tbuckley/cabot-search huggingface dataset:
Comparison of 6 tests for diagnosing minimal hepatic encephalopathy and predicting clinical outcome: A prospective, observational study
Authors: Alena F. Ehrenbauer, Julius F.M. Egge, Maria M. Gabriel, Anja Tiede, Meike Dirks, Jennifer Witt, Heiner Wedemeyer, Benjamin Maasoumy, Karin Weissenborn
Journal: Hepatology (2024)

Current guidelines recommend the assessment for minimal HE in patients with liver cirrhosis. Various efforts were made to find tools that simplify the diagnosis. Here, we compare the 6 most frequently used tests for their validity and their predictive value for overt hepatic encephalopathy (oHE), rehospitalization, and death.
Letter to the Editor: Additional viewpoints from transplant surgeons on Banff consensus recommendations for the assessment of steatotic donor livers
Authors: Huan Cao, Jinyang Gu
Journal: Hepatology (2024)

To the editor, We read with great interest the article by Neil et al.1 The utilization of severely macrovesicular steatotic donor livers may result in grave consequences, such as primary nonfunction of the liver allograft; hence, an accurate assessment of steatotic livers is imperative. Given the lack of uniformity in pathological criteria and variations in pathologists' assessments, the precise evaluation of hepatic steatosis poses a formidable challenge for transplant teams. The pathological assessment criteria and algorithmic approach established by Neil et al hold significant promise for accurately discerning hepatic steatosis in donor livers. However, several issues deserve further discussion and investigation from the perspective of transplant surgeons. First, when establishing an algorithmic approach, it is advisable to include more cases of severe hepatic steatosis. Admittedly, severe macrovesicular steatosis of donor livers is generally less likely to be considered for transplantation2; however, the limited number of severe steatotic liver cases in this study may raise potential bias in algorithm development resulting in assessment mistakes. Second, clarification regarding the timing of pathological specimen collection is warranted. In fact, liver assessment may occur at various intervals, such as donor maintenance, preorgan retrieval, postretrieval, and pretransplantation. Simultaneously, the comprehensive evaluation of cold ischemia time and the degree of hepatic steatosis will also impact surgeons' decisions regarding the utilization of the donor liver. Given that hepatic steatosis may evolve during donor maintenance and postretrieval storage,3 it is crucial to emphasize the importance of time-zero liver allograft biopsies acquisition to surgeons. Lastly, the algorithmic approach established by Neil was exclusively conducted based on frozen sections. Although uncommon in clinical practice, some transplant centers, such as the Division of Liver and Transplant Pathology at the University of Pittsburgh, possess the capability to prepare rapid paraffin sections.4 In addition, the accuracy of assessing hepatic steatosis degree on frozen sections may be slightly inferior to that on paraffin sections.5 Thus, it raises the question of whether a certain degree of error occurs when extending the algorithmic approach to other forms of pathological sections. In summary, confronting the increased donor liver steatosis rate and the lack of uniform pathological assessment standards, Banff consensus recommendations hold significant promise for accurately assessing hepatic steatosis. It is believed that addressing the above issues is instrumental in facilitating the clinical implementation of Banff consensus recommendations.
Advancing Cardiomyocyte Maturation: Current Strategies and Promising Conductive Polymer‐Based Approaches
Authors: Kamil Elkhoury, Sacha Kodeih, Eduardo Enciso‐Martínez, Ali Maziz, Christian Bergaud
Journal: Advanced Healthcare Materials (2024)

