tbuckley/cabot-search huggingface dataset:
Incidence of Pancreas and Colorectal Adenocarcinoma in the US
Authors: Arvind Bussetty, Jing Shen, Petros C. Benias, Michael Ma, Molly Stewart, Arvind J. Trindade
Journal: JAMA Network Open (2025)

Importance Pancreas cancer is the seventh leading cause of cancer death and colorectal cancer is the second leading cause of cancer death worldwide, with increasing incidence for both, particularly in younger age cohorts. Objective To report updated incidence trends for pancreas and colorectal adenocarcinomas in the US, with the specific intent of examining the annual percentage changes (APCs) in younger age groups. Design, Setting, and Participants This retrospective cohort study used data from the Surveillance, Epidemiology, and End Results database to examine incidence trends from 2000 to 2021. Individuals with pancreatic and colorectal adenocarcinoma were included. Data through 2021 were released on April 17, 2024. Data analysis occurred from December 4, 2024, to February 1, 2025. Main Outcomes and Measures Yearly incidence rates were obtained for pancreatic and colorectal adenocarcinoma. Temporal trends of pancreas adenocarcinoma incidence rates by covariates were measured by APC and 95% CIs. Results From 2000 to 2021, 275 273 cases of pancreas adenocarcinoma were identified (142 633 male patients [51.8%]; 239 840 patients [87.1%] aged ≥55 years). The APC for pancreatic adenocarcinoma was 4.35 (95% CI, 2.03 to 6.73) in the group aged 15 to 34 years, which was statistically significantly higher than the APCs of 1.74 (95% CI, 1.59 to 1.89) ( P = .007) for the group aged 55 years and older and 1.54 (95% CI, 1.18 to 1.90) ( P = .004) for the group aged 35 to 54 years. A total of 1 215 200 cases of colorectal cancer were identified (641 776 male patients [52.8%]; 976 716 patients [80.4%] aged ≥55 years). The APC for colorectal adenocarcinoma was −3.31 (95% CI, −3.54 to −3.08) for the group aged 55 years and older, which was statistically significantly lower than the APCs of 1.75 (95% CI, 1.08 to 2.42) ( P = .001) for the group aged 15 to 34 years and 0.78 (95% CI, 0.51 to 1.06) ( P = .002) for the group aged 35 to 54 years. Conclusions and Relevance The findings of this cohort study suggest that the incidence of pancreatic adenocarcinoma has increased among all age groups, whereas that of colorectal adenocarcinoma has increased among younger age groups. Clinicians should be aware of this trend when evaluating younger patients with relevant symptoms.
Cataracts
Authors: Stephanie P. Chen, Fasika Woreta, David F. Chang
Journal: JAMA (2025)

Importance Age-related cataract, defined as progressive opacification or clouding of the eye’s natural lens, is a leading cause of visual disability and blindness. Cataract surgery is one of the most commonly performed procedures in high-income countries. More than 3.5 million cataract operations are performed annually in the US. Observations Older age is the primary risk factor for cataracts, with approximately two-thirds of the population older than 80 years affected. As the population ages, the number of people with cataracts in the US is expected to increase to 50 million by 2050. Additional risk factors for cataracts include a hereditary or genetic predisposition, certain medications (corticosteroids), ocular trauma, significant UV exposure or radiation therapy, and certain medical conditions such as uncontrolled diabetes, retinitis pigmentosa, Down syndrome, and congenital rubella. Painless, progressive blurring of vision and visual glare are common symptoms of cataracts. Cataracts are diagnosed during an eye examination by an ophthalmologist or optometrist. Surgery to remove the cataract and implant a permanent intraocular lens (IOL) is indicated if visual impairment impedes activities of daily living and is associated with lower rates of falls (&amp;amp;gt;30%) and dementia (20%-30%). Most cataract operations are performed with topical anesthesia. Therefore, patients do not require preoperative general medical testing such as bloodwork or electrocardiogram, and do not need to discontinue anticoagulants for cataract surgery. Systemic α1-adrenergic antagonists for symptomatic benign prostatic hyperplasia, such as tamsulosin, increase the risk of surgical complications and some ophthalmologists temporarily discontinue the drug preoperatively. Intraocular antibiotics, such as moxifloxacin or cefuroxime, delivered intraoperatively have reduced the rates of sight-threatening postsurgical endophthalmitis from 0.07% to 0.02%. In addition to reversing and preventing progressive vision loss, cataract surgery can reduce dependence on eyeglasses. These optional refractive benefits are achieved with advanced technology IOL designs, such as multifocal IOLs. However, multifocal and other advanced technology refractive IOLs are associated with increased costs that are not covered by medical insurance. Conclusions and Relevance Cataracts are common among older adults and may cause visual disability and blindness without treatment. Cataract surgery reverses and prevents progressive vision loss, and advanced technology lens implants facilitate reduced dependence on eyeglasses.
Tongue Myokymia in IgLON5-IgG Autoimmunity
Authors: Shemonti Hasan, Divyanshu Dubey, Allen Aksamit
Journal: JAMA Neurology (2025)

