tbuckley/cabot-search huggingface dataset:
Revealing patterns of SARS-CoV-2 variant emergence and evolution using RBD amplicon sequencing of wastewater
Authors: Xingwen Chen, John Balliew, Cici X Bauer, Jennifer Deegan, Anna Gitter, Blake M Hanson, Anthony W Maresso, Michael J Tisza, Catherine L Troisi, Janelle Rios, Kristina D Mena, Eric Boerwinkle, Fuqing Wu
Journal: Journal of Infection (2024)

Rapid evolution of SARS-CoV-2 has resulted in the emergence of numerous variants, posing significant challenges to public health surveillance. Clinical genome sequencing, while valuable, has limitations in capturing the full epidemiological dynamics of circulating variants in the general population. This study aimed to monitor the SARS-CoV-2 variant community dynamics and evolution using receptor-binding domain (RBD) amplicon sequencing of wastewater samples.
Clinical and epidemiological investigation of human infection with zoonotic parasite Trypanosoma dionisii in China
Authors: Nannan Xu, Xiaoai Zhang, Hui Liu, Yintao Xu, Huixia Lu, Lianhui Zhao, Yishan He, Meiqi Zhang, Jingtao Zhang, Guangqian Si, Ziyi Wang, Muxin Chen, Yuchun Cai, Yi Zhang, Qiang Wang, Yuwan Hao, Yuanyuan Li, Zhengbin Zhou, Yunhai Guo, Caiyun Chang, Ming Liu, Chuanmin Ma, Yongbin Wang, Liqun Fang, Shizhu Li, Gang Wang, Qin Liu, Wei Liu
Journal: Journal of Infection (2024)

Trypanosomiasis continues to pose a global threat to human health, with human infection mainly caused by Trypanosoma brucei and Trypanosoma cruzi. We present a 30-year-old pregnant woman with persistent high fever from Shandong Province, China. High-throughput sequencing revealed the presence of Trypanosoma dionisii in blood. We conducted an analysis of the patient's clinical, epidemiological, and virological data. The patients exhibited fever, shortness of breath, chest tightness, accompanied by change in liver function and inflammatory response. She made a full recovery without any long-term effects. T. dionisii was detected in blood collected 23 days after onset of illness. The 18S rRNA gene sequence showed close similarity to T. dionisii found in bats from Japan, while the gGAPDH gene was closely related to T. dionisii from bats in Mengyin County, Shandong Province. Phylogenetic analysis demonstrated the current T. dionisii belongs to clade B within its species group. Positive anti-Trypanosoma IgG antibody was detected from the patient on Day 23, 66 and 122 after disease onset, as well as the cord blood and serum from the newborn. Retrospective screening of wild small mammals captured from Shandong Province revealed a prevalence rate of 0.54% (7/1304) for T. dionisii; specifically among 0.81% (5/620) of Apodemus agrarius, and 0.46% (2/438) of Mus musculus. The confirmation of human infection with T. dionisii underscores its potential as a zoonotic pathogen, while the widespread presence of this parasite in rodent and bat species emphasizes the emerging threat it poses to human health.
Severity of Respiratory Syncytial Virus compared with SARS-CoV-2 and Influenza among hospitalised adults ≥65 years
Authors: Lorena Vega-Piris, Silvia Galindo Carretero, José Luis Mayordomo, Mercedes Belén Rumayor Zarzuelo, Virginia Álvarez Río, Virtudes Gallardo García, Miriam García Vázquez, María Del Carmen García Rodríguez, Luca Basile, Nieves López González-Coviella, Maria Isabel Barranco Boada, Olaia Pérez-Martínez, Ana Lameiras Azevedo, Carmen Quiñones Rubio, Jaume Giménez Duran, Ana Fernández Ibáñez, María Victoria García Rivera, Violeta Ramos Marín, Daniel Castrillejo, Luis Javier Viloria Raymundo, Amparo Larrauri, Susana Monge
Journal: Journal of Infection (2024)

