tbuckley/cabot-search huggingface dataset:
Prevalence of Post–COVID-19 Condition and Activity-Limiting Post–COVID-19 Condition Among Adults
Authors: Anjel Vahratian, Sharon Saydah, Jeanne Bertolli, Elizabeth R. Unger, Cria O. Gregory
Journal: JAMA Network Open (2024)

This cross-sectional study examines the prevalence of ever and current post–COVID-19 condition (long COVID) and self-reported limitations of activity due to symptoms of post–COVID-19 condition among US adults.
Resuscitation With Placental Circulation Intact Compared With Cord Milking
Authors: Simone Pratesi, Martina Ciarcià, Luca Boni, Stefano Ghirardello, Cristiana Germini, Stefania Troiani, Eleonora Tulli, Miria Natile, Gina Ancora, Giovanni Barone, Stefania Vedovato, Federica Bertuola, Francesca Parata, Giovanna Mescoli, Fabrizio Sandri, Roberta Corbetta, Luisa Ventura, Giulia Dognini, Flavia Petrillo, Luigia Valenzano, Raffaele Manzari, Anna Lavizzari, Fabio Mosca, Iuri Corsini, Chiara Poggi, Carlo Dani, Silvia Perugi, Valentina Leonardi, Caterina Coviello, Daniele Roncati, Serena Elia, Alessandra Cecchi, Marta Capocasale, Caterina Franco, Genny Gottardi, Alessandra Grison, Valentina Dal Cengio, Valentina Vanzo
Journal: JAMA Network Open (2024)

Importance Among preterm newborns undergoing resuscitation, delayed cord clamping for 60 seconds is associated with reduced mortality compared with early clamping. However, the effects of longer durations of cord clamping with respiratory support are unknown. Objective To determine whether resuscitating preterm newborns while keeping the placental circulation intact and clamping the cord after a long delay would improve outcomes compared with umbilical cord milking. Design, Setting, and Participants This randomized clinical trial (PCI Trial) was conducted at 8 Italian neonatal intensive care units from April 2016 through February 2023 and enrolled preterm newborns born between 23 weeks 0 days and 29 weeks 6 days of gestation from singleton pregnancies. Interventions Enrolled newborns were randomly allocated to receive at-birth resuscitation with intact placental circulation for 180 seconds or umbilical cord milking followed by an early cord clamping (within 20 seconds of life). Main Outcomes and Measures The primary outcome was the composite end point of death, grade 3 to 4 intraventricular hemorrhage, and bronchopulmonary dysplasia at 36 weeks of postconception age. Prespecified secondary end points were the single components of the composite primary outcome. An intention-to-treat analysis was conducted. Results Of 212 mother-newborn dyads who were randomized, 209 (median [IQR] gestational age, 27 [26-28] weeks; median [IQR] birth weight, 900 [700-1070] g) were enrolled in the intention-to-treat population; 105 were randomized to the placental circulation intact group, and 104 were randomized to the cord milking group. The composite outcome of death, grade 3 to 4 intraventricular hemorrhage, or bronchopulmonary dysplasia occurred in 35 of 105 newborns (33%) in the placental circulation intact group vs 39 of 104 newborns (38%) in the cord milking group (odds ratio, 0.83; 95% CI, 0.47-1.47; P = .53). Conclusions and Relevance In a randomized clinical trial of preterm newborns at 23 to 29 weeks’ gestational age, intact placental resuscitation for 3 minutes did not lower the composite outcome of death, grade 3 to 4 intraventricular hemorrhage, or bronchopulmonary dysplasia compared with umbilical cord milking. Trial Registration Clinicaltrials.gov Identifier: NCT02671305
Parent and Primary Care Clinician Perceptions About Pediatric Hypertension
Authors: Abbas H. Zaidi, Erica Sood, Sarah De Ferranti, Samuel Gidding, Varsha Zadokar, Jonathan Miller, Anne Kazak
Journal: JAMA Network Open (2024)

