tbuckley/cabot-search huggingface dataset:
Optimizing Prehabilitation—Aligning the Right Patients With the Right Program
Authors: Katherine M. Reitz, Shipra Arya
Journal: JAMA Surgery (2025)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2025 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Transitioning to Intravenous Tenecteplase for the Treatment of Acute Ischemic Stroke
Authors: Lina Palaiodimou, Georgios Tsivgoulis
Journal: JAMA Network Open (2025)

Justin F. Rousseau, MD, MMSc; Jeremy M. Weber, MS; Brooke Alhanti, PhD, MPH; Jeffrey L. Saver, MD; Steven R. Messé, MD; Lee H. Schwamm, MD; Gregg C. Fonarow, MD; Kevin N. Sheth, MD; Eric E. Smith, MD, MPH; Michael T. Mullen, MD; Gisele Sampaio Silva, MD, MPH, PhD; Brian Mac Grory, MBBCh BAO, MHSc; Ying Xian, MD, PhD; Steven J. Warach, MD, PhD
Polygenic Scores of Cardiometabolic Risk Factors in American Indian Adults
Authors: Quan Sun, Jiawen Du, Yihan Tang, Lyle G. Best, Karin Haack, Ying Zhang, Shelley A. Cole, Nora Franceschini
Journal: JAMA Network Open (2025)

Importance Numerous efforts have been made to include diverse populations in genetic studies, but American Indian populations are still severely underrepresented. Polygenic scores derived from genetic data have been proposed in clinical care, but how polygenic scores perform in American Indian individuals and whether they can predict disease risk in this population remains unknown. Objective To study the performance of polygenic scores for cardiometabolic risk factors of lipid traits and C-reactive protein in American Indian adults and to determine whether such scores are helpful in clinical prediction for cardiometabolic diseases. Design, Setting, and Participants The Strong Heart Study (SHS) is a large American Indian cohort recruited from 1989 to 1991, with ongoing follow-up (phase VII). In this genetic association study, data from SHS American Indian participants were used in addition to data from 2 large-scale, external, ancestry-mismatched genome-wide association studies (GWASs; 450 865 individuals from a European GWAS and 33 096 individuals from a multi-ancestry GWAS) and 1 small-scale internal ancestry-matched American Indian GWAS (2000 individuals). Analyses were conducted from February 2023 to August 2024. Exposure Genetic risk score for cardiometabolic disease risk factors from 6 traits including 5 lipids (apolipoprotein A, apolipoprotein B, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), and an inflammatory biomarker (C-reactive protein [CRP]). Main Outcomes and Measures Data from SHS participants and the 2 GWASs were used to construct 8 polygenic scores. The association of polygenic scores with cardiometabolic disease was assessed using 2-sided z tests and 1-sided likelihood ratio tests. Results In the 3157 SHS participants (mean [SD] age, 56.44 [8.12] years; 1845 female [58.4%]), a large European-based polygenic score had the most robust performance (mean [SD] R 2 = 5.0% [1.7%]), but adding a small-scale ancestry-matched GWAS using American Indian data helped improve polygenic score prediction for 5 of 6 traits (all but CRP; mean [SD] R 2 , 7.6% [3.2%]). Lipid polygenic scores developed in American Indian individuals improved prediction of diabetes compared with baseline clinical risk factors (area under the curve for absolute improvement, 0.86%; 95% CI, 0.78%-0.93%; likelihood ratio test P = 3.8 × 10 −3 ). Conclusions and Relevance In this genetic association study of lipids and CRP among American Indian individuals, polygenic scores of lipid traits were found to improve prediction of diabetes when added to clinical risk factors, although the magnitude of improvement was small. The transferability of polygenic scores derived from other populations is still a concern, with implications for the advancement of precision medicine and the potential of perpetuating health disparities, particularly in this underrepresented population.
Novel Controlled Metabolic Accelerator for Obesity-Related HFpEF
Authors: Ambarish Pandey, Gregory D. Lewis, Barry A. Borlaug, Sanjiv J. Shah, Andrew J. Sauer, Sheldon Litwin, Kavita Sharma, Diane K. Jorkasky, Elizabeth A. Tarka, Shaharyar M. Khan, Dalane W. Kitzman
Journal: JAMA Cardiology (2025)

