tbuckley/cabot-search huggingface dataset:
Persistent Hyperglycemia and Insulin Resistance With the Risk of Worsening Cardiac Damage in Adolescents: A 7-Year Longitudinal Study of the ALSPAC Birth Cohort
Authors: Andrew O. Agbaje, Justin P. Zachariah, Alan R. Barker, Craig A. Williams, Dimitris Vlachopoulos, Christoph Saner, Tomi-Pekka Tuomainen
Journal: Diabetes Care (2025)

OBJECTIVE Insulin resistance (IR) and dysglycemia can induce cardiac remodeling in adulthood, but little evidence exists with respect to cardiac remodeling in youth with and without evidence of new-onset glucose metabolic alterations. This study investigated whether changes in metabolic status from adolescence to young adulthood are associated with the risk of progressive cardiac remodeling and examined potential mechanistic pathways. RESEARCH DESIGN AND METHODS From the Avon Longitudinal Study of Parents and Children (ALSPAC), U.K. cohort, 1,595 adolescents, mean (SD) age 17.7 (0.4) years, who had data on fasting plasma glucose and insulin levels, and echocardiography left ventricular (LV) mass indexed for height raised to the power of 2.7 (LVMI2.7) and in whom these factors repeatedly were measured at a clinic visit when they were aged 24 years were included. HOMA-IR was computed, hyperglycemia was defined as glucose concentration of ≥5.6 mmol/L and ≥6.1 mmol/L, and LV hypertrophy was defined as LVMI2.7 ≥51g/m2.7. RESULTS The prevalence of LV hypertrophy increased from 2.4% at baseline to 7.1% at follow-up. Each unit increase of glucose (β = 0.37 g/m2.7 [95% CI 0.23–0.52]; P &amp;lt; 0.001) and HOMA-IR (1.10 g/m2.7 [0.63–1.57]; P &amp;lt; 0.001) was independently associated with increased LVMI2.7 over 7 years. Persistent hyperglycemia of 5.6 mmol/L and 6.1 mmol/L was associated with higher odds (odds ratio [OR] 1.46 [95% CI 1.35–1.47], P &amp;lt; 0.001; and 3.10 [95% CI 1.19–8.08], P = 0.021, respectively) of worsening LV hypertrophy over 7 years. Increased fat mass (62% mediation) significantly mediated the association of increased HOMA-IR with increased LVMI2.7. CONCLUSIONS Persistent adolescent hyperglycemia and worsening IR were associated with the risk of worsening structural and functional cardiac damage, and these were largely explained by increased fat mass.
Oncologist-Patient Concordance and Treatment Adherence in Chronic Myeloid Leukemia
Authors: J. Felipe Montano-Campos, Erin E. Hahn, Eric C. Haupt, Jerald Radich, Aasthaa Bansal
Journal: JAMA Network Open (2025)

This cohort study investigates the association between oncologist-patient demographic concordance and adherence to tyrosine kinase inhibitor treatment in chronic myeloid leukemia.
Wildfire Smoke Exposure and Cause-Specific Hospitalization in Older Adults
Authors: Sofia L. Vega, Marissa L. Childs, Sarika Aggarwal, Rachel C. Nethery
Journal: JAMA Network Open (2025)

