tbuckley/cabot-search huggingface dataset:
Patient and Health Care Worker Perceptions of Communication and Ability to Identify Emotion When Wearing Standard and Transparent Masks
Authors: Jacqueline N. Chu, Joy E. Collins, Tina T. Chen, Peter R. Chai, Farah Dadabhoy, James D. Byrne, Adam Wentworth, Ian A. DeAndrea-Lazarus, Christopher J. Moreland, Jaime A. B. Wilson, Alicia Booth, Omkar Ghenand, Chin Hur, Giovanni Traverso
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Adoption of mask wearing in response to the COVID-19 pandemic alters daily communication. <h3>Objective</h3> To assess communication barriers associated with mask wearing in patient-clinician interactions and individuals who are deaf and hard of hearing. <h3>Design, Setting, and Participants</h3> This pilot cross-sectional survey study included the general population, health care workers, and health care workers who are deaf or hard of hearing in the United States. Volunteers were sampled via an opt-in survey panel and nonrandomized convenience sampling. The general population survey was conducted between January 5 and January 8, 2021. The health care worker surveys were conducted between December 3, 2020, and January 3, 2021. Respondents viewed 2 short videos of a study author wearing both a standard and transparent N95 mask and answered questions regarding mask use, communication, preference, and fit. Surveys took 15 to 20 minutes to complete. <h3>Main Outcomes and Measures</h3> Participants' perceptions were assessed surrounding the use of both mask types related to communication and the ability to express emotions. <h3>Results</h3> The national survey consisted of 1000 participants (mean [SD] age, 48.7 [18.5] years; 496 [49.6%] women) with a response rate of 92.25%. The survey of general health care workers consisted of 123 participants (mean [SD] age, 49.5 [9.0] years; 84 [68.3%] women), with a response rate of 11.14%. The survey of health care workers who are deaf or hard of hearing consisted of 45 participants (mean [SD] age, 54.5 [9.0] years; 30 [66.7%] women) with a response rate of 23.95%. After viewing a video demonstrating a study author wearing a transparent N95 mask, 781 (78.1%) in the general population, 109 general health care workers (88.6%), and 38 health care workers who are deaf or hard of hearing (84.4%) were able to identify the emotion being expressed, in contrast with 201 (20.1%), 25 (20.5%), and 11 (24.4%) for the standard opaque N95 mask. In the general population, 450 (45.0%) felt positively about interacting with a health care worker wearing a transparent mask; 76 general health care workers (61.8%) and 37 health care workers who are deaf or hard of hearing (82.2%) felt positively about wearing a transparent mask to communicate with patients. <h3>Conclusions and Relevance</h3> The findings of this study suggest that transparent masks could help improve communication during the COVID-19 pandemic, particularly for individuals who are deaf and hard of hearing.
Abstract 12282: Mismanagement of Hypertension: ColausPsycolaus Study
Authors: Valeriya Chekanova, Pedro-Manuel Marques-Vidal
Journal: Circulation (2021)

Introduction: The importance of genetic factors in management of hypertension in a population setting is unclear. Hypothesis: To identify the clinical and genetic factors associated with poor control of hypertension in the Swiss population. Methods: Data from first (2009-2012) and second (2014-2017) follow-ups of a population-based, prospective study conducted in Lausanne, Switzerland. Management of hypertension was assessed according to the ESC guidelines based on the 140/90 or the 130/80 mm Hg thresholds. Two genetic risk scores for hypertension (18 and 28 SNPs) and 133 individual SNPs related to response to specific antihypertensive drugs were tested. Results: 1073 and 1157 participants of first and second follow-ups were included. The prevalence of controlled participants using the 140/90 threshold was 58.8% and 63.6% in first and second follow-ups, respectively. Using the 130/80 threshold, the prevalence rates were 31.4% and 34.0%, respectively. On multivariable analysis, using the 140/90 threshold, older age was negatively associated to hypertension control. Using the 130/80 threshold, older age and increased BMI were negatively associated while total number of drugs was positively associated with hypertension control. The associations with gender, education, alcohol drinking and antidiabetic drug treatment varied between surveys and thresholds. No consistent associations were found between genetic risk scores and hypertension control for both surveys and both thresholds. Finally, no significant association was found between individual SNPs and hypertension control according to antihypertensive drug used. Conclusions: Control of hypertension is poor in Switzerland, namely among older adults and possibly among overweight or obese subjects. No association between genetic scores or individual SNPs and hypertension control could be found.
PATH-09. THE SEARCH FOR A NOVEL SUBTYPE OF GLIOBLASTOMA AND ITS CELL-OF-ORIGIN
Authors: Yu-Jung Chen, Swathi Iyer, Xuanhua Xie, Luis Parada
Journal: Neuro-Oncology (2021)

