tbuckley/cabot-search huggingface dataset:
Abstract 16482: Cardiac Remodeling During Pregnancy With Challenge: A Prologue of Pathological Remodeling
Authors: Yijun Yang, Justin Kurian, Giana Schena, Jaslyn Johnson, Hajime KUBO, Chunya Kang, Anna Maria Lucchese, Deborah Eaton, Mohsin Khan, Sadia Mohsin, Steven R Houser
Journal: Circulation (2020)

Introduction: Life-style changes in the past decades have led to an increased incidence of metabolic syndrome (MetS), obesity and hypertension in women of childbearing age. These comorbidities are known to predispose individuals to adverse cardiovascular events. There is also evidence that cardiovascular complications during pregnancy may link to future heart diseases. During normal pregnancy, the heart undergoes physiological hypertrophy without fibrosis or fetal gene activation. However, recent study showed extremely obese women have increased cardiac hypertrophy and more frequent diastolic dysfunction at term. The objective of this research was to determine if MetS modifies the cardiac remodeling that takes place during pregnancy. Hypothesis: MetS during pregnancy induces pathological rather than physiological cardiac remodeling. Methods and Results: We performed long-term feeding of high fat (45%kcal) diet (HFD) in C57BL/6J female mice to establish a model of MetS, which showed increased body weight, impaired glucose tolerance and dyslipidemia compared to normal chow, resembling the features of human MetS. After pregnancy, HFD fed mice showed higher heart weight and ECHO-derived LV mass compared with Ctrl. Pregnant mice with MetS had signs of pathological cardiac remodeling, such as cardiomyocyte hypertrophy, fetal gene activation and interstitial fibrosis. At the transcriptome level, pregnancy in HFD fed mice lead to distinct gene expression patterns compared to normal pregnancy, with enrichment in genes involved in cardiac hypertrophy, oxidative stress and fibroblast activation that likely underly the adverse remodeling. Moreover, when animals were stressed with Angiotensin/phenylephrine infusion, MetS postpartum hearts had more severe cardiac hypertrophy, with overt concentric remodeling and increased fibrosis accumulation compared with nulliparous females Conclusions: MetS can induce maladaptive cardiac remodeling during pregnancy and exacerbate pathological remodeling in the postpartum heart.
Cannula With Long and Narrow Tubing vs Short Binasal Prongs for Noninvasive Ventilation in Preterm Infants
Authors: Ori Hochwald, Arieh Riskin, Liron Borenstein-Levin, Irit Shoris, Gil P. Dinur, Waseem Said, Huda Jubran, Yoav Littner, Julie Haddad, Malka Mor, Fanny Timstut, David Bader, Amir Kugelman
Journal: JAMA Pediatrics (2020)

Use of cannulas with long and narrow tubing (CLNT) has gained increasing popularity for applying noninvasive respiratory support for newborn infants thanks to ease of use, perceived patient comfort, and reduced nasal trauma. However, there is concern that this interface delivers reduced and suboptimal support.To determine whether CLNT is noninferior to short binasal prongs and masks (SPM) when providing nasal intermittent positive pressure ventilation (NIPPV) in preterm infants.This randomized controlled, unblinded, prospective noninferiority trial was conducted between December 2017 and December 2019 at 2 tertiary neonatal intensive care units. Preterm infants born between 24 weeks' and 33 weeks and 6 days' gestation were eligible if presented with respiratory distress syndrome with the need for noninvasive ventilatory support either as initial treatment after birth or after first extubation. Analysis was performed by intention to treat.Randomization to NIPPV with either CLNT or SPM interface.The primary outcome was the need for intubation within 72 hours after NIPPV treatment began. Noninferiority margin was defined as 15% or less absolute difference.Overall, 166 infants were included in this analysis, and infant characteristics and clinical condition (including fraction of inspired oxygen, Pco2, and pH level) were comparable at recruitment in the CLNT group (n = 83) and SPM group (n = 83). The mean (SD) gestational age was 29.3 (2.2) weeks vs 29.2 (2.5) weeks, and the mean (SD) birth weight was 1237 (414) g vs 1254 (448) g in the CLNT and SPM groups, respectively. Intubation within 72 hours occurred in 12 of 83 infants (14%) in the CLNT group and in 15 of 83 infants (18%) in the SPM group (risk difference, -3.6%; 95% CI, -14.8 to 7.6 [within the noninferiority margin], χ2﻿ P = .53). Moderate to severe nasal trauma was significantly less common in the CLNT group compared with the SPM group (4 [5%] vs 14 [17%]; P = .01). There were no differences in other adverse events or in the course during hospitalization.In this study, CLNT was noninferior to SPM in providing NIPPV for preterm infants, while causing significantly less nasal trauma.ClinicalTrials.gov Identifier: NCT03081611.
CD25-Treg-depleting antibodies preserving IL-2 signaling on effector T cells enhance effector activation and antitumor immunity
Authors: Isabelle Solomon, Maria Amann, Anne Goubier, Frederick Arce Vargas, Dimitrios Zervas, Chen Qing, Jake Y. Henry, Ehsan Ghorani, Ayse U. Akarca, Teresa Marafioti, Anna Śledzińska, Mariana Werner Sunderland, Dafne Franz Demane, Joanne Ruth Clancy, Andrew Georgiou, Josephine Salimu, Pascal Merchiers, Mark Adrian Brown, Reto Flury, Jan Eckmann, Claudio Murgia, Johannes Sam, Bjoern Jacobsen, Estelle Marrer-Berger, Christophe Boetsch, Sara Belli, Lea Leibrock, Joerg Benz, Hans Koll, Roger Sutmuller, Karl S. Peggs, Sergio A. Quezada
Journal: Nature Cancer (2020)
Widespread Glial Activation in Primary Progressive Multiple Sclerosis Revealed by 18F-PBR06 PET
Authors: Tarun Singhal, Eero Rissanen, John Ficke, Steven Cicero, Kelsey Carter, Howard L. Weiner
Journal: Clinical Nuclear Medicine (2020)

