tbuckley/cabot-search huggingface dataset:
Abstract 13132: Reclassification of CHA <sup>2</sup> DS <sup>2</sup> -VASc Thromboembolic Risk by Coronary Calcifications on Cardiac Computed Tomography in Atrial Fibrillation
Authors: Tom Kai Ming Wang, Nicholas Chan, Paul C Cremer, Mohammed Kanj, Bryan Baranowski, Walid I Saliba, Oussama M Wazni, Wael A Jaber
Journal: Circulation (2020)

Background: CHA 2 DS 2 -VASc is the most widely used thromboembolism risk score in patients with atrial fibrillation (AF). Cardiac computed tomography (CCT) routinely performed before or after pulmonary vein isolation (PVI) for AF rhythm control offers the opportunity to detect coronary calcifications (CAC) and this vascular pathology. We evaluated the frequency of CAC and the extent it affects the CHA 2 DS 2 -VASc and decision for anticoagulation for AF patients undergoing PVI. Methods: In 2014, 772 consecutive patients underwent PVI at Cleveland clinic, and 621 patients who had CCT within 1-year before or after PVI were studied. Relationships between CAC recorded as a binary variable with clinical characteristics and reclassification of CHA 2 DS 2 -VASc was analyzed. Results: Mean age was 63.1±9.8 years, 163 (26.2%) were females, 322 (51.9%) had paroxysmal AF and 264 (42.5%) having prior PVI. CAC was identified on CCT in 388 (62.5%) patients. Age was the only factor independently associated with CAC, odds ratio 1.02 (95% confidence interval 1.01-1.04), P=0.004. CAC increased the CHA 2 DS 2 -VASc in 306 (49.3%) patients, and the mean from 2.0±1.5 to 2.5±1.4 (Table). Using gender-specific cutpoints from the latest guidelines, 71 (11.4%) had CHA 2 DS 2 -VASc going from 0 to 1 in men or 1 to 2 in women (where anticoagulation may be considered), and 113 (18.2%) had CHA 2 DS 2 -VASc going from 1 to 2 in men or to 3 in women (where long-term anticoagulation is indicated). Conclusion: Almost two-thirds of patients undergoing PVI have CAC detectable on CCT, and after incorporating this information, long-term anticoagulation may or would be indicated in an additional 30% of the cohort. By assessing vascular pathology, CCT can play an important screening role for thromboembolic risk in AF patients incremental to clinical risk factors.
The loss of RNA N6-adenosine methyltransferase Mettl14 in tumor-associated macrophages promotes CD8+ T cell dysfunction and tumor growth
Authors: Lihui Dong, Chuanyuan Chen, Yawei Zhang, Peijin Guo, Zhenghang Wang, Jian Li, Yi Liu, Jun Liu, Renbao Chang, Yilin Li, Guanghao Liang, Weiyi Lai, Mengxue Sun, Urszula Dougherty, Marc B. Bissonnette, Hailin Wang, Lin Shen, Meng Michelle Xu, Dali Han
Journal: Cancer Cell (2021)
CMV, MHC-E, and the quest for an unconventional AIDS vaccine
Authors: Bruce D. Walker
Journal: Science Immunology (2021)

In the evolutionary battle between virus and host, a genetic alteration in cytomegalovirus caused by an inversion-deletion event during tissue culture passage opens an unconventional path toward an HIV vaccine (see the related Research Articles by Malouli et al., Yang et al., and Verweij et al.).
Abstract 14683: Efficacy of Sovateltide (PMZ-1620), a First-in-Class Neuronal Progenitor Cell Therapeutics, in Patients With Cerebral Ischemic Stroke
Authors: Anil Gulati, Nilesh R Agrawal, Deepti Vibha, U.K. Misra, Birinder S Paul, Rajnish Kumar, Jeyaraj D Pandian, Manish S Lavhale
Journal: Circulation (2019)

Introduction: Sovateltide (IRL-1620, PMZ-1620) provided significant neuroprotection following cerebral ischemia in animal models and was found to be safe and well tolerated in healthy human volunte...
Abstract 17011: Impact of Donor Cardiopulmonary Resuscitation Duration on Survival After Heart Transplantation
Authors: Morgan Harloff, Laura Piechura, Farhang Yazdchi, Mohamed Keshk, Hunbo Shim, Mitsugu Ogawa, Antonio Coppolino, Daniel Rinewalt, Hari R MALLIDI
Journal: Circulation (2020)