Importance Despite published guidelines and a prevalence of pediatric hypertension of approximately 3%, less than 25% of affected children are identified, with 60% not receiving any intervention despite detection. Understanding the knowledge and perceptions of parents or caregivers and health care teams is crucial to identify factors that may contribute to these unacceptably low detection rates. Objective To examine the knowledge and perceptions of parents and health care teams regarding pediatric hypertension to identify common themes contributing to low hypertension detection. Design, Setting, and Participants This qualitative study, interviewed parents of children diagnosed with hypertension who did not follow up within 1 year after diagnosis and health care clinicians (medical assistants, nurses, managers, pediatricians, and nurse practitioners) across 10 clinics in Delaware and Pennsylvania between November 1, 2022, and March 31, 2023. Main Outcomes and Measures With the use of an inductive thematic approach, codes were developed and themes identified by multidisciplinary research investigators. Results A total of 38 stakeholders (mean [range] age, 43 [25-64] years; 33 [86%] female), including 13 parents and 25 health care clinicians, were interviewed. The parent sample was diverse based on race (5 [46%] Black, 5 [38%] White, and 3 [23%] other race), ethnicity (5 [38%] Hispanic and 8 [62%] non-Hispanic), and Child Opportunity Index (5 [38%] very low or low, 3 [23%] moderate, and 5 [38%] high or very high). Parents and clinicians demonstrated awareness of the significance of pediatric hypertension. Parents thought blood pressure checks were important; however, clinicians often had competing priorities during annual visits. Both groups expressed skepticism about high blood pressure readings, attributing them to situational factors or white coat syndrome. Parents and clinicians shared concerns about medication use and preferred lifestyle change. Parents advocated for further testing, whereas clinicians exhibited varying perspectives on additional diagnostics, emphasizing targeted testing strategies and cautious medication approaches. Conclusions and Relevance In this qualitative study of parents and clinicians, both groups were skeptical of blood pressure readings and expressed concerns about medication use, with a preference for lifestyle changes over medication. Improving detection may require better measurement tools, reassurance about medications, and clear communication on the role of nonpharmacologic treatments, while future interventions should incorporate the perspectives of both parents and clinicians to develop practical strategies for managing pediatric hypertension.
The Diversity of Spiculated Erythrocytes
Authors: Barbara J. Bain
Journal: American Journal of Hematology (2024)

Spiculated erythrocytes come in a variety of forms, which are of diagnostic importance. They can be broadly classified as echinocytes, acanthocytes, keratocytes, and schistocytes. However, complexity is added by the superimposition of one abnormality on another. Other spiculated cells can, for example, undergo an echinocytic or acanthocytic change. In addition, other poikilocytes, for example, spherocytes, can also undergo spiculation. An acanthocyte is an erythrocyte with a small number of irregularly shaped and irregularly disposed projections on its surface. The name comes from the Greek, άκανθα, meaning thorn. These cells are most often a feature of hyposplenism but also occur in liver failure, when the term "spur cell hemolytic anemia" has been used. The upper images show acanthocytosis in a patient with drug-induced acute liver failure (all images May–Grunwald–Giemsa, ×100 objective). Acanthocytes also occur in rare inherited disorders such as the McLeod phenotype and choreo-acanthocytosis [1]. The lower images show a more complex situation. Here we have spheroacanthocytes in a patient with hereditary spherocytosis who has had a splenectomy. The formation of the spicules has been constrained by the spherical form of the cell. An echinocyte is a cell with numerous short regular spicules. The name comes from the Greek, εχĩνος meaning sea-urchin. Echinocytosis is most often seen as a storage artifact, when it is referred to as crenation. It is a feature of pyruvate kinase deficiency, particularly post-splenectomy when the defective cells persist in the circulation [2]. A keratocyte is a cell with two or four paired spicules, from the Greek, κέρας, for horn, while a schistocyte is a jagged red cell fragment, from the Greek, σχίζω, for split or divide. Both are features of microangiopathic and mechanical hemolytic anemias [3]. Keratocytes are also seen in Heinz body hemolytic anemia, as in acute hemolysis in glucose-6-phosphate dehydrogenase deficiency. An appreciation of these diverse spiculated cells can be important in diagnosis. The author declares no conflicts of interest.
Integrating a Postpartum Contraception Intervention in the Maternal and Child Health Care System of China
Authors: AnXin Yin, XiaoYan Zhou, Xu Qian, Lei Zhang, XiuRui Wang, HuiBin Yang, YuHan Song, LongMei Jin, Mu Li, Hong Jiang
Journal: JAMA Network Open (2024)

