tbuckley/cabot-search huggingface dataset:
HLA Class II (<i>DR</i>, <i>DQ, DP</i>) Genes Were Separately Associated With the Progression From Seroconversion to Onset of Type 1 Diabetes Among Participants in Two Diabetes Prevention Trials (DPT-1 and TN07)
Authors: Lue Ping Zhao, George K. Papadopoulos, Jay S. Skyler, Alberto Pugliese, Hemang M. Parikh, William W. Kwok, Terry P. Lybrand, George P. Bondinas, Antonis K. Moustakas, Ruihan Wang, Chul-Woo Pyo, Wyatt C. Nelson, Daniel E. Geraghty, Åke Lernmark
Journal: Diabetes Care (2024)

OBJECTIVE To explore associations of HLA class II genes (HLAII) with the progression of islet autoimmunity from asymptomatic to symptomatic type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS Next-generation targeted sequencing was used to genotype eight HLAII genes (DQA1, DQB1, DRB1, DRB3, DRB4, DRB5, DPA1, DPB1) in 1,216 participants from the Diabetes Prevention Trial-1 and Randomized Diabetes Prevention Trial with Oral Insulin sponsored by TrialNet. By the linkage disequilibrium, DQA1 and DQB1 are haplotyped to form DQ haplotypes; DP and DR haplotypes are similarly constructed. Together with available clinical covariables, we applied the Cox regression model to assess HLAII immunogenic associations with the disease progression. RESULTS First, the current investigation updated the previously reported genetic associations of DQA1*03:01-DQB1*03:02 (hazard ratio [HR] = 1.25, P = 3.50*10−3) and DQA1*03:03-DQB1*03:01 (HR = 0.56, P = 1.16*10−3), and also uncovered a risk association with DQA1*05:01-DQB1*02:01 (HR = 1.19, P = 0.041). Second, after adjusting for DQ, DPA1*02:01-DPB1*11:01 and DPA1*01:03-DPB1*03:01 were found to have opposite associations with progression (HR = 1.98 and 0.70, P = 0.021 and 6.16*10−3, respectively). Third, DRB1*03:01-DRB3*01:01 and DRB1*03:01-DRB3*02:02, sharing the DRB1*03:01, had opposite associations (HR = 0.73 and 1.44, P = 0.04 and 0.019, respectively), indicating a role of DRB3. Meanwhile, DRB1*12:01-DRB3*02:02 and DRB1*01:03 alone were found to associate with progression (HR = 2.6 and 2.32, P = 0.018 and 0.039, respectively). Fourth, through enumerating all heterodimers, it was found that both DQ and DP could exhibit associations with disease progression. CONCLUSIONS These results suggest that HLAII polymorphisms influence progression from islet autoimmunity to T1D among at-risk subjects with islet autoantibodies.
Clinical Outcomes With Electronic Nudges to Increase Influenza Vaccination
Authors: Niklas Dyrby Johansen, Muthiah Vaduganathan, Ankeet S. Bhatt, Simin Gharib Lee, Daniel Modin, Brian L. Claggett, Erica L. Dueger, Sandrine Samson, Matthew M. Loiacono, Rebecca C. Harris, Lars Køber, Scott D. Solomon, Pradeesh Sivapalan, Jens Ulrik Stæhr Jensen, Cyril Jean-Marie Martel, Tyra Grove Krause, Tor Biering-Sørensen
Journal: Annals of Internal Medicine (2024)

