tbuckley/cabot-search huggingface dataset:
Prognostic impact and timing considerations for allogeneic hematopoietic stem cell transplantation in chronic myelomonocytic leukemia
Authors: Prateek Pophali, Aasiya Matin, Abhishek A. Mangaonkar, Ryan Carr, Moritz Binder, Aref Al-Kali, Kebede H. Begna, Kaaren K. Reichard, Hassan Alkhateeb, Mithun V. Shah, Ayalew Tefferi, William J. Hogan, Mark R. Litzow, Mrinal M. Patnaik
Journal: Blood Cancer Journal (2020)

Chronic myelomonocytic leukemia (CMML) is a clonal disorder of aging hematopoietic stem cells characterized by overlapping features of myeloproliferation and myelodysplasia 1 , with a median overall survival (OS) of ≤36 months 1,2 .Hypomethylating agents (HMAs) have an overall response rate of about 30-40%; however, these agents are ineffective in altering the natural disease biology due to inability to prevent acquisition of molecular abnormalities and transformation to acute myeloid leukemia (AML) 3 .Allogeneic hematopoietic stem cell transplantation (alloHCT) is a potentially curative option, with 20-50% patients achieving long-term remissions.However, as the median age of presentation is 73 years, only a fraction (<20%) of CMML patients are eligible for alloHCT 4 .Prognostic models such as the Mayo Prognostic Model (MPM), Mayo Molecular Model (MMM), Groupe Francais des Myelodysplasies, and the CMML-specific prognostic scoring system (CPSS) are important tools to identify patients at high risk for disease progression and death [5][6][7][8][9] .Several retrospective analyses of outcomes in alloHCT patients have identified adverse cytogenetics, blast percentage, HCT-comorbidity Index, time to alloHCT, disease control at the time of alloHCT and acute and chronic graft vs. host disease (GVHD) as factors influencing OS and AML-free survival (LFS) [10][11][12]14,15 .
Abstract 223: Association Between Covid-19 Pandemic Related Anxiety and Advanced Care Planning Desire in Cardiac Arrest Survivors
Authors: Benjamin J Meyer, Samuel Jacobson, David Roh, Soojin Park, Jan Claassen, Sachin Agarwal
Journal: Circulation (2020)

Introduction: Patients with cardiovascular disease conditions are at high risk for direct and indirect impacts of COVID-19 on morbidity and mortality. In light of this, we aimed to assess the extent to which COVID-19-related anxiety in patients with a history of cardiac arrest (CA) correlates with the desire to change or discuss advanced directives. Methods: Between May 15-28, 2020, a month after the New York City (NYC) COVID-19 pandemic peak, CA survivors from a prospective cohort were invited to participate in a telephone-based assessment of the pandemic’s impact on psychological and other survivorship dimensions. COVID-19-related anxiety was measured by the Generalized Anxiety Disorder-3 scale, which asks how often respondents felt (1) anxious, (2) unable to stop worrying, and (3) excessively worried over two weeks, and was keyed to the COVID-19 pandemic. Desire to discuss or to change financial and/or health-related advanced directives were reported on a yes-or-no basis. Results: 100 approached, 69 CA survivors participated (53% male; age 61±15 years; 44% White, 20% Black, and 31% Latinx). A majority, 58 of 69 (84%), had no COVID-19 symptoms and/or were not tested. Only 12 of the 69 respondents (17%) showed interest in discussing or changing advanced directives. There were no significant differences in the age, sex, race, or COVID-19 symptoms status between those who showed desire versus those who did not. Desire to change advance directives was significantly associated with increased COVID-19-related anxiety (OR 1.5, CI 95% [1.2-1.9] p&lt;0.002). Conclusions: In CA survivors, a desire to change financial or healthcare-related advanced directives during the COVID-19 outbreak was associated with increased pandemic-related anxiety. The causality and directionality of this relationship require further, qualitative study.
Endpiece: Improvement of the practice of medicine
Authors: Jeremy Hugh Baron
Journal: BMJ (2004)

That such practitioners of Physick and Surgery as have the good of mankind and advancement of their own profession earnestly at hand, would note down such practical hints suggested by their own observation, reading, or reflexion, as are new, and appear to them rational, and as they have not the boldness to put into execution, till they be further satisfied about them; and after mature deliberation publish them from time to time.

