tbuckley/cabot-search huggingface dataset:
The GERMELATOX DeCOG-trial: German melanoma patients and their attitude toward toxicity during adjuvant interferon treatment.
Authors: Katharina C. Kaehler, Thomas Kornek, Christine Blome, Tobias Wagner, Jochen Utikal, Christoffer Gebhardt, Ralf Gutzmer, Florian Schenck, Elisabeth Livingstone, Dirk Schadendorf, Carmen Loquai, Berenice M Rudolph, Peter Mohr, Andrea Forschner, Claus Garbe, Patrick Terheyden, Ozan Anguen, Barbara Stade, Matthias Augustin, Axel Hauschild
Journal: Journal of Clinical Oncology (2014)

TPS9113^ Background: Although trials of adjuvant interferon alfa-2b (IFN alpha-2b) in high-risk melanoma patients suggest improvement in disease-free survival (DFS), a metaanalysis could only show a marginal OS survival benefit (OS). Widespread use of adjuvant IFN alpha-2b has been decreased by its significant toxicity.In 2001 Kilbridge et al. (J Clin Oncol 2001) asked US-patients about the degree of improvement in 5-year DFS they would expect to tolerate IFN. At least half of the patients were willing to tolerate mild to moderate and severe IFNa-2b toxicity for 4% and 10% improvements of DFS. On average, patients rated quality of life (QoL) with melanoma recurrence much lower than even severe IFNa-2b toxicity.To date, no data exist on willingness of German melanoma patients to be treated with IFNa-2b. In Germany, melanoma patients are managed by specialized skin cancer units mainly located in certified skin cancer centers and core university hospitals. The willingness of dermatologists to use IFN depends strongly on their experience and capacity to manage IFN-related side effects.A comparison between a German cohort and the US-cohort of Kilbridge would allow new insights into country specific treatment differences. So far no direct comparison has been made between willingness of patients compared to their physicians. Methods: In this multicenter non-interventional trial (“GERMELATOX trial”) of the Dermatologic Cooperative Oncology Group we assessed preferences and utilities for health outcomes associated with adjuvant IFN among 200 melanoma patients not eligible for IFN due to the low-risk features of their melanoma and 100 dermatooncologists from 10 different melanoma units using the standard gamble technique supported by the willingness to pay mode. The trial described four typical IFN alpha-2b toxicity scenarios and the following three posttreatment outcomes: disease-free health and melanoma recurrence (with or without IFN alpha-2b) leading to cancer death. We also asked patients the improvement in 5-year disease-free survival they would require to tolerate IFN toxicities.The recruitment of the study will be completed in mid 2014.
Remaining life expectancy as a dynamically changing value for lung cancer survivors.
Authors: Douglas Kelly
Journal: Journal of Clinical Oncology (2014)

e20614 Background: Traditional survival curves are limited in how much information they can provide to cancer survivors and their physicians. For example what is the remaining life expectancy of a patient who has already reached or surpassed the median survival duration? A graph that shows “remaining life expectancy” as a function of “time since survival” may be more useful for cancer survivors. Methods: The cancer registry was searched for all new analytic lung cancer cases at a single hospital over a 10-year period, all stages. Patients who survived at least “X” months were grouped to see how much longer they would continue surviving beyond that point, using Kaplan Meier analysis. A graph was created for time since diagnosis versus remaining life expectancy (RLE). Results: At diagnosis the 749 patients had a median life expectancy of 16.0 months. After an initial mild decline, remaining life expectancy then rose for several years, peaking at 38.1 months by 4.5 years after diagnosis. Beyond that, the RLE curve turned downward. Survivors were more likely to be female and have an earlier stage. Subgroup analysis performed for stage 3 revealed a similar shaped curve with RLE peaking at 4 years after diagnosis. Conclusions: Remaining life expectancy does not simply drop downward like a typical actuarial survival curve. After the initial acute survival phase there is a large rise in the RLE between roughly 9 months and 4.5 years reflecting a “long survivor effect”. Survivors are a special group with underlying tumor, host, or treatment prognostic characteristics that have allowed them to survive through the first year and are responsible for increasing RLE beyond that point. The drop in survival beyond 4.5 years is speculated to be due to competing risks of mortality such as the normal human lifespan, diseases that share common underlying causes, and toxic effects from therapy.Remaining life expectancy is a dynamically changing value in lung cancer survivors.
Multimorbidity and racial disparities in use of hospice by older patients dying from cancer.
Authors: Siran M. Koroukian, Nicholas K Schiltz, David Warner, Charles W Given, Cynthia Owusu, Mark D. Schluchter, Nathan A. Berger
Journal: Journal of Clinical Oncology (2014)

