tbuckley/cabot-search huggingface dataset:
Efficacy and safety of nivolumab in renal cell carcinoma patients with BONE metastases: Results of the GETUG: AFU 26 nivoren multicenter phase II study.
Authors: Maud Velev, Cécile Dalban, Christine Chevreau, Gwenaelle Gravis, Sylvie Negrier, Brigitte Laguerre, Marine Gross-Goupil, Sylvain Ladoire, Victoria Ferrari, Lionnel Geoffrois, Hubert Curcio, Frank Priou, Quentin Dominique Thomas, Cécile Mione, Philippe Barthélémy, Florence Tantot, Bernard Escudier, Sylvie Chabaud, Laurence Albiges, Constance Thibault
Journal: Journal of Clinical Oncology (2022)

342 Background: Bone metastases (BM) in renal cell carcinoma (RCC) are associated with a poor prognosis based on retrospective studies in which patients were treated with antiangiogenic agents. Since the development of immune checkpoint inhibitors, few data are available regarding the prognosis impact of BM or the efficacy and safety of checkpoint inhibitors in patients with bones metastatic RCC. GETUG-AFU26-NIVOREN (NIVOREN) is a French multicenter prospective study in which patients were treated with nivolumab after failure of one or more antiangiogenic tyrosine kinase inhibitors. We therefore aim to evaluate the impact of BM on prognosis, and the efficacy and safety of nivolumab in patients with BM enrolled in NIVOREN trial. Methods: All adult patients with BM at inclusion were included in our study. The primary endpoint of this ancillary study was overall survival (OS). Secondary endpoints were progression-free survival (PFS), objective response rate (ORR), safety, and skeletal-related events (SRE) in patients with BM. Clinical data were collected prospectively, except for SRE data which were collected retrospectively in a complementary consent report form. Results: Among 720 patients treated with nivolumab in the NIVOREN study, 194 had BM at inclusion. After a median follow-up of 23.9 months, the median OS was 17.9 months in patients with BM versus 26.1 months in patients without BM (HR = 1.42 CI95% [1.13-1.79], p = 0.0023). After adjustment on sex, age, IMDC group and line of treatments, the difference was not significant (HR = 1.24, CI95% [0.98-1.56], p = 0.0707). The median PFS was shorter in patients with BM even after adjustment (2.8 versus 4.6 months, HR = 1.30 CI95% [1.08-1.56]), as well as the ORR (14.8% versus 23.3%). The safety profile was similar between patients with or without BM at inclusion. The incidence of SRE in the BM population was 36% during the treatment period with nivolumab. A post-hoc analysis evaluating the impact of bone-targeting agents in association with nivolumab on SRE incidence was performed. There was a statistically significant benefit in patients treated with bone-targeting agents on the incidence of SRE (OR = 0.367, CI95% [0.151-0.895], p = 0.0276). Conclusions: Nivolumab is associated with shorter OS, PFS, and lower ORR in patients with BM. Our study confirms, in the era of immunotherapy that patients with BM are associated with poorer prognosis and suggests that association with bone-targeting agents decreases the incidence of SRE. Clinical trial information: 2015-004117-24.
Phylodynamic Inference of Bacterial Outbreak Parameters Using Nanopore Sequencing
Authors: Eike Steinig, Sebastián Duchêne, Izzard Aglua, Andrew Greenhill, Rebecca Ford, Mition Yoannes, Jan Jaworski, Jimmy Drekore, Bohu Urakoko, Harry Poka, Clive Wurr, Eri Ebos, David Nangen, Laurens Manning, Moses Laman, Cadhla Firth, Simon Smith, William Pomat, Steven Y C Tong, Lachlan Coin, Emma McBryde, Paul Horwood
Journal: Molecular Biology and Evolution (2022)

