tbuckley/cabot-search huggingface dataset:
Cannabis Use Among Older Adults
Authors: Vira Pravosud, Emily Lum, Marzieh Vali, Beth E. Cohen, Katherine J. Hoggatt, Amy L. Byers, Peter C. Austin, Louise C. Walter, Deborah Hasin, Tauheed Zaman, Salomeh Keyhani
Journal: JAMA Network Open (2025)

Importance Little is known about patterns (forms, frequency, and reasons) and factors associated with cannabis use in older veterans (aged ≥65 years). Objective To examine factors associated with past 30-day cannabis use and cannabis use disorder (CUD) in older veterans. Design, Setting, and Participants In this cross-sectional study, community-dwelling adults aged 65 to 84 years who used Veterans Health Administration care were interviewed between February 5, 2020, and August 29, 2023. Exposure Sociodemographic, behavioral, and health-related characteristics. Main Outcomes and Measures Past 30-day cannabis use (smoking, vaping, dabbing, or edibles) and any CUD (≥2 criteria based on Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) were assessed using weighted multivariable logistic regressions. Results Of the 4503 participants (weighted mean age, 73.3 years [95% CI, 73.0-73.5 years]; 85.4% [95% CI, 83.6%-87.2%] men), 58.2% (95% CI, 55.3%-61.0%) had ever used cannabis, 28.9% (95% CI, 26.0%-31.8%) of whom reported using cannabis for medical reasons, most commonly for pain (56.4%; 95% CI, 50.9%-61.9%), mood or mental health (18.4%; 95% CI, 14.7%-22.1%), and sleep (16.0%; 95% CI, 11.9%-20.0%). More than 1 in 10 reported past 30-day cannabis use (10.3%; 95% CI, 8.9%-11.7%), with 52.4% (95% CI, 45.4%-59.4%) of these using cannabis for 20 days or more; smoking (72.4%; 95% CI, 65.4%-79.3%) and edibles (36.9%; 95% CI, 29.8%-43.9%) were the most common forms of use. Characteristics associated with past 30-day use included younger age (65-75 years), economic hardship, tobacco and illicit drug use, and residing in a state with recreationally legal cannabis. Among those with past 30-day cannabis use, 36.3% (95% CI, 30.1%-42.6%) screened positive for CUD, with higher odds among younger respondents, those reporting anxiety, those with 1 or more deficits in activities of daily living, those with illicit drug use, those with frequent cannabis use, and those using cannabis recreationally. Past 30-day inhaled cannabis use, compared with edibles only, was associated with increased odds of any CUD (adjusted odds ratio, 3.56; 95% CI, 1.12-11.26). Conclusions and Relevance In this cross-sectional study of cannabis use in older veterans, use was common, and more than one-third who used in the past 30 days had any CUD. The prevalence of past 30-day cannabis use was close to tobacco use prevalence, and risk factors for cannabis use were similar to those observed in other populations. Frequent and inhaled cannabis use was associated with higher odds of any CUD. Routine health screening for cannabis use in Veterans Health Administration clinical settings is necessary to identify older adults with cannabis use.
Wealth Among Adults Aged 26 to 34 Years Born Very Preterm and Full Term
Authors: Elif Gonen, E. Sabrina Twilhaar, Nicole Tsalacopoulos, Barbara Busch, Peter Bartmann, Dieter Wolke
Journal: JAMA Network Open (2025)

This cohort study examines changes in the wealth gap between adults born very preterm and/or very low birth weight compared with their peers who were born full term.
Salary Differences by Gender, Race, and Ethnicity Among Assistant Professors at US Medical Schools
Authors: Dalia Owda, Michael O. Mensah, David Yang, Maureen E. Canavan, Cary P. Gross, Sarwat I. Chaudhry
Journal: JAMA Network Open (2025)

