tbuckley/cabot-search huggingface dataset:
Clinical consequences of computer-aided colorectal polyp detection
Authors: Pieter Sinonquel, Tom Eelbode, Oliver Pech, Dominiek De Wulf, Pieter Dewint, Helmut Neumann, Giulio Antonelli, Federico Iacopini, David Tate, Arnaud Lemmers, Nastazja Dagny Pilonis, Michal Filip Kaminski, Philip Roelandt, Cesare Hassan, Demedts Ingrid, Frederik Maes, Raf Bisschops
Journal: Gut (2024)

Background and aim Randomised trials show improved polyp detection with computer-aided detection (CADe), mostly of small lesions. However, operator and selection bias may affect CADe’s true benefit. Clinical outcomes of increased detection have not yet been fully elucidated. Methods In this multicentre trial, CADe combining convolutional and recurrent neural networks was used for polyp detection. Blinded endoscopists were monitored in real time by a second observer with CADe access. CADe detections prompted reinspection. Adenoma detection rates (ADR) and polyp detection rates were measured prestudy and poststudy. Histological assessments were done by independent histopathologists. The primary outcome compared polyp detection between endoscopists and CADe. Results In 946 patients (51.9% male, mean age 64), a total of 2141 polyps were identified, including 989 adenomas. CADe was not superior to human polyp detection (sensitivity 94.6% vs 96.0%) but outperformed them when restricted to adenomas. Unblinding led to an additional yield of 86 true positive polyp detections (1.1% ADR increase per patient; 73.8% were &lt;5 mm). CADe also increased non-neoplastic polyp detection by an absolute value of 4.9% of the cases (1.8% increase of entire polyp load). Procedure time increased with 6.6±6.5 min (+42.6%). In 22/946 patients, the additional detection of adenomas changed surveillance intervals (2.3%), mostly by increasing the number of small adenomas beyond the cut-off. Conclusion Even if CADe appears to be slightly more sensitive than human endoscopists, the additional gain in ADR was minimal and follow-up intervals rarely changed. Additional inspection of non-neoplastic lesions was increased, adding to the inspection and/or polypectomy workload.
Phase 1 study of BA3071, an anti–CTLA-4 conditionally active biologic, in combination with nivolumab in advanced solid tumors.
Authors: Jacob Stephen Thomas, Jennifer Eva Selfridge, Costantine Albany, Matthew H. Taylor, Inderjit Mehmi, Vineet Kwatra, Siwen Hu-Lieskovan, Paul L. de Souza, Judith Dubal Llorin-Sangalang, Kartik Aysola, Omid Hamid
Journal: Journal of Clinical Oncology (2024)

