tbuckley/cabot-search huggingface dataset:
Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl
Authors: Leslie W. Suen, Amy Y. Chiang, Benjamin L. H. Jones, Christine S. Soran, Michelle Geier, Hannah R. Snyder, John Neuhaus, Janet J. Myers, Kelly R. Knight, Alexander R. Bazazi, Phillip O. Coffin
Journal: JAMA Network Open (2025)

Importance The rise of high-potency opioids such as fentanyl makes buprenorphine initiation challenging due to the risks of precipitated withdrawal, prompting the exploration of strategies, such as low-dose initiation (LDI) of buprenorphine. However, no comparative studies on LDI outcomes exist. Objective To evaluate outpatient outcomes associated with 2 LDI protocols of buprenorphine among individuals with opioid use disorder (OUD) using fentanyl. Design, Setting, and Participants This cohort study analyzed data on adults with OUD who self-reported daily fentanyl use and underwent buprenorphine initiation using LDI. Data were extracted from the electronic health records of 2 substance use disorder treatment clinics using a specialty behavioral health pharmacy in San Francisco, California, from May 2021 to November 2022. Exposures Type of LDI protocol selected by individuals: 4-day or 7-day protocol. Main Outcomes and Measures The primary outcome was successful buprenorphine initiation, defined as self-reported LDI completion and pickup of a refill maintenance prescription, and buprenorphine retention. Logistic regression with generalized estimating equations assessed associations between LDI protocol (4-day vs 7-day) and successful initiation, adjusting for multiple attempts, age, gender identity, race and ethnicity, and housing status. Kaplan-Meier survival curves were used to estimate buprenorphine retention, and survival curves were adjusted using a fitted Cox proportional hazards regression model. Results A total of 126 individuals (median [IQR] age, 35 [29-44] years; 90 identified as men [71%]; 26 [21%] identified as Black or African American, 20 [16%] as Latine, and 66 [52%] as White individuals) with 175 initiation attempts were included. Across attempts, 72 (41%) had a 4-day LDI protocol and 103 (59%) had a 7-day protocol. Initiation was successful in 60 attempts (34%), including 27 (38%) among 4-day protocol and 29 (28%) among 7-day protocol attempts. Buprenorphine retention rate at 28 days was 21% for a 4-day protocol and 18% for a 7-day protocol. Logistic regression found no significant differences between LDI protocols and successful initiation, while repeated LDI attempts had lower odds of success (second attempt: adjusted odds ratio [AOR], 0.30 [95% CI, 0.14-0.66]; third or more attempt: AOR, 0.22 [95% CI, 0.09-0.53]). Unadjusted and adjusted survival models did not detect a significant difference in retention between LDI protocol types. Conclusions and Relevance This cohort study found that among people with OUD using fentanyl and attempting outpatient LDI of buprenorphine, successful buprenorphine initiation and retention rates were low. Future studies should examine interventions to improve LDI success and increase buprenorphine uptake and retention.
Risk Factors for Developmental Dysplasia of the Hip Before 3 Months of Age
Authors: Maria Tirta, Ole Rahbek, Søren Kold, Hans-Christen Husum
Journal: JAMA Network Open (2025)

Importance Two meta-analyses published in 2012 found breech presentation, family history of developmental dysplasia of the hip (DDH), female sex, and primiparity to increase the risk of DDH. However, the DDH definition, reference tests, and the age of the examined children varied considerably, complicating the translation of those findings to current screening guidelines. Objective To evaluate the association of previously proposed risk factors with the risk of sonography-verified DDH. Data Sources A literature search strategy used MeSH (Medical Subject Heading) terms and text words associated with DDH and prognostic studies or risk factors. PubMed, Embase, and the Cochrane Library were searched on November 23, 2023, to identify the cohort. Study Selection Criteria included articles that were in English and published from January 1, 1980, to November 23, 2023. Eligible studies included randomized clinical trials and cohort, case-control, and cross-sectional studies that involved participants younger than 3 months in whom a diagnosis of DDH was made by hip ultrasonography using the criterion standard Graf method, reported information on 1 or more of the proposed risk factors, and reported the final diagnosis. Data Extraction and Synthesis Collected variables included an evaluated risk factor, the number of infants with a risk factor, the number of infants without risk factors, and the number of infants with and without DDH in the at-risk group and in the no-risk group. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Main Outcomes and Measures The main outcome measures were risk of DDH (using odds ratios [ORs]) for each of the risk factors. Results Of 5363 studies screened, 20 studies comprising 64 543 infants were included. Breech presentation (OR, 4.15 [95% CI, 2.62-6.57]), family history of DDH (OR, 3.83 [95% CI, 2.05-7.15]), female sex (OR, 2.50 [95% CI, 1.74-3.59]), oligohydramnios (OR, 3.76 [95% CI, 1.66-8.53]), and high birth weight (OR, 2.00 [95% CI, 1.60-2.49]) were associated with a significant increased risk of DDH. Cesarean delivery, primiparity, multiple births, low birth weight, and prematurity were not associated with DDH risk. Heterogeneity was high ( I 2 &amp;amp;gt; 70.00%) in all of the tested factors except high birth weight ( I 2 = 0%). The subgroup analysis was performed to investigate these heterogeneities. Conclusions and Relevance The findings of this meta-analysis suggest that family history and breech presentation were associated with a significant increase in the risk of sonography-verified DDH in infants younger than 3 months, and a DDH risk increase of female sex was found to be lower than previously reported. A risk increase was detected for oligohydramnios, which has not been included in many screening programs and might also be considered as a referral criterion for hip ultrasonography.
City-Level Sugar-Sweetened Beverage Taxes and Changes in Adult Body Mass Index
Authors: Emily F. Liu, Deborah R. Young, Margo A. Sidell, Catherine Lee, Deborah A. Cohen, Lee J. Barton, Jennifer Falbe, Galina Inzhakova, Sneha Sridhar, Allison C. Voorhees, Bing Han, Monique M. Hedderson
Journal: JAMA Network Open (2025)