Nanopore sequencing and phylodynamic modeling have been used to reconstruct the transmission dynamics of viral epidemics, but their application to bacterial pathogens has remained challenging. Cost-effective bacterial genome sequencing and variant calling on nanopore platforms would greatly enhance surveillance and outbreak response in communities without access to sequencing infrastructure. Here, we adapt random forest models for single nucleotide polymorphism (SNP) polishing developed by Sanderson and colleagues (2020. High precision Neisseria gonorrhoeae variant and antimicrobial resistance calling from metagenomic nanopore sequencing. Genome Res. 30(9):1354-1363) to estimate divergence and effective reproduction numbers (Re) of two methicillin-resistant Staphylococcus aureus (MRSA) outbreaks from remote communities in Far North Queensland and Papua New Guinea (PNG; n = 159). Successive barcoded panels of S. aureus isolates (2 × 12 per MinION) sequenced at low coverage (>5× to 10×) provided sufficient data to accurately infer genotypes with high recall when compared with Illumina references. Random forest models achieved high resolution on ST93 outbreak sequence types (>90% accuracy and precision) and enabled phylodynamic inference of epidemiological parameters using birth-death skyline models. Our method reproduced phylogenetic topology, origin of the outbreaks, and indications of epidemic growth (Re > 1). Nextflow pipelines implement SNP polisher training, evaluation, and outbreak alignments, enabling reconstruction of within-lineage transmission dynamics for infection control of bacterial disease outbreaks on portable nanopore platforms. Our study shows that nanopore technology can be used for bacterial outbreak reconstruction at competitive costs, providing opportunities for infection control in hospitals and communities without access to sequencing infrastructure, such as in remote northern Australia and PNG.
Abstract 113: Signs of Perfusion During Cardiopulmonary Resuscitation as Noted by First Responders is Predictive of Good Neurologic Outcome in Cardiac Arrest
Authors: Johanna C Moore, Michael Grahl, Tracy Marko, Ariel Blythe-Reske, Amber Lage, Erin Hedge, Andrew Bancroft-Howard, Lauren Klein, Sarah Scharber, Clayton Garthe, Jeffrey Ho
Journal: Circulation (2018)

Background: Rates of neurologically intact survival after cardiac arrest remain abysmal. Neuro-prognostication intra-arrest is challenging, with few real-time factors that can be used to determine patient prognosis. During the implementation of a new cardiopulmonary resuscitation (CPR) protocol in a large urban pre-hospital system, first responders prospectively recorded the presence of signs of perfusion during CPR. Hypothesis: Positive signs of perfusion would be a predictor of a good neurologic outcome in this observational study, as defined by Cerebral Performance Category (CPC) Score of 1 or 2. Methods: Basic life support first responders (n = 420) and paramedics (n = 207) underwent training including didactic and hands-on sessions to learn the new protocol, which included active compression-decompression CPR with an impedance threshold device. In addition to patient demographics and circumstances of cardiac arrest, signs of perfusion during CPR were prospectively recorded and included improved color, pulse during CPR, gasping, and movement during CPR. Chart review was performed to determine CPC score at discharge. Data were analyzed using descriptive statistics and calculation of unadjusted odds ratios. Results: The new protocol began May 1, 2017. Cases from May 2017-November 2017 (n= 102) were reviewed, with complete data available for 96 patients (94%). The median age was 56 (range 25-97), 54/91 (59%) male, 43/102 (42%) witnessed, 31/90 (34%) shockable rhythm, and 51/102 (50%) receiving bystander CPR. Improved color during CPR was seen in 23/102 (23%), pulse during CPR in 17/102 (17%), gasping in 18/102 (18%), and movement during CPR in 5/102 (5%). Any sign of perfusion during CPR was seen in 47/102 (46%), and 13/96 (13.5%) had a CPC score of 1 or 2 at discharge. The unadjusted OR for any sign of perfusion during CPR for a CPC score of 1 or 2 was 26 (95% CI 3 - 213) and for any sign of perfusion during CPR for ROSC was 9 (95% CI 3 - 24). Conclusions: Positive signs of perfusion during CPR noted by first responders strongly predicted ROSC and neurologically intact survival in this small sample. This suggests the importance of prospectively recording signs of perfusion during resuscitation, and communicating these observations during transfer of care.
Abstract 105: Accuracy of Team Perception of Performance With Actual CPR Quality Metrics in Children
Authors: Lynda Knight, Todd Sweberg, Pual Mullan, Anita Sen, Matthew Braga, Priti Jani, Felice Su, Shlipa Balikai, David Kessler, Joan Roberts, Aaron Donoghue, Jesse Wenger, Dana Niles, Vinay Nadkarni, Marc Berg
Journal: Circulation (2018)

