tbuckley/cabot-search huggingface dataset:
Population-Level Exposure to Particulate Air Pollution during Active Travel: Planning for Low-Exposure, Health-Promoting Cities
Authors: Steve Hankey, Greg Lindsey, Julian D. Marshall
Journal: Environmental Health Perspectives (2016)

Background:Providing infrastructure and land uses to encourage active travel (i.e., bicycling and walking) are promising strategies for designing health-promoting cities. Population-level exposure to air pollution during active travel is understudied.Objectives:Our goals were a) to investigate population-level patterns in exposure during active travel, based on spatial estimates of bicycle traffic, pedestrian traffic, and particulate concentrations; and b) to assess how those exposure patterns are associated with the built environment.Methods:We employed facility–demand models (active travel) and land use regression models (particulate concentrations) to estimate block-level (n = 13,604) exposure during rush-hour (1600–1800 hours) in Minneapolis, Minnesota. We used the model-derived estimates to identify land use patterns and characteristics of the street network that are health promoting. We also assessed how exposure is correlated with indicators of health disparities (e.g., household income, proportion of nonwhite residents). Our work uses population-level rates of active travel (i.e., traffic flows) rather than the probability of walking or biking (i.e., "walkability" or "bikeability") to assess exposure.Results:Active travel often occurs on high-traffic streets or near activity centers where particulate concentrations are highest (i.e., 20–42% of active travel occurs on blocks with high population-level exposure). Only 2–3% of blocks (3–8% of total active travel) are "sweet spots" (i.e., high active travel, low particulate concentrations); sweet spots are located a) near but slightly removed from the city-center or b) on off-street trails. We identified 1,721 blocks (~ 20% of local roads) where shifting active travel from high-traffic roads to adjacent low-traffic roads would reduce exposure by ~ 15%. Active travel is correlated with population density, land use mix, open space, and retail area; particulate concentrations were mostly unchanged with land use.Conclusions:Public health officials and urban planners may use our findings to promote healthy transportation choices. When designing health-promoting cities, benefits (physical activity) as well as hazards (air pollution) should be evaluated.Citation:Hankey S, Lindsey G, Marshall JD. 2017. Population-level exposure to particulate air pollution during active travel: planning for low-exposure, health-promoting cities. Environ Health Perspect 125:–534; http://dx.doi.org/10.1289/EHP442
A revisit of the devastating outcome of leptomeningeal disease.
Authors: Ahmad Hatem Mattour, Tobias Walbert, Ian Lee, Ding Wang
Journal: Journal of Clinical Oncology (2016)

e13504 Background: Leptomeningeal metastasis (LM) represents a devastating complication of malignancies by forming tumor deposits on the leptomeninges at about 5% to 8% of cancer patients (Pts). Standard therapies include radiotherapy (RT) to focal involved areas, systemic and/or intrathecal (IT) chemotherapies which have been recommended for palliation but with unclear benefit toward survival. This study is to review the pattern of the clinical practice and outcomes on Pts with LM who have received care at Henry Ford Hospital between 2004 and 2014 Methods: A retrospective study targeted all Pts of LM (icd-9 code 198.4) between 01/01/2004 and 01/01/2014. Pts with primary brain, orbital and spinal lesions as well as Pts with cord compressions were excluded from this study. LM Pts were included based on MRI images, cerebral spinal fluid (CSF) cytology and/or dural biopsy. Data from onset of primary tumor, therapeutic interventions, methods of LM diagnosis, duration (days) from initial cancer onset to LM diagnosis, then from LM diagnosis to death were collected and analyzed as shown Results: 328 Pts with LM (icd-9: 198.4) were identified, but 58 Pts fulfilled inclusions. Of 58 Pts, 22 (38%) had breast cancer (38%), 12 (21%) NSCLC. LM was diagnosed in 34 Pts (59%) based on MRI findings, 4 (6%) by CSF cytology and 19 (33%) by both. Majority (37 Pts, 64%) received therapy after LM diagnosis: 16 (27%) received IT chemotherapy, 15 (26%) received RT while 6 (10%) received both. Twenty-one of LM Pts (36%) received no treatment under various circumstances. Of 58 Pts, the median time from cancer onset to LM diagnosis was 686 days while median overall survival (OS) was 1038 days, and median OS from LM to death was 95 days. Survival difference was observed for Pts (37, 64%) received LM-directed treatment as 113 days but only 61 days for those received no therapies Conclusions: LM is a prognostic complication in malignancies. It poses a grave challenge due to limited therapeutics that only carry modest survival benefit. Data from these 58 Pts shown a benchmarks of survival from LM diagnosis was 4 months with treatment, and 2 months without. These are consistent with published data over last decades without improvement. Therefore, more clinical researches in LM diagnosis and therapies are needed
Exosome-derived Developmental Endothelial Locus-1 as a novel diagnostic marker for breast cancer.
Authors: Yee Soo Chae, Pyong-Gon Moon, Jeong-Eun Lee, Young-Eun Cho, Soo Jung Lee, Jin Hyang Jung, Han-Ik Bae, In-San Kim, Ho Yong Park, Moon-Chang Baek
Journal: Journal of Clinical Oncology (2015)

