bluuebunny/crossref_metadata_2025_split huggingface dataset:
Updated survival results of the randomized phase II study comparing cisplatin/capecitabine (CX) with epirubicin plus CX (ECX) in advanced gastric cancer (AGC).
Authors: Lim T. , Yun J. , Lee J. , Park S. , Park J. , Park Y. , Lim H. , Kang W. 
Published: February 2017

46 Background: We previously reported results of a randomized study showing that CX is equally active to ECX in terms of progression-free survival (PFS) (Yun et al. Eur J Cancer. 2010). Here we report updated overall survival (OS) results with an additional 12 months' follow-up. Methods: Ninety-one chemotherapy-naïve patients with histologically-confirmed, measurable AGC were randomized to receive CX (cisplatin 75 mg/m2 iv on day 1 and capecitabine 1,000 mg/m2 bid po on days 1-14, n=45) or ECX (epirubicin 50 mg/m2 plus CX, n=44) every 3 weeks. After CX or ECX had failed, second-line chemotherapy (SLC) was recommended for all patients if their performance status was preserved. Results: Treatment duration was similar for both arms (4.4 for CX v 4.2 months for ECX). There was no relevant difference in the occurrence of overall grade 3 or 4 toxicities between the CX and ECX arms (80% v 78%, respectively; p=0.516). However, none in the CX and 12% in the ECX arm discontinued treatment because of toxicity. There were no significant differences in therapeutic efficacy between CX and ECX with respect to the response rate (38% v 37%, respectively), PFS (6.4 v 6.5 months), as well as OS (12.7 v 13.8 months; p=0.51). After failure, 60% of patients (26 CX and 28 ECX patients) received SLC. However, OS was not differed whether a patient was treated with SLC or not (13.1 v 11.2 months; p=0.94). Conclusions: The present analysis confirms previous findings that both CX and ECX appear to be comparatively active as first-line chemotherapy for AGC. Furthermore, the role of SLC in AGC warrants further evaluation. No significant financial relationships to disclose.
Conatumumab (CON) plus FOLFIRI (F) or ganitumab (GAN) plus F for second-line treatment of mutant (MT) KRAS metastatic colorectal cancer (mCRC).
Authors: Cohn Allen Lee , Tabernero Josep , Maurel Juan , Nowara Elzbieta , Dubey Sarita , Baker Nigel , Hei Yong Jiang , Galimi Francesco , Choo SuPin 
Published: February 2017

534 Background: EGFR inhibitors are not an option for patients (pts) with MT KRAS mCRC; therefore, there is an unmet medical need for novel agents to treat this pt population. CON (agonist) and GAN (antagonist) are investigational, fully human monoclonal antibodies to death receptor 5 and type 1 insulin-like growth factor receptor, respectively. In colorectal xenografts, CON enhanced the activity of 5FU, and both agents enhanced the activity of irinotecan. A 3-arm, placebo (pbo)-controlled, double-blind, double dummy, randomized phase 2 study evaluated both agents in MT KRAS mCRC. Methods: Planned sample size = 150. Eligibility: MT KRAS mCRC; disease progression on 1 prior oxaliplatin and fluoropyrimidine therapy. Randomization was 1:1:1 to Arm 1: CON 10 mg/kg + GAN pbo + F Q2W; Arm 2: CON pbo + GAN 12 mg/kg + F Q2W; Arm 3: CON pbo + GAN pbo + F Q2W. Randomization was stratified by PS (0 vs 1) and prior anti-VEGF therapy (yes vs no). Pts received CON, GAN, or pbo IV day (D)1 and 15; irinotecan 180 mg/m2 D1; leucovorin 400 mg/m2 over 2 h D1; 5FU bolus 400 mg/m2 over 2-4 min D1 then 5FU 2400 mg/m2 over 46-48 h. Primary endpoint: PFS by investigator assessment. Results: 155 pts (Arms 1/2/3: 51/52/52 pts) were randomized between 3/09 and 2/11; 50/50/52 received ≥ 1 dose of study drug. Median age, 59/58/59 years; women, 47/54/56%; colon cancer, 75/65/83%; PS 1, 37/42/40%; prior anti-VEGF therapy, 43/40/42%. See table for efficacy. % pts with grade 3-5 adverse events (Arms 1/2/3) included: neutropenia 30/25/18%; diarrhea 18/2/10%; intestinal obstruction 4/6/8%. There was 1 treatment-related death of unknown cause on Arm 1. Conclusions: CON + F and GAN + F were tolerable in this pt population. CON + F, but not GAN + F, improved PFS. ORR was increased vs pbo. OS data are immature. Further study of CON may be warranted in mCRC. [Table: see text]
A phase III randomized, open-label multicenter trial to evaluate the benefit of leuprorelin acetate for 24 months after radical prostatectomy in patients with high risk of recurrence (AFU-GETUG 20/0310).
Authors: Rozet Francois , Habibian Muriel , Berille Jocelyne , Roca Lise , Salomon Laurent , Soulie Michel , Culine Stephane 
Published: February 2017

