tbuckley/cabot-search huggingface dataset:
Abstract 17073: In Hospital Outcomes in Patients With Infective Endocarditis With and Without Liver Cirrhosis - Insight From National Inpatient Sample
Authors: Shakeel Jamal, muhammad shah zaib, Asim Kichloo, Iqra Riaz, Beth Bailey, Michael Aljadah, Waseem Amjad, Muhammad Zatmar Khan, Navya Sree Vipparla, Ronak Soni, Jagmeet P SINGH, Rajeev Sudhakar
Journal: Circulation (2020)

Introduction: Chronic liver disease is known to be an important prognostic factor in determining morbidity and mortality in preoperative risk assessment and mortality in general. Data are limited on outcomes in patients with infective endocarditis (IE) and comorbid concurrent liver cirrhosis. Objective of our study is to evaluate the clinical outcomes of patient with IE with and without underlying liver cirrhosis and determining in-hospital mortality and outcomes of interest i.e. renal failure, cardiogenic shock, hematologic (coagulopathy/thrombocytopenia) and hepatic complications (hepatic encephalopathy/hepatitis). Hypothesis: Liver Cirrhosis worsen clinical outcomes in patients with IE. Methods: Patients with principle diagnosis of IE with and without liver cirrhosis were identified by querying the Healthcare Cost and Utilization (HCUP) database, specifically, National Inpatient Sample for year 2013 and 2014 based on ICD9 codes. Results: During 2013 and 2014, a total of 17, 952 patients were admitted with diagnosis of IE, out of whom 780 had concurrent liver cirrhosis. There was an increased in-hospital mortality [15.6% vs 10.2%, aOR 1.57(1.27-1.93)], acute kidney injury [41.4% vs 32.6%, aOR 1.45(1.24-1.69)], coagulopathy/thrombocytopenia [32.1 vs 14.7%, aOR 2.87(2.44-3.37)] in patients with IE with liver cirrhosis when compared to patients with IE without liver cirrhosis. IE without liver cirrhosis underwent increased number of interventions i.e. aortic (7.2 vs 3.7%, 0.51(0.34-0.76)] and mitral (4.9% vs 3.4%, aOR 0.39(0.23-0.69)] valvular replacements as compared to without liver cirrhosis. Conclusions: Liver cirrhosis is an important prognostic marker of in-hospital mortality in patients with concurrent IE. High risk surgical state with coagulopathy, bleeding complications, worsening hepatic complications and renal dysfunction lead to higher mortality.
Global Prevalence and Impact of Hostility, Discrimination, and Harassment in the Cardiology Workplace
Authors: Garima Sharma, Pamela S. Douglas, Sharonne N. Hayes, Roxana Mehran, Anne Rzeszut, Robert A. Harrington, Athena Poppas, Mary Norine Walsh, Toniya Singh, Ranna Parekh, Roger S. Blumenthal, Laxmi S. Mehta
Journal: Journal of the American College of Cardiology (2021)
Helicobacter pylori CagA elicits BRCAness to induce genome instability that may underlie bacterial gastric carcinogenesis
Authors: Satoshi Imai, Takuya Ooki, Naoko Murata-Kamiya, Daisuke Komura, Kamrunnesa Tahmina, Weida Wu, Atsushi Takahashi-Kanemitsu, Christopher Takaya Knight, Akiko Kunita, Nobumi Suzuki, Adriana A. Del Valle, Mayo Tsuboi, Masahiro Hata, Yoku Hayakawa, Naomi Ohnishi, Koji Ueda, Masashi Fukayama, Tetsuo Ushiku, Shumpei Ishikawa, Masanori Hatakeyama
Journal: Cell Host & Microbe (2021)
CircMEMO1 modulates the promoter methylation and expression of TCF21 to regulate hepatocellular carcinoma progression and sorafenib treatment sensitivity
Authors: Zhao-Ru Dong, Ai-Wu Ke, Tao Li, Jia-Bing Cai, Ya-fei Yang, Wei Zhou, Guo-Ming Shi, Jia Fan
Journal: Molecular Cancer (2021)

