tbuckley/cabot-search huggingface dataset:
Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID‐19
Authors: Joht Singh Chandan, Dawit Tefra Zemedikun, Rasiah Thayakaran, Nathan Byne, Samir Dhalla, Dionisio Acosta‐Mena, Krishna M. Gokhale, Tom Thomas, Christopher Sainsbury, Anuradhaa Subramanian, Jennifer Cooper, Astha Anand, Kelvin O. Okoth, Jingya Wang, Nicola J. Adderley, Thomas Taverner, Alastair K. Denniston, Janet Lord, G. Neil Thomas, Christopher D. Buckley, Karim Raza, Neeraj Bhala, Krishnarajah Nirantharakumar, Shamil Haroon
Journal: Arthritis & Rheumatology (2020)

To identify whether active use of nonsteroidal antiinflammatory drugs (NSAIDs) increases susceptibility to developing suspected or confirmed coronavirus disease 2019 (COVID-19) compared to the use of other common analgesics.We performed a propensity score-matched cohort study with active comparators, using a large UK primary care data set. The cohort consisted of adult patients age ≥18 years with osteoarthritis (OA) who were followed up from January 30 to July 31, 2020. Patients prescribed an NSAID (excluding topical preparations) were compared to those prescribed either co-codamol (paracetamol and codeine) or co-dydramol (paracetamol and dihydrocodeine). A total of 13,202 patients prescribed NSAIDs were identified, compared to 12,457 patients prescribed the comparator drugs. The primary outcome measure was the documentation of suspected or confirmed COVID-19, and the secondary outcome measure was all-cause mortality.During follow-up, the incidence rates of suspected/confirmed COVID-19 were 15.4 and 19.9 per 1,000 person-years in the NSAID-exposed group and comparator group, respectively. Adjusted hazard ratios for suspected or confirmed COVID-19 among the unmatched and propensity score-matched OA cohorts, using data from clinical consultations in primary care settings, were 0.82 (95% confidence interval [95% CI] 0.62-1.10) and 0.79 (95% CI 0.57-1.11), respectively, and adjusted hazard ratios for the risk of all-cause mortality were 0.97 (95% CI 0.75-1.27) and 0.85 (95% CI 0.61-1.20), respectively. There was no effect modification by age or sex.No increase in the risk of suspected or confirmed COVID-19 or mortality was observed among patients with OA in a primary care setting who were prescribed NSAIDs as compared to those who received comparator drugs. These results are reassuring and suggest that in the absence of acute illness, NSAIDs can be safely prescribed during the ongoing pandemic.
Genetic predictors of educational attainment and intelligence test performance predict voter turnout
Authors: Lene Aarøe, Vivek Appadurai, Kasper M. Hansen, Andrew J. Schork, Thomas Werge, Ole Mors, Anders D. Børglum, David M. Hougaard, Merete Nordentoft, Preben B. Mortensen, Wesley Kurt Thompson, Alfonso Buil, Esben Agerbo, Michael Bang Petersen
Journal: Nature Human Behaviour (2020)
Point-of-care ultrasonography had 92% sensitivity and 97% specificity for diagnosing diverticulitis in the ED
Authors: Gregory Hall
Journal: Annals of Internal Medicine (2020)

Cohen A, Li T, Stankard B, Nelson M. A prospective evaluation of point-of-care ultrasonographic diagnosis of diverticulitis in the emergency department. Ann Emerg Med. 2020. [Epub ahead of print]. 32653332.
Abstract 238: A Deep Neural Network Approach for Continuous Electrocardiogram-based Shock Advisory System During Cardio Pulmonary Resuscitation
Authors: Shirin Hajeb Mohammadalipour, Alicia Cascella, Matt Valentine, K.H. Chon
Journal: Circulation (2020)

