tbuckley/cabot-search huggingface dataset:
Abstract MP45: Social Jetlag, Independent Of Other Sleep Characteristics, Is Associated With Obesity-related Outcomes In 9-11-year-old Girls
Authors: Simon Higgins, Lee Stoner, Katherine Black, Jyh Eiin Wong, Kim Meredith-Jones, Robin Quigg, Paula Skidmore
Journal: Circulation (2021)

Introduction: Though short sleep has been identified as a predictor of childhood obesity, few have explored the importance of sleep characteristics beyond duration. Literature in adolescents examining the influence of social jetlag, the difference in hours between the midpoint of sleep during weekdays (school) and weekend days (free), has suggested a potential sex-specific relationship with obesity-related indices. However, little is known about the potential sex-specific relationships between social jetlag or other sleep characteristics and obesity-related outcomes earlier in youth. Objective: To examine the relationships between sleep duration, disturbances, and social jetlag with obesity-related outcomes during childhood, with an emphasis on sex-specific relationships. Methods: This cross-sectional study included 381 children from Dunedin, New Zealand (9-11 years, 49.6% female). Average sleep duration, social jetlag, and physical activity were assessed via wrist-worn accelerometry, measured over 8 consecutive days. Sleep disturbances were quantified from the Children's Sleep Habits Questionnaire, with higher scores (range 1-3) denoting more frequent sleep disturbances. Obesity-related outcomes included age-specific body mass index z-scores (zBMI) calculated using the World Health Organization method, relative (% fat) and absolute (kg) adiposity and fat mass index (kg/m 2 ) assessed via bioelectrical impedance analysis, and waist-to-height ratio (WHtR). Linear mixed models that nested children within schools, with a random intercept and fixed slope were used to identify relationships among sleep variables and obesity-related outcomes. Multivariable analyses included all sleep variables (unadjusted) and known covariates (adjusted). Cross-level interactions assessed the presence of sex-specific relationships. Results: Positive associations between social jetlag with zBMI, % fat, and fat mass index were seen in univariable and unadjusted multivariable analyses. Associations between sleep duration and sleep disturbances with body composition variables were non-significant. Following adjustments for known confounders, social jetlag remained significantly associated with zBMI ( B =0.23, 95%CI: 0.03, 0.43, p =0.025), though not with any other obesity-related outcome. Furthermore, cross-level interactions were present for social jetlag with zBMI ( B =-0.40, 95%CI: -0.80, -0.00, p =0.051) and LnWHtR ( B =-0.01, 95%CI: -0.03, -0.00, p=0.042), with simple slopes suggesting positive associations in girls but not boys (girls B =0.43 and 0.01, respectively, both p &lt;0.05 ). Conclusions: Social jetlag may be an important target for youth obesity prevention efforts, given its association with obesity-related outcomes. Importantly, these associations were seen in girls but not boys, suggesting that a targeted approach to prevention may be needed.
Nearly 700 anaesthetists have training interrupted after cuts
Authors: Clara Munro
Journal: BMJ (2021)

Nearly 700 anaesthetic trainees will be unable to continue their training this year despite 680 consultant anaesthetist posts having been unfilled in the UK in 2020.1

Anaesthetic training, like many UK training programmes, comprises two stages: core training (CT1-2/3) and specialist training (ST3-8). Completion of both stages allows application to consultant level. ST3 posts have been cut from 392 in 2018 to 359 in 2021 despite 569 trainees having been accepted into core training in 2020.2

This creates a bottleneck situation, as 185 fewer posts are available at ST3 than are offered at CT1 level,2 a pattern that has continued for several years. With 1056 applications for just 359 ST3 jobs, this leaves 697 doctors without a training post.3

These trainees all have a minimum of four years’ postgraduate experience, have paid at least £1000 in personal costs towards exams,4 and have committed time towards their own training.