Importance The escalating intensity of wildfires in the western US is increasing exposure to smoke pollution. Previous studies of wildfire smoke and health have primarily focused on mortality and respiratory and cardiovascular events, with limited research on broader health impacts or on the shape of concentration-response curves. Objective To characterize the associations between exposure to smoke-specific fine particulate matter (PM 2 . 5 ) and cause-specific hospitalizations among older adults in the western US. Design, Setting, and Participants This retrospective cohort study used Medicare inpatient claims data from 2006 to 2016 linked with machine learning–derived smoke-specific PM 2 . 5 to assess associations between smoke PM 2 . 5 and hospitalization rates. Participants included Medicare beneficiaries aged 65 years or older who lived in a western US state (ie, Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, or Wyoming). Analyses were conducted from October 2023 to February 2025. Exposures Daily county-level smoke-specific PM 2 . 5 concentrations were estimated from machine learning models trained on monitor and satellite data. Main Outcomes and Measures Daily county-level rates of unscheduled hospitalization for each of 13 broad cause categories. To characterize the association between each cause of hospitalization and smoke PM 2.5 , distributed lag models were fitted with hospitalization rates modeled as a function of same-day smoke PM 2.5 exposure and exposures on each day of the preceding week, using splines on exposure to allow for nonlinearity. Results The study included 10 369 361 individuals (mean [SD] age, 74.7 [7.9] years; 4 862 826 male [46.9%]; 5 506 535 female [53.1%]; 373 252 Black [3.6%]; 420 577 Hispanic [4.1%]; and 8 365 607 White [80.7%]), 57 million person-months of follow-up, and 4.7 million unscheduled hospitalizations. Smoke PM 2 . 5 concentration-response curves for respiratory hospitalizations and cardiovascular hospitalizations were flat at lower concentrations but showed increasing trends at concentrations above 25 μg/m 3 . On average, daily hospitalizations (per 100 000) increased by 2.40 (95% CI, 0.17 to 4.63) for respiratory concerns when increasing same-day and preceding week smoke PM 2.5 concentrations from 0 to 40 μg/m 3 ; hospitalizations for cardiovascular concerns increased by 2.61 (95% CI, –0.09 to 5.30), a difference that was not statistically significant. No associations were observed for other causes of hospitalization. Conclusions and Relevance In this cohort study, exposure to high levels of smoke pollution was associated with an increase in hospitalizations for respiratory diseases. These findings underscore the need for interventions to mitigate the health impacts of wildfire smoke exposure.
Postoperative Outcomes Among Sodium-Glucose Cotransporter 2 Inhibitor Users
Authors: Roberta Teixeira Tallarico, Bocheng Jing, Kaiwei Lu, Shweta Amy Chawla, Yanting Luo, Anusha Badathala, Catherine L. Chen, Arthur W. Wallace, Matthieu Legrand
Journal: JAMA Surgery (2025)

Importance Case reports and small retrospective studies have suggested that there is an increased risk of postoperative euglycemic ketoacidosis (eKA) and acute kidney injury (AKI) among patients using sodium-glucose cotransporter 2 inhibitors (SGLT2i) preoperatively. However, there has not been a representative assessment of the risks of these agents among patients undergoing surgery. Objective To evaluate the risk of postoperative eKA, AKI, and mortality within 30 days after surgery among preoperative long-term SGLT2i users compared with nonusers. Design, Settings, and Participants This is a multicenter, propensity-matched, retrospective case-control study from the Veterans Affairs Health Care System (VAHCS) National Registry performed from January 1, 2014, to December 31, 2022. Adult patients using SGLT2i preoperatively who underwent inpatient surgical procedures were compared with a 1:5 matched control group using propensity score matching, including the patient’s demographic characteristics, comorbidities, and surgical characteristics. Data analysis was performed from June 2023 to August 2024. Exposure Long-term use of SGLT2i, defined as having more than 3 fills of outpatient prescription or less than a 180-day gap of the last fill according to the VAHCS pharmacy registries. Main Outcomes and Measures The primary outcome was the rate of postoperative eKA among SGLT2i users vs control patients. Secondary outcomes included postoperative AKI and 30-day mortality after surgery. Results Among 462 968 patients undergoing surgery, 7448 SGLT2i users (mean [SD] age, 67.7 [8.1] years; 7204 [96.7%] male) and 455 520 nonusers (mean [SD] age, 65.8 [11.0] years; 424 785 [93.3%] male) were identified. After propensity score matching, 7439 patients were identified as SGLT2i users and compared with 33 489 control patients. SGLT2i use was associated with an increased risk of eKA (odds ratio [OR], 1.11; 95% CI, 1.05-1.17) but reduced risks of perioperative AKI (OR, 0.69; 95% CI, 0.62-0.78) and 30-day mortality (OR, 0.70; 95% CI, 0.55-0.88). The mortality rate 30 days after surgery was 1.1% among SGLT2i users vs 1.6% among control patients. The median hospital length of stay among the patients presenting with eKA increased by 3 days (median [IQR], 6 [3-10] days for those with eKA vs 3 [2-6] days for those without eKA). Conclusions and Relevance Patients treated with SGLT2i had a small but significantly higher risk of postoperative eKA but lower risks of postoperative AKI and 30-day mortality.
An Isolated Red Plaque on the Anterior Chest
Authors: Bin Peng, Xiaojuan Nan, Songmei Geng
Journal: JAMA Dermatology (2025)

A 6-year-old girl had a slightly sunken red plaque was observed on the chest, approximately 1.5 cm in diameter, with a smooth surface, associated vascular dilation, well-defined borders, and no scaling or ulceration. What is your diagnosis?
Parental Leave Benefits and Maternal Postpartum Mental Health in Sweden
Authors: Amy Heshmati, Helena Honkaniemi, Sara Fritzell, Sol P. Juárez
Journal: JAMA Network Open (2025)

