tbuckley/cabot-search huggingface dataset:
State Variation in Low-Dose Computed Tomography Scanning for Lung Cancer Screening in the United States
Authors: Stacey A Fedewa, Ella A Kazerooni, Jamie L Studts, Robert A Smith, Priti Bandi, Ann Goding Sauer, Megan Cotter, Helmneh M Sineshaw, Ahmedin Jemal, Gerard A Silvestri
Journal: JNCI Journal of the National Cancer Institute (2020)

Annual lung cancer screening (LCS) with low-dose chest computed tomography in older current and former smokers (ie, eligible adults) has been recommended since 2013. Uptake has been slow and variable across the United States. We estimated the LCS rate and growth at the national and state level between 2016 and 2018.The American College of Radiology's Lung Cancer Screening Registry was used to capture screening events. Population-based surveys, the US Census, and cancer registry data were used to estimate the number of eligible adults and lung cancer mortality (ie, burden). Lung cancer screening rates (SRs) in eligible adults and screening rate ratios with 95% confidence intervals (CI) were used to measure changes by state and year.Nationally, the SR was steady between 2016 (3.3%, 95% CI = 3.3% to 3.7%) and 2017 (3.4%, 95% CI = 3.4% to 3.9%), increasing to 5.0% (95% CI = 5.0% to 5.7%) in 2018 (2018 vs 2016 SR ratio = 1.52, 95% CI = 1.51 to 1.62). In 2018, several southern states with a high lung-cancer burden (eg, Mississippi, West Virginia, and Arkansas) had relatively low SRs (<4%) among eligible adults, whereas several northeastern states with lower lung cancer burden (eg, Massachusetts, Vermont, and New Hampshire) had the highest SRs (12.8%-15.2%). The exception was Kentucky, which had the nation's highest lung cancer mortality rate and one of the highest SRs (13.7%).Fewer than 1 in 20 eligible adults received LCS nationally, and uptake varied widely across states. LCS rates were not aligned with lung cancer burden across states, except for Kentucky, which has supported comprehensive efforts to implement LCS.
Patient‐Specific Bone Particles Bioprinting for Bone Tissue Engineering
Authors: Greeshma Ratheesh, Cedryck Vaquette, Yin Xiao
Journal: Advanced Healthcare Materials (2020)

Abstract Although bioinks with both high printability and shape fidelity while maintaining high cell viability are developed, the biofunctionality of the resulting bioprinted construct is often overlooked. To address this, a methacrylated gelatin (GelMA)‐based bioink biofunctionalized with bone particles (BPs) is developed as a personalized treatment strategy for bone regeneration. The bioink consists of incorporating BPs of various sizes (0–500 µm) in GelMA at various concentrations (ranging from 5 to 15% w/v). The printability of the bioink is systematically investigated and it is demonstrated that a 15% w/v BP‐loading results in high print quality for 10% and 12.5% GelMA concentrations. Rheological evaluation reveals a strong shear thinning behavior essential for printing and a high gel strength in bioink with 15% w/v 0–500 µm BPs for both GelMA concentrations. In addition, the printability of the bioink and the metabolic activity of the resulting scaffolds are dependent on both the concentration of hydrogel and size of the BPs. Importantly, the cells initially contained in the BPs are able to migrate and colonize the bioprinted scaffold while maintaining their capacity to express early osteogenic markers. This study demonstrates the feasibility of bioprinted viable BPs and may have some potential for chairside clinical translation.
Abstract 14117: Clinical Characteristics and Cardiovascular Outcomes in Childhood-Onset Hypertrophic Cardiomyopathy
Authors: Nicholas A Marston, Larry Han, iacopo olivotto, Sharlene Day, Euan A Ashley, Michelle Michels, Alexandre D Pereira, Jodie Ingles, Christopher Semsarian, Daniel L Jacoby, Steven D Colan, Rossano Joseph, Samuel Wittekind, James S Ware, Sara Saberi, Adam S Helms, Seema Mital, Carolyn Ho
Journal: Circulation (2020)

