tbuckley/cabot-search huggingface dataset:
Association of neighbourhood migrant density and risk of non-affective psychosis: a national, longitudinal cohort study
Authors: Jennifer Dykxhoorn, Glyn Lewis, Anna-Clara Hollander, James B Kirkbride, Christina Dalman
Journal: The Lancet Psychiatry (2020)

BackgroundElevated risk of psychotic disorders in migrant groups is a public mental health priority. We investigated whether living in areas of high own-region migrant density was associated with reduced risk of psychotic disorders among migrants and their children, and whether generation status, probable visible minority status, or region-of-origin affected this relationship.MethodsWe used the Swedish registers to identify migrants and their children born between Jan 1, 1982, and Dec 31, 1996, and living in Sweden on or after their 15th birthday. We tracked all included participants from age 15 years or date of migration until emigration, death, or study end (Dec 31, 2016). The outcome was an ICD-10 diagnosis of non-affective psychosis (F20–29). We calculated own-region and generation-specific own-region density within the 9208 small areas for market statistics neighbourhoods in Sweden, and estimated the relationship between density and diagnosis of non-affective psychotic disorders using multilevel Cox proportional hazards models, adjusting for individual confounders (generation status, age, sex, calendar year, lone dwelling, and time since migration [migrants only]), family confounders (family income, family unemployment, and social welfare), and neighbourhood confounders (deprivation index, population density, and proportion of lone dwellings), and using the Akaike information criterion (AIC) to compare model fit.FindingsOf 468 223 individuals included in the final cohort, 4582 (1·0%) had non-affective psychotic disorder. Lower own-region migrant density was associated with increased risk of psychotic disorders among migrants (hazard ratio [HR] 1·05, 95% CI 1·02–1·07 per 5% decrease) and children of migrants (1·03, 1·01–1·06), after adjustment. These effects were stronger for probable visible minority migrants (1·07, 1·04–1·11), including migrants from Asia (1·42, 1·15–1·76) and sub-Saharan Africa (1·28, 1·15–1·44), but not migrants from probable non-visible minority backgrounds (0·99, 0·94–1·04). Among migrants, adding generation status to the measure of own-region density provided a better fit to the data than overall own-region migrant density (AIC 36 103 vs 36 106, respectively), with a 5% decrease in generation-specific migrant density corresponding to a HR of 1·07 (1·04–1·11).InterpretationMigrant density was associated with non-affective psychosis risk in migrants and their children. Stronger protective effects of migrant density were found for probable visible minority migrants and migrants from Asia and sub-Saharan Africa. For migrants, this risk intersected with generation status. Together, these results suggest that this health inequality is socially constructed.FundingWellcome Trust, Royal Society, Mental Health Research UK, University College London, National Institute for Health Research, Swedish Research Council, and FORTE.
Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo
Authors: Ji Hae Lee, Hyuck Sun Kwon, Han Mi Jung
Journal: JAMA Dermatology (2019)

