tbuckley/cabot-search huggingface dataset:
Telemedicine vs Telephone Consultations and Medication Prescribing Errors Among Referring Physicians
Authors: James P. Marcin, Monica K. Lieng, Jamie Mouzoon, Hadley S. Sauers-Ford, Daniel Tancredi, Annie Cabri, Vaibhavi A. Pandya, Alex S. Park, Nathan Kuppermann
Journal: JAMA Network Open (2024)

Importance Critically ill children presenting to emergency departments (EDs) in non–children’s hospitals are at high risk for experiencing medical errors, including medication errors. Video telemedicine consultations with pediatric specialists have the potential to reduce the risk of medication errors beyond the current standard of care, telephone consultations. Objective To compare the rates of ED physician-related medication errors among critically ill children randomized to receive either video telemedicine or telephone consultations. Design, Setting, and Participants This cluster randomized, unbalanced crossover trial was conducted at 15 community EDs in northern California between September 2014 and March 2018. Analyses were conducted from May 2022 to January 2023. Participants included acutely ill children younger than 15 years presenting to a participating ED. Interventions Participating EDs were randomized to use video telemedicine or telephone for consultations with pediatric critical care physicians according to 1 of 4 unbalanced (3 telemedicine to 1 telephone) crossover treatment assignment sequences. Main Outcomes and Measures Pharmacists reviewed medical records to document physician-related medication errors using a previously validated instrument. Multilevel logistic regression analyses were performed to create models with the medication order as the unit of analysis and adjusting for age, the log-transformed Revised Pediatric Emergency Assessment Tool score, and hospital study period. Results A total of 696 patient encounters were included in the trial (mean [SD] age, 4.2 [4.6] years; median [IQR] age, 2.1 [0.5-2.1] years; 304 female [43.7%]), with 537 patient encounters (77.2%) assigned to video telemedicine and 159 patient encounters (22.8%) assigned to telephone. At least 1 physician-related medication error occurred for 87 patients (12.5%), including 20 of 159 patients (12.6%) in the telephone cohort and 67 of 537 patients (12.5%) in the telemedicine cohort. Of the 2414 medication orders, errors occurred in 124 cases (5.1%), including 26 of 513 orders (5.1%) in the telephone cohort and 98 of 1901 orders (5.2%) in the telemedicine cohort. In the multivariable analysis, the adjusted odds ratio of experiencing a medication error among those assigned to telemedicine was 0.86 (95% CI, 0.49-1.52; P = .61). Conclusions and Relevance This cluster randomized crossover trial found no statistically significant differences in physician-related medication errors between critically ill children assigned to receive telephone consultations vs video telemedicine consultations. Trial Registration ClinicalTrials.gov Identifier: NCT02877810
GLP-1 Agonists for Obesity—A New Recipe for Success?
Authors: Dariush Mozaffarian
Journal: JAMA (2024)

This Viewpoint discusses the drawbacks of using glucagon-like peptide 1 (GLP-1) agonists to treat obesity and presents an alternative approach of initial, staged GLP-1 agonist treatment supported by long-term lifestyle programming, including medically appropriate groceries or meals (“Food Is Medicine”), to address the cost, health, and equity burdens of obesity.
Disparities in Patient Portal Use Among Adults With Chronic Conditions
Authors: Esther Yoon, Scott Hur, Lauren Opsasnick, Wei Huang, Stephanie Batio, Laura M. Curtis, Julia Yoshinso Benavente, Marquita W. Lewis-Thames, David M. Liebovitz, Michael S. Wolf, Marina Serper
Journal: JAMA Network Open (2024)

