Baylor University Medical Center Proceedings最新文献_第4页

Volatomic profiling of blood identifies environmental chemicals associated with metabolic dysfunction-associated steatotic liver disease in lean US adults. 血液的挥发性分析鉴定与美国瘦肉成年人代谢功能障碍相关的脂肪变性肝病相关的环境化学物质。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-08-13 DOI: 10.1080/08998280.2026.2713923

Basile Njei, Khaled W Halwani, Solomon Gyabaah, Sarpong Boateng, Guy Loic Nguefang, Yazan A Al-Ajlouni, Ulrick Sidney Kanmounye

{"title":"Volatomic profiling of blood identifies environmental chemicals associated with metabolic dysfunction-associated steatotic liver disease in lean US adults.","authors":"Basile Njei, Khaled W Halwani, Solomon Gyabaah, Sarpong Boateng, Guy Loic Nguefang, Yazan A Al-Ajlouni, Ulrick Sidney Kanmounye","doi":"10.1080/08998280.2026.2713923","DOIUrl":"10.1080/08998280.2026.2713923","url":null,"abstract":"Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects lean individuals, but the contribution of environmental exposures remains poorly understood. This study investigated whether blood volatomic profiling of volatile organic compounds (VOCs) identifies environmental chemicals associated with MASLD and advanced fibrosis in lean adults using explainable machine learning.Methods: We performed a cross-sectional analysis of lean adults from the NHANES 2017-2020 survey with whole-blood measurements of nine VOCs. XGBoost decision trees were used to evaluate associations between VOC profiles, MASLD, and advanced fibrosis. Shapley additive explanations (SHAP) quantified the contribution of individual VOCs and characterized exposure-response patterns.Results: Among 860 lean adults, 9.0% had MASLD and 1.6% had advanced fibrosis. The MASLD model demonstrated modest discrimination (area under the receiver-operating characteristic curve [AUC-ROC] 0.65), whereas the advanced fibrosis model performed poorly (AUC-ROC 0.24) because of limited events. Chloroform was the strongest VOC associated with both MASLD and advanced fibrosis, followed by o-xylene, bromodichloromethane, benzene, and furan. SHAP analyses demonstrated nonlinear exposure-response relationships and high sensitivity to small variations in low-level VOC concentrations.Conclusion: Blood volatomic profiling identified distinct VOC signatures associated with MASLD in lean adults, with chloroform as the dominant contributor. Exploratory findings also suggested potential associations with advanced fibrosis that warrant validation in larger studies.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1012-1021"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Researching palliative care documentation outcomes: coding alone fails to find the true bleeder. 研究姑息治疗文档的结果：仅靠编码无法找到真正的出血点。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-09-14 DOI: 10.1080/08998280.2026.2730097

Kyle Weinstein, Derek Chui

引用次数: 0

Thyroid tissue in cervical lymph nodes: clinical significance, management, and review of the literature. 颈部淋巴结中的甲状腺组织：临床意义、处理和文献回顾。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-07-14 DOI: 10.1080/08998280.2026.2700125

Payam S Pahlavan

{"title":"Thyroid tissue in cervical lymph nodes: clinical significance, management, and review of the literature.","authors":"Payam S Pahlavan","doi":"10.1080/08998280.2026.2700125","DOIUrl":"10.1080/08998280.2026.2700125","url":null,"abstract":"Background: When thyroid tissue is found within a cervical lymph node, clinicians must distinguish between a benign ectopic inclusion (thyroidosis) and metastatic thyroid carcinoma-a distinction with major management implications. This narrative review synthesizes the available literature on benign thyroid tissue incidentally identified in cervical lymph nodes.Methods: A focused literature search was conducted using the PubMed/MEDLINE database with an end date of April 15, 2026. Publications were included if they reported cases of benign thyroid tissue identified in cervical lymph nodes with histological or molecular confirmation, encompassing case reports, case series, or original studies.Results: Fifteen publications were identified, covering approximately 35 to 45 cases. Patients ranged in age from 13 to 72 years (mean 46), with a marked female predominance (∼75%). Lateral cervical nodes (levels II-IV) were involved in ∼80% of cases. Histologically, benign inclusions were characterized by well-formed follicles with colloid, capsular or subcapsular positioning, and no malignant cytology. Immunohistochemical markers (e.g., HBME-1, CK19) and molecular testing (BRAF/RAS mutation analysis) were reported to be helpful in differentiating benign from malignant thyroid tissue. Associated conditions included autoimmune thyroiditis, head and neck malignancies, and postablative states. Over follow-up periods of 6 months to 10 years, no malignant transformation was observed.Conclusion: Rigorous histological evaluation, supported by ancillary testing, enables confident diagnosis. Conservative surveillance-rather than thyroidectomy-is appropriate when malignancy has been excluded.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1129-1136"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Shattered kidney: a case report highlighting the use of conservative interventions in high-grade pediatric renal trauma. 肾破碎：一个病例报告强调使用保守干预在高度儿童肾外伤。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-06-15 DOI: 10.1080/08998280.2026.2672313

