tbuckley/cabot-search huggingface dataset:
Abstract 038: A Novel Histology Based Classification System to Identify Patients at Risk for Postoperative Atrial Fibrillation
Authors: Mahek Mirza, Anton Strunets, Ekhson Holmuhamedov, Jasbir Sra, Paul H Werner, Bijoy K Khandheria, A Jamil Tajik, David C Kress, Arshad Jahangir
Journal: Circulation Research (2013)

Postoperative atrial fibrillation (PoAF) is a common complication in up to 40% of patients after cardiac surgery, increasing morbidity, hospital stay and costs. The myocardial substrate underlying PoAF is not fully characterized. The objective was to assess the impact of atrial fibrosis on incident AF and define the fibrosis threshold level predictive of PoAF. Methods: Right atrial appendages removed from patients undergoing elective CABG with no history of AF or class III/IV heart failure were used to characterize the ratio of collagen to myocardium (Masson’s trichrome; NIH ImageJ software; Fig A), which was correlated with incident AF. Percentage burden of fibrosis predictive of PoAF with high sensitivity and specificity was determined by ROC curve. Results: Of 28 patients (67±10 years, 64% males), 15 had PoAF. There were no age, gender or comorbidity differences between groups. Compared to the group that remained in sinus rhythm, patients with PoAF had a significantly higher ratio of extracellular collagen to myocardium (45±16% vs. 5±4%, p &lt;0.001; Fig B). A threshold ratio of 12.7% collagen to myocardium (ROC area under the curve 0.997; z statistic 137; P&lt;0.0001) with 96% sensitivity and 97% specificity identified those with PoAF (Fig C). A classification system based on histological extent of atrial fibrosis is proposed for identifying patients at risk for PoAF (Fig D). Conclusion: Ongoing studies will confirm the predictive value of this new classification system for identifying the atrial substrate predisposing PoAF and correlate with preoperative cardiac imaging and circulatory serum biomarkers to provide a novel noninvasive tool to stratify patients at risk for PoAF.
Primary care sequential use of FIB-4 and the enhanced liver fibrosis test to stratify patients with non-alcoholic fatty liver disease increases cirrhosis detection and reduces referrals of patients with mild disease – 2 year study analysis
Authors: A. Srivastava, R. Gailer, S. Demma, A. Warner, D. Suri, S. Morgan, K. Sennett, D. Thorburn, J. Parkes, E. Tsochatzis, W. Rosenberg
Journal: Journal of Hepatology (2017)
Hepatitis C virus mediated chronic inflammation and tumorigenesis in the Humanised Immune system and Liver mouse model
Authors: F.Z. Zheng, C.W. Sze, C.T. Keng, M. Al-Haddawi, M. Liu, S.Y. Tan, H.L. Kwek, Z. Her, X.Y. Chan, B. Barnwal, E. Loh, T.C. Tan, K.T.E. Chang, Q. Chen, Y.J. Tan
Journal: Journal of Hepatology (2017)
Genetic and epigenetic bases of the relationship between reduced OCT1 expression and poor response to sorafenib in hepatocellular carcinoma and cholangiocarcinoma
Authors: R. Al-Abdulla, E. Lozano, R.I. Macias, C.J. O’Rourke, M.J. Perez, M.A. Serrano, M.R. Romero, M.J. Monte, E. Herraez, O. Briz, J.M. Banales, L. Bujanda, A. Geier, J.B. Andersen, J.J. Marin
Journal: Journal of Hepatology (2017)
Transcriptome profiles of NK and T cells associated with immune control in chronic hepatitis B patients treated with pegylated interferon alpha-nucleos(t)ide analogue sequential therapy
Authors: U.S. Gill, N.L. Bert, K. Kunasegaran, A. Khakpoor, N. Hansi, D. Tan, L. Rivino, H.D. Singh, W.-C. Huang, D. Peppa, M.K. Maini, A. Bertoletti, P.T.F. Kennedy
Journal: Journal of Hepatology (2017)
Significant incidence of psyquiatric disorders despite rapid and positive impact of direct acting antivirals on quality of life
Authors: Z. Mariño, E. Egmond, A. Pla, C. Bartres, G. Oriolo, M. Cavero, S. Lens, R. Navinés, X. Forns, R. Martín-Santos
Journal: Journal of Hepatology (2017)
Cardiotoxicity with adjuvant trastuzumab + anthracycline: Incidence and risk factors in a cohort of 962 HER2+ breast cancers from 2005-2011.
