tbuckley/cabot-search huggingface dataset:
Abstract 14607: Randomized Controlled Trial of Once-Per-Week Intermittent Fasting for the Reduction of Low-Density Lipoprotein Cholesterol
Authors: Ciera Bartholomew, Joseph B Muhlestein, Heidi T May, Viet T Le, Oxana Galenko, Kelly D Garrett, Cherie Brunker, Ramona Hopkins, Kristin Konery, Jeffrey L Anderson, John F Carlquist, Kirk U Knowlton, Bruce W Bailey, Benjamin D Horne
Journal: Circulation (2020)

Introduction: High-frequency intermittent fasting (IF) diets reduce weight similarly to continuous calorie restriction (CR). In patients with type 2 diabetes, twice-weekly IF and CR equivalently reduced HbA1c. IF may improve chronic disease risk factors, but no controlled trial has evaluated whether IF reduces low-density lipoprotein cholesterol (LDL-C), regardless of weight loss, in patients with elevated LDL-C. Hypothesis: The Weekly ONe-Day watER-only Fasting interventionaL (WONDERFUL) randomized (1:1) controlled trial (NCT02770313) tested whether IF reduced LDL-C compared to ad libitum control over 6 months. Methods: Subjects (N=103) were ages 21-70 years, not taking a statin, had elevated baseline LDL-C (90-189 mg/dL for ages 21-39, 90-159 mg/dL for ages 40-70, ≥90 mg/dL for statin intolerant/contraindicated), and had diet-controlled type 2 diabetes or ≥1 metabolic syndrome feature but no anti-diabetes medication. The water-only IF regimen was 4 weeks of 2/week 24-hour IF followed by 22 weeks of 1/week 24-hour IF. Exclusions included pregnant, lactating, or chronic disease (e.g., CAD, MI, stroke/TIA, CKD, COPD, cancer, PE, PAD, DVT, dementia, type 1 diabetes). Results: At baseline, IF (n=50) and control (n=53) were, respectively, 49.3±12.0 and 47.0±9.8 years of age, 66.0% and 67.9% females, weight 103±24 and 100±21 kg, and LDL-C 124±19 and 128±20 mg/dL. Lost to follow-up (n=5 IF, n=4 control) and withdrawals (n=7 IF, n=16 control) gave a final sample of n=71 (n=38 IF, n=33 control). LDL-C change from baseline to 6 months was not different between IF and control (Table). HOMA-IR, one of 4 pre-specified secondary endpoints, was improved (-0.75 vs. -0.10) at p≤0.01 vs. control (Table). Conclusions: A once-per-week IF regimen did not reduce LDL-C compared to control, but HOMA-IR was significantly reduced. This more sustainable IF regimen may reduce some chronic cardiometabolic disease risks (e.g., HOMA-IR) with minimal effects on cholesterol and weight.
Abstract 311: Machine Learning of the Electrocardiogram to Detect Regional Structural Abnormalities of the Heart
Authors: Albert J Rogers, James Tooley, Vyom Thakkar, Jessica Torres, JUSTIN XU, Neal K Bhatia, Jagteshwar Tung, Mahmood Alhusseini, Tina Baykaner, Gari Clifford, Matei Zaharia, Euan A Ashley, Marco V Perez, Sanjiv M Narayan
Journal: Circulation (2020)

