tbuckley/cabot-search huggingface dataset:
Short-term efficacy of inhaled short-acting beta-2-agonists for acute wheeze/asthma symptoms in preschool-aged children: a systematic review and meta-analysis
Authors: Rosa Storgaard Petersen, Henrik Hallas, Nicklas Brustad, Bo Chawes
Journal: Thorax (2025)

Background Inhaled short-acting β2-agonists (SABA) is recognised as an effective treatment in adults and older children with asthma, but the effect in young children and infants is still up for debate. We examine the efficacy of inhaled SABA for preschool-aged children presenting with acute wheeze/asthma in this systematic review and meta-analysis. Methods PubMed and Embase were searched through August 2024. Clinical trials investigating the effect of inhaled SABA on acute wheeze/asthma symptoms in children below age 6 years were included. The study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Summary standardised mean differences, 95% CIs and p values were derived from random effects meta-analyses to analyse the effect on clinical composite respiratory score, respiratory rate, oxygen saturation, respiratory work and degree of wheezing. Results A total of 19 studies including 1022 children were included. Treatment with inhaled SABA showed decreased respiratory score within 60 min (10 studies, N=523): standardised mean difference −2.05 points (95% CI −2.50; −1.59), I 2 =86%, p&lt;0.001, decreased respiratory rate (8 studies, N=319): −0.86 (95% CI −1.30; −0.41), I 2 =87%, p&lt;0.001, increased oxygen saturation (7 studies, N=190): 0.56 (95% CI 0.16; 0.95), I 2 =71%, p&lt;0.01, decreased respiratory work (3 studies, N=68): −0.80 (95% CI −1.60; −0.00), I 2 =74%, p=0.05 and decreased wheezing score (3 studies, N=68): −1.07 (95% CI −1.80; −0.33), I 2 =72%, p&lt;0.01. Subgroup analyses of children below age 2 years showed similar significant effects for all outcomes. Conclusions Inhaled SABA treatment for acute wheeze/asthma symptoms showed beneficial effects in young children and infants. Findings from this study may provide evidence to support inhaled SABA in future treatment guidelines for acute wheeze/asthma among young children and infants; however, an overall high heterogeneity and small sample size of the studies were a limitation. PROSPERO registration number CRD42023429381.
“Diamonds Are Forever”: Novel VEGF-Nanodiamond Therapy for the Treatment of Congenital Diaphragmatic Hernia
Authors: Andreas Damianos, Bernard Thébaud, Vladimir V. Kalinichenko
Journal: American Journal of Respiratory and Critical Care Medicine (2025)

""Diamonds Are Forever": Novel VEGF-Nanodiamond Therapy for the Treatment of Congenital Diaphragmatic Hernia." American Journal of Respiratory and Critical Care Medicine, 0(ja), pp.
Kidney Transplant Wait Times Under Waiting List Expansion Scenarios
Authors: Jillian S. Caldwell, Xingxing S. Cheng, Glenn M. Chertow, Jeremy D. Goldhaber-Fiebert
Journal: JAMA Network Open (2025)

