tbuckley/cabot-search huggingface dataset:
Diagnostic Performance of an Antigen Test with RT-PCR for the Detection of SARS-CoV-2 in a Hospital Setting — Los Angeles County, California, June–August 2020
Authors: Auguste Brihn, Jamie Chang, Kelsey OYong, Sharon Balter, Dawn Terashita, Zach Rubin, Nava Yeganeh
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

Prompt and accurate detection of SARS-CoV-2, the virus that causes COVID-19, has been important during public health responses for containing the spread of COVID-19, including in hospital settings (1-3).In vitro diagnostic nucleic acid amplification tests (NAAT), such as real-time reverse transcription-polymerase chain reaction (RT-PCR) can be expensive, have relatively long turnaround times, and require experienced laboratory personnel.*Antigen detection tests can be rapidly and more easily performed and are less expensive.The performance † of antigen detection tests, compared with that of NAATs, is an area of interest for the rapid diagnosis of SARS-CoV-2 infection.The Quidel Sofia 2 SARS Antigen Fluorescent Immunoassay (FIA) (Quidel Corporation) received Food and Drug Administration Emergency Use Authorization for use in symptomatic patients within 5 days of symptom onset (4).The reported test positive percentage agreement § between this test and an RT-PCR test result is 96.7% (95% confidence interval [CI] = 83.3%-99.4%),and the negative percentage agreement is 100.0%(95% CI = 97.9%-100.0%) in symptomatic patients.¶ However, performance in asymptomatic persons in a university setting has shown lower sensitivity (5); assessment of performance in a clinical setting is ongoing.Data collected during June 30-August 31, 2020, were analyzed to compare antigen test performance with that of RT-PCR in a hospital setting.Among 1,732 paired samples from asymptomatic patients, the antigen test sensitivity was 60.5%, and specificity was 99.5% when compared with RT-PCR.Among 307 symptomatic persons, sensitivity and specificity were 72.1% and 98.7%, respectively.Health care providers must remain aware of the lower sensitivity of this test among asymptomatic and symptomatic persons and consider confirmatory NAAT testing in high-prevalence settings because a false-negative result might lead to failures in infection control and prevention practices and cause delays in diagnosis, isolation, and treatment.* https://www.medrxiv.org/content/10.1101/2020.06.22.20136309v3† Test performance includes sensitivity, specificity, positive predictive values, and negative predictive value.§ The estimate for positive percentage agreement and negative percentage agreement is used in place of sensitivity in the absence of a reference standard test for comparison.
Abstract 16135: Higher Body Mass Index in Early Childhood is Associated With Adult Obesity in Patients With a Fontan Circulation
Authors: Anjali P Chadayammuri, Tarek ALSAIED, Adam W Powell, Samuel G Wittekind, James Cnota, Alexander R Opotowsky, Adam M Lubert
Journal: Circulation (2020)

Introduction: Obesity is associated with comorbidities that may be detrimental to single-ventricle patients who have had a Fontan procedure. We assessed the prevalence of obesity in adults with a Fontan circulation and evaluated the hypothesis that higher body mass index (BMI) in early childhood is associated with obesity in adulthood. Methods: Retrospective cohort study of patients with a Fontan circulation aged 18-32 years, seen 2011-2019. Those with an atriopulmonary Fontan or chromosomal abnormality known to affect growth were excluded. Historical height and weight measurements, results of recent cardiac testing, and body mass index (BMI) over time were recorded. Obesity was defined as BMI ≥30 kg/m 2 . The associations between childhood anthropometrics, adult BMI, and most recent cardiac testing were assessed. Results: The cohort included 113 adults with a Fontan circulation (median age 22.7 [IQR 20.2-26.4] years; 44% female). There were no significant differences in age, age at Fontan, Fontan type, or ventricular morphology between obese (n=21, 19%; 52% female) and non-obese (n=92, 81%; 41% female) patients. Compared to non-obese