Introduction: Regional dysfunction of cardiac myocardium can result from diverse underlying conditions and cause adverse events even in patients without clinically apparent cardiovascular disease over ejection fraction. Assessment of regional wall motion abnormalities (WMA) currently requires sophisticated imaging that is not feasible for population screening or frequent disease monitoring. Hypothesis: We hypothesized that an AI-enabled ECG model trained on a dataset of qualitative labels could identify and localize wall motion abnormalities with higher accuracy than traditional ECG analysis Methods: In a large academic center, a deep convolutional network was developed with raw 12-lead ECGs and associated reports from 82,424 transthoracic echocardiograms (N = 50,960 patients, age 64 ± 17 years, 54.5% male). 80% of the data was used in model development and the remaining 20% was used for testing. ECGs with ventricular pacing and non-finalized echocardiography reports were excluded. Pre-processing included Kors transformation and beat extraction for input size of 3x300 samples (Figure 1A) and output labels were established by NLP of semi-structured echocardiography reports. Results: ML ECG based models predicted inferior/posterior regional wall motion abnormality with C-statistic of 0.772 (Figure 1B). Physician interpretation of Q-wave ECG pattern was inferior (C-statistic of 0.505). Other segments had similar AUC (apex 0.81, anterior 0.80, lateral 0.75, septal 0.75). Patients with positive ECG screen had +LR 2.70 of having a wall motion abnormality on echocardiography and patients with WMA by echocardiography had decreased survival (LR 0.41, CI: 0.34-0.47, p&lt;0.005) mortality over follow-up of &gt;1500 days (Figure 1C). Conclusion: This study is the first to evaluate the presence and location of regional wall motion abnormalities from inexpensive and noninvasive 12-lead ECG. This approach could be applied for widespread ambulatory screening.
Integrated-omics endotyping of infants with rhinovirus bronchiolitis and risk of childhood asthma
Authors: Yoshihiko Raita, Carlos A. Camargo, Yury A. Bochkov, Juan C. Celedón, James E. Gern, Jonathan M. Mansbach, Eugene P. Rhee, Robert J. Freishtat, Kohei Hasegawa
Journal: Journal of Allergy and Clinical Immunology (2020)
Abstract 16320: Enhanced Tissue Repair by Myoblast Administration With Extracellular Matrix Framework Through Regulation of Macrophage Polarization in Hind Limb Ischemia
Authors: Keisuke Miyake, Shigeru Miyagawa, Takashi Shibuya, Yoshiki Sawa
Journal: Circulation (2020)

Introduction: How to control inflammation, especially induction of macrophage polarization that are regulated by Extra-cellular matrix (ECM) is a prerequisite for tissue regeneration in damaged organs. In this study, we administered clustered myoblast cells with ECM framework into hind limb ischemia (HLI) model, and evaluated the change in macrophages and effect on tissue regeneration. Methods: Myoblast cells isolated from C57BL/6 mice were expanded to form cell patch with ECM framework (10 6 cells/sheet) and then fragmented and administered as cluster cells (CC group, n=6). As control groups, non-clustered single myoblast cells (SC, n=6) or saline (SA, n=6) was administered. Blood perfusion was evaluated with Laser Doppler Perfusion imaging (LDPI). Leg muscles were obtained and analyzed regarding angiogenesis, skeletal muscle regeneration, and inflammation including macrophage status. Results: LDPI showed significant improvement in CC compared with SC (P=0.001) and SA (P&lt;0.0001) at day 28. Also, markedly augmented angiogenesis and muscle regeneration were detected in CC. Regarding inflammation, the number of CD68+ macrophages is significantly larger in CC throughout within 7 days after administration, but the character of the macrophages was quite different during time courses. Although in SC and SA macrophage polarization was rarely detected within 7 days, marked polarization was detected at day 5 only in CC. At day 5, CD11c+/CD206- (inflammatory, M1) and CD11c-/CD206+ (anti-inflammatory, M2) macrophages are discerned conspicuously (M1: 148.7±104.4/mm 2 , M2: 185.2±46.3/mm 2 , non-polarized CD11c+/CD206+: 140.9±99.4/mm 2 ), while at day 3 non-polarized macrophages were almost exclusive (M1: 2.0±2.3/mm 2 , M2: 3.1±4.0/mm 2 , CD11c+/CD206+: 410.2±90.6/mm 2 ). Consistently significant increase in IL-10 and TGF-β, that are cytokines secreted by M2 macrophages, was detected at day 5 and 7 in CC. Conclusions: Myoblast cells administration with ECM framework, which was formed during cell patch formation, augmented macrophage polarization to show anti-inflammatory effect, creating appropriate microenvironment for angiogenesis and muscle regeneration in HLI.
Effect of video conference clinics on medical education
Authors: Alexander E Dalton, Thomas L Christensen, Hannah F Starling
Journal: BMJ (2020)

Thank you to Car and colleagues for providing clear and comprehensive guidance for digital consultations.1 It is something that medical students are seeing more frequently. It is not included in our curriculum, unfortunately, and as a result our digital consultation skills are lacking.

