tbuckley/cabot-search huggingface dataset:
OP0092 Effects of calcitonin and calcium treatment on bone mineral density in patients with juvenile chronic arthritis
Authors: R Celiker, S Bal, A Bakkaloglu, E Ozaydin, T Coskun
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Osteoporosis is one of the most important and common complications in children with Juvenile Chronic Arthritis (JCA). Osteoporosis in JCA has a multifactorial origin. Reduced or absent physical activity, decreased production of endogenous vitamin D, anaemia and drug treatment, especially steroid treatment are thought to be possible mechanisms of osteoporosis in children with JCA. <h3>Objectives</h3> The aim of this study was to evaluate the effect of calcitonin and calcium treatment on bone mineral status in patients with JCA. <h3>Methods</h3> According to EULAR criteria 16 patients (7 male, 9 female) with JCA (2 patients with systemic, 2 patients with oligoarticular and 12 patients with polyarticular type) and 13 age and sex similar healthy controls (8 male, 5 female) were included in the study. The mean age of the patients and control groups were 10,12 ± 3,80 and 10,2 ± 3,26 years respectively. Patients with JCA were randomly treated for 6 months with either 50 IU/day salmon calcitonin administered intranasal and 500 mg calcium per day per oral (Group 1) or 500 mg/day calcium only (Group 2) to determine their effect on bone status. Bone mineral density (BMD) of the lumbar spine at the L1-L4 level was measured by dual energy x-ray absorptiometry (Hologic QDR-4500 A). Disease activity was determined by clinical and laboratory evaluation (serum erythrocyte sedimentation rate and C reactive protein levels), and Juvenile Arthritis Functional Assessment Report (JAFAR). Data from BMD measurements were obtained at baseline and 6 months later. <h3>Results</h3> The mean age and the duration of disease for groups 1&amp;2 were 9,4 ± 4,31 years and 41,10 ± 42,29 months and 11,33 ± 2,65 years and 40,66 ± 33,31 months respectively. The mean baseline BMD results were 0.458 ± 0.157 gr/cm² in Group 1, 0.580 ± 0.137 gr/cm² in Group 2 and 0.599 ± 0.096 gr/cm² in control group. BMD values of the JCA group were significantly lower than the control group (p = 0,038). In both treatment groups (Group 1 and Group 2) there were an increase in BMD values (p1 = 0,05 and p2 = 0,028 respectively). As the increments were compared the difference in between was not statistically significant (p &gt; 0.05). <h3>Conclusion</h3> Our results suggest that children with JCA would benefit from calcium supplementation and calcitonin treatment. No adverse effects were observed in both treatment groups during the follow-up period.
Environmental Protection Requires Accurate Application of Scientific Evidence
Authors: Craig R. Smith, Verena Tunnicliffe, Ana Colaço, Jeffrey C. Drazen, Sabine Gollner, Lisa A. Levin, Nelia C. Mestre, Anna Metaxas, Tina N. Molodtsova, Telmo Morato, Andrew K. Sweetman, Travis Washburn, Diva J. Amon
Journal: Trends in Ecology & Evolution (2020)
Abstract 230: Bystander Cardio Pulmonary Resuscitation Quality: Potential for Improvements in Cardiac Arrest Resuscitation
Authors: Richard Chocron, Julia Jobe, Madeleine Kim, Sally Guan, Carol Fahrenbruch, Mia Shigemura, Thomas Rea
Journal: Circulation (2020)

Background: Bystander cardiopulmonary resuscitation (CPR) is a critical intervention to improve survival following out-of-hospital cardiac arrest (OHCA). We evaluated the quality of bystander CPR and whether performance varied according to the number of bystanders or provision of telecommunicator assistance (TCPR) to identify opportunities to improve care. Methods: We conducted a cohort investigation of non-traumatic cardiac arrest occurring in a large metropolitan EMS system during a 6-month period. Information about bystander care was ascertained through review of the 9-1-1 recordings in addition to EMS