Prescriptions of opioid-containing drugs in patients with chronic cough.

Background: Chronic cough (CC) affects about 10% of adults, but opioid use in CC is not well understood.

Objectives: To determine the use of opioid-containing cough suppressant (OCCS) prescriptions in patients with CC using electronic health records.

Design: Retrospective cohort study.

Patient-reported experiences with refractory or unexplained chronic cough: a qualitative analysis.

Background: Chronic cough, defined as a cough lasting 8 or more weeks, affects up to 10% of adults. Refractory chronic cough (RCC) is a cough that is uncontrolled despite comprehensive investigation and treatment of comorbid conditions while unexplained chronic cough (UCC) is a cough with no identifiable cause despite extensive evaluation of comorbid conditions. RCC and UCC are often poorly controlled.

Systematic literature review of treatments used for refractory or unexplained chronic cough in adults.

Background: Refractory or unexplained chronic cough (RCC or UCC) is difficult to manage and is usually treated by the off-label use of drugs approved for other indications.

Objective: The objectives of this systematic literature review (SLR) were to identify and characterize the current published body of evidence for the efficacy and safety of treatments for RCC or UCC.

Methods: The SLR was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Machine learning to identify chronic cough from administrative claims data.

Accurate identification of patient populations is an essential component of clinical research, especially for medical conditions such as chronic cough that are inconsistently defined and diagnosed. We aimed to develop and compare machine learning models to identify chronic cough from medical and pharmacy claims data. In this retrospective observational study, we compared 3 machine learning algorithms based on XG Boost, logistic regression, and neural network approaches using a large claims and electronic health record database.

Chronic cough: more than just a persistent cough: a systematic literature review to understand the impact of chronic cough on quality of life.

Purpose: Chronic cough (CC), defined as a cough persisting ≥ 8 weeks, can have a substantial negative impact on health-related quality of life (HRQoL). This is exacerbated by challenges with timely diagnosis and a lack of approved therapies. A systematic literature review (SLR) was conducted to identify evidence on HRQoL and health state utility values associated with refractory CC or unexplained CC.

Understanding the economic burden of chronic cough: a systematic literature review.

Chronic cough (CC) is associated with high healthcare resource utilization (HCRU) due to challenges in diagnosis and treatment and is anticipated to have a substantial economic impact. This systematic literature review (SLR) sought to identify evidence on the cost-effectiveness of treatments and the economic burden associated with CC. Electronic database searches were supplemented with searches of conference proceedings and health technology assessment body websites.

Quantitative analysis of human hairs and nails.

Hair and nails are human biomarkers capable of providing a continuous assessment of the concentrations of elements inside the human body to indicate the nutritional status, metabolic changes, and the pathogenesis of various human diseases. Laser-induced breakdown spectroscopy (LIBS) and X-ray fluorescence (XRF) spectrometry are robust and multi-element analytical techniques able to analyze biological samples of various kinds for disease diagnosis. The primary objective of this review article is to focus on the major developments and advances in LIBS and XRF for the elemental analysis of hair and nails over the last 10-year period.

Prediction of persistent chronic cough in patients with chronic cough using machine learning.

Introduction: The aim of this study was to develop and validate prediction models for risk of persistent chronic cough (PCC) in patients with chronic cough (CC). This was a retrospective cohort study.

Methods: Two retrospective cohorts of patients 18-85 years of age were identified for years 2011-2016: a specialist cohort which included CC patients diagnosed by specialists, and an event cohort which comprised CC patients identified by at least three cough events.

Health-related experiences of adults with chronic cough: Empirical research mixed methods.

Aim: To describe adults' health-related experiences with chronic cough.

Design: Survey and interviews.

Methods: Participants completed questionnaires and interviews, to explore chronic cough's impact and management.

Safety assessment of a solid lipid curcumin particle preparation: In vitro and in vivo genotoxicity studies.

Curcumin, one of the three principal curcuminoids found within turmeric rhizomes, has long been associated with numerous physiologically beneficial effects; however, its efficacy is limited by its inherently low bioavailability. Several novel formulations of curcumin extracts have been prepared in recent years to increase the systemic availability of curcumin; Longvida®, a solid lipid curcumin particle preparation, is one such formulation that has shown enhanced bioavailability compared with standard curcuminoid extracts. As part of a safety assessment of Longvida® for use as a food ingredient, a bacterial reverse mutation test (OECD TG 471) and mammalian cell erythrocyte micronucleus test (OECD TG 474) were conducted to assess its genotoxic potential.

Enteric glial adenosine 2B receptor signaling mediates persistent epithelial barrier dysfunction following acute DSS colitis.

Intestinal epithelial barrier function is compromised in inflammatory bowel disease and barrier dysfunction contributes to disease progression. Extracellular nucleotides/nucleosides generated in gut inflammation may regulate barrier function through actions on diverse cell types. Enteric glia modulate extracellular purinergic signaling and exert pathophysiological effects on mucosal permeability.

Development of a natural language processing algorithm to detect chronic cough in electronic health records.

Background: Chronic cough (CC) is difficult to identify in electronic health records (EHRs) due to the lack of specific diagnostic codes. We developed a natural language processing (NLP) model to identify cough in free-text provider notes in EHRs from multiple health care providers with the objective of using the model in a rules-based CC algorithm to identify individuals with CC from EHRs and to describe the demographic and clinical characteristics of individuals with CC.

Methods: This was a retrospective observational study of enrollees in Optum's Integrated Clinical + Claims Database.

Application of unsupervised deep learning algorithms for identification of specific clusters of chronic cough patients from EMR data.

