tbuckley/cabot-search huggingface dataset:
User-reported quality of care: findings from the first round of the People's Voice Survey in 14 countries
Authors: Todd P Lewis, Munir Kassa, Neena R Kapoor, Catherine Arsenault, Rodrigo Bazua-Lobato, Rashmi Dayalu, Günther Fink, Theodros Getachew, Prashant Jarhyan, Hwa-Young Lee, Agustina Mazzoni, Jesus Medina-Ranilla, Inbarani Naidoo, Ashenif Tadele, Margaret E Kruk
Journal: The Lancet Global Health (2023)

High-quality care is essential for improving health outcomes, although many health systems struggle to maintain good quality. We use data from the People's Voice Survey-a nationally representative survey conducted in 14 high-income, middle-income, and low-income countries-to describe user-reported quality of most recent health care in the past 12 months. We described ratings for 14 measures of care competence, system competence, and user experience and assessed the relationship between visit quality factors and user recommendation of the facility. We disaggregated the data by high-need and underserved groups. The proportion of respondents rating their most recent visit as high quality ranged from 25% in Laos to 74% in the USA. The mean facility recommendation score was 7·7 out of 10. Individuals with high needs or who are underserved reported lower-quality services on average across countries. Countries with high health expenditure per capita tended to have better care ratings than countries with low health expenditure. Visit quality factors explained a high proportion of variation in facility recommendations relative to facility or demographic factors. These results show that user-reported quality is low but increases with high national health expenditure. Elevating care quality will require monitoring and improvements on multiple dimensions of care quality, especially in public systems.
Trends in prevalence of fractures among adults in the United States across 1999–2020
Authors: Jin Tang, Ming Ji, Keyi Feng, Yan Peng
Journal: International Journal of Surgery (2023)

Department of Orthopaedics, Chongqing University Three Gorges Hospital, Chongqing, 404000, China Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of Orthopaedics, Chongqing University Three Gorges Hospital, No. 165 Xincheng Road, Wanzhou District, Chongqing, 404000, China. E-mail address: [email protected] (Y. Peng). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0/
Comparing the impact of three-dimensional digital visualization technology versus traditional microscopy on microsurgeons in microsurgery: a prospective self-controlled study
Authors: Andi Xu, Ying Yao, Wenben Chen, Yuanfan Lin, Ruiyang Li, Ruixin Wang, Liuqing Pan, Qingqing Ye, Yangfei Pang, Xiaohang Wu, Duoru Lin, Lanqin Zhao, Ling Jin, Hang Shao, Wei Liu, Kun Gao, Xin Zhang, Pisong Yan, Xinpei Deng, Dongni Wang, Weiming Huang, Xulin Zhang, Meimei Dongye, Jinrong Li, Haotian Lin
Journal: International Journal of Surgery (2023)

Background: Emerging three-dimensional digital visualization technology (DVT) provides more advantages than traditional microscopy in microsurgery; however, its impact on microsurgeons’ visual and nervous systems and delicate microsurgery is still unclear, which hinders the wider implementation of DVT in digital visualization for microsurgery. Methods and material: Forty-two microsurgeons from the Zhongshan Ophthalmic Center were enrolled in this prospective self-controlled study. Each microsurgeon consecutively performed 30 min conjunctival sutures using a three-dimensional digital display and a microscope, respectively. Visual function, autonomic nerve activity, and subjective symptoms were evaluated before and immediately after the operation. Visual functions, including accommodative lag, accommodative amplitude, near point of convergence and contrast sensitivity function (CSF), were measured by an expert optometrist. Heart rate variability was recorded by a wearable device for monitoring autonomic nervous activity. Subjective symptoms were evaluated by questionnaires. Microsurgical performance was assessed by the video-based Objective Structured Assessment of Technical Skill (OSATS) tool. Results: Accommodative lag decreased from 0.63 (0.18) diopters (D) to 0.55 (0.16) D ( P =0.014), area under the log contrast sensitivity function increased from 1.49 (0.15) to 1.52 (0.14) ( P =0.037), and heart rate variability decreased from 36.00 (13.54) milliseconds (ms) to 32.26 (12.35) ms ( P =0.004) after using the DVT, but the changes showed no differences compared to traditional microscopy ( P &gt;0.05). No statistical significance was observed for global OSATS scores between the two rounds of operations [mean difference, 0.05 (95% CI: −1.17 to 1.08) points; P =0.95]. Subjective symptoms were quite mild after using both techniques. Conclusions: The impact of DVT-based procedures on microsurgeons includes enhanced accommodation and sympathetic activity, but the changes and surgical performance are not significantly different from those of microscopy-based microsurgery. Our findings indicate that short-term use of DVT is reliable for microsurgery and the long-term effect of using DVT deserve more consideration.
Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2022 Clinical Practice Guideline
Authors: Ahmed Arslan Yousuf Awan, Marina C. Berenguer, Annette Bruchfeld, Fabrizio Fabrizi, David S. Goldberg, Jidong Jia, Nassim Kamar, Rosmawati Mohamed, Mário Guimarães Pessôa, Stanislas Pol, Meghan E. Sise, Ethan M. Balk, Craig E. Gordon, Gaelen Adam, Michael Cheung, Amy Earley, Paul Martin, Michel Jadoul
Journal: Annals of Internal Medicine (2023)

