tbuckley/cabot-search huggingface dataset:
Reassessment of the Role of Race in Calculating the Risk for Urinary Tract Infection
Authors: Nader Shaikh, Matthew C. Lee, Lynissa R. Stokes, Elizabeth Miller, Marcia Kurs-Lasky, Isabella Conway, Timothy R. Shope, Alejandro Hoberman
Journal: JAMA Pediatrics (2022)

A previously reported prediction model included a child's race to estimate risk of urinary tract infection (UTI), but race-conscious medicine encourages investigating how race is likely to be a proxy for other factors that should instead be used for risk prediction.To systematically review the available literature to evaluate the robustness of the association between race and UTI and to assess whether other variables could replace race as a variable in a previously developed prediction tool without adversely affecting its accuracy.MEDLINE was searched through May 28, 2021.English-language studies that reported data on the prevalence of UTI according to race for children younger than 18 years were included.Two independent reviewers assessed studies for risk of bias and abstracted data. Random-effects models were used to pool odds ratios, and meta-regression was used to explore heterogeneity.Odds of UTI among non-Black children vs Black children.Sixteen studies (17 845 children) were included. In the primary analysis, which included 11 studies, the pooled odds ratio of UTI among non-Black children was 2.44-fold higher (95% CI, 1.87-3.20) than among Black children. The corresponding odds ratio in studies with low or very low risk of bias was 4.84-fold higher (95% CI, 3.16-7.41; I2 = 0%) among non-Black children than among Black children. Replacing race with history of UTI and duration of fever resulted in a model with similar accuracy (training cohort: overall sensitivity, 96% [95% CI, 94%-98%]; overall specificity, 35% [95%, 32%-38%]; overall area under the receiver operating characteristic curve, 0.80 [95% CI, 0.77-0.82]; validation cohort: overall sensitivity, 97% [95% CI, 90%-100%]; overall specificity, 32% [95% CI, 26%-37%]; overall area under the receiver operating characteristic curve, 0.84 [95% CI, 0.77-0.92]).Although previous studies suggested that an association between race and UTI exists, because of the issues associated with the inclusion of race in decision models, we replaced the variable of race with history of UTI and duration of fever in a previously developed risk prediction model and found similar accuracy.
Prevalence of Children With Medical Complexity and Associations With Health Care Utilization and In-Hospital Mortality
Authors: JoAnna K. Leyenaar, Andrew P. Schaefer, Seneca D. Freyleue, Andrea M. Austin, Tamara D. Simon, Jeanne Van Cleave, Erika L. Moen, A. James O’Malley, David C. Goodman
Journal: JAMA Pediatrics (2022)

Children with medical complexity (CMC) have substantial health care needs and frequently experience poor health care quality. Understanding the population prevalence and associated health care needs can inform clinical and public health initiatives.To estimate the prevalence of CMC using open-source pediatric algorithms, evaluate performance of these algorithms in predicting health care utilization and in-hospital mortality, and identify associations between medical complexity as defined by these algorithms and clinical outcomes.This retrospective cohort study used all-payer claims data from Colorado, Massachusetts, and New Hampshire from 2012 through 2017. Children and adolescents younger than 18 years residing in these states were included if they had 12 months or longer of enrollment in a participating health care plan. Analyses were conducted from March 12, 2021, to January 7, 2022.The pediatric Complex Chronic Condition Classification System, Pediatric Medical Complexity Algorithm, and Children With Disabilities Algorithm were applied to 3 years of data to identify children with complex and disabling conditions, first in their original form and then using more conservative criteria that required multiple health care claims or involvement of 3 or more body systems.Primary outcomes, examined over 2 years, included in-hospital mortality and a composite measure of health care services, including specialized therapies, specialized medical equipment, and inpatient care. Outcomes were modeled using logistic regression. Model performance was evaluated using C statistics, sensitivity, and specificity.Of 1 936 957 children, 48.4% were female, 87.8% resided in urban core areas, and 45.1% had government-sponsored insurance as their only primary payer. Depending on the algorithm and coding criteria applied, 0.67% to 11.44% were identified as CMC. All 3 algorithms had adequate discriminative ability, sensitivity, and specificity to predict in-hospital mortality and composite health care services (C statistic = 0.76 [95% CI, 0.73-0.80] to 0.81 [95% CI, 0.78-0.84] for mortality and 0.77 [95% CI, 0.76-0.77] to 0.80 [95% CI, 0.79-0.80] for composite health care services). Across algorithms, CMC had significantly greater odds of mortality (adjusted odds ratio [aOR], 9.97; 95% CI, 7.70-12.89; to aOR, 69.35; 95% CI, 52.52-91.57) and composite health care services (aOR, 4.59; 95% CI, 4.44-4.73; to aOR, 18.87; 95% CI, 17.87-19.93) than children not identified as CMC.In this study, open-source algorithms identified different cohorts of CMC in terms of prevalence and magnitude of risk, but all predicted increased health care utilization and in-hospital mortality. These results can inform research, programs, and policies for CMC.
View Across the Pond: Insights from a National Survey on Clinical Ethics Services in Switzerland
Authors: Ralf J. Jox, Rouven C. Porz
Journal: The American Journal of Bioethics (2022)

