tbuckley/cabot-search huggingface dataset:
The relationship of metabolic syndrome and cardiovascular disease and mortality in maintenance hemodialysis patients
Authors: Ling Yu, Han Li
Journal: BMJ (2013)

Objective
To investigate the potential contributing effects of metabolic syndrome (MS) on cardiovascular events and mortality in maintenance hemodialysis (MHD) patients.


Methods
According to the diagnostic criteria for MS set by Chinese Diabetes Society, 201 subjects undergoing MHD were assigned into MS group(n=78) or non-MS group(n=123), in August 2009. General and laboratory data were collected for cross-sectional analyses, and the participants were followed up for 36 months. Cardiovascular events, cause of death and time were recorded for longitudinal analyses.


Results
Prevalence of MS was 38.8%. Weight, waist circumference, triglyceride, total cholesterol, low density lipoprotein, fasting glucose level, uric acid and high-sensitivity C-reactive protein were significant higher in MS group compared to non-MS group, but duration of dialysis and high-density lipoprotein were lower (P<0.05). During the 36 months follow-up, cumulative incidence of cardiovascular events, cardiovascular and all-cause mortality were 41.0% (32/78), 19.2% (15/78), 28.2% (22/78), in MS group respectively. Those of non-MS group were 22.8% (28/123), 10.6% (13/123), 17.1% (21/123). There was significant difference between patients with and without MS in cumulative incidence of cardiovascular events (χ2=7.601, P=0.006). There was relationship between the number of metabolic syndrome parameters and cardiovascular events (r=0.236, P=0.001). Kaplan-Meier curves showed the relationship between two groups did not remained statistically significant in cardiovascular and all-cause mortality. Impaired glycometabolism in 5 parameters of MS was a cardiovascular mortality risk factor in MHD patients.


Conclusions
The prevalence of MS is high in MHD patients. MS is a risk factor of cardiovascular events, but it is not associated with cardiovascular and all-cause 3-year mortality in patients with MHD.


Key words: 
Metabolic syndrome; Maintenance hemodialysis; Cardiovascular disease; Mortality
Thinking <i>with</i> other minds
Authors: Edward Baggs, Anthony Chemero
Journal: Behavioral and Brain Sciences (2020)

We applaud the ambition of Veissière et al.'s account of cultural learning, and the attempt to ground higher order thinking in embodied theory. However, the account is limited by loose terminology, and by its commitment to a view of the child learner as inference-maker. Vygotsky offers a more powerful view of cultural learning, one that is fully compatible with embodiment.
Lack of assocation of robotic radical cystectomy with increased incidence of local pelvic recurrence.
Authors: Rabii Madi
Journal: Journal of Clinical Oncology (2020)

e17045 Background: Robotic radical cystectomy (RRC) might be associated with an increased incidence of local pelvic recurrence and peritoneal seeding. We performed an institutional study evaluating the incidence and type of cancer recurrence following RRC. Methods: Between January 2012 and July 2019, 100 consecutive robotic radical cystectomies (RRC) were performed by a single surgeon RM. Pre-and Peri-operative characteristics were analyzed. Early and late, local and distant recurrences were studied, with the assumption that early local recurrences might suggest technical causative factors. Results: Median age was 63 ( IQR: 57-75). Male to female ratio is 2 to 1. Median BMI was 27.7 ( IQR: 24-32). 70% of patients were white, 27% were black, 2% were Hispanic, and 2% were Asians. Indications for cystectomy were refractory CIS in 6%, T disease in 26%, T2 disease in 52%, T3 disease in 5%, and T4 disease in 11%. Console time was 249 minutes ( IQR: 205-318). 70% of patients underwent ileal conduit, 30% underwent neobladder. 85% of patients underwent extended PLND and median blood loss was 150 ml, no patient required transfusion. Final pathology showed T0, Ta, CIS, T1, T2, T3, and T4 diseases in 2%, 5%, 10%, 10%, 21%, 36%, and 16% respectively. Median hospital stay was 6 days and 34% of patients had 30 days complications. 50% of patients had more than 36 months follow-up and overall, 24% of patients had cancer recurrences. Only 3 patients had recurrence within 3 months. Patient 1 had PT1, N1 disease with recurrences in common iliac lymph nodes and was treated by chemotherapy and is in complete remission. Patient 2 had pT3b N1 SCC with 3 months CT scans showing extensive pelvic and systemic recurrences and expired 6 months after surgery. Patient 3 had pT3a, N1 disease and had recurrence in the aorto-caval LN, received chemo-and immune therapy and has no evidence of disease. Conclusions: Our experience with robotic radical cystectomy did not show an increased incidence of early or local recurrence that could be attributed to the surgical approach. We believe that adherence to oncological principles is achievable with robotic approach.
Sublobar resection versus lobectomy for early-stage pulmonary carcinoid tumors with three centimeters or less in size: A population-based study.
Authors: Xiongfei Li, Fan Ren, Shikang Zhao, Yanye Wang, Dian Ren, Renwang Liu, Gang Chen, Jun Chen, Song Xu
Journal: Journal of Clinical Oncology (2020)