Cirrhosis is a recognized risk factor for developing hepatocellular carcinoma (HCC). Few studies have reported the expression profile of circRNAs in HCC samples compared to paratumour dysplastic nodule (DN) samples.The Arraystar Human circRNA Array combined with laser capture microdissection (LCM) was used to analyse the expression profile of circRNAs in HCC samples compared to paratumour DN samples. Then, both in vitro and in vivo HCC models were used to determine the role and mechanism of key circRNA in HCC progression and treatment sensitivity.We found that circMEMO1 was significantly downregulated in HCC samples and that the level of circMEMO1 was closely related to the OS and disease-free survival (DFS) of HCC patients. Mechanistic analysis revealed that circMEMO1 can modulate the promoter methylation and gene expression of TCF21 to regulate HCC progression by acting as a sponge for miR-106b-5p, which targets the TET family of genes and increases the 5hmC level. More importantly, circMEMO1 can increase the sensitivity of HCC cells to sorafenib treatment.Our study determined that circMEMO1 can promote the demethylation and expression of TCF21 and can be considered a crucial epigenetic modifier in HCC progression.
20P Is evaluation of phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutational status on circulating tumour DNA (ctDNA) by liquid biopsy ready for prime-time? A systematic review and an individual patient meta-analysis
Authors: L. Castellana, V. Gristina, A. Galvano, M. La Mantia, L. Insalaco, N. Barraco, S. Cutaia, F. Iacono, G. Santanelli, A. Cucinella, G. Madonia, M.R. Ricciardi, M.C. Lisanti, V. Calò, M. Castiglia, A. Perez, S. Cusenza, S. Rizzo, A. Russo, V. Bazan
Journal: Annals of Oncology (2021)
Inhibition of Thrombin and Its Generation By Recombinant Thrombomodulin and Activated Protein C in Whole Blood and Plasma Based Systems
Authors: Jawed Fareed, Debra Hoppensteadt, Walter Jeske, Jeanine Walenga, Paula D'Almeida Maia, Kosuke Tanaka, Kazuhisa Tsuruta
Journal: Blood (2017)
Measuring the effect of Non-Pharmaceutical Interventions (NPIs) on mobility during the COVID-19 pandemic using global mobility data
Authors: Berber T. Snoeijer, Mariska Burger, Shaoxiong Sun, Richard J. B. Dobson, Amos A. Folarin
Journal: npj Digital Medicine (2021)

The implementation of governmental Non-Pharmaceutical Interventions (NPIs) has been the primary means of controlling the spread of the COVID-19 disease. One of the intended effects of these NPIs has been to reduce population mobility. Due to the huge costs of implementing these NPIs, it is essential to have a good understanding of their efficacy. Using aggregated mobility data per country, released by Apple and Google we investigated the proportional contribution of NPIs to the magnitude and rate of mobility changes at a multi-national level. NPIs with the greatest impact on the magnitude of mobility change were lockdown measures; declaring a state of emergency; closure of businesses and public services and school closures. NPIs with the greatest effect on the rate of mobility change were implementation of lockdown measures and limitation of public gatherings. As confirmed by chi-square and cluster analysis, separately recorded NPIs like school closure and closure of businesses and public services were closely correlated with each other, both in timing and occurrence. This suggests that the observed significant NPI effects are mixed with and amplified by their correlated NPI measures. We observed direct and similar effects of NPIs on both Apple and Google mobility data. In addition, although Apple and Google data were obtained by different methods they were strongly correlated indicating that they are reflecting overall mobility on a country level. The availability of this data provides an opportunity for governments to build timely, uniform and cost-effective mechanisms to monitor COVID-19 or future pandemic countermeasures.
Abstract 15206: Stethaid: Automated Point-of-care Recognition of Innocent Still’s Murmur in Children
Authors: Robin Doroshow, Titus John, Ravi Tej Ambati, Raj Shekhar
Journal: Circulation (2020)