9542 Background: While previous studies have documented lower use of hospice by Non-Hispanic Blacks (NHBs) than by Non-Hispanic Whites (NHWs), racial variations have not been examined in the context of multimorbidity (MM), which affects minority patients disproportionately. We sought to determine the impact of MM severity on NHBs’ use of hospice in a U.S. representative sample of older adults. Methods: We used data from the linked 1991-2008 Health and Retirement Study (HRS), Medicare data, and the National Death Index (NDI). From the NDI, we identified fee-for-service patients ≥65 years of age who died from cancer (n=812), and retrieved their demographic data, presence of comorbidities (COM), functional limitations (FL), and geriatric syndromes (GS) from their last HRS interview. We characterized severity of MM by 3 levels: none or only one of COM, FL, or GS (MM0/1); presence of two of COM, FL, or GS (MM2); or presence of all three of COM, FL, and GS (MM3). Hospice use was identified from Medicare claims data. We developed multivariable logistic regression models to analyze the association between race and hospice use, adjusting for MM and other patient covariates. Results: Nearly 12% of the study population was NHB; 61.3% of NHBs and 53.0% of NHWs were identified in MM3 (p=0.057). Overall, 61% of the patients received hospice care (63.7% in NHWs, and 43.0% in NHBs, p < 0.001). The distribution NHBs and NHWs by MM was similar across hospice users and non-users. Adjusting for MM and other confounders, NHBs were significantly less likely than NHWs to utilize hospice (Adjusted odds ratio: 0.42, 95% Confidence Interval: 0.27-0.66, p < 0.001). Conclusions: Despite the greater representation of NHBs in the highest severity of MM category, NHBs remain significantly less likely than NHWs to use hospice, even after adjusting for MM. The findings carry important implications with regard to disparities in providing optimal, and cost effective quality of end-of-life care.
Outcomes of Ewing’s sarcoma: Real-world scenario from the developing world—An 11-year analysis.
Authors: Srividya Nasaka, Ranga Raman Ganta, Ravi Sankar Arigela, Krishnamani Iyer Kalpathi, Rajesh Kota, Muralidhar Gullipalli, Sailaja Kagita, Ashok Kumar Pillai, Ramu Kandula, Joseph Stalin Bala, Vijay Gandhi Linga, Sadashivudu Gundeti, Lakshmi S. Maddali, Raghunadharao Digumarti
Journal: Journal of Clinical Oncology (2014)

e21507 Background: Data on Ewing’s sarcoma from the developing world is limited. Despite uniformity in diagnosis and treatment protocols outcomes have differed between centers. Methods: We retrospectively analyzed the records of newly diagnosed Ewing’s sarcoma patients from January 2002 to December 2012. Standard procedures were followed for staging and treatment. Results: One hundred and sixteen patients were analyzed, the median age at presentation being 16 years (2-45 yrs). Males constituted 57.8%. The most common site of presentation was ribs (16.4%), followed by pelvis (14.7%) and femur (12.9%). Extra-osseous Ewing’s constituted (15.5%). Ninety seven (83.6%) underwent complete diagnostic work up. Sixty two patients (63.9%) had localized disease with 55.7% completing the planned treatment, while 13.1% progressed during treatment, 31.1% were lost to follow-up. In the metastatic group, 63.9% completed treatment, while the rest either progressed (8.3%) or were lost to follow-up (27.8%). Local treatment for limited stage disease was RT in 59.5%, surgery +RT in 26.2% and surgery in 14.3% patients. There was no statistically significant difference in overall survival among the three groups (p= 0.93). The median OS in localized and metastatic disease were 18.6 and 11.7 months respectively. High lactate dehydrogenase (p= 0.0003) and stage (p= 0.03) were associated with poor survival. No significance was found with respect to age, site and total leukocyte count. Conclusions: Axial skeleton was the common site of presentation. Despite majority of patients having localized disease, outcome was poor due to lack of compliance. Strategies to improve compliance are necessary to achieve standard outcomes. Survival analysis by Logrank test (using Graphpad version 6). Variables Median OS (months) HR (CI 95%) P Age ≤ 15 years 12.70 0.8643 0.5788 > 15years 13.55 (0.512 to 1.448) Site Axial 12.75 0.7132 0.2381 Appendicular 13.35 (0.3753 to 1.257) Stage Localised 16.80 0.5698 0.0300 Metastatic 11.75 (0.2966 to 0.9282) (significant) LDH Low 25.35 0.402 0.0003 High 11.80 (0.2049 to 0.5803) (significant) TLC ≥ 11,000 15.15 0.6747 0.1506 < 11,000 11.80 Treatment modality in localized disease RT 17.25 0.9358 Surgery 16.80 RT + surgery 19.50
Expansion of FOXP3<sup>+</sup> regulatory CD4 T cells upon exposure to hymenoptera venom during the beekeeping season
Authors: M. C. P. Santos, A. Serra‐Caetano, E. Pedro, A. Melo, I. Caramalho, M. P. Barbosa, R. M. M. Victorino, A. E. Sousa
Journal: Allergy (2018)

