tbuckley/cabot-search huggingface dataset:
A Pragmatic Approach to Weaning Temporary Mechanical Circulatory Support
Authors: Varinder Kaur Randhawa, Abdulrahman Al-Fares, Michael Z.Y. Tong, Edward G. Soltesz, Jaime Hernandez-Montfort, Ziad Taimeh, Aaron J. Weiss, Venu Menon, Joseph Campbell, Paul Cremer, Jerry D. Estep
Journal: JACC Heart Failure (2021)

Temporary mechanical circulatory support (TMCS) provides short-term support to patients with or at risk of refractory cardiogenic shock. Although indications, contraindications, and complications of TMCS may guide device selection, optimal strategies for device weaning and explant remain poorly defined. Under the revised adult heart allocation policy implemented by the United Nations for Organ Sharing in October 2018, rejustification of heart transplant listing status includes demonstrating TMCS dependency with attempted device wean trials. However, standardized device-specific weaning and explant protocols have not been proposed or evaluated. This review highlights when to use percutaneous TMCS in cardiogenic shock, with a focus on weaning and explant considerations. Terminology for important concepts that guide device escalation, de-escalation, and explantation have been defined. Clinical, hemodynamic, metabolic, and imaging features have been defined, which can guide a tailored approach to TMCS weaning and explant based on the approach used at the Cleveland Clinic. A narrative review of published studies that have reported TMCS weaning protocols and survey results of member centers from CS-MCS working group centers is also provided. Future research is needed to better understand optimal timing and implementation of standardized protocols to achieve successful TMCS weaning and explant.
Effects on Growth of Smell and Taste of Milk During Tube Feeding of Preterm Infants
Authors: Friederike Beker, Helen G. Liley, Ian P. Hughes, Susan E. Jacobs, Judith Macey, Emily Twitchell, Peter G. Davis
Journal: JAMA Pediatrics (2021)

Smell and taste of food increase food anticipation, activate gut motility, and stimulate digestion and metabolism. Despite poor growth of many preterm infants in neonatal intensive care units, the smell and taste of milk with tube feeding are not generally considered a regular component of care.To determine the effect of smell and taste of milk with tube feeding on weight z scores at discharge from the hospital.A randomized, controlled, nonblinded, superiority trial was conducted at 2 perinatal centers between May 9, 2017, and February 1, 2020. Eligible infants (n = 659) were born at less than 29 weeks' postmenstrual age (PMA) and/or with a birth weight of less than 1250 g.Infants were randomly assigned to receive either the smell and taste of milk with each tube feeding or routine care without the provision of smell and taste of milk.The primary outcome was weight z score at discharge from any hospital. Secondary outcomes included anthropometric measures at predefined time points, time to full enteral feeds, and other health outcomes associated with prematurity.Of the 658 infants, a total of 396 infants were randomized; some parents had not been approached for consent (n = 144) or declined participation (n = 117), and 1 infant with consent was not randomized. Of the 396 infants, 196 were assigned to the treatment group (51% male; mean [SD] PMA at birth, 27.5 [2.2] weeks) and 200 were assigned to the control group (52% male; mean [SD] PMA at birth, 27.6 (2.3) weeks). Mean weight z scores at discharge were -0.87 (95% CI, -1.02 to -0.72) for the treatment group and -0.97 (95% CI, -1.11 to -0.83) for the control group (P = .40). The mean difference in z scores between the treatment and control groups at 36 weeks' PMA was 0.21 (95% CI, 0.01 to 0.4; P = .04) for head circumference and 0.26 (95% CI, 0.05 to 0.51; P = .04) for length. There were no clinically notable differences between the study groups for any other anthropometric, feeding, or health outcomes.In this randomized clinical trial, regular smell and taste of milk included with tube feeding did not improve weight at discharge in preterm infants. Secondary outcomes suggest exposure to smell and taste may improve head circumference and length at 36 weeks' PMA, but not at discharge. Regular exposure to the smell and taste of milk is a simple and inexpensive intervention with potential benefits and no apparent adverse effects.anzctr.org.au Identifier: ACTRN12617000583347.
Prognostic and Predictive Value of HER2 Expression in Ductal Carcinoma <i>In Situ</i>: Results from the UK/ANZ DCIS Randomized Trial
Authors: Mangesh A. Thorat, Pauline M. Levey, J. Louise Jones, Sarah E. Pinder, Nigel J. Bundred, Ian S. Fentiman, Jack Cuzick
Journal: Clinical Cancer Research (2021)

