tbuckley/cabot-search huggingface dataset:
Risk for Suicide Attempts Assessed Using the Patient Health Questionnaire–9 Modified for Teens
Authors: Fuchiang Tsui, Victor M. Ruiz, Neal D. Ryan, Lingyun Shi, Nadine M. Melhem, Jami F. Young, Molly Davis, Robert Gibbons, David A. Brent
Journal: JAMA Network Open (2024)

Importance Suicide is a leading cause of death in US youths. Objective To assess whether screening with supplemental items 10 to 13 on the Patient Health Questionnaire–9 modified for teens (PHQ-9M) improves prediction of youth suicide attempts beyond the information provided by the first 9 items alone (the PHQ-9). Design, Setting, and Participants This retrospective cohort study used a retrospective cohort of adolescents aged 12 to 17 years who were screened for depression in outpatient facilities within a pediatric health care system between January 1, 2016, and December 31, 2022, with up to 1 year of follow-up to assess the occurrence of suicidal behavior. Follow-up was completed on December 31, 2023. Exposure Screening with the PHQ-9M. Main Outcomes and Measures This study developed and compared prediction using 3 Cox proportional hazards regression models (CR-9, CR-13, and CR-3) of subsequent suicide attempts, determined by the hospital’s electronic health records up to 1 year following the last PHQ-9M screening. The CR-9 model used the PHQ-9 and the CR-13 model used all 13 items of PHQ-9M. The CR-3 model used the 3 most impactful variables selected from the 13 PHQ-9M items and PHQ-9 total score. All models were evaluated across 4 prediction horizons (30, 90, 180, and 365 days) following PHQ-9M screenings. Evaluation metrics were the area under the receiver operating characteristic curve (AUROC) and the area under the precision recall curve (AUPRC). Results Of 130 028 outpatients (65 520 [50.4%] male) with 272 402 PHQ-9M screenings, 549 (0.4%) had subsequent suicide attempts within 1 year following the PHQ-9M screening. The AUROC of the CR-9 model in the 365-day horizon was 0.77 (95% CI, 0.75-0.79); of the CR-13 model, 0.80 (95% CI, 0.78-0.82); and of the CR-3 model, 0.79 (95% CI, 0.76-0.81); the AUPRC of the CR-9 model was 0.02 (95% CI, 0.02-0.03); of the CR-13 model, 0.03 (95% CI, 0.02-0.03); and of the CR-3 model, 0.02 (95% CI, 0.02-0.03). The 3 most impactful items using adjusted hazard ratios were supplemental item 13 (lifetime suicide attempts; 3.06 [95% CI, 2.47-3.80]), supplemental item 10 (depressed mood severity in the past year; 2.99 [95% CI, 2.32-3.86]), and supplemental item 12 (serious suicidal ideation in the past month; 1.63 [95% CI, 1.25-2.12]). All of the models achieved higher AUROCs as prediction horizons shortened. Conclusions and Relevance In this cohort study of adolescent PHQ-9M screenings, the supplemental items on PHQ-9M screening improved prediction of youth suicide attempts compared with screening using the PHQ-9 across all prediction horizons, suggesting that PHQ-9M screening should be considered during outpatient visits to improve prediction of suicide attempts.
Outcomes After Early Pregnancy Loss Management With Mifepristone Plus Misoprostol vs Misoprostol Alone
Authors: Lyndsey S. Benson, Navya Gunaje, Sarah K. Holt, John L. Gore, Vanessa K. Dalton
Journal: JAMA Network Open (2024)

