tbuckley/cabot-search huggingface dataset:
Association of Use of Electronic Appointment Reminders With Waiting Times in the Veterans Affairs Health System
Authors: Lianjun Li, Haiqing Zhao, Noah Lim, Joel Goh, Bernard Ng
Journal: JAMA Network Open (2022)

<h3>Importance</h3> Electronic appointment reminder systems are increasingly used across health systems. However, their association with patients’ waiting times for their appointments, a measure of timely access to care, has yet to be assessed. <h3>Objective</h3> To assess the associations between the introduction of an electronic appointment reminder system and the number of days patients had to wait from appointment booking to appointment completion in patients in the Veterans Affairs Health System. <h3>Design, Setting, and Participants</h3> Cohort study of patients who completed appointments from January 1, 2018, to October 13, 2018, inclusive in all 130 Veterans Affairs (VA) health centers in the US. The study population comprised a census of all patients who received care at any VA health center during the period of the study for outpatient, procedural, rehabilitation, or radiology services. Data were analyzed from May 15, 2021, to December 15, 2021. <h3>Exposures</h3> Phased introduction of an electronic appointment reminder system (VEText) in 6 waves spread across the study period. <h3>Main Outcomes and Measures</h3> The unit of observation in this study was a completed appointment made by any such patients. Observations were excluded if the appointment was booked before but completed after the exposure, or if data were duplicated, missing, or incomplete. For each completed appointment, the number of days between which the appointment was booked and when it was completed. <h3>Results</h3> The number of observations after exclusion comprised 39.5 million completed appointments from 5.1 million patients (91.1% male) with a mean (SD) age of 62.57 (16.24) years. The adoption of VEText was associated with an estimated reduction in patient waiting time by a mean of 6.51 days (95% CI, 5.51-7.52 days). Adoption of VEText was also associated with an increase of 8.54 (95% CI, 7.65-9.44) days of additional waiting per incomplete booking. <h3>Conclusions and Relevance</h3> Results of this study suggest that appointment reminder systems may be associated with decreases in the mean number of days patients in the VA system have to wait for their appointments but can potentially lengthen waiting times for patients who miss their bookings. Further study is warranted to assess whether these findings may be generalizable to other populations.
Abstract 17253: Gender Disparities Across the Spectrum of Valvular Heart Disease in Elderly Chinese Patients
Authors: Bin Zhang, Haitong Zhang, Qinghao Zhao, Haiyan Xu, Yongjian Wu
Journal: Circulation (2018)

Introduction: Evidence for the gender gap in valvular heart disease (VHD) has been mixed. This study aimed to investigate the potential gender differences concerning distribution patterns, clinical characteristics, management and in-hospital outcomes of noteworthy VHD in the elderly Chinese population. Hypothesis: Gender disparities exist across the spectrum and management of valvular heart disease in elderly Chinese patients. Methods: The China Degenerative Valve Disease (China DVD) Cohort Study was conducted from October 2016 to December 2017 in 72 centers from China. It included prospectively 8923 patients aged ≥60 years with moderate to severe native VHD, infective endocarditis, or previous valve intervention. In-hospital outcomes after invasive treatments were evaluated by composite endpoint consisting of death, major bleeding and nonfatal stroke. Results: Of all the 8923 VHD patients, men accounted for 52.48%, with aortic regurgitation (AR; 13.2% vs. 6.5%) and aortic stenosis (AS; 5.8% vs. 3.8%) contributing more of the VHD diagnosis than women. By contrast, the proportion of women with mitral stenosis (MS; 4.8% vs. 1.8%) was much higher than men. While the rheumatic causes stayed significant in MS, a growing predominance of degenerative causes was detected regardless of gender in patients with aortic VHD and MR. Body mass index, history of smoking, hypertension, CHD, cardiomyopathy, aortic diseases and previous intervention were significantly higher in men whereas women were more frequently complicated with atrial fibrillation or atrial flutter. Concerning medical intervention, coronary angiography was used in 51.5% of male patients compared to 47.3% of female patients (p=0.01). Among the 2188 patients received invasive treatments, the prosthetic replacement was performed in 61% of women with AS in comparison to 47.2% of men with AS (p=0.006). Conversely, men with AR were more likely to receive prosthetic replacement than women (29.8% vs. 21.3%, p=0.008). No significant differences were found in patients with mitral VHD. Operative mortality was &lt; 5% for single VHD. Multivariate regression analysis revealed an association between in-hospital outcomes and higher BMI as well as concomitant aortic disease regardless of gender. Conclusions: This study provides sex-specific data on characteristics and management of elderly Chinese patients with VHD. Pronounced sex-specific patterns were observed for aortic VHD and MS.
Abstract 17168: Stroke Stabilization Following Repetitive Xenon Liposomal Delivery
Authors: Xing Yin, Manoj P Dandekar, Tao Peng, Melvin E Klegerman, Melanie R Moody, Hyunggun Kim, David McPherson, Shaoling Huang
Journal: Circulation (2018)

