tbuckley/cabot-search huggingface dataset:
Associations between concordance with oncology clinical decision support and clinical outcomes in lung cancer patients.
Authors: Suthida Suwanvecho, Harit Suwanrusme, Tanawat Jirakulaporn, Palita Lungchukiet, Nittaya Thanakarn, Nimit Taechakraichana, Wimolrat Decha, Wisanu Boonpakdee, Pattanawadee Wongrattananon, Anita M Preininger, Metasebya Solomon, Suwei Wang, Rezzan Hekmat, Jaime Esquivel, Irene Dankwa-Mullan, Vimla L Patel, Edward Shortliffe, Yull Edwin Arriaga, Gretchen Purcell Jackson, Narongsak Kiatikajornthada
Journal: Journal of Clinical Oncology (2020)

e14114 Background: Watson for Oncology (WfO) is an artificial intelligence-based clinical decision-support system which provides therapeutic options and associated scientific evidence to cancer-treating physicians. Oncologists at Bumrungrad International Hospital (BIH) have used WfO since 2015. We examined the association between concordance of WfO therapeutic options and BIH treatment decisions with short-term clinical outcomes for lung cancer patients. Methods: This study included lung cancer patients seen at BIH for treatment and follow-up care and for whom WfO was used from 2015 to 2018. Charts were reviewed for concordance with WfO, documentation of disease progression, response to treatment, and survival. We evaluated concordance between oncologists’ treatments and therapeutic options listed as “recommended” by WfO. We evaluated association between WfO concordance and partial or complete response rates over a 24-month period by comparison of proportions with odds ratio. Progression-free survival (PFS, time from diagnosis until progression or death) was evaluated by Kaplan-Meier log-rank test. Results: Seventy-nine lung cancer patients were included. We identified a trend towards higher response rates in concordant cases (59.2%, N = 32), as compared to discordant (48.0%, N = 12), with an odds ratio of 1.56 (see table). There was not a significant difference in PFS between concordant and discordant cohorts. Conclusions: In this small-cohort, retrospective study, lung cancer patients receiving treatments that are concordant with WfO recommended therapeutic options trended towards higher response rates than patients with discordant treatments. Use of a clinical decision-support system may help support cancer-treating physicians in delivering best practice and evidence-based care that may improve short-term outcomes. Prospective studies with larger samples and other cancer types are underway. [Table: see text]
A study on the change in blood pre-adaptation factors among patients with obstructive sleep apneahypopnea syndrome
Authors: Xiu-hong Nie, Yun-yun Chen, Lian-guo Zhang, Xiao-jun Fan
Journal: BMJ (2009)

Objective To investigate the changes in serum level of vascular endothelial growth factor (VEGF), nitric oxide (NO), erythropoietin (EPO) and plasma level of carbon monoxide (CO) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their clinical significance. Methods Sixty-four patients diagnosed as OSAHS by polysomnography (PSG), were divided into two groups according to apnea-hypopnea index (AHI), 20 in mild group [5/h≤AHI≤20/h, with a mean of (12± 5)/hi and 44 in moderate-severe group[AHI > 20/h, with a mean of (63±23)/h]. Blood samples were obtained from all the patients after PSG for measurement of levels of serum VEGF, NO and EPO and plasma CO. Results Levels of serum VEGF [(101±91) ng/L], NO [(10.3±3.3) μmol/L]and plasma CO [(0.56±0. 35) mg/L]in moderate-severe OSAHS group were significantly higher than those in mild group (all P   0.05). Levels of serum VEGF, NO and plasma CO in OSAHS patients positively correlated with AHI and percentage of time with percutaneous arterial blood oxygen saturation lower than 0. 9 (SLT90) of all sleep time (all P  0.05). No correlation between EPO and all the indicators was found (P>0.05). Multiple linear regression analysis showed that LSaO2 was an independent risk factor to affect levels of serum VEGF and plasma CO (R2=0.198, P=0.001, and R2=0.210, P=0.000, respectively) and SLT90 was an independent risk factor to affect serum level of NO (R2= 0. 148, P=0.004) in OSAHS patients. Conclusion Hypoxia at night is a main cause leading to increased level of serum VEGF, NO and plasma CO in OSAHS patients.