252 Background: Post radical prostatectomy patients (RP) with extra prostatic extension or high Gleason grade are considered to have a high risk of treatment failure. Actual role of LH-RH agonists after RP in patients with high risk of recurrence remains unclear, except for the patients with positive lymph nodes. No randomized prospective study has been published with LH-RH agonists in the PSA era. Recent SWOG 9921 study shows a favorable disease-free and 5-year overall survival of 96% for high-risk patients treated with 24 months of ADT after surgery. However, this study does not define the optimal protocol of adjuvant ADT, and does not demonstrate the superiority of immediate vs delayed treatment. The Objective of the AFU-GETUG 20 study is to evaluate the benefit of leuprorelin acetate for 24 months after RP in patients with high risk of recurrence. Methods: Academic Phase III randomised, open-label, multicenter trial starting in late 2011. Inclusion criteria : R0, N0-Nx M0 patients after RP in the 3 months preceding inclusion and with postoperative Gleason score > 7, or ≥ 7 with the presence of 5 grade Gleason patterns or, or pT3b tumor, and with postoperative PSA < 0.1 ng/mL. Exclusion criteria : previous/current therapy for PCa. Primary endpoint is the evaluation of metastatic progression free survival. Secondary endpoints include overall survival, disease-specific survival, PSA evolution, evaluation of testosterone level, and quality of life. Results: A total of 700 patients (350 in each arm) and 250 events are required to have 80% ability to detect a difference with a bilateral Logrank test with α= 0.05 and β= 0.20. Decision rules will be determined by the O’ Brien-Fleming sequential boundaries at the time of the analysis. Interim analysis is planned at the 125th event (50% of events) for 6.5 years after the start of the trial. Final analysis is planned for 12 years after the inclusion of the first patient. Conclusions: The AFU-GETUG 20 study is a pioneering French multicenter trial aiming to evaluate the actual role and place of ADT after RP for patients with high-risk prostate cancer.
Use of Palliative Cisplatinum for Advanced Cervical Cancer in a Resource-Poor Setting: A Case Series From Kenya
Authors: Orang’o Elkanah , Itsura Peter , Tonui Philip , Muliro Hellen , Rosen Barry , van Lonkhuijzen Luc 
Published: February 2017

PurposeTo evaluate the effectiveness and feasibility of cisplatinum for palliative treatment of advanced cervical cancer in a resource-poor setting.MethodsAn observational case series is reported from a university teaching hospital in Kenya. All women presenting with advanced cervical cancer and planned for palliative cisplatinum therapy from 2010 to 2014 were included. Women were treated with cisplatinum 50 mg/m2every 4 weeks in an outpatient setting. Data on tumor stage and symptoms control were prospectively collected in an electronic database. The main outcome measure was control of symptoms such as bleeding, discharge, and pain.ResultsOf the women who originally presented with bleeding, 62% reported improvement in this symptom, 31.3% reported the bleeding completely stopped, 58% had improvement of their vaginal discharge, and 20.5% reported complete resolution. Of the women who presented with pain, 54% reported improvement; 30.9% reported pain had completely resolved. After each treatment cycle, approximately 30% of patients did not return for their next treatment.ConclusionCisplatinum as palliative treatment of advanced cervical cancer is feasible in a resource-poor setting and leads to effective symptom control. However, unknown barriers may inhibit women from returning for regular treatment.
Chemotherapy Use at the End of Life in Uganda
Authors: Low Daniel , Merkel Emily C. , Menon Manoj , Lyman Gary H. , Ddungu Henry , Namukwaya Elizabeth , Leng Mhoira , Casper Corey 
Published: February 2017

