tbuckley/cabot-search huggingface dataset:
Abstract MP31: Diurnal Patterns of Physical Activity and Cardiovascular Risk Factors Over 10 Years: Results From the Coronary Artery Risk Development in Young Adults Study
Authors: Amanda E Paluch, Kelley Pettee Gabriel, Samantha Montag, Juned Siddique, Pamela Schreiner, Cora E Lewis, Gareth Dutton, Barbara Sternfeld, Steve Sidney, Jared Reis, Mercedes Carnethon
Journal: Circulation (2019)

Introduction: Moderate to vigorous intensity physical activity (MVPA) is associated with lower cardiovascular (CV) disease risk. Cross-sectional studies has shown beneficial associations of morning MVPA with CV risk factors. We hypothesized that participants aged 38-50 yrs accumulating a greater proportion of MVPA earlier in the day will have lower risk of obesity, diabetes, and hypertension 10 years later. Methods: We included CARDIA participants with valid (≥4 of 7 days with ≥10 hr/d) accelerometer wear (ActiGraph 7164) at the year 20 exam (2005-2006) who performed at least 10 min/d MVPA (≥2020 counts per minute). Diurnal patterns were calculated from individual waking time, based on the first valid minute of wear after 4 AM. Diurnal patterns were operationalized as: 1) cumulative percent of MVPA counts within 4 hours after waking, and 2) time after waking when accumulating 50% MVPA counts. Logistic regression estimated odds of obesity, diabetes, and stage 2 hypertension and generalized linear models estimated the prevalence risk of stage 1 or above hypertension at the year 25 or 30 exam. Results: Participants (aged 45.2±3.6 yrs, 57.8% women) averaged 33.7±24.1 min/d MVPA, 34.1±1.3% MVPA was accumulated within 4 hours of waking, and 50% of MVPA was accumulated by 7.2±2.2 hours after waking. There were no statistically significant associations of diurnal patterns with obesity or hypertension (Table). However, every 10% greater MVPA accumulated within the first 4 hours was associated with a 20% higher odds of diabetes. Similarly, every 1 hour earlier accumulating 50% of MVPA was associated with 15% higher odds of diabetes. Total MVPA (min/d) was inversely associated with diabetes, obesity, and stage 2 hypertension. Conclusions: Total volume of MVPA is more important for cardiometabolic health than the time of day at which it is performed. In regards to diabetes risk, our findings showing higher odds with earlier accumulation of MVPA may be suggestive of a benefit in spreading activity throughout the entire day.
Long-Term Outcomes of Partial Oral Treatment of Endocarditis
Authors: Henning Bundgaard, Nikolaj Ihlemann, Sabine U Gill, Niels E Bruun, Hanne Elming, Trine Madsen, Kaare T Jensen, Kurt Fursted, Jens J Christensen, Martin Schultz, Lauge Østergaard, Flemming Rosenvinge, Henrik C Schønheyder, Jannik Helweg-Larsen, Emil L Fosbøll, Lars Køber, Christian Torp-Pedersen, Niels Tønder, Claus Moser, Kasper Iversen
Journal: New England Journal of Medicine (2019)

Follow-up of Oral Antibiotics for Endocarditis This letter describes outcomes of the POET trial at a median follow-up of 3.5 years. The authors found that in patients with endocarditis on the left ...
Unenhanced Magnetic Resonance Imaging in the evaluation of High Risk Breast Cancer Individuals.
Authors: Elsa Perez, Angel Izquierdo, Jorge Soriano, Esther Darder, Maria Buxo, Angela Velasco, Roser Lleuger, Lidia Feliubadalo, Conxi Lazaro, Gabriel Capella, Elena Alvarez, Salvador Pedraza, Joan Brunet
Journal: Journal of Clinical Oncology (2015)