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV
Authors: E. Jennifer Edelman, Kirsha S. Gordon, Kristina Crothers, Kathleen Akgün, Kendall J. Bryant, William C. Becker, Julie R. Gaither, Cynthia L. Gibert, Adam J. Gordon, Brandon D. L. Marshall, Maria C. Rodriguez-Barradas, Jeffrey H. Samet, Amy C. Justice, Janet P. Tate, David A. Fiellin
Journal: JAMA Internal Medicine (2019)

<h3>Importance</h3> Some opioids are known immunosuppressants; however, the association of prescribed opioids with clinically relevant immune-related outcomes is understudied, especially among people living with HIV. <h3>Objective</h3> To assess the association of prescribed opioids with community-acquired pneumonia (CAP) by opioid properties and HIV status. <h3>Design, Setting, and Participants</h3> This nested case-control study used data from patients in the Veterans Aging Cohort Study (VACS) from January 1, 2000, through December 31, 2012. Participants in VACS included patients living with and without HIV who received care in Veterans Health Administration (VA) medical centers across the United States. Patients with CAP requiring hospitalization (n = 4246) were matched 1:5 with control individuals without CAP (n = 21 146) by age, sex, race/ethnicity, length of observation, and HIV status. Data were analyzed from March 15, 2017, through August 8, 2018. <h3>Exposures</h3> Prescribed opioid exposure during the 12 months before the index date was characterized by a composite variable based on timing (none, past, or current); low (&lt;20 mg), medium (20-50 mg), or high (&gt;50 mg) median morphine equivalent daily dose; and opioid immunosuppressive properties (yes vs unknown or no). <h3>Main Outcome and Measure</h3> CAP requiring hospitalization based on VA and Centers for Medicare &amp; Medicaid data. <h3>Results</h3> Among the 25 392 VACS participants (98.9% male; mean [SD] age, 55 [10] years), current medium doses of opioids with unknown or no immunosuppressive properties (adjusted odds ratio [AOR], 1.35; 95% CI, 1.13-1.62) and immunosuppressive properties (AOR, 2.07; 95% CI, 1.50-2.86) and current high doses of opioids with unknown or no immunosuppressive properties (AOR, 2.07; 95% CI, 1.50-2.86) and immunosuppressive properties (AOR, 3.18; 95% CI, 2.44-4.14) were associated with the greatest CAP risk compared with no prescribed opioids or any past prescribed opioid with no immunosuppressive (AOR, 1.24; 95% CI, 1.09-1.40) and immunosuppressive properties (AOR, 1.42; 95% CI, 1.21-1.67), especially with current receipt of immunosuppressive opioids. In stratified analyses, CAP risk was consistently greater among people living with HIV with current prescribed opioids, especially when prescribed immunosuppressive opioids (eg, AORs for current immunosuppressive opioids with medium dose, 1.76 [95% CI, 1.20-2.57] vs 2.33 [95% CI, 1.60-3.40]). <h3>Conclusions and Relevance</h3> Prescribed opioids, especially higher-dose and immunosuppressive opioids, are associated with increased CAP risk among persons with and without HIV.
An integrated molecular genetic profiling of WHO grade II glioma to identify clinically relevant mRNA genes.
Authors: Li Bie, Yunqian Li
Journal: Journal of Clinical Oncology (2014)

