tbuckley/cabot-search huggingface dataset:
Robotic versus open pancreaticoduodenectomy, comparing therapeutic indexes; a systematic review
Authors: Artemis Mantzavinou, Mallikarjuna Uppara, Jeremy Chan, Bijendra Patel
Journal: International Journal of Surgery (2022)

Pancreaticoduodenectomy (PD) is a challenging procedure with peri-operative complications. Robotic surgery offers improved dexterity, visibility, and accessibility. Recently, many centres have reported improved clinical outcomes for robotic PD. We reviewed the safety and efficacy of robotic PD in comparison to open PD using 'Therapeutic Index' (TI). A systematic review of the literature was conducted in various databases. Articles published between January 2010 and March 2021 reporting totally-robotic and open PD were included, according to the PRISMA and AMSTAR-2 guidelines. The Cochrane tool was used for risk of bias assessment. We compared 30-day mortality rates (MR30), lymphadenectomy rates (LR), R0 resection rates (R0RR) and therapeutic index (TI). STATA 16.1 was used for statistical analysis. The four studies that met inclusion criteria included 5090 PDs, out of which 617 were totally-robotic (RPD) and 4473 were open (OPD). Variance ratio tests demonstrated a)Higher TI for RPD versus OPD (1807.42 vs 1723.37, p = 0.86), b)Significantly smaller MR30 (2.50 vs 19.00, p = 0.0004), c)Significantly lower R0RR (130.50 vs 939.25, p = 0.00) and d)No significant difference in LR between RPD and OPD (35.63 vs 38.25, p = 0.81). Meta-regression analysis showed a significantly higher TI coefficient of RPD than OPD (0.66 vs −0.40, p = 0.08, α = 0.1). Our study suggests that robotic PD is safe and not inferior to open PD and our analysis RPD demonstrated a higher therapeutic index than OPD. Randomised controlled trials are required to establish the efficacy of robotic PD. Also, standardisation of reporting mortality, survival and oncological outcomes is needed for the effective calculation of TI.
Reflections on a contemporary European tragedy
Authors: Iain B McInnes, Annamaria Iagnocco, Daniel Aletaha, Xenofon Baraliakos, Johannes WJ Bijlsma, Elsa F Mateus, Zoltan Szekanecz, Theodora P M Vliet Vlieland, Josef S Smolen
Journal: Annals of the Rheumatic Diseases (2022)

No valuable talent exists without the following qualities: 1. Compassion for the oppressed; 2. Love for the good; 3. Hate against evil; 4. Courage,
COVID-19 Vaccine Effectiveness in Youth Varies by Age, Variant
Authors: Bridget M. Kuehn
Journal: JAMA (2022)

Two doses of the BNT162b2 (Pfizer-BioNTech) vaccine were more effective for reducing infections with the Delta variant of SARS-CoV-2 than the Omicron variant, a multi-institution study showed. Adolescents also received greater protection from vaccination than younger age groups.
Clinical Trials Disrupted During War in Ukraine
Authors: Rita Rubin
Journal: JAMA (2022)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer
Authors: Steven P. Dehmer, Lauren R. O’Keefe, Corinne V. Evans, Janelle M. Guirguis-Blake, Leslie A. Perdue, Michael V. Maciosek
Journal: JAMA (2022)