As medical students, we have observed clinics in primary and secondary care both before and …
Machine-learned epidemiology: real-time detection of foodborne illness at scale
Authors: Adam Sadilek, Stephanie Caty, Lauren DiPrete, Raed Mansour, Tom Schenk, Mark Bergtholdt, Ashish Jha, Prem Ramaswami, Evgeniy Gabrilovich
Journal: npj Digital Medicine (2018)

Machine learning has become an increasingly powerful tool for solving complex problems, and its application in public health has been underutilized. The objective of this study is to test the efficacy of a machine-learned model of foodborne illness detection in a real-world setting. To this end, we built FINDER, a machine-learned model for real-time detection of foodborne illness using anonymous and aggregated web search and location data. We computed the fraction of people who visited a particular restaurant and later searched for terms indicative of food poisoning to identify potentially unsafe restaurants. We used this information to focus restaurant inspections in two cities and demonstrated that FINDER improves the accuracy of health inspections; restaurants identified by FINDER are 3.1 times as likely to be deemed unsafe during the inspection as restaurants identified by existing methods. Additionally, FINDER enables us to ascertain previously intractable epidemiological information, for example, in 38% of cases the restaurant potentially causing food poisoning was not the last one visited, which may explain the lower precision of complaint-based inspections. We found that FINDER is able to reliably identify restaurants that have an active lapse in food safety, allowing for implementation of corrective actions that would prevent the potential spread of foodborne illness.
Hyperacute Spontaneous Intracerebral Hemorrhage During Computed Tomography Scanning
Authors: Bence Gunda, Péter Böjti, Lajos R. Kozák
Journal: JAMA Neurology (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Neurology journal
Surgical outcomes of testicular prostheses implantation in transgender men with a history of prosthesis extrusion or infection
Authors: Catherine M. Legemate, Freek P. W. de Rooij, Mark-Bram Bouman, Garry L. Pigot, Wouter B. van der Sluis
Journal: International Journal of Transgender Health (2020)

Background: Testicular prostheses implantation may be used for neoscrotal augmentation in transgender men. In current literature, explantation rates range from 0.6% to 30% and most are a result of infection or extrusion. Information on the surgical path of individuals after prosthesis explantation is scarce.Aim: To assess the frequency and success rate of testicular prosthesis implantation after previous explantation due to infection or extrusion.Methods: All transgender men who underwent testicular prosthesis explantation between January 1991 and December 2018 were retrospectively identified from a departmental database. A retrospective chart study was conducted, recording demographics, surgical and prosthesis characteristics, reoperations, and outcomes.Results: A total of 41 transgender men were included who underwent testicular prosthesis explantation in the study time period. Of these, 28 (68%) opted for new prosthesis implantation. Most explanted prosthesis had a volume ≥30cc and were replaced with an equally sized one. The postoperative course was uneventful in 19 out of 28 (68%) individuals. Explantation of one or both prostheses occurred in 7 out of 28 (25%) individuals, because of infection (n = 3, 11%) or extrusion (n = 4, 14%). Patients that experienced complications had more often a history of smoking (p = 0.049). The explantation rate was lower if a smaller or lighter prosthesis was reimplanted (p = 0.020).Discussion: Most patients opt for testicular prosthesis implantation after previous explantation due to extrusion or infection. Explantation rates are higher than after the primary implantation procedure. Results of current study can be used to inform individuals on postoperative outcomes.
Abstract 16383: Inhibition of Egfr Signalling Promotes Maladaptive Cardiac Remodelling in Hypertensive Heart Disease
Authors: Susanna Cooper, Zoe Haines, Viridiana Alcantara Alonso, Joshua J Cull, Feroz Ahmad, Hajed O Alharbi, Stephen Fuller, Peter Sugden, Angela Clerk, Daniel N Meijles
Journal: Circulation (2020)

