tbuckley/cabot-search huggingface dataset:
Assessing Psychosocial Risk and Resilience to Support Readiness for Gene Therapy in Sickle Cell Disease
Authors: Steven J. Hardy, Lori E. Crosby, Jerlym S. Porter, Soumitri Sil, Cecelia R. Valrie, Charles R. Jonassaint, Shawn M. Bediako, Clayton Andrews, Maria Rivera, Teonna Woolford, Victoria H. Coleman-Cowger
Journal: JAMA Network Open (2024)

Importance The introduction of gene therapies into the clinical care landscape for individuals living with sickle cell disease (SCD) represents a momentous achievement with the potential to rewrite the story of the world’s most prevalent heritable blood disorder. This disease, which was first described in 1910 and did not see a US Food and Drug Administration–approved therapeutic until 1998, is poised to be among the first to realize the promise of gene therapy and genome editing. However, the future of these treatments now rests on how evidence of safety, outcomes, and acceptance in clinical practice unfolds in SCD. Furthermore, historic injustices involving the exploitation of individuals from minoritized racial and ethnic groups in medical contexts necessitate extreme care in ensuring readiness among individuals with SCD considering genetic therapies. Objective To address a gap in resources focused on patient readiness for gene therapy. Evidence Review The Cure Sickle Cell Initiative organized the Patient Readiness and Resilience Working Group in September 2020. Membership was comprised of behavioral health clinicians and scientists with expertise in SCD, adults with lived experience with SCD, and a caregiver. Over 2 years, the working group developed consensus recommendations and created resources to guide implementation of pregene therapy patient readiness assessments. Recommendations centered on strategies to enhance delivery of education about gene therapy and assess knowledge and understanding, interest and motivation, and psychosocial risk and resilience factors. Findings Five goals of a pregene therapy patient readiness assessment were identified: (1) gathering information about a patient’s understanding of and perceived readiness for gene therapy; (2) encouraging an open dialogue; (3) providing a conceptualization of psychosocial factors that may influence participation in gene therapy; (4) identifying patient strengths that can be used to promote psychosocial well-being before, during, and after gene therapy; (5) identifying and addressing psychosocial risks. Conclusions and Relevance Patient readiness and psychosocial factors will have tangible implications for the success of gene therapy at individual and collective levels. Health care institutions, industry, payers, policymakers, and clinicians all shoulder responsibility for ensuring that patients with SCD are adequately prepared for gene therapy and supported in ways that optimize readiness and access. Resources described here may be leveraged as a guide to support implementation of pregene therapy assessments of patient readiness and resilience in SCD.
Rosebud
Authors: Scott C. Biggerstaff
Journal: JAMA (2024)

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 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 2024 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
Unraveling the Sex Disparity in Postoperative Atrial Fibrillation and Mortality After Cardiac Surgery
Authors: Mariana Fragão-Marques
Journal: JAMA Network Open (2024)

Sergey Karamnov, MD; Natalia Sarkisian, PhD; Jakob Wollborn, MD, PhD; Samuel Justice, PhD; Kara Fields, MS; Vesela P. Kovacheva, MD, PhD; Asishana A. Osho, MD, MPH; Ashraf Sabe, MD; Simon C. Body, MBChB, MPH; Jochen D. Muehlschlegel, MD, MMSc, MBA
Household Firearm Ownership and Firearm Mortality
Authors: Andrew R. Morral, Denis Agniel, Rosanna Smart, Terry L. Schell
Journal: JAMA Network Open (2024)