Introduction: The prevalence of childhood-onset hypertrophic cardiomyopathy (HCM) is lower than adult-onset disease, thus natural history is not well characterized. We aim to describe the characteristics and outcomes of childhood-onset HCM. Methods: We performed an observational cohort study of 6345 HCM patients from the Sarcomeric Human Cardiomyopathy Registry (SHaRe) and Toronto's SickKids hospital. HCM patients were stratified by age at diagnosis (&lt;1 year (infancy), 1-18 years (childhood), &gt;18 years (adulthood)) and assessed for composite endpoints reflecting heart failure (HF), life-threatening ventricular arrhythmias, atrial fibrillation (AF), and an overall composite that also included stroke and death. Results: Based on defined age of diagnosis stratification, 173 (3%) patients were diagnosed in infancy, 909 (14%) in childhood, and 5263 (83%) in adulthood. Childhood-onset HCM patients had a 2%/year event rate for the overall composite endpoint, with ventricular arrhythmias representing the most common event in the 1st decade following diagnosis, and HF and AF more common by the end of the 2nd decade ( Fig, a ). Sarcomeric HCM was more common in childhood-onset HCM (62%) and carried a worse prognosis than non-sarcomeric disease, including a &gt;2-fold increased risk of HF (HR adj 2.39 [1.36-4.20], p=0.003) and 67% increased risk of overall composite events (HR adj 1.67 [1.16-2.41], p=0.006). When compared to adult-onset HCM, childhood-onset was 36% more likely to develop life-threatening ventricular arrhythmias (HR adj 1.36 [1.03-1.80]) and twice as likely to require transplant or ventricular assist device (HR adj 1.99 [1.23-3.23]) ( Fig, b ). Conclusion: Patients with childhood-onset HCM are more likely to have sarcomeric disease, carry higher risk of life-threatening ventricular arrythmias, and have greater need for advanced HF therapies. These findings provide insight into disease biology and can help improve the precision of risk prediction.
Abstract 14459: The Cardioprotective Effect on Energy Metabolism of Empagliflozin in Heart of Type 2 Diabetes Model Mouse <i>in vivo</i>
Authors: Masamichi Yamamoto, Yuichirou Kitai, Shigenori Yamamoto, Michael P Pieper, Yutaro Kotobuki, Atsutaka Yasui, Motoko Yanagita
Journal: Circulation (2020)

Chronic pathological conditions, such as type 2 diabetes mellitus, involve various mechanisms in promoting heart failure by remodelling energy metabolic pathways and impairing cardiac contractility. The major source of myocardial energetics has been reported to shifts from OXPHOS in normal conditions to glycolysis in heart failure. Therefore, we decided to focus on the effect of empagliflozin on energy metabolic status in the heart.Recently, we generated two types of transgenic mice to monitor energy metabolism, intracellular ATP levels (iATP Tg) and mitochondrial ATP levels (mATP Tg) using FRET biosensor “ATeam” in the whole body, organ, and cellular levels as well as in beating heart. We intercrossed these mice with db/db, a mouse model of type 2 diabetes, and examined the energy metabolism of the heart in the empagliflozin -treated or non-treated groups.db/db;iATP Tg mice were fed EMPA-containing diets (30 mg/kg b.w., day) from 7 weeks of age for 10 weeks, and the ATP levels in the heart were measured by imaging with a fluorescence microscope. The results showed that, unlike the lowered ATP levels in the placebo group, the intracellular ATP level in the heart was significantly increased in the empagliflozin-treated group. Also, the ATP level was recovered in this empagliflozin-treated group to the same level as the wild type.Next, 8 weeks-old db/db;mATP Tg mice received a single dose of empagliflozin (30 mg/kg b.w.) via oral gavage after 4 hr of fasting. After another 3 hr of fasting, monitor the mitochondrial ATP level of the heart in vivo under the fluorescent microscope. The results showed that, unlike the placebo group, the ATP level in the mitochondria of the heart was significantly increased in the empagliflozin-treated group.These results suggest that empagliflozin may restore normal remodelling of energy metabolism in type 2 diabetic hearts.
Abstract 14526: The Effect of Radiofrequency Catheter Ablation of Typical Atrial Flutter on Cardiac Chambers' Size and Function
Authors: Stephanie Jou, Isaac L Goldenthal, Angelo B Biviano, Elaine Wan, Amardeep S Saluja, Jose Dizon, John P Morrow, Geoffrey Rubin, Marc Waase, Frederick Ehlert, Qi Liu, Hasan Garan, Hirad Yarmohammadi
Journal: Circulation (2020)

