bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective comparison of response rates and survival with neoadjuvant docetaxel versus anthracycline-based chemotherapy for locally advanced breast cancer patients
Authors: Gupta D. , Raina V. , Shukla N. K. , Rath G. K. , Mohanti B. K. , Sharma D. N. 
Published: August 2020

e11564 Background: LABC is a major problem in our country comprising of ≥ 20% of all breast cancer patients. Neoadjuvant chemotherapy is now standard treatment for LABC but randomized trials have failed to show survival advantage. Methods: We retrospectively analyzed locally advanced breast cancer (stage III) patients who received neoadjuvant chemotherapy (NACT) from January 2000 to December 2008. Out of 3000 case records screened, 570 (19%) were LABC and 110/570 (19%) treatment-naïve patients started on NACT were analyzed. Ninety one (37 docetaxel [D], 54 anthracycline [A]) patients were eligible for response and survival analysis. Pathological CR (pCR) was defined as no evidence of malignancy in both breast and axilla. Survival curves generated using Kaplan-Meier method and survivals compared using log-rank test. Results: Median age of whole cohort was 45 years (range 25–68 years). Premenopausal were 42% and ER+ 49.5%. Most (90%) were T4 tumors and 70% were stage IIIB. Median number of preoperative cycles was 3 and 6 in D and A group. Overall clinical response rates for breast primary were 74.3% (CR 28.6%) and 53.7% (CR 16.7%, p=0.58) while for axilla ORR were 75.7% (51.4% CR) vs 54.8% (40.4% CR, p=0.77) respectively for D and A. Corresponding pCR rates were 19% vs 13% respectively. There was no significant difference in disease free (3 year 56.84% vs 61.16%, p=0.80) and overall survival (3 year 70% vs 78.5%, p=0.86) between two groups. Those who achieved pCR in both groups also had no survival advantage (p=0.34) over non achievers. There was no difference in pCR rates for ER+ vs ER- patients but ER+ patients had significantly higher DFS than ER- patients (p=0.05). Conclusions: Although pCR rates were higher with docetaxel based NACT, it did not translate into superior DFS/OS compared to anthracycline based chemotherapies. Achievement of pCR too, was not associated with any survival advantage. No significant financial relationships to disclose.
Safety and effectiveness of dose dense neoadjuvant chemotherapy in patients with stage II/III breast cancer
Authors: Koya S. , Li Y. , McDaniel S. A. , LoBuglio A. F. , Krontiras H. , Carpenter J. , Nabell L. , Bland K. , Falkson C. , Forero A. 
Published: August 2020

e11566 Background: NSABP B-18 randomized women with operable breast cancer to receive chemotherapy (AC) either pre- or postoperatively; in the study there was no significant difference in disease free survival (DFS) or overall survival (OS) among patients in either group. Pathologic complete response rate (pCR) was directly proportional to DFS and OS. Dose dense adjuvant chemotherapy (ATC) has shown a statistically significant improvement in DFS and OS. Methods: We performed a single institution review of pts enrolled in a neoadjuvant trial and who received dose dense neoadjuvant chemotherapy (doxorubicin 60 mg/m2 IV Q2wks x4, paclitaxel 175 mg/m2 IV Q2wks x4, and cyclophosphamide 600 mg/m2 IV Q2wks x4) to assess response rates, safety, and DFS. Women with newly diagnosed breast cancer, T ≥ 3cm, any N, M0 were enrolled. Results: Since 02/2003, 43 pts were enrolled (mean age 47.6, range 28–64) and received dose dense chemotherapy. 41.4% of the pts were triple negative and 14.6% were Her2+ by FISH or IHC. The median follow-up is 49 months (range 8–69). Two patients dropped out without finishing therapy. Forty one pts completed dose dense chemotherapy and proceeded to surgery. 17 pts (41.4%) achieved a pCR in the breast and of those 14 pts were also negative in the axillary lymph nodes (34.1% pCR in the breast and lymph nodes). 10 of the 17 pts with pCR in the breast (8 out of the 14 pts with pCR in breast and axillary lymph nodes) were triple negative. 18 pts (43.9%) achieved PR, 3 pts (7.31%) had SD and 3 pts (7.31%) had PD. Up to November 2008, 7 pts who did not have a pCR have relapsed (4 triple negative, 1 Her2+, 1 ER/PR positive and 1 ER negative, PR positive) with a relapsed free survival rate of 85%. Hematologic toxicity consisted of grade 3 anemia in 2 patients with no grade 4 anemia, no G4 thrombocytopenia and febrile neutropenia in 2 pts. Non-hematologic grade 3 or 4 toxicity consisted of mediport thrombosis in 2 pts, hyperglycemia in 2 pts, syncope in 1 pt, neuropathy in 1 pt, and varicella zoster in 1 pt. Conclusions: Our results show that dose dense neoadjuvant chemotherapy achieves a pCR (breast + node) in about 1/3 of patients (34%) with tolerable toxicity; although the number of patients is limited, our data suggest that triple negative breast cancer seems to be the most sensitive tumor to this regimen. No significant financial relationships to disclose.
Video-assisted skin-sparing breast-conserving surgery for breast cancer and immediate reconstruction with autologous tissue: Clinical outcomes
Authors: Fujiwara I. , Nakajima H. , Mizuta N. , Sakaguchi K. , Hachimine Y. 
Published: August 2020

