tbuckley/cabot-search huggingface dataset:
Abstract 14920: Predictors of Adverse Outcomes Following Elective Ascending Aortic Aneurysm Repair: A Nationwide Cohort Study
Authors: Sebastian E Beyer, Kamal R Khabbaz, Alec Schmaier, Eric A Secemsky, Brett Carroll
Journal: Circulation (2020)

Introduction: Elective surgical intervention for ascending aortic aneurysm (AA) is performed when the risk of a future aortic catastrophe outweighs the risk of surgery; however, the data of complication rates following elective repair are limited. Methods: We analyzed adults &gt;18 years of age hospitalized for elective ascending AA surgical intervention in the 2016 and 2017 Nationwide Readmissions Databases. The primary outcome was in-hospital mortality. Secondary outcomes were acute ischemic stroke (AIS), acute myocardial infarction (AMI) and non-elective 30-day readmission. Bayesian lasso probit regression models were used to identify independent predictors of primary and secondary outcomes. Results: Among 4,073 patients hospitalized for elective surgical repair, 28.9% were female. Mean age was 63.0 ± 12.4 years. Concomitant aortic valve surgery was performed in 67%. Overall, 72 (1.8%) died during the initial hospitalization (Figure A). Predictors of in-hospital mortality are shown in Figure B. Of patients alive at discharge, 482 (11.8%) were readmitted within 30 days, with a mortality rate of 2.3% during readmission. Predictors of non-elective 30-day readmission included non-urban localization (Change in probability: 32.5%, 21.7 - 45.7%), chronic liver disease (18.1%, 11.4 - 27.0%), and chronic neurological disorder (15.9%, 12.1 - 20.1%). Main causes of readmissions were arrythmias (20.3%), procedural complications (14.5%), and peri-, endo-, or myocarditis (9.3%). While procedural volume varied between one and 68 procedures / institution, it was not associated with in-hospital mortality, AIS, AMI, or 30-day readmission (p&gt;0.05 for all). Conclusions: One in 25 patients will have a significant complication or die following elective ascending aortic repair and 1 in 8 will be readmitted within 30 days. The risk of surgery compared to the risk of a future aortic catastrophe should be thoroughly assessed prior to recommendation of an ascending AA repair.
Vascular and Hemostatic Alterations Associated with Pulmonary Hypertension in β-Thalassemia Hemoglobin E Patients Receiving Regular Transfusion and Iron Chelation
Authors: Noppacharn Uaprasert, Sudarat Satitthummanid, Benjaporn Akkawat, Pranee Sutcharitchan, Ponlapat Rojnuckarin
Journal: Blood (2017)
The evolution of the cancer stem cell state in glioblastoma: emerging insights into the next generation of functional interactions
Authors: Kelly Mitchell, Katie Troike, Daniel J Silver, Justin D Lathia
Journal: Neuro-Oncology (2020)

Cellular heterogeneity is a hallmark of advanced cancers and has been ascribed in part to a population of self-renewing, therapeutically resistant cancer stem cells (CSCs). Glioblastoma (GBM), the most common primary malignant brain tumor, has served as a platform for the study of CSCs. In addition to illustrating the complexities of CSC biology, these investigations have led to a deeper understanding of GBM pathogenesis, revealed novel therapeutic targets, and driven innovation towards the development of next-generation therapies. While there continues to be an expansion in our knowledge of how CSCs contribute to GBM progression, opportunities have emerged to revisit this conceptual framework. In this review, we will summarize the current state of CSCs in GBM using key concepts of evolution as a paradigm (variation, inheritance, selection, and time) to describe how the CSC state is subject to alterations of cell intrinsic and extrinsic interactions that shape their evolutionarily trajectory. We identify emerging areas for future consideration, including appreciating CSCs as a cell state that is subject to plasticity, as opposed to a discrete population. These future considerations will not only have an impact on our understanding of this ever-expanding field but will also provide an opportunity to inform future therapies to effectively treat this complex and devastating disease.
A global strategy for tuberculosis research and innovation
Authors: Nebiat Gebreselassie, Tereza Kasaeva, Matteo Zignol
Journal: European Respiratory Journal (2020)