This case report discusses a man who tested positive for IgLON5-IgG antibody after intermittent episodes of paresthetic feeling involving the throat and jaw, associated with subtle dysarthria and dysphagia, and upper-extremity paresthesia with piloerection of the forearms.
Prevalence of Motor Milestone Delays in Autistic Children
Authors: Olivia M. Pokoski, Sarah M. Furnier, Ronald E. Gangnon, Ellen M. Howerton, Anne V. Kirby, Tyra Protho, Marin L. Schweizer, Brittany G. Travers, Maureen S. Durkin
Journal: JAMA Pediatrics (2025)

Importance Prior literature has explored the prevalence of motor impairments in autistic individuals, but estimates come from clinical, convenience, or small samples, limiting generalizability. Better understanding of the frequency of motor milestone delays in autistic individuals could improve early identification and subsequently lead to earlier intervention and better developmental outcomes. Objective To determine the prevalence of motor milestone delays in a population-based sample of 8-year-old autistic children and to evaluate if having motor milestone delays is associated with an earlier age at autism evaluation or diagnosis. Design, Setting, and Participants This cross-sectional study of autistic 8-year-old children was conducted using Autism and Developmental Disabilities Monitoring (ADDM) Network data between surveillance years 2000 and 2016. ADDM Network data are population based and are drawn from 17 sites across the US. Data were analyzed from October 2023 to August 2024. Exposure Binary indicator of motor milestone delays documented in health or educational records. Main Outcomes and Measures The primary outcome was the prevalence of motor milestone delays among autistic 8-year-old children. Associations between motor milestone delays and age at autism evaluation or diagnosis were evaluated using linear regression. Covariates included study site, surveillance year, the number of autism discriminators, intellectual disability, child sex, and child race and ethnicity. Results Among 32 850 children aged 8 years identified with autism by active surveillance, 23 481 children (71.5%) met criteria for motor milestone delays. A total of 5973 children (18.2%) were female. In linear regression models, children with motor milestone delays were evaluated for autism significantly earlier (mean age, 43.65 months; 95% CI, 43.38-43.91) than children without motor milestone delays (mean age, 51.64 months; 95% CI, 51.22-52.06). After stratifying by the co-occurrence of intellectual disability (ID), children with motor milestone delays were evaluated for autism earlier than those without motor milestone delays, regardless of ID. Conclusions and Relevance This cross-sectional study estimates the prevalence of motor milestone delays among autistic 8-year-old children and highlights the association between these delays and an earlier autism evaluation, even in children without co-occurring ID. Early identification of autism is a public health priority, and assessing motor milestone delays, particularly in children with an increased likelihood of being autistic, may facilitate an earlier autism evaluation, leading to more timely interventions and better developmental outcomes.
Risk of Dementia in Individuals With Emergency Department Visits or Hospitalizations Due to Cannabis
Authors: Daniel T. Myran, Michael Pugliese, Lyndsay D. Harrison, Nathan M. Stall, Colleen Webber
Journal: JAMA Neurology (2025)