and hospital information to determine bystander CPR status (none vs TCPR vs unassisted), the number of bystanders on-scene, and CPR performance metrics of compression fraction and compression rate. Results: Of the 428 eligible OHCA, average age was 62.9 years (+/- 16.6), 31.5% (n=135) were female, and 76.4% (n=327) received bystander CPR. Of those receiving bystander CPR, 43.7% (n=143) received unassisted CPR and 56.3% (n=184) involved TCPR; 35.2% (N=115) had one bystander, 33.3% (N=109) had 2 bystanders, and 31.5% (n=103) had 3 or more bystanders. Overall CPR fraction was 59% with a compression rate of 88 per minute. CPR differed according to TCPR status (compression fraction=52% and rate=87 per minute for TCPR vs 69% and 102 for unassisted CPR, p&lt;0.05 for each comparison) and the number of bystanders (compression fraction=55% and rate=87 per minute for 1 bystander, 59% and 89 for 2 bystanders, 65% and 97 for &gt;=3 bystanders, test for trend p&lt;0.05 for each metric). Additional bystander actions were uncommon to include rotation of compressors (3.1%) or application of an AED (8.0%). Conclusion: Overall bystander CPR quality as gauged by fraction and compression rate approached guideline goals though performance depended upon the type of CPR and number of bystanders. The findings suggest opportunities for how CPR quality and early defibrillation may be improved.
Abstract 14959: Effect of Empagliflozin on Total Events of Myocardial Infarctions by Subtype in the EMPA-REG OUTCOME Trial
Authors: David H Fitchett, Bernard Zinman, Silvio E Inzucchi, Christoph Wanner, Stefan D Anker, Stuart Pocock, Stefan Kaspers, Jyothis T George, Odd Erik Johansen, Waheed Jamal, Michaela Mattheus, Ola Vedin, Stefan Hantel, Søren S Lund
Journal: Circulation (2020)

Introduction: In EMPA-REG OUTCOME®, the sodium-glucose transporter inhibitor, empagliflozin (EMPA), reduced the risk of first cardiovascular (CV) events primarily CV mortality and hospitalization for heart failure in patients with type 2 diabetes (T2D) and established atherosclerotic cardiovascular disease. In analyses including total events, EMPA also reduced the risk of myocardial infarction (MI). Here we report the effects of EMPA on the total number of MIs by subtype. Methods: Patients were randomized to receive EMPA 10 mg, EMPA 25 mg, or placebo. We assessed the effect of pooled EMPA versus placebo on total (first plus recurrent) events of fatal and non-fatal MI using a negative binomial model with robust confidence intervals (CI) that preserves randomization and accounts for the within-patient correlation of multiple events. Post-hoc, we analyzed established subtypes of MI: Type 1: Typically related to plaque-rupture or thrombus; Type 2: Supply-demand; Type 3: Sudden-death related (i.e., fatal MI); Type 4: Percutaneous coronary intervention related; and Type 5: Coronary artery bypass graft related. Except type 3 MIs, MIs were non-fatal. The MIs, including subtypes, were centrally adjudicated and could be assigned to more than one subtype. Results: 7,020 patients were treated. Overall, there was 421 total events of MIs. Specifically, 299, 86, 26, 19, and 1 of the MIs were classified as type 1, 2, 3, 4, and 5 MIs, respectively (not mutually exclusive). Overall, EMPA reduced the risk of total events of MI by 21% versus placebo (rate ratio [95% CI], EMPA versus placebo: 0.79 [0.620; 0.998], p=0.0486; each MI only counted once). The overall reduction in total events of MIs by EMPA was driven by the effect on type 1 and 2 MIs, as well as type 3 MIs, with limited number of type 4 and 5 MIs (Figure). Conclusions: EMPA reduced the risk of total MI events with consistent effects across the most common etiologies, the type 1 (plaque-rupture or thrombus) and 2 (supply-demand) MIs.
Impact of Obesity on Outcomes in Myocardial Infarction: Combating the “Obesity Paradox”⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.