Importance Generous parental leave benefits have been associated with better mental health outcomes for parents after childbirth. However, few studies account for preconception mental health and working conditions, the latter being a requirement for generous parental leave benefits. Objective To evaluate the association between levels of parental leave benefits and maternal postpartum mental health when preconception mental health, income, and employment status were considered. Design, Setting, and Participants This population-based nationwide cohort study included first-time mothers aged 18 to 52 years who gave birth to a live singleton offspring between January 1, 2007, and December 31, 2011. Data were analyzed from March 8 to February 18, 2025. Exposure Paid parental leave benefits, including higher level (qualified for earnings-related benefits equal to approximately 80% of their salary) vs basic level (a flat-rate benefit for those not meeting the work requirements for earnings-related benefits). Main Outcomes and Measures Nationwide registers were used to perform multivariable logistic regression to calculate the odds of mental health outcomes from different levels of severity (prescription of antidepressants or anxiolytics, specialist outpatient care, and hospitalization) between mothers receiving higher-level and basic benefits. Decomposition analyses using the Karlson-Holm-Breen method were conducted to examine the contribution of preconception mental health, income, and employment status. Results The sample included 210 800 first-time mothers (mean [SD] age, 28.6 [5.0] years), of whom 35 255 (16.72%) received basic benefits and 175 545 (83.28%) qualified for higher-level benefits. Mothers receiving basic benefits had higher odds of being prescribed antidepressants or anxiolytics (odds ratio [OR], 1.44; 95% CI, 1.37-1.51), receiving specialist outpatient care (OR, 2.27; 95% CI, 2.13-2.44), and being hospitalized (OR, 2.47; 95% CI, 2.06-2.97) compared with mothers receiving higher-level benefits. Higher odds remained after adjusting for preconception mental health, accounting for a 46.1% decrease for prescribed antidepressants or anxiolytics, 15.1% for outpatient care, and 10.7% for hospitalization. After adjustment for income and employment status, the odds remained elevated for specialist outpatient care (OR, 1.13; 95% CI, 1.02-1.24) and hospitalization (OR, 1.34; 95% CI, 1.03-1.76). Conclusions and Relevance In this cohort study of first-time mothers in Sweden, higher-level benefits were associated with better mental health, particularly moderate-to-severe mental disorders. However, since eligibility for higher-level parental leave benefits is contingent on labor market attachment, both improving women’s labor market attachment and relaxing the work requirements for higher-level parental leave could promote women’s postpartum mental health.
Cumulative Human Health Risk Assessment of Regional Ozone and Volatile Organic Compounds from Unconventional Oil and Gas Sites in Colorado’s Front Range
Authors: Meagan L. Weisner, Paige M. Varner, I Ting Ku, Jeffrey L. Collett Jr., Brent Buck, Lisa M. McKenzie
Journal: Environmental Health Perspectives (2025)

Most unconventional oil and gas (UOG) extraction in Colorado occurs within the Denver Metro/North Front Range (DMNFR) ozone Non-attainment Area (NAA). Previous UOG human health risk assessments do not consider cumulative risk from both volatile organic compounds (VOCs) and criteria air pollutants (CAPs) like ozone. We conducted a cumulative human health risk assessment (CHHRA) utilizing regulatory-grade 1- and 8-hour ozone measurements from a DMNFR United States Environmental Protection Agency (EPA) monitoring station and weekly and short-term (15 second - 1 minute) VOC air quality monitoring (AQM) data collected between 2018-2023 from ten near-pad air monitoring sites, three community sites, and one background site. Acute and chronic non-cancer hazard indices (HIs) for multiple health endpoints, as well as cancer risks, were calculated during well drilling, well completions, and production activity periods and compared between sites. VOC concentrations were compared between operations that used a petroleum-based drilling fluid versus a synthetic drill fluid. Differences in weekly chemical concentrations between sites, UOG phases, and drill muds were analyzed using repeated measures analysis of variance (ANOVA) with post-hoc pairwise comparisons with Bonferroni adjustment. Acute HIs of VOCs and ozone ranged from 1.34 x 10-4 to 31.33 at the 95th percentile concentrations at all sites. One of the three community monitoring sites, Anthem, exceeded EPA thresholds for respiratory, immunological, and developmental endpoints during production and for the immunological endpoint during well completions. At the near-pad sites, acute hazards exceeded EPA thresholds during well completions for immunological, respiratory, reproductive, developmental, and neurological endpoints. Neurological and immunological HIs were above thresholds for the drilling phase at near-pad sites. Chronic HIs ranged from 8.43 x 10-4 to 0.47 at 95th percentile concentrations and, therefore, were below the HI threshold for all near-pad and community sites for all health endpoints. Cancer risks ranging from 209 to 335 in a million at 95th percentile concentrations were above EPA's thresholds for all sites, including the background site which is more heavily influenced by Denver-metro traffic emissions. Our results suggest that for communities located near UOG well pads in the DMNFR ozone NAA, acute health risks persist after the implementation of best management practices to reduce emissions. Greater protection to public health could be afforded by establishing policies that require drilling and well completions to be conducted outside of summer ozone season. Further research is needed to address potential health risks from the use of synthetic drilling fluid. https://doi.org/10.1289/EHP16272.
No-touch versus conventional vein in coronary artery bypass grafting: three year follow-up of multicentre randomised PATENCY trial
Authors: Meice Tian, Xianqiang Wang, Wei Feng, Huaibin Wang, Su Liu, Zhigang Liu, Yu Chen, Qi Miao, Pixiong Su, Xi Li, Yang Wang, Bin Lu, Kai Chen, Changwei Zhang, Shengshou Hu
Journal: BMJ (2025)

