tbuckley/cabot-search huggingface dataset:
Consensus recommendations for an integrated diagnostic approach to peripheral nerve sheath tumors arising in the setting of Neurofibromatosis type 1 (NF1)
Authors: Calixto-Hope G Lucas, Andrea M Gross, Carlos G Romo, Carina A Dehner, Alexander J Lazar, Markku Miettinen, Melike Pekmezci, Martha Quezado, Fausto J Rodriguez, Anat Stemmer-Rachamimov, David Viskochil, Arie Perry
Journal: Neuro-Oncology (2024)

Abstract Consensus recommendation published in 2017 histologically defining atypical neurofibromatous neoplasm of uncertain biologic potential (ANNUBP) and malignant peripheral nerve sheath tumor (MPNST) were codified in the 2021 WHO Classification of Tumors of the Central Nervous System and the 2022 WHO Classification of Tumors of Soft Tissue and Bone. However, given the shift in diagnostic pathology toward the use of integrated histopathologic and genomic approaches, the incorporation of additional molecular strata in the classification of Neurofibromatosis Type 1 (NF1)-associated peripheral nerve sheath tumors should be formalized to aid in accurate diagnosis and early identification of malignant transformation to enable appropriate intervention for affected patients. To this end, we assembled a multi-institutional expert pathology working group as part of a “Symposium on Atypical Neurofibroma: State of the Science”. Herein, we provide a suggested framework for adequate interventional radiology and surgical sampling, and recommend molecular profiling for clinically or radiologically worrisome non-cutaneous lesions in patients with NF1 to identify diagnostically-relevant molecular features, including CDKN2A/B inactivation for ANNUBP, as well as SUZ12, EED, or TP53 inactivating mutations, or significant aneuploidy for MPNST. We also propose renaming “low-grade MPNST” to “ANNUBP with increased proliferation” to avoid the use of the “malignant” term in this group of tumors with persistent unknown biologic potential. This refined integrated diagnostic approach for NF1-associated peripheral nerve sheath tumors should continue to evolve in concert with our understanding of these neoplasms.
Association of self-reported health problems and interpersonal violence in sport: a cross-sectional study in world-level performing athletes
Authors: Margo Mountjoy, Karolien Adriaens, Astrid Junge, Helena Verhelle, Felien Laureys, Sandi Kirby, Lenka Dienstbach-Wech, Jeremy Foster, Tine Vertommen
Journal: British Journal of Sports Medicine (2024)

Objectives A paucity of studies assesses the intersection of physical health (injury and illness), mental health and experiences of interpersonal violence (IV, also known as harassment and abuse) in sport. The objectives of this study were to examine the (a) frequency of self-reported physical and mental health problems of elite athletes in the 12 months prior to the survey, (b) differences in physical and mental health between male and female athletes and (c) relationship of athlete health with experiences of IV. Methods Elite adult athletes from four sports were approached at eight international events to answer an online questionnaire on their physical and mental health, as well as experiences of IV in sport within the past 12 months. Results A total of 562 athletes completed the questionnaire. Overall, 75% reported at least one physical symptom, most commonly headache and fatigue (n=188; 33.5% each), followed by musculoskeletal symptoms (n=169; 29.4%). 65.1% reported at least one mental health symptom, mostly of anxiety or depression. More female than male athletes reported physical (F:81.9%; M:68.3%; p&lt;0.001) and mental (F:71.9%; M:58.4%; p&lt;0.001) health problems, while addiction problems were more frequent in male athletes (F:1.8%; M:6.4%; p=0.006. 53.0% of the female and 42.3% of the male participants reported having experienced at least one form of IV. Linear regression analysis demonstrated that all forms of IV, except physical IV (all p’s&lt;0.001), were associated with an increasing number of physical and mental health symptoms. In addition, the analysis showed that female athletes had a higher increase in symptoms in response to IV than male athletes. Conclusions This study demonstrates the relationship of elite athlete physical and mental health with IV. Injury and illness prevention programmes in international sport should include strategies to reduce IV.
