tbuckley/cabot-search huggingface dataset:
Abstract MP68: Association of Clinical and Subclinical Blood Pressure Elevation During Pregnancy With Maternal Health and Risk of Neonatal Low Birth Weight
Authors: Jie Hu, Jun Li, Yang Peng, Yuanyuan Li
Journal: Circulation (2018)

Introduction: Gestational hypertension is a leading cause of maternal mortality and fetal growth restriction (FGR). However, elevated maternal blood pressure at which trimester contributes to FGR is unknown, and whether gestational prehypertension (a systolic blood pressure [SBP] of 120 - 139 mmHg or a diastolic blood pressure [DBP] of 80 - 89 mmHg) is related with FGR and maternal health is not fully studied. Methods: We analyzed the relation of elevated gestational blood pressure with risk of neonatal low-birth-weight (LBW, birth weight &lt; 2,500 g) and maternal health throughout pregnancy in 21,620 women from a birth cohort in Wuhan, China. Maternal health indicators, including SBP and DBP, were clinically measured during up to 22 antenatal visits. LBW were acquired from medical records. Linear mixed models were used to evaluate the relations of maternal SBP and DBP with LBW. Logistic regressions were used to assess the associations of SBP and DBP in late pregnancy (38.3 weeks) with LBW. Linear regressions were used to evaluate the association of prehypertension/hypertension with indicators of maternal health. Results: Gestational blood pressure increases throughout pregnancy, but a significant elevation of SBP and DBP between 15 and 25 gestational weeks were only observed for women who later delivered LBW newborns. High gestational SBP (≥ 140 mmHg) or DBP (≥ 90 mmHg) was associated with a 220% or 98% higher risk of LBW ( P &lt; 0.03). Notably, preclinical high SBP (120 - 139 mmHg) was also associated with a 40% higher risk of LBW ( P = 0.036). At late pregnancy, elevated gestational SBP and DBP were associated with elevated liver enzymes, blood urea nitrogen, creatinine, and uric acid levels, and decreased activated partial thromboplastin time and prothrombin time. Conclusions: A fast blood pressure elevation in the second trimester may relate with increased risk of LBW. Pregnancy prehypertension was associated with not only LBW risk, but also impaired maternal liver, kidney, and coagulation functions.
Folk-economic beliefs as moral intuitions
Authors: Neil Malhotra
Journal: Behavioral and Brain Sciences (2018)

Abstract Although Boyer &amp; Petersen's (B&amp;P's) cataloguing of and evolutionary explanations for folk-economic beliefs is important and valuable, the authors fail to connect their theories to existing explanations for why people do not think like economists. For instance, people often have moral intuitions akin to principles of fairness and justice that conflict with utilitarian approaches to resource allocation.
Abstract 16158: A Novel Integrated Electrocardiographic Algorithm for Differentiation of Regular Wide QRS Complex Tachycardia
Authors: Federico Moccetti, Mrinal Yadava, Nikola Pavlovic, Sven Knecht, Aline Mühl, Michael Kühne, Beat Schär, Beat Kaufmann, Stefan Osswald, Charles Henrikson, Christian Sticherling, Tobias Reichlin
Journal: Circulation (2016)

Background: The differentiation of regular, wide QRS-complex tachycardia (WCT) into ventricular tachycardia (VT) or supraventricular tachycardia with aberrant conduction (SVT-AC) is an important di...
Longitudinal Liquid Biopsy and Mathematical Modeling of Clonal Evolution Forecast Time to Treatment Failure in the PROSPECT-C Phase II Colorectal Cancer Clinical Trial
Authors: Khurum H. Khan, David Cunningham, Benjamin Werner, Georgios Vlachogiannis, Inmaculada Spiteri, Timon Heide, Javier Fernandez Mateos, Alexandra Vatsiou, Andrea Lampis, Mahnaz Darvish Damavandi, Hazel Lote, Ian Said Huntingford, Somaieh Hedayat, Ian Chau, Nina Tunariu, Giulia Mentrasti, Francesco Trevisani, Sheela Rao, Gayathri Anandappa, David Watkins, Naureen Starling, Janet Thomas, Clare Peckitt, Nasir Khan, Massimo Rugge, Ruwaida Begum, Blanka Hezelova, Annette Bryant, Thomas Jones, Paula Proszek, Matteo Fassan, Jens C. Hahne, Michael Hubank, Chiara Braconi, Andrea Sottoriva, Nicola Valeri
Journal: Cancer Discovery (2018)