<b>Member States have adopted the global strategy for TB research and innovation through a written silence procedure of the 73rd World Health Assembly to accelerate TB research and innovation, and to improve equitable access to the benefits of research</b>https://bit.ly/36dyVmB
Exposure to Armed Conflict in Childhood vs Older Ages and Subsequent Onset of Major Depressive Disorder
Authors: Corina Benjet, William G. Axinn, Sabrina Hermosilla, Paul Schulz, Faith Cole, Laura Sampson, Dirgha Ghimire
Journal: JAMA Network Open (2020)

This study offers a rare opportunity to evaluate life-course differences in the likelihood of developing major depressive disorder (MDD) after exposure to georeferenced neighborhood-level violence during an armed conflict.To examine age cohort (age <11 vs ≥11 years) differences in associations of neighborhood-level violence with subsequent depression onset, independently of individual exposure and other key characteristics.The Chitwan Valley Family Study is a population-representative panel study (1995 to present) conducted in Western Chitwan in Nepal, a low-income country that experienced a medium-intensity armed conflict from 2000 to 2006. Data for violent events were collected during the armed conflict and were linked to lifetime histories of MDD (collected in 2016-2018). The present cohort study analyzes 10 623 participants within 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15 to 59 years at MDD assessment were eligible (response rate, 93%). Data analysis was performed from May 2019 to July 2020.Georeferenced number of armed conflict-related physical beatings within 1 km of residential neighborhood.The main outcome was onset of MDD, as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), during or after the conflict, stratified by children (aged <11 years) and older individuals (aged ≥11 years), assessed by the Nepal-specific World Mental Health-Composite International Diagnostic Instrument 3.0 with a life history calendar.In total, 10 623 participants (5745 female [54.08%]; 4074 [38.35%] aged <11 years at the conflict start) contributed 171 899 person-years of exposure to the risk of MDD. Two or more beatings occurred within 1 km of 15 neighborhoods (9.9%). Discrete-time survival models showed that children (but not older individuals) living in neighborhoods with 2 or more beatings had a higher likelihood of developing MDD than those who lived in a community with no beatings (odds ratio, 1.82; 95% CI, 1.17-2.84; P = .008); there was also a significant interaction between age group and neighborhood beatings (odds ratio, 1.85; 95% CI, 1.27-2.70; P = .001). A confirmatory, multivariable, multilevel matching analysis showed a neighborhood association for children (z = -2.66; P = .008), but not older individuals (z = -0.454; P = .65). The mean (SE) incidence of MDD among children living in neighborhoods with 2 or more beatings nearby was 12.69% (2.37%) vs 5.08% (1.56%) in the matched unexposed sample.The youngest individuals may be the most at risk during times of violence, with mental health consequences lasting long after conflicts have subsided and should be a priority for population-level interventions. Future research should consider other disorders, other types of violence, and elderly individuals.
Abstract 253: Trajectory of Ventricular Fibrillation Prognostic Status During Cardiopulmonary Resuscitation
Authors: Jason Coult, Shiv Bhandari, Diya Sashidhar, Thomas Rea, Jennifer E Blackwood, Peter Kudenchuk, Heemun Kwok
Journal: Circulation (2020)