2602 Background: Immune checkpoint inhibition of cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) in combination with programmed cell death protein 1 (PD-1) has demonstrated durable clinical benefit in patients with advanced solid tumors. However, dose density is limited due to toxicity. BA3071 is a conditionally active biologic (CAB) anti–CTLA-4 monoclonal antibody that blocks the interaction of CTLA-4 with its ligands CD80 and CD86 [1]. CABs are activated within the acidic tumor microenvironment. Conditional and reversible binding of BA3071 may reduce on- and off-tumor immune-related adverse events (AEs) and autoimmunity, avoid tissue-mediated drug deposition, and improve pharmacokinetics. We evaluated the safety and antitumor activity of BA3071 in patients with advanced solid tumors. Methods: Patients naïve to anti–CTLA-4 therapy with advanced solid tumors received escalating doses of single-agent BA3071 every 3 weeks (Q3W) at cycle 1, followed by combination BA3071 + nivolumab from cycle 2 onward. Treatment continued until disease progression or unacceptable toxicity. Response assessment was performed Q6W with RECIST v1.1. Results: Eighteen patients were treated with BA3071 (7–700 mg) and nivolumab (240 mg); 61% had received ≥3 lines of prior systemic therapy, and all patients had experienced failure of anti–PD-1 therapy. Four patients experienced grade 3 related treatment-emergent AEs (TEAEs; hypertension, increased lipase, atrial fibrillation, gastritis, and diabetic ketoacidosis); no grade 4 related TEAEs were observed. Two patients experienced grade 3 immune-related TEAEs (diarrhea [BA3071 350 mg] and diabetic ketoacidosis [BA3071 700 mg]). Among 16 efficacy-evaluable patients, 9 experienced stable disease, and 2 out of 5 patients receiving BA3071 in the 350-mg cohort achieved confirmed RECIST v1.1 responses (complete response in cervical carcinoma and partial response in gastroesophageal carcinoma). One patient with metastatic small cell lung cancer who received 7 mg BA3071 remained without progression for &gt;1 year (69 weeks). Conclusions: Treatment with the novel, conditionally active anti–CTLA-4 agent BA3071, in combination with anti–PD-1 therapy (at doses higher than those currently approved for anti–CTLA-4/PD-1 therapy), yielded confirmed responses with a promising tolerability profile. Phase 1 dose escalation of BA3071 continues at 700 mg up to 1000 mg, and phase 2 monotherapy and combination therapy expansion cohorts are currently enrolling at a starting dose level of 350 mg. 1. Chang HW et al. Proc Natl Acad Sci USA.2021;118(9):e2020606118. Clinical trial information: NCT05180799 .
Inactivation of Avian Influenza A(H5N1) Virus in Raw Milk at 63°C and 72°C
Authors: Franziska Kaiser, Dylan H Morris, Arthur Wickenhagen, Reshma Mukesh, Shane Gallogly, Kwe Claude Yinda, Emmie de Wit, James O Lloyd-Smith, Vincent J Munster
Journal: New England Journal of Medicine (2024)
Medical Maximizing Preferences and Beliefs About Cancer Among US Adults
Authors: Alexander S. Chiu, Ines Hoxha, Catherine B. Jensen, Megan C. Saucke, Susan C. Pitt
Journal: JAMA Network Open (2024)

Importance Medical overutilization contributes to significant health care expenditures and exposes patients to questionably beneficial surgery and unnecessary risk. Objectives To understand public attitudes toward medical utilization and the association of these attitudes with beliefs about cancer. Design, Setting, and Participants In this cross-sectional survey study conducted from August 26 to October 28, 2020, US-based, English-speaking adults were recruited from the general public using Prolific Academic, a research participant platform. Quota-filling was used to obtain a sample demographically representative of the US population. Adults with a personal history of cancer other than nonmelanoma skin cancer were excluded. Statistical analysis was completed in July 2022. Main Outcome and Measures Medical utilization preferences were characterized with the validated, single-item Maximizer-Minimizer Elicitation Question. Participants preferring to take action in medically ambiguous situations (hereafter referred to as “maximizers”) were compared with those who leaned toward waiting and seeing (hereafter referred to as “nonmaximizers”). Beliefs and emotions about cancer incidence, survivability, and preventability were assessed using validated measures. Logistic regression modeled factors associated with preferring to maximize medical utilization. Results Of 1131 participants (mean [SD] age, 45 [16] years; 568 women [50.2%]), 287 (25.4%) were classified as maximizers, and 844 (74.6%) were classified as nonmaximizers. Logistic regression revealed that self-reporting very good or excellent health status (compared with good, fair, or poor; odds ratio [OR], 2.01 [95% CI, 1.52-2.65]), Black race (compared with White race; OR, 1.88 [95% CI, 1.22-2.89]), high levels of cancer worry (compared with low levels; OR, 1.62 [95% CI, 1.09-2.42]), and overestimating cancer incidence (compared with accurate estimation or underestimating; OR, 1.58 [95% CI, 1.09-2.28]) were significantly associated with maximizing preferences. Those who believed that they personally had a higher-than-average risk of developing cancer were more likely to be maximizers (23.6% [59 of 250] vs 17.4% [131 of 751]; P = .03); this factor was not significant in regression analyses. Conclusions and Relevance In this survey study of US adults, those with medical maximizing tendencies more often overestimated the incidence of cancer and had higher levels of cancer-related worry. Targeted and personalized education about cancer and its risk factors may help reduce overutilization of oncologic care.
Clinical Practice Guideline for Red Blood Cell Transfusion Thresholds in Very Preterm Neonates
Authors: Emöke Deschmann, Christof Dame, Martha C. Sola-Visner, Susanna F. Fustolo-Gunnink, Gordon H. Guyatt, Ravi Mangal Patel, Simon J. Stanworth, Helen New, Enrico Lopriore, Charles Christoph Roehr, Estela Coutinho, Corina Croitoru, Livia Nagy-Bonnard, Valerie Matthäus, Eirik Nestaas, Giuseppe Buonocore, Daniele de Luca, Manuel Sanchez-Luna, Matteo Di Nardo, Nabiha Huq Saifee, Cassandra Josephson, Elise J. Huijssen-Huisman, Lani Lieberman, Evan Orenstein
Journal: JAMA Network Open (2024)