adults, obese patients had higher BMI percentiles at age 2 years (80 th [33-95] vs 43 rd [13-82] percentile, p=0.02), at age 4 years (90 th [73-93] vs 57 th [22-81] percentile, p=0.002), and at the time of the Fontan procedure (85 th [51-98] vs 20 th [5-57] percentile, p=0.002). Being overweight at time of Fontan (BMI percentile &gt;85%) strongly predicted later obesity (OR=18.3, 95% CI 3.7-90.3, p&lt;0.001). Obese adults had lower peak VO 2 (19.1±5.2 vs 25.5±6.6 mL/kg/min, p&lt;0.001,) a trend to a lower % predicted VO 2 (59±13 vs 65±14% predicted, p=0.06), higher systolic blood pressure (121±17 vs 112±12 mmHg, p=0.007) and higher ventricular end-diastolic pressure (11±4 vs 9±3 mmHg, p= 0.03). Adult BMI weakly correlated with ventricular end-diastolic pressure (r=0.24, p=0.048). Conclusions: Higher BMI in early childhood is associated with obesity in adults with a Fontan circulation. Adult obesity is associated with worse exercise capacity, higher blood pressure, and higher ventricular end-diastolic pressure. Weight interventions in children with a Fontan circulation may help prevent later obesity and its adverse consequences.
Preliminary Results from an Open-Label, Phase 2 Study of Tipifarnib in Chronic Myelomonocytic Leukemia (CMML)
Authors: Mrinal M. Patnaik, David A Sallman, Mikkael A. Sekeres, Selina Luger, Rafael Bejar, Gabriela S. Hobbs, Amy E. DeZern, James Bolognese, Mary Traynor, Vishnu Mishra, David Wages, Antonio Gualberto, Catherine Scholz, Eric Padron
Journal: Blood (2017)
Abstract 16965: Paraoxanase-1 Modulates Cardiotonic Steroid Induced Cardiac Inflammation and Fibrosis in Dahl Salt Sensitive Model of Chronic Kidney Disease
Authors: Prabhatchandra R Dube, Fatimah Khalaf, Mitra Patel, Bella Khatibshahidi, Armelle DeRiso, Apurva Lad, Chrysan J Mohammed, Andrew Kleinhenz, Olga Fedorova, Steven Haller, David J Kennedy
Journal: Circulation (2020)

Objective: Cardiotonic steroids (CTS) are known ligands of the Na+/K+-ATPase (NKA) and chronic elevations in volume expanded conditions such as hypertension and chronic kidney disease (CKD) can mediate a pro-inflammatory and pro-fibrotic phenotype. Paraoxonase1 (PON1) is a lactonase enzyme that circulates bound to HDL and possesses antioxidant, anti-inflammatory and anti-atherogenic properties. PON1 can hydrolyze CTS to inactive open-ring forms making them incapable of stimulating NKA and initiating pro-inflammatory signaling cascades. Diminished PON1 activity results in detrimental clinical outcomes in the context of CKD but whether reduced PON1 activity is mechanistically linked to adverse cardiovascular events in CKD remains unknown. We hypothesized that PON-1 can attenuate progression of cardiac inflammation in CKD via modulating the pathogenic pathways induced by CTS signaling using a well characterized Dahl salt-sensitive rat model of hypertensive renal disease and elevated CTS. Methods: Dahl salt-sensitive wild type ( SS-WT ), PON1 knockout ( SS-PON1KO ), and PON1 knockout rats treated with 3E9 anti-CTS antibody (3E9 mAb,50μg/kg i.p. every week for a total of 4 injections) were fed a high salt (8%) diet for five weeks to induce hypertensive renal disease and elevate CTS levels. H&amp;E staining was performed on hearts to analyze immune cell infiltration. Real-time PCR (RT-PCR) analysis was performed for markers of inflammation (IL6, IL1β, and CCL2), hypertrophy (Myh7, NPPA, and Slc8a), and fibrosis (Timp1). Results: RT-PCR analysis revealed significantly increased (≥1.5 fold) expression of cardiac inflammatory (p&lt;0.005), hypertrophy (p&lt;0.0005), and fibrotic markers (p&lt;0.05) in SS-PON1 KO compared to SS-WT rats after high salt feeding. Treatment of SS-PON1 KO rats with 3E9 mAb significantly decreased (≥ 2.5 fold) expression of Timp1, IL6, Ccl2, IL1β, NPPA, Myh7 and Slc8a (all p&lt;0.005). H&amp;E analysis of hearts revealed significantly decreased immune cell infiltration in SS-PON1KO rats treated with 3E9 mAb compared to SS-PON-1 KO rats (3.5±0.5 VS1.813±0.4094,p&lt;0.005). Conclusion: Our findings suggest that PON-1 via its counter-regulatory mechanism of the CTS signaling axis exhibits a cardioprotective role in chronic kidney disease.
