Miracle-dz/UniFAR-FTUs huggingface dataset:
Phase III trial of cetuximab with continuous or intermittent fluorouracil, leucovorin, and oxaliplatin (Nordic FLOX) versus FLOX alone in first-line treatment of metastatic colorectal cancer: the NORDIC-VII study.

PURPOSE The NORDIC-VII multicenter phase III trial investigated the efficacy of cetuximab when added to bolus fluorouracil/folinic acid and oxaliplatin (Nordic FLOX), administered continuously or intermittently, in previously untreated metastatic colorectal cancer (mCRC). The influence of KRAS mutation status on treatment outcome was also investigated. PATIENTS AND METHODS Patients were randomly assigned to receive either standard Nordic FLOX (arm A), cetuximab and FLOX (arm B), or cetuximab combined with intermittent FLOX (arm C). Primary end point was progression-free survival (PFS). Overall survival (OS), response rate, R0 resection rate, and safety were secondary end points. RESULTS Of the 571 patients randomly assigned, 566 were evaluable in intention-to-treat (ITT) analyses. KRAS and BRAF mutation analyses were obtained in 498 (88%) and 457 patients (81%), respectively. KRAS mutations were present in 39% of the tumors; 12% of tumors had BRAF mutations. The presence of BRAF mutations was a strong negative prognostic factor. In the ITT population, median PFS was 7.9, 8.3, and 7.3 months for the three arms, respectively (not significantly different). OS was almost identical for the three groups (20.4, 19.7, 20.3 months, respectively), and confirmed response rates were 41%, 49%, and 47%, respectively. In patients with KRAS wild-type tumors, cetuximab did not provide any additional benefit compared with FLOX alone. In patients with KRAS mutations, no significant difference was detected, although a trend toward improved PFS was observed in arm B. The regimens were well tolerated. CONCLUSION Cetuximab did not add significant benefit to the Nordic FLOX regimen in first-line treatment of mCRC.
Dual targeting of the epidermal growth factor receptor using the combination of cetuximab and erlotinib: preclinical evaluation and results of the phase II DUX study in chemotherapy-refractory, advanced colorectal cancer.

PURPOSE This preclinical and phase II study evaluated the efficacy and safety of the combination of cetuximab and erlotinib in metastatic colorectal cancer (mCRC). PATIENTS AND METHODS The activity and mechanism of action of the combination of cetuximab plus erlotinib were investigated in vitro in colorectal cancer cell lines. In the clinical study, patients with chemotherapy-refractory mCRC were treated with cetuximab 400 mg/m(2) as a loading dose and then weekly cetuximab 250 mg/m(2) with erlotinib 100 mg orally daily. The primary end point was response rate (RR), which was evaluated separately in KRAS wild-type (WT) versus KRAS mutant tumors. Secondary end points included toxicity, progression-free survival (PFS), and overall survival. Target accrual was 50 patients, with a one-stage design. RESULTS Preclinical studies demonstrated synergistic activity of cetuximab and erlotinib cotreatment on growth inhibition of colon cancer cell lines both as a result of enhanced inhibition of the epidermal growth factor receptor pathway and differential effects on STAT3. In the clinical study, 50 patients were enrolled, with 48 patients evaluable for response. The overall RR was 31% (95% CI, 26% to 57%), with a median PFS of 4.6 months (95% CI, 2.8 to 5.6 months). RR was 41% (95% CI, 26% to 57%) in KRAS WT tumors, with a median PFS of 5.6 months (95% CI, 2.9 to 5.6 months). There was no response in 11 patients with KRAS mutations. Frequent grade 3 and 4 toxicities were rash (48%), hypomagnesaemia (18%), and fatigue (10%). CONCLUSION The combination of cetuximab and erlotinib synergistically inhibits growth of colon cancer cell lines, achieves promising efficacy in patients with KRAS WT mCRC, and merits evaluation in further randomized studies.
Legacy of the chameleon: Edible wild plants in the kingdom of Swaziland, Southern Africa. A cultural, ecological, nutritional study. Part I ‐ Introduction, objectives, methods, Swazi culture, landscape and diet

