tbuckley/cabot-search huggingface dataset:
Survival Patterns Among Patients With Breast Cancer in Sub-Saharan Africa
Authors: Miteku Andualem Limenih, Eskedar Getie Mekonnen, Frehiwot Birhanu, Beshada Rago Jima, Binyam Girma Sisay, Eskeziaw Abebe Kassahun, Hamid Yimam Hassen
Journal: JAMA Network Open (2024)

Importance Breast cancer is the most prevalent cancer globally with tremendous disparities both within specific regions and across different contexts. The survival pattern of patients with breast cancer remains poorly understood in sub-Saharan African (SSA) countries. Objective To investigate the survival patterns of patients with breast cancer in SSA countries and compare the variation across countries and over time. Data Sources Embase, PubMed, Web of Science, Scopus, and ProQuest were searched from inception to December 31, 2022, with a manual search of the references. Study Selection Cohort studies of human participants that reported 1-, 2-, 3-, 4-, 5-, and 10-year survival from diagnosis among men, women, or both with breast cancer in SSA were included. Data Extraction and Synthesis Independent extraction of study characteristics by multiple observers was performed using open-source software, then exported to a standard spreadsheet. A random-effects model using the generalized linear mixed-effects model was used to pool data. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline for reporting was followed. Main Outcome and Measures Survival time from diagnosis. Results Forty-nine studies were included in the review with a sample size ranging from 21 to 2311 (total, 14 459; 196 [1.35%] men, 13 556 [93.75%] women, and 707 [4.90%] unspecified; mean age range, 38 to 71 years), of which 40 were summarized using meta-analysis. The pooled 1-year survival rate of patients with breast cancer in SSA was 0.79 (95% CI, 0.67-0.88); 2-year survival rate, 0.70 (95% CI, 0.57-0.80); 3-year survival rate, 0.56 (95% CI, 0.45-0.67); 4-year survival rate, 0.54 (95% CI, 0.43-0.65); and 5-year survival rate, 0.40 (95% CI, 0.32-0.49). The subgroup analysis showed that the 5-year survival rate ranged from 0.26 (95% CI, 0.06-0.65) for studies conducted earlier than 2010 to 0.47 (95% CI, 0.32-0.64) for studies conducted later than 2020. Additionally, the 5-year survival rate was lower in countries with a low human development index (HDI) (0.36 [95% CI, 0.25-0.49) compared with a middle HDI (0.46 [95% CI, 0.33-0.60]) and a high HDI (0.54 [95% CI, 0.04-0.97]). Conclusions and Relevance In this systematic review and meta-analysis, the survival rates for patients with breast cancer in SSA were higher in countries with a high HDI compared with a low HDI. Enhancing patient survival necessitates a comprehensive approach that involves collaboration from all relevant stakeholders.
Letter to the Editor: Chronic hepatitis B baseline viral load and on-treatment liver cancer risk: A multinational cohort study of HBeAg-positive patients
Authors: Cong Luo
Journal: Hepatology (2024)

Department of Hepatopancreatobiliary Surgery, The People's Hospital of Zizhong County, Zizhong, China Publication type: Letter to the Editor. Linked Content: This article is linked to Choi WM et al.'s paper. To view this article, please visit https://doi: 10.1097/HEP.0000000000000752 Correspondence Cong-Luo, Department of Hepatopancreatobiliary Surgery, The People's Hospital of Zizhong County, Zizhong, China. Email: [email protected]
Clinician-Level Knowledge and Barriers to Hepatocellular Carcinoma Surveillance
Authors: Robert J. Wong, Patricia D. Jones, Bolin Niu, George Therapondos, Mae Thamer, Onkar Kshirsagar, Yi Zhang, Paulo Pinheiro, Beverly Kyalwazi, Ronnie Fass, Mandana Khalili, Amit G. Singal
Journal: JAMA Network Open (2024)

