tbuckley/cabot-search huggingface dataset:
Intensification of Diabetes Medications at Hospital Discharge and Clinical Outcomes in Older Adults in the Veterans Administration Health System
Authors: Timothy S. Anderson, Alexandra K. Lee, Bocheng Jing, Sei Lee, Shoshana J. Herzig, W. John Boscardin, Kathy Fung, Anael Rizzo, Michael A. Steinman
Journal: JAMA Network Open (2021)

Transient elevations of blood glucose levels are common in hospitalized older adults with diabetes and may lead clinicians to discharge patients with more intensive diabetes medications than they were using before hospitalization.To investigate outcomes associated with intensification of outpatient diabetes medications at discharge.This retrospective cohort study assessed patients 65 years and older with diabetes not taking insulin who were hospitalized in the Veterans Health Administration Health System between January 1, 2011, and September 28, 2016, for common medical conditions. Data analysis was performed from January 1, 2020, to March 31, 2021.Discharge with intensified diabetes medications, defined as filling a prescription at hospital discharge for a new or higher-dose medication than was being used before hospitalization. Propensity scores were used to construct a matched cohort of patients who did and did not receive diabetes medication intensifications.Coprimary outcomes of severe hypoglycemia and severe hyperglycemia were assessed at 30 and 365 days using competing risk regressions. Secondary outcomes included all-cause readmissions, mortality, change in hemoglobin A1c (HbA1c) level, and persistent use of intensified medications at 1 year after discharge.The propensity-matched cohort included 5296 older adults with diabetes (mean [SD] age, 73.7 [7.7] years; 5212 [98.4%] male; and 867 [16.4%] Black, 47 [0.9%] Hispanic, 4138 [78.1%] White), equally split between those who did and did not receive diabetes medication intensifications at hospital discharge. Within 30 days, patients who received medication intensifications had a higher risk of severe hypoglycemia (hazard ratio [HR], 2.17; 95% CI, 1.10-4.28), no difference in risk of severe hyperglycemia (HR, 1.00; 95% CI, 0.33-3.08), and a lower risk of death (HR, 0.55; 95% CI, 0.33-0.92). At 1 year, no differences were found in the risk of severe hypoglycemia events, severe hyperglycemia events, or death and no difference in change in HbA1c level was found among those who did vs did not receive intensifications (mean postdischarge HbA1c, 7.72% vs 7.70%; difference-in-differences, 0.02%; 95% CI, -0.12% to 0.16%). At 1 year, 48.0% (591 of 1231) of new oral diabetes medications and 38.5% (548 of 1423) of new insulin prescriptions filled at discharge were no longer being filled.In this national cohort study, among older adults hospitalized for common medical conditions, discharge with intensified diabetes medications was associated with an increased short-term risk of severe hypoglycemia events but was not associated with reduced severe hyperglycemia events or improve HbA1c control. These findings indicate that short-term hospitalization may not be an effective time to intervene in long-term diabetes management.
Protecting the world from future pandemics: 3/11 is another day to remember
Authors: Arnaud Chiolero
Journal: BMJ (2021)

11 September 2001 is a day that will remain in our memory. On that 9/11, the terrorist attack against the US was a turning point in security policy, the way we travel, and the way we conduct surveillance. With around 3000 deaths, it precipitated the “war on terror.” The mood following this event was …
Brain tumour related epilepsy with co-existing non epileptic attacks: Characteristics of a clinically challenging cohort
Authors: Shanika Samarasekera, Di Liang
Journal: Neuro-Oncology (2021)