The US Preventive Services Task Force (USPSTF) is updating its 2016 recommendation on the use of aspirin for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC).To provide updated model-based estimates of the net balance in benefits and harms from routine use of low-dose aspirin for primary prevention.Microsimulation modeling was used to estimate long-term benefits and harms for hypothetical US cohorts of men and women aged 40 to 79 years with up to 20% 10-year risk for an atherosclerotic CVD event and without prior history of CVD or elevated bleeding risks.Low-dose (≤100 mg/d) aspirin for lifetime use, unless contraindicated by a bleeding event, and with stopping ages in 5-year intervals from age 65 to 85 years.Primary outcomes were lifetime net benefits measured in quality-adjusted life-years (QALYs) and life-years. Benefits included reduced nonfatal myocardial infarction and ischemic stroke. Harms included increased nonfatal major gastrointestinal bleeding and intracranial hemorrhage. Reduced CRC incidence was considered in sensitivity analysis.Estimated lifetime net QALYs were positive for both men and women at 5% or greater 10-year CVD risk when starting between ages 40 and 59 years and at 10% or greater 10-year CVD risk when starting between ages 60 and 69 years. These estimates ranged from 2.3 (95% CI, -2.7 to 7.4) to 66.2 (95% CI, 58.2 to 74.1) QALYs per 1000 persons. Lifetime net life-years were positive for men at 5% or greater and women at 10% or greater 10-year CVD risk starting aspirin at ages 40 to 49 years and for men at 7.5% or greater and women at 15% or greater 10-year CVD risk at ages 50 to 59 years. These estimates ranged from 0.4 (95% CI, -6.1 to 6.9) to 52.4 (95% CI, 43.9 to 60.9) life-years per 1000 persons. Lifetime net life-years were negative in most cases for persons starting aspirin between ages 60 and 79 years, as were lifetime net QALYs for persons aged 70 to 79 years. Stopping aspirin between ages 65 and 85 years generally showed little advantage compared with lifetime use. Sensitivity analyses showed lifetime net benefits may be higher if aspirin reduced CRC incidence or CVD mortality and lower if aspirin increased fatal major gastrointestinal bleeding or reduced quality of life with routine use.This microsimulation study suggested that several population groups may benefit from taking aspirin for the primary prevention of CVD, primarily in persons starting at younger ages with higher 10-year CVD risk.
Aspirin Use to Prevent Cardiovascular Disease
Authors: Karina W. Davidson, Michael J. Barry, Carol M. Mangione, Michael Cabana, David Chelmow, Tumaini Rucker Coker, Esa M. Davis, Katrina E. Donahue, Carlos Roberto Jaén, Alex H. Krist, Martha Kubik, Li Li, Gbenga Ogedegbe, Lori Pbert, John M. Ruiz, James Stevermer, Chien-Wen Tseng, John B. Wong
Journal: JAMA (2022)

<h3>Importance</h3> Cardiovascular disease (CVD) is the leading cause of mortality in the US, accounting for more than 1 in 4 deaths. Each year, an estimated 605 000 people in the US have a first myocardial infarction and an estimated 610 000 experience a first stroke. <h3>Objective</h3> To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the effectiveness of aspirin to reduce the risk of CVD events (myocardial infarction and stroke), cardiovascular mortality, and all-cause mortality in persons without a history of CVD. The systematic review also investigated the effect of aspirin use on colorectal cancer (CRC) incidence and mortality in primary CVD prevention populations, as well as the harms (particularly bleeding) associated with aspirin use. The USPSTF also commissioned a microsimulation modeling study to assess the net balance of benefits and harms from aspirin use for primary prevention of CVD and CRC, stratified by age, sex, and CVD risk level. <h3>Population</h3> Adults 40 years or older without signs or symptoms of CVD or known CVD (including history of myocardial infarction or stroke) who are not at increased risk for bleeding (eg, no history of gastrointestinal ulcers, recent bleeding, other medical conditions, or use of medications that increase bleeding risk). <h3>Evidence Assessment</h3> The USPSTF concludes with moderate certainty that aspirin use for the primary prevention of CVD events in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk has a small net benefit. The USPSTF concludes with moderate certainty that initiating aspirin use for the primary prevention of CVD events in adults 60 years or older has no net benefit. <h3>Recommendation</h3> The decision to initiate low-dose aspirin use for the primary prevention of CVD in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one. Evidence indicates that the net benefit of aspirin use in this group is small. Persons who are not at increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit. (C recommendation) The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults 60 years or older. (D recommendation)
Dermoscopy practice guidelines for use in telemedicine
Authors: Linda Camaj Deda, Rebecca H. Goldberg, Taylor A. Jamerson, Ivy Lee, Trilokraj Tejasvi
Journal: npj Digital Medicine (2022)