The ability of an automatic external defibrillator (AED) to make a reliable shock decision during cardio pulmonary resuscitation (CPR) would improve the survival rate of patients with out-of-hospital cardiac arrest. Since chest compressions induce motion artifacts in the electrocardiogram (ECG), current AEDs instruct the user to stop CPR while an automated rhythm analysis is performed. It has been shown that minimizing interruptions in CPR increases the chance of survival. While deep learning approaches have been used successfully for arrhythmia classification, their performance has not been evaluated for creating an AED shock advisory system that can coexist with CPR. To this end, the objective of this study was to apply a deep-learning algorithm using convolutional layers and residual networks to classify shockable versus non-shockable rhythms in the presence and absence of CPR artifact using only the ECG data. The feasibility of the deep learning method was validated using 8-sec segments of ECG with and without CPR. Two separate databases were used: 1) 40 subjects’ data without CPR from Physionet with 1131 shockable and 2741 non-shockable classified recordings, and 2) CPR artifacts that were acquired from a commercial AED during asystole delivered by 43 different resuscitators. For each 8-second ECG segment, randomly chosen CPR data from 43 different types were added to it so that 5 non-shockable and 10 shockable CPR-contaminated ECG segments were created. We used 30 subjects’ and the remaining 10 for training and test datasets, respectively, for the database 1). For the database 2), we used 33 and 10 subjects’ data for training and testing, respectively. Using our deep neural network model, the sensitivity and specificity of the shock versus no-shock decision for both datasets using the four-fold cross-validation were found to be 95.21% and 86.03%, respectively. For shockable versus non-shockable classification of ECG without CPR artifact, the sensitivity was 99.04% and the specificity was 95.2%. A sensitivity of 94.21% and a specificity of 86.14% were obtained for ECG with CPR artifact. These results meet the AHA sensitivity requirement (&gt;90%).
Abstract 14548: Coronary and Aortic Calcification Are Common in Men With Recurrent Prostate Cancer Undergoing PET/CT Imaging
Authors: Avira Som, Preet Ayoub Shaikh, Daniel Lenihan, Kathleen W Zhang
Journal: Circulation (2020)

Background: Men who receive androgen deprivation therapy for prostate cancer may be at increased risk for cardiovascular events. Vascular calcification is predictive of coronary events in the general population. The prevalence of vascular calcification in men with prostate cancer is not known. Methods: 211 consecutive patients who underwent 18F-fluciclovine positron emission tomography (PET) /computed tomography (CT) at Washington University School of Medicine for recurrent prostate cancer were retrospectively identified. Clinical, demographic, and cardiac biomarker data were obtained from the medical record. Coronary and aortic calcification were qualitatively assessed on non-gated CT scans using standardized scoring systems. Results: Among 211 men with recurrent prostate cancer, median age was 69 (IQR 64, 75) years. Cardiovascular comorbidities were common (70% hypertension, 65% hyperlipidemia, 20% diabetes mellitus, 47% current or former smoking). 21% carried a clinical diagnosis of coronary artery disease while 6% had peripheral vascular disease. On CT imaging, 147 patients (70%) had coronary artery calcification of whom 29 (20%) had severe calcification. Additionally, 189 patients (90%) had aortic calcification on CT imaging of whom 48 (25%) had severe thoracic aortic calcification and 109 (58%) had severe calcification at the aortoiliac bifurcation. Conclusions: Coronary and peripheral vascular calcification are common on PET/CT imaging in men with prostate cancer. Vascular calcification on CT imaging may have utility for cardiovascular risk stratification and guiding implementation of cardiovascular therapies in men receiving androgen deprivation therapy.
Population-based case-finding to identify airflow obstruction in symptomatic adults at high risk for asthma and COPD
Authors: Jennifer L. Perret, Don Vicendese, Shyamali C. Dharmage
Journal: European Respiratory Journal (2020)

<b>Preteroti and co-workers have highlighted the importance of detecting undiagnosed adults with airflow obstruction in the community, but some methodological considerations relating to their work in respiratory risk prediction warrant mention</b>https://bit.ly/3kp2SUV
A novel HSP90 inhibitor targeting the C-terminal domain attenuates trastuzumab resistance in HER2-positive breast cancer
Authors: Jung Min Park, Yoon-Jae Kim, Soeun Park, Minsu Park, Lee Farrand, Cong-Truong Nguyen, Jihyae Ann, Gibeom Nam, Hyun-Ju Park, Jeewoo Lee, Ji Young Kim, Jae Hong Seo
Journal: Molecular Cancer (2020)

Trastuzumab resistance in HER2-positive breast cancer is associated with a poorer prognosis. HSP90 is thought to play a major role in such resistance, but N-terminal inhibitors of this target have had little success. We sought to investigate the utility of NCT-547, a novel, rationally-designed C-terminal HSP90 inhibitor in the context of overcoming trastuzumab resistance. NCT-547 treatment significantly induced apoptosis without triggering the heat shock response (HSR), accompanied by caspase-3/- 7 activation in both trastuzumab-sensitive and -resistant cells. NCT-547 effectively promoted the degradation of full-length HER2 and truncated p95HER2, while also attenuating hetero-dimerization of HER2 family members. The impairment of cancer stem-like traits was observed with reductions in ALDH1 activity, the CD24low/CD44high subpopulation, and mammosphere formation in vitro and in vivo. NCT-547 was an effective inhibitor of tumor growth and angiogenesis, and no toxic outcomes were found in initial hepatic and renal analysis. Our findings suggest that NCT-547 may have applications in addressing trastuzumab resistance in HER2-positive breast cancer.
Travel time to health-care facilities, mode of transportation, and HIV elimination in Malawi: a geospatial modelling analysis
Authors: Laurence Palk, Justin T Okano, Luckson Dullie, Sally Blower
Journal: The Lancet Global Health (2020)

