tbuckley/cabot-search huggingface dataset:
It's Time to Revise the Uniform Determination of Death Act
Authors: Ariane Lewis, Richard J. Bonnie, Thaddeus Pope
Journal: Annals of Internal Medicine (2020)

Letters7 July 2020It's Time to Revise the Uniform Determination of Death ActAriane Lewis, MD, Richard J. Bonnie, LLB, and Thaddeus Pope, JD, PhDAriane Lewis, MDNYU Langone Medical Center, New York, New York (A.L.), Richard J. Bonnie, LLBUniversity of Virginia Schools of Law, Charlottesville, Virginia (R.J.B.), and Thaddeus Pope, JD, PhDMitchell Hamline School of Law, Saint Paul, Minnesota (T.P.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0257 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Drs. Kasarskis and Goldstein that clinicians must ensure that determination of death by neurologic criteria is performed accurately and consistently. To that end, we recommend that the Uniform Determination of Death Act clearly specify the medical standards to use when evaluating for death by neurologic criteria (presently the 2010 American Academy of Neurology standard for determination of brain death in adults and the 2011 Society of Critical Care Medicine, American Academy of Pediatrics, and Child Neurology Society standard in pediatric patients). In addition, we (A.L. and R.J.B.) are working with the American Academy of Neurology ...References1. Lewis A, Bernat JL, Blosser S, et al. An interdisciplinary response to contemporary concerns about brain death determination. Neurology. 2018;90:423-426. [PMID: 29386276] doi:10.1212/WNL.0000000000005033 CrossrefMedlineGoogle Scholar2. Neurocritical Care Society. Brain death determination course. 2019. Accessed at www.neurocriticalcare.org/higherlogic/s/p/cm/ld/fid=1101 on 9 December 2019. Google Scholar Author, Article, and Disclosure InformationAffiliations: NYU Langone Medical Center, New York, New York (A.L.)University of Virginia Schools of Law, Charlottesville, Virginia (R.J.B.)Mitchell Hamline School of Law, Saint Paul, Minnesota (T.P.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2731. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIt's Time to Revise the Uniform Determination of Death Act Ariane Lewis , Richard J. Bonnie , and Thaddeus Pope It's Time to Revise the Uniform Determination of Death Act Edward J. Kasarskis and Larry B. Goldstein Metrics Cited byCommission Will Revise the Uniform Determination of Death ActStatement in Support of Revising the Uniform Determination of Death Act and in Opposition to a Proposed RevisionEthical and legal considerations related to disorders of consciousness 7 July 2020Volume 173, Issue 1Page: 75-76KeywordsApneaBrainCritical careDisclosureNeurologyPediatrics ePublished: 7 July 2020 Issue Published: 7 July 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Does “AI” stand for augmenting inequality in the era of covid-19 healthcare?
Authors: David Leslie, Anjali Mazumder, Aidan Peppin, Maria K Wolters, Alexa Hagerty
Journal: BMJ (2021)

Among the most damaging characteristics of the covid-19 pandemic has been its disproportionate effect on disadvantaged communities. As the outbreak has spread globally, factors such as systemic racism, marginalisation, and structural inequality have created path dependencies that have led to poor health outcomes. These social determinants of infectious disease and vulnerability to disaster have converged to affect already disadvantaged communities with higher levels of economic instability, disease exposure, infection severity, and death. Artificial intelligence (AI) technologies are an important part of the health informatics toolkit used to fight contagious disease. AI is well known, however, to be susceptible to algorithmic biases that can entrench and augment existing inequality. Uncritically deploying AI in the fight against covid-19 thus risks amplifying the pandemic's adverse effects on vulnerable groups, exacerbating health inequity. In this paper, we claim that AI systems can introduce or reflect bias and discrimination in three ways: in patterns of health discrimination that become entrenched in datasets, in data representativeness, and in human choices made during the design, development, and deployment of these systems. We highlight how the use of AI technologies threaten to exacerbate the disparate effect of covid-19 on marginalised, under-represented, and vulnerable groups, particularly black, Asian, and other minoritised ethnic people, older populations, and those of lower socioeconomic status. We conclude that, to mitigate the compounding effects of AI on inequalities associated with covid-19, decision makers, technology developers, and health officials must account for the potential biases and inequities at all stages of the AI process.
POS0257 TOWARDS A SIMPLIFIED FLUID-SENSITIVE MRI-PROTOCOL IN SMALL JOINTS OF THE HAND IN EARLY ARTHRITIS PATIENTS: RELIABILITY BETWEEN MDIXON AND REGULAR FSE FAT SATURATION MRI-SEQUENCES
Authors: E. Niemantsverdriet, M. Verstappen, F. Wouters, M. Reijnierse, H. Bloem, A. Van der Helm - van Mil
Journal: Annals of the Rheumatic Diseases (2021)