Authors: Louis Fehrenbacher, Angela Capra, Ashok Krishnaswami, Charles Quesenberry, Laurel A. Habel
Journal: Journal of Clinical Oncology (2015)

e11599 Background: Prospective clinical trials and observational studies using diagnostic codes from electronic health records have reported varying cardiotoxicity risk for adjuvant trastuzumab (T). Accurate estimates of patient-specific cardiotoxicity risk are essential for treatment decisions in early HER2+ breast cancer (BC). Methods: 1,109 consecutive non metastatic HER2+ invasive BC’s diagnosed 5/1/2005 to 12/31/2011 at Kaiser Permanente Northern California receiving adjuvant T were reviewed for symptomatic congestive heart failure (SxCHF), CHF ICD9 codes, baseline and post T cardiac ejection fraction (EF), anthracycline (A) use, and CHF risk factors (RF) including age, race, hypertension (HTN), diabetes (DM), obesity, smoking. Records of patients with CHF ICD9 codes or an EF drop to < 50% were reviewed by a RN, a cardiologist, and an oncologist. Primary outcomes were SxCHF (NYHA Class II), EF fall to < 50%, and < 38 weeks of T (75% of prescribed). Results: Median age of 962 eligible patients was 54 years (range 24-95). During a median follow-up of 4.1 years, 4.6% of patients had CHF ICD9 codes, but only 2.4% developed SxCHF, and 1 had a cardiac death. A total of 13.2% had an EF fall to < 50%. The cumulative incidence of SxCHF at 1, 2 and 5 years post start of T was 1.3%, 1.7% and 2.4% with T alone and 1.9%, 1.9% and 2.8% with T + A. At 1 year, cumulative incidence of an EF fall to < 50% was 6.9% with T and 17.2% with T+ A. A total of 15.3% finished < 38 weeks of T, 9.5% with T alone and 20.5% with T+A. Incidence of SxCHF and EF fall to < 50% for all patients and for RF-specific subgroups were examined (table). RF-outcome associations will be presented. Conclusions: Cardiotoxicity risk was consistent with prior clinical trials and differed substantially based on definition of CHF (ICD code vs SxCHF vs EF fall to < 50%), use of A, and patient RFs. Predictors N Cumulative Incidence (%) Symptomatic CHF EF fall < 50% 2-year 5-year 1-year All 962 1.8 2.6 12.1 Anthracycline 484 1.9 2.8 17.2 Non-anthracycline 478 1.7 2.4 6.9 Age > 60 275 3.7 6.5 12.8 Age > 70 67 7.5 11.3 12.1 Baseline EF 50-55% 92 8.8 8.8 31.8 HTN dx 392 3.4 4.2 12.9 BMI 30+ 315 2.6 4.5 16.7 DM dx 103 5.0 6.9 16.5 Age < 50, No RF 203 0.0 0.0 6.9 Age > 60, 2+ RF 112 6.3 9.8 18.0
Do elevated liver values necessarily indicate a health problem or could poorly defined upper limits of normal be an issue? Alanine aminotransferase and gamma-glutamyltransferase depend strongly on age
Authors: J. Wiegand, D. Petroff, O. Bätz, K. Jedrysiak, J. Kramer, I. Wolffram, T. Berg
Journal: Journal of Hepatology (2017)
EpCAM-independent isolation of EMT- circulating tumor cells in patients with primary breast cancer who receive primary systemic therapy.