Our aim was to estimate the risk of pneumonia, admission to intensive care unit (ICU) or death in individuals ≥65 years old admitted to hospital with RSV, compared to influenza or COVID-19.
<b>Continuous Glucose Monitoring With Geriatric Principles in Older Adults With Type 1 Diabetes and Hypoglycemia: A Randomized Controlled</b> <b>Trial</b>
Authors: Medha N. Munshi, Christine Slyne, Atif Adam, Colin Conery, Adeolu Oladunjoye, Simon Neuwahl, David Wypij, Elena Toschi
Journal: Diabetes Care (2024)

OBJECTIVE Continuous glucose monitoring (CGM) use in older adults with type 1 diabetes (T1D) has shown benefits. However, the impact of CGM use, coupled with simplified treatment regimens and personalized glycemic goals that are better suited for older patients with multiple comorbidities and hypoglycemia, is not known. RESEARCH DESIGN AND METHODS Older adults (≥65 years) with T1D with hypoglycemia (two or more episodes of hypoglycemia [blood glucose &amp;lt;70 mg/dL for ≥20 min over 2 weeks]) who were CGM naïve or CGM users were randomized to intervention and control groups. The intervention consisted of the combined use of CGM with geriatric principles (i.e., adjusting goals based on overall health, and simplification of regimens based on CGM patterns and clinical characteristics) over 6 months. The control group received usual care by their endocrinologist. The primary end point was change in time when blood glucose was &amp;lt;70 mg/dL from baseline to 6 months. Cost-effectiveness was calculated using a health care sector perspective. RESULTS We randomized 131 participants (aged 71 ± 5 years; 21% ≥75 years old) to the intervention (n = 68; CGM users = 33) or the control (n = 63; CGM users = 40) group. The median change in hypoglycemia from baseline to 6 months was −2·6% in the intervention group and −0.3% in the control group (median difference, −2.3% [95% CI −3.7%, −1.3%]; P &amp;lt; 0.001). This improvement was seen in both CGM naïve (−2.8%; 95% CI −5.6%, −0.8%) and CGM users (−1.2%; 95% CI −2.7%, −0.1%). The HbA1c did not differ between the groups (7.5% vs 7.3%). The intervention was cost-effective (incremental cost-effectiveness ratio $71,623 per quality adjusted life-year). CONCLUSIONS In older adults with T1D and high risk of hypoglycemia, CGM use enhanced by geriatric principles can lower hypoglycemia without worsening glycemic control in a cost-effective fashion.
Proteomic Assessment of the Risk of Secondary Cardiovascular Events among Individuals with CKD
Authors: Rajat Deo, Ruth F. Dubin, Yue Ren, Jianqiao Wang, Harold Feldman, Haochang Shou, Josef Coresh, Morgan E. Grams, Aditya L. Surapaneni, Jordana B. Cohen, Mayank Kansal, Mahboob Rahman, Mirela Dobre, Jiang He, Tanika Kelly, Alan S. Go, Paul L. Kimmel, Ramachandran S. Vasan, Mark R. Segal, Hongzhe Li, Peter Ganz
Journal: Journal of the American Society of Nephrology (2024)

Key Points Machine learning and large-scale proteomics led to a 16-protein secondary cardiovascular risk model in patients with CKD. Hepatic fibrosis and liver X receptor activation represented biologic pathways that link kidney disease and risk of secondary cardiovascular events. An understanding of the circulating proteins associated with secondary cardiovascular events may help to identify novel therapeutic targets. Background Cardiovascular risk models have been developed primarily for incident events. Well-performing models are lacking to predict secondary cardiovascular events among people with a history of coronary heart disease, stroke, or heart failure who also have CKD. We sought to develop a proteomic risk score for cardiovascular events in individuals with CKD and a history of cardiovascular disease. Methods We measured 4638 plasma proteins among 1067 participants from the Chronic Renal Insufficiency Cohort (CRIC) and 536 individuals from the Atherosclerosis Risk in Communities (ARIC) Cohort. All had non–dialysis-dependent CKD and coronary heart disease, heart failure, or stroke at study baseline. A proteomic risk model for secondary cardiovascular events was derived by elastic net regression in CRIC, validated in ARIC, and compared with clinical models. Biologic mechanisms of secondary events were characterized through proteomic pathway analysis. Results A 16-protein risk model was superior to the Framingham Risk Score for secondary events, including a modified score that included eGFR. In CRIC, the annualized area under the receiver operating characteristic curve (area under the curve) within 1–5 years ranged between 0.77 and 0.80 for the protein model and 0.57 and 0.72 for the clinical models. These findings were replicated in the ARIC validation cohort. Biologic pathway analysis identified pathways and proteins for cardiac remodeling and fibrosis, vascular disease, and thrombosis. Conclusions The proteomic risk model for secondary cardiovascular events outperformed clinical models on the basis of traditional risk factors and eGFR.
Potential Utility of SPECT/CT for Early Detection of Scapular Stress Reaction Following Reverse Total Shoulder Arthroplasty
Authors: Chul-Hyun Cho, Du-Han Kim, Kyoung Sook Won
Journal: Clinical Nuclear Medicine (2024)

