tbuckley/cabot-search huggingface dataset:
Trends in Outpatient Care Delivery and Telemedicine During the COVID-19 Pandemic in the US
Authors: Sadiq Y. Patel, Ateev Mehrotra, Haiden A. Huskamp, Lori Uscher-Pines, Ishani Ganguli, Michael L. Barnett
Journal: JAMA Internal Medicine (2020)

This cohort study examines trends in the use of telemedicine and in-person outpatient visits in 2020 among a national sample of 16.7 million individuals with commercial or Medicare Advantage insurance.
Activatable nanomedicine for overcoming hypoxia-induced resistance to chemotherapy and inhibiting tumor growth by inducing collaborative apoptosis and ferroptosis in solid tumors
Authors: Jingke Fu, Tao Li, Yangzi Yang, Liping Jiang, Wenhao Wang, Lingjie Fu, Yingchun Zhu, Yongqiang Hao
Journal: Biomaterials (2020)
Guidelines for the Diagnosis and Treatment of Hepatocellular Carcinoma (2019 Edition)
Authors: Jian Zhou, Huichuan Sun, Zheng Wang, Wenming Cong, Jianhua Wang, Mengsu Zeng, Weiping Zhou, Ping Bie, Lianxin Liu, Tianfu Wen, Guohong Han, Maoqiang Wang, Ruibao Liu, Ligong Lu, Zhengang Ren, Minshan Chen, Zhaochong Zeng, Ping Liang, Changhong Liang, Min Chen, Fuhua Yan, Wenping Wang, Yuan Ji, Jingping Yun, Dingfang Cai, Yongjun Chen, Wenwu Cheng, Shuqun Cheng, Chaoliu Dai, Wenzhi Guo, Baojin Hua, Xiaowu Huang, Weidong Jia, Yaming Li, Yexiong Li, Jun Liang, Tianshu Liu, Guoyue Lv, Yilei Mao, Tao Peng, Weixin Ren, Hongcheng Shi, Guoming Shi, Kaishan Tao, Wentao Wang, Xiaoying Wang, Zhiming Wang, Bangde Xiang, Baocai Xing, Jianming Xu, Jiamei Yang, Jianyong Yang, Yefa Yang, Yunke Yang, Shenglong Ye, Zhengyu Yin, Bixiang Zhang, Boheng Zhang, Leida Zhang, Shuijun Zhang, Ti Zhang, Yongfu Zhao, Honggang Zheng, Jiye Zhu, Kangshun Zhu, Rong Liu, Yinghong Shi, Yongsheng Xiao, Zhi Dai, Gaojun Teng, Jianqiang Cai, Weilin Wang, Xiujun Cai, Qiang Li, Feng Shen, Shukui Qin, Jiahong Dong, Jia Fan
Journal: Liver Cancer (2020)

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Primary liver cancer, around 90% are hepatocellular carcinoma in China, is the fourth most common malignancy and the second leading cause of tumor-related death, thereby posing a significant threat to the life and health of the Chinese people. &lt;b&gt;&lt;i&gt;Summary:&lt;/i&gt;&lt;/b&gt; Since the publication of &lt;i&gt;Guidelines for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition)&lt;/i&gt; in 2018, additional high-quality evidence has emerged with relevance to the diagnosis, staging, and treatment of liver cancer in and outside China that requires the guidelines to be updated. The new edition &lt;i&gt;(2019 Edition)&lt;/i&gt; was written by more than 70 experts in the field of liver cancer in China. They reflect the real-world situation in China regarding diagnosing and treating liver cancer in recent years. &lt;b&gt;&lt;i&gt;Key Messages:&lt;/i&gt;&lt;/b&gt; Most importantly, the new guidelines were endorsed and promulgated by the Bureau of Medical Administration of the National Health Commission of the People’s Republic of China in December 2019.
Abstract 15059: Prevalence of Recovery of Conduction in the Left Atrial Appendage Following Electrical Isolation of the Appendage in Patients With Atrial Fibrillation
Authors: Sanghamitra Mohanty, CHINTAN G TRIVEDI, Domenico G Della Rocca, Carola Gianni, Faiz M Baqai, Bryan MacDonald, Angel Mayedo, Mohamed Bassiouny, G Gallinghouse, John Burkhardt, Rodney Horton, Luigi Di Biase, Amin Al-ahmad, Andrea Natale
Journal: Circulation (2020)

