tbuckley/cabot-search huggingface dataset:
Urine-Xpert Ultra for the diagnosis of tuberculosis in people living with HIV: a prospective, multicentre, diagnostic accuracy study
Authors: Bianca Sossen, Rita Székely, Madalo Mukoka, Monde Muyoyeta, Elizabeth Nakabugo, Jerry Hella, Hung Van Nguyen, Sasiwimol Ubolyam, Berra Erkosar, Marcia Vermeulen, Chad M Centner, Sarah Nyangu, Nsala Sanjase, Mohamed Sasamalo, Huong Thi Dinh, The Anh Ngo, Weerawat Manosuthi, Supunnee Jirajariyavej, Nhung Viet Nguyen, Anchalee Avihingsanon, Andrew D Kerkhoff, Claudia M Denkinger, Klaus Reither, Lydia Nakiyingi, Peter MacPherson, Graeme Meintjes, Morten Ruhwald
Journal: The Lancet Global Health (2024)
Balloon guide catheters for endovascular thrombectomy in patients with acute ischaemic stroke due to large-vessel occlusion in China (PROTECT-MT): a multicentre, open-label, blinded-endpoint, randomised controlled trial
Authors: Jianmin Liu, Yu Zhou, Lei Zhang, Zifu Li, Wenhuo Chen, Yueqi Zhu, Xiaoxi Yao, Liyong Zhang, Shen Liu, Ya Peng, Ming Wei, Quanbin Zhang, Hansheng Shu, Shouchun Wang, Wenhua Liu, Shu Wan, Tong Li, Yibin Fang, Hongxing Han, Guang Zhang, Li'an Huang, Feng Wang, Guangsen Cheng, Lianbo Gao, Hongchao Shi, Jintao Han, Yun Luo, Shuai Li, Chuwei Cai, Rong Yin, Zhenglong Jin, Chengwei Shao, Bing Tian, Yongxin Zhang, Qiang Li, Yingying Zhang, Ping Zhang, Binben Li, Pengfei Xing, Hongjian Shen, Xuan Zhu, Xiaoxi Zhang, Weilong Hua, Fang Shen, Meihua Huyan, Rundong Chen, Qiao Zuo, Qiang Li, Qinghai Huang, Yi Xu, Benqiang Deng, Rui Zhao, Mayank Goyal, Yongwei Zhang, Pengfei Yang
Journal: The Lancet (2024)
Estimating dementia prevalence using remote diagnoses and algorithmic modelling: a population-based study of a rural region in South Africa
Authors: Meagan T Farrell, Darina T Bassil, Muqi Guo, M Maria Glymour, Ryan G Wagner, Stephen Tollman, Kenneth M Langa, Adam M Brickman, Jennifer J Manly, Lisa F Berkman
Journal: The Lancet Global Health (2024)
Diabetes in China part 2: prevention, challenges, and progress
Authors: Yu Xu, Jieli Lu, Mian Li, Tiange Wang, Kan Wang, Qiuyu Cao, Yi Ding, Yu Xiang, Siyu Wang, Qianqian Yang, Xuan Zhao, Xiaoyun Zhang, Min Xu, Weiqing Wang, Yufang Bi, Guang Ning
Journal: The Lancet Public Health (2024)
Diabetes in China part 1: epidemiology and risk factors
Authors: Yu Xu, Jieli Lu, Mian Li, Tiange Wang, Kan Wang, Qiuyu Cao, Yi Ding, Yu Xiang, Siyu Wang, Qianqian Yang, Xuan Zhao, Xiaoyun Zhang, Min Xu, Weiqing Wang, Yufang Bi, Guang Ning
Journal: The Lancet Public Health (2024)
Sensitivity and specificity of a seed amplification assay for diagnosis of multiple system atrophy: a multicentre cohort study
Authors: Yihua Ma, Carly M Farris, Sandrina Weber, Sebastian Schade, Hieu Nguyen, Alexandra Pérez-Soriano, Darly M Giraldo, Manel Fernández, Marta Soto, Ana Cámara, Celia Painous, Esteban Muñoz, Francesc Valldeoriola, Maria J Martí, Jordi Clarimon, Pekka Kallunki, Thong Chi Ma, Roy N Alcalay, Bárbara Fernandez Gomes, Kaj Blennow, Henrik Zetterberg, Julius Constantinescu, David Mengel, Vaibhavi Kadam, Piero Parchi, Kathrin Brockmann, Thomas F Tropea, Andrew Siderowf, Matthis Synofzik, Un Jung Kang, Yaroslau Compta, Per Svenningsson, Brit Mollenhauer, Luis Concha-Marambio
Journal: The Lancet Neurology (2024)
Genetic Carrier Screening — Call for a Global Mission
Authors: Lidewij Henneman
Journal: New England Journal of Medicine (2024)