In the NUDGE-FLU (Nationwide Utilization of Danish Government Electronic letter system for increasing inFLUenza vaccine uptake) trial, electronic letters incorporating cardiovascular (CV) gain-framing and repeated messaging increased influenza vaccination by approximately 1 percentage point. To evaluate the effects of the successful nudging interventions on downstream clinical outcomes. Prespecified exploratory analysis of a nationwide randomized implementation trial. (ClinicalTrials.gov: NCT05542004). The 2022 to 2023 influenza season. 964 870 Danish citizens aged 65 years or older. Usual care or 9 different electronically delivered behavioral nudging letters. Cardiovascular, respiratory, and other clinical end points during follow-up from intervention delivery (16 September 2022) through 31 May 2023. The analysis set included 691 820 participants. Hospitalization for pneumonia or influenza occurred in 3354 of 346 327 (1.0%) participants in the usual care group, 396 of 38 586 (1.0%) in the CV gain-framing group (hazard ratio [HR], 1.06 [95% CI, 0.95 to 1.18]; versus usual care), and 403 of 38 231 (1.1%) in the repeated letter group (HR, 1.09 [CI, 0.98 to 1.21]; versus usual care). In the usual care group, 44 682 (12.9%) participants were hospitalized for any cause, compared with 5002 (13.0%) in the CV gain-framing group (HR, 1.00 [CI, 0.97 to 1.03]; versus usual care) and 4965 (13.0%) in the repeated letter group (HR, 1.01 [CI, 0.98 to 1.04]; versus usual care). A total of 6341 (1.8%) participants died in the usual care group, compared with 721 (1.9%) in the CV gain-framing group (HR, 1.02 [CI, 0.94 to 1.10]; versus usual care) and 646 (1.7%) in the repeated letter group (HR, 0.92 [CI, 0.85 to 1.00]; versus usual care). Prespecified but exploratory analysis, potential misclassification of events in routinely collected registry data, and results may not be generalizable to other health systems or countries with other racial compositions and/or cultural or societal norms. In a prespecified exploratory analysis, modest increases in influenza vaccination rates seen with electronic nudges did not translate into observable improvements in clinical outcomes. Seasonal influenza vaccination should remain strongly recommended. Sanofi.
Mesothelioma: Pleural, Version 1.2024
Authors: James Stevenson, David S. Ettinger, Douglas E. Wood, Dara L. Aisner, Wallace Akerley, Jessica R. Bauman, Ankit Bharat, Debora S. Bruno, Joe Y. Chang, Lucian R. Chirieac, Malcolm DeCamp, Aakash Desai, Thomas J. Dilling, Jonathan Dowell, Gregory A. Durm, Marina C. Garassino, Scott Gettinger, Travis E. Grotz, Matthew A. Gubens, Rudy P. Lackner, Michael Lanuti, Jules Lin, Billy W. Loo, Christine M. Lovly, Fabien Maldonado, Erminia Massarelli, Daniel Morgensztern, Trey C. Mullikin, Thomas Ng, Gregory A. Otterson, Dawn Owen, Sandip P. Patel, Tejas Patil, Patricio M. Polanco, Gregory J. Riely, Jonathan Riess, Theresa A. Shapiro, Aditi P. Singh, Alda Tam, Tawee Tanvetyanon, Jane Yanagawa, Stephen C. Yang, Edwin Yau, Kristina Gregory, Lisa Hang
Journal: Journal of the National Comprehensive Cancer Network (2024)

Mesothelioma is a rare cancer that originates from the mesothelial surfaces of the pleura and other sites, and is estimated to occur in approximately 3,500 people in the United States annually. Pleural mesothelioma is the most common type and represents approximately 85% of these cases. The NCCN Guidelines for Mesothelioma: Pleural provide recommendations for the diagnosis, evaluation, treatment, and follow-up for patients with pleural mesothelioma. These NCCN Guidelines Insights highlight significant updates to the NCCN Guidelines for Mesothelioma: Pleural, including revised guidance on disease classification and systemic therapy options.
Long-Term Outcomes of dMMR/MSI-H Rectal Cancer Treated With Anti–PD-1–Based Immunotherapy as Curative-Intent Treatment
Authors: Jie-Hai Yu, Le-En Liao, Bin-Yi Xiao, Xuan Zhang, Ai-Wen Wu, Yong Cheng, Jing-Hua Tang, Wu Jiang, Ling-Heng Kong, Kai Han, Wei-Jian Mei, Zhi-Gang Hong, Wan-Jun Yang, Dan-Dan Li, Zhi-Zhong Pan, Yun-Feng Li, Xiao-Shi Zhang, Pei-Rong Ding
Journal: Journal of the National Comprehensive Cancer Network (2024)

