tbuckley/cabot-search huggingface dataset:
Improvement in appropriateness and diagnostic yield of fast-track endoscopy during the COVID-19 pandemic in Northern Italy
Authors: Gianpiero Manes, Simone Saibeni, Lucienne Pellegrini, Desiree Picascia, Fabio Pace, Mario Schettino, Cristina Bezzio, Germana de Nucci, Cesare Hassan, Alessandro Repici
Journal: Endoscopy (2020)

During the COVID-19 outbreak in Italy, only fast-track endoscopic procedures have been performed; nevertheless, a significant drop in their number has been reported. We evaluated whether the pandemic has impacted the appropriateness and diagnostic yield of fast-track endoscopic procedures compared with those performed in 2019.This retrospective study involved endoscopy services in Northern Italy. We compared data regarding endoscopic procedures performed in March and April 2020 with those performed during the same period in 2019.In 2020, there was a 53.6 % reduction in the number of fast-track endoscopic procedures compared with 2019. Patients undergoing endoscopy in 2020 were younger than in 2019. Both appropriate referral and diagnostic yield increased in 2020 for both upper and lower endoscopy. A higher rate of cancer was diagnosed in 2020 by upper endoscopy (3.6 % vs. 6.6 %; P = 0.04).The high level of inappropriate endoscopy referrals registered in 2019 significantly improved during the COVID-19 outbreak of 2020, with an increase in the diagnostic yield.
The clinical characterization of the adult patient with depression aimed at personalization of management
Authors: Mario Maj, Dan J. Stein, Gordon Parker, Mark Zimmerman, Giovanni A. Fava, Marc De Hert, Koen Demyttenaere, Roger S. McIntyre, Thomas Widiger, Hans‐Ulrich Wittchen
Journal: World Psychiatry (2020)

Depression is widely acknowledged to be a heterogeneous entity, and the need to further characterize the individual patient who has received this diagnosis in order to personalize the management plan has been repeatedly emphasized. However, the research evidence that should guide this personalization is at present fragmentary, and the selection of treatment is usually based on the clinician's and/or the patient's preference and on safety issues, in a trial‐and‐error fashion, paying little attention to the particular features of the specific case. This may be one of the reasons why the majority of patients with a diagnosis of depression do not achieve remission with the first treatment they receive. The predominant pessimism about the actual feasibility of the personalization of treatment of depression in routine clinical practice has recently been tempered by some secondary analyses of databases from clinical trials, using approaches such as individual patient data meta‐analysis and machine learning, which indicate that some variables may indeed contribute to the identification of patients who are likely to respond differently to various antidepressant drugs or to antidepressant medication vs. specific psychotherapies. The need to develop decision support tools guiding the personalization of treatment of depression has been recently reaffirmed, and the point made that these tools should be developed through large observational studies using a comprehensive battery of self‐report and clinical measures. The present paper aims to describe systematically the salient domains that should be considered in this effort to personalize depression treatment. For each domain, the available research evidence is summarized, and the relevant assessment instruments are reviewed, with special attention to their suitability for use in routine clinical practice, also in view of their possible inclusion in the above‐mentioned comprehensive battery of measures. The main unmet needs that research should address in this area are emphasized. Where the available evidence allows providing the clinician with specific advice that can already be used today to make the management of depression more personalized, this advice is highlighted. Indeed, some sections of the paper, such as those on neurocognition and on physical comorbidities, indicate that the modern management of depression is becoming increasingly complex, with several components other than simply the choice of an antidepressant and/or a psychotherapy, some of which can already be reliably personalized.
The Relationship between AKI and CKD in Patients with Type 2 Diabetes: An Observational Cohort Study
Authors: Simona Hapca, Moneeza K. Siddiqui, Ryan S.Y. Kwan, Michelle Lim, Shona Matthew, Alex S.F. Doney, Ewan R. Pearson, Colin N.A. Palmer, Samira Bell
Journal: Journal of the American Society of Nephrology (2020)