Abstract Glioblastoma (GBM) has been computationally classified into three molecular subtypes (i.e., classical, proneural and mesenchymal). However, these subtypes lack strong biological and clinical implications. Therefore, our group has proposed to classify GBM according to its cell of origins. We have previously shown that different cell of origins give rise to biologically and transcriptionally distinct subtypes of GBM. We termed tumors that derived from subventricular zone (SVZ) neural stem cells as type 1 tumors and that from oligodendrocytic progenitor cells (OPC) as type 2 tumors. Based on murine lineage transcriptional profiles, we have also identified corresponding human GBM (40-50% of the TCGA GBM samples) tumors with conserved lineage properties. However, a majority of the TCGA GBM tumors remains unexplained by the cell-of-origin model. This study aims to search for other distinct GBM subtypes by addressing the tumorigenic potential of a putative stem progenitor population in the murine basilar pons. By using a recently reported Nestin transgenic mouse line (Nestin- C reERT2; e G FP-H2B; h D TR, or CGD in short), we have shown that conditionally deleting the commonly mutated glioma genes, Nf1 f/f ; Tp53 f/f and Pten f/+ (NPP), in pontine GFP+ cells, give rise to tumors that histologically resembles human GBM. Further transcriptomic analysis showed that a subset of these tumors highly express lineage markers of the differentiation-committed oligodendrocytic precursors (COP). We further probed the TCGA GBM database and identified 5% of the tumors to be enriched with our CGD pontine tumor-derived signature. In summary, our results showed that CGD-NPP cells can give rise to a previously uncharacterized tumor subtype with enrichment of COP lineage markers. Therefore, we propose COP as another cell of origin for GBM and that COP-derived tumor may contribute to a novel tumor subtype of the GBM classification.
Forced Sexual Initiation and Early Sexual Debut and Associated Risk Factors and Health Problems Among Adolescent Girls and Young Women — Violence Against Children and Youth Surveys, Nine PEPFAR Countries, 2007–2018
Authors: Ashleigh L. Howard, Sherri Pals, Brianna Walker, Regina Benevides, Greta M. Massetti, Rose Patricia Oluoch, Obinna Ogbanufe, Louis Herns Marcelin, Toni Cela, Chabila C. Mapoma, Elizabeth Gonese, Wezi Msungama, Daniel Magesa, Alick Kayange, Katelyn Galloway, Rose Apondi, Lydia Wasula, Owen Mugurungi, Getrude Ncube, Iven Sikanyiti, Justin Hamela, Gerald V. Kihwele, Nozipho Nzuza-Motsa, Janet Saul, Pragna Patel
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

