tbuckley/cabot-search huggingface dataset:
Abstract 16462: Using Geospatial Mapping to Target Risk and Facilitate Placement of Community Health Workers, Educational Tools, and AHA Field Teams
Authors: Zoe L Zwecker, Susan Spratt, Benjamin A Goldstien, Bradi B Granger
Journal: Circulation (2020)

Introduction: Diabetes is a chronic condition that affects 34.2 million Americans. Long-lasting or undiagnosed diabetes increases the risk of developing cardiovascular disease (CVD). Geographic Information Systems (GIS) inform healthcare delivery interventions to target patients, clinicians, health systems and communities at highest risk. A gap remains in how data and GIS are applied and leveraged in the context of value-based care delivery systems. This spatial analysis demonstrates the application of a generalizable methodology for allocating resources such as AHA Field Teams, community health workers (CHWs), and educational tools to areas most burdened by diabetes and CVD. Methods: The automated geocoding infrastructure from the Duke Medicine electronic data warehouse was developed to standardize and scale geocoding addresses for a population of people with type 2 diabetes from the Southeastern Diabetes Initiative (SEDI) in 2017. While maintaining accuracy and assuring that patients’ protected health information was secure, we used geocoded data and public data (public health data, census tract data, and information on the built environment) to assess risk and identify accessible resources. Results and Discussion: Using this method to understand racial distribution, level of education, and income,we identified high risk communities in Durham County. We correlated geospatial patterns of health risk, illness burden, and determined accessible resources for diabetes and CVD.We calculated a resource ratio of one CHW to 100 patient-population and identified a central hub for fixed resource access. Using neighborhood boundaries, we identified a community where the burden of diabetes reached 17%, 60% of inhabitants were African American, median income was $55,945, and just 17.7% had a bachelor’s degree. Understanding risk using these social determinants (Figure 1) supports the intentional allocation of resources and hiring of CHWs.
구연 : 배양 음성 중성구 복수를 동반한 환자에서 박테리아 DNA 중합효소연쇄반응(PCR)의 유용성
Authors: 조재희, 전재윤, 김윤재, 전태주, 최종원, 안상훈, 박영수, 장경희, 백용한, 이관식, 한광협, 문영명
Journal: Clinical and Molecular Hepatology (2003)

배경/목적: 자발성 세균성 복막염은 복강내 수술적 치료가 가능한 감염의 증거없이 발생하는 세균 감염으로 간경변증의 특징적인 합병증이다. 발생기전은 장관내 세균의 과증식으로 인한 장간막 림프절 세균 이동과 균혈증을 통한 복수내 세균 집락이 원인으로 생각되며, 현재까지는 복수 및 혈액 세균 배양검사를 통해 원인 균주를 진단하였다. 그러나 조기 항생제 투여 및 부적절한 배양 검사로 인해 복막염 원인 균주의 규명은 40-80%에 그치고 있으며, 배양 음성 중성구 복수(culture-negative neutrocytic ascites)의 대부분도 배양 기술 미숙이나 최근의 항생제 투여에 의한 것으로 알려져 복막염 각각의 균주의 규명은 어려운 실정이다. 본 연자 등은 세균 배양 검사상 음성인 자발성 세균성 복막염의 원인 균주 규명을 위해 복수내 박테리아 DNA 중합효소연쇄반응(PCR) 검사의 진단적 유용성을 분석하고자 하였다. 대상과 방법: 2002년 5월부터 2003년 4월까지 병원에서 간경변증으로 진단되어 추적 관찰중, 배양 음성 중성구 복수가 있는 자발성 세균성 복막염 환자 22예를 대상으로 하였다. 대상 환자는 이차성 복막염 혹은 혈복강, 췌장염, 결핵성 복막염 등의 다른 질환 없이, 복통 및 발열 등의 임상증상과 복수내 다형백혈구가 250/mm3 이상이었다. 자발성 세균성 복막염 진단 당시 항생제 투여 전 1회의 복수 배양 검사 및 중합효소연쇄반응(PCR)을 이용한 박테리아 DNA 검사를 시행하였고, 항생제 투여 7일째 다시 복수 배양 검사 및 박테리아 DNA 검사를 시행하였다. 결과: 대상환자의 간경변증 원인은 B형 간염 18예(81.8%), C형 간염 2예(9.1%), 알코올성 2예(9.1%)였으며, Child-Pugh 분류는 B군 1예(4.5%), C군 21예(95.5%) 이었다. 13예(59.1%)의 경우에서는 간암이 동반되었다. 항생제 투여 전 시행한 복수내 박테리아 DNA 중합효소연쇄반응(PCR) 검사상 9예(40.9%)에서 양성소견을 보였으며, 7일간 항생제 투여후 시행한 박테리아 DNA 중합효소연쇄반응(PCR) 검사상 3예(13.6%)에서 양성소견을 보였다. 복수내 박테리아 DNA 중합효소연쇄반응(PCR) 검사상 양성군과 음성군 간의 연령, Child-Pugh 분류, 혈액내 백혈구, 빌리루빈, 알부민, 프로트롬빈 시간과 복수내 백혈구 및 다형백혈구 수치는 의미있는 차이가 없었다. 결론: 복수 박테리아 DNA 중합효소연쇄반응(PCR) 검사의 양성도는 40.9%로, 배양음성 중성구 복수가 있는 자발성 세균성 복막염의 원인 균주 존재 및 규명에 유용할 것으로 생각되고 현재 구체적인 원인 균주 확인을 진행 중이다.
Abstract 031: Age-related Homeostatic Dysregulation In Midlife And Physical Function In Late Life: The Atherosclerosis Risk In Communities (aric) Study
Authors: Yifei Lu, James R Pike, Anna Kucharska-newton, Priya Palta, Eric A Whitsel, Ganga Bey, Anthony Zannas, Gwen Windham, Keenan Walker, Michael Griswold, Gerardo M Heiss
Journal: Circulation (2021)

