tbuckley/cabot-search huggingface dataset:
Hypothalamic-pituitary-ovarian axis suppression is common among women during US Army Basic Combat Training
Authors: Kristin L Popp, Brittany N Bozzini, Marinaliz Reynoso, Jennifer Coulombe, Katelyn I Guerriere, Susan P Proctor, Colleen M Castellani, Leila A Walker, Nicholas Zurinaga, Katherine Kuhn, Stephen A Foulis, Mary L Bouxsein, Julie M Hughes, Nanette Santoro
Journal: British Journal of Sports Medicine (2024)

Objective Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using women and explore potential contributors to HPO axis suppression. Methods In this 10-week prospective observational study, we enrolled multi-ethnic women entering BCT. Trainees provided daily first-morning voided urine, and weekly blood samples during BCT. Urinary luteinising hormone, follicle stimulating hormone, and metabolites of estradiol and progesterone were measured by chemiluminescent assays (Siemens Centaur XP) to determine hormone patterns and luteal activity. We measured body composition, via dual-energy X-ray absorptiometry, at the beginning and end of BCT. Results Trainees (n=55) were young (mean (95% CI): 22 (22, 23) years) with average body mass index (23.9 (23.1, 24.7) kg/m 2 ). Most trainees (78%) reported regular menstrual cycles before BCT. During BCT, 23 (42%) trainees reported regular menses. However, only seven trainees (12.5%) had menstrual cycles with evidence of luteal activity (ELA) (ie, presumed ovulation), all with shortened luteal phases. 41 trainees (75%) showed no ELA (NELA), and 7 (12.5%) were categorised as indeterminant. Overall, women gained body mass and lean mass, but lost fat mass during BCT. Changes in body mass and composition appear unrelated to luteal activity. Conclusions Our findings reveal profound HPO axis suppression with NELA in the majority of women during BCT. This HPO axis suppression occurs among women who report normal menstrual cycles.
ZY5301 Tablet vs Placebo for Treatment of Chronic Pelvic Pain After Pelvic Inflammatory Disease
Authors: Xiuxiang Teng, Hongmei Li, Defeng Yang, Zheng Gao, Li Cui, Hong Chen, Qingxia Song, Lianwei Xu, Huaifang Li, Qin Zhang, Junyu Wu, Jing Leng
Journal: JAMA Network Open (2024)

Chronic pelvic pain (CPP) is the main sequela of pelvic inflammatory disease (PID), with no established treatment. ZY5301 tablets, an effective part preparation extracted from Ajuga decumbens Thunb. (jingucao), are being tested as a treatment for CPP caused by PID.
Perinatal Outcomes Associated With Metformin Use During Pregnancy in Women With Pregestational Type 2 Diabetes Mellitus
Authors: Jennifer J. Yland, Krista F. Huybrechts, Amelia K. Wesselink, Loreen Straub, Yu-Han Chiu, Ellen W. Seely, Elisabetta Patorno, Brian T. Bateman, Helen Mogun, Lauren A. Wise, Sonia Hernández-Díaz
Journal: Diabetes Care (2024)

