tbuckley/cabot-search huggingface dataset:
Operative vs Nonoperative Management of Fractures of the Humeral Diaphysis
Authors: William M. Oliver, Katrina R. Bell, Thomas H. Carter, Catriona Graham, Timothy O. White, Nicholas D. Clement, Andrew D. Duckworth, Samuel G. Molyneux
Journal: JAMA Surgery (2025)

Importance Humeral shaft fractures are routinely managed nonoperatively, but this approach is potentially associated with higher nonunion rates and inferior functional outcomes when compared with operative fixation. Objective To assess whether there is any difference in outcome between surgery and functional bracing for adults with an isolated, closed humeral shaft fracture. Design, Setting, and Participants This prospective, superiority, parallel-group randomized clinical trial was conducted between September 2018 and October 2023 and took place at an academic major trauma center in the United Kingdom. Patients were reviewed at 2 and 6 weeks and 3, 6, and 12 months postintervention. Patients included 70 adults with an isolated, closed humeral shaft fracture. Exclusion criteria included absolute indications for surgery, pathological/periprosthetic fractures, multiple traumas, significant frailty, and inability to comply with follow-up. Data were analyzed from November 2023 through January 2024. Interventions Open reduction and plate fixation (n = 36) or functional bracing (n = 34). Seven patients did not receive their assigned treatment (operative, 5; nonoperative, 2). Main Outcomes and Measures The primary outcome measure was the Disabilities of the Arm, Shoulder, and Hand score (DASH) at 3 months postintervention. Secondary outcomes included health-related quality of life (EuroQol 5-Dimension [EQ-5D]/health visual analog scale [EQ-VAS] and Short Form [SF]-12 Physical Component Summary [PCS]/Mental Component Summary [MCS] scores), pain, shoulder/elbow range of motion, and complications. Intention-to-treat analyses were used. Results The study included 70 patients (mean [SD] age, 49 [17.1] years; 38 female [54%] and 32 male [46%]). At 3 months, 66 patients (94%) had completed follow-up. The operative group had a significantly better DASH score (difference, 15.0; P = .01). Surgery was also associated with a superior DASH score at 6 weeks (difference, 14.7; P = .01), but not at 6 months ( P = .10) or at 12 months ( P = .78). Surgery was further associated with a higher EQ-5D score (6 weeks: difference, 0.126, P = .03), EQ-VAS score (6 months: difference, 7; P = .04), and SF-12 MCS score (6 weeks: difference, 9.3; P = .001; 3 months: difference, 6.9; P = .01; and 6 months: difference, 7.1; P = .01). Brace-related dermatitis was significantly more common in the nonoperative group (18% vs operative 3%; P = .05). There were 8 nonunions (11%; operative 6% vs nonoperative 18%, P = .14). Conclusions and Relevance For patients with a humeral shaft fracture in this study, surgery conferred early functional advantages over bracing. However, these benefits should be considered in the context of potential operative risks and the absence of any difference in outcomes at 1 year. Trial Registration ClinicalTrials.gov Identifier: NCT03689335
Malignant JAK-signaling: at the interface of inflammation and malignant transformation
Authors: Florian Perner, Heike L. Pahl, Robert Zeiser, Florian H. Heidel
Journal: Leukemia (2025)

