tbuckley/cabot-search huggingface dataset:
Association of Insulin Resistance With Cardiovascular Disease and All-Cause Mortality in Type 1 Diabetes: Systematic Review and Meta-analysis
Authors: Rui Sun, Jianxin Wang, Meng Li, Jingen Li, Yi Pan, Birong Liu, Gregory Y.H. Lip, Lijing Zhang
Journal: Diabetes Care (2024)

OBJECTIVE The association of insulin resistance (IR) with cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes (T1D) remains unclear. PURPOSE To investigate whether IR is associated with CVD and all-cause mortality among individuals with T1D. DATA SOURCES PubMed, Embase, and the Cochrane Library databases were searched from inception to 31 October 2023. STUDY SELECTION Observational studies reporting the associations between IR, as calculated by the estimated glucose disposal rate (eGDR), and the risk of CVD and all-cause mortality in individuals with T1D were eligible for inclusion. DATA EXTRACTION Data from eight selected studies were extracted, pooled by random-effects models, and results are presented as hazard ratios (95% CIs). DATA SYNTHESIS Eight studies involving 21,930 individuals were included, of which five studies involving 19,960 individuals with T1D reported the risk of CVD. During a median follow-up of 10 years, there were 2,149 cases of incident CVD. The pooled hazard ratio for composite CVD outcome per 1-unit increase in the eGDR index was 0.83 (95% CI 0.78–0.90, I2 = 58.9%). Five studies involving 19,403 individuals reported the risk of all-cause mortality. During a median follow-up of 10 years, 1,279 deaths were observed. The pooled hazard ratio for all-cause mortality per 1-unit increase in the eGDR index was 0.84 (95% CI 0.81–0.87, I2 = 0%). LIMITATIONS The small number of available studies restricted our ability to perform meta-regression analyses or more detailed subgroup analyses. CONCLUSIONS IR, as calculated by the eGDR, may be an additional risk factor for CVD and all-cause mortality in T1D.
Altered CD8<sup>+</sup>T cell subpopulation in the bone marrow microenvironment of cynomolgus monkeys with spontaneous ankylosing spondylitis
Authors: Tangming Guan, Zhenhua Bian, Hongbin Gao, Yi He, Junru Yuan, Hongping Wan, Shuangjie Tang, Yongfeng Li, Jianming Qiu, Panyue Luo, Xiaolan Ye, Shi Liang, Siyu Chen, Nvlue Cai, Yezhi Guan, Jianxin Liu, Zhibin Zhao, Huanhuan Jia, Wei Yang, Wende Li
Journal: Annals of the Rheumatic Diseases (2024)
Racial variability in immune responses only partially explains differential systemic sclerosis disease severity
Authors: Kamini E Kuchinad, Ji Soo Kim, Adrianne Woods, Gwen Leatherman, Laura Gutierrez-Alamillo, Maureen D Mayes, Robyn Domsic, Paula S Ramos, Richard M Silver, John Varga, Lesley Ann Saketkoo, Suzanne Kafaja, Victoria K Shanmugan, Jessica Gordon, Lorinda Chung, Elana J Bernstein, Pravitt Gourh, Francesco Boin, Daniel L Kastner, Scott L Zeger, Livia Casciola-Rosen, Fredrick M Wigley, Ami A Shah
Journal: Annals of the Rheumatic Diseases (2024)

Objective To understand if autoantibodies account for racial variation in disease severity, we compared autoantibody distribution and associated phenotype between self-identified black and white systemic sclerosis (SSc) patients. Methods 803 black and 2178 white SSc patients had systematic testing for autoantibodies using Euroimmun (centromere (ACA), RNA-polymerase III (POLR3), Scl70, PM/Scl, NOR90, Th/To, Ku, U3RNP and Ro52) and commercial ELISA (U1RNP). In this observational study, logistic regression was performed to assess the association between self-identified race and outcomes, adjusting for autoantibodies. To estimate whether the effect of race was mediated by autoantibody status, race coefficients from multivariate models including and excluding autoantibodies were compared. Results Anti-Scl70, anti-U1RNP, anti-U3RNP, anti-Th/To, anti-Ku and anti-NOR90 were more common in the black cohort than in the white cohort, which was enriched for ACA, anti-POLR3 and anti-PM/Scl. Black individuals had a higher prevalence of severe Raynaud’s, skin, lung, gastrointestinal and renal disease whereas white individuals had a higher prevalence of severe heart and muscle disease. Adjusting for autoantibodies decreased the effect of race on outcome for telangiectasias, forced vital capacity &lt;70%, pulmonary hypertension and severe lung, heart, muscle and gastrointestinal disease by 11%–44% and increased the association between race and renal crisis and severe kidney disease by 37%–52%. Conclusions This study is the largest systematic analysis of autoantibody responses in a geographically diverse population of black SSc patients. Black and white individuals with SSc have distinct autoantibody profiles. Autoantibodies explain only a fraction of the effect of race on clinical outcomes, suggesting other factors contribute to disparate outcomes between these groups.
Early identification of rheumatoid arthritis: does it induce treatment-related cost savings?
Authors: Elise van Mulligen, Maureen Rutten-van Mölken, Annette van der Helm-van Mil
Journal: Annals of the Rheumatic Diseases (2024)