Authors: Fanny Le Du, Takeo Fujii, Darren W. Davis, Weiguo Wu, Summer Jackson, Mariana Chavez-Mac Gregor, Carlos Hernando Barcenas, James L. Murray, Vicente Valero, Debu Tripathy, James M. Reuben, Naoto T. Ueno
Journal: Journal of Clinical Oncology (2015)

11034 Background: Tumor cells with amesenchymal phenotype and/or cancer stem-like cells (CSCs) are known to contribute to metastasis. Circulating tumor cells (CTCs) undergoing epithelial-mesenchymal transition (EMT) may not be detected using an anti-EpCAM antibody. We have developedan antibody-independent CTC enrichment platform, Apostream that does not rely on EpCAM-based capture, assessing morphologic and dielectric properties gated on CD45- cells. We used this instrument to determine the feasibility and clinical relevancy of measuring EMT-CTCs in breast cancer patients who received primary systemic chemotherapy (NST). Methods: Blood samples from newly diagnosed breast cancer patients were prospectively collected before NST (T0), after NST (T1), and after definitive surgery (T2) and processed using the Apostream system. Isolated cells were stained with antibodies to leukocytes (anti-CD45), and the DAPI nuclear stain, to identify CTCs. These CTCs were also stained with additional markers and examined on a laser scanning cytometer to measure protein expression levels of various markers to define 4 CTC-phenotypes: epithelial (CK+, EpCAM+, E-cadherin+), EMT (β-catenin,+ vimentin+), combined epithelial and EMT (CK+, EpCAM+, E-cadherin+, vimentin+), and CSC (CD44+, CD24low). Pathological complete response (pCR) was correlated to CTCs and marker expression. Results: Of the 15 patients enrolled, 5 patients achieved pCR. Epithelial-CTCs were detected in 60%, 67%, and 77% of the T0, T1, and T2 samples, respectively. EMT-CTCs were detected in 80%, 87%, and 85% of these samples, respectively. The mean number of CTCs with epithelial and EMT phenotype was 32.8 (range, 0-434) and 68.7 (range, 0-687) respectively. Number ofCTCs with epithelial phenotype and CSC phenotype were more likely to decrease, after NST, if N stage (nodes) > or equal 3 (P = 0.014) or T stage (primary tumor) > or equal 4 (P = 0.066), respectively. Neither EMT (P = 0.505) nor epithelial (P = 0.580) phenotypes of CTCs seem to predict pCR. Conclusions: Apostream was successful in detecting both epithelial and EMT-CTCs. We will present the final data analysis of 50 patients to conclude on their predictive impact.
Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study
Authors: Anya Topiwala, Charlotte L Allan, Vyara Valkanova, Enikő Zsoldos, Nicola Filippini, Claire Sexton, Abda Mahmood, Peggy Fooks, Archana Singh-Manoux, Clare E Mackay, Mika Kivimäki, Klaus P Ebmeier
Journal: BMJ (2017)

Objectives To investigate whether moderate alcohol consumption has a favourable or adverse association or no association with brain structure and function.Design Observational cohort study with weekly alcohol intake and cognitive performance measured repeatedly over 30 years (1985-2015). Multimodal magnetic resonance imaging (MRI) was performed at study endpoint (2012-15).Setting Community dwelling adults enrolled in the Whitehall II cohort based in the UK (the Whitehall II imaging substudy).Participants 550 men and women with mean age 43.0 (SD 5.4) at study baseline, none were "alcohol dependent" according to the CAGE screening questionnaire, and all safe to undergo MRI of the brain at follow-up. Twenty three were excluded because of incomplete or poor quality imaging data or gross structural abnormality (such as a brain cyst) or incomplete alcohol use, sociodemographic, health, or cognitive data.Main outcome measures Structural brain measures included hippocampal atrophy, grey matter density, and white matter microstructure. Functional measures included cognitive decline over the study and cross sectional cognitive performance at the time of scanning.Results Higher alcohol consumption over the 30 year follow-up was associated with increased odds of hippocampal atrophy in a dose dependent fashion. While those consuming over 30 units a week were at the highest risk compared with abstainers (odds ratio 5.8, 95% confidence interval 1.8 to 18.6; P≤0.001), even those drinking moderately (14-21 units/week) had three times the odds of right sided hippocampal atrophy (3.4, 1.4 to 8.1; P=0.007). There was no protective effect of light drinking (1-<7 units/week) over abstinence. Higher alcohol use was also associated with differences in corpus callosum microstructure and faster decline in lexical fluency. No association was found with cross sectional cognitive performance or longitudinal changes in semantic fluency or word recall.Conclusions Alcohol consumption, even at moderate levels, is associated with adverse brain outcomes including hippocampal atrophy. These results support the recent reduction in alcohol guidance in the UK and question the current limits recommended in the US.
