tbuckley/cabot-search huggingface dataset:
Excellent outcomes in bilateral testicular germ cell tumors over four decades.
Authors: Ning-Ning Lu, Aaron Richard Hansen, Philippe L. Bedard, Padraig Richard Warde, Joan Sweet, Robert James Hamilton, Martin O'Malley, Peter W. M. Chung
Journal: Journal of Clinical Oncology (2019)

523 Background: Bilateral testicular germ cell tumours (BTC) form a small minority of testicular cancer and detailed management data are sparse. Methods: Bilateral testicular cancer (BTC) patients managed at a single cancer centre were retrospectively analyzed. Synchronous BTC was defined as uni+contralateral presentation within 3 months. Patient characteristics, treatment and outcomes were collected. Kaplan-Meier method was used to calculate the overall survival (OS) and relapse-free survival (RFS). Results: Between Jan 1971 to Jun 2018, 118 pts were included. Nine patients (7.6%) had cryptorchidism. Twenty-two patients (18.6%) had synchronous BTC at median age of 30(21-54) years, 11 presented with concordant histology (10-seminoma). Median follow-up time was 96(1-220) months. Two of 14 patients (14%) with stage I disease on surveillance had retroperitoneal nodal recurrence, other 3 (21%) had testicular recurrence after partial orchiectomy alone. No recurrence occurred for 8 stage II/III patients (36%) who received stage-appropriate treatment. All patients were alive without disease at last follow-up. For metachronous BTC, the median age was 27(16-68) and 37(19-78) years for first and second diagnosis, respectively. The median time interval was 88 (8-352) months, with shorter interval when second primary was non-seminoma, median 69 vs. 92 months. Concordant histology was present in 58 (38-seminoma) patients and discordant in 38 patients. There were 66, 23, 7 and 84, 9, 3 patients with stage I, II, III disease for first and second testicular cancer (TC), respectively. For all stage I disease, 69% of non-seminoma (n = 33) and 79% of seminoma (n = 81) were on surveillance, of whom the crude relapse rate was 15%. The median follow-up time after second diagnosis was 87 months. In all, 35 patients (30%) with recurrence except 1 were successfully salvaged. The 10-year OS and RFS for whole cohort was 99% and 69.8%, respectively. Conclusions: In our series, seminoma was the more common pathology, and management based on pathology and stage yielded excellent outcomes regardless of prior therapy. Metachronous BTC may occur at extremely long time intervals such that longer follow-up is needed to capture the majority of contralateral primary TC.
Abstract MP67: Reduction in Calories Purchased by Employees Two Years After Implementation of Cafeteria Traffic-light Labels and Choice Architecture
Authors: Anne N Thorndike, Emily D Gelsomin, Douglas E Levy
Journal: Circulation (2019)

Background: Point-of-purchase strategies, such as traffic-light labels and choice architecture, promote healthy food choices. However, there is little research to determine if these interventions reduce caloric intake and prevent weight gain. Methods: We previously demonstrated that a worksite cafeteria traffic-light labeling and choice architecture intervention increased employees’ green (healthy) purchases and reduced red (unhealthy) purchases over 2 years. The objective of the current study is to determine if the intervention reduced calories purchased. We analyzed cafeteria purchases of 5,695 employees who visited the cafeteria during the 3-mo baseline period (Dec 2009-Feb 2010) and the 24-mo intervention period (March 2010-Feb 2012). We compared mean calories purchased per transaction (kcal/transaction) during the baseline quarter to the kcal/transaction purchased during the same 1-year (Dec 2010-Feb 2011) and 2-year (Dec 2011-Feb 2012) quarters. All analyses were adjusted for employee age, gender, race/ethnicity, and job type. To assess potential impact of a change in purchased calories on weight, we analyzed the total calories purchased per quarter (kcal/quarter) by employees who visited the cafeteria frequently (≥36 times/quarter). We calculated the combined mean change from baseline in kcal/quarter at 1 and 2-years and divided this number by 90 days to estimate change in daily calories per employee. We predicted the effect of the change in daily calories on employees’ weight using a dynamic model of weight change (Hall, et al. Lancet , 2011). Results: Employees’ mean age was 34 yrs; 71% were female and 73% white. Mean kcal/transaction was 499.5 at baseline, 478.9 at 1 year, and 470.2 at 2 years (change from baseline to 2 years: -29.3 [95% CI, -33.7, -25.0], p&lt;.001). The decrease in kcal/transaction at 2 years occurred for both food (-17.0, p&lt;.001) and beverages (-17.6, p&lt;.001). At 2 years compared to baseline, kcal/transaction increased for green-labeled items (13.3, p&lt;.001) and decreased for red-labeled items (-42.0, p&lt;.001). Among 461 employees with ≥36 transactions/quarter, mean total calories purchased during the baseline quarter was 37,198 kcal; this decreased by 4,380 kcal/quarter (p&lt;.001) at 1 year and 5,666 kcal/quarter (p&lt;.001) at 2 years relative to baseline. Assuming no other changes in employees’ dietary intake or activity, this equates to a reduction of 56 kcal/day; if maintained over time, the dynamic model of weight change predicts weight loss of 2.8 lbs at 1 year and 5.3 lbs at 3 years. Conclusions: A traffic-light labeling and choice architecture intervention reduced calories purchased by employees over 2 years. These findings have implications for helping employees manage their weight, particularly those who use the cafeteria regularly. Simple point-of-purchase interventions are important tools for addressing the obesity epidemic.
Abstract P303: Clinically Recognized Varicose Veins and Physical Function in Older Individuals: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Yejin Mok, Junichi Ishigami, Anna Kucharska-Newton, Maya Salameh, Jennifer Schrack, Priya Palta, Josef Coresh, B. Gwen Windham, Pamela Lutsey, Aaron Folsom, Kunihiro Matsushita
Journal: Circulation (2019)

