tbuckley/cabot-search huggingface dataset:
Use of Hematopoietic Cell Transplant for Hematologic Cancers by Race, Ethnicity, and Age
Authors: Theresa Hahn, Megan M. Herr, Ruta Brazauskas, Jinalben Patel, Sikander Ailawadhi, Wael Saber, Nandita Khera
Journal: JAMA Network Open (2024)

Importance Utilization of hematopoietic cell transplantation (HCT) for hematologic cancers previously demonstrated race, ethnicity, and age-based disparities. Objective To evaluate utilization over time by race, ethnicity, and age to determine if disparities persist in light of recent significant increases in HCT volume. Design, Setting, and Participants This US population-based retrospective cohort study includes patients who received transplants from January 2009 to December 2018. Data collection and cleaning occurred from February 2019 to November 2021, and data analysis occurred from January 2022 to October 2023. Method 1 restricted the analysis to Surveillance, Epidemiology and End Results (SEER) reporting areas for cases and transplants. Method 2 applied SEER age-, race-, and ethnicity-specific incidence rates to corresponding US census population and included all transplants reported to the Center for International Blood and Marrow Transplant Research. Race and ethnicity groups were hierarchically defined as Hispanic (any race), non-Hispanic White, non-Hispanic Black, and non-Hispanic Other (Asian and American Indian). Exposure Receipt of HCT. Main Outcomes and Measures Utilization rate of autologous or allogeneic HCT for patients with hematologic cancers by age, race, and ethnicity. Results From 2009 to 2018, 136 280 HCTs were analyzed for 6 hematologic cancers comprising 16.7% pediatric/adolescent/young adults (0-39 years), 83.3% adults (40-84 years), 58% male, 10.3% Hispanic, 11.4% non-Hispanic Black, 3.8% non-Hispanic Other, and 74.5% non-Hispanic White patients, with 49 385 allogeneic and 86 895 autologous HCTs performed. HCT utilization increased over time for all disease, age, race, and ethnic groups. From 2017 to 2018, adult (40-84 years) allogeneic transplant utilization for acute myeloid leukemia and myelodysplastic syndrome (MDS) was similar for Hispanic and non-Hispanic White or Other patients but was lower for non-Hispanic Black patients (acute myeloid leukemia: 19% vs 13%; MDS: 9%-10% vs 5%). Similarly, autologous transplant utilization for lymphoma was similar for all race and ethnicity groups; however, autologous transplant for multiple myeloma was highest for non-Hispanic White patients and lower for all other groups (31% vs 26%-27%). In patients aged 0 to 39 years, utilization of allogeneic transplant for acute lymphoblastic leukemia was highest in Hispanic patients, followed by non-Hispanic White, Black, and Other races (acute lymphoblastic leukemia: 19%, 18%, 17%, and 16%, respectively). Conclusions and Relevance In this cohort study of autologous and allogeneic transplant utilization for hematologic cancers, disparities persisted for non-Hispanic Black patients. Hispanic, non-Hispanic Other, and younger age groups had increased utilization over time that was on par with non-Hispanic White patients in the most recent cohort.
The Patent Trial and Appeals Board
Authors: Janet Freilich, Aaron S. Kesselheim
Journal: JAMA (2024)

This Viewpoint summarizes the role of the Patent Trial and Appeal Board (PTAB) in reforming the drug patent process to avoid erroneously granted patents; highlights how other reform efforts, such as the PREVAIL Act, actually weaken the PTAB; and suggests changes to strengthen the PTAB and promote generic availability and reduced health care costs.
Inherited Basaloid Neoplasms Associated With <i>SUFU</i> Pathogenic Variants
Authors: James J. Abbott, Angela J. Jiang, Rama Godse, Sarah Ahmed, Stephen C. Senft, Melissa A. Wilson, Justine V. Cohen, Tara C. Mitchell, Temitayo A. Ogunleye, H. William Higgins, Thuzar M. Shin, Christopher J. Miller, Jacquelyn J. Roth, Salvatore F. Priore, Leslie Castelo-Soccio, Rosalie Elenitsas, John T. Seykora, Katherine L. Nathanson, Emily Y. Chu
Journal: JAMA Dermatology (2024)

