tbuckley/cabot-search huggingface dataset:
ACTR-26. A FEASIBILITY STUDY OF THE NATIVIS VOYAGER® SYSTEM IN PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA (GBM)
Authors: Garni Barkhoudarian, Sajeel Chowdhary, Nicholas Blondin, Santosh Kesari
Journal: Neuro-Oncology (2018)

The Nativis Voyager® system is a non-sterile, non-invasive, non-thermal, portable, investigational medical device that uses a specific, localized ultra-low radio frequency energy (ulRFE®) cognate for the treatment of brain cancer. In this prospective, open-label, multi-center trial, adults newly diagnosed with GBM, following maximal tumor debulking, are eligible for enrollment. The objective of the study is to assess if the Voyager ulRFE therapy is a safe and feasible treatment for newly diagnosed GBM when combined with standard of care (i.e., focal radiotherapy + temozolomide). Patients receive continual therapy with the Voyager, concurrently with radiotherapy + temozolomide. Upon progression, investigators can choose to maintain patients on study with the Voyager and to add second-line therapy. The primary outcome measure is safety, which is assessed by the incidence and evaluation of any adverse events associated with the Voyager through follow-up. The secondary outcome measure is clinical utility, which is assessed by progression-free survival and overall survival. Eleven patients were enrolled at 3 centers into the first (safety) cohort of this study. No device-related adverse events were reported by patients receiving concurrent therapy with Voyager + radiotherapy + temozolomide. All patients remain progression-free and on study as of June 2018. Given the safety profile, enrollment was expanded to 32 patients. Additional interim safety and clinical utility data will be reported. The Nativis Voyager system appears to be safe and feasible for the treatment of GBM. Given that therapy is delivered non-invasively and no device-related adverse events were reported, further prospective study of the investigational device is warranted.
Prospective study of the prevalence and co-morbidities of obstructive sleep apnea in active-duty army personnel in the three southernmost provinces of Thailand using questionnaire screening
Authors: Anisong Pilakasiri, Prasit Mahakit
Journal: Military Medical Research (2018)

It is crucial for the army to know the prevalence of obstructive sleep apnea (OSA) syndrome in active-duty army personnel. Little information has been reported on the prevalence of OSA and clinical features in active-duty army personnel. This study was aimed to estimate the prevalence of snoring and risk of developing OSA in active-duty army personnel in Thailand and to identify the co-morbidities of OSA. In total, 1107 participants who were aged 20-60 years and were deployed to the three southernmost provinces of Thailand were enrolled. All the participants completed the Phramongkutklao (PMK) Hospital OSA Questionnaire that was modified and validated from the Berlin Questionnaire and underwent physical examination. The participants were 1107 active-duty army personnel in the three southernmost provinces of Thailand, both males and females, aged 20-60 years.The PMK OSA Questionnaire was used to assess the risk of OSA together with interviewing for snoring, fatigue, falling asleep and day-time sleepiness. Physical examination of the neck, chest and hip circumference, and height was performed. Information concerning physical training, co-morbid diseases, smoking and alcoholic consumption was collected.The prevalence of snoring was 58.5, and 4.8% met the PMK OSA Questionnaire criteria, thus indicating a high risk of OSA. The information obtained indicated that laryngopharyngeal reflux (LPR), current smoking and alcoholic consumption were significantly higher in the high-risk OSA group.Early detection and treatment of OSA in active-duty army personnel are imperative. Physical examination and polysomnography can be used to reveal the high-risk group. High body mess index (BMI), laryngopharyngeal reflux, current smoking and alcoholic consumption are modifiable factors for OSA and are avoidable. A policy to decrease the BMI and risk of LPR, as well as to stop smoking and alcoholic consumption, should be applied.
Abstract 16795: Improving the Coronary Artery Calcium Score - Addition of Regional Measures of Calcium Distribution: Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Michael J Blaha, Khurram Nasir, Jeffrey J Carr, Nathan Wong, Richard Kronmal, Wendy Post, Roger S Blumenthal, Matthew J Budoff
Journal: Circulation (2012)

