tbuckley/cabot-search huggingface dataset:
Non-surgical pancreatic cancer: The role of radiotherapy in prolonging survival, A retrospective cohort study in the SEER database
Authors: Di Yupeng, Jiazhao Song, Zhijia Sun, Yingjie Wang, Lingling Meng
Journal: International Journal of Surgery (2024)

Background: Limited research has compared external beam radiotherapy (RT) to non-RT in patients with non-surgical locally advanced pancreatic cancer (LAPC). Therefore, this study investigates the impact of RT on overall survival (OS) in patients with non-surgical LAPC in a real-world context. Methods: We conducted an analysis of patients with non-surgical LAPC using data from the Surveillance, Epidemiology, and End Results (SEER) database. This analysis involved the utilization of Kaplan-Meier survival curves and multivariable Cox regression analyses. Results: A total of 5,413 individuals with non-surgical LAPC were included in this analysis. Among them, 2,320 (42.9%) received RT, while 3,093 (57.1%) underwent non-RT treatment. The median OS was 12.0 months for the RT group and 9.0 months for the non-RT group, with a statistically significant difference ( P &lt;0.001). Multivariate analysis revealed that RT had a statistically significant impact on OS (HR, 0.86; 95% CI, 0.81–0.91; P &lt;0.001). Propensity score matching (PSM) analysis confirmed a statistically significant association of RT with improved OS (HR, 0.84, 95% CI, 0.79–0.90; P &lt;0.001). These results remained consistent after conducting sensitivity analyses, subgroup analyses, and PSM. Conclusion: The study findings suggest that RT could be advantageous for patients with non-surgical LAPC. Further investigations are warranted to explore the relationship between RT and OS.
Regarding the artificial intelligence-based classification of breast lesion from contrast enhanced mammography
Authors: Baorong Wang, Heguo Jiang
Journal: International Journal of Surgery (2024)

aDepartment of Cardiology, Zhenjiang First People's Hospital, Zhenjiang, 212000, P. R. China bDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, P. R. China Financial support and sponsorship: None. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, P. R. China. E-mail: [email protected] (H. Jiang). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
Comparison of long-term survival of neoadjuvant therapy plus surgery versus upfront surgery and the role of adjuvant therapy for T1b-2N0-1 esophageal cancer: a population study of the SEER database and Chinese cohort
Authors: Lingling Xia, Wei Shi, Yuxin Cai, Zhengkai Liao, Zhen Huang, Hu Qiu, Jing Wang, Yongshun Chen
Journal: International Journal of Surgery (2024)

For stage T1b-2N0-1 esophageal cancer, the impact of neoadjuvant therapy plus surgery (NS), surgery alone (SA), and surgery plus adjuvant therapy (ST) on cancer-specific survival (CSS) and overall survival (OS) is uncertain.
Predictors of renal replacement therapy following isolated coronary artery surgery – a retrospective case controlled study
Authors: Alena Krauchuk, Tomasz Hrapkowicz, Piotr Suwalski, Bartłomiej Perek, Marek Jasiński, Tomasz Hirnle, Paweł Nadziakiewicz, Piotr Knapik
Journal: International Journal of Surgery (2024)

