tbuckley/cabot-search huggingface dataset:
Barriers to Optimal Clinician Guideline Adherence in Management of Markedly Elevated Blood Pressure
Authors: Yuan Lu, Oreoluwa Arowojolu, Xiaoliang Qiu, Yuntian Liu, Leslie A. Curry, Harlan M. Krumholz
Journal: JAMA Network Open (2024)

IMPORTANCE Hypertension poses a substantial public health challenge. Despite clinical practice guidelines for hypertension management, clinician adherence to these guidelines remains suboptimal. OBJECTIVE To develop a taxonomy of suboptimal adherence scenarios for severe hypertension and identify barriers to guideline adherence. DESIGN, SETTING, and PARTICIPANTS This qualitative content analysis using electronic health records (EHRs) of Yale New Haven Health System included participants who had at least 2 consecutive visits with markedly elevated blood pressure (BP; defined as at least 2 consecutive readings of systolic BP ≥160 mm Hg and diastolic BP ≥100 mm Hg) between January 1, 2013, and December 31, 2021, and no prescription for antihypertensive medication within a 90 days of the second BP measurement. Data analysis was conducted from January to December 2023. MAIN OUTCOMES AND MEASURES The primary outcome was scenarios and influencing factors contributing to clinician nonadherence to the guidelines for hypertension management. A thematic analysis of EHR data was conducted to generate a pragmatic taxonomy of scenarios of suboptimal clinician guideline adherence in the management of severe hypertension. RESULTS Of the 20 654 patients who met criteria, 200 were randomly selected and thematic saturation was reached after analyzing 100 patients (mean [SD] age at index visit, 66.5 [12.8] years; 50 female [50%]; 8 Black [8%]; 5 Hispanic or Latino [5%]; 85 White [85%]). Three content domains emerged: (1) clinician-related scenarios (defined as noninitiation or nonintensification of treatment due to issues relating to clinician intention, capability, or scope), which included 2 subcategories (did not address and diffusion of responsibility); (2) patient-related scenarios (defined as noninitiation or nonintensification of treatment due to patient behavioral considerations), which included 2 subcategories (patient nonadherence and patient preference); and (3) clinical complexity–related scenarios (defined as noninitiation or nonintensification of treatment due to clinical situational complexities), which included 3 subcategories (diagnostic uncertainty, maintenance of current intervention, and competing medical priorities). CONCLUSIONS AND RELEVANCE In this qualitative study of EHR data, a taxonomy of suboptimal adherence scenarios for severe hypertension was developed and barriers to guideline adherence were identified. This pragmatic taxonomy lays the foundation for developing targeted interventions to improve clinician adherence to guidelines and patient outcomes.
Ongoing expansion of journal activities to meet the needs of stakeholders
Authors: Susan M Chang
Journal: Neuro-Oncology (2024)

Journal Article Ongoing expansion of journal activities to meet the needs of stakeholders Get access Susan M Chang, M.D Susan M Chang, M.D University of California at San Francisco, Department of Neurological Surgery, 505 Parnassus Ave., M774, San Francisco, CA 94143-0112, UNITED STATES University of California at San Francisco, Department of Neurological Surgery, 505 Parnassus Ave., M774, San Francisco, CA 94143-0112, UNITED STATES, 415-353-2270, FAX: 415-353-2167 (S.M.C) Susan.Chang@ucsf.edu Search for other works by this author on: Oxford Academic PubMed Google Scholar Neuro-Oncology, Volume 26, Issue 8, August 2024, Pages 1353–1354, https://doi.org/10.1093/neuonc/noae117 Published: 05 August 2024
Electrohydraulic lithotripsy: a safe and effective technique to retrieve an impacted Dormia basket
Authors: Sébastien Carbillet, Franck Brazier, Mathurin Fumery, Clara Yzet
Journal: Endoscopy (2024)