e11580 Background: This study analyzed clinical results of video-assisted breast-conserving surgery for breast cancer. Methods: Video-assisted breast-conserving surgery is indicated for breast cancer that has not invaded the skin. A skin incision is made at an inconspicuous site. Skin-sparing partial mastectomy was performed endoscopically on 244 patients (stage I, n=94; stage II, n=150). Morbidity, curability and patient satisfaction were analyzed. Results: Skin necrosis was seen in 9 patients. Local recurrence was seen in 13 patients (mean postoperative interval, 65.3 months). Distant metastasis-free survival at 60 months was 93.6% for stage I and 90.5% for stage II. Overall survival was 95.7% for stage I and 96.9% for stage II. Satisfaction with surgery as investigated by questionnaire was “good” for 72.3% of patients. Conclusions: Video-assisted breast-conserving surgery showed no increases in local or distant recurrence and patient satisfaction was high. Video-assisted breast-conserving surgery appears useful for local treatment of breast cancer. No significant financial relationships to disclose.
Same-day breast core biopsy result: Effect on ER/PR and HER-2 scores
Authors: Al-Sam S. , Al-Ramadhani S. , Jader S. , Singer J. , Aylwin A. 
Published: August 2020

e11585 Background: The peloris rapid tissue processor promises same-day biopsy results. It uses a unique ActivFlo system achieving fast processing by rapid even heating and reagent exchange. The effect on ER/PR, Her2 scores and morphology of tumour cells are assessed Methods: 80 breast core biopsies were so far included in this study. For each case, one of three core biopsies was processed by the Peloris and the other two by the Leica histology processor for next day reporting. Each core biopsy was fixed in formalin for at least 3 - 6 hours before being processed by both systems.Immunohistochemistry for ER, PR and Her2 was carried out as well as FISH for borderline Her2 cases scoring 2+. Microscopical features were compared by the same histopathologist and tumour grade and type were recorded Results: On comparing cases processed by Peloris and Leica, 47 out of 68 biopsies (69%) scored exactly the same for ER and PR. 16 biopsies (23.5%) had minor scoring differences but did not affect the overall hormone receptor status. In total, 63 out of 68 biopsies (94%) scored similar receptor status. 4 cases (6%) had differing ER/PR status. 56 cases had Her2 tested, 51 (91%) had similar scores and 5 (9%) had different scores. 14 borderline cases had FISH tests and no different results were seen between Peloris and Leica processed tissue. Morphologically there were differences in size of nuclei and nuclear chromatin appearances. We have started the second part of the study in which biopsies for the Peloris are loaded immediately on receipt giving about 30 minutes of formalin fixation. Of the 9 biopsies so far processed, there have been no noticeable differences between the fixed tissue on the Leica processor and the fresh tissue on Peloris with regards to ER, PR and Her2. Conclusions: In conclusion, immunohistochemistry for ER/PR and Her2 is similar in 93% and 91% cases respectively. Results for FISH test were similar in all 14 cases. However, morphological differences were noted and the effect on tumour grade was discussed. Further evaluation and comparison of tissue using both processors on morphological architecture need to be carried out and any differences reported. No significant financial relationships to disclose.
Gene Expression and RNA Splicing Imputation Identifies Novel Candidate Genes Associated with Osteoporosis
Authors: Liu Yong , Shen Hui , Greenbaum Jonathan , Liu Anqi , Su Kuan-Jui , Zhang Li-Shu , Zhang Lei , Tian Qing , Hu Hong-Gang , He Jin-Sheng , Deng Hong-Wen 
Published: August 2020

