tbuckley/cabot-search huggingface dataset:
Short-Chain Fatty Acid Production by Gut Microbiota Predicts Treatment Response in Multiple Myeloma
Authors: Alba Rodríguez-García, Andrés Arroyo, Roberto García-Vicente, María Luz Morales, Rubén Gómez-Gordo, Pablo Justo, Clara Cuéllar, José Sánchez-Pina, Nieves López, Rafael Alonso, Noemí Puig, María-Victoria Mateos, Rosa Ayala, Dulcenombre Gómez-Garre, Joaquín Martínez-López, María Linares
Journal: Clinical Cancer Research (2023)

Abstract Purpose: The gut microbiota plays important roles in health and disease. We questioned whether the gut microbiota and related metabolites are altered in monoclonal gammopathies and evaluated their potential role in multiple myeloma and its response to treatment. Experimental Design: We used 16S rRNA sequencing to characterize and compare the gut microbiota of patients with monoclonal gammopathy of undetermined significance (n = 11), smoldering multiple myeloma (n = 9), newly diagnosed multiple myeloma (n = 11), relapsed/refractory multiple myeloma (n = 6), or with complete remission (n = 9). Short-chain fatty acids (SCFA) were quantified in serum and tested in cell lines. Relevant metabolites were validated in a second cohort of 62 patients. Results: Significant differences in alpha- and beta diversity were present across the groups and both were lower in patients with relapse/refractory disease and higher in patients with complete remission after treatment. Differences were found in the abundance of several microbiota taxa across disease progression and in response to treatment. Bacteria involved in SCFA production, including Prevotella, Blautia, Weissella, and Agathobacter, were more represented in the premalignant or complete remission samples, and patients with higher levels of Agathobacter showed better overall survival. Serum levels of butyrate and propionate decreased across disease progression and butyrate was positively associated with a better response. Both metabolites had antiproliferative effects in multiple myeloma cell lines. Conclusions: We demonstrate that SCFAs metabolites and the gut microbiota associated with their production might have beneficial effects in disease evolution and response to treatment, underscoring its therapeutic potential and value as a predictor.
Long term outcomes of metabolic/bariatric surgery in adults
Authors: Anita P Courcoulas, Christopher R Daigle, David E Arterburn
Journal: BMJ (2023)

The prevalence of obesity continues to rise around the world, driving up the need for effective and durable treatments. The field of metabolic/bariatric surgery has grown rapidly in the past 25 years, with observational studies and randomized controlled trials investigating a broad range of long term outcomes. Metabolic/bariatric surgery results in durable and significant weight loss and improvements in comorbid conditions, including type 2 diabetes. Observational studies show that metabolic/bariatric surgery is associated with a lower incidence of cardiovascular events, cancer, and death. Weight regain is a risk in a fraction of patients, and an association exists between metabolic/bariatric surgery and an increased risk of developing substance and alcohol use disorders, suicidal ideation/attempts, and accidental death. Patients need lifelong follow-up to help to reduce the risk of these complications and other nutritional deficiencies. Different surgical procedures have important differences in risks and benefits, and a clear need exists for more long term research about less invasive and emerging procedures. Recent guidelines for the treatment of obesity and metabolic conditions have been updated to reflect this growth in knowledge, with an expansion of eligibility criteria, particularly people with type 2 diabetes and a body mass index between 30.0 and 34.9.
A digital health algorithm to guide antibiotic prescription in pediatric outpatient care: a cluster randomized controlled trial
Authors: Rainer Tan, Godfrey Kavishe, Lameck B. Luwanda, Alexandra V. Kulinkina, Sabine Renggli, Chacha Mangu, Geofrey Ashery, Margaret Jorram, Ibrahim Evans Mtebene, Peter Agrea, Humphrey Mhagama, Alan Vonlanthen, Vincent Faivre, Julien Thabard, Gillian Levine, Marie-Annick Le Pogam, Kristina Keitel, Patrick Taffé, Nyanda Ntinginya, Honorati Masanja, Valérie D’Acremont
Journal: Nature Medicine (2023)