Introduction: Stroke is a leading cause of brain injury. Most stroke survival has long-term disability due to cerebral damage. We have demonstrated that xenon(Xe) liposomal injection provides novel neuroprotection. Hypothesis: Repetitive Xe-liposomal administration over a longer period post stroke results in brain protection. Methods: Stroke was induced by middle cerebral artery occlusion(MCAO) for 6 hours. Xe-liposomes were intravenously administrated for varying duration and time periods to investigate the administration frequency and administration duration. Infarct size was evaluated by TTC staining. Forelimb placing/Grid walking were conducted to evaluate neurological function. Results: MCA occlusion for 6 hours generated a 23%±2.8% infarct volume. Repetitive injections at every one hour for 5 injections effectively reduced infract volume(3.8%±0.2%,p&lt;0.05) than a single injection(11%±2.3). Extending Xe liposomal treatment to 3 days further decreased infarct volume to 1.9%%±0.7 (p&lt;0.01,Fig.1A). Behavior tests results are correlated with TTC staining(Fig. 1B). Conclusions: Repetitive Xe-liposomal administration over the first 6 hours following MCAO and extending daily administration results in brain stabilization.This novel method may help may help extend the time window for stroke treatment.
Colon Cancer Data Key as Pfizer Buys Array
Journal: Cancer Discovery (2019)

Pfizer announced plans to acquire Array BioPharma, maker of a BRAF-MEK inhibitor combination that is currently approved for melanoma and could become a first-in-class treatment for colorectal cancer. The $11.4 billion deal also lands Pfizer a small pipeline of other targeted cancer medicines in development and a portfolio of out-licensed medicines with the potential to generate substantial royalties.
Correction
Authors: Dr Guillouzo, Roberto Groszmann, J Henderson, Louise Rappaport, Helga Witt-Sullivan, Jenny Heathcote, Karen Cauch, Laurence Blendis, Cameron Ghent, Allen Katz, Ruth Milner, S Pappas, James Rankin, Ian Wanless
Journal: Hepatology (1991)

On page 101, right column, lines 3 and 4 state erroneously that 127 (71.3%) patients were asymptomatic (no jaundice and/or pruritus).It should have read as follows: "127 (71.3%) were symptomatic (jaundice and/or pruritus) and 51 (28.7%) were asymptomatic.
Phenacetin nephropathy.
Authors: S. J. Surtees
Journal: BMJ (1970)

<h3>Objectives</h3> COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios. <h3>Methods</h3> We used country-specific epidemiological projections from a dynamic transmission model to determine number of cases, hospitalisations and deaths over 1 year under four mitigation scenarios. We defined the health sector response for three base LMICs through guidelines and expert opinion. We calculated costs through local resource use and price data and extrapolated costs across 79 LMICs. Lastly, we compared cost estimates against gross domestic product (GDP) and total annual health expenditure in 76 LMICs. <h3>Results</h3> COVID-19 clinical management costs vary greatly by country, ranging between &lt;0.1%–12% of GDP and 0.4%–223% of total annual health expenditure (excluding out-of-pocket payments). Without mitigation policies, COVID-19 clinical management costs per capita range from US$43.39 to US$75.57; in 22 of 76 LMICs, these costs would surpass total annual health expenditure. In a scenario of stringent social distancing, costs per capita fall to US$1.10–US$1.32. <h3>Conclusions</h3> We present the first dataset of COVID-19 clinical management costs across LMICs. These costs can be used to inform decision-making on priority setting. Our results show that COVID-19 clinical management costs in LMICs are substantial, even in scenarios of moderate social distancing. Low-income countries are particularly vulnerable and some will struggle to cope with almost any epidemiological scenario. The choices facing LMICs are likely to remain stark and emergency financial support will be needed.
Abstract 151: Do the Simplified 2015 ERC Guidelines Improve Basic Life Support Performance Compared to 2010 ERC Guidelines?
Authors: Dung T Nguyen, Kasper G Lauridsen, Josephine Johnsen, Katrine B Bomholt, Bo Løfgren
Journal: Circulation (2018)

