tbuckley/cabot-search huggingface dataset:
Digitally Fabricated and Naturally Augmented In Vitro Tissues
Authors: Daniela F. Duarte Campos, Laura De Laporte
Journal: Advanced Healthcare Materials (2020)

Abstract Human in vitro tissues are extracorporeal 3D cultures of human cells embedded in biomaterials, commonly hydrogels, which recapitulate the heterogeneous, multiscale, and architectural environment of the human body. Contemporary strategies used in 3D tissue and organ engineering integrate the use of automated digital manufacturing methods, such as 3D printing, bioprinting, and biofabrication. Human tissues and organs, and their intra‐ and interphysiological interplay, are particularly intricate. For this reason, attentiveness is rising to intersect materials science, medicine, and biology with arts and informatics. This report presents advances in computational modeling of bioink polymerization and its compatibility with bioprinting, the use of digital design and fabrication in the development of fluidic culture devices, and the employment of generative algorithms for modeling the natural and biological augmentation of in vitro tissues. As a future direction, the use of serially linked in vitro tissues as human body‐mimicking systems and their application in drug pharmacokinetics and metabolism, disease modeling, and diagnostics are discussed.
Abstract 16728: The Association of 0,1-Hour and 3-Hour Serial Cardiac Troponin T and Positive Coronary Angiogram in Renal Dysfunction Patients
Authors: Praew Kotruchin, Nirut Srimakam, Thapanawong Mitsungnern, Pariwat Phungeon
Journal: Circulation (2020)

Introduction: Patients with renal dysfunction particularly have chronic high-sensitivity cardiac troponin T (hscTnT) elevation. Serial measurement of hsTnT at 3 hours was found effective for diagnosing non-ST elevation myocardial infarction (non-STEMI). However, there is limited data on the 0,1-hour serial protocol in patients with renal dysfunction. Hypothesis: There is a differential association between the positivity of hsTnT serial protocol; 0,1-hour and 3-hour serial protocol and the positive findings of coronary angiogram (CAG). Methods: A retrospective cohort study of patients who presented with angina pectoris, STEMI cases were excluded. Clinical data were collected from hospital electronic records. The positivity of 0,1-hour and 3-hour serial hsTnT was interpreted based on the standard clinical practice guidelines. Renal dysfunction was defined by the estimated glomerular filtration rate &lt;60 ml/min/1.73m 2 . Results: A total of 318 patients were enrolled (40.4%, male; mean age, 66±13 years old), 157 patients (40.4%) had renal dysfunction. Positive CAG findings were reported in 99 patients (70.2%) and 86 (58.1%) in the renal dysfunction and the normal renal function group. The positive 3-hour serial hsTnT was significantly associated with the positive CAG findings in the total population (OR 2.00, 95%CI 1.04-3.85) and in the renal dysfunction group (OR 2.98, 95%CI 1.12-7.95) while the positive 0,1-hour serial hsTnT had a significant association with the positive CAG findings in the total population (OR 2.20, 95%CI 1.03-4.71) but not in the renal dysfunction group (OR 2.46, 95%CI 0.56-10.83). Conclusions: The positive 3-hour serial hsTnT had a significant association with the positive CAG findings in patients with renal dysfunction. Therefore, the 3-hour serial hsTnT protocol is recommended in renal dysfunction patients.
Abstract 15854: Early Cardiac Dysfunction in Obese Adolescents With Intellectual and Developmental Disabilities (idd)
Authors: gEETHA HALIGHERI, johnson Tyler, Kathol Melanie, kuzava Laura, Goth Natalie, Rita France, Joseph Donnelly, Lauren Ptomey, Daniel E Forsha
Journal: Circulation (2020)

