tbuckley/cabot-search huggingface dataset:
Antimicrobial resistance and antibiotic consumption in intensive care units, Switzerland, 2009 to 2018
Authors: Stefanie Barnsteiner, Florent Baty, Werner C Albrich, Baharak Babouee Flury, Michael Gasser, Catherine Plüss-Suard, Matthias Schlegel, Andreas Kronenberg, Philipp Kohler
Journal: Eurosurveillance (2021)

BackgroundIntensive care units (ICU) constitute a high-risk setting for antimicrobial resistance (AMR).AimWe aimed to describe secular AMR trends including meticillin-resistant Staphylococcus aureus (MRSA), glycopeptide-resistant enterococci (GRE), extended-spectrum cephalosporin-resistant Escherichia coli (ESCR-EC) and Klebsiella pneumoniae (ESCR-KP), carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CRPA) from Swiss ICU. We assessed time trends of antibiotic consumption and identified factors associated with CRE and CRPA.MethodsWe analysed patient isolate and antibiotic consumption data of Swiss ICU sent to the Swiss Centre for Antibiotic Resistance (2009-2018). Time trends were assessed using linear logistic regression; a mixed-effects logistic regression was used to identify factors associated with CRE and CRPA.ResultsAmong 52 ICU, MRSA decreased from 14% to 6% (p = 0.005; n = 6,465); GRE increased from 1% to 3% (p = 0.011; n = 4,776). ESCR-EC and ESCR-KP increased from 7% to 15% (p < 0.001, n = 10,648) and 5% to 11% (p = 0.002; n = 4,052), respectively. CRE, mostly Enterobacter spp., increased from 1% to 5% (p = 0.008; n = 17,987); CRPA remained stable at 27% (p = 0.759; n = 4,185). Antibiotic consumption in 58 ICU increased from 2009 to 2013 (82.5 to 97.4 defined daily doses (DDD)/100 bed-days) and declined until 2018 (78.3 DDD/100 bed-days). Total institutional antibiotic consumption was associated with detection of CRE in multivariable analysis (odds ratio per DDD: 1.01; 95% confidence interval: 1.0-1.02; p = 0.004).DiscussionIn Swiss ICU, antibiotic-resistant Enterobacterales have been steadily increasing over the last decade. The emergence of CRE, associated with institutional antibiotic consumption, is of particular concern and calls for reinforced surveillance and antibiotic stewardship in this setting.
Retrospective Single-Institution Analysis of Patients with Chronic Lymphocytic Leukemia with <i>TP53</i> alterations Treated First-Line with Bruton's Tyrosine Kinase Inhibitor-Based Therapy
Authors: Hua-Jay J. Cherng, Raamis Khwaja, Rashmi Kanagal-Shamanna, Jan A. Burger, Philip A. Thompson, Alessandra Ferrajoli, Zeev E. Estrov, Koji Sasaki, Deepa Sampath, Guilin Tang, Xuemei Wang, Hagop Kantarjian, Michael J. Keating, William G. Wierda, Nitin Jain
Journal: Blood (2021)
Treatment Patterns and Overall Survival in Patients with Intermediate-Risk MDS: A Retrospective Analysis in the Spanish MDS Registry
Authors: María Diez-Campelo, Luis E. Benlloch, Emma Sasse, David Wormser, Leyla Hernandez Donoso, Silvia Colicino, Teresa Bernal, Antonieta Molero Yordi, Mar Tormo, Montserrat Arnan Sangerman, Guillermo Sanz, Marina Díaz-Beyá, María Teresa Cedena Romero, Andres Jerez, Brayan Merchán, David Valcárcel
Journal: Blood (2021)
Abstract 9103: Electrophysiological Arrhythmia Characterization of a Stress-Induced Idiopathic VF IPS-CMs Using Fluorescent Optical Mapping
Authors: Manasa Kalluri, Di Lang, Corey Anderson, Alexey Glukhov, Lee L Eckhardt, Louise Reilly
Journal: Circulation (2021)

Background: Idiopathic ventricular fibrillation (IVF) is a clinically challenging disease entity as phenotypic characteristics are lacking. We studied induced pluripotent stem cell-derived cardiomyocytes (iPS-CMs) from a patient with stress-induced IVF to define the cellular arrhythmic behavior and create a path to test therapeutics. Methods: iPS-CMs were generated from control (WT) and stress-induced IVF (si-IVF) patient-specific iPSC lines. Cells were characterized by single-cell optical mapping using calcium sensitive dye (Fluo-4) and electrical pacing (0.5Hz), with β-adrenergic stimulation (1x10 -6 mM isoproterenol (ISO)). Results: si-IVF cells had longer CaT rise time (ms) at baseline (BSL) (p&lt;0.05) (86 +/- 5.45, n=54) and after ISO (83.88 +/- 5.12, n=41) than WT cells (BSL: 64.5 +/- 3.72, n=40) (ISO: 72 +/- 9.92, n=10). si-IVF cells had shorter CaT duration (ms) at BSL (1,069 +/- 36.00, n=54) than WT cells at BSL (1,280 +/- 37.59, n=40), with no significant difference after ISO (IVF: 1,073 +/- 44.51, n= 41 and WT: 1,230 +/- 32.79, n=10). Following ISO, 11.5% of si-IVF cells showed arrhythmic behavior with rapid continuous spontaneous Ca 2+ release (Fig. 1), compared to 0.0% of WT cells. Conclusion: We demonstrate feasibility of differentiating iPS-CMs from patients while investigating arrhythmogenicity of si-IVF cells compared to controls using optical mapping. Insights from CaT duration, rise time, and arrhythmogenic behavior helps establish the arrhythmogenic behavior, and begins to provide mechanistic insights into si-IVF. This methodology can be applied to test therapeutics for IVF patients with β-adrenergic triggers. Figure 1: Patient #1-specific si-IVF iPS-CM. A) Representative optical mapping recordings of iPS-CMs baseline paced at 1Hz (each trace is a separate cell) B) Application of ISO caused arrhythmic behavior and failure to capture paced beats in black, red, blue, and yellow traces but retention of paced response in green and grey traces.
Single Cell Mutation Analysis Delineates Clonal Architecture in Leukemic Transformation of Myeloproliferative Neoplasms
Authors: Paola Guglielmelli, Laura Calabresi, Chiara Carretta, Giada Rotunno, Sandra Parenti, Simone Romagnoli, Selene Mallia, Niccolò Bartalucci, Sebastiano Rontauroli, Chiara Chiereghin, Sara Castellano, Francesco Mannelli, Matteo G. Della Porta, Rossella Manfredini, Alessandro Vannucchi
Journal: Blood (2021)
Sexual dimorphism in functional pain syndromes
Authors: Edita Navratilova, Roger B. Fillingim, Frank Porreca
Journal: Science Translational Medicine (2021)

Injury-free pain conditions, defined as functional pain syndromes, are more prevalent and more disabling in women. Mechanisms of sexual dimorphism in functional pain are now emerging from preclinical studies, suggesting an opportunity to advance the development of sex-specific therapies that may improve treatment of pain in women.
High-Throughput Characterization of Cytogenomic Heterogeneity of MDS Using High-Resolution Optical Genome Mapping
Authors: Hui Yang, Guillermo Garcia-Manero, Guillermo Montalban-Bravo, Kelly S. Chien, Awdesh Kalia, Zhenya Tang, Yue Wei, Manjunath Nimmakayalu, Diana Rush, Saradhi Mallampati, Hagop Kantarjian, Rajyalakshmi Luthra, L. Jeffrey Medeiros, Rashmi Kanagal-Shamanna
Journal: Blood (2021)
Integrating A Clinical Decision Support Reminder To Improve Blood Pressure Reassessment For Patients With Uncontrolled Hypertension
Authors: K. Souffront, L. Rivera, G. Loo, N. Genes, P. L. Richardson, Levy Levy
Journal: Clinical Cardiology and Cardiovascular Interventions (2019)

Background: Emergency department clinicians often overlook asymptomatic hypertension (HTN). Clinical decision support can help improve adherence to the emergency nursing and emergency medicine clinical policy for asymptomatic HTN. While the policy indicates referral for all adults with two or more elevated blood pressures, less than 10% of patients are referred. We sought to determine the efficacy of an electronic health record clinical reminder on nursing (RN) reassessment of blood pressure (BP) for hypertensive patients. Methods: We conducted a 2-arm, pilot RCT, at an academic medical center in New York City. 107 RNs were randomized to the control group or to the intervention of a 'Best Practice Alert' (BPA) reminding him/her to recheck the BP in adult patients with an initial BP reading ≥140/90 mmHg. Descriptive statistics that included univariate and bivariate analyses were used to obtain adjusted measures of association between the intervention and control group. Results: RNs were more likely to repeat BP after receiving a BPA alert (56%) compared to RNs who did not receive an alert (44%) (OR=2.3, CI 2.1-2.5; p&lt;.001). Patients who received BP reassessment were more likely to be triaged category 4 (OR 2.88, CI 1.81-4.59, p=.0001); age&gt;75 years (OR 1.47; CI 1.07-2.03; p=.02); had Stage II HTN (OR 3.48; CI 2.63-4.59, p=.0001) and an ED length of stay of 3-4 hours (OR 5.85; CI 4.43-7.73; p=.0001). Conclusion: The BPA alert was effective in increasing BP reassessment by ED nurses. The findings of this study will help us translate this evidence ED practices.