This article refers to:Ethics Consultation in U.S. Hospitals: A National Follow-Up StudyEthics Consultation in U.S. Hospitals: Determinants of Consultation VolumeEthics Consultation in U.S. Hospitals: Opinions of Ethics Practitioners
Phenotypic Features of Coronary Atheroma in Diabetic and Nondiabetic Patients With Low-Density Lipoprotein Cholesterol &lt;55 mg/dL
Authors: Takamasa Iwai, Yu Kataoka, Stephen J. Nicholls, Rishi Puri, Shunsuke Murata, Kunihiro Nishimura, Kota Murai, Satoshi Kitahara, Kenichiro Sawada, Hideo Matama, Satoshi Honda, Kensuke Takagi, Masashi Fujino, Shuichi Yoneda, Fumiyuki Otsuka, Kensaku Nishihira, Yasuhide Asaumi, Yoshihiro Miyamoto, Satoshi Yasuda, Teruo Noguchi
Journal: JACC. Cardiovascular imaging (2022)
Hospital-Administered Cancer Therapy Prices for Patients With Private Health Insurance
Authors: Roy Xiao, Joseph S. Ross, Cary P. Gross, Stacie B. Dusetzina, J. Michael McWilliams, Rosh K. V. Sethi, Vinay K. Rathi
Journal: JAMA Internal Medicine (2022)

The federal Hospital Price Transparency final rule, which became effective in 2021, requires hospitals to publicly disclose payer-specific prices for drugs. However, little is known about hospital markup prices for parenterally administered therapies.To assess the extent of price markup by hospitals on parenterally administered cancer therapies and price variation among hospitals and between payers at each hospital.A cross-sectional analysis was conducted of private payer-specific negotiated prices for the top 25 parenteral (eg, injectable or infusible) cancer therapies by Medicare Part B spending in 2019 using publicly available hospital price transparency files. Sixty-one National Cancer Institute (NCI)-designated cancer centers providing clinical care to adults with cancer were included. The study was conducted from April 1 to October 15, 2021.Estimated hospital acquisition costs for each cancer therapy using participation data from the federal 340B Drug Pricing Program.The primary outcome was hospital price markup for each cancer therapy in excess of estimated acquisition costs. Secondary outcomes were the extent of across-center price ratios, defined as the ratio between the 90th percentile and 10th percentile median prices across centers, and within-center price ratios, defined as the ratio between the 90th percentile and 10th percentile prices between payers at each center.Of 61 NCI-designated cancer centers, 27 (44.3%) disclosed private payer-specific prices for at least 1 top-selling cancer therapy as required by federal regulations. Median drug price markups across all centers and payers ranged between 118.4% (sipuleucel-T) and 633.6% (leuprolide). Across-center price ratios ranged between 2.2 (pertuzumab) and 15.8 (leuprolide). Negotiated prices also varied considerably between payers at the same center; median within-center price ratios for cancer therapies ranged from 1.8 (brentuximab) to 2.5 (bevacizumab).Most NCI-designated cancer centers did not publicly disclose payer-specific prices for cancer therapies as required by federal regulation. The findings of this cross-sectional study suggest that, to reduce the financial burden of cancer treatment for patients, institution of public policies to discourage or prevent excessive hospital price markups on parenteral chemotherapeutics might be beneficial.
Clinical impact and proposed application of molecular markers, genetic variants, and cytogenetic analysis in mast cell neoplasms: Status 2022
Authors: Michel Arock, Gregor Hoermann, Karl Sotlar, Olivier Hermine, Wolfgang R. Sperr, Karin Hartmann, Knut Brockow, Cem Akin, Massimo Triggiani, Sigurd Broesby-Olsen, Andreas Reiter, Jason Gotlib, Hans-Peter Horny, Alberto Orfao, Dean D. Metcalfe, Peter Valent
Journal: Journal of Allergy and Clinical Immunology (2022)
Lipoprotein(a), Menopausal Hormone Therapy, and Risk of Coronary Heart Disease in Postmenopausal Individuals
Authors: Michael C. Honigberg, Mark Trinder, Pradeep Natarajan
Journal: JAMA Cardiology (2022)