Abstract

Context
Though genome-wide association studies (GWASs) have identified hundreds of genetic variants associated with osteoporosis related traits, such as bone mineral density (BMD) and fracture, it remains a challenge to interpret their biological functions and underlying biological mechanisms.

Objective
Integrate diverse expression quantitative trait loci and splicing quantitative trait loci data with several powerful GWAS datasets to identify novel candidate genes associated with osteoporosis.

Design, Setting, and Participants
Here, we conducted a transcriptome-wide association study (TWAS) for total body BMD (TB-BMD) (n = 66 628 for discovery and 7697 for validation) and fracture (53 184 fracture cases and 373 611 controls for discovery and 37 857 cases and 227 116 controls for validation), respectively. We also conducted multi-SNP-based summarized mendelian randomization analysis to further validate our findings.

Results
In total, we detected 88 genes significantly associated with TB-BMD or fracture through expression or ribonucleic acid splicing. Summarized mendelian randomization analysis revealed that 78 of the significant genes may have potential causal effects on TB-BMD or fracture in at least 1 specific tissue. Among them, 64 genes have been reported in previous GWASs or TWASs for osteoporosis, such as ING3, CPED1, and WNT16, as well as 14 novel genes, such as DBF4B, GRN, TMUB2, and UNC93B1.

Conclusions
Overall, our findings provide novel insights into the pathogenesis mechanisms of osteoporosis and highlight the power of a TWAS to identify and prioritize potential causal genes.
Prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) in Patients With Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: de Vries Marieke , Westerink Jan , Kaasjager Karin H A H , de Valk Harold W 
Published: August 2020

AbstractContextNonalcoholic fatty liver disease (NAFLD) prevalence is high, especially in patients with obesity and type 2 diabetes, and is expected to rise steeply in the coming decades.ObjectiveWe estimated NAFLD prevalence in patients with type 1 diabetes and explored associated characteristics and outcomes.Data SourcesWe reviewed PubMed and Embase for studies on NAFLD and type 1 diabetes to March 2020. We screened references of included articles.Study SelectionTwo authors independently screened titles/abstracts. One author screened full text articles. NAFLD was defined as described in the individual studies: steatosis and/or fibrosis. Studies not reporting alternative causes of hepatic steatosis or defining NAFLD only as elevated liver enzymes, were excluded. Initially, 919 articles met the selection criteria.Data ExtractionOne researcher performed data extraction and risk of bias assessment using standardized tables.Data SynthesisWe assessed pooled prevalence rates by meta-analysis using a random-effects model, subsequently exploring heterogeneity by subgroup-, meta-regression-, and sensitivity analysis. Twenty studies between 2009 and 2019 were included (n = 3901). Pooled NAFLD prevalence was 19.3% (95% CI, 12.3%-27.5%), increasing to 22.0% (95% CI, 13.9%-31.2%) in adults only. Pooled prevalence of ultrasound studies was high (27.1%, 95% CI, 18.7%-36.3%) compared to studies using magnetic resonance imaging (8.6%, 95% CI, 2.1%-18.6%), liver biopsy (19.3%, 95% CI, 10.0%-30.7%), or transient elastography (2.3%, 95% CI, 0.6%-4.8%).ConclusionNAFLD prevalence in patients with type 1 diabetes is considerable and is highly dependent on the specific diagnostic modality and NAFLD definition used. These data are helpful in directing actions to standardize NAFLD diagnosis, which will help defining contributing mechanisms and outcomes.
Increased Prevalence of Nephrolithiasis and Hyperoxaluria in Paget Disease of Bone
Authors: Rendina Domenico , De Filippo Gianpaolo , Merlotti Daniela , Di Stefano Marco , Mingiano Christian , Giaquinto Alfonso , Evangelista Marco , Bo Mario , Arpino Sergio , Faraonio Raffaella , Strazzullo Pasquale , Gennari Luigi 
Published: August 2020