Early cardiac dysfunction in obese adolescents with intellectual and developmental disabilities (IDD)Background: Adolescents with IDD (IQ range 40-74) are more frequently obese than the general population and the IDD population has a higher risk of early cardiovascular (CV) mortality in adulthood. The relationship between obesity and echo strain has not been studied in those with IDD. We hypothesize that obese adolescents with IDD will have diminished LV strain vs non-obese controls. Methods: Non-obese (21/50; &lt; 95 th %ile BMI) and obese (29/50; &gt; 95 th %ile BMI) adolescents with IDD (Down syndrome (DS) or autism) were enrolled excluding those with congenital heart disease. Echo LV systolic measures included ejection fraction (bullet), myocardial performance index (MPI; tissue Doppler), 2D global longitudinal systolic strain (GLS), strain rate (GLSr) and global circumferential strain (GCS). LV diastolic measures were E/e’ and LV early diastolic strain rate (LV ED Sr). The RV measures included RV GLS and TAPSE. Statistical analyses included unpaired t-tests and simple linear regression, p≤0.05 significant. Results: In 50 subjects (age 16.9, range 13.3-21.8 yrs; 27/50 males), LV GLS and GCS were mildly diminished with normal LV volume and ejection fraction (Table). The obese group had diminished LV strain compared to the non-obese group (P &lt; 0.001). Increased BMI %ile predicted diminished LV GLS (P &lt; 0.001) and GCS (P &lt; 0.001) as well as LV ED Sr (P=0.001) on regression analysis. RV GLS was also mildly diminished in the total cohort but not significantly diminished in the obese group (p=0.06). Diastolic function (E/e’) was abnormally elevated in the DS subgroup (only difference found between DS and autism subgroups). Conclusions: Obese adolescents with IDD had abnormal LV strain measures not detected by traditional echo emphasizing the need for successful weight loss strategies focused on this special population.
Abstract 15466: Trajectory of Acute Coronary Syndrome Cases During the COVID-19 Pandemic
Authors: Pooja S Desai, Elias Fanous, Weiyi Tan, Rushi Parikh, Marcella Calfon Press, Asim Rafique
Journal: Circulation (2020)

Background: The COVID-19 pandemic was associated with a worrisome decrease in acute coronary syndrome (ACS) cases. We sought to investigate the trajectory of ACS following the relaxation of isolation orders and public service education. Hypothesis: We hypothesized that during the COVID-19 pandemic, ACS cases would decrease during the period of strict isolation and thereafter increase, illustrating a “rebound effect”, during the period of relaxed isolation. Methods: All adults with concern for ACS requiring cardiac catheterization at one academic center from 22 December 2019 to 13 June 2020 were included. Cases were designated as ST-elevation myocardial infarction (STEMI), STEMI activation, out-of-hospital cardiac arrest (OHCA), Non-STEMI/unstable angina (NSTEMI/UA), and/or total ACS. 18 December - 14 March, 15 March - 9 May, and 10 May - 13 June were designated as pre-isolation COVID-19 (piC), strict isolation COVID-19 (siC), and relaxed isolation COVID-19 (riC), respectively. Fisher’s exact test was used to compare average cases per week in piC vs. siC and siC vs. riC. One-way ANOVA was used to compare cases across piC, siC, and riC together. Analysis was completed with STATA/MP 16.1. Results: 315 cases concerning for ACS requiring cardiac catherization lab activation were included. When comparing piC with siC and siC with riC, there were no significant differences in STEMI, STEMI activation, OHCA, NSTEMI/UA, or total ACS. When compared across piC, siC, and riC simultaneously there were no significant differences in STEMI (p=0.426), STEMI activation (p=0.172), OHCA (p=0.167), NSTEMI/UA (p=0.362), and total ACS (p=0.219). Total ACS, STEMI activation, NSTEMI/UA, and OHCA exhibited a trend towards a rebound effect (Graph). Conclusions: There were no significant changes in the incidence of total ACS, OHCA, STEMI, STEMI activation, or NSTEMI/UA between pre-isolation, strict isolation, and relaxed isolation periods of the COVID-19 pandemic.
Abstract 14500: Physical Activity in Individuals With the Long Qt Syndrome: Baseline Data From the Lifestyle and Exercise in Long Qt Study (live Lqts)
Authors: Rachel J Lampert, Sharlene Day, Bradley S Marino, Matthew Burg, Barbara Ainsworth, Maite Tome, Susan P Etheridge, Dominic J Abrams, Peter F Aziz, Marina Cerrone, Richard J Czosek, Christopher C Erickson, Belinda Gray, Christopher Johnsrude, Prince J Kannankeril, Ian H Law, Rebecca McClellan, Silvana M Molossi, Marco V Perez, Shubhayan Sanatani, Maully S Shah, Jonathan Skinner, James S Ware, Gregory G Webster, Fangyong Li, Laura Simone, Cheryl Barth, Kim Harmon, Kevin Hall, Brian Olshansky, Mark Estes, Gordon F TOMASELLI, Mark S Link, Elizabeth Saarel, David S Cannom, Michael J Ackerman
Journal: Circulation (2020)

