tbuckley/cabot-search huggingface dataset:
Reducing low risk of transmissible infection in duodenoscopes: at what cost to the planet?
Authors: Anjan Dhar, Bu'Hussain Hayee, Emma Wesley, William Stableforth, Shaji Sebastian
Journal: Gut (2021)

We read with interest the paper by Bang et al on the equivalence of single-use duodenoscopes compared with conventional reusable duodenoscopes to prevent transmissible infections.1 We congratulate the authors for their study demonstrating the economic, technical and safety equivalence of single-use duodenoscopes to conventional reusable duodenoscopes for endoscopic retrograde cholangiopancreatography (ERCP).

The drive toward single-use endoscopes was generated by the incidence of duodenoscope-related infections in the USA, prompting the Food and Drug Administration in 2019 to recommend that healthcare providers and manufacturers transition to disposable components in duodenoscopes to reduce transmissible infections. A systematic review and meta-analysis of the rate and impact of duodenoscope infection involved 15 studies with over 13 000 duodenoscope analysis and found a 15.25% rate of contamination from preprocessed patient-ready duodenoscopes.2

It must be stated that the risk …
ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN YOUNG AND VERY YOUNG PATIENTS:INCIDENCE AND OUTCOMES FROM THE MIDWEST STEMI CONSORTIUM
Authors: Ilias Nikolakopoulos, Brynn Okeson, Christian Schmidt, Santiago Garcia, Timothy Henry, Scott Sharkey, Mario Gossl, Ivan Chavez, Michael Mooney, Jay Traverse, Yale Wang, Anil Poulose, Paul Sorajja, M. Nicholas Burke, Judit Karacsonyi, Evangelia Vemmou, Emmanouil Brilakis
Journal: Journal of the American College of Cardiology (2021)
Tissue Engineering: Stabilization of Damaged Articular Cartilage with Hydrogel‐Mediated Reinforcement and Sealing (Adv. Healthcare Mater. 10/2021)
Authors: Jay M. Patel, Claudia Loebel, Kamiel S. Saleh, Brian C. Wise, Edward D. Bonnevie, Liane M. Miller, James L. Carey, Jason A. Burdick, Robert L. Mauck
Journal: Advanced Healthcare Materials (2021)

In article number 2100315 by Robert L. Mauck and co-workers, a hyaluronic acid (HA) system is used to modify the surface of damaged cartilage. This interdigitating microenvironment enhances the multi-scale mechanics of degenerated cartilage, restoring the response of chondrocytes within. This modified tissue surface can then be used to improve the adhesion and behavior of stem cells, providing a route to “seal” cartilage defects. Together, this combined reinforcement and sealing may present an innovative therapy for the treatment of damaged cartilage.
Abstract 12802: Trajectory of Recovery Following Sudden Cardiac Arrest After an Initial Icd in a Social Cognitive Theory Intervention
Authors: Cynthia M Dougherty, Ana Carolina Sauer Liberato, Ka Yee Kwan, Tao Zheng, Johathon Auld, Megan M Streur, Elaine A Thompson
Journal: Circulation (2020)

Introduction: Sudden cardiac arrest (SCA) survivorship results in unique issues in return to physical &amp; psychological functioning. The purpose of this study was to examine trajectories of recovery between SCA survivors &amp; other patients who received an initial secondary prevention implantable cardioverter defibrillator (ICD) &amp; participated in a social cognitive theory (SCT) intervention. Hypothesis: One-year recovery trajectories will differ for SCA survivors vs others who received an ICD for secondary prevention. Methods: 168 (129 men, 39 women) who received an ICD for secondary prevention [VF cardiac arrest (N=65), ICD other reason (N=103)] were randomized to a SCT intervention (N=85) or usual care (N=83). The SCT intervention consisted of 8 weeks of nurse led telephone coaching &amp; self-management strategies to enhance recovery over 1 year. Outcomes measured at baseline hospital discharge, 1, 3, 6, &amp; 12 months included: 1) Physical Function [Patient Concerns Assessment (PCA), SF-36 (PCS)]; 2) Psychological Adjustment [State Trait Anxiety Inventory (STAI), CES-D depression, SF-36 (MCS)]; &amp; 3) Self-Efficacy [SCA Self-Efficacy (SCA-SE), Self-management behaviors (SMB), Outcome Expectations (OE)]. Outcome differences were compared over 12 months by intervention group (SCT vs UC) &amp; by SCA vs. ICD-other groups, using general estimating equations (GEE), adjusting for baseline age, gender, &amp; ethnicity. Results: Participants were Caucasian (89%), averaged 63.95±12.3 years, EF% 33.95±13.9, BMI 28.19±6.2, &amp; Charlson Index 4.27±2.3. No significant demographic differences were noted between groups. Physical function (PCS) remained low &amp; anxiety (STAI) high in all groups over time. Self-efficacy (SCA-SE) was lower in SCA survivors compared to others. Physical symptoms (PCA) decreased significantly (Wald X 2, 8.38, p=0.04) for SCA survivors vs. ICD-others over 1 year; Psychological Adjustment (MCS) was significantly lower in SCA survivors in the SCT intervention at 6 months &amp; recovered at 12 months (Wald X 2 , 7.25, p=0.05); OEs were significantly lower for SCA survivors in the SCT intervention (Wald X 2 , 6.99, p=0.008). Conclusion: SCA survivors had fewer physical symptoms, lower levels of mental health &amp; OE over 12 months, despite a SCT intervention.
Covid-19: Offer staff military-style mental health support, say healthcare leaders
Authors: Abi Rimmer
Journal: BMJ (2021)