Importance The interpregnancy intervals are suboptimal worldwide, and women lack access to high-quality postpartum contraceptive services in China. Objective To evaluate the effectiveness of integrating postpartum contraceptive interventions into the existing maternal and child health care (MCH) system. Design, Setting, and Participants This cluster randomized trial randomly allocated 13 communities in Minhang District in Shanghai, China, to the intervention or the control group. Data were collected between September 2020 and February 2023. Eligible participants included women who registered their pregnancy in community health centers and were followed up to 1 year post partum. Data analysis was conducted from April 2023 to May 2024. Interventions Participants in the intervention group received postpartum contraception consultations, online educational videos, a 45-minute class, health prescriptions, and educational pamphlets at 5 stages in alignment with the MCH system of China. The control group received routine MCH services. Main Outcomes and Measures The primary outcome was incidence of unintended pregnancy within 1 year after childbirth. The secondary outcomes included knowledge level of postpartum contraception, utilization rate of reliable long-acting reversible contraception (LARC), and incidence of induced abortion. Results A total of 1279 participants (698 in intervention from 7 clusters and 581 in control from 6 clusters) were recruited, and 995 (521 older than 30 years [40.7%]; 539 intervention [54.2%] and 456 control [45.8%]) completed the trial. The incidence of unintended pregnancy, LARC utilization, and induced abortion within 1 year after childbirth was 1.5% (8 participants), 3.2% (17 participants), and 0.6% (3 participants), respectively, in the intervention group, and 3.9% (18 participants), 1.1% (5 participants), and 2.0% (9 participants), respectively, in the control group. Participants in the intervention group were significantly less likely to experience unintended pregnancy (adjusted odds ratio [aOR], 0.33; 95% CI, 0.16-0.70), had a higher rate of LARC utilization (aOR, 2.47; 95% CI, 1.02-5.98), and a lower rate of induced abortion due to unintended pregnancy (aOR, 0.30; 95% CI, 0.09-0.99). The postpartum contraception knowledge level in the intervention group was substantially higher than the control group (β = 24.20; 95% CI, 20.92-27.47). Conclusions and Relevance This cluster randomized clinical trial demonstrated the designed postpartum contraceptive interventions were effective in reducing unintended pregnancy and induced abortion and increasing postpartum contraception knowledge and LARC utilization among women at 1-year post partum. Trial Registration Chictr.org.cn Identifier: ChiCTR2000034603
Estimated Vaccine Effectiveness for Respiratory Syncytial Virus–Related Lower Respiratory Tract Disease
Authors: Sara Y. Tartof, Negar Aliabadi, Gabriella Goodwin, Jeff Slezak, Vennis Hong, Bradley Ackerson, Qing Liu, Sally Shaw, Sabrina Welsh, Julie A. Stern, Banshri Kapadia, Brigitte C. Spence, Joseph A. Lewnard, Gregg S. Davis, Michael Aragones, Michael Dutro, Erica Chilson, Elisa Gonzalez, Robin Hubler, Brandon Chia, Luis Jodar, Bradford D. Gessner, Elizabeth Begier
Journal: JAMA Network Open (2024)

