tbuckley/cabot-search huggingface dataset:
Abstract MP47: Associations Between Novel Biomarkers and Risk of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Weihong Tang, Lu Yao, Ron C Hoogeveen, Alvaro Alonso, David J Couper, Richard Maclehose, Pamela L Lutsey, Carol C Steenson, David W Hunter, Frank A Lederle, Aaron A Folsom
Journal: Circulation (2016)

Introduction: Abdominal aortic aneurysms (AAA) are an important manifestation of vascular disease in older age and rupture of an AAA is associated with high mortality. Traditional atherosclerotic disease risk factors contribute to the etiology of AAA. Biomarkers for novel etiopathogenic mechanisms, including extracellular matrix remodeling and inflammation, have been assessed primarily in cross-sectional studies of AAA. The objective of this study was to prospectively assess the association between biomarkers for these novel mechanisms and clinical AAA during 24 years of follow-up in the ARIC study, a large, community-based cohort. Methods: Clinical AAAs were ascertained from baseline in 1987-1989 (45-64 years of age) to 2011 through hospital discharge codes, death codes, and Medicare outpatient claims. Over a maximum 24 years of follow-up, a total of 554 AAAs (85.3% whites) were identified. Using a nested case-cohort design, novel biomarkers, including MMP3, MMP9, IL6, IL1-beta, N-terminal propeptide of Type III procollagen (PIIINP), and osteopontin, were measured at baseline (90% of sample) or Visit 2 (1990-1992, 10% of sample) in all AAAs and a random sample of 747 participants who were selected from baseline and matched with AAAs by age (≤55 and &gt;55), race, and gender. The association of the biomarkers with the risk of future AAA was estimated using multivariable Cox proportional hazard models with weighting to adjust for the varying sampling fractions of cases and controls across strata. Results: MMP9, IL6, PIIINP, and osteopontin were significantly associated with future risk of AAA after adjusting for age, gender, race and field center (Table). The associations for PIIINP and osteopontin were no longer significant after further adjusting for other traditional risk factors for AAA. Conclusions: Blood concentrations of MMP9, IL6, and osteopontin measured in middle-age were risk markers for incident AAA. These results highlight the role of inflammation and extracellular remodeling in the development of AAA.
Analysis of State Cannabis Laws and Dispensary Staff Recommendations to Adults Purchasing Medical Cannabis
Authors: Jessica S. Merlin, Andrew Althouse, Robert Feldman, Julia H. Arnsten, Hailey W. Bulls, Jane M. Liebschutz, Shannon M. Nugent, Steven R. Orris, Rebecca Rohac, Joanna L. Starrels, Benjamin J. Morasco, Devan Kansagara
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Over the last decade, cannabis has become more accessible through the proliferation of dispensaries in states that have legalized its use. Most patients using cannabis for medical purposes report getting advice from dispensaries, yet there has been little exploration of frontline dispensary staff practices. <h3>Objective</h3> To describe the practices of frontline dispensary workers who interact with customers purchasing cannabis for medical purposes and assess whether dispensary practices are associated with medicalization of state cannabis laws (degree to which they resemble regulation of prescription or over-the-counter drugs) and statewide adult use. <h3>Design, Setting, and Participants</h3> This nationwide cross-sectional survey study was conducted from February 13, 2020, to October 2, 2020, using an online survey tool. Potential respondents were eligible if they reported working in a dispensary that sells tetrahydrocannabinol-containing products and interacting with customers about cannabis purchases. <h3>Main Outcomes and Measures</h3> Participant responses to questions about formulating customer recommendations and talking to customers about risks. <h3>Results</h3> The 434 survey responses from 351 unique dispensaries were most often completed by individuals who identified as budtenders (40%), managers (32%), and pharmacists (13%). Most respondents reported basing customer recommendations on the customer's medical condition (74%), the experiences of other customers (70%), the customer's prior experience with cannabis (67%), and the respondent's personal experience (63%); fewer respondents relied on clinician input (40%), cost (45%), or inventory (12%). Most respondents routinely advised customers about safe storage and common adverse effects, but few counseled customers about cannabis use disorder, withdrawal, motor vehicle collision risk, or psychotic reactions. A higher state medicalization score was significantly associated with using employer training (odds ratio, 1.41; 95% CI, 1.18-1.67) and physician or clinician input (odds ratio, 1.23; 95% CI, 1.05-1.43) as a basis for recommendation. Medicalization score was not associated with counseling about cannabis risks. <h3>Conclusions and Relevance</h3> This survey study provides insight into how frontline dispensary staff base cannabis recommendations and counsel about risks. The findings may have utility for clinicians to counsel patients who purchase cannabis, customers who want to be prepared for a dispensary visit, and policy makers whose decisions affect cannabis laws.
Valsartan in early-stage hypertrophic cardiomyopathy: a randomized phase 2 trial
Authors: Carolyn Y. Ho, Sharlene M. Day, Anna Axelsson, Mark W. Russell, Kenneth Zahka, Harry M. Lever, Alexandre C. Pereira, Steven D. Colan, Renee Margossian, Anne M. Murphy, Charles Canter, Richard G. Bach, Matthew T. Wheeler, Joseph W. Rossano, Anjali T. Owens, Henning Bundgaard, Lee Benson, Luisa Mestroni, Matthew R. G. Taylor, Amit R. Patel, Ivan Wilmot, Philip Thrush, Jose D. Vargas, Jonathan H. Soslow, Jason R. Becker, Christine E. Seidman, Neal K. Lakdawala, Allison L. Cirino, Jose E. Krieger, Luciana Sacilotto, Edmundo Arteaga, Murilo O. Antunes, E. Kevin Hall, Lubna Choudhury, Elfriede Pahl, Kimberly Y. Lin, Gregory D. Lewis, Akshay S. Desai, Kristin M. Burns, John J. V. McMurray, Calum A. MacRae, Scott D. Solomon, E. John Orav, Eugene Braunwald
Journal: Nature Medicine (2021)
Implementing the cancer and aging research group (CARG) tool in the ambulatory oncology setting to drive informed treatment selection.
Authors: Alexander Mbewe, Paula Pike, Russell Lewis, Jeremy S. Kortmansky, Anne C. Chiang, Jane Kanowitz
Journal: Journal of Clinical Oncology (2021)