Importance Sugar-sweetened beverage (SSB) excise taxes are popular policy interventions aimed at decreasing SSB purchasing and consumption to improve cardiometabolic health and generate revenue for public health initiatives. There is limited evidence that these taxes in the US are associated with weight-related outcomes in adults, a primary contributor to cardiometabolic health. Objective To determine the association between SSB excise taxes and adult body mass index (BMI) and proportion of adults with overweight or obesity among California cities and assess whether associations vary by demographic characteristics. Design, Setting, and Participants This cohort study compared California cities with SSB taxes (Albany, Berkeley, Oakland, and San Francisco) and demographically matched cities without SSB excise taxes from 6 years before the tax and 4 to 6 years after the tax from January 2009 through December 2020 using electronic health record data. Participants were Kaiser Permanente (KP) members aged 20 to 65 years at cohort entry with at least 1 pretax and 1 posttax BMI measurement. Data were analyzed from January 2021 to May 2023. Exposure Implementation of city-level SSB excise taxes. Main outcomes and measures Mean BMI and proportion of adults with overweight or obesity. Analysis used the differences-in-differences (DID) method. Results The cohort had a total of 1 044 272 members (178 931 participants in 4 cities with excise taxes; mean [SD] age, 39.7 [11.2] years; 99 501 [55.6%] female; 865 343 participants in 40 control cities without excise taxes; mean [SD] age, 39.9 [11.6] years; 480 155 [55.5%] female). DID estimates for mean BMI showed a modest decrease among adults aged 20 to 39 years (20-25 years: −0.30; 95% CI, −0.51 to −0.08; 26-39 years: −0.19; 95% CI, −0.37 to −0.20), female participants (−0.19; 95% CI, −0.26 to −0.11), and White participants (−0.19; 95% CI, −0.35 to −0.04) living in cities with SSB excise taxes. There was a statistically significant reduction in mean BMI in Berkeley (−0.16; 95% CI, −0.27 to −0.04). There were no overall differences in BMI or proportion with overweight or obesity. Conclusions and relevance In this cohort study, SSB excise taxes were associated with reduced mean BMI among adults in demographic subgroups, including in young adults who consumed the most SSBs, and in Berkeley. Future research should examine the mechanisms of these associations to inform how SSB taxes could be more equitable for weight-related outcomes.
Duration in Immigration Detention and Health Harms
Authors: Altaf Saadi, Caitlin Patler, Paola Langer
Journal: JAMA Network Open (2025)

