tbuckley/cabot-search huggingface dataset:
Abstract 13756: The Hematopoietic and Megakaryocytic Protective Effect of PDGF-BB on Radiation-Induced Myelosuppression Model
Authors: Huimin Kong, Liang Li, Hui Chen, xiaocheng zhao, hua zhang, Weiqing Su, Yi Luo, Mo Yang
Journal: Circulation (2021)

Introduction: Platelet-derived growth factors (PDGF) was initially purified from platelets and characterized as a mitogen for fibroblasts and smooth muscle cells. The PDGF family comprises four different genes that form at least five different dimers, including PDGF-AA, AB, BB, CC and DD. In the hematopoietic system, genetic studies have reported that knock-out mice for PDGF-BB show anemia and thrombocytopenia. PDGF also stimulates the proliferation of megakaryocytes, erythrocytes, leukocytes, and their progenitors, and enhances the expansion of megakaryocyte progenitors from human CD34+ cells. Methods: Blood counts, bone marrow histology, and CFU were performed to investigate the protective effect of PDGF-BB on mice bone marrow hematopoiesis. Flow cytometry was used to detect early apoptosis (Annexin V), mitochondrial membrane potential (JC-1) and Caspase-3 of Meg-01. Results: Peripheral blood count showed that PDGF stimulated the recovery of white blood cells and platelets on radiation-induced myelosuppression model (P&lt;0.01, n=4). Bone marrow histology showed that the numbers of megakaryocytes and their progenitor cells were higher than that in PDGF-BB group. PDGF-BB significantly stimulated the formation of CFU-MK, CFU-GM, BFU-E and CFU-F (P&lt;0.01, n=4). PDGF-BB had a dose-dependent effect on cell proliferation in the range of 5-50 μg/mL in vitro (P&lt;0.001, n=4). Late apoptotic and necrotic cells (Annexin V +, PI +) and total dead cells (Annexin V +) were decreased in the PDGF-BB (50 μg/ml) group (P&lt;0.01, n=4). The mitochondrial membrane potential in the PDGF-BB group was increased when compared with control group, which indicated that the number of apoptotic cells was decreased (P&lt;0.01, n=4). Besides, the expression of Caspase-3 in PDGF-BB treatment group was also lower than that in control group (P&lt;0.05, n=4). Conclusions: PDGF-BB has a hematopoietic protective effect on the myelopoietic mice model, especially on megakaryocytes and their progenitor cells. It has proliferative and anti-apoptotic effects on Meg-01, and the mechanism may be mediated through JC-1 and Caspase-3 pathway.
QOLP-10. A LONGITUDINAL OBSERVATIONAL STUDY OF EXERCISE BEHAVIOR IN GLIOBLASTOMA PATIENTS TREATED WITH TUMOR-TREATING FIELDS
Authors: Katherine Peters, Mary Affronti, Jung-Young Kim, Mallika Patel, Margaret Johnson, David Bartlett, Nicole Cort, Eric Lipp, Deborah Iden, Gloria Broadwater, James Herndon, Daniel Landi, Mustafa Khasraw, Annick Desjardins, Henry Friedman, David M Ashley
Journal: Neuro-Oncology (2021)

Abstract Glioblastoma (GBM) patients can use tumor-treating fields (TTFs) with adjuvant temozolomide (TMZ) to treat their disease. TTFs involve wearing transfixed transducers to the shaved scalp, and the transducers are wired to a battery pack that is either fixed or carried (weighing 2.7 pounds). EF-14 clinical trial did evaluate health-related quality of life with standardized patient-report outcome measures but did not measure exercise behavior. We sought to evaluate the exercise behavior of GBM patients using TTFs. We consented GBM patients who intended to use TTFs with adjuvant TMZ after completion of chemoradiation. After informed consent and before starting TTFs, patients completed a self-administered questionnaire, Godin Leisure-Time Exercise Questionnaire, to assess exercise behavior/physical function. To calculate our primary outcome of total exercise behavior, the frequency of exercise sessions per week within each intensity category was multiplied by the average reported duration, weighted by an estimate of the MET, summed across all intensities, and expressed as average MET-hr/wk. Prior work has defined that physical function can be compared as &amp;lt; 9 MET-h/wk vs. ≥ 9 MET-h/wk. We evaluated at baseline and up to 24-week exercise behavior in patients with TTFs vs. historical controls not using TTFs. We enrolled 19 total GBM patients, with 14 proceeding to use TTFs. Of the 14 patients on TTFs, seven patients (50%) completed ≥ 9 MET-h/wk of exercise, and this level was maintained 8, 16, and 24 weeks after starting TTFs. Six months after the completion of chemoradiation, mean MET-h/wk was decreased in the TTFs group (n=6) (10.71 sd=7.06) vs. historical controls (n=38) (27.35 sd=46.94). TTFs did not interfere with exercise behavior in our GBM cohort, but when compared to GBM patients not utilizing TTFs, there could be a long-term impact on exercise behavior. More research is needed to evaluate exercise behavior in GBM patients using TTFs.