Importance Clinical trials have demonstrated high vaccine efficacy (VE) against lower respiratory tract disease (LRTD) but enrolled a smaller proportion of persons aged 75 years or older and those with comorbidities than seen in highest-risk populations in clinical practice settings. Additionally, VE against respiratory syncytial virus (RSV)–related hospitalizations and emergency department (ED) visits is not yet fully described. Objective To estimate Respiratory Syncytial Virus Prefusion F (RSVpreF) effectiveness in older adults. Design, Setting, and Participants This was a retrospective case-control study with a test negative design. Cases were adults aged 60 years or older with hospitalizations or ED visits at Kaiser Permanente of Southern California for LRTD from November 24, 2023, to April 9, 2024, who had respiratory swabs collected and tested for RSV. Two control definitions were prespecified: (1) strict controls included RSV-negative LRTD events that were negative for human metapneumovirus, SARS-CoV-2, and influenza, and positive for a nonvaccine preventable cause (primary) and (2) broad controls included all RSV-negative LRTD events (sensitivity analysis). Enhanced specimen collection was conducted to salvage clinical respiratory swabs not tested for RSV during routine care. Data were analyzed from May to September 2024. Exposure RSVpreF vaccine receipt during the first RSV season after licensure and 21 or more days before LRTD event. Main outcomes and measures Estimated VE against first episode of RSV-related LRTD hospitalization or ED visit. Results A total of 7047 LRTD-related hospitalizations or ED encounters with RSV testing results were included. The mean (SD) age was 76.8 (9.6) years; 3819 (54.2%) were female; 839 (11.9%) were non-Hispanic Asian or Pacific Islander, 2323 (33.0%) were Hispanic, 1197 (17.0%) were non-Hispanic Black, and 2602 (36.9%) were non-Hispanic White; 998 (14.2%) were immunocompromised; and 6573 (93.3%) had 1 or more Charlson comorbidity. Using strict controls, estimated adjusted VE was 91% (95% CI, 59%-98%). Using broad controls, estimated adjusted VE was 90% (95% CI, 59%-97%). Conclusions and Relevance In a high-risk, general population, RSVpreF vaccination conferred protection against RSV-related LRTD in the hospital and ED settings among US adults aged 60 years or older, the majority of whom were aged 75 years or older and had comorbidities. These data support use of this vaccine in older adults.
Loss to Follow-Up in Patients With Proliferative Diabetic Retinopathy or Diabetic Macular Edema
Authors: Ryan S. Huang, Sumana C. Naidu, Andrew Mihalache, Marko M. Popovic, Peter J. Kertes, David Sarraf, SriniVas R. Sadda, Rajeev H. Muni, Radha P. Kohly
Journal: JAMA Network Open (2024)

Importance Effective management of proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) requires reliable patient follow-up to prevent disease progression. Objective To investigate the sociodemographic and clinical factors associated with being lost to follow-up (LTFU) among individuals with PDR or DME treated with anti–vascular endothelial growth factor (VEGF) intravitreal injections (IVIs) or panretinal photocoagulation (PRP). Design, Setting, and Participants This cohort study included a multicenter, retrospective review of patients with PDR or DME treated in Toronto, Canada, from January 1, 2012, to December 31, 2021. Data were analyzed from February 1 to May 31, 2024. Exposures All patients received at least 1 anti-VEGF IVI or PRP session. Main Outcomes and Measures The primary outcome was the LTFU rate, defined as the absence of an ophthalmic visit or intervention in the 1-year period following an individual’s last visit with the treating retinal specialist. Univariable and multivariable logistic regression models were conducted to evaluate associations between sociodemographic and clinical factors with the LTFU rate. Results Overall, 2961 patients with PDR or DME (mean [SD] age, 71 [13] years; 1640 [55.4%] male) were included, of whom 507 (17.1%) were LTFU over a mean (SD) follow-up period of 61 (22) months. In the multivariable analysis, older patients (age ≥85 years vs age &amp;amp;lt;65 years: odds ratio [OR], 0.58; 95% CI, 0.40-0.81; P = .002), those with worse baseline visual acuity (&amp;amp;gt;20/200 Snellen vs 20/40 Snellen or better: OR, 0.68; 95% CI, 0.48-0.97; P = .04), those with DME (OR vs no DME, 0.60; 95% CI, 0.43-0.83; P = .003), those with frequent clinic visits (≥6 visits vs &amp;amp;lt;6 visits: OR, 0.78; 95% CI, 0.62-0.98; P = .04), and those with a high anti-VEGF IVI burden in the first year (OR vs low anti-VEGF burden, 0.40; 95% CI, 0.21-0.76; P = .006) were less likely to be LTFU. In contrast, males (OR vs females, 1.23; 95% CI, 1.04-1.52; P = .04), patients living further from the point of care (&amp;amp;gt;200 vs ≤20 km OR, 2.65; 95% CI, 1.85-3.76; P &amp;amp;lt; .001), and those treated with PRP (OR vs anti-VEGF IVIs, 2.10; 95% CI, 1.24-3.55; P &amp;amp;lt; .001) were more likely to be LTFU. Compared with White patients, Black patients (OR, 2.10; 95% CI, 1.50-2.95; P &amp;amp;lt; .001) and Hispanic patients (OR, 1.54; 95% CI, 1.05-2.21; P = .03) were more likely to be LTFU. Conclusions and Relevance This cohort study found multiple factors associated with LTFU rates. Identifying individuals at higher risk of LTFU and developing targeted strategies may reduce disease progression and vision loss in individuals with PDR.
Associations of anxiety and depression with prognosis in chronic obstructive pulmonary disease: A systematic review and meta-analysis
Authors: Kefan Wu, Lifei Lu, Yubiao Chen, Jieqi Peng, Xiaohui Wu, Gaoying Tang, Ting Ma, Jing Cheng, Pixin Ran, Yumin Zhou
Journal: Pulmonology (2024)

