tbuckley/cabot-search huggingface dataset:
Spectral Endoscopy Enhances Contrast for Neoplasia in Surveillance of Barrett's Esophagus
Authors: Dale J. Waterhouse, Wladyslaw Januszewicz, Sharib Ali, Rebecca C. Fitzgerald, Massimiliano di Pietro, Sarah E. Bohndiek
Journal: Cancer Research (2021)

Abstract Early detection of esophageal neoplasia enables curative endoscopic therapy, but the current diagnostic standard of care has low sensitivity because early neoplasia is often inconspicuous with conventional white-light endoscopy. Here, we hypothesized that spectral endoscopy could enhance contrast for neoplasia in surveillance of patients with Barrett's esophagus. A custom spectral endoscope was deployed in a pilot clinical study of 20 patients to capture 715 in vivo tissue spectra matched with gold standard diagnosis from histopathology. Spectral endoscopy was sensitive to changes in neovascularization during the progression of disease; both non-dysplastic and neoplastic Barrett's esophagus showed higher blood volume relative to healthy squamous tissue (P = 0.001 and 0.02, respectively), and vessel radius appeared larger in neoplasia relative to non-dysplastic Barrett's esophagus (P = 0.06). We further developed a deep learning algorithm capable of classifying spectra of neoplasia versus non-dysplastic Barrett's esophagus with high accuracy (84.8% accuracy, 83.7% sensitivity, 85.5% specificity, 78.3% positive predictive value, and 89.4% negative predictive value). Exploiting the newly acquired library of labeled spectra to model custom color filter sets identified a potential 12-fold enhancement in contrast between neoplasia and non-dysplastic Barrett's esophagus using application-specific color filters compared with standard-of-care white-light imaging (perceptible color difference = 32.4 and 2.7, respectively). This work demonstrates the potential of endoscopic spectral imaging to extract vascular properties in Barrett's esophagus, to classify disease stages using deep learning, and to enable high-contrast endoscopy. Significance: The results of this pilot first-in-human clinical trial demonstrate the potential of spectral endoscopy to reveal disease-associated vascular changes and to provide high-contrast delineation of neoplasia in the esophagus.
Incidence and outcomes of poor healing and poor squamous regeneration after radiofrequency ablation therapy for early Barrett’s neoplasia
Authors: Sanne N. van Munster, Charlotte N. Frederiks, Esther A. Nieuwenhuis, Lorenza Alvarez Herrero, Auke Bogte, Alaa Alkhalaf, Boudewijn E. Schenk, Erik J. Schoon, Wouter L. Curvers, Arjun D. Koch, Steffi E. M. van de Ven, Pieter J. F. de Jonge, Thjon J. Tang, Wouter B. Nagengast, Frans T. M. Peters, Jessie Westerhof, Martin H. M. G. Houben, Jacques J. G. H. M. Bergman, Roos E. Pouw, Bas L. A. M. Weusten
Journal: Endoscopy (2021)

Background Endoscopic eradication therapy with radiofrequency ablation (RFA) is effective in most patients with Barrett’s esophagus (BE). However, some patients experience poor healing and/or poor squamous regeneration. We evaluated incidence and treatment outcomes of poor healing and poor squamous regeneration. Methods We included all patients treated with RFA for early BE neoplasia from a nationwide Dutch registry based on a joint treatment protocol. Poor healing (active inflammatory changes or visible ulcerations ≥ 3 months post-RFA), poor squamous regeneration (&lt; 50 % squamous regeneration), and treatment success (complete eradication of BE [CE-BE]) were evaluated. Results 1386 patients (median BE C2M5) underwent RFA with baseline low grade dysplasia (27 %), high grade dysplasia (30 %), or early cancer (43 %). In 134 patients with poor healing (10 %), additional time and acid suppression resulted in complete esophageal healing, and 67/134 (50 %) had normal squamous regeneration with 97 % CE-BE. Overall, 74 patients had poor squamous regeneration (5 %). Compared with patients with normal regeneration, patients with poor squamous regeneration had a higher risk for treatment failure (64 % vs. 2 %, relative risk [RR] 27 [95 % confidence interval [CI] 18–40]) and progression to advanced disease (15 % vs. &lt; 1 %, RR 30 [95 %CI 12–81]). Higher body mass index, longer BE segment, reflux esophagitis, and &lt; 50 % squamous regeneration after baseline endoscopic resection were independently associated with poor squamous regeneration in multivariable logistic regression. Conclusions In half of the patients with poor healing, additional time and acid suppression led to normal squamous regeneration and excellent treatment outcomes. In patients with poor squamous regeneration, however, the risk for treatment failure and progression to advanced disease was significantly increased.
Prognostic value of measurable residual disease monitoring by next-generation sequencing before and after allogeneic hematopoietic cell transplantation in acute myeloid leukemia
Authors: Hee-Je Kim, Yonggoo Kim, Dain Kang, Hoon Seok Kim, Jong-Mi Lee, Myungshin Kim, Byung-Sik Cho
Journal: Blood Cancer Journal (2021)