The unexpected diagnosis of a severe autosomal recessive condition in a child is often the first moment that parents become aware of their risk of having a child with the condition. This was the case for Rachael and Jonathan Casella; spinal muscular atrophy was diagnosed in their daughter Mackenzie, who died at the age of 7 months. Carrier testing for recessive conditions is increasingly available to inform parents, even before pregnancy, of their risk of having a child with a genetic condition. Mackenzie's parents declared a mission to raise awareness and make carrier testing available to all prospective parents to . . .
Safety and Efficacy of Immunization with a Late-Liver-Stage Attenuated Malaria Parasite
Authors: Olivia A C Lamers, Blandine M D Franke-Fayard, Jan Pieter R Koopman, Geert V T Roozen, Jacqueline J Janse, Severine C Chevalley-Maurel, Fiona J A Geurten, Helena M de Bes-Roeleveld, Eva Iliopoulou, Emil Colstrup, Els Wessels, Geert-Jan van Gemert, Marga van de Vegte-Bolmer, Wouter Graumans, Thabitha R Stoter, Benjamin G Mordmüller, Emma L Houlder, Teun Bousema, Rajagopal Murugan, Matthew B B McCall, Chris J Janse, Meta Roestenberg
Journal: New England Journal of Medicine (2024)

BackgroundCurrently licensed and approved malaria subunit vaccines provide modest, short-lived protection against malaria. Immunization with live-attenuated Plasmodium falciparum malaria parasites is an alternative vaccination strategy that has potential to improve protection.MethodsWe conducted a double-blind, controlled clinical trial to evaluate the safety, side-effect profile, and efficacy of immunization, by means of mosquito bites, with a second-generation genetically attenuated parasite (GA2) — a mei2 single knockout P. falciparum NF54 parasite (sporozoite form) with extended development into the liver stage. After an open-label dose-escalation safety phase in which participants were exposed to the bites of 15 or 50 infected mosquitoes (stage A), healthy adults who had not had malaria were randomly assigned to be exposed to 50 mosquito bites per immunization of GA2, an early-arresting parasite (GA1), or placebo (bites from uninfected mosquitoes) (stage B). After the completion of three immunization sessions with 50 mosquito bites per session, we compared the protective efficacy of GA2 against homologous P. falciparum controlled human malaria infection with that of GA1 and placebo. The primary end points were the number and severity of adverse events (in stages A and B) and blood-stage parasitemia greater than 100 P. falciparum parasites per milliliter after bites from GA2-infected mosquitoes (in stage A) and after controlled human malaria infection (in stage B).Download a PDF of the Plain Language Summary.ResultsAdverse events were similar across the trial groups. Protective efficacy against subsequent controlled human malaria infection was observed in 8 of 9 participants (89%) in the GA2 group, in 1 of 8 participants (13%) in the GA1 group, and in 0 of 3 participants in the placebo group. A significantly higher frequency of P. falciparum–specific polyfunctional CD4+ and Vδ2+ γδ T cells were observed among participants who received GA2 than among those who received GA1, whereas GA2 and GA1 induced similar antibody titers targeting the P. falciparum circumsporozoite protein.ConclusionsIn this small trial, GA2 was associated with a favorable immune induction profile and protective efficacy, findings that warrant further evaluation. (Funded by the Bontius Foundation; ClinicalTrials.gov number, NCT04577066.) Quick Take Late-Liver-Stage Attenuated Malaria Vaccine 2m 30s
Climate Change, Floods, and Human Health
Authors: Yao Wu, Bo Wen, Danijela Gasevic, Jonathan A Patz, Andy Haines, Kristie L Ebi, Virginia Murray, Shanshan Li, Yuming Guo
Journal: New England Journal of Medicine (2024)

