tbuckley/cabot-search huggingface dataset:
A new traction method – integrated multipoint traction – in endoscopic submucosal dissection for the treatment of a laterally spreading tumor
Authors: Yijun Cheng, YuRong Cui, Jinxin Li, Bing Zhao, Junying Liu
Journal: Endoscopy (2025)

Resection of large colorectal tumors using endoscopic submucosal dissection (ESD) remains challenging [1]. Several reports have shown that traction with a snare can be an effective aid in ESD [2] [3]; however, existing snare traction methods are constrained by a single direction and force of traction, hindering adequate exposure of the submucosal layer when applied to large laterally spreading tumors (LSTs). Our team explored a new integrated multipoint traction (IMPT) method that combines multiple endoclips and a snare to achieve all-round traction of the tumor, increasing the visibility of the submucosal layer during peeling, thereby reducing the risk of inadvertent cuts, bleeding, and perforation. This method helps to remove tumor tissue efficiently, safely, and completely.
Carbon dioxide digital subtraction enterography for route identification in post-Roux-en-Y biliary interventions
Authors: Akihiro Maruyama, Makoto Kobayashi, Hirotaka Takeshima, Hiroshi Nakayabu, Hiroki Kato, Shintaro Tominaga, Motoyoshi Yano
Journal: Endoscopy (2025)

Endoscopic retrograde cholangiography (ERC) with balloon-equipped endoscopy is used for treating biliary diseases in patients with altered gastrointestinal anatomy. Carbon dioxide enterography is commonly used during ERC for route selection at the anastomotic branch, as it allows noninvasively visualizing intestinal pathways [1] [2]. However, route identification accuracy may be compromised in cases with excessive intestinal gas, where overlapping shadows obscure the anatomy. Digital subtraction imaging (DSI) is a radiological technique widely used to enhance visualization. By subtracting a pre-contrast image from a post-contrast image, DSI allows for clear identification of vascular and anatomical structures while minimizing interference from surrounding tissues [3]. When applied to carbon dioxide enterography, this technique is termed carbon dioxide digital subtraction enterography. To acquire DSI sequences, we used the Ultimax-i DREX-U180 (Canon, Tokyo, Japan). In ERC, DSI can improve the effectiveness of carbon dioxide enterography, particularly in challenging cases involving excessive intestinal gas. This report highlights the successful use of carbon dioxide digital subtraction enterography in overcoming the limitations of traditional imaging and enabling better visualization.
Benchmarking the diagnostic performance of open source LLMs in 1933 Eurorad case reports
Authors: Su Hwan Kim, Severin Schramm, Lisa C. Adams, Rickmer Braren, Keno K. Bressem, Matthias Keicher, Paul-Sören Platzek, Karolin Johanna Paprottka, Claus Zimmer, Dennis M. Hedderich, Benedikt Wiestler
Journal: npj Digital Medicine (2025)

Abstract Recent advancements in large language models (LLMs) have created new ways to support radiological diagnostics. While both open-source and proprietary LLMs can address privacy concerns through local or cloud deployment, open-source models provide advantages in continuity of access, and potentially lower costs. This study evaluated the diagnostic performance of fifteen open-source LLMs and one closed-source LLM (GPT-4o) in 1,933 cases from the Eurorad library. LLMs provided differential diagnoses based on clinical history and imaging findings. Responses were considered correct if the true diagnosis appeared in the top three suggestions. Models were further tested on 60 non-public brain MRI cases from a tertiary hospital to assess generalizability. In both datasets, GPT-4o demonstrated superior performance, closely followed by Llama-3-70B, revealing how open-source LLMs are rapidly closing the gap to proprietary models. Our findings highlight the potential of open-source LLMs as decision support tools for radiological differential diagnosis in challenging, real-world cases.
Successful transcolonic endoscopic ultrasound-guided fine-needle biopsy of retroperitoneal fibrosis
Authors: Xu Ji, Zheng Zhang, Feng Du, Shutian Zhang, Peng Li
Journal: Endoscopy (2025)

