tbuckley/cabot-search huggingface dataset:
Abstract 14066: Black-White Differences in the Influence of Risk Factors in Childhood on Left Ventricular Mass in Young Adulthood
Authors: Brenda Mendizabal, Phil R Khoury, Jessica G Woo, Elaine M Urbina
Journal: Circulation (2016)

Introduction: Cross-sectional studies have demonstrated a relationship between cardiovascular (CV) risk factors and left ventricular mass (LVM) in adolescents. Few data exist relating the burden of...
Abstract MP35: Discordant Visceral and Liver Fat Phenotypes are Differentially Associated With Incident Cardiovascular Disease and Type 2 Diabetes
Authors: Sanaa Tejani
Journal: Circulation (2020)

Background: Visceral adipose tissue (VAT) and ectopic liver fat (ELF) are linked with cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) but little is known about their joint associations when they are discordant in an individual. Objective and Hypothesis: This study aims to evaluate cardiometabolic health outcomes associated with discordant VAT-ELF phenotypes in a multi-ethnic, population-based cohort of adults. We hypothesized that high VAT-low ELF, but not low VAT-high ELF, would be associated with incident cardiovascular disease, but both would be associated with incident T2DM. Methods: Participants of the Dallas Heart Study with no history of CVD or T2DM had assessments of VAT and ELF by MRI and MRS, respectively, between 2000 and 2002 and were followed for a median (IQR) of 12.0 (11.5-12.7) years for the incidence of CVD or T2DM. Associations between VAT-ELF phenotypes (high/low based on sex- and race-specific median values) and outcomes were evaluated using multivariable adjusted Cox proportional hazards and logistic regression models, as appropriate. Results: The study cohort included 1731 participants (mean age 43, 54% female, 44% black, 18% Hispanic, 41% obese). 128 (7.4%) participants had incident CVD and 95 (5.5%) had incident T2DM during follow-up. In unadjusted models, those with high VAT-low ELF had the highest hazard for CVD ( Table ), but associations were attenuated after multivariable adjustment. In both unadjusted and adjusted models, high VAT and/or high ELF phenotypes were associated with T2DM, with the high VAT-high ELF phenotype demonstrating the highest odds for T2DM ( Table ). Conclusions: In conclusion, we found that the heterogeneous manifestations of abdominal obesity impact cardiometabolic health outcomes. Elevated liver fat in the presence of low or normal VAT is associated with incident T2DM but not CVD.
Abstract P467: Premature Coronary Artery Disease Mortality in the Appalachian Region: Is the Problem Driven by Rural-urban or Socioeconomic Disparities?
Authors: Alexander V Sergeev
Journal: Circulation (2020)

Background: Premature mortality under the age of 75 years exacerbates the burden of coronary artery disease (CAD) as the leading cause of death in the nation, with particular concerns being raised about its disproportionate effect on the vulnerable population of the Appalachian region compared to other regions of the United States. It is unknown whether the problem of premature CAD mortality in the Appalachian residents is further aggravated by disparities across various population groups within the Appalachian region itself. We hypothesized that within-region socioeconomic and geographic (rural-urban) disparities, independently of each other, aggravate the premature CAD mortality problem in the Appalachian population. Methods: A population-based study of age-adjusted premature CAD mortality among 25-74 year old residents of the Appalachian region was conducted (n=63,630,221). Counties’ rurality status was defined using the U.S. Department of Agriculture Economic Research Service’s (USDA ERS) Rural-Urban Continuum Codes: of 420 Appalachian counties, 217 were classifies as rural and 203 - as urban. To adjust for multiple covariates, general linear modeling (GLM) analysis was conducted (SAS, ver. 9.4). Results: Age-adjusted premature CAD mortality rates were higher in rural than urban Appalachian counties: 99.0 + 40.2 vs. 78.8 + 26.4 per 100,000 (p&lt;0.01). Compared to urban counties, their rural counterparts had a higher prevalence of poverty (30.8 + 7.3% vs. 24.4 + 5.7%, p&lt;0.01), unemployment (8.1 + 2.0% vs. 6.7 + 1.2%, p&lt;0.01), lack of insurance (18.4 + 3.5% vs. 16.0 + 3.6%, p&lt;0.01), smoking (22.2 + 3.8% vs. 20.2 + 2.9%, p&lt;0.01), obesity (33.1 + 3.8% vs. 32.0 + 3.5%, p&lt;0.01), sedentary lifestyle (32.2 + 4.5% vs. 29.6 + 4.7%, p&lt;0.01). In the multivariate-adjusted analysis, smoking ( beta 3.322, p&lt;0.01), sedentary lifestyle ( beta 0.947, p&lt;0.01), healthcare services accessibility and utilization ( beta -0.532, p&lt;0.05), unemployment ( beta 2.761, p&lt;0.05) and poverty ( beta 0.652, p&lt;0.05) were statistically significantly associated with age-adjusted premature CAD mortality. Conclusions: Premature CAD mortality in rural Appalachian counties is statistically significantly higher than in urban Appalachian counties. Socioeconomic disparities and modifiable CAD risk factors further aggravate the problem.
Abstract P506: Dietary Self-monitoring Using An App: Are Frequency, Consistency And Completeness Related To Weight Loss?
Authors: Jason E Payne, Melanie T Turk, Christine A Pellegrini, Melissa A Kalarchian
Journal: Circulation (2020)

