tbuckley/cabot-search huggingface dataset:
Mental Health Factors in Semaglutide Discontinuation
Authors: Michioki Endo, Masahiro Kami
Journal: JAMA Internal Medicine (2025)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI 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) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2025 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 Internal Medicine journal
Genomic Screening at a Single Health System
Authors: Juliann M. Savatt, Melissa A. Kelly, Amy C. Sturm, Cara Z. McCormick, Marc S. Williams, Michelle Pistner Nixon, David D. Rolston, Natasha T. Strande, Karen E. Wain, Huntington F. Willard, W. Andrew Faucett, David H. Ledbetter, Adam H. Buchanan, Christa L. Martin
Journal: JAMA Network Open (2025)

Importance Completion of the Human Genome Project prompted predictions that genomics would transform medicine, including through genomic screening that identifies potentially medically actionable findings that could prevent disease, detect it earlier, or treat it better. However, genomic screening remains anchored in research and largely unavailable as part of routine care. Objective To summarize 11 years of experience with genomic screening and explore the landscape of genomic screening efforts. Design, Setting, and Participants This cohort study was based in Geisinger’s MyCode Community Health Initiative, a genomic screening program in a rural Pennsylvania health care system in which patient-participants exomes are analyzed. Main Outcomes and Measures Genomic screen-positive rates were evaluated and stratified by condition type (cancer, cardiovascular, other) and US Centers for Disease Control and Prevention (CDC) Tier 1 designation. The proportion of participants previously unaware of their genomic result was assessed. Other large-scale population-based genomic screening efforts with genomic results disclosure were compiled from public resources. Results A total of 354 957 patients participated in Geisinger’s genomic screening program (median [IQR] age, 54 [36-69] years; 194 037 [59.7%] assigned female sex at birth). As of June 2024, 175 500 participants had exome sequencing available for analysis, and 5934 participants (3.4%) had a pathogenic variant in 81 genes known to increase risk for disease. Between 2013 and July 2024, 5119 results were disclosed to 5052 eligible participants, with 2267 (44.2%) associated with risk for cardiovascular disease, 2031 (39.7%) with risk for cancer, and 821 (16.0%) with risk for other conditions. Most results (3040 [59.4%]) were in genes outside of those with a CDC Tier 1 designation. Nearly 90% of participants (4425 [87.6%]) were unaware of their genomic risk prior to disclosure. In a survey of large-scale biobanks with genomic and electronic health record (EHR) data, only 25.0% (6 of 24) disclosed potentially actionable genomic results. Conclusions and Relevance In this large, genomics-informed cohort study from a single health system, 1 in 30 participants had a potentially actionable genomic finding. However, nearly 90% were unaware of their risk prior to screening, demonstrating the utility of genomic screening in identifying at-risk individuals. Most large-scale biobanks with genomic and EHR data did not return genomic results with potential medical relevance, missing opportunities to significantly improve genomic risk ascertainment for these individuals and to perform longitudinal studies of clinical and implementation outcomes in diverse settings.
Persistence of Delirium in Postacute Care at Skilled Nursing Facilities
Authors: Chan Mi Park, Sandra Shi, Richard N. Jones, Eran D. Metzger, Sarinnapha M. Vasunilashorn, Tamara Fong, Dae Hyun Kim, Sharon K. Inouye
Journal: JAMA Network Open (2025)