Sequential profiling of plasma cell-free DNA (cfDNA) holds immense promise for early detection of patient progression. However, how to exploit the predictive power of cfDNA as a liquid biopsy in the clinic remains unclear. RAS pathway aberrations can be tracked in cfDNA to monitor resistance to anti-EGFR monoclonal antibodies in patients with metastatic colorectal cancer. In this prospective phase II clinical trial of single-agent cetuximab in
Clinical Proteomics of Breast Cancer Reveals a Novel Layer of Breast Cancer Classification
Authors: Gali Yanovich, Hadar Agmon, Michal Harel, Amir Sonnenblick, Tamar Peretz, Tamar Geiger
Journal: Cancer Research (2018)

Abstract Breast cancer classification has been the focus of numerous worldwide efforts, analyzing the molecular basis of breast cancer subtypes and aiming to associate them with clinical outcome and to improve the current diagnostic routine. Genomic and transcriptomic profiles of breast cancer have been well established, however the proteomic contribution to these profiles has yet to be elucidated. In this work, we utilized mass spectrometry–based proteomic analysis on more than 130 clinical breast samples to demonstrate intertumor heterogeneity across three breast cancer subtypes and healthy tissue. Unsupervised analysis identified four proteomic clusters, among them, one that represents a novel luminal subtype characterized by increased PI3K signaling. This subtype was further validated using an independent protein-based dataset, but not in two independent transcriptome cohorts. These results demonstrate the importance of deep proteomic analysis, which may affect cancer treatment decision making. Significance: These findings utilize extensive proteomics to identify a novel luminal breast cancer subtype, highlighting the added value of clinical proteomics in breast cancer to identify unique features not observable by genomic approaches. Cancer Res; 78(20); 6001–10. ©2018 AACR.
Abstract 19770: TAVR Versus Medical Management Among Patients With Severe Aortic Stenosis and Left Ventricular Systolic Dysfunction
Authors: Amit N Vora, John K Harrison, Allison Dunning, Phillip Schulte, Matthew W Sherwood, Joseph Kisslo, G C Hughes, Fawaz A Alenezi, Eric Velazquez, Zainab Samad
Journal: Circulation (2015)

Background: The decision for transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) and left ventricular systolic dysfunction (LSVD) can be challenging. We sought to evaluate mortality differences in patients with AS and LVSD undergoing TAVR compared with a medically matched historical cohort. Methods: We studied 206 patients who underwent TAVR and had an echocardiogram that demonstrated LVSD within six months prior to the procedure and a matched medically managed historical cohort (n = 206). All TAVR patients had severe aortic stenosis and high or extreme risk for open surgical AVR as determined by the Duke multidisciplinary team. Patients were matched 1:1 using optimal matching methods by AS resting mean gradient and/or peak velocity, age, gender, LVEF, and EURO score. LVSD was subclassified into mild (LVEF 36-50%) or severe (LVEF ≤35%). We used Cox multivariable modeling to assess the relationship between TAVR and all-cause mortality censored at 3 years. Results: The median age of the cohort was 82 (IQR 76-87). Compared with the medically matched cohort, TAVR patients were more likely to be male, have a history of ischemic heart disease, renal insufficiency, CHF, and prior CABG (all p&lt;0.05). TAVR was associated with mortality reduction compared with medical management (HR 0.26, 95% CI 0.17-0.40, p&lt;0.0001), which persisted after multivariable adjustment (HR 0.19, 95% CI 0.12-0.30, p&lt;0.0001) (Figure). After adjustment, TAVR provided a larger decrease in mortality risk in patients with LVEF ≤ 35% (HR 0.25, 95%CI 0.06-1.01), than in patients with LVEF 36-50% (HR 0.42, 95%CI 0.14-1.27), but this difference did not reach statistical significance (p interaction = 0.52). Conclusion: Compared with medical management, TAVR is associated with higher survival with a trend for benefit in patients with severe LVSD. Given the poor prognosis associated with medical management, TAVR should be explored as a therapeutic option in patients with AS and LSVD.
Contributions of prescribed and non-prescribed opioids to opioid related deaths: population based cohort study in Ontario, Canada
Authors: Tara Gomes, Wayne Khuu, Diana Martins, Mina Tadrous, Muhammad M Mamdani, J Michael Paterson, David N Juurlink
Journal: BMJ (2018)

