tbuckley/cabot-search huggingface dataset:
Association of Medicare Mandatory Bundled Payment Program With the Receipt of Elective Hip and Knee Replacement in White, Black, and Hispanic Beneficiaries
Authors: Hyunjee Kim, Thomas H. A. Meath, Ana R. Quiñones, K. John McConnell, Said A. Ibrahim
Journal: JAMA Network Open (2021)

<h3>Importance</h3> The Comprehensive Care for Joint Replacement (CJR) model was designed to reduce the cost and improve the quality of hip or knee replacement among Medicare beneficiaries. Yet whether this model may exacerbate existing racial/ethnic disparities in access to the surgery is unclear. <h3>Objective</h3> To examine the association of the CJR model with the receipt of elective hip or knee replacement across White, Black, and Hispanic Medicare beneficiaries. <h3>Design, Setting, and Participants</h3> Retrospective cohort study of Medicare claims from 2013 through 2017 among White, Black, and Hispanic Medicare beneficiaries undergoing elective joint replacement in 65 treatment (selected for CJR participation) and 101 control metropolitan statistical areas (MSAs). <h3>Exposures</h3> Starting in April 2016, hospitals in the treatment MSAs were required to participate in the CJR model and were accountable for expenditures occurring during patients' hospitalization for hip or knee replacement and 90 days after the hospital discharge. <h3>Main Outcomes and Measures</h3> Beneficiary-level elective hip or knee replacement receipt in a given year. <h3>Results</h3> Among 17 243 304 patients, 9 839 996 (57%) were women; 2 107 425 (12%) were age 85 years or older. Of the final sample, 14 632 434 (85%) were White beneficiaries, 1 518 629 (9%) were Black beneficiaries, and 1 092 241 (6%) were Hispanic beneficiaries. The CJR model was associated with an increase of 1.6 elective hip or knee replacements per 1000 beneficiary-years for Hispanic beneficiaries (95% CI, 0.06-2.05) and a decrease of 0.64 replacements for Black beneficiaries (95% CI, −1.25 to −0.02). No evidence was found for any changes for White beneficiaries per 1000 beneficiary-years (0.04 replacements, 95% CI, −0.35 to 0.42 replacements). The Black-White difference in the rate of elective hip or knee replacement per 1000 beneficiary-years further widened by 0.68 replacements (−0.68, 95% CI, −1.20 to −0.15). <h3>Conclusions and Relevance</h3> In this cohort study, the CJR model was associated with increased receipt of elective hip or knee replacement among Hispanic beneficiaries, decreased receipt among Black beneficiaries, and no change in receipt among White beneficiaries. The decreased receipt of elective hip or knee replacement among Black beneficiaries may suggest that value-based payment models, including the CJR model, could be monitored for unintended consequences. However, the lack of similar findings among Hispanic beneficiaries suggests that payment models may have differential impacts across racial/ethnic groups.
USPSTF Recommendations for Hearing Loss Screening in Asymptomatic Older Adults—A Case of Missing Evidence and Missing Treatment Options
Authors: Jennifer A. Deal, Frank R. Lin
Journal: JAMA Network Open (2021)

Cynthia Feltner, MD, MPH; Ina F. Wallace, PhD; Christine E. Kistler, MD, MASc; Manny Coker-Schwimmer, MPH; Daniel E. Jonas, MD, MPH
P14.07 Clinically Predictive Value of Plasma Cell-Free DNA in Lung Cancer Immunotherapy
Authors: J. Yu, Z. Zhou, P. Zhang, P. Li, M. Tang, N. Fang, X. Wu, X. Nie, Y. Guan, X. Xia, L. Yang, X. Yi, L. Li
Journal: Journal of Thoracic Oncology (2021)
With Good Adherence, Daily Aspirin May Prevent Pregnancy Loss
Authors: Anita Slomski
Journal: JAMA (2021)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
Excess mortality for men and women above age 70 according to level of care during the first wave of COVID-19 pandemic in Sweden: A population-based study
Authors: K. Modig, M. Lambe, A. Ahlbom, M. Ebeling
Journal: The Lancet Regional Health - Europe (2021)

