tbuckley/cabot-search huggingface dataset:
INJURY SURVEILLANCE IN COMMUNITY AUSTRALIAN RULES FOOTBALL USING SMS TECHNOLOGY AND ONLINE SURVEYS
Authors: Laura M Schwab
Journal: British Journal of Sports Medicine (2017)

Background Participant compliance in community injury surveillance studies can be challenging. Novel collection methods such as short message service text (SMS) and online surveys may help compliance by participants. Objective To examine injury epidemiology in community Australian Rules players as well as to investigate novel methods for data collection in community populations. Design Prospective epidemiological study using SMS technology and online surveys to record training loads and new injuries. Setting Community Australian Rules football, South East Queensland, Australia. Participants 175 community male footballers, age 16–35 years. Intervention Automated SMS and online survey of new injuries and weekly training load over the playing season (20 weeks). Main Outcome Measurements injury incidence, location of injury, type of injury or illness, mechanism of injury, field position, initial perceived severity, place of referral, participant SMS compliance. Results 202 registered injuries over 20 weeks, trauma (58.7%), overuse (24.4%), illness (9.0%). Top 5 injuries- thigh (12.2%), ankle (11.2%), head (10.6%), shoulder (10.1%), knee (10.1%) are comparable to elite studies. Most common mechanisms- contact with player (27.2%), running (18.5%), and landing from jumping (10.3%). There was no significant playing position injury finding. Severity of injury- mild (&lt;2 weeks, 80.1%), moderate (3–6 weeks, 10.9%), severe (&gt;6 weeks, 9.0%). Two thirds of all injuries presented for medical attention, almost half to physiotherapy followed by doctor/ or emergency department (30.1%). There was a SMS compliance rate of approximately 80%, adjusted for season duration of different community leagues. Conclusion Injury rates in this community study were comparable to findings in elite studies for injury location and mechanisms. This study confirms the high burden of community ARF injuries on the medical system in Australia. Compliance to injury surveillance in the community was considerably better than previous sports trainer lead studies. SMS technology and online survey self-report have been shown to be an effective way of collecting injury data in a community setting. Accurate community studies can help shape government funding in areas of need.
Study of the conformity of post-chemotherapy retroperitoneal lymph-node dissection (RPLND) to standard recommendations in patients with testicular (T) and primary retroperitoneal (PR) non-seminomatous germ-cell tumor (NSGCT): impact on outcome
Authors: A. Flechon, E. Tavernier, P. Meeus, M. Rivoire, J.-P. Droz
Journal: Journal of Clinical Oncology (2004)

4584 Background: Post-chemotherapy RPLND is a major part of the initial treatment of T-PR NSGCT patients. The aim of the study was to determine whether its conformity to standard recommendations had an impact on pts outcome. Methods: We reviewed the clinical, surgical and histological charts of 533 T-PR NSGCT patients who were treated between 01/93 to 12/00 in our center. RPLND was performed in 153 patients after first-line chemotherapy by 69 different surgeons. One surgeon and 68 surgeons operated 49 patients and less than 8 patients respectively. We reviewed the distribution of involved lymph-node according to Donohue et al (J Urol 1982, 128:315). Recommendations used to define conformity to RPLND standards were: indication based on initial and residual lymph-node sizes and shrinkage (Toner, J Clin Oncol, 1990, 8: 1683), extension of dissection (Wood et al, J Urol 1992, 148: 1812 and Aprikian et al, Cancer 1994, 74: 1329) and completeness of exeresis. Criteria for outcome were relative risk (RR) of relapse and death. Results: RPLND was in conformity to standard recommendations in 71/153 (46%) patients (indication: 149/153, extension: 76/153, completeness of exeresis 129/153). Conformity was 100% for the surgeon who operated 49 patients and 26% for the others. Median follow-up was 3.08 years (0.42–11). There were 26 (17%) relapses (12 in the retroperitoneum) and 14 deaths. Patients who had not conformable RPLND had a 4.33 and 3.17 RR of retroperitoneal relapse and death respectively when compared to patients who had RLNPD performed according to standard recommendations. Conclusions: Conformity of RLNPD procedure to standard recommendation has an impact on outcome. Patients should be treated in reference centers. No significant financial relationships to disclose.
Cancer screening, patient characteristics, and shared decision making (SDM): A complicated equation.
Authors: James Austin Talcott, Maureen Bezuhly, Gina Aharanoff, Danielle Seiden, Michael P. Osborne, Manjeet Chadha
Journal: Journal of Clinical Oncology (2017)

