Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk of serious adverse event and fatal adverse event with molecular target anticancer drugs in cancer patients: A meta-analysis

Molecular target anticancer drugs are commonly used in various forms of cancers. It is a concern that the risk of serious adverse events (SAEs) and fatal adverse events (FAEs) of molecular target drugs are increasing. An up-to-date meta-analysis of all Phase II/III/IV randomized trials of molecular target anticancer drugs was conducted to calculate the increased risk of SAEs and FAEs. A systematic search of PubMed, Web of Science, and Cochrane Library up to April 6, 2017, was conducted. The study enrolled Phase II/III/IV randomized trials of cancer that compared molecular target drugs alone versus placebo or performed single-arm analysis of molecular target drugs. Data on SAEs and FAEs were extracted from the included studies and pooled to compute risk ratio (RR), the overall incidence, and 95% confidence interval (CI). In this meta-analysis, a total of 19,965 and 26,642 patients in randomized 53 and 65 Phase II/II/IV trials were included in the analysis of SAEs and FAEs associated with molecular target anticancer drug, respectively. There were significant differences in the relationship of molecular target anticancer drugs with SAEs (RR = 1.57, 95% CI = 1.35–1.82, P < 0.01, I2 = 81%) and FAEs (RR = 1.51, 95% CI = 1.19–1.91, P < 0.01, I2 = 0%) compared to placebo. The overall incidence of SAEs and FAEs was 0.269 (95% CI = 0.262–0.276, P < 0.01) and 0.023 (95% CI = 0.020–0.025, P < 0.01), respectively. Molecular target anticancer drugs significantly increased the risk of SAEs and FAEs. For patients taking molecular target drugs, efforts are needed to prevent the occurrence of SAEs and FAEs.
Association between the muscle mass index and physical frailty in geriatric outpatients

Objective: Frailty syndrome is commonly seen in geriatric patients. In this study, we investigated the association between the muscle mass index and physical frailty in elderly outpatients. Materials and Methods: A cross-sectional study was conducted among elderly patients (≥60 years old) from the Geriatric Clinic of the Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia, from April to June 2018. Each subject underwent anthropometric measurements, a frailty evaluation using the Cardiovascular Health Study questionnaire, and lean mass measurements using dual-energy X-ray absorptiometry. The appendicular lean mass (ALM) measurement was adjusted by the height squared (ALM/ht2) and by the body mass index (ALM/BMI) to indicate the muscle mass index. Results: The proportions of the frail, prefrail, and robust patients were 29.17%, 58.33%, and 12.5%, respectively. There was a significant difference in the ALM/ht2 values between the frail and nonfrail (prefrail and robust) patients (6.54 [1.01] kg/m2 vs. 7.03 [0.91] kg/m2, P = 0.01), but not in the ALM/BMI values. No significant association was observed between frailty and the muscle mass index. Multivariate analysis indicated that the frailty status was significantly associated with the nutritional status (odds ratio [OR] = 3.67, 95% confidence interval [CI] = 1.59–8.49) and functional status (OR = 4.94, 95% CI = 2.01–11.75). Conclusion: Physical frailty was not significantly associated with the muscle mass index, but it was associated with the nutritional and functional statuses.
The relationship between empathy, prosocial behavior, peer relationships, and emotional problems in elementary schoolchildren in Indonesia

Introduction: Empathy is an essential attribute for coping in society. Empathy can be exhibited in the form of good prosocial behavior management and the ability to build peer relationships and regulate emotions. One of the most serious mental health problems is the antisocial behavior that arises from a lack of empathy. The study aimed to elaborate the association between empathy quotient and prosocial behavior, peer relationship and emotional problems among elementary schoolchildren. Materials and Methods: This was a cross-sectional study that included 620 parents and their children, and it was performed using an online questionnaire. The study used the Empathy Quotient-Children/Systemizing Quotient-Children Questionnaires and the strength and difficulties questionnaire, in which the Indonesian versions have been validated. The inclusion criteria were that the parents had a minimum educational background of junior high school level and had a child attending elementary school. The Chi-square analysis was done through the SPSS for Mac software, version 21. Results: The children ranged in age from 4 to 14 years. The study found that a lack of empathy was associated with emotional problems and problems with peer relations (P < 0.05). However, the relationship between empathy and prosocial behavior showed no statistically significant relationship (P > 0.05). Conclusion: Children require good empathy to properly function in their daily lives. Therefore, it is necessary to create and foster an educational environment that supports the development of empathy.
Camrelizumab combined with microwave ablation improves the objective response rate in advanced non-small cell lung cancer

