tbuckley/cabot-search huggingface dataset:
Fully Automatic Quantitative Measurement of Equilibrium Radionuclide Angiocardiography Using a Convolutional Neural Network
Authors: Sejin Ha, Seung Yeon Seo, Byung Soo Park, Sangwon Han, Jungsu S. Oh, Sun Young Chae, Jae Seung Kim, Dae Hyuk Moon
Journal: Clinical Nuclear Medicine (2024)

Purpose The aim of this study was to generate deep learning–based regions of interest (ROIs) from equilibrium radionuclide angiography datasets for left ventricular ejection fraction (LVEF) measurement. Patients and Methods Manually drawn ROIs (mROIs) on end-systolic and end-diastolic images were extracted from reports in a Picture Archiving and Communications System. To reduce observer variability, preprocessed ROIs (pROIs) were delineated using a 41% threshold of the maximal pixel counts of the extracted mROIs and were labeled as ground-truth. Background ROIs were automatically created using an algorithm to identify areas with minimum counts within specified probability areas around the end-systolic ROI. A 2-dimensional U-Net convolutional neural network architecture was trained to generate deep learning–based ROIs (dlROIs) from pROIs. The model’s performance was evaluated using Lin’s concordance correlation coefficient (CCC). Bland-Altman plots were used to assess bias and 95% limits of agreement. Results A total of 41,462 scans (19,309 patients) were included. Strong concordance was found between LVEF measurements from dlROIs and pROIs (CCC = 85.6%; 95% confidence interval, 85.4%–85.9%), and between LVEF measurements from dlROIs and mROIs (CCC = 86.1%; 95% confidence interval, 85.8%–86.3%). In the Bland-Altman analysis, the mean differences and 95% limits of agreement of the LVEF measurements were −0.6% and −6.6% to 5.3%, respectively, for dlROIs and pROIs, and −0.4% and −6.3% to 5.4% for dlROIs and mROIs, respectively. In 37,537 scans (91%), the absolute LVEF difference between dlROIs and mROIs was &lt;5%. Conclusions Our 2-dimensional U-Net convolutional neural network architecture showed excellent performance in generating LV ROIs from equilibrium radionuclide angiography scans. It may enhance the convenience and reproducibility of LVEF measurements.
68Ga-NODAGA–Exendin-4 PET/CT Findings in a Case of Metastatic Insulinoma With Refractory Hypoglycemia Controlled by 90Y Transarterial Radioembolization
Authors: Rahime Şahin, İbrahim Taşkın Rakıcı, Mehmet Can Baloğlu, Ömer Faruk Şahin, Tevfik Fikret Çermik
Journal: Clinical Nuclear Medicine (2024)

Metastatic insulinomas can cause recurrent hypoglycemia requiring continuous IV glucose infusion. Various medical and chemotherapeutic treatment options are used to reduce the patient's risk of death due to hypoglycemia. Treatment-resistant hepatic metastatic insulinomas may benefit clinically from 90Y transarterial radioembolization therapy. In this case, we present a case of liver metastatic insulinoma that achieved clinical improvement after 2 cycles of 90Y microspheres transarterial radioembolization, and the presence of active metastases was demonstrated with 68Ga-NODAGA-exendin-4 PET/CT imaging.
KLHL21 suppresses gastric tumourigenesis via maintaining STAT3 signalling equilibrium in stomach homoeostasis
Authors: Xiao-Bo Huang, Qiang Huang, Mei-Chen Jiang, Qing Zhong, Hua-Long Zheng, Jia-Bin Wang, Ze-Ning Huang, Hua-Gen Wang, Zhi-Yu Liu, Yi-Fan Li, Kai-Xiang Xu, Mi Lin, Ping Li, Zhi-Hong Huang, Jian-Wei Xie, Jian-Xian Lin, Jun Lu, Jian-Wen Que, Chao-Hui Zheng, Qi-Yue Chen, Chang-Ming Huang
Journal: Gut (2024)

