tbuckley/cabot-search huggingface dataset:
Heat Exposure and Dementia-Related Mortality in China
Authors: Ya Gao, Lin Lin, Peng Yin, Haidong Kan, Renjie Chen, Maigeng Zhou
Journal: JAMA Network Open (2024)

Although existing research has found daily heat to be associated with dementia-related outcomes, there is still a gap in understanding the differing associations of nighttime and daytime heat with dementia-related deaths.
Multifunctional scaffolds for bone repair following age-related biological decline: Promising prospects for smart biomaterial-driven technologies
Authors: Jonathan D Schwartzman, Max McCall, Yasmine Ghattas, Abinaya Sindu Pugazhendhi, Fei Wei, Christopher Ngo, Jonathan Ruiz, Sudipta Seal, Melanie J Coathup
Journal: Biomaterials (2024)
Smoking Cessation Pharmacotherapy Use in Pregnancy
Authors: Annelies L. Robijn, Duong T. Tran, Jacqueline M. Cohen, Sarah Donald, Carolyn E. Cesta, Kari Furu, Lianne Parkin, Sallie-Anne Pearson, Johan Reutfors, Helga Zoega, Nicholas Zwar, Alys Havard
Journal: JAMA Network Open (2024)

Importance Significant evidence gaps exist regarding the safety of smoking cessation pharmacotherapies during pregnancy, especially for the risk of congenital malformations. Consequently, professional bodies advise against the use of varenicline and bupropion and recommend caution with nicotine replacement therapy (NRT). Contemporary estimates of the use of smoking cessation pharmacotherapies during pregnancy are lacking. Objective To quantify the proportion of individuals using prescribed smoking cessation pharmacotherapies during pregnancy and during the first trimester specifically, in 4 countries. Design, Setting, and Participants This retrospective, population-based cohort study used linked birth records, hospital admission records, and dispensing records of prescribed medications from all pregnancies resulting in birth between 2015 and 2020 in New South Wales, Australia; New Zealand; Norway; and Sweden. Data analyses were conducted in October and November 2023. Exposure Prescribed smoking cessation pharmacotherapy use (varenicline, NRT, and bupropion) during pregnancy was defined as days’ supply overlapping the period from date of conception to childbirth. Main Outcomes and Measures Prevalence of use among all pregnancies and pregnancies with maternal smoking were calculated. Among women who used a pharmacotherapy, the proportion of women with use during the first trimester of pregnancy was also calculated. Results Among 1 700 638 pregnancies in 4 countries, 138 033 (8.1%) had maternal smoking and 729 498 (42.9%) were younger than 30 years. The prevalences ranged from 0.02% to 0.14% for varenicline, less than 0.01% to 1.86% for prescribed NRT, and less than 0.01% to 0.07% for bupropion. Among pregnant individuals who smoked, use of pharmacotherapies was up to 10 times higher, with maximum prevalences of 1.25% for varenicline in New South Wales, 11.39% for NRT in New Zealand, and 0.39% for bupropion in New Zealand. Use in the first trimester occurred among more than 90% of individuals using varenicline, approximately 60% among those using NRT, and 80% to 90% among those using bupropion. Conclusions and Relevance In this cohort study of pregnant individuals in 4 high-income countries, the low prevalence of varenicline and bupropion use during pregnancy and higher prevalence of NRT use aligned with current clinical guidelines. As most use occurred in the first trimester, there is a need for evidence on the risk of congenital malformations for these medications.
Prospective Validation of a Prediction Model for the Diagnosis of Acute Pancreatitis
Authors: David X. Jin, Ronilda Lacson, Mahsa Eskian, Julia McNabb-Baltar, Peter A. Banks, Stephanie R. Kayden, Ali S. Raja, Ramin Khorasani
Journal: JAMA Network Open (2024)