Cardiovascular diseases are a leading cause of mortality and pose a significant burden on healthcare systems worldwide. Despite remarkable progress in medical research, the development of effective cardiovascular drugs has been hindered by high failure rates and escalating costs. One contributing factor is the limited availability of mature cardiomyocytes (CMs) for accurate disease modeling and drug screening. Human induced pluripotent stem cell-derived CMs offer a promising source of CMs; however, their immature phenotype presents challenges in translational applications. This review focuses on the road to achieving mature CMs by summarizing the major differences between immature and mature CMs, discussing the importance of adult-like CMs for drug discovery, highlighting the limitations of current strategies, and exploring potential solutions using electro-mechano active polymer-based scaffolds based on conductive polymers. However, critical considerations such as the trade-off between 3D systems and nutrient exchange, biocompatibility, degradation, cell adhesion, longevity, and integration into wider systems must be carefully evaluated. Continued advancements in these areas will contribute to a better understanding of cardiac diseases, improved drug discovery, and the development of personalized treatment strategies for patients with cardiovascular disorders.
Protein-rich foods, sea foods, and gut microbiota amplify immune responses in chronic diseases and cancers – Targeting PERK as a novel therapeutic strategy for chronic inflammatory diseases, neurodegenerative disorders, and cancer
Authors: Fatma Saaoud, Yifan Lu, Keman Xu, Ying Shao, Domenico Praticò, Roberto I. Vazquez-Padron, Hong Wang, Xiaofeng Yang
Journal: Pharmacology & Therapeutics (2024)
Management of Food Allergies and Food-Related Anaphylaxis
Authors: Edward G. A. Iglesia, Mildred Kwan, Yamini V. Virkud, Onyinye I. Iweala
Journal: JAMA (2024)

Importance An estimated 7.6% of children and 10.8% of adults have IgE-mediated food-protein allergies in the US. IgE-mediated food allergies may cause anaphylaxis and death. A delayed, IgE-mediated allergic response to the food-carbohydrate galactose-α-1,3-galactose (alpha-gal) in mammalian meat affects an estimated 96 000 to 450 000 individuals in the US and is currently a leading cause of food-related anaphylaxis in adults. Observations In the US, 9 foods account for more than 90% of IgE-mediated food allergies—crustacean shellfish, dairy, peanut, tree nuts, fin fish, egg, wheat, soy, and sesame. Peanut is the leading food-related cause of fatal and near-fatal anaphylaxis in the US, followed by tree nuts and shellfish. The fatality rate from anaphylaxis due to food in the US is estimated to be 0.04 per million per year. Alpha-gal syndrome, which is associated with tick bites, is a rising cause of IgE-mediated food anaphylaxis. The seroprevalence of sensitization to alpha-gal ranges from 20% to 31% in the southeastern US. Self-injectable epinephrine is the first-line treatment for food-related anaphylaxis. The cornerstone of IgE-food allergy management is avoidance of the culprit food allergen. There are emerging immunotherapies to desensitize to one or more foods, with one current US Food and Drug Administration–approved oral immunotherapy product for treatment of peanut allergy. Conclusions and Relevance IgE-mediated food allergies, including delayed IgE-mediated allergic responses to red meat in alpha-gal syndrome, are common in the US, and may cause anaphylaxis and rarely, death. IgE-mediated anaphylaxis to food requires prompt treatment with epinephrine injection. Both food-protein allergy and alpha-gal syndrome management require avoiding allergenic foods, whereas alpha-gal syndrome also requires avoiding tick bites.
Letter to the Editor: AGILE 3+ score, enhancing the diagnostic accuracy of advanced fibrosis in patients with nonalcoholic fatty liver disease
Authors: Luis Calzadilla-Bertot, Angus W. Jeffrey, Gary P. Jeffrey
Journal: Hepatology (2024)