e12579 Background: Individuals at high risk of developing breast cancer benefit from an annual surveillance with contrast enhanced breast magnetic resonance imaging (CEMRI). However, this technique has high rate of false positive findings and is associated with complications related to contrast media administration. Diffusion Weighted Imaging (DWI) is a fast sequence that does not need contrast media. Methods: We retrospectively reviewed 198 breast MRI performed to individuals that are under surveillance at the High Risk Clinic. 42 were BRCA 1 mutation carriers ,45 BRCA 2 and 111 belonging to non-informative BRCA1/2 test families. 13 patients (7 BRCA 1, 2 BRCA 2 and 4 non informative) developed breast tumors. CEMRI and DWI was analyzed. We considered as suspicious of malignancy a lesion with Apparent Diffusion coefficient (ADC) equal or less than 1x10-3 mm2 xsec-1 . Samples were obtained when CEMRI indicated suspicion of malignancy. This analysis was performed by two radiologists. Results: Thirteen malignant lesions were found in our study. Two neoplasms were only detected in DWI and not in CEMRI. The first reader detected neoplasm in all cases using DWI . Sensibility, specificity, positive predictive value and negative predictive value for CEMRI were 81%, 33%, 53% and 67%. For DWI were 100% , 94,59%, 56,52% and 100%. DWI values obtained by the second reader were 53,85%, 79,46%, 15,56% and 96,08%. The concordance observed between both readers was 0,23 (K) IC 95%(0,078-0,3920). In 2012 MRI equipment was improved. When studying the DWI values after this year, the first reader achieved 100%, 95,28%, 37,5% and 100% (sensibility, specificity, positive predictive value and negative predictive value) and the second reader 66,67%, 80,19%, 8,7% and 98,84%. Conclusions: Our results showed that DWI seems to be more accurate to predict malignant lesions in patients at high risk of breast cancer. However there was an important inter-observer variability, which can be improved with better acquisition technique. Further prospective studies should determine the predictive value of DWI with respect to CEMRI in the annual surveillance of High Risk individuals.
Analysis of home care coordination activities in oncology: A mixed methods study.
Authors: Fatima Yatim, Gregoire Moutel, Paula Cristofalo, Marie Ferrua, Mario Di Palma, Etienne Minvielle
Journal: Journal of Clinical Oncology (2015)

6533 Background: Many studies point out the importance of care coordination, but there are few descriptive studies about the content of coordination activities and how it responds to the needs of patients and professionals. Objectives: To identify the skills and competencies needed to perform home care coordination activities. Methods: The study was conducted at Gustave Roussy (Villejuif, France), into the department coordinating outpatient care for patients who need post-discharge home care. In a first step, a data grid was developed (a focus group with the nurses and the head of the department), and then refined during an observation period. After this qualitative analysis, a quantitative analysis studied the phone calls received at the coordination platform of this department (May-June 2014). The following data were systematically collected (date; caller; reason for the call; procedure performed), and then analyzed by two researchers. They identified five categories of actions, one clinical (F1), and four related to managerial and, organizational solutions (F2 to F5), validated by the staff members of the department. Results: 543 calls were analyzed. The callers were patients or their relatives (38%), private nurses (35%), medical devices providers (20%), other primary care providers (7%). Five categories of coordination activities were identified: (F1) Patient monitoring and management of clinical and non-clinical alerts (side effects) (32%); (F2) Helping to understand and navigate through the clinical pathway (information about healthcare professional contacts) (21%); (F3) Managing technical problems linked to the achievement of care (problem about medical devices delivery) (17%); (F4) Explaining some elements of the care protocol (use a medical device)(16%); (F5) Collecting and transmitting the patient medical record information (medical prescriptions) (14%). Conclusions: The majority of requirements for patients and professionals are related to managerial and organizational issues (e.g. navigation, lack of information about specific aspects of the clinical pathway). They require the implementation of new professional managerial skills, especially among nurse navigators and other new professions.
A microphysiological model of the bronchial airways reveals the interplay of mechanical and biochemical signals in bronchospasm
Authors: Onur Kilic, Arum Yoon, Sagar R. Shah, Hwan Mee Yong, Alejandro Ruiz-Valls, Hao Chang, Reynold A. Panettieri, Stephen B. Liggett, Alfredo Quiñones-Hinojosa, Steven S. An, Andre Levchenko
Journal: Nature Biomedical Engineering (2019)
The Low Von Willebrand Factor in Ireland Cohort Study - Defining Optimal Management for Procedures in Patients with Low VWF (30-50 IU/dL)
Authors: Dearbhla Doherty, Anjali Patel, Margaret Nolan, Mary Byrne, Sonia Aguila, Jamie M O'Sullivan, Kevin Ryan, Niamh M O'Connell, Michelle Lavin, James S O'Donnell
Journal: Blood (2018)
Abstract P226: Changes of Blood Pressure and Urinary Sodium Over 18 Years in Rural China: Results From the INTERMAP China Prospective Study
Authors: Li Yan, Ellison Carter, Yu Fu, Gaoqiang Xie, Wuxiang Xie, Frank Kelly, Paul Elliott, Xudong Yang, Majid Ezzati, Jill Baumgartner, Liancheng Zhao, Yangfeng Wu, Queenie Chan
Journal: Circulation (2019)