Authors: Carl J. Lavie, Richard V. Milani, Hector O. Ventura
Journal: Journal of the American College of Cardiology (2011)
Abstract 13202: <i>LncRNA-MAP3K4</i> Regulates Vascular Inflammation Through a P38 MAPK Signaling Pathway and <i>Cis</i> -modulation of MAP3K4
Authors: HaoYang Zhou, Viorel Simion, Jacob Pierce, Mark W Feinberg
Journal: Circulation (2020)

Introduction: Long non-coding RNAs (lncRNAs) are emerging regulators of biological processes in the vessel wall; however, their role in vascular inflammation remains poorly understood. Hypothesis: Identification of inflammation-responsive lncRNAs expressed in the aortic intima may provide novel mechanistic insights in vascular inflammation. Methods: Using RNA-Seq profiling to identify a lncRNA derived specifically from the aortic intima of atherosclerotic mice, we discovered an inflammation-responsive lncRNA, lncRNA-MAP3K4, and evaluated its role in the mechanisms mediating vascular cell inflammation. Results: Aortic expression of lncRNA-MAP3K4 , an intima-enriched and polyadenylated lncRNA , was reduced by 50% with atherosclerotic progression and by 75% following LPS-induced endotoxemia in mice. GapmeR-mediated silencing of lncRNA-MAP3K4 potently reduced mRNA and protein expression of adhesion molecules or chemokines (e.g. ICAM-1, E-selectin, MCP-1) in endothelial cells via a p38-MAPK pathway, and decreased PBMC adhesion to endothelium by 40%. Moreover, lncRNA-MAP3K4 knockdown also reduced inflammatory markers in vascular smooth muscle cells and macrophages. Analyzing the lncRNA-MAP3K4 locus, we found MAP3K4, an upstream kinase of the MAPK cascade, shared the promoter region with lncRNA-MAP3K4. In vitro and in vivo, lncRNA-MAP3K4 and MAP3K4 showed parallel inflammation-responsive expression patterns. lncRNA-MAP3K4 knockdown reduced mRNA and protein expression of MAP3K4 in cis in vessel wall cell types. ChIP-seq data showed chromatin modifications and bidirectional promoter characteristics in the lncRNA-MAP3K4/ MAP3K4 promoter region. MAP3K4 knockdown showed a similar anti-inflammation phenotype as lncRNA-MAP3K4 via a p38-MAPK pathway and cooperativity with lncRNA-MAP3K4 . Conclusions: Deficiency of lncRNA-MAP3K4 markedly reduced inflammation in vascular cells via a p38-MAPK pathway and cis -regulation of MAP3K4 from a shared bidirectional promoter. This study illustrated a divergently transcribed lncRNA/protein-coding gene pair involved in vascular inflammation and more broadly informs a better understanding of mammalian genome regulatory mechanisms in vascular disease states.