Marissa N Rosa, Priscilla Anderton, Samy Heshmat, Marawan M El Tayeb

引用次数: 0

Digital clinical decision support to save costs: a qualitative evaluation of the views of frontline healthcare professionals. 数字临床决策支持以节省成本：对一线医疗保健专业人员意见的定性评估。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-08-18 DOI: 10.1080/08998280.2026.2717063

George West, Jonathan Foo, Dragan Ilic, Kieran Walsh

{"title":"Digital clinical decision support to save costs: a qualitative evaluation of the views of frontline healthcare professionals.","authors":"George West, Jonathan Foo, Dragan Ilic, Kieran Walsh","doi":"10.1080/08998280.2026.2717063","DOIUrl":"10.1080/08998280.2026.2717063","url":null,"abstract":"Background: Digital clinical decision support (CDS) can improve clinical decision-making, prescribing, diagnostic accuracy, and guideline adherence. Its potential to reduce healthcare costs has received less attention, and the mechanisms by which cost savings might occur remain poorly understood. This study explored resident doctors' experiences of using CDS to improve care and reduce costs.Methods: A qualitative study was carried out. Individual semi-structured interviews were conducted by videoconference with resident doctors who were users of a digital CDS resource. Interviews explored experiences of CDS use, perceptions of cost implications, and barriers and enablers to cost-conscious care. Transcripts were analyzed using constant comparative analysis with open, axial, and selective coding.Results: Twenty-two resident doctors participated. Four main themes emerged. First, cost savings occurred indirectly through improved clinical decisions, including avoidance of unnecessary investigations, referrals, overtreatment, and inappropriate admissions. Second, workflow integration was central to achieving these outcomes; participants emphasized accessibility and integration with electronic systems. Third, CDS complemented rather than replaced clinical expertise, acting as an adjunct to decision-making. Fourth, organizational culture shaped adoption.Discussion: Resident doctors viewed CDS primarily as a means of improving care rather than reducing costs. Cost savings were perceived as secondary benefits arising from better clinical decisions.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1101-1106"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Geriatric syndromes in older stroke survivors: data from the multicenter cross-sectional study EVKALIPT. 老年脑卒中幸存者的老年综合征：来自多中心横断面研究EVKALIPT的数据

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-07-14 DOI: 10.1080/08998280.2026.2699607

