tbuckley/cabot-search huggingface dataset:
Abstract 14045: The Incidence and Associated Risk Factors of New-onset Atrial Fibrillation in the Medical Intensive Care Unit
Authors: Ryan J Brunetti, Edan Zitelny, Noah Newman, Jonathan Dowell, Matthew J Singleton, Prashant Bhave
Journal: Circulation (2020)

Introduction: New-onset AF (NOAF) in the medical ICU is associated with worse patient outcomes. The research on NOAF in this setting compared to that in the post-cardiothoracic and non-cardiac surgery patients is not as robust. For example, a 2019 literature review found that the reported incidence of NOAF in the medical ICU ranges between 1.7% and 43.9%. This retrospective single-center observational study examines the incidence and associated risk factors of this relatively understudied population. Methods: The total study population is comprised of 2682 consecutive patients with medical ICU stays in 2018. Post-operative patients as well as patients with preexisting AF were excluded. ICD-10 codes were used in conjunction with i2b2 to identify patients. Manual chart review confirmed those with NOAF during a 2018 ICU stay. These patients were compared with a control group comprised of 106 randomly-selected patients from the study population. Demographics and diagnoses were collected, along with length of stay (LOS), mortality at discharge and mortality after one year. Results: 90 patients of the 2682 patient cohort (3.4%) developed NOAF during their ICU stay. Patients with NOAF were more likely to be older (67.7 vs. 56.5 years), have hypertension (75.6% vs. 62.3%) and have peripheral vascular disease (41.1% vs. 26.4%) compared to the control group. More importantly, NOAF was associated with an increased LOS of 16.5 days relative to 9.6 days in the control group. No significant difference was found in mortality between the two groups. The results of this preliminary analysis are summarized in Table 1 . Conclusions: We found the incidence of NOAF in patients admitted to the medical ICU was 3.4%, and NOAF was associated with a significant increase in LOS. Upon completion of data extraction and multivariate analysis for the entire study population, we hope that this study will contribute to our understanding of the significance of NOAF in critically ill patients.
Metformin Carbon Dots for Promoting Periodontal Bone Regeneration via Activation of ERK/AMPK Pathway
Authors: Chunxia Ren, Xinqing Hao, Lu Wang, Yue Hu, Lin Meng, Shize Zheng, Feilong Ren, Wenhuan Bu, Huan Wang, Daowei Li, Kai Zhang, Hongchen Sun
Journal: Advanced Healthcare Materials (2021)

Abstract The osteogenic potential of mesenchymal stem cells (MSCs) is severely impaired under persistent inflammation of periodontitis. A highly efficient way to promote or rescue osteogenic potential of MSCs under inflammation remains an unmet goal. Herein, metformin carbon dots (MCDs) with excellent biocompatibility are prepared from metformin hydrochloride and citric acid via a hydrothermal method. The MCDs can more effectively enhance the alkaline phosphatase (ALP) activity, calcium deposition nodules formation, expression of osteogenic genes and proteins in rat bone marrow mesenchymal stem cells (rBMSCs) than metformin under both inflammatory and normal conditions. Moreover, a novel pathway of extracellular signal‐regulated kinases (ERK)/AMP‐activated protein kinase (AMPK) signaling is involved in the MCDs‐induced osteogenesis. In periodontitis rats, MCDs can effectively regenerate the lost alveolar bone, but not the metformin. Taken together, MCDs can be the promising candidate nanomaterial for periodontitis treatment. This work may provide a new pharmacological target of ERK/AMPK pathway for treating bone loss and also give additional insights into developing nanodrugs from the numerous medications.
Abstract 16451: The Temporal Trend in the Utilization of Noninvasive Cardiac Test for Chest Pain Evaluation and Its Impact on Cardiac Catheterization Trends
Authors: Stephanie Hong, Getu Teressa
Journal: Circulation (2020)