The government should take inspiration from the mental health services offered to veterans when designing services for NHS staff who have worked during the pandemic, leading healthcare organisations have urged.

The call from 13 organisations, including the BMA and several royal colleges, follows research conducted by Neil Greenberg, professor of defence mental health, and colleagues, which showed that NHS staff working in critical care during the pandemic reported more than twice the rate of probable post-traumatic stress disorder (PTSD) than the rate found in military veterans who had recently experienced combat.1

In a letter to England’s health secretary Matt Hancock, the healthcare organisations acknowledged the government’s …
Natural products as geroprotectors: An autophagy perspective
Authors: Stephen D. Raj, David Y. Fann, Esther Wong, Brian K. Kennedy
Journal: Medicinal Research Reviews (2021)

Over the past decade, significant attention has been given to repurposing Food and Drug Administration approved drugs to treat age-related diseases. In contrast, less consideration has been given to natural bioactive compounds. Consequently, there have been limited attempts to translate these compounds. Autophagy is a fundamental biological pathway linked to aging, and numerous strategies to enhance autophagy have been shown to extend lifespan. Interestingly, there are a number of natural products that are reported to modulate autophagy, and here we describe a number of them that activate autophagy through diverse molecular and cellular mechanisms. Among these, Urolithin A, Spermidine, Resveratrol, Fatty Acids and Phospholipids, Trehalose and Lithium are featured in detail. Finally, we outline possible strategies to optimise and increase the translatability of natural products, with the overall aim of delaying the ageing process and improving human healthspan.
Abstract 13047: Plasma Protein Expression and Incident Cvd, and the Role of Resilience: Results From the Mediators of Atherosclerosis in South Asians Living in America (masala) Study
Authors: Long Ngo, Austin Argentieri, Simon Dillon, Alka M Kanaya, Alexandra Shields, Towia Libermann
Journal: Circulation (2020)

Introduction: Few proteomics studies have included non-white individuals, and none have explored the influence of resiliency resources on the association between proteins and cardiovascular disease (CVD). Religious and spiritual beliefs and practices are understudied resiliency resources that may attenuate the influence of proteins associated with increased risk of CVD. Methods: We conducted a nested case-control study using data from the MASALA Study. We used baseline plasma samples from 50 South Asian participants with incident CVD and 50 sex- and age-matched controls. We analyzed plasma samples by SOMAscan, an aptamer-based proteomics platform, for 1305 unique proteins. Multivariable logistic regression models and model selection using Akaike Information Criteria were performed on the proteins and clinical covariates. We assessed the influence of measures of spiritual practices on the association between proteins and incident CVD events. Results: We identified 36 proteins that were significantly dysregulated among CVD cases compared to matched controls. These proteins are involved in immune cell recruitment, atherosclerosis, endothelial cell differentiation, and vascularization. A final multivariable model found three proteins (Contactin-5, Low affinity immunoglobulin gamma Fc region receptor II-a, Complement factor B) associated with CVD after adjustment for diabetes (c-statistic=0.82). Negative religious coping significantly modified the effect of Contactin-5 and Complement factor B for risk of CVD. ( Table ) Conclusions: Three novel plasma proteins were associated with incident CVD, and negative religious coping significantly modified the effect, in this pilot study of South Asians. Further investigation is needed to understand proteomic profiles across diverse communities, and the role that resiliency resources in modifying the putative effect of proteomic signatures.
Abstract 17496: The Effect of Statin on Ventricular Tachyarrhythmia Burden
Authors: Arwa Younis, Mehmet Aktas, Ilan Goldenberg, Scott McNitt, Bronislava Polonsky, Valentina Kutyifa, Spencer Z ROSERO, David T Huang, Abrar Shah, Jeffrey Alexis, James Daubert, Wojciech Zareba
Journal: Circulation (2020)