Early diagnosis and treatment-start is key for rheumatoid arthritis (RA), but the economic effect of an early versus a later diagnosis has never been investigated. We aimed to investigate whether early diagnosis of RA is associated with lower treatment-related costs compared with later diagnosis.
Obituary – Professor Joseph Lau 1947—2024
Authors: R. David Rosin, Riaz Agha
Journal: International Journal of Surgery (2024)

Joseph Lau was a dedicated surgeon, an excellent teacher, and a prolific researcher. He held many high positions in Hong Kong, which included being Chairman of the Medical Council, Academician of the Chinese Academy of Sciences, the founding Master of Lee Woo Sing College at the Chinese University of Hong Kong and President of the College of Surgeons of Hong Kong. Professor Lau left a legacy of unparalleled dedication and service to the medical community of China and beyond. He was a world-renowned expert in hepato-, pancreatic-biliary surgery. The Medical Council of Hong Kong stated 'he served Council with total commitment and passion'. His unwavering dedication to the advancement of surgical knowledge and his profound impact on the lives of countless people will forever be revered. Here we given our reflections of working with this great man. Prof David Rosin I was fortunate to meet Joseph when he worked for Professor G.B. Ong at Queen Mary Hospital in Pokfulam, Hong Kong, as a visiting Senior Registrar in 1978. At that time, he was working at Queen Elizabeth Hospital, Kowloon, but he attended all the meetings with Prof Ong's team, and we became good friends. When appointed as a consultant to St. Mary's Hospital in London the following year, he came to visit on many occasions, always giving a superb lecture to the surgical staff. I would always see him and attend rounds when I visited Hong Kong. When I was invited to become Editor-in-Chief of the International Journal of Surgery, I quickly asked Joseph to become an editor. He did sterling work in this position. When I relinquished the position as Editor-in-Chief in 2017, I thought immediately that Joseph would be the perfect successor. He was better than perfect and had many great new ideas, especially as to how to improve our Impact Factor. He was far better at this than I had been, attracting high-class research papers. In his time as Editor-in-Chief, the Impact Factor climbed from 3.158 to 15.3. An amazing achievement and a 384% increase! Dr Riaz Agha Joseph was an exceptional Editor and led the IJS with distinction and to great success. He helped build our brand in China and worked like a machine to stay on top of the considerable workload the position involves over his nearly 6-year stewardship as Editor-in-Chief 2017–2023. He was a great source of personal support and a great mentor to me. I was always impressed by how he attended board meetings in London every year, flying in from Hong Kong and going back the same day – I never could persuade him to stay for dinner, such was his work ethic. The IJS will miss his wisdom, guidance, attention to detail and hard work, and we will miss a good friend and colleague. Ethical approval Not applicable. Consent Not applicable. Source of funding Not applicable. Author contribution Both helped write the article. Conflicts of interest disclosure The authors declare no conflicts of interest. Guarantor Riaz Agha. Data availability statement Not applicable. Provenance and peer review Not applicable.
Long-Term Kidney Outcomes after Pediatric Acute Kidney Injury
Authors: Cal H. Robinson, Nivethika Jeyakumar, Bin Luo, David Askenazi, Akash Deep, Amit X. Garg, Stuart Goldstein, Jason H. Greenberg, Cherry Mammen, Danielle M. Nash, Rulan S. Parekh, Samuel A. Silver, Lehana Thabane, Ron Wald, Michael Zappitelli, Rahul Chanchlani
Journal: Journal of the American Society of Nephrology (2024)