Importance Topical calcineurin inhibitors (TCIs), including tacrolimus and pimecrolimus, have been widely used for the treatment of vitiligo; however, the efficacy of TCI monotherapy is often underestimated.  
Objectives To estimate the treatment responses to both TCI monotherapy and TCI accompanied by phototherapy for vitiligo, based on relevant prospective studies, and to systematically review the mechanism of action of TCIs for vitiligo treatment.  
Data Sources A comprehensive search of the MEDLINE, Embase, Web of Science and Cochrane Library databases from the date of database inception to August 6, 2018, was conducted. The main key words used were vitiligo, topical calcineurin inhibitor, tacrolimus, pimecrolimus, and FK506.  
Study Selection Of 250 studies initially identified, the full texts of 102 articles were assessed for eligibility. A total of 56 studies were identified: 11 studies on the TCI mechanism, 36 studies on TCI monotherapy, 12 studies on TCI plus phototherapy, and 1 study on TCI maintenance therapy.  
Data Extraction and Synthesis Two reviewers independently extracted data on study design, patients, intervention characteristics, and outcomes. Random-effects meta-analyses using the generic inverse variance weighting were performed for the TCI monotherapy and TCI plus phototherapy groups.  
Main Outcomes and Measures The primary outcomes were the rates of at least mild (≥25%), at least moderate (≥50%), and marked (≥75%) repigmentation responses to treatment. These rates were calculated by dividing the number of participants in an individual study who showed the corresponding repigmentation by the total number of participants who completed that study.  
Results In the 56 studies included in the analysis, 46 (1499 patients) were selected to evaluate treatment response. For TCI monotherapy, an at least mild response was achieved in 55.0% (95% CI, 42.2%-67.8%) of 560 patients in 21 studies, an at least moderate response in 38.5% (95% CI, 28.2%-48.8%) of 619 patients in 23 studies, and a marked response in 18.1% (95% CI, 13.2%-23.1%) of 520 patients in 19 studies after median treatment duration of 3 months (range, 2-7 months). In the subgroup analyses, face and neck lesions showed an at least mild response in 73.1% (95% CI, 32.6-83.5%) of patients, and a marked response in 35.4% (95% CI, 24.9-46.0%) of patients. For TCI plus phototherapy, an at least mild response to TCI plus phototherapy was achieved in 89.5% (95% CI, 81.1-97.9%) of patients, and a marked response was achieved in 47.5% (95% CI, 30.6-64.4%) of patients.  
Conclusions and Relevance The use of TCIs, both as a monotherapy and in combination with phototherapy, should be encouraged in patients with vitiligo.
Abstract P182: Diet Quality and Longitudinal Change in Kidney Function: Findings From the Hispanic Community Health Study/Study of Latinos (hchs/sol)
Authors: Celestin Missikpode, Ana Ricardo, Ramon Durazo-Arvizu, Josiemer Mattei, Carmen R Isasi, Yasmin Mossavar-Rahmani, Daniela Sotres-Alvarez, Gregory A Talavera, Kevin Abbott, Anjella Manoharan, Martha L DAVIGLUS, James Lash
Journal: Circulation (2020)

Introduction: Recent studies suggest an association between healthy diet and incident chronic kidney disease (CKD), but these included few Hispanics/Latinos. We examined the relationship of diet quality with change in kidney function in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Given the bidirectional relationship between CKD and cardiovascular disease (CVD), we assessed prevalent CVD as a potential effect modifier. Methods: Data from HCHS/SOL Visits 1 (2008-2011) and 2 (2014-2017) were used. The Alternative Healthy Eating Index (AHEI-2010), a measure of diet quality, was calculated from two 24-hour dietary recalls administered at Visit 1 and analyzed as quintiles (lowest to highest quality). Kidney function was assessed using CKD-EPI creat glomerular filtration rate estimating equation (eGFR), and urine albumin-to-creatinine ratio (UACR). Annualized change was computed as the difference in eGFR or UACR between visits divided by follow-up time in years. CVD was defined at Visit 1 as self-reported coronary heart disease, cerebrovascular events, peripheral artery disease or heart failure. Of 16415 HCHS/SOL participants, data from 9336 and 9209 persons with complete information on dietary intake, and change in eGFR and UACR, respectively, were analyzed using linear regression. Interaction between AHEI-2010 and CVD was explored. Analyses accounted for complex sampling design. Results: Average age was 41 years, 52% were women, and 22% had prevalent CVD. On average, eGFR declined by 0.67 mL/min/1.73 m 2 / year, and UACR increased by 2.0 mg/g/year. A significant interaction between diet quality and CVD was seen (p &lt; 0.01). Lower AHEI-2010 quintiles were associated with greater decline in eGFR in a dose-response manner in persons without CVD (P-trend &lt;0.01, Table). The association between diet quality and eGFR was stronger in those with CVD. AHEI-2010 was not associated with change in UACR. Conclusion: These findings have important implications for CKD prevention, especially for those with CVD.
Abstract P332: Urine Uromodulin Does Not Alter the Relationship Between Salt Intake and Blood Pressure: The DASH-Sodium Trial
Authors: Christine Bakhoum, Cheryl A Anderson, Stephen Juraschek, Casey M Rebholz, Lawrence J Appel, Edgar R Miller, Chirag Parikh, Wassim Obeid, Dena E Rifkin, Joachim H Ix, Pranav S Garimella
Journal: Circulation (2020)

