tbuckley/cabot-search huggingface dataset:
Rate of Recurrent Guillain-Barré Syndrome After mRNA COVID-19 Vaccine BNT162b2
Authors: Shirley Shapiro Ben David, Israel Potasman, Daniella Rahamim-Cohen
Journal: JAMA Neurology (2021)

On December 20, 2020, Israel initiated a national vaccination program against COVID-19.National and international vaccine guidelines did not preclude patients who have previously been diagnosed with Guillain-Barré Syndrome (GBS) from receiving the COVID-19 vaccine. 1,2However, previous association between vaccines and GBS raises the level of caution and hesitancy among clinicians and patients regarding administering the vaccine. [3]4][5] The aim of this study was to establish rates of GBS relapse among Pfizer-BioNTech BNT162b2 vaccine receivers.
Age-related disparities in modifiable risk factors for diabetes in adult populations
Authors: Ruoling Chen
Journal: The Lancet Healthy Longevity (2021)

Diabetes is one of the leading causes of morbidity and mortality and is associated with substantial economic costs worldwide.1,2 The risk of diabetes increases with age,3 particularly from middle age onwards, and clusters with other drivers of health, including socioeconomic and lifestyle factors and environmental exposures. Over the past few years, there has been increasing interest in investigating the differences in the effects of modifiable risk factors on diabetes incidence across different age groups to inform prevention strategies for diabetes.
Abstract 12514: Elevated Intracellular Adenosine Epigenetically Regulates Endothelial Inflammation <i>(Best of Basic Science Abstract)</i>
Authors: Yiming Xu, Yong Wang, Siyuan Yan, Yaqi Zhou, Zhiping Liu, Xianqiu Zeng, Neal L Weintraub, Yuqing Huo
Journal: Circulation (2015)

Background and Objectives: Adenosine is a potent modulator of endothelial inflammation. However, the molecular mechanisms by which adenosine regulates endothelial inflammation has not been fully understood. This study aims to determine the effect of elevated intracellular adenosine on endothelial inflammation and investigate the involvement of epigenetic mechanism in this effect. Methods and Results: Adenosine but not adenosine receptor agonists alleviated the TNF-α-induced expression of endothelial adhesion molecules (E-selectin, ICAM-1 and VCAM-1). This effect was abrogated by nucleoside transporter inhibitor NBMPR but not by adenosine receptor antagonists. Knockdown of adenosine metabolic enzyme adenosine kinase (ADK) by shRNA or inhibition of ADK by inhibitors augmented intracellular adenosine and also attenuated TNF-α-induced expression of adhesion molecules. This effect was also not affected by adenosine receptor antagonists. Mechanistically, adenosine treatment or ADK knockdown deactivated the SAH hydrolase (SAHH) and histone H3K4 methyltransferase (HMT) and lowered H3K4 di- and tri- methylation levels. Erasing these histone marks by inhibition of SAHH and depletion of WDR5, a core subunit of HMT complex blocked the anti-inflammatory effects of adenosine and ADK knockdown. Co-IP assay showed that ADK can bind with SAHH and WDR5 to methylate H3K4 in a spatially effective manner. With the intravital microscopy we observed the compromised rolling and adhesion of leukocytes in postcapillary venues of endothelial specific ADK deficient mice. Furthermore, atheroprotection in Apoe-/- mice on a Western diet and neuroprotection in acute cerebral ischemic mice were conferred in endothelial specific ADK deficient mice. Conclusion: Our study provides evidence that intracellular adenosine attenuates endothelial inflammation through epigenetic pathways and ADK is a promising therapeutic target to treat inflammatory vascular diseases.
Impact of Blinding on Patient-Reported Outcome Differences Between Treatment Arms in Cancer Randomized Controlled Trials
Authors: Fabio Efficace, David Cella, Neil K Aaronson, Melanie Calvert, Francesco Cottone, Massimo Di Maio, Francesco Perrone, Francesco Sparano, Eva-Maria Gamper, Marco Vignetti, Johannes M Giesinger
Journal: JNCI Journal of the National Cancer Institute (2021)