A 54-year-old man presented to our department with a 2-month history of back pain and painful urination. A contrast-enhanced computed tomography (CT) revealed a large retroperitoneal soft tissue mass encircling the abdominal aorta, surrounding vessels, and the right ureter ([Fig. 1]). He had an average leukocyte level (7300/µL), within the normal range for tumor markers and IgG4 levels, and a C-reactive protein level of 38.88 mg/L. The clinical picture was highly suggestive of retroperitoneal fibrosis (RPF); however, for a definite diagnosis, a biopsy of the lesion was necessary.
Endoscopic retrieval of a proximally migrated pancreatic stent complicated by a roomy ampulla of Vater and duodenal diverticula
Authors: Xu Ji, Can Sun, Zheng Zhang, Feng Du, Shutian Zhang, Peng Li
Journal: Endoscopy (2025)

Proximal migration of a pancreatic stent is a rare complication of endoscopic retrograde cholangiopancreatography (ERCP), with an incidence of approximately 5.2% [1]. This constitutes a dire scenario, as it may cause damage to the pancreatic duct, potentially necessitating surgical intervention. We describe a case of successful retrieval of a proximally migrated pancreatic stent using a retrieval basket in a roomy ampulla of Vater with duodenal diverticula.
A novel colonoscope with a wider field of view of 230° – first in human case
Authors: Horst Neuhaus, Anh Nguyen, Johannes Grossmann
Journal: Endoscopy (2025)

During colonoscopy, polyps can be missed, particularly those located behind folds or in tight bends, often due to the limited field of view (FOV) of standard colonoscopes [1] ([Fig. 1]). A recent model-based study evaluating a novel colonoscope with a wider FOV of 230° (PENTAX Medical, Tokyo, Japan) showed a significant improvement in polyp detection compared to standard colonoscopes [2] ([Fig. 2]). The video case highlights its first human use ([Video 1]). The patient, a 69-year-old man with no comorbidities, was scheduled for surveillance after a polypectomy five years ago.
A novel clip with mantis-like claws combined with the over-the-scope clip for fistula closure
Authors: Koichiro Kawano, Mamoru Takenaka, Reiko Kawano, Daisuke Kagoshige, Koutaro Mine, Katsuhisa Nishi, Masatoshi Kudo
Journal: Endoscopy (2025)

The over-the-scope (OTS) clip is a nitinol endoscopic clip widely used for hemostasis and fistula closure in the gastrointestinal tract [1] [2] [3]. During OTS clip application, endoscopic suction pulls tissue into the tip hood and the clip is released for fistula closure; however, suction alone may be insufficient due to inadequate traction. The Twin Grasper system (Ovesco Corp., Tübingen, Germany) is useful in such cases; it utilizes two jaws to grasp and pull tissue into the hood before releasing the clip. However, improper retraction can cause the OTS clip to bite into the Twin Grasper system, preventing its removal ([Fig. 1] a, b) [4]. Thus, we developed a new technique to address this issue.
Radiation-free mother-baby endoscopic balloon dilation for cervical esophago-ileal anastomotic stenosis
Authors: Su-Yu Chen, De-Rong Zhang, Hong Shi
Journal: Endoscopy (2025)

A 68-year-old man presented to our hospital with progressive dysphagia and retrosternal discomfort for 1 month. Endoscopy and pathological biopsy confirmed invasive squamous cell carcinoma of the distal esophagus ([Fig. 1] a) and poorly differentiated adenocarcinoma at the junction of the gastric antrum and body ([Fig. 1] b). Following preoperative preparation, the patient underwent subtotal esophagectomy, gastrectomy, and anterograde ileo-colon interposition for esophageal replacement via the retrosternal route.
The development and ex-vivo evaluation of a computer-aided quality control system for Barrett’s esophagus endoscopy
Authors: Martijn R. Jong, Tim J. M. Jaspers, Rixta A. H. van Eijck van Heslinga, Jelmer B. Jukema, Carolus H. J. Kusters, Tim G. W. Boers, Roos E. Pouw, Lucas C. Duits, Peter H. N. de With, Fons van der Sommen, Albert Jeroen de Groof, Jacques J. G. H. M. Bergman
Journal: Endoscopy (2025)