Background: Electrical isolation of the left atrial appendage (LAAEI) is considered in patients presenting with recurrence following effective PV isolation. Objective: We evaluated the prevalence of LAA reconnection following LAAEI in patients undergoing repeat procedure for AF recurrence. Methods: Consecutive AF patients undergoing repeat ablation for arrhythmia recurrence following LAAEI were included in this analysis. Transesophageal echocardiogram (TEE) was performed in all at baseline to evaluate LAA function. Isoproterenol infusion up to 30 μg/min for 10 to 15 min was administered to detect LAA triggers. Re-isolation of the LAA was performed if triggers were detected. Off-drug success rate was assessed in all. Results: A total of 594 post-LAAEI patients with recurrent AF were included in the analysis. At the redo, PVs were found to be electrically silent in all. LAA reconnection was detected in 214 (36%) patients. Baseline TEE revealed normal LAA contractility and flow-velocity in all. Re-isolation of the LAA was performed in these 214 patients. In patients with no LAA reconnection (n=380), non-PV triggers from other sites were targeted for ablation. There was no difference in the clinical characteristics of patients with vs. without LAA reconnection (Table). At 2 years after the repeat procedure, 201 (94%) patients with and 351 (92.3%) without LAA reconnection were arrhythmia-free off-drugs (p=0.47). Conclusion: In this series, LAA reconnection rate was 36% after single LAAEI procedure and re-isolation of the appendage led to high success rate. Additionally, normal LAA functions detected by TEE correctly predicted recovery of conduction in the LAA.
Assessing Niacin as an Atherosclerosis Therapeutic Agent: Valuable Insights Provided by High-Resolution Vascular Magnetic Resonance Imaging⁎⁎Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.
Authors: Farouc A. Jaffer
Journal: Journal of the American College of Cardiology (2009)
Abstract 322: Post-cardiac Arrest Care Variations in Michigan Hospitals and Their Impact on Survival
Authors: Jaemin Song, David Berger, Nai-Wei Chen, James Paxton, Joseph Miller, James Pribble, Robert A Swor
Journal: Circulation (2020)

Introduction: Targeted temperature management (TTM) is an important component of post cardiac arrest care. Current guidelines recommend deferring prognostic decisions for 72 hours post TTM. Most non survivors have care withdrawn and some hypothesize that early withdrawal of care adversely impacts survival. Our objective is to characterize hospital length of stay (LOS) post cardiac arrest, its relationship to survival and variation by hospitals using a statewide registry. Methods: We probabilistically linked out of hospital (OHCA) patients from 2014-2017 in a statewide Cardiac Arrest to Enhance Survival Registry (CARES) and the Michigan Inpatient Database (MIDB). We included resuscitated adult OHCA patients. To assess variation in LOS (arrival-death or discharge), those with &gt; 30 subjects/hospital were included. We abstracted subject demographics, arrest characteristics, in hospital care, and hospital LOS. Our outcome is survival to discharge. We define early death as hospital LOS&lt; 72 hours (LOS&lt;72). We calculated Pearson’s correlation coefficient (r) to characterize the relationship of LOS&lt;72 and patient survival. Results: We included 3,644 patients from 38 hospitals. They were predominately male (2160, 59.3%), mean age 62.4, 1716 (47.1%) received TTM, mean LOS was 6.1 days, and 1078 (29.6%) survived to discharge. Median LOS was longer in patients who were survivors (9.0 vs 2.0 days, p&lt;0.001). Median LOS was greater in patients who received TTM (5.0 vs 3.0 days, p&lt; 0.001) and almost half (1813, 49.8%) of all patients had a LOS &lt;72. We observed variation in LOS&lt;72 by hospitals (39.4% to 61.3%, Figure 1), and a negative relationship between LOC&lt;72 and survival (r = -0.36). Conclusion: We observed that nearly half of subjects had a LOS&lt;72, and a modest negative correlation of LOS&lt;72 and outcome. These data suggest that further work is needed to clarify whether early hemodynamic collapse or early withdrawal of care explains differences in hospital LOS and survival.
AB1035 INTESTINAL MICROBIOTA COMPOSITION OF ADULT PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER AND HEALTHY CONTROLS (THE RHEUMA-BIOTA STUDY)
Authors: N. S. Yasar Bilge, V. Perez Brocal, T. Kaşifoğlu, U. Bilge, N. Kasifoglu, A. Moya, E. C. Dinleyici
Journal: Annals of the Rheumatic Diseases (2020)

