tbuckley/cabot-search huggingface dataset:
Abstract 14085: Population Health Delivery: A Community Health Needs Assessment Related to Physical Activity and Exercise
Authors: Kavin Sundaram, Erica Podhajsky, Lisa Maher
Journal: Circulation (2020)

Introduction: A community health needs assessment asks members to measure the health of their community by prioritizing problems and identifying the needs. Methods: There are 10 counties in the Cedar Valley Area of Northeast Iowa, USA. Healthcare providers and allied service organizations came together as partners to write online survey to identify the community health needs of Cedar Valley residents. The online survey for residents was posted from March 1-May 15, 2019 and drew 1,554 unique responses. The online Survey Monkey for residents was supplemented by paper surveys distributed to and collected from members of minority church congregations. Responses were tabulated and analyzed. Once the initial responses arrived, the partners reached out to gather additional responses from minority populations to help match the overall return to the market profile. The resident survey was extended 45 days past its original deadline to ensure additional returns. This report focuses on physical inactivity and exercise part of the multi question survey. Results: For the question of risky adult behavior, 45% of the residents identified physical inactivity. For question of what healthy behaviors would you like to start or do more often to improve your health, 77% of the residents identified more exercise. For the question of what prevents you from doing the healthy behavior, 63% identified lack of motivation, 61% identified not enough time. But only 5% said that they were not aware of the healthy options. For the question of what would help you or your family members to start or maintain a healthier lifestyle, 58% identified more affordable facilities, 36% identified employee wellness programs, 32% identified community exercise programs and 17% identified school wellness programs. Conclusion: These results indicate that there is clear awareness in this community that physical inactivity is a risky adult behavior and 95% of the population was aware of exercise as a healthy option. The results also identified specific perceived needs. To achieve high degree of physical activity and exercise and to maintain population health, more efforts need to be focused on wellness programs to improve the motivation and make available affordable facilities.
Abstract IA-20: Team science: Lessons from a few decades on the pancreatic cancer research team
Authors: Steven D. Leach
Journal: Cancer Research (2020)

Abstract With the exception of a few examples of solitary genius embodied by Alfred Russell Wallace and Gregor Mendel, biomedical research has arguably always been a team sport. However, the genomic era has been associated with the increasing realization that large, multi-disciplinary scientific teams are required to push forward ambitious research programs combining computational and experimental work. At the same time, institutional promotions and tenure committees are increasingly recognizing participation and success in “team science” as worthy criteria for academic advancement. Opportunities for multi-institutional and multi-disciplinary collaboration are especially abundant in pancreatic cancer research, as our field is known for its particularly strong sense of community and for its collegial and collaborative spirit. Motivations for pursuing collaborative team science vary widely, and include the need to assemble the necessary workforce required to complete an ambitious body of work, transcend individual research disciplines, provide optimal educational opportunities for trainees, defuse unproductive competition, avoid being “scooped”, and simply to build fulfilling lifelong relationships with scientific colleagues. There are also many strategies by which investigators can effectively pursue team science, not all of which involve multiple authorship. In this short talk, I will review these motivations and strategies, drawing on lessons learned during several decades on the pancreatic cancer research team. Citation Format: Steven D. Leach. Team science: Lessons from a few decades on the pancreatic cancer research team [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2020 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2020;80(22 Suppl):Abstract nr IA-20.
Abstract 13432: Left Ventricular External Work as a Marker of Cardiac Functional Recovery and Outcome After Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis
Authors: Shingo Tsujinaga, Hiroyuki Iwano, Ko Motoi, Yasuyuki Chiba, Suguru Ishizaka, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal: Circulation (2020)