Introduction: Still’s murmurs are difficult to distinguish from other heart murmurs at the primary care level. This leads to an estimated 400,000 children being referred to pediatric cardiologists each year for evaluation of heart murmurs in the United States. The murmur is ultimately diagnosed as innocent Still’s murmur in approximately 90% of these children. This diagnosis requires no specialty referral, cardiac testing, exercise restrictions or cardiology follow-up. These unnecessary referrals and associated tests waste healthcare resources, add to healthcare costs, and are a source of avoidable anxiety in children and families while waiting to see a pediatric cardiologist. Hypothesis: We have developed a novel mobile technology to discriminate Still’s murmur from all other murmurs. A smartphone application (app) that could quickly distinguish Still’s murmur from all other murmurs with high accuracy at the point of care could reassure pediatricians in their identification of Still’s murmur, significantly reducing the current rate of unnecessary referrals to cardiologists. Methods: Our current prototype is StethAid, a smartphone app which accepts heart sound recordings, and a cloud-based deep learning algorithm for discriminating Still’s murmur from other murmurs. The algorithm was independently developed and evaluated using archived heart sounds, recorded by one of the authors (RWD), made using an electronic stethoscope (3M Littmann Model 4100). Results: Our algorithm offers a sensitivity (Still’s murmurs correctly identified) of 90% with a specificity (Non-Still’s murmurs correctly identified) of 99% on 5-fold cross-validation over the Murmur Library. The area under the curve was 0.99446. The algorithm’s result is available in real time at the point-of-care (&amp;lt 1 min). Conclusions: The described point-of-care mobile technology could automatically distinguish Still’s murmur from all other murmurs with high accuracy. The technology could lower the current high rate of specialist referrals associated with Still’s murmur and reduce the related financial and emotional costs. Future directions will include further improvement of the technology and validation through multi-center clinical trials.
Long-Term Ambient Air Pollution Exposures and Circulating and Stimulated Inflammatory Mediators in a Cohort of Midlife Adults
Authors: Sheila Tripathy, Anna L. Marsland, Ellen J. Kinnee, Brett J. Tunno, Stephen B. Manuck, Peter J. Gianaros, Jane E. Clougherty
Journal: Environmental Health Perspectives (2021)

Chronic exposure to air pollution may prime the immune system to be reactive, increasing inflammatory responses to immune stimulation and providing a pathway to increased risk for inflammatory diseases, including asthma and cardiovascular disease. Although long-term exposure to ambient air pollution has been associated with increased circulating markers of inflammation, it is unknown whether it also relates to the magnitude of inflammatory response.The aim of this study was to examine associations between chronic ambient pollution exposures and circulating and stimulated levels of inflammatory mediators in a cohort of healthy adults.Circulating interleukin (IL)-6, C-reactive protein (CRP) (n=392), and lipopolysaccharide stimulated production of IL-1β, IL-6, and tumor necrosis factor (TNF)-α (n=379) were measured in the Adult Health and Behavior II cohort. Fine particulate matter [particulate matter with aerodynamic diameter less than or equal to 2.5 μm (PM2.5)] and constituents [black carbon (BC), and lead (Pb), manganese (Mn), zinc (Zn), and iron (Fe)] were estimated for each residential address using hybrid dispersion land use regression models. Associations between pollutant exposures and inflammatory measures were examined using linear regression; models were adjusted for age, sex, race, education, smoking, body mass index, and month of blood draw.There were no significant correlations between circulating and stimulated measures of inflammation. Significant positive associations were found between exposure to PM2.5 and BC with stimulated production of IL-6, IL-1β, and TNF-α. Pb, Mn, Fe, and Zn exposures were positively associated with stimulated production of IL-1β and TNF-α. No pollutants were associated with circulating IL-6 or CRP levels.Exposure to PM2.5, BC, Pb, Mn, Fe, and Zn was associated with increased production of inflammatory mediators by stimulated immune cells. In contrast, pollutant exposure was not related to circulating markers of inflammation. These results suggest that chronic exposure to some pollutants may prime immune cells to mount larger inflammatory responses, possibly contributing to increased risk for inflammatory disease. https://doi.org/10.1289/EHP7089.
Ownership of general practice: partnerships are just one organisational model among many
Authors: Paul Zollinger-Read
Journal: BMJ (2021)

Are general practice partnerships fundamental to providing high quality care?1 Sadly, I don’t think so.