Background: Resuscitation from out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF) typically involves continuous CPR cycles interrupted every 2 minutes for rhythm analysis and potential defibrillation. Quantitative measures of the VF ECG waveform have been proposed to guide therapy for VF arrest because they are associated with myocardial energetics, are dynamic over the course of resuscitation, and predict outcome. However, while VF waveform measures have until recently have required CPR interruption to accurately gauge prognostic status, CPR interruptions are associated with a lower chance of survival. We used a novel waveform measure previously-validated during active CPR to estimate the course of VF status through the 2-minute CPR cycle between consecutive shocks. Methods: We conducted an observational study of patients with VF OHCA who experienced recurrent VF for at least 90 seconds following initial shock. We used the continuous defibrillator ECG to calculate the VF waveform measure as a function of predicted probability of survival-with-intact-neurologic-status at 1-s intervals over the course of resuscitation between shocks. Results: We collected 499 VF ECG segments (≥90 seconds) during CPR from 313 patients. The trajectory of the average prognostic VF measure had a 3-phase time-dependent pattern (Fig. 1). During CPR, the slope of the measure decreased during the initial 25 s of VF (slope = -12%/min) and was relatively flat during the subsequent 65-s interval of VF (slope = +1%/min). Furthermore, slope decreased sharply following the cessation of CPR for rhythm analysis, charge, and shock (slope = -23%/min). Conclusion: On average, a novel VF waveform measure assessed during the scheduled cycle of CPR and rhythm analysis between consecutive shocks was characterized by a period of decline, stabilization, and then decline. Whether these changes in VF status can be used to improve care for individual patients is uncertain.
Anti-centromere antibodies target centromere–kinetochore macrocomplex: a comprehensive autoantigen profiling
Authors: Nobuhiko Kajio, Masaru Takeshita, Katsuya Suzuki, Yukari Kaneda, Humitsugu Yamane, Kazuhiro Ikeura, Hidekazu Sato, Shin Kato, Hiroyuki Shimizu, Kazuyuki Tsunoda, Tsutomu Takeuchi
Journal: Annals of the Rheumatic Diseases (2020)

Objectives Anti-centromere antibodies (ACAs) are detected in patients with various autoimmune diseases such as Sjögren’s syndrome (SS), systemic sclerosis (SSc) and primary biliary cholangitis (PBC). However, the targeted antigens of ACAs are not fully elucidated despite the accumulating understanding of the molecular structure of the centromere. The aim of this study was to comprehensively reveal the autoantigenicity of centromere proteins. Methods A centromere antigen library including 16 principal subcomplexes composed of 41 centromere proteins was constructed. Centromere protein/complex binding beads were used to detect serum ACAs in patients with SS, SSc and PBC. ACA-secreting cells in salivary glands obtained from patients with SS were detected with green fluorescent protein-fusion centromere antigens and semiquantified with confocal microscopy. Results A total of 241 individuals with SS, SSc or PBC and healthy controls were recruited for serum ACA profiling. A broad spectrum of serum autoantibodies was observed, and some of them had comparative frequency as anti-CENP-B antibody, which is the known major ACA. The prevalence of each antibody was shared across the three diseases. Immunostaining of SS salivary glands showed the accumulation of antibody-secreting cells (ASCs) specific for kinetochore, which is a part of the centromere, whereas little reactivity against CENP-B was seen. Conclusions We demonstrated that serum autoantibodies target the centromere–kinetochore macrocomplex in patients with SS, SSc and PBC. The specificity of ASCs in SS salivary glands suggests kinetochore complex-driven autoantibody selection, providing insight into the underlying mechanism of ACA acquisition.
Analysis of the Human Plasma Proteome Using Multi‐Nanoparticle Protein Corona for Detection of Alzheimer's Disease
Authors: Claudia Corbo, Andrew A. Li, Hossein Poustchi, Gha Young Lee, Sabrina Stacks, Roberto Molinaro, Philip Ma, Theo Platt, Shahed Behzadi, Robert Langer, Vivek Farias, Omid C. Farokhzad
Journal: Advanced Healthcare Materials (2020)

Abstract As the population affected by Alzheimer's disease (AD) grows, so does the need for a noninvasive and accurate diagnostic tool. Current research reveals that AD pathogenesis begins as early as decades before clinical symptoms. The unique properties of nanoparticles (NPs) may be exploited to develop noninvasive diagnostics for early detection of AD. After exposure of NPs to biological fluids, the NP surface is altered by an unbiased but selective and reproducible adsorption of biomolecules commonly referred to as the biomolecular corona or protein corona (PC). The discovery that the plasma proteome may be differentially altered during health and disease leads to the concept of disease‐specific PCs. Herein, the disease‐specific PCs formed around NPs in a multi‐NPs platform are employed to successfully identify subtle changes in plasma protein patterns and detect AD (&gt;92% specificity and ≈100% sensitivity). Similar discrimination power is achieved using banked plasma samples from a cohort of patients several years prior to their diagnosis with AD. With the nanoplatform's analytic ability to analyze pathological proteomic changes into a disease‐specific identifier, this promising, noninvasive technology with implications for early detection and intervention could benefit not only patients with AD but other diseases as well.
Abstract 15626: Visualizing Self-reported Symptom Status Can Support Self-management for Heart Failure Patients
Authors: Meghan Reading Turchioe, Lisa Grossman Liu, Annie Myers, Ruth M Masterson Creber
Journal: Circulation (2020)