Abstract

Context
Nephrolithiasis (NL) and primary hyperparathyroidism (HPTH) are metabolic complications of Paget disease of bone (PDB), but recent data regarding their prevalence in PDB patients are lacking.

Objectives
Study 1: To compare the prevalence of primary HPTH and NL in 708 patients with PDB and in 1803 controls. Study 2: To evaluate the prevalence of NL-metabolic risk factors in 97 patients with PDB and NL, 219 PDB patients without NL, 364 NL patients without PDB, and 219 controls, all of them without HPTH.

Design
Cross-sectional multicentric study.

Setting
Italian referral centers for metabolic bone disorders.

Participants
Patients with PDB from the Associazione Italiana malati di osteodistrofia di Paget registry. Participants in the Olivetti Heart and the Siena Osteoporosis studies.

Main Outcome Measures
HPTH; NL; NL-metabolic risk factors.

Results
Patients with PDB showed higher prevalence of primary HPTH and NL compared with controls (P &lt; 0.01). The NL recurrence occurs more frequently in patients with polyostotic PDB. About one-half of patients with PDB but without NL showed 1 or more NL-related metabolic risk factors. The hyperoxaluria (HyperOx) prevalence was higher in patients with PDB and NL compared with patients with NL but without PDB and in patients with PDB without NL compared with controls (P = 0.01). Patients with PDB and HyperOx showed a longer lapse of time from the last aminobisphosphonate treatment.

Conclusions
NL and HPTH are frequent metabolic complication of PDB. The NL occurrence should be evaluated in patients with PDB, particularly in those with polyostotic disease and/or after aminobisphosphonate treatment to apply an adequate prevention strategy.
Efficacy of Once-Weekly Semaglutide vs Empagliflozin Added to Metformin in Type 2 Diabetes: Patient-Level Meta-analysis
Authors: Lingvay Ildiko , Capehorn Matthew S , Catarig Andrei-Mircea , Johansen Pierre , Lawson Jack , Sandberg Anna , Shaw Robert , Paine Abby 
Published: August 2020

Abstract

Context
No head-to-head trials have directly compared once-weekly (OW) semaglutide, a human glucagon-like peptide-1 analog, with empagliflozin, a sodium–glucose co-transporter-2 inhibitor, in type 2 diabetes (T2D).

Objective
We indirectly compared the efficacy of OW semaglutide 1 mg vs once-daily (OD) empagliflozin 25 mg in patients with T2D inadequately controlled on metformin monotherapy, using individual patient data (IPD) and meta-regression methodology.

Design, Setting, Participants, and Interventions
IPD for patients with T2D receiving metformin monotherapy and randomized to OW semaglutide 1 mg (SUSTAIN 2, 3, 8 trials), or to OD empagliflozin 25 mg (PIONEER 2 trial) were included. Meta-regression analyses were adjusted for potential prognostic factors and effect modifiers.

Main Outcome Measures
The primary efficacy outcomes were change from baseline to end-of-treatment (~1 year) in HbA1c (%-point) and body weight (kg). Responder outcomes and other clinically relevant efficacy measures were analyzed.

Results
Baseline characteristics were similar between OW semaglutide (n = 995) and empagliflozin (n = 410). Our analyses showed that OW semaglutide significantly reduced mean HbA1c and body weight vs empagliflozin (estimated treatment difference: −0.61%-point [95% confidence interval (CI): −0.72; −0.49] and −1.65 kg [95% CI: −2.22; −1.08], respectively; both P &lt; 0.0001). Complementary analyses supported the robustness of these results. A significantly greater proportion of patients on OW semaglutide vs empagliflozin also achieved HbA1c targets and weight-loss responses.

