tbuckley/cabot-search huggingface dataset:
Diagnosis of Perinatal Mental Health Conditions Following Medicaid Expansion to Include Low-Income Immigrants
Authors: Maria I. Rodriguez, Ann Martinez-Acevedo, Menolly Kaufman, Erin C. Nacev, Kristen Mackiewicz-Seghete, K. John McConnell
Journal: JAMA Network Open (2024)

Importance For some low-income people, access to care during pregnancy is not guaranteed through Medicaid, based on their immigration status. While states have the option to extend Emergency Medicaid coverage for prenatal and postpartum care, many states have not expanded coverage. Objective To determine whether receipt of first prenatal care services and subsequently receipt of postpartum care through extensions of Emergency Medicaid coverage were associated with increases in diagnosis and treatment of perinatal mental health conditions. Design, Setting, and Participants This cohort study used linked Medicaid claims and birth certificate data from 2010 to 2020 with a difference-in-difference design to compare the rollout of first prenatal care coverage in 2013 and then postpartum services in Oregon in 2018 with a comparison state, South Carolina, which did not cover prenatal or postpartum care as part of Emergency Medicaid and only covered emergent conditions and obstetric hospital admissions. Medicaid claims and birth certificate data were linked by Medicaid identification number prior to receipt by the study team. Participants included recipients of Emergency Medicaid who gave birth in Oregon or South Carolina. Data were analyzed from April 1 to October 15, 2023. Exposure Medicaid coverage of prenatal care and Medicaid coverage of postpartum care. Main Outcomes and Measures The main outcome was the diagnosis of a perinatal mental health condition within 60 days postpartum. Secondary outcomes included treatment of a mood disorder with medication or talk therapy. Results The study sample included 43 889 births to Emergency Medicaid recipients who were mainly aged 20 to 34 years (32 895 individuals [75.0%]), multiparous (33 887 individuals [77.2%]), and living in metropolitan areas (32 464 individuals [74.0%]). Following Oregon’s policy change to offer prenatal coverage to pregnant individuals through Emergency Medicaid, there was a significant increase in diagnosis frequency (4.1 [95% CI, 1.7-6.5] percentage points) and a significant difference between states in treatment for perinatal mental health conditions (27.3 [95% CI, 13.2-41.4] percentage points). Postpartum Medicaid coverage (in addition to prenatal Medicaid coverage) was associated with an increase of 2.6 (95% CI, 0.6-4.6) percentage points in any mental health condition being diagnosed, but there was no statistically significant difference in receipt of mental health treatment. Conclusions and Relevance These findings suggest that changing Emergency Medicaid policy to include coverage for prenatal and 60 days of postpartum care for immigrants is foundational to improving maternal mental health. Expanded postpartum coverage length, or culturally competent interventions, may be needed to optimize receipt of postpartum treatment.
PD-L1-expressing tumor-associated macrophages are immunostimulatory and associate with good clinical outcome in human breast cancer
Authors: Lei Wang, Weihua Guo, Zhikun Guo, Jiangnan Yu, Jiayi Tan, Diana L Simons, Ke Hu, Xinyu Liu, Qian Zhou, Yizi Zheng, Egelston A Colt, John Yim, James Waisman, Peter P Lee
Journal: Cell Reports Medicine (2024)

Tumor-associated macrophages (TAMs) are the predominant cells that express programmed cell death ligand 1 (PD-L1) within human tumors in addition to cancer cells, and PD-L1
Disruption of MerTK increases the efficacy of checkpoint inhibitor by enhancing ferroptosis and immune response in hepatocellular carcinoma
Authors: Shun Wang, Le Zhu, Tianen Li, Xinxin Lin, Yan Zheng, Da Xu, Yu Guo, Ze Zhang, Yan Fu, Hao Wang, Xufeng Wang, Tiantian Zou, Xiaotian Shen, Lumin Zhang, Nannan Lai, Lu Lu, Lunxiu Qin, Qiongzhu Dong
Journal: Cell Reports Medicine (2024)