Purpose Avoiding chemotherapy during the last 30 days of life has become a goal of cancer care in the United States and Europe, yet end-of-life chemotherapy administration remains a common practice worldwide. The purpose of this study was to determine the frequency of and factors predicting end-of-life chemotherapy administration in Uganda. Methods Retrospective chart review and surveys and interviews of providers were performed at the Uganda Cancer Institute (UCI), the only comprehensive cancer center in the area, which serves a catchment area of greater than 100 million people. All adult patients at the UCI with reported cancer deaths between January 1, 2014, and August 31, 2015 were included. All UCI physicians were offered a survey, and a subset of physicians were also individually interviewed. Results Three hundred ninety-two patients (65.9%) received chemotherapy. Age less than 55 years (odds ratio [OR], 2.30; P = .004), a cancer diagnosis greater than 60 days before death (OR, 9.13; P < .001), and a presenting Eastern Cooperative Oncology Group performance status of 0 to 2 (OR, 2.47; P = .001) were associated with the administration of chemotherapy. More than 45% of patients received chemotherapy in the last 30 days of life. No clinical factors were predictive of chemotherapy use in the last 30 days of life, although doctors reported using performance status, cancer stage, and tumor chemotherapy sensitivity to determine when to administer chemotherapy. Patient expectations and a lack of outcomes data were important nonclinical factors influencing chemotherapy administration. Conclusion Chemotherapy is administered to a high proportion of patients with terminal cancer in Uganda, raising concern about efficacy. Late presentation of cancer in Uganda complicates end-of-life chemotherapy recommendations, necessitating guidelines specific to sub-Saharan Africa.
Influence of Fraction of Inspired Oxygen on Noninvasive Hemoglobin Measurement: Parallel Assessment of 2 Monitors
Authors: Gayat Etienne , Imbert Nicolas , Roujansky Ariane , Lemasle Léa , Fischler Marc 
Published: February 2017

BACKGROUND:
Previous reports have brought specific attention to the relationship between oxygenation of the patient and the accuracy of noninvasive measurement of hemoglobin (Hb) using an optical sensor. This study aimed to assess prospectively the relationship between fraction of inspired oxygen (Fio
2) and the bias of the measurement of Hb by the use of 2 different noninvasive monitors compared with the classic invasive technique.

METHODS:
Forty-four patients were included prospectively. In each individual, Hb level was determined noninvasively by monitor Pronto-7™ (Masimo Corporation, Irvine, CA) and by monitor NBM-200MP™ (OrSense Ltd, Petah-Tikva, Israel), with the probe placed on 2 fingers on the same hand of the patient. Three measures were performed, first under breathing air and 2 others when fraction of expired oxygen rose to 50% ± 5% and to 90 ± 5%. Simultaneously, a nurse collected a venous blood sample, which was sent immediately to the hematology laboratory for Hb measurement. The main outcome measurement was the mean bias between noninvasive and invasive measurements.

RESULTS:
Results show no change in median bias [interquartile range] with Fio
2 for Pronto-7 (from 1.1 g/dL [0.0–2.0] in Fio
2 21% to 1.0 g/dL [0.2–1.5] in Fio
2 100%), but increasingly negative median bias with increasing Fio
2 for NBM-200MP (from −0.3 g/dL [−1.3 to 0.3] in Fio
2 21% to −0.8 g/dL [−1.5 to −0.1] in Fio
2 100%, P = .04).

DISCUSSION:
This study showed that noninvasive measurement of Hb could be influenced by inspired fraction of oxygen when the monitor NBM-200MP is used.
Red Cell Transfusion–Associated Hemolysis in Cardiac Surgery: An Observational Cohort Study
Authors: Karkouti Keyvan , Callum Jeannie L. , Acker Jason P. , Yip Paul , Rao Vivek 
Published: February 2017

BACKGROUND:Red cell viability is impaired during storage, resulting in excess hemolysis during storage and after transfusion. As a result, transfusions may oversaturate the hemoglobin clearance pathways, resulting in cell-free hemoglobin and iron toxicity in susceptible patients, such as those undergoing cardiac surgery with cardiopulmonary bypass. To explore this hypothesis, we assessed the relationship of red cell transfusions with cell-free hemoglobin and transferrin saturation levels in a consecutive cohort of cardiac surgical patients.METHODS:Laboratory measures of hemolysis were obtained in consecutive cardiac surgical patients 15 to 30 minutes after bypass. Multivariable regression models controlling for important confounders were constructed to determine the independent relationship of red cell transfusions during bypass with cell-free hemoglobin and transferrin saturation levels post-bypass, analyzed as continuous variables (linear regression) and categorized at the 90th percentiles (logistic regression).RESULTS:Of the 543 included patients, 82 (15.1%) received red cell transfusions during bypass (median 1; interquartile range 1–2 units). Cell-free hemoglobin was detected in all patients (mean 11.3; standard deviation ± 9.3; 90th percentile 18 μmol/L), and transferrin saturations were relatively high (mean 41 ± 19%; 90th percentile 66%). After controlling for confounders, transfusions were not associated with cell-free hemoglobin (P> .25 in linear and logistic regression) but were directly associated with transferrin saturation levels (P< .001 in linear and logistic regression). Transfused patients had a 6.2-fold (95% confidence interval: 2.4–16.1) risk-adjusted increase in the odds of having high (>66%) transferrin saturation levels.CONCLUSIONS:The findings support the hypothesis that transfusion-related adverse events may be in part caused by the excessive hemolysis of transfused red cells, which can lead to acute iron overload and related toxicity. This suggests that strategies aimed at avoiding or mitigating transfusion-related acute iron overload may improve the safety of red cell transfusions.
Pathogenic Link Between Postextubation Pneumonia and Ventilator-Associated Pneumonia: An Experimental Study
Authors: Rezoagli Emanuele , Zanella Alberto , Cressoni Massimo , De Marchi Lorenzo , Kolobow Theodor , Berra Lorenzo 
Published: February 2017

