tbuckley/cabot-search huggingface dataset:
Relationship between inhaling oxygen's flowing rate and respiratory depression in patients with chronic obstructive pulmonary disease plus carbon dioxide retention
Authors: Xun Sun, Chao-ying Jiang
Journal: BMJ (2012)

We observed 38 patients' breath frequency after different oxygen therapy according to their visit sequences and tolerance conditions.All patients with chronic obstructive pulmonary.disease (COPD) plus carbon dioxide retention from April 2008 to June 2011 were recruited at our hospital.Twentythree patients who could maintain SpO2≥92％ through inspiring O2 at ≤3.5 L/min were assigned into the first group.And another 15 subjects whose SpO2 could not reach 92％ at the same oxygen flow for 5 hours were assigned into the second group.The second group received an elevated oxygen flow until their SpO2 attained 92％ or so.But the maximal rate did not exceed 8 L/min even if SpO2 was below 92％.The state was maintained for 5 hours.Paired t-test showed PaO2 became elevated and PaCO2 decreased significantly on onset and termination of low oxygen flow in both groups.But the frequency of the second group's breaths per minute (BPM) had no significant differences.After elevating oxygen flow,the second group's BPM and PaCO2 on onset and termination were (19.4 ± 3.4) and (18.1 ± 2.6) perminute (P =0.038),(55.0 ±8.1) and (52.0 ±7.9) mm Hg (1 mm Hg =0.133 kPa) (P =0.030) respectively and the results showed significant decreases.But SpO2 was elevated [(85.8 ± 4.1) and (90.7 ± 2.4) mm Hg (P =0.000)].

Key words: 
Pulmonary diseases,chronic obstructive; Oxygen inhalation therapy
Job burnout and psychological status of the medical staff in Shennongjia forest region
Authors: Hui-min Sun
Journal: BMJ (2010)

The job burnout level and psychological status of 109 medical staff in Shennongjia forest region were investigated, and the Chinese maslach burnout inventory (CMBI) and symptom check list-90(SCL- 90) were adopted in the survey. The survey revealed that 69.7% (76/109) of the subjects had job burnout, including 53.2% (58/109) had slight burnout, 12. 8% (14/109) moderate burnout and 3. 7%(4/109) severe burnout. The single-factor detection rates of job burnout were 56.9% (62/109) for diminished personal accomplishment, 17.4% (19/109) for depersonalization, and 15.6% (17/109) for emotional exhaustion. Both the interpersonal sensitivity factor score and the positive symptom average score of SCL-90 were significant lower than those of Chinese norm ( P ＜ 0. 01 ), the total average score and the other factor scores of the subjects had no significant differences from those of Chinese norm ( P ＞ 0. 05 ). The results suggest that the majority of medical staff in the study region have experienced the job burnout, the main manifestation is the feeling of diminished personal accomplishment, on the other hand the psychological status of the subjects is similar with those in the general population.

Key words: 
Medical staff;  Fatigue
The compensatory phenomenon of the functional connectome related to pathological biomarkers in individuals with subjective cognitive decline
Authors: Haifeng Chen, Xiaoning Sheng, Caimei Luo, Ruomeng Qin, Qing Ye, Hui Zhao, Yun Xu, Feng Bai
Journal: Translational Neurodegeneration (2020)

Subjective cognitive decline (SCD) is a preclinical stage along the Alzheimer's disease (AD) continuum. However, little is known about the aberrant patterns of connectivity and topological alterations of the brain functional connectome and their diagnostic value in SCD.
Correlation between carotid intima-media thickness and glucose fluctuation in type 2 diabetic patients
Authors: Jin-xin Huang, Xiao-feng Lü, Pei Luo, Xing-guang Zhang, Xu-min Jiao
Journal: BMJ (2013)

Objective
To investigate the correlation between carotid intima-media thickness (CIMT) and glucose fluctuation in patients with type 2 diabetes mellitus (T2DM).


Methods
Sixty-eight T2DM patients admitted to Beijing Military General Hospital from March to August 2012 were enrolled in the study, including 32 cases with CIMT thickening (CIMT≥0.9 mm) and 32 cases with normal CIMT (CIMT<0.9 mm). The 72 h continuous blood glucose levels were monitored from the day of admission.


