tbuckley/cabot-search huggingface dataset:
Perceived Contributors to Job Quality and Retention at Home Care Cooperatives
Authors: Geoffrey M. Gusoff, Miguel A. Cuevas, Catherine Sarkisian, Madeline R. Sterling, Ariel C. Avgar, Gery W. Ryan
Journal: JAMA Network Open (2025)

Importance To safely age at home, millions of older adults rely on the services of home care workers (HCWs), a workforce marked by poor working conditions, high turnover, and critical worker shortages. Home care cooperatives—businesses co-owned and controlled by HCWs—have demonstrated significantly lower turnover and higher job quality than traditional home care businesses, but the factors associated with these outcomes have not been investigated. Objective To identify potential factors associated with higher job quality and lower turnover at home care cooperatives. Design, Setting, and Participants In this qualitative study, semistructured interviews were conducted in English from November 2023 to June 2024. To be eligible for the study, participants had to be 18 years old or older, speak English, and currently be employed by a home care cooperative. Interviews were conducted remotely over Zoom with individual HCWs and staff from home care cooperatives from across the US. Data were analyzed from May to July 2024. Exposure Employment at a home care cooperative. Main Outcomes and Measures Interviews were audio recorded and transcribed. A thematic analysis approach was used to code interviews and identify major themes and subthemes, informed by a conceptual model of direct care worker job outcomes. Results A total of 23 HCWs and 9 staff members (14 participants aged 20-39 years [44%]; 8 [25%] African American, 4 [13%] Latinx, and 17 [53%] non-Latinx White) from 5 home care cooperatives participated in the study. Participants identified 4 key aspects of the cooperative work environment they perceived to be contributing to higher job quality and lower turnover compared with traditional agencies: (1) greater workplace control regarding patient care, case assignments, and organizational policies; (2) stronger community support and camaraderie; (3) a deeper culture of respect in which HCWs felt more valued; and (4) higher overall compensation in the form of wages, benefits, or profit sharing. Conclusions and Relevance In this qualitative study of HCWs and staff at home care cooperatives, participants perceived cooperatives’ relatively high levels of HCW control, community, respect, and compensation to be important contributors to HCWs’ retention in the field. The participatory structure and practices of home care cooperatives in these areas may represent novel approaches for home care agencies to reduce HCW turnover and improve job quality to address critical workforce shortages.
Neighborhood Disadvantage, Individual Experiences of Racism, and Breast Cancer Survival
Authors: Etienne X. Holder, Mollie E. Barnard, Nuo N. Xu, Lauren E. Barber, Julie R. Palmer
Journal: JAMA Network Open (2025)

Importance Due to the legacy of structural racism in the United States, Black US residents are more likely to live in disadvantaged neighborhoods regardless of individual socioeconomic status. Black women are also more likely to die from their breast cancer. Objective To investigate whether neighborhood disadvantage and individual experiences of racism are associated with breast cancer mortality among Black US women. Design, Setting, and Participants Prospective follow-up study conducted within the Black Women’s Health Study (BWHS), a nationwide cohort study of 59 000 self-identified Black females enrolled in 1995 and followed up by biennial questionnaires. BWHS participants diagnosed with breast cancer at stages I to III and who survived 12 months after initial diagnosis were included (n = 2290). Deaths and cause of death were identified through linkage with the National Death Index. Exposures Geocoded participant addresses were linked with US Census Bureau and American Community Survey data to create neighborhood-level indices reflecting relative disadvantage. Data on experiences of racism were obtained from questionnaires. Main Outcomes and Measures Breast cancer–specific and all-cause mortality. Hazard ratios (HRs) and 95% CIs were estimated from multivariable Cox proportional hazards regression models. Results There were 305 breast cancer–specific deaths among 2290 women with invasive breast cancer (mean [SD] age at diagnosis, 56.7 [10.9] years) who were followed up for a median (IQR) of 10.5 (5.6-16.1) years. The mortality rate was 14.26 (95% CI, 11.01-17.51) per 1000 person-years for those living in the most disadvantaged neighborhoods and 8.82 (95% CI, 6.55-11.09) per 1000 person-years for those living in the least disadvantaged neighborhoods (HR, 1.47; 95% CI, 1.02-2.12). HRs for women living in areas of extreme economic deprivation (vs privilege) and for women who reported experiences of racism in at least 2 institutional spheres (vs none) were also greater than 1, but not statistically significant (extreme economic deprivation vs privilege: HR, 1.19; 95% CI, 0.88-1.61; racism in 2 spheres vs none: HR, 1.28; 95% CI, 0.96-1.73). Conclusions and Relevance In this cohort of Black women, living in disadvantaged neighborhoods was associated with a higher mortality from breast cancer, even after accounting for stage at diagnosis, treatments, and individual-level lifestyle factors. Community-level interventions to reduce environmental stressors and improve conditions in disadvantaged neighborhoods, including access to high-quality cancer care, may be critical to reducing racial disparities in breast cancer survival.