There are few observational studies evaluating the risk of AKI in people with type 2 diabetes, and even fewer simultaneously investigating AKI and CKD in this population. This limits understanding of the interplay between AKI and CKD in people with type 2 diabetes compared with the nondiabetic population.In this retrospective, cohort study of participants with or without type 2 diabetes, we used electronic healthcare records to evaluate rates of AKI and various statistical methods to determine their relationship to CKD status and further renal function decline.We followed the cohort of 16,700 participants (9417 with type 2 diabetes and 7283 controls without diabetes) for a median of 8.2 years. Those with diabetes were more likely than controls to develop AKI (48.6% versus 17.2%, respectively) and have preexisting CKD or CKD that developed during follow-up (46.3% versus 17.2%, respectively). In the absence of CKD, the AKI rate among people with diabetes was nearly five times that of controls (121.5 versus 24.6 per 1000 person-years). Among participants with CKD, AKI rate in people with diabetes was more than twice that of controls (384.8 versus 180.0 per 1000 person-years after CKD diagnostic date, and 109.3 versus 47.4 per 1000 person-years before CKD onset in those developing CKD after recruitment). Decline in eGFR slope before AKI episodes was steeper in people with diabetes versus controls. After AKI episodes, decline in eGFR slope became steeper in people without diabetes, but not among those with diabetes and preexisting CKD.Patients with diabetes have significantly higher rates of AKI compared with patients without diabetes, and this remains true for individuals with preexisting CKD.
Novel Method to Flag Cardiac Implantable Device Infections by Integrating Text Mining With Structured Data in the Veterans Health Administration’s Electronic Medical Record
Authors: Hillary J. Mull, Kelly L. Stolzmann, Marlena H. Shin, Emily Kalver, Marin L. Schweizer, Westyn Branch-Elliman
Journal: JAMA Network Open (2020)

Health care-associated infections (HAIs) are preventable, harmful, and costly; however, few resources are dedicated to infection surveillance of nonsurgical procedures, particularly cardiovascular implantable electronic device (CIED) procedures.To develop a method that includes text mining of electronic clinical notes to reliably and efficiently measure HAIs for CIED procedures.In this multicenter, national cohort study using electronic medical record data for patients undergoing CIED procedures in Veterans Health Administration (VA) facilities for fiscal years (FYs) 2016 and 2017, an algorithm to flag cases with a true CIED-related infection based on structured (eg, microbiology orders, vital signs) and free text diagnostic and therapeutic data (eg, procedure notes, discharge summaries, microbiology results) was developed and validated. Procedure data were divided into development and validation data sets. Criterion validity (ie, positive predictive validity [PPV], sensitivity, and specificity) was assessed via criterion-standard manual medical record review.CIED procedure.The concordance between medical record review and the study algorithm with respect to the presence or absence of a CIED infection. CIED infection in the algorithm included 90-day mortality, congestive heart failure and nonmetastatic tumor comorbidities, CIED or surgical site infection International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes, antibiotic treatment of Staphylococci, a microbiology test of a cardiac specimen, and text documentation of infection in specific clinical notes (eg, cardiology, infectious diseases, inpatient discharge summaries).The algorithm sample consisted of 19 212 CIED procedures; 15 077 patients (78.5%) were White individuals, 1487 (15.5%) were African American; 18 766 (97.7%) were men. The mean (SD) age in our sample was 71.8 (10.6) years. The infection detection threshold of predicted probability was set to greater than 0.10 and the algorithm flagged 276 of 9606 (2.9%) cases in the development data set (9606 procedures); PPV in this group was 41.4% (95% CI, 31.6%-51.8%). In the validation set (9606 procedures), at predicted probability 0.10 or more the algorithm PPV was 43.5% (95% CI, 37.1%-50.2%), and overall sensitivity and specificity were 94.4% (95% CI, 88.2%-97.9%) and 48.8% (95% CI, 42.6%-55.1%), respectively.The findings of this study suggest that the method of combining structured and text data in VA electronic medical records can be used to expand infection surveillance beyond traditional boundaries to include outpatient and procedural areas.
Wide Complex QRS Rhythm in a 52-Year-Old Man With Altered Mental Status
Authors: Joseph S. Krivda, Michael U. Williams, Takor B. Arrey-Mbi
Journal: Circulation (2020)