This paper presents objectives; methods; an introduction to the people, culture and diet of Swaziland, site for a cultural‐ecological study of edible wild plants. Swaziland is ethnically homogeneous, but environmentally diverse. Four distinct botanical zones are recognized: Highveld, Middleveld, Lowveld and Lubombo. Study objectives were to identify maintenance or abandonment of edible plant consumption by both Swazi adults and school children in each of the four ecological zones. Swazi diet is based on white maize. Relishes or side‐dishes are composed of meats, legumes or vegetables, but typically edible wild leaves. Most common legume is Voandzeia subterranea (bambara groundnut). Use of commercial fats is recent. Recently introduced foods include wheat bread, canned fish, carbonated beverages and tea. Prestige meat is beef. Nutritional value of traditional beer has declined because use of commercial beer powders has increased. Traditional Swazi meal patterns comprise two formal meals per day with extens.
Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone.

PURPOSE When designing this trial, there was no evidence that salvage chemotherapy (SLC) in advanced gastric cancer (AGC) resulted in substantial prolongation of survival when compared with best supportive care (BSC). However, SLC is often offered to pretreated patients with AGC for anecdotal reasons. PATIENTS AND METHODS Patients with AGC with one or two prior chemotherapy regimens involving both fluoropyrimidines and platinum and with an Eastern Cooperative Oncology Group performance status (PS) 0 or 1 were randomly assigned in a ratio of 2:1 to SLC plus BSC or BSC alone. Choice of SLC-either docetaxel 60 mg/m(2) every 3 weeks or irinotecan 150 mg/m(2) every 2 weeks-was left to the discretion of investigators. Primary end point was overall survival (OS). RESULTS Median OS was 5.3 months among 133 patients in the SLC arm and 3.8 months among 69 patients in the BSC arm (hazard ratio, 0.657; 95% CI, 0.485 to 0.891; one-sided P = .007). OS benefit for SLC was consistent in most of the prospectively defined subgroups, including age, PS, number of prior treatments, metastatic sites, hemoglobin levels, and response to prior chemotherapy. SLC was generally well tolerated, and adverse events were similar in the SLC and BSC arms. We found no median OS difference between docetaxel and irinotecan (5.2 v 6.5 months; P = .116). CONCLUSION To our knowledge, this is the largest phase III trial comparing SLC plus BSC with BSC alone in AGC. In pretreated patients, SLC is tolerated and significantly improves OS when added to BSC.
Plantar Fascia Release With Proximal and Distal Tarsal Tunnel Release: A Surgical Approach to Chronic, Disabling Plantar Fasciitis With Associated Nerve Pain

Chronic symptoms from proximal plantar fasciitis develop in about 10% of patients with plantar heel pain. A subset of these patients will develop chronic disabling plantar heel pain with associated nerve pain. Surgical intervention, which allows for complete resolution of symptoms and return to full activity without limitations, has been difficult to achieve in this group of patients. This paper reviews the typical presentation and appropriate evaluation for patients with chronic proximal plantar fasciitis and distal tarsal tunnel syndrome. The authors present a surgical approach that has yielded promising results with improved rates of total patient satisfaction. The surgical technique employs a complete plantar fascia release combined with a proximal and distal tarsal tunnel release. A detailed postoperative protocol is presented, and it is felt to play a major role in successful surgical outcomes. Data are presented from a study of 33 patients with a minimum 2-year follow-up. In primary surgery patients, high rates of total patient satisfaction (82%) can be expected, with corresponding high rates of resolution of pain and elimination of activity limitations. However, revision surgery results utilizing this technique are much more unpredictable, and further modification of treatment approach is needed.
Hearing, Vision, Communication, and Older People

The auditory thresholds of 248 older adults with normal vision were compared with ratings of their conversational fluency (4-point scale, unaided, face-to-face at 1m in quiet). Participants were placed into one of two general groups on the basis of conversational performance: a low group (conversational fluency rated 1 or 2) or a high group (conversational fluency rated 3 or 4). Hearing thresholds of the two groups differed in the lower frequencies, but overlapped considerably in the higher frequencies (i.e., high frequency thresholds were not closely related to communicative handicap). Most people with low unaided face-to-face conversational fluency reported regular use of hearing aids. Selected cases illustrated the combined effects of impaired hearing and impaired vision on conversational fluency and the need for amplification. There are implications for predicting hearing aid benefit: (1) during face-to-face interaction, many people with adequate vision can compensate for a high-frequency hearing loss through lip reading, precluding the need for hearing aids; (2) many people with poor vision cannot compensate for a high-frequency hearing loss through lip reading, and may require hearing aids; (3) people with poor low-frequency hearing cannot compensate through lip reading unless the sounds of speech are made audible; (4) in general, people with low unaided face-to-face conversational fluency are most likely to become reliable hearing aid users. It is recommended that clinicians assess each client’s vision and conversational performance along with hearing thresholds before considering directions for rehabilitation.
Involving men in antenatal education