<h3>Abstract</h3> <h3>Objective</h3> To describe the contributions of prescribed and non-prescribed opioids to opioid related deaths. <h3>Design</h3> Population based cohort study. <h3>Setting</h3> Ontario, Canada, from 1 January 2013 to 31 December 2016. <h3>Participants</h3> All Ontarians who died of an opioid related cause. <h3>Exposure</h3> Active opioid prescriptions, defined as those with a duration overlapping the date of death, and recent opioid prescriptions, defined as those dispensed in the 30 and 180 days preceding death. Postmortem toxicology results from the Drug and Drug/Alcohol Related Death database were used to characterise deaths on the basis of presence of prescribed and non-prescribed (that is, diverted or illicit) opioids, overall and stratified by year and age. <h3>Results</h3> 2833 opioid related deaths occurred. An active opioid prescription on the date of death was relatively common but declined slightly throughout the study period (38.2% (241/631) in 2013 and 32.5% (278/855) in 2016; P for trend=0.03). Older people and women were relatively more likely to have an active opioid prescription at time of death. In 2016, 46% (169/364) of people aged 45-64 had an active opioid prescription compared with only 12% (8/69) among those aged 24 or younger (P for trend&lt;0.001). Similarly, 46% (124/272) of women had an active opioid prescription at time of death compared with 26.4% (154/583) of men (P&lt;0.001). Among people with active opioid prescriptions at time of death, 37.8% (375/993) also had evidence of a non-prescribed opioid on postmortem toxicology. By 2016, the non-prescribed opioid most commonly identified after death was fentanyl (41%; 47 of 115 cases). Among people without an active opioid prescription at time of death, fentanyl was detected in 20% (78/390) of deaths in 2013, increasing to 47.5% (274/577) by 2016 (P&lt;0.001). <h3>Conclusions</h3> Prescribed, diverted, and illicit opioids all play an important role in opioid related deaths. Although more than half of all opioid related deaths still involved prescription drugs (either dispensed or diverted) in 2016, the increased rate of deaths involving fentanyl between 2015 and 2016 is concerning and suggests the need for a multifactorial approach to this problem that considers both the prescribed and illicit opioid environments.
Exhaled breath condensate volatilome allows sensitive diagnosis of persistent asthma
Authors: João Cavaleiro Rufo, Inês Paciência, Francisca Castro Mendes, Mariana Farraia, Ana Rodolfo, Diana Silva, Eduardo de Oliveira Fernandes, Luís Delgado, André Moreira
Journal: Allergy (2018)

Abstract Background The diagnosis and phenotyping of paediatric asthma are particularly complex due to the lack of currently available sensitive diagnostic tools. This often results in uncertainties associated with inhaled steroid therapy prescription. Therefore, this study aimed to investigate whether volatile organic compounds measured in exhaled breath condensate can be used as biomarkers for asthma diagnosis in the paediatric population. Methods A total of 64 participants, aged 6‐18 years, were recruited on a random basis during visits to an outpatient allergy clinic and to a juvenile football team training session. Lung function, airway reversibility and skin prick tests were performed. Exhaled breath condensate samples were collected, and breathprints were assessed using an electronic nose. Information on medical diagnosis of asthma, rhinitis and atopic dermatitis was retrieved for each participant. A hierarchical cluster model based on the volatilome profiles was then created. Results A two‐cluster exhaled volatile organic compound‐based hierarchical model was able to significantly discriminate individuals with asthma from those without the disease ( AUC = 0.81 [0.69‐0.93], P &lt; 0.001). Individuals who had persistent asthma and were prescribed corticosteroid therapy by the physician were also significantly distinguished in the model ( AUC = 0.81 [0.70‐0.92], P &lt; 0.001). Despite being less specific, the method showed higher overall accuracy, sensitivity and AUC values when compared to spirometry with bronchodilation. Conclusions Analysis of the exhaled breath condensate volatilome allowed the distinction of paediatric individuals with a medical diagnosis of asthma, identifying those in need of corticosteroid therapy.
Abstract 13197: Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Outpatient Setting
Authors: Krishna Patel, Laura Young, Erik H Howell, Bo Hu, Shannon J Morrison, Gregory Rutecki, George Thomas, Michael B Rothberg
Journal: Circulation (2015)

