tbuckley/cabot-search huggingface dataset:
Perceptions of Clinical Connectedness Among Hospital Environmental Service Workers
Authors: Nicholas Allis, Zhi Chen, Leah G. Jones, Timothy Kohanski, Zane Suttmore, Samantha Turnquest, Joyce Appiah-Asare, Stephen Appiah-Asare, Kendell Battle, Terry Frayer, Fateen Gilkey, Sherry D. Jones, Kelvin Little, Susan Murphy, Michelle Robinson, Anita Rouse, Jason Rupert, Moustapha Salawu, Zoreslava Osiv, Scott Rosas, Telisa Stewart
Journal: JAMA Network Open (2025)

Importance Environmental service workers (ESWs) have a critical role within the hospital infrastructure and are at the frontline of infection prevention. ESWs are highly trained in managing all forms of regulated waste, which includes biohazardous waste, and are responsible for the overall patient experience, janitorial work, and infection prevention. Without environmental services, patients have a 6 times greater risk of being infected by pathogens from patients who previously occupied their room. Objective To understand how ESWs felt proud, connected, and not connected to their hospital-based clinical teams. Design, Setting, and Participants This qualitative study included 10 ESWs who were members of clinical care teams at a medical university hospital in upstate New York. Data were collected from February to May 2024. Main Outcome and Measures Participants were asked to take pictures and write vignettes about what makes them feel proud of their work, how they feel connected to their clinical team, and how they feel disconnected from their clinical team. Results This study included 10 participants (5 males [50%]; 10 non-Hispanic Black or African American individuals [100%]; mean [range] age, 53 [38-66] years; 8 were high school graduates or had some college credit [80%]). When asked about their feeling of pride, participants expressed maintaining a clean space, having meaningful relationships, and helping others as generating a sense of pride. Participants’ feelings of disconnectedness were felt by their colleagues not following the rules set in place. In addition, participants reported feeling invisible, not listened to, unappreciated, and undervalued. Participants felt connected to their clinical teams by feeling a sense of community, having valuable relationships, and being able to communicate with members of the clinical team. Additionally, participants expressed a collective desire to be acknowledged, recognized, and treated as equals on the clinical team. Conclusions and Relevance The study found that ESWs identified feeling both connected to and disconnected from their clinical teams. Based on these results, hospital infrastructure and leadership should continue to exhaust all efforts to explore work experiences of ESWs to improve job retention, morale, satisfaction, overall clinical teamwork, and comradery.
Lipid nanoparticles deliver DNA-encoded biologics and induce potent protective immunity
Authors: Dafei Chai, Junhao Wang, Jing Ming Lim, Xiaohui Xie, Xinfang Yu, Dan Zhao, Perry Ayn Mayson Maza, Yifei Wang, Dana Cyril-Remirez, Ken H. Young, Yong Li
Journal: Molecular Cancer (2025)

Lipid nanoparticles (LNPs) for mRNA delivery have advanced significantly, but LNP-mediated DNA delivery still faces clinical challenges. This study compared various LNP formulations for delivering DNA-encoded biologics, assessing their expression efficacy and the protective immunity generated by LNP-encapsulated DNA in different models. The LNP formulation used in Moderna's Spikevax mRNA vaccine (LNP-M) demonstrated a stable nanoparticle structure, high expression efficiency, and low toxicity. Notably, a DNA vaccine encoding the spike protein, delivered via LNP-M, induced stronger antigen-specific antibody and T cell immune responses compared to electroporation. Single-cell RNA sequencing (scRNA-seq) analysis revealed that the LNP-M/pSpike vaccine enhanced CD80 activation signaling in CD8+ T cells, NK cells, macrophages, and DCs, while reducing the immunosuppressive signals. The enrichment of TCR and BCR by LNP-M/pSpike suggested an increase in immune response specificity and diversity. Additionally, LNP-M effectively delivered DNA-encoded antigens, such as mouse PD-L1 and p53R172H, or monoclonal antibodies targeting mouse PD1 and human p53R282W. This approach inhibited tumor growth or metastasis in several mouse models. The long-term anti-tumor effects of LNP-M-delivered anti-p53R282W antibody relied on memory CD8+ T cell responses and enhanced MHC-I signaling from APCs to CD8+ T cells. These results highlight LNP-M as a promising and effective platform for delivering DNA-based vaccines and cancer immunotherapies.
Metacognitive Training for Subjects with Bipolar Disorder: A Randomized Controlled Trial
Authors: Luisa de Siqueira Rotenberg, Renata Curvello, Clara Nardini, Milene da Silva Franco, Maria Eduarda Carozzino, Taís Boeira Biazus, Thuani Campanha, Alia Garrudo Guirado, Grace O'Malley, Thomas J Stamm, Beny Lafer
Journal: Psychotherapy and Psychosomatics (2025)

