bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunotherapy as second‐line treatment and beyond for non‐small cell lung cancer in a single center of China: Outcomes, toxicities, and clinical predictive factors from a real‐world retrospective analysis
Authors: Chen Minjiang , Li Qiang , Xu Yan , Zhao Jing , Zhang Li , Wei Lijuan , Zhong Wei , Wang Mengzhao 
Published: May 2020

AbstractBackgroundReal‐world evidence of second‐line treatment and beyond with immune checkpoint inhibitors (ICIs) in Chinese patients is lacking. Here, we aimed to assess the efficacy, responses, and immune‐related side effects of anti‐PD‐1 agents in real‐life practice.MethodsWe retrospectively analyzed consecutive patients who received nivolumab or pembrolizumab monotherapy at Peking Medical College Hospital. We collected baseline characteristics, evaluated treatment efficacy, and categorized immune‐related adverse effects (irAEs). Predictive factors of treatment response were also determined.ResultsThe study included 97 patients with a median age of 64 years. The majority of patients were male, with nonsquamous histological type and advanced stage tumor, and had a history of smoking. Most patients received ICIs as second‐line therapy. Expression of PD‐L1 was detected in 34.11% patients. Overall response rate (ORR) and disease control rate (DCR) were 16.49% and 60.82%, respectively. None of the patients achieved complete response (CR). The median PFS and OS were150 days and 537 days, respectively. The incidence of immune‐related toxicities was similar to the one previously reported. Patients with driver gene mutations had shorter PFS than patients without, while patients who encountered irAE had relatively longer PFS.ConclusionsThe real‐world clinical outcome of ICIs in second‐ and further‐line NSCLC therapy is promising. Several characteristics may have predictive value for efficacy. Occurrence of irAEs during treatment was acceptable and could be an independent positive predictive for PFS.Key pointsSignificant findings of the study
Efficacy and safety profile of ICIs as second‐line treatment or above for patients with NSCLC are promising in real world circumstances
Incidence and median time to the occurrence of irAEs vary between organs
What this study adds
Driver gene mutations are associated with lower progression‐free survival
Occurrence of irAEs is associated with higher progression‐free survival
Clinical recommendations on lung cancer management during the COVID‐19 pandemic
Authors: Xu Yan , Liu Hongsheng , Hu Ke , Wang Mengzhao 
Published: May 2020

Coronavirus disease 2019 (COVID‐19) is spreading worldwide, and has been declared as an international public health concern. Patients with lung cancer are highly susceptible to infection compared to healthy individuals because of systemic immunosuppression induced by malignancy and anticancer therapy. Furthermore, patients with cancer demonstrate poorer outcomes following infection. Hence, patients with lung cancer should be considered a priority group for COVID‐19 prevention. Furthermore, the routine treatment of patients with cancer has been affected during the COVID‐19 pandemic, and patients may not have been able to undergo timely and effective antitumor treatment, thereby indicating a poor prognosis. Here, we provide some suggestions for early identification of COVID‐19 and differential diagnosis in patients with lung cancer who have fever and respiratory symptoms. Our medical team also provide clinical recommendations on lung cancer management during the COVID‐19 pandemic, for carrying out meticulous and individualized clinical management of lung cancer patients and maximum protection to effectively prevent COVID‐19.Key pointsSignificant findings of the studyThis article provides suggestions for early identification of COVID‐19 and differential diagnosis in patients with lung cancer with fever and respiratory symptoms.What this study addsThis article makes clinical recommendations on lung cancer management during the COVID‐19 pandemic.
Low‐dose hilar and mediastinal stereotactic body radiation therapy for non‐small cell lung cancer: Analysis of outcomes in patients receiving one or multiple courses of treatment
Authors: Kowalchuk Roman O. , Waters Michael R. , Richardson Martin , Spencer Kelly , Larner James M. , Kersh Charles R. 
Published: May 2020