A Phase 2 Study of Dasatinib, Prednisone, and Blinatumomab for Older Patients with Philadelphia-Chromosome (Ph) Positive or Ph-like Acute Lymphoblastic Leukemia (ALL) (with Dasatinib Sensitive Fusions/ Mutations)
Authors: Anjali Advani, Anna Moseley, Kristen O'Dwyer, Brent Wood, Jae H Park, Matthew Wieduwilt, Deepa Jeyakumar, George Yaghmour, Ehab L. Atallah, Aaron T. Gerds, Susan M. O'Brien, Jane L. Liesveld, Megan Othus, Mark R. Litzow, Richard M. Stone, Elad Sharon, Harry P. Erba
Journal: Blood (2021)
Autophagy Blockade Disrupts Myeloma Cell Recovery from Proteasome Inhibition and Enhances Apoptosis
Authors: Selina J Chavda, Daria Galas-Filipowicz, Evelyn Fitzsimons, Anna Mikolajczak, Sharon Tooze, Holger W Auner, Katja Simon, Asim Khwaja, Kwee Yong
Journal: Blood (2021)
Ultraviolet radiation exposure to the face in patients with xeroderma pigmentosum and healthy controls: applying a novel methodology to define photoprotection behaviour*
Authors: R.P.E. Sarkany, M. Canfield, M. Morgan, L. Foster, K. Johnstone, K. Sainsbury, V. Araujo‐Soares, H.C. Wulf, J. Weinman, J. Walburn, S. Norton
Journal: British Journal of Dermatology (2021)

In xeroderma pigmentosum (XP), the main means of preventing skin and eye cancers is extreme protection against ultraviolet radiation (UVR). Protection is most important for the face.We aimed to assess how well patients with XP adhere to medical advice to protect against UVR by objectively estimating the mean daily dose of UVR to the face.We objectively estimated the UVR dose to the face in 36 patients with XP and 25 healthy individuals over 3 weeks in the summer. We used a new methodology which combined UVR dose measurements from a wrist-worn dosimeter with an activity diary record of face photoprotection behaviour for each 15-min period spent outside. A protection factor was associated with each behaviour, and the data were analysed using a negative binomial mixed-effects model.The mean daily UVR dose (weighted for DNA damage capacity) to the face in the patients with XP was 0·13 standard erythemal doses (SEDs) (mean in healthy individuals = 0·51 SED). There was wide variation between patients (range < 0·01-0·48 SED/day). Self-caring adult patients had a very similar UVR dose to the face as cared-for patients (0·13 vs. 0·12 SED/day), despite photoprotecting much more poorly when outside, because the self-caring adults were outside in daylight much less.Photoprotection behaviour varies widely within the XP group indicating that nonadherence to photoprotection advice is a significant issue. The timing and duration of going outside are as important as photoprotective measures taken when outside, to determine the UVR exposure to the face. This new methodology will be of value in identifying the sources of UVR exposure in other conditions in which facial UVR exposure is a key outcome, particularly in patients with multiple nonmelanoma skin cancers.