BACKGROUND : Timely detection of neoplasia in Barrett's esophagus (BE) remains challenging. While computer-aided detection (CADe) systems have been developed to assist endoscopists, their effectiveness depends heavily on the quality of the endoscopic procedure. This study introduces a novel computer-aided quality (CAQ) system for BE, evaluating its stand-alone performance and integration with a CADe system. METHOD : The CAQ system was developed using 7,463 images from 359 BE patients. It assesses objective quality parameters (e. g., blurriness, illumination) and subjective parameters (mucosal cleanliness, esophageal expansion) and can exclude low-quality images when integrated with a CADe system.To evaluate CAQ stand-alone performance, the Endoscopic Image Quality test set, consisting of 647 images from 51 BE patients across 8 hospitals, was labeled for objective and subjective quality. To assess the benefit of the CAQ system as a preprocessing filter of a CADe system, the Barrett CADe test set was developed. It consisted of 956 video frames from 62 neoplastic patients and 557 frames from 35 non-dysplastic patients, in 12 Barrett referral centers. RESULTS : As stand-alone tool, the CAQ system achieved Cohen's Kappa scores of 0.73, 0.91, and 0.89 for objective quality, mucosal cleanliness, and esophageal expansion, comparable to inter-annotator scores of 0.73, 0.93, and 0.83. As preprocessing filter, the CAQ system improved CADe sensitivity from 82 % to 90 % and AUC from 87 % to 91 %, while maintaining specificity at 75 %. CONCLUSION : This study presents the first CAQ system for automated quality control in BE. The system effectively distinguishes poorly from well-visualized mucosa and enhances neoplasia detection when integrated with CADe.
Salt repletion and diuretic response: The role of serum chloride. A post‐hoc analysis of the <scp>SALT</scp>‐<scp>HF</scp> trial on furosemide and hypertonic saline solution administration in ambulatory patients with worsening heart failure
Authors: Julio Núñez, Gema Miñana, Rafael de la Espriella, Isabel Zegrí‐Reiriz, Josep Comín‐Colet, Jorge Rubio Gracia, Jose Luis Morales‐Rull, Pau Llàcer, Pablo Diez‐Villanueva, Javier de Juan Bagudá, Carolina Ortiz Cortés, Josebe Goirigolzarri‐Artaza, Jose Manuel García‐Pinilla, Elvira Barrios, Susana del Prado Díaz, Santiago Jiménez‐Marrero, Maria Alejandra Restrepo‐Córdoba, Jeffrey Testani, Marta Cobo Marcos
Journal: European Journal of Heart Failure (2025)
Metal-phenolic networks specifically eliminate hypoxic tumors by instigating oxidative and proteotoxic stresses
Authors: Jia Liu, Zuoyu Chen, Lixue Deng, Chundong Yao, Zhixin Zhou, Cheng Zhou, Yawen Bin, Miaodeng Liu, Liping Wang, Lin Wang, Zheng Wang
Journal: Bioactive Materials (2025)
Association Between Nonfatal Self-Injury and Survival Following a Cancer Diagnosis: A Comparative Population-Based Cohort Study
Authors: Antoine Eskander, Rinku Sutradhar, Elie Isenberg-Grzeda, Rui Fu, Alyson Mahar, Simone N. Vigod, James Bolton, Julie Deleemans, Wing C. Chan, Natalie G. Coburn, Julie Hallet, _ _
Journal: Journal of the National Comprehensive Cancer Network (2025)

