Improving survival models in healthcare: a novel matching approach.

We present, to our knowledge, the first methodological study aimed at enhancing the prognostic power of Cox regression models, widely used in survival analysis, through optimized data selection. Our approach employs a novel two-stage mechanism: by framing the prognostic stratum matching problem intuitively, we select prognostically representative patient observations to create a more balanced training set. This enables the model to assign equal attention to distinct prognostic subgroups.

Computational Pathology-Enabled Residual Tumor Estimation is a Prognostic Factor for Overall Survival in Anal Squamous Cell Carcinoma.

Anal squamous cell carcinoma (SCC) incidence has increased, and treatment has shifted from surgery to chemoradiotherapy (CRT), with salvage abdominoperineal resection (APR) being reserved for persistent/recurrent cases. This study evaluates the utility of different Tumor Regression Scoring Systems (TRSS) in predicting survival in anal SCC patients, using pathologists' observations and digital pathology. Cases managed surgically from 2005 to 2019 were collected.

Roseburia intestinalis-derived butyrate alleviates neuropathic pain.

Approximately 20% of patients with shingles develop postherpetic neuralgia (PHN). We investigated the role of gut microbiota in shingle- and PHN-related pain. Patients with shingles or PHN exhibited significant alterations in their gut microbiota with microbial markers predicting PHN development among patients with shingles.

Machine Perfusion as a Strategy to Decrease Ischemia-Reperfusion Injury and Lower Cancer Recurrence Following Liver Transplantation.

Liver transplantation (LT) is a key treatment for primary and secondary liver cancers, reducing tumor burden with concurrent improvement of liver function. While significant improvement in survival is noted with LT, cancer recurrence rates remain high. Mitochondrial dysfunction caused by ischemia-reperfusion injury (IRI) is known to drive tumor recurrence by creating a favorable microenvironment rich in pro-inflammatory and angiogenic factors.

Efficacy and safety of prucalopride in patients with chronic idiopathic constipation stratified by age, body mass index, and renal function: a post hoc analysis of phase III and IV, randomized, placebo-controlled clinical studies.

Background: Prucalopride (1 or 2 mg once daily) is approved for treating adults with chronic idiopathic constipation (CIC).

Objectives: We determined the effect of age, body mass index (BMI), and renal function on the efficacy and safety of prucalopride in adults with CIC.

Design: Data were pooled from six 12-week, phase III-IV clinical studies in adults who received prucalopride (1 or 2 mg once daily) or placebo for CIC.

Selective vs Routine Cholangiography Across a Health Care Enterprise.

Importance: There is sparse literature on whether routine cholangiography (RC) vs selective cholangiography (SC) during cholecystectomy is associated with improved perioperative outcomes, regardless of whether an intraoperative cholangiogram (IOC) is performed.

Objective: To compare perioperative outcomes of cholecystectomy between surgeons who routinely vs selectively perform IOC.

Design, Setting, And Participants: This retrospective cohort study was conducted from January 2015 through June 2023 and took place within the Cleveland Clinic Enterprise, which includes 18 hospitals and 9 ambulatory surgery centers in 2 states (Ohio and Florida).

Patient reported outcomes and decision regret scores in redo-paraesophageal hernia repair.

Introduction: Recurrent paraesophageal hernia (PEH) repair presents significant technical challenges, with limited data weighing the benefit to the operative risk. This study aims to describe our experience with recurrent PEH repair, including long-term surgical and patient reported outcomes (PROs).

Methods: We conducted a retrospective review of recurrent PEH repairs from June 2018-March 2023 using our institutional database.

FAP gastric cancer mesenchymal stromal cells via paracrining INHBA and remodeling ECM promote tumor progression.

Gastric cancer (GC) mesenchymal stromal cells (GCMSCs) are the predominant components of the tumor microenvironment (TME) and play a role in the occurrence, development, and metastasis of tumors. However, GCMSCs exhibit phenotypic and functional heterogeneity. The key population of GCMSCs which are vital to tumor progression remains elusive.

Love Thy Neighbor? Exploring Gastroenterology Attitudes Toward Endometriosis Screening.

Endometriosis is a chronic painful condition affecting 10% of reproductive-aged women with a high prevalence of overlapping gastrointestinal symptoms. There is a significant diagnostic delay for endometriosis and current screening practices for endometriosis in gastroenterology clinic populations have not been evaluated. 112 gastroenterology providers (57.

The role of chemotherapy in the management of pancreatic acinar cell carcinoma.

Introduction: Pancreatic acinar cell carcinoma (pACC) is a rare malignancy with unique clinical and molecular features. The role of chemotherapy in pACC management is not well established.

Methods: The National Cancer Database (NCDB) for pACC was used.

Anti-fibrotics in inflammatory bowel diseases: Challenges and successes.

Stricture formation leading to obstruction in Crohn's disease (CD) remains one of the largest unmet needs in the field of inflammatory bowel diseases (IBD). Despite this need no selective anti-stricture drug has been approved for use in CD patients. This contrasts with other fibrotic diseases, such as in the lung, liver or kidney, where multiple drug development programs crossed the starting line and two anti-fibrotics are now being approved for pulmonary fibrosis.

Endoluminal approaches for colorectal neoplasia in inflammatory bowel disease: a viable alternative for colectomy?

Background: Endoscopic resection of visible dysplastic lesions in patients with inflammatory bowel disease (IBD) is an alternative to colectomy. The endoscopic techniques that can be used include endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and ESD combined with EMR. These endoscopic approaches may allow organ preservation in patients with IBD.

Gastrointestinal complications requiring operative intervention after cardiovascular surgery: Predictors of in-hospital mortality.

Background: Risk factors for in-hospital mortality related to gastrointestinal complications requiring operative intervention after cardiovascular surgery have not been previously described.

Methods: Adult patients who underwent cardiovascular surgery followed by gastrointestinal surgery during the same admission between January 2010 and June 2023 were included. Multivariable logistic regression was used to identify predictors of in-hospital mortality.

Does stage III rectal mucinous adenocarcinoma benefit from neoadjuvant chemoradiation?

Background: This study aimed to compare clinical outcomes of patients with clinical stage III mucinous rectal adenocarcinoma (M) and non-mucinous rectal adenocarcinoma (NM) and evaluate the effectiveness of neoadjuvant chemoradiation. It was hypothesized that patients with M would fare worse with neoadjuvant chemoradiation than those with NM and that patients with M and NM not receiving chemoradiation would have similar outcomes. Moreover, it was hypothesized that patients with M would have similar outcomes regardless of chemoradiation.

Identification of a novel PDC-E2 epitope in primary biliary cholangitis: Application for engineered Treg therapy.

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease, characterized by progressive destruction of small intrahepatic bile ducts and portal inflammation. Treatment options are limited, with reliance on liver transplantation in advanced cases. The adaptive immune response is implicated in disease pathogenesis by the presence of anti-mitochondrial antibodies targeting the E2 subunit of the pyruvate dehydrogenase complex (PDC-E2) in 90-95 % of patients and T cells infiltrating the portal tracts.