Background: Hypertensive urgency is a commonly encountered outpatient problem. Prevalence and short term outcomes of this condition are unknown. JNC VII recommends aggressive BP control over several days. However, a small percentage of patients are sent to the emergency department. It is unknown whether hospital management of these patients is better than outpatient BP management. Methods: Retrospective cohort study of all patients presenting to an office in a large health care system from 2008-2013 with SBP ≥180mmHg or DBP ≥ 110mmHg. We excluded pregnant women and patients referred to the hospital for symptoms or treatment of other conditions. Patients were divided into 2 groups: those sent home and those referred to hospital. We recorded baseline demographic and clinical data. Propensity matched outcomes recorded included MACE (acute coronary syndrome, stroke/TIA) uncontrolled hypertension (≥140/90 mmHg) and hospital admissions. Results: Of 2,199,019 office visits, 58,583 (5%) had hypertensive urgency. Mean age was 63±15 yrs, 58% were females, 76% Caucasian, mean BMI was 31±8 kg/m2 and mean SBP and DBP were 182±16 and 96±16 mmHg. Only 426 (0.7%) patients were referred to the ED/hospital. On propensity matched analysis between the patients referred to the hospital and sent home, there was no significant difference in MACE events at 7 days (0% vs. 0.13%, p=1), 30 days (0.25% vs. 0%, p=1) or 6 months (0.5% vs. 0.13%, p=0.26). Compared to patients sent home, patients referred to the hospital had less uncontrolled hypertension at 1 month (81% vs. 88%, p=0.001) but not at 6 months (65% vs 69%, p=0.16). They also had higher 7- and 30-day hospital admission rates (8.5% vs. 4.9%, p=0.01; 11.8% vs 7.6%, p=0.02). Conclusion: Hypertensive urgency occurs commonly, but the rate of MACE in asymptomatic patients is very low. ED visits increased hospitalizations, but did not improve outcomes. Most patients with hypertensive urgencies still had uncontrolled hypertension at 6 months.
Spending Among Patients With Cancer in the First 2 Years of Accountable Care Organization Participation
Authors: Miranda B. Lam, Jose F. Figueroa, Jie Zheng, E. John Orav, Ashish K. Jha
Journal: Journal of Clinical Oncology (2018)

Spending on patients with cancer can be substantial and has continued to increase in recent years. Accountable Care Organizations (ACOs) are arguably the most important national experiment to control health care spending, yet how ACOs are managing patients with cancer diagnoses is largely unknown. We aimed to determine whether practices that became ACOs had changes in overall or cancer-specific spending among patients with cancer.Using 2011 to 2015 national Medicare claims, practices that became part of ACOs were identified and matched to non-ACO practices within the same geographic region. We calculated total and category-specific annual spending per beneficiary as well as spending for and utilization of emergency departments, inpatient admissions, hospice, chemotherapy, and radiation therapy. A difference-in-differences model was used to examine changes in spending and utilization associated with ACO contracts in the Medicare Shared Savings Program for beneficiaries with cancer.We found that the introduction of ACOs had no meaningful impact on overall spending in patients with cancer (-$308 per beneficiary in ACOs v -$319 in non-ACOs; difference, $11; 95% CI, -$275 to $297; P = .94). We found no changes in total spending in patients within any of the 11 different cancer types examined. Finally, changes in spending and utilization did not meaningfully differ between ACO and non-ACO patients within various categories, including cancer-specific categories.Compared with patients with cancer treated at non-ACO practices, being a patient with a cancer diagnosis in a Medicare ACO is not associated with significantly reduced spending or heath care utilization. The introduction of ACOs does not seem to have had any meaningful effect on spending or utilization for patients with a cancer diagnosis.
Ureteral endometriosis: a systematic review of epidemiology, pathogenesis, diagnosis, treatment, risk of malignant transformation and fertility
Authors: Fabio Barra, Carolina Scala, Ennio Biscaldi, Valerio Gaetano Vellone, Marcello Ceccaroni, Carlo Terrone, Simone Ferrero
Journal: Human Reproduction Update (2018)

The ureter is the second most common site affected by urinary tract endometriosis, after the bladder. Optimal strategies in the diagnosis and treatment of ureteral endometriosis (UE) are not yet well defined.The aim of this study was to systematically review evidence regarding the epidemiology, pathophysiology, diagnosis, medical and surgical treatment, impact on fertility and risk of malignant transformation of UE.A systematic literature review, by searching the MEDLINE and PUBMED database until April 2018, was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and was registered in the PROSPERO registry (www.crd.york.ac.uk/PROSPERO CRD42017060065). A total of 67 articles were selected to be included in this review.The involvement of the ureter by endometriosis is often asymptomatic or leads to non-specific symptoms. When the diagnosis is delayed, UE may lead to persistent hydronephrosis and eventually loss of renal function. Ultrasonography is the first-line technique for the assessment of UE; alternatively, magnetic resonance imaging provides an evaluation of ureteral type involvement. The surgical treatment of UE aims to relieve ureteral obstruction and avoid disease recurrence. It includes conservative ureterolysis or radical approaches, such as ureterectomy with end-to-end anastomosis or ureteroneocystostomy performed in relation to the type of ureteral involvement. Fertility and pregnancy outcomes are in line with those observed after surgical treatment of deep infiltrating endometriosis (DIE). Current evidence does not support the potential risk of malignant transformation of UE.In this article, we review available evidence on ureteral endometriosis, providing a useful tool to guide physicians in the management of this disease. Diagnosis and management of UE remain a challenge. In relation to the degree of ureteral involvement and the association with other DIE implants, the surgical approach should be planned and carried out in an interdisciplinary collaboration between gynecologist and urologist.
Abstract 10976: Diagnostic Ability of Contrast Media Induced Fractional Flow Reserve to Assess Functional Significance of Entire Coronary Artery Stenosis
Authors: Hiroaki Takashima, Akiyoshi Kurita, Yuki Saka, Katsuhisa Waseda, Hirohiko Ando, Kazuyuki Maeda, Shinichiro Sakurai, Akihiro Suzuki, Tetsuya Amano
Journal: Circulation (2015)