Background: Tremendous dietary pattern changes could be a driver of the increasing burden of high blood pressure (BP) in developing countries. However, data on nutrition transitions and associated BP changes are scarce. Objective: To explore BP changes and sodium (Na) consumption over 18 years in China. Methods: International Collaborative Study of Macro-/Micro-nutrients and Blood Pressure (INTERMAP) enrolled 839 men and women aged 40-59 years from three geographically diverse regions (Beijing, Shanxi in the north and Guangxi in the south) in 1997. INTERMAP China Prospective (ICP) Study followed up these three populations in 2015-2016. Seated BP were measured at least twice following at least 5 minutes of rest, using a random zero sphygmomanometer for the INTERMAP (baseline) and an oscillometric device (Omron HEM-907) for the ICP (follow-up). When calculating BP changes, baseline values were converted using equations developed in a calibration study. Timed 24-hr urine samples were collected at baseline and follow-up using the same protocol. Urinary Na and creatinine (Cr) were measured by emission flame photometry method at baseline and ion-selective electrode method at follow-up. BP and dietary Na changes over time were compared using student t test. Results: Systolic BP increased considerably in all three sites; largest increment in Guangxi (18.6, 95% CI: 16.0-21.1 mm Hg, P&lt;0.001) and smallest in Beijing (9.1, 6.3-11.8 mm Hg, P&lt;0.001) (Table 1). Level of urinary Na was almost double in north (Beijing and Shanxi) than south (Guangxi) at follow-up (P&lt;0.001), similar as baseline. On average, participants consumed 10.8 (4.7) and 11.8 (4.7) grams of salt at Beijing and Shanxi and 6.3 (3.0) grams of salt at Guangxi at follow-up, though a trend of reduction in Na/Cr (-3.7, 95% CI: -4.7- -2.6, P&lt;0.001) overall was documented. Conclusions: Systolic BP levels increased considerably in this cohort between 1997 and 2015 in rural China. Na consumption might have a declining trend, but still at a very high level at northern China.
CLL Intraclonal Fractions Defined By Time Since Cell Birth/Division Promote a Leukemia-Supportive, Immune-Tolerant Microenvironment By Distinct Mechanisms
Authors: Shih-Shih Chen, Xiao J. Yan, Thomas M. Herndon, Clare C. Sun, Priyadarshini Ravichandran, Michael Ibrahim, Barbara Sherry, Adrian Wiestner, Kanti R Rai, Nicholas Chiorazzi
Journal: Blood (2018)
Closure of non-healing gastrocutaneous fistula after percutaneous endoscopic gastrostomy by endoscopic submucosal dissection and over-the-scope clip
Authors: Servane Gay-Chevallier, Alexandru Lupu, Jérôme Rivory, Florian Rostain, Thierry Ponchon, Jean-Christophe Saurin, Mathieu Pioche
Journal: Endoscopy (2019)

Fistulous leakage after percutaneous endoscopic gastrostomy (PEG) removal is a common adverse event occurring in around 25 % of patients and requiring surgery in 13 % of patients [1]. Conservative treatment with stomach emptying, silver nitrate, changing of the tube, and promotility agents are usually offered first. Previously persistent fistulas were usually closed surgically, but a variety of different endoscopic techniques that are less invasive than surgery have emerged, including electrochemical cautery, argon plasma coagulation and associated hemoclip placement [2], percutaneous endoscopic suturing [3], or use of the over-the-scope clip (OTSC) system [4].
Selected Expression and Functional Importance of α4a-Tubulin in Platelet Biogenesis
Authors: Catherine Strassel, Agnes Hovasse, Sylvie Moog, Magda Mageira, Morgane Batzenschlager, Christine Schaeffer-Reiss, Benjamin Kile, Christian Gachet, Carsten Janke, Francois Lanza
Journal: Blood (2016)
Abstract 005: Childhood Risk Factors and Cardiovascular Disease Outcomes in Adulthood. Preliminary Findings From the International Childhood Cardiovascular Cohort (i3C) Consortium
Authors: Olli Raitakari, David R Jacobs, Jessica Woo, Elaine M Urbina, Lydia Bazzano, Markus Juonala, Jorma Viikari, Wei Chen, Ronald Prineas, Julia Steinberger, Stephen Daniels, Alan Sinaiko, Alison Venn, Trudy L Burns, Tian Hu, Terence Dwyer
Journal: Circulation (2019)

