tbuckley/cabot-search huggingface dataset:
Partha Kar: We need to level up all staff, not level down doctors
Authors: Partha Kar
Journal: BMJ (2024)

Partha Kar: We need to level up all staff, not level down doctors Partha Kar consultant in diabetes and endocrinologyAfter years of underfunding, being undervalued, and issues around pay and working conditions, something finally seems to have changed for doctors.Whisper it softly, but there seem to be signs that they're acting more collectively against changes they disagree with in the healthcare system.I suspect that much of the credit must go to the younger generation, for speaking up and pushing back against learnt helplessness and reigniting the dedication to change.
Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial
Authors: Shuo Wang, Chun-Mei Deng, Yuan Zeng, Xin-Zhong Chen, Ai-Yuan Li, Shan-Wu Feng, Li-Li Xu, Liang Chen, Hong-Mei Yuan, Han Hu, Tian Yang, Tao Han, Hui-Ying Zhang, Ming Jiang, Xin-Yu Sun, Hui-Ning Guo, Daniel I Sessler, Dong-Xin Wang
Journal: BMJ (2024)

Abstract Objective To determine whether a single low dose of esketamine administered after childbirth reduces postpartum depression in mothers with prenatal depression. Design Randomised, double blind, placebo controlled trial with two parallel arms. Setting Five tertiary care hospitals in China, 19 June 2020 to 3 August 2022. Participants 364 mothers aged ≥18 years who had at least mild prenatal depression as indicated by Edinburgh postnatal depression scale scores of ≥10 (range 0-30, with higher scores indicating worse depression) and who were admitted to hospital for delivery. Interventions Participants were randomly assigned 1:1 to receive either 0.2 mg/kg esketamine or placebo infused intravenously over 40 minutes after childbirth once the umbilical cord had been clamped. Main outcome measures The primary outcome was prevalence of a major depressive episode at 42 days post partum, diagnosed using the mini-international neuropsychiatric interview. Secondary outcomes included the Edinburgh postnatal depression scale score at seven and 42 days post partum and the 17 item Hamilton depression rating scale score at 42 days post partum (range 0-52, with higher scores indicating worse depression). Adverse events were monitored until 24 hours after childbirth. Results A total of 364 mothers (mean age 31.8 (standard deviation 4.1) years) were enrolled and randomised. At 42 days post partum, a major depressive episode was observed in 6.7% (12/180) of participants in the esketamine group compared with 25.4% (46/181) in the placebo group (relative risk 0.26, 95% confidence interval (CI) 0.14 to 0.48; P&lt;0.001). Edinburgh postnatal depression scale scores were lower in the esketamine group at seven days (median difference −3, 95% CI −4 to −2; P&lt;0.001) and 42 days (−3, −4 to −2; P&lt;0.001). Hamilton depression rating scale scores at 42 days post partum were also lower in the esketamine group (−4, −6 to −3; P&lt;0.001). The overall incidence of neuropsychiatric adverse events was higher in the esketamine group (45.1% (82/182) v 22.0% (40/182); P&lt;0.001); however, symptoms lasted less than a day and none required drug treatment. Conclusions For mothers with prenatal depression, a single low dose of esketamine after childbirth decreases major depressive episodes at 42 days post partum by about three quarters. Neuropsychiatric symptoms were more frequent but transient and did not require drug intervention. Trial registration ClinicalTrials.gov NCT04414943 .
Bedaquiline, pretomanid and linezolid in multidrug-resistant and pre-extensively drug-resistant tuberculosis in refugees from Ukraine and Somalia in Germany
Authors: Janina Trauth, Vera Kantelhardt, Bohdan Usenko, Michael Knipper, Martin Kuhns, Inna Friesen, Susanne Herold
Journal: European Respiratory Journal (2024)

According to the WHO 2023 tuberculosis report, in the European Union region there are approximately 200.000 tuberculosis cases per year, among which 30.000 are rifampicin-resistant with treatment success rates of 57% [1], indicating a considerable gap from the UN's goal of an 80% reduction by 2030. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Conflict of Interest: All authors have nothing to disclose.
Systemic inflammation predicts diastolic dysfunction in patients with sleep disordered breathing
Authors: Philipp Hegner, Michael Wester, Maria Tafelmeier, Zdenek Provaznik, Susanne Klatt, Christof Schmid, Lars Siegfried Maier, Michael Arzt, Stefan Wagner, Simon Lebek
Journal: European Respiratory Journal (2024)

