tbuckley/cabot-search huggingface dataset:
Abstract 12984: Long-term Prognostic Value of the Serial Change of Acute Hemodynamic Index During Hospitalization in Patients Admitted for Acute Decompensated Heart Failure
Authors: Takahisa Yamada, Tetsuya Watanabe, Takashi Morita, Yoshio Furukawa, Shunsuke Tamaki, Masato Kawasaki, Atsushi Kikuchi, Tsutomu Kawai, Masahiro Seo, Kiyomi Kayama, Masatsugu Kawahira, Jun Nakamura, Kumpei Ueda, Takanari Kimura, Daisuke Sakamoto, Masatake Fukunami
Journal: Circulation (2020)

Backgrounds: Controlled heart rate (HR) and increased pulse pressure (PP) are related to better outcomes in stable heart failure. Hemodynamic response to stress evaluated by an acute hemodynamics index (AHI), the product of HR and PP, has been reported to be associated with poor outcomes in patients admitted for acute decompensated heart failure (ADHF). However, there is no information available on the long-term prognostic value of the serial change of AHI during hospitalization in patients admitted for ADHF. Methods and Results: We studied 259 patients admitted for ADHF and discharged with survival. We measured AHI (HR x PP/1000) at admission and discharge. AHI significantly decreased from admission to discharge (6.98±3.04 to 3.81±1.21 bpm·mmHg, p&lt;0.0001). During a mean follow-up period of 5.0±3.2 yrs, 53 patients had cardiac death. The change [ad-dis] of AHI from admission to discharge (AHI[ad-dis]) was significantly less in patients with than without cardiac death (1.98±2.17 vs 3.47±2.87 bpm·mmHg, p=0.0005). Multivariate Cox regression analysis revealed that AHI[ad-dis], but not PP[ad-dis], was significantly associated with cardiac death, independently of prior heart failure hospitalization, body mass index, estimated glomerular filtration rate, hemoglobin level and left ventricular end-diastolic dimension. ROC analysis revealed that AUC in AHI[ad-dis](0.668[0.588-0.749]) was greater than that in PP[ad-dis](0.637[0.572-0.717]). Patients with less AHI[ad-dis] (≤1.79 bpm·mmHg by ROC analysis) had a significantly higher risk of cardiac death than those with greater AHI[ad-dis] (adjusted hazard ratio: 3.19[1.77 to 5.76], 30% vs 13%, p&lt;0.0001). Conclusions: Cardiac death was frequently observed in ADHF patients who had less degree of the decrease in AHI during hospitalization. The change of AHI during hospitalization would be a simple and useful marker for risk stratification in patients admitted for ADHF.
Relapse of primary membranous nephropathy after inactivated SARS-CoV-2 virus vaccination
Authors: Mehmet Fethullah Aydın, Abdülmecit Yıldız, Ayşegül Oruç, Mehmet Sezen, Kamil Dilek, Mustafa Güllülü, Mahmut Yavuz, Alparslan Ersoy
Journal: Kidney International (2021)
Re: Timothy D. Jones, Liang Cheng. Histologic Grading of Bladder Tumors: Using Both the 1973 and 2004/2016 World Health Organization Systems in Combination Provides Valuable Information for Establishing Prognostic Risk Groups. Eur Urol 2021;79:489–91
Authors: Alessia Cimadamore, Antonio Lopez-Beltran, Marina Scarpelli, Rodolfo Montironi
Journal: European Urology (2021)
Abstract 17308: Unsupervised K-means Clustering to Identify Signatures of Right Ventricle Dysfunction in Patients With Pulmonary Hypertension
Authors: Alexandra M Janowski, Keeley S Ravellette, Joe G Garcia, Franz Rischard, Rebecca R Vanderpool
Journal: Circulation (2020)