Importance Excess body fat plays a pivotal role in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). HU6 is a novel, controlled metabolic accelerator that enhances mitochondrial uncoupling resulting in increased metabolism and fat-specific weight loss. Objective To assess efficacy and safety of HU6 in reducing body weight, improving peak volume of oxygen consumption (VO 2 ) and body composition among patients with obesity-related HFpEF. Design, Setting, and Participants The Exploratory Phase 2A, Double-Blind, Placebo-Controlled Dose Escalation Study of Safety, Tolerability, Pharmacodynamics, and Pharmacokinetics of HU6 for Subjects With Obese HFpEF (HuMAIN-HFpEF) trial was a multicenter, dose-escalation randomized clinical trial among patients with chronic stable HFpEF and obesity. Data were analyzed from July to October 2024. Intervention HU6 treatment for 19 weeks, starting at 150 mg per day and potentially up titrated to 450 mg per day based on safety and tolerability vs placebo. Main Outcomes and Measures The primary end point was change in body weight. Results Of 66 participants randomized (mean [SD] age, 64.5 [12] years; 38 female [58%]; mean [SD] weight, 110.9 [22.4] kg), 56 completed the trial. HU6 (vs placebo) significantly decreased weight (between-group difference, −2.86 kg; 95% CI, −4.68 to −1.04 kg; P = .003), total fat mass (between-group difference, −2.96 kg; 95% CI, −4.50 to −1.42 kg; P &amp;amp;lt; .001), and percentage visceral fat (between-group difference,−1.3%; 95% CI, −2.1 to −0.5%; P = .003), with no significant loss of muscle mass. There were no statistically significant changes in peak VO 2 , 6-minute walk distance, Kansas City Cardiomyopathy Questionnaire score, high-sensitivity C-reactive protein level, N-terminal pro–brain natriuretic peptide level, or diastolic function. Serious adverse events were noted in 5 participants (4 in the HU6 group; 1 in the placebo group), including 1 death, all judged unrelated to treatment. Conclusions and Relevance Among patients with obesity-related HFpEF, treatment with HU6 for 19 weeks led to modest but statistically significant weight loss without significant changes in peak VO 2 . Larger trials of longer duration are warranted to determine whether longer-term administration of HU6 can improve exercise function, quality of life, and cardiovascular outcomes in this increasingly common disorder. Trial Registration ClinicalTrials.gov Identifier: NCT05284617
Summative Assessment of Trainees—An Opportunity to Improve
Authors: Colleen E. McDermott, Ananya Anand, Tejas S. Sathe
Journal: JAMA Surgery (2025)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2025 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Why Are US Cervical Cancer Screening Exit Criteria Failing?
Authors: Rebecca B. Perkins, Sarah Feldman
Journal: JAMA Network Open (2025)

Shalini L. Kulasingam, PhD; Inge M. C. M. de Kok, PhD; Abhinav Mehta, MS; Erik E. L. Jansen, PhD; Mary Caroline Regan, MS; James W. Killen, BS; Stephen Sy, MS; Ran Zhao, PhD; Karen Canfell, DPhil; Jane J. Kim, PhD; Megan A. Smith, PhD; Nicole G. Campos, PhD
A Firm Pigmented Plaque on the Forearm of a Child
Authors: Ruba Srour, Zaaroura Hiba, Salih Mishlab
Journal: JAMA Dermatology (2025)

A 12-year-old boy was referred to the dermatology clinic with a nonprogressive hyperpigmented and indurated plaque on his right forearm for 5 years. What is your diagnosis?
Fluorescence, Lymph Nodes, and Minimal Invasiveness in Digestive Surgery
Authors: Mario Morino, Alberto Arezzo
Journal: JAMA Surgery (2025)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2025 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Food Insecurity and Incident Cardiovascular Disease Among Black and White US Individuals, 2000-2020
Authors: Jenny Jia, Mercedes R. Carnethon, Mandy Wong, Cora E. Lewis, Pamela J. Schreiner, Namratha R. Kandula
Journal: JAMA Cardiology (2025)

Importance Food insecurity is associated with prevalent cardiovascular disease (CVD), but studies have been limited to cross-sectional data. Objectives To study whether food insecurity is associated with incident CVD and to determine whether this association varies by sex, education, or race. Design, Setting, and Participants This prospective cohort study was conducted among US adults without preexisting CVD participating in the CARDIA (Coronary Artery Risk Development in Young Adults) study from 2000 to August 31, 2020. Data analysis was conducted from December 2022 to April 2024. Exposure Food insecurity, defined as endorsing limitations in household food variety and/or food quantity, assessed in the period 2000-2001. Main Outcomes and Measures The primary outcome was CVD events, consisting of fatal and nonfatal coronary heart disease, heart failure, stroke, transient ischemic attack, or peripheral arterial disease, identified annually through August 31, 2020. Results Of 3616 total participating adults, mean (SD) age was 40.1 (3.6) years, and 2027 participants (56%) were female. Of 3616 participants, 1696 (47%) self-reported Black race and 529 participants (15%) had food insecurity at baseline. Individuals with food insecurity were more likely to self-identify as Black and report lower educational attainment. The mean (SD) follow-up period was 18.8 (3.4) years, during which 255 CVD events occurred: 57 events (11%) in food-insecure participants and 198 events (6%) in food-secure participants over the study period. After adjusting for age, sex, and field center, food insecurity was associated with incident CVD (adjusted hazard ratio [aHR], 1.90; 95% CI, 1.41-2.56). The association persisted (aHR, 1.47; 95% CI, 1.08-2.01) after further adjustment for the socioeconomic factors of education, marital status, and usual source of medical care. Conclusions and Relevance In this prospective cohort study among participants in the CARDIA study, food insecurity was associated with incident CVD even after adjustment for socioeconomic factors, suggesting that food insecurity may be an important social deprivation measure in clinical assessment of CVD risk. Whether interventions to reduce food insecurity programs can potentially alleviate CVD should be further studied.
Characterizing Chronic Cutaneous Immune-Related Adverse Events Following Immune Checkpoint Inhibitors
Authors: Kylie A. Fletcher, Rachel S. Goodman, Aleigha Lawless, Rachel Woodford, Faisal Fa’ak, Asha Tipirneni, J. Randall Patrinely, Hui Ling Yeoh, Suthee Rapisuwon, Andrew Haydon, Iman Osman, Janice M. Mehnert, Georgina V. Long, Ryan J. Sullivan, Matteo S. Carlino, Alexander M. Menzies, Anna K. Dewan, Douglas B. Johnson
Journal: JAMA Dermatology (2025)

