tbuckley/cabot-search huggingface dataset:
In nursing homes, universal decolonization vs. routine care reduced transfers to hospital for infection
Authors: Adam Zimilover, Aaron E. Glatt
Journal: Annals of Internal Medicine (2024)

ACP Journal Club6 February 2024In nursing homes, universal decolonization vs. routine care reduced transfers to hospital for infectionAdam Zimilover, MD, MPH, Aaron E. Glatt, MDAdam Zimilover, MD, MPHMontefiore Medical Center–Albert Einstein College of Medicine, Bronx, New York, USA (A.Z.), Aaron E. Glatt, MDDepartment of Medicine, Mount Sinai South Nassau, Oceanside, New York, USA (A.E.G.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/J23-0118 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationMiller LG, McKinnell JA, Singh RD, et al. Decolonization in nursing homes to prevent infection and hospitalization. N Engl J Med. 2023;389:1766-1777. https://pubmed.ncbi.nlm.nih.gov/37815935Clinical Impact RatingsGIM/FP/GP: Geriatrics: Infectious Disease: Public Health: References1. Huang SS, Septimus E, Kleinman K, et al; CDC Prevention Epicenters Program; AHRQ DECIDE Network and Healthcare-Associated Infections Program. Targeted versus universal decolonization to prevent ICU infection. N Engl J Med. 2013;368:2255-2265. [PMID: 23718152] Google Scholar2. Heiks C, Sabine N. Long term care and skilled nursing facilities. Dela J Public Health. 2022;8:144-149. [PMID: 36751604] Google Scholar3. Chen AC, Epstein AM, Maddox KE, et al. Care delivery approaches and perceived barriers to improving quality of care: a national survey of skilled nursing facilities. J Am Geriatr Soc. 2023;71:2141-2150. [PMID: 36918371] Google Scholar Author, Article, and Disclosure InformationAuthors: Adam Zimilover, MD, MPH; Aaron E. Glatt, MDAffiliations: Montefiore Medical Center–Albert Einstein College of Medicine, Bronx, New York, USA (A.Z.)Department of Medicine, Mount Sinai South Nassau, Oceanside, New York, USA (A.E.G.)Disclosures: The commentators have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=J23-0118.This article was published at Annals.org on 6 February 2024.ACP Journal Club is editorially independent from Annals of Internal Medicine. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Latest Keywords Clinical trials Hospitalizations Nursing homes Prevention, policy, and public health Quality improvement Randomized trials Research quality assessment Risk ratio Soaps ePublished: 6 February 2024 Copyright & PermissionsCopyright © 2024 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
How can we better address patients’ needs in topical psoriasis treatment?
Authors: Junfen Zhang, Marie L A Schuttelaar
Journal: British Journal of Dermatology (2024)

Journal Article Corrected proof How can we better address patients' needs in topical psoriasis treatment? Get access Junfen Zhang, Junfen Zhang Conceptualization, Writing - original draft, Writing - review & editing Dermatology Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Dermatology, University Medical Center Groningen, Groningen, the Netherlands Correspondence: Junfen Zhang. Email: jzhang01@smu.edu.cn https://orcid.org/0000-0001-7816-0328 Search for other works by this author on: Oxford Academic Google Scholar Marie L A Schuttelaar Marie L A Schuttelaar Writing - review & editing Department of Dermatology, University Medical Center Groningen, Groningen, the Netherlands https://orcid.org/0000-0002-0766-4382 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, ljae046, https://doi.org/10.1093/bjd/ljae046 Published: 05 February 2024 Article history Received: 23 January 2024 Accepted: 24 January 2024 Published: 05 February 2024 Corrected and typeset: 16 March 2024
In patients with OSA and CVD, CPAP did not reduce major adverse cardiac and cerebrovascular events
Authors: Sven Günther, Bertrand Renaud
Journal: Annals of Internal Medicine (2024)

Source Citation Sanchez-de-la-Torre M, Gracia-Lavedan E, Benitez ID, et al. Adherence to CPAP treatment and the risk of recurrent cardiovascular events: a meta-analysis. JAMA. 2023;330:1255-1265. 37787793
In women aged 45 to 75 y, opt-out vs. opt-in breast cancer screening outreach did not increase mammography rates
Authors: Michael Tanner
Journal: Annals of Internal Medicine (2024)

