Miracle-dz/UniFAR-FTUs huggingface dataset:
Obesity and risk of recurrence or death after adjuvant endocrine therapy with letrozole or tamoxifen in the breast international group 1-98 trial.

PURPOSE To examine the association of baseline body mass index (BMI) with the risk of recurrence or death in postmenopausal women with early-stage breast cancer receiving adjuvant tamoxifen or letrozole in the Breast International Group (BIG) 1-98 trial at 8.7 years of median follow-up. PATIENTS AND METHODS This report analyzes 4,760 patients with breast cancer randomly assigned to 5 years of monotherapy with letrozole or tamoxifen in the BIG 1-98 trial with available information on BMI at randomization. Multivariable Cox modeling assessed the association of BMI with disease-free survival, overall survival (OS), breast cancer-free interval, and distant recurrence-free interval and tested for treatment-by-BMI interaction. Median follow-up was 8.7 years. RESULTS Seventeen percent of patients have died. Obese patients (BMI ≥ 30 kg/m(2)) had slightly poorer OS (hazard ratio [HR] = 1.19; 95% CI, 0.99 to 1.44) than patients with normal BMI (< 25 kg/m(2)), whereas no trend in OS was observed in overweight (BMI 25 to < 30 kg/m(2)) versus normal-weight patients (HR = 1.02; 95% CI, 0.86 to 1.20). Treatment-by-BMI interactions were not statistically significant. The HRs for OS comparing obese versus normal BMI were HR = 1.22 (95% CI, 0.93 to 1.60) and HR = 1.18 (95% CI, 0.91 to 1.52) in the letrozole and tamoxifen groups, respectively. CONCLUSION There was no evidence that the benefit of letrozole over tamoxifen differed according to patients' BMI.
Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis.

PURPOSE This study aimed to evaluate the effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer. METHODS Literature databases were searched to identify randomized controlled trials that compared a psycho-oncologic intervention delivered face-to face with a control condition. The main outcome measures were emotional distress, anxiety, depression, and quality of life. Outcomes were evaluated for three time periods: post-treatment, ≤ 6 months, and more than 6 months. We applied standard meta-analytic techniques to analyze both published and unpublished data from the retrieved studies. Sensitivity analyses and meta-regression were used to explore reasons for heterogeneity. RESULTS We retrieved 198 studies (covering 22,238 patients) that report 218 treatment-control comparisons. Significant small-to-medium effects were observed for individual and group psychotherapy and psychoeducation. These effects were sustained, in part, in the medium term (≤ 6 months) and long term (> 6 months). Short-term effects were evident for relaxation training. Studies that preselected participants according to increased distress produced large effects at post-treatment. A moderator effect was found for the moderator variable "duration of the intervention," with longer interventions producing more sustained effects. Indicators of study quality were often not reported. Small-sample bias indicative of possible publication bias was found for some effects, particularly with individual psychotherapy and relaxation training. CONCLUSION Various types of psycho-oncologic interventions are associated with significant, small-to-medium effects on emotional distress and quality of life. These results should be interpreted with caution, however, because of the low quality of reporting in many of the trials.
(90)Yttrium-ibritumomab-tiuxetan as first-line treatment for follicular lymphoma: 30 months of follow-up data from an international multicenter phase II clinical trial.

PURPOSE We report on a multicenter phase II trial of (90)yttrium-ibritumomab-tiuxetan ((90)YIT) as first-line stand-alone therapy for patients with follicular lymphoma (FL). PATIENTS AND METHODS Fifty-nine patients with CD20(+) FL grade 1 to 3a in stages II, III, or IV, age 50 years old or older requiring therapy were enrolled. They received (90)YIT according to standard procedure. If complete response (CR) or unconfirmed complete response (CRu) without evidence for minimal residual disease (MRD) 6 months after application of (90)YIT was achieved, patients were observed without further intervention. The same applied to patients with partial response (PR) or with stable disease (SD). Patients with CR but with persisting MRD were to receive a consolidation treatment with rituximab. Primary end point was the clinical and molecular response rate. Secondary end points were time to progression, safety, and tolerability. RESULTS Six months after treatment with (90)YIT, 56% of the patients showed a CR or CRu and 31% achieved a PR. After a median follow-up of 30.6 months, the progression-free survival (PFS) was 26 months. There was a trend for shorter PFS in patients with increased lactate dehydrogenase (LDH). Of the 26 patients who had CR 12 months after (90)YIT, only three had relapsed. Median time to next treatment has not been reached. The most common toxicities were transient thrombocytopenia and leukocytopenia. Nonhematologic toxicities never exceeded grade 2 according to Common Terminology Criteria for Adverse Events (CTCAE v2.0). CONCLUSION (90)YIT is well tolerated and achieves high response rates. Patients with increased LDH tend to relapse earlier, and individuals in remission 1 year after (90)YIT appear to have long- lasting responses.
An Efficient SSHI Interface With Increased Input Range for Piezoelectric Energy Harvesting Under Variable Conditions