Highlights From the American College of Cardiology's Scientific Sessions—New Heart Failure Management Guidelines, Alirocumab After a Myocardial Infarction, and Treating Mild Chronic Hypertension in Pregnancy
Clarifying Best Practices for Early Childhood Development—Reply
Authors: Dana C. McCoy, Sharon Wolf, Edward Tsinigo
Journal: JAMA Pediatrics (2022)

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Association of Left Atrial Structure and Function With Heart Failure in Older Adults
Authors: Riccardo M Inciardi, Brian Claggett, Masatoshi Minamisawa, Sung-Hee Shin, Senthil Selvaraj, Alexandra Gonçalves, Wendy Wang, Dalane Kitzman, Kunihiro Matsushita, Narayana G Prasad, Jimmy Su, Hicham Skali, Amil M Shah, Lin Yee Chen, Scott D Solomon
Journal: Journal of the American College of Cardiology (2022)
LAG3 associates with TCR–CD3 complexes and suppresses signaling by driving co-receptor–Lck dissociation
Authors: Clifford Guy, Diana M. Mitrea, Po-Chien Chou, Jamshid Temirov, Kate M. Vignali, Xueyan Liu, Hui Zhang, Richard Kriwacki, Marcel P. Bruchez, Simon C. Watkins, Creg J. Workman, Dario A. A. Vignali
Journal: Nature Immunology (2022)
Finding Lymph Nodes With Carbon Nanoparticle Suspension Injection
Authors: Anna Curell, Jose M. Balibrea
Journal: JAMA Network Open (2022)

Yuan Tian, MD; Peigang Yang, MD; Yecheng Lin, MD; Yiyang Hu, MD; Huiyan Deng, MD; Wenqian Ma, MD; Honghai Guo, MD; Yang Liu, MD; Ze Zhang, MD; Pingan Ding, MD; Yong Li, MD; Liqiao Fan, MD; Zhidong Zhang, MD; Dong Wang, MD; Qun Zhao, MD
Incidence rates, emerging serotypes and genotypes, and antimicrobial susceptibility of pneumococcal disease in Taiwan: A multi-center clinical microbiological study after PCV13 implementation
Authors: Chih-Ho Chen, Rajendra Prasad Janapatla, Lin-Hui Su, Hsin-Chieh Li, Kuang-Che Kuo, Chun-Chih Chien, Chang-Chun Hsiao, Cheng-Hsun Chiu
Journal: Journal of Infection (2022)
Pre-Morbid Body Mass Index and Mortality After Incident Heart Failure
Authors: Umair Khalid, Sameer Ather, Chirag Bavishi, Wenyaw Chan, Laura R. Loehr, Lisa M. Wruck, Wayne D. Rosamond, Patricia P. Chang, Joe Coresh, Salim S. Virani, Vijay Nambi, Biykem Bozkurt, Christie M. Ballantyne, Anita Deswal
Journal: Journal of the American College of Cardiology (2014)
Abstract 2557: Diagnosis of Left Ventricular Hypertrophy in the Presence of Anterior Fascicular Block: A Re-examination of the 2009 AHA/ACCF/HRS Guidelines
Authors: Sandeep Ravi, Vladimir Rukshin, Santhi Adigopula, Janardhan Srinivasan, Ravi Kalaga, Gilead Lancaster, Stuart Zarich, Craig McPherson
Journal: Circulation (2009)

PURPOSE: The 2009 “AHA/ACCF/HRS Recommendations for Standardization and Interpretation of the Electrocardiogram” (ECG) state that in the presence of left anterior fascicular block (LAFB), left vent...
Association Between Residential Proximity to Hydraulic Fracturing Sites and Adverse Birth Outcomes
Authors: Zoe F. Cairncross, Isabelle Couloigner, M. Cathryn Ryan, Carly McMorris, Lucija Muehlenbachs, Nickie Nikolaou, Ron Chik-Kwong Wong, Selwynne M. Hawkins, Stefania Bertazzon, Jason Cabaj, Amy Metcalfe
Journal: JAMA Pediatrics (2022)