ECG CHALLENGEA 52-year-old man with a history of hypertension, depression, stage 3 chronic kidney disease, alcohol abuse complicated by necrotizing pancreatitis with subsequent necrosectomy, chronic abdominal pain controlled with methadone, and a prior episode of cardiac arrest (unremarkable cardiac workup that included an echocardiogram, ambulatory monitor, nuclear stress test, and coronary angiogram) was found unresponsive at home, and on presentation to the emergency department, he reported diffuse abdominal tenderness, was somnolent with slurred speech, and denied chest pain and palpitations.Current medications include metoprolol succinate, pantoprazole, tamsulosin, pancrelipase, sertraline, nortriptyline, ondansetron, methadone, and gabapentin.Examination revealed tachycardia at 113 beats per minute, diffuse abdominal tenderness, and inability to follow multistep commands.ECG was ordered and evaluated by a cardiologist (Figure 1).Laboratory studies revealed elevated
Fibronectin in development and wound healing
Authors: Jennifer Patten, Karin Wang
Journal: Advanced Drug Delivery Reviews (2020)

Fibronectin structure and composition regulate contextual cell signaling. Recent advances have been made in understanding fibronectin and its role in tissue organization and repair. This review outlines fibronectin splice variants and their functions, evaluates potential therapeutic strategies targeting or utilizing fibronectin, and concludes by discussing potential future directions to modulate fibronectin function in development and wound healing.
Covid-19 in the workplace
Authors: Raymond M Agius, John F R Robertson, Denise Kendrick, Herb F Sewell, Marcia Stewart, Martin McKee
Journal: BMJ (2020)

Faced with a novel lethal virus, employers have struggled to implement their legal duty to protect staff from harm in the workplace.There is no international case definition for attributing an occupational origin to covid-19 cases, and the World Health Organization has so far prepared a surveillance protocol only for healthcare workers. 1 Employers are accountable, in the UK, to the Health and Safety Executive (HSE) and must notify it when there is "reasonable evidence" of a worker contracting covid-19 through occupational exposure. 2 3In general, HSE expects to be notified if it is "more likely than not that the person's work was the source of exposure-as opposed to general societal exposure."However, HSE also states that work with the general public-as opposed to work with people known to be infected-is not usually sufficient to trigger reporting. 2HSE has published a technical summary of the 8666 notifications of covid-19 in workers in England, Scotland, and Wales, including 125 deaths, from 10 April to 8 August. 4Data before 10 April 2020 are excluded because of a change in methods.The weekly number of notifications peaked at 1183 (including 23 deaths) in the week ending 2 May 2020, two weeks later than the peak of deaths among the general population, as reported by the Office for National Statistics (ONS). 51 World Health Organization.Surveillance protocol for SARS-CoV-2 infection among health workers.2020.https://apps.who.
Engineering of a Core–Shell Nanoplatform to Overcome Multidrug Resistance via ATP Deprivation
Authors: Genhua Liu, Liucan Wang, Junjie Liu, Lu Lu, Dong Mo, Ke Li, Xin Yang, Rui Zeng, Jixi Zhang, Peng Liu, Kaiyong Cai
Journal: Advanced Healthcare Materials (2020)

Abstract Inhibiting the function of P‐glycoprotein (P‐gp) transporter, which causes drug efflux through adenosine triphosphate (ATP)‐dependent manner, has become an effective strategy to conquer multidrug resistance (MDR) of cancer cells. However, there remains challenges for effective co‐delivery, sequential release of P‐gp modulator and chemotherapeutic agent. In this work, a novel type of core–shell nanoparticle is reported. It can independently encapsulate a high amount (about 683 µg mg −1 ) of chemotherapeutic agent doxorubicin (DOX) in the mesoporous polydopamine (MPDA) core and glucose oxidase (GOx) in the zeolite imidazolate frameworks‐8 (ZIF‐8) shell, namely MPDA@ZIF‐8/DOX+GOx. The fast release of GOx triggered by acid‐sensitive degradation of the ZIF‐8 shell consumes glucose to starve cancer cells for ATP deprivation and effective suppress ATP‐dependent drug efflux in advance, and then effectively facilitates the accumulation of DOX in MCF‐7/ADR cancer cells. Experiments in vitro and in vivo demonstrate that the fabricated nanosystem can dramatically improve anticancer effects for MDR through sequential release property and exhibit excellent biocompatibility. Overall, this work reveals new insights in the use of GOx for MDR treatment.
High-speed large-scale automated isolation of SARS-CoV-2 from clinical samples using miniaturized co-culture coupled to high-content screening
Authors: Rania Francis, Marion Le Bideau, Priscilla Jardot, Clio Grimaldier, Didier Raoult, Jacques Yaacoub Bou Khalil, Bernard La Scola
Journal: Clinical Microbiology and Infection (2020)
Radiotheranostic Agent 64Cu-cyclam-RAFT-c(-RGDfK-)4 for Management of Peritoneal Metastasis in Ovarian Cancer
Authors: Zhao-Hui Jin, Atsushi B. Tsuji, Mélissa Degardin, Aya Sugyo, Satoshi Obara, Hidekatsu Wakizaka, Kotaro Nagatsu, Kuan Hu, Ming-Rong Zhang, Pascal Dumy, Didier Boturyn, Tatsuya Higashi
Journal: Clinical Cancer Research (2020)