Precancerous metaplasia transition to dysplasia poses a risk for subsequent intestinal-type gastric adenocarcinoma. However, the molecular basis underlying the transformation from metaplastic to cancerous cells remains poorly understood.
Stem cell therapy for COVID-19 treatment: An umbrella review
Authors: Chaozhi Tang, Arkadiusz Dziedzic, Mahalaqua Nazli Khatib, Saad Alhumaid, Lakshmi Thangavelu, RP Parameswari, Prakasini Satapathy, Quazi Syed Zahiruddin, Sarvesh Rustagi, Maha Afri Alanazi, Majid S. Al-Thaqafy, Ali Hazazi, Jawaher Alotaibi, Nehad J. Al Faraj, Nisreen A. Al-Zaki, Mona J. Al Marshood, Thuria Y. Al Saffar, Khadija A. Alsultan, Shamsah H. Al-Ahmed, Ali A. Rabaan
Journal: International Journal of Surgery (2024)

COVID-19 has presented significant obstacles to healthcare. Stem cell therapy, particularly mesenchymal stem cells (MSCs), has emerged as a potential treatment modality due to its immunomodulatory and regenerative properties. This umbrella review aims to synthesize current evidence from systematic reviews on the safety and efficacy of stem cell therapy in COVID-19 treatment.
Interleukin-1β stimulated macrophage derived exosomes improve myocardial injury in sepsis via regulation of mitochondrial homeostasis: Experimental research
Authors: Chunhua Ma, Zhaocong Yang, Jing Wang, Han She, Lei Tan, Xuming Mo, Tao Li, Liangming Liu
Journal: International Journal of Surgery (2024)

Background: The purpose of this study was to investigate the effects of interleukin-1β (IL-1β) stimulation on the protection of macrophage derived exosomes miR-146a (M-IL-exo-146a) on sepsis induced myocardial injury (SMI) in vitro and in vivo . Methods: Macrophage derived exosomes (M-exo) and IL-1β stimulated macrophage exosomes (M-IL-exo) were isolated from macrophages of sepsis with or without IL-1β. The expressions of miR-146a in M-exo and M- IL-exo were detected by fluorescence quantitative PCR. Related molecular biology technologies were used to evaluate the role and mechanism of M-exo-146a and M-IL-exo-146a on SMI and the enhancing effect of IL-1β. Results: Compared with M-exo, the expression of miR-146a in M-IL-exo was significantly increased. M-IL-exo-146a significantly alleviated SMI by decreasing the level of serum myocardial enzymes, serum and myocardial oxidative stress and cytokines, and improved myocardial mitochondrial imbalance. The mechanism responsible for IL-1β enhancing the production of IL-M-exo miR-146a was via JNK-1/2 signal pathway. The mechanism responsible for M-exo-IL-miR-146a protecting SMI was related to miR-146a inhibiting inflammatory response and mitochondrial function via MAPK4/Drp1 signal pathway. Conclusions: This study provides a new strategy for the treatment of SMI by delivering IL-1β stimulated macrophage derived exosomes.
Incidental Breast Cancer Diagnosis From Lymphoscintography Using 99mTc-Labeled Nanocolloid for Cutaneous Melanoma of the Upper Arm
Authors: Kayan Chan, James Chan, Amit Roshan
Journal: Clinical Nuclear Medicine (2024)

A 51-year-old woman with a 2-mm-Breslow-thickness melanoma on her arm had 99mTc-nanocolloid lymphoscintigraphy to localize the associated sentinel lymph node. A single axillary node was identified, and histology confirmed a micrometastasis of breast tissue origin. Imaging of the patient's breasts and subsequent biopsy confirmed ipsilateral stage III breast cancer, which was treated with lumpectomy and axillary node clearance. This is the first reported case of an incidental solid cancer diagnosis from a sentinel lymph node biopsy undertaken for a different tumor origin. This illustrates the importance of recognizing overlapping lymphatic distribution of sentinel lymph nodes, which can drain multiple organs.
Unveiling the prognostic role of blood inflammatory indexes in a retrospective cohort of patients undergoing liver resection for intrahepatic cholangiocarcinoma
Authors: Flavio Milana, Michela A. Polidoro, Cristiana Soldani, Barbara Franceschini, Simone Famularo, Luca Di Tommaso, Luigi M. Terracciano, Ana Lleo, Matteo Donadon, Guido Torzilli
Journal: International Journal of Surgery (2024)