Importance Salary inequities by gender are well documented in medicine, but there is limited understanding of racial and ethnic disparities or how these intersect with gender across clinical specialties. Objective To determine whether salaries for assistant professors at US medical schools differ by gender, race and ethnicity, and gender-race-ethnicity intersections across clinical specialties. Design, Setting, and Participants This cross-sectional study of medical school assistant professor faculty salary data assessed 19 clinical specialties by gender, race and ethnicity, and gender-race-ethnicity intersections. Aggregated data were obtained from the Association of American Medical Colleges Faculty Salary Report for 2022 to 2023 for assistant professors at 153 US medical schools. Exposures Gender, race and ethnicity, and gender-race-ethnicity. Main Outcomes and Measures Median annual salary and salary ratios were calculated for assistant professors across gender, race and ethnicity, and at their intersections for the 2022-2023 academic year. Salary ratios compared women with men, Asian and underrepresented in medicine (URIM) faculty to White faculty, and various gender-race-ethnicity subgroups to White men. Results In this cross-sectional study of 45 906 assistant professor faculty members from 19 clinical specialties in 2022 and 2023, there were 23 538 (51%) men and 22 368 (49%) women, with a racial and ethnic composition of 10 294 (27%) Asian, 4543 (12%) URIM, and 23 781 (62%) White. Across all specialties, women (median annual salary, $266 450; salary ratio, $0.81:$1.00) earned less than men (annual median salary, $330 000). Asian (median annual salary, $291 360; salary ratio, $0.97:$1.00) and URIM (median annual salary, $278 010; salary ratio, $0.93:$1.00) physicians were paid less than White physicians (median annual salary, $300 000). Intersectional analyses showed that URIM women were paid the least (median annual salary, $259 570; salary ratio, $0.78:$1.00) compared with White men (median annual salary, $333 800). Conclusions and Relevance This cross-sectional study of assistant professor faculty across 19 clinical specialties found salary disparities, with Asian and URIM, both men and women, receiving lower pay than White men. These findings suggest the need to address salary inequities in academia using an intersectional approach that considers both gender and race and ethnicity.
Neighborhood Socioeconomic Status and New Hidradenitis Suppurativa Diagnoses in a Single Health System
Authors: Aileen Y. Chang, Maria Elena Sanchez-Anguiano, Krittin Supapannachart, Erin H. Amerson, Haley B. Naik, Stephen Shiboski, Mindy C. Derouen, Jinoos Yazdany
Journal: JAMA Dermatology (2025)

Importance Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition. Risk factors for developing HS (eg smoking and obesity) are influenced by social drivers of health at the neighborhood level. However, the association of neighborhood-level socioeconomic status (nSES) and HS has not been adequately assessed. Objective To evaluate the association of nSES with new HS diagnoses among dermatology patients within a single health system. Design, Setting, and Participants This was a cross-sectional study of patients of the dermatology clinics at the University of California San Francisco health system between August 1, 2019, and May 31, 2024, who were also residents of the San Francisco Bay Area at index visit. Data analyses were performed from June 1, 2024, to February 11, 2025. Exposure Census tract-level index measure of nSES that incorporated income, poverty, housing cost, rental cost, education, occupation, and employment. Quintiles of nSES were assigned based on nSES distribution in the San Francisco Bay Area counties. Main Outcomes and Measures A new HS diagnosis during the study period, identified by the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code, and confirmed by medical record review. Logistic regression models were constructed and fit by generalized estimating equations accounting for clustering by census tract with nSES quintile as the primary exposure (reference used was quintile 5, the highest nSES quintile); new HS diagnosis as the binary outcome; and age, sex, and race and ethnicity as confounders. In secondary analyses, smoking status, obesity, and health insurance type were assessed as possible mediators. Results The analyses included a total of 65 766 patients (mean [SD] age, 50.4 [18.3] years; 41.8% female), of whom 485 (0.7%) had a new HS diagnosis. Greater odds of a new HS diagnosis were observed in lower-SES neighborhoods (Q1-Q4)—after adjusting for age, sex, and race and ethnicity, odds ratio for Q1 was 3.32 (95% CI, 2.46-4.49); Q2, 2.25 (95% CI, 1.62-3.12); Q3, 1.97 (95% CI, 1.46-2.66); and Q4, 1.44 (95% CI, 1.06-1.96) ( P &amp;amp;lt;.001 [linear trend]). In race-stratified analyses, greater odds of a new HS diagnosis were observed among patients residing in lower-SES neighborhoods, although this pattern did not reach statistical significance at the 5% level in all racial and ethnic groups. Conclusions and Relevance This cross-sectional study found that nSES was independently associated with a new diagnosis of HS among dermatology patients. This finding supports the hypothesis that neighborhood-level factors may influence the development of HS.
Size matters: Superior Efficacy of Alpha Particle Radioimmunotherapy in Micrometastases versus Macrometastases
Authors: Ravi B. Patel, Stephen S. Adler, Freddy E. Escorcia
Journal: Clinical Cancer Research (2025)