Introduction: Age-related homeostatic dysregulation (Dm), characterized by multi-biomarker composite measures, has shown promise as a rate-of-aging metric. We tested the association of midlife Dm and its change over ~20 years of follow-up with later life physical function. Methods: We studied 4617 ARIC cohort participants (mean age 54.8 years, 58% female, 20% Black) who completed in-person examinations from 1990-92 (baseline) through 2011-13. Dm quantifies the multivariate statistical deviation of 15 physiology-motivated biomarkers from the distribution in a healthy sample at baseline. Midlife Dm was grouped by quartiles (higher quartiles indicating greater homeostatic dysregulation) and temporal change in Dm was quantified continuously. Physical function was assessed in 2011-13 and included measures from the Short Physical Performance Battery (SPPB) including repeated chair stands, balance, 4-meter walk and grip strength. Associations were quantified using linear regression and ordinal logistic regression as applicable, adjusting for age, sex, race, and education. Results: A graded association was observed between midlife Dm and physical functional performance in late life (Table). Compared to the 1 st quartile of midlife Dm, the odds ratio of a lower SPPB score in late life was 1.19 (95%CI 1.04, 1.35) for the 2 nd quartile, 1.63 (1.41, 1.90) for the 3 rd quartile, and 3.14 (2.60, 3.79) for the 4 th quartile. Similar associations were observed for each of SPPB components and grip strength, either modeled ordinally or continuously. Each standard deviation increase in 10-year Dm change was associated with ~2-3 times the odds of having a poorer physical functional performance. Conclusions: Greater homeostatic dysregulation at midlife and increases in dysregulation during follow-up were associated with poorer physical function in late life. Insights into the factors that lead to progression of multisystem deterioration during midlife may highlight opportunities to preserve functional abilities in late life.
VP4-2021: EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9: Interim analysis of phase III trial of cemiplimab vs. investigator's choice (IC) chemotherapy (chemo) in recurrent/metastatic (R/M) cervical carcinoma
Authors: K.S. Tewari, B.J. Monk, I. Vergote, A. Miller, A.C. de Melo, H.S. Kim, Y.M. Kim, A. Lisyanskaya, V. Samouëlian, D. Lorusso, F. Damian, C-L. Chang, E.A. Gotovkin, S. Takahashi, D. Ramone, J. Pikiel, J. Li, M. Mathias, M.G. Fury, A. Oaknin
Journal: Annals of Oncology (2021)
Abstract 17411: De Novo Protein Synthesis of Alpha-Toxin Activated Platelets
Authors: Michael Buerke, Linda Bingener, Priyanka Boettger
Journal: Circulation (2020)