e21062 Background: Pulmonary carcinoids (PCs), comprising of typical carcinoids (TCs) and atypical carcinoids (ACs), are rare low-grade malignant tumors and surgical resection is considered as the standard treatment for early stage PCs. However, it is not clear whether sublobar (Sub-L) resection of PCs would compromise the long-term oncologic outcomes. Here we investigate the equivalency of Sub-L resection versus lobectomy (Lobe) for patients with early stage PCs using the population-based Surveillance, Epidemiology, and End Results (SEER) registry. Methods: The clinical and survival data of early stage PC patients with less or equal 3cm diameter were retrieved. Kaplan-Meier method and log-rank tests were used to assess differences in overall survival (OS). We further performed the subgroup analysis by tumor size (T≤1cm, 1cm &lt; T≤2cm, 2cm &lt; T≤3cm) and patient age ( &lt; 70y and ≥70y). To reduce the bias of inherent retrospective study, we also performed propensity score matching (PSM) analysis by 1:1 fixed ratio nearest neighbor matching using Matchit package in R. Results: In total of 2934 PC patients, including 2741 TCs and 193 ACs, were recruited. 1011(34.46%) and 1923(65.54%) patients received Sub-L resection and lobectomy, respectively. After PSM, there was no significant difference between Sub-L and Lobe group in terms of OS in PC patients (P = 0.33). From the cox regression analysis, it indicated that older age, male gender, larger tumor size, AC histology type and Sub-L surgery were associated with a worse OS. We further performed PSM analysis on TCs and ACs, respectively. For TC patients, it indicated that patients in Lobe group had a much better OS compared to those in Sub-L group (p = 0.0067). In the subgroup analysis, the log-rank tests showed that there was a significant survival advantage for lobectomy in comparison with Sub-L resection for the TC patients with diameter 2cm &lt; T≤3cm (p = 0.0345), but not for those with diameter lower than 2cm. In the subgroup analysis of age, the log-rank test indicated that Lobe group in age &lt; 70 had a better prognosis with statistical difference compared to Sub-L group (p = 0.0032). For ACs, there was no statistic difference between Sub-L and Lobe group after PSM analysis in all the subgroup investigations. Conclusions: Sublobar resection may not significantly compromise the long-term oncologic outcomes in early stage PC patients. However, there is a survival benefit of lobectomy in certain pathological type and population, such as TCs patients with tumor size more than 2cm and age lower than 70-year-old.
α-干扰素高浓度雾化吸入治疗毛细支气管炎疗效观察
Authors: 王玉增, 周静, 石义英
Journal: BMJ (2004)

试用α-干扰素高浓度雾化吸入治疗毛细支气管炎36例,年龄＜6个月者每次50万单位,＞6个月者每次100万单位;同样剂量药物肌内注射治疗患者32例.雾化吸入治疗效果优于肌内注射,且给药途径安全简便。
Meta-analysis for relationship between different instillation methods and recurrence in superficial bladder carcinoma after surgical operation
Authors: 潘建刚, 韩瑞发
Journal: BMJ (2006)

