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Big data and associated approaches to analyse it are on the rise, especially in healthcare settings. This growth is also seen with unique applications in the field of dermatology. While big data offer a plethora of opportunity for improving our current understanding of disease and ability to deliver care, as with any technology innovation, the potential pitfalls should be addressed. In this piece, we highlight opportunities and challenges associated with big data in dermatology. Opportunities include large and novel data sources that may offer a wealth of information, automated detection, classification and diagnostics and improved public health monitoring. Challenges include data quality, issues of interpretability and disparities within artificial intelligence (AI) training data sets. Clinicians and researchers in the field should be aware of these developments within the field of big data to understand how best it may be used toward improving patient care and health outcomes, particularly in the field of dermatology., (© 2024 European Academy of Dermatology and Venereology.)

Background: Understanding COVID-19 vaccine hesitancy in organ transplant recipients (OTRs) is critical given clear-albeit attenuated-benefits from vaccination., Methods: Adult OTRs were surveyed regarding sociodemographic data, medical history, and vaccine-related values. A novel outcome variable called the Vaccine Acceptance Composite Score (VACS) was built as the average Likert score of seven domains of vaccine confidence. To examine its association with several factors and individual adherence to COVID-19 vaccine recommendations, univariable odds ratios and relative operating characteristic areas under the curve (AUC) values were calculated., Results: Of 46 OTRs included, 32.6% identified as female, 13.3% as Black, and 6.77% as Hispanic or Latino/a/x. The median age was 58 years old. 93.5% of patients were kidney transplant recipients, and 63.0% previously had COVID-19. Patients were most concerned about COVID-19 vaccine-associated risks (46.3%), its potential effect on allograft (47.6%), and motives of government officials involved with vaccine policy (55.6%). Politically conservative patients were likelier to have lower VACS, whereas those who lived with someone ≥65 years old were likelier to have higher VACS. The VACS was not significantly associated with race, income, religious beliefs, comorbidities, COVID-19 history, or influenza vaccination status. Higher VACS was associated with ≥3 and ≥4 COVID-19 immunizations., Conclusions: This study highlighted political beliefs and elderly household members as correlates of vaccine acceptance among OTRs. The VACS may be a useful tool to help standardize multifaceted analyses in vaccination-focused behavioral research. In clinical practice, it could help identify individuals and groups at risk for vaccine hesitancy, who may benefit from tailored outreach and educational interventions., Competing Interests: Declaration of competing interest DF has received research support from Viracor, Astellas, Merck, and AstraZeneca, as well as consultant fees from Viracor, outside of the scope of this work. All other authors have nothing to disclose., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: Immunocompromised individuals, such as those diagnosed with cancer, are at a significantly higher risk for severe illness and mortality when infected with SARS-CoV-2 (COVID-19) than the general population. Two oral antiviral treatments are approved for COVID-19: Paxlovid® (nirmatrelvir/ritonavir) and Lagevrio® (molnupiravir). There is a paucity of data regarding the benefit from these antivirals among immunocompromised patients with cancer, and recent studies have questioned their efficacy among vaccinated patients, even those with risk factors for severe COVID-19., Methods: We evaluated the efficacy and safety of nirmatrelvir/ritonavir and molnupiravir in preventing severe illness and death using our database of 457 patients with cancer and COVID-19 from Brown University-affiliated hospitals., Results: Sixty-seven patients received nirmatrelvir/ritonavir or molnupiravir and were compared to 45 concurrent controls who received no antiviral treatment despite being eligible to receive it. Administration of nirmatrelvir/ritonavir or molnupiravir was associated with improved survival and lower 90-day all-cause and COVID-19-attributed mortality (p < 0.05) and with lower peak O 2 requirements (ordinal odds ratio [OR] 1.52, 95% confidence interval [CI] 0.92-2.56)., Conclusion: Acknowledging the small size of our sample as a limitation, we concluded that early antiviral treatment might be beneficial to immunocompromised individuals, particularly those with cancer, when infected with SARS-CoV-2. Larger-scale, well-stratified