tbuckley/cabot-search huggingface dataset:
Tenofovir vs Entecavir for Hepatocellular Carcinoma Prevention in Patients With Chronic Hepatitis B
Authors: Jennifer A. Flemming, Norah A. Terrault
Journal: JAMA Oncology (2018)

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Abstract 19702: Excessive Hydration Volume Tends to be Associated With a Higher Risk of Contrast-induced Nephropathy After Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease
Authors: Yong Liu, Hualong Li, Jiyan Chen, Ning Tan, Yingling Zhou, Yuanhui Liu, Piao Ye, Peng Ran, Chongyang Duan, Shiqun Chen, Pingyan Chen
Journal: Circulation (2015)

Introduction: Adequate hydration with isotonic saline is generally recommended to prevent contrast-induced nephropathy (CIN) in patients with chronic kidney disease (CKD). However, no well-defined protocols regarding the optimal rate and duration of normal saline administration currently exist. Hypothesis: Higher intravascular hydration volume of normal saline adjusted by weight (hydration volume/weight [HV/W], mL/kg) can reduce the risk of CIN in patients with CKD undergoing percutaneous coronary intervention (PCI). Methods: Patients with CKD (creatinine clearance [CrCl] &lt;90 mL/min/1.73 m2) undergoing PCI with hydration at the speed recommended by the current guidelines (1 mL/kg/h [0.5 mL/kg/h for left ventricular ejection fraction &lt;40% or severe congestive heart failure]) were included in the study (n=1406). Results: Individuals with higher HV/W ratios were more likely to develop CIN (Q1, Q2, Q3, and Q4: 4.3%, 6.6%, 10.9%, and 15.0%, respectively; P&lt;0.001) and acute heart failure (0.29%, 2.28%, 2.73%, and 5.01%, respectively; P=0.001), and were associated with higher in-hospital costs (8,314, 8,634, 9,274, 10,073 dollars, respectively; P25 mL/kg), the adjusted OR was 1.93 (95% CI: 1.09~3.42; P=0.025). Additionally, higher hydration was significantly associated with an increased risk of death (Q2 vs. Q1: adjusted hazard ratio [HR]: 3.59, 95% CI: 1.19~10.84; Q3 vs. Q1: adjusted HR: 3.51, Q4 vs. Q1: adjusted HR: 4.29, P&lt;0.05). Conclusions: Excessive intravascular hydration volume at routine speed was associated with higher risks of CIN, acute heart failure, and death, as well as increased health care costs.
Using the Risk Assessment Index (RAI) to predict 90-day mortality and hospital utilization in cancer patients at UPMC Hillman Cancer Center.
Authors: Christine Ann Garcia, Jeffrey Borrebach, Stefanie C Altieri Dunn, Johanna E Bellon, Ellen Ormond, Melissa Amber Burgess
Journal: Journal of Clinical Oncology (2018)

243 Background: Patients with cancer vary considerably in health status and functional reserve. Identifying the most frail patients whom are at risk of treatment toxicity or death can be difficult. The Risk Assessment Index (RAI) is a validated tool used to assess frailty in patients prior to surgery. Thus, we aimed to investigate frailty assessment utilizing the RAI in cancer patients and its ability to predict hospital utilization and 90-day mortality. Methods: From 9/15/2017 to 1/31/2018, new patients with solid tumor malignancies at the UPMC Hillman Cancer Center completed the RAI. Age, cancer type and stage, and treatments were abstracted. ED visits, hospitalizations and mortality data were provided by the Wolff Center at UPMC. Mann-Whitney U and likelihood-ratio tests were performed comparing RAI, ED usage/hospitalizations, and mortality. Elective hospital admissions were excluded. Results: 273 patients completed the RAI. 58.6% of pts were male and average age was 62.7 (21-88), and the average RAI score was 39.9 (IQR 35-44). The most common cancer types were melanoma (22.7%), prostate (14.3%), and lung (11.4%). 43.6% of patients had stage IV cancer. Within 90 days after RAI, 51 patients (18.7%) experienced at least one unplanned ED visit or hospitalization, and 10 patients (3.7%) were deceased. Patients with an ED visit/hospitalization had an average RAI of 42 (IQR 37-46) compared to 39.4 (IQR 35-43) for patients without one: a 2.6-point difference (p = 0.008). 90-day mortalities had an average RAI score of 47.5 (IQR 42-53) compared to 39.6 (IQR 35-44) for non-mortalities: a 7.9-point difference (p = 0.003). Six of 242 (2.5%) patients without a hospitalization experienced mortality whereas 4 of 31 (12.9%) patients with a hospitalization experienced mortality (p = 0.017). Conclusions: This study shows that the RAI may be utilized to predict 90-day mortality in cancer patients. Patients at greatest risk of 90-day mortality were more likely to have unplanned hospitalizations. While there was a statistically significant difference in RAI scores between patients with and without unplanned ED visits/hospitalizations, this difference was too small to be clinically meaningful.
Hospital variation in outcomes after surgery for prostate cancer.
Authors: Michael J. Hassett, Matthew Mossanen, Shicheng Weng, Angel M. Cronin, Hajime Uno, Kristen K. McNiff
Journal: Journal of Clinical Oncology (2018)

