tbuckley/cabot-search huggingface dataset:
Incidence of Impaired Kidney Function Among Adolescent Patients Hospitalized With Anorexia Nervosa
Authors: Evgenia Gurevich, Shelly Steiling, Daniel Landau
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Anorexia nervosa (AN) is a common psychiatric disorder associated with electrolyte imbalances and impaired kidney function, but their incidence and association with disease severity are unknown. <h3>Objective</h3> To analyze kidney function in patients with AN and its association with body mass index (BMI) and physiologic parameters of disease severity. <h3>Design, Setting, and Participants</h3> Single-center retrospective case-control study of recently hospitalized patients with a diagnosis of AN according to<i>International Classification of Diseases, Ninth Revision</i>. All patients were aged 9 to 18 years and hospitalized in the general pediatric ward between 2010 and 2019. BMI and estimated glomerular filtration rate (eGFR) were compared with age- and sex-matched controls hospitalized with other diagnoses. <h3>Main Outcomes and Measures</h3> Impaired kidney function was defined as eGFR less than 90 mL/min/1.73 m<sup>2</sup>. Association between eGFR, BMI, minimal heart rate, and free triiodothyronine (T3) levels were determined using logistic regression. <h3>Results</h3> A total of 395 patients were included in the study group (81.6% were female; mean [SD] age, 14.6 [2.2] years; median BMI percentile, 12.3 [IQR, 0.9-42.0]). Impaired kidney function was found in 36.8% (146 of 395). Mean (SD) eGFR decreased during hospitalization in the group with kidney function impairment (admission: 83 [10.9] mL/min/1.73 m<sup>2</sup>; nadir: 79.1 [8.5] mL/min/1.73 m<sup>2</sup>; latest: 97.7 [15.7] mL/min/1.73 m<sup>2</sup>;<i>P</i> &lt; .001). Mean (SD) serum creatinine (SCr) to BMI ratio was higher in both anorexia groups compared with controls in impaired kidney function (4.9% [1.0%]), non–impaired kidney function (3.55% [0.84%]); and control groups (2.8 [1.1%]) (<i>P</i> &lt; .001). There was no difference in admission BMI between anorexia groups with and without kidney function impairment. Mean (SD) free T<sub>3</sub>levels (3.5 [0.2] pmol/L vs 4.08 [1.2] pmol/L;<i>P</i> &lt; .001) and mean (SD) minimal heart rate (44 [11] beats per min vs 56 [16] beats per min;<i>P</i> &lt; .001) were lower and hospital stay was longer (median, 13 [IQR, 6-21] days vs 8 [IQR, 4-19] days;<i>P</i> = .03) in the impaired kidney function group. The highest correlation was found between minimal heart rate and minimal eGFR (<i>R</i> = 0.53;<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> Impaired kidney function in patients with AN is common and transiently worsens during hospitalization. SCr values probably underestimate the degree of kidney function impairment in AN. Results of this study found that patients with impaired kidney function had worse anorexia severity parameters unrelated to admission BMI. Therefore, kidney function impairment may be a better marker of anorexia severity.
Long-Term (≥4 Year and ≥5 Year) Overall Survival (OS) By 12- and 24-Month Event-Free Survival (EFS): An Updated Analysis of ZUMA-1, the Pivotal Study of Axicabtagene Ciloleucel (Axi-Cel) in Patients (Pts) with Refractory Large B-Cell Lymphoma (LBCL)
Authors: Caron Jacobson, Frederick L. Locke, Armin Ghobadi, David B. Miklos, Lazaros J. Lekakis, Olalekan O. Oluwole, Yi Lin, Brian T. Hill, John M. Timmerman, Abhinav Deol, Patrick M. Reagan, Patrick Stiff, Ian W. Flinn, Umar Farooq, Andre H. Goy, Javier Muñoz, Tanya Siddiqi, Rhine R. Shen, Adrian Bot, Jinghui Dong, Kanwarjit Singh, Clare Spooner, Roshan Karalliyadda, Jenny J. Kim, Yan Zheng, Sattva S. Neelapu
Journal: Blood (2021)
Abstract 12754: Is an Induction Test Necessary While Catheter Ablation of Atrial Fibrillation
Authors: Tetsuro Sato, Jun Oikawa, Hidehira Fukaya, Jun Kishihara, Naruya Ishizue, Daiki Saito, Gen Matsuura, Yusuke Murayama, yutaro mitani, Shinichi Niwano, Junya Ako
Journal: Circulation (2021)

Introduction: In general, several reports have been that it is beneficial to confirm the induction test of atrial arrhythmias by burst and provide additional procedures after catheter ablation (CA) for atrial fibrillation (AF). However, few reports on whether the presence or absence of an induction test of arrhythmia affects long-term recurrence. Hypothesis: In this study, we sought to elucidate the relationship between induction test and recurrence of atrial arrhythmias in patients who underwent CA for AF. Methods: We enrolled 678 consecutive patients who underwent the first CA for AF from 2014 to 2020. Of all patients, 573 patients (85%) were performed induction test during CA. After propensity score matching with factors that may affect recurrence i.e., age, left atrial diameter, gender, disease type, and history of coronary artery disease, we divided into induction group (n = 104) and non-induction group (n = 104). The primary endpoint was the recurrence of AF and the occurrence of other atrial tachy-arrhythmias after the 90-day blanking period. The observational period was set at one year after the index. Results: The median age was 67 (59 - 73) years old with 22% of female. During the periods, the recurrence occurred in 46 (22%) patients. In the log-rank test, there was no significant difference in the recurrence rate between the two groups (P = 0.74). Conclusions: The induction test might not be required for atrial fibrillation ablation; however, we will need a prospective study in the future.