Partnership sounds like such an inclusive term—a model of cooperation and collaboration, and a description that will make our customers (sorry, patients) feel supported. But a partnership is only as strong as the individuals in it. Great general practice is delivered by nurses and doctors with a common …
Abstract 17012: Safety of Magnetic Resonance Imaging in Patients With Non-Transvenous Epicardial and Abandoned Cardiac Implantable Electronic Device Leads
Authors: Nicholas O Palmeri, Linda R York, Wacks Emily, Daniel B Kramer
Journal: Circulation (2020)

Background: Patients with cardiac implantable electronic devices (CIEDs) commonly require magnetic resonance imaging (MRI). Pivotal studies establishing MRI safety in non-MRI-conditional CIEDs excluded patients with nontransvenous epicardial and abandoned leads, which may be higher risk for pro-arrhythmia. Patients with these systems are therefore excluded from national reimbursement coverage and guideline recommendations, and are sparsely reported in the literature. Objective: To describe outcomes of CIED-MRI in patients with epicardial and/or abandoned leads. Methods: We reviewed a prospective registry of CIED-MRIs at a single academic medical center for patients with nontransvenous epicardial leads or abandoned leads, including lead fragments from partial extractions. All patients were scanned on a 1.5T magnet with a standardized protocol including deactivation of tachytherapies (for ICDs), change of pacing mode to asynchronous pacing (if dependent) or off/inhibited (if not dependent), and observation with ECG telemetry and pulse oximetry. The primary outcome was adverse events, defined as any clinical arrhythmia or CIED system malfunction requiring revision procedures. Secondary outcomes included whether the MRI was interpretable and clinically useful. Results: Among 540 CIED-MRIs performed on non-MRI-conditional systems from 6/2014 to 5/2020, 21 MRIs were performed in 15 patients with epicardial or abandoned leads. The Table describes MRI indications and characteristics of CIED systems scanned (most commonly abandoned RA leads, N=10, and abandoned RV leads, N=5). MRIs were predominantly (86%) of the central nervous system. No adverse events were observed during any of the MRI scans, and no CIED systems required revision. All MRIs were found to be interpretable and provided clinically meaningful results. Conclusions: CIED-MRI in patients with epicardial or abandoned leads is safe and provides useful clinical information.
COVID-19 and the Blitz compared: mental health outcomes in the UK
Authors: Edgar Jones
Journal: The Lancet Psychiatry (2021)

The Blitz narrative of resilience stands in contrast to the mental health risks identified as consequences of the COVID-19 pandemic. Although evidence from then-classified studies of World War 2 showed that most people managed the stress of bombing, those vulnerable and exposed to substantial trauma had lasting or severe mental illness. Studies of different towns and occupational groups identified the proportion of people killed and wounded, the percentage of housing destroyed, and the loss of paid employment as risk factors for psychological breakdown. Mothers and children suffered not only with evacuation, but also from the trauma of bombing and damage to schools. A general association between civilian physical and psychological casualties suggests that population groups with high rates of infection and mortality might be susceptible to mental illness as a result of the pandemic. Lockdown and distancing measures contrast with the wartime sense of belonging and shared identity, reinforced by community networks and social activities.
Single-cell characterization of macrophages in glioblastoma reveals MARCO as a mesenchymal pro-tumor marker
Authors: Andrew X. Chen, Robyn D. Gartrell, Junfei Zhao, Pavan S. Upadhyayula, Wenting Zhao, Jinzhou Yuan, Hanna E. Minns, Athanassios Dovas, Jeffrey N. Bruce, Anna Lasorella, Antonio Iavarone, Peter Canoll, Peter A. Sims, Raul Rabadan
Journal: Genome Medicine (2021)

