Miracle-dz/UniFAR-FTUs huggingface dataset:
Mesothelioma risk after 40 years since first exposure to asbestos: a pooled analysis

Background The risk of malignant mesothelioma (MM) increases proportionally to the cumulative exposure, and to the 3rd or 4th power of time since first exposed, to asbestos. However, little is known about the risk of MM after more than 40 years since first exposure because most epidemiological studies do not have follow-up for sufficient periods of time. Methods The data from six cohort studies of exposed workers and two cohorts with residential exposure have been pooled. A nested case control design matched cases and controls on calendar period and age. Conditional logistic regression modelled the relationship between time since first exposure and risk of MM. Results The combined data consisted of 22 048 people with asbestos exposure (5769 women), 707 cases of pleural MM (165 in women) and 155 cases of peritoneal MM (32 in women). Median time since first exposure for pleural MM cases was 38.4 years (IQR 31.3–45.3). Median duration of exposure for pleural MM cases was 3.75 years (IQR 0.7–18.2). The rate and risk of pleural MM increased until 45 years following first exposure and then appeared to increase at a slower power of time since first exposure. The rate of increase in peritoneal MM over the 10–50 years since first exposure continued to increase. Conclusions Exposure to asbestos confers a long-term risk of developing pleural and peritoneal mesothelioma which increases following cessation of exposure. While the rate of increase appears to start to level out after 40–50 years no one survives long enough for the excess risk to disappear.
A Fully Integrated 320 GHz Coherent Imaging Transceiver in 130 nm SiGe BiCMOS

A 320 GHz fully integrated terahertz imaging system is reported. The system is composed of a phase-locked high-power transmitter and a coherent high-sensitivity subharmonic-mixing receiver, which are fabricated using a 130 nm SiGe BiCMOS technology (fT/fmax = 220/280 GHz). To enhance the imaging sensitivity, a heterodyne coherent detection scheme is utilized. To obtain frequency coherency, fully integrated phase-locked loops are implemented on both the transmitter and receiver chips. According to the measurement results, consuming a total dc power of 605 mW, the transmitter chip achieves a peak radiated power of 2 mW and a peak EIRP of 21.1 dBm. The receiver chip achieves an equivalent incoherent responsivity of more than 7.26 MV/Wand a sensitivity of 70.1 pW under an integration bandwidth of 1 kHz, with a total dc power consumption of 117 mW. The achieved sensitivity with this proposed coherent imaging transceiver is around ten times better compared with other state-of-the-art incoherent imagers. To the best of our knowledge, this paper demonstrates the first fully integrated coherent terahertz imaging transceiver on silicon.
Young people's perspectives on health: empowerment, or risk?

Purpose – Research to date has identified young people's perspectives on a number of health‐related topics such as smoking, alcohol, sexual health, physical activity and healthy eating. Whilst this body of research draws important attention towards young people's views on topical health concerns, it arguably remains located within a pre‐defined agenda; thereby marginalising young people's own, and potentially different, frames of reference when discussing health. In light of this omission, the aim of this paper is to examine young people's own understandings of health in line with their own frames of reference.Design/methodology/approach – Data were collected from 55 young people aged 15‐16 years through group discussions, individual interviews and observational data in a school and surrounding community settings. Key themes were analysed for their implications for “emic” conceptualisations of health. Young people's perspectives were further compared with accounts given by professionals.Findings – Two key.
A 1/f Noise Upconversion Reduction Technique for Voltage-Biased RF CMOS Oscillators

In this paper, we propose a method to reduce a flicker (1/f) noise upconversion in voltage-biased RF oscillators. Excited by a harmonically rich tank current, a typical oscillation voltage waveform is observed to have asymmetric rise and fall times due to even-order current harmonics flowing into the capacitive part, as it presents the lowest impedance path. The asymmetric oscillation waveform results in an effective impulse sensitivity function of a nonzero dc value, which facilitates the 1/f noise upconversion into the oscillator's 1/f3 phase noise. We demonstrate that if the ω0 tank exhibits an auxiliary resonance at 2ω0, thereby forcing this current harmonic to flow into the equivalent resistance of the 2ω0 resonance, then the oscillation waveform would be symmetric and the flicker noise upconversion would be largely suppressed. The auxiliary resonance is realized at no extra silicon area in both inductor-and transformer-based tanks by exploiting different behaviors of inductors and transformers in differential-and common-mode excitations. These tanks are ultimately employed in designing modified class-D and class-F oscillators in 40 nm CMOS technology. They exhibit an average flicker noise corner of less than 100 kHz.
Comparative analysis of different approaches to measure treatment response in acute myeloid leukemia.

