tbuckley/cabot-search huggingface dataset:
A “Janus” structured nanoclay microgel system for targeted probiotic therapy in diarrhea-predominant irritable bowel syndrome
Authors: Youhe Wu, Yiheng Jiang, Yanrong Gong, Ting Yao, Qi Zheng, Yuetong Li, Qi Xia, Bo Li, Lanjuan Li
Journal: Journal of Controlled Release (2025)
Metabotypes are linked to uncontrolled childhood asthma, gut microbiota, and systemic inflammation
Authors: Mahmoud I Abdel-Aziz, Simone Hashimoto, Anne H Neerincx, Eric G Haarman, Alexander Cecil, Jutta Lintelmann, Michael Witting, Stefanie M Hauck, Nikki Kerssemakers, Joris C Verster, Corinna Bang, Andre Franke, Barbara S Dierdorp, Tamara Dekker, Nariman K A Metwally, Jan Willem Duitman, René Lutter, Mario Gorenjak, Antoaneta A Toncheva, Parastoo Kheiroddin, Susanne Harner, Susanne Brandstetter, Christine Wolff, Paula Corcuera-Elosegui, Leyre López-Fernández, Javier Perez-Garcia, Mario Martin Almeida, Olaia Sardón-Prado, Maria Pino-Yanes, Uroš Potočnik, Michael Kabesch, Susanne J H Vijverberg, Aletta D Kraneveld, Anke H Maitland-van der Zee
Journal: Journal of Allergy and Clinical Immunology (2025)

Childhood asthma has been linked to distinct metabolomic profiles. To identify phenotypes (metabotypes) in children with moderate-to-severe asthma through integrative fecal and serum metabolome analysis. Children from the Systems Pharmacology Approach to Uncontrolled Pediatric Asthma cohort with Global Initiative for Asthma treatment step ≥3 were recruited. Asthma control was defined by the Asthma Control Test and annual exacerbation history. Targeted metabolomics profiling of feces and serum was performed using liquid chromatography and flow injection electrospray ionization-triple quadrupole mass spectrometry. Similarity Network Fusion integrated fecal and serum metabolome profiles, followed by spectral clustering. Clusters were analyzed for differences in asthma characteristics, food diaries, fecal microbiota composition, and levels of serum inflammatory markers and blood cells. Integrative fecal and serum metabolome analysis of 92 children with moderate-to-severe asthma (median age: 11.5 years, 34% female) revealed three metabotypes. Metabotype1 had the lowest percentage of allergic rhinitis, with elevated serum ceramides and triglycerides. Metabotype2 had higher odds of asthma control, the highest percentage of children with ≥4 months of breastfeeding, reduced sugar intake, lowest levels of blood neutrophils and serum inflammatory markers, and with elevated serum acylcarnitines and ω-3 fatty acids. Metabotype3 included the highest percentage of uncontrolled asthma patients, with decreased serum cholesteryl esters, phosphatidylcholines, and sphingomyelins, elevated fecal amino acids, and reduced fecal microbiota diversity. Metabotypes in children with moderate-to-severe asthma are linked to asthma control, distinct fecal microbiota and systemic inflammatory patterns. The findings suggest that metabotyping can be valuable in precision medicine approaches for asthma.
Evaluating Metabolic Signatures in the Serum of South Korean Patients with Humidifier Disinfectant-Associated Lung Injury Identified through Untargeted Metabolomics
Authors: Jinwoo Kim, Mi-Jin Kang, So-Yeon Lee, Sang-Bum Hong, Ho Cheol Kim, Myung Hee Nam, Soo-Jong Hong
Journal: Environmental Health Perspectives (2025)