Although antenatal sessions have changed over the last 20years, there is still dissatisfaction among new parents about the level of preparation for their new role. In particular, research indicates that fathers feel ill-prepared. This paper reports the introduction in one Australian hospital of men-only discussion groups which are facilitated by a father. In each case the facilitator was a health professional, although this may not be a necessary qualification. Each group sets its own agenda, and so a range of issues may be discussed. These include ‘fathering’ — the adjustment to being a father, and different parenting styles; and ‘birth’ — the man's role in the childbirth process.
Randomized phase II trial of erlotinib alone or with carboplatin and paclitaxel in patients who were never or light former smokers with advanced lung adenocarcinoma: CALGB 30406 trial.

PURPOSE Erlotinib is clinically effective in patients with non-small-cell lung cancer (NSCLC) who have adenocarcinoma, are never or limited former smokers, or have EGFR mutant tumors. We investigated the efficacy of erlotinib alone or in combination with chemotherapy in patients with these characteristics. PATIENTS AND METHODS Patients with advanced NSCLC (adenocarcinoma) who were epidermal growth factor receptor tyrosine kinase inhibitor and chemotherapy naive never or light former smokers (smokers of > 100 cigarettes and ≤ 10 pack years and quit ≥ 1 year ago) were randomly assigned to continuous erlotinib or in combination with carboplatin and paclitaxel (ECP) for six cycles followed by erlotinib alone. The primary end point was progression-free survival (PFS). Tissue collection was mandatory. RESULTS PFS was similar (5.0 v 6.6 months; P = .1988) in patients randomly assigned to erlotinib alone (arm A; n = 81) or to ECP (arm B; n = 100). EGFR mutation analysis was possible in 91% (164 of 181) of patients, and EGFR mutations were detected in 40% (51 of 128) of never smokers and in 42% (15 of 36) of light former smokers. In arm A, response rate (70% v 9%), PFS (14.1 v 2.6 months), and overall survival (OS; 31.3 v 18.1 month) favored EGFR-mutant patients. In arm B, response rate (73% v 30%), PFS (17.2 v 4.8 months), and OS (38.1 v 14.4 months) favored EGFR-mutant patients. Incidence of grades 3 to 4 hematologic (2% v 49%; P < .001) and nonhematologic (24% v 52%; P < .001) toxicity was greater in patients treated with ECP. CONCLUSION Erlotinib and erlotinib plus chemotherapy have similar efficacy in clinically selected populations of patients with advanced NSCLC. EGFR mutations identify patients most likely to benefit.
An In-Band Full-Duplex Radio Receiver With a Passive Vector Modulator Downmixer for Self-Interference Cancellation

In-band full-duplex (FD) wireless, i.e., simultaneous transmission and reception at the same frequency, introduces strong self-interference (SI) that masks the signal to be received. This paper proposes a receiver in which a copy of the transmit signal is fed through a switched-resistor vector modulator (VM) that provides simultaneous downmixing, phase shift, and amplitude scaling and subtracts it in the analog baseband for up to 27 dB SI-cancellation. Cancelling before active baseband amplification avoids self-blocking, and highly linear mixers keep SI-induced distortion low, for a receiver SI-to-noise-and-distortion-ratio (SINDR) of up to 71.5 dB in 16.25 MHz BW. When combined with a two-port antenna with only 20 dB isolation, the low RX distortion theoretically allows sufficient digital cancellation for over 90 dB link budget, sufficient for short-range, low-power FD links.
Postoperative adjuvant chemotherapy use in patients with stage II/III rectal cancer treated with neoadjuvant therapy: a national comprehensive cancer network analysis.