Neoadjuvant anti-PD-1 therapy has shown encouraging efficacy in patients with deficient DNA mismatch repair (dMMR)/microsatellite instability-high (MSI-H) locally advanced rectal cancer (LARC), which suggests its potential as a curative-intent therapy and a promising treatment option for organ preservation. We aimed to investigate the long-term outcomes of patients with dMMR/MSI-H LARC who experienced clinical complete response (cCR) after anti-PD-1 therapy.
NCCN News
Journal: Journal of the National Comprehensive Cancer Network (2024)

For World Cancer Day, NCCN, American Cancer Society Cancer Action Network (ACS CAN), and the National Minority Quality Forum (NMQF) announced 3 key areas of policy focus as part of the Alliance for Cancer Care Equity (ACCE) joint collaboration, including advancing diversity in clinical trials, improving cancer screening and early detection, and increasing access to patient navigation.The organizations are also working with Congresswoman Terri Sewell (D-AL) to observe the day with a congressional resolution.According to the resolution, the United States Congress will designate February 4th as World Cancer Day to highlight the importance of taking meaningful action to raise awareness of the disparities that exist in cancer care, and support efforts to close the care gap.Despite progress in recent years, Black Americans have the highest death rate and lowest survival rate of any racial or ethnic group for most cancers. 1 Compared with White people, mortality rates are two-fold higher for prostate, stomach, and uterine corpus cancers in Black people and for liver, stomach, and kidney cancers in Native American people. 2 World Cancer Day is a global awareness day organized by the Union of International Cancer Control (UICC) every February 4th.The 2024 observance marks the third and final year for the "Close the Care Gap" campaign focused on reducing disparities in cancer treatment and outcomes.The ACCE will continue to identify governmental actions to drive further improvements in the three areas of focus and advance necessary structural changes to cancer care delivery throughout the United States.They call on members of Congress to support: H.R.
Frailty and Cognitive Function in Middle-Aged and Older Adults With Congenital Heart Disease
Authors: Bo Daelman, Liesbet Van Bulck, Koen Luyckx, Adrienne H. Kovacs, Alexander Van De Bruaene, Magalie Ladouceur, Hsiao-Ling Yang, Ju Ryoung Moon, André Schmidt, Birgitte Lykkeberg, Edward Callus, Michèle de Hosson, Camilla Sandberg, Bengt Johansson, Joanna Hlebowicz, Maria Emília Areias, Pascal Amedro, Louise Coats, Zacharias Mandalenakis, Anna Kaneva, Philip Moons, Eva Goossens, Navaneetha Sasikumar, Junko Enomoto, Yoshiko Mizuno, Ming Chern Leong, Izzatun Nafsi Binto Sabran, Laila Akbar Ladak, Babar Hasan, Ayat Siddiqui, Ju Ryoung Moon, June Huh, Hsiao-Ling Yang, Jou-Kou Wang, Chun-Wei Lu, Fatma Demir, Tuğba Öden, Endale Tefera, Julius Mwita, Jean-Claude Ambassa, Charles Mvondo, Marcel Fanka, Dejuma Yadeta, Mulualem Alemayehu, Mohamed Leye, Khadija Gueye, Harald Gabriel, Matthias Svhneider, Selina Seeliger, Werner Budts, Alexander Van De Bruaene, Philip Moons, Eva Goossens, Liesbet Van Bulck, Jessica Rassart, Koen Luyckx, Michele De Hosson, Julie De Backer, Anna Kaneva, Mila Markova, Birgitte Lykkeberg, Miriam Biyai, Magalie Ladouceur, Anissa Boubrit, Jean-Benoît Thambo, Amandine Ruissel, Cecile Jore, Pascal Amedro, Hamouda Abassi, Sonia Soltani, Charlene Bredy, George Giannakoulas, Diamantis Kosmidis, Despina Ntiloudi, Edward Callus, Silvana Pagliuca, Enrico Giuseppe Bertoldo, Valentina Fiolo, Maryanne Caruana, Justine Swain, Neil Grech, Rachel Xuereb, Sarah Craus, Maria Bonello, Darren Borg, Paul Farrugia, Joanne Cardona, Mette-Elise Estensen, Brith Andresen, Katrine Eriksen, Maria Emília Areias, Joana Miranda, José Carlos Areias, Cristina Cruz, Filipe Macedo, Filipa Manuela Ribeiro Nunes, Ana Maria Barbosa de Bessa, Sara Mafalda Espírito Santo, Paula Brito, Marisa Pereira, Sofia Teixeira, Brenda Marques, Ana Raquel Marques, Bengt Johansson, Camilla Sandberg, Helena Cronesten, Mikael Dellborg, Zacharias Mandalenakis, Eva Mattson, Christina Christersson, Louise Robertsson, Joanna Hlebowicz, Linda Ternrud, Corina Thomet, Javier Ruperti, Judith Bouchardy, Fanny Brand, Tobias Rutz, Coralie Blanche, Joost P. van Melle, Anna Boer, Andrew Constantine, Michael A. Gatzoulis, Konstantinos Dimopoulos, Louise Coats, Debbie McParlin, Paul Khairy, Anna Proietti, Veronique Roy, Jonathan Windram, Deborah Jandura, Susan Jameson, Melissa Major, Vaikom Subremanian Mahadevan, Thomas Nguyen, Shabir Sarwary, Arwa Saidi, Leah Breault, Dalia Lopez Colon, Ari Cedars, Shelby Kutty, Jong Ko, Anne Marie Valente, Sarah Brainard, Jeffrey Reichman, Ali Zaidi, Amrin Amlani, Jamie Jackson, Taylor Swenski, Steven Neville, Adrienne Kovacs, Lidija McGrath, Marshall Taunton, Yuli Kim, Jessica Carducci, Saffy Bashey, Luis Alday, Marina Lousararian, Héctor Maisuls, Marisa Quinteros, Mónica Lucero, Lucia Ortiz, Fernando Amaral, Andre Schmidt, Paulo Henrique Manso, Rafael Brolio Pavão, Fernando Baraona Reyes, M. Francisca Arancibia, John Jairo Araujo, Alberto Hernadez Súarez, Samuel Menahem, Pasangi Madhuka Wijayarathne
Journal: Journal of the American College of Cardiology (2024)
Arteriovenous Access for Hemodialysis
Authors: Charmaine E. Lok, Thomas S. Huber, Ani Orchanian-Cheff, Dheeraj K. Rajan
Journal: JAMA (2024)