The South Korean humidifier disinfectant-associated lung injury case was one of the worst disasters involving household chemical products, resulting in over 5,800 casualties. Despite the strong association between lung injury and humidifier disinfectants, the underlying pathogenic mechanisms remain unclear. We investigated patients with humidifier disinfectant-associated lung injury to identify key metabolic signatures, aiming to gain insights into the underlying pathogenic mechanisms based on the characteristics of these metabolites. We employed untargeted metabolomics to assess the differential enrichment of plasma metabolites in 80 South Korean children with lung injuries caused by exposure to humidifier disinfectant containing polyhexamethylene guanidine. The key metabolites identified were subsequently validated in an independent cohort of 132 South Korean adults. In the plasma of patients with humidifier disinfectant-associated lung injuries, we observed significantly higher levels of oxidized lipids compared to healthy controls, with these levels negatively correlating with lung function. These metabolic signatures differentiated humidifier disinfectant-associated lung injury from other respiratory diseases in children, such as asthma and bronchiolitis obliterans. The 47 key metabolites identified in children were validated in an independent adult cohort. Furthermore, the classification performance of these metabolic signatures for humidifier disinfectant-associated lung injury achieved an accuracy of 0.97, a precision of 0.95, an F1 score of 0.97, and a recall of 1.00. These findings suggest a connection between humidifier disinfectant-associated lung injury and oxidative stress-induced lipid peroxidation. The oxidative stress signatures provide valuable insights into the underlying pathogenesis of humidifier disinfectant-associated lung injury and may serve as potential targets for biomarker development. https://doi.org/10.1289/EHP14984.
Global Initiative on AI for Health (GI-AI4H): strategic priorities advancing governance across the United Nations
Authors: Vijaytha Muralidharan, Madelena Y Ng, Shada AlSalamah, Sameer Pujari, Kanika Kalra, Rajeshwari Singh, Denise Schalet, Tobi Olantuji, Rohit Malpani, Rubeta N Matin, Jesutofunmi A Omiye, Yu Zhao, Anita Sands, Andreas Reis, Jose Eduardo Diaz Mendoza, Tina Hernandez-Boussard, Roxana Daneshjou, Alain B Labrique
Journal: npj Digital Medicine (2025)

The Global Initiative on Artificial Intelligence for Health (GI-AI4H), established by the World Health Organization, serves to harmonize governance standards for artificial intelligence (AI). The GI-AI4H spearheads novel on-the-ground efforts, especially in low- and middle-income countries, to advance ethical, regulatory, implementation, and operational dimensions of global governance for health AI. The GI-AI4H's efforts across the United Nations drives safe, ethical, equitable, and sustainable health AI use for the global community.
Facility-Level Variation in Major Leg Amputation Among Patients With Newly Diagnosed Diabetic Foot Ulcer
Authors: Hiroyuki Suzuki, Mary Vaughan-Sarrazin, Michael Ohl, Bradley Mecham, Kimberly McCoy, Meghan B. Brennan, Jeffrey M. Robbins, Daniel J. Livorsi
Journal: JAMA Network Open (2025)

Importance The prevalence of diabetes is increasing over time, fueling an epidemic of diabetic foot ulcers (DFUs) and subsequent risk of leg amputation. However, little is known about the variation in outcomes for patients with DFUs according to the health care facilities treating them. Objective To examine facility-level variation in major leg amputation among veterans with incident DFUs using the Veterans Health Administration (VHA) cohort. Design, Setting, and Participants A retrospective cohort study was conducted from January 1, 2016, to December 31, 2021, of all veterans with a new diagnosis of DFU at 140 VHA facilities across the US. Patients were followed up to 1 year from DFU diagnosis. Analyses were conducted between March 22, 2024, and January 13, 2025. Exposure A facility was assigned to each patient corresponding to the health care site where the initial DFU diagnosis was made. Main Outcomes and Measures The primary outcome was major leg amputation during the follow-up period. A multivariable mixed-effects regression model with random facility intercepts was applied to assess variation in major leg amputation rates across facilities, adjusting for social drivers of health, comorbidities, and complicated DFU at initial diagnosis. The median odds ratio (MOR) was calculated to quantify facility-level variation in outcomes. Results A total of 86 094 veterans (98.3% male; mean [SD] age, 73.0 [8.1] years; age range, 55-102 years) were included. Major leg amputation was performed for 3279 veterans (3.8%) within a year of DFU diagnosis. The MOR for facility-level variation in major leg amputation was 1.85, indicating that the odds of major leg amputation were 1.85 times higher between 2 randomly selected facilities for an average patient ( P &amp;amp;lt; .001). In contrast, the MOR for facility-level variation in 1-year mortality was 1.16 ( P &amp;amp;lt; .001). Conclusions and Relevance This cohort study of veterans with newly diagnosed DFU found significant facility-level variation in major leg amputation rates within 1 year of DFU diagnosis. Facility-level variation in 1-year mortality rates was much smaller, suggesting variation in leg amputation was likely to stem from variation in DFU-specific care. The VHA should strive to minimize the odds of major leg amputation and interfacility variation.
Screening and Response for Adverse Social Determinants of Health in US Emergency Departments
Authors: Melanie F. Molina, Rebecca E. Cash, Stephanie S. Loo, Maeve F. Swanton, Janice A. Espinola, Krislyn M. Boggs, Olivia Chen, Alan J. Ardelean, Carlos A. Camargo, Margaret E. Samuels-Kalow
Journal: JAMA Network Open (2025)

