tbuckley/cabot-search huggingface dataset:
Abstract 9208: Prognostic Significance of Acute Reconnection Following Adenosine Administration During Catheter Ablation of Atrial Fibrillation: Insights from the UC San Diego AF Ablation Registry
Authors: Omar M Aldaas, Douglas J Darden, Praneet Mylavarapu, Frederick Han, Kurt S Hoffmayer, David E Krummen, Gordon Ho, Farshad Raissi, Gregory K Feld, Jonathan C Hsu
Journal: Circulation (2021)

Introduction: The use of adenosine-guided pulmonary vein isolation is controversial. We sought to evaluate the prognostic significance of unmasking acute pulmonary vein reconnection with adenosine during catheter ablation of atrial fibrillation (AF). Methods: We performed a retrospective study of all patients who underwent radiofrequency catheter ablation enrolled in the University of California, San Diego AF Ablation Registry. The primary outcome was freedom from atrial arrhythmias on or off antiarrhythmic drugs (AAD). Results: Of 357 patients who were administered adenosine during catheter ablation of AF, 39 (10.9%) had acute reconnection of at least one pulmonary vein and 318 (89.1%) did not. Fluoroscopy [75 (56, 89) vs 63.5 min (50,77); p=0.017] and procedure [309 (256, 362) vs 270 min (237,320); p=0.002] times were significantly longer when reconnection was seen after adenosine, but there were no statistically significant differences in antiarrhythmic drug use (p=0.086) or procedural complications (p=0.852). After multivariable adjustment, the recurrence of atrial arrhythmias on or off AAD (Adjusted Hazard Ratio (AHR) 0.95 (95% CI 0.56-1.62); p =0.848], all-cause hospitalizations [AHR 1.41 (95% CI 0.73-2.74); p=0.303] ( Figure 1 ) or all-cause mortality [AHR 5.61 (95% CI 0.09-362.87); p=0.418] were not different during follow-up in those with or without reconnection after adenosine. Conclusion: In this registry analysis, reconnections seen after adenosine resulted in longer fluoroscopy and procedure times without a reduction in recurrence of atrial arrhythmias, all-cause hospitalizations, or mortality.
Phase I Study of Oral Azacitidine (CC-486) Plus Salvage Chemotherapy in Relapsed/Refractory Diffuse Large B-Cell Lymphoma
Authors: Brian T. Hess, Leandro Cerchietti, Lindsey Hendrickson, Elizabeth Hill, Anshu Giri, Shanta Salzer, Sarah Hogan, Lacey Finch, Robin Klingenberg, Fang Hu, Nina D. Wagner-Johnston
Journal: Blood (2021)
Single Centre, Retrospective Analysis of Extracorporeal Photopheresis (ECP) Therapy in the Patients Who Are Heavily Pre-Treated for Steroid Resistant Chronic Graft-Versus-Host Disease (GVHD)
Authors: Swe Mar Linn, Igor Novitzky-Basso, Christopher J. Patriquin, Ivan Pasic, Wilson Lam, Arjun Law, Fotios Michelis, Armin Gerbitz, Auro Viswabandya, Jeffrey H. Lipton, Rajat Kumar, Jonas Mattsson, David Barth, Dennis Dong Hwan Kim
Journal: Blood (2021)
Clinical Outcomes of Relapsed/Refractory Multiple Myeloma Patients Following Treatment with Bispecific Antibodies (BiAbs)
Authors: Tarek H. Mouhieddine, Oliver Van Oekelen, Darren Pan, Sarita Agte, Adolfo Aleman, David T. Melnekoff, Guido Lancman, Santiago Thibaud, Larysa Sanchez, Shambavi Richard, Joshua Richter, Hearn Jay Cho, Ajai Chari, Sundar Jagannath, Samir Parekh
Journal: Blood (2021)
Fecal Calprotectin Is Increased in Pouchitis and Progressively Increases With More Severe Endoscopic and Histologic Disease
Authors: Jacob E. Ollech, Lian Bannon, Nitsan Maharshak, Nir Bar, Idan Goren, Hagit Tulchinsky, Henit Yanai, Iris Dotan
Journal: Clinical Gastroenterology and Hepatology (2021)
Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis
Authors: Faizul Hasan, Yu-Kang Tu, Chien-Ming Yang, Christopher James Gordon, Dean Wu, Hsin-Chien Lee, Lia Taurussia Yuliana, Lucky Herawati, Ting-Jhen Chen, Hsiao-Yean Chiu
Journal: Sleep Medicine Reviews (2021)
<i>Piggybac</i> Transposon Mediated CD19 CAR-T Cells Derived from CD45RA-Positive PBMCs Possess Potent and Sustained Antileukemic Function
