tbuckley/cabot-search huggingface dataset:
Empagliflozin in Patients With Type 2 Diabetes Undergoing On-Pump CABG: The POST-CABGDM Randomized Clinical Trial
Authors: Fabio Grunspun Pitta, Eduardo Gomes Lima, Caio Assis Moura Tavares, Eduardo Bello Martins, Fabiana Hanna Rached, Eduardo Martelli Moreira, Bruno Mahler Mioto, Simão Augusto Lottenberg, Paula Mathias Paulino Bolta, Larissa Gonçalves Justino, Desiderio Favarato, Letícia Neves Solon Carvalho, Henrique Trombini Pinesi, Camila Talita Machado Barbosa, Luís Alberto Oliveira Dallan, Luís Roberto Palma Dallan, Marcelo Henrique Moreira Barbosa, Roberto Kalil Filho, James A. de Lemos, Carlos Vicente Serrano
Journal: Diabetes Care (2025)

OBJECTIVE To evaluate the efficacy and safety of empagliflozin in patients with type 2 diabetes mellitus (T2DM) undergoing elective on-pump coronary artery bypass grafting (CABG). RESEARCH DESIGN AND METHODS Investigator-initiated, pragmatic, single-center, randomized, open-label trial with blinded outcome adjudication conducted in Brazil. A total of 145 patients with T2DM scheduled for elective on-pump CABG were randomized to receive empagliflozin 25 mg daily plus standard care (n = 71) for at least 3 months, which was discontinued 72 h before surgery, or to received standard care alone (n = 74). The primary outcome was postoperative acute kidney injury (AKI) within 7 days of surgery, defined by creatinine-based criteria (namely, Acute Kidney Injury Network; Risk, Injury, Failure, Loss of Kidney Function, and End-Stage Kidney Disease; or Kidney Disease: Improving Global Outcomes). Secondary outcomes included 30-day postoperative atrial fibrillation and type 5 myocardial infarction (MI). Safety outcomes were ketoacidosis, urinary tract infection, hospital-acquired pneumonia, and wound infection within 30 days after CABG. RESULTS AKI occurred in 22.5% of the empagliflozin group vs. 39.1% in the control group (relative risk [RR] 0.57 [95% CI 0.34–0.96]; P = 0.03). Rates of atrial fibrillation (15.4% vs. 13.5%; RR 1.15 [95% CI 0.52–2.53]; P = 0.73) and type 5 MI (1.4% vs. 4.1%; RR 0.35 [95% CI 0.04–3.26]; P = 0.62) were similar between groups. No statistically significant differences between groups were observed for safety events. Three deaths occurred, all in the control group. CONCLUSIONS Empagliflozin use before on-pump CABG in patients with T2DM was associated with a reduced incidence of postoperative AKI without an increase in safety events. These findings warrant confirmation in larger clinical trials.
Update on Surveillance in Von Hippel–Lindau Disease
Authors: Surya P. Rednam, Kerri D. Becktell, Anita Villani, Garrett M. Brodeur, Lisa J. States, Andrea S. Doria, Junne Kamihara, Kami Wolfe. Schneider, Stephan D. Voss, Elysa Widjaja, Kristin Zelley, Yoshiko Nakano, Kristian W. Pajtler, Maria Isabel Achatz, David Malkin, Lisa R. Diller, Bailey Gallinger, Chieko Tamura, Jonathan D. Wasserman
Journal: Clinical Cancer Research (2025)

Abstract Von Hippel-Lindau disease (VHL) is a genetic condition characterized by a high lifetime risk for tumors and cysts throughout the body including the central nervous system, visual-auditory systems, and intra-abdominal organs. This neoplasia leads to significant morbidity and potential mortality in affected individuals. Tumor surveillance enables early intervention and leads to improved clinical outcomes. Since the 2017 publication of VHL tumor surveillance recommendations from the inaugural AACR Childhood Cancer Predisposition Workshop, several other groups have proposed alternative consensus surveillance recommendations. Although these screening paradigms share some common elements, they also deviate from each other in some substantial ways. Clinical data continues to accrue in VHL, allowing the condition to be better characterized. Furthermore, surgical techniques have improved over time, and the option of targeted medical therapy has emerged for individuals with VHL. It is critical that surveillance strategies continue to be refined. In this perspective, we provide an up-to-date clinical overview of VHL, describe recently proposed tumor screening regimens, and finally present our updated consensus tumor surveillance recommendations during childhood and adolescence from the 2023 AACR Childhood Cancer Predisposition Workshop.