Objectives: Severe acute kidney injury (AKI) requiring postoperative renal replacement therapy (RRT) is associated with increased morbidity and mortality rates following cardiac surgery. Our study aimed to analyze patients requiring postoperative RRT in a population undergoing isolated coronary artery surgery. Methods: Following exclusions, we analyzed 124 944 consecutive patients in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry), scheduled for isolated coronary artery surgery between January 2010 and December 2019. Patients who underwent preoperative chronic dialysis were excluded from the study. Data of patients requiring postoperative RRT and patients without postoperative RRT were compared. Results: In the analyzed population, 1668 patients (1.3%) developed AKI requiring RRT. In-hospital mortality among patients with and without postoperative RRT was 40.1 and 1.6%, respectively ( P &lt;0.001). Patients requiring postoperative RRT had significantly more preoperative co-morbidities and more frequent postoperative complications. Preoperative chronic renal failure and cardiogenic shock were the two most prominent independent risk factors for postoperative RRT in these patients (OR: 5.0, 95% CI: 3.9–6.4, P &lt;0.001 and OR: 3.9, 95% CI: 2.8–5.6, P &lt;0.001, respectively). Conclusion: Severe AKI requiring postoperative RRT dramatically increases in-hospital mortality and is associated with the development of serious postoperative complications. The need for postoperative RRT is clearly associated with the presence of preoperative co-morbidities. Preoperative chronic renal failure and cardiogenic shock were particularly related to the development of this complication.
Negative predictive value of fecal immunochemical testing in significant bowel disease screening: A systematic review and meta-analysis
Authors: Zhen Junhai, Liao Fei, Zhang Jixiang, Xie Huabing, Tan Cheng, Dong Weiguo
Journal: International Journal of Surgery (2024)

General practitioners (GPs) must assess significant bowel disease (SBD) in patients with lower bowel symptoms during primary care. Studies have evaluated the efficacy of fecal immunochemical testing (FIT) for SBD screening. However, the effectiveness of FIT remains controversial. This study aimed to investigate the value of FIT in SBD screening.
Prediction of sepsis among patients with major trauma using artificial intelligence: a multicenter validated cohort study
Authors: Baisheng Sun, Mingxing Lei, Li Wang, Xiaoli Wang, Xiaoming Li, Zhi Mao, Hongjun Kang, Hui Liu, Shiying Sun, Feihu Zhou
Journal: International Journal of Surgery (2024)

Background: Sepsis remains a significant challenge in patients with major trauma in the ICU. Early detection and treatment are crucial for improving outcomes and reducing mortality rates. Nonetheless, clinical tools for predicting sepsis among patients with major trauma are limited. This study aimed to develop and validate an artificial intelligence (AI) platform for predicting the risk of sepsis among patients with major trauma. Methods: This study involved 961 patients, with prospective analysis of data from 244 patients with major trauma at our hospital and retrospective analysis of data from 717 patients extracted from a database in the United States. The patients from our hospital constituted the model development cohort, and the patients from the database constituted the external validation cohort. The patients in the model development cohort were randomly divided into a training cohort and an internal validation cohort at a ratio of 8:2. The machine learning algorithms used to train models included logistic regression (LR), decision tree (DT), extreme gradient boosting machine (eXGBM), neural network (NN), random forest (RF), and light gradient boosting machine (LightGBM). Results: The incidence of sepsis for the model development cohort was 43.44%. Twelve predictors, including gender, abdominal trauma, open trauma, red blood cell count, heart rate, respiratory rate, injury severity score, sequential organ failure assessment score, Glasgow coma scale, smoking, total protein concentrations, and hematocrit, were used as features in the final model. Internal validation showed that the NN model had the highest area under the curve (AUC) of 0.932 (95% CI: 0.917-0.948), followed by the LightGBM and eXGBM models with AUCs of 0.913 (95% CI: 0.883–0.930) and 0.912 (95% CI: 0.880–0.935), respectively. In the external validation cohort, the eXGBM model (AUC: 0.891, 95% CI: 0.866-0.914) had the highest AUC value, followed by the LightGBM model (AUC: 0.886, 95% CI: 0.860–0.906), and the AUC value of the NN model was only 0.787 (95% CI: 0.751-0.829). Considering the predictive performance for both the internal and external validation cohorts, the LightGBM model had the highest score of 82, followed by the eXGBM (81) and NN (76) models. Thus, the LightGBM was emerged as the optimal model, and it was deployed online as an AI application. Conclusions: This study develops and validates an AI application to effectively assess the susceptibility of patients with major trauma to sepsis. The AI application equips healthcare professionals with a valuable tool to promptly identify individuals at high risk of developing sepsis. This will facilitate clinical decision-making and enable early intervention.
Psychosocial predictors of doping intentions and use in sport and exercise: a systematic review and meta-analysis
Authors: Nikos Ntoumanis, Sigurd Dølven, Vassilis Barkoukis, Ian David Boardley, Johan S Hvidemose, Carsten B Juhl, Daniel F Gucciardi
Journal: British Journal of Sports Medicine (2024)