Teledermoscopy, or the utilization of dermatoscopic images in telemedicine, can help diagnose dermatologic disease remotely, triage lesions of concern (i.e., determine whether in-person consultation with a dermatologist is necessary, biopsy, or reassure the patient), and monitor dermatologic lesions over time. Handheld dermatoscopes, a magnifying apparatus, have become a commonly utilized tool for providers in many healthcare settings and professions and allows users to view microstructures of the epidermis and dermis. This Dermoscopy Practice Guideline reflects current knowledge in the field of telemedicine to demonstrate the correct capture, usage, and incorporation of dermoscopic images into everyday practice.
Diverse therapeutic developments for post-traumatic stress disorder (PTSD) indicate common mechanisms of memory modulation
Authors: Sanket B. Raut, Padmaja A. Marathe, Liza van Eijk, Rajaraman Eri, Manoj Ravindran, David M. Benedek, Robert J. Ursano, Juan J. Canales, Luke R. Johnson
Journal: Pharmacology & Therapeutics (2022)
Back to basics: the respiratory management of Duchenne muscular dystrophy
Authors: David J Birnkrant, John C Carter
Journal: Thorax (2022)

<h3></h3> Beta-lactam (BL) antibiotics are among the most prescribed drugs globally but can provoke hypersensitivity reactions which can lead to incorrectly labelling as ‘allergy’. Data on prevalence and incidence of drug hypersensitivity reactions (DHRs) are limited, especially in the pediatric age. It is important to assess subjects with history of hypersensitivity reactions to BL as up to 70% are not allergic based on diagnostic test results. Laboratory tests for identifying children who are allergic to drugs have low diagnostic accuracy and predictive value. The gold standard to diagnose DHR is drug provocation test (DPT). DHRs are classified as immediate or nonimmediate/delayed reactions. Mild delayed cutaneous reactions including maculopapular rashes and urticaria/angioedema are common reactions in children and often occur in the setting of viral infections. In mild cutaneous delayed reactions, some clinicians suggest performing only DPT because of its high negative predictive value, without skin testing and serum IgE measurement while other suggest SPT and/or specific IgE to culprit drug if patient/caregiver cannot provide a detailed description of the previous reaction. Aim: to investigate the proportion of positive oral provocation tests in children labeled as BL antibiotic allergy. Direct oral challenge was performed in patients with history of benign rash associated with beta-lactam antibiotic. Because detailed description of suspected allergic reaction could not be provided from all caregivers, all patients went specific IgE to amoxicillin and/or basophil degranulation test to culprit drug which was negative. 19 patients were included, average age 6 years and 1 month. In 17 patients suspected allergic reaction was caused by amoxicillin (AMX); 8 of which in combination with clavulanic acid, one with phenoxymethylpenicillin and one with cephalexin. A DPT involved open 3-step graded oral provocation test with AMX, time interval between the doses was 2h. The patients were monitored for 24h after challenge and were discharged with instructions to call in the event of a delayed reaction. After DPT there was no reaction in 89% of patients, one patient developed benign rash and one drug-induced enterocolitis syndrome. BL antibiotics can be safely readministered to children with history of benign rash to beta-lactams using graded oral challenge in medically supervised settings if spIgE is negative even if uncertain history. It is important to establish a correct diagnosis of BL antibiotic allergy since using alternative non–β-lactam antibiotics in these patients leads to higher healthcare costs and adverse events.
Degradation of 3D-printed magnesium phosphate ceramics in vitro and a prognosis on their bone regeneration potential
Authors: Gefel Eugen, Moseke Claus, Schmitt Anna-Maria, Dümmler Niklas, Stahlhut Philipp, Ewald Andrea, Meyer-Lindenberg Andrea, Vorndran Elke
Journal: Bioactive Materials (2022)