Key Points Among 4173 children with AKI, 18% had major adverse kidney events (death, kidney failure, or CKD) during a median 10-year follow-up. AKI survivors were at 2–4 times higher risk of major adverse kidney events, hypertension, and subsequent AKI versus matched hospitalized comparators. This justifies improved surveillance after pediatric AKI to detect CKD and hypertension early and improve long-term kidney health. Background AKI is common in hospitalized children. Pediatric AKI receiving acute KRT is associated with long-term CKD, hypertension, and death. We aim to determine the outcomes after AKI in children who did not receive acute KRT because these remain uncertain. Methods Retrospective cohort study of all hospitalized children (0–18 years) surviving AKI without acute KRT between 1996 and 2020 in Ontario, Canada, identified by validated diagnostic codes in provincial administrative health databases. Children with prior KRT, CKD, or AKI were excluded. Cases were matched with up to four hospitalized comparators without AKI by age, neonatal status, sex, intensive care unit admission, cardiac surgery, malignancy, hypertension, hospitalization era, and a propensity score for AKI. Patients were followed until death, provincial emigration, or censoring in March 2021. The primary outcome was long-term major adverse kidney events (a composite of all-cause mortality, long-term KRT, or incident CKD). Results We matched 4173 pediatric AKI survivors with 16,337 hospitalized comparators. Baseline covariates were well-balanced following propensity score matching. During a median 9.7-year follow-up, 18% of AKI survivors developed long-term major adverse kidney event versus 5% of hospitalized comparators (hazard ratio [HR], 4.0; 95% confidence interval [CI], 3.6 to 4.4). AKI survivors had higher rates of long-term KRT (2% versus &lt;1%; HR, 11.7; 95% CI, 7.5 to 18.4), incident CKD (16% versus 2%; HR, 7.9; 95% CI, 6.9 to 9.1), incident hypertension (17% versus 8%; HR, 2.3; 95% CI, 2.1 to 2.6), and AKI during subsequent hospitalization (6% versus 2%; HR, 3.7; 95% CI, 3.1 to 4.5), but no difference in all-cause mortality (3% versus 3%; HR, 0.9; 95% CI, 0.7 to 1.1). Conclusions Children surviving AKI without acute KRT were at higher long-term risk of CKD, long-term KRT, hypertension, and subsequent AKI versus hospitalized comparators.
A Urine pH-Ammonium Acid/Base Score and CKD Progression
Authors: Samuel Levi Svendsen, Amalie Quist Rousing, Rasmus Kirkeskov Carlsen, Dinah Khatir, Danny Jensen, Nikita Misella Hansen, Louise Salomo, Henrik Birn, Niels Henrik Buus, Jens Leipziger, Mads Vaarby Sorensen, Peder Berg
Journal: Journal of the American Society of Nephrology (2024)

Key Points This study developed a urine acid/base score to assess tubular acid excretion capacity and identify early acid retention in CKD. The results show that early signs of acid retention (a low acid/base score) are associated with a higher risk for CKD progression. Future research should address if a low urine acid/base score can be improved and if this translates into clinically meaningful effects. Background Acidosis is associated with exacerbated loss of kidney function in CKD. Currently, acid/base status is assessed by plasma measures, although organ-damaging covert acidosis, subclinical acidosis, may be present before reflected in plasma. Low urine NH 4 + excretion associates with poor kidney outcomes in CKD and is proposed as a marker for subclinical acidosis. However, low NH 4 + excretion could result from either a low capacity or a low demand for acid excretion. We hypothesized that a urine acid/base score reflecting both the demand and capacity for acid excretion would better predict CKD progression. Methods Twenty-four–hour urine collections were included from three clinical studies of patients with CKD stage 3 and 4: a development cohort ( N =82), a variation cohort ( N =58), and a validation cohort ( N =73). A urine acid/base score was derived and calculated from urinary pH and [NH 4 + ]. Subclinical acidosis was defined as an acid/base score below the lower limit of the 95% prediction interval of healthy controls. The main outcomes were change in measured GFR after 18 months and CKD progression (defined as ≥50% decline in eGFR, initiation of long-term dialysis, or kidney transplantation) during up to 10 years of follow-up. Results Subclinical acidosis was prevalent in all cohorts ( n =54/82, 48/73, and 40/58, respectively, approximately 67%). Subclinical acidosis was associated with an 18% (95% confidence interval [CI], 2 to 32) larger decrease of measured GFR after 18 months. During a median follow-up of 6 years, subclinical acidosis was associated with a higher risk of CKD progression. Adjusted hazard ratios were 9.88 (95% CI, 1.27 to 76.7) in the development cohort and 11.1 (95% CI, 2.88 to 42.5) in the validation cohort. The acid/base score had a higher predictive value for CKD progression than NH 4 + excretion alone. Conclusions Subclinical acidosis, defined by a new urine acid/base score, was associated with a higher risk of CKD progression in patients with CKD stage 3 and 4.
Defining Death: Toward a Biological and Ethical Synthesis
Authors: John P. Lizza, Christos Lazaridis, Piotr G. Nowak
Journal: The American Journal of Bioethics (2024)