164 Background: SDM may vary by patient and clinical decision. In a randomized trial of physician (MD) educational interventions to improve cancer screening guideline compliance, we studied patient (PT) and MD recall of discussions and factors that affected recall. Methods: In a cluster-randomized trial of educational supports for MDs, we are enrolling an age- (30-89 years) and sex-stratified sample of 216 PTs who underwent a physical examination at 2 urban hospitals, 18 for each of 12 primary care MDs. Screening guideline formatting (color-coding) and academic detailing were randomly assigned in a 2x2 design. Immediate post-encounter surveys recorded PT and MD recall of screening discussions. Results: The first 174 participants were diverse (63% white) and highly educated (77% college degree). PTs and MDs differed in recall of screening discussions, and the differences varied by screening test. When MDs reported a colorectal cancer (CRC) screening discussion, 21% of PTs did not; 20% of MDs disagreed when PTs reported the discussion. The discrepancies were greater for prostate specific antigen (PSA) screening, 29% and 29%, respectively, but much less for mammograms (MAM), 8% and 5%, respectively. Recall of the MD recommendation also differed: 15% of PTs disagreed when their MD reported it, and 33% of MDs when their PT reported it. For PSA, disagreement was 26% and 33%, respectively, and for MAM, disagreement was 17% and 10%, respectively. Overall, agreement between all PTs and MDs on whether screening was recommended was fair for CRC, PSA and MAM: kappa = 0.33, 0.34 and 0.29, respectively. Older PT age ( &gt; 70) sharply eroded agreement on recalled CRC and PSA recommendations (kappa = -0.02 and -0.03, respectively) but much higher for MAM (kappa = 0.39). Recall concordance improved when elements of SDM were recalled. For CRC, kappa rose from -0.12 to 0.52 if the MD recalled any MDM element. Conclusions: In a highly educated, diverse PT population, PTs and MDs surveyed immediately after their encounter often disagreed on what had occurred in screening discussions. Disagreement was greater for CRC and PSA vs. MAM, greater for older PTs but improved when SDM was recalled. Clinical trial information: NCT02430948.
Phase I study of transgenic B lymphocyte immunization (TLI) against telomerase in androgen-independent prostate cancer (PC)
Authors: F. E. Millard, M. Gerloni, D. Darrah, P. Farness, M. Zanetti
Journal: Journal of Clinical Oncology (2004)

2519 Background: Human telomerase reverse transcriptase (hTRT) is expressed in the majority of human tumor cells (>90% of PC) but is absent from most normal adult cells, identifying it as a potential immunotherapeutic target (PNAS 97:4796, 2000). We developed a new approach to induce T cell responses in vivo based on the injection of primary B lymphocytes genetically programmed to serve as antigen presenting cells with the dual function of antigen synthesis and presentation. This is done ex vivo by exploiting the phenomenon of spontaneous B cell transgenesis (Gene Therapy 11:42, 2003), using a plasmid with a modified immunoglobulin heavy chain gene incorporating 3 inserts: two HLA-A2-restricted hTRT peptides: p540 (PNAS 97:4796, 2000) in CDR 3, p572 (PNAS 99:12275, 2002) in CDR1; and a 12mer malarial peptide acting as a Th cell determinant in CDR2. Methods: HLA-A2(+) subjects had androgen-independent PC with (8) or without (1) overt metastases, PS<3, life expectancy >6 months, no current steroid treatment. The median pretreatment PSA value was 248. Prior treatment, except immunotherapy, was allowed. Mononuclear cells were separated from peripheral blood and incubated overnight with plasmid DNA. Nine subjects (3 in each of 3 cohorts) were reinfused once with 104, 105, or 106 autologous transgenic B cells. Results: All subjects remain alive with followup of 6 months-cohort 1, 3 months-cohort 2 and 1 month-cohort 3. No infusion-related events or dose-limiting toxicities were seen. No PSA responses were seen. Tetramer staining of hTRT-specific CD8 T lymphocytes was seen in 1/3 pts in cohort 1 and 3/3 in cohort 2. Cohort 3 is too early to assess. Conclusions: single-dose TLI is feasible, safe and capable of inducing a T cell response against hTRT. A 4th cohort is planned with 2 infusions 1 month apart using frozen cells for the 2nd dose. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Cosmo Bioscience Cosmo SpA Cosmo SpA Cosmo SpA Cosmo Bioscience, Inc. Cosmo Bioscience Cosmo Bioscience
Clinical and nonclinical factors associated with confirmatory biopsy in metastatic breast cancer.
Authors: Jennifer J. Griggs, Thomas Braun, Dawn Marie Severson, Elizabeth Marie Layhe, David H. Gorski, Tara M. Breslin, Norah Lynn Henry
Journal: Journal of Clinical Oncology (2017)

