Two-Layer Retrieval-Augmented Generation Framework for Low-Resource Medical Question Answering Using Reddit Data: Proof-of-Concept Study.

Background: The increasing use of social media to share lived and living experiences of substance use presents a unique opportunity to obtain information on side effects, use patterns, and opinions on novel psychoactive substances. However, due to the large volume of data, obtaining useful insights through natural language processing technologies such as large language models is challenging.

Objective: This paper aims to develop a retrieval-augmented generation (RAG) architecture for medical question answering pertaining to clinicians' queries on emerging issues associated with health-related topics, using user-generated medical information on social media.

Trastuzumab Plus Pertuzumab Versus Cetuximab Plus Irinotecan in Patients With Wild-Type, HER2-Positive, Metastatic Colorectal Cancer (S1613): A Randomized Phase II Trial.

Purpose: overexpression/amplification in wild-type (WT) metastatic colorectal cancer (mCRC; human epidermal growth factor receptor 2 [HER2]-positive mCRC) appears to be associated with limited benefit from anti-EGFR antibodies and promising responses to dual-HER2 inhibition; however, comparative efficacy has not been investigated. We conducted a randomized phase II trial to evaluate efficacy and safety of dual-HER2 inhibition against standard-of-care anti-EGFR antibody-based therapy as second/third-line treatment in HER2-positive mCRC.

Methods: Patients with -WT mCRC after central confirmation of HER2 positivity (immunohistochemistry 3+ or 2+ and in situ hybridization amplified [HER2/CEP17 ratio >2.

Clinical Impact of Pancreatic and Peripancreatic Hemorrhage Associated With Acute Pancreatitis.

Purpose: The significance of pancreatitis-associated hemorrhage outside the context of a ruptured pseudoaneurysm remains unclear. This study aims to characterize the clinical significance of pancreatic hemorrhage during acute pancreatitis (AP).

Methods: This retrospective study included adult patients diagnosed with hemorrhagic pancreatitis (HP) from 2010 to 2021.

Treatment Patterns and Costs Among Patients With Metastatic Renal Cell Carcinoma in the United States: A Real-World Study Using Integrated Claims and Clinical Data.

Purpose: The treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved in recent years with the use of tyrosine kinase inhibitors (TKIs) and immuno-oncology (IO) therapies. This study examined patient characteristics, treatment patterns, health care resource utilization (HCRU), costs, and survival for individuals with mRCC who received either IO + IO or IO + TKI combinations as first-line (1L) regimens.

Methods: This retrospective cohort study used integrated claims and clinical data from a commercial health plan to study adults with mRCC who began 1L treatment between April 1, 2018, and January 31, 2023.

Datopotamab Deruxtecan in Advanced or Metastatic Non-Small Cell Lung Cancer With Actionable Genomic Alterations: Results From the Phase II TROPION-Lung05 Study.

Purpose: Datopotamab deruxtecan (Dato-DXd) is a trophoblast cell-surface antigen-2-directed antibody-drug conjugate with a highly potent topoisomerase I inhibitor payload. The TROPION-Lung05 phase II trial (ClinicalTrials.gov identifier: NCT04484142) evaluated the safety and clinical activity of Dato-DXd in patients with advanced/metastatic non-small cell lung cancer (NSCLC) with actionable genomic alterations progressing on or after targeted therapy and platinum-based chemotherapy.

Completion of lunar magma ocean solidification at 4.43 Ga.

Crystallization of the lunar magma ocean yielded a chemically unique liquid residuum named KREEP. This component is expressed as a large patch on the near side of the Moon and a possible smaller patch in the northwest portion of the Moon's South Pole-Aitken basin on the far side. Thermal models estimate that the crystallization of the lunar magma ocean (LMO) could have spanned from 10 and 200 My, while studies of radioactive decay systems have yielded inconsistent ages for the completion of LMO crystallization covering over 160 My.

High organofluorine concentrations in municipal wastewater affect downstream drinking water supplies for millions of Americans.