Background: American Heart Association (AHA) recommends high quality CPR to promote optimal patient outcomes. Few reports compare team members’ perceptions of CPR quality with quantitative CPR data during actual pediatric CPR. Hypothesis: Self-reported team perception of CPR performance will not meet quantitative CPR metrics using AHA BLS guideline criteria. Methods: Prospective data from an international pediatric (pediRES-Q) resuscitation collaborative from February 2016 to August 2017. A modified Team Emergency Assessment Measure framework for qualitative content analysis was used to assess data from “hot” debriefings (held soon after arrest) by language processing experts blinded to CPR data. Events without reported perception of CPR and quantitative CPR data were excluded. Comments regarding CPR perception were grouped as either Plus perceptions of performance (PPP) or Delta perceptions of performance (DPP). Grouped events were matched and compared to quantitative CPR data of chest compression (CC) fraction (CCF), rate, and depth as collected by CPR-recording defibrillators. Compliance with AHA BLS guidelines were defined as events with mean: CCF &gt;60%, CC rate 100-120/min; and CC depth for infants &lt;1yo, ~4 cm (3.6-4.4 cm.); children 1-18 yo, 5-≤6 cm. Results: Of 227 arrests, 108 (48%) hot debriefings were reported. Reported CPR perceptions with paired quantitative CPR data were available for 53/108 (49%) events; 32/53 (60%) PPP and 21/53 (39%) DPP. Event CPR metric summaries (median [IQR]) for PPP - CCF 0.87 [0.77, 0.93]; CC rate 116/min [108.5, 120]; CC depth age &lt;1yo 2.35 [2.01, 3.0] cm; &gt;1yr 4.2 [3.3, 5.05] cm. DPP - CCF 0.79 [0.69, 0.92]; CC rate 118/min [109,129]; CC depth &lt; 1 yo 2.03 [1.95, 2.2] cm; &gt;1yo 3.93 [3.3, 5.06] cm. PPP events, 28/32 (87%) met guideline criteria for CCF, 25/32 (78%) for CC rate; 6/32 (19%) for CC depth; and 4/32 (12%) met criteria for all 3 categories. For DPP events, 17/21 (80%) met guideline criteria for CCF; 15/21 (71%) for CC rate; and 3/21 (15%) for CC depth, and 2/21 (9%) met criteria for all 3 categories. Conclusions: Self-reported team perception of CPR quality does not match quantitative CPR metrics using AHA guideline criteria whether CPR was positively perceived or not, depth being main reason for non-compliance.
Abstract 17207: Cardiovascular Risks in Acute Leukemia Patients Treated With Anthracyclines
Authors: Yu Kang, Srinivas Denduluri, Bruna M Assuncao, Marielle Scherrer-Crosbie
Journal: Circulation (2018)

Introduction: The incidence of acute leukemia has been increasing by about 1.6% per year in the last decade. Anthracyclines remain a standard of care for patients with acute leukemia; survival is increasing at about 1.0% per year. However, little is known about the incidence and risk of major adverse cardiovascular events (MACE) in patients with acute leukemia. Hypothesis: To investigate the incidence of MACE and the risk factors for MACE in patients with acute leukemia treated with anthracyclines. Methods: All adult patients with acute leukemia treated with anthracyclines between January 2005 and April 2018 at the hospital of University of Pennsylvania were studied. MACE were defined as cardiovascular death, symptomatic heart failure, non-fatal acute coronary syndrome, non-fatal ventricular arrhythmia and non-fatal ischemic stroke. Differences between patients with or without MACE were compared by Student’s t test or the Wilcoxon rank comparison. Cox proportional hazard analysis was used to determine significant clinical and echocardiographic parameters associated with MACE. Results: Six hundred and seventy-four patients (234 acute lymphoblastic leukemia (ALL), 440 acute myeloid leukemia (AML), age range: 22 to 93 years) were studied. Seventy-one patients (10.5%) experienced MACEs during a median follow-up period of 16 months (4 to 146 months) after the initiation of chemotherapy. The median time to MACE was 13 months (5 to 107 months). In the patients with MACE,59 (8.8%) developed symptomatic heart failure, 7 (1.0%) died of cardiovascular causes, 3 (0.4%) experienced non-fatal acute myocardial syndrome and 2 (0.3%) had an ischemic stroke. The Table summarizes the characteristics of patients with and without MACE. In a multivariable analysis, a previous history of heart failure (HR: 4.632, P=0.000, 95% CI: 2.572-8.341), leukemia type (HR: 3.155, P=0.002, 95% CI: 1.544-6.446) and baseline LVEF (HR: 0.973, P=0.000, 95% CI: 0.955-0.991) remained associated with MACE. Conclusion: Patients with acute leukemia treated with anthracyclines have a high rate of MACE after chemotherapy. A previous history of heart failure, baseline LVEF and type of leukemia may help to stratify acute leukemia patients at highest risk for MACEs after anthracycline therapy.
Correction: The EZH2-PHACTR2-AS1- Ribosome Axis Induces Genomic Instability and Promotes Growth and Metastasis in Breast Cancer
Authors: Wenhui Chu, Xi Zhang, Lihua Qi, Yenan Fu, Peng Wang, Wei Zhao, Juan Du, Jing Zhang, Jun Zhan, Yunling Wang, Wei-Guo Zhu, Yu Yu, Hongquan Zhang
Journal: Cancer Research (2022)