Adolescent girls and young women aged 13-24 years are disproportionately affected by HIV in sub-Saharan Africa (1), resulting from biologic, behavioral, and structural* factors, including violence. Girls in sub-Saharan Africa also experience sexual violence at higher rates than do boys (2), and women who experience intimate partner violence have 1.3-2.0 times the odds of acquiring HIV infection, compared with those who do not (3). Violence Against Children and Youth Survey (VACS) data during 2007-2018 from nine countries funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) were analyzed to estimate prevalence and assess factors associated with early sexual debut and forced sexual initiation.† Among adolescent girls and young women aged 13-24 years who ever had sex, the prevalence of lifetime sexual violence ranged from 12.5% to 49.3%, and forced sexual initiation ranged from 14.7% to 38.9%; early sexual debut among adolescent girls and young women aged 16-24 years ranged from 14.4% to 40.1%. In multiple logistic regression models, forced sexual initiation was associated with being unmarried, violence victimization, risky sexual behaviors, sexually transmitted infections (STIs), and poor mental health. Early sexual debut was associated with lower education, marriage, ever witnessing parental intimate partner violence during childhood, risky sexual behaviors, poor mental health, and less HIV testing. Comprehensive violence and HIV prevention programming is needed to delay sexual debut and protect adolescent girls and young women from forced sex.
Abstract 12017: Correlates of Regional Diastolic Dysfunction in Patients With Heart Failure With Preserved Ejection Fraction
Authors: Sabina Frljak, Gregor Poglajen, Neza Zorz, Andraz Cerar, Gregor Zemljic, Bojan Vrtovec
Journal: Circulation (2021)

Introduction: The underlying mechanisms of regional myocardial dysfunction in patients with heart failure with preserved ejection fraction (HFpEF) remain poorly defined. Hypothesis: We investigated physiological correlates of regional diastolic dysfunction in HFpEF using a novel technique based on point-by-point measurement of local diastolic delay. Methods: We enrolled 30 patients with HFpEF (LVEF &gt;50%, E/e' &gt;15, NT-proBNP &gt;300 pg/ml). In all patients we performed electroanatomical mapping of the left ventricle and assessed regional diastolic function by a novel algorithm based on the measurement of local diastolic delay. Local diastolic delay was considered significant if the time delay between global left ventricular end diastolic time and local diastolic time was &gt;50 msec. At the time of mapping, we performed clinical evaluation, echocardiography and measured plasma levels of 27 biomarkers of angiogenesis and endothelial dysfunction. Results: Our cohort included 23 male and 7 female patients, aged 46-70 years. Using electroanatomical mapping we measured regional diastolic function in 4820 mapping points. The mean local diastolic delay was &gt;50 msec in 12 patients (Group A), and &lt;50 msec in 18 patients (Group B). The groups did not differ in age (64±11 years in Group A vs. 51±8 years in Group B, P=0.22), gender, (male: 83% vs. 73%, P=0.48), creatinine (1.08±0.31 mg/dL vs. 1.10±0.30 mg/dL, P=0.52), LVEF (56±4% vs. 58±7%, P=0.42), or NT-proBNP levels (1570±1310 pg/mL vs. 1230±1240 pg/mL, P=0.22). However, in Group A, we found higher values of E/e’ (18.2±3.4 vs. 17.0±2.8 in Group B, P=0.04), and lower myocardial viability (unipolar voltage: 7.73±1.8 mV vs. 9.03±2.1 mV, P=0.02). When compared to Group B, patients in Group A displayed lower levels of pro-angiogenic biomarkers (vascular endothelial growth factor: 33±22 pg/mL vs. 47±24 pg/mL, P=0.01; platelet-derived growth factor: 47±23 pg/mL vs. 78±34 pg/mL, P=0.02), and higher levels of anti-angiogenic biomarkers (agiopoietin-2: 7.0±3.8 ng/mL vs. 2.7±1.0 ng/mL, P=0.01; endostatin: 87±33 ng/mL vs. 65±21 ng/mL, P=0.02). Conclusion: In patients with HFpEF, regional diastolic dysfunction appears to be associated with increased E/e’, decreased myocardial viability, and impaired angiogenesis.
Abstract 13874: A Mitochondrial Polygenic Risk Score is Associated With Metabolite Levels Implicated in Heart Failure
Authors: Lauren K Truby, Stephanie Giamberardino, Lydia Kwee, William E Kraus, Jawan Abdulrahim, Jessica A Regan, Svati H Shah
Journal: Circulation (2021)