28 Background: Surgery for prostate cancer can lead to adverse outcomes, such as incontinence and erectile dysfunction. Studies have identified hospital variation in survival after surgery for other types of cancer; few studies have assessed hospital variation in outcomes after prostate cancer surgery. We sought to characterize hospital variation in incontinence/erectile dysfunction (IED) and overall survival (OS) after prostate surgery. Methods: Using SEER-Medicare claims, we identified men &gt; 65 years old who had surgery for prostate cancer from 2009-13, excluding those with metastatic disease, chemotherapy, or radiation therapy. We computed the difference in the number of days with claims for incontinence or erectile dysfunction in the year after versus the year before prostate surgery (IED score). Then, we assigned each patient to the hospital where prostate surgery was performed, and derived the mean IED score for hospitals that treated ≥10 patients (n = 239). Hierarchical linear and cox regression models were used to assess the association of patient, tumor, and hospital factors with the IED score and OS, respectively. The Kaplan-Meier method was used to estimate 3-year OS. Results: Among 10,850 Medicare-insured men with prostate cancer, the mean difference in claim-days for incontinence or erectile dysfunction during the year after versus before prostate surgery was +2.34 (standard deviation [SD] 3.72, minimum -18, maximum 54). After rescaling the IED score using a 0 (worst) to 100 (best) scale, the mean unadjusted hospital performance was 52.7 (SD 8.0). Controlling for other factors, hospital, NCI-cancer center designation (comprehensive vs. none), region in the US (south or west vs. northeast), and type of prostate surgery (open vs. not) were associated with a higher IED score. The mean 3-year OS across all hospitals was 98% (SD 3%). Conclusions: This claims-based analysis identified significant variation in incontinence/erectile dysfunction after prostate cancer surgery by hospital, but not by patient socio-demographic factors. The IED score may help identify opportunities to improve outcomes. Efforts to validate claims as indicators of patient-centric outcomes and to explore the reasons for hospital-level variation are needed.
Central venous access in oncology patients: A pragmatic approach to minimizing complications following port insertion.
Authors: William Paul Skelton, Aaron J Franke, Lindsey Woody, Samantha Welniak, Raphael Bosse, Martina Cathryn Murphy, Jason Scott Starr
Journal: Journal of Clinical Oncology (2018)