Risk Stratification and Treatment Selection in Patients With Asymptomatic Abdominal Aortic Aneurysms
Authors: Lorenz Meuli, Alexander Zimmermann, Jeppe Kofoed Petersen, Emil Loldrup Fosbøl, Vaiva Dabravolskaité, Vladimir Makaloski, Jonas Peter Eiberg, Lars Valeur Køber, Timothy Andrew Resch
Journal: JAMA Network Open (2025)

Importance Open surgical repair (OSR) should be prioritized for patients with asymptomatic abdominal aortic aneurysm (AAA) and long life expectancy, whereas endovascular repair (EVAR) is preferred for patients with suitable anatomy and life expectancy less than 2 to 3 years. However, life expectancy estimation and risk stratification are not well established. Objective To evaluate risk-stratified survival differences between OSR and EVAR following elective AAA treatment. Design, Setting, and Participants This cohort study used data from Danish national health registries. Patients older than 60 years undergoing elective AAA repair between 2004 and 2023 were categorized into 4 risk groups according to age, estimated glomerular filtration rate, and chronic obstructive pulmonary disease. Follow-up was until March 31, 2024. Exposure OSR or EVAR for AAA. Main Outcomes and Measures The primary outcome was overall survival. Secondary outcomes were incidence of AAA rupture and new cancer diagnosis. Comorbidities were balanced using inverse probability weighting. Kaplan-Meier estimators were generated for both treatments and the 4 risk score groups. Results Of 6891 identified patients, 5757 (83.4%) were men. Women were older (median [IQR] age, 75.4 [70.9-79.3] vs 74.5 [70.5-78.5] years), more often had chronic obstructive pulmonary disease (156 women [13.6%] vs 512 men [8.9%]), and had lower estimated glomerular filtration rate (median [IQR], 68.4 [54.2-80.4] vs 70.4 [56.5-82.4] mL/min/1.73 m 2 ) compared with men. The median follow-up was 8.28 years (95% CI, 8.10-8.50 years). OSR was associated with higher perioperative mortality in all risk groups. In low-risk patients, OSR was associated with a 10-month (95% CI, 2.2-18.3 months; P = .02) longer mean survival time restricted at 15 years compared with EVAR. In moderate-to-high-risk patients, OSR was associated with a 9-month (95% CI, 1.9-16.9 months; P = .008) shorter mean survival time restricted after 12.5 years compared with EVAR. No difference in mean survival time was seen in low-to-moderate-risk and high-risk patients at the study end. No differences in 10-year incidence of secondary AAA ruptures (OSR, 2.6% [95% CI, 1.9%-3.4%] vs EVAR, 2.2% [95% CI, 1.7%-2.7%]; P = .34) or solid malignant tumor (OSR, 18.6% [95% CI, 16.7%-20.5%] vs EVAR, 20.5% [95% CI, 18.9%-22.1%]; P = .35) were detected. Conclusions and Relevance In this cohort study of 6891 patients with AAA, OSR was associated with higher perioperative mortality in all risk groups, but with longer mean survival only in low-risk patients. Conversely, EVAR was associated with longer mean survival in moderate-to-high-risk patients. These findings highlight the potential benefits of risk stratification when planning AAA treatment.