Some concerns have been raised about potential bias in patient-reported outcome (PRO) results from open-label cancer randomized controlled trials (RCTs). We investigated if open-label trials favor the experimental treatment over the standard treatment more frequently than blinded trials. We also examined if the effect of blinding differs for distal vs more proximal PROs. We assessed 538 RCTs with a PRO endpoint conducted in the most prevalent cancers, of which 366 (68.0%) were open-label, 148 (27.5%) were blinded, and 24 (4.5%) were categorized as unclear. In our multivariable logistic regression model, we did not observe a statistically significant association of the independent variable treatment concealment (blinded vs open-label) on the dependent variable measuring the proportion of trials favoring the experimental treatment (adjusted odds ratio = 1.19, 95% confidence interval = 0.79 to 1.79; 2-sided P = .40). This was also the case when comparing distal and proximal PROs. Our findings provide novel evidence-based data that support the validity of PRO results from open-label cancer RCTs.
Hospitalizations Associated with COVID-19 Among Children and Adolescents — COVID-NET, 14 States, March 1, 2020–August 14, 2021
Authors: Miranda J. Delahoy, Dawud Ujamaa, Michael Whitaker, Alissa O'Halloran, Onika Anglin, Erin Burns, Charisse Cummings, Rachel Holstein, Anita K. Kambhampati, Jennifer Milucky, Kadam Patel, Huong Pham, Christopher A. Taylor, Shua J. Chai, Arthur Reingold, Nisha B. Alden, Breanna Kawasaki, James Meek, Kimberly Yousey-Hindes, Evan J. Anderson, Kyle P. Openo, Kenzie Teno, Andy Weigel, Sue Kim, Lauren Leegwater, Erica Bye, Kathryn Como-Sabetti, Susan Ropp, Dominic Rudin, Alison Muse, Nancy Spina, Nancy M. Bennett, Kevin Popham, Laurie M. Billing, Eli Shiltz, Melissa Sutton, Ann Thomas, William Schaffner, H. Keipp Talbot, Melanie T. Crossland, Keegan McCaffrey, Aron J. Hall, Alicia M. Fry, Meredith McMorrow, Carrie Reed, Shikha Garg, Fiona P. Havers, Pam Daily Kirley, Sarah McLafferty, Isaac Armistead, Emily Fawcett, Katelyn Ward, Ruth Lynfield, Richard Danila, Sarah Khanlian, Kathy Angeles, Kerianne Engesser, Adam Rowe, Christina Felsen, Sophrena Bushey, Nasreen Abdullah, Nicole West, Tiffanie Markus, Mary Hill, Andrea George
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

hospital admissions are subject to lag.
Ozone Exposure, Outdoor Physical Activity, and Incident Type 2 Diabetes in the SALSA Cohort of Older Mexican Americans
Authors: Yu Yu, Michael Jerrett, Kimberly C. Paul, Jason Su, I-Fan Shih, Jun Wu, Eunice Lee, Kosuke Inoue, Mary Haan, Beate Ritz
Journal: Environmental Health Perspectives (2021)

Background: Type 2 diabetes is a leading contributor to the global burden of morbidity and mortality. Ozone (O3) exposure has previously been linked to diabetes. Objective: We studied the impact of O3 exposure on incident diabetes risk in elderly Mexican Americans and investigated whether outdoor physical activity modifies the association. Methods: We selected 1,090 Mexican American participants from the Sacramento Area Latino Study on Aging conducted from 1998 to 2007. Ambient O3 exposure levels were modeled with a land-use regression built with saturation monitoring data collected at 49 sites across the Sacramento metropolitan area. Using Cox proportional hazard models, we estimated the risk of developing incident diabetes based on average O3 exposure modeled for 5-y prior to incident diabetes diagnosis or last follow-up. Further, we estimated outdoor leisure-time physical activity at baseline and investigated whether higher vs. lower levels modified the association between O3 exposure and diabetes. Results: In total, 186 incident diabetes cases were identified during 10-y follow-up. Higher levels of physical activity were negatively associated with incident diabetes [hazard ratio (HR)=0.64 (95% CI: 0.43, 0.95)]. The estimated HRs for incident diabetes was 1.13 (95% CI: 1.00, 1.28) per 10-ppb increment of 5-y average O3 exposure; also, this association was stronger among those physically active outdoors [HR=1.52 (95% CI: 1.21, 1.90)], and close to null for those reporting lower levels of outdoor activity [HR=1.04 (95% CI: 0.90, 1.20), pinteraction=0.01]. Conclusions: Our findings suggest that ambient O3 exposure contributes to the development of type 2 diabetes, particularly among those with higher levels of leisure-time outdoor physical activity. Policies and strategies are needed to reduce O3 exposure to guarantee that the health benefits of physical activity are not diminished by higher levels of O3 pollution in susceptible populations such as older Hispanics. https://doi.org/10.1289/EHP8620
Perspectives on Kidney Disease Education and Recommendations for Improvement Among Latinx Patients Receiving Emergency-Only Hemodialysis
Authors: Tessa K. Novick, Santiago Diaz, Francisco Barrios, Doris Cubas, Kavyaa Choudhary, Paul Nader, Raymonda ElKhoury, Lilia Cervantes, Elizabeth A. Jacobs
Journal: JAMA Network Open (2021)

