tbuckley/cabot-search huggingface dataset:
The infiltrative margins in glioblastoma: important is what has been left behind
Authors: Philipp Karschnia, Joerg C. Tonn, Daniel P. Cahill
Journal: Clinical Cancer Research (2024)

Supramaximal resection beyond the contrast-enhancing tumor borders represents an emerging surgical strategy for patients with newly diagnosed glioblastoma. A recent study provides evidence detailing the interactive effects of more aggressive surgery with other clinical predictors of outcome, supporting guidance for surgical decision-making and informing clinical trialists about the need to stratify for extent of resection.
Potential reevaluation needed for the meta-analysis of high-pressure recruitment maneuvers in the 2023 ESICM guidelines on acute respiratory distress syndrome
Authors: Siyao Zeng, Yue Li, Zhipeng Yao, Junbo Zheng, Hongliang Wang
Journal: Intensive Care Medicine (2024)

The results from these omitted studies could significantly affect the meta-analysis outcomes.In addition, upon careful review of the studies included in the meta-analysis, we found that outcomes such as mortality at 6 months, incidence of arrhythmia, incidence of desaturation, the rates of rescue therapies (such as rates requiring prone position and rates requiring inhalation of nitric oxide) and oxygenation index on days 1, 3, and 7 can be evaluated.Furthermore, the outcomes in the articles by Hodgson et al. [8], Kung et al. [9] and Hodgson et al. [10]-which include length of hospital stay, length of stay in the intensive care unit (ICU), ventilation duration, and ventilator-free days to day 28-were statistically presented using median values and interquartile ranges (IQR).The formulas provided in the articles by Luo et al. and Wan et al. could be utilized to convert these data into mean values and standard deviations (SD) for inclusion in subsequent meta-analyses [11,12].Evaluating these additional outcomes could provide a more comprehensive analysis of the impact of OLV on ARDS patients.In conclusion, if possible, we recommend updating the meta-analysis of high-pressure RMs in the supplementary materials of the ESICM 2023 ARDS guidelines to address the above limitations.This could provide evidence on the impact of OLV on ARDS to guide clinical practice.
Contract Termination and Insurance Enrollment Among Medicare Advantage Beneficiaries
Authors: Meehir N. Dixit, Amal N. Trivedi, David J. Meyers
Journal: JAMA Network Open (2024)

