tbuckley/cabot-search huggingface dataset:
Abstract 14705: Clinical Profile and Health Disparities in Patients With Hypertrophic Cardiomyopathy in a Multi-ethnic Cohort
Authors: Alexandra Butters
Journal: Circulation (2020)

Background: The clinical characteristics and management of hypertrophic cardiomyopathy (HCM) are well-described in European cohorts. However, less is known about other ethnic groups. We compared demographic, clinical, genetic and service use characteristics of patients with HCM across major ethnic groups represented in our cohort. Methods: Retrospective cohort study of 812 HCM probands attending a specialised clinic between 2002 and 2020. The ethnic groups were European n=611, East Asian n=75, South Asian n=58 and Middle Eastern and North African n=68. Analysis included one-way ANOVA with Dunnett's post-hoc comparison or Bonferroni adjustment. Results: The mean age was 55 ± 17 years and 527 (65%) were male. Using the European group as the control, East Asians had a lower body mass index (29 versus 25 kg/m 2 , p&lt;0.05) and South Asians had a lower prevalence of atrial fibrillation (10% versus 31%, p&lt;0.02). Differences also existed in echocardiographic characteristics with East Asians more likely to have apical hypertrophy (23% versus 6%, p&lt;0.02 and Middle Eastern and North African patients more likely to present with left ventricular outflow tract obstruction (46% versus 34%, p&lt;0.02). East Asians were less likely to undergo genetic testing (55% versus 85%, p&lt;0.02) or have an implantable cardioverter defibrillator (19% versus 36%, p&lt;0.02) despite similar HCM-Risk score. Middle Eastern and North Africans and South Asians had the highest rates of variants of unknown significance (27% and 21%, p&lt;0.02; Fig A), while East Asians were more likely to have a causative sarcomere gene variant other than MYBPC3 or MYH7 (58% versus 11%, p&lt;0.02 (Fig B). Conclusion: We demonstrate variability in the phenotype expression and management of HCM by ethnic group, representing differences in pathophysiology, sociocultural contexts, and access to healthcare. This may indicate a role of ethnicity in understanding the clinical course of HCM, and highlight disparities faced by some groups.
Current Trends in In Vitro Modeling to Mimic Cellular Crosstalk in Periodontal Tissue
Authors: Sanja Aveic, Rogerio B. Craveiro, Michael Wolf, Horst Fischer
Journal: Advanced Healthcare Materials (2020)

Abstract Clinical evidence indicates that in physiological and therapeutic conditions a continuous remodeling of the tooth root cementum and the periodontal apparatus is required to maintain tissue strength, to prevent damage, and to secure teeth anchorage. Within the tooth's surrounding tissues, tooth root cementum and the periodontal ligament are the key regulators of a functional tissue homeostasis. While the root cementum anchors the periodontal fibers to the tooth root, the periodontal ligament itself is the key regulator of tissue resorption, the remodeling process, and mechanical signal transduction. Thus, a balanced crosstalk of both tissues is mandatory for maintaining the homeostasis of this complex system. However, the mechanobiological mechanisms that shape the remodeling process and the interaction between the tissues are largely unknown. In recent years, numerous 2D and 3D in vitro models have sought to mimic the physiological and pathophysiological conditions of periodontal tissue. They have been proposed to unravel the underlying nature of the cell–cell and the cell–extracellular matrix interactions. The present review provides an overview of recent in vitro models and relevant biomaterials used to enhance the understanding of periodontal crosstalk and aims to provide a scientific basis for advanced regenerative strategies.
Determining dengue virus serostatus by indirect IgG ELISA compared with focus reduction neutralisation test in children in Cebu, Philippines: a prospective population-based study
Authors: Anna Lena Lopez, Cameron Adams, Michelle Ylade, Ramesh Jadi, Jedas Veronica Daag, Caitlyn T Molloy, Kristal An Agrupis, Deok Ryun Kim, Maria Wilda Silva, In-Kyu Yoon, Laura White, Jacqueline Deen, Aravinda M de Silva
Journal: The Lancet Global Health (2020)