With climate change, exposure to floods has increased and is linked to adverse health outcomes, such as injuries, diseases, and mental health harms, all of which are greater in vulnerable populations.
Middle Meningeal Artery Embolization and Nonacute Subdural Hematoma
Authors: Peter Kan
Journal: New England Journal of Medicine (2024)

Nonacute subdural hematoma is common among older persons. With an aging population and increasing use of antiplatelet and anticoagulant agents, subdural hematoma is projected to become the most common cranial neurosurgical disease by 2030.1 Standard treatments — including glucocorticoids and statins for milder cases, with the addition of surgery for more severe cases — are associated with a high risk of recurrence, which leads to repeat surgery in 15% of cases.2,3 Hematoma progression or recurrence is thought to arise from repeated hemorrhage from the outer vascularized hematoma membrane under the dura, which is supplied by the middle meningeal artery. Embolization . . .
Susceptibility to Vaccine-Preventable Infections in Asylum Seekers
Authors: Christian Olivo-Freites, Patricia Miguez-Arosemena, Cristina Olivo-Freites, Deborah Edelman, Kayla Leschly, Jayme Leschly, Louise C. Ivers, Amir M. Mohareb
Journal: New England Journal of Medicine (2024)

In this report, serologic susceptibility to vaccine-preventable infections is assessed among U.S. asylum seekers.
Small-Bowel Obstruction and Intestinal Fistula from Accidental Ingestion of Magnets
Authors: Gaurav Prasad, Vishesh Jain
Journal: New England Journal of Medicine (2024)

An 18-month-old girl was evaluated for sudden-onset abdominal distention, diarrhea, and vomiting. An abdominal radiograph showed three circular radiopaque objects in the intestines and dilated loops of bowel.
Case 36-2024: A 16-Year-Old Girl with Abdominal Pain
Authors: Garrett C Zella, Ali Pourvaziri, Erica L Greenberg, Maureen M Leonard
Journal: New England Journal of Medicine (2024)

A 16-year-old girl was admitted to the hospital because of abdominal pain, nausea, and vomiting. Abdominal tenderness and guarding with palpation were present.
Diagnostic Complexity in Monoclonal Gammopathy of Thrombotic Significance
Authors: Adam J Kanack, Nelson Leung, Anand Padmanabhan
Journal: New England Journal of Medicine (2024)

A man with monoclonal gammopathy of undetermined significance and thrombosis was found to have a previously undetected pathogenic monoclonal antibody that activated platelets in a PF4-dependent manner.
Middle Meningeal Artery Embolization for Nonacute Subdural Hematoma
Authors: Jianmin Liu, Wei Ni, Qiao Zuo, Heng Yang, Ya Peng, Zhiqing Lin, Zhenbao Li, Jiyue Wang, Yong Zhen, Jing Luo, Yuanxiang Lin, Jian Chen, Xuming Hua, Hua Lu, Ming Zhong, Mingfa Liu, Jianmin Zhang, Yang Wang, Jieqing Wan, Yi Li, Tianxiao Li, Guohua Mao, Wenyuan Zhao, Liang Gao, Conghui Li, E Chen, Xin Cheng, Ping Zhang, Zigao Wang, Lei Chen, Yongxin Zhang, Bing Tian, Fang Shen, Yu Lei, Yina Wu, Yanjiang Li, Guoli Duan, Liquan Xu, Nan Lv, Jian Yu, Xiaolong Xu, Zhuoying Du, Hongjian Zhang, Jin Hu, Zifu Li, Qiang Yuan, Yu Zhou, Gang Wu, Lei Zhang, Chao Gao, Dongwei Dai, Xuehai Wu, Yongwei Zhang, Hanqiang Jiang, Rui Zhao, Jiabin Su, Yi Xu, Johanna Maria Ospel, Charles B L M Majoie, Mayank Goyal, Qiang Li, Pengfei Yang, Yuxiang Gu, Ying Mao
Journal: New England Journal of Medicine (2024)

