tbuckley/cabot-search huggingface dataset:
Abstract MP14: The Effect Of Time-restricted Feeding On 24-hour Ambulatory Blood Pressure: Results From The Time-restricted Intake Of Meals (TRIM) Study
Authors: Ruth-Alma N Turkson-Ocran, Edgar R Miller, Di Zhao, Scott Pilla, Daisy Duan, Byron Jaeger, Paul Muntner, Jeanne Clark, Nisa Maruthur
Journal: Circulation (2021)

Introduction: Some studies suggest that time-restricted feeding may decrease blood pressure (BP), but the current evidence is inconclusive. Objective: To determine the effect of a time-restricted feeding pattern compared to a usual feeding pattern on ambulatory 24-hour BP in adults. Hypothesis: An isocaloric, time-restricted feeding pattern will lower 24-hour BP more than an isocaloric usual feeding pattern over 12 weeks. Methods: Forty-one persons with prediabetes (HbA1c 5.7-6.9%) and obesity (BMI 30-50 kg/m 2 ) were randomized to consume 80% of their total calories before 1 pm (i.e., time-restricted feeding) or more than 50% of their calories after 5 pm (i.e., usual feeding) with identical macronutrient content. We used ambulatory BP monitoring to measure BP over 24-hours at baseline and 12-weeks. Outcomes of interest were mean systolic and diastolic 24-hr, daytime (7 am - 11 pm), and nighttime (11 pm - 7 am) BP. To examine the difference in BP patterns between time-restricted feeding and usual feeding pattern groups in change in BP outcomes from baseline to 12 weeks, we used linear mixed-effects regression models with participant-specific random intercepts and fixed effects for visit and intervention group. To assess whether feeding patterns affected BP levels over the 12 week intervention period, we tested whether there was an intervention-by-time interaction. Results: Thirty-five adults (mean age 60.4 years; 91% female, 91% African American) had sufficient data. We found reductions from baseline in systolic and diastolic BP for both groups for the 24-hour, daytime, and nighttime periods. The decrease in BP was larger in the usual feeding pattern group compared to the time-restricted feeding group (Table). Conclusion: Time-restricted feeding may attenuate the effect of a healthy isocaloric diet on BP compared to typical feeding patterns, and at this time, should not be recommended as a way to lower BP more than simply adopting a healthy diet.
Geographical distribution of fertility rates in 70 low-income, lower-middle-income, and upper-middle-income countries, 2010–16: a subnational analysis of cross-sectional surveys
Authors: Carla Pezzulo, Kristine Nilsen, Alessandra Carioli, Natalia Tejedor-Garavito, Sophie E Hanspal, Theodor Hilber, William H M James, Corrine W Ruktanonchai, Victor Alegana, Alessandro Sorichetta, Adelle S Wigley, Graeme M Hornby, Zoe Matthews, Andrew J Tatem
Journal: The Lancet Global Health (2021)

Understanding subnational variation in age-specific fertility rates (ASFRs) and total fertility rates (TFRs), and geographical clustering of high fertility and its determinants in low-income and middle-income countries, is increasingly needed for geographical targeting and prioritising of policy. We aimed to identify variation in fertility rates, to describe patterns of key selected fertility determinants in areas of high fertility.
Abstract 15752: Acute Kidney Injury and Shock Severity for Mortality Risk Stratification in Cardiac Intensive Care Unit Patients
Authors: Mitchell R Padkins, Thomas Breen, Gregory W Barsness, Kianoush Kashani, Jacob C Jentzer
Journal: Circulation (2020)

