tbuckley/cabot-search huggingface dataset:
Intelligent Vacuum-Assisted Biopsy to Identify Breast Cancer Patients With Pathologic Complete Response (ypT0 and ypN0) After Neoadjuvant Systemic Treatment for Omission of Breast and Axillary Surgery
Authors: André Pfob, Chris Sidey-Gibbons, Geraldine Rauch, Bettina Thomas, Benedikt Schaefgen, Sherko Kuemmel, Toralf Reimer, Markus Hahn, Marc Thill, Jens-Uwe Blohmer, John Hackmann, Wolfram Malter, Inga Bekes, Kay Friedrichs, Sebastian Wojcinski, Sylvie Joos, Stefan Paepke, Tom Degenhardt, Joachim Rom, Achim Rody, Marion van Mackelenbergh, Maggie Banys-Paluchowski, Regina Große, Mattea Reinisch, Maria Karsten, Michael Golatta, Joerg Heil
Journal: Journal of Clinical Oncology (2022)

Neoadjuvant systemic treatment (NST) elicits a pathologic complete response in 40%-70% of women with breast cancer. These patients may not need surgery as all local tumor has already been eradicated by NST. However, nonsurgical approaches, including imaging or vacuum-assisted biopsy (VAB), were not able to accurately identify patients without residual cancer in the breast or axilla. We evaluated the feasibility of a machine learning algorithm (intelligent VAB) to identify exceptional responders to NST.We trained, tested, and validated a machine learning algorithm using patient, imaging, tumor, and VAB variables to detect residual cancer after NST (ypT+ or in situ or ypN+) before surgery. We used data from 318 women with cT1-3, cN0 or +, human epidermal growth factor receptor 2-positive, triple-negative, or high-proliferative Luminal B-like breast cancer who underwent VAB before surgery (ClinicalTrials.gov identifier: NCT02948764, RESPONDER trial). We used 10-fold cross-validation to train and test the algorithm, which was then externally validated using data of an independent trial (ClinicalTrials.gov identifier: NCT02575612). We compared findings with the histopathologic evaluation of the surgical specimen. We considered false-negative rate (FNR) and specificity to be the main outcomes.In the development set (n = 318) and external validation set (n = 45), the intelligent VAB showed an FNR of 0.0%-5.2%, a specificity of 37.5%-40.0%, and an area under the receiver operating characteristic curve of 0.91-0.92 to detect residual cancer (ypT+ or in situ or ypN+) after NST. Spiegelhalter's Z confirmed a well-calibrated model (z score -0.746, P = .228). FNR of the intelligent VAB was lower compared with imaging after NST, VAB alone, or combinations of both.An intelligent VAB algorithm can reliably exclude residual cancer after NST. The omission of breast and axillary surgery for these exceptional responders may be evaluated in future trials.
Quality assessment standards in artificial intelligence diagnostic accuracy systematic reviews: a meta-research study
Authors: Shruti Jayakumar, Viknesh Sounderajah, Pasha Normahani, Leanne Harling, Sheraz R. Markar, Hutan Ashrafian, Ara Darzi
Journal: npj Digital Medicine (2022)

Artificial intelligence (AI) centred diagnostic systems are increasingly recognised as robust solutions in healthcare delivery pathways. In turn, there has been a concurrent rise in secondary research studies regarding these technologies in order to influence key clinical and policymaking decisions. It is therefore essential that these studies accurately appraise methodological quality and risk of bias within shortlisted trials and reports. In order to assess whether this critical step is performed, we undertook a meta-research study evaluating adherence to the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool within AI diagnostic accuracy systematic reviews. A literature search was conducted on all studies published from 2000 to December 2020. Of 50 included reviews, 36 performed the quality assessment, of which 27 utilised the QUADAS-2 tool. Bias was reported across all four domains of QUADAS-2. Two hundred forty-three of 423 studies (57.5%) across all systematic reviews utilising QUADAS-2 reported a high or unclear risk of bias in the patient selection domain, 110 (26%) reported a high or unclear risk of bias in the index test domain, 121 (28.6%) in the reference standard domain and 157 (37.1%) in the flow and timing domain. This study demonstrates the incomplete uptake of quality assessment tools in reviews of AI-based diagnostic accuracy studies and highlights inconsistent reporting across all domains of quality assessment. Poor standards of reporting act as barriers to clinical implementation. The creation of an AI-specific extension for quality assessment tools of diagnostic accuracy AI studies may facilitate the safe translation of AI tools into clinical practice.
MISCELLANY.
Journal: JAMA (1892)

