tbuckley/cabot-search huggingface dataset:
Temporal Associations and Outcomes of Breast Cancer and Heart Failure in Postmenopausal Women
Authors: Phillip H. Lam, Ana Barac, Anju Nohria, Kerryn W. Reding, Samer S. Najjar, Gregg C. Fonarow, Kathy Pan, Helen Sheriff, Charity J. Morgan, Rowan T. Chlebowski, Liviu Klein, Charles B. Eaton, Barbara V. Howard, Ali Ahmed, Selma F. Mohammed
Journal: JACC CardioOncology (2020)

Heart failure (HF) and breast cancer are 2 of the leading causes of death in postmenopausal women. The temporal association between HF and breast cancer in postmenopausal women has not been described. This study sought to examine the temporal association between HF and breast cancer. Postmenopausal women within the WHI (Women's Health Initiative) cohort were studied. All prevalent HF and prevalent breast cancer at enrollment were self-reported. Incident hospitalized HF and breast cancer diagnoses were adjudicated through 2017. Among a cohort of 44,174 women (mean age 63 ± 7 years), 2,188 developed incident invasive breast cancer and 2,416 developed incident hospitalized HF over a median follow-up of 14 and 15 years, respectively. When compared with a breast cancer- and HF-free cohort, there was no association between prevalent HF and incident invasive breast cancer and similarly, there was no association between prevalent breast cancer and incident hospitalized HF. Across the entire cohort, the median survival after incident hospitalized HF was worse compared with an incident invasive breast cancer diagnosis (5 and 19 years, respectively). In women with incident invasive breast cancer, prevalent HF was associated with an increased risk of mortality (hazard ratio: 2.28; 95% confidence interval: 1.31 to 3.95). In women with incident hospitalized HF, prevalent breast cancer was associated with an increased risk of mortality (hazard ratio: 1.66; 95% confidence interval: 1.03 to 2.68). Cause of death after incident HF was different only in women with prevalent and interim breast cancer compared with those without prevalent and interim breast cancer. In postmenopausal women, prevalent HF was not associated with a higher incidence of breast cancer and vice versa. However, the presence of incident invasive breast cancer or incident HF in those with prevalent HF or prevalent breast cancer, respectively, was associated with increased mortality.
Abstract 15572: Gender, Race, and Age Specific Baseline Predictors of All-cause Mortality in STICHES Trial Identified by Machine Learning
Authors: Ian C Atkinson, Anwar Husain, Gauri Dandi, Nuha Gani, Zyannah Mallick, Victoria Xin, Scout Hayashi, Natalie Lewis, Noah Hasan, Nayab Mahmood, Khizar Qureshi, Avantika Banerjee, Amit Dey, Yves D Rosenberg, Ahmed A Hasan
Journal: Circulation (2020)

Introduction: NHLBI supported STICHES trial (The Surgical Treatment for Ischemic Heart Failure Extended Study) (NCT00023595) was conducted to test whether blood flow restoration by coronary revascularization recovers chronic left ventricular dysfunction and improves survival, as compared to medical therapy alone in patients with congestive heart failure and coronary artery disease amenable to surgical revascularization. We reused publicly available individual patient-level STICHES trial data from NHLBI Data Repository (BioLINCC) to perform hypothesis-generating secondary analyses by machine learning (ML) using random survival forest (RSF) to identify gender, race and ethnicity, and age specific predictors for all-cause mortality (ACM). Methods: The population was sub-grouped by gender (male vs. female), race (white vs. Hispanic/Latinos/non-white), and age (&lt; 55, 55-60, 61-69, and ≥70). RSF was performed on 48 baseline variables from 1212 patients to identify predictors of ACM. Top 10 RSF predictors for each subgroup were included in a multivariate analysis using a Cox proportional hazards model. Results: Top 10 predictors of ACM are shown in Table 1. While known cardiometabolic and vascular predictors were among the top predictors, RSF uniquely identified renal function related biomarkers and plasma sodium among important top predictors across the subgroups. Age was an important predictor for male and female, Hispanics/Latinos/non-whites, and patient groups ≥70 years old. Also, top predictors of ACM were current smoking status among age groups of &lt;55 and 55-60, clinical recruitment site in age group 61-69, and female gender in age group 55-60. Conclusions: Using ML, we uncovered in an unbiased fashion, gender, age, race and ethnicity specific, unanticipated top predictors of ACM in STICHES trial. This highlights the value of ML for analyzing disease and therapeutic intervention outcomes to help implement precision medicine.
Abstract 16748: Stent Type and Outcomes in Patients With Malignancy Undergoing Percutaneous Coronary Intervention
Authors: Muhammad Mohsin Munawar, Ahmad A Awan, Richard Ogunti, Urooj Fatima, basharat Ahmad, issac Opoku
Journal: Circulation (2020)