目的 应用荟萃(Meta)分析探讨浅表膀胱癌不同灌注方法对膀胱癌术后复发的影响.方法应用Meta分析固定效应模型和随机效应模式对1989年1月至2005年2月有关浅表膀胱癌不同灌注方法与膀胱癌术后复发的文献进行综合定量评价.结果纳入本次Meta分析的43篇文献中,卡介苗(BCG)灌注与其他方法比较与浅表膀胱癌术后复发、使用其他方法灌注与浅表膀胱癌术后复发、BCG联合其他方法灌注与浅表膀胱癌术后复发的合并OR值分别为0.55(95%CI值0.40～0.74)、0.32(95%CI值0.06～1.64)和0.43(95%CI值0.33～0.57);漏斗图各点基本呈漏斗状排列,表明发表性偏倚对本研究影响较小,结论较可靠.结论 BCG灌注或者联合其他灌注方法能有效降低浅表膀胱癌术后的复发率。
死亡狂犬病15例临床分析
Authors: 唐徐英, 欧强
Journal: BMJ (2006)

对15例死于狂犬病患者的资料进行分析. 1.临床资料:15例死亡患者中,男11例,女4例,年龄16～62岁,2004年4月至2006年3月均在本院感染病科住院,符合 狂犬病临床诊断标准.[1].15例中除1例为上海市郊区人员外,其他均为来沪务工者.
Nickel and dimed: Parking fees at NCI-designated cancer centers.
Authors: Anna Lee, Kanan Shah, John Byun, Fumiko Chino
Journal: Journal of Clinical Oncology (2020)

2029 Background: Nonmedical costs from cancer treatment can be a significant out-of-pocket expense. As treatment may span over months, parking costs can become a significant burden on patients and caregivers. This cross-sectional study aims to report parking fees at National Cancer Institute (NCI)-designated cancer centers and to project parking costs for the treatment duration of certain cancers. Methods: Parking fees from NCI treatment centers were obtained via online search or phone call in Fall of 2019. City cost of living, median city household income, and discount availability were documented. Pearson correlation was used between parking costs and city variables. Parking costs were estimated for treatment of node positive breast cancer (12 daily rates plus 20 1-hr rates), definitive head and neck cancer (35 1-hr rates) and acute myeloid leukemia (AML) (42 daily rates). RStudio Version 1.2.5033 was used for analyses. Results: Parking costs were obtained for 100% of the 63 NCI centers included. Median city cost of living relative to New York City was 75.0 (out of 100); median city household income was $55,295 (range $28,974-$120,573). Twenty-five (40%) of NCI centers did not have detailed parking cost information online. Average parking costs were $3.55/hr (median $2, range 0-$15) and $7.79/day (median $5, range 0-$40). Twenty centers (32%) offered completely free parking for patients. Free parking was available at 43 (68%) centers for radiation appointments and 34 (54%) centers for chemotherapy appointments. Averaged estimated parking costs including discounts for a course of treatment for breast cancer was $122.03 (range 0-$800); head and neck cancer, $85.56 (range 0-$665); and AML hospitalization, $327.33 (range 0-$1470). City cost of living was positively correlated with daily parking costs (R = 0.7, p &lt; 0.01) and negatively correlated with both free daily parking (R = -0.33, p = 0.02) and free parking during radiation (R = -0.34, p = 0.02) or chemotherapy (R = -0.37, p &lt; 0.01). The median city household income was correlated with the daily parking costs (R = 0.30 p = 0.02) but not with free daily parking (R = -0.19, p = 0.16), free parking for patients on radiation (R = -0.23, p = 0.09) or on chemotherapy (R = -0.21, p = 0.14). Conclusions: Patients may face significant nonmedical costs through parking fees, even at centers that reflect the highest standard of care. There was high variability in costs with the potential for patients to pay hundreds of dollars in parking in order to receive their care. Efforts to minimize financial toxicity should focus on this potentially under-reported patient concern.
An open-label phase Ib study to determine safety and preliminary efficacy of oral Lucitanib (AL3810) in patients with locally advanced or metastatic gastric, hepatocellular, nasopharyngeal carcinoma, malignant biliary, and thymic tumors.
Authors: Hongming Pan, Shukui Qin, Li Zhang, Jin Li, Jianming Xu, Ruihua Xu
Journal: Journal of Clinical Oncology (2020)