Abstract Radiopharmaceuticals, which emit either alpha or beta particles, have changed the landscape of prostate cancer imaging and treatment. Each particle type has unique physical properties that can be exploited to optimize treatment effect. Using murine models of disseminated prostate cancer and a CD46-targeted alpha-particle emitting radioimmunoconjugate, a recent study shows superior efficacy in mice bearing micrometastastic versus to macrometastatic disease.
Incorporating Behavioral Science in Medication Adherence Communication
Authors: Punam Keller, Ted Robertson, Lee-Sien Kao, Yong Li, Brandon Merrell, Linda Chung, Emily Boudreau, Alex James, Lauren Esterly, Kaitlin Hanken, Niteesh K. Choudhry
Journal: JAMA Network Open (2025)

Importance Hypertension increases the risk of myocardial infarction and strokes, but adherence to antihypertensive medications remains suboptimal. Increasing medication adherence may help prevent hypertension-related disability and death. Objective To estimate the effect of incorporating behavioral science principles in mailed communications intended to increase hypertension medication adherence. Design, Setting, and Participants This randomized clinical trial was conducted from August 18 to December 31, 2023, at Humana, a large health insurance provider, and included Medicare Advantage beneficiaries aged 65 to 80 years who were taking hypertension medications with adherence rates of 60% to 85%. Data were extracted for the as-treated analysis on April 14, 2024. Intervention Study participants were randomized in equal proportions to 1 of 7 groups: 6 received mailed communications that incorporated combinations of behavioral science principles, and 1 received no mailing (control, or usual care condition). The specific principles included were social norming (the mailing noted that more Humana beneficiaries each year were improving their medication adherence scores), messenger effects (the mailing signatory was a pharmacist), and processing fluency (the mailing incorporated a visual circle metaphor indicating current and complete adherence to prompt “closing the ring”). The first mailing contained the participant’s baseline refill score, and a second mailing noted any changes in the participant’s refill score after 60 days. Main Outcomes and Measures The primary outcome was end-of-year hypertension medication adherence calculated from pharmacy claims data using the proportion of days covered (PDC) metric (having medication available for 1 target hypertension drug, as measured through prescription claims, counted as adherent on a given day). A secondary outcome was the proportion of study participants with end-of-year PDC of 80% or greater. Results The study participants (n = 64 290) had a mean (SD) age of 71.4 (4.1) years, and 54.1% were female. Mean (SD) end-of-year adherence in the control group was 0.81 (0.12) and was no different in any of the intervention arms (absolute mean difference compared with control was 0.00 [95% CI, −0.01 to 0.01]). The proportion of participants with an end-of-year PDC greater than 80% also did not differ significantly between the control group (6587 of 9183 [71.7%]) and any of the intervention arms (range, 6467 of 9180 [70.4%] to 6598 of 9177 [71.9%]). Conclusions and Relevance In this randomized clinical trial, use of social norms, messenger effects, and processing fluency in mailed communications did not significantly increase hypertension medication adherence. Further research is needed to identify tactics to effectively increase adherence. Trial Registration ClinicalTrials.gov Identifier: NCT06066541
Microglial TMEM119 binds to amyloid-β to promote its clearance in an Aβ-depositing mouse model of Alzheimer’s disease
Authors: Jing Liu, Zhimeng Wang, Wenwen Liang, Zhenhao Zhang, Yusen Deng, Xiaowei Chen, Zongren Hou, Yuanzhi Xie, Qi Wang, Yuan Li, Chaobo Bai, Da Li, Fan Mo, Huinan Wang, Dongmei Wang, Junliang Yuan, Yukai Wang, Zhao-Qian Teng, Baoyang Hu
Journal: Immunity (2025)
Referral Criteria for Specialist Palliative Care for Patients With Dementia
Authors: Yuchieh Kathryn Chang, Jennifer Philip, Jenny T. van der Steen, Lieve Van den Block, Allyn Yin Mei Hum, Pedro E. Pérez-Cruz, Carlos Paiva, Masanori Mori, Ping-Jen Chen, Meera R. Agar, Laura Hanson, Catherine J. Evans, David Hui
Journal: JAMA Network Open (2025)