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
Osteocalcin and Risks of Incident Diabetes and Diabetic Kidney Disease: A 4.6-Year Prospective Cohort Study
Authors: Xiaoqi Ye, Rong Yu, Fusong Jiang, Xuhong Hou, Li Wei, Yuqian Bao, Weiping Jia
Journal: Diabetes Care (2022)

OBJECTIVE We aimed to examine the relationship between osteocalcin (OC) and the risk of incident diabetes and the risk of incident diabetic kidney disease (DKD). RESEARCH DESIGN AND METHODS We followed 5,396 participants without diabetes (nondiabetes subcohort) and 1,174 participants with diabetes and normal kidney function (diabetes subcohort) at baseline. Logistic regression and modified Poisson regression models were used to estimate the relative risk (RR) of baseline OC levels with incident diabetes and DKD. RESULTS During a mean 4.6-year follow-up period, 296 cases of incident diabetes and 184 cases of incident DKD were identified. In the nondiabetes subcohort, higher OC levels were linearly associated with a decreased risk of diabetes (RR for 1-unit increase of loge-transformed OC 0.51 [95% CI 0.35–0.76]; RR for highest vs. lowest quartile 0.65 [95% CI 0.44–0.95]; P for trend &amp;lt; 0.05). In the diabetes subcohort, OC levels were linearly inversely associated with incident DKD (RR for 1-unit increase of loge-transformed OC 0.49 [95% CI 0.33–0.74]; RR for highest vs. lowest quartile 0.56 [95% CI 0.38–0.83]; P for trend &amp;lt; 0.05), even independent of baseline estimated glomerular filtration rate and urinary albumin-to-creatinine ratio. No significant interactions between OC and various subgroups on incident diabetes or DKD were observed. CONCLUSIONS Lower OC levels were associated with an increased risk of incident diabetes and DKD.
Endoscopic management of bleeding Dieulafoy-like lesion at hepaticojejunal anastomosis
Authors: Sergio Rubel Cohen, Raúl Araya Jofré, Gino Baccigaluppi Méndez, César Acevedo Sylvester
Journal: Endoscopy (2022)

This case describes a 64-year-old man with a history of total pancreatectomy, duodenectomy, and total gastrectomy for pancreatic cancer. He previously underwent reconstruction with esophagojejunal anastomosis and hepaticojejunal anastomosis, without Roux-en-Y. Arterial bridges of the superior mesenteric artery and the celiac trunk were performed, for which he received permanent antiplatelet therapy; he also uses oral anticoagulants to treat a deep vein thrombosis of the right upper extremity related to a central venous catheter. The patient presented with melena and acute anemia. Computed tomography angiography showed dense content in the small bowel with no evidence of active bleeding. It was decided to do an upper endoscopy ([Video 1]).
AhR/IL-22 pathway as new target for the treatment of post-infectious irritable bowel syndrome symptoms
Authors: Maëva Meynier, Elodie Baudu, Nathalie Rolhion, Manon Defaye, Marjolène Straube, Valentine Daugey, Morgane Modoux, Ivan Wawrzyniak, Frédéric Delbac, Romain Villéger, Mathieu Méleine, Esther Borras Nogues, Catherine Godfraind, Nicolas Barnich, Denis Ardid, Philippe Poirier, Harry Sokol, Jean-Marc Chatel, Philippe Langella, Valérie Livrelli, Mathilde Bonnet, Frédéric Antonio Carvalho
Journal: Gut Microbes (2022)

Alterations in brain/gut/microbiota axis are linked to Irritable Bowel Syndrome (IBS) physiopathology. Upon gastrointestinal infection, chronic abdominal pain and anxio-depressive comorbidities may persist despite pathogen clearance leading to Post-Infectious IBS (PI-IBS). This study assesses the influence of tryptophan metabolism, and particularly the microbiota-induced AhR expression, on intestinal homeostasis disturbance following gastroenteritis resolution, and evaluates the efficacy of IL-22 cytokine vectorization on PI-IBS symptoms. The
Assessment of Patiromer Monotherapy for Hyperkalemia in an Acute Care Setting
Authors: Katherine E. Di Palo, Mark J. Sinnett, Pavel Goriacko
Journal: JAMA Network Open (2022)