Introduction: Endovascular infections with bacteria are often devastating with subsequent high morbidity and mortality. Exo- and or endotoxins of bacteria can activate endothelial cells, leukocytes and platelets. Platelets are first line defence they accumulate at sites of vascular injury or infection. Platelet activation is a necessary step in thrombus formation. Nevertheless, stimulation of platelets will result in de novo protein synthesis despite missing nucleus since platelets armed with translational equipment. Methods: In the present study we determined the effect of staphylococcus aureus α-toxin on platelet activation and de novo protein synthesis analysed with 2-D gels, proteomics and phosphorylation analysis. Results: α-toxin induced platelet activation resulted in modulation of de novo protein synthesis of DJ-1 Protein, ras suppressor protein1, PLEK protein, fumaryl aceto acetase sowie das coronin actin binding protein. This synthesis was time- and concentration-dependent and was markedly increased when platelets adhered to collagen or fibrinogen and required ligation of α IIb β 3 . Accumulation of protein synthesis in platelets was blocked by global translational inhibitors and attenuated by inhibitors that regulate signalling through the mammalian Target of Rapamycin (mTOR). In addition with phosphorylation analysis we were able demonstrate modulation of threonine phosphorylation of fumaryl aceto acetase, phosphor threonin signal of coronin actin binding protein, phosphorylation of peroxiredoxin-6, phosphorylation of tropomyosin-2, phosphothreonin signal of H + transporting two sector ATPase upon α-toxin stimulation. Conclusion: Interactions with staphylococcus aureus α-toxin and platelets might lead to their activation and de novo protein synthesis. These results suggest that platelets have an important role in inflammation besides their aggregating duties in inflammatory disease.
インシュリン受容体基質-1非依存性脂肪PAI-1の誘導によるインスリン抵抗性における低線維素溶解の主要決定基
Authors: Furumoto T, Zaman T, Andoh Y, Imagawa S, Jie D, Terauchi Y, Kadowaki T, Fujii S
Journal: Circulation (2005)
Abstract 14860: Echocardiographic Assessment of Shunt Fraction in Complex Cyanotic Heart Diseases Palliated With Aortopulmonary Shunts
Authors: Joan K Lee, briana olson, Neal Jorgensen, Matthew D Files
Journal: Circulation (2020)

Introduction: Neonates with complex heart defects with inadequate pulmonary blood flow require aortopulmonary shunts (APS) either as surgical-placed modified Blalock-Taussig shunt or a catheter-based stent implantation into a patent ductus arteriosus. An ideal APS provides equal pulmonary blood flow (Qp) as the systemic blood flow (Qs), which is considered balanced circulation. Pulmonary over-circulation leads to complications from inadequate systemic circulation, such as organ dysfunction, shock, and death. Accurately determining Qp:Qs ratio in these patients relies on catheterization, which is invasive and may falsely lower the Qp due to anesthetic effects. To our knowledge, there has not been any studies on echocardiographic comparisons of balanced versus overcirculated APS. We aim to evaluate echocardiographic Doppler assessment of velocity-time integral (VTI) at the aortic arch isthmus distal to APS origin as a measure of shunt fraction in APS patients. We defined shunt fraction ratio (SFR) as retrograde to prograde flow by VTI. Methods: This is a retrospective pilot study of neonates with APS. We selected two cohorts of patients with appropriately balanced circulation (n=12) and those with excessive Qp (n=5) resulting in end-organ damage. We analyzed serial echocardiograms, with repeated measurements for inter-observer agreement. Results: Mean SFR is lower in balanced cohort compared to the overcirculated cohort (0.45 ± 0.07 vs. 0.55 ± 0.09, p=0.02). For both groups, SFR was positively associated with oxygen saturation (r= 0.57, p=0.01), as well as markers of ventricular volume load, such as the highest brain naturetic peptide during hospitalization (Pearson’s correlation r=0.83, p= 0.04) and as outpatient (r= 0.72, p =0.02). Inter-observer agreement was 0.74, suggesting that this is a reproducible technique. Conclusions: SFR by VTI is a simple echocardiographic technique to estimate the volume of APS flow and appears to have important implications for clinical outcomes. Prompt characterization of pulmonary overcirculation without invasive assessment could improve clinical management. Further prospective studies are needed to validate these findings.
DNA Methylation in Babies Born to Nonsmoking Mothers Exposed to Secondhand Smoke during Pregnancy: An Epigenome-Wide Association Study
Authors: Bernard F. Fuemmeler, Mikhail G. Dozmorov, Elizabeth K. Do, Junfeng (Jim) Zhang, Carole Grenier, Zhiqing Huang, Rachel L. Maguire, Scott H. Kollins, Cathrine Hoyo, Susan K. Murphy
Journal: Environmental Health Perspectives (2021)