Impairments in social cognition in bipolar disorder (BD) have been extensively described in the last decade but few treatment strategies have been studied to address this issue. This study presents findings from a randomized controlled trial (RCT) investigating the efficacy of metacognitive training for bipolar disorder (MCT-BD) compared to Treatment as Usual (TAU) among individuals with BD in remission. The aim was to determine whether MCT-BD could improve social cognition and overall functioning in this population. Participants (N = 56) were recruited via social media and an internal database at the University of São Paulo Medical School. Inclusion criteria included a confirmed BD diagnosis, current state of remission, and the presence of social functioning impairments. Exclusion criteria included any impairments that could hinder neuropsychological testing. Patients were randomly assigned to either MCT-BD or TAU, with assessments conducted at baseline and follow-up. The MCT-BD program consisted of nine sessions. The overall attendance rate across all MCT-BD intervention sessions was 96.6%. The MCT-BD program demonstrated added value in improving social cognition, specifically in emotion recognition reaction time. However, no significant changes were found in theory of mind, psychosocial functioning, or quality of life. This RCT provides preliminary evidence for the efficacy of MCT-BD in improving emotion recognition latency, emphasizing the importance of targeted interventions in social cognition outcomes for individuals with BD. The study's strengths include high completion rates and comprehensive cognitive assessments. Future studies should explore long-term effects and personalized treatment approaches aiming to improve social-cognitive deficits in this population.
Three-Year Follow-up After Antiviral Treatment in New-Onset Type 1 Diabetes: Results From the Diabetes Virus Detection and Intervention Trial
Authors: Ida M. Mynarek, Lars Krogvold, Freja B. Mørk, Trine W. H. Lawaetz, Trine Roald, Morten W. Fagerland, Nina Lindblom, Jacob Westman, Peter Barker, Heikki Hyöty, Johnny Ludvigsson, Kristian F. Hanssen, Jesper Johannesen, Knut Dahl-Jørgensen
Journal: Diabetes Care (2025)

In the Diabetes Virus Detection and Intervention trial, antiviral treatment with pleconaril and ribavirin decreased the decline, compared with placebo, in endogenous C-peptide 1 year after diagnosis of type 1 diabetes (T1D) in children and adolescents. This article reports the results 2 and 3 years after diagnosis. This was a multicenter, randomized, placebo-controlled (1:1) trial of 96 children and adolescents aged 6-15.9 years newly diagnosed with T1D. Antiviral treatment (pleconaril and ribavirin) or placebo was given for 6 months from diagnosis, and participants were followed for 3 years. The primary outcome was residual C-peptide secretion, reported as the area under the curve (AUC), assessed by 2-h mixed-meal tolerance test. Secondary outcomes included insulin doses and HbA1c. At the 3-year follow-up, 75 participants attended. At 2 years, the mean ± SD AUC for C-peptide in the placebo group was 0.27 ± 0.33 compared with 0.34 ± 0.37 in the pleconaril and ribavirin group. After 3 years, the AUC had decreased to 0.17 ± 0.23 and 0.25 ± 0.34, respectively. There was no statistically significant difference between the groups. The groups were also comparable with regard to secondary end points. The decreased reduction in C-peptide levels after antiviral treatment is no longer present after 2 or 3 years. Further investigations are needed to explore options to use antiviral treatment in the prevention and treatment of T1D.
Interpreting the 100% disease control rate of Sin-Bev-RT in HCC with PVTT
Authors: Tongtong Pan, Lihuang Su
Journal: Hepatology (2025)