Both age and comorbidity are established risk factors for death among those infected with COVID-19. Because they often co-exist, it is difficult to assess if age is a risk factor on its own.We used administrative register data of the total Swedish population from 01/2015 until 07/2020. We stratified the population aged 70+ into three groups according to level of care (in care homes, with home care, and in independent living). Within these groups, we explored the level of excess mortality in 2020 by estimating expected mortality with Poisson regression and compared it to observed levels. We investigated if excess mortality has been of the same magnitude in the three groups, and if age constitutes a risk factor for death during the pandemic regardless of level of care.Individuals living in care homes experienced the highest excess mortality (75- >100% in April, 25-50% in May, 0-25% in June, depending on age). Individuals with home care showed the second highest magnitude (30-60% in April, 15-40% in May, 0-25% in June), while individuals in independent living experienced excess primarily at the highest ages (5-50% in April, 5-50% in May, 0-25% in June). Although mortality rates increased, the age-pattern of mortality during the pandemic resembled the age-pattern observed in previous years.We found stepwise elevated excess mortality by level of care during the first wave of the COVID-19 pandemic in Sweden, suggesting that level of frailty or comorbidities plays a more important role than age for COVID-19 associated deaths. Part of our findings are likely attributable to differences in exposure to the virus between individuals receiving formal care and those living independently, and not only different case fatality between the groups. Although age is a strong predictor for mortality, the relative effect of age on mortality was no different during the pandemic than before. We believe this is an important contribution to the discussion of the pandemic, its consequences, and which groups need the most protection.This study was funded by the Swedish Research Council for Health, Working Life and Welfare (FORTE: grant 2016-07115).
Rhinitis medication use in patients with persistent rhinitis: Belgian cross-sectional study with historical control
Authors: Sophie Scheire, S. Germonpre, Els Mehuys, Thierry Christiaens, An De Sutter, Inge Van Tongelen, S. Demarche, T. Van Hees, Lies Lahousse, Philippe Gevaert, Koen Boussery
Journal: Allergy (2019)
Molecular analysis of clinical isolates of ceftazidime-avibactam-resistant Klebsiella pneumoniae
Authors: Carolina Venditti, Ornella Butera, Marcello Meledandri, Maria Pia Balice, Giulio Cesare Cocciolillo, Carla Fontana, Silvia D'Arezzo, Chiara De Giuli, Mario Antonini, Alessandro Capone, Francesco Messina, Carla Nisii, Antonino Di Caro
Journal: Clinical Microbiology and Infection (2021)

To analyse the strains collected during a 1-year survey of ceftazidime-avibactam-resistant KPC-producing Klebsiella pneumoniae, in order to investigate the molecular mechanisms potentially responsible for their resistant phenotype.Clinical KPC-producing K. pneumoniae isolates were collected from 31 patients in six different hospitals in Rome. For eight of the patients, an additional strain grown before the start of treatment was also available, bringing the total of isolates studied to 39. Antimicrobial susceptibility was determined by automated system, broth microdiluition and E-test as appropriate. In silico analysis of acquired resistance genes was achieved by whole-genome sequencing, while multilocus sequence typing and core genome multilocus sequence typing were employed for molecular typing. Mutations associated with ceftazidime-avibactam resistance were identified by Sanger sequencing of the blaKPC gene. Possible mutations in OmpK35 and OmpK36 outer membrane proteins were also investigated.Molecular analyses highlighted the circulation of the ST512, 101 and 307 high-risk clones; 26 of the 31 patients carried a mutated KPC variant, five had a wild-type KPC-3. Among the KPC variants detected, 11 were different mutations within the blaKPC-3 gene, four of which were novel mutational changes.Different mutations including single amino-acid substitutions, insertions or deletions within the blaKPC gene were found in 26/31 ceftazidime-avibactam-resistant KPC-producing K. pneumoniae strains belonging to high-risk clones circulating in Italy. Of note, in 14/31 cases the isolates displayed resistance to both ceftazidime-avibactam and carbapenems, raising concerns for the possible selection of a multidrug-resistant phenotype.
<i>CBLB</i> ablation with CRISPR/Cas9 enhances cytotoxicity of human placental stem cell-derived NK cells for cancer immunotherapy
Authors: Xuan Guo, Tanel Mahlakõiv, Qian Ye, Srinivas Somanchi, Shuyang He, Hemlata Rana, Andrea DiFiglia, Joseph Gleason, William van der Touw, Robert Hariri, Xiaokui Zhang
Journal: Journal for ImmunoTherapy of Cancer (2021)