Abstract Aims The co-existence of non-epileptic attacks (NEAD) in patients with brain tumour related epilepsy (BTRE) is poorly described. Non epileptic attacks (NEAD) co-occur in up to 30% of patients with epilepsy PWE. Adverse life events are associated with development of NEAD; their co-occurrence in those with BTRE is potentially un-surprising. We sought to characterise the evolution of symptoms in this cohort. Method Clinical trajectories of patients with BTRE and co-existing NEAD were characterised. The diagnosis of NEAD was based on the epilepsy specialist’s observation of attacks and /or capture of attacks on video. Some patients had additional video EEG correlate. Patients had been referred because of persisting symptoms in spite of escalating antiepileptic therapy. Results Of eight patients, six were initially misdiagnosed with escalating seizures. One patient developed NEAD de novo following tumour biopsy, the remaining patients developed NEAD following onset of BTRE. Onset of NEAD was not temporally linked with the diagnosis of a brain tumour. In five patients, NEAD onset occurred when seizures were controlled (&amp;lt; 1 seizure/ month). All patients reported fear of developing uncontrolled seizures as being associated with their symptoms and identified their NEAD as more disabling than their epilepsy. Patients were eventually managed with polytherapy -two found adjunctive clobazam helpful and four were offered antidepressant/ anxiolytic medication. Behavourial strategies including mindfulness were also discussed. At time of last follow up, seven patients had on-going NEAD symptoms in spite of good seizure control. Conclusion NEAD can co-occur with BTRE and should be considered in those with rapidly escalating symptoms in spite of antiepileptic therapy and radiologically stable lesions. Both making the diagnosis of NEAD and providing ongoing support is challenging. These patients require a multidisciplinary approach with support from allied specialties including neuropsychiatry and neuropsychology.
P48.15 EGFR Mutated Non-Small Cell Lung Cancer Treatment Pathway – What Is the Best Way?
Authors: M. Soares, S. Gonçalves-Monteiro, L. Antunes, F. Bernardo, S. Figueiredo, M. Borges, M.J. Bento, P. Redondo
Journal: Journal of Thoracic Oncology (2021)
Healthcare-associated foodborne outbreaks in high-income countries: a literature review and surveillance study, 16 OECD countries, 2001 to 2019*
Authors: Idesbald Boone, Bettina Rosner, Raskit Lachmann, Michele Luca D'Errico, Luigi Iannetti, Yves Van der Stede, Frank Boelaert, Steen Ethelberg, Tim Eckmanns, Klaus Stark, Sebastian Haller, Hendrik Wilking
Journal: Eurosurveillance (2021)