Abstract Purpose: HER2 is overexpressed more frequently in ductal carcinoma in situ (DCIS) than in invasive breast cancer but its prognostic significance and predictive role for radiotherapy has not been clearly established. We investigated the prognostic and predictive value of HER2 overexpression in DCIS. Experimental Design: HER2 expression was evaluated by IHC using the HercepTest™ in samples from UK/ANZ DCIS trial participants (n = 755) with IHC 3+ expression categorized as HER2 positive for primary analyses. Sensitivity analyses included HER2 categorization as negative (IHC 0,1+), equivocal (IHC 2+), and positive (IHC 3+) and analyses restricted to a nested case–control component where 181 cases (with recurrence) were matched to 362 controls by treatment arm and age. Results: Two-hundred and forty-five (34.4%) of evaluable 713 samples [181 ipsilateral breast events (IBE)] were HER2 positive. HER2 overexpression was associated with significantly increased risk of IBE [HR = 2.29; 95% confidence interval (95% CI), 1.64–3.14; P &amp;lt; 0.0001] and in situ IBE (DCIS-IBE; HR = 2.90; 95% CI, 1.91–4.40; P &amp;lt; 0.0001), but not of invasive IBE (I-IBE; HR = 1.40; 95% CI, 0.81–2.42; P = 0.23; Pheterogeneity = 0.04). Inclusion of HER2 significantly improved [Δχ2 (1d.f.) 12.25; P = 0.0005] a prognostic model of clinicopathological and treatment variables, HER2 being an independent predictor of IBE (multivariate HR = 1.91; 95% CI, 1.33–2.76; P = 0.0004). Radiotherapy benefit in preventing DCIS-IBE was significantly greater (Pheterogeneity = 0.04) in HER2-positive DCIS (HR = 0.16; 95% CI, 0.07–0.41) compared with HER2-negative DCIS (HR = 0.58; 95% CI, 0.28–1.19). Conclusions: HER2 overexpression is associated with significantly increased risk of in situ recurrence and is also predictive of radiotherapy benefit, with greater reductions in in situ but not invasive recurrences in HER2-positive DCIS.
AIEgens for Bacterial Imaging and Ablation
Authors: Qinggele Borjihan, Haixia Wu, Alideertu Dong, Hui Gao, Ying‐Wei Yang
Journal: Advanced Healthcare Materials (2021)

Accurate and sensitive diagnosis of pathogenic bacterial infection is a fundamental first step for correct bacteria management, helping to avoid the development of drug-resistant bacteria caused by the inappropriate use and overuse of antibiotics. Fluorescence probes as a promising visual tool can help identify pathogens rapidly and reliably. However, rigidly structured traditional fluorescence probes generally suffer from the drawback of aggregation-caused quenching (ACQ) effect, which greatly undermines their advantages with respect to sensitivity. Luminogens with aggregation-induced emission properties, namely AIEgens, can overcome the ACQ effect and certain AIEgen-based materials are capable of generating reactive oxygen species (ROS) in the aggregate states. Hence, they have become powerful tools for imaging and killing bacteria. This review summarizes the recent advances in AIEgens for the diagnosis and treatment of pathogen infections. Special attention has been paid to the molecular design, the application in bacterial imaging and ablation in vitro and in vivo, and the biocompatibility of AIEgens. Finally, the challenges and prospects are discussed in terms of using AIEgens to advance precision therapies for pathogen infections.
Lifetime risk of rheumatoid arthritis-associated interstitial lung disease in <i>MUC5B</i> mutation carriers
Authors: Antti Palomäki, Aarno Palotie, Jukka Koskela, Kari K Eklund, Matti Pirinen, Samuli Ripatti, Tarja Laitinen, Nina Mars
Journal: Annals of the Rheumatic Diseases (2021)