Background:  Conventional CAC scoring ignores information on the regional distribution of calcified plaque by coronary vessel and location. We investigated whether inclusion of simple measures of calcified plaque distribution might improve the predictive power of the traditional Agatston CAC score.   Methods:  Of 6,544 participants in MESA who underwent a baseline CAC scan scored on a per-vessel basis, we studied the 3,262 (50%) with CAC >0. Multi-territory CAC was defined by the number of vessels with CAC (scored 1 to 4, including the left main). We first tested for heterogeneity between CAC score group and the number of calcified vessels. We then performed Cox regression and AUC analyses to determine whether inclusion of number of calcified vessels added to the CAC score for prediction of CHD events. We further tested whether score in individual vessels, particular the left main, added information beyond the total CAC score.   Results:  Mean age of the population was 66 ± 10 years, with 42% women. Median follow-up was 7.6 years. Considerable heterogeneity existed between CAC score group and number of calcified vessels (CAC 1-100: 57% 1-vessel, 30% 2-vessel, 12% 3-vessel, 1% 4-vessel; CAC 101-400: 9% 1-vessel, 31% 2-vessel, 47% 3-vessel, 14% 4-vessel). Addition of number of vessels with calcium significantly improved the predictive power of the traditional CAC score (considered as a categorical, continuous, or log-transformed variable) in both survival and AUC analyses (Table). In multivariable models, inclusion of Framingham risk variables attenuated, but did not abolish, the improvement. CAC score in individual coronary arteries, including the left main, did not improve predictive value of the overall total CAC score (all p=NS).   Conclusion:  The number of coronary arteries with calcified plaque, indicating multi-vessel increasingly “diffuse” subclinical atherosclerosis, adds significantly to the standard Agatston CAC score for the prediction of CHD events.
Frequency of Transition From Stage A to Stage B Heart Failure After Initiating Potentially Cardiotoxic Chemotherapy
Authors: Deanna N. Jones, Jennifer H. Jordan, Giselle C. Meléndez, Zanetta Lamar, Alexandra Thomas, Dalane W. Kitzman, Cynthia Suerken, Ralph B. D’Agostino, W. Gregory Hundley
Journal: JACC Heart Failure (2018)
Asbestos and Smoking as Risk Factors for Idiopathic Retroperitoneal Fibrosis
Authors: Matteo Goldoni, Silvia Bonini, Maria L. Urban, Alessandra Palmisano, Giuseppe De Palma, Elisa Galletti, Marco Coggiola, Carlo Buzio, Antonio Mutti, Augusto Vaglio
Journal: Annals of Internal Medicine (2014)

Idiopathic retroperitoneal fibrosis (RPF) is a rare disease that has an unclear but probably multifactorial pathogenesis. This case–control study examined the role of exposure to occupational and e...
Recommendations for hamstring injury prevention in elite football: translating research into practice
Authors: Matthew Buckthorpe, Steve Wright, Stewart Bruce-Low, Gianni Nanni, Thomas Sturdy, Aleksander Stephan Gross, Laura Bowen, Bill Styles, Stefano Della Villa, Michael Davison, Mo Gimpel
Journal: British Journal of Sports Medicine (2018)

Injuries in football exert negative impacts on team performance1 and club finance.2 Hamstring strain injuries (HSI) are consistently the most prevalent time loss injury in football3 and as such are an important issue in football medicine. Despite an ever-increasing wealth of information emerging on the aetiology of HSIs, their incidence in football is increasing.3 This could be explained by the increased intensity and physical demands of football match play over the last decade4; but practitioners should also question their approach to injury prevention and physical preparation of players, an area where research is lacking.5–8 

There is an evidence-based strategy to prevent HSIs, however, there appears to be a large disconnect between this available evidence and its adoption in elite football.5 6 For example, the Nordic hamstring exercise (NHE) programme has been shown to effectively reduce HSIs by 65%–70%.9 10 But recent surveys of elite European Champions League (n=32) and Norwegian Premier League (n=18) teams showed that only 11% of these teams fully adopt the programme.11 

Within elite football, there is a large disconnect between evidence-based practice and the actual interventions used by science and medical teams to prevent injuries.12 In line with an emerging body of evidence-based research, we believe that preventing HSIs in elite football requires a holistic approach, which considers multiple risk factors and their inter-relations, implemented effectively.6–8 13 In designing our injury prevention programme, we combine both the theory and the available evidence on HSI risk factors and intervention studies, as well as considering the context surrounding the player when designing our overall injury prevention approach.