Importance Red blood cell (RBC) transfusion is a common medical intervention to treat anemia in very preterm neonates; however, best transfusion practices, such as thresholds, remain uncertain. Objective To develop recommendations for clinicians on the use of RBC transfusions in very preterm neonates. Evidence Review An international steering committee reviewed evidence from a systematic review of 6 randomized clinical trials (RCTs) that compared high vs low hemoglobin-based or hematocrit-based transfusion thresholds. The steering committee reached consensus on certainty-of-evidence ratings and worked with a panel from stakeholder organizations on reviewing the evidence. With input from parent representatives and the stakeholder panel, the steering committee used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop recommendations. Findings A systematic review of 6 RCTs encompassing 3483 participants (1759 females [51.3%]; mean [SD] age range, 25.9-29.8 [1.5-3.0] weeks) was used as the basis of the recommendations. The ranges for higher hemoglobin concentration (liberal) vs lower hemoglobin concentration (restrictive) threshold study arms were similar across the trials. However, specific thresholds differed based on the severity of illness, which was defined using variable criteria in the trials. There was moderate certainty of evidence that low transfusion thresholds likely had little to no difference in important short-term and long-term outcomes. The recommended hemoglobin thresholds varied on the basis of postnatal week and respiratory support needs. At postnatal weeks 1, 2, and 3 or more, for neonates on respiratory support, the recommended thresholds were 11, 10, and 9 g/dL, respectively; for neonates on no or minimal respiratory support, the recommended thresholds were 10, 8.5, and 7 g/dL, respectively (to convert hemoglobin to grams per liter, multiply by 10.0). Conclusions and Relevance This consensus statement recommends a restrictive RBC transfusion strategy, with moderate certainty of evidence, for preterm neonates with less than 30 weeks’ gestation.
Two-Stage Syphilis Testing
Authors: Lais Lopes Almeida Gomes, Caroline J. Stone, Katharina S. Shaw
Journal: JAMA (2024)

A 54-year-old woman presented with erythematous annular and indurated plaques on her face, trunk, and extremities and had false-positive syphilis test results during 2 pregnancies 25 and 22 years prior. What would you do next?
The Global Prevalence of Nonsuicidal Self-Injury Among Adolescents
Authors: Ellen-ge Denton, Kiara Álvarez
Journal: JAMA Network Open (2024)

Fiona Moloney, MD; Jasmine Amini, HBSc; Mark Sinyor, MD; Ayal Schaffer, MD; Krista L. Lanctôt, PhD; Rachel H.B. Mitchell, MD
Rare Inherited Tumor Syndrome Tied to Nail Condition
Authors: Emily Harris
Journal: JAMA (2024)