To conduct a meta-analytic review of psychosocial predictors of doping intention, doping use and inadvertent doping in sport and exercise settings.
How race and socioeconomic status moderate the association between moderate-to-vigorous physical activity and depressive symptoms: a cross-sectional study with compositional data
Authors: Yujie Liu, Xin Ge, Ying Wang, Shan Qiao, Yong Cai
Journal: British Journal of Sports Medicine (2024)

Objectives This study explored how race and socioeconomic status (SES) moderated the association between moderate-to-vigorous physical activity (MVPA) and depressive symptoms with compositional data. Methods Participants were 2803 US adults from the 2005–2006 cycle of the National Health and Nutrition Examination Survey. Accelerometers were used to measure MVPA, light-intensity physical activity (LPA) and sedentary behaviours (SB). Participants self-reported sleep duration and depressive symptoms. SES was derived by latent class analysis using household income level, education attainment and occupation. The association between the relative time of MVPA and depressive symptoms and the moderating effects of race and SES were investigated through compositional data analysis. Isotemporal substitution analysis was employed to estimate the association of time reallocation from other movement behaviours to MVPA with depressive symptoms. Results Increased time spent in MVPA relative to time spent in LPA, SB and sleep was inversely associated with depressive symptoms (OR (95% CI)=0.679 (0.538–0.855)). The relative time of MVPA significantly interacted with race and SES for depressive symptoms (P for interaction &lt;0.05). Reallocating 10–30 min from sleep, SB or LPA to MVPA was associated with lower odds of depressive symptoms solely among non-Hispanic white individuals and those with higher SES. Conclusion This study used compositional data to reveal a reverse association between MVPA and depressive symptoms among white individuals and those with higher SES. Our results provide evidence of how race and SES moderate the relationship between MVPA and depressive symptoms. Future research is needed to further explore these racial and socioeconomic differences.
Changes in New Patient Consultations During the COVID-19 Pandemic at a Canadian Comprehensive Cancer Center
Authors: Carly C. Barron, Tyler Pittman, Wei Xu, Mary Madunic, Niki Agelastos, David Goldstein, James Brierley, Monika K. Krzyzanowska
Journal: Journal of the National Comprehensive Cancer Network (2024)

The impact of COVID-19 pandemic-related disruptions on cancer services is emerging. We evaluated the impact of the first 2 years of the pandemic on new patient consultations for all cancers at a comprehensive cancer center within a publicly funded health care system and assessed whether there was evidence of stage shift.
Clocking Cancer Immunotherapy Responses
Authors: Catherine L. Wang, Xue Zhang, Chi V. Dang
Journal: Cancer Research (2024)

Two recent papers document that responses to immunotherapy are circadian and peak at the end of resting phase (evening) of mice with syngeneic and genetic models of cancers. The circadian effect is attributed to diurnal T-cell trafficking through the endothelium on the one hand, and to the circadian expression of PD-L1 on myeloid suppressors on the other. Overall, it appears that tumor immunity as a system, including dendritic cell function, behaves in a circadian manner that is also observed in patients in cancer immunotherapy clinical trials. Importantly, these observations uncover time-of-day as an unforeseen variable for cancer immunotherapy responses. This insight on the immune circadian clock should be further explored to enhance immunotherapy responses in the clinic.
Racism, Medicine, and NEJM since 1812 — The Historical Roots of Injustice in Medicine, Symposium 1
Authors: Joan Y. Reede, Winfred W. Williams, David S. Jones, Meghan Bannon Kerr, Scott H. Podolsky, Evelynn Hammonds, Joseph P. Gone, Merlin Chowkwanyun, Eric J. Rubin
Journal: New England Journal of Medicine (2024)
A national survey of obstetrics and gynecology resident perspectives on their preparedness to provide care for racially and socioeconomically diverse gynecologic oncology populations.
Authors: Khaoula Ben Haj Frej, Nicole Janell Hardy, Bradford Whitcomb
Journal: Journal of Clinical Oncology (2024)