Introduction: Noninvasive diagnostic testing serves as gatekeepers to invasive cardiac catheterization. Computed tomography coronary angiogram (CTCA) has been shown to have high sensitivity and negative predictive value in the diagnosis of coronary artery disease (CAD). However, the temporal trend of CTCA compared to functional tests and the differential downstream impact on cardiac catheterization is unknown. Objective: This study aimed to investigate the temporal trend of the use in CTCA for the evaluation of patients with chest pain and how it compares to the temporal trend of stress testing. The secondary aim was to investigate the temporal pattern in the cardiac catheterization rate and how it varies between CTCA and stress testing. Methods: We performed a retrospective review of 65,686 patients who presented to a large academic medical center with chest pain between 2012 and 2019. We identified those who received CTCA testing or stress testing as the initial diagnostic testing for diagnosing suspected CAD and collected data on downstream cardiac catheterization. We calculated the testing rate per 1000 for each year. Results: Of the patient who received noninvasive imaging (n=18,843), more CTCA was performed (18.6%) compared to stress test (10.1%). After an initial upward trend in CCTA use and a downward trend in stress test use between 2012 and 2014, the trend reversed for both modalities after 2015. The rate of cardiac catheterization increased after 2014, mirroring an increase in stress test utilization. Patients who had stress test first have increased odds of undergoing catheterization compared to those who had CTCA first, even after adjusting for risk factors. However, compared to CTCA, stress test shows a relative decline in the odds of catheterization (Relative adjusted Odd Ratio: 5.6 in 2012 down to 2.8 in 2019) Conclusion: In this large single-center study of chest pain patients, stress-testing leads to increased odds of cardiac catheterization compared to CCTA. However, the relative odds of undergoing catheterization following stress testing show a declining trend.
Abstract 008: Machine Learning For Sudden Cardiac Death Prediction: The Artherosclerosis Risk In Communities Study
Authors: Zhi Yu, Shannon Wongvibulsin, Linda Zhou, Kunihiro Matsushita, Pradeep Natarajan, Josef Coresh, Scott L Zeger
Journal: Circulation (2021)

Introduction: Sudden cardiac death (SCD) is the leading cause of death in the US and has significant public health impact. However, effective risk stratification for SCD remains lacking as current prediction models do not address the dynamic impact of time-varying risk factors including interim clinical events on SCD risk. Hypothesis: A recently developed machine learning approach that uses time-dependent variables and incorporate complex interactions between risk factors, Random Forest for Survival, Longitudinal, and Multivariate Data (RF-SLAM), will be able to improve SCD risk prediction. Methods: ARIC study participants were followed for adjudicated SCD. RF-SLAM partitions the information for each individual into multiple units (analogous to risk sets) and uses Poisson regression log-likelihood as the split statistic thus allowing for modeling time-varying variables. It was compared to a Poisson regression model with stepwise selection to predict SCD. Time-varying variables collected at four visits were used as candidate predictors for both prediction models, including demographics and clinical characteristics, anthropometric variables, lifestyle factors, cardiac risk factors, medication, laboratory values and biomarkers, electrophysiologic variables, and other cardiac functional indices. Predictive accuracy was assessed by area under the receiver operating characteristic curve (AUC) through out-of-bag prediction for RF-SLAM model and 10-fold cross validation for Poisson regression model. Results: Over 25 years follow-up, 590 SCD events occurred among 15792 ARIC participants mean age 54 years (55% women). Compared to Poisson regression (cross-validated mean AUC 0.75), RF-SLAM model improved prediction (mean AUC 0.83). RF-SLAM model identified prior coronary heart disease (CHD) as the top predictor for SCD. Other predictors selected by RF-SLAM included clinical characteristics (diabetes, prior myocardial infarction, prior stroke, and prior heart failure), electrophysiologic variables (T wave abnormality in any of leads I, aVL, and V6, and ST junction &amp; segment depression in any of leads I, aVL, or V6), medication (anti-hypertensive medications and anti-diabetic medications), biomarkers (N-terminal pro-B-type natriuretic peptide, troponin T, troponin I, and creatinine), subclinical atherosclerotic indices (carotid intima-media thickness), as well as race, sex and visit. Using the 17 predictors selected by RF-SLAM model to fit a Poisson regression model, a generalized linear model, resulted in a mean AUC of 0.73, suggesting that the interactions captured by random forest improve prediction performance. Conclusions: Applying a novel machine-learning approach with time-varying predictors improves the prediction of SCD. Clinical characteristics, especially prior CHD, are important for predicting SCD in the general population.
Abstract 16197: Influence of Coronary Artery Disease on the Prognosis of a Positive Stress Echocardiogram in Patients With Advanced Liver Disease
Authors: Kutaiba Nazif, Ronald Mastouri, Harvey Feigenbaum, Joseph Zenisek, Deborah Hess-Green, Stephen G Sawada
Journal: Circulation (2020)