Background: The European Resuscitation Council (ERC) 2015 basic life support (BLS) algorithm has been simplified compared with the ERC 2010 BLS algorithm. Simplification of resuscitation guidelines may facilitate learning and improve guidelines adherence. This study aimed to study BLS performance using ERC 2015 compared with ERC 2010 guidelines. Methods: This is an observational study including video recordings of laypersons being skill tested after participation in a standardized ERC BLS/AED course using either the simplified ERC 2015 or ERC 2010 guidelines. The endpoints were 1) performing all steps of the BLS/AED algorithm correctly, 2) remembering the sequence of actions of the BLS/AED algorithm, 3) time to emergency medical service call, 4) time to first chest compression and 5) time to first shock. Results: We analyzed videos of 100 laypersons (50 trained using the simplified 2015 guidelines and 50 trained using the 2010 guidelines). Overall, 78% and 62% correctly performed all of the steps of the 2015 and 2010 guidelines respectively (p=0.08), whereas 94% and 82% remembered the correct sequence of actions of the 2015 and 2010 algorithms, respectively (p=0.06). There was no significant difference between participants following the 2015 vs 2010 algorithms with respect to time to emergency medical service call (difference: 0 sec, (95% confidence interval (CI): -3; 2) P=0.70), time to first chest compression (difference: 0 sec, (95% CI: -3;3) P=1.00), and time to first shock (difference: 0 sec, (95% CI: -6; 7) P=0.90). Conclusion: Laypersons tends to better perform resuscitation and adhere to the BLS algorithm when using the simplified ERC 2015 guidelines compared to the 2010 Guidelines. There were however no differences in time to emergency medical service call, time to first chest compression and shock delivery.
Factors associated with the quality of end-of-life care for patients with metastatic renal cell carcinoma.
Authors: Hannah Elizabeth Dzimitrowicz, Lauren E. Wilson, Bradford E. Jackson, Lisa Spees, Christopher Baggett, Melissa A. Greiner, Deborah Kaye, Tian Zhang, Daniel J. George, Charles D. Scales, Jessica Pritchard, Michael S. Leapman, Cary Philip Gross, Michaela Ann Dinan, Stephanie B. Wheeler
Journal: Journal of Clinical Oncology (2022)

300 Background: Although oral anti-cancer agents (OAAs) have improved outcomes for patients with metastatic renal cell carcinoma (mRCC), most patients still die from the disease. High quality end-of-life (EOL) care remains a crucial component of optimal care for patients with mRCC, but neither it nor systemic therapy use at EOL have been well characterized in these patients. Methods: We conducted a retrospective study of decedents with mRCC in 2 cohorts analyzed in parallel: 1) patients aged ≥18 years (diagnosed with RCC in 2004 through 2015) drawn from the University of North Carolina Cancer Information Population Health Resource (NC-CIPHR) and 2) patients aged ≥66 years (diagnosed with RCC in 2007 through 2015) from SEER-Medicare. OAA use was measured from date of mRCC diagnosis until 30 days prior to death. We assessed use of hospice in the last 30 days of life as well as established measures of low EOL care quality: receipt of systemic therapy, hospital admission, and ICU admission in last 30 days of life, and death in hospital. Multivariable logistic regression was used to estimate odds ratios (OR) and 95% confidence limits (95%CL) for associations between OAA use, patient and provider characteristics, and EOL care quality in both cohorts. Results: We identified 410 (NC-CIPHR) and 1508 (SEER-Medicare) patients with median ages of 69 and 75 years, respectively. 53.4% and 43.5% of decedents received an OAA in NC-CIPHR and SEER-Medicare, respectively. OAA use was associated with increased systemic therapy in the last 30 days prior to death in both datasets, increased hospice in the last 30 days prior to death in SEER-Medicare, and increased death in hospital in NC-CIPHR. OAA use was not associated with inpatient or ICU admission near EOL in both cohorts. Older patients were less likely to receive chemotherapy, be admitted, or die in the hospital near EOL in both cohorts. Dual-enrolled beneficiaries (Medicare and Medicaid) had decreased likelihood of hospice use in 30 days prior to death (OR = 0.71; 95%CL: 0.54, 0.94) and increased death in hospital (OR = 1.40; 95%CL: 1.02, 1.93) in SEER-Medicare. Conclusions: Patients with mRCC who received OAAs were more likely to receive systemic therapy at the EOL, however, they were also more likely to receive hospice care at EOL in the SEER-Medicare cohort with no differences in hospitalization near EOL. Future directions include characterization of EOL care in the era of immunotherapy treatments. [Table: see text]
Paracetamol overdose.
Authors: A Lyell, S Alexander
Journal: BMJ (1971)