Systemic inflammation is relevant in intrahepatic cholangiocarcinoma (iCCA), but controversial results exist on the prognostic role of inflammatory indexes and their correlation with tumor microenvironment. The authors aimed to explore the biological and prognostic values of these indexes. A retrospective cohort study involving iCCA patients who underwent hepatic resection between 2010 and 2021 was conducted. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and clinic-pathological factors were recorded. Immune-cell subpopulations, isolated from surgical specimens, were analyzed by flow cytometry. NLR and LMR cut-offs were calculated by X-Tile software. Linear regression, Kaplan-Meier, and Cox regression analyses were conducted. A total of 101 iCCA patients were considered. NLR ≥3.83 and LMR <2.28 correlated with worse survival. Patients were divided into groups: 67 (66.3%) in the low-risk and 34 (33.7%) in the high-risk (having at least one worse prognostic ratio). The 5-year overall survival was 49.8 and 18.9% for low- and high-risk groups, respectively ( P =0.003). An elevated CA19-9 in the high-risk group gives 2.148 HR (95% CI: 1.060-4.349) of mortality and 2.182 HR (95% CI: 1.206-3.948) of disease recurrence. Flow cytometry analysis of 20 surgical specimens highlighted that NLR was associated with tumor-derived NLR ( P =0.026) and LMR with tumor-infiltrating lymphocytes ( P =0.002). In a subset of five high-risk vs five low-risk patients, T-cell evaluation showed a higher prevalence of CD4+ compared to CD8+ cells in the high-risk group (78.5 vs. 21.5%, P <0.0001). Conversely, low-risk patients demonstrated a noteworthy infiltration of CD8+ cells compared to the high-risk group (21.5 vs. 48.7%, P =0.037). The combination of blood inflammatory indexes determined two survival-risk profiles. The correlation between the blood scores and the iCCA microenvironment suggests a link between immune-cell infiltration and the risk group. These findings open the possibility of patient stratification with the chance to identify subgroups suitable for dedicated follow-up and targeted immuno-chemotherapy protocols.
Development of Chronic Pain Conditions Among Women in the Military Health System
Authors: Andrew J. Schoenfeld, Madison N. Cirillo, Jonathan Gong, Matthew R. Bryan, Amanda Banaag, Joel S. Weissman, Tracey P. Koehlmoos
Journal: JAMA Network Open (2024)

The incidence of chronic pain has been increasing over the last decades and may be associated with the stress of deployment in active-duty servicewomen (ADSW) as well as women civilian dependents whose spouse or partner served on active duty.
Preeclampsia, Fetal Growth Restriction, and 24-Month Neurodevelopment in Very Preterm Infants
Authors: Jennifer Check, Coral Shuster, Julie Hofheimer, Marie Camerota, Lynne M. Dansereau, Lynne M. Smith, Brian S. Carter, Sheri A. DellaGrotta, Jennifer Helderman, Howard Kilbride, Cynthia M. Loncar, Elisabeth McGowan, Charles R. Neal, T. Michael O’Shea, Steven L. Pastyrnak, Stephen J. Sheinkopf, Barry M. Lester
Journal: JAMA Network Open (2024)