Importance The 2014 Improving Medicare Post-Acute Care Transformation (IMPACT) Act aimed to improve postacute care quality and outcomes. This study examines changes in delirium, a key quality indicator, over 5 years following its implementation. Objective To compare the persistence and resolution of delirium within skilled nursing facilities (SNFs) between 2014 and 2019. Design, Setting, and Participants This cross-sectional study included SNF admissions from a 5% Medicare random sample, with delirium assessments conducted between January 1 and December 31 in 2014 and 2019. The analysis of persistent delirium consisted of patients with delirium at SNF admission and a subsequent delirium assessment during their SNF stay. Analyses were conducted from December 2023 to October 2024. Exposures Year 2019 compared with year 2014. Main Outcomes and Measures Delirium was measured using the Minimum Data Set (MDS) Confusion Assessment Method at SNF admission and at a subsequent assessment within 30 days of admission. Multinomial logistic regression was used to compare the rates of resolved delirium, persistent delirium, and death between 2014 and 2019 after adjusting for patient characteristics and SNF care factors. Results The sample included a total of 432 037 SNF admissions before exclusions and 306 998 after exclusions. For SNF admissions in 2014, 6933 of 162 161 patients (4.3%) had delirium at admission, compared with 3595 of 144 837 patients (2.5%) in 2019. In 2014, there were 6096 patients (mean [SD] age, 80.6 [11.0] years; 3565 women [58.5%]), and in 2019, there were 2778 patients (mean [SD] age, 80.2 [10.7] years; 1546 women [55.7%]) with delirium and follow-up assessments. The adjusted prevalence of persistent delirium decreased from 3347 of 6096 patients (62.3%; 95% CI, 60.2%-64.4%) in 2014 to 1316 of 2778 patients (54.7%; 95% CI, 52.0%-57.4%) in 2019, whereas delirium resolution increased from 1734 of 6096 patients (29.1%; 95% CI, 27.1%-31.1%) in 2014 to 1010 of 2778 patients (37.4%; 95% CI, 34.7%-40.0%) in 2019. Conclusions and Relevance This cross-sectional study found a reduction in the prevalence of delirium at SNF admission and an improvement in delirium resolution during the stay in the 5 years following the IMPACT Act. However, the high prevalence of persistent delirium warrants further efforts to improve delirium management in SNF.
Tailored Adherence Incentives for Childhood Asthma Medications
Authors: Chén C. Kenyon, William O. Quarshie, Rui Xiao, Mishaal Yazdani, Carina M. Flaherty, G. Chandler Floyd, Victoria A. Miller, Tyra C. Bryant-Stephens, Joseph J. Zorc, Chris Feudtner
Journal: JAMA Pediatrics (2025)

Importance Differential adherence to efficacious preventive medications is one potentially modifiable driver of racial disparities in childhood asthma outcomes. Objective To determine the effect of a financial incentive-enhanced intervention on adherence to inhaled asthma preventive medication in a high-risk, predominantly racially minoritized cohort of children with asthma. Design, Setting, and Participants This was a randomized clinical trial conducted from September 2019 through June 2022 at a large mid–Atlantic pediatric health system in the US. Children were eligible if they were between 5 and 12 years old, prescribed a preventive inhaler for daily use, and had at least 2 asthma exacerbations requiring systemic steroids in the preceding year. Data were analyzed from December 2022 to December 2024. Intervention Inhaled medication use was monitored using electronic inhaler sensors over a 7-month period. Families who completed a 1-month run-in interval were randomized to 1 of 3 arms for a 3-month experiment interval: (1) daily text message medication reminders, weekly adherence feedback, and gain-framed, financial incentives of up to $1 per day (full intervention); (2) daily text message medication reminders and weekly adherence feedback (hybrid intervention); or (3) no reminders, feedback, or incentives (active control). Medication adherence monitoring then continued for a 3-month observation interval, where all arms reverted to active control conditions. Main Outcomes and Measures The primary outcome was adherence to inhaled maintenance medication during the experiment; secondary outcomes included adherence during the observation phase. The study was powered to detect a difference in average monthly adherence between the full intervention and active control condition. Results Of the 106 children randomized, 99 had at least 1 month of monitoring data (56 male [57%] and 43 female [43%]; mean [SD] age, 8.0 [2.3] years). Most participants (81 [82%]) identified as non-Hispanic Black and demographic and clinical characteristics were similar across study arms. During the experiment interval, participants receiving the full intervention had a 15–percentage point (95% CI, 2-29 percentage points) higher inhaled maintenance medication adherence compared with participants in the active control. There was no evidence of adherence differences in the observation interval. Conclusion and Relevance While a financial incentive-enhanced mobile health intervention led to higher inhaled preventive medication adherence as compared with the active control group, there was no evidence for enduring effect after the intervention components ceased, consistent with other studies that include financial incentives to encourage behavior change. Trial Registration ClinicalTrials.gov Identifier: NCT03907410
Mental Health Factors in Semaglutide Discontinuation—Reply
Authors: Thomas A. Wadden, Ofir Frenkel, Robert F. Kushner
Journal: JAMA Internal Medicine (2025)