Detection of dengue virus antibodies is important for understanding future dengue virus risk and for prevaccination screening. We aimed to evaluate the performance of a dengue IgG indirect ELISA in determining dengue seroprevalence in a cohort of children in the Philippines, using a focus reduction neutralisation test (FRNT) as the reference test.In this prospective population-based cohort study, we enrolled healthy children residing in Bogo or Balamban, Cebu, Philippines, who were to be aged 9-14 years at the time of a mass dengue vaccination campaign. Sera were collected from participants and batch tested by indirect IgG ELISA and FRNT. The primary endpoint was dengue seroprevalence in the cohort, detected by ELISA, and validated by that detected by reference FRNT. This study is registered with ClinicalTrials.gov, NCT03465254.We collected 2996 serum samples between May 2, and June 2, 2017, and we tested each sample with IgG ELISA. Using 1961 samples (65·5%) that were tested with FRNT, and 1035 samples (34·5%) with imputed results, we found that 320 (10·7%) of 2996 children were dengue naive and 2676 (89·3%) were seropositive for previous dengue virus infection. Based on the 1961 non-imputed FRNT results classified as dengue seronegative or seropositive, the ELISA (with a 0·9 index value cutoff) showed 95·2% sensitivity, 93·4% specificity, 6·6% false positivity, and 4·8% false negativity. However, sensitivity of the ELISA was poor (77·1%) among children with immunity to just one dengue virus serotype. Of the 11 sera that were false positive with ELISA, seven samples (63·6%) were seropositive for Zika virus or Japanese encephalitis virus with FRNT.Most children (89·3%) assessed in our study and eligible to participate in the mass dengue vaccination campaign were seropositive for previous dengue virus infection. Compared with FRNT, ELISA had high sensitivity and specificity (>90%), but the false-negative and false-positive rates makes the test suboptimal for prevaccination screening. Individuals who are falsely identified as seropositive by dengue IgG ELISA and then vaccinated might be at risk of developing severe disease during a subsequent exposure to wild-type dengue virus. Those with a monotypic profile would benefit the most from vaccination, but the sensitivity of the IgG ELISA was much lower in this group than in those with a multitypic profile.Philippine Department of Health, Hanako Foundation, WHO, Swedish International Development Cooperation Agency through the International Vaccine Institute, and University of North Carolina, Chapel Hill, NC, USA.
Ranolazine and Its Anti-Ischemic Effects: Revisiting an Old Mechanistic Paradigm Anew?⁎⁎Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.
Authors: William E. Boden
Journal: Journal of the American College of Cardiology (2010)
Abstract 15899: A Hybrid Artificial Intelligence-Intrinsic Frequency Method for Instantaneous Determination of Myocardial Infarct Size
Authors: Rashid Alavi, Wangde Dai, Robert A Kloner, Niema M Pahlevan
Journal: Circulation (2020)

Introduction: Intrinsic Frequency (IF) method is a recently developed systems-based method that extracts dynamics information about left ventricle function (LV), arterial dynamics, and the LV-arterial coupling from arterial waveforms. We have recently shown (Alavi et al. Circulation, 140 (2019), A12573-A12573) that IF can detect occurrence of an acute myocardial infarction (MI) using a single carotid pressure waveform. Here, we propose that the myocardial infarct size (area of necrosis over total LV area) can be approximated using a hybrid IF-artificial neural network (ANN) method. Methods: The standard MI model was used in anesthetized Sprague Dawley rats (n=27). The proximal left coronary artery was occluded for 30 minutes to ensure necrosis followed by 3 hours of reperfusion. The left ventricle slices were incubated in triphenyl tetrazolium chloride (TTC) to distinguish the necrotic (white) and the non-necrotic (dark red) areas (Fig.1a), thereby obtaining the size of MI through histopathology. IF parameters were computed from random carotid pressure waveforms 2 hours after the reperfusion. A 3-layer ANN model (4 input, 5 hidden, and 1 output node) was applied on IFs from 22 rats to design the ANN (18 for training, 4 for validation). The model was then tested on 5 different rats with the same MI procedure described above. Results: The results showed a significant correlation (R=0.64, P&lt;0.0005) between our IF-artificial intelligence (IF-AI) model and the infarct size. The correlation was especially strong (R=0.84, P&lt;0.0001) without the two outliers shown in Fig.1b. Conclusions: Our results suggest that a hybrid IF-AI method can predict the anatomic infarct size from an arterial waveform without advanced imaging. This technique is clinically significant since infarct sizes are link to the survival and development of heart failure in MI patients, and IF parameters can be obtained noninvasively from carotid waveforms using arterial tonometry devices or an iPhone.
Abstract 14105: Geographic Variation in Infant Mortality Due to Congenital Heart Disease
Authors: Michelle Udine, Frank Evans, Kristin M Burns, Gail D Pearson, Jonathan Kaltman
Journal: Circulation (2020)

