tbuckley/cabot-search huggingface dataset:
Respiratory Syncytial Virus and US Pediatric Intensive Care Utilization
Authors: Alice Shanklin, Taylor Olson, Anita K. Patel, Eduardo A. Trujillo Rivera, Murray M. Pollack
Journal: JAMA Network Open (2024)

Importance Bronchiolitis is the most common diagnosis necessitating respiratory support and pediatric intensive care, and respiratory syncytial virus (RSV) is the most common cause of bronchiolitis. In 2023, the monoclonal antibody nirsevimab and the maternal RSVpreF vaccine were implemented to prevent RSV in infants. Objective To determine the potential association of novel RSV prevention strategies with pediatric intensive care unit (ICU) utilization. Design, Setting, and Participants This retrospective cross-sectional study examined US pediatric ICU encounters with and without RSV from January 1, 2017, to June 1, 2023. Data were from Oracle Cerner RealWorld Data, a national electronic health record database. All children (aged &amp;amp;gt;1 day and &amp;amp;lt;18 years) admitted to an ICU during the study period were included in the analysis. Statistical analysis was performed from February to May 2024. Main Outcomes and Measures The primary outcomes were ICU encounters with RSV and ICU encounters with RSV eligible for RSV prevention. Results There were 119 782 ICU encounters from 53 hospitals; 65 757 encounters (54.9%) were male; median (IQR) age was 4.5 (1.1-12.5) years, median (IQR) ICU length of stay was 1.8 (1.0-3.9) days; 13 702 ICU encounters (11.4%) had RSV, of which 38.6% (5217) were eligible for prevention (4.4% of total ICU encounters). Encounters with RSV accounted for 21.1% (109 334) of ICU days, of which 43.8% (47 888) were eligible for prevention (9.2% of total ICU days). Encounters with RSV were associated with a greater use of positive pressure ventilation (4074 [29.7%] vs 18 821 [17.7%]; P &amp;amp;lt; .001) and vasoactive medications (3057 [22.3%] vs 18 570 [17.5%]; P &amp;amp;lt; .001) compared with those without RSV. Conclusions and Relevance The findings of this retrospective cross-sectional study of RSV and US pediatric intensive care utilization suggest that if 65% to 85% of eligible children received RSV prevention, an estimated 2.1% to 2.8% reduction in pediatric ICU encounters and an estimated 4.5% to 5.9% reduction in pediatric ICU days could be achieved.
Ambulatory Follow-Up Visits After Emergency Department Discharge Among Medicaid Beneficiaries
Authors: Michelle P. Lin, Canada Parrish, Laura G. Burke, Ryan C. Burke, Amber Sabbatini
Journal: JAMA Network Open (2024)

This cohort study examines Medicaid beneficiary visits to emergency departments (EDs) in Washington state from 2009 to 2017 to investigate the association between time to follow-up visit and 30-day ED revisits.
Social Media and Suicide Risk in Youth
Authors: Lisa H. Jaycox, Eric R. Murphy, Julia L. Zehr, Jane L. Pearson, Shelli Avenevoli
Journal: JAMA Network Open (2024)

Importance Youth, parents, educators, and policymakers are concerned about the potential relationship between social media use and negative mental health outcomes, including risk for suicidal thoughts and behaviors. Observations Current research shows complex and conflicting relationships between social media use and suicide risk. A key limiting factor in clarifying these relationships is a dearth of available information on contextual factors around social media use, with most research focusing only on hours or amount of engagement. Whereas there are clear associations between some types of social media use and suicide risk, there are also many opportunities to mitigate suicide risk through social media. Several methodologic and measurement issues make research challenging. Researchers have only begun to explore how specific risk factors interact with individual vulnerabilities, how social media can be used to enhance youth well-being, and whether and under what circumstances mitigation strategies can be helpful. Conclusions and Relevance This overview identifies research gaps and methodological challenges that need to be addressed to guide intervention strategies and future policy relevant to youth and suicide risk.
Metabolic Bariatric Surgery in the Era of GLP-1 Receptor Agonists for Obesity Management
Authors: Kevin Lin, Ateev Mehrotra, Thomas C. Tsai
Journal: JAMA Network Open (2024)