Key words: 
Sleep apnea, obstructive;  Vascular endothelial growth factor A;  Nitrric oxide;  Carbon monoxide
The effect of concomitant cannabinoids during immune checkpoint inhibitor treatment of advanced stage malignancy.
Authors: Adam Biedny, Susan Szpunar, Ahmed Abdalla, Zyad Kafri, Tarik H. Hadid
Journal: Journal of Clinical Oncology (2020)

e15064 Background: Immune checkpoint inhibitors are used in treatment of advanced neoplasms. Immunotherapy agents create a potent pro-inflammatory effect in cancer. The efficacy of immunotherapy may negatively be impacted by the use of anti-inflammatory agents. An anti-inflammatory effect of cannabinoids has been described in literature in several models. Recent data suggests a negative impact of cannabis on tumor response to immunotherapy. Methods: We retrospectively reviewed medical records of all patients with metastatic cancer who received at least 2 months of immune checkpoint inhibitors between August 2014 and August 2018. The patients were stratified by use of cannabis (cannabis vs non-cannabis users). Baseline patients’ characteristics were compared. Overall survival was estimated and compared between the two groups. An analysis was performed using analysis of variance, Student's t-test, correlation, chi-squared test, and logrank test. All data were analyzed with SPSS v. 26.0 and a p-value less than 0.05 was set to indicate statistical significance. Results: A total of 104 patients with advanced-stage malignancy met the inclusion criteria. The median age was 63.9±10.5 years, 48.1% males and 81.7% Caucasians. 41.3% of patients has lung adenocarcinoma, 20.3% has squamous cell carcinoma of the lung, 11.5% has squamous cell carcinoma of the head and neck and 26.9% have other tumor types. Twenty patients (19.2%) had brain metastasis and twenty-three patients (22.1%) had bone metastasis. Seventy patients (66.8%) received Nivolumab, and twenty-seven patients (26%) received Pembrolizumab. The mean duration of immunotherapy use was 10.2 months. Characteristics of patients were similar between the groups except for a higher prevalence of tobacco use in the cannabis group. Twenty-eight patients (26.9%) reported concomitant cannabis use during immunotherapy treatment, 23 were prescribed (dronabinol) and 5 used it recreationally (smoking marijuana/cannabis oil). Non-cannabis users had significantly longer overall survival (OS) compared to cannabis users (40 months vs 16 months, p = 0.004). Conclusions: This study shows significant association between the use of cannabis during immunotherapy treatment and worse OS. This can be explained by an anti-inflammatory effect of cannabis, which may decrease response to immune checkpoint inhibitors. This observation should be further investigated in randomized trials. Health care professionals should be aware of the potentially harmful effect of cannabis on cancer care.
Patient-reported gastrointestinal outcomes in patients with anal cancer.
Authors: Ramez Kouzy, Joseph Abi Jaoude, Daniel Lin, Molly Blue El Alam, Bruce D. Minsky, Eugene Jon Koay, Prajnan Das, Emma B. Holliday, Ann Klopp, Lauren Elizabeth Colbert, Cullen M. Taniguchi
Journal: Journal of Clinical Oncology (2020)

4055 Background: Among patients with anal cancer, chemoradiotherapy tends to offer an excellent prognosis but is often associated with undesirable toxicities that diminish quality of life. We sought to quantify the gastrointestinal-related patient-reported outcomes (PROs) of anal cancer patients receiving chemoradiotherapy in order to improve patient-physician communication and shared decision making. Methods: We prospectively followed patients with non-metastatic squamous cell carcinoma of the anal canal who received definitive chemoradiotherapy. Patients reported outcomes were collected using the bowel subdomain of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire before treatment and at 4 subsequent timepoints. We used descriptive statistics to summarize the patients’ characteristics and EPIC scores, then used the paired Wilcoxon test to compare EPIC scores at different timepoints. Results: The study included 21 patients (16 women and 5 men), whose median age was 57 years. Most patients (52%) had T2, and either N0 (38%) or N1 (43%) disease. Most patients (91%) received standard of care chemoradiotherapy. Compared with the patients’ median overall summary score at baseline (66), their median score at 1 week (82) was significantly higher (p = 0.009), whereas their median score at 5 weeks (54) was significantly lower (p = 0.025). However, the patients’ median overall summary score at baseline and at 3 months did not differ significantly (p = 0.919). Three months after radiotherapy, most patients (73%) reported rarely or never having bloody stools, and most (82%) reported rarely or never being bothered by bloody stools. Overall, EPIC scores show initial improvement of all domains, followed by some worsening of symptoms before returning to baseline levels. Conclusions: Anal cancer patients’ gastrointestinal-related PROs tend to fluctuate during radiotherapy but return to baseline by 3 months, at which time most patients report few or no residual side effects. Our data provide a clear timeline of gastrointestinal acute toxicity using sequential PRO measurements that will improve patient-physician communication regarding expectations for cancer treatment and help in shared decision making.
Proteomic screening of saturated fatty acid-induced hepatocytes-derived exosomes.
Authors: Yi-Ting Liu, Jee-Fu Huang, Ming-Lung Yu, Shu-Chi Wang
Journal: Journal of Clinical Oncology (2020)