Introduction: Acute kidney injury (AKI) is a highly prevalent risk factor for mortality among patients with cardiogenic shock (CS). We sought to assess the incidence and prognostic relevance of AKI as a function of shock severity in unselected Cardiac Intensive Care Unit (CICU) patients, as measured by the Society for the Cardiovascular Angiography and Interventions (SCAI) shock stage. Methods: We retrospectively reviewed admissions to the Mayo Clinic from 2007 to 2015 and stratified patients by the SCAI shock stage. AKI was defined and staged based on changes in serum creatinine during hospitalization as per KDIGO guidelines. Predictors of in-hospital mortality were analyzed using Kaplan-Meier survival analysis, and one-year mortality was analyzed using Cox proportional-hazards analysis. Results: The final study population included 10,004 unique patients with a mean age of 67 years and 37% females. The percentage of patients with SCAI shock stages A, B, C, D, and E were 47%, 30%, 15%, 7%, and 1%, respectively. AKI of any severity occurred in 51% of patients during hospitalization, including severe (stage 2/3) AKI in 16%. The incidence of AKI and severe AKI increased with the SCAI shock stage. Hospital mortality occurred in 8% of patients and increased as a function of the AKI stage and SCAI shock stage. AKI was associated with increased hospital mortality after multivariable adjustment (adjusted OR per AKI stage 1.17, 95% CI 1.05-1.30, p=0.005). Twenty-one percent of patients died within one year of CICU admission, and worse AKI was associated with increased one-year mortality (adjusted HR per AKI stage 1.11, 95% CI 1.05-1.18, p=&lt;0.001). Hospital survivors with AKI of any severity had higher mortality compared with patients who did not have AKI (p&lt;0.001). Conclusions: AKI was increasingly common in CICU patients with higher shock severity. In-hospital and one-year mortality risk increased as a function of the severity of AKI and the SCAI shock stage. This analysis emphasizes the importance of AKI as a complication of shock and as a predictor of adverse outcomes in CICU patients.
Abstract 12974: Successful VT Ablation Utilising Intracoronary Gelatin Sponge Injection
Authors: Eugene M Gan, Paul C Lim, Kelvin C Chua, Eric T Lim, Daniel T Chong, Boon Yew Tan, Kah Leng Ho, Aaron S Wong, Soo Teik Lim, Wee Siong Teo, Chi Keong Ching
Journal: Circulation (2020)

Introduction: We report two cases of recurrent ventricular tachycardia (VT) successfully treated by intra-coronary Gelatin sponge embolization where initial endocardial ablation was unsuccessful and epicardial approaches were unfavourable. Case Histories: (1) A 75-year-old male with Inferior STEMI who underwent PCI to oRPDA developed VT storm that required DCCV 11 times. The VT was hemodynamically unstable, hence only substrate modification was performed. He still had recurrent episodes of VT and a second ablation attempt localised VT circuit breakout to the infero-apical septum, but ablation was unsuccessful due to a deep intramural circuit. Epicardial ablation was not attempted due to a 1cm pericardial effusion after the first procedure. Unipolar signals from selective wiring of the distal rPDA with a percutaneous coronary intervention guidewire and microcatheter showed early local electrograms. 5ml of Gelatin sponge injection was injected after a 5x2mm coil failed to occlude the distal rPDA. Post occlusion, VT was not inducible with double ventricular extra-stimuli. He has been VT free for 5 months (2) A 41-year-old female with dilated cardiomyopathy, previous left ventricular assist device and revision was admitted for VT storm. The VT map identified earliest activation with far-field pre-systolic potentials at the baso-lateral LV segment. Pre-systolic far field ventricular EGMs were also seen in the adjacent coronary sinus, consistent with a likely epicardial exit site of the VT. Endocardial ablation failed, and epicardial access was not feasible due to adhesions. Coronary angiography revealed a small calibre non dominant left circumflex artery supplying the VT exit site. Cold saline injection down the mLCX terminated the VT and the vessel was occluded with 5 ml of Gelatin sponge. VT was subsequently not inducible. Discussion &amp; Conclusion: Critical portions of VT circuits may course epicardially or intramurally 3 , limiting successful endocardial catheter ablation. Epicardial access was risky. Coronary vessel embolization using coils 4 and ethanol 5 have been performed. Use of absorbable Gelatin sponge has been described in managing coronary perforation 6 , but to the best of our knowledge these are the first cases of its use in VT ablation.
Prevalence of Perceived Racism and Discrimination Among US Children Aged 10 and 11 Years
Authors: Jason M. Nagata, Kyle T. Ganson, Omar M. Sajjad, Samuel E. Benabou, Kirsten Bibbins-Domingo
Journal: JAMA Pediatrics (2021)