This cross-sectional study investigates rates of bariatric surgery and glucagon-like peptide-1 receptor agonist prescription among adults with obesity in 2022 to 2023.
Eligible Infants Included in Neonatal Clinical Trials and Reasons for Noninclusion
Authors: Henna Shaikh, Allison N. J. Lyle, Ellie Oslin, Megan M. Gray, Elliott Mark Weiss
Journal: JAMA Network Open (2024)

Importance Results of clinical trials can only represent included participants, and many neonatal trials fail due to insufficient participation. Infants not included in research may differ from those included in meaningful ways, biasing the sample and limiting the generalizability of findings. Objective To describe the proportion of eligible infants included in neonatal clinical trials and the reasons for noninclusion. Evidence Review A systematic search of Cochrane CENTRAL was performed by retrieving articles meeting the following inclusion criteria: full-length, peer-reviewed articles describing clinical trial results in at least 20 human infants from US neonatal intensive care units, published in English, and added to Cochrane CENTRAL between 2017 and 2022. Retrieved articles were screened for inclusion by 2 independent researchers. Findings In total 120 articles met inclusion criteria and 91 of these (75.8%) reported the number of infants eligible for participation, which totaled 26 854 in aggregate. Drawing from these, an aggregate of 11 924 eligible infants (44.4%) were included in reported results. Among all eligible infants, most reasons for noninclusion in results were classified as modifiable or potentially modifiable by the research team. Parents declining to participate (8004 infants [29.8%]) or never being approached (2507 infants [9.3%]) were the 2 predominant reasons for noninclusion. Other modifiable reasons included factors related to study logistics, such as failure to appropriately collect data on enrolled infants (859 of 26 854 infants [3.2%]) and other reasons (1907 of 26 854 infants [7.1%]), such as loss to follow-up or eligible participants that were unaccounted for. Nonmodifiable reasons, including clinical change or death, accounted for a small proportion of eligible infants who were not included (858 of 26 854 infants [3.2%]). Conclusions and Relevance This systematic review of reporting on eligible infants included and not included in neonatal clinical trials highlights the need for improved documentation on the flow of eligible infants through neonatal clinical trials and may also inform recruitment expectations for trialists designing future protocols. Improved adherence to standardized reporting may clarify which potential participants are being missed, improving understanding of the generalizability of research findings. Furthermore, these findings suggest that future work to understand why parents decline to participate in neonatal research trials and why some are never approached about research may help increase overall participation.
Hospitalization for COVID-19, Other Respiratory Infections, and Postacute Patient-Reported Symptoms
Authors: Yaqing Gao, Yunhe Wang, Li Chen, Junqing Xie, Daniel Prieto-Alhambra
Journal: JAMA Network Open (2024)

This cohort study examines patient-reported, multisystem, postacute symptoms among individuals hospitalized with COVID-19 or other lower respiratory tract infections vs those without such hospitalizations during the same period.
Prevalence of HCV Infection Among People Experiencing Homelessness in Madrid, Spain
Authors: Pablo Ryan, Jorge Valencia, Daniel Sepúlveda-Crespo, Rafael Amigot-Sánchez, Guillermo Cuevas, Jeffrey V. Lazarus, Felipe Pérez-García, Isidoro Martínez, Salvador Resino
Journal: JAMA Network Open (2024)