Introduction: Right ventricular (RV) function is a determinant of mortality in patients with pulmonary hypertension but current assessments are based on individual variables. Unsupervised k-means clustering can be used as an unbiased approach to determine distinct patient groups based on RV dysfunction. The aim of the study was to use unsupervised clustering to identify clinically meaningful RV phenotypes. Methods: Participants were identified from the University of Arizona PH registry (n=213). Patients with missing hemodynamic RV function data were excluded (n=23). Unsupervised clustering (k-means) was applied to variables of systolic and diastolic ventricular function including: max dP/dt/RVSP, Ees, Ea, Ees/Ea, max dP/dt, min dP/dt, RV EDP, β and Eed. Linear discriminant analysis (LDA) was performed to determine the weight of variables in cluster assignment. Results: Participants without PH (n=41) and World Symposium Pulmonary Hypertension (WSPH) Groups 1 (n=104), 2 (n=22), 3 (n=28), 4 (n=12), 5 (n=2) were assigned to four clusters based on the elbow method (Figure 1A). Two major determinants of cluster assignment were arterial elastance (Ea) and end systolic elastance (Ees). Participants with WSPH Group 1 were distributed across clusters (Figure 1B). Degree of RV dysfunction was highest in cluster 4 with increased Ees and Ea compared to other clusters (Figure 1C). Eed, Ees/Ea and mPAP (61 ± 22 mmHg) were increased compared to clusters 1 and 3. Sex, Ethnicity, BMI and cardiac output were not significant between clusters. Cluster 4 had increased PVR (11.1 ± 5.5 WU), and decreased PA compliance (1.2 ± 0.6 mmHg/ml) compared to other clusters. Conclusions: Unsupervised k-means clustering based on hemodynamic measures of RV function identified four distinct RV dysfunction phenotypes ranging from mild to severe.
Abstract 16137: Cardiac Implantable Devices Identification Based on Chest-x-rays Using Machine Learning Algorithms
Authors: Dorys A C Melendez, Seth Lowey, Lily N Dastmalchi, Tran Nguyen, Gina Adam, Marco Mercader
Journal: Circulation (2020)

Introduction: High-quality care of patients with Cardiac Implantable Electronic Devices, involves early identification of device manufacturer, which leads to timely interrogation using specific programmers. Pacemaker ID is a phone application that aims to identify the manufacturer of pacemakers and defibrillators from a chest X-Ray image. The app utilizes machine learning, including autonomous learning software leading the algorithm to improve over time. Our study aims to investigate the accuracy of the Pacemaker ID app at detecting the manufacturer of cardiac implantable electronic devices Methods: A total of 200 consecutive x-rays were collected from a two year period at The George Washington University in Washington DC and Centro Medico Hospital in Honduras. Chest X-Rays with implanted devices were scanned using the app. The device manufacturer was recorded from the initial operative report Results: The dataset included 146 Medtronic, 23 Boston Scientific, 24 St. Jude and 7 Biotronik devices. The app has a weighted average precision of 85.5%, recall of 73% and F1-score of 77.28%. Dataset accuracy 73%. Medtronic had the most precise prediction at 95.5%, while Biotronik only had 15.2% precision. Boston Scientific had the best recall at 87%. Medtronic, the most abundant in the dataset, showed a high recall of 72% and a very high precision of 95.5%. The F1-score, where Medtronic score the highest with 82%. Biotronik has a low F1-score, at 25% due to the low precision of estimates, particularly because 17% of the Medtronic images were wrongly identified as Biotronik Conclusions: The PacemakerID application was found to have a 73 % overall accuracy in identifying devices. It has the potential to expedite the interrogation process in hospital settings and improve the quality of care among patients with cardiac devices. Taking into account the following limitations: device model, camera type and image quality
Improving social cognition in people with a psychotic disorder: preliminary results of a pilot study on Dynamic interactive Social Cognition training in Virtual Reality (DiSCoVR)
Authors: Saskia Nijman, Gerdina Marieke Pijnenborg, Chris Neeltje Wil Geraets, Willem Veling
Journal: World Psychiatry (2017)

Aim: Dysfunctions in emotion recognition, reading others’ mental states and assessing social situations are common in individuals with a psychotic disorder. Social cognitive deficits such as these strongly predict problems in social functioning. Meta-analyses show that social cognition can be improved by social cognition training (SCT); however, it is unclear whether these effects persist over time. The stimuli and techniques that are typically used in SCT may not adequately mimic real-life social interactions. Several key characteristics of real-world interactions are also absent from conventional training materials, particularly interaction. We have therefore developed a SCT which is provided using Virtual Reality (VR). VR is highly realistic and interactive, eliciting genuine psychological responses, and the environment and the virtual people (‘avatars’) in it, react to the actions of the participant. VR also allows for control of several parameters, facilitating structured and individualized training. Methods: A novel form of SCT using VR (called ‘DiSCoVR’) has been developed. DiSCoVR consists of 16 sessions, provided over the course of eight weeks, targeting the following social-cognitive domains: 1) Emotion perception; 2) Social perception and Theory of Mind (i.e., understanding the social context and interdependence of emotions, thoughts and behavior); and 3) Social interaction training (i.e., selecting and practicing adequate responses in social situations). These domains are trained in VR, supplemented by coaching from a therapist and homework assignments. A pilot study of DiSCoVR is currently conducted amongst 25 mental health service clients in the northern Netherlands. In this pilot study, our primary outcome of interest is the acceptability and feasibility of the intervention. Our secondary outcome measure is the efficacy of DiSCoVR on several domains of social cognition: emotion perception, social perception and theory of mind. These domains are measured using conventional tests of social cognition, as well as performance on Virtual Reality tasks. The mental health service client group is compared on these measures to a healthy control group (n=25), to determine ‘normal’ performance on these measures and in VR. Results & Conclusion: We will demonstrate the intervention and provide preliminary results of the ongoing pilot study.
Natural History and Clinical Characteristics of the First 10 Danish Families With Familial ST-Depression Syndrome
Authors: Alex Hørby Christensen, Benjamin Chris Nyholm, Christoffer Rasmus Vissing, Adrian Pietersen, Jacob Tfelt-Hansen, Morten Salling Olesen, Steen Pehrson, Kasper K. Iversen, Henrik Kjærulf Jensene, Henning Bundgaard
Journal: Journal of the American College of Cardiology (2021)
Abstract 16593: Secondary Raynaud’s Phenomenon is Associated With Microvascular Peripheral Endothelial Dysfunction
Authors: Jaskanwal Deep S Sara, Riad Taher, Takumi Toya, Lilach O Lerman, Amir LERMAN
Journal: Circulation (2020)

