tbuckley/cabot-search huggingface dataset:
Investigations of Possible Multistate Outbreaks of <i>Salmonella</i>, Shiga Toxin–Producing <i>Escherichia coli</i>, and <i>Listeria monocytogenes</i> Infections — United States, 2016
Authors: Katherine E. Marshall, Thai-An Nguyen, Michael Ablan, Megin C. Nichols, Misha P. Robyn, Preethi Sundararaman, Laura Whitlock, Matthew E. Wise, Michael A. Jhung
Journal: MMWR Surveillance Summaries (2020)

Problem/Condition: Salmonella, Shiga toxin-producing Escherichia coli (STEC), and Listeria monocytogenes are the leading causes of multistate foodborne disease outbreaks in the United States.Responding to multistate outbreaks quickly and effectively and applying lessons learned about outbreak sources, modes of transmission, and risk factors for infection can prevent additional outbreak-associated illnesses and save lives.This report summarizes the investigations of multistate outbreaks and possible outbreaks of Salmonella, STEC, and L. monocytogenes infections coordinated by CDC during the 2016 reporting period.Period Covered: 2016.An investigation was considered to have occurred in 2016 if it began during 2016 and ended on or before March 31
A Prospective Validation and Observer Performance Study of a Deep Learning Algorithm for Pathologic Diagnosis of Gastric Tumors in Endoscopic Biopsies
Authors: Jeonghyuk Park, Bo Gun Jang, Yeong Won Kim, Hyunho Park, Baek-hui Kim, Myeung Ju Kim, Hyungsuk Ko, Jae Moon Gwak, Eun Ji Lee, Yul Ri Chung, Kyungdoc Kim, Jae Kyung Myung, Jeong Hwan Park, Dong Youl Choi, Chang Won Jung, Bong-Hee Park, Kyu-Hwan Jung, Dong-Il Kim
Journal: Clinical Cancer Research (2020)

Gastric cancer remains the leading cause of cancer-related deaths in Northeast Asia. Population-based endoscopic screenings in the region have yielded successful results in early detection of gastric tumors. Endoscopic screening rates are continuously increasing, and there is a need for an automatic computerized diagnostic system to reduce the diagnostic burden. In this study, we developed an algorithm to classify gastric epithelial tumors automatically and assessed its performance in a large series of gastric biopsies and its benefits as an assistance tool.Using 2,434 whole-slide images, we developed an algorithm based on convolutional neural networks to classify a gastric biopsy image into one of three categories: negative for dysplasia (NFD), tubular adenoma, or carcinoma. The performance of the algorithm was evaluated by using 7,440 biopsy specimens collected prospectively. The impact of algorithm-assisted diagnosis was assessed by six pathologists using 150 gastric biopsy cases.Diagnostic performance evaluated by the AUROC curve in the prospective study was 0.9790 for two-tier classification: negative (NFD) versus positive (all cases except NFD). When limited to epithelial tumors, the sensitivity and specificity were 1.000 and 0.9749. Algorithm-assisted digital image viewer (DV) resulted in 47% reduction in review time per image compared with DV only and 58% decrease to microscopy.Our algorithm has demonstrated high accuracy in classifying epithelial tumors and its benefits as an assistance tool, which can serve as a potential screening aid system in diagnosing gastric biopsy specimens.
Abstract 15254: Elevated Calcium Drives Ischemia-Induced Angiogenesis
Authors: Jocelyne Mulangala, Emma Akers, Emma L Solly, Panashe M Bamhare, Laura A Wilsdon, Joanne T Tan, Stephen J Nicholls, Belinda A DiBartolo
Journal: Circulation (2019)

Introduction: Peripheral arterial disease (PAD) is characterised by accelerated arterial calcification and impairment in angiogenesis, both of which associate with adverse cardiovascular outcomes. ...
Abstract 13915: Cryoballoon Catheter Ablation versus Antiarrhythmic Drug as a First-Line Therapy for Patients With Paroxysmal Atrial Fibrillation: Results of the Cryo-FIRST Study
Authors: Vedran Velagic, NIkola Pavlovic, Gian-Battista Chierchia, Jean-Sylvain Hermida, Stewart Healey, Giuseppe Arena, Nicolas Badenco, Christian Meyer, Jian Chen, Saverio Iacopino, Frederic Anselme, Malte Kuniss
Journal: Circulation (2020)