In a statement the Royal College of Anaesthetists said that the total number of training posts was set by the statutory education bodies in the UK—Health Education England, NHS Education Scotland, Health Education and Improvement Wales, and the Northern Ireland Medical and …
Abstract 12959: Inflammation and Diabetes Mellitus in Acute Myocardial Infarction. Are They Risk Equivalent of Short-Term and Long-Term Prognosis?
Authors: Nicola Cosentino, Stefano Genovese, Jeness Campodonico, Filomena Pacelli, Maria Luisa Biondi, Maurizio Rondinelli, Alice Bonomi, Valentina Milazzo, Monica de Metrio, Katia Celentano, Marco Moltrasio, Claudia Lucci, Mara Rubino, Giancarlo Marenzi
Journal: Circulation (2019)

Introduction: High-sensitivity C-reactive protein (hs-CRP) is the most used marker for detecting inflammation in acute myocardial infarction (AMI) and its levels are associated with outcome. Diabet...
Abstract 16412: The Predictors of Hemodynamic Response to Phosphodiesterase-5a Inhibition in Advanced HFrEF
Authors: Vojtech Melenovsky, Adrian Reichenbach, Luca Monzo, Hikmet Al-Hiti, Ivana Jurcova, Tereza Havlenova, Martin Kotrc, Josef Kautzner
Journal: Circulation (2020)

Introduction: In advanced HFpEF, acute phosphodiesterase 5 (PDE5) inhibition leads to favorable change in pulmonary vascular resistance (PVR) and to an increased cardiac output (CO) of variable degree. The determinants of the response are poorely understood. Methods: 47 HFrEF patients (85% males, 57±11 years, NYHA 2.9±0.5, 55% non-ischemic, PAmean 42±8 mmHg, 43% RV dysfunction) underwent clinical exam, echocardiography, biochemical tests and right heart catheterization (RHC) before and after I.V. administration of sildenafil (20 mg). Baseline predictors of absolute and relative (%diff) change of PVR and CO were studied. Results: PDE5i led to highly significant (p&lt;0.001) reduction of pulmonary artery (PA) mean pressure (-11±9 mmHg), PVR (-2.2±1.6 WU;-42±24%), PA wedge pressure (-5.2±7.3 mmHg), CVP (-3.2±2.3 mmHg) and to increase in cardiac output (+0.6±0.7 l/min; +18±23%). PVR decreased more than systemic resistance (PVR/SVR -27±30%diff). Predictors of high CO response (COdiff%) were: low BMI, no diabetes, low baseline CO and severity of mitral or tricuspid regurgitation (r=0.53 or =0.43, both p&lt;0.003). The strongest predictor of high PVR%diff was plasma potassium level. HF etiology, renal function, gender, RAAS inhibitor dose, renin or aldosterone levels were unelated to pulmonary vasoreactivity. Patients who dropped PVR&lt;3 WU after PDE5i had higher plasma K+ (4.1±0.5 vs 4.5±0.3 mmol/L, p=0.01) than those who did not, similar relation was found for K+ and PDE5i-induced change of transpulmonary gradient. Conclusions: The largest increase in CO after PDE5i is observed in HFrEF patients with severe mitral (or tricuspid) regurgitation, probably due to chamber unloading and reduction of regurgitant SV. Pulmonary vasodilator response to PDE5i may be influenced by plasma potassium level. High-normal plasma potassium levels may preserve normal pulmonary vasoreactivity in HFrEF, perhaps by influencing K-channels in pulmonary vascular smooth muscle cells.
16P Understanding the biologic determinants of ribociclib efficacy in breast cancer
Authors: F. Brasó-Maristany, M. Palafox, L. Monserrat, M. Bellet, M. Oliveira, M. Capelán, P. Galván, D. Martínez, N. Chic, C. Viaplana, R. Dienstmann, P. Nuciforo, C. Saura Manich, A. Prat, V. Serra
Journal: Annals of Oncology (2021)
Abstract 16519: Meta-analysis of Outcome After Implantable Cardioverter Defibrillator Therapy in Patients With Cardiac Amyloidosis
Authors: Sisir Siddamsetti, Mojgan Golzy, Sandeep Gautam
Journal: Circulation (2020)