Importance Hemodialysis requires reliable vascular access to the patient’s blood circulation, such as an arteriovenous access in the form of an autogenous arteriovenous fistula or nonautogenous arteriovenous graft. This Review addresses key issues associated with the construction and maintenance of hemodialysis arteriovenous access. Observations All patients with kidney failure should have an individualized strategy (known as Patient Life-Plan, Access Needs, or PLAN) for kidney replacement therapy and dialysis access, including contingency plans for access failure. Patients should be referred for hemodialysis access when their estimated glomerular filtration rate progressively decreases to 15 to 20 mL/min, or when their peritoneal dialysis, kidney transplant, or current vascular access is failing. Patients with chronic kidney disease should limit or avoid vascular procedures that may complicate future arteriovenous access, such as antecubital venipuncture or peripheral insertion of central catheters. Autogenous arteriovenous fistulas require 3 to 6 months to mature, whereas standard arteriovenous grafts can be used 2 to 4 weeks after being established, and “early-cannulation” grafts can be used within 24 to 72 hours of creation. The prime pathologic lesion of flow-related complications of arteriovenous access is intimal hyperplasia within the arteriovenous access that can lead to stenosis, maturation failure (33%-62% at 6 months), or poor patency (60%-63% at 2 years) and suboptimal dialysis. Nonflow complications such as access-related hand ischemia (“steal syndrome”; 1%-8% of patients) and arteriovenous access infection require timely identification and treatment. An arteriovenous access at high risk of hemorrhaging is a surgical emergency. Conclusions and Relevance The selection, creation, and maintenance of arteriovenous access for hemodialysis vascular access is critical for patients with kidney failure. Generalist clinicians play an important role in protecting current and future arteriovenous access; identifying arteriovenous access complications such as infection, steal syndrome, and high-output cardiac failure; and making timely referrals to facilitate arteriovenous access creation and treatment of arteriovenous access complications.
Factors Associated With Use of the Preventive Health Inventory in US Veterans
Authors: Chelle L. Wheat, Edwin S. Wong, Kristen E. Gray, Susan E. Stockdale, Karin M. Nelson, Ashok Reddy
Journal: JAMA Network Open (2024)