Deaths from Tuberculosis SIR,-I have recently conducted an analysis of 71 new cases of tuberculosis diagnosed in a large general hospital over a six-year period.The results confirm some of the comments in your leading article on this subject (22 May, p. 419).In 17 (24%') there was undue delay in making the correct diag- nosis.In 15 an interval of more than three weeks elapsed between hospital admission and diagnosis, and in two tuberculosis was not discovered until necropsy.In these two cases and in seven others, failure to con- sider tuberculosis in the initial differential diagnosis was a major factor in causing this delay.Three of these nine patients had recognized predisposing factors (one was an alcoholic and two were receiving cortico- steroid drugs), and four had extrathoracic tuberculosis.None were immigrants.The necessity of considering tuberculosis in the elderly is confirmed by the case of an 80-year-old woman who presented with weakness, anorexia, abdominal discomfort, and weight loss.Though there was a diffuse bilateral abnormality on chest radiograph, a diagnosis of intra-abdominal malignant disease was made.At necropsy, disseminated miliary tuberculosis was found.These findings and the report of the Research Committee of the British Thoracic and Tuberculosis Association' stress the im- portance of communicating to medical students and postgraduates the continuing need to consider tuberculosis in the differen- tial diagnosis of any unexplained illness, particularly where this occurs in the elderly, in immigrants, and in patients with recog- nized predisposing factors such as diabetes, alcoholism, and corticosteroid therapy.-I
Sociodemographic Patterns of Exposure to Civil Aircraft Noise in the United States
Authors: Matthew C. Simon, Jaime E. Hart, Jonathan I. Levy, Trang VoPham, Andrew Malwitz, Daniel Nguyen, Matthew Bozigar, L. Adrienne Cupples, Peter James, Francine Laden, Junenette L. Peters
Journal: Environmental Health Perspectives (2022)

Background: Communities with lower socioeconomic status and higher prevalence of racial/ethnic minority populations are often more exposed to environmental pollutants. Although studies have shown associations between aircraft noise and property values and various health outcomes, little is known about how aircraft noise exposures are sociodemographically patterned. Objective: Our aim was to describe characteristics of populations exposed to aviation noise by race/ethnicity, education, and income in the United States. Methods: Aircraft noise contours characterized as day–night average sound level (DNL) were developed for 90 U.S. airports in 2010 for DNL ≥45 dB(A) in 1-dB(A) increments. We compared characteristics of exposed U.S. Census block groups at three thresholds (≥45, ≥55, and ≥65 dB(A)), assigned on the basis of the block group land area being ≥50% within the threshold, vs. unexposed block groups near study airports. Comparisons were made across block group race/ethnicity, education, and income categories within the study areas (n=4,031–74,253). We performed both multinomial and other various multivariable regression approaches, including models controlling for airport and models with random intercepts specifying within-airport effects and adjusting for airport-level means. Results: Aggregated across multiple airports, block groups with a higher Hispanic population had higher odds of being exposed to aircraft noise. For example, the multinomial analysis showed that a 10-percentage point increase in a block group's Hispanic population was associated with an increased odds ratio of 39% (95% CI: 25%, 54%) of being exposed to ≥65 dB(A) compared with block groups exposed to <45 dB(A). Block groups with higher proportions of residents with only a high school education had higher odds of being exposed to aircraft noise. Results were robust across multiple regression approaches; however, there was substantial heterogeneity across airports. Discussion: These results suggest that across U.S. airports, there is indication of sociodemographic disparities in noise exposures. https://doi.org/10.1289/EHP9307
Abstract 138: A Before and After Study of Active Compression Decompression Cardiopulmonary Resuscitation With the Impedance Threshold Device in a Large Urban Pre-Hospital System
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)