Importance Disparities in patient access and use of health care portals have been documented. Limited research has evaluated disparities in portal use during and after the COVID-19 pandemic. Objective To assess prevalence of health care portal use before, during, and after the most restrictive phase of the pandemic (2019-2022) among the COVID-19 &amp;amp;amp; Chronic Conditions (C3) cohort and to investigate any disparities in use by sociodemographic factors. Design, Setting, and Participants This cohort study uses data from the C3 study, an ongoing, longitudinal, telephone-based survey of participants with multiple chronic conditions. Participants were middle aged and older-adult primary care patients who had an active portal account, recruited from a single academic medical center in Chicago, Illinois, between 2019 and 2022. Data were analyzed between March and June 2022. Main Outcomes and Measures Outcomes of portal use (ie, number of days of portal login by year) were recorded for all study participants by the electronic data warehouse. All parent studies had uniform sociodemographic data and measures of social support, self-efficacy, health literacy, and health activation. Results Of 536 participants (mean [SD] age, 66.7 [12.0] years; 336 [62.7%] female), 44 (8.2%) were Hispanic or Latinx, 142 (26.5%) were non-Hispanic Black, 322 (60.1%) were non-Hispanic White, and 20 individuals (3.7%) identified as other race, including Asian, Native American or Alaskan Native, and self-reported other race. In multivariable analyses, portal login activity was higher during the 3 years of the COVID-19 pandemic compared with the 2019 baseline. Higher portal login activity was associated with adequate health literacy (incidence rate ratio [IRR], 1.51; 95% CI, 1.18-1.94) and multimorbidity (IRR, 1.38; 95% CI, 1.17-1.64). Lower portal activity was associated with older age (≥70 years: IRR, 0.69; 95% CI, 0.55-0.85) and female sex (IRR, 0.77; 95% CI, 0.66-0.91). Compared with non-Hispanic White patients, lower portal activity was observed among Hispanic or Latinx patients (IRR, 0.66; 95% CI, 0.49-0.89), non-Hispanic Black patients (IRR, 0.68; 95% CI, 0.56-0.83), and patients who identified as other race (IRR, 0.42; 95% CI, 0.28-0.64). Conclusions and Relevance This cohort study using data from the C3 study identified changes in portal use over time and highlighted populations that had lower access to health information. The COVID-19 pandemic was associated with an increase in portal use. Sociodemographic disparities by sex and age were reduced, although disparities by health literacy widened. A brief validated health literacy measure may serve as a useful digital literacy screening tool to identify patients who need further support.
Progression-Free Survival Analysis With a Graphical Estimand Approach in the Phase 2 SAMCO-PRODIGE 54 Trial
Authors: Yi-Cheng Tai, Weijing Wang, Martin T. Wells
Journal: JAMA Oncology (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 Oncology HomeNew OnlineCurrent IssueFor Authors Podcast 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 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 Oncology journal
Increasing the Uptake of Cancer Risk Management Strategies for Women With <i>BRCA1/2</i> Sequence Variations
Authors: Meghna S. Trivedi, Katrina A. Armstrong
Journal: JAMA Oncology (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 Oncology HomeNew OnlineCurrent IssueFor Authors Podcast 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 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 Oncology journal
Errors in Service Counts in Results and Figure
Journal: JAMA Network Open (2024)

titled "Changes in the Clinical Workforce Providing Contraception and Abortion Care in the US, 2019-2021," 1 published November 1, 2022, services were inadvertently overcounted in Results and the Figure by including both the general procedure/visit code and the device/medication code for intrauterine device and medication abortion.The article has been corrected.
Progress Toward Rubella and Congenital Rubella Syndrome Elimination — Worldwide, 2012–2022
Authors: Alan C. Ou, Laura A. Zimmerman, James P. Alexander, Natasha S. Crowcroft, Patrick M. O’Connor, Jennifer K. Knapp
Journal: MMWR Morbidity and Mortality Weekly Report (2024)