Introduction: Early catheter ablation (CA) may increase procedure efficacy and reduce the risk of atrial fibrillation (AF) disease progression. Cryo-FIRST (NCT01803438) evaluated whether pulmonary vein isolation (PVI) with cryoballoon CA is superior to antiarrhythmic drug (AAD) therapy as a first-line treatment for the prevention of atrial arrhythmia recurrence (AAR) in patients with paroxysmal AF (PAF). Methods: Patients with symptomatic PAF, free of heart disease and not administered an AAD for &gt;48 hours were enrolled at 18 sites in 9 countries, randomized (1:1) to cryoballoon CA (Arctic Front Advance, Medtronic) or AAD therapy (Class IC or III). Using a 90-day blanking period, subjects were followed at 1, 3, 6, 9, and 12 months by 7-day Holter monitoring. Primary endpoint failure was defined as AAR lasting &gt;30 s. Safety was evaluated by comparing the incidence of serious adverse events (SAEs). Palpitations were monitored by a patient diary. Results: Of the 218 randomized subjects (age 52±13 years, 68% male), 187 (86%) completed the 12-month follow-up. Crossovers occurred in 20 subjects (9%; 1 subject from CA-to-AAD and 19 from AAD-to-CA). By intention-to-treat analysis, freedom from AAR after blanking was achieved in 82.2% of subjects in the cryoballoon CA arm and 67.6% of subjects in the AAD arm (HR=0.48, 95% CI: 0.26-0.86; P =0.013). There were no group differences in the time-to-first SAEs (HR=0.76, 95% CI: 0.46-1.26; P =0.28), and there was no death, atrio-esophageal fistula, pericardial tamponade, or stroke reported during the study. Also, there was no phrenic nerve injury present at the time of hospital discharge. The incidence rate of symptomatic palpitations after the 3 month follow-up was lower in the cryoballoon CA (4.61 days/year) compared to the AAD arm (15.18 days/year; IRR=0.30, 95% CI: 0.16-0.58; P&lt;0.001) with a mean duration [min]of 54.4 (131.1) for CA and 102.7 (162.8) for AAD. Conclusions: Cryoballoon CA was superior to AAD for the prevention of AAR in treatment naïve patients with PAF, and CA was associated with less frequent symptom recurrence. Moreover, CA had a safety profile comparable to AAD therapy. These results suggest cryoballoon CA is an effective first-line treatment for patients with symptomatic PAF.
Misguided Use of Hydroxychloroquine for COVID-19
Authors: Michael S. Saag
Journal: JAMA (2020)

Wesley H. Self, MD, MPH; Matthew W. Semler, MD; Lindsay M. Leither, DO; Jonathan D. Casey, MD, MSc; Derek C. Angus, MD, MPH; Roy G. Brower, MD; Steven Y. Chang, MD, PhD; Sean P. Collins, MD; John C. Eppensteiner, MD; Michael R. Filbin, MD; D. Clark Files, MD; Kevin W. Gibbs, MD; Adit A. Ginde, MD, MPH; Michelle N. Gong, MD, MS; Frank E. Harrell Jr, PhD; Douglas L. Hayden, PhD; Catherine L. Hough, MD, MSc; Nicholas J. Johnson, MD; Akram Khan, MD; Christopher J. Lindsell, PhD; Michael A. Matthay, MD; Marc Moss, MD; Pauline K. Park, MD; Todd W. Rice, MD; Bryce R. H. Robinson, MD, MS; David A. Schoenfeld, PhD; Nathan I. Shapiro, MD, MPH; Jay S. Steingrub, MD; Christine A. Ulysse, MS; Alexandra Weissman, MD, MPH; Donald M. Yealy, MD; B. Taylor Thompson, MD; Samuel M. Brown, MD, MS; National Heart, Lung, and Blood Institute PETAL Clinical Trials Network
Abstract 16731: Early Onset of Menopause and Premature Cardiovascular Disease: The Coronary Artery Risk Development in Young Adults Study
Authors: Ruth Misha, Laura A Colangelo, Lucia Petito, Cora E Lewis, Pamela Schreiner, Melissa Wellons, Catherine Kim, James G Terry, Donald M Lloyd-jones, Norrina B Allen, Sadiya S Khan
Journal: Circulation (2020)