267 Background: Subcutaneous venous access devices, specifically implantable ports, are vital in the care of oncology patients. Despite routine use, complications remain prevalent. This retrospective single-institutional review was performed to identify rates of complications following port placement and target areas to improve patient outcomes. Methods: Retrospective analysis of 539 cancer patients who underwent port insertion in a one-year span at University of Florida was conducted. Data examining 18 potentially predictive factors was collected, and multivariate analysis was conducted using logistic regression and odds ratios with standard errors to determine predictive factors. Results: Of 539 patients, 100 (19%) experienced a complication, and 12 (2%) experienced 2 or more complications. An overall lower rate of complications was seen in patients on therapeutic anticoagulation (OR 0.17, p &lt; 0.001) or on antiplatelet agents (OR 0.47, p = 0.02). No patients on therapeutic anticoagulation developed VTE (0%). Right-sided port insertion was associated with decreased rates of infection (OR 0.44, p = 0.04). Insertion as inpatient was associated with increased risk for mechanical failure (OR 4.60, p &lt; 0.01) and catheter migration (OR 4.33, p &lt; 0.01). Conclusions: This analysis identified multiple predictive factors that can potentially put patients at higher risk of complication following port insertion. A thorough risk assessment for VTE should be done prior to port insertion, and high-risk patients (i.e. prior VTE, Khorana score &gt; 3) should be considered for prophylactic anticoagulation. Further analysis on optimal port insertion site (right/left) and location (inpatient/outpatient) are also targets that can potentially decrease complication rates. As ports inserted while inpatient had increased risk of both mechanical failure and catheter migration, and as ports inserted on the left side had increased risk of infectious complications, a prospective quality improvement initiative coordinated between Oncology and Interventional Radiology departments as to whether insertion of right-sided ports on an outpatient basis may improve outcomes is the next step in our investigation.
Dual-modality management of non-lifting colorectal neoplasia: CAST or ACA?
Authors: Vasilios Papastergiou, Zacharias Tsiamoulos, Ioannis Stasinos, Brian Saunders
Journal: Endoscopy (2018)

See also: Cold-forceps avulsion with adjuvant snare-tip soft coagulation (CAST) is an effective and safe strategy for the management of non-lifting large laterally spreading colonic lesions Endoscopy 2018; 50(01): 52-62DOI: 10.1055/s-0043-119215 See also: Advantages of CAST for non-lifting adenomasEndoscopy 2018; 50(10): 1037-1037DOI: 10.1055/a-0607-2671
A single pheromone receptor gene conserved across 400 million years of vertebrate evolution
Authors: Hikoyu Suzuki, Hidefumi Nishida, Hiro Kondo, Ryota Yoda, Tetsuo Iwata, Kanako Nakayama, Takayuki Enomoto, Jiaqi Wu, Keiko Moriya-Ito, Masao Miyazaki, Yoshihiro Wakabayashi, Takushi Kishida, Masataka Okabe, Yutaka Suzuki, Takehiko Ito, Junji Hirota, Masato Nikaido
Journal: Molecular Biology and Evolution (2018)

Pheromones are crucial for eliciting social and sexual behaviors in diverse animal species. The vomeronasal receptor type-1 (V1R) genes, encoding members of a pheromone receptor family, are highly variable in number and repertoire among mammals due to extensive gene gain and loss. Here, we report a novel pheromone receptor gene belonging to the V1R family, named ancient V1R (ancV1R), which is shared among most Osteichthyes (bony vertebrates) from the basal lineage of ray-finned fishes to mammals. Phylogenetic and syntenic analyses of ancV1R using 115 vertebrate genomes revealed that it represents an orthologous gene conserved for >400 My of vertebrate evolution. Interestingly, the loss of ancV1R in some tetrapods is coincident with the degeneration of the vomeronasal organ in higher primates, cetaceans, and some reptiles including birds and crocodilians. In addition, ancV1R is expressed in most mature vomeronasal sensory neurons in contrast with canonical V1Rs, which are sparsely expressed in a manner that is consistent with the "one neuron-one receptor" rule. Our results imply that a previously undescribed V1R gene inherited from an ancient Silurian ancestor may have played an important functional role in the evolution of vertebrate vomeronasal organ.
Sex Differences in Cancer Driver Genes and Biomarkers
Authors: Constance H. Li, Syed Haider, Yu-Jia Shiah, Kevin Thai, Paul C. Boutros
Journal: Cancer Research (2018)