Introduction: Statins may reduce risk for ventricular tachyarrhythmia (VTA) in patients with implantable cardioverter defibrillator (ICD). Ranolazine was shown to increase plasma concentrations of statin. Objective: To evaluate the effect of statin on recurrent VTA, and to explore the interaction with both Ranolizine and cardiomyopathy (CMP) origin. Methods: The Andersen-Gill extension of the Cox proportional hazards regression was used to assess the association between statin treatment and the risk for recurrent VTA among 1012 ICD patients enrolled in the Ranolazine Implantable Cardioverter-Defibrillator Trial (RAID). Interaction-term analysis with ranolazine and ischemic status were performed. Number of events was limited to a maximum of 10 VTA events per patient to avoid any patients having an undue influence on model estimates. Results: A total of 740 (73%) RAID patients were treated with statins. Multivariable analysis showed that statin use was associated with an overall 30% reduction in the risk for recurrent VTA (HR=0.70; p&lt;0.001)(Figure). Interaction analysis showed that the benefit of statin use was seen only among patients with non-ischemic CMP (HR=0.53 [95%CI 0.41-0.69]; p&lt;0.001), whereas there was no evidence of benefit among patients with ischemic CMP for recurrent VTA (HR=1.03 [95%CI 0.70-1.54] p=0.70), with an interaction p-value of &lt;0.01 for the differential effect of statin use on recurrent VTA by CMP origin. The effect of statin was relatively consistent and did not differ significantly between the ranolazine and placebo arms (Figure). Statin use was not associated with increased adverse events, and ranolazine discontinuation was higher among those who were not treated with statins vs. those who received statin therapy (53% vs 42%, respectively; p&lt;0.01). Conclusion: Our findings suggest that treatment with statin (regardless if with or without ranolazine) is highly effective in reducing VTA burden in non-ischemic ICD recipients.
Abstract P067: Left Ventricular Hypertrophy And Inflammation Modify The Harmful Effects Of Fine Particulate Matter On Sudden Death
Authors: Kristen Rappazzo, Nicole Egerstrom, Sanjana Thota, Alia Capone, Sarah D Chen, Golsa Joodi, Wayne Cascio, Ross J Simpson
Journal: Circulation (2021)

Sudden death accounts for approximately 10% of deaths among working age adults and is associated with poor air quality. We hypothesize that clinical risk factors for sudden death would modify the relationship of fine particulate matter (PM 2.5 ) to sudden death. Sudden death victims in Wake County, NC from 3/1/2013 - 2/28/2015 were identified by screening Emergency Medical Services (EMS) reports and adjudicated based on EMS, medical, and death records (n=399). Daily PM 2.5 concentrations for Wake County from the Air Quality Data Mart were linked to event and control periods for each individual. Using a case-crossover design, conditional logistic regression estimated OR (95%CI) for sudden death for a 5μg/m 3 increase in PM 2.5 with a 1-day lag, adjusted for temperature and humidity, across risk factor strata. Sensitivity analysis assessed consistency of main effects. Left ventricular hypertrophy (LVH) and neutrophil to lymphocyte ratio (NLR) were included as estimates of arrhythmic potential and inflammation, respectively. Low concentrations of PM 2.5 are potential risk factors for sudden death (Table 1). However, no clinical risk factors for sudden death modify that association. LVH and NLR, in contrast to clinical risk factors, are associated PM 2.5 and sudden death. Sensitivity analysis had no effect on the direction and minimal effect on the magnitude of the associations. Left ventricular hypertrophy and inflammation may be the final step in the mechanism whereby poor air quality and clinical risk factors trigger arrhythmia or myocardial ischemia and sudden death. This abstract does not necessarily reflect EPA policy.
Pulmonary Artery Enlargement Is Associated with Exacerbations and Mortality in Ever-Smokers with Preserved Ratio Impaired Spirometry
Authors: R. Chad Wade, J. Patrick Simmons, Adel Boueiz, Andrew Gregory, Emily S. Wan, Elizabeth A. Regan, Surya P. Bhatt, MeiLan K. Han, Russell P. Bowler, James D. Crapo, Edwin K. Silverman, George R. Washko, Mark T. Dransfield, J. Michael Wells
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