Abstract Given limited studies on next-generation sequencing-based measurable residual disease (NGS-MRD) in acute myeloid leukemia (AML) patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT), we longitudinally collected samples before and after allo-HSCT from two independent prospective cohorts ( n = 132) and investigated the prognostic impact of amplicon-based NGS assessment. Persistent mutations were detected pre-HSCT (43%) and 1 month after HSCT (post-HSCT-1m, 20%). All persistent mutations at both pre-HSCT and post-HSCT-1m were significantly associated with post-transplant relapse and worse overall survival. Changes in MRD status from pre-HSCT to post-HSCT-1m indicated a higher risk for relapse and death. Isolated detectable mutations in genes associated with clonal hematopoiesis were also significant predictors of post-transplant relapse. The optimal time point of NGS-MRD assessment depended on the conditioning intensity (pre-HSCT for myeloablative conditioning and post-HSCT-1m for reduced-intensity conditioning). Serial NGS-MRD monitoring revealed that most residual clones at both pre-HSCT and post-HSCT-1m in patients who never relapsed disappeared after allo-HSCT. Reappearance of mutant clones before overt relapse was detected by the NGS-MRD assay. Taken together, NGS-MRD detection has a prognostic value at both pre-HSCT and post-HSCT-1m, regardless of the mutation type, depending on the conditioning intensity. Serial NGS-MRD monitoring was feasible to compensate for the limited performance of the NGS-MRD assay.
AB0642 CLINICAL CHARACTERISTICS AND FACTORS ASSOCIATED WITH BONE EROSION IN GOUT PATIENTS WITH TOPHI
Authors: W. Deng, Y. Huang, Y. Liu, Z. Huang, S. Chen, Q. Huang, T. W. LI
Journal: Annals of the Rheumatic Diseases (2021)

