tbuckley/cabot-search huggingface dataset:
Polyphosphazene and Non‐Catechol‐Based Antibacterial Injectable Hydrogel for Adhesion of Wet Tissues as Wound Dressing
Authors: Zhipeng Ni, Haojie Yu, Li Wang, Xiaowei Liu, Di Shen, Xiang Chen, Jiyang Liu, Nan Wang, Yudi Huang, Yan Sheng
Journal: Advanced Healthcare Materials (2021)

Wound dressings with excellent adhesiveness, antibacterial, self-healing, hemostasis properties, and therapeutic effects have great significance for the treatment of acute trauma. So far, numerous mussel-inspired catechol-based wet adhesives have been reported, opening a pathway for the treatment of acute trauma. However, catechol-based hydrogels are easily oxidized, which limits their applications. Here, the design of a polyphosphazene and non-catechol based antibacterial injectable hydrogel is reported as a multifunctional first aid bandage. Inspired by barnacle cement proteins, a series of dynamic phenylborate ester based adhesive hydrogels are prepared by combining the cation-π structure modified polyphosphazene with polyvinyl alcohol. The inherent antibacterial property (4 h antibacterial rate 99.6 ± 0.2%), anti-mechanical damage, and hemostatic behavior are investigated to confirm multi-functions of wound dressings. In water, the hydrogels firmly adhere to tissue surfaces through cation-π and π-π interactions as well as hydrogen bonding (adhesion strength = 45 kPa). Moreover, in vivo experiments indicate the hydrogels can shorten the bleeding time and reduce the amount of bleeding by 88%, and significantly accelerate the wound healing rate. These hydrogels have a promising application in the treatment of acute trauma, which is in urgent need of anti-infection and hemostasis.
Safety and efficacy of tofacitinib up to 48 months in patients with active psoriatic arthritis: final analysis of the OPAL Balance long-term extension study
Authors: P Nash, L C Coates, D Fleishaker, A J Kivitz, P J Mease, D D Gladman, O FitzGerald, C Wang, J Wu, Hsu M-A., S Menon, L Fallon, K S Kanik
Journal: The Lancet (2021)
Inequalities responsible for thousands of adverse birth outcomes in black and Asian women
Authors: Elisabeth Mahase
Journal: BMJ (2021)

Socioeconomic inequalities account for an estimated quarter of stillbirths, fifth of preterm births, and a third of births with fetal growth restriction, according to a study of over one million births in England.1

The nationwide study across England’s NHS was carried out by the National Maternity and Perinatal Audit team, who analysed birth records between April 2015 and March 2017 to quantify socioeconomic and ethnic inequalities in pregnancy outcomes.

They found that an estimated two thirds (63.7%) of stillbirths and half (55.0%) of births with fetal growth restriction in black women from the most deprived neighbourhoods could be avoided if this population had the same risks as white women living in the most affluent 20% of neighbourhoods.

For South Asian women, half …
Hypoglycemic and Hyperglycemic Crises Among U.S. Adults With Diabetes and End-stage Kidney Disease: Population-Based Study, 2013–2017
Authors: Rodolfo J. Galindo, Mohammed K. Ali, Shealeigh A. Funni, Andrew B. Dodge, Shaheen S. Kurani, Nilay D. Shah, Guillermo E. Umpierrez, Rozalina G. McCoy
Journal: Diabetes Care (2021)