Importance Approximately one-fifth of Medicare Advantage (MA) contracts terminated their participation in the MA program between 2011 and 2020. Little is known about subsequent insurance choices following a termination. Objective To examine the insurance destinations of MA enrollees and the characteristics of enrollees who switch into traditional Medicare (TM) after a contract termination. Design, Setting, and Participants This cross-sectional study examined MA program data of MA beneficiaries in the Medicare Master Beneficiary File from 2016 to 2018. Statistical analysis was performed from June 2023 to April 2024. Exposures Beneficiary characteristics, including age, sex, race and ethnicity, dual eligibility; hospital, nursing home, and home health utilization; and contract characteristics, including plan type, vertical integration, premium, and MA star rating. Main Outcome and Measures The main outcome was switching to TM in the year immediately after termination. We also evaluated the characteristics of contracts among those who remained in MA. Results A total of 117 681 beneficiaries were included in this analysis (64 654 [54.9%] female; 409 [0.4%] American Indian or Alaska Native; 2817 [2.4%] Asian; 76 725 [16.8%] Black; 11 131 [9.5%] Hispanic; 81 226 [69.0%] White; and 2373 [2.0%] other race or ethnicity; 27 078 [23.0%] dual-eligible; mean [SD] age, 71.2 [10.4] years). Following a contract termination, 20.1% (95% CI, 19.9%-20.4%) of enrollees switched to TM, including 32.7% (95% CI, 32.4%-33.1%) of dual-eligible beneficiaries and 16.4% (95% CI, 16.2%-16.5%) of non–dual-eligible beneficiaries. In nonterminated contracts, the concurrent switch rate was 6.2% (95% CI, 6.2%-6.2%) for all, 10.4% (95% CI, 10.4%-10.4%) for dual-eligible beneficiaries and 5.1% (95% CI, 5.1%-5.1%) for non–dual-eligible enrollees. The highest switch rates to TM were among Black enrollees (32.3% [95% CI, 31.7%-32.8%]) and those with prior use of hospital (31.3% [95% CI, 30.7%-31.9%], nursing home, 41.4% [95% CI, 40.4%-42.4%], or home health care (28.3% [95% CI, 27.4%-29.2%]). Beneficiaries who stayed in MA selected higher-rated star plans (mean posttermination contract star rating of 3.8 [95% CI, 3.8-3.8] stars compared with 3.3 [95% CI, 3.3-3.3] stars in the terminated year), but did not pay more in monthly premiums with 66.5% (95% CI, 66.2%-66.8%) paying the same or lower premiums. Conclusions and Relevance In this cross-sectional study, 1 in 5 MA beneficiaries switched to TM after a contract termination, with Black beneficiaries and those with more intensive health needs having the highest switch rates. These findings highlight the need to examine consequences of contract terminations and subsequent insurance destinations on access to care and health outcomes, especially among those with marginalized race and ethnicity, those who are dual-eligible, and beneficiaries with higher health care needs.
Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy
Authors: Wanda K. Nicholson, Michael Silverstein, John B. Wong, David Chelmow, Tumaini Rucker Coker, Esa M. Davis, Carlos Roberto Jaén, Marie Krousel-Wood, Sei Lee, Li Li, Goutham Rao, John M. Ruiz, James Stevermer, Joel Tsevat, Sandra Millon Underwood, Sarah Wiehe
Journal: JAMA (2024)

Importance Iron deficiency is the leading cause of anemia during pregnancy. According to survey data from 1999 to 2006, overall estimated prevalence of iron deficiency during pregnancy is near 18% and increases across the 3 trimesters of pregnancy (from 6.9% to 14.3% to 28.4%). An estimated 5% of pregnant persons have iron deficiency anemia. Objective The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on the benefits and harms of screening and supplementation for iron deficiency with and without anemia on maternal and infant health outcomes in asymptomatic pregnant persons. Population Asymptomatic pregnant adolescents and adults. Evidence Assessment The USPSTF concludes that the current evidence is insufficient, and the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in asymptomatic pregnant persons on maternal and infant health outcomes cannot be determined. The USPSTF also concludes that the current evidence is insufficient, and the balance of benefits and harms of iron supplementation in asymptomatic pregnant persons on maternal and infant health outcomes cannot be determined. Recommendation The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine supplementation for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes. (I statement)
A State-of-the-Science Review of the Effect of Damp- and Mold-Affected Housing on Mental Health
Authors: Maria Rosa Gatto, Adelle Mansour, Ang Li, Rebecca Bentley
Journal: Environmental Health Perspectives (2024)

While it is well-established that exposure to dampness or mold in homes negatively affects physical health, the association with mental health remains less well evidenced. As plausible psychosocial and biological pathways exist between dampness and mold exposure and poor mental health, a review of evidence is required.
Microbiota during pregnancy and early life: role in maternal−neonatal outcomes based on human evidence
Authors: Alessio Fasano, Benoit Chassaing, Dirk Haller, Eduard Flores Ventura, Maria Carmen-Collado, Nitida Pastor, Omry Koren, Roberto Berni Canani
Journal: Gut Microbes (2024)