Importance Germline SUFU pathogenic variants (PVs) have previously been associated with basal cell nevus syndrome (BCNS) and multiple infundibulocystic basal cell carcinoma syndrome; however, a broader spectrum of cutaneous findings in patients with SUFU PVs has not been well delineated. Objective To define the clinical and histopathologic spectrum of cutaneous findings in patients with germline SUFU PVs. Design, Setting, and Participants This case series was conducted in multiple US academic dermatology, medical genetics, and medical oncology clinics between July 2014 and July 2022. The study included patients with confirmed germline SUFU PVs who were evaluated by a dermatologist. The analysis took place from March to September 2023. Main Outcomes and Measures Histopathologic evaluation of skin biopsies with or without immunohistochemical staining, and targeted next-generation sequencing (NGS) on tumor specimens. Results All 5 patients were women. The mean (range) age at presentation was 50.2 (31-68) years, with skin manifestations initially appearing in the fourth to sixth decades of life. None had keratocystic odontogenic tumors. A total of 29 skin pathology specimens from the 5 patients were reviewed; of these, 3 (10.3%) were diagnosed as basaloid follicular hamartomas (BFHs), 10 (34.5%) classified as infundibulocystic basal cell carcinomas (iBCCs), 6 (20.7%) classified as nodular basal cell carcinomas (nBCCs), and 1 (3.4%) as infiltrative basal cell carcinoma (BCC). Targeted NGS studies on tumor specimens suggest that an increased number of UV-signature variants is associated with basal cell carcinomas compared with more indolent basaloid follicular hamartomas. Conclusions and Relevance Patients with germline SUFU PVs may present with multiple indolent basaloid neoplasms in addition to conventional basal cell carcinomas, typically appearing in the fourth to sixth decades of life. Although there are overlapping clinical manifestations, these findings help to differentiate the clinical syndrome associated with SUFU PVs from PTCH1 BCNS. Awareness of the clinicopathologic spectrum of SUFU -associated basaloid neoplasms is important for dermatologists and dermatopathologists because many (although not all) of these lesions are indolent and do not require aggressive surgical treatment. Importantly, because SUFU lies downstream of the protein smoothened, vismodegib and other smoothened inhibitors are unlikely to be effective therapies in this subset of patients.
Treatment of Pembrolizumab-Induced Mucocutaneous Lichen Planus With Metronidazole
Authors: Sierra Parkinson, Sabah Osmani, Paul B. Googe, Donna A. Culton
Journal: JAMA Dermatology (2024)

This case report describes a man in his 50s with a diffuse pruritic rash after initiating treatment with pembrolizumab and enfortumab vedotin for metastatic urothelial carcinoma.
An Update on the Survival of the First 50 Face Transplants Worldwide
Authors: Pauliina Homsy, Lioba Huelsboemer, Juan P. Barret, Phillip Blondeel, Daniel E. Borsuk, Daniel Bula, Bruce Gelb, Pedro Infante-Cossio, Laurent Lantieri, Samir Mardini, Emmanuel Morelon, Serdar Nasir, Francis Papay, Palmina Petruzzo, Eduardo Rodriguez, Özlenen Özkan, Selahattin Özmen, Bohdan Pomahac, Patrik Lassus
Journal: JAMA Surgery (2024)