Abstract The JAK pathway is central to mammalian cell communication, characterized by rapid responses, receptor versatility, and fine-tuned regulation. It involves Janus kinases (JAK1, JAK2, JAK3, TYK2), which are activated when natural ligands bind to receptors, leading to autophosphorylation and activation of STAT transcription factors [1, 2]. JAK-dependent signaling plays a pivotal role in coordinating cell communication networks across a broad spectrum of biological systems including development, immune responses, cell growth, and differentiation. JAKs are frequently mutated in the aging hematopoietic system [3, 4] and in hematopoietic cancers [5]. Thus, dysregulation of the pathway results in various diseases, including cancers and immune disorders. The binding of extracellular ligands to class I and II cytokine receptors initiates a critical signaling cascade through the activation of Janus kinases (JAKs). Upon ligand engagement, JAKs become activated and phosphorylate specific tyrosine residues on the receptor, creating docking sites for signal transducer and activator of transcription (STAT) proteins. Subsequent JAK-mediated phosphorylation of STATs enables their dimerization and nuclear translocation, where they function as transcription factors to modulate gene expression. Under physiological conditions, JAK-signaling is a tightly regulated mechanism that governs cellular responses to external cues, such as cytokines and growth factors, ensuring homeostasis and maintaining the functional integrity of tissues and organs. Highly defined regulation of JAK-signaling is essential for balancing cellular responses to inflammatory stimuli and growth signals, thus safeguarding tissue health. In contrast, dysregulated JAK-signaling results in chronic inflammation and unrestrained cellular proliferation associated with various diseases. Understanding the qualitative and quantitative differences at the interface of physiologic JAK-signaling and its aberrant activation in disease is crucial for the development of targeted therapies that precisely tune this pathway to target pathologic activation patterns while leaving homeostatic processes largely unaffected. Consequently, pharmaceutical research has targeted this pathway for drug development leading to the approval of several substances with different selectivity profiles towards individual JAKs. Yet, the precise impact of inhibitor selectivity and the complex interplay of different functional modules within normal and malignant cells remains incompletely understood. In this review, we summarize the current knowledge on JAK-signaling in health and disease and highlight recent advances and future directions in the field.
Suicide Risk and Living Alone With Depression or Anxiety
Authors: Daa Un Moon, Hyewon Kim, Jin-Hyung Jung, Kyungdo Han, Hong Jin Jeon
Journal: JAMA Network Open (2025)

Importance Living alone and mental health disorders, including depression and anxiety, are associated with high suicide risk, but their combined impact remains underexplored. Objective To examine the association of living arrangements and depression or anxiety with suicide risk. Design, Setting, and Participants This population-based cohort study used data from the Korean National Health Insurance Service database from January 1, 2009, to December 31, 2021, that included adults aged 20 years or older who participated in the General Health Screening Program in Korea in 2009. Individuals with incomplete data and those who died by suicide within the first year were excluded to minimize the possibility of reverse causation. Data were analyzed from December 28, 2023, to December 27, 2024. Exposures Living arrangements, categorized as living alone (≥5 years) or living with others, and depression and anxiety, determined using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. Main Outcomes and Measures The primary outcome was death by suicide, identified through national death records. Multivariable Cox proportional hazards regression models were used to estimate adjusted hazard ratios (AHRs) and 95% CIs for suicide risk. Results The study included 3 764 279 adults (mean [SD] age, 47.2 [14.0] years; 55.8% male). Of these individuals, 112 460 (3.0%) had depression, 232 305 (6.2%) had anxiety, and 319 993 (8.5%) lived alone. Compared with individuals who had neither depression nor anxiety nor lived alone, individuals living alone with both depression and anxiety exhibited a 558% increased risk of suicide (AHR, 6.58 [95% CI, 4.86-8.92]). Living alone with depression was associated with a 290% increased risk (AHR, 3.91 [95% CI, 2.96-5.16]), and living alone with anxiety was associated with a 90% increased risk (AHR, 1.90 [95% CI, 1.48-2.43]). The AHRs were higher for the association between living alone and suicide among middle-aged individuals (aged 40 to 64 years) and men compared with other demographic groups. Conclusions and Relevance In this cohort study of 3 764 279 individuals, living alone with depression or anxiety was associated with an increased risk of suicide, particularly among middle-aged individuals and men. These findings underscore the importance of preventing mental illness, such as depression and anxiety, while addressing living arrangements as a critical factor in suicide risk assessments for individuals with these conditions.
Correction: The clinical journey of belantamab mafodotin in relapsed or refractory multiple myeloma: lessons in drug development
Authors: Pralay Mukhopadhyay, Hesham A. Abdullah, Joanna B. Opalinska, Prani Paka, Eric Richards, Katja Weisel, Suzanne Trudel, Maria-Victoria Mateos, Meletios Athanasios Dimopoulos, Sagar Lonial
Journal: Blood Cancer Journal (2025)
A fusion protein that targets antigen-loaded extracellular vesicles to B cells enhances antigen-specific T cell expansion
Authors: Annemarijn Offens, Loes Teeuwen, Gozde Gucluler-Akpinar, Loïc Steiner, Sander Kooijmans, Doste Mamand, Hannah Weissinger, Alexander Käll, Maria Eldh, Oscar P B Wiklander, Samir E L Andaloussi, Mikael C I Karlsson, Pieter Vader, Susanne Gabrielsson
Journal: Journal of Controlled Release (2025)
The Delicate Balancing Act of Accelerated Approval for Cancer Medicines—Speed, Certainty, and Benefit
Authors: Kristina Jenei, Christopher M. Booth
Journal: JAMA Network Open (2025)