Background Healthcare-associated foodborne outbreaks (HA-FBO) may have severe consequences, especially in vulnerable groups. Aim The aim was to describe the current state of HA-FBO and propose public health recommendations for prevention. Methods We searched PubMed, the Outbreak Database (Charité, University Medicine Berlin), and hand-searched reference lists for HA-FBO with outbreak onset between 2001 and 2018 from Organisation for Economic Co-operation and Development (OECD) countries and HA-FBO (2012–2018) from the German surveillance system. Additionally, data from the European Food Safety Authority were analysed. Results The literature search retrieved 57 HA-FBO from 16 OECD countries, primarily in the US (n = 11), Germany (n = 11) and the United Kingdom (n = 9). In addition, 28 HA-FBO were retrieved from the German surveillance system. Based on the number of outbreaks, the top three pathogens associated with the overall 85 HA-FBO were Salmonella (n = 24), norovirus (n = 22) and Listeria monocytogenes (n = 19). Based on the number of deaths, L. monocytogenes was the main pathogen causing HA-FBO. Frequently reported implicated foods were ‘mixed foods’ (n = 16), ‘vegetables and fruits’ (n = 15) and ‘meat and meat products’ (n = 10). Consumption of high-risk food by vulnerable patients, inadequate time-temperature control, insufficient kitchen hygiene and food hygiene and carriers of pathogens among food handlers were reported as reasons for HA-FBO. Conclusion To prevent HA-FBO, the supply of high-risk food to vulnerable people should be avoided. Well working outbreak surveillance facilitates early detection and requires close interdisciplinary collaboration and exchange of information between hospitals, food safety and public health authorities.
P02.04 Three Cases of Endoscopic Snare Resection for Tracheal and Main Bronchial Tumors
Authors: F. Hoshi, T. Hasumi, S. Eba, K. Onodera, K. Kobayashi, K. Ueda, S. Murai, F. Tomiyama, S. Shibata, N. Sato
Journal: Journal of Thoracic Oncology (2021)
A Multicenter Experience of Thrombotic Microangiopathies in Turkey: The Turkish Hematology Research and Education Group (ThREG) - TMA01 Study
Authors: Emre Tekgunduz, Mehmet Yilmaz, Mehmet Ali Erkurt, Ilhami Kiki, Ali Hakan Kaya, Leylagul Kaynar, Inci Alacacioglu, Guven Cetin, Ibrahim Ozarslan, Irfan Kuku, Gulden Sincan, Ozan Salim, Sinem Namdaroglu, Abdullah Karakuş, Volkan Karakuş, Gulsum Emel Pamuk, Fevzi Altuntas, Hakan Ismail Sari, Gulsum Ozet, Ismet Aydogdu, Vahap Okan, Emin Kaya, Rahsan Yildirim, Esra Yildizhan, Gokhan Ozgur, Osman Ilhami Ozcebe, Bahriye Payzin, Seval Akpinar, Fatih Demirkan
Journal: Blood (2016)
Surgical Overtreatment and Shared Decision-making—The Limits of Choice
Authors: Justin T. Clapp, Margaret L. Schwarze, Lee A. Fleisher
Journal: JAMA Surgery (2021)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
OA16.02 The Economic Value of Liquid Biopsy for Genomic Profiling in Advanced Non-Small Cell Lung Cancer
Authors: D. Ezeife, E. Spackman, R. Juergens, J. Laskin, J. Agulnik, D. Hao, S. Laurie, J. Law, L. Le, L. Kiedrowski, B. Melosky, F.A. Shepherd, V. Cohen, P. Wheatley-Price, R. Vandermeer, J. Li, R. Fernandes, A. Shokoohi, R. Lanman, N. Leighl
Journal: Journal of Thoracic Oncology (2021)
Abstract 12623: Contemporary Embolic Protection in Saphenous Vein Graft Intervention. 3-Year Outcomes From 49,325 Patients in the Medicare-Linked NCDR CathPCI Registry
Authors: J. Matthew Brennan, Wesam A Al-Hejily, David Dai, Richard E Shaw, Marina Trilesskaya, Sunil V Rao, Emmanouil Brilakis, Kevin Anstrom, John C Messenger, Pamela S Douglas, Michael Sketch
Journal: Circulation (2013)

Background: Data supporting the continued use of embolic protection devices (EPD) in contemporary saphenous vein graft (SVG) intervention is limited, and survey data indicate low uptake of EPD in c...
P29.03 Thoracic Organs at Risk (OARs) Contouring Variations and Consensus in Radiation Therapy for Non-Small Cell Lung Cancer
Authors: J.L. Liu, X. Jiang, Z. Tan, Z. Li, Y. Wang, Y. Xie, J. Cai, G. Zhu, J. Li, C. Xie, X. Ma, G. Xiao, H. Liu, H. Ge, J. Zhao, J. Liang, Q. Shen, Q. Xu, R. Liu, S. Zhou, W. Zhong, W. Kong, Y. Jiang, Y. Xu, Z. Fu, Y. Liu, Z. Zhu, N. Bi, S. Yuan, L. Zhao, Q. Song, Y. Lu, X.L. Fu, L. Wang, M. Machtay, W. Curran, F.M. Kong
Journal: Journal of Thoracic Oncology (2021)
SlideGraph<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" altimg="si3.svg"><mml:msup><mml:mrow/><mml:mo>+</mml:mo></mml:msup></mml:math>: Whole slide image level graphs to predict HER2 status in breast cancer
Authors: Wenqi Lu, Michael Toss, Muhammad Dawood, Emad Rakha, Nasir Rajpoot, Fayyaz Minhas
Journal: Medical Image Analysis (2022)