e13568 Background: Most countries continuously westernize and industrialize, the prevalence of NAFLD is expected to increase, which will greatly increase social and economic burden. Meanwhile, the trend that NAFLD acts as a main stream of liver diseases will be much emphasized with the eradication and/or effective control of viral hepatitis in the future. There are many studies indicated that lipotoxicity of hepatocyte plays an important role in the inflammation and hepatic injury during the progression of liver steatohepatitis and HCC. However, the extracellular vesicles (EVs) participate in intercellular signaling, tissue injury and repair, and matrix remodeling still unclear. Methods: In this research, we used hepatitis liver cells (Huh 7.5.1 and Hep-G2) and LX-2 cell lines (liver stellate cells, HSCs) with palmitic acid (PA) to study the cell inflammation/fibrosis response and exosome contents. Results: The Oil red lipid droplet cell stain result found the liver cells has produced higher fatty oil droplet than HSCs cells in the same PA dose. However, the inflammation cytokines (IL-6, TNF-α, and IL-1β) and fibrosis-related protein (α-SMA and COL1A1) only significant increasing in HSCs cells but not in liver cells after the PA treatment. Isolation of exosomes from PA-treated hepatocytes presenting the same effect on the activation of HSCs, which lead to significant expression of fibrosis markerα-SMA and COL1A1. Based on the finding, we further analyzed the exosomes from PA-treated hepatocytes by LC-MS analysis and found 6 proteins (CFHR-4, A2M, HBG, APOB, IG, DCTN1) presenting compare to un-treated liver cells. Conclusions: This study provide the released Hep-EVs have important roles in hepatocyte-to-HSC communication.
Effect of the oral CXCR4 inhibitor X4-136 on tumor control and side effects in cervical cancer treated with radiotherapy and concurrent chemotherapy.
Authors: Naz Chaudary, Richard (Dick) P Hill, Lynne Kelley, Michael F. Milosevic
Journal: Journal of Clinical Oncology (2020)

e18010 Background: Cervical cancer is a global health problem. Despite scale up of prevention programs, there will be an ongoing need to improve the effectiveness of radiotherapy/cisplatin (RTCT) for women with established, locally advanced disease. We have shown that RTCT with the CXCR4 inhibitor plerixafor improves tumor control, reduces metastases and reduces RT-related side effects compared to RTCT alone. X4-136 is an oral CXCR4 inhibitor that is better suited to long-term, once daily use. In this study we examined: 1. The efficacy of RTCT and X4-136 in cervical cancer; 2. Biomarkers of response to RTCT and X4-136; and 3. Effects of RTCT and X4-136 on intestinal toxicity, an important dose-limiting RT side effect in these patients. Methods: Orthotopic cervical cancer xenografts derived from our patients were treated with RT (30 Gy; 2 Gy/day) and cisplatin (4 mg/kg/week ip) with or without concurrent X4-136 (100 mg/kg/day orally) for 3 weeks. Mice were sacrificed immediately after treatment for biomarker assessment. In separate experiments, mice had CT imaging weekly after treatment to evaluate tumor response. Acute and late intestinal toxicity was assessed histologically 3.5 and 90 days after treatment respectively. Results: RTCT alone increased CXCL12/CXCR4 signaling, intratumoral accumulation of myeloid cells and PD-L1 expression. The addition of X4-136 during RTCT abrogated these effects and improved tumor response in 2 cervical cancer models. Furthermore, the addition of X4-136 increased the proportion of surviving intestinal crypt cells in keeping with a reduction in acute RT toxicity, and reduced late histologic changes of late RT toxicity. Conclusions: The addition of X4-136 blunts RTCT-induced upregulation of the CXCL12/CXCR4 pathway, reduces intratumoral myeloid cells, improves tumor control and reduces side effects in cervical cancer. Few if any pharmacologic strategies have been identified previously that expand the therapeutic window with RT in this way. The combination of RTCT and CXCR4 inhibition warrants testing in clinical trials to validate these findings. These benefits may apply to other tumors where RTCT plays a curative role.
Serum levels of macrophage migration inhibitory factor in patients with vitiligo vulgaris
Authors: Tianguan He, Bo Cheng, Zhimin Li
Journal: BMJ (2015)

