tbuckley/cabot-search huggingface dataset:
Abstract 9918: Decreased Rate but Worsened Outcomes of Acute Myocardial Infarction-Related Hospitalizations Among Young Tobacco Smokers: A Decade Apart Nationwide Analysis (2007 vs 2017)
Authors: Ankit Vyas, Sashwath Srikanth, Priya Shenwai, Harika Varma Chintalapalli Patta, Taherunnisa Rida, Nibras Yar Khan, Ummul Asfeen, Zainab J Gandhi, Rupak Desai
Journal: Circulation (2021)

Background: Considering a dearth of contemporary data, we aim to compare the demographics, comorbidities, outcomes of acute myocardial infarction (AMI) hospitalizations among young smokers across two national cohorts selected a decade apart. Methods: We utilized National Inpatient Sample (2007 &amp; 2017) to identify AMI in young (18-44 years) tobacco smokers. Demographics, comorbidities, outcomes (all-cause mortality, cardiogenic shock, atrial/ventricular fibrillation/flutter) including hospital resource utilization were assessed. Results: Overall hospitalizations for AMI decreased across a decade among young smokers from 1.7% (23,592/1,355,916) in 2007 to 1.3% (28,775/2,269,124) in 2017. Cohort of 2017 consisted of female (30.8% vs 26.0%), non-white, and Medicaid enrollees (35.1% vs 15.9%), admitted to urban teaching facilities compared to 2007. Young smokers with AMI in 2017 had comorbid hypertension (62.1% vs 48.7%), diabetes (24.3% vs 19.1%), obesity (26.6% vs 15.8%), renal failure (9.6% vs 2.8%), fluid &amp; electrolyte disturbances (24.3% vs 9.5%), congestive heart failure (4.5% vs 1.0%), depression (8.4% vs 6.1%), liver disease (2.5% vs 0.8%) and hyperlipidemia compared to 2007 (p&lt;0.05). Cohort of 2017 showed higher all-cause mortality [2.7% vs 0.9%; OR1.67 (CI 1.39-2.02)], post-MI complications like cardiogenic shock [3.5% vs 1.8%; OR1.40 (CI 1.21-1.62)], atrial fibrillation/flutter [4.6% vs 1.7%; OR2.55 (CI 2.21-2.96)], ventricular fibrillation/flutter [3.3% vs 2.8%; OR1.24 (CI 1.09-1.41)] and lower routine discharges. Despite shortened hospital stay, hospital charges increased in 2017 (p&lt;0.05). Conclusion: Two cohorts of young tobacco smokers with AMI selected a decade-apart showed lower rate of AMI admissions, however, with significantly higher burden of CVD risk factors, all-cause mortality and post-MI complications in 2017 vs 2007.
小児における多系統炎症性症候群-重症急性呼吸器症候群コロナウイルス2(SARS-CoV-2)感染後の急性心不全を合併した新しい症候群【JST・京大機械翻訳】|||
Authors: Uchida Momoko, Kashima Yuichiro, Mochizuki Katsunori, Sakamoto Hiroto, Mori Kotaro, Ebisawa Soichiro, Takeshige Kanako, Nitta Kenichi, Kuwahara Koichiro, Imamura Hiroshi
Journal: Circulation (2021)
Role of the macula densa sodium glucose cotransporter type 1-neuronal nitric oxide synthase-tubuloglomerular feedback pathway in diabetic hyperfiltration
Authors: Jie Zhang, Jing Cai, Yu Cui, Shan Jiang, Jin Wei, Young Chul Kim, Jenna Chan, Anish Thalakola, Thanh Le, Lan Xu, Lei Wang, Kun Jiang, Ximing Wang, Haibo Wang, Feng Cheng, Jacentha Buggs, Hermann Koepsell, Volker Vallon, Ruisheng Liu
Journal: Kidney International (2021)
Abstract 10207: Association Between Age and the Von Willebrand Factor-ADAMTS13 Axis in Patients with ST-Elevation Myocardial Infarction
Authors: Takumi Osawa, Tomomi Koizumi, Koji Nakano, Yu Yamada, Yuto Abe, Yuta Ito
Journal: Circulation (2021)

Introduction: The incidence of arterial thrombosis increases with age, but its underlying mechanisms are unclear. Myocardial infarction is associated with increased von Willebrand factor (VWF) and decreased a disintegrin-like and metalloproteinase with thrombospondin type-1 motif 13 (ADAMTS13) levels. We aimed to examine the relationship between the VWF-ADAMTS13 axis and age in ST-elevation myocardial infarction (STEMI). Methods: Patients who underwent endovascular arterial recanalization for STEMI or acute ischemic stroke (AIS) and had aspirated thrombi at our institute between June 2019 and August 2020 were enrolled. Seventy-one patients were divided into two age groups—&lt;65 years (n = 23) and ≥65 years (n = 48). The ADAMTS13 and VWF antigen levels were evaluated. Results: Among all patients (STEMI and AIS), ADAMTS13 levels were significantly lower in the ≥65 years group than in the &lt;65 years group (0.77 ± 0.16 vs. 0.67 ± 0.16 U/mL, p = 0.024). The VWF antigen/ADAMTS13 levels were significantly higher in the ≥65 years group (319 ± 223 vs. 359 ± 160, P = 0.032). Among patients with STEMI, compared to the &lt;65 years group, the ≥65 years group had significantly lower ADAMTS13 levels and a significantly higher VWF antigen-ADAMTS13 ratio. Among patients with AIS, there were no significant differences in ADAMTS13 and WVF antigen levels and VWF antigen-ADAMTS13 ratio between the &lt;65 and the ≥65 years groups. Conclusions: Our study demonstrated low ADAMTS13 levels in elderly patients with STEMI, but not in those with AIS. The VWF-ADAMTS13 axis may be more involved in the pathogenesis of STEMI than in that of AIS among elderly patients.