The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD) is an update of the 2018 guideline from KDIGO. The KDIGO Work Group (WG) updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and used expert judgment to develop recommendations. New evidence led to updating of recommendations in the chapters on treatment of hepatitis C virus (HCV) infection in patients with CKD (Chapter 2), management of HCV infection before and after kidney transplant (Chapter 4), and diagnosis and management of kidney disease associated with HCV infection (Chapter 5). Recommendations in chapters on detection and evaluation of hepatitis C in CKD (Chapter 1) and prevention of HCV transmission in hemodialysis units (Chapter 3) were not updated because of an absence of significant new evidence. The 2022 updated guideline includes 43 graded recommendations and 20 ungraded recommendations, 7 of which are new or modified on the basis of the most recent evidence and consensus among the WG members. The updated guidelines recommend expanding treatment of hepatitis C with sofosbuvir-based regimens to patients with CKD glomerular filtration rate categories G4 and G5, including those receiving dialysis; expanding the donor pool for kidney transplant recipients by accepting HCV-positive kidneys regardless of the recipient's HCV status; and initiating direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis without requiring kidney biopsy. The update also addresses the use of immunosuppressive regimens in such patients.
Endoscopic En Bloc Versus Piecemeal Resection of Large Nonpedunculated Colonic Adenomas
Authors: Jérémie Jacques, Marion Schaefer, Timothée Wallenhorst, Thomas Rösch, Vincent Lépilliez, Stanislas Chaussade, Jérôme Rivory, Romain Legros, Jean-Baptiste Chevaux, Sarah Leblanc, Florian Rostain, Maximilien Barret, Jérémie Albouys, Arthur Belle, Anaïs Labrunie, Pierre-Marie Preux, Hugo Lepetit, Martin Dahan, Thierry Ponchon, Sabrina Crépin, Loïc Marais, Julien Magne, Mathieu Pioche
Journal: Annals of Internal Medicine (2023)

Endoscopic resection of adenomas prevents colorectal cancer, but the optimal technique for larger lesions is controversial. Piecemeal endoscopic mucosal resection (EMR) has a low adverse event (AE) rate but a variable recurrence rate necessitating early follow-up. Endoscopic submucosal dissection (ESD) can reduce recurrence but may increase AEs.
A commentary on ‘Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals’
Authors: Xiao-Ming Zhang
Journal: International Journal of Surgery (2023)

Department of emergency, the people's hospital of baoan Shenzhen, Shenzhen, China Running Title: Metabolic Syndrome and Surgical Complications. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of emergency, the people's hospital of Baoan Shenzhen, Shenzhen, China. E-mail address: [email protected] (X. M. Zhang). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
Postoperative results, learning curve, and outcomes of pancreatectomy with arterial resection: a single-center retrospective cohort study on 236 procedures
Authors: Niccolò Napoli, Emanuele F. Kauffmann, Carlo Lombardo, Michael Ginesini, Di Dato Armando, Lami Lucrezia, Elena Annunziata, Fabio Vistoli, Daniela Campani, Carla Cappelli, Gabriella Amorese, Ugo Boggi
Journal: International Journal of Surgery (2023)