Importance Surveillance for hepatocellular carcinoma (HCC) in patients with cirrhosis is underused. Identifying potentially modifiable factors to address barriers in HCC surveillance is critical to improve patient outcomes. Objective To evaluate clinician-level factors contributing to underuse of HCC surveillance in patients with cirrhosis. Design, Setting, and Participants This survey study included primary care clinicians (PCCs) and gastroenterology and hepatology clinicians at 5 safety-net health systems in the US. Clinicians were surveyed from March 15 to September 15, 2023, to assess knowledge, attitudes, beliefs, perceived barriers, and COVID-19–related disruptions in HCC surveillance in patients with cirrhosis. Data were analyzed from October to November 2023. Main Outcome and Measures HCC surveillance knowledge was assessed with 6 questions querying the respondent’s ability to correctly identify appropriate use of HCC surveillance. Attitudes, perceived barriers, and beliefs regarding HCC surveillance and perceived impact of the COVID-19 pandemic–related disruptions with HCC surveillance were assessed with a series of statements using a 4-point Likert scale and compared PCCs and gastroenterology and hepatology clinicians. Results Overall, 347 of 1362 clinicians responded to the survey (25.5% response rate), among whom 142 of 237 (59.9%) were PCCs, 48 of 237 (20.3%) gastroenterology and hepatology, 190 of 236 (80.5%) were doctors of medicine and doctors of osteopathic medicine, and 46 of 236 (19.5%) were advanced practice clinicians. On HCC knowledge assessment, 144 of 270 (53.3%) scored 5 or more of 6 questions correctly, 37 of 48 (77.1%) among gastroenterology and hepatology vs 65 of 142 (45.8%) among PCCs ( P &amp;amp;lt; .001). Those with higher HCC knowledge scores were less likely to report barriers to HCC surveillance. PCCs were more likely to report inadequate time to discuss HCC surveillance (37 of 139 [26.6%] vs 2 of 48 [4.2%]; P = .001), difficulty identifying patients with cirrhosis (82 of 141 [58.2%] vs 5 of 48 [10.4%]; P &amp;amp;lt; .001), and were not up-to-date with HCC surveillance guidelines (87 of 139 [62.6%] vs 5 of 48 [10.4%]; P &amp;amp;lt; .001) compared with gastroenterology and hepatology clinicians. While most acknowledged delays during the COVID-19 pandemic, 62 of 136 PCCs (45.6%) and 27 of 45 gastroenterology and hepatology clinicians (60.0%) reported that patients with cirrhosis could currently complete HCC surveillance without delays. Conclusions and Relevance In this survey study, important gaps in knowledge and perceived barriers to HCC surveillance were identified. Effective delivery of HCC education to PCCs and health system–level interventions must be pursued in parallel to address the complex barriers affecting suboptimal HCC surveillance in patients with cirrhosis.
Identifying a therapeutic window of opportunity for people living with primary sclerosing cholangitis: Embryology and the overlap of inflammatory bowel disease with immune-mediated liver injury
Authors: Richard Kellermayer, Marco Carbone, Thomas D. Horvath, Reka G. Szigeti, Cynthia Buness, Gideon M. Hirschfield, Peter J. Lewindon
Journal: Hepatology (2024)