Importance Cannabis use is associated with short-term memory impairment and long-term changes in brain structure; however, little is known about whether disordered cannabis use is associated with an increased risk of a dementia diagnosis. Objective To investigate the association between emergency department visits or hospitalizations (acute care encounters) due to cannabis and future dementia diagnosis. Design, Setting, and Participants Population-based, retrospective, matched cohort study using health administrative data from Ontario, Canada, between 2008 and 2021 (with follow-up until 2022) including all individuals aged 45 to 105 years living in Ontario who were eligible and did not have a diagnosis of dementia at cohort entry (2 620 083 individuals excluded). Exposure Individuals with incident acute care due to cannabis use, defined using International Classification of Diseases and Related Health Problems, Tenth Revision coding. Main Outcomes and Measures We used cause-specific adjusted hazard models to compare new diagnoses of dementia (from a validated algorithm) between individuals with acute care due to cannabis use with (1) individuals with all-cause acute care (excluding cannabis), (2) the general population, and (3) individuals with acute care due to alcohol use. Results The study included 6 086 794 individuals, of whom 16 275 (0.3%) had incident acute care due to cannabis use (mean age, 55.2 [SD, 8.3] years; 60.3% male). Annual rates of incident acute care due to cannabis use increased 5.0-fold in individuals aged 45 to 64 years (from 10.16 to 50.65 per 100 000) and 26.7-fold in individuals aged 65 years or older (from 0.65 to 16.99 per 100 000) between 2008 and 2021. Individuals with incident acute care due to cannabis use were at a 1.5-fold and 3.9-fold increased risk of dementia diagnosis within 5 years relative to individuals with all-cause acute care and the general population of the same age and sex, respectively (absolute rates of dementia diagnosis: 5.0% for cannabis-related acute care, 3.6% for all-cause acute care, and 1.3% in the general population). After adjustment for sociodemographics and chronic health conditions, individuals with acute care due to cannabis use remained at elevated risk relative to those with all-cause acute care (adjusted hazard ratio [aHR], 1.23; 95% CI, 1.09-1.39) and the general population (aHR, 1.72; 95% CI, 1.38-2.15). Individuals with acute care due to cannabis use were at lower risk than those with acute care due to alcohol use (aHR, 0.69; 95% CI, 0.62-0.76). Conclusions and Relevance Individuals with cannabis use severe enough to require hospital-based care were at increased risk of a new dementia diagnosis compared with those with all-cause hospital-based care or the general population. These findings have important implications considering increasing cannabis use among older adults.
Uncinate Fasciculus Lesion Burden and Anxiety in Multiple Sclerosis
Authors: Erica B. Baller, Audrey C. Luo, Matthew K. Schindler, Elena C. Cooper, Margaret K. Pecsok, Matthew C. Cieslak, Melissa Lynne Martin, Amit Bar-Or, Ameena Elahi, Christopher M. Perrone, Bailey C. Spangler, Theodore D. Satterthwaite, Russell T. Shinohara
Journal: JAMA Network Open (2025)

Importance Multiple sclerosis (MS) is an immune-mediated neurological disorder that affects 2.4 million people worldwide, and up to 60% experience anxiety. Objective To investigate whether anxiety in MS is associated with white matter lesion burden in the uncinate fasciculus (UF). Design, Setting, and Participants This was a retrospective case-control study of participants aged 18 years or older diagnosed with MS by an MS specialist and identified from the electronic medical record at a single-center academic medical specialty MS clinic in Pennsylvania. Participants received research-quality 3-Tesla magnetic resonance neuroimaging as part of MS clinical care from January 6, 2010, to February 14, 2018. After excluding participants with poor image quality, participants were stratified into 3 groups naturally balanced in age and sex: (1) MS without anxiety, (2) MS with mild anxiety, and (3) MS with severe anxiety. Analyses were performed from June 1 to September 30, 2024. Exposure Anxiety diagnosis and anxiolytic medication. Main Outcomes and Measures Main outcomes were whether patients with severe anxiety had greater lesion burden in the UF than those without anxiety and whether higher anxiety severity was associated with greater UF lesion burden. Generalized additive models were used, with the burden of lesions (eg, proportion of fascicle impacted) within the UF as the outcome measure and sex, spline of age, and total brain volume as covariates. Results Among 372 patients with MS (mean [SD] age, 47.7 [11.4] years; 296 [80%] female), after anxiety phenotype stratification, 99 (27%) had no anxiety (mean [SD] age, 49.4 [11.7] years; 74 [75%] female), 249 (67%) had mild anxiety (mean [SD] age, 47.1 [11.1] years; 203 [82%] female), and 24 (6%) had severe anxiety (mean [SD] age, 47.0 [12.2] years; 19 [79%] female). UF burden was higher in patients with severe anxiety compared with no anxiety ( T = 2.01 [ P = .047]; Cohen f 2 , 0.19 [95% CI, 0.08-0.52]). Additionally, higher mean UF burden was associated with higher severity of anxiety ( T = 2.09 [ P = .04]; Cohen f 2 , 0.10 [95% CI, 0.05-0.21]). Conclusions and Relevance In this case-control study of UF lesion burden and anxiety in MS, overall lesion burden in the UF was associated with the presence and severity of anxiety. Future studies linking white matter lesion burden in the UF with treatment prognosis are warranted.
Epidemiology and Mortality of Invasive <i>Staphylococcus aureus</i> Infections in Hospitalized Infants
Authors: Maria Rain Jennings, Nora Elhaissouni, Elizabeth Colantuoni, Erica C. Prochaska, Julia Johnson, Shaoming Xiao, Reese H. Clark, Rachel G. Greenberg, Daniel K. Benjamin, Aaron M. Milstone
Journal: JAMA Pediatrics (2025)