Introduction: Cardiovascular disease (CVD) is the leading cause of death in women and early onset of menopause before the age of 40 years has been identified as a risk enhancer for future CVD events. Quantifying the magnitude of risk for premature CVD among women with early menopause may inform and guide the intensity of sex-specific preventive strategies. Methods: We included all women in the Coronary Artery Risk Development in Young Adults (CARDIA) study who attended a follow-up exam after the age of 40 years, had available data on menopausal status, and had not experienced premature CVD before 40 years. We performed multivariable Cox proportional hazards regression to examine the relationship between early onset of menopause defined as &lt;40 years and incident CVD (coronary heart disease, peripheral arterial disease, stroke, and heart failure) prior to the age of 65 years. We performed Cox proportional hazards models and adjusted for risk factors levels at baseline: age, race, age at menarche, years of education, smoking status, body mass index, diabetes, hypertension, and total cholesterol: high-density lipoprotein ratio. Results: Among 2136 women with mean age of 43.0 (SD 3.0), 9.1% reported premature menopause before the age of 40 years (4.5% in white and 13.9% in black women). Over a median follow-up of 14.0 (IQR 11.5, 16.9) years, 81 premature CVD events occurred. Incidence rate (95% CI) of CVD was 6.46 (2.43, 17.22) and 1.41 (0.92, 2.17) per 1,000 per person-years for white women with and without early onset menopause, respectively; 4.94 (2.66, 9.16) and 3.92 (2.94, 5.24) per 1,000 person-years for black women with and without early onset menopause (FIGURE). Conclusions: In a population-based sample, white women with early onset of menopause had a 3-fold higher rate of premature CVD events, independent of perimenopausal risk factor levels. Interventions to intensify CVD prevention in at-risk women are needed following early onset of menopause.
Abstract 16393: In Hospital Outcomes and Prevalence of Comorbidities in Patients With Amyloidosis With and Without Atrial Fibrillation - Insight From National Inpatient Sample (nis) Database (2013-14)
Authors: Asim Kichloo, Shakeel Jamal, Beth Bailey, muhammad shah zaib, HUH Virk, Ronak Soni, MUHAMMAD AJMAL, Sindhura Ananthaneni, Jagmeet P SINGH, Rajeev Sudhakar
Journal: Circulation (2020)

Introduction: Amyloidosis is a systemic illness that affects multiple organ systems including cardiovascular, renal, gastrointestinal and pulmonary systems manifesting as restrictive cardiomyopathy, atrial and ventricular arrhythmias, nephrotic syndrome and gastrointestinal hemorrhage. Unknown is whether co-occurrence atrial fibrillation (AF), further worsens the outcomes in systemic amyloidosis. Hypothesis: Atrial Fibrillation worsen clinical outcomes in Amyloidosis. Methods: Patients with diagnosis of amyloidosis with and without concurrent AF were identified by querying the Healthcare Cost and Utilization (HCUP), specifically, National Inpatient Sample for year 2016 based on ICD10 codes. Results: During 2016, a total of 2997 patients were admitted with diagnosis of Amyloidosis, out of which 918 had concurrent AF. There was an increased risk of mortality (7.4% vs 5.6%), heart block (6.8% vs 2.8%), cardiogenic shock (5% vs 1.6%), placement of an ICD/CRT/PPM (14.5% vs 4.5%), renal failure (29% vs 21%), heart failure (66% vs 30%) and bleeding complications (5.7% vs 2.8%) in patients with diagnosis of Amyloidosis and concurrent AF when compared to patients with only diagnosis of Amyloidosis. It’s interesting to note that patients with amyloidosis without comorbid AF had increased risk of stroke when compared to concurrent AF (7.9% vs 3.4%). Conclusions: Concurrent AF increases the risk of heart failure, cardiogenic shock, supraventricular tachycardia, bleeding complications and an overall increase in mortality in patients with amyloidosis.
Abstract 16215: Ventricular Dyssynchrony is Associated With Arrhythmic Mitral Prolapse Prior to Chamber Remodeling
Authors: Dimosthenis Pandis, Marc Miller, Ahmed El-Eshmawi, Ioulia A Grapsa, Percy Boateng, Maria Giovanna Trivieri, Stamatios Lerakis, Gianni Pedrizzetti, Ani Anyanwu, David H Adams
Journal: Circulation (2020)