Background: Geographic variation in ischemic heart disease and stroke mortality is well-known and likely mediated by health care access, environmental, and sociodemographic factors. Little is known, however, about geographic variation in infant mortality due to congenital heart disease (CHD-IM). This study examines county-level estimates of CHD-IM to understand geographic patterns and factors that may influence variation in mortality. Methods: In this cross-sectional population-based study, we used linked live birth-infant death cohort files from the National Center for Health Statistics containing live births from 2006 to 2015 with cause of death attributed to congenital heart disease. Hierarchical Bayesian models were used to estimate CHD-IM rate for all US counties (N=3,142). Model based estimates were mapped to explore geographic patterns. Covariates included sex, maternal race and ethnicity, percentage of the county population below the poverty level, and proximity of the county to a US News and World Report top 50 ranked pediatric cardiac center (PCC). Results: From 2006 to 2015, there were 13,987 infant deaths due to congenital heart disease and 40,847,089 live births, giving an unadjusted CHD-IM rate of 0.34/1,000 live births. In our model, decreased mortality risk correlated with close proximity to a top 50 PCC, while increased mortality risk correlated with higher level of poverty. The figure shows predicted CHD-IM rates by county. Kentucky and Mississippi had the greatest proportion of counties with a predicted CHD-IM rate &gt; 95th percentile. All counties in Connecticut, Massachusetts, and Rhode Island had a predicted CHD-IM rate &lt; 5th percentile. Conclusion: Analyzing county-level variation of CHD-IM reveals patterns that can help to identify health care disparities and inform local efforts to understand and address variation in outcomes of infants born with congenital heart disease.
Maternity services: Health regulator and coroner warn of failings at Essex trust
Authors: Clare Dyer
Journal: BMJ (2020)

An NHS hospital trust has had conditions placed on its registration, as maternity services at one of its hospitals remained “inadequate for being safe, effective and well led” after a previous formal warning to improve.1

In a separate development a coroner has blamed the same trust, Mid and South Essex NHS Foundation Trust, for the stillbirth of a healthy baby from a botched attempt at forceps delivery at another of its hospitals. Baby Frederick Terry endured a skull fracture and brain haemorrhage during the attempt before he was finally delivered by caesarean section at Broomfield Hospital in Essex in November 2019.

“The evidence showed that baby Freddie’s very serious scalp and brain injuries were sustained during the failed forceps attempted delivery and, but for these, baby Freddie would have …
New Xpert MTB/XDR: added value and future in the field
Authors: Arnold Bainomugisa, Christopher Gilpin, Christopher Coulter, Ben J. Marais
Journal: European Respiratory Journal (2020)

The recent launch of the new Xpert MTB/XDR assay (Cepheid Inc., Sunnyvale, CA, USA) by the Foundation for Innovative New Diagnostics [1] was widely welcomed by the tuberculosis (TB) community, given the critical need for new and better diagnostics to guide the treatment of drug resistant tuberculosis (DR-TB). Xpert MTB/XDR detects resistance to isoniazid (target genes: inhA promoter, katG , fabG1 , oxyR-aphC intergenic region), ethionamide ( inhA promoter), fluoroquinolones ( gyrA and gyrB ), and second-line injectables ( rrs and eis promoter) and is positioned as an add-on or "reflex test" in patients with rifampicin resistance detected by Xpert MTB/RIF or Ultra [2, 3]. Xpert MTB/XDR is a new rapid molecular test for drug resistant tuberculosis <https://bit.ly/3l2t4op>
US lags other rich nations in maternal health care
Authors: Janice Hopkins Tanne
Journal: BMJ (2020)

More women die from complications of pregnancy and childbirth in the US than in 10 other wealthy countries, according to a study by the Commonwealth Fund. In the US there were 17.4 maternal deaths per 100 000 live births, compared with 1.7 in New Zealand and 6.5 in the UK.

The rates in the other countries were 1.8 in Norway, 3 in the Netherlands, 3.2 in Germany, 4.3 in Sweden, 4.6 in Switzerland, 4.8 in Australia, 8.6 in Canada, and 8.7 in France.1

The rate for black non-Hispanic American women was 37.1, more than double the rate for white US women (14.7). The UK has an even worse record: maternal deaths were five times as high for black women …
Abstract IA-07: Mechanisms of cellular heterogeneity in pancreatic cancer
Authors: Axel Behrens
Journal: Cancer Research (2020)

