tbuckley/cabot-search huggingface dataset:
Usage and factors associated with adjuvant bisphosphonate therapy among postmenopausal women diagnosed with early-stage breast cancer.
Authors: Veera Durga Sravanthi Panuganty, Suganija Lakkunarajah, Sumugan Shanmuganathan, Morgan Black, Sharifa Nasreen, Igor Karp, Theodore A. Vandenberg, Jacques Raphael, Ricardo Fernandes, Phillip S. Blanchette
Journal: Journal of Clinical Oncology (2020)

e12532 Background: Early Breast Cancer Trialist Collaborative Group meta-analysis suggested significant reduction in bone metastasis and breast cancer mortality among post-menopausal women diagnosed with early breast cancer when treated with an adjuvant bisphosphonate. Cancer Care Ontario and American Society of Clinical Oncology clinical practice guideline published in 2017, recommends the use of an adjuvant bisphosphonate in postmenopausal women who are candidates for adjuvant systemic therapy. Our goal was to evaluate trends and factors associated with adjuvant bisphosphonate usage since the guideline’s publication. Methods: This study is a retrospective review of postmenopausal women treated for early breast at the London Regional Cancer Program from 2017-2018. Univariate and a multivariable logistic regression models were used to investigate factors potentially associated with adjuvant bisphosphonate use including age, stage, grade, estrogen receptor, progesterone receptor, HER2 receptor status and previous use of adjuvant chemotherapy. The percentage of patients offered, receiving and declining therapy was also recorded and the time interval from surgery to start of bisphosphonate therapy (&lt; 6 months, 6-12 months or &gt;12 months). Results: We identified 286 postmenopausal breast cancer patients, of whom 75 (28%) received adjuvant bisphosphonate therapy. In our multivariable model, cancer stage [odds ratio (OR) stage II vs. I=2.26, 95% confidence interval (CI) 1.08-4.74) and OR Stage III vs. I=4.94, 95% CI 1.84-13.17] and previous use of adjuvant chemotherapy (OR=2.76, 95%CI 1.37-5.55) were significantly associated with adjuvant bisphosphonate use. Among 133 patients who received adjuvant systemic chemotherapy, 51% were offered adjuvant bisphosphonate and of these 81% patients accepted therapy. Among a total of 75 patients receiving adjuvant bisphosphonate therapy 19% initiated therapy within 6 months of surgery, 48% within 6-12 months of surgery, and 33% after 12 months following surgery. Conclusions: Stage and previous use of chemotherapy were significantly associated with adjuvant bisphosphonate therapy. Our study observes the potential underutilization of adjuvant bisphosphonate therapy and possible need to start treatment earlier in some patients. Further education and awareness of the clinical practice guidelines regarding adjuvant bisphosphonate therapy may be warranted and additional population-based study investigating treatment patterns and real-world effectiveness.
1H-NMR spectroscopic characteristics of serum from patients with esophageal squamous cell carcinoma
Authors: Yu-zhang Jiang, Xiao-yang Sun
Journal: BMJ (2011)

1H-nuclear magnetic resonance spectroscopy ( 1H-NMRs ) analysis was performed on serum specimens obtained from 60 preoperative patients with esophageal squamous cell carcinoma ( ESCC )and 30 healthy controls, and supernatant from 2 ESCC cell lines Eca-109 and TE-13.The characteristic fingerprint was profiled with 1H-NMRs data in healthy controls.Serum 1H-NMRs from 60 preoperative patients with ESCC were measured and compared with the 1H-NMRs from 30 healthy controls.We found some specific peaks in 1H-NMRs profile of serum specimens from ESCC patients, especially at 1.0-1.2 mg/L and 3.4 - 3.6 mg/L.The results were verified by the 1H-NMRs measurement on the supernatant from 2 ESCC cell lines Eca-109 and TE-3.Our results suggest that this two absorption peaks may be characteristic for ESCC and 1H-NMRs analysis on serum specimens may provide information for early diagnosis of ESCC.