Factors Associated With COVID-19 Vaccine Receipt by Health Care Personnel at a Major Academic Hospital During the First Months of Vaccine Availability
Authors: Judith Green-McKenzie, Frances S. Shofer, Florence Momplaisir, Barbara J. Kuter, Gregory Kruse, Usama Bilal, Maryam Behta, Judith O’Donnell, Nida Al-Ramahi, Nishaminy Kasbekar, Patricia Sullivan, Philip Okala, Patrick J. Brennan
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Several COVID-19 vaccines have been authorized in the US, yet preliminary evidence suggests high levels of vaccine hesitancy and wide racial, ethnic, and socioeconomic disparities in uptake. <h3>Objective</h3> To assess COVID-19 vaccine acceptance among health care personnel (HCP) during the first 4 months of availability in a large academic hospital, compare acceptance with previously measured vaccine hesitancy, and describe racial, ethnic, and socioeconomic disparities in vaccine uptake. <h3>Design, Setting, and Participants</h3> This cross-sectional study included 12 610 HCP who were offered COVID-19 vaccination at a major academic hospital in Philadelphia between December 16, 2020, and April 16, 2021. <h3>Exposures</h3> For each HCP, data were collected on occupational category, age, sex, race and ethnicity (Asian or Pacific Islander, Black or African American [Black], Hispanic, White, and multiracial), and social vulnerability index (SVI) at the zip code of residence. <h3>Main Outcomes and Measures</h3> Vaccine uptake by HCP at the employee vaccination clinic. <h3>Results</h3> The study population included 4173 men (34.8%) and 7814 women (65.2%) (623 without data). A total of 1480 were Asian or Pacific Islander (12.4%); 2563 (21.6%), Black; 452 (3.8%), Hispanic; 7086 (59.6%), White; and 192 (1.6%), multiracial; 717 had no data for race and ethnicity. The mean (SD) age was 40.9 (12.4) years, and 9573 (76.0%) received at least 1 vaccine dose during the first 4 months of vaccine availability. Adjusted for age, sex, job position, and SVI, Black (relative risk [RR], 0.69; 95% CI, 0.66-0.72) and multiracial (RR, 0.80; 95% CI, 0.73-0.89) HCP were less likely to receive vaccine compared with White HCP. When stratified by job position, Black nurses (n = 189; 62.8%), Black HCP with some patient contact (n = 466; 49.9%), and Black HCP with no patient contact (n = 636; 56.3%) all had lower vaccine uptake compared with their White and Asian or Pacific Islander counterparts. Similarly, multiracial HCP with some (n = 26; 52.0%) or no (n = 48; 58.5%) patient contact had lower vaccine uptake. In contrast, Black physicians were just as likely to receive the vaccine as physicians of other racial and ethnic groups. <h3>Conclusions and Relevance</h3> In this cross-sectional study, more than two-thirds of HCP at a large academic hospital in Philadelphia received a COVID-19 vaccine within 4 months of vaccine availability. Although racial, ethnic, and socioeconomic disparities were seen in vaccine uptake, no such disparities were found among physicians. Better understanding of factors driving these disparities may help improve uptake.