Artificial intelligence applied to coronary artery calcium scans (AI-CAC) significantly improves cardiovascular events prediction
Authors: Morteza Naghavi, Anthony P. Reeves, Kyle Atlas, Chenyu Zhang, Thomas Atlas, Claudia I. Henschke, David F. Yankelevitz, Matthew J. Budoff, Dong Li, Sion K. Roy, Khurram Nasir, Sabee Molloi, Zahi Fayad, Michael V. McConnell, Ioannis Kakadiaris, David J. Maron, Jagat Narula, Kim Williams, Prediman K. Shah, Daniel Levy, Nathan D. Wong
Journal: npj Digital Medicine (2024)

Coronary artery calcium (CAC) scans contain valuable information beyond the Agatston Score which is currently reported for predicting coronary heart disease (CHD) only. We examined whether new artificial intelligence (AI) applied to CAC scans can predict non-CHD events, including heart failure, atrial fibrillation, and stroke. We applied AI-enabled automated cardiac chambers volumetry and calcified plaque characterization to CAC scans (AI-CAC) of 5830 asymptomatic individuals (52.2% women, age 61.7 ± 10.2 years) in the multi-ethnic study of atherosclerosis during 15 years of follow-up, 1773 CVD events accrued. The AUC at 1-, 5-, 10-, and 15-year follow-up for AI-CAC vs. Agatston score was (0.784 vs. 0.701), (0.771 vs. 0.709), (0.789 vs. 0.712) and (0.816 vs. 0.729) (p < 0.0001 for all), respectively. AI-CAC plaque characteristics, including number, location, density, plus number of vessels, significantly improved CHD prediction in the CAC 1–100 cohort vs. Agatston Score. AI-CAC significantly improved the Agatston score for predicting all CVD events.
Yield and Effectiveness of Two-Sample Fecal Immunochemical Test-based Screening Program for Colorectal Cancer
Authors: Zenghao Xu, Jinhua Yang, Jiabei He, Qilong Li, Xinglin Fei, Hao Bai, Kai Gao, Yuanliang He, Chen Li, Mengling Tang, Jianbing Wang, Mingjuan Jin, Kun Chen
Journal: Clinical Gastroenterology and Hepatology (2024)
Global Disparities of Cancer and Its Projected Burden in 2050
Authors: Habtamu Mellie Bizuayehu, Kedir Y. Ahmed, Getiye Dejenu Kibret, Abel F. Dadi, Sewunet Admasu Belachew, Tanmay Bagade, Teketo Kassaw Tegegne, Rebecca L. Venchiarutti, Kelemu Tilahun Kibret, Aklilu Habte Hailegebireal, Yibeltal Assefa, Md Nuruzzaman Khan, Amanuel Abajobir, Kefyalew Addis Alene, Zelalem Mengesha, Daniel Erku, Daniel A. Enquobahrie, Tsion Zewdu Minas, Eyaya Misgan, Allen G. Ross
Journal: JAMA Network Open (2024)

Importance Cancer prevention and care efforts have been challenged by the COVID-19 pandemic and armed conflicts, resulting in a decline in the global Human Development Index (HDI), particularly in low- and middle-income countries. These challenges and subsequent shifts in health care priorities underscore the need to continuously monitor cancer outcome disparities and statistics globally to ensure delivery of equitable and optimal cancer prevention and care in uncertain times. Objective To measure the global burden of 36 cancers in 2022 by sex, age, and geographic location and to project future trends by 2050. Design, Setting, and Participants This cross-sectional study used population-based data from 2022 in 185 countries and territories were obtained from the Global Cancer Observatory database. Data extraction and analysis were carried out in April 2024. Main Outcomes and Measures Counts, rates, prevalence, mortality to incidence ratios (MIRs), and demography-based projections were used to characterize current and future cancer burden. Results This population-based study included 36 cancer types from 185 countries and territories. By 2050, 35.3 million cancer cases worldwide are expected, a 76.6% increase from the 2022 estimate of 20 million. Similarly, 18.5 million cancer deaths are projected by 2050, an 89.7% increase from the 2022 estimate of 9.7 million. Cancer cases and deaths are projected to nearly triple in low-HDI countries by 2050, compared to a moderate increase in very high–HDI countries (142.1% vs 41.7% for cancer cases and 146.1% vs 56.8% for cancer deaths). Males had a higher incidence and greater number of deaths in 2022 than females, with this disparity projected to widen by up to 16.0% in 2050. In 2022, the MIR for all cancers was 46.6%, with higher MIRs observed for pancreatic cancer (89.4%), among males (51.7%), among those aged 75 years or older (64.3%), in low-HDI countries (69.9%), and in the African region (67.2%). Conclusions and Relevance In this cross-sectional study based on data from 2022, cancer disparities were evident across HDI, geographic regions, age, and sex, with further widening projected by 2050. These findings suggest that strengthening access to and quality of health care, including universal health insurance coverage, is key to providing evidence-based cancer prevention, diagnostics, and care.