Importance Length of custody is a mechanism by which carceral systems can worsen health. However, there are fewer studies examining US immigration detention, in large part because US immigration detention is largely privately operated and opaque by design. Objectives To examine the association between duration spent in US immigration detention with subsequent health outcomes. Design, Setting, and Participants This cross-sectional study used a referral sample of recently detained immigrants who were released from Immigrations and Customs Enforcement (ICE) under a series of court orders in 2020 and 2021. Data were analyzed from June 2023 to October 2024. Exposure Detention duration less than 6 months vs 6 months or longer. Main Outcomes and Measures We used multivariable regression analysis to assess the association of detention duration and several variables: (1) self-rated health, (2) mental illness (Kessler 6-item psychological distress scale), and (3) posttraumatic stress disorder (PTSD) (Primary Care-PTSD-5 Screen). We then calculated the likelihood of experiencing each outcome, controlling for covariates. As a robustness check, we conducted sensitivity analyses with detention duration as a continuous measure. Results The study included 200 respondents (mean [SD] age, 40.3 [10.1] years; 175 male [87.5%]; 149 Hispanic or Latino ethnicity [74.5%]). Results revealed a high prevalence of poor self-rated health, mental illness, and PTSD for all respondents, but especially among those who had been detained for 6 months or longer, who had significantly higher likelihood of poor or fair self-rated health (49.1% [95% CI, 40.5%-57.6%] vs 30.4% [95% CI, 21.8%-39.1%]; P &amp;amp;lt; .001), mental illness (37.0% [95% CI, 28.2%-45.8%] vs 20.7% [95% CI, 12.6%-28.7%]; P &amp;amp;lt; .001), and PTSD (59.3% [95% CI, 50.3%-68.3%] vs 34.8% [95% CI, 25.3%-44.3%]; P &amp;amp;lt; .001). Sensitivity analysis confirmed the general robustness of these findings, with longer detention duration significantly associated with mental illness (OR, 1.11 [95% CI, 1.02-1.20]; P = .01) and PTSD (OR, 1.11 [95% CI, 1.03-1.20]; P = .005) in our adjusted models. Conclusions and Relevance In this cross-sectional study, detained immigrants experienced a high prevalence of poor health, mental illness, and PTSD, with detention periods of 6 months or more associated with higher rates compared with those detained less than 6 months. Duration of custody is one mechanism by which immigration detention might be a catalyst for worsening health.
FDA Approves Tirzepatide as First Drug for Obstructive Sleep Apnea
Authors: Samantha Anderer
Journal: JAMA (2025)

The US Food and Drug Administration (FDA) recently approved tirzepatide, marketed as Zepbound, for moderate to severe obstructive sleep apnea (OSA) in adults with obesity, making it the first sleep apnea drug, according to an agency press release.
Follow-Up Analysis Enhances Understanding of Molecular Residual Disease in Localized Non-Small Cell Lung Cancer
Authors: Jia-Tao Zhang, Si-Yang Liu, Xuan Gao, Si-Yang Maggie. Liu, Bingfa Yan, Chen Huang, Zicong Jiao, Hong-Hong Yan, Yi Pan, Song Dong, Wei Gao, Yuhua Gong, Hai-Yan Tu, Xue-Feng Xia, Qing Zhou, Wen-Zhao Zhong, Xue-Ning Yang, Xin Yi, Yi-Long Wu
Journal: Clinical Cancer Research (2025)

Abstract Purpose: The prognostic value of molecular residual disease (MRD) in non-small cell lung cancer (NSCLC) is well-established, with treatment-guiding results anticipated. Here, we present updated analyses from our previous published cohort study of 261 NSCLC patients undergoing complete resection. Experimental Design: 261 patients with stage I-III lung cancer who underwent radical surgery were enrolled. Enrolled patients underwent follow-up blood draws according to the predefined time points after surgery. As of December 31st, 2023, with a median follow-up of 43.4 months, 948 postoperative blood samples were collected. Results: Landmark and longitudinal MRD exhibited positive predictive values of 91.3% and 92.8%, respectively, with a median lead times of 5.2 months. Negative predictive values were 76.5% and 93.2%, respectively. Patients with landmark undetectable MRD could not be benefited from adjuvant therapy through the updated follow-up (p=0.529). Among the 13 patients with recurrent NSCLC and longitudinal undetectable MRD, seven (53.8%) had brain-only metastases, and four (30.8%) had no updated blood samples for over six months prior to recurrence. Besides, for those with longitudinal detectable MRD, higher maximum variant allele frequency (&amp;gt;0.55%) and ctDNA level (&amp;gt;13 hGE/ml) were associated with a high risk of short-term recurrence. Additionally, updated follow-up data further support the peak time for detectable MRD was 18 months after landmark detection. Conclusions: These findings suggest the significant potential of MRD in guiding personalized treatment for NSCLC. And postoperative longitudinal undetectable MRD can indicate a cured population.
Accumulation of CD38 in Hybrid Epithelial/Mesenchymal Cells Promotes Immune Remodeling and Metastasis in Breast Cancer
Authors: Tanvi H. Visal, Recep Bayraktar, Petra den Hollander, Michael A. Attathikhun, Tieling Zhou, Jing Wang, Li Shen, Corina-Elena Minciuna, Meng Chen, Elizve Barrientos-Toro, Harsh Batra, Maria Gabriela Raso, Fei Yang, Edwin R. Parra, Aysegul A. Sahin, George A. Calin, Sendurai A. Mani
Journal: Cancer Research (2025)