Maternal smoking during pregnancy is related to altered DNA methylation in infant umbilical cord blood. The extent to which low levels of smoke exposure among nonsmoking pregnant women relates to offspring DNA methylation is unknown.
The Utility of Spermidine Serum Levels as a Biomarker of Alzheimer's Disease a Pilot Study
Authors: Sternberg Zohara, Podolsky Rebecca, Nir Adam, Yu Jihnhee, Nir Raphael, Halvorsen Stanley W, Quinn Joseph F, Kaye Jeffrey, Kolb Channa
Journal: Alzheimers Disease & Dementia (2021)

There is a close link between iron and polyamine biosynthesis and metabolism. In a recent study, we reported alterations in the serum levels of hepcidin and other iron-related proteins in Alzheimer's disease (AD) patients (Sternberg, et al., 2017). Based on these findings, this pilot study compared serum levels of one of the polyamines, Spermidine, between AD, mild cognitive impairment (MCI), and control subjects, correlating with the existing neuroimaging data.
Abstract 020: C-reactive Protein As A Moderator And Insulin Resistance As A Mediator For The Association Between Endothelin-1 And Type 2 Diabetes Progression Among African Americans In The Jackson Heart Study
Authors: Xiang Gao, Steven R Horbal, Hao Fan, Le Su, Solomon K Musani, Ervin R Fox, Arnaud D Kaze, Roger S Zoh, Justin Echouffo-Tcheugui, Aurelian Bidulescu
Journal: Circulation (2021)