Piezoelectric vibration energy harvesters have been widely researched and are increasingly employed for powering wireless sensor nodes. The synchronized switch harvesting on inductor (SSHI) circuit is one of the most efficient interfaces for piezoelectric vibration energy harvesters. However, the traditional incarnation of this circuit suffers from a significant startup issue that limits operation in low and variable amplitude vibration environments. This paper addresses this start-up issue for the SSHI rectifier by proposing a new architecture with SSHI startup circuitry. The startup circuitry monitors if the SSHI circuit is operating correctly and re-starts the SSHI interface if required. The proposed circuit is comprehensively analyzed and experimentally validated through tests conducted by integrating a commercial piezoelectric vibration energy harvester with the new interface circuit designed in a 0.35-μm HV CMOS process. Compared to conventional SSHI rectifiers, the proposed circuit significantly decreases the required minimum input excitation amplitude before energy can be harvested, making it possible to extract energy over an increased excitation range.
Randomized controlled trial of interval-compressed chemotherapy for the treatment of localized Ewing sarcoma: a report from the Children's Oncology Group.

PURPOSE Chemotherapy with alternating vincristine-doxorubicin-cyclophosphamide and ifosfamide-etoposide cycles and primary tumor treatment with surgery and/or radiation therapy constitute the usual approach to localized Ewing sarcoma in North America. We tested whether chemotherapy intensification through interval compression could improve outcome. PATIENTS AND METHODS This was a prospective, randomized controlled trial for patients younger than 50 years old with newly diagnosed localized extradural Ewing sarcoma. Patients assigned to standard and intensified treatment were to begin chemotherapy cycles every 21 and 14 days, respectively, provided an absolute neutrophil count greater than 750×10(6)/L and a platelet count greater than 75×10(9)/L. Patients received vincristine (2 mg/m2), doxorubicin (75 mg/m2), and cyclophosphamide (1.2 g/m2) alternating with ifosfamide (9 g/m2) and etoposide (500 mg/m2) for 14 cycles, with filgrastim (5 mg/kg per day; maximum, 300 mg) between cycles. Primary tumor treatment (surgery, radiation, or both) was to begin at week 13 (after four cycles in the standard arm and six cycles in the intensified arm). The primary end point was event-free survival (EFS). The study is registered at ClinicalTrials.gov (identifier: NCT00006734). RESULTS Five hundred eighty-seven patients were enrolled and randomly assigned, and 568 patients were eligible, with 284 patients in each regimen. For all cycles, the median cycle interval for standard treatment was 21 days (mean, 22.45 days); for intensified treatment, the median interval was 15 days (mean, 17.29 days). EFS at a median of 5 years was 65% in the standard arm and 73% in the intensified arm (P=.048). The toxicity of the regimens was similar. CONCLUSION For localized Ewing sarcoma, chemotherapy administered every 2 weeks is more effective than chemotherapy administered every 3 weeks, with no increase in toxicity.
Is the pooled analysis of the north central cancer treatment group phase III trials N9741 and N9841 biased?