Prevalence of Hepatitis B Vaccination Coverage and Serologic Evidence of Immunity Among US-Born Children and Adolescents From 1999 to 2016
Authors: Michael H. Le, Yee Hui Yeo, Samuel So, Ed Gane, Ramsey C. Cheung, Mindie H. Nguyen
Journal: JAMA Network Open (2020)

<h3>Importance</h3> The World Health Assembly has called for the elimination of hepatitis B and C by 2030. As hepatitis B has no cure, the US strategy to eliminate hepatitis B has focused on prevention through vaccination. However, there are limited data on the trend in vaccine-associated immunity since the US implementation of universal infant hepatitis B vaccination. <h3>Objective</h3> To compare self-reported hepatitis B vaccination coverage among children and adolescents with serologic evidence of immunity and infection in the US from 1999 to 2016. <h3>Design, Setting, and Participants</h3> This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. US-born persons aged 2 to 18 years without missing hepatitis B serologic test results and with reported vaccination history were included. Data were analyzed from September 2017 to June 2018. <h3>Main Outcomes and Measures</h3> The proportion of participants who reported complete vaccination for hepatitis B and who had positive serologic test results indicating immunity. <h3>Results</h3> Of 21 873 children and adolescents, 51.2%% were male, and the mean (SD) age was 10.6 (4.6) years. The survey reported that hepatitis B vaccination coverage increased significantly from 1999 to 2016 (from 62.6% [95% CI, 58.6%-66.4%] to 86.3% [95% CI, 82.9%-89.2%];<i>P</i> &lt; .001). Vaccine-associated immunity also increased from 1999 to 2016 among children aged 2 to 5 years (from 60.7% [95% CI, 48.8%-71.4%] to 65.2% [95% CI, 57.4%-72.3%];<i>P</i> = .001) but decreased among children aged 6 to 10 years (from 64.6% [95% CI, 57.7%-70.9%] to 46.5% [95% CI, 39.1%-54.0%];<i>P</i> &lt; .001), adolescents aged 11 to 13 years (from 68.8% [95% CI, 58.1%-77.8%] to 26.2% [95% CI, 18.6%-35.5%];<i>P</i> &lt; .001), and adolescents aged 14 to 18 years (from 68.5% [95% CI, 62.9%-73.6%] to 15.6% [95% CI, 12.2%-19.8%];<i>P</i> &lt; .001). By birth year, serologic evidence of vaccine-associated immunity significantly decreased in the 1994-2003 NHANES birth cohort but not among those born between 1988 and 1993. Non-US–born children and adolescents did not show the same decreasing trend in immunity. <h3>Conclusions and Relevance</h3> In this cross-sectional study, decreasing hepatitis B immunity was observed among US-born children and adolescents in the 1994-2003 NHANES birth cohort despite increasing rates of hepatitis B vaccination coverage. These findings suggest a possible need for surveillance and a booster vaccine dose for hepatitis B as those without serologic evidence of immunity become young adults and may engage in behaviors associated with an increased risk for infection.
Association of Insurance Status With Provision of Recommended Services During Comprehensive Postpartum Visits
Authors: Kimberley Geissler, Brittany L. Ranchoff, Michael I. Cooper, Laura B. Attanasio
Journal: JAMA Network Open (2020)

<h3>Importance</h3> Improving care during the postpartum period is a clinical and policy priority. During the comprehensive postpartum visit, guidelines recommend delivery of a large number of assessment, screening, and counseling services. However, little is known about services provided during these visits. <h3>Objective</h3> To examine rates of recommended services during the comprehensive postpartum visits and differences by insurance type. <h3>Design, Setting, and Participants</h3> This cross-sectional study included 20 071 093 weighted office-based postpartum visits (645 observations) with obstetrical-gynecological or family medicine physicians from annual National Ambulatory Medical Care Surveys from December 28, 2008, to December 31, 2016, and estimated multivariate regression models to calculate the frequency of recommended services by insurance type, controlling for visit, patient, and physician characteristics. Data analysis was conducted from November 1, 2019, to September 1, 2020. <h3>Exposures</h3> Visit paid by Medicaid vs other payment types. <h3>Main Outcomes and Measures</h3> Visit length and binary indicators of blood pressure measurement, depression screening, contraceptive counseling or provision, pelvic examinations, Papanicolaou tests, breast examinations, medication ordered or provided, referral to other physician, and counseling for weight reduction, exercise, stress management, diet and/or nutrition, and tobacco use. <h3>Results</h3> A total of 20 071 093 weighted comprehensive postpartum visits to office-based family medicine or obstetrical-gynecological physicians were included (mean patient age, 29.7 [95% CI, 29.1-30.3] years). Of these visits, 34.3% (95% CI, 27.6%-41.1%) were covered by Medicaid. Mean visit length was 17.4 (95% CI, 16.4-18.5) minutes. The most common procedures were blood pressure measurement (91.1% [95% CI, 88.0%-94.2%]), pelvic examinations (47.3% [95% CI, 40.8%-53.7%]), and contraception counseling or provision (43.8% [95% CI, 38.2%-49.3%]). Screening for depression (8.7% [95% CI, 4.1%-12.2%]) was less common. When controlling for visit, patient, and physician characteristics, the only significant difference in visit length or provision of recommended services based on insurance type was a difference in provision of breast examinations (14.7% [95% CI, 8.0%-21.5%] for Medicaid vs 25.6% [95% CI, 19.4%-31.8%] for non-Medicaid;<i>P</i> = .02). <h3>Conclusions and Relevance</h3> These findings suggest that receipt of recommended services during comprehensive postpartum visits is less than 50% for most services and is similar across insurance types. These findings underscore the importance of efforts to reconceptualize postpartum care to ensure women have access to a range of supports to manage their health during this sensitive period.