Publisher Correction: A genome-wide association analysis reveals new pathogenic pathways in gout
Authors: Tanya J. Major, Riku Takei, Hirotaka Matsuo, Megan P. Leask, Nicholas A. Sumpter, Ruth K. Topless, Yuya Shirai, Wei Wang, Murray J. Cadzow, Amanda J. Phipps-Green, Zhiqiang Li, Aichang Ji, Marilyn E. Merriman, Emily Morice, Eric E. Kelley, Wen-Hua Wei, Sally P. A. McCormick, Matthew J. Bixley, Richard J. Reynolds, Kenneth G. Saag, Tayaza Fadason, Evgenia Golovina, Justin M. O’Sullivan, Lisa K. Stamp, Nicola Dalbeth, Abhishek Abhishek, Michael Doherty, Edward Roddy, Lennart T. H. Jacobsson, Meliha C. Kapetanovic, Olle Melander, Mariano Andrés, Fernando Pérez-Ruiz, Rosa J. Torres, Timothy Radstake, Timothy L. Jansen, Matthijs Janssen, Leo A. B. Joosten, Ruiqi Liu, Orsolya I. Gaal, Tania O. Crişan, Simona Rednic, Fina Kurreeman, Tom W. J. Huizinga, René Toes, Frédéric Lioté, Pascal Richette, Thomas Bardin, Hang Korng Ea, Tristan Pascart, Geraldine M. McCarthy, Laura Helbert, Blanka Stibůrková, Anne-K. Tausche, Till Uhlig, Véronique Vitart, Thibaud S. Boutin, Caroline Hayward, Philip L. Riches, Stuart H. Ralston, Archie Campbell, Thomas M. MacDonald, Akiyoshi Nakayama, Tappei Takada, Masahiro Nakatochi, Seiko Shimizu, Yusuke Kawamura, Yu Toyoda, Hirofumi Nakaoka, Ken Yamamoto, Keitaro Matsuo, Nariyoshi Shinomiya, Kimiyoshi Ichida, Chaeyoung Lee, Linda A. Bradbury, Matthew A. Brown, Philip C. Robinson, Russell R. C. Buchanan, Catherine L. Hill, Susan Lester, Malcolm D. Smith, Maureen Rischmueller, Hyon K. Choi, Eli A. Stahl, Jeff N. Miner, Daniel H. Solomon, Jing Cui, Kathleen M. Giacomini, Deanna J. Brackman, Eric M. Jorgenson, Hongbo Liu, Katalin Susztak, Suyash Shringapure, Suyash Shringarpure, Alexander So, Yukinori Okada, Changgui Li, Yongyong Shi, Tony R. Merriman
Journal: Nature Genetics (2024)
Pressure-Mediated Biofeedback With Pelvic Floor Muscle Training for Urinary Incontinence
Authors: Xiuqi Wang, Jin Qiu, Dan Li, Zhongmin Wang, Yanjing Yang, Guorong Fan, Xiaoyan Mao, Jiandi Wang, Shan Gao, Xihui Zhu, Tao Xu, Zhijing Sun
Journal: JAMA Network Open (2024)

Importance Supervised pelvic floor muscle training (PFMT) has been recommended as the first-line treatment for women with stress urinary incontinence (SUI), but more evidence on whether adjunctive methods would provide additional benefits is needed. Objective To compare the efficacy of PFMT with or without a home-based pressure-mediated biofeedback (BF) device. Design, Setting, and Participants This multicenter assessor-blinded randomized clinical trial was conducted in the obstetric clinics of 5 participating tertiary hospitals in China. Participants included eligible women with new-onset postpartum SUI who were enrolled from March 28, 2022, to October 13, 2023. Intervention All participants received 3 months of supervised PFMT and were randomized to either the intervention (PFMT with a home-based pressure-mediated BF device) or the control group (home-based PFMT). Main Outcome and Measures The primary outcome was the severity of urinary incontinence evaluated by the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form after 3 months of supervised PFMT. The secondary outcomes included the cure and improvement rates, PFM strength, quality of life, self-efficacy, and adherence. Results A total of 452 participants (median age, 34 [IQR, 31-36] years; median body mass index [calculated as the weight in kilograms divided by the height in square meters], 23.71 [IQR, 21.37-25.97]; median time since delivery, 50 [IQR, 43-61] days) were included in the analysis, with 223 in the intervention group and 229 in