<h3>Importance</h3> Hyperkalemia is a common electrolyte disorder in hospitalized patients; however, the clinical usefulness of administering patiromer for reduction of serum potassium levels in this setting is unknown. <h3>Objective</h3> To evaluate the outcomes associated with patiromer as monotherapy in patients with acute hyperkalemia in an acute care setting. <h3>Design, Setting, and Participants</h3> This cohort study used electronic health record data from adult patients treated with patiromer for acute hyperkalemia in emergency departments, inpatient units, and intensive care units at an urban, academic medical center in the Bronx, New York, between January 30, 2018, and December 30, 2019. Data analysis was conducted between June 2020 and February 2021. <h3>Exposures</h3> A single dose of oral patiromer (8.4 g, 16.8 g, or 25.2 g). <h3>Main Outcomes and Measure</h3> The primary outcome was the mean absolute reduction in serum potassium level from baseline at 3 distinct time intervals after patiromer administration: 0 to 6 hours, greater than 6 to 12 hours, and greater than 12 to 24 hours. Key secondary outcomes were the incidence of hypokalemia and potassium reduction stratified by baseline potassium level and care setting. <h3>Results</h3> Among 881 encounters of patiromer treatment, the mean (SD) age of patients was 67.4 (14.4) years; 463 encounters (52.6%) were for male patients, and most (338 [38.4%]) were for patients who identified as non-Hispanic Black. The mean (SD) baseline serum potassium level was 5.60 (0.35) mEq/L (to convert to mmol/L, multiply by 1.0), and within the first 6 hours after patiromer administration, the mean (SD) potassium reduction was 0.50 (0.56) mEq/L (<i>P</i> &lt; .001). Both absolute and relative potassium reduction from baseline varied across baseline hyperkalemia severity but not by care setting. The lowest dose of patiromer (8.4 g) was used in 721 encounters (81.8%), and in 725 encounters (82.3%), no further doses of a potassium binder were required. Hypokalemia was noted in 2 encounters (0.2%) at 24 hours after patiromer administration. <h3>Conclusions and Relevance</h3> In this cohort study of patients with acute, non–life-threatening hyperkalemia, a single dose of patiromer was associated with a significant decrease in serum potassium levels and a low incidence of hypokalemia. These findings suggest that patiromer monotherapy may be useful in an institutional setting for managing elevated potassium levels and minimizing the risk of hypokalemia associated with other potassium control measures.
A review on biodegradable biliary stents: materials and future trends
Authors: Ge Song, Hugh Q. Zhao, Qing Liu, Zhongyong Fan
Journal: Bioactive Materials (2022)

Biliary stricture is defined as the reduction and narrowing of the bile duct lumen, which can be caused by many factors such as cancer and inflammation. Biliary stent placement can effectively alleviate benign and malignant biliary strictures. However, the commonly used plastic or metallic biliary stents are far from ideal and do not satisfy all clinical requirements,although several types of biodegradable biliary stents have been developed and used clinically. In this review, we summarized current development status of biodegradable stents with the emphasis on the stent materials. We also presented the future development trends based on the published literature.
Recent advances and application of whole genome amplification in molecular diagnosis and medicine
Authors: Xiaoyu Wang, Yapeng Liu, Hongna Liu, Wenjing Pan, Jie Ren, Xiangming Zheng, Yimin Tan, Zhu Chen, Yan Deng, Nongyue He, Hui Chen, Song Li
Journal: MedComm (2022)

Whole genome amplification (WGA) is a technology for non-selective amplification of the whole genome sequence, first appearing in 1992. Its primary purpose is to amplify and reflect the whole genome of trace tissues and single cells without sequence bias and to provide sufficient DNA template for subsequent multigene and multilocus analysis, along with comprehensive genome research. WGA provides a method to obtain a large amount of genetic information from a small amount of DNA and provides a valuable tool for preserving limited samples in molecular biology. WGA technology is especially suitable for forensic identification and genetic disease research, along with new technologies such as next-generation sequencing (NGS). In addition, WGA is also widely used in single-cell sequencing. Due to the small amount of DNA in a single cell, it is often unable to meet the amount of samples needed for sequencing, so WGA is generally used to achieve the amplification of trace samples. This paper reviews WGA methods based on different principles, summarizes both amplification principle and amplification quality, and discusses the application prospects and challenges of WGA technology in molecular diagnosis and medicine.
P125: EMPOWERING YOUNG ADOLESCENTS ON THE TRANSITION BY THE EDUCATION METHOD ORBIS SENSUALIUM PICTUS - THEIR OWN IMPROVING BLOOD CELL MORPHOLOGY AND MEDICAL RESULTS ON ACTIVE TREATMENT
Authors: P Kotoucek, R Caples, R Culpin, A Abdussalam
Journal: HemaSphere (2022)