Flemyng M [physician, Hull]. A proposal for the improvement of the practice of medicine. 2nd ed. Hull: G Ferraby, 1748:10
Abstract 350: Impact on Knowledge Retention on CPR Using a Smartphone App in Teenagers
Authors: Felipe M Crepaldi, Miguel A Moretti, Bárbara G Maya, Beatriz G Magnoni, Giane P Costa, Isabella O Holsapfel, João F Ferreira, Antonio C Chagas
Journal: Circulation (2020)

Cardiopulmonary arrest occurs more frequently outside the hospital, often in the presence of a teenager. Studies show that knowledge retention of basic procedures in CPR tends to decrease with time. Hypothesis: To evaluate the contribution to learning and retention of CPR techniques using a smartphone application (APP) Ressuscita. Methods: An application was developed to assist the training of CPR maneuvers. One group of students (gAPP) was trained according to the BLS principles along with the App (which was installed on the smartphones) and the group control (gCT) received the same training, without the APP. Both groups were evaluated at 3 moments, immediately after the first training (T0), 3 months (T3m) and 6 months later (T6m). Theoretical and practical evaluations were performed. After the 3-month, the gCT was received the APP (they were also able to keep the APP). The groups were matched for age and sex. Data were subjected to statistical analysis and treated as mean values and standard deviation. Shapiro-Wilk test, Mann-Whitney test and t test were used. Results: 93 teenagers were trained, with a mean age of 14 years, 49 in gAPP and 44 in gCT. The graphics show that they were homogeneous and at the end of the training presented the same grade profile in the theoretical and practical evaluation. After 3 months, the gAPP had a better knowledge and retention profile. In the practical evaluation the gAPP demonstrated a smaller reduction in score compared to those with gCT: 0.1 + 0.2 steps vs. 2.1 + 0.3 steps (p &lt;0.001). After six months, the groups returned to the same profile of knowledge and retention. Detailing the practical evaluation, the practical skills were the most improved with the application. Conclusion: There was greater retention of knowledge, especially skills, in relation to CPR maneuvers in individuals trained with the app.
Abstract 15194: The Distribution of Anti-factor Xa Activity Values, Prothrombin Time and Activated Partial Thromboplastin Time Assessed at Multiple Points in Patients on Edoxaban Therapy
Authors: Ryohei Ono, Kenichi Fukushima, Hidehisa R Takahashi, Yasuhiko Hori, Yoshio Kobayashi
Journal: Circulation (2020)

Introduction: Edoxaban is one of the direct oral anticoagulants (DOACs) used for non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE). Chromogenic anti-factor Xa activity (AXA) is the appropriate assay to measure the pharmacodynamics of a factor Xa inhibitor and to estimate plasma drug concentrations. Although patients taking DOACs do not require routine coagulation monitoring, the distributions of AXA values have not been assessed at multiple points in the previous study. Purpose: To clarify the distribution of AXA values at two-hour intervals in patients taking edoxaban. Methods: Sixteen patients (66.8 ± 9.6 years, 11 males) with NVAF or VTE on edoxaban therapy were enrolled in the study. We measured AXA, using chromogenic assay with the HemosIL Liquid Heparin kit, at two-hour intervals (from immediately before the intake of edoxaban to 8 hours after the intake). The dosage of edoxaban was 30 mg (n=11) once daily (OD) or 60 mg (n=5) OD according to the prescribing information. Results: The distributions of AXA values of 30 mg OD at 0, 2, 4, 6 and 8 hours after the intake of edoxaban were 0.12±0.08, 0.80±0.48, 0.94±0.48, 0.72±0.34 and 0.53±0.32 (IU/mL), respectively. The distributions of AXA values of 60 mg OD at 0, 2, 4, 6 and 8 hours after the intake of edoxaban were 0.17±0.04, 1.59±0.76, 1.43±0.34, 1.29±0.32 and 0.96±0.21 (IU/mL), respectively. Conclusions: Our findings reveal that the peak time of AXA values might be different depending on the dosage. The peak time of 30 mg OD is between 0 to 4 hours, whereas that of 60 mg OD is between 2 to 6 hours after the intake of edoxaban. In addition, the AXA values of 60 mg OD are almost twice as much as that of 30 mg at each point.
Abstract 12876: Impact of Anesthesia Type on Short- and Long-term Outcomes After Transcatheter Aortic Valve Replacement: The Cleveland Clinic Experience
Authors: Yasser Sammour, Jimmy L Kerrigan, Rama D Gajulapalli, Kinjal Banerjee, Sanchit Chawla, Hassan Mehmood Lak, Lars G Svensson, James J Yun, Andrej Alfirevic, Shiva Sale, Anand Mehta, Amar Krishnaswamy, Samir R Kapadia
Journal: Circulation (2020)