Results
There were no significant differences in the gender, age, body mass index (BMI), systolic and diastolic blood pressure, HDL-C, LDL-C, CHO, TG, glycosylate hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial average blood glucose (MPBG) between two groups (P>0.05). The atherosclerosis (AS) score and mean amplitude of glycemic excursion (MAGE), glucose standard deviation, frequency of glycemic excursion (FGE) and absolute mean of daily differences (MODD) in patients with thickening CIMT were (11±7) years,(6.9±3.0) mmol/L,(2.8±1.2) mmol/L,(3.4±1.5) times/d,(2.8±1.3) mmol/L,(4.5±1.0) score, respectively; while those in patients with normal CIMT were (8±6) years,(4.2±1.1) mmol/L,(1.6±0.5) mmol/L,(2.2±0.8) times/d,(2.0±1.0) mmol/L,(3.3±0.6) score, respectively. There were significant differences between two groups (all P<0.05). Pearson correlation showed that CIMT was positively correlated with MAGE, FGE, MODD, course of disease, diastolic blood pressure, LDL-C, MPBG and AS score (P<0.05). Multiple stepwise regression analysis showed that MAGE, MBPG were the influencing factors of CIMT.


Conclusions
The CIMT of patients with T2DM is closely correlated with glucose fluctuation, indicating that reduction of blood glucose fluctuation and MAGE, MPBG levels may delay the occurrence of diabetic macroangiopathy.


Key words: 
Diabetes mellitus, type 2; Glucose fluctuation; Continuous glucose monitoring system; Carotid intima-media thickenss
Endogenous TCR promotes in vivo persistence of CD19-CAR-T cells compared to a CRISPR/Cas9-mediated TCR knockout CAR
Authors: Dana Stenger, Tanja A. Stief, Theresa Kaeuferle, Semjon Willier, Felicitas Rataj, Kilian Schober, Binje Vick, Ramin Lotfi, Beate Wagner, Thomas G. P. Grünewald, Sebastian Kobold, Dirk H. Busch, Irmela Jeremias, Franziska Blaeschke, Tobias Feuchtinger
Journal: Blood (2020)
Peripheral blood leukocytes-related early diagnosis for lung cancer.
Authors: Qi Mei, Jian Li, Weiting Cheng, Ulrich Robert Mansmann, Guangyuan Hu, Xianglin Yuan
Journal: Journal of Clinical Oncology (2020)

e21020 Background: Early diagnosis of lung cancer is critically important to reduce disease severity and improve overall survival. For patients with suspicious lung lesions, a definitive diagnosis of malignant cancer currently requires surgical biopsy. Newer, minimally invasive biopsy procedures often fail to provide adequate specimens for accurate tumor subtyping or staging which is necessary to inform appropriate use of molecular targeted therapies and immune checkpoint inhibitors. Thus newer approaches to diagnosis and staging in early lung cancer are needed. Methods: In order to address this need, peripheral blood samples from 99 individuals with clinically evident pulmonary nodules (benign and malignant), as well as ten healthy persons, were obtained. Average RNA sequencing (RNAseq) data from these samples were integrated into an artificial intelligence (AI) model in order to perform a pathway flux analysis at the system level. The AI model utilized the biological knowledge derived from the literature and publicly available databases and possessed four layers with following relationship: (1) gene→ (2) RNA→ (3) protein/complex/compound → (4) pathway. The last layer (pathway) was connected back to the first layer (gene) via diverse feedback mechanisms. Based on these results, an immune index system, IM-Index, was defined and tested for early lung cancer diagnosis and staging. Results: The leukocyte-based IM-Index correctly identified the malignancy status of lung cancer patients with high accuracy (specificity 93.5%, sensitivity 70.5%), and was able to differentiate between the three accepted phases of the cancer immunoediting concept (i.e., elimination, equilibrium, escape) (odds ratio: 1.17 [95% CI: 1.1-1.25, p&lt; 0.001). Further, the IM-Index clearly differentiated between adenocarcinoma and squamous cell carcinoma (OR: 1.2 [95% CI 1.14-1.35, p = 0.019]). In addition, tumor- and host-specific signaling pathways and metabolic profiles were identified that fully distinguished between tumor and host immunity (p &lt; 0.05). Conclusions: Taken together, these findings suggest that our rapid, non-invasive peripheral blood leukocyte-based AI approach may be useful for early definitive cancer diagnosis and staging.
Nivolumab (Nivo) and ipilimumab (Ipi) in combination with radiotherapy (RT) in high-risk patients (pts) with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN).
Authors: Jennifer Maria Johnson, Voichita Bar Ad, Emily Lorber, Dawn Poller, Gregor Manukian, Adam Luginbuhl, Joseph M. Curry, David M. Cognetti, Scott W. Keith, Rita Susan Axelrod, Ulrich Rodeck, Larry Harshyne, Athanassios Argiris
Journal: Journal of Clinical Oncology (2020)