Racism, Diminished Returns of Socioeconomic Resources, and Black Middle-Income Children's Health Paradox
Abstract 12814: Systematic Review and Meta-Analysis of Noninvasive Angiographically-Derived Virtual Fractional Flow Reserve (vFFR)
Authors: Saarik Gupta, Gayatri Suresh Kumar, Abdur R Khan, Shahab Ghafghazi
Journal: Circulation (2019)

Introduction: Pressure-wire fractional flow reserve (FFR) remains the gold standard in detection of hemodynamically significant coronary lesions. Noninvasive angiography derived FFR (vFFR) without ...
Abstract 16512: Alirocumab Treatment Was Not Associated With a Higher Risk of Neurocognitive Events in 3340 High and Very High Cardiovascular Risk Patients
Authors: Philip D Harvey, Marwan Sabbagh, John E Harrison, Henry N Ginsberg, John M Chapman, Garen Manvelian, Angele Moryusef, Jonas Mandel, Michel A Farnier
Journal: Circulation (2016)

Introduction: Subjective cognitive complaints have been reported by patients receiving lipid-lowering therapies (LLTs) such as statins. However, clinical trials of LLTs have offered no objective ev...
Abstract 17044: Effect of Sham Controlled Renal Denervation in Uncontrolled Hypertension. A Systematic Review and Meta-Analysis
Authors: Mohammad Saud Khan, Abdullah Zoheb Azhar, Abdelmoniem Moustafa
Journal: Circulation (2020)