Regenerative bone implants promote new bone formation and ideally degrade simultaneously to osteogenesis. Although clinically established calcium phosphate bone grafts provide excellent osseointegration and osteoconductive efficacy, they are limited in terms of bioresorption. Magnesium phosphate (MP) based ceramics are a promising alternative, because they are biocompatible, mechanically extremely stable, and degrade much faster than calcium phosphates under physiological conditions. Bioresorption of an implant material can include both chemical dissolution as well as cellular resorption. We investigated the bioresorption of 3D powder printed struvite and newberyite based MP ceramics in vitro by a direct human osteoclast culture approach. The osteoclast response and cellular resorption was evaluated by means of fluorescence and TRAP staining, determination of osteoclast activities (CA II and TRAP), SEM imaging as well as by quantification of the ion release during cell culture. Furthermore, the bioactivity of the materials was investigated via SBF immersion, whereas hydroxyapatite precipitates were analyzed by SEM and EDX measurements. This bioactive coating was resorbed by osteoclasts. In contrast, only chemical dissolution contributed to bioresorption of MP, while no cellular resorption of the materials was observed. Based on our results, we expect an increased bone regeneration effect of MP compared to calcium phosphate based bone grafts and complete chemical degradation within a maximum of 1.5–3.1 years.
CD19 CAR T-cells for pediatric relapsed acute lymphoblastic leukemia with active CNS involvement: a retrospective international study
Authors: Elad Jacoby, Sara Ghorashian, Britta Vormoor, Barbara De Moerloose, Nicole Bodmer, Olga Molostova, Asaf D Yanir, Jochen Buechner, Ronit Elhasid, Bella Bielorai, Srdan Rogosic, Marie-Emilie Dourthe, Michael Maschan, Claudia Rossig, Amos Toren, Arend von Stackelberg, Franco Locatelli, Peter Bader, Martin Zimmermann, Jean Pierre Bourquin, Andre Baruchel
Journal: Leukemia (2022)
Research on the Clinical Translation of Health Care Machine Learning: Ethicists Experiences on Lessons Learned
Authors: Jennifer Blumenthal-Barby, Benjamin Lang, Natalie Dorfman, Holland Kaplan, William B. Hooper, Kristin Kostick-Quenet
Journal: The American Journal of Bioethics (2022)

This article refers to:A Research Ethics Framework for the Clinical Translation of Healthcare Machine Learning
Singling out motor neurons in the age of single-cell transcriptomics
Authors: Jacob A. Blum, Aaron D. Gitler
Journal: Trends in Genetics (2022)

Motor neurons are a remarkably powerful cell type in the central nervous system. They innervate and control the contraction of virtually every muscle in the body and their dysfunction underlies numerous neuromuscular diseases. Some motor neurons seem resistant to degeneration whereas others are vulnerable. The intrinsic heterogeneity of motor neurons in adult organisms has remained elusive. The development of high-throughput single-cell transcriptomics has changed the paradigm, empowering rapid isolation and profiling of motor neuron nuclei, revealing remarkable transcriptional diversity within the skeletal and autonomic nervous systems. Here, we discuss emerging technologies for defining motor neuron heterogeneity in the adult motor system as well as implications for disease and spinal cord injury. We establish a roadmap for future applications of emerging techniques - such as epigenetic profiling, spatial RNA sequencing, and single-cell somatic mutational profiling to adult motor neurons, which will revolutionize our understanding of the healthy and degenerating adult motor system.
The role of ATP-binding cassette subfamily A in the etiology of Alzheimer’s disease
Authors: Liene Bossaerts, Rita Cacace, Christine Van Broeckhoven
Journal: Molecular Neurodegeneration (2022)

Abstract Background Alzheimer’s disease (AD) is the leading cause of dementia, clinically characterized by memory deficits and progressive cognitive decline. Despite decades of research effective therapies are lacking, and a large part of the genetic heritability remains unidentified. ABCA7 and ABCA1 , members of the ATP-binding cassette subfamily A (ABCA), were identified as AD risk genes in genome-wide association studies. Nevertheless, genetic and/or functional studies propose a link between AD and two other members of the ABCA subclass, i.e., ABCA2 and ABCA5. Main body Changes in expression or dysfunction of these transporters were found to increase amyloid β levels. This might be related to the common role of ABCA transporters in cellular cholesterol homeostasis, for which a prominent role in AD development has been suggested. In this review, we provide a comprehensive overview and discussion on the contribution of the ABCA subfamily to the etiopathogenesis of AD. Conclusions A better understanding of the function and identification of disease-associated genetic variants in ABCA transporters can contribute to the development of novel therapeutic strategies for AD.
Endoscopic pyloromyotomy for the treatment of severe and refractory gastroparesis: a pilot, randomised, sham-controlled trial
Authors: Jan Martinek, Rastislav Hustak, Jan Mares, Zuzana Vackova, Julius Spicak, Eva Kieslichova, Marie Buncova, Daniel Pohl, Sunil Amin, Jan Tack
Journal: Gut (2022)

