tbuckley/cabot-search huggingface dataset:
Abstract 10996: Predictors of Surgical Reintervention Before Bidirectional Cavopulmonary Shunt in Children with Single Ventricle Physiology Who Underwent Main Pulmonary Artery Banding
Authors: Bhavikkumar Langanecha, sajith kesavan, Mike Seed, Steven M Schwartz, Osami Honjo, Chun-po S Fan, Jennifer Russell, Paula Pereira-Solomos, jennifer thomas, Andreea Dragulescu, Katherine Taylor, Alejandro Floh
Journal: Circulation (2021)

Introduction: Unplanned intervention before stage 2 palliation (S2P) in patients with single ventricle (SV) lesions with dual unobstructed outflows palliated with pulmonary artery banding (PAB) is common. The factors contributing to intervention and its association with successfully undergoing S2P are unclear. Hypothesis: Early intervention is more common when PAB is placed at a younger age and with a lower initial PAB pressure gradient. Methods: Retrospective single center study of patients with SV lesions undergoing PAB between Jan 2000 and Dec 2020. Association with reintervention and successful S2P was modeled using exploratory cause-specific hazard regression. A multivariable model was developed adjusting for clinical and statistically relevant predictors. The cumulative proportion of patients undergoing intervention were summarized using a competing risk model. Results: A total of 77 patients - 53% female, 86% term and 12% syndromic - underwent PAB at median (IQR) 47 (24-66) days and 3.73 (3.2-4.5) kg. Within 18 months of PAB, 60 (78%) reached S2P, 9 (12%) died, 1 (1%) transplanted and 7 (9%) were alive without S2P. Intervention occurred in 18 (23%) prior to S2P (10/18) or death (4/18); 16 (21 %) occurred within 6 months of PAB. Intervention included PAB adjustment (n=7), conversion to DKS/BTT shunt (n=5), balloon atrial septostomy (n=4) and addition of a BTT shunt (n=2). Repeat intervention was required in 4 patients. Intervention was associated with genetic syndrome (p= 0.03) and lower weight at PAB (p=0.02) but not with age at PAB, pre/postoperative oxygen saturation, PAB length or gradient. Presence of genetic syndrome was the only risk factor associated with not reaching S2P (p=0.02). Conclusions: Intervention is common following PAB and associated with presence of genetic disorder or smaller patient size. Children with genetic syndrome aiming to undergo S2P are at higher risk for intervention and death and may benefit from alternate treatment strategy.
Abstract 13052: Antiarrhythmic Effect of Artemisinin in Canine Experimental Model of Brugada Syndrome
Authors: Hyung Ki Jeong, Namsik Yoon, Ki Hong Lee, Hyung Wook Park, Jeong gwan Cho
Journal: Circulation (2021)

Introduction: Brugada syndrome is an inherited arrhythmia syndrome which presents sudden cardiac death (SCD) without structural heart diseases. One of the mechanisms of SCD has been suggested that uneven dispersion of Ito channel between epicardium and endocardium induces ventricular arrhythmia. Hypothesis: Artemisinin is used as antimalarial drug widely. Its antiarrhythmic effect which included suppression of Ito channel was reported previously. We investigated the effect of Artemisinin for suppression of Brugada syndrome in canine experimental model Methods: Transmural pseudo-ECG and epicardial/endocardial action potentials were recorded from coronary-perfused canine right ventricular wedge preparation (N=7). To mimic the Brugada syndrome model, acetylcholine (3 μM), calcium channel blocker verapamil (1 μM), Ito agonist NS5806 (7-10 μM) were used and waited until ventricular arrhythmia induction. Then, Artemisinin 100-150 μM was perfused to ameliorate the ventricular arrhythmia. Action potential duration, J wave area, notch index and T wave dispersion were measured. Results: In 5 sample models, ventricular arrhythmia was induced. The Artemisinin suppressed ventricular arrhythmia (n=5) and recovering the action potential dome of RV epicardium after provocation of ventricular arrhythmia in all preparations (n=7). J wave area and epicardial notch index were also decreased after Artemisinin perfusion. Action potential duration prolonged as the ventricular arrhythmia provocation and recovered after Artemisinin perfusion. Conclusions: Our findings suggest that Artemisinin alleviate the Brugada syndrome in the wedge preparation model by inhibition of Ito channel and it suppressed the development of phase 2 reentry and ventricular tachycardia/ventricular fibrillation.
Abstract 12180: Comparison of Hemodynamically Measured Systemic Arterial Pulsatility Index With Measured Aortic Pulsatility on Gated Computed Tomography in Pre-TAVR Patients
Authors: Jarred Strickling, Christian Selinksi, Kajal Shah, Joshua Makepeace, Jay Jalenak, Olivia Ondigi, Kara Harrison, Scott Lim, Nishtha Sodhi, Michael Salerno, Kenneth Bilchick, Sula Mazimba
Journal: Circulation (2021)