The association between hydraulic fracturing and human development is not well understood. Several studies have identified significant associations between unconventional natural gas development and adverse birth outcomes; however, geology and legislation vary between regions.To examine the overall association between residential proximity to hydraulic fracturing sites and adverse birth outcomes, and investigate whether well density influenced this association.This population-based retrospective cohort study of pregnant individuals in rural Alberta, Canada, took place from 2013 to 2018. Participants included reproductive-aged individuals (18-50 years) who had a pregnancy from January 1, 2013, to December 31, 2018, and lived in rural areas. Individuals were excluded if they lived in an urban setting, were outside of the age range, or were missing data on infant sex, postal code, or area-level socioeconomic status.Oil and gas wells that underwent hydraulic fracturing between 2013 to 2018 were identified through the Alberta Energy Regulator (n = 4871). Individuals were considered exposed if their postal delivery point was located within 10 km of 1 or more wells that was hydraulically fractured during 1 year preconception or during pregnancy.Outcomes investigated were spontaneous and indicated preterm birth, small for gestational age, major congenital anomalies, and severe neonatal morbidity or mortality.After exclusions, the sample included 26 193 individuals with 34 873 unique pregnancies, and a mean (SD) parental age of 28.2 (5.2) years. Small for gestational age and major congenital anomalies were significantly higher for individuals who lived within 10 km of at least 1 hydraulically fractured well after adjusting for parental age at delivery, multiple births, fetal sex, obstetric comorbidities, and area-level socioeconomic status. Risk of spontaneous preterm birth and small for gestational age were significantly increased in those with 100 or more wells within 10 km.Results suggest that individuals who were exposed to hydraulic fracturing within pregnancy may be at higher risk of several adverse birth outcomes. These results may be relevant to health policy regarding legislation of unconventional oil and gas development in Canada and internationally.
Consensus Statement on Mandatory Measurements for Pancreatic Cancer Trials for Patients With Resectable or Borderline Resectable Disease (COMM-PACT-RB)
Authors: Esther N. Pijnappel, J. Annelie Suurmeijer, Bas Groot Koerkamp, Milan Kos, Jens T. Siveke, Roberto Salvia, Paula Ghaneh, Casper H. J. van Eijck, Faridi S. van Etten-Jamaludin, Ross Abrams, Birute Brasiūnienė, Markus W. Büchler, Riccardo Casadei, Jean-Luc van Laethem, Jordan Berlin, Narikazu Boku, Thierry Conroy, Henriette Golcher, Marianne Sinn, John P. Neoptolemos, Geertjan van Tienhoven, Marc G. Besselink, Johanna W. Wilmink, Hanneke W. M. van Laarhoven
Journal: JAMA Oncology (2022)

<h3>Importance</h3> Pancreatic cancer is the third most common cause of cancer death; however, randomized clinical trials (RCTs) of survival in patients with resectable pancreatic cancer lack mandatory measures for reporting baseline and prognostic factors, which hampers comparisons between outcome measures. <h3>Objective</h3> To develop a consensus on baseline and prognostic factors to be used as mandatory measurements in RCTs of resectable and borderline resectable pancreatic cancer. <h3>Evidence Review</h3> We performed a systematic literature search of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Embase for RCTs on resectable and borderline resectable pancreatic cancer with overall survival as the primary outcome. We produced a systematic summary of all baseline and prognostic factors identified in the RCTs. A Delphi panel that included 13 experts was surveyed to reach a consensus on mandatory and recommended baseline and prognostic factors. <h3>Findings</h3> The 42 RCTs that met inclusion criteria reported a total of 60 baseline and 19 prognostic factors. After 2 Delphi rounds, agreement was reached on 50 mandatory baseline and 20 mandatory prognostic factors for future RCTs, with a distinction between studies of neoadjuvant vs adjuvant treatment. <h3>Conclusion and Relevance</h3> This findings of this systematic review and international expert consensus have produced this Consensus Statement on Mandatory Measurements in Pancreatic Cancer Trials for Resectable and Borderline Resectable Disease (COMM-PACT-RB). The baseline and prognostic factors comprising the mandatory measures will facilitate better comparison across RCTs and eventually will enable improved clinical practice among patients with resectable and borderline resectable pancreatic cancer.
Reduced neutralizing antibody response in naïve Covishield vaccinees against Omicron emphasizes booster vaccination
Authors: Pragya D. Yadav, Gajanan N. Sapkal, Rima R. Sahay, Deepak Y. Patil, Sachee Agrawal, Balkrishna Adsul, Srikanth Tripathy, Gururaj R. Deshpande, Dimpal A. Nyayanit, Anita M. Shete, Manish Manraie, Sanjay Kumar, Jayanthi Shastri, Priya Abraham
Journal: Journal of Infection (2022)
Moving the Translational Needle in Breast Cancer Survivorship: Connecting Intervention Research to Clinical Practice
Authors: Eden R. Brauer, Patricia A. Ganz
Journal: Journal of Clinical Oncology (2022)