PURPOSE In acute myeloid leukemia (AML), initial treatment response by morphologic analysis of bone marrow predicts long-term outcome. Response can now be assessed by minimal residual disease (MRD) monitoring with flow cytometry or polymerase chain reaction (PCR). We determined the relation among the results of these approaches and their prognostic value. PATIENTS AND METHODS In the multicenter AML02 study, follow-up bone marrow samples from 203 children and adolescents with newly diagnosed AML were examined by flow cytometry (n = 1,514), morphology (n = 1,382), and PCR amplification of fusion transcripts (n = 508). Results were correlated with treatment outcome. RESULTS Among 1,215 samples with less than 5% leukemic myeloblasts by morphology, 100 (8.2%) were MRD positive (≥ 0.1%) by flow cytometry, whereas 96 (57.5%) of the 167 samples with ≥ 5% blasts were MRD negative. Virtually all (308 of 311; 99.0%) MRD-negative samples by PCR were also MRD negative by flow cytometry. However, only 19 (9.6%) of the 197 PCR-positive samples were flow cytometry positive, with analyses of AML1-ETO and CBFβ-MYH11 accounting for most discrepancies, whereas eight of 13 MLL-positive samples had detectable MRD by flow cytometry. MRD by flow cytometry after induction 1 or 2 predicted lower event-free survival and higher relapse rate (P < .001) and was an independent prognostic factor in a multivariable analysis; prediction was not improved by morphologic information or molecular findings. CONCLUSION In childhood AML, morphologic assessment of treatment response has limited value if MRD is measured by flow cytometry. MLL fusion transcripts can provide prognostic information in some patients, whereas monitoring of AML1-ETO and CBFβ-MYH11 transcripts is largely uninformative.
Under-representation of older adults in cancer registration trials: known problem, little progress.

The oncology literature from the last decade is replete with articleslamentingthescarcityofdatatoguidetreatmentdecisionsforthe elderly population with cancer. With the aging of the United States and worldwide population and the known association between older ageandcancer, 1 cliniciansandresearchersunderstandtheimportance of studying the efficacy and toxicity of cancer therapies in this at-risk population. The importance of this knowledge is highlighted by the US Food and Drug Administration in its Guideline for the Study of Drugs Likely to Be Used in the Elderly, 2 which advocates enrollment of older adults in clinical trials as a means to understand treatment effects among differing populations. Almostadecadeago,JournalofClinicalOncologyhighlightedthe under-representation of older adults in registration trials for new cancertherapiesfrom1992to2002.Talaricoetal 3 showedtheproportions enrolled onto registration trials versus the proportions in the overall populations age 65, 70, and 75 years were 36%, 20%, and9%comparedwith60%,46%,and31%,respectively.Theauthors surmised that decline in functional reserve, increased comorbid con
Increased risk of mycobacterial infections associated with anti-rheumatic medications

Rationale Anti-tumour necrosis factor (TNF) agents and other anti-rheumatic medications increase the risk of TB in rheumatoid arthritis (RA). Whether they increase the risk of infections with nontuberculous mycobacteria (NTM) is uncertain. Objectives To determine the effect of anti-TNF therapy and other anti-rheumatic drugs on the risk of NTM disease and TB in older patients with RA. Methods Population-based nested case–control study among Ontario seniors aged ≥67 years with RA who were prescribed at least one anti-rheumatic medication between 2001 and 2011. We identified cases of TB and NTM disease microbiologically and identified drug exposures using linked prescription drug claims. We estimated ORs using conditional logistic regression, controlling for several potential confounders. Measurements and main results Among 56 269 older adults with RA, we identified 37 cases of TB and 211 cases of NTM disease; each case was matched to up to 10 controls. Individuals with TB or NTM disease were both more likely to be using anti-TNF therapy (compared with non-use); adjusted ORs (95% CIs) were 5.04 (1.27 to 20.0) and 2.19 (1.10 to 4.37), respectively. Exposure to leflunomide and other anti-rheumatic drugs with high immunosuppressing potential also were associated with both TB and NTM disease, while oral corticosteroids and hydroxychloroquine were associated with NTM disease. Conclusions Anti-TNF use is associated with increased risk of both TB and NTM disease, but appears to be a relatively greater risk for TB. Several other anti-rheumatic drugs were also associated with mycobacterial infections.
Parameters recorded by software of non-invasive ventilators predict COPD exacerbation: a proof-of-concept study