<h3>Importance</h3> In most states, undocumented Latinx immigrants with kidney failure receive dialysis in acute care settings on an emergency-only basis. How much kidney disease education Latinx immigrants receive and how to improve kidney disease education and outreach among Latinx populations are unknown. <h3>Objective</h3> To understand the kidney disease educational gaps of Latinx individuals who need but lack access to scheduled outpatient dialysis. <h3>Design, Setting, and Participants</h3> This qualitative study used semistructured interviews in a Texas hospital system from March 2020 to January 2021 with 15 individuals who received emergency-only dialysis when they were first diagnosed with kidney failure. Demographic information was collected, and a thematic analysis was performed using the constant comparative method on interviews after they were audio-recorded, translated, and transcribed verbatim. Data analysis was performed from April 2020 to February 2021. <h3>Main Outcomes and Measures</h3> Subthemes and themes from semistructured interviews. <h3>Results</h3> All 15 persons interviewed (9 male individuals [60%]; mean [SD] age, 51 [17] years) identified as Hispanic, 11 (73%) were born in Mexico, and none reported knowing about their kidney disease more than 6 months before starting dialysis. The themes identified were (1) lack of kidney disease awareness, (2) education provided was incomplete and poor quality, (3) lack of culturally concordant communication and care, (4) elements that Latinx patients receiving emergency-only dialysis want in their education, (5) facilitators of patient activation and coping, and (6) Latinx patient recommendations to improve community outreach. <h3>Conclusions and Relevance</h3> Latinx adults receiving emergency-only dialysis are usually unaware of their kidney disease until shortly before or after they start dialysis, and the education they receive is poor quality and often not culturally tailored. Participants made feasible recommendations on how to improve education and outreach among Latinx communities.
The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews
Authors: R.J. Chan, M. Crichton, F. Crawford-Williams, O.A. Agbejule, K. Yu, N.H. Hart, F. de Abreu Alves, F.D. Ashbury, L. Eng, M. Fitch, H. Jain, M. Jefford, D. Klemanski, B. Koczwara, K. Loh, M. Prasad, H. Rugo, E. Soto-Perez-de-Celis, C. van den Hurk, A. Chan
Journal: Annals of Oncology (2021)
Can Salt Substitution Save At-Risk Persons from Stroke?
Authors: Julie R. Ingelfinger
Journal: New England Journal of Medicine (2021)

For decades, opinions about the degree to which sodium intake affects the blood pressure level and the risk of adverse effects such as stroke have been varied, even partisan.1 Much relevant data have shown an association between high dietary sodium intake — and also low dietary potassium intake — and increased blood pressure levels, as well as higher risks of cardiovascular disease, stroke, and death.2 In addition, multiple studies have reported that reducing dietary sodium intake while increasing potassium intake lowers blood pressure levels and decreases morbidity. Although many debate the extent of these effects,3 there is no doubt that . . .
Abstract 17535: Carotid Artery Calcifications and High-risk Carotid Plaques Identified by CT Angiograms are Associated With an Increased Predisposition of Ischemic Strokes
Authors: Andres Carmona Rubio, Keenan Adib, Narasa Madam, Roshan Karki, Gregory Gudleski, Umesh Sharma
Journal: Circulation (2015)