Alexandra Lebensohn, MS, CGC; Azam Ghafoor, MD; Luke Bloomquist, MD; Michael C. Royer, MD; Leslie Castelo-Soccio, MD, PhD; Kelli Karacki, PA-C; Olanda Hathaway, CRNP; Tenin Maglo, CRNP; Cathy Wagner, RN; Maria G. Agra, RN; Andrew M. Blakely, MD; David S. Schrump, MD; Raffit Hassan, MD; Edward W. Cowen, MD, MHSc
Sex Differences in the Global Prevalence of Nonsuicidal Self-Injury in Adolescents
Authors: Fiona Moloney, Jasmine Amini, Mark Sinyor, Ayal Schaffer, Krista L. Lanctôt, Rachel H.B. Mitchell
Journal: JAMA Network Open (2024)

Importance Nonsuicidal self-injury (NSSI) is a strong predictor of suicide attempts. The prevalence of NSSI has been increasing among female adolescents in North America and Europe, but less is known about trends in other geographical regions. Objective To examine sex differences in the prevalence of NSSI among adolescents within and between geographical regions. Data Sources MEDLINE and PsycINFO were searched using the keywords adolescents , self-injury , sex factors , and synonyms for articles published in English between January 1, 2000, and May 10, 2022. Study Selection Studies were included if they presented original data (any study design), included adolescents aged 10 to 19 years, reported results stratified by sex, and explicitly defined self-injury as behaviors occurring without suicidal intent. Data Extraction and Synthesis This meta-analysis was registered with PROSPERO and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Articles were assessed for quality by 2 independent coders (F.M. and J.A.). A random-effects model was used to calculate prevalence. Data were analyzed from July 2022 to April 2023. Main Outcomes and Measures The prevalence of NSSI in male and female adolescents within and between regions was the main outcome. Odds ratios (OR) with 95% CIs were calculated for community samples. Results Eight hundred and two studies were screened, and 38 were included (266 491 participants). Across 17 countries, the pooled prevalence of NSSI was 17.7% (female:male OR, 1.60; 95% CI, 1.29-1.98). NSSI was twice as prevalent among female adolescents compared with male adolescents in North America (OR, 2.49; 95% CI, 2.16-2.86) and Europe (OR, 2.08; 95% CI, 1.69-2.58), but not in Asia (OR, 1.00; 95% CI, 0.71-1.41). Conclusions and Relevance In this meta-analysis of sex differences in global prevalence of NSSI, the female predominance of NSSI observed among adolescents in North America and Europe aligned with rising rates of suicide in these populations. The comparable prevalence of NSSI among male and female adolescents in Asia also aligned with the lower male-to-female suicide ratio compared with other countries. More research is needed to characterize regional (and potentially cultural) sex differences among adolescents with NSSI to prevent and treat the behavior and to understand the possible interplay with corresponding regional trends in suicide.
Having Peers With Mental Disorders Might Increase Classmates’ Risk
Authors: Emily Harris
Journal: JAMA (2024)

Jussi Alho, PhD; Mai Gutvilig, MSc; Ripsa Niemi, MSc; Kaisla Komulainen, PhD; Petri Böckerman, PhD; Roger T. Webb, PhD; Marko Elovainio, PhD; Christian Hakulinen, PhD
Sarcopenic Obesity and Outcomes for Patients With Cancer
Authors: Chenan Liu, Tong Liu, Li Deng, Qi Zhang, Mengmeng Song, Jinyu Shi, Chenning Liu, Hailun Xie, Yue Chen, Shiqi Lin, Xin Zheng, Heyang Zhang, Rocco Barazzoni, Hanping Shi
Journal: JAMA Network Open (2024)