Introduction: The early approach was to perform transcatheter aortic valve replacement (TAVR) under general anesthesia (GA). Over time, monitored anesthesia care (MAC) has been introduced as a less invasive option to facilitate TAVR. Objective: We sought to compare short- and long-term outcomes between TAVR patients undergoing GA versus those receiving MAC. Methods: We identified all consecutive patients with severe symptomatic aortic stenosis who underwent Transfemoral (TF)-TAVR at our institution between January 2012 and April 2017. Results: We included 998 patients who met our inclusion criteria. Overall, the mean age was 80.4 ± 9.7 years, 57.4% were males and 95.2% were Caucasians. MAC was used in 43.9%. The mean STS risk score (SD) was lower with MAC (6.7 ± 4.3% vs. 7.6 ± 4.5%; p = 0.004). MAC was associated with lower all-cause mortality at both 30 days (0.5% vs. 4.2%; log-rank p &lt; 0.001), and 1 year (11.7% vs. 16%; log-rank p = 0.024). However, this difference was negated at 3 years (37% vs. 39%; log-rank p = 0.271). Further, there were no differences in major adverse cardiac and cerebrovascular events (MACCE) at either 30 days (4.6% vs. 7.6%; log-rank p = 0.089) or 1 year (21.5% vs. 24.2%; log-rank p = 0.242). There were no differences in the rates of myocardial infarction (1.6% vs. 0.9%; log-rank p = 0.375), stroke or transient ischemic attacks (3.1% vs. 3.4%; log-rank p = 0.817) or heart failure hospitalizations (9.6% vs. 9.5%; log-rank p = 0.815) at 1 year. In multivariate analysis, MAC predicted lower all-cause death at 1 year after TAVR (HR 0.672; 95% CI 0.453 - 0.996; p = 0.048) but not at 3 years (HR 0.882 (0.705 - 1.103; p = 0.271). MAC was not an independent predictor of MACCE (HR 0.851; 95% CI 0.643 - 1.126; p = 0.258). Conclusions: Compared to GA, MAC was associated with lower all-cause mortality at both 30 days and 1 year, but not at 3 years. There were no differences in MACCE between the two groups at either 30 days or 1 year.
Autochthonous West Nile virus infection outbreak in humans, Leipzig, Germany, August to September 2020
Authors: Corinna Pietsch, Dominik Michalski, Johannes Münch, Sirak Petros, Sandra Bergs, Henning Trawinski, Christoph Lübbert, Uwe G Liebert
Journal: Eurosurveillance (2020)

Following a distinct summer heat wave, nine autochthonous cases of West Nile fever and West Nile neuroinvasive disease, including one fatality, were observed in Leipzig, Germany, in August and September 2020. Phylogenetic analysis demonstrated close relationships in viruses from humans, animals and mosquitos in eastern Germany, obtained during the preceding 2 years. The described large cluster of autochthonous West Nile virus infections in Germany indicates endemic seasonal circulation of lineage 2 viruses in the area.
Treatment of Hidradenitis Suppurativa
Authors: Gordon B. Newell
Journal: JAMA (1973)

<h3>To the Editor.—</h3> In a recent article advocating the treatment of hidradenitis suppurativa by excision and skin grafting, Shaughnessy et al (222:320, 1972) stated that "all... therapy short of total excision of the apocrinegland-bearing tissue is temporizing." Several hundred cases of hidradenitis suppurativa seen at our institution during the past 20 years have been successfully treated by exteriorization, curettage, and electrocoagulation. The basic exteriorization procedure had been employed for some time, but its modification with curettage and electrocoagulation, as advocated by one of us has led to excellent results.<sup>1</sup>It is unfortunate that more surgeons do not learn and use this simple technique. The depth of perirectal lesions should be investigated preoperatively. Fissure-inano and processes that involve the deep subcutaneous tissues require more extensive surgery and are not treated by the method herein described. Adequate preoperative evaluation of perirectal lesions should include gentle probing of the sinus tracts, a
LIVER INJURY IS ASSOCIATED WITH INCREASED MORBIDITY AND MORTALITY IN COVID-19 PATIENTS
Authors: M. B. Siddiqui, S. Suresh, M. A. Ghanimeh, M. Karrick, F. Nimri, M. Musleh, V. Mendiratta, M. Al-Shammari, S. Simmer, J. Jou, S. M. Russell, D. Dang, R. J. Salgia, T. Zuchelli
Journal: Hepatology (2020)