Importance Since 2005, a total of 50 face transplants have been reported from 18 centers in 11 countries. The overall survival of the grafts has not yet been established. Objective To assess the survival of the face transplant grafts and evaluate factors potentially influencing it. Design, Setting, and Participants Data on all the transplants included in this multicenter cohort study were collected at participating transplant centers for updated nonpublished data, supplemented with literature review for nonparticipating centers. Data from 2005 until September 2023, were included. Data were analyzed from November 11, 2005, through September 18, 2023. Patients included the first 50 patients in the world to have received a face transplant. Exposure Face transplant graft. Main Outcomes and Measures The primary outcome was the overall survival of the face transplant graft, defined as either transplant loss or patient death. The secondary outcome was the number of acute rejection episodes per year. Results The 50 transplants were performed on 39 men (81%) and 9 women (19%) with a median age of 35 (range, 19-68) years at the time of the transplant. The median follow-up time was 8.9 (range, 0.2-16.7) years. During the follow-up, 6 transplants were lost with 2 patients retransplanted. There were 10 patients who died, 2 of whom had lost a transplant. The 5- and 10-year survival of the transplants was 85% (SD, 5%) and 74% (SD, 7%), respectively. The sequential number of the transplant in the world was a significant predictor of survival (hazard ratio, 95; 95% CI, 90-100; P &amp;amp;lt; 05). The median number of acute rejection episodes per year was 1.2 (range, 0-5.3) for the transplants that were lost and 0.7 (range, 0-4.6) for the transplants that survived. No correlation with patient and transplant variables was detected for either the transplant survival or the number of rejection episodes. Conclusions and Relevance In this study, the overall survival of the face transplants is encouraging. These data suggest that the acceptable long-term survival of face transplants makes them a reconstructive option for extensive facial defects.
Characteristics and Trends of Prehospital Encounters for Opioid Overdoses Among US Youth, 2018-2022
Authors: Jamie K. Lim, Sriram Ramgopal, Jennifer A. Hoffmann, Doug Lorenz, Michael S. Toce
Journal: JAMA (2024)

This cross-sectional study analyzes characteristics of prehospital encounters for youth opioid overdoses and trends before and during the COVID-19 pandemic.
Year-Long Cannabis Use for Medical Symptoms and Brain Activation During Cognitive Processes
Authors: Debbie C. L. Burdinski, Alisha Kodibagkar, Kevin Potter, Randi M. Schuster, A. Eden Evins, Satrajit S. Ghosh, Jodi M. Gilman
Journal: JAMA Network Open (2024)

Importance Cannabis is increasingly being used to treat medical symptoms, but the effects on brain function in those using cannabis for these symptoms are not known. Objective To test whether 1 year of cannabis use for medical symptoms after obtaining a medical cannabis card was associated with increased brain activation during working memory, reward, and inhibitory control tasks, areas of cognition affected by cannabis. Design, Setting, and Participants This cohort study was conducted from July 2017 to July 2020 among participants from the greater Boston area who were recruited as part of a clinical trial of individuals seeking medical cannabis cards for anxiety, depression, pain, or insomnia symptoms. Participants were aged between 18 and 65 years. Exclusion criteria were daily cannabis use and cannabis use disorder at baseline. Data analysis was conducted from August 2021 to April 2024. Main Outcomes and Measures Outcomes were whole brain functional activation during tasks involving working memory, reward, and inhibitory control at baseline and after 1 year of medical cannabis card ownership. Results Imaging was collected from participants before and 1 year after obtaining medical cannabis cards, with 57 participants at baseline (38 female [66.7%]; 6 [10.5%] Black and 45 [78.9%] White participants; 1 [1.8%] Hispanic participant; median [IQR] age, 34.0 [24.0-51.0] years) and 54 participants at 1 year (37 female [68.5%]; 4 [7.4%] Black and 48 [88.9%] White participants; 1 [1.9%] Hispanic participant, median [IQR] age, 36.5 [25.0-51.0] years). Imaging was also collected in 32 healthy control participants at baseline (22 female [68.8%]; 2 [6.2%] Black and 27 [84.4%] White participants; 3 [9.4%] Hispanic participants; median [IQR] age, 33.0 [24.8-38.2] years). In all groups and at both time points, functional imaging revealed canonical activations of the probed cognitive processes. No statistically significant difference in brain activation between the 2 time points (baseline and 1 year) in those with medical cannabis cards and no associations between changes in cannabis use frequency and brain activation after 1 year were found. Conclusions and Relevance In this cohort study of adults obtaining medical cannabis cards for medical symptoms, no significant association between brain activation in the areas of cognition of working memory, reward, and inhibitory control and 1 year of cannabis use was observed. The results warrant further studies that probe the association of cannabis at higher doses, with greater frequency, in younger age groups, and with larger, more diverse cohorts.
The Precision Resuscitation With Crystalloids in Sepsis (PRECISE) Trial
Authors: Sivasubramanium V. Bhavani, Andre Holder, Danielle Miltz, Rishikesan Kamaleswaran, Sharaf Khan, Kirk Easley, David J. Murphy, Nicole Franks, David W. Wright, Colleen Kraft, Matthew W. Semler, Matthew M. Churpek, Greg S. Martin, Craig M. Coopersmith
Journal: JAMA Network Open (2024)