BackgroundThis study reports the outcomes of a single institutional experience treating non‐small cell lung cancer (NSCLC) involving the pulmonary hilum with low‐dose stereotactic body radiation therapy (SBRT). The authors also present a series of repeat hilar SBRT.MethodsInclusion criteria required treatment with SBRT for NSCLC involving regional lymph nodes of the: (i) hilum, (ii) mediastinum, (iii) aortopulmonary window (station 5), or (iv) mainstem bronchus. At least one clinical follow‐up with imaging was required, unless the patient had a prior documented death from cancer.ResultsA total of 32 patients with 44 treatments were included, and 37 treatments targeted the hilum directly, with seven concerning the mediastinum, AP window, or mainstem bronchus. Median dose was 28 Gy in four fractions with once‐weekly fractionation. At a median clinical follow‐up of 23 months, local control was 64%. Median overall survival was 24 months, and median progression‐free survival was 15 months. A total of 48% of treatments resulted in complete radiographic response on last imaging follow‐up, and no cases of grade ≥ 3 toxicity were reported. For repeat SBRT (after prior hilar SBRT), local control was 92%. Median overall survival was 20 months, and median progression‐free survival was 19 months. Complete radiographic response was noted after 58% of treatments, with 0 instances of progressive response and no reported side effects.ConclusionsLow‐dose hilar SBRT was efficacious and well‐tolerated, with impressive overall survival and no grade ≥ 3 toxicity. Repeat treatments with SBRT were feasible and effective, demonstrating overall survival, local control, and toxicity comparable to primary treatments.Key pointsSignificant findings of the study
Low‐dose hilar SBRT was efficacious and well‐tolerated
Repeated treatments with SBRT demonstrated encouraging results, comparable to primary treatments
What this study adds
This study contributes to the small body of literature concerning hilar SBRT
Repeat hilar SBRT was safe and feasible
Toxicity was minimal with low‐dose SBRT
Once‐weekly fractionation may have contributed to low rate of side effects.
Older adults with sarcopenia have distinct skeletal muscle phosphodiester, phosphocreatine, and phospholipid profiles
Authors: Hinkley James Matthew , Cornnell Heather H. , Standley Robert A. , Chen Emily Y. , Narain Niven R. , Greenwood Bennett P. , Bussberg Valerie , Tolstikov Vladimir V. , Kiebish Michael A. , Yi Fanchao , Vega Rick B. , Goodpaster Bret H. , Coen Paul M. 
Published: May 2020

AbstractThe loss of skeletal muscle mass and function with age (sarcopenia) is a critical healthcare challenge for older adults. 31‐phosphorus magnetic resonance spectroscopy (31P‐MRS) is a powerful tool used to evaluate phosphorus metabolite levels in muscle. Here, we sought to determine which phosphorus metabolites were linked with reduced muscle mass and function in older adults. This investigation was conducted across two separate studies. Resting phosphorus metabolites in skeletal muscle were examined by 31P‐MRS. In the first study, fifty‐five older adults with obesity were enrolled and we found that resting phosphocreatine (PCr) was positively associated with muscle volume and knee extensor peak power, while a phosphodiester peak (PDE2) was negatively related to these variables. In the second study, we examined well‐phenotyped older adults that were classified as nonsarcopenic or sarcopenic based on sex‐specific criteria described by the European Working Group on Sarcopenia in Older People. PCr content was lower in muscle from older adults with sarcopenia compared to controls, while PDE2 was elevated. Percutaneous biopsy specimens of the vastus lateralis were obtained for metabolomic and lipidomic analyses. Lower PCr was related to higher muscle creatine. PDE2 was associated with glycerol‐phosphoethanolamine levels, a putative marker of phospholipid membrane damage. Lipidomic analyses revealed that the major phospholipids, (phosphatidylcholine, phosphatidylethanolamine, and phosphatidylglycerol) were elevated in sarcopenic muscle and were inversely related to muscle volume and peak power. These data suggest phosphorus metabolites and phospholipids are associated with the loss of skeletal muscle mass and function in older adults.
Late‐onset Hypogonadism: Bone health
Authors: Rochira Vincenzo 
Published: May 2020