Background: Prediction of cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) is still challenging. We hypothesized that left ventricular (LV) external work estimated by echocardiography before TAVR would reflect potential myocardial damage and thus could be associated with changes in cardiac function and prognosis after TAVR. Methods: Echocardiography was performed in 70 AS patients (83 ± 5 years old) before and after TAVR (1 month and 6 months). LV stroke work index (SWI) was calculated as stroke volume index (SVI) х [mean systemic blood pressure + mean pressure gradient across aortic valve (mPG)] before TAVR as a parameter of LV external work. Patients were divided into reduced and preserved SWI group based on the median value (6106 mmHg · mL/m 2 ). Cardiac events were defined as cardiac death or worsening heart failure within 12 months after TAVR. Results: Reduced group had lower SVI (40 ± 7 vs 57 ± 8 mL/m 2 ), mPG (44 ± 14 vs 57 ± 16 mmHg), and smaller aortic valve area index (0.4 ± 0.1 vs 0.5 ± 0.1 cm 2 /m 2 ) than preserved group at baseline (p &lt; 0.05 for all), although LV mass index (LVMI) (116 ± 35 vs 128 ± 30 g/m 2 ) and left atrial volume index (LAVI) (56 ± 20 vs 52 ± 17 mL/m 2 ) were comparable. LV ejection fraction (EF) (57 ± 13 vs 66 ± 7%) and global longitudinal strain (GLS) (–14.2 ± 4.6 vs –16.6 ± 4.8%) at baseline were significantly lower in reduced group than in preserved one. After TAVR, LVMI and LAVI did not change in reduced group ( Table 1 ). In contrast, preserved group showed significant decrease in these parameters. Although LV EF did not change in both groups, GLS was significantly improved only in preserved group but not in reduced group ( Table 1 ). Seven patients (10%) experienced cardiovascular events after TAVR and all these belonged reduced group. Conclusions: Reduced SWI before TAVR was associated with poor response in cardiac function after TAVR and might be a prognostic marker in AS patients undergoing TAVR.
Abstract 15412: Long-term Outcomes of the Truncal Valve in Truncus Arteriosus
Authors: Laura Gellis, Geoffrey Binney, Minmin Lu, Laith Alshawabkeh, John E Mayer, Mary P Mullen, Anne M Valente, Lynn A Sleeper, David W BROWN
Journal: Circulation (2020)

Objectives: Long-term survival in patients with truncus arteriosus (TA) is favorable, but there remains significant morbidity associated with need for ongoing re-interventions. The purpose of this study was to understand the long-term outcomes of the truncal valve (TV) and identify risk factors associated with the need for TV intervention. Methods: We retrospectively reviewed 170 patients who underwent initial TA repair at our institution from 1985-2015. Analysis of long-term outcomes was performed on the 148 patients who survived greater than 30 days post-operatively and to hospital discharge using multivariable competing risks Cox regression modeling. Results: Median follow up time was 12.6 years (IQR 5.0, 22.1 years) after full repair. Freedom from death or transplant at 1, 5, 10, and 20 years was 93.1 ± 2.1%, 88.0 ± 2.7%, 86.2 ± 3.0% and 78.3 ± 4.1%. Thirty patients (20%) underwent at least one intervention on the TV (22 repairs, 21 replacements). Freedom from any TV intervention at 1, 5, 10 and 20 years was 99 ± 1%, 94 ± 8%, 82 ± 9%, and 70 ± 5%. Of those with TV repair, 59% subsequently underwent TV replacement. Independent risk factors for need for TV intervention included ≥moderate TV regurgitation (TVR) (HR 4.77, p&lt;0.001) or stenosis (HR 4.12, p&lt;0.001) prior to full repair, and ≥moderate TVR at initial hospital discharge after full repair (HR 8.6, p&lt;0.001). A single coronary ostium was also independently associated with need for TV intervention (HR 6.94, p=0.01). Quadricuspid valve morphology and TV repair at initial TA repair, risk factors in univariate analysis, were not independent predictors on multivariable analysis. Overall, 28% of patients progressed to ≥moderate TVR and to Z-scores of greater than 5 for valve dimensions. Conclusion: Long-term need for TV intervention remains significant. Moderate or worse initial TVR or stenosis, residual TVR after initial TA repair, and single coronary ostium are risk factors associated with need for subsequent TV intervention.
AB0901 PREVALENCE OF OSTEOPOROSIS IN ITALIAN POSTMENOPAUSAL WOMEN ACCORDING TO DEFRA ALGORITHM
Authors: A. M. Lurati, A. Laria, L. Castelnovo, P. Faggioli, A. Tamburello, A. Mazzone
Journal: Annals of the Rheumatic Diseases (2020)