We emulated a modified randomized trial (Metformin in Women With Type 2 Diabetes in Pregnancy [MiTy]) to compare the perinatal outcomes in women continuing versus discontinuing metformin during pregnancy among those with type 2 diabetes treated with metformin plus insulin before pregnancy.
New WHO ACPA standard enables standardisation among anti-CCP2 assays, but not other ACPA assays using different antigens
Authors: Lieve Van Hoovels, Liesbeth E Bakker-Jonges, Dina Vara, Caroline Bijnens, Lucy Studholme, Daniela Sieghart, Bert Vander Cruyssen, Patrick Verschueren, Guenter Steiner, Jan G M C Damoiseaux, Xavier Bossuyt
Journal: Annals of the Rheumatic Diseases (2024)
A Randomized Comparison of Postprandial Glucose Excursion Using Inhaled Insulin Versus Rapid-Acting Analog Insulin in Adults With Type 1 Diabetes Using Multiple Daily Injections of Insulin or Automated Insulin Delivery
Authors: Irl B. Hirsch, Roy W. Beck, Martin Chase Marak, Peter Calhoun, Adham Mottalib, Amna Salhin, Anastasios Manessis, Andrea D. Coviello, Anuj Bhargava, Ashley Thorsell, Astrid Atakov Castillo, Bruce W. Bode, Camilla Levister, Carol J. Levy, Cassandra Donahue, Christian Cordero, Christie Beatson, Christine R. Langel, Christopher Jacobson, Corey Kurek, Dana Cruse, David Pickering, Denisa Tamarez, Devin W. Steenkamp, Donna Desjardins, Grazia Aleppo, Grenye O’Malley, Halis K. Akturk, Jamie Diner, Jesica D. Baran, John B. Buse, Katrina Ruedy, Kevin Codorniz, Klara R. Klein, Kristin Castorino, Lin Fan Jordan, Mark Kipnes, Mei Mei Church, Osama Hamdy, Philip Raskin, Quang T. Nguyen, Ruth S. Weinstock, Scott Lee, Shafaq Rizvi, Suzan Bzdick, Tahereh Ghorbani Rodriguez, Tareq Salah, Thomas Blevins, Yogish C. Kudva, Zehra Haider, Bruce W. Bode, Jonathan Ownby, Joseph Johnson, Adriana Ruiz, Nashia Stephens, Amanda Maxson, Halis K. Akturk, Zehra Haider, Christie Beatson, Emma Mason, Devin W. Steenkamp, Howard Wolpert, Astrid Atakov-Castillo, Asya Sullivan, Mark Kipnes, Amna Salhin, Tina Copple, Stephanie Beltran, Terri Ryan, Carol J. Levy, Grenye O’Malley, Camilla Levister, Denisa Tamarez, Aslihan Ipek, Anuj Bhargava, Christine Burke, Christine Langel, Shannon Bauman, Cristina Haight, Allie Bohr, Osama Hamdy, Adham Mottalib, Tareq Salah, Marwa Al Badri, Shilton Dhaver, Quang T. Nguyen, Loida Nguyen, Kevin Codorniz, Scott Lee, Christopher Jacobson, Christian Cordero, Brittney Migliozzi, Yogish Kudva, Donna Desjardins, Corey Reid, Shafaq Rizvi, Ravinder Jeet Kaur, Daine Livingood, David Pickering, Dana Cruse, Grazia Aleppo, Jelena Kravarusic, Kasey Coyne, Stefanie Herrmann, Evelyn Fronczyk, Anastasios Manessis, Lorcan McKillop, Jamie Hyatt, Maria Patruno, Kristin Castorino, Mei Mei Church, Ashley Thorsell, Maggie Shuirman, Brandon Cobb, Olivia Watt, Ruth Weinstock, Suzan Bzdick, Thomas Blevins, Luis Casaubon, Valerie Espinosa, Keta Pandit, Jennifer Perez, Chloe Armstrong, Maritza Martinez-Arredondo, Ana Stewart, Olivia Johnson, Jamie Diner, John Buse, Klara Klein, Tahereh Ghorbani Rodriguez, Laura Young, Andrea D. Coviello, Cassandra Donahue, Alexander Kass, Karla Fulghum, Philip Raskin, Lin Jordan, Baomei Shao, Irl B. Hirsch, Jesica Baran, Patali Mandava, Rosanna Holod, Kevin Kaiserman, Johanna Ulloa, Jennifer Pleitez, Joey Sylvan, Lynn Badgett, Katrina Ruedy, Roy Beck, Sarah Borgman, Sarah Frey, Nnenna Mba-Oduwusi, Paige Miller, Ashleigh Fults, Martin Marak, Peter Calhoun, Rosa Pritchard, Elizaveta Dolzhenko, Chris McCarthy, Deanna Gabrielson, Sue Brown, Andrew Ahmann, Richard Bergenstal
Journal: Diabetes Care (2024)