Background: Chronic cough affects approximately 10% of adults. The lack of ICD codes for chronic cough makes it challenging to apply supervised learning methods to predict the characteristics of chronic cough patients, thereby requiring the identification of chronic cough patients by other mechanisms. We developed a deep clustering algorithm with auto-encoder embedding (DCAE) to identify clusters of chronic cough patients based on data from a large cohort of 264,146 patients from the Electronic Medical Records (EMR) system.

Risk Factors for Persistent Chronic Cough During Consecutive Years: A Retrospective Database Analysis.

Background: The identification of patients at high risk for diseases provides clinicians essential information to better manage such patients. Persistent chronic cough (PCC) is a condition with high clinical burden and limited knowledge of the risk factors that drive the persistent symptoms.

Objective: To understand the risk factors of PCC in patients with CC diagnosed by specialists.

Health systems and nutrition in the time of COVID-19.

As infection rates rise, job losses increase and workers leave cities to walk back home, and there is a silent hunger and nutrition crisis striking the country. Those who will bear the brunt of this are the already vulnerable-namely, children, adolescent girls, nursing and expectant mothers-now denied even basic calories. Among these are some who are also suffering huge weight losses because of the 15 days of high fever.

When You "Can't See" a Case of Relapsing Polychondritis.

Relapsing polychondritis (RP) is a rare and, if not treated, potentially lethal autoimmune disorder. Involvement of central nervous system (CNS) in RP is rare and, when present, makes it extremely difficult to diagnose. In this report, we present a case of a 22-year-old Hispanic woman who presented with sudden onset of headache and blurred vision.

Applying interpretable deep learning models to identify chronic cough patients using EHR data.

Background And Objective: Chronic cough (CC) affects approximately 10% of adults. Many disease states are associated with chronic cough, such as asthma, upper airway cough syndrome, bronchitis, and gastroesophageal reflux disease. The lack of an ICD code specific for chronic cough makes it challenging to identify such patients from electronic health records (EHRs).

A Case of S-Variant Hepatitis B Virus: An Immune System Escape Artist.

Genomic variants of the hepatitis B virus (HBV) preS/S protein are well-known to occur. Typically, immunity is gained through recovered HBV infection or by immunization. Very rarely, there are certain mutations that may enable HBV escape from the immune detection.

Serum- and glucocorticoid-inducible kinase 1 activity in ventral tegmental area dopamine neurons regulates cocaine conditioned place preference but not cocaine self-administration.

Drugs of abuse regulate the activity of the mesolimbic dopamine (DA) system, and drug-induced changes in ventral tegmental area (VTA) cellular activity and gene regulation are linked to behavioral outputs associated with addiction. Previous work from our lab determined that VTA serum- and glucocorticoid-inducible kinase 1 (SGK1) transcription and catalytic activity were increased by repeated cocaine administration; however, it was unknown if these biochemical changes contributed to cocaine-elicited behaviors. Using transgenic and viral-mediated manipulations, we investigated the role of VTA SGK1 catalytic activity in regulating cocaine conditioned place preference and self-administration.

Characterization of proinflammatory markers in the ventral tegmental area across mouse models of chronic stress.

Despite the high prevalence of major depressive disorder (MDD), understanding of the biological underpinnings remains limited. Rodent models suggest that changes in activity and output of dopamine (DA) neurons in the ventral tegmental area (VTA) are important for depressive-like phenotypes. Additionally, brain inflammatory processes are thought to contribute to MDD pathology and inflammation in the VTA has been linked to changes in VTA DA neuronal activity.

Prevalence and Characteristics of Chronic Cough in Adults Identified by Administrative Data.

Context: International Classification of Diseases-9/10 codes for chronic cough (CC) do not exist, limiting investigation.

Objective: To develop a computerized algorithm to determine CC prevalence and its characteristics.

Design: This observational study using administrative data identified hierarchically patients aged 18 to 85 years with CC from 2013 to 2016.

Patient-Reported Burden of Chronic Cough in a Managed Care Organization.

Background: The burden of chronic cough (CC) requires better understanding.

Objective: To determine the severity, health status, and health care resource utilization among patients with CC identified by electronic health records on 2 visits separated by ≥1 year.

Methods: Information on cough-related burden was collected through survey from patients with CC, including validated questionnaires (the cough health status Leicester Cough Questionnaire [LCQ], the cough hypersensitivity Hull Airway Reflux Questionnaire [HARQ], and the Cough Quality of Life Questionnaire [CQLQ]), CC-associated respiratory and gastrointestinal comorbidities, and treatment responses.

Perinatal androgens organize sex differences in mast cells and attenuate anaphylaxis severity into adulthood.

Mast cell (MC)-associated diseases, including allergy/anaphylaxis and neuroinflammatory pain disorders, exhibit a sex bias, with females at increase risk. While much attention has been directed toward adult sex hormones as drivers of sex differences, that female sex bias in MC-associated diseases is evident in prepubertal children, suggesting early-life origins of sex differences which have yet to be explored. Utilizing rodent models of MC-mediated anaphylaxis, our data here reveal that, 1) compared with females, males exhibit significantly reduced severity of MC-mediated anaphylactic responses that emerge prior to puberty and persist into adulthood, 2) reduced severity of MC-mediated anaphylaxis in males is linked with the naturally high level of perinatal androgens and can be recapitulated in females by perinatal exposure to testosterone proprionate, 3) perinatal androgen exposure guides bone marrow MC progenitors toward a masculinized tissue MC phenotype characterized by decreased concentration of prestored MC granule mediators (e.