e22262 Background: Extracellular vesicles (EVs) or exosomes were recently identified to participate in intercellular communication through exosomal proteins or RNAs suggesting its potential role in cancer development and progression. Therefore, the current study focused to identify exosomal proteins from plasma of breast cancer patients and evaluated their role for breast cancer. Methods: The developmental endothelial locus-1 protein (Del-1) was identified and selected as a biomarker candidate by analyzing circulating EVs isolated from plasma of 10 patients with early breast cancer (stages I and II) and 5 disease-free individuals using LC-MS/MS. A subsequent study analyzed derived Del-1 in plasma samples from normal subjects (n = 81), patients with breast cancer (n = 269), patients who underwent removal of a breast tumor (n = 50), patients with benign breast tumor (n = 64), and patients with non-cancerous diseases (thyroiditis, gastritis, hepatitis B, and rheumatoid arthritis; n = 99) by using two different ELISA methods. Plus, a duplication study was performed in a different cohort (n = 242) to confirm its role in breast cancer. Results: ExosomalDel-1 level was significantly elevated (P < .0001) in patients at all stages of breast cancer compared with normal controls or patients with benign diseases, and moreover returned to normal after tumor removal. The area under receiver operating characteristic curve (AUC) was 0.99 (95% CI, 0.98 to 0.99) providing sensitivity of 76.8% and specificity of 90.2%, which was similar in both the early-stage BC and all BC patients. Plus, the diagnostic value of these exosomal Del-1 was reconfirmed in an independent validation cohort. Conclusions: Our findings showDel-1 on circulating EVs could improve identification of patients with early breast cancer thereby suggesting exosomal Del-1 as a possible biomarker for early detection of breast cancer in particular for high-risk subjects or breast cancer patients who underwent curative surgery.
Patients with lichen sclerosus experience moderate satisfaction with treatment and impairment of quality of life: results of a cross-sectional study
Authors: O.D. van Cranenburgh, S.B.W. Nijland, R. Lindeboom, J. de Korte, M.A. de Rie, J.A. ter Stege, C.A.C. Prinsen
Journal: British Journal of Dermatology (2016)

Although they are considered relevant, little is known about satisfaction with treatment and health‐related quality of life (HRQoL) among patients with lichen sclerosus (LS). In a cross‐sectional study, we aimed to examine (i) satisfaction with treatment, (ii) patient characteristics associated with satisfaction and (iii) HRQoL in Dutch patients with LS. Members of the Dutch LS Patient Association (n = 750) were invited to complete a web‐based survey. We measured satisfaction with treatment with a study‐specific questionnaire, and HRQoL with the Skindex‐29. We calculated domain scores for symptoms, emotions and functioning, and categorized scores into little, mildly, moderately or severely impaired HRQoL. We used a multiple linear regression analysis to examine whether patient characteristics were associated with treatment satisfaction. In total 303 patients (40·4%) were included. Patients under current treatment (n = 265, 87·5%) were moderately satisfied with their treatment. Patients rated 'treatment effectiveness' as most important, although 58 (22%) were dissatisfied with the effectiveness of their current treatment. More impairment on the HRQoL emotions domain and a higher degree of disease severity were both associated with lower satisfaction with treatment and explained in total 13·5% of the variance in treatment satisfaction. On all HRQoL domains, one‐third of the patients (range 34·7–38·9%) reported severe impairment. Patients with LS are moderately satisfied with their treatment, and one‐third of patients experience severe impairment of HRQoL. To improve dermatological care, we recommend enhancement of doctor–patient communication, information provision and organization, which may be more amenable to change than treatment effectiveness or safety.
Optimization of routine KRAS genotyping procedure for rational selection of first-line targeted therapy in metastatic colorectal cancer (mCRC).
Authors: A. Chrétien, M. Rouyer, M. Husson, C. Ramacci, P. Genin, A. Leroux, J. Merlin
Journal: Journal of Clinical Oncology (2010)