Does sex affect second ACL injury risk? A systematic review with meta-analysis
Authors: Akash D Patel, Garrett S Bullock, Jordan Wrigley, Mark V Paterno, Timothy C Sell, Justin M Losciale
Journal: British Journal of Sports Medicine (2021)

Objective To determine sex-based differences in risk of a second ACL injury (overall and by laterality) following primary ACL reconstruction in athletes who are attempting to return to sport. Design Systematic review with meta-analysis. Data sources Systematic search of five databases conducted in August 2019. Eligibility criteria for selecting studies Studies reporting sex-based differences in the incidence of second ACL injury in athletes attempting to return-to-sports and who were followed for at least 1 year following primary ACL reconstruction. Results Nineteen studies were included in this review, with seven studies excluded from the primary meta-analysis due to high risk of bias. The remaining 12 studies (n=1431 females, n=1513 males) underwent meta-analysis, with all 19 studies included in a sensitivity analysis. Total second ACL injury risk was 21.9% (females: 22.8%, males: 20.3%). Females were found to have 10.7% risk of an ipsilateral ACL injury and 11.8% risk of a contralateral ACL injury. Males were found to have 12.0% risk of an ipsilateral ACL injury and 8.7% risk of a contralateral ACL injury. No statistically significant differences were observed for total second ACL injury risk (risk difference=−0.6%, 95% CI −4.9 to 3.7, p=0.783, I 2 =41%) or contralateral ACL injury risk (risk difference=1.9%, 95% CI −0.5% to 4.4%, p=0.113, I 2 =15%) between sexes. Females were found to have a 3.4% absolute risk reduction in subsequent ipsilateral ACL injury risk compared with males (risk difference=−3.4%, 95% CI −6.7% to −0.02%, p=0.037, I 2 =35%). Conclusion Both sexes have &gt;20% increased risk of experiencing a second ACL injury. Any difference in the absolute risk of either a subsequent ipsilateral or contralateral ACL injury between sexes appears to be small. Registration PROSPERO (CRD42020148369)
International consensus on initial screening and follow-up of asymptomatic SDHx mutation carriers
Authors: Laurence Amar, Karel Pacak, Olivier Steichen, Scott A. Akker, Simon J. B. Aylwin, Eric Baudin, Alexandre Buffet, Nelly Burnichon, Roderick J. Clifton-Bligh, Patricia L. M. Dahia, Martin Fassnacht, Ashley B. Grossman, Philippe Herman, Rodney J. Hicks, Andrzej Januszewicz, Camilo Jimenez, Henricus P. M. Kunst, Dylan Lewis, Massimo Mannelli, Mitsuhide Naruse, Mercedes Robledo, David Taïeb, David R. Taylor, Henri J. L. M. Timmers, Giorgio Treglia, Nicola Tufton, William F. Young, Jacques W. M. Lenders, Anne-Paule Gimenez-Roqueplo, Charlotte Lussey-Lepoutre
Journal: Nature Reviews Endocrinology (2021)

Abstract Approximately 20% of patients diagnosed with a phaeochromocytoma or paraganglioma carry a germline mutation in one of the succinate dehydrogenase ( SDHx ) genes ( SDHA , SDHB , SDHC and SDHD ), which encode the four subunits of the SDH enzyme. When a pathogenic SDHx mutation is identified in an affected patient, genetic counselling is proposed for first-degree relatives. Optimal initial evaluation and follow-up of people who are asymptomatic but might carry SDHx mutations have not yet been agreed. Thus, we established an international consensus algorithm of clinical, biochemical and imaging screening at diagnosis and during surveillance for both adults and children. An international panel of 29 experts from 12 countries was assembled, and the Delphi method was used to reach a consensus on 41 statements. This Consensus Statement covers a range of topics, including age of first genetic testing, appropriate biochemical and imaging tests for initial tumour screening and follow-up, screening for rare SDHx -related tumours and management of elderly people who have an SDHx mutation. This Consensus Statement focuses on the management of asymptomatic SDHx mutation carriers and provides clinicians with much-needed guidance. The standardization of practice will enable prospective studies in the near future.