Background: Coronary artery disease and cancer share some of the same risk factors, so it is not uncommon to find them in same patient. So PCI is increasingly performed in these patients. However type of stent and its impact on mortality is largely unknown. Methods: Nationwide Inpatient Sample (HCUP-NIS) database was utilized to identify patient who have underwent BMS or DES placement and had active cancer. Appropriate ICD 9 codes was used to identify lung, colon, breast, prostrate, hematological, liver, brain and kidney cancer as well as metastatic cancer. Patient were randomly assigned in 1:1 ratio to BMS and DES group. Propensity score analysis was performed using neighborhood matching to baseline co-variates and reduce confounding bias. Percentage of patients getting BMS and DES were analyzed and compared to general population. While comparing DES and BMS group, outcomes included in-hospital mortality, stent thrombosis, length of stay, acute kidney injury and bleeding complications.R esults: A total of 8755 patients were selected in BMS group and 11,611 patients were selected in DES group. Following propensity matching, 4313 patients were selected in both groups and randomly assigned 1:1 ratio to BMS and DES. As compared to general population (BMS 23.2%, DES 76.8%), there is high use of BMS stent in cancer patient (BMS 43.0%, DES 57.2%). When comparing BMS to DES group, there is no statistically significant difference in mortality (4.7 vs 3.8 percent p=0.097), acute kidney injury (11.3 in BMS vs 10.6 in DES p = 0.425), bleeding complications (3.50 in BMS vs 3.45 in DES p = 0.914) and length of stay (5.4 in BMS vs 5.2 in DES p = 0.119). There is increased incidence of stent thrombosis in DES group (4.26% vs 3.01%, p-value 0.02). Among the cancers, adjusted for type of stent placed, liver and pancreatic cancer was associated with significant increase in stent thrombosis Conclusion: In patients with active malignancy, there is higher incidence of BMS placement as compared to general population. There is high incidence of stent thrombosis is DES without increase in mortality. Among the cancers, adjusted for type of stent placed, liver and pancreatic cancer was associated with significant increase in stent thrombosis
Oral Antidiabetic Agents
Authors: J. A. Weaver
Journal: BMJ (1959)

surprises.A slightly more critical attitude to treatment, and an attempt to reduce insulin or the sulphonylureas whenever possible, to withdraw them even, has for several years suggested to me the frequent temporary nature of the disease.It is suggested that in suitable diabetic centres attempts might be made to systematically organize patient material in such a way that six- monthly repeated glucose-tolerance tests might give us a real clue to the nature and time limitation of the diabetic state.-Iam, etc.,
Scaffold‐Free Bioprinting: Hybrid Bioprinting of Zonally Stratified Human Articular Cartilage Using Scaffold‐Free Tissue Strands as Building Blocks (Adv. Healthcare Mater. 22/2020)
Authors: Yang Wu, Bugra Ayan, Kazim K. Moncal, Youngnam Kang, Aman Dhawan, Srinivas V. Koduru, Dino J. Ravnic, Fadia Kamal, Ibrahim T. Ozbolat
Journal: Advanced Healthcare Materials (2020)

Using a novel hybrid approach integrating aspiration-assisted bioprinting and extrusion-based bioprinting, a zonally stratified cartilage is fabricated, in which collagen fibers are aligned with designated orientation in each zone imitating the anatomical regions and matrix orientation of native cartilage tissue. These findings, in article number 2001657 by Ibrahim T. Ozbolat and co-workers, highlight the potential of this approach for building biologically, mechanically, and histologically relevant cartilage for tissue engineering purposes.
Abstract 12888: Discrepancy of Aortic Valve Endocarditis in Patients With Bicuspid and Tricuspid Aortic Valve
Authors: Tan Le, Juan Caceres, Bailey Brown, Alexander Makkinejad, Emma St. Pierre, Tom Ren, Jeffrey Clemence, Xiaoting Wu, Karen M Kim, Himanshu J Patel, G. Michael Deeb, Bo Yang
Journal: Circulation (2020)