Introduction: Systemic Arterial Pulsatility Index, (SAPi), [systemic pulse pressure/left ventricular end diastolic pressure (LVEDP)] has emerged as a useful prognostic tool in many cardiac diseases. We aimed to compare this hemodynamically derived index of pulsatility with directly measured pulsatility on gated CT imaging (SAPi-CT) in pre-TAVR patients, as well as with SAPi calculated from pre-TAVR transthoracic echocardiography (SAPi-TTE). We also evaluated the correlation of each of these measurements with the patients’ pre-TAVR 5-meter walk times (5MWT). Methods: The three SAPi were calculated as; SAPi-Cath using invasive hemodynamics, SAPi-TTE using the Nagueh formula (PCWP = 1.24 X (E/e’) +1.9) as surrogate for LVEDP, and SAPi-CT by calculating the difference in aortic cross-sectional area during systole and diastole on gated CT imaging at the level of the ascending aorta (the level of right pulmonary artery). Correlational comparisons of these methods with each other and with pre-TAVR 5MWT were made using R software. Results: Among 110 patients studied (mean age 77.3, 56% female), the mean SAPi-Cath, SAPi-TTE, and cross-sectional area on CT were 3.15, 3.03, and 53.83mm 2 respectively. There was a significant positive correlation between SAPi-Cath and SAPi-CT [(r=0.275, p=0.0073); shown in Figure 1a], but not between SAPi-Cath and SAPi-TTE (r=0.163, p=0.1852). SAPI-Cath was significantly associated 5MWT (r=0.287, p=0.0064); shown in Figure 1b. Using a linear regression, the relationship between SAPi-Cath and the 5MWT is estimated to be: 5MWT=4+SAPI. SAPi-CT did not correlate with 5MWT (r=0.021, p=0.8478). Conclusions: SAPi-Cath and SAPi-CT showed a significant positive correlation. Only SAPi-Cath showed a significant correlation with 5MWT. Given the known prognostic value of SAPi-Cath, future studies utilizing imaging variables should be performed to enhance prognostication with multi-modal data.
Abstract 9573: Significant Reduction in Ventricular Tachyarrhythmia After Myocardial Infarction in Cardiovascular Progenitors Transplanted Pig Hearts
Authors: Lynn Yap, Li Yen Chong, Clarissa Tan, Swarnaseetha Adusumalli, Millie Seow, Jing Guo, Zuhua Cai, Sze Jie Loo, Eric Lim, Narayan Lath, Lei Ye, Enrico Petretto, Karl Tryggvason
Journal: Circulation (2021)