To estimate lifetime risk of developing rheumatoid arthritis-associated interstitial lung disease (RA-ILD) with respect to the strongest known risk factor for pulmonary fibrosis, a MUC5B promoter variant.FinnGen is a collection of epidemiological cohorts and hospital biobank samples, integrating genetic data with up to 50 years of follow-up within nationwide registries in Finland. Patients with RA and ILD were identified from the Finnish national hospital discharge, medication reimbursement and cause-of-death registries. We estimated lifetime risks of ILD by age 80 with respect to the common variant rs35705950, a MUC5B promoter variant.Out of 293 972 individuals, 1965 (0.7%) developed ILD by age 80. Among all individuals in the dataset, MUC5B increased the risk of ILD with a HR of 2.44 (95% CI: 2.22 to 2.68). Out of 6869 patients diagnosed with RA, 247 (3.6%) developed ILD. In patients with RA, MUC5B was a strong risk factor of ILD with a HR similar to the full dataset (HR: 2.27, 95% CI: 1.75 to 2.95). In patients with RA, lifetime risks of ILD were 16.8% (95% CI: 13.1% to 20.2%) for MUC5B carriers and 6.1% (95% CI: 5.0% to 7.2%) for MUC5B non-carriers. The difference between risks started to emerge at age 65, with a higher risk among men.Our findings provide estimates of lifetime risk of RA-ILD based on MUC5B mutation carrier status, demonstrating the potential of genomics for risk stratification of RA-ILD.
Testicular Cancer
Authors: G. P. Murphy
Journal: CA A Cancer Journal for Clinicians (1983)

â€¢¿ teratoma (with malignant areas termed teratocarcinoma) â€¢¿ choriocarcinoma.A large percentage of testis tumors are mixed and may contain many of these ele ments.From the clinician's point of view, testis tumors can be classified as either pure seminoma or nonseminoma, this distinc tion determining the therapy.'Initial diagnosis is usually made or suspected by physical examination, and treatment of the primary tumor is accom plished by inguinal orchiectomy.There are many phases of evaluation.Subsequent workup of the patient, histological assess ment of the primary tumor, and micro scopic evaluation for all potential cellular elements are fundamental and cannot be overemphasized.Following initial diag nosis, most urologists complete other cur rently available evaluatory tests that will be described below. Misdiagnosis of Testis TumorsTestis tumors are frequently misdiagnosed as nontumors.The resulting treatment de lays are usually associated with a more advanced stage of tumor.A history of her nia, cryptorchidism.or atrophy should be sought.Abdominal flank pain suggests ex tensive retroperitoneal disease.Occasion ally, patients with extragonadal tumors present both diagnostic and therapeutic di
Thromboembolism risk among patients with diabetes/stress hyperglycemia and COVID-19
Authors: Stefania L. Calvisi, Giuseppe A. Ramirez, Marina Scavini, Valentina Da Prat, Giuseppe Di Lucca, Andrea Laurenzi, Gabriele Gallina, Ludovica Cavallo, Giorgia Borio, Federica Farolfi, Maria Pascali, Jacopo Castellani, Vito Lampasona, Armando D'Angelo, Giovanni Landoni, Fabio Ciceri, Patrizia Rovere Querini, Moreno Tresoldi, Lorenzo Piemonti
Journal: Metabolism (2021)

PurposeIndividuals with diabetes/stress hyperglycemia carry an increased risk for adverse clinical outcome in case of SARS-CoV-2 infection. The purpose of this study was to evaluate whether this risk is, at least in part, modulated by an increase of thromboembolic complications.MethodsWe prospectively followed 180 hospitalized patients with confirmed COVID-19 pneumonia admitted to the Internal Medicine Units of San Raffaele Hospital. Data from 11 out of 180 patients were considered incomplete and excluded from the analysis. We analysed inflammation, tissue damage biomarkers, hemostatic parameters, thrombotic events (TEs) and clinical outcome according to the presence of diabetes/stress hyperglycemia.ResultsAmong 169 patients, 51 (30.2%) had diabetes/stress hyperglycemia. Diabetes/stress hyperglycemia and fasting blood glucose (FBG) were associated with increased inflammation and tissue damage circulating markers, higher D-dimer levels, increased prothrombin time and lower antithrombin III activity. Forty-eight venous and 10 arterial TEs were identified in 49 (29%) patients. Diabetes/stress hyperglycemia (HR 2.71, p = 0.001), fasting blood glucose (HR 4.32, p < 0.001) and glucose variability (HR 1.6, p < 0.009) were all associated with an increased risk of thromboembolic complication. TEs significantly increased the risk for an adverse clinical outcome only in the presence of diabetes/stress hyperglycemia (HR 3.05, p = 0.010) or fasting blood glucose ≥7 mmol/L (HR 3.07, p = 0.015).ConclusionsThromboembolism risk is higher among patients with diabetes/stress hyperglycemia and COVID-19 pneumonia and is associated to poor clinical outcome. In case of SARS-Cov-2 infection patients with diabetes/stress hyperglycemia could be considered for a more intensive prophylactic anticoagulation regimen.
Soluble trivalent engagers redirect cytolytic T cell activity toward tumor endothelial marker 1
Authors: Julie K. Fierle, Matteo Brioschi, Mariastella de Tiani, Laureline Wetterwald, Vasileios Atsaves, Johan Abram-Saliba, Tatiana V. Petrova, George Coukos, Steven M. Dunn
Journal: Cell Reports Medicine (2021)