Immune checkpoint inhibitors, particularly PD-1/PD-L1 blockades, have been approved for unresectable hepatocellular carcinoma (HCC). However, high resistance rates still limit their efficacy, highlighting the urgent need to understand the underlying mechanisms and develop strategies for overcoming the resistance. In this study, we demonstrate that HCC with high MER proto-oncogene tyrosine kinase (MerTK) expression exhibits anti-PD-1/PD-L1 resistance in two syngeneic mouse models and in patients who received anti-PD-1/PD-L1 therapy. Mechanistically, MerTK renders HCC resistant to anti-PD-1/PD-L1 by limiting ferroptosis with the upregulation of SLC7A11 via the ERK/SP1 pathway and facilitating the development of an immunosuppressive tumor microenvironment (TME) with the recruitment of myeloid-derived suppressor cells (MDSCs). Sitravatinib, an inhibitor of MerTK, sensitizes resistant HCC to anti-PD-L1 therapy by promoting tumor ferroptosis and decreasing MDSC infiltration into the TME. In conclusion, we find that MerTK could serve as a predictive biomarker for patient stratification and as a promising target to overcome anti-PD-1/PD-L1 resistance in HCC.
Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Management of ANCA–Associated Vasculitis
Authors: Jürgen Floege, David R.W. Jayne, Jan-Stephan F. Sanders, Vladimír Tesar, Ethan M. Balk, Craig E. Gordon, Gaelen Adam, Marcello A. Tonelli, Michael Cheung, Amy Earley, Brad H. Rovin
Journal: Kidney International (2024)

In 2021, the Kidney Disease: Improving Global Outcomes (KDIGO) Guideline for the Management of Glomerular Diseases was published. KDIGO is committed to providing the nephrology community with periodic updates, based on new developments for each disease. For patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), avacopan received regulatory approval in late 2021, leading to this KDIGO guideline update. In addition, the evidence supporting a lower-dose glucocorticoid induction regimen or even complete replacement of glucocorticoids has become stronger. Herein, an executive summary of the most important guideline changes from the AAV chapter is provided as a quick reference.
KDIGO 2024 Clinical Practice Guideline for the Management of Antineutrophil Cytoplasmic Antibody (ANCA)–Associated Vasculitis
Authors: Jürgen Floege, David R.W. Jayne, Jan-Stephan F. Sanders, Vladimír Tesar, Brad H. Rovin
Journal: Kidney International (2024)

This article is published as part of a supplement sponsored by Kidney Disease: Improving Global Outcomes (KDIGO). The opinions or views expressed in this supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the International Society of Nephrology or Elsevier. Dosages, indications, and methods of use for products that are referred to in the supplement by the authors may reflect their clinical experience or may be derived from the professional literature or other clinical sources.
Monocarboxylate transporters facilitate succinate uptake into brown adipocytes
Authors: Anita Reddy, Sally Winther, Nhien Tran, Haopeng Xiao, Josefine Jakob, Ryan Garrity, Arianne Smith, Martha Ordonez, Dina Laznik-Bogoslavski, Jeffrey D. Rothstein, Evanna L. Mills, Edward T. Chouchani
Journal: Nature Metabolism (2024)
Misfolded protein oligomers: mechanisms of formation, cytotoxic effects, and pharmacological approaches against protein misfolding diseases
Authors: Dillon J. Rinauro, Fabrizio Chiti, Michele Vendruscolo, Ryan Limbocker
Journal: Molecular Neurodegeneration (2024)

The conversion of native peptides and proteins into amyloid aggregates is a hallmark of over 50 human disorders, including Alzheimer's and Parkinson's diseases. Increasing evidence implicates misfolded protein oligomers produced during the amyloid formation process as the primary cytotoxic agents in many of these devastating conditions. In this review, we analyze the processes by which oligomers are formed, their structures, physicochemical properties, population dynamics, and the mechanisms of their cytotoxicity. We then focus on drug discovery strategies that target the formation of oligomers and their ability to disrupt cell physiology and trigger degenerative processes.
Hierarchical Composite Scaffold with Deferoxamine Delivery System to Promote Bone Regeneration via Optimizing Angiogenesis
Authors: Raokaijuan Wang, Xiangjun Zha, Jouchen Chen, Ruijie Fu, Yajun Fu, Jie Xiang, Wei Yang, Lixing Zhao
Journal: Advanced Healthcare Materials (2024)