Social Risk at Individual vs Neighborhood Levels and Health Care Use in Medicaid Enrollees
Authors: Margae J. Knox, Emma L. Tucher, Chris Miller-Rosales, Jodi McCloskey, Richard W. Grant, Esti Iturralde
Journal: JAMA Network Open (2025)

Importance Health-related social risks are increasingly recognized as important contributors to health. Compared with individual screening, neighborhood measures are potentially a lower cost, scalable strategy for identifying social risk. Objective To inform health resource planning and social risk screening strategies by comparing self-reported vs neighborhood-level social risk with inpatient, emergency department (ED), and outpatient care. Design, Setting, and Participants A cross-sectional analysis of self-reported social risks measured during Medicaid enrollment and neighborhood-level social risk in relation to health care use was conducted. Members of Kaiser Permanente Northern California, a large integrated health care delivery system, who completed the Medicaid Integrated Outcomes Questionnaire from January 1, 2018, to February 29, 2020, were included. Analysis took place from January 8 to November 29, 2024. Exposure Neighborhood-level social risk (living in the least-resourced Neighborhood Deprivation Index quartile) and self-reported social risk (indicating a need or wanting help with finances, food, housing, or transportation domains). Main Outcomes and Measures Hospital and ED admissions, primary care, specialty care, mental health, and social work visits in the year prior to questionnaire completion. Multivariable negative binomial regression models were analyzed for each type of health care use, controlling for demographic characteristics and several health conditions (eg, asthma, hypertension, and chronic pain). Results Among 13 527 respondents (8631 [63.8%] female; 5289 [39.1%] aged 25-44 years; 2846 [21.0%] Asian, 1986 [14.7%] Black or African American, 3040 [22.5%] Hispanic, 4602 [34.0%] White, and 1053 [7.8%] other race or ethnicity), 33.8% in the most-resourced neighborhood reported at least 1 social risk vs 40.1% in the least-resourced quartile ( P &amp;amp;lt; .001). Individual- and neighborhood-level measures were each associated with ED visits (marginal effect estimate for both measures: 0.23; 95% CI, 0.17-0.29). Neither measure was associated with hospital admissions. Individual risk was associated with greater use of all outpatient services (ranging from primary care visit marginal effect estimate: 0.22; 95% CI, 0.13-0.31 to mental health visit marginal effect estimate: 1.21; 95% CI, 0.67-1.75). Neighborhood-level risk was not associated with most outpatient visits and was negatively associated with mental health visits. Conclusions and Relevance In this cross-sectional study, associations were found for hospital and ED use but not outpatient visits, especially mental health visits. These findings suggest that individual social risk screening appears to provide distinct information compared with neighborhood social risk.