1Zhejiang Provincial Key Laboratory for Accurate Diagnosis and Treatment of Chronic Liver Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China 2Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China Abbreviations: AFP, Alpha-fetoprotein; DCR, Disease control rate; ECOG, Eastern Cooperative Oncology Group; HCC, Hepatocellular carcinoma; ORR, Objective response rate; PVTT, Portal vein tumor thrombosis; Sin-Bev-RT, Sintilimab and Bevacizumab combined with Radiotherapy Correspondence Su Lihuang, Department of Respiratory Medicine The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325035, Zhejiang, China. Email: [email protected]
Factors associated with tuberculosis treatment initiation among bacteriologically negative individuals evaluated for tuberculosis: An individual patient data meta-analysis
Authors: Sun Kim, Melike Hazal Can, Tefera B. Agizew, Andrew F. Auld, Maria Elvira Balcells, Stephanie Bjerrum, Keertan Dheda, Susan E. Dorman, Aliasgar Esmail, Katherine Fielding, Alberto L. Garcia-Basteiro, Colleen F. Hanrahan, Wakjira Kebede, Mikashmi Kohli, Anne F. Luetkemeyer, Carol Mita, Byron W. P. Reeve, Denise Rossato Silva, Sedona Sweeney, Grant Theron, Anete Trajman, Anna Vassall, Joshua L. Warren, Marcel Yotebieng, Ted Cohen, Nicolas A. Menzies
Journal: PLoS Medicine (2025)

Background Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative bacteriological test result. There is limited information on the factors that determine clinicians’ decisions to initiate TB treatment when initial bacteriological test results are negative. Methods and findings We performed a systematic review and individual patient data meta-analysis using studies conducted between January 2010 and December 2022 (PROSPERO: CRD42022287613). We included trials or cohort studies that enrolled individuals evaluated for TB in routine settings. In these studies, participants were evaluated based on clinical examination and routinely used diagnostics and were followed for ≥1 week after the initial test result. We used hierarchical Bayesian logistic regression to identify factors associated with treatment initiation following a negative result on an initial bacteriological test (e.g., sputum smear microscopy (SSM), Xpert MTB/RIF). Multiple factors were positively associated with treatment initiation: male sex [adjusted odds ratio (aOR) 1.61 (1.31, 1.95)], history of prior TB [aOR 1.36 (1.06, 1.73)], reported cough [aOR 4.62 (3.42, 6.27)], reported night sweats [aOR 1.50 (1.21, 1.90)], and having HIV infection but not on ART [aOR 1.68 (1.23, 2.32)]. Treatment initiation was substantially less likely for individuals testing negative with Xpert [aOR 0.77 (0.62, 0.96)] compared to smear microscopy and declined in more recent years. We were not able assess why clinicians made treatment decisions, as these data were not available. Conclusions Multiple factors influenced decisions to initiate TB treatment despite negative test results. Clinicians were substantially less likely to treat in the absence of a positive test result when using more sensitive, PCR-based diagnostics.
Efficacy and Safety of Finerenone in Patients With Primary Aldosteronism: A Pilot Randomized Controlled Trial
Authors: Jinbo Hu, Qixin Zhou, Yue Sun, Zhengping Feng, Jun Yang, Wenwen He, Ying Song, Yue Wang, Xiangjun Chen, Hang Shen, Ying Jing, Shumin Yang, Qifu Li, Zhipeng Du, Suxin Luo, Kangla Liao, Yao Zhang, Weiyang He, Yihong He, Ming Xiao, Bin Peng
Journal: Circulation (2025)
Supervised Exercise for Patients With Metastatic Breast Cancer: A Cost-Utility Analysis Alongside the PREFERABLE-EFFECT Randomized Controlled Trial
Authors: Aniek E.M. Schouten, Anouk E. Hiensch, Geert W.J. Frederix, Evelyn M. Monninkhof, Martina E. Schmidt, Dorothea Clauss, Nadira Gunasekara, Jon Belloso, Mark Trevaskis, Helene Rundqvist, Joachim Wiskemann, Jana Müller, Maike G. Sweegers, Carlo Fremd, Renske Altena, Rhodé M. Bijlsma, Gabe Sonke, Ainhara Lahuerta, G. Bruce Mann, Prudence A. Francis, Gary Richardson, Wolfram Malter, Joanna Kufel-Grabowska, Elsken van der Wall, Neil K. Aaronson, Elzbieta Senkus, Ander Urruticoechea, Eva M. Zopf, Wilhelm Bloch, Martijn M. Stuiver, Yvonne Wengstrom, Karen Steindorf, Miriam P. van der Meulen, Anne M. May
Journal: Journal of Clinical Oncology (2025)