Background: Bone erosion is a frequent complication of gout patients with tophi and can lead to joint damage, deformity and musculoskeletal disability. Few studies have focused on clinical characteristics and factors associated with bone erosion in gout patients with tophi. Objectives: The aim of this study was to describe clinical characteristics of bone erosion in gout patients with tophi. Methods: Bone erosion was detected by X-ray. Gout patients with tophi were divided into bone erosion group and non bone erosion group. The clinical characteristics were recorded. Comparison of clinical characteristics and risk factors for bone erosion were analyzed between two groups. Multivariate logistic regression analysis was conducted. Results: A total of 171 gout patients with tophi were enrolled, 121 patients with bone erosion and 50 patients without bone erosion. Bone erosion group were older, with prolonged duration with gout and tophi, higher levels of serum creatinine, lower levels of glomerular filtration rate (GFR), C-reactive protein and BMI. In univariate regression analysis, age, gout duration, tophi duration, GFR were associated with bone erosion. In multivariable logistic regression analysis, tophi duration was independently associated with bone erosion. Conclusion: Gout patients with bone erosion present different clinical characteristics compared with those without bone erosion. Tophi duration was strongly associated with bone erosion in patients with gout. Table 1. Comparison of clinical characteristics between bone erosion patients and non bone erosion patients. Non Bone erosion Bone erosion P Value N(male) 50(47) 121(118) 0.255 Age(year) 45.82±14.15 53.74±14.88 0.002 BMI (kg/m2) 26.01±4.58 24.18±4.72 0.027 WBC(10 9 /mL) 9.73±3.40 11.37±13.26 0.404 PLT(10 9 /mL) 329.86±96.22 328.31±124.02 0.938 HGB(g/L) 86.58±63.78 102.75±51.16 0.201 ALT(U/L) 37.74 ±26.56 34.26±35.26 0.561 sUA(umol/L) 540.16±121.79 539.00±121.46 0.962 sCr(umol/L) 111.47±25.26 135.77±52.43 &lt;0.001 GFR (ml/min/1.73m 2 ) 74.01±27.94 56.68±22.84 0.003 ESR(mm/h) 61.78±37.32 53.08±36.70 0.181 CRP(mg/L) 60.00±58.26 36.45±42.62 0.014 Gout duration (year) 9.22±5.46 12.63±7.59 0.001 Tophi duration(year) 3.77±3.22 6.64±4.81 0.001 Hypertension, n 17 52 0.277 Diabetes, n 9 12 0.143 Smoking history, n 20 55 0.513 Drinking history, n 14 37 0.737 Ulceration, n 10 35 0.228 Disclosure of Interests: None declared.
POS0270-HPR FLARE-OA QUESTIONNAIRE TO MEASURE FLARES IN OSTEOARTHRITIS OF THE KNEE AND HIP: ASSESSMENT OF ITS PSYCHOMETRIC PROPERTIES
Authors: Y. Traore, J. Epstein, E. Spitz, L. March, J.F. Maillefert, C. Rutherford, C. Ricatte, C. Alleyrat, M. Cross, L. King, L. Callahan, B. Fautrel, T. Buttel, G.A. Hawker, D. Hunter, F. Guillemin
Journal: Annals of the Rheumatic Diseases (2021)

Background: Hip and knee OA is characterised by disease flares – understanding the determinants and consequences of OA flares has been hampered by lack of a standardized flare measure beyond the pain aspect. The patients point of view on the different aspect of their flares is essential. Objectives: The objective was to assess the psychometric properties of a new questionnaire for measuring the multidimensional aspect of flares in OA. Methods: Using a bilingual version of the questionnaire (33 items, response on a numeric scale, from 0 to 10), a multicentre survey (Australia, France and United States) was conducted on line with patients diagnosed with OA of the hip and/or the knee. Based on an international OMERACT/OARSI endorsed definition of the five core domains (pain, swelling, stiffness, consequences of symptoms and psychological aspects) composing a flare in OA [1], a confirmatory factorial analysis linked to the content analysis has been used to reduce the number of items and to determine the validity of the structure. The Flare-OA questionnaire (score from 0 to 100) has been tested in French and English for its internal consistency, its convergent validity with HOOS/KOOS and Mini-OAKHQOL questionnaires, and its discriminant validity. Results: Out of 398 patients (mean age 64 years old) who completed the questionnaire, 70.4% were female and 86.7% had knee OA. The confirmatory factorial analysis retained a model with 19 items (RMSEA =0.06; SRMR =0.04; CFI =0.96 and TLI = 0.94). The Cronbach Alpha was &gt; 0.9 for the 5 domains and for the whole questionnaire. The correlations between the Flare-OA and the other instruments were in line with that hypothesis flare is related but different from other concepts usually measured. The discriminant validity was evidenced by a significant score difference (31.8; p&lt;0,0001) between patients with and without flare, i.e. over twice the standard measurement error. Conclusion: The optimized Flare-OA questionnaire (19 items) is a reliable and valid instrument freely available from the authors for measuring the frequency and severity of flare in knee and hip OA in clinical research. References: [1]King LK, Epstein J, Cross M, et al. Establishing the Domains of Knee and Hip Osteoarthritis (OA) Flare: A Report from the OMERACT 2020 Inaugural Virtual Consensus Vote from the Flares in OA Working Group. (Submitted) Disclosure of Interests: None declared
Neuroblastoma Shown on 18F-DOPA PET/CT Performed to Evaluate Congenital Hyperinsulinism
Authors: Sophia R. O’Brien, Lisa J. States, Hongming Zhuang
Journal: Clinical Nuclear Medicine (2021)