This cohort study describes the morphologic classification, histopathologic characteristics, treatments, and outcomes of chronic cutaneous immune-related adverse events occurring in adjuvant or metastatic setting.
Expectancy Effects, Failure of Blinding Integrity, and Placebo Response in Trials of Treatments for Psychiatric Disorders
Authors: Nathan T. M. Huneke, Guilherme Fusetto Veronesi, Matthew Garner, David S. Baldwin, Samuele Cortese
Journal: JAMA Psychiatry (2025)

Importance Expectancy effects are significant confounding factors in psychiatric randomized clinical trials (RCTs), potentially affecting the interpretation of study results. This narrative review is the first, to our knowledge, to explore the relationship between expectancy effects, compromised blinding integrity, and the effects of active treatment/placebo in psychiatric RCTs. Additionally, we present statistical and experimental approaches that may help mitigate the confounding impact of expectancy effects. The review concludes with recommendations to enhance the reliability of RCTs in psychiatry. Observations The placebo response comprises both specific and nonspecific elements, with expectation being a key specific component. Evidence from experimental and clinical studies suggests that expectancy can influence treatment responses in RCTs. Blinding integrity may be compromised by perceived treatment efficacy and adverse effects, introducing bias into outcome assessments. Treatment expectations can lead to unblinding during RCTs, and meta-analytic data from studies in the fields of psychedelics and anxiety disorders indicate that this can influence effect sizes. Therefore, controlling for expectancy effects is essential when interpreting RCT results. Novel statistical methods, though still in need of further validation, offer strategies to address this issue. Another approach may involve experimental medicine models, which aim to develop objective improvement markers (readouts) less affected by expectancy effects. Conclusions and Relevance Expectancy effects represent a significant confound in psychiatric RCTs. We recommend collecting data on treatment expectations alongside monitoring blinding integrity to more accurately interpret study results. Additionally, developing objective readouts that are less confounded by expectancy effects offers another promising avenue for mitigating these confounding influences in psychiatric RCTs.
Toward a “Therapeuticks of Poesy”
Authors: Rafael Campo
Journal: JAMA (2025)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2025 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Exercise-Induced Dyspnea in an Older Woman With a History of Coronary Artery Disease
Authors: Soundous M’Rabet, Jean-Christophe Eicher, Charles Guenancia
Journal: JAMA Cardiology (2025)

An older woman with a history of coronary artery disease presents with dyspnea upon exertion. A transthoracic echocardiogram reveals severe mitral regurgitation, and an electrocardiogram reveals sinus tachycardia with left bundle branch block. What would you do next?
Eladocagene Exuparvovec for Aromatic L-Amino Acid Decarboxylase Deficiency
Authors: Avanti Golikeri, Sojeong Yi, Lola Fashoyin-Aje
Journal: JAMA (2025)

This JAMA Insights discusses the US Food and Drug Administration approval of Kebilidi, eladocagene exuparvovec, for the treatment of aromatic L-amino acid decarboxylase deficiency in adult and pediatric patients.
Lipid Profiles After Changes in Alcohol Consumption Among Adults Undergoing Annual Checkups
Authors: Takahiro Suzuki, Sho Fukui, Tomohiro Shinozaki, Taku Asano, Toshiko Yoshida, Jiro Aoki, Atsushi Mizuno
Journal: JAMA Network Open (2025)

