tbuckley/cabot-search huggingface dataset:
Differences in heart failure with preserved ejection fraction management between care providers: an international survey
Authors: Federica Guidetti, Clara Inés Saldarriaga Giraldo, Anastasia Shchendrygina, Keisuke Kida, David Niederseer, Carmen Basic, Peter P. Rainer, Marta Załęska‐Kocięcka, Elijah Ogola, Dania Mohty, Giuseppina Lanfranchi, Novi Yanti Sari, Hafsteinn Einarsson, Marzena Zurek, Frank Ruschitzka, Gianluigi Savarese, Nathan Mewton
Journal: European Journal of Heart Failure (2024)

Abstract Aims Heart failure (HF) with preserved ejection fraction (HFpEF) is characterized by growing incidence and poor outcomes. A large majority of HFpEF patients are cared by non‐cardiologists. The availability of sodium–glucose cotransporter 2 inhibitors (SGLT2i) as recommended therapy raises the importance of prompt and accurate identification and treatment of HFpEF across diverse healthcare settings. We evaluated HFpEF management across specialties through a survey targeting cardiologists, HF specialists, and non‐cardiologists. Methods and results An independent web‐based survey was distributed globally between May and July 2023. We performed a post‐hoc analysis, comparing cardiologists, HF specialists, and non‐cardiologists. A total of 1460 physicians (61% male, median age 41[34–49]) from 95 countries completed the survey; 20% were HF specialists, 65% cardiologists, and 15% non‐cardiologists. Compared with HF specialists, non‐cardiologists and cardiologists were less likely to use natriuretic peptides ( p = 0.003) and HFpEF scores ( p = 0.004) for diagnosis, and were also less likely to have access to or consider specific echocardiographic parameters ( p &lt; 0.001) for identifying HFpEF. Diastolic stress tests were used in less than 30% of the cases, regardless of the specialty ( p = 1.12). Multidrug treatment strategies were similar across different specialties. While SGLT2i and diuretics were the preferred drugs, angiotensin receptor blockers and angiotensin receptor–neprilysin inhibitors were the least frequently prescribed in all three groups. However, when constrained to choose one drug, the proportion of physicians favoring SGLT2i varied significantly among specialties (66% HF specialists, 52% cardiologists, 51% non‐cardiologists). Additionally, 10% of non‐cardiologists and 8% of cardiologists considered beta blocker the drug of choice for HFpEF. Conclusion Significant differences among specialty groups were observed in HFpEF management, particularly in the diagnostic work‐up. Our results highlight a substantial risk of underdiagnosis and undertreatment of HFpEF patients, especially among non‐HF specialists.
Knowledge and dispositions of caring professionals in school settings regarding trans, gender diverse and non-binary students: A scoping review of empirical research
Authors: Nicole Williams, Annette Brömdal
Journal: International Journal of Transgender Health (2024)

Background and Aim This scoping review investigates the knowledge and dispositions of caring professionals in school settings regarding TGN students. Current literature highlight how trans, gender diverse and non-binary (TGN) students' self-reported wellbeing and feelings toward school climate are affected by the perceived attitudes and behaviors of caring professionals in school settings, however the research synthesizing the existing research is limiting. This scoping review brings together existing empirical literature identifying what is known about the knowledge and dispositions of caring professionals in school settings regarding TGN students.
Suicide rates among physicians compared with the general population in studies from 20 countries: gender stratified systematic review and meta-analysis
Authors: Claudia Zimmermann, Susanne Strohmaier, Harald Herkner, Thomas Niederkrotenthaler, Eva Schernhammer
Journal: BMJ (2024)