Outcomes with Interferon in Polycythemia Vera: A Systematic Review and Meta-Analysis
Authors: Moazzam Shahzad, Mamoon Ahmed, Muhammad Arslan, Sakina Abbas, Tooba Kashif, Iqra Anwar, Muhammad Salman Faisal, Muhammad Usman Zafar, Sibgha Gull Chaudhary, Leyla Shune, Sunil Abhyankar, Joseph P. McGuirk, Abdulraheem Yacoub, Muhammad Umair Mushtaq
Journal: Blood (2021)
Real-World Utilization of Fedratinib for Myelofibrosis Post-Ruxolitinib: Patient Characteristics, Treatment Patterns, and Characterization of Ruxolitinib Failure
Authors: Claire N. Harrison, John Mascarenhas, Pranav Abraham, Arianna Kee, Jose Alberto Nadal, Alexandrina Balanean, Ali McBride, Jonathan K. Kish, Djibril Liassou, Bruce A. Feinberg, Aaron T. Gerds
Journal: Blood (2021)
BRUIN CLL-321: A Phase 3 Open-Label, Randomized Study of Pirtobrutinib Versus Investigator's Choice of Idelalisib Plus Rituximab or Bendamustine Plus Rituximab in BTK Inhibitor Pretreated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (Trial in Progress)
Authors: Jeff P. Sharman, Wojciech Jurczak, Catherine C. Coombs, Marisa Hill, Denise Wang, Nora C. Ku, Ananya Guntur, Safi Shahda, Ching Ching Leow, Paolo Ghia, Anthony R. Mato
Journal: Blood (2021)
SRSF2-P95Hdelays Myelofibrosis Development through Altered JAK/STAT Signaling in JAK2-V617F Megakaryocytes
Authors: Christophe Willekens, Lucie Laplane, Tracy Dagher, Camélia Benlabiod, Catherine Lacout, Philippe Rameau, Cyril Catelain, Alexia Alfaro, Valérie Edmond, Nicolas Signolle, Aymeric Silvin, Florent Ginhoux, Valentine Marchand, Nathalie Droin, Remco Hoogenboezem, Rebekka K. Schneider, Alexander V Penson, Omar Abdel-Wahab, Patrick Gonin, Caroline Marty, Isabelle Plo, Jean-Luc Villeval, Francoise Porteu, William Vainchenker, Eric Solary
Journal: Blood (2021)
Whole Transcriptome Analysis Identifies Distinct Gene Expression Profiles between <i>SF3B1</i>mut and <i>SF3B1 wt</i> Myelodysplastic Syndrome with Ring Sideroblasts
Authors: Gabriele Todisco, Maria Creignou, Elsa Bernard, Ann-Charlotte Björklund, Pedro Luis Moura, Monika Jansson, David Chang, Sigita Venckute, Gunilla Walldin, Luca Malcovati, Bianca Tesi, Teresa Mortera-Blanco, Indira Barbosa, Elli Papaemmanuil, Eva Hellstrom Lindberg
Journal: Blood (2021)
Single Cell Deconvolution of Myeloblasts Reveals Depletion of HSCs and Expansion of Inflammatory Granulocyte-Monocyte Progenitors (GMPs) Associated with Adverse Outcomes in Chronic Myelomonocytic Leukemia (CMML)
Authors: Abhishek Dhawan, Meghan Ferrall-Fairbanks, Brian Johnson, Hannah Newman, Virginia Volpe, Christopher Letson, Anthony M. Hunter, Maria Balasis, Traci L. Kruer, Jodi Kroeger, Robert Balderas, Rami S. Komrokji, David A. Sallman, Rafael Bejar, Philipp M. Altrock, Eric Padron
Journal: Blood (2021)
Combined Blockade of CD47-Sirpa Interaction By 5F9 (Magrolimab) and Azacitidine/Venetoclax Therapy Facilitates Macrophage-Mediated Anti-Leukemia Efficacy in AML Pre-Clinical Models
Authors: Yannan Jia, Qi Zhang, Connie Weng, Cassandra L Ramage, Yuki Nishida, Mark Chao, Roy Louis Maute, Shelley Herbrich, Weiguo Zhang, Michael Andreeff, Naval Daver, Marina Konopleva
Journal: Blood (2021)
A Pilot Study of MG4101, Allogeneic Natural Killer Cell, in Patients with Relapsed or Refractory Acute Myeloid Leukemia