Background: Osteoporosis is a recognized health problem and the burden of the disease is mostly associated with the occurrence of hip and vertebral fracture. Objectives: This study was aimed at evaluating the prevalence of osteoporosis in Italian postmenopausal women, defined by DeFRA calculation as a 10 years fracture risk equal or higher than 20%. Methods: This is a monocenter cohort study evaluating 1850 post-menopausal women aged 50 years and older. All the participants were evaluated as far as anthropometrics. Defra questionnaire was administered and calculated with bone mineral density (DXA) measured at lumbar spine and femoral neck. Results: The prevalence of osteoporosis as assessed by DeFRA was 29.8% in the whole population, according to literature. The frequency of a risk fracture equal or higher than 20% varied from 7.9% in the group aged 50-59 years to 35% in subjects aged &gt;80. Among clinical risk factors for fracture, the presence of a previous fracture (spine primarily) was the most commonly observed. Conclusion: Our data showed that about one third of post-menopausal women aged 50 and older in Italy has osteoporosis on the basis of DeFRA algorithm, with a high 10 years fracture risk. A previous fracture is the most common risk factor. The data should be considered in relation to the need to increase prevention strategies and therapeutic intervention. Disclosure of Interests: None declared
Establishing key research questions for the implementation of artificial intelligence in colonoscopy: a modified Delphi method
Authors: Omer F. Ahmad, Yuichi Mori, Masashi Misawa, Shin-ei Kudo, John T. Anderson, Jorge Bernal, Tyler M. Berzin, Raf Bisschops, Michael F. Byrne, Peng-Jen Chen, James E. East, Tom Eelbode, Daniel S. Elson, Suryakanth R. Gurudu, Aymeric Histace, William E. Karnes, Alessandro Repici, Rajvinder Singh, Pietro Valdastri, Michael B. Wallace, Pu Wang, Danail Stoyanov, Laurence B. Lovat
Journal: Endoscopy (2020)

BACKGROUND : Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed to identify the top implementation research priorities. METHODS : An established modified Delphi approach for research priority setting was used. Fifteen international experts, including endoscopists and translational computer scientists/engineers, from nine countries participated in an online survey over 9 months. Questions related to AI implementation in colonoscopy were generated as a long-list in the first round, and then scored in two subsequent rounds to identify the top 10 research questions. RESULTS : The top 10 ranked questions were categorized into five themes. Theme 1: clinical trial design/end points (4 questions), related to optimum trial designs for polyp detection and characterization, determining the optimal end points for evaluation of AI, and demonstrating impact on interval cancer rates. Theme 2: technological developments (3 questions), including improving detection of more challenging and advanced lesions, reduction of false-positive rates, and minimizing latency. Theme 3: clinical adoption/integration (1 question), concerning the effective combination of detection and characterization into one workflow. Theme 4: data access/annotation (1 question), concerning more efficient or automated data annotation methods to reduce the burden on human experts. Theme 5: regulatory approval (1 question), related to making regulatory approval processes more efficient. CONCLUSIONS : This is the first reported international research priority setting exercise for AI in colonoscopy. The study findings should be used as a framework to guide future research with key stakeholders to accelerate the clinical implementation of AI in endoscopy.
Abstract 14397: Sotatercept Analog RAP-011 Inhibits Right Ventricular Remodeling and Restores Function in a Mouse Model of Pressure Overload
Authors: Sachindra R Joshi, Jun Liu, R. Scott Pearsall, Patrick Andre, Gang Li, Kumar Ravindra
Journal: Circulation (2020)