Introduction: The safety of vigorous exercise for individuals with appropriately-treated LQTS remains unproven, and physical activity practices in this population have not been described. Methods: LIVE-LQTS prospectively enrolled individuals age 8-60 years with overt LQTS or gene mutation carriers. Participants (or parents, for children) answered surveys describing activity patterns. Vigorous exercise was defined as &gt; 6 METS for &gt; 60 hours per year. Clinical and demographic data were derived from medical record review. Results: Among 1554 participants, 804 (52%) reported exercising vigorously, 473 of these competitively, 577 (37%) exercising at moderate, and 173 (11%) at low levels. Seven percent of those working describe jobs more active than walking, including 10 in protective services and 19 in sports/coaching. Over 90% are genotype positive, 57% are phenotype positive at rest and an additional 16% have exercise-induced QT prolongation. Forty four percent have had documented ventricular arrhythmias or syncope. Eighty-four percent are appropriately treated with either beta-blockers, ICD, and/or sympathectomy, although among beta-blocked patients, only 60% are on the most effective agents. Among adults, BMI was significantly lower among the vigorous exercisers. Conclusion: While the high percentage of vigorous exercisers seen in this study may not represent all patients with LQTS due to self-selection for study participation, many patients with LQTS are engaged in vigorous exercise or competitive athletics. Prospective follow up of this cohort is ongoing and will determine safety of vigorous exercise through comparison of arrhythmic outcomes in vigorous exercisers vs moderate/low level exercisers.
Abstract 16688: Effects of Evolocumab in Patients With Prior Percutaneous Coronary Intervention: An Analysis From the Fourier Trial
Authors: Remo H Furtado, Antonio A Fagundes, Kazuma Oyama, Thomas A Zelniker, Minao Tang, Julia F Kuder, Sabina A Murphy, Huei Wang, Andrew Hammer, Anthony C Keech, Terje R Pedersen, Robert Giugliano, Marc S Sabatine, Brian A Bergmark
Journal: Circulation (2020)

Introduction: Among patients with atherosclerotic cardiovascular disease (ASCVD), those with history of PCI represent an important population for potential high risk for cardiovascular (CV) events. We examined the clinical efficacy of the PCSK9 inibitor evolocumab in patients with prior PCI. Methods: FOURIER randomized 27,564 patients with ASCVD on statin therapy to evolocumab or placebo with a median follow-up of 2.2 yrs. The primary end point (PEP) was the composite of CV death, MI, stroke, unstable angina, or coronary revascularization; major coronary events were the composite of coronary death, MI, or coronary revascularization. The risk of events in patients with and without a history of PCI were compared in the placebo arm. The clinical benefit of evolocumab vs. placebo was compared using a Cox proportional hazards model. Results: 17,073 (62%) patients had prior PCI at baseline. Among patients in the placebo arm, those with prior PCI (N=8563) had a 1.6x higher rate of the PEP (16.8 vs 10.7%; adjusted HR 1.61; 95% CI 1.42-1.84 P&lt;0.0001) and nearly double the rate of major coronary events (14.5 vs. 7.8%; P&lt;0.0001; adjusted HR 1.72; 95% CI 1.49-1.99; Figure left). In patients with prior PCI, evolocumab reduced the risk of the PEP by 16% (HR 0.84; 95% CI 0.77-0.91; P&lt;0.0001) and of major coronary events by 18% (HR 0.82; 95% CI 0.75-0.90, P&lt;0.0001; Figure right), including a 30% reduction in fatal or non-fatal MI (P&lt;0.001) and a 24% reduction in coronary revascularization (P&lt;0.001). After the first year, there was a 25% reduction in major coronary events (HR 0.75, 95% CI 0.66-0.86, P&lt;0.0001). The absolute risk reduction at 3 years with evolocumab for major coronary events was 2.8% in patients with prior PCI vs. 0.3% in those without. Conclusions: In a contemporary cohort with ASCVD on statin therapy, patients with prior PCI were at heightened risk for coronary events. Evolocumab was highly effective in this group, reducing major coronary events by 18% with a NNT at 3 years of only 36.
Abstract 15802: Diet and Exercise in 2020 in America: Where Are We?
Authors: Armaan Yaseyyedi, Amy Rao, Ashley Pratt-Cordova, Gregory Coe, William Cornwell
Journal: Circulation (2020)