Background: Nonfatal self-injury (NFSI) following a cancer diagnosis is a very serious mental health sequalae. Whether NFSI has an impact on patient outcomes is unknown. To help determine the impact and burden of NFSI in cancer care, this study examined the association between NFSI following a cancer diagnosis and subsequent overall survival (OS). Methods: A retrospective population-based cohort study using linked administrative health care included patients with a new cancer diagnosis in 2007 through 2019. The exposure was NFSI (emergency department visit for self-injury of intentional or undetermined intent), treated as time-varying. The outcome was OS, as death from any cause measured from cancer diagnosis. Extended Cox multivariable models examined the association between NFSI and OS, adjusting for patient, cancer, and mental health history characteristics. Results: Of 806,910 patients, 2,482 (0.31%) had NFSI at a median of 29 months (IQR, 11–57) from cancer diagnosis. Of those, 81 had &gt;1 NFSI event. Patients with NFSI had inferior OS compared with those who had not yet experienced an NFSI (adjusted hazard ratio [HR], 1.73; 95% CI, 1.61–1.85). When treating NFSI as a count variable, there was an association between each additional NFSI and OS (adjusted HR, 1.17; 95% CI, 1.08–1.26). Conclusions: NFSI following a cancer diagnosis was independently associated with inferior OS. This finding highlights NFSI as a crucial event for patients with cancer and supports the importance of identifying and providing treatment for patients with cancer with cancer-related distress, such as marked by higher risk of NFSI.
“Off-Label” Use of Checkpoint Inhibitors in Patients With Negative or Unknown PD-L1 Status in Advanced Head and Neck Cancer
Authors: Margaret Stalker, Kewen Qu, Roger B. Cohen, Ronac Mamtani, Wei-Ting Hwang, Lova Sun
Journal: Journal of the National Comprehensive Cancer Network (2025)

Background: The KEYNOTE-048 study established the checkpoint inhibitor (CPI) pembrolizumab, with/without chemotherapy, as frontline treatment for recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). However, pembrolizumab monotherapy has limited efficacy in PD-L1–negative disease. Clinical practice patterns regarding PD-L1 combined positive score (CPS) testing and PD-L1–guided treatment selection remain unknown. Patients and Methods: This retrospective analysis included patients who initiated treatment for R/M HNSCC from 2011 to 2023 in a nationwide electronic health record–derived deidentified database. Frontline therapy was categorized as CPI monotherapy, CPI with chemotherapy, or chemotherapy ± cetuximab without CPI. A subset of patients treated in 2019 and beyond (2019+ cohort) were analyzed to investigate PD-L1 testing rates, treatment patterns following FDA approval of pembrolizumab, and the proportion receiving “off-label” CPI monotherapy (single-agent use in patients with metastatic HNSCC and negative/unknown PD-L1 status). Factors associated with “off-label” use were identified using multivariable logistic regression. Results: The total cohort included 7,657 patients with a median age of 65 years (IQR, 58–72); 67% were White, 78% had a history of smoking, 66% had an ECOG performance status (PS) of 0–1, and 31% were HPV-positive. The 2019+ subset included 3,395 patients, of whom nearly half (47%) did not have a known PD-L1 CPS prior to systemic treatment initiation. The most common frontline treatment in the total cohort was CPI monotherapy (43%). CPI monotherapy use was even higher in patients aged ≥75 years (54%) and those with ECOG PS ≥2 (52%). Among the 2019+ subgroup with PD-L1 CPS negative/unknown tumors (n=1,926), 536 (28%) received CPI monotherapy “off-label.” Factors associated with “off-label” use on multivariable regression included age ≥75 years (odds ratio [OR], 1.4), community practice setting (OR, 1.5), and earlier year of treatment (OR, 1.3 per year) (all P &lt;.05). Conclusions: Most US patients with R/M HNSCC are now receiving CPI-based therapy in the frontline setting; however, PD-L1 testing remains underutilized. “Off-label” use of CPI monotherapy in PD-L1–negative/unknown HNSCC is common, particularly among elderly patients.
CD4 T cell depletion increases memory differentiation of endogenous and CAR T cells and enhances the efficacy of Super2 and IL-33-armored CAR T cells against solid tumors
Authors: Asmaa O Mohamed, David Tyler Boone, Shannon L Ferry, Melanie C Peck, Alicia M Santos, Haille E Soderholm, Megen C Wittling, Chrystal Paulos, Mary Jo Turk, Yina H Huang
Journal: Journal for ImmunoTherapy of Cancer (2025)