Heart failure with preserved ejection fraction (HFpEF) constitutes approximately half of all patients with heart failure and causes mortality similar to heart failure with reduced ejection fraction [1]. HFpEF is highly relevant as novel evidence-based therapies emerge but treatment options remain limited [1]. Diastolic dysfunction is a hallmark of HFpEF and is also very common in up to 80% of high-risk cardiovascular patients undergoing cardiac surgery [2]. Even without overt HFpEF, echocardiographic diastolic dysfunction is independently associated with increased mortality [3]. Another important characteristic of HFpEF is the frequent presence of comorbidities with one of the most important being sleep-disordered breathing (SDB). SDB affects over one billion patients in the general population and is highly prevalent in cardiovascular high-risk patients, which underscores its high socio-economic relevance [4]. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: MA received honoraria from ResMed, Philips Respironics, Inspire and Zoll and grant supports from Philips Respironics, ResMed Foundation, and ResMed. Conflict of interest: The other authors declare no conflict of interest.
The association of blood eosinophil counts and FEV<sub>1</sub>decline: a cohort study
Authors: Yun Soo Hong, Hye Yun Park, Seungho Ryu, Sun Hye Shin, Di Zhao, Dave Singh, Eliseo Guallar, Juhee Cho, Yoosoo Chang, Seong Yong Lim
Journal: European Respiratory Journal (2024)

Background Accelerated lung function decline is characteristic of COPD. However, the association between blood eosinophil counts and lung function decline, accounting for current smoking status, in young individuals without prevalent lung disease is not fully understood. Methods This is a cohort study of 629 784 Korean adults without COPD or a history of asthma at baseline who participated in health screening examinations including spirometry and differential white blood cell counts. We used a linear mixed-effects model to estimate the annual change in forced expiratory volume in 1 s (FEV 1 ) (mL) by baseline blood eosinophil count, adjusting for covariates including smoking status. In addition, we performed a stratified analysis by baseline and time-varying smoking status. Results During a mean follow-up of 6.5 years (maximum 17.8 years), the annual change in FEV 1 (95% CI) in participants with eosinophil counts &lt;100, 100–199, 200–299, 300–499 and ≥500 cells·µL −1 in the fully adjusted model were −23.3 (−23.9–−22.7) mL, −24.3 (−24.9–−23.7) mL, −24.8 (−25.5–−24.2) mL, −25.5 (−26.2–−24.8) mL and −26.8 (−27.7–−25.9) mL, respectively. When stratified by smoking status, participants with higher eosinophil count had a faster decline in FEV 1 than those with lower eosinophil count in both never- and ever-smokers, which persisted when time-varying smoking status was used. Conclusions Higher blood eosinophil counts were associated with a faster lung function decline among healthy individuals without lung disease, independent of smoking status. The findings suggest that higher blood eosinophil counts contribute to the risk of faster lung function decline, particularly among younger adults without a history of lung disease.
The gut microbe pair of <i>Oribacterium</i> sp. GMB0313 and <i>Ruminococcus</i> sp. GMB0270 confers complete protection against SARS-CoV-2 infection by activating CD8+ T cell-mediated immunity
Authors: Mingda Wang, Enkhchimeg Lkhagva, Sura Kim, Chongkai Zhai, Md Minarul Islam, Hyeon J. Kim, Seong-Tshool Hong
Journal: Gut Microbes (2024)

Despite the potential protective role of the gut microbiome against COVID-19, specific microbes conferring resistance to COVID-19 have not yet been identified. In this work, we aimed to identify and validate gut microbes at the species level that provide protection against SARS-CoV-2 infection. To identify gut microbes conferring protection against COVID-19, we conducted a fecal microbiota transplantation (FMT) from an individual with no history of COVID-19 infection or immunization into a lethal COVID-19 hamster model. FMT from this COVID-19-resistant donor resulted in significant phenotypic changes related to COVID-19 sensitivity in the hamsters. Metagenomic analysis revealed distinct differences in the gut microbiome composition among the hamster groups, leading to the identification of two previously unknown bacterial species:
Performance of the galactomannan test for the diagnosis of invasive pulmonary aspergillosis using non-invasive proximal airway samples
Authors: June Young Chun, Sahng-Joon Jeong, Sinae Kim, Soyoung Choi, Jong Hyuk Lee, Hyun Sung Chung, Seungman Park, Hyewon Lee, Hyae Young Kim, Bin Hwangbo, Young Ju Choi
Journal: Journal of Infection (2024)