Key words: 
Esophageal neoplasms;  Magnetic resonance spectroscopy
Venous thromboembolism prophylaxis in ambulatory cancer patients initiating chemotherapy: A cost-effectiveness analysis.
Authors: Emma Ryan, Julia Salinaro, Laura J Havrilesky, Brittany Anne Davidson
Journal: Journal of Clinical Oncology (2020)

7074 Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality among cancer patients. The Apixaban for the Prevention of Venous Thromboembolism in High-Risk Ambulatory Cancer Patients (AVERT) randomized controlled trial concluded that apixaban is a safe and effective option for VTE prophylaxis in high-risk ambulatory cancer patients initiating a new chemotherapy regimen. We performed a cost-effectiveness analysis from a health system perspective to determine if apixaban is a feasible prophylactic strategy for this population. Methods: A decision model was created from a third party payer perspective with a time horizon of 6 months, based on the treatment arms of the AVERT trial: (1) apixaban 2.5 mg twice daily for 6 months during active chemotherapy versus (2) placebo. Rates of VTE (4.2% apixaban vs 10.2% placebo), major bleeding (3.5% vs 1.8%) and clinically relevant nonmajor bleeding (CRNMB) (7.3% vs 5.5%) were modeled from the results of the AVERT trial. Cost estimates for treatments and events were obtained from wholesale drug costs, previously published studies and Medicare reimbursement data, and adjusted for inflation to 2018 dollars. Quality adjusted life years were calculated based on previously published utility values for the health states of advanced cancer, DVT, PE, and major bleeding events. An exploratory analysis was performed comparing prophylactic aspirin to no prophylaxis assuming a VTE rate of 7.2%, major bleeding rate of 3.5%, and CRNMB rate of 7.3%, based on the conservative assumptions that while aspirin may not be as effective at preventing VTE, the rate of clinically significant bleeding events would be similar or greater than that of apixaban. Results: In the base case model, apixaban is more costly and more effective than placebo (ICER = $5,013,190/QALY), and the cost per VTE prevented in the apixaban arm is $33,000. In one-way sensitivity analysis, if the cost of apixaban were reduced by 40% from $3,197 to $1,250 for a 6 month course, this could potentially be a cost-effective prophylaxis strategy with an ICER less than $100,000/QALY. In the alternative analysis, aspirin dominates placebo as it is both more effective and less expensive, and remains cost-effective even when the rate of clinically recognized bleeding with aspirin exceeds 15%. Conclusions: Further investigation into less costly prophylactic options such as generic direct oral anticoagulants (once available) and aspirin is warranted prior to broader implementation of a VTE prophylaxis strategy in this population.
Integrin β6 microparticles in nasal lavage fluids; potential new biomarkers for basal cell activation in chronic rhinosinusitis
Authors: Toru Takahashi, Atsushi Kato, Lydia A. Suh, Roderick G. Carter, Whitney W. Stevens, Caroline P.E. Price, James E. Norton, Ava R. Weibman, Kathleen E. Harris, Anju T. Peters, Leslie C. Grammer, Kevin Welch, Stephanie Shintani‐Smith, David B. Conley, Sergejs Berdnikovs, Bruce K. Tan, Robert C. Kern, Robert P. Schleimer
Journal: Allergy (2020)

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Early nutrition intervention in cancer patients: A systematic review and meta-analysis.
Authors: Bhavina D O Batukbhai, Madeleine Champagne, Karan Rai, Odeth Barrett-Campbell, Natalie Riblet
Journal: Journal of Clinical Oncology (2020)