BACKGROUND:
The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours. Subsequently, we assessed the incidence of lung colonization and PEP at 48 hours after extubation in sheep previously ventilated for 24 hours.

METHODS:
To simulate intubated intensive care unit patients placed in semirecumbent position, 14 sheep were intubated and mechanically ventilated with the head elevated 30° above horizontal. Seven of them were euthanized after 24 hours (Control Group), whereas the remaining were euthanized after being awaken, extubated, and left spontaneously breathing for 48 hours after extubation (Awake Group). Criteria of clinical diagnosis of pneumonia were tested. Microbiological evaluation was performed on autopsy in all sheep.

RESULTS:
Only 1 sheep in the Control Group met the criteria of VAP after 24 hours of mechanical ventilation. However, heavy pathogenic bacteria colonization of trachea, bronchi, and lungs (range, 104–109 colony-forming unit [CFU]/g) was reported in 4 of 7 sheep (57%). In the Awake Group, 1 sheep was diagnosed with VAP and 3 developed PEP within 48 hours after extubation (42%), with 1 euthanized at 30 hours because of respiratory failure. On autopsy, 5 sheep (71%) confirmed pathogenic bacterial growth in the lower respiratory tract (range, 103–109 CFU/g).

CONCLUSIONS:
Twenty-four hours of intubation and mechanical ventilation in semirecumbent position leads to significant pathogenic colonization of the lower airways, which can promote the development of PEP. Strategies directed to prevent pathogenic microbiological colonization before and after mechanical ventilation should be considered to avert the onset of PEP.
Disease Campaigns and the Decline of Treatment Advocacy
Authors: Best Rachel Kahn 
Published: February 2017

AbstractIn the past fifty years, disease advocacy organizations have multiplied and gained political influence, but they have often been reluctant to ask the government to intervene in health care provision. This article asks why. Using original quantitative and qualitative data on the goals and political claims of over one thousand organizations from 1960 through 2014, I find that many early disease advocacy organizations prioritized health care access. But unfavorable political climates discouraged new organizations from focusing on access to treatment. When health care became particularly controversial, even organizations with health care-related missions refrained from pursuing this goal politically. Eventually, politically active organizations began to drop treatment provision from their missions. Over the decades, the troubled politics of health care reshaped the field of disease advocacy, diminishing its focus on medical treatment.
Estimated Glomerular Filtration Rate and Albuminuria Are Associated with Biomarkers of Cardiac Injury in a Population-Based Cohort Study: The Maastricht Study
Authors: Martens Remy J H , Kimenai Dorien M , Kooman Jeroen P , Stehouwer Coen D A , Tan Frans E S , Bekers Otto , Dagnelie Pieter C , van der Kallen Carla J H , Kroon Abraham A , Leunissen Karel M L , van der Sande Frank M , Schaper Nicolaas C , Sep Simone J S , Schram Miranda T , van Suijlen Jeroen D , van Dieijen-Visser Marja P , Meex Steven J R , Henry Ronald M A 
Published: February 2017