Gut microbiota–driven brain Aβ amyloidosis in mice requires microglia
Authors: Hemraj B. Dodiya, Holly L. Lutz, Ian Q. Weigle, Priyam Patel, Julia Michalkiewicz, Carlos J. Roman-Santiago, Can Martin Zhang, Yingxia Liang, Abhinav Srinath, Xulun Zhang, Jessica Xia, Monica Olszewski, Xiaoqiong Zhang, Matthew John Schipma, Eugene B. Chang, Rudolph E. Tanzi, Jack A. Gilbert, Sangram S. Sisodia
Journal: The Journal of Experimental Medicine (2021)

We previously demonstrated that lifelong antibiotic (ABX) perturbations of the gut microbiome in male APPPS1-21 mice lead to reductions in amyloid β (Aβ) plaque pathology and altered phenotypes of plaque-associated microglia. Here, we show that a short, 7-d treatment of preweaned male mice with high-dose ABX is associated with reductions of Aβ amyloidosis, plaque-localized microglia morphologies, and Aβ-associated degenerative changes at 9 wk of age in male mice only. More importantly, fecal microbiota transplantation (FMT) from transgenic (Tg) or WT male donors into ABX-treated male mice completely restored Aβ amyloidosis, plaque-localized microglia morphologies, and Aβ-associated degenerative changes. Transcriptomic studies revealed significant differences between vehicle versus ABX-treated male mice and FMT from Tg mice into ABX-treated mice largely restored the transcriptome profiles to that of the Tg donor animals. Finally, colony-stimulating factor 1 receptor (CSF1R) inhibitor-mediated depletion of microglia in ABX-treated male mice failed to reduce cerebral Aβ amyloidosis. Thus, microglia play a critical role in driving gut microbiome–mediated alterations of cerebral Aβ deposition.
Abstract 10688: The Association of Atrial Cardiomyopathy with Ischemic Stroke is Minimally Explained by Atrial Fibrillation: The Atherosclerosis Risk in Communities (aric) Study
Authors: Ankit Maheshwari, Faye L Norby, Riccardo M Inciardi, Wendy Wang, Michael J Zhang, Elsayed Z Soliman, Alvaro Alonso, Michelle C Johansen, Rebecca F Gottesman, Scott Solomon, Amil M Shah, Lin Y Chen
Journal: Circulation (2021)

Introduction: Atrial cardiomyopathy, characterized by abnormalities in left atrial (LA) size and function, is a risk factor for atrial fibrillation (AF) and ischemic stroke. We aimed to determine if 2D-echocardiographic (2DE) LA strain and volumetric parameters are independently associated with ischemic stroke and the extent to which AF mediates this risk in the ARIC study, a community-based cohort study. Methods: We included 4817 ARIC participants (mean age 75; 59% women; 22% Black) and who had 2DE in 2011-13. We evaluated LA volume index (maximum, minimum), LA emptying fraction (total, passive, active), LA strain (reservoir, conduit, contractile). Incident ischemic strokes (2013-2019) were physician adjudicated after review of medical records. AF was ascertained from hospitalization discharge codes and 2-week ambulatory rhythm monitoring in 2016-17. We used multivariable Cox proportional hazards models to estimate hazard ratios and 95% confidence intervals (CI) of LA parameters for stroke and performed mediation analyses to quantify the indirect effect of AF in these associations. Results: After a median follow-up of 5.9 years, each SD increment in LA reservoir stain, LA conduit strain, LA contractile strain, total LA emptying fraction, and active LA emptying fraction was associated with a percent (95% CI) decrease in stroke risk of 27 (14-38), 19 (4-32), 17 (4-29), 19 (6-31), and 14 (1-26), respectively. Greater left atrial minimum, but not maximum volume index was associated with higher stroke risk. The proportion of these associations which was mediated by AF ranged from 3-36%. Our findings remained unchanged in sensitivity analysis excluding participants with AF and on anticoagulants. Conclusions: The associations of LA strain and volumetric parameters with stroke are minimally mediated by AF. Future research should determine whether LA strain and volumetric analysis can guide anticoagulation for stroke prevention in people independent of AF status.