209 Background: Smilow Cancer Hospital is a NCI designated cancer center in Connecticut that has built a network of 15 community-based oncology (CBO) clinics. Older patients present with unique clinical challenges including multiple comorbidities, decreased functional status, and cognitive impairment. ASCO Geriatric Oncology guidelines recommend completing both a comprehensive geriatric assessment and a chemotherapy toxicity risk assessment on all oncology patients ≥65 years old for informed treatment selection. The CARG calculator is a simple, validated tool to assess chemotherapy toxicity risk in older patients with solid tumors. Despite ASCO guidelines, the existence of validated tools, and literature confirming improved patient outcomes, oncologists’ utilization of risk calculators is limited; therefore, we conducted a pilot CARG quality improvement initiative throughout our CBO network. Methods: 36 CBO physicians agreed to complete five CARG tools, document toxicity scores in the EMR, and complete a post-survey between March and June 2021. PDSA cycles included interventions of a hyperlink to the CARG tool incorporated in the EMR and creating a dot phrase built to simplify documentation. Education was provided on both the CARG and the survey. The survey captured perceived clinical value, time commitment, and barriers to implementation. Baseline data was collected during February 2021 and included geriatric patients receiving a new chemotherapy regimen for a solid tumor. Results: 180 consecutive new chemotherapy starts in geriatric patients were monitored. The CARG score utilization in new chemotherapy starts increased from 6.5% of new cases during the first month, to 26.4% in the third month. 82% of providers found the CARG score helpful in discussing chemotherapy risks with patients. In 32% of cases, the CARG score led to a decision to dose attenuate, and in 15% of cases, the CARG score led to a different treatment regimen. Most oncologists (65%) reported spending ≤5 minutes calculating toxicity, and 88% spent ≤10 minutes. 89% of oncologists reported the CARG score was worth the added time. Conclusions: This QI initiative demonstrates feasibility and increased use of the CARG geriatric chemotherapy toxicity tool in accordance with ASCO geriatric guideline-based care. Physician education and EMR workflow modification were utilized. In the CBO setting, oncologists found the CARG tool to be quick and helpful in discussing treatment risks with patients. Use of the CARG tool led to meaningful changes in treatment, including chemotherapy dose attenuation. Further study metrics such as palliative and supportive care referrals, ED visits, and hospitalizations will fuel sustainability.
Vaccine-induced interstitial lung disease: a rare reaction to COVID-19 vaccination
Authors: Alison M DeDent, Erica Farrand
Journal: Thorax (2021)

