tbuckley/cabot-search huggingface dataset:
Abstract P023: Predictors of Oral Anticoagulation Resumption Among Atrial Fibrillation Patients Surviving an Intracranial Hemorrhage
Authors: Nemin Chen, Terri Newman, Meiqi He, Inmaculada Hernandez
Journal: Circulation (2019)

Background: The clinical benefit of resuming oral anticoagulation (OAC) in atrial fibrillation (AF) patients who have survived an intracranial hemorrhage (ICH) remains unclear. It is important to understand what patient characteristics affect whether patients are restarted on OAC after an ICH. Hypothesis: We hypothesized that younger patients, those without chronic kidney disease, and at high stroke risk would be more likely to restart OAC. Methods: Using claims data from a 5% random sample of Medicare beneficiaries, we selected patients with a diagnosis of non-valvular AF who experienced an ICH while using OAC (n=4,822). The primary outcome was OAC resumption at 12 weeks after ICH. Among patients who restarted OAC, we further evaluated the likelihood of resuming warfarin versus direct oral anticoagulants (DOACs). We constructed multivariate logistic regression to evaluate the association between a comprehensive list of demographics and clinical characteristics (list in table) and OAC resumption. Results: Among the 4,822 patients, 1,766 (37%) restarted OAC during the first 12 weeks. Among them, 280 (16%) started direct oral anticoagulants, and 1,486 (84%) started warfarin. Younger patients, those eligible for Medicaid, with a previous ischemic stroke and higher CHA 2 DS 2 -VASc score were more likely to restart OAC (Table). Among participants who resumed OAC in 12 weeks, patients with a history of ischemic stroke were less likely to use DOACs; however, those with a higher risk of bleeding, measured by HAS-BLED score, were more likely to use them. Conclusion: Around 35% of AF patients who survived an ICH restarted OAC within 12 weeks of the ICH, and, among them, most used warfarin. Although a history of ischemic stroke increased the odds of OAC resumption, it decreased the odds of using DOACs.
Antibacterial Envelope to Prevent Cardiac Implantable Device Infection
Authors: Khaldoun G. Tarakji, Suneet Mittal, Charles Kennergren, Ralph Corey, Jeanne E. Poole, Edward Schloss, Jose Gallastegui, Robert A. Pickett, Rudolph Evonich, François Philippon, Janet M. McComb, Steven F. Roark, Denise Sorrentino, Darius Sholevar, Edmond Cronin, Brett Berman, David Riggio, Mauro Biffi, Hafiza Khan, Marc T. Silver, Jack Collier, Zayd Eldadah, David J. Wright, Jeff D. Lande, Daniel R. Lexcen, Alan Cheng, Bruce L. Wilkoff
Journal: New England Journal of Medicine (2019)

Infections after placement of cardiac implantable electronic devices (CIEDs) are associated with substantial morbidity and mortality. There is limited evidence on prophylactic strategies, other than the use of preoperative antibiotics, to prevent such infections.
Ian Adamson: paediatrician who became mayor of Belfast and persuaded Ian Paisley to talk to Sinn Féin
Authors: Rebecca Wallersteiner
Journal: BMJ (2019)

Credit: Dalaradia Group

Born in Conlig, County Down, Samuel Ian Gamble Adamson grew up in a modest but bookish family. His father, John, who ran the village store and enjoyed reading, was from Bolton in Lancashire and his mother was from East Ayrshire. He had two sisters, who survive him. The studious young Adamson was educated at Bangor Grammar School, where he read assiduously and developed an interest in history and culture, as well as in science. The teachers tried to make him lose his working class accent.

After the news of his death, Ireland’s president, Michael Higgins, paid tribute to Adamson, describing him as a “friend,” a “respected scholar,” and a “supporter of countless organisations that served to celebrate and protect our common heritage.”