Choledocholithiasis is a common indication for endoscopic retrograde cholangiopancreatography (ERCP). Mechanical lithotripsy is a frequently used technique for the extraction of complex common bile duct (CBD) stones; however, impaction of the Dormia basket around a large stone and fracture of Dormia basket wires have been described in up to 6% of procedures [1] [2] [3]. This complication is one of the most challenging to treat, often requiring endoscopic, percutaneous, or surgical intervention, with a risk of morbidity and mortality.
Computational Strategies and Algorithms for Inferring Cellular Composition of Spatial Transcriptomics Data
Authors: Xiuying Liu, Xianwen Ren
Journal: Genomics Proteomics & Bioinformatics (2024)

Abstract Spatial transcriptomics technology has been an essential and powerful method for delineating tissue architecture at the molecular level. However, due to the limitations of the current spatial techniques, the cellular information cannot be directly measured but instead spatial spots typically varying from a diameter of 0.2 to 100 µm are characterized. Therefore, it is vital to apply computational strategies for inferring the cellular composition within each spatial spot. The main objective of this review is to summarize the most recent progresses in estimating the exact cellular proportions for each spatial spot, and to prospect the future directions of this field.
Rectal endoscopic full-thickness resection of peritoneal loose body
Authors: Minyuan Yang, Jinfeng Ren, Zhengying Yang, Xihui Yuan, Tianyu Liu
Journal: Endoscopy (2024)

A 36-year-old woman presented with recurrent lower abdominal pain for 6 months. Abdominal contrast-enhanced computed tomography (CT) showed a 1.2-mm enhancing lesion in the upper rectum ([Fig. 1]). Intestinal endoscopy revealed a 1.5 × 1.2-cm rectal mass located 15 cm from the anal dentate line ([Fig. 2]). Mucosal biopsy indicated mild chronic inflammation. Endoscopic ultrasonography revealed a 2.2-cm submucosal lesion with an intact mucosal layer ([Fig. 3]). After obtaining consent from the patient, submucosal tumor endoscopic resection was planned, but formation of the liquid pad by injection proved difficult. The margins of the lesion on the mucosal surface were marked using electrocoagulation ([Fig. 4]). After obtaining a second consent, rectal endoscopic full-thickness resection was performed ([Video 1]). A balloon catheter was placed in the sigmoid colon to block fecal matter. An endoscopic mucotomy knife (KD-650Q; Micro-Tech Co., Ltd., Nanjing, China) was used to incise the marked mucosa until an orifice formed. Then, an IT knife (KD-650L; Micro-Tech Co., Ltd.) was used to incise the full thickness around the lesion. After inspecting the outer intestinal wall fascia, an endoscopic electrified snare was used to dissect the lesion into two sections. The defect in the rectal wall was sutured using three three-armed clips (STA00002; Micro-Tech Co., Ltd.) and several titanium clips (ROCC-D-26–195-C; Micro-Tech Co., Ltd.). Histological examination of the biopsy specimen showed chronic submucosal inflammation with foam cell reaction and no abnormal cells at the horizontal and vertical margins. During the operation, no gas entered the abdominal cavity, all abdominopelvic cavity organs remained unaffected, and there was minimal bleeding. Follow-up after 6 weeks showed no residual mass on contrast-enhanced CT, with only scars and two clips at the junction site observed.
Will computer-aided detection of polyps decrease colorectal cancer incidence and mortality?
Authors: Uri Ladabaum
Journal: Endoscopy (2024)

Artificial intelligence (AI) is arriving with great fanfare across all human endeavors. Some applications will fulfill their promises, and some will disappoint. It remains to be seen whether computer-aided detection (CADe) of polyps will deliver decreases in colorectal cancer (CRC) incidence and mortality.
Underwater endoscopic mucosal resection for circumferential adenoma of the ileocecal valve
Authors: Masakatsu Fukuzawa, Sakiko Naito, Takashi Morise, Yasuyuki Kagawa, Takahiro Muramatsu, Takashi Kawai, Takao Itoi
Journal: Endoscopy (2024)