In Reply We thank Endo and Kami for their comments and for raising these questions in response to our post hoc analysis of the psychiatric safety of semaglutide, 2.4 mg, for weight management in persons without known major psychopathology, as evaluated in the STEP 1, 2, 3, and 5 studies.1
Building Biobanks to Drive Biomedical Research and Genomically Informed Care
Authors: Heidi L. Rehm
Journal: JAMA Network Open (2025)

Juliann M. Savatt, MS; Melissa A. Kelly, MS; Amy C. Sturm, MS; Cara Z. McCormick, MPH; Marc S. Williams, MD; Michelle Pistner Nixon, PhD; David D. Rolston, MD; Natasha T. Strande, PhD; Karen E. Wain, MS; Huntington F. Willard, PhD; W. Andrew Faucett, MS; David H. Ledbetter, PhD; Adam H. Buchanan, MS, MPH; Christa L. Martin, PhD
Adenotonsillectomy and Health Care Utilization in Children With Snoring and Mild Sleep Apnea
Authors: Jessie P. Bakker, Fang Zhang, Raouf Amin, Cristina M. Baldassari, Ronald D. Chervin, Susan L. Garetz, Fauziya Hassan, Sally Ibrahim, Stacey L. Ishman, Erin M. Kirkham, Ariel Linden, Ron B. Mitchell, Kamal Naqvi, Carol L. Rosen, Kristie Ross, Ignacio E. Tapia, Lisa R. Young, Phoebe K. Yu, Susan Redline, Rui Wang
Journal: JAMA Pediatrics (2025)

Importance The literature indicates that health care utilization (HCU) of children with untreated moderate-to-severe obstructive sleep apnea is greater than that of matched controls before diagnosis, and treatment is associated with a decline in HCU not observed in those who remain untreated. Research on this topic has been limited to retrospective analyses and observational cohort studies; little is known about HCU among the many children with snoring and mild sleep-disordered breathing (SDB). Objective To determine whether adenotonsillectomy in comparison with watchful waiting with supportive care is associated with fewer health care encounters and prescriptions. Design, Setting, and Participants This randomized clinical trial, Pediatric Adenotonsillectomy Trial for Snoring (PATS), was a 12-month, parallel-arm trial conducted from 2016 to 2022 in tertiary care centers in the United States. Participants were recruited from otolaryngology, sleep, pulmonary, or general pediatric clinics; aged 3 to 13 years; diagnosed with mild SDB; had a tonsillar hypertrophy grade of 2 or more; and had a body mass index z score less than 3. Children referred from a clinician outside of the local electronic medical record system were excluded. Data analysis was conducted from June 2022 to April 2024. Intervention Early adenotonsillectomy. Main Outcomes and Measures Evaluation of HCU was a prespecified secondary aim of PATS. Total encounters and total prescriptions over the 12 months after randomization were analyzed. Results Among 459 children who were randomized, the analytic sample included 381 children, after excluding those referred from outside the local electronic medical record system. The median (IQR) age was 6 (4-8) years; 192 participants (50%) were female and 189 (50%) male. Adenotonsillectomy was associated with a 32% reduction in total health care encounters (mean difference, −1.25 per participant per year; 95% CI, −1.96 to −0.53) and a 48% reduction in prescriptions (mean difference, −2.53 per participant per year; 95% CI, −4.12 to −0.94). The difference in encounters was primarily driven by fewer office visits and outpatient procedures rather than by reduced hospitalizations or urgent care visits. Conclusions and Relevance This study found that adenotonsillectomy was associated with reduced all-cause HCU in children with mild SDB, supporting early intervention for children with mild SDB. Future research focused on the cost effectiveness of adenotonsillectomy for pediatric SDB is warranted. Trial Registration ClinicalTrials.gov Identifier: NCT02562040
PSMA-Uptake Reveals Globet Cell Cancer of the Appendix in a Patient Staged for Prostate Cancer With PET/CT
Authors: Nina A. Lampe, Nina Anzic, Joe Stürmlin, Klaus Strobel, Hannes Grünig
Journal: Clinical Nuclear Medicine (2025)