Abstract Cancer differs significantly between men and women; even after adjusting for known epidemiologic risk factors, the sexes differ in incidence, outcome, and response to therapy. These differences occur in many but not all tumor types, and their origins remain largely unknown. Here, we compare somatic mutation profiles between tumors arising in men and in women. We discovered large differences in mutation density and sex biases in the frequency of mutation of specific genes; these differences may be associated with sex biases in DNA mismatch repair genes or microsatellite instability. Sex-biased genes include well-known drivers of cancer such as β-catenin and BAP1. Sex influenced biomarkers of patient outcome, where different genes were associated with tumor aggression in each sex. These data call for increased study and consideration of the molecular role of sex in cancer etiology, progression, treatment, and personalized therapy. Significance: This study provides a comprehensive catalog of sex differences in somatic alterations, including in cancer driver genes, which influence prognostic biomarkers that predict patient outcome after definitive local therapy. Cancer Res; 78(19); 5527–37. ©2018 AACR.
Accelerating anticancer drug development — opportunities and trade-offs
Authors: Sharyl J. Nass, Mace L. Rothenberg, Rebecca Pentz, Hedvig Hricak, Amy Abernethy, Kenneth Anderson, Amanda Wagner Gee, R. Donald Harvey, Steven Piantadosi, Monica M. Bertagnolli, Deborah Schrag, Richard L. Schilsky
Journal: Nature Reviews Clinical Oncology (2018)
Protect pregnant women by including them in clinical research
Authors: Joyce Browne, Indira van der Zande, Maarten van Smeden, Rieke van der Graaf
Journal: BMJ (2018)

The decision to stop the STRIDER trial with sildenafil (better known as Viagra) to improve uteroplacental blood flow, fetal growth, and infant outcomes for fetuses with severe growth restriction was disappointing for all involved.1 International media extensively reported on this trial, triggering debates in academic journals and (social) media.234 But one aspect remains neglected: …
Long‐term exposure to neighborhood smoke from household heating and risk of respiratory and dermatological prescription medications—Growing Up in New Zealand child cohort study
Authors: Hak Kan Lai, Carlos A. Camargo, Alistair Woodward, Mark Hobbs, Avinesh Pillai, Susan M. Morton, Cameron C. Grant
Journal: Allergy (2018)

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Incidental imaging findings on oral radiology
Authors: Paul Monsarrat, Norbert Telmon, Delphine Maret
Journal: BMJ (2018)

O’Sullivan and colleagues emphasise the importance of incidental imaging findings.1 We agree with their conclusions: the high prevalence of incidental imaging findings; that clinicians should weigh up the benefits and risks before ordering an imaging test; and the need for precise guidelines about management.1

Nevertheless, we would like to draw readers’ attention to an aspect not tackled by the authors: oral …
TLR7 agonist imiquimod is a potent vaccine adjuvant
Authors: Yushe Dang, Wolfgang Wagner, Ekram Gad, Carmen Berger, Mary Disis
Journal: Cancer Research (2008)

2844  Potent adjuvants are key to successful vaccination against weakly immunogenic antigens such as those involved in cancer or chronic infection. In particular, agents that can recruit and activate dendritic cells (DC) in vivo may enhance immune responses generated during active immunization. We evaluated the adjuvant effects of the TLR7 agonist imiquimod as compared with GM-CSF, which has been widely used as a vaccine adjuvant. Topical imiquimod elicited a profound inflammatory infiltrate at the application site. Although both topical imiquimod and intradermal GM-CSF as adjuvant effectively induced the accumulation and activation of DC in draining lymph nodes (DLN), imiquimod preferentially stimulated the accumulation of skin Langerhans cells (CD11c+/CD86+/CD205+/CD8-) in DLN. The phenotypic difference in the DC mobilized by GM-CSF and imiquimod was accompanied by functional differences. Both GM-CSF and imiquimod augmented ova specific-CD4 T cell response in ova-tg mice when used in conjunction with CD4 peptide-based vaccines, as demonstrated by in vivo proliferation of CFSE labeled DO11.10 cells. Although both GM-CSF and imiquimod stimulated OVA specific CD8 T cell responses in OVA-tg mice when immunized with a CD8 peptide, the response induced by imiquimod was of greater magnitude. Finally, imiquimod was markedly more effective in stimulating ova specific T cell immunity with a protein-based vaccine as compared to GM-CSF. Thus, imiquimod is a potent vaccine adjuvant in promoting Th1 type of responses and has the potential for clinical use as a vaccine adjuvant.
Physiotherapists are not corn
Authors: Laura Ritchie
Journal: British Journal of Sports Medicine (2018)

It turns out I am a terrible physiotherapist. If you practise in a ‘Hands On’ manner and believe everything you read online, then you might come to the conclusion that you are too. Such is the vehemence of opinion in the ‘Hands On-Hands Off’ debate on platforms such as Twitter, it seems to echo the polarising political discourse that is now so common.