PURPOSE Practice guidelines recommend that patients who receive neoadjuvant chemotherapy and radiation for locally advanced rectal cancer complete postoperative adjuvant systemic chemotherapy, irrespective of tumor downstaging. PATIENTS AND METHODS The National Comprehensive Cancer Network (NCCN) Colorectal Cancer Database tracks longitudinal care for patients treated at eight specialty cancer centers across the United States and was used to evaluate how frequently patients with rectal cancer who were treated with neoadjuvant chemotherapy also received postoperative systemic chemotherapy. Patient and tumor characteristics were examined in a multivariable logistic regression model. RESULTS Between September 2005 and December 2010, 2,073 patients with stage II/III rectal cancer were enrolled in the database. Of these, 1,193 patients receiving neoadjuvant chemoradiotherapy were in the analysis, including 203 patients not receiving any adjuvant chemotherapy. For those seen by a medical oncologist, the most frequent reason chemotherapy was not recommended was comorbid illness (25 of 50, 50%); the most frequent reason chemotherapy was not received even though it was recommended or discussed was patient refusal (54 of 74, 73%). After controlling for NCCN Cancer Center and clinical TNM stage in a multivariable logistic model, factors significantly associated with not receiving adjuvant chemotherapy were age, Eastern Cooperative Oncology Group performance status ≥ 1, on Medicaid or indigent compared with private insurance, complete pathologic response, presence of re-operation/wound infection, and no closure of ileostomy/colostomy. CONCLUSION Even at specialty cancer centers, a sizeable minority of patients with rectal cancer treated with curative-intent neoadjuvant chemoradiotherapy do not complete postoperative chemotherapy. Strategies to facilitate the ability to complete this third and final component of curative intent treatment are necessary.
Trends in home smoking bans in the USA, 1995–2007: prevalence, discrepancies and disparities

Background Home smoking bans significantly reduce the likelihood of secondhand smoke exposure among children and non-smoking adults. The purpose of this study was to examine national trends in (1) the adoption of home smoking bans, (2) discrepancies in parental smoking ban reports and (3) household and parental correlates of home smoking bans among households with underage children from 1995 to 2007. Methods The authors used data from the 1995–1996, 1998–1999, 2001–2002, 2003 and 2006–2007 Tobacco Use Supplement of the US Current Population Survey to estimate prevalence rates and logistic regression models of parental smoking ban reports by survey period. Results Overall, the prevalence of a complete home smoking bans increased from 58.1% to 83.8% (p<0.01), while discrepancies in parental reports decreased from 12.5% to 4.6% (p<0.01) from 1995 to 2007. Households with single parent, low income, one or two current smokers, parents with less than a college education or without infants were consistently less likely to report a home smoking ban over this period (p<0.05). Conclusions Despite general improvements in the adoption of home smoking bans and a reduction on parental discrepancies, disparities in the level of protection from secondhand smoke have persisted over time. Children living in households with single parents, low income, current smoker parents, less educated parents or without infants are less likely to be protected by a home smoking ban. These groups are in need of interventions promoting the adoption of home smoking bans to reduce disparities in tobacco-related diseases.
FAT EXCRETION OF PREMATURE INFANTS: I. EFFECT ON FECAL FAT OF DECREASING FAT INTAKE

In a previous study of the nitrogen metabolism of premature infants,1attention was called to the defective ability of such infants to absorb fat. This defect had been noted earlier by Rubner and Langstein,2by Muhl3and by Holt and his co-workers4and was considered by Ylppo5to be a factor contributing to the tendency for rickets to develop in premature infants. In a subsequent study of the energy exchange of premature infants,6the loss of calories in the feces was found to be two to three times that reported for full term infants. It was suggested that the use for premature infants of a feeding mixture from which half the fat had been removed, such as the one described by Powers,7might permit more efficient absorption of food. In the present paper data from a total of 79 observations on 38 premature
Follow-up of the Finnish Asthma Programme 2000–2010: reduction of hospital burden needs risk group rethinking

The Finnish Asthma Programme 1994–2004 focused on early intervention and disease control, thereby resulting in a significant reduction of asthma morbidity. During the follow-up period from 2000 to 2010, the number of hospital days continued to fall by 54%. Patients ≥65 years, especially women, accounted for 39% of the hospital days, and they need attention if the hospital burden is to be reduced further.
A pathologic review of ophthalmic tumors in Kano, Northern Nigeria

