bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Hemoglobin A1c and Fasting Glucose Levels with hs-CRP in Adults Not Diagnosed with Diabetes from the KNHANES, 2017
Authors: Seo Jeong Woo , Park Sat Byul 
Published: April 2021

Purpose. High sensitivity C-reactive protein (hs-CRP) has been used as a biomarker to assess the risk of cardiovascular accidents (CVA) and to measure general inflammation in the body. This study investigated the relationship and extent of correlation between serum glucose level markers and hs-CRP as a means to assess CVA risk through hemoglobin A1c (HbA1c) and fasting glucose levels. Methods. This cross-sectional, population-based study used data from the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). From the total sample of 8,127 people, 4,590 subjects were excluded due to age (<19 years) (

n
=
1,505

), diabetes mellitus (DM) diagnosis or medication (

n
=
596

), inactivity (

n
=
424

), pregnancy (

n
=
17

), hypoglycemia (<70 mg/dL) (

n
=
8

), smoking history (

n
=
1,077

), and missing data (

n
=
963

). In total, 3,537 adults not diagnosed with diabetes were selected. Their hs-CRP levels were compared with the glucose level markers using a complex sample general linear regression analysis. Results. We adjusted for sedentary hours, smoking, binge drinking frequency, age, sex, mean SBP, triglycerides, and waist circumference. Increases in HbA1c correlated with hs-CRP levels (

B

coefficient

95
%
CI

=
0.185

,

p
=
0.001

, and

R

2

=
0.087

). Changes in the fasting glucose levels were also associated with the hs-CRP levels (

B

coefficient

95
%
CI

=
0.005

,

p
=
0.006

, and

R

2

=
0.086

). Conclusion. This study showed a linear association between HbA1c and fasting glucose levels and hs-CRP. It also showed that changes in the hs-CRP level were better correlated with those in the HbA1c levels than in the fasting glucose levels.
The Impact of Longitudinal Surveillance on Tumor Thickness for Melanoma-Prone Families with and without Pathogenic Germline Variants of CDKN2A and CDK4
Authors: Sargen Michael R. , Pfeiffer Ruth M. , Elder David E. , Yang Xiaohong R. , Goldstein Alisa M. , Tucker Margaret A. 
Published: April 2021

Abstract

Background:
Skin cancer screening is routinely performed for members of melanoma-prone families, but longitudinal studies evaluating the efficacy of surveillance in this high-risk population are lacking.

Methods:
We evaluated thickness for first primary melanomas diagnosed in melanoma-prone families (≥2 individuals with melanoma) enrolled in NCT00040352 (NCI familial melanoma study) from 1976 through 2014; enrolled patients received routine skin cancer screening and education about skin self-exams. We used linear and ordinal logistic regression models adjusted for gender and age with a generalized estimating equations approach to report changes in thickness and tumor (T) stage over time, comparing outcomes for NCI cases diagnosed before (pre-study) versus after study participation (prospective) and for NCI cases versus nonfamilial cases [Surveillance, Epidemiology, and End Results (SEER) 9 registries].

Results:
Tumor thickness was evaluated for 293 NCI (pre-study = 246; prospective = 47) patients. Compared with NCI pre-study cases, NCI prospective melanomas were thinner (0.6 vs. 1.1 mm; P &lt; 0.001) and more likely to be T1 stage [39/47 (83%) vs. 98/246 (40%); P &lt; 0.001]. Similar findings (P &lt; 0.05) were observed for familial cases with and without germline CDKN2A and CDK4 mutations. Peters–Belson modeling suggested that calendar period effects of decreasing thickness in the general population (SEER 9) did not fully explain thickness trends in NCI families.

Conclusions:
Participation in a longitudinal surveillance program providing skin cancer screening and education about skin self-exams was associated with thinner melanomas for members of melanoma-prone families.

Impact:
The study findings support the clinical benefit of screening (physician and self) for this high-risk population.
Less Is More—Ways to Move Forward for Improved Breast Cancer Risk Stratification
Authors: Tehranifar Parisa , Wei Ying , Terry Mary Beth 
Published: April 2021