OBJECTIVE We characterized annual trends of severe hypoglycemic and hyperglycemic crises (diabetic ketoacidosis/hyperglycemic hyperosmolar state) in patients with diabetes and end-stage kidney disease (ESKD). RESEARCH DESIGN AND METHODS This was a nationwide, retrospective study of adults (≥18 years old) with diabetes/ESKD, from the United States Renal Data System registry, between 2013 and 2017. Primary outcome was annual rates of emergency department visits or hospitalizations for hypoglycemic and hyperglycemic crises, reported as number of events/1,000 person-years. Event rates and risk factors were adjusted for patient age, sex, race/ethnicity, dialysis modality, comorbidities, treatment regimen, and U.S. region. RESULTS Among 521,789 adults with diabetes/ESKD (median age 65 years [interquartile range 57–73], 56.1% male, and 46% White), overall adjusted rates of hypoglycemic and hyperglycemic crises were 53.64 and 18.24 per 1,000 person-years, respectively. For both hypoglycemia and hyperglycemia crises, respectively, the risks decreased with age and were lowest in older patients (≥75 vs. 18–44 years old: incidence rate ratio 0.35, 95% CI 0.33–0.37, and 0.03, 0.02–0.03), women (1.09, 1.06–1.12, and 1.44, 1.35–1.54), and those with smoking (1.36, 1.28–1.43, and 1.71, 1.53–1.91), substance abuse (1.27, 1.15–1.42, and 1.53, 1.23–1.9), retinopathy (1.10, 1.06–1.15, and 1.36, 1.26–1.47), and insulin therapy (vs. no therapy; 0.60, 0.59–0.63, and 0.44, 0.39–0.48). For hypoglycemia, specifically, additional risk was conferred by Black race (1.11, 1.08–1.15) and amputation history (1.20, 1.13–1.27). CONCLUSIONS In this nationwide study of patients with diabetes/ESKD, hypoglycemic crises were threefold more common than hyperglycemic crises, greatly exceeding national reports in nondialysis patients with chronic kidney disease. Young, Black, and female patients were disproportionately affected.
Well-Being of Nephrology Fellows: Evolution over the Course of a Pandemic Year
Authors: Hitesh H. Shah, Kurtis Pivert, Susan M. Halbach, Anna M. Burgner, Benjamin S. Ko, Lili Chan, Suzanne Boyle, Joshua S. Waitzman, Stephen M. Sozio
Journal: Journal of the American Society of Nephrology (2021)

Background: We sought to assess changes in well-being of nephrology fellows over the first year of the COVID-19 pandemic in the U.S. Methods: The Resident Well-Being Index (RWBI), a validated tool assessing physician distress, was distributed as part of ASN's annual nephrology fellow survey to 920 current adult, pediatric, and adult/pediatric fellows. An RWBI ≥5 (range 0-7) indicated distress. Demographic and fellowship factors associated with meeting the distress threshold were evaluated in univariable and multivariable logistic regression. Results: A total of 511 fellows participated (56% response), of whom 463 completed the RWBI instrument. After 1 year of the COVID-19 pandemic, there were a higher proportion of nephrology fellows meeting the RWBI distress threshold-22% in 2021 versus 15% in 2020. Female nephrology fellows had higher RWBI scores (median 3 [IQR 5]) than their male colleagues (median 1 [IQR 3]). Higher proportions of 1st-year fellows (50% vs 42% for 2nd years, OR 0.61 for 2nd years [95% CI 037-0.99], p=0.046) and women (27% vs 18% of men, OR 1.71 [95%CI 1.06-2.76], p=0.028) met the distress threshold (Figure 1). There were no significant differences by race, ethnicity, medical school location, or adult vs pediatric fellowship. Despite the higher proportion of distress overall, 88% of respondents would recommend nephrology to medical students and residents. Conclusions: Our follow-up assessment of nephrology fellows' well-being after the first year of the COVID-19 pandemic indicate the continued need for supportive measures to ensure the health of the future nephrology workforce, especially among 1st year and women trainees. (Figure Presented).
SquiggleNet: real-time, direct classification of nanopore signals
Authors: Yuwei Bao, Jack Wadden, John R. Erb-Downward, Piyush Ranjan, Weichen Zhou, Torrin L. McDonald, Ryan E. Mills, Alan P. Boyle, Robert P. Dickson, David Blaauw, Joshua D. Welch
Journal: Genome biology (2021)

Abstract We present SquiggleNet, the first deep-learning model that can classify nanopore reads directly from their electrical signals. SquiggleNet operates faster than DNA passes through the pore, allowing real-time classification and read ejection. Using 1 s of sequencing data, the classifier achieves significantly higher accuracy than base calling followed by sequence alignment. Our approach is also faster and requires an order of magnitude less memory than alignment-based approaches. SquiggleNet distinguished human from bacterial DNA with over 90% accuracy, generalized to unseen bacterial species in a human respiratory meta genome sample, and accurately classified sequences containing human long interspersed repeat elements.
Impaired Humoral but Substantial Cellular Immune Response to Variants of Concern B1.1.7 and B.1.351 in Hemodialysis Patients after Vaccination with BNT162b2
Authors: Constantin J. Thieme, Arturo Blazquez-Navarro, Lema Safi, Sviatlana Kaliszczyk, Krystallenia Paniskaki, Isabel E. Neumann, Kita Schmidt, Mara Stockhausen, Jan Hörstrup, Ocan Cinkilic, Linus Flitsch-Kiefner, Toni L. Meister, Corinna Marheinecke, Stephanie Pfaender, Eike Steinmann, Felix S. Seibert, Ulrik Stervbo, Timm H. Westhoff, Toralf Roch, Nina Babel
Journal: Journal of the American Society of Nephrology (2021)