Reporting of Noninferiority Margins on ClinicalTrials.gov
Authors: Camille Reinaud, Sandra Mavoungou, David Hajage, Chloé Lieng, Deivanes Rajendrabose, Diane Ferreira, Jules Blanchard, Agathe Turpin, Agnès Dechartres
Journal: JAMA Network Open (2025)

Importance The noninferiority margin is a key methodological parameter in noninferiority trials that affects both sample size calculation and interpretation of results. Objective To assess (1) the reporting of the noninferiority margin on ClinicalTrials.gov, including when it was reported; (2) the consistency of the noninferiority margin between registration and publication; and (3) the reporting of the noninferiority margin at registration in a sample of recent trials. Evidence Review This systematic review was conducted in 2 stages. Stage 1 involved identifying all noninferiority trials registered on ClinicalTrials.gov with a primary completion date of January 1, 2010, to January 1, 2015, and searching for corresponding publications. Stage 2 included all noninferiority trials registered between January 1, 2022, and June 30, 2023. Two reviewers independently and manually extracted methodological characteristics related to the noninferiority design for each trial at registration and, when available, in results posted on ClinicalTrials.gov and in publications. The time points for reporting the noninferiority margin were at registration, during the patient enrollment phase (between start date and primary completion date), after the primary completion date, or in results posted. Findings Among the 266 trials completed between 2010 and 2015, only 8 (3.0%) reported the noninferiority margin at registration. The noninferiority margin was reported after registration for 31 of 266 trials (11.7%), with 11 (4.1%) reporting it during the patient enrollment phase and 20 (7.5%) reporting it after the primary completion date. Of the 132 trials with results posted on ClinicalTrials.gov, 79 (59.8%) reported the noninferiority margin. A corresponding publication was found for 208 trials, with 196 (94.2%) reporting the noninferiority margin. For 5 trials reporting the margin at both registration and in publication, the noninferiority margin was consistent in both sources. Among the 327 noninferiority trials first posted between 2022 and 2023, 30 (9.2%) reported the noninferiority margin at registration. Conclusions and Relevance In this systematic review, the reporting of the noninferiority margin on ClinicalTrials.gov was low. Mandatory reporting of the design and the noninferiority margin at registration could enhance the transparency and favor more reliable results.
Cardioprotective Glucose-Lowering Agents and Dementia Risk
Authors: Allie Seminer, Alfredi Mulihano, Clare O’Brien, Finn Krewer, Maria Costello, Conor Judge, Martin O’Donnell, Catriona Reddin
Journal: JAMA Neurology (2025)

Importance Although diabetes is a risk factor for dementia, the effect of glucose-lowering therapy for prevention of incident dementia is uncertain. Objective To determine whether cardioprotective glucose-lowering therapy (sodium-glucose cotransporter-2 inhibitors [SGLT2is], glucagon-like peptide-1 receptor agonists [GLP-1RAs], metformin, and pioglitazone), compared with controls, was associated with a reduction in risk of dementia or cognitive impairment, and among primary dementia subtypes. Data Sources The PubMed and Embase databases were searched for studies published from inception of the database to July 11, 2024. Study Selection Randomized clinical trials comparing cardioprotective glucose-lowering therapy with controls that reported dementia or change in cognitive scores. Cardioprotective glucose-lowering therapies were defined as drug classes recommended by guidelines for reduction of cardiovascular events, based on evidence from phase III randomized clinical trials. Inclusion criteria were assessed independently and inconsistencies were resolved by consensus. Data Extraction and Synthesis Data were screened and extracted independently by 2 authors adhering to the PRISMA guidelines in August 2024. Random-effects meta-analysis models were used to estimate a pooled treatment effect. Main Outcomes and Measures The primary outcome measure was dementia or cognitive impairment. The secondary outcomes were primary dementia subtypes, including vascular and Alzheimer dementia, and change in cognitive scores. Results Twenty-six randomized clinical trials were eligible for inclusion (N = 164 531 participants), of which 23 trials (n = 160 191 participants) reported the incidence of dementia or cognitive impairment, including 12 trials evaluating SGLT2is, 10 trials evaluating GLP-1RAs, and 1 trial evaluating pioglitazone (no trials of metformin were identified). The mean (SD) age of trial participants was 64.4 (3.5) years and 57 470 (34.9%) were women. Overall, cardioprotective glucose-lowering therapy was not significantly associated with a reduction in cognitive impairment or dementia (odds ratio [OR], 0.83 [95% CI, 0.60-1.14]). Among drug classes, GLP-1RAs were associated with a statistically significant reduction in dementia (OR, 0.55 [95% CI, 0.35-0.86]), but not SGLT2is (OR, 1.20 [95% CI, 0.67-2.17]; P value for heterogeneity = .04). Conclusions and Relevance While cardioprotective glucose-lowering therapies were not associated with an overall reduction in all-cause dementia, this meta-analysis of randomized clinical trials found that glucose lowering with GLP-1RAs was associated with a statistically significant reduction in all-cause dementia.