Introduction: It’s unknown if patients with Bicuspid Aortic Valve (BAV) endocarditis behave differently compared to Tricuspid Aortic Valve (TAV), and if BAV patients are more susceptible to aortic valve endocarditis. Hypothesis: We aimed to distinguish BAV and TAV infectious endocarditis, including the short and long-term outcomes after surgical treatment. Methods: From 1997-2017, 336 patients underwent surgical treatment for aortic valve endocarditis, including 63(19%) BAV, which is 10-20 times higher than the BAV incidence in the general population (1-2%), and 273(81%) TAV endocarditis. Results: Postoperatively, the BAV group had significant shorter intubation time, and less renal failure on dialysis compared to TAV group. There was no compelling difference in postoperative stroke, sepsis, pacemaker requirement and in-hospital mortality [3/65(4.6%) vs. 19/283(6.7%)] between groups. The 10-year survival was better in the BAV group than the TAV group (62% vs. 33%, p=0.004) (Figure). The significant risk factors for late mortality were renal failure on dialysis [hazard ratio (HR)=2], intravenous drug user (HR=2.4), congestive heart failure (HR=1.6), previous coronary artery bypass (HR=1.8) and liver disease (HR=2.4), all p&lt;0.05, but not TAV (HR=1.6, p=0.14). Conclusions: In conclusion, BAV patients have a higher likelihood of infectious endocarditis requiring surgery at a younger age than TAV patients, but similar outcomes. Strong consideration of utilizing prophylactic antibiotics and early surgical treatment for BAV patients, to lower the likelihood of aortic valve endocarditis.
Diagnosis, Clinical Features, and Management of Patients With Granulomatous Cheilitis
Authors: Joseph S. Durgin, Olaf Rodriguez, Thomas Sollecito, Takako Tanaka, Joseph C. English, Bridget E. Shields, Misha Rosenbach
Journal: JAMA Dermatology (2020)

This case series study of patients with granulomatous cheilitis at a tertiary referral center seeks to better describe the demographic characteristics, presenting features, associated disorders, and response to treatment of granulomatous cheilitis.
Abstract 14474: Cdk9-activated Sgk3 Promotes Myocardial Repair and Regeneration After Myocardial Infarction via Gsk-3Å/Å-catenin Pathway
Authors: YaFei Li, Tianwen Wei, Fan Yi, Hao Wang, Liansheng Wang
Journal: Circulation (2020)

Background: Neonatal heart maintains entire regeneration capacity in a transient regeneration window, but the adult heart loses this function. This process involves numberous core hubs dysregulation of expression and activity that adversely affect the myocardium regeneration ability. Present study screened a functional kinase of serine/threonine-protein kinase 3 (SGK3) in cardiac regeneration after neonatal myocardial infarction (MI) using quantitative phosphoproteomics. Methods: We used quantitative phosphoproteomics data of infarct border zone in newborn heart after MI to identify regeneration related kinases. Gain- and loss-of-function experiments were performed to determine the effect of SGK3 in cardiomyocyte (CM) proliferation and cardiac repair after apical resection (AR) or MI. Pull-down assay and co-immunoprecipitation (Co-IP) experiments were conducted to investigate the direct binding target proteins of SGK3. Results: SGK3 protein expression was highly expressed at postnatal day 1 (P1), reduced at postnatal day 7 (P7) until adult. In vitro, CM proliferation ratio was elevated by SGK3 overexpression, while it was decreased by knockdown of SGK3. In vivo, inhibition of SGK3 shortened the time window of cardiac regeneration after AR in neonatal mice, and overexpression of SGK3 significantly promoted CM proliferation and cardiac repair after MI. Mechanistically, SGK3 could be directly combined with and activated by cyclindependent kinase 9 (CDK9). Inhibition of CDK9 partially abolished the effect of SGK3 on CM proliferation. Moreover, SGK3 could repress GSK-3β activity and increase β-catenin expression. Conclusions: Our study revealed a key role of SGK3 in cardiac regeneration following AR or MI injury, which may reopen a novel therapeutic avenue for MI.
Abstract 15210: Do Idiopathic Ventricular Fibrillation and Brugada Syndrome Patients Have Favor Outcomes in the Targeted Temperature Management Era?
Authors: Eisuke Kagawa, Masaya Kato, Noboru Oda, Eiji Kunita, Michiaki NAGAI, AYA YAMANE, Haruko Shiota, Keigo Dote
Journal: Circulation (2020)