Introduction: Ischemic strokes account for nearly 90% of all strokes in the United States. Non-invasive computed tomographic angiograms (CTA) are performed routinely in patients with stroke-like symptoms. While the severity of carotid stenosis is conventionally used to plan medical therapy or interventions, there is no data to predict the future risk of ischemic strokes based on additional high-risk characteristics that can be visualized by modern CTA. Methods: We examined the head and neck CTA of 485 patients who presented to our tertiary stroke center with symptoms suggestive of transient ischemic attacks or stroke. Using the post-processed CT images, we analyzed the severity of stenosis and plaque characteristics of the common, internal and external carotid arteries, and also evaluated for evidence of ischemic strokes. Carotid lesions were defined in terms of the degree of stenosis, calcifications (speckled or eccentric), presence of non-calcified plaques, positive remodeling, and presence of a Napkin-Ring Sign. Results: Of the 485 patients, 278 were males (mean age: 67 years), with 109 having a history of stroke. Our data showed that patients with unilateral or bilateral high-risk soft plaques and carotid calcifications visualized by CTA were associated with increased risk of ischemic cerebral events (p&lt;0.001). Additionally, we found that patients with stroke had a greater number of calcium speckles (6-speckles in stroke group vs 4-speckles in non-stroke group; P&lt;0.01) in their carotid arteries. Receiver-Operating Curve analysis showed that the presence of more than 2 speckles in the carotid arteries portends a higher likelihood of developing a stroke (P&lt;0.01). Conclusions: This novel study shows that the presence of carotid artery calcifications or non-calcified high-risk soft plaques on one or both carotid arteries, in addition to &gt;2 calcium speckles in the carotid arteries were associated with an ischemic stroke. These results emphasize that the nature of atherosclerosis, and utility of comprehensive non-invasive CTA to identify patients who are at higher risk of developing ischemic stroke with a goal of early therapeutic strategies.
The growth inhibitory effect of paclitaxel on gefitinib-resistant non-small cell lung cancer (NSCLC) cells during the COVID-19 pandemic
Authors: M. Mohiuddin, H. Kimura, T. Sone, S. Watanabe, H. Matsuoka, K. Saeki, N. Terada, M. Abo, K. Kasahara
Journal: Cancer Research (2021)
General Anesthesia vs Local Anesthesia in Microelectrode Recording–Guided Deep-Brain Stimulation for Parkinson Disease
Authors: Rozemarije A. Holewijn, Dagmar Verbaan, Pepijn M. van den Munckhof, Maarten Bot, Gert J. Geurtsen, Joke M. Dijk, Vincent J. Odekerken, Martijn Beudel, Rob M. A. de Bie, P. Rick Schuurman
Journal: JAMA Neurology (2021)

<h3>Importance</h3> It is unknown if there is a difference in outcome in asleep vs awake deep brain stimulation (DBS) of the subthalamic nucleus for advanced Parkinson disease. <h3>Objective</h3> To determine the difference in adverse effects concerning cognition, mood, and behavior between awake and asleep DBS favoring the asleep arm of the study. <h3>Design, Setting, and Participants</h3> This study was a single-center prospective randomized open-label blinded end point clinical trial. A total of 187 persons with Parkinson disease were referred for DBS between May 2015 to March 2019. Analysis took place from January 2016 to January 2020. The primary outcome follow-up visit was conducted 6 months after DBS. <h3>Interventions</h3> Bilateral subthalamic nucleus DBS was performed while the patient was asleep (under general anesthesia) in 1 study arm and awake in the other study arm. Both arms of the study used a frame-based intraoperative microelectrode recording technique to refine final target placement of the DBS lead. <h3>Main Outcomes and Measures</h3> The primary outcome variable was the between-group difference in cognitive, mood, and behavioral adverse effects as measured by a composite score. The secondary outcomes included the Movement Disorders Society Unified Parkinson's Disease Rating Scale, the patient assessment of surgical burden and operative time. <h3>Results</h3> A total of 110 patients were randomized to awake (local anesthesia; n = 56; mean [SD] age, 60.0 (7.4) years; 40 [71%] male) or to asleep (general anesthesia; n = 54; mean [SD] age, 61.3 [7.9] years; 38 [70%] male) DBS surgery. The 6-month follow-up visit was completed by 103 participants. The proportion of patients with adverse cognitive, mood, and behavioral effects on the composite score was 15 of 52 (29%) after awake and 11 of 51 (22%) after asleep DBS (odds ratio, 0.7 [95% CI, 0.3-1.7]). There was no difference in improvement in the off-medication Movement Disorders Society Unified Parkinson's Disease Rating Scale Motor Examination scores between groups (awake group: mean [SD], −27.3 [17.5] points; asleep group: mean [SD], −25.3 [14.3] points; mean difference, −2.0 [95% CI, −8.1 to 4.2]). Asleep surgery was experienced as less burdensome by patients and was 26 minutes shorter than awake surgery. <h3>Conclusions and Relevance</h3> There was no difference in the primary outcome of asleep vs awake DBS. Future large randomized clinical trials should examine some of the newer asleep based DBS technologies because this study was limited to frame-based microelectrode-guided procedures. <h3>Trial Registration</h3> trialregister.nl Identifier:NTR5809
Offer medical cannabis to patients with chronic pain, experts recommend
Authors: Elisabeth Mahase
Journal: BMJ (2021)