Stem cell therapy could potentially replace damaged heart muscle for regenerative cardiology. We hypothesized that immature cardiovascular progenitors (CVPs) when transplanted into infarcted hearts would electrically synchronized and mature in vivo thus avoiding the occurrence of VTs. In this study, we reported the derivation and applications of hESC-derived CVPs using highly reproducible (R 2 &gt; 0.95) laminin-221 differentiation protocol. The infarction model was created on 3 months old Sus scrofa pigs where we permanently ligated the coronary arteries and intramyocardially transplanted 200 million CVPs. A total of 3 sham, 10 medium control and 10 CVP transplanted pigs were monitored at 4- and 12-weeks post-transplantation. We demonstrated using 10X spatial transcriptomic analysis at 1-week following transplantation the engraftment of the human CVPs into the pig heart. The cells remained viable and proliferated to formed human graft in the infarcted region at 4- and 12-weeks as indicated by IVIS imaging and histology staining. Heart function was analyzed by magnetic resonance imaging (MRI) and revealed overall improvement in left ventricular ejection fraction by 21.35 ± 3.3 %, which was accompanied by significant improvements in ventricular wall thickness and wall motion, as well as a reduction in infarction size after CVP transplantation as compared to medium control pigs (P &lt; 0.05). Electrophysiology analyses revealed electrical propagation between transplanted cells and host tissue CMs. Temporary episodes of VT over a period of 25 days were developed in 4 out of 10 CVP transplanted pigs and 1 pig had persistent VT, while the rest (n = 5) remained in normal sinus rhythm. All ten pigs survived the experiment without any VT-related death. Finally, computerized tomography (CT) scans revealed no tumor formation after 12-weeks transplantation indicating the long-term safety of the treatment. In conclusion, we reported the generation of an effective and potent CVPs and a significant reduction (50 %) in graft induced VT as compared to studies transplanted with contracting cardiomyocytes. This method may pave the way for stem cell therapy of myocardial infarction in humans.
Cash transfers for HIV prevention: A systematic review
Authors: Marie C. D. Stoner, Kelly Kilburn, Peter Godfrey-Faussett, Peter Ghys, Audrey E. Pettifor
Journal: PLoS Medicine (2021)

Background Given the success of cash programs in improving health outcomes and addressing upstream drivers of HIV risk such as poverty and education, there has been an increasing interest in their potential to improve HIV prevention and care outcomes. Recent reviews have documented the impacts of structural interventions on HIV prevention, but evidence about the effects of cash transfer programs on HIV prevention has not been systematically reviewed for several years. Methods and findings We did a systematic review of published and unpublished literature to update and summarize the evidence around cash programs for HIV prevention from January 2000 to December 17, 2020. We included studies with either a cash transfer intervention, savings program, or program to reduce school costs. Included studies measured the program’s impact on HIV infection, other sexually transmitted infections (STIs), or sexual behaviors. We screened 1,565 studies and examined 78 in full-text review to identify a total of 45 peer-reviewed publications and reports from 27 different interventions or populations. We did not do a meta-analysis given the range of outcomes and types of cash transfer interventions assessed. Most studies were conducted in sub-Saharan Africa ( N = 23; South Africa, Tanzania, Malawi, Lesotho, Kenya, Uganda, Zimbabwe, Zambia, and eSwatini) followed by Mexico ( N = 2), the United States ( N = 1), and Mongolia ( N = 1)). Of the 27 studies, 20 (72%) were randomized trials, 5 (20%) were observational studies, 1 (4%) was a case–control study, and 1 (4%) was quasi-experimental. Most studies did not identify a strong association between the program and sexual behaviors, except sexual debut (10/18 finding an association; 56%). Eight of the 27 studies included HIV biomarkers, but only 3 found a large reduction in HIV incidence or prevalence, and the rest found no statistically significant association. Of the studies that identified a statistically significant association with other STIs ( N = 4/8), 2 involved incentives for staying free of the STI, and the other 2 were cash transfer programs for adolescent girls that had conditionalities related to secondary schooling. Study limitations include the small number of studies in key populations and examining interventions to reduce school costs and matched saving programs. Conclusions The evidence base for large-scale impacts of cash transfers reducing HIV risk is limited; however, government social protection cash transfer programs and programs that incentivize school attendance among adolescent girls and young women show the greatest promise for HIV prevention.
Impact of Crizanlizumab on Acute Medical Care Utilization in the Height of the COVID-19 Pandemic
Authors: Shivani Rao, Nicole K. Yun, James L. Coggan, Peter Wu, Teresa O'Brien, Katherine Barnett, Sean O'Mahony, Ramandeep Kaur, Christopher Bruti, Celine Goetz, Jerome J Martin, Sefer Gezer, Parameswaran Venugopal, Shivi Jain
Journal: Blood (2021)
Dudley trust fined £2.5m over deaths of two patients from infection
Authors: Clare Dyer
Journal: BMJ (2021)