18 F-PSMA 1007 is an established tracer for staging intermediate and high-risk prostate cancer. Besides prostate cancer cells, benign tumors and inflammations/infections can show unspecific PSMA uptake. We present a case of incidental PSMA uptake of the appendix revealing a globet cell adenocarcinoma in histology after surgical resection. Globet cell tumors are rare neoplasms of the appendix. Patients with incidental PSMA uptake in the appendix should undergo further work-up.
Gender-Affirming Hormone Therapy and Depressive Symptoms Among Transgender Adults
Authors: Sari L. Reisner, David R. Pletta, Alex S. Keuroghlian, Kenneth H. Mayer, Madeline B. Deutsch, Jennifer Potter, Jaclyn M. W. Hughto, Alexander Harris, Asa E. Radix
Journal: JAMA Network Open (2025)

Importance In the US, transgender, nonbinary, and gender diverse (TGD) adults have high rates of depression. Gender-affirming hormone therapy (GAHT) is associated with improved mental health outcomes, yet existing US studies have short follow ups and lack sample diversity. Objective To evaluate the use of GAHT delivered in primary care as an intervention for moderate-to-severe depressive symptoms in diverse TGD adult patients. Design, Setting, and Participants LEGACY was an observational cohort study conducted in federally qualified community health centers in Boston and New York that followed up TGD patients (N = 3592) from calendar years 2016 to 2019 (48 months). Participants included individuals aged 18 years or older, gender identity different from sex at birth, a past 12-month medical visit, and signed patient consent form in the electronic health record (EHR). Exposures Prescriptions for GAHT obtained from EHR data, using the date of the first and last GAHT prescription in each calendar year of observation (GAHT within the year vs no GAHT during the year). Main Outcomes and Measures A binary outcome of patient-reported moderate-to-severe depressive symptoms was obtained using the validated Patient-Health Questionnaire (PHQ), scoring 10 or greater on the PHQ-9 or scoring 3 or greater on the PHQ-2. Following multiple imputation, generalized estimating equations (GEE) longitudinally modeled GAHT and moderate-to-severe depressive symptoms (n = 20 320 observations) and adjusted for age, gender identity, race and ethnicity, health insurance, federal poverty level, HIV serostatus, number of cohort years, and clinical site. Results The median age of the 3592 patients was 28 (IQR, 24-36) years. Race and ethnicity was diverse (1.3% Asian/Pacific Islander, 11.7% Black, 16.1% Hispanic/Latinx, 63.1% White, 6.8% multiracial, and 1.4% other). In addition, 18.9% were nonbinary, 52.1% lived below the federal poverty level, 34.2% were publicly insured, 4.1% were uninsured, and 5.1% were living with HIV. At baseline, 84.5% of the individuals were prescribed GAHT and 15.3% reported moderate-to-severe depressive symptoms. Patients prescribed GAHT had a statistically significantly lower risk of moderate-to-severe depressive symptoms over follow-up compared with those not prescribed GAHT (adjusted risk ratio, 0.85; 95% CI, 0.75-0.98). Conclusions and Relevance In this longitudinal observational cohort study, GAHT was associated with lower rates of moderate-to-severe depressive symptoms, highlighting the importance of gender-affirming primary care models for TGD patients.
Donepezil for Fatigue and Psychological Symptoms in Post–COVID-19 Condition
Authors: Kensuke Nakamura, Kazuhiro Kondo, Naomi Oka, Kazuma Yamakawa, Kenya Ie, Tadahiro Goto, Shigeki Fujitani
Journal: JAMA Network Open (2025)