Importance The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) have recently proposed a consensus definition and diagnostic criteria for sarcopenic obesity (SO). Objective To implement the ESPEN-EASO diagnostic algorithm to investigate the prevalence of SO and its association with outcomes in patients with solid tumor cancers, with particular regard to associations among SO, overall survival (OS), and patient quality of life (QoL). Design, Setting, and Participants This prospective cohort study included patients diagnosed with solid tumor starting in May 7, 2013, with the last follow-up on June 30, 2022. Patients with solid tumors were categorized into SO and non-SO groups according to ESPEN-EASO criteria. The primary outcome was OS and the secondary outcomes included patient QoL and risk of intensive care unit (ICU) admission. Data were analyzed from June to December 2023. Results A total of 6790 patients were included in the study (mean [SD] age, 59.64 [10.77] years; 3489 were female [51.4%]). The prevalence of SO was 4.36% (296 of 6790) in the whole cohort and 14.98% (296 of 1976) in the subgroup with obesity. SO prevalence increased with age. During a median (IQR) follow-up period of 6.83 (5.67-7.04) years, 2103 patients died. Cox regression analysis indicated that SO was independently associated with lower OS (hazard ratio [HR], 1.54; 95% CI, 1.23-1.92), which was observed in both men (HR, 1.51; 95% CI, 1.09-2.10) and women (HR, 1.53; 95% CI, 1.12-2.07). SO was also associated with poorer QoL and higher risk of ICU admission (odds ratio, 2.39; 95% CI, 1.06-5.29). Among the diagnostic components of SO, low hand grip strength (HGS) was the only SO component associated with poor OS (HR, 1.15; 95% CI, 1.04-1.28). Conclusions and Relevance This cohort study of SO found that SO was significantly associated with lower OS, poorer QoL, and higher risk of ICU admission. Weak HGS, 1 of the diagnostic conditions, was the only component of SO associated with OS. The ESPEN-EASO algorithm appears to be an applicable tool to identify cancer-associated SO, which represents a major clinical complication and factor associated with risk for poor outcomes in these patients.
Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022
Authors: Tyrone F. Borders, Amanda Thaxton Wiggins
Journal: JAMA Network Open (2024)

Importance Little nationally representative research has examined Papanicolaou testing rates from before the pandemic in 2019 through the COVID-19 pandemic in 2022. Papanicolaou testing rates among rural females are a concern as they have historically had lower screening rates than their urban counterparts. Objective To examine the receipt of a Papanicolaou test in the past year among US females overall and females residing in rural and urban areas in 2019, 2020, and 2022. Design, Setting, and Participants This repeated cross-sectional study used data from 3 years of the Health Information National Trends Survey (HINTS), a nationally representative survey that asks respondents about cancer screenings, sources of health information, and health and health care technologies. Study participants were females aged 21 to 65 years. Individuals who received a Papanicolaou test more than 1 to 3 years prior to a HINTS interview were excluded as they were likely not due for a Papanicolaou test. Exposures Survey year (2019, 2020, and 2022) and rural or urban residence were the main exposure variables. Main Outcomes and Measures Self-reported receipt of a Papanicolaou test within the past year. Results Among the 188 243 531 (weighted; 3706 unweighted) females included in the analysis, 12.5% lived in rural areas and 87.5% in urban areas. Participants had a mean (SE) age of 43.7 (0.27) years and were of Hispanic (18.8%), non-Hispanic Asian (5.2%), non-Hispanic Black (12.2%), non-Hispanic White (59.6%), or non-Hispanic other (4.1%) race and ethnicity. In 2022, unadjusted past-year Papanicolaou testing rates were significantly lower among rural vs urban residents (48.6% [95% CI, 39.2%-58.1%] vs 64.0% [95% CI, 60.0%-68.0%]; P &amp;amp;lt; .001). Adjusted odds of past-year Papanicolaou testing were lower in 2022 than 2019 (odds ratio, 0.70; 95% CI, 0.52-0.95; P = .02). Conclusions and Relevance This repeated cross-sectional study found that past-year Papanicolaou testing rates were lower in 2022 than 2019, pointing to a need to increase access to screenings to prevent an uptick in cervical cancer incidence. Rural-vs-urban differences in 2022 indicate a need to specifically target rural females.
Development of a Longitudinal Prostate Cancer Transcriptomic and Clinical Data Linkage
Authors: Michael S. Leapman, Julian Ho, Yang Liu, Christopher P. Filson, Xin Zhao, Alexander Hakansson, James A. Proudfoot, Elai Davicioni, Darryl T. Martin, Yi An, Tyler M. Seibert, Daniel W. Lin, Daniel E. Spratt, Matthew R. Cooperberg, Ashley E. Ross, Preston C. Sprenkle
Journal: JAMA Network Open (2024)