Introduction: Prolonged cardiopulmonary resuscitation (CPR) duration remains a source of apprehension with regards to the acceptance of donor hearts for orthotopic heart transplantation (OHT). Unfortunately, many of these organs are declined due to concern for adverse outcomes after OHT, further straining an already limited donor pool. Nevertheless, donor hearts with a history of prolonged CPR may represent an opportunity to expand the donor pool for patients with end-stage heart failure on the waiting list for OHT. Therefore, we sought to examine the duration of donor CPR and its impact on recipient survival after OHT. Methods: The United Network of Organ Sharing (UNOS) database was retrospectively quarried to identify all adult patients who underwent first-time OHT between 2000 and 2019 from a donor who had experienced cardiac arrest with a quantified downtime duration. The population was divided into five groups with a granular focus on longer downtimes: donors with CPR &lt; 30 minutes, 30-39 minutes, 40-49 minutes, 50-59 minutes, and ≥ 60 minutes. Primary outcome of interest was post-transplant survival. Kaplan-Meier analysis was used to compare recipient survival between groups after OHT. Results: In total, 7,470 patients were identified during the study period. Overall survival by Kaplan-Meier analysis was not statistically different among the five groups (p=0.69) (Figure 1). In a Cox proportional-hazards model, duration of CPR was found to have no influence on survival (HR 1.00, p=0.56). Significant predictors of mortality included donor age (HR 1.01, p=0.013), donor smoking history (HR 1.11, p&lt;0.005), and recipient diabetes (HR 1.27, p&lt;0.0001). Conclusions: These findings suggest that, for hearts determined appropriate for transplant, duration of CPR performed on the donor heart does not significantly impact survival after OHT. Therefore, donor hearts with a prolonged downtime should be fully evaluated for OHT to maximize the donor pool.
American Medical Society for Sports Medicine sports ultrasound curriculum for sports medicine fellowships
Authors: Mederic M Hall, David Bernhardt, Jonathan T Finnoff, Douglas Hoffman, Melody Hrubes, Kenneth Mautner, Ashwin Rao, Jeremiah Wayne Ray, Jay Smith, Anna Waterbrook
Journal: British Journal of Sports Medicine (2021)

Sports ultrasound is commonly used by sports medicine physicians to enhance diagnostic and procedural accuracy. This expert consensus statement serves as an update to the 2015 American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships. Although written in the context of the American sports medicine fellowship training model, we present a stepwise progression in both diagnostic and interventional sports ultrasound that may be applicable to the broader sports medicine community. The curriculum is divided into 12 units with each unit including didactic instructional sessions, practical hands-on instruction, independent scanning practice sessions and mentored clinical experience. To assist with prioritisation of learning, we have organised relevant pathology and procedures as essential, desirable and optional The expanded content can serve as an outline for continuing education postfellowship or for any physician to further advance their sports ultrasound knowledge and skill. We also provide updated scanning protocols, sample milestones and a sample objective structured clinical examination to aid fellowships with implementation of the curriculum and ongoing assessment of fellow progress.
Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study
Authors: Emily N. Satinsky, Bernard Kakuhikire, Charles Baguma, Justin D. Rasmussen, Scholastic Ashaba, Christine E. Cooper-Vince, Jessica M. Perkins, Allen Kiconco, Elizabeth B. Namara, David R. Bangsberg, Alexander C. Tsai
Journal: PLoS Medicine (2021)