Objective: Little is known about the moderation and mediation factors among the association between endothelin-1 (ET-1) level and type 2 diabetes progression in African Americans. We explored the role of high sensitivity C-reactive protein (hsCRP) as a moderator and homeostatic model assessment of insulin resistance (HOMA-IR) as a mediator for the association between ET-1 level and type 2 diabetes progression among African Americans enrolled in the Jackson Heart Study (JHS). Methods: We included 1,692 participants free of prediabetes and diabetes at baseline, who attended Exam 1 of the JHS in 2000-2004 and Exam 3 in 2009-2013, and with measured ET-1 level at Exam 1. Incident prediabetes and diabetes were ascertained at Exam 3. We used a sequential regression model procedure. Zou’s modified Poisson multivariable models were used to calculate risk ratios (RR) and 95% confidence intervals (CI) for prediabetes and diabetes. Effect modification was assessed in the multivariable adjusted model. Valeri and VanderWeele’s mediation analysis approach was utilized to evaluate mediation. Results: A higher log-transformed ET-1 level was detected when comparing non-diabetes versus prediabetes and diabetes participants (p-value for trend = 0.03). Compared to quartile 1 (&lt;0.9 pg/mL) of ET-1, quartile 2 (0.9-1.2 pg/mL) of ET-1 was significantly associated with higher risk of prediabetes (RR=1.19 [95% CI 1.02, 1.38]) and diabetes (RR=1.19 [95% CI 1.02, 1.40]). This association only remained significant for diabetes in the multivariable adjusted model (RR=1.20 [95% CI 1.02, 1.40]) and was not attenuated after adjusted for hsCRP (RR=1.20 [95% CI 1.03, 1.40]), HOMA-IR (RR=1.20 [95% CI 1.02, 1.40]), and both hsCRP and HOMA-IR (RR=1.20 [95% CI 1.03, 1.40]) in quartile 2 of ET-1.The risk of elevated ET-1 level on diabetes was higher in participants with increased hsCRP level in the multivariable adjusted model (RR=1.06 [95% CI 1.02, 1.09]), and further adjusted for HOMA-IR (RR=1.06 [95% CI 1.02, 1.09]. The indirect effect of ET-1 on prediabetes through HOMA-IR is 0.96 (P&lt;0.01), but not found for hsCRP (p=0.26). The total effect of ET-1 on prediabetes mediated by HOMA-IR is 47%. No such mediation effect of HOMA-IR was found among diabetes participants. Conclusions: African Americans with higher ET-1 levels have a higher risk of prediabetes and diabetes. Additionally, the risk of diabetes is elevated among those African Americans with increased hsCRP levels. The mediation analysis result supports that ET-1 is involved in the stage of glucose metabolism imbalances leading to diabetes progression.
Repression of CTSG, ELANE and PRTN3-mediated histone H3 proteolytic cleavage promotes monocyte-to-macrophage differentiation
Authors: Peggie Cheung, Steven Schaffert, Sarah E. Chang, Mai Dvorak, Michele Donato, Claudia Macaubas, Mariko H. Foecke, Tie-Mei Li, Lichao Zhang, John P. Coan, Grant S. Schulert, Alexei A. Grom, Lauren A. Henderson, Peter A. Nigrovic, Joshua E. Elias, Or Gozani, Elizabeth D. Mellins, Purvesh Khatri, Paul J. Utz, Alex J. Kuo
Journal: Nature Immunology (2021)
腫瘍微小環境(TME)依存性および自己適応高分子ナノクラスタに基づく光支援階層的腫瘍内浸透およびプログラム化抗腫瘍療法【JST・京大機械翻訳】
Authors: Yan Jing, Wu Qinghua, Zhao Ziyin, Wu Jianhua, Ye Huan, Liang Qiujun, Zhou Zhuchao, Hou Mengying, Li Xudong, Liu Yong, Yin Lichen
Journal: Biomaterials (2020)
Dual and opposing roles of the androgen receptor in VETC-dependent and invasion-dependent metastasis of hepatocellular carcinoma
Authors: Hui-Chao Zhou, Chu-Xing Liu, Wei-Dong Pan, Li-Ru Shang, Jia-Lin Zheng, Bi-Yu Huang, Jie-Ying Chen, Limin Zheng, Jian-Hong Fang, Shi-Mei Zhuang
Journal: Journal of Hepatology (2021)
Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial
Authors: Nuala Calder, Kevin Walsh, Peter Olupot-Olupot, Tonny Ssenyondo, Rita Muhindo, Ayub Mpoya, Jerusa Brignardello, Xuedan Wang, Eleanor McKay, Douglas Morrison, Elaine Holmes, Gary Frost, Kathryn Maitland
Journal: Cell Reports Medicine (2021)

Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) with conventional feeds (ConF, n = 18). Baseline measurements of gut permeability (lactulose:mannitol ratio 1.19 ± SD 2.00), inflammation (fecal calprotectin 539.0 μg/g, interquartile range [IQR] 904.8), and satiety (plasma polypeptide YY 62.6 pmol/l, IQR 110.3) confirm gastrointestinal dysfunction. By day 28, no differences are observable in proportion achieving weight gain >5 g/kg/day (87%, 92%, 86%; p > 0.05), mortality (16%, 30%, 17%; p > 0.05), or edema resolution (83%, 54%, 91%; p > 0.05) among CpF, InF, and ConF. Decreased fecal bacterial richness from day 1 (abundance-based coverage estimator [ACE] 53.2) to day 7 (ACE 40.8) is observed only in ConF (p = 0.025). Bifidobacterium relative abundance increases from day 7 (5.8% ± 8.6%) to day 28 (10.9% ± 8.7%) in CpF (corrected p = 1.000). Legume-enriched feeds support aspects of gut function and the microbiome. Trial registration PACTR201805003381361.
Abstract P173: Physical Activity In Relation To Fasting And Post-meal Blood Glucose In Pregnant Women With Diabetes
Authors: Kimberly L Savin, Linda C Gallo, Britta A Larsen
Journal: Circulation (2021)