Macrophages are the most common infiltrating immune cells in gliomas and play a wide variety of pro-tumor and anti-tumor roles. However, the different subpopulations of macrophages and their effects on the tumor microenvironment remain poorly understood.
Abstract 062: Global Patterns Of Mean Systolic Blood Pressure Over Three Decades: Results From The Global Burden Of Disease 2019 Study
Authors: Saate S Shakil, Catherine O Johnson, Gregory A Roth, Christian A Razo
Journal: Circulation (2021)

Background: Atherosclerotic cardiovascular disease and its risk factors are increasing globally. We estimated global and regional mean levels of systolic blood pressure (SBP) for the Global Burden of Disease (GBD) 2019 study. Methods: Mean SBP in mm Hg was estimated by age (adults &gt;25 years), sex, location and year using all available population-based health surveys and studies that systematically measured brachial blood pressure. Estimates were produced using a Bayesian statistical model, spatiotemporal Gaussian process regression, which produces a smoothed time series from 1990 to 2019, borrowing strength over space and time, then aggregates to GBD regions. Each point in the figure represents age- and sex-specific mean SBP for one of 21 GBD regions, color coded by the 7 GBD super regions; black triangles denote global mean SBP. We report 95% uncertainty intervals in brackets. Results: Globally, mean SBP increased with age, peaking at 75-84 years, followed by a plateau and slight decline amongst oldest adults. In adults &gt;60 in 1990 and &gt;70 in 2019, females had higher SBP than males globally; this difference declined over time. In 1990, mean SBP was highest among females in Central Europe aged 60-64 (150 [147- 154]) and High-income Asia Pacific aged 80-84 (150 [147 - 152]), and in males aged 80-84 in Western Europe (150 [147-152]) and High-income Asia Pacific (148 [146 - 150]). By 2019, mean SBP was highest among adults aged 80-84 in Western and Southern Sub-Saharan Africa for both females (150 [136 - 164]; 149 [142 - 156], respectively), and males (145 [140 - 150]; 144 [136 - 153], respectively). Conclusions: SBP increased globally with age and was higher in older women than men. The 5-year age group with highest estimated SBP shifted over time from parts of Europe and High-income Asia Pacific to parts of Sub-Saharan Africa. Elevated SBP remains a major health risk for the world’s population, suggesting a need for increased investments in understanding its etiologies and how to treat and eventually prevent it as a cause of disease.
Abstract 13552: Clinical Relevance of Endogenous Tissue-plasminogen Activator in Patients With Aortic Valve Sclerosis
Authors: Ke Yang, Zhongli Chen, Ying Shen, Yangyang Zhang, Bo Wen Lin, Xiao Yan He, Yi Bo Zhang, Shutong Shen, Ying Yang, Wei Feng Shen, Walter J. Koch, Ye Hong Liu
Journal: Circulation (2020)