BackgroundThe effect of embolization of the middle meningeal artery in patients with subacute or chronic subdural hematoma is uncertain.MethodsWe performed a multicenter, open-label, randomized trial in China, involving patients with symptomatic nonacute subdural hematoma with mass effect. Patients were assigned to undergo burr-hole drainage or receive nonsurgical treatment at the surgeon's discretion, and patients in each group were then randomly assigned, in a 1:1 ratio, to undergo middle meningeal artery embolization with liquid embolic material or to receive usual care. Patients whose condition warranted craniotomy were excluded. The primary outcome was symptomatic recurrence or progression of subdural hematoma within 90 days after randomization. Secondary outcomes included clinical and imaging outcomes. The main safety outcome was any serious adverse event (including death).Download a PDF of the Plain Language Summary.ResultsThe analysis included 722 patients, of whom 360 were assigned to the embolization group and 362 to the usual-care group. Burr-hole drainage was performed in 78.3% of the enrolled patients; among the patients who underwent burr-hole drainage, the procedure occurred after embolization in 99.6%. Symptomatic recurrence or progression of subdural hematoma within 90 days occurred in 24 patients (6.7%) in the embolization group and in 36 (9.9%) in the usual-care group (between-group difference, −3.3 percentage points; 95% confidence interval, −7.4 to 0.8; P=0.10). The incidence of serious adverse events was lower in the embolization group than in the usual-care group (6.7% vs. 11.6%, P=0.02).ConclusionsAmong patients with symptomatic nonacute subdural hematoma (of whom 78% underwent burr-hole drainage), middle meningeal artery embolization resulted in a 90-day incidence of symptomatic recurrence or progression similar to that with usual care but was associated with a lower incidence of serious adverse events. (Funded by Shanghai Shenkang Hospital Development Center and others; MAGIC-MT ClinicalTrials.gov number, NCT04700345.) Quick Take Meningeal Artery Embolization for Nonacute Subdural Hematoma 2m 6s
Reduced Aqueous Retinol-Binding Protein 3 Concentration Is Associated With Diabetic Macular Edema and Progression of Diabetic Retinopathy
Authors: Tanvi Chokshi, Ward Fickweiler, Surya Jangolla, Kyoungmin Park, I-Hsien Wu, Hetal Shah, Jennifer K. Sun, Lloyd Paul Aiello, George L. King
Journal: Diabetes Care (2024)