Introduction: Active Compression Decompression cardiopulmonary resuscitation with an impedance threshold device (ACD+ITD CPR) is available for use in the United States. However, little is known regarding integration of this CPR system into a large urban prehospital system with short response times, routine use of mechanical CPR and ITD, and transport of patients to cardiac arrest centers. This is an ongoing before and after study of the implementation of ACD+ITD CPR in non-traumatic cardiac arrest cases 6 months pre and post protocol change. Hypothesis: Neurologically intact rates of survival, defined by Cerebral Performance Category (CPC) score of 1 or 2, would be higher post protocol. Methods: Basic life support first responders (n = 420) and paramedics (n = 207) underwent training including didactic and hands-on sessions to learn ACD+ITD CPR. The protocol included ACD+ITD CPR initially, with the option to transition to mechanical CPR at 15 minutes. Demographics, response time, CPR duration, initial rhythm, signs of perfusion during CPR, and return of spontaneous circulation (ROSC) were recorded prospectively by first responders. Chart review was performed to determine survival to hospital admission and CPC score at discharge. Results: Training occurred October 2016 to March 2017, with protocol change on May 1, 2017. Cases from November 2016-April 2017 (n = 136) and May 2017-November 2017 (n= 103) were reviewed. Complete data were available for 128 subjects pre-protocol change (94%) and 96 subjects (94%) post. Age, gender, response time, rhythm, total CPR time, and rates of bystander CPR and witnessed arrest were similar between groups. Post protocol change, 87% (89/102) received ACD+ITD CPR with median ACD+ITD CPR time of 15 minutes (range 2-300). Pre-protocol, 6/128 (4.7%) subjects survived with CPC score 1 or 2, versus 8/96 (13.5%) subjects post (difference 8.8%, 95% CI 1%-17%). ROSC rates were similar (pre: 54/127, 42.5% post: 44/93, 47%, difference 4.8%, 95% CI -8% - 18%) Conclusions: The change in protocol was straightforward with a high rate of adherence of the system for the recommended duration of therapy. Results are suggestive of a higher rate of neurological survival with the routine use of ACD+ITD CPR in a small cardiac arrest patient population.
The British Society of Gastroenterology. 1986 spring meeting. 9-11 April 1986.
Authors: J Crampton, L Gibbons, D Cunningham, J Taggart, M Soukop, L Sellers, A Allen, M Benne1r, C Hudson, J Caygill, M Hill, J Kirkham, T Northfield, N Womack, J Morrison, N Williams
Journal: Gut (1986)

the University of Lancaster under the presidency of Dr G P Crean.The following are the abstracts of the 70 oral and 112 poster communications selected for presentation at the meeting.
SNX10-mediated degradation of LAMP2A by NSAIDs inhibits chaperone-mediated autophagy and induces hepatic lipid accumulation
Authors: Wonseok Lee, Hyun Young Kim, You-Jin Choi, Seung-Hwan Jung, Yoon Ah Nam, Yunfan Zhang, Sung Ho Yun, Tong-Shin Chang, Byung-Hoon Lee
Journal: Theranostics (2022)

Rationale: While some non-steroidal anti-inflammatory drugs (NSAIDs) are reported to induce hepatic steatosis, the molecular mechanisms are poorly understood.This study presented the mechanism by which NSAIDs induce hepatic lipid accumulation.Methods: Mouse primary hepatocytes and HepG2 cells were used to examine the underlying mechanism of NSAID-induced hepatic steatosis.Lipid accumulation was measured using Nile-red assay and BODIPY 493/503.The activity of chaperone-mediated autophagy (CMA) was determined by western blotting, qRT-PCR, and confocal imaging.The effect of NSAID on CMA inhibition was evaluated in vivo using diclofenac and CMA activator (AR7) administered mice.Results: All tested NSAIDs in this study accumulated neutral lipids in hepatocytes, diclofenac having demonstrated the most potency in that regard.Diclofenac-induced lipid accumulation was confirmed in both mouse primary hepatocytes and the liver of mice.NSAIDs inhibited CMA, as reflected by the decreased expression of lysosome-associated membrane glycoprotein 2 isoform A (LAMP2A) protein, the increased expression of CMA substrate proteins such as PLIN2, and the decreased activity of photoactivatable KFERQ-PAmCherry reporter.Reactivation of CMA by treatment with AR7 or overexpression of LAMP2A inhibited diclofenac-induced lipid accumulation and hepatotoxicity.Upregulation of sorting nexin 10 (SNX10) via the CHOP-dependent endoplasmic reticulum stress response and thus maturation of cathepsin A (CTSA) was shown to be responsible for the lysosomal degradation of LAMP2A by diclofenac. Conclusion:We demonstrated that NSAIDs induced SNX10-and CTSA-dependent degradation of LAMP2A, thereby leading to the suppression of CMA.In turn, impaired CMA failed to degrade PLIN2 and disrupted cellular lipid homeostasis, thus leading to NSAID-induced steatosis and hepatotoxicity.