Introduction: Epidermal growth factor (EGF) receptors (EGFRs: ERBB1-4) are activated by a family of ligands (e.g. EGF, Hb-EGF, EREG, TGFa), signaling through ERK1/2 and Akt to promote cell division and cancer. Antibody-based inhibition of ERBB2 in breast cancer can cause heart failure, but the role of other receptors and EGFR ligands in the heart, and potential cardiotoxicity of generic EGFR inhibitors is unclear. Hypothesis: We hypothesize that EGFR ligands play an important role in cardiac adaptation to hypertension, acting through EGFRs to promote adaptive remodelling. Methods &amp; Results: EGF ligand/receptor mRNA expression was assessed in human failing hearts and normal controls (n=12/8). EGFRs were expressed at similar levels, but ligand expression differed with significant up- or downregulation of EGF/Hb-EGF vs EREG/TGFa, respectively, in failing hearts (p&lt;0.05). EGF potently activated ERK1/2 and Akt (assessed by immunoblotting) in neonatal rat cardiomyocytes, leading to hypertrophy (p&lt;0.05, n=4). The anti-cancer drug afatinib inhibits EGFRs. To assess the role of EGF signaling in cardiac adaptation to hypertension in vivo , C57Bl/6J mice (n=6) were treated with 0.8 mg/kg/d angiotensin II (AngII; 7d) ± 0.45 mg/kg/d afatinib. AngII promoted cardiac hypertrophy with increased left ventricular (LV) wall thickness (WT) and decreased LV internal diameter (ID; assessed by echocardiography). Afatinib enhanced AngII-induced hypertrophy with significantly increased WT:ID ratios (1.30-fold and 1.54-fold in diastole and systole, respectively; p&lt;0.05) but inhibited AngII-induced increases in Nppb mRNA expression and cardiomyocyte cross-sectional area (208.80±9.78 vs 161.10±3.87μm 2 ; p&lt;0.05). In contrast, Col1a1 mRNA expression was enhanced by afatinib, along with interstitial and perivascular fibrosis (3.21±0.38 vs 5.61±0.46, 0.98±0.06 vs 1.45±0.18 % area; p&lt;0.05). Conclusion: EGFR signaling is modulated in human heart failure, promotes cardiomyocyte hypertrophy and is required for cardiac adaptation to hypertension. Since EGFR inhibition in hypertension prevents adaptive cardiomyocyte hypertrophy whilst promoting fibrosis, EGFR inhibitors are likely to cause cardiac dysfunction and be cardiotoxic in hypertensive patients.
Abstract 15979: Utility of Post-extraction Follow-up Blood Cultures in Patients With Cardiovascular Implantable Electronic Device Infection
Authors: sarwat khalil, Zerelda Esquer Garrigos, Douglas W Challener, Pooja Gurram, Wajeeha Tariq, Natalia CastilloAlmeida, Larry M Baddour, Daniel C DeSimone, Walter R Wilson, Brian D Lahr, M Rizwan R Sohail
Journal: Circulation (2020)

Introduction: Cardiovascular implantable electronic devices (CIED) infections are frequently complicated with bloodstream infection (BSI). Complete device removal and prolonged antimicrobial therapy is essential for cure. The frequency of persistent BSI after source control (device extraction) is not well described. This study aims to assess the utility of repeat blood cultures (BC) after device extraction as recommended by the American Heart Association (AHA) guidelines. Methods: We selected patients who presented with BSI in the setting of CIED infection and underwent device removal at Mayo Clinic Rochester between 2012 and 2017. Cases where BC were not drawn prior to extraction, or repeated within 72 hours of device extraction, or met criteria for contamination were excluded. Results: Of 656 patients who underwent CIED extraction for device infection, 190 with post-extraction BC met study criteria. Among the final study cohort (Table 1), 159 patients had negative BC, while 31 had positive BC following CIED extraction. Pre-extraction, the most common causative organism was Staphylococcus aureus (91/190, 48%) (Figure 1a). Post-extraction, 22 of the 31 (71%) cases of persistent BSI were due to S. aureus (Fig 1b). The median duration of BSI was not significantly different between negative and positive BC groups (3 versus 4 days, p=0.92). Conclusions: Majority of patients had resolution of BSI after CIED extraction. S. aureus was the most common cause of persistent BSI post-extraction. Our findings support the AHA guidelines of repeating BC after device extraction, especially for S aureus .
Inhibition of NF- κB-DNA binding by organoselenocyanate through covalent modification of the p50 subunit: structure elucidation by MALDI-TOF-MS/MS analysis
Authors: Kun-Ming Chen, Thomas Spratt, Bruce Stanley, Dhimant Desai, Arunangshu Das, Shantu Amin, Karam El-Bayoumy
Journal: Cancer Research (2007)