Depression is recognized globally as a leading cause of disability. Early-life adverse childhood experiences (ACEs) have been shown to have robust associations with poor mental health during adulthood. These effects may be cumulative, whereby a greater number of ACEs are progressively associated with worse outcomes. This study aimed to estimate the associations between ACEs and adult depression and suicidal ideation in a cross-sectional, population-based study of adults in Uganda.Between 2016 and 2018, research assistants visited the homes of 1,626 adult residents of Nyakabare Parish, a rural area in southwestern Uganda. ACEs were assessed using a modified version of the Adverse Childhood Experiences-International Questionnaire, and depression symptom severity and suicidal ideation were assessed using the Hopkins Symptom Checklist for Depression (HSCL-D). We applied a validated algorithm to determine major depressive disorder diagnoses. Overall, 1,458 participants (90%) had experienced at least one ACE, 159 participants (10%) met criteria for major depressive disorder, and 28 participants (1.7%) reported suicidal ideation. We fitted regression models to estimate the associations between cumulative number of ACEs and depression symptom severity (linear regression model) and major depressive disorder and suicidal ideation (Poisson regression models). In multivariable regression models adjusted for age, sex, primary school completion, marital status, self-reported HIV status, and household asset wealth, the cumulative number of ACEs was associated with greater depression symptom severity (b = 0.050; 95% confidence interval [CI], 0.039-0.061, p < 0.001) and increased risk for major depressive disorder (adjusted relative risk [ARR] = 1.190; 95% CI, 1.109-1.276; p < 0.001) and suicidal ideation (ARR = 1.146; 95% CI, 1.001-1.311; p = 0.048). We assessed the robustness of our findings by probing for nonlinearities and conducting analyses stratified by age. The limitations of the study include the reliance on retrospective self-report as well as the focus on ACEs that occurred within the household.In this whole-population, cross-sectional study of adults in rural Uganda, the cumulative number of ACEs had statistically significant associations with depression symptom severity, major depressive disorder, and suicidal ideation. These findings highlight the importance of developing and implementing policies and programs that safeguard children, promote mental health, and prevent trajectories toward psychosocial disability.
Ischemic Change of Papillary Muscles in Acute Myocardial Infarction Assessed by Cardiac Magnetic Resonance Imaging
Authors: Kawaguchi Naohiko, Kakuta Tsunekazu, Yonetsu Taishi, Lee Tetsumin, Takayama Kei, Iwamoto Tarou, Kakita Ken, Komatsu Yuki, Kato Masaru, Taniguchi Hiroshi, Otomo Kiyoshi, Nagata Yasutoshi, Uno Kikuya, Iesaka Yoshito, Fujiwara Hideomi, Isobe Mitsuaki
Journal: Circulation (2009)
Covid-19: UK cases of variant from India rise by 160% in a week
Authors: Jacqui Wise
Journal: BMJ (2021)

Covid-19: UK cases of variant from India rise by 160% in a week Jacqui WiseFailures in the government's test and trace system may have contributed to the spread of the B.1.617.2 variant in the UK, cases of which have risen by more than 160% in the past week.1
Abstract 10456: Spironolactone in Acute Heart Failure Patients With Renal Dysfunction and Risk Factors for Diuretic Resistance: From the ATHENA-HF Trial
Authors: Stephen J Greene, G. Michael Felker, Anna Giczewska, Andreas P Kalogeropoulos, Andrew P Ambrosy, Hrishikesh Chakraborty, Adam D DeVore, Marat Fudim, Steven E McNulty, Robert J Mentz, Muthiah Vaduganathan, Adrian F Hernandez, Javed Butler
Journal: Circulation (2018)

Introduction: In the ATHENA-HF trial, addition of high-dose spironolactone to standard care did not improve congestion among acute heart failure (HF) patients with a broad range of renal function. ...
Addressing Children’s Exposure to Violence and the Role of Health Care
Authors: Howard Dubowitz
Journal: JAMA Network Open (2021)

Many children experience abuse, neglect, and other forms of violence, jeopardizing their physical and emotional health and their social and cognitive development.The study by Finkelhor and colleagues 1 characterizes children and youth evaluated medically following their experience of some type of violence.The nationally representative sample consisted of 8503 children and youth aged 2 to 17 from 2 surveys conducted in 2011 and 2014.Caregivers responded via telephone interviews for children aged 9 years or younger regarding possible exposure to violence, other adversities, and trauma symptoms; the youth aged 10 years and older reported on themselves.There were follow-up probes regarding injury and medical treatment for those with any of the 16 types of violence.As
Associations between Inhaled Corticosteroid Use in the First 6 Years of Life and Obesity-related Traits
Authors: Asja Kunøe, Astrid Sevelsted, Bo L. Chawes, Jakob Stokholm, Anders Eliasen, Martin Krakauer, Klaus Bønnelykke, Hans Bisgaard
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

Rationale: Infants and young children might be particularly likely to experience the potential clinical side effects of inhaled corticosteroids (ICSs) on body mass index (BMI), adiposity rebound (AR), and body composition, but this has rarely been studied in long-term studies in this age group. Objectives: To determine the association between ICS exposure in the first 6 years of life and the BMI, AR, body composition, and blood lipid concentrations. Methods: Children from the two mother–child cohorts of the COPSAC (Copenhagen Prospective Studies on Asthma in Childhood) were included. ICS use was registered prospectively to age 6 years, and the cumulative dose was calculated. Multiple linear regression models were used for analysis. Measurements and Main Results: A total of 932 (84%) of the 1,111 children from the COPSAC cohorts had BMI data, 786 (71%) had dual-energy X-ray absorptiometry scan data at the age of 6 years, and 815 (73%) had an AR age calculated. Two hundred ninety-one children (31%) received a cumulative ICS dose higher than that from 10 weeks of standard treatment before the age of 6. ICS treatment during 0–6 years of age was associated with an increased BMI z-score (0.05 [95% confidence interval, 0.005 to 0.09] SDs per each year of standard treatment; P = 0.03) an earlier age at AR (−0.18 [95% confidence interval, −0.28 to −0.08] yr; P = 0.0006), and a 2% increased geometric mean android fat percentage (P = 0.05). ICS exposure and dual-energy X-ray absorptiometry scan data were not associated. Conclusions: ICS use in early childhood was associated with an increased BMI z-score at age 6, an earlier AR, and a trend of association with an increased android body fat percentage.
Abstract 15328: Higher Non-exercise Estimated Cardiorespiratory Fitness in Midlife is Associated With Lower Risk of Incident Heart Failure: The Framingham Heart Study
Authors: Joowon Lee, Tara Shrout, Ramachandran S Vasan, Vanessa Xanthakis
Journal: Circulation (2020)