Background: Cardiac complications are the leading cause of mortality after orthotopic liver transplantation (OLT). In the general population, a positive dobutamine stress echocardiogram (DSE) in the absence of coronary artery disease (CAD) still identifies a high risk group whose outcome is similar to those with positive DSE and CAD. DSE is widely employed as a screening method prior to OLT but less is known about the prognostic impact of a positive DSE in the end stage liver disease (ESLD) population and whether CAD also influences their outcome. We investigated the prognostic impact of a positive DSE and clinical factors including CAD in patients with ESLD. Methods: Follow-up data was obtained in 61 liver transplant candidates with positive DSE and coronary angiography for cardiovascular events including angina requiring revascularization, heart failure, infarction, and cardiac death. Event free survival was compared between patients with (22 patients &gt;70% stenosis) and without (39 patients) obstructive CAD and Cox regression was used to identify factors associated with events. Results: Over a mean follow-up of 27 + 28 months, 21 % (8/39) of patients with positive DSE and no CAD had events compared with 46% (10/22) of patients with positive DSE and CAD, p = 0.04. At one year of follow-up, cardiac death had occurred in 8% (3/39) of patients with positive DSE and no CAD, and in 9% (2/22) of those with positive DSE and CAD. Overall, event free survival was significantly better in those without CAD (p = 0.014). Beta blocker use (HR: 4.1, 95% CI: 1.7 - 9.9, p-value = 0.010), CAD (HR: 4.4 95% CI: 1.8- 10.8, p-value = 0.008), and non-alcoholic steatohepatitis (NASH) (HR: 4.9, 95% CI: 2.0 - 11.7, p-value = 0.04) were independently associated with cardiac events. Conclusion: ESLD patients with a positive DSE and no CAD had a one year cardiac mortality that was similar to patients that had a positive DSE and CAD. However, the overall prevalence of cardiac events and the event free survival was significantly worse in the CAD group. Thus, ESLD patients with a positive DSE are at increased risk and the presence of CAD further increases their risk. In addition to CAD, beta blocker use and NASH were independently associated with cardiac events.
Noninvasive Oscillometry to Measure Pulmonary Mechanics in Preterm Infants
Authors: Colm P. Travers, Andrew P. Klinger, Inmaculada Aban, Wynton Hoover, Waldemar A. Carlo, Namasivayam Ambalavanan
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

"Noninvasive Oscillometry to Measure Pulmonary Mechanics in Preterm Infants." American Journal of Respiratory and Critical Care Medicine, 204(4), pp. 485–488
Renal function and the effects of vericiguat in patients with worsening heart failure with reduced ejection fraction: insights from the <scp>VICTORIA</scp> (<scp>Vericiguat</scp> Global Study in Subjects with <scp>HFrEF</scp>) trial
Authors: Adriaan A. Voors, Hillary Mulder, Eugene Reyes, Martin R. Cowie, Johan Lassus, Adrian F. Hernandez, Justin A. Ezekowitz, Javed Butler, Christopher M. O'Connor, Joerg Koglin, Carolyn S.P. Lam, Burkert Pieske, Lothar Roessig, Piotr Ponikowski, Kevin J. Anstrom, Paul W. Armstrong
Journal: European Journal of Heart Failure (2021)