To compare postprandial glucose excursions following a bolus with inhaled technosphere insulin (TI) or subcutaneous rapid-acting analog (RAA) insulin.
Diagnostic Accuracy of Mental Health Screening Tools After Mild Traumatic Brain Injury
Authors: Michelle Gitaari, Ana Mikolić, William J. Panenka, Noah D. Silverberg
Journal: JAMA Network Open (2024)

Importance Mental health disorders are common after mild traumatic brain injury (mTBI) and likely exacerbate postconcussive symptoms and disability. Early detection could improve clinical outcomes, but the accuracy of mental health screening tools in this population has not been well established. Objective To determine the diagnostic accuracy of the Patient Health Questionnaire–9 (PHQ-9), Generalizaed Anxiety Disorder–7 (GAD-7), and Primary Care PTSD (Posttramatic Stress Disorder) Screen for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5 ) (PC-PTSD-5) in adults with mTBI. Design, Setting, and Participants This diagnostic study was performed as a secondary analysis of a cluster randomized clinical trial. Self-report mental health screening tools (PHQ-9, GAD-7, and PC-PTSD-5) were administered online 12 weeks after mTBI and compared against a structured psychodiagnostic interview (Mini-International Neuropsychiatric Interview for DSM-5 (MINI) over videoconference at the same time. Adults with mTBI (N = 537) were recruited from February 1, 2021, to October 25, 2022. Main Outcomes and Measures Presence of a major depressive episode, anxiety disorders, and PTSD were determined by a blinded assessor with the MINI. Diagnostic accuracy statistics were derived for the PHQ-9, GAD-7, and PC-PTSD-5. Findings were disaggregated for participants with and without persistent postconcussion symptoms (PPCS) by International and Statistical Classification of Diseases, Tenth Revision criteria. Results Data were available for 499 of 537 trial participants, 278 (55.7%) of whom were female; the mean (SD) age was 38.8 (13.9) years. Each screening questionnaire had strong diagnostic accuracy in the overall sample for optimal cut points (area under the curve [AUC], ≥0.80; sensitivity, 0.55-0.94; specificity, 0.64-0.94). The AUC (difference of 0.01-0.13) and specificity (difference, 5-65 percentage points) were lower in those with PPCS present compared with PPCS absent, but the prevalence of at least 1 mental health disorder was 3 to 5 times higher in patients with PPCS present. The GAD-7 had slightly better performance than the PC-PTSD-5 for detecting PTSD (AUC, 0.85 [95% CI, 0.80-0.89] vs 0.80 [95% CI, 0.72-0.87]). The optimal cutoff on the PHQ-9 was 5 or more symptoms experienced on more than half of days; on the GAD-7, a total score of at least 7. Conclusions and Relevance The findings of this diagnostic study suggest that the PHQ-9, GAD-7 and PC-PTSD-5 accurately screen for mental health disorders in patients with mTBI. Future research should corroborate optimal test cutoffs for this population.
Medicare Advantage Plan Star Ratings and County Social Vulnerability
Authors: Avni Gupta, Diana Silver, David J. Meyers, Sherry Glied, José A. Pagán
Journal: JAMA Network Open (2024)