Management of T‐cell malignancies: Bench‐to‐bedside targeting of epigenetic biology
Authors: Ariana Sabzevari, Johnson Ung, Jeffrey W. Craig, Kallesh D. Jayappa, Ipsita Pal, David J. Feith, Thomas P. Loughran, Owen A. O’Connor
Journal: CA A Cancer Journal for Clinicians (2025)

Abstract The peripheral T‐cell lymphomas (PTCL) are the only disease for which four histone deacetylase (HDAC) inhibitors have been approved globally as single agents. Although it is not clear why the PTCL exhibit such a vulnerability to these drugs, understanding the biological basis for this activity is essential. Many lines of data have established that the PTCL exhibit marked sensitivity to other epigenetically targeted drugs, including EZH2 and DNMT3 (DNA‐methyltransferase 3) inhibitors. Even more compelling is the finding that combinations of drugs targeting the epigenetic biology of PTCL are beginning to produce provocative data, leading some to wonder if these agents can replace historical chemotherapy regimens routinely used for patients with the disease. Simultaneously, the field has identified a spectrum of mutations in genes governing epigenetic biology in many subtypes of PTCL, although the T follicular helper lymphomas, including angioimmunoblastic T‐cell lymphoma, appear to be particularly enriched for these genetic features. While the direct relationship between the presence of any one of these mutations and responsiveness to a particular epigenetic drug has yet to be established, it is increasingly accepted that the PTCL may be the prototypical epigenetic disease as no other form of cancer has exhibited such a vulnerability to this diversity of epigenetically targeted agents. Herein, we comprehensively review this esoteric and rapidly evolving field to identify themes and lessons from these experiences that may guide efforts to improve outcomes of patients with T‐cell neoplasms. Furthermore, we will discuss how these concepts might be applied to the broader field of cancer medicine.
Research Derived From Medicare’s Coverage With Evidence Development Program
Authors: Guneet S. Janda, Osman Moneer, Maryam Mooghali, Reshma Ramachandran, Joshua D. Wallach, Sanket S. Dhruva, Joseph S. Ross
Journal: JAMA Network Open (2025)

This cross-sectional study assesses published research articles about medical items and services approved by the Coverage With Evidence Development program to characterize their scientific impact.
Screening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer
Authors: Sida Huang, Sarah J. Westvold, Pamela R. Soulos, Jane Fan, Eric P. Winer, Haiying Zhan, Maryam B. Lustberg, John Lewin, Timothy J. Robinson, Michaela A. Dinan
Journal: JAMA Network Open (2025)

Importance Screening mammography promotes early detection of breast cancer and is associated with reduced breast cancer mortality. Screening history prior to diagnosis may impact stage at diagnosis and breast cancer mortality but has not been comprehensively examined within a diverse US cohort. Objective To determine whether having a prior screening is associated with earlier stage at breast cancer diagnosis and lower breast cancer–specific mortality. Design, Setting, and Participants This cohort study used linked Surveillance, Epidemiology, and End Results–Medicare data of women aged at least 70 years, diagnosed with estrogen receptor–positive or human epidermal growth factor receptor 2–negative breast cancer from 2010 to 2017, and enrolled in fee-for-service Medicare Parts A and B from 5 years prior to through 1 year after diagnosis. Data were analyzed from March 1 to September 18, 2024. Exposure Presence of 1 or more screening mammograms during the 5 years prior to the mammogram at breast cancer diagnosis. Main Outcomes and Measures Outcomes of interest were stage of breast cancer at diagnosis, dichotomized into very early (T1N0) vs later stage (T2+ or N1+) and breast cancer–specific mortality. Results Among 13 028 included women, most had at least 1 prior screening (10 094 women [77.5%]) and were aged between 70 and 79 years (9034 women [69.4%]) and not dual-eligible for Medicare and Medicaid (11 475 women [88.1%]). Additionally, 3812 women (29.3%) were diagnosed with later-stage disease (T2+ or N1+) at the time of diagnosis. In multivariable analyses, prior screening was associated with 54% lower odds of later-stage breast cancer diagnosis (adjusted odds ratio, 0.46; 95% CI, 0.42-0.50) and 36% lower hazard of breast cancer–specific death (adjusted hazard ratio, 0.63; 95% CI, 0.52-0.76) compared with no prior screenin. In the adjusted Cox proportional hazards model, having 3 or 4 prior screenings was associated with 37% reduced hazard of breast cancer–specific mortality compared with having 1 prior screening (adjusted hazard ratio, 0.63; 95% CI, 0.44-0.89). Conclusions and Relevance In this cohort study of older women with screen-detected estrogen receptor–positive or human epidermal growth factor receptor 2–negative breast cancer, prior screening mammography was associated with earlier stage at breast cancer diagnosis and lower breast cancer mortality. These findings support the potential for routine screening to improve breast cancer outcomes. As with all observational studies, this study is limited by the potential effects of other differences between the screening and nonscreening groups.