Authors: Masaya Suematsu, Shigeki Yagyu, Nobuyoshi Nagao, Susumu Kubota, Yuto Shimizu, Miyuki Tanaka, Yozo Nakazawa, Toshihiko Imamura
Journal: Blood (2021)
Abstract 9515: Heterogeneity of Benefit on Quality of Life With an Invasive versus Conservative Strategy for Chronic Coronary Disease. Results From the ISCHEMIA Trial
Authors: Suzanne Arnold, Philip Jones, David J Maron, Daniel B Mark, Harmony R Reynolds, Sripal Bangalore, Jonathan D Newman, Jiyan Chen, Robert A Harrington, David J Cohen, Gregg W Stone, Judith S Hochman, John Spertus
Journal: Circulation (2021)

Background: The ISCHEMIA trial recently showed that, on average, patients with chronic coronary disease (CCD) and at least moderate ischemia randomized to an invasive strategy (INV) reported less angina and better quality of life (QOL) than those treated conservatively (CON)—an effect sustained through follow-up. To better support shared decision-making for individual patients, we explored the heterogeneity of treatment benefit of the INV vs CON strategy within the ISCHEMIA trial. Methods: Disease-specific QOL was assessed with the Seattle Angina Questionnaire (SAQ; scores range 0-100, higher=less angina/better QOL). An ordinal (proportional odds) model for 1-year SAQ summary score (SAQ SS) produced estimates of the odds of better QOL with randomization to INV vs CON, with potential heterogeneity of treatment benefit explored via interactions between patient factors and treatment. The final model included both significant interactions (accounting for multiple testing) and main effects. Results: Among 4617 patients with CCD from 37 countries randomized to INV vs CON treatment (mean age 64 ± 10 y, 23% women, 40% diabetes), mean SAQ SS was 74.1 ± 18.9 at baseline and 85.7 ± 15.6 at 1 year (p&lt;0.001). Patients with lower baseline SAQ SS (i.e., more angina) and younger patients derived greater symptomatic treatment benefit from INV management (model-based interaction p=0.005 and p=0.004, respectively; Figure). No other patient factor was associated with a differential treatment effect. In the final model, female sex and diabetes were also associated with worse 1-year QOL, independent of treatment. Conclusion: Using data from a large multinational randomized trial, we found that younger patients and those with more angina at baseline derived greater QOL benefit from INV management. As the primary benefit of revascularization in CCD is symptom improvement, this model could be used to better inform individual patient’s decision-making for initial treatment.
Preliminary Efficacy and Safety of MK-1026, a Non-Covalent Inhibitor of Wild-Type and C481S Mutated Bruton Tyrosine Kinase, in B-Cell Malignancies: A Phase 2 Dose Expansion Study
Authors: Jennifer A. Woyach, Ian W. Flinn, Farrukh T. Awan, Herbert Eradat, Danielle M. Brander, Michael Tees, Sameer A. Parikh, Tycel Phillips, Wayne Wang, Nishitha M. Reddy, Mohammed Z.H. Farooqui, John C. Byrd, Deborah M. Stephens
Journal: Blood (2021)
Racial Disparities in Access to Alternative Donor Allografts Persist in the Era of "Donors for All"
Authors: Warren Fingrut, Ioannis Politikos, Eric Davis, Stephanie Chinapen, Kristine Naputo, Christina Cho, Sergio A Giralt, Boglarka Gyurkocza, Ann A Jakubowski, Esperanza B Papadopoulos, Miguel-Angel Perales, Doris M Ponce, Andromachi Scaradavou, Brian C Shaffer, Juliet N Barker
Journal: Blood (2021)
Combining the IAP Antagonist Tolinapant with a DNA Hypomethylating Agent Enhances Immunogenic Cell Death in Preclinical Models of T-Cell Lymphoma
Authors: George A. Ward, Simone Jueliger, Martin Sims, Matthew Davis, Adam Boxall, Harpreet Saini, Jason A. Taylor, Andrea Biondo, John F. Lyons, Tomoko Smyth
Journal: Blood (2021)
Abstract 12468: Atlas of Human Cardiac Promoters Reveals Regulatory Shift Between Healthy and Failing States
Authors: Anna Gams, Ruslan Deviatiiarov, Syunyaev Roman, Tatiana V Tatarinova, Ramesh Singh, Palak Shah, Oleg Gusev, Igor R Efimov
Journal: Circulation (2021)