Here, we explored the vast potential of microbiome-based interventions in preventing and managing non-communicable diseases including obesity, diabetes, allergies, celiac disease, inflammatory bowel diseases, malnutrition, and cardiovascular diseases across different life stages. We discuss the intricate relationship between microbiome and non-communicable diseases, emphasizing on the "window of opportunity" for microbe–host interactions during the first years after birth. Specific biotics and also live biotherapeutics including fecal microbiota transplantation emerge as pivotal tools for precision medicine, acknowledging the "one size doesn't' fit all" aspect. Challenges in implementation underscore the need for advanced technologies, scientific transparency, and public engagement. Future perspectives advocate for understanding maternal−neonatal microbiome, exploring the maternal exposome and delving into human milk's role in the establishment and restoration of the infant microbiome and its influence over health and disease. An integrated scientific approach, employing multi-omics and accounting for inter-individual variance in microbiome composition and function appears central to unleash the full potential of early-life microbiome interventions in revolutionizing healthcare.
Iron Deficiency and Iron Deficiency Anemia During Pregnancy—Opportunities to Optimize Perinatal Health and Health Equity
Authors: Ashley E. Benson, Jamie O. Lo, Aaron B. Caughey
Journal: JAMA Network Open (2024)

US Preventive Services Task Force; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MD, MPH; John B. Wong, MD; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Marie Krousel-Wood, MD, MSPH; Sei Lee, MD, MAS; Li Li, MD, PhD, MPH; Goutham Rao, MD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Joel Tsevat, MD, MPH; Sandra Millon Underwood, PhD, RN; Sarah Wiehe, MD, MPH
Error in Author Degree
Journal: JAMA Network Open (2024)

Sanjay Goel, MD; Abdissa Negassa, PhD; Mohammad H. Ghalib, MBBS; Imran Chaudhary, MD; Kavita Desai, MD; Umang Shah, MD; Umang Swami, MD; Bruce Cohen, MD; Radhashree Maitra, PhD; Sridhar Mani, MD
Individual- and Community-Level Risk Factors of Cancer-Related Financial Hardship Among Cancer Survivors
Authors: Apoorv Dhir, Kristian Donald Stensland, Lindsey Allison Herrel, Rishi Robert Sekar
Journal: JAMA Network Open (2024)

This cross-sectional study estimates the prevalence of financial hardship among cancer survivors and investigates its associations with individual- and community-level characteristics.
Machine learning-causal inference based on multi-omics data reveals the association of altered gut bacteria and bile acid metabolism with neonatal jaundice
Authors: Wanling Chen, Peng Zhang, Xueli Zhang, Tiantian Xiao, Jianhai Zeng, Kaiping Guo, Huixian Qiu, Guoqiang Cheng, Zhangxing Wang, Wenhao Zhou, Shujuan Zeng, Mingbang Wang
Journal: Gut Microbes (2024)

Early identification of neonatal jaundice (NJ) appears to be essential to avoid bilirubin encephalopathy and neurological sequelae. The interaction between gut microbiota and metabolites plays an important role in early life. It is unclear whether the composition of the gut microbiota and metabolites can be used as an early indicator of NJ or to aid clinical decision-making. This study involved a total of 196 neonates and conducted two rounds of "discovery-validation" research on the gut microbiome-metabolome. It utilized methods of machine learning, causal inference, and clinical prediction model evaluation to assess the significance of gut microbiota and metabolites in classifying neonatal jaundice (NJ), as well as the potential causal relationships between corresponding clinical variables and NJ. In the discovery stage, NJ-associated gut microbiota, network modules, and metabolite composition were identified by gut microbiome-metabolome association analysis. The NJ-associated gut microbiota was closely related to bile acid metabolites. By Lasso machine learning assessment, we found that the gut bacteria were associated with abnormal bile acid metabolism. The machine learning-causal inference approach revealed that gut bacteria affected serum total bilirubin and NJ by influencing bile acid metabolism. NJ-associated gut bile acids are potential biomarkers of NJ, and clinical prediction models constructed based on these biomarkers have some clinical effects and the model may be used for disease risk prediction. In the validation stage, it was found that intestinal metabolites can predict NJ, and the machine learning-causal inference approach revealed that bile acid metabolites affected NJ itself by affecting the total bilirubin content. Intestinal bile acid metabolites are potential biomarkers of NJ. By applying machine learning-causal inference methods to gut microbiome-metabolome association studies, we found NJ-associated intestinal bacteria and their network modules and bile acid metabolite composition. The important role of intestinal bacteria and bile acid metabolites in NJ was determined, which can predict the risk of NJ.
Can optical evaluation distinguish between t1a and t1b esophageal adenocarcinoma: an international expert inter-observer agreement study
Authors: Sunil Gupta, Francesco Vito Mandarino, Neal Shahidi, Luke F. Hourigan, Helmut Messmann, Michael B. Wallace, Alessandro Repici, Mario Dinis-Ribeiro, Gregory B. Haber, Andrew C.F. Taylor, Irving Waxman, Peter D. Siersema, Roos E. Pouw, Arnaud Lemmers, Raf Bisschops, Jeffrey D. Mosko, Christopher Teshima, Krish Ragunath, Thomas Rösch, Oliver Pech, Torsten Beyna, Prateek Sharma, Eric Y. T. Lee, Nicholas G. Burgess, Michael J. Bourke
Journal: Endoscopy (2024)