Abstract 6933: Mapping the Global Trends of Heart Failure Burden and its Contributing Factors from 1990 to 2019
Authors: Zahra Aryan, Sahar Saeedi Moghaddam, Farshad Farzadfar
Journal: Circulation (2021)

Introduction: This study aims to provide global, regional, and national estimates of the trend of heart failure (HF) prevalence and its etiologies. Methods: Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we estimated the prevalence, and disability-adjusted life years (DALYs) because of stage C or D of HF according to AHA/ACC. The prevalence and etiologies of HF were estimated using cause-specific mortality rates from redistribution algorithms for 204 countries and territories, stratified by sex and Socio-demographic Index (SDI) from 1990 to 2019. Results: Globally, there were 56.2 million (95% uncertainty interval [UI] 46·5-67·8) prevalent cases of HF in 2019, a +106% (99-114) increase from 1990. Globally, DALY rate of HF increased by +29.4% (27.4 to 31.3), since 1990. The highest burden of HF was observed in high SDI regions including the United States, and China. The leading etiologies of HF were ischemic heart disease (IHD), followed by hypertensive heart disease (HHD), and chronic obstructive pulmonary disease contributed to 265.7 (197.2-346.4), 233.8 (170.5-312.9), and 65.6 (45.3-94.1) prevalent cases per 100,000 population, respectively. Although HF because of IHD is decreasing worldwide, the age-standardized prevalence rate of HF due to IHD has increased in low SDI regions since 1990, by +9% (6 to 12). Conclusions: Currently, HF is a big health issue in high SDI regions including the United States and China. The trend of HF prevalence rates and its contributing etiologies supports a transition in epicenter of IHD and subsequently HF epidemic to low SDI regions.
Abstract 11638: Cardiologists’ Knowledge and Attitude Toward Geriatric Cardiology Training
Authors: Maha A Alfaraidhy, Jessica P Brown, Brock A Beamer, Jacob B Blumenthal, Daniel E Forman, Raya E Kheirbek
Journal: Circulation (2021)

Introduction: By 2030, it is projected that 20% of the population will be 65 or older. Older adults aged 85 and over (the oldest old) are the fastest growing segment of the US population and globally. As the population ages, cardiovascular disease is becoming a major public health challenge. Providing optimal care to older adults with CVD is challenging due to their complexity, competing vulnerabilities and a lack of evidence-based knowledge to bridge the existing gap between guidelines and real-world clinical practice. Hypothesis: Exposure to geriatric education during training will associate with attitudes toward treatment of older adult patients. Objective: Evaluate current cardiologists’ knowledge and attitude toward geriatric care. Methods: IRB-approved, quantitative cross-sectional study using an online survey distributed to all cardiologists and cardiology fellows within a large academic medical system. Result: Of the 98 physicians invited, 26 responded (26.5% response rate) of which 19.2% were female; 45% cardiology fellows, 5% early career (&lt; 5 years) and 50% experienced cardiologists (&gt;10 years). Of those surveyed, 77% reported more than half of their patients were over age 65. While 87% believed it was very important for cardiologists to have knowledge about geriatric syndromes, 70% reported little to moderate levels of knowledge about their impact on CV care. Only 20% reported a deep fund of knowledge. Most knowledge was gained through experience rather than formal education. None of the participants were aware of the “Essentials of Cardiovascular Care in Older Adults (ECCOA)” curriculum within the Geriatric Cardiology section of ACC. Two thirds were concerned about potential overtreatment for older adults, whereas 41% were concerned for potential undertreatment. Conclusion: Academic-affiliated cardiologists surveyed reported unmet educational needs regarding care of older adults. Efforts to equip cardiologists with the requisite up- to -date knowledge of geriatric cardiology are needed to formulate a balanced and holistic therapeutic plan of care for our most vulnerable patients.
