tbuckley/cabot-search huggingface dataset:
Redefining Tumor Burden in Patients with Intermediate-Stage Hepatocellular Carcinoma: The Seven-Eleven Criteria
Authors: Ya-Wen Hung, I-Cheng Lee, Chen-Ta Chi, Rheun-Chuan Lee, Chien-An Liu, Nai-Chi Chiu, Hsuen-En Hwang, Yee Chao, Ming-Chih Hou, Yi-Hsiang Huang
Journal: Liver Cancer (2021)

For patients with intermediate-stage hepatocellular carcinoma (HCC), the definition of high tumor burden remains controversial. This study aimed to compare the prognostic value of different criteria of tumor burden in patients with intermediate-stage HCC undergoing transarterial chemoembolization (TACE).From 2007 to 2019, 632 treatment-naive patients with intermediate-stage HCC undergoing TACE were retrospectively enrolled. We compared different criteria of tumor burden in discriminating radiologic response and survival, including up-to-7, up-to-11, 5-7, 7 lesions criteria, and newly proposed 7-11 criteria.The proportions of patients classified as high tumor burden were varied by different criteria. Among the 5 criteria, 7-11 criteria have the best performance to discriminate complete response (CR) and overall survival (OS) after TACE. In patients with low, intermediate, and high tumor burden classified by 7-11 criteria, the CR rate was 21, 12, and 2.5%, respectively (p < 0.001), and the median OS was 33.1, 22.3, and 11.9 months, respectively (p < 0.001). By multivariate analysis, 7-11 criteria were significantly associated with CR (intermediate vs. high burden, odds ratio = 4.617, p = 0.002; low vs. high burden, odds ratio = 8.675, p < 0.001) and OS (intermediate vs. high burden, hazard ratio = 0.650, p < 0.001; low vs. high burden, hazard ratio = 0.520, p < 0.001). Seven to 11 criteria also had the lowest corrected Akaike information criteria, highest homogeneity value, and highest area under the receiver operating characteristic curve in predicting 1-, 2-, and 3-year mortality among all criteria.Conventional definitions of tumor burden were not optimal for patients with intermediate HCC. The new 7-11 criteria had the best discriminative power in predicting radiologic response and survival in patients with intermediate-stage HCC undergoing TACE.
Myocardial Revascularization Surgery
Authors: Michael J Mack, John J Squiers, Bruce W Lytle, J Michael DiMaio, Friedrich W Mohr
Journal: Journal of the American College of Cardiology (2021)

Coronary artery bypass grafting (CABG) was introduced in the 1960s as the first procedure for direct coronary artery revascularization and rapidly became one of the most common surgical procedures worldwide, with an overall total of more than 20 million operations performed. CABG continues to be the most common cardiac surgical procedure performed and has been one of the most carefully studied therapies. Best CABG techniques, optimal bypass conduits, and appropriate patient selection have been rigorously tested in landmark clinical trials, some of which have resolved controversy and most of which have stoked further debate and trials. The evolution of CABG cannot be properly portrayed without presenting it in the context of the parallel development of percutaneous coronary intervention. In this Historical Perspective, we a provide a broad overview of the history of coronary revascularization with a focus on the foundations, evolution, best evidence, and future directions of CABG.
Effect of Liver and Heart Iron Overload Detected By MRI T2 * on HLA Matched HSCT in Child Patients with β-Thalassemia Major
Authors: Wenjing Yang, Jianyun Liao, Jianyun Wen, Yongsheng S Ruan, Libai Chen, Yuelin He, Huaying Liu, Chunfu Li, Xuedong Wu
Journal: Blood (2017)
Adverse Events Associated with Cryopreserved and Non-Cryopreserved Hematopoietic Stem Cell Infusion: A Prospective and Multicenter Surveillance Study
Authors: Kazuhiko Ikeda, Yoshiki Okuyama, Minami Yamada-Fujiwara, Heiwa Kanamori, Shin-ichiro Fujiwara, Kazuo Muroi, Takehiko Mori, Kinuyo Kasama, Tohru Iseki, Tokiko Nagamura-Inoue, Nobuharu Fujii, Takashi Ashida, Kazuaki Kameda, Asao Hirose, Tsutomu Takahashi, Kazuhiro Nagai, Keiji Minakawa, Ryuji Tanosaki, Hitoshi Ohto
Journal: Blood (2017)
Abstract 16409: Temporal Trends of Diagnosis and Complications of Bicuspid Aortic Valve: Insight From a Large Korean Registry
Authors: Chi Young Shim, Shinjeong Song, Ji Won Seo, Geu-Ru Hong, Jong-Won Ha
Journal: Circulation (2019)