Conclusions
This indirect comparison suggests that OW semaglutide 1 mg provides superior reductions in HbA1c and body weight vs OD empagliflozin 25 mg in patients with T2D when added to metformin monotherapy.
Intermittent Fasting as a Trigger of Ketoacidosis in a Patient With Stable, Long-term Type 1 Diabetes
Authors: Fernández-Cardona Alejandra , González-Devia Deyanira , Mendivil Carlos O 
Published: August 2020

Abstract
Diabetic ketoacidosis (DKA) is an acute complication of type 1 diabetes (T1DM) with a high morbidity and mortality. Diabetic ketoacidosis is usually triggered by metabolic stressors that increase insulin requirements like infection, trauma, surgery, or some medications. Ketogenic diets are nutritional regimes that drastically reduce the intake of carbohydrates in order to increase circulating ketones and reduce appetite. Intermittent fasting diets similarly aim to impact appetite and body weight, but through the restriction of feeding to specific periods of time or days. A 58-year-old woman with T1DM and no prior episodes of DKA since her diagnosis 16 years ago was admitted to the emergency room with severe metabolic acidosis, ketosis, dehydration, and back pain after 9 days of practicing a ketogenic, intermittent fasting diet on the advice of a friend. The standard management of DKA led to the resolution of the symptoms and metabolic alterations, but this might not be the case in other patients. This case highlights the relevance of close professional monitoring of dietary and insulin schemes in patients with T1DM, and of the adequate nutritional education of patients in order to avoid having them follow fashionable dietary trends without knowledge of their implications.
Instancje nadawczo-odbiorcze w traktatach stawiarskich z XVI i XVII w.
Authors: Tutak Kinga 
Published: August 2020

Sender-Recipient Instances in Treatises on Ponds from the 16th and 17th Centuries
The paper discusses the ways in which sender–recipient strategy is realized in old treatises on pond economy. It focuses on the indices of textual relations between the master of the pond art and the student. The analysis has shown that in both treatises, the recipient is that communicative instance which plays a much more significant role than the sender. The organization and arrangement of the textual space serves the good of the recipient. The sender employs for this purpose desiderative constructions, lexical indices of cohesion of the utterance, and semantic-syntactic parallelism of elements. The authors of the treatises skilfully include an iconographic component in their lecture; Strumieński even refers to specific objects in the extra-linguistic reality.
Miniature Biomass Conversion Unit for Learning the Fundamentals of Heterogeneous Reactions through Analysis of Heat Transfer and Thermochemical Conversion
Authors: Gartner Jacqueline B. , Reynolds Olivia M. , Garcia-Perez Manuel , Thiessen David B. , Van Wie Bernard J. 
Published: August 2020

HighlightsA miniaturized thermochemical conversion system has been designed, manufactured, and optimized.Five laboratories can be performed with the system, incorporating heat transfer and reaction engineering phenomena.Educational materials to deploy the system in the classroom, including worksheets and solutions, are provided.Pyrolysis, combustion, and gasification exercises are shown with reaction visualization and product validation.Abstract. We describe a simple new miniaturized thermochemical module (MTM). Special considerations are needed to make the MTM useful not only for studying biomass conversion but also for providing safe classroom learning opportunities for heat and mass transfer and heterogeneous reaction engineering students and for training new researchers. The MTM consists of a quartz reactor wrapped with a Kanthal resistance wire and a silvered concentric annular glass shield for retaining thermal energy, placed in a protective Plexiglas viewing case. Safety is considered for use by new research trainees and within the classroom. We demonstrate MTM usage through five laboratory exercises beginning with an experimental design to determine operating modes to establish thermochemical conversion temperatures. Heat transfer skills are developed with the aid of a first-order differential heat transfer model and fractional factorial design. Thermochemical conversion is demonstrated and products are validated for pyrolysis, gasification, and combustion. The combustion laboratory also offers significant insight into reaction versus mass transfer-controlled regimes and for modeling heat transfer. Discussion is provided on the utility of the system for demonstrating heat transfer, kinetic, and mass transfer concepts, with applications across the engineering curriculum. Keywords: Combustion, Education, Gasification, Heat transfer modeling, Miniature thermochemical module, Pyrolysis.