e14008 Background: KRAS genotyping represents a first step towards individualized therapy and has become a crucial issue in mCRC. The optimization of KRAS genotyping delay enabling rational prescription of first-line treatment in mCRC including anti-EGFR targeted therapy, requires robust and rapid molecular biology techniques. Methods: Between June 2008 and December 2009, 844 mCRC have been analyzed for KRAS mutations. Following prescription of KRAS genotyping by medical oncologists, the tumor specimens were collected from private and academic pathologists, as paraffin-embedded tissue specimens, and macrodissected after hematoxylin-eosin slide analysis by a pathologist to ensure a minimum of 50% tumor tissue content. DNA was then extracted and controlled. Routine KRAS genotyping, restricted to exon 2 mutations in codon 12 and 13, was performed using three molecular biology techniques i.e. high resolution melting (HRM), PCR-RFLP and allelic discrimination PCR (TaqMan). Results: Among the 844 tumor specimens, 3% (25/844) had excessive DNA degradation and could not be analyzed. KRAS mutations were detected in 41% (334/819) of the analysable specimens with 81% (274/334) of the mutations being located in codon 12 and 19% (60/334) in codon 13. Among 549 specimens in which all three techniques were used, 15 (2.7%) cases of discordance between the three techniques were observed. In these discordant cases, the whole procedure (from DNA extraction) was systematically repeated. 53% of the discordances was due to PCR-RFLP, as revealed by a second analysis of the same sample, 33% to TaqMan, 13% to HRM. From these results, in order to reduce the duration of KRAS genotyping, HRM and TaqMan are used as genotyping techniques and PCR-RFLP only used in cases of discordance, helping to optimize the genotyping delay that is a crucial point for the prescription of first-line treatment in mCRC. Conclusions: The results obtained show an excellent correlation between the three techniques used. Using HRM warrants high quality and rapid routine KRAS genotyping in paraffin-embedded tumor specimens enabling rational prescription of first-line targeted therapy in mCRC. No significant financial relationships to disclose.
An Unbiased Lipidomics Approach Identifies Early Second Trimester Lipids Predictive of Maternal Glycemic Traits and Gestational Diabetes Mellitus
Authors: Liangjian Lu, Albert Koulman, Clive J. Petry, Benjamin Jenkins, Lee Matthews, Ieuan A. Hughes, Carlo L. Acerini, Ken K. Ong, David B. Dunger
Journal: Diabetes Care (2016)

OBJECTIVE To investigate the relationship between early second trimester serum lipidomic variation and maternal glycemic traits at 28 weeks and to identify predictive lipid biomarkers for gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS Prospective study of 817 pregnant women (discovery cohort, n = 200; validation cohort, n = 617) who provided an early second trimester serum sample and underwent an oral glucose tolerance test (OGTT) at 28 weeks. In the discovery cohort, lipids were measured using direct infusion mass spectrometry and correlated with OGTT results. Variable importance in projection (VIP) scores were used to identify candidate lipid biomarkers. Candidate biomarkers were measured in the validation cohort using liquid chromatography–mass spectrometry and tested for associations with OGTT results and GDM status. RESULTS Early second trimester lipidomic variation was associated with 1-h postload glucose levels but not with fasting plasma glucose levels. Of the 13 lipid species identified by VIP scores, 10 had nominally significant associations with postload glucose levels. In the validation cohort, 5 of these 10 lipids had significant associations with postload glucose levels that were independent of maternal age and BMI, i.e., TG(51.1), TG(48:1), PC(32:1), PCae(40:3), and PCae(40:4). All except the last were also associated with maternal GDM status. Together, these four lipid biomarkers had moderate ability to predict GDM (area under curve [AUC] = 0.71 ± 0.04, P = 4.85 × 10−7) and improved the prediction of GDM by age and BMI alone from AUC 0.69 to AUC 0.74. CONCLUSIONS Specific early second trimester lipid biomarkers can predict maternal GDM status independent of maternal age and BMI, potentially enhancing risk factor–based screening.
Plasma Endothelin-1 and Leukocyte Microparticles Increase during Pain Episode in Patients with Sickle Cell Disease.
Authors: Ofelia Alvarez, Joaquin Jimenez, Mary Donovan, Gabriela Lopez-Mitnik, Carlos Bidot, Wenche Jy, Loreta Bidot, Lawrence Horstman, Yeon-Soong Ahn
Journal: Blood (2007)
Furanyl-Fentanyl Overdose Events Caused by Smoking Contaminated Crack Cocaine — British Columbia, Canada, July 15–18, 2016
Authors: Salman A. Klar, Elizabeth Brodkin, Erin Gibson, Shovita Padhi, Christine Predy, Corey Green, Victoria Lee
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