Abstract A bone defect refers to the loss of bone tissue caused by trauma or lesion. Bone defects result in high morbidity and deformity rates worldwide. Autologous bone grafting has been widely applied in clinics as the gold standard of treatment; however, it has limitations. Hence, bone tissue engineering has been proposed and developed as a novel therapeutic strategy for treating bone defects. Rapid and effective vascularization is essential for bone regeneration. In this study, a hierarchical composite scaffold with deferoxamine (DFO) delivery system, DFO@GMs‐pDA/PCL‐HNTs (DGPN), is developed, focusing on vascularized bone regeneration. The hierarchical structure of DGPN imitates the microstructure of natural bone and interacts with the local extracellular matrix, facilitating cell adhesion and proliferation. The addition of 1 wt% of halloysite nanotubes (HNTs) improves the material properties. Hydrophilic and functional groups conferred by polydopamine (pDA) modifications strengthen the scaffold bioactivity. Gelatin microspheres (GMs) protect the pharmacological activity of DFO, achieving local application and sustained release for 7 days. DFO effectively promotes angiogenesis by activating the signaling pathway of hypoxia inducible factor‐1 α. In addition, DFO synergizes with HNTs to promote osteogenic differentiation and matrix mineralization. These results indicate that DGPN promotes bone regeneration and accelerates cranial defect healing.
This Issue at a Glance
Authors: Sandeep Ravindran
Journal: Ophthalmology (2024)

Panarelli et al (p. 266) conducted a 2-year prospective, randomized trial to compare the effectiveness and safety of the MicroShunt with trabeculectomy in patients with uncontrolled primary open-angle glaucoma. Analysis of 395 patients with stand-alone MicroShunt implantation and 132 patients with trabeculectomy found that the rate of surgical success was lower in the MicroShunt group than in the trabeculectomy group (50.6% vs. 64.4%). The IOP reduction was also statistically greater in the trabeculectomy group.
A Simple Vista en Este Número
Authors: Sandeep Ravindran
Journal: Ophthalmology (2024)

Panarelli y otros (p. 266) realizaron un estudio aleatorio prospectivo de 2 años, para comparar la seguridad y eficacia del MicroShunt con la trabeculectomía, en pacientes con glaucoma primario de ángulo abierto no controlado. El análisis de 395 pacientes con implantación de MicroShunt independiente y 132 pacientes con trabeculectomía, encontró que la tasa de éxito quirúrgico fue menor en el grupo de MicroShunt que en el grupo de trabeculectomía (50,6 % en comparación con 64,4 %). La reducción de la IOP también fue estadísticamente mayor en el grupo de trabeculectomía.
期刊一览
Authors: Sandeep Ravindran
Journal: Ophthalmology (2024)

Panarelli (p. 266) 等进行了一项2年的前瞻性随机试验,以比较MicroShunt和小梁切除术对未控制原发性开角型青光眼患者的治疗效果和安全性。对395名接受单纯MicroShunt植入的患者和132名接受小梁切除术患者的分析发现,MicroShunt组手术成功率低于小梁切除术组(50.6% vs. 64.4%)。小梁切除术组的IOP降低效果统计学更为显著。威胁视力的并发症在两组间均不常见,不良事件在两组中基本类似,但接受小梁切除术患眼低眼压较为常见。研究者得出结论,MicroShunt和小梁切除术均可在2年显著降低IOP并减少用药,而小梁切除术成功率较高。
Six‐week low‐molecular‐weight heparin versus 12‐week warfarin for calf deep vein thrombosis: A randomized, prospective, open‐label study
Authors: Michelangelo Sartori, Matteo Iotti, Giuseppe Camporese, Sergio Siragusa, Davide Imberti, Eugenio Bucherini, Sara Corradini, Walter Ageno, Paolo Prandoni, Angelo Ghirarduzzi
Journal: American Journal of Hematology (2024)