Importance Causal associations between household firearm ownership rates (HFRs) and firearm mortality rates are not well understood. Objective To assess the population-level temporal sequencing of firearm death rates and HFRs. Design, Setting, and Participants This cohort study used autoregressive cross-lagged models to analyze HFRs, firearm suicide rates, and firearm homicide rates in the US from 1990 to 2018. The suicide analyses included 16 demographic subgroups of adults, defined by study year, state, sex, race and ethnicity, marital status, and urbanicity. The homicide analyses consisted of adult subgroups living in urban or rural areas. Data analysis was conducted from March to December 2023. Exposures Firearm mortality rates and HFRs. Main Outcomes and Measures Firearm homicide and suicide rates with HFRs as the exposure, and HFR with mortality as the exposure. Results A total of 10 416 observations of 16 demographic subgroups by state and 2-year periods were included in the suicide analyses, while 1302 observations from 2 demographic subgroups by state and 2-year period were included in the homicide analysis. At baseline, the mean (SD) rate per 100 000 population across strata was 7.46 (7.21) for firearm suicides and 3.32 (2.13) for firearm homicides. The mean (SD) baseline HFR was 36.9% (20.2%) for firearm suicides and 36.9% (14.8%) for firearm homicides. Higher HFR preceded increases in suicide rates: demographic strata with equal firearm suicide rates but which differ by 18.6 percentage points on HFR (1 SD) would be expected to have firearm suicide rates that diverged by 0.19 (95% CI, 0.15-0.23) deaths per 100 000 population per period. With these differences accumulated over 8 years, firearm suicide rates in subgroups with the highest decile HFR would be expected to have 1.93 (95% CI, 1.64-2.36) more suicides per 100 000 population than strata with lowest decile HFR, a difference of 25.7% of the overall firearm suicide rate in 2018 and 2019. Firearm suicide rates had a smaller magnitude of association with subsequent changes in HFR: strata with equal HFRs but which differ by 1 SD in firearm suicide rates had minimal subsequent change in HFRs (−0.02 [95% CI, −0.04 to 0.01] percentage points). A 1-SD difference in HFRs was associated with little difference in next-period overall firearm homicides rates (0.03 [95% CI, −0.02 to 0.08] per 100 000 population), but a 1-SD difference in homicide rates was associated with a decrease in HFR (−0.09 [95% CI, −0.16 to −0.04] percentage points). Conclusions and Relevance This cohort study found an association between high HFRs and subsequent increases in rates of firearm suicide. In contrast, higher firearm homicide rates preceded decreases in HFRs. By demonstrating the temporal sequencing of firearm ownership and mortality, this study may help to rule out some theories of why gun ownership and firearm mortality are associated at the population level.
Role of bacteriophages in shaping gut microbial community
Authors: Md. Rayhan Mahmud, Sanjida Khanam Tamanna, Sharmin Akter, Lincon Mazumder, Sumona Akter, Md. Rakibul Hasan, Mrityunjoy Acharjee, Israt Zahan Esti, Md. Saidul Islam, Md. Maksudur Rahman Shihab, Md. Nahian, Rubaiya Gulshan, Sadia Naser, Anna Maria Pirttilä
Journal: Gut Microbes (2024)

Phages are the most diversified and dominant members of the gut virobiota. They play a crucial role in shaping the structure and function of the gut microbial community and consequently the health of humans and animals. Phages are found mainly in the mucus, from where they can translocate to the intestinal organs and act as a modulator of gut microbiota. Understanding the vital role of phages in regulating the composition of intestinal microbiota and influencing human and animal health is an emerging area of research. The relevance of phages in the gut ecosystem is supported by substantial evidence, but the importance of phages in shaping the gut microbiota remains unclear. Although information regarding general phage ecology and development has accumulated, detailed knowledge on phage-gut microbe and phage-human interactions is lacking, and the information on the effects of phage therapy in humans remains ambiguous. In this review, we systematically assess the existing data on the structure and ecology of phages in the human and animal gut environments, their development, possible interaction, and subsequent impact on the gut ecosystem dynamics. We discuss the potential mechanisms of prophage activation and the subsequent modulation of gut bacteria. We also review the link between phages and the immune system to collect evidence on the effect of phages on shaping the gut microbial composition. Our review will improve understanding on the influence of phages in regulating the gut microbiota and the immune system and facilitate the development of phage-based therapies for maintaining a healthy and balanced gut microbiota.
Sex, Atrial Fibrillation, and Long-Term Mortality After Cardiac Surgery
Authors: Sergey Karamnov, Natalia Sarkisian, Jakob Wollborn, Samuel Justice, Kara Fields, Vesela P. Kovacheva, Asishana A. Osho, Ashraf Sabe, Simon C. Body, Jochen D. Muehlschlegel
Journal: JAMA Network Open (2024)