### Why do HSIs happen? Risk factor analysis and programme planning

To prevent HSIs, it is important to understand why they occur, so that an appropriate intervention can be developed, targeted at the specific risk factors. Importantly, there is not a …
NIMG-13. SEGMENTATION AND VOLUMETRIC ANALYSIS IMPROVES DETECTION OF PROGRESSION IN LOW GRADE GLIOMAS
Authors: Hassan Fathallah-Shaykh, L Burt Nabors, Andrew DeAtkine, Asim Bag, Markus Bredel, Paula Warren, Xiaosi Han, Nidhal Bouaynaya
Journal: Neuro-Oncology (2018)

Tumor surveillance is a common practice in oncology; its goal is timely detection of cancer progression, which is typically diagnosed by Visual Comparison (VC) or bidirectional measurement of longitudinal radiological images. Low-grade gliomas (LGG) can cause significant neurological morbidity by progressive brain invasion over time. We analyzed the longitudinal magnetic resonance imaging (MRI) studies of patients, diagnosed with grade 2 gliomas without any radiation therapy at the initial diagnosis, who had at least 4 MRI studies. Forty-eight patients met the inclusion criteria, including 13 oligodendrogliomas, 24 astrocytomas and 11 mixed gliomas. Thirty-four patients had clinical progression (CP) and 14 patients were considered clinically stable (CS) by VC at the time of the study. The computer assisted diagnosis (CAD) method consisted of segmentation of the fluid-attenuated inversion recovery (FLAIR) images, computing tumor volumes, and determining progression by the online abrupt change of point method, which considered only past MRIs. In the CP group, CAD detected progression at earlier times than the clinical diagnosis in 26/34 patients. In the CS group, CAD detected progression in 10/14 patients. Six physicians from the departments of neurology (neuro-oncology), radiology, and radiation oncology reviewed and agreed with the progression determined by the CAD method including the study subjects in the CS group. CAD was able to diagnose tumor progression when the tumor size grew at an average of 74% (range 14% to 364%) since the base line compared to 320% (range 25% to 2019%) in the VC method. The average time to progression was only 17 months when CAD was used compared to 50 months when VC method was used. Early detection of tumor progression is critical for LGG patients because it can optimize therapeutic options with significantly lower volume of brain resection or irradiation
Re-examining the Association Between “4/20” and Fatal Crashes—Doobie-ous Data?
Authors: Jayson D. Aydelotte, Alexandra L. Mardock, Pedro G. Teixeira, Lawrence H. Brown
Journal: JAMA Internal Medicine (2018)

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Abstract 16249: Risk Factors for Cardiovascular Death in Japanese Patients With Atrial Fibrillation: The Fushimi AF Registry
Authors: Yoshimori An, Mitsuru Ishii, Moritake Iguchi, Nobutoyo Masunaga, Kohsuke Doi, Masahiro Esato, Yeong-Hwa Chun, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Hisashi Ogawa, Mitsuru Abe, Masaharu Akao
Journal: Circulation (2017)

Background: Data regarding the relationship between clinical factors and causes of cardiovascular (CV) death in AF patients are limited in the real-world clinical setting. Methods: The Fushimi AF R...
Abstract 18919: Awareness of Hands-only CPR in an Urban Minority Population
Authors: Revathi Balakrishnan, Kelly Axsom, Robert Roswell, Lawrence Phillips, Stuart Katz
Journal: Circulation (2015)