BackgroundUNAIDS has prioritised Malawi and 21 other countries in sub-Saharan Africa for fast-tracking the end of their HIV epidemics. UNAIDS' elimination strategy requires achieving a treatment coverage of 90% by 2030. However, many individuals in the prioritised countries have to travel long distances to access HIV treatment and few have access to motorised transportation. Using data-based geospatial modelling, we investigated whether these two factors are barriers to achieving HIV elimination in Malawi and assessed the effect of increasing bicycle availability on expanding treatment coverage.MethodsWe built a data-based geospatial model that we used to estimate the minimum travel time needed to access treatment, for every person living with HIV in Malawi. We constructed our model by combining a spatial map of health-care facilities, a map that showed the number of HIV-infected individuals per km2, and an impedance map. We quantified impedance using data on road and river networks, land cover, and topography. We estimated travel times for the existing coverage of 70%, and the time that HIV-infected individuals would need to spend travelling in order to achieve a coverage of 90%, whether driving, bicycling, or walking.FindingsWe identified a quantitative relationship between the maximum achievable coverage of treatment and the minimum travel time to the nearest health-care facility. At 70% coverage, health-care facilities can be reached within approximately 45 min if driving, 65 min if bicycling, and 85 min if walking. Increasing coverage above 70% will become progressively more difficult. To reach 90% coverage, many HIV-infected individuals (who have yet to initiate treatment) will need to travel for almost twice as long as those already on treatment. Bicycling, rather than walking, in rural areas would substantially increase the maximum achievable coverage.InterpretationThe long travel times needed to reach health-care facilities coupled with little motorised transportation in rural areas are substantial barriers to reaching 90% coverage in Malawi. Increased bicycle availability could help eliminate HIV.FundingUS National Institute of Allergy and Infectious Diseases.
Abstract 13346: The Rate of Incomplete Revascularization Following Coronary Artery Bypass Surgery Has Increased Over Time
Authors: Chase R Soukup, Christian W Schmidt, Carmen Chan-Tram, Ross F Garberich, Benjamin Sun, Jay H TRAVERSE
Journal: Circulation (2020)

Introduction: Incomplete revascularization following coronary artery bypass surgery (CABG) is associated with increased repeat revascularization, myocardial infarction and death. However, whether the rate of incomplete revascularization is increasing over time has not been previously described. Methods: We performed a retrospective review of consecutive patients who underwent elective and isolated CABG for multi-vessel coronary artery disease in 2007 (n=291) and in 2017 (n=290) at a single Institution. All coronary angiograms and CABG operative reports were reviewed and a Revascularization Index Score (RIS) was created to compare rates of incomplete revascularization between the two time periods based on the coronary anatomy and degree of stenosis. Thus a patient with complete revascularization will have an RIS score of 1.0 while a patient who has 3 of 4 eligible vessels bypassed will have an RIS score of 0.75. Results: Over a 10 year period, the rate of incomplete revascularization increased from 17.9% to 28.3% (p = 0.003) and was accompanied by a decline in the RIS score from 0.73 to 0.67 (p= 0.005). Mortality significantly increased over time with incomplete compared to complete revascularization in the 2007 cohort. Conclusions: The incidence of incomplete revascularization following CABG significantly increased over a 10-year time period between 2007 and 2017. These differences may be attributable to patient factors including more severe coronary artery disease associated with older age, greater incidence of smoking and previous PCI. In line with previous. meta-analyses, the incidence of mortality over time was higher in those patients with incomplete compared to those with complete revascularization. These results suggest that patients with incomplete revascularization represents an important target for the development of novel therapies.
Abstract 13646: Clinical Profile and Ablation Outcomes in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy and Biventricular Involvement
Authors: Lishui Shen, Lihui Zheng, Yan Yao
Journal: Circulation (2020)