IOTG-01. Computational Neurosurgery in Brain Tumors: A paradigm shift on the use of Artificial Intelligence and Connectomics in pre- and intra-operative imaging
Authors: Antonio Di Ieva, Carlo Russo, Abdulla Al Suman, Sidong Liu
Journal: Neuro-Oncology (2021)

Abstract Computational Neurosurgery is a novel field where computational modeling and artificial intelligence (AI) are used to analyze diseases of neurosurgical interest. Our aim is to apply AI models to brain tumor (BT) images to a) automatically segment BTs on pre-operative MRI, b) predict the genetic subtype of glioma on intra- and post-operative histological specimens; and c) predict the extent of resection according to connectomics data. For the segmentation task, we used 510 BT images to train a deep learning (DL) model for automatic segmentation of the tumors’ edges and comparison of the AI-generated masks versus experts’ consensus (quantified by means of the dice score). For the histopathology task, we digitalized 266 hematoxylin/eosin slides of gliomas (including 130 IDH-wildtype and 136 IDH-mutant) and applied a DL architecture to predict the IDH genetic status, then validated by immunohistochemistry and genetic sequencing. The datasets were also augmented by generating synthetic glioma images by means of a Generative Adversarial Network methodology. The resection of 10 BTs was also customized according to connectomics data. In the segmentation experiment, we reached a dice score of ~0.9 (out of 1.0), while further demonstrating that only the T1, T1 after gadolinium, and FLAIR sequences are necessary for accurate automatic segmentation. In the histopathology task, we were able to predict the genetic status with accuracy between 76% and 95% using the DL model. The machine learning-based connectome analysis allowed us to perform safe supramaximal resection. We have shown the robustness of applying AI methodology or the automatic segmentation of BTs in MR imaging. Moreover, we have also shown that AI can be used to predict the genetic status, specifically, IDH, in histopathology images of gliomas. Our results support the use of AI in the clinical scenario for a fast and objective computerized characterization of patients affected by BTs.