A graduate of Queen’s University Belfast, Adamson worked as a consultant paediatrician for many years and was a specialist in community child health and in immunisation against tropical diseases. He spoke 10 languages, including Ulster Scots, Lakota Sioux, Russian, Swahili, Dutch, and Irish; had an interest in anthropology; and loved meeting people from different countries and cultures. He liked to show friends the precious pipe of peace presented to him by Sioux elders, when he was accepted as a member of the …
New Treatment for Rare Blood Clotting Disorder
Authors: Feyza Sancar
Journal: JAMA (2019)

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Abstract P354: Work-Family Conflict and Ideal Cardiovascular Health Score in ELSA-Brasil Baseline Assessment
Authors: Priscila T Rocco, Isabela M Bensenor, Rosane H Griep, Sandhi M Barreto, Arlinda B Moreno, Airlane P Alencar, Paulo A Lotufo, Itamar S Santos
Journal: Circulation (2019)

Introduction: Perceived stress (including work-related stress) is associated with cardiovascular health. We studied the association between work-family conflict and AHA’s ideal cardiovascular health (ICH) score at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline. Hypothesis: Individuals with more frequent work-family conflict have worse ICH scores. Methods: We analyzed data from 11,351 active workers, aged 35-74 years. ICH scores were calculated based on the four lifestyle (diet, physical activity, smoking and body-mass index) and three health (blood pressure, fasting plasma glucose and total cholesterol) metrics proposed by the AHA. Work-family conflict was assessed as time and strain-based work interference with family; family interference with work and lack of time for personal care and leisure. We used quasi-Poisson regression models to analyze the association between work-family conflict and ICH scores, with positive relative predicted score differences (rPSD) indicating higher predicted ICH scores. Results: Subjects with frequent lack of time for personal care and leisure had lower global (rPSD: -2.9%; p=0.01) and lifestyle (rPSD: -8.2%; p&lt;0.01) ICH scores but higher health ones (rPSD: +4.8%; p=0.02). After stratifying by sex, the negative association between lack of time for personal care and leisure and global ICH scores remained significant only in women. In addition, women had a negative association between lifestyle ICH scores and both frequent strain-based work interference with family (rPSD: -5.1%; p&lt;0.01) and family interference with work (rPSD: -8.6%; p&lt;0.01). Conclusions: We found significant associations between work-family conflict and ICH scores in this large multicenter sample. Associations between work-family conflict and ICH score (especially lifestyle metrics) were more intense in women.
Gemcitabine-<i>c</i>arboplatin (GCb) versus gemcitabine-oxaliplatin (GemOx) in cisplatin un-fit advanced urothelial <i>c</i>arcinoma: Randomized phase II study (COACH Study).
Authors: Jae-Lyun Lee, Bong-Seog Kim, Ho Yeong Lim, Hee Jun Kim, Inkeun Park, Hyo Jin Lee, Yoon Ji Choi, Kyong Hwa Park, Kyung Hee Lee, Shinkyo Yoon, Bumsik Hong, Jun Hyuck Hong, Hanjong Ahn
Journal: Journal of Clinical Oncology (2019)

355 Background: More than half of patients (pts) with advanced urothelial cell carcinoma (UCC) are ineligible for cisplatin because of renal dysfunction or poor performance status. We investigated the activity and safety of first-line gemcitabine-oxaliplatin (GemOx) compared with gemcitabine-carboplatin (GCb) in cisplatin-ineligible pts with advanced UCC. Methods: Treatment naïve, cisplatin-ineligible pts with advanced UCC were randomly assigned to GemOx (gemcitabine 1000 mg/m2, oxliplatin 100 mg/m2 on D1 Q2W) or GCb (gemcitabine 1000 mg/m2 on D1 and 8, carboplatin AUC 4.5 on D1 Q3W) stratified by ECOG performance status (PS) and visceral metastases. The primary endpoint was response rate (RR), and secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Between May 2013 and Mar 2017, 80 pts were enrolled and 79 pts received at least one dose of chemotherapy (39 pts in GCb; 40 pts in GemOx). Median age was 73 years (47-86) and ECOG PS was 2 in 42% of pts and 60% had visceral metastases. Median GFR was 45 ml/min (range 22-108) in GCb and 47 ml/min (range 15-73) in GemOx arm. With median follow-up duration of 37.8 months, all pts were off study treatments. RR were 48.7% and 55.0% in GCb and GemOx, respectively (p = 0.742). Median PFS and OS in GCb and GemOx arm were 5.5 months (95% CI, 4.8-6.2) vs. 4.4 months (95% CI, 2.7-6.1) [HR GemOx/GCb 0.92; p = 0.756] and 9.1 months (95% CI, 5.2-13.0) vs. 11.0 months (95% CI, 6.9-15.0) [HR 0.72; p = 0.194], respectively. The median cycle was 6 (1-10) in GCb and 7 (1-12) in GemOx. Grade 3 leukopenia, neutropenia and fatigue were more common in GCb arm (25.6% vs. 2.5%, p = 0.003; 33.3% vs. 10.0%, p = 0.014; 15.4% vs. 0%, p = 0.012). Dose delay and reduction in GCb and GemOx group were needed in 46.2%, 50.0% and 53.8%, 32.5%, respectively. Salvage chemotherapy after study treatment was offered in 54.3% and 55.9% of patients who experienced PD in GCb and GemOx arm. Conclusions: GemOx has showed comparable efficacy with GCb and favorable hematologic toxicity profile. GemOx may be used as a new option for patients who are not suitable for cisplatin-containing chemotherapy. Clinical trial information: NCT01487915.
Abstract P125: Cardiovascular Health Improves in High Transportation Vulnerable Girls With Decreased Exposures to Residential Segregation
Authors: Emily M D’Agostino, Hersila H Patel, Eric Hansen
Journal: Circulation (2019)