(VTE) may be associated with a poor outcome. 2 VTE is a major public health issue and one of the most important causes of morbidity and mortality in patients with cancer, with a negative impact on their quality of life. It has been estimated that VTE is the second leading cause of death in hospitalized and ambulatory patients with cancer. While receiving chemotherapy, patients with cancer have a seven-fold risk of developing VTE as compared with other patients without cancer. 3 In the N9741 and N9841 trials, Franko et al 1 did not report this type of toxicity. There are several reasons for the underreporting of VTE events. First, in its initial version, the National Cancer Institute Criteria for Common Toxicity did not include VTE. This observation is particularly pertinent for the study published by Franko et al because the authors used version 2 of the Common Toxicity Criteria. Second, the current toxicity definitions with respect to VTE are poor and need clarification. No differences are highlighted between proximal and distal venous thrombosis, although patients with deep vein thrombosis (DVT) of the calf have approximately half the risk of recurrent VTE as those who have had a proximal DVT. Furthermore, the risk of developing pulmonary embolism is increased for patients with proximal DVT as compared to those with distal DVT. In addition, grade 2 and grade 3 are strictly related to the need of a therapeutic approach, whereas clinical situations where oncologist cannot give an active treatment because of thrombocytopenia or other transient medical conditions are not uncommon.
The effect of oxidative stress polymorphisms on the association between long-term black carbon exposure and lung function among elderly men

Background Black carbon (BC) is a pro-oxidant, traffic-related pollutant linked with lung function decline. We evaluated the influence of genetic variation in the oxidative stress pathway on the association between long-term BC exposure and lung function decline. Methods Lung function parameters (FVC and FEV1) were measured during one or more study visits between 1995 and 2011 (n=651 participants) among an elderly cohort: the Normative Aging Study. Residential BC exposure levels were estimated using a spatiotemporal land use regression model. We evaluated whether oxidative stress variants, combined into a genetic score, modify the association between 1-year and 5-year moving averages of BC exposure and lung function levels and rates of decline, using linear mixed models. Results We report stronger associations between long-term BC exposure and increased rate of lung function decline, but not baseline lung function level, among participants with higher oxidative stress allelic risk profiles compared with participants with lower risk profiles. Associations were strongest when evaluating 5-year moving averages of BC exposure. A 0.5 µg/m3 increase in 5-year BC exposure was associated with a 0.1% yearly increase in FVC (95% CI −0.5 to 0.7) among participants with low genetic risk scores and a 1.3% yearly decrease (95% CI −1.8 to −0.8) among those with high scores (p-interaction=0.0003). Discussion Our results suggest that elderly men with high oxidative stress genetic scores may be more susceptible to the effects of BC on lung function decline. The results, if confirmed, should inform air-quality recommendations in light of a potentially susceptible subgroup.
Communicating and understanding the purpose of pediatric phase I cancer trials.

PURPOSE Quality informed consent should provide a clear understanding of the purpose of the research. Given the ethical challenges of pediatric phase I cancer trials, it is important to investigate physician-parent communication during informed consent conferences (ICCs) and parental understanding of the purpose of these studies. METHODS In the multisite Informed Consent in Pediatric Phase I Cancer Trials study, 85 ICCs for phase I research between June 2008 and May 2011 were directly observed, and 60 parents were subsequently interviewed. The scientific purpose was defined as composite understanding of drug safety, dose finding, and dose escalation. We determined the frequency with which physicians explained these and other phase I-related concepts during the ICC. Parent interviews were analyzed to determine understanding. RESULTS The child was present at 83 of 85 ICCs. Only 32% of parents demonstrated substantial understanding of the scientific purpose of phase I cancer trials; 35% demonstrated little or no understanding. Parents of higher socioeconomic status and racial majority status were more likely to understand the scientific purpose. Factors associated with understanding included physician explanation of the goal of the applicable phase I protocol offered (explained in 85% of ICCs) and explanation of the dose cohorts (explained in 43% of ICCs). Physicians explained drug safety in 23% of ICCs, dose finding in 52% of ICCs, and dose escalation in 53% of ICCs. CONCLUSION Many parents of children participating in phase I trials do not understand the purpose of these trials. Physician-parent communication about the purpose of phase I research is lacking during ICCs.
Comparison of a new portable digital meniscometer and optical coherence tomography in tear meniscus radius measurement