Abstract 6996: A Deep Neural Network Model for Predicting In-Hospital Postoperative Mortality and Complications of Open-Heart Surgeries: The Shiraz Open Heart Surgery Study
Authors: Mohammad Hosein Yazdanpanah, Mahnaz Mahmoodian, Fateme Ghanaat, Mohammad Hasan Nemati
Journal: Circulation (2021)

Introduction: A reliable model for the pre-op prognostic evaluation of open-heart surgery outcomes is a worthwhile pursuit. This study aimed to develop a model to select risk variables and predict mortality and complications after open-heart surgery using deep neural networks (DNN). Methods: In this retrospective cohort study, data from all patients aged more than 18 years old who underwent open-heart surgery at Shiraz Central Hospital (Iran) between Nov 2004-Sep 2018 were used. Model to predict postoperative mortality and complications were constructed using DNN. For calibration, a 5-fold cross-validation technique was used, and risk variables were ranked and minimized in number by calibrated DNN. The bootstrap technique obtained mortality prediction with 95% confidence limits for each patient. Evaluation of DeepScore and other models was based on sensitivity analysis and Area Under the Curve (AUC). All the statistical analyses were performed in the Python library (scikit-learn). Results: A total of 6787 patients that entered the study had a mean age of 61.06±11.1 years, and 4692 (69.1%) were male. Among these patients, 94 cases (1.38%) died in hospital, 120 cases (1.77%) had respiratory complications, 259 cases (3.82%) suffered from renal complications, and 114 patients (1.68%) had neurological complications. The proposed DeepScore model ( deep.artinanalysis.com ) predicts the risk of in-hospital postoperative mortality and complications from 36 baseline pre-op variables. The AUC of the DeepScore was 0.81, which was significantly higher than the values obtained for the other models(P&lt;0.001). The AUC of the EuroScore II model, which was ranked second was 0.71, followed by logistic regression (LR), support vector machine (SVM), random forest (RF), and gradient boosting machine (GBM) models with AUC values of 0.68, 0.67, 0.55, and 0.54 respectively. Conclusion: In conclusion, our DeepScore model outperformed the RF, SVM, GBM, or LR models and EuroSCORE II to predict postoperative in-hospital mortality. This model can be used preoperatively to identify patients whose baseline characteristics suggest an elevated risk for mortality and complications. Also, these patients may benefit from additional support and monitoring allocation.
Abstract 12234: Is Maintenance of a Subcutaneous Implantable Cardioverter-Defibrillator a Feasible Option in Hypertrophic Cardiomyopathy Patients With Left Bundle Branch Block After Septal Myectomy?