Abstract 9193: Peripheral Artery Disease and the Risk of Venous Thromboembolism
Authors: Daniel Sykora, Shubhang K Bhatt, Andrew S Tseng, Marlene Girardo, Christine Firth, Alanna M Chamberlain, Paul W Wennberg, David Liedl, Fadi E Shamoun
Journal: Circulation (2021)

Introduction: Peripheral artery disease impacts 202 million patients worldwide and is commonly diagnosed via ankle-brachial index. PAD is associated with endothelial dysfunction, which is also common to venous thromboembolism formation. Despite the suspected overlap in pathogenesis, few studies exist investigating the association between these pathologies. We investigated whether PAD with low or elevated ABI is an independent risk factor for VTE. Methods: We reviewed medical records of patients ≥18 years old undergoing ABI measurement with or without PAD symptoms from 01/01/1996 to 08/31/2018 and classified patients by ABI: severely low (ABI 0.00-0.39), moderately low (0.40-0.69), mildly low (0.70-0.90), borderline (0.91-0.99), normal (1.00-1.40), and elevated (&gt;1.40). The primary outcome was incident VTE event after ABI measurement, defined as deep vein thrombosis or pulmonary embolism. Multivariable Cox proportional regression was used to calculate hazard ratios (HR) with 95% confidence intervals after adjusting for age, sex, active smoking, cancer or VTE history, thrombophilia, anticoagulation, and revascularization within 14 days of VTE. Results: In 39,384 unique patients (mean age 66.3±14.2 years, median follow-up 34 months), 5,141 VTE events were observed. Increased VTE risk was observed in PAD patients with severely low ABI (HR 1.26, 95%CI [1.02, 1.29]) compared to patients with normal ABI after multivariable regression. Patients with elevated ABI did not demonstrate an increased risk of VTE. Conclusions: Patients with severe PAD are at higher risk for VTE than patients with normal ABI, which may be due to a multifactorial pathophysiology of profound endothelial injury as well as immobility due to claudication. Further exploration of VTE incidence in patients with severe PAD stratified by functional status is warranted to determine the optimal strategy to minimize thromboembolic morbidity and mortality in this population.
Abstract 13582: A Quality Improvement Project to Increase Primary Care Follow Up After Congestive Heart Failure Exacerbation in an Academic Medical Center Using a Quality and Safety Award
Authors: Lea Monday, Joseph Sebastian, Paul Nguyen, Omid Yazdanpanah, Caleb Solokowski, Jane Chi, KAREEM BAZZY
Journal: Circulation (2021)

Introduction: Readmission after Congestive heart failure (CHF) exacerbation may be reduced by early follow-up with primary care physicians (PCP). We present a resident-driven quality improvement (QI) initiative to increase early follow-up for Veterans after CHF exacerbation. Primary outcomes were percentage of PCP follow-up within 7-days and median time to follow-up. Secondary outcomes were percentage of patients attending a PCP visit within 7-days, 30-day readmission, and mortality. Methods: This pre-post quasi-experimental study evaluated concurrent QI interventions including a standardized discharge scheduling order, monthly education, and aggregated performance feedback for medical residents with an award to the team with the highest rate of PCP appointments scheduled within 7-days (Fig 1). Patient characteristics and outcomes for a 6-month historic period and 6-month intervention period were compared using test of proportions and Wilcoxon Rank-Sum test. Results: A total of 294 patients were discharged due to CHF exacerbation (161 in historic group and 133 in intervention group). Appointments scheduled within 7-days increased from 43% to 79% (p&lt;0.001). Median time to follow-up decreased from 8 to 6 days (p&lt;0.001). A control chart is shown in figure 2. Patients who completed a PCP appointment within 7-days increased from 16% to 41% (p&lt;0.001). 30-day readmission and mortality were unchanged. Conclusion: A standardized discharge scheduling order, robust resident education, and a monthly patient safety and quality award resulted in a significant increase in the rate of primary care follow-up within 7-days of CHF exacerbation.