Importance Regulatory agencies have begun incentivizing screening for adverse social determinants of health (SDOH) and responses in inpatient settings, missing a crucial safety net: the emergency department (ED). Little is known about the prevalence of ED-based adverse SDOH screening and response practices nationally. Objective To describe the prevalence of ED-based adverse SDOH screening and response policies and to identify associated hospital characteristics. Design, Setting, and Participants This survey study utilized a 5% random sample from the National Emergency Department Inventory–USA, including EDs stratified by geography, urbanicity, and practice setting (academic vs community). Data regarding 2022 policies were collected in 2023. Exposures Practice setting, urbanicity, visit volume, and availability of social work. Main Outcomes and Measures The presence of written policies for any adverse SDOH (housing, food, transportation, and utility payment difficulties) screening and responses, as well as other requirement-driven screening for SDOH risk factors (intimate partner violence, substance use, and mental health conditions). Responses were categorized as consultations (eg, social work), standardized information sheets, individualized resource information, or other. Results Of a total of 280 EDs, 232 responded (83% response rate). Among 232 EDs, 28.4% (survey-weighted proportion; 95% CI, 21.0%-37.2%) had screening policies for at least 1 adverse SDOH domain, and 93.1% (95% CI, 89.2%-95.7%) performed at least 1 other requirement-driven screening (eg, intimate partner violence). Of EDs performing any screening (adverse SDOH or other), 81.6% (95% CI, 73.4%-87.7%) had response policies, primarily involving consultations (78.2%; 95% CI, 67.2%-86.3%), standardized information sheets (43.0%; 95% CI, 32.5%-54.3%), and individualized resource information (12.9%; 95% CI, 7.2%-21.8%). Among all responding EDs, only 23.4% (95% CI, 17.1%-31.2%) had around-the-clock social work availability, and 20.5% (95% CI, 14.2%-28.6%) had an ED-based social worker. There was no association between practice setting, urbanicity, visit volume, or around-the-clock social work with adverse SDOH screening or response policies. Conclusions and Relevance Despite the high prevalence of adverse SDOH in ED populations, in this survey study of 232 EDs, less than one-third performed screening, and one-fifth did not have policies requiring a response to positive screens. Bridging this gap may require expanding adverse SDOH screening practices while also ensuring that EDs have the resources and infrastructure to respond appropriately to identified social needs. Future research might explore advanced technological solutions to enhance screening and responses in these resource-constrained settings.
Varenicline for Youth Nicotine Vaping Cessation
Authors: A. Eden Evins, Corinne Cather, Harrison T. Reeder, Bryn Evohr, Kevin Potter, Gladys N. Pachas, Kevin M. Gray, Sharon Levy, Nancy A. Rigotti, Vanessa Iroegbulem, Jason Dufour, Kelly Casottana, Meghan A. Costello, Jodi M. Gilman, Randi M. Schuster
Journal: JAMA (2025)