Introduction: Symptom self-management is important in heart failure (HF) but challenging given the high prevalence of associated cognitive impairment. Visualizations may support symptom self-management by improving recognition of meaningful changes in symptoms over time. The purpose of this study was to evaluate whether visualizations of self-reported symptom status were associated with recognition of worsening symptoms (risk perception) and intention to act on worsening symptoms (behavioral intention) . Methods: We recruited hospitalized, English-speaking adults with HF from 2 inpatient cardiac units at an urban academic medical center. A professional designer developed 4 visualizations of simulated changes in self-reported symptoms (e.g., fatigue; Figure 1 ) using best practices for displaying health information to adults with cognitive impairment. Using the participants’ favorite visualization of the 4, we evaluated risk perception and behavioral intention using validated scales. We also collected demographics, health literacy, and cognitive status using the Montreal Cognitive Assessment (MoCA). Results: Participants (n=40) had an average age of 61.3 years (±12.5) and were 22% female, 52% White, and 38% Latino. More than half (55%) had low health literacy. Most (88%) had mild/moderate cognitive impairment (MoCA score &lt; 26). The favorite visualization (selected by 42%) was the number line. Regarding risk perception, 70% reported it was very/extremely likely their HF was getting worse and 54% reported they were very/extremely worried about their HF getting worse based on the visualization. Regarding behavioral intention, most (82%) were very/extremely likely to act based on the visualization. Conclusion: Visualizations of symptoms over time communicated risk to most patients who in turn reported being more likely to act, and may be an effective tool to support symptom self-management among HF patients with mild/moderate cognitive impairment.
Validation of the Bronchiectasis Impact Measure (BIM): a novel patient-reported outcome measure
Authors: Megan L. Crichton, Emily K. Dudgeon, Amelia Shoemark, James D. Chalmers
Journal: European Respiratory Journal (2020)

Introduction Existing quality-of-life and symptom tools used in bronchiectasis trials are either not disease specific or are complex and have not been consistently responsive. We developed a simple patient-reported visual analogue outcome measure, the Bronchiectasis Impact Measure (BIM), for use in clinical research, including clinical trials. Methods Patients with bronchiectasis attending a tertiary referral clinic in the east of Scotland were invited to complete the BIM questionnaire and the quality-of-life bronchiectasis questionnaire at baseline with repeat questionnaires after 2 weeks and 6 months. We assessed internal consistency, test–retest reliability, construct validity and responsiveness by evaluating change during an acute exacerbation. Results 173 patients were included. The eight domains (cough, sputum, breathlessness, tiredness, activity, general health, control, exacerbations) showed excellent internal consistency (Cronbach's α 0.93). The intraclass correlation coefficient demonstrated excellent reliability over a 2-week period: cough (0.79, 95% CI 0.70–0.85), sputum (0.86, 95% CI 0.80–0.90), dyspnoea (0.82, 95% CI 0.74–0.87), tiredness (0.88, 95% CI 0.82–0.91), activity (0.84, 95% CI 0.77–0.89), general health (0.81, 95% CI 0.74–0.87), control (0.83, 95% CI 0.75–0.88) and exacerbation (0.71, 95% CI 0.60–0.79). Domains correlated strongly with bronchiectasis severity and exacerbation history. Both distribution and patient-based methods estimated the minimal clinically important difference for each domain as 1.5 points on a 10-point scale. Statistically significant changes in all BIM domains were observed during an acute exacerbation. Conclusion The BIM is a simple patient-reported outcome. This study validates the internal consistency, reliability, construct validity and response of the tool at acute exacerbation. Further validation of the tool is now required.
Abstract 344: Comparing the Efficacy of Real-Time Audiovisual Feedback Devices and Active Compression-Decompression Devices in Out-of-Hospital Cardiac Arrest: A Network Meta-Analysis
Authors: Nitish Sood, Anish Sangari, Joseph A Hauger
Journal: Circulation (2020)