Importance While most patients with acute pancreatitis (AP) fulfill diagnostic criteria with characteristic abdominal pain and serum lipase levels of at least 3 times the upper limit of normal (reference range) at presentation, early imaging is often used for confirmation. A prior prediction model and corresponding point-based score were developed using nonimaging parameters to diagnose AP in patients presenting to the emergency department (ED). Objective To evaluate the performance of the prediction model to diagnose AP in a prospective patient cohort. Design, Setting, and Participants This prospective diagnostic study included consecutive adult patients presenting to the ED between January 1, 2020, and March 9, 2021, at 2 large academic medical centers in the northeastern US with serum lipase levels at least 3 times the upper limit of normal. Patients transferred from outside institutions or with malignant disease and established intra-abdominal metastases, acute trauma, or altered mentation were excluded. Data were analyzed from October 15 to October 23, 2023. Exposures Participants were assigned scores for initial serum lipase level, number of prior AP episodes, prior cholelithiasis, abdominal surgery within 2 months, presence of epigastric pain, pain of worsening severity, duration from pain onset to presentation, and pain level at ED presentation. Main Outcome and Measures A final diagnosis of AP, established by expert review of hospitalization records. Results Prospective scores in 349 participants (mean [SD] age, 53.0 [18.8] years; 184 women [52.7%]; 66 Black [18.9%]; 199 White [57.0%]) demonstrated an area under the receiver operating characteristics curve of 0.91. A score of at least 6 points achieved highest accuracy ( F score, 82.0), corresponding to a sensitivity of 81.5%, specificity of 85.9%, positive predictive value of 82.6%, and negative predictive value of 85.1% for AP diagnosis. Early computed tomography or magnetic resonance imaging was performed more often in participants predicted to have AP (116 of 155 [74.8%] with a score ≥6 vs 111 of 194 [57.2%] with a score &amp;amp;lt;6; P &amp;amp;lt; .001). Early imaging revealed an alternative diagnosis in 8 of 116 participants (6.9%) with scores of at least 6 points, 1 of 93 (1.1%) with scores of at least 7 points, and 1 of 73 (1.4%) with scores of at least 8 points. Conclusions and Relevance In this multicenter diagnostic study, the prediction model demonstrated excellent AP diagnostic accuracy. Its application may be used to avoid unnecessary confirmatory imaging.
Contraception Use and Pregnancy Risk Among Adolescents in Pediatric Emergency Departments
Authors: Hannah Canter, Jennifer Reed, Chella Palmer, T. Charles Casper, Kristin Stukus, Sarah Schmidt, Michelle Pickett, Cynthia Mollen, Cara Elsholz, Andrea T. Cruz, Erin Augustine, Monika K. Goyal
Journal: JAMA Network Open (2024)

Importance Unintended pregnancy is a major health risk for adolescents in the US, and adolescents face many barriers to obtaining effective and reliable contraception. Objective To measure and describe the use of contraception, pregnancy risk index (PRI), and emergency contraception (EC) prescriptions among female adolescents accessing the emergency department (ED) for care. Design, Setting, and Participants This cross-sectional study is a planned secondary analysis of a multicenter trial from April 2021 through April 2022 that used a tablet-based, content-validated, confidential sexual health survey at 6 urban, pediatric tertiary care EDs affiliated with the Pediatric Emergency Care Applied Research Network. Participants were individuals aged 15 to 21 years presenting to the ED who completed the confidential sexual health survey and indicated female sex assigned at birth and prior penile-vaginal sexual intercourse. Data analysis was performed from January 2023 to February 2024. Main Outcomes and Measures The primary outcomes were the type and proportion of contraception use, the PRI, and provision of EC. Separate multivariable logistic regression models were performed to identify sociodemographic factors associated with these outcomes. Results A total of 1063 participants (median [IQR] age, 17.5 [16.5-18.3] years) were included in this analysis; 219 (20.8%) identified as Hispanic, 464 (44.1%) identified as non-Hispanic Black, 308 (29.3%) identified as non-Hispanic White, and 61 (5.8%) identified as other races and ethnicities. In total, 756 participants (71.1%) reported contraception use during their last sexual encounter. Long-acting reversible contraception use (LARC) was the least used (164 participants [15.4%]), and 307 (28.9%) reported no contraception use. Sociodemographic factors associated with overall contraception use, and LARC use specifically, included insurance and race and ethnicity. The overall PRI was 7.89, or an expected 8 pregnancies per 100 female individuals per year. Although 108 participants (10.2%) were eligible for EC, EC was ordered for only 6 (5.6%) of those eligible. Conclusions and Relevance In this cross-sectional study of sexually active adolescents presenting to the ED, the majority of participants reported using at least 1 form of contraception; however, LARCs were the least used option, and 28.9% of participants reported no contraceptive use. The unintended pregnancy risk was almost 8% in the study population. Few patients eligible for EC received it. These data suggest a high need and potential opportunity for provision of contraception services in the ED setting.
Hip Fracture Risk Assessment Tools for Adults Aged 80 Years and Older
Authors: Kristine E. Ensrud, John T. Schousboe, Carolyn J. Crandall, William D. Leslie, Howard A. Fink, Peggy M. Cawthon, Deborah M. Kado, Nancy E. Lane, Jane A. Cauley, Lisa Langsetmo
Journal: JAMA Network Open (2024)