Introduction: Idiopathic ventricular fibrillation (IVF) including Brugada syndrome (BS) is one of causes of cardiac arrest without prior overt cardiac dysfunction. Hypothesis: We assessed the hypothesis that patents of IVF had favor outcomes than those of non-IVF after cardiac arrest treated with targeted temperature management (TTM). Methods: Patients who were treated with TTM after cardiac arrest between 2000 and 2019 were enrolled in the study. Patients were divided into 2 groups according to whether the patients were diagnosed as IVF or not. The patients treated with TTM were routinely performed coronary angiography. Results: Among the study patients (N = 306), 35 (11%) patients were IVF and 7 were BS. The patients of the IVF group were significantly younger (median 53 y vs. 64 y) than those of the non-IVF group. The prevalence of initial rhythm was shockable (69% vs. 47%, P = 0.02) was significantly higher in the patients of the IVF group than those of the non-IVF group. Among the patients in the non-IVF group, 114 patients (42%) were diagnosed as acute coronary syndrome and 93 patients (35%) were treated with coronary revascularization. The prevalence of male sex (77% vs 74%, P = 0.70) and witnessed to arrest (80% vs. 81%, P = 0.87), and low-flow time (29 min vs. 38 min [20 - 43 min vs. 21 - 52 min, P = 0.15]) were similar between the 2 groups. The prevalence of performing extracorporeal resuscitation (9% s 43%, P &lt; 0.001) were lower in the patients of the IVF group. The 8-y survival rate were shown in the figure. All of the BS patients were witnessed arrest and were discharged without severe neurological deficit. The IVF as the cause of arrest was independently associated with 8-y survival. Conclusions: The patients of IVF had favor outcomes than those of non-VF. One of causes may be the lower prevalence of requiring extracorporeal circulatory support due to less cardiac dysfunction. The patients of BS had the tendency toward higher survival rate than those of non-BS IVF patients.
Feasible and accurate measurement of left ventricular volume and ejection fraction by new real-time three-dimensional echocardiography
Authors: K Arai, Takeshi Hozumi, Yoshiki Matsumura, Hiroki Oe, Kenichi Sugioka, Keiji Ujino, Yasuhiko Takemoto, Takashi Muro, Hiroyuki Yamagishi, Kaname Akioka, Minoru Yoshiyama, Kazuhide Takeuchi, Junichi Yoshikawa
Journal: Circulation (2004)
Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation
Authors: Oussama M. Wazni, Gopi Dandamudi, Nitesh Sood, Robert Hoyt, Jaret Tyler, Sarfraz Durrani, Mark Niebauer, Kevin Makati, Blair Halperin, Andre Gauri, Gustavo Morales, Mingyuan Shao, Jeffrey Cerkvenik, Rachelle E. Kaplon, Steven E. Nissen
Journal: New England Journal of Medicine (2020)

In patients with symptomatic paroxysmal atrial fibrillation that has not responded to medication, catheter ablation is more effective than antiarrhythmic drug therapy for maintaining sinus rhythm. However, the safety and efficacy of cryoballoon ablation as initial first-line therapy have not been established.
Abstract 13296: Risk Loci of Hypertrophic Cardiomyopathy Identified via the UK Biobank
Authors: Alex Gyftopoulos, Yi-Ju Chen, Libin Wang, Charles H Williams, Young Wook Chun, James A Perry, Charles C Hong
Journal: Circulation (2020)

Introduction: Hypertrophic cardiomyopathy (HCM) is the most commonly inherited cardiac disease affecting 1:500 to 1:200 individuals worldwide. HCM has a heterogeneous genetic profile and phenotypic expression. More than 1400 known pathogenic variants have been identified in 11 sarcomere genes. In about 40% of HCM patients, the genetic cause may not be identified. The same mutation may lead to different phenotypes and severity in different individuals. Identification of novel HCM genes and modifiers will expand our understanding of the signaling pathways that are responsible for phenotypic expression of HCM. Methods: The UK Biobank comprises clinical and genetic data for greater than 500,000 individuals. We used OASIS, an information system for analyzing, searching, and visualizing associations between phenotype and genotype data to analyze this data. We compared control individuals to HCM individuals identified by ICD-10 code (I42.1 and I42.2) in a 20-to-1 fashion. Related individuals and those with confounding diagnoses were excluded. Results: The analysis was performed with Plink’s GLM option, and we identified 84 variants with a minor allele frequency of 0.5% or greater in 65 genes associated with HCM with a p &lt; 1x10 -6 , including 4 with p &lt; 5x10 -8 . The identified genes encode lncRNAs, miRNAs, and membrane proteins. Variants with high significance were identified in the genes encoding putative ciliary components DNAL4 (dynein axonemal light chain 4; p = 2.9x10 -8 ), MYO1D (unconventional myosin 1D; p = 3.1x10 -8 ), ITFAP (intraflagellar transport associated protein; p = 9.5x10 -8 ), CABCOCO1 (ciliary associated calcium biding coiled-coil 1; p = 3.7x 10 -7 ), EVL (Enah-Vasp-like; p = 4.4x 10 -7 ) and IFT122 (intraflagellar transport 122; p = 8.0 x10 -7 ). Conclusion: While none of these have previously associated with HCM, our findings suggest ciliary structure and function may play a role in disease manifestation. Our method is unique by pooling individuals in a large population set to identify potential causative or contributing mutations. Bioinformatic tools, such as OASIS, allow for the identification of previously unrecognized variants that may play a role in the development of HCM. This approach has identified numerous novel genes as possible risk loci.
Abstract 15270: Coronary Plaque Natural History Displays Marked Longitudinal Heterogeneity Along the Length of Individual Coronary Plaques
Authors: Jolanda J Wentzel, Michail I Papafaklis, Antonios Antoniadis, Saeko Takahashi, Nicholas V Cefalo, Michelle Cormier, Shigeru Saito, Ahmet U Coskun, Peter H STONE
Journal: Circulation (2020)