Introduction: Cardiac amyloidosis is associated with high risk for sudden cardiac death. However, the potential benefit of implantable cardioverter defibrillator (ICD) implantation in CA is unknown due to limited available data regarding outcomes following ICD implantation in this patient population. We sought to perform a meta-analysis of trials that evaluated the outcomes of ICD implantation in CA. Methods: We performed a systematic literature review in PubMed, SCOPUS, and Cochrane to identify all studies that evaluated ICD therapy in CA until May 2020. Outcomes analyzed were all-cause mortality and appropriate ICD therapy rates. A random effects model was used to calculate percentages and 95% confidence intervals (CI) of outcomes. Results: Of the screened articles, 5 observational studies were included for analysis. A total of 151 patients were analyzed. Mean age of population was 61.6 +/- 0.7 years and 79.2% were male. The all-cause mortality rate was 33% (95% CI:16 to 51%) and the incidence of appropriate ICD therapy was 23% (95% CI:16 to 30%) over a mean follow up period of 16 months (Figure). In trials that evaluated ICD therapy in non-ischemic cardiomyopathy such as DANISH, DEFINITE and SCD-HeFT trials mortality rates in the ICD arm were 21.6 % over 67.6 months, 9.4% over 29 months and 16.7% over 45.5 months, respectively. The incidence of appropriate therapy in DANISH, DEFINITE and SCD-HeFT trials were 28.9%, 19.8 % and 21% respectively. Conclusions: CA patients with ICD have equivalent appropriate therapy with disproportionately higher mortality over a shorter follow up compared to randomized trials of primary prevention ICD placement in NICMP. The benefit of ICD placement for mortality reduction in CA remains unclear and further large-scale studies are required to address this issue.
Abstract 077: <i>In Utero</i> Exposure To Metal Mixtures And Offspring Blood Pressure: An Analysis Of The Boston Birth Cohort Using Bayesian Kernel Machine Regression
Authors: Mingyu Zhang, Tiange Liu, Guoying Wang, Jessie P Buckley, Eliseo Guallar, Xiumei Hong, Mei Cheng Wang, Marsha Wills-Karp, Lawrence J Appel, Xiaobin Wang, Noel T Mueller
Journal: Circulation (2021)