Controlled attenuation parameter predicts steatosis in alcoholic liver disease and correlates with poor metabolic phenotype and cardiovascular risk: a biopsy-controlled multicenter study
Authors: M. Thiele, V. Rausch, G. Fluhr, F. Piecha, J. Mueller, B.S. Madsen, B. Straub, S. Detlefsen, M. Lupsor-Platon, V. de Ledinghen, H.K. Seitz, A. Krag, S. Mueller
Journal: Journal of Hepatology (2017)
Abstract 254: 14, 15-EET Protects Heart Pericytes by Delaying I/R Injury-induced Calcium Overloading
Authors: Zhiping Cao, Catherine M Davis, Sanjiv Kaul, Nabil J Alkayed
Journal: Circulation Research (2015)

Background - Pericytes are an important cellular component of the blood vessel wall of the arteries, arterioles, and microvessels of the heart; they provide structural integrity and regulate vessel diameter by contracting and relaxing dynamically in response to vasoactive stimuli. It has been suggested that pericytes contribute to coronary no-flow due to pericyte constriction following myocardial infarction, thus worsening outcome. It has also been demonstrated that intracellular calcium is involved in perciyte constriction. Our previous findings indicate that cardiomyocytes are protected following ischemia/ reperfusion injury (I/R) by the eicosanoid 14,15-EET. Since 14,15-EET is protective following I/R and a vasodilator, we tested the hypotheses that I/R injury induces calcium overloading, which injures peciytes, and that 14, 15-EET is able to block this process. Methods and Results - We isolated and cultured pericytes from the mouse heart ventricle by 3G5 antibody Dynabead sorting. Pericytes were characterized by multiple immunocytochemical markers for contractile proteins, cytoskeletal protein, and cell surface receptors (alpha-smooth muscle actin, calponin-1, NG2, vimentin, CD31,smoothlin, and fibroblast protein-1). Cultured pericytes were subjected to 5 hours of oxygen and glucose deprivation, with or without 14,15-EET, followed by 15 hours of re-oxygenation in the absence of 14,15-EET. Calcium imaging and cell death during re-oxygenation were assessed by Fluo-4 and propidium iodide respectively. Digital images were taken with confocal microscope (Nikon Eclipse Tie-A1RSi). The brightness of the green fluorescent signals represents the relative level of intracellular calcium and the red fluorescent signals represent the cell death. We found that calcium signal peak (overloading) occurred during re-oxygenation, immediately followed by cell death. This process was delayed by 14,15-EET treatment during oxygen and glucose deprivation. The cell death at 5h, 10h, and 15h of re-oxygenation was 57.2%, 71.1%, and 85.3% in control group, and 19.9%, 35.3%, and 58.3% in 14,15-EET treated group. Conclusions - Our data suggests that 14,15-EET-induced protection in pericytes is mediated through the calcium signaling pathway.