Abstract Objectives To estimate age standardised suicide rate ratios in male and female physicians compared with the general population, and to examine heterogeneity across study results. Design Systematic review and meta-analysis. Data sources Studies published between 1960 and 31 March 2024 were retrieved from Embase, Medline, and PsycINFO. There were no language restrictions. Forward and backwards reference screening was performed for selected studies using Google Scholar. Eligibility criteria for selecting studies Observational studies with directly or indirectly age standardised mortality ratios for physician deaths by suicide, or suicide rates per 100 000 person years of physicians and a reference group similar to the general population, or extractable data on physician deaths by suicide suitable for the calculation of ratios. Two independent reviewers extracted data and assessed the risk of bias using an adapted version of the Joanna Briggs Institute checklist for prevalence studies. Mean effect estimates for male and female physicians were calculated based on random effects models, with subgroup analyses for geographical region and a secondary analysis of deaths by suicide in physicians compared with other professions. Results Among 39 included studies, 38 studies for male physicians and 26 for female physicians were eligible for analyses, with a total of 3303 suicides in male physicians and 587 in female physicians (observation periods 1935-2020 and 1960-2020, respectively). Across all studies, the suicide rate ratio for male physicians was 1.05 (95% confidence interval 0.90 to 1.22). For female physicians, the rate ratio was significantly higher at 1.76 (1.40 to 2.21). Heterogeneity was high for both analyses. Meta-regression revealed a significant effect of the midpoint of study observation period, indicating decreasing effect sizes over time. The suicide rate ratio for male physicians compared with other professions was 1.81 (1.55 to 2.12). Conclusion Standardised suicide rate ratios for male and female physicians decreased over time. However, the rates remained increased for female physicians. The findings of this meta-analysis are limited by a scarcity of studies from regions outside of Europe, the United States, and Australasia. These results call for continued efforts in research and prevention of physician deaths by suicide, particularly among female physicians and at risk subgroups. Systematic review registration PROSPERO CRD42019118956.
Comparative oral monotherapy of psilocybin, lysergic acid diethylamide, 3,4-methylenedioxymethamphetamine, ayahuasca, and escitalopram for depressive symptoms: systematic review and Bayesian network meta-analysis
Authors: Tien-Wei Hsu, Chia-Kuang Tsai, Yu-Chen Kao, Trevor Thompson, Andre F Carvalho, Fu-Chi Yang, Ping-Tao Tseng, Chih-Wei Hsu, Chia-Ling Yu, Yu-Kang Tu, Chih-Sung Liang
Journal: BMJ (2024)

Abstract Objective To evaluate the comparative effectiveness and acceptability of oral monotherapy using psychedelics and escitalopram in patients with depressive symptoms, considering the potential for overestimated effectiveness due to unsuccessful blinding. Design Systematic review and Bayesian network meta-analysis. Data sources Medline, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, ClinicalTrial.gov, and World Health Organization’s International Clinical Trials Registry Platform from database inception to 12 October 2023. Eligibility criteria for selecting studies Randomised controlled trials on psychedelics or escitalopram in adults with depressive symptoms. Eligible randomised controlled trials of psychedelics (3,4-methylenedioxymethamphetamine (known as MDMA), lysergic acid diethylamide (known as LSD), psilocybin, or ayahuasca) required oral monotherapy with no concomitant use of antidepressants. Data extraction and synthesis The primary outcome was change in depression, measured by the 17-item Hamilton depression rating scale. The secondary outcomes were all cause discontinuation and severe adverse events. Severe adverse events were those resulting in any of a list of negative health outcomes including, death, admission to hospital, significant or persistent incapacity, congenital birth defect or abnormality, and suicide attempt. Data were pooled using a random effects model within a Bayesian framework. To avoid estimation bias, placebo responses were distinguished between psychedelic and antidepressant trials. Results Placebo response in psychedelic trials was lower than that in antidepression trials of escitalopram (mean difference −3.90 (95% credible interval −7.10 to −0.96)). Although most psychedelics were better than placebo in psychedelic trials, only high dose psilocybin was better than placebo in antidepression trials of escitalopram (mean difference 6.45 (3.19 to 9.41)). However, the effect size (standardised mean difference) of high dose psilocybin decreased from large (0.88) to small (0.31) when the reference arm changed from placebo response in the psychedelic trials to antidepressant trials. The relative effect of high dose psilocybin was larger than escitalopram at 10 mg (4.66 (95% credible interval 1.36 to 7.74)) and 20 mg (4.69 (1.64 to 7.54)). None of the interventions was associated with higher all cause discontinuation or severe adverse events than the placebo. Conclusions Of the available psychedelic treatments for depressive symptoms, patients treated with high dose psilocybin showed better responses than those treated with placebo in the antidepressant trials, but the effect size was small. Systematic review registration PROSPERO, CRD42023469014.
Head and neck cancer: pathogenesis and targeted therapy
Authors: Yan Liu, Nannan Zhang, Yi Wen, Jiaolin Wen
Journal: MedComm (2024)