Introduction: Heart failure (HF) is characterized by metabolic inflexibility in fuel substrate selection and results in dysregulation of downstream mitochondrial processes. Prior work has identified greater plasma concentrations of circulating long-chain acylcarnitines (LCAC) in HF. LCAC are metabolites reporting on impaired mitochondrial fatty acid catabolism and predict incident adverse events in HF. Hypothesis: We hypothesized that a polygenic risk score (PRS) of genetic variation in mitochondrially-associated genes may be associated with circulating LCAC as well as HF phenotypes. Methods: The study population consisted of 2277 European-ancestry participants from the CATHGEN (CATHeterization GENetics) cohort, consisting of sequential individuals undergoing cardiac catheterization at Duke University. Using PRSice software, a PRS was generated from variants in 1462 nuclear genes implicated in mitochondrial function; weights were derived from the HERMES HF GWAS meta-analysis. Linear regression was used to test the association between the mitochondrial function PRS and plasma metabolite levels, as well as HF phenotypes, in models adjusting for ancestry principal components and batch. Results: The analysis cohort included 515 participants with HF, with 39% females and a mean age 61.2 11.8 years. The mitochondrial PRS was associated with three LCAC: C10, C10:1 and C12:1 (nominal p-values 0.02-0.008, 18-70 variants). The PRS was not associated with prevalent cardiomyopathy (p=0.097) or HF (p=0.16). Conclusions: We have generated a focused PRS inclusive of mitochondrial nuclear genetic variants weighted on HF association and found it to be associated with relevant circulating metabolites of mitochondrial fatty acid metabolism. These results highlight the utility of a novel biology-focused PRS in cardiovascular disease traits.
Abstract 14025: Atrial Fibrillation is Associated With Reduced Telomere Length
Authors: Moritz F Sinner, Danny Kupka, Aenne Solvejg S von Falkenhausen, Wolfgang Wilfert, Melanie Waldenberger, Annette Peters, Leska M Holdt, Stefan Kaab
Journal: Circulation (2021)

Background: Atrial Fibrillation (AF) is common pathophysiologically complex. Age is among the most important AF risk factors. However, some young patients develop early-onset AF, whereas many others do not despite an advanced age. Advanced biological aging as opposed to advanced calendar age may be an explanation. Telomere length is associated with age and may be considered a measurable marker of biological age. AF and telomere length have previously been associated, but results remained inconclusive. Hypothesis: AF is age-related and associates with telomere length in a large case-control cohort. Methods: Between 2005 and 2018, we enrolled 2475 early-onset AF patients into the prospective AFLMU cohort. 3077 AF-free individuals from the community-based KORA study (enrollment 2006-08) served as controls. Clinical characteristics, an electrocardiogram, and a blood sample was obtained in all participants. We determined telomere length by a qPCR-based method using a multiplex TaqMan assay. Telomere length was expressed as delta-CT referenced to the single copy gene 36B4 .Lower CT values indicate shorter telomere length. Telomere length in cases vs. controls was assessed using multi-variably adjusted logistic regression. Results: Mean age was 58 years in AFLMU and 56 years in KORA. Men accounted for 72.3% in AFLMU and for 51.7% in KORA. For quality control, we confirmed a reduction of telomere length with age and demonstrated shorter telomere length in men compared to women. Median telomere length was also significantly shorter in AF patients compared to controls (9.81 [5.98, 13.1] vs. 13,10 [12.60, 13.63], p&lt;0,001). The association remained significant after adjustment for sex, body mass index, hypertension, and diabetes (odds ratio per telomere length unit 0.77 [95% confidence interval 0.74-0.77], p&lt;0.001). Conclusion: In a large case-control cohort, AF significantly associates with telomere length. Information on telomere length may help to inform if a patient develops AF due to premature biological aging. The underlying pathomechanisms for premature aging remain to be elucidated.
Abstract 9893: Polypills for Primary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Clinical Trials
Authors: Omneya A. Kandil, Karam R. Motawea, Merna M. Aboelenein, Jaffer Shah
Journal: Circulation (2021)