Importance Although tissue-based gene expression testing has become widely used for prostate cancer risk stratification, its prognostic performance in the setting of clinical care is not well understood. Objective To develop a linkage between a prostate genomic classifier (GC) and clinical data across payers and sites of care in the US. Design, Setting, and Participants In this cohort study, clinical and transcriptomic data from clinical use of a prostate GC between 2016 and 2022 were linked with data aggregated from insurance claims, pharmacy records, and electronic health record (EHR) data. Participants were anonymously linked between datasets by deterministic methods through a deidentification engine using encrypted tokens. Algorithms were developed and refined for identifying prostate cancer diagnoses, treatment timing, and clinical outcomes using diagnosis codes, Common Procedural Terminology codes, pharmacy codes, Systematized Medical Nomenclature for Medicine clinical terms, and unstructured text in the EHR. Data analysis was performed from January 2023 to January 2024. Exposure Diagnosis of prostate cancer. Main Outcomes and Measures The primary outcomes were biochemical recurrence and development of prostate cancer metastases after diagnosis or radical prostatectomy (RP). The sensitivity of the linkage and identification algorithms for clinical and administrative data were calculated relative to clinical and pathological information obtained during the GC testing process as the reference standard. Results A total of 92 976 of 95 578 (97.2%) participants who underwent prostate GC testing were successfully linked to administrative and clinical data, including 53 871 who underwent biopsy testing and 39 105 who underwent RP testing. The median (IQR) age at GC testing was 66.4 (61.0-71.0) years. The sensitivity of the EHR linkage data for prostate cancer diagnoses was 85.0% (95% CI, 84.7%-85.2%), including 80.8% (95% CI, 80.4%-81.1%) for biopsy-tested participants and 90.8% (95% CI, 90.5%-91.0%) for RP-tested participants. Year of treatment was concordant in 97.9% (95% CI, 97.7%-98.1%) of those undergoing GC testing at RP, and 86.0% (95% CI, 85.6%-86.4%) among participants undergoing biopsy testing. The sensitivity of the linkage was 48.6% (95% CI, 48.1%-49.1%) for identifying RP and 50.1% (95% CI, 49.7%-50.5%) for identifying prostate biopsy. Conclusions and Relevance This study established a national-scale linkage of transcriptomic and longitudinal clinical data yielding high accuracy for identifying key clinical junctures, including diagnosis, treatment, and early cancer outcome. This resource can be leveraged to enhance understandings of disease biology, patterns of care, and treatment effectiveness.
Hope on the Horizon: Promising Therapies for Steatotic Liver Disease
Authors: Amirhossein Sahebkar, Ali H. Eid
Journal: Pharmacological Reviews (2024)

Steatotic liver disease (SLD) is a highly prevalent chronic liver disease with significant challenges for global health. The pathophysiology of SLD involves an interplay among genetic, endocrine, and metabolic factors. Successful management of SLD entails accurate diagnosis and disease monitoring through noninvasive methods such as advanced imaging techniques and biomarkers. Many emerging pharmacotherapies for SLD are now in the pipeline, which target different pathways like collagen turnover, fibrogenesis, inflammation, and metabolism. The recent approval of resmetirom for noncirrhotic metabolic dysfunction–associated steatohepatitis (MASH) has been a milestone in addressing the unmet medical need for an efficacious SLD treatment. Finally, the potential of personalized medicine approaches and interdisciplinary cooperation in improving patient outcomes and reducing disease burden should be strongly pursued. <h3>Significance Statement</h3> The healthcare burden due to steatotic liver disease (SLD) is enormous. This perspective sheds light on the recent advances in understanding the pathophysiology and diagnosis of SLD as well as promising drug development approaches.