IIntroduction: Right ventricular (RV) failure is the primary cause of death in patients with pulmonary arterial hypertension (PAH). Beneficial effects of sotatercept - an activin receptor type IIA-Fc fusion protein that traps activins and growth differentiation factors - have been reported in PAH patients treated with standard-of-care therapies in a recent phase 2 study (PULSAR). We have reported that therapeutic treatment with sotatercept analog RAP-011 reverses RV remodeling and function in rats with severe angio-obliterative PAH, providing benefits on top of standard care. Hypothesis: To determine whether RAP-011 exerts a direct cardioprotective effect in a mouse model of pressure overload-induced RV failure. Methods: RV failure was induced in male C57BL/6 mice by pulmonary artery banding (PAB). RAP-011 or vehicle were administered subcutaneously twice weekly for 3 weeks beginning one day post surgery. RV remodeling and function were assessed by echocardiography and RV pressure measured by catheterization. RV fibrosis was assessed by Masson’s trichrome staining. Results: PAB caused RV hypertrophy and increased RV wall thickness in comparison to sham surgery. RAP-011 treatment markedly attenuated these PAB-induced changes (by 72% and 41%, respectively; P &lt; 0.0001). PAB significantly reduced tricuspid annular plane systolic excursion (0.68 ± 0.03 vs. 0.98 ± 0.03 mm), which was partially restored by RAP-011 (0.84 ± 0.04 mm; P &lt; 0.01). In addition, the PAB-induced increase in myocardial performance index was reversed by RAP-011 (1.86 vs. 1.48, P &lt; 0.0001). RAP-011 attenuated PAB-induced RV developed pressure (by 82%, P &lt; 0.0001) and partially normalized peak rates of RV pressure change (+dP/dt max and -dP/dt min , P &lt; 0.05). RAP-011 also reduced the extent of PAB-induced RV fibrosis (19.5% vs. 10.5%, P &lt; 0.001). Conclusions: Consistent with our previous findings in a rat model of severe angio-obliterative PAH, RAP-011 treatment reduces RV remodeling and improves function in a PAB model, thus implicating direct cardioprotective actions of RAP-011 as an important component of its therapeutic effects in severe experimental PAH.
Abstract 14565: Simultaneous Heart-Kidney Transplant - Does Hospital Experience With Heart Transplant or Kidney Transplant Have a Greater Impact on Patient Outcomes?
Authors: Michael A Catalano, Stevan Pupovac, Brian Lima, Gerin R Stevens, Alan R Hartman, Pey-Jen Yu
Journal: Circulation (2020)

Objective: High institutional transplant volume is known to be associated with improved outcomes in heart transplant and kidney transplant. However, little is known regarding the impact of institutional experience on outcomes in simultaneous heart-kidney transplant (SHKT). The aim of this study was to assess trends and outcomes of SHKT nationally, as well as the impact of institutional heart and kidney transplant volume on mortality for SHKT patients. Methods: All adult patients (age ≥18) who underwent SHKT between 2005 - 2019 were identified using the United Network for Organ Sharing (UNOS) database. Annual institutional volume in heart transplant and kidney transplant were determined. Univariate and multivariable analyses were conducted to assess the impact of patient demographics, comorbidities, and institutional transplant volumes on 1-year mortality. Results: There were 1564 SHKT identified in the sample, increasing fourfold from 54 in 2005 to 221 in 2019 (p &lt; .001). Median annual institutional heart transplant volume among centers performing SHKT was 35 (IQR 24 - 56); median annual kidney transplant volume was 166 (IQR 89 - 224). One-year mortality was 11.8%. In multivariable analysis, increasing annual institutional heart transplant volume was associated with reduced 1-year-month mortality. Contrarily, annual institutional kidney transplant volume was not associated with mortality. Increasing body mass index, dialysis, requirement for extracorporeal membrane oxygenator support (ECMO) at time of transplant, ischemic times, and total bilirubin levels were independently associated with increased 1-year mortality (Table 1). Conclusion: Increased institutional heart transplant volume is associated with reduced mortality in SHKT. A similar association was not identified between institutional kidney transplant volume and mortality. Thus, emphasis should be placed on high-volume heart transplant centers to manage SHKT patients.
Abstract 367: Factors That Influence Emergency Responder Treatment Versus Transport Decisions for Out-of-hospital Cardiac Arrest
Authors: Valencia Waller, Sydney Fouche, Kaitlyn Entel, Nasma Berri, Wilson Nham, Courtney Armstrong, Jane Forman, Brahmajee K Nallamothu, Christopher Nelson, Peter Mendel, Mahshid Abir
Journal: Circulation (2020)