Introduction: Hands-only CPR has been associated with improved survival rates for out of hospital cardiac arrest. There is wide geographic variation in bystander CPR rates and increased barriers to CPR knowledge in minority populations. Our aim was to assess the awareness and willingness to perform hands-only CPR in an ethnically diverse population. Methods: English-speaking patients in primary care and cardiac subspecialty clinics were approached to answer a 33 question survey. Demographic information was collected, and awareness of CPR and hands-only CPR was assessed. A brief instructional video of hands-only CPR was administered and willingness to perform hands-only CPR was assessed after. Results: Of 255 approached, 127 completed the survey. 53.4% were Hispanic or Black, and 81% spoke English at home. Median age was 49 years old, and majority were male (63%). 48% had a cardiac history or had a friend or family member with heart disease. 61% had no prior CPR training. The most common reasons identified for not doing CPR were fear of doing it incorrectly (33%) and no training (28%). 52% were unaware of hands-only CPR and 52% were unsure or unwilling to do CPR on a stranger. Willingness to perform CPR on a stranger was associated with higher educational level and prior training. After viewing the hands-only CPR instructional video,93% of those who were initially unsure or unwilling to do CPR were significantly more likely to do hands-only CPR (p&lt;0.001). Conclusions: In this predominantly minority population, we found reduced awareness of hands-only CPR and demonstrated that an educational video can increase willingness to perform hands-only CPR. This educational tool can be used to target areas and populations where bystander CPR rates are low.
SURG-16. MRI NEURONAVIGATION-GUIDED RESECTION FOR RECURRENCE-INITIATING GBM CLONES.
Authors: Ichiro Nakano
Journal: Neuro-Oncology (2018)

Diffuse infiltration is a hallmark of Glioblastoma (GBM) and surgical resection of the entire tumor cells is practically impossible. Residual tumor cells at surgery retain a subpopulation that initiates life-threatening tumor recurrence, termed recurrence-initiating cells (RICs). From the standpoint of spatial distribution, given that the tumor cells in the gadolinium-enhancing lesions (tumor core) can largely be removed at surgery, RICs are supposedly located at the non-enhancing edge lesions with T2-FLAIR changes. Although intratumoral molecular and phenotypic heterogeneity is representative of malignant tumors such as GBM, the edge-located RICs have not been well-defined due to the difficulty in safe resection. As a neuro-oncology surgeon, I have developed a means to molecularly and phenotypically characterize the edge-located RICs by combining the Stealth MRI-guided localized tumor resection at surgery, followed by clonal characterization of tumor cells in my laboratory. In this presentation, I will summarize the strength and limitations of this established approach.
TMOD-15. RELIABILITY OF IMAGING-BASED MEASURES OF TUMOR ‘MASS-EFFECT’– EVIDENCE FROM A COMPUTATIONAL STUDY
Authors: Daniel Abler, Philippe Büchler, Russell Rockne
Journal: Neuro-Oncology (2018)

Elevated tumor mass-effect is associated to poor prognosis in GBM [1,2]. However, tumor mass-effect is poorly quantified in clinical practice. Recently, Steed et al. [2] proposed ‘Lateral ventricle displacement’ (LVd), defined as the change in center-of-mass position of the lateral ventricles between an undeformed reference and the tumor-bearing anatomy, as quantitative imaging measure of mass-effect. They found that the magnitude of LVd in GBM patients can be associated with overall survival. These results show the clinical importance of tumor mass-effect in GBM, warranting robust clinical measures. This study characterizes image-derived estimates of tumor mass-effect by their ability to measure mass-effect accurately and reliably. We use a mathematical model to simulate tumor growth, which allows us to control and objectively quantify ‘mass-effect’ [3]. For given simulation parameters and growth location, we compute estimates of mass-effect from anatomical deformation during the growth process. We use multiple regression analysis to evaluate the ability of different estimates to explain the tumor’s objective mass-effect, measured by the tumor-induced pressure on the skull. Preliminary results from tumor growth simulations at 15 locations across a normal brain atlas confirm the potential of LVd as predictor of tumor mass-effect (R2=0.98). The maximum left-right displacement along the midline in a selected plane, a measure for ‘midline shift’, only explains a smaller percentage of mass-effect variability in the simulated population and strongly depends on the measurement plane (R2=0.20–0.85). We will report results of an extended study that applies our analysis approach to a large and diverse population of approximately 100 simulated tumors, by varying growth location and parameters related to the tumor’s proliferative and invasive potential. References: [1] Gamburg et al. IJROBP, 2000, 48, 5: 1359–62, [2] Steed et al. Scientific Reports, 2018, 8: 2827, [3] Abler et al. Neuro-Oncology, 2017, 19, suppl 6: vi245.
DRES-11. A SYSTEMS APPROACH FOR DETERMINING THE MECHANISM OF RESISTANCE TO TUMOR TREATING FIELDS IN GLIOBLASTOMA
Authors: Dongjiang Chen, Nagheme Thomas, Son Le, Changwang Deng, Dan Jin, Mathew Sebastian, Duy Nguyen, Jie Ren, David Tran
Journal: Neuro-Oncology (2018)