Underwater endoscopic mucosal resection (UEMR), which was first described by Binmoeller et al. [1], is an endoscopic procedure that reduces the risk of perforation by using buoyancy to maintain a distance from the muscularis propria. Although the en bloc resection rate for UEMR is lower than that for endoscopic submucosal dissection (ESD) for tumors of 20–30 mm in diameter, it has similar local recurrence rates, shorter procedure times, and fewer intraoperative and postoperative adverse events [2].
Removal of obstructed pancreatic stent tube and biliary stones in patient with Roux-en-Y anatomy under direct endoscopic view
Authors: Jingjing Yao, Shengxue Pan, Hongbo Li, Kunpeng Liu, Guangyao Zhao, Jindong Fu
Journal: Endoscopy (2024)

A 42-year-old man was admitted due to upper abdominal pain for 2 hours. He had undergone a pancreaticoduodenectomy for a pancreatic tumor with a Roux-en-Y anastomosis 3 years earlier. Over the past year, he had experienced recurrent episodes of acute pancreatitis. Abdominal computed tomography scans revealed high-density images at the terminus of the pancreatic stent tube and the hilar bile duct ([Fig. 1]). Stent obstruction was suspected and endoscopic removal was performed ([Video 1]).
Combined endoscopic drainage for afferent loop obstruction and bilioenteric anastomosis stricture in a patient after pancreatoduodenectomy
Authors: Tingting Yu, Suning Hou, Hongfei He, Yaoting Li, Lichao Zhang, Jiao Tian, Senlin Hou
Journal: Endoscopy (2024)

Tumor recurrence is a common cause of bilioenteric anastomosis stricture or afferent loop obstruction (ALO) in patients who have undergone pancreaticoduodenectomy. Endoscopic management in ALO included enteroscopy-assisted luminal stenting with a self-expanding metal stent or plastic stents and endoscopic ultrasound (EUS)-guided enteroenterostomy with a lumen-apposing metal stent [1] [2]. In addition, the bridge technique for drainage of the right liver across the left liver through hepaticogastrostomy (HGS) is feasible [3] [4]. We describe a case of concurrent ALO and bilioenteric anastomosis stricture in a patient who received the above two endoscopic treatments.
Which is cheaper: a fully covered metallic stent or a choledochoscope?
Authors: Liang-Hao Hu, Ping-Ping Zhang, Ting Yang, Yan-Wei Lv
Journal: Endoscopy (2024)

Benign biliary obstruction may occur in patients with chronic pancreatitis [1] [2]. Endoscopic placement of a fully covered self-expandable metallic stent (FCSEMS) for biliary drainage is an effective treatment strategy for biliary obstruction [3]. However, the migration rate of FCSEMSs is approximately 10% to 33% [4] [5]. We report successfully repositioning a dislocated biliary FCSEMS using a choledochoscope.
Mantis-like claw clip as a rescue therapy for the closure of an unexpected cricopharyngeal mucosal tear during peroral endoscopic myotomy
Authors: Oscar V. Hernández Mondragón, Julio Gil Ferral Mejia
Journal: Endoscopy (2024)

The closure of an inadvertent mucosal defect during a third-space procedure is mandatory to avoid severe adverse events [1]. Multiple closure methods have been described (endoscopic clips, suture device, cyanoacrylate, over-the-scope [OTS] clip, etc.), with excellent outcomes [2]. However, some anatomic areas such as the cricopharynx can be difficult to close. A recently released mantis-like claw clip named Mantis clip (Boston Scientific, Marlborough, Massachusetts, USA) has shown excellent outcomes in the closure of gastrointestinal defects less than 30mm in size [3] and fixation of esophageal stents [4], even in patients with a high risk of bleeding [5].
Interpreting studies comparing lumen-apposing metal stents and plastic stents for walled-off necrosis: wisdom is the need of the hour
Authors: Shyam Varadarajulu
Journal: Endoscopy (2024)