6577 Background: Immune checkpoint inhibitors (ICI) are the standard of care in recurrent/metastatic SCCHN but their role in the curative therapy setting with RT is under study. We evaluated the novel approach of combining Nivo, a PD-1 inhibitor, and Ipi, a CTLA-4 inhibitor, in lieu of chemotherapy, with concurrent RT in pts with high-risk LA SCCHN. Methods: We enrolled newly diagnosed, chemotherapy eligible pts with AJCC 7 th edition stage IVA-IVB SCCHN of the oral cavity, oropharynx (OP), hypopharynx, and larynx. HPV+ OP were T4, N2c or N3 OP. Nivo (3 mg/kg every 2 weeks IV x 17 doses) and Ipi (1 mg/kg every 6 weeks x 6 doses) were administered starting 2 weeks prior to the start of RT. RT was prescribed to a dose of 70 Gy delivered in 2 Gy/fraction/day using VMAT. The primary objective was safety of combination ICI with RT. Secondary objectives included 1-year progression-free survival (PFS), overall survival, and correlative studies. Results: 24 pts were enrolled; median age of 60 (range 48-77); 20 were male; 16 oropharynx (14 HPV+), 2 hypopharynx, and 6 larynx; AJCC 7 th edition stage IVA (23), IVB (1). Grade 3 acute in-field adverse events (AEs) occurred in 17/24 (71%) of patients during concurrent ICI-RT (9 mucositis, 6 dysphagia, 5 dermatitis, 4 odynophagia, 1 dysphonia); there were no grade 4/5 AEs during ICI-RT. During ICI maintenance 5 pts developed in-field ulcerations at the primary site detected at an average of 3 months post RT; 1 of them died of bleeding due to erosion into the carotid artery with no evidence of active cancer; 4 additional pts developed in-field necrosis. 7 pts discontinued ICI treatment at &gt; 3 months post-RT: 1 due to immune AE, 5 due to in-field ulcerations, 1 due to persistent mucositis without ulceration. 4 pts (17%) had grade 3 immune AEs: 1 elevation of lipase, 1 colitis, and 2 rash. There were no grade 4/5 immune AEs. The median follow-up is 16 months (range, 6.3-30.6). 21 of 24 pts (87.5%) are alive with no evidence of disease progression. 2 pts recurred at distant sites: 1 had a solitary lung lesion at 11 months and was treated with RT; 1 in mediastinal lymph nodes at 9 months and was treated with chemo-RT. Locoregional control remains at 100%. Conclusions: RT plus dual ICI combination was feasible and resulted in no locoregional relapses so far in 24 high-risk LA SCCHN pts. Longer follow-up is needed to fully assess PFS and locoregional control as well as post-treatment in-field ulceration/necrosis that may be attributed to the potent radiosensitizing effect of dual PD-1 and CTLA-4 blockade. Clinical trial information: NCT03162731 .
Chemotherapy-induced peripheral neuropathy (CIPN) as a predictor of decreased quality of life and cognitive impairment in testicular germ cell tumor survivors.
Authors: Michal Chovanec, Dominika Galikova, Lucia Vasilkova, Valentina De Angelis, Katarina Rejlekova, Jana Obertova, Zuzana Sycova-Mila, Patrik Palacka, Katarina Kalavska, Daniela Svetlovska, Beata Mladosievicova, Jozef Mardiak, Michal Mego
Journal: Journal of Clinical Oncology (2020)