Background: Atherosclerosis develops silently for decades before clinical cardiovascular disease (cCVD) occurs. Longitudinally, childhood risk factors predict adult pre-clinical atherosclerosis (carotid artery plaques, coronary artery calcification). There is currently no evidence directly linking childhood risk factors to cCVD. Methods: Using data from the i3C Consortium, consisting of five cohorts from the United States, one from Australia and one from Finland, we linked youth risk factors to adult cCVD. cCVD events were ascertained by re-contacting the participants in the US and Australia, then obtaining and medically adjudicating hospital records; and using the Finnish national health registry. Of 16,964 of these adult participants (mean age 49 years, range 24-67 years) who had been examined during ages 3-19 years, 201 people with any cCVD event (coronary artery, cerebrovascular, and peripheral artery disease, 70%, 25%, and 5% of events, respectively) have so far been ascertained. Analysis of deaths is in process. The associations between each youth risk variable and adult cCVD were examined in Cox proportional hazard models. Each model was additionally adjusted for childhood age, age at followup, sex and cohort/race. Continuous youth variables were z-scored for each participant’s last repeated measure during childhood. Results: Youth body mass index (BMI), serum total cholesterol (TC) and triglycerides, and systolic blood pressure were (all P &lt;0.0001) positively associated with adult cCVD events. Regular smoking in youth was associated with a nearly 50% increased risk of adult cCVD (P=0.08). BMI and TC remained significant in the simultaneous risk factor model. The adjudication pipeline suggests that over 500 hospitalized cCVD events will be found when adjudication is complete. Regression using the full set of imputed events yielded similar findings. Conclusion: These international data find that exposure to CVD risk factors in youth predicts adult cCVD with implications for primordial CVD prevention.
Technologist training to improve mammography quality.
Authors: Katherine Y Tossas-Milligan, Danielle Dupuy, Majdoline Sarah Abdallah, Louise Miller, Anne Marie Murphy
Journal: Journal of Clinical Oncology (2015)

e17614 Background: In Chicago, black women are less likely to develop breast cancer compared to white women, but die from the disease at a much higher rate. One way to address this disparity is via mammography quality improvement. Prior research showed considerable variation in mammography technologists’ understanding of the American College of Radiology guidelines for compression and positioning and identified this as a training need. The technologist is responsible for positioning the patient between the mammogram machine paddles with sufficient breast tissue, adequate breast compression and tautness to ensure identification of possible abnormalities. The technologist also assess whether additional views are necessary, prior to the patient departing. Patients recalled for technical reasons (inadequate compression, insufficient coverage of the breast) incur additional cost, worries and radiation exposure. We test if delivering a standardized mammography positioning curriculum sustainably and reproducibly improved positioning among trained technologists over time. Methods: For 2 primary trainees and 1 secondary trainee a random sample of up to 40 images 12 months before and up to 40 images 12 months after training were evaluated for presence or absence of 2 anatomical markers of good positioning: Cleavage and Inframmary Fold. A matched analysis by technologists was performed controlling for height, weight and age, where necessary. Results: A total of 180 views were analyzed representing 45 patients. Overall, the proportion of views where positioning markers could be identified increased from 30% to 70%. This improvement was consistent across both primary (40% to 70%) and secondary trainees (20% to 70%) and across mammographic views (MLO view increased from 42% to 80% and the CC view increased from 25% to 65%) Conclusions: Results show that teaching a standardized mammography positioning curriculum to community technologists appreciably improved the quality of mammographic images and that this knowledge was transferable and sustainable across time. Such an intervention could be scaled to address mammography quality deficits and decrease the existing breast cancer mortality gap between black and white women.
Prostate cancer cost-of-care and evaluation of traditional cost control measures.
Authors: Dhruv Bansal, John Wong
Journal: Journal of Clinical Oncology (2019)