<h3>Abstract</h3> Whole genome sequencing (WGS) is increasingly used to aid in understanding pathogen transmission [1]. Very often the number of single nucleotide polymorphisms (SNPs) separating isolates collected during an epidemiological study are used to identify sets of cases that are potentially linked by direct transmission. However, there is little agreement in the literature as to what an appropriate SNP cut-off threshold should be, or indeed whether a simple SNP threshold is appropriate for identifying sets of isolates to be treated as "transmission clusters". The SNP thresholds that have been adopted for inferring transmission vary widely even for one pathogen. As an alternative to reliance on a strict SNP threshold, we suggest that the key inferential target when studying the spread of an infectious disease is the number of transmission events separating cases. Here we describe a new framework for deciding whether two pathogen genomes should be considered as part of the same transmission cluster, based jointly on the number of SNP differences and the length of time over which those differences have accumulated. Our approach allows us to probabilistically characterize the number of inferred transmission events that separate cases. We show how this framework can be modified to consider variable mutation rates across the genome (e.g. SNPs associated with drug resistance) and we indicate how the methodology can be extended to incorporate epidemiological data such as spatial proximity. We use recent data collected from tuberculosis studies from British Columbia, Canada and the Republic of Moldova to apply and compare our clustering method to the SNP threshold approach. In the British Columbia data, different cases break off from the main clusters as cut-off thresholds are lowered; the transmission-based method obtains slightly different clusters than the SNP cut-offs. For the Moldova data, straightforward application of the methods shows no appreciable difference, but when we take into account the fact that resistance conferring sites likely do not follow the same mutation clock as most sites due to selection, the transmission-based approach differs from the SNP cut-off method. Outbreak simulations confirm that our transmission based method is at least as good at identifying direct transmissions as a SNP cut-off. We conclude that the new method is a promising step towards establishing a more robust identification of outbreaks.
TCT-462 Long-Term Follow-Up Clinical Results of Percutaneous Coronary Intervention in Bifurcated Left Main Coronary Artery Disease
Authors: Ignacio Sanchez-Perez, Ricardo Concepcion-Suárez, Fernando Lozano, Alfonso Freites Esteves, Jorge Martinez del Río, Manuel Muñoz Garcia, Alfonso Morón Alguacil, Martin Negreira, Daniel Aguila-Gordo, Jesus Piqueras-Flores, Ariana Gonzálvez-García
Journal: Journal of the American College of Cardiology (2021)
TCT-228 Prasugrel or Clopidogrel in Patients With Acute Coronary Syndromes With Multivessel Disease: Results From the PROMETHEUS Study
Authors: Mauro Chiarito, Carlo Andrea Pivato, Davide Cao, Zhongjie Zhang, Samantha Sartori, Johny Nicolas, Matteo Nardin, Samir Kapadia, Sandra Weiss, Sunil Rao, Timothy Henry, Mark Effron, William Weintraub, Stuart Pocock, George Dangas, Annapoorna Kini, Roxana Mehran
Journal: Journal of the American College of Cardiology (2021)
Abstract 13831: Handheld Wireless Digital Phonocardiography for Machine Learning-Based Detection of Mitral Regurgitation
Authors: Brent E White, Avi M Shapiro, Mia M Kanzawa, Subramaniam Venkatraman, Jason Paek, Steve Pham, John Maidens, James D Thomas, Patrick M McCarthy
Journal: Circulation (2019)

Background: Mitral regurgitation (MR) is a common disease which can be detected as a murmur on auscultation, but studies show that the majority of new primary care physicians do not detect MR murmu...
Ambient Temperature Stable, Scalable COVID‐19 Polymer Particle Vaccines Induce Protective Immunity
Authors: Shuxiong Chen, Benjamin Evert, Adetayo Adeniyi, Mercè Salla‐Martret, Linda H.‐L. Lua, Victoria Ozberk, Manisha Pandey, Michael F. Good, Andreas Suhrbier, Peter Halfmann, Yoshihiro Kawaoka, Bernd H. A. Rehm
Journal: Advanced Healthcare Materials (2021)