"Pulmonary Artery Enlargement Is Associated with Exacerbations and Mortality in Ever-Smokers with Preserved Ratio Impaired Spirometry." American Journal of Respiratory and Critical Care Medicine, 204(4), pp. 481–485
Impact of the Implementation of the EAU Guidelines Recommendation on Reporting and Grading of Complications in Patients Undergoing Robot-assisted Radical Cystectomy: A Systematic Review
Authors: Paolo Dell’Oglio, Iulia Andras, David Ortega, Antonio Galfano, Walter Artibani, Riccardo Autorino, Elio Mazzone, Nicolae Crisan, Aldo Massimo Bocciardi, Rafael Sanchez-Salas, Inderbir Gill, Peter Wiklund, Mihir Desai, Dionysios Mitropoulos, Alexandre Mottrie, Giovanni E. Cacciamani
Journal: European Urology (2021)
Abstract 13026: Homogeneous 2D and 3D Alignment of Cardiomyocytes in Dilated Cardiomyopathy Revealed by Intravital Heart Imaging
Authors: Kiyoshi Masuyama, Tomoaki Higo, Jong-Kook Lee, Shigeru Miyagawa, Yoshiki Sawa, Yasushi Sakata
Journal: Circulation (2020)

Background: In contrast to hypertrophic cardiomyopathy, there has been reported no specific pattern of cardiomyocyte array in dilated cardiomyopathy (DCM). This might be because it is assessed only on heart tissue sections two-dimensionally (2D). To address this, we sought to evaluate cardiomyocyte alignment in DCM three-dimensionally (3D) using intravital heart imaging techniques. Methods and Results: We observed cardiomyocytes of membrane fluorescent reporter mice up to 100μm depth by an intravital imaging system with two-photon microscopy. On each 2D images taken at 1μm interval, the angles of cardiomyocytes from a vertical line were measured and their distribution was plotted. Then the plots of all layers were merged so that layer-to-layer change of angle distribution can be visualized. In these merged plots, cardiomyocytes exhibited several peaks with a certain spread around each peak, suggesting that cardiomyocytes change their alignments by every layer in 3D and position twistedly even in a single layer (Figure). We next assessed cardiac mutant Troponin T knock-in mice as a DCM model. The angle distribution in these mice was less various within a single layer and between layers as well. These results indicate that cardiomyocytes of DCM model mice align homogeneously both in 2D and in 3D. To determine how homogeneous alignment contributes to cardiomyocyte contractility, we captured the motion of cultured cardiomyocytes and found that cardiomyocytes seeded on the top of linearly aligned fibers show greater motion than those seeded on randomly aligned fibers. Conclusion: Using intravital imaging, we have provided a first evidence of cardiomyocyte array in 3D and demonstrated that cardiomyocytes of DCM model mice align homogeneously both in 2D and in 3D. Homogeneous alignment of those mice might be the consequences of impaired cardiac function as a way to increase let ventricular contractility.
Abstract 16691: The Effect of Socioeconomic Status: Patients in the Lowest Quartile of Income May be Subject to Worse Outcomes After Major Cardiac Surgery
Authors: Joshua C Chao, Xiaoyan Deng, Alexis K Okoh, Fady K Soliman, Jigesh Baxi, Lindsay Volk, Amy Suhotliv, Justin W Ady, Mark J Russo, Leonard Y Lee
Journal: Circulation (2020)

Introduction: Racial disparities in cardiac surgery (CS) are well documented, but socioeconomic status (SES)’s role, independent of race and other factors, requires further study. Our purpose is to investigate effects of low SES on patient outcomes after CS. Methods: National Inpatient Sample 2010-15, was queried. Adult patients undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), mitral valve repair (MVRR) or replacement (MVRT) were identified. Patient &amp; hospital characteristics, charges, and outcomes of patients in the lowest quartile of income by zip code (low SESP) and highest (high SESP) were compared, per procedure. Multivariable analysis was used to determine effects of SES on outcomes; primary was in-hospital mortality (death). Results: Number of procedures, low v. high SESP: CABG (30,799).
Erratum to: “Hepatobiliary acid-base homeostasis: Insights from analogous secretory epithelia” (J Hepatol 2021; 74: 428-441)
Authors: David C. Trampert, Stan F.J. van de Graaf, Aldo Jongejan, Ronald P.J. Oude Elferink, Ulrich Beuers
Journal: Journal of Hepatology (2021)
Abstract 13192: <i>Xbp1s - Foxo1</i> Axis Governs Lipid Accumulation and Cardiac Performance in Heart Failure With Preserved Ejection Fraction
Authors: Gabriele G Schiattarella, Francisco J Altamirano, Dan Tong, Esther Kim, Anwarul Ferdous, Hande Piristine, Subhajit Dasgupta, Xuliang Wang, Kristin French, Elisa Villalobos, Stephen B Spurgin, Mayaan Hotiner Waldman, Nan Jiang, Herman May, Theodore M Hill, Vlad G Zaha, Sergio Lavandero, Thomas G Gillette, Joseph A Hill
Journal: Circulation (2020)