In the original version of this article (1), there was an error in Fig. 6L. Specifically, the image of H&amp;E staining of PHACTR2-AS1 lung metastases shown in Fig. 5J was mistakenly reused to represent 30nt-RNA lung metastases in Fig. 6L. The correct images have been provided, and the error has been corrected in the latest online HTML and PDF version of the article. The authors regret this error.
Canadian Medical Association Journal, Toronto
Journal: JAMA (1964)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
14. Management of Diabetes in Pregnancy: <i>Standards of Medical Care in Diabetes—2019</i>
Journal: Diabetes Care (2018)

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Editorial: Cuddling: the influences of culture and sex
Authors: H. H. Hussey
Journal: JAMA (1976)

The reference lists in two articles<sup>1,2</sup>attest to the fact that Hollender, sometimes with co-authors, has written extensively on the meaning and extent of the human desire to be held (cuddled). Previous studies, however, have not addressed the question of whether cultural influences affect women's attitudes toward the amount of holding permitted or encouraged. In the first article cited,<sup>1</sup>the authors examined the differences in the wish to be held among five groups of Asian women living in Kuala Lumpur, Malaysia. Of most immediate interest is the contrast in the desire for body contact between Chinese women educated in English schools (and influenced by English customs) and their native-educated counterparts. Of the subjects in the study, there were 24 Chinese-educated and 65 English-educated women. All subjects were married; most were in their 20s or 30s. They were asked to respond to a questionnaire, with the explanation that information
ACC/AHA 2006 Guideline Update on Perioperative Cardiovascular Evaluation for Noncardiac Surgery: Focused Update on Perioperative Beta-Blocker Therapy
Authors: Lee A. Fleisher, Joshua A. Beckman, Kenneth A. Brown, Hugh Calkins, Elliott Chaikof, Kirsten E. Fleischmann, William K. Freeman, James B. Froehlich, Edward K. Kasper, Judy R. Kersten, Barbara Riegel, John F. Robb, Sidney C. Smith, Alice K. Jacobs, Cynthia D. Adams, Jeffrey L. Anderson, Elliott M. Antman, David P. Faxon, Valentin Fuster, Jonathan L. Halperin, Loren F. Hiratzka, Sharon A. Hunt, Bruce W. Lytle, Rick Nishimura, Richard L. Page, Barbara Riegel
Journal: Journal of the American College of Cardiology (2006)
Impact of frailty on persistent critical illness: a population-based cohort study
Authors: Jai N. Darvall, Rinaldo Bellomo, Michael Bailey, Paul J. Young, Kenneth Rockwood, David Pilcher
Journal: Intensive Care Medicine (2022)

Acute illness severity predicts mortality in intensive care unit (ICU) patients, however, its predictive value decreases over time in ICU. Typically after 10 days, pre-ICU (antecedent) characteristics become more predictive of mortality, defining the onset of persistent critical illness (PerCI). How patient frailty affects development and death from PerCI is unknown.
MOTOR NOTES FOR MEDICAL MEN
Authors: H. M. Buist
Journal: BMJ (1917)