Abstract A 64-year-old man with primary progressive multiple sclerosis (Expanded Disability Status Scale 3.5) underwent PET using 18 F-PBR06, a second-generation 18-kDa translocator protein ligand targeting activated brain microglia and astrocytes. Voxel-by-voxel statistical comparison of patient’s PET images (acquired 60–90 minutes postinjection) with a healthy control data set was performed to generate a 3-dimensional z -score map of increased radiotracer uptake, which showed widespread increased glial activation in normal-appearing cerebral white matter, white matter lesional and perilesional areas, brainstem and cerebellum. In contrast, patient’s 3-T MRI scan showed only a few small white matter brain lesions without contrast enhancement.
Hypoferremia is Associated With Increased Hospitalization and Oxygen Demand in COVID‐19 Patients
Authors: Theresa Hippchen, Sandro Altamura, Martina U. Muckenthaler, Uta Merle
Journal: HemaSphere (2020)

Abstract Iron metabolism might play a crucial role in cytokine release syndrome in COVID‐19 patients. Therefore, we assessed iron metabolism markers in COVID‐19 patients for their ability to predict disease severity. COVID‐19 patients referred to the Heidelberg University Hospital were retrospectively analyzed. Patients were divided into outpatients (cohort A, n = 204), inpatients (cohort B, n = 81), and outpatients later admitted to hospital because of health deterioration (cohort C, n = 23). Iron metabolism parameters were severely altered in patients of cohort B and C compared to cohort A. In multivariate regression analysis including age, gender, CRP and iron‐related parameters only serum iron and ferritin were significantly associated with hospitalization. ROC analysis revealed an AUC for serum iron of 0.894 and an iron concentration &lt;6 μmol/l as the best cutoff‐point predicting hospitalization with a sensitivity of 94.7% and a specificity of 67.9%. When stratifying inpatients in a low‐ and high oxygen demand group serum iron levels differed significantly between these two groups and showed a high negative correlation with the inflammatory parameters IL‐6, procalcitonin, and CRP. Unexpectedly, serum iron levels poorly correlate with hepcidin. We conclude that measurement of serum iron can help predicting the severity of COVID‐19. The differences in serum iron availability observed between the low and high oxygen demand group suggest that disturbed iron metabolism likely plays a causal role in the pathophysiology leading to lung injury.
Abstract 13354: Effectiveness of a Complex Intervention Based on Electronic Decision Support to Improve Management of Cardiovascular Disease Risk in Primary Healthcare: A Cluster-randomised Controlled Trial
Authors: Ruth Webster, Tim Usherwood, Rohina Joshi, Bandana Saini, Carol Armour, Gian Luca di Tanna, Charlotte Hespe, Stephen Jan, Ines Krass, Tracey Lea Laba, Qiang Li, Serigne Lo, David Peiris, Chris Reid, Anthony Rodgers, Anushka Patel
Journal: Circulation (2020)