Introduction: Cardiovascular disease (CVD) is the primary cause of death among individuals living in the United States. Adherence to heart-healthy diets and exercise reduce risk of CVD. However, a contemporary analysis of specific diet and exercise types adhered to by Americans is lacking. Therefore, the primary objective of this study was to characterize methods by which Americans engage in healthy lifestyle habits. Methods: Internet-based materials were collected through an exhaustive search, conducted between 6/1/2019 and 4/30/20. Google, Google Scholar and Pubmed search engines were reviewed to identify relevant articles. Articles were reviewed by the senior author who made the final decision on incorporation into this analysis. 26 and 23 articles on diet and exercise, respectively, were included for analysis. Results: Only approximately 20-25% of Americans engage in routine physical activity. Of individuals who do exercise, the majority engage in either low dynamic/low static, high dynamic/low static, or low dynamic/high static types of exercise ( figure 1 ). Americans grossly underconsume recommended healthy foodtypes such as vegetables, fruits and dairy products, by 85%, 75% and 85%, respectively, based on recommended daily allowance. Of individuals who follow a specific diet, the most common types were low-carbohydrate (18%), reduced caloric (14%), and ketogenic (11%). Conclusion: In a contemporary analysis of American lifestyle habits, adherence to healthy diet and exercise patterns is unacceptably low. Among individuals who do adhere to healthy habits, there is a heterogeneous admixture of diet and exercise types.
Worldwide Epidemiology of Diabetes-Related End-Stage Renal Disease, 2000–2015
Authors: Hui-Teng Cheng, Xiaoqi Xu, Paik Seong Lim, Kuan-Yu Hung
Journal: Diabetes Care (2020)

OBJECTIVE The annual risk among patients with diabetes of reaching end-stage renal disease (ESRD) is largely unknown worldwide. This study aimed to compare the incidence of diabetes-related ESRD by creating a global atlas during 2000–2015. RESEARCH DESIGN AND METHODS The annual incidence of ESRD among patients with diabetes was calculated as the quotient of the number of incident ESRD patients with diabetes divided by the total number of patients with diabetes after subtraction of the number with existing ESRD. The estimated ESRD prevalence and annual incidence were validated with use of the data provided by Fresenius Medical Care, Germany, and previously reported data, respectively. RESULTS Data were obtained from 142 countries, covering 97.3% of the world population. The global percentage of the prevalent ESRD patients with diabetes increased from 19.0% in 2000 to 29.7% in 2015 worldwide, while the percentage of incident ESRD patients due to diabetes increased from 22.1% to 31.3%. The global annual incidence of ESRD among patients with diabetes increased from 375.8 to 1,016.0/million with diabetes during 2000–2015. The highest average rates were observed in the Western Pacific Region. Comparatively, the rates of incident ESRD among European patients with diabetes ranged from one-half (309.2 vs. 544.6) to one-third (419.4 vs. 1,245.2) of the rates of the Western Pacific population during 2000–2015. CONCLUSIONS Great and nonrandom geographic variation in the annual rates among patients with diabetes of reaching ESRD suggests that distinct health care, environmental, and/or genetic factors contribute to the progression of diabetic kidney disease. Measures to prevent and treat diabetes-related ESRD require better patient susceptibility stratification.
Abstract 16713: Major Adverse Cardiovascular Events are Linked to Risk of Mortality in Covid-19 Patients
Authors: Chirag Patel, Farukh Ikram, Nicholas Nguyen, Hao Nguyen, Priyanka Acharya, Manavjot S Sidhu
Journal: Circulation (2020)

Introduction: As a predominantly respiratory viral illness, it comes as no surprise that severe respiratory failure has portended greater risk of mortality in COVID-19 patients. We aimed to investigate whether the occurrence of a major adverse cardiovascular event (MACE) was an indicator of higher risk of eventual death in COVID-19 infected and hospitalized patients. Methods: A retrospective review was performed on 225 hospitalized patients that tested positive for COVID-19 between March and May 2020 at a major quaternary care hospital in a metropolitan area of the southwestern United States. Baseline characteristics and clinical outcomes of their disease course were identified. Survival analyses were performed on this patient pool, which was divided into two cohorts: (i) patients that experienced a MACE [a composite of myocardial infarction (MI), stroke, pulmonary embolism (PE), deep venous thrombosis (DVT), or shock requiring vasopressor support] and (ii) patients that did not experience a MACE. Pearson’s chi square test was used to examine the difference in mortality between those who had a MACE and those who did not have a MACE. Results: Of the 222 hospitalized patients for whom final discharge disposition was available, 59 had a MACE, and 163 did not. Specifically, 19 (8.59%) patients experienced a type 1 or type 2 MI, 3 (1.36%) experienced stroke, 7 (3.20%) experienced PE/DVT, and 37 (16.67%) experienced shock. A significant difference in mortality was observed between those who had a MACE and those who did not have a MACE [p-value &lt;0.0001, OR = 11.23; 95% CI = 4.29 31.33]. In the “No MACE” cohort, 61.52% were alive after t = 43 days; 30.33% of the “Yes MACE” were alive after t = 43 days. More than 50% of the COVID-19 patients that had a MACE died by day 23 of hospitalization. Conclusions: Based on our data, hospitalized COVID-19 patients who experience a MACE are over 11 times more likely to die than those who did not experience a MACE. As such, it is important for clinicians to remain vigilant in assessing for the occurrence of these events, and to promptly respond to them with an evidence-based approach.
Abstract 15886: When the Giant is Hidden but Not Dormant
Authors: Yevgeniy Brailovsky, Amirali Masoumi, Rachel Bijou, Estefania Oliveros, Gabriel T Sayer, Koji Takeda, Nir Uriel
Journal: Circulation (2020)