Introduction: Emergency medical system factors that improve out-of-hospital cardiac arrest (OHCA) survival have not been well elucidated. This study explores factors important to decisions to transport patients before obtaining sustained return of spontaneous circulation (ROSC) in the field throughout the OHCA system of care. Choosing to treat versus transport is a complex decision and reflects various aspects of EMS care that may differ across agencies at different levels of performance. Methods: This sequential mixed-methods study used data from the Michigan Cardiac Arrest Registry to Enhance Survival (MI-CARES) for the years 2014—2017 to identify variation in OHCA outcomes across emergency medical services (EMS) agencies. We then sampled emergency medical stakeholders—dispatch, fire, police, EMS, and receiving emergency departments (EDs)—across nine EMS system sites of varied urbanicity: four high-survival, two intermediate-survival, and three low-survival based on a primary outcome of sustained ROSC with pulse upon ED arrival. To qualitatively explore variations in OHCA survival, we conducted key informant and focus group interviews at each site. Qualitative data were analyzed through combined rapid and rigorous analysis, with a focus on treat versus transport decisions in the Advanced Care link of the “chain of survival” within a broader system of care framework. Results: Key factors that weighed into OHCA treatment versus transport decisions pre-ROSC across all sites included: clearly defined roles and protocols, on-scene decision-making authority, distance to the hospital, level of training and expertise, resource availability with regard to personnel and equipment, and payment and reimbursement models. Conclusions: Recognizing the critical role of each link in the “chain of survival,” this study identified key factors that impact treat versus transport decisions from the perspective of EMS stakeholders. The next phase of this work will include validating the importance of the identified factors to OHCA survival through a statewide survey of EMS agencies in Michigan. The final product will be a toolkit of best practices to improve survival across U.S. communities.
Improving target assessment in biomedical research: the GOT-IT recommendations
Authors: Christoph H. Emmerich, Lorena Martinez Gamboa, Martine C. J. Hofmann, Marc Bonin-Andresen, Olga Arbach, Pascal Schendel, Björn Gerlach, Katja Hempel, Anton Bespalov, Ulrich Dirnagl, Michael J. Parnham
Journal: Nature Reviews Drug Discovery (2020)
Abstract 124: Chest Compression Pause Duration is Associated with Worse Survival Outcomes Following Pediatric In-hospital Cardiac Arrest
Authors: Kasper Glerup Lauridsen, Ryan W Morgan, Robert A Berg, Dana E Niles, Monica E Kleinman, Xuemei Zhang, Heather M Griffis, Hiroshi Kurosawa, Jimena Del Castillo, Sophie Skellett, Javier J Lasa, Tia T Raymond, Jordan M Duval-arnould, Robert M Sutton, Vinay M Nadkarni
Journal: Circulation (2020)

Introduction: The association between chest compression (CC) pause duration and pediatric in-hospital cardiac arrest (IHCA) survival outcomes is unknown. We hypothesized that longer maximum CC pause durations are associated with worse survival and neurological outcomes. Methods: Cohort study of all index pediatric IHCAs (&lt;18 years of age) ≥1 min in the Pediatric Resuscitation Quality (PediRES-Q) Network from July 2015 through December 2019. We used multivariate logistic regression with mixed effects and robust standard errors to analyze association of 5-sec increments of longest CC pause duration with survival and neurologic outcomes. Favorable neurological outcome was defined as Pediatric Cerebral Performance Category (PCPC) at discharge ≤3 or no change from baseline. Results: We identified 371 index IHCAs: median [Q1,Q3] age 2.6 [0.6,9.4] years, female 46%, shockable rhythm 13%, CPR duration 23 [9,47] min. Median length of the longest pause was 17 [8,27] sec. Each 5 sec increase in longest CC pause duration was associated with 6% lower odds for survival with favorable neurological outcome, even after adjusting for age, defibrillation, intubation, extracorporeal CPR, illness category, hypotension as etiology for arrest, CC depth, and clustering by site (aOR 0.94 [95% CI:0.88-0.99], p=0.04). Analyses controlling for the same factors demonstrated an association of longest pause duration with lower odds for survival to hospital discharge (aOR 0.94 [95% CI: 0.90-0.99, p=0.02) and return of spontaneous circulation (aOR 0.91 [(95% CI: 0.86-0.96], p=0.001). Conclusions: Longest CC pause duration is associated with favorable neurological outcome, survival to hospital discharge, and return of spontaneous circulation following pediatric IHCA, even when controlling for known confounders and clustering by site. Each 5 sec. increment in longest CC pause duration was associated with 6% lower odds for survival with favorable neurological outcome.