Introduction: Transportation equity ensures that all citizens benefit from a clean, fair, safe and healthy environment. Residential segregation also impacts health, and transportation disadvantage is particularly high in areas with high segregation, where residents typically lack proximity to quality education, jobs, healthy food, safe playgrounds, and medical care. Recent research demonstrates improvements in cardiovascular risk profiles among minority girls after reduced exposure to segregation. There is a need to examine differences in the segregation-youth cardiovascular health association across transportation vulnerability and gender to inform health equity interventions. Hypothesis: It was hypothesized that girls with reduced segregation exposure and low transportation vulnerability would have the most improved cardiovascular health. Methods: Data for these analyses were drawn from the Fit2Play dataset (2010-2018; N=2742). Youth were followed over 4 consecutive years of participation in a year-long afterschool physical activity program. Change in segregation exposure was based on concentration of minorities living in block groups from the participant’s home to program areas using the 2010 Census. Transportation vulnerability was based on percent of households in the participant’s home zip code with vehicle access (0, 1, 2, or ≥3 vehicles) drawn from the American Community Survey (2012-16). Longitudinal mixed models were used to compare the association between change in residential segregation and five cardiovascular health risk measures (body mass index, systolic and diastolic blood pressure, skinfold thickness and 400 meter run tests) stratified by transportation vulnerability and gender. Results: Participants were 54% male, 51% Hispanic, 49% non-Hispanic black, and 52% high poverty (mean age 9.5 years). After accounting for child age, race/ethnicity, poverty, and year, girls with high transportation vulnerability and reduced segregation exposure showed the most reduced cardiovascular health risk profiles, including improvements in body mass index (26%, 95% CI: 23.84, 28.30), skinfold thicknesses (18%, 95% CI: 14.90, 20.46), run time (17%, 95% CI: 14.88, 18.64), systolic blood pressure (15%, 95% CI: 11.96, 17.08), and diastolic blood pressure (12%, 95% CI: 9.09, 14.61). In contrast, no clear patterns emerged for low transportation vulnerable girls, and high or low transportation vulnerable boys. Conclusions: In conclusion, high transportation vulnerable girls exposed to reduced segregation had greater improvements in all cardiovascular health risk outcomes compared with low transportation vulnerable girls, and both high and low transportation vulnerable boys. Transportation equity interventions may provide a means to reduce youth cardiovascular health disparities, particularly for girls living highly segregated areas.
5 years experience of the first public breast cancer screening center in the capital of Kingdom of Saudi Arabia.
Authors: Omalkhair A. M. Abulkhair, Fatina Altahan, Salma Musaad, Sara Al Sheikh, Mona Al-Shahed, Mushabab Alasiri, Abdullah Alamro, Abdulrahman Alnuaim, Manal Alzaid, Dorothy Makanjoula, Lolwah Abdullah Riyees, Ahmed Saadeddin
Journal: Journal of Clinical Oncology (2015)