A hospital trust has been fined more than £2.5m after pleading guilty to failing to provide safe care to two patients who died and for causing them avoidable harm.

Dudley Group NHS Foundation Trust was also ordered to pay £38 000 in costs to the Care Quality Commission, the healthcare regulator that brought the prosecution, after a sentencing hearing at Wolverhampton magistrates court.

Both patients were cared for at Russells Hall Hospital, Dudley, in early 2018. Natalie Billingham, a 33 year old mother of six, died …
The 2021 annual report of DataDerm: The database of the American Academy of Dermatology
Authors: Marta J. Van Beek, Robert A. Swerlick, Barbara Mathes, Margo J. Reeder, Toni Kaye, Arik Aninos, Mason Totaro, Alyssa Burns, Matthew Fitzgerald, Caryn D. Etkin, Jeffrey P. Jacobs
Journal: Journal of the American Academy of Dermatology (2021)
Abstract 10695: Early Overnutrition in Rats Induces Premature Cardiac Alterations Independently of Blood Pressure: Leptin-TRH Pathway Involvement
Authors: Maia Aisicovich, Macarena Luz Rosati, Mariano Schuman, Graciela L Giardina, MarÃa Silvina Landa, Silvia Garcia
Journal: Circulation (2021)

Animal models are an interesting tool to evaluate future consequences of early nutritional insults. We described in adult mice that: leptin induces cardiac cTRH, leading to cardiac damage regardless of blood pressure in hyperleptinemic Agouti. Conversely, cTRH in the ob/ob lacking leptin is similar to control and even do not have Left Ventricular Hypertrophy (LVH). Moreover, leptin restitution induces cTRH and later LVH. Also, in C57BL/6 a 3-week subanorexigenic leptin dose induced cTRH and sequent LVH. All this suggests that heart damage in obesity depends on the novel leptin-cTRH pathway. Plus, Leptin directly induces TRH in cell culture (Aisicovich 2019, AHA) To further investigate the impact of early dietary interventions in childhood, we studied rat litter size reduction, a model with a reported increase in body weight, fat, leptin, insulin and cholesterol levels (Stefanidis A, 2012) We hypothesize that leptin rise increases cTRH leading to cardiac damage, independently of hypertension. On postnatal day 4, Wistar rat litters of 11 pups at birth were adjusted to 4 male pups (overnourished ON) or 11 (control C). At weaning, we individualized rats with free access to water and standard diet up to 7 weeks old. The rise in body weight, food consumption, and fat in ON vs C (p&lt;0.02 n=10 ANOVA) confirmed the model. There weren’t any blood pressure differences between groups, still LVH index increased (heart weight/tibia length) (p&lt; 0.01 n=6) in ON vs C. As expected, in ON the higher leptin increased cTRH mRNA (p&lt; 0.01 n=6) as protein [WB (p=0.05 n=3) IHQ (p&lt;0.04 n=6)] vs C. According to cTRH actions, hypertrophic and fibrotic markers TGF-B and Collagens 1 and 3 mRNA increased (p&lt;0.01, n=6) confirmed by IHQ and Sirius red staining (p&lt; 0.01 n=6) Also, echocardiogram showed increases in LV end-diastolic (0.26±0.08 vs 0.61±0.07 ml p &lt;0.01) and end-systolic (0.02±0.02 vs 0.11±0.01 ml p &lt;0.01) volumes, and decreases in LV ejection fraction (94.5±2.2 vs 83.3±1.9 % p &lt;0.01) and SF (54.4±2.6 vs 45.0±2.3 % p &lt;0.02) This could be restored by cTRH inhibition as demonstrated in the cardiac infarct model (Schuman ML, 2021) Our results point out that early overnutrition induces evident cardiac damage already at 7 weeks, independently of blood pressure and mostly driven by the leptin-TRH pathway.
Research and Care Networks in Acute Leukemia As a Model for Global Healthcare Collaboration