Aim: The present study evaluated the safety and efficacy of camrelizumab (a programmed death-1 antibody) in combination with microwave ablation (MWA) in advanced non-small cell lung cancer (NSCLC). Materials and Methods: A total of 21 patients were prospectively enrolled. MWA was performed in 25 pulmonary lesions during 21 sessions. Camrelizumab was administered 5–7 days after MWA as a dose of 200 mg, which was repeated every 2 weeks until disease progression or intolerable toxicities. The primary endpoints were safety and the objective response rate (ORR). Other endpoints included progression-free survival (PFS) and overall survival (OS). Results: The technical success rate was 100%. No treatment-associated deaths were identified. Major complications, minor complications, and side effects of MWA were observed in 9, 8, and 14 patients, respectively. The main major complications included pneumothorax, pneumonia, hemorrhage, and pleural effusion. The adverse events of camrelizumab included reactive skin capillary hyperplasia (n = 9), hypothyroidism (n = 5), pneumonia (n = 4), fatigue (n = 2), leukopenia (n = 1), and neutropenia (n = 1). Grade 2 and 3 camrelizumab adverse events were identified in eight and three patients, respectively. The ORR was 33.3%, with two patients achieving complete response and five patients achieving partial response. The median PFS was 5.1 months and OS was not reached. Conclusions: Camrelizumab administration combined with MWA was safe in the treatment of advanced NSCLC, and the combination improved the ORR of camrelizumab alone compared to previous reports.
Metformin enhances radiosensitivity in hepatocellular carcinoma by inhibition of specificity protein 1 and epithelial-to-mesenchymal transition

Objective: Radiotherapy becomes more and more important in hepatocellular carcinoma (HCC) due to the development of technology, especially in unresectable cases. Metformin has a synergistic benefit with radiotherapy in some cancers, but remains unclear in HCC. This study aims to investigate the effect of metformin on radiosensitivity of HCC cells and the roles of specificity protein 1 (Sp1) as a target of metformin. Methods: The SMMC-7721 cell line was exposed to various doses of γ-ray irradiation (0, 2, 4, 6, and 8 Gy) and with or without different concentrations of metformin (0, 1, 5, 10, and 20 mM) to measure the radiosensitivity using MTT assay. Flow cytometry was used to determine cell cycle by propidium iodide (PI) staining and apoptosis by Hoechst 33342/PI staining and Annexin V-FITC/PI staining. Real-time polymerase chain reaction and Western blotting were performed to analyze the Sp1 mRNA and protein expressions of Sp1 and epithelial-to-mesenchymal transition (EMT) marker E-cadherin and Vimentin. The invasion capability was measured by the Boyden chamber assay. Results: In SMMC-7721 cells exposed to irradiation, metformin reduced proliferation and survival cells at various concentrations (0, 1, 5, 10, and 20 mM) and induced cell cycle arrest, apoptosis, and inhibited invasion. In SMMC-7721 cells with irradiation, the mRNA and protein expressions of Sp1 were significantly decreased by metformin as well as a selective Sp1 inhibitor. Metformin attenuated transforming growth factor-β1 induced decrease of E-cadherin and increase of Vimentin proteins. Conclusion: Metformin demonstrated enhanced radiosensitivity and inhibition of EMT in HCC cells. Sp1 might be a target of metformin in radiosensitization.
Value of intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic from nonmetastatic mesorectal lymph nodes with different short-axis diameters in rectal cancer