Importance Kidney transplantation offers survival benefits and superior quality of life compared with maintenance dialysis for patients with end-stage kidney disease (ESKD), but it is limited to approximately 25 000 patients annually in the United States. Expanding access to transplant could be accomplished by allowing more patients to join the waiting list or by increasing organ supply. Objective To estimate how these interventions could affect transplant wait times. Design, Setting, and Participants This decision-analytic study used a Markov model with a simulated cohort of transplant-eligible US patients over 10 years (2022-2032). Exposures Three expansion strategies: waiting list expansion alone, waiting list expansion with deceased-donor transplant (DDT) expansion, and waiting list expansion with living-donor transplant (LDT) expansion. Relative 10%, 25%, 50%, and 100% expansions of the current deceased-donor organ supply and 25%, 50%, 100%, and 200% expansions of current living donation rates were simulated, modeling 2 degrees of waiting list expansion (10% and 50%) for each strategy. Main Outcomes and Measures Median wait time to kidney transplant using Kaplan-Meier survival analysis. Results There were a total of 662 190 transplant-eligible patients in the simulated cohort, with a mean (SD) age of 58.7 (14.7) years; 327 126 (49%) female individuals; and 269 082 (41%) Black, 163 028 (25%) Hispanic, 233 739 (35%) non-Hispanic White, and 78 496 (12%) Asian individuals and individuals with another race or ethnicity. Under the baseline strategy, median (IQR) wait time was 32.8 (13.1-66.4) months and increased to 36.8 (14.7-74.7) months and 52.6 (21.0-107.9) months for 10% and 50% waiting list expansion alone. DDT and LDT expansion strategies added 1911 to 20 035 organs. For 10% waiting list expansion, median (IQR) wait times ranged from 23.7 (9.3-47.8) months to 34.5 (13.9-74.7) months. For 50% waiting list expansion, median (IQR) wait times ranged from 34.2 (13.6-69.4) months to 49.4 (19.7-101.0) months. Conclusions and Relevance In this decision-analytic model, expansion strategies without additional organ supply increased the median time to kidney transplant by nearly 2 years; 10% waiting list expansion required at least 2850 additional organs to shorten wait times. However, 50% waiting list expansion required at least 11 000 additional organs to approximate current wait times. Reduction in the deceased-donor organ nonuse rate alone is unlikely to meet the shortfall. Systems-level efforts to significantly increase deceased and living donation should be prioritized alongside increased access to the transplant waiting list.
Projected Out-of-Pocket Savings of the Medicare Part D $2 Drug List Model
Authors: Inmaculada Hernandez, Nico Gabriel, Yuvraj Pathak, Ryan N. Hansen, Sean D. Sullivan, A. Mark Fendrick
Journal: JAMA (2025)

This study evaluates the amount of out-of-pocket cost savings Medicare Part D beneficiaries would have experienced if a proposed Medicare $2 drug list model had been in place in 2021.
Patient Comprehension via Explanatory Communication—Reply
Authors: LaKesha N. Anderson, Christy J. W. Ledford
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
Medicare Competitive Bidding Program and the SOAR Act
Authors: Christopher M. Worsham
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Continued Use of Cholinesterase Inhibitors and Memantine in Hospice
Authors: Lauren J. Hunt, Siqi Gan, W. John Boscardin, Krista L. Harrison, Matthew E. Growdon, Ulrike U. Muench, Lauren B. Gerlach, Alexander K. Smith, Michael A. Steinman
Journal: JAMA Internal Medicine (2025)

This cohort study examines the use of cholinesterase inhibitors and memantine among older adults with dementia after admission into hospice care despite the medications’ limited clinical benefit following enrollment into hospice.
Albuminuria Responses to Dapagliflozin in Patients With Type 2 Diabetes
Authors: Jelle M. Beernink, Niels Jongs, Cees J. A. Doelman, Gozewijn D. Laverman, Hiddo J. L. Heerspink
Journal: JAMA Network Open (2025)