Non‐invasive measurement of tear meniscus radius (TMR) is useful in the assessment of tear volume for dry eye diagnosis. This study investigates the agreement between a new, portable, slit‐lamp mounted, digital meniscometer (PDM) and optical coherence tomography (OCT) in the measurement of human TMR.
MMG and EMG responses during fatiguing isokinetic muscle contractions at different velocities

The purpose of this study was to determine mechanomyographic (MMG) and electromyographic (EMG) responses of the superficial quadriceps muscles during repeated isokinetic contractions in order to provide information about motor control strategies during such activity, and to assess uniformity in mechanical activity (MMG) between the investigated muscles. Ten adults performed 50 maximal concentric muscle contractions at three randomly selected contraction velocities (60, 180, and 300°·s−1) on different days. Surface electrodes and an MMG sensor were placed on the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM). EMG and MMG amplitude and peak torque (PT) were calculated for each contraction, normalized, and averaged across all subjects. The results demonstrated that MMG amplitude more closely tracked the fatigue‐induced decline in torque production at each velocity than did EMG amplitude. This indicates that MMG amplitude may be useful for estimating force production during fatiguing dynamic contractions when a direct measure is not available, such as during certain rehabilitative exercises. MMG amplitude responses of the VL, RF, and VM were not uniform for each velocity or across velocities, indicating that it may be possible to detect the individual contribution of each muscle to force production during repeated dynamic contractions. Therefore, MMG amplitude may be clinically useful for detecting abnormal force contributions of individual muscles during dynamic contractions, and determining whether various treatments are successful at correcting such abnormalities. © 2002 Wiley Periodicals, Inc. Muscle Nerve 26: 367–373, 2002
Comparing coding between interventional radiologists and hospital coding departments

Correspondence: J Cox Consultant radiologist, Department of radiology, University hospital North Durham, North rd, Durham, Dh1 5TW, UK Tel +44 191 333 2491 email julie.cox@cddft.nhs. uk Purpose: The purpose of this audit was to assess whether there was a difference in the health care resource groups coding and subsequent reimbursement of interventional radiology cases, depending on whether the coding was carried out by a clinician or an administrator in the coding department Methodology: A retrospective analysis was undertaken of 137 consecutive patients who had therapeutic endovascular procedures in our Trust from 2005–2007. Six patients were excluded due to lack of data. The audit was carried out at a single center. A single clinician, under the supervision of a consultant interventional radiologist, proceeded to code the procedure after referring to the patient’s radiology report and notes. Findings: The error rate by part of the coding department in terms of assessing nonelective versus elective procedures was 7%. This had lead to a £2,352 excess charge on the part of the coding department. Additionally, there were errors in a further 19 procedures (15%), in which vascular stents had been inserted during the procedure but had not been coded for. The stent usage had not been recognised by the coding administrators in their evaluation, and this equipment-based undercoding resulted in underpayment by the patient’s primary care trust of £11,153. Originality/value: This is the first published audit of coding in interventional radiology in the UK. Coding in complex subspecialties like vascular interventional radiology requires more clinical input and engagement to ensure the case complexity is accurately reflected in the codes assigned and in the subsequent reimbursement.
Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease: results from a cross-sectional study in China

Objective The association between exposure to ambient particles with a median aerodynamic diameter less than 10/2.5 µm (particulate matter, PM10/2.5) and COPD remains unclear. Our study objective was to examine the association between ambient PM10/2.5 concentrations and lung functions in adults. Methods A cross-sectional study was conducted in southern China. Seven clusters were randomly selected from four cities across Guangdong province. Residents aged ≥20 years in the participating clusters were randomly recruited; all eligible participants were examined with a standardised questionnaire and spirometry. COPD was defined as a post-bronchodilator FEV1/FVC less than 70%. Atmosphere PM sampling was conducted across the clusters along with our survey. Results Of the subjects initially recruited, 84.4% (n=5993) were included for analysis. COPD prevalence and atmosphere PM concentration varied significantly among the seven clusters. COPD prevalence was significantly associated with elevated PM concentration levels: adjusted OR 2.416 (95% CI 1.417 to 4.118) for >35 and ≤75 µg/m3 and 2.530 (1.280 to 5.001) for >75 µg/m3 compared with the level of ≤35 µg/m3 for PM2.5; adjusted OR 2.442 (95% CI 1.449 to 4.117) for >50 and ≤150 µg/m3 compared with the level of ≤50 µg/m3 for PM1. A 10 µg/m3 increase in PM2.5 concentrations was associated with a 26 mL (95% CI −43 to −9) decrease in FEV1, a 28 mL (−49 to −8) decrease in FVC and a 0.09% decrease (−0.170 to −0.010) in FEV1/FVC ratio. The associations of COPD with PM10 were consistent with PM2.5 but slightly weaker. Conclusions Exposure to higher PM concentrations was strongly associated with increased COPD prevalence and declined respiratory function. Trial registration number ChiCTR-OO-14004264; Post-results.
Chapter 8. Rural-Urban Differences in Seniors' Neighbourhood Preferences