Introduction: Although fractional flow reserve (FFR) is helpful to evaluate functional lesion severity, the need of adenosine limits the widespread adoption of FFR. Hypothesis: We hypothesized that contrast media induced FFR (cFFR) with submaximal hyperemic condition could assess functional lesion severity of coronary artery stenos. The aim of this study was to evaluate the diagnostic ability of cFFR compared to FFR in entire range of coronary artery stenosis. Methods: A total of 96 patients with 123 lesions were prospectively enrolled in this study. At first, we measured resting Pd/Pa ratio before inducing hyperemia. Then, cFFR was obtained after intracoronary injection of 6 ml of contrast media, while FFR was measured after intravenous adenosine triphosphate administration (180 mcg/kg/min). Lesions with FFR less than or equal 0.80 were considered functional significance of coronary artery stenosis. Results: In 123 lesions, reference diameter, diameter stenosis, resting Pd/Pa ratio, cFFR, and FFR were 2.7±0.8 mm, 47±12%, 0.91±0.10, 0.83±0.12, and 0.81±0.12, respectively. Functional significance was observed in 41% of all lesions. Both of resting Pd/Pa and cFFR showed strong correlations with FFR (r=0.861, p&lt;0.001, and r=0.930, p&lt;0.001, respectively). The correlation coefficient of cFFR was significantly superior to that of resting Pd/Pa ratio (p&lt;0.05). This strong correlation between cFFR and FFR was shown in every coronary artery (LAD; r=0.924, p&lt;0.001, LCX; r=0.923, p&lt;0.001, and RCA; r=0.926, p&lt;0.001, respectively). The Bland-Altman plot demonstrated a good agreement with a mean difference of -0.02 and a standard deviation of 0.05 between cFFR and FFR across entire range of coronary artery stenosis. ROC curve analysis showed an excellent accuracy of cFFR &lt;0.84 in predicting functional significance (AUC 0.96, sensitivity 90%, specificity 89%, and diagnostic accuracy 89%). Moreover, the cFFR &gt;0.89 was not corresponded to functional significance of entire coronary artery stenosis. Conclusions: The cFFR is an accurate, rapid and easy method in predicting functional significance of entire coronary artery stenosis. This physiology-based approach may be a possible alternative method for FFR measurements in daily practice.
Abstract 17614: 6-mercaptopurine Reduces Progression of Experimentally Induced Pulmonary Arterial Hypertension by Dampening Inflammation and Inhibition of Proliferation
Authors: Xiao-Qing Sun, Kondababu Kurakula, Chris Happé, Denielli da Silva Goncalves Bos, Ingrid Schalij, Harm-Jan Bogaard, Marie-Jose Goumans
Journal: Circulation (2016)

Rationale: Inflammation plays a crucial role in pulmonary arterial hypertension (PAH). Inflammatory cytokines stimulate proliferation of pulmonary arterial smooth muscle cells (PASMC) and endothelial cells (EC). 6-Mercaptopurine (6-MP) is a well-established immunosuppressive drug used to treat various autoimmune and chronic inflammatory diseases. Recently, we and others have shown that 6-MP not only inhibits macrophage and T cell activation, but also reduces the proliferation of SMC and EC as well as the inflammatory response of EC. Collectively, given the effects of 6-MP on inflammation, SMC and EC, we hypothesized that 6-MP may be a promising treatment of PAH. Methods: Pulmonary hypertension was induced in male Sprague-Dawley rats by a single injection of SU5416 (25 mg/kg) followed by a 4-week transient exposure to hypoxia and a 2-week normoxic re-exposure. After randomization (treatment vs. vehicle) animals were divided into two groups, receiving 6-MP (1 mg/kg) or vehicle (DMSO) in drinking water from ...