Importance While adults aged 80 years and older account for 70% of hip fractures in the US, performance of fracture risk assessment tools in this population is uncertain. Objective To compare performance of the Fracture Risk Assessment Tool (FRAX), Garvan Fracture Risk Calculator, and femoral neck bone mineral density (FNBMD) alone in 5-year hip fracture prediction. Design, Setting and Participants Prognostic analysis of 3 prospective cohort studies including participants attending an index examination (1997 to 2016) at age 80 years or older. Data were analyzed from March 2023 to April 2024. Main Outcomes and Measures Participants contacted every 4 or 6 months after index examination to ascertain incident hip fractures and vital status. Predicted 5-year hip fracture probabilities calculated using FRAX and Garvan models incorporating FNBMD and FNBMD alone. Model discrimination assessed by area under receiver operating characteristic curve (AUC). Model calibration assessed by comparing observed vs predicted hip fracture probabilities within predicted risk quintiles. Results A total of 8890 participants were included, with a mean (SD) age at index examination of 82.6 (2.7) years; 4906 participants (55.2%) were women, 866 (9.7%) were Black, 7836 (88.1%) were White, and 188 (2.1%) were other races and ethnicities. During 5-year follow-up, 321 women (6.5%) and 123 men (3.1%) experienced a hip fracture; 818 women (16.7%) and 921 men (23.1%) died before hip fracture. Among women, AUC was 0.69 (95% CI, 0.67-0.72) for FRAX, 0.69 (95% CI, 0.66-0.72) for Garvan, and 0.72 (95% CI, 0.69-0.75) for FNBMD alone (FNBMD superior to FRAX, P = .01; and Garvan, P = .01). Among men, AUC was 0.71 (95% CI, 0.66-0.75) for FRAX, 0.76 (95% CI, 0.72-0.81) for Garvan, and 0.77 (95% CI, 0.72-0.81) for FNBMD alone ( P &amp;amp;lt; .001 Garvan and FNBMD alone superior to FRAX). Among both sexes, Garvan greatly overestimated hip fracture risk among individuals in upper quintiles of predicted risk, while FRAX modestly underestimated risk among those in intermediate quintiles of predicted risk. Conclusions and Relevance In this prognostic study of adults aged 80 years and older, FRAX and Garvan tools incorporating FNBMD compared with FNBMD alone did not improve 5-year hip fracture discrimination. FRAX modestly underpredicted observed hip fracture probability in intermediate-risk individuals. Garvan markedly overpredicted observed hip fracture probability in high-risk individuals. Until better prediction tools are available, clinicians should prioritize consideration of hip BMD, life expectancy, and patient preferences in decision-making regarding drug treatment initiation for hip fracture prevention in late-life adults.
Semirecumbent Positioning During Anesthesia Recovery and Postoperative Hypoxemia
Authors: Xinghe Wang, Kedi Guo, Jia Sun, Yuping Yang, Yan Wu, Xihui Tang, Yuqing Xu, Qingsong Chen, Si Zeng, Liwei Wang, Su Liu
Journal: JAMA Network Open (2024)