Importance Electronic cigarette use (vaping) among adolescents and young adults is common. Few treatments have been tested in this population. Objective To evaluate the efficacy of varenicline for nicotine vaping cessation in youth who do not smoke tobacco regularly. Design, Setting, and Participants A 3-group randomized clinical trial compared 12 weeks of double-blind varenicline vs placebo, each added to brief, remotely delivered behavioral counseling and compared with single-blind enhanced usual care, with monthly follow-up to 24 weeks. The trial was conducted among youth, aged 16 to 25 years, who vaped nicotine daily or near daily, did not regularly smoke tobacco, and wanted to reduce or quit vaping, in a single US state from June 2022 to May 2024. Data collection ended May 28, 2024. Interventions Participants were randomized (1:1:1) to 12 weeks of varenicline titrated to 1 mg twice daily over 7 days (standard titration), weekly counseling, and referral to text messaging vaping cessation support (This is Quitting [TIQ]) (n = 88); identical placebo, weekly counseling, and referral to TIQ (n = 87); or enhanced usual care (referral to TIQ only) (n = 86). Main Outcomes and Measures Biochemically verified continuous vaping abstinence for the last 4 weeks of varenicline treatment vs placebo (primary outcome). Secondary outcomes included bioverified continuous abstinence from weeks 9 through 24 in the varenicline and placebo groups. Additional analyses compared varenicline group and placebo group with enhanced usual care. Results Of 261 randomized participants (mean age, 21.4 years; 53% female), 254 completed the trial (97.3%). For varenicline and placebo, continuous abstinence rates were 51% vs 14% during weeks 9 through 12 (adjusted odds ratio [aOR], 6.5 [95% CI, 3.0-14.1]; P &amp;amp;lt; .001) and 28% vs 7% during weeks 9 through 24 (aOR, 6.0 [95% CI, 2.1-16.9]; P &amp;amp;lt; .001). Varenicline had higher continuous abstinence rates vs enhanced usual care during weeks 9 through 12 (51% vs 6%; aOR, 16.9 [95% CI, 6.2-46.3]) and during weeks 9 through 24 (28% vs 4%; aOR, 11.0 [95% CI, 3.1-38.8]). Continuous abstinence rates were not significantly different between the placebo and enhanced usual care groups. Study medication was generally well tolerated. Two varenicline participants (2%) and 1 placebo participant (1%) discontinued study medications due to adverse events. No drug-related serious adverse events occurred. Treatment-emergent adverse events were reported by 76 (86%) in the varenicline group, 68 (79%) in the placebo group, and 68 (79%) in the enhanced usual care group. Conclusions and Relevance Varenicline, combined with behavioral counseling, increased vaping abstinence in youth who vape nicotine and do not regularly smoke tobacco. Trial Registration ClinicalTrials.gov Identifier: NCT05367492
Trends in Clinical Outcomes After Major Emergency Abdominal Surgery in Denmark, Data From 2002-2022
Authors: Johanne Gormsen, Dunja Kokotovic, Thomas Korgaard Jensen, Jakob Burcharth
Journal: JAMA Surgery (2025)

Importance Major emergency abdominal surgery is associated with high morbidity and mortality. Understanding trends in outcomes over time can reveal critical practice-changing improvements, identify gaps in postoperative care, and establish a large-scale benchmark for future research. Objective To investigate trends in morbidity and mortality after major emergency abdominal surgery in Denmark. Design, Setting, and Participants This was a nationwide, population-based cohort study. Analyses were performed based on data from Danish nationwide administrative registries. Within the public health care system in Denmark, all adult patients undergoing major emergency abdominal surgery from 2002 to 2022 were included. Major emergency abdominal surgeries included laparotomy or laparoscopy due to intra-abdominal pathologies, including intestinal perforation, ischemia, bowel obstruction, abscess, or bleeding. Exposure Major emergency abdominal surgery. Main Outcomes and Measures The primary outcome was the trend in 30- and 90-day mortality after major emergency abdominal surgery over time. Results A total of 61 476 patients (mean [SD] age, 66.2 [16.3] years; 34 827 female [56.7%]) were included. The annual number of surgeries remained constant, with a mean (SD) of 3044 (165) surgeries per year. The 30- and 90-day mortality was reduced from 25% and 33%, respectively, to 13% and 18%, respectively ( P &amp;amp;lt; .001). Median (IQR) hospital length of stay was decreased from 10 (5-17) days to 6 (4-13) days ( P &amp;amp;lt; .001). The rate of 30-day postoperative complications (classified Clavien-Dindo ≥3a) was reduced from 49% to 44% ( P &amp;amp;lt;.001) and the 90-day rate was reduced from 53% to 48% ( P &amp;amp;lt;.001), however, with a tendency toward more patients undergoing earlier intervention. The 30- and 90-day readmission rate increased drastically from 9% and 13%, respectively, to 25% and 33%, respectively ( P &amp;amp;lt; .001). Conclusions and Relevance Results of this cohort study suggest notable reductions in mortality and hospital length of stay after major emergency abdominal surgery. A marked increased readmission rate and a persistently high rate of postoperative complications were found. These shifts underscore the need for enhanced postoperative monitoring and postdischarge follow-up.
Incidence and Prevalence of Reported Euthanasia Cases in Belgium, 2002 to 2023
Authors: Jacques Wels, Natasia Hamarat
Journal: JAMA Network Open (2025)