Importance Fatigue is the most commonly reported symptom of post–COVID-19 condition (also known as long COVID) and impairs various functions. One of the underlying mechanisms may be intracerebral inflammation due to decreases in acetylcholine levels. Objective To examine the effects of donepezil hydrochloride, an acetylcholinesterase inhibitor, on post–COVID-19 fatigue and psychological symptoms. Design, Setting, and Participants A multicenter, double-blind randomized clinical trial was performed in Japan. Between December 14, 2022, and March 31, 2024, adult patients within 52 weeks of the onset of COVID-19 and with a global binary fatigue score of 4 or greater on the Chalder Fatigue Scale were randomized into a donepezil or a placebo group. Exposure The intervention was conducted during a 3-week period, with donepezil hydrochloride being administered at a dosage of 3 mg/d for the first week and then 5 mg/d for 2 weeks. Main Outcomes and Measures The primary outcome was a change in the Chalder Fatigue Scale score and the absolute score 3 weeks after the initiation of treatment. Other outcomes at 3 and 8 weeks, such as psychological symptoms and quality of life, were evaluated as secondary outcomes. Results A total of 120 eligible patients were enrolled and 10 withdrew or were lost to follow-up; therefore, 110 patients (55 in each group) were included in the efficacy analysis (64 [58%] female; mean [SD] age, 43 [12] years). No significant differences were observed in baseline characteristics between the 2 groups. The baseline-adjusted estimating treatment effect of donepezil, measured as the mean difference on Chalder Fatigue Scale scores at 3 weeks, was 0.34 (95% CI, −2.23 to 2.91), showing no significant effect of the intervention ( P = .79). Scores for the Hospital Anxiety and Depression Scale, Impact of Event Scale–Revised, EuroQol 5-Dimension 5-Level Version, Patient Health Questionnaire, and Daily Health Status at 3 and 8 weeks were similar. No serious adverse events occurred in either group. Conclusions and Relevance In this randomized clinical trial of donepezil to treat post–COVID-19 condition, the efficacy for fatigue and psychological symptoms was not confirmed in a general population. The development of effective therapeutics for post–COVID-19 symptoms is needed, and more clinical trials should be conducted in the future. Trial Registration Japan Registry of Clinical Trials Identifier: jRCT 2031220510
The Bad Medicine of <i>Doctored</i>
Authors: Joshua D. Grill, Gil D. Rabinovici
Journal: JAMA (2025)

This Viewpoint discusses a recent book that alleges scientific misconduct in Alzheimer disease (AD) research; summarizes actual progress made in the field; suggests that the book contributes to a narrative that jeopardizes momentum in AD research; and calls for increased transparency and public engagement with science to minimize misinformation.
Biomarker-Based Model for Prediction of Ischemic Stroke in Patients With Atrial Fibrillation
Authors: Lars Wallentin, Johan Lindbäck, Ziad Hijazi, Jonas Oldgren, Anthony P Carnicelli, John H Alexander, David D Berg, John W Eikelboom, Shinya Goto, Renato D Lopes, Christian T Ruff, Agneta Siegbahn, Robert P Giugliano, Christopher B Granger, David A Morrow
Journal: Journal of the American College of Cardiology (2025)
Pulmonary Embolism in Patients with End-Stage Kidney Disease Starting Dialysis
Authors: Kunal N. Patel, Wan-Chi Chan, Vivek Bhat, Monil M. Majmundar, Harsh Mehta, Cyrus Munguti, Kartik Munshi, Sri G. Yarlagadda, Gaurav M. Parmar, Aditya M. Sharma, Daniella Kadian-Dodov, Lewis G. Satterwhite, Jinxiang Hu, Jordan Baker, MS, Kamal Gupta
Journal: JAMA Network Open (2025)