Substrate stiffness differentially impacts autophagy of endothelial cells and smooth muscle cells
Authors: Mi Hu, Fan Jia, Wei-Pin Huang, Xu Li, Deng-Feng Hu, Jing Wang, Ke-Feng Ren, Guo-Sheng Fu, Yun-Bing Wang, Jian Ji
Journal: Bioactive Materials (2020)

Stiffening of blood vessels is one of the most important characteristics in the process of many cardiovascular pathologies such as atherosclerosis, angiosteosis, and vascular aging. Increased stiffness of the vascular extracellular matrix drives artery pathology and alters phenotypes of vascular cell. Understanding how substrate stiffness impacts vascular cell behaviors is of great importance to the biomaterial design in tissue engineering, regenerative medicine, and medical devices. Here we report that changing substrate stiffness has a significant impact on the autophagy of vascular endothelial cells (VECs) and smooth muscle cells (VSMCs). Interestingly, our findings demonstrate that, with the increase of substrate stiffness, the autophagy level of VECs and VSMCs showed differential changes: endothelial autophagy levels reduced, leading to the reductions in a range of gene expression associated with endothelial function; while, autophagy levels of VSMCs increased, showing a transition from contractile to the synthetic phenotype. We further demonstrate that, by inhibiting cell autophagy, the expressions of endothelial functional gene were further reduced and the expression of VSMC calponin increased, suggesting an important role of autophagy in response of the cells to the challenge of microenvironment stiffness changing. Although the underlying mechanism requires further study, this work highlights the relationship of substrate stiffness, autophagy, and vascular cell behaviors, and enlightening the design principles of surface stiffness of biomaterials in cardiovascular practical applications.
Abstract 228: Evaluation of Telephone-Assisted Cardiopulmonary Resuscitation Performance Recommendations for Out-Of-Hospital Sudden Cardiac Arrest
Authors: Audrey L Blewer, Angel Guerrero, Benjamin Sieu-Hon Leong, Nur Shahidah Binte Ahmad, Pin Pin Pek, Anjni Joiner, Yih Yng Ng, Shalini Arulanandam, Truls Ostbye, Marcus E Ong
Journal: Circulation (2020)

Introduction: Telephone-assisted CPR (T-CPR) may improve bystander CPR (B-CPR) rates and survival from sudden cardiac arrest (SCA). The American Heart Association (AHA) has specified performance measures to ensure rapid provision of T-CPR instructions. Few studies have examined whether these individual T-CPR recommendations are associated with SCA outcomes. Objectives: We sought to assess whether the 2012 AHA Scientific Statement’s T-CPR evaluation metrics are associated with increased B-CPR and survival from SCA. We hypothesized that recognition of arrest and compliance with the T-CPR protocol will result in increased likelihood of B-CPR. Methods: We conducted a retrospective assessment of non-traumatic SCAs from the Singapore T-CPR Pan-Asian Resuscitation Outcomes Study. We modeled the likelihood of receipt of B-CPR and survival to hospital discharge controlling for potential confounders. Exposure variables were identified from the Scientific Statement including adherence to T-CPR algorithms, dispatcher recognition of need for CPR, barriers to CPR (yes/no), and time intervals. Results: From 7/2012-2016, the Singapore T-CPR registry contained 3,224 adjudicated SCA events. Mean age was 67±19, 62% of the patients were male, and 87% of the arrests occurred in the home; of these arrests, 75% received T-CPR and 4% survived to hospital discharge. Compliance with the T-CPR