Importance Medication management of early pregnancy loss (EPL), or miscarriage, typically involves the administration of misoprostol with or without pretreatment with mifepristone. Combination treatment with mifepristone plus misoprostol is more effective than misoprostol alone but is underutilized in the US. Objective To describe differences in clinical outcomes after EPL management with mifepristone plus misoprostol vs misoprostol alone using commercial claims data. Design, Setting, and Participants This retrospective cohort study used national insurance claims data from the IBM MarketScan Research Database. Participants included pregnant people (aged 15-49 years) with private insurance who presented with an initial EPL diagnosis between October 1, 2015, and December 31, 2022. Exposures The primary exposure was the medication used to manage EPL (ie, mifepristone plus misoprostol or misoprostol alone). Other exposures of interest included demographic characteristics and location of service. Main Outcomes and Measures The primary outcome was subsequent procedural management (eg, uterine aspiration) after EPL diagnosis and medication management. Other outcomes of interest included return visits, hospitalizations, and complications occurring in the subsequent 6 weeks. Descriptive statistics and bivariate analyses were used, and a multivariable logistic regression model was created to examine factors associated with subsequent procedural management. Results This study included 31 977 patients (mean [SD] age, 32.7 [5.6] years) with claims for EPL who received medication management. Of these patients, 3.0% received mifepristone plus misoprostol and 97.0% received misoprostol alone. Patients who received misoprostol with pretreatment with mifepristone were less likely to have subsequent uterine aspiration (10.5% vs 14.0%; P = .002), and they were also less likely to have subsequent emergency department (ED) visits for EPL (3.5% vs 7.9%; P &amp;amp;lt; .001). In multivariable analysis, use of mifepristone plus misoprostol was associated with decreased odds of subsequent procedural management (adjusted odds ratio, 0.71 [95% CI, 0.57-0.87]). Conclusions and Relevance The findings of this study suggest that mifepristone is underutilized for the medication management of EPL, but its use is associated with a lower need for subsequent uterine aspiration and a decrease in the number of subsequent visits to an ED. Increasing access to mifepristone for EPL management may decrease health care utilization and expenditures.
Annual Wellness Visits and Early Dementia Diagnosis Among Medicare Beneficiaries
Authors: Huey-Ming Tzeng, Mukaila A. Raji, Yong Shan, Peter Cram, Yong-Fang Kuo
Journal: JAMA Network Open (2024)

Importance Early recognition of cognitive impairment is key to optimal dementia care. No previous research has examined the probability of developing mild cognitive impairment (MCI) or Alzheimer disease and related dementias (ADRD) at 5-year follow-up among older adult Medicare beneficiaries by receipt of an annual wellness visit (AWV). Objective To assess the association of incident AWV with the first ADRD or MCI diagnosis among older adults with Medicare fee-for-service benefits. Design, Setting, and Participants This retrospective population-based cohort study used 100% Texas fee-for-service Medicare data from 2015 to 2022. Participants comprised 549 516 community-dwelling Medicare beneficiaries aged 68 years or older in 2018, with complete Medicare fee-for-service Parts A and B and no Medicare Advantage plan enrollment for 2015 to 2018. Exposure Medicare AWVs. Main Outcomes and Measures The first MCI or ADRD diagnosis (reported as MCI or ADRD diagnosis, MCI diagnosis, and ADRD diagnosis) from the AWV index date in 2018 through December 31, 2022. Results In this cohort study of 549 516 Medicare beneficiaries with no diagnosis of MCI or ADRD in 2015 to 2017 (mean [SD] age, 76.7 [6.6] years; 289 932 women [52.8%]), 66 433 (12.1%) had an incident AWV in 2018. Annual wellness visit recipients were more likely than those who did not receive an AWV to be female, to be non-Hispanic White (followed by Hispanic, non-Hispanic Black, and other), to have more education, to reside in a metropolitan area, to have more comorbidities, and to have a primary care professional in the 12 months before the AWV index date. After propensity score matching, AWV receipt was associated with a 21% increase in MCI diagnosis (hazard ratio, 1.21 [95% CI, 1.16-1.27]) and a 4% increase in ADRD diagnosis (hazard ratio, 1.04 [95% CI, 1.02-1.06]). The increase in MCI diagnosis associated with AWV was larger when the AWV was censored or treated as a time-dependent covariate in the follow-up period. Conclusions and Relevance These findings indicate that AWV recipients had a timelier first MCI diagnosis than those who did not receive an AWV, but first ADRD diagnosis differed little. This study suggests that the Medicare AWV health policy may increase MCI identification, prompting more specialized care.
Posterior retroperitoneoscopic thoracic duct ligation: a Promising approach for management of iatrogenic chylothorax
Authors: Franck Billmann, Therezia Bokor-Billmann, Ewan A. Langan, Fabian Schuh, Andrea Boskovic
Journal: International Journal of Surgery (2024)

Billmann, Franck MD, PhD; Bokor-Billmann, Therezia MD; Langan, Ewan A. MD; Schuh, Fabian MD; Boskovic, Andrea MD Author Information
Redefining chimeric antigen receptor T-cell (CAR-T) regulation: China’s responses to address secondary cancer risks of CAR-T therapy
Authors: Ruirong Tan, Rui Li, Meng-Yuan Dai, Miao Liu, Junning Zhao
Journal: Journal of Hematology & Oncology (2024)