Abstract P015: Serum Thrombospondin-2 Of Cardiovascular Risk Factor Is Strongly Associated With Liver Fibrosis In A General Population
Authors: Nagisa Morikawa, Hisashi Adachi, Mika Enomoto, Ako Fukami, Akiko Sakaue, Kenta Toyomasu, Maki Yamamoto, Yoshihiro Fukumoto
Journal: Circulation (2021)

Background: Non-alcoholic fatty liver disease is increasing in decades and has been recently reported to be associated with cardiovascular disease (CVD). However, the underlying pathophysiology has not been elucidated. Thrombospondin(TSP)-2 is a cardio-protective extracellular matrix, while some clinical studies showed that high serum TSP-2 is a good predictor for adverse events in patients with heart failure. We previously found that in healthy people, serum TSP-2 was associated with insulin resistance, N-terminal pro-brain natriuretic peptide and atrial fibrillation, which suggested a potential CVD risk factor. Therefore, serum thrombospondin-2 can affect on the association between liver fibrosis and CVD. Hypotheses: Serum TSP-2 levels were associated with liver fibrosis in a general population. Methods: We performed a cross-sectional study with a health-check up in 224 participants (mean age: 69.0±7.8 years, men: 42.0%) in Uku, Japan in 2019. Serum TSP was measured by ELISA. Liver fibrosis was defined by the Fibrosis-4 (FIB-4) index ≥2.67, where FIB-4 was calculated as {(ageхaspartate aminotransferase)/(plateletх(alanine aminotransferase) 0.5 )}/10. Continuous serum TSP-2 was modeled using restricted cubic splines with 3 knots (5 th , 50 th , 95th) to allow a nonlinear association with the log odds ratio of liver fibrosis. Results: Mean FIB-4 was 1.92±0.89 and 14.3% of total had liver fibrosis. Age and sex adjusted log odds ratios (ORs) for liver fibrosis was associated with serum TSP-2 non-linearly and the risk accelerate when serum TSP-2 ≥29.5ng/mL(Figure 1). ORs(95% CI) for 29.5 and 31.0 of serum TSP-2 compared to 23.0(median) were 1.57(1.11-2.21) and 1.86(1.25-2.78), respectively. Conclusion: Serum TSP-2, which is a CVD biomarker, was strongly associated with liver fibrosis in the pathological range in a general population. This finding provides a new insight into the pathology in the link between liver fibrosis and CVD.