Background Tumors often develop resistance to surveillance by endogenous immune cells, which include natural killer (NK) cells. Ex vivo activated and/or expanded NK cells demonstrate cytotoxicity against various tumor cells and are promising therapeutics for adoptive cancer immunotherapy. Genetic modification can further enhance NK effector cell activity or activation sensitization. Here, we evaluated the effect of the genetic deletion of ubiquitin ligase Casitas B-lineage lymphoma pro-oncogene-b ( CBLB ), a negative regulator of lymphocyte activity, on placental CD34 + cell-derived NK (PNK) cell cytotoxicity against tumor cells. Methods Using CRISPR/Cas9 technology, CBLB was knocked out in placenta-derived CD34 + hematopoietic stem cells, followed by differentiation into PNK cells. Cell expansion, phenotype and cytotoxicity against tumor cells were characterized in vitro. The antitumor efficacy of CBLB knockout (KO) PNK cells was tested in an acute myeloid leukemia (HL-60) tumor model in NOD- scid IL2R gamma null (NSG) mice. PNK cell persistence, biodistribution, proliferation, phenotype and antitumor activity were evaluated. Results 94% of CBLB KO efficacy was achieved using CRISPR/Cas9 gene editing technology. CBLB KO placental CD34 + cells differentiated into PNK cells with high cell yield and &gt;90% purity determined by CD56 + CD3 − cell identity. Ablation of CBLB did not impact cell proliferation, NK cell differentiation or phenotypical characteristics of PNK cells. When compared with the unmodified PNK control, CBLB KO PNK cells exhibited higher cytotoxicity against a range of liquid and solid tumor cell lines in vitro. On infusion into busulfan-conditioned NSG mice, CBLB KO PNK cells showed in vivo proliferation and maturation as evidenced by increased expression of CD16, killer Ig-like receptors and NKG2A over 3 weeks. Additionally, CBLB KO PNK cells showed greater antitumor activity in a disseminated HL60-luciferase mouse model compared with unmodified PNK cells. Conclusion CBLB ablation increased PNK cell effector function and proliferative capacity compared with non-modified PNK cells. These data suggest that targeting CBLB may offer therapeutic advantages via enhancing antitumor activities of NK cell therapies.
Former British Cycling and Team Sky doctor is struck off for professional misconduct
Authors: Clare Dyer
Journal: BMJ (2021)

Richard Freeman, the former chief doctor for British Cycling and Team Sky who was found guilty of ordering banned testosterone gel knowing or believing that it was to be used to dope an athlete, has been struck off the UK medical register.

Freeman had told a medical practitioners’ tribunal that he ordered the Testogel in 2011 to treat the former head coach’s erectile dysfunction, but the tribunal dismissed his evidence as “an elaborate falsehood.”

The decision that he had ordered 30 sachets of Testogel knowing or believing it was to be used to dope an …
Exploring Posttraumatic Stress Disorder as a Cardiovascular Risk Factor in Women Veterans
Authors: Beth E. Cohen
Journal: JAMA Cardiology (2021)

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 Cardiology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Cardiology journal
Dabigatran activates inflammation resolution by promoting fibrinogen-like protein 2 shedding and RvD5<sub>n-3 DPA</sub> production
Authors: Juan Lei, Yu Zhou, Huakan Zhao, Yu Chen, Guifang Yan, Lei Wu, Yanquan Xu, Jiangang Zhang, Xiao Zhang, Jingchun Wang, Dingshan Li, Yongsheng Li
Journal: Theranostics (2021)