Introduction: Bicuspid aortic valve (BAV) is the most common congenital heart valve disease with an estimated prevalence of 0.5-2.0%, but its temporal trends of diagnosis and complications are not ...
Delays during Reproduction and Their Effects on the Embryo and Fetus
Authors: Jonathan T. Lanman
Journal: New England Journal of Medicine (1968)

THE egg, like the sperm, is intolerant of abnormal delays. There have been many observations in a wide variety of animals on the effects of such delays on both mortality and defective growth or development among the offspring. As with sperm, early studies were directed toward the marine invertebrates.InvertebratesGemmill1 found that the eggs of a species of sea urchin, Echinus sphaera, were optimally fertile beginning one hour after shedding and for a period up to four hours after shedding. After that time, fertilization rates fell until at 20 to 24 hours only 1 to 2 per cent . . .
CYP2D6 genotype predicts tamoxifen discontinuation and drug response: a secondary analysis of the KARISMA trial
Authors: W. He, M. Eriksson, E. Eliasson, F. Grassmann, M. Bäcklund, M. Gabrielson, M. Hammarström, S. Margolin, L. Thorén, Y. Wengström, S. Borgquist, P. Hall, K. Czene
Journal: Annals of Oncology (2021)

Guidelines regarding whether tamoxifen should be prescribed based on women's cytochrome P450 2D6 (CYP2D6) genotypes are conflicting and have caused confusion. This study aims to investigate if CYP2D6 metabolizer status is associated with tamoxifen-related endocrine symptoms, tamoxifen discontinuation, and mammographic density change.We used data from 1440 healthy women who participated the KARISMA dose determination trial. Endocrine symptoms were measured using a modified Functional Assessment of Cancer Therapy - Endocrine Symptoms (FACT-ES) questionnaire. Change in mammographic density was measured and used as a proxy for tamoxifen response. Participants were genotyped and categorized as poor, intermediate, normal, or ultrarapid CYP2D6 metabolizers.The median endoxifen level per mg oral tamoxifen among poor, intermediate, normal and ultrarapid CYP2D6 metabolizers were 0.18 ng/ml, 0.38 ng/ml, 0.56 ng/ml and 0.67 ng/ml, respectively. Ultrarapid CYP2D6 metabolizers were more likely than other groups to report a clinically relevant change in cold sweats, hot flash, mood swings, being irritable, as well as the overall modified FACT-ES score, after taking tamoxifen. The 6-month tamoxifen discontinuation rates among poor, intermediate, normal, and ultrarapid CYP2D6 metabolizers were 25.7%, 23.6%, 28.6%, and 44.4%, respectively. Among those who continued and finished the 6-month tamoxifen intervention, the mean change in dense area among poor, intermediate, normal, and ultrarapid CYP2D6 metabolizers were -0.8 cm2, -4.5 cm2, -4.1 cm2, and -8.0 cm2 respectively.Poor CYP2D6 metabolizers are likely to experience an impaired response to tamoxifen, measured through mammographic density reduction. In contrast, ultrarapid CYP2D6 metabolizers are at risk for exaggerated response with pronounced adverse effects that may lead to treatment discontinuation.
Macrophage-adipocyte communication and cardiac remodeling
Authors: Gautham Yepuri, Syed Nurul Hasan, Ann Marie Schmidt, Ravichandran Ramasamy
Journal: The Journal of Experimental Medicine (2021)