Abstract P013: Validating The Utility Of Plasma Biomarkers In The Prediction Of Readmission Or Mortality Following Congenital Heart Surgery
Authors: Devin Parker, Michael Zappitelli, Heather Thiessen-Philbrook, Allen D Everett, Meagan Stabler, Marshall Jacobs, Jeffrey P Jacobs, Chirag Parikh, Jeremiah R Brown
Journal: Circulation (2021)

Introduction: Unplanned readmission is associated with higher risks of complications, death, and increased costs. Accurate statistical models to stratify the risk of 30-day readmission or death after congenital heart surgery could help clinical teams focus care on those patients at highest risk. We hypothesized biomarkers could improve prediction for readmission or mortality. Methods: Levels of pre- and postoperative ST2, Galectin-3, NT-proBNP and GFAP were measured in plasma samples from 162 pediatric congenital heart surgery patients from Johns Hopkins Hospital with external validation in 360 pediatric patients from an international multi-center TRIBE-AKI cohort. A model based on clinical variables from the Society of Thoracic Surgery Congenital database (STS-CHSD) was developed in the Hopkins cohort. We tested and externally validated the clinical models and biomarker panels in the TRIBE-AKI cohort using AUROC statistics and Kaplan-Meier cox hazard regression models. Results: There were 55 patients (10.5%) that experienced unplanned readmission or died within 30 days after congenital heart surgery. The STS-CHSD clinical model resulted in an AUROC of 0.617 (95% CI: 0.47 - 0.76). The derivation cohort with the biomarker augmented STS-CHSD clinical model resulted in a significantly improved AUROC of 0.802 (95%CI: 0.72 - 0.89; p=0.003). External validation of the biomarker augmented STS-CHSD clinical model showed limited improvement (AUROC: 0.60; 95% CI: 0.49-0.72; p value= 0.47). Conclusions: Our findings indicate that these biomarkers can be used for early identification of children at increased risk of readmission or death after pediatric congenital heart surgery. While the addition of biomarkers improve prediction in our derivation cohort, external validation was poor. Our findings suggest there are other potential biomarkers and factors to be explored to improve prediction of readmission or mortality for children following congenital heart surgery.
Determination of the Anatomical Features of the Temporal Bones at the Stage of Planning Extraoral Implantation in Ectoprosthetics of the Auricle
Authors: D. A. Lezhnev, S. D. Arutyunov, E. Yu. Lazarenko, M. V. Magomedbekova
Journal: Radiology - Practice (2021)

At the present stage of the development of maxillofacial surgery, the treatment of patients with defects in the auricles is one of the most difficult. Defects of the auricles, characterized by its absence, are divided according to the etiological factor into two main groups: congenital (microtia) and acquired (as a result of injuries of various origins). Microtia (including anotia the complete absence of the auricle) is a malformation of the auricle and the external auditory canal caused by anomalies of the first and second zygomatic arch and the first sulcus.Congenital malformations of the auricle occur in 1 out of 700–15 000 newborns and more often have a right-sided localization. In 15 % of cases, they are hereditary, and in 85 % they are sporadic, in boys they are detected on average 2–2,5 times more often than in girls.Currently, much attention is paid to the prosthetic reconstruction of the auricle with fixation by means of cranial intraosseous implants. At the same time precise diagnostics of the state of the temporal bones in the area of the proposed implantation and the correct positioning of the intraosseous supports are the basis of an effective fixation system. Among the methods of radiological diagnostics used for planning ectoprosthetics of the auricles, radiography has long been preferred. However, the introduction of computed tomography into clinical practice has provided a high-quality assessment of the temporal bones state, which has increased the efficiency of surgical intervention planning and treatment.