After millions of deaths worldwide and months of widespread social and economic devastation, the first vaccine against SARS-CoV-2 (COVID-19) was given emergency use listing by the WHO.1 Approved only 1 year after the virus was first identified in Wuhan, China, this historic achievement was the result of public and private institutional partnerships, as well as decades of foundational scientific research. Two of the earliest vaccines authorised for widespread use were the BNT162b2 (Pfizer/BioNTech) and mRNA-1273 (Moderna) messenger RNA (mRNA) vaccines, demonstrating 95% and 94.1% efficacy, respectively, in phase II/III clinical trials. Notably, both vaccines have strong safety profiles, with the most common adverse events including injection site reactions, fever, chills, fatigue, headache, and muscle and joint aches.2 3 Postauthorisation reports of severe reactions, including anaphylaxis, have been extremely rare, occurring in only 4.5 reported cases per million doses.4

In this issue of Thorax , Park and colleagues5 present the first published case of COVID-19 vaccine-related interstitial lung disease (ILD). An 86-year-old man developed an acute onset of fever, weakness, shortness of breath and hypoxaemia requiring high-flow nasal cannula 1 day after receiving a dose of a COVID-19 mRNA vaccine. He had no history of ILD, connective tissue …
Correction: Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
Authors: Konstantinos Triantafyllou, Paraskevas Gkolfakis, Ian M. Gralnek, Kathryn Oakland, Gianpiero Manes, Franco Radaelli, Halim Awadie, Marine Camus Duboc, Dimitrios Christodoulou, Evgeny Fedorov, Richard J. Guy, Marcus Hollenbach, Mostafa Ibrahim, Ziv Neeman, Daniele Regge, Enrique Rodriguez de Santiago, Tony C. Tham, Peter Thelin-Schmidt, Jeanin E. van Hooft
Journal: Endoscopy (2021)

Correction to: Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) GuidelineEndoscopy 2021; 53(08): 850-868DOI: 10.1055/a-1496-8969
Vanadyl nanocomplexes enhance photothermia-induced cancer immunotherapy to inhibit tumor metastasis and recurrence
Authors: Doudou Hu, Hongxia Xu, Wei Zhang, Xiaodan Xu, Bing Xiao, Xueying Shi, Zhuxian Zhou, Nigel K.H. Slater, Youqing Shen, Jianbin Tang
Journal: Biomaterials (2021)
Out-of-Pocket Costs of Specialty Medications for Psoriasis and Psoriatic Arthritis Treatment in the Medicare Population
Authors: Sarah P. Pourali, Leonce Nshuti, Stacie B. Dusetzina
Journal: JAMA Dermatology (2021)

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Social determinants of health and the Barrio Advantage among Hispanics during the COVID-19 pandemic.
Authors: Nerea Lopetegui-Lia, Jasmin Hundal, Katarina Bade, Emily Hsu, Jyoti Chhabra, Oscar Serrano, Alvaro G. Menendez
Journal: Journal of Clinical Oncology (2021)