Source Citation Marcotte LM, Deeds S, Wheat C, et al. Automated opt-out vs opt-in patient outreach strategies for breast cancer screening: a randomized clinical trial. JAMA Intern Med. 2023;183:1187-1194. 37695621
Bleeding Outcomes in Patients Treated With Asundexian in Phase II Trials
Authors: John W. Eikelboom, Hardi Mundl, John H. Alexander, Valeria Caso, Stuart J. Connolly, Rosa Coppolecchia, Martin Gebel, Robert G. Hart, Gerlind Holberg, Lars Keller, Manesh R. Patel, Jonathan P. Piccini, Sunil V. Rao, Ashkan Shoamanesh, Miriam Tamm, Thomas Viethen, Ashraf Yassen, Marc P. Bonaca
Journal: Journal of the American College of Cardiology (2024)
The Web-Based Portal SpatialTME Integrates Histological Images with Single-Cell and Spatial Transcriptomics to Explore the Tumor Microenvironment
Authors: Jintong Shi, Xia Wei, Zhenzhen Xun, Xinyu Ding, Yao Liu, Lianxin Liu, Youqiong Ye
Journal: Cancer Research (2024)

Abstract The tumor microenvironment (TME) represents a complex network in which tumor cells communicate not only with each other but also with stromal and immune cells. The intercellular interactions in the TME contribute to tumor initiation, progression, metastasis, and treatment outcome. Recent advances in spatial transcriptomics (ST) have revolutionized the molecular understanding of the TME at the spatial level. A comprehensive interactive analysis resource specifically designed for characterizing the spatial TME could facilitate further advances using ST. In this study, we collected 296 ST slides covering 19 cancer types and developed a computational pipeline to delineate the spatial structure along the malignant–boundary–nonmalignant axis. The pipeline identified differentially expressed genes and their functional enrichment, deconvoluted the cellular composition of the TME, reconstructed cell type–specific gene expression profiles at the sub-spot level, and performed cell–cell interaction analysis. Finally, the user-friendly database SpatialTME (http://www.spatialtme.yelab.site/) was constructed to provide search, visualization, and downloadable results. These detailed analyses are able to reveal the heterogeneous regulatory network of the spatial microenvironment and elucidate associations between spatial features and tumor development or response to therapy, offering a valuable resource to study the complex TME. Significance: SpatialTME provides spatial structure, cellular composition, expression, function, and cell–cell interaction information to enable investigations into the tumor microenvironment at the spatial level to advance understanding of cancer development and treatment.
Pharmacological Management of Cardiac Arrhythmias in the Fetal and Neonatal Periods: A Scientific Statement From the American Heart Association
Authors: Anjan S. Batra, Michael J. Silka, Alejandro Borquez, Bettina Cuneo, Brynn Dechert, Edgar Jaeggi, Prince J. Kannankeril, Christine Tabulov, James E. Tisdale, Diana Wolfe
Journal: Circulation (2024)

Disorders of the cardiac rhythm may occur in both the fetus and neonate. Because of the immature myocardium, the hemodynamic consequences of either bradyarrhythmias or tachyarrhythmias may be far more significant than in mature physiological states. Treatment options are limited in the fetus and neonate because of limited vascular access, patient size, and the significant risk/benefit ratio of any intervention. In addition, exposure of the fetus or neonate to either persistent arrhythmias or antiarrhythmic medications may have yet-to-be-determined long-term developmental consequences. This scientific statement discusses the mechanism of arrhythmias, pharmacological treatment options, and distinct aspects of pharmacokinetics for the fetus and neonate. From the available current data, subjects of apparent consistency/consensus are presented, as well as future directions for research in terms of aspects of care for which evidence has not been established.
Immunometabolic Adaptation of CD19-Targeted CAR T Cells in the Central Nervous System Microenvironment of Patients Promotes Memory Development
Authors: Lior Goldberg, Eric R. Haas, Ryan Urak, Vibhuti Vyas, Khyatiben V. Pathak, Krystine Garcia-Mansfield, Patrick Pirrotte, Jyotsana Singhal, James L. Figarola, Ibrahim Aldoss, Stephen J. Forman, Xiuli Wang
Journal: Cancer Research (2024)