In obesity complicated by hypertension, multicellular processes integrate to orchestrate cardiac fibrosis; the underlying mechanisms, however, remain elusive. In this issue of JEM, Cheng et al. (2021. J. Exp. Med. https://doi.org/10.1084/jem.20210252) describe adipocyte–macrophage collaboration to foster cardiac fibrosis through the actions of angiotensin II in obesity.
BTK inhibition sensitizes acute lymphoblastic leukemia to asparaginase by suppressing the amino acid response pathway
Authors: Miriam Butler, Dorette S. van Ingen Schenau, Jiangyan Yu, Silvia Jenni, Maria P. Dobay, Rico Hagelaar, Britt M. T. Vervoort, Trisha M. Tee, Fieke W. Hoff, Jules P. Meijerink, Steven M. Kornblau, Beat Bornhauser, Jean-Pierre Bourquin, Roland P. Kuiper, Laurens T. van der Meer, Frank N. van Leeuwen
Journal: Blood (2021)
Abstract 16942: Maternal Hypertension and Low Birth Weight: Do Socio-Economic and Racial/Ethnic Disparities Matter?
Authors: Alexander V Sergeev, Christina M Nyirati
Journal: Circulation (2011)

Background: Maternal hypertension (HTN) can increase risk for low birth weight (LBW, weight&lt; 2,500 grams), a compelling, unsolved health problem. Identification of high risk groups for HTN-related LBW is essential to designing evidence-based interventions addressing vulnerable populations. We hypothesized that selected disparities contribute to HTN-related LBW. Methods: A case-control study of 114,298 births in the year 2010 in Ohio was conducted. Comprehensive Ohio birth data were obtained from Ohio Department of Health. Maternal HTN status was classified as: pre-pregnancy HTN, gestational HTN, or non-hypertensive. Mothers utilizing Medicaid or the Federal Special Supplemental Nutrition Program for Women, Infants and Children were considered of low socio-economic status (SES). Adjusted odds ratios (OR) for LBW in relation to mother's HTN status, race, ethnicity, and SES were obtained using multivariable logistic regression (SAS software), adjusting for known confounders - gestational age, mother's age, pre-pregnancy or gestational diabetes, pre-pregnancy and pregnancy smoking status, and plurality. Results: Maternal pre-pregnancy HTN and gestational HTN were associated with a statistically significant increase in LBW risk (adjusted OR 1.286, 95% CI 1.061-1.560, p&lt;0.05, and adjusted OR 1.588, 95% CI 1.417-1.780, p&lt;0.01, respectively). Adjusted for HTN status and confounders, African American and Asian mothers had a statistically significantly higher risk of delivering a LBW infant than Caucasian mothers (adjusted OR 1.931, 95% CI 1.763-2.115, p&lt;0.01, and adjusted OR 1.780, 95% CI 1.522-2.083, p&lt;0.01, respectively), and Hispanic ethnicity was associated with lower risk of LBW (adjusted OR 0.750, 95% CI 0.615-0.915, p&lt;0.01). When adjusted for confounders, effect of low SES on LBW was only borderline significant (adjusted OR 1.081, 95% CI 0.990-1.180, p=0.08). Conclusions: Adjusted for demographic and clinical confounders, maternal HTN increases risk of LBW. Independently from HTN, racial/ethnic and SES disparities contribute to risk of LBW. Epidemiological phenomenon of Hispanic paradox extends its effect to the HTN-related LBW issue. Effect of low SES on HTN-related LBW may be partially attributed to racial disparities.
Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic
Authors: Suze G. Berkhout, Kathleen A. Sheehan, Susan E. Abbey
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic. <h3>Objective</h3> To examine sources of distress and concern for HCWs in Canada during the COVID-19 pandemic. <h3>Design, Setting, and Participants</h3> In this qualitative study, a critical discourse analysis was performed of questions posed by HCWs to hospital senior leadership between March 16, 2020, and December 1, 2020, through an online employee forum as part of a larger mixed-methods evaluation of a stepped-care mental health support program for HCWs at 1 of Canada's largest health care institutions. Questions could be submitted online anonymously in advance of the virtual forums on COVID-19 by any of the University Health Network's 21 555 employees, and staff members were able to anonymously endorse questions by<i>upvoting</i>, indicating that an already posed question was of interest. <h3>Main Outcomes and Measures</h3> Themes, text structure, and rhetorical devices used within the questions were analyzed, taking into consideration their larger institutional and societal context. <h3>Results</h3> Unique individual views of the forums ranged from 2062 to 7213 during the study period. Major individual-level concerns related to risks of contamination and challenges coping with increased workloads as a result of the pandemic intersected with institutional-level challenges, such as feeling or being valued within the health care setting and long-standing stratifications between types of HCWs. Concerns were frequently reported in terms of calls for clarity or demands for transparency from the institutional leadership. <h3>Conclusions and Relevance</h3> The findings of this qualitative study suggest that larger institutional-level and structural concerns need to be addressed if HCWs are to be engaged in support and coping programs. Potential service users may be dissuaded from seeing their needs as being met by workplace mental health interventions that solely relate to individual-level concerns.
Large cell neuroendocrine carcinoma of the lung: Prognostic factors to predict clinical outcomes.
Authors: Elisa Andrini, Valentina Tateo, Dario De Biase, Davide Campana, Giuseppe Lamberti
Journal: Journal of Clinical Oncology (2021)