e12598 Background: Breast cancer is the commonest malignancy among Saudi female. Median age at diagnosis 47 years. > 50% were stage II and III stage 0 or DCIS represented < 5%. The most proven modality of breast cancer screening is mammography which contribute of diagnosis of early stage disease in the western countries. In the Kingdom of Saudi Arabia (KSA), there is no national screening program. But there is pilot BC screening Center in Riyadh, the capital of Saudi Arabia. The objective is to describe the 5 year result of this center in relation to cancer detection rate, uptake rate and recall rate. Methods: The center was established July 2007 located in Riyadh, where the total Saudi population in 2007-2008 was 3.3 million. Female represent 45% (1.492) and > 403,080 female eligible for screening. The program was made available for all women, self-referral. An asymptomatic women aged 40-65 years old not pregnant or lactating. Women will be interviewed by primary care physicians in the center who complete risk assessment questionnaire and perform physical exam. Then conventional 2 view film screening mammograms were performed and reviewed independently by two radiologist. Mammogram was scored on a 5-point scale using the American College Radiology Breast Imaging Reporting and Database System( BIRADS). A screening mammogram with a BIRAD 0, R3 or above were referred to a hospital for further work-up and management, including biopsy. All analyses were conducted using the Statistical Analysis Software (SAS) version 9.3 ( SAS Institute, Cary, NC, USA). No adjustment for multiple testing was conducted. Results: 3778 were screened represent 0.8% of eligible women for screening. 347 (9.2) referred to hospital for further investigation, 81 (2.1%) had biopsy proven carcinoma which represent cancer detection rate. The recall rate was 6.3 %. Only 30% of women continue follow up within annual screening. Conclusions: Although our recall rate meet the international guideline. The uptake rate is much lower than the standard figure. There is an urgent need to revise. The program in order to achieve the goals. Increase participation rate Build a database for long term follow up for risk assessment.
Fractionated stereotactic radiotherapy (fSRT) with or without chemotherapy and immunotherapy for recurrent Glioblastoma Multiforme: A single institution experience.
Authors: Shaakir Hasan, Eda Chen, Rachelle Marie Lanciano, Jun Yang, Alex Hanlon, Luther W. Brady
Journal: Journal of Clinical Oncology (2015)

e13044 Background: The current standard of care for salvage treatment of Gliobloastoma Multiforme (GBM) is gross total resection and adjuvant chemoradiation, or bevacizumab for inoperable patients. We aim to contribute our experience of fractionated stereotactic radiotherapy (fSRT) with and without chemo/immunotherapy for recurrent GBM, which thus far has shown varied results. Methods: From 2007 to 2014, 19 patients between the ages 29 and 78 years (median 55) with recurrent GBM following resection and chemoradiation for their initial tumor, received 18 – 35 Gy (median 25) in 3 – 5 fractions via Cyberknife fSRT. Clinical target volume (CTV) ranged from 0.9 to 152 cc. Sixteen patients received adjuvant systemic therapy with bevacizumab (BEV), temozolomide(TMZ), I-425 mAb, or some combination thereof. Kaplan-Meier log rank and univariate Cox regression models were used to report survival and prognostic factors. Results: The median overall survival (OS) from date of recurrence was 8 months (2.5 – 53) and 5.3 months (2 – 52) from the end of fSRT. The OS at 6 and 12 months was 47% and 32%, respectively. Three of 19 patients were alive at the time of this review. Hazard ratios for survival indicated that patients with a frontal lobe tumor, adjuvant treatment with either BEV or TMZ, time to first recurrence >16 months, CTV < 36 cc, Recursive Partitioning Analysis (RPA) < 5, and ECOG (Eastern Cooperative Oncology Group) performance status < 2 were all associated with improved survival (P < 0.05). There was no evidence of radionecrosis for any patient. Conclusions: Radiation Therapy Oncology Group (RTOG) 1205 will establish the role of re-irradiation for recurrent GBM, however our study suggests that cyberknife fSRT with chemotherapy can be safely delivered, and is most effective in patients with smaller frontal tumors with good performance status and long interval from diagnosis. Variable Median Survival (mo) P Value Recurrence > 16 mo 10.2 0.01 Recurrence < 16 mo 4.7 CTV < 36 cc 8.6 0.001 CTV > 36 cc 2.6 Systemic Therapy 8.0 0.02 No Systemic Therapy 3.3 Frontal Tumor 8.6 0.04 Non-frontal Tumor 4.9
Evaluation of the Safety, Immunogenicity, and Hemostatic Efficacy of Nonacog Gamma (BAX326) in Previously Treated and Naïve Patients with Severe or Moderately Severe Hemophilia B: A Continuation Study
Authors: Jerzy Windyga, Oleksandra Stasyshyn, Werner Engl, Srilatha D. Tangada
Journal: Blood (2018)
Impact of a Ten-Year National Italian Networking on Cardiac Complications in Patients with Thalassemia Major
Authors: Alessia Pepe, Laura Pistoia, Aurelio Maggio, Annamaria Carrà, Maria Grazia Roberti, Pier Paolo Bitti, Rosamaria Rosso, Maurizio Caniglia, Roberto Mattei, Anna Maria Petrungaro, Ada Riva, Riccardo Righi, Vincenzo Positano, Antonella Meloni
Journal: Blood (2018)
Comprehensive multiplatform biomarker analysis of 206 squamous cell anal cancers.
Authors: Patrick McKay Boland, Sherri Z. Millis, David Arguello, Zoran Gatalica, Sandeep K. Reddy, Joshua E. Meyer, Thorvardur Ragnar Halfdanarson
Journal: Journal of Clinical Oncology (2015)