Glioblastoma (GBM) is the most common and deadliest malignant brain cancer in adults despite aggressive chemoradiotherapy. Recently, Tumor Treating Fields (TTFields) were approved in combination with adjuvant temozolomide chemotherapy for newly diagnosed GBM. The addition of TTFields resulted in a significant improvement in overall survival. TTFields are low-intensity alternating electric fields that are thought to disturb mitotic macromolecules’ assembly, leading to disrupted chromosomal segregation and cell death. However, many TTFields responders eventually develop progression. The mechanism of TTFields resistance remains largely unexplored. Understanding how cancer cells gain the ability to circumvent the biophysical forces of TTFields and their downstream effects will provide new opportunities to improve therapeutic efficacy of this novel anti-cancer treatment. To accomplish these objectives, we have developed several human GBM cell lines that demonstrated relative resistance to the cytotoxic effects of TTFields compared to the parental cells. Importantly TTFields-induced chromosomal instability such as the formation of micronuclei was unchanged in resistant cells compared to their sensitive counterparts. In contrast, TTFields-induced inflammatory response was severely suppressed in resistant cells, suggesting that resistance to TTFields may be conferred by a selective loss of the deleterious effects downstream of the biophysical insults. Importantly, this acquired TTFields resistance phenotype of GBM cells was associated with a transition to a stem-like state. Using a systems approach aided by a suite of innovative computational platforms, we methodically dissected this renewed stemness program in resistant cells to identify master regulators of the resistance mechanism. Our long-term goal is to develop targeted therapies that prevent tumor’s resistance to TTFields.
CSIG-12. ANNEXIN A7 ISOFORMS DIFFERENTIALLY REGULATE TUMORIGENIC EGFR SIGNALING IN GLIOBLASTOMA MULTIFORME
Authors: Sindhu Nair, Susan Nozell, Centdrika Hurt, Rajani Rajbhandari, Markus Bredel
Journal: Neuro-Oncology (2018)

Dysregulation of receptor tyrosine kinase genes is a frequent genetic abnormality in GBM. A common genetic alteration is amplification and/or overexpression of the epidermal growth factor receptor (EGFR) gene. Annexin A7 (ANXA7) is a hydrophilic protein that binds membranes in a calcium dependent manner; it is important for membrane scaffolding and vesicle trafficking. ANXA7 is alternatively spliced and expressed as two isoforms – unspliced ANXA7 Isoform 1 (I1), containing cassette exon 6 and spliced Isoform 2 (I2). Our lab has determined that I1 is tumor suppressive in GBM and that loss of I1 promotes tumorigenicity by perpetuating EGFR signaling. However, if restored, I1 but not I2, reduces EGFR levels, activation and downstream pathways and diminishes tumorigenicity. In patients, I1 levels directly correlate with survival and prognosis. We propose that I1 inhibits EGFR signalling by binding to and promoting degradation of EGFR in a calcium dependent manner. In GBM, I1 is absent, preventing endosomal degradation of EGFR and leading to perpetual signalling. Our approach is novel; rather than address how/whether EGFR is activated, we focus on why EGFR fails to be downregulated afterwards. Herein, we present a mechanism that explains, in part, how I1 mediates endosomal degradation of EGFR. Further studies are underway to identify exactly where and how I1 modifies endosomal trafficking and degradation of EGFR. We are also exploring the role of I1 in regulating the degradation of other receptor tyrosine kinases (RTKs), such as MET and PDGFRA. Collectively, understanding how I1 functions will provide the foundation for future, selective therapies that restore I1 expression and/or function to reduce GBM tumorigenicity.