Background and Objective: Tumors of eye and ocular adnexa are reported to be common in Africa, but no formal study has been conducted here in Kano, the largest Northern Nigerian city. This study is a documentation of the pattern of ophthalmic tumors in our locality. Materials and Methods: This was a 12-year (1999-2010 inclusive) retrospective study of all orbito-ocular neoplasms diagnosed at the pathology department of a teaching hospital. Results : 438 ophthalmic tumors were diagnosed during the study period, of which 79.7% were malignant and 20.3% benign. Males were slightly more preponderant with M/F ratio of 1.3:1. Retinoblastoma and conjunctival squamous carcinoma were the commonest tumors respectively comprising 44.5% and 18.9%. These two ocular malignancies also largely accounted for the bimodal age distribution peaks of ophthalmic cancer in the 1 st and 4 th decades. Conjunctival squamous papilloma and hemangioma were the most prevalent benign ophthalmic tumors. Conclusion : Our findings were broadly similar to most other Nigerian and African studies but significantly at variance with those of the western world.
Parenthood in survivors of Hodgkin lymphoma: an EORTC-GELA general population case-control study.

PURPOSE We investigated the impact of Hodgkin lymphoma (HL) on parenthood, including factors influencing parenthood probability, by comparing long-term HL survivors with matched general population controls. PATIENTS AND METHODS A Life Situation Questionnaire was sent to 3,604 survivors treated from 1964 to 2004 in successive clinical trials. Responders were matched with controls (1:3 or 4) for sex, country, education, and year of birth (10-year groups). Controls were given an artificial date of start of treatment equal to that of their matched case. The main end point was presence of biologic children after treatment, which was evaluated by using conditional logistic regression analysis. Logistic regression analysis was used to analyze factors influencing spontaneous post-treatment parenthood. RESULTS In all, 1,654 French and Dutch survivors were matched with 6,414 controls. Median follow-up was 14 years (range, 5 to 44 years). After treatment, the odds ratio (OR) for having children was 0.77 (95% CI, 0.68 to 0.87; P < .001) for survivors compared with controls. Of 898 survivors who were childless before treatment, 46.7% achieved post-treatment parenthood compared with 49.3% of 3,196 childless controls (OR, 0.87; P = .08). Among 756 survivors with children before treatment, 12.4% became parents after HL treatment compared with 22.2% of 3,218 controls with children before treatment (OR, 0.49; P < .001). Treatment with alkylating agents, second-line therapy, and age older than 35 years at treatment appeared to reduce the chances of spontaneous post-treatment parenthood. CONCLUSION Survivors of HL had slightly but significantly fewer children after treatment than matched general population controls. The difference concerned only survivors who had children before treatment and appears to have more personal than biologic reasons. The chance of successful post-treatment parenthood was 76%.
Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case–control study

Background Laboratory studies suggest that the clotting cascade is activated in fibrotic lungs. Since humans vary in their tendency to clot due to a variety of inherited or acquired defects, we investigated whether a prothrombotic state increases the chance of developing idiopathic pulmonary fibrosis (IPF) and/or worsens the prognosis of IPF. Methods We recruited 211 incident cases of IPF and 256 age- and sex-matched general population controls and collected data on medical history, medication, smoking habit, blood samples as well as lung function and high-resolution CT scans done as part of routine clinical care. A prothrombotic state was defined as the presence of at least one inherited or acquired clotting defect or marker of fibrinolytic dysfunction. We used logistic regression to quantify the association between a prothrombotic state and IPF adjusted for age, sex, smoking habit and highly sensitive C reactive protein. Cox regression was used to determine the influence of a prothrombotic state on survival. Results Cases were more than four times more likely than controls to have a prothrombotic state (OR 4.78, 95% CI 2.93 to 7.80; p<0.0001). Cases with a prothrombotic state were also likely to have more severe disease (forced vital capacity <70% predicted) at presentation (OR 10.79, 95% CI 2.43 to 47.91) and had a threefold increased risk of death (HR 3.26, 95% CI 1.09 to 9.75). Conclusions People with IPF are more likely to have a prothrombotic state than general population controls and the presence of a prothrombotic state has an adverse impact on survival.