Background: Approximately 70% of the U.S. adult population has obesity and/or overweight and thus increased risk for heart disease, stroke, and type II diabetes mellitus. Standard obesity treatment includes a behavior modification technique, dietary self-monitoring, which entails recording all foods and beverages consumed with calorie amounts and time of consumption. Greater adherence to dietary self-monitoring using a paper diary is associated with weight loss. Self-monitoring via a mobile phone application (app) is an appealing, convenient alternative to paper-based techniques; however, few studies have examined the relationship between adherence to a dietary self-monitoring app and weight loss. Objectives: The objectives of the study were to 1) examine if there is an association between app-based dietary self-monitoring and weight change and 2) explore the relationships between the frequency, consistency, and completeness of app-based dietary self-monitoring and weight change at 8 weeks among adults with overweight or obesity. Frequency was the percentage of days that any self-monitoring occurred during the study; consistency was the recording of any dietary intake on &gt; 3 days each week; completeness was the recording of 50% or more of the weekly individual calorie goal. Methods: Ninety participants interested in weight loss were recruited to self-monitor dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned a daily calorie goal to achieve a one-pound weight loss per week. Paired sample t-test and linear regression were used to examine the relationships between app-based self-monitoring and weight change as well as the frequency, consistency and completeness of self-monitoring and weight change at 8 weeks. Results: The sample [N = 90, mean ( M ) age = 42 ± 10 years (SD)] was employed (100%), primarily female (96.7%), White (90%), and married (63.3%) with a Bachelor’s or Associate’s degree (60%). Paired-sample t test revealed a significant mean difference [ t (89) = 6.59, p &lt; .001] between baseline and 8-week weight in pounds ( M = -3.26 ± 4.70). Linear regression analysis revealed an association [ F (1, 88) = 7.18, p = .009] between total weeks of consistently self-monitoring ( M = 4.44 ± 2.77) and percent weight loss ( M = -1.54 ± 2.26) as well as an association ( F (1, 88) = 6.42, p = .013] between the frequency of self-monitoring ( M = 50.14 ± 33.0) and percent weight loss. Completeness of self-monitoring was not associated with percent weight loss. Conclusion: Results suggest that consistent ( &gt; 3 days/week) and frequent ( &gt; 50% of days) app-based self-monitoring aids weight loss. Clinicians may wish to emphasize frequent and consistent self-monitoring, rather than complete self-monitoring, when providing weight loss counseling. Future research should examine app-based self-monitoring in men as well as ethnically and racially diverse populations. .
David Oliver: Social care—back to an uncertain future
Authors: David Oliver
Journal: BMJ (2020)

If I’d been writing this column in early 2010, on the threshold of a new five year parliament, I’d have called for a credible long term solution for social care in England, lamented the lack of meaningful action to date, and doubted the political commitment or public will to change.

Sometimes, the more things change, the more they stay the same, and so it is with social care. Three general elections later, at the start of this new decade I could virtually cut and paste the same introduction. Recent history makes me doubt the future.