Background: Based on current literature there appears to be a high prevalence of liver injury (LI) in patients with COVID-19 However, there are limited large scale studies on risk factors, morbidity, and mortality associated with LI in these patients We aim to determine risk factors and outcomes of patients hospitalized with COVID-19 and LI Methods: We performed a retrospective single-center study at a large tertiary care hospital  All index admissions of adult patients with confirmed COVID19 between 3/1 to 4/30/2020 were included Data on baseline characteristics and clinical outcomes was collected during manual chart review Mild elevation in LFTs (MEL), defined as peak levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TB) above upper limit of normal (ULN) but lower than the threshold for LI  LI was defined as peak ALT/AST three times ULN and/or peak ALP/TB two times ULN ULN threshold values of ALT 52, AST 35, TB 1 2, ALP 140 were used Both cohorts were compared with our control group, who had normal LFTs at presentation and throughout the hospitalization SAS 9 4 was used for analysis Results: A total of 1935 patients were included of which 507 (26 2%) had normal LFTs, 1030 (53 2%) had MEL, and 397 (20 5%) had LI Males were more commonly found in the MEL (p=0 0004) and LI groups compared to control (p< 0001) Patients in the MEL cohort were older (p=0 0005) African Americans were more likely to develop LI (p=0 0318) There was no difference in comorbidities between all groups Among patients with LI, 241 (61%) had a hepatocellular pattern, 20 (5%) had a cholestatic pattern, and 135 (34%) had a mixed pattern Patients with LI had an increased risk of mortality (RR 4 26 [95% CI 3 12, 5 81;p< 0001]), ICU admission (RR 5 52 [95% CI 4 07, 7 49;p< 0001]), intubation (RR 11 01 [95% CI 6 97, 17 34]);p< 0001) and 30-day readmission (1 81 [95% CI 1 17, 2 80;p< 0076]) (Table 2, Figure 1) compared to the control group Conclusion: Our study demonstrates that patients with COVID-19 who present with LI have a significantly increased risk of mortality, mechanical ventilation, ICU admission, and 30-day re-admission compared to patients with MEL and normal LFTs This information is important to appropriately manage COVID-19 patients Further research looking at risk prediction models and pooling multi-center data should include liver injury as a key variable
Abstract 14943: Comparison of Heart Failure Patients Newly Prescribed Sacubitril/valsartan With Those Newly Prescribed Aceis/arbs; A Cohort Study Using Us Optum Electronic Health Record Data
Authors: Emil Loefroth, Xian Shen, Rachel Studer, Raymond Schlienger, Clare Proudfoot, Stefano Corda, Sibasish Saha, Sarvesh K Satwase, Emma Houchen
Journal: Circulation (2020)

Background: The clinical development program of sacubitril/valsartan (sac/val) for heart failure with reduced ejection fraction (HFrEF) only included a very limited number of patients being naive to prior angiotensin converting enzyme inhibitors (ACEis) or angiotensin II receptor antagonists (ARBs). Recent studies support the use of sac/val in hospitalised HF patients without prior ACEis/ARBs. This study aims to compare HF patients newly prescribed either sac/val or ACEis/ARBs. Methods: Retrospective non-interventional cohort study describing two mutually exclusive adult patient cohorts diagnosed with HFrEF either initiating sac/val or ACEis/ARBs. All patients were naive to both sac/val and ACEis/ARBs for 12 months prior to the first prescription. All patients had a left ventricular ejection fraction (LVEF) ≤40%. Patients were identified any time between 1 st July 2015 and 31 st Dec 2018 in the Optum® de-identified EHR dataset from providers across the continuum of care. Results: 2,414 patients were initiated on sac/val, 36,563 on ACEis/ARBs. Mean age was 66.1 (SD 12.9) and 67.2 years (SD 13.7) for sac/val and ACEis/ARBs users, respectively. Sac/val patients were more likely to be male: 70.8% vs 67.2% (p&lt;0.0001) and had a lower mean LVEF: 26.9% vs 29.3% (p&lt;0.0001). Patients newly initiated on sac/val had similar proportion of ischemic heart disease (67.9% vs 68.2%, p=0.72), and more often valvular heart disease (48.6% vs 44.3%, p&lt;0.0001), and use of cardio resynchronization therapy device (40.9% vs 24.0%, p&lt;0.0001). Conclusions: This real-world study indicates that sac/val tends to be newly prescribed to younger, male HFrEF patients with lower LVEF and a higher proportion of cardio resynchronization therapy devices compared with patients newly initiated on ACEis/ARBs. The prevalence of ischemic heart disease is similar between the groups.
Assessing Alternative Payment Models—Reply
Authors: Amol S. Navathe, Connor W. Boyle, Ezekiel J. Emanuel
Journal: JAMA (2020)