Importance Intravenous fluids are an essential part of treatment in sepsis, but there remains clinical equipoise on which type of crystalloid fluids to use in sepsis. A previously reported sepsis subphenotype (ie, group D) has demonstrated a substantial mortality benefit from balanced crystalloids compared with normal saline. Objective To test the hypothesis that targeting balanced crystalloids to patients with group D sepsis through an electronic health record (EHR) alert will reduce 30-day inpatient mortality. Design, Setting, and Participants The Precision Resuscitation With Crystalloids in Sepsis (PRECISE) trial is a parallel-group, multihospital, single-blind, pragmatic randomized clinical trial to be conducted at 6 hospitals in the Emory Healthcare system. Patients with suspicion of group D infection in whom a clinician initiates an order for normal saline in the emergency department (ED) or intensive care unit (ICU) will be randomized to usual care and intervention arms. Intervention An EHR alert that appears in the ED and ICUs to nudge clinicians to use balanced crystalloids instead of normal saline. Main Outcomes and Measures The primary outcome is 30-day inpatient mortality. Secondary outcomes are ICU admission, in-hospital mortality, receipt of vasoactive drugs, receipt of new kidney replacement therapy, and receipt of mechanical ventilation (vasoactive drugs, kidney replacement therapy, and mechanical ventilation are counted if they occur after randomization and within the 30-day study period). Intention-to-treat analysis will be conducted. Discussion The PRECISE trial may be one of the first precision medicine trials of crystalloid fluids in sepsis. Using routine vital signs (temperature, heart rate, respiratory rate, and blood pressure), available even in low-resource settings, a validated machine learning algorithm will prospectively identify and enroll patients with group D sepsis who may have a substantial mortality reduction from used of balanced crystalloids compared with normal saline. Results On finalizing participant enrollment and analyzing the data, the study’s findings will be shared with the public through publication in a peer-reviewed journal. Conclusions With use of a validated machine learning algorithm, precision resuscitation in sepsis could fundamentally redefine international standards for intravenous fluid resuscitation. Trial Registration ClinicalTrials.gov Identifier: NCT06253585
Flavonoid-Rich Foods, Dementia Risk, and Interactions With Genetic Risk, Hypertension, and Depression
Authors: Amy Jennings, Alysha S. Thompson, Anna Tresserra-Rimbau, Joshua K. O’Neill, Claire Hill, Nicola P. Bondonno, Tilman Kühn, Aedín Cassidy
Journal: JAMA Network Open (2024)