the control group. Compared with the control group, the intervention group achieved a significantly greater reduction in incontinence severity (median, 3.00 [IQR, 1.00-6.00] vs 2.00 [IQR, 0-4.00] points; z = −3.05; P = .002), significantly increased cure rate (45 of 223 [20.2%] vs 20 of 229 [8.7%]; z = 12.02; P = .001) and improvement (132 of 223 [59.2%] vs 102 of 229 [44.5%]; z = 9.71; P = .002), significantly greater pelvic floor muscle strength (median, 26.00 [IQR, 17.00-38.00] vs 21.00 [IQR, 13.50-33.50] cm H 2 O; z = −2.28; P = .02), and a significantly greater correlation between subjective and objective adherence ( r = 0.825 vs r = 0.627). Conclusion and Relevance In this randomized clinical trial, the efficacy of pressure-mediated BF combined with PFMT was superior to that of PFMT alone. These findings support the use of pressure-mediated BF devices for improving treatment outcomes for patients with SUI. Trial Registration ClinicalTrials.gov Identifier: NCT05115864
Virtual Mental Health Care and Suicide-Related Events
Authors: Kertu Tenso, Kiersten Strombotne, Melissa M. Garrido, Jessica Lum, Steven Pizer
Journal: JAMA Network Open (2024)

Importance The rising suicide rates in the US emphasize the need for effective prevention. While telehealth has transformed access to mental health care, the impact of telehealth on suicide outcomes is unknown. Objective To evaluate the association of virtual mental health services with individual-level suicide-related events (SREs). Design, Setting, and Participants This retrospective cohort study using broadband access as an instrumental variable assessed a national sample of Veterans Health Administration patients who received mental health care between March 1, 2020, and December 31, 2021. Participants were recently separated (ie, discharged or released from active duty) veterans who completed their active duty service between March 1, 2019, and December 31, 2020, and who received at least 2 outpatient or inpatient diagnoses related to major depressive disorder, substance use disorder, or posttraumatic stress disorder within the year before their most recent separation date. Data were analyzed May 1 to October 31, 2023. Exposure Percentage of a patient’s total mental health visits that were conducted virtually by psychiatrists, psychologists, or social workers within a calendar month. Main Outcomes and Measures Binary measure indicating whether the patient had experienced an SRE (defined as a nonfatal suicide attempt, intentional self-harm, or suicide death) in a specific month and year as evaluated an instrumental variable probit model. Results The sample included 66 387 data points from 16 236 unique recently separated veterans. Among these entries, 44 766 were for male veterans (67.4%), the mean (SD) age across the sample was 32.9 (8.9) years, and the sample was representative of the US veteran population. There were 929 SREs (1.4%). Virtual mental health visits comprised a mean (SD) of 44.6% (46.1%) of all mental health visits. In instrumental variable probit analyses accounting for factors simultaneously associated with use of virtual mental health care and SRE risk, a 1% increase in the probability of virtual mental health visits was associated with a 2.5% decrease in SREs. Conclusions and Relevance Findings from this cohort study using a retrospective quasi-experimental design found that an increase in virtual mental health visits relative to total visits was associated with a statistically significant decrease in SREs, suggesting that providing virtual mental health services may reduce suicide-related outcomes.