Abstract
Breast cancer risk models increasingly are including mammographic density (MD) and polygenic risk scores (PRS) to improve identification of higher-risk women who may benefit from genetic screening, earlier and supplemental breast screening, chemoprevention, and other targeted interventions. Here, we present additional considerations for improved clinical use of risk prediction models with MD, PRS, and questionnaire-based risk factors. These considerations include whether changing risk factor patterns, including MD, can improve risk prediction and management, and whether PRS could help inform breast cancer screening without MD measures and prior to the age at initiation of population-based mammography. We further argue that it may be time to reconsider issues around breast cancer risk models that may warrant a more comprehensive head-to-head comparison with other methods for risk factor assessment and risk prediction, including emerging artificial intelligence methods. With the increasing recognition of limitations of any single mathematical model, no matter how simplified, we are at an important juncture for consideration of these different approaches for improved risk stratification in geographically and ethnically diverse populations.
See related article by Rosner et al., p. 600
Early Life Exposure to Tobacco Smoke and Ovarian Cancer Risk in Adulthood
Authors: Wang T , Townsend MK , Vinci C , Jake-Schoffman DE , Tworoger SS 
Published: April 2021

Abstract
Background: Ovarian cancer risk in adulthood may be affected by early life exposure to tobacco smoke. We investigated this relationship in two large prospective cohorts, the Nurses' Health Study (NHS) and NHSII. Methods: In total, analyses included 110,305 NHS participants (1976–2016) and 112,859 NHSII participants (1989–2017). Self-reported early life smoking exposures were queried at baseline or follow-up questionnaires. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of ovarian cancer overall and by tumor histotype. Results: Compared with women who never smoked, ovarian cancer risk was similar for women who started to smoke at age &lt;18 (HR = 0.98, 95%CI: 0.86–1.11) or ≥18 (HR = 1.02, 95%CI: 0.93–1.12). Overall, ovarian cancer risk was not different among participants whose mother did versus did not smoke during pregnancy (HR = 1.05, 95%CI: 0.87–1.27); however, an increased risk was observed among women who themselves were never smokers (HR = 1.38, 95%CI: 1.05–1.81) but not ever smokers (HR = 0.86, 95%CI: 0.66–1.14; Pheterogeneity = 0.02). These associations did not differ by histotype (Pheterogeneity≥0.35). Parental smoking in the home during childhood/adolescence was related to a 15% increased risk of ovarian cancer in adulthood (HR = 1.15, 95%CI: 1.04–1.27) and this association was notably stronger among women with non-serous/ low- grade serous tumors (HR = 1.28, 95%CI: 1.02–1.61) versus high-grade serous/ poorly differentiated tumors (HR = 1.09, 95%CI: 0.93–1.28, Pheterogeneity = 0.25). Conclusions: Exposure to parental tobacco smoke, but not early initiation of smoking, was associated with a modest elevated risk of ovarian cancer. Further investigations are required to confirm these findings and elucidate underlying mechanisms.
Feasibility of a Group-based Telehealth Psychosocial Intervention for Women with Non-Small Cell Lung Cancer (NSCLC)
Authors: Kroll JL , Higgins H , Snyder S , Chen A , Antonoff M , Li Y , Tsao A , Milbury K 
Published: April 2021

Abstract
Purpose of study: As women with lung cancer are particularly vulnerable to psychological distress and social isolation, which may be further exacerbated by current COVID-19 physical distancing precautions, we examined the feasibility and acceptability of a group-based telehealth psychosocial intervention for this understudied patient population. Methods: Women with a recent diagnosis (3 months) of non based telehealth psychosocial intervention for this understudied patient population. Methods: Women with a recent diagnosis (3 months) of non-small cell lung cancer (NSCLC) currently undergoing treatment completed baseline measures of computer literacy and were randomized to a group-based telehealth psychosocial intervention consisting of ether coping skills or attention control (AC) psychoeducation. Both arms consisted of five, 60 min. telehealth (video conference over Zoom) sessions. Groups were comprised of 3–5 members and led by a masters-level clinician. Participants completed one “practice run” with technology prior to starting the group session. After the final session, patients rated overall experience of intervention delivery and telehealth platform. Results: Seventy patients (mean age = 66 yrs, 54% &gt;65 yrs; 71% non-Hispanic White; 50% college educated; 75% advanced stage) consented (63% consent rate) and 65 were randomized to intervention or AC. At baseline, 47% of patients indicated daily computer use while 50% said they rarely or never use a computer. Attendance was high in both arms with 63% of patients attending all sessions (means: intervention = 3.18; AC = 3.56). Across arms, 89% preferred group delivery and 92% preferred online delivery. The majority used a smartphone or tablet to participate (72%). Regarding the Zoom platform, 71% said it was easy to use, 65% would recommend it to others, and 41% felt comfortable with it after one use. Only 44% thought that telehealth was the same as it would have been in-person. Conclusions: The present findings suggest the feasibility and acceptability of delivering a group-based psychosocial intervention via telehealth for middle to older aged women with NSCLC undergoing treatment, which may be particularly beneficial to address isolation during the current season of physical distancing.
Receipt of Next-generation Genomic Sequencing among Patients with Metastatic Colorectal Cancer (mCRC) in a Real-World Cohort
Authors: Markt SC , Schumacher FR , Booker B , Rose J , Cooper GS , Koroukian SM 
Published: April 2021