A PART from one's own recent experiences, those of readers in regard to starting the engines of their cars, or motor cycles, suggest that it may be useful to give some brief hints on the matter at the pre.sent juncture.Tile idea that obtains is that difficulty is wholly due to the poor quality of the petrol available.Inasmuch as the bulk of related experience goes to indicate, thiat the trouble has occurred dIuring the last two months, and seems to have been grow- ing worse, it is plain that it does not lie wholly with the quality of the petrol, but that it is in part due to the weather.The rapid changes fromll frost to tlhaw, from dry to rain or snow, from strog ryig wind to saturating fog, causes penetration into most houses, witlh the result that temporarily damp walls have been a common experience during tlho last two months.This is in part an explanation of the difficulties being experienced as well in starting as in ruinning nmotor-car -engines.Sonetimes when a motor is qiuite liot af-ter a run, stilltheire is considerable rluctance for it to fire.Whien the engine is standing overnight in the motor house in such weather as we have experienced, as well aS W11en it i iLn use in the daytime, the amount of con- dlusation from moisture, combined With the failing off of the quality of the petrol, has resulted in a vast number of cases, including mtuy own, in a gradual accumulation of wvatercitlher in the lowermost portion of the petrol supply pipe to the carburettor, if at anypoint thiat pipe falls lower than any part of-the carburettor into which the petrol has to flow, or.if the carburettor details tlhemselves are lower than tlho piping, in the la-chamber itself.In my own case investigation reveals that a quarter of an inch of water las accumulated in, and has had to be drained out of, the carburettor.WATER IN PEJTH(,L L'iIPE OR CAR IBURETTOR.The remedy for this, perhaps the greatest cause of starting trouble, is simple.A drain tap should be fitted.'either to the petrol suppy pipe, whereby any water can be drlawn off immediately, as has been the standard Sunbeam practico for years past; or some similar draining con- trivajucc should be supplied to the bottom of the car- burettor so that before turning on tlhe petrol prior to starting up the engine the tap can be opened, whlereupon aiy water that may have accumulated will run off.In this connexion it should be pointed out that wlhatever form of tap is employed its closed position shiould be such that its handle tthen hangs down vertically; in other words1 to open it you should have to turn it utp into the hOrizital pition.By rranging matters thus any wear that might occur as the result of vibration, or what not, and so looson t h tap, would nevertheless not cause petrol to escape, because, whenloose, the tap handle would hang dcown by the0 action of gr.vity, and th1erefore remain always in the closed position.
Skeletal dysplasias.
Authors: R Wynne-Davies
Journal: BMJ (1987)

used in hair replacement (both for traumatic loss and for male pattern baldness), scar and tattoo removal, ear and nose reconstruction, facial reconstruction, and in treating syndactyly, port wine stains, and giant pigmented naevi.Expanders are even available for closing cleft palates as a primary procedure and for restoring an alveolar ridge in edentulous patients to allow dentures to be fitted.They can be used almost wherever there is a defect to be covered.
Bone Marrow Cells Improve Coronary Flow Reserve in Ischemic Nonrevascularized Myocardium
Authors: Antonildes N. Assuncao-Jr, Carlos Eduardo Rochitte, Raymond Y. Kwong, Luís Henrique Wolff Gowdak, José Eduardo Krieger, Michael Jerosch-Herold
Journal: JACC. Cardiovascular imaging (2022)

This study investigated whether intramyocardial bone marrow–derived hematopoietic progenitor cells (BMCs) increase coronary flow reserve (CFR) in ischemic myocardial regions where direct revascularization was unsuitable. Patients with diffuse coronary artery disease frequently undergo incomplete myocardial revascularization, which increases their risk for future adverse cardiovascular outcomes. The residual regional ischemia related to both untreated epicardial lesions and small vessel disease usually contributes to the disease burden. The MiHeart/IHD study randomized patients with diffuse coronary artery disease undergoing incomplete coronary artery bypass grafting to receive BMCs or placebo in ischemic myocardial regions. After the procedure, 78 patients underwent cardiovascular magnetic resonance (CMR) at 1, 6, and 12 months and were included in this cardiac magnetic resonance substudy with perfusion quantification. Segments were classified as target (injected), adjacent (surrounding the injection site), and remote from injection site. Of 1,248 segments, 269 were target (22%), 397 (32%) adjacent, and 582 (46%) remote. The target had significantly lower CFR at baseline (1.40 ± 0.79 vs 1.64 ± 0.89 in adjacent and 1.79 ± 0.79 in remote; both P < 0.05). BMCs significantly increased CFR in target and adjacent segments at 6 and 12 months compared with placebo. In target regions, there was a progressive treatment effect (27.1% at 6 months, P = 0.037, 42.2% at 12 months, P = 0.001). In the adjacent segments, CFR increased by 21.8% (P = 0.023) at 6 months, which persisted until 12 months (22.6%; P = 0.022). Remote segments in both the BMC and placebo groups experienced similar improvements in CFR (not significant at 12 months compared with baseline). BMCs, injected in severely ischemic regions unsuitable for direct revascularization, led to the largest CFR improvements, which progressed up to 12 months, compared with smaller but persistent CFR changes in adjacent and no improvement in remote segments.