Abstract 13664: Identification of Myocardial Scar Using Deep Residual Network Integration of CMR Images in Ischemic Cardiomyopathy
Authors: Michael Udin, Ciprian Ionita, Alice Kai, Saraswati Pokharel, Umesh C Sharma
Journal: Circulation (2021)

Introduction: Ischemic scar development is a potential precursor of lethal arrhythmias and heart failure, conditions with exceptionally high mortality rates. Contrast-enhanced cardiac magnetic resonance imaging (CMR) is frequently used in clinical practice to quantify myocardial scar. With the advance of machine learning, increasing amounts of information can be garnered from CMR scans, including information that has both diagnostic and prognostic value for patients with ischemic cardiomyopathy. Hypothesis: We hypothesize that deep residual network integration combined with an augmented CMR scan selection can more accurately differentiate between patients with and without myocardial ischemic scarring. Methods: CMR scans from 170 patients, 138 with ischemic scarring and 32 controls without myocardial scarring, were collected from a tertiary care facility. CMR scans were selected to include those that had a clear visualization of the left ventricle and the surrounding myocardium. This region of interest (ROI) was then cropped. Images from patients with no myocardial scarring were additionally rotated 3 times to improve class balance. The final dataset was composed of 9,840 images from the patients with no myocardial scarring and 10,480 images with ischemic scarring. Results: Applying a ResNet-50-based convolutional neural network machine learning algorithm, we were able to identify patients with ischemic scarring at an accuracy of 75.9%. Sensitivity and specificity were 76.2% and 75.7%, respectively, with an F1 Score of 76.7%. By introducing targeted ROI selection, we were able to further improve accuracy to 81.7% with an F1 score of 82.4%. Sensitivity and specificity were also higher at 83.4% and 79.8%, respectively. The data acceptance rate of the short axis images for this implementation was 22.0%. Conclusion: Application of our residual network integration algorithm- along with targeted ROI selection- can significantly enhance the accuracy of myocardial scar detection in patients with ischemic cardiomyopathy. When tested in larger samples this is expected to aid clinical adjudication and enhance workflow.
RADT-15. FIRST EXPERIENCE WITH MAXIMAL SAFE RESECTION AND GAMMATILE BRACHYTHERAPY AS TREATMENT FOR RECURRENT GLIOBLASTOMA
Authors: Dominic Gessler, Elizabeth Neil, Rena Shah, Joseph Levine, James Shanks, Christopher Wilke, Margaret Reynolds, Clara Ferreira, Kathryn Dusenbery, Clark Chen
Journal: Neuro-Oncology (2021)

Abstract INTRODUCTION Gammatile (GT) is a recently FDA-cleared brachytherapy platform with 131Cs seeds imbedded into a resorbable collagen carrier for surgically targeted radiation delivery. We report the first experience for recurrent glioblastoma patients who underwent GT treatment following surgical resection. METHODS Twenty-two consecutive patients with 23 isocitrate dehydrogenase (IDH) wild-type glioblastomas (14 second; eight third recurrence) who underwent intra-operative MRI/5-ALA guided maximal safe resection followed by GT placement were prospectively followed. There were 6 methylguanine-DNA-methyltransferase promoter methylated (MGMTm) and 17 unmethylated (MGMTu) glioblastomas. RESULTS The median hospital stay was one day (range:1-15 days). There was one 30-day readmission (4.5%) for a cerebrospinal fluid leak from the incision site, which resolved with lumbar drainage. There were no other wound complications. One patient (4.5%) suffered new post-operative seizure. Eight patients experienced worsened neurological deficit (8/22 or 36%). While all deficits improved by the 30-day follow-up, 7 of these 8 patients suffered KPS decline due to persistent deficits. There was one 30-day mortality (4.5%) from intracranial hemorrhage secondary to heparinization for an ischemic limb. The median follow-up after GT placement for the remaining 21 patients was 296 days (range:111-931 days). Six months local control (LC) was achieved in ~75% of the patients irrespective of MGMT status. Median overall survival (OS) was 715 days for the MGMTu patients, and not reached (&amp;gt;1000 days) for MGMTm patients. These outcomes compared favorably to the published literature (LC: 3-49%; OS MGMTu: 135-285 days; OS MGMTm: 174-564 days) and an age, KPS, extent of resection matched glioblastoma cohort who underwent maximal safe resection without GT at our institution (LC: 52%; OS MGMTu: 462 days; OS MGMTm: 821 days; p=0.0089 and p=0.0271, respectively when compared to the GT treated patients). CONCLUSION This clinical experience supports the safety and efficacy of GT brachytherapy as a treatment option for recurrent glioblastomas.