9037 Background: Despite 83% female representation, Obstetrics and Gynecology (Ob/Gyn) lags behind other residencies in racial diversity, with 35.2% of trainees classified as Underrepresented in Medicine (URM). Fellowships are markedly less diverse, with Gynecologic Oncology representing 26.1% URM. While studies have examined Ob/Gyn residents’ self-perceived preparedness for surgical skills, little is known about their confidence in treating vulnerable patients with gynecologic malignancies. This survey assessed resident confidence in providing Gynecologic Oncology care to patient populations diverse in racial/ethnic background and insurance status, while accounting for residents’ own racial/ethnic backgrounds. Methods: An anonymous, novel Qualtrics survey was disseminated to current US Ob/Gyn residents, to elicit their self-reported preparedness to provide NCCN guideline-based care to diverse Gynecologic Oncology patient populations. Subjects were asked multiple-choice questions to record their own demographics followed by Likert scale questions which ranged from strongly disagree (1) to strongly agree (5) regarding their perceived readiness to care for patients diverse in insurance and racial background. Differences in responses between racial groups were analyzed using the Kruskal-Wallis Rank Sum test while differences in responses between ethnic groups were evaluated using the Wilcoxon Rank Sum test. Results: 207 residents complete the survey, mirroring sample sizes of national surveys of Ob/Gyn residents. There was no statistical difference in self-perceived preparedness between Hispanic and non-Hispanic Ob/Gyn residents regarding providing care for diverse racial minorities (mean Likert Non-Hispanic = 4.1 vs. Hispanic = 4.2; p = 0.222) or insurance types (mean Likert Non-Hispanic= 4.0 vs. Hispanic = 4.0; p=0.563). There was a significant difference in the number of Hispanic residents who felt that patients with Medicaid insurance experienced more difficulty obtaining non-operative gynecologic care compared to those with other insurance types (Hispanic = 3.7 vs. non-Hispanic = 3.2; p = 0.044). Further, there was a significant difference in the number of Hispanic residents who felt that patients with Medicaid insurance had to wait longer for outpatient appointments with a gynecologic oncologist (Hispanic = 3.6 vs. non-Hispanic = 3.0; p=0.016). Conclusions: All Ob/Gyn residents will encounter, screen for, and diagnose gynecologic malignancies, regardless of pursuit of Gynecologic Oncology fellowship. This study evaluated Ob/Gyn resident perceptions, finding that they feel overall prepared to provide Gynecologic Oncology care to socioeconomically diverse patient populations, though differences exist when residents are compared based on their backgrounds.
Filling the gap in competency-based training for medical oncology with supervised online patient counseling: A qualitative study.
Authors: Sergei Iugai, Daria Panchenko, Mary Caitlin King, Vladislav Kovalik, Andrei Nikiforchin, Philipp Barakat, Panayotis Ledakis, Vadim Gushchin
Journal: Journal of Clinical Oncology (2024)