A short course of gamma-tocopherol mitigates LPS-induced inflammatory responses in humans ex vivo
Authors: Allison J. Burbank, Charity G. Duran, Martha Almond, Heather Wells, Sha'Leema Jenkins, Qing Jiang, Chao Yang, Ting Wang, Haibo Zhou, Michelle L. Hernandez, David B. Peden
Journal: Journal of Allergy and Clinical Immunology (2017)
A pragmatic algorithm to rule out Non-alcoholic steatohepatitis in patients at risk of non-alcoholic fatty liver disease in spite of a normal ultrasound
Authors: J. Ampuero, R. Aller, R. Gallego-Durán, J. Bañales, A. Loste, M. Teresa, C. García-Monzón, E. Vilar-Gómez, A. Escudero, J. Gómez-Camarero, H.P. Ramirez, J. Caballería, V. Aguilar-Urbano, J. Salmeron, J.L. Calleja, J.L.O. Goñi, A. Albillos, M. Diago, O. Lo lacono, R. Francés, C.M. Fernández-Rodriguez, J. García-Samaniego, S. Benlloch, P. Aspichueta, M. Romero-Gómez
Journal: Journal of Hepatology (2017)
Differences in Medicare Expenditures Between Appalachian and Nationally Representative Cohorts of Elderly Women With Breast Cancer: An Application of Decomposition Technique
Authors: Ami Vyas, S. Suresh Madhavan, Usha Sambamoorthi
Journal: Journal of the National Comprehensive Cancer Network (2017)

Background: Differences in Medicare expenditures during the initial phase of cancer care among rural and medically underserved elderly women with breast cancer (BC) and those from a nationally representative cohort have not been reported. The objective of this study was to determine Medicare expenditures during the initial phase of care among women in West Virginia (WV) who were Medicare beneficiaries with BC and compare them with national estimates. The magnitude of differences in these expenditures was also determined by using a linear decomposition technique. Methods: A retrospective observational study was conducted using the WV Cancer Registry-Medicare database and the SEER-Medicare database. Our study cohorts consisted of elderly women aged ≥66 years diagnosed with incident BC in 2003 to 2006. Medicare expenditures during the initial year after BC diagnosis were derived from all of the Medicare files. Generalized linear regressions were performed to model expenditures, after controlling for predisposing factors, enabling resources, need, healthcare use, and external healthcare environmental factors. Blinder-Oaxaca decomposition was conducted to examine the proportion of the differences in the average expenditures explained by independent variables included in the model. Results: Average Medicare expenditures for the WV Medicare cohort during the initial phase of BC care were $25,626 compared with $29,502 for the SEER-Medicare cohort; a difference of $3,876. In the multivariate regression, this difference decreased to $708 and remained significant. Only 16% of the differences in the average expenditures between the cohorts were explained by the independent variables included in the model. Enabling resources (6.86%), healthcare use (7.55%), and external healthcare environmental factors (3.33%) constituted most of the explained portion of the differences in the average expenditures. Conclusions: The difference in average Medicare expenditures between the elderly beneficiaries with BC from a rural state (WV) and their national counterparts narrowed but remained significantly lower after multivariate adjustment. The explained portion of this difference was mainly driven by enabling and healthcare use factors, whereas 84% of this difference remained unexplained.
Animal protein is the most important macronutrient associated with non-alcoholic fatty liver disease in overweight participants: The Rotterdam Study
Authors: L. Alferink, J.C. Kiefte-deJong, B. Veldt, J.D. Schoufour, P. Taimr, A.M. Ikram, H.L.A. Janssen, H.J. Metselaar, O.H. Franco, S.D. Murad
Journal: Journal of Hepatology (2017)
Complementary and alternative medicine (CAM) use in lung cancer: The impact of control.