Abstract Metabolic reprogramming is a hallmark of T-cell activation, and metabolic fitness is fundamental for T-cell–mediated antitumor immunity. Insights into the metabolic plasticity of chimeric antigen receptor (CAR) T cells in patients could help identify approaches to improve their efficacy in treating cancer. Here, we investigated the spatiotemporal immunometabolic adaptation of CD19-targeted CAR T cells using clinical samples from CAR T-cell–treated patients. Context-dependent immunometabolic adaptation of CAR T cells demonstrated the link between their metabolism, activation, differentiation, function, and local microenvironment. Specifically, compared with the peripheral blood, low lipid availability, high IL15, and low TGFβ in the central nervous system microenvironment promoted immunometabolic adaptation of CAR T cells, including upregulation of a lipolytic signature and memory properties. Pharmacologic inhibition of lipolysis in cerebrospinal fluid led to decreased CAR T-cell survival. Furthermore, manufacturing CAR T cells in cerebrospinal fluid enhanced their metabolic fitness and antileukemic activity. Overall, this study elucidates spatiotemporal immunometabolic rewiring of CAR T cells in patients and demonstrates that these adaptations can be exploited to maximize the therapeutic efficacy of CAR T cells. Significance: The spatiotemporal immunometabolic landscape of CD19-targeted CAR T cells from patients reveals metabolic adaptations in specific microenvironments that can be exploited to maximize the therapeutic efficacy of CAR T cells.
Deep learning-aided decision support for diagnosis of skin disease across skin tones
Authors: Matthew Groh, Omar Badri, Roxana Daneshjou, Arash Koochek, Caleb Harris, Luis R. Soenksen, P. Murali Doraiswamy, Rosalind Picard
Journal: Nature Medicine (2024)

Abstract Although advances in deep learning systems for image-based medical diagnosis demonstrate their potential to augment clinical decision-making, the effectiveness of physician–machine partnerships remains an open question, in part because physicians and algorithms are both susceptible to systematic errors, especially for diagnosis of underrepresented populations. Here we present results from a large-scale digital experiment involving board-certified dermatologists ( n = 389) and primary-care physicians ( n = 459) from 39 countries to evaluate the accuracy of diagnoses submitted by physicians in a store-and-forward teledermatology simulation. In this experiment, physicians were presented with 364 images spanning 46 skin diseases and asked to submit up to four differential diagnoses. Specialists and generalists achieved diagnostic accuracies of 38% and 19%, respectively, but both specialists and generalists were four percentage points less accurate for the diagnosis of images of dark skin as compared to light skin. Fair deep learning system decision support improved the diagnostic accuracy of both specialists and generalists by more than 33%, but exacerbated the gap in the diagnostic accuracy of generalists across skin tones. These results demonstrate that well-designed physician–machine partnerships can enhance the diagnostic accuracy of physicians, illustrating that success in improving overall diagnostic accuracy does not necessarily address bias.
Less Obvious Than One Might Think: Why Is There Grouped Beating?
Authors: Adrian M. Petzl, Andrew E. Epstein, Gustavo S. Guandalini
Journal: Circulation (2024)

An 84-year-old man presented to the hospital with recurrent palpitations.His symptoms had started about 2 months earlier, shortly after β-blocker discontinuation due to bradycardia incidentally noted on ECG (Figure 1).It is notable that he was asymptomatic at the time and never experienced lightheadedness or syncope despite taking β-blockers for more than a decade.His entire physical examination and an echocardiogram were unremarkable.After β-blocker discontinuation, he was no longer bradycardic but experienced palpitations (Figure 2).Given recurrent symptoms, cardiology was consulted to assess the safety of resuming β-blockers and consideration of pacemaker implantation.Please turn the page to read the diagnosis.
Integrating AI-Powered Digital Pathology and Imaging Mass Cytometry Identifies Key Classifiers of Tumor Cells, Stroma, and Immune Cells in Non–Small Cell Lung Cancer
Authors: Alessandra Rigamonti, Marika Viatore, Rebecca Polidori, Daoud Rahal, Marco Erreni, Maria Rita Fumagalli, Damiano Zanini, Andrea Doni, Anna Rita Putignano, Paola Bossi, Emanuele Voulaz, Marco Alloisio, Sabrina Rossi, Paolo Andrea Zucali, Armando Santoro, Vittoria Balzano, Paola Nisticò, Friedrich Feuerhake, Alberto Mantovani, Massimo Locati, Federica Marchesi
Journal: Cancer Research (2024)