Introduction: Previous studies in patients with Raynaud’s phenomenon (RP) have found an association between microvascular abnormalities assessed via nail fold capillaroscopy as well as macrovascular peripheral endothelial dysfunction (PED). However, the association between RP and microvascular PED is not yet established. Hypothesis: We hypothesized that patients with RP have greater microvascular PED compared to controls without RP Methods: We performed a retrospective cross-sectional analysis of patients referred to Mayo Clinic between 2006 and 2014 for routine cardiovascular evaluation, and who underwent evaluation of Reactive Hyperemia Peripheral Arterial Tonometry (index &lt; 2 consistent with PED). Patients with RP were identified by chart review. Results: Six hundred sixty six individuals were included in this study (mean age 51.9±13.5 years, 411 (61.3%) women), 637 (95.1%) individuals did not have RP (control group), and 29 (4.3%) had secondary RP. Only 4 patients had primary RP and were excluded from the final analyses. Individuals with secondary RP had a higher frequency of microvascular PED compared to controls ( Figure ). In a multivariate analysis adjusting for age, sex, smoking status, and use of statins we found a significant association between secondary RP and microvascular PED (OR: 2.45; 95% CI 1.13-5.34; P=0.0236) that remained significant in women after stratifying by sex. In a sensitivity analysis, we compared the frequency of PED in 29 patients with secondary RP and 58 controls matched with respect to age, sex, hypertension, dyslipidemia, and diabetes mellitus. Individuals with secondary RP had a higher frequency of microvascular PED compared to the risk factor-matched controls (18/29 [62.1%] vs 18/58 [31.0%], P=0.01). Conclusions: Secondary RP is associated with microvascular PED. Early detection of microvascular PED could help identify individuals with secondary RP who are at risk for developing cardiovascular disease.
Impact of COVID-19 on diagnoses, monitoring, and mortality in people with type 2 diabetes in the UK
Authors: Matthew J Carr, Alison K Wright, Lalantha Leelarathna, Hood Thabit, Nicola Milne, Naresh Kanumilli, Darren M Ashcroft, Martin K Rutter
Journal: The Lancet Diabetes & Endocrinology (2021)
Six distinct NFκB signaling codons convey discrete information to distinguish stimuli and enable appropriate macrophage responses
Authors: Adewunmi Adelaja, Brooks Taylor, Katherine M. Sheu, Yi Liu, Stefanie Luecke, Alexander Hoffmann
Journal: Immunity (2021)

Macrophages initiate inflammatory responses via the transcription factor NFκB. The temporal pattern of NFκB activity determines which genes are expressed and thus, the type of response that ensues. Here, we examined how information about the stimulus is encoded in the dynamics of NFκB activity. We generated an mVenus-RelA reporter mouse line to enable high-throughput live-cell analysis of primary macrophages responding to host- and pathogen-derived stimuli. An information-theoretic workflow identified six dynamical features—termed signaling codons—that convey stimulus information to the nucleus. In particular, oscillatory trajectories were a hallmark of responses to cytokine but not pathogen-derived stimuli. Single-cell imaging and RNA sequencing of macrophages from a mouse model of Sjögren's syndrome revealed inappropriate responses to stimuli, suggestive of confusion of two NFκB signaling codons. Thus, the dynamics of NFκB signaling classify immune threats through six signaling codons, and signal confusion based on defective codon deployment may underlie the etiology of some inflammatory diseases.
Abstract 14308: Treatment Patterns of Discontinuation in New Users of Oral Anticoagulants (OACs) in Patients With Non-Valvular Atrial Fibrillation (NVAF): Real-Word Evidence From NAXOS French Study
Authors: Nicolas Danchin, Isabelle Mahe, Olivier Hanon, Philippe Gabrie Steg, Bruno Falissard, Manon Belhassen, Flore Jacoud, Maeva Nolin, Marine Ginoux, Faustine Dalon, Cinira Lefevre, François-Emery Cotte, Sabrina Gollety, Eric Van Ganse
Journal: Circulation (2019)