Primary sclerosing cholangitis (PSC) is a variably progressive, fibrosis-causing autoimmune disorder of the intrahepatic and extrahepatic bile ducts of unclear etiology. PSC is commonly (in 60%–90% of cases) associated with an inflammatory bowel disease (IBD) like PSC-IBD and less commonly with an autoimmune hepatitis (AIH) like PSC-AIH or AIH-overlap disorder. Hepatologists and Gastroenterologists often consider these combined conditions as distinctly different from the classical forms in isolation. Here, we review recent epidemiologic observations and highlight that PSC-IBD and PSC-AIH overlap appear to represent aspects of a common PSC clinico-pathological pathway and manifest in an age-of-presentation-dependent manner. Particularly from the pediatric experience, we hypothesize that all cases of PSC likely originate from a complex “Early PSC”-“IBD”-“AIH” overlap in which PSC defines the uniquely and variably associated “AIH” and “IBD” components along an individualized lifetime continuum. We speculate that a distinctly unique, “diverticular autoimmunity” against the embryonic cecal- and hepatic diverticulum-derived tissues may be the origin of this combined syndrome, where “AIH” and “IBD” variably commence then variably fade while PSC progresses with age. Our hypothesis provides an explanation for the age-dependent variation in the presentation and progression of PSC. This is critical for the optimal targeting of studies into PSC etiopathogenesis and emphasizes the concept of a “developmental window of opportunity for therapeutic mitigation” in what is currently recognized as an irreversible disease process. The discovery of such a window would be critically important for the targeting of interventions, both the administration of current therapies and therapeutic trial planning.
Exploring Anabolic Androgenic Steroid Use Among Cisgender Gay, Bisexual, and Queer Men
Authors: Eric Kutscher, Arslaan Arshed, Richard E. Greene, Mat Kladney
Journal: JAMA Network Open (2024)

Importance Anabolic androgenic steroids (AAS) are disproportionately used by sexual minority men, with the physical and mental health implications of AAS use incompletely understood. Objective To understand the reasons for use and health care needs of gay, bisexual, and queer cisgender men using AAS. Design, Setting, and Participants This qualitative study was conducted from November 2021 to May 2023 using self-administered questionnaires and semistructured interviews that were transcribed and coded using reflexive thematic analysis. Participants were recruited through convenience and snowball sampling from lesbian, gay, bisexual, transgender, and queer clinical centers in New York, New York, as well as through online platforms. All patients self-identified as cisgender and gay, bisexual, or queer. Exposures History of nonprescribed AAS use for a minimum of 8 consecutive weeks was required. Main Outcomes and Measures The primary outcomes were reasons for and health implications of AAS use and interactions with health care practitioners, as determined through interviews. Interview transcripts were collected and analyzed. Results Thematic saturation was reached after interviews with 12 male participants (mean [SD] age, 44 [11] years), with the majority of participants identifying as gay (10 participants [83%]), White non-Hispanic (9 participants [75%]), being in their 30s and 40s (9 participants [75%]), holding a bachelor’s degree or higher (11 participants [92%]), and having used steroids for a mean (SD) of 7.5 (7.1) years. One participant (8%) self-identified as Black, and 2 (17%) identified as Hispanic. Seven men (58%) met the criteria for muscle dysmorphia on screening. Nine overarching themes were found, including internal and external motivators for initial use, continued use because of effectiveness or fear of losses, intensive personal research, physical and emotional harms experienced from use, using community-based harm reduction techniques, frustration with interactions with the medical community focused on AAS cessation, and concerns around the illegality of AAS. Conclusions and Relevance In this qualitative study, AAS use among cisgender gay, bisexual, and queer men was found to be associated with multifactorial motivators, including a likely AAS use disorder and muscle dysmorphia. Despite all participants experiencing harms from use, men seeking medical help found insufficient support with practitioners insistent on AAS cessation and, thus, developed their own harm reduction techniques. Further research is needed to assess the utility of practitioner education efforts, the safety and efficacy of community-developed harm reduction methods, and the impact of AAS decriminalization on health care outcomes for this patient population.
Breast Cancer Survival in Sub-Saharan Africa—Diversity Across Disparities
Authors: Daniel S. O’Neil
Journal: JAMA Network Open (2024)

Miteku Andualem Limenih, MSc, MEPI; Eskedar Getie Mekonnen, MPH, MSc; Frehiwot Birhanu, MPH; Beshada Rago Jima, MPH; Binyam Girma Sisay, MPH; Eskeziaw Abebe Kassahun, MPH, MSc; Hamid Yimam Hassen, PhD
Insights into ALD and AUD diagnosis and prognosis: Exploring AI and multimodal data streams
Authors: Praveena Narayanan, Tiffany Wu, Vijay H. Shah, Brenda L. Curtis
Journal: Hepatology (2024)