Newer chemotherapy regimens are reviving the role of pancreatectomy with arterial resection (PAR) in locally advanced pancreatic cancer. However, concerns about the early outcomes and learning curve of PAR remain. This study aimed to define the postoperative results and learning curve of PAR and provide preliminary data on oncologic outcomes.
Management of Heart Failure in Hospitalized Patients
Authors: Michelle M. Kittleson
Journal: Annals of Internal Medicine (2023)

Heart failure affects more than 6 million people in the United States, and hospitalizations for decompensated heart failure confer a heavy toll in morbidity, mortality, and health care costs. Clinical trials have demonstrated effective interventions; however, hospitalization and mortality rates remain high. Key components of effective hospital care include appropriate diagnostic evaluation, triage and risk stratification, early implementation of guideline-directed medical therapy, adequate diuresis, and appropriate discharge planning.
Annals Graphic Medicine - The Heart Attack
Authors: Mark Glick
Journal: Annals of Internal Medicine (2023)

Web Exclusives12 December 2023Annals Graphic Medicine - The Heart AttackFREEMark Glick, MDMark Glick, MDHummelstown, Pennsylvania (M.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G22-0077 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Author, Article, and Disclosure InformationAuthors: Mark Glick, MDAffiliations: Hummelstown, Pennsylvania (M.G.)Disclosures: The author has reported no disclosures of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G22-0077.Author/Illustrator Information: Mark Glick, MD, is a retired cardiologist (e-mail, mglickmd@comcast.net).This article was published at Annals.org on 12 December 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics December 2023Volume 176, Issue 12 ePublished: 12 December 2023 Issue Published: December 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
CD5 Gene Signature Identifies Diffuse Large B-Cell Lymphomas Sensitive to Brutonʼs Tyrosine Kinase Inhibition
Authors: Alan Cooper, Sravya Tumuluru, Kyle Kissick, Girish Venkataraman, Joo Y. Song, Andrew Lytle, Gerben Duns, Jovian Yu, Nikita Kotlov, Aleksander Bagaev, Brendan Hodkinson, Srimathi Srinivasan, Sonali M. Smith, David W. Scott, Christian Steidl, James K. Godfrey, Justin Kline
Journal: Journal of Clinical Oncology (2023)

A genetic classifier termed LymphGen accurately identifies diffuse large B-cell lymphoma (DLBCL) subtypes vulnerable to Bruton's tyrosine kinase inhibitors (BTKis), but is challenging to implement in the clinic and fails to capture all DLBCLs that benefit from BTKi-based therapy. Here, we developed a novel CD5 gene expression signature as a biomarker of response to BTKi-based therapy in DLBCL.
Reply to E.J. Lehrer et al and J.B. De Vis et al
Authors: Ernest Nadal, Noelia Vilariño, Marta Simó, Valentí Navarro, Jordi Bruna
Journal: Journal of Clinical Oncology (2023)

We appreciate the thoughtful comments from Lehrer et al 1 and De Vis et al 2 on our study. 3Recent advancements in cancer biology and systemic treatments have led to intricate therapeutic approaches.Hence, we agree that a multidisciplinary tumor board should always be involved in the treatment plan of patients with brain metastases.
Chemoimmunotherapy for Untreated Lung Cancer Brain Metastases: A Reason for Optimism While Avoiding Overreaching Interpretations
Authors: Eric J. Lehrer, Daniel M. Trifiletti, Camilo E. Fadul, Paul D. Brown, Jason P. Sheehan
Journal: Journal of Clinical Oncology (2023)

Brain metastases represent a common problem in patients with cancer.In the United States alone, there are up to 100,000 patients diagnosed with brain metastases annually.Treatment paradigms of patients with brain metastases have become increasingly complex, and the therapeutic approach 1,2 is typically rendered by a multidisciplinary team that must consider a myriad of factors including tumor burden, location, phenotype, and genotype, as well as patient signs, symptoms, performance status, and goals of care. 3,4uide care of patients with brain metastases
A whole sector approach to policy change will accelerate integration of sex and gender in research
Authors: Alice Witt, Marina Politis, Kate Womersley
Journal: BMJ (2023)