Background: Varicose veins recently attract attention in medical community due to its high prevalence and potential impact on major clinical consequences like deep venous thrombosis. Also, a few small studies (n&lt;50) have reported that patients with varicose veins have reduced physical function than those without. However, a large study is required to quantify the association of varicose veins and reduced physical function in the community. Methods: In 6,506 ARIC participants (aged 71-90 years, 2011-2013 at visit 5), varicose veins were identified using outpatient and inpatient ICD codes from Medicare claims (sample limited to fee for service beneficiaries) or hospitalization data after visit 1 through visit 5. We assessed the cross-sectional associations of clinically recognized varicose veins with the Short Physical Performance Battery (SPPB) score (0-12) (based on the sum of scores from three components [chair stands, standing balance, and gait speed] [0-4 points each]) and frailty (frail if ≥3 of the five components [weight loss, exhaustion, low physical activity, slow walking, and grip strength]. Results: There were 361 participants with a clinical diagnosis of varicose veins (124 inpatient and 256 outpatient). Varicose veins were independently associated with poor physical function (SPPB ≤6 vs. &gt;6) (adjusted odds ratio 1.72 [95% CI 1.24, 2.37]) and with all individual components of the SPPB (Table). Similarly, varicose veins were associated with being frail (frailty ≥3 vs. &lt;3) (adjusted odds ratio 1.76 [95%CI 1.26, 2.46]) and with only slower walking of frailty components. Conclusions: In community-dwelling older adults, persons with varicose veins had lower physical function and were more frail compared to their counterparts. Longitudinal research is warranted to explore the temporality between varicose veins and reduced physical function.
Abstract P005: Related Factors for Cognitive Impairment in Older Japanese Men in Hawaii and Japan
Authors: Naoko Miyagawa, Takayoshi Ohkubo, Akira Fujiyoshi, Akihiko Shiino, Randi Chen, George W Ross, Bradley Willcox, Katsuyuki Miura, Hirotsugu Ueshima, Kamal Masaki
Journal: Circulation (2019)

Background: The number of people with dementia is increasing in the world and it is of great public health concern. Previous observational studies, mainly from western countries, have reported that modifiable factors for development of dementia were cardiometabolic risk factors, related to genetically determined metabolic abilities and lifestyle. There are no studies comparing which modifiable factors relate to low cognitive scores among populations with the same genetic background but different lifestyle. Objective: The purpose of the present study is to describe factors related to low cognitive scores in Japanese men in two cohorts that are genetically similar but with different lifestyle exposures. Methods: Population-based cross-sectional data from the Kuakini Honolulu-Asia Aging Study (HAAS) in Hawaii and Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) in Japan were analyzed. Participants were Japanese men aged 71-81 years (2,628 men in Hawaii and 349 men in Japan). Cognitive function was assessed using the Cognitive Abilities Screening Instrument (CASI), with low CASI score &lt; 82. Related factors were obtained by questionnaire and measurements. Multivariable adjusted odds ratios of low CASI score by different factors among the two cohorts were calculated by logistic regression analysis. Results: Low CASI score was more common in elderly men in Hawaii compared to Japan (21.2% or 556/2,628 versus 12.3% or 43/349, p&lt;0.001). After adjustment for age and educational attainment, these differences were no longer significant (Hawaii 20.3% versus Japan 17.9%, p=0.328). Odds ratios for low cognitive scores were 1.65 in Hawaii with history of stroke, and 1.93 in Japan with history of CHD. Higher odds of low cognitive score were seen with diabetes in Hawaii (OR=1.20), and with BMI≥25 in Japan (OR=1.88). Conclusion: We found different strengths of associations between cardiovascular diseases and cardiometabolic factors with low cognitive scores among genetically similar men in Hawaii and Japan with different lifestyles.
Clostridium difficile infection in adult patients with acute myeloid leukemia: Incidence, recurrence, and outcomes.
Authors: Rohini Chintalapally, Tarun Kukkadapu, Samip Parikh, Abhishek Avinash Mangaonkar, Hima R. Boppidi, Vamsi Kota, Sumanth Daram
Journal: Journal of Clinical Oncology (2015)