Abstract 18 F-DOPA PET/CT was performed to evaluate congenital hyperinsulinism in a 55-day-old boy with hypoglycemia. The images revealed not only a focal 18 F-DOPA–avid lesion in the pancreas but also in a left thoracic paraspinal neuroblastoma.
POS0438 IS IMAGING DETECTED JOINT INFLAMMATION HELPFUL IN EXPLAINING FATIGUE IN RHEUMATOID ARTHRITIS AT DIAGNOSIS AND DURING THE DISEASE COURSE? – A LARGE MRI STUDY
Authors: X. Matthijssen, F. Wouters, N. Sidhu, A. van der Helm - van Mil
Journal: Annals of the Rheumatic Diseases (2021)

Background: Fatigue in rheumatoid arthritis (RA) is hypothesized to be caused by inflammation. Still ~50% of fatigue in RA cannot be explained by the disease activity score (DAS), nor by generic or psychological factors. Objectives: Since MRI can detect joint inflammation more sensitively than DAS, we hypothesized that residual inflammation detected by MRI could aid in explaining fatigue in RA at diagnosis and during follow-up. Methods: 526 consecutive RA-patients were followed longitudinally. Fatigue was assessed yearly on a numerical rating scale. Hand and foot MRIs were performed at inclusion, after 12 and 24-months in 199 patients and were scored for inflammation (synovitis, tenosynovitis and osteitis combined). We studied whether RA-patients with more MRI-inflammation were more fatigued at diagnosis (linear regression), whether the 2-year course of MRI-inflammation associated with the course of fatigue (linear mixed models) and whether decrease in MRI-inflammation in year-1 associated with subsequent improvement in fatigue in year-2 (cross-lagged models). Similar analyses were done with DAS as inflammation measure. Results: At diagnosis, higher DAS-scores were associated with more severe fatigue (p&lt;0.001). However, patients with more MRI-inflammation were not more fatigued (p=0.94). During 2-year follow-up, DAS decrease associated with improvement in fatigue (p&lt;0.001), but MRI-inflammation decrease did not (p=0.96). DAS decrease in year-1 associated with fatigue improvement in year-2 (p=0.012), as did MRI-inflammation decrease (p=0.039), with similar effect strength. Conclusion: Sensitive measurements of joint inflammation did not aid in explaining fatigue in RA at diagnosis and follow-up. This supports the concept that fatigue in RA is partly uncoupled from inflammation. Disclosure of Interests: None declared
Marking the 40th Anniversary of the AIDS Epidemic — American Physicians Look Back
Authors: Ronald Bayer, Gerald M. Oppenheimer, Valentina Parisi
Journal: New England Journal of Medicine (2021)

At a time when the world is gripped by the Covid-19 pandemic, early AIDS doctors look back on 40 years of HIV/AIDS. Many of them first encountered AIDS when they were in their early 30s, and their lives have been shaped to a large extent by that earlier pandemic.
Outbreak of OXA-48-producing Enterobacterales in a haematological ward associated with an uncommon environmental reservoir, France, 2016 to 2019
Authors: Sarah Jolivet, Jeanne Couturier, Xavier Vuillemin, Cyril Gouot, Didier Nesa, Marine Adam, Eolia Brissot, Mohamad Mohty, Rémy A Bonnin, Laurent Dortet, Frédéric Barbut
Journal: Eurosurveillance (2021)