Lumen-apposing metal stents (LAMSs) are being increasingly used for the drainage of walled-off necrosis (WON). It was postulated that their placement, compared with plastic stents, is technically easier, decreases the need for necrosectomy, lowers adverse events, enables faster disease resolution, and is potentially more cost effective. However, with the exception of shorter procedural duration, other perceived advantages have not been borne out in randomized trials [1].
Predicting ERCP procedure time – the SWedish Estimation of ERCP Time (SWEET) tool
Authors: Alexander Waldthaler, Anna Warnqvist, Josefine Waldthaler, Miroslav Vujasinovic, Poya Ghorbani, Erik von Seth, Urban Arnelo, Mathias Lohr, Annika Bergquist
Journal: Endoscopy (2024)

Abstract Background: The duration of an endoscopic retrograde cholangiopancreatography (ERCP) is influenced by a multitude of factors. The aim of this study was to describe the factors influencing ERCP time and to create a tool for preintervention estimation of ERCP time. Methods: Data from 74 248 ERCPs performed from 2010 to 2019 were extracted from the Swedish National Quality Registry (GallRiks) to identify variables predictive for ERCP time using linear regression analyses and root mean squared error (RMSE) as a loss function. Ten variables were combined to create an estimation tool for ERCP duration. The tool was externally validated using 9472 ERCPs from 2020 to 2021. Results: Mean (SD) ERCP time was 36.8 (25.3) minutes. Indications with the strongest influence on ERCP time were primary sclerosing cholangitis and chronic pancreatitis. Hilar and intrahepatic biliary strictures and interventions on the pancreatic duct were the anatomic features that most strongly affected ERCP time. The procedure steps with most influence were intraductal endoscopy, lithotripsy, dilation, and papillectomy. Based on these results, we built and validated the Swedish Estimation of ERCP Time (SWEET) tool, which is based on a 10-factor scoring system (e.g. 5 minutes for bile duct cannulation and 15 minutes for pancreatic duct cannulation) and predicted ERCP time with an average difference between actual and predicted duration of 17.5 minutes during external validation. Conclusions: Based on new insights into the factors affecting ERCP time, we created the SWEET tool, the first specific tool for preintervention estimation of ERCP time, which is easy-to-apply in everyday clinical practice, to guide efficient ERCP scheduling.
Antral early gastric neoplasm with severe oral scarring successfully treated by endoscopic submucosal dissection using retroflex approach and a novel, thin therapeutic endoscope
Authors: Ryohei Maruoka, Mitsuru Esaki, Yosuke Minoda, Mei Tadokoro, Kazuhiro Haraguchi, Haruei Ogino, Eikichi Ihara
Journal: Endoscopy (2024)

Endoscopic submucosal dissection (ESD) for early gastric neoplasms (EGNs) may be associated with challenges. A recently developed endoscope (EG-840TP; Fujifilm Co., Tokyo, Japan), with a thinner outer diameter (7.9 mm) that is equipped with a waterjet function and a large channel (3.2 mm), facilitates easy cleaning and suction without device restrictions during therapeutic procedures [1] [2] [3] [4]. The small radius of curvature enables the procedure to be performed in the retroflex view and in a narrow space ([Fig. 1], [Fig. 2]). Herein, we describe a case of antral EGN with severe oral scarring following ESD that was successfully treated by ESD using the retroflex approach and the thin therapeutic endoscope ([Video 1]).
Endoscopic direct therapy for appendicitis and diverticulitis in one patient with right-sided abdominal pain
Authors: Jianzhen Ren, Silin Huang, Jun Cai, Bo Li, Guang Yang, Suhuan Liao, Ronggang Zhang
Journal: Endoscopy (2024)