Authors: Sang A Kim, Youngil Koh, Miyoung Jung, Yu Kyeong Hwang, Ja Min Byun, Junshik Hong, Dong-Yeop Shin, Inho Kim, Sung-Soo Yoon
Journal: Blood (2021)
Efpeglenatide and Clinical Outcomes With and Without Concomitant Sodium-Glucose Cotransporter-2 Inhibition Use in Type 2 Diabetes: Exploratory Analysis of the AMPLITUDE-O Trial
Authors: Carolyn S.P. Lam, Chinthanie Ramasundarahettige, Kelley R.H. Branch, Naveed Sattar, Julio Rosenstock, Richard Pratley, Stefano Del Prato, Renato D. Lopes, Elisabeth Niemoeller, Nardev S. Khurmi, Seungjae Baek, Hertzel C. Gerstein
Journal: Circulation (2021)

Both sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists reduce cardiovascular events among patients with type 2 diabetes. However, no cardiovascular outcome trial has evaluated the long-term effects of their combined use. The AMPLITUDE-O trial (Effect of Efpeglenatide on Cardiovascular Outcomes) reported that once-weekly injections of the glucagon-like peptide-1 receptor agonists efpeglenatide (versus placebo) reduced major adverse cardiovascular events (MACEs); MACEs, coronary revascularization, or unstable angina hospitalization (expanded MACEs); a renal composite outcome; and MACEs or death in people with type 2 diabetes and cardiovascular or renal disease. The trial uniquely stratified randomization by baseline or anticipated use of SGLT2 inhibitors and included the highest prevalence at baseline (N=618, 15.2%) of SGLT2 inhibitor use among glucagon-like peptide-1 receptor agonist cardiovascular outcome trials to date. Its results were analyzed to estimate the combined effect of SGLT2 inhibitors and efpeglenatide on clinical outcomes.Cardiovascular and renal outcomes were analyzed with Cox proportional hazards models adjusted for region, SGLT2 inhibitor randomization strata, and the SGLT2 inhibitor-by-treatment interaction. Continuous variables were analyzed with a mixed-effects models for repeated measures that also included an interaction term.The effect (hazard ratio [95% CI]) of efpeglenatide versus placebo in the absence and presence of baseline SGLT2 inhibitors on MACEs (0.74 [0.58-0.94] and 0.70 [0.37-1.30], respectively), expanded MACEs (0.77 [0.62-0.96] and 0.87 [0.51-1.48]), renal composite (0.70 [0.59-0.83] and 0.52 [0.33-0.83]), and MACEs or death (0.74 [0.59-0.93] and 0.65 [0.36-1.19]) did not differ by baseline SGLT2 inhibitor use (P for all interactions >0.2). The reduction of blood pressure, body weight, low-density lipoprotein cholesterol, and urinary albumin-to-creatinine ratio by efpeglenatide also appeared to be independent of concurrent SGLT2 inhibitor use (all interaction P≥0.08). Last, adverse events did not differ by baseline SGLT2 inhibitor use.The efficacy and safety of efpeglenatide appear to be independent of concurrent SGLT2 inhibitor use. These data support combined SGLT2 inhibitor and glucagon-like peptide-1 receptor agonist therapy in type 2 diabetes. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03496298.
A Possible Role for Anti-idiotype Antibodies in SARS-CoV-2 Infection and Vaccination
Authors: William J Murphy, Dan L Longo
Journal: New England Journal of Medicine (2021)

Anti-idiotype Antibodies in SARS-CoV-2 The authors hypothesize that anti-idiotype immune responses may contribute to rare adverse events, such as myocarditis, after SARS-CoV-2 vaccination, as well ...