The hospital water environment, including the wastewater drainage system, is increasingly reported as a potential reservoir for carbapenemase-producing Enterobacterales (CPE). We investigated a persistent outbreak of OXA-48 CPE (primarily Citrobacter freundii) in a haematological ward of a French teaching hospital by epidemiological, microbiological and environmental methods. Between January 2016 and June 2019, we detected 37 new OXA-48 CPE-colonised and/or ‑infected patients in the haematological ward. In October 2017, a unit dedicated to CPE-colonised and/or ‑infected patients was created. Eleven additional sporadic acquisitions were identified after this date without any obvious epidemiological link between patients, except in one case. Environmental investigations of the haematological ward (June-August 2018) identified seven of 74 toilets and one of 39 drains positive for OXA-48 CPE (seven C. freundii, one Enterobacter sakazakii, one Escherichia coli). Whole genome comparisons identified a clonal dissemination of OXA-48-producing C. freundii from the hospital environment to patients. In addition to strict routine infection control measures, an intensive cleaning programme was performed (descaling and bleaching) and all toilet bowls and tanks were changed. These additional measures helped to contain the outbreak. This study highlights that toilets can be a possible source of transmission of OXA-48 CPE.
POS0561 OBESITY PHENOTYPES IN EARLY RHEUMATOID ARTHRITIS
Authors: Y. Gorbunova, T. Popkova, L. Kondrateva, M. Cherkasova, E. Nasonov, A. Lila
Journal: Annals of the Rheumatic Diseases (2021)

Background: Patients with rheumatoid arthritis (RA) and obesity have a lower risk of early death than patients with normal weight due to the so-called “obesity paradox”. Available publications discuss three phenotypes of obesity: classical obesity, metabolically healthy overweight/obesity, and latent obesity (normal weight associated with metabolic disorders, most importantly - with insulin resistance and adipocytokines imbalance). Objectives: To clarify the prevalence of obesity phenotypes and to identify factors predisposing to «latent obesity» in early RA without diabetes mellitus or hyperglycemia. Methods: The study included 35 pts (23 women, 12 men) with early RA (criteria ACR / EULAR, 2010), 56 [43,0; 60,0] years old, naïve to treatment with glucocorticoids and disease-modifying anti-rheumatics, without established diabetes mellitus. Pts were seropositive for IgM RF and anti-CCP, with highly active RA (DAS28 5,9 [5,2; 6,4]; SDAI 35,4 [27,0; 45,8], and CDAI 31,0 [26,0; 44,0]) scores, and median disease duration of 8.0 [6,0;15.0] months. Electrochemiluminescence assay Elecsys (Roche Diagnostics) was used to measure patients’ insulin levels, and ELISA (DBS – Diagnostics Biochem Canada Inc.) - for evaluation of serum leptin concentrations. Insulin resistance (IR) was defined as Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) ≥2,77. Leptin levels were considered elevated at values ≥11,1 ng/ml for women, ≥5,6 ng/ml for men. The overweight/obesity status was determined by World Health Organization criteria in pts with body mass index (BMI) ≥25kg/m 2 . Results: Overweight/obesity were documented in 19 (54, 3%) pts with early RA, 4/19 (21%) had high leptin levels and IR, 11/19 (58%) had isolated hyperleptinemia. Normal BMI was found in 16 (45,7%) pts with early RA, 2/16 (12,5%) had elevated leptin levels and IR, and 6/16 (37,5%) – only hyperleptinemia. Four (21%) out of 19 overweight and 8 (50%) out of 16 pts with normal BMI did not show any metabolic disorders (p=0,02). Сlassical obesity was found in 15 (43%), and latent obesity – in 8 (23%) pts with early RA. Leptin levels correlated with waist circumference (r=0,58, p =0,02), BMI (r=0,71, p =0,0006), ESR (r=0,5, p =0,02) in the overweight/obese pts, and with waist circumference (r=0,59, p =0,03), IgM RF (r=0,58, p =0,03), triglyceride levels (r=0,77, p =0,003), and atherogenic index (r=0,62, p =0,03) in pts with normal weight. Conclusion: The classical obesity phenotype associated with abdominal obesity and inflammation was the most common and prevailing over other phenotypes in early RA. Latent obesity was less common and was associated with an unfavorable lipid profile and accumulation of abdominal fat, therefore increasing the risk of cardiovascular diseases in RA. Metabolically healthy overweight/obesity in early RA was really a rare phenotype. Disclosure of Interests: None declared
Evaluation of bronchial wall thickness in asthma using magnetic resonance imaging
Authors: Ilyes Benlala, Gaël Dournes, Pierre-Olivier Girodet, Thomas Benkert, François Laurent, Patrick Berger
Journal: European Respiratory Journal (2021)