e15502 Background: Angiogenesis is an essential prerequisite for tumor growth, invasion and metastasis. Targeting tumor angiogenesis has become a common therapeutic target in clinical work. Lucitanib, an oral tyrosine kinase inhibitor, precisely targets FGFR/VEGFR/PDFGR. In this study, we evaluated the safety profile and preliminary anti-tumor effects of lucitanib in patients with locally advanced or metastatic gastric (GC), hepatocellular (HCC), nasopharyngeal carcinoma (NPC), malignant biliary (MBT) and thymic tumors (TT). Methods: Patients (Pts) with locally advanced or metastatic GC, HCC, NPC, BTC and TT, standard therapy failed, ECOG status ≤1, were enrolled. Total 44 subjects (6 GC, 4 HCC, 10 BTC, 4 TT, 20 NPC) were recruited, then randomized into two groups with lucitanib 10 mg QD given continuously (CON) or intermittently (INT) lucitanib 10 mg QD three weeks on and one week off. Results: 22 pts were included in CON and INT group respectively. The most common drug-related treatment emergent adverse events (TEAEs) for CON (AE≥10%, Grade≥3 ): proteinuria (19 [86.4%], 4 [18.2%]), hypertension (18 [81.8%], 7 [31.8%]), haematuria (3 [13.6%], 0), aspartate aminotransferase increased (8 [36.4%], 1 [4.5%]), hypothyroidism (7 [31.8%], 0), blood creatinine increased (5 [22.7%], 0), platelet count decreased (5 [22.7%], 1[4.5%]), white blood cell count decreased (3 [13.6%], 0), weight decreased (4 [18.2%], 0), diarrhea (4 [18.2%], 0) and rash(6 [27.3%], 0). For INT: proteinuria (8 [36.4%], 1[4.5%]), hypertension (9 [40.9%], 4 [18.2%]), hypothyroidism (6 [27.3%], 0), platelet count decreased (3 [13.6%], 0), white blood cell count decreased (4 [18.2%], 0). Treatment discontinuation due to drug-related TEAEs were 3 pts (13.6%) and 1 pt (4.5%) in CON and INT respectively. Preliminary efficacy for CON: ORR: 13.6%, DCR: 72.7%, median PFS: 3.8 months; for INT: ORR: 4.5%, DCR: 40.9%, median PFS: 1.9 months. Conclusions: Although CON exhibited higher incidence, drug-related TEAEs at both groups were expected and manageable. Lucitanib exhibited better efficacy profile when administrated 10mg QD continuously. Further safety and efficacy of lucitanib is being evaluated in phase II/III studies. Clinical trial information: 03260179.
ACTL6A to drive gastric cancer progression through induction of glutathione synthesis.
Authors: Lekun Fang, Ziqing Yang, Shaomin Zou, Yunling Xie
Journal: Journal of Clinical Oncology (2020)