Rubella virus is a leading cause of vaccine-preventable birth defects.Infection during pregnancy can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects, including cataracts, deafness, heart defects, and developmental delay, known as congenital rubella syndrome (CRS).A single dose of rubella-containing vaccine can provide lifelong protection against rubella.The Global Vaccine Action Plan 2011-2020 included a target to achieve elimination of rubella in at least five of the six World Health Organization (WHO) regions by 2020, and rubella elimination is a critical goal of the Immunization Agenda 2030.This report updates a previous report and describes progress toward rubella and CRS elimination during 2012 -2022 .During 2012 -2022, among 194 , among 194 WHO countries, the number that included rubella-containing vaccine (RCV) in their immunization schedules increased from 132 (68%) to 175 (90%) and the percentage of the world's infants vaccinated against rubella increased from 40% to 68%.Reported rubella cases declined 81%, from 93,816 in 2012 to 17,407 in 2022.Verification of rubella elimination was achieved in 98 (51%) of 194 countries by 2022, an increase from 84 (43%) countries in 2019.Despite significant progress in the introduction of RCV into routine immunization programs worldwide, approximately 25 million infants annually still do not have access to RCV.Nevertheless, even in complex settings, the increasing number of countries that have achieved and sustained rubella elimination demonstrates progress toward global rubella elimination.
Formation of Different Polyploids Through Disrupting Meiotic Crossover Frequencies Based on <i>cntd1</i> Knockout in Zebrafish
Authors: Yuan Ou, Huilin Li, Juan Li, Xiangyan Dai, Jiaxin He, Shi Wang, Qingfeng Liu, Conghui Yang, Jing Wang, Rurong Zhao, Zhan Yin, Yuqin Shu, Shaojun Liu
Journal: Molecular Biology and Evolution (2024)

Abstract Polyploidy, a significant catalyst for speciation and evolutionary processes in both plant and animal kingdoms, has been recognized for a long time. However, the exact molecular mechanism that leads to polyploid formation, especially in vertebrates, is not fully understood. Our study aimed to elucidate this phenomenon using the zebrafish model. We successfully achieved an effective knockout of the cyclin N-terminal domain containing 1 (cntd1) using CRISPR/Cas9 technology. This resulted in impaired formation of meiotic crossovers, leading to cell-cycle arrest during meiotic metaphase and triggering apoptosis of spermatocytes in the testes. Despite these defects, the mutant (cntd1−/−) males were still able to produce a limited amount of sperm with normal ploidy and function. Interestingly, in the mutant females, it was the ploidy not the capacity of egg production that was altered. This resulted in the production of haploid, aneuploid, and unreduced gametes. This alteration enabled us to successfully obtain triploid and tetraploid zebrafish from cntd1−/− and cntd1−/−/− females, respectively. Furthermore, the tetraploid-heterozygous zebrafish produced reduced-diploid gametes and yielded all-triploid or all-tetraploid offspring when crossed with wild-type (WT) or tetraploid zebrafish, respectively. Collectively, our findings provide direct evidence supporting the crucial role of meiotic crossover defects in the process of polyploidization. This is particularly evident in the generation of unreduced eggs in fish and, potentially, other vertebrate species.
Spatial Mapping of Hematopoietic Clones in Human Bone Marrow
Authors: Andrew L. Young, Hannah C. Davis, Maggie J. Cox, Tyler M. Parsons, Samantha C. Burkart, Diane E. Bender, Lulu Sun, Stephen T. Oh, Grant A. Challen
Journal: Blood Cancer Discovery (2024)

Abstract Clonal hematopoiesis (CH) is the expansion of somatically mutated cells in the hematopoietic compartment of individuals without hematopoietic dysfunction. Large CH clones (i.e., &amp;gt;2% variant allele fraction) predispose to hematologic malignancy, but CH is detected at lower levels in nearly all middle-aged individuals. Prior work has extensively characterized CH in peripheral blood, but the spatial distribution of hematopoietic clones in human bone marrow is largely undescribed. To understand CH at this level, we developed a method for spatially aware somatic mutation profiling and characterized the bone marrow of a patient with polycythemia vera. We identified the complex clonal distribution of somatic mutations in the hematopoietic compartment, the restriction of somatic mutations to specific subpopulations of hematopoietic cells, and spatial constraints of these clones in the bone marrow. This proof of principle paves the way to answering fundamental questions regarding CH spatial organization and factors driving CH expansion and malignant transformation in the bone marrow. Significance: CH occurs commonly in humans and can predispose to hematologic malignancy. Although well characterized in blood, it is poorly understood how clones are spatially distributed in the bone marrow. To answer this, we developed methods for spatially aware somatic mutation profiling to describe clonal heterogeneity in human bone marrow. See related commentary by Austin and Aifantis, p. 139.
<i>QuickStats:</i> Percentage* of Children and Adolescents Aged 5–17 Years Who Had Chronic School Absenteeism Due to Illness, Injury, or Disability During the Past 12 Months,† by Age Group and Year — National Health Interview Survey,§ United States, 2019 and 2022
Journal: MMWR Morbidity and Mortality Weekly Report (2024)
Exposure-response associations between chronic exposure to fine particulate matter and risks of hospital admission for major cardiovascular diseases: population based cohort study
Authors: Yaguang Wei, Yijing Feng, Mahdieh Danesh Yazdi, Kanhua Yin, Edgar Castro, Alexandra Shtein, Xinye Qiu, Adjani A Peralta, Brent A Coull, Francesca Dominici, Joel D Schwartz
Journal: BMJ (2024)