Background: Giant cell myocarditis is a rare etiology of cardiogenic shock, which requires high index of suspicion, rapid immunosuppressive therapy, and sometimes mechanical circulatory supportCase presentation69 year old woman with prior medical history of non-ischemic dilated cardiomyopathy and recovered left ventricular ejection fraction (LVEF) presented with cardiogenic shock complicated by acute renal and liver injury requiring support with Impella 5.5. Suspicion for myocarditis was high and patient underwent endomyocardial biopsy and started on high dose steroids. Biopsy was negative for myocarditis. Despite support, patient had progressive shock and incessant ventricular arrhythmia necessitating IV antiarrhytmics and escalation to VA ECMO in addition to Impella and eventually to central Centrimag BiVAD with drainage cannulas in right atrium and LV apex, and reinfusion catheters in pulmonary artery and ascending aorta. (Figure 1) She was urgently listed for heart transplantation as a status 1 and one day later underwent successful orthotopic heart transplantation. Pathological examination of the explanted heart was consistent with Giant cell Myocarditis (Figure 2) Conclusion: Giant cell myocarditis is a rare etiology of cardiogenic shock. Suggestive features include rapid hemodynamic deterioration and incessant ventricular arrhythmia. Negative initial endomyocardial biopsy is not enough to rule out the disease in high clinical suspicion. Rapid escalation of support is warranted in fulminant cases to preserve end organ function and improve survival.(Figure 1 Created with BioRender.com)
Alcohol decreases intestinal ratio of <i>Lactobacillus</i> to <i>Enterobacteriaceae</i> and induces hepatic immune tolerance in a murine model of DSS-colitis
Authors: Paulius V. Kuprys, Abigail R. Cannon, Jennifer Shieh, Noama Iftekhar, Sun K. Park, Joshua M. Eberhardt, Xianzhong Ding, Mashkoor A. Choudhry
Journal: Gut Microbes (2020)

Alcohol can potentiate disease in a mouse model of dextran sodium sulfate (DSS) colitis; however, the underlying mechanism remains to be established. In this study, we assessed whether the potentiated disease could be related to Enterobacteriaceae and Lactobacillus, as changes in their relative abundance can impact intestinal health. We also assessed whether the intestinal barrier is compromised after alcohol and DSS as it may increase bacterial translocation and liver inflammation. Mice were administered DSS followed by binge ethanol or water vehicle, generating four experimental groups: (Control+Vehicle, Control+Ethanol, DSS+Vehicle, DSS+Ethanol). DNA was isolated from colon and cecal contents followed by qPCR for levels of Enterobacteriaceae and Lactobacillus. Colon and liver sections were taken for histology. Intestinal epithelial cells were isolated from the colon for RNA expression. DSS+Ethanol cecal contents exhibited a 1 log increase in Enterobacteriaceae (p < .05), a 0.5 log decrease in Lactobacillus, and a 1.5 log decrease (p < .05) in the Lactobacillus:Enterobacteriaceae ratio compared to DSS+Vehicle, with similar trends in colon contents. These changes correlated with shorter colons and more weight loss. Irrespective of ethanol administration, DSS compromised the mucosal barrier integrity, however only DSS+Ethanol exhibited significant increases in circulating endotoxin. Furthermore, the livers of DSS+Ethanol mice had significantly increased levels of triglycerides, mononuclear cells, yet exhibited significantly depressed expression of liver inflammatory pathways, suggestive of tolerance induction, compared to mice receiving DSS+Vehicle. Our results suggest that ethanol after DSS colitis increases the intestinal burden of Enterobacteriaceae which may contribute to intestinal and liver damage, and the induction of immune tolerance.