Abstract Scapular stress fracture (SSF) after reverse total shoulder arthroplasty is a unique and common complication that may have negative impact for long-term outcomes. Scapular stress reaction (SSR), characterized by pain and tenderness without radiographic evidence of fracture, can be precursor of SSF. We believe that early detection using SPECT/CT with proper management for SSRs including acromion, scapular spine, and coracoid process is crucial for better prognosis without additional complications by preventing SSFs. Therefore, we present 3 typical cases with SSR following reverse total shoulder arthroplasty with the findings of SPECT/CT.
Arthroscopic partial meniscectomy versus exercise therapy for degenerative meniscal tears: 10-year follow-up of the OMEX randomised controlled trial
Authors: Bjørnar Berg, Ewa M Roos, Martin Englund, Nina Jullum Kise, Lars Engebretsen, Cathrine Nørstad Eftang, May Arna Risberg
Journal: British Journal of Sports Medicine (2024)

Objective To evaluate radiographic knee osteoarthritis (OA) progression, development of knee OA, patient-reported outcomes and knee muscle strength at 10-year follow-up after arthroscopic partial meniscectomy (APM) or exercise therapy for degenerative meniscal tears. Methods Randomised controlled trial including 140 participants, with a degenerative meniscal tear and no or minimal radiographic OA changes. Participants were randomised to either APM or 12 weeks of exercise therapy (1:1 ratio). The primary outcome was knee OA progression assessed by the Osteoarthritis Research Society International (OARSI) atlas sum score (sum of medial and lateral compartment joint space narrowing and osteophyte score). Secondary outcomes included incidence of radiographic and symptomatic knee OA, patient-reported pain and knee function and isokinetic knee muscle strength. Results The adjusted mean difference in change in the OARSI sum score was 0.39 (95% CI −0.19 to 0.97), with more progression in the APM group. The incidence of radiographic knee OA was 23% in the APM group and 20% in the exercise group (adjusted risk difference 3% (95% CI −13% to 19%)). No clinically relevant differences were found in patient-reported outcomes or isokinetic knee muscle strength. Conclusion No differences in radiographic knee OA progression and comparable rates of knee OA development were observed 10 years following APM and exercise therapy for degenerative meniscal tears. Both treatments were associated with improved patient-reported pain and knee function. Trial registration number NCT01002794 .
Mechanisms behind the high mortality rate in chronic <scp>Chagas</scp> cardiomyopathy: Unmasking a three‐headed monster
Authors: Luis E. Echeverría, Angie Yarlady Serrano‐García, Lyda Z. Rojas, Enrique A. Berrios‐Bárcenas, Juan Esteban Gómez‐Mesa, Sergio A. Gómez‐Ochoa
Journal: European Journal of Heart Failure (2024)
Effectiveness of the enterovirus A71 vaccine on hand, foot and mouth disease: a real-world study in China
Authors: Yuanhua Liu, Yang Song, Fengfeng Liu, Yue Chen, Yang Liu, Jin Shi, Ke Li, Yun Yin, Qingqing Liang, Na Liu, Ming Ming, Lei Hua, Qian Shi, Jiayao Xu, Rui Yuan, Shuting Li, Lele Zhang, Yu Zhao, Na Wang, Jidan Zhang, Yanping Zhang, Zhaorui Chang, Zhijie Zhang
Journal: Clinical Microbiology and Infection (2024)
No Association Between Phenylketonuria or Hyperphenylalaninemia and Type 1 Diabetes: Insights From the German DPV Registry
Authors: Svenja Meyhöfer, Johanna Hammersen, Stefanie Schmid, Semik Khodaverdi, Roschan Salimi Dafsari, Karl Otfried-Schwab, Matthias Papsch, Susanne Bechtold-Dalla Pozza, Sebastian M. Meyhöfer, Reinhard W. Holl, Nicole Prinz
Journal: Diabetes Care (2024)
WHO 2024 Hepatitis B Guidelines and Treatment-Eligible Rate Among Treatment-Naive Patients
Authors: Jian Wang, Shaoqiu Zhang, Chuanwu Zhu, Chao Wu, Rui Huang
Journal: JAMA Network Open (2024)