To the editor, Dalbeni et al1 have performed a thorough systematic review and meta-analysis evaluating the accuracy of the AGILE 3+ score in identifying advanced fibrosis in biopsy-proven subjects with NAFLD. Their findings revealed substantial heterogeneity between the 6 included observational studies for both sensitivity (I2=89.2%) and specificity (I2=97.68%) of the AGILE 3 +score. Meta-regression analysis revealed both age and body mass index potentially impacted the diagnostic accuracy of AGILE 3+ (rule out cutoff). There may be benefit in further exploring heterogeneity through subanalyses for obese or overweight individuals. Older age, specifically, 65 years and older impacted the performance of Fibrosis-4 to estimate advanced fibrosis. The AGILE 3+ and Fibrosis-4 scores shared 2 similar variables in their formula (age and platelet count) but with different covariate contribution. It would be of value to investigate if the specificity of AGILE 3+ for advanced fibrosis is impacted in patients aged ≥65 as it is for Fibrosis-4.2 An unexplored topic is the role of ethnicity in model performance. This study included research from varied sites in Japan, China, Europe, and North America. A recent multicenter Asian-based study that was not included in this meta-analysis3 reported similar diagnostic accuracy for liver stiffness measurement by transient elastography alone compared with AGILE 3+ (AUC, 0.82 for both) for advanced fibrosis in NAFLD. Notably, AGILE 3+ performed slightly better (AUC, 0.86) than liver stiffness measurement by transient elastography alone (AUC, 0.84) in patients with a Body mass index <25, warranting further investigation into AGILE 3+ performance in lean Asian patients. A sub and meta-regression analysis could clarify the impact of ethnicity on AGILE-3+ diagnostic accuracy. An advantage of AGILE 3+ is the low proportion of patients who are classified as indeterminate (around 10% of participants). An accurate estimation of the pool prevalence of this indeterminate population based on individual patient data would enhance the results. In addition, analyzing potential factors associated with the indeterminate area through meta-regression analysis would provide valuable information. The integration of liver stiffness measurement estimation with parameters known to influence liver fibrosis in AGILE 3+ is an important step forward in better identifying patients with advanced fibrosis. The authors have made a valuable contribution to the challenging pursuit of identifying accurate noninvasive tests for advanced fibrosis in NAFLD and are to be commended for this.
Safety and Efficacy of Midline vs Peripherally Inserted Central Catheters Among Adults Receiving IV Therapy
Authors: Simon L. Thomsen, Rikke Boa, Lars Vinter-Jensen, Bodil S. Rasmussen
Journal: JAMA Network Open (2024)

Midline catheters (MCs) are widely used, but safety and efficacy compared with peripherally inserted central catheters (PICCs) has not been adequately evaluated.
Prepandemic Physical Activity and Risk of COVID-19 Diagnosis and Hospitalization in Older Adults
Authors: Dennis Muñoz-Vergara, Peter M. Wayne, Eunjung Kim, I-Min Lee, Julie E. Buring, JoAnn E. Manson, Howard D. Sesso
Journal: JAMA Network Open (2024)

Importance Higher prepandemic physical activity (PA) levels have been associated with lower risk and severity of COVID-19. Objective To investigate the association between self-reported prepandemic PA levels and the risk and severity of COVID-19 in older US adults. Design, Setting, and Participants This cohort study combined cohorts from 3 ongoing prospective randomized clinical trials of US adults aged 45 years or older who provided prepandemic self-reports of baseline leisure-time PA and risk factors for COVID-19 outcomes using the most recent questionnaire completed as of December 31, 2019, as the baseline PA assessment. In multiple surveys from May 2020 through May 2022, participants indicated whether they had at least 1 positive COVID-19 test result or were diagnosed with or hospitalized for COVID-19. Exposure Prepandemic PA, categorized into 3 groups by metabolic equivalent hours per week: inactive (0-3.5), insufficiently active (&amp;amp;gt;3.5 to &amp;amp;lt;7.5), and sufficiently active (≥7.5). Main Outcome and Measures Primary outcomes were risk of COVID-19 and hospitalization for COVID-19. Multivariable logistic regression was used to estimate odd ratios (ORs) and 95% CIs for the association of COVID-19 diagnosis and/or hospitalization with each of the 2 upper PA categories vs the lowest PA category. Results The pooled cohort included 61 557 participants (mean [SD] age, 75.7 [6.4] years; 70.7% female), 20.2% of whom were inactive; 11.4%, insufficiently active; and 68.5%, sufficiently active. A total of 5890 confirmed incident cases of COVID-19 were reported through May 2022, including 626 hospitalizations. After controlling for demographics, body mass index, lifestyle factors, comorbidities, and medications used, compared with inactive individuals, those insufficiently active had no significant reduction in infection (OR, 0.96; 95% CI, 0.86-1.06) or hospitalization (OR, 0.98; 95% CI, 0.76-1.28), whereas those sufficiently active had a significant reduction in infection (OR, 0.90; 95% CI, 0.84-0.97) and hospitalization (OR, 0.73; 95% CI, 0.60-0.90). In subgroup analyses, the association between PA and SARS-CoV-2 infection differed by sex, with only sufficiently active women having decreased odds (OR, 0.87; 95% CI, 0.79-0.95; P = .04 for interaction). Conclusions and Relevance In this cohort study of adults aged 45 years or older, those who adhered to PA guidelines before the pandemic had lower odds of developing or being hospitalized for COVID-19. Thus, higher prepandemic PA levels may be associated with reduced odds of SARS-CoV-2 infection and hospitalization for COVID-19.
Development and Validation of a Risk Score Predicting Death Without Transplant in Adult Heart Transplant Candidates
Authors: Kevin C. Zhang, Nikhil Narang, Carine Jasseron, Richard Dorent, Kevin A. Lazenby, Mark N. Belkin, Jonathan Grinstein, Anoop Mayampurath, Matthew M. Churpek, Kiran K. Khush, William F. Parker
Journal: JAMA (2024)