Introduction: Catheter-based ablation of renal artery has been studied as one of the interventions for blood pressure control in patients with uncontrolled hypertension. Previous randomized control trials (RCTs) comparing renal denervation versus sham procedure for the same have shown equivocal results. This meta-analysis summarizes the current evidence on the effect of sham-controlled renal denervation on blood pressure reduction. Methods: Pubmed, Embase and Cochrane Central databases were searched from inception until April 30, 2020. RCTs comparing catheter-based renal denervation with a sham control were included. Outcomes assessed were changes in ambulatory systolic blood pressure, change in ambulatory diastolic blood pressure, change in office systolic blood pressure and change in office diastolic blood pressure. Weighted mean differences (WMD) were calculated and pooled using inverse variance method into a random effect model meta-analysis. Results: Six studies with 1118 participants were included in the analysis. Catheter based renal denervation was associated with significant decrease in ambulatory systolic blood pressure (WMD: -3.71; 95% CI: -2.32 to -5.11, p value &lt;.00001) and ambulatory systolic blood pressure (WMD: -1.71; 95% CI: -0.59 to -2.82, p value=0.003) compared with sham. The reduction in office systolic and office diastolic blood pressure was also significantly greater with catheter renal denervation than sham control (WMD: -5.82; 95% CI: -3.67 to -7.92; p value&lt;0.00001 and WMD: -3.51; 95% CI: -2.29 to -4.73; p value&lt;0.00001 respectively) Conclusion: This meta-analysis showed significant benefit of catheter-based renal denervation for uncontrolled hypertension for all the studied outcomes. Based on this data patients with uncontrolled hypertension, on lifestyle and pharmacological management may benefit from catheter-based renal denervation
Medical Treatment Following Violence Exposure in a National Sample of Children and Youth
Authors: David Finkelhor, Heather Turner, Deirdre LaSelva
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Children and youth experience high rates of exposure to violence, which is associated with later poor physical and mental health outcomes. The immediate injuries and impacts from these exposures are often treated in emergency departments and medical offices. <h3>Objective</h3> To characterize, using nationally representative data, the size and characteristics of the child and youth population being seen by medical authorities in the wake of violence exposure. <h3>Design, Setting, and Participants</h3> The survey study used a representative sample of children and youth aged 2 to 17 years, from 2 waves (2011 and 2014) of the National Survey of Children Exposed to Violence, drawn from a mix of random digit dialing and address-based sampling. Interviews were conducted (1) over the phone with caregivers of young children or (2) directly with the youth aged 10 to 17 years. Data analysis was performed from September to December 2020. <h3>Main Outcomes and Measures</h3> Violence exposures were assessed with the 53-item Juvenile Victimization Questionnaire, which had follow-up questions that asked about injury and going "to the hospital, a doctor's office, or some kind of health clinic because of what happened." Additional questions were asked about lifetime and past-year childhood adversities and current trauma symptoms using the Trauma Symptom Checklist and the Trauma Symptom Checklist for Young Children. <h3>Results</h3> The combined 2-survey sample had 5187 children and youth who reported a lifetime violence exposure, of whom 45.6% (95% CI, 43.1%-48.2%) were aged 2 to 9 years, and 54.4% (95% CI, 51.8%-56.9%) were aged 10 to 17 years; 53.6% (95% CI, 51.0%-56.2%) were male. Based on the full sample of 8503 children and youth, 3.4% (95% CI, 2.6%-4.4%) had a violence-related medical visit at some time in their lives. The rate of past-year medical visits due to a violence exposure was 1.9% (95% CI, 1.2%-2.7%), equivalent to a point estimate of approximately 1.4 million children and youth. Of those with medical visits, 33.3% (95% CI, 23.1%-45.4%) were aged 2 to 9 years. Those with a past-year visit had higher levels of trauma symptoms (risk ratio, 1.71; 95% CI, 1.44-2.03) adverse childhood experiences (risk ratio, 2.55; 95% CI, 2.34-2.78) and multiple violence exposures (risk ratio, 3.91; 95% CI, 3.22-4.76) compared with the general sample of children and youth. <h3>Conclusions and Relevance</h3> The estimated large number of violence-related visits with medical professionals offers an opportunity to address a source of frequent injury, and provide counseling and referral for a high-risk segment of the population to treat and prevent further physical and mental health and social consequences.
Abstract 16169: Modes of Failure and Patient Adverse Events of Fractional Flow Reserve Guidewires: Insights From the United States Food and Drug Administration Manufacturer and User Facility Device Experience Database
Authors: Yagya Pandey, Nauman Khalid, Mirza Khalid, Hassan Kamran, Hussain Raza, Hani Jneid, Nasser M Lakkis, Waleed T Kayani
Journal: Circulation (2020)

Introduction: Fractional Flow Reserve (FFR) measurement is commonly used in the cardiac catheterization laboratory to assess functional significance of coronary arterial plaques. Robust real-world data on complications and modes of failure of FFR guidewires are limited. We analyzed the post-marketing surveillance data from the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database to report these endpoints for commonly utilized FFR guidewire. Methods: MAUDE database was queried from January 1, 2010, to April 1, 2020, for 3 commonly used FFR guidewires (PressureWire TM X (Abbott), Comet TM (Boston Scientific) and Verrata TM (Philips)) by searching for following events: “injury”, “malfunction”, “death”, and “other” yielding 544 reports. After excluding incomplete reports and older devices not in current use, 486 reports were analyzed. Results: Figure 1 shows reported modes of failure and patient adverse events. Guidewire tip fracture was the most reported mode of failure in 174 (35.8%) cases. Guidewire kinking (n= 152 (31.3%)), communication failure (n= 141 (29.0%)), and shaft fracture (n= 67 (13.8%)) were also reported. 133 (27.4%) of total device failures resulted in patient adverse events. Most common patient adverse event was retained guidewire tip in 71 (53.4%) cases followed by freshly deployed stent dislodgment (n= 26 (19.6%)) and coronary artery dissection (n=23 (17.3%)) respectively. 6 patient deaths were reported. Conclusions: FFR guidewire failures can occur due to a variety of mechanisms and lead to patient adverse events. MAUDE database serves as an important platform for improved collaboration between clinicians, device manufacturers, and regulatory bodies to improve device performance and optimize patient outcomes. Our analysis provides insights into the mechanism of FFR guidewire failure and associated adverse events but cannot verify causality or provide a comparison among different guidewires.
Response to Comment on Neeland et al. The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial. Diabetes Care 2020;43:3007–3015
Authors: Ian J. Neeland, Takatoshi Kasai, Silvio E. Inzucchi, Brian S. Wojeck, Henry K. Yaggi, Odd Erik Johansen
Journal: Diabetes Care (2021)