Authors: Chockalingam Narayanan, Srijan Shrestha, William Gionfriddo, Jonathan Weinstock, Munther Homoud, Barry Maron, Martin S Maron, Ethan J Rowin, Ann Garlitski, Christopher Madias
Journal: Circulation (2021)

Introduction: Subcutaneous implantable cardioverter-defibrillators (SICD) are effective for sudden death (SCD) prevention in patients (pts) with hypertrophic cardiomyopathy (HCM). Pre-implant ECG screening to evaluate R and T wave sensing is done to decrease the risk of inappropriate shocks (IAS). Pts who undergo septal myectomy are at high risk of developing left bundle branch block (LBBB) that could potentially result in SICD T wave oversensing (TWOS). Objective: We describe 6 cases of pts with SICD and septal myectomy to understand the risks and benefits of maintaining SICD therapy in this cohort. Methods: We performed a retrospective cohort study of all pts with HCM who underwent SICD implantation and septal myectomy from 2013 to 2021. Results: Six pts with HCM underwent both SICD implantation and myectomy. Post myectomy ECGs for all pts show LBBB with QRS between 137 to 166 ms. Four of these pts were implanted prior to myectomy. The average time to myectomy after SICD was 1.3 years. Three out of the four pts have had no IAS or TWOS since myectomy. One patient experienced TWOS with 2 IAS 4 months after myectomy. The sensing vector was changed from primary to alternate with no further TWOS for the last 6 years. The remaining two pts underwent SICD implantation after myectomy, both of whom screened “OK” using the manual screening tool prior to implant. Neither patient has experienced IAS. One patient displayed episodes of TWOS and underwent vector change with no TWOS for the last 5 years. At the time of recent SICD generator replacement, he was screened using the automated programmer software and failed screening in all 3 vectors (Figure 1). Conclusions: This series demonstrates that maintenance of SICD is a viable option for SCD prevention in young pts who develop LBBB after septal myectomy. With close monitoring and vector adjustment, IAS and TWOS can be avoided. Further larger studies are necessary to assess the long-term risk of TWOS and IAS in this unique population.
Abstract 10561: Attending Cardiac Rehabilitation Reduces Incidence of Dementia but Not Mild Cognitive Impairment in Patients with Coronary Artery Disease
Authors: Jenna L Taylor, Jose R Medina-inojosa, Ronald C Petersen, Jonathan Graff-Radford, Bruce D Johnson, Amanda R Bonikowske
Journal: Circulation (2021)

Introduction: Coronary artery disease (CAD) has been associated with cognitive decline. Cardiac rehabilitation (CR) is a class 1A recommendation for patients with CAD as it reduces future cardiac events and mortality. However, the impact of CR on incidence of mild cognitive impairment (MCI) and dementia has not been extensively studied. We investigated the association of CAD on incidence of MCI and dementia; and whether CR attendance reduces incidence of MCI and dementia in patients with CAD Methods: The Mayo Clinic Study of Aging (MCSA), a prospective, population-based cohort was probed for this study. At baseline and every 15-months thereafter, subjects were evaluated for MCI and dementia using a standardized protocol. Data on CR participation were collected via record linkage to the Rochester Epidemiology Project. To evaluate association with incident MCI or dementia, cox proportional hazard models were used and adjusted for age, sex, and clinical predictors of cognitive decline. Participants with MCI at baseline were excluded for MCI analysis and adjusted for in dementia analysis. Results: We included 5960 MCSA participants (female: 50%; age: 70±13). Of those, 1934 participants (32%) had CAD and 702 (12%) had MCI at baseline. Mean follow-up was 3.9±3.7yrs, with 760 incident cases of MCI (13%) and 290 cases of dementia (5%). CAD was a significant predictor of MCI and dementia, although after adjustment for other clinical predictors, CAD was only associated with MCI incidence ( Table 1, Figure ). Incidence of dementia was reduced in CAD patients who had a greater attendance at CR when adjusted for other predictors of cognitive decline ( Table 2 ). Attendance at CR did not reduce incidence of MCI ( Table 2 ). Conclusions: CAD was a significant predictor of MCI and dementia. In patients with CAD, a higher attendance of CR was associated with reduced incidence of dementia but not MCI. Specific CR programming and outcome targets may be needed to prevent MCI in patients with CAD.