Since the United States Food and Drug Administration (FDA) approved the first chimeric antigen receptor T-cell (CAR-T) therapy in 2017, it has marked a major breakthrough in cancer treatment, leading to a surge in global research and applications in this field. In recent years, China has made rapid progress, quickly catching up through heavy investment in CAR-T construction, preparation processes, and treatment strategies. China's CAR-T therapy market is driven by substantial pharmaceutical investment targeting its vast population, yet high therapy costs remain uncovered by basic medical insurance. In November 2023, FDA issued a warning about the risk of secondary cancers in patients undergoing CAR-T therapy, sparking global concern. In fact, the China National Medical Products Administration (NMPA) preemptively implemented a series of measures to address the safety concerns of CAR-T therapy, emphasizing the risk of secondary cancers and advising lifelong monitoring as part of the approval process for CAR-T products. Nevertheless, additional regulatory measures are needed to address emerging risks, particularly the threat of secondary cancers. The authors believe that raising the standards for Investigational New Drug (IND) approval and establishing a dynamic reporting and feedback system based on real-world data will strengthen regulatory oversight and support the sustainable growth of the CAR-T industry in China.
Reply to Zhang et al. regarding ‘Re: ChatGPT encounters multiple opportunities and challenges in neurosurgery’
Authors: Min-Liang Yang, Bo-Wen Zheng, Jian-Feng Song
Journal: International Journal of Surgery (2024)

aDepartment of Spine Surgery, Hunan Aerospace Hospital, Changsha, 410205, Hunan, China bMusculoskeletal Tumor Center, Peking University People's Hospital, Peking University, Beijing 100044, China cNational Clinical Research Center for Metabolic Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 139 Middle Renmin Road, Changsha, 410011, Hunan, China Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Musculoskeletal Tumor Center, Peking University People's Hospital, Peking University, No. 11, Xizhimen South Street, Xicheng District, Beijing 100044, China. Tel.: +(86)-1088326666; fax: +(86)-1066853666. E-mail: [email protected] (B.-W. Zheng). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0/
Maximizing Early Dementia Detection Through Medicare Annual Wellness Visits
Authors: Márlon Juliano Romero Aliberti, Thiago J. Avelino-Silva, Claudia Kimie Suemoto
Journal: JAMA Network Open (2024)

Huey-Ming Tzeng, PhD; Mukaila A. Raji, MD, MS; Yong Shan, PhD; Peter Cram, MD, MBA; Yong-Fang Kuo, PhD
Mapping the scientific landscape and evolution of the international journal of surgery: A scientometric analysis (2004-2024)
Authors: Chong Li, Jing Hu, Anqi He, Chengqi He, Weihua Zhuang
Journal: International Journal of Surgery (2024)

Aim: The purpose of this study was to analyze the publication characteristics and development of the International Journal of Surgery over its 20-year history. Methods: This study included articles published in IJS during the 20 years from 2004 to 2024. The data were analyzed using the Citespace, VOS viewer, and the ‘Bibliometrix’ package in R software. We studied the dynamics and trend patterns of IJS literature production through descriptive bibliometrics and identified the most prolific authors, publications, institutions, and countries. Bibliometric maps were utilized to visualize published articles’ content and identify the most prolific research terms and topics in IJS , as well as their evolution over time. Results: A total of 5964 publications in the IJS from 2004 to 2023 and 356 publications in 2024 were included in the analysis. The study revealed a positive trend in literature production, although the number of articles published in IJS has slightly decreased recently. The most productive country was China (n=1,211), the most productive institution was Sichuan University (n=151), and the most prolific author was Wang Yang (n=87). The top 15 most cited articles focus primarily on research reporting standard guidelines for surgical studies. Research published in IJS mainly targeted middle-aged and older adults, emphasizing postoperative complications and treatment outcomes. The future research focus in IJS might center on integrating artificial intelligence and deep learning technologies to revolutionize surgical research and practice. Conclusions: The International Journal of Surgery significantly contributes to advances in surgical research. IJS prioritized enhancing patient outcomes and advancing surgical techniques, focusing on middle-aged and older adults, postoperative complications, and treatment outcomes. The journal emphasized robust evidence through retrospective, controlled, and cohort surgical studies. Integrating artificial intelligence and deep learning represented a significant frontier poised to revolutionize surgical care, shaping the future landscape of research and practice.
Diagnostic value of three complete blood count abnormalities, hypereosinophilia, hyperlymphocytosis and basophilic lymphocytes, in DRESS
Authors: Patti C Liccardo, Saskia Ingen-Housz-Oro, Pierre Wolkenstein, Orianne Wagner-Ballon, Bouchra Badaoui
Journal: British Journal of Dermatology (2024)