e13018 Background: WHO Grade II glioma (G2G) is a pre-malignant brain tumor and continuous growth, migration along the white matter tracts and unavoidable malignant transformation. Methods: To identify an mRNA expression signature that can predict G2G patient survival, we analyzed the mRNA expression data of GBM patients (n = 91) derived from The Cancer Genome Atlas (TCGA) and GEO microarray datasets by WebArrayDB software. We divided the patients randomly into training (n = 46) sets and testing sets (n = 45) with equal number in each group. Results: We identified 8 significant mRNAs using Cox regression analysis on the training set and formulated a risk score based on the expression signature of these mRNAs that segregated the patients into high and low risk groups with significantly different survival times (hazard ratio [HR] = 3.2; 95% CI = 2.1–6.7; p < 0.001). This signature was independently validated in the testing set (HR = 1.2; 95% CI = 0.5–2.7; p < 0.01). G2G patients with high risk scores had overall poor survival compared to the patients with low risk scores. Cox multivariate analysis with patient age as a covariate on the entire patient set identified risk score based on the 8 mRNA expression signature to be an independent predictor of patient survival (HR = 1.3; 95% CI = 0.47–3.12; p = 0.02). Conclusions: Thus we have identified an mRNA expression signature that can predict G2G patient survival. These findings may have implications in the understanding of gliomagenesis, development of targeted therapy and selection of high risk G2G patients for adjuvant therapy.
Responsive and Synergistic Antibacterial Coatings: Fighting against Bacteria in a Smart and Effective Way
Authors: Ting Wei, Qian Yu, Hong Chen
Journal: Advanced Healthcare Materials (2019)

Abstract Antibacterial coatings that eliminate initial bacterial attachment and prevent subsequent biofilm formation are essential in a number of applications, especially implanted medical devices. Although various approaches, including bacteria‐repelling and bacteria‐killing mechanisms, have been developed, none of them have been entirely successful due to their inherent drawbacks. In recent years, antibacterial coatings that are responsive to the bacterial microenvironment, that possess two or more killing mechanisms, or that have triggered‐cleaning capability have emerged as promising solutions for bacterial infection and contamination problems. This review focuses on recent progress on three types of such responsive and synergistic antibacterial coatings, including i) self‐defensive antibacterial coatings, which can “turn on” biocidal activity in response to a bacteria‐containing microenvironment; ii) synergistic antibacterial coatings, which possess two or more killing mechanisms that interact synergistically to reinforce each other; and iii) smart “kill‐and‐release” antibacterial coatings, which can switch functionality between bacteria killing and bacteria releasing under a proper stimulus. The design principles and potential applications of these coatings are discussed and a brief perspective on remaining challenges and future research directions is presented.
Abstract 12705: Mechanisms of Decreased Exercise Capacity with Sleep Disordered Breathing in Hypertrophic Cardiomyopathy
Authors: Tomas Konecny, Peter Brady, Ondrej Ludka, Alexander Placek, Marek Orban, Tomas Kara, Bernard Gersh, Jamil A Tajik, Thomas Allison, Steve R Ommen, Virend Somers
Journal: Circulation (2012)

Tomas Konecny, 2012 Finalist and Presenting Author
FLT3 Inhibitor Treatment Increases FLT3 Expression That Exposes FLT3-ITD+ AML Blasts to Elimination By FLT3 CAR-T Cells
Authors: Hardikkumar Jetani, Irene García-Cadenas, Thomas Nerreter, Ralph Goetz, Jorge Sierra, Halvard Bonig, Markus Sauer, Hermann Einsele, Michael Hudecek
Journal: Blood (2018)
Assessment of biomarkers reflecting collagen formation and degradation in breast and ovarian cancer patients.
Authors: Cecilie Liv Bager, Nicholas Willumsen, Morten Asser Karsdal, Diana Julie Leeming, Susanne Jacobsen, Per Hägglund, Anne-Christine Bay-Jensen
Journal: Journal of Clinical Oncology (2014)