e20515 Background: Large cell neuroendocrine carcinoma of the lung (LCNEC) is a rare tumor, with clinical and molecular features between non-small cell and small-cell lung cancer (NSCLC and SCLC, respectively). To date, little is known about factors able to predict clinical outcome of these patients. We sought to identify prognostic factors in LCNEC. Methods: We retrospectively collected pathologically-confirmed LCNEC patients treated at the S. Orsola Malpighi Hospital of Bologna between 01/01/2009 and 31/12/2020. LCNEC was defined as tumor with neuroendocrine morphology, expression of ≥2 neuroendocrine markers (including chromogranin A, synaptophysin, or CD56) at immunohistochemistry and high tumor grade (defined as necrosis and high Ki67 ≥ 50% or high mitotic rate, ≥ 10 mitoses per 2 mm 2 ). Clinical features, pathological features, and blood test values (including neuron-specific enolase [NSE], carcinoembryonic antigen [CEA], cytokeratin 19 fragment [cyfra 21-1]) were correlated with progression-free survival to first-line chemotherapy (PFS) and overall survival from the diagnosis of extensive disease (OS). Results: Eighty-one LCNEC patients (median age 69 years, range 63-76) were identified. Twenty-seven (33.3%) had limited-stage disease and 52 patients (67.5%) had Eastern cooperative oncology group performance status (ECOG PS) ≥ 1 at diagnosis. When extensive disease was found (ED-LCNEC, N = 67), 23 patients (34.3%) had liver metastases, 10 (14.9%) had brain metastases and 24 (35.8%) had bone metastases. Treatment in ED-LCNEC was platinum plus etoposide in 45 patients (81.9%) and platinum plus paclitaxel in 10 patients (18.1%). Among 55 patients treated with platinum-based chemotherapy, 5 patients (9.1%) received cisplatin, while 50 (90.9%) received carboplatin. Overall, OS was 9.17 months (95% confidence interval [95%CI]7.17-13.87), PFS was 4.87 months (95%CI 4.21-6.02) and ORR was 38.2% (95%CI 25.4-42.3, N = 21/56). At univariate analysis, ECOG PS ≥ 1 (P = 0.049), presence of liver (P = 0.004) and bone metastases (P = 0.009), ≥ 2 non-nodal metastatic sites (P &lt; 0.001), elevated NSE (P = 0.009) and CEA level at diagnosis (P = 0.011) were associated with increased risk of death. At multivariate analysis, ECOG PS ≥ 1 (P = 0.020), ≥ 2 metastatic sites (P = 0.002), and elevated NSE level at diagnosis (P = 0.009) were independently associated with the risk of death. At univariate analysis brain metastases (P = 0.017), ≥2 metastatic sites (P = 0.006) and elevated value of CEA at baseline (P = 0.026) were associated with increased risk of progression. At multivariate analysis, only the presence of brain metastases (P = 0.043) retained its association with the risk of progression. Conclusions: In ED-LCNEC of the lung, ECOG PS, number of non-nodal sites of metastases and NSE at baseline are associated with worse survival, while the presence of brain metastases is associated with shorter PFS.
Early Rhythm Control Therapy in Patients With Atrial Fibrillation and Heart Failure
Authors: Andreas Rillig, Christina Magnussen, Ann-Kathrin Ozga, Anna Suling, Axel Brandes, Günter Breithardt, A. John Camm, Harry J.G.M. Crijns, Lars Eckardt, Arif Elvan, Andreas Goette, Michele Gulizia, Laurent Haegeli, Hein Heidbuchel, Karl-Heinz Kuck, Andre Ng, Lukasz Szumowski, Isabelle van Gelder, Karl Wegscheider, Paulus Kirchhof
Journal: Circulation (2021)