Breast cancer is the most common cancer in women worldwide, and advances in its early detection and treatment have yielded large and growing numbers of long-term survivors. 1Since 1989, the death rate for breast cancer has been in decline, and the 5-year and 10-year survival rates for invasive breast cancer have now reached 90% and 84%, respectively. 2Breast cancer has also been one of the most studied cancers with respect to both observational and intervention research, dating back to some of the earliest psychosocial research 50 years ago, first describing the impact of radical mastectomy. 3As a result, there is a large body of published literature that focuses on interventions for the physical and psychosocial outcomes after a breast cancer diagnosis, including pain, fatigue, neuropathy, body image, sexual dysfunction, cognitive impairment, and others.The focus of intervention research has also evolved over time with broader trends in health care delivery, and contemporary topics, such as financial toxicity, have only recently emerged.Many of these studies have also contributed to our understanding of biologic and behavioral mechanisms underlying long-term and late effects in cancer survivors.Importantly, these research advancements are a testament to the accessibility and willingness of survivors of breast cancer to participate in research that might help them or others.Through this historical lens, we consider the findings of the article accompanying this editorial, 4 in which the authors conducted a data synthesis that mapped systematic reviews of interventions for breast cancer survivors onto a contemporary survivorship framework. 5The overall aim of this analysis was to identify key gaps in the intervention research literature and examine the level of connectivity among the framework content elements.Published in 2019, the Cancer Survivorship Care Quality framework consists of five distinct, but inter-related domains of cancer survivorship care (physical effects, psychosocial effects, recurrences and new cancers, health promotion, and chronic conditions), surrounded by four contextual health care delivery domains (clinical structure, communication/decision making, care coordination, and patient/caregiver experience), which are then linked to four health care outcomes (health-related quality of life, emergency services/hospitalizations, costs, and mortality; Fig 1). 5 As one of the few comprehensive frameworks in the field, it provides a useful roadmap and common terminology to guide improvements in cancer survivorship care delivery, research, and policy.
Long-term trends in the loss in expectation of life after a diagnosis of chronic lymphocytic leukemia: a population-based study in the Netherlands, 1989–2018
Authors: Lina van der Straten, Carolien C. H. M. Maas, Mark-David Levin, Otto Visser, Eduardus F. M. Posthuma, Jeanette K. Doorduijn, Anton W. Langerak, Arnon P. Kater, Avinash G. Dinmohamed
Journal: Blood Cancer Journal (2022)
PD-1 and ICOS coexpression identifies tumor-reactive CD4+ T cells in human solid tumors
Authors: Rebekka Duhen, Olivier Fesneau, Kimberly A. Samson, Alexandra K. Frye, Michael Beymer, Venkatesh Rajamanickam, David Ross, Eric Tran, Brady Bernard, Andrew D. Weinberg, Thomas Duhen
Journal: Journal of Clinical Investigation (2022)

CD4+ Th cells play a key role in orchestrating immune responses, but the identity of the CD4+ Th cells involved in the antitumor immune response remains to be defined. We analyzed the immune cell infiltrates of head and neck squamous cell carcinoma and colorectal cancers and identified a subset of CD4+ Th cells distinct from FOXP3+ Tregs that coexpressed programmed cell death 1 (PD-1) and ICOS. These tumor-infiltrating lymphocyte CD4+ Th cells (CD4+ Th TILs) had a tissue-resident memory phenotype, were present in MHC class II-rich areas, and proliferated in the tumor, suggesting local antigen recognition. The T cell receptor repertoire of the PD-1+ICOS+ CD4+ Th TILs was oligoclonal, with T cell clones expanded in the tumor, but present at low frequencies in the periphery. Finally, these PD-1+ICOS+ CD4+ Th TILs were shown to recognize both tumor-associated antigens and tumor-specific neoantigens. Our findings provide an approach for isolating tumor-reactive CD4+ Th TILs directly ex vivo that will help define their role in the antitumor immune response and potentially improve future adoptive T cell therapy approaches.