Excessive antibiotic use and antimicrobial resistance are major global public health threats. We developed ePOCT+, a digital clinical decision support algorithm in combination with C-reactive protein test, hemoglobin test, pulse oximeter and mentorship, to guide health-care providers in managing acutely sick children under 15 years old. To evaluate the impact of ePOCT+ compared to usual care, we conducted a cluster randomized controlled trial in Tanzanian primary care facilities. Over 11 months, 23,593 consultations were included from 20 ePOCT+ health facilities and 20,713 from 20 usual care facilities. The use of ePOCT+ in intervention facilities resulted in a reduction in the coprimary outcome of antibiotic prescription compared to usual care (23.2% versus 70.1%, adjusted difference -46.4%, 95% confidence interval (CI) -57.6 to -35.2). The coprimary outcome of day 7 clinical failure was noninferior in ePOCT+ facilities compared to usual care facilities (adjusted relative risk 0.97, 95% CI 0.85 to 1.10). There was no difference in the secondary safety outcomes of death and nonreferred secondary hospitalizations by day 7. Using ePOCT+ could help address the urgent problem of antimicrobial resistance by safely reducing antibiotic prescribing. Clinicaltrials.gov Identifier: NCT05144763.
CD7 activation regulates cytotoxicity-driven pathology in systemic sclerosis, yielding a target for selective cell depletion
Authors: Theodoros Ioannis Papadimitriou, Prashant Singh, Arjan van Caam, Birgitte Walgreen, Mark A J Gorris, Elly L Vitters, Iris L van Ingen, Marije I Koenders, Ruben L Smeets, Madelon Vonk, Jolanda M de Vries, Peter M van der Kraan, Ypke van Oosterhout, Martijn A Huynen, Hans J P M Koenen, Rogier M Thurlings
Journal: Annals of the Rheumatic Diseases (2023)

Cytotoxic T cells and natural killer (NK) cells are central effector cells in cancer and infections. Their effector response is regulated by activating and inhibitory receptors. The regulation of these cells in systemic autoimmune diseases such as systemic sclerosis (SSc) is less defined.
Antimicrobial learning systems: an implementation blueprint for artificial intelligence to tackle antimicrobial resistance
Authors: Alex Howard, Stephen Aston, Alessandro Gerada, Nada Reza, Jason Bincalar, Henry Mwandumba, Tom Butterworth, William Hope, Iain Buchan
Journal: The Lancet Digital Health (2023)

The proliferation of various forms of artificial intelligence (AI) brings many opportunities to improve health care. AI models can harness complex evolving data, inform and augment human actions, and learn from health outcomes such as morbidity and mortality. The global public health challenge of antimicrobial resistance (AMR) needs large-scale optimisation of antimicrobial use and wider infection care, which could be enabled by carefully constructed AI models. As AI models become increasingly useful and robust, health-care systems remain challenging places for their deployment. An implementation gap exists between the promise of AI models and their use in patient and population care. Here, we outline an adaptive implementation and maintenance framework for AI models to improve antimicrobial use and infection care as a learning system. The roles of AMR problem identification, law and regulation, organisational support, data processing, and AI development, assessment, maintenance, and scalability in the implementation of AMR-targeted AI models are considered.
End-to-end prognostication in colorectal cancer by deep learning: a retrospective, multicentre study
Authors: Xiaofeng Jiang, Michael Hoffmeister, Hermann Brenner, Hannah Sophie Muti, Tanwei Yuan, Sebastian Foersch, Nicholas P West, Alexander Brobeil, Jitendra Jonnagaddala, Nicholas Hawkins, Robyn L Ward, Titus J Brinker, Oliver Lester Saldanha, Jia Ke, Wolfram Müller, Heike I Grabsch, Philip Quirke, Daniel Truhn, Jakob Nikolas Kather
Journal: The Lancet Digital Health (2023)
Annals Consult Guys - Surgery After Thromboembolic Stroke
Authors: Howard H. Weitz, Geno J. Merli, Curtis Benesch
Journal: Annals of Internal Medicine (2023)