Importance Historically, Staphylococcus aureus has been a leading cause of morbidity and mortality in the neonatal intensive care unit (NICU). The current incidence and attributable mortality of late-onset invasive S aureus infection in hospitalized infants is unknown. Objective To estimate the incidence and attributable mortality of late-onset S aureus infection among hospitalized infants in the US. Design, Setting, and Participants This retrospective cohort study included an emulated trial among a national convenience sample of 315 NICUs within the US between 2016 and 2021. Participants were infants aged at least 4 postnatal days who were hospitalized in a participating NICU. Data were analyzed from May to August 2024. Exposures The primary exposures were birth weight and postnatal age. Main Outcomes and Measures The outcomes were the incidence and attributable mortality of late-onset invasive S aureus infection. Methicillin-resistant and methicillin-sensitive S aureus classification was not universally available; thus, all invasive S aureus infections were pooled. Results From 468 201 infants (260 491 [55.6%] male; median [IQR] gestational age, 36 [33-38] weeks) eligible for analysis, 1724 infants experienced 1762 infections for an overall incidence of 37.6 (95% CI, 35.9-39.4) invasive S aureus infections per 10 000 infants. Most infants with invasive infections were 32 weeks’ gestational age or younger (1394 infants [80.9%]), very low birth weight (VLBW; ie, &amp;amp;lt;1500 g) (1318 infants [76.5%]), and/or had a central line during their hospital stay (1509 infants [87.5%]). Invasive infections mostly included bloodstream infections (1505 infections [85.4%]), and 1160 infections (65.8%) occurred within 4 to 28 postnatal days. Birth weight inversely correlated with incidence: infants with VLBW experienced a more than 20-fold higher incidence relative to infants born weighing at least 1500 g (227.1 [95% CI, 215.3-239.4] vs 10.1 [95% CI, 9.1-11.1] infections per 10 000 infants). Most deaths following invasive infection occurred among VLBW infants (189 of 209 deaths [90.4%]). Compared with matched infants without a late-onset invasive S aureus infection, infected infants had an absolute difference in mortality rate of 5.3% (95% CI, 3.8%-6.8%). Conclusions and Relevance This cohort study found late-onset invasive S aureus infection and subsequent attributable mortality disproportionally affected infants with VLBW. Targeted infection prevention and control measures are necessary to reduce morbidity and mortality from invasive S aureus infections in this vulnerable population.
Housing Instability and Type 2 Diabetes Outcomes
Authors: Seth A. Berkowitz, Aileen Ochoa, Marlena L. Kuhn, Jenine Dankovchik, Jenna M. Donovan, Myklynn LaPoint, Mufeng Gao, Sanjay Basu, Michael G. Hudgens, Rachel Gold
Journal: JAMA Network Open (2025)