Rationale: The interaction between coagulation and inflammation resolution remains elusive. We recently highlighted a link between fibrinogen-like protein 2 (Fgl2) and a specialized pro-resolving mediator (SPM)-n-3 docosapentaenoic acid-derived resolvin D5 (RvD5n-3 DPA) in sepsis. This study aimed to investigate the functions of commonly used anticoagulants warfarin, dabigatran and heparin in regulating inflammation resolution. Methods: Peripheral blood was collected from clinical sepsis patients and healthy control for the determination of indicated indexes. Mouse sepsis models of zymosan-induced peritonitis and cecal ligation and puncture (CLP) were employed for the measurement of inflammation- and coagulation-related indexes. Western-blotting, ELISA and flow cytometry were applied to assess proteins. UPLC-MS/MS was used to evaluate lipid metabolites. Results: Here we report that the transmembrane Fgl2 (mFgl2) was positively associated with coagulation, while soluble Fgl2 (sFgl2) level correlated with the enhanced number of peripheral blood mononuclear cells in the sepsis patients. The anticoagulants dabigatran and warfarin attenuated zymosan-induced peritonitis, which was not shared by heparin, while only dabigatran significantly improved sepsis survival in the CLP sepsis mouse model. Although these anticoagulants consistently inhibited pro-inflammatory mediators including prostaglandin E2 and leukotriene B4, only dabigatran increased sFgl2 at both the initiation and resolution phases of inflammation. Mechanistically, dabigatran elicited the shedding of sFgl2 via prothrombin-related metalloproteases, thereby enhanced the subsequent biosynthesis of RvD5n-3 DPAvia STAT6-ALOX15 axis. Blocking metalloproteases or ALOX15 significantly impaired dabigatran-enhanced macrophage efferocytosis in vitro, as well as delayed the dabigatran-accelerated inflammation resolution in vivo. Conclusions: Our findings identify the dual anti-inflammatory and pro-resolving actions of dabigatran, through promoting sFgl2-triggered RvD5n-3 DPA production, which has important implications for promoting tissue homeostasis of sepsis.
A complex immune response to flagellin epitope variation in commensal communities
Authors: Nicholas R. Colaianni, Katarzyna Parys, Ho-Seok Lee, Jonathan M. Conway, Nak Hyun Kim, Natalie Edelbacher, Tatiana S. Mucyn, Mathias Madalinski, Theresa F. Law, Corbin D. Jones, Youssef Belkhadir, Jeffery L. Dangl
Journal: Cell Host & Microbe (2021)
Hematological and Genetic Markers in the Rational Approach to Patients With HCV Sustained Virological Response With or Without Persisting Cryoglobulinemic Vasculitis
Authors: Laura Gragnani, Serena Lorini, Silvia Marri, Umberto Basile, Veronica Santarlasci, Monica Monti, Francesco Madia, Luisa Petraccia, Cristina Stasi, Niccolò Marello, Cecilia Napodano, Francesco Annunziato, Anna Linda Zignego
Journal: Hepatology (2021)

Direct-acting antivirals (DAAs) usually lead to improvement/remission of cryoglobulinemic vasculitis (CV), although symptoms may persist/recur after a sustained virological response (SVR). We evaluated hematological and genetic markers in patients with HCV-SVR vasculitis with and without persisting/recurring symptoms to early predict the CV outcome.Ninety-eight patients with HCV-CV were prospectively enrolled after a DAA-induced SVR: Group A: 52 with complete clinical response; Group B: 46 with symptom maintenance/recurrence. Monoclonal B-cell lymphocytosis, t(14;18) translocation, and abnormal free light chains κ/λ ratios were detected by flow cytometry or nested-PCR or nephelometry in 4% Group A versus 17% Group B (P = 0.04) patients, 17% Group A versus 40% Group B patients (P = 0.02), and 17% Group A versus 47% Group B (P = 0.003) patients, respectively. At least 1 out of 3 clonality markers was altered/positive in 29% of Group A versus 70% of Group B patients (P < 0.0001). When available, pretherapy samples were also tested for t(14;18) translocation (detected in 12/37 [32%] Group A and 21/38 [55%] Group B) and κ/λ ratios (abnormal in 5/35 [14%] Group A and 20/38 [53%] Group B) (P = 0.0006), whereas at least one clonality marker was detected/altered in 16/37 (43%) Group A and 30/38 (79%) Group B (P = 0.002). CV-associated single-nucleotide polymorphisms were tested by real-time PCR. Among them, notch4 rs2071286 T minor allele and TT genotype showed a higher frequency in Group B versus Group A (46% vs. 29%, P = 0.01, and 17% vs. 2%, P = 0.006, respectively).Hematological or genetic analyses could be used to foresee the CV clinical response after DAA therapy and could be valuable to assess a rational flowchart to manage CV during follow-up.
Response to Comment on Hásková et al. Real-time CGM Is Superior to Flash Glucose Monitoring for Glucose Control in Type 1 Diabetes: The CORRIDA Randomized Controlled Trial. Diabetes Care 2020;43:2744–2750
Authors: Jan Šoupal, Aneta Hásková, Martin Prázný
Journal: Diabetes Care (2021)

We thank Seibold (1) for his interest in our randomized study comparing real-time CGM (rtCGM) and intermittently scanned CGM (isCGM) in patients with type 1 diabetes (T1D) and normal hypoglycemia awareness during physical activity and over the subsequent home phase (2).