Human epidermal growth factor receptor 2 (HER2) is an important prognostic and predictive factor which is overexpressed in 15–20% of breast cancer (BCa). The determination of its status is a key clinical decision making step for selection of treatment regimen and prognostication. HER2 status is evaluated using transcriptomics or immunohistochemistry (IHC) through in-situ hybridisation (ISH) which incurs additional costs and tissue burden and is prone to analytical variabilities in terms of manual observational biases in scoring. In this study, we propose a novel graph neural network (GNN) based model (SlideGraph+) to predict HER2 status directly from whole-slide images of routine Haematoxylin and Eosin (H&E) stained slides. The network was trained and tested on slides from The Cancer Genome Atlas (TCGA) in addition to two independent test datasets. We demonstrate that the proposed model outperforms the state-of-the-art methods with area under the ROC curve (AUC) values > 0.75 on TCGA and 0.80 on independent test sets. Our experiments show that the proposed approach can be utilised for case triaging as well as pre-ordering diagnostic tests in a diagnostic setting. It can also be used for other weakly supervised prediction problems in computational pathology. The SlideGraph+ code repository is available at https://github.com/wenqi006/SlideGraph along with an IPython notebook showing an end-to-end use case at https://github.com/TissueImageAnalytics/tiatoolbox/blob/develop/examples/full-pipelines/slide-graph.ipynb.
MA11.06 Multi-Omic Characterization of Lung Tumors Implicates AKT and MYC Signaling in Adenocarcinoma to Squamous Cell Transdifferentiation
Authors: A. Quintanal-Villalonga, H. Taniguchi, Y. Zhan, M. Hasan, S. Chavan, F. Uddin, V. Allaj, P. Manoj, N. Shah, J. Chan, A. Chow, M. Offin, U. Bhanot, J. Egger, J. Qiu, E. De Stanchina, J. Chang, N. Rekhtman, B. Houck-Loomis, R. Koche, H. Yu, T. Sen, C. Rudin
Journal: Journal of Thoracic Oncology (2021)
Improving Interdisciplinary Communication: Barriers and Facilitators for Implementation of Standardized Structured Reporting in Oncology
Authors: Julie E.M. Swillens, Quirinus J.M. Voorham, Iris D. Nagtegaal, Rosella P.M.G. Hermens
Journal: Journal of the National Comprehensive Cancer Network (2021)

Background: Standardized structured reporting (SSR) improves quality of diagnostic cancer reporting and interdisciplinary communication in multidisciplinary team (MDT) meetings, resulting in more adequate treatment decisions and better health outcomes. However, use of SSR varies widely among pathologists, but might be encouraged by MDT members (MDTMs). Our objectives were to identify barriers and facilitators (influencing factors) for SSR implementation in oncologic pathology from the perspective of MDTMs and their determinants. Methods: In a multimethod design, we identified influencing factors for SSR implementation related to MDT meetings, using 5 domains: (1) innovation factors, (2) individual professional factors, (3) social setting factors, (4) organizational factors, and (5) political and legal factors. Four focus groups with MDTMs in urologic, gynecologic, and gastroenterologic oncology were conducted. We used an eSurvey among MDTMs to quantify the qualitative findings and to analyze determinants affecting these influencing factors. Results: Twenty-three MDTMs practicing in 9 oncology-related disciplines participated in the focus groups and yielded 28 barriers and 28 facilitators in all domains. The eSurvey yielded 211 responses. Main barriers related to lack of readability of SSR: difficulties with capturing nuances (66%) and formulation of the conclusion (43%); lack of transparency in the development (50%) and feedback processes of SSR templates (38%); and lack of information exchange about SSR between pathologists and other MDTMs (45%). Main facilitators were encouragement of pathologists’ SSR use by MDTMs (90%) and expanding the recommendation of SSR use in national guidelines (80%). Oncology-related medical discipline and MDT type were the most relevant determinants for SSR implementation barriers. Conclusions: Although SSR makes diagnostic reports more complete, this study shows important barriers in implementing SSR in oncologic pathology. The next step is to use these factors for developing and testing implementation tools to improve SSR implementation.
High‐oxygen‐affinity hemoglobinopathy‐associated erythrocytosis: Clinical outcomes and impact of therapy in 41 cases
Authors: Naseema Gangat, Jennifer L. Oliveira, James D. Hoyer, Mrinal M. Patnaik, Animesh Pardanani, Ayalew Tefferi
Journal: American Journal of Hematology (2021)