Abstract Current guidelines suggest a 3‐month anticoagulant treatment course for isolated distal deep vein thrombosis (IDDVT), but shorter durations of treatment are frequently prescribed in clinical practice. We investigated whether a 6‐week treatment with low‐molecular‐weight heparin (LMWH) at intermediate dosage can be an effective and safe alternative to vitamin K antagonists (VKA) in patients with IDDVT (non‐inferiority trial). In a multicenter, open‐label, randomized trial, 260 outpatients with symptomatic IDDVT were randomly assigned to receive either LMWH followed by VKA for 12 weeks or LMWH 1 mg/kg subcutaneously twice a day for 2 weeks followed by 1 mg/kg subcutaneously once a day for 4 weeks. The follow‐up was 6 months and the primary endpoint was the composite measure of recurrent venous thromboembolism (VTE) defined as: recurrence or extension of IDDVT, proximal DVT, and pulmonary embolism (PE). The study was stopped prematurely due to slow recruiting rates. The primary efficacy outcome occurred in 14 patients receiving LMWH (10.8%) and in five patients receiving VKA (3.8%); risk difference was 0.069 (95% CI: 0.006–0.132), hazard ratio 2.8 (95% CI: 1.04–7.55). There was one PE in the VKA group and one proximal DVT in the LMWH group. IDDVT recurrence was 10.0% in the LMWH group versus 3.1% in the VKA group ( p = .024). Two patients had clinically relevant bleedings (1.6%) in the LMWH group versus one (0.8%) in VKA group ( p = .56). In conclusion, VKA for 12 weeks seems superior to LMWH for 6 weeks in reducing the risk of VTE recurrences in our cohort of outpatients with IDDVT.
Addressing Barriers to Entry and Retention of Women in Interventional Vascular Specialties With Proposed Solutions: A Scientific Statement From the American Heart Association
Authors: S. Elissa Altin, Mimmie Kwong, Naomi M. Hamburg, Mark A. Creager, Subhash Banerjee, Lola Oladini, Marabel D. Schneider, Jean Marie Ruddy
Journal: Circulation (2024)

Representation of women in interventional vascular fields (interventional cardiology, interventional radiology, and vascular surgery) lags behind that in other specialties. With women representing half of all medical school graduates, encouraging parity of women in these fields needs to start in medical school. Barriers to pursuing careers in vascular intervention include insufficient exposure during core clerkships, early mentorship, visibility of women in the field, length of training, lifestyle considerations, work culture and environment, and concerns about radiation exposure. This scientific statement highlights potential solutions for both the real and perceived barriers that women may face in pursuing careers in vascular intervention, including streamlining of training (as both interventional radiology and vascular surgery have done with a resultant increase in percentage of women trainees), standardization of institutional promotion of women in leadership, and professional and industry partnerships for the retention and advancement of women.
Unsynchronized butyrophilin molecules dictate cancer cell evasion of Vγ9Vδ2 T-cell killing
Authors: Zeguang Wu, Qiezhong Lamao, Meichao Gu, Xuanxuan Jin, Ying Liu, Feng Tian, Ying Yu, Pengfei Yuan, Shuaixin Gao, Thomas S. Fulford, Adam P. Uldrich, Catherine CL Wong, Wensheng Wei
Journal: Cellular and Molecular Immunology (2024)
CT whole lung radiomic nomogram: a potential biomarker for lung function evaluation and identification of COPD
Authors: Tao-Hu Zhou, Xiu-Xiu Zhou, Jiong Ni, Yan-Qing Ma, Fang-Yi Xu, Bing Fan, Yu Guan, Xin-Ang Jiang, Xiao-Qing Lin, Jie Li, Yi Xia, Xiang Wang, Yun Wang, Wen-Jun Huang, Wen-Ting Tu, Peng Dong, Zhao-Bin Li, Shi-Yuan Liu, Li Fan
Journal: Military Medical Research (2024)