Vadim Zakiev, Natalya Vorobyeva, Irina Malaya, Yulia Kotovskaya, Olga Tkacheva

{"title":"Geriatric syndromes in older stroke survivors: data from the multicenter cross-sectional study EVKALIPT.","authors":"Vadim Zakiev, Natalya Vorobyeva, Irina Malaya, Yulia Kotovskaya, Olga Tkacheva","doi":"10.1080/08998280.2026.2699607","DOIUrl":"10.1080/08998280.2026.2699607","url":null,"abstract":"Background: Advanced age is a primary risk factor for geriatric syndromes (GSs) and stroke, yet the association between stroke history and the prevalence of these syndromes in long-term survivors remains insufficiently characterized. The current analysis aimed to investigate the associations between a history of stroke, frailty, and other GSs in individuals aged ≥65 years.Methods: We conducted a post hoc analysis of the cross-sectional multicenter study EVKALIPT.Results: The analysis included 4294 participants (median [interquartile range] age: 78 [71, 85] years). Stroke prevalence was 14.9%. Based on the SPPB test, the cohort comprised 794 (18.5%) nonfrail, 807 (18.8%) prefrail, and 2693 (62.7%) frail patients. The prevalence of stroke history was significantly higher among frail patients (18.1%) compared to nonfrail (9.9%) and prefrail (9.0%) participants (P for trend <0.001). Stroke survivors showed a higher frequency of dependence in all domains of the Barthel Index (basic activities of daily living) and the Lawton Scale (instrumental activities of daily living). All GSs were more prevalent in the stroke group except for orthostatic hypotension. Univariate regression analysis indicated that stroke was associated with 1.4 to 3.9 times higher odds of these GSs. In a multivariate model adjusted for age and sex, seven GSs remained independently associated with a history of stroke (odds ratio 1.24 to 2.23).Conclusions: A history of stroke is significantly associated with frailty and a higher burden of GSs in older adults. These results highlight the need for comprehensive geriatric assessment in stroke survivors to address their complex functional and clinical needs.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1045-1052"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increasing incidence of hepatobiliary cancer in adolescents and young adult females: a Surveillance, Epidemiology, and End Results database study. 青少年和年轻成年女性肝胆癌发病率增加：一项监测、流行病学和最终结果数据库研究。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-08-07 DOI: 10.1080/08998280.2026.2712788

Alec Fulton, Derek Friesen, Phi Tran, Ian Fladie, Lucas Wong

{"title":"Increasing incidence of hepatobiliary cancer in adolescents and young adult females: a Surveillance, Epidemiology, and End Results database study.","authors":"Alec Fulton, Derek Friesen, Phi Tran, Ian Fladie, Lucas Wong","doi":"10.1080/08998280.2026.2712788","DOIUrl":"10.1080/08998280.2026.2712788","url":null,"abstract":"Background: Recent studies suggest shifting epidemiological patterns in hepatobiliary cancers (HBC), with an increasing incidence among younger populations. This study evaluated incidence and mortality trends of HBC in adolescents and young adults (AYA) in the United States.Methods: We conducted a retrospective population-based study using SEER 21 Registries. Individuals aged 15 to 39 years diagnosed with liver and intrahepatic bile duct cancers from 2000 to 2022 were included. Adults aged 40 to 64 years served as a comparator group. Age-adjusted incidence (AAI) and mortality rates (MR) per 100,000 were calculated, and trends were analyzed using annual percent change (APC).Results: Among AYA, AAI increased from 0.34 (95% confidence interval [CI] 0.29-0.40) per 100,000 in 2000 to 0.56 (95% CI 0.49-0.63) in 2022. This was driven by an increase among females: APC 3.18%, 95% CI 2.24-4.30. Hispanic females had the greatest increase, with an APC of 6.96% (95% CI 4.07-20.03). The incidence in adults aged 40 to 64 years peaked in 2014 and declined thereafter. Mortality increased in AYA females (APC 0.99%, 95% CI 0.27-1.75), while remaining stable in males.Conclusion: HBC incidence is rising among AYAs in the United States, disproportionately affecting females, especially Hispanic women, and is accompanied by increasing mortality. Further research is needed to identify underlying causes, including potential metabolic risk factors.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"952-958"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing the readability of AI-generated medication counseling for common Medicaid drug classes: metformin, lisinopril, and atorvastatin. 评估人工智能生成的常见医疗补助药物类别的药物咨询的可读性：二甲双胍、赖诺普利和阿托伐他汀。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-07-15 DOI: 10.1080/08998280.2026.2703446