We acknowledge the thought-provoking hypothesis that Brikman and Dori (1) suggest to explain the lower incidence of new-onset obstructive sleep apnea (OSA) observed among participants treated with empagliflozin compared with placebo we recently reported. They suggest that sodium–glucose cotransporter 2 inhibition (SGLT2i) decreases endogenous carbon dioxide (CO2) through a shift in metabolic substrate away from carbohydrates and toward utilization of lipids and proteins, leading to a lower concentration of CO2 in the pulmonary circulation and lower likelihood of apneic events during sleep. While the mechanisms explaining our observations remain unknown and open to discussion, we disagree with the physiological description proposed and believe this hypothesis is unlikely to be correct.

First, alkalization of the blood through lower CO2 production should decrease, not increase, …
Abstract 16072: Clinical Outcomes of Catheter Ablation for Left Ventricular Summit/intramural Premature Ventricular Contractions Comparing Conventional vs. Fluoroless Techniques
Authors: Jorge Romero, Juan C Diaz, Isabella Alviz, David Briceno, Chintan Trivedi, Sanghamitra Mohanty, Alejandro Velasco, Kavisha Patel, Domenico G Della Rocca, David Burkhardt, Amin Al Ahmad, G Gallinghouse, Dhanunjaya Lakkireddy, Andrea Natale, Luigi Di Biase
Journal: Circulation (2020)

Introduction: Radiofrequency catheter ablation (CA) is the preferred treatment for premature ventricular contractions (PVCs). Ionizing radiation has major side effects for both patients and personnel in the electrophysiology laboratory. Fluoroless procedures are routinely performed for atrial fibrillation and simple PVC cases. Nonetheless, left ventricular (LV) summit/intramural PVCs cases are more challenging and clinical outcomes and complications have been poorly studied in this category with the use of fluoroless ablation. Hypothesis: We aimed to compare acute, long-term success rate and complications between fluoroless procedures versus standard approach for left ventricular (LV) summit/intramural PVCs. Methods: We conducted a retrospective analysis of patients who underwent PVC ablation under fluoroscopy and non-fluoroscopy at two institutions. Results: A total of 41 cases were enrolled (male: 61%; mean age: 55 ). Twenty-five cases underwent ablation under fluoroscopy whereas 16 underwent non-fluoroscopy ablation. Acute success was seen in 88% of non-fluoroscopy cases compared to 87.5% in the fluoroscopy group ( p = 0.9). The PVC recurrence at 12 months was similar between both groups (non-fluoroscopy: 15% vs Fluoroscopy: 18%) ( p = 0.9). No complications occurred in any group. Conclusions: Fluoroless CA is an emerging technique in the treatment of LV summit/intramural PVCs that appears to have similar clinical outcomes and complications compared to conventional fluoroscopic procedures.
Abstract 13374: Larger Atria and Increased Atrial Filling Pressures in Corrected Atrial Septal Defect Patients
Authors: Zarmiga Karunanithi, Mads Andersen, Søren Mellemkjær, Mathias Alstrup, Farhad Waziri, Steen Poulsen, Vibeke Hjortdal
Journal: Circulation (2020)