Abstract 17309: Scope and Determinants of Nonfinancial Barriers to Healthcare Access in Individuals With Atherosclerotic Cardiovascular Disease
Authors: Isaac Acquah, Javier Valero-Elizondo, Miguel Cainzos Achirica, Rahul Singh, Karan Shah, Maryam Hyder, Khurram Nasir
Journal: Circulation (2020)

Introduction: Barriers to healthcare - financial and nonfinancial - may result in unmet health needs and adverse outcomes. Despite this, the nonfinancial barriers to care among adults with atherosclerotic cardiovascular disease (ASCVD) is poorly defined in the US. We aimed to explore the scope and determinants of nonfinancial barriers to care among individuals with ASCVD. Methods: We analyzed data from the 2013-17 National Health Interview Survey (NHIS). We included adults with self-reported ASCVD (heart attack, angina, and/or stroke). Nine key variables in the NHIS that represent nonfinancial barriers to healthcare were assessed as absent/present, and participants were classified as having 0-1, 2, or ≥3 barriers. Multinomial logistic regression (using 0-1 nonfinancial barriers as reference) was used to evaluate the relationship between various sociodemographic factors, and an increasing number of nonfinancial barriers. Results: Of all the 15,758 adults with ASCVD (8.1% annually in the US; representing 19.6 million), 23.4% reported having at least one nonfinancial barrier to care while 4.9% reported 3 nonfinancial barriers. In a multivariable multinomial logistic regression, after stratifying by age, individuals from low-income families had an almost 2-fold relative prevalence of 3 nonfinancial barriers ( Figure) . In the elderly, however, lack of insurance was the strongest predictor (relative prevalence ratio of 6.51 [95% confidence interval; 2.25, 18.87]) of having ≥3 barriers. Conclusion: Among adults with ASCVD, the relative prevalence of ≥3 nonfinancial barriers was low (4.9%) with low-income being the only modifiable predictor of reporting ≥3 nonfinancial barriers and lack of insurance being the strongest predictor in the elderly. Addressing financial barriers to healthcare may help alleviate these nonfinancial barriers.
Plasma high-density lipoprotein cholesterol and risk of dementia: observational and genetic studies
Authors: Emilie W Kjeldsen, Jesper Q Thomassen, Ida Juul Rasmussen, Børge G Nordestgaard, Anne Tybjærg-Hansen, Ruth Frikke-Schmidt
Journal: Cardiovascular Research (2021)

The association of plasma high-density lipoprotein (HDL) cholesterol with risk of dementia is unclear. We, therefore, tested the hypothesis that high levels of plasma HDL cholesterol are associated with increased risk of dementia and whether a potential association is of a causal nature.In two prospective population-based studies, the Copenhagen General Population Study and the Copenhagen City Heart Study (N = 111 984 individuals), we first tested whether high plasma HDL cholesterol is associated with increased risk of any dementia and its subtypes. These analyses in men and women separately were adjusted multifactorially for other risk factors including apolipoprotein E (APOE) genotype. Second, taking advantage of two-sample Mendelian randomization, we tested whether genetically elevated HDL cholesterol was causally associated with Alzheimer's disease using publicly available consortia data on 643 836 individuals. Observationally, multifactorially adjusted Cox regression restricted cubic spline models showed that both men and women with extreme high HDL cholesterol concentrations had increased risk of any dementia and of Alzheimer's disease. Men in the 96th-99th and 100th vs. the 41st-60th percentiles of HDL cholesterol had multifactorially including APOE genotype adjusted hazard ratios of 1.66 (95% confidence interval 1.30-2.11) and 2.00 (1.35-2.98) for any dementia and 1.59 (1.16-2.20) and 1.87 (1.11-3.16) for Alzheimer's disease. Corresponding estimates for women were 0.94 (0.74-1.18) and 1.45 (1.03-2.05) for any dementia and 0.94 (0.70-1.26) and 1.69 (1.13-2.53) for Alzheimer's disease. Genetically, the two-sample Mendelian randomization odds ratio for Alzheimer's disease per 1 SD increase in HDL cholesterol was 0.92 (0.74-1.10) in the IGAP2019 consortium and 0.98 (0.95-1.00) in the ADSP/IGAP/PGC-ALZ/UKB consortium. Similar estimates were observed in sex stratified analyses.High plasma HDL cholesterol was observationally associated with increased risk of any dementia and Alzheimer's disease, suggesting that HDL cholesterol can be used as an easily accessible plasma biomarker for individual risk assessment.