Background: MRI facilitates early recognition of rheumatoid arthritis (RA) by depicting inflammation. Contrast-enhanced T1-weighted and T2-weighted fat-suppressed sequences have been sensitive and thus recommended, but are hampered by invasiveness, costs and long scan time. Therefore we introduced a modified Dixon-sequence (mDixon) which is more patient-friendly, reduces cost, and scan times by 83%. However, it is not known if this mDixon-sequence is reliable in relation to regular MRI-sequences with and without contrast (T1- and T2-weighted, respectively). Objectives: We determined the reliability between regular MRI-sequences with and without contrast (T1- and T2-weighted, respectively) and mDixon-MRI in early arthritis patients. Methods: 29 early arthritis patients underwent regular fat-suppressed-MRI (T1- and T2-weighted) and mDixon-sequences, of metacarpophalangeal-2-5 and wrist-joints. Two readers scored erosions, osteitis, synovitis and tenosynovitis. Intraclass correlation coefficients (ICCs) between readers, and comparing the two sequences, were studied. Spearman correlations were determined. Results: Performance between the two readers with the regular-MRI sequences, was good to excellent (ICCs all ≥0.88). The between reader ICC was also good to excellent for the mDixon-MRI (ICCs all ≥0.76). Next, ICCs between the two sequences was investigated to determine the reliability of mDixon. ICCs were good to excellent for total RAMRIS score 0.87 (95%CI 0.74-0.94), for erosions 0.88 (95%CI 0.69-0.95), and total inflammation score 0.84 (95%CI 0.69-0.82). The individual MRI-inflammation scores, had ICCs for osteitis 0.97 (95%CI 0.93-0.98), for tenosynovitis 0.78 (95%CI 0.58-0.89), and for synovitis 0.57 (95%CI 0.26-0.77). In addition, scores were highly correlated for total RAMRIS, erosions, and total MRI-inflammation score (ρ=0.82, ρ=0.81, ρ=0.80, respectively). Conclusion: Regular-MRI sequences and mDixon-MRI perform equally well, this suggests that mDixon-sequence is reliable to detect joint inflammation. Thus, this is the first step towards an simplified and abridged MRI-protocol in small hand-joints in early arthritis patients. The ultimate goal will be implementation of this mDixon-MRI sequence. Validation in larger studies is warranted. Disclosure of Interests: None declared
AB0351 PROGRESSION TO SEVERE LUPUS NEPHRITIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOUS: UPDATE FROM A COLOMBIAN COHORT
Authors: S. Herrera, J. Marenco Maldonado, J. C. Diaz-Coronado, D. Rojas-Gualdrón, D. Hernandez-Parra, R. Pineda.Tamayo
Journal: Annals of the Rheumatic Diseases (2021)

Background: Continuous monitoring of patients with Systemic lupus erythematosus (SLE) provides relevant information Objectives: To update the analysis of clinical and immunological characteristics associated with time to severe renal involvement in patients with Systemic Lupus Erythematous in a Colombian cohort followed from January 2015 to October 2020 Methods: A retrospective follow-up study based on clinical records. Patients with SLE diagnosis fulfilled either 1987 American College of Rheumatology Classification Criteria for SLE or 2011 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. We included patients with the diagnosis of lupus nephritis according to Wallace and Dubois criteria. Patients who did not have at least two follow-up measurements or had a cause of nephritis other than lupus were excluded. The primary outcome was defined as the time from diagnosis to severe renal involvement defined as creatinine clearance ≤50ml/min, 24-hour proteinuria ≥3.5 grams o end-stage renal disease. Updated age and sex-adjusted survival functions and Hazard ratios (HR) with 95% confidence intervals and p-values were estimated using parametric Weibull models for interval-censored data. P values &lt;0.05 were considered statistically significant. Descriptive statistics were previously reported in EULAR 2020 (1) Results: 548 patients were analyzed: 67 were left-censored as they presented renal involvement at entry, 25 were interval censored as outcome occurred between study visits (19 new events), and 456 were right-censored as involvement was not registered during follow-up. In this cohort update Age and sex-adjusted Hazard Ratios for high blood pressure were HR = 3.1 (95%CI 1.5-6.3; p-value = 0.003) and Anti-RO (per unit increase) HR = 1.003 (95%CI 1.001-1.005; p-value = 0.029). Figure 1 shows the updated age and sex-adjusted survival function Conclusion: In this cohort update, we found similar clinical and immunological characteristics associated with time to severe renal involvement in SLE patients to those reported in (1). However, continuous follow-up allows us to deepen our understanding of the progression to severe renal involvement in SLE patients References: [1]Herrera S, Diaz-Coronado JC, Rojas-Gualdrón D, Betancur-Vasquez L, Gonzalez-Hurtado D, Gonzalez-Arango J, et al. SAT0210 factors associated with time to severe lupus nephritis in a cohort of colombian patients. Ann Rheum Dis. junio de 2020;79(Suppl 1):1048.2-1048 Disclosure of Interests: None declared
AB0148 CHARACTERISTICS OF RHEUMATOID ARTHRITIS PATIENTS WITH HIP INVOLVEMENT
Authors: H. Hajji, K. Maatallah, H. Ferjani, W. Triki, D. Ben Nessib, D. Ameni, D. Kaffel, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2021)