Ariadna Tibau, MD, PhD; Thomas J. Hwang, MD; Alejandra Romano, MD; Maria Borrell, MD; Ignasi Gich, MD, PhD; Consolacion Molto, MD, PhD; Aaron S. Kesselheim, MD, JD, MPH
Lichen Sclerosus of the Neovagina and Neovulva
Authors: Sorcha O’Sullivan, Natalia Castrejón de Anta, Stephen Mounsey, Jaime Eduardo Calonje, Fiona Lewis
Journal: JAMA Dermatology (2025)

This case report describes a transgender woman who developed lichen sclerosus of the neovagina and neovulva after receiving gender-affirming care.
Artemisinin Partial Resistance in Ugandan Children
Authors: Pamela Weathers, Stephen M. Rich, Dominique Mazier
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
The Rose as a Symbol of Love and Healing in Poetry and Medicine
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
Encouraging Pharmacist Referrals for Evidence-Based Statin Initiation
Authors: Alexander C. Fanaroff, Qian Huang, Kayla Clark, Laurie A. Norton, Wendell E. Kellum, Dwight Eichelberger, John C. Wood, Zachary Bricker, Andrea G. Dooley Wood, Greta Kemmer, Jennifer I. Smith, Srinath Adusumalli, Mary E. Putt, Kevin G. Volpp
Journal: JAMA Cardiology (2025)

Despite statins' benefit in preventing major adverse cardiovascular events, most patients with an indication for statin therapy are not appropriately treated. Clinicians' limited time and lack of systematic efforts to address preventive care likely contribute to gaps in statin prescribing. To determine the effect on statin prescribing of 2 interventions to refer appropriate patients to a pharmacist for lipid management. These 2 pragmatic cluster randomized clinical trials were conducted among 12 total primary care practices in a community health system. Trial 1 was a delayed-intervention design of a visit-based intervention with randomization at the clinician level in a single clinic, and trial 2 was a parallel-arm trial of an asynchronous intervention with randomization at the clinic level in 11 clinics. Patients who were assigned to a primary care clinician at a participating practice, had an indication for a high-intensity or moderate-intensity statin, and were either not prescribed a statin or prescribed an inappropriately low statin dose were eligible for inclusion. Trial 1 tested an interruptive electronic health record alert that appeared during eligible patients' visits and facilitated referral to a pharmacist, while trial 2 tested an order for pharmacist referral placed by the study team for cosignature by the primary care clinician without regard to the timing of a clinic visit. The primary outcome was the proportion of patients prescribed a statin. Overall, 1412 patients were enrolled in trial 1 and 1950 in trial 2. Across both trials, mean (SD) patient age was 65.6 (9.9) years, and 1485 patients (44.2%) were female. Mean (SD) baseline 10-year risk of major cardiovascular events was 17.9% (9.4). In trial 1, the interruptive alert was not associated with a significant increase in statin prescriptions compared with usual care (15.6% vs 11.6%; unadjusted absolute difference, 3.9 percentage points; 95% CI, -0.4 to 8.3). In trial 2, semiautomated pharmacist referrals were associated with an increase in statin prescriptions by 16 percentage points compared with usual care (31.6% vs 15.2%; unadjusted absolute difference, 16.4 percentage points; 95% CI, 12.7-20.1). In these 2 cluster randomized clinical trials, visit-based interruptive alerts were not associated with a significant increase in statin prescribing compared with usual care, whereas a strategy of asynchronous semiautomated referral for pharmacist comanagement was associated with a substantial increase. This strategy of asynchronous semiautomated referrals for pharmacist involvement in lipid management could be a scalable and effective approach to increasing statin prescribing for patients at high risk. ClinicalTrials.gov Identifier: NCT05537064.
Faculty Characteristics and Surgery Trainee Attrition
Authors: Haley Harris, Isabelle M.C. Tan, Yuqing Qiu, Julianna Brouwer, Julie Ann Sosa, Heather Yeo
Journal: JAMA Surgery (2025)