Gut microbiota regulates stress responsivity via the circadian system
Authors: Gabriel S S Tofani, Sarah-Jane Leigh, Cassandra E Gheorghe, Thomaz F S Bastiaanssen, Lars Wilmes, Paromita Sen, Gerard Clarke, John F Cryan
Journal: Cell Metabolism (2024)

Stress and circadian systems are interconnected through the hypothalamic-pituitary-adrenal (HPA) axis to maintain responses to external stimuli. Yet, the mechanisms of how such signals are orchestrated remain unknown. Here, we uncover the gut microbiota as a regulator of HPA-axis rhythmicity. Microbial depletion disturbs the brain transcriptome and metabolome in stress-responding pathways in the hippocampus and amygdala across the day. This is coupled with a dysregulation of the circadian pacemaker in the brain that results in perturbed glucocorticoid rhythmicity. The resulting hyper-activation of the HPA axis at the sleep/wake transition drives time-of-day-specific impairments of the stress response and stress-sensitive behaviors. Finally, microbiota transplantation confirmed that diurnal oscillations of gut microbes underlie altered glucocorticoid secretion and that L. reuteri is a candidate strain for such effects. Our data offer compelling evidence that the microbiota regulates stress responsiveness in a circadian manner and is necessary to respond adaptively to stressors throughout the day.
Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability
Authors: Richard E. Nelson, Alec Chapman, Thomas Byrne, Nathorn Chaiyakunapruk, Ying Suo, Atim Effiong, Warren Pettey, Lillian Gelberg, Stefan G. Kertesz, Jack Tsai, Ann Elizabeth Montgomery
Journal: JAMA Network Open (2024)

Importance The US Department of Veterans Affairs (VA) partners with community organizations (grantees) across the US to provide temporary financial assistance (TFA) to vulnerable veterans through the Supportive Services for Veteran Families (SSVF) program. The goal of TFA for housing-related expenses is to prevent homelessness or to quickly house those who have become homeless. Objective To assess the cost-effectiveness of the SSVF program with TFA vs without TFA as an intervention for veterans who are experiencing housing insecurity. Design, Setting, and Participants This study used a Markov simulation model to compare cost and housing outcomes in a hypothetical cohort of veterans enrolled in the SSVF program. Enrollees who are homeless receive rapid rehousing services, while those who are at risk of becoming homeless receive homelessness prevention services. Exposure The SSVF program with TFA for veterans who are experiencing housing insecurity. Main Outcomes and Measures The effectiveness measure was the incremental cost-effectiveness ratio (ICER) with quality-adjusted life-years (QALYs). The model was parameterized using a combination of inputs taken from published literature and internal VA data. The model had a 2-year time horizon and a 1-day cycle length. In addition, probabilistic sensitivity analyses were conducted using 10 000 Monte Carlo simulations. Results The base case analyses found that the SSVF program with TFA was more costly ($35 814 vs $32 562) and yielded more QALYs (1.541 vs 1.398) than the SSVF program without TFA. The resulting ICER was $22 676 per QALY, indicating that TFA is the preferred strategy at a willingness-to-pay threshold of $150 000 per QALY. This ICER was $19 114 per QALY for veterans in the rapid rehousing component of the SSVF program and $29 751 per QALY for those in the homelessness prevention component of the SSVF program. At a willingness-to-pay threshold of $150 000 per QALY, probabilistic sensitivity analyses showed that TFA was cost-effective in 8972 of the 10 000 Monte Carlo simulations (89.7%) for rapid rehousing and in 8796 of the 10 000 Monte Carlo simulations (88.0%) for homelessness prevention only. Conclusions and Relevance This economic evaluation suggests that TFA is a cost-effective approach (ie, yields improved health benefits at a reasonable cost) for addressing housing insecurity for veterans enrolling in the SSVF program. Future research could examine the cost effectiveness of large, nationwide housing interventions such as this one among subpopulations of veterans such as those with certain comorbidities including severe mental illness or substance use disorders, those with chronic diseases, or those experiencing long-term housing instability vs acute loss of housing.