Background: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that affects both small and large joints. Hip involvement is an evolutionary turning point in RA and significantly alters the patient’s quality of life. Objectives: This study aimed to assess characteristics of RA patients with hip involvement. Methods: It was a cross-sectional study, including patients with RA (according to 2010 ACR/European League Against Rheumatism (EULAR) criteria).We divided patients into two groups: G0 patients without hip involvement, G1 patients with hip involvement. Hip involvement was defined with a limited movement during examination with abnormalities on standard radiographs. We collected the following data: age, the disease activity score (DAS28), the inflammatory biomarkers C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR), Rheumatoid Factor (RF), and Anti Citrullinated Peptides Antibodies (ACPA), and SHARP score (A scoring system used to assess the radiological changes in patients with RA. It describes erosions and narrowing of the joint space of 27 small joints of the hands, including the carpal bones and feet). Results: Among the 224 patients included, 25had hip involvement (11%). The male / female sex-ratio was higher in G1 (0.66 vs 0.22, p=0.017).Patients in G1 were younger at disease onset (44,16±16,11 years vs 51.9±13.9 years, p= 0.022) and had a longer disease duration (12,28 ± 11,49 years vs 6,2010 ± 6,45 years, p=0.02). They had also higher HAQ(1,7692 vs 1,3054, p=0.05).SHARP score was higher in G1 (176.32 vs. 106.88, p=0.011). Atlantoaxial subluxation was more common in G1 (32% vs 14%,p=0.035).When comparing the groups we did not find any significant difference regarding age (56.12 ± 11.88 years vs 58,24±12,26 years, p=0.341), disease activity (DAS28-ESR:5.41 vs. 5.65, p=0.380; DAS28-CRP: 5.19 vs. 5.51, p=0.290), ESR (53.88 vs. 46.95, p=0.237), CRP:23,8894 vs 22,89, p=0.975), and in the serological profile (RF; G1:68% vs G0: 70.8%, p=0.817, ACPA; G1: 60% vs G0:69%, p=0.366). Conclusion: Patients with hip involvement were commonly male, were younger at disease onset and had more functional impairment based on the HAQ score. C1-C2 dislocation wasalso more common in this group.The SHARP score was also significantly higher in G1, which shows a severe and destructive disease. Disclosure of Interests: None declared
N6-Methyladenosine on mRNA facilitates a phase-separated nuclear body that suppresses myeloid leukemic differentiation
Authors: Yuanming Cheng, Wei Xie, Brian F. Pickering, Karen L. Chu, Angela M. Savino, Xuejing Yang, Hanzhi Luo, Diu TT. Nguyen, Shanlan Mo, Ersilia Barin, Anthony Velleca, Thomas M. Rohwetter, Dinshaw J. Patel, Samie R. Jaffrey, Michael G. Kharas
Journal: Cancer Cell (2021)
Combination of Avastin and Xeloda synergistically inhibits colorectal tumor growth in a Colo205 tumor xenograft model.
Authors: Ben-Quan Shen, Shannon Stainton, Dongwei Li, Suzanne Zhu, Nicolas Pelletier, Thomas F. Zioncheck
Journal: Cancer Research (2004)