Head and neck cancer (HNC) is a highly aggressive type of tumor characterized by delayed diagnosis, recurrence, metastasis, relapse, and drug resistance. The occurrence of HNC were associated with smoking, alcohol abuse (or both), human papillomavirus infection, and complex genetic and epigenetic predisposition. Currently, surgery and radiotherapy are the standard treatments for most patients with early-stage HNC. For recurrent or metastatic (R/M) HNC, the first-line treatment is platinum-based chemotherapy combined with the antiepidermal growth factor receptor drug cetuximab, when resurgery and radiation therapy are not an option. However, curing HNC remains challenging, especially in cases with metastasis. In this review, we summarize the pathogenesis of HNC, including genetic and epigenetic changes, abnormal signaling pathways, and immune regulation mechanisms, along with all potential therapeutic strategies such as molecular targeted therapy, immunotherapy, gene therapy, epigenetic modifications, and combination therapies. Recent preclinical and clinical studies that may offer therapeutic strategies for future research on HNC are also discussed. Additionally, new targets and treatment methods, including antibody-drug conjugates, photodynamic therapy, radionuclide therapy, and mRNA vaccines, have shown promising results in clinical trials, offering new prospects for the treatment of HNC.
Perioperative hypothermia and stress jeopardize anti-metastatic immunity and TLR-9 immune activation: potential mediating mechanisms (experimental studies)
Authors: Elad Sandbank, Pini Matzner, Anabel Eckerling, Liat Sorski, Ella Rossene, Ido Nachmani, Shamgar Ben-Eliyahu
Journal: International Journal of Surgery (2024)

The perioperative period often involves stress responses and surgery-induced hypothermia, which were suggested to hinder antimetastatic immunity and promote cancer metastasis. During this critical period, immunotherapies are rarely used, given contraindications to surgery. However, recent preclinical studies support the feasibility of perioperative TLR-9 activation using CpG-C.
Comparison of reperfusion- and central repair-first strategies for acute type a dissection with mesenteric malperfusion: a single-center retrospective cohort study
Authors: Xia Gao, Yu-Xin Chen, Wei-Guo Ma, Li Zhang, Cong Cui, Ping-Fan Wang, Yi-Qiang Yuan
Journal: International Journal of Surgery (2024)

We seek to compare the early and late outcomes of reperfusion-first versus central repair-first strategies in patients with acute type A dissection (ATAAD) complicated by mesenteric malperfusion.
Hepatic arterial infusion chemotherapy-based conversion hepatectomy in responders versus nonresponders with hepatocellular carcinoma: A multicenter cohort study
Authors: Min Deng, Chong Zhong, Dong Li, Renguo Guan, Carol Lee, Huanwei Chen, Wei Qin, Hao Cai, Rongping Guo, Zubing Chen
Journal: International Journal of Surgery (2024)

Background: Hepatic arterial infusion chemotherapy (HAIC) has shown satisfactory therapeutic efficacy in unresectable hepatocellular carcinoma (HCC) and is regarded as an important conversion treatment. However, limited information is available regarding the optimal timing of HAIC-based conversion hepatectomy. This study aims to determine the optimal timing for HAIC-based conversion surgery in patients with HCC. Methods: Data from a retrospective cohort of patients who underwent HAIC-based conversion hepatectomy were reviewed. Oncological outcomes, surgical information, and risk factors were comparatively analyzed. Results: In total, 424 patients with HCC who underwent HAIC-based conversion hepatectomy were included and were divided into responder (n=312) and nonresponder (n=112) groups. The overall survival (OS) and recurrence-free survival (RFS) rates of both the whole responder cohort and patients who achieved a response after 4–6 cycles of HAIC were significantly better than those of the nonresponder cohort. Higher OS and RFS were observed in responders than in nonresponders with advanced-stage HCC. Patients in the responder group had a shorter occlusion duration and less intraoperative blood loss than those in the nonresponder group. There were no significant differences in other surgical information or postoperative complications between the two groups. Tumor response, differentiation, postoperative alpha-fetoprotein level, postoperative protein induced by vitamin K absence or antagonist-II level, age, microvascular invasion, pre-HAIC neutrophil-to-lymphocyte ratio, and preoperative systemic inflammatory response index were independent risk factors for poor long-term survival. Conclusions: Conversion surgery should be considered when tumor response is achieved. Our findings may be useful in guiding surgeons and patients in decision-making regarding HAIC-based conversion hepatectomy.
Smooth muscle-specific deletion of Ccn2 causes severe aorta malformation and atherosclerosis
Authors: Jannik H Larsen, Julie S Hegelund, Matilde K Pedersen, Cecilie M Andersson, Caroline A Lindegaard, Didde R Hansen, Jane Stubbe, Jes S Lindholt, Camilla S Hansen, Andrietta Grentzmann, Maria Bloksgaard, Boye L Jensen, Raúl R Rodriguez-Díez, Marta Ruiz-Ortega, Sebastian Albinsson, Gerard Pasterkamp, Michal Mokry, Andrew Leask, Roel Goldschmeding, Bartosz Pilecki, Grith L Sorensen, Charles Pyke, Martin Overgaard, Hans C Beck, Daniel F J Ketelhuth, Lars M Rasmussen, Lasse B Steffensen
Journal: Cardiovascular Research (2024)