AbstractBackgroundBone health is underdiagnosed and undermanaged in men. Bone loss occurs in men with hypogonadism and in aging men. Thus, patients with a diagnosis of late‐onset hypogonadism (LOH) are at risk of osteoporosis and osteoporotic fractures.ObjectivesTo provide an update on research data and clinical implications regarding bone health in men with LOH by reviewing literature articles on this issue.Materials and MethodsA thorough search of listed publications in PubMed on bone health in older men with hypogonadism was performed, and other articles derived from these publications were further identified.ResultsLate‐onset Hypogonadism may be associated with reduced bone mineral density (BMD). In a pathophysiological perspective, the detrimental effects of testosterone (T) deficiency on BMD are partly ascribed to relative estrogen deficiency and both serum T and serum estradiol (E2) need to be above 200 ng/dL and 20 pg/mL to prevent bone loss. The effects of exogenous T on BMD are controversial, but most of the studies confirm that testosterone replacement therapy (TRT) increases BMD and prevents further bone loss in men with hypogonadism. No data are available on TRT and the prevention of fractures.Discussion and ConclusionIn men with documented LOH, a specific clinical workup should be addressed to the diagnosis of osteoporosis in order to program subsequent follow‐up and consider specific bone active therapy. TRT should be started according to guidelines of male hypogonadism while keeping in mind that it may also have positive effects also on bone health in men with LOH.
Significance of umbilical trocar size and intra‐abdominal pressure on postoperative pain after transabdominal preperitoneal repair for inguinal hernia
Authors: Kinoshita Shoichi , Ohyama Takao , Kawaguchi Chihiro , Ikeda Naoya , Sho Masayuki 
Published: May 2020

AbstractIntroductionLaparoscopic inguinal hernia repair is reported to be associated with lower postoperative pain than open repair. However, in the actual clinical setting, some patients experience relatively severe pain. This study aimed to elucidate surgical factors that affect pain after transabdominal preperitoneal (TAPP) repair.MethodsWe evaluated 199 patients who underwent elective TAPP for inguinal hernia from 2014 to 2019 in Heisei Memorial Hospital. The umbilical trocar size was changed from 12 to 5 mm from October 2017. The pneumoperitoneum intra‐abdominal pressure was changed from 10 to 8 mmHg from 2019. Postoperative pain scores and analgesics were compared between patients who were grouped according to trocar size and intra‐abdominal pressure, as well as 80 patients who received open repair.ResultsPatients with a 12 mm trocar had significantly higher pain than open repair patients (P < .0001). Patients with a 5 mm umbilical trocar and 8 mm Hg intra‐abdominal pressure had significantly lower pain than a 12 mm trocar (P = .025) and did not significantly differ with pain after open repair. Analgesic use significantly decreased in patients using a 5 mm trocar than 12 mm (P = .002).ConclusionUmbilical trocar size and pneumoperitoneum intra‐abdominal pressure were significantly associated with post‐TAPP pain. Using a 5 mm umbilical trocar and 8 mm Hg intra‐abdominal pressure achieved pain levels as comparatively low as open repair.
Effects of Antimicrobial peptides on egg production, egg quality and caecal microbiota of hens during the late laying period
Authors: Chen Xiaochen , Zhan Yaowen , Ma Wenfeng , Zhu Yanzhi , Wang Zhanbin 
Published: May 2020

AbstractThis study was conducted to determine the effects of diet supplementation of laying hens with antimicrobial peptides (AMP) on egg production, egg quality and caecal microbiota. A total of 360 Hy‐Line Brown laying hens (72 weeks old) were divided into three groups with four replicates of 30 birds each. The laying hens were fed with the basal diet (Control), the basal diet + 50 mg/kg AMP (group 1) and the basal diet + 100 mg/kg AMP (group 2). The experiment lasted for 45 d. Eggs were collected daily and caecal samples were collected at the end of the experiment. The results showed that AMP supplementation caused a significantly increased laying rate and decreased feed/egg ratio (p ＜ .05). Meanwhile, a distinctive difference in cecal microbiota was observed between AMP and control groups and the average values of microbial diversity and richness were lower in the AMP group than in the control group. At the phylum level, the relative abundance of Verrucomicrobia and Cyanobacteria were lower in the AMP group than in the control group. In conclusion, the results indicated that dietary supplementation with AMP can improve egg production and affect the cecal microbial community membership and structure of hens during late laying period.
Ferric citrate in the management of hyperphosphataemia and iron deficiency anaemia: A meta‐analysis in patients with chronic kidney disease
Authors: Choi Yeo Jin , Noh Yoojin , Shin Sooyoung 
Published: May 2020