Background: The transition from childhood to adulthood is an important part of a journey of people with inherited haemoglobinopathy and their families. The most difficult part is to find the way of motivation, so children and young adolescents can comply with taking their medications and attending their appointments even without the support of their families to achieve desirable targets and to maintain their good health. Method: We started regular education of young adolescents on the transition in adult haematology department by an efficient and powerful method ORBIS SENSUALIUM PICTUS developed by Jan Amos Komensky, Czech teacher, living in the Netherlands in 17th century - teaching with images. We educate and motivate our clients by morphology of their own blood cells before the commencement of treatment and during it with showing them their results of full blood count, biochemistry, HbS, HbF levels, reticulocytes and others in the same time. Visualising their own blood cells under microscope and comparison of previous unhealthy and now healthy blood cells on hydroxyurea or after regular transfusions empower young adolescents to take ownership of their own health and can improve their self esteem and confidence. We have included into the transition also regular visits in Haematology laboratory, Adult Day therapy unit and Adult haematology department. Results: We are presenting improvement in compliance of the attendance and taking regular medication of young adolescents empowered by imaginary education in our transition clinic. Summary: Empowering young adolescents by visualising technique of reviewing their own blood cells under microscope and understanding the purpose of each medication and medical result is very powerful method of motivation. It can help them to engage better in regular consultantions and to find the new meaning on their journey with inherited haemoglobinopathy. It can open the way of understanding their own disease with consideration of therapeutical options including hydroxyurea, voxelotor, crizanlizumab and gene therapy and allogeneic transplant. References 1. Komensky, Orbis Sensualium Pictus, Nurember 1658, (Sydney University Press, 1968) 2. Kotoucek et al, The Morphology Ward Rounds improve haematology care and training, BJHaem 2018 3. Frankl, Man’s searching of meaning, Rider 2004 4. NICE guideline NG43, Transition from children’s to adult’s services for young people, 2016
34th Bethesda Conference:“can atherosclerosis imaging techniques improve the detection of patients at risk for ischemic heart disease?”**The recommendations set forth in this report are those of the Conference participants and do not necessarily reflect the official position of the American College of Cardiology. When citing this document the American College of Cardiology would appreciate the following citation format: Can Atherosclerosis Imaging Techniques Improve the Detection of Patients at…
Authors: Allen J Taylor, C.Noel Bairey Merz, James E Udelson
Journal: Journal of the American College of Cardiology (2003)
False-Positive Cuff Leak Test due to Glossoptosis
Authors: Shunsaku Goto, Jun-ya Ishikawa, Masafumi Idei, Takeshi Nomura
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

"False-Positive Cuff Leak Test due to Glossoptosis." American Journal of Respiratory and Critical Care Medicine, 205(2), pp. e4–e5
斑秃:一项英国全科诊所记录研究的结果
Journal: British Journal of Dermatology (2022)

Journal Article 斑秃:一项英国全科诊所记录研究的结果 Get access British Journal of Dermatology, Volume 186, Issue 2, 1 February 2022, Page e107, https://doi.org/10.1111/bjd.20935 Published: 01 February 2022
S106: LONG-TERM FOLLOW-UP OF BETA-THALASSEMIA PATIENTS TREATED WITH HEMATOPOIETIC STEM CELL GENE THERAPY
Authors: S Marktel, S Scaramuzza, F Giglio, M Cicalese, M Lidonnici, C Rossi, V Calbi, N Masera, E D’Angelo, N Mirra, R Origa, I Tartaglione, S Perrotta, G Viarengo, L Santoleri, R Milani, S Gattillo, A Calabria, E Montini, G Graziadei, L Naldini, M Cappellini, A Aiuti, F Ciceri, G Ferrari
Journal: HemaSphere (2022)