e14037 Background: Malnutrition is a common finding seen in 50-80% of cancer patients. Malnutrition negatively impacts quality of life (QOL), treatment-related outcomes, and survival. While early nutrition interventions (ENI) may be beneficial in preventing malnutrition, they are not part of routine cancer care. We conducted a systematic review and meta-analysis to assess the benefits of ENI compared to standard of care (SC) on nutritional status, QOL, and survival in patients with newly diagnosed cancer. Methods: We searched MEDLINE, EMBASE, Cochrane, and CINAHL databases from inception through October 2019 to identify randomized control trials (RCT) and cohort studies comparing ENI to SC in adult patients with newly diagnosed oncologic malignancies. We required that nutrition interventions began within 8 weeks of diagnosis and lasted at least 6 weeks. Outcomes of interest included nutritional status (change in weight or BMI), mortality, and QOL. We assessed for risk of bias among included studies using the Cochrane Risk of Bias tool (RCT) and the Newcastle-Ottawa scale (cohort studies). We summarized change in weight (kilogram, kg) at 3 and 6 months using standardized mean differences (SMD) and 95% Confidence Intervals (CI). Because some studies had insufficient data on weight to allow for quantitative analysis, we summarized their findings qualitatively. We used a qualitative approach to summarize QOL. Mortality at 1 and 2 years was compared using relative risk (RR) and 95%CI. Random effects models were used to pool data as there was meaningful and statistically significant heterogeneity (I 2 &gt; 50%; p-value &lt; 0.1). Results: 2,781 studies were identified and screened by two independent reviewers for eligibility. 18 independent studies (subjects = 1936) met inclusion criteria. Among 9 studies included in the quantitative analysis for nutritional status, patients who received ENI had better nutritional status compared to SC (SMD at 3 months 0.49kg, 95%CI 0.08-0.79; at 6 months: 0.27kg, 95% CI 0.09-0.45). ENI was also associated with a lower risk of death compared to SC, although the findings were not significant (1 year RR: 0.41[95% CI 0.09-1.81]; 2 year RR: 0.79 [95 CI 0.58-1.09]). Of the ten studies reporting on QOL, six found that patients in the ENI group had improved QOL outcomes. There was insufficient data available to perform subgroup analysis based on cancer type. The quality of studies was generally good and 11 of the included studies had low risk of bias. Conclusions: Patients with newly diagnosed cancer may benefit from ENI due to better weight outcomes, QOL, and survival.
Estimation of the Incident Homebound Population in the US Among Older Medicare Beneficiaries, 2012 to 2018
Authors: Katherine A. Ornstein, Melissa M. Garrido, Evan Bollens-Lund, Mohammed Husain, Katelyn Ferreira, Amy S. Kelley, Albert L. Siu
Journal: JAMA Internal Medicine (2020)

This cohort study examines the incidence of becoming homebound, being placed in a nursing home, and death in the US from 2012 to 2018 among Medicare beneficiaries aged 65 years and older.
北京降压0号和氨氯地平降压疗效性价比及抗凋亡作用的比较
Authors: 吴金玲, 范谦, 侯原平, 刘淼冰, 殷宝玲, 张麟
Journal: BMJ (2007)

将49例原发性轻中度高血压患者随机分为2组,分别口服北京降压0号或氨氯地平1～2片,每日1次,治疗8周.比较两组血压变化、治疗前后可溶性细胞凋亡促进因子(sFas/Apo-1)血浆浓度的变化及8周期间的人均费用.结果 显示治疗后两组血压均显著下降(P＜0.01),北京降压0号组2～4周的降压效果更明显;治疗后sFas/Apo-1的血浆浓度两组均显著下降,但氨氯地平组程度显著;治疗人均费用北京降压0号组约为62.2元,明显低于氨氯地平组的403.2元(P＜0.01).提示北京降压0号降压效果同氨氯地平,同时具有抗凋亡作用,且治疗的人均费用明显低于氨氯地平。
Relationship of insomnia with anxiety/depression and its management
Authors: Qingwei Li, Zheng Lu
Journal: BMJ (2016)

失眠和焦虑障碍及抑郁障碍有显著关联，失眠患者可表现为焦虑、抑郁情绪，同时，焦虑障碍、抑郁障碍患者多有失眠症状，失眠和焦虑障碍、抑郁障碍具有双向因果联系。通过阐述失眠和焦虑障碍、抑郁障碍的关系及其治疗，为临床医生提供参考。
Survey on training needs of general practioners in Shanghai
Authors: Jie Gu, Sun-fang Jiang, Shan-zhu Zhu, Yao Liu, Ming-hui Peng, Xiang-jie Zhang
Journal: BMJ (2012)