Importance The US heart allocation system prioritizes medically urgent candidates with a high risk of dying without transplant. The current therapy-based 6-status system is susceptible to manipulation and has limited rank ordering ability. Objective To develop and validate a candidate risk score that incorporates current clinical, laboratory, and hemodynamic data. Design, Setting, and Participants A registry-based observational study of adult heart transplant candidates (aged ≥18 years) from the US heart allocation system listed between January 1, 2019, and December 31, 2022, split by center into training (70%) and test (30%) datasets. Adult candidates were listed between January 1, 2019, and December 31, 2022. Main Outcomes and Measures A US candidate risk score (US-CRS) model was developed by adding a predefined set of predictors to the current French Candidate Risk Score (French-CRS) model. Sensitivity analyses were performed, which included intra-aortic balloon pumps (IABP) and percutaneous ventricular assist devices (VAD) in the definition of short-term mechanical circulatory support (MCS) for the US-CRS. Performance of the US-CRS model, French-CRS model, and 6-status model in the test dataset was evaluated by time-dependent area under the receiver operating characteristic curve (AUC) for death without transplant within 6 weeks and overall survival concordance (c-index) with integrated AUC. Results A total of 16 905 adult heart transplant candidates were listed (mean [SD] age, 53 [13] years; 73% male; 58% White); 796 patients (4.7%) died without a transplant. The final US-CRS contained time-varying short-term MCS (ventricular assist–extracorporeal membrane oxygenation or temporary surgical VAD), the log of bilirubin, estimated glomerular filtration rate, the log of B-type natriuretic peptide, albumin, sodium, and durable left ventricular assist device. In the test dataset, the AUC for death within 6 weeks of listing for the US-CRS model was 0.79 (95% CI, 0.75-0.83), for the French-CRS model was 0.72 (95% CI, 0.67-0.76), and 6-status model was 0.68 (95% CI, 0.62-0.73). Overall c-index for the US-CRS model was 0.76 (95% CI, 0.73-0.80), for the French-CRS model was 0.69 (95% CI, 0.65-0.73), and 6-status model was 0.67 (95% CI, 0.63-0.71). Classifying IABP and percutaneous VAD as short-term MCS reduced the effect size by 65%. Conclusions and Relevance In this registry-based study of US heart transplant candidates, a continuous multivariable allocation score outperformed the 6-status system in rank ordering heart transplant candidates by medical urgency and may be useful for the medical urgency component of heart allocation.
Mass Azithromycin Distribution to Prevent Child Mortality in Burkina Faso
Authors: Catherine E. Oldenburg, Mamadou Ouattara, Mamadou Bountogo, Valentin Boudo, Thierry Ouedraogo, Guillaume Compaoré, Clarisse Dah, Alphonse Zakane, Boubacar Coulibaly, Cheik Bagagnan, Huiyu Hu, Kieran S. O’Brien, Fanice Nyatigo, Jeremy D. Keenan, Thuy Doan, Travis C. Porco, Benjamin F. Arnold, Elodie Lebas, Ali Sié, Thomas M. Lietman
Journal: JAMA (2024)