Ovarian cancer peritoneal metastases (OCPMs) are a pathophysiologically heterogeneous group of tumors that are rarely curable. αVβ3 integrin (αVβ3) is overexpressed on tumoral neovessels and frequently on ovarian cancer cells. Here, using two clinically relevant αVβ3-positive OCPM mouse models, we studied the theranostic potential of an αVβ3-specific radiopeptide, 64Cu-cyclam-RAFT-c(-RGDfK-)4 (64Cu-RaftRGD), and its intra- and intertumoral distribution in relation to the tumor microenvironment.αVβ3-expressing peritoneal and subcutaneous models of ovarian carcinoma (IGR-OV1 and NIH:OVCAR-3) were established in nude mice. 64Cu-RaftRGD was administered either intravenously or intraperitoneally. We performed intratumoral distribution (ITD) studies, PET/CT imaging and quantification, biodistribution assay and radiation dosimetry, and therapeutic efficacy and toxicity studies.Intraperitoneal administration was an efficient route for targeting 64Cu-RaftRGD to OCPMs with excellent tumor penetration. Using the fluorescence surrogate, Cy5.5-RaftRGD, in our unique high-resolution multifluorescence analysis, we found that the ITD of 64Cu-RaftRGD was spatially distinct from, but complementary to, that of hypoxia. 64Cu-RaftRGD-based PET enabled clear visualization of multiple OCPM deposits and ascites and biodistribution analysis demonstrated an inverse correlation between tumor uptake and tumor size (1.2-17.2 mm). 64Cu-RaftRGD at a radiotherapeutic dose (148 MBq/0.357 nmol) showed antitumor activities by inhibiting tumor cell proliferation and inducing apoptosis, with negligible toxicity.Collectively, these results demonstrate the all-in-one potential of 64Cu-RaftRGD for imaging guided radiotherapy of OCPM by targeting both tumoral neovessels and cancerous cells. On the basis of the ITD finding, we propose that pairing αVβ3- and hypoxia-targeted radiotherapies could improve therapeutic efficacy by overcoming the heterogeneity of ITD encountered with single-agent treatments.
Clinical Benefit of Depth of Response for Relapsed/Refractory Multiple Myeloma Patients Treated on Clinical Trials: Retrospective Analysis from Two Tertiary Centres
Authors: Hian Li Esther Chan, Dunnya De-Silva, Rakesh Popat, Neil Rabin, Ashu Wechalekar, Sufyan Achhala, Adeline Lin, Wee Joo Chng, Kwee Yong
Journal: Blood (2017)
In-Hospital Acute Strokes—Opportunities to Optimize Care and Improve Outcomes
Authors: Amy Y. X. Yu, Michael D. Hill
Journal: JAMA Neurology (2020)

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Time Course of LDL Cholesterol Exposure and Cardiovascular Disease Event Risk
Authors: Michael J. Domanski, Xin Tian, Colin O. Wu, Jared P. Reis, Amit K. Dey, Yuan Gu, Lihui Zhao, Sejong Bae, Kiang Liu, Ahmed A. Hasan, David Zimrin, Michael E. Farkouh, Charles C. Hong, Donald M. Lloyd-Jones, Valentin Fuster
Journal: Journal of the American College of Cardiology (2020)
Automatic detection of colorectal neoplasia in wireless colon capsule endoscopic images using a deep convolutional neural network
Authors: Atsuo Yamada, Ryota Niikura, Keita Otani, Tomonori Aoki, Kazuhiko Koike
Journal: Endoscopy (2020)