Abstract There is an unmet need for safe and effective severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines that are stable and can be cost‐effectively produced at large scale. Here, a biopolymer particle (BP) vaccine technology that can be quickly adapted to new and emerging variants of SARS‐CoV‐2 is used. Coronavirus antigen‐coated BPs are described as vaccines against SARS‐CoV‐2. The spike protein subunit S1 or epitopes from S and M proteins (SM) plus/minus the nucleocapsid protein (N) are selected as antigens to either coat BPs during assembly inside engineered Escherichia coli or BPs are engineered to specifically ligate glycosylated spike protein (S1‐ICC) produced by using baculovirus expression in insect cell culture (ICC). BP vaccines are safe and immunogenic in mice. BP vaccines, SM‐BP‐N and S1‐ICC‐BP induced protective immunity in the hamster SARS‐CoV‐2 infection model as shown by reduction of virus titers up to viral clearance in lungs post infection. The BP platform offers the possibility for rapid design and cost‐effective large‐scale manufacture of ambient temperature stable and globally available vaccines to combat the coronavirus disease 2019 (COVID‐19) pandemic.
Trends in Hospital Costs and Levels of Services Provided for Children With Bronchiolitis Treated in Children’s Hospitals
Authors: Robert J. Willer, Eric R. Coon, Wade N. Harrison, Shawn L. Ralston
Journal: JAMA Network Open (2021)

Increasing hospital costs for bronchiolitis have been associated with increasing patient complexity and mechanical ventilation. However, the associations of illness severity and diagnostic coding practices with bronchiolitis hospitalization costs have not been examined.To investigate the association of patient complexity, illness severity, and diagnostic coding practices with bronchiolitis hospitalization costs.This retrospective cross-sectional study included 385 883 infants aged 24 months or younger who were hospitalized with bronchiolitis at 39 hospitals in the Pediatric Health Information System database from January 1, 2010, to December 31, 2019.Hospitalization for bronchiolitis.Inflation-adjusted standardized unit cost (expressed in dollar units) per hospitalization over time. A nested subgroup analysis was performed to further examine factors associated with changes in cost.A total of 385 883 bronchiolitis hospitalizations were studied; the patients had a mean (SD) age of 7.5 (6.4) months and included 227 309 of 385 883 boys (58.9%) and 253 870 of 385 883 publicly insured patients (65.8%). Among patients hospitalized with bronchiolitis, the median standardized unit cost per hospitalization increased significantly during the study period (from $5636 [95% CI, $5558-$5714] in 2010 to $6973 [95% CI, $6915-$7030] in 2019; P < .001 for trend). Similar increases in cost were observed among subgroups of patients without a complex chronic condition and without the need for mechanical ventilation. However, costs for patients without a complex chronic condition or mechanical ventilation, who received care outside the intensive care unit did not change in an economically significant manner (from $4803 [95% CI, $4752-$4853] in 2010 to $4853 [95% CI, $4811-$4895] in 2019; P < .001 for trend), suggesting that intensive care unit use was a primary factor associated with cost increases. Substantial changes in coding practices were observed. Among patients hospitalized with bronchiolitis, 1.2% (95% CI, 1.1%-1.3%) were assigned an APR-DRG (All Patient Refined Diagnosis Related Group) for respiratory failure in 2010, which increased to 21.6% (95% CI, 21.2%-21.9%) in 2019 (P < .001 for trend). Increased costs and coding intensity were not accompanied by objective evidence of worsening illness severity.This cross-sectional study suggests that hospitalized children with bronchiolitis are receiving costlier and more intensive care without objective evidence of increasing severity of illness. Changes in coding practices may complicate efforts to study trends in the use of health care resources using administrative data.
TCT-207 First Experience With the Novel Selution SLR Sirolimus-Eluting Balloon in All-Comer Patients Presenting With Acute and Chronic Coronary Artery Disease
Authors: Giacomo Maria Cioffi, Mehdi Madanchi, Adrian Attinger-Toller, Thomas Seiler, Luca Vercelli, Mario Teufer, Mathias Wolfrum, Federico Moccetti, Stefan Toggweiler, Richard Kobza, Matthias Bossard, Florim Cuculi
Journal: Journal of the American College of Cardiology (2021)
A Forgotten Technique of RRT for Correction of Severe Hyponatremia in CKD: Case Report
Authors: Rodolfo A. Moreno, Alexandra M. Trochez, Pedro Gonzales, Antonio J. Palma, Lidia B. Sánchez, Rafael J. Hernández, Jorge A. Hernández
Journal: Journal of the American Society of Nephrology (2021)