Acute appendicitis and cecal diverticulitis are both common causes of acute right-sided abdominal pain, but it is extremely rare for both to be found in one patient. Acute appendicitis and diverticulitis are mainly treated through medication and surgical intervention [1] [2]. Digital single-operator cholangioscopy (dSOC) has proven effective for managing inflammation in natural conduits such as the bile duct, pancreatic duct, and appendix [3] [4]. Herein, we present endoscopic direct therapy for appendicitis and diverticulitis in a man with right-sided abdominal pain ([Video 1]).
The association of adverse birth outcomes with flood exposure before and during pregnancy in Australia: a cohort study
Authors: Zhengyu Yang, Wenzhong Huang, Joanne E McKenzie, Pei Yu, Yao Wu, Rongbin Xu, Tingting Ye, Ke Ju, Yiwen Zhang, Yujia Huang, Yuming Guo, Shanshan Li
Journal: The Lancet Planetary Health (2024)
Ebola virus disease mathematical models and epidemiological parameters: a systematic review
Authors: Rebecca K Nash, Sangeeta Bhatia, Christian Morgenstern, Patrick Doohan, David Jorgensen, Kelly McCain, Ruth McCabe, Dariya Nikitin, Alpha Forna, Gina Cuomo-Dannenburg, Joseph T Hicks, Richard J Sheppard, Tristan Naidoo, Sabine van Elsland, Cyril Geismar, Thomas Rawson, Sequoia Iris Leuba, Jack Wardle, Isobel Routledge, Keith Fraser, Natsuko Imai-Eaton, Anne Cori, H Juliette T Unwin
Journal: The Lancet Infectious Diseases (2024)
Quantifying urban park use in the USA at scale: empirical estimates of realised park usage using smartphone location data
Authors: Michael T Young, Swapnil Vispute, Stylianos Serghiou, Akim Kumok, Yash Shah, Kevin J Lane, Flannery Black-Ingersoll, Paige Brochu, Monica Bharel, Sarah Skenazy, Alan Karthikesalingam, Shailesh Bavadekar, Mansi Kansal, Tomer Shekel, Evgeniy Gabrilovich, Gregory A Wellenius
Journal: The Lancet Planetary Health (2024)
Effects of global change on snakebite envenoming incidence up to 2050: a modelling assessment
Authors: Gerardo Martín, Joseph James Erinjery, Dileepa Ediriweera, Eyal Goldstein, Ruchira Somaweera, H Janaka de Silva, David G Lalloo, Takuya Iwamura, Kris A Murray
Journal: The Lancet Planetary Health (2024)
Diet or optimised medical therapy for people with irritable bowel syndrome – Authors' reply
Authors: Sanna Nybacka, Hans Törnblom, Axel Josefsson, Johann P Hreinsson, Lena Böhn, Åsa Frändemark, Cecilia Weznaver, Stine Störsrud, Magnus Simrén
Journal: The Lancet. Gastroenterology & hepatology (2024)
Guiding principles for the next generation of health-care sustainability metrics
Authors: Matthew J Eckelman, Ulli Weisz, Peter-Paul Pichler, Jodi D Sherman, Helga Weisz
Journal: The Lancet Planetary Health (2024)