This cohort study examines the incidence and outcomes of pulmonary embolism as well as anticoagulant use among patients with end-stage kidney disease initiating dialysis.
Risk of Cancer in Newborns With Congenital Heart Disease and Their Mothers: A Nationwide Cohort Study
Authors: Danbee Kang, Gwang-Jun Choi, Jihye Heo, Seung Woo Park, Juyoung Sung, Insung Kim, Taegyun Park, Juhee Cho, June Huh
Journal: Circulation (2025)
Correction to: Low Penetrance Sarcomere Variants Contribute to Additive Risk in Hypertrophic Cardiomyopathy
Authors: Joshua K. Meisner, Aaron Renberg, Eric D. Smith, Yao-Chang Tsan, Brynn Elder, Abbey Bullard, Owen L. Merritt, Sean L. Zheng, Neal K. Lakdawala, Anjali T. Owens, Thomas D. Ryan, Erin M. Miller, Joseph W. Rossano, Kimberly Y. Lin, Brian L. Claggett, Euan A. Ashley, Michelle Michels, Rachel Lampert, John C. Stendahl, Dominic Abrams, Christopher Semsarian, Victoria N. Parikh, Matthew T. Wheeler, Jodie Ingles, Iacopo Olivotto, Sharlene M. Day, Sara Saberi, Mark W. Russell, Michael Previs, Carolyn Y. Ho, James S. Ware, Adam S. Helms
Journal: Circulation (2025)
Subtyping breast lesions via collective intelligence based long-tailed recognition in ultrasound
Authors: Ruobing Huang, Yinyu Ye, Ao Chang, Han Huang, Zijie Zheng, Long Tan, Guoxue Tang, Man Luo, Xiuwen Yi, Pan Liu, Jiayi Wu, Baoming Luo, Dong Ni
Journal: Medical Image Analysis (2025)
Imaging the impact of sex and age on OATP function in humans: consequences for whole-body pharmacokinetics and liver exposure
Authors: Solène Marie, Anne-Lise Lecoq, Louise Breuil, Fabien Caillé, Vincent Lebon, Claude Comtat, Sébastien Goutal, Laurent Becquemont, Michel Bottlaender, Céline Verstuyft, Nicolas Tournier
Journal: Acta Pharmaceutica Sinica B (2025)
Celastrol-loaded ginsenoside Rg3 liposomes boost immunotherapy by remodeling obesity-related immunosuppressive tumor microenvironment in melanoma
Authors: Hongyan Zhang, Jingyi Huang, Yujie Li, Wanyu Jin, Jiale Wei, Ninghui Ma, Limei Shen, Mancang Gu, Chaofeng Mu, Donghang Xu, Yang Xiong
Journal: Acta Pharmaceutica Sinica B (2025)
Selection of Plasmodium falciparum kelch13 mutations in Uganda in comparison with southeast Asia: a modelling study
Authors: Cecile P G Meier-Scherling, Oliver J Watson, Victor Asua, Isaac Ghinai, Thomas Katairo, Shreeya Garg, Melissa D Conrad, Philip J Rosenthal, Lucy C Okell, Jeffrey A Bailey
Journal: The Lancet Microbe (2025)
Ocular infectivity and replication of a clade 2.3.4.4b A(H5N1) influenza virus associated with human conjunctivitis in a dairy farm worker in the USA: an in-vitro and ferret study
Authors: Jessica A Belser, Joanna A Pulit-Penaloza, Nicole Brock, Xiangjie Sun, Troy J Kieran, Claudia Pappas, Hui Zeng, Michelle N Vu, Seema S Lakdawala, Terrence M Tumpey, Taronna R Maines
Journal: The Lancet Microbe (2025)