Abstract Artificial intelligence (AI)–powered approaches are becoming increasingly used as histopathologic tools to extract subvisual features and improve diagnostic workflows. On the other hand, hi-plex approaches are widely adopted to analyze the immune ecosystem in tumor specimens. Here, we aimed at combining AI-aided histopathology and imaging mass cytometry (IMC) to analyze the ecosystem of non–small cell lung cancer (NSCLC). An AI-based approach was used on hematoxylin and eosin (H&amp;E) sections from 158 NSCLC specimens to accurately identify tumor cells, both adenocarcinoma and squamous carcinoma cells, and to generate a classifier of tumor cell spatial clustering. Consecutive tissue sections were stained with metal-labeled antibodies and processed through the IMC workflow, allowing quantitative detection of 24 markers related to tumor cells, tissue architecture, CD45+ myeloid and lymphoid cells, and immune activation. IMC identified 11 macrophage clusters that mainly localized in the stroma, except for S100A8+ cells, which infiltrated tumor nests. T cells were preferentially localized in peritumor areas or in tumor nests, the latter being associated with better prognosis, and they were more abundant in highly clustered tumors. Integrated tumor and immune classifiers were validated as prognostic on whole slides. In conclusion, integration of AI-powered H&amp;E and multiparametric IMC allows investigation of spatial patterns and reveals tissue relevant features with clinical relevance. Significance: Leveraging artificial intelligence–powered H&amp;E analysis integrated with hi-plex imaging mass cytometry provides insights into the tumor ecosystem and can translate tumor features into classifiers to predict prognosis, genotype, and therapy response.
Vulvar Carcinoma: Standard of Care and Perspectives
Authors: Cyrus Chargari, Johanna Wasserman, Alexandra Gabro, Geoffroy Canlobre, Jean-Philippe Spano, Catherine Uzan, Philippe Maingon
Journal: Journal of Clinical Oncology (2024)

Treatment of vulvar carcinoma (VC) is challenging. The objectives of this review were to describe for clinicians the epidemiologic and clinical aspects of VC, the standard of care in terms of primary local treatment and systemic therapies, and the recent innovations and perspectives emerging from translational research in immuno-oncology.
In persons aged ≥45 y, the mt-sRNA test had 94% sensitivity for colorectal cancer and 46% for advanced adenomas
Authors: Harvey J. Murff
Journal: Annals of Internal Medicine (2024)

ACP Journal Club6 February 2024In persons aged ≥45 y, the mt-sRNA test had 94% sensitivity for colorectal cancer and 46% for advanced adenomasHarvey J. Murff, MD, MPHHarvey J. Murff, MD, MPHVanderbilt University Medical Center, Nashville, Tennessee, USA (H.J.M.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/J23-0114 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationBarnell EK, Wurtzler EM, La Rocca J, et al. Multitarget stool RNA test for colorectal cancer screening. JAMA. 2023;330:1760-1768. https://pubmed.ncbi.nlm.nih.gov/37870871Clinical Impact RatingsGIM/FP/GP: Gastroenterology: References1. US Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325:1965-1977. [PMID: 34003218] Google Scholar2. Fisher DA, Princic N, Miller-Wilson LA, et al. Utilization of a colorectal cancer screening test among individuals with average risk. JAMA Netw Open. 2021;4:e2122269. [PMID: 34473259] Google Scholar3. Allen CJ, Bloom N, Rothka M, et al. Comprehensive cost implications of commercially available noninvasive colorectal cancer screening modalities. J Am Coll Surg. 2023;237:465-472. [PMID: 37219020] Google Scholar Author, Article, and Disclosure InformationAuthors: Harvey J. Murff, MD, MPHAffiliations: Vanderbilt University Medical Center, Nashville, Tennessee, USA (H.J.M.)Disclosures: The commentator has reported no disclosures of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=J23-0114.This article was published at Annals.org on 6 February 2024.ACP Journal Club is editorially independent from Annals of Internal Medicine. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Latest Keywords Adenomas Cancer detection and diagnosis Cancer screening Colonoscopy Colorectal cancer Fecal immunochemical test Genetic testing Lesions RNA Specificity ePublished: 6 February 2024 Copyright & PermissionsCopyright © 2024 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Mild elevation of pulmonary vascular resistance predicts mortality regardless of mean pulmonary artery pressure in mild interstitial lung disease
Authors: Tomonori Sato, Taiki Furukawa, Ryo Teramachi, Jun Fukihara, Yasuhiko Yamano, Toshiki Yokoyama, Toshiaki Matsuda, Kensuke Kataoka, Tomoki Kimura, Koji Sakamoto, Makoto Ishii, Yasuhiro Kondoh
Journal: Thorax (2024)