Background Piecemeal endoscopic mucosal resection (EMR) is an acceptable technique for T1a esophageal adenocarcinoma, but en bloc R0 excision is advocated for T1b disease as it may offer a potential cure and mitigate recurrence. Thus, distinguishing between T1a and T1b disease is imperative under current treatment paradigms. We investigated whether expert Barrett’s endoscopists could make this distinction based on optical evaluation. Methods Endoscopic images of histologically confirmed high grade dysplasia (HGD), T1a, and T1b disease (20 sets for each) were compiled from consecutive patients at a single institution. Each set contained four images including an overview, a close-up in high definition white light, a near-focus magnification image, and a narrow-band image. Experts predicted the histology for each set. Results 19 experts from 8 countries (Australia, USA, Italy, Netherlands, Germany, Canada, Belgium, and Portugal) participated. The majority had been practicing for &gt; 20 years, with a median (interquartile range) annual case volume of 50 (18–75) for Barrett’s EMR and 25 (10–45) for Barrett’s endoscopic submucosal dissection. Esophageal adenocarcinoma (T1a/b) could be distinguished from HGD with a pooled sensitivity of 89.1 % (95 %CI 84.7–93.4). T1b adenocarcinoma could be predicted with a pooled sensitivity of 43.8 % (95 %CI 29.9–57.7). Fleiss’ kappa was 0.421 (95 %CI 0.399–0.442; P &lt; 0.001), indicating fair-to-moderate agreement. Conclusions Expert Barrett’s endoscopists could reliably differentiate T1a/T1b esophageal adenocarcinoma from HGD. Despite fair-to-moderate agreement for T staging, T1b disease could not be reliably distinguished from T1a disease. This may impact clinical decision making and selection of endoscopic techniques.
Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis
Authors: Young Eun Chon, Young-Joo Jin, Jihyun An, Hee Yeon Kim, Miyoung Choi, Dae Won Jun, Mi Na Kim, Ji Won Han, Han Ah Lee, Jung Hwan Yu, Seung Up Kim
Journal: Clinical and Molecular Hepatology (2024)