studies are needed in this patient population., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This scoping review aims to characterize the use of biologics and Janus Kinase inhibitors (JAKi) in the treatment of Hidradenitis Suppurativa (HS), which is a chronic inflammatory condition. A comprehensive literature search was conducted in PubMed/NCBI, Embase, Web of Science databases, and the Clinicaltrials.gov register. The search included interventional trials assessing the use of biologics or JAKi in HS, with no geographic or time restrictions. Secukinumab and adalimumab were identified as the only two drugs approved by the FDA for treating moderate to severe HS in adults. Several other drug classes showed promising results based on clinical studies reviewed. IL-12/23 inhibitor ustekinumab demonstrated improvements in disease severity scores and HiSCR rates in small trials. IL-17 inhibitors such as brodalumab, bimekizumab, and CJM112 showed preliminary positive responses in early-phase clinical studies and case reports. While evidence was mixed, some TNF-α inhibitors such as infliximab provided benefits according to a randomized controlled trial, though etanercept trials yielded non-significant or inconsistent findings. Larger, well-designed studies are required to further establish their efficacy and safety, but biologics and JAKis show potential as alternative treatment options for moderate to severe HS. The findings of this review contribute to the growing interest among patients and to enhancing the understanding of physician's regarding potential alternative therapeutic options for HS and provide a basis for further research in this field., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This literature review introduces the integration of Large Language Models (LLMs) in the field of dermatopathology, outlining their potential benefits, challenges, and prospects. It discusses the changing landscape of dermatopathology with the emergence of LLMs. The potential advantages of LLMs include a streamlined generation of pathology reports, the ability to learn and provide up-to-date information, and simplified patient education. Existing instances of LLMs encompass diagnostic support, research acceleration, and trainee education. Challenges involve biases, data privacy and quality, and establishing a balance between AI and dermatopathological expertise. Prospects include the integration of LLMs with other AI technologies to improve diagnostics and the improvement of multimodal LLMs that can handle both text and image input. Our implementation guidelines highlight the importance of model transparency and interpretability, data quality, and continuous oversight. The transformative potential of LLMs in dermatopathology is underscored, with an emphasis on a dynamic collaboration between artificial intelligence (AI) experts (technical specialists) and dermatopathologists (clinicians) for improved patient outcomes.

Objective: To describe the frequency and severity of magnetic resonance imaging (MRI) based peripheral osteoarthritis (OA) in athletes during the Rio de Janeiro 2016 Olympic Games., Methods: All MRIs of the peripheral joints in Olympic athletes, performed at the centralized imaging facility, either following acute trauma or for non-traumatic joint pain, were included. All MRIs were retrospectively reviewed for presence and severity of MRI-based OA using an adapted Outerbridge classification for cartilage and adapted classifications for other tissues. Scoring of MRI abnormalities was independently and retrospectively performed without reference to the on-site clinical reports. The frequencies of MRI-detected OA were tabulated and grouped into sports categories, athletes' age (<25; 25-29; and ≥30 years of age), and sex., Results: 11,274 athletes participated in the Games. 320 athletes underwent MRI of the peripheral joints. One hundred sixty (50.0%) were female, 109 (34.1%) were <25 years, 132 (41.3%) between the ages of 25 and 29 years old, and 79 (24.7%) ≥30 years old. 53 (16.6%) had MRI-based OA, with slightly more than half having severe OA. In every age category, severe OA was the most frequent finding and there was a linear trend for increased likelihood of having OA with increasing age (Cochran-Armitage test, p ​= ​0.009). Frequencies of OA were similar in male and female athletes. The wrist (29.2%) and the knee (23.3%) were the most commonly affected joints., Conclusions: MRI-defined OA was not uncommon among elite athletes in this selected sample., Competing Interests: AG is also shareholder of BICL, LLC, and Consultant to Pfizer, Novartis, Regeneron, AstraZeneca, MerckSerono and TissueGene. FWR and MDC are shareholders of BICL, LLC. FWR is consultant to Calibr – California Institute of Biomedical Research. Other authors have nothing to disclose.