163 Background: In the current era of rapid advances in cancer care, economic burden of these treatments is becoming increasingly apparent. Measures taken by Centers for Medicare &amp; Medicaid Services (CMS) such as closely monitoring length of inpatient stay might be inadequate in their goal to curtail costs. SEER analysis shows a 5-year overall survival for prostate cancer of 98.2 % and incidence of 179.1 in 2000 versus 97.8 in 2015 per 100,000, respectively. This encouraging result comes at the cost of increasing healthcare costs. Methods: We used National Inpatient Sample (NIS) database to extract data for patients hospitalized with primary diagnosis of prostate cancer using ICD-9 code 185. The 15-year time from 2000 till 2014 was analyzed. The metrics focused on were mean length of stay (LOS), mean cost of hospitalization and rate of discharges. Results: Discharge rate was 32.2 +/- 1.3 in 2000 versus 20.4 +/- 0.8 in 2014 per 100,000, respectively. Mean LOS declined from 3.7 +/- 0.115 days in 2000 to 2.2 +/- 0.044 days in 2014. During this same time period mean hospitalization charges increased from $14,680 +/- 466 to $49,464 +/- 1,019. The average annual inflation rate during this time period was 2.26%. After adjusting for inflation, the cost of stay in 2000 was $20,072 versus $49,464 in 2014. This effect is magnified when analyzing the cost per day of hospitalization. Cost per day in 2000 was $5,424 versus $22,483 in 2014. Conclusions: The increase in cost of inpatient stay is likely due to the advances in multi-modality treatment in prostate cancer. With the aging population and focus on cost conscious allocation of resources, this increase in costs will remain a challenge for hospital decision makers and insurance companies. We have to apply models such as the Markov model that are increasingly used to justify exorbitant prices of individual drugs. Also, given the complexity of health care costs, more variables should be included to rationalize health care spending. Cost metrics such as LOS are out dated given costs of treatments will continue to exceed costs such as nursing care and room and board costs. These complex analyses might be feasible with advances in deep learning which enable consideration of multiple variables in the decision-making process.
Abstract P255: Central Fat Distribution and Metabolic Health in Normoglycemic Young Women
Authors: Katherine H Ingram, Janeen S Amason
Journal: Circulation (2019)

Purpose: The purpose of this pilot study is to test the hypothesis that fat distribution, rather than overall obesity, is strongly related to insulin sensitivity in young, normoglycemic women. Methods: Thirty-eight non-diabetic young women completed the study (ages 20.7 ±2.8 years; BMI 27.6 ±3.6; 44% Caucasian (17 of 38). Matsuda Insulin Sensitivity Index was calculated from plasma glucose and insulin at 0, 30, 60, and 90 minutes after ingestion of 75g glucose, using established formula, to estimate whole body insulin sensitivity. Whole body and regional adipose tissue was assessed via DXA, abdominal ultrasound of intra-abdominal and pre-peritoneal adipose depots, circumference measures, and skinfold measures. ANOVA was used to assess mean differences among tertiles of Matsuda Index. Partial correlations were controlled for age and race, then additionally controlled for DXA percent body fat to assess associations of fat distribution independent of overall obesity. Results: ANOVA revealed a higher waist circumference (83.8 ±7.8cm vs. 75.6 ±7.2), waist/hip ratio (0.777 ±0.48 vs. 0.716 ±0.05 ), waist/height ratio (0.524 ±0.028 vs. 0.468 ±0.043), ultrasound intra-abdominal thickness (3.57 ±1.3 vs. 2.48 ±1.1) in the least insulin-sensitive tertile, when compared to the most insulin-sensitive tertile, while age, BMI, and other measures of adiposity were comparable among the three groups. Partial correlations controlled for age and race revealed strong negative relationships between Matsuda Index and measures of upper-body and central adiposity, including waist circumference ( r =-.416, p &lt;0.05), waist/hip ratio ( r = -0.500, p &lt;0.01), waist/height ratio ( r =-0.431, p &lt;0.05), IAAT ( r = -0.412, p &lt;0.05), PPAT ( r =-0.381, p &lt;0.05), but not BMI ( r = -0.173, p =ns) or overall percent fat ( r =-0.132 , p =ns). When further controlled for percent body fat, correlations persisted between Matsuda and waist circumference ( r =-.433, p &lt;0.05), waist/hip ratio ( r =-0.488, p &lt;0.01), waist/height ratio (r= -.470, p &lt;0.01), intra-abdominal fat thickness ( r =-0.394, p &lt;0.05) and pre-peritoneal fat thickness ( r =-0.361, p =0.05). Conclusions: Central and upper-body fat distribution, independent of overall obesity, is strongly associated with metabolic health in young non-diabetic women. These data underscore the clinical utility of central adiposity as an marker of metabolic health.