Plastic Waste and COVID-19 Incidence Among Hospital Staff After Deescalation in PPE Use
Authors: Stephanie Sutjipto, Aung Hein Aung, Margaret M. L. Soon, Chen Jing, Brenda S. P. Ang, Sapna P. Sadarangani, Kai Wei Chong, Oon Tek Ng, Kalisvar Marimuthu, Wei Yen Lim, Angela Chow, Shawn Vasoo
Journal: JAMA Network Open (2025)

Importance In September 2023, the Singapore Ministry of Health revised the national personal protective equipment (PPE) guideline for health care personnel (HCP) attending to suspected or confirmed patients with COVID-19, recommending the use of N95 respirators alone. However, data on the associations between PPE deescalation, staff COVID-19 incidence, and sustainability outcomes are limited. Objective To evaluate the associations between PPE deescalation guidelines on staff COVID-19 incidence and the environmental sustainability outcomes of the measure. Design, Setting, and Participants This was a retrospective quality improvement study of hospital PPE usage using data from Tan Tock Seng Hospital and the National Centre for Infectious Diseases (NCID), analyzing monthly COVID-19 incidence rates among HCP (all medical staff, allied health care workers, ancillary staff, and administrative staff from the hospital campus) and in the community over 12 months before and after PPE deescalation measures (October 2021 to September 2022 and October 2022 to September 2023). Main Outcomes and Measures COVID-19 incidence rates among HCP and in the community; economic and environmental outcomes of removing single-use gowns from routine COVID-19 care, including reductions in carbon footprint, plastic waste generation, and cost savings. Results The mean (SD) monthly number of HCP was 10 774 (79) (range, 10 636-10 891) preimplementation and 11 099 (200) (range, 10 864-11 449) postimplementation. Our analysis revealed PPE deescalation was not associated with an increase in monthly COVID-19 infections among hospital staff, with the trends aligning with population infection rates. The median (IQR) staff COVID-19 infection rate relative to the community COVID-19 infection rate was 2.6 (1.9-3.6) preimplementation compared with 1.5 (0.9-3.1) postimplementation. An estimated 4 gowns per patient-day were saved, totaling 440 532 gowns over 12 months. This equated to an estimated reduction in health care costs by SGD 453 748 (approximately USD 333 970) and reductions of 398 681.46 kg carbon dioxide equivalent in carbon emissions and 66 080 kg of plastic waste. Conclusions and Relevance This quality improvement study of hospital PPE usage observed that the national PPE deescalation guidelines corresponded with the reductions in protective gown use, associated costs, carbon footprint, and plastic waste generation with no apparent compromise to staff safety and health.