Cost-Related Prescription Drug Rationing by Adults With Obesity
Authors: Alissa S. Chen, Caroline G. Borden, Maureen E. Canavan, Joseph S. Ross, Carol R. Oladele, Kasia J. Lipska
Journal: JAMA Network Open (2024)

This cross-sectional study analyzes data from the National Health Interview Survey to examine the prevalence of cost-related prescription drug rationing by adults with obesity.
Team and Electronic Health Record Features and Burnout Among Family Physicians
Authors: Lisa S. Rotenstein, Nathaniel Hendrix, Robert L. Phillips, Julia Adler-Milstein
Journal: JAMA Network Open (2024)

Importance In the context of a growing volume of electronic health record (EHR)–based work and post–COVID-19 pandemic staffing pressures, health system leaders need an up-to-date understanding of changes in family physicians’ experiences of burnout, determinants of burnout, and how to enhance the family physicians’ experience. Objective To evaluate the association of family physicians’ perceptions of team structure and EHR experiences with burnout and identify modifiable practice structure factors associated with team and EHR experiences. Design, Setting, and Participants A serial cross-sectional survey study was conducted from December 1, 2016, to October 24, 2023. Participants included family physicians seeking continuous certification through the American Board of Family Medicine. Main Outcomes and Measures Yearly prevalence of burnout, perceived team efficiency, perceived EHR proficiency, and perceived EHR time were the outcomes. Multivariable logistic regression models subsequently assessed associations of team- and EHR-related experiences with burnout and the association between practice structure and staffing features in team efficiency and EHR time. Results The study included 10 315 physicians who answered the subset of questions related to burnout on the American Board of Family Medicine’s Continuous Certification Questionnaire between 2017 and 2023. Among the sample, 5584 respondents (54.1%) were male, and the median age was 50 (IQR, 43-58) years. The proportion of physicians reporting burnout ranged from 37.9% in 2017 to a peak of 42.8% in 2022, which did not represent a significant temporal trend ( P = .91). Appropriate home EHR use was associated with 0.58 (95% CI, 0.53-0.64; P &amp;amp;lt; .001) times the odds of burnout, while high team efficiency was associated with 0.61 (95% CI, 0.56-0.67; P &amp;amp;lt; .001) times the odds of burnout. Physician collaboration with a registered nurse was associated with greater odds of high team efficiency (odds ratio [OR], 1.35; 95% CI, 1.22-1.50). Collaboration with a physician assistant was associated with greater odds of appropriate home EHR time (OR, 1.13; 95% CI, 1.03-1.24). Conclusions and Relevance In this national cross-sectional study of US family physicians, appropriate time spent on the EHR at home and primary care team efficiency were associated with lower odds of burnout. These findings suggest that clinical leaders and policymakers should focus on optimizing primary care team support and family physicians’ EHR experiences to enhance the sustainability of primary care practice.