Introduction: Cavo-tricuspid isthmus (CTI) dependent atrial flutter (AFL) is one of the most common atrial arrhythmias involving the right atrium (RA) for which radiofrequency catheter ablation has been widely used as a therapy of choice. However, there is limited data on the effect of this intervention on cardiac size and function. Hypothesis: CTI dependent ablation for patients with AFL will improve tricuspid valve function, biatrial enlargement, and ventricular function. Methods: A retrospective study was conducted on 468 patients who underwent CTI dependent ablation for clinical typical AFL at a single institution between 2010 and 2019. After patients with congenital or rheumatic heart disease, heart transplant recipients, or those without baseline echocardiogram were excluded, 211 patients remained in the analysis. Echocardiographic data were analyzed at baseline prior to ablation, and at early follow-up within 1-year post-ablation. Follow-up echocardiographic data was available for 130 patients. Results: Of the 211 patients with CTI-AFL, 200 had typical counterclockwise flutter. The mean age was 64.2±12.1 years old with 12% (n=26) female. The average left ventricular (LV) ejection fraction (EF) significantly improved on follow-up echo (45.55±14.26 to 49±14.4%, p=0.0075), of which 63 (48%) patients had an improvement in EF of 5% or more and 19 (25%) patients had an increased EF of 20% or more. The prevalence of moderate to severe tricuspid regurgitation (TR) was 24% (n=50) at baseline and 18% (n=22) at follow-up with no significant difference (p=0.27). However, 30% (n=39) of the patients had one grade or more improvement in their TR within the 1-year follow-up. Echocardiography also showed improvement of RA size in 48.6%, and left atrial (LA) size in 48.2% of the patients. Conclusions: Patients who underwent CTI dependent AFL ablation showed an improvement in cardiac size and function at follow-up evaluation. Although longer-term results are unknown, these findings suggest that restoration of sinus rhythm from atrial flutter is associated with improvement in TR severity, RA size, LA size, and LVEF.
Abstract 14606: Endothelial Injury Biomarkers and Risk Factors Associated With Discordant Risk of Acute Coronary Syndrome Despite Controlled Low-density Lipoprotein Cholesterol Identified by a Novel Coronary Artery Disease Predictive Algorithm
Authors: Ned Premyodhin, WENJUN FAN, Masood Younus, Douglas S Harrington, Nathan D Wong
Journal: Circulation (2020)