Even on optimal therapy, many patients with heart failure and atrial fibrillation experience cardiovascular complications. Additional treatments are needed to reduce these events, especially in patients with heart failure and preserved left ventricular ejection fraction.This prespecified subanalysis of the randomized EAST-AFNET4 trial (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial) assessed the effect of systematic, early rhythm control therapy (ERC; using antiarrhythmic drugs or catheter ablation) compared with usual care (allowing rhythm control therapy to improve symptoms) on the 2 primary outcomes of the trial and on selected secondary outcomes in patients with heart failure, defined as heart failure symptoms New York Heart Association II to III or left ventricular ejection fraction [LVEF] <50%.This analysis included 798 patients (300 [37.6%] female, median age 71.0 [64.0, 76.0] years, 785 with known LVEF). The majority of patients (n=442) had heart failure and preserved LVEF (LVEF≥50%; mean LVEF 61±6.3%), the others had heart failure with midrange ejection fraction (n=211; LVEF 40%-49%; mean LVEF 44 ± 2.9%) or heart failure with reduced ejection fraction (n=132; LVEF<40%; mean LVEF 31±5.5%). Over the 5.1-year median follow-up, the composite primary outcome of cardiovascular death, stroke, or hospitalization for worsening of heart failure or for acute coronary syndrome occurred less often in patients randomly assigned to ERC (94/396; 5.7 per 100 patient-years) compared with patients randomly assigned to usual care (130/402; 7.9 per 100 patient-years; hazard ratio, 0.74 [0.56-0.97]; P=0.03), not altered by heart failure status (interaction P value=0.63). The primary safety outcome (death, stroke, or serious adverse events related to rhythm control therapy) occurred in 71 of 396 (17.9%) patients with heart failure randomly assigned to ERC and in 87 of 402 (21.6%) patients with heart failure randomly assigned to usual care (hazard ratio, 0.85 [0.62-1.17]; P=0.33). LVEF improved in both groups (LVEF change at 2 years: ERC 5.3±11.6%, usual care 4.9±11.6%, P=0.43). ERC also improved the composite outcome of death or hospitalization for worsening of heart failure.Rhythm control therapy conveys clinical benefit when initiated within 1 year of diagnosing atrial fibrillation in patients with signs or symptoms of heart failure. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01288352. URL: http://www.controlled-trials.com; Unique identifier: ISRCTN04708680. URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2010-021258-20.
Abstract 10355: Cost-effectiveness of an Inpatient Heart Failure Nurse Practitioner Service for Patients Admitted With Heart Failure
Authors: Andrea Driscoll, Watts Jennifer, Sharon Meagher, Rhoda Kennedy, Ronald Mar, Douglas Johnson, David L Hare, Omar Farouque, Louise M Burrell, Melodie Heland, Bernadette Twomey, Lan Gao
Journal: Circulation (2019)