The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28–3.45, p = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge (HR: 1.36, 95% CI: 1.10–1.69, p = 0.004). Similar results were observed in the associations of anxiety and depression with 30-day readmission. Our results suggested that anxiety and depression were associated with an increased risk of 30-day readmission and AECOPD in patients with COPD.
Longitudinal blood immune-inflammatory and radiomic profiling to decode different patterns of acquired resistance to immunotherapy in patients with NSCLC
Authors: Giulia Mazzaschi, Cristina Marrocchio, Lucas Moron Dalla Tor, Ludovica Leo, Maurizio Balbi, Gianluca Milanese, Ganiyat A.R. Adebanjo, Bruno Lorusso, Gregorio Monica, Monica Pluchino, Roberta Minari, Simona D'Agnelli, Elisa Cardinale, Fabiana Perrone, Paola Bordi, Alessandro Leonetti, Roberta E. Ledda, Mario Silva, Sebastiano Buti, Giovanni Roti, Stefano Bettati, Federico Quaini, Marcello Tiseo, Nicola Sverzellati
Journal: Clinical Cancer Research (2024)

Abstract Purpose: To uncover the underpinnings of acquired resistance (AR) to immunotherapy (IO), we determined whether distinctive clinico-pathological, radiomic and peripheral blood (PB) immune-inflammatory features reflect oligo- and systemic (sys)-AR in advanced NSCLC patients undergoing immune checkpoints inhibitors. Experimental Design: On 105 consecutive IO-treated advanced NSCLC, PB immunophenotypes, cytokines and CT-derived radiomic features (RFs), extracted from primary and merged metastatic lesions, were prospectively collected at baseline (T0) and first disease assessment (T1, 9-12 weeks), and their delta (Δ) variation [(T1-T0)/T0] computed. AR, defined as progression after initial response (complete/partial) or stable disease ≥ 6 months, was subdivided according to the number of new and/or progressive lesions in oligoAR (≤3) and sysAR (&amp;gt;3). Clinico-pathological, PB and radiomic parameters and survival outcome were statistically correlated to AR patterns. Results: OligoAR and sysAR involved 24% and 12.4% of cases, respectively. While baseline PB immune profiles were comparable, a Δpos cytotoxic (NK, CD8+GnzB+) and Δneg immunosuppressive (CD14+ monocytes) dynamic coupled with different modulation of IL-6, TGF-β1, TNFα and sPD-L1 represented distinctive features of oligoAR vs sysAR (P&amp;lt;0.05). Significantly longer post-progression survival characterized oligoAR vs sysAR (median 20.3 vs 5.6 months;HR:0.22,P&amp;lt;0.001). The number and sites of oligoAR involvement appeared to condition blood immune background (P&amp;lt;0.05) and survival. Delta radiomic outperformed baseline RFs, with 15 ΔRFs sharply discriminating oligoAR from sysAR (P range:&amp;lt;0.001-0.04). ROC analysis confirmed the optimal performance of top-ranked ΔRFs (AUC range:0.88-0.99). Conclusions: Longitudinal analysis of blood immune hallmarks and radiomic descriptors may decipher distinct patterns of AR to IO in advanced NSCLC patients.
FcRn-dependent IgG accumulation in adipose tissue unmasks obesity pathophysiology
Authors: Lexiang Yu, Yong Xiao Yang, Zhen Gong, Qianfen Wan, Yifei Du, Qiuzhong Zhou, Yang Xiao, Tarik Zahr, Zhaobin Wang, Zhewei Yu, Kangkang Yang, Jinyang Geng, Susan K Fried, Jing Li, Rebecca A Haeusler, Kam W Leong, Lin Bai, Yingjie Wu, Lei Sun, Pan Wang, Bao Ting Zhu, Liheng Wang, Li Qiang
Journal: Cell Metabolism (2024)