Background: In utero exposure to metals lead (Pb), cadmium (Cd), and mercury (Hg) may be associated with higher childhood systolic blood pressure (SBP), while trace elements manganese (Mn) and selenium (Se) may have protective, antioxidant effects that modify metal-SBP associations. No study has examined how in utero co-exposure to these metals affect offspring SBP. Objectives: To examine the individual and joint effects of in utero exposure to Cd, Pb, Hg, Mn, and Se on offspring SBP. Methods: We used data from the Boston Birth Cohort (enrolled 2002-2013). We measured metals in maternal red blood cells collected 24-72 hours after delivery. We calculated child age-, sex-, and height-specific SBP percentile per 2017 American Academy of Pediatrics guidelines. We used linear regression models to estimate associations of each metal, and Bayesian kernel machine regression (BKMR) to examine metal co-exposures, with child SBP between 3 to 15 years of age. Results: Our analytic sample comprised 1194 mother-child pairs (61% Black, 20% Hispanic). Hg and Pb were not associated with child SBP. Se and Mn were inversely associated with child SBP: each log2(Se) and log2(Mn) increment was associated with a 6.23 (95% CI: 0.96-11.51) and a 2.62 (95% CI: 0.04-5.20) percentile lower child SBP, respectively. BKMR models showed similar results ( Panel A ). While Cd was not overall associated with child SBP, there was an antagonistic interaction between Cd and Mn (P-interaction = 0.036): the association of Mn and lower child SBP was stronger with higher levels of Cd ( Panel B ). Consistent with this finding, in utero exposure to cigarette smoke (a major source of Cd) modified the association of Mn and child SBP: among children born mothers who smoked cigarette in pregnancy, each log2(Mn) increment was associated with a 10.09 (95% CI: 2.15-18.03) percentile lower SBP ( Panel C ). Conclusion: Optimizing in utero Se levels, as well as Mn levels in pregnant women who had high Cd or smoked during pregnancy, may protect offspring from developing high BP during childhood.
IVUS-guided DCA 探査用ワイヤーを用いた新手法について
Authors: Sone Takahito, Tsuboi Hideyuki, Kondo Jun'ichiro, Takekawa Hiroaki, Morishima Itsuro, Kawano Tomohiro, Yoshida Tomohiro, Kosaka Takashi, Morita Yasuhiro
Journal: Circulation (2002)
Lifileucel, a Tumor-Infiltrating Lymphocyte Therapy, in Metastatic Melanoma
Authors: Amod A. Sarnaik, Omid Hamid, Nikhil I. Khushalani, Karl D. Lewis, Theresa Medina, Harriet M. Kluger, Sajeve S. Thomas, Evidio Domingo-Musibay, Anna C. Pavlick, Eric D. Whitman, Salvador Martin-Algarra, Pippa Corrie, Brendan D. Curti, Judit Oláh, Jose Lutzky, Jeffrey S. Weber, James M. G. Larkin, Wen Shi, Toshimi Takamura, Madan Jagasia, Harry Qin, Xiao Wu, Cecile Chartier, Friedrich Graf Finckenstein, Maria Fardis, John M. Kirkwood, Jason A. Chesney
Journal: Journal of Clinical Oncology (2021)

Effective treatment options are limited for patients with advanced (metastatic or unresectable) melanoma who progress after immune checkpoint inhibitors and targeted therapies. Adoptive cell therapy using tumor-infiltrating lymphocytes has demonstrated efficacy in advanced melanoma. Lifileucel is an autologous, centrally manufactured tumor-infiltrating lymphocyte product.We conducted a phase II open-label, single-arm, multicenter study in patients with advanced melanoma who had been previously treated with checkpoint inhibitor(s) and BRAF ± MEK targeted agents. Lifileucel was produced from harvested tumor specimens in central Good Manufacturing Practice facilities using a streamlined 22-day process. Patients received a nonmyeloablative lymphodepletion regimen, a single infusion of lifileucel, and up to six doses of high-dose interleukin-2. The primary end point was investigator-assessed objective response rate (ORR) per RECIST, version 1.1.Sixty-six patients received a mean of 3.3 prior therapies (anti-programmed death 1 [PD-1] or programmed death ligand 1 [PD-L1]: 100%; anticytotoxic T-lymphocyte-associated protein-4: 80%; BRAF ± MEK inhibitor: 23%). The ORR was 36% (95% CI, 25 to 49), with two complete responses and 22 partial responses. Disease control rate was 80% (95% CI, 69 to 89). Median duration of response was not reached after 18.7-month median study follow-up (range, 0.2-34.1 months). In the primary refractory to anti-PD-1 or PD-L1 therapy subset, the ORR and disease control rate were 41% (95% CI, 26 to 57) and 81% (95% CI, 66 to 91), respectively. Safety profile was consistent with known adverse events associated with nonmyeloablative lymphodepletion and interleukin-2.Lifileucel demonstrated durable responses and addresses a major unmet need in patients with metastatic melanoma with limited treatment options after approved therapy, including the primary refractory to anti-PD-1 or PD-L1 therapy subset.
Small-molecule inhibitor targeting the Hsp70-Bim protein–protein interaction in CML cells overcomes BCR-ABL-independent TKI resistance
Authors: Ting Song, Yafei Guo, Zuguang Xue, Zongwei Guo, Ziqian Wang, Donghai Lin, Hong Zhang, Hao Pan, Xiaodong Zhang, Fangkui Yin, Hang Wang, Laura Bonnette Uwituze, Zhichao Zhang
Journal: Leukemia (2021)
The Impact of Tolvaptan for Preventing Re-hospitalization in Patients with Acute Decompensated Heart Failure
Authors: Ohmura Junichi, Nomura Akihiro, Arita Takeshi, Soga Yoshimitsu, Kondo Katsuhiro, Hyodoh Makoto, Andoh Kenji, Sakai Koyu, Iwabuchi Masashi, Gohya Masahiko, Yokoi Hiroyoshi, Nobuyoshi Masakiyo
Journal: Circulation (2013)
Abstract 13129: Chest Pain and Inflammation: A Story Where Hickam’s Dictum Prevailed
Authors: Kris Kumar, Joshua Vogt, Ahmad Masri, Harsh Golwala, Firas Zahr, Punag Divanji, Hind Rahmouni, Babak Nazer
Journal: Circulation (2020)