2203  Inhibition of VEGF with Avastin has been shown to be an efficacious approach to treat colorectal tumors when combined with irinotecan/fluorouracil/leucovorin (CPT-11/5-FU/LV; IFL). Xeloda (Capecitabine), an oral fluoropyrimidine pro-drug approved for hte treatment of colorectal and breast cancers, is metabolically activated by thymidine phosphorylase within the tumor site and shows potent antineoplastic activity. We hypothesized that combination of Avastin and Xeloda would be more efficacious in inhibiting tumor progression than either single agent alone. Here we report that Avastin and Xeloda given concomitantly or sequentially provided a synergistic inhibition of Colo205 tumor growth in a mouse xenograft model. Colo205 cells were inoculated into nude mice. When tumors reached ∼200 mm3, animals were randomized into 6 groups and treated either with control buffer (group 1), Xeloda alone (360 mg/kg, po, daily, day 0-6, group 2), Avastin alone (2.5mg/kg, IP, day 0 and 3, group 3). To determine potential dose sequencing effects, Avastin was given either concomitantly with Xeloda (Avastin 2.5mg/kg, ip, day 0 and 3; Xeloda, 360mg/kg, po, day 0-6, group 4), prior to Xeloda (Avastin 2.5 mg/kg on day 0 and 3; Xeloda, 360mg/kg, day 7-13, group 5), or following Xeloda (Xeloda on day 0-6, Avastin on day 7 and 10, group 6). Tumor growth was monitored over 9 weeks. Avastin alone or Xeloda alone resulted in significant tumor growth inhibition but tumor regrowth occurred after 2-3 weeks. However, combination therapy with Avastin and Xeloda resulted in a significantly greater duration of tumor inhibition (beyond 7 weeks) relative to either single agent alone. Dose schedule had little or no effect on the extended tumor growth inhibition in the Colo205 tumor xenograft model. These results provide new evidence to support the combined use of Avastin and Xeloda for the treatment of colorectal cancers.
Abstract 14926: Ultrasound-Mediated Delivery of antimiR-34a to Cardiac Cells for Cardiovascular Therapy
Authors: Mariah C Priddy, Marcin Wysoczynski, Joseph B Moore, Phani K Patibandla, Guruprasad Giridharan, Roberto Bolli, Jonathan A Kopechek
Journal: Circulation (2018)

Background: MicroRNAs (miRNAs) have emerged as important biological regulators with significant therapeutic potential for treatment of cardiovascular diseases. Prior studies have found that inhibit...
Abstract 12867: Myoglobin for Detection of High Risk Patients With Acute Myocarditis
Authors: Jan Kottwitz, Jan Berg, Mawahib Elhassan, Nora Baltensperger, Christine K Kissel, Marina Lovrinovic, Andrea Baltensweiler, Frank Scherff, Christian Schmied, Christian Templin, Thomas F Luescher, Robert Manka, Bettina Heidecker
Journal: Circulation (2018)

Introduction: There is a major unmet need for accurate and practical screening to detect myocarditis. Thus, we sought to identify a suitable routine blood marker and its optimal cutoff value to est...
Abstract 11297: Usefulness of Low Intensity Exercise Stress Echocardiography for Predicting Exercise Tolerance in Patients with Atrial Fibrillation
Authors: Kosuke Uchida, Yasuaki Wada, Shinichi Okuda, Yoshio Nose, Wakako Murakami, Takeshi Nakamura, Takako Maeda, Noriko Harada, Toru Ariyoshi, Takeshi Yamamoto, Takeshi Ueyama, Yasuhiro Yoshiga, Kozo Shiraishi, Tadamitsu Nakashima, Tomoko Fumimoto, Kimikazu Hamano
Journal: Circulation (2012)

Background: Exercise stress echocardiography is well recognized to reflect exercise capacity in patients with sinus rhythm. The incidence of atrial fibrillation (AF) is higher in elder people. Howe...
Diffuse Cutaneous Angiosarcoma in the Scalp and Face Demonstrated on FDG PET/CT Imaging
Authors: Liu Xiao, Wenjie Zhang, Lin Li
Journal: Clinical Nuclear Medicine (2021)

Abstract Diffuse cutaneous angiosarcomas are rare. Herein, we reported FDG PET/CT findings of cutaneous angiosarcoma in a 59-year-old man. FDG PET/CT imaging was performed for staging, showing diffuse intense FDG uptake with an SUV max of 19 in the scalp and face. Chemotherapy was recommended for this patient because surgery and radiotherapy were not appropriate due to the widespread skin involvement. Our case suggests that cutaneous angiosarcoma can present with diffuse skin involvement, and FDG PET/CT plays an important role in determining the treatment plan to avoid unnecessary surgery and radiotherapy.
AB0238 SECOND BIOLOGICAL DMARD THERAPY IN RHEUMATOID ARTHRITIS: A RETROSPECTIVE COHORT ANALYSIS
Authors: K. Saadaoui, H. Sahli, S. Jemmali, S. Boussaid, S. Rekik, E. Cheour, M. Elleuch
Journal: Annals of the Rheumatic Diseases (2021)