Importance The COVID-19 pandemic caused significant declines in the quality of preventive and chronic disease care. The Veterans Health Administration (VHA) used the Preventive Health Inventory (PHI), a multicomponent care management intervention, to catch up on care disrupted by the pandemic. Objective To identify key factors associated with PHI use. Design, Setting, and Participants This cohort study of veterans receiving primary care used administrative data from national VHA primary care clinics for February 1, 2021, through February 1, 2022. Exposure Patient PHI receipt. Main Outcomes and Measures The main outcomes were patient, practitioner, and clinic factors associated with PHI receipt. Binomial generalized linear models with fixed effects for clinic were used to analyze factors associated with receipt of PHI. Least absolute shrinkage and selection operator procedures were used for variable selection. Results A total of 4 358 038 veterans (mean [SD] age, 63.7 [16.0] years; 90% male; 76% non-Hispanic White) formed the study cohort, of whom 389 757 (9%) received the PHI. Veterans who received the PHI had higher mean Care Assessment Need (CAN) scores, which indicate the likelihood of hospitalization or death within 1 year (mean [SD], 51.9 [28.6] vs 47.2 [28.6]; standardized mean difference [SMD], −0.16). They were also more likely to live in urban areas (77% vs 64%; SMD, 0.28) and have a shorter drive distance to primary care (mean [SD], 13.2 [12.4] vs 15.7 [14.6] miles; SMD, 0.19). The mean outpatient use was higher among PHI recipients compared with non-PHI recipients (mean [SD], 18.4 [27.8] vs 15.1 [24.1] visits; SMD, −0.13). In addition, veterans with primary care practitioners with higher caseloads were more likely to receive the PHI (mean [SD], 778 [231] vs 744 [249] patients; SMD, −0.14), and they were more likely to be seen at larger clinics (mean [SD], 9670 [6876] vs 8786 [6892] patients; SMD, −0.13). Prior outpatient use and CAN score were associated with PHI receipt in the final model. Conclusions and Relevance In this cohort study of the VHA’s PHI, patients with higher CAN scores and more outpatient use in the previous year were more likely to receive the PHI. This study identifies potential intervention points to improve care coordination for veterans.
Text vs Patient Portal Messaging to Improve Influenza Vaccination Coverage
Authors: Peter G. Szilagyi, O. Kenrik Duru, Alejandra Casillas, Michael K. Ong, Sitaram Vangala, Chi-Hong Tseng, Christina Albertin, Sharon G. Humiston, Emma Clark, Mindy K. Ross, Sharon A. Evans, Michael Sloyan, Craig R. Fox, Carlos Lerner
Journal: JAMA Internal Medicine (2024)