<b>Magnetic resonance imaging of the lung using sequences with ultrashort echo times is a radiation-free alternative to computed tomography to assess bronchial thickness in asthma, and will help improve the management of severe asthma</b>https://bit.ly/3fGLE4B
Broad clinical spectrum of SARS-CoV-2-associated inflammatory joint disease in adults: a report of 35 cases from the COVID-19 &amp; Autoimmune Systemic Disease Italian study group
Authors: Francesco Ursini, Piero Ruscitti, Salvatore D'Angelo, Fabio Cacciapaglia, Rossella De Angelis, Corrado Campochiaro, Francesco Caso, Maria De Santis, Ilenia Di Cola, Simone Parisi, Vincenzo Raimondo, Giuseppina Abignano, Luisa Costa, Jacopo Ciaffi, Lorenzo Dagna, Annamaria Iagnocco, Florenzo Iannone, Riccardo Meliconi, Roberto Giacomelli, Clodoveo Ferri
Journal: Annals of the Rheumatic Diseases (2021)

Large cohort studies demonstrated that a sizeable proportion of patients with acute COVID-19 present with symptoms or signs of rheumatological interest such as arthralgia/myalgia, inflammatory skin lesions and/or autoantibodies positivity.1 Subsequent clinical observations disclosed the existence of a post-acute COVID-19 syndrome, characterised by a large constellation of manifestations including fatigue, arthralgia and myalgia.2 The potential role of viruses in the development of rheumatic diseases is well recognised, either as causative agents or antigenic triggers for the ensuing development of autoimmunity.3 Consistent with these premises, from the earliest phases of the pandemic, inflammatory musculoskeletal manifestations following COVID-19 have been described in isolated case reports although no systematically collected cohorts are still available to unveil the clinical spectrum of post-COVID-19 arthritis.4

To contribute to shed light on this field, in December 2020, we built a web-based survey platform and invited all members of our study group to submit cases of inflammatory …
Exercise Standards for Testing and Training
Authors: Gerald F. Fletcher, Gary J. Balady, Ezra A. Amsterdam, Bernard Chaitman, Robert Eckel, Jerome Fleg, Victor F. Froelicher, Arthur S. Leon, Ileana L. Piña, Roxanne Rodney, Denise A. Simons-Morton, Mark A. Williams, Terry Bazzarre
Journal: Circulation (2001)

T he purpose of this report is to provide revised standards and guidelines for the exercise testing and training of individuals who are free from clinical manifestations of cardiovascular disease and those with known cardiovascular disease.These guidelines are intended for physicians, nurses, exercise physiologists, specialists, technologists, and other healthcare professionals involved in exercise testing and training of these populations.This report is in accord with the "Statement on Exercise" published by the American Heart Association (AHA). 1 These guidelines are a revision of the 1995 standards of the AHA that addressed the issues of exercise testing and training. 2An update of background, scientific rationale, and selected references is provided, and current issues of practical importance in the clinical use of these standards are considered.These guidelines are in accord with the American College of Cardiology (ACC)/AHA Guidelines for Exercise Testing. 3 The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional or business interest of a member of the writing panel.Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.
Inappropriate use of lateral flow tests by patients with symptoms
Authors: Milan Dagli
Journal: BMJ (2021)

Concerns have been raised about the use of lateral flow tests in the government’s mass testing programme as a means of facilitating the easing of the lockdown measures and the opening up of society.1

As a general practitioner I have encountered increased use of these tests among my patients, largely in the context of work based asymptomatic testing. …