The star rating of a Medicare Advantage (MA) plan is meant to represent plan performance, and it determines the size of quality bonuses. Consumer access to MA plans with a high star rating may vary by the extent of social vulnerability in geographic regions. To examine the association between a county's Social Vulnerability Index (SVI) and the star rating of a county's MA plans. This cross-sectional study used 2023 Centers for Medicare & Medicaid Services data for all MA plans linked to 2020 county-level SVI data from the Centers for Disease Control and Prevention. Data were analyzed from March to October 2023. Quintile rank of county based on composite and theme-specific SVI scores, with quartile 1 (Q1) representing the least vulnerable counties and Q5, the most vulnerable counties. The SVI is a multidimensional measure of a county's social vulnerability across 4 themes: socioeconomic status, household characteristics (such as disability, age, and language), racial and ethnic minority status, and housing type and transportation. County-level mean star rating and the number of MA plans with low-rated (<3.5 stars), high-rated (3.5 or 4.0 stars), and highest-rated (≥4.5 stars) plans. Across 3075 counties, the median county-level star rating was 4.1 (IQR, 3.9-4.3) in Q1 counties and 3.8 (IQR, 3.6-4.0) in Q5 counties (P < .001). The mean star rating of MA plans was lower (difference, -0.24 points; 95% CI, -0.28 to -0.21 points; P < .001), the number of low-rated plans was higher (incidence rate ratio, 1.81; 95% CI, 1.61-2.06; P < .001), and the number of highest-rated plans was lower (incidence rate ratio, 0.75; 95% CI, 0.70-0.81; P < .001) in Q5 counties compared with Q1 counties. Similar patterns were found across theme-specific SVI score quintiles and for 2022 star ratings. In this cross-sectional study, the most socially vulnerable counties were found to have the fewest highest-rated plans for MA beneficiaries. As MA enrollment grows in socially vulnerable regions, this may exacerbate regional differences in health outcomes for Medicare beneficiaries.
Pediatric Lipid Screening Prevalence Using Nationwide Electronic Medical Records
Authors: Angela M. Thompson-Paul, Emily M. Kraus, Renee M. Porter, Samantha L. Pierce, Lyudmyla Kompaniyets, Ahlia Sekkarie, Alyson B. Goodman, Sandra L. Jackson
Journal: JAMA Network Open (2024)

Importance Universal screening to identify unfavorable lipid levels is recommended for US children aged 9 to 11 years and adolescents aged 17 to 21 years (hereafter, young adults ); however, screening benefits in these individuals have been questioned. Current use of lipid screening and prevalence of elevated lipid measurements among US youths is not well understood. Objective To investigate the prevalence of ambulatory pediatric lipid screening and elevated or abnormal lipid measurements among US screened youths by patient characteristic and test type. Design, Setting, and Participants This cross-sectional study used data from the IQVIA Ambulatory Electronic Medical Record database and included youths aged 9 to 21 years with 1 or more valid measurement of height and weight during the observation period (2018-2021). Body mass index (BMI) was calculated and categorized using standard pediatric BMI percentiles (9-19 years) and adult BMI categories (≥20 years). The data were analyzed from October 6, 2022, to January 18, 2023. Main Outcomes and Measures Lipid measurements were defined as abnormal if 1 or more of the following test results was identified: total cholesterol (≥200 mg/dL), low-density lipoprotein cholesterol (≥130 mg/dL), very low-density lipoprotein cholesterol (≥31 mg/dL), non–high-density lipoprotein cholesterol (≥145 mg/dL), and triglycerides (≥100 mg/dL for children aged 9 years or ≥130 mg/dL for patients aged 10-21 years). After adjustment for age group, sex, race and ethnicity, and BMI category, adjusted prevalence ratios (aPRs) and 95% CIs were calculated. Results Among 3 226 002 youths (23.9% aged 9-11 years, 34.8% aged 12-16 years, and 41.3% aged 17-21 years; 1 723 292 females [53.4%]; 60.0% White patients, 9.5% Black patients, and 2.4% Asian patients), 11.3% had 1 or more documented lipid screening tests. The frequency of lipid screening increased by age group (9-11 years, 9.0%; 12-16 years, 11.1%; 17-21 years, 12.9%) and BMI category (range, 9.2% [healthy weight] to 21.9% [severe obesity]). Among those screened, 30.2% had abnormal lipid levels. Compared with youths with a healthy weight, prevalence of an abnormal result was higher among those with overweight (aPR, 1.58; 95% CI, 1.56-1.61), moderate obesity (aPR, 2.16; 95% CI, 2.14-2.19), and severe obesity (aPR, 2.53; 95% CI, 2.50-2.57). Conclusions and Relevance In this cross-sectional study of prevalence of lipid screening among US youths aged 9 to 21 years, approximately 1 in 10 were screened. Among them, abnormal lipid levels were identified in 1 in 3 youths overall and 1 in 2 youths with severe obesity. Health care professionals should consider implementing lipid screening among children aged 9 to 11 years, young adults aged 17 to 21 years, and all youths at high cardiovascular risk.
Obstetric Characteristics and Outcomes of Gestational Carrier Pregnancies
Authors: Shinya Matsuzaki, Aaron D. Masjedi, Satoko Matsuzaki, Zachary S. Anderson, Katherine V. Erickson, Rachel S. Mandelbaum, Joseph G. Ouzounian, Richard J. Paulson, Koji Matsuo
Journal: JAMA Network Open (2024)