603 Background: Anal squamous cell carcinoma (Anal SCC) is a rare, HPV-associated malignancy accounting for 2.4% of digestive system cancers. In most cases, these malignancies are detected in the early stages and successfully managed with chemoradiation therapy. Uncommonly, these cancers recur or present with metastases. In this setting, cisplatin and 5-fluorouracil represent the only endorsed regimen. Once beyond standard therapy, few therapeutic options exist for those patients with aggressive disease. The purpose of this study is to identify other novel, potential targets and therapeutic options for this disease, utilizing a multiplatform approach. Methods: 206 anal SCC specimenswere tested via a multiplatform profiling service (Caris Life Sciences, Phoenix, AZ) consisting of gene sequencing (Sanger or next generation sequencing [NGS]), protein expression (immunohistochemistry [IHC]) and gene amplification (CISH or FISH). 6 cases were documented as positive for HPV or HIV; status was not provided on the remaining 200. Results: Key results are shown in the table below, shown as percent change/total cases. Conclusions: Multiplatform tumor profiling identified a low incidence of gene mutations. Protein expression aberrations identified potential treatment options not routinely considered, such as topoisomerase inhibitors and taxanes. Mutations in PIK3CA, Akt1, and FBXW7 as well as PTEN loss indicate potential for targeting the PI3 kinase pathway. Additionally, immunomodulatory agents may be a therapeutic option, based on PD-1 expression levels. Targeting the ErbB-family receptors, namely with anti-EGFR agents or newer generation pan-HER - inhibitors, may represent another option, given EGFR and HER2 amplification as well as EGFR overexpression. It should be mentioned that differences in anal carcinomas whose etiology is of viral origin may present different treatment options based on the driver mutations. [Table: see text]
3D Plotted Biphasic Bone Scaffolds for Growth Factor Delivery: Biological Characterization In Vitro and In Vivo
Authors: Tilman Ahlfeld, Felix Paul Schuster, Yvonne Förster, Mandy Quade, Ashwini Rahul Akkineni, Claudia Rentsch, Stefan Rammelt, Michael Gelinsky, Anja Lode
Journal: Advanced Healthcare Materials (2019)

Abstract Bioprinting enables the integration of biological components into scaffolds during fabrication that has the advantage of high loading efficiency and better control of release and/or spatial positioning. In this study, a biphasic scaffold fabricated by extrusion‐based 3D multichannel plotting of a calcium phosphate cement (CPC) paste and an alginate/gellan gum (AlgGG) hydrogel paste laden with the angiogenic factor VEGF (vascular endothelial growth factor) is investigated with regard to biological response in vitro and in vivo. Rat mesenchymal stromal cells are able to adhere and grow on both CPC and AlgGG strands, and differentiate toward osteoblasts. A sustained VEGF release is observed, which is able to stimulate endothelial cell proliferation as well as angiogenesis in vitro that indicates maintenance of its biological activity. After implantation into a segmental bone defect in the femur diaphysis of rats, a clear reduction of the defect size by newly formed bone tissue occurs from the distal and proximal ends of the host bone within 12 weeks. The CPC component shows excellent osteoconductivity whereas the local VEGF release from the AlgGG hydrogel gives rise to an enhanced vascularization of the defect region. This work contributes to the development of novel therapeutic concepts for improved bone regeneration which are based on 3D bioprinting.