Introduction: Asymptomatic patients on active surveillance for degenerative mitral regurgitation are at risk of ventricular arrhythmia and sudden death. Hypothesis: Abnormal myocardial mechanics may precede ventricular remodeling and may help identify at-risk patients. Methods: Multi-directional myocardial mechanics and LV dyssynchrony were assessed in 204 consecutive patients awaiting surgical mitral repair for severe degenerative MR in a quaternary mitral reference center. Results: The mean age was 58 ±12.5 years and 40% were females. The mean EF was 63% ± 6% and 92% had compensated LV function (EF&gt;60% and LVESD&lt;4cm) and only 24% had elevated LV filling pressures (E/e'≥13). Indexed LV wall stress-to-LVEDD, relative wall thickness and indexed LV mass-to-BSA were similar amongst males-females, although males had higher mean blood pressure (94 Vs. 90, P=0.02) . The peak global longitudinal strain (GLS) was -25.2% ± 3.3% and the mid-ventricular circumferential and radial strains were -33.5%±6.7% and 56%±25% respectively. Ventricular ectopy was present in 24.5% of patients and only 17% had atrial fibrillation (Afib) despite the significantly dilated left atria (mean LAVi 70±26.6 ml/m 2 ). The median LV mechanical dispersion was 40msec (IQR 30.7-56.5) but increased significantly with ventricular ectopy (65msec, P&lt;0.01) and further influenced by concomitant Afib (p=0.001 for 2-factor interaction). Diastolic LV function did not correlate with dispersion (r=0.02 and 0.01 for E/A and E/e', P=NS) but was associated with the duration of LV diastolic filling (mean 502±140msec; r=0.2, P=0.004). Interpapillary radial strain delay was noted in the study cohort (mean delay 52.8msec, range 0-335msec) while intepapillary activation delay was manifested with concomitant ventricular ectopy (mean time-to-peak LS delay 57.5±48msec). Conclusions: Left ventricular dyssynchrony manifested by increased mechanical dispersion and imbalanced interpapillary mechanics are observed prior to overt chamber remodeling in significant degenerative MR and is associated with ventricular ectopy. Further studies are needed to assess the related clinical implications and potential impact on risk stratification in this patient group.
Abstract P23: Comparison of Effects of Pulsed Biphasic Waveform and Rectilinear Biphasic Waveform for Ventricular Fibrillation
Authors: Yongqin Li, Hao Wang, Jun Hwi Cho, Jean-Philippe Didon, Joe Bisera, Giuseppe Ristagno, Max Harry Weil, Wanchun Tang
Journal: Circulation (2008)

Introduction Biphasic waveforms are superior to monophasic waveforms for electrical defibrillation. However, biphasic waveforms may themselves differ in efficacy. We hypothesized that the Pulsed Bi...
Abstract 16273: Safety of Subcutaneous ICD Implantation in Patients With Prior Sternotomy
Authors: Mejalli AlKofahi, Moghniuddin Mohammed, Madhu Reddy, Raghuveer Dendi, Rhea C Pimentel, Loren D Berenbom, Martin Emert, Rigoberto Ramirez, Amit Noheria, Seth H Sheldon
Journal: Circulation (2020)