e16521 Background: Actin-like 6A (ACTL6A), an actin-like protein, is a member of ATP-dependent SWI/SNF like BAF chromatin remodeling complexes. Previous reports revealed that ACTL6A was involved in varying cellular processes including chromatin remodeling, transcriptional regulation, vesicular transport, and nuclear migration. Nevertheless, its role and mechanism in Gastric Cancer (GC), the second leading causes of cancer-related death worldwide, has not been reported. To explore it, we found that ACTL6A inhibits ferroptosis of GC cells via regulating glutathione (GSH) metabolism. Ferroptosis is a regulated form of cell death driven by accumulation of lipid-based reactive oxygen species (ROS). Methods: GC cell line snu638 was used for studies. Firstly, silencing ACTL6A in snu638 with shRNA, cell proliferation was measured by counting cell confluence in incucyte. Overlapping the Gene Set Enrichment Analysis (GSEA) results of RNA-sequencing and two databases, we found that ACTL6A is positively correlated with GSH metabolism, which can be validated by real time-PCR. Next, cells were treated with ferrostatin-1 (fer-1), a ferroptosis inhibitor, to check if ACTL6A can inhibit ferroptosis. Finally, 13 C-glucose and 13 C-glutamine were used for tracing the metabolites in snu638, which were measured by LC-MS system. Results: Suppression of ACTL6A significantly inhibits GC cell growth. In our RNA-sequence results, ACTL6A is positively correlated with GSH metabolism, which is also enrich in two GC databases. ROS level was increased after ACTL6A knockdown. Since ROS plays an important role in ferroptosis, we found that fer-1 can rescue cell death caused by suppression of ACTL6A. When tracing with 13 C-glucose, total GSH and 13 C incorporation from 13 C-glucose in the m+2 and m+4 isotopomer of GSH is reduced when ACTL6A is depleted, while total contribution of U- 13 C glucose to serine, glycine and glutamate have no significant changes. When tracing with 13 C-glutamine, m+5 fractional contributions of 13 C-glutamine to γ-glutamyl-cysteine and GSH are decreased when silencing ACTL6A. These results reveal that ACTL6A promotes de novo GSH synthesis. Conclusions: ACTL6A acts as an oncogene in GC via regulating GSH metabolism, and ferroptosis is inhibited for increasing GSH by ACTL6A, which highlights the importance of ACTL6A in GC metabolism and tumorigenesis. Therefore, ACTL6A could be a potential diagnosis marker or target gene of chemotherapy for GC.
Evaluating barriers to uptake of comprehensive genomic profiling (CGP) in advanced cancer patients (pts).
Authors: Kortnye Maureen Smith, Sophie O Haire, Dong Anh Khuong-Quang, Ben Markman, Hui Kong Gan, Paul G Ekert, Kenneth John O'Byrne, Michael Millward, Benjamin J. Solomon, Ben Tran, Clare L. Scott, Damien Kee, Grant A. McArthur, Andrew Fellowes, Rona Weerasuriya, Elly Lynch, Melissa Martyn, Clara Gaff, Stephen B. Fox, Jayesh Desai
Journal: Journal of Clinical Oncology (2020)

2033 Background: Despite increasing evidence of benefit supporting CGP in personalizing cancer therapy, its widespread uptake remains limited. Barriers include low patient understanding, unmet patient expectations related to low utility, clinician concerns over cost-effectiveness, perceived value, and discomfort in management of complex genomic results. Methods: This prospective cross-institutional demonstration study was designed to evaluate implementation of CGP in the care of adult and paediatric advanced cancer pts, incorporating pt reported outcomes (PROMs), discrete choice experiment (DCE), ongoing process optimization and clinician evaluations. DNA sequencing of FFPE tumor and matched blood was completed with CGP (PMCC Comprehensive Cancer Panel; 391 genes) via central laboratory. A tumor board reported results weekly with emphasis on therapeutic relevance. Oncologists performed consent and results delivery. Pts completed pre-and post-test surveys, including validated and study-specific questions, DCE and if eligible, semi-structured interviews. Qualitative interviews were undertaken with study clinicians and laboratory staff to evaluate processes. Results: 86% (315) of 365 enrolled pts had successful CGP; of these 63% (199) had relevant therapeutic, diagnostic or germline results. 50 (16%) had treatment change at 6m, 49 (16%) had germline mutations. 293 (88% of adult pts) completed PROMs. 17 of 19 clinicians/laboratory staff approached consented to an interview. At consent pts cited multifaceted value in testing, showed good understanding of basic concepts, but most (69%) overestimated the likelihood of result-led change. Post-test pts remained consistently satisfied with accessing CGP; valuing research contribution, taking opportunities and information for family. 21% struggled with understanding results but there were low levels of decisional regret following participation (89% had nil/mild regret). Pt-elicited preferences (via DCE) indicated priority for high rates of clinical utility and timeliness. Clinicians sited collaboration and communication as critical to delivery of CGP. Conclusions: Pts undergoing CGP are generally satisfied, and derive value on its use beyond potential therapeutic benefit. Our results suggest that to improve test utility and delivery of CGP with value to pts and investing institution, focus must be placed on addressing the additional barriers to its wider implications including efforts to improve process efficiencies, clinician genomic literacy and decision-making support.
Research progress on status and mechanism of low sensitivity or resistance of Neisseria gonorrhoeae to cephalosporin
Authors: Dan Wu, Senlin Dong, Qiuye Zi
Journal: BMJ (2018)