New Acalabrutinib Formulation Enables Co-Administration with Proton Pump Inhibitors and Dosing in Patients Unable to Swallow Capsules (ELEVATE-PLUS)
Authors: Shringi Sharma, Xavier Pepin, Harini Burri, Lianqing Zheng, Nataliya Kuptsova-Clarkson, Anouk de Jong, Ting Yu, Holly L MacArthur, Michal Majewski, Joseph A Ware, James Mann, David Ramies, Veerendra Munugalavadla, Louise Sheridan, Helen Tomkinson
Journal: Blood (2021)
EPCO-05. GENOME-WIDE ANALYSIS OF TEAD1 OCCUPANCY IN BIOLOGICALLY DISTINCT GLIOBLASTOMA SAMPLES
Authors: Tanvi Joshi, German Nudelman, Elena Zaslavsky, Nadejda Tsankova
Journal: Neuro-Oncology (2021)

Abstract The diffusely infiltrative nature of glioblastoma (GBM) cells is a major contributor to the disease’s aggressive behavior, including its rapid progression and therapeutic resistance. Moreover, current treatment options do not target the invasive nature of GBM. Recent chromatin accessibility studies prioritized enrichment of the TEAD1 transcription factor motif in glioblastoma stem cell biology and subsequent knockout and overexpression studies confirmed a critical role for TEAD1 in GBM migration, in vitro and in vivo. However, the downstream mechanisms through which TEAD1 regulates GBM cell migration remain poorly understood. In this study, we performed chromatin immunoprecipitation (ChIP-seq) using TEAD1-specific antibody and IgG as non-specific binding control, to characterize TEAD1 occupancy across GBM samples with unique genomic alterations. ChIP-seq peaks were called using MACS2, filtered for duplicates and blacklisted regions, and normalized per sample to their respective genomic input. Initial functional enrichment analyses were performed on three GBM samples with the highest number of TEAD1 occupancy peaks using CistromeGO, which ranked genes based on their TEAD1-specific regulatory potential (RP) score, as a function of peak number and distance from the transcription start site. Analyses of the top 1000 genes with highest TEAD1 RP scores identified 132 common targets across all samples, including known TEAD target genes ETV1 and Cyr61, which related to angiogenesis, cadherin and integrin signaling, cell adhesion, and chromatin regulation gene ontology terms, among others. Interestingly, KEGG pathway analysis also revealed Hippo pathway enrichment across all GBM samples, suggesting a possible TEAD1 regulatory feedback loop in GBM. Analysis of TEAD1 ChIP-seq peaks in non-GBM negative control tissue did not show functional enrichment for any of the terms seen in the GBM samples. Ongoing analyses are focused on characterizing TEAD1 occupancy at active cis-regulatory regions using parallel H3K27ac ChIP-seq data, in order to prioritize the most salient TEAD1-regulatory targets in GBM.
Abstract 13068: Use of Cardiac Implantable Electronic Devices in Carcinoid Heart Disease
Authors: Robert Ward, Sushil A Luis, Samuel Shabtaie, Patricia A Pellikka, Heidi M Connolly, William Miranda, Hartzell Schaff, Win-Kuang Shen, Yong-mei Cha, Samuel Asirvatham, Abhishek Deshmukh, Christopher V Desimone
Journal: Circulation (2021)

Introduction: Carcinoid heart disease (CHD) is a rare sequelae of hormonally active neuroendocrine tumors that often requires cardiac surgical intervention. Little is reported on cardiac implantable electronic device (CIED) implantation in the CHD patient population. Hypothesis: We sought to establish the safety and efficacy of CIED implantation in patients with CHD. Methods: We retrospectively reviewed patients with a diagnosis of CHD who underwent CIED implantation at our institution (Mayo Clinic) and evaluated indications for implant, perioperative complications, and mortality. Results: A total of 27 patients with a cumulative follow up of 75 patient-years were identified during the study period. The most common indication for device implant was high grade atrioventricular block (n=18, 66.7%). 14 (51.8%) had baseline conduction disease and 26 (96.2%) underwent cardiac surgery prior to CIED implant. The majority of devices implanted were dual chamber permanent pacemakers (PPM) (n=17, 63.0%), while other devices included single chamber PPM, epicardial PPM, chronic resynchronization devices, and intracardiac defibrillators. Peri-operative complication occurred in 6 patients (22.2%), with 2 patients requiring ICU level care. No patient suffered carcinoid crisis during implantation and there was no peri-implant mortality. Long term, 3 patients required device extraction: 1 for infection, 1 for lead related pain, and 1 for generator migration. The median time to death from implant was 2.5 years, with one-year mortality at 15%. Conclusions: In this unique cohort of patients with CHD, CIED can be performed safely. CIED most often occurred in the post cardiac surgical period and carcinoid crisis was uncommon.
Utilization of External Control Arm to Contextualize Clinical Efficacy of Tisagenlecleucel Treated Among Patients with Relapsed/Refractory Follicular Lymphoma from the Single-Arm Elara Trial
Authors: Yanni Hao, Wei-Chun Hsu, Craig S Parzynski, C Lobetti Bodoni, Lisa Hampson, Aisha Masood, Whitney Rhodes, Wen-Hsing Wu
Journal: Blood (2021)