Advancements in assisted reproductive technology (ART) have led to an increase in gestational carrier (GC) pregnancies. However, the perinatal outcomes of GC pregnancies remain understudied, necessitating a deeper understanding of their associated risks.
Esophageal large-cell neuroendocrine carcinoma mimicking benign submucosal tumor treated with endoscopic submucosal dissection
Authors: Jiao Li, Zhengkui Zhou, Xiaobin Sun
Journal: Clinical Gastroenterology and Hepatology (2024)

A 68-year-old man with dysphagia was referred after being diagnosed with a submucosal tumor (SMT) in the mid-esophagus at another hospital. The initial biopsy indicated chronic inflammation, and his medical history and physical examination were unremarkable. At our hospital, endoscopy showed an SMT with a biopsy scar on the surface (Figure A). Endoscopic ultrasound (EUS) revealed a mixed-echoic lesion originating from the submucosa (Figure B). Contrast-enhanced computed tomography confirmed a uniformly enhancing soft tissue lesion without lymph node involvement (Figure C). Endoscopic submucosal dissection was performed, achieving en bloc resection without complications (Supplementary Video 1). Pathology identified the lesion as a large-cell neuroendocrine carcinoma with geographic necrosis (Figure D). Immunohistochemistry was positive for synaptophysin, cytokeratin Pan, and CD56, with a Ki-67 index of 90%. The patient refused to undergo surgery and chemotherapy as recommended. Three months later, follow-up endoscopy and computed tomography showed no recurrence or metastasis. This case highlights that esophageal large-cell neuroendocrine carcinoma, an aggressive malignancy, can mimic benign SMTs. The proximal aspect of the lesion showed uniform hyperechogenicity on EUS, indicating densely packed tumor cells on histopathology, whereas the distal part contained anechoic cystic areas, indicating geographic necrosis. Combining EUS with endoscopic submucosal dissection is valuable for diagnosing and treating SMTs of unknown nature. Jiao Li and Zhengkui Zhou contributed equally to this work. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJkYzE4ZjJkMzRmYThlNDYyN2Q3M2RiYzE0YTI1ZDVkYSIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNzI0MDgwNjMwfQ.elUfPS88rwx97SVCbqoctl4GQsKyIDnFWdeLJu_MzRLvT1Ivcqd1bhSuE7fgw0hf8aO3jwrwEHaQjA9FP_V4dVKeuzob5SgKgx-enF3yE5c_pxe6DNT_iNxXmAgTLGflcz7SJ1bRBAuX_QQpOI01WlBWQdWmSzFdhp8f3lRnBpo-wmS2eoaNuSVjDV8Ad_0ZIp08UdZMhc_jH0N59GIg3NdvUYMNiWpUI1OWANMMA9m-QpC7aV1v4rLw9KOfWgfE3sjEPzdZs3g7NTzEz4-lcbPRp8pKfxvPl2eMupF2al1ct0fHJoOgDZdyIjw7JDz_S3TMjfh289dHA-I-9wCPSQ Download .mp4 (10.3 MB) Help with .mp4 files Supplementary Video 1EUS and histopathologic correlation of the esophageal large-cell neuroendocrine carcinoma.
MicroRNAs as Bile-based biomarkers in pancreaticobiliary cancers (MIRABILE): a cohort study
Authors: Daniel S.K. Liu, Jisce R. Puik, Morten T. Venø, Mireia Mato Prado, Eleanor Rees, Bhavik Y. Patel, Nabeel Merali, Daniel Galloway, Grace Chan, Natalie Phillips, Christopher Wadsworth, Panagiotis Vlavianos, Jonathan Potts, Shivan Sivakumar, Brian R. Davidson, Marc G. Besselink, Rutger-Jan Swijnenburg, Long R. Jiao, Geert Kazemier, Elisa Giovannetti, Jonathan Krell, Adam E. Frampton
Journal: International Journal of Surgery (2024)