Authors: Martin R Guscott, Stacy L Cooper, Poonam Bagai, Archie Bleyer, Randal K Buddington, Dan Douer, Tina B Chong, Ryan R Combs, Jennifer L Hylton, Gabriela Ines-Villanueva, Jennifer A Lowe, Rishabh Pandey, Aman N Patel, Scott C Howard
Journal: Blood (2021)
Low Incidence of Chronic Graft-Versus-Host Disease in Myeloablative Allogeneic Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide Using Matched Related or Unrelated Donors: Phase II Study Interim Analysis
Authors: Najla H El Jurdi, Daniel O'Leary, Fiona He, Todd E. DeFor, Armin Rashidi, Erica D. Warlick, Ashish O. Gupta, Joseph E. Maakaron, Mukta Arora, Murali Janakiram, Arne Slungaard, Angela R. Smith, Veronika Bachanova, Claudio G. Brunstein, Margaret L. MacMillan, Jeffrey S. Miller, Brian C. Betts, Christen L. Ebens, Heather Stefanski, Troy C Lund, Paul Orchard, Gregory M. Vercellotti, Daniel J. Weisdorf, Shernan G Holtan
Journal: Blood (2021)
TAMI-40. PEDIATRIC H3K27M MUTANT GLIOMAS UNDERGO METABOLIC REPROGRAMMING THAT CAN BE LEVERAGED FOR NON-INVASIVE METABOLIC IMAGING
Authors: Meryssa Tran, Georgios Batsios, Céline Taglang, Anne Marie Gillespie, Javad Nazarian, Sabine Mueller, Pavithra Viswanath
Journal: Neuro-Oncology (2021)

Abstract Diffuse midline gliomas (DMGs) are a universally lethal form of childhood cancer. The infiltrative nature of DMGs makes them difficult to visualize by conventional magnetic resonance imaging. Genomics studies indicate that DMGs are driven by unique histone H3K27M mutations that result in broad epigenetic dysregulation. Many of the resulting changes in gene expression have the potential to induce metabolic reprogramming, which has been identified as a hallmark of cancer. The goal of this study was to dissect metabolic reprogramming in preclinical DMG models in order to identify novel magnetic resonance spectroscopy (MRS)-detectable metabolic biomarkers that can be exploited for non-invasive imaging. First, we used 1H-MRS, which reports on steady-state metabolism, to examine H3K27M mutant SF7761 cells and H3 wild-type normal human astrocytes (NHA). Lactate, glutathione and phosphocholine, which are involved in glycolysis, redox and phospholipid metabolism respectively, were elevated in SF7761 cells relative to NHAs. Mechanistically, these metabolic alterations were associated with upregulation of key enzymes including hexokinase 2, glutamate cysteine ligase and choline kinase a. Importantly, in vivo 1H-MRS showed elevated lactate, glutathione and total choline (combined signal from choline, phosphocholine and glycerophosphocholine) in mice bearing orthotopic SF7761 tumors relative to tumor-free controls. We then examined alterations in dynamic metabolic pathways in our models. Using thermally-polarized 13C-MRS, we identified elevated production of [2-13C]-lactate from [2-13C]-glucose in SF7761 cells relative to NHAs. Hyperpolarized 13C-MRS is a method of enhancing the 13C-MR signal such that metabolic fluxes can be interrogated with high sensitivity. Hyperpolarized [1-13C]-pyruvate flux to [1-13C]-lactate non-invasively monitors glycolysis and is in clinical trials in adult glioma patients. Importantly, hyperpolarized [1-13C]-pyruvate metabolism to lactate was elevated in SF7761 cells relative to NHAs. Collectively, our studies suggest that H3K27M mutant DMGs undergo reprogramming of glucose, redox and phospholipid metabolism that can be leveraged for non-invasive 1H- and hyperpolarized 13C-MRS-based imaging.
Abstract 12044: Predictors of Engagement With a Remotely Delivered Cardiovascular Disease Risk Reduction Intervention
Authors: Ifeanyi Madujibeya, Misook L Chung, Jennifer Miller, Mary Kay Rayens, Frances J Feltner, Debra K Moser
Journal: Circulation (2021)