Importance There are limited data on the association of sex with the incidence of postoperative atrial fibrillation (poAF) and subsequent long-term mortality after cardiac surgery. Objective To evaluate whether the incidence of poAF and associated long-term mortality after cardiac surgery differ by sex. Design, Setting, and Participants This retrospective cohort study was conducted at 2 tertiary care centers in Massachusetts from January 1, 2002, until October 1, 2016, with follow-up until December 1, 2022. Adult (aged &amp;amp;gt;20 years) women and men undergoing coronary artery bypass graft surgery, aortic valve surgery, mitral valve surgery, and combined procedures with cardiopulmonary bypass were examined using medical records. Patients who had data on poAF were included in data analyses. Exposures Sex and poAF. Main Outcomes and Measures Primary outcomes were the incidence of poAF and all-cause mortality. poAF was defined as any atrial fibrillation detected on electrocardiogram (EKG) during the index hospitalization in patients presenting for surgery in normal sinus rhythm. Data on poAF were obtained from EKG reports and supplemented by information from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. All-cause mortality was assessed via hospital records. The hypotheses were formulated prior to data analysis. Results Among 21 568 patients with poAF data (mean [SD] age, 66.5 [12.4] years), 2694 of 6601 women (40.8%) and 5805 of 14 967 men (38.8%) developed poAF. In a multivariable logistic regression model, women had lower risk of poAF (odds ratio [OR], 0.85; 95% CI, 0.79-0.91; P &amp;amp;lt; .001). During the follow-up study period, 1294 women (50.4%) and 2376 men (48.9%) in the poAF group as well as 1273 women (49.6%) and 2484 men (51.1%) in the non-poAF group died. Cox proportional hazards analysis found that the association between poAF and mortality was significantly moderated (ie, effect modified) by sex. Compared with same-sex individuals without poAF, men with poAF had a 17% higher mortality hazard (hazard ratio [HR], 1.17; 95% CI, 1.11-1.25; P &amp;amp;lt; .001), and women with poAF had a 31% higher mortality hazard (HR, 1.31; 95% CI, 1.21-1.42; P &amp;amp;lt; .001). Conclusions and Relevance In this retrospective cohort study of 21 568 patients who underwent cardiac surgery, women were less likely to develop poAF than men when controlling for other relevant characteristics; however, women who did develop poAF had a higher risk of long-term mortality than men who developed poAF. This observed elevated risk calls for a tailored approach to perioperative care in women undergoing cardiac surgery.
Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis
Authors: Jung Hwan Yu, Ji Won Han, Young Ju Suh, Young Eun Chon, Hee Yeon Kim, Ji Hyun An, Young-Joo Jin, Miyoung Choi, Seung Up Kim, Dae Won Jun, Han Ah Lee, Mi Na Kim
Journal: Clinical and Molecular Hepatology (2024)