Biliary obstruction can be due to both malignant and benign pancreaticobiliary disease. Currently, there are no biomarkers that can accurately help make this distinction. MicroRNAs (miRNAs) are stable molecules in tissue and biofluids that are commonly deregulated in cancer. The MIRABILE study aimed to identify miRNAs in bile that can differentiate malignant from benign pancreaticobiliary disease.
Energy Intake and Dietary Glycemic Load in Late Morning and Risk of Type 2 Diabetes: The Hispanic Community Health Study/Study of Latinos, a Multicenter Prospective Cohort Study
Authors: Jin Dai, Roch Nianogo, Nathan D. Wong, Tannaz Moin, Amanda C. McClain, Sarah Alver, Christina Cordero, Martha L. Daviglus, Qibin Qi, Daniela Sotres-Alvarez, Liwei Chen
Journal: Diabetes Care (2024)

To evaluate the association between meal timing and type 2 diabetes risk in U.S. Hispanic/Latino adults.
Hemoglobin A1c Genetics and Disparities in Risk of Diabetic Retinopathy in Individuals of Genetically Inferred African American/African British and European Ancestries
Authors: Ravi Mandla, Philip H. Schroeder, Jose C. Florez, Josep M. Mercader, Aaron Leong
Journal: Diabetes Care (2024)

Individuals with diabetes who carry genetic variants that lower hemoglobin A1c (HbA1c) independently of glycemia may have higher real, but undetected, hyperglycemia compared with those without these variants despite achieving similar HbA1c targets, potentially placing them at greater risk for diabetes-related complications. We sought to determine whether these genetic variants, aggregated in a polygenic score, and the large-effect African ancestry-specific missense variant in G6PD (rs1050828) that lower HbA1c were associated with higher retinopathy risk.
Large-Scale Proteomics Improve Prediction of Chronic Kidney Disease in People With Diabetes
Authors: Ziliang Ye, Yuanyuan Zhang, Yanjun Zhang, Sisi Yang, Panpan He, Mengyi Liu, Chun Zhou, Xiaoqin Gan, Yu Huang, Hao Xiang, Fan Fan Hou, Xianhui Qin
Journal: Diabetes Care (2024)

OBJECTIVE To develop and validate a protein risk score for predicting chronic kidney disease (CKD) in patients with diabetes and compare its predictive performance with a validated clinical risk model (CKD Prediction Consortium [CKD-PC]) and CKD polygenic risk score. RESEARCH DESIGN AND METHODS This cohort study included 2,094 patients with diabetes who had proteomics and genetic information and no history of CKD at baseline from the UK Biobank Pharma Proteomics Project. Based on nearly 3,000 plasma proteins, a CKD protein risk score including 11 proteins was constructed in the training set (including 1,047 participants; 117 CKD events). RESULTS The median follow-up duration was 12.1 years. In the test set (including 1,047 participants; 112 CKD events), the CKD protein risk score was positively associated with incident CKD (per SD increment; hazard ratio 1.78; 95% CI 1.44, 2.20). Compared with the basic model (age + sex + race, C-index, 0.627; 95% CI 0.578, 0.675), the CKD protein risk score (C-index increase 0.122; 95% CI 0.071, 0.177), and the CKD-PC risk factors (C-index increase 0.175; 95% CI 0.126, 0.217) significantly improved the prediction performance of incident CKD, but the CKD polygenic risk score (C-index increase 0.007; 95% CI −0.016, 0.025) had no significant improvement. Adding the CKD protein risk score into the CKD-PC risk factors had the largest C-index of 0.825 (C-index from 0.802 to 0.825; difference 0.023; 95% CI 0.006, 0.044), and significantly improved the continuous 10-year net reclassification (0.199; 95% CI 0.059, 0.299) and 10-year integrated discrimination index (0.041; 95% CI 0.007, 0.083). CONCLUSIONS Adding the CKD protein risk score to a validated clinical risk model significantly improved the discrimination and reclassification of CKD risk in patients with diabetes.