Introduction: Genome-wide association studies have revealed susceptibility variants for hypertension in the UMOD gene. The encoded protein, uromodulin, modulates NKCC2 transporter in the thick ascending limb of the loop of Henle, and its overexpression in murine models leads to salt-induced hypertension. Hypothesis: Individuals with higher levels of urine uromodulin will have a greater increase in systolic blood pressure compared to those with lower uromodulin levels. Methods: We used data from 157 subjects in the control diet of the DASH-Sodium trial assigned to 30 days of low (1500 mg/d), medium (2400 mg/d), and high salt (3300 mg/d) diets in random order. Blood pressure was measured at baseline and at 5 visits during the last 9 days of each feeding period. We evaluated the association of urine uromodulin with change in systolic blood pressure between diets, as measured by the average at the end of each feeding period, using multivariable linear regression. Results: Baseline urine uromodulin stratified by tertiles was less than or equal to 17.64, 17.65 - 31.97, and greater than or equal to 31.98 μg/mL (overall mean 30.0 μg/mL, SEM 1.85 μg/mL). Across the tertiles, there were no significant differences in systolic blood pressure (SBP) at baseline, nor was there a differential effect of sodium diet on SBP across tertiles (low to high p = 0.81, Figure). After adjusting for age, sex, BMI, and race, uromodulin levels were not significantly associated with SBP change from low to high sodium diet (β = -0.68 per 10 μg/mL increase in urine uromodulin, p = 0.28). Conclusion: In a randomized trial of different levels of salt intake, higher urine uromodulin levels were not associated with a greater increase in blood pressure in response to high salt intake. Further human studies are needed to evaluate the findings seen in animal models, where the expression of higher levels of urine uromodulin has been associated with salt sensitive hypertension.
Correction to: Parkinson’s disease-related Leucine-rich repeat kinase 2 modulates nuclear morphology and genomic stability in striatal projection neurons during aging
Authors: Xi Chen, Chengsong Xie, Wotu Tian, Lixin Sun, Wang Zheng, Sarah Hawes, Lisa Chang, Justin Kung, Jinhui Ding, Shengdi Chen, Weidong Le, Huaibin Cai
Journal: Molecular Neurodegeneration (2020)

The original article had mistakenly inverted co-author, Wang Zheng's name. This has since been corrected.
Titin Truncating Variants in Adults Without Known Congestive Heart Failure
Authors: James P. Pirruccello, Alexander Bick, Mark Chaffin, Krishna G. Aragam, Seung Hoan Choi, Steven A. Lubitz, Carolyn Y. Ho, Kenney Ng, Anthony Philippakis, Patrick T. Ellinor, Sekar Kathiresan, Amit V. Khera
Journal: Journal of the American College of Cardiology (2020)
Chemotherapy for poor prognosis non seminomatous germ cell tumors (NSGCT): Should doses be reduced at first cycle to prevent acute respiratory distress syndrome (ARDS) in patients with multiple lung metastases?
Authors: K. Fizazi, C. Massard, S. Postel-Vinay, B. Escudier, S. Culine, B. Raynard, F. Blot, S. Antoun, G. Nitenberg, A. Plantade
Journal: Journal of Clinical Oncology (2007)