To assess the three year outcomes of the no-touch vein harvesting technique in coronary artery bypass grafting surgery compared with the conventional approach. Three year extended follow-up of the randomised PATENCY (graft patency between the no-touch vein harvesting technique and conventional approach in coronary artery bypass graft surgery) trial. Seven cardiac surgery centres in China; enrolment between April 2017 and June 2019. 2655 participants aged 18 and older undergoing isolated coronary artery bypass grafting surgery. Patients were randomly assigned 1:1 to the no-touch vein harvesting technique group or the conventional approach group during surgery and followed up. Vein graft occlusion (based on computed tomography angiography) at three years. Mean age of participants was 61 years (standard deviation ±8 years) and 22% were women. 99.4% (2621) attended the three year follow-up visit, while 86.5% (2281) received computed tomography angiography. At three years, the no-touch group showed a significantly lower vein graft occlusion rate (5.7% v 9.0%, P<0.001) than the conventional group (odds ratio 0.62, 95% confidence interval 0.48 to 0.80), with absolute risk difference of -3.2% (95% confidence interval -5.0% to -1.4%). The intention-to-treat analysis, including all 2655 randomised patients with multiple imputations for missing data, showed consistent findings, with occlusion rates of 6.1% in the no-touch group versus 9.3% in the conventional group (odds ratio 0.63, 95% confidence interval 0.51 to 0.81; absolute risk difference-3.1%, 95% confidence interval -4.9% to -1.4%; P<0.001). These results confirm the robustness of the no-touch technique in reducing vein graft occlusion. The no-touch technique consistently and robustly reduced the risk of vein graft occlusion and several cardiac events by one third to one half within three years after coronary artery bypass grafting surgery. ClinicalTrials.gov NCT03126409.
Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults: ASCO-SNO Guideline Rapid Recommendation Update
Authors: Jaishri Blakeley, Nimish A Mohile, Hans Messersmith, Andrew B Lassman, David Schiff, Jaishri Blakeley, Na Tosha Gatson, Andreas F Hottinger, Andrew Lassman, Nimish A Mohile, Jordan Morton, Douglas Ney, Phioanh Leia Nghiemphu, James Perry, Anne Shannon, Helen A. Shih, Roy Strowd, Martin van den Bent, Mateo Ziu
Journal: Neuro-Oncology (2025)
Treating Depression With Repetitive Transcranial Magnetic Stimulation: A Clinician’s Guide
Authors: Leo Chen, Andrew M. Fukuda, Shixie Jiang, Michael K. Leuchter, Sanne J. H. van Rooij, Alik S. Widge, William M. McDonald, Linda L. Carpenter
Journal: American Journal of Psychiatry (2025)