Background: Transfusion-dependent ß-thalassemia (TDT) is a disorder due to mutations in the gene encoding the ß-globin chain causing a reduced or absent production of haemoglobin A leading to severe anaemia and lifelong transfusion dependence. Gene therapy has now been accepted as a possible alternative cure to allogeneic bone marrow (BM) transplantation. Aims: We developed a gene therapy approach based on autologous mobilized hematopoietic stem cell transduced by lentiviral vector, expressing human ß-globin gene, administered by intrabone injection, following a myeloablative conditioning (NCT02453477). Methods and Results: Nine patients with severe TDT with different genotypes have been treated with a drug product with a median cell dose of 19.5x106 CD34+ cells/kg, a transduction efficiency from 38 to 77% and a median vector copy number/genome (VCN) in bulk CD34+ cells of 0.9 (range: 0.7–1.5). Overall, gene therapy was generally well-tolerated with no adverse events related to the investigational product. No severe infectious-related adverse events were reported, except for those related to neutropenia as expected after myeloablative conditioning. Polyclonal vector integrations profiles with no evidence of clonal dominance have been detected in all patients with the expected genomic distribution for lentiviral vectors. Clinical outcome showed a reduction of transfusion requirement both in frequency and volume in adult patients up to more than 50%. Among the pediatric patients, 4 out of 6 discontinued transfusions shortly after gene therapy and are transfusion-independent at the last follow-up (up to 75 months). A robust and persistent engraftment was observed in 7 out of 9 patients, with a marking of BM progenitors that, in engrafted patients, ranged between 25.3 and 79.8% and with a median VCN in CD34+ cells of 0.53 (range: 0.34–2.21). As a relevant target for transgene expression, BM erythroid cells were stably marked (VCN range 0.3 - 2.5). Summary and Conclusions: A longer follow-up will provide further results on long-term clinical efficacy and safety of this approach. References 1. Marktel et al, Nat Med 2019; 25(2):234
Meeting Highlights
Authors: James J. Ferguson
Journal: Circulation (2001)

The study: A randomized, double-blind, parallel-group trial comparing a stent coated with sirolimus (an immunosuppressive macrolide antibiotic; nϭ120) with a similar uncoated stent (BX Velocity; nϭ118) in patients undergoing stent implantation.Qualifying patients had to have de novo singlevessel disease in a native coronary artery that was Ͻ18 mm in length and 2.5 to 3.5 mm in diameter.The primary end point was in-stent lumen diameter loss measured at 6-month follow-up angiography.The results: Mean reference vessel size was 2.6 mm; mean lesion length was 9.6 mm.Late loss in the control uncoated stent was 0.80Ϯ0.53mm; late loss with the sirolimus-coated stent was 0.01Ϯ0.33mm (PϽ0.001).The binary restenosis rate was 2.6% with the uncoated stents and 0% with the coated stents.Preliminary long-term clinical follow-up (to 210 days) showed a target lesion revascularization rate of 26% in the uncoated stent group versus 0% in the coated stent group (PϽ0.0001).Survival free from major adverse cardiovascular events was 73% in the uncoated stent group and 97% in the coated stent group (PϽ0.001) when used for the treatment of discrete lesions.Summary: Sirolimus-coated stents seem to have virtually no restenosis (at 6 months) in native vessels that are 2.5 to 3 mm in diameter.These exciting data will need to be confirmed in larger trials, in other lesion types, and with longer-term follow-up.
<i>Erratum:</i> Vol. 69, No. RR-5
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

In the MMWR Recommendations and Reports "Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020," an error occurred on page 11.In the third sentence of the second paragraph, the vaccines Havrix and Twinrix were incorrectly listed as having preservatives.This sentence should have read "Havrix, Twinrix, and Vaqta are formulated without a preservative."
MEDICAL MEMBERS OF LOCAL PUBLIC BODIES: SCOTLAND
Journal: BMJ (1929)

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International Conference on Mechanisms of Antimutagenesis and Anticarcinogenesis
Journal: JNCI Journal of the National Cancer Institute (1985)

International Conference on Mechanisms of Antimutagenesis and Anticarcinogenesis Get access JNCI: Journal of the National Cancer Institute, Volume 74, Issue 5, May 1985, Page 1154, https://doi.org/10.1093/jnci/74.5.1154-a Published: 01 May 1985