Vericiguat reduced the primary composite outcome of cardiovascular death or heart failure (HF) hospitalization in patients with worsening HF with reduced ejection fraction (HFrEF) and a lower limit of baseline estimated glomerular filtration rate (eGFR) of 15 mL/min/1.73 m
Abstract 13085: Post-icd Implant Intervention: Secondary Prevention and Partner Support Associated With Improved Physical and Psychological Outcomes
Authors: Ana Carolina Sauer Liberato, Frances Elaine Thompson, Cynthia M Dougherty
Journal: Circulation (2020)

Introduction: Health characteristics and symptoms of patients with an ICD differ based on ICD indication (primary or secondary prevention). The purpose of this study was to examine for differential effects of ICD indication on health outcomes in 2 post-implant interventions: a patient-only intervention (P-only) and a patient intervention that included the patient’s partner (P+P). Hypothesis: Intervention effects on patient health outcomes will be influenced by ICD indication. Methods: A prospective RCT (N = 301) compared the 2 interventions on: Physical Function (SF-36 Physical functioning , Vitality and Physical Component Score - PCS; physical health, Patient Concerns Assessment - PCA) and Psychological Adjustment (SF-36 Social Functioning and Mental Component Score - MCS; State Anxiety, STAI; and Depression, PHQ-9). Study participants were randomized to intervention condition, blocked by comorbidities and ICD indication. The 2 nurse-led social cognitive theory interventions (P-only or P+P) were delivered by telephone during the first 12 weeks post implant. Health outcomes were measured at baseline, 3, and 12 months. Using repeated measures ANOVA, comparisons were made among 4 study groups, defined by ICD indication (primary vs secondary) and intervention condition (P-only vs P+P). Results: The sample was primarily white (91%), male (88%), average age 64±11.90 years, BMI = 29.57±6.17, EF = 34.08±14.33, Charlson Comorbidity = 2.29±1.49, with 60% receiving ICD for primary prevention. Secondary, compared to primary, prevention patients in both interventions showed improved physical functioning, vitality, physical health, and depression (F = 8.5, P = &lt;0.001; F = 5.75, P = 0.001; F = 6.15, P = &lt; 0.001; F = 4.09, P = 0.007, respectively). The greatest improvements were observed at 3 months (end of interventions) and maintained or improved at 12 months. Secondary prevention patients participating in P+P showed the greatest improvement in vitality and depression across 12 months. Conclusion: Patients who received an ICD for secondary prevention and were also in the P+P intervention showed greatest improvement across recovery, indicating promising health outcomes for patients in intervention programs that include the partner.
Abstract 15132: Inpatient Outcome of Infective Pericarditis in the United States: An Analysis From National Inpatient Sample 2016-2017
Authors: Bolun Liu, Bing Chen, Omid Behnamfar, Trisha Gomez, Ajoe Kattoor
Journal: Circulation (2020)

Introduction: Infective pericarditis is a relatively uncommon condition in the modern antibiotic era, has a high mortality rate (20-30%) and is associated with immunosuppression, alcohol use, illicit drug use, thoracic surgery. Outcomes data in the current era is unknown. We aim to analyze the baseline characteristics and outcomes of patients admitted in the hospital with infective pericarditis. Methods: We conducted a retrospective study using National Inpatient Sample (NIS) database from 2016 to 2017. Hospital visits with a primary diagnosis of infective pericarditis (ICD10, I30.1) during which a pericardial procedure was performed were identified using ICD-10-CM and ICD-10-PCS Codes. Our primary outcome was basic characteristics and in-hospital all-cause mortality. Multivariate regression model was used to adjust for the pericardial procedure approach, age, and cardiac tamponade. R (Version 3.6.1) was utilized for the analysis. Results: A total of 1010 weighted hospitalizations in adult patients with infective pericarditis were identified. The mean age was 56.7±1.1 years (woman - 41.4%). The baseline characteristics and comorbidities are described in table 1 and table 2. 60.5% of the patients underwent percutaneous pericardial drainage, 36.4% had open surgery, and 3.2% had VATs. The mean time from admission to a pericardial procedure is 1.7±0.2 days. In-hospital all-cause mortality was 2.27%. The mean length of stay was 7.59±0.43 days. The mean total cost was 22530±1193 US dollars. Among all hospitalizations, 61.8% of them were complicated by hemodynamic instability and 56.8% had cardiac tamponade. Compared to pericardiocentesis, patients who underwent pericardiotomy had a higher mortality (5% vs 0.8%, adjusted OR 8.03, P = 0.043). Conclusions: Our study demonstrates relatively low inpatient mortality with infective pericarditis compared to older studies. Around half of the patients had cardiac tamponade.
Setting Assessment Standards for Artificial Intelligence Computer Vision Wound Annotations
Authors: Jeffrey K. Jopling, Brian C. Pridgen, Serena Yeung
Journal: JAMA Network Open (2021)