We acknowledge the challenges associated with using outcomes from the isCGM (FreeStyle Libre) and rtCGM (Guardian Connect Mobile) devices in our study. Nevertheless, we disagree that this disqualifies any comparisons. It does, however, stimulate further discussion.

We agree that different sensors may have different performance characteristics, especially at low glucose range (3). However, there are more similarities in hyperglycemia (3). In fact, rtCGM was superior to isCGM not only in hypoglycemia but also in hyperglycemia (>10.0 mmol/L [>180 mg/dL] …
4D spatiotemporal modulation of biomolecules distribution in anisotropic corrugated microwrinkles via electrically manipulated microcapsules within hierarchical hydrogel for spinal cord regeneration
Authors: Min-Yu Chiang, Hung-Wei Cheng, Yu-Chih Lo, Wei-Chun Wang, Shwu-Jen Chang, Chu-Hsun Cheng, Yu-Chang Lin, Huai-En Lu, Ming-Wen Sue, Nien-Ti Tsou, Yu-Chun Lo, Ssu-Ju Li, Chao-Hung Kuo, You-Yin Chen, Wei-Chen Huang, San-Yuan Chen
Journal: Biomaterials (2021)
P14.21 Baseline Derived Neutrophil-to-Lymphocyte Ratio (dNLR) and Clinical Outcomes to First-Line Pembrolizumab in NSCLC with High PD-L1 (≥50%)
Authors: J.V. Alessi, B. Ricciuti, S. Alden, M. Awad
Journal: Journal of Thoracic Oncology (2021)
CLO21-013: Atrial Fibrillation With Ibrutinib Therapy: Potential Pharmacologic Interactors in a Single-Institution Retrospective Study
Authors: Mitchell Flagg, Lauren Kristen Fang, Alhussin Khawaji, Asim Alshehri, Michael Y. Choi, Anna Narezkina, Gregory Kent Feld
Journal: Journal of the National Comprehensive Cancer Network (2021)

"CLO21-013: Atrial Fibrillation With Ibrutinib Therapy: Potential Pharmacologic Interactors in a Single-Institution Retrospective Study" published on 17 Mar 2021 by National Comprehensive Cancer Network.
A rapid genotyping panel for detection of primary central nervous system lymphoma
Authors: Mihir Gupta, Evan J. Burns, Nicholas Z. Georgantas, Julia Thierauf, Naema Nayyar, Amanda Gordon, SooAe S. Jones, Michelle Pisapia, Ying Sun, Ryan P. Burns, Jose Velarde, Justin T. Jordan, Matthew J. Frigault, Brian V. Nahed, Pamela S. Jones, Fred G. Barker, William T. Curry, Rajiv Gupta, Tracy T. Batchelor, Javier M. Romero, Priscilla K. Brastianos, Hetal D. Marble, Maria Martinez-Lage, Kensuke Tateishi, Jochen K. Lennerz, Jorg Dietrich, Daniel P. Cahill, Bob S. Carter, Ganesh M. Shankar
Journal: Blood (2021)
Managing Calcified Coronaries: the Bugaboo of Percutaneous Coronary Intervention
Authors: Debabrata Dash
Journal: Clinical Cardiology and Cardiovascular Interventions (2021)

Background Percutaneous coronary intervention (PCI) of lesions with heavily coronary artery calcium (CAC) still represents a challenge for interventionists, with increased risk of immediate complications, late failure due to stent underexpansion and malapposition, and consequently poor clinical outcome. In this focused review, we provide the summary of principles, technique and contemporary evidence for various existing and emergent plaque modifying strategies. Main text PCI of lesions with heavy CAC still poses a challenge for the interventionists due to an increased risk of incomplete lesion preparation with subsequent suboptimal stent deployment and higher rates of acute and chronic stent failure. With the emergence of many novel devices and technologies, the treatment of lesions with heavy CAC has become increasingly feasible, safe and predictable. It seems likely that combining enhanced intravascular imaging modalities with traditional or new dedicated tools for the treatment of such lesions grant better lesion preparation. This optimizes delivery and deployment of drug-eluting stents translating into improved patient outcome. Conclusion The lesions with significant CAC are likely to surge due to aging population and increased rates of diabetes and chronic renal disease. The optimal therapy for such lesions is multi-adjunctive and requires the availability of several modalities including intracoronary imaging which could impact the clinical outcome favourably.