Abstract Triple-negative breast cancer (TNBC) is a highly metastatic subtype of breast cancer. The epithelial-to-mesenchymal transition is a nonbinary process in the metastatic cascade that generates tumor cells with both epithelial and mesenchymal traits known as hybrid EM cells. Recent studies have elucidated the enhanced metastatic potential of cancers featuring the hybrid EM phenotype, highlighting the need to uncover molecular drivers and targetable vulnerabilities of the hybrid EM state. Here, we discovered that hybrid EM breast tumors are enriched in CD38, an immunosuppressive molecule associated with worse clinical outcomes in liquid malignancies. Altering CD38 expression in tumor cell impacted migratory, invasive, and metastatic capabilities of hybrid EM cells. Abrogation of CD38 expression stimulated an antitumor immune response, thereby preventing the generation of an immunosuppressive microenvironment in hybrid EM tumors. CD38 levels positively correlated with PD-L1 expression in samples from patients with TNBC. Moreover, targeting CD38 potentiated the activity of anti–PD-L1, eliciting strong antitumor immunity, with reduced tumor growth in hybrid EM models. Overall, this research exposes upregulation of CD38 as a specific survival strategy utilized by hybrid EM breast tumors to suppress immune cell activity and sustain metastasis, with strong implications in other carcinomas that have hybrid EM properties. Significance: Hybrid cells co-featuring epithelial and mesenchymal traits in triple-negative breast cancer express elevated levels of CD38 to induce immunosuppression and metastasis, indicating CD38 inhibition as potential strategy for treating breast cancer.
Ambient Toxic Air Contaminants in the Maternal Residential Area during Pregnancy and Cerebral Palsy in the Offspring
Authors: Haoran Zhuo, Beate Ritz, Joshua L. Warren, Krystal Godri Pollitt, Zeyan Liew
Journal: Environmental Health Perspectives (2025)

Cerebral palsy (CP) is the most common permanent neuromotor disorder diagnosed in childhood. Although most cases have unknown etiology, emerging evidence suggests environmental risk factors of CP. We investigated whether ambient toxic air contaminants (TACs) in the maternal residential area during pregnancy, specifically volatile organic compounds (VOCs) and metals, were associated with offspring CP risk in California. We conducted a case-cohort study that included CP cases (N=906) and a 20% random sample of all live singleton births (N=184,954) who lived within a 5-mile (8-km) radius of air toxics monitoring stations in California during 2005-2015 as the control comparison group. CP cases were ascertained from diagnostic records of the California Department of Developmental Services. We a priori selected TACs with suspected neurotoxicity and developmental toxicity, including 14 VOCs and 6 metals. We estimated the adjusted risk ratio (RR) and 95% confidence interval (CI) for CP and the average maternal residential exposures to each TAC over the entire pregnancy using modified Poisson regression. For air contaminant mixtures, we used quantile-based g-computation to estimate the effects of mixtures of VOCs or metals. Finally, we performed a negative control exposure analysis on exposure estimates of 36-48 months after delivery to evaluate uncontrolled confounding bias. Maternal residential exposures to six VOCs (benzene, toluene, 1,3-butadiene, acetone, acetonitrile, and methylene chloride) and four metals (antimony, lead, nickel, and vanadium) were associated with 3%-25% higher risk of CP per interquartile range increase, and the estimated mixture effects of VOCs (RR=1.24; 95% CI: 1.08, 1.43) or metals (RR=1.38; 95% CI: 1.20, 1.58) were stronger. The observed associations were close to null for negative control exposures (36-48 months after delivery) to mixtures of VOCs or metals and CP. In California, maternal prenatal residential exposure to VOCs and metals in the outdoor air, largely attributed to mobile traffic emission sources, was associated with an increased risk of CP in offspring. https://doi.org/10.1289/EHP14742.
High PSMA Avidity, Yet Still Benign
Authors: Ryan Reddy, Gary A. Ulaner
Journal: Clinical Nuclear Medicine (2025)