Repeated mass distribution of azithromycin has been shown to reduce childhood mortality by 14% in sub-Saharan Africa. However, the estimated effect varied by location, suggesting that the intervention may not be effective in different geographical areas, time periods, or conditions.
Gefapixant for Chronic Cough
Authors: Richard D. Turner, Jaclyn A. Smith, Surinder S. Birring
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
Pharmacologic Treatment for High BP and Risk of CVD
Authors: Jose-Alberto Palma, Horacio Kaufmann
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
An open label non-inferiority randomized controlled trial evaluated alternate day prednisolone given daily during infections vs. levamisole in frequently relapsing nephrotic syndrome
Authors: Aditi Sinha, Kshetrimayum Ghanapriya Devi, Suprita Kalra, Kalaivani Mani, Pankaj Hari, Arvind Bagga
Journal: Kidney International (2024)
Opportunities for Pharmacogenetic Testing to Guide Dosing of Medications in Youths With Medicaid
Authors: Sonya Tang Girdwood, Matthew Hall, James W. Antoon, Kathryn E. Kyler, Derek J. Williams, Samir S. Shah, Lucas E. Orth, Jennifer Goldman, James A. Feinstein, Laura B. Ramsey
Journal: JAMA Network Open (2024)

There are an increasing number of medications with a high level of evidence for pharmacogenetic-guided dosing (PGx drugs). Knowledge of the prevalence of dispensings of PGx drugs and their associated genes may allow hospitals and clinical laboratories to determine which pharmacogenetic tests to implement. To investigate the prevalence of outpatient dispensings of PGx drugs among Medicaid-insured youths, determine genes most frequently associated with PGx drug dispenses, and describe characteristics of youths who were dispensed at least 1 PGx drug. This serial cross-sectional study includes data from 2011 to 2019 among youths aged 0 to 17 years in the Marketscan Medicaid database. Data were analyzed from August to December 2022. PGx drugs were defined as any medication with level A evidence as determined by the Clinical Pharmacogenetics Implementation Consortium (CPIC). The number of unique youths dispensed each PGx drug in each year was determined. PGx drugs were grouped by their associated genes for which there was CPIC level A evidence to guide dosing, and a dispensing rate (No. of PGx drugs/100 000 youths) was determined for each group for the year 2019. Demographics were compared between youths dispensed at least 1 PGx drug and those not dispensed any PGx drugs. The number of Medicaid-insured youths queried ranged by year from 2 078 683 youths in 2011 to 4 641 494 youths in 2017, including 4 126 349 youths (median [IQR] age, 9 [5-13] years; 2 129 926 males [51.6%]) in 2019. The proportion of Medicaid-insured youths dispensed PGx drugs increased from 289 709 youths (13.9%; 95% CI, 13.8%-14.0%) in 2011 to 740 072 youths (17.9%; 95% CI, 17.9%-18.0%) in 2019. Genes associated with the most frequently dispensed medications were CYP2C9, CYP2D6, and CYP2C19 (9197.0 drugs [95% CI, 9167.7-9226.3 drugs], 8731.5 drugs [95% CI, 8702.5-8759.5 drugs], and 3426.8 drugs [95% CI, 3408.1-3443.9 drugs] per 100 000 youths, respectively). There was a higher percentage of youths with at least 1 chronic medical condition among youths dispensed at least 1 PGx drug (510 445 youths [69.0%; 95% CI, 68.8%-69.1%]) than among 3 386 277 youths dispensed no PGx drug (1 381 544 youths [40.8%; 95% CI, 40.7%-40.9%) (P < .001) in 2019. In this study, there was an increasing prevalence of dispensings for PGx drugs. This finding suggests that pharmacogenetic testing of specific drug-gene pairs should be considered for frequently prescribed PGx drugs and their implicated genes.