The prevalence and kinetics of hypereosinophilia (HE), hyperlymphocytosis (HL), basophilic lymphocyte (BL), are misdescribed. We aimed to assess their diagnostic value in the acute phase of DRESS in a monocentric retrospective study. Among 60 patients, 47% had probable DRESS, and 53% definite DRESS. HE and HL were present in 62% and 27% of patients, respectively, with no link to DRESS severity. BL, found in 85% of blood smears, were associated with definite DRESS. BL detection, although not specific nor sufficient alone, appears to be the most sensitive hematological factor for diagnosing DRESS, especially when HE or HL is absent. Clinicians should ensure that a blood smear review is performed whenever a DRESS is suspected. A prospective study is needed to confirm these findings.
Innovative approaches in stem cell therapy: revolutionizing cancer treatment and advancing neurobiology- A comprehensive review
Authors: Dhrupad Banerjee, Arghya Bhattacharya, Abhijeet Puri, Shubham Munde, Nobendu Mukerjee, Popat Mohite, Syeda Wajida Kazmi, Abhishek Sharma, Taha Alqahtani, Humood Al Shmrany
Journal: International Journal of Surgery (2024)

Stem cell therapy represents a transformative frontier in medical science, offering promising avenues for revolutionizing cancer treatment and advancing our understanding of neurobiology. This review explores innovative approaches in stem cell therapy that have the potential to reshape clinical practices and therapeutic outcomes in cancer and neurodegenerative diseases. In this dynamic and intriguing realm of cancer research, recent years witnessed a surge in attention towards understanding the intricate role of Mesenchymal Stem Cells (MSCs). These cells, capable of either suppressing or promoting tumors across diverse experimental models, have been a focal point in the exploration of exosome-based therapies. Exosomes released by MSCs have played a pivotal role, in unraveling the nuances of paracrine signaling and its profound impact on cancer development. Recent studies have revealed the complex nature of MSC-derived exosomes, showcasing both pro-tumor and anti-tumor effects. Despite their multifaceted involvement in tumor growth, these exosomes show significant promise in influencing both tumor development and chemosensitivity, acting as a pivotal factor that increases stem cells' potential for medicinal use. Endogenous MSCs, primarily originating from the bone marrow, exhibited a unique migratory response to damaged tissue sites. The genetic modification of stem cells, including MSCs, opened avenues for the precise delivery of therapeutic payloads in the milieu around the tumor (TME). Stem cell therapy offers groundbreaking potential for treating neurodegenerative and autoimmune disorders by regenerating damaged tissues and modulating immune responses. This approach aims to restore lost function and promote healing through targeted cellular interventions. In this review, we explored the molecular complexities of cancer and the potential for breakthroughs in personalized and targeted therapies. This analysis offers hope for transformative advancements in both cancer treatment and neurodegenerative disorders, highlighting the promise of precision medicine in addressing these challenging conditions.
Advancing aesthetic outcomes: A critical analysis of autologous free flap reconstruction post-minimally invasive mastectomy
Authors: Qirui Guo, Mohan Liu, Yan Li, Qiang Sun
Journal: International Journal of Surgery (2024)

Guo, Qirui MB, MSc; Liu, Mohan MB, MSc; Li, Yan Prof. MD, PhD; Sun, Qiang Prof. MD, PhD Author Information
Novel self-expandable metallic stent with dumbbell-shape and spiral outer cover for malignant distal biliary obstruction
Authors: Haruo Miwa, Yugo Ishino, Shotaro Tsunoda, Kazuki Endo, Ritsuko Oishi, Yuichi Suzuki, Shin Maeda
Journal: Endoscopy (2024)