On July 15 2016, Surrey Memorial Hospital's emergency department notified the medical health officer on call of a sharp increase in opioid overdose events in Surrey, Fraser Health Authority, in British Columbia, Canada. During July 15-18, the number of persons with suspected opioid overdose evaluated in Surrey Memorial Hospital's emergency department increased approximately 170%, from an average of four suspected cases per day during the period January-June 2016 to 43 (nearly 11 per day) during the 4-day period (Figure). Most patients (22 [51%]) became unconscious after smoking what they believed to be crack cocaine. The majority of overdose events occurred within a small geographic area in Surrey that has a high population of homeless persons and persons who use illicit drugs, including opioids and crack cocaine. Most cases occurred in males (36 cases [84%]); the average age of the patients was 42 years (range = 18-63 years). Forty (93%) patients were brought to the emergency department by ambulance. A total of 37 (86%) patients received injectable naloxone before arriving in the emergency department, including 12 who received it only from community members, 16 who received it only from paramedics, five who received it from both community members and paramedics, one who received it from the fire department and paramedics, and one who received it from the fire department, community, and paramedics; for two patients, the source of naloxone was not known. Reports from first responders, the community, and emergency department staff members indicated that patients required high doses of injectable naloxone, in some cases up to 3.0 mg (usual dose = 0.4 mg). Thirty-five (81%) patients were treated and discharged within a few hours, two patients left without being seen by a health care provider, and six patients were admitted to the hospital; among these, three were transferred to the intensive care unit, one of whom died.
Improved selection of patients for hepatic surgery of colorectal liver metastases with FDG-PET: A randomized study
Authors: B. Wiering, W. Oyen, J. Van der Sijp, R. Roumen, K. De Jong, E. Comans, J. Pruim, H. Dekker, P. Krabbe, T. Ruers
Journal: Journal of Clinical Oncology (2008)

4004 Background: Careful selection of patients who may benefit from surgical treatment of colorectal liver metastases is critical. Staging by PET with FDG is thought to be better than conventional staging. Evidence that the addition of FDG-PET leads to superior clinical results and improved clinical management in these patients is lacking. In this randomised controlled trial, we investigated whether the addition of FDG-PET is beneficial and reduces the number of futile laparotomies. Methods: 150 patients with colorectal liver metastases selected for surgical treatment by imaging with CT scan were randomly assigned to CT imaging only (n=75) or CT imaging plus FDG-PET (n=75). Primary outcome measure was futile laparotomy, defined as any laparotomy that did not result in complete tumour treatment, that revealed benign disease or that did not result in a disease free survival period longer than 6 months. Results: Clinical characteristics were similar for both groups. The number of futile laparotomies was 34 (45%) in the group without PET and 21 (28%) in the group with PET, the relative risk reduction was 38% (95%CI = 4%-60%). Conclusions: Addition of FDG- PET to the work-up for surgical resection of colorectal liver metastases prevents unnecessary surgery in one out of six patients. No significant financial relationships to disclose.
Exercise to prevent falls in older adults: an updated systematic review and meta-analysis
Authors: Catherine Sherrington, Zoe A Michaleff, Nicola Fairhall, Serene S Paul, Anne Tiedemann, Julie Whitney, Robert G Cumming, Robert D Herbert, Jacqueline C T Close, Stephen R Lord
Journal: British Journal of Sports Medicine (2016)