Background: Although Familial Mediterranean Fever (FMF) is a monogenic disease, microbiota composition may play role in the pathogenesis or phenotypic expression. Objectives: We aim to evaluate the intestinal microbiota composition in patients with FMF and to compare with healthy controls. Methods: In this prospective cohort study, a group of 10 adult patients with FMF and 10 age-appropriate healthy controls, for which there was strict inclusion/exclusion, were enrolled. Fecal samples were stored at -80°C until DNA extraction. A region of the 16S rRNA gene (V3-V4) was selected and sequencing was performed on the Illumina MiSeq platform at the Sequencing and Bioinformatics Service of FISABIO foundation. Results: Alpha and beta diversity tests were similar between FMF and control groups except that Chao1 index. Chao1 index was modestly decreased in FMF group comparing the healthy controls (p&lt;0.05). Our results showed differences in the intestinal microbiota composition of patients with FMF, with a higher abundance of Eggerthella , at genus level. At species level, Eggerthella sinensis and Eggerthella lenta were more abundant in patients with FMF. Conclusion: Eggerthella lenta was previously shown to be higher in type II diabetes, multiple sclerosis, rheumatoid arthritis and some disseminated infections. In this study we firstly showed abundance of Eggerthella in patients with FMF, especially in E. sinensis and E. lenta; in addition to. Whether any of observed associations are causal, or the direction of causality is unclear yet and further studies with patients with FMF at the first diagnosis might clarify this issue. Disclosure of Interests: None declared
Abstract 14984: Post-Discharge Beta-Blockers and Early Mortality and Readmission in Older Patients With Heart Failure: An Instrumental Variable Analysis
Authors: Lauren Gilstrap, Andrea Austin, Barbara Gladders, Amber Barnato, Anna Tosteson, James O'Malley, Jonathan Skinner
Journal: Circulation (2020)