Objective Endoscopic pyloromyotomy (G-POEM) is a minimally invasive treatment option with promising uncontrolled outcome results in patients with gastroparesis. Design In this prospective randomised trial, we compared G-POEM with a sham procedure in patients with severe gastroparesis. The primary outcome was the proportion of patients with treatment success (defined as a decrease in the Gastroparesis Cardinal Symptom Index (GCSI) by at least 50%) at 6 months. Patients randomised to the sham group with persistent symptoms were offered cross-over G-POEM. Results The enrolment was stopped after the interim analysis by the Data and Safety Monitoring Board prior to reaching the planned sample of 86 patients. A total of 41 patients (17 diabetic, 13 postsurgical, 11 idiopathic; 46% male) were randomised (21 G-POEM, 20-sham). Treatment success rate was 71% (95% CI 50 to 86) after G-POEM versus 22% (8–47) after sham (p=0.005). Treatment success in patients with diabetic, postsurgical and idiopathic gastroparesis was 89% (95% CI 56 to 98), 50% (18–82) and 67% (30–90) after G-POEM; the corresponding rates in the sham group were 17% (3–57), 29% (7–67) and 20% (3–67). Median gastric retention at 4 hours decreased from 22% (95% CI 17 to 31) to 12% (5–22) after G-POEM and did not change after sham: 26% (18–39) versus 24% (11–35). Twelve patients crossed over to G-POEM with 9 of them (75%) achieving treatment success. Conclusion In severe gastroparesis, G-POEM is superior to a sham procedure for improving both symptoms and gastric emptying 6 months after the procedure. These results are not entirely conclusive in patients with idiopathic and postsurgical aetiologies. Trial registration number NCT03356067 ; ClinicalTrials.gov.
Tissue-resident memory T cells in gastrointestinal cancer immunology and immunotherapy: ready for prime time?
Authors: Syrine Abdeljaoued, Sara Arfa, Marie Kroemer, Myriam Ben Khelil, Angélique Vienot, Bruno Heyd, Romain Loyon, Alexandre Doussot, Christophe Borg
Journal: Journal for ImmunoTherapy of Cancer (2022)

Tissue-resident memory T (T RM ) cells have emerged as immune sentinels that patrol the tissue microenvironment and orchestrate localized antitumor immunity in various solid cancers. Recent studies have revealed that T RM cells are key players in cancer immunosurveillance, and their involvement has been linked to favorable responses to immunotherapy as well as general better clinical outcome in cancer patients. In this review, we provide an overview of the major advances and recent findings regarding T RM cells phenotype, transcriptional and epigenetic regulation in cancer with a special focus on gastrointestinal tumors. Finally, we highlight the exciting clinical implication of T RM cells in these types of tumors.
Auxilin is a novel susceptibility gene for congenital heart block which directly impacts fetal heart function
Authors: Sabrina Meisgen, Malin Hedlund, Aurelie Ambrosi, Lasse Folkersen, Vijole Ottosson, David Forsberg, Gudny Ella Thorlacius, Luca Biavati, Linn Strandberg, Johannes Mofors, Daniel Ramskold, Sabrina Ruhrmann, Lauro Meneghel, William Nyberg, Alexander Espinosa, Robert Murray Hamilton, Anders Franco-Cereceda, Anders Hamsten, Tomas Olsson, Lois Greene, Per Eriksson, Kristina Gemzell-Danielsson, Stina Salomonsson, Vijay K Kuchroo, Eric Herlenius, Ingrid Kockum, Sven-Erik Sonesson, Marie Wahren-Herlenius
Journal: Annals of the Rheumatic Diseases (2022)

Neonatal lupus erythematosus (NLE) may develop after transplacental transfer of maternal autoantibodies with cardiac manifestations (congenital heart block, CHB) including atrioventricular block, atrial and ventricular arrhythmias, and cardiomyopathies. The association with anti-Ro/SSA antibodies is well established, but a recurrence rate of only 12%-16% despite persisting maternal autoantibodies suggests that additional factors are required for CHB development. Here, we identify fetal genetic variants conferring risk of CHB and elucidate their effects on cardiac function.