OBJECTIVE To evaluate the association of aqueous retinol-binding protein 3 (RBP3) with history of diabetic macular edema (DME) and diabetic retinopathy (DR) progression. RESEARCH DESIGN AND METHODS RBP3 concentration was measured by ELISA in aqueous from patients undergoing cataract surgery at Joslin Diabetes Center. DR progression was defined as two-step or more worsening on the Early Treatment Diabetic Retinopathy Study severity scale, and DME history was determined by clinical diagnosis. RESULTS In 153 eyes (31 with type 1 and 122 with type 2 diabetes; n = 149 patients), 37% had no signs of DR, 40% had mild nonproliferative DR (NPDR), and 23% had moderate NPDR. Aqueous RBP3 decreased from a median of 2.1 nmol/L (interquartile range 0.8–3.4) in eyes with no DR to 1.5 nmol/L (0.8–3.8) in eyes with mild-to-moderate NPDR (P = 0.047). The difference between aqueous RBP3 levels in those with type 1 or type 2 diabetes was not significant. Elevated RBP3 (β = −0.701, 95% CI −1.151 to 0.250, P = 0.002) was associated with no DME history. With a mean follow-up of 5.5 ± 3.6 years, elevated RBP3 at baseline was associated with less subsequent DR progression (odds ratio 0.51, 95% CI 0.28–0.93, P = 0.03). In multivariable analyses, RBP3 remained significantly associated with a DR progression and history of DME. A 5% improvement was seen in the area under the curve when RBP3 was added to clinical models for predicting DR progression (P &amp;lt; 0.05). CONCLUSIONS This study suggests that aqueous RBP3 may be an important protective factor, the first neuroretinal-specific biomarker of DME or DR progression, and a possible therapeutic target.
Systemic Therapy for Small Cell Lung Cancer: ASCO Guideline Rapid Recommendation Update
Authors: Gregory P. Kalemkerian, Humera Khurshid, Nofisat Ismaila, Humera Khurshid, Nofisat Ismaila, Jessica Bian, Raetasha Dabney, Millie Das, Peter Ellis, Jill Feldman, Christine L. Hann, Swati Kulkarni, Janessa Laskin, Rami Manochakian, Deebya Raj Mishra, Isabel Preeshagul, Pavan Reddy, Ashish Saxena, Frank Weinberg, Gregory P. Kalemkerian
Journal: Journal of Clinical Oncology (2024)

ASCO Rapid Recommendation Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual. The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options. Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only).
The quality and safety of using generative AI to produce patient-centred discharge instructions
Authors: Kristian Stanceski, Sharleen Zhong, Xumou Zhang, Sam Khadra, Marguerite Tracy, Linda Koria, Sarita Lo, Vasi Naganathan, Jinman Kim, Adam G. Dunn, Julie Ayre
Journal: npj Digital Medicine (2024)

Patient-centred instructions on discharge can improve adherence and outcomes. Using GPT-3.5 to generate patient-centred discharge instructions, we evaluated responses for safety, accuracy and language simplification. When tested on 100 discharge summaries from MIMIC-IV, potentially harmful safety issues attributable to the AI tool were found in 18%, including 6% with hallucinations and 3% with new medications. AI tools can generate patient-centred discharge instructions, but careful implementation is needed to avoid harms.
Digital image processing to detect adaptive evolution
Authors: Md Ruhul Amin, Mahmudul Hasan, Michael DeGiorgio
Journal: Molecular Biology and Evolution (2024)

In recent years, advances in image processing and machine learning have fueled a paradigm shift in detecting genomic regions under natural selection. Early machine learning techniques employed population-genetic summary statistics as features, which focus on specific genomic patterns expected by adaptive and neutral processes. Though such engineered features are important when training data are limited, the ease at which simulated data can now be generated has led to the recent development of approaches that take in image representations of haplotype alignments and automatically extract important features using convolutional neural networks. Digital image processing methods termed α-molecules are a class of techniques for multiscale representation of objects that can extract a diverse set of features from images. One such α-molecule method, termed wavelet decomposition, lends greater control over high-frequency components of images. Another α-molecule method, termed curvelet decomposition, is an extension of the wavelet concept that considers events occurring along curves within images. We show that application of these α-molecule techniques to extract features from image representations of haplotype alignments yield high true positive rate and accuracy to detect hard and soft selective sweep signatures from genomic data with both linear and nonlinear machine learning classifiers. Moreover, we find that such models are easy to visualize and interpret, with performance rivaling those of contemporary deep learning approaches for detecting sweeps.
Cost-Effectiveness of the National Diabetes Prevention Program: A Real-World, 2-Year Prospective Study
Authors: Shihchen Kuo, Wen Ye, Di Wang, Laura N. McEwen, Claudia Villatoro Santos, William H. Herman
Journal: Diabetes Care (2024)