Background: Conventional magnetic resonance imaging (MRI) does not accurately evaluate lymph node (LN) status, which is essential for the treatment and prognosis assessment in patients with rectal cancer. Objective: The aim of this study is to evaluate the diagnostic value of intravoxel incoherent motion (IVIM) MRI in differentiating metastatic and nonmetastatic mesorectal LNs with different short-axis diameters in rectal cancer patients. Materials and Methods: Forty patients (154 LNs) were divided into three groups based on short-axis diameter: 3 mm ≤ × ≤5 mm, 5 mm < × ≤7 mm, and × >7 mm. MRI characteristics and IVIM parameters were compared between the metastatic and nonmetastatic LNs to determine the diagnostic value for discriminating them. Results: In the 3 mm ≤ × ≤ 5 mm group, mean D values were significantly lower in metastatic than in the nonmetastatic LNs (P < 0.001). In the 5 mm < × ≤7 mm group, mean f values were significantly lower in metastatic than nonmetastatic LNs (P < 0.05). In the × >7 mm group, only the short-axis diameter of metastatic LNs was significantly greater than that of nonmetastatic LNs (P < 0.05). The area under the curve, sensitivity, specificity, and cutoff values were used for differentiating the metastatic from the nonmetastatic LNs. Conclusion: IVIM parameters can differentiate metastatic from nonmetastatic LNs with smaller short-axis diameters (× ≤7 mm) in rectal cancer, and the short-axis diameter is a significant factor in identifying metastatic and nonmetastatic LNs in larger short-axis diameter groups (× >7 mm).
Evaluation of sanger sequencing method for ESR1 mutation detection in primary breast tumor

Objective: Exon 8 estrogen receptor 1 (ESR1) mutations in the ligand-binding domain play an important role in mechanisms of hormonal therapy resistance in breast cancer. Identification of ESR1 mutations is very important in determining the appropriate steps of therapy. In this study, we evaluate Sanger sequencing technique to detect the ESR1 mutation. Methods: This retrospective study was conducted using 49 advanced breast cancer patients with estrogen receptor positive. Deoxyribonucleic acid (DNA) material was extracted from primary breast tumor samples. Exon 8 ESR1 gene mutation was analyzed by Sanger sequencing method using BigDye Direct Sequencing Kit (Applied Biosystem) with gBlock synthesis gene fragment (Integrated DNA Technologies) D538G as a positive control. Results: The mean age of patients was 46.14 (±9.6) years, and 61.2% were in stage 4. There are no exon 8 ESR1 gene mutations detected in 49 primary tumor samples, whereas the gBlock-positive control showed base substitution in 1613A>G (D538G) indicating the success of sequencing reaction. Conclusion: Sanger sequencing has failed to detect ESR1 mutation in primary tumor breast samples. Other advanced molecular techniques should be performed for diagnosis of primary breast tumors.
Effectiveness and safety of robotic versus traditional laparoscopic gastrectomy for gastric cancer: An updated systematic review and meta-analysis

Gastrectomy is considered the gold standard treatment for gastric cancer patients. Currently, there are two minimally invasive surgical methods to choose from, robotic gastrectomy (RG) and laparoscopic gastrectomy (LG). Nevertheless, it is still unclear which is superior between the two. This meta-analysis aimed to investigate the effectiveness and safety of RG and LG for gastric cancer. A systematic literature search was performed using PubMed, Embase, and the Cochrane Library databases until September 2018 in studies that compared RG and LG in gastric cancer patients. Operative and postoperative outcomes analyzed were assessed. The quality of the evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluations. Twenty-four English studies were analyzed. The meta-analysis revealed that the RG group had a significantly longer operation time, lower intraoperative blood loss, and higher perioperative costs compared to the LG group. However, there were no differences in complications, conversion rate, reoperation rate, mortality, number of lymph nodes harvested, days of first flatus, postoperative hospitalization time, and survival rate between the two groups. RG was shown to be associated with decreased intraoperative blood loss and increased perioperative cost and operation time compared to LG. Several higher-quality original studies and prospective clinical trials are required to confirm the advantages of RG.
Computed tomography-guided iodine-125 brachytherapy for unresectable hepatocellular carcinoma