Introduction: Genome regulatory elements capture transcription networks across diverse biological states. We aimed to identify and compare active promoter networks in healthy and failing human hearts in all four chambers. Methods: Samples were collected from the left and right atria and ventricles of 21 healthy and 4 ischemic (ICM) and 6 non-ischemic (NICM) human hearts. Cap analysis of gene expression (CAGE) was used to identify transcription start sites (TSS) with one nucleotide resolution. This method allows identifying promoter regions located directly upstream of TSS. Analyses performed included differential gene expression and pathway enrichment. Results: We identified over 10,000 novel promoter clusters (Fig A) . Additionally, atria express over 1,000 more genes compared to ventricles (Fig B) . We also showed that over 300 single nucleotide polymorphisms related to cardiac disease are located in the regulatory region (Fig C) . Contrary to the previous RNA-sequencing findings, we found a clear distinction between ICM and NICM, the former having upregulation in metabolism-related genes and the latter in the immune system (Fig D) . We also showed that the sets of genes related to sex dimorphism are different in healthy vs failing states (Fig E) . CAGE analysis allows studying alternative usage of promoters which can result in different binding of transcription factors. Several electrophysiology-related genes showed atrioventricular TSS alternatives (Fig F) . For example, failing hearts lost a second TSS location compared to healthy in KCNIP2 (KChIP2) while in KCNJ4 (IK1) they showed an increased expression of the second TSS relative to annotated TSS (Fig G) . Conclusion: We present evidence of the importance of the cardiac regulatory element database since it allows to explore transcription factor binding sites and regulatory networks or find specific targets for drug development in a specific biological context, such as ICM or NICM.
Abstract 9077: Long-Term Prognostic Value of Controlling Nutritional Status Score and Six-Minute Walk Distance in Patients With Implantable Cardioverter Defibrillator
Authors: Masato Kawasaki, Takahisa Yamada, Tetsuya Watanabe, Takashi Morita, Atsushi Kikuchi, Tsutomu Kawai, Masahiro Seo, Jun Nakamura, Kiyomi Kayama, Kunpei Ueda, Daisuke Sakamoto, Takehiro Kougame, Yuto Tamura, Takeshi Fujita, Keisuke Nishigaki, Yuki Kokubu, Yuto Fukuda, Masatake Fukunami
Journal: Circulation (2021)

Backgrounds: Both Controlling Nutritional Status (CONUT) score and 6-minute walk distance (6MWD) provide prognostic information in patients with chronic heart failure. However, there is little information available on long-term prognostic value of CONUT score and 6MWD for the prediction of severe ventricular tachyarrhythmias and cardiac death in implantable cardioverter defibrillator (ICD) patients. Methods and Results: We prospectively enrolled 233 consecutive outpatients with ICD (age: 66±14 years, male: 82%, NYHA class: 1.7±0.7, LVEF: 47±17%). At entry, laboratory data and 6MWD were obtained in all patients. During a follow-up period of 4.3±2.8 years, 75 patients had appropriate ICD discharge for severe ventricular tachyarrhythmias and 45 patients had cardiac death. At multivariate Cox regression analysis, 6MWD was significantly and independently associated with appropriate ICD discharge after adjustment with age, sex, NYHA class and LVEF, while CONUT score was not. Patients with short 6MWD (≤300m) had a higher risk of appropriate ICD discharge (42 % vs 23%, p=0.0002). On the other hand, at multivariate Cox regression analysis, CONUT score was significantly and independently associated with cardiac death after adjustment with age, sex, NYHA class and LVEF, while 6MWD showed the association with cardiac death at univariate analysis. Patients with higher CONUT score (≥4) had a higher risk of cardiac death (35% vs 15%, p&lt;0.0001). Conclusions: CONUT score would be associated with cardiac death, while 6MWD might be associated with appropriate ICD discharge, in patients with ICD.