e17063 Background: Chemotherapy-induced peripheral neuropathy (CIPN20) after curative treatment for testicular germ cell tumors (GCTs) has been previously reported. The impact of CIPN on long-term quality of life (QOL) in GCT survivors remains unclear. Herein, we aimed to evaluate chemotherapy-induced peripheral neuropathy (CIPN20) in association with QOL in GCT survivors. Methods: European Organisation for Research and Treatment of Cancer (EORTC) CIPN20, QLQ-C30 and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) questionnaires were prospectively completed by GCT survivors (N = 153) at National Cancer Institute in Slovakia during their annual follow-up. The median follow-up was 10 years (range 4-25). Upon obtaining the scores from each questionnaire per recommended guidelines, each score from QLQ-C30 and FACT-Cog was correlated with CIPN defined as high or low (above and below median) as obtained from CIPN20. Results: GCT survivors with CIPN high reported impairment in quality of life in QLQ-C30. The global health status was lower in survivors with high vs low CIPN (mean score ± SEM: 66.5 ± 1.9 vs. 86.2 ± 1.8, P &lt; 0.00001). Survivors with CIPN high reported substantially worse physical, role, emotional, cognitive and social functioning compared to CIPN low (all P &lt; 0.00001). CIPN high survivors perceived more fatigue, nausea, pain, dyspnoea, appetite loss and more sleeping disorders compared to CIPN low (all P &lt; 0.0001). Higher burden of CIPN was associated with more financial problems vs CIPN low (mean score ± SEM: 19.6 ± 2.6 vs. 6.67 ± 2.3, P = 0.0002). Cognitive impairment was higher in all FACT-Cog domains including the overall cognitive function score (all P &lt; 0.001) for CIPN high. Spearman analysis has confirmed negative correlations of CIPN20 overall score with QLQ-C30 global health status (R = -0.54, P &lt; 0.0001) and with FACT-Cog overall cognitive function score (R = -0.52, P &lt; 0.0001). Conclusions: CIPN is a powerful predictor of disturbances in QOL and cognitive functioning among GCT survivors. Physicians should never over-treat patients unnecessarily and novel therapies with lower burden of late toxicity should be researched
The prognostic value of CINSARC in a randomised trial comparing histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in patients with high-risk soft-tissue sarcomas (ISG-STS 1001).
Authors: Sandro Pasquali, Luca Braglia, Frederic Chibon, Jean Michel Coindre, Antoine Italiano, Cleofe Romagosa, Silvia Bague, Angelo Paolo Dei Tos, Emanuela Palmerini, Vittorio Quagliuolo, Javier Martin Broto, Antonio Lopez-Pousa, Giovanni Grignani, Antonella Brunello, Jean-Yves Blay, Robert Diaz Beveridge, Silvia Stacchiotti, Domenico F Merlo, Paolo Giovanni Casali, Alessandro Gronchi
Journal: Journal of Clinical Oncology (2020)