Introduction: Plaque natural history is related to local shear stress, and shear stress has been shown to be heterogeneously distributed along the length of individual plaques. We investigated the longitudinal spatial heterogeneity of plaque progression/regression/quiescence in human coronary arteries. Methods: 591 coronary arteries from 302 patients with coronary disease who presented with an acute coronary syndrome from the PREDICTION study were investigated for local plaque progression/regression/quiescence patterns in non-culprit plaques after 6-10 month FU. Arterial geometry was derived from angiography/IVUS-based vascular profiling and reported in 3 mm segments. Plaques were defined as &gt;3 consecutive segments with maximal wall thickness&gt;0.5 mm. Plaque progression was defined as &gt;5% increase, regression as &lt;-5% decrease, and quiescence as no change in plaque burden (plaque area/ total vessel area * 100%). Results: 5658 3mm-segments of 661 plaques were analyzed. Plaque burden changes ranged from -22% to +20%. Among all plaques, 56% showed segments with plaque progression, 60% with regression and 96% with quiescence. On average, 17% of the plaque length displayed plaque progression, 20% regression and 63% quiescence. The presence and number of natural history features (progression, regression, quiescence) within the individual plaques were significantly related to plaque length using logistic mixed model regression analysis (figure). Conclusions: Coronary plaque natural history is extremely heterogeneous along the length of an individual plaque. These observations may explain why revascularization of a focal severe obstruction in the ISCHEMIA trial did not affect clinical outcomes, since remaining high-risk plaque up- or down-stream from the revascularization may have led to future cardiac events.
Diffuse bruising on left breast
Authors: Ye Ru Chin, Robert Warner
Journal: BMJ (2020)

A woman in her late 50s was referred to breast clinic with a two month history of rapidly progressing, diffuse purplish discoloration on the medial aspect of her left breast. Eight years earlier she had undergone left wide local excision and sentinel lymph node biopsy for a grade II, triple negative invasive ductal carcinoma. She also received adjuvant chemotherapy and breast radiotherapy.

On examination, the skin of the left breast showed multiple ill defined purplish discoloured lesions, which were fragile and bled intermittently (fig 1). The skin appeared inflamed and thickened and the skin changes and bruising extended laterally towards the patient’s back.



Fig 1 
Left breast skin changes and lesions





### 1. What is the most likely diagnosis?

Radiotherapy induced angiosarcoma of the left …
Inverse Opal Films for Medical Sensing: Application in Diagnosis of Neonatal Jaundice
Authors: Natalie J. Nicolas, Meredith A. Duffy, Anne Hansen, Joanna Aizenberg
Journal: Advanced Healthcare Materials (2020)

Abstract A non‐invasive, at‐home test for neonatal jaundice can facilitate early jaundice detection in infants, improving clinical outcomes for neonates with severe jaundice and helping to prevent the development of kernicterus, a type of brain damage whose symptoms include hearing loss, impairment of cognitive capacity, and death. Here a photonic sensor that utilizes color changes induced by analyte infiltration into a chemically functionalized inverse opal structure is developed. The sensor is calibrated to detect differences in urinary surface tension due to increased bile salt concentration in urine, which is symptomatic of abnormal liver function and linked to jaundice. The correlation between neonatal urinary surface tension and excess serum bilirubin, the physiologic cause of neonatal jaundice, is explored. It is shown that these non‐invasive sensors can improve the preliminary diagnosis of neonatal jaundice, reducing the number of invasive blood tests and hospital visits necessary for healthy infants while ensuring that jaundiced infants are treated in a timely manner. The use of inverse opal sensors to measure bulk property changes in bodily fluids can be extended to the detection of several other conditions, making this technology a versatile platform for convenient point‐of‐care diagnosis.