5087 Background: Patients with multiple lung metastases from NSGCT and dyspnea at presentation are at high risk of ARDS and death in the first days after chemotherapy induction. This entity has been designated the “choriocarcinoma syndrome” or “very high risk NSGCT”. It is linked to acute intra-alveolar hemorrhage related to early tumor necrosis, which in turn, may be complicated by pulmonary infection promoted by neutropenia. To try to avoid this complication, The policy to manage these patients was changed at Institut Gustave Roussy in 1997. Methods: Data from all patients with lung metastases from NSGCT and dyspnea or a pO2 &lt; 80 and treated between1980–2006 in our institution were collected. Patients were treated in a specialized intensive care unit. From 1980–1997, the first cycle of chemotherapy consisted in a full dose regimen. After 1997, it consisted in a 3-day reduced induction regimen of EP (cisplatin 20 mg/m 2 /day and etoposide 100 mg/m 2 /day), with bleomycin and two additional days of EP being postponed to day 15, and the regular BEP regimen being started at day 21. Results: 25 patients with a poor risk NSGCT according to the IGCCCG classification had extensive lung metastases plus either dyspnea at presentation (n=6) or a pO2&lt;80 (n=2), or both criteria (n=17). Median age was 30 years (range 18–49). Median hCG was 200,000 UI (range 11–8,920,000) and 18/25 (72%) patients also had non-pulmonary visceral metastases. During the 1980–1997 period, 13/15 patients (87%) developed ARDS, of whom 10 died, and only 4/15 (27%) patients were long-term survivors. In contrast, during the 1997-2006 period, only 3/10 patients (30%) developed ARDS, of whom 2 died, and 4/10 (40%) survived. Conclusions: Reducing doses of chemotherapy during the first cycle of chemotherapy for poor-prognosis NSGCT with extensive and symptomatic lung metastases seems to prevent the risk of early death due to ARDS and should therefore be recommended. No significant financial relationships to disclose.
Abstract P310: Contribution of AHA Life’s Simple 7 to Sex Differences in the Incidence of Coronary Heart Disease and Stroke
Authors: Tianyi Huang, Eric Rimm, Janet Rich-Edwards, Frank Hu, Kathryn M Rexrode
Journal: Circulation (2020)

Background: Substantial sex differences exist in the incidence of cardiovascular disease (CVD), with women at lower risk for coronary heart disease (CHD) but higher risk for stroke compared with men. However, the underlying reasons remain poorly understood, and no study to date has quantified the contribution of conventional cardiovascular risk factors to these sex differences. Methods: We prospectively followed 71,342 women from the Nurses’ Health Study and 36,499 men from the Health Professionals Follow-up Study (1986-2012) without CVD history at baseline who had complete data on Life’s Simple 7 (LS7), including smoking, diet quality, physical activity, body mass index (BMI), hypertension, hypercholesterolemia and diabetes. Time-varying Cox proportional hazards regression was used to estimate hazard ratios (HRs) for CHD and stroke comparing men versus women adjusted for age. Impact of LS7 on sex differences was evaluated by change in the sex HR estimate after further adjustment for LS7. We assessed effect modification by sex for the associations between individual components of LS7 and risk of CHD and stroke. Results: The age-adjusted HR (95% CI) comparing men versus women was 2.21 (2.10, 2.32) for CHD and 0.74 (0.69, 0.80) for stroke. Rates of achieving LS7 goals were in general worse among women compared to men (age-standardized mean LS7 score: 3.7 versus 4.1). Smoking, diabetes, hypertension and hypercholesterolemia were more strongly associated with CHD risk in women than in men (p-interaction&lt;0.01), whereas the associations with BMI, diet quality and physical activity were similar by sex (p-interaction&gt;0.23). For example, every 5 pack-years of smoking was associated with 19% higher CHD risk in women (95% CI: 1.17, 1.21) and 8% higher risk in men (95% CI: 1.06, 1.10). The HR (95% CI) associated with diabetes was 2.63 (2.40, 2.88) in women and 1.32 (1.15, 1.50) in men. By contrast, while most risk factors showed stronger associations with stroke risk in women than in men, only the difference for smoking reached statistical significance (p-interaction=0.009). After adjustment for LS7, the HR (95% CI) by sex increased to 2.61 (2.47, 2.75) for CHD and was attenuated to 0.83 (0.76, 0.89) for stroke. Conclusion: Lower LS7 achievement and stronger associations of LS7 with CVD outcomes in women than in men appeared to explain some of the sex difference in stroke risk but not CHD risk on the risk ratio scale. Ongoing work is exploring the impact of LS7 on sex differences on the absolute risk difference scale.
Abstract P478: Trends in Concurrent Heart Failure and Acute Coronary Syndrome Hospitalizations: A Literature Review
Authors: Sarah Godfrey, Laura Cohen, Susan Hennessy, Brandon Bellows
Journal: Circulation (2020)