Introduction: The rate of growth of the older heart failure population has outpaced that of any other age group. Importantly, these older patients were underrepresented in the early beta-blocker trials and there are several reasons, including a decreased potential for mortality benefit and an increased risk of side effects, why the risk/benefit trade-off may be different in this older population. Hypothesis: The association between receipt of a beta-blocker at the time of hospital discharge and early mortality and readmissions in heart failure with reduced ejection fraction (HFrEF) patients aged ≥75 is not significantly different than among HFrEF patients &lt;75 years old. Methods: We used 100% Medicare Parts A and B and a random 40% sample of Part D to create a cohort of beneficiaries with ≥1 hospitalization for HFrEF between 2008 and 2016 and determined beta-blocker use at hospital discharge. The primary outcome was 90-day, all-cause mortality; the secondary outcome was 90-day, all-cause readmission. To address both measured and unmeasured confounding, we used the two-stage least squared instrumental variable analysis method. Results: Among all HFrEF patients, receipt of a beta-blocker at the time of discharge was associated with a -4.34% (95% CI -6.26% to -2.42%, p&lt;0.001) decrease in 90-day mortality and a -4.67% (95% CI -7.41% to -1.91%, p=0.001) decrease in 90-day readmission rates. Among patients &gt;75 years old, receipt of a beta-blocker was also associated with a significant -4.74% decrease (95% CI -7.13% to -2.34%, p&lt;0.001) in 90-day mortality and a -4.67% (95% CI -8.96% to -2.93%, p&lt;0.00) decrease in 90-day readmissions. Conclusions: We find that patients aged ≥75 years who receive a beta-blocker at HFrEF discharge have significantly lower 90-day mortality and readmission rates. The magnitude of benefit from beta-blocker therapy after HFrEF discharge does not appear to wane with age.
Abstract 16868: Predicted Heart Mass and Organ Offer Turn-Down in Heart Transplant
Authors: Lillian Benck, Evan Kransdorf, Michelle Kittleson, Joshua Chung, Fardad Esmailian, Jon A Kobashigawa
Journal: Circulation (2018)

Introduction: Size mismatch is a frequent reason for organ offer turn-down in heart transplantation (HT). While weight is frequently used as the metric for size matching in HT, several recent studies have shown that predicted heart mass (PHM) is a better predictor of mortality. Here, we sought to assess the potential impact of utilizing PHM for size matching. Methods: A data set of all potential transplant recipients from January 1, 2007 to December 31, 2016 was obtained from the United Network for Organ Sharing. For each recipient, offers turned-down for donor size/weight were selected. Donor-recipient ratio of PHM was calculated for each donor-potential recipient pair and a value of 0.85 or higher was considered adequate as determined by previous survival modeling. Distribution of PHM for offers turned-down and accepted according to sex mismatch category was assessed. Mean PHM for each sex mismatch category was compared. Results: There were 18,251 recipients in the study cohort who received 639,247 offers. Of these, 96,043 (15%) were turned down for donor size/weight. Of offers turned down, mean PHM ratio differed significantly between sex-mismatch categories. Mean donor to recipient PHM ratio was 0.75 for female donor/male potential recipient, 0.98 for female donor/female potential recipient, 0.92 for male donor/male potential recipient and 1.36 for male donor/female potential recipient pairs (p &lt; 0.001) The percentage of offers turned-down for donor size/weight (Figure 1) but with an adequate PHM ratio (solid line) ranged from 98% for male donors/female potential recipients to 19% for female donors/male potential recipients. Conclusion: Utilizing PHM for assessment of donor-recipient size match shows that a large number of donors turned down for size would likely be an adequate size match. Thus, the use of PHM has the potential to increase donor heart utilization.
Abstract 16707: Incidence of In-Hospital Venous Thromboembolism Across Heart Failure Subtypes and Their Effect on 30-Day Readmission Due to Thrombotic Complication
Authors: sandipan chakraborty, Dhrubajyoti Bandyopadhyay, Birendra Amgai, Neel Patel, Adrija Hajra, Zeel Patel, Soniya Koirala, Wilbert S Aronow, Ahmed Bakhit, mazin Khalid
Journal: Circulation (2020)