<h3>Objective</h3> Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects. <h3>Design</h3> Update of a systematic review with random effects meta-analysis and meta-regression. <h3>Data sources</h3> Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched from January 2010 to January 2016. <h3>Study eligibility criteria</h3> We included randomised controlled trials that compared fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group. <h3>Results</h3> 99 comparisons from 88 trials with 19 478 participants were available for meta-analysis. Overall, exercise reduced the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, p&lt;0.001, I<sup>2</sup> 47%, 69 comparisons) with greater effects seen from exercise programmes that challenged balance and involved more than 3 hours/week of exercise. These variables explained 76% of the between-trial heterogeneity and in combination led to a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, p&lt;0.001). Exercise also had a fall prevention effect in community-dwelling people with Parkinson9s disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I<sup>2</sup> 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I<sup>2</sup> 21%, 3 comparisons). There was no evidence of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital. <h3>Summary/conclusions</h3> Exercise as a single intervention can prevent falls in community-dwelling older people. Exercise programmes that challenge balance and are of a higher dose have larger effects. The impact of exercise as a single intervention in clinical groups and aged care facility residents requires further investigation, but promising results are evident for people with Parkinson9s disease and cognitive impairment.
Treatments for Nausea and Vomiting During Pregnancy
Authors: Jill Jin
Journal: JAMA (2016)

Catherine McParlin, PhD; Amy O’Donnell, PhD; Stephen C. Robson, MD; Fiona Beyer, PGDip; Eoin Moloney, MSc; Andrew Bryant, MSc; Jennifer Bradley, BSc (Hons); Colin R. Muirhead, PhD; Catherine Nelson-Piercy, FRCP; Dorothy Newbury-Birch, PhD; Justine Norman, MD; Caroline Shaw, PhD; Emma Simpson, Msc; Brian Swallow, PhD; Laura Yates, MBChB; Luke Vale, PhD
High Body Mass Index in Elderly Patients With DLBCL Treated With Rituximab-Containing Therapy Compensates for Negative Impact of Male Sex
Authors: Zheng Zhou, Alfred W. Rademaker, Leo I. Gordon, Ann S. LaCasce, Allison Crosby-Thompson, Ann Vanderplas, Gregory A. Abel, Maria A. Rodriguez, Auayporn Nademanee, Mark S. Kaminski, Myron S. Czuczman, Michael M. Millenson, Andrew D. Zelenetz, Joyce Niland, Jonathan W. Friedberg, Jane N. Winter
Journal: Journal of the National Comprehensive Cancer Network (2016)

Background: The impact of patient body habitus and sex on outcomes in diffuse large B-cell lymphoma (DLBCL) remains controversial. We investigated the impact of body mass index (BMI), body surface area (BSA), age, and sex on clinical outcomes in patients with DLBCL treated in the rituximab era. Patients and Methods: Patients with de novo DLBCL (n=1,386) diagnosed between June 2000 and December 2010 treated with rituximab-containing chemotherapy were identified from the NCCN Oncology Outcomes Database for Non-Hodgkin's Lymphoma. Progression-free survival (PFS) and overall survival (OS) at 3 years were analyzed based on sex, age, and baseline BMI/BSA. Results: High BMI was associated with a lower risk of disease progression or death than low or normal BMI, whereas male sex was associated with poor clinical outcomes, especially among elderly patients (age >60 years). Compared with elderly women, elderly men experienced worse PFS (3-year hazard ratio [HR], 1.5) and OS (3-year HR, 1.6), but these differences diminished with increases in BMI and BSA. In multivariable analysis, normal BMI compared with high BMI was independently associated with poor outcomes (3-year PFS HR, 1.5; OS HR, 1.6) after adjusting for sex. Notably, only 13% of elderly men had BMI less than 25 kg/m2 and only 26% had BSA less than 2 m2. Conclusions: Analysis of unselected patients with DLBCL treated with rituximab-containing chemotherapy confirmed an age-dependent disadvantage to male sex in treatment outcomes, but this effect is abrogated by higher levels of BMI and BSA in most North American men.