Abstract A 64-year-old man with newly diagnosed prostate cancer underwent 18 F-Piflufolastat PET/CT. Radiotracer avidity localized to the primary prostate malignancy and to a left rib (SUV max , 9.0). The high 18 F-Piflufolastat avidity may have been mistaken for a metastasis if not for the corresponding CT images demonstrating a well-circumscribed sclerotic rim at the site of the PET focus. This CT finding is uncommon for osseous malignancy, but common in benign fibrous dysplasia. Biopsy confirmed benign fibrous dysplasia. This case emphasizes that benign CT morphology may supersede even high avidity on PSMA-targeted PET imaging. Physicians interpreting PET/CT must recognize CT findings that supersede PET findings.
A Rare Case of Peritoneal Mesothelioma Detected by 18F-AlF-NOTA-Octreotide PET/CT
Authors: Guozhu Hou, Xin Cheng, Yuanyuan Jiang, Rong Zheng, Xuejuan Wang
Journal: Clinical Nuclear Medicine (2025)

Abstract We present a case of 37-year-old man with multiple masses in the abdominal and pelvic cavity who underwent 18 F-AlF-NOTA-octreotide PET/CT. The masses demonstrated heterogeneously increased uptake on 18 F-AlF-NOTA-octreotide PET/CT and were suggestive of neuroendocrine tumor. However, the histopathological examinations confirmed the masses to be peritoneal mesothelioma. This case indicated that peritoneal mesothelioma should be kept in mind as one of the differential diagnoses for 18 F-AlF-NOTA-octreotide-avid tumors.
Incense Use and the Risk of Chronic Limb-Threatening Ischemia Among Middle-Aged and Older Adults in the Singapore Chinese Health Study
Authors: Ariel Fangting Ying, Derek John Hausenloy, Woon-Puay Koh
Journal: Environmental Health Perspectives (2025)

Epidemiologic studies have shown that daily exposure to incense smoke is associated with greater risk of cardiovascular mortality, which suggests that chronic exposure to incense could be linked to atherosclerosis. We studied the association between home incense use and the risk of chronic limb-threatening ischemia (CLTI), the most severe outcome of peripheral arterial disease. We used data from the Singapore Chinese Health Study, which recruited 63,257 Chinese participants 45-74 years old from 1993-1998. Data were collected via in-person interviews conducted at the participants' homes by trained interviewers. Linkage to the nationwide hospital discharge database was used to determine incident cases, defined as participants who underwent revascularization or lower extremity amputation for CLTI. Association between use of incense and risk of CLTI was examined using multivariable Cox proportional hazards regression models, adjusted for demographics and cardiovascular risk factors. In this cohort, 76.9% were current users of incense at recruitment, and 92.6% of those used incense daily at home. During a mean 18.8 years of follow-up, 1,097 participants developed CLTI. Compared to never or former users, current users had a 22% higher risk of CLTI [hazard ratio (HR)=1.22; 95% confidence interval (CI): 1.04, 1.43]. The risk was greater with chronicity of use, and the HR was highest and statistically significant in participants who had used incense daily for >40 years [HR=1.25 (95% CI: 1.06, 1.46)]. The results did not differ by sex, history of diabetes, or smoking status. Daily exposure to incense in the home environment for more than 40 years was associated with a greater risk of developing CLTI. https://doi.org/10.1289/EHP14674.
RNase T2 restricts TLR13-mediated autoinflammation in vivo
Authors: Carlos Gomez-Diaz, Wilhelm Greulich, Benedikt Wefers, Meiyue Wang, Silvia Bolsega, Maike Effern, Daniel P. Varga, Zhe Han, Minyi Chen, Marleen Bérouti, Natascia Leonardi, Ulrike Schillinger, Bernhard Holzmann, Arthur Liesz, Axel Roers, Michael Hölzel, Marijana Basic, Wolfgang Wurst, Veit Hornung
Journal: The Journal of Experimental Medicine (2025)

RNA-sensing TLRs are strategically positioned in the endolysosome to detect incoming nonself RNA. RNase T2 plays a critical role in processing long, structured RNA into short oligoribonucleotides that engage TLR7 or TLR8. In addition to its positive regulatory role, RNase T2 also restricts RNA recognition through unknown mechanisms, as patients deficient in RNase T2 suffer from neuroinflammation. Consistent with this, mice lacking RNase T2 exhibit interferon-dependent neuroinflammation, impaired hematopoiesis, and splenomegaly. However, the mechanism by which RNase T2 deficiency unleashes inflammation in vivo remains unknown. Here, we report that the inflammatory phenotype found in Rnaset2−/− mice is completely reversed in the absence of TLR13, suggesting aberrant accumulation of an RNA ligand for this receptor. Interestingly, this TLR13-driven inflammatory phenotype is also fully present in germ-free mice, suggesting a role for RNase T2 in limiting erroneous TLR13 activation by an as yet unidentified endogenous ligand. These results establish TLR13 as a potential self-sensor that is kept in check by RNase T2.