ABSTRACT Past research has indicated that it is important to consider the neighbourhood environment when addressing the issue of housing for seniors. Because rural and urban environments differ, neighbourhood preferences may vary as well. The following study attempts to ascertain the neighbourhood amenity preferences of a sample of rural and urban living elderly. A total of 1,408 seniors were asked to consider the importance of 11 amenities in a place to live. A factor analysis of the items indicates that planners need to consider three broad areas of amenities in a place to live: necessities, social interaction and life enrichment. Bivariate crosstabulations and multiple regression results demonstrate the importance of social interaction amenities to rural elders, confirming the instrumental importance that social relations serve for those living in rural areas.
The median informs the message: accuracy of individualized scenarios for survival time based on oncologists' estimates.

PURPOSE To determine the accuracy and usefulness of oncologists' estimates of survival time in individual patients with advanced cancer. PATIENTS AND METHODS Twenty-one oncologists estimated the "median survival of a group of identical patients" for each of 114 patients with advanced cancer. Accuracy was defined by the proportions of patients with an observed survival time bounded by prespecified multiples of their estimated survival time. We expected 50% to live longer (or shorter) than their oncologist's estimate (calibration), 50% to live from half to double their estimate (typical scenario), 5% to 10% to live ≤ one quarter of their estimate (worst-case scenario), and 5% to 10% to live three or more times their estimate (best-case scenario). Estimates within 0.67 to 1.33 times observed survival were deemed precise. Discriminative value was assessed with Harrell's C-statistic and prognostic significance with proportional hazards regression. RESULTS Median survival time was 11 months. Oncologists' estimates were relatively well-calibrated (61% shorter than observed), imprecise (29% from 0.67 to 1.33 times observed), and moderately discriminative (Harrell C-statistic 0.63; P = .001). The proportion of patients with an observed survival half to double their oncologist's estimate was 63%, ≤ one quarter of their oncologist's estimate was 6%, and three or more times their oncologist's estimate was 14%. Independent predictors of observed survival were oncologist's estimate (hazard ratio [HR] = 0.92; P = .004), dry mouth (HR = 5.1; P < .0001), alkaline phosphatase more than 101 U/L (HR = 2.8; P = .0002), Karnofsky performance status ≤ 70 (HR = 2.3; P = .007), prostate primary (HR = 0.23; P = .002), and steroid use (HR = 2.4; P = .02). CONCLUSION Oncologists' estimates of survival time were relatively well-calibrated, moderately discriminative, independently associated with observed survival, and a reasonable basis for estimating worst-case, typical, and best-case scenarios for survival.
Delayed Effect of Radiation Therapy with or without Chemotherapy on Ovarian Function in Women with Hodgkin's Disease

In this retrospective investigation of 51 female patients with Hodgkin's disease, the age of the patient at the time of primary treatment and the extent of radiation therapy were the two most important factors determining post-therapy ovarian function. Favourable indicators of ovarian preservation included young age, especially premenarchal, at the time of primary therapy, and irradiation confined to above the pelvic brim, whereas, age over 40 and irradiation below the pelvic brim predicted high probability of ovarian failure. Overall, 55 per cent of female patients under the age of 50 treated with chemotherapy alone or with radiation therapy above the pelvic brim retained normal ovarian function. The stage of disease at presentation and the post-therapy status of disease had no apparent effect on subsequent menstrual function.