133 Background: Institutional data confirmed that despite Hispanics having a higher morbidity related to COVID19, mortality and outcomes were more favorable compared to other ethnic counterparts. We decided to study the role of the Barrio Advantage (BA), living in ethnically similar communities leading to health advantage, by taking into account acculturation in our patients in hopes of identifying potential avenues to educate our population and minimize healthcare delivery gaps. Methods: A 15-item IRB-approved questionnaire was administered to cancer patients receiving care at participating cancer centers in English and Spanish. Multivariable analysis was performed using Chi Square test to determine associations between examined variables which included socio-demographic information, fears and attitudes related to COVID19. Results: A total of 251 surveys were analyzed. 43.4% were Hispanic with 72% of them listing Spanish and 28% English as their preferred language. Similar amount of English Speaking Hispanics (ESH) and Spanish Speaking Hispanics (SSH) had no personal or family exposure to COVID19 (66.7% and 59.5%, respectively). SSH have a lower degree of education (33% with at least some college, vs 53.3%). More SSH depend on government issued insurance or have no insurance at all (78.5% vs 63.3%). COVID19 has disproportionately worsened fears in SSH (Table). The Barrio Advantage effect was evidenced by the fact that SSH rely more on faith-based institutions or family/friends for emotional support and healthcare inquiries (22.8% vs 13.3%) although more ESH would do so in the case of food security (53.3% vs 41.8%). Comparison of fears to financial, personal and community health based on English proficiency. Conclusions: Financial, personal and community health concerns are deepened in Hispanics, particularly for SSH, potentially due to the lack of acculturation process. Understanding Hispanics and other underrepresented populations are far from monolithic. Loco-regional social determinants of health must be studied in an attempt minimize health disparities including those related to COVID19. The BA, English proficiency and the acculturation process should be considered when developing interventions aimed at decreasing negative outcomes in this dynamic population.[Table: see text]
P04.02 Single-cell transcriptomic analysis reveals shifts in glioblastoma cell composition in different BMP4-treated primary tumor cultures
Authors: I S C Verploegh, A Conidi, R W W Brouwer, W F J van IJcken, M Lamfers, S Leenstra, D Huylebroeck
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Glioblastoma (GBM) is the most aggressive primary brain tumor. The well-known cellular heterogeneity of this cancer, which includes glioma tumor-initiating cells with stem cell characteristics (GSCs), (co)influences therapy resistance and tumor recurrence. Bone Morphogenetic Protein-4 (BMP4) promotes differentiation of GSCs towards astroglial lineage while suppressing oligodendrocyte maturation. Treatment with BMP4 is associated with increased survival in mice. BMPs exert effects in cell-type and context dependent fashion, but also generate subtle heterogeneity in transcriptional response among similar cells. We studied first the cell viability of BMP4-treated primary GBM cultures followed by single-cell RNA-sequencing (scRNA-seq) on two differently responding cultures, and found correlation between their responses and therapy sensitivity. MATERIAL AND METHODS Cell viability, proliferation and apoptosis were assessed in 17 patient-derived BMP4-treated GBM cell cultures. We selected one culture in which this treatment induced high in vitro therapeutic efficacy, and one in which the treatment was ineffective, for analysis by scRNA-seq and then compared the results on the initial panel of 17 cultures. RESULTS After 7 days of treatment with BMP4, cell viability ranged from 28% (referred to as highest in vitro therapeutic efficacy) to 132% compared to untreated cells. scRNA-seq of the previously mentioned cultures in passage 7 showed that all neural cell types that are usually found in freshly resected GBM, were also present in our cultures. In the culture where BMP4 induced high in vitro therapeutic efficacy, BMP4 induces the formation of a large new cell population displaying decreased cell proliferation, increased migration and cell death, while the pro-inflammatory cells were depleted. RNA-velocity analysis revealed that, the cycling of cells was greatly diminished in the culture where therapy with BMP4 was efficacious, whereas this was enhanced in the GBM culture with the lowest cell viability after treatment. Astroglial differentiation was induced in all BMP4-treated cultures, while neuronal differentiation was reduced most in the cultures in which BMP4 induced lower or no in vitro therapeutic efficacy. In the culture without therapeutic efficacy of BMP4 cell cycle arrest was not induced anymore. In addition, OLIG1/2 mRNA and protein levels seemed predictive for BMP4-therapy efficacy, while activation of translation-associated genes (RPL27A, RPS27) was a suitable, immediate post-therapeutic marker for this. CONCLUSION scRNA-seq of in vitro GBM cultures provides advanced insights into the mechanism underlying therapy efficacy of BMP4. Neural differentiation status is distinctive for therapeutic efficacy of BMP4 in vitro before and after therapy.
P09.04 T2 hyperintense regions on MRI in gliomas: a comparison between routine clinical MRI and 7T MRI
Authors: B Schmitz-Abecassis, M J P van Osch, L Dirven, M J B Taphoorn, J A F Koekkoek, J de Bresser
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Gliomas can be highly heterogeneous on brain MRI, especially at higher grades. These tumors often include a low-grade component and/or surrounding edema. Both these components appear as hyperintense regions on clinical T2-weighted MR images and cannot be accurately distinguished. Ultrahigh field 7T MR systems have the potential for a higher sensitivity due to its increase signal-to-noise ratio (SNR). This could allow for enhanced detailed visualization of gliomas. Therefore our goal was to assess the difference in extent of T2 hyperintense regions in glioma patients between clinical (1.5T/3T) and 7T MR images. MATERIAL AND METHODS We prospectively scanned 6 glioma patients (3 glioblastomas (GBM) WHO grade IV post-operative, 1 anaplastic diffuse glioma (ADG) WHO grade III, 1 biopsied oligodendroglioma (OD) WHO grade II and 1 suspected low-grade glioma (LGG); 4 Females, mean age: 56.8 years and 2 Males, mean age: 45.5 years) on a routine clinical MRI scanner (3T or 1.5T) and on a 7T MRI scanner (Philips Achieva). Resolution of the T2-weighted image at 7T, 3T and 1.5T: 0.75mm3, 3mm3 and 5mm3, respectively. T2-weighted scans were visually assessed by an independent researcher and experienced neuro-radiologist. The T2 hyperintense regions were measured in 3 directions and compared brain structures as reference points between the clinical and 7T scans (e.g. brain stem, gyri), also considering differences in slice thickness and spatial resolution. RESULTS T2 hyperintensity lesion measurements in the AP direction were as follows: GBM: 114.7mm (clinical field strength) vs 115.56mm (7T); ADG: 45mm vs 58.87mm and 24.7mm vs 25.55mm; OD: 45.1mm vs 48.5mm; GBM: 45.3mm vs 44.75mm; suspected LGG: 47.4mm vs 51.57mm; GBM: 105.8mm vs 114.5mm. We observed the largest difference between 3T and 7T T2 hyperintense region measurement to be 13.87mm (30%), belonging to a GBM WHO grade IV patient. For all patients the T2 hyperintense region was measured on average 8.3% larger at 7T MRI compared to the routine clinical MRI scan. Overall the T2 hyperintense regions at 7T appeared sharper and tumor boundaries were better defined. Likewise, the contrast between the tumor and healthy tissue was enhanced, most likely because of the increase in spatial resolution. CONCLUSION In gliomas the T2 hyperintense regions were more extensive at 7T MRI compared to the routine clinical MRI. These preliminary results might indicate that at clinical field strength the extent of the lesion is underestimated and that 7T MRI can potentially aid in detecting this more extensive disease process. Therefore, 7T MRI scan in gliomas might have a future role in treatment decisions regarding the extent of tumor resection and radiotherapy planning.
Access to the digital NHS is not much of a problem in Wales
Authors: Gemma Johns, Sara Khalil, Mike Ogonovsky, Bethan Whistance, Jessica Williams, Alka Ahuja
Journal: BMJ (2021)