We describe presenting features, treatment strategies, and follow-up events involving 41 patients (median age 39 years, range 1-81; 54% males) with high oxygen affinity (HOA) hemoglobinopathy-associated erythrocytosis, seen at our institution (1973-2020). Thirty-four (83%) patients carried β-chain (13 Malmo, 4 Olympia, 3 San Diego, 2 Wood) and 7 (17%) α-chain (4 Dallas and one each Columbia-Missouri, Jackson, and Wayne) variants. Median (range) hemoglobin (Hgb)/hematocrit (Hct), serum erythropoietin and p50 were 18 g/dL/52.9% (16-21.9/48-66), 10.4 mIU (4-36.3), and 20 mmHg (12-25), respectively. Family history was documented in 24 patients and history of thrombosis in two (5%). Treatment included phlebotomy in 23 and antiplatelet therapy in 21 patients. At a median follow-up of 10 years, 23 (56%) patients reported one or more symptoms that were thought to be related to their increased Hct while thrombosis was documented in 10 (24%) patients. Neither Hgb/Hct level nor active phlebotomy showed a significant correlation with either thrombotic or nonthrombotic symptoms (p > .1 in all instances). Among 23 pregnancies recorded, 78% resulted in live births and no fetal loss was attributed to erythrocytosis. The current study does not implicate Hgb/Hct level as a major contributor of morbidity in HOA hemoglobinopathy-associated erythrocytosis and suggests limited therapeutic value for phlebotomy.
MA13.02 Phase II Study of Nivolumab and Ipilimumab Combined With Nintedanib in Recurrent Non-Small Cell Lung Cancer
Authors: S. Puri, T. Tanvetyanon, B. Creelan, M. Shafique, A. Saltos, A. Chiappori, E. Haura, R. Thapa, D. Chen, S. Antonia, J. Gray
Journal: Journal of Thoracic Oncology (2021)
Lipoprotein Z, a hepatotoxic lipoprotein, predicts outcome in alcohol‐associated hepatitis
Authors: Kunpeng Hu, Maria C. Perez‐Matos, Josepmaria Argemi, Eduardo Vilar‐Gomez, Irina Shalaurova, Esther Bullitt, Lee Landeen, Go Sugahara, Huiyan Deng, Karan Mathur, Stephanie Tran, Huimei Cai, Hanchang He, Yusuf Yalcin, Joana Vieira Barbosa, Meritxell Ventura‐Cots, Katherine Marx, Aniket P. Gad, Sebastian Niezen, Sofia Izunza Barba, Lay‐Hong Ang, Yury V. Popov, Zachary Fricker, Michelle Lai, Michael Curry, Nezam Afdhal, Gyongyi Szabo, Kenneth J. Mukamal, Arun J. Sanyal, James D. Otvos, Raza Malik, Takeshi Saito, Margery A. Connelly, Naga P. Chalasani, Ramon Bataller, Z. Gordon Jiang
Journal: Hepatology (2021)