Importance The efficacy of a semirecumbent position (SRP) in reducing postoperative hypoxemia during anesthesia emergence is unclear despite its widespread use. Objective To determine the differences in postoperative hypoxemia between patients in an SRP and a supine position. Design, Setting, and Participants This randomized clinical trial was performed at a tertiary hospital in China between March 20, 2021, and May 10, 2022. Patients scheduled to undergo laparoscopic upper abdominal surgery under general anesthesia were enrolled. Study recruitment and follow-up are complete. Interventions Patients were randomized to 1 of the following positions at the end of the operation until leaving the postanesthesia care unit: supine (group S), 15° SRP (group F), or 30° SRP (group T). Main Outcomes and Measures The primary outcome was the incidence of postoperative hypoxemia in the postanesthesia care unit. Severe hypoxemia was also evaluated. Results Out of 700 patients (364 men [52.0%]; mean [SD] age, 47.8 [11.3] years), 233 were randomized to group S (126 men [54.1%]; mean [SD] age, 48.2 [10.9] years), 233 to group F (122 men [52.4%]; mean [SD] age, 48.1 [10.9] years), and 234 to group T (118 women [50.4%]; mean [SD] age, 47.2 [12.1] years). Postoperative hypoxemia differed significantly among the 3 groups (group S, 109 of 233 [46.8%]; group F, 105 of 233 [45.1%]; group T, 76 of 234 [32.5%]; P = .002). This difference was statistically significant for groups T vs S (risk ratio [RR], 0.69 [95% CI, 0.55-0.87]; P = .002) and groups T vs F (RR, 0.72 [95% CI, 0.57-0.91]; P = .007), but not for groups F vs S (RR, 0.96 [95% CI, 0.79-1.17]; P = .78). Severe hypoxemia also differed among the 3 groups (group S, 61 of 233 [26.2%]; group F, 53 of 233 [22.7%]; group T, 36 of 234 [15.4%]; P = .01). This difference was statistically significant for groups T vs S (RR, 0.59 [95% CI, 0.41-0.85]; P = .005). Conclusions and Relevance In this randomized clinical trial of SRP during anesthesia recovery in patients undergoing laparoscopic upper abdominal surgery, postoperative hypoxemia was significantly reduced in group T compared with group F or group S. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR2100045087
Source-Specific Air Pollution and Loss of Independence in Older Adults Across the US
Authors: Boya Zhang, Carlos F. Mendes de Leon, Kenneth M. Langa, Jennifer Weuve, Adam Szpiro, Jessica Faul, Jennifer D’Souza, Joel D. Kaufman, Richard A. Hirth, Lynda D. Lisabeth, Jiaqi Gao, Sara D. Adar
Journal: JAMA Network Open (2024)

Air pollution is a recognized risk factor associated with chronic diseases, including respiratory and cardiovascular conditions, which can lead to physical and cognitive impairments in later life. Although these losses of function, individually or in combination, reduce individuals' likelihood of living independently, little is known about the association of air pollution with this critical outcome.
Single-cell topographical profiling of the immune synapse reveals a biomechanical signature of cytotoxicity
Authors: Miguel de Jesus, Alexander H. Settle, Daan Vorselen, Thomas K. Gaetjens, Michael Galiano, Yevgeniy Romin, Esther Lee, Yung Yu Wong, Tian-Ming Fu, Endi Santosa, Benjamin Y. Winer, Fella Tamzalit, Mitchell S. Wang, Anthony Santella, Zhirong Bao, Joseph C. Sun, Pavak Shah, Julie A. Theriot, Steven M. Abel, Morgan Huse
Journal: Science Immunology (2024)

Immune cells have intensely physical lifestyles characterized by structural plasticity and force exertion. To investigate whether specific immune functions require stereotyped mechanical outputs, we used super-resolution traction force microscopy to compare the immune synapses formed by cytotoxic T cells with contacts formed by other T cell subsets and by macrophages. T cell synapses were globally compressive, which was fundamentally different from the pulling and pinching associated with macrophage phagocytosis. Spectral decomposition of force exertion patterns from each cell type linked cytotoxicity to compressive strength, local protrusiveness, and the induction of complex, asymmetric topography. These features were validated as cytotoxic drivers by genetic disruption of cytoskeletal regulators, live imaging of synaptic secretion, and in silico analysis of interfacial distortion. Synapse architecture and force exertion were sensitive to target stiffness and size, suggesting that the mechanical potentiation of killing is biophysically adaptive. We conclude that cellular cytotoxicity and, by implication, other effector responses are supported by specialized patterns of efferent force.
Circulating KLRG1 <sup>+</sup> long-lived effector memory T cells retain the flexibility to become tissue resident
Authors: Erin D. Lucas, Matthew A. Huggins, Changwei Peng, Christine O’Connor, Abigail R. Gress, Claire E. Thefaine, Emma M. Dehm, Yoshiaki Kubota, Stephen C. Jameson, Sara E. Hamilton
Journal: Science Immunology (2024)