Importance Despite growing criticism of alcohol consumption due to its overall health risks, it remains unknown how changes in alcohol consumption, particularly cessation, affect lipid profiles outside of intense interventions. Objective To clarify the association of alcohol initiation and cessation with subsequent changes in low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Design, Setting, and Participants This cohort study included individuals undergoing annual checkups at a center for preventive medicine in Tokyo, Japan, from October 2012 to October 2022. Individuals treated with lipid-lowering medications were excluded. Data were analyzed from May to December 2024. Exposures Alcohol initiation (vs remaining abstainer) and cessation (vs continuing same alcohol intake) between 2 consecutive visits. One standard drink was equivalent to 10 g of pure ethanol. Main Outcomes and Measures Change in LDL-C and HDL-C levels between 2 consecutive visits. Results Among the 328 676 visits from 57 691 individuals (mean [SD] age, 46.8 [12.5] years; 30 576 female [53.0%]), the cohort for evaluating alcohol cessation comprised 49 898 visits among 25 144 participants (mean [SD] age, 49 [12.1] years; 12 334 female [49.1%]; mean [SD] LDL-C, 114.7 [28.4] mg/dL; mean [SD] HDL-C, 65.5 [16.4] mg/dL). Alcohol cessation was associated with changes in LDL-C of 1.10 mg/dL (95% CI, 0.76 to 1.45 mg/dL) among those discontinuing habits of fewer than 1.5 drinks/d, 3.71 mg/dL (95% CI, 2.71 to 4.71 mg/dL) for 1.5 to 3.0 drinks/d, and 6.53 mg/dL (95% CI, 5.14 to 7.91 mg/dL) for 3.0 or more drinks/d. Cessation was associated with a change in HDL-C of −1.25 mg/dL (95% CI, −1.41 to −1.09 mg/dL) among those discontinuing habits of fewer than 1.5 drinks/d, −3.35 mg/dL (−4.41 to −2.29 mg/dL) for 1.5 to 3.0 drinks/d, and −5.65 mg/dL (95% CI, −6.28 to −5.01 mg/dL) for 3.0 or more drinks/d. The cohort for evaluating alcohol initiation (107 880 visits; 29 042 participants) showed inverse dose-response associations. Conclusions and Relevance In this cohort study of Japanese annual health checkup participants, alcohol initiation was associated with modest cholesterol improvement, whereas cessation was associated with less favorable changes. After alcohol reduction, lipid profile changes should be carefully monitored to optimize cardiovascular disease risk management at both individual and population levels.
Risk Prediction Models for Sentinel Node Positivity in Melanoma
Authors: Bryan Ma, Maharshi Gandhi, Sonia Czyz, Jocelyn Jia, Brian Rankin, Selena Osman, Eva Lindell Jonsson, Lynne Robertson, Laurie Parsons, Claire Temple-Oberle
Journal: JAMA Dermatology (2025)

Importance There is a need to identify the best performing risk prediction model for sentinel lymph node biopsy (SLNB) positivity in melanoma. Objective To comprehensively review the characteristics and discriminative performance of existing risk prediction models for SLNB positivity in melanoma. Data Sources Embase and MEDLINE were searched from inception to May 1, 2024, for English language articles. Study Selection All studies that either developed or validated a risk prediction model (defined as any calculator that combined more than 1 variable to provide a patient estimate for probability of melanoma SLNB positivity) with a corresponding measure of model discrimination were considered for inclusion by 2 reviewers, with disagreements adjudicated by a third reviewer. Data Extraction and Synthesis Data were extracted in duplicate according to Data Extraction for Systematic Reviews of Prediction Modeling Studies, Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Effects were pooled using random-effects meta-analysis. Main Outcome and Measures The primary outcome was the mean pooled C statistic. Heterogeneity was assessed using the I 2 statistic. Results In total, 23 articles describing the development of 21 different risk prediction models for SLNB positivity, 20 external validations of 8 different risk prediction models, and 9 models that included sufficient information to obtain individualized patient risk estimates in routine preprocedural clinical practice were identified. Among all risk prediction models, the pooled weighted C statistic was 0.78 (95% CI, 0.74-0.81) with significant heterogeneity ( I 2 = 97.4%) that was not explained in meta-regression. The Memorial Sloan Kettering Cancer Center and Melanoma Institute of Australia models were most frequently externally validated with both having strong and comparable discriminative performance (pooled weighted C statistic, 0.73; 95% CI, 0.69-0.78 vs pooled weighted C statistic, 0.70; 95% CI, 0.66-0.74). Discrimination was not significantly different between models that included gene expression profiles (pooled C statistic, 0.83; 95% CI, 0.76-0.90) and those that only used clinicopathologic features (pooled C statistic, 0.77; 95% CI, 0.73-0.81) ( P = .11). Conclusions and Relevance This systematic review and meta-analysis found several risk prediction models that have been externally validated with strong discriminative performance. Further research is needed to evaluate the associations of their implementation with preprocedural care.