Statements of support from across the UK research sector underscore the need for unity to improve the accuracy, reproducibility, and equity of science through better accounting of sex and gender, write <b>Alice Witt</b>, <b>Marina Politis</b>, and <b>Kate Womersley</b>
Maintenance of remission of ANCA vasculitis by rituximab based on B cell repopulation versus serological flare: a randomised trial
Authors: Reza Zonozi, Frank B Cortazar, Anushya Jeyabalan, Gabriel Sauvage, Pravarut Nithagon, Noah R Huizenga, Jillian M Rosenthal, Alexander Sipilief, Katherine Cosgrove, Karen A Laliberte, Eugene P Rhee, William F Pendergraft,, John L Niles
Journal: Annals of the Rheumatic Diseases (2023)

Objective To compare two long-term remission maintenance strategies for antineutrophil cytoplasmic antibody (ANCA) vasculitis. Methods We conducted a prospective, single-centre, open-label, randomised controlled trial of patients with ANCA vasculitis in remission after completing at least 2 years of fixed-schedule rituximab. In the B cell arm, rituximab was reinfused upon B cell repopulation; in the ANCA arm, rituximab was reinfused upon significant rise in ANCA level. Evaluations were conducted every 3 months. The primary endpoint was clinical relapse, defined as a modified BVAS/WG &gt;0 by 36 months. Secondary endpoints included serious adverse events (SAEs) and rituximab exposure. Results 115 patients were enrolled. Median follow-up time was 4.1 years (IQR 2.5–5.0). By Kaplan-Meier analysis, 4.1% (95% CI 1.0 to 15.6) of patients had a clinical relapse in the B cell arm, compared with 20.5% (95% CI 11.9 to 34.1) in the ANCA arm, at 3 years after study entry (log-rank p=0.045). Total SAEs, including infectious SAEs, and deaths did not differ. The number of SAEs due to COVID-19 was higher in the B cell arm (p=0.049). In the B cell arm, patients received a mean of 3.6 (SD 2.4) infusions (3.6 g) per person over the median study follow-up time of 4.1 years, compared with 0.5 (SD 1.4) infusions (0.5 g) per patient in the ANCA arm (p&lt;0.001). Conclusions Rituximab dosed for B cell repopulation results in fewer clinical relapses than when dosed for a rise in ANCA level in maintenance of remission for ANCA vasculitis. Overall safety was equivalent; SAEs due to COVID-19 and rituximab exposure were higher with the B cell strategy. Trial registration number NCT02749292 .
Self‐Assembled Multilayered Coatings with Multiple Cyclic Self‐Healing Capability, Bacteria Killing, Osteogenesis, and Angiogenesis Properties on Magnesium Alloys
Authors: Yanbin Zhao, Peng He, Junyan Yao, Mei Li, Jing Bai, Feng Xue, Chenglin Chu, Yu Cong, Paul K. Chu
Journal: Advanced Healthcare Materials (2023)

Self-healing coatings improve the durability of magnesium (Mg) implants, but rapid corrosion still poses a challenge in the healing stage. Moreover, Mg-based materials with acceptable bacteria killing, osteogenic and angiogenic properties are challenging in biomedical applications. Herein, the self-healing polymeric coatings are fabricated on Mg alloys using the spin-assisted layer-by-layer (SLbL) assembly of hyaluronic acid (HA) and branched polyethyleneimine (bPEI) followed by chemical crosslinking treatment. The self-healing coatings show excellent adhesion strength and structure stability. The corrosion resistance is improved due to the physical barrier of polymer coatings, which also promotes the formation of hydroxyapatite (HAp) during degradation for further protection of Mg substrate. Owing to the dynamic reversible hydrogen bonds existing between HA and bPEI, the crosslinked multilayered coatings possess fast, substantial, and cyclic self-healing capabilities leading to restoration of the original structure and functions. In vitro investigations reveal that the self-healing coatings have multiple functionalities pertaining to bacteria killing, cytocompatibility, osteogenesis, as well as angiogenesis. In addition, the self-healing coatings stimulate alkaline phosphatase activity (ALP), extracellular matrix (ECM) mineralization, and the expression of osteogenesis-related genes of mBMSCs and HUVECs. This study reveals a feasible strategy to design and prepare versatile self-healing coatings on Mg implants for biomedical applications.
Human‐in‐the‐loop: Human involvement in enhancing medical inquiry performance in large language models
Authors: Linping Shu, Qunshan He, Bing Yan, Di Wu, Menglin Wang, Chengshuo Wang, Luo Zhang
Journal: Allergy (2023)