ObjectiveTo diagnose invasive pulmonary aspergillosis (IPA), galactomannan (GM) detection in serum or bronchoalveolar lavage fluid (BALF) is widely used. However, the utility of proximal airway GM test (from induced sputum or tracheal aspirate) has not been well elucidated.MethodsIn this retrospective cohort study, we evaluated the diagnostic performance of proximal airway GM in diagnosis of IPA including COVID-19 associated pulmonary aspergillosis (CAPA). Between January 2022 and January 2023, patients who had been tested for GM with clinical suspicion or for surveillance from any specimen (serum, induced sputum, tracheal aspirate, and BALF) were screened. IPA was diagnosed using EORTC/MSGERC criteria, and CAPA was diagnosed following the 2020 ECMM/ISHAM consensus criteria.ResultsOf 624 patients with GM results, 70 met the criteria for proven/probable IPA and 427 had no IPA. The others included possible IPA and chronic form of aspergillosis. The sensitivities and specificities of serum, proximal airway, and BALF GM for proven/probable IPA versus no IPA were 78.9% and 70.6%, 93.1% and 78.7%, and 78.6% and 91.0%, respectively. Areas under the receiver operating characteristic curve (AUCs) were 0.742 for serum GM, 0.935 for proximal airway GM, and 0.849 for BALF GM (serum GM vs proximal airway GM, p = 0.014; proximal airway GM vs BALF GM, p = 0.334; serum GM vs BALF GM, p = 0.286).ConclusionThis study demonstrates that the performance of GM test from non-invasive proximal airway samples is comparable or even better than those from serum and distal airway sample (BALF).
Heat-Related Emergency Department Visits — United States, May–September 2023
Authors: Ambarish Vaidyanathan, Abigail Gates, Claudia Brown, Emily Prezzato, Aaron Bernstein
Journal: MMWR Morbidity and Mortality Weekly Report (2024)

Unprecedented heat waves can affect all persons, but some are more sensitive to the effects of heat, including children and adults with underlying health conditions, pregnant women, and outdoor workers. Many regions of the United States experienced record-breaking high temperatures in 2023, with populations exposed to extremely high temperatures for prolonged periods. CDC examined emergency department (ED) visits associated with heat-related illness (HRI) from the National Syndromic Surveillance Program and compared daily HRI ED visit rates during the warm-season months (May-September) of 2023 with those during 2018-2022. In the 2023 warm-season months, daily HRI ED visit rates peaked in several regions and remained elevated for a prolonged duration. More males than females sought care in EDs for HRI, especially males aged 18-64 years. CDC issued multiple public health alerts using the Epidemic Information Exchange system to bring attention to increases in ED utilization for HRI. Deaths and illnesses associated with heat exposure are a continuing public health concern as climate change results in longer, hotter, and more frequent episodes of extreme heat. Near real-time monitoring of weather conditions and adverse health outcomes can guide public health practitioners' timing of risk communication and implementation of prevention measures associated with extreme heat.
Cost-Effectiveness of Unselected Multigene Germline and Somatic Genetic Testing for Epithelial Ovarian Cancer
Authors: Ranjit Manchanda, Li Sun, Monika Sobocan, Isabel V. Rodriguez, Xia Wei, Ashwin Kalra, Samuel Oxley, Michail Sideris, Caitlin T. Fierheller, Robert D. Morgan, Dhivya Chandrasekaran, Kelly Rust, Pavlina Spiliopoulou, Rowan E. Miller, Shanthini M. Crusz, Michelle Lockley, Naveena Singh, Asma Faruqi, Laura Casey, Elly Brockbank, Saurabh Phadnis, Tina Mills-Baldock, Fatima El-Khouly, Lucy A. Jenkins, Andrew Wallace, Munaza Ahmed, Ajith Kumar, Elizabeth M. Swisher, Charlie Gourley, Barbara M. Norquist, D. Gareth Evans, Rosa Legood
Journal: Journal of the National Comprehensive Cancer Network (2024)

Parallel panel germline and somatic genetic testing of all patients with ovarian cancer (OC) can identify more pathogenic variants (PVs) that would benefit from PARP inhibitor (PARPi) therapy, and allow for precision prevention in unaffected relatives with PVs. In this study, we estimate the cost-effectiveness and population impact of parallel panel germline and somatic BRCA testing of all patients with OC incorporating PARPi therapy in the United Kingdom and the United States compared with clinical criteria/family history (FH)-based germline BRCA testing. We also evaluate the cost-effectiveness of multigene panel germline testing alone.
White Matter Alterations in Military Service Members With Remote Mild Traumatic Brain Injury
Authors: Sharon Kim, John Ollinger, Chihwa Song, Sorana Raiciulescu, Srija Seenivasan, Aaron Wolfgang, Hosung Kim, J. Kent Werner, Ping-Hong Yeh
Journal: JAMA Network Open (2024)

Mild traumatic brain injury (mTBI) is the signature injury experienced by military service members and is associated with poor neuropsychiatric outcomes. Yet, there is a lack of reliable clinical tools for mTBI diagnosis and prognosis.
Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France
Authors: Arnaud Fernandez, Florence Askenazy, Radia Zeghari, Philippe Auby, Philippe Robert, Susanne Thümmler, Morgane Gindt
Journal: JAMA Network Open (2024)