Importance A composite score of flavonoid-rich foods (flavodiet) may provide a clear public health message regarding the range of foods with the potential to lower dementia risk. Objective To examine associations of flavodiet score and intakes of flavonoid subclasses with dementia risk according to genetic risk and presence of depression and hypertension. Design, Setting, and Participants This prospective, population-based cohort study included dietary data from adults aged 40 to 70 years in the UK Biobank, recruited between 2006 and 2010, with a mean (SD) follow-up of 9.2 (1.5) years. The data analyses were conducted from September 1 to 30, 2023. Exposure Flavodiet score adherence and intake of flavonoid subclasses derived from 24-hour computerized dietary assessments. Main Outcome and Measures The main outcome was incident all-cause dementia and interactions with genetic risk, hypertension, and depressive symptoms using multivariable Cox proportional hazards regression models. Results The sample included 121 986 participants (mean [SD] age, 56.1 [7.8] years; 55.6% female; 882 with incident dementia). Comparing the highest with lowest quintile of flavodiet score, consuming 6 additional servings per day of flavonoid-rich foods was associated with a lower risk of dementia among all participants (adjusted hazard ratio [AHR], 0.72; 95% CI, 0.57-0.89), those at high genetic risk (AHR, 0.57; 95% CI, 0.42-0.78), and those with depressive symptoms (AHR, 0.52; 95% CI, 0.33-0.81) after multivariable adjustment. The greatest risk reduction was observed in participants consuming at least 2 of the following per day: 5 servings of tea, 1 serving of red wine, and 0.5 servings of berries, compared with those who did not achieve any of these intakes (AHR, 0.62; 95% CI, 0.46-0.84). Higher intakes of flavonoid subclasses, including anthocyanins, flavan-3-ols, flavonols, and flavones, of which tea, red wine, and berries are the main contributors, supported these findings, showing inverse associations with dementia risk. Conclusions and Relevance In this cohort study, high adherence to a flavonoid-rich diet score was associated with a lower risk of dementia, with reductions more pronounced in individuals with a high genetic risk, hypertension, and depressive symptoms. These findings suggest that simple dietary changes of increasing intakes of commonly consumed flavonoid-rich foods and drinks may lower dementia risk.
Social Determinants of Health and Insurance Claim Denials for Preventive Care
Authors: Alex Hoagland, Olivia Yu, Michal Horný
Journal: JAMA Network Open (2024)

Importance The Patient Protection and Affordable Care Act (ACA) eliminated out-of-pocket cost-sharing for recommended preventive care for most privately insured patients. However, patients seeking preventive care continue to face cost-sharing and administrative hurdles, including claim denials, which may exacerbate inequitable access to care. Objective To determine whether patient demographics and social determinants of health are associated with denials of insurance claims for preventive care. Design, Setting, and Participants This cohort study of patients insured through their employers or the ACA Marketplaces used claims and remittance data from Symphony Health Solutions’ Integrated DataVerse from 2017 to 2020; analysis was completed from January to July 2024. Exposure Seeking preventive care. Main Outcomes and Measures The primary outcome was the frequency of insurer denials for preventive services across 5 categories: specific benefit denials, billing errors, coverage lapses, inadequate coverage, and other. Subgroup analysis was performed across patient household income, education, and race and ethnicity. Secondary outcomes included charges for denied claims, approximating patients’ remaining financial responsibility for care. Results A total of 1 535 181 patients received 4 218 512 preventive services in 2 507 943 unique visits (mean [SD] age at visits, 54.02 [13.19] years; 1 804 637 visits for female patients [71.96%]); 585 299 patients (23.30%) had an annual household income $100 000 or higher, and 824 540 patients had some college education (32.88%). A total of 20 658 individuals (0.82%) were Asian, 139 950 (5.58%) were Hispanic, 219 646 (8.76%) were non-Hispanic Black, 1 372 223 (54.72%) were non-Hispanic White, and 25 412 (1.0%1) were other races and ethnicities not included in the other 4 groups. Of preventive claims, 1.34% (95% CI, 1.32%-1.36%) were denied, consisting mainly of specific benefit denials (0.67%; 95% CI, 0.66%-0.68%) and billing errors (0.51%; 95% CI, 0.50%-0.52%). The lowest-income patients had 43.0% higher odds of experiencing a denial than the highest-income patients (odds ratio, 1.43; 95% CI, 1.37-1.50; P &amp;amp;lt; .001). The least educated enrollees had a denial rate of 1.79% (95% CI, 1.76%-1.82%) compared with 1.14% (95% CI, 1.12%-1.16%) for enrollees with college degrees. Denial rates for Asian (2.72%; 95% CI, 2.55%-2.90%), Hispanic (2.44%; 95% CI, 2.38%-2.50%), and non-Hispanic Black (2.04%; 95% CI, 1.99%-2.08%) patients were significantly higher than those for non-Hispanic White patients (1.13%; 95% CI, 1.12%-1.15%). Conclusions and Relevance In this cohort study of 1 535 181 patients seeking preventive care, denials of insurance claims for preventive care were disproportionately more common among at-risk patient populations. This administrative burden potentially perpetuates inequitable access to high-value health care.
Video Analysis of Concussion Among Slap Fighting Athletes
Authors: Raj Swaroop Lavadi, Rohit Prem Kumar, Michael R. Kann, Manan J. Shah, D. Kojo Hamilton, Joseph C. Maroon, Nitin Agarwal
Journal: JAMA Surgery (2024)