Rajat Goel

{"title":"Assessing the readability of AI-generated medication counseling for common Medicaid drug classes: metformin, lisinopril, and atorvastatin.","authors":"Rajat Goel","doi":"10.1080/08998280.2026.2703446","DOIUrl":"10.1080/08998280.2026.2703446","url":null,"abstract":"Background: Metformin, lisinopril, and atorvastatin rank among the most commonly prescribed medications for Medicaid patients; however, patients often have inadequate knowledge regarding their safe usage. Generative artificial intelligence (AI) tools are becoming a prevalent source of medication information, but their readability for low-literacy populations compared to authoritative drug information sources lacks empirical assessment.Methods: Sixteen standardized medication counseling inquiries (5 for metformin, 5 for lisinopril, and 6 for atorvastatin) were presented to three AI platforms (ChatGPT, Google Gemini, and Meta Llama 4) under default and sixth-grade-prompted conditions, as well as to six pharmaceutical information websites (FDA.gov, MedlinePlus, Drugs.com, Mayo Clinic, WebMD, and RxList). The Flesch-Kincaid Grade Level (FKGL) was calculated automatically from extracted passages utilizing Python textstat v0.7.3. Identical normalized-text duplicates within each source folder were omitted (84 exclusions; final unique source count = 12). The Mann-Whitney U and Wilcoxon signed-rank tests evaluated FKGL disparities (α = 0.05).Results: The average pooled default AI FKGL was 12.19 ± 4.85, while the pooled sixth-grade AI FKGL was 7.63 ± 3.16. The pooled website FKGL after deduplication was 10.49 ± 3.95 (Mann-Whitney U = 343.0, P = 0.31, rank-biserial r = -0.19).Conclusion: The AI-generated medication counseling passages in this sample frequently exhibited a higher FKGL than the aggregated website passages; sixth-grade prompting markedly decreased FKGL across all three models (all P ≤ 0.001). This article exclusively addresses readability. Pharmacists and prescribers should endorse reputable websites that provide suitable assistance; grade-level prompts may facilitate patient comprehension of AI-generated summaries.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1097-1100"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corneal abrasions in burn admissions: severity and geographic access factors in a retrospective cohort. 在一项回顾性队列研究中，烧伤入院中的角膜擦伤：严重程度和地理通路因素。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-07-24 DOI: 10.1080/08998280.2026.2703441

Bryce L Palmer, Cameron L Miller, Isaac T Edwards, Harrison Marsh, Ariel Santos

{"title":"Corneal abrasions in burn admissions: severity and geographic access factors in a retrospective cohort.","authors":"Bryce L Palmer, Cameron L Miller, Isaac T Edwards, Harrison Marsh, Ariel Santos","doi":"10.1080/08998280.2026.2703441","DOIUrl":"10.1080/08998280.2026.2703441","url":null,"abstract":"Background: Characterizing the incidence and determinants of corneal abrasions in burn patients and evaluating the roles of burn severity, comorbidities, and social determinants of health (SDOH) in shaping risk can inform screening and care.Methods: We conducted a retrospective cohort study of patients admitted to a regional burn center between January 1, 2019, and January 1, 2024. Eligible patients had documented burns and a complete ophthalmologic examination at admission. Demographics, burn severity, comorbidities, SDOH indices (Social Vulnerability Index [SVI], Area Deprivation Index [ADI]), geographic access, and outcomes were abstracted from the medical record. Group comparisons were performed using standard statistical tests.Results: Among 2023 patients, 90 (4.4%) had corneal abrasions. They had greater total body surface area burned (17.5% vs 6.2%, P < 0.001) and longer hospitalizations, intensive care unit stays, and ventilation durations (all P < 0.001). Abrasions were associated with inhalation injury (58% vs 19%, P < 0.001) and in-hospital mortality (18.9% vs 4.9%, P < 0.001). Patients with abrasions traveled farther (151 vs 121 miles, P = 0.02) and were more often from out of state (8.2% vs 3.6%). No significant differences were found in SVI, ADI, or most comorbidities, though diabetes was less common (7.8% vs 16.4%, P = 0.04).Conclusion: Corneal abrasions occur in about 1 in 20 burn admissions and are strongly associated with burn severity and critical illness. Geographic distance and incomplete race documentation were additional risk factors, while SDOH indices and diabetes were not. These findings identify corneal abrasions as markers of systemic severity and health system disparities, supporting standardized eye-care protocols for high-risk burn patients.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1076-1079"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Big data: from signal to action. 大数据：从信号到行动。

Baylor University Medical Center Proceedings Pub Date : 2026-11-01 Epub Date: 2026-09-21 DOI: 10.1080/08998280.2026.2731826

Kenneth Youens, Elisa Priest

引用次数: 0