Objective To assess whether daily variations in three parameters recorded by non-invasive ventilation (NIV) software (respiratory rate (RR), percentage of respiratory cycles triggered by the patient (%Trigg) and NIV daily use) predict the risk of exacerbation in patients with chronic obstructive pulmonary disease (COPD) treated by home NIV. Methods Patients completed the EXACT-Pro questionnaire daily to detect exacerbations. The 25th and 75th percentiles of each 24 h NIV parameter were calculated and updated daily. For a given day, when the value of any parameter was >75th or <25th percentile, the day was marked as ‘abnormal value’ (‘high value’ >75th, ‘low value’ <25th). Stratified conditional logistic regressions estimated the risk of exacerbation when ≥2 days (for RR and %Trigg) or ≥3 days (for NIV use) out of five had an ‘abnormal value’. Results Sixty-four patients were included. Twenty-one exacerbations were detected and medically confirmed. The risk of exacerbation was increased when RR (OR 5.6, 95% CI 1.4 to 22.4) and %Trigg (OR 4.0, 95% CI 1.1 to 14.5) were considered as ‘high value’ on ≥2 days out of five. Conclusions This proof-of-concept study shows that daily variations in RR and %Trigg are predictors of an exacerbation.
Adjuvant chemotherapy in older patients with stage III colon cancer: an underused lifesaving treatment.

absolute 5-year improvement in survival for all patients of 7% favoring chemotherapy (64% for surgery alone v 71% for surgery and chemotherapy), and similar survival benefits were seen in the 506 patients in this data set who were older than 70 years of age. Moreover, there was no relationship between age and chemotherapy toxicity, including nausea and vomiting, stomatitis, and diarrhea; however, leucopenia was more common in older patients in two of the trials. A key goal of the Sanoff et al 4 analysis was to determine the value of oxaliplatin when added to fluoropyrimidine (fluorouracil [FU] or capecitabine) therapy. Of those patients who received chemotherapy, oxaliplatin was administered to 46%, 25%, and 7% of patients age 75 to 79, 80 to 84, and 85 years or older, respectively. There was a trend for improved survival with oxaliplatin (HR, 0.82; 95% CI, 0.51 to 1.33) that corresponded to an absolute 5% improvement in survival at 3 years compared with fluoropyrimidines alone; these results are similar to the HRs reported in the MOSAIC (Multicenter International Study of Oxaliplatin/FU/Leucovorin in the Adjuvant Treatment of Colon
A Bluetooth Low-Energy Transceiver With 3.7-mW All-Digital Transmitter, 2.75-mW High-IF Discrete-Time Receiver, and TX/RX Switchable On-Chip Matching Network

We present an ultra-low-power Bluetooth low-energy (BLE) transceiver (TRX) for the Internet of Things (IoT) optimized for digital 28-nm CMOS. A transmitter (TX) employs an all-digital phase-locked loop (ADPLL) with a switched current-source digitally controlled oscillator (DCO) featuring low frequency pushing, and class-E/F<sub>2</sub> digital power amplifier (PA), featuring high efficiency. Low 1/<inline-formula> <tex-math notation="LaTeX">$f$ </tex-math></inline-formula> DCO noise allows the ADPLL to shut down after acquiring lock. The receiver operates in discrete time at high sampling rate (~10 Gsamples/s) with intermediate frequency placed beyond 1/<inline-formula> <tex-math notation="LaTeX">$f$ </tex-math></inline-formula> noise corner of MOS devices. New multistage multirate charge-sharing bandpass filters are adapted to achieve high out-of-band linearity, low noise, and low power consumption. An integrated on-chip matching network serves to both PA and low-noise transconductance amplifier, thus allowing a 1-pin direct antenna connection with no external band-selection filters. The TRX consumes 2.75 mW on the RX side and 3.7 mW on the TX side when delivering 0 dBm in BLE.
Is graded prognostic assessment an improvement compared with radiation therapy oncology group's recursive partitioning analysis classification for brain metastases?