249 Background: In patients with metastatic breast cancer, clinical practice guidelines include obtaining histologic confirmation of metastases when possible. The purpose of this study was to investigate patterns and correlates of receipt of a confirmatory biopsy. Methods: Data were abstracted from the records of patients diagnosed with metastatic breast cancer in the Michigan Breast Oncology Quality Initiative (MiBOQI), a statewide registry of 25 health systems. Patients with Stage IV disease at diagnosis were excluded. Analyses investigated associations between receipt of a confirmatory biopsy and disease, clinical and non-clinical factors, and treating health system. Results: Data were available for 1,231 (96%) of eligible patients between 2006 and 2015. Of these, 66% had a confirmatory biopsy; the proportion of patients having a biopsy varied between the 25 sites from 41% to 100% (p = 0.03). In bivariate analyses, younger age (p = 0.02), lower comorbidity (p = 0.007), longer time between the primary and recurrence (p &lt; 0.001), more recent year of recurrence (p = 0.01), having liver, skin, soft tissue, or multiple metastases (p &lt; 0.001), and private or government insurance (p = 0.002) were associated with biopsy. In multivariate analyses, longer time since the primary diagnosis (p &lt; 0.001), more recent year of recurrence (p = 0.03), initial site(s) of recurrence (p &lt; 0.001), and private or government insurance (p = 0.004) remained significant predictors of biopsy. Treatment site was no longer significant (p = 0.14). Minority status, obesity status, and disease characteristics (stage, estrogen receptor, progesterone receptor, HER2, grade) of the primary were not significant in either bivariate or multivariate analyses. Analyses were repeated without insurance with no change in the other findings. Conclusions: In a statewide collaborative, the proportion of patients having a confirmatory biopsy increased over the study period and was associated with several clinical factors. Insurance was an independent and significant predictor of receipt of what is considered standard care.
The impact of diabetes and obesity on endometrial cancer outcomes.
Authors: Emily Meichun Ko, Paige Walter, Leslie Horn Clark, Amanda Lynn Jackson, Jason Franasiak, Laura Jean Havrilesky, Angeles Alvarez Secord, Dominic T. Moore, Paola A. Gehrig, Victoria Lin Bae-Jump
Journal: Journal of Clinical Oncology (2013)

5523 Background: Diabetes (DM) is a known risk factor for endometrial cancer (EC), yet its effect on cancer outcomes remains unclear. We sought to investigate of the relationship between DM, obesity, and anti-diabetic medication on EC recurrence and survival. Methods: An IRB approved multi-institution retrospective study included all EC patients diagnosed with carcinosarcoma as well as endometrioid, serous, and clear cell cancers between January 2005 to December 2010. Demographics, comorbidities, and medications were captured at the time of cancer diagnosis. Cohorts for comparison included women with and without DM; and diabetics treated with metformin-only (METFO) were compared to those not treated with METFO. Cox regression models were used to evaluate the effect of selected covariates on PFS and OS. Results: Of 1495 EC patients, 364 (24%) had DM. Diabetics were more likely to be African American (30 v 16%, p&lt;0.0001) and have higher BMIs (median 37.0 v 31.2, p &lt; 0.001). After adjusting for age, race, stage, and BMI, women with DM had a worse OS (HR 1.40, 95CI 1.03-1.79), but similar recurrence risk (HR 1.16, 95CI 0.91-1.48) to non-diabetics. In a subset analysis of women with endometrioid EC (n = 1144), those with DM were 1.6 times more likely to recur (95CI 1.01-1.89, p = 0.04) and 2.4 times more likely to die (95CI 1.6-3.46, p &lt; 0.0001). METFO use was associated with a decreased risk of recurrence (PFS HR 0.54, 95CI 0.3-0.96, p = 0.04), and death (OS HR 0.43, 95CI 0.22-0.83, p = 0.01) compared to no METFO use. METFO users had a similar clinical outcome compared to non-diabetics (PFS HR 1.05, p = 0.82; OS HR 1.3, p = 0.46). Obese women with DM who were treated with non-METFO regimens had a 1.8-fold increased risk of recurrence (95CI 0.94-3.7, p = 0.07) and 2.7-fold increased risk of death (95CI 1.2-5.9, p = 0.01). No survival differences were seen in women with serous, clear cell, or carcinosarcoma. Conclusions: Our data demonstrates worse clinical outcomes for EC patients with DM and improved outcomes for METFO users, suggesting a link between tumor pathogenesis and insulin growth factor and mTOR pathways. Future investigation is required to elucidate the complex relationship between diabetes, anti-hyperglycemic agents, and cancer outcomes.
Association of hypoxia inducible factor-1 alpha and carbonic anhydrase IX overexpression and survival in HER2/neu positive hormone-unresponsive breast cancer patients
Authors: A. O. Kaya, N. Gunel, M. Benekli, N. Akyurek, S. Buyukberber, H. Tatli, U. Coskun, R. Yildiz, E. Yaman, B. Ozturk
Journal: Journal of Clinical Oncology (2009)