Web ExclusivesDecember 2023Annals Consult Guys - Surgery After Thromboembolic StrokeFREEHoward H. Weitz, MD, Geno J. Merli, MD, and Curtis Benesch, MDHoward H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.), Geno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.), and Curtis Benesch, MDUniversity of Rochester, Rochester, New York (C.B.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/W22-0025 CME/MOC SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Annals Consult Guys discuss the vexing problem of appropriate timing of surgery after a thromboembolic stroke.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment BRIAN WILLOUGHBYnone29 December 2023 Decreasing risk of stroke in the perioperative DOAC free interval Is there a role for enoxaprin during the perioperative interval off DOAC to lessen the risk of embolic stroke without appeciably affecting the bleeding risk? i.e., is there shorter on /off anticoagulation effect with enoxaprin vs DOAC's? Bimal K AgrawalM M Institute of Medical Sciences & Research, Maharishi Markandeshwar Deemed University, Mullana-1332076 January 2024 Bridging anticoagulation As per observational studies bridging anticoagulation (with low molecular weight heparin) perioperatively increases the risk of bleeding without making any difference to the risk of ischemic (thromboembolic) stroke except in situations of recent stroke, TIA, or mechanical valve. As per the opinion of 'Consult Guys,' the risk of recurrent stroke levels off after 90 days . So, I think 'recent' stroke can be considered to be a period up to 90 days after stroke. Disclosures: Nil Author, Article, and Disclosure InformationAuthors: Howard H. Weitz, MD; Geno J. Merli, MD; Curtis Benesch, MDAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.)University of Rochester, Rochester, New York (C.B.)Disclosures: Drs. Merli, Weitz, and Benesch report that they have no financial relationships or interests to disclose. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=W22-0025.Editors' Disclosures: The editors have no relevant financial relationships to disclose. Individual forms may be viewed at www.annals.org/editorsdisclosures. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics December 2023Volume 176, Issue 12 ePublished: 19 December 2023 Issue Published: December 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.Loading ...
Abstract 15650: Recovery of Cardiomyopathy Following Accessory Pathway Ablation
Authors: Taylor Goulding Avedisian, Abul Moiz Qureshi, Haris Manan, Mariam Riad, Bassam Omar
Journal: Circulation (2023)

Background: Wolf-Parkinson-White (WPW) can cause significant arrhythmia in addition to left ventricular (LV) dessynchrony and cardiomyopathy, which may be reversible by accessory pathway ablation. Case: A 21-year-old female athletics major college student presents with dyspnea, fatigue and occasional palpitations associated with dizziness. Electrocardiogram (EKG) revealed WPW with left bundle branch block pattern suggestive of right-sided bypass tract (panel A). Transthoracic echocardiogram (TTE) revealed LV ejection fraction (LVEF) 35 - 40% and significant interventricular dessynchrony on M-mode (panel B). Decision-making: It was felt that her symptoms and LV dysfunction are due to QRS widening and possibly arrhythmia caused by the bypass tract, and that ablation is warranted. Electrophysiology study 3-D map revealed 2 insertion points of the bypass tract along the tricuspid annulus (panel C). Ablation was performed initially along the inferior tricuspid annulus, leading to QRS complex narrowing with a change in the delta wave axis. Another activation site was mapped separately to the anterolateral tricuspid annulus; ablation at this site eliminated pre-excitation altogether. Post procedure EKG revealed normalization of the PR interval and diffuse T wave abnormalities likely due to cardiac memory (panel D). Follow-up in 6 weeks revealed an LVEF of 60 - 65% and normal wall motion on TTE with improvement of her symptoms; she was cleared to resume sports. Conclusion: WPW can be associated with significant cardiomyopathy and heart failure due both to arrhythmia and marked LV dessynchrony, which may be reversed by radiofrequency ablation.
Abstract 15647: Patient Perceptions of Cardiac Rehabilitation and an Adjunct Mobile Application: A Qualitative Analysis
Authors: Prerna Gupta, Joy Waughtal, Monica Martinez, Catia Chavez, Elijah Finer, Silvia Gutierrez-Raghunath, Prateeti Khazanie, Michael Ho, Sheana Bull, Pamela Peterson
Journal: Circulation (2023)

Background: Cardiac rehabilitation (CR) is underutilized despite demonstrated improvement to quality of life and mortality for patients with cardiovascular disease (CVD) patients. As a part of an ongoing study among an underserved urban population to improve participation in CR alongside a mobile application (app) to encourage healthful habits, we assessed CR and app perceptions among participants. Methods: We conducted in-depth open-ended interviews with a sample of patients with low socioeconomic status at Denver Health, an urban safety-net hospital with generally racially and ethnically diverse patients. We transcribed interviews and performed content analysis to identify themes. Study staff trained in qualitative methods interviewed patients on thevia phone with the goal of understanding their perceptions of CR and app use. We transcribed interviews and performed content analysis to identify themes. Results: Among 19 interviews (6 female), all patients enjoyed CR, especially the interaction with CR staff. Four patients self-identified as non-app users (1 female) vs. 15 users (5 female). Users were aged 55 years old (SD 10.4) on average, versus 66.5 years old (SD 3.4 years) among non-users. Overall 18/19 interviewees were below the poverty line in Denver for a single income household (Table). Non-users expressed reluctance around technology, and one could not recall training on app use by research study staff though they had generally higher educational status. Users identified communication with CR staff via the app as the most useful feature. Conclusion: Overall, patients liked CR, and most identified themselves as app users. Users appreciated education about healthy diet, and the ability to interact with CR staff. App users were surprisingly of lower educational status, but similar income backgrounds. This may suggest that older users among a vulnerable population require more support in accessing mobile interventions despite educational status.
Abstract 15673: Evaluation of the Use of Wearable Device Signals for Patients With Heart Failure: A Subgroup Analysis in the Michigan Predictive Activity &amp; Clinical Trajectories in Health (MIPACT) Study
Authors: Aishwarya Pastapur, Nicole Pescatore, Nirav Shah, Sachin Kheterpal, Brahmajee K Nallamothu, Jessica R Golbus
Journal: Circulation (2023)