Introduction: Cardiovascular disease (CVD) risk management is suboptimal in Australian primary healthcare. Following trials demonstrating efficacy of individual components, we developed a complex intervention comprised primarily of electronic point-of-care decision support, availability of cardiovascular polypills and a pharmacy-based adherence program. We sought to determine whether this combined multifaceted intervention, compared with usual care, would improve control of CVD risk factors in the Australian primary care setting. Methods and Results: In a parallel-arm cluster randomized trial, 71 general practices were allocated 1:1 either to the intervention or usual care. The primary outcome was the proportion of patients at high CVD risk and not on optimal preventive treatments at baseline (“high-risk under-treated”) achieving both blood pressure (BP) and low density lipoprotein (LDL) cholesterol targets at study end (BP ≤140/90 mmHg, or ≤130/80 mmHg in people with diabetes or albuminuria; LDL &lt;2.0 mmol/L). All outcomes were evaluated using automated extracts from the electronic medical record. After a median period of 15 months follow-up, among 4477 high-risk under-treated patients in whom follow-up data were available, there was a negligible difference between randomized groups in the proportion achieving SBP and LDL cholesterol targets (19.6% vs. 20.1%; RR 1.06 [95% CI: 0.85 to 1.32]; p=0.59). There was also no major impact of the intervention on any pre-specified secondary outcomes, mostly relating to risk factor screening, preventive medication prescription and risk factor levels. Uptake of all components of the intervention was poor, with greatest use observed for the electronic decision support component (used at least once in 10.7% of high-risk under-treated patients) and minimal use of the other two interventions. Conclusions: Despite the proven efficacy of individual components, this complex multifaceted intervention was poorly adopted and did not lead to relevant improvements in cardiovascular risk factor outcomes.
Abstract 14420: Outcomes in Women With Cardiogenic Shock: Data From the Critical Care Cardiology Trial Network (CCCTN)
Authors: Nicholas Phreaner, Haider Aldiwani, David Berg, Jeong-Gun Park, Jason N Katz, Sean Van Diepen, David A Morrow, Erin A Bohula, Lori B Daniels
Journal: Circulation (2020)

Introduction: Although sex-specific differences in treatment and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) have been described, little is known about sex-specific differences in acute decompensated heart failure-related CS (ADHF-CS). Methods: The CCCTN is an investigator-initiated multicenter network of cardiac intensive care units (CICUs) in North America. Consecutive admissions (n=8240) to the CICU during annual snapshots (mostly 2 months) were submitted to the coordinating center (TIMI Study Group, Boston, MA). Patients were stratified by sex and type of CS. Adjustments were made for age and SOFA score. Results: Between 2017 and 2019, 1487 admissions were for CS of which 879 (33% women) were for ADHF-CS. In this cohort, age (median 62 y), race, and BMI (median 28 kg/m 2 ) did not differ by sex. Women and men also had similar SOFA and IABP-SHOCK II scores. Women were less likely to have CKD (28% vs 42%, p=&lt;0.001) and CAD (28% vs 45%, p&lt;0.001) but were significantly more likely to have underlying pulmonary disease (23% vs 15%, p&lt;0.01). Although women and men had a similar burden of pre-existing HF (72% vs 75%, p=0.35), women were more likely to have HF with preserved ejection fraction (19% vs. 5%, p&lt;0.001). Women had shorter CICU stays (4.0 vs 5.5 days, p&lt;0.001), and numerically, though not significantly, lower use of pulmonary artery catheters (48% vs 53%, p=0.13) and mechanical circulatory support (28% vs 34%, p=0.11). In-hospital mortality in women with ADHF-CS was significantly higher than in men (39% vs 26%, p&lt;0.001, adj-OR 2.05 (95% CI 1.47-2.86; p&lt;0.001)). In contrast, in-hospital mortality for AMICS did not differ by sex (38% vs 40%, p=0.69). Conclusions: Compared to men, women admitted to the CICU with ADHF-CS had higher mortality despite similar indices of illness severity. The reason(s) behind this difference merit further study.
Author Correction: A randomised controlled feasibility trial of E-health application supported care vs usual care after exacerbation of COPD: the RESCUE trial
Authors: Mal North, Simon Bourne, Ben Green, Anoop J. Chauhan, Tom Brown, Jonathan Winter, Tom Jones, Dan Neville, Alison Blythin, Alastair Watson, Matthew Johnson, David Culliford, Jack Elkes, Victoria Cornelius, Tom M. A. Wilkinson
Journal: npj Digital Medicine (2020)