Backgrounds/Aims: This meta-analysis examined whether preoperative vibration-controlled transient elastography (VCTE) can predict postoperative complications and recurrence in patients undergoing hepatic resection for hepatocellular carcinoma (HCC).Methods: A systematic literature search was conducted using Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases. Out of 431 individual studies, thirteen published between 2008 and 2022 were included. Five studies focused on HCC recurrence, while eight examined postoperative complications.Results: The meta-analysis of five studies on HCC recurrence showed that the high-risk group with a high VCTE score had a significantly increased recurrence rate after hepatic resection (hazard ratio 2.14). The cutoff value of VCTE in the high-risk group of HCC recurrence was 7.4–13.4 kPa, the sensitivity was 0.60 (95% confidence interval [CI] 0.47–0.72), and the specificity was 0.60 (95% CI 0.46–0.72). The area under the receiver operating characteristic curve (AUC) of the liver stiffness measured by VCTE to predict the HCC recurrence was 0.63 (95% CI 0.59–0.67). The meta-analysis on the postoperative complications revealed a significantly increased risk of postoperative complications in the high-risk group (12–25.6 kPa) with a high VCTE value (odds ratio [OR], 8.32). The AUC of the liver stiffness measured by VCTE to predict the postoperative complications was 0.87 (95% CI 0.84–0.90), the sensitivity was 0.76 (95% CI 0.55–0.89) and the specificity was 0.85 (95% CI 0.73–0.92).Conclusions: This meta-analysis suggests that preoperative VCTE in patients undergoing hepatic resection for HCC is useful in identifying individuals at a high risk of postoperative complications and HCC recurrence.
High Fresh Frozen Plasma to Red Blood Cell Ratio and Survival Outcomes in Blunt Trauma
Authors: Gaku Fujiwara, Yohei Okada, Wataru Ishii, Tadashi Echigo, Naoto Shiomi, Shigeru Ohtsuru
Journal: JAMA Surgery (2024)

Current trauma-care protocols advocate early administration of fresh frozen plasma (FFP) in a ratio close to 1:1 with red blood cells (RBCs) to manage trauma-induced coagulopathy in patients with severe blunt trauma. However, the benefits of a higher FFP to RBC ratio have not yet been established.
Inflammatory Biomarkers and Risk of Psychiatric Disorders
Authors: Yu Zeng, Charilaos Chourpiliadis, Niklas Hammar, Christina Seitz, Unnur A. Valdimarsdóttir, Fang Fang, Huan Song, Dang Wei
Journal: JAMA Psychiatry (2024)

Individuals with psychiatric disorders have been reported to have elevated levels of inflammatory biomarkers, and prospective evidence is limited regarding the association between inflammatory biomarkers and subsequent psychiatric disorders risk.
Trends in the Use of Observation for Small Nonfunctional Pancreatic Neuroendocrine Tumors
Authors: Samantha M. Ruff, Mary Dillhoff, Susan Tsai, Timothy M. Pawlik, Vineeth Sukrithan, Bhavana Konda, Jordan M. Cloyd
Journal: JAMA Surgery (2024)

This study assesses nationwide trends in the use of observation for pancreatic neuroendocrine tumors 2 cm or smaller and to evaluate factors associated with resection.
Virtual Learning in Kindergarten Through Grade 12 During the COVID-19 Pandemic and Chronic Absenteeism
Authors: William N. Evans, Kathryn Muchnick, Olivia Rosenlund
Journal: JAMA Network Open (2024)

Importance Chronic absenteeism among kindergarten through grade 12 students has increased considerably after the COVID-19 pandemic. Objective To examine the association between virtual learning during the 2020-2021 school year and chronic absenteeism during the 2021-2022 school year at the school district level. Design, Setting, and Participants This cross-sectional study used a panel of 11 017 school districts throughout the US comprising kindergarten through grade 12 for the 2018-2019 and 2021-2022 school years. Exposures The key covariates were the percentage of hybrid and virtual school days in the previous school year, with an assumption that these values in the 2018-2019 school year were zero. Main Outcome and Measures Chronic absenteeism rates at the district level, which were regressed on the percentage of school days in a learning mode in the previous school year, demographic characteristic and socioeconomic status controls, plus district and year fixed effects. Observations were weighted by district enrollment, and SEs were clustered at the district level. Results The dataset includes 11 017 school districts for 2 years and 22 034 observations. Chronic absenteeism rates increased by 13.5 percentage points, from a mean (SD) of 15.9% (8.1%) in the 2018-2019 school year to 29.4% (13.2%) in the 2021-2022 school year. Students whose schools had 100% virtual instruction during the COVID-19 pandemic had chronic absenteeism rates that were 6.9 percentage points (95% CI, 4.8-8.9 percentage points) higher than those that were 100% in person. Hybrid instruction was not associated with increased absenteeism. The association between virtual learning and chronic absenteeism varied by socioeconomic status, with the conditional correlation much larger for at-risk students; chronic absenteeism rates were 10.6 percentage points (95% CI, 7.2-14.1 percentage points) higher among students with 100% of days in virtual learning from districts in the top quintile of poverty rates compared with 100% in-persion districts. Conclusions and Relevance In this cross-sectional study, chronic absenteeism rates were substantially higher in school districts that used virtual learning during the COVID-19 pandemic compared with in person. Understanding how to reduce chronic absenteeism and use virtual learning without potentially negative consequences are key policy questions moving forward.
Surrogate Markers and Clinical Outcomes—Reply
Authors: Joshua D. Wallach, Reshma Ramachandran, Joseph S. Ross
Journal: JAMA (2024)