PURPOSE To evaluate the cost utility of a 9-month supervised exercise program for patients with metastatic breast cancer (mBC), compared with control (usual care, supplemented with general activity advice and an activity tracker). Evidence on the cost-effectiveness of exercise for patients with mBC is essential for implementation in clinical practice and is currently lacking. METHODS A cost-utility analysis was performed alongside the multinational PREFERABLE-EFFECT randomized controlled trial, conducted in 8 centers across Europe and Australia. Patients with mBC (N = 357) were randomly assigned to either a 9-month, twice-weekly, supervised exercise group (EG) or control group (CG). Costs of the exercise program were calculated through a bottom-up approach. Other health care resource use, productivity losses, and quality of life were collected using country-adapted, self-reported questionnaires. Analyses were conducted from a societal perspective with a time horizon of 9 months. Costs were collected and reported in 2021 Euros (€1 = $1.18 US dollars). RESULTS Compared with the CG, EG resulted in a quality-adjusted life-year (QALY) gain of 0.013 (95% CI, –0.02 to 0.05) over a 9-month period. The mean costs of the exercise program were €1,696 per patient with one-on-one supervision (scenario 1) and €609 with one-on-four supervision (scenario 2). These costs were offset by savings in health care and productivity costs, resulting in mean total cost differences of –€163 (scenario 1) and –€1,249 (scenario 2) in favor of EG. The probability of supervised exercise being cost-effective was 65% in scenario 1 and 91% in scenario 2 at a willingness-to-pay threshold of €20,000 per QALY. CONCLUSION Exercise for patients with mBC increases quality of life, decreases costs, and is likely to be cost-effective. Group-based supervision is expected to have even higher cost-savings. Our positive findings can inform reimbursement of supervised exercise interventions for patients with mBC.
Detecting early cognitive deficits in preclinical Alzheimer’s disease using a remote digital multi-day learning paradigm
Authors: Roos J. Jutten, Daniel Soberanes, Cassidy P. Molinare, Stephanie Hsieh, Michelle E. Farrell, Aaron S. Schultz, Dorene M. Rentz, Gad A. Marshall, Keith A. Johnson, Reisa A. Sperling, Rebecca E. Amariglio, Kathryn V. Papp
Journal: npj Digital Medicine (2025)

Remote, digital cognitive testing on an individual's own device provides the opportunity to deploy previously understudied but promising cognitive paradigms in preclinical Alzheimer's disease (AD). The Boston Remote Assessment for NeuroCognitive Health (BRANCH) captures a personalized learning curve for the same information presented over seven consecutive days. Here, we examined BRANCH multi-day learning curves (MDLCs) in 167 cognitively unimpaired older adults (age = 74.3 ± 7.5, 63% female) with different amyloid-β (A) and tau (T) biomarker profiles on positron emission tomography. MDLC scores decreased across ascending biomarker groups, with the A + T- group performing numerically worse (β = –0.24, 95%CI[–0.55,0.07], p = 0.128) and the A + T+ group performing significantly worse (β = –0.58, 95%CI[–1.06,–0.10], p = 0.018) than the A-T- group. Further, lower MDLC scores were associated with greater cortical thinning (β = 0.18, 95%CI[0.04,0.34], p = 0.013). Our results suggest that diminished MDLCs track with advanced AD pathophysiology, and demonstrate how a digital multi-day learning paradigm can provide novel insights about cognitive decline during preclinical AD.
Clinical implications of maternal multikingdom transmissions and early-life microbiota
Authors: Shuqin Zeng, Meicen Zhou, Dezhi Mu, Shaopu Wang
Journal: The Lancet Microbe (2025)

SummaryMother-to-infant transmission of the bacteriome, virome, mycobiome, archaeome, and their mobile genetic elements has been recognised in nature as an important step for the infant to acquire and maintain a healthy early-life (from birth till age 3 years) microbiota. A comprehensive overview of other maternal multikingdom transmissions remains unavailable, except for that of the bacteriome. Associations between microorganisms and diseases throughout the human life span have been gradually discovered; however, whether these microorganisms are maternally derived and how they concomitantly interact with other microbial counterparts remain poorly understood. This Review first discusses the current understanding of maternal multikingdom transmissions, their contributions to the development of early-life microbiota, and the primary factors that influence the transmission processes. The clinical implications of the inherited microbiota on human health in early life have been emphasised upon next, along with highlighting of knowledge gaps that should be addressed in future research. Finally, interventions to restore typical vertical transmission or disturbed early-life microbiota have been discussed as potential therapeutic approaches.
Effectiveness of Synchronous Postdischarge Contacts on Health Care Use and Patient Satisfaction
Authors: Joel C. Boggan, Spoorthi Sankineni, Paul A. Dennis, Dazhe Chen, Tina Wong Sledge, David Halpern, Sharron Rushton, John W. Williams, Tatyana Der, Amir Alishahi Tabriz, Adelaide M. Gordon, Morgan Jacobs, Nathan A. Boucher, Maria Colandrea, Anastasia-Stefania Alexopoulos, Joanne Roman Jones, Nina Leflore-Lloyd, Sarah Cantrell, Karen M. Goldstein, Jennifer M. Gierisch
Journal: Annals of Internal Medicine (2025)