IHC/FISH equivocal case that was also equivocal by ODX. In our study, 23 IHC/FISH equivocal cases were all negative by ODX. We have previously suggested that dilution of invasive tumor with noninvasive tissue may have resulted in discordant results. Christgen et al mentioned that this might not be the only cause, and we do not completely disagree. Apart from the dilution artifact, one should also question the primers, probes, and failure of the reverse transcriptase polymerase chain reaction process, especially when HER2 FISH shows increased gene copies and HER2 IHC shows protein overexpression. The ODX HER2 assay fails to identify a significant number of unequivocal IHC 3 and FISH-amplified cases and almost always produces a negative result in FISH equivocal cases. Therefore, we do not see a role for the ODX HER2 assay (or other mRNA-based assays) as an adjunct to the current IHC/FISH-based approach for HER2 assessment. Rohit Bhargava and David J. Dabbs Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA
Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma: 1-year follow-up of a prospective randomized trial.

PURPOSE To assess the efficacy of gonadotropin-releasing hormone agonist (GnRHa) in preventing chemotherapy-induced ovarian failure in patients treated for Hodgkin or non-Hodgkin lymphoma within the setting of a multicenter, randomized, prospective trial. PATIENTS AND METHODS Patients age 18 to 45 years were randomly assigned to receive either the GnRHa triptorelin plus norethisterone (GnRHa group) or norethisterone alone (control group) concomitantly with alkylating agents containing chemotherapy. The primary end point was the premature ovarian failure (POF) rate (follicle-stimulating hormone [FSH] ≥ 40 IU/L) after 1 year of follow-up. RESULTS Eighty-four of 129 randomly assigned patients completed the 1-year follow-up. The mean FSH values were higher in the control group than in the GnRHa group during chemotherapy; however, this difference was no longer observed after 6 months of follow-up. After 1 year, 20% and 19% of patients in the GnRHa and control groups, respectively, exhibited POF (P = 1.00). More than half of patients in each group completely restored their ovarian function (FSH < 10 IU/L), but the anti-Müllerian hormone values were higher in the GnRHa group than in the control group (1.4 ± 0.35 v 0.5 ± 0.15 ng/mL, respectively; P = .040). The occurrence of adverse events was similar in both groups with the exception of metrorrhagia, which was more frequently observed in the control group than the GnRHa group (38.4% v 15.6%, respectively; P = .024). CONCLUSION Approximately 20% of patients in both groups exhibited POF after 1 year of follow-up. Triptorelin was not associated with a significant decreased risk of POF in young patients treated for lymphoma but may provide protection of the ovarian reserve.
Erdheim-Chester disease harboring the BRAF V600E mutation.

Introduction Erdheim-Chester disease (ECD) is a rare, non-Langerhans histiocytosis characterized by xanthogranulomatous infiltration of numerous tissues (in particular, bone, orbits, heart, and retroperitoneum). ECD is associated with an aggressive disease course that is resistant to treatment and has a poor prognosis. The pathogenesis of ECD remains poorly understood, and evidence regarding the clonal basis of ECD has been conflicting. In this article, we describe a patient with ECD harboring a BRAF V600E mutation, which has important therapeutic implications for the patient and provides insight into the biologic basis of the disease itself.
Reduced physical activity in lymphangioleiomyomatosis compared with COPD and healthy controls: disease-specific impact and clinical correlates

