandri, Daniele Penna
Journal: Journal of Thoracic Oncology (2020)
Defining Undertreatment and Overtreatment in Older Adults With Cancer: A Scoping Literature Review
Authors: Clark DuMontier, Kah Poh Loh, Paul A. Bain, Rebecca A. Silliman, Tammy Hshieh, Gregory A. Abel, Benjamin Djulbegovic, Jane A. Driver, William Dale
Journal: Journal of Clinical Oncology (2020)

PURPOSE The terms undertreatment and overtreatment are often used to describe inappropriate management of older adults with cancer. We conducted a comprehensive scoping review of the literature to clarify the meanings behind the use of the terms. METHODS We searched PubMed (National Center for Biotechnology Information), Embase (Elsevier), and CINAHL (EBSCO) for titles and abstracts that included the terms undertreatment or overtreatment with regard to older adults with cancer. We included all types of articles, cancer types, and treatments. Definitions of undertreatment and overtreatment were extracted, and categories underlying these definitions were derived through qualitative analysis. Within a random subset of articles, C.D. and K.P.L. independently performed this analysis to determine final categories and then independently assigned these categories to assess inter-rater reliability. RESULTS Articles using the terms undertreatment (n = 236), overtreatment (n = 71), or both (n = 51) met criteria for inclusion in our review (n = 256). Only 14 articles (5.5%) explicitly provided formal definitions; for the remaining, we inferred the implicit definitions from the terms’ surrounding context. There was substantial agreement (κ = 0.81) between C.D. and K.P.L. in independently assigning categories of definitions within a random subset of 50 articles. Undertreatment most commonly implied less than recommended therapy (148; 62.7%) or less than recommended therapy associated with worse outcomes (88; 37.3%). Overtreatment most commonly implied intensive treatment of an older adult in whom the harms of treatment outweigh the benefits (38; 53.5%) or intensive treatment of a cancer not expected to affect an older adult in his/her remaining lifetime (33; 46.5%). CONCLUSION Undertreatment and overtreatment of older adults with cancer are imprecisely defined concepts. We propose new, more rigorous definitions that account for both oncologic factors and geriatric domains.
Letter to the Editor: Thromboelastography‐Guided Blood Product Transfusion in Cirrhosis With Coagulopathy: Real Saving or Just Less Waste?
Authors: Massimo Primignani, Giulia Tosetti, Armando Tripodi
Journal: Hepatology (2020)

Potential conflict of interest: Nothing to report. To the Editor: We read with interest the article by Kumar et al.(1) and wish to make comments. A thromboelastography (TEG)–guided transfusion policy (with arbitrary thresholds of r > 10 minutes for fresh frozen plasma [FFP] and maximal amplitude [MA] <55 mm for platelet transfusion) led to sparing blood products compared to standard of care (SOC) in patients with advanced cirrhosis, nonvariceal bleeding, and coagulopathy, defined by an international normalized ratio (INR) >1.8 and/or a platelet count <50 × 109/L. Presently, all acknowledge that the INR is inappropriate to investigate the coagulopathy of patients with cirrhosis, partly due to the absence of thrombomodulin in its formulation. Instead, thrombin generation (TG) assays performed with thrombomodulin, mimicking what occurs in vivo, indicate that TG is normal/increased in cirrhosis because of the deficiency of both procoagulants and anticoagulants.(2) Furthermore, infusion of FFP in patients with cirrhosis prior to invasive procedures does not modify TG, despite INR shortening.(3) Accordingly, although INR‐based guidelines are still pervasively applied worldwide, they should be reconsidered. Kumar et al.(1) arbitrarily chose a TEG reaction time of >10 minutes as an indication for FFP infusion. Such a policy allowed sparing 50% of FFP units but does not answer the question of whether FFP is really required. We surmise that if the clotting system is rebalanced, FFP infusion lacks biological plausibility. What about platelets? Kumar et al.(1) chose an MA <55 mm to guide platelet transfusion and spared 50% platelet units. Again, such a threshold might be questionable as elevated von Willebrand factor levels in cirrhosis support in vitro platelet adhesion, despite reduced platelet count.(2) Besides primary hemostasis, platelets support TG by assembling activated coagulation factors on their surface. The platelet count still able to secure in vitro TG corresponding to the lower reference limit is around 60 × 109/L.(2) Thus, and at variance with FFP infusion, a rationale for platelet infusion in patients with thrombocytopenic cirrhosis exists, though the effect ex vivo of a single adult platelet unit in such patients barely affects TG or thromboelastometry.(4) In conclusion, although TEG‐guided policy allows sparing FFP or platelet transfusion compared to SOC, it is not biologically plausible. Whether such sparing of resources is a real benefit rather than a lesser waste should be ascertained by studies comparing TEG‐guided transfusion versus restrictive protocols (i.e., no transfusion, unless severe coagulation derangement), which have not been considered in most studies dealing with thromboelastometry‐guided transfusion policy.
Effectiveness of one-time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population-based cohort study
Authors: Ru Chen, Yong Liu, Guohui Song, Bianyun Li, Deli Zhao, Zhaolai Hua, Xinzheng Wang, Jun Li, Changqing Hao, Liwei Zhang, Shuzheng Liu, Jialin Wang, Jinyi Zhou, Yongzhen Zhang, Bo Li, Yanyan Li, Xiang Feng, Lin Li, Zhiwei Dong, Wenqiang Wei, Guiqi Wang
Journal: Gut (2020)