Importance Reported cases of assisted dying have increased in countries with such legislation. In Belgium, where euthanasia was legalized in mid-2002, cases rose from 236 in 2003 to 3423 in 2023. Most previous studies have focused on occurrence rates. Objective To examine the magnitude of the increase in euthanasia cases and its association with demographic changes observed during the study period. Design, Setting, and Participants This cross-sectional study analyzed complete data from the Belgian Federal Commission for the Control and Evaluation of Euthanasia (FCCEE) from September 1, 2002, to December 31, 2023, and adjusted the model for demographic composition and change by gender, age group, and region using data from the Belgian Office for Statistics. All cases of euthanasia reported to the FCCEE during the selected period were included. Exposure Euthanasia reported to the FCCEE. Main Outcome and Measures Poisson regression with and without a demographic offset was used to provide the rate ratios (RRs) and the prevalence rates (PRs) for euthanasia. The RRs were calculated by age, gender, region, and euthanasia characteristics. Estimates used a model including demographic offsets to calculate PRs and explore interactions across subcategories. Results During the selected period, 33 647 cases of euthanasia were reported (50.23% male; 84.74% 60 years or older); analyses focused on 33 580 valid cases. The yearly RR was 1.07 (95% CI, 1.07-1.07), while the yearly PR was 1.05 (95% CI, 1.05-1.06), indicating that demographic changes were associated with the observed increase. The PR for euthanasia among males relative to females was overall higher (PR, 1.36; 95% CI, 1.33-1.39) but has decreased slightly (PR, 0.99; 95% CI, 0.99-1.00). Cases citing multimorbidity increased relative to those citing tumors (PR, 1.03; 95% CI, 1.02-1.04), whereas cases related to psychiatric disorders and deaths in care homes did not show significant increases. Higher prevalence was observed in the Flemish region relative to Wallonia (PR, 1.51; 95% CI, 1.47-1.55), but the gap has narrowed over the years. Conclusions and Relevance This study found that a substantial part of the increase in euthanasia cases was attributable to demographic changes. Early increases were mainly due to the regulatory onset, while recent trends reflect a growing influence of demographic factors and regional adjustments. These findings suggest that considering demographic shifts is essential, and long-term trends should be monitored.
Emergency Department–Based Education and mHealth Empowerment Intervention for Hypertension
Authors: Heather Prendergast, Spyros Kitsiou, Renee Petzel Gimbar, Sally Freels, Anissa Sanders, Martha Daviglus, Pavitra Kotini-Shah, Barry Carter, Marina Del Rios, Sara Heinert, Shaveta Khosla
Journal: JAMA Cardiology (2025)

Importance Hypertension is a leading risk factor for cardiovascular diseases and is often undiagnosed. Emergency department (ED) visits serve as critical access points within health care and present a unique opportunity for hypertension screening and intervention. Objective To evaluate the effectiveness of an Education and mHealth Empowerment (E2) intervention compared with usual care in reducing systolic blood pressure (SBP) among patients with elevated BP discharged from the ED. Design, Setting, and Participants This randomized clinical trial enrolled participants who presented to an urban academic medical center ED for any indication and had elevated blood pressure (≥140/90 mm Hg and ≤180/110 mm Hg). Eligible participants who were discharged from the ED were enrolled between February 12, 2019, and March 31, 2023, and were randomized to receive either usual care or the intervention with follow-up visits at 3 and 6 months. Interventions Usual care involved standard hypertension discharge instructions with a referral for outpatient follow-up. The E2 intervention involved a 3-prong approach, which included a brief Post-Acute Care Hypertension consultation (PACHT-c) with a clinical pharmacist or an advanced practice nurse, a smartphone-enabled BP monitoring kit (Withings device and mobile app) for daily self-monitoring along with behavior change text messages, and primary care referral. Main Outcomes and Measures The primary outcome was the mean change in SBP (mm Hg) from baseline to 6 months. Results Of the 574 participants enrolled, mean (SD) age was 51.1 (12.5) years, and 323 (56%) were female; 413 were Black (72%), 115 were Hispanic or Latino (20%), 27 were White (5%), and 19 were other race and ethnicity (3%), which included Asian, American Indian, and other racial or ethnic groups. Of the 413 patients with BP data at 6 months, the E2 intervention group (n = 210) showed a greater mean reduction in SBP (mean difference, 4.9 mm Hg; 95% CI, 0.8-9.0 mm Hg; P = .02) compared with the usual-care group (n = 203). A similar proportion of patients achieved BP less than or equal to 140/90 mm Hg at 6 months in the intervention arm (42.9% [90 of 210]) and the control arm (36.9% [75 of 203]; P = .22). Conclusions and Relevance In this single-center randomized clinical trial, a multicomponent intervention directed at patients in the ED who have elevated BP was associated with greater reduction in SBP at 6 months. Identifying patients who present to the ED with hypertension may be a viable strategy to improve BP management. Trial Registration ClinicalTrials.gov Identifier: NCT03749499