Introduction: Non-exercise estimated cardiorespiratory fitness (eCRF) algorithms have shown similar accuracy to CRF estimated from submaximal and maximal exercise tests in healthy adults. Using easily accessible health indicators, eCRF measurement does not involve in-person exercise testing, trained personnel, or specialized equipment for measuring CRF. Thus, eCRF may be a cost-effective alternative for heart disease risk stratification. The relation between eCRF and Heart failure (HF) remains unclear. Hypothesis: We hypothesized that higher midlife eCRF is associated with a lower risk of incident HF in later life. Methods: We evaluated 2,226 Framingham Offspring cohort participants attending examination cycles 2 and 7 (mean age of 42- 61years; 53% women). We used a validated longitudinal non-exercise algorithm for eCRF including age, sex, body mass index, waist circumference, resting heart rate, physical activity, and smoking status. Midlife eCRF was defined as a sex-specific standardized average of eCRF (z-score of the average eCRF with mean=0 and a standard deviation [SD]=1) between cycles 2 and 7. The sex-specific midlife eCRF were then categorized into three groups based on tertiles and was also analyzed as a continuous variable (per 1 SD increment). We used multivariable Cox proportional hazards regression models for pooled sexes to relate the midlife eCRF to incident HF after examination cycle 7. Results: Overall, 189 participants developed HF during a median of 17 years of follow-up. Participants in either moderate or high eCRF group experienced a 52% lower risk of HF compared to those in the low eCRF group, after adjustment for potential confounders. Additionally, each SD increment in midlife eCRF was associated with a 40% lower risk of HF in later life. The associations remained significant after excluding participants on antihypertensive treatment (Table). Conclusions: Lower eCRF during midlife may be a marker of higher HF risk in later life.
Abstract 15985: Comparison of Survival Benefit From Angiotensin Inhibitors in Patients With Heart Failure and Reduced Ejection Fraction by Race and Genomic Ancestry
Authors: Jasmine A Luzum, edward peterson, Jia Li, Ruicong She, Hongsheng Gui, BIN LIU, L. Keoki Williams, Hani N Sabbah, David E Lanfear
Journal: Circulation (2020)

Introduction: Definitive evidence for the efficacy of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) in Black Americans with heart failure and reduced ejection fraction (HFrEF) is deficient. It is based on retrospective data, and there were very few Black patients enrolled in the landmark ACEI/ARB trials. Moreover, self-reported race does not reliably reflect genomic ancestry, particularly in Black Americans. Therefore, the objective of this study was to assess ACEI/ARB associated survival benefit in a prospective cohort of HFrEF patients, by both self-reported race and proportion of African genomic ancestry. Methods: Insured HFrEF patients (n=989) were enrolled in a prospective genomic registry from 2007-2015. ACEI/ARB exposure (ACEI/ARBexp) was calculated from pharmacy claims as % target exposure, and the proportion of African ancestry was determined from genome-wide array data. Cox proportional hazards regression with time-dependent ACEI/ARBexp and adjusted for established risk factors tested the association with all-cause mortality by self-reported race and proportion of African ancestry (≤5% vs. ≥80%). Results: Overall, 36% of patients were female, 52% self-identified as Black, average age was 68±12 years, and the mean follow-up was 3.0 years. Self-reported Black patients were significantly younger, more were women, more often had hypertension and non-ischemic etiology, had lower LVEF, and mean proportion African genomic ancestry of 84%. ACEI/ARBexp was similar among self-reported Blacks and Whites (52% and 55%; p=0.228), as was mortality (121 [24%] and 121 [25%]; p=0.526). ACEI/ARBexp was associated with similar survival benefit in all groups (Table 1). Conclusions: In this prospective registry, estimates of survival benefit associated with ACEI/ARB use in HFrEF patients appear similar regardless of self-reported race or African genomic ancestry.
血管形成術は多枝冠動脈疾患患者に対するバイパス手術を越える治療のゴールドスタンダードとなることができるか?-3枝冠動脈疾患に対する治療方針:OPCAB対PCI(PCIサイド)
Authors: Takayama Tadateru, Hiro Takafumi, Hirayama Atsushi
Journal: Circulation (2010)
Abstract 16873: Association of Preoperative Cell-Free DNA Levels and Outcome Following Pediatric Cardiopulmonary Bypass
Authors: Justinn Tanem, John Scott, George M Hoffman, Robert A Niebler, Aoy TOMITA-MITCHELL, Karl Stamm, Rebecca Bertrand, Ronald K Woods, Viktor Hraska, Michael Mitchell
Journal: Circulation (2020)