Introduction: Heart failure (HF) nurse practitioners (NP) are part of the HF specialist workforce and to date their impact on improving patient outcomes is untested. The aim of this study was to de...
Implementation of European Society of Gastrointestinal Endoscopy (ESGE) recommendations for small-bowel capsule endoscopy into clinical practice: Results of an official ESGE survey
Authors: Lazaros-Dimitrios Lazaridis, Georgios Tziatzios, Ervin Toth, Hanneke Beaumont, Xavier Dray, Rami Eliakim, Pierre Ellul, Ignacio Fernandez-Urien, Martin Keuchel, Simon Panter, Emanuele Rondonotti, Bruno Rosa, Cristiano Spada, Rodrigo Jover, Pradeep Bhandari, Konstantinos Triantafyllou, Anastasios Koulaouzidis
Journal: Endoscopy (2021)

Abstract Background We aimed to document international practices in small-bowel capsule endoscopy (SBCE), measuring adherence to European Society of Gastrointestinal Endoscopy (ESGE) technical and clinical recommendations. Methods Participants reached through the ESGE contact list completed a 52-item web-based survey. Results 217 responded from 47 countries (176 and 41, respectively, from countries with or without a national society affiliated to ESGE). Of respondents, 45 % had undergone formal SBCE training. Among SBCE procedures, 91 % were performed with an ESGE recommended indication, obscure gastrointestinal bleeding (OGIB), iron-deficiency anemia (IDA), and suspected/established Crohn’s disease being the commonest and with higher rates of positive findings (49.4 %, 38.2 % and 53.5 %, respectively). A watchful waiting strategy after a negative SBCE for OGIB or IDA was preferred by 46.7 % and 70.3 %, respectively. SBCE was a second-line exam for evaluation of extent of new Crohn’s disease for 62.2 % of respondents. Endoscopists adhered to varying extents to ESGE technical recommendations regarding bowel preparation ( &gt; 60 %), use in those with pacemaker holders (62.5 %), patency capsule use (51.2 %), and use of a validated scale for bowel preparation assessment (13.3 %). Of the respondents, 67 % read and interpreted the exams themselves and 84 % classified exams findings as relevant or irrelevant. Two thirds anticipated future increase in SBCE demand. Inability to obtain tissue (78.3 %) and high cost (68.1 %) were regarded as the main limitations, and implementation of artificial intelligence as the top development priority (56.2 %). Conclusions To some extent, endoscopists follow ESGE guidelines on using SBCE in clinical practice. However, variations in practice have been identified, whose implications require further evaluation.
Vaccine nanodiscs plus polyICLC elicit robust CD8+ T cell responses in mice and non-human primates
Authors: Alireza Hassani Najafabadi, Zeynab Izadi Najaf Abadi, Marisa E. Aikins, Kathryn E. Foulds, Mitzi M. Donaldson, Wenmin Yuan, Emeka B. Okeke, Jutaek Nam, Yao Xu, Priyan Weerappuli, Taryn Hetrick, David Adams, Patrick A. Lester, Andres M. Salazar, Dan H. Barouch, Anna Schwendeman, Robert A. Seder, James J. Moon
Journal: Journal of Controlled Release (2021)