The recommendations of the 1999 Royal Commission on Long Term Care for older people were largely ducked by Labour in the 2000 NHS plan.12 And in early 2010 the Labour government published a white paper on the future of social care funding, Building the National Care …
Tumor-associated stroma cell therapy in patients with pancreatic cancer potentiates therapeutic effect of tumor B-cell hybrid (TBH) auto-vaccines
Authors: G. A. Moviglia, C. Gaeta, G. Varela, N. Iraola, A. Paes de Lima, H. Costanzo, P. Farina, F. Bastos, C. Ayala, G. Schuster
Journal: Journal of Clinical Oncology (2007)

4569 Background: Pancreatic Cancer (PC) tumor-associated stroma cells play an important role in PC’s immune surveillance escape. Secretion of Transforming Growth Factor β (TGFβ) and IL10 by PC tumor cells disturb the antigen presenting function of the stroma cells. It may explain the poor results of most immunotherapeutic approaches. Granger et al. reported a successful approach for treating small size pancreatic tumors, namely Mixed Lymphocyte Culture (MLC) cytoimplant. MLC cytoimplants, acting as a Th1 cytokine pump inside the tumor, are thought to revert the tumor-associated stroma cell dysfunction, and facilitate an immune attack. In view that TBH auto-vaccines have modest activity in advanced PC, we considered the possibility that a combination of MLC cytoimplant and TBH vaccines might potentiate the immune response. In this study we compared the response of MLC cytoimplant, TBH vaccines, and combinations of both therapies. Methods: 40 patients with advanced PC were treated: Group 1 MLC cytoimplan (10); Group 2 TBH vaccines (3); Group 3 one MLC cytoimplant and three TBH vaccines (9); Group 4 one MLC cytoimplant and six TBH vaccines (12) and Group 5 one MLC cytoimplant followed by two TBH immunizations, then second MLC cytoimplant followed by 4 TBH vaccines (6). Anti-tumor immune response was measured by Lymphocyte proliferation assay against autologous PC. Results: MLC cytoimplant combined with TBH vaccines appears to have synergistic and effective anti-tumor activity in advanced PC. Kaplan Meyer analysis showed a significant difference in the survival of group 4 as compared with the other four groups (P&lt;0.001). After cytoimplant administration, 1/12 patients in Group 4 and 1/6 patients in Group 5 experienced transient bleeding episodes (lasting less than 12 hours). After the second MLC cytoimplant, all patients in Group 5 developed significant Graft Vs Host Disease (GVHD), an occurrence that probably contributed to the Group’s shorter survival when compared to Group 4’s survival. Conclusions: The observation that a second MLC cytoimplant leads to GVHD is consistent with a pro-inflammatory change in the tumor-associated stroma cells. MLC cytoimplant followed by TBH vaccines appear to prolong survival. No significant financial relationships to disclose.
Abstract P522: Alcohol Consumption and Cardiovascular Mortality After Myocardial Infarction
Authors: Leanne K Küpers, Anne J de Ruiter, Maria C Busstra, Johanna M Geleijnse
Journal: Circulation (2020)

Background: Little is known about alcohol consumption in relation to long-term mortality risk after myocardial infarction (MI). We examined alcohol consumption in relation to total, coronary heart disease (CHD) and cardiovascular disease (CVD) mortality in the Alpha Omega Cohort of Dutch post-MI patients. Methods: We included 4,365 patients (60-80y, 79% male) with MI ≤10y before enrolment. Heavy alcohol users (≥6 glasses/d) were excluded from cohort participation. Dietary intake and alcohol consumption were assessed using a 203-item validated food-frequency questionnaire. Patients were classified as non-drinkers (0 g/d, n=956), very light (&gt;0-≤2 g/d, n=385), light (M: &gt;2-≤10, F: &gt;2-≤5 g/d, n=1,125), moderate (M: &gt;10-≤30, F: &gt;5-≤15 g/d, n=1,207) or heavy drinkers (M :&gt;30, F: &gt;15 g/d, n=692). Hazard ratios (HRs) for total, CHD and CVD mortality were obtained, adjusting for age, sex, education, smoking, BMI, physical activity, energy intake and other dietary factors. Results: Alcohol was consumed by 83% of men and 61% of women. During 11.1y follow up, 2,035 deaths occurred of which 575 from CHD and 801 from CVD. Compared to the reference group of very light drinkers, HRs (95%CI) for total mortality were 1.01 (0.85, 1.19) in non-drinkers, and 0.88 (0.74, 1.04), 0.85 (0.72, 1.01) and 0.91 (0.76, 1.10) in light, moderate and heavy drinkers respectively. Adding non-drinkers to the reference group did not affect HRs: 0.87 (0.78, 0.98), 0.85 (0.76, 0.96) and 0.91 (0.79, 1.05) for light, moderate and heavy drinkers. Associations were slightly stronger but non-significant for CVD and CHD mortality. Findings were roughly similar after exclusion of former drinkers (n=385), diabetics (n=883) and patients with poor health (n=1,010). Conclusion: Light to moderate alcohol consumption was weakly inversely associated with total, CVD and CHD mortality risk in post-MI patients. In this observational study, potential bias and confounding cannot be ruled out and findings should be interpreted cautiously in light of the totality of evidence.
A randomized, double-blind phase II study of the oral tyrosine kinase inhibitor (TKI) axitinib (AG-013736) in combination with docetaxel (DOC) compared to DOC plus placebo (PL) in metastatic breast cancer (MBC)
Authors: H. S. Rugo, A. Stopeck, A. A. Joy, S. Chan, S. Verma, A. Lluch, K. F. Liau, S. Kim, P. Bycott, D. Soulieres
Journal: Journal of Clinical Oncology (2007)