Background: The development of biologic disease modifying antirheumatic drugs (bDMARD) has dramatically improved the management of rheumatoid arthritis (RA). However, some patients did not respond or partially respond to biologic agents. Management of first bDMARD failure may involve another biotherapy. Objectives: The aim of our study is to assess the efficacy of second line biologic as well as survival rates of 2 nd line biotherapy in RA. Methods: This is a retrospective study based on Tunisian data including 374 RA patients treated with biologic agent from 2014 and followed until December 2018. Results: Tumor necrosis factor inhibitor (TNFi) was the most prescribed class as first-line therapy with 86.4% patients (Etanercept: ETA 54%; adalimumab: ADA 13.6%; certolizumab pegol: CZP 12.8% and infliximab: IFX 5.9%), IL-6 inhibitor (Tociluzimab: TCZ) and anti-CD 20 (Rituximab: RTX) were given respectively to 6.4% and 7.2% cases. The first biotherapy was discontinued for 146 patients (39%). Of these, 79 patients (21.1%) received a second bDMARD (mean age 52.6 ± 11.8; sex ratio = 0.12; ETA 17.7%, ADA 7.6%, CZP 41.8%, IFX 1.3%, TCZ 24.1% and RTX 7.6%). Average DAS 28 at second line biotherapy initiation was 5.93 ± 0.96. Overall survival rates of 2 nd line bDMARD at 12, 24 and 36 months was respectively 91%, 76.4% and 72.1%. Among the patients receiving second biologic agent, 30.4% patients (24 cases) achieved either low disease activity (LDA) or remission. On average 38 weeks [14 – 96] were needed to reach that therapeutic target. In fact, 27.8% of the TNFi vs. 40% of the non TNFi patients achieved LDA (p = 0.277). Second biotherapy was withdrawn in 16.7% of the cases of TNFi group vs. 20% of the non TNFi group (p = 0.718). Moreover, no significant difference has emerged between the TNFi and the non-TNFi patients when comparing time to biotherapy discontinuation (15.8 months vs. 20.9; p = 0.11). Conclusion: In our study, no significant difference was found between TNFi and non-TNFi switcher in RA. But, treatment strategy after first bDMARD failure is still controversial. Further studies have to be done to get the most beneficial strategy in RA. Disclosure of Interests: None declared
OP0073 SINGLE-CELL TRANSCRIPTOMICS UNCOVERS DEFECTIVE BONE MARROW EARLY B CELL DEVELOPMENT IN A SUBSET OF LUPUS PATIENTS ASSOCIATED WITH AGGRAVATED INFLAMMATION
Authors: C. Dong, X. Gu, J. Ji, X. Zhang, Z. Gu
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that occurs when the body’s immune system attacks own tissues and organs. B cells play a central role in SLE pathogenesis by producing autoantibodies as well as antibody-independent functions. Peripheral B cell abnormality is well known in lupus patients such as expansions of plasmablasts and atypical memory B cells, which are associated with active diseases. However, little is known about the B cell development in the bone marrow of lupus patients. Objectives: We conduct this survey to explore the disorder of the B cell development in the bone marrow of lupus patients. Methods: In this study, we have performed the scRNASeq to profile the bone marrow B cell compartment in lupus patients and healthy donors. Results: We identified that in a subset of lupus patients, the early B cells (proB and preB cells) were strongly decreased, which were confirmed by flow cytometry in an expanded cohort. Furthermore, bone marrow B cells from these patients showed a strong proinflammatory signature revealed by pathway analysis. Interestingly, BCR repertoire analysis showed that the IGHV-4-34 was highly enriched in these patients, indicating an enhanced B cell tolerance defect. Finally, a panel of proinflammatory cytokines (TNF-a, IL-1a, IL-12p70, IFN-g, et al.) were strongly increased in the bone marrow plasma of these patients compared with early B normal patients and healthy donors, confirming a localized proinflammatory microenvironment. Conclusion: Altogether, the current study has revealed that a defective early B cell development in lupus patients is associated with a more severe B cell tolerance defect and aggravated inflammation, which may shed new light on developing novel therapies by targeting relevant pathways. References: [1]Min Wang, Hua Chen, Jia Qiu, et al. Antagonizing miR-7 suppresses B cell hyperresponsiveness and inhibits lupus development. J Autoimmun 2020. [2]A M Jacobi, D M Goldenberg, F Hiepe, et al. Differential effects of epratuzumab on peripheral blood B cells of patients with systemic lupus erythematosus versus normal controls. Ann Rheum Dis, 2008. Acknowledgements: This work was funded by Special project of clinical medicine of Nantong University (Grant/Award number: 2019LQ001), National Natural Science Foundation of China (Grant/Award number: 81671616, 81871278 and 82071838). Disclosure of Interests: None declared