A Correction to this paper has been published: https://doi.org/10.1038/s41746-020-00360-w
Abstract 12593: Sex-related Differences in Health Care Utilization in Patients With Atrial Flutter
Authors: Kathryn Kim, Steven Kim, Michael H Kim
Journal: Circulation (2020)

Introduction: Sex-related differences in health care utilization have been described for patients (pts) with any atrial fibrillation (AF) either with or without atrial flutter (AFL). Limited data, however, are available when stratified by sex in pts with AFL only. Methods: Using MarketScan Commercial and Medicare databases, pts aged ≥ 20 years with a minimum of one inpatient or two outpatient AFL diagnoses in 2005 and a minimum of 12 months of continuous enrollment pre and post index were identified. Any AF pts were excluded. AFL only pts were propensity score matched to pts without AFL or AF based on age, sex, region, payer, and cardiovascular (CV) comorbidities. Using projected prevalence of AFL for 2010, costs were estimated 12 months post index. Results: 1,042 pts (62 % men) with AFL were identified. Men exceeded women in the age adjusted prevalence of AFL across all age groups (mean age 67 with 8 age ranges from 20 to ≥ 85). Cost projections were made for 74,466 AFL pts. Men ($453 million) had a significantly higher national total incremental cost burden for all expenditures than women ($253 million). Men had higher per patient incremental cost and national cost burden for treatment specific to AFL across the age groups. Men also had a higher per patient incremental cost and national total cost burden ($291 versus $90 million) for CV specific expenditures, especially at ages &lt; 85. Total costs were greatest for men &lt; 55 years old with total costs of 25,643 dollars per patient of which 75 % of the value represented CV specific costs. Per patient costs were more similar for men and women with AFL at 55 years and older. Per patient inpatient costs were greater in men whereas per patient outpatient costs were greater in women. On a national and per patient cost level, AFL treatment specific costs decreased in men and women 75 years and older. Conclusions: Costs in pts with AFL only are more driven by men from both a per patient and national cost perspective with the highest burden at younger ages &lt; 55. These sex-related differences in epidemiology and resource utilization need further exploration. Potential disparities in care delivery may exist given these cost data.
A 7-Point Action Agenda to End the COVID-19 Pandemic for President-elect Biden
Authors: Lawrence O. Gostin
Journal: JAMA (2021)

resident-elect Joseph Biden has a historic opportunity to reset the US response to coronavirus disease 2019 (COVID-19), but it is unrealistic to expect a sharp turnaround, given steep spikes in cases and deaths.Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the US, the federal government has undermined science, conveyed confusing health messages, politicized public health agencies, and sowed distrust.Despite being ranked by the Global Health Security Index as first in pandemic preparedness before COVID-19, the US has been among the world's worst performers, with the most cases and deaths.The Biden/Harris plan to tackle COVID-19 has strong public health support.Had the plan been implemented earlier, it might have saved tens of thousands of lives.Drawing from, and going beyond, Biden's plan, here is a 7-point action agenda for the new administration.
Abstract 17254: Right Ventricular Myoarchitecture is Associated With RV Function in Pulmonary Arterial Hypertension
Authors: Denielli da Silva Goncalves Bos, Dana Leichter, Alexander Vang, Ana Fernandez Nicolas, Mohsen Nowruzpour, Reza Avazmohammadi, Owen P Leary, Thomas Mancini, Richard Gilbert, Gaurav Choudhary
Journal: Circulation (2020)