Background: Single pills with fixed-dose combinations (FDC) of lipid and blood pressure lowering medications have been proposed for the treatment of cardiovascular disease. Although polypills have proven to be effective in secondary prevention of major cardiovascular events, there is a lack of evidence regarding polypill use in primary prevention in intermediate and high-risk patients. This systematic review and meta-analysis was conducted to evaluate the effect of polypills on primary prevention of cardiovascular (CV) events using data from clinical trials. Methods: We searched Pubmed, Web of Science, EBSCO, and SCOPUS through May 2021. Two authors independently screened articles for fulfillment of inclusion criteria. The RevMan (version 5.4) software was used to calculate the pooled risk ratios (RRs) and mean differences (MDs), along with their associated confidence intervals (95% CI). Results: Eight trials with a total of 20653 patients were included. There was a significant reduction in total fatal and non-fatal CV events among the polypill group [RR (95% CI) = 0.71 (0.63, 0.80); P &lt; 0.001]. Moreover, this reduction was present for both the intermediate [RR (95% CI) = 0.76 (0.65, 0.89); P &lt; 0.001] and high-risk [RR (95% CI) = 0.63 (0.52, 0.76); P &lt; 0.001] group of patients. Subgroup analysis based on the follow up duration revealed this benefit was only evident in the five-year follow up duration group [RR (95% CI) = 0.70 (0.62, 0.79); P&lt; 0.001] and was absent in the one-year or less interval group [RR (95% CI) = 0.77 (0.47, 1.29); P= 0.330]. Furthermore, there was a significant reduction in 10-year predicted cardiovascular risk in the polypill group [MD (95% CI) = -3.74 (-5.96, -1.51); P&lt; 0.001] compared to controls. Conclusion: A polypill strategy decreases the incidence of fatal and non-fatal CV events in patients with intermediate and high cardiovascular risk and may be an effective component in the care of these patients.
Abstract 13573: Prediction of Culprit Lesions in Acute Coronary Syndrome Based Upon Myocardial Mass At-Risk From Coronary CT Angiography
Authors: Shant Malkasian, Ghazal Shadmani, James Earls, James K Min, Sabee Molloi
Journal: Circulation (2021)

Introduction: Stratifying patients with coronary artery disease (CAD) remains challenging. Assessing CAD using myocardial mass at-risk may help identify patients at higher risk of acute coronary syndrome. Hypothesis: This study investigated whether quantitative myocardial mass at-risk (MMAR) can improve prognostication of future culprit coronary lesions at the time of acute coronary syndrome (ACS) events. Methods: From the multicenter, international ICONIC study, 49 patients suspected of coronary artery disease (CAD) going coronary CT angiography imaging (CCTA) were followed to the occurrence of the first ACS. At the time of ACS, culprit lesion was adjudicated by invasive coronary angiography by a group of cardiologists blinded to the previously acquired CCTA. MMAR was calculated for each lesion using the minimum-cost path technique, a previously validated method for calculating myocardial perfusion territories. Left ventricle myocardial segmentation and coronary centerline extraction was performed and used to calculate MMAR distal to all identifiable culprit and non-culprit coronary lesions. Results: In the study sample, 243 coronary lesions were identified on CCTA (194 non-culprit lesions; 49 culprit lesions). The mean MMAR, as a percentage of total left ventricle myocardial mass, for all lesions was 24.6±12.4%. The mean MMAR was 23.1±12.5% and 30.3±10.3% for non-culprit and culprit lesions, respectively (p&lt;0.05). Receiver operating characteristic curve analysis was performed to determine the value of MMAR in predicting a culprit lesion, with an area-under-the-curve analysis for MMAR predicting a culprit lesion of 0.68. Conclusions: MMAR is larger for lesions that will versus will not become culprit at the time of future ACS. The addition of MMAR in the assessment of CAD on CCTA may help stratify the risk of individual coronary lesions.
Chimerism of Blood T-Cells and Leukemia Lineage Cells Following Myeloablative Hematopoietic Cell Transplantation Is a Risk Factor for Relapse and Chronic Graft-Versus-Host Disease
Authors: Rutvij A. Khanolkar, Poonam Dharmani-Khan, Faisal M Khan, Jan Storek
Journal: Blood (2021)
Abstract P410: A Novel Curcumin Formulation, ASD-cur Suppressed Heart Failure After Myocardial Infarction In Rats
Authors: Hidemichi Takai, Tatsuya Morimoto
Journal: Circulation Research (2021)