Background: Individuals with no history of coronary artery disease can develop acute coronary syndrome (ACS), often in the absence of major risk factors including low-density lipoprotein cholesterol (LDL-C). We identified risk factors and biomarkers that can help identify those at discordantly high risk of ACS who have normal LDL-C using a novel coronary artery disease predictive algorithm (CADPA) incorporating biomarkers of endothelial injury validated in the Multi-Ethnic Study of Atherosclerosis cohort. Methods: Five-year predicted ACS risk was calculated using the CADPA for 8589 patients. Common risk factors and serum levels of 9 biomarkers utilized by the CADPA were tracked. We identified a “discordant high ACS” risk group with serum LDL-C &lt; 130 mg/dL but 5-year CADPA predicted risk ≥ 7.5% and a “discordant low ACS” risk group defined as LDL-C ≥ 130 mg/dL but 5-year CADPA risk of &lt; 7.5%. Multiple logistic regression identified risk factors and biomarkers that predicted discordance in two separate models. Results: The average age and percent male of the high ACS discordant group was higher compared to non-discordant (68±10 vs 54±13 years and 61% vs 43%, respectively). Diabetes (OR 2.84 [2.21-3.66]), male sex (OR 2.83 [2.40-3.35]), family history (OR 2.23 [1.88-2.64]) and active smoking (OR 1.99 [1.50-2.62]) exhibited greatest odds of high ACS discordance compared to other risk factors (all p &lt; 0.01). Increased serum soluble FAS (OR 2.12 [1.97-2.29]), Hemoglobin A1c (OR 1.60 [1.48-1.72]) and interleukin-16 (OR 1.40 [1.32-1.48]) were the biomarkers most associated with discordant risk, independent of global risk factors. Conclusion: Men with diabetes and family history of myocardial infarction who are actively smoking may be at highest risk of developing ACS despite controlled LDL-C. Future studies should examine whether using the CADPA can help identify such individuals that could benefit from earlier targeting of risk factor modification for prevention of ACS.
Abstract 231: Single Bystander CPR Performance During Drone AED Delivery for Simulated Out of Hospital Cardiac Arrest
Authors: Christine Chow, Audrey L Blewer, Edward Sharpe, Lee Van Vleet, Evan Arnold, Joseph Slattery, Daniel M Buckland, Anjni Joiner, Daniel B Mark, Monique A Starks
Journal: Circulation (2020)

Background: Drones have great potential to speed the delivery of AEDs in the critical first few minutes of OHCA. However, it is unclear whether bystanders can balance high-quality cardiopulmonary resuscitation (CPR) with AED deployment. The 2015 AHA CPR guidelines recommend a chest compression (cc) rate of 100-120/minute, cc depth of 50-60mm, and cc fraction of &gt;60%. Method: We performed mock cardiac arrest simulations using bystander volunteers, including simulated 911 call, telephone-assisted dispatcher CPR instructions, bystander CPR, drone-delivered AED, and AED application. CPR performance was recorded by a Laerdal Resusci Anne Quality Feedback System and compared between two groups of participants: recent CPR training (&lt;2 years) versus remote (&gt;2 years) or no CPR training. Prior data had shown CPR skill degradation after 2 years. Chi-squared tests compared demographics; T-tests compared age and CPR performance data. Results: Between 9/2019-3/2020, 5 simulations were conducted with 51 participants. The mean age was 39.7 years, 56.9% were female, and 78.4% had a college or graduate degree. Racial/ethnic makeup consisted of 64.7% White, 15.7% African-American, 15.7% Asian, and 11.8% Hispanic. 41.2% had recent CPR training (n=21); 58.8% had remote CPR training (n=19) or no CPR training (n=11). There were no differences in demographics by CPR training groups. Participants with recent CPR training had shorter time from CPR initiation to AED shock delivery (3:45 vs. 4:14 [min:sec], p=0.01) and a trend toward higher percent of time with cc depth (77.4% vs 50.4%, p=0.11) and higher cc fraction (46.8% vs 42.9 %, p=0.12). There were no differences for percent of time with cc rate or CPR recoil. Conclusion: Overall, CPR quality was low regardless of prior CPR training status. Those recently trained had shorter resuscitation time and appeared to have better CPR performance. Realization of a drone AED networks may require novel CPR programs focused on high-quality CPR.
Flt3 ligand augments immune responses to anti-DEC-205-NY-ESO-1 vaccine through expansion of dendritic cell subsets
Authors: Nina Bhardwaj, Philip A. Friedlander, Anna C. Pavlick, Marc S. Ernstoff, Brian R. Gastman, Brent A. Hanks, Brendan D. Curti, Mark R. Albertini, Jason J. Luke, Ana B. Blazquez, Sreekumar Balan, Davide Bedognetti, Joseph M. Beechem, Andrea S. Crocker, Leonard D’Amico, Patrick Danaher, Thomas A. Davis, Thomas Hawthorne, Bruce W. Hess, Tibor Keler, Lisa Lundgren, Chihiro Morishima, Nirasha Ramchurren, Darawan Rinchai, Andres M. Salazar, Bob A. Salim, Elad Sharon, Laura A. Vitale, Ena Wang, Sarah Warren, Michael J. Yellin, Mary L. Disis, Martin A. Cheever, Steven P. Fling
Journal: Nature Cancer (2020)
Abstract 17182: Coronary Endothelial Dysfunction in Humans is Associated With Elevated Expression of Clonal Hematopoiesis of Indeterminate Potential
Authors: Morsaleh Ganji, Terra Lasho, Takumi Toya, Ali Ahmed, Michel Corban, Lilach O Lerman, Mrinal Patnaik, Amir LERMAN
Journal: Circulation (2020)