AbstractBACKGROUNDChronic kidney disease (CKD) is associated with an increased cardiovascular disease mortality risk. It is, however, less clear at what point in the course from normal kidney function to CKD the association with cardiovascular disease appears. Studying the associations of estimated glomerular filtration rate (eGFR) and albuminuria with biomarkers of (subclinical) cardiac injury in a population without substantial CKD may clarify this issue.METHODSWe examined the cross-sectional associations of eGFR and urinary albumin excretion (UAE) with high-sensitivity cardiac troponin (hs-cTn) T, hs-cTnI, and N-terminal probrain natriuretic-peptide (NT-proBNP) in 3103 individuals from a population-based diabetes-enriched cohort study.RESULTSAfter adjustment for potential confounders, eGFR and UAE were associated with these biomarkers of cardiac injury, even at levels that do not fulfill the CKD criteria. For example, eGFR 60–&lt;90 mL · min−1 ·(1.73 m2)−1 [vs ≥90 mL · min−1 · (1.73 m2)−1] was associated with a [ratio (95% CI)] 1.21 (1.17–1.26), 1.14 (1.07–1.20), and 1.19 (1.12–1.27) times higher hs-cTnT, hs-cTnI, and NT-proBNP, respectively. The association of eGFR with hs-cTnT was statistically significantly stronger than that with hs-cTnI. In addition, UAE 15–&lt;30 mg/24 h (vs &lt;15 mg/24 h) was associated with a 1.04 (0.98–1.10), 1.08 (1.00–1.18), and 1.07 (0.96–1.18) times higher hs-cTnT, hs-cTnI, and NT-proBNP, respectively.CONCLUSIONSeGFR and albuminuria were already associated with biomarkers of (subclinical) cardiac injury at levels that do not fulfill the CKD criteria. Although reduced renal elimination may partly underlie the associations of eGFR, these findings support the concept that eGFR and albuminuria are, over their entire range, associated with cardiac injury.
The place of practice in tertiary popular music studies: An epistemology
Authors: Weston Donna 
Published: February 2017

Abstract
This article explores the potential role of popular music studies when integrated into popular music practice programmes in higher education, and proposes that purely theoretical popular music studies could inform creative practice in the education of popular music practitioners. In bringing popular music studies and popular music practice together under the banner of popular music education, it is proposed that popular music practice educators should consider the study of popu- lar music from a sociocultural perspective as well as a practical one. The argument is informed by two field reports that map higher education in popular music in the United Kingdom and in Australia, respectively, supported by responses of students to the integration of popular music studies into an Australian popular music prac- tice programme. The findings show that students of popular music practice benefit- ted from the inclusion of popular music studies into their curriculum through the development of critical listening skills and songwriting ability, expansion of a range of vocational skills and a stronger sense of purpose within the music industry.
Book Reviews
Authors: Hjelm Titus , Kelley Jamey 
Published: February 2017

Abstract

Heavy Metal Studies and Popular Culture, Brenda Gardenour Walter, Gabby Riches, Dave Snell and Bryan Bardine (2016) Basingstoke: Palgrave, 214 pp., ISBN: 978-1-137-45667-0, h/bk, £68.00

Playing Along: Digital Games, Youtube, and Virtual Performance, Kiri Miller (2012) New York, NY: Oxford University Press, 272 pp., ISBN: 019-9-753-466, p/bk, $31.95
The power of popular music in China’s music education: From the Chinese dream and personal dreams to Confucianism
Authors: Ho Wai-Chung 
Published: February 2017

Abstract
The ‘Chinese dream’, a term popularized by the Chinese socialist state and put forth by Chinese President Xi Jinping in 2013, refers to the collective aspiration of a great rejuvenation of the Chinese nation, as well as the personal dreams of its individual citizens to attain healthy, happy and productive lives. Attempts to integrate this vision into people’s thoughts have been made via Chinese propaganda songs broadcast through state-run media and textbook materials. The ‘core socialist values’ linked to the Chinese dream reflect the wish for all Chinese to have a better future through national rejuvenation. The current rise of Confucianism is a manifestation of cultural nationalism in education that has emerged from the growing political and economic power of China. In terms of soft power, transmitting select popular music through education and culture is one way to bring about harmony in the changing society of mainland China. With particular and sustained attention to the power of China’s popular music, this article examines how music education (with a particular selection of songs adopted for official propaganda and state-approved music textbooks) responds to the rule of the Communist Party of China and its attempts to consolidate power in a global age.
(Un)popular music and young audiences: Exploring the classical chamber music concert from the perspective of young adult listeners
Authors: Dearn Lucy K. , Pitts Stephanie E. 
Published: February 2017

Abstract
This empirical study explores the responses of 40 young people to a chamber music concert, considering how their greater experience of popular music listening formed a frame of reference for their responses to live classical music. Using qualitative methods including the ‘Write-Draw’ technique to investigate the young people’s responses before, during and after the concert, we demonstrate how the emotional, responsive listening of popular music conflicted with the etiquette of the concert hall and the structures of classical music. Our study sheds new light on the continued decline of young audiences for classical concerts and presents a challenge to music education to equip young people for all kinds of live musical experience.