Importance Patients with dementia have considerable supportive care needs. Specialist palliative care may be beneficial, but it is unclear which patients are most appropriate for referral and when they should be referred. Objective To identify a set of consensus referral criteria for specialist palliative care for patients with dementia. Design, Setting, and Participants In this survey study using 3 rounds of Delphi surveys, an international, multidisciplinary panel of clinicians from 5 continents with expertise in the integration of dementia and palliative care were asked to rate 83 putative referral criteria (generated from a previous systematic review and steering committee discussion). Specialist palliative care was defined as an interdisciplinary team consisting of practitioners with advanced knowledge and skills in palliative medicine offering consultative services for specialist-level palliative care in (nonhospice) inpatient, outpatient, community, and home-based settings. Main Outcomes and Measures Consensus was defined a priori as at least 70% agreement among experts. A criterion was coded as major if the experts advocated that meeting 1 criterion alone was satisfactory to justify a referral. Data were summarized using descriptive statistics. Results Of the 63 invited and eligible panelists, the response rate was 58 (92.1%) in round 1, 58 (92.1%) in round 2, and 60 (95.2%) in round 3. Of the 58 panelists who provided demographic data in round 1, most were aged 40 to 49 years (28 of 58 [48.3%]), and 29 panelists (50%) each were men and women. Panelists achieved consensus on 15 major and 42 minor criteria for specialist palliative care referral. The 15 major criteria were grouped under 5 categories, including dementia type (eg, rapidly progressive dementia), symptom distress (eg, severe physical symptoms), psychosocial factors or decision-making (eg, request for hastened death, assisted suicide, or euthanasia), comorbidities or complications (eg, ≥2 episodes of aspiration pneumonia in the past 12 months); and hospital use (eg, ≥2 hospitalizations within the past 3 months). Conclusions and Relevance In this Delphi survey study, international experts reached consensus on a range of criteria for referral to specialist palliative care. With testing and validation, these criteria may be used to standardize specialist palliative care access for patients with dementia across various care settings.
Failure Rate of Nonoperative Treatment of Appendicitis—Closer to 15% Than 50%?
Authors: David A. Talan, Salomone Di Saverio
Journal: JAMA Surgery (2025)

This Viewpoint outlines the problems with the failure rates for nonoperative treatment of uncomplicated appendicitis (NOTA) reported in several major trials and discusses why NOTA may be preferable to appendectomy.
Spironolactone vs Amiloride for Resistant Hypertension
Authors: Chan Joo Lee, Sang-Hyun Ihm, Dong-Ho Shin, Jin-Ok Jeong, Ju Han Kim, Kyeong-Hyeon Chun, JiWung Ryu, Hae-Young Lee, Seonghoon Choi, Eun Mi Lee, Jung Hyun Choi, Kwang-Il Kim, Jinho Shin, Wook Bum Pyun, Dae-Hee Kim, Sungha Park, Bryan Williams
Journal: JAMA (2025)

Importance Amiloride has been proposed as an alternative to spironolactone for treating resistant hypertension. However, no randomized clinical trials have compared the efficacy of spironolactone and amiloride in patients with resistant hypertension. Objective To determine whether amiloride is noninferior to spironolactone in reducing home-measured systolic blood pressure (SBP) in patients with resistant hypertension. Design, Setting, and Participants Prospective, open-label, blinded end-point randomized clinical trial conducted at 14 sites in South Korea. From November 16, 2020, to February 29, 2024, 118 patients with home SBP of 130 mm Hg or greater after a 4-week run-in period with a fixed-dose triple medication combination (angiotensin receptor blocker, calcium channel blocker, and thiazide) were enrolled. Intervention Patients were randomized in a 1:1 ratio to receive 12.5 mg/d of spironolactone (n = 60) or 5 mg/d of amiloride (n = 58). If home SBP remained 130 mm Hg or greater and serum potassium was less than 5.0 mmol/L after 4 weeks, dosages were increased to 25 mg/d and 10 mg/d, respectively. Main Outcomes and Measures The primary end point was the between-group difference in home SBP change at week 12, with a noninferiority margin of −4.4 mm Hg for the lower bound of the confidence interval. Secondary end points included achievement rates of home- and office-measured SBP of less than 130 mm Hg. Results The median age of the study population was 55 years, with 70% male. There were no differences between groups in demographic characteristics other than use of α-blockers (8.6% in the amiloride group and 0% in the spironolactone group). The mean baseline home SBPs were 141.5 (SD, 7.9) mm Hg and 142.3 (SD, 8.5) mm Hg in the amiloride and spironolactone groups, respectively. At week 12, mean home SBP measurements were changed from baseline by −13.6 (SD, 8.6) mm Hg and −14.7 (SD, 11.0) mm Hg in the amiloride and spironolactone groups, respectively (between-group difference in change, −0.68 mm Hg; 90% CI, −3.50 to 2.14 mm Hg), with amiloride demonstrating noninferiority to spironolactone. Home-measured achievement rates of SBP less than 130 mm Hg in the amiloride and spironolactone groups were 66.1% and 55.2%, respectively, and office-measured achievement rates of SBP less than 130 mm Hg were 57.1% and 60.3%, respectively, with no difference between the 2 groups. One case of hyperkalemia-related discontinuation occurred in the amiloride group, with no cases of gynecomastia in either group. Conclusions and Relevance Amiloride was noninferior to spironolactone in lowering home SBP, suggesting that it could be an effective alternative for treatment of resistant hypertension. Trial Registration ClinicalTrials.gov Identifier: NCT04331691
Estimated Costs and Cost-Effectiveness of a Pediatric Weight Management Program
Authors: Meg Simione, Sophie Wagner, Caroline J. Kistin, Kelsey A. Egan, Sheila Kelly, William G. Adams, Elsie M. Taveras, Chin Hur
Journal: JAMA Network Open (2025)