Raelina S. Howell, MD; Helen H. Liu, DO; Aziz A. Khan, MD; Jon S. Woods, MD; Lawrence J. Lin, BA; Mayur Saxena, PhD; Harshit Saxena, MS; Michael Castellano, MD; Patrizio Petrone, MD, PhD; Eric Slone, MD; Ernest S. Chiu, MD; Brian M. Gillette, PhD; Scott A. Gorenstein, MD
Abstract 16139: A Targeted Proteomic Approach to Identify Circulating Biomarkers of Heart Failure Risk in Patients With Type 2 Diabetes Mellitus in DECLARE-TIMI 58
Authors: David Berg, Stephen D Wiviott, Itamar RAZ, Frederick Kamanu, KyungAh Im, Avivit Cahn, ofri Mosenzon, Deepak L Bhatt, Petr Jarolim, Lawrence A Leiter, Darren K McGuire, JOHN WILDING, Yong Huo, Jose L Lopez-sendon, Diego Ardissino, Ingrid A Gause-nilsson, Marc S Sabatine, David A Morrow
Journal: Circulation (2020)

Background: Patients (pts) with type 2 diabetes mellitus (T2DM) are at increased risk of heart failure (HF); however, the underlying mechanisms by which T2DM contributes to HF are incompletely understood. Hypothesis: We aimed to identify biological pathways associated with risk of hospitalization for HF (HHF) in a well-characterized cohort with T2DM followed for a median of 4.2 yrs. Methods: DECLARE-TIMI 58 was a randomized trial of dapagliflozin in pts with T2DM. We performed a nested case-control study of 184 candidate biomarkers (Olink CV II and CV III) in pts hospitalized for HF (n=432) and controls matched on age, sex, prior HF, prior CV disease, and f/u time (n=432). We evaluated associations between baseline biomarkers and HHF using logistic regression with a stringent threshold for significance (Bonferroni). Biomarkers were ranked according to Wald χ 2 values. ORs for the top 10 biomarkers were further adjusted for the components of the TIMI Risk Score for HF in Diabetes (AF, UACR, eGFR, CAD). ORs are per 1-SD. Results: 45 biomarkers were significantly associated with HHF. The 10 strongest associations were seen with N-terminal pro-B type natriuretic peptide (NT-proBNP), B type natriuretic peptide (BNP), spondin-1 (SPON1), insulin-like growth factor-binding protein 7 (IGFBP7), interleukin-6 (IL-6), fibroblast growth factor-23 (FGF-23), transferrin receptor protein 1 (TR), metalloproteinase inhibitor 4 (TIMP4), matrix metalloproteinase-2 (MMP-2), C-X-C motif chemokine 16 (CXCL16) ( Fig ). All 10 biomarkers were significantly associated with HHF both in pts with and without a history of HF. These proteins represent pathobiological axes implicated in hemodynamic stress, inflammation, myocardial hypertrophy, and cellular senescence, among others. Conclusions: A targeted proteomic approach identified established (NT-proBNP, BNP), investigational (IGFBP7, FGF-23, IL-6, TR, TIMP4, MMP-2, CXCL16), and novel (SPON1) biomarkers of HHF in pts with T2DM.
Fortification of Breast Milk With Preterm Formula Powder vs Human Milk Fortifier in Preterm Neonates
Authors: Arunambika Chinnappan, Akash Sharma, Ramesh Agarwal, Anu Thukral, Ashok Deorari, M. Jeeva Sankar
Journal: JAMA Pediatrics (2021)