Introduction: Heart failure (HF) hospitalizations are associated with increased short-term and long-term risk for venous thromboembolism. We retrospectively analyzed Nationwide Readmission Database (NRD) to identify the incidence of venous thromboembolism (VTE) during index hospitalization based on HF subtypes and whether index VTE events influence 30-day readmission due to VTE. Hypothesis: Venous thromboembolism during index admission can influence 30-day readmission risk between different HF subtypes. Methods: NRD 2012-2014 was used to identify all patients with discharge diagnosis with HF and categorized into HF with reduced ejection fraction (HF-rEF) and (HF-pEF) using appropriate ICD-9-CM codes. After the exclusion of patients with cancer, 950385 patients with HF-rEF, and 798590 patients with HF-pEF were included for final analysis. Multivariate logistic regression and Cox-regression model were used to calculate adjusted Hazard Ration (HR) and Odds Ratio (OR). Results: Patients with HF-rEF were younger, African American, and more likely to be men, whereas HF-pEF population is older, white, and more likely to be women (table 1.). Incidence of anemia, chronic lung disease, hypertension, diabetes, and obesity was higher in the HF-pEF group. In contrast, HF-rEF patients had a higher incidence of prior CABG, PCI, and CAD. HF-pEF patients had lower odds of pulmonary embolism (PE) (OR, 0.80; p &lt; 0.001), deep vein thrombosis (DVT) (OR, 0.73; p &lt; 0.001) and other VTE (OR, 0.50; p &lt; 0.001) during index hospitalization. Patients with HF-pEF who had VTE in index hospitalization had an increased risk of readmission due to DVT (HR, 1.16: 95% CI: 1.07-1.26, p &lt; 0.001). Conclusion: Patients with HF-rEF had a higher incidence of VTE during the index admission, whereas HF-pEF patients with index VTE were more likely to be readmitted within 30-day with DVT.
Abstract 17186: Left Atrial Strain Predicts Adverse Outcomes in Hypertrophic Cardiomyopathy
Authors: Nestor Vasquez, Benjamin Ostrander, Dai-Yin Lu, Ioannis Ventoulis, Bereketeab Haileselassie, Sagar Goyal, Styliani Vakrou, Theodore P Abraham, M. Roselle Abraham
Journal: Circulation (2018)

Introduction: Hypertrophic cardiomyopathy (HCM) patients are at increased risk for heart failure (HF), stroke, death, and paroxysmal atrial fibrillation (PAF) development. There is no consensus whether atrial fibrillation (AF) is a marker or mediator of adverse outcomes in HCM patients. Hypothesis: We hypothesized that PAF and left atrial (LA) remodeling predict adverse outcomes in HCM. Methods: Echocardiography (2D and speckle tracking) was used to assess LA size, function, and mechanics in a cohort of HCM patients with history of PAF (PAF group, n=45) and age/gender-matched HCM patients without history of AF (No-AF group; n=59). AF was diagnosed by review of EKGs, event recorder/holter monitor data, and ICD interrogation. Patients were followed for a mean of 53 months for development of the composite endpoint of HF, death, and stroke. Results: Clinical/demographic characteristics were similar in the 2 groups; 67% of PAF group had a CHADS 2 VASC score ≤ 1. The PAF group had higher LA volume, lower LA ejection fraction, and higher E/A ratio (reflecting LV diastolic dysfunction) compared to the No-AF group. LA contractile and reservoir strain/strain rate (SR) were significantly lower in the PAF group (Table 1). Male gender, LA reservoir and conduit strain/SR (not PAF presence) were associated with the development of the composite endpoint in univariate analysis. Only LA conduit and reservoir strain/SR independently predicted the composite endpoint in a multivariate model. Kaplan Meier survival analysis showed greater event-free survival among HCM patients with LA conduit strain &gt;10.2% (Figure 1a) and LA reservoir strain &gt;23.8% (p &lt; 0.01) (Figure 1b). Conclusions: PAF is associated with greater degree of LA myopathy in HCM. LA myopathy assessed by conduit and reservoir strain/SR may be useful for risk stratification for HF, stroke, and death in HCM.
Abstract 14199: Long-term Impact of Baseline Anemia and Dual Antiplatelet Therapy Duration After Percutaneous Coronary Intervention
Authors: Huntae Kim, Jong-Il Park, Byung-Jun Kim, Jung-hee Lee, Ung Kim, Jong-Seon Park
Journal: Circulation (2020)