Serum levels of macrophage migration inhibitory factor (MIF) were measured with enzyme linked immunosorbent assay(ELISA)in 60 patients with vitiligo vulgaris (case group) and 30 healthy individuals (control group). The case group was further divided into two subgroups: progressive stage (n=30) and stable stage (n=30). The association of MIF level with vitiligo area and severity index (VASI) score of disease was analyzed. The results showed that the serum MIF levels in patients with progressive stage were significantly higher than those in stable stage and in healthy controls(79.8±38.0)μg/L vs.(48.4±17.6) μg/L vs.(29.6±22.1)μg/L, respectively, both P<0.001. Serum MIF levels were positively correlated with VASI scores of patients (r=0.48, P<0.001). The results indicate that MIF may be involved in the pathogenesis of vitiligo vulgaris.


Key words: 
Macrophage migration inhibitory factor; Vitiligo
指骨骨髓创面植皮八例
Authors: 杨加保, 李民, 褚福海, 赵静
Journal: BMJ (2005)

在治疗特大面积(60%～93%)烧伤后期,如手指背侧指骨、肌腱外露,难以用临近皮瓣及远处皮瓣修复,可应用指骨骨髓创面植皮修复创面.我科自2000年10月至2004年4月共行指骨骨髓创面植皮8例,效果满意,现报告如下。
Comprehesion of guideline of diagnosis and treatment on osteoporosis and some bone mineral diseases
Authors: 中华医学会骨质疏松和骨矿盐疾病分会
Journal: BMJ (2006)

受卫生部和中华医学会的委托,中华医学会骨质疏松和骨矿盐疾病分会组织编写了骨质疏松和部分骨矿盐疾病的诊疗指南.本期杂志刊出了该指南讨论稿的部分内容,包括原发性骨质疏松症、骨质疏松性骨折、继发性骨质疏松症、糖皮质激素诱发的骨质疏松症、甲状旁腺功能亢进症、佝偻病和骨软化症等6个部分。
Clinical significance ofultrasonic scanning in detecting umbilical abnormality and measuring notch depth of nuchalcord entanglement
Authors: Cui-lan Li, Min Wei
Journal: BMJ (2010)

：Type B ultrasonicscanning was performed routinely for 10 944 pregnant women at their third semester whenthey visited outpatient department or were admitted to our hospital during January 2004 toDecember 2008, and their fetal heart rate, amniotic fluid, umbilical cord and neonateconditions were monitored and recorded during delivery. The sensitivity and specificity oftype B ultrasonic were 95.74% (3301/3448) and 96. 25 % (7215/7496). Umbilical abnormalitywas diagnosed in 3448 pregnancies by type B ultrasonic scanning, with prevalence of31.51%, cesarean section was performed in 44.00 %, fetal distress occurred in 18. 27% ofthem, 15.46% of them with Apgar score equal to or less than seven, and fetal deathoccurred in 2. 41% of them, all significantly higher than those in pregnant women withoutumbilical abnormal (23. 77%, 8. 56%, 7.84% and 1.36%, respectively, all P ＜0.01 ). Cesarean section was performed in 41.90 % of those with 0. 8 cm or more in the notchdepth of nuchal cord entanglement,fetal distress occurred in 29.76% of them, 25.30% ofthem with Apgar score equal to or less than seven and fetal death occurred in 4. 05% ofthem, all significantly higher than those in pregnant women with the notch depth less than0. 8 cm (20. 22%, 8. 60%, 9. 26% and 0. 54%, respectively, all P ＜0. 01 ). Type B ultrasonicscanning plays an important role in clinical diagnosis for umbilical abnormality, guidingselection of delivery method and improving neonatal prognosis.