Abstract Objective To estimate exposure-response associations between chronic exposure to fine particulate matter (PM 2.5 ) and risks of the first hospital admission for major cardiovascular disease (CVD) subtypes. Design Population based cohort study. Setting Contiguous US. Participants 59 761 494 Medicare fee-for-service beneficiaries aged ≥65 years during 2000-16. Calibrated PM 2.5 predictions were linked to each participant’s residential zip code as proxy exposure measurements. Main outcome measures Risk of the first hospital admission during follow-up for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, valvular heart disease, thoracic and abdominal aortic aneurysms, or a composite of these CVD subtypes. A causal framework robust against confounding bias and bias arising from errors in exposure measurements was developed for exposure-response estimations. Results Three year average PM 2.5 exposure was associated with increased relative risks of first hospital admissions for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, and thoracic and abdominal aortic aneurysms. For composite CVD, the exposure-response curve showed monotonically increased risk associated with PM 2.5 : compared with exposures ≤5 µg/m 3 (the World Health Organization air quality guideline), the relative risk at exposures between 9 and 10 µg/m 3 , which encompassed the US national average of 9.7 µg/m 3 during the study period, was 1.29 (95% confidence interval 1.28 to 1.30). On an absolute scale, the risk of hospital admission for composite CVD increased from 2.59% with exposures ≤5 µg/m 3 to 3.35% at exposures between 9 and 10 µg/m 3 . The effects persisted for at least three years after exposure to PM 2.5 . Age, education, accessibility to healthcare, and neighborhood deprivation level appeared to modify susceptibility to PM 2.5 . Conclusions The findings of this study suggest that no safe threshold exists for the chronic effect of PM 2.5 on overall cardiovascular health. Substantial benefits could be attained through adherence to the WHO air quality guideline.
Small molecules that disrupt RAD54-BLM interaction hamper tumor proliferation in colon cancer chemoresistance models
Authors: Ekjot Kaur, Ritu Agrawal, Rimpy Arun, Vinoth Madhavan, Vivek Srivastava, Dilip Kumar, Pragyan Parimita Rath, Nitin Kumar, Sreekanth Vedagopuram, Nishant Pandey, Swati Priya, Patrick Legembre, Samudrala Gourinath, Avinash Bajaj, Sagar Sengupta
Journal: Journal of Clinical Investigation (2024)