Abstract Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic cancer and is predicted to be the second leading cause of cancer-related mortality in the next decade in Western countries. Treatment options are very limited, with even resectable tumours conferring a five-year survival rate of only 30%. Thus, there is an urgent need to better understand the biology of PDAC. Cancer cell heterogeneity is believed to be one of the main causes of tumour aggressiveness and resistance to therapy. I will describe our work to understand the sources of intratumoural PDAC diversity and the characterisation of a PDAC cancer stem cell population. Citation Format: Axel Behrens. Mechanisms of cellular heterogeneity in pancreatic cancer [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2020 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2020;80(22 Suppl):Abstract nr IA-07.
Abstract 15900: Incidence of Mortality and Morbidity in a Cohort of Congenital Complete Heart Block Patients Followed for Over 40 Years
Authors: Scott J Weinreb, Victoria L Vetter
Journal: Circulation (2020)

Introduction: Congenital complete heart block (CCHB) is rare, 1:15,000 - 1:20,000 live births. The most important risk factors for mortality and cardiac morbidities in this population are not clear. Our CCHB population with structurally normal hearts is uniquely suited to evaluate natural history, impact of chronic pacing, and associated morbidities. Methods: We performed a retrospective cohort study of all identifiable subjects at the Children’s Hospital of Philadelphia from 1/1/1970-4/3/2018 with a CCHB ICD-9 or 10 code and confirmed CCHB by medical record review. We excluded those with structural congenital heart disease, genetic, or acquired cardiac conditions. The primary outcome was a composite of death, cardiomyopathy (CM), heart failure (HF), echocardiographic systolic dysfunction (SD), or cardiac resynchronization therapy (CRT). We applied univariate analysis using chi-square, ANOVA, and determined relative risk. Results: The cohort includes 114 subjects, 58% female, 68% white, 65% diagnosed in the first year of life, with 1571 person-years of follow-up. Maternal antibody testing was positive in 49 subjects (42%). Sixteen (14%) were paced on first day of life and 88 (77%) had at least one permanent pacemaker implanted. Median age at first implant was 1.9 years (IQR 0.1-7.9) and median paced duration 11.8 years (IQR 5.8-16.2). Of those born before 2000, 92% received a pacemaker; 66% born since 2000 have a pacemaker. Pacemaker lead fracture or dislodgement occurred in 28 (32% of paced subjects, 28 per 1000 pacemaker-years). Twenty-five (22%, 16 per 1000 person-years) reached the composite outcome, 23 with cardiac dysfunction (HF, CM or SD); 5 received CRT. Seven of the 25 subjects died. Pacing on first day of life and male sex had relative risks of 3.6 (95% CI 1.9-6.8) and 2.6 (95% CI 1.3-5.2), respectively, of reaching the primary outcome. Maternal antibody positivity, in utero diagnosis, age at diagnosis, birth decade, and duration of pacing were not associated with a higher risk of the primary outcome. Conclusions: The rate of a composite outcome of death, cardiac dysfunction, or CRT was 16 per 1000 person-years in a cohort of 114 subjects with CCHB. Pacing on first day of life and male sex were associated with a higher risk of the composite outcome.
Abstract 260: Regional Routing for Extracorporeal Membrane Oxygenation to Increase Survival From Refractory Ventricular Fibrillation/Ventricular Tachycardia Out-of-Hospital Cardiac Arrest
Authors: Nichole E Bosson, Amy H Kaji, James T Niemann, Shira Schlesinger, David Shavelle, Juliana Tolles, Marianne Gausche-Hill
Journal: Circulation (2020)