AimsPhosphate‐lowering effects of ferric citrate were reported in several clinical trials, but mostly in small‐scale studies. The aim of this meta‐analysis was to investigate the efficacy and safety of ferric citrate in controlling hyperphosphataemia and iron‐deficiency anaemia in chronic kidney disease (CKD) patients.MethodsPubMed, Embase and Cochrane Library were searched for clinical trials that enrolled CKD patients receiving ferric citrate for hyperphosphataemia. Two investigators performed systematic literature search to identify eligible studies, evaluated risk of bias and extracted relevant data.ResultsSixteen studies were included in the meta‐analysis. Phosphate‐lowering effects of ferric citrate were greater compared to no active treatment (standardized mean difference [SMD] = −1.15; P < 0.001) and comparable to other phosphate binders (SMD = 0.03; P = 0.61). Calcium concentrations post ferric citrate treatment did not differ compared to no active treatment (SMD = 0.15; P = 0.21) but were significantly lower compared to other phosphate binders (SMD = −0.14; P = 0.01). These led to significant reductions in calcium‐phosphorus product with ferric citrate versus no active control (SMD = −1.02; P < 0.001) but no difference versus active control (SMD = −0.01; P = 0.93). Intact parathyroid hormone showed no substantial between‐group difference in both comparison against no active and active controls. Ferric citrate improved iron stores and anaemia parameters, but increased risk of diarrhoea, abdominal pain and discoloured faeces.ConclusionFerric citrate was effective in lowering phosphorus and phosphorus‐calcium product versus no active treatment and had comparable effects versus other phosphate binders. Calcium levels were significantly lower with ferric citrate than with other phosphate‐lowering treatment. Ferric citrate had additive effects on iron repletion and anaemia control and was associated with mostly gastrointestinal side effects.
Conceptualizing the later stage of bipolar disorder: Descriptive analyses from the ORBIT trial
Authors: Tremain Hailey , Fletcher Kathryn , Murray Greg 
Published: May 2020

AbstractObjectivesThis study aimed to investigate the features of later stage bipolar disorder (BD) and specifically, factors underlying later stage BD and potential subgroups within this stage, to understand more about the later stage group and contribute to the measurement of stage.MethodsAn exploratory factor analysis was conducted using variables relating to current phenomenological aspects of illness, followed by cluster analyses based on the identified factors. Finally, the resultant clusters were compared based on course of illness variables.ResultsFourteen extracted factors explained 57 percent of the variance. Latent structures aligned with current depressive symptoms, energy and interest, independence, occupational functioning, symptoms of anxiety, pain, elevated symptoms, interpersonal functioning, anger, perceptions of social connections, and perceptions of current medication effectiveness, cognitive issues, sleep issues, and sense of isolation. Two clusters were identified which differed significantly on each of these factors, and on a range of course of illness features including lifetime number of episodes, duration of illness and number of depressive hospitalizations.ConclusionsLatent phenomenological features relevant to individuals in the later stage of BD were identified. Two clusters of individuals in later stage BD differ based on these features as well as course of illness, suggesting that there are distinct subgroups of individuals in the later stage of BD, distinguishable based on current phenomenology and illness history. However, findings are exploratory and therefore require confirmation before they can be applied clinically.
Creating equitable healthcare quality and safety for children with intellectual disability in hospital
Authors: Mimmo Laurel , Woolfenden Susan , Travaglia Joanne , Harrison Reema 
Published: May 2020