Background Pulmonary hypertension (PH) is defined by elevated mean pulmonary arterial pressure (MPAP), and elevated pulmonary vascular resistance (PVR) reflects pulmonary vascular abnormalities. The clinical significance of non-severe PH in patients with various interstitial lung diseases (ILDs) has not been fully elucidated. We aimed to investigate the clinical significance of MPAP and PVR for mortality in patients with newly diagnosed ILD. Methods We retrospectively analysed consecutive patients with ILD at initial evaluations that included right heart catheterisation from 2007 to 2018. These patients were classified by MPAP and PVR using the 2022 the European Society of Cardiology (ESC)/the European Respiratory Society (ERS) guidelines for PH. The clinical significance of MPAP and PVR for mortality was analysed. Results Among 854 patients, 167 (19.6%) had MPAP&gt;20 mm Hg. The proportion of patients with PVR&gt;2 Wood units (WU) among those with MPAP≤20 mm Hg, 20&lt;MPAP&lt;25 mm Hg, and ≥25 mm Hg were 26.2%, 60.4% and 86.4%, respectively. In Cox proportional hazards analyses with adjustment for ILD–Gender, Age and Physiology Index, PVR but not MPAP was associated with a higher mortality rate (HR 1.37, 95% CI 1.23 to 1.52, p&lt;0.0001; HR 0.98, 95% CI 0.96 to 1.01, p=0.1671, respectively). PVR&gt;2 WU was associated with a higher mortality rate (HR 1.61, 95% CI 1.28 to 2.02, p&lt;0.0001) even in a group with MPAP≤20 mm Hg. Conclusions Mild elevation of PVR was associated with a higher mortality rate in patients with newly diagnosed ILD, even in those with MPAP≤20 mm Hg.
Single-Agent Trabectedin Versus Physician's Choice Chemotherapy in Patients With Recurrent Ovarian Cancer With <i>BRCA</i>-Mutated and/or BRCAness Phenotype: A Randomized Phase III Trial
Authors: Domenica Lorusso, Francesco Raspagliesi, Dominique Ronzulli, Giorgio Valabrega, Nicoletta Colombo, Carmela Pisano, Chiara Cassani, Germana Tognon, Stefano Tamberi, Giorgia Mangili, Serafina Mammoliti, Ugo De Giorgi, Filippo Greco, Anna Maria Mosconi, Enrico Breda, Grazia Artioli, Claudia Andreetta, Claudia Casanova, Rita Ceccherini, Antonio Frassoldati, Vanda Salutari, Serena Giolitto, Giovanni Scambia
Journal: Journal of Clinical Oncology (2024)

Literature evidence suggests that trabectedin monotherapy is effective in patients with recurrent ovarian cancer (OC) presenting
Enhanced optical imaging and fluorescent labeling for visualizing drug molecules within living organisms
Authors: Ting Sun, Huanxin Zhao, Luyao Hu, Xintian Shao, Zhiyuan Lu, Yuli Wang, Peixue Ling, Yubo Li, Kewu Zeng, Qixin Chen
Journal: Acta Pharmaceutica Sinica B (2024)

The visualization of drugs in living systems has become key techniques in modern therapeutics. Recent advancements in optical imaging technologies and molecular design strategies have revolutionized drug visualization. At the subcellular level, super-resolution microscopy has allowed exploration of the molecular landscape within individual cells and the cellular response to drugs. Moving beyond subcellular imaging, researchers have integrated multiple modes, like optical near-infrared II imaging, to study the complex spatiotemporal interactions between drugs and their surroundings. By combining these visualization approaches, researchers gain supplementary information on physiological parameters, metabolic activity, and tissue composition, leading to a comprehensive understanding of drug behavior. This review focuses on cutting-edge technologies in drug visualization, particularly fluorescence imaging, and the main types of fluorescent molecules used. Additionally, we discuss current challenges and prospects in targeted drug research, emphasizing the importance of multidisciplinary cooperation in advancing drug visualization. With the integration of advanced imaging technology and molecular design, drug visualization has the potential to redefine our understanding of pharmacology, enabling the analysis of drug micro-dynamics in subcellular environments from new perspectives and deepening pharmacological research to the levels of the cell and organelles.