Background: Oral anticoagulants (OACs) reduce the risk of thromboembolic events in NVAF patients. Discontinuation of treatment may expose NVAF patients to an increased risk of stroke. The respectiv...
Evaluation of a Pharmacist-Led Penicillin Allergy Assessment Program and Allergy Delabeling in a Tertiary Care Hospital
Authors: Nicholas A. Turner, Rebekah Wrenn, Christina Sarubbi, Renee Kleris, Patricia L. Lugar, Christine Radojicic, Rebekah W. Moehring, Deverick J. Anderson
Journal: JAMA Network Open (2021)

Penicillin allergies are frequently mislabeled, which may contribute to use of less-preferred alternative antibiotics.To evaluate a pharmacist-led allergy assessment program's association with antimicrobial use and clinical outcomes.A pharmacist-led allergy assessment program was launched in 2 phases (June 1, 2015, and November 2, 2016) at a single-center tertiary referral hospital. The longitudinal cross-sectional study included all study period adult admissions; hospitalwide outcomes were assessed by segmented regression. Individual outcomes were assessed within an embedded propensity score-matched case-control study of inpatients undergoing comprehensive allergy assessment following self-report of penicillin allergy. Analysis occurred from March 1, 2020, to February 29, 2020.The longitudinal study analyzed hospital-level outcomes over 3 periods: preintervention (15 months), phase 1 (structured allergy history alone, 16 months), and phase 2 (comprehensive assessment including penicillin skin testing, 52 months). The case-control study defined cases as individuals undergoing comprehensive allergy assessment.Hospital-level outcomes included antibiotic days of therapy per 1000 patient-days and hospital-acquired Clostridioides difficile infection (CDI) incidence per 10 000 patient-days. Individual outcomes included antibiotic selection, overall survival, and CDI-free survival.Longitudinal analysis spanned 2014-2020 (median admissions, 46 416 per year; interquartile range [IQR], 46 001-50 091 per year). Hospitalwide, allergy histories were temporally associated with decreased use of nonpenicillin alternative antibiotics (rate ratio, 0.87; 95% CI, 0.79-0.97) and high-CDI-risk antibiotics (rate ratio, 0.91; 95% CI, 0.85-0.98). Penicillin skin testing was temporally associated with lower hospital-acquired CDI rates (rate ratio, 0.61; 95% CI, 0.43-0.86). The embedded case-control study included 272 cases and 819 controls. Median age was 63 years (interquartile range, 51-73 years), 553 (50.7%) patients were women, and 229 (21.0%) patients were Black. Allergy-assessed patients were less likely to receive high-CDI-risk antibiotics at discharge (odds ratio, 0.66; 95% CI, 0.44-0.98). Estimated reductions in mortality (hazard ratio, 0.77; 95% CI, 0.55-1.07) and hospital-acquired CDI risk (hazard ratio, 0.53; 95% CI, 0.18-1.55) were not statistically significant.Pharmacist-led allergy assessments may be associated with reduced high-CDI-risk antibiotic use at both hospitalwide and individual levels. Although individual reductions in mortality and CDI risk did not achieve significance, divergence of survival curves suggest longer-term benefits of allergy delabeling warrant future study.
Nano-Leish-IL: A novel iron oxide-based nanocomposite drug platform for effective treatment of cutaneous leishmaniasis
Authors: Sriram Kannan, Yifat Harel, Esthy Levy, Avishay Dolitzky, Assaf E. Sagiv, Saurav Aryal, Laila Suleman, Jean-Paul Lellouche, Shulamit Michaeli
Journal: Journal of Controlled Release (2021)
Abstract 16450: Early Identification of High Risk Cardiac Decompensation Phenotypes via Real-time Electronic Health Record Data
Authors: William Ratliff, Zachary K Wegermann, Harvey Shi, Michael Gao, mark sendak, Aman Kansal, Cara O'Brien, Stephanie Skove, Sicong Zhao, Sehj Kashyap, Marshall Nichols, William S Jones, Chetan B Patel, Jason N Katz, Suresh Balu, Ajar Kochar, Manesh R Patel
Journal: Circulation (2020)