Importance Housing instability may worsen control of type 2 diabetes outcomes. Objective To estimate the association between stable vs unstable housing and type 2 diabetes outcomes. Design, Setting, and Participants This cohort study analyzed electronic health record data of adults with type 2 diabetes from US community-based health centers from June 2016 to April 2023. Targeted minimum loss estimation was used to examine the association between having vs not having housing instability and subsequent type 2 diabetes outcomes, adjusting for age, date of housing instability assessment, sex, race and ethnicity (social constructs that may indicate the experience of racism), language, comorbidities, health insurance, income, and census-tract level social vulnerability index. Analyses were conducted from July 2023 to September 2024. Exposure Report of housing stability or instability. Main Outcomes and Measures Mean hemoglobin A 1c (HbA 1c ) level was the primary outcome; secondary outcomes included systolic and diastolic blood pressure (SBP and DBP) and low-density lipoprotein (LDL) cholesterol. The primary time point was 12 months after initial assessment, with secondary time points at 6, 18, 24, 30, and 36 months. Results A total of 90 233 individuals were included (mean [SD] age, 55.4 [13.7] years; 50 772 female [56.3%]; 25 602 Black [28.4%], 27 277 Hispanic [31.4%], 51 720 White [57.3%]); 28 784 individuals (31.9%) had a primary language other than English, and 15 713 (17.4%) reported housing instability. Prior to first housing instability assessment, mean (SD) HbA 1c was 7.64% (1.94%), mean (SD) SBP was 130.0 (13.5) mm Hg, mean (SD) DBP was 78.2 (7.8) mm Hg, and mean (SD) LDL cholesterol was 101.1 (35.2) mg/dL. We estimated had all individuals experienced stable housing, compared with unstable housing, mean HbA 1c would have been 0.12% lower (95% CI, −0.16% to −0.07%; P &amp;amp;lt; .001), SBP would have been 0.77 mm Hg lower (95% CI, −1.14 mm Hg to −0.39 mm Hg; P &amp;amp;lt; .001), and DBP 0.27 mm Hg lower (95% CI, −0.49 mm Hg to −0.06 mm Hg; P = .01), but LDL cholesterol would not have been lower (estimated difference, −1.46 mg/dL, 95% CI, −2.96 mg/dL to 0.03 mg/dL; P = .05) at 12 months, with numerically similar results at other time points. Conclusions and Relevance In this cohort study, housing stability was associated with small differences in type 2 diabetes outcomes; combining housing stability interventions with other diabetes interventions may be needed to improve type 2 diabetes outcomes more substantially.
Use of Life Support and Outcomes Among Patients Admitted to Intensive Care Units
Authors: Emily E. Moin, Nicholas J. Seewald, Scott D. Halpern
Journal: JAMA (2025)

Importance Nationwide data are unavailable regarding changes in intensive care unit (ICU) outcomes and use of life support over the past 10 years, limiting understanding of practice changes. Objective To portray the epidemiology of US critical care before, during, and after the COVID-19 pandemic. Design, Setting, and Participants Retrospective cohort study of adult patients admitted to an ICU for any reason, using data from the 54 US health systems continuously contributing to the Epic Cosmos database from 2014-2023. Exposures Patient demographics, COVID-19 status, and pandemic era. Main Outcomes and Measures In-hospital mortality unadjusted and adjusted for patient demographics, comorbidities, and illness severity; ICU length of stay; and receipt of life-support interventions, including mechanical ventilation and vasopressor medications. Results Of 3 453 687 admissions including ICU care, median age was 65 (IQR, 53-75) years. Patients were 55.3% male; 17.3% Black and 6.1% Hispanic or Latino; and overall in-hospital mortality was 10.9%. The adjusted in-hospital mortality was elevated during the pandemic in COVID-negative (adjusted odds ratio [aOR], 1.3 [95% CI, 1.2-1.3]) and COVID-positive (aOR, 4.3 [95% CI, 3.8-4.8]) patients and returned to baseline by mid-2022. The median ICU length of stay was 2.1 (IQR, 1.1-4.2) days, with increases during the pandemic among COVID-positive patients (difference for COVID-positive vs COVID-negative patients, 2.0 days [95% CI, 2.0-2.1]). Rates of invasive mechanical ventilation were 23.2% (95% CI, 23.1%-23.2%) before the pandemic, increased to 25.8% (95% CI, 25.8%-25.9%) during the pandemic, and declined below prepandemic baseline thereafter (22.0% [95% CI, 21.9%-22.2%]). The use of vasopressors increased from 7.2% to 21.6% of ICU stays. Conclusions and Relevance Pandemic-era increases in length of stay and adjusted in-hospital mortality among US ICU patients returned to recent historical baselines. Fewer patients are now receiving mechanical ventilation than prior to the pandemic, while more patients are administered vasopressor medications.