Abstract 6940: Demographics and Healthcare Utilization of Percutaneous and Open Cardiac Interventions in Diabetic Patients With Coronary Artery Disease in the U.S
Authors: Beka Aroshidze, Srishti Visen, Susan C Mirabal, Junxin Shi, beka bakhtadze, Tamta Chkhikvadze
Journal: Circulation (2021)

Introduction: Socioeconomic, sex and racial disparities have been observed in percutaneous coronary interventions (PCI) and coronary artery bypass grafting (CABG). Our aim was to assess the nationwide trends and detect any changes in practice patterns. Methods: Nationwide Inpatient Sample (NIS) was analysed from 2000-2018 for adult hospitalizations with coronary artery disease (CAD) and diabetes who underwent PCI and CABG. Respective ICD-9 and ICD-10 diagnosis and procedural codes were used. Each intervention type group was analyzed separately for sociodemographic and resource utilization. Results: A total of 3,653,882 PCI and 1,692,938 CABG hospitalizations were analyzed. Both interventions have decreased in female patients and increased in minority groups. PCI rates increased evenly across the races, while CABG increased more in Hispanic, and Pacific Islander populations than Black and Native Americans. CABG has decreased in &lt;59 as well as &gt;70 age groups and increased in the 60-69 age group. Both PCI and CABG increased in publicly insured and significantly so in the lowest income population (PCI:7% in 2000 vs. 32% in 2018; CABG:7% to 30%, respectively) (Table 1.) All procedures have shifted to teaching hospitals between 2000-2018 (CABG: 63% to 83%; PCI: 63% to 73%). Mean hospitalization charges have increased by 28.7% for CABG (+Δ$49,613) and by 40% for PCI(+Δ$34,262); LOS increased for both PCI (+Δ16%; Mean LOS 3.4 to-3.9 days) and CABG (+Δ4.4%; Mean LOS 9.3 to 9.7 days). Overall, by 2018 inflation adjusted CABG hospitalisation cost was $222,634 and $119,316 for PCI. Conclusion: Our analysis has demonstrated the increasing trends of PCI, and CABG performance in minorities, publicly insured and patients residing in lowest socioeconomic areas. Efforts are necessary to address sex disparities and decreasing rate of interventions in females with diabetes and CAD.
Abstract P330: Growth Differentiation Factor 15 Causes Cardiac Cachexia In Heart Failure
Authors: Da Young Lee, Zhe Jiao, Andrew Antolic, Daiana Weiss, M. Neale Weitzmann, Michael Burke
Journal: Circulation Research (2021)

Background: Cachexia is wasting of normal body tissue and occurs in chronic medical diseases. It is a common complication of heart failure (HF) that is associated with very high mortality. Growth differentiation factor 15 (GDF15) regulates food intake and can cause cancer cachexia. GDF15 is a sensitive biomarker in humans, though its biologic function in HF is unknown. This study investigated the role of GDF15 in HF. Methods: We utilized a genetic mouse model of dilated cardiomyopathy (DCM) caused by a mutation in the phospholamban gene (PLN R9C ). PLN R9C mice have dysregulated cardiac calcium handling (a common feature of nearly all forms of HF) and develop progressive DCM that leads to HF and premature death. Q-PCR and ELISA were performed to assess expression, tissue distribution and circulating levels of GDF15 in PLN R9C and age-matched wild type (WT) mice. A double transgenic mouse was created by crossing our DCM model with a constitutive Gdf15 knock-out (KO). Using this novel model, we quantified food intake, and assessed fat and lean tissue mass by tissue weight at necropsy and by dual-energy X-ray absorptiometry (DXA). Cardiac function was assessed using echocardiography, and histochemistry performed to quantify cardiac fibrosis. Survival was assessed by Kaplan-Meier. Results: GDF15 mRNA (43-fold; p&lt;0.01) and protein (54-fold; p&lt;0.01) were increased in LV tissue, and circulating GDF15 was elevated (8.3-fold; p=0.03) in PLN R9C mice. Gdf15 was expressed at low levels and was not increased in other organs in PLN R9C mice. PLN R9C mice developed cachexia (reduced fat and lean mass by tissue weight, reduced fat mass by DXA vs. WT; p&lt;0.01 for all) and consumed less food (p&lt;0.01 vs. WT). Gdf15 KO in PLN R9C preserved fat and lean tissue mass and resulted in higher food intake (p≤0.01 for all). Gdf15 KO had no effect on cardiac structure or function by echocardiography and PLN R9C / Gdf15 KO mice displayed only a small reduction in cardiac fibrosis relative to PLN R9C mice (3%; p&lt;0.01). Despite this, Gdf15 KO prolonged survival in PLN R9C (29±3 vs. 25±3 weeks; p&lt;0.01). Conclusions: GDF15 is a novel cardiac hormone produced in HF that triggers anorexia and cachexia in HF by an extra-cardiac mechanism.