Objectives To estimate the effectiveness of endoscopic screening programme in reducing incidence and mortality of upper gastrointestinal cancer in high risks areas of China. Design This multicentre population-based cohort study was conducted in six areas in China from 2005 to 2015. All permanent residents aged 40 to 69 years were identified as target subjects. We refer to those who were invited for screening collectively as the invited group. Of these, we classify those who were invited and undertook endoscopic screening as the screened group and those who were invited but did not accept screening as the non-screened group. Target subjects who were not invited to the screening were assigned to the control group. The effectiveness of the endoscopic screening and screening programme were evaluated by comparing reductions in incidence and mortality from upper gastrointestinal cancer in the screened and invited group with control group. Results Our cohort analysis included 637 500 people: 299 483 in the control group and 338 017 in the invited to screening group, 113 340 (33.53%) of whom were screened eventually. Compared with subjects in the control group, upper gastrointestinal cancer incidence and mortality decreased by 23% (relative risk (RR)=0.77, 95% CI 0.74 to 0.81) and 57% (RR=0.43, 95% CI 0.40 to 0.47) in the screened group, respectively, and by 14% (RR=0.86, 95% CI 0.84 to 0.89) and 31% (RR=0.69, 95% CI 0.66 to 0.72) in the invited group, respectively. Conclusion Among individuals aged 40 to 69 years in high risk areas of upper gastrointestinal cancer, one-time endoscopic screening programme was associated with a significant decrease in upper gastrointestinal cancer incidence and mortality.
The doctors navigating covid-19 with no internet
Authors: Puja Changoiwala
Journal: BMJ (2020)

Like many countries, India has entered a nationwide shut-in to protect its 1.3 billion citizens from coronavirus. But communications blackouts in the conflicted region of Jammu and Kashmir make lockdown doubly frightening, confusing, and dangerous, writes <b>Puja Changoiwala</b>
Clinician Burnout and Professional Well-being—Reply
Authors: Pascale Carayon, Christine Cassel, Victor J. Dzau
Journal: JAMA (2020)

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Gender in idiopathic pulmonary fibrosis diagnosis: time to address unconscious bias
Authors: Mary E Strek
Journal: Thorax (2020)

Physicians have long incorporated gender into their diagnostic algorithms of pulmonary disease in an effort to use available clinical clues when a single confirmatory diagnostic test does not exist. Gender is thought to be a relevant patient characteristic in phenotyping lung disease with a female predominance noted in patients with adult-onset asthma and male predominance in idiopathic pulmonary fibrosis (IPF).1 2 Gender also may be of prognostic value in individual patients; severity of asthma is associated with female sex and increased mortality in interstitial lung disease (ILD) with male gender.2 3 While gender may increase diagnostic confidence, if the strength of the gender and disease association is not based on rigorously validated data, inaccurate diagnosis or underdiagnosis may result. In an earlier era, the failure to diagnose COPD in women was associated with gender bias when formally studied.4 More recently, the stereotype of the male smoker with lung cancer has been upended by the surprising data demonstrating higher lung cancer incidence rates in young women as compared with young men, not explained by differences in cigarette smoking.5

In this issue, Dr Assayag and colleagues investigate the role of gender in making a confident diagnosis of IPF, and conclude there is evidence for bias when …
Abstract 11415: Potatoes and Cardiometabolic Health: A Randomized, Cross-over Study
Authors: Emily A Johnston, Kristina S Petersen, Penny M Kris-Etherton
Journal: Circulation (2019)

Intake of potassium (K+), a nutrient of public health concern, is inversely associated with blood pressure (BP) and vascular function. Potatoes are a rich source of K+, but are also carbohydrate (C...