RAD54 and BLM helicase play pivotal roles during homologous recombination repair (HRR) ensuring genome maintenance. BLM amino acids (181-212) interacts with RAD54 and enhances its chromatin remodelling activity. Functionally, this interaction heightens HRR, leading to a decrease in residual DNA damage in colon cancer cells. This contributes to chemoresistance in colon cancer cells against cisplatin, camptothecin and oxaliplatin, eventually promoting tumorigenesis in preclinical colon cancer mouse models. ChIP-seq analysis and validation revealed increased BLM/RAD54 co-recruitment on MRP2 promoter in camptothecin resistant colon cancer cells, leading to BLM-dependent enhancement of RAD54-mediated chromatin remodelling. We screened Prestwick small molecule library intending to revert camptothecin and oxaliplatin induced chemoresistance by disrupting BLM-RAD54 interaction. Three FDA/EMA approved candidates were identified which could disrupt this interaction. These drugs bind to RAD54, alter its conformation and abrogate BLM-RAD54 dependent chromatin remodeling on G5E4 and MRP2 arrays. Notably, the small molecules also reduced HRR repair efficiency in resistant lines, diminished anchorage independent growth, hampered the proliferation of tumors generated using camptothecin and oxaliplatin resistant colon cancer cells in both xenograft and syngeneic mouse models in BLM dependent manner. Hence the three identified small molecules can serve as possible viable candidates for adjunct therapy in colon cancer treatment.
Granulocytic myeloid-derived suppressor cell activity during biofilm infection is regulated by a glycolysis/HIF1a axis
Authors: Christopher M. Horn, Prabhakar Arumugam, Zachary Van Roy, Cortney E. Heim, Rachel W. Fallet, Blake P. Bertrand, Dhananjay Shinde, Vinai C. Thomas, Svetlana G. Romanova, Tatiana K. Bronich, Curtis W. Hartman, Kevin L. Garvin, Tammy Kielian
Journal: Journal of Clinical Investigation (2024)

Staphylococcus aureus is a leading cause of biofilm-associated prosthetic joint infection (PJI). A primary contributor to infection chronicity is an expansion of granulocytic myeloid-derived suppressor cells (G-MDSCs) that are critical for orchestrating the anti-inflammatory biofilm milieu. Single-cell sequencing and bioinformatic metabolic algorithms were used to explore the link between G-MDSC metabolism and S. aureus PJI outcome. Glycolysis and the hypoxia response through hypoxia-inducible factor-1 alpha (HIF-1a) were significantly enriched in G-MDSCs. Interfering with both pathways in vivo, using a 2-deoxyglucose nanopreparation and granulocyte-targeted HIF-1a conditional knockout mice, respectively, attenuated G-MDSC-mediated immunosuppression and reduced bacterial burden in a mouse model of S. aureus PJI. In addition, scRNA-seq analysis of granulocytes from PJI patients also showed an enrichment in glycolysis and hypoxia response genes. These findings support the importance of a glycolysis/HIF-1a axis in promoting G-MDSC anti-inflammatory activity and biofilm persistence during PJI.
Perinatal Outcomes in Early and Late Gestational Diabetes Mellitus After Treatment From 24-28 Weeks’ Gestation: A TOBOGM Secondary Analysis
Authors: David Simmons, Jincy Immanuel, William M. Hague, Helena Teede, Christopher J. Nolan, Michael J. Peek, Jeff R. Flack, Mark McLean, Vincent Wong, Emily J. Hibbert, Alexandra Kautzky-Willer, Jürgen Harreiter, Helena Backman, Emily Gianatti, Arianne Sweeting, Viswanathan Mohan, N. Wah Cheung, David Simmons, N. Wah Cheung, Jincy Immanuel, William M. Hague, Helena Teede, Christopher J. Nolan, Michael J. Peek, Jeff R. Flack, Mark McLean, Vincent Wong, Emily Hibbert, Emily Gianatti, Arianne Sweeting, Suzette Coat, Raiyomand Dalal, Georgia Soldatos, Suja Padmanabhan, Rohit Rajagopal, Victoria Rudland, Jürgen Harreiter, Alexandra Kautzky-Willer, Herbert Kiss, Helena Backman, Erik Schwarcz, Glynis Ross, Viswanathan Mohan, Ranjit Mohan Anjana, Uma Ram
Journal: Diabetes Care (2024)

In most gestational diabetes mellitus (GDM) studies, cohorts have included women combined into study populations without regard to whether hyperglycemia was present earlier in pregnancy. In this study we sought to compare perinatal outcomes between groups: women with early GDM (EGDM group: diagnosis before 20 weeks' gestation but no treatment until 24-28 weeks' gestation if GDM still present), with late GDM (LGDM group: present only at 24-28 weeks' gestation), and with normoglycemia at 24-28 weeks' gestation (control participants).