Tumor endothelial marker 1 (TEM1) is an emerging cancer target with a unique dual expression profile. First, TEM1 is expressed in the stroma and neo-vasculature of many human carcinomas but is largely absent from healthy adult tissues. Second, TEM1 is expressed by tumor cells of mesenchymal origin, notably sarcoma. Here, we present two fully human anti-TEM1 single-chain variable fragment (scFv) reagents, namely, 1C1m and 7G22, that recognize distinct regions of the extracellular domain and possess substantially different affinities. In contrast to other, well-described anti-TEM1 binders, these fragments confer cytolytic activity when expressed as 2nd generation chimeric antigen receptors (CARs). Moreover, both molecules selectively redirect human T cell effector functions toward TEM1+ tumor cells when incorporated into experimental soluble bispecific trivalent engagers that we term TriloBiTEs (tBs). Furthermore, systemic delivery of 1C1m-tB prevents the establishment of Ewing sarcoma tumors in a xenograft model. Our observations confirm TEM1 as a promising target for cancer immunotherapy and illustrate the prospective translational potential of certain scFv-based reagents.
XPS and ToF‐SIMS Characterization of New Biodegradable Poly(Peptide‐Urethane‐Urea) Block Copolymers
Authors: Gilad Zorn, Felix I. Simonovsky, Buddy D. Ratner, David G. Castner
Journal: Advanced Healthcare Materials (2021)

Abstract New, linear, segmented poly(peptide‐urethane‐urea) (PPUU) block copolymers are synthesized and their surface compositions are characterized with angle dependent X‐ray photoelectron spectroscopy (ADXPS) and time‐of‐flight secondary ion mass spectrometry (ToF‐SIMS). These new PPUU block copolymers contain three types of segments. The soft segment (SS) is poly(caprolactone diol) (PCL). The hard segment is lysine diisocyanate with a hydrazine chain extender. The oligopeptide segment (OPS) contains three types of amino acids (proline, hydroxyproline, and glycine). Incorporation of the OPS into the polyurethane backbone is done to provide a synthetic polymer material with controllable biodegradation properties. As biodegradation processes normally are initiated at the interface between the biomaterial and the living tissue, it is important to characterize the surface composition of biomaterials. ADXPS and ToF‐SIMS results show that the surfaces of all four polymers are enriched with the PCL SS, the most hydrophobic component of the three polymer segments.
Concerns Regarding Surgeon Special Interest and Years Following Termination of Training—Reply
Authors: Kevin M. Schuster, Bishwajit Bhattacharya
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 Journals 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
Prehospital Comprehensive Stroke Center vs Primary Stroke Center Triage in Patients With Suspected Large Vessel Occlusion Stroke
Authors: Tareq Kass-Hout, Jungwha Lee, Katie Tataris, Christopher T. Richards, Eddie Markul, Joseph Weber, Scott Mendelson, Kathleen O’Neill, Renee M. Sednew, Shyam Prabhakaran
Journal: JAMA Neurology (2021)