Background Responsiveness to chimeric antigen receptor (CAR) T cell therapy correlates with CAR T cell expansion and persistence in vivo. Multiple strategies improve persistence by increasing stem-like properties or sustaining CAR T cell activity with combination therapies. Here, we describe the intrinsic ability of CAR T cells to differentiate into memory T cells, the effect of cytokine armoring, and neoadjuvant CD4 depletion therapy on CAR and tumor-specific endogenous memory T cells. Methods TRP1-specific or NKG2D CAR T cells alone or with Super2+IL-33 (S233) armoring and/or CD4 depletion were evaluated in immunocompetent B16F10 melanoma or MC38 colon cell carcinoma models without preconditioning. We characterized CAR and endogenous tumor-specific memory T cell precursors, establishment of circulating (T CIRC ) and resident (T RM ) memory T cell subsets, and ability to protect against secondary tumors. Results TRP1-specific or NKG2D CAR T cells had no effect on primary tumor growth in immunocompetent mice unless they were combined with S233 armoring or CD4 depletion. Unarmored CAR T cells expressed a stem-like phenotype in the tumor-draining lymph node and differentiated into CAR T CIRC memory cells in lymphoid organs and CAR T RM cells in the skin. In contrast, S233-armored CAR T cells exhibited an activated effector phenotype and differentiated inefficiently into CAR effector and central memory T cells. Combining CD4 therapy with unarmored CAR T cells increased CAR T CIRC and T RM memory T cells. Either CD4 depletion therapy or S233-armored CAR T cells induced activation of tumor-specific endogenous T cells that differentiated into both T CIRC and T RM memory T cells. CD4 depletion and S233-armored CAR T cell combination therapy synergized to increase endogenous memory T cells. Conclusions Unarmored TRP-1-specific or NKG2D CAR T cells have intrinsic stem-like properties and differentiate into memory T cell subsets but are non-protective against primary or secondary tumors. S233 cytokine armoring alone or with CD4 depletion improved effector responses but limited CAR memory T cell generation. S233-armored CAR T cells or CD4 depletion therapy induced endogenous tumor-specific T CIRC and T RM T cells, but the combination potentiated endogenous memory T cell generation and resulted in improved protection against B16F10 rechallenge.
Living on the Rocks: Genomic Analysis of Limestone Langurs Provides Novel Insights into the Adaptive Evolution in Extreme Karst Environments
Authors: Liu Zhijin, Xiongfei Zhang, Peipei Wang, Minheng Hong, Xiaochan Yan, Xiaoqiu Qi, Qian Zhao, Zhenghao Chen, Huajian Nie, Hui Li, Ziwen Li, Liye Zhang, Jiwei Qi, Chaolei He, Nguyen Van Truong, Minh D Le, Tilo Nadler, Hiroo Imai, Christian Roos, Ming Li
Journal: Genomics Proteomics & Bioinformatics (2025)