Background: Anemia is a known risk factor for future ischemic events and bleeding for patients with ischemic heart disease. However, there are little data about dual antiplatelet therapy (DAPT) duration for patients with anemia after percutaneous coronary intervention (PCI). Methods: From 2010 to 2013, a total of 1,470 patients who underwent PCI were investigated. We categorized the study population into four groups based on the DAPT duration and anemia (Hemoglobin &lt;13g/dL for men and &lt;12g/dL for women): Group A (non-anemia &amp; ≤12m DAPT, n=521), Group B (non-anemia &amp; &gt;12m DAPT, n=501), Group C (anemia &amp; ≤12m DAPT, n=226), and Group D (anemia &amp; &gt;12m DAPT, n=222). We evaluated major adverse cardiovascular and cerebrovascular events (MACCEs), defined as cardiac death, myocardial infarction, repeat target vessel revascularization, or stroke, and bleeding complication. Results: Even though anemic patients had more severe angiographic findings, such as three-vessel disease or diffuse long lesion, the DAPT duration was similar between anemia and non-anemia group. MACCEs occurred less frequently in Group B (16.9%) than Group A (24.7%), Group C (34.6%), and Group D (35.1%) (p&lt;0.001) at 8 years. After multivariate analysis, with Group A as a reference, the adjusted hazard ratio for MACCEs was 0.711 (95% confidence interval [CI] 0.526-0.961, p=0.027) for Group B, 1.126 (95% CI 0.802-1.581, p=0.494) for Group C, and 0.995 (95% CI 0.706-1.405, p=0.980) for Group D. However, major bleeding occurred more frequently occurred in Group D (13.0%) than Group A (5.7%), Group B (7.5%), and Group C (11.2%) (p=0.035) at 8 years. Conclusions: Although extended DAPT showed reduced rate of MACCEs for non-anemic patients, it can be related with increased of major bleeding for anemic patients.
The Umbilical Cord: An Ally in Targeted Imaging Research?⁎⁎Editorials published in JACC: Cardiovascular Imaging reflect the views of the authors and do not necessarily represent the views of JACC: Cardiovascular Imaging or the American College of Cardiology.
Authors: Jonathan R. Lindner, Scott Chadderdon
Journal: JACC. Cardiovascular imaging (2009)
Abstract 15430: Comparison of Ventricular Activation Time in Sinus and His Bundle Paced Beats
Authors: Shakeel Jamal, Beth Bailey, Rehan Mahmud
Journal: Circulation (2020)

Introduction: The relationship between conduction time of a sinus impulse and a paced impulse from His bundle to peak of left ventricular activation (HVAT) has not been systematically studied. Hypothesis: To perform a comparative analysis of HVAT of sinus and paced impulse in non-selective (NS) His bundle pacing (HBP) and selective (S)-HBP. Furthermore, to determine if pacing voltage and presence of His Purkinje system (HPS) disease affects HVAT. Methods: In 102 consecutive patients a comparative analysis of native HVAT and paced HVAT at higher (5-volt) and lower voltage (1-volt) was done in all patients and in groups subdivided into NS-HBP, S-HBP, with and without HPS disease. Results: Compared to sinus HVAT (105.9 ± 24.0 ms), paced HVAT was shorter at 5-volt (97.2 ± 17.9 ms) ( p&lt;0.01 ) and longer at 1-volt ( p&lt;0.01 ). This voltage effect was significant only in NS-HBP (-15.8 ± 15.7 ms, p&lt;0.01 ) but not in selective-HBP (-6.2± 13.6 ms p=0.16 ). In NS-HBP, decrease in HVAT caused by 5-volt was the same in normal vs diseased HPS (-14.5 ± 12.8 vs-13.2 ±16.3 ms). Conclusions: 1) Compared to sinus HVAT, NS-HBP HVAT is significantly shorter at 5-volt, however, tends to prolong at 1-volt.2) The 1-volt to 5-volt HVAT decrease appears to be similar both normal and diseased NS-HBP thus not related to correction of HPS delay. 3) The voltage related decrease in HVAT is significant in presence of pre-excitation wave seen in NS-HBP and is not significant in S-HBP.