Objective To investigate the training needs of general practioners (GPs) in Shanghai and to analyze the related factors.Methods A questionnaire survery on the training needs was conducted among 428 GPs who attended a municipal training program of clinical compentance in Shanghai during July 2011 to February 2012.Results Among 428 GPs receiving the survey,23.9％ (102/427) expressed great willingness for training; 40.2％ ( 169/421 ) preferred part-time and 41.3％ ( 174/421 ) preferred on-job training; 31.7％ (377/1188) wished to have case analysis method of teaching.In the aspect of training contents,common clinical skills were ranked the first,accounting for 32.1％ (1376/4280) of the choices,on the other hand,health care for women,children and the elderly in community was ranked the last,accounting for 18.9％ (485/2568) of the choices.Logistic regression showed that the gender (OR =2.194,P=0.010),age (OR=0.435,P=0.011) and education levels of GPs (OR=0.293,P=0.006) were related factors of training needs.Conclusion The survay reveals that training needs of GPs are strong in Shanghai and GPs prefer short-term training in real clinical situations.

Key words: 
General practioner;  Training;  Questionaires
Human sperm cryopreservation prior cancer treatment: Follow up of 480 males for 23 years.
Authors: Isadora B Teloken, Alvaro Petracco, Andre P. Fay, Claudio Teloken, Mariangela Badalotti
Journal: Journal of Clinical Oncology (2020)

e24061 Background: Cancer treatment represents a potential risk for spermatogenesis and may compromise male fertility. Semen freezing has become a routine process for male patients prior to cancer treatment to preserve their fertility. We sought to provide information regarding what happens to the cryopreserved material and the fertility in cancer treated patients. Using a cohort from a 23-year cryopreservation program. Methods: Patients whom cryopreserved sperm to preserve fertility due to diagnosis of cancer between 1995 and 2018 in a single private center of reproductive medicine in south of Brazil were selected. A retrospective analysis of medical records was performed and clinico-pathological characteristics were collected using standard templates. Results: A total of 480 patients were evaluated for sperm cryopreservation before cancer treatment. Testis cancer was the most prevalent (59.3%), followed by hematologic malignancies (21.4%) and prostate cancer (5.4%). The age at cryopreservation varied from 14 to 72 y/o. Among them, 61.3% were up to 30 years old, and 10.8% more than 40 y/o. 8 patients decided to not cryopreserve The mean time between the freezing and the beginning of cancer treatment was 5.5 days. Eleven patients presented azoospermia; 3 of them froze testicular tissue. A shorter time between cancer diagnosis and sperm banking was observed for hematologic malignancies ( p=0.044). Out of the 472 patients, 46.8% still keep the sperm cryopreserved, 34.3% decided to discard it, 1.9% transferred it to another clinic, 8,5% abandon the specimen and 8,5% died without using it. The main reason for discard the sample was pregnancy and/or normal sperm count after treatment. The mean age of discarding was 35.7±10.3 years old. The period of maintenance cryopreservation was 5 years (min 1 month, max 23 years). The mean time of freezing before abandoning was 7.5±4.4 years Eighty-two patients achieved pregnancy. Spontaneous pregnancies occurred in 53 cases, and 47 underwent assisted reproduction with the cryopreserved sample, with 61,7% of pregnancy (n=29).15.3% of those that have children still keep the sperm cryopreserved; 11.4% gave up on having children. Out of the 133, 66.9% authorized the use of their specimen post-mortem. Conclusions: Only one third of the patients have maintained fertility after cancer treatment and 35% of pregnancies after cancer treatment were possible due to sperm preservation. Considering the high pregnancy rate with assisted reproduction techniques in patients that lost testicular functionsemen cryopreservation is warranted.
A survey on training and satisfaction of staff working at community health-care service centers employing appropriate techniques on a trial basis in east and west China
Authors: Too Yin, Feng Xiao, Rui-li Li, Li-hong Wang, Hui-min Yang, Bo-wen Chen
Journal: BMJ (2011)