Background/aims: Opinions differ regarding vibration-controlled transient elastography and magnetic resonance elastography (VCTE/MRE) cut-offs for diagnosing advanced fibrosis (AF) in patients with non-alcoholic fatty liver disease (NAFLD). We investigated the diagnostic performance and optimal cut-off values of VCTE and MRE for diagnosing AF.Methods: Literature databases, including Medline, EMBASE, Cochrane Library, and KoreaMed, were used to identify relevant studies published up to June 13, 2023. We selected studies evaluating VCTE and MRE regarding the degree of liver fibrosis using liver biopsy as the reference. The sensitivity, specificity, and area under receiver operating characteristics curves (AUCs) of the pooled data for VCTE and MRE for each fibrosis stage and optimal cut-offs for AF were investigated.Results: A total of 19,199 patients from 63 studies using VCTE showed diagnostic AUC of 0.83 (95% confidence interval: 0.80–0.86), 0.83 (0.80–0.86), 0.87 (0.84–0.90), and 0.94 (0.91–0.96) for ≥F1, ≥F2, ≥F3, and F4 stages, respectively. Similarly, 1,484 patients from 14 studies using MRE showed diagnostic AUC of 0.89 (0.86–0.92), 0.92 (0.89–0.94), 0.89 (0.86–0.92), and 0.94 (0.91–0.96) for ≥F1, ≥F2, ≥F3, and F4 stages, respectively. The diagnostic AUC for AF using VCTE was highest at 0.90 with a cut-off of 7.1–7.9 kPa, and that of MRE was highest at 0.94 with a cut-off of 3.62–3.8 kPa.Conclusions: VCTE (7.1–7.9 kPa) and MRE (3.62–3.8 kPa) with the suggested cut-offs showed favorable accuracy for diagnosing AF in patients with NAFLD. This result will serve as a basis for clinical guidelines for non-invasive tests and differential diagnosis of AF.
Trajectories of Inflammation in Youth and Risk of Mental and Cardiometabolic Disorders in Adulthood
Authors: Edward R. Palmer, Isabel Morales-Muñoz, Benjamin I. Perry, Steven Marwaha, Ella Warwick, Jack C. Rogers, Rachel Upthegrove
Journal: JAMA Psychiatry (2024)