Importance Hepatitis C virus (HCV) microelimination aims to detect and treat hidden infections, especially in at-risk groups, like people experiencing homelessness (PEH) with alcohol or drug use disorders. Point-of-care HCV RNA testing and peer support workers are crucial for identifying and preventing HCV infection among marginalized populations, contributing to overall elimination goals. Objective To assess risk factors, prevalence, and trends of active HCV infection among PEH in Madrid, Spain (2019-2023). Design, Setting, and Participants This cross-sectional study was conducted between 2019 and 2023 in PEH, defined as people who lacked a fixed, regular, and adequate night residence, screened on the street or in homeless shelters via mobile unit using rapid HCV antibody testing, followed by HCV-RNA testing in Madrid, Spain. Data were analyzed from January to June 2024. Main Outcomes and Measures Active HCV infection among PEH was the main outcome. Risk factors analyzed included being born outside of Spain, alcohol misuse, lacking financial income, benzodiazepine use, injection drug use (IDU; including nonactive IDU and active IDU within the last year), opioid substitution therapy participation, and sexual behavior patterns. Data were analyzed using logistic regression. P values were adjusted for multiple testing using the false discovery rate ( q -values). Results A total of 4741 individuals were screened for HCV infection, of whom 2709 (mean [SD] age, 42.2 [12.7]; 1953 [72.2%] men) were PEH and included in analysis. A total of 363 PEH (13.4%) had test results positive for HCV antibodies, of whom 172 (47.4%) had test results positive for HCV-RNA, and 148 of these (91.9%) started HCV treatment. Overall, active HCV infection prevalence was 6.3%, and the main risk factors associated with active HCV infection included IDU, encompassing both nonactive IDU (adjusted odds ratio [aOR], 10.9; 95% CI, 6.1-19.4; q &amp;amp;lt; .001) and active IDU in the last year (aOR, 27.0; 95% CI, 15.2-48.0; q &amp;amp;lt; .001); a lack of financial income (aOR, 1.8; 95% CI, 1.1-2.9; q = .03); and alcohol misuse (aOR, 1.8; 95% CI, 1.3-2.6; q = .008). There was a significant decrease between 2019 and 2023 in active HCV infection prevalence across the entire population, from 7.2% to 3.4% ( P = .04). Conclusions and Relevance In this cross-sectional study of PEH in Madrid, IDU, lack of income, and alcohol misuse were primary risk factors associated with HCV infection. The significant decline in HCV rates observed across all risk groups during the study period suggests preventive policies were effective in reducing HCV prevalence among the homeless population.
Psychosocial Well-Being at the Time of Trauma Exposure and Risk of PTSD
Authors: Dawne Vogt, Shelby Borowski, Shaina A. Kumar, Lewina O. Lee, Paula P. Schnurr
Journal: JAMA Network Open (2024)

This cohort study examines whether 3 well-being domains—vocational, financial, and social—are associated with the risk of developing subsequent posttraumatic stress disorder (PTSD) after a traumatic event.
Improvement in Palmoplantar Keratoderma–Congenital Alopecia Type 2 Treated with Topical Simvastatin-Cholesterol Ointment
Authors: Fang Yang, Wanting Luo, Huijun Wang, Qian Li, Shuanghai Hu, Zhimiao Lin
Journal: British Journal of Dermatology (2024)

We report the successful treatment of two patients with palmoplantar keratoderma-congenital alopecia type 2 (PPKCA2) using topical compound ointment containing 2% simvastatin and 2% cholesterol.
Aberrant BCAT1 expression augments MTOR activity and accelerates disease progression in chronic lymphocytic leukemia
Authors: Qiangqiang Shao, Jedrzej Wykretowicz, Nan Hu, Karan Bedi, Mohamed Rizk, Isabella A Malek, Surinder Kumar, David B Lombard, Kerby Shedden, David Scott, Sami N Malek
Journal: Leukemia (2024)