Abstract Aims Cellular communication network factor 2 (CCN2) is a matricellular protein implicated in fibrotic diseases, with ongoing clinical trials evaluating anti-CCN2-based therapies. By uncovering CCN2 as abundantly expressed in non-diseased artery tissue, this study aimed to investigate the hypothesis that CCN2 plays a pivotal role in maintaining smooth muscle cell (SMC) phenotype and protection against atherosclerosis. Methods and results Global- and SMC-specific Ccn2 knockout mouse models were employed to demonstrate that Ccn2 deficiency leads to SMC de-differentiation, medial thickening, and aorta elongation under normolipidaemic conditions. Inducing hyperlipidaemia in both models resulted in severe aorta malformation and a 17-fold increase in atherosclerosis formation. Lipid-rich lesions developed at sites of the vasculature typically protected from atherosclerosis development by laminar blood flow, covering 90% of aortas and extending to other vessels, including coronary arteries. Evaluation at earlier time points revealed medial lipid accumulation as a lesion-initiating event. Fluorescently labelled LDL injection followed by confocal microscopy showed increased LDL retention in the medial layer of Ccn2 knockout aortas, likely attributed to marked proteoglycan enrichment of the medial extracellular matrix. Analyses leveraging data from the Athero-Express study cohort indicated the relevance of CCN2 in established human lesions, as CCN2 correlated with SMC marker transcripts across 654 transcriptomically profiled carotid plaques. These findings were substantiated through in situ hybridization showing CCN2 expression predominantly in the fibrous cap. Conclusion This study identifies CCN2 as a major constituent of the normal artery wall, critical in regulating SMC differentiation and aorta integrity and possessing a protective role against atherosclerosis development. These findings underscore the need for further investigation into the potential effects of anti-CCN2-based therapies on the vasculature.
Revolutionizing patient education with GPT-4o: A new approach to preventing surgical site infections in total hip arthroplasty
Authors: Bin Zhao, Weiwen Zhang, Qianqian Zhou, Qi Zhang, Jianer Du, Yi Jin, Xiaojian Weng
Journal: International Journal of Surgery (2024)

Total hip arthroplasty (THA) is a common surgical procedure known for its generally positive outcomes, but it also comes with the risk of surgical site infections (SSIs), which can result in significant complications and higher healthcare costs. Effective patient education plays a vital role in reducing these risks, as well-informed patients are more likely to take preventive measures and identify early signs of complications. The advent of advanced language models like GPT-4o has opened new avenues for patient education, potentially revolutionizing the way information is delivered and understood. This research letter explores the utility of GPT-4o in enhancing patient education specifically related to SSIs following THA. The capabilities of GPT-4o include offering tailored educational materials, providing 24/7 availability, facilitating humanized interactive learning, and supporting multilingual education. These features significantly improve patient understanding, engagement, and adherence to preventive measures, enhancing the overall quality of healthcare services. However, challenges such as equitable access, language and cultural barriers, and data privacy must be addressed. Utilizing GPT-4o’s advanced AI capabilities can revolutionize patient education, thereby decreasing the incidence of SSIs and enhancing postoperative recovery for THA patients.
Evaluation of the efficacy of chlorhexidine-alcohol vs. aqueous/alcoholic iodine solutions for the prevention of surgical site infections: a systematic review and meta-analysis
Authors: Qiong Yang, Jingxian Sun, Zhao Yang, Sanjay Rastogi, Yan-feng Liu, Bin-bin Zhao
Journal: International Journal of Surgery (2024)