This cohort study examines correlations between underrepresented-in-medicine and female faculty representation, retention, and promotion and general surgery resident attrition at a national level.
Protecting the Future of Medical Innovation: Balancing Fiscal Responsibility with the Need for National Institutes of Health and Federal Health Funding
Authors: Irina Petrache, Raed A Dweik, Michelle Ng Gong, Jesse Roman, M. Patricia Rivera, Karen J Collishaw
Journal: American Journal of Respiratory and Critical Care Medicine (2025)

"Protecting the Future of Medical Innovation: Balancing Fiscal Responsibility with the Need for National Institutes of Health and Federal Health Funding." American Journal of Respiratory and Critical Care Medicine, 0(ja), pp.
Author Correction: First-line cadonilimab plus chemotherapy in HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a randomized, double-blind, phase 3 trial
Authors: Lin Shen, Yanqiao Zhang, Ziyu Li, Xiaotian Zhang, Xiangyu Gao, Bo Liu, Yusheng Wang, Yi Ba, Ning Li, Ruixing Zhang, Jingdong Zhang, Ye Chen, Jian Chen, Mingzhu Huang, Yang Fu, Mulin Liu, Zheng Liu, Jun Zhao, Wei Li, Jia Wei, Changzheng Li, Nong Xu, Zengqing Guo, Bangwei Cao, Lian Liu, Peng Nie, Lixin Wan, Lili Sheng, Zhenyang Liu, Yifu He, Kangsheng Gu, Guowu Wu, Weibo Wang, Futong Zhang, Wensheng Qiu, Jun Guo, Jieer Ying, Hongming Pan, Huiting Xu, Yuan Yuan, Yuansong Bai, Zhenghua Wang, Jiye Xu, Xuehong Zhao, Hao Liu, Xizhi Zhang, Wenxiang Dai, Hongyan Xu, Ming Liu, Lin Xie, Yong Tang, Jianying Jin, Xiujuan Qu, Xuefeng Fang, Mingwei Huang, Hao Chen, Zhendong Zheng, Ying Wang, Daqing Wang, Xiaoqin Li, Guohua Yu, Haiyan Liu, Yongjian Zhou, Diansheng Zhong, Shan Zeng, Mafei Kang, Meiqing Wang, Yong Gao, Wenxin Li, Zejun Wang, Minghui Zhang, Jinghua Zhang, Qingshan Li, Shujuan Sun, Aimin Zang, Lizhu Lin, Ming Xie, Zhixiang Zhuang, Tao Zhang, Zhifang Yao, Dongmei Lu, Wei Liu, Mingxiu Hu, Zhongmin Maxwell Wang, Baiyong Li, Michelle Xia, Jiajia Zhang, Xiangji Ying, Drew M. Pardoll, Jiafu Ji
Journal: Nature Medicine (2025)
Genetic liability to sedentary behaviour and cardiovascular disease incidence in the FinnGen and HUNT cohorts
Authors: Laura Joensuu, Kaisa Koivunen, Niko Paavo Tynkkynen, Teemu Palviainen, Jaakko Kaprio, Marie Klevjer, Karsten Øvretveit, Ulrik Wisløff, Anja Bye, Ulf Ekelund, Elina Sillanpää
Journal: British Journal of Sports Medicine (2025)