e18020 Background: Clostridium difficile infection (CDI) is the most common cause of hospital-acquired diarrhea. Acute Myeloid Leukemia (AML) patients may have increased predisposition to CDI as well as recurrent CDI. Recurrence rates of 13-50% have been described for CDI in the literature. Patients with at least one episode of recurrent CDI have a 45 to 65 percent chance of additional episodes. Clinical course including need for colectomy and/or fecal transplant, recurrence and outcomes for AML patients with CDI are not well described. In this study, we attempted to determine the incidence of CDI in AML patients at our center. Recurrence, and mortality associated with CDI in this patient population were also studied. Methods: We performed a retrospective chart review of consecutive patients in the AML registry at our institution. Patients were deemed to be positive for CDI on the basis of a positive toxin assay and/or PCR, in the presence of diarrhea. Demographic characteristics, risk factors, mode of treatment of CDI and clinical outcomes were reviewed. Results: 36 of the 192 patients (18.8%) with AML had CDI during the study period; of these, 9 patients (25%) had one recurrent episode of CDI, and 3 patients (8.3%) had two recurrences. None of the patients underwent fecal transplant or colectomy. There was no CDI specific mortality in these 36 patients. 5 of 31 patients (16.1%) with AML who underwent SCT developed CDI. 47% of patients with AML who had neutropenia developed CDI; of these, all 11 patients with neutropenia of greater than 10 days duration developed CDI. Conclusions: The incidence of CDI in AML patients is much higher than that reported for non-AML hospitalized patients in the literature. However, the rate of recurrence in AML patients does not seem to be different from that reported for non-AML patients reported in the literature. All patients with CDI had a favorable outcome, with no patient requiring fecal transplant or colectomy. There was no mortality attributable to CDI.
Racial differences in 20-year cardiovascular outcomes among childhood and young adult cancer survivors.
Authors: Amy M Berkman, Lee Jones, Abigail Crocker, Abenaa M. Brewster, Susan Gilchrist Lakoski
Journal: Journal of Clinical Oncology (2015)