People living with chronic pain should be offered a trial of non-inhaled medical cannabis or cannabinoids if standard care is not sufficient, a panel of international experts has said.1

The guideline panel—which reviewed the evidence as part of The BMJ ’s Rapid Recommendations initiative —noted that it is a “weak recommendation” because of the close balance between benefits and harms, as well as the high value placed on small to very small …
Therapist-supported online remote behavioural intervention for tics in children and adolescents in England (ORBIT): a multicentre, parallel group, single-blind, randomised controlled trial
Authors: Chris Hollis, Charlotte L Hall, Rebecca Jones, Louise Marston, Marie Le Novere, Rachael Hunter, Beverley J Brown, Charlotte Sanderson, Per Andrén, Sophie D Bennett, Liam R Chamberlain, E Bethan Davies, Amber Evans, Natalia Kouzoupi, Caitlin McKenzie, Isobel Heyman, Kareem Khan, Joseph Kilgariff, Cristine Glazebrook, David Mataix-Cols, Tara Murphy, Eva Serlachius, Elizabeth Murray
Journal: The Lancet Psychiatry (2021)

Exposure and Response Prevention (ERP) is a form of behavioural therapy for tics; however, its effectiveness remains uncertain. We aimed to evaluate the effectiveness of internet-delivered, therapist-supported, and parent-assisted ERP for treatment of tics in children and young people with Tourette syndrome or chronic tic disorder.
Long-Term Neurocognitive Outcome in Patients With Continuous Flow Left Ventricular Assist Device
Authors: Sung-Min Cho, Darlene Floden, Kristie Wallace, Nicholas Hiivala, Susan Joseph, Jeffrey Teuteberg, Joseph G. Rogers, Francis D. Pagani, Nahush Mokadam, David Tirschwell, Song Li, Randall C. Starling, Claudius Mahr, Ken Uchino
Journal: JACC Heart Failure (2021)
Health and Care Bill: the government does not want to limit privatisation or integrate services
Authors: John Puntis
Journal: BMJ (2021)

I am pleased that the BMA has come out firmly against the Health and Social Care Bill.1 If passed, it will disrupt the NHS while it is struggling with huge pressures from covid, staff shortages, and work backlog. The workforce crisis and the massive problem of social care are not tackled and it brings no extra funds to help trusts …
Innate Lymphoid Cells Promote Recovery of Ventricular Function After Myocardial Infarction
Authors: Xian Yu, Stephen A Newland, Tian X Zhao, Yuning Lu, Andrew S Sage, Yanyi Sun, Rouchelle S Sriranjan, Marcella K L Ma, Brian Y H Lam, Meritxell Nus, James E Harrison, Simon J Bond, Xiang Cheng, Jean-Sébastien Silvestre, James H F Rudd, Joseph Cheriyan, Ziad Mallat
Journal: Journal of the American College of Cardiology (2021)

Innate lymphoid cells type 2 (ILC2s) play critical homeostatic functions in peripheral tissues. ILC2s reside in perivascular niches and limit atherosclerosis development. ILC2s also reside in the pericardium but their role in postischemic injury is unknown. We examined the role of ILC2 in a mouse model of myocardial infarction (MI), and compared mice with or without genetic deletion of ILC2. We determined infarct size using histology and heart function using echocardiography. We assessed cardiac ILC2 using flow cytometry and RNA sequencing. Based on these data, we devised a therapeutic strategy to activate ILC2 in mice with acute MI, using exogenous interleukin (IL)-2. We also assessed the ability of low-dose IL-2 to activate ILC2 in a double-blind randomized clinical trial of patients with acute coronary syndromes (ACS). We found that ILC2 levels were increased in pericardial adipose tissue after experimental MI, and genetic ablation of ILC2 impeded the recovery of heart function. RNA sequencing revealed distinct transcript signatures in ILC2, and pointed to IL-2 axis as a major upstream regulator. Treatment of T-cell–deficient mice with IL-2 (to activate ILC2) significantly improved the recovery of heart function post-MI. Administration of low-dose IL-2 to patients with ACS led to activation of circulating ILC2, with significant increase in circulating IL-5, a prototypic ILC2-derived cytokine. ILC2s promote cardiac healing and improve the recovery of heart function after MI in mice. Activation of ILC2 using low-dose IL-2 could be a novel therapeutic strategy to promote a reparative response after MI.