We performed gene expression profiling of mRNA/cDNA isolated from N = 117 flow sorted CLL. We detected aberrant expression of the metabolic enzyme branched chain amino acid transferase (BCAT1) in CLL with del17p/TP53mut. Through extensive validation, we confirmed the highly preferential expression of BCAT1 in CLL with del17p/TP53mut (66%) or trisomy 12 (77%). BCAT1 was not expressed in B cells isolated from normal human lymph nodes. The products of the bidirectional BCAT1 reaction, including leucine, acetyl-CoA, and alpha-ketoglutarate are known activators of MTOR. We measured an ~two-fold higher MTOR activity via normalized p-S6K levels in primary CLL with BCAT1 high versus absent expression before and after sIgM crosslinking. Through steady state metabolomics and heavy isotope metabolic tracing in primary CLL cells, we demonstrate that CLL cells are avid consumers of branched chain amino acids (BCAAs) and that BCAT1 in CLL engages in bidirectional substrate reactions. Of additional interest, CLL with aberrant BCAT1 expression were less sensitive to Venetoclax-induced apoptosis. Biologically, three CLL-derived cell lines with disruption of BCAT1 had substantially reduced growth ex vivo. Clinically, the expression of any detectable BCAT1 protein in CLL independently associated with shorter median survival (125 months versus 296 months; p < 0.0001), even after exclusion of del17p/TP53mut cases.
Leveraging CRISPR gene editing technology to optimize the efficacy, safety and accessibility of CAR T-cell therapy
Authors: Tao Lei, Yazhuo Wang, Yuchen Zhang, Yufei Yang, Jiaying Cao, Jiansong Huang, Jiali Chen, Huajing Chen, Jiayi Zhang, Luzheng Wang, Xinjie Xu, Robert Peter Gale, Liang Wang
Journal: Leukemia (2024)
In Vitro Simulation of Hemodialysis Reveals Hemodialysis-Associated Pro-arrhythmic Effects in a Human Cardiomyocyte Model
Authors: Thomas Körtl, Niklas Hankowitz, Laura Stengel, Oliver Pfeuffer, Dominic Riedl, Frank Schweda, Katrin Streckfuß-Bömeke, Samuel Sossalla
Journal: Journal of the American Society of Nephrology (2024)
Relationship of Plasma Apolipoprotein C-I Truncation With Risk of Diabetes in the Multi-Ethnic Study of Atherosclerosis and the Actos Now for the Prevention of Diabetes Study
Authors: Juraj Koska, Yueming Hu, Jeremy Furtado, Dean Billheimer, Dobrin Nedelkov, Dawn Schwenke, Matthew J. Budoff, Alain G. Bertoni, Robyn L. McClelland, Peter D. Reaven
Journal: Diabetes Care (2024)

OBJECTIVE Higher truncated-to-native apolipoprotein (apo) C-I proteoform ratios (C-I′/C-I) are associated with favorable cardiometabolic risk profiles, but their relationship with longitudinal changes in insulin resistance (IR) and incident diabetes is unknown. RESEARCH DESIGN AND METHODS Plasma apoC-I proteoforms were measured by mass spectrometry immunoassay at baseline in 4,742 nondiabetic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) and 524 participants with prediabetes in the Actos Now for Prevention of Diabetes (ACT NOW) study. The primary outcome was incident diabetes (fasting glucose [FG] ≥7.0 mmol/L or hypoglycemic medication use in MESA; FG ≥7.0 mmol/L or 2-h glucose ≥11.1 mmol/L in an oral glucose tolerance test [OGTT] in ACT NOW). Secondary outcomes were changes in FG and HOMA-IR in MESA, and OGTT-glucose area under the curve (AUCglucose) and Matsuda insulin sensitivity index (ISI) in ACT NOW. RESULTS In MESA, a higher C-I′/C-I was associated with lower risk of diabetes (n = 564 events; HR 0.87 [95% CI 0.79, 0.95] per SD; P = 0.0036; median follow-up, 9 years), and smaller increases (follow-up adjusted for baseline) in FG (−0.5%; P &amp;lt; 0.0001) and HOMA-IR (−2.9%; P = 0.011) after adjusting for baseline clinical and demographic covariates, including plasma triglycerides and HDL cholesterol. Total apoC-I concentrations were not associated with changes in FG, HOMA-IR, or incident diabetes. In ACT NOW, higher C-I′/C-I was associated with smaller increases in AUCglucose (−1.8%; P = 0.0052), greater increases in ISI (7.2%; P = 0.0095), and lower risk of diabetes (n = 59 events; 0.66 [95% CI 0.48, 0.91]; P = 0.004; median follow-up, 2.5 years) after adjusting for treatment group and diabetes risk factors, including plasma lipids. CONCLUSIONS Our results indicate that apoC-I truncation may contribute to changes in glucose levels, IR, and risk of diabetes.
Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial
Authors: Ellen M Apperloo, Jose L Gorriz, Maria Jose Soler, Secundino Cigarrán Guldris, Josep M Cruzado, Maria Jesús Puchades, Marina López-Martínez, Femke Waanders, Gozewijn D Laverman, Annemarie van der Aart-van der Beek, Klaas Hoogenberg, André P van Beek, Jacobien Verhave, Sofia B Ahmed, Roland E Schmieder, Christoph Wanner, David Z I Cherney, Niels Jongs, Hiddo J L Heerspink
Journal: Nature Medicine (2024)
Orientation-dependent CD45 inhibition with viral and engineered ligands
Authors: Marta T. Borowska, Liu D. Liu, Nathanael A. Caveney, Kevin M. Jude, Won-Ju Kim, Takeya Masubuchi, Enfu Hui, Robbie G. Majzner, K. Christopher Garcia
Journal: Science Immunology (2024)