Conversion of HbS to Hb G-Makassar By Adenine Base Editing Is Compatible with Normal Hemoglobin Function
Authors: S. Haihua Chu, Manuel Ortega, Paty Feliciano, Valerie Winton, Chavonna Xu, Daniel Haupt, Teresa McDonald, Salette Martinez, Alexander Liquori, Jeffrey Marshall, Daisy Lam, Jenny Olins, Conrad Rinaldi, Kyle Rehberger, Colin Lazarra, Jeremy Decker, Bob Gantzer, Tanggis Bohnuud, David Born, Luis Barrera, Bo Yan, Ian Slaymaker, Michael S. Packer, Sarah Smith, Carlo Zambonelli, Matt Lee, Nicole M. Gaudelli, Adam J. Hartigan, Giuseppe Ciaramella
Journal: Blood (2021)
Abstract 13148: Cardiometabolic Risk Factors Partially Mediate the Association of Physical Inactivity With MRI Markers of Brain Aging
Authors: Nicole L Spartano, Ruiqi Wang, Qiong Yang, Ariel Chernofsky, JoAnne M Murabito, Vasan S Ramachandran, Alexa S Beiser, Sudha Seshadri
Journal: Circulation (2021)

Introduction: Physical inactivity is associated with a higher risk of dementia, and has also been associated with unfavorable brain morphology. It is also clear that cardiometabolic risk factors accelerate the brain aging process. Hypothesis: Cardiometabolic risk factors mediate the association of physical inactivity with unfavorable brain morphology. Methods: Our investigation included participants from the Third Generation (exam 2) and Offspring (exam 9) cohorts of the Framingham Heart Study who wore an accelerometer for &amp;gte10 hours on &amp;gte3 days (to measure moderate to vigorous physical activity [MVPA] and steps walked per day), underwent brain MRI scans, and had no dementia, stroke, or missing cardiometabolic risk factor data (n=2416, 54% women, mean age 54.1 years). Higher levels of brain peak width of skeletonized mean (white matter) diffusivity, higher free water, and lower total cerebral brain volume were measured by MRI as markers of brain aging. We examined mediation by the 2017 revised version of the Framingham Stroke Risk Profile (FSRP, using weights for age, prevalent cardiovascular disease, atrial fibrillation, diabetes and smoking status, antihypertension medications and systolic blood pressure) and the homeostatic model of insulin resistance (HOMA-IR) in models of the association of MVPA and steps with brain volume, white matter diffusivity, and free water, adjusting for age, age-squared, sex, wear time, smoking status (for HOMA-IR mediation analysis only), cohort, time from exam to MRI, and season of exam. Results: The associations of lower MVPA and steps with lower brain volume, higher white matter diffusivity, and higher free water were partially mediated through FSRP, accounting for 14.1-25.7% (p&amp;lt0.05) of the total association of physical inactivity with brain aging. The association of fewer steps (but not MVPA) with lower brain volume was mediated by HOMA-IR (20.1% of the total association, p&amp;lt0.05). Conclusions: Our results suggest that the associations of physical inactivity with lower brain volume, poorer white matter microstructure and aggregation of free water in the extracellular compartments of the brain are partially mediated by cardiometabolic risk factors.
Abstract 9784: Association of Physical Activity with Bioactive Lipids, BMI, and Risk of Future Cardiovascular Events - Mediation Analysis from the Vitamin D and Omega-3 Trial (Vital) and Jupiter Studies
Authors: Rosangela Hoshi, Yanyan Liu, Yanjun Guo, Saumya Tiwari, Heike Gibson, Allen M Andres, Jeramie Watrous, Nancy R Cook, Trisha Copeland, Karen Costenbader, Olivia Okereke, Paul M Ridker, Joann Manson, I-min M Lee, Susan Cheng, Mohit Jain, Olga Demler, Samia Mora
Journal: Circulation (2021)

Introduction: To better understand the cardioprotective mechanisms of regular physical activity (PA), we examined its association with plasma bioactive lipids (BAL) and prospective cardiovascular disease (CVD) events and evaluated the extent to which BMI might mediate this association. Hypothesis: 1) Higher PA associates with a bioactive lipid profile related to lower CVD risk; 2) BMI mediates the PA-BAL and BAL-CVD associations. Methods: Using linear models (adjusted for age, sex, race, smoking, LDL, and total cholesterol), self-reported PA was examined with BAL assayed by an untargeted metabolomics platform in VITAL (N=1032) with validation in JUPITER (N=589). After performing mediation analysis through BMI (same adjustments), we evaluated both BMI-mediated and non-mediated PA-BAL associations with incident CVD using similarly adjusted conditional logistic regression in two nested CVD case-control studies: VITAL-CVD (770 pairs, followed by mediation analysis) and JUPITER-CVD (415 case-control pairs - validation) Results: We detected 237 significant PA-BAL associations in VITAL with replication in JUPITER (FDR&lt;.1). Mediation analysis revealed 146 BMI-mediated associations (indirect effect p&lt;.05), of which 53 showed a relationship with incident CVD in VITAL-CVD. Of those, 22 significant CVD-BAL associations were found in JUPITER-CVD (20 from 49 BMI-mediated and 2 from 4 non-BMI-mediated associations in VITAL-CVD). No relationship with CVD was found from the set of PA-BAL associations not mediated by BMI (indirect effect p≥.05). Notably, BALs related to decreased risk of CVD were positively associated with PA and vice-versa . Conclusion: We identified a signature of 22 PA-related BAL, which were also associated with incident CVD in two independent case-control studies. Although BMI-mediated associations were predominant, non-mediated effects were also detected, implying that more than one pathway may play a role in the PA-CVD relationship.