Biomimetic Glycosaminoglycan‐Analog Hydrogel for Improved Embolization of Aneurysms: Environment‐Selective Swelling
Authors: Sarit S. Sivan, Iris Bonshtein, Maria Khoury, Yevgeniy Kreinin, Dmitry Korneyev, Tirosh Mekler, Sumaya Kaiyal, Iris Sonia Weitz, Netanel Korin
Journal: Advanced Healthcare Materials (2025)

Abstract Injectable hydrogels are promising biomaterials for treating aneurysms, life‐threatening blood‐filled saccular lesions, enabling complete filling of the aneurysm and supporting tissue repair. Yet, the challenge is to enable clinical translation as hydrogels must not protrude into the parent vessel, nor migrate from the aneurysm cavity. Here, injectable, negatively‐charged, biologically and mechanically compatible hydrogels with environment‐sensitive swelling capabilities that cease swelling upon contact with blood are developed. Hydrogels are fabricated by copolymerizing sodium 2‐acrylamido‐2‐methylpropanesulfonic acid (NaAMPS) and 3‐sulfopropyl acrylate (KSPA) by using polyethylene glycol diacrylate (PEGDA). Three formulations (2%, 4%, and 6%) demonstrating a wide range of physiological‐relevant stiffnesses are fabricated. The selected mechano‐compatible 4% hydrogel exhibits a suitable swelling pressure (125 kPa) and supports high endothelial cell viability (&gt; 75%). Importantly, the hydrogel demonstrates a significant differential swell with respect to blood (30 ± 4%), plasma (58 ± 3%), and PBS (82 ± 2%). This environment‐selective swelling, upon exposure to blood, results in minimal directional swelling toward the parent artery, which can improve embolization outcomes. Hydrogel embolization in 3D‐printed aneurysm models subjected to physiological blood flow shows no protrusion toward the main artery while completely blocking flow into the aneurysm. This approach provides promising opportunities for efficient embolization of a variety of aneurysms and vascular malformations.
Vaccine‐Induced Anti‐<scp>IgE</scp> Antibodies Neutralize Free <scp>IgE</scp> but Fail to Bind and Activate <scp>Mast Cell</scp>‐Displayed <scp>IgE</scp>
Authors: Zahra Gharailoo, Monique Vogel, Paul Engeroff, Martin F. Bachmann
Journal: Allergy (2025)

ABSTRACT Background In Type I hypersensitivity, IgE is the antibody that contributes to the onset of anaphylaxis through the activation of effector cells, causing the release of allergic mediators. Blocking IgE activity with anti‐IgE autoantibodies induced by active immunization could potentially offer an efficient and cost‐effective method to treat allergic disorders. We recently developed an effective and safe anti‐IgE vaccine in mice, but the mechanisms by which the vaccine protects and the explanation for its safety remained largely unknown. Here, our objective was to better understand those mechanisms. Methods CuMV TT ‐Cε3‐Cε4 is a virus‐like particles (VLP)‐based vaccine designed to target domains 3 and 4 of IgE. Here, we studied the role of FcγRIIb and CD23 in vaccine‐mediated protection from allergy using FcγRIIb KO and CD23 KO mice. Moreover, vaccine‐induced IgGs were purified for passive immunization studies and for in vitro experiments with murine bone marrow‐derived mast cells (BMMCs). Results Immunized mice generated high titers of IgG antibodies specific for IgE that conferred protection against allergic responses, independently of FcγRIIb and CD23. Sera of immunized mice blocked IgE binding to BMMC FcεRI and suppressed degranulation, independent of FcγRIIb. Purified anti‐IgE antibodies did not provoke an anaphylactic response when transferred into allergic mice but protected against subsequent allergen challenge. Interestingly, the purified IgG antibodies were unable to recognize receptor‐bound IgE in BMMCs, explained by the finding that recognition by these anti‐IgEs depends on the same mannose moieties on IgE that are essential for FcεRI binding and thus hidden when receptor‐bound. Conclusions In conclusion, the CuMV TT ‐Cε3‐Cε4 vaccine induces high titers of anti‐IgE IgGs that confer protection by neutralizing IgE through its glycan epitopes, without causing FcεRI cross‐linking. Our results imply that an anti‐IgE vaccine may represent a promising therapeutic strategy, offering effective protection while minimizing the risk of adverse reactions similar to the monoclonal antibody omalizumab.