Transcranial magnetic stimulation (TMS) applies electromagnetic pulses to stimulate cortical neurons. The antidepressant effect of the repetitive application of TMS (rTMS) was first shown nearly three decades ago. The therapeutic potential of TMS has been extensively investigated, mostly in treatment-resistant depression (TRD). Studies have extensively evaluated stimulation parameters, treatment schedules, methods to localize the stimulation target, and different magnetic coil designs engineered for desired stimulation breadth and depth. Several of these stimulation protocols and coils/devices have received U.S. Food and Drug Administration (FDA) clearance for application in TRD and other neuropsychiatric disorders, such as obsessive-compulsive disorder. Some stimulation protocols, while not FDA-cleared, have substantial clinical trial-derived evidence to support their safety and antidepressant efficacy. The proliferation of rTMS translational and clinical research has resulted in the field's advancement. This clinician-oriented review contains an overview of fundamental TMS principles, physiological effects, and studies of rTMS in TRD. Also discussed are two innovations that are increasingly applied in the clinic: theta burst stimulation and accelerated scheduling. A synthesis of the key clinical considerations given to patient assessment and safety, treatment setup, and the minimization and management of adverse effects is provided.
The IARC Perspective on the Effects of Policies on Reducing Alcohol Consumption
Authors: Susan M. Gapstur, Daniela Mariosa, Luciana Neamtiu, Suzanne T. Nethan, Jürgen Rehm, Taisia Huckle, David H. Jernigan, Elizabeth A. O’Connor, Mindaugas Štelemėkas, Peter Allebeck, Sawitri Assanangkornchai, Nicholas Carah, Surasak Chaiyasong, Samantha Cukier, The Son Dao, Rijo M. John, Richard Matzopoulos, Petra S. Meier, Paula O’Brien, Guillermo Paraje, Robin Room, Claire Wilkinson, Norman D. Maldonado, Tim Stockwell, Maria Neufeld, Dag Rekve, Béatrice Lauby-Secretan
Journal: New England Journal of Medicine (2025)
Lentiviral Gene Therapy for Severe Leukocyte Adhesion Deficiency Type 1
Authors: Claire Booth, Julián Sevilla, Elena Almarza, Caroline Y. Kuo, Josune Zubicaray, Dayna Terrazas, Gráinne O’Toole, Maria Chitty-Lopez, Grace Choi, Eileen Nicoletti, Janel Long-Boyle, Augustine Fernandes, Kritika Chetty, Satiro De Oliveira, Crystal Banuelos, Jinhua Xu-Bayford, Antonella Lucía Bastone, Philipp John-Neek, Connie Jackson, Theodore B. Moore, Kimberly Gilmour, Axel Schambach, Michael Rothe, Sanchali Kasbekar, Gayatri R. Rao, Kinnari Patel, Gaurav Shah, Adrian J. Thrasher, Juan A. Bueren, Jonathan D. Schwartz, Donald B. Kohn
Journal: New England Journal of Medicine (2025)

The β2 common integrin subunit CD18 is essential for leukocyte-endothelial adhesion and extravasation to inflamed or infected tissue. Damaging variants in ITGB2, which encodes CD18, cause leukocyte adhesion deficiency type I (LAD-I), an inborn error of immunity that leads to frequent life-threatening infections and a high risk of death among affected children. Allogeneic hematopoietic stem-cell transplantation (HSCT) represents a curative treatment but is limited by donor availability, a high incidence of graft-versus-host disease, and graft failure. In a phase 1-2, multinational, open-label study, we enrolled nine children who had severe LAD-I and treated them with marnetegragene-autotemcel (marne-cel), a gene therapy of autologous CD34+ hematopoietic stem cells transduced with a self-inactivating lentiviral vector containing human ITGB2, and followed them for 24 months. The primary efficacy end point of the phase 2 study was survival without allogeneic HSCT (HSCT-free survival) at least 1 year after marne-cel infusion and at 2 years of age among the patients who were younger than 1 year of age at enrollment, tested against a null hypothesis of survival of 39% of the patients. We also report interim data from six patients enrolled in the long-term follow-up study. Serious adverse events related to myeloablative busulfan conditioning were observed. No adverse events attributed to gene therapy were reported. None of the patients had graft failure. HSCT-free survival was 100% (95% confidence interval [CI], 66 to 100) at 1 year after infusion (P<0.001). All the patients who were enrolled at younger than 1 year of age were alive beyond 2 years of age. Pretreatment neutrophilia and skin abnormalities related to LAD-I resolved. The annualized incidence of infection-related hospitalizations beyond 90 days after engraftment through 24 months after marne-cel infusion was 74.45% lower than the incidence before marne-cel infusion, the annualized incidence of prolonged infection-related hospitalizations was 81.95% lower, and the annualized incidence of prespecified serious infections was 84.90% lower. In this study, lentiviral vector-transduced autologous CD34+ HSCT was successful in treating severe LAD-I. (Funded by Rocket Pharmaceuticals and the California Institute for Regenerative Medicine; ClinicalTrials.gov numbers, NCT03812263 and NCT06282432.).