27  The protective role of selenium is supported by numerous epidemiological studies conducted in the United States and abroad, as well as in the preclinical and clinical investigations. Synthetic organoselenium compounds developed in our laboratory, benzyl selenocyanate (BSC) and 1,4-phenylenebis(methylene)selenocyanate (p-XSC), are more effective cancer preventive agents than those naturally-occurring selenium compounds in numerous animal models. Previous studies have shown that p-XSC in vitro reduces the binding activity of nuclear factor-κB (NF-κB) to its substrate. Alteration of NF-κB activity can regulate the expression of over 150 target genes that are important in the regulation of critical cellular events in the multistep carcinogenesis process. Inhibition of cell proliferation and induction of apoptosis have been suggested as critical cellular events in cancer chemoprevention by selenium. Our hypothesis is that BSC and p-XSC may inhibit tumorigenesis through the inhibition of NF-κB via the formation of selenium-sulfur bonds, thereby down-regulating its target genes leading to the inhibition of cell proliferation and induction of apoptosis. To test our hypothesis, in the present study we initially demonstrate that both BSC and p-XSC can inhibit the binding of pure NF-κB p50 protein to its oligonucleotide substrate using an ELISA-based transcription factor assay kit (TransAM assay). The inhibition of DNA binding was reversed by the addition of dithiothreitol (DTT), suggesting the formation of DTT-reducible selenium-sulfur bonds between p-XSC and cysteine residues in the DNA-binding domain of NF-κB p50 protein. Furthermore, the inhibitory effect of p-XSC on NF-κB was not altered in the presence of physiological level of GSH (1mM) suggesting that p-XSC can also inhibit NF-κB in vivo. We further demonstrated that these synthetic organoselenium compounds can inhibit the DNA binding of NF-κB p50 protein in both oral cancer SCC 1483 and lung cancer NSCLC NCI-H460 cells that had been stimulated with TNF-α. The structure modification of p50 protein by BSC was confirmed using both MALDI-TOF and MS/MS fragmentation. We demonstrate for the first time that the Cys62 residue in the active site of NF-κB p50 protein was modified by BSC through the formation of a selenium-sulfur bond. To further demonstrate the modification of p50 protein by selenocyanates, a computer modeling study was initiated and the results support the binding capacity of p50 protein by both BSC and p-XSC. Our results indicate that the selenocyanate chemopreventive agents may exert their activity by inhibiting NF-κB activity in part through covalent modification of the p50 subunit NF-κB. Support: CA 100924 and P01 CA 70972
Abstract 14671: Cardiovascular Outcomes of Diabetic Covid-19 Patients: A Multi-center Research Network Study
Authors: Ali Yousaf, Mark Studney, Mehiar EL-HAMDANI, Eva Patton-Tackett
Journal: Circulation (2020)

Introduction: Diabetes mellitus is a known risk factor for COVID-19. It remains unknown if these patients suffer worse cardiovascular outcomes following COVID-19 infection. This study aimed to determine if COVID-19 patients with diabetes are at increased risk of hospitalization and acute myocardial infarction. Methods: A real-time search and analysis were performed for adult patients (≥ 18 years old) diagnosed with COVID-19 using the TriNetX (Cambridge, MA, USA) Research Network. TriNetX provided real-time access to electronic medical records (EMR) for o ver 53 million patients from 42 healthcare organizations (HCOs). COVID-19 patients were divided into those with documented diabetes mellitus within 12 months of CoVid-19 diagnosis and those without diabetes. Likelihood of hospitalization and acute myocardial infarction, defined using International Classification of Diseases, 10th Revision, Clinical Modification code I21, were compared between groups with and without propensity score matching for confounding factors. Results: Out of 53,516,662 patients, 28,893 patients were identified with COVID-19 of whom 4,543 (15.7%) were diabetic. COVID-19 patients with diabetes were older (62.5 ± 15.0 years vs. 53.2 ± 19.3 years, p&lt;0.001), more frequently male (51.1% vs. 44.8%, p&lt;0.001), and African- American (38.6% vs. 19.8%, p&lt;0.001). After propensity matching on age, gender, race, BMI, chronic kidney disease, cerebrovascular disease, and disorders of the peripheral nervous system, likelihood of hospitalization was significantly increased in the diabetic cohort (risk ratio 1.16, 95% confidence interval [CI] 1.10-1.21, p&lt;0.001). COVID-19 patients with diabetes were significantly more likely to suffer from acute myocardial infarction (risk ratio 1.32, 95% confidence interval [CI] 1.03-1.68, p=0.03) compared to COVID-19 patients without diabetes. Conclusions: This study suggests that COVID-19 patients with diabetes have increased likelihood of hospitalization and acute myocardial infarction compared to non-diabetic COVID-19 patients.
In older adults with type 1 diabetes, continuous glucose monitoring reduced hypoglycemia over 6 months
Authors: Darin E. Olson
Journal: Annals of Internal Medicine (2020)

Source Citation Pratley RE, Kanapka LG, Rickels MR, et al. Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial. JAMA. 2020;323:2397-406. 32543682