Rationale Sporadic lymphangioleiomyomatosis (LAM) is an orphan lung disease for which daily physical activity has not been studied so far and it is unclear whether a disease-specific impact beyond airflow limitation exists. Clinical correlates indicating reduced physical activity in addition to established parameters like airflow limitation and hypoxaemia are largely undetermined. Method We measured physical activity (steps per day, SPD; physical activity level, PAL; minutes of moderate activity, MMA) in 34 women with LAM, 32 FEV1-matched female patients with COPD and 15 age-matched healthy women for 1 week using an accelerometer. In addition, we assessed lung function measurements, questionnaires for generic and respiratory health status (12-Item Short Form Survey, SF-12; St. George's Respiratory Questionnaire, SGRQ), dyspnoea (modified Medical Research Council dyspnoea scale, mMRC) and fatigue (Multidimensional Fatigue Inventory, MFI-20). Results Patients with LAM (mean age 52.7 years, mean FEV1 62.7% predicted) showed reduced SPD, PAL and MMA (p<0.01) compared with healthy controls and reduced MMA (p=0.032) compared with female patients with COPD (mean age 65.2 years, mean FEV1 62.6% predicted). In multivariate regression analyses, adjusting for FEV1 and long-term oxygen therapy, either generic health status (SF-12 physical health) or fatigue (MFI-20) were the strongest independent predictors for SPD in patients with LAM (p=0.006 and p=0.004, respectively). Conclusions Physical activity in daily life is substatially reduced in LAM, when compared with healthy controls and COPD - indicating a disease specific impact. The regular assessment of fatigue and generic health status may improve disease management in LAM by taking daily physical activity of patients with LAM more adequately into account.
Clinical and functional differences between early-onset and late-onset adult asthma: a population-based Tasmanian Longitudinal Health Study

Background Differences between early-onset and late-onset adult asthma have not been comprehensively described using prospective data. Aims To characterise the differences between early-onset and late-onset asthma in a longitudinal cohort study. Methods The Tasmanian Longitudinal Health Study (TAHS) is a population-based cohort. Respiratory histories and spirometry were first performed in 1968 when participants were aged 7 (n=8583). The cohort was traced and resurveyed from 2002 to 2005 (n=5729 responses) and a sample, enriched for asthma and bronchitis participated in a clinical study when aged 44 (n=1389). Results Of the entire TAHS cohort, 7.7% (95% CI 6.6% to 9.0%) had early-onset and 7.8% (95% CI 6.4% to 9.4%) late-onset asthma. Atopy and family history were more common in early-onset asthma while female gender, current smoking and low socioeconomic status were more common in late-onset asthma. The impact on lung function of early-onset asthma was significantly greater than for late-onset asthma (mean difference prebronchodilator (BD) FEV1/FVC −2.8% predicted (−5.3 to −0.3); post-BD FEV1FVC −2.6% predicted (−5.0 to −0.1)). However, asthma severity and asthma score did not significantly differ between groups. An interaction between asthma and smoking was identified and found to be associated with greater fixed airflow obstruction in adults with late-onset asthma. This interaction was not evident in adults with early-onset disease. Conclusions Early-onset and late-onset adult asthma are equally prevalent in the middle-aged population. Major phenotypic differences occur with asthma age-of-onset; while both share similar clinical manifestations, the impact on adult lung function of early-onset asthma is greater than for late-onset asthma.
Effects of melatonin on appetite and other symptoms in patients with advanced cancer and cachexia: a double-blind placebo-controlled trial.

PURPOSE Prior studies have suggested that melatonin, a frequently used integrative medicine, can attenuate weight loss, anorexia, and fatigue in patients with cancer. These studies were limited by a lack of blinding and absence of placebo controls. The primary purpose of this study was to compare melatonin with placebo for appetite improvement in patients with cancer cachexia. PATIENTS AND METHODS We performed a randomized, double-blind, 28-day trial of melatonin 20 mg versus placebo in patients with advanced lung or GI cancer, appetite scores ≥ 4 on a 0 to 10 scale (10 = worst appetite), and history of weight loss ≥ 5%. Assessments included weight, symptoms by the Edmonton Symptom Assessment Scale, and quality of life by the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire. Differences between groups from baseline to day 28 were analyzed using one-sided, two-sample t tests or Wilcoxon two-sample tests. Interim analysis halfway through the trial had a Lan-DeMets monitoring boundary with an O'Brien-Fleming stopping rule. Decision boundaries were to accept the null hypothesis of futility if the test statistic z < 0.39 (P ≥ .348) and reject the null hypothesis if z > 2.54 (P ≤ .0056). RESULTS After interim analysis of 48 patients, the study was closed for futility. There were no significant differences between groups for appetite (P = .78) or other symptoms, weight (P = .17), FAACT score (P = .95), toxicity, or survival from baseline to day 28. CONCLUSION In cachectic patients with advanced cancer, oral melatonin 20 mg at night did not improve appetite, weight, or quality of life compared with placebo.