Objective A cross-sectional survey was conducted to investigate difference in job-related satisfaction indexes among staff working at community health-care service centers ( CHSC ) employing appropriate techniques on a trial basis between east and west areas of China. Methods In total, 339 staff members working at CHSC employing appropriate techniques on a trial basis, including good practice of community medical records management for hypertension , good practice of community case management for type 2 diabetes , good practice of community case management for  , etc. , were recruited for questionnaire survey from Tianjin, Jinan and Shenzhen of east China and Chengdu and Chongqing in westChina by cluster sampling. Their demographic information, training for appropriate techniques and job-related satisfaction were collected. Results There was a significant difference in proportion of CHSC staff who receiving training for tuberculosis management launched by local government between west and east areas (34. 8% vs. 41. 4% , P <0. 05). There also was significant difference in satisfaction with the support from the superior sectors of government between west and east areas ( 59. 6% vs. 52. 0% , P = 0. 022 ) . Satisfaction towards income ranked the highest, and that towards work environment the lowest among the staff either in west or east areas. Conclusions Proportion of CHSC staff receiving training for tuberculosis and satisfaction with the support from superior sectors of government vary with communities in east and west areas employing appropriate techniques on a trial basis, and work condition of CHSC should be improved further.

Key words: 
Community health services;  Community health planning;  Questionnaires
Lack of association of immune checkpoint protein expression with T stage or stage grouping in colorectal cancer (CRC): A tissue microarray (TMA) based analysis of clinical data.
Authors: Rachel Levy, Ana Acuna-Villaorduna, Radhashree Maitra, Sanjay Goel
Journal: Journal of Clinical Oncology (2020)

e15241 Background: Immunotherapy is a valuable therapeutic intervention in multiple cancer types. In CRC, it is currently limited to those with microsatellite instability–high expression. Thus, immunotyping of CRC patients is critical to identifying potential targets for drug development. In this study, we profiled 171 CRC patient tumor samples to assess the expression of three immune check-point regulators (HHLA2, B7H3, and PD-L1), and 3 clinically useful biomarkers (CK7, CK20, and CDX2) and their association with T stage and stage grouping. Methods: TMA was created from 171 samples of CRC diagnosed between 2000 and 2016 in a major urban cancer center. Formalin fixed paraffin embedded (FFPE) tissues were used for immunohistochemistry (IHC). Antibodies specific for IHC staining were used for HHLA2, B7H3, PD-L1, CK7, CK20, and CDX2. Each specimen was scored from 4-12, based on multiplication of tumor tissue staining value (1 if 1-25%, 2 if 26-50%, 3 if 51-75%, and 4 if 76-100% of area visualized) by the intensity (1-3X). Expression of the proteins was sub divided into two or three groups, depending on the mean expression. Association between the six proteins and pathologic features including T stage and stage grouping (based on the AJCC stage at time of diagnosis) was assessed using chi-square or Fisher Exact tests. Results: Of the 171 patients, 62 (36.3%) presented with a primary cancer that recurred at a later date, and 109 (63.7%) had metastatic disease at presentation. Twenty patients were excluded from statistical analysis due to lack of staging data. The % of tumors with positive expression was 38.1 (HHLA), 37.6 (B7H3), 54.7 (PD-L1), 20.9 (CK7), 52.5 (CK20), and 58.2 (CDX2). There was no significant association between expression of each of the 6 proteins (HHLA2, B7H3, PD-L1, CK7, CK20, and CDX2) and the T stage (T1-2, T3 or T4) or stage grouping (stage 1-2 or stage 3). Consistent with clinical expectation, the expression of CK20 was higher than CK7 (p &lt; 0.05). Conclusions: Expression of HHLA2, B7H3, PD-L1, CK7, CK20, and CDX2 were not associated with T stage or stage grouping of CRC samples in our study. These data suggest that these proteins are expressed early in the onset of CRC. Studies to determine their predictive and prognostic implications are underway.
如何计算饮食摄入量
Authors: 张晓林
Journal: BMJ (2007)