Abstract Understanding how organisms adapt to their environments is a central question in evolutionary biology. Limestone langurs are unique among primates, as they are exclusively found in karst limestone habitats and have evolved mechanisms to tolerate high levels of mineral ions, which are typically associated with metal toxicity affecting organs, cells, and genetic material. We generated a high-quality reference genome (Tfra_5.0) for the limestone langur (Trachypithecus francoisi), along with genome re-sequencing data for 48 langurs representing 15 Trachypithecus species. Genes coding for ion channels (e.g., Na+, K+, and Ca2+) exhibited significantly accelerated evolution in limestone langurs. Limestone langur-specific mutations in Na+ and Ca2+ channels were experimentally confirmed to modify inward ion currents in vitro. Unexpectedly, scans for positive selection also identified genes involved in DNA damage response/repair pathways, a previously unknown adaption. This finding highlights an evolutionary adaptation in limestone langurs that mitigate the increased risk of DNA damage posed by elevated metal ion concentrations. Notably, a limestone langur-specific mutation (E94D) of the melanocortin 1 receptor was associated with increased basal cyclic adenosine monophosphate (cAMP) production, contributing to the species’ darker coat color, which likely serves as camouflage on limestone rocks. Our findings reveal novel adaptive evolutionary mechanisms of limestone langurs and offer broader insights into organismal adaptation to extreme environments, with potential implications for understanding human health, biological evolution, and biodiversity conservation.
The heart–kidney axis in cirrhosis: rethinking hepatorenal and cardiorenal syndromes—authors’ reply
Authors: Lui G. Forni, Mitra K. Nadim, Marlies Ostermann, Mitra K. Nadim, John A. Kellum, Lui Forni, Claire Francoz, Sumeet K. Asrani, Andrew S. Allegretti, Javier A. Neyra, Jody C. Olson, Salvatore Piano, Lisa B. VanWagner, Elizabeth C. Verna, Ayse Akcan-Arikan, Paolo Angeli, Justin M. Belcher, Scott W. Biggins, Akash Deep, Guadalupe Garcia-Tsao, Yuri S. Genyk, Pere Gines, Patrick S. Kamath, Sandra L. Kane-Gill, Manish Kaushik, Nuttha Lumlertgul, Etienne Macedo, Rakhi Maiwall, Sebastian Marciano, Raimund H. Pichler, Claudio Ronco, Puneeta Tandon, Juan-Carlos Q. Velez, Ravindra L. Mehta, François Durand
Journal: Intensive Care Medicine (2025)
Pooled screening for CAR function identifies novel IL-13Rα2-targeted CARs for treatment of glioblastoma
Authors: Khloe S Gordon, Caleb R Perez, Andrea Garmilla, Maxine S Y Lam, Joey J Y Aw, Anisha Datta, Douglas A Lauffenburger, Andrea Pavesi, Michael E Birnbaum
Journal: Journal for ImmunoTherapy of Cancer (2025)

Background Chimeric antigen receptor (CAR) therapies have demonstrated potent efficacy in treating B-cell malignancies, but have yet to meaningfully translate to solid tumors. Nonetheless, they are of particular interest for the treatment of glioblastoma, which is an aggressive form of brain cancer with few effective therapeutic options, due to their ability to cross the highly selective blood-brain barrier. Methods Here, we use our pooled screening platform, CARPOOL, to expedite the discovery of CARs with antitumor functions necessary for solid tumor efficacy. We performed selections in primary human T cells expressing a library of 1.3×10 6 third generation CARs targeting IL-13Rα2, a cancer testis antigen commonly expressed in glioblastoma. Selections were performed for cytotoxicity, proliferation, memory formation, and persistence on repeated antigen challenge. Results Each enriched CAR robustly produced the phenotype for which it was selected, and one enriched CAR triggered potent cytotoxicity and long-term proliferation on in vitro tumor rechallenge. It also showed significantly improved persistence and comparable tumor control in a microphysiological human in vitro model and a xenograft model of human glioblastoma, but also demonstrated increased off-target recognition of IL-13Rα1. Conclusion Taken together, this work demonstrates the utility of extending CARPOOL to diseases beyond hematological malignancies and represents the largest exploration of signaling combinations in human primary cells to date.