Covered self-expandable metallic stent (SEMS) placement is effective for malignant distal biliary obstruction [1]; however, it carries the risk of cholecystitis, pancreatitis, and stent migration [2] [3] [4]. The novel HILZO dumbbell-shaped, spiral cover stent (ABIS Inc., Hyogo, Japan) has a unique structure that prevents such complications ([Fig. 1]). The dumbbell-shaped proximal end prevents stent migration. The belt-like gap in the spiral outer cover helps bile and pancreatic juice flow out, whereas the inner full cover prevents tumor growth. Herein, we report the first case of a malignant distal biliary obstruction treated using the novel HILZO stent ([Video 1]).
Endoscopic biliary drainage using a narrow-diameter endoscope in a patient with obstructive jaundice and pancreatic cancer
Authors: Koichi Soga, Mayumi Yamaguchi, Takeshi Fujiwara, Fuki Hayakawa, Yumi Kusano, Ikuhiro Kobori, Masaya Tamano
Journal: Endoscopy (2024)

Standard endoscopic retrograde cholangiopancreatography (ERCP) involves the insertion of a duodenoscope and side-viewing endoscope. However, advancement of the scope into the correct gastrointestinal lumen can be challenging in patients with a deformed superior duodenal angle caused by peritoneal dissemination or direct tumor invasion [1].
Successful removal of a migrated stent retriever tip using wire-guided forceps
Authors: Tomohiro Ishii, Kazuya Sugimori, Arisa Omata, Shoichiro Yonei, Takashi Kurosawa, Shin Maeda
Journal: Endoscopy (2024)

Stent retriever dilation (Soehendra stent retriever, SSR-7; Cook, Tokyo, Japan) has demonstrated effectiveness in treating main pancreatic duct stenosis in chronic pancreatitis [1] [2]. However, there have been few reports on stent retriever tip breakage [3]. In this study, we describe a case of dislodgment of the stent retriever tip during main pancreatic duct stenosis owing to chronic pancreatitis, including the removal method.
Endoscopic ultrasound-guided salvage technique for pancreatic duct injury during endoscopic papillectomy
Authors: Haruo Miwa, Kazuki Endo, Ritsuko Oishi, Yugo Ishino, Shotaro Tsunoda, Yuichi Suzuki, Shin Maeda
Journal: Endoscopy (2024)

Pancreatic stent placement is suggested after endoscopic papillectomy [1] [2]; however, there is a risk of pancreatic duct injury during guidewire manipulation. Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD) can be an alternative technique after failed endoscopic retrograde pancreatography [3] [4].
Hemostasis using a novel self-assembling peptide for a bleeding gastric hyperplastic polyp after endoscopic resection
Authors: Yo Kubota, Risako Sudo, Kenji Ishido, Chika Kusano
Journal: Endoscopy (2024)

Endoscopic resection (ER) is considered when a gastric hyperplastic polyp (HPP) leads to bleeding or anemia [1]. However, achieving hemostasis for bleeding from a gastric HPP after ER can be challenging, depending on the lesion location and the patient's clinical background. PuraStat (3-D Matrix Ltd., Tokyo, Japan), a novel self-assembling peptide, has been utilized as a hemostatic agent in various endoscopic procedures [2] [3] [4] [5]. We report a case of successful hemostasis using PuraStat for post-ER bleeding from a gastric HPP.
Clinical evaluation of a novel therapeutic single-use gastroscope: a pilot feasibility study
Authors: Christoph Römmele, Mousa Ayoub, Julia Wanzl, Vidan Tadic, Georg Braun, Tobias Weber, Markus Wolfgang Scheppach, David Roser, Katharina Matic, Sandra Nagl, Helmut Messmann, Alanna Ebigbo
Journal: Endoscopy (2024)

Abstract Background The trend toward disposable products in gastrointestinal endoscopy, including single-use endoscopes, remains undeterred, even though crucial questions of sustainability and performance have not been sufficiently studied. The first single-use therapeutic gastroscope was recently approved in Europe, but clinical data to support its use are currently lacking. We aimed to evaluate the performance of this novel device in routine procedures requiring a large working channel. Methods Between January and May 2024, consecutive patients with an indication for therapeutic gastroscopy were included prospectively. The primary outcome was intraprocedural technical success rate. Results Eight gastrointestinal bleedings, two pancreatic necrosectomies, four foreign body removals, four stent placements, and two cryo-balloon ablations were performed. The technical success rate was 84% (16/19 patients). Crossover to a standard endoscope was required in three procedures. Clinical success was achieved in all cases with technical success. Overall user experience was 3.2 on a Likert scale of 1–5. No adverse events were reported. Conclusions The single-use therapeutic gastroscope demonstrated feasibility in various therapeutic procedures; however, a 16% crossover rate and fair user assessment score suggest that further technical improvements to the device are necessary.