Introduction: Preoperative risk stratification in congenital cardiac surgery includes patient and procedure related factors, which may be used in clinical decision making as well program performance evaluation. Despite these tools, unidentified factors contribute to wide variation in outcomes both within and between centers. Identification of latent physiologic risk factors may strengthen predictive models. Hypothesis: Total cell-free DNA (TCF) functions as a biomarker for cellular injury as well as a pro-inflammatory cytokine. We hypothesized that elevated preoperative TCF would be associated with poor outcome following pediatric cardiac surgery requiring cardiopulmonary bypass (CPB). Methods: Prospective observational study of children age &lt; 18 yr and wt &gt; 3 kg undergoing planned CPB surgery. The Children’s Wisconsin Institutional Review Board approved the protocol . A serum TCF sample was obtained after induction of anesthesia prior to surgical incision. The primary outcome measure was a composite of postoperative cardiac arrest, ECMO, or death (CAED). Association of outcome to TCF was assessed by logistic regression with a cutpoint chosen by ROC curve exploration. Odds ratios with 95% CI were calculated. Results: Data were available in 117 patients, median age 0.9 years (range 0-17.4), median weight 7.8kg (range 3.2-98). The primary outcome (CAED) was met in 6/117 (5.1%). Table 1 summarizes characteristics of patients with and without CAED. Risk of CAED was 2% with TCF&lt;20 ng/ml, and 27% with TCF&gt;20 ng/ml (OR=18.2, CI 2.2- 212, p&lt;0.01). Elevated TCF was associated to fewer hospital free days (GLM p&lt;0.01). Data in table reported as median [IQR]. Conclusions: Preoperative TCF has an important association with postoperative cardiac arrest, ECMO, and death. Alternative or intensified treatment strategies could be considered in patients with elevated preoperative TCF.
Abstract 16916: Asymptomatic Patients With Duchenne Muscular Dystrophy Have Elevated Troponin
Authors: Aryaz Sheybani, Kim CRUM, Frank J Raucci, Larry W Markham, Jonathan H Soslow
Journal: Circulation (2020)

Introduction: Cardiomyopathy is the leading cause of death in Duchenne Muscular Dystrophy (DMD), but traditional heart failure biomarkers have limited utility. Cardiac Troponin I (cTnI) has been used in DMD research studies as a marker of toxicity, but little is known about cTnI levels in asymptomatic patients. The goal of this study was to longitudinally evaluate cTnI, NTproBNP, and BNP in an asymptomatic DMD cohort. We hypothesized the biomarkers would not correlate with cardiac function, but some asymptomatic patients would exhibit a cTnI leak, reflecting ongoing myocardial inflammation related to disease progression. Methods: Asymptomatic DMD patients (N=69) and controls with normal cardiac evaluations (N=18) were enrolled. In DMD subjects, biomarker levels were obtained at time of cardiac magnetic resonance imaging (CMR), which included assessment of atrial and ventricular volumes, function, and late gadolinium enhancement (LGE). Normal ranges for biomarkers were created based on control values. Spearman correlation was used for analysis. Results: There was no consistent correlation between biomarkers and disease progression by CMR (Table 1). Several DMD subjects had transiently elevated cTnI (Fig 1). Those with elevated cTnI trended towards being more likely to have LGE on baseline CMR, though this did not reach statistical significance (p= 0.08). Conclusions: CTnI, BNP, and NTproBNP do not correlate with CMR assessment of cardiomyopathy progression. There is a subset of the DMD cohort with asymptomatic cTnI leak. While this cTnI leak is of uncertain clinical significance, it is important to recognize if cTnI is used to assess for cardiac toxicity in future drug trials.