Introduction: Curcumin prevents the development of heart failure and is a potential treatment for heart failure. Although curcumin is known to be safe, its therapeutic efficiency is limited due to its low bioavailability. To overcome this problem, we developed ASD-Cur, an amorphous formulation of curcumin. In this study, we investigated the effect of ASD-Cur and compared it with Theracurmin ® , a colloidal submicron dispersion of curcumin. Methods: Male SD rats were orally administrated with ASD-Cur or Theracurmin ® (10 mg/kg curcumin). The plasma levels of curcumin were measured at 0.25, 0.5, 1, 2, 4 and 6 hours after administration. Twelve healthy volunteers, who had provided written informed consent, were administrated with ASD-Cur and Theracurmin ® containing 30 mg curcumin, and plasma curcumin concentrations were determined at 0.5, 1, 2, 4, and 8 hours. Next, male SD rats were subjected to MI or sham surgery. One week after surgery, the MI rats were randomly assigned to 4 groups: vehicle, ASD-Cur (0.2 mg/kg curcumin) or Theracurmin ® (0.2 or 0.5 mg/kg curcumin). Oral administration of these compounds was repeated for 6 weeks. After echocardiographic examinations, myocardial cell diameter, perivascular fibrosis, mRNA levels, and the acetylation of histone H3K9 were measured. Results: After administration in rats, the area under the plasma concentration-time curve ( AUC 0-6h ) and the maximum plasma concentration ( C max ) of ASD-Cur were 3.7-fold and 9.6-fold higher than those of Theracurmin ® , respectively. The AUC 0-8h and C max of ASD-Cur in humans were 3.4-fold and 5.4-fold higher than those of Theracurmin ® , respectively. Echocardiographic analysis showed that 0.2 mg/kg ASD-Cur and 0.5 mg/kg Theracurmin ® significantly improved the MI-induced deterioration of FS and left ventricular hypertrophy to the same extent. Both treatments significantly suppressed MI-induced increases in myocardial cell diameter, perivascular fibrosis, mRNA levels of hypertrophic markers and cardiac fibrosis, and acetylation of histone H3K9 to the same extent. Conclusion: These findings indicated that ASD-Cur has greater bioavailability than Theracurmin ® , and could exhibit greater therapeutic potency towards for MI-induced heart failure at a lower dose.
Treatment withdrawal: judges to get advice about visiting patients after decision on covid patient is overturned
Authors: Clare Dyer
Journal: BMJ (2021)

New guidance is to be given to judges on their hospital visits to patients in cases where NHS trusts seek to withdraw treatment, after the Court of Appeal overturned a High Court judge’s decision that a 56 year old woman severely affected by covid-19 should come off ventilation and be allowed to die.1

Mr Justice Hayden, vice president of the Court of Protection, decided in September that AH, described by doctors as “the most complex covid patient in the world,” should have ventilation withdrawn by the end of October.2

But three senior judges ruled that the way Hayden’s visit to AH was conducted meant that his decision could …