Although colorectal neoplasms are the most common abnormalities found in colon capsule endoscopy (CCE), no computer-aided detection method is yet available. We developed an artificial intelligence (AI) system that uses deep learning to automatically detect such lesions in CCE images.We trained a deep convolutional neural network system based on a Single Shot MultiBox Detector using 15 933 CCE images of colorectal neoplasms, such as polyps and cancers. We assessed performance by calculating areas under the receiver operating characteristic curves, along with sensitivities, specificities, and accuracies, using an independent test set of 4784 images, including 1850 images of colorectal neoplasms and 2934 normal colon images.The area under the curve for detection of colorectal neoplasia by the AI model was 0.902. The sensitivity, specificity, and accuracy were 79.0 %, 87.0 %, and 83.9 %, respectively, at a probability cutoff of 0.348.We developed and validated a new AI-based system that automatically detects colorectal neoplasms in CCE images.
Exposure to Manganese in Drinking Water during Childhood and Association with Attention-Deficit Hyperactivity Disorder: A Nationwide Cohort Study
Authors: Jörg Schullehner, Malene Thygesen, Søren Munch Kristiansen, Birgitte Hansen, Carsten Bøcker Pedersen, Søren Dalsgaard
Journal: Environmental Health Perspectives (2020)

Manganese (Mn) in drinking water may increase the risk of several neurodevelopmental outcomes, including attention-deficit hyperactivity disorder (ADHD). Earlier epidemiological studies on associations between Mn exposure and ADHD-related outcomes had small sample sizes, lacked spatiotemporal exposure assessment, and relied on questionnaire data (not diagnoses)-shortcomings that we address here.Our objective was to assess the association between exposure to Mn in drinking water during childhood and later development of ADHD.In a nationwide population-based registry study in Denmark, we followed a cohort of 643,401 children born 1992-2007 for clinical diagnoses of ADHD. In subanalyses, we classified cases into ADHD-Inattentive and ADHD-Combined subtypes based on hierarchical categorization of International Classification of Diseases (ICD)-10 codes. We obtained Mn measurements from 82,574 drinking water samples to estimate longitudinal exposure during the first 5 y of life with high spatiotemporal resolution. We modeled exposure as both peak concentration and time-weighted average. We estimated sex-specific hazard ratios (HRs) in Cox proportional hazards models adjusted for age, birth year, socioeconomic status (SES), and urbanicity.We found that exposure to increasing levels of Mn in drinking water was associated with an increased risk of ADHD-Inattentive subtype, but not ADHD-Combined subtype. After adjusting for age, birth year, and SES, females exposed to high levels of Mn (i.e., >100μg/L) at least once during their first 5 y of life had an HR for ADHD-Inattentive subtype of 1.51 [95% confidence interval (CI): 1.18, 1.93] and males of 1.20 (95% CI: 1.01, 1.42) when compared with same-sex individuals exposed to <5μg/L. When modeling exposure as a time-weighted average, sex differences were no longer present.Mn in drinking water was associated with ADHD, specifically the ADHD-Inattentive subtype. Our results support earlier studies suggesting a need for a formal health-based drinking water guideline value for Mn. Future Mn-studies should examine ADHD subtype-specific associations and utilize direct subtype measurements rather than relying on ICD-10 codes alone. https://doi.org/10.1289/EHP6391.
111In-Oxine-WBC SPECT/CT of Lumbosacral Facet Joint Septic Arthritis
Authors: Edgar Zamora, Ana Y. Valdivia, Arun Kumar, Kwang J. Chun
Journal: Clinical Nuclear Medicine (2020)

Spinal facet joint septic arthritis is a rare pathology associated with pyogenic organisms. It may present in older adults with back pain, fever, and positive bacterial blood cultures. However, clinical presentation may be equivocal, and diagnosis relies on anatomic imaging for differentiation from other pathologies. Magnetic resonance is considered the imaging modality of choice and has been found superior to CT; however, it is unable to differentiate facet joint septic arthritis from other inflammatory arthropathies. We present a case of lumbosacral facet joint septic arthritis as seen on In-oxine-WBC scintigraphy and SPECT/CT.