6548 Background: Individuals diagnosed with childhood (0-14 years) or young adulthood (15-34 years) cancers are at higher risk of cardiovascular disease (CVD) death compared to those without a history of cancer. No study has investigated whether CVD risk differs as a function of race and primary cancer type. Methods: Case data from the years 1973-2011 were analyzed using the 2013 Surveillance, Epidemiology and End Reports (SEER) registries. We categorized cases according to ICD-0-3 / WHO 2008 Adolescent and Young Adult classification. CVD death was based on ICD-10 codes for: diseases of the heart, atherosclerosis, cerebrovascular diseases or other diseases of the arteries. Hazard ratios were calculated using Fine & Gray methodology for competing risks (all-cause, cancer and CVD mortality) and relative risk ratios were calculated to compare risk of CVD death by race (black : white). Results: A total of 164,316 cases of childhood and young adult primary cancers were identified, of which 16,060 cases were black (10%), 133,932 cases (82%) were white, and 14,314 (8%) were other or unknown. There were a total of 1,584 CVD deaths. Overall, blacks had a higher risk of CVD death compared to whites at 5-years (RR 2.15, 95% CI: 1.65-2.80), 10-years (RR 2.23, 95% CI: 1.80-2.76), and 20-years (RR 1.83, 95% CI: 1.54-2.17) from the date of cancer diagnosis. The relative risk for CVD death between blacks and whites varied by cancer type, with the largest black:white difference among those diagnosed with CNS neoplasms at 10-years (HR 3.02, 95% CI: 1.47-6.18) and melanoma at 5-years (HR 26.9, 95% CI: 3.40-212.08). Conclusions: Black individuals diagnosed with cancer in childhood or young adulthood have a higher risk of CVD at 5-, 10-, and 20-years compared to whites. The risk of CVD mortality among blacks and whites varied by cancer type and time from cancer diagnosis. Further study is needed to understand the etiology of racial differences in this population.
Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial
Authors: Aquilla S Turk, Adnan Siddiqui, Johanna T Fifi, Reade A De Leacy, David J Fiorella, Eugene Gu, Elad I Levy, Kenneth V Snyder, Ricardo A Hanel, Amin Aghaebrahim, B Keith Woodward, Harry R Hixson, Mohammad I Chaudry, Alejandro M Spiotta, Ansaar T Rai, Donald Frei, Josser E Delgado Almandoz, Mike Kelly, Adam Arthur, Blaise Baxter, Joey English, Italo Linfante, Kyle M Fargen, J Mocco
Journal: The Lancet (2019)
Mitochondrial Complex I Inhibitor Iacs-010759 Reverses the NOTCH1-Driven Metabolic Reprogramming in T-ALL Via Blockade of Oxidative Phosphorylation: Synergy with Chemotherapy and Glutaminase Inhibition
Authors: Natalia Baran, Alessia Lodi, Shannon Renee Sweeney, Pandey Renu, Vinitha Mary Kuruvilla, Antonio Cavazos, Daniel Herranz, Anna Skwarska, Marc Warmoes, R. Eric Davis, Karine Harutyunyan, Ningping Feng, Jason P Gay, Sergej Naumovich Konoplev, Marcin Kaminski, Jeffrey J Kovacs, Di Du, Elias J. Jabbour, Adolfo A. Ferrando, Maria E Di Francesco, Philip L Lorenzi, Joseph R Marszalek, Stefano Tiziani, Marina Y. Konopleva
Journal: Blood (2018)
Novel perioperative parameters-based nomograms for survival outcomes in upper tract urothelial carcinoma after radical nephroureterectomy.
Authors: Ping Tan, Lu Yang, Hang Xu, Qiang Wei
Journal: Journal of Clinical Oncology (2019)

414 Background: Recently, several postoperative nomograms for cancer-specific survival (CSS) after radical nephroureterectomy (RNU) were proposed, while they did not incorporate the same variables; meanwhile, many preoperative blood-based parameters, which were recently reported to be related to survival, were not included in their models. In addition, no nomogram for overall survival (OS) was available to date. Methods: The full data of 716 patients were available. The whole cohort was randomly divided into two cohorts: the training cohort for developing the nomograms (n = 508) and the validation cohort for validating the models (n = 208). Univariate and multivariate Cox proportional hazards regression models were used for establishing the prediction models. The discriminative accuracy of nomograms were measured by Harrell’s concordance index (C-index). The clinical usefulness and net benefit of the predictive models were estimated and visualized by using Decision curve analyses (DCA). Results: The median follow-up time was 42.0 months (IQR: 18.0-76.0). For CSS, tumor size, grade and pT stage, lymph node metastasis, NLR, PLR and fibrinogen level were identified as independent risk factors in the final model; while tumor grade and pT stage, lymph node metastasis, PLR, Cys-C and fibrinogen level were identified as independent predictors for OS model. The C-index for CSS prediction was 0.82 (95%CI: 0.79-0.85), and the OS nomogram model had an accuracy of 0.83 (95%CI: 0.80-0.86). The results of bootstrapping showed no deviation from the ideal. The calibration plots for the probability of CSS and OS at 3 or 5-year after RNU showed a favorable agreement between the prediction by the nomograms and actual observation. In the external validation cohort, the C-indexes of the nomograms for predicting CSS and OS were 0.79 (95%CI: 0.74-0.84) and 0.80 (95%CI: 0.75-0.85), respectively. As indicated by calibration plots, optimal agreement was observed between prediction and observation in the external cohort. Conclusions: The nomograms developed and validated based on preoperative blood-based parameters were superior to any single variable for predicting CSS and OS after RNU.
Evolutionary-developmental modeling of neurodiversity and psychopathology
Authors: D. K. Oller
Journal: Behavioral and Brain Sciences (2019)