Importance Preeclampsia has direct influences on a developing fetus and may impact postnatal health, and fetal growth restriction (FGR) is often seen co-occurring with preeclampsia. The development of children born very preterm after preeclampsia diagnosis with and without FGR is not well characterized. Objective To examine the associations of preeclampsia and FGR with developmental and/or behavioral outcomes in a cohort of very preterm infants. Design, Setting, and Participants In this cohort study, infants in the prospective Neonatal Neurobehavior and Outcomes in Very Preterm Infants study were enrolled between April 2014 and June 2016 from 9 US university-affiliated neonatal intensive care units (NICUs). Eligible infants were born before 30 weeks’ gestation. Infants were excluded for any major congenital anomalies and for maternal age younger than 18 years or cognitive impairment impacting the ability to provide informed consent. Data analysis was performed from November 2023 to January 2024. Exposure Maternal preeclampsia and FGR in very preterm infants. Main Outcomes and Measures The Bayley-III cognition, motor, and language scores less than 85 (−1 SD) indicated developmental delay. Child Behavior Checklist/Preschool 1.5-5 T-scores greater than or equal to 64 for internalizing, externalizing, or total problems indicated clinical importance. Results Of 704 infants enrolled, 529 (mean [SD] gestational age, 27.0 [1.9] weeks; 287 male [54.3%]) were studied at 24-month follow-up. A total of 94 infants’ mothers had preeclampsia (23.2%), and 46 infants (8.7%) had FGR. In adjusted models, preeclampsia was not associated with Bayley-III (cognitive, B = 3.43 [95% CI, −0.19 to 6.66]; language, B = 3.92 [95% CI, 0.44 to 7.39]; motor, B = 1.86 [95% CI, −1.74 to 5.47]) or Child Behavior Checklist/Preschool 1.5-5 (internalizing, B = −0.08 [95% CI, −2.58 to 2.73]; externalizing, B = 0.69 [95% CI, −1.76 to 3.15]; total, B = 0.21 [95% CI, −2.48 to 2.91]) outcomes. FGR was associated with significantly lower Bayley-III scores (cognitive, B = −8.61 [95% CI, −13.33 to −3.89]; language, B = −8.29 [95% CI, −12.95 to −3.63]; motor, B = −7.60 [95% CI, −12.40 to −2.66]), regardless of preeclampsia status. Conclusions and Relevance In this cohort study of preterm infants, preeclampsia was not associated with developmental and/or behavioral outcomes, but infants with FGR may be prone to developmental delays. These findings suggest future areas of research for understanding the roles of preeclampsia and FGR separately and together in early child development for preterm infants.
Temporal Trends in End-Tidal Capnography and Outcomes in Out-of-Hospital Cardiac Arrest
Authors: Michelle M. J. Nassal, Andoni Elola, Elisabete Aramendi, Xabier Jaureguibeitia, Jonathan R. Powell, Ahamed Idris, Banu Priya Raya Krishnamoorthy, Mohamud R. Daya, Tom P. Aufderheide, Jestin N. Carlson, Shannon W. Stephens, Ashish R. Panchal, Henry E. Wang
Journal: JAMA Network Open (2024)

While widely measured, the time-varying association between exhaled end-tidal carbon dioxide (EtCO2) and out-of-hospital cardiac arrest (OHCA) outcomes is unclear.
Community-Level Disadvantage of Adults With Firearm- vs Motor Vehicle–Related Injuries
Authors: Lauren L. Agoubi, Samantha Banks, Ashley B. Hink, Deborah Kuhls, Shelbie D. Kirkendoll, Alex Winchester, Christopher Hoeft, Bhavin Patel, Avery Nathens
Journal: JAMA Network Open (2024)