1003 Background: Single-agent DOC is commonly used to treat MBC. Axitinib (AG) is a potent TKI of VEGFRs. A phase I lead-in study identified 80 mg/m 2 q3wks of DOC in combination with 5 mg BID of AG as the recommended phase 2 dose. The primary objective was to determine whether the time to progression (TTP) of AG+DOC arm is superior to DOC+PL. Methods: Pts with no prior chemotherapy for MBC and =12 mos from adjuvant chemotherapy (aCT), measurable disease, ECOG performance status (PS) of 0–2, and no uncontrolled brain metastases were randomly assigned (2:1) to receive treatment with either DOC+AG or DOC+PL without prophylactic growth factor in cycle 1. Tumor measurements were performed q9wks. Pts were stratified according to estrogen receptor (ER) status, prior aCT and PS (0–1 or 2). Results: A total of 168 pts were randomized. 92 pts had received prior aCT, 27 of whom received a prior taxane. Treatment arms were well balanced for prior adjuvant and taxane therapy. A median of 7 cycles of AG+DOC (range: 1–18) and 7 cycles of DOC+PL (range: 1–23) were administered. The most common non-hematologic adverse events observed in the AG+DOC arm included diarrhea (60%), nausea (53%), alopecia (51%), fatigue (49%), stomatitis (44%) and vomiting (40%). Grade 3/4 adverse events that were increased with AG+DOC vs DOC included febrile neutropenia (16 vs 7%), fatigue (13 vs 5%), stomatitis (13 vs 2%), diarrhea (11 vs 0%) and hypertension (5 vs 2%). Other grade 3/4 hematologic toxicities were similar in both arms. The median TTP (by RECIST) was 8.2 mo with AG+DOC arm and 7 mo with DOC+PL arm with a hazard ratio of 0.73 (prespecified, one-sided p=0.052). The overall response rate (ORR) was 40% for AG+DOC arm and 23% for DOC+PL arm (p=0.038). In a hypothesis-generating subgroup analysis, the median TTP in patients receiving prior aCT was 9.0 mo with AG+DOC arm and 6.3 mo with DOC+PL arm with a hazard ratio of 0.54 (p=0.012). Within this stratum, ORR was 45% for AG+DOC arm and 13% for DOC+PL arm (p=0.003). Conclusions: The anti-angiogenic TKI AG combined with DOC (80 mg/m 2 q3wks) as first line therapy for MBC has an acceptable safety profile and promising anti-tumor activity. No significant financial relationships to disclose.
Tricuspid Intervention Following Pulmonary Valve Replacement in Adults With Congenital Heart Disease
Authors: Catherine Deshaies, Helen Trottier, Paul Khairy, Mohammed Al-Aklabi, Luc Beauchesne, Pierre-Luc Bernier, Santokh Dhillon, Sanjiv K. Gandhi, Christoph Haller, Camille L. Hancock Friesen, Edward J. Hickey, David Horne, Frédéric Jacques, Marla C. Kiess, Jean Perron, Maria Rodriguez, Nancy C. Poirier
Journal: Journal of the American College of Cardiology (2020)
Clip with thread attachment prior to incision – new strategy for traction-assisted esophageal endoscopic submucosal dissection
Authors: Shuichi Miyamoto, Tomohiko R. Ohya, Masayuki Higashino, Kazuteru Hatanaka, Yoshiya Yamamoto, Hirohito Naruse, Naoya Sakamoto
Journal: Endoscopy (2020)