Introduction: Nearly 350,000 out-of-hospital cardiac arrest (OHCA) cases occur annually in the United States, with a fatality rate nearing 90%. Quality of cardiopulmonary resuscitation (CPR) is known to significantly influence survival. Randomized controlled trials (RCT) on real-time audiovisual feedback (RTAVF) and active compression-decompression (ACD) devices show both provide substantial advantages to standard CPR. We conducted the first network meta-analysis comparing the efficacy of RTAVF and ACD devices in OHCA based on a literature review. Methods: Studies examining the efficacy of RTAVF or ACD devices to standard CPR by emergency medical personnel in OHCA cases were identified in PubMed, SCOPUS, Cochrane, Google Scholar, and Embase. Outcomes of interest were return of spontaneous circulation (ROSC), survival to hospital discharge (SHD), and favorable neurological recovery. Both a frequentist and Bayesian network meta-analysis were conducted. The p-values, P-scores and Surface under the Cumulative Ranking (SUCRA) scores were computed to analyze significance and effect size. Results: The search yielded 31 eligible studies (n = 35,575). RTAVF devices significantly improved ROSC (Risk Ratio (RR) 1.15, 95% CI: 1.09 - 1.22, p &lt; 0.001, P-score &gt; 0.999) and SHD (RR 1.16, 1.07 - 1.26, p &lt; 0.001, P-score &gt; 0.91), but did not significantly improve favorable neurological recovery (RR 1.05, 0.92 - 1.19, p &gt; 0.05). ACD devices did not report significant improvement in either ROSC (RR 1.03, 0.99 - 1.08, p &gt; 0.05) or SHD (RR 1.10, 0.99 - 1.21, p &gt; 0.05), but did report significant benefits in favorable neurological outcome (RR 1.30, 1.07 - 1.58, p &lt; 0.01, P-score &gt; 0.97). Similar findings were also seen in SUCRA scores. Conclusion: We found RTAVF devices increased ROSC and SHD, while ACD devices increased favorable neurological recovery. Our meta-analysis supports the adoption of RTAVF devices, but an RCT directly comparing RTAVF with ACD devices is recommended.
Abstract 288: Rapid Response Team Implementation Associated with Reductions in In-hospital Mortality Rate and Hospitalization Costs: A Retrospective Analysis
Authors: Jacob Sessim Filho, Renato P Azevedo, Antonildes N Assuncao, Marcia M Sa, Felipe D Silva, Laerte Pastore, Luiz F Cardoso, Fernando Ganem
Journal: Circulation (2020)

Introduction: Early recognition of clinical deterioration in inpatient subjects seems to be one of the main factors associated with prevention of in-hospital severe adverse events occurrence. Previous studies failed to demonstrate that the implementation of a rapid response team (RRT) could reduce in-hospital mortality rate. Hypothesis: Could a RRT implementation reduces in-hospital mortality and/or hospitalizations costs in a private general hospital in Brazil? Methods: This is a retrospective cohort built from data of electronic medical database of consecutive adult inpatients admitted to general wards who had to be transferred to an ICU after an acute clinical deterioration between May 1st, 2012 and June 30th, 2016. Subjects were divided into two groups as follows: group 1 (G1) with those admitted to ICU before RRT implementation on June 1st, 2014 and group 2 (G2) with the ones admitted to ICU after the implementation. All patients in G2 received care by the RRT before ICU admittance. In cases in which a patient had more than one hospital admission, only the first admittance was used for analyses. Results: Patients data are shown in table 1.Outcome data are shown in table 2. Conclusions: From these data, it is possible to infer that this RRT implementation at this hospital was associated with improvement in clinical outcomes of inpatients who needed an ICU admittance after an acute clinical deterioration, as well as a significant reduction of their hospitalization costs. These data reinforce the hypotheses that MERIT study was underpowered. Further multicenter randomized trials, with appropriate statistical power, shall be proposed to address these questions.