9036 Background: The Higher School of Oncology (HSO) is a collaborative US-Russian postgraduate program that improves learning outcomes for young oncologists. Many HSO medical oncology (MO) residents/graduates are also engaged in online supervised patient counseling, known as ‘Just Ask.’ We aimed to explore the educational role of ‘Just Ask’ in shaping the competency-based learning outcomes of MO graduates, who have recently begun independent clinical practice. Methods: This qualitative study included 10 HSO alumni (2019-2023) who practice MO in Russia. All participants were current or prior ‘Just Ask’ consultants. Anonymous, online semi-structured in-depth interviews were conducted to explore interviewees reflection on competencies obtained at HSO and ‘Just Ask.’ The interview guide included 42 open-ended questions based on the American Accreditation Council for Graduate Medical Education (ACGME) list of competencies for MO physicians. All interviews were recorded and transcribed. Inductive-deductive coding with code categorization was followed by thematic analysis. Themes were mapped against the ACGME competencies. Results: Interviews, with a median duration of 69 (IQR: 54-80) minutes,involved participants with 0.5-3 years of practice. Six (60%) interviewees worked in hospitals, while 2 (20%) were in outpatient and another 2 (20%) were in mixed settings. We identified 85 codes and categorized them into 10 educational experience themes. Interviewees attributed learning an evidence-based approach, basic oncology knowledge, and patient communication skills through the HSO curriculum. Themes associated with learning from online counseling included integration into real-world practice, specific types of expertise (rare tumors), and advanced communication (explaining differences in management, written communication), which are less covered by HSO. This activity enhanced skills in patient navigation, advocacy, and the ability to detect care not supported by evidence. Safe-space learning provided by ‘Just Ask’ was a unique theme reflecting the ability of trainees to hone skills in a secure and resource-enriched environment with easy access to mentoring. The association of the selected 'Just Ask'-related themes with ACGME competencies is presented in the table. Conclusions: Supervised online counseling has emerged as a valuable educational tool aimed at supplementing competencies insufficiently covered by medical oncology postgraduate curriculum. [Table: see text]
Factors influencing career choices and post-fellowship perspectives in adult hematology/oncology physicians: A nationwide cross-sectional study.
Authors: Luis Gonzalez Mosquera, Nino Balanchivadze, Faria Ali, Matthew Meranda, Oscar Hinojosa Castro, Philip Kuriakose
Journal: Journal of Clinical Oncology (2024)

9015 Background: We aimed to investigate the timing and influence of factors behind career choices in hematology and medical oncology, assess levels of job satisfaction, and identify factors contributing to professional retention and the prevention of attrition. Methods: An anonymous survey with 13 questions was distributed to practicing hematologists and oncologists who were members of the American Society of Clinical Oncology and/or American Society of Hematology. The respondents encompassed diverse areas of primary focus within the field, varied practice settings, and all geographical regions. Results: Out of 423 respondents, 66% were male and 32% female. The majority identified as White (69%), followed by Asian (19%), Middle Eastern (4%), Hispanic (3%), and Black (1%). Most were practicing either Medical Oncology (43%) or combined Hematology/Oncology (36%), with 46% working in an academic/university setting and 57% located in an urban region. In terms of timing, about a third had decided on their career choice in medical school, with the majority of the remaining having decided by residency. While most of those surveyed were practicing in the area they had hoped to, about one-sixth (17.5%) appeared to be working in an area they hadn't planned on. Most said they would choose their current profession again (67% definitely yes, 24% likely yes). Science and academic interest (81%) ranked the highest when combining the top two responses for factors influencing choice, followed by mentor influence (47%), with work/life balance (19%) and financial considerations (6%) being less frequently cited. Satisfaction levels were generally high across key dimensions (Table), with intellectual fulfillment receiving the highest satisfaction (63.1% very satisfied, 26% satisfied). Importantly, better work/life balance (37% respondents), fewer non-medical tasks (35%), and a higher salary (20%) were key considerations to deter professional attrition. Conclusions: This study offers valuable insights into the career perspectives of Hematologists and Medical Oncologists, providing a foundation for developing strategies for career development and retention initiatives within the specialty. Efforts should be undertaken to enhance participation from different minorities within Hematology/Oncology and physicians practicing Classical Hematology to identify specific support and retention needs for these areas. [Table: see text]