Introduction: Patients with chronic kidney disease (CKD) present electrolytes disorders. This represents a challenge when hyponatremia is below 125mmol/L associated with any criteria for urgent renal replacement therapy (RRT) with conventional hemodialysis because of higher risk of over correction above the security threshold of 10mmol/L/day and osmotic demyelination syndrome. Case Description: A 49-year-old Guatemalan female with history of 15 days of edema and slurred speech. Only history of T2DM. Was brought to the ER with BP 100/80mmHg and anasarca. Initial laboratories: negative COVID-19Ag, Cr 5.12mg/dl, (previous 2mg/dl) BUN 105mg/dl, glucose 156mg/dl, Na 108mmol/L, K 5.2meq/L, Cl 70meq/L. SOsm 224mOsm/kg, UOsm 875mOsm/kg, UNa 28meq/L. Because of neurologic symptoms, received a 150ml bolus of 3% saline twice with a rise to 112mmol/L. After the bolus, we initiated a 24-hour infusion with 3% hypertonic solution reaching a rise of Na up to 119mmol/L in 48 hours, but because of persistence of neurologic symptoms plus fluid overload >10% of body weight and hyperkalemia, we initiated RRT. In the absence of CRRT or CVVH we planned a conventional HD with blood flow of 100ml/min, dialysate flow 600ml/min, dialysate Na 130meq/L (the lowest Na possible) and 3 hours duration. After the first session had neurological and edema improvement. After two sessions with interdialytic period of 48 hours, Na control of 122mmol/L and 132mmol/L respectively with resolution of uremic syndrome. Later was diagnosed with hospitalacquired pneumonia receiving antibiotic treatment for 14 days and was discharged home with ambulatory HD. Discussion: In undeveloped countries where the access to CRRT or CVVH is unavailable, conventional modalities can be used with low blood flows and modification of the dialysate Na to a minimum (130mmol/L) offering a safe option to Na correction for patients with severe hyponatremia and any other HD criteria.
Alcohol abstinence and mortality in a general population sample of adults in Germany: A cohort study
Authors: Ulrich John, Hans-Juergen Rumpf, Monika Hanke, Christian Meyer
Journal: PLoS Medicine (2021)

Evidence suggests that people who abstain from alcohol have a higher mortality rate than those who drink low to moderate amounts. However, little is known about factors that might be causal for this finding. The objective was to analyze former alcohol or drug use disorders, risky drinking, tobacco smoking, and fair to poor health among persons who reported abstinence from alcohol drinking in the last 12 months before baseline in relation to total, cardiovascular, and cancer mortality 20 years later.
Endoscopic stenting for stenosing cancer and digestive canal structures
Authors: Yu.M. Stepanov, O.M. Babii, B.F. Shevchenko, S.O. Tarabarov
Journal: GASTROENTEROLOGY (2021)

Background. The purpose of the work was to evaluate the effectiveness of the endoscopic stenting method in stenosing cancer and strictures of the digestive tract. Materials and methods. Since January 2015, endoscopic stenting has been performed in 12 patients using self-expanding nitinol stents with/without polymer coating manufactured by Boston Scientific, Ltd (USA) and uncoated nitinol stents manufactured by Garson (Korea). The study included 8 men (66.7 %) and 4 women (33.3 %) aged 51–80 years, (63.0 ± 4.2) years on average. Stenosing esophageal cancer was diagnosed in 5 patients, stenosing cancer of the gastric outlet— in 3, stenosing duodenal cancer — in one, esophageal stricture — in 3 people. In all patients, the indication for stenting was impaired patency of the digestive tract due to the underlying di-sease. Results. Nutrition was restored in all patients. In the group of stenosing esophageal cancer, the 30-day mortality rate was 20%, the median survival rate was 9 months. Recurrence of dysphagia was diagnosed in one person, recanalization of the stent lumen was performed. In the group with stenosing cancer of the gastric outlet and duodenum, the 30-day mortality rate was 33.3%, the median survival rate was 11 months. Impaired gastric emptying was detected in one patient, repeated stent-to-stent stenting was performed. In the group with esophageal stricture, one individual had stent migration, so the stent was repositioned. Conclusions. Endoscopic stenting with self-expanding nitinol stents in incurable patients with malignant stenoses of the esophagus, stomach, duodenum and in those with benign esophageal strictures is the surgery of choice, a safe and effective method that allows you to restore and continue natural nutrition and thereby improve the quality of life in incurable cases. Complications arising in the late period after stenting were found in 25 % of patients, and were corrected endoscopically.