Abstract Background Computed tomography (CT) plays a great role in characterizing and quantifying changes in lung structure and function of chronic obstructive pulmonary disease (COPD). This study aimed to explore the performance of CT-based whole lung radiomic in discriminating COPD patients and non-COPD patients. Methods This retrospective study was performed on 2785 patients who underwent pulmonary function examination in 5 hospitals and were divided into non-COPD group and COPD group. The radiomic features of the whole lung volume were extracted. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied for feature selection and radiomic signature construction. A radiomic nomogram was established by combining the radiomic score and clinical factors. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to evaluate the predictive performance of the radiomic nomogram in the training, internal validation, and independent external validation cohorts. Results Eighteen radiomic features were collected from the whole lung volume to construct a radiomic model. The area under the curve (AUC) of the radiomic model in the training, internal, and independent external validation cohorts were 0.888 [95% confidence interval (CI) 0.869–0.906], 0.874 (95%CI 0.844–0.904) and 0.846 (95%CI 0.822–0.870), respectively. All were higher than the clinical model (AUC were 0.732, 0.714, and 0.777, respectively, P &lt; 0.001). DCA demonstrated that the nomogram constructed by combining radiomic score, age, sex, height, and smoking status was superior to the clinical factor model. Conclusions The intuitive nomogram constructed by CT-based whole-lung radiomic has shown good performance and high accuracy in identifying COPD in this multicenter study.
Age and associated outcomes among patients receiving venovenous extracorporeal membrane oxygenation for acute respiratory failure: analysis of the Extracorporeal Life Support Organization registry
Authors: Shannon M. Fernando, Daniel Brodie, Ryan P. Barbaro, Cara Agerstrand, Jenelle Badulak, Errol L. Bush, Thomas Mueller, Laveena Munshi, Eddy Fan, Graeme MacLaren, Daniel I. McIsaac
Journal: Intensive Care Medicine (2024)
Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left‐sided valvular heart disease in Europe. Insights from the <scp>ESC‐EORP</scp> Valvular Heart Disease <scp>II</scp> survey
Authors: Julien Dreyfus, Monika Komar, David Attias, Michele De Bonis, Frank Ruschitzka, Bogdan A. Popescu, Cécile Laroche, Christophe Tribouilloy, Alexander Bogachev Prokophiev, Vaida Mizariene, Jeroen J. Bax, Aldo Pietro Maggioni, David Messika‐Zeitoun, Alec Vahanian, Bernard Iung
Journal: European Journal of Heart Failure (2024)
Immunotherapy-resistant acute lymphoblastic leukemia cells exhibit reduced CD19 and CD22 expression and BTK pathway dependency
Authors: Sarah Aminov, Orsi Giricz, David T. Melnekoff, R. Alejandro Sica, Veronika Polishchuk, Cristian Papazoglu, Bonnie Yates, Hao-Wei Wang, Srabani Sahu, Yanhua Wang, Shanisha Gordon-Mitchell, Violetta V. Leshchenko, Carolina Schinke, Kith Pradhan, Srinivas Aluri, Moah Sohn, Stefan K. Barta, Beamon Agarwal, Mendel Goldfinger, Ioannis Mantzaris, Aditi Shastri, William Matsui, Ulrich Steidl, Joshua D. Brody, Nirali N. Shah, Samir Parekh, Amit Verma
Journal: Journal of Clinical Investigation (2024)