Now, we know we are not terrible therapists. We know that as physiotherapists who include manual therapy in our treatment approach, we are part of a network with a long, proud history of excellence in clinical knowledge, techniques and reasoning. But lately it seems that special interest groups such as the Orthopaedic Division of the Canadian Physiotherapy Association (CPA) are facing some serious challenges. There has long been a perception that we are all about mobilisations (‘mobes’) and manipulations (‘manips’) but this has been amplified recently through social media. The potential impact of this negative rhetoric is worth considering, even if you are not active on social media yourself. Will recent graduates continue to study manual therapy-based curricula when faced with the plethora of alternative educational opportunities in conjunction with obdurate voices on social media? Similarly, in the face of the naysaying, will some therapists lose faith in their training and think twice about instructing in orthopaedic or manual therapy courses? The net result could be that therapists of all levels of training develop an ortho identity crisis.

A clear professional identity is important. It guides our path and it gives us strength when facing challenges. The identity of our profession has been and continues to be evaluated in different ways. Pat Miller, Vanina Dal Bello-Haas and Chantal Lauzon are finalising the core professional values of the CPA through a Delphi process.1 Dave Walton and the Physio Moves Canada team connected …
Cancer-related financial burden among patients with metastatic breast cancer.
Authors: Stephanie B. Wheeler, Jennifer Spencer, Michelle L. Manning, Cleo A. Samuel, Katherine Elizabeth Reeder-Hayes, Jean B. Sellers, Donald L. Rosenstein
Journal: Journal of Clinical Oncology (2018)

32 Background: Recent data suggest that the adverse financial impact of cancer is an underappreciated source of potential harm to patients, also known as “financial toxicity”. Little is known about the financial impact of cancer in patients with widespread, incurable disease, despite the relatively high cost of their care. We conducted a national survey of patients with metastatic breast cancer to address this gap. Methods: We partnered with the Metastatic Breast Cancer Network to field an online survey of metastatic breast cancer patients over a fourteen-day period using Qualtrics. The survey required approximately 20 minutes to complete, and participants were offered a $10 Amazon gift card. Survey items included sociodemographic information, health insurance status, cost-related communication with providers, post-treatment financial burden, financial coping strategies, and emotional well-being. We report financial outcomes stratified by health insurance status, as insurance is an important protective mechanism against health-related financial shocks. Results: 1,513 participants responded from 41 states. More than a third of these women (35%) were uninsured. Uninsured individuals more often reported refusing or delaying treatment due to cost (98% vs. 41% of insured, p &lt; .001) and were also more likely to report skipping non-medical bills (40% vs. 16%, p &lt; .001), stopping work after diagnosis (65% vs. 46%, p &lt; .001), or being contacted by a collections agency (77% vs. 36%, p &lt; .001). Despite this, insured participants reported higher cost-related emotional distress, including being “quite a bit” or “very” stressed about not knowing cancer costs (53% vs. 32%, p &lt; .001) and about financial stress on their family due to their cancer (52% vs. 27%, p &lt; .001). Conclusions: Metastatic breast cancer patients reported an unprecedented level of cancer-related financial harm and significant worry about the financial legacy left behind in the wake of their illness. Health insurance expansion is a necessary, but insufficient strategy to address this financial burden; additional interventions to prevent and mitigate cancer-related financial harm are urgently needed.
Temporal Trends and Characteristics of Reportable Health Data Breaches, 2010-2017
Authors: Thomas H. McCoy, Roy H. Perlis
Journal: JAMA (2018)

data breaches involving at least 29.1 million patient records were reported.The ongoing transition to electronic health records may increase such breaches. 1,2 We used public data to examine the nature and extent of breaches from 2010 through 2017.
Innervation of the Tumor Microenvironment–Letter
Authors: Mark R Goldstein, Luca Mascitelli
Journal: Cancer Research (2018)

The intriguing article by Allen and colleagues recently published in Cancer Research ([1][1]) further elucidates how the catecholamine norepinephrine is produced in the tumor microenvironment and leads to cancer progression and metastasis ([2][2]). The authors demonstrated, in mice, that