Endovascular therapy (EVT) improves functional outcomes in acute ischemic stroke (AIS) with large vessel occlusion (LVO). Whether implementation of a regional prehospital transport policy for comprehensive stroke center triage increases use of EVT is uncertain.To evaluate the association of a regional prehospital transport policy that directly triages patients with suspected LVO stroke to the nearest comprehensive stroke center with rates of EVT.This retrospective, multicenter preimplementation-postimplementation study used an interrupted time series analysis to compare treatment rates before and after implementation in patients with AIS arriving at 15 primary stroke centers and 8 comprehensive stroke centers in Chicago, Illinois, via emergency medical services (EMS) transport from December 1, 2017, to May 31, 2019 (9 months before and after implementation in September 2018). Data were analyzed from December 1, 2017, to May 31, 2019.Prehospital EMS transport policy to triage patients with suspected LVO stroke, using a 3-item stroke scale, to comprehensive stroke centers.Rates of EVT before and after implementation among EMS-transported patients within 6 hours of AIS onset.Among 7709 patients with stroke, 663 (mean [SD] age, 68.5 [14.9] years; 342 women [51.6%] and 321 men [48.4%]; and 348 Black individuals [52.5%]) with AIS arrived within 6 hours of stroke onset by EMS transport: 310 of 2603 (11.9%) in the preimplementation period and 353 of 2637 (13.4%) in the postimplementation period. The EVT rate increased overall among all patients with AIS (preimplementation, 4.9% [95% CI, 4.1%-5.8%]; postimplementation, 7.4% [95% CI, 7.5%-8.5%]; P < .001) and among EMS-transported patients with AIS within 6 hours of onset (preimplementation, 4.8% [95% CI, 3.0%-7.8%]; postimplementation, 13.6% [95% CI, 10.4%-17.6%]; P < .001). On interrupted time series analysis among EMS-transported patients, the level change within 1 month of implementation was 7.15% (P = .04) with no slope change before (0.16%; P = .71) or after (0.08%; P = .89), which indicates a step rather than gradual change. No change in time to thrombolysis or rate of thrombolysis was observed (step change, 1.42%; P = .82). There were no differences in EVT rates in patients not arriving by EMS in the 6- to 24-hour window or by interhospital transfer or walk-in, irrespective of time window.Implementation of a prehospital transport policy for comprehensive stroke center triage in Chicago was associated with a significant, rapid, and sustained increase in EVT rate for patients with AIS without deleterious associations with thrombolysis rates or times.
Glucose-Lowering Therapy in Patients With Postpancreatitis Diabetes Mellitus: A Nationwide Population-Based Cohort Study
Authors: Rikke Viggers, Morten Hasselstrøm Jensen, Henrik Vitus Bering Laursen, Asbjørn Mohr Drewes, Peter Vestergaard, Søren Schou Olesen
Journal: Diabetes Care (2021)

Postpancreatitis diabetes mellitus (PPDM) is a type of secondary diabetes that requires special considerations for management. The main objective was to examine prescription patterns of glucose-lowering therapy among adults with PPDM compared with type 1 and type 2 diabetes.In a Danish nationwide population-based cohort study, we identified all individuals with adult-onset diabetes in the period 2000-2018 and categorized them as having type 1 diabetes, type 2 diabetes, or PPDM. We ascertained diabetes incidence rates, clinical and demographic characteristics, and classifications and prescription patterns of glucose-lowering therapy and compared these parameters across diabetes subgroups.Among 398,456 adults with new-onset diabetes, 5,879 (1.5%) had PPDM, 9,252 (2.3%) type 1 diabetes, and the remaining type 2 diabetes (96.2%). The incidence rate of PPDM was 7.9 (95% CI 7.7-8.1) per 100,000 person-years versus 12.5 (95% CI 12.2-12.7) for type 1 diabetes (incidence rate ratio 0.6 [95% CI 0.6-0.7]; P < 0.001). A sizeable proportion of patients with PPDM were classified as having type 2 diabetes (44.9%) and prescribed sulfonylureas (25.2%) and incretin-based therapies (18.0%) that can potentially be harmful in PPDM. In contrast, 35.0% of patients never received biguanides, which are associated with a survival benefit in PPDM. Increased insulin requirements were observed for patients with PPDM compared with type 2 diabetes (hazard ratio 3.10 [95% CI 2.96-3.23]; P < 0.001) in particular for PPDM associated with chronic pancreatitis (hazard ratio 4.30 [95% CI 4.01-4.56]; P < 0.001).PPDM is a common type of secondary diabetes in adults but is often misclassified and treated as type 2 diabetes, although PPDM requires special considerations for management.
モンテプラーゼを血管形成術と結合する急性心筋梗塞において、左室機能を維持し、左室リモデリングを予防する経皮的冠動脈介入以前モンテプラーゼ注射:COMA試験
Authors: Yaguchi I, Inoue T, Nishiki R, Watanabe J, Takizawa K, Sakai Y, Takayanagi K, Morooka S
Journal: Journal of the American College of Cardiology (2003)