Introduction: Impaired fibrinolysis featuring elevated tissue plasminogen activator (t-PA) induces cardiovascular outcomes. Aortic valve sclerosis (AVSc) shares similar aspects of pathophysiology with atherosclerosis and correlates with adverse cardiovascular events. Hypothesis: We investigated whether endogenous t-PA is associated with AVSc and clinical outcomes of these patients. Methods: Plasma levels of t-PA were measured in 155 AVSc patients and 140 non-AVSc counterparts. The composite major adverse cardio-cerebral events (MACCE), including cardiovascular death, nonfatal myocardium infarction, stroke, and re-hospitalization because of heart failure or unplanned revascularization were recorded during follow-up in 143 patients with AVSc (median, 6.5 years). Expression of t-PA was detected in human aortic valves with and without sclerosis by immunochemical analysis. Results: Plasma t-PA was higher in patients with AVSc than in those without (median, 2163.10 pg/mL vs 1403.17 pg/mL, p &lt; 0.001). After adjusting for confounding variables, t-PA level remained an independent risk factor for AVSc (OR=1.66, 95%CI: 1.18-2.34, P=0.004). Based on the optimal cut-off of 1787.8 pg/mL determined by X-tile program, AVSc patients with low t-PA displayed better survival free from MACCE than those with high t-PA (p=0.0018). After full adjustment, t-PA was independently associated with composite MACCE (HR=1.33, 95% CI: 1.07-1.66, p=0.009). The area under the curve of plasma t-PA for predicting composite MACCE within three years was 0.71(95%CI: 0.63-0.80). The expression of t-PA was three times higher in sclerotic compared to non-sclerotic aortic valves. Conclusions: Elevated endogenous t-PA in plasma may serve as an indicator of AVSc and is associated with poor clinical outcomes in patients with AVSc.
29P Plasma ESR1 mutations and outcome to first-line chemotherapy with bevacizumab and paclitaxel in patients with advanced ER-positive/HER2-negative breast cancer
Authors: M.K. Bos, S.W. Lam, J.C.A. Helmijr, C.M. Beaufort, A. Jager, J.W.M. Martens, E. Boven, M.P.H.M. Jansen, S. Sleijfer
Journal: Annals of Oncology (2021)
Cervical cancer screening outcomes in Zambia, 2010–19: a cohort study
Authors: Jake M Pry, Albert Manasyan, Sharon Kapambwe, Katayoun Taghavi, Miquel Duran-Frigola, Mulindi Mwanahamuntu, Izukanji Sikazwe, Jane Matambo, Jack Mubita, Kennedy Lishimpi, Kennedy Malama, Carolyn Bolton Moore
Journal: The Lancet Global Health (2021)

Globally, cervical cancer is the fourth leading cause of cancer-related death among women. Poor uptake of screening services contributes to the high mortality. We aimed to examine screening frequency, predictors of screening results, and patterns of sensitisation strategies by age group in a large, programmatic cohort.We did a cohort study including 11 government health facilities in Lusaka, Zambia, in which we reviewed routine programmatic data collected through the Cervical Cancer Prevention Program in Zambia (CCPPZ). Participants who underwent cervical cancer screening in one of the participating study sites were considered for study inclusion if they had a screening result. Follow-up was accomplished per national guidelines. We did descriptive analyses and mixed-effects logistic regression for cervical cancer screening results allowing random effects at the individual and clinic level.Between Jan 1, 2010, and July 31, 2019, we included 183 165 women with 204 225 results for visual inspection with acetic acid and digital cervicography (VIAC) in the analysis. Of all those screened, 21 326 (10·4%) were VIAC-positive, of whom 16 244 (76·2%) received treatment. Of 204 225 screenings, 92 838 (45·5%) were in women who were HIV-negative, 76 607 (37·5%) were in women who were HIV-positive, and 34 780 (17·0%) had an unknown HIV status. Screening frequency increased 65·7% between 2010 and 2019 with most appointments being first-time screenings (n=158 940 [77·8%]). Women with HIV were more likely to test VIAC-positive than women who were HIV-negative (adjusted odds ratio 3·60, 95% CI 2·14-6·08). Younger women (≤29 years) with HIV had the highest predictive probability (18·6%, 95% CI 14·2-22·9) of screening positive.CCPPZ has effectively increased women's engagement in screening since its inception in 2006. Customised sensitisation strategies relevant to different age groups could increase uptake and adherence to screening. The high proportion of screen positivity in women younger than 20 years with HIV requires further consideration. Our data are not able to discern if women with HIV have earlier disease onset or whether this difference reflects misclassification of disease in an age group with a higher sexually transmitted infection prevalence. These data inform scale-up efforts required to achieve WHO elimination targets.US President's Emergency Plan for AIDS Relief.