The rapid evolution of artificial intelligence and the widespread embrace of digital technologies have ushered in a new era of clinical research and practice in hepatology. Although its potential is far from realization, these significant strides have generated new opportunities to address existing gaps in the delivery of care for patients with liver disease. In this review, we discuss how artificial intelligence and opportunities for multimodal data integration can improve the diagnosis, prognosis, and management of alcohol-associated liver disease. An emphasis is made on how these approaches will also benefit the detection and management of alcohol use disorder. Our discussion encompasses challenges and limitations, concluding with a glimpse into the promising future of these advancements.
The neonatal gut microbiome and global health
Authors: Pinaki Panigrahi
Journal: Gut Microbes (2024)

The role of gut microbiome in health, a century-old concept, has been on the center stage of medical research recently. While different body sites, disease conditions, and populations have been targeted, neonatal and early infancy appear to be the most suitable period for such interventions. It is intriguing to note that, unlike traditional use in diarrhea and maintenance of gastrointestinal health, microbiome-mediating therapies have now addressed the most serious medical conditions in young infants such as necrotizing enterocolitis and neonatal sepsis. Unfortunately, almost all new endeavors in this space have been carried out in the Western world leaving behind millions of neonates that can benefit from such manipulations while serving as a large resource for further learning. In this review, an attempt has been made to quantify the global burden of neonatal morbidity and mortality, examples presented on interventions that have failed as a result of drawing from studies conducted in the West, and a case made for manipulating the neonatal gut microbiome to address the biggest killers in early life. A brief comparative analysis has been made to demonstrate the differences in the gut microbiota of North and South and a large clinical trial of synbiotics conducted by our group in a South Asian setting has been presented. Although challenging, the value of conducting such global health research is introduced with an intent to invite medical scientists to engage in well-planned, scientifically robust research endeavors. This can bring about innovation while saving and serving the most vulnerable citizens now and protecting them from the negative health consequences in the later part of their lives, ultimately shaping a resilient and equitable world as pledged by 193 United Nations member countries in 2015.
Fecal transplant from vaginally seeded infants decreases intraabdominal adiposity in mice
Authors: Sivaranjani Namasivayam, Curtis Tilves, Hua Ding, Shaoguang Wu, Jada C Domingue, Camilo Ruiz-Bedoya, Ankit Shah, Eric Bohrnsen, Benjamin Schwarz, Mickayla Bacorn, Qing Chen, Shira Levy, Maria Gloria Dominguez Bello, Sanjay K Jain, Cynthia L Sears, Noel T Mueller, Suchitra K Hourigan
Journal: Gut Microbes (2024)

Exposing C-section infants to the maternal vaginal microbiome, coined "vaginal seeding", partially restores microbial colonization. However, whether vaginal seeding decreases metabolic disease risk is unknown. Therefore, we assessed the effect of vaginal seeding of human infants on adiposity in a murine model. Germ-free mice were colonized with transitional stool from human infants who received vaginal seeding or control (placebo) seeding in a double-blind randomized trial. There was a reduction in intraabdominal adipose tissue (IAAT) volume in male mice that received stool from vaginally seeded infants compared to control infants. Higher levels of isoleucine and lower levels of nucleic acid metabolites were observed in controls and correlated with increased IAAT. This suggests that early changes in the gut microbiome and metabolome caused by vaginal seeding have a positive impact on metabolic health.
Classical monocyte ontogeny dictates their functions and fates as tissue macrophages
Authors: Sébastien Trzebanski, Jung-Seok Kim, Niss Larossi, Ayala Raanan, Daliya Kancheva, Jonathan Bastos, Montaser Haddad, Aryeh Solomon, Ehud Sivan, Dan Aizik, Jarmila Sekeresova Kralova, Mor Gross-Vered, Sigalit Boura-Halfon, Tsvee Lapidot, Ronen Alon, Kiavash Movahedi, Steffen Jung
Journal: Immunity (2024)
Expression of the membrane tetraspanin claudin 18 on cancer cells promotes T lymphocyte infiltration and antitumor immunity in pancreatic cancer
Authors: Francesco De Sanctis, Silvia Dusi, Simone Caligola, Cristina Anselmi, Varvara Petrova, Barbara Rossi, Gabriele Angelini, Michael Erdeljan, Stefan Wöll, Anna Melissa Schlitter, Thomas Metzler, Katja Steiger, Zea Borok, Peter Bailey, Aline Bauer, Cornelia Halin, Federico Boschi, Rosalba Giugno, Stefania Canè, Rita Lawlor, Vincenzo Corbo, Aldo Scarpa, Gabriela Constantin, Stefano Ugel, Fulvia Vascotto, Ugur Sahin, Özlem Türeci, Vincenzo Bronte
Journal: Immunity (2024)