The data that support the findings of this study are available from the corresponding author upon reasonable request. Figure S1. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Inborn errors of type I interferon immunity in patients with symptomatic acute hepatitis E
Authors: Ali Saadat, Jérôme Gouttenoire, Paolo Ripellino, David Semela, Soraya Amar, Beat M. Frey, Stefano Fontana, Elise Mdawar-Bailly, Darius Moradpour, Jacques Fellay, Montserrat Fraga
Journal: Hepatology (2023)

Background and Aims: The clinical spectrum of human infection by HEV ranges from asymptomatic to severe acute hepatitis. Furthermore, HEV can cause diverse neurological manifestations, especially Parsonage-Turner syndrome. Here, we used a large-scale human genomic approach to search for genetic determinants of severe clinical presentations of HEV infection. Approach and Results: We performed whole genome sequencing in 3 groups of study participants with PCR-proven acute HEV infection: (1) 24 patients with symptomatic acute hepatitis E; (2) 12 patients with HEV-associated Parsonage-Turner syndrome; and (3) 16 asymptomatic blood donors (controls). For variant calling and annotation, we used GATK4 best practices followed by Variant Effect Predictor (VEP) and Annovar. For variant classification, we implemented the American College of Medical Genetics and Genomics/Association for Molecular Pathology Bayesian classification framework in R. Variants with a probability of pathogenicity &gt;0.9 were considered damaging. We used all genes with at least 1 damaging variant as input for pathway enrichment analyses. We observed a significant enrichment of type I interferon response pathways in the symptomatic hepatitis group: 10 out of 24 patients carried a damaging variant in one of 9 genes encoding either intracellular viral sensors ( IFIH1 , DDX58 , TLR3 , POLR3B , POLR3C ) or other molecules involved in type I interferon response [interferon regulatory factor 7 ( IRF7 ), MYD88 , OAS3 , GAPDH ]. We did not find any enriched pathway in the Parsonage-Turner syndrome group or in the controls. Conclusions: Our results highlight the essential role of type I interferon in preventing symptomatic acute hepatitis E.
Association of Body Weight Time in Target Range With the Risk of Kidney Outcomes in Patients With Overweight/Obesity and Type 2 Diabetes Mellitus
Authors: Cheng Zu, Mengyi Liu, Xinyue Su, Yuanxiu Wei, Qiguo Meng, Chengzhang Liu, Ziliang Ye, Xiaoqin Gan, Yuanyuan Zhang, Panpan He, Chun Zhou, Fan Fan Hou, Xianhui Qin
Journal: Diabetes Care (2023)

OBJECTIVE We assessed the relationship of body weight time in target range (TTR) with composite kidney outcome in people with overweight/obesity and type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS Included in this study were 3,601 participants with baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 from the Look AHEAD (Action for Health in Diabetes) trial. Body weight TTR was defined as the proportion of time during the first 4 years that body weight was within the weight loss target (a weight loss of ≥7% from baseline). The primary outcome was composite kidney outcome, defined as eGFR decline ≥30% from baseline and to a level &amp;lt;60 mL/min/1.73 m2 at follow-up visit, or end-stage kidney disease. RESULTS During a median follow-up of 8.0 years, 435 cases of composite kidney outcome were documented. Body weight TTR during the first 4 years was inversely associated with the subsequent risk of composite kidney outcome (per SD increment; adjusted hazard ratio [HR] 0.81; 95% CI 0.70–0.93). Accordingly, the adjusted HRs (95% CI) of composite kidney outcome were 1.00 (reference), 0.73 (0.54–1.00), 0.71 (0.52–0.99), and 0.54 (0.36–0.80) for participants with body weight TTR of 0%, &amp;gt;0% to &amp;lt;29.9%, 29.9% to &amp;lt;69.7%, and 69.7% to &amp;lt;100%, respectively. Similar results were found for a doubling of the urine albumin to creatinine ratio (secondary outcome). CONCLUSIONS A higher body weight TTR, with a weight loss target of losing ≥7% of initial weight, was associated with a lower risk of kidney outcomes in participants with overweight/obesity and T2DM.