Importance Childhood obesity remains a significant public health challenge, with ongoing racial, ethnic, and socioeconomic disparities in its prevention and treatment. Economic evaluations of pediatric obesity interventions are essential for guiding resource allocation in health care settings. Objective To develop and analyze a simulation model of the Connect for Health program to estimate the costs of implementing the program and assess its cost-effectiveness. Design, Setting, and Participants This economic evaluation used a Markov cohort model based on the Connect for Health randomized clinical trial (RCT) conducted from June 2014 through March 2016 and the Connect for Health implementation study conducted at 2 academic medical centers in Boston, MA. The study first estimated costs of implementation for new sites, and then simulated program implementation in a cohort that mirrored the RCT population. Data were analyzed from October 2023 to March 2025. Exposure The Connect for Health pediatric weight management program. Main Outcomes and Measures Outcomes include costs associated with program implementation and the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained. Results This study used a cohort of 2494 individuals to mirror the RCT population and included 1178 female participants (47%), a mean (SD) age of 8.0 (3.0) years, and a mean (SD) body mass index z score of 1.91 (0.56). The costs of implementing the Connect for Health program in primary care settings were estimated at $58 000 in 1-time startup costs and $1300 in ongoing monthly costs. The economic model showed that the Connect for Health strategy had an ICER of $10 554 per QALY gained over 2 years compared with no intervention. The study found a threshold of 534 children in a cohort was needed to effectively amortize costs. Conclusions and Relevance In this economic evaluation of a pediatric weight management program, the Connect for Health program was estimated to be cost-effective. These findings are important for health care systems that serve children who are less likely to receive obesity-related care in making decisions about program adoption.
Hepatic lipid remodeling in cold exposure uncovers direct regulation of bis(monoacylglycero)phosphate lipids by phospholipase A2 group XV
Authors: Jessica W Davidson, Raghav Jain, Thomas Kizzar, Gisela Geoghegan, Daniel J Nesbitt, Amy Cavanagh, Akira Abe, Kwamina Nyame, Andrea Hunger, Xiaojuan Chao, Isabella James, Helaina Walesewicz, Dominique A Baldwin, Gina Wade, Sylwia Michorowska, Rakesh Verma, Kathryn Schueler, Vania Hinkovska-Galcheva, Evgenia Shishkova, Wen-Xing Ding, Joshua J Coon, James A Shayman, Monther Abu-Remaileh, Judith A Simcox
Journal: Cell Metabolism (2025)

Cold exposure is a selective environmental stress that elicits a rapid metabolic shift to maintain energy homeostasis. In response to cold exposure, the liver rewires the metabolic state, shifting from glucose to lipid catabolism. By probing the liver lipids in cold exposure, we observed that the lysosomal bis(monoacylglycero)phosphate (BMP) lipids were rapidly increased during cold exposure. BMP lipid changes occurred independently of lysosomal abundance but were dependent on the lysosomal transcriptional regulator transcription factor EB (TFEB). Knockdown of Tfeb in hepatocytes decreased BMP lipid levels and led to cold intolerance in mice. We assessed TFEB-binding sites of lysosomal genes and determined that the phospholipase a2 group XV (PLA2G15) regulates BMP lipid catabolism. Decreasing Pla2g15 levels in mice increased BMP lipids, ablated the cold-induced rise in BMP lipids, and improved cold tolerance. Mutation of the catalytic site of PLA2G15 ablated the BMP lipid breakdown. Together, our studies uncover TFEB regulation of BMP lipids through PLA2G15 catabolism.
Heterozygosity for Crohn’s disease risk allele of ATG16L1 promotes unique protein interactions and protects against bacterial infection
Authors: Xiaomin Yao, Eugene Rudensky, Patricia K Martin, Brittany M Miller, Isabel Vargas, Erin E Zwack, Keenan A Lacey, Zhengxiang He, Glaucia C Furtado, Sérgio A Lira, Victor J Torres, Bo Shopsin, Ken Cadwell
Journal: Immunity (2025)