Partial Fracture of a Subcutaneous ICD Lead from Mechanical Trauma
Authors: Hieu Huynh, Gregory Siroky, Devendra Bisht, Patrick Lam, Asad Mohammad, Davendra Mehta
Journal: Clinical Cardiology and Cardiovascular Interventions (2020)

Transvenous implantable cardioverter-defibrillators (TV-ICD) have electrode failure rates as high as 20% over a 10 year followup with 12% as a result of lead fractures. [1] The development of the Boston Scientific subcutaneous ICD (S-ICD) promoted the benefit of significantly reduced post-implant complication rates. [4] We present the first reported case of a S-ICD electrode failure secondary to partial fracture as a result of mechanical trauma.
Granulocytic Myeloid-Derived Suppressor Cells in Murine Models of Immune-Mediated Bone Marrow Failure
Authors: Xingmin Feng, Jisoo Kim, Gladys Gonzalez Matias, Zhijie Wu, Sabrina Solorzano, Sai Batchu, Shouguo Gao, Jichun Chen, Neal S. Young
Journal: Blood (2021)
Validation and Implementation of the Use of Peripherally Inserted Central Catheter (PICC) for the Administration of Peripheral Blood Stem Cells (PBSC): A Single-Institution Experience
Authors: Sai Lon Wann, Shi Hui Clarice Choong, Teck Guan Soh, Foong Gwan Lee, Yee Mei Lee, Jedidah Lieow, Yelly Yelly, Sharmila Kasinathan, Chue Teng Chua, Kwee Cheng Chia, Belinda Tan, Hui Li Lim, Eric Soong Wen Jian, Davanaliz Gonzales Ramos, Joanne Lee, Lip Kun Tan, Liang Piu Koh, Michelle Poon, Eng Soo Yap
Journal: Blood (2021)
Rituximab, Bendamustine and Cytarabine Followed By Venetoclax (V-RBAC) in High-Risk Elderly Patients with Mantle Cell Lymphoma
Authors: Carlo Visco, Valentina Tabanelli, Claudia Peracchio, Andrea Evangelista, Maria Chiara Tisi, Anna Merli, Costanza Fraenza, Stefano Fiori, Alessandro Re, Claudia Castellino, Vittorio Ruggero Zilioli, Francesco Piazza, Paolo Corradini, Stefan Hohaus, Gerardo Musuraca, Valeria Ferla, Benedetta Puccini, Federica Cavallo, Filippo Ballerini, Roberta Sciarra, Alice Di Rocco, Annalisa Arcari, Carola Boccomini, Francesco Merli, Guido Gini, Monica Tani, Riccardo Bruna, Vincenzo Pavone, Andrés J M Ferreri, Armando Santoro, Caterina Patti, Giacomo Loseto, Marco Ladetto, Michele Merli, Michele Spina, Pier Luigi Zinzani, Pietro Maria Stefani, Sara Veronica Usai, Caterina Stelitano, Stefano Volpetti, Stefano A Pileri, Monica Balzarotti
Journal: Blood (2021)
Detecting Liquid Remnants of Solid Tumors: Circulating Tumor DNA Minimal Residual Disease
Authors: Everett J. Moding, Barzin Y. Nabet, Ash A. Alizadeh, Maximilian Diehn
Journal: Cancer Discovery (2021)

Growing evidence demonstrates that circulating tumor DNA (ctDNA) minimal residual disease (MRD) following treatment for solid tumors predicts relapse. These results suggest that ctDNA MRD could identify candidates for adjuvant therapy and measure response to such treatment. Importantly, factors such as assay type, amount of ctDNA release, and technical and biological background can affect ctDNA MRD results. Furthermore, the clinical utility of ctDNA MRD for treatment personalization remains to be fully established. Here, we review the evidence supporting the value of ctDNA MRD in solid cancers and highlight key considerations in the application of this potentially transformative biomarker.