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 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 2024 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
Tyrosine Kinase 2 Inhibition With Zasocitinib (TAK-279) in Psoriasis
Authors: April W. Armstrong, Melinda Gooderham, Charles Lynde, Catherine Maari, Seth Forman, Lawrence Green, Vivian Laquer, Xinyan Zhang, Nathalie Franchimont, Esha A. Gangolli, Jessamyn Blau, Yiwei Zhao, Wenwen Zhang, Bhaskar Srivastava, Graham Heap, Kim Papp
Journal: JAMA Dermatology (2024)

New, effective, and well-tolerated oral therapies are needed for treating psoriasis. Zasocitinib, a highly selective allosteric tyrosine kinase 2 (TYK2) inhibitor, is a potential new oral treatment for this disease.
Redefining Cardiac Involvement and Targets of Treatment in Systemic Immunoglobulin AL Amyloidosis
Authors: Aldostefano Porcari, Ambra Masi, Ana Martinez-Naharro, Yousuf Razvi, Rishi Patel, Adam Ioannou, Muhammad U. Rauf, Giulio Sinigiani, Brendan Wisniowski, Stefano Filisetti, Jasmine Currie-Cathey, Sophie O’Beara, Tushar Kotecha, Dan Knight, James C. Moon, Gianfranco Sinagra, Ruta Virsinskaite, Janet Gilbertson, Lucia Venneri, Aviva Petrie, Helen Lachmann, Carol Whelan, Peter Kellman, Sriram Ravichandran, Oliver Cohen, Shameem Mahmood, Charlotte Manisty, Philip N. Hawkins, Julian D. Gillmore, Ashutosh D. Wechalekar, Marianna Fontana
Journal: JAMA Cardiology (2024)

Cardiac amyloid infiltration is the key determinant of survival in systemic light-chain (AL) amyloidosis. Current guidelines recommend early switching therapy in patients with a nonoptimal or suboptimal response regardless of the extent of cardiac amyloid infiltration.
Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Abdominal Pain and Gallstones
Authors: Daan J. Comes, Sarah Z. Wennmacker, Carmen S. S. Latenstein, Jarmila van der Bilt, Otmar Buyne, Sandra C. Donkervoort, Joos Heisterkamp, Klaas in’t Hof, Jan Jansen, Vincent B. Nieuwenhuijs, Pascal Steenvoorde, Hein B. A. C. Stockmann, Djamila Boerma, Joost P. H. Drenth, Cornelis J. H. M. van Laarhoven, Marja A. Boermeester, Marcel G. W. Dijkgraaf, Philip R. de Reuver
Journal: JAMA Surgery (2024)

The 1-year results of the SECURE trial, a randomized trial comparing a restrictive strategy vs usual care for select patients with symptomatic cholelithiasis for cholecystectomy, resulted in a significantly lower operation rate after restrictive strategy. However, a restrictive strategy did not result in more pain-free patients at 1 year.
Tombstone Pattern Electrocardiogram in a Young Woman
Authors: Yun Chen, Ping Ge, Xiao-Feng Zhuang
Journal: JAMA Cardiology (2024)

A woman in her mid-20s presented with acute fever, chest pain, and exertional dyspnea. Electrocardiogram results showed sinus tachycardia, QRS widening, low-voltage complexes, and ST-segment elevation. What would you do next?