True representation is essential when it comes to attesting facts and busting myths, especially related to social groups and inequalities. These myths can cost governments millions of pounds as they attempt to fix an apparent divide. Technology Enabled Care Cymru captures data on digital use across Wales.1 Social demographic and geographic uptake are essential parts of its data …
Time-restricted Eating for the Prevention and Management of Metabolic Diseases
Authors: Emily N C Manoogian, Lisa S Chow, Pam R Taub, Blandine Laferrère, Satchidananda Panda
Journal: Endocrine Reviews (2021)

Time-restricted feeding (TRF, animal-based studies) and time-restricted eating (TRE, humans) are an emerging behavioral intervention approach based on the understanding of the role of circadian rhythms in physiology and metabolism. In this approach, all calorie intake is restricted within a consistent interval of less than 12 hours without overtly attempting to reduce calories. This article will summarize the origin of TRF/TRE starting with concept of circadian rhythms and the role of chronic circadian rhythm disruption in increasing the risk for chronic metabolic diseases. Circadian rhythms are usually perceived as the sleep-wake cycle and dependent rhythms arising from the central nervous system. However, the recent discovery of circadian rhythms in peripheral organs and the plasticity of these rhythms in response to changes in nutrition availability raised the possibility that adopting a consistent daily short window of feeding can sustain robust circadian rhythm. Preclinical animal studies have demonstrated proof of concept and identified potential mechanisms driving TRF-related benefits. Pilot human intervention studies have reported promising results in reducing the risk for obesity, diabetes, and cardiovascular diseases. Epidemiological studies have indicated that maintaining a consistent long overnight fast, which is similar to TRE, can significantly reduce risks for chronic diseases. Despite these early successes, more clinical and mechanistic studies are needed to implement TRE alone or as adjuvant lifestyle intervention for the prevention and management of chronic metabolic diseases.