Camaraderie Among US Veterans and Their Preferences for Health Care Systems and Practitioners
Authors: Kevin Vigilante, Sonja V. Batten, Qingkun Shang, Shiping Zhang, Wenshu Li, Regina Little, Paula P. Schnurr, Kenneth W. Kizer
Journal: JAMA Network Open (2025)

Importance Unlike convenience, cost, and quality, camaraderie with other similar patients has not been reported as a prominent patient consideration when choosing a health care system or practitioner. As the Veterans Affairs (VA) Health System expands choice of practitioners for its enrollees, it is important to identify ways to promote veteran camaraderie in community care settings. Objective To determine whether camaraderie with other veterans is important to veterans using the VA Health System. Design, Setting, and Participants In 2019, a web-based survey was administered to veterans who reported using VA health care. The survey included questions about cultural factors, such as camaraderie, practitioners’ understanding of veterans, trust of VA caregivers, and a scenario-based question to ascertain whether veterans would choose VA or private health care if cost and distance were equivalent. Data analysis was performed from November 2024 to January 2025. Exposure Using the VA health care system. Main Outcomes and Measures The primary outcome was the importance of camaraderie in selecting a health care system or practitioner, measured as the percentage of veterans who reported positive ratings on relevant survey items. Results In this survey study of 652 veterans, the majority were male (486 veterans [74.54%]). Respondents were categorized into 3 age groups: 18 to 34 years (246 veterans [37.73%]), 35 to 64 years (320 veterans [49.08%]), and 65 years and older (86 veterans [13.19%]). In total, 52.41% of respondents rated camaraderie and being around other veterans as important; this increased to 75.88% among veterans aged 18 to 34 years and to 65.35% for those aged 35 to 64 years. For those aged 65 years and older, only 35.75% felt it was important. When asked whether they would choose VA or a private sector health system if cost and travel distance were equal, 69.00% of respondents indicated they would choose VA. The risk-adjusted model demonstrated those who valued being around veterans at VA were 2.24 times more likely (95% CI, 1.81-2.77) to choose VA. Conclusions and Relevance In this survey study of 652 veterans, camaraderie was important to most of these VA Health System users, especially younger veterans. As VA provides more choice of practitioners to its enrollees, it will be important to consider ways to preserve veterans’ ability to affiliate with other veterans in community care settings, especially for younger veterans who are often challenged in transitioning from military service to civilian life.
The current landscape of gastric cancer and gastroesophageal junction cancer diagnosis and treatment in China: a comprehensive nationwide cohort analysis
Authors: Yang Chen, Keren Jia, Yi Xie, Jiajia Yuan, Dan Liu, Lei Jiang, Haoxin Peng, Jia Zhong, Jian Li, Xiaotian Zhang, Lin Shen
Journal: Journal of Hematology & Oncology (2025)

Gastric cancer is the fifth most common cancer globally and is associated with significant morbidity and mortality. Despite its alarming prevalence, limited comparative evidence exists on its treatment efficacy and prognosis across diverse China populations. To address this, our study used a large-scale dataset from the National Cancer Information Database, including data from 220,304 patients from 53 leading hospitals across 27 provinces in China. From 2017 to 2023, early-stage (Stages I-II) gastric cancer diagnoses increased to 35.63% of all cancer cases. Our study evaluated the neoadjuvant treatment strategies, adjuvant post-operative therapy, first- and second-line management for progressive stages, alongside current gastric cancer treatment guidelines in China. Notably, immunotherapy accounted for 16.17% and 23.28% of first- and second-line treatments for late-stage gastric cancers, and 14.56% and 5.00% for neoadjuvant and adjuvant therapies, respectively. Analysis of survival rates revealed that the 1-, 2-, 3-, 4-, and 5-year survival rates were 74.07%, 54.89%, 44.21%, 37.97%, and 33.53%, respectively. The 5-year survival rates across stages I-IV were 85.07%, 49.34%, 35.56%, and 13.15%, respectively. These findings offer critical insights into the current state of gastric cancer treatment in China and can inform future initiatives to improve therapeutic outcomes for patients with gastric cancer.