Importance Motor vehicle crash (MVC) and firearm injuries are 2 of the top 3 mechanisms of adult injury-related deaths in the US. Objective To understand the differing associations between community-level disadvantage and firearm vs MVC injuries to inform mechanism-specific prevention strategies and appropriate postdischarge resource allocation. Design, Setting, and Participants This multicenter cross-sectional study analyzed prospectively collected data from the American College of Surgeons (ACS) Firearm Study. Included patients were treated either for firearm injury between March 1, 2021, and February 28, 2022, or for MVC-related injuries between January 1 and December 31, 2021, at 1 of 128 participating ACS trauma centers. Exposures Community distress. Main outcome and Measure Odds of presenting with a firearm as compared with MVC injury based on levels of community distress, as measured by the Distressed Communities Index (DCI) and categorized in quintiles. Results A total of 62 981 patients were included (mean [SD] age, 42.9 [17.7] years; 42 388 male [67.3%]; 17 737 Black [28.2%], 9052 Hispanic [14.4%], 36 425 White [57.8%]) from 104 trauma centers. By type, there were 53 474 patients treated for MVC injuries and 9507 treated for firearm injuries. Patients with firearm injuries were younger (median [IQR] age, 31.0 [24.0-40.0] years vs 41.0 [29.0-58.0] years); more likely to be male (7892 of 9507 [83.0%] vs 34 496 of 53 474 [64.5%]), identified as Black (5486 of 9507 [57.7%] vs 12 251 of 53 474 [22.9%]), and Medicaid insured or uninsured (6819 of 9507 [71.7%] vs 21 310 of 53 474 [39.9%]); and had a higher DCI score (median [IQR] score, 74.0 [53.2-94.8] vs 58.0 [33.0-83.0]) than MVC injured patients. Among admitted patients, the odds of presenting with a firearm injury compared with MVC injury were 1.50 (95% CI, 1.35-1.66) times higher for patients living in the most distressed vs least distressed ZIP codes. After controlling for age, sex, race, ethnicity, and payer type, the DCI components associated with the highest adjusted odds of presenting with a firearm injury were a high housing vacancy rate (OR, 1.11; 95% CI, 1.04-1.19) and high poverty rate (OR, 1.17; 95% CI, 1.10-1.24). Among patients sustaining firearm injuries patients, 4333 (54.3%) received no referrals for postdischarge rehabilitation, home health, or psychosocial services. Conclusions and Relevance In this cross-sectional study of adults with firearm- and motor vehicle–related injuries, we found that patients from highly distressed communities had higher odds of presenting to a trauma center with a firearm injury as opposed to an MVC injury. With two-thirds of firearm injury survivors treated at trauma centers being discharged without psychosocial services, community-level measures of disadvantage may be useful for allocating postdischarge care resources to patients with the greatest need.
Socioeconomic Disadvantage and Youth Mental Health During the COVID-19 Pandemic Lockdown
Authors: Shana Adise, Amy E. West, Panteha Hayati Rezvan, Andrew T. Marshall, Samantha Betts, Eric Kan, Elizabeth R. Sowell
Journal: JAMA Network Open (2024)

Importance Adolescence is a period in which mental health problems emerge. Research suggests that the COVID-19 lockdown may have worsened emotional and behavioral health. Objective To examine whether socioeconomic status was associated with mental health outcomes among youths during the COVID-19 pandemic. Design, Setting, and Participants The Adolescent Brain Cognitive Development (ABCD) Study is a multisite 10-year longitudinal study of youth neurocognitive development in the US. Recruitment was staggered where the baseline visit (ages 9 to 10 years) occurred from 2016 to 2018, and visits occurred yearly. The COVID-19 lockdown halted research collection during the 2-year follow-up visits (ages 11 to 12 years), but eventually resumed. As some youths already underwent their 2-year visits prior to lockdown, this allowed for a natural experiment-like design to compare prepandemic and intrapandemic groups. Thus, data were gathered from the 1-year follow-up (pre–COVID-19 lockdown for all youths) and the 2-year follow-up, of which a portion of youths had data collected after the lockdown began, to compare whether a period of near social isolation was associated with mental health symptoms in youths. The prepandemic group consisted of youths with a 2-year follow-up visit collected prior to March 11, 2020, and the intrapandemic group had their 2-year follow-up visit after lockdown restrictions were lifted. Main Outcomes and Measures Assessments included measures on income-to-needs ratio (INR; derived from total household income), the Child Behavior Checklist (a measure of mental health symptomology), and the Family Environmental Scale. Results The final sample included 10 399 youths; 3947 (52.3%) were male; 2084 (20.3%) were Latinx/Hispanic; 6765 (66.0%) were White; 4600 (44.2%) reported caregiver education levels below a 4-year college degree; and 2475 (26.2%) had INR either below 100% (indicating poverty) or between 100% and less than 200% (near poverty). Among youths in the intrapandemic group, worse mental health symptoms (eg, more total problems, greater depression, and greater anxiety) over time were associated with being from a household with higher socioeconomic status (eg, when comparing individuals who differed by 1 unit on INR between prepandemic and intrapandemic groups from 1-year to 2-year follow-up, their expected difference in total problems score was 0.79 [95% CI, 0.37-1.22]; false discovery rate–corrected P &amp;amp;lt; .001). Conclusions and Relevance This cohort study found that the COVID-19 lockdown was associated with disproportionately negative mental health outcomes among youths from higher socioeconomic status backgrounds. Although this study does not shed light on the direct mechanisms driving these associations, it does provide some support for positive outcomes for youths. Future studies are needed to understand whether these associations persist over longer periods of time.
Gender Differences in the Path to Medical School Deanship
Authors: Maya S. Iyer, Carol Bradford, Amy S. Gottlieb, David B. Kling, Reshma Jagsi, Christina Mangurian, Lilly Marks, Carolyn C. Meltzer, Barbara Overholser, Julie K. Silver, David P. Way, Nancy D. Spector
Journal: JAMA Network Open (2024)