Surgical site infection (SSI) is the prevailing complication that occurs after surgery and significantly escalates healthcare expenses. Published meta-analyses and international standards vary in their recommendations for the most effective preoperative skin antiseptic solution and concentration.
Blood-brain barrier-associated biomarker correlated with cerebral small vessel disease and shunt outcome in normal pressure hydrocephalus: a prospective cohort study
Authors: Pao-Hui Tseng, Li-Chuan Huang, Xiang-Ling Huang, Bor-Ren Huang, Shinn-Zong Lin, Sheng-Tzung Tsai, Hsin-Yi Huang
Journal: International Journal of Surgery (2024)

Blood-brain barrier (BBB) breakdown is associated with neurodegeneration and cognitive impairment. Cerebral small vessel disease (CSVD) is also common in idiopathic normal pressure hydrocephalus (iNPH). Biomarkers in the cerebrospinal fluid (CSF) may reflect the severity of neuropathological damage and indicate a relationship between BBB integrity and iNPH and its surgical outcome. The authors investigated the association of CSVD and comorbidity-related CSF biomarkers with shunt outcomes in iNPH.
Bridging therapy versus direct endovascular thrombectomy in patients with established large infarct: a prospective cohort study
Authors: Wenzhe Sun, Jinfu Ma, Xu Xu, Yuan Zhao, Jiacheng Huang, Changwei Guo, Lingyu Zhang, Nizhen Yu, Chengsong Yue, Wenjie Zi, Minzhen Zhu, Jinzhao He
Journal: International Journal of Surgery (2024)

Background: Whether patients with large core infarctions should undergo intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) is currently a subject of controversy. The study aimed to investigate the association of prior use of IVT with outcomes of EVT patients with large core infarctions. Materials and methods: This prospective cohort included patients with acute large vessel occlusion and Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 0-5 from 38 stroke centers across China between November 2021 and February 2023. The primary outcome was defined as favorable functional outcomes, which is 90-day modified Rankin Scale (mRS) scores ranging from 0 to 3. Procedural outcomes included measures of successful and effective recanalization. Safety outcomes included the incidence of any intracranial hemorrhage (ICH), symptomatic ICH, and 90-day mortality. Results: Of 490 patients, 122 (24.5%) were treated with IVT before EVT. Bridging therapy and its transfer modes showed no association with any of the measured outcomes. Compared to direct EVT, bridging therapy was associated with a decreased risk of symptomatic ICH in very elderly patients and a decreased risk of any ICH in patients with admission NIHSS scores of 20 or higher. Additionally, early stroke severity may alter the odds of any ICH in patients with bridging therapy versus direct EVT (inverse probability weighting adjusted P value for interaction=0.003 and 0.007, respectively). Conclusion: In large core infarction patients with high admission NIHSS or very elderly age, bridging therapy appears to have some advantages over direct EVT in reducing the risk of ICH.
Transcriptional network dynamics in early T cell development
Authors: Boyoung Shin, Samantha J. Chang, Brendan W. MacNabb, Ellen V. Rothenberg
Journal: The Journal of Experimental Medicine (2024)

The rate at which cells enter the T cell pathway depends not only on the immigration of hematopoietic precursors into the strong Notch signaling environment of the thymus but also on the kinetics with which each individual precursor cell reaches T-lineage commitment once it arrives. Notch triggers a complex, multistep gene regulatory network in the cells in which the steps are stereotyped but the transition speeds between steps are variable. Progenitor-associated transcription factors delay T-lineage differentiation even while Notch-induced transcription factors within the same cells push differentiation forward. Progress depends on regulator cross-repression, on breaching chromatin barriers, and on shifting, competitive collaborations between stage-specific and stably expressed transcription factors, as reviewed here.
Heart‐on‐a‐Chip Model of Epicardial–Myocardial Interaction in Ischemia Reperfusion Injury (Adv. Healthcare Mater. 21/2024)
Authors: Dawn Bannerman, Simon Pascual‐Gil, Qinghua Wu, Ian Fernandes, Yimu Zhao, Karl T. Wagner, Sargol Okhovatian, Shira Landau, Naimeh Rafatian, David F. Bodenstein, Ying Wang, Trevor R. Nash, Gordana Vunjak‐Novakovic, Gordon Keller, Slava Epelman, Milica Radisic
Journal: Advanced Healthcare Materials (2024)