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a progressive disease which can involve both ventricles. This study aimed to elucidate the clinical profile and ablation efficacy in Chinese ARVC patients with biventricular (BiV) involvement. Methods and Results: Based on cardiovascular magnetic resonance findings, 255 ARVC patients were divided into two groups: the BiV involved group (n=137) and the isolated right ventricular (RV) involved group (n=118). Patients with BiV involvement were more likely to suffer from heart failure (28.5% vs. 8.5%; P &lt;0.001) and recurrent syncope (32.8% vs. 21.2%; P =0.038), and presented with lower heart transplantation-free survival and composed endpoint (death or heart transplantation)-free survival (all P &lt;0.05). Of the 255 subjects, 52 BiV involved patients and 77 isolated RV involved patients underwent catheter ablation for ventricular tachycardia (VT). After 5 years’ follow-up, the outcomes including VT recurrence and all-cause mortality in 2 groups showed no difference (all P &gt;0.05). The age, amount of induced VT during electrophysiology study and non-acute procedural success (partial success, defined as inducing the same VT with cycle length 30% longer after ablation; substrate modification only) were independent predictors of VT recurrence in BiV involved patients (all P &lt;0.05). Conclusion: BiV involvement in ARVC indicated worse symptoms and poor prognosis. Nonetheless, catheter ablation remained effective for VT control in this population. The younger age, more induced VTs and non-acute procedural success were associated with VT recurrence after ablation.
Abstract 13947: The Acute and Long-term Effects of Transcatheter Aortic Valve Implantation on Aortic Stiffness and Hemodynamics
Authors: Vasiliki Gardikioti, Dimitrios Terentes-printzios, Konstantinos Aznaouridis, George Latsios, Gerasimos Siasos, Maria Drakopoulou, Evangelos Oikonomou, Vasiliki Tsigkou, Maria Xanthopoulou, Konstantinos Toutouzas, Manolis Vavuranakis, Dimitrios TOUSOULIS, Charalambos Vlachopoulos
Journal: Circulation (2020)

Introduction: Transcatheter aortic valve implantation (TAVI) is a procedure that alters dramatically the hemodynamics in patients with severe aortic valve stenosis who undergo this procedure. Hypothesis: We investigated the hypothesis that arterial properties and hemodynamics are affected immediately after TAVI as well as in the long-term. Methods: We enrolled 90 patients (mean age 80.2 ± 8.1 years, 50% males) with severe symptomatic aortic stenosis undergoing TAVI. Carotid-femoral and brachial-ankle pulse wave velocity (cfPWV and baPWV) were used for the assessment of arterial stiffness. Augmentation index corrected for heart rate (AIx@75) and subendocardial viability ratio (SEVR) were measured non-invasively. Measurements were conducted at baseline, after the procedure (during hospitalization) and at 1 year. Results: Acutely after TAVI we observed a statistically significant increase in arterial stiffness (7.5 ± 1.5 m/s vs 8.4 ± 1.9 m/s, p=0.001 for cfPWV and 1,773 ± 459 cm/s vs 2,383 ± 645 cm/s, p&lt;0.001 for baPWV) without a concomitant change in systolic blood pressure (Figure). One year later, arterial stiffness was still increased compared to pre-TAVI measurements (7.5 ± 1.5 m/s vs 8.7 ± 1.7 m/s, p&lt;0.001 for cfPWV and 1,773 ± 459 cm/s vs 2,286 ± 575 cm/s, p&lt;0.001 for baPWV). We also found a decrease in AIx@75 (32.2 ± 12.9 % vs 27.9± 8.4 %, p=0.016) after TAVI that was attenuated at 1-year follow-up (32.2 ± 12.9 % vs 29.8± 9.1 %, p=0.38). SEVR displayed an increase acutely after TAVI (131.2 ± 30.0 % vs 148.4± 36.1 %, p=0.002) and remained improved 1 year after the procedure (131.2 ± 30.0 % vs 146± 32.2 %, p=0.01). Conclusions: In conclusion, shortly after TAVI the aorta exhibits a "stiffer" behavior in response to the acute change in hemodynamics, which settles in the long term. Our findings further elucidate the hemodynamic consequences of TAVI and may entail a prognostic role in this growing population.
A Predictive Instrument for Cesarean Delivery After Labor Induction
Authors: Susan B. Brogly
Journal: JAMA Network Open (2020)

Rebecca F. Hamm, MD, MSCE; Jennifer McCoy, MD; Amal Oladuja, BA; Hilary R. Bogner, MD, MSCE; Michal A. Elovitz, MD; Knashawn H. Morales, ScD; Sindhu K. Srinivas, MD, MSCE; Lisa D. Levine, MD, MSCE
Abstract 14089: Reduced Pain External Defibrillation (RPD) and MRI-conditional RPD: Reduced Pain ind Equivalent Efficiency Validation in Swine
Authors: Ehud J Schmidt, Hassan Elahi, Ryan Baumgaertner, Henry R Halperin
Journal: Circulation (2020)