Importance Increasing influenza vaccination rates is a public health priority. One method recommended by the US Centers for Disease Control and Prevention and others is for health systems to send reminders nudging patients to be vaccinated. Objective To evaluate and compare the effect of electronic health record (EHR)–based patient portal reminders vs text message reminders on influenza vaccination rates across a health system. Design, Setting, and Participants This 3-arm randomized clinical trial was conducted from September 7, 2022, to April 30, 2023, among primary care patients within the University of California, Los Angeles (UCLA) health system. Interventions Arm 1 received standard of care. The health system sent monthly reminder messages to patients due for an influenza vaccine by portal (arm 2) or text (arm 3). Arm 2 had a 2 × 2 nested design, with fixed vs responsive monthly reminders and preappointment vs no preappointment reminders. Arm 3 had 1 × 2 design, with preappointment vs no preappointment reminders. Preappointment reminders for eligible patients were sent 24 and 48 hours before scheduled primary care visits. Fixed reminders (in October, November, and December) involved identical messages via portal or text. Responsive portal reminders involved a September message asking patients about their plans for vaccination, with a follow-up reminder if the response was affirmative but the patient was not yet vaccinated. Main Outcomes and Measures The primary outcome was influenza vaccination by April 30, 2023, obtained from the UCLA EHR, including vaccination from pharmacies and other sources. Results A total of 262 085 patients (mean [SD] age, 45.1 [20.7] years; 237 404 [90.6%] adults; 24 681 [9.4%] children; 149 349 [57.0%] women) in 79 primary care practices were included (87 257 in arm 1, 87 478 in arm 2, and 87 350 in arm 3). At the entire primary care population level, none of the interventions improved influenza vaccination rates. All groups had rates of approximately 47%. There was no statistical or clinically significant improvement following portal vs text, preappointment reminders vs no preappointment reminders (portal and text reminders combined), or responsive vs fixed monthly portal reminders. Conclusions and Relevance At the population level, neither portal nor text reminders for influenza vaccination were effective. Given that vaccine hesitancy may be a major reason for the lack of impact of portal or text reminders, more intensive interventions by health systems are needed to raise influenza vaccination coverage levels. Trial Registration ClinicalTrials.gov Identifier: NCT05525494
Estimated Childhood Lead Exposure From Drinking Water in Chicago
Authors: Benjamin Q. Huynh, Elizabeth T. Chin, Mathew V. Kiang
Journal: JAMA Pediatrics (2024)

Importance There is no level of lead in drinking water considered to be safe, yet lead service lines are still commonly used in water systems across the US. Objective To identify the extent of lead-contaminated drinking water in Chicago, Illinois, and model its impact on children younger than 6 years. Design, Setting, and Participants For this cross-sectional study, a retrospective assessment was performed of lead exposure based on household tests collected from January 2016 to September 2023. Tests were obtained from households in Chicago that registered for a free self-administered testing service for lead exposure. Machine learning and microsimulation were used to estimate citywide childhood lead exposure. Exposure Lead-contaminated drinking water, measured in parts per billion. Main Outcomes and Measures Number of children younger than 6 years exposed to lead-contaminated water. Results A total of 38 385 household lead tests were collected. An estimated 68% (95% uncertainty interval, 66%-69%) of children younger than 6 years were exposed to lead-contaminated water, corresponding to 129 000 children (95% uncertainty interval, 128 000-131 000 children). Ten-percentage-point increases in block-level Black and Hispanic populations were associated with 3% (95% CI, 2%-3%) and 6% (95% CI, 5%-7%) decreases in odds of being tested for lead and 4% (95% CI, 3%-6%) and 11% (95% CI, 10%-13%) increases in having lead-contaminated drinking water, respectively. Conclusions and Relevance These findings indicate that childhood lead exposure is widespread in Chicago, and racial inequities are present in both testing rates and exposure levels. Machine learning may assist in preliminary screening for lead exposure, and efforts to remediate the effects of environmental racism should involve improving outreach for and access to lead testing services.
Magnetic Resonance Imaging Characteristics of LGI1-Antibody and CASPR2-Antibody Encephalitis
Authors: Mark J. Kelly, Eleanor Grant, Andrew G. Murchison, Sophie Binks, Sudarshini Ramanathan, Sophia Michael, Adam E. Handel, Lahiru Handunnetthi, Christopher E. Uy, John N. Soltys, Divyanshu Dubey, Gregory S. Day, A. Sebastian Lopez-Chiriboga, Eoin P. Flanagan, Fintan Sheerin, Sarosh R. Irani
Journal: JAMA Neurology (2024)

Rapid and accurate diagnosis of autoimmune encephalitis encourages prompt initiation of immunotherapy toward improved patient outcomes. However, clinical features alone may not sufficiently narrow the differential diagnosis, and awaiting autoantibody results can delay immunotherapy.
Discussion on the Application of Rapid Immunoblot Assay for AQP4-IgG Detection
Authors: Yang Su, Minjin Wang
Journal: JAMA Neurology (2024)

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