e22231 Background: The hallmarks of breast and ovarian cancer include increased collagen deposition (desmoplasia) and breakdown. The combination of these processes result in the release of specific collagens fragments to the circulation, which when measured may reflect disease pathogenesis. The aim of this study was to investigate if biomarkers reflecting collagen degradation and formation could differentiate ovarian and breast cancer patients from healthy controls when measured in serum. Methods: The levels of markers reflecting MMP-mediated degradation of type I (C1M), type III (C3M) and type VI (C6M) collagen; as well as markers reflecting formation of type I (P1NP) and type III (pro C3) collagen were assessed in serum from female ovarian cancer patients (n=10, stage I-III), breast cancer patients (n=15, stage II-III) and healthy controls (n=23) using validated competitive ELISAs. The levels of the individual markers were compared using one way ANOVA on log transformed data and AUROC was calculated. Results: Compared to the control group, the levels of C1M, C3M and C6M (table) were significantly elevated in serum from ovarian cancer patients (p<0.0001-0.0002) and breast cancer patients (p=0.02-p=0.0004), but there were no significant difference in the levels of P1NP and Pro-C3 between the groups. ROC curve analyses revealed that the serum level of C1M, C3M and C6M were useful for differentiating ovarian and breast cancer patients from the healthy control both as individual markers (AUROC 77%-91%) and combined (90%-99%). Conclusions: The collagen degradation markers C1M, C3M and C6M, but not the formation markers P1NP and Pro-C3 were able to separate ovarian and breast cancer patients from healthy controls when measured in serum. Additional information may therefore be obtained from the collagen degradation profile as compared to the more traditional collagen formation profile. Controls (n=23) Ovarian (n=10) Breast (n=14) Median, ng/ml Median, ng/ml ANOVA (P-value) AUROC % Combined AUROC % Median, ng/ml ANOVA (P-value) AUROC % Combined AUROC % C1M 54 313 <0.0001 91 99 173 0.001 79 90 C3M 14 29 0.0002 86 21 0.02 77 C6M 5 14 <0.0001 87 13 0.0004 88 Pro-C3 19 27 0.22 61 20 0.99 66 P1NP 306 180 0.38 75 211 0.21 58
Experience on deep sedation anesthesia given to children with malignancy for invasive procedures at the pediatric ward.
Authors: Fatma Betul Cakir, Rejin Kebudi, O. Bulent Zulfikar, Tarik Umutoglu, Ufuk Topuz, Erdogan Ozturk
Journal: Journal of Clinical Oncology (2014)

e20715 Background: Children with malignancy frequently require invasive procedures. One of the complications of these invasive procedures is pain. By using deep sedation general anesthesia, we can eliminate both pain of the patients and also the anxiety of the parents and physicians during invasive procedures. Methods: Between August 2012-January 2014, children with malignancy were given deep sedation in a room in the pediatric ward (in contrast to the operative room) by the anesthesiologist for bone marrow aspiration or biopsy (BMA or BMB) and/or lumbar puncture (LP) and intrathecal treatment (IT). The patients had premedication with midazolam and atropine and respirated with O2. The O2 saturation (SpO2), electrocardiography, heart rhytm and blood pressure were measured continuously during the procedure and propophol with ketamine were given for deep sedation. When the deep sedation level reached RAMSEY sedation scale 3 or 4, the procedures were done under stable vital findings at prone position. The patients were returned to supine position before waking them up. Results: Fifty-three patients (Acute leukemia= 19, Neuroblastoma n=13, Central Nervous System Tumor=8, Non-Hodgkin/Hodgkin Lymphoma=7, Ewing sarcoma n=2, Rhabdomyosarcoma n=2, Langerhans Cell Histiocytosis=2) had 60 BMA, 36 BMB, and 115 LP and IT. Among them, 44 patients had both BMA/B and LP during the same procedure. No desaturation or hypoxia occured during procedures. The patients were sent to their rooms after the termination of the procedure and waited until their arousal under O2. Parents, patients and physicians were interviewed before and after the procedure regarding pain and anxiety. Conclusions: In children with cancer, invasive procedures might be done safely in the pediatric ward by the supervision of the anesthesiologist. Deep sedation anesthesia prevents pain of the patient. Performing the procedure in the pediatric ward instead of the operating room decreases the anxiety of the patient and family, thus of the health care team and saves time for the health care team.