While therapies targeting CD19 by antibodies, CAR-T cells and T cell engagers have improved the response rates in B-cell malignancies; the emergence of resistant cell populations with low CD19 expression can lead to relapsed disease. We developed an in vitro model of adaptive resistance facilitated by chronic exposure of leukemia cells to a CD19-immunotoxin. Single-cell (sc) RNAseq showed increase in transcriptionally distinct CD19low populations in resistant cells. Mass cytometry demonstrated that CD22 was also decreased in these CD19low resistant cells. ATAC-seq showed decreased chromatin accessibility at promoters of both CD19 and CD22 during development of resistance. Combined loss of both CD19 and CD22 antigens was validated in samples from pediatric and young adult patients with ALL that relapsed after CD19 CAR-T targeted therapy. Functionally, resistant cells were characterized by slower growth and lower basal levels of MEK activation. CD19low resistant cells exhibited preserved B cell receptor signaling and were more sensitive to both BTK and MEK inhibition. These data demonstrate that resistance to CD19 immunotherapies can result in decreased expression of both CD19 and CD22 and can result in dependency on BTK pathways.
Mucus clears from the trachea in a helix: a new twist to understanding airway diseases
Authors: David Abelson, James Di Michiel, Clayton Frater, Mark Pearson, Robert Russo, Martin Wechselberger, Alice Cottee, Lucy Morgan
Journal: Thorax (2024)

Background Mucociliary clearance (MCC) is critical to lung health and is impaired in many diseases. The path of MCC may have an important impact on clearance but has never been rigorously studied. The objective of this study is to assess the three-dimensional path of human tracheal MCC in disease and health. Methods Tracheal MCC was imaged in 12 ex-smokers, 3 non-smokers (1 opportunistically imaged during acute influenza and repeated after recovery) and 5 individuals with primary ciliary dyskinesia (PCD). Radiolabelled macroaggregated albumin droplets were injected into the trachea via the cricothyroid membrane. Droplet movement was tracked via scintigraphy, the path of movement mapped and helical and axial models of tracheal MCC were compared. Measurements and main results In 5/5 participants with PCD and 1 healthy participant with acute influenza, radiolabelled albumin coated the trachea and did not move. In all others (15/15), mucus coalesced into globules. Globule movement was negligible in 3 ex-smokers, but in all others (12/15) ascended the trachea in a helical path. Median cephalad tracheal MCC was 2.7 mm/min ex-smokers vs 8.4 mm/min non-smokers (p=0.02) and correlated strongly to helical angle (r=0.92 (p=0.00002); median 18 o ex-smokers, 47 o non-smokers (p=0.036)), but not to actual speed on helical path (r=0.26 (p=0.46); median 13.6 mm/min ex-smokers vs 13.9 mm/min non-smokers (p=1.0)). Conclusion For the first time, we show that human tracheal MCC is helical, and impairment in ex-smokers is often caused by flattened helical transit, not slower movement. Our methodology provides a simple method to map tracheal MCC and speed in vivo.
Prompt engineering in consistency and reliability with the evidence-based guideline for LLMs
Authors: Li Wang, Xi Chen, XiangWen Deng, Hao Wen, MingKe You, WeiZhi Liu, Qi Li, Jian Li
Journal: npj Digital Medicine (2024)

Abstract The use of large language models (LLMs) in clinical medicine is currently thriving. Effectively transferring LLMs’ pertinent theoretical knowledge from computer science to their application in clinical medicine is crucial. Prompt engineering has shown potential as an effective method in this regard. To explore the application of prompt engineering in LLMs and to examine the reliability of LLMs, different styles of prompts were designed and used to ask different LLMs about their agreement with the American Academy of Orthopedic Surgeons (AAOS) osteoarthritis (OA) evidence-based guidelines. Each question was asked 5 times. We compared the consistency of the findings with guidelines across different evidence levels for different prompts and assessed the reliability of different prompts by asking the same question 5 times. gpt-4-Web with ROT prompting had the highest overall consistency (62.9%) and a significant performance for strong recommendations, with a total consistency of 77.5%. The reliability of the different LLMs for different prompts was not stable (Fleiss kappa ranged from −0.002 to 0.984). This study revealed that different prompts had variable effects across various models, and the gpt-4-Web with ROT prompt was the most consistent. An appropriate prompt could improve the accuracy of responses to professional medical questions.