Introduction: Subcutaneous ICD (S-ICD) implantation is a viable alternative to transvenous ICD implantation in patients without a pacing indication. The S-ICD lead is placed near the sternum. The safety of S-ICD implantation and risk for inappropriate shocks is uncertain in patients with prior sternotomy. Methods: This single-center retrospective cohort study included patients that had implantation of an S-ICD between February 2014 - May 2020. The 30-day complication rates and long-term risks of inappropriate shocks were compared between patients with and without prior sternotomy. Results: Ninety-eight patients (52 ± 15 years old, 43% men, BMI 29 ± 6, 72% primary prevention, 28% ischemic cardiomyopathy, median LVEF 30% (IQR 25-45%)) underwent S-ICD implantation, among whom 19 (19.4%) had a prior sternotomy. The median time between sternotomy and S-ICD implantation was 96 (IQR 4.1-306) months. The sternal coil was primarily implanted left of the sternum (n=17/19, 89%). A two-incision technique was used in 79% of patients with prior sternotomy vs. 65% without sternotomy (p=0.23). The 30-day complication rate was similar between those with and without prior sternotomy (n=1/19 vs. n=10/79, 5% vs. 13%, p=0.36). The only 30-day complication in patients with prior sternotomy was a hematoma without intervention. The 30-day complications in patients without prior sternotomy included: superficial site infection resolving with brief antibiotics (n=4), inappropriate shock (n=3), lead migration requiring revision (n=2), and a hematoma without intervention (n=1). Over a median follow-up of 17.1 (IQR 3.4-29.1) months, the frequency of inappropriate shocks was similar between patients with and without prior sternotomy (n=1/19 and n=6/79, 5% vs. 8%, p=0.72). The median time to inappropriate shock from S-ICD implantation was 1.1 (IQR 0.1-19.8) months. The mechanisms of inappropriate shocks were T-wave oversensing or other oversensing (n=5/7, 72%), air in the pocket (n=1/7, 14%), and atrial tachycardia (n=1/7, 14%). Conclusions: Implantation of S-ICD in patients with prior sternotomy was not associated with an increased risk of 30-day complications or inappropriate shocks. These outcomes need to be confirmed in larger, multicenter studies.
Combined TCR Repertoire Profiles and Blood Cell Phenotypes Predict Melanoma Patient Response to Personalized Neoantigen Therapy plus Anti-PD-1
Authors: Asaf Poran, Julian Scherer, Meghan E. Bushway, Rana Besada, Kristen N. Balogh, Amy Wanamaker, Reid G. Williams, Jasmina Prabhakara, Patrick A. Ott, Siwen Hu-Lieskovan, Zakaria S. Khondker, Richard B. Gaynor, Michael S. Rooney, Lakshmi Srinivasan
Journal: Cell Reports Medicine (2020)

T cells use highly diverse receptors (TCRs) to identify tumor cells presenting neoantigens arising from genetic mutations and establish anti-tumor activity. Immunotherapy harnessing neoantigen-specific T cells to target tumors has emerged as a promising clinical approach. To assess whether a comprehensive peripheral mononuclear blood cell analysis predicts responses to a personalized neoantigen cancer vaccine combined with anti-PD-1 therapy, we characterize the TCR repertoires and T and B cell frequencies in 21 patients with metastatic melanoma who received this regimen. TCR-α/β-chain sequencing reveals that prolonged progression-free survival (PFS) is strongly associated with increased clonal baseline TCR repertoires and longitudinal repertoire stability. Furthermore, the frequencies of antigen-experienced T and B cells in the peripheral blood correlate with repertoire characteristics. Analysis of these baseline immune features enables prediction of PFS following treatment. This method offers a pragmatic clinical approach to assess patients' immune state and to direct therapeutic decision making.
Heterogeneity of the Effect of Vitamin D Supplementation in Randomized Controlled Trials on Cancer Prevention
Authors: Lina Zgaga
Journal: JAMA Network Open (2020)

Paulette D. Chandler, MD, MPH; Wendy Y. Chen, MD, MPH; Oluremi N. Ajala, MD, MPH; Aditi Hazra, PhD, MPH; Nancy Cook, ScD; Vadim Bubes, PhD; I-Min Lee, MBBS, ScD; Edward L. Giovannucci, MD, ScD; Walter Willett, MD, DrPH; Julie E. Buring, ScD; JoAnn E. Manson, MD, DrPH; VITAL Research Group
Network strategies to understand the aging process and help age-related drug design
Authors: Gábor I Simkó, Dávid Gyurkó, Dániel V Veres, Tibor Nánási, Peter Csermely
Journal: Genome Medicine (2009)