Rurality and Area Deprivation and Outcomes After Out-of-Hospital Cardiac Arrest
Authors: Lakota Cheek, Robert H. Schmicker, Remle Crowe, Emily Goren, Amanda West, Jason McMullan, Colin Raelson, Jeanne Poole, Karen Adams, Antje Hoering, Brent Myers, Graham Nichol
Journal: JAMA Network Open (2025)

Importance Large regional variations in outcomes after out-of-hospital cardiac arrest (OHCA) exist. Objective To assess whether neighborhood rurality or economic deprivation where an OHCA occurred is associated with variation in emergency medical services (EMS) outcomes after OHCA. Design, Setting, and Participants This cohort study used data collated by ESO Inc on US adult patients (aged ≥18 years) with nontraumatic OHCA receiving chest compressions or defibrillation from EMS between January 1, 2022, and December 31, 2023. Exposures Rurality was assessed using Rural-Urban Commuting Area codes. Deprivation was assessed using the Area Deprivation Index. Both were derived from US Census data and grouped by EMS agency. Main Outcomes and Measures Outcomes were restoration of spontaneous circulation (ROSC) at emergency department (ED) arrival, survival to hospital discharge, and favorable discharge destination. Discharge outcomes were only available for patients transported to hospitals using health data exchange. Generalized estimating equations were used to account for correlated data. Results A total of 162 289 patients with OHCA had resuscitation attempted (median [IQR] age, 66 [53-76] years; 62.3% male). Overall, 28.1% of these patients lived in rural or suburban locations, 12.3% lived in areas with high deprivation, 18.7% had a first rhythm of ventricular tachycardia or ventricular fibrillation or shockable by automated external defibrillator rhythm, and 27.6% received bystander cardiopulmonary resuscitation. The mean (SD) EMS response time was 8.7 (5.6) minutes. Upon arrival at the ED, 23.7% of patients had ROSC. Compared with OHCAs in urban areas with low deprivation, those in rural areas with high deprivation (adjusted odds ratio [AOR], 0.81; 95% CI, 0.72-0.91), moderate deprivation (AOR, 0.75; 95% CI, 0.70-0.81), or low deprivation (AOR, 0.74; 95% CI, 0.62-0.88) had lower odds of ROSC at ED arrival. Among patients transported to hospitals using health data exchange, OHCAs in urban areas with high or moderate deprivation had lower odds of survival (AOR, 0.78 [95% CI, 0.68-0.90] and 0.82 [95% CI, 0.75-0.89], respectively) and favorable discharge destination (AOR, 0.65 [95% CI, 0.53-0.79] and 0.77 [95% CI, 0.69-0.87], respectively). Conclusions and Relevance In this cohort study, OHCAs in rural areas of all levels of economic deprivation were associated with less ROSC at ED arrival vs urban areas with low deprivation, and OHCAs in urban areas with high or moderate deprivation are associated with less survival and less favorable discharge destination, suggesting worse neurologic outcomes. Care improvements alone may not reduce geographic differences in outcomes after OHCA.
Treatment of IL-18-binding protein biologics suppresses fibrotic progression in metabolic dysfunction-associated steatohepatitis
Authors: Dong-Hyun Kim, Gona Choi, Eun-Bi Song, Hanna Lee, Jaehui Kim, Young-Saeng Jang, JinJoo Park, Susan Chi, Jaekyu Han, Sun-Mi Kim, Dongyoon Kim, Soo Han Bae, Hye Won Lee, Jun Yong Park, Seung Goo Kang, Sang-Hoon Cha, Yong-Hyun Han
Journal: Cell Reports Medicine (2025)
A ROS-Responsive Nanoparticle for Nuclear Gene Delivery and Autophagy Restoration in Parkinson's Disease Therapy
Authors: Limin Zhai, Yifei Gao, Hao Yang, Haoyuan Wang, Beining Liao, Yuxue Cheng, Chao Liu, Jingfeng Che, Kunwen Xia, Lingkun Zhang, Yanqing Guan
Journal: Biomaterials (2025)
Specific macrophage RhoA targeting CRISPR-Cas9 for mitigating osteoclastogenesis-induced joint damage in inflammatory arthritis
Authors: Jianhai Chen, Jianwei Tan, Nannan Wang, Hui Li, Wenxiang Cheng, Jian Li, Benguo Wang, Adam C Sedgwick, Zhitong Chen, Guojun Chen, Peng Zhang, Wei Zheng, Chengbo Liu, Jingqin Chen
Journal: Cell Reports Medicine (2025)