Hospital Addiction Consultation Service and Opioid Use Disorder Treatment
Authors: Allison J. Ober, Cristina Murray-Krezan, Kimberly Page, Peter D. Friedmann, Jess Anderson, Karen Chan Osilla, Stephen Ryzewicz, Sergio Huerta, Mia W. Mazer, Randall A. Hoskinson, Richard Garvey, Alexandra Peltz, Katherine E. Watkins, Teryl Nuckols, Waguih William IsHak, Louis T. Mariano, Itai Danovitch
Journal: JAMA Internal Medicine (2025)

Importance Medications for opioid use disorder (MOUD) are effective, but hospitalized people with opioid use disorder (OUD) seldom receive MOUD while in the hospital or link with treatment after. Objective To test whether an addiction-focused consultation service, the Substance Use Treatment and Recovery Team (START), increases MOUD initiation during hospitalization and linkage to follow-up care after discharge. Design, Setting, and Participants This 1:1 randomized clinical trial grouped participants into the START intervention or usual care. The study was conducted between November 2021 and September 2023 at 3 hospitals in the following cities: Los Angeles, California; Albuquerque, New Mexico; and Springfield, Massachusetts. The last follow-up was in December 2023. Eligible individuals were 18 years and older and met criteria for OUD. Intervention START consists of an addiction medicine specialist and a care manager delivering a motivational and addiction-focused discharge planning intervention and follow-up calls. Main Outcomes and Measures Primary outcomes were the proportions of patients (1) initiating MOUD (naltrexone, buprenorphine, or methadone) during hospitalization (per electronic medical record data) and (2) successfully linking to OUD treatment within 30 days after discharge (per patient self-report). Results A total of 325 were consented and randomized to START (n = 164) or usual care (n = 161). Median (IQR) age was 41.0 (32.0-50.0) years. A total of 213 participants (65.5%) were male at birth, 28 (8.6%) were American Indian or Alaska Native, 21 (6.5%) were Black, 156 (48.0%) were Hispanic, and 125 (38.5%) were White. More than half, 175 (53.8%), were unhoused in the past year, and 163 (50.2%) were unemployed. START participants were more likely than usual care participants to initiate MOUD during hospitalization (94/164 [57.3%] vs 43/161 [26.7%], respectively; adjusted risk ratio [aRR], 2.10 [97.5% CI, 1.51-2.91]) and to link to OUD care after discharge (90/125 [72.0%] vs 50/104 [48.1%], respectively; aRR, 1.49 [97.5% CI, 1.15-1.93]). Conclusions and Relevance By addressing gaps in inpatient care, the hospital-based addiction-focused consultation service presented in this randomized clinical trial improved receipt of evidence-based treatment for people with OUD in the hospital and linkage to treatment after discharge. Trial registration ClinicalTrials.gov Identifier: NCT05086796
Correction to: Integrative Multiomics in the Lung Reveals a Protective Role of Asporin in Pulmonary Arterial Hypertension
Authors: Jason Hong, Lejla Medzikovic, Wasila Sun, Brenda Wong, Grégoire Ruffenach, Christopher J. Rhodes, Adam Brownstein, Lloyd L. Liang, Laila Aryan, Min Li, Arjun Vadgama, Zeyneb Kurt, Tae-Hwi Schwantes-An, Elizabeth A. Mickler, Stefan Gräf, Mélanie Eyries, Katie A. Lutz, Michael W. Pauciulo, Richard C. Trembath, Frédéric Perros, David Montani, Nicholas W. Morrell, Florent Soubrier, Martin R. Wilkins, William C. Nichols, Micheala A. Aldred, Ankit A. Desai, David-Alexandre Trégouët, Soban Umar, Rajan Saggar, Richard Channick, Rubin M. Tuder, Mark W. Geraci, Robert S. Stearman, Xia Yang, Mansoureh Eghbali
Journal: Circulation (2025)
Correction to: Principles for the Future of Biomedical Research in the United States and Optimizing the National Institutes of Health: A Presidential Advisory From the American Heart Association
Authors: Joseph C. Wu, Donna K. Arnett, Ivor J. Benjamin, Mark A. Creager, Robert A. Harrington, Joseph A. Hill, P. Michael Ho, Steven R. Houser, Stephanie Scarmo, Svati H. Shah, Gordon F. Tomaselli
Journal: Circulation (2025)