Tumors weakly infiltrated by T lymphocytes poorly respond to immunotherapy. We aimed to unveil malignancy-associated programs regulating T cell entrance, arrest, and activation in the tumor environment. Differential expression of cell adhesion and tissue architecture programs, particularly the presence of the membrane tetraspanin claudin (CLDN)18 as a signature gene, demarcated immune-infiltrated from immune-depleted mouse pancreatic tumors. In human pancreatic ductal adenocarcinoma (PDAC) and non-small cell lung cancer, CLDN18 expression positively correlated with more differentiated histology and favorable prognosis. CLDN18 on the cell surface promoted accrual of cytotoxic T lymphocytes (CTLs), facilitating direct CTL contacts with tumor cells by driving the mobilization of the adhesion protein ALCAM to the lipid rafts of the tumor cell membrane through actin. This process favored the formation of robust immunological synapses (ISs) between CTLs and CLDN18-positive cancer cells, resulting in increased T cell activation. Our data reveal an immune role for CLDN18 in orchestrating T cell infiltration and shaping the tumor immune contexture.
Author Correction: Axicabtagene ciloleucel as second-line therapy in large B cell lymphoma ineligible for autologous stem cell transplantation: a phase 2 trial
Authors: Roch Houot, Emmanuel Bachy, Guillaume Cartron, François-Xavier Gros, Franck Morschhauser, Lucie Oberic, Thomas Gastinne, Pierre Feugier, Rémy Duléry, Catherine Thieblemont, Magalie Joris, Fabrice Jardin, Sylvain Choquet, Olivier Casasnovas, Gabriel Brisou, Morgane Cheminant, Jacques-Olivier Bay, Francisco Llamas Gutierrez, Cédric Menard, Karin Tarte, Marie-Hélène Delfau, Cédric Portugues, Emmanuel Itti, Xavier Palard-Novello, Paul Blanc-Durand, Yassine Al Tabaa, Clément Bailly, Camille Laurent, François Lemonnier
Journal: Nature Medicine (2024)
<i>Vital Signs</i>: Drowning Death Rates, Self-Reported Swimming Skill, Swimming Lesson Participation, and Recreational Water Exposure — United States, 2019–2023
Authors: Tessa Clemens, Briana Moreland, Karin A. Mack, Karen Thomas, Gwen Bergen, Robin Lee
Journal: MMWR Morbidity and Mortality Weekly Report (2024)

Drowning is the cause of approximately 4,000 U.S. deaths each year and disproportionately affects some age, racial, and ethnic groups. Infrastructure disruptions during the COVID-19 pandemic, including limited access to supervised swimming settings, might have affected drowning rates and risk. Data on factors that contribute to drowning risk are limited. To assess the potential impact of the pandemic on drowning death rates, pre- and post-COVID-19 pandemic rates were compared.
Comprehensive periodic health evaluations of 454 Norwegian Paralympic and Olympic athletes over 8 years: what did we learn?
Authors: Kathrin Steffen, Roald Bahr, Benjamin Clarsen, Bjørn Fossan, Hilde Fredriksen, Hilde Gjelsvik, Lars Haugvad, Aasne Fenne Hoksrud, Erik Iversen, Anu Koivisto-Mørk, Ellen Moen, Vibeke Røstad, Tonje Reier-Nilsen, Thomas Torgalsen, Hilde Moseby Berge
Journal: British Journal of Sports Medicine (2024)