Introduction: Heart failure with preserved ejection fraction (HFpEF) is now the dominant form of heart failure (HF). Limited insight into underlying mechanisms has culminated in the longstanding absence of evidence-based therapies capable of mitigating the substantial morbidity and mortality associated with the syndrome. Existing clinical and epidemiological evidence suggests that excessive body fat and lipid mishandling contribute to HFpEF. However, molecular mechanism(s) governing metabolic alterations and perturbations in lipid homeostasis in HFpEF are unknown. We recently developed a novel, clinically relevant, murine model of HFpEF, uncovering suppression of the Xbp1s (spliced form of the X-box-binding protein 1) arm of the UPR (unfolded protein response) signaling pathway as a critical driver of HFpEF pathogenesis. Objectives: To define and manipulate mechanisms downstream of Xbp1s in HFpEF and decipher its cardioprotective actions. Methods and Results: In the myocardium of experimental HFpEF, we detected cardiomyocyte steatosis coupled with increases in the abundance and activity of FoxO1 (Forkhead box protein O1), a conserved transcription factor involved in cell metabolism. FoxO1 depletion, as well as Xbp1s over-expression, in cardiomyocytes each ameliorated the HFpEF phenotype and reduced myocardial lipid accumulation. Strikingly, forced expression of Xbp1s in cardiomyocytes triggered proteasomal degradation of FoxO1. Furthermore, we discovered that FoxO1 is ubiquitinated upon Xbp1s over-expression, and Xbp1s-induced proteasomal degradation of FoxO1 occurs, in large part, through activation of the E3 ubiquitin ligase STUB1 (STIP1 homology and U-Box-containing protein 1), a protein we identified as a novel and direct transcriptional target of Xbp1s. Conclusions: Our findings uncover the Xbp1s-FoxO1 axis as a pivotal mechanism in the pathogenesis of HFpEF and unveil previously unrecognized mechanisms whereby the UPR governs metabolic alterations in cardiomyocytes.
Abstract 12941: Long-term Prognostic Value of Cardiac Metaiodobenzylguanidine Imaging and Non-sustained Ventricular Tachycardia in Patients With Implantable Cardioverter Defibrillator
Authors: Masato Kawasaki, Takahisa Yamada, Tetsuya Watanabe, Takashi Morita, Yoshio Furukawa, Shunsuke Tamaki, Atsushi Kikuchi, Tsutomu Kawai, Masahiro Seo, Jun Nakamura, Masatsugu Kawahira, Kiyomi Kayama, Kunpei Ueda, Takanari Kimura, Daisuke Sakamoto
Journal: Circulation (2020)

Background: Cardiac MIBG imaging provides prognostic information in patients with chronic heart failure (CHF). Recent studies showed that the highest occurrence of severe arrhythmic events (SAE) was seen in CHF patients with an intermediate decrease in MIBG uptake rather than the lowest values. On the other hand, non-sustained ventricular tachycardia (NSVT) has been shown to be associated with SAE in CHF patients. However, there is little information available on long-term prognostic value of intermediate decrease in MIBG up take and NSVT for the prediction of severe ventricular tachyarrhythmias in implantable cardioverter defibrillator (ICD) patients. Methods and Results: We prospectively enrolled 201 consecutive outpatients with ICD (age: 64±14 years, male: 81%, NYHA class:1.7±0.7, LVEF: 49±17%). At entry, all patients underwent cardiac MIBG imaging and 24-hour Holter electrocardiogram monitoring. An intermediate decrease in heart-to-mediastinum ratio on delayed planar image (H/M) was defined as 1.40-1.89. NSVT was defined as consecutive 3 or more beats and more than 100 bpm. During a follow-up period of 4.0±2.5 years, 59 patients had appropriate ICD discharge for severe ventricular tachyarrhythmias. At multivariate Cox regression analysis, intermediate decrease in H/M and NSVT were significantly and independently associated with appropriate ICD discharge after adjustment with age, sex and low left ventricular ejection fraction (≤35%). Appropriate ICD discharge was significantly more frequently observed in patients with both intermediate decrease in H/M and NSVT and with either intermediate decrease in H/M or NSVT than with none of them (47% vs 36% vs 14%, p&lt;0.0001). Conclusions: Combination of cardiac MIBG imaging and NSVT would be more strongly associated with an increased risk for severe ventricular tachyarrhythmias in ICD patients.