Humanized C3 Mouse: A Novel Accelerated Model of C3 Glomerulopathy
Authors: A. Angel-Korman, T. Brosh-Nissimov, A. Leiba
Journal: Journal of the American Society of Nephrology (2020)

C3 glomerulopathy (C3G) is characterized by the alternative-pathway (AP) hyperactivation induced by nephritic factors or complement gene mutations. Mice deficient in complement factor H (CFH) are a classic C3G model, with kidney disease that requires several months to progress to renal failure. Novel C3G models can further contribute to understanding the mechanism behind this disease and developing therapeutic approaches.A novel, rapidly progressing, severe, murine model of C3G was developed by replacing the mouse C3 gene with the human C3 homolog using VelociGene technology. Functional, histologic, molecular, and pharmacologic assays characterize the presentation of renal disease and enable useful pharmacologic interventions in the humanized C3 (C3hu/hu) mice.The C3hu/hu mice exhibit increased morbidity early in life and die by about 5-6 months of age. The C3hu/hu mice display elevated biomarkers of kidney dysfunction, glomerulosclerosis, C3/C5b-9 deposition, and reduced circulating C3 compared with wild-type mice. Administration of a C5-blocking mAb improved survival rate and offered functional and histopathologic benefits. Blockade of AP activation by anti-C3b or CFB mAbs also extended survival and preserved kidney function.The C3hu/hu mice are a useful model for C3G because they share many pathologic features consistent with the human disease. The C3G phenotype in C3hu/hu mice may originate from a dysregulated interaction of human C3 protein with multiple mouse complement proteins, leading to unregulated C3 activation via AP. The accelerated disease course in C3hu/hu mice may further enable preclinical studies to assess and validate new therapeutics for C3G.
Differentiation of self: A scoping review of Bowen Family Systems Theory’s core construct
Authors: M. Calatrava, Mariana V. Martins, M. Schweer-Collins, C. Duch-Ceballos, M. Rodríguez-González
Journal: Clinical Psychology Review (2021)

Bowen Family Systems Theory's central construct, differentiation of self (DoS), is one of the most recognized constructs to systemic researchers and psychology professionals. The present study reviewed the available evidence on DoS from the inception of the construct until July 31, 2020. A scoping review was conducted and a total of 295 primary studies were eligible for inclusion. Literature was categorized according to the hypotheses postulated by Bowen regarding: the associations between DoS and psychological and health outcomes and how DoS stability and similarity in partner levels operate within family systems. Descriptive data regarding studies on the measurement of DoS and in the area of psychotherapy were also compiled. Results revealed that there is ample support for DoS as a predictor of psychological health and marital quality, and that there are positive associations between DoS and better physical health and intergenerational relationships. Results of this review show that there continue to be underexplored hypotheses and a paucity of longitudinal or causal research designs to test the stability of DoS, the intergenerational transmission of DoS, and the efficacy of clinical interventions in modifying DoS to promote optimal well-being. Recommendations and next steps for researchers and practitioners are outlined.
Efficacy and Safety of Daratumumab with Dexamethasone in Patients with Relapsed/Refractory Multiple Myeloma and Severe Renal Impairment or on Dialysis: Final Analysis of the Phase 2 Dare Study
Authors: Efstathios Kastritis, Evangelos Terpos, Argiris Symeonidis, Sosana Delimpasi, Michele Cavo, Elena Zamagni, Eirini Katodritou, Elena Rivolti, Marie-Christine Kyrtsonis, Maria Roussou, Despina Fotiou, Evdoxia Hatjiharissi, Nikolaos Kanellias, Magdalini Migkou, Alexandros Leonidakis, Kyriaki Manousou, Maria Gavriatopoulou, Meletios A. Dimopoulos
Journal: Blood (2021)
Effects of Cytogenetic Risk on Outcomes in Multiple Myeloma Treated with Selinexor, Bortezomib, and Dexamethasone (XVd)