OBJECTIVE We evaluated the real-world cost-effectiveness of the National Diabetes Prevention Program (NDPP) for people with prediabetes in a large workforce with employer-sponsored health insurance. RESEARCH DESIGN AND METHODS We performed difference-in-differences analyses using individual-level health insurance claims and survey data for 5,948 adults with prediabetes who enrolled (n = 575) or did not enroll (n = 5,373) in the NDPP to assess NDPP’s effects on health economic outcomes. We assessed direct medical costs for the year before the NDPP enrollment/index date and for 2 years thereafter; EuroQol 5-Dimension 5-level questionnaire (EQ-5D-5L) utility scores at baseline, 1 year, and 2 years; and quality-adjusted life-years (QALYs) over 2 years. We used propensity score weighting to adjust for potential bias due to self-selection for enrollment, multiple imputation to handle missing data, and bootstrapping to produce CIs. We adopted a health care sector perspective and discounted costs and QALYs at 3% annually. Costs were expressed in 2020 U.S. dollars. RESULTS Compared with nonenrollees, each NDPP enrollee had an average reduction of $4,552 (95% CI −13,231, 2,014) in 2-year total direct medical costs. Cost savings were primarily related to hospitalizations, outpatient visits, and emergency room visits. Compared with nonenrollees, each enrollee had no difference in EQ-5D-5L utility scores at 2 years or QALYs gained over 2 years. The uncertainty analyses found that enrollment in the NDPP had an 88% probability of saving money and 84% probability of being cost-effective at a willingness-to-pay threshold of $100,000/QALY-gained over 2 years. CONCLUSIONS In this real-world population with prediabetes, enrollment in the NDPP was likely to provide cost savings.
Projected Outcomes of Reduced-Biopsy Management of Grade Group 1 Prostate Cancer: Implications for Relabeling
Authors: Yibai Zhao, Roman Gulati, Zhenwei Yang, Lisa Newcomb, Yingye Zheng, Kehao Zhu, Menghan Liu, Eveline A M Heijnsdijk, Michael C Haffner, Matthew Cooperberg, Scott E Eggener, Angelo M De Marzo, Adam S Kibel, Dimitris Rizopoulos, Ingrid J Hall, Ruth Etzioni
Journal: JNCI Journal of the National Cancer Institute (2024)

Abstract Background Implications of relabeling grade group (GG) 1 prostate cancer as non-cancer will depend on the recommended active surveillance (AS) strategy. Whether relabeling should prompt de-intensifying, PSA-based active monitoring approaches is unclear. We investigated outcomes of biopsy-based AS strategies vs PSA-based active monitoring for GG1 diagnoses under different patient adherence rates. Methods We analyzed longitudinal PSA levels and time to GG ≥ 2 reclassification among 850 patients diagnosed with GG1 disease from the Canary Prostate Active Surveillance Study (2008-2013). We then simulated 20,000 patients over 12 years, comparing GG ≥ 2 detection under biennial biopsy against three PSA-based strategies:(1) PSA: biopsy for PSA change ≥20%/year, (2) PSA+MRI: MRI for PSA change ≥20%/year and biopsy for PI-RADS ≥3, and (3) Predicted risk: biopsy for predicted upgrading risk ≥10%. Results Under biennial biopsies and 20% dropout to active treatment, 17% of patients had a &amp;gt; 2-year delay in GG ≥ 2 detection. The PSA strategy reduced biopsies by 39% but delayed detection in 32% of patients. The PSA+MRI strategy cut biopsies by 52%, with a 34% delay. The predicted risk strategy reduced biopsies by 31%, with only an 8% delay. These findings are robust to biopsy sensitivity and confirmatory biopsy. Conclusions PSA-based active monitoring could substantially reduce biopsy frequency; however, a precision strategy based on an individual upgrading risk is most likely to minimize delays in disease progression detection. This strategy may be preferred if AS is deintensified under relabeling, provided patient adherence remains unaffected.