Introduction: After atrial septal defect (ASD) correction, pulmonary arterial pressures drop and the right-sided chambers start to remodel. Full normalization may not occur, which can explain the increased morbidity and mortality observed later in life. We described cardiac physiology in adults with a corrected ASD in order to understand the long-term morbidity and mortality. Hypothesis: ASD patients have enlarged right atria and increased pulmonary arterial pressures despite correction. Methods: Participants (percutaneously (n=19) and surgically (n=19) corrected ASD patients and 11 controls of similar age) underwent echocardiography, International Physical Activity Questionnaire, right heart catheterization, cardiopulmonary exercise test, and Holter-monitoring 15-20 years after ASD correction as part of a larger study. Echocardiographic measurements and invasive pressures obtained at rest are reported. Results: Right and left atrial end-systolic volumes, volume index, and filling pressures are higher in corrected ASD patients (particularly the surgically corrected) when compared with controls. Conclusion: ASD patients (particularly surgically corrected) have higher atrial volumes compared with healthy matched controls 15-20 years after correction, while still within the normal range. During systole, the peak atrial pressures are increased in ASD corrected patients, which correlate well with the atrial volumes seen on echocardiography. These findings show that cardiac remodeling has occurred post-correction, but full normalization is not reached. The differences in atrial size and filling pressure in corrected ASD compared to that in controls may be a marker of ASDs leading to myocardial disease and explain why ASD patients experience increased morbidity and mortality later in life.
False Positive 99mTc-Pyrophosphate Scanning Leading to Inappropriate Tafamidis Prescriptions
Authors: Timothy J. Poterucha, Pierre Elias, Frederick L. Ruberg, Albert DeLuca, Mona Kinkhabwala, Lynne L. Johnson, Jan M. Griffin, Shivda Pandey, Andrew J. Einstein, Mathew S. Maurer
Journal: JACC. Cardiovascular imaging (2021)
The Importance of Harmonized Databases for Infants Born Extremely Preterm—If You Are Not Counted, You Are Not Accounted
Authors: Marc Beltempo, Prakesh S. Shah
Journal: JAMA Network Open (2021)

Zhicheng Zhu, MD; Lin Yuan, MD; Jin Wang, MD; Qiuping Li, MD; Chuanzhong Yang, MD; Xirong Gao, MD; Shangqin Chen, MD; Shuping Han, MD; Jiangqin Liu, MD; Hui Wu, MD; Shaojie Yue, MD; Jingyun Shi, MD; Rui Cheng, MD; Xiuyong Cheng, MD; Tongyan Han, MD; Hong Jiang, MD; Lei Bao, MD; Chao Chen, MD
Implications of Enhancer Transcription and eRNAs in Cancer
Authors: Santanu Adhikary, Siddhartha Roy, Jessica Chacon, Shrikanth S. Gadad, Chandrima Das
Journal: Cancer Research (2021)

Abstract Despite extensive progress in developing anticancer therapies, therapy resistance remains a major challenge that promotes disease relapse. The changes that lead to therapy resistance can be intrinsically present or may be initiated during treatment. Genetic and epigenetic heterogeneity in tumors make it more challenging to deal with therapy resistance. Recent advances in genome-wide analyses have revealed that the deregulation of distal gene regulatory elements, such as enhancers, appears in several pathophysiological conditions, including cancer. Beyond the conventional function of enhancers in recruiting transcription factors to gene promoters, enhancer elements are also transcribed into noncoding RNAs known as enhancer RNAs (eRNA). Accumulating evidence suggests that uncontrolled enhancer activity with aberrant eRNA expression promotes oncogenesis. Interestingly, tissue-specific, transcribed eRNAs from active enhancers can serve as potential therapeutic targets or biomarkers in several cancer types. This review provides a comprehensive overview of the mechanisms of enhancer transcription and eRNAs as well as their potential roles in cancer and drug resistance.