Authors: Nizar J. Bahlis, Shambavi Richard, Darrell J. White, Sebastian Grosicki, Christine Chen, Sosana Delimpasi, Heather J. Sutherland, Zvenyslava Maslyak, Michael Sebag, Maria Gavriatopoulou, Suzanne Lentzsch, Ajai Chari, Maryana Simonova, Ivan Spicka, Iryna Kriachok, Meletios A. Dimopoulos, Halyna Pylypenko, Holger W Auner, Xavier Leleu, Ganna Usenko, Roman Hajek, Reuben Benjamin, Tuphan Kanti Dolai, Dinesh Kumar Sinha, Christopher P. Venner, Mamta Garg, Don Stevens, Hang Quach, Sundar Jagannath, Philippe Moreau, Moshe Levy, Ashraf Z. Badros, Larry D. Anderson, Thierry Facon, Maria-Victoria Mateos, Michele Cavo, Andrew DeCastro, Yi Chai, Dane R. Van Domelen, Moran Mishal, Ohad S. Bentur, Jatin Shah, Sharon Shacham, Michael G. Kauffman, Paul G. Richardson
Journal: Blood (2021)
Progress Toward Regional Measles Elimination — Worldwide, 2000–2020
Authors: Meredith G. Dixon, Matt Ferrari, Sebastien Antoni, Xi Li, Allison Portnoy, Brian Lambert, Sarah Hauryski, Cynthia Hatcher, Yoann Nedelec, Minal Patel, James P. Alexander, Claudia Steulet, Marta Gacic-Dobo, Paul A. Rota, Mick N. Mulders, Anindya S. Bose, Alexander Rosewell, Katrina Kretsinger, Natasha S. Crowcroft
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan,* with the objective of eliminating measles
Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis
Authors: Xinxing Tantai, Yi Liu, Yee Hui Yeo, Michael Praktiknjo, Ezequiel Mauro, Yuhei Hamaguchi, Cornelius Engelmann, Peng Zhang, Jae Yoon Jeong, Jeroen Laurens Ad van Vugt, Huijuan Xiao, Huan Deng, Xu Gao, Qing Ye, Jiayuan Zhang, Longbao Yang, Yaqin Cai, Yixin Liu, Na Liu, Zongfang Li, Tao Han, Toshimi Kaido, Joo Hyun Sohn, Christian Strassburg, Thomas Berg, Jonel Trebicka, Yao-Chun Hsu, Jan Nicolaas Maria IJzermans, Jinhai Wang, Grace L. Su, Fanpu Ji, Mindie H. Nguyen
Journal: Journal of Hepatology (2021)

The association between sarcopenia and prognosis in patients with cirrhosis remains to be determined. In this study, we aimed to quantify the association between sarcopenia and the risk of mortality in patients with cirrhosis, stratified by sex, underlying liver disease etiology, and severity of hepatic dysfunction.PubMed, Web of Science, EMBASE, and major scientific conference sessions were searched without language restriction through 13 January 2021 with an additional manual search of bibliographies of relevant articles. Cohort studies of ≥100 patients with cirrhosis and ≥12 months of follow-up that evaluated the association between sarcopenia, muscle mass and the risk of mortality were included.Twenty-two studies involving 6,965 patients with cirrhosis were included. The pooled prevalence of sarcopenia in patients with cirrhosis was 37.5% overall (95% CI 32.4%-42.8%), and was higher in male patients, those with alcohol-associated liver disease, those with Child-Pugh grade C cirrhosis, and when sarcopenia was defined by L3-SMI (third lumbar-skeletal muscle index). Sarcopenia was associated with an increased risk of mortality in patients with cirrhosis (adjusted hazard ratio [aHR] 2.30, 95% CI 2.01-2.63), with similar findings in a sensitivity analysis of patients with cirrhosis without hepatocellular carcinoma (aHR 2.35, 95% CI 1.95-2.83) and in subgroups stratified by sex, liver disease etiology, and severity of hepatic dysfunction. The association between quantitative muscle mass index and mortality further supports the association between sarcopenia and poor prognosis (aHR 0.95, 95% CI 0.93-0.98). There was no significant heterogeneity in any of our analyses.Sarcopenia was highly and independently associated with higher risk of mortality in patients with cirrhosis.The prevalence of sarcopenia and its association with death in patients with cirrhosis remain unclear. This meta-analysis indicated that sarcopenia affected about one-third of patients with cirrhosis and up to 50% of patients with alcohol-related liver disease or Child-Pugh class C cirrhosis. Sarcopenia was independently associated with an ∼2-fold higher risk of mortality in patients with cirrhosis. The mortality rate increased with greater severity or longer durations of sarcopenia. Increasing awareness about the importance of sarcopenia in patients with cirrhosis among stakeholders must be prioritized.