Fortification of expressed breast milk (EBM) using commercially available human milk fortifiers (HMF) increases short-term weight and length in preterm very low-birth-weight (VLBW) neonates. However, the high cost and increased risk of feed intolerance limit their widespread use. Preterm formula powder fortification (PTF) might be a better alternative in resource-limited settings.To demonstrate that fortification of EBM by preterm formula powder is noninferior to fortification by HMF, in terms of short-term weight gain, in VLBW neonates.Open-label, noninferiority, randomized trial conducted from December 2017 to June 2019 at a level 3 neonatal unit in India. The trial enrolled preterm (born at or before 34 weeks of gestation) VLBW neonates receiving at least 100 mL/kg/d of feeds and consuming 75% of milk or more as EBM.Neonates were randomly assigned to receive fortification by either PTF or HMF. Calcium, phosphorus, iron, vitamin D, and multivitamins were supplemented in PTF and only vitamin D in the HMF group to meet the recommended dietary allowances.The primary outcome was the weight gain until discharge from the hospital or 40 weeks' postmenstrual age, whichever was earlier; the prespecified noninferiority margin was 2 g/kg/d. Secondary outcomes included morbidities such as necrotizing enterocolitis, feed intolerance, and extrauterine growth restriction (<10th percentile on the Fenton chart at 40 weeks' postmenstrual age).Of the 123 neonates enrolled, 60 and 63 were randomized to the PTF and HMF groups, respectively. The mean gestation (30.5 vs 29.9 weeks) and birth weight (1161 vs 1119 g) were comparable between the groups. There was no difference in the mean (SD) weight gain between the PTF and HMF groups (15.7 [3.9] vs 16.3 [4.0] g/kg/d; mean difference, -0.5 g/kg/d; 95% CI, -1.9 to 0.7). The lower bound of 95% CI did not cross the noninferiority margin. The incidence of feed intolerance was lower in the PTF group (1.4 vs 6.8 per 1000 patient-days; incidence rate ratio 0.19; 95% CI, 0.04 to 0.95), and fewer neonates required withholding of fortification for 24 hours or more (5% vs 22%; risk ratio, 0.22; 95% CI, 0.07 to 0.75). The incidence of necrotizing enterocolitis stage II or more (0 vs 5%) and extrauterine growth restriction (73% vs 81%) was comparable between the groups.Fortification with preterm formula powder is not inferior to fortification with human milk fortifiers in preterm neonates. Given the possible reduction in feed intolerance and lower costs, preterm formula might be a better option for fortification, especially in resource-restricted settings.Clinical Trial Registry, India Identifier: CTRI/2017/11/010593.
Epstein Barr Virus-Associated Lymphoproliferative Disorder during Maintenance Therapy of Childhood Acute Lymphoblastic Leukemia
Authors: Sarah Elitzur, Andishe Attarbaschi, Susan Baird, Miri Ben Harosh, Lisa Hjalgrim, Shai Izraeli, Michaela Kuhlen, Anja Moricke, Shoshana Revel-Vilk, Kjeld Schmiegelow, Martin Schrappe, Melanie Tamesberger, Ajay Vora, Arndt Borkhardt
Journal: Blood (2017)
一次経皮的冠状動脈介入時代において、急性心筋梗塞後の長期追跡期間中の心突然死および左室駆出率 日本心臓病学心臓学会登録簿から得た結果
Authors: Shiga T, Ogawa H, Takagi A, Nagashima M, Yamauchi T, Tsurumi Y, Koyanagi R, Hagiwara N, Kasanuki H
Journal: Circulation (2007)