Abstract Modeling the extremes of mental/emotional conditions requires explicit accounts of evolutionary-developmental sources of human neurodiversity, not merely psychopathology. The target article's approach could be improved by incorporation of a hierarchical scheme wherein mental/emotional infrastructure interacts across differentiated layers of function. The notion of “symptom networks” thus calls for differentiation into hierarchically interacting components of mental/emotional evolution and development.
Real-world treatment patterns and outcomes associated with bevacizumab (bev) in metastatic colorectal cancer (mCRC).
Authors: Kimberly Saverno, Mark S. Walker, Daniel Hennessy, Ravinder Dhawan
Journal: Journal of Clinical Oncology (2015)

e14553 Background: Real-world data on regimen assignment and sequencing in mCRC are limited. We used electronic medical records to assess first- (1L) and second-line (2L) treatment duration and outcomes, and associations between 1L and 2L, in patients (pts) receiving 1L chemotherapy regimens containing bev. Methods: Pts with mCRC (2008–2012) who received two chemotherapy lines, including 1L regimens containing bev, were identified from community oncology practices using the Vector Oncology database. Primary analysis assessed association between duration of 1L and 2L therapy. Regimens included: 1L 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX) + bev, other oxaliplatin-based + bev or other + bev; 2L oxaliplatin-based ± bev, irinotecan-based ± bev and other ± bev. Impact of 1L progression-free survival (PFS) on 2L PFS was assessed; only pts initiating a new treatment regimen due to progression were considered to be receiving a new line of therapy. Results: The study population (N = 279) had a mean age (SD) of 59 years (11.8) and was 56% male. 81% received 1L FOLFOX + bev and 56% received bev in 2L. Disease progression was the main reason for bev discontinuation in 1L (38%) and 2L (28%). Median duration of 1L therapy (5.8 months overall) differed between regimens (P = 0.046). Median PFS in 1L was 9.5 months with no differences between regimens (P = 0.207). In 2L, median duration of therapy and PFS was 3.9 and 6.1 months, respectively. There was no association between duration of 1L and 2L therapies (P = 0.936). However, in pts who discontinued 1L therapy due to disease progression, a non-significant trend (P = 0.232) suggested shorter duration of 1L therapy was associated with shorter duration of 2L therapy. Shorter PFS in 1L was associated with shorter PFS in 2L treatment (P < 0.0001); significant association was maintained irrespective of 2L bev administration. Conclusions: Although there was no association between duration of 1L and 2L therapy, pts with shorter PFS in 1L had shorter PFS in 2L. Further research is needed to assess whether pts progressing on 1L therapy may benefit from other 2L anti-angiogenic regimens vs. continuing bev-based, other targeted (e.g. EGFR-targeted) or no targeted therapy. Funding: Sanofi.
Impact of standard chemotherapy on peripheral blood immune cell subsets in metastatic colorectal cancer.
Authors: Christopher Ryan Heery, Caroline Jochems, Geraldine Helen O'Sullivan Coyne, Ravi Amrit Madan, Harpreet Singh, James L. Gulley, Jeffrey Schlom, John Marshall
Journal: Journal of Clinical Oncology (2015)

597 Background: To date, there has been minimal impact with immunotherapy in patients with metastatic colorectal cancer. We have hypothesized that the lack of effect seen may be due to the refractory nature of the disease after multiple lines of standard chemotherapy. We hope to evaluate immunotherapeutic agents in combination with standard chemotherapy agents for evidence of additional clinical benefit. To our knowledge, there has never been an effort to evaluate the effects of standard chemotherapy agents for metastatic colorectal cancer on the immune system and its ability to respond to immunotherapeutic agents. Methods: We enrolled 8 patients with previously untreated metastatic colorectal cancer starting 5-FU based therapy and collected peripheral blood mononuclear cell (PBMC) samples prior to treatment, on day 8, and on day 15. PBMC were analyzed by a flow-cytometry based analysis using a panel of 26 markers to identify 40+ predefined immune cell subsets. Comparisons from baseline, day 8, and day 15 were made using the Friedman test and Dunn’s Multiple Comparison test to evaluate whether standard chemotherapy significantly altered the frequency of immune cells in any subset. Results: No significant differences were observed post treatment with this regimen in the frequency of any immune subset analyzed. Conclusions: Our preliminary findings indicate that 5-FU- based chemotherapy does not significantly affect the frequency of any of 40 analyzed peripheral blood immune cell subsets in patients with previously untreated metastatic colorectal cancer. Based on findings from other groups indicating potential tumor microenvironmental benefits of active chemotherapy on the immune response, we conclude that there should be no concern of detrimental effects of standard chemotherapy for use in combination with immunotherapy in the first line metastatic disease setting for colorectal cancer. We plan to enroll more patients for further analysis, which will be presented at the time of the meeting.