Wastewater receives per- and polyfluoroalkyl substances (PFAS) from diverse consumer and industrial sources, and discharges are known to be a concern for drinking water quality. The PFAS family includes thousands of potential chemical structures containing organofluorine moieties. Exposures to a few well-studied PFAS, mainly perfluoroalkyl acids (PFAA), have been associated with increased risk of many adverse health outcomes, prompting federal drinking water regulations for six compounds in 2024.

Starch-rich plant foods 780,000 y ago: Evidence from Acheulian percussive stone tools.

In contrast to animal foods, wild plants often require long, multistep processing techniques that involve significant cognitive skills and advanced toolkits to perform. These costs are thought to have hindered how hominins used these foods and delayed their adoption into our diets. Through the analysis of starch grains preserved on basalt anvils and percussors, we demonstrate that a wide variety of plants were processed by Middle Pleistocene hominins at the site of Gesher Benot Ya'aqov in Israel, at least 780,000 y ago.

Advancing diagnostic consistency: Statistical methods and interrater reliability in neuropsychological assessments with the MNB.

In the field of neuropsychology, the accuracy of neuropsychological data interpretation has significant implications for both research and clinical practice. The process of test interpretation is fraught with challenges, and a lack of consensus among neuropsychologists can lead to discrepancies in assessment outcomes. Smith et al.

A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett's Esophagus Using the AGREE II Tool.

Background: Several clinical practice guidelines (CPGs) exist for managing Barrett's esophagus (BE). However, the methodological quality of these CPGs is not known. To summarize the methodological quality of CPGs, we performed a critical appraisal of all available CPGs for the management of BE published from January 2018 to February 2023.

Assessing Non-Oral PrEP Alternatives Among Young Black Women in the Southern USA.

Young Black women in the southern US face a high HIV burden. While daily oral HIV pre-exposure prophylaxis (PrEP) can effectively prevent HIV, its use is low among Black women. The acceptability of and perceived intention to use emerging PrEP products among young Black women in the southern US are not well understood.

Rebound in Fecal Testing, Colonoscopy Utilization, and Colorectal Neoplasia Detection During the COVID-19 Pandemic.

Objectives: The COVID-19 pandemic reduced colorectal cancer (CRC) screening, but the rebound in testing and outcomes following the pandemic has not been widely reported. We evaluated CRC test utilization and colorectal neoplasia detection among screening eligible patients in a large health system in 2020 and 2021, compared to 2019 (pre-pandemic).

Methods: Using a retrospective cohort study design, fecal immunochemical test (FIT) and colonoscopy utilization, FIT positivity, and neoplasia detection were evaluated annually in 2019-2021 among Kaiser Permanente Northern California patients aged 50-75 years overall and by sex, age, race and ethnicity, and spoken language preference.

Effects of implant status and breed type on feedlot performance, carcass characteristics, sera metabolites, and immunohistochemical responses in finishing steers.

The number of beef × dairy animals entering feedlots has increased, but the response of beef × dairy cattle to growth-promoting implants has not been well characterized. The objective of this study was to evaluate the effects of breed type and implant administration on live performance, carcass characteristics, sera metabolites, and immunohistochemical (IHC) outcomes. Forty-eight steers (average body weight [BW] = 417±22 kg) were sorted by breed into groups of predominantly Angus (B), black-hided beef × primarily Holstein (B×D), or Holstein (D), and half of the steers within each breed type were administered a steroidal implant.

Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database.

Background: Stroke associated with atrial fibrillation (AF) is a significant cause of mortality. This study analyzed demographic trends and disparities in mortality rates due to stroke in AF patients aged ≥25 years.

Methods: A retrospective analysis was conducted to acquire death data using the Centers for Disease Control and Prevention database from 1999 to 2020.

Isolated external iliac artery aneurysm in a patient without any concomitant vascular disease.

Iliac artery aneurysms commonly present in patients with associated aortic disease. Isolated aneurysms of the iliac arteries are uncommon, mostly involving the common iliac artery. Isolated external iliac artery aneurysms are the rarest iliac aneurysmal pathology.

Association Between Chronic Kidney Disease Risk Categories and Abdominal Aortic Calcification: Insights From the National Health and Nutrition Examination Survey.