Abstract Background and Aims Lipoprotein Z (LP‐Z) is an abnormal free cholesterol (FC)–enriched LDL‐like particle discovered from patients with cholestatic liver disease. This study aims to define the diagnostic value of LP‐Z in alcohol‐associated hepatitis (AH) and interrogate the biology behind its formation. Approach and Results We measured serum levels of LP‐Z using nuclear magnetic resonance spectroscopy, a well‐established clinical assay. Serum levels of LP‐Z were significantly elevated in four AH cohorts compared with control groups, including heavy drinkers and patients with cirrhosis. We defined a Z‐index, calculated by the ratio of LP‐Z to total apolipoprotein B–containing lipoproteins, representing the degree of deviation from normal VLDL metabolism. A high Z‐index was associated with 90‐day mortality independent from the Model for End‐Stage Liver Disease (MELD) and provided added prognosticative value. Both a Z‐index ≤ 0.6 and a decline of Z‐index by ≥0.1 in 2 weeks predicted 90‐day survival. RNA‐sequencing analyses of liver tissues demonstrated an inverse association in the expression of enzymes responsible for the extrahepatic conversion of VLDL to LDL and AH disease severity, which was further confirmed by the measurement of serum enzyme activity. To evaluate whether the FC in LP‐Z could contribute to the pathogenesis of AH, we found significantly altered FC levels in liver explant of patients with AH. Furthermore, FC in reconstituted LP‐Z particles caused direct toxicity to human hepatocytes in a concentration‐dependent manner, supporting a pathogenic role of FC in LP‐Z. Conclusions Impaired lipoprotein metabolism in AH leads to the accumulation of LP‐Z in the circulation, which is hepatotoxic from excessive FC. A Z‐index ≤ 0.6 predicts 90‐day survival independent from conventional biomarkers for disease prognostication.
The kinase PDK1 regulates regulatory T cell survival via controlling redox homeostasis
Authors: Peiran Feng, Quanli Yang, Liang Luo, Yadong Sun, Wenkai Lv, Shuo Wan, Zerong Guan, Zhiqiang Xiao, Feng Liu, Zehua Li, Zhongjun Dong, Meixiang Yang
Journal: Theranostics (2021)

Regulatory T cells (Treg cells) play an important role in maintaining peripheral tolerance by suppressing over-activation of effector T cells. The kinase PDK1 plays a pivotal role in conventional T cell development. However, whether PDK1 signaling affects the homeostasis and function of Treg cells remains elusive.
Non-canonical glutamine transamination sustains efferocytosis by coupling redox buffering to oxidative phosphorylation
Authors: Johanna Merlin, Stoyan Ivanov, Adélie Dumont, Alexey Sergushichev, Julie Gall, Marion Stunault, Marion Ayrault, Nathalie Vaillant, Alexia Castiglione, Amanda Swain, Francois Orange, Alexandre Gallerand, Thierry Berton, Jean-Charles Martin, Stefania Carobbio, Justine Masson, Inna Gaisler-Salomon, Pierre Maechler, Stephen Rayport, Judith C. Sluimer, Erik A. L. Biessen, Rodolphe R. Guinamard, Emmanuel L. Gautier, Edward B. Thorp, Maxim N. Artyomov, Laurent Yvan-Charvet
Journal: Nature Metabolism (2021)
Abstract 16556: BRD4 Antagonist RVX208 Reverses Vascular Remodeling and Supports the Right Ventricle in Pulmonary Arterial Hypertension via PLK1 and FoxM1
Authors: Diederik E van der Feen, Kondababu Kurakula, Olivier Boucherat, Guido P Bossers, Eve Tremblay, Ravi Jahagirdar, Ewelina Kulikowski, Steeve Provencher, Harm Jan Bogaard, Beatrijs Bartelds, Rolf M Berger, Marie-José T Goumans, Sébastien Bonnet
Journal: Circulation (2018)

Introduction: Pulmonary arterial hypertension (PAH) is a degenerative arteriopathy that leads to right ventricular (RV) failure. BMPR2 loss and DNA damage are early phenomena in its pathogenesis th...