Objective A periodic health evaluation (PHE) is a comprehensive and multidisciplinary investigation of athlete health widely used in elite sport, but its contents and benefits can be questioned. This study aimed to determine the prevalence of conditions identified by a PHE among Paralympic and Olympic athletes over four consecutive Games cycles from Rio de Janeiro 2016 to Beijing 2022 and to assess the benefits and potential pitfalls of a comprehensive PHE programme in detecting existing injuries, illnesses and other health issues. Methods We collected extensive health history and clinical examination data on elite athletes: medical history, ECG, blood pressure, blood samples, spirometry, musculoskeletal health, cognitive function, mental health and compliance with public health programmes. Results The final cohort included 87 Paralympic and 367 Olympic athletes, representing 565 PHE cycles. Musculoskeletal problems and unspecified pain, infections and allergies were the most frequent health issues. High blood pressure was the most prevalent cardiovascular finding, and vitamin D deficiency the most common laboratory abnormality. Most athletes complied with the public childhood vaccination programmes, but fewer with recommended cancer screening. Follow-up of health issues was variable. Conclusion Our PHE programme identified musculoskeletal problems, infections, allergies, elevated blood pressure and vitamin D deficiency as common health conditions. Longitudinal follow-up of health conditions identified during screening and improved compliance with public health and cancer screening programmes is needed to determine the true benefits of athlete care prompted by the PHE.
Impact of busulfan versus treosulfan dose intensity in myelofibrosis undergoing hematopoietic cell transplantation
Authors: Nico Gagelmann, Claudia Schuh, Sarah Flossdorf, Desiree Kunadt, Matthias Stelljes, Igor W. Blau, Arne Brecht, Wolfgang Bethge, Thomas Schroeder, Gerald Wulf, Elisa Sala, Gesine Bug, Katharina Fleischhauer, Nicolaus Kröger
Journal: American Journal of Hematology (2024)

Abstract One key aspect of allogeneic hematopoietic cell transplantation (HCT) is pretransplant conditioning, balancing risk for relapse versus non‐relapse mortality. Conditioning regimens with different alkylators at different doses can influence outcome, but data are missing for myelofibrosis, a challenging cohort of patients usually presenting at older age and with comorbidities. We evaluated in a multicenter retrospective study the comparative efficacy and safety of busulfan versus treosulfan in combination with fludarabine for myelofibrosis patients undergoing HCT. This study included 1115 patients (busulfan, n = 902; treosulfan, n = 213) receiving first HCT between 2005 and 2021. Patients were generally balanced for key patient characteristics. Overall survival at 4 years was 62% for the busulfan group versus 58% for the treosulfan group ( p = .22). Impact on outcome was dose‐dependent. Overall survival was 65% (95% CI, 61%–69%) for reduced intensity busulfan versus 69% (95% CI, 54%–84%) for reduced intensity treosulfan, 53% (95% CI, 44%–63%) for higher intensity busulfan, and 55% (95% CI, 46%–63%) for higher intensity treosulfan. Incidence of relapse was similar across intensity groups. In multivariable analysis, the hazard for death (with reduced intensity busulfan as reference) was 0.88 (95% CI, 0.39–2.01) for reduced intensity treosulfan ( p = .77), 1.42 (95% CI, 0.96–2.10) for higher intensity busulfan (0.08), and 1.61 (95% CI, 1.14–2.26) for higher intensity treosulfan ( p = .006). In terms of non‐relapse mortality, comparison was not significantly different, while the hazard ratio for higher intensity treosulfan was 1.48 (95% CI, 0.98–2.23; p = .06). Here, we showed comparable outcomes and improved survival in myelofibrosis undergoing HCT with reduced intensity busulfan or treosulfan.