Introduction: Right Ventricular (RV) dysfunction in pulmonary arterial hypertension (PAH) is the major cause of mortality. Myocardial architecture determines the basis of heart function and can be assessed by generalized Q-space imaging by MRI (GQI), yet remains understudied in the RV. Therefore, we assessed myocardial fiber architecture patterns and correlated them with disease severity in two models of PAH. Methods: PAH was induced in Sprague-Dawley (SD) and Fischer (CDF) male rats by SU5416 (20 mg/kg; s.c.) followed by 3 wks of hypoxia (10% FiO2). Controls received vehicle and were kept at normoxia. After 4 wks, echocardiography and hemodynamics were performed. Whole hearts were resected in some animals (SD n=9, CDF n=8) and imaged via high-angular resolution GQI using a 7T magnet (512 directions, b=750 s/mm2). Patterns of inter-voxel coherence (tractography) were reconstructed, and transmural helix angle distribution (HAD) were assessed at 3 points across the LV and RV (Panel A) and normalized to a common vector. Finite-element models were developed via registering myofiber direction to anatomical mesh. Results: Both animal strains developed PAH, however CDF rats had lower pulmonary artery acceleration time (14±0.6 vs. 19±1.3 ms, p&lt;0.05) and TAPSE (1.5±0.06 vs. 1.9±0.09 mm, p&lt;0.05) and higher RV afterload (1023±167 vs. 285±17, mmHg/mL p&lt;0.05) compared to SD. PAH was associated with steeper slope of the RV transmural HAD in both SD and CDF vs. controls and slightly higher in CDF-PAH compared to SD-PAH (Panel B). No significant changes were noted in the LV (Panel C). Moreover, the RV HAD slope significantly correlated to RV functional parameters (TAPSE r= 0.58, RV global longitudinal strain r= -0.49) and RA area (r= -0.58). Transmural and regional variation in fiber direction was also observed (Panel D). Conclusion: Myoarchitectural analysis of the RV in the setting of PAH reveals that myocardial HAD relates to functional parameters and may be a marker of maladaptation.
Women's Preventive Services Initiative recommends screening women for anxiety
Authors: Erin L. Tomkins, Patrick G. O’Malley
Journal: Annals of Internal Medicine (2020)

Gregory KD, Chelmow D, Nelson HD, et al. Screening for anxiety in adolescent and adult women: a recommendation from the Women's Preventive Services Initiative. Ann Intern Med. 2020;173:48-56. 32510990.
Abstract 15269: Baseline Relationships of Walking, Physical Activity Habits and Self-perceived Recovery After Stroke in People Engaged in a Healthy Lifestyle Program
Authors: Chad Swank, Evan Elizabeth McShan, Stephanie Calhoun, Megan Douglas, Megan Reynolds, Simon Driver
Journal: Circulation (2020)

Introduction: Recovery of walking is an important goal for people after stroke and is linked with acquiring secondary conditions deleterious to health. Our purpose was to assess the baseline relationships between walking performance, physical activity habits and self-perceived recovery after stroke in people engaged in a healthy lifestyle program. Hypothesis: We hypothesized that walking performance would be strongly related to self-reported stroke recovery and physical activity habits. Methods: Community dwelling adults at least 12 months post-stroke with a body mass index (BMI) of 25 or greater were recruited to participate in a healthy lifestyle program adapted for people with stroke. Baseline measures of walking performance [10-meter walk test (10MWT); 6-minute walk test (6MWT)] and self-reported outcomes [Self-Report Habits Index (SRHI); Stroke Impact Scale (SIS)] were correlated. Results: Adults (34 male, 31 female; 64.6% scored as having some disability on the Modified Rankin Scale) aged 57.9±12.8 years with a BMI of 33.0±5.9 and median of 3 years post-stroke participated. 10MWT walking speed was 1.0±0.4m/s and 6MWT distance walked was 343.3±132.3m. SRHI physical activity scores of 4.6±1.7 (above average habit formation; scale = 1 - 7) and SIS subscales ADL/IADL and mobility normed scores of -0.1±0.7 and -1.3±0.8 respectively, and perceived recovery of 70.9±16.9% were reported. The 10MWT was significantly and moderately correlated with SIS ADL/IADL (r=0.48; p&lt;0.001) and mobility (r=0.41; p&lt;0.001), but weakly with SIS perceived recovery (r=0.34; p&lt;0.01) and SRHI physical activity (r=-0.32; p&lt;0.01). The 6MWT was significantly and moderately correlated with SIS ADL/IADL (r=0.48; p&lt;0.001) and mobility (r=0.47; p&lt;0.001), but weakly with SIS perceived recovery (r=0.33; p&lt;0.01) and SRHI physical activity (r=-0.33; p&lt;0.01). Conclusions: Walking performance among our participants post-stroke was consistent with community dwelling adults, but only somewhat related to their perception of recovery of function and mobility. Additional factors beyond perceived recovery likely contribute to walking abilities post-stroke.
AID in Antibody Diversification: There and Back Again
Authors: Yuqing Feng, Noé Seija, Javier M. Di Noia, Alberto Martin
Journal: Trends in Immunology (2020)

The publisher regrets that the surname of the author Javier M. Di Noia is incorrect in the printed version of the article and was incorrect in the online version. The online version has been corrected.