Importance Dapagliflozin reduces the urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) decline at a population level, but individuals show a large variation in responses. The n-of-1 trial design allows for direct assessment of treatment effects within an individual, and digital technologies and remote study assessments can reduce clinic visits, ease participant burden, and improve trial efficiency. Objective To assess individual UACR responses to dapagliflozin treatment in a decentralized clinical trial and the feasibility of remote data collection. Design, Setting, and Participants This decentralized, randomized, double-blind, placebo-controlled crossover trial using an n-of-1 approach was conducted using data from the Dutch primary and secondary health care systems between May 2021 and September 2022. Participants included adults with type 2 diabetes, a UACR greater than 20 mg/g, and an eGFR greater than 30 mL/min/1.73 m 2 . Statistical analyses were performed between June and August 2023. Interventions Participants were assigned to two 1-week treatment periods with dapagliflozin, 10 mg/d, and two 1-week treatment periods with placebo in random order, with 1-week washout periods in between. Main Outcomes and Measures The primary outcome was the difference in the change in UACR from start to end of treatment between dapagliflozin and placebo in the per-protocol population. A post hoc exploratory analysis assessed the feasibility of remote data collection, including the proportion of urine and capillary blood samples successfully delivered to the central laboratory. Results In total, 20 participants (mean [SD] age, 64.9 [8.7] years; 17 [85.0%] male) with a mean (SD) eGFR of 70.2 (20.3) mL/min/1.73 m 2 and a median UACR of 94.7 (IQR, 29.8-242.6) mg/g were included in the study. They experienced a relative change in UACR with dapagliflozin compared with placebo of –15.1% (95% CI, –28.2% to –3.3%; P = .01). UACR changes showed considerable variation during both dapagliflozin and placebo treatment (first treatment period: median, –12.8% [range, –56.3% to 36.2%] and 2.9% [range, –86.7% to 35.1%], respectively). UACR changes correlated significantly between the first and second dapagliflozin exposure ( r = 0.50; P = .03), with no correlation observed between the placebo exposure periods ( r = 0.09; P = .69). With regard to remote data collection, 811 of 816 urine samples (99.4%) and 433 of 440 capillary blood samples (98.4%) were successfully delivered to the central laboratory. Conclusions and Relevance In this crossover trial, individual UACR responses to dapagliflozin reflected a pharmacological response. Remote data collection proved to be reliable, supporting its use in future studies and clinical practice for monitoring individual dapagliflozin responses. Trial Registration EudraCT identifier: 2020-004929-23
Autosomal Dominant Polycystic Kidney Disease
Authors: Fouad T. Chebib, Christian Hanna, Peter C. Harris, Vicente E. Torres, Neera K. Dahl
Journal: JAMA (2025)

Importance Autosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive development of kidney cysts and is the most common inherited kidney disorder worldwide. ADPKD accounts for 5% to 10% of kidney failure in the US and Europe, and its prevalence in the US is 9.3 per 10 000 individuals. Observations ADPKD is typically diagnosed in individuals aged 27 to 42 years and is primarily caused by pathogenic variants in the PKD1 (78%) or PKD2 (15%) genes. Most persons with ADPKD have an affected parent, but de novo disease is suggested in 10% to 25% of families. More than 90% of patients older than 35 years have hepatic cysts, which may cause abdominal discomfort and occasionally require medical or surgical intervention. Hypertension affects 70% to 80% of patients with ADPKD, and approximately 9% to 14% develop intracranial aneurysms, which have a rupture rate of 0.57 per 1000 patient-years. Approximately 50% of individuals with ADPKD require kidney replacement therapy by 62 years of age. The severity of kidney disease can be quantified using the Mayo Imaging Classification (MIC), which stratifies patients based on total kidney volume adjusted for height and age and ranges from 1A to 1E. Patients with MIC 1C to MIC 1E have larger kidneys because of more rapid growth (6%-10% per year) compared with those with MIC 1A and 1B (1%-5% per year) and have earlier progression to kidney replacement therapy, which occurs at a mean age of 58.4 years for MIC 1C, 52.5 years for MIC 1D, and 43.4 years for MIC 1E. Optimal management of ADPKD includes systolic blood pressure lower than 120 mm Hg for most patients, but lower than 110/75 mm Hg for patients with MIC 1C to 1E who have an estimated glomerular filtration rate (eGFR) greater than 60 mL/min/1.73 m 2 and are younger than 50 years, dietary sodium restriction (&amp;amp;lt;2000 mg/d), weight management, and adequate hydration (&amp;amp;gt;2.5 L daily). The vasopressin type 2 receptor antagonist tolvaptan reduces the annual rate of eGFR decline by 0.98 to 1.27 mL/min/1.73 m 2 and is indicated for patients with MIC 1C to 1E or an eGFR decline greater than 3 mL/min/1.73 m 2 per year to slow disease progression and delay the onset of kidney failure. Conclusion ADPKD is the most common genetic kidney disease worldwide and is characterized by progressive development of kidney cysts. Patients typically have hypertension and liver cysts, and 9% to 14% develop intracranial aneurysms. First-line treatment includes blood pressure control, dietary and weight management, and adequate hydration. Tolvaptan reduces the rate of eGFR decline for those at high risk of rapid progression to kidney failure.
Mycoestrogen Exposure During Pregnancy: Impact of the ABCG2 Q141K Variant on Birth and Placental Outcomes
Authors: Zorimar Rivera-Núñez, Carolyn Kinkade, Anita Brinker, Ranran Zhang, Brian Buckley, Jessica Brunner, Pamela Ohman-Strickland, Xing Qiu, Rani J. Qasem, John K. Fallon, Phillip C. Smith, Richard K. Miller, Carolyn S. Salafia, Thomas G. O'Connor, Lauren M. Aleksunes, Emily S. Barrett
Journal: Environmental Health Perspectives (2025)