Cephalosporin is still the first-line drug chosen for the treatment of gonorrhea, although it is likely to develop resistance to Neisseria gonorrhoeae. Recently, the resistance or low sensitivity of cephalosporin to Neisseria gonorrhoeae have been reported at home and abroad. The studies of resistance mechanism to Neisseria gonorrhoeae are particularly important. The resistance mechanism is mainly lied in three aspects. The first is the changes in antibiotic target sites, for example, the changes in penicillin-binding proteins would affect the binding of antibiotics to Neisseria gonorrhoeae; the second is the changes in bacterial cell membrane porin which effects drugs influxing; the third is the changes in efflux system which enhances the bacterial efflux capacity. To study and explore the mechanism of Neisseria gonorrhoeae resistance is of great importance for the prevention and treatment of gonorrhea.


Key words: 
Neisseria gonorrhoeae; Cephalosporin resistance; Cephalosporins
Prognostic value of HER2, PD-L1 and RET mRNA expression in salivary gland tumor.
Authors: Svetlana Kutukova, Evgeny Imyanitov, Grigory Raskin, Julia V. Ivaskova, Natalia P. Beliak, Andrey I. Yaremenko, Alexandra Razumova, Natalia Pakhomova
Journal: Journal of Clinical Oncology (2020)

e18534 Background: The objective of our study was to evaluate the cytologically, morphologically and IGH detection of salivary gland (SGT), expression of HER2 and PD-L1, CPS and determine these associations with patient survival. Methods: The study included 59 patients with a confirmed diagnosis of salivary gland cancer (stage II-IVA) by cytology, morphology and IGH analyses. After that HER2, in tumor and tumor infiltrating immune cell PD-L1 expression (with CPS) was determined using IHC-testing. RET mRNA gene expression calculated with using real-time PCR. Results: Aspiration biopsies results: only in 22 (37.29%) cases the malignant tumor was cytologically confirmed. An IHC study showed the proportion of high-grade tumors significantly exceeded 3.82 times the proportion of low-grade tumors (p &lt; 0.00001). Low grade SGT were 2 times more often recorded by morphological studies (p = 0.0172), high grade SGT - 1.37 times more often by IHC study (p = 0.0176). HER2 expression: (0) – 29(60.42%), (1+) – 11(22.92%), (2+) – 4(8.33%), (3+) – 4(8.33%). Median OS HER2-neg pp was 170.25±24.49 mo (95% CI 125.25-218.26), median OS of 8 pp (16.33%) with HER2 (2+,3+) was 41,00 mo (95%CI 4.50-72.00) (HR 0,07; 95% CI 0,01-0,38; p = 0.00715). Median PFS HER2-neg pp was 168.00 mo (95% CI 75.00-168.00), median PFS of 8 pp (16.33%) with HER2 (2+,3+) was 19,00 mo (95%CI 1.00-31.00) (HR 0,23; 95% CI 0.04-1.22; p = 0.01641). PD-L1 expression was: in tumor cells 0-90% in 11/49 pp (22.45%), in immune cells 0-50% in 26/49 pp (53.06%) (p = 0.0006). CPS was 0-100, median CPS 5 (95% CI 0.03-10.00). Median OS pp with CPS &gt; 1 was 72.00 mo (95% CI 19.5-72.00); with CPS &lt; 1 hasn’t yet been achieved (OR 0.26; 95% CI 0.09-0.75; p = 0.0124). RET mRNA expression was detected in 13 of 48 cases (27.08%). The expression level ranged from 0 to 0.205. The median PFS in the RET mRNA-positive pp was 168.00 mo (95% CI 16.00-168.00) and tended to exceed the median TTP in the RET mRNA-naive patient group. Conclusions: The results suggest that the understanding the receptor status of salivary gland cancer can be effective prognostic factors.