Introduction: Early identification of cardiac decompensation remains critical for improved patient outcomes. Digital phenotypes using real-time electronic health record (EHR) data offer an unbiased method to detect decompensation in at-risk individuals. Methods: Phenotypes designed to detect cardiac decompensation and its sequelae were retrospectively evaluated in 108,697 adult patient hospitalizations at a single center from October 2015-August 2018. The 6 phenotypes included hypotension, end organ dysfunction (EOD), hypoperfusion (concomitant hypotension and EOD), escalating vasoactive medication use (vasoactive meds), respiratory decline, and respiratory intervention. Median time from admission to phenotype development was measured in hours. In-hospital mortality and unanticipated ICU transfers were determined across all phenotypes and phenotype combinations. Results: Prevalence and time to detection varied across all six phenotypes (Table 1), with EOD found most frequently (35.7%) and detected earliest (3.4h, IQR 0.9-26.2h). Among individual phenotypes, patients with hypoperfusion had the highest rates of unanticipated ICU transfer (20.62%) and in-hospital mortality (20.99%). Patients meeting at least one phenotype had a 5.90% ICU transfer rate and 5.04% in-hospital mortality rate, compared to 0.62% mortality and 2.19% ICU transfer rates for patients meeting zero phenotypes. Among the 41 measured phenotype combinations, patients meeting all 6 phenotypes had the highest rates of unanticipated ICU transfer (28.75%) and in-hospital mortality (36.45%). Conclusions: Digital phenotypes of decompensation using real-world EHR data identify patients at higher risk of unexpected ICU transfer and in-hospital mortality at early times points in the hospitalization. Further studies will evaluate if implementation of a digital phenotype detection tool can improve care pathways and outcomes.
Long‐term clinical experience with cardiac contractility modulation therapy delivered by the Optimizer Smart system
Authors: Jürgen Kuschyk, Peter Falk, Thomas Demming, Oliver Marx, Deborah Morley, Ishu Rao, Daniel Burkhoff
Journal: European Journal of Heart Failure (2021)

Abstract Aims We assessed long‐term effects of cardiac contractility modulation delivered by the Optimizer Smart system on quality of life, left ventricular ejection fraction (LVEF), mortality and heart failure and cardiovascular hospitalizations. Methods and results CCM‐REG is a prospective registry study including 503 patients from 51 European centres. Effects were evaluated in three terciles of LVEF (≤25%, 26–34% and ≥35%) and in patients with atrial fibrillation (AF) and normal sinus rhythm (NSR). Hospitalization rates were compared using a chi‐square test. Changes in functional parameters of New York Heart Association (NYHA) class, Minnesota Living with Heart Failure Questionnaire (MLWHFQ) and LVEF were assessed with Wilcoxon signed‐rank test, and event‐free survival by Kaplan–Meier analysis. For the entire cohort and each subgroup, NYHA class and MLWHFQ improved at 6, 12, 18 and 24 months ( P &lt; 0.0001). At 24 months, NYHA class, MLWHFQ and LVEF showed an average improvement of 0.6 ± 0.7, 10 ± 21 and 5.6 ± 8.4%, respectively (all P &lt; 0.001). LVEF improved in the entire cohort and in the LVEF ≤25% subgroup with AF and NSR. In the overall cohort, heart failure hospitalizations decreased from 0.74 [95% confidence interval (CI) 0.66–0.82] prior to enrolment to 0.25 (95% CI 0.21–0.28) events per patient‐year during 2‐year follow‐up ( P &lt; 0.0001). Cardiovascular hospitalizations decreased from 1.04 (95% CI 0.95–1.13) events per patient‐year prior to enrolment to 0.39 (95% CI 0.35–0.44) events per patient‐year during 2‐year follow‐up ( P &lt; 0.0001). Similar reductions of hospitalization rates were observed in the LVEF, AF and NSR subgroups. Estimated survival was significantly better than predicted by MAGGIC at 1 and 3 years in the entire cohort and in the LVEF 26–34% and ≥35% subgroups. Conclusions Cardiac contractility modulation therapy improved functional status, quality of life, LVEF and, compared to patients' prior history, reduced heart failure hospitalization rates. Survival at 1 and 3 years was significantly better than predicted by the MAGGIC risk score.
Medicine: An Historical Outline.
Journal: JAMA (1925)

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