Background: Wearable devices are increasingly used by patients and the data made available to their care teams. However, interpretation of these data, especially in diverse populations, remains challenging. Herein, we report on the results of a subgroup analysis of wearable device data among participants with heart failure (HF) within a large observational digital health study. Methods: The MIPACT Study enrolled 6765 adult Michigan Medicine patients with an iPhone 6 or newer between August 2018 and December 2019. All were provided with an Apple Watch. The electronic medical record was reviewed to determine New York Heart Association (NYHA) functional class and HF phenotype. Wearable activity data (e.g., step count, exercise minutes) were compared across phenotypes and functional classes using a one-way ANOVA. Results: 118 participants had an ICD-10 code for HF within 90 days of enrollment and were confirmed to have HF on chart review. Participants were 57.4 (SD 14.2) years of age; 68 (57.6 %) were male and 29 (24.6%) Black. 29 (26.9%) participants had NYHA class 2 and 10 (8.5%) NYHA class 3 symptoms; 35 (29.9%) had HF with preserved EF (HFpEF) and 85 (81%) nonischemic cardiomyopathy. Participants with NYHA class 1 HF symptoms had significantly higher mean daily exercise minutes and mean daily step counts when compared to patients with NYHA class 2 HF symptoms and with a composite of NYHA classes 2-4 (Figure 1). Participants with HF with mildly reduced EF (HFmrEF) had significantly higher exercise minutes and step counts when compared with participants with HFpEF and HF with reduced EF (HFrEF). Participants with HFrEF and HFpEF were similar with respect to exercise minutes (p = 0.82) and step counts (p = 0.91). Conclusion: Wearable physical activity measures vary by HF phenotype and functional classification with similar profiles for patients with HFpEF and HFrEF. Further research is necessary to understand longitudinal changes in wearable device signals and prognosis.
The burden of bacterial antimicrobial resistance in the WHO African region in 2019: a cross-country systematic analysis
Authors: Benn Sartorius, Authia P Gray, Nicole Davis Weaver, Gisela Robles Aguilar, Lucien R Swetschinski, Kevin S Ikuta, Tomislav Mestrovic, Erin Chung, Eve E Wool, Chieh Han, Anna Gershberg Hayoon, Daniel T Araki, Sherief Abd-Elsalam, Richard Gyan Aboagye, Lawan Hassan Adamu, Abiola Victor Adepoju, Ayman Ahmed, Gizachew Taddesse Akalu, Wuraola Akande-Sholabi, John H Amuasi, Ganiyu Adeniyi Amusa, Ayele Mamo Argaw, Raphael Taiwo Aruleba, Tewachew Awoke, Melese Kitu Ayalew, Ahmed Y Azzam, Francois-Xavier Babin, Indrajit Banerjee, Afisu Basiru, Nebiyou Simegnew Bayileyegn, Melaku Ashagrie Belete, James A Berkley, Julia A Bielicki, Denise Dekker, Dessalegn Demeke, Desalegn Getnet Demsie, Anteneh Mengist Dessie, Susanna J Dunachie, Abdelaziz Ed-Dra, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Iman El Sayed, Muhammed Elhadi, Ibrahim Elsohaby, David Eyre, Adeniyi Francis Fagbamigbe, Nicholas A Feasey, Ginenus Fekadu, Frederick Fell, Karen M Forrest, Mesfin Gebrehiwot, Kebede Embaye Gezae, Ramy Mohamed Ghazy, Tewodros Tesfa Hailegiyorgis, Georgina Haines-Woodhouse, Ahmed I Hasaballah, Andrea Haekyung Haselbeck, Yingfen Hsia, Arnaud Iradukunda, Kenneth Chukwuemeka Iregbu, Chidozie C D Iwu, Chinwe Juliana Iwu-Jaja, Assefa N Iyasu, Fatoumatta Jaiteh, Hyonjin Jeon, Charity Ehimwenma Joshua, Gebrehiwot G Kassa, Patrick DMC Katoto, Ralf Krumkamp, Emmanuelle A P Kumaran, Hmwe Hmwe Kyu, Aseer Manilal, Florian Marks, Jürgen May, Susan A McLaughlin, Barney McManigal, Addisu Melese, Kebede Haile Misgina, Nouh Saad Mohamed, Mustapha Mohammed, Shafiu Mohammed, Shikur Mohammed, Ali H Mokdad, Catrin E Moore, Vincent Mougin, Neema Mturi, Temesgen Mulugeta, Fungai Musaigwa, Patrick Musicha, Lillian A Musila, Saravanan Muthupandian, Pirouz Naghavi, Hadush Negash, Dooshanveer C Nuckchady, Christina W Obiero, Ismail A Odetokun, Oluwaseun Adeolu Ogundijo, Lawrence Okidi, Osaretin Christabel Okonji, Andrew T Olagunju, Isaac Iyinoluwa Olufadewa, Gi Deok Pak, Olga Perovic, Andrew Pollard, Mathieu Raad, Clotaire Rafaï, Hazem Ramadan, Elrashdy Moustafa Mohamed Redwan, Anna Roca, Victor Daniel Rosenthal, Mohamed A Saleh, Abdallah M Samy, M Sharland, Aminu Shittu, Emmanuel Edwar Siddig, Eskinder Ayalew Sisay, Andy Stergachis, Wegen Beyene Tesfamariam, Caroline Tigoi, Marius Belmondo Tincho, Tenaw Yimer Tiruye, Chukwuma David Umeokonkwo, Timothy Walsh, Judd L Walson, Hadiza Yusuf, Naod Gebrekrstos Zeru, Simon I Hay, Christiane Dolecek, Christopher J L Murray, Mohsen Naghavi
Journal: The Lancet Global Health (2023)