Metrics for health-care sustainability are crucial for tracking progress and understanding the advantages of different operations or systems as the health-care sector addresses the climate crisis and other environmental challenges. Measurement of the key metrics of absolute energy use and greenhouse gas emissions now has substantial momentum, but our overall measurement framework generally has serious deficiencies. Because existing metrics are often borrowed from other sectors, many are unconnected to the specifics of health-care provision or existing health system performance indicators, the potential negative effects of health care on public health are largely absent, a consistent and standardised set of health-care sustainability measurement concepts does not yet exist, and current dynamics in health systems such as privatisation are largely ignored. The next generation of health-care sustainability metrics must address these deficiencies by expanding the scope of observation and the entry points for interventions. Specifically, metrics should be standardised, reliable, meaningful, integrated with data management systems, fair, and aligned with the core mission of health care. Incentives with the potential to contradict sustainability goals must be addressed in future planning and implementation if the next generation of metrics is to be effective and incentivise positive systemic change.
Estimated number of lives directly saved by COVID-19 vaccination programmes in the WHO European Region from December, 2020, to March, 2023: a retrospective surveillance study
Authors: Margaux M I Meslé, Jeremy Brown, Piers Mook, Mark A Katz, José Hagan, Roberta Pastore, Bernhard Benka, Monika Redlberger-Fritz, Nathalie Bossuyt, Veerle Stouten, Catharina Vernemmen, Elisabet Constantinou, Marek Maly, Jan Kynčl, Ondrej Sanca, Tyra Grove Krause, Lasse Skafte Vestergaard, Tuija Leino, Eero Poukka, Kassiani Gkolfinopoulou, Kassiani Mellou, Maria Tsintziloni, Zsuzsanna Molnár, Gudrun Aspelund, Marianna Thordardottir, Lisa Domegan, Eva Kelly, Joan O'Donell, Alberto-Mateo Urdiales, Flavia Riccardo, Chiara Sacco, Viktoras Bumšteinas, Rasa Liausediene, Joël Mossong, Anne Vergison, Maria-Louise Borg, Tanya Melillo, Dragan Kocinski, Enkela Pollozhani, Hinta Meijerink, Diana Costa, João Paulo Gomes, Pedro Pinto Leite, Alina Druc, Veaceslav Gutu, Valentin Mita, Mihaela Lazar, Rodica Popescu, Odette Popovici, Monika Musilová, Maja Mrzel, Maja Socan, Veronika Učakar, Aurora Limia, Clara Mazagatos, Carmen Olmedo, Gavin Dabrera, Meaghan Kall, Mary Sinnathamby, Graham McGowan, Jim McMenamin, Kirsty Morrison, Dorit Nitzan, Marc-Alain Widdowson, Catherine Smallwood, Richard Pebody
Journal: The Lancet Respiratory Medicine (2024)
Plant-based and planetary-health diets, environmental burden, and risk of mortality: a prospective cohort study of middle-aged and older adults in China
Authors: Hui Chen, Xiaoxi Wang, John S Ji, Liyan Huang, Ye Qi, You Wu, Pan He, Yanping Li, Benjamin Leon Bodirsky, Christoph Müller, Walter C Willett, Changzheng Yuan
Journal: The Lancet Planetary Health (2024)
Discontinuation versus continuation of imatinib in patients with advanced gastrointestinal stromal tumours (BFR14): exploratory long-term follow-up of an open-label, multicentre, randomised, phase 3 trial
Authors: Jean-Yves Blay, Quentin Devin, Florence Duffaud, Maud Toulmonde, Nelly Firmin, Olivier Collard, Emmanuelle Bompas, Benjamin Verret, Isabelle Ray-Coquard, Sebastien Salas, Clemence Henon, Charles Honoré, Mehdi Brahmi, Armelle Dufresne, Marc Pracht, Alice Hervieu, Nicolas Penel, Francois Bertucci, Maria Rios, Esma Saada-Bouzid, Pauline Soibinet, David Perol, Sylvie Chabaud, Antoine Italiano, Axel Le Cesne
Journal: The Lancet Oncology (2024)
Where and how to invest in greenspace for optimal health benefits: a systematic review of greenspace morphology and human health relationships
Authors: Huaqing Wang, Simin Gholami, Wenyan Xu, Amirhossein Samavatekbatan, Ole Sleipness, Louis G Tassinary
Journal: The Lancet Planetary Health (2024)

Research on the relationship between greenspace morphology and health is a growing field that informs the spatial design of greenspace to enhance health outcomes. This study reviews the current progress, methodologies, and knowledge gaps in this area. From a database search of 272 940 English articles and 39 053 Chinese articles up to April 18, 2024, we identified 22 and 7 studies on the topic for further evaluation. Predominantly cross-sectional and neighbourhood-scale analyses were conducted using land cover maps ranging from 0·25 to 100 meters in resolution. Six primary characteristics of greenspace morphology have been studied, including size, shape, fragmentation, connectedness, aggregation, and diversity. While associations between greenspace morphology and health outcomes have been observed, both their reliability and generalisability remain suggestive due to ecological study designs and heterogeneity among studies. Future research should prioritise individual-level prospective cohorts and intervention studies. Exploring mechanisms linking greenspace morphology and health, determining optimal map resolution, and distinguishing it from greenness magnitude in statistical analysis is essential. This evidence is crucial for health-promoting greenspace planning and should be routinely integrated into urban epidemiological research.