This cross-sectional study compares rates of hepatitis B treatment eligibility among treatment-naive patients according to the World Health Organization (WHO) 2024 guidelines with eligibility rates across other international guidelines.
Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl
Authors: Ashish P. Thakrar, Paul J. Christine, Andrew Siaw-Asamoah, Anthony Spadaro, Sophia Faude, Christopher K. Snider, M. Kit Delgado, Margaret Lowenstein, Kyle Kampman, Jeanmarie Perrone, Lewis S. Nelson, Austin S. Kilaru
Journal: JAMA Network Open (2024)

Importance Buprenorphine treatment of opioid use disorder (OUD) is safe and effective, but opioid withdrawal during treatment initiation is associated with poor retention in care. As fentanyl has replaced heroin in the drug supply, case reports and surveys have indicated increased concern for buprenorphine-precipitated withdrawal (PW); however, some observational studies have found a low incidence of PW. Objective To estimate buprenorphine PW incidence and assess factors associated with PW among emergency department (ED) or hospitalized patients. Design, Setting, and Participants This retrospective cohort study at 3 academic hospitals in Philadelphia, Pennsylvania, included adults with OUD who underwent traditional or high-dose buprenorphine initiation between January 1, 2020, and December 31, 2021. Exclusion criteria included low-dose buprenorphine initiation and missing documentation of opioid withdrawal severity within 4 hours of receiving buprenorphine. Exposure Buprenorphine initiation with an initial dose of at least 2 mg of sublingual buprenorphine after a Clinical Opiate Withdrawal Scale (COWS) score of 8 or higher. Additional exposures included 4 predefined factors potentially associated with PW: severity of opioid withdrawal before buprenorphine (COWS score of 8-12 vs ≥13), initial buprenorphine dose (2 vs 4 or ≥8 mg), body mass index (BMI) (&amp;amp;lt;25 vs 25 to &amp;amp;lt;30 or ≥30; calculated as weight in kilograms divided by height in meters squared), and urine fentanyl concentration (0 to &amp;amp;lt;20 vs 20 to &amp;amp;lt;200 or ≥200 ng/mL). Main Outcome and Measures The main outcome was PW incidence, defined as a 5-point or greater increase in COWS score from immediately before to within 4 hours after buprenorphine initiation. Logistic regression was used to estimate the odds of PW associated with the 4 aforementioned predefined factors. Results The cohort included 226 patients (150 [66.4%] male; mean [SD] age, 38.6 [10.8] years). Overall, 26 patients (11.5%) met criteria for PW. Among patients with PW, median change in COWS score was 9 points (IQR, 6-13 points). Of 123 patients with confirmed fentanyl use, 20 (16.3%) had PW. In unadjusted and adjusted models, BMI of 30 or greater compared with less than 25 (adjusted odds ratio [AOR], 5.12; 95% CI, 1.31-19.92) and urine fentanyl concentration of 200 ng/mL or greater compared with less than 20 ng/mL (AOR, 8.37; 95% CI, 1.60-43.89) were associated with PW. Conclusions and Relevance In this retrospective cohort study, 11.5% of patients developed PW after buprenorphine initiation in ED or hospital settings. Future studies should confirm the rate of PW and assess whether bioaccumulated fentanyl is a risk factor for PW.
Hearing Aid Use Trends Among Older Adults by Income and Metropolitan vs Nonmetropolitan Residence
Authors: Sarah Y. Bessen, Wuyang Zhang, Emmanuel Garcia-Morales, Jennifer A. Deal, Nicholas S. Reed
Journal: JAMA Network Open (2024)