protocol algorithm was not associated with an increased likelihood of B-CPR and survival (p=ns, both). Dispatcher recognition of the need for CPR was associated with a 24.9 (12.9-47.9) increased likelihood of B-CPR p&lt;0.01, but was not associated with survival (OR: 1.77(0.37-8.45)). Recognized barriers to CPR were associated with a lower likelihood of B-CPR and survival (p&lt;0.05, both). B-CPR was associated with a 2.40 (1.04-5.45) increased likelihood of survival (p=0.04). Call time to dispatch of EMS of &lt;2 min was associated with a 1.33 (1.07-1.67) p=0.01 increased likelihood of receipt of B-CPR. Conclusion: Rapid dispatch of EMS (&lt;2 min) and successful recognition of need for CPR increased the likelihood of B-CPR. B-CPR was associated with a two-fold increased likelihood of survival. Future work should consider refining T-CPR evaluation metrics using a data driven approach.
Abstract 13502: Impact of Udenafil on Echocardiographic Indices of Single Ventricle Size and Function in Fuel Study Participants
Authors: Michael V Di Maria, David J Goldberg, Stephen Paridon, Adam Lubert, Andreea Dragulescu, Andrew S Mackie, Andrew McCrary, Angela Weingarten, Anitha Parthiban, Benjamin GOOT, Bryan H Goldstein, carolyn taylor, Christopher Lindblade, Christopher Petit, Christopher Spurney, David M Harrild, Elaine M Urbina, Eleanor Schuchardt, Felicia Trachtenberg, Gi Beom Kim, Ja Kyoung Yoon, Jamie N Colombo, Ke Wang, Matthew D Files, Megan Schoessling, Peter R Ermis, Pierre Wong, Ruchira Garg, Sara Swanson, Shaji C Menon, Shubhika Srivastava, Thor Thorsson, Tiffanie Johnson, Usha Krishnan, Peter C Frommelt
Journal: Circulation (2020)

Introduction: The Pediatric Heart Network’s Fontan Udenafil Exercise Longitudinal (FUEL) Trial (Mezzion Pharma Co. Ltd., NCT 02741115) demonstrated improvements in exercise capacity following 6 months of treatment with udenafil (87.5 mg po BID). The effect of udenafil on echocardiographic measures of single ventricle (SV) function in this cohort has not been studied. Methods: Protocol echocardiograms were obtained at baseline and 26 weeks after initiation of udenafil/placebo. Linear regression compared change from baseline in indices of SV systolic, diastolic and global function, atrioventricular valve (AVV) regurgitation and mean Fontan fenestration gradient in the udenafil cohort vs placebo, controlling for ventricular morphology (LV vs. RV/other). Effects of ventricular morphology on echo measures and its interaction over time was also evaluated. Difficult imaging windows limited consistent capture of all measures. Results: The 191 udenafil participants had significantly improved myocardial performance index (p=0.03), AVV inflow peak E and A velocities (p = 0.007 and 0.03), and annular DTI-derived peak e’ velocity (p = 0.008) compared to 195 placebo participants (Table). There were no significant differences in change in SV size, systolic function, AVV regurgitation severity or mean fenestration gradient. Although LV morphology participants had significantly more favorable indices of SV size and function (lower volumes and areas, E/e’ ratio, systolic:diastolic time and AVV regurgitation, and higher annular s’ and e’ velocity) at baseline, there was no differential effect of udenafil by ventricular morphology at 26 weeks. Conclusions: FUEL participants who received udenafil demonstrated a significant improvement in global and diastolic echo indices. The changes in diastolic function suggest improvement in pulmonary venous return and/or augmented ventricular relaxation, which may help explain improved exercise performance in that cohort.