Importance Women account for only 28% of current US medical school deans. Studying the differences between women and men in their preparation to becoming deans might help to explain this discrepancy. Objective To identify differences in the leadership development experiences between women and men in their ascent to the medical school deanship. Design, Setting, and Participants In this qualitative study, volunteers from the roster of the Association of American Medical Colleges Council of Deans were solicited and interviewed from June 15 to November 9, 2023. Women deans were recruited first, then men who had been appointed to their deanships at a similar time to their women counterparts were recruited. Deans were interviewed on topics related to number of applications for deanships, prior leadership roles, leadership development, personal factors, and career trajectories. Interviews were coded, and themes were extracted through conventional content analysis. Main Outcome and Measures Career and leadership development experiences were elicited using a semistructured interview guide. Results We interviewed 17 women and 17 men deans, representing 25.8% (34 of 132) of the total population of US medical school deans. Most deans (23 [67.6%]) practiced a medicine-based specialty or subspecialty. No statistically significant differences were found between women and men with regard to years to attain deanship (mean [SD], 2.7 [3.4] vs 3.7 [3.7] years), years as a dean (mean [SD], 5.7 [5.2] vs 6.0 [5.0] years), highest salary during career (mean [SD], $525 769 [$199 936] vs $416 923 [$195 848]), or medical school rankings (mean [SD], 315.5 [394.5] vs 480.5 [448.9]). Their reports indicated substantive gender differences in their paths to becoming a dean. Compared with men, women deans reported having to work harder to advance, while receiving less support and opportunities for leadership positions by their own institutions. Subsequently, women sought leadership development from external programs. Women deans also experienced gender bias when working with search firms. Conclusions and Relevance This qualitative study of US medical school deans found that compared with men, women needed to be more proactive, had to participate in external leadership development programs, and had to confront biases during the search process. For rising women leaders, this lack of support had consequences, such as burnout and attrition, potentially affecting the makeup of future generations of medical school deans. Institutional initiatives centering on leadership development of women is needed to mitigate the gender biases and barriers faced by aspiring women leaders.
Creating Equitable Paths to Medical School Deanship
Authors: Elizabeth A. Jacobs, L. Ebony Boulware
Journal: JAMA Network Open (2024)

Maya S. Iyer, MD, MEd; Carol Bradford, MD, MS; Amy S. Gottlieb, MD; David B. Kling Jr, DO; Reshma Jagsi, MD, DPhil; Christina Mangurian, MD, MAS; Lilly Marks, BA, BS; Carolyn C. Meltzer, MD; Barbara Overholser, MA; Julie K. Silver, MD; David P. Way, MEd; Nancy D. Spector, MD
Tapping AI’s Strengths—From Operating Room Safety to Wearable Device Interpretation
Authors: Jennifer Abbasi, Yulin Hswen
Journal: JAMA (2024)

In this Medical News interview, Sachin Kheterpal, the University of Michigan Medical School’s associate dean for research information technology, joins JAMA Editor in Chief Kirsten Bibbins-Domingo to discuss AI’s number-crunching potential for improving patient care.