A 39-year-old male presented with a chief complaint of chest pain that worsened with deep breathing for one day. He was found to be tachycardic, with distant heart sounds and a skin nodule over his right upper extremity. ECG revealed diffuse ST elevations and PR segment depressions with TTE showing a small pericardial effusion. Troponin I was 8.98 ng/mL and NT-proBNP was 981 pg/mL. One day after admission, he developed respiratory distress, and repeat TTE showed a large pericardial effusion with collapse of the RV free wall during diastole with variation of mitral and tricuspid valve inflows consistent with tamponade. Pulsus paradoxus was 24 mmHg and he was taken for pericardiocentesis. Skin nodule biopsy revealed nodular and interstitial granulomatous dermatitis. Anti-nuclear antibody and double stranded DNA antibody were positive with pericardial fluid cytology showing acute inflammation with lupus erythematosus cells. Based upon this constellation of findings, he was diagnosed with systemic lupus erythematosus (SLE) myopericarditis, and started on colchicine and immunosuppression, with resolution of symptoms. One week into hospitalization, the chest pain recurred but was sharp and substernal, with a rising troponin from 1.23 ng/mL to 8.23 ng/mL. TTE showed depressed LVEF of 45% and RCA territory hypokinesis without effusion. CTA PE showed no evidence of thromboembolism and CT coronary demonstrated mural thickening of the mid LAD and aneurysmal dilation of the left main to the LAD and left circumflex bifurcation concerning for vasculitis. The mid RCA was occluded, and patient was taken to the cardiac catherization laboratory revealing thrombotic occlusion of the proximal-to-mid RCA. Despite serial balloon dilation, thrombotic occlusion persisted, Aspiration thrombectomy evacuated organized thrombus prior to deployment of two overlapping drug-eluting stents in the proximal-to-mid RCA, restoring flow. TTE prior to discharge showed normal LVEF and no effusion. This case illustrates various cardiac manifestations of SLE and the unusual dynamic nature of this patient’s multiple presentations of chest pain. Avoiding “diagnostic anchoring” is important to diagnosing and treating conditions such as SLE, that can affect the heart in multiple ways.
Abstract 17026: Pericardial Effusion in Children After Bone Marrow Transplant
Authors: Niti Dham, Kelly Lyons, Blachy Davila Saldana
Journal: Circulation (2020)