This cross-sectional study assesses the prevalence of hearing aid use among older US adults with hearing loss and stratifies the findings by income and metropolitan vs nonmetropolitan residence.
Prevalence of Exclusive Breastfeeding Among US Children
Authors: Guodong Ding, Chaochao Wen, Yan Chen, Angela Vinturache, Yongjun Zhang
Journal: JAMA Network Open (2024)

This cross-sectional study analyzes temporal changes in the prevalence of exclusive breastfeeding at 4 and 6 months among US children from 2016 to 2022.
Social Risks and Health Care Use in Medically Complex Patients
Authors: Emma L. Tucher, Allison L. Steele, Connie S. Uratsu, Jodi K. McCloskey, Richard W. Grant
Journal: JAMA Network Open (2024)

Importance Integrated health care systems have initiated major investments to identify and address social risks, particularly for patients with multiple medical conditions. Objective To evaluate the association of social risks with health care use among patients with complex multimorbidity. Design, Setting, and Participants This longitudinal cohort study assessed Kaiser Permanente Northern California (KPNC) patients with (1) moderate medical complexity (defined by high comorbidity score, high risk of hospitalization, and/or prior emergency department [ED] admissions) and (2) high medical complexity (eg, meeting additional criteria, such as ≥7 medications and laboratory evidence of poor disease control). Exposure Social risks (eg, requiring medical financial assistance and self-reported social barriers to care). Main Outcomes and Measures Inpatient and outpatient health care use during 12 months of follow-up (January 15, 2023, to January 14, 2024). Results The sample included 97 252 KPNC patients (mean [SD] age, 69.5 [16] years; 52.1% female; 10.6% Asian, 11.1% Black, 18.3% Hispanic, 54.6% White, and 5.5% other race or ethnicity [eg, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, multiracial, or unknown race]; and 8.8% insured by Medicaid), including 27 827 with moderate medical complexity (5074 [18.2%] with social risks) and 69 425 with high medical complexity (17 343 [25.0%] with social risks). In fully adjusted models, for moderate medical complexity, social risks were associated with higher odds of inpatient admissions (odds ratio [OR], 1.2; 95% CI, 1.1-1.4), ED visits (OR, 1.2; 95% CI, 1.1-1.3), and mental health visits (OR, 1.2; 95% CI, 1.1-1.3) vs individuals without social risks. Among individuals with high medical complexity, social risks were associated with higher odds of inpatient admissions (OR, 1.2; 95% CI, 1.1-1.2), ED visits (OR, 1.2; 95% CI, 1.1-1.2), and 30-day readmissions (OR, 1.2; 95% CI, 1.1-1.3) and higher odds of mental health visits (OR, 1.3; 95% CI, 1.2-1.3) vs individuals without social risks. Conclusions and relevance In this cohort study of individuals with medical complexity, coexisting social risks were associated with substantial downstream health care use. Efforts to reduce use in individuals with complex medical comorbidity could include concurrent efforts to identify and reduce social risks.
Prehospital Intervention Among Black Patients With Traumatic Injury in Los Angeles County
Authors: Lindsey Loss, Martin Schreiber, Kazuhide Matsushima, Luis Tinoco-Garcia, Li Ding, Kenji Inaba, Reynold Henry
Journal: JAMA Network Open (2024)

This cohort study examined the differences in prehospital treatment received by patients with traumatic injury belonging to different racial and ethnic groups between 2013 and 2020 in Los Angeles County.
Intergenerational Chain of Violence, Adverse Childhood Experiences, and Elder Abuse Perpetration
Authors: Chie Koga, Taishi Tsuji, Masamichi Hanazato, Atsushi Nakagomi, Takahiro Tabuchi
Journal: JAMA Network Open (2024)