Postdischarge contacts (PDCs) after hospitalization are common practice, but their effectiveness in reducing use of acute care after discharge remains unclear. To assess the effects of PDC on 30-day emergency department (ED) visits, 30-day hospital readmissions, and patient satisfaction. MEDLINE, Embase, and CINAHL searched from 2012 to 25 May 2023. Randomized and nonrandomized trials of PDC within 7 days. Two investigators independently screened articles and assessed risk of bias (ROB). Single reviewers extracted data, with verification by second investigators. Random-effects meta-analyses were done on outcomes shared by at least 3 studies, and the certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Of 13 included studies (11 randomized trials [RTs]), 12 delivered PDCs via telephone. Three of 11 RTs were rated as having low ROB, with 1 rated high. Most PDC interventions (n = 10) consisted of single telephone contacts, often within 3 days. Eight studies focused on patients identified as higher-risk by the authors. There were no differences in 30-day ED use (5 RTs; 3054 patients; risk difference, 0.00 [95% CI, -0.02 to 0.03]; moderate certainty) or 30-day hospital readmissions (7 RTs; 7075 patients; risk difference, 0.00 [CI, -0.02 to 0.02]; moderate certainty) with PDC. Adherence and fidelity to PDC interventions were poorly described, and only 1 study investigated nontelephone PDC. Postdischarge contacts within 7 days of discharge were not associated with reductions in 30-day ED use or readmissions compared with usual care. Health systems should reconsider the utility of universal PDCs because multifaceted interventions targeting higher-risk patients may be necessary to reduce use of acute care after discharge. Department of Veterans Affairs. (PROSPERO: CRD42023465675).
Metabolic Dysfunction–Associated Steatotic Liver Disease
Authors: Sajjadh M.J. Ali, Michelle Lai
Journal: Annals of Internal Medicine (2025)

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease in the United States. It is characterized by steatosis in the liver and is potentially reversible. Risk factors include obesity, type 2 mellitus, and other metabolic disorders. Metabolic dysfunction-associated steatohepatitis (MASH), a more severe form of MASLD, puts patients at risk for cirrhosis, liver decompensation, and liver cancer. Diet, exercise, and weight loss are the cornerstones of management. Although only 1 medication has been approved for treatment of MASH, other pharmacotherapies and surgeries that aid weight loss and optimize metabolic risk factors can be used. Early diagnosis and intervention are important to prevent progression to cirrhosis and its complications, including cancer.
Census Tract Rurality, Predominant Race and Ethnicity, and Distance to Lung Cancer Screening Facilities
Authors: Solmaz Amiri, Candice L. Wilshire, Clemma Jacobsen Muller, Cole Allick, Allison C. Welch, Gary Ferguson, Dedra Buchwald, Jed A. Gorden
Journal: Annals of Internal Medicine (2025)

The U.S. Preventive Services Task Force recommends annual lung cancer screening (LCS) for adults who meet specific age and smoking history criteria. To evaluate race-, ethnicity-, and rurality-based differences in distance to the nearest LCS facility. Cross-sectional ecological study. U.S. census tracts. 71 691 census tracts. The outcome variable was road network distance in miles between a census tract and the nearest LCS facility. Distance was log-transformed, and geometric means are reported. Census tracts were classified as majority (>50%) American Indian/Alaska Native (AI/AN), Asian, Black, non-Hispanic White (NHW), no single race, or Hispanic. Rurality was defined using the rural-urban commuting area codes. Ordinary least-squares regression examined the associations between distance and census tract race, ethnicity, and rurality. Geometric mean distance to the nearest LCS facility was 6.5 miles. Compared with NHW-majority census tracts, distance to the nearest LCS facility was 5.26 times (426%) longer in AI/AN-majority census tracts and 7% to 39% shorter in Asian-, Black-, and Hispanic-majority census tracts. Adjustment for rurality reduced the mean distance in AI/AN-majority census tracts, but the mean distance was still 3.16 times the distance in NHW-majority census tracts. Adjustment for rurality reduced the observed advantage in Asian- and Black-majority census tracts and changed the direction of associations in Hispanic-majority census tracts. Analyses did not account for travel time or cost. Differences exist in distance to LCS facilities by race and ethnicity that can only be partially explained by rurality. Lung Ambition Alliance and the Center for Lung Research in Honor of Wayne Gittinger.