Key words: 
Ultrasongraphy, prenatal; Nuchal cord entanglement
Susceptibility and severity of COVID-19 in patients treated with bDMARDS and tsDMARDs: a population-based study
Authors: Carlo Salvarani, Gianluigi Bajocchi, Pamela Mancuso, Elena Galli, Francesco Muratore, Luigi Boiardi, Mariagrazia Catanoso, Nicolò Pipitone, Giulia Cassone, Nicolò Girolimetto, Stefania Croci, Luca Cimino, Federeica Gradellini, Marina Beltrami, Vito Di Lernia, Giovammi Dolci, Marco Massari, Anna Maria Marata, Massimo Costantini, Paolo Giorgi Rossi
Journal: Annals of the Rheumatic Diseases (2020)

Susceptibility and severity of COVID-19 in patients treated with bDMARDS and tsDMARDs: a population-based studyPatients with autoimmune conditions treated with biological agents have an increased risk of severe infections. 1 2 Very few studies have evaluated the susceptibility and severity of coronavirus disease 2019 (COVID-19) in patients treated with biological disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic DMARDs (tsDMARDs). 3 4Some of these studies suggest a protective role of these drugs for COVID-19; however, they consist of small series, and the results are unclear.Therefore, we decided to evaluate in a population-based study the risk of COVID-19 infection and its severity in the patients treated with bDMARDs or tsDMARDs in a geographic area (Emilia Romagna) at high diffusion of COVID-19.We identified 1195 patients treated with the bDMARDs or tsDMARDs listed in table 1 in Reggio Emilia area on 31 December 2019.Biological agents were classified according to the mechanism of action.The patients were registered in the database of the Hospital Pharmaceutical Service of the Reggio Emilia area, which delivers the drug directly to the patients.The database is updated every 3 months.All residents of Reggio Emilia area who have had rhinopharyngeal swabs, positive swabs and were hospitalised or died from COVID-19 from the beginning of the outbreak (27 February 2020) are registered in a centralised index.Swabs were performed in symptomatic patients at risk of having COVID-19.The fiscal code was used to identify and match patients treated with biological agents and with COVID-19 infection.We used data updated at 24 April.Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research.
Hyperprogressive disease during treatment with immune checkpoint inhibitors in patients with advanced non-small cell lung cancer (NSCLC).
Authors: Pablo Ayala de Miguel, Javier López Gallego, Itziar Gorospe García, Pablo René Rivera Vargas, Andrea Posada Restrepo, Jonathan Aires Machado, Rubén Alonso Calderón, José Manuel Rodríguez García, Eduardo Ceballos, Alfonso Acero Caballero, Andrea Illán Varella, Laura Quintana Cortés, Pablo Borrega Garcia
Journal: Journal of Clinical Oncology (2020)

e21664 Background: Hyperprogressive disease (HPD) is a new pattern of progressión during immunotherapy and is described as an acceleration of tumor growth during treatment with immune checkpoint inhibitors (ICI). The rate of HPD in advanced solid tumors remains unknown, but it has been reported in 9% to 29% of patients in two recent series. Our aim was to study prognostic factors of HPD. Methods: We collected data of 104 patients diagnosed of advanced NSCLC and treated with ICI in monotherapy at our institution between December 2015 and December 2019. Several variables as clinical, tumour-related and therapeutical were included in the analysis. The variables were compared by chi-square and Fisher test, then we performed a multivariate logistic regression model to analyse the effects of the covariates, and finally we performed a Kaplan Meier survival analysis. We described HPD as disease progression at first evaluation with an increase in tumor growth rate exceeding 50%, according to Gustave Roussy criteria previously reported. Results: Cohort of 84 men and 20 women, median age of 67 years and 86% with Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1. 89% were active or ex-smokers and 11% had never smoked. 60% of patients had adenocarcinoma histology, 39% scamous and 1% had not otherwise specified (NOS) carcinoma histology. 3% of patients had III-B stage at the moment of start of immunotherapy, 37% M1a, 30% M1b and 30% M1c. 2 patients had driver mutations in EGFR gene. 41% of patients had unknown PDL1 status; 14% had no PDL1 expression, 14% low expression and 31% high expression. 78% of patients had progressed to prior line of treatment, while 22% were treatment-naive. Nine of 104 patients (8.7%) in our population developed HPD during treatment with ICI. HPD occured within the first two months of treatment in all 9 patients, and was associated with worse overall survival in the multivariate analysis by Cox regression (12.6 vs 2.6 months; HR 13.94, p &lt; 0.001). The presence of 2 or more metastatic sites was related to the development of HPD in the multivariate analysis (HR 8.59, p = 0.026). Conclusions: The incidence of HPD in our population is concordant with previous report about this topic. As previously described by Ferrara et al, HPD was significantly associated with a high number of metastatic sites before start treatment with ICI and correlated with poor outcomes in patients with advanced NSCLC.