Zearalenone (ZEN) is an estrogenic mycotoxin ('mycoestrogen') that contaminates global grain crops leading to detectable concentrations of ZEN and its metabolites, including the synthetic version alpha-zearalanol (ZER), in human populations. Despite in vitro and in vivo animal evidence of endocrine disruption by ZEN, there has been limited investigation in humans.
Breastfeeding Duration and Child Development
Authors: Inbal Goldshtein, Yair Sadaka, Guy Amit, Nitsa Kasir, Thomas Bourgeron, Varun Warrier, Pinchas Akiva, Meytal Avgil Tsadok, Deena R. Zimmerman
Journal: JAMA Network Open (2025)

Importance Detecting and addressing potentially modifiable factors associated with healthy development is key to optimizing a child’s potential. When investigating the outcomes of child development, it is important to account for disparities in feeding practices and avoid confounding bias. Objectives To estimate the independent association between breastfeeding and attainment of developmental milestones or neurodevelopmental conditions. Design, Setting, and Participants This retrospective cohort study used data from a national network for routine child development surveillance in Israel linked with national social insurance financial entitlements for neurodevelopmental deficiencies. Participants were children born between January 2014 and December 2020 after at least 35 weeks’ gestation without severe morbidity and with at least 1 follow-up surveillance visit at 2 to 3 years of age. Outcome data were collected in March 2023. Exposures Duration and exclusivity of breastfeeding in infancy. Main Outcomes and Measures The primary outcomes were delays in attainment of developmental milestones and diagnosis of prespecified neurodevelopmental conditions. Multivariable regression, matching, and within-family analyses were used to estimate adjusted odds ratios (AORs) after accounting for potential confounding factors related to the child (gestational age, birth weight, multiple gestation, and child order in the family) and mother (age, socioeconomic status, educational level, marital status, employment, nationality, and postpartum depression). Results Of 570 532 children (291 953 [51.2%] male), 20 642 (3.6%) were preterm, 38 499 (6.7%) were small for gestational age, and 297 571 (52.1%) were breastfed for at least 6 months (123 984 [41.7%] were exclusively breastfed). Children who were breastfed for at least 6 months exhibited fewer delays in attaining language and social or motor developmental milestones compared with children exposed to less than 6 months of breastfeeding (AOR, 0.73 [95% CI, 0.71-0.76] for exclusive breastfeeding; AOR, 0.86 [95% CI, 0.83-0.88] for nonexclusive breastfeeding). Among 37 704 sibling pairs, children who were breastfed for at least 6 months were less likely to demonstrate milestone attainment delays (OR, 0.91 [95% CI, 0.86-0.97]) or be diagnosed with neurodevelopmental conditions (OR, 0.73 [95% CI, 0.66-0.82]) compared with their sibling with less than 6 months of breastfeeding or no breastfeeding. Conclusions and Relevance In this cohort study, exclusive or longer duration of breastfeeding was associated with reduced odds of developmental delays and language or social neurodevelopmental conditions. These findings may guide parents, caregivers, and public health initiatives in promoting early child development.
Regional Growth in US Neonatal Intensive Care Capacity and Mortality, 1991-2020
Authors: Gwenyth M. Gasper, Patrick M. Stuchlik, Therese A. Stukel, David C. Goodman
Journal: JAMA Pediatrics (2025)