A 55-year-old had a 20-mm 0-IIc lesion located in the middle thoracic esophagus. Endoscopic submucosal dissection (ESD) was performed using an electrosurgical knife (Flush Knife BT; Fujifilm Corporation, Tokyo, Japan). First, the mucosa of the anal side of the tumor was cut after submucosal injection of 0.4 % sodium hyaluronate ([Fig. 1]). Subsequently, the oral mucosa of the tumor was adequately elevated by submucosal injection. A clip attached with dental floss was then deployed to the elevated mucosa ([Fig. 2]) prior to incision of the oral-side mucosa ([Video 1]). The oral-side mucosal incision was performed under ideal countertraction ([Fig. 3]), facilitating entry to the submucosal layer with sufficient countertraction throughout the ESD procedure. Dissection and the remaining circumferential incision could then be performed with excellent traction ([Fig. 4]), enabling this lesion to be resected easily en-bloc ([Fig. 5]).
Histological and Environmental Changes in Longstanding Ileal Conduits
Authors: D J Thomas, N M Goble, D A Gillatt, J C Hammonds, P J B Smith
Journal: Journal of the Royal Society of Medicine (1990)

Seventeen patients with urinary diversions present for between 10 and 17 years were examined endoscopically. The region of the anastomosis was successfully biopsied in 13 cases. Biopsy specimens were examined both histologically and cytologically. Urine was aspirated from the conduits under sterile conditions and sent for qualification of bacterial flora. Histology revealed a variable degree of villous atrophy, mucosal metaplasia, crypt hyperplasia and in one case, antral type gland metaplasia. The finding of hyperplasia was corroborated by flow cytometry which demonstrated a high percentage of cells in G2 and metaphase. The majority of cases showed a colonic type of bacterial colonization and mucin histochemistry demonstrated a colonic type of mucin.
Current and Future Spatiotemporal Patterns of Lyme Disease Reporting in the Northeastern United States
Authors: Donal Bisanzio, Maria P. Fernández, Elisa Martello, Richard Reithinger, Maria A. Diuk-Wasser
Journal: JAMA Network Open (2020)

<h3>Importance</h3> The incidence and geographic range of Lyme disease continues to increase in the United States because of the expansion of<i>Ixodes scapularis</i>, the species of tick that is the main Lyme disease vector. Currently, no dynamic model for the disease spread exists that integrates information of both acarological and human case surveillance data. <h3>Objective</h3> To characterize the spatiotemporal spread of Lyme disease in humans among counties in US endemic regions. <h3>Design, Setting, and Participants</h3> This cross-sectional study modeled the spread of Lyme disease county-level case reporting, accounting for county-level demographic factors, environmental factors associated with tick presence and human exposure, and the spatiotemporal association between counties. The analyses were conducted between January and August 2019. The setting was 1405 counties in the following regions of the United States: West North Central, East North Central, New England, Middle Atlantic, and the South. Assessments were based on publicly available Lyme disease case data reported to the US Centers for Disease Control and Prevention (CDC) between January 2000 and December 2017. <h3>Main Outcomes and Measures</h3> Probability of reporting the first case of Lyme disease by county by year. <h3>Results</h3> Between 2000 and 2017, a total of 497 569 Lyme disease cases were reported to the CDC in the study area. Reporting a first case of Lyme disease was associated with a county's and county's neighbors' forest coverage, elevation, percentage of population living in the wildland-urban interface, tick presence, county's population size, proportion of neighbors reporting cases, and neighbors' years since first reporting. The model that included these variables showed high predictive power, with a mean area under the receiver operating characteristic curve of 81.1 (95% CI, 68.5-86.2). The model predicted the first reported Lyme disease case a mean (SD) of 5.5 (3.5) years earlier than was reported to the CDC, with a mean spread velocity estimated at 27.4 (95% CI, 13.6-54.4) km per year. Among 162 counties without reported cases, 47 (29.0%) had a high probability of reporting Lyme disease by 2018. The estimated mean time lag between the first reported case in a neighboring county and any county was 7 (95% CI, 3-8) years. <h3>Conclusions and Relevance</h3> This study's findings suggest that, if updated regularly and expanded geographically, this predictive model could enable states and counties to develop more specific Lyme disease prevention and control plans, including improved sensitization of the general population and medical community.