Abstract 11206: In-Hospital Outcomes of Aortic Valve Repair in Diabetes Patients: Data from the National Inpatient Sample
Authors: Sarah Khan, SOHA DARGHAM, Jassim M Al suwaidi, Hani Jneid, Charbel Abi Khalil
Journal: Circulation (2021)

Introduction: Diabetes is associated with increased cardiovascular complications. Hypothesis: We hypothesized that patients hospitalized for aortic valve repair have a worse outcome in the presence of diabetes. Methods: Data from the National Inpatient Sample (NIS) was analysed between 2012 to 2017. We compared hospitalization, in-hospital cardiovascular outcomes and socio-economic outcomes between patients with diabetes vs non-diabetes hospitalized for SAVR and TAVR. Results: In diabetes patients undergoing TAVR, mean age of participants decreased from 79.6 ±8 to 67.8 ±8, total cases increased from the number of cases increased from 2280 to 18940 (p&lt;0.002 for both). Mortality, acute renal failure (ARF) and stroke decreased with time. When compared to non-diabetic patients, diabetes patients were younger and had a similar risk of mortality. However, they had a higher risk of stroke and ARF (adjusted OR= 1.174 [1.03-1.34], 1.294 [1.24-1.35]; respectively). In diabetes patients undergoing sAVR, mean age of participants decreased from 70.4 ±10 to 68 ±9 (p&lt;0.001). Total cases remained stable but mortality, bleeding, acute renal failure and vascular complications decreased with time (p&lt;0.036 for all). When compared to non-diabetic patients, diabetes patients were older and had a higher risk of mortality, stroke and ARF (adjusted OR= 1.115 [1.06-1.17], 1.140 [1.05-1.23], 1.217 [1.18-1.26]; respectively). Mortality of diabetes patients undergoing TAVR was initially higher than those in the TAVR group. However, the trend was inversed starting 2014 (Figure 1) Conclusions: Mortality and other cardiovascular outcomes are decreasing with time in patients with diabetes undergoing aortic valve repair. In TAVR patients, there was no difference in the burden of diabetes on mortality. However, SAVR patients with diabetes still experience a higher mortality rate. Nevertheless, most post-procedural complications are higher in the presence of diabetes
Global Phase 3, Randomized, Placebo-Controlled Trial with Open-Label Extension Evaluating the Oral CXCR4 Antagonist Mavorixafor in Patients with WHIM Syndrome (4WHIM): Trial Design and Enrollment
Authors: David C. Dale, Laia Alsina, Antoine Azar, Raffaele Badolato, Ashish Bhandari, Andrea Belschner, Yves Bertrand, Diego Cadavid, Kathryn E. Dickerson, Navid Ezra, Henrik Hasle, Harold Hoffman, Honghua Jiang, Hyoung Jin Kang, Sorena Kiani-Alikhan, Taco W. Kuijpers, Aleksandr D. Kulagin, Daman Langguth, Carina Levin, Richard MacLeod, Olaf Neth, Jane Peake, Yulia Rodina, Anjali Sharathkumar, Anna Shcherbina, Weihua Tang, Matthias G. Vossen, Jean Donadieu
Journal: Blood (2021)
The complex associations between late life depression, fear of falling and risk of falls. A systematic review and meta-analysis
Authors: Eleonora Gambaro, Carla Gramaglia, Danila Azzolina, Daiana Campani, Alberto Dal Molin, Patrizia Zeppegno
Journal: Ageing Research Reviews (2021)

Depression rates in older people worldwide vary from 10% to 15% of community-dwelling older persons. There are two others problems related to depression in old age, namely the high incidence of falls and the so-called fear of falling (FOF), with a prevalence ranging from 20% to 85%; it was initially considered a post-fall syndrome, which later as a fall-independent event. Study aims to conduct a systematic review and meta-analysis to bridge the existing gap in literature about the association between depressive symptomatology, FOF, use of antidepressant therapy and falls, also identifying a possible effect of the study quality on the outcome. The selection of studies was carried out between May 20, 2020, and July 27, 2020 and only observational clinical trials, written in English, with participants aged more or equal to 60 years affected by diagnosis of depression or treatment for depression mentioned both as a clinical diagnosis in older patient, and as a predictor/consequence of falls were included. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for reporting systematic reviews and meta-analysis, and the protocol was recorded in the International Prospective Register of Systematic Reviews (PROSPERO). The screening process ultimately led to the inclusion of 18 articles. Many of the included studies showed that depressive symptoms caused the subsequent increase in the number of falls. Results from the meta-analysis had no highlighted association between depression and falls, in contrast to other review and meta-analysis works: our work includes a substantial number of studies, with a relatively recent publication date, including patients diagnosed with depression, clearly evaluating the association between depression and falls. Results all seem to confirm the hypothesis of an interdependent association between the presence of FOF and the risk of fall, despite the high percentage of cross-sectional studies prevents inferring on the direction of the association. Therapeutic interventions aimed at decrease rate of falls reducing depressive symptoms and FOF.