Introduction: Recent evidence has demonstrated that Clonal Hematopoiesis of Indeterminate Potential (CHIP) increases the risk of cardiovascular events. However, the exact role played by CHIP in early stages of coronary atherosclerosis, characterized by coronary endothelial dysfunction remains to be elucidated. Hypothesis: The current study was designed to test the hypothesis that the presence of CHIP in peripheral blood cells is associated with coronary endothelial dysfunction and increased levels of inflammatory markers. Methods: Next generation sequencing was used to detect mutations among patients who had coronary endothelial dysfunction and control group (normal coronary endothelial function). Endothelial dysfunction was defined by ≥ 20% decrease in coronary artery diameter or ≤50% increase in blood flow in response to acetylcholine injection compared to baseline. Plasma cytokine levels of Interleukin (IL)-6 and IL-8 were also assessed. Results: Clonal hematopoiesis relevant gene mutations were found in 1 out of 64 patients with normal endothelial function (1.5%) and 11 out of 119 cases in the endothelial dysfunction group (9.2%) (P = 0.04) with ASXL1 (Additional sex combs-like 1) being the most frequent gene (4.2%) mutated. Cytokine analysis demonstrated that mutations in ASXL1, DNMT3A (DNA methyltransferase 3A) and TET2 (Ten-eleven-translocation-2) in the endothelial dysfunction group were associated with increased levels of IL-6 and IL-8 (P = 0.001, P = 0.003; respectively). Conclusions: The current study supports a potential role for CHIP in mechanisms of coronary artery disease starting at early stage of atherosclerosis. Furthermore, enhanced expression levels of IL-6 and IL-8 seem to be related to mutations in DNMT3A, ASXL1 and TET2 genes, more than other gene mutations relevant CHIP.
Emerging arboviruses in the urbanized Amazon rainforest
Authors: Rachel Lowe, Sophie Lee, Raquel Martins Lana, Cláudia Torres Codeço, Marcia C Castro, Mercedes Pascual
Journal: BMJ (2020)

Degradation of rainforest, extreme weather events, and climate change affect the spread of mosquito borne diseases like dengue, chikungunya, and Zika, write <b>Rachel Lowe and colleagues</b>. Urgent action is needed
Fully synthetic injectable depots with high drug content and tunable pharmacokinetics for long-acting drug delivery
Authors: Duy-Khiet Ho, Clare LeGuyader, Selvi Srinivasan, Debashish Roy, Vladimir Vlaskin, Thomas E.J. Chavas, Ciana L. Lopez, Jessica M. Snyder, Almar Postma, John Chiefari, Patrick S. Stayton
Journal: Journal of Controlled Release (2020)
Abstract 16409: Prevalence of Annual Influenza (flu) Vaccination Among Young Adults (18-44 Years) With Cardiovascular Diseases: BRFSS 2018
Authors: Tarang Parekh, Smit Patel, Phani Harshitha Yarlagadda
Journal: Circulation (2020)