Purpose: This study aimed to retrospectively assess the outcome of interstitial iodine-125 brachytherapy for unresectable hepatocellular carcinoma (HCC). Materials and Methods: Between February 2013 and March 2019, 57 patients with 108 unresectable HCC lesions treated with computed tomography (CT)-guided iodine-125 seed brachytherapy were retrospectively analyzed. The primary endpoint was overall survival (OS). The secondary endpoints included local tumor control and progression-free survival (PFS). Potential factors associated with OS were assessed. Results: The mean follow-up duration was 24.3 ± 15.6 months (median, 20.5 months; range, 3.9–66.8 months). The median OS time was 23.6 months (95% confidence interval [CI], 18.4–28.8 months). The 1-, 2-, and 3-year actuarial OS rates were 80.0%, 46.1%, and 24.3%, respectively. The median PFS time was 12 months (95% CI, 9.9–14.5 months). The 1- and 2-year actuarial PFS rates were 50% and 20.1%, respectively. Local progression was noted in 11 (11.3%) of 108 lesions with mean local control time of 20.5 ± 8.8 months. The 1- and 2-year local control rates were 96.5% and 88.8%, respectively. Barcelona clinic liver cancer stage and Child–Pugh score were independent risk factors affecting the prognosis (hazard ratio [HR] = 0.330 [95% CI, 0.128–0.853] and HR = 0.303 [95% CI, 0.151–0.610], respectively). Hepatic artery pseudoaneurysm was found in 1 (1.8%) patient with lesion located in the porta hepatis. No other major complications developed during follow-up. Conclusion: CT-guided iodine-125 brachytherapy may be an effective and safe alternative with promising survival and increased local control rate in unresectable HCC treatment.
Kinetics versus Statistics in the Analysis of Therapeutic Effects of Mometasone and Calcipotriol for the Treatment of Alopecia Areata

© 2020 International Journal of Trichology | Published by Wolters Kluwer Medknow Sir, A recent article published by Alam et al. examines the therapeutic efficacy of potential drugs for alopecia areata. [1] Based on their statistical analysis, the authors concluded that the application of calcipotriol ointment with mometasone cream (Group A) had higher efficacy than that of mometasone alone (Group B) in the treatment of alopecia areata. [1] While their research suggests cooperative or additive effects of both drugs, our kinetic analysis of their data indicates that calcipotriol ointment has no additional beneficial effects in the treatment. In this letter, we show our kinetic analysis of the results.
Contribution of a program of insecticide treated nets for reducing malaria prevalence in Kori Subdistrict, Southwest Sumba

Introduction: Malaria is endemic in Indonesia, especially in East Nusa Tenggara (ENT). To reduce its prevalence, the Ministry of Health has launched a program of insecticide-treated net (ITN) distribution to protect people from mosquito bites. The aim of this study was to evaluate the contribution of ITNs in reducing malaria prevalence in Kori Subdistrict, Southwest Sumba, ENT. Materials and Methods: This study used secondary data from the primary healthcare center in Kori. The data were the number of patients, gender, age, and presenting with fever and diagnosed by rapid diagnostic test in the year before and after the distribution of ITNs. The effects were evaluated using Chi-square test. Results: The prevalence of malaria in 2014 was 51.1% and consisted of 30.6% Plasmodium falciparum, 19.5% Plasmodium vivax, and 1% mixed infection. After the distribution of ITNs in 2015, the prevalence decreased to 41.3% (P < 0.001) with the fall occurring in infections by P. falciparum, though the prevalence of P. vivax and of mixed infections did not change identifiably. The decrease in the prevalence was most marked for women and children under the age of five. Conclusion: The prevalence of malaria in Kori subdistrict, Southwest Sumba, fell substantially from 51.1% to 41.3% in the year after ITN distribution.
Outcome of salvage ureteral reimplantation after endoscopic treatment failure for high-grade vesicoureteral reflux compared to primary ureteral reimplantation