Introduction: External defibrillators are used for cardioversion and resuscitation after sudden cardiac arrest (SCA). External defibrillators are also required for emergency MRI (acute stroke, spinal trauma). Low-power (9 Joule) ICD RPDs [1], and MRI-conditional external defibrillator prototypes exist [2]. An RPD external defibrillator was constructed, consisting of a Zoll defibrillator integrated with a tetanizing unit. The tetanizing waveform slowly compressed chest musculature prior to the strong biphasic defibrillating pulse, reducing chest contraction during the biphasic pulse, the major pain source. This RPD system (Fig. 1A-D) was evaluated for pain reduction and defibrillation effectiveness in swine. Method: The tetanizing unit consisted of a programmable generator that delivered a triangular 1-KHz pulse of 250-2000msec duration and 10-100 Volt peak amplitude, and subsequently triggered the conventional defibrillator to send out standard short (8msec) powerful (20-400 J) biphasic pulses. Forward limb motion (Fig. 1E), an established pain measure [3], was evaluated by measuring limb acceleration, acceleration rate and work (energy). 5 swine were arrested electrically and then defibrillated. RPD was repeated 15-20 times/swine, varying tetanizing parameters and biphasic energy. Results: Fig. 1F-H compare an RPD defibrillation and equivalent biphasic defibrillation, showing smaller accelerations and acceleration rates. Fig. 1J shows work results, at 30-200J biphasic energy, demonstrating an 83 + 15% limb work reduction with the RPD waveforms. Optimal tetanizing parameters were 15-25V amplitude and 500-750msec duration. Rhythm recovery for RPD and conventional defibrillation was identical. Conclusions: Reduced pain defibrillation may allow cardioversion without anesthesia and faster defibrillation after SCA. References: [1] Hunter DW 2016. [2] Schmidt EJ 2016. [3] Boriani G, 2005.
Abstract 13300: Hepatocyte Growth Factor and 10-year Change in Left Ventricular Structure: The Multi-Ethnic Study of Atherosclerosis
Authors: Richard A Ferraro, Oluseye Ogunmoroti, Di Zhao, Chiadi E Ndumele, Joao A Ac Lima, Vinita Subramanya, Ambarish Pandey, Nicholas B Larson, Suzette J Bielinski, Erin D Michos
Journal: Circulation (2020)

Introduction: Hepatocyte Growth Factor (HGF) is a mesenchymal cytokine linked to incident heart failure (HF), with recent data from our group showing a strong and independent association with HF with preserved ejection fraction (HFpEF). Cardiac MRI (cMRI) allows for precise analysis of morphologic changes in left ventricular (LV) structure. Increasing LV mass and concentric remodeling (defined by an increasing mass:volume ratio) are imaging markers of HFpEF risk. Whether HGF is associated with adverse LV remodeling over time is unknown. Hypothesis: Higher HGF will be associated with increasing LV mass, decreasing LV volume and increasing mass:volume ratio over 10 yrs. Methods: We studied 4762 participants of the MESA cohort, free of cardiovascular disease (CVD) and HF at baseline, who completed both HGF measurement and cMRI at baseline. Participants with LV EF&lt;50% were excluded. Of these, 2855 completed a 2 nd cMRI at 10 yrs. We examined the cross-sectional and longitudinal associations of HGF and LV parameters using multivariable-adjusted linear mixed effect models. Results: The mean (SD) for age was 61 (10) yrs. Median (IQR) for HGF level was 888 pg/mL (745-1066); 53% women. At baseline, the 3 rd HGF tertile, compared to the 1 st , was associated with greater mass:volume ratio [relative difference 1.66 (0.43, 2.89)] and lower LV end diastolic volume [-1.87 mL (-3.45, -0.28)], after adjustment for CVD risk factors and NT- proBNP (model 2) [Table] . In longitudinal analysis, the 3 rd HGF tertile was also associated with increasing mass:volume ratio [difference in 10-yr change: 4.79 (2.73, 6.85)] and decreasing LV end diastolic volume [-4.97 (-7.10, -2.85)]. Conclusions: In a community cohort, higher HGF levels were independently associated with a concentric LV remodeling pattern of increasing mass:volume ratio and decreasing LV end diastolic volume over 10 yrs. This association may suggest an intermediate phenotype explaining the association of HGF with HFpEF risk.