Authors: Joshua Bauml, Corey J. Langer, Tracey L. Evans, Sheila N. Garland, Krupali Desai, Jun J Mao
Journal: Journal of Clinical Oncology (2013)

9613 Background: Lung cancer (LC) remains the leading cause of cancer death for both men and women in the U.S., and is associated with significant symptom burden. The diagnosis and treatment of LC can make patients feel a loss of control, and desire for control has been associated with CAM use. While interest in CAM has surged recently, scant literature exists on its use in LC. This study aimed to quantify the prevalence of and identify the factors associated with CAM use in patients (pts) with LC with a specific focus on perceived control. Methods: We performed a cross sectional survey in pts with LC treated at the oncology clinic of an academic medical center. Self-reported CAM use was the primary outcome. Demographic and clinical variables were collected by chart abstraction. Pts’ perception of their degree of control was measured using the Cancer Locus of Control scale. Multivariate logistic regression was performed to determine which factors were independently associated with CAM use. Results: 296 pts were surveyed (77.5% response rate) with a mean age of 63.1 (28-84). 45.6% were male, 83.5% were Caucasian, 21% had never smoked, and 52.4% had Stage IV disease. 50.9% of pts used ≥1 form of CAM, most commonly vitamins (31.5%), herbs (19.3%), relaxation techniques (16%) and special diets (15.7%). In multivariate analysis, CAM use was associated with age≤65 (AOR 1.64, 95% CI 1.01-2.67), college level or greater education (AOR 2.17, 95% CI 1.29-3.64), never having smoked tobacco (AOR 2.39, 95% CI 1.25-4.54), and having a greater feeling of control over the cause of cancer (AOR 2.27, 95% CI 1.35-3.80). Gender and perceived control over treatment outcome were not associated with CAM use. Conclusions: In the largest study evaluating CAM in LC, half of pts surveyed used CAM. CAM use was associated with younger age, increased education, never having smoked tobacco and a greater feeling of control over the cause of cancer. In contrast to prior research, we did not find an association with CAM usage and gender or perceived control over treatment outcome. Since CAM use is common, future research is needed to evaluate how to integrate CAM into clinical care to help patients with LC regain a sense of control and improve their quality of life.
Physicians’ ability to correctly identify values important to cancer patients enrolled in phase I clinical trials.
Authors: Rebecca D. Pentz, Yuan Liu, Louise Wall, Christopher Daugherty, Michael J Green, Fay J. Hlubocky, Susan K. Peterson, Charlotte C. Sun, Margie Dixon, R Donald Harvey, Taofeek Kunle Owonikoko, Fadlo Raja Khuri
Journal: Journal of Clinical Oncology (2012)

e13026 Background: ASCO recommends that physicians assess treatment preferences of patients with advanced cancer. To facilitate this process, we developed a tool to assess patients’ treatment-related values, since no standardized tool exists. This study evaluated the need for the tool by testing concordance between patient and physician identification of values important to the patient. Methods: Forty patients enrolled in phase I trials chose the 4 most important values from a list of 16 pretested values. The treating physicians also selected the values they thought their patient would choose based on their independent assessment of the patient. Concordance and discordance between the patient and physician choices were calculated. Subsequently, 18 physicians were given the tool to use during a phase I consent conversation. Satisfaction was tabulated. Results: Physicians (PHY) were unsuccessful in choosing the values selected by patients (P) 56% of the time. The highest concordance was observed for (1) fighting my cancer as much as possible (68%P, 80%PHY); (2) having access to the best cancer treatment (65%P, 58%PHY). The highest discordance was observed for (1) Feeling as good as possible every day given my condition (60%P; 18%PHY p=0.002); (2) Taking part in a research study if it is my only option (8%P; 55%PHY p=0.0001); (3) Having access to new treatments even if they are not yet proven and are a part of research (18%P; 55%PHY p=0.0008). Physicians agreed that the values tool has great utility, influences treatment recommendations and should be used with all patients (4.5/5). Physicians were neutral about whether the tool would save time (3.5/5). Patients were neutral on tool utility (3.8/5). Conclusions: Physicians’ ability to identify their patients’ most important values is poor (44% concordance). This is low compared to levels reported in other concordance studies for treatment choices (53-56%) and for what makes life worth living (57%). While physicians thought patients would value participation in research, patients more frequently identified quality of life as an important value. The tool was considered useful for portraying patients’ values by the majority of physicians, but not by most patients.