KLRG1 + CD8 T cells persist for months after clearance of acute infections and maintain high levels of effector molecules, contributing protective immunity against systemic pathogens. Upon secondary infection, these long-lived effector cells (LLECs) are incapable of forming other circulating KLRG1 − memory subsets such as central and effector memory T cells. Thus, KLRG1 + memory T cells are frequently referred to as a terminally differentiated population that is relatively short lived. Here, we show that after viral infection of mice, effector cells derived from LLECs rapidly enter nonlymphoid tissues and reduce pathogen burden but are largely dependent on receiving antigen cues from vascular endothelial cells. Single-cell RNA sequencing reveals that secondary memory cells in nonlymphoid tissues arising from either KLRG1 + or KLRG1 − memory precursors develop a similar resident memory transcriptional signature. Thus, although LLECs cannot differentiate into other circulating memory populations, they still retain the flexibility to enter tissues and establish residency.
Cytokines drive the formation of memory-like NK cell subsets via epigenetic rewiring and transcriptional regulation
Authors: Jennifer A. Foltz, Jennifer Tran, Pamela Wong, Changxu Fan, Evelyn Schmidt, Bryan Fisk, Michelle Becker-Hapak, David A. Russler-Germain, Jeanette Johnson, Nancy D. Marin, Celia C. Cubitt, Patrick Pence, Joseph Rueve, Sushanth Pureti, Kimberly Hwang, Feng Gao, Alice Y. Zhou, Mark Foster, Timothy Schappe, Lynne Marsala, Melissa M. Berrien-Elliott, Amanda F. Cashen, Jeffrey J. Bednarski, Elana Fertig, Obi L. Griffith, Malachi Griffith, Ting Wang, Allegra A. Petti, Todd A. Fehniger
Journal: Science Immunology (2024)

Activation of natural killer (NK) cells with the cytokines interleukin-12 (IL-12), IL-15, and IL-18 induces their differentiation into memory-like (ML) NK cells; however, the underlying epigenetic and transcriptional mechanisms are unclear. By combining ATAC-seq, CITE-seq, and functional analyses, we discovered that IL-12/15/18 activation results in two main human NK fates: reprogramming into enriched memory-like (eML) NK cells or priming into effector conventional NK (effcNK) cells. eML NK cells had distinct transcriptional and epigenetic profiles and enhanced function, whereas effcNK cells resembled cytokine-primed cNK cells. Two transcriptionally discrete subsets of eML NK cells were also identified, eML-1 and eML-2, primarily arising from CD56
Knowledge, Attitudes, and Beliefs About Opioid Use Disorder Treatment in Primary Care
Authors: Brandon del Pozo, Ju Nyeong Park, Bruce G. Taylor, Sarah E. Wakeman, Lori Ducharme, Harold A. Pollack, Josiah D. Rich
Journal: JAMA Network Open (2024)

This survey study assesses the US public’s perception and awareness regarding medication for opioid use disorder and its availability in primary care settings.
Expanding Access to Contraception for Adolescents—Reproductive Justice and the Emergency Department
Authors: Colleen K. Gutman, Atsuko Koyama, Rosemarie Fernandez
Journal: JAMA Network Open (2024)

Hannah Canter, MD; Jennifer Reed, MD, MS; Chella Palmer, MPH; T. Charles Casper, PhD; Kristin Stukus, MD; Sarah Schmidt, MD, MSHI; Michelle Pickett, MD; Cynthia Mollen, MD, MSCE; Cara Elsholz, MPH; Andrea T. Cruz, MD, MPH; Erin Augustine, MD; Monika K. Goyal, MD, MSCE
Errors in Abstract, Figure 3, and Supplement 1
Journal: JAMA Network Open (2024)

In the Original Investigation titled "Helicobacter pylori Treatment and Gastric Cancer Risk Among Individuals With High Genetic Risk for Gastric Cancer," 1 published on May 29, 2024, there were errors in the Abstract, Figure 3, and Supplement 1.In the Abstract, the hazard ratio for individuals with high genetic risk should have read 0.45 (95% CI, 0.24-0.82).In the caption for Figure 3, the sample size for gastric cancer tissue from The Cancer Genome Atlas-Stomach Adenocarcinoma should have read 431, and the sample size for independent nontumor tissue from Genotype-Tissue Expression should have read 174.This change was also made in the eMethods and eTable 9 in Supplement 1.This article has been corrected. 1
Quantifying Research and Development Expenditures in the Drug Industry
Authors: Olivier J. Wouters, Aaron S. Kesselheim
Journal: JAMA Network Open (2024)

US patients pay more than twice as much per capita for brand-name prescription drugs as patients in most other developed countries. 1Since Joseph Biden was elected President in 2020, the federal government has undertaken a variety of initiatives to address these high costs: the Federal Trade Commission has moved to challenge improper patents listed by brand-name drug
Error in Figure
Journal: JAMA Network Open (2024)

Error in FigureIn the Original Investigation titled "Maternal Urinary Fluoride and Child Neurobehavior at Age 36 Months," 1 published May 20, 2024, there were errors in the Figure, including mislabeled y-axes (which should have been "Frequency" rather than "Frequency, %"), a mislabeled x-axis in panel B (which should have been "Externalizing Problems T-scores" rather than "Internalizing Problems T-Scores"), and a shifted y-axis scale that made the frequencies in the histogram appear incorrect.