AbstractChildren with intellectual disability are susceptible to poor experiences of care and treatment outcomes, and this may compound existing health inequities. Evidence to date indicates three priority areas that must be addressed in order to reduce these inequities in the safety and quality of care for children with intellectual disability. Firstly, we need reliable methods to identify children with intellectual disability so that healthcare organizations understand their needs. Secondly, we need to develop quality metrics that can assess care quality and unwarranted care variation for children with intellectual disability in hospital. Finally, for a comprehensive understanding of the safety and quality of care for these children, and how to improve, it is critical that healthcare organizations partner with parents/carers and enable children with intellectual disability to voice their experiences of care. Children with intellectual disability have higher healthcare utilization than their peers; yet, their voice is rarely sought to optimize the safety and quality of their healthcare experience. Patient experience narratives enhance our understanding of the genesis of adverse events. By addressing these priorities, children with intellectual disability will be identified, and health services will measure and understand the problematic and beneficial variations in care delivery and can then effectively partner with children and their parents/carers to address the inequities in care quality and create safer healthcare.
Quantifying the relative performance of two undetected‐extinction models
Authors: Lum Deon , Tedesco Pablo A. , Hugueny Bernard , Giam Xingli , Chisholm Ryan A. 
Published: May 2020

AbstractExtinctions of undiscovered species (undetected extinctions) constitute a portion of biodiversity loss that is often ignored. We compared the performance of 2 models of undetected extinctions – Tedesco and SEUX – when estimating undetected extinctions with both simulated and real‐world data. We generated simulated data by considering a birth‐death process in which less abundant species were more likely to go extinct. When detection rates were higher for common species, the 2 models underestimated the true number of undetected extinctions by up to 88.7%, and when detection rates were independent of abundance, the 2 models performed better; the SEUX model had an average bias of +3.1% and the Tedesco model had an average bias of −62.3%. We applied the models to 8 real‐world data sets (e.g., Australian amphibians, Australian birds, North American bivalves) and found that true extinctions may be from 15% to 180% higher than observed values. For 6 of the 8 data sets, the SEUX model yielded absolute estimates that were 5.7–66.8% lower than those of the Tedesco model. We mainly attributed this difference to the SEUX model's assumption that there are no undetected extant species currently. We assessed the accuracy of the models’ estimates with a logistic regression to test whether detection and extinction rates were uncorrelated across species. Rates were correlated for 3 of the 8 data sets; species discovered later had a higher probability of being extinct, suggesting that extinction numbers could be even higher for these groups. Despite caveats associated with the models, the evidence from both show biodiversity loss in these groups may be more severe than what has been documented.
Triple‐nanostructuring‐based noninvasive electro‐immune sensing of CagA toxin for Helicobacter pylori detection
Authors: Jain Utkarsh , Gupta Shaivya , Soni Shringika , Khurana Manish Punit , Chauhan Nidhi 
Published: May 2020

AbstractBackgroundHelicobacter pylori (H pylori) is gram‐negative, spiral, and microaerophilic bacteria which can survive in ~2%‐10% oxygen level. It was reported to populate in human gastric mucosa and leads to gastric cancer without any age or gender difference.Materials and MethodsIn this study, we are targeting label‐free electrochemical immunosensor development for rapid H pylori detection after covalently immobilizing the antibody (CagA) over the nanomaterials modified Au electrode. Titanium oxide nanoparticles (TiO2NPs), carboxylated multi‐walled carbon nanotubes (c‐MWCNT), and conducting polymer polyindole carboxylic acid (Pin5COOH) composites (TiO2NPs/c‐MWCNT/Pin5COOH) were synthesized and further utilized in immunosensor development as an electrochemical interface onto Au electrode. The stepwise modifications of CagAantibody/TiO2NPs/c‐MWNCT/Pin5COOH/Au electrode were electrochemically studied.ResultsPossessing the unique features of advanced materials, the proposed immunosensor reported low sensing limit of 0.1 ng/mL in dynamic linear range of 0.1‐8.0 ng/mL with higher stability and reproducibility. Furthermore, developed sensor‐based determination of H pylori in five human stool specimens has shown good results with suitable accuracy.ConclusionsThis work lays strong foundation toward developing nanotechnology‐enabled electrochemical sensor for ultrasensitive and early detection of H pylori in noninvasively collected clinical samples.