Much of the debate over the definition and criteria for determining our death has focused on disagreement over the correct biological account of death, i.e., what it means for any organism to die. In this paper, we argue that this exclusive focus on the biology of death is misguided, because it ignores ethical and social factors that bear on the acceptability of criteria for determining our death. We propose that attention shift from strictly biological considerations to ethical and social considerations that bear on the determination of what we call "civil death." We argue for acceptance of a neurological criterion for determining death on grounds that it is the most reasonable way to synthesize biological, ethical, and social considerations about our death..
Selonsertib in Patients with Diabetic Kidney Disease
Authors: Hiddo J.L. Heerspink, Vlado Perkovic, Katherine R. Tuttle, Pablo E. Pergola, Kenneth W. Mahaffey, Uptal D. Patel, Julie H. Ishida, Albert Kuo, Fang Chen, Robert Kustra, Vladimir Petrovic, Peter Rossing, Naoki Kashihara, Glenn M. Chertow
Journal: Journal of the American Society of Nephrology (2024)

Selonsertib is an apoptosis signal-regulating kinase 1 inhibitor that reduces inflammation, fibrosis, and apoptosis. The MOSAIC study evaluated whether selonsertib attenuated kidney function decline in patients with diabetic kidney disease.
Outcomes in Critically Ill Allogeneic Hematopoietic Stem-Cell Transplantation Recipients
Authors: Antoine Lafarge, Thibault Dupont, Emmanuel Canet, Anne-Sophie Moreau, Muriel Picard, Djamel Mokart, Laura Platon, Julien Mayaux, Florent Wallet, Nahema Issa, Jean-Herlé Raphalen, Frédéric Pène, Anne Renault, Régis Peffault de la Tour, Christian Récher, Patrice Chevallier, Lara Zafrani, Michael Darmon, Naike Bigé, Elie Azoulay
Journal: American Journal of Respiratory and Critical Care Medicine (2024)

Allogeneic hematopoietic stem-cell transplantation (Allo-HSCT) recipients are still believed to be poor candidates for ICU management.
PIKing up and AKTing on resistance mutations in osimertinib-treated EGFR-mutated NSCLC
Authors: Natalie I. Vokes, Xiuning Le, Timothy A. Yap
Journal: Clinical Cancer Research (2024)

A recent study identified high rates of PI3K-AKT pathway mutations from the FLAURA and AURA3 osimertinib trials and pre-clinically validated that these mutations decreased osimertinib sensitivity in EGFR-mutated non-small cell lung cancer. The AKT inhibitor capivasertib was found to overcome this resistance, providing an important rationale for the development of AKT inhibitors in non-small cell lung cancer. See related article by Grazini et al., p. 4143.
Liver resection had better disease-free survival rates compared with radiofrequency ablation in hepatocellular carcinoma: A meta-analysis based on randomized clinical trials
Authors: Yee-Hui Yeo, Yi-No Kang, Chiehfeng Chen, Teng-Yu Lee, Chun-Chieh Yeh, Tsai-Wei Huang, Chun-Ying Wu
Journal: International Journal of Surgery (2024)

Background: Liver resection (LR) and radiofrequency ablation (RFA) are the most commonly used treatment modalities for early-stage hepatocellular carcinoma (ES-HCC). The comparative efficacy of LR and RFA in ES-HCC remains debated. The authors conducted a meta-analysis based on randomized trials to compare the outcomes of LR and RFA. Methods: The authors searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing RFA and LR interventions for the treatment of ES-HCC. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The authors used meta-regression to determine the source of heterogeneity and conducted a trial sequential analysis to examine whether the outcome was statistically reliable. Results: Our meta-analysis included nine RCTs with a total of 1516 HCC patients. Compared with patients receiving RFA, those receiving LR did not have significantly different 2-year OS (HR=1.28, 95% CI: 0.73–2.23) and 5-year OS (HR=1.49, 95% CI: 0.99–2.24). However, patients receiving LR showed a favorable trend in 2-year DFS (HR=1.40, 95% CI: 1.16–1.69) and 5-year DFS (HR=1.37; 95% CI: 1.05–1.77), although these results are not conclusive due to underpowered significance. The heterogeneity was low, and the outcomes were statistically reliable. Discussion: Meta-analysis suggests that while LR shows a favorable trend in DFS compared to RFA for ES-HCC, the present evidence does not thoroughly support recommending LR over RFA. The inconclusive nature of these findings highlights the need for further large-scale RCTs to establish definitive comparative efficacy.
Oncological survival in pancreatic head ductal carcinoma: hybrid minimally invasive versus open pancreatoduodenectomy - a single centre analysis
Authors: Johannes D. Lettner, Simon Kuesters, Stefan Fichtner-Feigl, Esther A. Biesel, Sophia Chikhladze, Uwe A. Wittel
Journal: International Journal of Surgery (2024)