Importance It is widely known that individuals with adverse childhood experiences (ACEs) have an increased risk of abusing their own children, thereby perpetuating the cycle of violence. However, the association between ACEs and elder abuse perpetration has not been fully examined. Objective To examine the association between ACEs and elder abuse and the mediating factors. Design, Setting, and Participants This cross-sectional study used data collected via the self-administered Japan COVID-19 and Society Internet Survey from September 12 to October 19, 2022. Men and women aged 20 to 64 years who responded to related questions were included. Data were analyzed from July 2023 to April 2024. Exposures ACEs, defined as the experience of any of 7 items—interpersonal loss (parental loss and parental divorce), family psychopathology (parental mental disease and violence in family), abuse (physical and psychological abuse), and neglect—before the age of 18 years. Main Outcomes and Measures The primary outcome was the perpetration of physical and/or psychological abuse against an older person (aged ≥65 years) self-reported via questionnaire. The direct and indirect effect estimates were determined using logistic regression analyses. Results Of a total of 13 318 participants (mean [SD] age, 41.1 [12.1] years; 6634 female [49.8%]), 1133 (8.5%) reported perpetrating violence against older adults. Compared with individuals without ACEs, the odds ratios (ORs) for perpetrating violence were 3.22 (95% CI, 2.74-3.79) for those with 1 ACE and 7.65 (95% CI, 6.41-9.13) for those with 2 or more ACEs. In the mediation analysis, factors with large indirect effect estimates included depression (OR, 1.13; 95% CI, 1.11-1.14; proportion mediated [PM], 18.6%), mental illness other than depression (OR, 1.12; 95% CI, 1.10-1.14; PM, 17.3%), and self-rated health (OR, 1.04; 95% CI, 1.03-1.05; PM, 6.0%). Conclusions and Relevance These findings suggest that intergenerational cycles of violence may extend to any vulnerable group, not only children but also older adults. Further research into the prevention of ACEs and breaking these cycles of violence is warranted.
Patient Enrollment to Industry-Sponsored Versus Federally Sponsored Cancer Clinical Trials
Authors: Joseph M. Unger, Hong Xiao, Riha Vaidya, Michael LeBlanc
Journal: Journal of Clinical Oncology (2024)

PURPOSE The conduct of cancer clinical research in the United States is supported by both private and public sponsors. Industry aims to obtain new drug approvals. Federally-sponsored trials examine a broad set of research questions that are not typically addressed by industry; these trials, which are also more commonly conducted in diverse populations, were recently shown to have contributed to gains of 14 million life-years for patients with cancer. Despite the different mandates, the proportion of patients who might participate in industry-sponsored versus federally-sponsored cancer studies is unknown. METHODS We evaluated trial enrollment patterns from 2008 to 2022 using ClinicalTrials.gov data. The ratio of enrollments attributable to industry versus federal sponsors was estimated. A large set of estimates on the basis of different combinations of study characteristics were generated. Point estimates were determined as the mean of combinations and confidence limits by the IQR. Five-year intervals were examined to smooth annual variation. RESULTS In total, N = 26,080 studies were examined. The estimated enrollment ratio from 2018 to 2022 for all industry-sponsored versus federally-sponsored trials was 8.1 (IQR, 6.2-9.9). For adult trials, the ratio increased from 4.8 (IQR, 4.4-5.3) during 2008-2012 to 9.6 (IQR, 7.4-11.8) during 2018-2022; for trials in children, the ratio increased from 0.7 (IQR, 0.6-0.7) to 2.3 (IQR, 1.8-2.7). Despite increasing cancer incidence, enrollment counts for federally-sponsored trials were flat over the study period. CONCLUSION In the United States, there is a growing reliance on industry to conduct cancer clinical research. Underinvestment in federally-sponsored research comes at a cost for both patients and researchers, with lost opportunities for scientific, clinical, and population advances.