Abstract
Purpose of the Study: Disparities in genomic precision medicine approaches, through molecular profiling or next- generation sequencing (NGS), by race/ethnicity, insurance, and poverty have been identified in lung cancer, but not mCRC. Our goal was to examine disparities in receipt of NGS in patients with mCRC. Methods: We used all-payer electronic health record (EHR)-derived de-identified data from the Flatiron Health database generated from routine clinical care across the United States. Our study population included 26,524 patients with mCRC during the years 2013–2020. In addition to date of NGS testing, the FH-EHR data include demographics (age, sex, and race/ethnicity), payer type, and Eastern Cooperative Oncology Group (ECOG) performance status. We conducted descriptive analyses and multivariable logistic regression analysis to identify correlates of receipt of NGS within 6 months of metastatic diagnosis. Results: Among the 26,524 people with mCRC, 45% (n = 11,946) were women, 48% (n = 12,732) had a Commercial Health Plan, and the majority were seen in a community practice (92%) vs academic hospitals. Over 70% of the patients were White, 12% Black or African-American (AA), and 14% Other. Thirty-three percent (n = 8,821) of patients had documentation in the EHR of having received NGS. After simultaneously adjusting for other factors in the model, older age (ORper year increase: 0.97, 95% CI: 0.96–0.98) and Black/AA race (OR: 0.74, 95% CI: 0.68–0.81), compared to White, was associated with lower odds of receiving NGS testing. Conversely, female sex, better ECOG performance status, later calendar year, being seen in an academic practice, and having a Commercial Health Plan were associated with greater odds of receiving NGS. Conclusions: Our findings indicate that NGS is not received uniformly by all patients with mCRC. Future analyses will incorporate receipt of individual molecular biomarker tests, as recommended by professional societies, as well as their results (e.g., KRAS, NRAS, BRAF, MMR/MSI), treatment information, and survival.
Social Support and Mental Health during the COVID19-pandemic among Cancer Survivors: An Analysis of the COVID Impact Survey
Authors: Islam JY , Vidot DC , Camacho-Rivera M 
Published: April 2021

Abstract
Introduction: The COVID-19 pandemic has affected the mental health of adults in the United States (U.S.) due to recommended preventive behaviors such as social distancing. Our objective was to evaluate mental health symptoms and determinants of mental health symptoms among cancer survivors during the COVID-19 pandemic in the U.S. Methods: We used nationally-representative data of 10,760 U.S. adults from the COVID-19 Impact Survey. We defined cancer survivors as a self-reported diagnosis of cancer (n = 854, 7.6%). We estimated the association of mental health symptoms among cancer survivors using multinomial logistic regression and calculated adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). We estimated determinants of experiencing at least one mental health symptom 3–7 times in the last seven days among cancer survivors using Poisson regression models to estimated adjusted prevalence ratios (aPR) and 95% CI. Results: Most cancer survivors were over the age of 60 (65%), NH-White (74%), female (52%), and married or living with a partner (57%). Among cancer survivors who spoke to their neighbors basically every day prior to the start of the COVID-19 pandemic, 62% continued this behavior, and 34% reported to speak to their neighbors only a few times a week in the last month. Among cancer survivors, 16% felt depressed, 14% felt lonely, and 13% felt hopeless about the future in the last seven days. Cancer survivors were more likely to report feeling nervous, anxious or on edge (aOR:1.42, 95% CI: 1.07–1.90), depressed (aOR:1.69, 95% CI: 1.28–2.24), lonely (aOR:1.47, 95% CI: 1.09–1.98), and hopeless (aOR:1.55, 95% CI: 1.14–2.10) 3–7 days per week in the last seven days when compared to adults without cancer. Among cancer survivors, adults aged 30–44 years (aPR: 1.87, 95% CI: 1.18–2.95), females (aPR:1.55, 95% CI: 1.12– 2.13), without a high school degree (aOR: 1.79, 95% CI; 1.05–3.04), and adults with limited social interaction (aPR:1.40, 95% CI: 1.01–1.95) were more likely to experience mental health symptoms 3–7 days/week in the last week. Conclusions: Cancer survivors are experiencing mental health symptoms during the COVID-19 pandemic, particularly young adults, adults without a high school degree, females, and survivors with limited social support.
F-aza-T-dCyd (NSC801845), a Novel Cytidine Analog, in Comparative Cell Culture and Xenograft Studies with the Clinical Candidates T-dCyd, F-T-dCyd, and Aza-T-dCyd
Authors: Morris Joel , Wishka Donn G. , Lopez Omar D. , Rudchenko Vladimir , Huang Guangfei , Hoffman Sierra N. , Borgel Suzanne , Georgius Kyle , Carter John , Stotler Howard , Kunkel Mark W. , Collins Jerry M. , Hollingshead Melinda G. , Teicher Beverly A. 
Published: April 2021