Introduction: Videoconferencing (VC) technology is one approach to increasing access to interventions targeting cardiovascular disease (CVD) risk reduction among rural dwellers, particularly caregivers of those with chronic illnesses. It is important to understand factors affecting engagement with such interventions in order to improve engagement. We examined demographic, clinical, psychological, and technological factors that predicted engagement with VC-based interventions. Method: We used data from the intervention group (n=131) in a randomized controlled trial of a CVD risk reduction intervention. Engagement was defined as the number of interventions or booster sessions (total 26 possible) completed per participant. Depressive symptoms and caregiving stress were measured with the Patient Health Questionnaire and Zarit Burden Interview respectively. Negative binomial regression with backward stepwise regression was used to determine predictors of engagement. Result: Among participants (mean age = 54.83 ± 13.8 years, 79.4% female) the mean engagement rate was 17.08 ± 7.2 sessions. Higher level of depressive symptoms (incidence rate (IR) = 0.98 , p &lt; .05) was associated with decreased engagement. Higher caregiving burden (IR= 1.008, p &lt; .01) and, employment status (working in the home or retired compared to. employment outside the home IR: 1.25, p &lt; .03) were associated with increased engagement. The association between age and engagement rate was dependent on level of technical problems ( IR = 1.02, p &lt; .00 ), and financial status (average vs. low IR = 1.02, p &lt; .02, high vs. low IR = 1.04, p &lt; .00) (Fig. 1). Conclusion: Depressive symptoms, older age in those with low financial status, and working outside the home were associated with low engagement rate with VC-based intervention targeting CVD-risk reduction among rural caregivers. Thus, tailoring such interventions to address these factors is essential in improving engagement in remote interventions.
Annals Graphic Medicine - Dr. Mom: Saying No
Authors: Grace E. Farris
Journal: Annals of Internal Medicine (2021)

Web ExclusivesDecember 2021Annals Graphic Medicine - Dr. Mom: Saying NoFREEGrace E. Farris, MDGrace E. Farris, MDUniversity of Texas, Austin, Texas (G.E.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G21-0077 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: University of Texas, Austin, Texas (G.E.F.)Disclosures: Disclosures can be viewed atwww.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G21-0024.Author/Illustrator Information: Grace E. Farris, MD, is an assistant professor of medicine at Dell Medical School at the University of Texas in Austin, Texas. You can view her work at her website: www.farrisgrace.com.About Dr. Mom: In Dr. Mom, physician and cartoonist Grace Farris examines work–life balance while mothering and doctoring. Dr. Mom appears monthly in Annals Graphic Medicine at Annals.org.This article was published at Annals.org on 23 November 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics December 2021Volume 174, Issue 12Page: W118-W119 ePublished: 23 November 2021 Issue Published: December 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...