Background: Abdominal aortic calcification (AAC) is a critical indicator of cardiovascular risk, particularly in patients with chronic kidney disease (CKD). Traditional classification systems may underestimate the risk in those with moderate CKD. This study aimed to evaluate the association between CKD risk categories - defined by both estimated glomerular filtration rate (eGFR) and albuminuria - and the prevalence of severe AAC.

Effects of bilingual language exposure on toddlers with autism spectrum disorder.

Research analyzing the effects of bilingual language exposure on children with autism spectrum disorder (ASD) has increased in frequency. Utilizing the Bayley Scales of Infant and Toddler Development-Third Edition, the current study analyzed the effects of bilingual language exposure and age on language development, cognitive development, and social emotional development in toddlers with ASD. Older children demonstrated higher language scores than younger children.

Gastric Antral Vascular Ectasia Syndrome With Aortic Stenosis: A Twist on Heyde Syndrome?

Heyde syndrome is a triad of aortic stenosis (AS), gastrointestinal (GI) bleeding from angiodysplasia, and acquired von Willebrand disease (vWD). It is hypothesized that stenotic aortic valves cleave von Willebrand factor (vWF) multimers, predisposing patients to bleeding from GI angiodysplasias. This hypothesis is supported by the observation that aortic valve replacement often leads to the resolution of GI bleeding.

Impaired arbitration between reward-related decision-making strategies in Alcohol Users compared to Alcohol Non-Users: a computational modeling study.

Reinforcement learning studies propose that decision-making is guided by a tradeoff between computationally cheaper model-free (habitual) control and costly model-based (goal-directed) control. Greater model-based control is typically used under highly rewarding conditions to minimize risk and maximize gain. Although prior studies have shown impairments in sensitivity to reward value in individuals with frequent alcohol use, it is unclear how these individuals arbitrate between model-free and model-based control based on the magnitude of reward incentives.

Dietary or pharmacological inhibition of insulin-like growth factor-1 protects from renal ischemia-reperfusion injury in mice.

One-week protein restriction (PR) limits ischemia-reperfusion (IR) damages and improves metabolic fitness. Similarly, longer-term calory restriction results in increased lifespan, partly via reduced insulin-like growth factor (IGF)-1. However, the influence of short-term PR on IGF-1 and its impact on IR are unknown.

Heightened innate immune state induced by viral vector leads to enhanced response to challenge and prolongs malaria vaccine protection.

Cytomegalovirus is a promising vaccine vector; however, mechanisms promoting CD4 T cell responses to challenge, by CMV as a vector, are unknown. The ability of MCMV to prolong immunity generated by short-lived malaria vaccine was tested. MCMV provided non-specific protection to challenge with and increased interleukin-12 (IL-12) and CD8α dendritic cell (DC) numbers through prolonged MCMV-dependent interferon gamma (IFN-γ) production.

Incidence, healthcare and out-of-pocket costs, and mortality of infection among US adults aged 18 to 64 years.

Objective: To estimate incidence and healthcare costs and mortality associated with infection (CDI) among adults <65 years old.

Design: Retrospective cohort study.

Patients: First CDI episodes among commercially insured US patients 18-64 years old were identified from a large claims database.

Gene model for the ortholog of in .

Gene model for the ortholog of ( ) in the Dyak_CAF1 Genome Assembly (GenBank Accession: GCA_000005975.1) of . This ortholog was characterized as part of a developing dataset to study the evolution of the Insulin/insulin-like growth factor signaling pathway (IIS) across the genus using the Genomics Education Partnership gene annotation protocol for Course-based Undergraduate Research Experiences.

Perforated marginal ulceration in the setting of single anastomosis duodeno-ileal switch (SADI-S) with conversion to Roux-en-Y gastric bypass and literature review.

The single anastomosis duodenal-ileal switch (SADI-S) has become a safe alternative to Roux-en-Y gastric bypass (RYGB) in the treatment for morbid obesity. A known complication after bariatric surgery is the development of marginal ulceration. The current literature demonstrates an overwhelmingly low incidence of ulceration in patients who underwent SADI-S.