Abstract

In this article, 5-aza-4′-thio-2′-β-fluoro-2′-deoxycytidine (F-aza-T-dCyd, NSC801845), a novel cytidine analog, is first disclosed and compared with T-dCyd, F-T-dCyd, and aza-T-dCyd in cell culture and mouse xenograft studies in HCT-116 human colon carcinoma, OVCAR3 human ovarian carcinoma, NCI-H23 human NSCLC carcinoma, HL-60 human leukemia, and the PDX BL0382 bladder carcinoma. In three of five xenograft lines (HCT-116, HL-60, and BL-0382), F-aza-T-dCyd was more efficacious than aza-T-dCyd. Comparable activity was observed for these two agents against the NCI-H23 and OVCAR3 xenografts. In the HCT-116 study, F-aza-T-dCyd [10 mg/kg intraperitoneal (i.p.), QDx5 for four cycles], produced complete regression of the tumors in all mice with a response that proved durable beyond postimplant day 150 (129 days after the last dose). Similarly, complete tumor regression was observed in the HL-60 leukemia xenograft when mice were dosed with F-aza-T-dCyd (10 mg/kg i.p., QDx5 for three cycles). In the PDX BL-0382 bladder study, both oral and i.p. dosing of F-aza-T-dCyd (8 mg/kg QDx5 for three cycles) produced regressions that showed tumor regrowth beginning 13 days after dosing. These findings indicate that further development of F-aza-T-dCyd (NSC801845) is warranted.
Liquid Biopsy: From Discovery to Clinical Application
Authors: Alix-Panabières Catherine , Pantel Klaus 
Published: April 2021

Abstract

Over the past 10 years, circulating tumor cells (CTC) and circulating tumor DNA (ctDNA) have received enormous attention as new biomarkers and subjects of translational research. Although both biomarkers are already used in numerous clinical trials, their clinical utility is still under investigation with promising first results. Clinical applications include early cancer detection, improved cancer staging, early detection of relapse, real-time monitoring of therapeutic efficacy, and detection of therapeutic targets and resistance mechanisms. Here, we propose a conceptual framework of CTC and ctDNA assays and point out current challenges of CTC and ctDNA research, which might structure this dynamic field of translational cancer research.

Significance:
The analysis of blood for CTCs or cell-free nucleic acids called “liquid biopsy” has opened new avenues for cancer diagnostics, including early detection of tumors, improved risk assessment and staging, as well as early detection of relapse and monitoring of tumor evolution in the context of cancer therapies.
Metastasis-Initiating Cells and Ecosystems
Authors: Massagué Joan , Ganesh Karuna 
Published: April 2021

Abstract

Metastasis is initiated and sustained through therapy by cancer cells with stem-like and immune-evasive properties, termed metastasis-initiating cells (MIC). Recent progress suggests that MICs result from the adoption of a normal regenerative progenitor phenotype by malignant cells, a phenotype with intrinsic programs to survive the stresses of the metastatic process, undergo epithelial–mesenchymal transitions, enter slow-cycling states for dormancy, evade immune surveillance, establish supportive interactions with organ-specific niches, and co-opt systemic factors for growth and recurrence after therapy. Mechanistic understanding of the molecular mediators of MIC phenotypes and host tissue ecosystems could yield cancer therapeutics to improve patient outcomes.