This cross-sectional study assesses the risk of concussion among 56 slap fighting athletes via video analysis of 78 slap fighting matches.
Author Correction: Oligodendroglial fatty acid metabolism as a central nervous system energy reserve
Authors: Ebrahim Asadollahi, Andrea Trevisiol, Aiman S Saab, Zoe J Looser, Payam Dibaj, Reyhane Ebrahimi, Kathrin Kusch, Torben Ruhwedel, Wiebke Möbius, Olaf Jahn, Jun Yup Lee, Anthony S Don, Michelle-Amirah Khalil, Karsten Hiller, Myriam Baes, Bruno Weber, E Dale Abel, Andrea Ballabio, Brian Popko, Celia M Kassmann, Hannelore Ehrenreich, Johannes Hirrlinger, Klaus-Armin Nave
Journal: Nature Neuroscience (2024)
Human outbreaks of a novel reassortant Oropouche virus in the Brazilian Amazon region
Authors: Felipe Gomes Naveca, Tatiana Amaral Pires de Almeida, Victor Souza, Valdinete Nascimento, Dejanane Silva, Fernanda Nascimento, Matilde Mejía, Yasmin Silva de Oliveira, Luisa Rocha, Natana Xavier, Janis Lopes, Rodrigo Maito, Cátia Meneses, Tatyana Amorim, Luciana Fé, Fernanda Sindeaux Camelo, Samyly Coutinho de Aguiar Silva, Alexsandro Xavier de Melo, Leíse Gomes Fernandes, Marco Aurélio Almeida de Oliveira, Ana Ruth Arcanjo, Guilherme Araújo, Walter André Júnior, Renata Lia Coragem de Carvalho, Rosiane Rodrigues, Stella Albuquerque, Cristiane Mattos, Ciciléia Silva, Aline Linhares, Taynã Rodrigues, Francy Mariscal, Márcia Andréa Morais, Mayra Marinho Presibella, Nelson Fernando Quallio Marques, Anne Paiva, Karina Ribeiro, Deusilene Vieira, Jackson Alves da Silva Queiroz, Ana Maísa Passos-Silva, Lígia Abdalla, João Hugo Santos, Regina Maria Pinto de Figueiredo, Ana Cecília Ribeiro Cruz, Livia Neves Casseb, Jannifer Oliveira Chiang, Livia Vinhal Frutuoso, Agata Rossi, Lucas Freitas, Túlio de Lima Campos, Gabriel Luz Wallau, Emerson Moreira, Roberto Dias Lins Neto, Laura W Alexander, Yining Sun, Ana Maria Bispo de Filippis, Tiago Gräf, Ighor Arantes, Ana I Bento, Edson Delatorre, Gonzalo Bello
Journal: Nature Medicine (2024)
Pressure control plus spontaneous ventilation versus volume assist-control ventilation in acute respiratory distress syndrome. A randomised clinical trial
Authors: Jean-Christophe M. Richard, François M. Beloncle, Gaëtan Béduneau, Satar Mortaza, Stephan Ehrmann, Jean-Luc Diehl, Gwenaël Prat, Samir Jaber, Hassene Rahmani, Jean Reignier, Thierry Boulain, Hodane Yonis, Jack Richecoeur, Arnaud W. Thille, Pierre-Louis Declercq, Emmanuel Antok, Guillaume Carteaux, Bruno Vielle, Laurent Brochard, Alain Mercat
Journal: Intensive Care Medicine (2024)