Recent studies have demonstrated that network approaches are highly appropriate tools for understanding the extreme complexity of the aging process. Moreover, the generality of the network concept helps to define and study the aging of technological and social networks and ecosystems, which may generate novel concepts for curing age-related diseases. The current review focuses on the role of protein-protein interaction networks (inter-actomes) in aging. Hubs and inter-modular elements of both interactomes and signaling networks are key regulators of the aging process. Aging induces an increase in the permeability of several cellular compartments, such as the cell nucleus, introducing gross changes in the representation of network structures. The large overlap between aging genes and genes of age-related major diseases makes drugs that aid healthy aging promising candidates for the prevention and treatment of age-related diseases, such as cancer, atherosclerosis, diabetes and neurodegenerative disorders. We also discuss a number of possible research options to further explore the potential of the network concept in this important field, and show that multi-target drugs (representing 'magic-buckshots' instead of the traditional 'magic bullets') may become an especially useful class of age-related drugs in the future.
Camrelizumab plus gemcitabine and oxaliplatin (GEMOX) in patients with advanced biliary tract cancer: a single-arm, open-label, phase II trial
Authors: Xiaofeng Chen, Xiaofeng Wu, Hao Wu, Yanhong Gu, Yang Shao, Qianwen Shao, Feipeng Zhu, Xiao Li, Xiaofeng Qian, Jun Hu, Fengjiao Zhao, Weidong Mao, Jing Sun, Jian Wang, Gaohua Han, Changxian Li, Yongxiang Xia, Poshita Kumari Seesaha, Dongqin Zhu, Huajun Li, Junling Zhang, Guoqiang Wang, Xuehao Wang, Xiangcheng Li, Yongqian Shu
Journal: Journal for ImmunoTherapy of Cancer (2020)

Background Immune checkpoint inhibitors monotherapy has been studied in patients with advanced biliary tract cancer (BTC). The aim of this study was to assess the efficacy and safety of camrelizumab, plus gemcitabine and oxaliplatin (GEMOX) as first-line treatment in advanced BTC and explored the potential biomarkers associated with response. Methods In this single-arm, open-label, phase II study, we enrolled stage IV BTC patients. Participants received camrelizumab (3 mg/kg) plus gemcitabine (800 mg/m 2 ) and oxaliplatin (85 mg/m 2 ). Primary endpoints were 6-month progression-free survival (PFS) rate and safety. Secondary endpoints were objective response rate (ORR), PFS and overall survival (OS). Exploratory endpoints included association between response and tumor mutational burden (TMB), blood TMB, dynamic change of ctDNA and immune microenvironment. Results 54 patients with advanced BTC were screened, of whom 38 eligible patients were enrolled. One patient withdrew informed consent before first dose treatment. Median follow-up was 11.8 months. The 6-month PFS rate was 50% (95% CI 33 to 65). Twenty (54%) out of 37 patients had an objective response. The median PFS was 6.1 months and median OS was 11.8 months. The most common treatment-related adverse events (TRAEs) were fatigue (27 (73%)) and fever (27 (73%)). The most frequent grade 3 or worse TRAEs were hypokalemia (7 (19%)) and fatigue (6 (16%)). The ORR was 80% in patients with programmed cell death ligand-1 (PD-L1) tumor proportion score (TPS) ≥1% versus 53.8% in PD-L1 TPS &lt;1%. There was no association between response and TMB, blood TMB, immune proportion score or immune cells (p&gt;0.05), except that PFS was associated with blood TMB. Patients with positive post-treatment ctDNA had shorter PFS (p=0.007; HR, 2.83; 95% CI 1.27 to 6.28). Conclusion Camrelizumab plus GEMOX showed a promising antitumor activity and acceptable safety profile as first-line treatment in advanced BTC patients. Potential biomarkers are needed to identify patients who might respond to camrelizumab plus GEMOX. Trial registration number NCT03486678 .