Purpose: Patients who present with concurrent heart failure (HF) and acute coronary syndrome (ACS) have an increased risk of mortality, but changes in clinical practice have improved clinical outcomes. We sought to examine recent trends in concurrent HF and ACS hospitalizations in the United States (US) through review of published literature. Methods: We searched the Medline and PubMed databases for studies published after January 1, 2000 reporting the hospitalizations for HF with concurrent acute coronary syndromes. We included studies performed in the US or with at least 25% US participants, that reported the proportion with concurrent HF and ACS, and used a clinical definition of HF (e.g. Killip Class II or III, NYHA Class, or Framingham Criteria). Studies were reviewed by and data was extracted using a standardized form. We extracted study and patient characteristics, definition of HF, and rates of concurrent HF and ACS hospitalizations. We categorized included studies by ACS type: (1) non-specific myocardial infarction (MI) or ACS, (2) non-ST elevation (NSTE) MI or NSTE-ACS, or (3) ST elevation (STE) MI. We descriptively examined recent trends in hospitalizations for concurrent HF and ACS over time; rates reported for multiple time periods or ACS types were considered separately. Results: We identified 23 observational studies, systematic reviews, and randomized clinical trials. Of these, we excluded 13 due to non-US populations, use of non-clinical definitions of HF (i.e., diagnosis codes), or not reporting rates of concurrent HF and ACS. Of the 10 included studies, 7 reported concurrent HF with non-specific MI or ACS from 1975 through 2005 across multiple registries and literature reviews. Rates ranged from 12.5% to 48.0% with no clear time-related trends. We identified 3 studies reporting concurrent HF with NSTEMI or NSTE-ACS from pooled analysis or the Global Registry of Acute Coronary Events (GRACE) registry from 1994 to 2008. Reported rates ranged from 8.2%-15.7% for studies starting in the 1990s with one study reporting and 6.1% in 2005. We identified 4 studies reporting concurrent HF with STEMI, including a pooled analysis, the GRACE registry, and a clinical trial. Rates of concurrent HF with STEMI appeared to decrease over time from 32.5% in 1990 to 1998, 15.6%-19.5% from 1999 to 2001, and 2.6%-11.0% in 2005. Conclusion: Our literature review found that there may be a decrease in concurrent HF and STEMI hospitalizations in recent decades, but no apparent trends with other types of ACS. This may be related to emphasis on early revascularization strategies, improved primary prevention, and/or earlier time to presentation due to increasing public awareness.. However, there was a dearth of data reporting concurrent HF and ACS hospitalization within the last decade. Further research is needed to understand the impact of multiple changes in clinical practice on secular trends.
Abstract 13: Racial Differences in the Impact of Multiple Social Vulnerabilities to Health Disparities and Hypertension and Death in the Reasons for Geographic and Racial Differences in Stroke (regards) Study
Authors: Jordan B King, Laura Pinheiro, Joanna Bryan Ringel, Adam P Bress, Daichi Shimbo, Paul Muntner, Kristi Reynolds, Mary Cushman, George Howard, Jennifer Manly, Monika M Safford
Journal: Circulation (2020)

Background: Individual social vulnerabilities to health disparities increase the risk of developing hypertension and lower life expectancy, but their cumulative effect on these outcomes is unknown. Methods: Using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, we included participants aged 45 years or older without hypertension at baseline (i.e., systolic/diastolic blood pressure &lt;130/80 mm Hg and no antihypertensive medication use). The exposure was count of vulnerabilities at baseline which were defined across economic, education, health and health care, neighborhood and built environment, and social and community context domains. The primary outcome took on three levels: 1) alive at follow-up without hypertension (reference group), 2) alive at follow-up with hypertension, or 3) deceased prior to follow-up 10-year risk of hypertension or death. Multinomial logistic regression was used to determine associations of the count of vulnerabilities with hypertension and survival status at the second in-home visit, expressed as adjusted relative risk ratios (aRRR). Analyses were stratified by race. Results: Among 5425 participants (mean±SD age of 63±10 years, 24% black, and 54% female), 1785 (33%) participants developed hypertension and 1135 (21%) participants died. A greater proportion of black participants developed hypertension and died than did white participants (hypertension, 38% vs 31%; death, 25% vs 20%). The associations between vulnerability count and both hypertension and death were stronger in white participants than black participants (p-value for vulnerability count*race interaction: hypertension = 0.042, death =0.021; Figure 1). Conclusions: The relative effect of multiple social vulnerabilities on hypertension development may be stronger in white adults than black adults. Nonetheless, black adults experience the highest absolute rates of hypertension in all subpopulations.