e23531 Background: The Complexity INdex in SARComas (CINSARC) is a gene expression signature related to mitosis and chromosome integrity that stratifies risk for recurrence of soft tissue sarcoma (STS) patients. The aim of this study was to validate the prognostic value of CINSARC in patients enrolled in a randomised trial that compared histotype-tailored neoadjuvant chemotherapy with standard chemotherapy in patients with high-risk STS (ISG-STS 1001). Methods: CINSARC is 67-gene-expression-based signature that has been previously tested in retrospective series. The ISG-STS 1001 was a phase 3 RCT comparing histotype-tailored and anthracycline-based chemotherapy in localised, high-risk STS of the extremities or trunk wall, with one of five histological STS subtypes: high-grade myxoid liposarcoma, leiomyosarcoma, synovial sarcoma, malignant peripheral nerve sheath tumour, and undifferentiated pleomorphic sarcoma. Outcome variables were disease-free survival (DFS), overall survival (OS) and tumour response according to RECIST v1.1. Results: CINSARC was assessed in pre-treatment biopsies of 87 in 435 patients participating in the study. Thirty and 57 patients segregated in the lower (C1) and higher (C2) CINSARC risk group, respectively. Incidence of local recurrences (LR) and distant metastasis (DM) did not differ between C1 and C2 CINSARC groups [2 (6.6%) and 11 (19.3%) patients had a LR, respectively, and 10 (33.3%) and 14 (24.5%) patients had DM, respectively, P = 0.800]. Consistently, we did not observe statistically significant differences for DFS and OS between patients in the CINSARC C1 and C2 groups (log-rank test, P = 0.522 and P = 0.480, respectively). RECIST tumour response was analysed in a subset of patients (N = 39), showing that a RECIST SD was more likely in C1 (N = 12/14, 85.6%) compared to C2 (N = 18/25, 72%) group, while both RECIST PD and PR were more commonly detected in C2 [3/25 (12%) and 4/25 (16%), respectively] compared to C1 [0/14 (0%) and 1/14 (7.1%), respectively] group. Conclusions: In high-risk STS patients treated with preoperative chemotherapy within a RCT, CINSARC did not correlate with different DFS and OS. While this may well be due to a failure of this gene signature in this patient population, an alternative hypothesis is that preoperative chemotherapy may improve the prognosis of higher-risk patients. Clinical trial information: NCT01710176 .
Thinking through others’ emotions: Incorporating the role of emotional state inference in thinking through other minds
Authors: Ryan Smith, Richard D. Lane
Journal: Behavioral and Brain Sciences (2020)

Abstract The active inference framework offers an attractive starting point for understanding cultural cognition. Here, we argue that affective dynamics are essential to include when constructing this type of theory. We highlight ways in which interactions between emotional responses and the perception of those responses, both within and between individuals, can play central roles in both motivating and constraining sociocultural practices.
LDL Receptor Regulates the Reverse Transport of Macrophage-Derived Unesterified Cholesterol via Concerted Action of the HDL-LDL Axis
Authors: Lídia Cedó, Jari Metso, David Santos, Annabel García-León, Núria Plana, Sonia Sabate-Soler, Noemí Rotllan, Andrea Rivas-Urbina, Karen A. Méndez-Lara, Mireia Tondo, Josefa Girona, Josep Julve, Victor Pallarès, Aleyda Benitez-Amaro, Vicenta Llorente-Cortes, Antonio Pérez, Diego Gómez-Coronado, Anna-Kaisa Ruotsalainen, Anna-Liisa Levonen, José Luis Sanchez-Quesada, Luís Masana, Petri T. Kovanen, Matti Jauhiainen, Miriam Lee-Rueckert, Francisco Blanco-Vaca, Joan Carles Escolà-Gil
Journal: Circulation Research (2020)

The HDL (high-density lipoprotein)-mediated stimulation of cellular cholesterol efflux initiates macrophage-specific reverse cholesterol transport (m-RCT), which ends in the fecal excretion of macrophage-derived unesterified cholesterol (UC). Early studies established that LDL (low-density lipoprotein) particles could act as efficient intermediate acceptors of cellular-derived UC, thereby preventing the saturation of HDL particles and facilitating their cholesterol efflux capacity. However, the capacity of LDL to act as a plasma cholesterol reservoir and its potential impact in supporting the m-RCT pathway in vivo both remain unknown.We investigated LDL contributions to the m-RCT pathway in hypercholesterolemic mice.Macrophage cholesterol efflux induced in vitro by LDL added to the culture media either alone or together with HDL or ex vivo by plasma derived from subjects with familial hypercholesterolemia was assessed. In vivo, m-RCT was evaluated in mouse models of hypercholesterolemia that were naturally deficient in CETP (cholesteryl ester transfer protein) and fed a Western-type diet. LDL induced the efflux of radiolabeled UC from cultured macrophages, and, in the simultaneous presence of HDL, a rapid transfer of the radiolabeled UC from HDL to LDL occurred. However, LDL did not exert a synergistic effect on HDL cholesterol efflux capacity in the familial hypercholesterolemia plasma. The m-RCT rates of the LDLr (LDL receptor)-KO (knockout), LDLr-KO/APOB100, and PCSK9 (proprotein convertase subtilisin/kexin type 9)-overexpressing mice were all significantly reduced relative to the wild-type mice. In contrast, m-RCT remained unchanged in HAPOB100 Tg (human APOB100 transgenic) mice with fully functional LDLr, despite increased levels of plasma APO (apolipoprotein)-B-containing lipoproteins.Hepatic LDLr plays a critical role in the flow of macrophage-derived UC to feces, while the plasma increase of APOB-containing lipoproteins is unable to stimulate m-RCT. The results indicate that, besides the major HDL-dependent m-RCT pathway via SR-BI (scavenger receptor class B type 1) to the liver, a CETP-independent m-RCT path exists, in which LDL mediates the transfer of cholesterol from macrophages to feces. Graphical Abstract: A graphical abstract is available for this article.
Number of reflux episodes on pH-impedance monitoring associates with improved symptom outcome and treatment satisfaction in gastro-oesophageal reflux disease (GERD) patients with regurgitation
Authors: Benjamin D Rogers, Luis R Valdovinos, Michael D Crowell, Reginald Bell, Marcelo F Vela, C Prakash Gyawali
Journal: Gut (2020)