Introduction: Influenza (flu) immunization is one of the major goals in Healthy People 2020 and recommended by AHA and ACC as secondary prophylaxis in a person with coronary and other cardiovascular diseases. However, little is known about flu vaccine coverage in young adults with cardiovascular disease (CVD). We aim to take a broader view by assessing the prevalence of flu vaccine by different CVDs among young adults in 2018. Methods: We included 117,978 young adults aged between age 18 to 44 years from BRFSS 2018 with information on the history of flu vaccination and CVD. Flu vaccination was defined as having a flu shot or a vaccine within the past 12 months. CVD was defined as having a history of either heart attack/myocardial infarction (MI), angina/congestive heart disease (CHD), or stroke. We used separate weighted univariate analyses to calculate prevalence for a different set of samples based on age groups (18-34 years, 35-44 years). Results: Overall flu vaccine rate in 2018 remained higher among adults aged 35-44 years compared to younger adults (18-34 years). The flu vaccination rate was comparatively lower among adults aged 35-44 with any CVD (26.7% vs. 28%) than those without any known CVD. In contrast, the vaccine rate was similar among younger adults aged 18-34 regardless of CVD history. Prevalence of flu vaccination was lower (19.5%) among adults aged 18-34 years with MI compared to those without MI (24.5%). Similarly, adults aged 35-44 years with MI reported lower flu vaccine prevalence (22.3% vs. 28.1%) compared to those without MI. Overall individuals with CHD reported higher vaccination rate than those without CHD. Stroke survivors aged 35-44 years reported significantly lower flu vaccine rate than those without stroke. In contrast, the rate was higher among younger stroke survivors (27.3% vs. 24.5%). Conclusions: There is a dire need to increase the annual flu vaccine rate among young adults with CVD to decrease overall morbidity and mortality.
Abstract 13468: Effect of Listing Criteria on Transplant Rate and Early Outcomes in Adults With Congenital Heart Disease
Authors: Wagih m Zayed, Neha Bansal, Snehal R Patel, Jacqueline M Lamour, Daniel J GOLDSTEIN, Ulrich P Jorde, Daphne T Hsu
Journal: Circulation (2020)

Introduction: Heart failure (HF) is the leading cause of death in adults with congenital heart disease (ACHD). Heart transplant (HT) is one of the few options for the treatment of advanced HF in this growing population. In October 2018, the United Network for Organ Sharing (UNOS) implemented a change in organ allocation criteria. The effect of this change on outcomes in ACHD patients (pts) after listing and transplant has not been evaluated. Hypothesis: Change in organ allocation criteria negatively impacts outcomes in ACHD patients. Methods: Data from the Scientific Registry of Transplant Recipients in pts age &gt; 18 years old listed for HT between Oct. 2016 and 0ct. 2019 and followed through March 2020 were analyzed. Pts were grouped by diagnosis (ACHD and non-ACHD) and by the time of listing (pre- and post-change in allocation criteria). Differences in comorbidities, outcomes while listed, and 1-year Kaplan Meier survival post-HT were compared among groups. For comparison, post-change criteria (status 1-6) were equated to pre-change criteria (status 1A, 1B, 2). Results: Over 3 years, 11,931 patients were listed for HT; 459 had a primary diagnosis of ACHD. ACHD was present in 279/7942 pts listed in the 2 years pre-change and 180/3989 pts in the year post-change. ACHD pts listed post-change were less likely to have a history of cardiac surgery (88% vs. 79%, p=0.01) and more likely to have an abnormal BMI (p=0.015) than ACHD pts pre-change. Post-change, ACHD pts were listed at a higher priority status compared to pre-change ACHD. (Figure). The proportion of pts transplanted with ACHD increased slightly pre- and post-change (3.7% vs. 4.1%). There was no difference in 1-year survival in ACHD pts transplanted pre- and post-change (Figure). Conclusions: Recent changes to the UNOS organ allocation policy increased the proportion of ACHD patients transplanted with no change in early post-HT survival.