CD45 is a cell surface phosphatase that shapes the T cell receptor signaling threshold but does not have a known ligand. A family of adenovirus proteins, including E3/49K, exploits CD45 to evade immunity by binding to the extracellular domain of CD45, resulting in the suppression of T cell signaling. We determined the cryo-EM structure of this complex and found that the E3/49K protein is composed of three immunoglobulin domains assembled as "beads on a string" that compel CD45 into a closely abutted dimer by cross-linking the CD45 D3 domain, leading to steric inhibition of its intracellular phosphatase activity. Inspired by the E3/49K mechanism, we engineered CD45 surrogate ligands that can fine-tune T cell activation by dimerizing CD45 into different orientations and proximities. The adenovirus E3/49K protein has taught us that, despite a lack of a known ligand, CD45 activity can be modulated by extracellular dimerizing ligands that perturb its phosphatase activity and alter T cell responses.
Gastrointestinal germinal center B cell depletion and reduction in IgA <sup>+</sup> plasma cells in HIV-1 infection
Authors: Francesca Cossarini, Joan Shang, Azra Krek, Zainab Al-Taie, Ruixue Hou, Pablo Canales-Herrerias, Minami Tokuyama, Michael Tankelevich, Adam Tillowitz, Divya Jha, Alexandra E. Livanos, Louise Leyre, Mathieu Uzzan, Gustavo Martinez-Delgado, Matthew D. Taylor, Keshav Sharma, Arno R. Bourgonje, Michael Cruz, Giorgio Ioannou, Travis Dawson, Darwin D'Souza, Seunghee Kim-Schulze, Ahmed Akm, Judith A. Aberg, Benjamin K. Chen, Douglas S. Kwon, Sacha Gnjatic, Alexandros D. Polydorides, Andrea Cerutti, Carmen Argmann, Ivan Vujkovic-Cvijin, Mayte Suarez-Fariñas, Francesca Petralia, Jeremiah J. Faith, Saurabh Mehandru
Journal: Science Immunology (2024)

Gastrointestinal (GI) B cells and plasma cells (PCs) are critical to mucosal homeostasis and the host response to HIV-1 infection. Here, high-resolution mapping of human B cells and PCs sampled from the colon and ileum during both viremic and suppressed HIV-1 infection identified a reduction in germinal center (GC) B cells and follicular dendritic cells (FDCs) during HIV-1 viremia. Immunoglobulin A-positive (IgA
Randomized Controlled Trial of Acceptance and Commitment Therapy for Fatigue Interference With Functioning in Metastatic Breast Cancer
Authors: Catherine E. Mosher, Shieun Lee, Elizabeth L. Addington, Seho Park, Ashley B. Lewson, Stella Snyder, Adam T. Hirsh, Jonathan B. Bricker, Kathy D. Miller, Tarah J. Ballinger, Bryan P. Schneider, Anna Maria Storniolo, Erin V. Newton, Victoria L. Champion, Shelley A. Johns
Journal: Journal of Clinical Oncology (2024)

Fatigue is a highly prevalent and disabling symptom for patients with metastatic breast cancer (MBC). Evidence-based interventions for managing fatigue in advanced cancer populations are lacking. This phase II randomized controlled trial tested the effect of acceptance and commitment therapy (ACT) on fatigue interference with functioning in patients with MBC.
Endoscopic evaluation of the oral cavity and pharynx: how to do it
Authors: Renata Nobre, Noriya Uedo, Ryu Ishihara, Yuki Okubo, James Weiquan Li, Fauze Maluf-Filho
Journal: Endoscopy (2024)