Introduction: Extracorporeal membrane oxygenation (ECMO) is increasingly used to support patients with refractory ventricular fibrillation/ventricular tachycardia (rVF/VT) out-of-hospital cardiac arrest (OHCA). Los Angeles County (LAC) operates a regional system of care for 10.2 million persons, routing patients with OHCA to the closest cardiac receiving center. The purpose of this study was to determine 1) the number of patients eligible and 2) the potential for increased neurologically intact survival routing patients with rVF/VT OHCA to ECMO-capable cardiac centers. Methods: This was a retrospective study utilizing LAC quality improvement databases. Patients 18-75 years treated by EMS from 2011-2017 for rVF/VT OHCA, defined as persistent VF/VT after 3 defibrillations, were included in the analysis. Actual survival with good neurologic outcome, defined as cerebral performance category (CPC) 1 or 2, was abstracted from the LAC OHCA Registry. Theoretical patient outcome with routing directly to an ECMO-capable center was determined by applying outcomes as described by the Minnesota Resuscitation Consortium (MRC) for rVF/VT transported for ECMO. Assumptions included the availability of ECMO within a 30-minute transport time, and similar proportions of patients meeting criteria for transport/cannulation and surviving with CPC 1-2 as the MRC cohort, 78% and 40% respectively. For the remaining patients, we assumed no change in outcome. We compared the actual to the theoretical outcome with regional ECMO to determine the annual increase in survival with good neurologic outcome. Results: During the 7-year study period, there were 1862 patients with rVT/VT OHCA with outcomes available for 1454 (78%) patients. Median age was 59 years (IQR 51-66); 76% were male. Actual survival with CPC 1-2 was 13% (187 patients). Theoretical survival with CPC 1-2 in a regional ECMO-capable system was 34% (495 patients); OR 3.5 (95%CI 2.9-4.2), p&lt;0.0001 with ECMO routing versus without. Conclusion: Assuming ECMO availability within a 30-minute transport time throughout the regional system, routing patients with rVF/VT to ECMO-capable centers could improve survival with CPC 1-2 nearly three-fold and result in 44 additional patients/year with meaningful survival.
Towards scaling Twitter for digital epidemiology of birth defects
Authors: Ari Z. Klein, Abeed Sarker, Davy Weissenbacher, Graciela Gonzalez-Hernandez
Journal: npj Digital Medicine (2019)

In recent work, we identified and studied a small cohort of Twitter users whose pregnancies with birth defect outcomes could be observed via their publicly available tweets. Exploiting social media's large-scale potential to complement the limited methods for studying birth defects, the leading cause of infant mortality, depends on the further development of automatic methods. The primary objective of this study was to take the first step towards scaling the use of social media for observing pregnancies with birth defect outcomes, namely, developing methods for automatically detecting tweets by users reporting their birth defect outcomes. We annotated and pre-processed approximately 23,000 tweets that mention birth defects in order to train and evaluate supervised machine learning algorithms, including feature-engineered and deep learning-based classifiers. We also experimented with various under-sampling and over-sampling approaches to address the class imbalance. A Support Vector Machine (SVM) classifier trained on the original, imbalanced data set, with n-grams, word clusters, and structural features, achieved the best baseline performance for the positive classes: an F1-score of 0.65 for the "defect" class and 0.51 for the "possible defect" class. Our contributions include (i) natural language processing (NLP) and supervised machine learning methods for automatically detecting tweets by users reporting their birth defect outcomes, (ii) a comparison of feature-engineered and deep learning-based classifiers trained on imbalanced, under-sampled, and over-sampled data, and (iii) an error analysis that could inform classification improvements using our publicly available corpus. Future work will focus on automating user-level analyses for cohort inclusion.
Correspondence on ‘Impact of COVID-19 pandemic on patients with large-vessels vasculitis in Italy: a monocentric survey’
Authors: Cloé Comarmond, Mathilde Leclercq, Gaëlle Leroux, Cindy Marques, Alexandre Le Joncour, Fanny Domont, Céline Hatte, Ségolène Toquet-Bouedec, Perrine Guillaume-Jugnot, Anne-Claire Desbois, Mathieu Vautier, Aude Rigolet, Yves Allenbach, Olivier Benveniste, David Saadoun, Patrice Cacoub
Journal: Annals of the Rheumatic Diseases (2020)

COVID-19, caused by the SARS-CoV-2, is an unprecedented global pandemic. Advanced age and cardiovascular diseases are recognised as major comorbidities associated with severe forms of COVID-19. Patients with large vessels vasculitis (LVV) could be considered at-risk for severe COVID-19 due to frequent age over 65 years in patients with giant cell arteritis (GCA), severe hypertension in patients with Takayasu arteritis (TAK) and current use of immunomodulating therapies in both LVV. Data on prevalence, clinical presentation and outcome of SARS-CoV-2 infection among patients with LVV are lacking.1–3 Tomelleri et al reported their experience in a single tertiary centre in Lombardy, the Italian region with the highest proportion of infected subjects.2 Their incidence rate of confirmed COVID-19 infection by nasopharyngeal PCR was 2.5% (4/162). Two patients required hospitalisation for COVID-19 interstitial pneumonia and no death was observed. We report our experience on clinical presentation and outcome of COVID-19 among patients with LVV in Paris-Ile de France, another region particularly affected during the same period.

A phone survey was conducted between 04 and 20 May 2020, 8 weeks after lockdown started in France, among patients with LVV followed in Pitie-Salpetriere Hospital (Paris, France). Patients with positive nasopharyngeal PCR and/or thoracic CT scan suggestive of …