Importance Research suggests that low-grade, nonresolving inflammation may predate adult mental and physical illness. However, evidence to date is largely cross-sectional or focuses on single disorder outcomes. Objectives To examine trajectories of inflammation as measured by C-reactive protein (CRP) levels in a large sample of children and adolescents, and to explore associations between different identified trajectories and mental and related cardiometabolic health outcomes in early adulthood. Design, Setting, and Participants In a longitudinal cohort study using data from the large UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), latent class growth analysis (LCGA) was used to explore different trajectories of inflammation, with logistic regression exploring association with mental and physical health outcomes. Participants with measurable CRP data and associated mental and cardiometabolic health outcomes recorded were included in the analysis. Data analysis was performed from May 1, 2023, to March 30, 2024. Exposures Inflammation was assessed via CRP levels at ages 9, 15, and 17 years. LCGA was used to identify different trajectories of inflammation. Main Outcomes and Measures Outcomes assessed at age 24 years included psychotic disorders, depressive disorders, anxiety disorders, hypomania, and, as a measure of insulin resistance, Homeostasis Model Assessment (HOMA2) score. Results A total of 6556 participants (3303 [50.4%] female) were included. Three classes of inflammation were identified: persistently low CRP levels (reference class, n = 6109); persistently raised CRP levels, peaking at age 9 years (early peak, n = 197); and persistently raised CRP levels, peaking at age 17 years (late peak, n = 250). Participants in the early peak group were associated with a higher risk of psychotic disorder (odds ratio [OR], 4.60; 95% CI, 1.81-11.70; P = .008), a higher risk of severe depression (OR, 4.37; 95% CI, 1.64-11.63; P = .02), and higher HOMA2 scores (β = 0.05; 95% CI, 0.01-0.62, P = .04) compared with participants with persistently low CRP. The late peak group was not associated with any outcomes at age 24 years. Conclusions and Relevance Low-grade systemic inflammation peaking in midchildhood was associated with specific mental and cardiometabolic disorders in young adulthood. These findings suggest that low-grade persistent inflammation in early life may be an important shared common factor for mental-physical comorbidity and so could be relevant to future efforts of patient stratification and risk profiling.
COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
Authors: Venexia M. Walker, Praveetha Patalay, Jose Ignacio Cuitun Coronado, Rachel Denholm, Harriet Forbes, Jean Stafford, Bettina Moltrecht, Tom Palmer, Alex Walker, Ellen J. Thompson, Kurt Taylor, Genevieve Cezard, Elsie M. F. Horne, Yinghui Wei, Marwa Al Arab, Rochelle Knight, Louis Fisher, Jon Massey, Simon Davy, Amir Mehrkar, Seb Bacon, Ben Goldacre, Angela Wood, Nishi Chaturvedi, John Macleod, Ann John, Jonathan A. C. Sterne, Agnieszka Lemanska, Alex Kwong , Alexia Sampri, Alicja Rapala, Alisia Carnemolla, Alun Hughes, Amelia Green, Amos Folarin, Amy Roberts , Ana Goncalves Soares, Andrew Steptoe, Andrew Wong, Andy Boyd, Andy Gibson, Anika Knueppel , Anoop Shah, Archie Campbell, Arun Kanagaratnam, Arun Karthikeyan Suseeladevi , Bang Zheng , Betty Raman, Bo Hou, Bozena Wielgoszewska, Brain Mackenna , Callum Stewart, Chao Fang, Charis Bridger-Staatz, Charlotte Booth , Chelsea Beckford, Chloe Park, Claire Steves, Colm Andrews, Daniel McCartney , Daniel Kopasker , Diane Foster, Dominik Piehlmaier, Dylan Williams, Edward Parker, Elena Rafeti , Elena Lukaschuk , Elizabeth Tunnicliffe , Ellena Badrick, Emily Herrett, Emma L Turner, Eoin McElroy, Fatima Almaghrabi , Felix Greaves, Fintan McArdle, Fiona Glen, Francisco Perez-Reche, Gareth Griffith, George Ploubidis, Gillian Santorelli, Giorgio Di Gessa, Hannah Woodward, Helen Curtis  , Annie Herbert, Ian Douglas, Jacqui Oakley, James M Wild, Jane Maddock, JD Carpentieri, Jess Morley, Jingmin Zhu, John Tazare, John Wright, John Kellas, Jonathan Kennedy, Kate Northstone, Kate Tilling, Kate  Mansfield, Katharine M Evans, Kathryn Mansfield , Kathryn Willan, Kevin Wang, Kirsteen C Campbell, Kishan Patel, Laura Fox, Laura Sheard, Laura C Saunders, Laurie Tomlinson, Lee Hamill Howes, Liam Smeeth , Lidia Nigrelli, Linda Nab, Lisa Hopcroft , Lizzie Huntley, Louise Jones, Lucy Finnigan , Lucy Teece, Mark Green , Matthew Crane, Maxim Freydin, Michael Parker, Michael Green, Milla Kibble, Nathan Cheetham, Nicholas Timpson, Olivia Hamilton, Paola Zaninotto, Paz Garcia, Peter Jezzard, Rebecca Whitehorn, Rebecca Rhead, Renin Toms, Richard Thomas, Richard Silverwood, Richard Dobson, Robert Willans, Robin Flaig , Rosie McEachan, Ruth Mitchell, Ruth Bowyer, Ruth Costello, Sam Parsons, Samantha Berman, Samantha Ip, Sarah Baz, Scott Walker, Shah Syed Ahmar, Richard Shaw, Sheikh Aziz, Sinead Langan, Sinead Brophy , Spiros Denaxas, Stefan Neubauer , Stefan Piechnik , Stela McLachlan, Stephen Smith , Steve Sharp, Teri North , Theocharis Kromydas , Thomas Cowling, Tiffany Yang, Tom Bolton , Vanessa Ferreira , Vittal Katikireddi , Viyaasan Mahalingasivam, Wels Jacques, William Hulme, Yatharth Ranjan, Zeena-Britt Sanders 
Journal: JAMA Psychiatry (2024)

Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.