According to the field cancerization theory, patients with squamous cell carcinoma in the esophagus or head and neck regions are at an increased risk of synchronous and metachronous lesions. Therefore, such patients should undergo endoscopic surveillance for both regions [1].
Abdominal pain: ingestion of a toothpick leads to a presentation similar to acute pancreatitis
Authors: SaiLing Wei, JiaXun Xie, Huan He, HaiTao Zhang, Muhan Lü, Lei Shi
Journal: Endoscopy (2024)

A 39-year-old man presented to our hospital with abdominal pain for 12 days. His serum amylase concentration was 772.4 U/L and his pancreatic amylase concentration was 529.9 U/L. Abdominal computed tomography (CT) demonstrated a thin strip of high density shadowing on the lower curved side of the stomach body and the pancreatic body, consistent with pancreatitis ([Fig. 1]). After a detailed medical history had been taken, the patient could not remember whether he had ingested any foreign bodies.
Endoscopic variceal ligation combined with endoscopic submucosal dissection in the treatment of esophageal varices complicated by early esophageal cancer
Authors: Huan Ma, Yuan-jing He, Li-meng Wu, Xin-hua Zhao, Xiao-an Li
Journal: Endoscopy (2024)

A 61-year-old patient with cirrhosis and esophageal varices underwent gastroscopy, during which mucosal lesions, about 3 cm in length and 1.5 cm in width, were found in the lower esophagus ([Fig. 1]). Pathological examination revealed high grade intraepithelial neoplasia, and endoscopic submucosal dissection (ESD) treatment was planned. However, the right posterior wall of the lesion was closely related to a varicose vein, and the whole local area was located on the edge of the vein, which could not be avoided during mucosal incision. Therefore, endoscopic variceal ligation (EVL) was first used to ligate the distal end of the varicose vein to block blood flow, and then ESD was performed to treat the mucosal lesions ([Video 1]).
Endoscopic ultrasound-guided hepaticogastrostomy using a biopsy needle may improve the technical success rate of the one-step technique
Authors: Takeshi Ogura, Yuki Uba, Nobuhiro Hattori, Kimi Bessho, Hiroki Nishikawa
Journal: Endoscopy (2024)

Bile peritonitis is a frequent adverse event of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) [1]. To prevent this adverse event, a one-step technique that skips the tract dilation step has recently been reported [2]. To further improve the technical success of the one-step technique, EUS-guided biliary drainage using fine-needle biopsy (FNB) needle has been reported [3]. However, although this technique might be technically feasible with the transduodenal approach, in EUS-HGS, intrahepatic bile duct puncture might be challenging because the penetration ability of the FNB needle is poor compared with a fine-needle aspiration (FNA) needle. Recently, a flexible FNB needle with a sharper tip has become available (Sono Tip TopGain; Medi-Globe GmbH, Rohrdorf, Germany) [Fig. 1]). Compared with an FNA needle, the puncture hole might be larger with the novel FNB needle. In addition, the penetration function might be stronger than that of the conventional FNB needle [4]. Therefore, the good puncture ability and larger hole obtained with this novel needle might increase the utilization of the one-step EUS-HGS technique. EUS-HGS using the novel FNB needle is described below.
Endoscopic full-thickness resection of type 1 gastric neuroendocrine tumor: step-by-step description of technique
Authors: Rafael Sartori Balbinot, Diego Cadena, Bruno Costa Martins, Cesar Capel de Clemente Junior, Evandro Sobroza de Mello, Adriana Vaz Safatle-Ribeiro, Fauze Maluf-Filho
Journal: Endoscopy (2024)

A 47-year-old woman with autoimmune chronic gastritis and type 1 gastric neuroendocrine tumor (gNET) was referred for resection of a gastric subepithelial lesion (SEL). Esophagogastroduodenoscopy showed atrophic pangastritis and a 13-mm SEL located at the anterior wall that was evaluated by endoscopic ultrasound ([Fig. 1], [Fig. 2]).