e22078 Background: Hypoxia is common in solid tumors with overexpression of hypoxia inducible factor-1 alpha (HIF-1 alpha) and carbonic anhydrase IX (CA IX). In our study, we evaluated HIF-1alpha and CA IX expression in Her-2/neu positive hormone- unresponsive breast cancer patients. Methods: One hundred and eleven patients with operable breast cancer were identified who had paraffin-embedded tissue blocks available. Estrogen and progesterone receptors and Her-2/neu expression were evaluated by immunohistochemistry (IHC). FISH was used for IHC 2+ cases. We assigned two groups with 56 patients who have ER and PR receptor positive, Her-2/neu negative (group 1) and with 55 patients who have ER and PR negative, Her-2/neu positive (group 2). HIF 1 alpha and CA IX expressions were investigated and results were compared for both groups. Additionally, we investigated the association between HIF 1 alpha and CA IX expressions with stage, grade, lymph node metastasis, tumor dimension and menopause status. Results: Median age of the patients was 52 years (range, 34–77) in group 1 and 47 years (range, 27–83) in group 2. Nuclear HIF-1alpha expression was detected in 26 (46.4%) and 46 patients (83.6%) in group 1 and 2, respectively (p&lt;0.0001). Membranous CA IX expression was detected in 25 (46.4%) and 37 (67.3%) patients in group 1 and 2, respectively (p&lt;0.013). In group 1, median disease free survival (DFS) has not been reached. In group 2, median DFS was 46 months (95%CI: 42.98–49.02) (p= 0.0308). In group 1, median overall survival (OS) was 108 months (95%CI: 90.65–125.35) whereas in group 2, median OS was 75 months (95 % CI: 64.94- 85.06) (p= 0.0339). Conclusions: HIF-1 alpha and CA IX overexpressions were more frequently observed in ER and PR negative, Her-2/neu positive breast cancer. This was associated with shorter disease-free and overall survival. No significant financial relationships to disclose.
Cesarean Section before the Onset of Labor and Subsequent Motor Function in Infants with Meningomyelocele Diagnosed Antenatally
Authors: David A. Luthy, Terrence Wardinsky, David B. Shurtleff, Kathryn A. Hollenbach, Durlin E. Hickok, David A. Nyberg, Thomas J. Benedetti
Journal: New England Journal of Medicine (1991)

Meningomyelocele can now be detected before birth. Few data are available on its natural history, however, and optimal management at the time of delivery is controversial, although it has been suggested that labor and vaginal delivery may cause pressure on exposed nerve roots, resulting in additional loss of neural function.
Free Paper Session : Hepatitis B ; Adding adefovir compared with switching to entecavir in patients with Lamivudine-resistant chronic hepatitis B (ACE study) - a multicenter prospective randomized study: final results (초)
Authors: Hyung Joon Yim, Ei Leen Yoon, Yeon Seok Seo, Chang Wook Kim, Chang Don Lee, Sang Hoon Park, Myung Seok Lee, Choong Kee Park, Hee Bok Chae, Moon Young Kim, Soon Koo Baik, Ju Hyun Kim, Yun Soo Ki
Journal: Clinical and Molecular Hepatology (2011)
Functional Testing or Coronary Computed Tomography Angiography in Patients With Stable Coronary Artery Disease
Authors: Mads E. Jørgensen, Charlotte Andersson, Bjarne L. Nørgaard, Jawdat Abdulla, Jacqueline B. Shreibati, Christian Torp-Pedersen, Gunnar H. Gislason, Richard E. Shaw, Mark A. Hlatky
Journal: Journal of the American College of Cardiology (2017)
PERSEPHONE: Duration of trastuzumab with chemotherapy in patients with HER2-positive early breast cancer—Six versus twelve months.
Authors: Helena Margaret Earl, David A. Cameron, David Miles, Andrew M. Wardley, Emma Ogburn, Anne-Laure Vallier, Shrushma Loi, Louise Hiller, Janet Dunn
Journal: Journal of Clinical Oncology (2014)