Objective Energy-saving sedentary behaviour may be an evolutionarily selected trait that is no longer advantageous. We investigated the associations between genetic liability to sedentary behaviour and the incidence of the most common cardiovascular disease (CVD). Methods We constructed and validated a genome-wide polygenic score for leisure screen time (PGS LST) as a measure of genetic liability to sedentary behaviour. We performed survival analyses between higher PGS LST and register-based CVDs using the FinnGen cohort (N=293 250–333 012). Replication and exploratory analyses were conducted in an independent Norwegian Trøndelag Health Study (HUNT) cohort (N=35 289). Results In FinnGen, each SD increase in PGS LST was associated with a higher risk of incident CVD (HR: 1.05 (95% CI 1.05 to 1.06)) (168 770 cases over 17 101 133 person-years). The magnitudes of association for the three most common CVDs were 1.09 ((95% CI 1.08 to 1.09), 1.06 ((95% CI 1.05 to 1.07) and 1.05 ((95% CI 1.04 to 1.06) for hypertensive disease, ischaemic heart disease and cerebrovascular disease, respectively. Those in the top decile of PGS LST had 21%, 35%, 26% and 19% higher risk of any CVD, hypertensive disease, ischaemic heart disease and cerebrovascular disease, respectively, than those in the bottom decile. Associations were replicated in HUNT and remained independent of covariates (socioeconomic status, body mass index and smoking) except for cerebrovascular disease. Besides direct effects, reduced physical activity served as a potential mediating pathway for the observed associations. Conclusions We found that genetic liability to sedentary behaviour is associated with incident CVD, although effect sizes with current PGS remained small. These findings suggest that genetic liability to sedentary behaviour is an under-recognised driver of common CVDs.
Author Correction: Disruption of neural periodicity predicts clinical response after deep brain stimulation for obsessive-compulsive disorder
Authors: Nicole R. Provenza, Sandesh Reddy, Anthony K. Allam, Sameer V. Rajesh, Nabeel Diab, Gabriel Reyes, Rose M. Caston, Kalman A. Katlowitz, Ajay D. Gandhi, Raphael A. Bechtold, Huy Q. Dang, Ricardo A. Najera, Nisha Giridharan, Katherine E. Kabotyanski, Faiza Momin, Mohammed Hasen, Garrett P. Banks, Brian J. Mickey, Brent M. Kious, Ben Shofty, Benjamin Y. Hayden, Jeffrey A. Herron, Eric A. Storch, Ankit B. Patel, Wayne K. Goodman, Sameer A. Sheth
Journal: Nature Medicine (2025)
Sézary Syndrome—Eosinophilia Explained by a Blood Film
Authors: Merel T. A. Soeterik, Joris Janssen, Leo M. Budel, Anton W. Langerak, Yorick Sandberg, Barbara J. Bain
Journal: American Journal of Hematology (2025)

A 61-year-old man, with no significant medical history, presented with a six-month history of fatigue, pruritus, night sweats, and weight loss. Physical examination revealed erythroderma and generalized lymphadenopathy. Laboratory tests showed prominent eosinophilia (white blood cell count 10.6 × 109/L, eosinophils 2.9 × 109/L). There was no lymphocytosis (lymphocyte count 1.1 × 109/L). Lactate dehydrogenase (LDH) was elevated at 469 U/L. A peripheral blood smear (top left and top right, May–Grünwald–Giemsa [MGG], ×100 objective) highlighted marked eosinophilia alongside large, atypical lymphocytes with convoluted and grooved nuclei. Lymph node biopsy confirmed infiltration by an aberrant T-cell population. Bone marrow examination showed atypical large T cells accounting for 14% of the total cell population and an eosinophil fraction of 25% (bottom left, MGG, ×100). A skin punch biopsy (bottom right, hematoxylin and eosin, ×20) demonstrated superficial perivascular lymphocytic and eosinophilic dermatitis, with no spongiosis or epidermotropism. Immunohistochemical analysis identified abnormal lymphocytes expressing CD4 with a CD4:CD8 ratio ≥ 10 and concurrent loss of CD5 and partial loss of CD7. Subsequent immunophenotyping of peripheral blood, bone marrow, and lymph nodes confirmed the presence of an identical clonal T-cell population with loss of CD26 expression also being shown. Based on these peripheral blood and histopathological findings in the context of erythroderma, the diagnosis of Sézary syndrome was established. Sézary syndrome is an aggressive form of mature T-cell leukemia, characterized by refractory symptoms and a poor prognosis. Eosinophilia occurs frequently [1] and is believed to result from the secretion of specific Th2-associated cytokines by neoplastic cells [2]. There are innumerable causes of eosinophilia. Sézary syndrome is one of a number of causes that may be revealed by peripheral blood examination. This may be so even when the lymphocyte count is not increased. In addition, the eosinophil count may be of prognostic significance in cutaneous T-cell lymphomas [1]. The authors declare no conflicts of interest.