Abstract 6988: The Role of Frailty in Identifying Benefit from Transcatheter versus Surgical Aortic Valve Replacement
Authors: Jordan B Strom, Jiaman Xu, Ariela R Orkaby, Changyu Shen, Brian Charest, Dae H Kim, David J Cohen, Daniel B Kramer, John Spertus, Robert E Gerszten, Robert W Yeh
Journal: Circulation (2021)

Background: Frailty is associated with a higher risk for adverse outcomes after aortic valve replacement (AVR) for severe aortic valve stenosis, but whether or not frail patients have differential benefit from transcatheter (TAVR) vs. surgical (SAVR) AVR is uncertain. Methods: We linked adults ≥ 65 years old in the US CoreValve High Risk (HiR) or Surgical or Transcatheter Aortic-Valve Replacement in Intermediate Risk Patients (SURTAVI) trial to 100% Medicare claims 2/2/2011-9/30/2015. Two frailty measures, a deficit-based (DFI) and phenotype-based (PFI) frailty index, based on the Rockwood and Fried definitions of frailty respectively, were generated for linked individuals. The absolute and relative treatment effect of TAVR vs. SAVR were evaluated within frailty index (FI) tertiles for the primary endpoint of death and non-death secondary outcomes, as defined by the trials, using multivariable Cox regression. Functional status decline was additionally in TAVR vs. SAVR by FI tertile using multivariable logistic regression. Results: Of 1,442 (linkage rate = 60.0%) individuals in the linked HiR and SURTAVI trials, 741 (51.4%) individuals received TAVR and 701 (48.6%) received SAVR (mean age 81.8 ± 6.1 years, 44.0% female, mean Society of Thoracic Surgeons risk score 5.9 ± 2.7). Those in higher FI tertiles had a greater burden of comorbidities. Though the rates of death in the highest FI tertiles (DFI 38.6%, PFI 33.8%) were 2-3-fold higher than the lowest tertile (DFI 14.8%, HR 2.86, 95% CI 2.15-3.79, p &lt; 0.001; PFI 17.9%; HR 2.05, 95% CI 1.58-2.67, p &lt; 0.001), there were no significant differences in the relative or absolute treatment effect of SAVR vs. TAVR across FI tertiles for all death, non-death, and functional outcomes (all interaction p-values &gt; 0.05). Results were overall consistent across individual trials and frailty definitions ( Figure ). Conclusions: Among CoreValve trial participants linked to Medicare claims, two different frailty indices based on Fried and Rockwood definitions identified individuals at higher risk of death and functional decline but no differential benefit from TAVR vs. SAVR.
Abstract 10986: Use of the “Pill in the Pocket” Approach for Atrial Fibrillation Termination as Determined from the Antiarrhythmic Medication for Atrial Fibrillation (AIM-AF) Study: A Physician Survey on the Prescription of Antiarrhythmic Drugs in the USA and Europe
Authors: James A Reiffel, Carina Blomstrom-Lundqvist, Giuseppe Boriani, Andreas Goette, Peter R Kowey, Jose L Merino, Jonathan P Piccini, Sanjeev Saksena, Alan Camm
Journal: Circulation (2021)

Introduction: USA and European guidelines recognize that an oral antiarrhythmic drug (AAD) for acute conversion of symptomatic atrial fibrillation (AF) can be effective in AF termination, provided a drug with rapid effect is used and safety precautions are followed. How the ‘pill in the pocket’ (PIP) approach is used in physicians’ practices has not been examined. We performed a survey to understand clinicians’ AAD PIP prescription practices in the USA and Europe. Methods: An online physician survey of 629 cardiologists and interventional electrophysiologists (EPs) was conducted in the USA, Germany, Italy, Sweden, and the UK. Respondents were treating ≥10 AF patients who received AAD therapy and/or had received or were referred for ablation. This exploratory survey contained 96 questions on physician demographics, AF types, and drug treatment practices. Results: Respondents in the USA and Europe, reported PIP use in 24% and 19% of their