TPS656 Background: PERSEPHONE is a randomised controlled trial comparing six months of trastuzumab to the standard 12 months in patients with HER2 positive early breast cancer. Methods: 4,000 patients will be randomised into the two arms (1:1). The power calculations assume that the disease-free survival (DFS) of standard treatment (12 months trastuzumab) is 80% at 4 years. Randomisation of 4,000 pts will allow the trial to prove non-inferiority of six months trastuzumab (5% 1-sided significance & 85% power). Non-inferiority is defined as ‘no worse than 3%’ below the control arm (12 month) 4 year DFS. Primary outcome is DFS, and secondary outcomes are overall survival (OS) non-inferiority; cost effectiveness; cardiac function & quality of life. Tumour blocks are collected to research molecular predictors of survival with respect to duration of trastuzumab treatment. Blood samples are analysed for single nucleotide polymorphisms (SNPs) as pharmaco-genetic determinants of prognosis, toxicity and treatment outcome. Exciting developments led to a protocol amendment (Dec 2013) which allows sites to administer IV or sub-cutaneous trastuzumab according to their standard practice. Cardiology data on the first 2,500 patients is now being analysed. PERSEPHONE is funded by the NIHR HTA programme in the UK. Results: PERSEPHONE commenced recruitment in October 2007. At abstract submission, 3,166 pts (79%) had been randomised from 154 UK sites. Recruitment is due to complete mid-2015 with the first planned interim analysis of the primary outcome mid-2016. The iDMSC reviewed all data available on HERA and PHARE in 2012 as well as a PERSEPHONE interim analysis. There were no safety findings or signals that would warrant a change of the study plan & the high quality of data was noted. Conclusion:PERSEPHONE continues the active recruitment phase as planned with the sub-cutaneous form of trastuzumab proving popular. Publication of early PHARE results have reinforced interest in the PERSEPHONE trial both nationally and internationally. There has been full support from the Breast International Group (BIG) and the international breast cancer community to answer this important shorter duration question. Clinical trial information: 52968807.
Elevating expression of MeCP2 T158M rescues DNA binding and Rett syndrome–like phenotypes
Authors: Janine M. Lamonica, Deborah Y. Kwon, Darren Goffin, Polina Fenik, Brian S. Johnson, Yue Cui, Hengyi Guo, Sigrid Veasey, Zhaolan Zhou
Journal: Journal of Clinical Investigation (2017)

Mutations in the X-linked gene encoding methyl-CpG–binding protein 2 (MeCP2) cause Rett syndrome (RTT), a neurological disorder affecting cognitive development, respiration, and motor function. Genetic restoration of MeCP2 expression reverses RTT-like phenotypes in mice, highlighting the need to search for therapeutic approaches. Here, we have developed knockin mice recapitulating the most common RTT-associated missense mutation, MeCP2 T158M. We found that the T158M mutation impaired MECP2 binding to methylated DNA and destabilized MeCP2 protein in an age-dependent manner, leading to the development of RTT-like phenotypes in these mice. Genetic elevation of MeCP2 T158M expression ameliorated multiple RTT-like features, including motor dysfunction and breathing irregularities, in both male and female mice. These improvements were accompanied by increased binding of MeCP2 T158M to DNA. Further, we found that the ubiquitin/proteasome pathway was responsible for MeCP2 T158M degradation and that proteasome inhibition increased MeCP2 T158M levels. Together, these findings demonstrate that increasing MeCP2 T158M protein expression is sufficient to mitigate RTT-like phenotypes and support the targeting of MeCP2 T158M expression or stability as an alternative therapeutic approach.