Somatic symptoms are a major concern among the pediatric population because of frequency and burden. The association between adverse childhood experiences and somatic symptoms in adults is well established but less is known concerning somatic symptoms in young people.
Estrogen-Only Hormone Therapy and Dementia—Reply
Authors: Nelsan Pourhadi, Lina S. Mørch, Amani Meaidi
Journal: JAMA (2024)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 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
<i>International Classification of Diseases</i> Coding for Inflammatory Arthritides
Authors: Justin R. Zhu, Anoop R. Galivanche, Michael J. Gouzoulis, Alexander J. Kammien, Stephen M. Gillinov, Rahul H. Jayaram, Jonathan N. Grauer
Journal: JAMA Network Open (2024)

This quality improvement study investigates usage patterns of codes for inflammatory arthritides under International Statistical Classification of Diseases and Related Health Problems, Tenth Revision vs International Classification of Diseases, Ninth Revision.
T-Cell Malignant Neoplasms After Chimeric Antigen Receptor T-Cell Therapy
Authors: Ryan Storgard, Kai Rejeski, Miguel-Angel Perales, Adam Goldman, Roni Shouval
Journal: JAMA Oncology (2024)

This cohort study assesses the increase in second primary malignant neoplasms and T-cell malignant neoplasm cases associated with chimeric antigen receptor–T cells.
The Metastatic Waltz
Authors: Antonio Yaghy
Journal: JAMA Oncology (2024)

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 Oncology 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 2024 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 Oncology journal
Dynamics of clonal hematopoiesis under DNA-damaging treatment in patients with ovarian cancer
Authors: Christopher Maximilian Arends, Klara Kopp, Raphael Hablesreiter, Natalia Estrada, Friederike Christen, Ute Martha Moll, Robert Zeillinger, Wolfgang Daniel Schmitt, Jalid Sehouli, Hagen Kulbe, Maximilian Fleischmann, Isabelle Ray-Coquard, Alain Zeimet, Francesco Raspagliesi, Claudio Zamagni, Ignace Vergote, Domenica Lorusso, Nicole Concin, Lars Bullinger, Elena Ioana Braicu, Frederik Damm
Journal: Leukemia (2024)

Clonal hematopoiesis (CH) driven by mutations in the DNA damage response (DDR) pathway is frequent in patients with cancer and is associated with a higher risk of therapy-related myeloid neoplasms (t-MNs). Here, we analyzed 423 serial whole blood and plasma samples from 103 patients with relapsed high-grade ovarian cancer receiving carboplatin, poly(ADP-ribose) polymerase inhibitor (PARPi) and heat shock protein 90 inhibitor (HSP90i) treatment within the phase II EUDARIO trial using error-corrected sequencing of 72 genes. DDR-driven CH was detected in 35% of patients and was associated with longer duration of prior PARPi treatment. TP53- and PPM1D-mutated clones exhibited substantially higher clonal expansion rates than DNMT3A- or TET2-mutated clones during treatment. Expansion of DDR clones correlated with HSP90i exposure across the three study arms and was partially abrogated by the presence of germline mutations related to homologous recombination deficiency. Single-cell DNA sequencing of selected samples revealed clonal exclusivity of DDR mutations, and identified DDR-mutated clones as the origin of t-MN in two investigated cases. Together, these results provide unique insights into the architecture and the preferential selection of DDR-mutated hematopoietic clones under intense DNA-damaging treatment. Specifically, PARPi and HSP90i therapies pose an independent risk for the expansion of DDR-CH in a dose-dependent manner.
Neighborhood Disadvantage and Breast Cancer–Specific Survival in the US
Authors: Neha Goel, Alexandra E. Hernandez, Angela Mazul
Journal: JAMA Network Open (2024)

Despite improvements in breast cancer screening, treatment, and survival, disparate breast cancer-specific survival outcomes persist, particularly in disadvantaged neighborhoods. Most of these disparities are attributed to disparities in individual, tumor, and treatment characteristics. However, a critical knowledge gap exists as to whether disparities in breast cancer-specific survival remain after accounting for individual, tumor, and treatment characteristics.
Incidence of Total Knee Arthroplasty After Arthroscopic Surgery for Knee Osteoarthritis
Authors: Trevor B. Birmingham, Codie A. Primeau, Salimah Z. Shariff, Jennifer N. S. Reid, Jacquelyn D. Marsh, Melody Lam, Stephanie N. Dixon, J. Robert Giffin, Kevin R. Willits, Robert B. Litchfield, Brian G. Feagan, Peter J. Fowler
Journal: JAMA Network Open (2024)

It is unclear whether arthroscopic resection of degenerative knee tissues among patients with osteoarthritis (OA) of the knee delays or hastens total knee arthroplasty (TKA); opposite findings have been reported.
Estrogen-Only Hormone Therapy and Dementia
Authors: Sarah Glynne
Journal: JAMA (2024)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 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