Surgery remains the only curative treatment option for pancreatic head cancer. Laparoscopic surgical techniques are increasingly used, in line with the development of visceral surgery as a whole. The success of surgery is measured by the oncological outcome. Aim of this study is to evaluate the oncological outcome and survival after laparoscopic assisted resection of the pancreatic head compared to open surgery for ductal adenocarcinoma.
Author Response: Deep learning-assisted detection and segmentation of intracranial hemorrhage in noncontrast computed tomography scans of acute stroke patients: a systematic review and meta-analysis
Authors: Ping Hu, Tengfeng Yan, Hongxing Shu, Xingen Zhu
Journal: International Journal of Surgery (2024)

aDepartment of Neurosurgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University bInstitute of Neuroscience, Nanchang University cJiangxi Key Laboratory of Neurological Tumors and Cerebrovascular Diseases dJiangxi Health Commission Key Laboratory of Neurological Medicine, Nanchang, Jiangxi eDepartment of Neurosurgery, Panzhihua Central Hospital, Panzhihua, Sichuan, People's Republic of 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 Neurosurgery, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang City 330006, Jiangxi Province, People's Republic of China. E-mail: [email protected] (P. Hu). 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/
Associations of biological age accelerations and genetic risk with incident endometrial cancer: a prospective analysis in UK Biobank
Authors: Ziye Yang, Yufei Shen, Tongtong Zhang, Xiaolin Tang, Rui Mao
Journal: International Journal of Surgery (2024)

Endometrial cancer (EC) is one of the gynecologic malignancy cancer with increasing incidence and mortality rates, partly due to aging populations and genetic risks. This study explores the associations between biological age accelerations (BAA) and risk of incident EC and assesses the joint effect of genetic factor and BAA.
Assessing and evaluating the impact of operative vision compromise (OViC) on surgeons’ practice – a qualitative study
Authors: Ahmad Nabeel, Salman Al-Sabah, Khalifa Al-Ghanim, Dalal Al-Roumi, Dana Al-Basri, Ali Ziyab, Hutan Ashrafian
Journal: International Journal of Surgery (2024)

Assessing the effects of compromised vision in laparoscopic and robotic procedures is crucial to understanding its impact on surgical practice and patient safety. Our aim was to examine the impact of operative vision compromise (OViC) on surgeons' practice.
Treatment of posterolateral tibial plateau fractures: a narrative review and therapeutic strategy
Authors: Chen-Dong Liu, Sun-Jun Hu, Shi-Min Chang, Shou-Chao Du, Yong-Qian Chu, Yi-Ming Qi, Hao-Tao Li, Wei Mao
Journal: International Journal of Surgery (2024)

The posterolateral tibial plateau is crucial for maintaining knee stability during flexion, and fractures in this area often involve ligament and meniscus injuries, necessitating effective management. However, treating posterolateral tibial plateau fractures (PLF) poses significant challenges due to the complex anatomy. Therefore, this review aims to explore contemporary concepts of PLF, from identification to fixation, and proposes a comprehensive treatment strategy. In this article, the authors detail the injury mechanisms, fracture morphology, PLF classification systems, surgical approaches, and techniques for open reduction and internal fixation (ORIF) as well as arthroscopic-assisted internal fixation (ARIF). The findings indicate that PLF is typically caused by flexion-valgus forces, resulting in depression or split-depression patterns. For isolated PLF, the supra-fibular head approach is often preferable, whereas posterior approaches are more suitable for combined fractures. Additionally, innovative plates, particularly the horizontal belt plate, have shown satisfactory outcomes in treating PLF. Currently, the 'bicondylar four-quadrant' concept is widely used for assessing and managing the tibial plateau fractures involving PLF, forming the cornerstone of the comprehensive treatment strategy. Despite challenges in surgical exposure and implant placement, ORIF remains the mainstream treatment for PLF, benefiting significantly from the supra-fibular head approach and the horizontal belt plate. Furthermore, ARIF has proven effective by providing enhanced visualization and surgical precision in managing PLF, emerging as a promising technique.