Significance:
Understanding the origins, traits, and vulnerabilities of progenitor cancer cells with the capacity to initiate metastasis in distant organs, and the host microenvironments that support the ability of these cells to evade immune surveillance and regenerate the tumor, is critical for developing strategies to improve the prevention and treatment of advanced cancer. Leveraging recent progress in our understanding of the metastatic process, here we review the nature of MICs and their ecosystems and offer a perspective on how this knowledge is informing innovative treatments of metastatic cancers.
Fighting the Sixth Decade of the Cancer War with Better Cancer Models
Authors: Tuveson David A. 
Published: April 2021

Abstract

Summary:
Cancer models have helped solve many mysteries of cancer research, and are poised to bring our understanding to the next level as we dissect the relevance of cancer-associated alleles and heterocellular interactions. However, the ability of cancer models to correctly identify new therapeutic methods has been less fruitful, and a reconsideration of model designs and model applications should help develop more effective approaches for patients.
СОЦІАЛЬНА, КЛІНІЧНА ТА ЕПІДЕМІОЛОГІЧНА ДОЦІЛЬНІСТЬ ВЕДЕННЯ РЕЄСТРУ ХВОРИХ НА ХРОНІЧНІ ВІРУСНІ ГЕПАТИТИ НА ПРИКЛАДІ ДНІПРОПЕТРОВСЬКОГО РЕГІОНУ
Authors: Shostakovich-Koretska L. R. , Shevchenko-Makarenko O. P. , Nikolaychuk M. A. , Sheveleva O. V. , Chykarenko Z. O. , Andrieieva I. A. , Tkachenko V. D. 
Published: April 2021

Мета: дослідити можливості Реєстру хворих на хронічні вірусні гепатити в Дніпропетровському регіоні як спостережної програми та інструменту моніторингу і менеджменту за пацієнтами.
Матеріали і методи. Аналіз поширеності хронічних вірусних гепатитів проведено епідеміологічним методом. У роботі застосовано методи дескриптивної статистики, статистичний метод та метод структурно-логічного аналізу з використанням програмних продуктів Excel і Statistica v.6.1.
Результати. Проведено оцінку дієвих реєстрів пацієнтів в Україні, обрано найкращі практики та адаптовано, оптимізовано і впроваджено в Реєстр хворих на хронічні вірусні гепатити дорослого віку та дітей в Дніпропетров­ському регіоні. Обґрунтовано доцільність його використання як дослідного інструменту при менеджменті 4699 хворих на хронічні вірусні гепатити В та С віком понад 18 років та 195 дітей. Оцінено ефективність різних схем лікування.
Висновки. Десятирічний досвід ведення Реєстру дозволив оцінити тяжкість хронічних вірусних гепатитів у Дніпропетровському регіоні, здійснювати моніторинг населення, ураженого хронічними вірусними гепатитами, проводити аналіз динаміки та прогностичну оцінку визначених показників ризику прогресування хвороби в різних клінічних групах хворих, контролювати якість та ефективність лікування, повноту та режим динамічного нагляду за хворими. Запропоновано імплементувати досвід для створення Реєстру та персоніфікованого автоматизованого обліку хворих на хронічні вірусні гепатити в Україні.
КОМПЛЕКСНА ОЦІНКА УСПІШНОСТІ ЛІКАРІВ-ІНТЕРНІВ ЗА РЕЗУЛЬТАТАМИ ДЕРЖАВНОЇ АТЕСТАЦІЇ
Authors: Sichkoriz O. Ye. 
Published: April 2021

Мета: покращити якість фахової підготовки здобувачів вищої медичної освіти на основі комплексного аналізу їхньої успішності.
Матеріали і методи. Дослідження проводили серед здобувачів, які навчались в інтернатурі Львівського національного медичного університету імені Данила Галицького та проходили заключну державну атестацію у період 2011–2017 рр. за такими критеріями: результати складання ліцензійних тестових іспитів «Крок-1», «Крок-2», «Крок-3», складання державних іспитів та результат заключної атестації. Використано статистичні методи, структурно-логічний аналіз та системний підхід.
Результати. За результатами складання ліцензійного іспиту «Крок-1» протягом 2011–2017 рр. зафіксовано зростання середнього бала для спеціальності «Медицина невідкладних станів» та «Загальна практика – сімейна медицина». Спостерігали тенденцію до зростання середнього результату проходження іспитів «Крок-2» та «Крок-3» та середньої оцінки складання державних іспитів для здобувачів усіх лікарських спеціальностей. Найнижчу середню оцінку заключної атестації протягом 2011–2017 рр. констатовано у здобувачів зі спеціальності «Стоматологія».
Висновки. Дослідження результатів успішності здобувачів вищої медичної освіти на додипломному та післядипломному рівнях дозволить оцінити та покращити якість фахової підготовки та наблизити її до європейських стандартів.