Objective Number of reflux episodes, an adjunctive metric on pH-impedance monitoring, is incompletely studied. We aimed to determine if number of reflux episodes associates with therapeutic outcome in regurgitation predominant gastro-oesophageal reflux disease (GERD). Design We performed post hoc analysis of postintervention pH-impedance data from adult patients with moderate/severe regurgitation despite QD proton pump inhibitor (PPI), randomised to either two times a day PPI or magnetic sphincter augmentation (MSA) in 2:1 allocation. After 6 and 12 months, symptom response was defined by improvement in Foregut Symptom Questionnaire (FSQ) regurgitation score to none or minimal, ≥50% reduction in GERD health-related quality of life (HRQL) score and satisfaction with therapy. Univariate and multivariate analyses were performed to determine predictors of symptom improvement. Results Of 152 randomised patients, 123 (age 46.9±1.2 year, 43% female) had complete data. Symptom and satisfaction scores significantly improved after MSA compared with two times a day PPI. Both acid exposure time (13.4%±0.7% to 1.3±0.2%, p&lt;0.001) and reflux episodes (86±4 to 48±4, p&lt;0.001) declined with therapy. Reduction to &lt;40 reflux episodes was significantly more frequent in those with symptom response by FSQ regurgitation score, GERD HRQL score and satisfaction with therapy (p≤0.03 for each); &lt;35 episodes performed better on receiver operating characteristic analysis. On multivariate analysis, improvement in regurgitation score remained independently predictive of satisfaction with therapy (p&lt;0.001 for each). In patients crossing over to MSA, &gt;80 episodes pretreatment predicted improvement. Conclusions Reduction of reflux episodes on pH-impedance to physiological levels associates with improved outcomes, while pathological levels predict improvement with MSA in regurgitation predominant GERD. Trail registration number ClinicalTrials.gov: NCT02505945 .
Analysis for changes in awareness and behavior of prevention and treatment for hypertension in an urban community of Beijing
Authors: 王凯, 马洪进, 吐达洪
Journal: BMJ (2006)

目的 探讨社区医院实施健康促进对城市社区人群高血压防治的影响.方法采用典型抽样法,抽取街道办事处、市属某厂为干预社区,干预前318人,干预后为272人.于2003年6月至2004年12月进行高血压防治干预,干预前后均发放《疾病及行为危险因素》问卷,干预前有效回收287份,干预后回收250份,对两次回收的问卷进行分析.结果干预后问卷与干预前相比,高血压危害知晓率由51%升至60%(P＜0.05), 高血压危险因素知晓率由13%升至26%(P＜0.05),不运动率由64%降至23%(P＜0.05),居民健康教育率由34%升至68%(P＜0.05),参加患者自助活动人数由2%升至36%(P＜0.05).恶化的指标是女工高脂摄入率,由30%升至43%(P＜0.05),正常体重者由70%降至58%(P＜0.05).结论经过政府牵头、社区医院实施的慢性病防治体系对高血压的干预效果令人满意,但仍有需完善和探讨之处。