在为糖尿病和肥胖居民讲授健康教育课时,我们往往会告诉居民要限制总热量的摄入,甚至会举一两个例子告诉他们,例如:每10 g食用油含热量376 kJ(90 kcal),其热量约相当于1个半两馒头的热量,每人每天炒菜油不宜超过20 g,就是2瓷勺。
Clinical course of COVID-19 in patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine
Authors: Lionel Carbillon, Amélie Benbara, Jeremy Boujenah
Journal: Annals of the Rheumatic Diseases (2020)

As obstetricians with a maternal–foetal medicine practice taking care of pregnant women treated with hydroxychloroquine (HCQ) in the prevention of systemic lupus erythematosus (SLE) flare, we read with interest the recent report of clinical data collected through the COVID-19 Global Rheumatology Alliance registry.1 Indeed, in the current epidemic, a number of cases of severe acute respiratory syndrome have occurred worldwide in pregnant women and have jeopardised both mother and fetus and have sometimes led to extreme prematurity, confirming reports from previous coronavirus outbreaks.2 Hence, any safe treatment with a potential for prevention of severe forms of COVID-19 would be of great interest. As HCQ used in the prevention of SLE flare has a good safety profile during pregnancy, and its …
IPAX-1: Phase I/II study of <sup>131</sup>I-iodo-phenylalanine combined with external radiation therapy as treatment for patients with glioblastoma multiforme.
Authors: Josef Pichler, Rosalind Wilson
Journal: Journal of Clinical Oncology (2020)

TPS2578 Background: Many tumor types, including glioblastoma multiforme (GBM), overexpress the L-type amino transporter 1 (LAT-1). 131 I-iodo-phenylalanine ( 131 I-IPA) is a small-molecule amino acid derivative taken up by LAT-1 with designated orphan status in the United States and European Union for the treatment of GBM. In preclinical research, combining 131 I-IPA with external radiation therapy (XRT) yielded additive cytotoxic effects (Israel et al. Nucl Med Biol 2011). Tumor accumulation of 131 I-IPA was shown in a proof-of-principle study (Baum et al. Nucl Med Mol Imaging 2011) and confirmed with single dosing of 2–7 GBq 131 I-IPA in combination with XRT in patients with recurrent GBM (Verburg et al. Nuklearmedizin 2013). The 131 I-IPA + XRT as Treatment for Patients with Glioblastoma Multiforme (IPAX-1) study evaluates the safety, tolerability, dosing schedule, and preliminary efficacy of 131 I-IPA in combination with second-line XRT in patients with recurrent GBM. Methods: IPAX-1 is a multi-center, open-label, phase 1/2, dose-finding study recruiting patients with previously confirmed histological diagnosis of GBM and evidence of first recurrence. Other key inclusion criteria are history of GBM standard therapy, at least 6 months since end of first-line XRT, pathologically increased amino acid tumor uptake shown by molecular imaging, and current indication for repeat radiation. Participants receive intravenous 131 I-IPA either as a single fraction (1f) followed by XRT, or as three equal fractions (3f) at weekly intervals followed by XRT commencing between the first and second 131 I-IPA administration. The 1f regimen (n = 5) evaluates single administration of 2 GBq 131 I-IPA. The 3f regimen is used to assess dose escalation, starting with 2 GBq (3 × 0.66 GBq; n = 5) and increasing in 2 GBq increments (n = 3 per activity level). The highest total dose planned is 8 GBq. XRT delivery is in 18 fractions (2 Gy each) on consecutive working days over 4 weeks. The study’s primary aim is to assess the safety and tolerability of 131 I-IPA + XRT. Secondary objectives include evaluating the maximum tolerated dose of 131 I-IPA, feasibility of fractionated administration, radiation absorbed dose to tumor and biodistribution; and exploring the antineoplastic effect of combination therapy. IPAX-1 enrollments began in July 2019; the study will enroll up to 44 patients and is currently recruiting at five sites in Europe and Australia. Clinical trial information: NCT03849105 .