Importance The effectiveness of neonatal intensive care in very ill newborns has led to rapid growth in US neonatal intensive care unit (NICU) capacity that is uncorrelated with regional perinatal risk. It is not known if there is an association between growth of regional capacity and newborn mortality. Objective To estimate the association between change in NICU capacity and neonatal mortality across 246 neonatal intensive care regions. Design, Setting, and Participants In this repeated cross-sectional study of US infants, the association between change in regional capacity and mortality was estimated in the years 1991, 2003, 2007, 2012, 2017, 2018, 2019, and 2020 using Poisson generalized estimating equations models adjusted for maternal and newborn characteristics, with newborns as the units of analysis. Data were analyzed June 30, 2024. This study used a 25% sample of all US infants born live with a birth weight of 400 g or more and gestational age of between 22 and less than 45 weeks (N = 30 902 221 newborns). Exposure Change in regional NICU capacity, measured as both counts of neonatologists and staffed NICU beds per 1000 live births (LBs) from 1991 to the birth year. Main Outcomes and Measures The primary outcome was neonatal (&amp;amp;lt;28 days) mortality and the secondary outcome was 180-day mortality. Results From 1991-2020, total adjusted neonatologists and NICU beds per 1000 LBs increased from 0.44 to 1.44 (227%) and 5.43 to 8.02 (48%), respectively, while neonatal mortality decreased from 3.87 to 2.21 (−43%) and 180-day mortality decreased from 6.27 to 3.19 (−49%) per 1000 LBs. There was no meaningful correlation between change in regional capacity (neonatologists: r , −0.12; 95% CI, −0.25 to 0.00; NICU beds: r , −0.07; 95% CI, −0.19 to 0.06) and change in regional neonatal mortality. No meaningful associations with capacity were observed in multilevel models (neonatologists: adjusted relative rate [aRR], 1.01; 95% CI, 0.93-1.01; NICU beds: aRR, 1.00; 95% CI, 0.99-1.00) nor was 180-day mortality associated with capacity. No associations were observed in birth cohorts stratified by relative need based on gestational age, maternal education, or maternal race or ethnicity. Conclusions and Relevance In this cross-sectional study, growth in regional NICU capacity was not associated with observable mortality benefit. Additional studies are needed to investigate the costs and benefits associated with NICU care expansion.
Avoidable Mortality Across US States and High-Income Countries
Authors: Irene Papanicolas, Maecey Niksch, Jose F. Figueroa
Journal: JAMA Internal Medicine (2025)

Importance Although there are increasing differences in health policy and population health across US states over the past decade, little is known about how US states compare with other countries on avoidable mortality. Objective To compare trends in avoidable mortality across US states and countries in the European Union (EU) and the Organisation for Economic Co-operation and Development (OECD). Design, Setting, and Participants Retrospective, population-based, repeated cross-sectional study comparing changes in avoidable mortality among decedents aged 0 to 74 years in 50 US states (and Washington, DC) and 40 high-income countries between 2009 and 2021. Data analysis was conducted from May to July 2024. Main Outcomes and Measures Avoidable mortality comprising both preventable deaths related to prevention and public health and treatable deaths related to timely and effective health care treatment. Results Between 2009 and 2019, total avoidable mortality increased in all US states (median [IQR], 29.0 [20.1 to 44.2] deaths per 100 000 people), while it decreased in most comparator countries (−14.4 [−28.4 to −8.0]). During this period, variation in avoidable mortality widened across US states (2009: median [IQR], 251.1 [228.4 to 280.4]; 2019: 282.8 [249.1 to 329.5]), but narrowed in comparator countries (2009: 201.5 [166.2 to 320.8]; 2019: 187.1 [152.0 to 298.2]). During the COVID-19 pandemic (2019-2021), avoidable mortality increased for all US states (median [IQR], 101.5 [64.7 to 143.1]) and comparator countries (25.8 [9.1 to 117.7]). The states and countries that experienced the greatest increase in avoidable deaths during the COVID-19 period were those with the highest baseline avoidable mortality (Pearson ρ = 0.86; P &amp;amp;lt; .001). Health spending and avoidable mortality have a consistent, negative, and significant association among comparator countries (2019: Pearson ρ = −0.7; P &amp;amp;lt; .001) but no statistically significant association within US states (2019: Pearson ρ = −0.12; P = .41). Conclusions and Relevance This cross-sectional study found that the stark contrast in avoidable mortality trends between all US states compared with EU and OECD countries suggests that broad, systemic factors play a role in worsening US population health. While other countries appear to make gains in health with increases in health care spending, such an association does not exist across US states, raising questions regarding US health spending efficiency.