patients, respectively. Frequency of PIP use was greatest in paroxysmal AF without structural heart disease (SHD; 41%) vs paroxysmal AF with SHD (16%). In contrast to guideline recommendations, PIP was used in persistent AF (pers-AF) in 18% without SHD and in 12% with SHD. Use for pers-AF was highest in the USA and by EPs. For AF without SHD, class IC AADs were used most often (flecainide, 77%; propafenone, 32%), but there was notable use of amiodarone (Amio) (13%) and sotalol (Sot) (13%), the latter more in the USA and by EPs. For AF with SHD, class IC use diminished considerably. PIP was given with a rate control agent (new or chronically, beta blocker &gt; calcium channel blocker) in 71%, while 29% gave PIP AADs without concomitant rate control agents. Optimal arrhythmia frequencies for PIP were felt to be: monthly (13%), q2-3 months (46%), q4-6 months (26%), q7-12 months (11%), and yearly or less (4%), with no notable differences between the USA and Europe, or cardiologists and EPs. Conclusions: Our survey revealed that clinicians in both the USA and Europe use PIP in almost a quarter of their patients, mostly for AF with minimal or no heart disease (guideline appropriate). However, Amio and Sot use for PIP and use of PIP for pers-AF was evident, highlighting the need for further interventions on the appropriate and optimal use of the PIP strategy.
Analysis of Polymorphism in the Genes TLR3, TLR4 and TLR9 in Patients with Acute Myeloid Leukemia
Authors: Justyna Rybka, Katarzyna Bogunia-Kubik, Bartłomiej Kuszczak, Elżbieta Kalicińska, Piotr Łacina, Marta Dratwa, Tomasz Wróbel
Journal: Blood (2021)
Abstract 14085: Evaluating the Geographical Dispersion and Outcomes of Carotid Artery Revascularization in the United States: A Report From the Vascular Quality Initiative
Authors: Michael N Young, Stanislav Henkin, Stephen Kearing, Alexander Iribarne, Philip P Goodney, Jesse Columbo
Journal: Circulation (2021)

Introduction: Carotid artery revascularization - including endarterectomy (CEA) and stenting (CAS) - is the standard of care for severe carotid stenosis. The contemporary geographic dispersion of CAS relative to CEA is not well described and has implications on access-to-care in the United States. Methods: We identified 83,825 patients undergoing CEA and CAS between 2015-2019 among participating centers in the Vascular Quality Initiative. Patients were stratified according to type of revascularization and by urban vs. rural geographical designation based on Rural Urban Commuting Area coding. For CEA and CAS cohorts, demographic profiles and clinical outcomes were compared between urban vs. rural patients. Multivariable logistic regression was performed to estimate the association of geographical locale with 30-day and 1-year outcomes. Results: There was a progressive annual increase in CAS, CEA, and the relative ratio of CAS/CEA performed throughout the study period. (Figure 1) The proportion of carotid stents increased from 25.1% in 2015 to 48.7% in 2019. This finding was consistent in both rural (28.7% to 51.4%) and urban areas (23.9% to 47.7%). In both CEA and CAS cohorts, demographic characteristics, medical profiles, and in-hospital outcomes were overall comparable between rural and urban subgroups. For CAS, geographic locale was not associated with 30-day or 1-year mortality (OR 1.12, 95% CI 0.89-1.41; p=0.34 and OR 1.11, 95% CI 0.97-1.28; p=0.13, respectively). Similarly for CEA, 30-day and 1-year mortality were not significantly different between rural vs. urban subgroups (OR 1.04, 95% CI 0.84-1.29; p=0.72 and OR 1.05, 95% CI 0.94-1.17; p=0.40). Conclusions: Over a short time period, there has been progressive uptake in the relative use of CAS and CEA across the United States. There were no significant differences in either short- or long-term outcomes of carotid revascularization based on rurality.