Introduction: Pregnant women with diabetes often show low levels of physical activity (PA) and high sedentary behavior (SED). Longitudinal studies with objective measures are needed to understand the relationships of daily PA with daily and next-day blood glucose (BG). Hypothesis: Increased steps or moderate to vigorous PA (MVPA) and decreased SED are linked with lower post-meal BG and next day fasting BG in pregnant women. Methods: Participants were 10 pregnant women with diabetes [mean age= 29.3 (SD= 3.6); mean gestational age= 21.9 (SD= 3.9); 90% (9 of 10) Latina] enrolled in a 12-week pilot PA intervention. Participants self-reported demographic and BG data (morning fasting BG, up to 3 daily post-meal BGs). Steps, MVPA (mins/day), and SED (mins/day) were measured using a Fitbit Alta HR. Participants had on average 49 (range: 21 to 77) days with valid PA and BG data, for a total of 469 observations. Multi-level models (MLMs) were fit to examine mean and day-level effects of steps, MVPA, and SED on post-meal and next-day fasting BG after adjusting for age, gestational age, education, and participant mean PA or SED. Due to the small sample size, effect sizes are emphasized in results instead of statistical significance. Results: The mean post-meal BG was 122.5 mg/dL and mean fasting BG was 92.81 mg/dL. After adjustment, an increase of mean steps by 1000 was linked to a lower mean post-meal BG by 11.79 mg/dL (p=0.22) and fasting BG by 7.26 mg/dL (p=0.54), though neither between effect was statistically significant. The within-individual effects of daily steps on post-meal and fasting BG were very small and non-significant (b=-1.78; p=0.59; b=0.72; p=0.30, respectively). A 1-minute increase in mean MVPA was associated with a slight increase in mean post-meal BG by 1.53 mg/dL (p=0.07). The within-individual effect of daily MVPA on daily post-meal BG was negligible and non-significant (b=-0.39, p=0.51). Between-individual effects showed SED had small, positive, non-significant associations with post-meal BG. Specifically, per 60-minute mean SED increase, mean post-meal BG increased by 1.02 mg/dL (p=0.44). Within-individual daily SED increases of 60 minutes were associated with increases of 1.87 mg/dL (p=0.63) in daily post-meal BG. MVPA and SED were not associated with fasting BG. Conclusions: Greater mean steps were linked to lower post-meal and fasting BG while greater SED and MVPA were linked to greater post-meal BG. However, within individual daily increases in MVPA and decreases in SED, were protective for post-meal BG, while controlling for individual mean MVPA and SED. Most effect sizes were small and results were not statistically significant in part due to the small sample size. Participants generally had well-controlled post-meal and fasting BGs, so results may not be generalizable to larger populations.
Abstract 006: Predictors Of Establishing Outpatient Care Following A Heart Failure Hospitalization In Rural And Urban Dwelling Underserved Populations
Authors: Stephen Clarkson, Todd Brown, Erin Clarkson, Reid Eagleson, Connie White-Williams
Journal: Circulation (2021)

Objective: The HRTSA (HeaRt Failure Transitional Services for Adults) clinic at the University of Alabama at Birmingham Hospital serves underinsured individuals with heart failure (HF). We examined the frequency and predictors of rural and urban dwelling individuals establishing care after a HF hospitalization. Methods: We included individuals ≥18 years of age referred to the HRTSA clinic after a HF hospitalization from 2016-2019. We used zip code of residence and the Rural-Urban Commuting Area classification system to define urban or rural. Urban zip codes have &gt;30% of workers commuting to Census Bureau defined urbanized areas. We defined establishing care as attending the first clinic visit. Sociodemographic and clinical variables were collected at the time of referral and compared between groups using chi-square or t-tests as appropriate. Multivariable logistic regression was used to identify predictors of establishing care separately in urban and rural dwelling individuals. Results: Of 855 individuals referred to the HRTSA clinic after a HF hospitalization, mean age was 50±11 years, 15% were rural dwelling, 59% were African American (AA), and 32% were female. Rural dwelling individuals were less likely to establish care than their urban counterparts, although not statistically significant (71% vs. 77%; p=0.16). In rural dwelling individuals, AAs (OR 0.11, 95% CI 0.04-0.31), those with diabetes (OR 0.26, 95% CI 0.09-0.81), and current alcohol users (OR 0.25, 95% CI 0.08-0.83) had lower odds of establishing care; whereas in urban dwelling individuals, AAs (OR 2.75, 95% CI 1.65-4.59) and those with no insurance (OR 6.22, 95% CI 3.55-10.90) had higher odds of establishing care after multivariable adjustment (Table). Conclusions: We identified a significant disparity in AAs. Rural dwelling AAs with HF had lower odds of establishing care after a HF hospitalization, whereas urban dwelling AAs with HF had higher odds. Efforts to reduce this disparity are warranted to improve HF care in rural dwelling AAs.