Introduction: Surgical treatment of vesicoureteral reflux is required after conservative treatment has failed. However, there is a controversy if fibrosis related to previous attempts of dextranomer/hyaluronic acid (Dx/Ha) injection increases the risk of surgical difficulty and postoperative complications. Therefore, the purpose of our study was to compare the outcome of salvage ureteral reimplantation (SUR), after failed endoscopic therapy, to that of primary ureteral reimplantation in patients with high-grade primary vesicoureteral reflux (VUR). Materials and Methods: We conducted a retrospective analysis of children, <14 years old, treated for Grade IV or V VUR, between 1998 and 2014. Cases were classified into the SUR or the PUR group. Cases of secondary VUR were excluded. All patients were treated using a cross-trigonal ureteral reimplantation technique by two surgeons. The following demographic and clinical variables were included in the analysis: presentation, reflux severity, scarring on imaging, age at endoscopic injection, total amount of Dx/Ha injected, operative time, postoperative hospital stay, operative complications, incidence of febrile urinary tract infections (UTIs) after surgery, and persistent VUR. Between the groups, differences were evaluated using Fisher's exact test. Results: Twenty-six patients were included, 19 in the SUR and 7 in the primary ureteral reimplantation (PUR) group. In the SUR group, 12 cases had a bilateral VUR and 7 had a unilateral VUR, with 4 bilateral and 3 unilateral VUR cases in the PUR group. In the SUR group, 13 patients had received one Dx/Ha injections, with the other 6 receiving two injections, of 0.5 ml of Dx/Ha (range, 0.5–2.0 ml). A bilateral reimplantation was performed in 14/19 patients in the SUR group and 4/7 in the PUR group. The median age at surgery was 4 years in the SUR group and 3 years in the PUR group (P < 0.02). The median operative time was comparable between the groups (120 and 140 min for the SUR and PUR groups, respectively, P = 0.73), with a comparable length of hospital stay (5 and 6 days, respectively, P = 0.061). Blood loss was generally <10 ml, except in three cases in the SUR group, due to difficult dissection. Over the median follow-up of 1 year, persistent Grade III SUR was identified in only one patient in the SUR group, with no occurrence of febrile UTIs postoperatively. Conclusion: SUR for high-grade primary VUR after failed Dx/Ha injection has the same success rate as PUR, with no significant complication rate, although the necessary dissection may be more difficult.
Newer advances in the treatment of Duchenne muscular dystrophy and spinal muscular atrophy

Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA) are two common and important Inherited neuromuscular disorders which have witnessed immense advances in their treatment owing to ongoing developments in gene therapy. Better modalities for clinical testing and improved clinical awareness has led to facilitation of innovative therapeutic research. Multiple new agents have been approved by regulatory authorities. A continuing research on evaluating such treatment options is required more than ever. These novel therapies have immense potential to transform this field and prolong the functional independence and lifespan of patients.
A Microstructural and Damage Investigation into the Low Temperature Impact Behavior of an HSLA Steel

A MICROSTRUCTURAL AND DAMAGE INVESTIGATION INTO THE LOW TEMPERATURE IMPACT BEHAVIOR OF AN HSLA STEEL Siyu Wu University of Guelph, 2019 Advisor: Dr. Alexander Bardelcik Stelco, a Canadian steel making company produced a hot rolled coil of a G40.21 50WT High Strength Low Alloy (HSLA) steel. The material needed to meet a demanding Drop Weight Tear Test (DWTT) specification at -35°C. The coils produced using a coiling temperature of 540°C did not meet the DWTT specification with mixed pass/fail results. A second coil produced using a coiling temperature of 500°C met the DWTT specification, but still with mixed results. To investigate this, a two-part study was undertaken. The first part investigated the effect of coiling temperature on the microstructure and CVN impact behavior. It was found that 540°C coiling temperature resulted in a coarser grain size but less initial void/inclusion content. Furthermore, CVN testing showed that the material coiled at 540°C had better impact toughness. The second part investigated the mixed pass/fail results for the DWTT and CVN tests conducted at -35°C for the material coiled at 500°C. The results showed that there were no obvious differences between the pass and failed specimen in terms of microstructure, initial porosity, damage evolution and impact testing behavior, which suggests that the test temperature of -35°C was within the ductilebrittle transition of this material.