Background: Bone marrow transplant (BMT) is necessary in varying diseases. However, it has known cardiac risks and complications, including pericardial effusions (PE). PE can be life threatening if not identified early, and its treatment can be invasive, ie pericardiocentesis. Our objective is to identify echocardiographic (echo) findings that could help identify high risk subsets for developing a PE post BMT. Methods: We retrospectively identified BMT patients from January 2011 - December 2019 in our institution that developed moderate to large PE requiring treatment. Our controls consisted of BMT patients that did not develop PE. Baseline demographics, BMT data, PE treatments, and echo data was obtained. Echo variables included markers of systolic function, diastolic function, and LV size prior to BMT in both sets of patients. We performed a t-test for comparison and Pearson correlation. Results: We performed over 180 BMTs in our institution during this time. Of these, 50 were noted to have any degree of pericardial effusion, but 15 patients developed symptomatic pericardial effusions requiring further interventions. Our study included 13 subjects and 12 controls. Our subjects ranged from 8 months to 17 years old, 3F/10M. Even though the left ventricle end diastolic diameter (LVIDd) z-scores were within normal, they were statistically larger (p 0.02) in the PE group. Both groups had the same average hemoglobin (9.2). There was no difference in the pre-BMT systolic function or diastolic function parameters between the two groups. The duration of the PE (after the BMT)correlated with LVIDd z-score (Figure 1; r 0.6, p 0.02) and MV septal E’ (r -0.6, p 0.03) and E/E’ (r 0.6, p 0.05) from the pre-BMT echo. Conclusions: Assessing LV size and LV diastolic markers pre-BMT could be simple yet important measurements to pay closer attention to, which can then help direct improved screening in pediatric post-BMT patients. These findings should be explored further in larger studies.
Assessment of Patient Attribution to Care From Medical Oncologists, Surgeons, or Radiation Oncologists After Newly Diagnosed Cancer
Authors: Suhas Gondi, Alexi A. Wright, Mary Beth Landrum, Laurie Meneades, Jose Zubizarreta, Michael E. Chernew, Nancy L. Keating
Journal: JAMA Network Open (2021)

who visited more than 1 practice of each type.This analysis was
AAV Capsid Proteins Fused with SARS-CoV-2 RBD or RBM: Expression in E. coli, In-Vitro Assembly, and Characterization
Authors: D. T. Le, O. Behrsing, C. Rothschild, M. T. Radukic, K. M. Arndt, K. M. Muller
Journal: Molecular Therapy (2021)
Correction: Postsurgical bile duct disruption: Digital single-operator cholangioscopy-assisted recanalization
Authors: Carolina G. González-Olivares, José R. Foruny, Andreína Olavarría, Juan Ángel González Martín, Sergio López-Durán, Enrique Vázquez-Sequeiros, Agustín Albillos
Journal: Endoscopy (2021)

Correction to: Postsurgical bile duct disruption: Digital single-operator cholangioscopy-assisted recanalizationEndoscopy 2021; 53(07): 764-765DOI: 10.1055/a-1258-4176
Stretch occlusion of stone extraction balloon catheter
Authors: Shou-jiang Tang
Journal: Endoscopy (2021)

A 65-year-old woman underwent endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis, and a standard stone extraction balloon (Multi-3V; Olympus, Tokyo, Japan) was used initially to remove the stone after biliary sphincterotomy. After several attempts of downward pulling on the balloon catheter, aiming for stone expulsion, we were unable to deflate the balloon ([Fig. 1]). No elevator manipulation was used during stone removal. We suspected that the balloon catheter had developed stretch occlusion: total collapse of the air channel within the balloon catheter caused by the stretched surrounding plastic housing catheter. Through this mechanism the air inside the balloon becomes totally trapped above the stretched occlusion site. The balloon could not be deflated even after we cut the catheter close to the handle ([Fig. 2]). So, the inflated balloon was pulled to the biliary opening. Next to the cut catheter, an endoscopic needle-knife without cauterization was used to puncture the inflated balloon ([Fig. 3]) under endoscopic and fluoroscopic guidance. The balloon deflated immediately and was removed ([Video 1]). We removed all stone fragments during the same ERCP session. All ERCP endoscopists need to be aware of this rare potential complication when using stone extraction balloons and know how to manage it accordingly.