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Exercise Intolerance in Heart Failure With Preserved Ejection Fraction: Shifting Focus From the Heart to Peripheral Skeletal Muscle⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.
Authors: Mathew S. Maurer, P. Christian Schulze
Journal: Journal of the American College of Cardiology (2012)
Abstract 14436: Nightly Lower Body Negative Pressure Redistributes Blood Volume and Prevents Maladaptive Vascular Remodeling Induced by Microgravity
Authors: Katrin A Dias, Christopher M Hearon, Gautam Babu, John E Marshall, James P Macnamara, James Leidner, Michael Gillespie, Kirsten Peters, Benjamin D LEVINE
Journal: Circulation (2020)

Introduction: During space flight and ground based simulations of microgravity, transmural distending pressure increases in resistance vessels above the level of the heart, causing maladaptive vascular remodeling over time. Lower body negative pressure (LBNP) mimics gravity by redistributing blood volume and reinstating hydrostatic gradients, and may preserve vascular structures above the heart while in microgravity. Methods: Ten healthy subjects (5 female, 29 ± 9 years) completed three days of supine (0°) bed rest with and without eight hours of nightly LBNP (-20mmHg) in a randomized, crossover design. Area and volume of the choroid, a highly vascularized layer of the eye sensitive to changes in hydrostatic gradients, were assessed using optical coherence tomography on the first and last day of bed rest. Central venous pressure (CVP) was measured during spontaneous breathing with a peripherally inserted central catheter. Results: CVP increased significantly from the seated to supine position (+9.1 ± 2.4mmHg, P &lt; 0.001), leading to choroid engorgement over three days of supine bed rest (choroid area: +0.09 mm 2 95% CI 0.04 to 0.13, P = 0.0014; choroid volume: +0.37 mm 3 95% CI 0.19 to 0.55, P = 0.0011). Nightly LBNP caused a sustained reduction in supine CVP (5.7 ± 2.2mmHg to 1.2 ± 1.4mmHg, P &lt; 0.001), indicating effective redistribution of blood volume and significantly attenuated the increase in choroid area (3.5% control vs. 0.9% LBNP, P = 0.0164) and volume (3.8% control vs. 1.8% LBNP, P = 0.0040) compared to control (Figure). Conclusions: Nightly LBNP caused caudal redistribution of blood volume that partially reinstated hydrostatic gradients and mitigated the increase in choroid area and volume by 74% and 53%, respectively. These findings illustrate that normalizing transmural distending pressures during simulated microgravity preserves vascularized structures above the level of the heart and may prevent adverse remodeling during long duration spaceflight.
Hydroxyapatite–Bovine Serum Albumin–Paclitaxel Nanoparticles for Locoregional Treatment of Osteosarcoma
Authors: Yongjia Liu, Zhiguang Qiao, Jian Gao, Fengren Wu, Binbin Sun, Meifei Lian, Jiwen Qian, Yue Su, Xinyuan Zhu, Bangshang Zhu
Journal: Advanced Healthcare Materials (2020)

Abstract Osteosarcoma is the most primary type of bone tumor occurring in the pediatric and adolescent age groups. In order to obtain the most appropriate prognosis, both tumor recurrence inhibition and bone repair promotion are required. In this study, a ternary nanoscale biomaterial/antitumor drug complex including hydroxyapatite (HA), bovine serum albumin (BSA) and paclitaxel (PTX) is prepared for post‐surgical cancer treatment of osteosarcoma in situ. The HA–BSA–PTX nanoparticles, about 55 nm in diameter with drug loading efficiency (32.17 wt%), have sustained release properties of PTX and calcium ions (Ca 2+ ) and low cytotoxicity to human fetal osteoblastic (hFOB 1.19) cells in vitro. However, for osteosarcoma (143B) cells, the proliferation, migration, and invasion ability are significantly inhibited. The in situ osteosarcoma model studies demonstrate that HA–BSA–PTX nanoparticles have significant anticancer effects and can effectively inhibit tumor metastasis. Meanwhile, the detection of alkaline phosphatase activity, calcium deposition, and reverse transcription‐polymerase chain reaction proves that the HA–BSA–PTX nanoparticles can promote the osteogenic differentiation. Therefore, the HA–BSA–PTX nanodrug delivery system combined with sustained drug release, antitumor, and osteogenesis effects is a promising agent for osteosarcoma adjuvant therapy.