A critical and persistent challenge to global health and modern health care is the threat of antimicrobial resistance (AMR). Previous studies have reported a disproportionate burden of AMR in low-income and middle-income countries, but there remains an urgent need for more in-depth analyses across Africa. This study presents one of the most comprehensive sets of regional and country-level estimates of bacterial AMR burden in the WHO African region to date.
The applied principles of EEG analysis methods in neuroscience and clinical neurology
Authors: Hao Zhang, Qing-Qi Zhou, He Chen, Xiao-Qing Hu, Wei-Guang Li, Yang Bai, Jun-Xia Han, Yao Wang, Zhen-Hu Liang, Dan Chen, Feng-Yu Cong, Jia-Qing Yan, Xiao-Li Li
Journal: Military Medical Research (2023)

Electroencephalography (EEG) is a non-invasive measurement method for brain activity. Due to its safety, high resolution, and hypersensitivity to dynamic changes in brain neural signals, EEG has aroused much interest in scientific research and medical fields. This article reviews the types of EEG signals, multiple EEG signal analysis methods, and the application of relevant methods in the neuroscience field and for diagnosing neurological diseases. First, three types of EEG signals, including time-invariant EEG, accurate event-related EEG, and random event-related EEG, are introduced. Second, five main directions for the methods of EEG analysis, including power spectrum analysis, time-frequency analysis, connectivity analysis, source localization methods, and machine learning methods, are described in the main section, along with different sub-methods and effect evaluations for solving the same problem. Finally, the application scenarios of different EEG analysis methods are emphasized, and the advantages and disadvantages of similar methods are distinguished. This article is expected to assist researchers in selecting suitable EEG analysis methods based on their research objectives, provide references for subsequent research, and summarize current issues and prospects for the future.
Incidence of Type 1 Diabetes in Children Has Fallen to Pre–COVID-19 Pandemic Levels: A Population-Wide Analysis From Scotland
Authors: William Berthon, Stuart J. McGurnaghan, Luke A.K. Blackbourn, Louise E. Bath, David A. McAllister, Diane Stockton, Sarah H. Wild, Paul M. McKeigue, Helen M. Colhoun
Journal: Diabetes Care (2023)